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.

I suspect the reason Boris J had it badly is he has a weight problem whereas Prince Charles had it mildly because he has always watched what he ate, eats organic food and is fit and slim.

In my view the obesity epidemic is a much greater threat to Covid 19 then CV.

"Obesity: 67% of UK adult males and 60% of UK adult females are overweight or obese in 2018. Deaths: 541,500 deaths in the UK in 2018, 10,000 more than in 2017."

I am not sure if the above can be right as we have 600,000 deaths a year in the UK. his 40k a year looks more likely www.theguardian.com/society/2019/may/01/cutting-obesity-would-slash-number-of-early-deaths-research-finds

May be we need a new compact between people and state re. the NHS - that you pay if you are over weight.

NoMorePoliticsPlease I agree the press are not helping at times

But having witnessed and trying to care for someone with so called mild symptoms for many they should have been admitted and should they have been presenting such serious symptoms pre covid they would have

What is needed for some that are not admitted is constant medical observation and oxygen available. Many residential caring settings and mh units are having to look after very unwell people without medics around. We are well aware that they will not be admitted unless they are extremely unwell and should they develop an infection it can easily go unnoticed and we are aware how very quickly people can suddenly become seriously in need of medical attention

We should look to Germany not only were they on top of testing and tracing so soon they also have more people being admitted to hospital earlier

it's clear that you are just slowly ramping up to your peak and haven't gotten close to arriving there.

The deaths curve for the UK peaked a couple of weeks ago, and is following almost exactly the same trend as Italy, Spain and France, although have been a little ahead since the beginning.
And no country has reported over 5000 deaths a day so far.

In addition, when you look at deaths per million population, UK is behind France, Italy and Spain, while tracking similar curves, and way behing Belgium which is shooting up much faster.

On the underlying health thing -- I hesitate to write this, because it's purely anecdotal, but having lived in both the UK and Germany, there does seem to be a huge difference in general attitudes toward health. Part of this is at the individual level, in that Germans seem to be much more sporty and active, eat more organic food, but it's also about how society is structured. The roads are set up so it's much safer to cycle, so voila, more people cycle instead of drive. Everything is closed on Sundays so people tend to go for long walks or do sport on those days. There are GPs everywhere and not usually a problem seeing one quickly, so people go to the doctor for even little things. It's easy to take sick leave so people stay home from work as soon as they get a sniffle.

If people are serious about improving overall health in the UK, I think that's a good thing but it can't just be about berating people to behave better. There needs to be real structural change as well.

Actually, most of the expats I know in Germany think this is a big reason why the virus has been better contained here -- because Germans are notoriously quick to stay home as soon as they get a sniffle or a tickle in the throat. And this is socially acceptable, you can stay home from work, you can keep kids home from school without much bother.

Contrast this to the UK where everyone is pressured to keep working until they're dead on their feet, parents have to send their unwell kids to school or face sanctions. You would expect this country to have a harder time containing a virus.

May be we need a new compact between people and state re. the NHS - that you pay if you are over weight.

How does that work with all the overweight NHS staff - do they suffer a pay cut??

It was on the news this morning, I’ve been frantically trying to find a breakdown, but un helpfully, I can’t.
there’s been criticism fromWHO about the non standardised recording. Making it impossible to compare, which also makes it hard to know if we should be looking at what they are doing or not.

Do you pay also if you are a smoker or you drink ?

Either it’s free at the point of service or it’s not and we move into another system

I agree @xenia that obesity is a far greater problem than CV.

It is a ticking timebomb, killing thousands of people prematurely and costing us billions a year.

I also agree that this is not about berating individuals, this is a cultural and economic issue. Individuals are not, imo, well informed about the impact on their health of sugar and have been badly misinformed about fats and told it causes heart disease (it doesn't unless you mix it with sugar or use shitty refined vegetable oils). The whole system needs an enormous shake up.

You could basically turn the shitty NHS food pyramid upside-down and save 1000's of lives a year

I've used the word shitty a lot there, but it really is....shitty....that people have slept walked into bad health conditions because of terrible advice.

