Am I missing something? (covid related)

[IamAporcupine]

Apologies if there is thread about this already.

So the number of new cases is rising rapidly, I get that.
But if you look at the number of total deaths is flat as a pancake.

As far as I know, hospitals are doing OK, no inminent risk of overwhelming the NHS, and a big proportion of the affected cases are relatively mild or even asympomatic.

Again, I know health workers in Spain and France who were up to their noses in April but are absolutely fine now, even though they are a couple of weeks ahead and their 'numbers' are rocket high now too.

I must be missing something because I really do not understand why the panic about 'the new cases', surely the important figures are hospital admissions and mortality?

[weepingwillow22]

@SheepandCow

Thanks for the reply *@Vintagevixen*
It's reassuring to know the test shortage isn't affecting hospitals.

Out of interest, what's the percentage of false negatives?

If we're already seeing so many flu deaths, it's definitely advisable to get the flu jab. I agree with the government warning about double infection of flu/Covid being something to avoid.

There is also some research showing that having the flu vaccine may help make covid less severe
www.news-medical.net/news/20200705/Research-suggests-protective-effect-of-influenza-vaccine-against-COVID-19-severity-and-mortality.aspx

[Vintagevixen]

They have also been swabbing people pre elective surgery, plus sometimes asking them to isolate before.If you stand still long enough in a hospital you will get swabbed!!

Not sure about the percentage of false negatives - that is out of my realm of knowledge. I know there is a lot of research on false positives, don't know if there is as much on false negatives? Someone with more knowledge may be along soon.

[SheepandCow]

Thanks for the reply @Vintagevixen
It's reassuring to know the test shortage isn't affecting hospitals.

Out of interest, what's the percentage of false negatives?

If we're already seeing so many flu deaths, it's definitely advisable to get the flu jab. I agree with the government warning about double infection of flu/Covid being something to avoid.

[Vintagevixen]

IMO as a hospital nurse, probably not many.

Everything/everyone gets swabbed for Covid at the smallest sign of a sniffle or temp, let alone full blown respiratory illnesses. Plus regular reswabbing.

Most people that die of flu/pnuemonia are sick enough to have been in hospital and thus get swabbed, or GP and community carers can swab also in the community I believe.

The numbers are what you would expect for this time of the year, and a rise at this time is normal in all respiratory illnesses.

[IamAporcupine]

Thank you very much everyone for the comments.


@Porcupineinwaiting - I like your username

[SheepandCow]

@Vintagevixen

ONS stats (its all in their latest reports) week 37 of the year 1,125 death certificates with Flu and pneumonia, 99 with Covid ( as in mentioned on the death certificate.)

Numbers are as expected for this time of the year re. other respiratory illnesses, so with all these extra measures and masks why are other respiratory infections not very much reduced? Anyone with an enquiring mind must surely question things.

I wonder how many of those 'summer flu' and 'pneumonia' deaths were in actual fact undiagnosed Covid?

@NekoShiro I posted yesterday about Long Covid but unfortunately it's not getting enough attention from government or media. It's worrying and definitely reason for us all, young and healthy included, to take precautionary measures against Covid.

[NekoShiro]

I'm surprised no one mentioned long covid, I'm assuming that has a part to play, people who have mild or even asymptomatic cases of covid are reporting fatigue and breathlessness months after catching the virus. Covid can cause blood clots and damage to the heart and lungs, so out of these 5k cases a day how many people are going to become chronic illness suffers? How many years does catching covid cut off the end of your life? You could catch it and have a mild case but unknowingly have damage to your lungs or heart and end up having an early heart attack because of it, you could get blood clots that travel to your brain and have a stroke at 30 or 18.

These are the things that worry me personally about the increase in cases, not so much the death but the unknown future health repercussions.

Fatigue from long covid article:
www.bbc.com/news/stories-54106272

Sometimes she slept more than 16 hours per day, and struggled with the day-to-day activities needed to look after herself.

"When I did speak with the doctor regarding my dizziness, the fact I have fainted, and also about my fatigue, he openly stated that he did not know how to support me and that the virus is still so new. This of course left me feeling even worse."

In such cases, the WHO says, symptoms may include extreme fatigue, persistent cough or exercise intolerance. The virus can cause inflammation in the lungs, cardiovascular and neurological systems, and it can take a long time for the body to recover.

According to the Covid Symptom Study app, which tracks people's symptoms regardless of whether they had a test, about 300,000 people in the UK have reported symptoms lasting for more than a month, and 60,000 people have been ill for more than three months.

