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.

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(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:

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@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.