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To contain the virus completely is possible in an island nation, but it involves completely closing the borders to incoming trade and visitors, and strict quarantine protocols. That only works if it happens before the virus is out in the general population. The present quarantine protocols are more ‘firm’ than ‘strict’, but anything stronger than ‘firm’ tends to look a lot like martial law.
So, the UK is unlikely to do that. The onus falls on the individual to self-quarantine if exposed. As a pandemic strikes, we as a species tend to do that anyway, first by staying away from obviously crowded places (sporting fixtures attendance figures drop fast, shopping malls become empty, bars and restaurants suffer sharp downturns, etc), but these may be informed by a series of public information guides posted online, on TV and even pushed through the door. This may or may not contain the outbreak.
However, if the UK can’t fully contain the virus, can it cope? This is a problem that most nations are not owning up to, the UK included. Here’s why:
The UK has a population of a 66.4m. Even in the most pandemicky pandemic that has ever panned, only a percentage of that population will be infected. A reasonable figure of infection is around 40% of the population could be infected during the virus’ life cycle (that’s roughly how much of the population catches a particularly virulent cold strain). That means around 26.6m people will contract COVID-19 in the UK. Of those, 80% will be asymptomatic or have mild symptoms (about as severe as a bad cold at worst). They will take a week or two off work, drink lots of fluids, have lots of bed rest, and get bored senseless watching Judge Rinder and re-runs of Heartbeat. They will not be productive during their self-enforced quarantine, but no big deal long-term.
About 14% of the cases are more severe, possibly requiring hospitalisation, and 6% of the cases require critical care. Which means potentially as many as 3.72m cases that probably should be in hospital, and nearly 1.64m people requiring intensive care treatment, in many cases for several weeks.
The NHS has less than 200,000 beds, and around 6,000 critical care beds (of which less than 4,500 are adult critical care beds) for the whole of the UK. At any given time, the NHS works to overcapacity, so those 200,000 beds have maybe 210,000 people requiring hospitalisation, and that means non-urgent treatment can get postponed almost indefinitely.
While not all of those 5.32m more seriously ill people will require hospital treatment and those that do are unlikely to rock up at the same time, those of the 14% with viral pneumonia requiring hospitalisation will typically require six days in hospital, and may take as long as six months to fully recover (although most can return to work after about a month). Those needing critical care will typically extend that stay by around 50%, and their recovery is even more protracted. Of the 6% most serious cases, a proportion will die, and will likely occupy a critical care bed for three to four weeks before they finally succumb to the disease. That will break the existing medical facilities as they stand.
Currently this terminal group stands at about 0.7% of the total infected population, or around 186,000 people in the UK who may die from COVID-19. In reality, that’s about 12x worse than the most severe flu epidemics this century, although only about 60% of the numbers of those who died in the 1919 Flu pandemic. So, hey… look on the bright side!
Granted this is near to a worst case scenario, and the likelihood is we are more prepared for prevention and containment meaning the number of likely infected people in the population will be far smaller, but even at 10% of the population infected, if the same percentages apply, the NHS will struggle to cope.
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