Coronavirus: Britain on course to be European country worst-hit

London Letter: Despite ramped up capacity, how many will die over slow social distancing?

At the daily press briefing in Downing Street on Thursday, Dominic Raab and the British government's two top advisers on coronavirus, chief medical officer Chris Whitty and chief scientific adviser Patrick Vallance, were determined to accentuate the positive.

Three weeks of social distancing measures were bearing fruit and Whitty said the number of cases, which had been doubling every two days, was now doubling only every six days.

The news from Boris Johnson’s hospital bed was encouraging too and shortly after the press briefing, the prime minister was moved out of intensive care.

Raab, who is deputising for the prime minister during his illness, admitted he had not been in contact with him. “Not yet, I think it’s important particularly while he’s in intensive care to let him focus on the recovery,” he said.

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“We in the government have got this covered. I chaired the Cobra meeting that I have just come from, we are pursuing all the different strands of our strategy to defeat the coronavirus and I’m confident we’ll get there.”

To put it in perspective, every year in seasonal flu the number of deaths is thought to be about 8,000 excess deaths

It was not all good news, however, and the 881 new deaths reported on Thursday took Britain’s death toll from the virus to 7,978. Vallance said the daily death toll would continue to climb for weeks before it started to decline because most of those who were critically ill now were infected before the social distancing measures were introduced.

Final toll

Three weeks ago, Vallance told the House of Commons health committee that keeping the final death toll below 20,000 would be a good outcome.

“To put it in perspective, every year in seasonal flu the number of deaths is thought to be about 8,000 excess deaths,” he said.

"So if we can get this down to numbers of 20,000 and below, that is a good outcome in terms of where we hope to get to with this outbreak, but I mean it is still horrible. That is still an enormous amount of deaths and it is an enormous pressure on the health service. And having spent 20 years as an NHS [National Health Service] consultant as well as an academic, I know exactly what that looks and feels like."

At the beginning of the crisis, some in government hoped Britain might have a better outcome than other European countries facing coronavirus. If the daily death toll continues to climb, Britain is instead on course to match or even overtake Italy and Spain as the European country that suffers the most from the pandemic.

After its shift towards the social distancing measures employed by most developed countries last month, Britain’s strategy has appeared to be playing catch-up. This is most obvious where testing is concerned and health secretary Matt Hancock’s target of 100,000 tests a day by the end of April is a stretch for a system that is currently conducting 14,000 a day.

Nightingale hospital

There have been important successes, however, notably in scaling up the NHS’s intensive care capacity. The most dramatic expression of this effort is in the 4,000-bed Nightingale hospital in east London, built by the British army in a matter of days. Another such hospital opens in Birmingham on Friday and others are planned elsewhere in the country.

Vallance and Whitty appear to be confident the NHS will have the capacity to deal with the peak of the epidemic in the coming weeks so that nobody will die for want of the appropriate care.

The question they cannot answer is how many of those who are dying now could have been spared from infection altogether if Britain had introduced social distancing measures earlier. And how many infections might have been prevented if the NHS had not abandoned testing and contact tracing a few weeks into the epidemic.

Britain is now seeking to increase its testing capacity and developing a contact tracing app as it considers how to exit the lockdown. Just as its failure to test and trace may have hampered the country’s fight against coronavirus, patchy information about the spread of the virus could complicate and delay plans to lift the restrictions.