Coronavirus statistical update: Have the five tests been met?

Further easing of the lockdown which the government introduced today is running into opposition from within the expert circles on which it claims its policy-making is based. To what extent do the latest statistics show that the five tests put forward by prime minister Boris Johnson for deciding that restrictions can be eased are being met? Nick Terdre takes a look.

As from today outdoor retail operations such as street markets and car showrooms are allowed back in business, nurseries and primary schools may reopen to some of their children, gatherings of up to six are permitted in private outdoor spaces such as gardens and – thrown in at the last moment – very vulnerable people who until now have been urged to shield are being encouraged to go out.

Not a few voices have criticised these moves as premature and risky. Among them is the Association of Directors of Public Health (ADPH), whose president Jeanelle de Gruchy said yesterday that, “Directors of Public Health are increasingly concerned that the Government is misjudging this balancing act and lifting too many restrictions, too quickly.”

The critical debate, she said, concerned R – the retransmission rate. “The rapid and multiple ways in which measures are being eased is likely to make it difficult to judge the cumulative impact on R. As we saw in March, R can go above 1 in a very short space of time – and once it does it can take many months to bring it back down…

“The NHS ‘Test and Trace’ programme is currently far from being the robust operation that is now urgently required as a safeguard to easing restrictions.”

Among others questioning the easing of restrictions were the Royal College of Nursing, which said staff were “anxious that easing lockdown could undo the progress we’ve made as a country in combatting this virus,” and Sally Bloomfield, an honorary professor at the London School of Hygiene and Tropical Medicine, who was reported in The Guardian as asking, “Why introduce all of these measures at the same time – which means that if the situation deteriorates it will be impossible to know which measures need to be reimposed, and we will just have to go back to lockdown?”

So what do the latest statistics tell us about how well the five tests set by the government for easing restrictions are being met?

Protecting the NHS’s ability to cope The number of people in hospital with the infection continues to fall, hitting a total of 7,639 on 31 May, down from 8,945 seven days previously. Hospital admissions on 29 May, the last day for which figures are available, were 545, down from 685 on 22 May, while the proportion of intensive care unit beds occupied by Covid-19 patients was 9% on 30 May, against 12% seven days before.

Due to lack of ‘demand,’ the Nightingale hospital in east London, which was specially built to boost the NHS’s Covid capacity, has been mothballed.

A sustained and consistent fall in daily death rates In fact the reduction in daily deaths since the peak of 1,172 on 21 April appears to be flattening out. The number of deaths confirmed with a positive Covid-19 test was 113 on 31 May, down from 215 the previous day and taking the total to 38,489. But the rolling seven-day average is 242, little changed from 244 on 26 May.

The rate of infection is falling to manageable levels On 31 May testing identified 1,936 new cases of infection, down from 2,445 the previous day. The rate is certainly falling – the rolling seven-day average stands at 2,001, down from a peak of 5,195 on 14 April.

Hastings and Rother remain relatively lightly hit by the virus – as of 4.05pm on 31 May the total number of cases in Hastings was 55 and in Rother 95.

Last updated on 29 May, R stands at 0.7-0.9 – in other words, the upper end of the range is uncomfortably close to 1. Arguably it is higher now than when the prime minister announced the first phase of relaxation on 11 May, when it stood at 0.5-0.9%.

The range of operational challenges, including testing capacity and PPE (personal protective equipment) is under control Of the PPE situation, the ADPH says, “PPE manufacturing and supply chains are stronger, but shortages are still being reported and it is not clear that supply can meet new demand as different parts of society, public services and the economy open.”

Meanwhile testing capacity in terms of lab capacity on 31 May was 205,634 tests a day, so if the government target of 200,000 tests a day by end May referred to capacity, it was met.

It is however a hybrid figure, made up of four of the five pillars on which the testing strategy is based. Pillars 1, 2 and 4 are antigen tests for showing whether a person is currently infected. Pillars 1 and 2 are used for diagnostic purposes while Pillar 4 tests are for research purposes. Pillar 3 comprises antibody tests to indicate whether a person has had the coronavirus.

Actual testing has never approached 200,000 tests a day. The highest numbers recorded were 177,216 on 20 May and 140,497 on 22 May. On 31 May a total of 115,725 tests were reported.

The actual number of diagnostic tests is also a lot less than the test total. On 31 May 42,139 kits were put in the post and 3,174 tests were performed for research purposes. So the number of diagnostic tests yielding results that day was 70,412. The true figure will be higher as a number of test kits will also have been analysed that day, but these have already been included in the stats at the time of dispatch; the notes to the statistics confirm that there is no double-counting of tests carried out with kits. But no figure has been released for the number of test kits that for whatever reason don’t end up in a lab and get analysed.

Also currently missing from the stats is a figure for the actual number of people tested. For clinical reasons some people are tested more than once. For example, according to the Department of Health and Social Care and Public Health England, on 26 April 37,024 tests were carried out on 26,255 people – the number of people tested was just over 70% of the number of tests performed.

Now, according to the notes, reporting on the number of people tested has been temporarily paused while a check of data is made that might require the stats to be corrected. This check extends back to late March.

Any adjustment to current measures does not risk a second wave of infection that overwhelms the NHS The stats are trending in the right direction, although it would be good to see the death rate resume its downward path. But how do you decide when the number of new cases, the number of deaths, and so on, has declined sufficiently to justify relaxing the restrictions? Opinions clearly differ.

 

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