Dr Stephanie Steels, Lecturer in Integrated Health and Social Care. at MMU Dr Steels has previously worked for and advised the World Health Organization and the Department of Health and Social Care on Public Health policy and Global Health security.

I teach students about the importance of evidence when making decisions about public health policy. As a teacher, the Coronavirus (COVID-19) pandemic in the UK is proving to be a textbook example for future students on how not to handle a pandemic.

It’s been five months since COVID-19 was first detected in the UK, and yet the information on the number of people infected and the number of people who have died, still doesn’t represent the full picture. We still lack reliable evidence on how many people have been infected with the disease and how many people have sadly passed away. It’s this evidence that’s vital to protecting the population into the future and preventing a second wave of infection.

Every day, our official figures are presented in the daily briefing on the number of infected, and the number who have died from COVID-19. These figures tend to be by which many of us measure the country’s progress in combatting the spread of COVID-19. However, the numbers only reflect the total number of lab-confirmed UK cases.

This leaves out:

  • Anyone asymptomatic (e.g. they have COVID-19 but don’t have any symptoms)
  • Those who have yet to be tested and have symptoms
  • Those who have died, having never received a test – but may have had symptoms, however, COVID-19 was not listed as a possible cause of death on the death certificate.

My profession as a health researcher puts me in the position to understand just how complex this data is, that our progress in fighting COVID-19 cannot be distilled down to a single figure, especially when that figure is so clearly unrepresentative of the bigger picture of how people have been affected by this disease. For most, the figures that accompany dramatic headlines are often the top line to which most people are exposed. But the answers lie in the detail, the evidence, the bigger picture.

Reading between the lines

An example is recent coverage on data released by the Office of National Statistics (ONS). The occupations with the highest death rate linked to COVID-19 were found to be among men. Some specific occupations had noticeably higher death rates linked to COVID-19, including taxi drivers and chauffeurs (36.4 deaths per 100,000), chefs (35.9) and security guards (45.7). But as we dig through the original data release that is available on the Office for National Statistics (ONS) website, we find that the analysis itself does not prove that it’s the occupation that causes this increased risk.

The data has been adjusted for age, but not ethnic group, place of residence or deprivation. These are all factors that are possible causes of this increased risk, that may in turn affect men more in these roles or shed light on a possible area of focus that may have not been considered. For example: do the men in these roles live in houses with other key workers? Do they have underlying health conditions? We simply don’t know the answers to these questions without better information.

The long-term impact– have the measures worked?

The UK population has made great sacrifices to follow advice to stay at home, practise social distancing and curb the spread of the disease. To measure if these actions have worked, we need to dig deeper.

Collecting a much wider range of data will provide us with an impartial overview of people who have had and not had COVID-19. The most comprehensive way of achieving this is through mass testing of the UK population, and this is even more important if ‘local lockdowns’ will be introduced to tackle localised flare ups of COVID-19. Standardising how our NHS and social care collect this information across organisations, regions and countries would also go some way to help.

But what about life after COVID-19? We know that people’s behaviour has been changing throughout lockdown, but consideration must be given to the other side effects of these policies on the population. We must make sure that the decisions made to protect us from one disease do not lead to other health or behavioural issues, both in the short term and long term, for example, social isolation’s impact on mental health.

Insights provided by a recent ONS survey looking at the social impacts of COVID-19 are just as important to consider as the rate of infection. Nearly half of adults (47%) said their wellbeing was affected by the Coronavirus. The measures taken could potentially impact on some people’s long-term mental health, while for others it might result in ignoring lockdown and social distancing, therefore increasing the number of infections.

As we begin to slowly resume ‘normal service’, we are regularly reminded of the risks of a ‘second wave’ of infections.

It’s for that reason we should be reading between the lines. Just as you would build up a strong bank of evidence before making a significant decision in life, we should be applying this theory to collecting data on COVID-19, to construct the reliable evidence that guides our work and decision making now, and in the future.

We should remember this as members of the public reading the headlines, and as a government measuring the success of our actions.

The ‘new normality’ needs to be as safe as possible. If there was ever a time for the decisions of the government to be based in comprehensive, reliable evidence and to learn from the population’s sacrifice, it’s now.

LEAVE A REPLY

Please enter your comment!
Please enter your name here