Eight million Britons with underlying health conditions should be exempt from going back to work when the coronavirus lockdown eases, scientists say.
Experts at University College London and Cambridge University fear not protecting society’s most vulnerable could see UK’s death toll rise to 73,000 within a year.
One in five people – more than 8million people in Britain – are at a higher risk of dying if they catch COVID-19 because of their age or poor health.
But most of this group are not deemed ‘extremely clinically vulnerable’ people, who were asked to ‘shield’ for 12 weeks by the Department of Health.
Britons with long-term conditions such as heart disease and diabetes would make up between 80 and 90 per cent of the fatalities, the researchers calculated.
And they said it means another 30,000 Brits could die unless everyone at high-risk is protected for as long as possible and not forced back to work post lockdown.
In a separate, worst-case scenario estimate they predicted up to 590,000 deaths if the government did nothing and 80 per cent of the population were infected within a year.
Office for National Statistics data today suggested more than 40,000 people have already died with COVID-19, confirming Britain’s status as the worst-hit nation in Europe. But the researchers said this is set to rise much higher.
The Government is tomorrow set to relax lockdown rules after 50 days of urging people to stay at home, fuelling concerns that a step too far could trigger a second wave of disease.
If 10 per cent of people in England are allowed to catch the virus, the scientists said – and four per cent are already thought to have done so – the death toll could double.
The study showed that millions of people in Western countries are in vulnerable ‘high risk’ categories from COVID-19 because of their old age or a long-term health problem. In England, one in five people (a total 7.1million) are at risk. Scientists argue they must be protected as lockdown relaxes
The researchers modelled the normal one-year death risk for different groups of people, and then added in the additional effect of the pandemic on top of these risks. They worked out how different levels of exposure to the virus after lockdown might affect the death risk, and therefore the number of people dying, differently
Lead author Dr Amitava Banerjee, of the UCL Institute of Health Informatics, said someone with heart disease is five times as likely to die of coronavirus as a healthy person.
Someone with heart disease and diabetes could be at 10 times the risk.
‘If my six-year-old – who is at very low risk – can wait until June or July to go to school, then these people shouldn’t be going back to work tomorrow,’ Dr Banerjee said. ‘These are the people at the highest risk.
‘I don’t think they should be rushing to go back to work until we have made sure that the infection rate is down, that transport is set up and that workplaces are safe.’
The study, published in The Lancet, looked at the medical records of 3.8million people and predicted what could happen after lockdown.
It said vulnerable people – including all over-70s and those who have high blood pressure or asthma – make up 20 per cent of the British population.
Dr Banerjee said: ‘This group is more likely to be admitted to hospital, to go to intensive care and to die.
‘Why are we even discussing them going back to work at this stage?’
FOUR PER CENT OF UK MAY HAVE ALREADY HAD COVID-19, EARLY DATA SUGGESTS
Sir Patrick Vallance, Number 10’s chief scientific adviser, revealed last night in the Downing Street press conference that around four per cent of Britain and 10 per cent of London has developed antibodies against COVID-19, meaning they have already had the infection.
The estimate – based on data from antibody testing across the home nations carried out a fortnight ago – means only around 2.64million Brits have had the infection.
It also suggests the illness kills around 1.21 per cent of all cases, making it around 12 times deadlier than the flu.
However, the infection fatality rate could be even higher, when the thousands of the UK’s hidden COVID-19 deaths are included in the tally.
Estimates on backdated data from the Office for National Statistics suggest at least 45,550 Britons have actually died – a death rate of around 1.73 per cent.
Sir Patrick said results suggest around 10 per cent of people whose blood was analysed in London tested positive for antibodies.
This means around 900,000 people in the capital have developed some form of immunity to the virus. Around 8,000 people are estimated to have died in London – giving COVID-19 a death rate of 0.89 per cent in London.
But the rate of people who tested positive for antibodies across the whole of Britain is around 4 per cent – 15 times lower than what is needed for the nation to develop any kind of herd immunity.
Sir Patrick Vallance has previously said around 60 per cent of the population need to catch the virus to build up a national tolerance to curb the spread.
He stressed that this group people are not included in the ‘shielded’ group of ‘extremely clinically vulnerable’ – the 1.5million cancer patients and those with compromised immune systems who have been told to stay at home until the end of June.
The researchers modelled the normal one-year death risk for different groups of people, and then added in the additional effect of the pandemic on top of these risks.
They worked out how different levels of exposure to the virus after lockdown might affect the death risk, and therefore the number of people dying, differently.
In a ‘mitigation’ scenario in which some measures remain in place and 10 per cent of the population catches the virus – which appears to most closely resemble the way the UK is heading – they expected the total number of deaths to be between 37,000 and 73,000.
The coronavirus has spread too far in England for it to keep the death toll down to a ‘partial suppression’ or ‘full suppression’ level, which could have saved thousands of lives, the study showed.
It could be kept below 73,498 within the first year if no more than 10 per cent of the population are allowed to catch the virus.
But if 80 per cent of the population caught the virus in a worst-case scenario, the researchers said, between 146,996 and 587,982 could die.
A compound effect would take place if this happened because hospitals would become completely overwhelmed.
The study considered different levels of social distancing and how well people would be protected as the country moves forward out of lockdown.
Prime Minister Boris Johnson announced on Sunday that, from Wednesday, people would no longer be limited in how much time they can spend outside in a day.
Picnics and sunbathing will be permitted, as well as ‘unlimited’ amounts of exercise, all on the condition that people remain at least 2m (6’6″) away from others at all times.
