COVID-19: Is the Fat Lady Gargling Yet?

Today, I’ll focus once more on the four countries of the UK, and the effectiveness of their measures against COVID. The data was taken on March 11^th, 2022, and runs up to March 10^th (or 9^th in the case of some Welsh figures).

Lockdowns over the course of the epidemic

In contrast to my normal approach, I’ll begin with lockdowns. Here are the lockdown stringencies for the four countries over the course of the epidemic:

England’s lower average stringency than the rest is mainly a reflection of less stringent lockdown policies since Sajid Javid took over as health secretary in June 2021. It’s interesting to note that Northern Ireland has tended to go the other way, having been the heaviest locked down of the four countries for most of the second half of 2021.

Recent lockdowns

Here is the current lockdown status in the four countries:

In England now, the only lockdown measure of any kind is screening of incoming international passengers. All four countries have the same status with regard to international lockdowns. Scotland, Wales and Northern Ireland have all recommended school closures; but, I expect, no school will actually be closed unless explicitly ordered to close. As to face masks, the four countries have (conveniently) chosen four different levels of lockdown. We may get some idea of how well, if at all, face mask mandates restrict COVID!

Here is a list of the lockdown measures in place in each country since December 15^th:

Country	Date	Stringency	Measures
England	20211215	38.89	Schools: Recommended closed, Workplaces: Some closed, Events: Mandatory cancelled, Gatherings: No restrictions, Public transport: Open, Stay at home: No measures, Travel: No restrictions, International: Quarantine high-risk, Face covering: Required in some places
England	20220127	20.37	Workplaces: Open, Events: Allowed, Face covering: No measures
England	20220211	17.59	International: Screening
England	20220224	13.89	Schools: Open
Northern Ireland	20211215	52.78	Schools: Recommended closed, Workplaces: Some closed, Events: Mandatory cancelled, Gatherings: Up to 11-100, Public transport: Recommended closed, Stay at home: No measures, Travel: No restrictions, International: Quarantine high-risk, Face covering: Required when with others
Northern Ireland	20220211	50	International: Screening
Northern Ireland	20220215	17.59	Workplaces: Open, Events: Allowed, Gatherings: No restrictions, Public transport: Open, Face covering: Recommended
Scotland	20211215	38.89	Schools: Recommended closed, Workplaces: Some closed, Events: Mandatory cancelled, Gatherings: No restrictions, Public transport: Open, Stay at home: No measures, Travel: No restrictions, International: Quarantine high-risk, Face covering: Required when with others
Scotland	20211225	44.44	Gatherings: Up to 101-1000
Scotland	20220117	38.89	Gatherings: No restrictions
Scotland	20220211	36.11	International: Screening
Scotland	20220228	17.59	Workplaces: Open, Events: Allowed
Wales	20211215	38.89	Schools: Recommended closed, Workplaces: Some closed, Events: Mandatory cancelled, Gatherings: No restrictions, Public transport: Open, Stay at home: No measures, Travel: No restrictions, International: Quarantine high-risk, Face covering: Required in some places
Wales	20211226	47.22	Gatherings: Up to 11-100
Wales	20220115	44.44	Gatherings: Up to 101-1000
Wales	20220121	41.67	Gatherings: Up to >1000
Wales	20220211	38.89	International: Screening
Wales	20220218	17.59	Workplaces: Open, Events: Allowed, Gatherings: No restrictions

The reduction of the international lockdown level from Quarantine high-risk to Screening took place in all four countries on February 11^th. The move to the current lockdown status in each country took place on February 15^th in Northern Ireland, 18^th in Wales, 24^th in England and 28^th in Scotland.

Cases over the course of the epidemic

Here are the total cases per million in each country:

Northern Ireland is well ahead in total cases per million, so is also likely to be the quickest to reach herd immunity. Scotland is starting to catch up, after being bottom of the four for more than a year. And Wales seems to be moving slowest in terms of getting the virus through the population.

Recent New Cases

Here are the daily new cases per million (weekly averaged):

After the huge peak in January 2022, all four countries show a bottoming-out, followed by a rise in daily new cases, in the third or fourth week of February. The recent rise is more marked in Scotland and England than in Wales and Northern Ireland. In England at least, it would seem that this rise must have been caused by the abolition of quarantine for incoming international passengers, since the inflection point took place before the schools were completely re-opened. The timing of the inflection is similar in Wales and (maybe) Scotland, but a little later in Northern Ireland.

