Thread by @jonworth

Right. I have been trying to get my head around the UK Government's #CoronaVirus approach for the past few hours.

Here follows a thread that's a summary of my thinking. Open workings if you like.

🚨 I am *not* a medical professional, so treat all of this with extreme care 🚨

I do however have some core questions about the UK Government's approach, and whether it actually fails on its own terms, and that's what I'll examine.

Before going any further, read this thread which is the best summary of the UK Government's approach I have found, and explains the overall aims:

https://twitter.com/iandonald_psych/status/1238518371651649538

That makes 3 assumptions I am *not* going to challenge, even though each could be questioned:
- that you can separate low risk from high risk groups
- if you were infected with it, reinfection will not re-occur
- that there are no ill effects of getting it and recovering from it

So, to the workings

There is a daily % increase in the number of reported #COVIDー19 cases

That daily % increase should reduce once social distancing measures are imposed (I take today as that day), but with a 5 day lag

See this from FT

The number of ICU beds is restricted, and occupancy already high, but I assume that numbers of ICU beds can be steadily, if rather slowly, increased, but that there is no limit on adding ICU beds

Stats on UK ICU beds here
england.nhs.uk/statistics/sta…

I use the Jan 2020 number of 4123 ICU beds, with a 83% current occupancy rate

I set 21 days as the time a patient will need on a ventilator, based on this
inquirer.com/health/coronav…

My workings can be found as a .ods file here
jonworth.eu/downloads/coro…

And as a .xls here
jonworth.eu/downloads/coro…

So what happens?

Taking a *conservative* % daily increase now of 25%, a *conservative* % daily increase of 15% 5 days from now, and 4% of patients needing ICU, and NHS adding 20 ICU beds a day, ICU capacity is exceeded on 5 April

Keep all that the same, but reduce the days in a ICU bed to 14 (from 21), and set the NHS to adding 50 new ICU beds per day and the peak then comes in the middle of April instead

Instead take the FT's 33% daily increase now, and reduce that to 25% 5 days from now, and patients needing ICU set at 5% (i.e. realistic figures) - then ICU capacity is exceeded on 27 March (NHS still adding 20 ICU beds a day in this scenario)

All the sources I have used for the calculations are in the spreadsheets linked above

But my conclusion is this
⚠️ Unless the rate of daily increase in infections is massively reduced *and* ICU capacity hugely stepped up, I cannot see how the NHS is not going to run out of ICU capacity ⚠️

In other words before the UK even gets to the stage of herd immunity or anything close to that, its hospitals are going to be overloaded, and doctors having to decide who lives and who does not - as has happened in Lombardy

Note that this calculation does not take into account the lack of trained staff for additional ICU units, nor the fact that the spread of ICU beds may not reflect the needs of the demographic of an area

I am ready for someone to point out some error in my workings, or some other way out of this. Indeed I am hoping someone does do that.

But currently I cannot see how the UK avoids a crisis in its health system. The question is if it's this month or next.

/ends