Lies, Damned Lies and Statistics

It’s very depressing when the numbers of people dying from or testing positive for Covid-19 are released each day. Everyone wants the numbers to come down, but whilst the testing figures are suggesting better things, the deaths figure remains stubbornly high. A reduction here would surely provide the population with some much-needed good news, and possibly signal a further easing of lockdown restrictions.

The desperation for explanations, answers and future concerns about the virus is evident in all newspapers, which speculate on who is more likely to contract the virus (it varies according to your newspaper of choice), how it will affect you (it varies according to your newspaper of choice), and how long the virus will be around (it varies…see previous comments), confirms there is a real need for accurate statistical information to be made available that allows informed decisions to be reached and policy formed. Without this, uninformed opinions and misinformation spread across social media platforms. Then, on top of this, there’s the Donald Trump factor. The ability of the public (and one POTUS) to believe everything they read, however unsubstantiated, is truly incredible.

With all of this in mind, the Office for National Statistics (ONS) collates information supplied from a wide range of sources to build a more reliable picture of how Covid-19 is affecting the country. Hopefully, this assuages much of the more spurious speculation around. But it’s a new virus which keeps changing, so the speculation also changes and widens its focus.

The people charged with providing the numbers for both Government and the ONS therefore have to build in additional levels of information to address the increased desire to understand more accurately what is happening. Take Julie Meadows for example. It’s her job to assess and quantify all non-Covid hospital admissions for her NHS region during the pandemic for onward transmission to the ONS.

She only deals with Accident and Emergency cases which are serious enough to require a stay in hospital of at least 24 hours. There are four hospitals in her region, but only three have A & E capability. Before the start of the crisis she was very busy. At least, on the plus side, the analysis required was simple. The onset of the crisis substantially reduced A & E visits by the public and, by extension, the number of admissions, but things are slowly increasing again. On the downside, the different types of reason for admission are now needed by the ONS, which has increased her workload considerably and made it necessary for each case she sees to be read more thoroughly than before.

She considers herself good at what she does, and believes her sense of humour is the only thing stopping her from going completely mad. Reading some of the case-notes provided lately has made her cry or, alternatively, laugh out loud. She told her husband about it a few nights ago. He suggested she seek a transfer. She’s learning more about him than she expected to at the moment, and it’s depressing her. Something else to blame on the pandemic then. It’s totally random and always unsympathetic.

Julie was fortunate in that she could work from home. She lived quite a distance away from her base hospital, so the arrangement was suiting her. From conversations she’d had with colleagues still based there, it was sadly a fact that the virus had paid it a visit, so it was safer too being at home. It wasn’t suiting her husband so well though. He’d been furloughed and his original plan to do as little as he thought he could get away with has been stymied by his wife remaining under the same roof. He is now chief cook and home cleaner whilst she taps away at her keyboard in the downstairs study. He’s hoping to get back to work soon, before he does something he may later regret.

The email Julie received from her boss outlining the additional information required by the ONS has been printed off and occupies pride of place on her wall. Her boss would be impressed until she found out it was there to remind Julie what a ridiculous world she inhabited, and how she was contributing to its ridiculousness.

The criteria required by the ONS are split into three categories: -  

(1) Complete accident (like those that used to occur before the lockdown started). 

(2)  Covid-19 related accidents (those where an accident has occurred as a response to the lockdown).

(3) Re-admission (the initial hospital stay didn’t resolve the problem).

These criteria are themselves subdivided into cause, severity, gender, length of time in hospital (if assessable), waiting times for initial treatment, method of arrival at hospital (ambulance or own transport) and so on. Julie found it relatively straightforward to fill in the spreadsheet, but it was a ball-ache on occasion reading through the bloody notes to obtain the correct information. If asked, she would confirm the long-held belief that doctors write illegibly.

To make things a bit more interesting, she had started to keep her own records covering those A & E admissions emanating from the area in which she lived. This was against all the rules, but she was working from home and she was quite sure no-one would find out. In any event, she was doing this to keep sane rather than to leak what she discovered to social media.

The initial findings from her home area had astounded her. 72% of all the admissions to the three A & E departments in her region over the last month, where the individual lived local to her, were fitness related.  Or, more accurately, lack of fitness related. For example, there were nine heart attacks, all of which occurred in persons who had done little or no exercise before lockdown started. She recalled driving to the supermarket with her husband the previous weekend. She’d commented to him on the way that a couple of people she’d spotted jogging along the side of the road seemed hopelessly unfit, judging by their size and the amount of sweat pouring down their faces. Here was some proof exercise could be bad.

Julie carried on with her private investigations. The explanations provided by these individuals when actually in the A & E Dept. were wide-ranging. People had fallen off things whilst trying to exercise. Static and standard bikes for example. Limbs had been broken or severely strained. One unlucky man had fallen from his bike into the road, where he had been run over by a van. He survived. The van driver was treated for shock.

