UK may be worst-affected country in Europe
Should Britain’s virus response get the wooden spoon? A government advisor warns that, despite its famed National Health Service, it could be a case study for poor public health management.
Just a few weeks ago, it all seemed so reassuring. The coronavirus was just like a bad flu. Britain was extraordinarily well prepared. It was lucky to have the world’s best scientists and doctors – and the world’s most advanced research labs. It was a nation with a superbly efficient civil service. And then of course, the NHS – the envy of the entire globe.
How swiftly things have changed. “The UK is likely to be certainly one of the worst, if not the worst-affected country in Europe,” said Sir Jeremy Farrar, director of the Wellcome Trust and a senior member of the government’s official scientific advisory committee, as the nation’s death toll passed 10,000 on Sunday.
The graph above, representing blue-chip data from the World Health Organisation, shows how the UK is surging up the per capita charts compared to other stricken countries.
It is likely that the highly-regarded Johns Hopkins University database will show the UK’s case fatality ratio, later this week, as the worst in the world. Yesterday, it was just a tiny 0.1% behind Italy and Belgium, tied at equal-worst.
This situation has left many global experts and commentators slack-jawed with amazement. What on Earth, they say, can be going on?
Not enough testing? Many experts look to Germany, where the death toll has only just risen above 3,000. There, widespread testing was used early to isolate cases and stop the virus from taking hold. The UK is weeks behind.
Too slow to lockdown? Countries that began social distancing early have been more effective at controlling the epidemic. Ireland cancelled all its St Patrick’s Day events at the same time that Britain went ahead with sports events and the Cheltenham Festival. A month later, the UK’s mortality rate is twice as high as in Ireland.
Is the NHS up to the task? It may have saved the prime minister and let no one doubt that Britain loves its NHS. But critics are beginning to think the unthinkable: could the NHS – the biggest employer in Europe and the fifth-biggest in the world – be part of the problem? Is it simply too big, bureaucratic, and complicated?
After all, case fatality ratio – at least, partially – measures the effectiveness of a health service. And it is countries, like Switzerland and Germany, with smaller, privately-run healthcare systems that are doing best so far.
So, should Britain get the wooden spoon and hang its head in shame?
Some say there’s no question that Britain’s response has been poor. With major outbreaks in China, Italy, and Spain, the UK had plenty of time to prepare and find the right approach. On 16 March, the head of the World Health Organisation warned that you can’t “fight a fire blindfolded” and the key was to “test, test, test” to stop Covid-19. Germany listened to that advice. The UK, with its mantra: “listen to the scientists”, took a different path.
Others say it is far too early to be handing out wooden spoons and dunce’s caps, and we simply don’t have enough data to draw accurate conclusions. It takes weeks for the full story to show in the statistics. Not only are countries testing and reporting differently, but experts believe there will be a second and even third wave of infections later in the year. This is a marathon, not a sprint.
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Some People Say...
“An unsophisticated forecaster uses statistics as a drunken man uses lamp-posts – for support rather than for illumination.”Andrew Lang (1844-1912), Scottish writer
What do you think?
Q & A
- What do we know?
- There are many ways to measure the current state of the epidemic. In the UK, 88,621 people have tested positive, of which 11,329 (12.8%) have died. But since some countries are much bigger than others, experts prefer to look at the mortality rate. In the UK, 16 in every 100,000 people have died. And because each country is at a different stage of the epidemic, researchers count “days from the first case” to make comparisons between countries.
- What do we not know?
- Even after we take all this into account, there are still many factors that help or hinder the virus and our attempts to stop it. For example, older populations living close together in big cities are going to be worse affected. We have years of experience studying how other diseases behave, but less than four months of information about Covid-19. So, we can expect heated debate between experts and scientists about how important all these factors are and whether the UK could have done things differently.
- Sir Jeremy Farrar
- A professor of tropical medicine, Farrar is a member of the government’s Scientific Advisory Group for Emergencies (SAGE), which is the body of experts advising the government on its response to Covid-19.
- Of the highest quality.
- Per capita
- For each person.
- Case fatality ratio
- The proportion of infected people who die from the disease, not to be confused with the mortality rate. When there is a shortage of medical supplies, such as ventilators and oxygen, this rate rises dramatically.
- With your mouth open in surprise.
- There are two types of test: antigen tests tell us whether a person is currently infected; antibody tests identify people who have had the virus and now have immunity. Whilst Germany is doing half a million tests a week, the UK is still only testing less than 20,000 a day.
- Social distancing
- The first UK case of the virus was on 28 February. The government first advised that the vulnerable should self-isolate on 15 March and did not order a nationwide lockdown until 23 March.
- Cheltenham Festival
- The four-day festival of horse racing for prize money takes place annually in March at Cheltenham Racecourse in Cheltenham.
- Mortality rate
- Also known as the death rate. This measures the proportion of the general population dying of the virus. For example, as of Saturday, there had been 14.81 deaths per 100,000 people in the UK, but only 6.5 deaths in Ireland.
- The NHS employs 1.5 million people and is a very complex organisation with many layers of administration. This makes it difficult to make decisions quickly and respond to quickly changing events.
- Wooden spoon
- An award that is given to an individual or team that comes last in a competition.
- Dunce’s caps
- Tall, cone-shaped hats that, many years ago, students who made lots of mistakes, or were slow or lazy, were made to wear as a punishment in school.