MPs who want to avoid a second lockdown have seized on falling rates of confirmed coronavirus cases in Liverpool as evidence that the three-tier Covid alert system is bringing the virus under control and should be given more time to work.
There is good reason to believe that the top tier of restrictions have had an impact in Liverpool. When the tier system was announced on 12 October, and Liverpool entered tier 3, the number of cases the previous week stood at 3,440. That figure has fallen steadily ever since, reaching 1,828 by 29 October.
The decline is precisely what was hoped for, but there are subtleties in the data that are causing government advisers to pause. Prof Chris Whitty told MPs on the science and technology committee that the fall in confirmed infections in the north of England was driven by younger people and brought about by what he called real and artificial effects: a levelling off and perhaps a decline in positivity rates, but also a slight reduction in the uptake of tests.
What concerns advisers most is that they do not see a convincing decline in infections among the older age groups – those most vulnerable to developing severe disease, being hospitalised and dying from the infection. “The data are still tracking up in all the data that I have seen in the older age groups who are the ones who are likely to translate into hospitalisations, intensive care unit cases and deaths,” Whitty said.
Because of the lag time between infections and deaths from coronavirus, the impact of the tier system, brought in only three weeks ago, will only start to show in the death data this week or next. The latest data for Liverpool, up to 31 October, show that deaths have risen fairly steadily since the tier system came in, from a seven-day average of 5.4 to 6.9 deaths a day. There is a hint that the rate is slowing, but it is not convincing.
When the tier system came in, scientific advisers made clear that the baseline restrictions in the highest, tier 3, were unlikely to be effective enough to bring the R value below 1 and suppress the virus. Their assessment now is that in some areas in the north of England, R seems to have been pushed down close to 1 but may not have been driven any lower. “We do not have, in my view, clear evidence that R is below 1 anywhere that we actually have significantly high rates,” Whitty told the MPs.
The risk is that the top tier holds R close to 1 when the rate of new infections is still high, meaning that large numbers of people, if not rapidly rising numbers, are still admitted to hospital, where a sizeable proportion will die. It locks in a high prevalence of infections. The lockdown is intended to push cases down faster.
MPs voting on the lockdown are not helped by the prime minister’s timing. The full impact of the three-tier system has yet to be seen. But waiting two or three weeks more could be extremely costly given how late restrictions were brought in. According to Simon Stevens, the chief executive of NHS England, the number of coronavirus patients in English hospitals has risen from 2,000 at the beginning of October to nearly 11,000 today, the equivalent of 22 hospitals’ worth of Covid patients. Faced with rising infections and deaths across the country, and some hospitals, such as Liverpool, already above their spring peaks for Covid patients, advisers are not keen to sit back and watch what happens.