Week 29: Two very different ways of dealing with a pandemic: planning ahead, or drifting from one crisis to another

The problem

We will compare Norway as a country that planned ahead, with the UK which made almost every mistake possible. Our planners ahead would be South Korea, Denmark, Finland, Germany and New Zealand. Our drifters would be France, Spain, Italy, the Netherlands and Portugal. We will be using rates per million at risk, in contrast to numbers given on tv, which are often simplecounts.

 

Planning ahead: the example of Norway.

The first dramatic difference was that quite large sums of money was spent early, and detailed plans were made to cover a wide range of problems. Large sums of money were spent early on for vaccine development, digital solutions for contact tracing, for a mobile app  for contact tracing, for remote medical consultation, for training medical personel in intensive care medicine, and for updating and distributing a digital tool to facilitate contact tracing. It is an interesting country in terms of low covid cases and deaths, and many days to double prevalence of both cases and deaths. ng.. They use various interventions: detection & isolation of infected people; closing down businesses & events; Norway emerges as an interesting country with a relatively long time to double prevalence. Social distancing was only 1 metre. All those arriving who are positive are quarantined whether or not symptomatic. Meetings of <50 people were initially allowed, detailed exit plans. On 12th March, rising numbers of cases suggested that community transmission was under way, and a lockdown was declared, and visits to Norway through Oslo airport were banned. All places of education & kindergartens were closed.  By 6th April 2020 the outbreak was said to be under control with an R value of 0.7. Schools were reopened on 20th April 2020, and no increase in cases was reported. By 27th September  2020, Norway had performed 1.04 million tests, and reported 13,741 positive tests and 274 deaths. All the ‘planning’ countries set up testing facilities, while the usual practices in the ‘drifting’ countries was to delay testing in the numbers that were required. Since August 7th 2020 there has been a ban on alcohol after midnight, and since 28th September face masks are mandatory on all who use public transport. 

 

Drifting from one crisis to another: the example of the UK

Entirely typical, we seem not to have thought ahead at all before we had to. We made no arrangements to obtain PPE, we had no firm plans for setting up facilities for virus testing on the scale that would be required, we did not make arrangements for obtaining ventilators for severely ill people. It was clear that the NHS would not have enough beds to care for so many sick people. Eventually several ‘Nightingale Hospitals’ were requisitioned, but testing facilities took a long time for the government to understand why they would need them. When after a long delay the test facilities were expanded, it soon became apparent that the government had no very clear ideas why they needed them. Most crucially of all, there was no understanding of what Test and Trace might achieve, but yet again they claimed that our services were among the best in the world. Unfortunately our services were put into the hands of a woman who wished to dismantle the NHS and have it replaced by a scheme based upon social insurance, and who had previously made a huge and expensive mess of her duties at a non-medical organisation, ‘Talk, talk’. Government ministers talked up our ability to introduce Test and Trace, and our Health Minister (Matt Hancock) boasted about it. But in reality it was left to a private firm (Serco) and an incompetent Tory peer who was responsible for  carrying out this quite basic task.

 

	Cumulative Cases/M at risk	New cases /M at risk	Cumul. Cases of death /M at risk	New deaths, /M at risk
Norway	1800	20.3	51.6	0.119th
The other 5	Denmark, Germany, Finland, New Zealand, South Korea
Mean of 5:	2170	19.1	293.9	0.108

Note:  ​There was no overlap between the two 5-fold groups

​The 2 highest centres of these 5 were Denmark & Germany, responsible for the higher deaths rates then the other 3 countries

 

	Cumulative Cases/M at risk	New cases /M at risk	Cumul. Cases of death /M at risk	New deaths, /M at risk
United Kingdom	9000	200	598	0.85
The other drifters	France, Italy, Spain, Portugal, Netherlands
Mean of 5:	10200	150	448.8	1.004

Note:​There are no overlaps between these 5 and those grouped with Norway

 

We have achieved a neat separation between 5 EU countries near ourselves, and those that plan ahead. There is a massive tenfold difference between Norway and the UK. For the five countries for comparison, there is a tenfold difference for all except cumulative deaths/M, where the planners had a higher rate, due to Germany and Denmark not being as efficient as the other three. But there difference was in the right direction, so there was no overlap.

 

Conclusion. There are 10 times as many deaths per million, and 5 times as many cases with the virus, in the UK than in Norway. These are huge differences. It is not known which of the three components are responsible for these differences – hand washing, wearing masks or social distancing; or just being ready for the virus, with all reasonable steps having been taken. 

There’s a special providence in the fall of a sparrow. If it be now, tis not to come. If it be not to come, it will be now. If it be not now, yet it will come, the readiness is all (Hamlet, Act 5). Unhelpful leadership by Trump and Bolsonaro has made an extremely bad situation even worse in their countries. 

 

 

David Goldberg

10th October 2020. 

(I think we have sheltered behind the incompetence of our European colleagues. A use for the EU?)