10 1GM Tuesday October 20 2020 | the times
News
HOW RISING CASES COMPARE
Daily hospital admissions
4,3,
3,
2,
2,
1,
1,
500
0
25,
20,
15,
10,
5,
0
Daily critical care admissions*
500400
300
200
100
0
700
600
500
400
300
200
100
0
100
80
60
40
20
0
Daily deaths
England
1,
1,
800
600
400
200
0
500
400
300
200
100
0
000s
Average age at critical
care admission(sample
of 10,900)(sample
of 1,233)Care homes with outbreaks
Weekly excess deaths
Testing Cases by age
Tests 15,
Positives 5,
Tests
Positives
April 5
307,
18,
Yesterday
Percentage of patients surviving
Estimated infections
Mechanically
ventilated within first
24 hours in critical care58.1%
26.6%
All deaths
Covid-
deaths5-year
averageMarch to
August
From
September
(37.1%)
(6.1%)
0 7 14 21 28
Days since start of critical care
MAM J J A SO
80+
70-
60-50-
40-
30-20-
10-
5-Under 5
Age
Jun
22-Jun
1-May
11-Apr
20-Mar 30-
Apr 7Mar
9-Coronavirus arrived like a stone
thrown into a still pond. Out from this
impact surged a first wave, a tsunami of
infections that subsumed countries as it
spread. Behind it, as many had predict-
ed, has come the second wave, almost
exactly six months later.
But just as with a stone in a pond, this
ripple does not match up to the first. Of
all the statistical comparisons between
the waves, two from hospitals exempli-
fy the trends that matter. One is a graph
going up, and the other a graph going
down.
The first, the graph that is going up,
shows how fast hospital beds are filling.
Between March 1 and April 1, the num-
ber of covid patients entering hospital
went from 0 a day to 3,500 a day.
Between September 1 and October 1,
the number went from 100 to 500.
Ours is not the naive, socially undis-
tanced, office-working world of spring
- Today, the virus can still spread
— we are very far from herd immunity
— but with the connections between
people and groups cut or fractured it
finds its task a lot harder.
Back in March, the number of new
infections doubled every three to four
days. Today, at the speediest end of esti-
mates, it managed seven to eight days.
Probably, it took longer still. This tells
us that we have longer to respond, and
have to do less to bring outbreaks under
control.
However, ours is also a society where
there is less that we can do. The easiest
social restrictions are already in place.
Some, such as school closures, will
never be enacted again. This leaves us
with just a few tools with which to bring
that graph of new hospital cases down.
So far, the levers we have available
have not worked so well — as the same
graph shows us. The first wave may
have been more dramatic, but it also
faded faster. After a month, back in
Second wave
is more of a
ripple... but
still a threat
Tom Whipple Science Editor spring, new admissions to hospital
started to fall. Six weeks into the second
wave, and they are still continuing their
slow and steady upwards path. If any-
thing, in fact, they are accelerating.
Partly, the trajectory is a sign there
has been a shift in who is being infected.
This is not a disease that strikes all
sections of society equally. When the
second wave started, some hoped it
would stay where it began, in the young.
Was it inevitable that teenagers and
students, tired of a virus that did not
affect them but still demanded so much
of them, would pass it to their grand-
parents?
Heat maps of its spread among
society show that it seems it was indeed
inevitable: the idea we could somehow
seal off one section of society appears to
be misplaced.
Despite our efforts, an infection of
the young is rapidly becoming one of
the old yet again. Or as one expert
memorably put it, trying to have an
infection-free demographic in a pan-
demic is like trying to have a urine-free
lane in a swimming pool.
How worrying is this? With deaths
lagged from infections by around a
month, it is too soon into the second
wave to judge how deadly the virus will
be this time.
It is, in fact, hard to even judge how
deadly it was the first time. Calculating
fatality rates depends on who is count-
ed as a Covid-19 case when they die and
who is spotted as a Covid-19 case when
they don’t. In April, when testing levels
were a 20th of what they are now, scien-
tists estimate that we missed 90-95 per
cent of all cases.
We don’t tend to miss ICU cases
though. When assessing what has
changed, statistics of critical care beds
provide a reasonably solid anchor in a
shifting sea of data.
