WHEN the death rate from coronavirus in Italy has surpassed that of China, the rest of the world has watched the terrifying scenes of doctors and nurses in combat gear fighting to save lives.
Experts have put the rapidly escalating situation on the shoulders of the aging Italian population, a higher rate of smokers and a culture of connection between generations.
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It quickly became clear that the UK was following the same path and unless drastic measures were taken, it was likely that the NHS would bow to immense pressure.
For example, on March 23, the Prime Minister locked the country and ordered people to stay at home to protect health services and ultimately save lives.
Yet just over two weeks later, on April 10, the number of deaths per day in Britain surpassed Italy’s deadliest day – and Spain which had also seen an increase in deaths – with 980 deaths in 24 hours.
Famous scientist Anthony Costello even predicted today that as many as 40,000 Britons could die in the first wave of coronavirus – making it the most affected country in Europe.
As of yesterday, the death toll in the UK has risen to 13,729 after the death of 861 patients in hospital.
however, gloomy new figures today suggest that the figures could be 15% higher than those reported after the revelation of nearly 800 deaths hidden outside the hospital in England.
But so far the government has yet to explain exactly why the UK is starting to see much worse rates than the rest of Europe.
Here, take a look at some of the possible reasons why Britain has been more severely affected…
1. Test for delays
Testing is essential to contain the coronavirus crisis because it can tell us who is currently infected and who has already had it and who is presumed to be immune.
Originally – during the containment phase of this crisis – all Britons who returned from Italy or China suspected of having Covid-19 were tested, and each person with whom they came into contact was meticulously traced.
But on March 12, the government abandoned this strategy, admitting that the struggle to “contain” the virus had been lost.
After that, only those hospitalized would be tested and the government stopped knowing for sure how many people were infected.
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Since then, Britain has continued to lag behind other countries, including Germany and South Korea, in terms of faster mass testing.
The government has pledged to reach its goal of 100,000 tests by the end of the month and has lagged behind global demand for test components.
Cabinet Minister Michael Gove blamed the lack of reagents – the chemicals needed for testing.
But scientists say there is no shortage and that the problem lies in the complicated manufacturing process and the verification of test kits produce reliable results.
Britain suffered another blow when components that had been shipped from abroad were found to be contaminated.
Meanwhile, officials have ordered 3.5 million “game-changing” antibody tests – only to find that they were not reliable enough when subjected to rigorous testing.
The national army of small laboratories in universities, hospitals and the private sector is asked to participate and start testing.
But Health Secretary Matt Hancock continued to reiterate that “no test is better than a bad test.”
2. Delays in starting lockout
Boris Johnson locked out the UK on March 23, ordering people to leave their homes only for essential reasons like going to the supermarket or exercising every day.
But people are starting to wonder if strict measures should have been taken sooner.
Ireland locked out two weeks before the UK and saw far fewer deaths as a result.
Some analysts now believe that this early intervention helped stop the spread of the coronavirus – but experts are divided on the impact.
Writer and researcher Dr. Elaine Doyle wrote a series of tweets comparing the two approaches, and said, “While Boris [Johnson] told the British people to wash their hands, our taoiseach was closing the schools.
“As Cheltenham went ahead and more than 250,000 people gathered in what would have been a massive super-spreader event, Ireland had canceled St. Patrick’s Day. “
But Dr. William Hanage, an associate professor of epidemiology at Harvard University, told the Guardian that “it remains to be seen how it will all turn out.”
Asked whether Britain should have gone further, earlier, the government’s scientific adviser, Sir Patrick Vallance, said that we had to wait to find out.
He said at a press conference in Downing Street: “We still have a long way to go in this disease. It’s still new. “
3. Underlying health conditions
Scientists who had followed Covid-19 since its early onset made it clear that those with underlying health conditions were more vulnerable.
New figures show that 91% of people who died of Covid-19 had at least one underlying health problem, according to the Office for National Statistics (ONS).
The most common preexisting disease was heart disease, which affects 7.4 million people in the UK, and is the biggest killer every year.
It was followed by dementia and Alzheimer’s disease – conditions with which 850,000 people currently live in Britain.
Chronic lower respiratory disease, diabetes and influenza were other pre-existing conditions that accounted for the most deaths in England and Wales in March.
Another recent study found that people with only one pre-existing condition were 80% more likely to die from the disease.
Experts from the Expert Panel on Medical Treatment in China have identified cancer and chronic obstructive pulmonary disease (COPD) as the most at risk.
COPD – a type of lung disease – affects 1.2 million people in the UK, while the most recent figures estimate that there are 2.5 million people living with cancer in Britain.
Research published in the European Respiratory Journal has also found that people with high blood pressure, diabetes or cardiovascular disease are at increased risk for Covid-19.
Other conditions that have been identified include asthma – which affects 5.4 million Britons, cystic fibrosis, primary immunodeficiency (PID), HIV and AIDS, chronic liver or kidney disease and neurological conditions such as Parkinson’s disease.
To reduce the risk of catching the virus, 1.5 million Britons have received a letter saying they are considered vulnerable and should self-isolate for 12 weeks.
Smoking can damage the lungs and airways – and as Covid-19 attacks the respiratory system, it can increase your risk of developing worsening symptoms.
Research has shown that smokers are actually 14 times more likely to develop severe coronavirus than non-smokers.
