Are the government’s ‘scary’ graphs as bad as they seem?

Graphs of coronavirus data presented to the public by chief scientists Sir Patrick Vallance and Professor Chris Whitty today may not be as scary as they were made out to be, according to experts.

The chief scientific adviser and chief medical officer for England this morning warned that Britain is heading for a surge in hospital cases and deaths caused by Covid-19, if the outbreak doesn’t change course.

They claimed new cases could rise exponentially to 50,000 per day within a month if nothing is done, that infections are surging across the country and that resurgences in France and Spain could be what is in store for the UK.

But critics say the officials were ‘just scaring people’, that infections will not hit 50,000 per day – three times more than what France or Spain are currently seeing – because lockdown measures will be tightened, and that death is less likely for Covid-19 patients now than it was in April.

Here, MailOnline breaks down the numbers behind the official graphs: 

The chief scientific adviser, Sir Patrick Vallance (left), and chief medical officer for England, Professor Chris Whitty (right) this morning warned that Britain is heading for a surge in hospital cases and deaths caused by Covid-19 if it doesn’t change course

Warning UK will follow the same trajectory as France and Spain – or worse

Sir Patrick’s first point of warning came with the spectre of cases, hospitalisations and deaths rising in France and Spain.

Health Secretary Matt Hancock warned at the end of July that he was afraid a ‘second wave rolling across Europe’ would arrive in the UK.

In France and Spain, Sir Patrick said today: ‘We’ve seen an increase in the numbers of cases that started with younger people in their 20s and spread gradually to older ages as well. 

‘That increase in case number has translated into an increase in hospitalisations. As the hospitalisations have increased… you will see that very sadly, but not unexpectedly, deaths are also increasing.’

French hospital cases have risen by 28 per cent in a month, with 5,800 people currently being treated, while Spanish hospitals have admitted 10,800 people since August 20 – more than the 7,000 in the previous three months combined. 

At the height of the crisis in the spring there were up to 23,000 people being admitted every week in Spain, with hundreds dying every day.

But across France and Spain as a whole, hospital capacity is far higher than it was in the spring – with Madrid’s virus patients filling up 22 per cent of hospital beds, compared to 100 per cent in early April, while France has thousands of free intensive care beds and only a fifth as many hospital patients as it did in April.

HOSPITAL ADMISSIONS: France and Spain have both seen rises in hospital cases, with older people especially affected, but the numbers are nowhere near the levels of March and April

HOSPITAL ADMISSIONS: France and Spain have both seen rises in hospital cases, with older people especially affected, but the numbers are nowhere near the levels of March and April 

ICU ADMISSIONS: While intensive care wards are reaching crisis levels in hotspots such as Madrid and Marseille, both countries as a whole have far more capacity than in the spring

ICU ADMISSIONS: While intensive care wards are reaching crisis levels in hotspots such as Madrid and Marseille, both countries as a whole have far more capacity than in the spring 

And while both countries have seen their death tolls increase, there has been no return so far to the hundreds of daily deaths that became the norm six months ago.  

During the peak in late March and early April, Spain regularly recorded between 600 and 1,000 deaths per day, while there were more than 1,000 on multiple occasions in France.

Now, in comparison, daily deaths have risen above 200 only once in Spain since June and above 100 only once in France in the past three months, according to statistics from Our World in Data. 

Professor Lawrence Young, a virologist and oncologist at the University of Warwick, told MailOnline earlier this month that although cases are on an upward trajectory, ‘it is becoming increasingly clear that people are less likely to die if they get Covid-19 now compared with earlier in the pandemic, at least in Europe’.

He said: ‘Possible explanations include that a larger number of younger people – 15-44 year olds – are now being infected compared to the first peak in cases in April and this group are less likely to get severe disease.

‘Two; there is now more effective treatment for patients with Covid-19 with far fewer needing mechanical ventilation; and three; less aggressive variants of SARS-CoV-2, particularly the D614G variant, are more prevalent – these remain very infectious but are less likely to cause severe disease.’    

Government officials claim Britain is around six weeks behind the rest of Europe and could face a similar situation of rising deaths in the wake of its current rise in cases.

A senior government source told The Times: ‘The Prime Minister has a very difficult challenge. At the moment we are on the same trajectory of Spain and France.

‘Spain on Thursday clocked 240 deaths — they are six weeks ahead of us so it is now being translated from cases to deaths.’ 

