20,000 deaths

[unhappyclap]

I have heard on the news that if 20,000 people die from Coronavirus then they would have essentially done a "good job"...What I am confused about is, who do they expect these 20,000 to be? Will these people be those who are not currently social distancing? Those who are key workers and are still working?

20,000 deaths to me sounds horrific, we are already at over a 1000 which is far too many.

If everyone is at home, following the rules then who are the people getting the virus?

The big question that some people are asking is how many of those 20,000 will have died anyway. What is the incremental deaths, no one knows and/or no one can tell us. Isn't it around 30,000 that die of pneumonia each year?

@gavisconismyfriend thanks for pointing that out - reminder for us all. I read that and didn't bat an eyelid but you're right, this word can be hurtful.

The people who were cramming into supermarkets last week will only just be developing symptoms. We have yet to see the deaths from that particular ugly episode or from the people crowding onto beaches and into parks, last weekend.

@doofusmoof I think winter flu does overwhelm the NHS each year, i’m guessing but not an expert, it’s a lot of people in a short space of time with the same illness and patients will need ICU equipment. The problem is no one knows how the numbers will pan out and how long this will go on for. To be honest I think the numbers will be a lot more.

Honestly, LittleRen - it doesn't matter if every one of them would have died in the next year anyway. What we are actually doing is stopping the number being much bigger - so big that the health system cannot cope and people who could otherwise survive die unnecessarily for lack of treatment.

That is the main goal.

And as Gin96 says, sometimes the health system does already get overwhelmed - for example this, last winter... www.bbc.co.uk/news/health-42572116

Yes some will be the workers keeping us going and others will be the family members of and strangers sadly passing by idiots ignoring the advice. There was yet another is it OK if I....threads earlier where no one supported the OP but she flounced off to walk to dog with a cough and a fever.

I think a lot of the deaths will come later from the 7.1milion key workers who are not in lock down. Of course the virus is still circulating. We are staying home to play our part. Sorry to be morbid.

The article that @Oakmaiden has linked is very interesting. Is it fair to say that lockdown and other measures are in place to stop the understaffed and underfunded NHS being overwhelmed and not to save lives? Would this play out differently if the NHS could cope with much higher levels all at once.
It seems a good proportion of the country would have got the virus with or without lockdown, just at different stages. So are lives being saved or deaths delayed?

@marchez I don't understand though, 500k is on average 9.5k a week, the NHS can't be equipped for that. Surely a lot of that 500k just don't require care?

But I agree that the thinking seems to be people will get it, people will die but let's try & spread that over months as opposed to days.

500k could be any death at home/ in care/ accident etc. Those seriously affected by the coronavirus will require beds in ICU with ventilators. This is the issue for the NHS as supply of these is limited.

@leolion81 that's what I assumed that a vast majority of the 500k didn't need care.

So are lives being saved or deaths delayed?

Both.

By delaying some people getting ill (and dying) it means there is less of a pressure on the health service so fewer people will die.

For example. Lets say 100 people catch CV this week. About 20 of those people are poorly enough to go to hospital, and five of those require intensive treatment. We nare lucky enough to have 20 beds in the hospital, and 5 ICU beds, so they all get treated, but one sadly dies anyway.

Now - same hospital, but this week 300 people have caught CV. That means we need 60 hospital beds, and 15 ICU places. If we could provide this only 3 people would die. But we can't - we only have 20 beds, 5 of which are ICU. So we have to decide - which 5 critically ill people shall we put in the ICU beds? If we put in the 5 illest, 3 of them might die anyway, so maybe we shouldn't even try with them? What do we do with the other 10 critically ill? Shall we put them in normal hospital beds? But this probably won't be enough to save their lives - they need far more care to stand a hope of surviving. And then we won't have enough beds for those who are "merely" seriously ill - so we have 50 severely ill people who are now getting no hospital treatment and are getting worse and worse, until they may need critical care too... And, as you can see, they are not getting the care they need so more than the 3 expected fatalities occur. In fact, the chances are at least 10 of them (those who need but won't get critical care" will die.

