New Sage leak says NHS could be overwhelmed within weeks

A few days ago, The Spectator published a classified ‘reasonable worst-case scenario’ from Sage, written back in the summer and fearing a second wave that would claim 85,000 lives, peaking at about 800 deaths a day. A new leak this morning from the Cabinet Office, using current data, paints a far-bleaker picture: 2,000 deaths a day – even 4,000 if no action is taken. The NHS is shown to be just weeks away from being overwhelmed, even if it uses its surge capacity. This is likely to be the document being used on Boris Johnson to urge a national lockdown. It’s worth looking at in some detail.

We have moved away from being two weeks behind France and Spain and are back in the territory of modelling by SPI-M, the group that feeds into Sage. The document, leaked to the BBC, gives dates when the NHS will run out of capacity: first its standard capacity, and then when the NHS Nightingale ‘surge’ hospitals are filled. It also gives the ‘last day to prevent rationing of emergency healthcare’. To ration emergency healthcare – as opposed to routine operations – implies allowing people to die who could otherwise be saved: precisely the Lombardy-style scenarios that so focused minds last time. That date seems to be tomorrow for the South West and North West, next weekend for the South East and about four weeks’ time for London. The language in the graph is as stark as you get in government documents: surge capacity ‘is burnt through’ in many places within weeks.

The below graph, again a leak from the Cabinet Office, shows the death trajectories from various modelling groups that inform Sage. The black line at the bottom seems to be the Sage ‘reasonable worst-case scenario’ that we published in The Spectator a few days ago. It is now shown to be the most optimistic scenario around

What’s missing from this document is the assumptions used to make these projections: we have no means of knowing if they are reasonable or extreme, based on evidence or hypothesis. But the release of these documents obviously changes the political balance. The Prime Minister may have his doubts about a national lockdown, but if the Cabinet Office is showing him a prediction of the NHS being hit by Covid tsunami within a few days, then it becomes far harder for him to risk ignoring the advice given to him in these leaked documents.