Quick stats update for those who asked…
1. Lockdown works. We stopped the doubling of this thing every 3 days. That’s 1,000 times worse if you left it a month longer. Without lockdown we would almost certainly have had many hundreds of thousands of excess deaths so far – and part of this is once you have an overwhelmed health service we lose maybe 5 times the number of people, and the age profile of fatalities comes down. Non old/vulnerable
(like Boris age and health) who survived in hospital only because we flattened the curve within NHS capability. This is not a political show, it’s just how it affects a proportion of mid-age people. So we did the right thing to lockdown. Well done all, and thanks to the younger generation who would 99% be fine without lockdown. Nice of you on behalf of the rest of us.
2. But three big problems…in order…what economic cost? Where are we now? And what the heck to do next?
3. Make no mistake…the economic cost is huge. As well as the current effects that are only just the beginning, national income is (was) a bit over £2 trillion per year and is currently being trashed of course. We’re already borrowing towards a trillion on Covid-19 soon via government. Economically, borrowing can’t just be ignored later. It means our children’s and their children’s tax rates will be far higher through their lifetime as they pay this back on our behalf. Sorry kids. We did this without asking your permission of course, but that’s what we always do. That’s what government borrowing is about! That will be in the order of £1,000 pa per working person for your child’s whole career. And with a smaller economy due to all this. Oh, and we had already borrowed enough for another grand a year, so just add this on. Thanks kids – sorry about that.
4. Country comparisons: Unsurprising that fatality rate is correlated (probably in a squared relation or so) with population density, eg Sweden is 10x less densely pop than UK; New Zealand much less again. With good info, education and social cohesion that’s automatic good social distancing and aware hygiene – and that’s all you need. So many countries can and should eradicate the whole thing. Unfortunately UK has about the highest population density in Europe (except Holland – who have lost more people per population than UK but have done a fantastic job of flattening new cases in recent weeks) and a massive city – London. Many European countries have nothing on this scale. So it’s tough for UK, although it’s the densely populated cities of the poorer world with less institutional infrastructure that I worry most about next. They started later but numbers are climbing. Hope there’s a reason these will manage OK.
5. What now? Well we said last week that Government will be in the chaos phase of data for the rest of initial lockdown, so no big news to come from them yet. Lots coming in to them…new data, thoughts and ideas about virology, R- estimates, country comparisons, social behaviour predictions, PPE, testing, tracing, etc. All to be integrated into an overall analysis and a simple plan. Lots to synthesise, and good decisions will vary widely depending on the interaction of these unreliable variables. Fascinating work for the statisticians, and then they interact with the social scientists and then the politicians and advisors to estimate what the public will do with any messages. So it is necessarily political, as it’s about what the public will think and do with the messages. We, the ‘free’ public are both the solution and the problem. Not easy for them all but interesting work to try to optimise. As data converges, a clear set of options will emerge.
6. Looking ahead: The relief for the politicians for the moment is that fatalities per day has peaked, new hospitalisations are down. ‘New cases’ are not falling despite lockdown, but this data-point is ever more meaningless at this stage as testing has risen so much and we are logging the milder cases more and more. So a great relief for Ministers as the first challenge recedes and they have the illusion of control for a moment. But next is big – lockdown is already softening from mixed messages (this is deliberate so people can self-define ‘essential travel’ in order to survive, and especially to see how sensitive ‘R’ the re-infection rate is, as human interaction increases). If R is not sensitive, we de-lock partially but confidently (government is using the term ‘sure-footed approach’). And then we delock further if R still holds low. But don’t bank on that. I think natural R is high (2-3-ish) and still not enough people have had it yet. If R shows itself very sensitive and hospitalisations jump as lockdown-lite softens, we have the same problem as we had 8 weeks ago, but with a trillion already gone and its social consequences.
The choice then is threefold:
1. ‘Freedom’: Hundreds of thousands of excess deaths as we open the economy, made several times worse as NHS overwhelm means tons of people of Boris’ age and health die for lack of medical availability, in addition to the older, and younger vulnerable.
2. We maintain lockdown-lite to enable some economy and hold the curve flattened to 100% of NHS capacity with associated 500-1000 fatalities per day for foreseeable future until something changes. 3. We lockdown harder to save lives short-term and have to let the economy crumble altogether and accept we are at 1945 when we come out (yes we built the NHS then but it was very hard during, and for a decade long after, and there was no economy to try to salvage anyway). In my view the political choice will be clear – lockdown-lite with 50-100% of NHS capacity the goal (remainder of NHS can do some non-Covid work) until enough people in the population have had the virus and new cases falls away. Politicians won’t be able to make any other choice.
Conclusion: So hope for a low R. If not, then expect a long and austere 2020 and I’ll have to forego my Genesis concert tickets for December. The reason not to go for full ‘freedom’ by the way, is the risk that with an ongoing high R we consign hundreds of thousands to unnecessary death soon, only to find that a vaccine or treatment or natural virus-killer comes sooner than we had assumed, and had we been patient, they would have been OK. Oops. By playing for time, we may find tech or nature may come to rescue the hunkered.
Just like in Ping Pong, if you’re losing and have insufficient capability and few ideas, still just play for time. They might break a leg, or there might be a power cut and you get a draw! You never know, so just hang on, suffer it a bit, lose slowly, and keep going til the metaphorical ‘sun comes out’. Eventually it will.
I hope you have a good and lucky week.