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ASPHER is the key independent European organisation dedicated to strengthening the role of public health by improving education and training of public health professionals for both practice and research.
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The English Pandemic

Publication date: 04.08.2020
Author: John Middleton

From our UK correspondent: A personal blog from John Middleton, President of ASPHER 

It is very tempting to talk about the war with COVID-19. Right now, the United Kingdom finds itself in a period of what might be called a ‘phoney war’. Prime Minister Johnson has led us through the difficult times to the point we may now enjoy the little sun we have in the beer garden and beach. Chancellor Sunak will give us a half price meal deal out, to help the 1.5 million people who went hungry in lockdown. The deaths were down to single figures –9– for the first time on Monday 3rd August. Monday – when the hospitals still haven’t forwarded their death count after the weekend. And anyway, the same number for one day as Malta and Iceland recorded in their entire outbreaks. The danse-macabre continues. The ‘war’ is drifting, the virus is going to the pub and the beach too, ticking over, regrouping for its big winter outing.

New cases have not gone away to zero. In fact they are going up. (figure 1)

Figure 1 

The Office of National Statistics estimates 35,700 people within the community population in England had COVID-19 from 20 to 26 July 2020, around 1 in 1,500 individuals. They also estimated there were around 0.78 new COVID-19 infections for every 10,000 people in the community population in England, equating to around 4,200 new cases per day (95% credible interval: 2,200 to 8,100). Well distant from Independent-SAGE’s 1 case per million Zero COVID target. And well distant from those countries, like Norway, whose numbers have been in single figures since June, where they can track and trace easily and afford to have their schools fully open. Cambridge scientists predict UK COVID deaths from 43-84 per day in the middle of August. Did they need to be that precise? Do we take no notice when we look at the graph? And we must now say ‘English deaths’. (figure 2)

Figure 2 

The English Pandemic

Much of the commentary has been of the ‘United Kingdom’s terrible record’ in the pandemic. Over 46,000 deaths directly from COVID-19, 56,000 with a recording of COVID-19 anywhere on the death certificate, excess mortality over 68,000 deaths. Only relatively recently have we seen the reality that these are deaths in England. (Figure 2) Taking the 56,000 figure, as the Belgians do, the death rate for England becomes the highest in the world.

Figure 3

By any score, deaths, excess deaths, case fatality, we are in an extraordinary national disaster already, https://coronavirus.jhu.edu/data/mortality. Guardian writer, Nesrine Malik sums up the full extent of the human tragedy, being air brushed out now, ‘A nation mourns its Covid dead. But for Boris Johnson, it’s a time for triumphalism’.

Complacent, lazy, incompetent

We are observing continuing complacent, lazy incompetence, in the policy and in the messaging – contradictory messages on travel quarantine, a late change to self-isolation period, still not up to the WHO 14 days, incomprehensible rules on distancing and bubbles, dithering on masks and the appalling privatised track and trace system flailing about, with some local authorities building their own local service in complete exasperation.

The United Kingdom faces a perfect storm of resurgent COVID-19, a severe flu epidemic, pandemic untreated long-term conditions, along with the effects of a cold winter, economic collapse and a crash-out Brexit. These parts of the perfect storm are brewing on the horizon, charted for us by the Academy of Medical SciencesFood shortages, civil unrest and breakup of the union may be only a little further off.

There is little clear evidence that there is political understanding and commitment to action.

Lockdowns across much of the north west of England, and Leicester. Many more on the cusp. As WHO Euro boss Hans Kluge warns us, now is the time for preparation, not celebration. But at this point the UK government went on holiday. Leaving the new All Party Parliamentary Group on coronavirus in an empty chamber. Many countries around the world have dealt better with the pandemic. It may be possible to deal with it if you have a corrupt government, it is not possible to deal with it if you have a corruptincompetent, and lazy government. Blind acceptance of our leaders’ actions will get us killed.

John Middleton
August 4th 2020 

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