Covid-19 – The Known Unknowns
Kent Barker asks if UK’s East Sussex ‘patient-zero’ shifts the expected Coronavirus epidemic peak. And considers other confusing data.
When should we expect the epidemic to peak? The government suggests not for several weeks, but other evidence points to the possibility that it has already done so.
The key is when did Covid-19 arrive in Britain? The first officially recorded case was 31st January and the first documented incidence of transmission within the UK, February 28th. But we now know that one East Sussex family contracted the virus in mid-January after Maresfield father, Daren Bland, returned from skiing in Austria and transmitted it to his wife and children – probably a month before the official date. Hundreds of cases around Europe have been traced back to the Austrian ski resort. This could seriously affect epidemiologists’ assumptions about the rate of transmission throughout the country.
The NHS is reported to be facing a ‘tsunami’ of cases in the next month, but if transmission within the UK began at the end of January and not the end of February, then it could be wrong, and the country should already have seen the peak.
Eminent epidemiologist Neil Ferguson originally predicted possibly a million deaths in the UK, but last week US media reported he had revised down those figures to 20,000 or ‘far fewer’. His new figures assume many more people probably have, or have had, Covid-19 than previously thought. Which is consistent with it being transmitted up to a month before previously thought. However Ferguson’s revised figures are predicated on continued lockdown and social isolation.
What is the death rate from Coronavirus?
Or put another way, when is a death from Covid-19 NOT actually a death from it?
Testing for the virus is a long and complex procedure. Nasal swab RT-PCR tests carried out in hospital need laboratory analysis, so it can be days before results are known. So are all deaths attributed to
the virus actually from it and, anyway, might a number of patients have died of respiratory illness regardless? As HIP reported last year, posters promoting annual flu jabs claimed ‘10,000 die from flu infections annually in England and Wales’. But former Chief Medical Officer, Sir Liam Donaldson, revealed that influenza related deaths for England and Wales were in fact 44 in 2005 falling to 39 in 2008. This massive discrepancy seems to have begun with US policies to lump together all deaths from respiratory disease, including ‘flu-like’ illness and pneumonia. Thus the US figures for these deaths in 2001 was 62,000. The BMJ (British Medical Journal) later revealed that only 257 of the deaths were actually attributable to flu, and of those just 18 were confirmed cases of the virus.
Could the same or a similar thing be happening with the current Coronavirus epidemic? If so then the death rate – put at 3.4% of all who contract the disease – is unlikely to be accurate. In fact, because some cases of the disease are asymptomatic and others are very mild, many people don’t know they have it or don’t report it. Edinburgh University’s Professor Mark Woolhouse believes it means the overestimation of mortality rates could be 10 times too high, making it nearer 0.34% rather than 3.4%.
How complete should the lockdown be?
The government has been criticised for sending mixed messages over who can continue to work and to travel while civil liberties campaigners argue that the police are already using unnecessarily heavy-handed techniques that are at odds with the actual law. Sunbathers in a London park were dispersed by officers who told them it was not a holiday and “you can’t just come here and sunbathe”. Quite apart from the clear health benefits from exposure to sunlight providing vital vitamin ‘D’, people travelling on public transport or shopping for essentials are at much greater risk than those observing a safe distance outdoors.
The use of police drones to monitor visitors to national parks, and the closure of beaches or beach car parks are also seen as excessive and counterproductive. The government’s advice is to stay indoors where possible. But as we reported in the last issue, fresh air is a tried and tested method of both treating and preventing infection for many airborne diseases. Dr Jill Vines told The Guardian: “I am surprised that the intervention of fresh air and increased air flow to reduce Covid-19 infection does not appear to be mentioned in the advice to the public.”
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