COVID 19: What have we learned?

Click for a larger image. Logarithmic graph showing positive caseshospital admissions and deaths since the start of the pandemic. The blue arrows show the dates of ‘opening’ events. See text for further details. The red dotted line shows cases increasing by a factor 10 every 150 days.

Friends, so here we are, May 26th 2021, and I have spent the day listening to Dominic Cummings testify to the “Lessons to Learn” inquiry in Parliament.

  • I found his testimony compellingly plausible.

As I explained previously (link), I can forgive the government for failing to act at the start of pandemic. They should have known better, but actually very few people in this country could quite believe what was happening.

But I refuse to forgive the government’s failure to act in September last year. What was required was obvious even to an amateur like me (link).

Dominic Cumming’s testimony explained how, despite advice to the contrary, Boris Johnson refused to act, asserting he was the “The Mayor in “Jaws” and he would keep “the beaches” open.

But unlike the “Mayor in Jaws” who was responsible for a few fictional deaths, Boris Johnson was personally responsible for tens of thousands of real deaths – the majority of the 86,164 who died in the second wave.

I won’t go on about this, because this is not that sort of blog, but this is, in my opinion, a criminal failure.

So what can we learn now?

The graph at the head of page shows cases, deaths and admissions throughout the pandemic.

It is striking that deaths and hospital admissions are very similar now to what they were in between the first and second waves.

Positive cases are higher than at the end of the first wave, but this could easily be due to the current extensive testing of asymptomatic people. The actual prevalence of the virus is probably similar or less.

As I mentioned in my previous blog, we should not care about:

  • the absolute number of cases,
  • the population prevalence of cases,
  • or even the rate of change of cases.

What matters is this:

  • Is there the potential for the pandemic to expand into the general population and kill hundreds of thousands of people?

Last summer the answer was definitely ‘Yes’.

This summer the answer is still in my estimation probably ‘No’.

Why? Because 57% of the entire population, including practically all of the most vulnerable groups have received a first dose of the vaccine. Vaccination is reaching an additional 8% of the population per month.

Together with the 10% – 20% (roughly) of the population who have had the disease, we are close to herd immunity.

So what is the worst case?

The current resurgence in cases appears be localised in communities with low vaccination rates, having been seeded by people returning from India.

The public health response – local mass vaccination and surge testing – seems appropriate.

The likely worst outcome with 3000 cases/day amongst the least vulnerable groups – aged under 30 – is that deaths might amount to 0.1% of cases, or 3/day. Tragic as each death is, in the context of this pandemic, this seems to me “acceptable”.

Cases nationally are rising slowly: by a factor 10 in about 150 days – or 5 months.

However vaccinations are proceeding at a rate of about 8% per month, so in 5 months the entire population will be vaccinated with at least a first dose.

My guess – and it is just a guess – is that with continued attention to local outbreaks, and continued progress with vaccination, we will avoid any significant third wave.

So returning to the key question:

  • Is there the potential for the pandemic to expand into the general population and kill hundreds of thousands of people?

As far as I can tell, the answer is still ‘No’. Probably.

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