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What if highway fatalities were treated as seriously as those of Covid?

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squizzler

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The opinion is often expressed on these forums (and amongst the rail advocacy scene) that there is a massive disconnect between the way that highway deaths are perceived and investigated and deaths that occur on the railways.

Perhaps there is a similar disconnect between deaths caused by covid and those from highway crashes:
  • According to DfT, between 1951 and 2006 a total of 309,144 people were killed and 17.6 million were injured in accidents on British roads.
  • In 2019, toxic air leads to the premature deaths of at least 40,000 people a year in the UK – 9,000 in London – and it leaves hundreds of thousands more suffering serious long-term health problems. (Royal College of Physicians).
  • If you break your Covid quarantine in England - thus endangering public safety - the fine is £1000. If you public lives in danger with your car through excess speed the speeding ticket is £60. Does this difference in fine represent the likelihood and amount of injury that could be caused by these different misdemeanours?
Do you feel there is an absence of proportionality between our tolerance of highway and covid deaths? If so, how could the sense of public duty we have invoked for the covid crisis be applied to highway safety? If nothing else, highway deaths are an interesting experiment against which to measure the costs on personal freedom imposed by the Covid response. I believe we could as a society choose to reduce highway costs to zero and with fewer restrictions on personal liberty than that imposed by "lockdowns" which reduce (but not eliminate) covid deaths.
 
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bramling

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The opinion is often expressed on these forums (and amongst the rail advocacy scene) that there is a massive disconnect between the way that highway deaths are perceived and investigated and deaths that occur on the railways.

Perhaps there is a similar disconnect between deaths caused by covid and those from highway crashes:
  • According to DfT, between 1951 and 2006 a total of 309,144 people were killed and 17.6 million were injured in accidents on British roads.
  • In 2019, toxic air leads to the premature deaths of at least 40,000 people a year in the UK – 9,000 in London – and it leaves hundreds of thousands more suffering serious long-term health problems. (Royal College of Physicians).
  • If you break your Covid quarantine in England - thus endangering public safety - the fine is £1000. If you public lives in danger with your car through excess speed the speeding ticket is £60. Does this difference in fine represent the likelihood and amount of injury that could be caused by these different misdemeanours?
Do you feel there is an absence of proportionality between our tolerance of highway and covid deaths? If so, how could the sense of public duty we have invoked for the covid crisis be applied to highway safety? If nothing else, highway deaths are an interesting experiment against which to measure the costs on personal freedom imposed by the Covid response. We could as a society choose to reduce highway costs to zero and with fewer restrictions on personal liberty than that imposed to by "lockdowns" which reduce (but not eliminate) covid deaths.

The difference is that one element is gripped by hysteria and the other isn’t. Being cynical one could also say that road deaths doesn’t disproportionately include a group of people more likely to vote...
 

Horizon22

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The opinion is often expressed on these forums (and amongst the rail advocacy scene) that there is a massive disconnect between the way that highway deaths are perceived and investigated and deaths that occur on the railways.

Perhaps there is a similar disconnect between deaths caused by covid and those from highway crashes:
  • According to DfT, between 1951 and 2006 a total of 309,144 people were killed and 17.6 million were injured in accidents on British roads.
Not saying I disagree but that's an average of 5,620 direct deaths a year (accepting its probably more skewed towards later years with more cars on the road). Covid has reached almost 10x that in the UK.

If you want to win the stats war, best not to include this one - or at least not for such a long length of time!
 

yorkie

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Not saying I disagree but that's an average of 5,620 direct deaths a year (accepting its probably more skewed towards later years with more cars on the road). Covid has reached almost 10x that in the UK.

If you want to win the stats war, best not to include this one - or at least not for such a long length of time!
What's the average age of a death on the roads?

The average age of a death with Covid is over 80.
 

westv

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Saying an average of 5,620 deaths per year is a little flawed. Currently the average is a lot lower - 1770 in 2018. Despite far more cars there are fewer deaths now then in past years - 7,700 in 1972 for example.
 

yorkie

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The discussion of numbers is a distraction from the principles; the point is well made that fines and punishments are disproportionately skewed.

Also, arguably a serious injury to a young child in a road traffic incident has far more of an impact than the death of an elderly person with pre-existing conditions.
 

