Ben Lowry: Milestones in virus spread suggest grounds for hope but protecting the vulnerable will still be a long haul

Three of them are somewhat reassuring, and one is perhaps less so.

• The first milestone is that it is four weeks to the day since deaths in Italy, one of the worst hit countries, began to plateau.

Deaths are the best figures we have, because case total figures are almost meaningless (they just reflect varying testing methods).

On Saturday March 28 news bulletins led with news that 800 people had died in Italy in a day. Deaths had been spiralling there and in Spain, but each of the five days in Italy after March 28 had a lower death toll.

The numbers of fatalities then moved up and down between 700 and 900 for two weeks, and then began to fall two weeks ago. I noticed that on days it rose TV news breathlessly reported the rise, and on days it fell they cited another statistic, such as overall death totals, almost as if to make it sound bad.

The toll was awful, but far below worst case scenarios which would have been 2,000 deaths daily. Yet many news reports on Italy wrongly used the word exponential (steeper and steeper rise) after March 28.

Incidentally, the UK came out of exponential rise two weeks ago and has hovered between 700 and 980 daily deaths since April 4. Yet the BBC 6 O’Clock news last night led with the misleading headline that the number of deaths “keeps rising” (it does, but at an ever slower pace).

• The second milestone is that it is also a month since an article (see link below) in the Canadian newspaper National Post by two infectious disease specialists who had experience of tackling SARS 2003.

The passage of time means that we are better able to assess the validity of their arguments.

The article was unnoticed in the UK and I only saw it when an old school pal who lives in Vancouver sent me it.

The pair said draconian measures cause unnecessary harm and described school closures as “a sledgehammer approach that will affect mainly able-bodied workers, children and students for whom Covid19 will be nothing more than a cold. It will put a huge segment of the workplace out of commission”.

They said testing and tracing “devotes enormous resources to finding cases that are largely mild and spontaneously resolving”.

Their arguments were persuasive but I wondered who to believe because other voices (such as The Lancet medical journal editor) were demanding much tougher action.

But the Canadian article has aged well because most nations are now moving the way the two experts advised, away from lockdown as economically ruinous towards a focus on protecting the vulnerable.

Even the Canadians’ testing and tracing point has held up better than it might seem.

Germany and South Korea tested early, but even Germany did not try to test everyone in the population randomly as some politicians want (which would take months, after which the virus might have swept the country and many people had recovered).

• The third milestone is the remarkable fact that the number of patients in hospital even in badly hit London is falling, without needing the new Nightingale hospital.

I wrote about this during week (see link below), since when I have heard of doctors, two in Belfast and one in London, who have been drafted to the Covid-19 frontline but have nothing to do. Note that the entire Belfast City Hospital tower block has been emptied, as well as half of UK NHS hospital beds.

So while such clearing beds was an entirely prudent step, given the risk from Covid-19, we might soon need to revise allocation radically back towards the norm, given the growing evidence that people are now dying from other conditions that are not being treated. Statisticians are now seeing an increase (of perhaps low hundreds a day) of non Covid-19 UK deaths.

Everyone says this is due to social distancing, as common sense suggests. But it is curious that Sweden never went into lockdown and has not lost control of spread.

• The final milestone is a new study of Dutch blood donors, that found 3% of them had antibodies (ie they have had Covid-19). There is no accepted antibody test so this is the first clue as to extent of the spread.

The Netherlands has a similar death toll per person to the UK, so it is reasonable to assume a similar 3% penetration of the population here (which would be two million of the UK’s 67 million people).

That is far above the 109,000 UK recorded cases, and shows such official numbers to be junk (109k would have meant only one person in 650 had it and anecdotal evidence alone showed infection was far more common than that).

But I was hoping far more than 3% of the population was infected, maybe even 10% or more. If so it would have meant fewer died than the oft cited one in 100 die figure.

But the Dutch figure, if it is representative (it might reflect the position far earlier in the cycle) and if such an infection rate applies to UK, would seem to confirm a 1% fatality rate (1% of 2 million is 20,000 dead, roughly the UK tally if community deaths are added to the 14,700 in hospital).

[Since this article was written on Friday for the Saturday print edition, a Stanford university study has found that 4% of people sampled in an area of California had antibodies, from which they conclude that the death rate of that infected 4% sample is well under 1%]

Ten per cent infection levels would also have been better because it is far easier to get from 10% of people to 60% (‘herd immunity’ level, where so many people are immune that infection chains begin to be broken) than from 3%.

People scoff at herd immunity but this week the German chancellor Angela Merkel explained that if Germany cut infection rates so that every infected person infected 1.1 people instead of 1.3, their health service would go from being full in June to not being full until October.

That could be seen as an argument for controlled spread of Covid-19.

I suspect schools should have closed later than they did and should reopen soon, and run into July to make up for last time. But if so there are risks – children are overwhelmingly OK from Covid-19 but could infect grandparents so it might mean months of separation.

That is another emerging trend – deaths are, even more than was realised, massively skewed to the very old or people with serious health issues.

• Ben Lowry (@BenLowry2) is News Letter deputy editor

• Ben Lowry: It is good that the NHS is nowhere near as badly hit by Covid-19 as feared but other patients might be dying

• National Post article

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