Time for a deep dive into pandemic cases and deaths in England. There are reasons to be optimistic. There are also reasons to be concerned.
First, some optimism: thanks to the vaccine, better hospital treatment, more effective medicines etc., COVID-19 is definitely less deadly.
However, if you're aged 65 or over, it's still a risky disease to catch, even with all those improvements.
And if you're aged 85+, your chance of dying (if you're ill enough to get tested and test positive) remains over 10%. That's down a lot from the early days, but still high.
Looking at the data above, we can see why the recent explosion in cases hasn't been mirrored by a wave of deaths:
- It's less dangerous at every age group
- Older at-risk people aren't catching it nearly as much
However, we must also turn to the concerning aspects of the situation.
Younger people are catching COVID-19 in unthinkable numbers compared to early in the pandemic. For example, 27% of all cases in the 20-24 age group have come in the last 90 days.
Why does that matter, if they're unlikely to die?
Well, young people can still...
- infect others, even if they're asymptomatic
- get ill enough to need hospitalisation, tying up the NHS
- catch long covid (this is a MAJOR issue, not to be minimised)
- on rare occasions, die
So if the pandemic slips ever further out of control, we can expect to see...
- A rise in deaths, though not in proportion to the rise in cases (and almost exclusively in older age groups)
- Hospitals more and more overwhelmed
- A huge wave of long covid (long-term NHS pressure)
If the only metric used to judge the current severity of the pandemic is deaths, things aren't as bad as before (though the death toll remains tragically high in older people)
But if we consider the whole picture (NHS pressures, long covid etc.) it's still very much a disaster.
We should also remember that new variants could change the picture very quickly when it comes to deaths, especially if the vaccines lose their effectiveness.
And having the virus run wild through a partially vaccinated population is THE best way to breed new variants.
SOURCES
Coronavirus Dashboard, the following 2 datasets (for England):
NewCasesBySpecimenDateAgeDemographics
NewDeaths28DaysByDeathDateAgeDemographics coronavirus.data.gov.uk/details/downlo…
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Boris Johnson's made so many appalling decisions, not enough attention is paid to the fact that he had the option of delaying the implementation of Brexit until 1 January 2023.
All he had to do was ask for a transition period extension before 30 June 2020.
For context, by 30 June 2020, we were 4 months into the pandemic. The economy was on its knees, with millions furloughed. We'd seen shortages of some essentials in the shops. And 40,734 people had died.
So it wasn't as if Boris Johnson didn't realise how destructive covid was.
And yet, instead of giving the UK 2.5 years breathing room (from then) he stuck to the original schedule, setting Brexit proper for 1 January 2021.
So instead of facing one overwhelming challenge at a time, his arrogant pig-headedness inflicted parallel catastrophes on us.
As the current pandemic wave has grown more and more severe, case reporting has fallen further and further behind "reality".
A meaningful gap has opened up between the cases being reported daily, and the actual number of new cases whose test specimens were collected each day.
In other words, for the last few weeks, the ultimate number of new cases has always been higher than the figure reported that day. It takes a few days for the data to catch up (because tests aren't taken and returned instantaneously).
So today's 51,870 new case figure is low.
The gap seems to be about 1-2 days now. Presumably reflecting the time it takes to process and return tests.
So today's headline figure of 51,870 new cases broadly reflects the situation on Tuesday rather than yesterday.
This current coronavirus wave has the potential to be far more devastating than the previous ones.
Why? Two words: long covid.
We may not see the same horrific death toll, but if we climb to 100,000+ new daily cases, that will mint thousands of new long covid sufferers a day.
As well as changing so many lives in a profoundly debilitating way, this will also heap lasting additional pressure on the NHS. It may be called upon to deal with the complications of long covid cases for years or decades to come.
So a rigid focus on the death toll is blinkered.
In fact, if you force yourself to adopt a coldly analytical view, a surge in long covid cases is much more damaging to the NHS than a surge in deaths.
One is a series of profound individual tragedies which are quickly over from a medical POV. The other is an enduring problem.
This graph comes with a couple of important health warnings - please see later in thread - but it's still instructive.
It shows (approximately) what % of all deaths that occurred in England involved COVID-19.
So for example, it was present in about 10% of all deaths age 35-39.
Now for the health warnings. Both relate to a lack of suitable data sources.
HEALTH WARNING 1
I had to use the combined figure for deaths in England AND Wales for 2019 as a baseline for all deaths.
This overcounts all deaths by about 30,000 out of 530,000 (5.6% overcount).
HEALTH WARNING 2
The deaths with COVID-19 cover the whole pandemic, not just a 1-year period. Approx 4,000 out of 128,000 deaths fall outside of 1 year (3.1% overcount).
Those two overcounts almost cancel each other out, so the end ratios should be a pretty close approximation.
Last time we hit 30,000 daily cases (mid-December) we were testing 325,000 people a day. Now, we're testing 1,000,000 people a day.
If COVID-19 is rampant in the community, 1,000,000 tests will turn up lots more cases than 325,000. And that will make the death rate "look lower".
Of course, more testing doesn't kill people! In fact, it can help to save them.
But if you're only comparing KNOWN cases with deaths, then if you find a lot more cases it will magically seem that the disease has become less deadly.
We can also look at the actual deaths.
Those are much lower now than back in December.
So the virus is less deadly now, because of the vaccine and better treatments.
But it may not be as "less deadly" as the headline stats indicate.