LSWR Cavalier

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Average survival years, doubtless actuaries can calculate them
Placing more value, say 70 lost years, on a child, and 20 years on me (retired) maybe
 

radamfi

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@squizzler mentioned deaths and health problems caused by road traffic pollution, these exceed those as a result of accidents, and so therefore need to be addressed in the discussion.
 

ainsworth74

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Not saying I disagree but that's an average of 5,620 direct deaths a year (accepting its probably more skewed towards later years with more cars on the road).
It'll be the reverse. Far more fatalities will have happened earlier in the period than are happening now. As despite there being more cars and more people travelling on the roads cars have gotten safer and the way we engineer roads to enhance safety has improved as well. One of the reason cars have gotten bigger, for instance, is that they now have more safety features. Crumple zones for example mean you need somewhere to crumple that isn't the passenger compartment. We have collapsing steering columns so that drivers don't get impaled on their steering wheels, airbags all over the interior of the car, we use laminated and toughened glass which doesn't turn into deadly shrapnel and of course the big dog of them all the seat belt.

To be quite honest a modern car probably doesn't get enough credit for the miraculous piece of engineering that it really is when you look at the safety features that are now built into them. The underlying technology of containing exploding dead dinosaurs to generate motion might not have changed all that much in the last hundred years but everything that goes around it has changed out of all recognition.
 

island

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  • If you break your Covid quarantine in England - thus endangering public safety - the fine is £1000. If you public lives in danger with your car through excess speed the speeding ticket is £60. Does this difference in fine represent the likelihood and amount of injury that could be caused by these different misdemeanours?
Speeding’s gone up to £100, but the point does remain.

I think it’s the same kind of bias that makes people overreact to terrorism and spend massive amounts on bag checks at venues and airports and so on – and then miss the chap meandering around suspiciously with a backpack. An availability heuristic I think it’s called. People find road deaths to be normalized.

They recognize this in some countries. In Finland, for example, the starting point for a speeding fine is ”half a day’s income”, hence the chap who runs Nokia getting a six-figure fine a few years back.
 

ainsworth74

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They recognize this in some countries. In Finland, for example, the starting point for a speeding fine is ”half a day’s income”, hence the chap who runs Nokia getting a six-figure fine a few years back.

That is also probably just a fairer way of dishing out fines generally as well. A £100 fine for me would be annoying but perfectly affordable (though more than I earn in half a day!) and it's actually the likely, substantial, increase in my insurance premium which acts as more of a financial deterrent to speeding than a fine. But then I'm employed full-time at more than minimum wage. If you were working part time for minimum wage or relying solely on welfare benefits then £100 could be a significant sum of money for you. For someone on benefits that £100 is likely to be more than a weeks income.

People find road deaths to be normalized.

This is the main issue I suspect. People have become normalised to road deaths/injuries and they are just seen as the price of living in our society. Unlike Covid which is the new thing and especially earlier in the pandemic almost totally unknown both things which make it harder for people to become normalised to the potential risks and possible fatalities that might result from the spread of the disease.

Now personally I think we should be a lot hotter on the danger represented by roads and road users (speaking even as a car driver!) and should be taking steps to improve safety and, in reality, reduce the usage of our road network by individuals. But that seems unlikely. One measure that might help, for instance, would be mandatory refresher training on the highway code followed by a test on your knowledge of it. But can you imagine the outrage that even such a simple suggestion would meet? Even though we're supposed to know the highway code in order to use the road network? Yet right now you could pass your test at seventeen and then never again have to prove you've even so much as looked at that highway code (let alone read it) until you stop driving at some point potentially many decades hence.
 

JonathanP

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The difference is that one element is gripped by hysteria and the other isn’t. Being cynical one could also say that road deaths doesn’t disproportionately include a group of people more likely to vote...
No the difference is one grows exponentially and the other doesn't. Comparing them is ludicrous.

If everytime someome was killed in a car accident, their relatives went out and started deliberately driving dangerously until they had caused a few more crashes, that would be like Covid, and there would surely a be a Covid-like reponse.
 

DB

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No the difference is one grows exponentially and the other doesn't. Comparing them is ludicrous.

