Thoughts on UK corona virus

Well I didn’t see this coming!

And even now – as we all hunker down – I can scarcely believe it.

I struggled like many to make sense of the magnitude of what was happening, oscillating between a “this isn’t really very serious” and concern that “this really might be catastrophic“.

Eventually I understood that this was in fact very serious. I am writing this to try to express clearly my own understanding and explain why, slightly to my surprise, I am feeling positive about the UK’s response.

My sources of information have been:

In looking at the data I have ignored statistics about ‘cases’ or ‘hospitalisations’ because these terms are not clearly defined – and the true scale of the epidemic is still unknown. I have – grimly – only concentrated on deaths.

7000 UK lives saved so far

Deaths in the UK from Corona virus are shown below. The data were complete today 27th March 2020 and the national ‘lock down’ began on 22nd March, day 81 of the year. The deaths reported here would have been from people who were ill before the ‘lock down’.

UK CV deaths in contextThe vertical scale on the graph is logarithmic and can be tricky to read, but this type of graph allows one to  see the trends in data more clearly.

In particular – the rapid so-called exponential – growth typical of the early stages of an epidemic appears as a straight line, and the slope of the line tells us the time for the number of deaths to double.

If we extrapolate from data around day 74 – just two weeks ago – we might have plausibly expected many thousands of deaths by now. But looking at current data (day 85) we see the trend has significantly changed. So whatever we did – social distancing etc – has saved by my estimate around 7000 lives already.

I emphasise this because media coverage speaks only of failure and death. They make it seem like we are paying a great economic cost pointlessly. In fact, the price we are paying is high – but unless my understanding is flawed, we have already saved many lives.

I expect the initial three weeks of this current ‘lock down’ (out to day 102 in the year) will achieve more, but I think it will be extended, and there may a ‘super strict’ phase. The international lesson (see below) is that it takes around 6 weeks of the strictest measures to control the spread of the virus.

The above graphic is from the New York Times and is updated daily. It charts the number of deaths versus the time since the 25th death in that particular country.

(Link to New York Times Tracker)

What happens next?

Nobody knows. It’s the future and it is notoriously unpredictable, even guided by the experience of other countries (above).

But using the epidemic modeler we can make some guesses.

UK Epidemic Model

I took the basic numbers describing the spread of the virus from the internet (R0 = 2.4 etc.) and assumed there were 10 initial ‘seeds’ in the UK population of 66 million. I then chose the date of ‘lock down’ (Day 67 in the model but day 81 in the year) such that the death rate matched the observed death rate – about 50 deaths per day.

For a wide range of parameters, the model predicts that the peak in hospitalisations will occur in two to three weeks time – and there will be about 5 times as many patients as there are now.

It looks like the field hospital being built in the ExCel centre is likely to be required. Also around 10,000 intensive care beds may be required – more than twice those currently available (New Scientist Article) but this number is being increased rapidly.

  • So the model tells me to expect it to all get worse for about another two weeks. 

Of course a model is just a model, and people are not uniformly distributed around the country. In fact London, with about one eighth the population of the UK has about a third of cases. So the situation is likely to be worst in London.

So I expect that things will get worse. And the death toll will rise to probably between 10,000 and 20,000. But I feel it is important to bear in mind the actions we have taken will have saved hundreds of thousands of people from a premature death in the most appalling of circumstances.

Each year in the UK roughly 500,000 people die, and so – while each death is a loss – the likely death toll is … I can’t find the right word. But it is typical of the number of excess deaths from flu in a bad year.

Could we have acted sooner?

Technically, Yes. But – and I am not an apologist for this government – I think nobody could quite believe the scale of what was required, or the rate at which things were changing around the world.

By the time of the ‘lock down’, public opinion was overwhelmingly in favour of it, but even one week earlier that might not have been the case. If such an epidemic happens again, then I think our collective memory of the crisis will allow for much earlier action. This seems to be the case in countries in the Far East that successfully battled SARS and prevented it becoming a pandemic.

