I’m posting early this week, because this is an important message that can no longer be delayed. There are no jokes in this week’s blog post. Normal service will be resumed next week with more light-hearted banter to see us through difficult times, but please bear with me for now and take this message on board.
You may have seen a lot of posts like this over the last few days. I’m not going to tell you anything that hasn’t already been said; and I’m not going to provide medical advice – that’s not my area of expertise. I’m simply helping to get the message out there, adding a dose of common sense with the help of a few graphs, because some people in the outdoor community still believe they can carry on heading out into the countryside instead of self isolating.
On Saturday, the outdoor writer Alex Roddie (who also edits my books) led the way by arguing eloquently that the outdoor community needs to start changing its messaging about the COVID-19 virus, and stop promoting the idea that the hills are still open as usual. Yesterday the British Mountaineering Council (BMC) followed suit by announcing that it’s time to put climbing and hill walking on hold, and the Outdoor Industries Associations (OIA), which represents 35 organisations who rely on people getting outdoors, urged everyone to stay local.
The UK government’s messaging has been ambiguous. On Sunday the prime minister said in his daily COVID-19 briefing that ‘It is very important for people’s mental and physical wellbeing that they should be able to get out and exercise if they possibly can’. However, yesterday the government announced a partial lockdown, including a limit on how much we can exercise. It’s not yet clear how many people in the outdoor community will respect these restrictions. So in this post, I hope to do what the government hasn’t, by making clear with the help of a few graphs and data why self isolation should mean self isolation.
I’m going to focus on the UK, because that’s where I live, but these trends are going to apply to a lot of you wherever you are in the world. I will start with the graphs. All of this is publicly available data from trusted sources. At the time of writing, the number of confirmed COVID-19 cases and fatalities in the UK is relatively small for a country of over 60 million people, which suggests a relatively small risk. But the important thing is not the exact numbers, but the rate of increase.
Here’s the first graph – the cumulative number of COVID-19 cases in the UK:
This data comes from Public Health England. It’s a bit small to read, but you can click on it to get the full updated figures. In any case, it’s pretty obvious which direction the graph is heading: upwards at an alarming rate. Four weeks ago, there were 9 cases. Three weeks ago, there were 35 cases. Two weeks ago, there were 271 cases. One week ago there were 1,400 cases; now there are 6,700. At this rate, we’re going to be into the 100,000s in only a couple of weeks. So it’s not the raw numbers, which will be different tomorrow, but the rate of increase.
Now, you may know that COVID-19 affects people in different ways. For the lucky majority, it’s not much worse that the bog-standard flu virus; a cough, a high temperature, laboured breathing, then recovery within a couple of weeks. It’s even possible that some people may feel nothing at all (but they can still transmit it to others). For some, however, it’s considerably more dangerous than the flu. The breathing difficulties they experience are so serious that they need level-3 critical care in a hospital. This involves putting them on a ventilator to do the work of their lungs. If they can get this treatment, the good news is that they can make a full recovery quite quickly. If they don’t get this treatment, however, then they will die.
It’s clear then, that we need to have enough hospital beds and ventilators to cope with the number of people needing critical care. As long as we have enough then we’re going to be OK. So let’s look at the next graph. And here’s a warning: you’re not going to like this graph one bit.
This graph shows some modelling done by the Imperial College COVID-19 Response Team. This modelling was presented to the UK government earlier this month, and it helped to persuade them that herd immunity (which involves large numbers of people getting infected to build up a natural immunity) maybe wasn’t such a good strategy to pursue. You can click on the image to view the full report.
The graph shows the number of people likely to need critical care and when, based on a number of different social distancing strategies. The scary thing on this graph for me aren’t those five hills showing the number of patients, but that flat red line at the bottom of the graph showing the number of critical care beds available.
