Are we at the peak and why is the UK death total so high?

QHave we reached the peak of the outbreak yet? And will things get better now?

AIt’s likely we’re approaching the peak of this outbreak – but it’s a complex issue. When officials talk about the peak of the pandemic, they’re referring to the point at which the number of daily confirmed Covid-19 infections and infection-related deaths reaches an all-time high. The Chief Medical Officer, Professor Chris Whitty, said the UK was ‘probably approaching’ this point after the daily death toll reached 980 on April 11. Numbers of infections and deaths have since decreased, but complications with reporting the figures mean we cannot be certain this is the true ‘peak’.

‘We will still see many hundreds of hospital deaths announced each day for some weeks ahead,’ says Professor James Naismith, Director of the Rosalind Franklin Institute at the University of Oxford. The daily figures also don’t count those who die at home or in care homes, so it’s

virtually impossible to know if the infection rate has plateaued, according to Dr Andrew

Preston, reader of microbial pathogenesis at the University of Bath. ‘Only a small proportion of people are getting tested – those in hospitals and frontline care workers,’ he says. ‘And many people are asymptomatic.’

Data from Spain and Italy, which saw their peaks earlier, shows that although numbers rose incredibly fast, they decline far more slowly. We have flattened the curve, thanks to social distancing. But it’s not possible to tell exactly what shape the curve will take on the other side of the peak. And if lockdown measures are relaxed too soon, it is clear the numbers could rapidly shoot up again.

QWhy is the UK death rate so high, compared to other European countries?

AReports last week suggested that the UK is expected to have the highest death toll in all of Europe.

The current UK toll is passing 15,000 – far higher than Germany, Switzerland and the Netherlands, where only a few thousand have died.

There are several reasons for this, according to Dr

Preston. ‘Firstly, many of our big cities are especially densely populated, increasing transmission rates. This is why most of our deaths have been in London. We are also the largest travel hub in Europe, so we’ve had more people bringing the virus over. Like Italy, which has the highest death toll in Europe, we have an ageing population.’

Another crucial factor is that other countries, such as Germany, had a ‘head start’, he says. ‘They had 50 testing laboratories already set up so they could test and isolate cases. Whereas we have only eight, so we’re playing catchup.’ But Dr Preston adds: ‘It’s very possible that other nations [who relax lockdown measures earlier] will have a second wave and the UK won’t. We simply won’t know until the restrictions have been lifted and the infection can spread again.’

QIs it not safe to lift the restrictions until we have a vaccine?

AAn effective vaccine is our best chance of beating the virus. Yet scientists predict it won’t be available until at least the autumn.

‘Studies suggest it is possible to lift some restrictions safely, while keeping infection rates under control,’ says Dr Preston. ‘We’ve seen evidence of this in other countries such as Singapore. We will need to maintain strict social-distancing measures and have controlled access to shops and supermarkets. We’ll need to identify sectors most at risk of infection and those who can remain working from home. Perhaps we let specific sectors go back to work at different times or introduce a shift system. But limits on the use of public transport must remain in place. Mass testing – even for those without obvious symptoms – and contact-tracing is key so we can isolate people and stop the number of cases growing. We must be prepared for a second lockdown, if figures rise significantly again.’

QIf I’ve had the virus, surely I won’t need to be so careful about social distancing?

AIt is still essential that you follow Government guidelines even if you have recovered, says Dr Preston.

‘Data from China suggests that a small number of people may be susceptible to reinfection.’

He adds: ‘Although most of the reports show that after two weeks of being symptom-free, you are no longer infectious, some reports suggest it could be longer. ’