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Update of Elusive Government Report on Collateral Lockdown Damage

Story on the front page of today’s Telegraph – 08 August 2020

Readers will recall that on July 21st I asked them for help in tracking down an elusive Government report. This was the analysis done by the Department of Health and Social Care (DHSC), Office for National Statistics (ONS), Government Actuary’s Department (GAD) and the Home Office (HO) of the collateral damage of the lockdown. Eventually, I tracked it down – it was published with absolutely no fanfare here. The only reason it came to public attention is because Sir Patrick Vallance referred to it in passing when testifying before the House of Commons Science and Technology Committee on July 16th.

Well, yesterday the Government published an update entitled “Direct and Indirect Impacts of COVID-19 on Excess Deaths and Morbidity”– and, thankfully, it was picked up by the Telegraph (see today’s front page above). This update was presented to SAGE on July 23rd, but it was only published yesterday.

The headline news is that the lockdown killed two people for every three that died of COVID-19 by the beginning of May. However, when you take into account the age of those who died from coronavirus, as well as their underlying health conditions, the loss of life as measured in Quality Adjusted Life Years, or Qalys, for those who died as a result of the lockdown was greater than it was for those who died of COVID-19. This is how the authors of the report put it:

The direct COVID-19 deaths account for the majority of all excess deaths. However, when morbidity is taken into account, the estimates for the health impacts from a lockdown and lockdown induced recession are greater in terms of QALYs than the direct
COVID-19 deaths. Much of the health impact, particularly in terms of morbidity, will be felt long after the pandemic is assumed to last…

According to Sarah Knapton, the Science Editor of the Telegraph:

The estimates show that 16,000 people had died through missed medical care by May 1st, while coronavirus killed 25,000 in the same period.

The figures include 6,000 people who did not attend A&E at the height of lockdown because of fears they might catch the virus and the feeling they should remain at home because of the “Stay Home, Protect the NHS, Save Lives” message.

Likewise, 10,000 people are thought to have died in care homes due to early discharge from hospital and not being able to access critical care.

The article includes some choice quotes from the President of the Royal Society of Surgeons:

Professor Neil Mortensen, the President of the Royal College of Surgeons of England, warned that the health service “must never again be a coronavirus-only service”.

“We have to deal first with the most clinically urgent patients, and then as soon as possible with those who have been waiting the longest,” he said. “The period through August and September is vitally important in making progress before routine winter pressures emerge.”

Pretty damning, but before you pop the champagne corks with cries of “finally!”, a caveat. The authors of the report claim that the Covid death toll in an “unmitigated scenario”, i.e. a scenario in which the Government did nothing to encourage social distancing and people carried on as normal, would have been a whopping 1.5 million!

It should be noted that the health impacts modelled here represent a scenario with mitigations in place. Without mitigations, a far larger number of people would have died from COVID-19 such that the QALY impact from COVID-19 deaths would be more than three times the total QALY impact of all the categories (mortality and morbidity impacts) for the CSS mitigated scenario presented here. A comparison with an unmitigated scenario 3 is provided in Annex G and shows that mitigation have prevented up to 1.5m direct COVID-19 deaths.

Total balls, obviously. The relevant counter-factual is not this fantastical “unmitigated scenario”, but a continuation of the mitigation strategy put in place by the Government on March 16th in which people were encouraged to observe modest social distancing measures, with quarantining restricted to the infected, the elderly and the vulnerable. As even Chris Whitty now admits, this strategy proved effective and the number of daily cases was falling before the full lockdown was imposed on March 23rd. The real question is “Did the full lockdown prevent more loss of life than it caused?” and, thanks to this report, we can conclude with some confidence that it didn’t.

Source: Lockdown Sceptics

Notes: Bellow it’s the Telegrph original article in full

Lockdown ‘killed two people for every three who died of coronavirus’ at peak of outbreak – By Sarah Knapton, SCIENCE EDITOR, 7 August 2020 • 7:04pm

The UK lockdown killed two people for every three whose deaths had been caused by coronavirus by the beginning of May, new Government figures suggest.

