Is there light at the end of the tunnel in the global coronavirus crisis?
PUBLISHED: 06:00 29 March 2020 | UPDATED: 08:17 29 March 2020
The UK finally entered lockdown this week after numerous shutdowns – and scenes from Suffolk and beyond show empty streets and abandoned shops, restaurants and cafes.
Scientists advising the government believe measures could be in place for up to six months – but the effects of lockdown are beginning to show, experts said this week.
At the moment, the way ahead is still relatively unclear until we start to see concrete results – but lessons are being learnt from China and Italy, which are both at more advanced stages than the UK.
The lockdown in Hubei province, the original epicentre of Covid-19, was lifted last week after daily new cases began to fall significantly – with the rest of China set to follow on April 6.
Earlier this week, Suffolk County Council leader Matthew Hicks, Labour group leader Sarah Adams and Liberal Democrat, Green and Independent group leader Penny Otton said in a statement that whether this response takes weeks or months, “we are driven by compassion, determination and versatility to do the very best for the people of Suffolk”.
Mr Hicks added: “Everyone in Suffolk must listen and follow this very clear direction from the Government. We must all stay at home unless journeys are absolutely essential. This isn’t about us as individuals. This is about protecting the NHS and saving the lives of our neighbours and loved ones.
“Please, everyone, do what society needs you to do. Our actions today determine the futures of others in the days and weeks to come.
“It’s as simple as that.”
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Some questions about the UK’s actions remain – did we implement tough restrictions early enough?
Using data from the World Health Organisation situation reports and other global health statistics, our analysis compares the UK’s approach to the Covid-19 crisis with steps taken by other affected nations.
How does the UK’s coronavirus fatality rate compare with others?
To work out how many people are dying from coronavirus per 1,000 cases, the number of deaths is divided by the total number of positive cases in a given country or region, and multiplied by 1,000.
This is the case fatality rate.
As of March 27, the UK’s case fatality rate was 52 deaths per 1,000 positive coronavirus cases.
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The USA and Germany have some of the lowest case fatality rates per 1,000 cases, with 15 deaths per 1,000 testing positive across the pond and six per 1,000 in Germany.
Italy and Spain currently have the highest mortality rates from coronavirus, with 102 deaths per 1,000 positive cases in Italy and 77 per 1,000 in Spain.
So why does Germany have such a low fatality rate, and why is Italy’s so high?
If a country only tests seriously ill patients, a higher proportion of these people will die, and therefore the mortality rate from coronavirus cases will appear significantly higher.
Only people who need medical help are being tested in the UK, making the fatality rate in coronavirus patients appear worse than countries such as Germany.
In the initial stages of the outbreak, Germany carried out extensive and widespread community testing.
This early intervention appears to have been successful in identifying more mild cases and allowing contacts to be traced quicker – helping people to be isolated earlier.
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Germany had its first positive coronavirus case on January 27 – five days earlier than both Italy and the UK’s initial positive results – and as of Friday, March 20, it had carried out 2,023 tests per million people.
Italy got its first positive result back on January 31 and has carried out even more tests than Germany (more than 3,000 per million) in the weeks since.
However, the length of time between testing beginning and the first death was significantly longer in Germany, suggesting that intervention techniques such as self-isolation may have been possible earlier.
Much has also been said about the number of acute hospital beds available in Germany – it has 620 per 100,000 population – compared with 227 per 100,000 in the UK (one of the lowest in Europe) and 274 per 100,000 in Italy.
When did other countries bring in lockdown?
The original coronavirus epicentre, China, identified several cases of the unusual virus now known as Covid-19 in December 2019 and alerted the WHO to them on New Year’s Eve.
It was placed on lockdown from January 22 and is set to remain that way until April 6, aside from Hubei province which lifted lockdown this week.
So what happened when China imposed the restrictions? Plotting positive cases and deaths on a line chart allows us to identify a distinctly flattened curve – what the UK hopes to achieve – from March 7 onwards, with numbers of cases rising at a much slower rate than the rapid rise in February.
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However, the spike in positive cases and deaths in China came after its lockdown began – a trend which has been observed in Italy and is beginning to emerge in the UK.
Lockdown was imposed when 25 positive cases were identified in China, compared with 463 cases in Italy and 335 in the UK.
All pubs, bars and restaurants were shut down and social distancing measures rolled out in England on March 20, when 171 people had tested positive for the illness.
How long will the UK lockdown last?
Earlier this week, Public Health England’s deputy chief medical officer Dr Jenny Harries said it could be several months before we come out of lockdown.
She said social distancing measures are starting to have an effect on the growth of coronavirus in the UK – but added “we must not take our foot off the pedal”.
The full effects of the UK’s lockdown are unlikely to be felt in intensive care units for at least a fortnight after it was enforced on March 23, experts said.
But Dr Harries would not be drawn on a precise timing for when the peak of the epidemic would hit the UK, after experts predicted on Wednesday it was two to three weeks away.
“We are only just starting to see a bite in the interventions of social distancing that have been put in place, it would be far too early to predict that,” she said.
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“I think we are starting to see some helpful movement.
“What we would be looking for is a change in the slope, rather than it being a very steep curve upwards we would be looking for it to be a gentler slope but we must not take out foot off the pedal.
“People have been really co-operative and I think in the last few days the public have really understood that this is something very serious and their actions wherever they are will save lives.
“So, it’s too early to say yet but starting to move in the right direction.”
On Wednesday, Professor Neil Ferguson, from Imperial College London and one of the scientists advising the Government, said that if current measures continue, intensive care demand will peak in two to three weeks and should decline after that.
Will social distancing help to ‘flatten the peak’?
Experts at the Scientific Advisory Group for Emergencies (SAGE), upon whose advice the government is basing its coronavirus measures, suggest actions taken to reduce social contact would be expected to flatten the peak of the UK epidemic, and extend it to some extent.
It is predicted that more stringent measures – such as the current lockdown – will have a greater impact and reduce transmission rates from person to person even further.
On March 16, a consensus published by SAGE showed scientists agreed that adding social distancing measures and school closures to case isolation, household isolation and social distancing of vulnerable groups would be likely to control the epidemic when enforced for a long period.
They also said there may be a two to three week delay between measures being put into place and their impact being felt in intensive care units.
The number of new coronavirus cases per day in China has reduced significantly in recent weeks – hence the flattened curve on the cumulative graphs featured above.
When plotting the number of new coronavirus cases per day on a graph (see the two China-specific charts above) a bell curve appears – and shows a significant fall in the number of new daily cases and deaths throughout lockdown.
So is there a light at the end of the tunnel?
The government is set to monitor how long the current lockdown is in place – with an initial period of three weeks anticipated, though this could be extended depending on changes in cases and deaths.
This is because they will not know if the lockdown and other measures have had an impact for at least a fortnight.
What we have learned from China is that the number of daily cases and deaths have reduced significantly and appear to have ‘peaked’ – though it remains to be seen if the number of cases will begin to rise again.
For more information on SAGE, visit the Government website.
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