UKH

Today is the day - the UK has reached 546 fatalities / million from covid-19, and Italy is still on 545 / million. I find these numbers a little bit abstract - so these can also be thought of as 1 out of every 1800 people (approximately) dying from covid-19.
Let this grim milestone be a reminder of the seriousness of what's already happened.

A like for this. Not for where we have got to.

Should this not read 'dying with Covid-19' rather than 'dying from'? They are very different things. 

UK excess deaths approaching 60,000. Deaths in Greece a 173.

No. See elsewhere's reply below, there have been 60,000 excess deaths in the period over a normal year. Even though there has been a drastic reduction in occupational and road deaths - the true total extra from covid-19 won't be known for a long time - but will be higher than even this 60,000.

Awful isn’t it.  Not many countries left ahead of us per-capita.  Currently the media are giving zero attention to this.

Genetics didn’t save us then ClimberEd - https://www.ukhillwalking.com/forums/off_belay/we_are_not_going_to_follow_ital... - the irony being nobody said we would blindly follow Italy.  They gave reasoned arguments why, and those arguments came to pass.  A process eased by the British exceptionalism some brought to this with no evidence.

Can I get a refund on my plastic Union Jack bowler hat (made in China) please ?

There is no way that the U.K. could have enforced a lockdown like the Greeks did.

Almost everyone has died of Covid not with it.

It is a myth that many/most/all of the Covid victims were dying anyway and just caught Covid on their way out. This myth is built on the fact that most people dying of Covid have underlying health conditions. However, these conditions, typically things like diabetes, obesity, hypertension, COPD, are mostly things which take years or decades to kill whereas Covid kills in 2 to 4 weeks. What are the chances that these people were about to die of a decades long condition and Covid just happened to get them all in the last 2 to 4 weeks?

P.S. if these people were about to die anyway then we wouldn't be seeing 60,000 excess deaths. The clue is in the word excess!

If someone dies and you are not sure what from but you stick Covid 19 down then isn’t this going to affect the numbers Of people who actually died from Covid 19?

It looks like it's the other way round, people are dying with symptoms of respiratory distress (months outside flu season) and Covid is being left off the death certificate.

https://www.homecare.co.uk/news/article.cfm/id/1624501/Coronavirus-left-off...

https://www.theguardian.com/society/2020/may/08/more-people-dying-at-home-d...

Forget about trips to Durham or sight tests in Barnard Castle, Cummings sat on Sage and was orchestrating our various responses to this crisis. Shouldn't he just be sacked for incompetence?

Do you think that either of these articles might have an amount of bias in them?

Why? Is our government crap compared to Greece? Is our population stupider than the Greeks?

No more bias than your post saying it was the other way round.

Do you want chapter and verse? How about this:

http://www.hcaf.biz/2020/Covid_Excess_Deaths.pdf

It might help your argument if you were to illustrate your suggestions of bias with examples from the linked articles. Simply saying 'they're biased' doesn't really advance the discussion. 

I agree fully that family and friends have been taken from us early and unexpected, but Covid-19 can't always be to blame, yet if someone dies naturally with the virus present, they are added to the statistics. Only time will tell what the shockingly true number will be, but in the meantime I still stick with using 'with' rather than 'from'. 

The Greeks imposed a strict lockdown.

No going out without your passport or ID and other documentation.

Enforced isolation of entire villages using police and roadblocks.

How would that have been implemented or enforced in the U.K. with its system of policing by consent?

That's why you look at excess deaths.

Doesn't tell you what happened to an individual and it is an imperfect measure but avoids obfuscation as little uncertainty in death compared to cause of death.

You won't know if they'd have 'died soon' until the year is out. If average deaths are lower than normal for the next 6 or 7 months then you could well argue that however many would have died 'anyway'. 

Thanks for that.

Do you think we could have locked down two weeks sooner?  Do you think we could have fired up the PPE supply chain 3 months sooner?  Do you think we could have started planing to do large scale qPCR testing 3 months sooner?  Do you think we could have had a broader quarantine on incoming travellers early on?  Do you think we could have started growing mechanism for test and trace 3 months sooner?  (1)  I could do go - the point being there were many things we definitely could have done so it's a bit disingenuous to focus on one thing you think we couldn't have done.  

Perhaps if we'd done all the things we definitely could have done, only 35× as many people would have died here as in Greece, rather than 350× as many.   

(1) Radical idea -we could have started expanding the local, skilled teams already in place rather than putting contracts out to outsourcing firms with no speciality, experience or local knowledge.

