Covid-19 – Ireland acted sooner than UK, double the testing, less than half the deaths per 1m

A comparison between Ireland and England in dealing with the Covid-19 virus and their casualty rate seems to reinforce the importance of timing in locking down countries, and in testing rates.

Irish Central (March 17): Britain and Ireland’s differing approaches to Covid-19

The United Kingdom may be Ireland’s closest neighbor, but the two nations could hardly be further apart in how they are approaching COVID-19. 

They are virtually polar opposites and Britain’s approach could deeply impact the Republic of Ireland, especially since the countries share a significant border in Northern Ireland.

The UK has lagged behind Ireland (and indeed the rest of Europe) in implementing stringent measures to curb the spread of Coronavirus.

From a Twitter thread by historian and writer Elaine Doyle @laineydoyle (edited):

I don’t understand the British media. I really, really don’t. Basic things: Ireland and the UK started this pandemic with roughly the same number of ICU beds (6.5 per 100,000 for Ireland, 6.6 per 100,000 in the UK). If anything, the UK was slightly better off.

Image

(ICU beds is just one indicator of country preparedness. Germany and Austria have relatively low death sates compared to Italy, France and Belgium, but so do Portugal and Finland).

As of today, there have been 320 deaths from the coronavirus in Ireland, and 9,875 deaths in the UK.

So we adjust per capita – how many deaths per 100,000 people?

As of Saturday 11 April, there have been 6.5 deaths per 100,000 people in Ireland (now 6.8).

There have been 14.81 deaths per 100,000 people in the UK (now 15.6).

Guys, people have been dying at more than *twice the rate* in the UK.

That the UK’s closest neighbour, with almost the *exact* same starting line in terms of its health system, is having a wildly different outcome? Not saying Ireland’s a paragon of virtue! Loads to discuss & critique & make better!

But wait, it’s worse! Because if you compare the per capita death rate between Ireland and *England*, rather than the UK as a whole, England has almost *2.5* times the number of deaths as Ireland (14.81 deaths per 100,000 vs 6.5 deaths per 100,000).

So you have two English-speaking countries, with close cultural and historical associations, both with underfunded health systems, & comparable levels of ICU beds (almost half the EU average) going into the pandemic.

But England has more than 2.5 times the deaths? Why?

If you’re arguing over whether Boris & Co’s ‘herd immunity’ policy (& the resulting delay in lockdown) had any effect on death rates – here’s your angle, lads. You have a real-time A/B test happening *right in front of you*.

Because Ireland closed down earlier. Much earlier.

While Boris was telling the British people to wash their hands, our Taoiseach was closing the schools.

While Cheltenham was going ahead, and over 250,000 people were gathering in what would have been a massive super-spreader event, Ireland had *cancelled St Patrick’s Day*.

The four-day Cheltenham Festival is a meeting in the National Hunt racing calendar in the United Kingdom. It place annually in March at Cheltenham Racecourse in Cheltenham, Gloucestershire – Wikipedia

Daily Mail: Cheltenham Festival organisers say Boris Johnson’s trip to England-Wales Twickenham rugby match was one reason they didn’t cancel race meeting blamed for coronavirus spread  – since the festival took place hundreds of people have complained of getting symptoms of the deadly virus.

In Ireland, we watch a lot of British media and news, and let me tell you, it was like living in bizarro-world.

Because our Irish TV news was filled with very direct, serious pronouncements about what was coming. But when we switched to the British TV channels… *crickets*.

Particularly vivid for the weekend before Paddy’s Day. Rolling restrictions in Ireland, so no groups > 100, but pubs not yet closed. Video emerged of people singing in a pub in Temple Bar => public outcry, #shutthepubs trended, Health Minister comments, voluntary closure ensued.

 

I remember watching that video being posted on Twitter that Saturday night, and feeling sick to my stomach. How many people were being infected, at that very moment, singing along to the Stereophonics? It was such a huge crowd.

I assume there were people in Cardiff who felt the same way I did. But the difference was: I was supported by my government. You weren’t.

