Why are UK numbers so high?

[howdidwegetheremary]

Sorry if this has been asked on other threads.

The numbers of infections and deaths in the U.K., US, Italy, France, and Spain are far higher than anywhere else in the world and this really bothers me.

I know the U.K. was slower to lockdown, didn’t close borders, and is heavily populated but I can’t see how this adds up?

Don’t get me wrong I’m relieved that lots more places are not as heavily affected but how is this?

We are constantly told that the virus thrives through close contact but there are many other countries that are far more heavily populated and live in closer contact than the U.K., US, etc.

Any clue?

Parts of India have unexpectedly recorded falls in death rates amid coronavirus.

All over the world, mortality rates are being scrutinised to determine the true impact of the coronavirus, which emerged in China late last year.

While deaths in some countries have risen sharply in recent weeks, in India the opposite seems to be happening in some places, leaving hospitals, funeral services and cremation sites wondering what is going on.
Central Mumbai, home to some 12 million people, saw the number of deaths fall by about 21% in March compared with the same month of 2019, according to municipal data.

Overall deaths plummeted 67% in Ahmedabad, the biggest city in Prime Minister Narendra Modi's home state of Gujarat, over the same period.

Indian doctors, officials and crematorium employees suspect a drop in the number of road and rail accidents is a major factor.
Accidents on India's chaotic roads killed more than 151,400 people in 2018, according to official data.

Potential causes for variations:

International travel hub- global interconnections
High population density
Very interconnected country, easy to travel across the majority of the country within a few hours. Long distance commuting, meetings, university. Larger countries tend to be more regional.
Timing of half term with travel to north Italy for skiing and other tourism.
Public health (including factors like obesity)
Age structure
Ethnic structure (poverty/ systemic discrimination/ genetic variations in suceptibility?)
Impacts of policy and timing.
Access/ resourcing of health service.
Accuracy and comparability of statistics. Suppression of data in some countries.
Accuracy of testing- Chris Witty has cited problems of accuracy in the earlier stages, hence slower roll out. Is data in other countries distorted if their testing has unreliable results.
Supply chains for PPE production and ability to adapt in the face of global competition for limited resources. The NHS is universal and accessible for all, but procurement procedures are not highly adaptable and flexible!
Wider economic and social costs of various lockdown policies.
Ability to manage future waves of C19.

If the lockdown had been introduced a week earlier, would the public have seen the need and been so supportive? Would so many measures to help protect the economy/ salaries have been introduced ready?

It's still early days and it is surprisingly difficult to make fair comparisions between countries. The full extent of what happened and how well (or not) the situation has been managed will not be clear until vaccines are widespread and societies return to "normal" i.e. no lockdown policies.

The Gov did not mention Herd Immunity. That was the medical officer.
The South East of England is very densley populated, and Key Workers are still commuting into London. They cannot maintain social distance due to the fewer trains, etc.
Also, a lot depends on how the numbers are counted. It is clear that China probably have a much higher number than reported.
My own view is that it would seem that patients should get to hospital and be treated sooner, not with a ventilator, but with oxygen.
This does not cure you, but hopefully keeps you alive until the body has time to fight off the disease.
The total number of deaths include those in hospital, who have been tested for the disease, and then later the ONS figures are added in, which includes those that have died at home, or in a Care Home. This can include those only suspected of CV-19, but may not necessarily have had it.

But if a person can contaminate an are then why is letting anyone from an infected country a good idea?

It’s a bit like worrying about contaminating a dirty swimming pool with a teaspoon of dirty water... We are the hotspot now and have been for weeks, yet I think some people still think of it as a “foreign” contagion festering in less developed locations.

Presumably the few that are coming in are coming for good reason and as likely to observe the rules as anyone else. I don’t really see what purpose additional quarantining measures brings, apart from a load more cost.

Parts of India have unexpectedly recorded falls in death rates amid coronavirus.

Surprising and good that Coronavirus hasn’t seemingly become endemic in India. They seem to be getting the benefits of their lockdown without the associated C19 downsides, from a health perspective of nothing else.

They didn’t... Different countries locked down earlier or later than others. The UK locked down later, and has higher mortality as a result than many other places

No. The reason they locked down earlier or later was because they had reached the same number of cases but at different times

So for example if the scientists say you must lockdown when you reach X amount of confirmed cases, say 1000 or whatever, then this is when each country locksdown, but because some countries are ahead of others in the spread, the date of the lockdown will be different but they are all following the same pattern

It's science based. To start the attempt at the flattening of curve at a specific number of cases, not a specific date.

This is also why the country comparison graphs will say something like 'from the first 10 deaths' for every country and not all from the same date

...the reason Sweden’s numbers have remained low is due the low population density as pp in Sweden has said.

I think this is a red herring. People are not spread evenly throughout the country. The vast swathes of northern 2/3s of Sweden where hardly anyone lives isn’t really of any relevance.