Exercise programmes provided on-line by currently closed fitness centres were also a common cause of accidents. It’s very different bouncing about in the living room in front of the TV, than it is in an exercise class, trying to keep up. Furniture, animals and children tended to get in the way. Julie was amazed to discover there had been one stroke, two head injuries caused when tripping on the carpet into furniture, and seven snapped hamstrings. The common denominators were lack of familiarity with the routines and a blatant disregard for warming up before commencing the programme.

Even those people who perhaps appreciated they were too unfit to undertake an exercise routine weren’t spared. Julie counted 27 – yes, 27! – different visits to A & E involving local people who had damaged themselves whilst simply out for a walk. Reasons ranged from panic attack to being stung and all points in between.

Julie was particularly amused when she read one report where a 41 year old man (name withheld) had been walking along a towpath, minding his own business and wearing earphones, when two kids on pushbikes flashed past on his inside. He’d been miles away, as he admitted later, listening to Gilbert and Sullivan, and the shock of what happened made him fall into the canal. Passers-by dragged him out and an ambulance was called. He’d swallowed water and developed symptoms similar to food poisoning, which was why he had to stay in hospital for three days. The kids were never traced. His earphones and trendy trainers were ruined.

And so it went on. Julie realised that there was a degree of merit in what she was doing. If she was able to undertake statistical analysis over and above that required by the ONS she felt sure it would be of some use to someone. If nothing else, her figures would highlight how dangerous exercise can be to people unfamiliar with it or out of condition. The trouble was she was only using information based upon her local population. That might raise eyebrows if she was challenged.

She painstakingly went back and re-read all files she’d seen since she started working from home. It took her all weekend to do it, which didn’t please her husband. She then created a spreadsheet separate to that which included the ONS-required criteria. It identified a wider range of accident types, outcomes and reasons where exercise was involved.  She then submitted it to her boss in an email headed ‘Detailed Breakdown of A & E Admissions – Exercise Related Injury’. The covering note suggested the information provided was of more than a little interest. When Julie had finished, she felt it was a job well done.

Julie had received no reply to her email some two days after writing it. She was disappointed. Her boss could be a bit strange sometimes, but she always replied to emails. Julie decided to ring her the next morning.

“You’ve reached the answer-phone of Sylvia Harte. I’m afraid your call cannot be answered at the moment. Please leave a message. I’ll try to get back to you as soon as possible.”

 Julie left a message, which received no reply. By the end of the week, she decided she’d phone again. The same answer-phone message played, so Julie hung up and called one of her work colleagues who shared an office with her boss. The call was immediately answered.

“Hello, can I help you?”

“Hi Kathy,” said Julie, “is Sylvia around?”

It went quiet. “You’ve not heard then?” asked her colleague.

“Heard what?” enquired Julie, suddenly very alert.

“About Sylvia. You’ve not heard about Sylvia. She’s dead. It seems she was out for a walk with her partner a couple of evenings ago when she just keeled over. The para-medics who attended think she was dead before she hit the ground. She was only 57.”

“Oh Kathy, that’s awful news.”

“Yes, isn’t it? Funny though, since the lockdown started she’d become addicted to those evening walks. It was like the walk was suddenly available and recommended, and the government told everyone, so she needed to do it. Her partner said that before the lockdown she hardly did any exercise at all. She was quite unfit.”

The conversation eventually ended. What a tragedy! Ironic that what Julie had discovered was precisely what killed her boss. Julie decided not to pursue the matter. She stuck to what the ONS required and no more.

A new boss was appointed within a couple of weeks. Julie was informed, but didn’t know much about her. They spoke on the phone a few times. The new boss seemed pleasant enough, and was happy with the work Julie was doing. Julie decided her additional and more in-depth research should stay hidden.

On the thirteenth week of lockdown, Julie was sat down with her husband watching the daily briefing. More Covid-19 deaths were being reported, but the figures were at last beginning to reduce. The Cabinet Minister leading the briefing seemed moderately optimistic about the future. He and his colleagues read their prepared statements before taking questions from journalists. First up was Hugh Pym from the BBC.

“Minister, you said at the start of lockdown that exercise should be restricted to about one hour each day. This was later changed to exercise is allowed whenever you want, subject to social distancing measures being observed. Do you think the nation in general is now fitter than it was?”

It was obvious the Minister had prior knowledge of the questions he was going to be asked that day, even though this was and is strongly denied.

“Overall, I would say yes. Taking exercise is better than not taking exercise.”

Hugh cut in. “The reason I ask is that I’ve been sent what I believe is a genuine report compiled by NHS staff somewhere in the north of the country that indicates a lot of resources the NHS should be directing at fighting the coronavirus pandemic are instead being used to deal with injuries and even fatalities caused through exercise by people unaccustomed to it. The figures, if true, are very worrying. In light of this, does the government intend to qualify its position at all? ”

Julie looked at the TV in disbelief. “Shit” was all she managed to say.