Coronavirus: Second wave death toll set to exceed worst-case scenario, Sage warns

Scientists fear deaths and pressure on hospitals is going to continue to increase in coming weeks

The number of deaths caused by coronavirus is likely to exceed the government’s worst-case scenario predictions, with ministers being told the second wave is too far advanced now for a short circuit-breaker lockdown to stop it.

Newly released documents from the Scientific Advisory Group for Emergencies, or Sage committee, warn the scale of the virus’s spread throughout the UK means the number of deaths could surpass the 85,000 deaths that had been predicted by government modelling.

At a meeting of Sage on 8 October the committee warned: “In England the numbers of infections and hospital admissions exceed the Reasonable Worst Case Scenario (RWCS) planning levels at this time. Near-term projections indicate the number of deaths is highly likely to exceed RWCS planning levels within the next two weeks. Well over 100 new deaths per day are projected to occur within two weeks, even if strict new interventions are put in place immediately.”

The number of reported daily deaths is already above that level, with 280 deaths reported on Thursday. Sage committee members fear the number of deaths will rise yet further in coming weeks, with a lag time of between two and four weeks before increased restrictions might affect those numbers.

Scientists had previously called on the government to implement a circuit breaker lockdown in September to try and bring the spread of the virus under control.

But members of Sage are now warning this will be unlikely to bring the rate of transmission of the virus down sufficiently to stop the spread, with more and more people becoming infected all the time.

The scenario means it is much more likely that any lockdown will have to be longer and deeper than a circuit breaker.

The government rejected that idea in September and instead opted for a regional approach with different tiers, which were brought into force just under a week after the Sage meeting on 14 October. Liverpool was among the first to enter the highest tier 3 alert level, with pubs and bars not serving meals forced to close.

Manchester entered tier 3 on 23 October after a public row between the mayor Andy Burnham and ministers over the level of financial support.

A leaked report obtained by The Independent on Friday revealed the region was close to running out of normal intensive care beds and may have to open makeshift intensive care units from next week.

In Nottinghamshire today the NHS said it now had 40 per cent more people with Covid in hospitals than at the start of April, while in Sheffield mayor Dan Jarvis said 700 people with coronavirus are being cared for in hospitals across Sheffield, Doncaster, Rotherham and Barnsley, compared with 414 in the spring.

The Sage report from earlier this month warned: “Incidence and prevalence across the UK continue to increase, and data show clear increases in hospital and ICU admissions, particularly in the north of England.”

It added: “In all scenarios the epidemic is still growing.

“Sage has previously advised that a package of non-pharmaceutical interventions [lockdown-style measures] need to be adopted to reverse the exponential rise in cases. As previously, the earlier additional measures are introduced the more effective they will be. Longer-term sustained measures will also be essential.”

There is mounting frustration among some Sage members at the worsening picture and lack of tougher steps being taken by ministers.

Some members have pointed to its predictions back in February and March where the government was warned over the likelihood of a problematic second wave.

Chief medical officer Chris Whitty has warned that the government’s tier 3 measures are unlikely to be enough to bring the R rate of transmission down below one.

With the virus spreading further and becoming more prevalent in society scientists believe it will take an even longer and deeper lockdown to successfully reduce the R rate. This will need to aim for getting the rate not just below one but even lower to avoid a plateauing effect of coronavirus cases neither rising nor falling.

Weekly reports from the Scientific Pandemic Influenza Group on Modelling (Spi-M-O) show that as early as 16 September, projections of the spread of the infection suggested that the NHS could be overwhelmed within 6-8 weeks.

The modelling group said at that point a “stay-at-home fortnight with restrictions similar to those in force in late May” could put back the progress of the epidemic by 28 days, potentially reducing the prevalence of infections at Christmas time by 25-50 per cent and preventing or delaying the need for national total lockdown.  

By 23 September, Spi-M-O was warning that the epidemic was close to breaching the “worst-case scenario” drawn up in the summer to guide policy-makers’ decisions.  

The group warned that a time-limited circuit-breaker lockdown would be most effective if implemented when the reproduction rate R was below 1.2. The rate was at that point estimated to be between 1.2 and 1.5 in the UK and above 1 in all four nations.

“The epidemic is close to breaching the agreed Reasonable Worst Case Scenario on which NHS, DHSC and HMG contingency plans are based,” said SPI-M-O on 23 September. “Unless the measures announced on 22 September reduce R back below 1, it is likely that infection incidence and hospital admissions will exceed the planning levels.”

By 7 October, Spi-M-O reported that infections and admissions in England had already breached the levels previously regarded as the worst-case scenario, and that deaths were likely to breach worst-case projections within a fortnight, at well over 100 a day.

“There is complete consensus in Spi-M-O that the current outlook for the epidemic’s trajectory is concerning, if there are no decisive interventions or behavioural changes in the near term,” said the group.

In its report on 14 October, it noted: “The number of daily deaths is now in line with the levels in the Reasonable Worst Case and is almost certain to exceed this within the next two weeks.”

A government spokesperson said:  "As a responsible government, we continue to prepare for a wide range of scenarios, including the reasonable worst-case scenario, and this is kept under constant review.  

“Our approach is based on the different levels of prevalence of the virus across the UK, but we will not hesitate to put in place further measures if necessary.

“We have made significant strides in our response to the pandemic – an extra £3bn in funding has been made available to the NHS to help it continue to provide high quality care as we head into winter, treatments like dexamethasone have been proven to save lives, and there is promising progress in finding a safe vaccine through government-backed scientific research.”