Had we done all of the things on your list we could have drastically reduced our death toll.

I’m sure we could have reduced it to almost zero with even more measures.

But it’s a question of what is possible not what is right.

I think that the U.K. population accepted lockdown because they could see the number of deaths quickly rising.

An attempt at lockdown two weeks earlier when deaths were much lower wouldn’t have been anywhere near as acceptable or successful.

Were the government scientists wrong in their advice at the time?

We can get a good idea if they would have died soon by looking at the different timescales of death: 2-4 weeks for covid vs decades for most of the co-morbidities.

My post explains exactly why it is mostly from and not with. Look at the different timescales. You can live for decades with these co-modbidities.

Certainly not with a PM messaging totally against it with things like his “shaking hands” debacle.  Strong leadership could have prepared people for an earlier lockdown.  We have leadership for that sort of thing

The message certainly seemed opposed to every other authority at home and internationally.  Sounds like SAGE was split with a minority spouting dangerous crap based on modelling - and being called out on this publicly by hundreds of UK medics and scientists, and in opposition to the WHO and the leaders of neighbouring countries who were in at least one case openly threatening us with isolation over it.  Yet Boris and Cummings backed the minority modelling driven opinion not the medical and epidemiological one.  Now we find out Cummings was attending SAGE and people are lining up to blame “the scientists”...

You can't throw average death numbers around willy nilly and dismiss what happens in the rest of the year.

I haven't thrown anything around willy nilly I've used logic and data! Are people really expecting that next year there will be a huge trough in the number of deaths, and that covid was just deaths brought forward?! Nobody has shown me any data for that so they are the ones throwing figures around willy nilly. 

When I mentioned government scientists I was thinking more of those who appear on the daily briefings.

As an example - They didn’t seem to think that mass gatherings were a problem and they sounded convincing to me.

Now we have other scientists saying that the LFC match and Cheltenham Festival have caused greater infections.

You've used logic and data that relate to a 12 month period, and are using it to state that people wouldn't have died anyway during that period. You can only have 60,000 excess deaths so far because it's compared to a 12 month average. If say for the rest of the year we have 60,000 fewer deaths than average then it would be fair to say that many of these excess deaths would have occurred anyway. This is the point, I'm saying we won't know until we've had the figures, you seem adamant that they wouldn't have died. You're the one using what is in reality an incomplete figure, willy nilly.

That doesn't make any death less tragic, but it is important for simple statistics. 

Yes, you can look at each individual case and say whether they would or would not have likely died due to the state of their underlying condition, but don't mix individual numbers with national averages. 

I think there’s going to be questions asked of those two.  Many of my colleagues and UKC posters were in disbelief at what they were saying.  Carried away by clever but not predictive modelling.  How they came to have precedence over other input to SAGE is going to be a key part of the inquiry I think.

OK but the difference in timescales of the co-morbidities strongly suggests that these covid deaths are not deaths brought forward. Decades vs 2-4 weeks. You are right, we will see next year, but I am highly sceptical that we will see a significant reduction in deaths next year, for the reasons I have explained. Nothing about my points is willy nilly! 

Given that most of us aren’t experts in anything other than are specialised fields, despite what we might think, how are we supposed to know what’s the best course of action in the face of conflicting evidence - without spending days on google?

Normally one might look to the government but that doesn’t seem a sensible option at this moment.

I personally would expect some overlap, but how much I wouldn't like to state. I'm not that confident, and as you're about to find out.. I might be terrible at numbers too.

But let's take a look at say diabetes. There's over 3.5 million diabetics in the UK, with an average life expectancy of 67. Let's say people on average are diagnosed at 40.. that means that roughly 1/27th of the diagnosed diabetics will die of the condition each year. That's around 130,000. Is there a chance that half of those in their statistical last year of the disease caught and succumbed to Covid? 

And that's just diabetes, one common underlying condition. Then you've got asthmatics. Kidney and liver conditions. Heart conditions. Obesity.

All these numbers are from quick Googling, it's fag packet maths so don't pull me up too harshly on them. But I think it does a good job in demonstrating that far, far more people will die of the co-morbidities anyway, than will have died from/with Covid. 

In general - you either trust the experts or you go about learning enough subject specific material to spot good arguments from bad.

