If the NHS isn’t overwhelmed, why aren’t our death rates better than Italy?

[CarolynMartens]

Totally prepared to be told I am stupid! We are 2 weeks behind Italy and their system was overwhelmed - but I keep reading the NHS isn’t at full capacity or overwhelmed. In 2 weeks it seems likely we’ll reach the figure they’re at now. Should it not be lower?

I know there are discrepancies between the way countries count deaths.

@bool
Thanks, yes it drives me mad, they are just looking for tomorrows soundbite. Its very depressing hearing them talk and knowing people will believe what they write. One classic was when Jenny Harries clearly (as she always does) explained we will still have the problem in November and the journalist one minute later said " Are you saying we will be in lockdown in Nov"

Maybe Delatron is an ICU consultant

Worst case combo of everything pp have said would be my guess:

• international travel permitted for too long
• no screening at arrivals
• lock down too late
• lock down really only partial lock down
• not enough PPE to prevent the spread where people had to work closely
• people not going into hospital until it's too late, sadly

It is really shocking that people are being told not to come in until they are blue. A former colleague of mine wrote about his experience, he really thought he was going to die because it was so difficult to breathe and his BP was through the roof, but he was told multiple times he should not go to hospital. Thankfully he pulled through but he is young and healthy, an older person might not have.

I'm in Germany and someone in his condition would have been in hospital. My DH knows two doctors treating corona patients in hospital here and they both say that Germany has had fewer deaths because they had the capacity to admit many more people and get them on oxygen sooner.

There was a very interesting article in the New York Times last week from a doctor treating patients, explaining why it's so important to treat people with oxygen earlier in order to avoid ventilation and death:
www.nytimes.com/2020/04/20/opinion/sunday/coronavirus-testing-pneumonia.html

Eventually they will find all sorts of reasons why there are such huge differences between countries, but it's not unreasonable to suspect that delayed treatment will lead to worse outcomes.

He classic on the BBC this morning was a journalist continually asking why the UK numbers were so high. I have no idea what she was comparing our numbers to. Life without a pandemic? Another country with a population half our size? She kept going on and on and I really didn’t understand what her point was. We are in the middle of a pandemic. People are going to die. We need to manage that as best we can together. The guy she was interviewing then started to answer he question by saying that Germany records its deaths differently as there is no standardised WHO way of recording deaths. She interrupted him and said - I don’t want to hear about other countries!!! I really then didn’t understand her point and on what basis she thought the UK numbers were high. I switched off. And that was the BBC!

Another agreeing with @BigChocFrenzy

The lockdown enabled the NHS to free up capacity by cancelling electives and other treatments. This is why we are seeing empty hospitals regionally.

Treating people too late and allowing a call handling service to decide whether threshold is met for admittance. .

@MaggieFS I really would love to understand what you think lockdown is for. Lockdown is to slow the stream of people being treated in hospital. When or how hard will only affect the death rates if the hospitals are overwhelmed. Which they aren’t. So with that logic we actually locked down too early and too hard.

Nobody said vitamin D was a cure for the virus. The point is that D deficiency is well established to put you at risk of severe respiratory problems caused by viruses and new research (the Indonesian paper that came out yesterday) is suggesting it puts you at much higher risk of death from covid.

There are big differences in levels of D deficiency between different countries at population level due to various factors (latitude, typical diet, previous health campaigns).

There are going to be a number of reasons for the differences in covid death numbers and this will be looked at as one likely one.

@bool I thought lockdown was to limit the spread of a highly infectious virus. Partial lockdown with somewhat woolly open to interpretation of the rules means more contact than a more extreme lockdown.

@thecountess agree it is likely to be linked. Also why there is a disproportionate number of BAME deaths in the UK vs population %. Vitamin D deficiency may be one reason why.

Sorry, to add, therefore more people will have it and be able to spread it, and more people will have it seriously and end up needing hospitalisation, and/or die from it.

@TheCountessofFitzdotterel air pollution may be another one. Lombardy in Italy has the worst air pollution In Europe. It is on a plain. Also average population age will play a part too. In Germany they are saying that the average age of people catching the virus started lower than other countries - 47 years old vs late 60s in Italy. Because they were skiers coming back from holidays.

As far as I understand, it is because there is no treatment so people will die

@MaggieFS lockdown is to slow the spread so that our health systems don’t get overwhelmed. Death rates will only be affected if people are unable to get the treatment that they need. We have been consistently under capacity so locking down earlier or harder would not make any difference to death rates.

@bool Yep, but I think we'll have to agree to disagree! I said combo because if everyone was then getting adequately treated, then all fine, but as that doesn't seem to be the case, then surely we should have locked down harder, and sooner, to prevent more people getting it - would be my point of view.

The vitamin D thing is interesting. I noticed in France the northern regions are seeing fewer deaths for the most part and it's much more common for people there to take prescription-strength Vit D supplements in the winter (and most children do).

I used to live in the western Loire valley near Brittany, if you saw the GP for any reason in the winter he would give you Vitamin D.

@MaggieFS you don’t think people are getting adequately treated in the NHS? Who told you that?

@dreamingbohemian I never realised how important vitamin D was until this happened and I watched that YouTube video with all the data. As said it is by no means a cure but it does seem to help prevent respiratory disease and if you get a respiratory disease it makes it less severe. That’s what all the scientific studies say anyway.

@bool I am definitely no expert, but there are just so many examples where people have been desperately ill, but apparently not ill enough to be admitted, I don't think that's adequate, and in the absence of any data, IMHO, it's a contributing factor to the Q the OP asked.

The Telegraph reported that elderly patients were transferred from hospital to care homes without being tested for Covid. The motive? To create capacity in hospitals.

a Government diktat that NHS hospitals should move hundreds of elderly patients to care homes has been branded “reckless” and blamed for the homes’ soaring coronavirus death rates. In two damning policy documents published on 19 March and 2 April, officials told NHS hospitals to transfer any patients who no longer required hospital level treatment, and set out a blueprint for care homes to accept patients with Covid-19 or who had not even been tested. Analysis by the Telegraph suggests that the rate of coronavirus deaths accelerated more than twice as fast in care homes than in hospitals in the week beginning 7 April - two and a half weeks after the first policy document was published

Bool if you have a severe vitamin deficiency you can feel absolutely awful, and the pain, oh the pain.

A Whitehall official told the Telegraph that the policy to offload hospital patients was designed as a “stiff broom” to free up capacity in hospitals.But care providers on Friday accused the Government of “reckless” behaviour which had “significantly” increased the number of coronavirus deaths in care homes.Dr Jamie Wilson, founder of Hometouch, which provides care to people in their own homes, said: “I’m astonished at the lack of foresight of these policies. To mandate that care homes should take back Covid-positive patients with such a high risk of cross infection and high mortality rate in vulnerable residents seems unfathomable

Don’t forget our testing figures are nonsense. No-one has been tested unless on deaths door. It will never reflect the Correct numbers
I think earlier testing and earlier treatment would improve the numbers
Also we’re very densely populated

@MaggieFS but is this based on hearsay or fact? I would be very cautious about saying that treatment our NHS is giving patients is inadequate unless you have data to back that up. That’s all.

We leave them at home to die so they aren't included in the figures and the Tories can pretend austerity didn't damage the NHS