To my mind, the lag in hospitalisations is the biggest issue, as no-one knows exactly what it will be, and a surge there is several days behind a surge in cases. The damage may have been done before it becomes obvious.
I post the hospital data every evening in here and have spent some time in the past few days making clear that it IS rising and has translated to a rise in ventilator patients too. And the North West - where the majority of the new cases over recent weeks have been coming from - is the worst impacted.
I know my data here can be overwhelming. And so many probably never read it. But there is a simple equation.
Cases can rise and - as Dr Heneghan said in that interview most of which I found excellent and accurate - that alone is not the serious problem. Because Covid IS highly infectious so numbers will rise unless you lock the nation down. Which likely will not happen again as it is unsustainable.
But IF these cases reach susceptible people - which up to now they have happily not been doing in this 'second wave' - THEN hospital numbers will shoot up a week or so after cases do - and deaths will increase a week or two after that.
So watching for signs of this is the single most critical thing right now.
And the first part of this has clearly started to show signs of happening in the past week or two. Look at my posts a few pages back from last night on the North West hospital numbers over the past month.
ICU patients are rising too - not just in the North West either.
These are danger signs as only one step is left after this - deaths increasing again.
This may not happen. Let us all hope not and as yet it is showing no signs here at all.
It may actually flatten out as so far increases even in hospital numbers are real but fairly modest (NW patient numbers doubling in a month could be deemed as either given it is at such a low level of around 150). So happily nothing like how things were in March and April when 1000 a week going in was a good week from not massively more new cases than today.
But the risk is far from zero. And the North West is where we should look to see which way this tips. As this is the epicentre right now.
It could go either way, WE must hope it goes the right way and there are as yet unknown factors at play behind the likelihood or not of a big rise in deaths - one that I agree with Dr Heneghan on and have mentioned in here is the idea that the virus has a very susceptible number of victims that it will strike down almost irrespective of what you do and the degree of severity and timing of your lockdown mostly increases or decreases the number of those you 'protect.
If you protect them too well then there are inevitably more in society afterwards who will be at high risk once you have to tip toe back to normality. If less well there will be fewer.
This alone might be the difference in terms of serious illness and deaths between a country who locked down tightly having a second wave and a country that was a bit less strict not having one as the potential number of patients likely to die left as a consequence of the way you locked down is different as a result of the different policies.
Could be this will turn out to be a big advantage for the UK this winter. Though probably by accident rather than design if it does.