I think the critical factor is how intensively people mix together socially in population centres. In

Sweden they seem to have adopted enough social
distance to prevent an explosion, though if you look at death rates, Sweden’s rose by 50% this week from last week so they aren’t as in control as made out to be. Russia is the only European country to have exceeded this rise.

@Flaxmeadow

That’s simply not true. Different countries did things very differently!

Denmark locked down when it had 500 recorded cases and zero deaths

Italy locked down when it had 12,000 recorded cases and 800 deaths!

Also, there isn’t a universally accepted “scientific”
point at which lockdown should be triggered. Look at Sweden, their “science” led approach hasn’t led to a lockdown at all, despite having over 2,000 deaths and a relatively small population! Even if there were a scientific consensus, politics drives lockdown decisions.

That’s simply not true. Different countries did things very differently

The major European countries, including the UK, have not done things much differently

Italy locked down when it had 12,000 recorded cases and 800 deaths

Er no

Italy locked down on the 9th of March at 463 deaths
The UK locked down on the 23rd of March at 335 deaths

Flax you need to look at a wider scope than just the U.K.

Australia has been locked down for several weeks albeit a less strict one than the U.K.

we have not even reached 100 deaths despite a population of approx 25m.
While our population density is much lighter than yours we still have huge hubs like Sydney where incidence is higher but nowhere near as high as it has reached in similar sized cities in the U.K.

the major differences are

• we closed our borders to anyone bar Aussie citizens and permanent residents weeks ago
• any Aussie arrivals from overseas are put into govt funded enforced quarantine in hotels for 14 days when they arrive
• we have a high rate of testing
• our contact tracing has been rigorous and very successful meaning we have a very low rate of community transmission
• most importantly we started early when spread can be controlled by contact tracing

Now we may get a worse second wave but hopefully by then treatment options will have improved.

Closer to home look at the comparison in deaths between NI and Ireland- same island, different lockdown dates. Ireland have only 2/3s of reported deaths (accounting for population) of NI. The figures are actually worse than that realistically as Ireland are counting all deaths, not just those in hospital. Again the difference? Ireland locked down earlier. The U.K. acted too late.

Flax you need to look at a wider scope than just the U.K

That's what I have been doing, since the middle of January

Australia...

Isn't comparable to Europe in any way shape or form

Closer to home look at the comparison in deaths between NI and Ireland- same island, different lockdown dates. Ireland have only 2/3s of reported deaths (accounting for population) of NI.The figures are actually worse than that realistically as Ireland are counting all deaths, not just those in hospital. Again the difference? Ireland locked down earlier. The U.K. acted too late.

Ireland locked down at the same time as the UK, or within the same week

But they are not comparable anyway. NI has a post industrial landscape, with a more urban and densely populated area than the rural south. The south has less than the population of Yorkshire but with a much larger land mass

Italy is more comparable with the UK. Similar populations, similar land mass and with densely populated urban areas, but also rural areas. Similar road networks and transport hubs too

Ireland had cancelled large events long before the U.K. the two states are very comparable. I have lived in both. Both have a mix of extremely rural areas, large market downs and dense cities with Dublin being much bigger and more densely populated than Belfast.

What happened in Cheltenham please? Probably common knowledge but I am abroad. I have lived there though so would be interested to know.

Ireland had cancelled large events long before the U.K.

Long before? Nope

the two states are very comparable. I have lived in both. Both have a mix of extremely rural areas, large market downs and dense cities

They are completely different. Ireland is more like Scotland

with Dublin being much bigger and more densely populated than Belfast

The city of Dublin has a population the size of Bradford

What happened in Cheltenham please? Probably common knowledge but I am abroad. I have lived there though so would be interested to know.

Cheltenham Festival is a massive annual horse racing event. It started on the 10th of March and I think it lasts 3 days?. The Jockey Club, who organise it, were rightly criticised for letting it go ahead. Bloody stupid idea

Which is much larger than Belfast!

Of course no two countries are directly comparable but it is clear that Boris and co made a few major mistakes.

• allowing Cheltenham etc to go ahead
• abandoning testing and contact tracing too early
• lockdown too late.
• failure to organise sufficient PPE

The death rate in the U.K. is heartbreaking and the world wants to see things improve there as everywhere.
If however you are unable to acknowledge mistakes were made it means you learn nothing from this. Boris’s failure to attend COBRA meetings and ignoring the EU offer of working together to source PPE must at least be seen as a failure by everyone.

Which is much larger than Belfast!

But there are many places the size of Belfast in the UK.

Of course no two countries are directly comparable but it is clear that Boris and co made a few major mistakes.

Yes probably but then many countries have made mistakes. But I still dont understand why Ireland is being compared to the UK. It is much harder to shut the UK down. By population It is a major European country. It has huge international transport hubs, business and commerce centres.

