‘A bit of a mystery’: why hospital admissions for Covid in England are going down

In early September, outbreak modelling for the government’s Sage advisers showed Covid hospitalisations had the potential to soar. If people rushed back to work and resumed all the socialising they had put on hold, the number of daily admissions in England could peak at 7,000 within six weeks. It was, in effect, a worst-case scenario, barring a dramatic waning of immunity or a troublesome new variant.

Ian Sample www.theguardian.com 

The optimistic scenario looked very different. Assuming a more gradual return to normality, the modelling had daily Covid hospitalisations rising slowly and slightly, topping out at nearly 2,000, before falling again in November. Now, even that looks overly gloomy. Over the past fortnight, hospitalisations have fallen in England, even as schools and offices reopened.

Mismatches between the modelling and the true course of the epidemic have caused confusion throughout the Covid crisis. The models are not predictions of what will happen. They are what the computers churn out when presented with a “what if?”. In this case, what if R (the reproduction number of the epidemic) reaches 1.1? And what if – as Jonathan Van-Tam, the deputy chief medical officer for England, would say – people “tear the pants out of it” and push R to 1.5? That would mean, on average, every two people infected go on to infect three more.

Sage expected hospitalisations in England to peak somewhere near the lower range, namely 2,000 a day, but no sooner was the modelling complete than hospitalisations began to fall. The decline was unexpected. What it suggests is that – for now – the effect of unlocking on fuelling the epidemic is more than offset by the combination of people’s behaviour and immunity, whether from vaccination or infection.

“Those are two very powerful forces. Each by itself is perfectly capable of making the number of cases or hospitalisations go up or down, and they are basically fighting each other right now,” said Mark Woolhouse, professor of infectious disease epidemiology at Edinburgh University.

On Friday, the Office for National Statistics reported a fall in infection rates in England for the second week running, with one in 90 now estimated to test positive for Covid. Elsewhere in the UK, rates remain stable but high.

According to Prof Graham Medley, chair of the Sage modelling subgroup, Spi-M, while infections and admissions have drifted down in the past couple of weeks, little has changed over the larger timeframe of the past 10 weeks. “This is unexpected,” he said. “There must be a balance between the increasing immunity from infection and vaccination, and the amount of contact, but how they exactly balance to keep R roughly at 1 is a bit of a mystery.”

It may be that vaccines are more effective at preventing transmission than studies – often based on symptomatic patients – suggest. If that is the case, Woolhouse said, immunity may be playing a larger role in suppressing the epidemic than thought. After a sharp rise in Scotland, cases appear to be falling back down, without any obvious change in behaviour, he added. “It’s a watershed moment. This is the first time in the history of the UK’s epidemic that we’ve had a sustained decline in cases in the absence of a lockdown or not far short of it,” he said. “We’ve never seen that before, so clearly something is fundamentally different, and the fundamental difference for me is the buildup of herd immunity.”

That would be excellent news, particularly if the rest of the UK follows suit. On Friday, the R number for England was revised to 0.8 to 1, with the number of new infections estimated to be shrinking at 1% to 3% a day. The difficulty is that, with a lot of virus still around, a manageable situation could become challenging very fast. “If there is an uptick then we need to react to that quickly. If this does go wrong, the NHS will be in trouble very quickly,” Woolhouse warned.

As Medley pointed out, the country has not rushed back to “life-before-Covid”. What happens next is still as murky as ever. “We are still a long way from normal levels of contact, so there is still the possibility of an increase in transmission and hospitalisations, but the past couple of months gives a lot of hope,” he said.

We may have reached another turning point

Tim Spector’s symptom tracker app, which has a track record of identifying turning points in the evolution of the pandemic across UK a couple of weeks in advance of confirmed cases, is now showing a slow down in the rate at which the infection is falling.

More on Lib Dems hold Exe Valley 

Some observations to make.

In 2019 turnout was 36% in this by-election it dropped to 26%.

In 2019 the Conservatives got 43% of the vote in a two way contest, this time it dropped to 32%. 

In 2015 general District Council elections, the turnout was 77% and the Conservatives won the ward with 52% of the vote in a two way contest.

So the Conservative proportion of the vote has consistently fallen from 52% through 32% to 26% since 2015. 

Not exactly a vote of confidence in the Tory “build, build, build” policies for East Devon. – Owl

Lib Dems hold Exe Valley ward in East Devon District Council by-election

Philippa Davies sidmouth.nub.news

The Liberal Democrats have held on to a seat on East Devon District Council after a closely fought by-election for the Exe Valley ward.

Jamie Kemp received 190 votes, seeing off Conservative Kevin Wraight who won 164 and Labour’s candidate, Mike Daniell, who earned 161. One voter made their opinion well known by spoiling their ballot paper, drawing sad faces next to each candidate’s’ name.

The turnout was 26 per cent.

Mr Kemp is expected to join the council’s ruling coalition known as the Democratic Alliance, a combination of the East Devon Alliance, Liberal Democrats, Greens, Labour and some, but not all, Independents.

He picks up the reins from fellow Liberal Democrat Fabian King who stepped down as a councillor in July to focus on his business, which he said had been affected by Covid.

Speaking after the result Mr Kemp said: “I’m over the moon. It’s been a fantastic campaign, the other candidates have worked really hard. It’s a win really for everybody in the Exe Valley and I look forward to representing them.

“And, yes, now my wife probably won’t moan at me quite so much – and the children won’t be as annoyed with me!

“I look forward to starting work with the other councillors and getting the job done.”

‘A good campaign with three strong candidates’

Conservative candidate Kevin Wraight said: “I’m disappointed, obviously. I wanted to win but it’s a fair fight – it’s been a good campaign and three extremely good, strong candidates.

“I think the Exe Valley has been very well served by an election that’s been so close.”

Labour candidate Mike Daniell was also pleased with the result: “I’m more than chuffed with it.

“We’ve given everyone a run for their money to the point that this has become a very well-fought campaign.

“I think Labour’s given everyone such a good kick up the arse as it were that they’ve gone out and really campaigned hard, so I congratulate Jamie on a very hard-fought success.”

The defeated candidates might not have to wait too long for another attempt with the next full district council elections expected to go ahead in 18 months.

What’s the political make-up of East Devon District Council?

For now, the make-up of the council is now as follows:

Conservatives – 22

East Devon Alliance – 13

Independents – 14

Liberal Democrats – 7

Green Party – 2

Labour – 2

The Exe Valley vote was the district council’s third by-election in recent months, with polls held in May and July this year.

The July by-elections returned some surprises as Conservative Alasdair Bruce took Feniton, previously held by an Independent, and teenager Jake Bonetta won Honiton St Michael’s.

The 19-year old took the seat previously held by the Liberal Democrats to become the first Labour councillor on the district council in more than 20 years. Since his election formerly independent councillor Paul Millar (Exmouth Halsdon) has joined Labour, giving the party two seats.