Update of Elusive Government Report on Collateral Lockdown Damage

Story on the front page of today’s Telegraph

Readers will recall that on July 21st I asked them for help in tracking down an elusive Government report. This was the analysis done by the Department of Health and Social Care (DHSC), Office for National Statistics (ONS), Government Actuary’s Department (GAD) and the Home Office (HO) of the collateral damage of the lockdown. Eventually, I tracked it down – it was published with absolutely no fanfare here. The only reason it came to public attention is because Sir Patrick Vallance referred to it in passing when testifying before the House of Commons Science and Technology Committee on July 16th.

Well, yesterday the Government published an update entitled “Direct and Indirect Impacts of COVID-19 on Excess Deaths and Morbidity”– and, thankfully, it was picked up by the Telegraph (see today’s front page above). This update was presented to SAGE on July 23rd, but it was only published yesterday.

The headline news is that the lockdown killed two people for every three that died of COVID-19 by the beginning of May. However, when you take into account the age of those who died from coronavirus, as well as their underlying health conditions, the loss of life as measured in Quality Adjusted Life Years, or Qalys, for those who died as a result of the lockdown was greater than it was for those who died of COVID-19. This is how the authors of the report put it:

The direct COVID-19 deaths account for the majority of all excess deaths. However, when morbidity is taken into account, the estimates for the health impacts from a lockdown and lockdown induced recession are greater in terms of QALYs than the direct
COVID-19 deaths. Much of the health impact, particularly in terms of morbidity, will be felt long after the pandemic is assumed to last…

According to Sarah Knapton, the Science Editor of the Telegraph:

The estimates show that 16,000 people had died through missed medical care by May 1st, while coronavirus killed 25,000 in the same period.

The figures include 6,000 people who did not attend A&E at the height of lockdown because of fears they might catch the virus and the feeling they should remain at home because of the “Stay Home, Protect the NHS, Save Lives” message.

Likewise, 10,000 people are thought to have died in care homes due to early discharge from hospital and not being able to access critical care.

The article includes some choice quotes from the President of the Royal Society of Surgeons:

Professor Neil Mortensen, the President of the Royal College of Surgeons of England, warned that the health service “must never again be a coronavirus-only service”.

“We have to deal first with the most clinically urgent patients, and then as soon as possible with those who have been waiting the longest,” he said. “The period through August and September is vitally important in making progress before routine winter pressures emerge.”

Pretty damning, but before you pop the champagne corks with cries of “finally!”, a caveat. The authors of the report claim that the Covid death toll in an “unmitigated scenario”, i.e. a scenario in which the Government did nothing to encourage social distancing and people carried on as normal, would have been a whopping 1.5 million!

It should be noted that the health impacts modelled here represent a scenario with mitigations in place. Without mitigations, a far larger number of people would have died from COVID-19 such that the QALY impact from COVID-19 deaths would be more than three times the total QALY impact of all the categories (mortality and morbidity impacts) for the CSS mitigated scenario presented here. A comparison with an unmitigated scenario 3 is provided in Annex G and shows that mitigation have prevented up to 1.5m direct COVID-19 deaths.

Total balls, obviously. The relevant counter-factual is not this fantastical “unmitigated scenario”, but a continuation of the mitigation strategy put in place by the Government on March 16th in which people were encouraged to observe modest social distancing measures, with quarantining restricted to the infected, the elderly and the vulnerable. As even Chris Whitty now admits, this strategy proved effective and the number of daily cases was falling before the full lockdown was imposed on March 23rd. The real question is “Did the full lockdown prevent more loss of life than it caused?” and, thanks to this report, we can conclude with some confidence that it didn’t.

By 8 August 2020