We can hope that this red line will show an upward incline over time as more hotels become makeshift hospitals and more manufacturing companies convert to producing ventilators. But as you can see, it seems certain that many thousands of people won’t be able to access the critical care that they need. But there’s a big difference between the steep black hill that reaches up to 280,000 and the gentler blue one at the bottom that ‘only’ goes up to 90,000. That’s nearly 200,000 people at the peak of the outbreak whose lives can be saved if we pull together to reduce the number of infections.
Of course, this is just a model; we don’t know for certain if things will actually happen this way. But we can get an idea of how things might pan out by looking elsewhere. Let’s look at the third graph:
This graph by the Financial Times shows the cumulative number of cases over time for different countries. Some countries developed the virus earlier in the year, so the line for each country starts when the 100th case was confirmed. The steeper the line, the faster the virus is spreading. Once the line is flat, this means the virus is no longer spreading. As you can see, countries in south-east Asia such as China, South Korea and Japan have been better at flattening this line. Over here in Europe, our lines are at differing degrees of steepness, but none of us have yet managed to flatten it. While Italy is the worst-affected country so far, you can see that the line is even steeper for Spain and the US, which means the virus is spreading even more quickly. But we are all on a similar trajectory.
But as we have seen, the total number of cases is only part of the story. Many of these cases aren’t going to trouble hospitals. What matters is the number of people needing critical care and the number of fatalities. Let’s have a look at the latter:
This interactive chart, provided by Our World in Data shows the total number of deaths for a selected group of countries. You can hover over the chart at different places to see the figures. The chart shows that South Korea, which has had a large number of cases, has also had great success in coping with the virus and preventing fatalities. China, where the outbreak started, now has it under control and has been far exceeded by Italy. Meanwhile Spain, France, UK and USA are all at different stages in the process, but appear to be on a similar trajectory as Italy. Germany is a curious anomaly. They have had nearly five times as many cases as the UK, but are experiencing a tiny death rate of only 0.3%. Nobody quite knows why.
So what happened in Italy to cause such a critical situation? This article in the Guardian describes a timeline of events. The first half of this timeline has also happened to an extent in the UK. On 27 February, four days after 11 towns in northern Italy had been quarantined (and when 17 people had died of the virus and 650 were infected), Nicola Zingaretti, the leader of the governing Democratic party, staged a drinks party in Milan with a group of students and boasted on social media that ‘We must not change our habits. Our economy is stronger than fear: let’s go out for an aperitivo, a coffee or to eat a pizza.’
On 6 March, nine days after his visit, Zingaretti announced that he himself had the virus. By then the death toll was 233 and there were 5,883 confirmed cases (233, incidentally, was precisely the death toll in the UK on Sunday, suggesting we are just 16 days behind them). On the 8 March, the prime minister Giuseppe Conte announced a lockdown in northern Italy, and on 10 March this was extended to the whole country.
Last Saturday, 21 March, 793 people in Italy died of the virus on a single day. In Bergamo, the worst-affected province which has seen nearly half of the deaths, one funeral director had to perform 600 funerals in the first half of the month, when they would normally see only 120 in a whole month. Bodies have to be put in a coffin straight away, without being dressed, for fear of infection. Relatives cannot see their loved ones to say goodbye. All religious ceremonies, including funerals and weddings, have been banned. The good news is that yesterday the death toll in Italy fell for the second successive day, though it’s too early to say whether it has now peaked.
We don’t know for sure if this is the shape of things to come in the UK, but some of it is already happening. Last Thursday, Northwick Park Hospital in north-west London ran out of critical care beds and had to ask nearby hospitals to look after some of its patients. Of the 93 cases received in London last Tuesday, 86 of them required a ventilator. And it’s not just beds and ventilators. Doctors have also raised concerns about widespread shortages of the personal protective equipment needed to treat patients. These are essential, given how infectious the virus is.
And if you’re still wondering just how infectious, it’s worth watching this short video from Channel 4 Dispatches, of a doctor explaining. With normal flu, we usually infect around 1.3 people, who in turn infect another 1.3 people. By the time that’s happened 10 times, each one of us has infected about 14 people (1.310 = 13.79). With COVID-19, on average we infect 3 people, who in turn infect 3 more. By the time that’s happened ten times, each of us has infected over 59,000 people (310 = 59,049).