In this case, the number of experts globally with a different opinion to ours was massive - to the point the French leadership was threatening to unilaterally sever all travel links with us over our approach.  That’s a pretty strong sign we had a minority opinion without googling.  Having established this it comes down to finding evidence to support our minority opinion - what is different about us?  What is special about us?  In the absence of those differences our minority opinion seemed highly unwise at the time.  It was also clearly - even to non experts - the most dangerous.  Sometimes it’s prudent to err on the side of caution.

Back in March the opposition was an awful option as well.  I’ve been wondering since then how to keep my family safe when government and the whole system fail to this level.  The events of this week have not improved my mood.

Yes, exactly that. Along with Johnson, Hancock and countless others. Herd immunity my arse.

I think what you've missed is the very low chance that Covid was only attacking the diabetics who were approaching their non-covid time of death. And what is behind you assumption of the average ago of diagnosis? This will have a big effect on the results of your calculation.

"Asthmatics. Kidney and liver conditions. Heart conditions. Obesity." Again, these people normally live for decades with their condition. 

Lots of people die all the time of all these conditions but 60 k excess deaths in the last 12 weeks or whatever really is massive even in this context. Look at this graph, which doesn't even go up to May:

https://assets.bwbx.io/images/users/iqjWHBFdfxIU/ioUsAlttt45o/v2/pidjEfPlU1...

You made a good point, but I think perhaps you've started to exaggerate somewhat: you now seem to be implying that anything which isn't Covid always takes decades to kill. In other words, by implication, you've slipped from "typically" to "always". And what does "typically" mean, anyway? It's very imprecise. Exactly how many Covid deaths would have been deaths in the near future anyway - much sooner than "decades" - is a very difficult number to estimate. But it's not an empty set.

OK 'typically' is vague but the way some people talk you'd think that asthma or hypertension means you will be dead in 6 months. This graph says it all and it doesn't even go up to May.

You must admit that almost all of the co-morbidites that the journals (or random UKC posters) mention are very long term. The UK also has a very unhealthy population which is another issue. What are the odds that these are mainly deaths brought forward? Has any pandemic in history been mainly deaths brought forward? 

https://assets.bwbx.io/images/users/iqjWHBFdfxIU/ioUsAlttt45o/v2/pidjEfPlU1...

P.S. the 'deaths brought forward' argument seems to go against Ocham's Razor. Some people (nobody on this thread, usually the hardcore anti-lockdown 'it's just a flu' brigade) seem adamant that this pandemic is barely killing anybody long-term. What is more likely, a big pandemic of a novel virus is killing lots of people, or somehow a series of improbable statistics all align so that most of the dead would have died soon anyway? 

You're missing the point that yes, people live for decades.. millions have the conditions, but hundreds of thousands also die each year of them. How do you know it's attacking an even spread of ages and progressions through the stages of disease? I'd argue that you don't.

What's behind the age of diagnosis? My gran was 42 and as I said.. I saw a number on Google that suggested 40 so seemed a reasonable suggestion. I was quite clear that it was fag packet maths and not an exact. I didn't miss 'that Covid was only attacking the diabetics approaching the non-covid time of death'.. I asked the very question you're accusing me of ignoring, 'Is there a chance that half of those in their statistical last year of the disease caught and succumbed to Covid?' which pretty much acknowledged that it probably wasn't purely attacked the oldest/weakest.

Yes, you're right that 60k excess deaths in 12 weeks is a lot, but until the year is out and we have the 12 month average you won't be able to say for sure if these deaths will have occurred or not. Which was my original point.

"How do you know it's attacking an even spread of ages and progressions through the stages of disease?  I'd argue that you don't."

My original point is this: What are the odds that the virus is just attacking the ones about to die anyway? Compare a window of 4 weeks to a window of decades. What are the odds that this 4 week window is consistently falling towards the end of the decades windows? You could think of it as overlap between two gaussians. OK it might be a skewed gaussian (not attacking an even spread of ages) but I still think the overlap will be small because of the wideness of one timescale and the narrowness of the other.

You are right, we won't be certain until next year or whenever, I've never denied I'm just saying that because of the difference in timescales I suspect that these mostly aren't deaths brought forwards from the new future. it seems too good to be true to expect a big reduction in deaths next year! Too many 'ifs' all having to align for that. 

PS I have to get back to work now (I promised myself I would stop wasting time on forums), and I don't think I have anything else to say, let's see what has happened in a year! All the best. 

You may find the attached from the Economist to be of interest. Particualary the bar chart as to where the UK ranks ( not anywhere near as bad as people suggest)

https://www.economist.com/science-and-technology/2020/05/21/the-risk-of-sev...

