I promised in my last post that I’d look at the UK numbers in more detail today, after the government’s warning that further lockdowns may be on the horizon. So how is the UK doing now? As of September 17 (the last day for which Northern Ireland figures are available), the UK government’s COVID-19 dashboard reports approximately 3,000 new Coronavirus cases a day, almost all of which are in England. As we can see from the graph, these cases appear to be on the rise:
Daily hospital admissions are still quite low, but also show a slight, but clear, upward trend:
Finally, daily deaths from COVID-19, defined as people who have died within 28 days of receiving a positive COVID test, are now tracking at about 16 per day:
Now, UK chief medical officer Chris Whitty and chief scientific adviser Patrick Vallance have held a briefing in which they caution that at the current rate, we could have 50,000 COVID cases a day by mid-October. Whitty advises that people minimize their contact with others outside their household, even at work, and suggests that more restrictions will follow shortly:
Since I’ve been using Oxford’s Our World in Data (which allows for comparison between countries), how do the government’s numbers compare to Oxford’s? The case numbers are fairly comparable, given Oxford’s use of the 7-day rolling average, which eliminates short-term anomalies. According to Oxford, on September 17, the UK had a daily average of 3,285 cases:
Whitty and Valance are relying for their predictions on a 7-day doubling of cases, so that means that Oxford should show around 1,600 daily cases on September 10, but we’d actually have to go back to September 6 for a similar number.
This seems close enough to be accounted for by the 7-day averaging. What about Oxford’s COVID death figures? Oxford puts daily deaths at 12.9 on September 17, but by September 20, the last day Oxford is reporting, that number had risen to 19.4, so again, given the slight difference in methodologies, it seems that the numbers are consistent. What of Whitty’s contention, then, that our numbers lag 2 weeks behind Spain’s, so we will likely see a hospitalization and death rate similar to Spain’s in about 2 weeks if we don’t do something to stop the spread now?
That seems to me to be overstating it a bit. Spain’s per capita cases started sharply increasing on about July 10. Since then, they’ve been on a constant, sharp incline, doubling every 6 to 7 days ever since. This is what Patrick Valance says the UK’s cases are doing now, but as of September 20, the UK was still taking 2 weeks for cases to double, and that rise only started around the end of August, which is more than 6 weeks from the start of Spain’s increase:
But what about deaths? While it’s not as smooth a curve as the one for cases, Spain’s daily deaths have risen tenfold since August 8. The UK’s per capita daily deaths have gone from a low of 0.10 on August 22 to 0.31 on September 21. Trying to adjust for the lag, we can go back to September 8 for Spain and see that the per capita deaths were already 1.35, or a sevenfold increase.
None of this is meant to minimize the very real increases the UK is experiencing, but instead of telling people we are following Spain’s trajectory, so that when we don’t hit those numbers, the doubters will once again doubt that there’s any problem at all, perhaps we should be examining Spain’s numbers and policies more closely to avoid their pitfalls. Certainly, they were trying to make up for their earlier losses in tourist income by courting foreign tourists, complaining when they were put on the UK’s quarantine list.
And we should think long and hard about a broad-brush second lockdown. Not only are people suffering, economically and psychologically, from the total lockdown, it’s also starting not to make sense. Back in March, I got an email from a friend who had done some research into past pandemics and said that pandemics usually had about an 18-month cycle. I reread that email in the process of searching for something else last week, and started thinking about it. Pandemics usually have an 18-month cycle without everyone going into total lockdown. What will our worldwide lockdowns do to the length of time the virus is still a significant risk? Are we, as critics have said, setting ourselves up for a bigger second wave because we’ve been sequestering ourselves and not requiring our immune systems to do their normal jobs? (The short answer is: probably not.)
It still seems to me that the most rational route forward, both for the government and for individuals, is for people to follow social distancing and mask-wearing measures and practice good hygiene. An article in Saturday’s Guardian asserts that the government’s message is in the wrong order, stressing hand-washing and mask-wearing ahead of social distancing. I have to say that I haven’t thought the government had been underplaying the importance of social distancing. They just recognized that in some situations, you can’t stay 2 meters apart, or guarantee a 2-meter distance. But then I realized that I am constantly confronted with people who seem to have forgotten to stay away from me on the streets and in shops. And I’d posted the video below on my Facebook page, because I was encouraged by the research on masks that Dr. Monica Gandhi has been carrying out. A friend commented that she thought it was either socially distance or wear masks, not both. Since I’d talked to her before about people not keeping their distance, I thought at first she was kidding, but as we continued the conversation, she insisted she was serious. I finally removed my post because I think people are already confused by the rules, so I didn’t want to add to the confusion by arguing a point that was not really related to the video.
But I started to think that maybe the Guardian had a point. It seems obvious to me that none of these measures is 100% guaranteed to stop transmission of the disease, but each provides partial protection. Therefore, if you can both keep your distance and cover your face, that would seem to provide more protection than simply doing one or the other. In cities, especially, you never know when you will encounter a crowd you can’t stay two meters away from. And hand washing can’t hurt, even if, by itself, it is inadequate. In the video below, Dr. Zubin Damania, a Stanford-trained doctor and professor of medicine at UNLV, interviews Dr. Monica Gandhi, a professor of medicine and AIDS researcher at the University of California, San Francisco. Since the start of the COVID-19 pandemic, Dr. Gandhi has been researching the virus, specifically the effectiveness of masks at protecting a person from the virus or limiting its severity. Dr. Gandhi gives me hope that there is a reasonable way forward that does not involve another lockdown and does not necessitate everyone’s compliance. If you are practicing social distancing as much as possible, avoiding big crowds, and wearing your mask, you are probably protecting yourself enough from the people out there who still don’t believe the pandemic exists. (For those of you who don’t have the time to watch the video or who want to read the actual research, here’s a link to Dr. Gandhi’s research paper in the New England Journal of Medicine.)