Thursday 4 June 2020

She is not doing better than England

When asked a few days ago about deaths from Covid in Scotland Nicola Sturgeon replied “They are still much higher than we want them to be.. . but they are lower than the excess deaths in England.” This sums up the SNP and its supporters perfectly. They might as well be renamed the “We are doing better than England” Party. Not that they are obsessed by England, of course, and not that their obsession is remotely hostile.

But what does doing better mean? It can’t simply be a matter of counting the number of deaths, after all the size of a country’s population must be taken into account.  One way of counting is to work out the number of excess deaths per million.

The UK has suffered approximately 891 excess deaths per million
England has suffered approximately 921 excess deaths per million
Scotland has suffered approximately 841 excess deaths per million

We are not finished. There will be more deaths. But given that the northern parts of Britain are slightly behind places like London it is likely that Scotland will have a similar number of deaths to the UK average.

There is little doubt that Britain is doing relatively poorly compared to some parts of the world. It might be argued that this is because we locked down too late, but Sweden has half the number of excess deaths per million and they didn’t fully lock down at all.

Some countries closed their borders very early and have kept them closed throughout the crisis. This has saved lives. It is senseless that we are imposing a 14-day quarantine now but didn’t do so in January.

Nicola Sturgeon’s we are doing better than England strategy may be popular with some Scottish voters, but it is hardly a fair comparison. Scotland has two major advantages over England that she never mentions.

Scotland has a population density of 65 persons per square kilometre
England has a population density of 430 persons per square kilometre.

But we know that one of the major factors in the spread of Covid is population density. It is for this reason that there have been zero deaths in the Outer Hebrides, but 1262 in Greater Glasgow and Clyde. People in big cities are far more likely to catch Covid and die than people in rural areas.

The non-white population of Scotland is 4%.
The non-white population of England is 14%.

But we know that ethnic minorities are massively more likely to die of Covid than white people. England has millions more of these people than Scotland does.

If we adjust for just these two factors it may be that Sturgeon’s assertion that she is doing better than England is dubious indeed. Scotland ought to be doing massively better than England given that we are six times less crowded than they are and only 4% of Scots are from ethnic minorities.

Where did things go wrong? Once we had let Covid into Britain and it was spreading freely, we could either have tried to follow Sweden with a loose voluntary policy of social distancing or we could have done what we did. If we had had no lockdown then it is likely that the short-term death toll would have been higher throughout Britain. After all Sweden’s death toll is higher than its neighbours. But the lockdown was introduced at the same time everywhere in Britain and obeyed by the vast majority. It’s hard to see what we could have done better.

The very high death toll in Britain is due to care homes. Elderly patients across Britain were sent back from hospitals to care homes when they had Covid in order to free up wards. This has been a catastrophe everywhere, but particularly in Scotland where deaths in care homes exceed deaths in hospitals.

Politicians cannot reasonably be blamed for the spread of Covid after lockdown within the community, but the decision to send elderly patients back to care homes did not have to be made. They could for instance have been sent to empty hotels.  Half of the Covid cases deaths in Scotland were due to the decision made by Nicola Sturgeon and her colleagues. She had limited information, some faulty assumptions about how the disease spreads, but the decision was hers and hers alone. It is no use saying we are doing better than England when half of the death toll in Scotland is due to the SNP.

More serious than this however is Sturgeon’s decision not to ease lockdown in line with the UK Government. The scientific experts at SAGE had already advised that lockdown could only last a short amount of time, but Sturgeon chose to extend it for political reasons. Outside care homes the level of Covid in Scotland is similar to other parts of Britain. The number of deaths in the Central Belt is far higher than anywhere else. Even if it made sense to maintain lockdown in Glasgow, it made no sense to maintain it in the Outer Hebrides.

Sturgeon’s approach has been to ease lockdown later and more slowly than in England. But this has not merely tried the patience of many Scots and led to widespread breaking of the rules it has also cost lives.

Lockdown is a double-edged sword. By stopping the spread of contagion in the short term it may save some lives, but by damaging the economy, the physical and mental health of the population it will also cost lives in the long run.

For this reason, it is too early to judge the success or failure of the Swedish experiment. More Swedes may have died in the short term, but Sweden may benefit physically mentally and educationally from keeping the country open in the long run.

So too, the fact that England has moved earlier than Scotland in easing lockdown, opening schools and getting the economy moving, will have a long-term effect on health, wellbeing and life expectancy.

It is therefore too early to judge whether Scotland has done better than England. Only when we find out how lockdown has changed our society will we discover how many lives lockdown saved and how many it cost.

The task now is to get our schools open. Not one Scot under 14 has died from Covid and only 24 Scots aged 44 and under have died. The risk of opening schools even without any social distancing would be less than driving to the school in a car.  Parents who refuse to send their pupils to school are more in need of education than their children.

I am not a lockdown sceptic, but proportionally fewer Swedes died without lockdown and largely keeping their country open than Scots who kept it closed. Sturgeon's desire to be different from England is what is keeping us inside not science. If she doesn’t get Scotland back to work soon, she will kill more Scots than died in care homes.