What just happened
- Britain recorded more new Covid cases per capita than any other country (more below).
- US Democrats said they plan to impeach Trump this week if he doesn’t resign, even if his Senate trial is delayed until after Biden’s first 100 days.
- Six wildlife rangers were killed by militias in the Virunga National Park, a stronghold of the mountain gorilla in eastern Congo.
The worst Covid in the world, in terms of cases per 100,000, is here in the UK. One in 50 people have it. Fifty thousand new cases were recorded on Sunday for the 13th day in a row and daily new cases peaked for the first time last week at over 60,000 – nearly four times the per capita rate in France, Italy and Spain. According to one new estimate one in five people have had Covid, or five times the number of confirmed cases, since the start of the pandemic.
Why? A surge in infections since December may be partly a result of the high transmissibility of a new variant traced to a single patient in Kent in September. But doctors are concerned and angry that ministers are blaming the variant for abject failures of public health policy, especially over Christmas. Chris Whitty, the chief medical officer, says parts of the NHS are in “the most dangerous situation anyone can remember”. Three basic questions:
Who is sick?
- More people of all ages are getting infected and going to hospital than in the first wave, but the infection rate is highest among teenagers and people in their 20s and 30s. They are vectors even if they have no symptoms. That means more people in their 40s, 50s and 60s are in hospital, even though patients’ overall age distribution is largely unchanged since the first wave.
- The elderly still outnumber young age-groups in hospitals, but not in intensive care. New Public Health England figures show ICU admission rates are highest for 65-74 year-olds, followed by 45-64 year-olds, who overtook 75-84 year-olds in mid-December. It’s unclear why but triage according to who has the best hope of survival could be a factor, as this heartbreaking piece from UnHerd suggests.
- As in wave one, infection levels correlate strongly with population density and multi-generation households. They’re highest in a London-Essex triangle formed by Thurrock, Redbridge and Barking, where up to two in five people have had Covid, according to modelling by Edge Health. This triangle is closely followed by other east London boroughs and Liverpool, Manchester, Rochdale and Salford.
“There are young people of all ethnicities who didn’t have what anyone would think of as significant medical problems before this,” a critical care consultant at the Royal London Hospital told the Sunday Times. Another senior London doctor said the population in intensive care at his hospital was younger than in April, possibly but not necessarily because of the Kent variant. Why else? The “idiocy” of government advice leading up to Christmas.
Who is dying?
- Still older people, overwhelmingly. The risk of death for under 40s in England is 0.1 per cent, doubling with every eight years of ageing to over 5 per cent for over 80s.
- Roughly five times as many over 70s as under 70s have died after a confirmed Covid test since June, although that ratio could change if ICU admission rates for the 45-64 age group continue to rise.
- Men are still more likely than women to die from Covid in all age groups over 40. In wave two men have been at least twice as likely as women to become critically ill in all age groups over 50, according to data studied by the BBC for England, Wales and Northern Ireland.
- Since the start of the pandemic a total of 344 people under 40 have died after testing positive for Covid, 80 per cent of them with underlying health conditions.
How much more of this can the NHS take?
Not much. There are 40 per cent more patients in hospital with Covid now than at the first peak in April. In raw numbers that’s 32,294 compared with 21,684. Hence Prof Whitty’s warning yesterday that “there is a material risk of our healthcare services being overwhelmed within 21 days”. If the government fails to meet its target of 2 million vaccinations a week and 13 million by mid-February, a Tier 5 lockdown may be the only option left.
Quote of the day: “We are on our knees out there.” Dr Anon.