“If you are irresponsible enough to think that you don’t mind if you get the flu, remember it’s not about you – it’s about everybody else.”
Intensive care specialist Professor Hugh Montgomery explains why this coronavirus is different from the ordinary flu. pic.twitter.com/h9sQorHQUv
— Channel 4 Dispatches (@C4Dispatches) March 22, 2020
But you may be wondering what the hell any of this has to do with mountains. This is a blog about the great outdoors. Why am I giving you all these facts and data about coronavirus? Please forgive the long preamble, but I believe it’s vital that we understand all this so that it can play a part in our decisions about whether to go to the mountains or even just head out for a walk.
We need to do whatever we can to slow down the spread of the virus; this means hospitals have fewer patients to deal with at any given time and therefore more capacity, and it also provides vital time for hotels to be converted into makeshift hospitals and for manufacturing companies to switch their operations over to producing ventilators. By doing this, many thousands of lives could be saved. As I’m sure you already know, the key is self-isolation. We need to avoid social interaction wherever possible. Not everyone has understood this message yet: while all those doctors in London were busy saving lives amid diminishing resources, this was happening in East London:
I don’t even know what to say anymore. I think I’m actually going to cry. pic.twitter.com/iZa5GJ7ti9
— Looking Cat (@lookingcat) March 22, 2020
Not much sign of anyone self-isolating there. Meanwhile, it was widely reported that hundreds of holiday makers flocked to Skegness last weekend to visit the beach. Most frustrating of all to me was the number of walkers and climbers who flocked to the mountains in their droves. The UK government has been accused of mixed messaging, but this is also true of the outdoor community. Many people have been promoting the idea that the outdoors is the safest place to be, as long as you don’t visit crowded places:
Addendum from Chief Medical Officer:
Avoid Snowdon, Scafell Pike and Ben Nevis https://t.co/N1T8xUkHc0
— Mark Horrell 🌋 (@markhorrell) March 16, 2020
Snowdon is one of Britain’s most crowded mountains. It should self-evidently be a place to avoid, but last Saturday the Pen y Pass car park was as crowded as ever, with lines of cars going all the way down the hill to Pen y Gwryd. Snowdonia National Park Authority described it as the busiest visitor weekend in living memory. Let’s just take a step back and consider that for a moment. We are in the midst of an unprecedented global pandemic, people are supposed to be self isolating, and in Snowdonia there were more visitors than they have ever seen before.
A similar thing has been happening across the pond. I read an article last week about a small town in California with 24 hospital beds, which happens to be a centre for bouldering. The weekend before last, there were 300 camper vans parked along the road, owned by climbers who had decided to self isolate by visiting their favourite crag. Clearly those 24 hospital beds won’t be enough if any of those 300+ climbers brought the virus and visited the local shops for supplies. Alex Roddie gave the example of Raigmore Hospital, the largest hospital in the Scottish Highlands, which has seven intensive care beds and serves a vast area. The hospital will be overwhelmed if hikers take the virus up to Scotland with them.
I have recently joined a Facebook group called Hiking Britain, where I was surprised to see that people were still posting photos of mountain porn, and carrying on as if coronavirus doesn’t affect them. One person posted a question on Friday ‘would it be irresponsible for me to go to the Lake District tomorrow with my wife for a few days?’. The majority of people who responded seemed to think that it was OK. ‘You would have less contact with people in the Lakes’, ‘Get some fresh air and keep your distance’, ‘Why not? I’m walking my local beach every day and so is everyone else’, ‘It’s a personal choice’, etc.
