The UK response to Covid-19 [MOD WARNING 1ST POST]

Just had a video call with family over in the UK. One huge row that has started over there is the revelation that patients were being discharged from hospitals into care homes. :eek:

theological wrote: »

I only have a question on this. Are these all deaths that occur? I ask because this number is radically different from the overall coronavirus death count.

These deaths are obviously tragic and there will be a lot to learn from this when we have a clearer picture.

My position is that the UK hasn't done significantly worse than other European countries on this and that many of the remarks on this thread are unsubstantiated. There is probably a lot to learn from Germany on how to handle both this going forward and on how to handle other pandemics for sure.

Excess deaths during a pandemic are a completely different figure from deaths attributed to the pandemic disease. But . . .

They are nevertheless a very important figure in assessing the impact of the pandemic and making judgments about how well it was handled. But . . .

They take a while to compile; they are not going to be instantly available.

Consider an entirely hypothetical CV-19 pandemic in an entirely hypothetical country. A number of things are going to happen, including:

- Some otherwise healthy people are going to die of CV-19.

- Some people who were otherwise sick are going to die and, of those

-- some will die of CV-19, and

-- some will die of whatever else they have, but they wouldn't have died of it of not weakened by CV-19, and

-- some would have died of their other disease, and quite soon, and

-- some would have died of their other disease, but not yet.

- Some people who don't have CV-19 at all will die who wouldn't otherwise have died, or at any rate who wouldn't have died yet, because the medical resources that would have saved them are consumed by CV-19 pandemic.

- Incredibly, some lives will be saved. (Deaths in road accidents, for example, are down, because we are all spending much less time on the roads.)

OK. Identifying these cases individually is difficult, and in some cases impossible. Obviously we can't identify the people who would have died in road accidents, were they not housebound. And if somebody gets less-than-optimal treatment for cancer and dies, how sure can we be about whether or when they would have died, if it had been possible to give them the optimal treatment?

And yet, even though we can't identify them individually, all these deaths (and lives saved) are consequences of the pandemic, and if we want to make judgments about the pandemic or draw lessons about how it was dealt with, we need a handle on these deaths. The standard technique for doing this is to measure "excess deaths"; how many more people died during or for a time after the pandemic than would have been expected, but for the pandemic?

This isn't a straightforward calculation, because death rates are affected by other factors. More people die in the winter than the summer, for example. Death rates go up and down as the demographic balance of the population shifts - a population with more old people in it has a higher death rate, and vice versa. There's random variation in death rates from year to year anyway. Etc, etc.

So what they do is something like this: Suppose this pandemic runs until July. You look at the overal death rates for the past (say) five years for the March-August period, or maybe March-September. You find the average over the past five years. You factor in any changes in the demographic structure of the population over that time, and to now. You make allowances for any other atypical events that you know of that might impact the death rate, either in the past five years or this year. Then you calculate, base on all that, the number of deaths that you would expect in March-September 2020. You compare that with the actual number of deaths in that period. The difference is the excess deaths, and it's a measure of the overall impact of the pandemic on mortality.

You can't do it until the pandemic is over. It has to cover the whole period of the pandemic - comparing deaths in (say) the second week of April 2020 with deaths in the second week of April 2019 is a crude exercise. It might tell you that the pandemic is having A Big Effect, but we knew that already. And there's far too many random factors at work there to tell you anything more than that. But the overall figure,when known, will be very useful. You can compare it with recorded deaths from CV-19 (inevitably, a lower figure) to make judgments about how CV-19 affects the course of other diseases. You can break it down by age and find, e.g. that there were virtually no excess deaths among children, but very great numbers in certain other age groups. You can break it down by location, and find out how much more lethal the disease was in densely-settled urban areas than in more sparsely-settled rural areas. Etc, etc.

There's no doubt that the CV-19 pandemic will result in signficant excess deaths. In due time, we'll know how many, but we can't know yet. We'll also know of excess deaths in other countries, and we'll look for answers about why country A fared worse than country B. The answer won't necessarily have anything to do with mismanagement, though; it could be that country A is more densely populated, or has an older demographic profile. It could be a bit of both - e.g. the government of country A adopted policies which they observed to be working well in country B, but they worked less well in country A because of other differences between the two countries. We might or might not be able to criticise the government of country A for this; the factors which mean these policies were less suitable for country A may not have been apparent to them at the time.