But in Sweden and the US, which have both seen case numbers increase again after the initial surge, death rates have not kept pace with infections.

In Sweden, the death rate has been falling steadily since April despite a peak of cases in the summer – with the country’s top epidemiologist saying that deaths can be kept low without drastic lockdown measures.  

In the United States, cases surged to record levels in July and August after the first wave had receded – but death rates in summer hotspots such as Texas and Florida were well below those in New York City where the virus hit hardest in the spring. 

Only 11 new deaths were announced last week in Sweden, down from a peak of 752 fatalities in seven days in mid-April. 

Cases reached their height in the Scandinavian nation in the second half of June, when some days saw more than 1,000 infections – but the death toll continued to fall regardless. 

Sweden’s state epidemiologist Anders Tegnell, who has become the face of the no-lockdown strategy, said in a recent interview that voluntary hygiene measures had been ‘just as effective’ as complete shutdowns. 

There are fears that the UK will experience a rise in the number of people dying of coronavirus as a direct result of cases surging. But data shows otherwise – the US has almost completely avoided a second wave in Covid-19 deaths despite seeing a huge increase in the number of people infected since June

There are fears that the UK will experience a rise in the number of people dying of coronavirus as a direct result of cases surging. But data shows otherwise – the US has almost completely avoided a second wave in Covid-19 deaths despite seeing a huge increase in the number of people infected since June

Despite seeing a new surge in coronavirus infections, Sweden has recorded a continuing fall in fatalities since the start of May

Despite seeing a new surge in coronavirus infections, Sweden has recorded a continuing fall in fatalities since the start of May

‘The rapidly declining cases we see in Sweden right now is another indication that you can get the number of cases down quite a lot in a country without having a complete lockdown,’ he told Unherd. 

Tegnell added that ‘deaths are not so closely connected to the amount of cases you have in a country’, saying the death rate was more closely linked to whether older people are being infected and how well the health system can cope. 

‘Those things will influence mortality a lot more, I think, than the actual spread of the disease,’ he said.  

Infections rising across all age groups in England

Sir Patrick warned that cases of coronavirus are now increasing in all age groups, with 20 to 29-year-olds the most likely people to get sick.

Rates of illness had remained flat throughout the summer but in July pubs, restaurants and sports clubs reopened and Chancellor Rishi Sunak’s ‘Eat Out to Help Out’ scheme encouraged millions of people to spend summer evenings going out.

People have also returned to offices and now children to schools, vastly increasing social contact on commutes, in classrooms and in busier shops and streets.

‘What you can see is there’s been an increase in cases across all age groups,’ Sir Patrick said.

‘The lowest increase has been in children and in the population aged 70-79 but in every age group we’ve seen an increase. 

‘Could that increase be due to increased testing? The answer is no. We see an increase in positivity of the tests done – so we see the proportion of people testing positive has increased, even if testing stays flat.’

The graph used in the briefing, however, does not line up with data published by Public Health England on Friday, September 18.

PHE’s data from its weekly surveillance report showed that the infection rate for 20 to 29-year-olds was 51.8 per 100,000 in the week ending September 13, whereas it appears to have risen above 60 in the official graph. 

The infection rate had actually fallen for the first time in 10 weeks for that age group, from 55.9 a week earlier, PHE’s report showed, although it still remained the highest. 

The over-80s age group also saw its infection rate fall, among whom it dropped from 20.6 to 19.8, but this appears to rise again in the chief scientists’ graph.

Infection rates presented in the official graph all appear higher than the Public Health England report which follows the same measure, and which is quoted as the source.

The line for the 30-39 age group clearly hits 45 in the official graph for the most recent week, while PHE’s report puts it at 37.5 per 100,000.

Likewise, the 40-49 and 10-19 age groups’ rates appear to be in the high 30s, while publicly released data for the same date puts them at 30.7 and 29.8, respectively. 

Public Health England said the data had been taken more recently than that in PHE’s report, but was unable to provide a copy of it.

A change in the ages of people getting infected may have a positive knock-on effect on bringing down the death rate of the virus.

Most cases are now among young people – 20 to 29-year-olds are the worst affected, with a rate of around 52 cases per 100,000, which has risen from a previous peak of 47.1 in the spring.

Young people are significantly less likely to die and, some experts say, the average risk of death for under-45s has not been increased at all because of the pandemic.

Among the elderly, however, the infection rate has plummeted by more than 90 per cent. For over-80s, there are now some 19.8 cases per 100,000 people.