If you can deal with some profession-specific jargon, the article below may be of interest:

https://www.theactuary.com/features/2020/05/07/co-morbidity-question

It's not just the deaths that are the issue, it's the longterm health issues are potentially of massive concern in terms of healthcare cost and loss of productivity:- https://elemental.medium.com/the-long-term-health-impacts-of-being-infected...

OK I broke my rule and came back to say this, but the actuarial study linked by AJM goes into detail about the question of deaths brought forward and concluded with this, seems to back up my point:

"Therefore we feel it is unfounded to claim that a large proportion of those who have died from COVID-19 in 2020 would have died in any case this year.

This claim, in addition to being false, is also dangerous from a public health perspective: it understates the risk from the disease, endangering adherence to government policy on social distancing. It also seems very callous, encouraging a ‘why should I care?’ attitude to the people in question – in our view, people who would (in the great majority of cases) be alive now in the absence of the coronavirus, and would probably still be alive in several years’ time."

https://www.theactuary.com/features/2020/05/07/co-morbidity-question

Why? If anyone does the Greeks well know what happens when you cede too much power to a government, they didn't do it lightly, they did it because the government asked for, earned and maintained trust. Ours is a government of known liars elected on lies, brazenly lying their way through what is fast becoming a genocide of born of negligence, arrogance and nationalist exceptionalism. 

Jk

You’ll note that I wasn’t making the point that they are largely deaths that would have occurred otherwise. My point was that we should wait until the year is finished before drawing conclusions which is surely a reasonable request. One study can not prove or disprove anything that hasn’t happened yet.

Can you really see armed police being used to block off villages?

Most of us also don’t have a culture of carrying documents and ID cards on a daily basis nor do we have the police numbers to enforce such restrictions.

The UK is very much dependent on the population doing what is asked, hence part of the anger for Cummings’ outrageous behaviour.

No, but the UK and the US have strong libertarian streaks. Look at the US protests. The UK hasn't seen protests but it has seen mass ignoring hence 10's of thousands of deaths. But it's also just been poorly managed from the off.

An Englishman's house is his castle and all that. It goes to the core of the island mentality too.

At least in the US we have levels of Government so the states stepped in to the vacuum left by what was the federal government. In the UK, Bojo et al run the show and nothing could step in.

It can't, but I do think that given we're nearly half way through a year and that in a calendar year deaths tend to be front loaded (heaviest mortality tends to be in the winter) the potential for it not to be is narrowing.

https://www.actuaries.org.uk/documents/england-wales-mortality-monitor-covi...

Chart 1 is a presentation of the data I find quite useful. You can see the similarity between 2019 and 2020 until early march and then the obvious spike. To get to be a year similar to 2019, you need a very steep down slope from where we are now to rejoin the 2019 line by December. 

Chart 2 is saying the same thing but in terms of mortality improvement versus the previous year - you can see a line near zero indicating a year much like 2019 and then a massive spike downwards indicating far heavier mortality than 2019. Given how flat the lines are for the remainder of all the other years it's obviously going to take fairly dramatically different summer and autumn mortality to get back to anything which looks like a standard year. 

Firm conclusions, you can't yet draw, but you can and I think it is reasonable to look at a balance of probabilities. 

Can you explain. I don't know much about the Greek lockdown. I thought that we were supposed to be better at following rules than those Southern Europeans.

We will all die anyway. You really can't play that game.

I’m not, if you bothered reading my posts.

The Greek lockdown involved armed police, blockades, ID cards,etc.

Even with all these in place how they’ve kept their death toll so low I have no idea.

Maybe we’re better at following the rules but the Greeks had better rules?

No need to get arsey. You very clearly played that game.

Having read a little about the Greek lockdown, it seems that draconian inforcement wasn't the critical factor, they may have had better rules, they certainly communicated them more effectively.

My personal experience is that the government has been clear in their communications.

I do spend far too much time listening to the news, browsing the internet, etc.

Obviously I’m not including the Cummings fiasco.

Nope, I said let’s wait for the data rather than prescribing them beforehand. I’ve nothing to gain from them being early deaths, or inevitable ones. Couldn’t care less for the politics of it all, I just like numbers and facts and stuff.

The facts are that someone dying now is generally worse  than that person dying is 6 months, 5 years or 30 years of something else.

