New figure for projected coronavirus deaths exposes a government in total confusion

On 28 March, at a daily coronavirus (Covid-19) press briefing, an NHS chief, speaking alongside a government minister, announced that deaths resulting from the outbreak would be “aimed” at 20,000. But over the last two weeks, government policy has been determined by a very different set of figures.

This latest development illustrates how the government appears to be lurching from one strategy to another. It does not inspire confidence in either the methodologies presented to date or the government’s understanding of the science.

Revised figures

At a press briefing on 28 March, NHS England medical director Stephen Powis explained:

If we can keep deaths below 20,000 we will have done very well in this epidemic…

It is early at the moment and the scientists who are working with the government to model what we can expect are of course adjusting their predictions now as we start to see the actuality of the epidemic in the UK, rather than what we believed might have happened a few weeks ago.

The NHS chief also took the opportunity to revise the anticipated peak for Covid-19 related deaths to the next two to three weeks. If that prediction and the revised figure of “20,000” deaths turn out to be accurate, then that’s welcome news when compared to previous figures.

At the time of publication, the UK coronavirus death toll had increased “by 209 people in the last 24 hours bringing the total number of deaths in the UK to 1,228 so far”.

20,000, 250,000 or 510,000 deaths?

Yet, much larger figures were first published only two weeks back. On 16 March, a report by an Imperial College London (ICL) team, led by Professor Neil Ferguson stated:

In total, in an unmitigated epidemic, we would predict approximately 510,000 deaths in GB and 2.2 million in the US, not accounting for the potential negative effects of health systems being overwhelmed on mortality.

But some mitigation measures would likely result in a different set of figures:

In the most effective mitigation strategy examined, which leads to a single, relatively short epidemic (case isolation, household quarantine and social distancing of the elderly), the surge limits for both general ward and ICU beds would be exceeded by at least 8-fold under the more optimistic scenario for critical care requirements that we examined. In addition, even if all patients were able to be treated, we predict there would still be in the order of 250,000 deaths in GB, and 1.1-1.2 million in the US.

That ICL report seemingly convinced the UK government that it’s dalliance with ‘herd immunity‘ was dangerous. That approach was condemned and questioned by leading clinicians across the UK.

Hence, a spectacular government u-turn that saw it abandon it’s ‘do very little’ strategy and instead adopt near-total lockdown.

Revisions

So where did the NHS chief get his 20,000 from?

On 25 March, Ferguson reported an update, including revisions regarding deaths, via a video link to a parliamentary committee.

The New Scientist reported that Ferguson told the parliamentary select committee on science and technology:

that expected increases in National Health Service capacity and ongoing restrictions to people’s movements make him “reasonably confident” the health service can cope when the predicted peak of the epidemic arrives in two or three weeks. UK deaths from the disease are now unlikely to exceed 20,000, he said, and could be much lower.

Quite a change.

Meanwhile, a Financial Times article, published on 22 March 2020, reported how a University College London (UCL), University of Cambridge and Health Data Research UK document argued that there would be 35,000 to 70,000 deaths from the outbreak.

It’s clearly important that there is a call for these contradictory figures between UCL and ICL to be fully explained. Not least because leading medical experts are now speaking out to criticise the government’s response to this crisis.

Hypocrisy

On 27 March, The Canary reported how Lancet editor Richard Horton on BBC Question Time gave his assessment on the government’s response to the crisis:

we wasted February when we could have acted. Time when we could’ve ramped up testing. Time when we could’ve got personal protective equipment ready and disseminated. We didn’t do it.

He added poignantly:

The hypocrisy of clapping NHS workers and yet the government not supporting them to go into that front line is tragic. And it was preventable.

Or to coin a phrase, when it comes to how the government has handled the crisis, it seems it doesn’t know its arse from its elbow.

A 28 March Lancet editorial summed this up well:

As leaders scramble to acquire diagnostic tests, personal protective equipment, and ventilators for overwhelmed hospitals, there is a growing sense of anger. The patchwork of harmful initial reactions from many leaders, from denial and misplaced optimism, to passive acceptance of large-scale deaths, was justified by words such as unprecedented.

Transparency

Public confidence at every level of society is essential to maintaining support for government action.

UCL professor Harry Hemingway told the Financial Times that:

Legislation is urgently needed to free up nationwide NHS data so that clinicians and services can rapidly learn ways to tackle the consequences of the epidemic, both in those with and those without the virus.

The current regulatory and legislative environment around NHS data hampers the public health emergency response to the Covid-19 pandemic.

Transparency on what science is reporting and the methodology behind its figures are now more important than ever. Otherwise, there will be more false starts. None of us can afford the consequences of that, or of more governmental u-turns. It’s not just people’s livelihoods at stake, but their lives too.

Featured image via Pixabay / Youtube