Coronavirus UK: Death toll hits 36,393 with 351 new fatalities

Britain today announced 351 more coronavirus deaths, taking the official number of victims to 36,393 – as Government scientists warned the reproductive rate is still teetering on the brink of spiraling back out of control. 

Experts sitting on Number 10’s SAGE panel today revealed the crucial R-value – the average number of people that will contract coronavirus from an infected person – was between 0.7 and 1 across the UK for the second week in a row.

Officials must keep the number below 1 otherwise the outbreak will start to grow exponentially again and threaten a second epidemic. However, the latest data is three weeks out of date due to a lag in the government’s mathematical modelling. 

The R is calculated by working out how fast the virus spreads by comparing data including hospital admissions, the number of patients in intensive care, death statistics and surveys to find out how many people members of the public are coming into contact with.  

The new number does not factor in the slight relaxation of Britain’s lockdown measures, announced by Prime Minister Boris Johnson on May 13. Mr Johnson has said ministers would reimpose controls if the rate of transmission of the virus started to pick up again.  

London is thought to be leading the way in terms of its R value, with experts from Public Health England and Cambridge University predicting it could be as low as 0.4 in the capital. But the nationwide reproduction number is being skewed upwards due to outbreaks in care homes and in Northern towns. It has prompted calls for regional easing of lockdown, with London leading the way. 

London was formerly the UK’s coronavirus epicentre and at least two million people are thought to have been infected there, according to estimates. But experts say around 15 per cent of residents in the capital have now had the disease already and have built up immunity, which makes it harder for the virus to spread.   

Today’s death toll is marginally lower than the 363 recorded yesterday, the lowest figure on a Thursday since March 26 (103). Of the new deaths, 172 were in hospitals in England, while Scotland recorded 24, Wales seven and Northern Ireland three, in all settings.  

The remaining deaths are thought to have occurred in care homes and in the wider community in England. Department of Health figures also showed that 3,287 more Britons had tested positive for the disease. 

In other developments to Britain’s coronavirus crisis today:

• A Nobel Prize-winning scientist tore into Boris Johnson’s lack of political leadership over coronavirus that has left the UK on the ‘back foot’ and ‘firefighting through successive crises’;
• Thousands of lives could have been saved from Covid-19 if Britain’s lockdown was imposed just one week earlier, a government scientific adviser claimed;
• JD Wetherspoon revealed its £11million masterplan to reopen its 875 pubs as soon as the Government gives them the nod in July;
• So-called coronavirus ‘immunity certificates’ that could allow Brits to return to work have come a step closer after ministers announced mass antibody tests are being deployed;
• Australia is pushing to be the first country exempted from the UK’s 14-day coronavirus quarantine – as arrivals face ‘spot checks’ on homes and £1,000 fines for breaking the rules.

WHAT IS THE R, AND HOW DOES THE GOVERNMENT ESTIMATE IT? 

Every infectious disease is given a reproduction number, which is known as R0 – pronounced ‘R nought’ – or simply R.

It is a value that represents how many people one sick person will, on average, infect if the virus is reproducing in its ideal conditions.

The value has been estimated by the Government’s Scientific Advisory Group for Emergencies (SAGE).

They assess data from hospitalisations, intensive care demand, deaths and the number of social contacts people have.

Experts use multiple sources to get this information, including NHS hospital admissions, Office for National Statistics and CQC death figures and behavioural contact surveys.  

Using mathematical modelling, they are able to calculate the virus’ spread. 

But a lag in the time it takes for coronavirus patients to fall unwell and die mean the R modelling is always roughly three weeks behind.   

Most epidemiologists – scientists who track disease outbreaks – believe the SARS-CoV-2 virus, which causes COVID-19, has an R value of around 3.

But some experts analysing outbreaks across the world have estimated it could be closer to the 6.6 mark.

As an outbreak goes on, the R0 may be referred to more accurately as Re or just R, as other factors come into play to influence how well it is able to spread. 

Estimates of the COVID-19 R vary because the true size of the pandemic remains a mystery, and how fast the virus spreads depends on the environment. 

As an outbreak progress the R may simply be referred to as R, which means the effective rate of infection – the nought works on the premise that nobody in the population is protected, which becomes outdated as more people recover. 

The chair of a Parliamentary science committee, Greg Clark MP, said last week officials should not focus too much on the R and should look at the wider picture because it is ‘heavily skewed’ by faster transmission in care homes and hospitals. 

The government’s Scientific Pandemic Influenza Group on Modelling (SPI-M) decided it thinks the R is between 0.7 and 1 by looking at hospitalisation and death rates, among other data. 

An R number of 1 means that on average every person who is infected will infect 1 other person, meaning the total number of new infections is stable. If it is higher, the virus spreads faster and, if lower, the outbreak shrinks. SAGE is confident that the number of infections is not increasing, and is very likely to be decreasing. 

