Coronavirus UK: Independent scientists blast SAGE lockdown approach

Fitness & Health:

A coronavirus lockdown row erupted today after No10‘s scientific advisers called for another national shutdown to curtail Britain’s Covid-19 resurgence amid projections that the second wave could end up being deadlier than the first because it will last for longer.

Top experts questioned why the ‘incredibly harmful intervention’ was being considered when Britain successfully squashed its epidemic earlier in the year and the NHS is still nowhere near full capacity. Oxford’s Professor Carl Heneghan told MailOnline: ‘We flattened the curve and protected the NHS. So what happened to learning to live with the virus?’

It emerged today that SAGE — the Scientific Advisory Group for Emergencies, which is steering the Government through the Covid-19 crisis — has projected the winter wave of the virus will be deadlier than the first and will take the shape of a ‘lampshade’. 

Modelling by the advisory panel, which is being circulated through Downing St, has predicted a smaller but more prolonged second peak, which could see a moderate number of daily deaths rumble on for months, eventually overtaking the death toll of 40,000 in spring. For comparison, about 200 Covid-19 patients are currently dying each day and more than 1,000 were being killed daily during the darkest spell in March and April. 

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Mr Johnson has previously described the Government’s coronavirus curve, which plot the number of deaths, as looking like a sombrero or a camel’s hump. But the latest SAGE modelling suggests the second wave will look like a ‘lampshade’, with deaths peaking in a month and then remaining high for months before eventually falling.

Sources within SAGE warn there could be 25,000 people in hospital with Covid-19 by the end of November, more than double the 10,000 currently receiving NHS care. 

Latest figures suggest the country has about 110,000 beds at its disposal, plus thousands more in the Nightingale hospitals built during the first wave which went unused. Thousands of private beds were also commandeered to give the NHS some breathing room if it’s faced with a surge in Covid-19 admissions. 

The main justification for a national lockdown is to protect the NHS from being overwhelmed, but the latest data suggests that, even if the bleak prediction of 25,000 Covid-19 patients in hospitals by next month comes true, the health service will not be overstretched. 

Professor Heneghan, director of the University of Oxford’s Centre for Evidence-Based Medicine, told MailOnline: ‘Lockdown should be a last resort to protect the NHS. The fundamental aim [of the first lockdown] was to protect the NHS, at that time we didn’t have testing and we didn’t have any treatments or Test and Trace, so it was justified.

‘We managed to flatten the curve and we have these now [knowledge of the virus and medicines and public health measures on how to prevent it spreading]. What happened to learning to live with the virus? People calling for lockdown need to realise that it is a blunt tool that will just kick the can down road, we need to get the message out now that this is not going away, it’s about managing Covid-19’s impact.’  

Sources within SAGE say there could be 25,000 people in hospital with Covid-19 by the end of November, more than double the 10,000 currently receiving care. Latest NHS England figures suggest the country has about 110,000 beds at its disposal, plus tens of thousands more in the Nightingale hospitals built during the first wave, which went unused. Its suggests that, even if the bleak prediction of 25,000 Covid-19 patients in hospitals by next month comes true, the health service will not be overstretched

According to internal analysis provided to Number 10 by the Scientific Advisory Group for Emergencies (SAGE), deaths will peak at a lower level than in the spring but could remain high for weeks or even months with a Christmas respite unlikely

According to internal analysis provided to Number 10 by the Scientific Advisory Group for Emergencies (SAGE), deaths will peak at a lower level than in the spring but could remain high for weeks or even months with a Christmas respite unlikely

The main justification for the first national shutdown in March was to protect the NHS from being overwhelmed and depriving non-virus patients from getting vital care. 

Covid-19 is a disease that primarily only kills the elderly and already-ill, so the majority of people who catch it will suffer mild or no symptoms. 

Therefore locking down the entire country and economy for a virus that kills just 0.1 per cent of sufferers was seen as many to be not enough of a reason on its own. But experts have warned thousands of survivors will suffer from lasting effects of the disease, known as ‘long Covid’.

Boris Johnson said in spring he had no choice but to hit the nuclear button on lockdown to flatten the curve of the epidemic — or ‘squash the sombrero’, as he put it — to bring cases to manageable levels and bring hospitals back from the brink. But data has since shown hospitals, as a whole, were never overwhelmed.

Scientists, MPs and other health professionals claimed once this had been achieved that the nation would have to ‘learn to live with the virus’ because a second lockdown would be too catastrophic on the fragile economy and healthcare.