This is where the second graph, the
one going down, becomes useful. It is a
measure of how likely it is that those
who go into intensive care, almost
entirely the late middle-aged and
elderly, will go on to leave it alive.
The graph shows that in the first
wave for every ten Covid-19 patients
who entered critical care, four never
left. So far in the second wave thingslook marginally more promising. A
month after entering ICU, more than
seven in ten patients are still alive.
This should not be surprising. Unlike
in the spring, the most severe cases
today have a drug that works — dexam-
ethasone. They also have protocols thathave been refined and improved. In
March and April, 60 per cent of those
entering ICU were put on ventilators in
the first 24 hours.
Today, with better understanding of
what helps and what hinders, the pro-
portion is less than half that. Paradoxi-News Coronavirus
The government paid a medical com-
pany run by a Labour donor to supply
ventilators that were more than
£40,000 above the usual price.
Excalibur Healthcare Services, whose
chairman is Sir Chris Evans, charged
£135 million, or £50,000 each, to supply
2,700 ventilators. Three weeks earlier
another company had provided the
same model of VG70 ventilator for
£8,800.
Excalibur, which is owned via a
secretive offshore structure based in
the Isle of Man, said that the fees were
due to a surge in competition. As of last
year the Isle of Man company was
owned by a trust, of which “discretiona-
ry beneficiaries include Chris Evans
and members of his close family”, com-
pany filings show.
Another UK company called Excali-
Ventilator firm charged £40,000 more
Ben Ellery, George Greenwood bur Healthcare Services Ltd, directed
by Sir Chris, changed its name six days
before a new Excalibur Healthcare Ser-
vices Ltd was founded on January 20,
- The company claimed that this
was “common practice”.
One company, Ninhao Inter-
national, based in Hong Kong, was paid
£4.8 million during the height of the
pandemic to supply 100 SH300 ventila-
tors for £48,000 each. The Times has
found a supplier that sells the same
model for $3,500 or £2,714 at present.
Analysis by The Times has found that
the official entry for the contract on
TED, where European governments
must disclose contracts they award,
incorrectly lists the supplier as a com-
pany that provides Chinese language
training for people in India.
An NHS procurement specialist said
they were aware that a similar model
had been bought for less than a quarter
of the price by an NHS trust. Ninhao
could not be reached for comment.
Meheco, a Chinese medtech com-
pany listed on the Shanghai stock ex-
change, charged the government
£32,000 each for five ventilators. About
the same time another company pro-
vided them to the NHS for £24,520.
Meheco could not be reached.
Jolyon Maugham, who runs the
Good Law Project, which is scrutinising
government contracting, said: “These
staggering price discrepancies defy all
rational explanation. How — and why
— were the lucky beneficiaries of this
state largesse chosen? Good Law
Project is seeing a worrying pattern.”
The Department of Health and
Social Care said: “The rapid action we
took to increase the number of ventila-
tors in the UK meant every patient who
required a ventilator during the pan-
demic has been able to access one.”Fraudster’s music agency
given cash in arts bailout
David Sanderson, Rosa Ellis
An American fraudster was in charge of
an agency that has received more than
£100,000 from the government’s bail-
out of Britain’s cultural sector.
In 2009 Barrett Wissman, who had a
controlling interest in IMG Artists
which represents musicians, pleaded
guilty to a securities fraud in New York
and was given a $12 million penalty.
The payment to IMG Artists has
drawn attention to the number of man-
agement agencies given large sums
from the bailout fund despite other or-
ganisations failing in their applications.
Another firm, Paradigm Talent Agen-
cy, whose parent company is based in
Los Angeles, was handed £967,679 by
the Cultural Recovery Fund.Joe Heap, the director of Towersey
Festival which draws 10,000 people to
Thame, Oxfordshire, said its own appli-
cation for £100,000 was rejected, leav-
ing it in a “precarious position”.
Jessica Toomey, of the Frog and
Bucket comedy club in Manchester,
said it had only asked for £60,000 and
got nothing. “There are comedy nights
that don’t have venues, no premises’ ex-
penses, no overheads and they’re get-
ting awarded over £100,000,” she said.
IMG Artists did not respond to re-
quests for a comment, but told Compa-
nies House said that Mr Wissman no
longer had “significant control” of it.
Arts Council England said “the crite-
ria to be awarded a grant are rigorous
and we are confident we have applied
them in all our decision making”.