It is thought to be because smoking can weaken the immune system and make people more susceptible to disease.
In the UK, 16.5% of men – around 3.9 million – and 13% of women – around 3.2 million – reported being current smokers, according to recent figures.
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Obesity can lead to a number of serious and life-threatening conditions, including type 2 diabetes, coronary heart disease, certain cancers, and stroke.
But experts say that being overweight could also be a high risk factor for suffering from severe coronavirus.
Studies have shown that obese patients are at higher risk for hospitalization due to the complications of Covid-19.
New York researchers have found that patients under the age of 60, considered obese by BMI standards, are almost twice as likely to be admitted to hospital for acute and critical care.
In the UK, it is estimated that about one in four adults and one fifth of children aged 10 to 11 are obese, according to NHS figures.
This means that – for adults – at least a quarter of the nation is at increased risk for serious complications from the coronavirus.
From what we know so far about the coronavirus, it is clear that it is a disease that mainly affects the elderly.
With one in six people over the age of 65 in the UK, this puts at least 10 million people at increased risk of contracting Covid-19.
The latest data from the National Critical Care Research and Audit Center (ICNARC) on intensive care units in the UK shows that the average patient who is critically ill is 60 years old.
Some people have raised the question of whether some of the deaths we see caused by the coronavirus would have happened anyway.
Each year around 600,000 people die in the UK – heart attacks, strokes and cancer are the deadliest.
Professor Sir David Spiegelhalter of the University of Cambridge said that almost 10% of people over the age of 80 would die next year.
He said the risk of death if they were infected with a coronavirus is almost exactly the same.
But it is important to note that the coronavirus does not make any age distinction – in recent weeks the UK has experienced a number of deaths among young people.
These include Ismail Mohamed Abdulwahab, 13, of Brixton, who died of coronavirus after being rushed to London’s College Hospital for breathing difficulties.
Luca Di Nicola, 19, from Italy but living in north London, died just 30 minutes after being taken to hospital last Tuesday – from apparent fulminant pneumonia.
None of the victims had experienced pre-existing health problems.
The message should be that young, healthy people are dying from this infection
Prof Paul Hunter
Research from Imperial College London suggests that the death rate is almost 10 times higher than the average for those over 80, and lower for those under 40.
However, although deaths in the youngest are rare – just as symptoms become more severe – they are not immune.
The college explained that 0.03% of people under 30 will die from the coronavirus, which, compared to 9.3% of those over 80, shows that everyone is susceptible to the virus.
Paul Hunter, professor of medicine at the UEA, warned, “The message should be that young, healthy people are dying from this infection. “
7. Living conditions
Cramped living conditions in crowded areas of the UK could accelerate the spread of the virus, experts said.
Research from the New Policy Institute shows that outside of London, the top five most populous areas in the country have seen 70% more cases of coronavirus than the five least populated.
Just over 11% of housing in the capital and 9% of housing in Birmingham are classified as overcrowded.
Peter Kenway, Director of NPI, said research has shown that crowded neighborhoods generate more Covid-19 infections than less crowded areas, even after taking into account the start of the epidemic, local deprivation and time.
He told the Guardian: “Our models show that even when you factor in the obvious factors, there is still an increased risk for overcrowded households, especially when older people live with younger people. “
Professor Gabriel Scally, president of epidemiology at the Royal Society of Medicine, said he was concerned that the virus would spread easily between people living nearby and sharing facilities such as toilets and kitchens.
He said, “Multi-occupancy homes have to be in the same category as nursing homes because of the pressure from people.
“I have no doubt that these kinds of crowding conditions are extremely powerful in spreading the virus.”
8. Ethnic minorities
People from black and ethnic minorities may be more exposed to more serious coronavirus disease for social, cultural and biological reasons, experts said.
Data on patients with Covid-19 confirmed by the National Critical Care Research and Audit Center (ICNARC) show that 35% of nearly 2,000 patients were not white – nearly triple the proportion of 13% in the general British population.
The ICNARC breakdown showed that of 1,966 patients with Covid-19, 64.8% were white, 13.6% were black, 13.8% were Asian and 6.6% were described as others.
The larger number of cases than expected in Asian and black patients may represent an effect of different social or cultural factors
Duncan Young, a professor of intensive care medicine at the University of Oxford, said: “The higher than expected number of cases in Asian and black patients may represent an effect of different social or cultural factors leading to more cases in these groups as a whole that is simply reflected in ICU admissions.
“Alternatively, it may be the burden of chronic conditions predisposing to severe Covid infections and therefore ICU admission is higher in these ethnic groups. “
Dr. Riyaz Patel, associate professor of cardiology at University College London, said the virus has so far hit densely populated areas like London first, where BAME populations are high.
He said: “So far, most of the data from the ITU has come from major London centers. As such, over time, we may see a leveling out of racial disparity while the rest of the country is affected.
“Nevertheless, there could be biological reasons for the difference on which we can speculate.
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“One thing that is very visible to us in the ITUs of London now is how diabetes, high blood pressure and maybe a little bit overweight seem to be such powerful risk factors for having severe lung disease, maybe more than having an existing lung disease that you think would be a greater risk.
“All of these risk factors are more common in black and Asian patients, so there might be a link here that needs to be further explored. “