If everytime someome was killed in a car accident, their relatives went out and started deliberately driving dangerously until they had caused a few more crashes, that would be like Covid, and there would surely a be a Covid-like reponse.

It grows exponentially until it hits a level, then drops right off again - so while it has a short-term high impact, this won't be long term unlike road deaths.

Perhaps a better comparison is flu - bad flu years can kill as many (there were several in the late 1990s), but attract nothing like the level of hysteria because flu is normalised.
 

OneOffDave

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We also tend not to record the numbers of people who die in RTCs who have pre-existing conditions. Statistically speaking, 112 of the 1770 people killed in 2018 would have had type 2 diabetes. 588 (33%) were over 60. Only 48 (2.7%) were under 18
 

DB

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We also tend not to record the numbers of people who die in RTCs who have pre-existing conditions. Statistically speaking, 112 of the 1770 people killed in 2018 would have had type 2 diabetes. 588 (33%) were over 60. Only 48 (2.7%) were under 18

Probably because in most cases it won't be directly relevant to the outcome - whereas with Covid it is.
 

OneOffDave

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It grows exponentially until it hits a level, then drops right off again - so while it has a short-term high impact, this won't be long term unlike road deaths.

Perhaps a better comparison is flu - bad flu years can kill as many (there were several in the late 1990s), but attract nothing like the level of hysteria because flu is normalised.

The thing that needs to be taken into account when comparing flu death years versus the current Covid-19 death figures is the Covid-19 figures are with the significant interventions in place and the flu figures are from years when there weren't widespread measures to prevent infections spreading
 

DB

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The thing that needs to be taken into account when comparing flu death years versus the current Covid-19 death figures is the Covid-19 figures are with the significant interventions in place and the flu figures are from years when there weren't widespread measures to prevent infections spreading

But all the interventions do (at most) is slow it down, they don't stop it - so it might not actually make much difference to the annual figures, if the infections are spread out over a year rather than say mostly in a 3-month period.
 

OneOffDave

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Probably because in most cases it won't be directly relevant to the outcome - whereas with Covid it is.
Pre-existing conditions massively affect your ability to survive significant trauma. If you look at the research you'll see a significant link, especially in increasing the risk of a more minor injury becoming fatal

The effect of pre-existing medical conditions and age on mortality after injury
Pre-existing medical conditions (PMCs) have been shown to increase mortality after trauma even after adjustment for the effect of chronological aging. It has been suggested that there is an interaction between injury severity and physiologic reserve, such that diminished physiologic reserve will have an adverse effect on survival at lower injury severity, but that at higher levels of injury severity, physiologic reserve will have much less of an impact.
But all the interventions do (at most) is slow it down, they don't stop it - so it might not actually make much difference to the annual figures, if the infections are spread out over a year rather than say mostly in a 3-month period.
What the slowing down does is increase the ability for the healthcare system to treat cases with less impact on the intensive and high care beds. If this capacity is overwhelmed, the numbers of deaths in Covid-19 cases, non-covid-19 medical cases and trauma cases all increase as those who may have survived, don't because there's no ventilated bed for them. That's why measures are based on demand smoothing rather than full eradication. Full eradication would take measures that would make the initial lockdown look like a holiday. Stuff like full closure of all businesses, forced quarrantine of all contacts of a case, complete closure of all borders including the transit of goods, decontamination of all locations where cases and their contacts had been, no travel in the UK. There is also the approach used in animal diseases that's very effective but would be ethically impossible
 

DB

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What the slowing down does is increase the ability for the healthcare system to treat cases with less impact on the intensive and high care beds. If this capacity is overwhelmed, the numbers of deaths in Covid-19 cases, non-covid-19 medical cases and trauma cases all increase as those who may have survived, don't because there's no ventilated bed for them. That's why measures are based on demand smoothing rather than full eradication. Full eradication would take measures that would make the initial lockdown look like a holiday. Stuff like full closure of all businesses, forced quarrantine of all contacts of a case, complete closure of all borders including the transit of goods, decontamination of all locations where cases and their contacts had been, no travel in the UK. There is also the approach used in animal diseases that's very effective but would be ethically impossible

We've been fed this line repeatedly, but there is no actual evidence of the medical services coming close to being overwhelmed, and the Nightingale hospitals have mostly been barely used. Of those retired medics who volunteered to work, have any actually been called on?

