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Thursday, February 27, 2020

Covid-19: die another day


The following is a riposte to some commenters at The Conservative Woman, where a version of yesterday's post was publishedhttps://conservativewoman.co.uk/prepare-for-the-worst-coronavirus-could-kill-hundreds-of-thousands-here/
Covid-19 a scare story? Pace a number of commenters on the last piece: no. You will recall that Professor Ferguson was quoted as saying the risk of infection in the UK could be 60% and the fatality rate 1%, meaning (given the size of our population) a possible 400,000 victims.
That is simply logic. If the coronavirus spreads easily and nobody does anything, many people will catch it. The point is to change our behaviour to reduce the risk. Some of those changes can be a matter of individual choice, some collective.
The wrong collective action may result in worse outcomes. The ‘Diamond Princess’ cruise ship had some 3,700 souls on board when ten passengers were diagnosed with the illness https://www.theguardian.com/world/2020/feb/21/brits-coronavirus-diamond-princess-cruise-ship-to-fly-home . In quarantine, the number of cases has risen to 691 (as of 26 Feb 12:25 GMT https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 ). That is about 18 per cent of passengers and crew, not the 60 per cent that the Professor speculated; on the other hand, these were frightened people keeping in their quarters, trying very hard not to be the next patients. Sadly, the ship’s ventilation system could have helped spread the virus https://metro.co.uk/2020/02/13/coronavirus-cruise-spread-room-room-air-conditioning-12236176/ , in a way similar to Legionnaire’s Disease https://www.nhs.uk/conditions/legionnaires-disease/ .
Of those infected, only four (less than one per cent) have died so far; but the passengers on a luxury sea voyage will be well-nourished, well-cared-for people, and the seriously ill were taken to Japanese hospitals, presumably among the best in the world. Globally (but so far, overwhelmingly in China), 3.4 per cent of cases have resulted in death, 37 percent have recovered and 59 per cent are still fighting the illness; so it is too early to say what the true ratios will finally turn out to be.
However, let’s say for the sake of argument everybody decides to ignore all risks and precautions and the Professor’s estimate is exactly correct. Result: 0.6 per cent of the UK population dies; but by the same token, that means 99.4 per cent will not die of Covid-19 (though many may suffer a period of unpleasant illness.)
What we need is neither panic nor blasé complacency; we need perspective. In 2017 the UK population was (officially) 65.6 million https://www.ons.gov.uk/aboutus/transparencyandgovernance/freedomofinformationfoi/ukpopulation2017 , and 607,172 people died from all causes https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/avoidablemortalityinenglandandwales/2017 – less than one in a hundred. In fact, the average person’s risk of dying in the next twelve months stays below one per cent until they hit their late fifties http://www.bandolier.org.uk/booth/Risk/dyingage.html . You have to be in your mid-eighties before the chance of meeting the Grim Reaper gets higher than ten per cent – good odds!
Why all the fuss then? you may ask. The issue is avoidability: the Office for National Statistics https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/avoidablemortalityinenglandandwales/2017 estimates that almost a quarter of those 2017 deaths – i.e. over 140,000 fatalities – could have been avoided, either by ‘timely and effective healthcare’ or ‘public health interventions’ (and there are three big things we can do personally to improve our chances of a long life https://web.archive.org/web/20121122110650/http://www.hsph.harvard.edu/news/press-releases/2009-releases/smoking-high-blood-pressure-overweight-preventable-causes-death-us.html .) A laissez-faire approach to Covid-19 could add up to 400,000 unnecessary deaths to the total – quadrupling the toll.
We can’t leave everything to our chronically inept government. Apart from anything else, we have to think what we would do if, say, some lockdown was imposed and shop shelves were cleared in panic buying, as has happened in Italy https://www.dailymail.co.uk/news/article-8045987/Shoppers-fight-food-supermarket-Italys-red-zone.html – our worst enemy could be other people’s behaviour. It’s no good waiting till then: as the ancient Greek saying goes, there is no borrowing a sword in time of war.
Not only are there practical things we can do to protect ourselves, we have a good idea who is most at risk so we can give them extra help. For example, we can ensure that an elderly or infirm relative has enough goods in the house not to have to go out if the virus has come nearby; and that visitors, carers and medical staff are firmly reminded to check who they’ve been in contact with recently and to sanitise their hands frequently. Alternatively, if you’re impatient for Granny’s worldly goods, take her out for a bus ride daily at schools chucking-out time; or a cruise.
We all have to go sometime, but if we plan the right course of action it is likely we will die another day, not today; that should provide us with a quantum of solace.

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