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To Be Responsible, or Not To Be Responsible, that is the Question – Week 8

 To Be Responsible, or Not To Be Responsible, that is the Question – Week 8

Dr Chris Staff
(former Senior Lecturer, Department of Artificial Intelligence, University of Malta)

This week:
• Take a moment to remember the thousands of people in Malta alone, and the hundreds more who will join them over the next six days, who will be unable to have a Very Merry Christmas with all of their families and loved ones.
• Malta is finally registering a lower 14-day rate of new infections per 100000 population when compared to the 23rd October 2020.
• Malta continues to have the third highest number of deaths per 1000 infections.

We are six days away from celebrating Christmas Day. I’d like to ask you to join me to take a moment to remember all those families who have lost someone this year. Remember all those people who have coronavirus and other illnesses and who cannotbe with their families. Remember all those people who are in quarantine because they were a close contact of a confirmed case and must be apart from their families and loved ones. Remember all the elderly in care homes and sick in hospital who cannot receive visitors due to coronavirus restrictions. Remember all the health care workers who continue to experience incredible workloads and unfathomable stress due to their daily contact with large numbers of coronavirus patients. Many of these health care workers will also be unable to be with their families on Christmas Day. Think about those thousands of people, in Malta alone, and the hundreds more who will join them over the next six days, who will be unable to have a Very Merry Christmas with all of their families and loved ones, and then reflect on whether more could and should have been done for them.

Malta, eight weeks after the latest restrictions were imposed (Week 0), is finally registering a lower 14-day rate of new infections per 100000 population than as at Week 0. In Figure 1, we see that six other countries are still registering higher levels than at their Week 0, but only Finland (FIN) imposed their latest restrictions as long ago as Malta. Denmark (DNK) imposed theirs seven weeks ago, and Germany (DEU), Greece (GRC), Norway (NOR), and Portugal (PRT) imposed theirs six weeks ago. Germany and Greece are in lockdown, while the others are not.

Of those countries with higher rates than as at Week 0, Norway, Greece, and Finland all have lower rates 14-day rates of new infections per 100000 population than Malta (see Figure 2). Germany, one of three countries with higher rates than Malta, are already in lockdown and will be tightening restrictions further over Christmas. Other countries increasing restrictions include the UK, who had been in lockdown and then relaxed it two weeks ago. They are beginning to realise that it was a mistake to relax restrictions while their 14-day rate of new infections per 100000 was still too high. The Netherlands (NLD), which is in partial lockdown, is having to impose further restrictions as the rate of increase which started two weeks ago is gathering pace. Italy, too, has decided that a nationwide lockdown is necessary from 24 to 27 December, 31 December to 3 January, and 5 to 6 January.

Ireland (IRL), France (FRA), and Belgium (BEL) loosened restrictions after lifting their lockdowns less than three weeks ago. In each country the impressive declines in the 14- day rates of new cases are either levelling out or beginning to register slight increases compared to last week. It demonstrates just how fragile the situation remains, even in Ireland which had brought its 14-day rate of new infections per 100000 population down to the lowest amongst the 16 countries we are monitoring.

Poland (POL), Italy (ITA), Portugal (PRT), and Spain (ESP), none of which are in lockdown (Italy’s lockdown will start later next week), continue to register decreases in the 14-rate of new infections, with only Portugal still above their Week 0 levels. Of the six countries which have not yet reached their Week 0 levels, only two (Germany and Greece) imposed lockdowns – Greece’s was total, and they continue to register an improvement, while Germany’s was partial and the situation there is deteriorating.

With the current exception of Ireland (IRL) and Spain (ESP), all countries have registered more cases of coronavirus in the last 56 days than in the seven months up to the 23rd October, with Italy, Greece, Austria, and Poland registering more than 75% of all their cases. Malta is one of seven countries that have registered between 50% and 60% of all cases in the last 56 days (Figure 3).

With the lessons learned during the first wave, and the knowledge that all countries have about coronavirus, we know that the rate of deaths is roughly related to the number of cases. The number of deaths may be strongly correlated with the number of new cases (i.e., the number of deaths increases at roughly the same rate as the number of new infections). In Figure 3 we see that Austria (AUT), Poland (POL), and Greece (GRC), who have all registered more than 75% of all new infections since the beginning of the pandemic in the last 56 days alone have had 80% or more of the total number of deaths in this period.

In several countries, the rate of death is much slower than the rate of new infections, which indicates that these countries are likely to have been able to keep the elderly and vulnerable protected during the current wave. In Ireland (IRL), Finland (FIN), and Denmark (DNK), the rate of death is less than half of the rate of new infections. In Spain (ESP), the UK, the Netherlands (NLD), Norway (NOR), and Italy (ITA), the rate of death is more than 50% but less than 75% of the rate of new infections. In these countries, more effort is required to protect the elderly and vulnerable. In Belgium (BEL), Germany (DEU), France (FRA), and Portugal (PRT), the rate of deaths is more than 75% of the rate of new infections. France and Belgium were in lockdown and have recently relaxed restrictions, but Germany have recently imposed more stringent restrictions.

Malta’s situation is of particular concern. Although Malta has one of the lowest percentages of new infections since 23rd October, compared to other countries that did not impose a lockdown since October, the percentage of deaths is much higher than the percentage of new infections. This suggests that compared to most other countries, the elderly and vulnerable may not be adequately protected.

As we move towards the Christmas festivities and the New Year, several other countries are imposing new restrictions, and imposing limits on the numbers of households that can meet over the Christmas period. Countries that lifted lockdown restrictions are reimposing them to prevent an escalation in new infections. In Malta, it continues to be left to individuals to manage the risks.

The World Health Organisation’s regional director for Europe, Dr Hans Henri P. Kluge says, “There remains a difference between what you are being permitted to do by your authorities and what you should do. The safest thing right now is to remain at home.” (my bold)
(https://www.euro.who.int/en/media-centre/sections/statements/2020/statement-holidayseason-amid-covid-19-and-a-growing-mental-health-crisis-in-europe).

Figure 4 reports the number of deaths since 23rd October, 2020, per 1000 new cases, in each country, compared to last week’s numbers. In Denmark (DNK), the Netherlands (NLD), and Belgium (BEL), there is a slight improvement. In all other countries, the number of deaths per 1000 infections is increasing. Malta continues to have the third highest number of deaths per 1000 infections.

A note about the source of data for this week’s article. The ECDC are no longer providing data on a daily basis. Instead, I have used data provided by Our World in Data (https://ourworldindata.org/covid-cases) except that I have relied upon ECDC for population data, for consistency with all the figures and charts in my previous ‘To Be Responsible…’ articles.

I wish you all a Very Responsible Christmas.

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