By the end of the year, our collective actions will have saved hundreds of thousands of lives. The epidemic modeler predicts that if the government had acted:

  • one week earlier, the death toll would have been ~5,000 rather than ~10,000.
  • one week later, the death toll would have been ~25,000 rather than ~10,000

In the longer term…

It is important to realise that even when the epidemic subsides – the corona virus will still be out there. When the social restrictions are lifted, the epidemic will grow again, until a vaccine is distributed.

Our experience of the crisis is likely to affect us collectively in too many ways to comment on here, but I am hopeful that this will have a positive effect both socially, and in our response to the climate crisis.

  • Air travel: This may never be the same. Ongoing quarantine regulations may yet mean that we might have already experienced peak-air. Wow!
  • Teleworking: Working from home and collaboratively across sites – organisations on the edge of adopting the technology will have been forced to do it. Vast numbers of commutes and business trips could be saved.
  • Cars: I am really enjoying quieter streets and I feel it will be hard to return the noise of even two weeks ago. Could the tide have turned against ‘excessive’ car use?
  • What government can do: We have seen that our government can act in dramatic ways with broad social support and – if we want it too – it can spend unbelievably large amounts of money on policies that people want, but which are not popular with many strong lobby groups.

Enough

I wish you all well wherever you are.

I am thinking in particular of colleagues in Italy and Spain where matters seem to be worse than in the UK, and of colleagues from China who have reached out to me with moving kindness.

11 Responses to “Thoughts on UK corona virus”

  1. Jane WILLIS Says:

    Hi Michael – that was fascinating modelling – it really put things into perspective – and your observations were very interesting – specially re air travel. Hope you and your family are managing ok through this strange time. Many thanks for the article and all the best.

    Jane Willis (Jason Smith’s sister-in-law)

  2. edhui Says:

    Great reading as ever. NPL’s loss is our gain.

  3. telescoper Says:

    Unfortunately the UK is only counting COVID-19 deaths as such if they occur in hospital and where the test was done in hospital. In Italy such cases are around 14% of actual deaths. The UK Government is actively choosing to understate deaths by up to 86%, so the real UK figure is very much higher than your graph suggests.

    • edhui Says:

      1. Michael is careful to mention his sources. Please mention yours.
      2. Your language is unnecessarily emotional in a distressing situation. If the UK government is choosing that particular number to count, then they are necessarily ‘actively’ choosing it. To say they are ‘actively’ choosing it implies that they are choosing it in order to give some political angle, or at least implies some ulterior motive. Maybe they’re actively choosing it because it’s a number they’re certain about. As long as we know what they’re choosing, we can use the numbers.

      For what it’s worth I don’t think it matters what numbers they choose as long as they keep using the same numbers. If the epidemic grows exponentially, it’ll be exponential on any number you choose, actively or not.

      • telescoper Says:

        Note the wording in the latest official DHSC announcement: “As of 5pm on 27 March, of those hospitalised in the UK, 1,019 have sadly died.’ Only deaths in hospital are being recorded in the daily statistics. You can draw your own conclusions about why.

      • protonsforbreakfast Says:

        My conclusion is that the uncounted deaths – presumably in private homes and nursing homes – will be difficult to collate ‘live’. I don’t have any doubt that the statistics will be fully analysed when they are available.

      • protonsforbreakfast Says:

        Thanks Ed. It is hard to discuss death ‘in bulk’ while remembering that each person’s death is a tragic loss, but also that our deaths are inevitable.

        Best wishes, Michael

    • protonsforbreakfast Says:

      Hi. Yes. The number of deaths will likely be an underestimate, a point made in this Washington Post article the other day

      https://www.washingtonpost.com/politics/2020/03/27/those-covid-19-death-toll-figures-are-incomplete/

      But if I understood the article correctly, the inference of the true number of ‘excess’ deaths can only be reliably done after the fact. That is why I concentrated on the simplest most robust statistic available.

      But whichever statistic you choose, the actions we are taking are saving lives now – that was my point. And if you consider a broader measure of mortality, that will only increase the estimate of the number of lives already saved.

      All the best, Michael

  4. abc Says:

    How does COVID-19 compare to seasonal flu?
    I think these (interesting) statistics should be put in context in terms of contagiousness, deaths, etc.

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