And that cost lives.

The Stereophonics gig was on the 14 March. Median 5-7 days to get sick, and let’s allow another 14 days to get seriously ill. The people infected at the Stereophonics gig were in hospital last week.

The people *they* infected will start dying next week.

Pandemics roll along exponential curves. The NYT (using @brittajewell’s calculations) showed it beautifully here:

.

@brittajewell used US figures, & showed that if you started to stay home *this week* (March 13, at the time of publication), you could prevent 2400 infections. But if you started to home *next week* instead, you prevented 600 infections. (Those figures were based on US infection numbers at that point, with 30% growth rate per day. It’s not the UK.)

It’s weird, right? Exponential curves are really counter-intuitive. When they go up, they go up FAST. Timing matters, a lot. By staying home *this week* rather than *next week*, one person could prevent an extra 1800 infections. One person!

And as @jkottke pointed out, assuming a 1% death rate, that’s 18 lives saved. 18 lives saved, by the choices of one person to stay home for the week starting 13 March, rather than the following week. That Stereophonics gig? Was on 14 March.

Ireland cancelled Paddy’s Day on 9 March, initiating a series of rolling, controlled restrictions, from school closures & large group bans (12 March), to closure of non-essential businesses & social distancing, to full lockdown. It was precise, clearly communicated, controlled.

The UK closed their schools on 20 March, a full week after we closed ours. Full lockdown came to the UK on 23 March.

And while there was some muddied, confused advice in the UK between times (avoid non-essential travel from 16 March? don’t go to the pub, but then again, they’re still open, so maybe do?) – there was an abrupt about-turn, after the Imperial College report came out.

The comparisons aren’t neat between the two countries, because the processes (and nomenclature) were different. Technically, the UK went into lockdown *before* Ireland; but that’s not a fair comparison, as we were already operating our ‘Delay Phase’ from 12-27 March.

But I would argue the crucial difference lies in that two-week period: from 9 March, when we cancelled Paddy’s Day, to 23 March, when the UK govt finally (and abruptly) wheeled about, and went into lockdown.

And because the UK government delayed, distorted and distracted for those two weeks, the UK people ended up on the wrong part of an exponential curve, when lockdown started. And now, the UK has over twice the number of deaths per capita than Ireland.

But wait, it’s worse! HOW how HOW can it be worse.

Because: testing.

Because the UK figures only include deaths, in hospitals, from people who had already been tested positive for COVID-19. That sentence has a whole pile of clauses and commas, doesn’t it? Let’s break it down.

It means that a person could die *in a UK hospital* of the coronavirus; and all their doctors could agree that yes, they definitely died of coronavirus; and their *death cert* says that yes, they did, in fact, die of coronavirus –

… and they wouldn’t be included in UK figures.

Because they weren’t tested.

And you have to have a positive test, before death, to be counted in the UK deaths.

The UK isn’t testing nearly as much as it needs to.

And Ireland is testing a *lot* more. We have a drive-through testing centre in the sacred sporting grounds of Croke Park – think turning Wembley Station into a testing centre, and you get somewhere close.

Ireland is still building its testing capacity, but we’ve been explicitly following the South Korean model of test, test, test (and contact trace). And we’re using our time in lockdown to build our testing network.

The aim is to have 15,000 tests per day, or 105,000 tests per week – that is, testing 2% of the population a week. 15,000 tests is about 7 months of flu testing for Ireland – and we’re planning this, every day, for months and months.

We’re not there! We had to grab Germany for a dig-out, we fell so far behind! There’s loads of teething problems! Like I said at the top of the thread: I’m not saying that Ireland is a paragon of virtue here.

Of course no country has dealt with Covid-19 perfectly, it was a rapidly evolving with big decisions needing to be made quickly that had huge health, economic and social ramifications. Not easy for any country to get things right.

And to date, Ireland has performed 8.69 tests per 1,000 people. ourworldindata.org/covid-testing# The UK has performed 4 tests per 1,000 people.