As well as the huge economic fallout — the number of people claiming unemployment benefits rose 120 per cent to 2.7 million between March and September — the crude lockdown also took an almighty toll on healthcare. The  NHS was forced to shut down most services for the better part of six months earlier this year.

Charities estimate there could be an additional 35,000 cancer deaths due to people missing vital tests in spring and nearly 27million GP appointments were ‘lost’, which could spur on the worsening of other conditions such as asthma and diabetes. 

Keith Neal, emeritus professor of the epidemiology of infectious diseases at University of Nottingham, questioned why ‘learning to live with the virus’ had been taken off the table, adding he was in favour of the tactic.

First the ‘sombrero’, then the ‘camel’s humps’, and now the ‘lampshade’

In the early days of Britain’s coronavirus outbreak, top scientists predicted the crisis would take a sombrero-hat shape on graphs. Boris Johnson told the nation the plan was to delay the peak of the outbreak, or ‘squash the sombrero’.

Then in September, when the virus started to make a resurgence when schools and universities returned, the Prime Minister warned tougher action would be needed if the country failed to ‘stop the second hump of the dromedary’.

Now, Whitehall insiders have resorted to another bizarre phrase to describe how the second Covid-19 wave could pan out — with startling projections presented by SAGE warning of a ‘lampshade’ curve.

The forecast being circulated through Government predicts deaths will hit 500 a day by the end of November. For comparison, more than 1,000 Covid-19 patients were dying each day during the darkest spell of the pandemic in March and April.

But experts fear daily coronavirus deaths will stay at a high level for a longer period of time — making the second wave more deadly overall than the first, which killed at least 40,000 people.

A source told the Daily Telegraph: ‘It’s going to be worse this time, more deaths. That is the projection that has been put in front of the Prime Minister, and he is now being put under a lot of pressure to lock down again.’

Dr Yvonne Doyle, Public Health England’s medical director, warned last night that the spike in fatalities would continue ‘for some time’, after the UK recorded another 367 Covid-19 victims — the highest daily death toll since the end of May.

It comes after a SAGE adviser last week warned the second wave of Covid-19 could peak at Christmas unless there is a national lockdown now. Professor John Edmunds, an epidemiologist based at the London School of Hygiene and Tropical Medicine, told MPs that he couldn’t see a way out of the current crisis without ‘deaths in the tens of thousands’.

Deaths climbed quickly in Britain’s first wave, rising almost 15-fold in a fortnight. On average, 42 infected patients were succumbing to the illness every day on March 23 — when lockdown was imposed. This jumped to 627 just a fortnight later.

But fatalities have yet to take off in the second wave. Department of Health statistics show around 200 Britons are currently dying from Covid-19 each day. But the figure two weeks ago stood at 82.

Britain is only now starting to record more coronavirus victims because of a spike in cases in September and October, following a lull in transmission over the summer. It can take infected patients weeks to fall severely ill and die.

And despite warnings that the death toll will continue to soar, a raft of statistics have suggested the outbreak has already started to slow down. It could mean that deaths may start to tail off in the coming weeks.

 

He told MailOnline today: ‘Why should places with declining cases — like Cornwall — go into another lockdown? Rural towns are some of the poorest in the country and have been hit hardest by this pandemic.

‘There are too many health consequences [that come with a national lockdown]. There’s a knock-on effect on mental health and particularly for people who live alone. If we were to go into lockdown again we’d be treating these people like prisoners.’  

Squashing the sombrero in spring and then using targeted approaches through winter was supposed to keep cases squashed low enough for people to live relatively normal lives. 

Professor Neal said this strategy should have worked, but too few people have been complying with social distancing rules since the end of summer, which has caused the resurgence.

The expert, who is helping Public Health England monitor the outbreak in Nottingham, added: ‘I’ve seen data showing only 11 per cent of people are isolating properly and do the full 14 days. One in four aren’t answering the phone to contact tracers.

‘Lockdown wouldn’t even be a consideration if Test and Trace was working better and more people were adhering to the rules.’ 

After referring to the crisis as a sombrero-hat shape on graphs, the Prime Minister warned tougher action would be needed if the country failed to ‘stop the second hump of the dromedary’ when the virus started to make a resurgence when schools and universities returned in September. 

Now, Whitehall insiders have resorted to another bizarre phrase to describe how the second Covid-19 wave could pan out — with startling projections presented by SAGE warning of a ‘lampshade’ curve.

Professor Paul Hunter, an epidemiologist at the University of East Anglia, said Britain didn’t flatten its first epidemic well enough or keep it squashed long enough, which was explaining the sudden rise in cases.

He said as recently as last month he was ‘absolutely sure’ deaths could not reach spring-like levels this winter, but he said the mid-September surge in cases had made him ‘uneasy’ about this prediction.

