Absolute case numbers remain small

The news this week reports a ‘surge’ of cases and hospitalisations of the Indian Variant (B1.617.2) in the Greater Manchester area. Indeed the Indian government is distinctly unimpressed with this nomenclature and does not concur that this variant belongs to them.

The obsession with named variants seems to be a phenomenon that is particularly ‘virulent’ in the UK, perhaps due to the overanalysis of samples never seen before in the history of disease epidemiology. The existence of sophisticated genomics laboratories is possibly our undoing in this regard and the old adage ‘seek and you shall find’ seems particularly pertinent.

Is this simply the next chapter in the long-running series of Operation Fear that the government refuses to end in spite of much recent coverage of the unethical use of these tactics throughout the past year? It feels as though we are perpetually ‘mining’ for disease, even in the absence of any observable problem. There is even a bid to start trawling the sewers. If you need to look in the sewers to find it, it probably isn’t a clinically relevant problem.

But what is the reality on the ground? There is currently no threat of any hospitals being overwhelmed and absolute case numbers are still very small, in spite of the use of emotive language such as ‘cases rocket’ in local press reporting. As of 24 May, hospital numbers stand at 43 in Bolton. The comorbidities and demographics of these hospital cases are never presented. Simply put, we know they are PCR positive, and in hospital. Given the many flaws of using PCR testing to diagnose disease, this really tells us nothing at all without confirmatory clinical diagnoses. It is worth noting that the government is testing about 10% of the population of Bolton every day. It is not entirely clear who — apart from those selling test kits — stands to gain from the mass testing for ‘cases’ of an endemic virus in a healthy population.

Comparison of COVID-19 cases per million by country (below).

Weekly number of PCR tests in Bolton and percentage that were positive (below).