Currently Worldometer shows Ireland with 10.73 and the UK with 5.2 (New Zealand 12.68).

So: to my UK friends, let’s lay it out there. You’re testing at half the rate that Ireland is, and your loved ones, your family, your friends are dying over twice as fast.

So timing and testing have been very important.

And that’s still a wild underestimate of how bad things are, because your low testing rates are artificially depressing your death figures; whereas Ireland’s high testing rate is (comparatively) inflating ours (or, more fairly, accurately recording them in our figures).

Failed by your government, and failed by your media.

Failed, by news reports that (correctly!) talk about how horrific the death toll is in NYC, while eliding the horrors of nearly 1000 people dying in a single day at home.

Failed, because it didn’t have to be like this.

Failed, because there are lessons and exchanges to be found here, but in those 2 weeks when so much could have been done, your media didn’t pay any heed to what was happening beside it.

Because your media didn’t report on the contrast between Boris’ choices and ours.

Failed, because your media STILL isn’t reporting on the contrasts in death rates between us, and why that might be the case.

It’s too late to get the timing of even cancellations and lockdowns right, but not too late to ramp up testing.

Failed, because in this long-standing, complicated, skewed relationship between us, we can see you clearly, and you seem to barely see us at all.

And it breaks my heart.

But there’s still time. Time to flatten your curve. Time to build testing. Time to develop a robust contact tracing system. Time to *use* your lockdown as it should be used, while we do the same. Time to be our partners in this, as we all must be, in a globalised pandemic.

The best time to plant an oak tree was 20 years ago; the second-best time is now.

The best time to stop this pandemic was last January. The second-best time is now.

And while we’re working this ground together, remember that over the fence, in your neighbouring allotment, we’re tackling the same tasks as you. It might be worth taking a peek over the fence sometime, to see what we can share.

The UK seems to be similar to how France was, not counting deaths in rest homes.

Business Insider: Hundreds of coronavirus deaths are taking place in UK care homes but not being included in the official death toll

BBC: Warning over daily death figures

Over the weekend, NHS England released new figures broken down by the actual date of death.

And these reveal that between 11 March and 1 April there were about 300 more deaths than previously thought during that period.

Separate figures, published by the Office for National Statistics (ONS) also suggest the number of people dying with coronavirus is higher than the daily totals indicate.

The ONS examined registrations and found deaths in the community not included in the daily hospital deaths figures.

In the week to 27 March, for the 501 deaths recorded in hospitals the ONS also found 38 deaths linked to coronavirus in the community.

Also from BBC:

Larissa Nolan (Irish Mirror:  7 April): UK and Ireland’s responses to Covid-19 crisis are worlds apart

For far too long, the Brits’ approach to this crisis was to stick their fingers in the ears, close their eyes and go: “Lalalalalala”.

Like many others in Ireland, I watched on; worried for relations and friends in England. What were they at over there?

British political leaders have subsequently made some attempts to address it, but it’s too late now. The “denialism” – as a senior British scientist called it – is too strong.

Reports from the weekend show Britons still gathering, regardless. Attitudes are ingrained. Behaviours have been set. Outcomes are following accordingly.

Here in New Zealand we don’t have such a stark contrast in approaches with our larger neighbour, Australia, except for timing. Covid-19 seemed to become established in Australia a few days sooner than here, particularly in New South Wales, but we lockdown harder and about the same time as Australia.

Current deaths in New Zealand 4, in Australia 59.

 

Leave a comment

37 Comments

  1. Alan Wilkinson

     /  13th April 2020

    As I noted, this is a marathon, not a sprint. Just as America’s outbreak was focused on New York, UK’s was focused on London. Both now show signs of moderating. Both are huge international hubs of activity and travel not comparable with anything in Ireland.

    Testing is fraught with false negatives. Contact tracing with clinical diagnoses is probably of greater importance. That us why NZ is reporting “probable” cases. Obviously people living in large dense cities have many more likely contacts.

