05 April 2020

SITUATION

Here we look at where we are today, having just completed the first two weeks of the lockdown in the UK, things are briefly as follows: 

‘Fragile’– those over age 70 and those with an established medical condition – are asked to be completely isolated, stay in their homes and only go out for exercise. They are not allowed to go to the shops and so all requirements have to be supplied by friends, neighbours or others.  This all seems to be working quite well.

Strong’ – we are calling the rest of the community the Strong – they also have been locked down and told to stay at home.  but are allowed out to buy food and essential supplies, to take reasonable exercise, and to go to work if they are employed in an essential role and cannot work from home.  Again, this seems to be working quite well.

Statistics - as of yesterday, the figures for the UK were 41,903 reported confirmed cases of the virus and 4,313 deaths. This gives an apparent death rate of 10% of reported cases - but it is believed there are many thousands of unreported minor cases and the true death percentage is probably around 1 to 3% of infected cases.

The original forecast was that, with no action taken, the death rate in the UK could be in the hundreds of thousands. Present forecast is that, providing people stay with the lockdown, there should be somewhere between seven and twenty thousand deaths. It is estimated that the peak of the infection will be reached in approximately two weeks’ time.

An interesting point about statistics us that there is no helpful comparison between the figures for the virus, and those who would have died anyway. The UK has a population of some 66 million - approximately 1 million people must either die or leave the country every year and another 1 million must be born or enter as immigrants.  Let us say that 700,000 people die every year – or some 2,000 deaths a day. This compares with today’s rate, said to be from the virus, of 700.  It does look as if the deaths caused directly by the virus could well be lower than the present figures.

 NHS Capacity – the present indication is that the NHS is coping, just, with the rate of infection and death - but is short of intensive care beds, personal protective equipment.  respirators and other necessary apparatus. The additional equipment seems now to have been properly organised and should be available to enable the NHS to manage the estimated maximum of 20,000 deaths.

 Strategy   there is increasing demand to know how long the lockdown will last and the long-term exit strategy. Understandably no one is prepared to define exactly what is going to happen until more facts are available about the progress of the disease.

 The most likely scenario seems to be as follows:

  • Continue the lockdown, for everyone, until a peak of infection is reached and a slowdown in the rate of infection observed.
  • Keep the Fragile in lockdown - release some, or all, of the Strong with a gradually easing of restrictions to enable some normality to return
  • Keep a close watch on what happens and control the virus within the capacity of the NHS
  • Hopefully, in due course either herd immunity or a vaccine will be developed and the Strong can return to some sort of normality
  • The Fragile could then be allowed to come out of hiding
  • This whole process could take many months

Economy – Lockdown is leading to a catastrophic loss of income for many businesses - particularly service businesses, shops, pubs, cafes et cetera. This has been compounded by the enormous that the government are providing to meet the needs of those who have lost their income. In due course there will need to be a huge national effort to rebuild businesses and find ways of paying off the huge debt that will have been incurred.

Conundrum – there is a growing awareness that it is in everyone’s interest to restrict the virus to a level at which the NHS can cope – but keeping restrictions in place to protect the Fragile involves a fundamental question:

  • Should the Strong be allowed to thrive, so reducing the damage to the economy and society, even though it leads to an increase in deaths of the Fragile ? – or
  • Should the Fragile be protected, with a high price to be paid by the Strong ?

Other Questions – There are many questions and ideas arising as a result of this virus. We will give some thought to these in later articles.