The Coronavirus Crisis: Statistics are Patients with the Tears Wiped Off

Dr John Ashton, a former director of public health, considers the fateful legacy of the Atlético Madrid-Liverpool football match and the Cheltenham races.

There are now estimated to be well over one million cases of COVID-19 infection worldwide, with a minimum of 50,000 deaths and at least 3,000 deaths in the UK alone.

With the grim tally accelerating daily, we are probably looking to exceed a total of 10,000 deaths sometime in the next two weeks. In the past couple of days, we have heard the sad news of a spike in deaths on Merseyside, with 21 bereaved families in Liverpool alone – something which may well be related to the European Championship match between Liverpool and Atlético Madrid, held on 11 March.       

The late professor of medical statistics at the London School of Hygiene and Tropical Medicine, Major Greenwood, used to tell his students that statistics were patients with the tears wiped off. We must remind ourselves constantly that, behind each of these numbers, is a person and a grieving family and a network of friends and that the impact is horrendous. The future toll of this crisis on mental health, as of yet, we can only ponder.

Liverpool and Cheltenham

As we face the coming weeks, the inexorable rise in the numbers of cases, of hospital admissions, and of deaths, will put not only the NHS and social care services under immense pressure, but will also test the ability of families and communities to care for thousands of loved ones in home settings.

We still cannot predict with any certainty whether the current Government strictures to stay at home and keep our distance will dampen the epidemic curve, but even if these measures do work, the outcome will be first seen in those parts – in particular London and the south east – that experienced the first cases, possibly relating to returning half-term skiers from Austria and Italy.

The likelihood is that we are witnessing an overlying series of epidemics resulting from the seeding of infection on a geographical basis that reflects other arrivals and spreading of the virus, not least in relation to the Anfield match and the Cheltenham races from 10 to 13 March.

The Liverpool story is that 21 deaths were reported on 2 April – 23 days after the Atlético Madrid game at Liverpool FC’s home stadium at Anfield. I said at the time that the game should not go ahead. 23 days would fit the timeline of people being infected, incubating the virus during the week after, becoming poorly and then more seriously ill over the second week, with those succumbing in recent days and appearing in the statistics in the course of this week.

It seems increasingly likely that the Cheltenham festival with 250,000 racegoers, drawn from far and wide, will have played its own part in amplifying the pandemic into many parts of the country and beyond. If we had taken the measures to  stop these mass gatherings sooner, we might have avoided this, together with the continuing concomitant escalation of infection.

So who was responsible for not acting? Where were the expert voices and why were they not listened to during those critical days?

Why Were The Experts Not Listened to?

It would seem that one part of the answer to this vital question may lie in the distraction brought about by the fatuous claims for the goal of ‘herd immunity’ that seems to have preoccupied COBRA, the Prime Minister, the Chief Medical Officer and the Government’s Chief Scientist during the previous week.

To this must be added the dubious advice apparently coming from statistical modeller, Professor Neil Ferguson of Imperial College – based on no obvious science – that large-scale outdoor events brought with them little contact time for viral spread. This was a bizarre conclusion that ignored the social dimension of large numbers of people congregating for days at a time in pubs, clubs and restaurants in addition to the events themselves.

In the case of the Cheltenham festival, claims are now emerging of significant pressure being exerted on MPs and the Government by the gambling industry to push ahead with the highly lucrative highlight of the racing season. Should this be found to be true it will surely mark a new low in our national life, when the money to be made from gambling trumped the importance of public health and human life.

Surely there is now a case for police involvement to secure the hard discs and other records of conversations that took place in the week of 9 March before the tracks are well and truly covered?

Dr John Ashton is a leading international authority on public health and a member of the Crown Prince of Bahrain’s Corona Task Force.