Intended for healthcare professionals

Letters The UK’s public health response to covid-19

UK’s response to covid-19: crude, unadjusted mortality figures are not the whole story

BMJ 2020; 369 doi: (Published 19 June 2020) Cite this as: BMJ 2020;369:m2453
  1. Aryeh L Greenberg, specialist trainee in clinical oncology1,
  2. Harry Greenberg, academic foundation year 2 doctor2
  1. 1North Middlesex University Hospital NHS Trust, London N18 1QX, UK
  2. 2King’s College Hospital, London, UK
  1. aryeh.greenberg{at}

We were surprised to read the editorial by Scally and colleagues, which criticises the UK government’s handling of the covid-19 pandemic.1 We agree that the UK response has been comparatively slow on testing, community contact tracing, and the eventual move to lockdown. But the authors play a simple game of mortal calculus, using the total number of deaths per million population to “evidence” their pandemic postmortem. Every death is a tragedy. But these are crude, unadjusted figures that do not currently lend themselves to international comparisons, as noted in the grey small print of an otherwise colourful infographic.

The authors acknowledge all cause mortality as a better measure,2 but collating these data across the globe takes time, amounting to what David Spiegelhalter calls a “fiendishly complex task . . . nothing like keeping score in a game”3 or indeed on an infographic.

The notably unbalanced editorial neglects to mention the many millions of pounds of government investment in therapeutic clinical trials, vaccine development, and antibody validation. There is little exploration of the potential positive effects of state funded economic interventions on the nation’s future wellbeing and as a means of countering the health inequalities—both mental and physical—created by social lockdown and economic decline.4 Meaningful judgment can be properly passed not now but in the fullness of time.


  • Competing interests: None declared.

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