The real Covid-19 threat

Daniel Kahneman called it anchoring; I call it tunnel vision. It’s when we depend too heavily on our pre-existing ideas and first pieces of information – the anchor – to inform our judgments. How a problem is perceived, how it is described, how it makes us feel alongside our individual experience and expertise shapes the decisions we make. Anchoring ensures emerging evidence is ignored. Even in the face of this new contradictory evidence, we refuse to change our early decisions.

In the week ending the 24th of July, 8,891 deaths were registered in England and Wales (161 fewer than the five-year average). This is the sixth week in a row that we have observed fewer deaths, a total of 1,413 fewer deaths than expected. While the number of deaths in care homes and hospitals remains below the average, the number in private homes remains higher than the five-year average. There were 727 more deaths in private homes in the week ending the 30th of July.

Deaths at home have been almost 40 per cent higher than the number registered with Covid-19 in any other setting in the last six weeks, (4,526 versus 2,799). It is not clear why there is such an excess of deaths in the home but one thing is clear: it is not Covid. Fewer than five per cent of deaths in private homes are due to the virus.

These excess deaths represent a considerable number of unexplained – and potentially avoidable deaths – particularly if they represent individuals deterred from visiting hospitals. Public Health England’s suggests this might be the case, and it is a substantial problem – half of people they surveyed with a worsening health condition did not seek advice for their condition. The most common reason was to avoid putting pressure on the NHS.

Analysis of NHS data reveals the deadly consequences of the government’s messaging to ‘stay at home, save lives, protect the NHS.’ During the lockdown, there was a near 50 per cent decline in admissions for heart attacks. The risks of Covid-19 outweighed the risk of seeking NHS care despite worsening symptoms for many people: 40 per cent more people died from lower-risk treatable heart attacks than usual. For strokes, the situation is further exacerbated by living alone and not having visitors as 98 per cent of emergency calls for strokes are made by someone else.

There have been seven registered Covid deaths in children – representing a tiny risk. However, delays in seeking medical help might have contributed to the deaths of at least nine children, according to a survey of doctors. One-third of the 241 emergency paediatricians asked had witnessed delayed presentations. Some doctors reported late presentations during labour that resulted in adverse outcomes; some said early discharges after birth led to infants returning with severe dehydration.

A recent Government report suggests 200,000 people might die because of delays in healthcare and the economic and social consequences of the Covid-19 lockdown. NHS figures show that urgent cancer referrals made by English GPs are down by 47 per cent in May compared to last year; 26,000 people are waiting more than a year for routine operations, and over half a million people have been waiting over six weeks for essential tests.

The coronavirus outbreak has involved powerful emotions and strong impulses for taking action. Despite evidence pointing to the contrary, many want to stay in lockdown. Relying too heavily on the first piece of information we come across is a bad idea. We all need to be aware of the fact that we have this anchoring tendency. The solution involves slowing your decision-making processes, seeking additional viewpoints and information. Reacting in haste acts to underpin anchoring and its associated problems.

When it comes to Covid-19, the real threat is not the disease; it’s how we react to the emerging information.