Wednesday 25 March 2020

Why Is The Health Service Being Overwhelmed?

Every day, we hear reports that the NHS is being overwhelmed. Its being reported that buildings are being taken over to turn into temporary hospitals, and so on. Yesterday, one undertaker was interviewed, who said that it might be necessary to introduce mass cremations! So, what is actually going on? 

I find this last statement about the need for mass cremations, particularly puzzling. The latest number of deaths, from confirmed coronavirus cases, in Britain, is 422. On average, each year, there are 500,000 deaths in England, about 1,370 per day. So, 422 additional deaths amounts to an increase of less than 0.1%, as against the average figure for deaths in England. That seems hardly a basis for needing to introduce such an extraordinary measure as mass cremations. In fact, if we look at the number of deaths last year, we see that it was 623,000, which was an increase of 3% over the previous year. That is an increase that is, therefore, 30 times greater than the current additional deaths attributed to COVID19. Yet, I don't recall anyone coming out, last year, warning that it was going to be necessary to institute mass cremations, to deal with such an increase! You might say, well, the 422 is just for the last month, and so means a surge in a short time. However, even multiplying it up by 12, only gets you to an increase of 1.2%, still less than half the increase, last year, from non-COVID19 causes. Even if you say, well, we are only at the start of the rise in morality, and take the worst current predictions, based on a mortality rate of 0.1%, you get to a figure between 20,000–30,000 deaths, on a worst case assumption that 30 million people are infected. That would give an increase of about 6% over the average of 500,000, but hardly seems a sufficiently large increase to justify hysterical warnings about the introduction of mass cremations. In fact, the last year's overall mortality figure of 623,000, represents an increase of 123,000 over the average 500,000 figure, or about 25%, which dwarfs the 30,000 worst case, COVID19 figure, but there was no such mass cremations last year! 

Of course, a cynic might say that undertakers have a vested interest in convincing potential customers that such serious conditions might apply, in the near future, so as to get people to sign up for funeral care plans early, a sort of panic buying, if you like, to beat the rush. It certainly doesn't harm them in currently increasing their prices, on the basis that such a phenomenal rise in deaths means that demand is outstripping supply. 

But, then, similarly, looking at the actual number of deaths from people who are confirmed to have had COVID19 leads to the further question, about why this rise, and any associated rise in hospital admissions, is also causing the NHS to be overwhelmed. In any year, we might expect that a part of that average 500,000 deaths are people who die at home, and are not themselves a drain on health services. But, by the nature of mortality, we would expect that the largest part of that 500,000 people are elderly people, or people who have some serious medical condition that eventually leads to their death, either directly or as a result of complications, secondary infections, and so on. Let's say that only half of the 500,000 people who die, were receiving hospital treatment at the time of their death. Then the actual current deaths of 422, represents an increase of 0.17%. That is such a small increase as to be statistically insignificant. Of course, the number of people that have died from COVID 19, is not the whole picture in terms of pressure on NHS resources. There is the number of people that require treatment. 

The latest figure for confirmed cases of COVID19, in Britain, is 8,077. As it is only people admitted to hospital with flu-like symptoms that are tested for COVID19, we can take this figure as the figure for people who are currently seriously ill, in Britain, as a result of COVID19 infection. Even if we assume that no one who was admitted to hospital in 2019, was actually seriously ill from a coronavirus infection, the figure of 8,077, represents a tiny proportion of the total NHS hospital admissions of around 16 million.  In fact, in 2015-2016, the number of hospital admissions for people aged 65-69, alone, was 1.3 million. The figure of 8,077 COVID19 admissions, therefore, represents an increase of just 0.62%, even in relation just to this latter category, in which the concentration of COVID19 patients could be expected to be manifest. Measured against the figure of total hospital admissions of 16 million, it is even more insignificant, at just around 0.05%. So, why are such tiny percentage increases in admissions causing panic, and causing hospital services to be overrun. Moreover, as Wobag's analysis demonstrates, we do not actually know how many of the patients admitted to hospital in previous year's were themselves infected by coronavirus, because, although coronavirus accounts for around 14% of all cases of people suffering from “flu-like” symptoms, each year, until the moral panic whipped up over COVID19, no one actually tested those admitted to hospital to identify what virus they had actually been infected by! And, as one specialist doctor admitted, yesterday, nearly all of those that have actually died, are people who would similarly have died from contracting any other flu-like infection, and that has almost certainly been the case, in previous years. So, the actual number of hospital admissions, and of deaths due to COVID19, as against those who were actually admitted to hospitals, in previous years, suffering from flu-like respiratory infections, and who were actually infected with a coronavirus, is much less than is being presented. 