- allowing Cheltenham etc to go ahead

I agree it shouldn't have gone ahead but it is the Jockey Club who organise it not the government. It started on the 10th of March. The lockdown wasnt until the 23rd of March. Incidentally the UK lockdown was 4 days before the lock down in Ireland (27th of March).

- abandoning testing and contact tracing too early

But baxk then there was a lot of disagreement about how effective this is. Whether or not resources would be better concentrated elsewhere. Even now no one is turning up to be tested at the testing hubs that have been set up. One hub had only 4 people turn up in a whole day. Contact tracing is only effective in the early days. For example when the WHO was insisting there was no human to human transmission or that the situation was stabilised. This was weeks after the first cases in the UK and Italy (31st of January)

- lockdown too late.

But earlier than Irelands

- failure to organise sufficient PPE

When? And was that the governments fault or the NHS

PPE is in shortage all over the world

The death rate in the U.K. is heartbreaking and the world wants to see things improve there as everywhere.

Yes it is but so is the death rate in other comparable countries in Europe

If however you are unable to acknowledge mistakes were made it means you learn nothing from this.

I think it has been acknowledged but then also hindsight is a wonderful thing

Boris’s failure to attend COBRA meetings

The prime minister doesnt usually attend COBRA meetings anyway. But Boris was attending them when the WHO was still saying that the virus was contained and under control in China

and ignoring the EU offer of working together to source PPE must at least be seen as a failure by everyone

Don't know what this is about but the EU have done absolutely nothing to help anyone, especially Italy, as far I can see and it hasn't gone unnoticed that they have been conspicuous by their absence. This will be the end of the EU

Ireland is being compared to Northern Ireland which is part of the U.K. And the differences are obvious.
Ireland ordered schools, sports clubs etc to close on 12th March and restricted numbers at all events. Pubs and restaurants closed on the 15th. This was well before similar restrictions in the U.K.

Countries which introduced early testing and contact tracing early have had much lower rates of transmission- yes many of these were in Asia but they are more used to pandemics so lessons should have been learned internationally. WHO advice on this was not implemented in the U.K. when they were still talking about herd immunity.

Adding screenshots from The Guardian re EU PPE and ventilators.

Hindsight is of course 20/20. It is clear from that that the U.K. government put the economy above health. There is no question we will all feel a huge economic impact of this but I know where I’d rather be right now.

@milveycrohn people commuting on the trains are able to maintain social distancing as people in the Home Counties aren't using them to commute in and out of London. Some lines aren't running and those that are have a maximum of 2 people per carriage. People commuting on the tubes, which apart from the Metropolitan line, are in London can't always. It seems mainly those commuting from East and West London have found the current timetable of Sunday services on the tubes hard. (Though if TFL run out of operating funds then they won't even have that.) Talking to the essential workers I know there are a lot more people cycling and driving to where they work.

@Flaxmeadow

Yes, I picked a date a couple of days later than the actual lockdown for Italy by mistake.

My point still stands. One reason why Italy and the UK have had a similar, larger, scale of outbreak (albeit it with some differences) is that they locked down at similar point, which was later in the progress of the virus than most other places in Europe.

Germany, with its somewhat larger population locked down I believe on 22 March when it had “only” 94 deaths.

Also, smaller European countries have same access to science as larger ones. If there was simply a commonly accepted scientific principle that you lock down when you get to a certain proportion of deaths, this would apply as much to Denmark, Czech Republic and a Greece as much as it would to the UK, Italy and Spain. The fact the former three countries to restrictive measures earlier is very likely to a significant factor in tempering the severity of the virus’ outbreak infected in those places.

What I struggle with is even if it was due to the U.K. government’s lack of preparedness, equipment, locking down later than they should have etc., it does not explain why in for example some of other countries such as India, Iran, African countries etc. there have been far less infections/deaths than European countries and the US. Or am I just over simplifying it?

There's so much latent British Exceptionalism/colonialist attitudes when mumsnetters discuss "India, African countries" etc. Most of these countries have extensive experience in handling epidemics, much more so than the UK, plus they followed the WHO advice while our arrogant deputy CMO was mocking it and saying it was only for poor countries which should aspire to be more like is. No surprise we are doing worse than them.

Boris Johnston what a joke do you really want us to believe he was touch and go come on he had a bad cold that looked worse by his appearance and the fact that he chews his words and cant speak properly anyway

some of other countries such as India, Iran, African countries etc.

I’m not sure why you’ve included Iran in your list!

Countries like India will be underreporting. Countries that have done really well at preventing deaths are those who introduced travel restrictions and have good healthcare systems. Take Australia for example. It’s metropolitan healthcare system is Pretty good, far better than the NHS at any rate. They also banned travel from Chiba when the outbreak came to light and have closed external and internal borders. They had a problem with a cruise ship which resulted in several outbreaks but even with that they have less than a hundred dead at the moment.