The estimates show that 16,000 people had died through missed medical care by May 1, while coronavirus killed 25,000 in the same period.

The figures include 6,000 people who did not attend A&E at the height of lockdown because of fears they might catch the virus and the feeling they should remain at home because of the “Stay Home, Protect the NHS, Save Lives” message.

Likewise, 10,000 people are thought to have died in care homes due to early discharge from hospital and not being able to access critical care.

The report also found that 2,500 lives may have been saved during lockdown because of healthier lifestyles, fewer infectious diseases in children, falls in air pollution and a decrease in road deaths.

The new figures – presented to the Government’s Scientific Advisory Group for Emergencies (Sage) in the middle of July – were calculated by the Department of Health, the Office for National Statistics (ONS), the Government Actuary’s Department and the Home Office.

The paper also estimates that a further 26,000 people could die by next month because of the healthcare restrictions.

In total, researchers predict that 81,500 people could lose their lives in the next 50 years through waiting longer for non-urgent elective care and the impact of the recession caused by the virus crisis.

In the next five years, 1,400 people are also expected to die because they were diagnosed with cancer too late.

Although the medium to long-term deaths from delayed healthcare have not been quantified, an earlier report by the same team suggested they could be as high as 185,000.

The report is the latest to show that the impact of lockdown has been severe, and puts more pressure on the Government to avoid further nationwide restrictions this winter (see video below).

Charities and medical organisations have consistently warned of the long term dangers of focusing so much of the NHS on coronavirus.

Professor Neil Mortensen, the president of the Royal College of Surgeons of England, warned that the health service “must never again be a coronavirus-only service”.

“We have to deal first with the most clinically urgent patients, and then as soon as possible with those who have been waiting the longest,” he said. “The period through August and September is vitally important in making progress before routine winter pressures emerge.”

New reproduction estimates for the pandemic, published by the Government on Friday, suggest the ‘R’ number is slightly higher across Britain than last week – now at between 0.8 and 1.0, up from 0.8 to 0.9 last week. The rate for England has remained unchanged at between 0.8 and 1.0.

The figures also estimated a growth rate of between 0 per cent to -5 per cent, meaning the number of new infections is somewhere between remaining stable and shrinking by five per cent every day.

The data is based on testing data, hospital admissions, intensive care admissions and deaths and is around two to three weeks behind the current situation, suggesting this was the picture in mid-July.

Sage said it was not confident that the ‘R’ number was currently below one but warned that the indicator is less useful in determining the state of the epidemic when disease incidence is low or where there is significant variability in the population – for example during local outbreaks.

Professor Keith Neal, emeritus professor of the epidemiology of infectious diseases at the University of Nottingham, said: “Making estimates of ‘R’ with small number of cases becomes increasingly difficult and inaccurate, hence the wide range of the estimates.

“For many parts of the country, infection rates continue to fall, but caution and avoidance of high-risk mixing needs to continue.”

The latest surveillance figures from the Office for National Statistics (ONS) Infection Pilot Survey also suggest cases of coronavirus are now levelling off or falling.

Last week, ONS swab testing suggested that 1 in 1,500 people were infected – a slight rise from the previous week, and one of the reasons that Boris Johnson called a halt to the lifting of more restrictions (see video below).

However, Friday’s results suggest cases have fallen to one in 1,900 for the week of July 27 to August 2, with an estimated 28,300 infected – down from 35,700 the previous week.

Katherine Kent, the co-head of the survey, said: “Although we are still reporting an increase in England since the lowest recorded level of infection in late June, this week’s estimates suggest this trend may be levelling off when compared with the data we published last week.”

Surveillance data from Public Health England also said the virus appeared to be stable. Case detections in England were stable at 4,605 this week compared to 4,625 the previous week.

On Friday, the Government said 46,511 people had died in hospitals, care homes and the wider community after testing positive for coronavirus in the UK. Separate figures, published by the ONS, show there have now been 56,600 deaths registered in the UK where coronavirus was mentioned on the death certificate.