Lock-down Policies - Some Comparisons
Initially in March 2020 the UK government appeared to be intending to take what was called a mitigation strategy for COVID-19 relying on building up herd immunity. Opponents of this strategy claimed that recent “modelling by scientists” showed such a strategy would result in a huge number of deaths in the UK. Additionally there would be massive overloading of the NHS caused by the rapid spread of COVID-19 which would result in additional deaths due to lack of both ICU capacity and of the medical staff and facilities to deal with the normal non-COVID medical care required.
As reported by the BBC on 17th March https://www.bbc.co.uk/news/health-51915302 the modelling projections were :
Do nothing - 81% of people would be infected 510,000 would die from COVID-19 by August.
Mitigation - 250,000 deaths and completely overwhelm intensive care in the NHS.
The experience of Italy's severe problems in dealing with the rapid spread of COVID-19 was used as supporting evidence for the projections - by March 17th the official Italian COVID-19 death toll was 2,185 and rising rapidly by over 300 a day and still rate accelerating. The UK government therefore decided to change tack and on 23rd of March moved to suppression rather than mitigation and implemented a “lock down” i.e. closing all schools and non-essential businesses, banning all non-essential travel, all public events etc. This was similar to the policy implemented by Italy a couple of weeks earlier, by China in February and being adopted by many, but not all countries world wide.
It was hoped that the lockdown could reduce the number of UK deaths caused by COVID-19 and “a very good result" would be limiting the deaths to 20,000. As it has turned out the impact of COVID-19 on the UK compared to on Italy has been worse, both in terms of deaths per million and total UK deaths now reported as over 42,000.
I should point out that for the comparisons I'm using,despite their limitations covered in Part 1, the figures for officially reported COVID-19 deaths. I consider that as they are consistent with the available excess mortality statistics they are suitable for drawing relative comparisons i.e countries with higher EM also have higher reported COVID-19 deaths. They also provide a more detailed picture of how events have unfolded over time (and also the data on excess mortality is simply not readily available for one of the countries I compare the UK with).
Note: All graphs shown are from the excellent Oxford University Site, "Our World in Data", where you can select the specif data you want to plot. Example as per link.
 |
| COVID-19 Reported Deaths per Million - UK vs. Italy |
However some EU countries have had vastly lower levels of deaths than those experienced in the most severely affected countries i.e UK, Italy, Spain, France, Belgium and the Netherlands. In particular Greece has fared remarkably well as shown below :
 |
| COVID-19 Reported Deaths per Million - UK vs. Greece |
So why the huge difference? A possible often cited and certainly, given experience on how previous epidemics have been controlled, credible explanation is that it was because Greece had implemented a lock-down faster than the UK and Italy. Greece closed schools as soon as the 3rd death in Greece from COVID-19 was confirmed, non-essential shops the day after and banned non-essential movement 9 days later. The UK took two weeks from the 3rd confirmed UK death before banning non-essential movement and closing schools. For details of the various lock downs and when they were implemented see here:
https://www.politico.eu/article/europes-coronavirus-lockdown-measures-compared/
However, some European countries did not implement a lock-down. Sweden in particular came and still comes under heavy criticism for not doing so and it was widely claimed they were recklessly ignoring "the science". A comparison with the UK however shows that the outcome to date in terms of deaths per million has been lower in Sweden than the UK .
 |
| COVID-19 Reported Deaths per Million - UK vs. Sweden |
Even more surprising is a comparison with Belarus with a population of 9.45 Million similar to Sweden. Belarus did not implement any form of lockdown and has received wider and harsher media criticism and claims of virus "denialism". As it has turned out the reported situation in Belarus is actually much more comparable to that of Greece and vastly better than the UK and Sweden
 |
| COVID-19 Reported Deaths per Million - UK vs. Belarus |
Comparison with Modelling
If we simply scale, to allow for their smaller populations, the early March UK modelling projections of UK COVID-19 deaths to the strategies applied by Sweden and Belarus we get.| Projected Deaths - note 1 | Sweden | Belarus | UK |
| Do Nothing | n/a | 69,690 | 500,000 |
| Mitigation only -note 2 | 37,000 | n/a | 250,000 |
| Suppression (lock down) | n/a | n/a | 20,000 - note 3 |
| Total reported to date | 5,053 | 331 | 42,000 |
note 1 The modelling projections always acknowledged they were based on a number of uncertainties
note 2 The Swedish strategy implemented was not as severe as the UK proposed mitigation strategy
note 3 As above the 20,000 figure was essentially only ever a hope
We will never know what would have happened in UK if we had not implemented or only implemented a less severe lockdown strategy.
If we reverse the logic and scale the Belarus experience to the UK then doing nothing hypothetically should have resulted in only 2375 UK deaths. Despite my significant misgivings about the accuracy of officially reported COVID-19 deaths (see Part 1) a death toll of only 2375 in no way aligns with the reality of the huge increase in UK excess mortality that has occurred and there is no credible argument available to explain how the suppression tactics adopted in the UK could have resulted in a much higher COVID-19 death toll relative to doing nothing
However see Part 3 for further discussion on this point since excess mortality that is not directly due to COVID has increased substantially - 12,900 above the the 5 year UK average by 1 May 2020 - as reported and discussed in the official UK statistics published by the ONS where it is clear, albeit not stated as such, that this increase may be due to both direct and indirect consequences of the "lock down" itself rather than COVID-19.
Conclusions
The vastly differing experiences of countries in dealing with COVID-19 are still not properly understood and no convincing (see Part 3) explanations have been put forward as to why the lack/limited level of lock-downs in Belarus and Sweden did not result in a much higher death toll.
note: I hope it goes without saying that i don't consider it credible that it's due to "drinking vodka having saunas and driving tractors" https://www.politico.eu/article/belarus-lukashenko-is-defying-the-coronavirus-and-putin/
We still don’t properly understand the new virus nor how COVID-19 will affect a given population.
Part 3 .....
No comments:
Post a Comment