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 was referring to this @ dey and did not think this was referring to excess deaths.

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.

FRance has 14,000 hospital deaths
Uk has 20,000
I would consider this much less.
If you were referring to something else then i apologise but it appeared to me to be coronavirus deaths.

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

I hope so too. The NHS London instructions to paramedics, ambulance crews circa March 12th to April 10th which stipulated that patients who were struggling to breathe did not merit hospitalization? How many died unnecessarily as a consequence? As for the cancelled cancer treatments and missed cancer diagnoses, that will continue to impact excess deaths for years to come. The backlog as a consequence of effectively shutting down the NHS to protect the NHS? How long will that negatively impact health care? In the febrile environment of clapping and rainbows, a catastrophe is evolving. Once again with the NHS, the gap between its reality and its rhetoric is becoming a chasm

FRance has 14,000 hospital deaths
Uk has 20,000

I was referring to reported deaths per million compared to France, Italy and Spain, in response to the claim that we are a long way from our peak.
It doesn't affect my point if France is above or below - the slope of the curve is similar, so unless it changes and increases sharply (hasn't done so for any other country) then I wouldn't expect us to be much worse than those countries, especially since we all seem to have peaked.

@dreamingbohemian Very well phrased on the challenges to tackling obesity. It seemingly plays a part in severity of Covid, but isn't a simple one to fix.

I cant see that sorry, i agree peak has been reached but in terms of number of hospital deaths the UK is worse than France. I dont actually like making these comparisions in this way but i feel the need to since the politicans and the gov advisers do it incorrecly all the time.

Whilst I don't agree that people with obesity should pay more, I do think there is something bizarre about all this hand wringing over deaths and then hand clapping on a Thursday.

If we really cared about the NHS we'd make better lifestyle choices, how many people do enough exercise? How many people drink alcohol (a guaranteed carcinogen - as bad as asbestos)? How many people eat enough fruit and vegetables? None of us. Yet, imagine how much further our tax would go if we did better at these things and I include myself in this.

This whole crisis has given me a kick up the bum, how dare I not exercise when doing so might allow money to be spent on illnesses which are genuinely no one's fault, how dare I not eat healthily when I know how to. I have no right to clap on a Thursday and then make unhealthy choices all week. I feel genuinely ashamed.

Thanks Maggie, I completely agree that it's a hugely complicated problem. It's easy to just blame individuals but there are so many things that the government (even local governments) could do to help, if they really wanted things to change.

NoMorePolitics- what's the name of the town in Italy sealed off? In what sense?

Death rate per million- Italy is higher than the UK as would be expected as it's approximately two weeks "ahead". Death rate of those infected by Covid the stats are almost identical- as of yesterday it was 13.5% of all those in the UK die, compared to 13.3% in Italy. Third and fourth highest in Europe. But that's not really fair on Belgium which is including carehome deaths in its stats unlike either the UK or Italy.

You don't pay for the Italian health service via your "health insurance". You pay for it via your national insurance contributions. Same as the UK. You can choose to have private healthcare obviously. Same as the UK.

People were NOT allowed to "walk into" doctor's surgeries in Italy. They have all been closed to everyone since the end of Feb/beginning of March. Likewise hospitals- for example, hospitals within a certain distance of each other were re-assigned- one would treat only Covid, one would continue with general medicine etc.

It must be remembered that Italy's hospitals in Lombardia were overwhelmed- not elsewhere. The original breakout of the virus was in the north/north west and remains largely there. Much of the south is virtually unaffected.

Also not true that everybody was ventilated who needed to be. There was very much a triage system going on at the end of February/beginning of March when the northern hospitals were overwhelmed with Covid patients- in fact there were threads on here citing articles/videos/news reports from Italian doctors saying they were in the position of having to choose who got a ventilator. These seem to have now been forgotten as they don't fit the narrative.

www.independent.co.uk/news/health/coronavirus-italy-hospitals-doctor-lockdown-quarantine-intensive-care-a9401186.html

www.abc.net.au/news/2020-03-27/coronavirus-doctor-cremona-hospital-decide-who-lives-and-dies/12090912

www.euronews.com/2020/03/12/coronavirus-italy-doctors-forced-to-prioritise-icu-care-for-patients-with-best-chance-of-s

Italy is NOT testing everyone arriving at its airports, there are temperature checks in place.

Back to apples and oranges again - stop comparing a national health service with a privatised one! also, population density - it's incomparable!

Which one is privatised?

Lack of a testing.

Lockdown too late.

Large social gatherings continued for too long.

Borders remained open with no checks or quarantine.

The public was told not to go to hospital with symptoms.

111 much too strict, early intervention is needed.

Not enough ambulances.

Lack of accurate published symptoms - not everyone has a fever or cough.

Not enough PPE.