    There are still a lot of unknowns.

    Reply
  2. UK could be ‘worst affected’ country in Europe

    The UK is likely to be among the European countries worst affected by coronavirus, one of the government’s senior scientific advisers has said.

    Wellcome Trust director Sir Jeremy Farrar told the BBC’s Andrew Marr Show the UK was likely to be “one of the worst, if not the worst affected country in Europe”.

    Sir Jeremy, a member of the government’s Scientific Advisory Group for Emergencies (Sage), told the BBC’s Andrew Marr Show the “remarkable” scale of testing in Germany had been key to keeping the number of hospital admissions for coronavirus lower than in the UK.

    Sir Jeremy said testing allowed countries to isolate people with Covid-19, preventing them from transmitting the virus to others, as well as buying time for hospitals to prepare.

    “Undoubtedly there are lessons to learn from that,” he added.

    The UK government has said it wants to do 100,000 coronavirus tests a day by the end of April but has faced criticism for not increasing the number more quickly.

    https://www.bbc.com/news/uk-52261859

    Reply
  3. David

     /  13th April 2020

    Its a bit of an odd comparison given Ireland has a total population that is half Londons and is one of the least densely populated places on earth.
    The bitterness and inferiority complex runs deep though to play politics with deaths with faux sympathy.

    Reply
  4. Conspiratoor

     /  13th April 2020

    As I suspected, ventilators are doing more harm than good. Watch for this to grow legs over coming weeks

    And another input for Al’s model as data improves…

    https://www.tvnz.co.nz/one-news/world/some-overseas-doctors-moving-away-using-ventilators-covid-19-patients

    Reply
    • Gezza

       /  13th April 2020

      How’s your own model going? Can you chart any results & post them like Sir Alan does? o_O

      Reply
      • Conspiratoor

         /  13th April 2020

        It’s a WIP G but keep the pressure on, you might get to see it. Quite different to Al’s approach which he keeps tweaking the thing to fit the current curve. Mine is more a scenario planner that forecasts the likely impact of changing inputs like the severity and duration of lockdowns.
        Also Al likes to work restrict himself to factual data which is fine but limits the value of this type of model where so much is unknown and anecdotal

        Whereas moi I’m less risk averse, not afraid to take a punt informed estimate

        Reply
      • Alan Wilkinson

         /  13th April 2020

        It might be useful to list the structural assumptions in my model (which you can see implemented as functions in the model sheet of the spreadsheet).
        1. The parameters are constant over the data set other than the isolation factor imposed from 26 Mar and the detection delay applying until 16 Mar.
        2. International arrivals present at the average midpoint of their infective period.
        3. Infected arrivals identified and reported positive within two days were quarantined immediately on arrival.
        4. All other detected cases were quarantined from the report date.
        5. The hospitalisation, death and recovery parameters are all guestimates.
        6. All the parameters are just averages for the ranges across the cases.
        7. The relative uncertainties of the derived parameter values are not estimated.

        Reply
    • David

       /  13th April 2020

      This has been clear for a few weeks, the missinformation came out of China and then Italy to intubate early but the mortality rate in the UK was hideous so they moved quickly to CPAP machines.
      You are on a ventilator for a few weeks with this sucker and thats really tough on your lungs, heart and kidneys so if you are old and frail it will literally kill you anyway. Spending weeks unconscious with a tube down your throat when you probably wont make it anyway is not a good option for many.

      Reply
      • Conspiratoor

         /  13th April 2020

        “Ventilator-associated pneumonia” is a thing.

        And as soon as you’re hooked up you’ve got oxygen and god knows what else forced into your lungs. If the infection gets into such an apparatus, then it will be brought directly into the lungs of everyone else.

        “four ports for four patients”. Not this kiwi

        Reply
        • Conspiratoor

           /  13th April 2020

          And as the resident health professional has just informed …HAP (hospital acquired pneumonia) is also a thing

          Reply
          • Duker

             /  13th April 2020

            Pneumonia virus exists every where , most of the time. Its probably in your nostrils right now…work out why you arent flat on your back.

