IHME analysis is disputed by scientists whose modelling is relied on by UK government
Sarah Boseley Health editor – The Guardian
Ambulances outside the NHS Nightingale hospital at the Excel Centre in London. Photograph: Matthew Childs/Reuters
World-leading disease data analysts have projected that the UK will become the country worst hit by the coronavirus pandemic in Europe, accounting for more than 40% of total deaths across the continent.
The Institute for Health Metrics and Evaluation (IHME) in Seattle predicts 66,000 UK deaths from Covid-19 by August, with a peak of nearly 3,000 a day, based on a steep climb in daily deaths early in the outbreak.
The analysts also claim discussions over “herd immunity” led to a delay in the UK introducing physical distancing measures, which were brought in from 23 March in England when the coronavirus daily death toll was 54. Portugal, by comparison, had just one confirmed death when distancing measures were imposed.
The IHME modelling forecasts that by 4 August the UK will see a total of 66,314 deaths – an average taken from a large estimate range of between 14,572 and 219,211 deaths, indicating the uncertainties around it.
The newly released data is disputed by scientists whose modelling of the likely shape of the UK epidemic is relied on by the government. Prof Neil Ferguson, of Imperial College London, said the IHME figures on “healthcare demand” – including hospital bed use and deaths – were twice as high as they should be.
The IHME, which is responsible for the ongoing Global Burden of Disease study, calculated the likely need for hospital admissions and intensive care beds and projected deaths in European countries hit by Covid-19.
Looking at the measures taken by the UK to curb the spread of the disease, the institute says the peak is expected in 10 days’ time, on 17 April. At that point the country will need more than 102,000 hospital beds, the IHME says. There are nearly 18,000 available, meaning a shortfall of 85,000.
The same grim picture applies to intensive care beds. At the peak, 24,500 intensive care beds will be needed and 799 are available, the analysts predict. There will be a need for nearly 21,000 ventilators, they say. At the peak the UK will see 2,932 deaths a day, the IHME forecasts.
The death toll in other European countries that are now struggling with Covid-19 will be lower, they say. Spain is projected to have 19,209 deaths by the same date, Italy 20,300 and France 15,058. All three countries have imposed tougher lockdown measures than the UK.
The IHME bases its forecasts in large part on the trajectory of deaths rather than case numbers and the speed with which distancing measures were put in place.
The UK will be severely short of beds, it finds. Germany, by contrast, is predicted to have enough hospital beds, including ICU beds, needed for its peak. The IHME predicts Germany will have 8,802 deaths in total by 4 August.
France will have enough general beds but will be about 4,000 short of ICU beds at the peak, says the forecast. There are projected to be just over 15,000 deaths there. Both Italy and Spain are past their peaks, says the IHME.
The IHME, based at the University of Washington in Seattle, published its forecast for the US on Sunday, revising down the projected number of Covid-19 deaths there from 93,500 to 81,800. These figures were relied on in part for the US government’s own, higher predictions of the coronavirus death toll.
In March, modellers relied on by the UK government, led by the team at Imperial College London, said deaths could reach 260,000 in the UK with no restrictions on movement, but they hoped to get deaths down to 20,000 through the lockdown strategy.
Ferguson said he did not think the predictions could be relied on. “This model does not match the current UK situation,” he said, adding that the numbers used by the IHME were at least twice as high as they should be for current bed usage and deaths in the NHS. “Basically, their healthcare demand model is wrong, at least for the UK,” he said.
The IHME said its model was designed to be updated from day to day as the pandemic goes on. For a country such as the UK, which is quite early on in its outbreak, the uncertainty was higher and the headline numbers might change over the next few days as more data is collected.
The high predicted numbers of UK deaths were driven by three factors, the IHME said:
- What had happened in other countries that are ahead in their epidemics, such as Italy and Spain.
- What had happened so far in the UK.
- When physical distancing measures were put in place.
In the early stages of the UK outbreak, deaths climbed steeply, which the IHME says is a major driver of predicted deaths.
The flirtation in government with the idea of “herd immunity” as a way out of the epidemic meant there was a delay in implementing physical distancing until 23 March, when there were already 54 daily deaths.
“We are expecting a foreboding few weeks for people in many parts of Europe,” said the IHME director, Dr Christopher Murray. “It seems likely the number of deaths will exceed our projections for the United States.
“It is unequivocally evident that social distancing can, when well-implemented and maintained, control the epidemic, leading to declining death rates.
“Those nations hit hard early on implemented social distancing orders and may have the worst behind them as they are seeing important progress in reducing their death rates.
“Each nation’s trajectory will change – and dramatically for the worse – if people ease up on social distancing or relax other precautions.”
Murray cautioned that easing these precautions too soon during the first wave of the pandemic could lead to new rounds of infections, hospitalisations and deaths. He defined the end of this “wave” as a ratio of 0.3 deaths per 1 million people.
“To decrease the risk of a second wave in places where the first wave is controlled by robust social distancing, governments would need to consider mass testing, contact tracing and quarantines for those infected until a vaccination is available, mass-produced and distributed widely,” Murray said.
A Department of Health and Social Care spokesperson said: “Our response to coronavirus – including decisions on which measures we introduce and when – is based on the latest scientific advice, modelling and evidence, and we are working round the clock with world-renowned clinicians, public health experts and scientists to keep this country safe.
“In England alone, the NHS successfully has freed up more than 33,000 beds – the equivalent of 50 new hospitals – and we are increasing the number of ventilators and opening more Nightingale hospitals, all of which will save even more lives in the coming weeks.”