This is down from a dizzying peak of 232.2 cases per 100,000 at the height of the crisis, driven largely by care homes. 

The shift from most cases among the old to most cases among the young could mean that the fatality rate of the virus is considerably lower than it was in April.

Disaster scenario of 50,000 cases per day by mid-October is ‘very unlikely’

The boldest claim of this morning’s briefing was that Britain could be facing 50,000 new cases of coronavirus per day by mid-October if no action is taken.

Sir Patrick made the warning based on the current epidemic doubling time of eight days, as revealed in Imperial College London’s official REACT study this month, which looked at mass testing results up to September 7.

And the Office for National Statistics (ONS), which tracks the spread of the disease through random swab tests, says the number of cases almost doubled in England between September 3 and 10, jumping from 3,200 new infections a day to 6,000. 

However, official numbers of cases found in positive tests have taken two weeks to double – from a daily average of 1,812 on Sunday, September 6, to 3,679 yesterday, September 20.

Sir Patrick said: ‘If that continues unabated and this grows, doubling every seven days, then what you see, of course, let’s say there were 5,000 today, it would be 10,000 next week, 20,000 the week after, 40,000 the week after, and you can see that by mid-October, if that continued, you would end up with something like 50,000 cases in the middle of October, per day.’

He said the 50,000 cases per day could be expected to lead a month later – the middle of November – to 200 or more deaths per day. 

However, 50,000 cases per day, which Sir Patrick framed as a possibility and not a prediction, would still likely be fewer than half as many infections as Britain saw in March and April.

Scientists predict that more than 100,000 people were getting newly infected each day during the peak of the crisis, but not enough testing was done to prove this. 

Professor Karol Sikora, a cancer doctor and former World Health Organization director, told MailOnline today: ‘They’re so negative. The graph for the worst case scenario, for 50,000 cases a day by next month, it’s just scaring people.’

Professor David Paton, an industrial economist at the University of Nottingham, also hit out at the 50,000 per day prediction.

He pointed out on Twitter that France and Spain, to which the UK was compared, are seeing cases double every three weeks, not every one, which he said would put Britain at more like 7,000 to 8,000 per day by mid-October.

He said the 50,000 per day would be a rate at least three times higher than currently being seen in Spain or France.

Professor Paton told MailOnline: ‘It seems a very strange scenario to present, it’s not, as far as I can tell, based on any particular modelling. 

‘If you look at the past few days, cases have been going down rather than going up, doesn’t seem to be any basis to select this doubling ‘every seven days’.

‘It [also] seems odd, to me, to choose to compare against France and Spain. There are other countries they could have looked at, where cases have been doubling every three weeks. Nobody knows what will happen to cases in the UK.

‘Do they really think we’ll have five to six times more cases than France?’

Dr Michael Head, from the University of Southampton, added: ‘It is important to note the Chief Medical Officer did say the potential for 50,000 cases a day is a “worst case scenario”. 

‘Modelling has to calculate best, worst, and likely scenarios to allow different plans to be put in place. 

‘We are very unlikely to see cases at that level because interventions will be rolled out that restrict the spread of the virus, such as regional lockdowns. However, it is a timely reminder that the pandemic is accelerating both globally and also here in the UK.’

And Professor Mark Woolhouse, an infectious disease expert at the University of Edinburgh who sits on a group that feeds into SAGE, said: ‘Only three countries in the world – India, US and Brazil – have ever reported more than 50,000 new cases per day (though in the early stages of the pandemic there will have been substantial under-reporting)…

‘Many observers may consider this an implausible scenario. Presumably the UK government intends it to illustrate the consequences of sustained exponential growth.’ 

Hospitalisations on the rise and could lead to an increase in deaths

Professor Whitty warned that the rising number of people going into hospital would lead to an increase in deaths which could multiply quickly.

He said that inpatient cases are doubling at around the same rate as infections – every seven to eight days.  

Professor Whitty said: ‘Now what that tells us is that if this carried on unabated, these numbers are relatively small, we’re talking about around 200 at the moment – but if this continued along the path that Patrick laid out, the number of deaths directly from Covid… will continue to rise, potentially on an exponential curve, that means doubling and doubling and doubling again.

‘And you can quickly move from really quite small numbers to really very large numbers because of that exponential process.

‘So we have, in a bad sense literally turned a corner, although only relatively recently.’

There are reasons to believe that fewer people admitted to hospital now will die of Covid-19.