Professor Hunter told MailOnline: ‘The ultimate number of deaths will depend on how many cases we have over winter, and that is difficult to be certain about. 

‘Since spring we’ve seen 10 to 15 per cent of the population catch and recover from Covid-19, and we know most of these people probably won’t fall ill again.

‘And the other thing is we’re a lot better at keeping people alive now, certainly those under 70. The death rate in people going to ICU with Covid-19 has almost halved since the first wave and that’s because of drugs like dexamethasone [a cheap steroid proven to benefit the most ill virus sufferers] and because we’ve learnt how to care for patients who have it .  

‘In April – due to a lack of testing – a lot of people died from Covid but doctors couldn’t put the virus on their death certificates, which meant there was a big underestimate in the number of fatalities. 

‘Now we don’t have that problem and we can more accurately record deaths. For these reasons, I lean towards believing deaths can never reach the levels in April, but I’m starting to think it could be plausible.

‘What’s made me uneasy is the very rapid increase [last month]. We’re approaching the real number of new cases per day that we were seeing at the end of March, I cant be certain but it’s round about the same figure now.’

Scientists have estimated that up to 100,000 people were getting infected per day in spring, though it’s been difficult to prove due to a lack of testing at the time. SAGE thinks around 60,000 people are getting infected every day at the moment.

Although he is against a full shutdown again, Professor Neal sympathises with the challenge the Government is facing. ‘With normal conditions, it is normally only the patient and their family who has to suffer. With Covid-19, if someone catches it they can pass it on to someone else who will then pass it to someone seriously vulnerable who could die through no fault of their own.

‘If it [the winter wave of infections] goes wildly out of control then the NHS will get stressed. Even if it’s not overwhelmed, it may have to cancel operations that would benefit people’s lives – like getting hip and knee replacements.’

Professor Neal said he was in favour of continued targeted approaches in hotspot areas, but said the current three-tier system was not strict enough. 

Sir Patrick Vallance, the Chief Scientific Adviser, is said to be leading calls within Government for Boris Johnson to take drastic action as soon as possible to halt the spread of infection

But Mr Johnson is having to perform a balancing act, with SAGE experts calling for tougher lockdowns while Tory MPs press for a road map out of restrictions

Sir Patrick Vallance, the Chief Scientific Adviser, is said to be leading calls within Government for Boris Johnson to take drastic action as soon as possible to halt the spread of infection. But Mr Johnson is having to perform a balancing act, with SAGE experts calling for tougher lockdowns while Tory MPs press for a road map out of restrictions

A Government source told The Sun the latest SAGE numbers are ‘utterly bleak’ with projections reportedly showing there could be 25,000 people in hospital with Covid-19 by the end of November. 

That would represent an even higher number than the peak in hospitalisations during the first wave. The number of people in hospital with Covid-19 is currently just below 10,000. 

However, latest NHS England figures suggest the country has about a 110,000 bed capacity. Health bosses also have thousands of free beds in the Nightingale hospitals built during the first wave, which went unused. Thousands of private beds have also been commandeered to give the NHS some breathing room if it’s faced with a surge in Covid-19 admissions. So even at 25,000, it would suggest the health service will be nowhere near overstretched in the winter.

Even at the peak of the crisis in Britain, only a quarter of all beds were occupied by virus patients. On April 7, 26.5 per cent of the 67,206 people in England’s hospitals were being treated for coronavirus — the highest proportion on record. 

Emmanuel Macron could announce new nationwide French lockdown TODAY

French President Macron could announce a new nationwide lockdown today as a growing wave of anti-lockdown protests sweep Europe.

The French government is envisaging a month-long national lockdown to combat the coronavirus resurgence which could take effect from midnight on Thursday, France’s BFM TV reported yesterday.

Macron is due to make a televised address at 8pm today which is expected to see a national lockdown imposed or a host of local measures and curfews extended.

His office did not comment on whether Macron would announce such a measure then.

The national lockdown under consideration would be ‘more flexible’ than the strict restrictions on movement imposed in France in March this year, reported BFM TV.

France has had a big spike in the number of daily deaths from COVID-19, recording an additional 523 deaths in 24 hours this evening, the highest daily death total since April.

The French government also reported an additional 33,417 new infections.

Lib Dems urge Boris Johnson to hold four-nation summit to save Christmas

Boris Johnson is being urged by the Liberal Democrats to convene a four-nation summit to save Christmas as the party warned it is ‘inevitable’ people will travel to be with their loved ones. 

