Utter Madness: The UK’s Covid-19 Plan

I was anxious when I thought the government didn’t have a plan for dealing with the Covid-19 epidemic. 

I was even more anxious when I’d actually read their plan

“DELAY Covid-19?  ‘FLATTEN THE CURVE’?  Are you stark, staring MAD?  It needs to be ERADICATED, the same as it has been in China.”  That’s what I’m thinking.  Why isn’t everyone else? 

Perhaps there’s a parable I’m blissfully unaware of: “If you see a lion, run away as fast as you can”, says the wise man.  “So I won’t get eaten?”, says the fool.  “No, don’t be stupid, you’ll still get eaten.  But you’ll delay it!”

The UK government apparently intends to let the Covid-19 epidemic run its course, trying only to prevent all the cases occurring in a short period of time and to protect the most vulnerable (which will be very difficult). 

Epidemiology 101 tells us that, without significant action to prevent it spreading, a virus as infectious as that which causes Covid-19 will infect 50-80% of the population before it dies out because it finds too few people who haven’t had it already and have therefore developed immunity.  At this point the population would have developed “herd immunity”, though small outbreaks would still be possible.

But it is now blindingly obvious that any health service on the planet will be totally overwhelmed if more than a few percent of the population it serves become infected with the coronavirus.  NHS professionalism and dedication will not be enough to save us.  It’s a numbers game.  It’s not the Battle of Britain where the Few can prevail.

We will therefore soon be forced to go into lockdown just as China and Italy have, when our hospitals can no longer cope with the number of Covid-19 cases.  But at this stage only a few percent, at most, of the UK population will have been infected.  The vast majority of the population will not have been exposed to the virus and will have no immunity, so there will be nothing to stop further waves of the epidemic, until a cure or vaccine becomes available.

Since we’re going to have to do it anyway, why isn’t the UK government taking decisive action now to minimise further transmission of the virus, with a view to eliminating it from the country altogether?  Coupled with a better understanding of the extent of the global pandemic and more effective travel protocols, together with much greater use of testing and contact-tracing than we have been able to employ so far, we should then be able to stamp on any further outbreaks, as China is already doing.  Especially if the rest of the world takes similar action.

Is it something in our culture, perhaps epitomised by Monty Python’s Black Knight?  Or maybe the British Brexit establishment simply believes we really do have nothing to learn from the rest of the world, like Blackadder’s ship’s captain

Or, conversely, is it a lack of confidence in our abilities?  After all, we haven’t stopped a pandemic since the Great Fire of London halted the plague in 1666.  And that’s not even true!  Hang about, though – SARS has been eradicated and MERS and Ebola have been contained.  Most importantly, China has rolled back Covid-19.  Surely we can do it too!

“Psychological reasons” have been cited for not enacting strict lockdown measures immediately.  It’s been suggested, for example, that people will only put up with restrictions on their liberty for a certain amount of time.  Poppycock.  The relevant psychology is that, once we start taking the necessary drastic steps, we’ll not want to stop until we believe the epidemic has really gone away (ref.: China, once again).  And the sooner we start, the fewer people will already be infected and therefore the shorter the time for which we will need extraordinary measures.  So the least-cost solution is to start now.  There are no trade‑offs.

A further clue to the government’s thinking comes from the evidence the Chief Medical Officer, Professor Chris Whitty, gave to the Health and Social Care Select Committee on 5th March.  The Committee Chair, Jeremy Hunt, asks (22:47 into the iPlayer program): “What is the overall prevalence rate in Hubei province?”

Whitty replies: “The reported proportion is probably somewhere around 20%.” [my stress]

The first time I listened to this I thought the Professor was trying to say that 20% of the population (of Wuhan?, of Hubei?) had been infected.  But that bothered me, because I couldn’t reconcile that figure with a mortality rate of around 1% which Whitty had suggested earlier in his evidence, given that the population of Wuhan alone is over 10 million and 1% of 20% of that is 20,000 (the population of Hubei province is around 60 million).  China has reported only about 3,000 deaths. 

The second time I listened, I thought, oh, he means only 20% of the actual cases have been reported, so there weren’t just 80,000, there were more like 400,000, and the mortality rate was not therefore 3.4%, but a fifth of that, around 0.7%.  That would imply up to 4% of the Wuhan population had been infected (though the true proportion may be significantly less and the mortality rate somewhat higher because the figure of 80,000 cases is for the whole of China, not just Wuhan or even Hubei province).  That’s plausible.  At least the numbers “stack up”.

But the third through tenth times I listened to Whitty’s whole reply to Hunt’s question I understood that he really believed that Wuhan at least had had an infection rate of 20%. 

So, has someone told Whitty the “reported proportion” in Wuhan (or Hubei – Whitty’s answers are vague on what area they refer to) was 20% and he’s taken that to mean the infection rate was 20%?

Are the UK government’s decisions about the country’s Covid-19 epidemic based on a misunderstanding of what the “reported proportion” referred to? 

Incidentally, even if Wuhan did have an infection rate of 20% and that is somehow enough to limit the spread of the virus (contrary to previous epidemiological experience), there are enough minimally exposed populations elsewhere in China to sustain many other Covid-19 epidemics of a similar scale, since 20% of the population of Wuhan is only around 0.2% of the population of China. The epidemic in China was not checked because it in any way ran its course.  It was stopped solely by the Churchillian efforts of that country’s people.  We must do something similar.