Reports from the Intensive Care National Audit & Research Centre (ICNARC) shows that survival rates for the sickest Covid-19 patients in England have improved by 10 per cent.

ICU mortality rates for Covid-19 patients dropped from 44 per cent to 34 per cent between March and July

ICU mortality rates for Covid-19 patients dropped from 44 per cent to 34 per cent between March and July

Analysis suggests, at the current trend, it would take little more than three weeks for daily admissions to top 2,000

Analysis suggests, at the current trend, it would take little more than three weeks for daily admissions to top 2,000

Its most recent analysis of NHS records shows that, in July, 34 per cent of ICU patients with Covid-19 were dying. This was a considerably higher 44 per cent in March.

Experts believe the finding shows doctors are getting better at treating the disease, and note medics are less keen on putting patients on ventilators amid concerns they could make the illness worse. 

It’s hoped survival rates will improve further still after a number of cheap steroids, including dexamethasone and hydrocortisone, were proven to treat severe Covid.

Hospitals are also far less busy than they were in April and May, meaning doctors and nurses can spend more time with virus patients. Staff sickness rates are also lower. 

Data does show, however, that hospitalisations are rising dramatically, which is cause for concern.

Health Secretary Matt Hancock last week said he was worried because hospitalisations were doubling every eight days and there was an ‘acceleration’ in cases. 

Government data shows 183 newly-infected Covid-19 patients were admitted to hospitals in England on Wednesday, compared to just 84 eight days earlier and just 38 on August 30. It means 160 patients are needing NHS care each day, on average — triple the figure of 52 on September 1.

More than 3,000 people each day were being admitted to NHS hospitals during the peak of the first wave in April. Analysis suggests, at the current trend, it would take little more than three weeks for daily admissions to top the 2,000 mark. 

But experts insist a second wave of Covid-19 in Britain would not be nearly as fatal as the first because doctors have got better at treating the disease, thanks to scientific breakthroughs. 

Vast majority of people ‘unprotected’ by herd immunity and still susceptible 

Sir Patrick warned that the ‘vast majority’ of Britain is still susceptible to catching Covid-19 because immunity is so low.

Government advisors believe that no more than 8 per cent of the population have developed neutralizing antibodies against the coronavirus.

Neutralising antibodies are substances created by the immune system to remember how to fight off a particular illness. But Sir Patrick warned that not everyone will develop antibodies.

Eight per cent of Britain — home to around 66.65million people — equates to around 5.3million people but Sir Patrick said the figure was closer to 3million.

It means between 61 and 63million people are still vulnerable to the disease, which poses a much graver threat to the elderly and obese.

And he admitted the rate could actually be even higher in London and other cities, saying as many as 17 per cent of people living in the capital may have already had the illness. Sir Patrick said these higher rates could mean the disease spreads slower in highly-populated areas in a second wave.

In a stark warning, Sir Patrick said: ‘It means the vast majority of us are not protected in any way and are susceptible to this disease.’

And he urged caution over the numbers, however, insisting that antibodies are not an ‘absolute protection’ with levels of the disease-fighting substances fading over time.

For example, research by King’s College London in July found immunity to Covid-19 might be lost within months, sparking fears it could infect people on an annual basis like the common cold and flu.

Sir Patrick also said there may be ‘other forms of protection’, meaning the 8 per cent figure is an underestimate.

Other studies have offered hope of long-lasting immunity, with survivors of SARS — a closely-related coronavirus — still having crucial T cells 17 years after they were first infected.

The crucial white blood cells — which can’t be detected by the ‘have you had it’ antibody tests — are also made in response to the infection.

Other scientific studies have shown people who have had a common cold in the past two years have T cells that show ‘cross-reactive protection’ against Covid-19.

It means the true proportion of the population who is protected against the disease is a mystery.

Scientific consensus says herd immunity — when a disease can no longer spread because enough of the population has been exposed to it — will kick in when around 60 to 70 per cent have had the virus, scientifically called SARS-CoV-2.

But some research has suggested this rate could actually be as low as 10 per cent, if it spreads more rampantly among the most socially active. This is because they are into contact with others more regularly and are, therefore, more likely to spread the illness.

If a vaccine was developed it would need 60-70 per cent coverage to work — but this threshold could be significantly lower for natural immunity.

Coronavirus ‘is not weaker or less deadly than it was in March’ 

Professor Whitty today insisted that the virus is not milder than it was during the first wave, despite claims it may have weakened.