I don't agree that individuals should have to pay due to their own health behaviours, that would be cruel. At least not at the moment as the education around this is woeful, often totally wrong.

BUT there has to be some targets that have to be set at population level around obesity and a huge public health transformation - based on science.

Sorry dey, that is not true for France, it is much less. The figures you probably got this from include care homes and is not just hospital deaths as you are using for the uk.

Even the gov experts have said this and this is very concerning.

This applies i believe to Belguim as well.

do we have the true death rate for any countries affected by the pandemic?

The FT article here shows excess death rates compared to normal level across a number of different countries so far into the pandemic. At a future date, I think looking at the overall excess death rate will give the most useful overall picture as data collection and recording has been variable.

Difference in UK health system and European ones.

Here, it is one big, underfunded national service.

In European countries, like France or Italy or Germany, you go to your doctor directly, pay partly via your health insurance. It is a bit like having access to Bupa as your regular doctor, for whatever speciality.

UK is regularly well outside the top 20 when health systems are compared (sits somewhere alongside Colombia and Saudi Arabia) whereas France is a world-leader, and Italy and Germany also normally in top 10 (depending on whose surveys).

Great idea Xenia - let's charge fat people for using the NHS! Another brilliant way to disproportionately penalize poor people.
Or maybe we could think about why your chance of being overweight or unhealthy correlates with your level of education, wealth or deprivation? Something more than just being irresponsible, greedy and lazy going on perhaps?

Here is Sky news article which states the excess death rate in the UK is one of the highest in Europe.

news.sky.com/story/coronavirus-englands-excess-deaths-among-the-highest-in-europe-11977394

America is comparable to the UK in terms of the overall health of the populations, them being slightly worse but with us catching up fast - and they are now the worst in the world I think in terms of death?

Places like Africa, untouched by the Western lifestyle are faring much better despite what I would imagine are much worse health systems.

Great idea Xenia - let's charge fat people for using the NHS! Another brilliant way to disproportionately penalize poor people.

I understand your sentiment behind this and agree that we shouldn't be charging / penalising people. But this diverts the point away from the fact that obesity is an epidemic in our country. And it is costing lives. Tens of thousands a year unnecessarily.

Here is Sky news article which states the excess death rate in the UK is one of the highest in Europe.

I hope any enquiry after all this will properly investigate the NHSs role in these excess deaths, i.e. why different trusts/hospitals are doing different things, i.e. why some hospitals are still treating cancers and others aren't. The lack of consistency is very worrying and suggests individual trust/hospital managers are making up their own decisions rather than being centrally instructed.

We put restrictions in place too late, virus was well into the population by then.
Don’t understand how we are still getting thousands of new cases Daily after 5 weeks in lockdown though, doesnt bode well for timescales before we can start lifting some restrictions. Italy not sending kids back til September and they are further along than us, wondering if we will now do the same?

Sorry dey, that is not true for France, it is much less.

Much less?
As far as I have seen, France is the only country including care home deaths, yet in the FT link DippyAvocado posted, shows France 16.5k extra deaths and UK 15.6k extra deaths, for almost identical populations, so even if we're closer to them than I said, they are still not much less than us.

I understand your sentiment behind this and agree that we shouldn't be charging / penalising people. But this diverts the point away from the fact that obesity is an epidemic in our country. And it is costing lives. Tens of thousands a year unnecessarily.

It doesn't divert from the issue hamstersarse it's central to the problem. Understanding why you are much more likely to be fat if you're poor is absolutely necessary to tackling the obesity 'crisis'.

@TheWordWomanIsTaken Care Home and at home deaths are included in the ONS figures published on a Tuesday for England and the NRS figures published for Scotland on a Wednesday. I presume Wales and NI have their own equivalent. This is why comparisons are so hard because there are different sets of stats which tell us different things.

@Bool is spot on - we closed GP surgeries, pharmacies and hospitals to anyone with suspected covid symptoms OP - most other countries, including Italy continued to allow anyone to walk straight in there.