Behind the scenes, members of the government’s Scientific Advisory Group for Emergencies, or Sage, have been forceful in stating clearly that the spread of the virus is going in the wrong direction, at a frightening pace –and that it has been for a substantial period of time.
In the last two weeks across England, hospitals have begun cancelling operations and reporting surges in numbers of coronavirus patients – in some parts of northern England the NHS is now treating more patients than it did in the first wave of coronavirus.
A planned national lockdown is increasingly being viewed within Whitehall and among scientists as the only way to take the heat out of the epidemic. All the recent studies show the virus is spreading and becoming more entrenched within communities.
At the start of October, Sage warned that the situation was so dire the numbers of deaths and pressure on the NHS would exceed the government’s ‘reasonable worst case scenario’ of 85,000 new deaths. This prompted ministers to bring in the three tiers of local restrictions.
All the latest assessments and studies of how the virus is spreading among communities shows these restrictions are not stopping the spread of the virus. The R-rate of transmission remains above the all important 1 across the country – meaning in effect people with the virus are continuing to infect others.
None of this should be a surprise – right back in March the very first modelling produced by Professor Neil Ferguson from Imperial College London warned of the risks of a second wave as we relaxed restrictions and second and even third lockdowns being needed. Sage has been clear throughout that what is happening now would come to pass if restrictions were eased over the summer.
Fears for the economy and the wellbeing of a nation wearied by the seemingly endless struggle with coronavirus were no doubt why ministers were not keen to press the lockdown button too soon. But it’s clear now that the measures so far have failed, with estimates of at least 50,000 infections a day.
Some areas such as Liverpool and Nottingham are reporting a fall in positive cases each day among some age groups – but this is likely to be because not everyone is coming forward for testing. The test and trace service is reporting around 22,000 positive cases a day – there are potentially another 28,000 infections not being picked up because people are not getting tested.
As cases spread, deaths inevitably follow – they are “baked in”, as deputy chief medical officer Jonathan Van Tam warned earlier this month.
The bleak reality is that its not the future cases that determine today’s deaths but what was happening a month ago. This means we should brace ourselves for a doubling of deaths in the next two to four weeks, meaning more than 500 deaths a day.
The only way to prevent this getting even worse in December is to break the transmission of the virus now – to push down the R-rate below 1. And that is easier when there is less virus around – this is why Sage was calling for a circuit breaker lockdown in September.
That is no longer possible. The virus is now far more widespread, so a lockdown will have to be deeper and last longer to put more downward pressure on the virus. The R-rate will need to not just get to 0.9 but to be depressed much further, otherwise Sage believes we will see a flattening of cases but no reduction.
The prime minister will undoubtedly face criticism for not acting sooner on the advice of his scientists. It now seems inevitable that delays will have cost more lives than would otherwise have been the case and a longer lockdown will harm the economy even more.
Even within the NHS, some leaders have been determined to present an optimistic picture to the politicians about being able to create extra capacity, while parts of the service have been struggling to cope.
Across large parts of northern England, NHS leaders have been privately warning their capacity was being stretched dangerously thin and modelling of the demand in coming weeks was looking dramatically worse than the first wave. Some areas are already seeing 40 per cent more patients than they did in April.
A leaked report seen by The Independent on Friday, showed for Greater Manchester the 10 hospitals there could run out of their normal intensive care beds as soon as next week. Other hospitals have cancelled routine operations and reported extraordinary long waits in their accident and emergency departments.
Hospitals do have the ability to expand capacity, but the public should be levelled with about what that will mean. It will require operations being cancelled as theatres are turned into makeshift ICUs and staff redeployed to look after patients. It will mean fewer beds available for non-Covid patients.
It will be a winter crisis the likes of which the NHS has never experienced.