More than 250,000 people have been officially diagnosed with the viral disease but the true scale of Britain’s outbreak is considerably larger, with government officials suggesting up to 6.6million are likely to have caught it in England alone.

An analysis by Cambridge University and Public Health England (PHE) suggested the disease could be eradicated in the capital within weeks at the current rate of transmission. 

And their data – which was fed into No 10’s scientific panel, SAGE – estimated up to 20 per cent of Londoners have already been infected. The rate across England is thought to be around 12 per cent.  

But the same data also showed the crucial R rate – the average number of people an infected patient passes the virus on to – in London, as well as every other region had already fallen before lockdown on March 23. 

It suggested the government’s social distancing measures introduced a week before, which saw public transport use plummet and millions of Brits work from home instead of risk travelling, slowed the crisis.

The Cambridge-PHE data prompted some MPs to urge the government to commit to lifting lockdown on a region-by-region basis, with one urging ministers to consider it because ‘it makes sense from a health perspective’.  

Meanwhile, it emerged today that hundreds of thousands of coronavirus tests sent to people’s homes have been counted but never returned to labs, PHE’s testing boss has suggested.

Professor John Newton, director of health improvement at Public Health England, could only say today that ‘more than half’ of home tests had been completed.

The Government claims that 719,000 tests have been delivered to people for them to complete the swabs themselves, but a significant chunk of these may never have been done. The posted tests form a huge section of the 3.2million tests the Department of Health claims to have carried out.

Professor Yvonne Doyle and Professor John Newton were today grilled by MPs and defended Publlic Health England’s actions throughout the COVID-19 pandemic, saying the Department of Health took the major decisions while PHE provided specialist advice

Matt Hancock’s promise to test 100,000 people per day by the beginning of May would not have been met if the Department of Health had not counted tests that were posted

And Health Secretary Matt Hancock would not have hit his lauded target of 100,000 tests in a day by May 1 if the department had not posted out 39,000 the day before. 

If up to half of the tests posted out to people had never been returned to a laboratory that could mean up to around 350,000 of them never completed the lab analysis – but they were counted anyway by the Government.

Professor Newton, speaking in a grilling by MPs on Parliament’s Science and Technology Committee this morning, said it had been the Department of Health’s decision to count tests that had been posted rather than those completed. 

In the same tense meeting, Professor Newton and his colleague Professor Yvonne Doyle, medical director at PHE, said Britain abandoned mass testing in March because the country’s outbreak was already too large.

‘Many hundreds of thousands’ of people had the virus after half-term, they admitted, and contact tracing ‘could not possibly’ have prevented the current disaster. 

Home tests have been available since the end of April but Professor Newton said he didn’t know how many people who ordered them were actually returning them to the labs.

When asked what the return rate was, Professor Newton hesitated at length before saying: ‘Certainly more than half.’

Pressed again by Conservative MP Greg Clark, chair of the committee, Professor Newton added: ‘I’m afraid I don’t have that figure.’

The fact that up to 50 per cent of the tests may not be getting sent back to labs for analysis suggests that the number of tests the Government is claiming to do each day could be wildly over-estimated.

Professor Newton, defending PHE’s involvement, said the Department of Health took the decision to count a test that had been posted.

Labour MP Graham Stringer said what the definition of a test was and said: ‘Clearly, posting a test is not a test.’ 

Professor Newton replied: ‘The way tests are counted [was] discussed with officials at the Department of Health and we were advised by the officials in the Department of Health on the appropriate method of counting the tests and that’s what we did.’

Greg Clark, the meeting’s chair, cut in: ‘They advised you, you didn’t advise them?’ 

‘No, they advised us, absolutely, yes,’ Professor Newton said.

Mr Stringer asked with a raised eyebrow: ‘Do you think it’s appropriate? Counting posted letters as opposed to real tests?’

And Professor Newton replied: ‘Well, I think the important thing is that they’re only counted once.

‘The basis on which we were advised  that the decision had been made was that the test should be counted at the point where the programme had control of what happened, and that was the point at which the tests were sent out and made available for testing.

‘The key thing is that a very large number of tests are now being conducted and, whichever way you count them, it’s a large number of tests – it’s a huge increase.’ 

In the meeting the PHE bosses also admitted that Britain had to abandon its South Korea-esque approach to testing and tracing infections in March because the UK’s outbreak was simply too large.

South Korea has earned global acclaim for its policy of intensively testing and isolating everyone in the population suspected of having COVID-19.

This means the cases there have been contained to relatively small areas and the number of them is extremely low (around 11,000 confirmed cases).

Britain had wanted to follow the same strategy but, by the time officials realised the virus was spreading in the UK, it was already too late.

Professor Doyle said today that ‘mass contact tracing needed to cease in March’.

She explained: ‘It was a decision that was come to because of the sheer scale of cases in the UK which had been introduced by multiple introductions, particularly after half term, from European countries we now know had large amounts of prevalence themselves.’

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