Sunday, 24 January 2021

This looks like good news to me - the article contradicts the headline. And itself.

From the BBC:

Lockdown looks to be having an impact on infection levels with the number of new cases starting to fall. But there are only tentative signs this has filtered through to a slowing of new admissions to hospital.

They illustrate this with a chart which seems to show that the lockdowns (starting late March and early December 2020) had no impact on hospitalisations whatsoever (although we will never know). Cases had fallen to a low level by July and even though the lockdown was then significantly loosened, they stayed that low until October.

They started falling a week before the December lockdown and started going up again after it started and continued going up until today (nearly two months). So at first glance, the chart looks like a seasonal illness like 'flu. Lots of cases when it's cold and very few when it's nice weather (which it was for most of last year).

Over the past week more than two million people have received their first dose [of the vaccine]. That puts the government on track for achieving its aim of offering a vaccine to everyone over 70, the extremely clinically vulnerable and frontline health and care workers.

The UK government and the NHS are doing really well with the vaccinations. I am impressed and 'proud to be British' for once. If they can keep this up, the 15 million most vulnerable will have had their second jab by the end of March. Daily vaccination data is here.

Even if the supply is good, there will still be lots of vulnerable people. Nearly 90% of Covid deaths have been in the groups due to get the jab by mid-February.

There's a lot that can still go wrong between now and the end of March, but this is a contradiction and the whole thing is starting to look rather positive. Out of (say) 1,000 daily deaths, 100 were people under 70 who won't even have had their first jab by then, so that's still 100 deaths a day in those groups. 900 deaths were the most vulnerable, if they are now 95% protected, that gets deaths in those groups to about 45 a day.

So total daily deaths will be down by six-sevenths (give or take a large margin of error) by April, at which stage the various effects will kick in:
- more natural immunity (huge numbers of people have had it. Those were presumably the more vulnerable - whether for health reasons or lifestyle reasons makes no difference - who are now immune for the time being);
- more people being vaccinated every day;
- nicer weather;
Their combined effects will mean that daily deaths are down to the dozens and declining. By next autumn/winter, it will all be over. Hopefully.

A couple of experts hit the nail on the head at the end of the article:

UK chief medical adviser Prof Chris Whitty has spoken about "de-risking" Covid. His point is that we will reach a situation at which the level of death and illness caused by Covid is at a level society can "tolerate" - just as we tolerate 7,000 to 20,000 people dying from flu every year.

It appears that 'flu deaths were unusually low last year. Those who would have died of 'flu died of Covid-19 instead. Callous but true.

Sociologist Prof Robert Dingwall, who advises the government on the science of human behaviour, believes that point will be reached sooner rather than later. "I think we will see a pretty rapid lifting of restrictions in the spring and summer. There are some sections of the science community that want to pursue an elimination strategy - but once you start seeing fatality levels down at the level of flu I think the public will accept that."

Yup. People can get used to anything except constant change.


DCBain said...

"People can get used to anything except constant change."

What this people can't get used to is being lied to, manipulated and treated like a 4king halfwit. This by a bunch of liars who are fed - and repeat - misinformation by a band of charlatans: neither robber band being willing to admit that they cocked up from the word go.

Mark Wadsworth said...

DCB, OK, but clearly we are used the government and civil servants lying to us, cocking things up, cheating etc all the time. We accept that as a fact of life.

Frank said...

"It appears that 'flu deaths were unusually low last year. Those who would have died of 'flu died of Covid-19 instead. Callous but true."

Also, the measures put in place to protect against Covid are effective against 'flu.

Mark Wadsworth said...

F, good point.

Matt said...

"His point is that we will reach a situation at which the level of death and illness caused by Covid is at a level society can "tolerate" - just as we tolerate 7,000 to 20,000 people dying from flu every year."

So why did we lock down in the first place then? If you believe the 100,000 deaths *from* (as opposed to *with*) COVID number then I have a bridge to sell you.

For those who want to jump in with their 2p - tell me where all the stiffs are then? If we have so many excess deaths, then wouldn't the morgues and funeral parlors be overloaded?

Matt said...

The economics of the government lock down are tenuous at best. I'm sure some will say you can't put a value on life, however you can - it's mostly the figure that is calculated that is for debated. The NHS uses Quality Adjusted Life Years (QALYs) as one such measurement [1].

Some might argue that economic value doesn't take into account "societal" value but that is also incorrect. Economics looks at the utility that people gain which is "all" the value they produce/consume. Of course, taking every single thing into account isn't possible, but the large ticket items (such as life) are included.

Different people have different agency which means they assign different values to different things. You might imagine that your life is as valuable as someone else's but that is not the case if you are, for example, in a persistent vegetative state. Sure, you might come out of it and become the next Jeff Bezos but that is a highly unlikely outcome. A person with advanced (stage 4) bowel cancer is not as valuable as someone without (and more so if they have greater number of years of life ahead). Note, that we're not saying "no value" just less value (see Lord Sumption and the furore around his comments).

At present, the UK government looks to have spent around £271bn on COVID support [2]. That doesn't take into account the reduction in the economy caused by the lock down which invariably will lead to lower employment and therefore lower tax receipts. But we can't predict them so we'll leave them out.

Neil Ferguson predicted a worst case of 500,000 deaths [3]. His track record on predictions has been questioned, but again, like the economic costs we don't have anything else (better?) to go on. We do however have his actions which show that it was more important (in terms of value/utility) to him to go shag his tart than to avoid exposure to COVID.

So spend of £217bn (best case) divided by 500,000 deaths (worst case) gives a "cost" of £542,000 per person. Is that good value?

Well, it's the very best case and so it likely to be much higher (greater costs still to be reckoned).

If we take the best case £80,000 QALY from the BBC link then the costs per person above would suggest they need to live for at least 6.75 years. A more oft quoted QALY figure of £30,000 means that this rises to 18 years.

If you are in the 45-64 age bracket then this might make sense as you could expect to live to about 82 (64 is just at the limit of 18 years). However the majority of deaths are in the 65 and over age brackets [4] where living 18 more years is less likely.

Would I want to sacrifice my parents to COVID for the sake of the economy? Personally no, but then this isn't about individuals - it's about what is best for the country.

SAGE members have no motivation to be anything other than extremely cautious - they will be criticised by the media if lots of people die. So you can at least rationalise why they might promote the worse case scenario.

Politicians, on the other hand, are meant to weigh these things in the whole. We wouldn't send people to war if losing lives was the only consideration. They do however also have a similar motivation to SAGE - they want electing, and poor media coverage might put paid to that, so they will also dodge the difficult decisions if they can.


Unknown said...

Matt, but then you have the "no matter what it costs (in terms of liberty and happiness as well as money), if it saves one life, it will have been worth it" mob.

Mark Wadsworth said...

Matt, excellent comment and agreed, that's how it should work.

Probably better than my original article, even though I was posing a different question, which was "Would that £271 billion not have been better spent on extra NHS so that everybody can bumble along as normal under milder restrictions (like face masks on public transport, no crowds at football matches etc)?"