The party has written to Mr Johnson as well as Scottish leader Nicola Sturgeon, Welsh First Minister Mark Drakeford and Northern Ireland First Minister Arlene Foster calling for them to work together on a blueprint for the festive period. 

Lib Dem leader Sir Ed Davey said that because family members are often split up across the different nations of the UK it makes sense for there to be one set of coronavirus rules during Christmas to avoid confusion. 

The party wants the four nations to agree ‘uniform guidance’ on the number of people who can gather, to cooperate on the safe return of students and to explore how to expand travel options to allow people to move around the country while complying with social distancing.  

Such a unified approach would represent a dramatic departure from the current way of working which has seen the four nations act largely independently in response to the coronavirus crisis. 

But Environment Secretary George Eustice rejected the idea this morning, saying it is ‘far too early’ to set out guidelines about Christmas.

He told BBC Radio 4’s Today programme: ‘It’s far too early to say exactly where things will be by Christmas, but the Prime Minister’s made clear he wants people to be able to have a Christmas that’s as close to possible as normal.’ 

SAGE has separately warned that it believes all of England will have to be put into the top tier of restrictions by mid-December, putting Christmas get-togethers at risk of being cancelled completely. But Mr Johnson is facing a difficult balancing act with advisers calling for tougher restrictions while Tory MPs demand the PM set out a lockdown exit strategy. 

The Northern Research Group of more than 50 Conservative MPs, many from constituencies in the so-called Red Wall, is adamant the PM must announce a road map for how areas can get out of Tier Three as rebels warned the north of England is being unfairly treated. 

The group’s efforts received a boost from Chancellor Rishi Sunak yesterday as he said he shared the MPs’ frustrations at rules being imposed and ‘you want to know when it is going to be over’ in an apparent hint at his opposition to a national shutdown. 

Despite the warnings from SAGE, Environment Secretary George Eustice insisted this morning a national lockdown is ‘not appropriate’ because there is ‘no point having a lockdown in those parts of the country where the incidence of the disease is very low’. 

A further 367 deaths were announced yesterday, the highest daily number since May, with the official UK death toll now at 43,365.

Health chiefs believe the daily total could rise to 500 within weeks, still significantly below the 1,000-plus recorded during the peak of the first wave, amid fears that the Government’s tier system is not enough to get infections back under control.

Professor Sir Mark Walport, a member of SAGE, said this morning there is currently ‘little to feel reassured about’ and that it is ‘certainly not unrealistic to think’ there could be 25,000 people in hospital by the end of the November.

He told BBC Radio 4’s Today programme: ‘We are still relatively early in the second wave and, as we know, there’s a significant lag – two to three, two to four weeks – between actually getting an infection and people potentially dying, and so the number of deaths is always lagging the number of cases that are reported at any one time, so there’s little to feel reassured about.’

He added: ‘There are still an awful lot of people out there who are vulnerable, it’s not, as it were, that the disease has killed off everyone who is vulnerable, there are still very many people that are vulnerable and we know that only still a relatively small proportion of the population has had this infection.’ However, Sir Mark said he hoped improved treatments for coronavirus could keep the death toll down. 

He said: ‘The number of cases is rising very significantly – it was 22,800 on 27 October and the seven-day average was just over 22,000, so there are an awful lot of cases.

‘One of the differences of course is that we are better at looking after people with coronavirus now and so hopefully the case fatality rate will be lower than it was in the first wave, but at the end of the day the fatality rate, the number of people who die is a product of the number of people who are infected and their vulnerability.’

More than eight million people across England are now in Tier Three areas, with almost all of them located in the north of the country. 

Mr Johnson has repeatedly refused to rule out imposing a nationwide circuit-breaker lockdown. 

But he is reluctant to push the nuclear button because of the damage it would do to the economy and because of a growing Tory revolt over lockdown measures

The Northern Research Group of more than 50 Conservative MPs wrote to the PM yesterday to demand he set out a ‘road map’ for how areas can get out of Tier Three. 

The group was given a boost as Mr Sunak, who represents a constituency in Yorkshire, lined up to sympathise with the argument it had made. 

He told the BBC: ‘I absolutely share my colleague’s frustration at restrictions, of course that is frustrating if you’re having to live under these things and you want to know when it is going to be over.’ 

Growing Tory disquiet over current coronavirus restrictions means Mr Johnson is likely to face a furious backlash if he does opt to impose a national lockdown, even if it is only for a few weeks. 

However, the NRG demands for an exit strategy were given short shrift by some in Whitehall who said it is not possible to set out simple criteria for leaving Tier Three as they stressed it has to be a judgement call based on myriad factors. 

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