This is the first loosening of strict lockdown rules since they were brought in on March 23, and Downing Street will wait with bated breath to see what effect it has on the numbers of people being diagnosed with COVID-19 before making its next move.
Sir Patrick Vallance, Britain’s chief scientific officer, said last night that early population surveys suggest around four per cent of the population has been infected.
He explained that antibody tests – which show who has had the virus in the past – put the rate of infection at about 10 per cent in London and four per cent across the UK as a whole, a total of around 2.64million people.
Officially, around 1.2 per cent of them have died (32,490). Estimates based drawn from backdated data, showing more than 45,000 people have died, put the death rate as high as 1.7 per cent.
The UCL and Cambridge researchers were able to calculate how much the pandemic might increase people’s risk of dying over the course of the next year.
Dr Banerjee said: ‘Our calculator provides one year mortality risks for common conditions by age and sex.
‘Before the pandemic neither doctors nor patients have been used to seeing such information, but in the current emergency there is an urgent need to develop better understanding of who is at risk based on reliable health data.
‘For example, we show how a 66-year-old man with chronic obstructive pulmonary disease (COPD) has a six per cent risk of dying over the next year and there are 25,000 “patients like me” – i.e. men of the same age with the same condition in England.’
The study based its estimates of the number of people dying on varying possible death rates of the virus, which is still unknown, and labelled these RR on the right hand side – RR 1.2 leads to a 20 per cent higher risk of death, while RR 2 is a doubled risk. Markers along the bottom denote age groups between 30 and >85. For example, if the virus doubled someone’s risk of dying over the course of a year (RR 2) and 10 per cent of the population caught it, scientists predicted there could be 14,922 excess deaths among over-85s (total of far right column in bottom section)
If the virus doubled someone’s risk of dying over the course of a year and 80 per cent of the population caught it, scientists predicted there could be 118,133 excess deaths among over-85s (total of far right column in bottom section)
The team added in their study: ‘A major concern is that relative risks will rise in a non-linear fashion with infection rates if health systems become overwhelmed by critically ill patients.
‘Thus, at high infection rates, relative risks for excess mortality would almost certainly be much higher – and these non-linear interactions are a subject for further modelling.
‘The impact of COVID-19 is likely to be much greater if there is poor compliance with social isolation policies and low treatment and health-system capacity.’
Experts have welcomed the findings.
Professor Sarah Harper of the University of Oxford, said: ‘This is an important paper which shows the complexity of mortality risk factors and how age, sex and underlying health conditions combine under different conditions to increase risk.
‘For example, a man aged 66 to 70 years with no underlying conditions, is not currently considered high risk.
‘Yet he has a higher background one-year mortality than that of a woman aged 56 to 60 years with one underlying condition who is considered high-risk.
‘Similarly, it shows that generally women’s mortality risk at any given age is the same as men’s who are around five years younger.
‘The blanket and arbitrary use of age – for example age 70 as a rough cut off for the high risk mortality-category – has been questioned by many already.
‘This paper highlights the difference between men and women, and the importance of identifying underlying health conditions.’
OBESITY IS A RISK FACTOR FOR COVID-19, STUDIES SHOW
There have been no studies which clearly mark the largest risk factors for COVID-19 – the disease caused by SARS-CoV-2.
But, using data from hospitals, researchers are able to identify which conditions are common among those who are frequently in hospital with the disease.
One study in New York City, the world’s coronavirus hotspot, found obese people were more likely to be hospitalised with the coronavirus than cancer or lung disease patients who have compromised immune systems.
The ‘surprising’ findings also showed that even smoking wasn’t a predictor of hospitalisation like obesity was, despite the habit being bad for the lungs.
The researchers at the NYU Grossman School of Medicine, who analysed hospital reports of 4,103 COVID-19 positive patients, found is that ‘in the decision tree for admission, the most important features were being over 65 and obesity.’
Researchers at New York University recently highlighted obesity as a main driver of patients under the age of 60 needing hospital care.
They looked at the records of 3,615 patients who tested positive between March 4 and April 4.
The team found those with a BMI between 30 and 34 were almost twice as likely to be admitted to acute or critical (ICU) care than those with a BMI under 30.
This likelihood increased to 3.6 times in those patients with a BMI of 35 or greater, according to the findings published in Clinical Infectious Diseases.
In patients over 60 years, the researchers didn’t find a significant link between obesity and severe illness that needed critical care.
One study by US health officials, which recorded the weights of 178 patients, found obesity was the most common underlying condition for patients aged under 65 who were admitted to hospital for COVID-19.
Of those aged between 18 and 49 who had a health condition, obesity accounted for 60 per cent. The second most common condition was asthma, at 27 per cent.
For those between 50 and 64 years of age with an underlying health problem, obesity accounted for 49 per cent – more than the 47 per cent who had high blood pressure.
Comparatively, according to data from the UK’s National Health and Nutrition Examination Survey, age-adjusted obesity prevalence is 42 per cent.
In the UK, according to data from hospitals, almost 75 per cent of COVID-19 patients in intensive care are overweight, compared with 65 per cent in the general population.
And NHS data last week revealed obesity raises the risk of dying from coronavirus in hospital by nearly 40 per cent.
The analysis of 17,000 COVID-19 admissions found death rates were 37 per cent higher among obese patients, second only to dementia (39 per cent) but more than heart disease (31 per cent).
The research was conducted by a team of Britain’s top infectious diseases scientists who are part of the pandemic-planning global body.