Part of the reason for many people’s worries must be that for nearly a year and a half we have been bombarded by the UK media with often sensationalist reporting of the risks from Covid-19. This has been added to by UK governments who have been justifiably concerned about overstretching an NHS which was already desperately overstretched even before Covid-19 came along.
And while the direct risks from Covid-19 have been kept right in our faces by the media, the huge potential damage from ongoing restrictions has, by and large, not been reported much, and certainly not in alarmist and dramatic headlines. These social and economic risks are more insidious than the Covid-19 risks, they are more complex and they may be longer term, but ultimately they are potentially much greater risks to our community than the direct risks from Covid.
With the coming of vaccination the world is changing, but the media still continue to report on infection rates, whereas what matters in Guernsey and the UK now is the rate of serious Covid-related illness. This is where things do become somewhat less well defined.
In the 15 July edition of The Briefing Room on Radio 4 there was an interview with Tom Chivers, science editor of Unherd.com and co-author of ‘How to read numbers: A guide to statistics in the media (and knowing when to trust them)’.
He said that in January this year, an average of 7% of those in the UK who had tested positive were admitted to hospital, and 30% of those hospitalised died. Now it’s 2.5% hospital admissions, of whom 12% are dying. By my calculations that’s 21 people per 1,000 testing positive dying in January and three per 1,000 now. This is not per head of population, but just of those testing positive. This is a very significant reduction, even though vaccination roll-out in the UK, as in Guernsey, has not been completed yet, but it’s not of course a reduction to zero.
Many commentators are starting to say that the link between infection rates and serious illness is now being broken by vaccination. If this link was well and truly broken, rather than just reduced, then it would seem that problems would now only be likely to be caused by Covid-19 infection rates because of the problems of compulsory self-isolation and other ongoing restrictions themselves. This is a critically important point.
If, as seems likely, the link is significantly weakened rather than broken, then there is still a balance to be struck between serious illness and the adverse effects of restrictions, even though this is not an easy balance to strike.
In early April the online Telegraph reported that Professor Whitty, the UK chief medical officer, had said that it was important to bring Covid deaths as low as possible, but warned that society would not tolerate being locked down to prevent similar numbers of deaths to those of flu. He was reported as saying that ‘every year somewhere between 7,000 and 9,000 [UK] citizens die of flu’ and that ‘every few years you get a bad flu year where 20,000 to 25,000 die of it. The last time we had that was three years ago and no one noticed it.’
It may seem difficult to believe that 25,000 deaths could go unnoticed. That is until we realise that, according to the UK Office for National Statistics, the UK annual death rate from all causes between 1990 and 2019 varied between 484,000 deaths per year (2011) and 578,000 deaths per year (1993). This is a difference of 94,000 deaths, but were any of us at the time conscious of living through years where deaths were higher or lower? No, we weren’t.
If we are no longer to worry about the number of infections, we do need reasonable confidence that vaccination has sufficiently reduced the risk of serious Covid-19 illness for the foreseeable future, and uncertainty is also provided by the likelihood of further variants, which can be expected to be progressively more resistant to existing vaccines. If and when they occur, then existing vaccines will have to be modified and revaccination programmes undertaken.
But there are great risks to all approaches to Covid-19, and we really now have no acceptable alternative than to put our trust in vaccination and continue to release restrictions. We are so fortunate that people have been able to develop such vaccines and are equally fortunate to have a CCA which is dealing so well with this extraordinarily difficult balance of risks, even given the recent about-turns.
Rue de la Ronde Cheminee