            Reply
            • Pneumonia isn’t a virus. It’s an inflammation of the lungs caused by many things, including most commonly infuenza (various viruses) and also bacterial infections. Bacterial infections causing pneumonia can be treated with antibiotics, but viruses causing pneumonia can’t be treated by antibiotics.

              Pneumonia can in turn lead to other complications like sepsis, pleural effusion, and empyema.

              And any of these things can put added strain on the heart, which can lead to death by heart attack.

            • Conspiratoor

               /  13th April 2020

              Oh I see, it’s a quiz…

              Q – work out why you arent flat on your back
              A – Because I’m healthy, have a good immune system and drink lots of water

              See that was easy. Dont forget to cough duker, you’ll be fine

            • Duker

               /  13th April 2020

              https://en.wikipedia.org/wiki/Bacterial_pneumonia
              https://en.wikipedia.org/wiki/Viral_pneumonia

              So its clear pneumonia like illness can come from (almost) entirely virus or bacteria origin. .. huge number of specific strains have the word pneumonia in them.
              Its clear that was the context I meant, ‘you bring it with you’ when you develop symptoms in hospital ,

      • Conspiratoor

         /  13th April 2020

        Damn thing might save my life. Not quite what the missus was thinking when she forced me onto it though

        Reply
        • David

           /  13th April 2020

          They are converting sleep apnea machines to treat people as its gentler, I think it was the McLaren formula 1 team that is doing it. Covid attacks the alvioli in the lungs and the force of a ventilator damages them further so they are finding gentler ways to get oxygen in there.
          The other strange thing about covid is it allows you to expel carbon monoxide even when your lung is operating 70% down so again less need for ventilation.

          Reply
          • Conspiratoor

             /  13th April 2020

            Yes, fibrosis caused by pneumonia is pretty hard on alveoli. If I get time later I might post a with and without comparison from my fitbit app. This clearly shows the smoothing effect of the cpap on O2 levels

            Reply
        • Gezza

           /  13th April 2020

          Damn they think of everything 😐

          Reply
    • Alan Wilkinson

       /  13th April 2020

      I agree, C. Ventilators look a bit more like a death sentence than a life saver. Boris’s doctors seem of the same view.

      It’s looking like best outcomes are from avoiding big hospitals and using ventilators only as a last resort.

      Reply
  5. Conspiratoor

     /  13th April 2020

    The number of ICP beds can be a misleading statistic and as we have seen with other inter-country comparisons it depends on who, how and what criteria are applied…. When this began NZ had 153 ICU ventilated beds however these are typically almost fully occupied as part of normal BAU activities. Only 10%, or 15.3 beds were available at lockdown plus one. There was talk of expanding capacity to 560 beds but I’m not aware this has materialised

    Reply
  6. Gezza

     /  13th April 2020

    Over the last few days I’ve stopped watching tv news. Even on Aljazeera tv it’s all Covid19, Covid19, Covid19, Covid19, Covid19, Covid19. And what with Melissa Wotserface shrieking it’s all just got to much for me & I fear for the survival of my television set.

    I’m getting most of my Covid19 info from this blog where at least there are interesting & intelligent debates about it, and other matters.

    Altho even here it’s pretty heavy on Covid19, Covid19, Covid19. 😀

    Reply
    • Gezza

       /  13th April 2020

      *Wotserface = Stokes. Soz … I knew it would come to me eventually. 😐

      Reply
  7. UK cancels order for simple ventilators, needs more complex ones

    Britain has cancelled an order for thousands of units of a simple model of ventilator developed by industrial companies to treat COVID-19 because more sophisticated devices are now needed, a source involved in the project said on Sunday.

    “We are no longer supporting the production of the BlueSky device following a reassessment of the product’s viability in light of the ever developing picture around what is needed to most effectively treat COVID-19,” said a spokesman for the Cabinet Office, which is coordinating ventilator orders.