Here is the same data looked at in terms of weekly case growth, which is a good proxy for the actual reproduction rate of the virus:

Except in Northern Ireland, the recent surge in weekly case growth seems to begin shortly after the relaxation of international lockdown on February 11^th. This suggests that the relaxation is indeed the cause of the surge. As was apparent from early in the epidemic, restrictions on international travel make a difference to the spread of the virus which is much greater than the small change in the stringency percentage would suggest.

The UK strategy now seems (rightly, in my opinion) to be to let the virus rip, provided hospital and ICU facilities aren’t likely to become overloaded. So, to get a handle on how things are really going in each country, I’ll have to look at the hospital and ICU figures.

Face masks

As to the effectiveness of face mask mandates, over the last three weeks or so England, Scotland and Wales have kept close together in weekly case growth, suggesting they have similar R-rates despite the differences in face mask mandates. And Northern Ireland, with face masks only “recommended,” has the lowest weekly case growth of all. It isn’t looking very good for the face mask fascists (or, if you like, “face-marxists.”) Though it must be said that, right now in my area at least, more people are wearing face masks of their own volition than was the case in 2021.

Hospitalizations

Here are the current COVID hospitalizations per million for the four countries:

COVID hospital occupancy seems to have been slowly trending up in all four countries since the delta variant hit in July 2021.

For comparison, here is the list of hospitalized COVID patients in each country at the peak of the epidemic back in January 2021:

The ratios of current to peak hospital occupancy by COVID patients in each country are: England 27%, Wales 30%, Northern Ireland 46%, Scotland 80%. So, England and Wales look fine at the moment, but the Scots have a hospitalization rate almost as high as at the peak of the epidemic. Northern Ireland is somewhere in the middle; but its COVID hospital occupancy is currently trending downwards.

ICU occupancy

Here are the current ICU occupancies by COVID patients in the four countries:

In contrast to hospitalizations which were slowly rising, ICU occupancies were roughly static from July to November 2021, and have since been trending down. This, I expect, reflects the lower severity of the omicron variant relative to delta, and of delta relative to its precursors.

For comparison, here is the list of ICU occupancy by COVID patients in each country at the peak of the epidemic:

The ratios of current to peak ICU occupancy by COVID patients in each country are: Northern Ireland 1.6%, England 5.9%, Wales 6.7%, Scotland 10.0%. So, there is no foreseeable chance in the short term of running out of ICU resources in any of the countries.

Deaths over the course of the epidemic

Here are the total deaths per million and cumulative deaths per case for the four countries:

The main reason for England’s clear lead in the total deaths per million league is that the early mis-handlings such as using the wrong ventilator protocol, and sending patients back to care homes without testing them for COVID, had their effects mainly in England. However, the Welsh have now very nearly caught up the English in terms of deaths per case. In both deaths per million and deaths per case, the Northern Irish have done better than anyone else, with the Scots second. It’s interesting to note that Southern Ireland, too, has done well against the virus in terms of deaths, in comparison to other European countries.

That ordering might seem to suggest that lower average lockdowns lead to more deaths! But of course, the English lead in deaths was seeded in the early part of the epidemic when all the lockdown stringencies were similar, whereas the decline in average stringency in England is down to more liberal policies in the latter part of the epidemic.

Deaths current status

Here are the lists of current daily deaths per million and current deaths per case (with cases offset by 21 days):

The differences in the order probably reflect the differences in lockdown policies during January and February, since success in controlling new cases will tend to increase deaths per case for a period. But England, at least, now seems to be in (relatively) good shape on deaths.

Is the fat lady gargling yet?

Some have expressed concern that despite the huge falls in new case counts since the new year, the recent rises in new cases mean that the epidemic isn’t anywhere near over. The fat lady, they might say, isn’t even doing her gargling exercises yet. But my reading of the data, from England at least, is that the COVID situation right now isn’t nearly as bad as the doomsayers would have us believe.

Moreover, in recent weeks, the UK has joined a number of other European countries (such as Sweden and Switzerland) in not publishing new cases or deaths figures at week-ends. The cases and deaths for Saturday, Sunday and Monday are all being reported together under Monday’s date. This suggests that the people who have been doing this data collection at week-ends have been “stood down.” This, in turn, suggests that those who have detailed knowledge about the UK’s status and prospects with regard to the virus are starting to think it may soon be a far lower priority than it has been.

To put all this in perspective, England is now essentially not locked down at all except for screening of incoming international travellers. You can’t go much further south than here. I can’t predict how fast the current trend of rising new cases will build, or how far it will go before turning down. I suggest you ask modeller Neil Ferguson.

But England is the place to watch. Once we’re over the next cases peak, absent another variant even more transmissible than omicron, I predict the fat English lady will be clearing her throat ready to serenade us all.