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Eight million people with underlying health conditions should be exempt from plans to return the country to work and normal life, according to scientists who warn that easing the blockade too quickly could boost the number of Covid-19 deaths to 73,000. this year.
About 80% of the population has little to fear from returning to work, but 20% are vulnerable to one or more common conditions such as diabetes, obesity, and heart problems, researchers from University College London (UCL) say in a published study. in Lancet. on Wednesday.
Most of them are not considered clinically extremely vulnerable by the Department of Health and are therefore instructed to fully protect themselves for 12 weeks.
NHS England originally said that the protection list included 1.5 million people. On Monday the government said it amounted to 2.5 million across the UK. The list focuses on people whose immune systems are damaged, for example, by chemotherapy or by taking anti-rejection medications after organ transplantation.
Dr. Amitava Banerjee, from the UCL Institute of Health Informatics, who led the study, said the government “only talks about the extremely vulnerable: they are rare in the population, while these diseases we are seeing are some of the most common chronic diseases. “
He added: “If we are going to start to get out of the blockade, we need clearer guidelines, definitely for this group. I couldn’t find this high-risk group in the 50-page document. If a man is under 70 and has diabetes or heart or kidney disease, which is a substantial proportion of the population, we need a clear message that nothing has changed.
“We all know people at work who have these conditions. It is a fact. These are exactly the people we need to give clear guidance to. ”
Someone who has the minimum wage and has COPD (Chronic Obstructive Pulmonary Disorder), who is at high risk of coronavirus disease or death, could otherwise return to work, Banerjee warned.
Union leaders have voiced concern over Boris Johnson’s calls for people in manufacturing and other jobs that cannot be done from home to return to work beginning Wednesday.
Figures from the National Statistics Office this week showed that people in some of the least-skilled occupations had the highest death rates, with 21.4 deaths per 100,000 men. Men who worked as security guards had one of the highest rates, with 45.7 deaths per 100,000.
In their study, Banerjee and colleagues calculated the number of people over the age of 30 who have underlying conditions and are likely to die from Covid-19 or because they don’t seek the treatment they need.
They analyze three scenarios: doing nothing in the hope of creating collective immunity, which would lead to up to 80% of the population becoming infected; mitigation, which was the strategy before the blockade, when people were asked to keep their distance and wash their hands, which is supposed to have led to an infection rate of 10%; and suppression during confinement.
Returning to a 10% infection rate would lead to 37,000 deaths during the year if the relative risk of dying is twice that of people with underlying conditions generally. They are 73,000 if the risk triples. The relative risk of death from the virus is currently uncertain.
Professor Harry Hemingway, lead author, said: “Vaccines and drugs will take time to develop and be evaluated. What works now is two things. First, keep the infection rate of the population as low as possible and avoid infection in people at greatest risk (direct effects of infection).
“Second, we must continue to provide high-quality health care to vulnerable people to prevent excess deaths in those who are not infected with the coronavirus (indirect effects of the emergency).”
Sarah Harper, professor of gerontology at the University of Oxford, said it was an important document showing how taking into account the combinations of age and underlying conditions could show that some people are more vulnerable to Covid-19 than those listed. extremely vulnerable officer.
“For example, a 66-70 year old man with no underlying conditions is not currently considered high risk. However, it has a higher one-year mortality (1.07%) than that of a 56-60-year-old woman with an underlying condition (0.91%), which is considered high risk. Similarly, it shows that, overall, the mortality risk for women at any age is the same as that of men who are around five years younger, “she said.
“The general and arbitrary use of age, for example, the age of 70 as an approximate limit for the high-risk mortality category, has already been questioned by many. This document highlights the difference between men and women, and the importance of identifying underlying health conditions.
“Importantly, the authors suggest that this allows for a publicly available tool for people to use to develop a better understanding of who is at risk based on reliable health data. The association between population risk and individual risk is complex, but many would welcome a transparent public health approach that allows people to understand the evidence behind government messages. “
It comes after warnings that the 2.5 million who are protecting themselves, and their families, face an “impossible choice” between paying the bills and their health. Rishi Sunak, the chancellor, extended the licensing plan but the 2.5 million, as well as the people living with them, do not have an automatic right to be paid through the plan, it emerged.