Doctors in Italy and the US have claimed SARS-CoV-2 is appearing to be become less potent over time, saying viral loads have reduced in size over time.

Viruses are known to change over time because they are subject to random genetic mutations in the same way that all living things are.

Some of the mutations may turn out to be advantageous to the virus, and get carried forward into future generations. For example, if a virus becomes less dangerous to its host – that is, it causes fewer symptoms or less death – it may find that it is able to live longer and reproduce more.

But dismissing the claims in a clear message to the nation today, Professor Whitty said: ‘I’m afraid, although it would be great if it were true, but we see no evidence that this is the case.’

He also revealed cases initially started to spike in young adults, who are the group ‘least likely to end up in hospital’.

Imperial College London academics have previously claimed fewer than 1 per cent of people under 30 will get hospitalised with Covid-19, and those who are admitted for care will often have underlying illnesses that leave them more prone to the disease.

But the rate is dramatically higher among the over-80s, and could be around one in five.

Professor Whitty added: ‘For many people, this remains a mild infection. As we move up the ages, then mortality rises to quite significantly rates.

‘What we’ve seen in other countries, and clearly seeing here, is they’re not staying in younger age groups.’

He accepted that mortality rates would be ‘similar to what we saw previously’, with the World Health Organization (WHO) estimating it kills around 0.6 per cent of all patients in total. But the rate is as high as 18 per cent for over-75s but less than seasonal flu — which kills around 0.1 per cent of patients — for under 45s.

The current case-fatality rate, which works out how many patients die for confirmed cases – not just everyone who gets infected, stands at around 10.5 per cent. But this will eventually drop with more testing.

Professor Whitty warned that Covid-19 is more virulent than flu, saying that influenza kills around 7,000 patients in a usual winter. For reference, more than 1,000 Covid-19 deaths were registered on nine different days during the first wave.

He did, however, admit that treatment has got better, saying there was ‘no doubt about that’. Professor Whitty said: ‘Doctors and nurses have learnt to treat this more effectively.’

He added: ‘And we have new drugs such as dexamethasone, these will reduce the mortality rate but definitely will not eliminate or take it right down to trivial levels.’

Dexamethasone was the first drug proven to cut the risk of dying from Covid-19. In the world’s biggest drug trial in June, Oxford University researchers concluded the £5 steroid could save up to 35 per cent of patients relying on ventilators – the most dangerously ill.

And the cheap steroid hydrocortisone can cut Covid-19 deaths by almost a third in the sickest patients, research found earlier this month.

But other promising drugs, such as the Donald Trump-backed hydroxychloroquine, have had disappointing results. 

Covid-19 cases are ‘rising significantly in the vast majority of areas’ 

Professor Whitty, presenting a heat map of the UK, warned that coronavirus cases are now rising all over the UK and not just in a handful of areas.

‘This is not someone else’s problem, this is all of our problem,’ the chief medical officer warned.

He explained: ‘What we’ve seen is a progression where… first we saw very small outbreaks, maybe associated with a workplace or another environment, then we’ve seen more localised outbreaks which have got larger over time, particularity in the cities.

‘And now what we’re seeing is a rate of increase across the great majority of the country. It is going at different rates but it is now increasing.’

Public Health England’s data from Friday shows that infections were actually falling or stagnant in 43 out of 149 areas – 29 per cent.

And 66 areas have an infection rate below 20 cases per 100,000, meaning just 0.02 per cent of the population there – only one in 5,000 people – are carrying the illness.

A further six areas have between 20 and 21 per 100,000. 20 per 100,000 is the threshold at which the UK Government considers quarantine for international travellers.

Only 40 areas out of the 149 have an infection rate higher than England’s average, of 33.8 per 100,000, meaning three quarters of places have below-average infection rates.

Critics have warned that national restrictions applied to the whole country unfairly tar the country with a ‘broad brush’. 

People in low or no-Covid areas will be affected by any national restrictions even though they are not at significant risk of the virus, simply because some areas have been unable to control infection rates.

A Conservative former Minister criticised the measures as a ‘very broad brush’ and said that something ‘more concentrated’ would have been better.

David Jones MP told MailOnline earlier this month: ‘I can understand that the Government has to do something, because there is certainly an uptick.

‘But it is not an uptick across the country as a whole. There are some parts of the country such as Devon, Dorset where there is very little virus activity at all.

‘So it does seem to be very broad brush… I would have thought something more concentrated would be better.’