    “We are continuing to work at unprecedented speed with a number of other manufacturers to scale up UK production of ventilators,” the spokesman said.

    https://www.reuters.com/article/us-health-coronavirus-britain-ventilator/uk-cancels-order-for-simple-ventilators-needs-more-complex-ones-source-idUSKCN21U0UI

    Reply
  8. david in aus

     /  13th April 2020

    Bald men fighting over a comb. These are petty comparisons, both Ireland and the UK have done poorly compared to the gold standard of East Asian countries.

    Ireland has fewer global links than London, that is where the outbreak has been concentrated in the UK. Nevertheless, I hope these countries learn their lesson for the next pandemic.

    Carte blanche, Europe has done poorly: Euro versus non-Euro, northern or southern, rich or poorer. They had advanced warning.

    Reply
    • David

       /  13th April 2020

      Ireland is 4 times as bad as Canada what does she think her government is doing wrong.

      Reply
      • Canada is obviously more closely linked to the US if you want to compare two countries.

        But…

        Provinces and territories have, to varying degrees, implemented school and daycare closures, prohibitions on gatherings, closures of non-essential businesses, restrictions on entry, and mandatory self-isolation for travellers. Canada severely restricted its border access, barring travellers from all countries with some exceptions. The Minister of Health invoked the Quarantine Act, legally requiring all travellers (excluding essential workers) returning to the country to self-isolate for 14 days.

        – On January 15, the Public Health Agency of Canada activates the Emergency Operation Centre to support Canada’s response to COVID-19
        – On February 9, Canada expands COVID-19 screening requirements for travellers returning from affected areas to 10 airports across 6 provinces.
        – On March 9, Canada confirms its first death related to COVID-19.
        – On March 13, Canada advises Canadians to avoid all non-essential travel outside of Canada until further notice.
        – On March 16, Canada advises travellers entering Canada to self-isolate for 14 days.
        – On March 18, Canada implements a ban on foreign nationals from all countries, except the United States from entering Canada, Canada-U.S. border closes to all non-essential travel, and redirects international passenger flight arrivals to four airports in Calgary, Vancouver, Toronto and Montreal.
        https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html

        …might explain a different timeline approach in Canada.

        Reply
  9. Blazer

     /  13th April 2020

    ‘as I suspected’
    ‘as I noted’
    ‘this has been clear…’

    amazing analysis of C19….the prescient,visionaries,luminaries….with Capt Hindsight togs in their bags,looking for a …phone booth.

    Reply
    • Alan Wilkinson

       /  13th April 2020

      Modestly apologising for repeating myself and I get lumbered with this calumny. Honestly.

      I suggest B should begin every comment with:
      Wrong as I was last time, I’ll be wrong again in saying …

      Reply
      • Blazer

         /  13th April 2020

        you did nail 3 things…

        this is a marathon, not a sprint.’
        ‘Obviously people living in large dense cities have many more likely contacts.’

        There are still a lot of unknowns.’

        uncanny!

        Reply
  10. Duker

     /  13th April 2020

    Then there are Super spreaders ( who can infect a lot of people at a large gathering) or the Non Spreaders
    “In the Covid-19 pandemic, there is a striking example from the far end of uninfectious — a couple in Illinois.

    On Jan. 23 the wife, who had returned from a visit to Wuhan — became the first laboratory-confirmed case of Covid-19 in the state. On Jan. 30, her husband was infected. It was the first known person-to person transmission in the United States.
    Both husband and wife became gravely ill and were hospitalized. Both recovered.
    State public health officials traced their contacts — 372 people, including 195 health care workers. Not a single one became infected.” NY times

    Reply
  11. Pink David

     /  13th April 2020

    I wonder why the comparison is between two countries that had had very slightly different lockdowns, not between those who locked down and those who did not?

    Reply
    • Duker

       /  13th April 2020

      Comparing Ireland to NZ shows them not so good. They are at 334 deaths ( yesterday with around 15 extra per day

      Reply

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s