Why Has The UK's Biggest Jump In Covid Deaths Gone Unmarked By The PM?

Awful fatalities toll adds to pressure to push back major easing of restrictions to Easter.
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There was no prime-time televised Boris Johnson address to the nation. No No.10 press conference with a cabinet minister. Not even a live update on the government’s daily Covid “dashboard” (tech gremlins were to blame). Instead, the UK’s highest daily increase in recorded Covid deaths – 1,610 more people killed by this vicious virus – was revealed in a tweet by Public Health England.‌

Despite a grim familiarity with the fatal consequences of this disease, the biggest daily jump in death numbers ought to shock us all. It was left to PHE’s medical director Yvonne Doyle to respond officially to the milestone, and she had a warning of more pain to come: “Each death is a tragedy and the number of Covid-19 related deaths within 28 days of a positive test will continue for some time throughout this second wave.”

I’ve written before that there ought to be a national memorial to all those who have died from Covid-19. We rightly mourn every year those killed in conflict, but surely there is a case to etch in stone the name of every single one of those who have died from coronavirus? Yes, more than 100,000 names would take up a lot of space, but that would make it all the more powerful in any garden of remembrance. At present I don’t think there is even an online register identifying all those who have died.

In yet more bad news, this invisible killer is once again creeping into care homes with devastating effect. New figures showed that deaths in care homes in England hit the highest level since mid-May, with a 46% jump in coronavirus-related deaths in the last week. The sheer transmissibility of the new variant is wreaking havoc among the elderly, making that race against time for the vaccination programme even more urgent.

Speaking of which, we should later this week finally get a localised breakdown of vaccine numbers, along with the “regional” statistics put out on Thursdays. That should tell us just where the biggest problems are. Today, the PM’s spokesman told us “we have ensured that all areas have had equal access to supply” of vaccines.‌

That may suggest the lower rates in some areas may be because of vaccine “hesitancy” among some, particularly BAME groups. More deprived areas may have individual difficulties with rollout too. It may also reflect local logistics and preparedness. Whatever the reasons, publicly available granular data is overdue.

The new mass vaccination centres are also having issues (one reader tells me how his 80-year-old brother was told to travel 10 miles from Oldham to the Etihad Stadium in Manchester, only to be told on arrival he hadn’t been given the right user number). One health source says NHS England is working on a “push model” for the vaccine right now, pushing the vaccine based on demographics. It will revert to a “pull model” once supply exceeds capacity. “If you have lots of 80+ left to do, then they’ll prioritise you. If you keep having lots to do and you’re giving it to easier cohorts then they’ll stop.”

What is interesting is just how vague the government is about its timetable for easing restrictions. Even with that February 15 deadline to inoculate the top 4 priority groups, and even with schools set to be the first to go back, deputy chief medical officer Jenny Harries told MPs on Tuesday that half term was not a “fixed date” for the return of pupils.

Instead of a national reopening of schools all at once in England, “it’s likely that we will have some sort of regional separation of interventions”, Harries added. The Guardian’s news tonight that ministers are set to pause plans for daily testing in schools (reverting to twice weekly testing instead) will fuel suspicions that many schools may not be fully back until Easter.

Still, in evidence to the education select committee, Harries did make a better job than most have recently in explaining the rationale for rapid, lateral flow tests. Yes, their false negatives are higher than the “gold standard” PCR tests, but if used frequently they can be effective. Twitter account The Sharing Scientist (@scienceshared) had a great thread on this recently, showing how the rapid test hold up well.

Harries said taking two lateral flow tests in a week “is equivalent [in] effectiveness and accuracy as one PCR...you can immediately take somebody who is positive out of circulation and prevent them being a risk of transmission”. She said rapid tests picked up around 80-85% of cases at their most infectious period, whereas PCR tests will pick up viral fragments over a much longer period of time when probably people are not infectious.

Schools may be relieved that twice-a-week testing is now going to be the norm, not least as daily testing would be even more of an organisational headache. Yet they will need some assurance soon on timetables of their return, particularly as they have been messed around so much over exams and other key dates in the year.

More widely, that staggered return of schools looks like it may be replicated in the staggered easing of restrictions in different areas of the country. No.10 said today that the PM was still sticking to his belief that a tiered system would be appropriate after the end of this current lockdown.

Vaccination rates will be one metric used in assessing the unlockdown, which may prompt a new row if some areas really power ahead of others, despite attempts to smooth our supply across the UK. Overall, it does feel like Easter, or rather early April, is when the PM may feel confident enough to allow significant easing of restrictions.

April won’t be the cruellest month, because January looks like it is already taking that mantle. It still feels odd that the PM hasn’t marked today’s awful figures in any way (at least not at the time of writing this). Maybe that’s because he knows the death toll could get even worse this week.