A look at the situation at a more local level, perhaps, illustrates the point. Sky provide data on COVID19, in your area. So, I looked at the data for how many people are confirmed cases in Stoke. Stoke has a population of 250,000 people. A look at Marx's Capital indicates its history of ill-health due to people working in the pottery industry, mining and steel production, where the inhalation of dust led to large numbers suffering from respiratory diseases; a legacy that continues until today. It has a large, shiny new hospital provided by the last Labour government, the kind of expenditure that the Tories consider extravagant as opposed to paying out rent and dividends, and to pump up asset prices. According to the data, the number of confirmed cases of COVID19, in Stoke, is 4!!! That is not 4 deaths, or even necessarily 4 people who are seriously ill, but just 4 confirmed cases. In other words, 4 people whose flu-like symptoms led them to be admitted to hospital, and to be tested for COVID19, which was then confirmed. It seems hardly credible that Stoke, with its quarter of a million population, and its large shiny new hospital, should find itself being overrun as a result of 4 additional admissions, due to COVID19. Of course, anyone who has actually spent any time trying to be seen in A&E, at that shiny new hospital, and waited for hour after hour, knows that, in actual fact, its resources were already overrun long before anyone had ever heard of coronavirus or COVID 19. 

And, that appears to be the actual truth in relation to NHS services being overrun. Its not that COVID19 is causing the NHS to be overrun, it is that the NHS was already overrun, having been pared down by ten years of Tory austerity. A service that already did not have the supply to meet the demands placed on it, appears even more overrun, as soon as any additional demands are placed on it. COVID19 has simply been a convenient excuse for the Tory government for the crisis its own policies of austerity, over ten years, have created, and that picture is reflected elsewhere, where austerity measures have decimated public services, such as in Italy, and so on. In the US, it is the gross inequality, and fact that neither the Republicans nor the conservative Democrats like Obama and Biden, could bring themselves to support a simple civilised measure such as Medicare For All, which leaves tens of millions prone to any kind of serious illness. 

The truth is that its not COVID19 that is causing the NHS to be overrun. It is that ten years of austerity, but even taking that into consideration, its not COVID19 that is causing this current situation. If we take the number of people confirmed to have COVID19, it is this 8,077 figure. However, the total number of people admitted to hospital and tested for COVID19 is 91,000. In, other words, of the total number of people admitted to hospital with flu-like symptoms, only 8,077 had COVID19, whereas, presumably, the vast majority had flu-like symptoms, because they were infected with actual flu, or some other virus that produces such symptoms. So, if COVID19 did not exist, there would still have been more than 80,000 people admitted to hospital with flu like symptoms, or about ten times the number admitted due to COVID19. So, if COVID19 is supposed to be causing the NHS to be overrun, imagine what this ten times larger number of people admitted because they are suffering with other flue-like viruses is doing to it! 

If COVID19 did not exist, or if no one had ever heard of it, and so was not testing for it, we would have had this same number of admissions due to what, in any other year, would simply be put down to a bad year for seasonal flu. In fact, in 2019, the number of deaths from “flu” was 1600, a good year, compared to the average number of deaths of 8,000, but in 2018, the number of deaths was more than 15,000 greater, at around 17,000. Yet, no one, in 2018, faced with this bad year for flu, talked about the need to close down the whole economy, or to consider mass cremations. There was certainly talk about the incapacity of the NHS to cope with an upsurge of flu deaths, but that was considered only in terms of the continued decimation of NHS funding, by a Tory government more concerned with inflating asset prices, and pushing through its Brexit ideological hobby-horse, not by any increase in demand that was impossible to meet. It was only impossible to meet due to the deliberate decisions to underfund the NHS. Indeed, a large part of the reason for the NHS, currently, being overloaded is due to the lack of basic equipment, not to mention the 100,000 vacancies for nursing staff, the lack of an appropriate number of ventilators, and even of adequate PPE. Given the idiotic policy of Brexit, and the fact that many of the skilled EU workers that the NHS depends on, are going home, and no one is coming to replace them, this situation can only get worse. 

COVID19 is a useful distraction and excuse for the Tories for the fact that it is again their policies that have caused a crisis of underfunding, understaffing, lack of trained workers, and inadequate equipment. It is a result of their policy of austerity, and the same can be said about socialised healthcare systems in Europe. In Britain that is exacerbated by the idiotic policy of Brexit that is undermining the economy, and leading to the inability to obtain the workers required to provide the goods and services upon which we all depend. 

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