Counting days

Life in lockdown is one of quiet tedium, for those of us lucky enough to have older kids, a big enough house for everyone to find some space and a garden to disappear into. The weather has been wonderful, warm and dry. The minute this is over, expect it to start raining and drop back 10C.

We’ve been isolated now for two weeks, and by isolation, I mean no contact with anyone outside of a single visit to a very quiet supermarket. By now, surely we’re disease free, yet paranoia about every cough, sneeze or sniffle is profound.

I’ve read that infection to death takes an average of 17 days. With more than that spent locked into our own home, we should feel relatively safe. For now.

Because covid-19 is pandemic, expected to become endemic. We will all be exposed to it, all of us catch it, sooner or later. Later is better not because it can be avoided, but because later means more health service resources available to keep us alive, more nurses, doctors, ventilators etc. It also means more chance of a vaccine though that’s 18 months away as a minimum and no one can stay in their own home, surrounded by their family for 18 months without going mad.

The UK coronavirus death toll is expected to continue to rise for at least two weeks, the government’s chief scientific adviser has said, despite encouraging signs about the rate of infections and hospital admissions. The official death toll understates the numbers because it only counts hospital deaths. Excluding deaths in care homes means the numbers can be misleading.

Pear tree

Sir Patrick Vallance told Thursday’s daily Downing Street briefing that the number of people to have died from coronavirus in UK hospitals had reached 7,978, after the deaths of a further 881 people. It is the second-highest daily total after Wednesday’s record 938 deaths.

Despite the slightly lower figure, Vallance said the peak of the outbreak could still be weeks away. “I would expect the deaths to continue to keep going up for about two weeks after the intensive care picture improves. We’re not there yet, but that’s the sort of timeframe I would expect.”

Presumably the people being hospitalised now, are likely to take a week or two to recover or die.

The chief medical officer for England, Prof Chris Whitty, pointed out that two weeks ago admissions to intensive care were doubling every three days. He said: “It’s now becoming not quite flat, but doubling time is now six or more days in almost every area in the country. That has only happened because of what everybody has done in terms of staying at home.”

Last week the health secretary, Matt Hancock, said the NHS was preparing for at least 1,000 deaths a day, at a time when scientific advisers were forecasting the outbreak to peak at Easter.

The peak was now expected to come in four weeks, after signs that the transmission rate was beginning to fall. New infections continue to fluctuate. On Thursday, 4,344 new cases were recorded, compared with 5,492 on Wednesday, but the day-on-day rise was still higher than three of the previous four days.

Again, the official numbers of new cases recorded in the UK is nothing like the total number, just the number hitting the hospital admissions and they tend to be the people with worst symptoms. It’s estimated that there are roughly 1000 cases undiagnosed for every one that hits the official lists.

James Naismith, a professor of structural biology at the University of Oxford, said: “It is a mercy that the number of deaths reported today is lower than yesterday but on its own, a single day’s number is of no value in judging the pandemic. The continuing volatility in daily figure of announced deaths [due to different reporting periods and delays] makes it almost impossible to identify any trend with certainty yet.”

He added: “If deaths are still following a rapid exponential growth, today’s new deaths would have been expected to be markedly higher than yesterday’s, and the total number of deaths to date would have doubled from that four days ago.

Most, if not all, the deaths reported today will have come from infections before the so-called ‘hard lockdown’. It does seem that the hard lockdown is, as expected, reducing the rate of increase in the number of new hospital admissions.”

But even with the hard lockdown, obviously infections within family groupings, locked down in close contact with each other, are likely to occur. Assuming an average family of four locked down together, infected in the first two weeks of lockdown will take another two weeks to recover or die – maybe four to five weeks total.

And then we have to expect a second wave of infections when we all come out of lockdown.

Though the UK government seems entirely unwilling to discuss how and when such an exit might occur.

With our PM in hospital, and the foreign secretary somehow promoted to take his place (how, why him?) with parliament not sitting over the Easter recess so very little by way of accountability, it’s becoming increasingly unclear who is making life and death decisions for the country in the event of likely conflicting medical advice on when to end the shutdown.

We have the world’s biggest crisis and no one apparently in charge.