@SimpleKindofLife

You forget people ignoring advice in the 2 weeks leading up to lockdown. People were told to wash their hands more, to observe social distancing, to avoid crowded places, to work from home if possible, etc etc. Huge numbers ignored that advice!

What kind of person talks about using a stiff broom to deal with frail and vulnerable people.

Dominic Cummings? Just off the top of my head.

I have only lived back in the UK for 4 years and I can tell you that we are less fit and now overweight. The fact that other people think I'm slim and sporty is a joke.

This isn't an excuse, because I usually don't suffer fools gladly at all, but the UK is a really stressful place to live. Long working hours, less job security, long commutes, little help from family and expensive help in the household or childcare, multiple high taxes (yes they are), massive mortgages, little community, little downtime and time for hobbies. We pass our spare time throwing sugar and alcohol down our throats.

Yes we need individual discipline and responsibility but our culture and structure work against us.

Figures from Wikipedia. UK not the worst, not worse than Italy.

People don't seem to understand that comparing countries is pointless. There are too many variables.

Population size, population density, health of population, age of population, weather, race, amount of travel in and out of country, intake of Chinese during the initial spread, how figures are being recorded, amount of people that died of flu in the previous season.

We could have more deaths simply because more people have had the illness. Which means we would also be closer to heard immunity and will not be as badly affected when we end lockdown.

This is a guessing game for everyone, and we won't really see who has managed best and who worst until probably next year or even longer.

Something along the lines of @Delatron's earlier post would make a great 'public' question at one of the briefings.

We are not admitting people on the whole until it’s too late. Look at what Germany do.
Why we can’t be more reactive to save lives I don’t know. We have capacity so get people in early and get them on oxygen and monitor them.

The UK is not as far along its trajectory as the three European countries with more deaths X population figure. And Belgium has reported all its carehome/community deaths unlike the UK and Italy (I don't know about Spain)

California - all those things are factored into the more complex analysis taking place. Check out the graphs thread for in-depth research and analysis. The UK for example had something like 6000 excess deaths cf average over last five years at the last reckoning.

@hamstersarse and others discussing obesity and general health
As someone working in the NHS in a deprived area I think I can say with some certainty that the fact we have a health service where people aren't aware of what they pay for it contributes hugely. In countries where patients pay some or all of their healthcare bills they have an awareness that being treated costs money and staying healthy is the responsible thing for yourself and for society. In the UK our NI is taken from pay and people see the NHS as free so attach no value to health or treatment at all. I regularly deal with patients who are non-compliant with health advice and medication then see it as the responsibility of the NHS to cure them

I have only lived back in the UK for 4 years and I can tell you that we are less fit and now overweight. The fact that other people think I'm slim and sporty is a joke.

Agree - you can see from Mumsnet threads that women sized 12 and 14 are called 'slim' which anywhere else in Europe would not be the case.

@CalmYoBadSelf

Very good point. There is currently no personal responsibility encouraged in any way

I regularly deal with patients who are non-compliant with health advice and medication then see it as the responsibility of the NHS to cure them

But when it comes to obesity, overweight patients really aren't going to take diet/lifestyle advice from overweight doctors or nurses are they?

Trouble is that being "overweight" is the new normal in Britain. Fat people aren't the exception anymore, they're the norm. The other day, there was an old school photo from 1983 on a local Facebook page - there was 1 fat boy out of about 100 people - he stood out like a sore thumb. All the others were normal weights, many looked pretty thin. A more recent school photo showed probably over half the kids were overweight, maybe a quarter were obese, but it was only the obese who stood out, the overweight ones were normalised.

That's throughout society, but sadly also obvious among NHS workers.

I'd like to think that the current virus would send a strong message to people with unhealthy lifestyles to highlight the risks they face. Trouble is that we're hard wired to think the NHS can cure anything, so perhaps Covid is a massive wake up call that smoking, drinking, being overweight, does increase your risks when something like Covid is about and there's little the NHS can do about it.

we've gone from 'healthy at any size/ big is beautiful /fat acceptance' to 'you have a duty to stay slim for the good of the country'
It's a hell of a lot for people to process😲
and yes what can we do about the 'moral hazard' issue that comes with the NHS🤔

@ lljkk Those figures are total figures for France and belguim (i think)and include care homes. The uk figures only has hospitals.
The hospital deaths are higher per 100,000 in the uk,than France. Many graphs/tables dont make this,clear.

we've gone from 'healthy at any size/ big is beautiful /fat acceptance' to 'you have a duty to stay slim for the good of the country'

No, it's the good of your health, not the country. Being overweight increases risks of all kinds of diseases and premature death. Somewhere along the line, that fact has been lost with all this "big is beautiful" excusing for over-indulging, poor lifestyle choices, and lack of exercise. The facts are in black and white.