The options for avoiding this are

1. Make more hospital beds. Which obviously the Government are trying to do. But it will be very hard to create enough beds for what is considered to be the likely peak of an unmitigated epidemic. Or

1. Try to make sure no more than 100 people get ill a week. We will still have 1 persona week die - but we will be able to save all the others who only die if they don't have the right treatment.

Does that make sense?

I know the country can't just grind to a halt and we need those essential workers, my dh is one and I resent it so much. Not because he has to go to work but because some of the people he works with just don't take any notice of distancing rules. Eg people coming over to his desk hanging over him to talk. I am petrified he is going to bring it home :(

I don't understand though, 500k is on average 9.5k a week, the NHS can't be equipped for that. Surely a lot of that 500k just don't require care?

Well, it depends whether the number is actually constant. Due to underfunding, and hospitals that are too small for the urban area they serve, the NHS has an annual struggle every winter, as seasonal flu sweeps across the country.

There are over 1000 hospitals, so if we didn't have seasonal peaks, that would be less than 10 deaths per hospital per week, if they all died in hospital. But you're right, many of them don't need care. People pass away at home, in care homes, and in palliative hospices. But this is hypothetical, because we do have seasonal peaks in numbers of people needing hospital treatment.

I hurd the chief scientist (cant remember his name but its the 1 with cv) said in a report on the BBC on Tuesday that if they did nothing then we were looking at 500,000 extra cv deaths and with the lockdown they hopped to bring it down to 20,000 and that would be a good result.
Also those people who are going to hospital now were exposed 10-14 days ago. We only went into lockdown 5 days ago, so all the people who were exposed in the last 5-10 days plus everyone they have exposed and all the idiots breaching lockdown. That's a lot of people. These people will get sick and may die but worst of all is the fact that they will be going to the shops ect and passing it on to the staff who will pass it on to customers before they know that they have it and directly to other customers.

Unfortunately this is why they are saying 20,000. Personally I think that it will be much higher and I expect London will be hit harder by cv than anywhere else in the UK due in part to the fact that 8 million people live there in very close quarters and they were much further ahead (on the curve) when lockdown came into effect.

Sorry about the spelling and grammatical errors but I'm dyslexic

Why are the numbers so low in Africa?

Probably lack of testing and identifying cases.

Even just popping to the supermarket is risky though isn't it ? I'm pleased to see small supermarkets only letting a couple of people in at once but there are so many hazards - the coin slot on he trolley, the basket handle , the key pad when the contactless doesn't work, the touch screen on the self service, the bargain bin where someone picks something up decides against it then put it back. The risk is everywhere- the bin handle that the bin man has touched, the shopping coming into your house, the take away we had last night because it was dh's birthday and there was no food in the shops. Our hands are raw from washing, dh thinks he has an infection in one of the cuts in his hand, it's just relentless and this is just the start.

Because it's not just the 'flu.

Lots of those that die will be those that don't need to, that could survive if the NHS capacity isn't over-stretched, but will die because thee won't be enough intensive care beds available and doctors are going to have to decide who gets the respirator and who doesn't.

Currently the survival rate for those that need intensive care is 50%.

20,000 deaths was the original "good job" figure, there's modelling today that suggests it could be held under 10k with China style lockdown. Remember that the worst case scenario started at 250,000+ just a few weeks ago.

The 500k includes a lot of elderly people who are already on the NHS end of life pathway. The NHS doesn't get overwhelmed by them because most will have no or little treatment. So my FIL died at home and only had an ambulance to take his body to hospital where he was declared DOA.
An average of 8,000 die of flu, most of whom will already be close to death.

there's modelling today that suggests it could be held under 10k with China style lockdown.

I think the moment has passed for that. China initiated their lockdown after,what, 35 deaths? We waited almost a week longer. That gives our numbers time to double another twice before the lockdown starts to take effect...

@Oakmaiden makes absolute sense, yes. Great explanation. But the worrying thing there is that if you're going to get it nothing will stop that, except you may get it in October not April. But you have a better chance of survival this way.
My understanding now is most of us this won't affect us any differently to a normal winter illness therefore it isn't anything to fear, but for people who it could kill (as with flu) or people who have loved ones who it could kill, it's better for it to be delayed therefore providing them with better treatment and higher survival rate.