Agreed. But it’s not a lack of empathy or anything of the sort to want to separate emotion from statistical fact. As I said above, every death is tragic regardless. Or will those reviewing the stats in the future be referred to as playing games too? 

The statistics will be the statistic, games will relate to how those statistics are used. The fact is, we cannot minimise the impact now by saying that a proportion of those would have died in the next six months anyway. Some almost certainly would have, but they have still been robbed of however many months of life.

slight rearrangement improves sense?

and he poisoned democracy with info-war

Deaths from occupational hazards and road deaths are absolutely tiny numbers, factoring them in one way or the other will make no noticeable difference to final figures.

Other commentators have suggested it is because their healthcare system is not strong so people acted in self interest as they did not want to go to hospital......sounds reasonable..Same in quite a few Eastern European countries as well.

Are you talking about Greece?

That wouldn't apply to Norway would it? Norway has had less than a hundredth of UK deaths for a tenth or so of our population.

After the government pissed away the vestiges of public trust this week to prop up the puppetmaster: yes I can see exactly that scenario playing out here when the second wave comes. We won't do as we're asked in sufficient numbers, society fragments where some break rules and other suffer to uphold them so they will need to be imposed by force. Not just police, we don't have the numbers, it'll have to be a joint forces effort. It is impossible to overstate how badly we've f*cked this all up. We are the failed state, not Greece, not Italy, brexit-Britain. 

Yes so now our options narrow.

Jk

Yes

https://www.ft.com/content/6b4c784e-c259-4ca4-9a82-648ffde71bf0

Looks like tomorrow is the day we pass Spain on per capita deaths.

Or Iceland?

So when they introduced their traffic light alert levels and they said it would be based on science and the numbers of tests and tracing infected people you believed this would happen, and they were clear this was integral to loosening lockdown.

But it's not in place yet, so how clear is that?

I’m not being held to account for something that has happened how long after I made that statement.
People want a clear, concise, well defined, timetabled plan.

Nice as that would be I’m not sure how possible that is given the nature of the virus, the scientists understanding of it and the often conflicting pressures that the government is under.

e.g. quarantining arrivals into the country - some people want it so that it helps to limit the spread of the virus but the tourist industry doesn’t want it because it will further damage their businesses.

So the government has a dilemma and its announced policy immediately comes under pressure so they change it and hence the confusion.

Strict enforcement of the rules is key. It’s something I’ve read from epidemiologists, the idea is that because just one person not following the rule can create new chains of transmission, there is a large disproportionate effect of even low levels of non-compliance.

I'm not sure if strict enforcement is the key as the list* of countries doing better than the UK is so long and so varied. I think the key was timeliness in February/March when daily growth was 20-30% and ongoing competence.

*too many to remember or check now but from Iceland/Norway to Aus/NZ and from Japan/S Korea to Germany/Greece. 

It's coming under pressure because it's poor policy, mistimed by months and poorly justified. There has to be, indeed there are better ways to mitigate (all this does with its countless loopholes) the risk of imported cases while maintaining significant freedom of movement especially since the government have already blown a colander load of holes in the plan as special pleading lead to exception after exception negating the efficacy and eroding the idea we're all in this together. Meanwhile the travel industry remains hamstrung and families outside the countless quarantine exemptions remain effectively separated indefinitely.

As with so much of our piss-poor response this bad policy stems in part from our inexplicable inability to get a distributed, robust and trusted testing regime widely accessible and still growing fast. Screen people onto planes departure side (requires international cooperation and trust, something we're squandering) then screen them out of a brief quarantine arrival side if more public reassurance becomes politically necessary (it isn't yet, we have virus everywhere anyway and open borders currently causing little public consternation). If we want the freedom to travel en masse (and that seems a reasonable hope) then effective risk mitigation through screening (and a plan to deal with the consequences of the cases we miss) is all we can realistically hope for, exception riddled quarantine is a terrible way of delivering that if it's even possible and meaningfully effective at any scale (how do people transit from aircraft to isolation safely for example?).

jk

Sadly the virus doesn't run to a timetable, you can predict that with accurate testing and tracing, and data. Sadly, again, we don't have any of this.

They're in control, we had warning this was coming 14 days more than Greece for instance, why has their response been so much better than ours?

Take it on the chin, maybe?

Where nearly the worst country in the world, at the moment we should be quarantining people leaving not coming in!!

The immediacy is self made, it their inadequacies, that put us in danger, not only of dying but a further lockdown and second wave as bad as the first.

There shouldn't be a dilemma!

Yes, acting early is also key.