Full eradication would also be completely impractical given the worldwide spread.

What is also not taken into account is how many of these people who died 'with' Covid would have died within the year anyway - given the profile of those who die with it, the number will be significant.
 
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dan5324

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Aside from banning all cars you’re never gonna get road deaths to zero. It’s the price society pays for the freedom to travel everywhere when we want and not rely on our terrible rail network (no offence)
 

Bantamzen

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We've been fed this line repeatedly, but there is no actual evidence of the medical services coming close to being overwhelmed, and the Nightingale hospitals have mostly been barely used. Of those retired medics who volunteered to work, have any actually been called on?

Full eradication would also be completely impractical given the worldwide spread.

What is also not taken into account is how many of these people who died 'with' Covid would have died within the year anyway - given the profile of those who die with it, the number will be significant.
If the hospitals were at the levels often claimed, the news would be all over it with film and pictures of people on trollies in corridors, social media would be full of the same. Yet all are conspicuous in their absence.
 

OneOffDave

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We've been fed this line repeatedly, but there is no actual evidence of the medical services coming close to being overwhelmed, and the Nightingale hospitals have mostly been barely used. Of those retired medics who volunteered to work, have any actually been called on?

Full eradication would also be completely impractical given the worldwide spread.

What is also not taken into account is how many of these people who died 'with' Covid would have died within the year anyway - given the profile of those who die with it, the number will be significant.
Given all elective surgery was stopped and recovery bays and theatres in most trusts were converted to ICUs and the staff/patient ratios were relaxed, 'ordinary' capacity was reached in a number of areas. London Ambulance Service initiated a new command cell just to coordinate the transfer of critical patients between locations to try and match availability to demand. They don't risk moving patients around just for a laugh.

As for your last point, that's why you compare excess deaths year on year which over time accounts for that proportion. You are also assuming that the majority of people who have died were very close to the end of life. The data doesn't bear this out, particularly for those with diabetes.

Those of you claiming that ICUs weren't full, perhaps you have data to back this up rather than just a reckon based on what you did or didn't see on the TV.
 

Bantamzen

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Given all elective surgery was stopped and recovery bays and theatres in most trusts were converted to ICUs and the staff/patient ratios were relaxed, 'ordinary' capacity was reached in a number of areas. London Ambulance Service initiated a new command cell just to coordinate the transfer of critical patients between locations to try and match availability to demand. They don't risk moving patients around just for a laugh.

As for your last point, that's why you compare excess deaths year on year which over time accounts for that proportion. You are also assuming that the majority of people who have died were very close to the end of life. The data doesn't bear this out, particularly for those with diabetes.

Those of you claiming that ICUs weren't full, perhaps you have data to back this up rather than just a reckon based on what you did or didn't see on the TV.
I'd love to, but strangely the data capture / publication was suspended at the start of the lockdowns.....


Due to the coronavirus illness (COVID-19) and the need to release capacity across the NHS to support the response, we are pausing the collection and publication of these and some of our official statistics.
 

OneOffDave

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So you've not bothered to look at the ICU data in the Covid-19 surveillance reporting then
 

DB

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Given all elective surgery was stopped and recovery bays and theatres in most trusts were converted to ICUs and the staff/patient ratios were relaxed, 'ordinary' capacity was reached in a number of areas. London Ambulance Service initiated a new command cell just to coordinate the transfer of critical patients between locations to try and match availability to demand. They don't risk moving patients around just for a laugh.

As for your last point, that's why you compare excess deaths year on year which over time accounts for that proportion. You are also assuming that the majority of people who have died were very close to the end of life. The data doesn't bear this out, particularly for those with diabetes.

Those of you claiming that ICUs weren't full, perhaps you have data to back this up rather than just a reckon based on what you did or didn't see on the TV.

And how much of that released capacity was actually used? Got any stats? As regard moving patients around, it's not at all uncommon if there is high demand in a particular hospital to move patients to another one.

As regards the excess deaths, yes I am assuming that the majority of people who have died were very close to the end of life because that is what the statistics are showing - the average age of someone dying with Covid is at around or slightly above the average life expectancy. That's not to say there aren't younger people too, but for the average to be that high they are clearly a minority.
 
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