One medical professional raised her head above the parapet to say please don’t visit the Lakes – we are already overstretched and we don’t want any more people spreading the virus. When she made the analogy of panic buying in your local supermarket, she was shouted down by someone who accused her of being ‘hyberbolic’. But as we have seen from the graphs above, this is not hyperbole and her analogy was a good one. It’s OK to buy some toilet rolls if you need them, but if we all buy toilet rolls at the same time, there are no longer any toilet rolls for those who really need them. It’s OK to be ill from time to time, but if we all need hospital treatment at the same time then there won’t be enough beds or ventilators for those whose lives are at risk.
I have seen many hikers on Facebook and Twitter claiming that they stick to quiet places and go wild camping – that they can go out for a whole day without seeing anyone. It’s therefore OK. But it’s not just about them; we need to consider the numbers, which as we have seen, are about to get very big. Ten thousand hikers, all heading out and claiming that they don’t see anyone are certainly helping to spread the virus. We don’t exist in a vacuum and our country is not a frozen wilderness devoid of people. Wherever we go, there is always a chance of coming into contact with other people.
We all need to make sacrifices to get us through this unprecedented time. How will I be doing my bit? My life revolves around contract work that enables me to travel and write. I work full time for a couple of years to save enough money to do a big trip and write a book about it. I’ve been working for quite a while now and haven’t had much time to write in the last couple of years. My contract came to an end last month and we planned to do a big trip to Italy that would produce enough material for a book. Obviously that can’t happen now. Then a friend who is a trekking guide approached me to propose an amazing adventure in Pakistan. This is also unlikely to happen now that region has also gone into lockdown.
It looks like this year will pretty much be a write off as far as major travelling is concerned. But that’s OK. I have many ideas for other writing projects that I can get stuck into until things have settled down and I can look for another contract.
I’m also incredibly lucky in other ways. Edita and I bought a place in the Cotswolds last year with half an acre of water meadow. Spring has arrived and the place is starting to bloom into a lovely wooded garden. There is much to do. I have been cutting the trees back and chopping firewood while Edita has been busy planting saplings and bulbs. We don’t worry about getting the virus for our own sake, because we are strong and healthy, but my 78-year-old father has been staying with us while he waits to move into a new house. Although he is also in good health, we have been taking self isolation seriously for his sake and others who are more vulnerable.
I am lucky not to be confined in our small flat in London, but last year I would have been. and in that case, I know I would have found other ways of keeping myself entertained. My way is by writing and gardening (and learning Italian), but there are other options. For example, when mountain leader Jo Bradshaw found herself temporarily out of work because of worldwide travel restrictions, she took a job in Tesco and is now hoping to be a delivery driver. If you need exercise, you might be inspired by this Frenchman, who ran an entire marathon on his 7m-long balcony during French lockdown. For more sedentary types, the Met Opera in New York is live streaming an entire opera free every evening.
But please don’t follow the example of this druid, who was sanguine about finding access restricted to his sacred sites:
Fantastic last sentence pic.twitter.com/THb7hOkTDZ
— . (@twlldun) March 22, 2020
For most of us, the restrictions will not be hard in the big scheme of things. I will avoid the temptation of heading to the Brecon Beacons, a range of hills that is now a much shorter distance away. If I need to go out walking then I will stay local, and I am prepared for the possibility that even that may be restricted soon.
People have talked a lot about the coronavirus pandemic being like a war. There are similarities, but there are also major differences. If you are going stir crazy in London, for example, remember that during the Second World War people in London had to endure the blitz. Every night there were sirens and whistles, and people prayed that the bombs wouldn’t land on them. In the First World War, people were conscripted and sent to the front line, where they would have to endure the guns and the barbed wire. Millions died. The front-liners now are the medical staff who are working 48-hour shifts under extreme stress to keep people alive, constantly at risk of contracting the virus themselves. We are indebted to each and every one of these people.
For those of us who are not on the front line, all we are being asked to do is stay confined within our houses and gardens. We can do this.
I will leave you all with a picture of my wood pile, lovingly cut by hand. No chainsaws involved. It took ages, but it’s been therapeutic.