system11 wrote:So while infections are allegedly increasing dramatically in the UK, the death rates haven't really reflected this.
Is it:
1) Infections are not actually rising as much as claimed, just more are being detected which would have been symptomless non-events before?
2) Less people are suffering the worst effects - either it's chilled out a bit, or doctors are getting better at treatment, or ?
It's a mix of factors.
Chiefly, delays to testing means that the daily reported figures are actually a mishmash of several days' worth (sometimes from a week or more ago) of testing data. This makes the daily reported figures utterly worthless, instead focus should be on the tests by sample date - as these figures reflect more closely when a case arose (i.e. a person developed symptoms sufficiently to get a test). It's still not perfect, given a case may have been picked up anywhere between 3 and 14 days prior (though that incubation period is based on early analysis and it is likely it's 3-5 days, in line with similar viruses) but it gives you a good picture - this is now further offset by data going missing since September 24th, so we could see a few steep jumps yet. The picture as it stands though, appears to have topped out at around 6000 cases per day in England, though that's the 24th September figure so may rise slightly due to the current issues with reporting.
The situation is a severe north/south divide - for a few weeks now, 75% or more of cases, hospitalisation, intensive case and fatalities are in the midlands and the north. This is easily gleaned from the government's covid website and I'm surprised the media is still presenting it as a dire situation nationally. Cases ARE up nationally - but across the south, south west and east this is marginal and from a very low baseline, with even London (12.5% of the national picture) not seeing the hefty jumps the midlands/north experienced in September. The southern situation is rather as you'd expect for viruses as you head into autumn (and people head indoors!). This is probably mainly an issue of population density, fuelled in recent days by student migration to universities and exacerbated by social/fiancial factors.
The healthcare situation is not and cannot be comparable to the initial outbreak, because testing was so limited - only the most severe cases were being tested and the early tests had questionable reliability compared to today's. It is suspected that, based on the heathcare situation then and now that the number of cases at that initial outbreak was orders of magnitude higher than the limited testing picked up.
Treatments are better - hospital stays for non-critical patients can be reduced with the Ebola anti-viral drug whose exact spelling escapes me, and early treatment with common steriods gives a better prognosis for those that require oxygen and/or ventilation. There are also trials of synthetic antibodies and convalescent plasma, whose overall impact on prognosis will be known in coming months.
It's also worth pointing out that persons may be hospitalised and die for reasons other than covid, particularly as the bulk of those impacted have serious underlying health issues, but either coincidentally have covid or catch it in hospital (and thus test positive) and thus end up as a covid statistic. We're not, for some reason, analysing the covid situation as we would with flu (detailed reports are published for each flu season and are not "person had flu and died therefore flu killed them" - they go into more depth on cases, causes of death and comorbidity factors) and even "excess deaths" is an inaccurate measure due to an unclear mental health picture and halting of many routine medical treatments/screening (it does give you an overall picture of the total cost due to the pandemic and response measures combined though).
However, the duration of the illness means any healthcare impact will be offset from any rise in infections. A rise in transmission will begin to be apparent to testing after 5-7 days, a few days later the hospitalisations will begin to go up and then a rise in fatalities will come 2-4 weeks later. It makes any measures difficult to implement, because it will take a few weeks to see if they have any impact and longer to see the true lasting picture - which may be too uncertain for some to accept, hence we see hurried measures tossed around seemingly without care or purpose.
Fatalities are a harsh reality, those with underlying health conditions and/or the elderly are capable of being killed from any common virus and not just covid (data in the initial wave of the virus did not put risk of death significantly higher than all but the top age brackets) - deaths will rise this time of year as virus transmission increases and there needs to be more comparison with normal death rates (ideally a per year basis and not an average, as strong/weak flu seasons can seriously skew the 5 year average that was being used as a baseline earlier in the pandemic) to see just how much of an impact covid is truly having vs. seasonal conditions. But you still need to find a way to isolate the impact of the containment measures from that data - it's important to know if the disease is indeed worse than the "cure".
Finally there is talk of "long covid" which I think important to put into perspective. A standard viral chest infection can take weeks to fully recover from in a healthy individual. Pneumonia can stretch into the months. Most viruses are capable of inflicting short and long term organ damage, it just isn't usually screened for unless complications arise. Anyone who has been on a ventilator will likely suffer health effects for even longer and may have mild delirium (or similar pschological symptoms). Anecdotal evidence of healthy people being badly impacted gains a media focus due to the nature of pandemic reporting and with this being a new virus to humams it is right that there is a post-recovery focus in healthcare. However all of this reported under "long covid" is not unique to covid-19 and happens on a regular basis - it just doesn't get a focus in the public consciousness. That the true picture will not emerge for months is reason for continued caution but the anecdotal reports thus far are not reason to live in fear either.