Barbara Melville is an admin of the Long Covid Support Group on Facebook, which was set up to provide a place for people to talk about their experiences and support each other. It now has over 21,000 members, who are living with a wide range of symptoms.

"The chronic illness community is used to waiting 12 months to see a specialist or spending three hours in a clinic waiting for a 10-minute test, but this may well come as an unpleasant shock to previously healthy folks," says Jo Southall, an occupational therapist who specialises in supporting people with chronic illness.

A group of long covid sufferes campaigning for better medical care and understanding of their illness:
www.longcovidsos.org/

The Zoe Covid Symptom Study has produced figures suggesting that 10% of people who contracted Covid-19 are still unwell after three weeks, and that 5% may continue to be sick for months.

While it’s still claimed that patients with ‘mild’ symptoms usually recover within a couple of weeks, previously fit, healthy and in many cases young people are battling continuing illness and are unable to return to their previous lives. Sufferers report breathing difficulties, muscle weakness and pain, fatigue and prolonged fever as well as neurological, vascular and cardiac symptoms.

[anuffername]

There is a very useful and informative thread running on the Coronavirus board which looks at graphs and stats in some detail.

www.mumsnet.com/Talk/coronavirus/4031056-Daily-numbers-graphs-analysis-thread-20

[Vintagevixen]

ONS stats (its all in their latest reports) week 37 of the year 1,125 death certificates with Flu and pneumonia, 99 with Covid ( as in mentioned on the death certificate.)

Numbers are as expected for this time of the year re. other respiratory illnesses, so with all these extra measures and masks why are other respiratory infections not very much reduced? Anyone with an enquiring mind must surely question things.

[Vintagevixen]

You aren't missing anything, currently a casedemic, google Carl Heneghan and centre for evidence based medicine and all will be explained.

All respiratory illnesses rise at this time of year, flu and pnuemonia are doing the same. Its just following the typical curve for a respiratory illness.

I speak as a health care worker - having gone to a huge party full of health care workers in the last few weeks, all singing and having a great time, most of whom have nursed Covid sufferers, lots of who have had Covid, but realise that you gotta live not just exist. Hospitals very quiet at present - some rise in the NW is all.

[Gatr]

The problem is any restrictions take time to come into effect. Its a bit like filling your bath with a tap that takes a few min to turn off.

Its a juggling act. If for example you have 100 hospital beds and were trying to manage it and the r rate is 1.5 (as estimated in some parts). If you know that 20 people have it, your beds are looking good, however presumably with that r rate those 20 will have infected an extra thirty in time before they got unwell enough for hospital. Covid patients often have extended hospital stay (even if its not an icu stay) so youre going to have used 50 beds now. If those 30 have followed pattern then easily within 14 days you are looking at needing 115 beds


If we are using the 14 day isolation time, then even if we went in to a extreme lockdown we would expect the cases to rise whilst all those who have already contracted it come foward

Its no good waiting till your at capacity to say no

[Porcupineinwaiting]

OP take a look at Florida.

After lockdown ended in May everything opened up.
By June cases were rising, esp amongst the young. But no one was worried because they had mild cases and hospitalizations were not increasing.
By the end of June infection rates had climbed again, but now the average age of those infected was increasing. Turns out young people also live and interact with older people, like their parents. Hospitalizations were beginning to creep up at this point but the death rate was flat as a pancake, and the hospitals had capacity, so no big problem right?
By July infection rates were very high. And suddenly hospitals were very busy and the death rate was rising every day. And so they have continued.

The disease that everyone thought was so different, turns out it was no different. It behaved exactly as you'd expect it to - spreading and spreading with the expected time lag until hospitalizations increased and the a further expected time lag til the death rate increased also.

That's what wi happen here if we let it. If you are happy with that, just say so. Dont try and kid yourself and others that somehow the outcome will be different this time.

[ChavvySexPond]

@IamAporcupine

but ChavvySexPond - look at the curves for Spain, if this second wave was exactly the same as March/April, shouldn't their number of deaths have gone up much more by now?

The virus hasn't changed, or not significantly.

We don't have comparable data to show you from February because there wasn't much testing going on outside hospitals.

But the vast majority of people who died in April and May were infected before Lockdown started in March. It takes time to get ill enough to get to hospital, and then weeks to die in most cases.

Spreading widely in the 10-40 age groups first means it takes a while to find many people it can kill. But only at first. It's like a snowball. and the more we let it spread the more killable people it finds.

The main thing that's different this time is that we have restrictions in place so it's doubling once a week rather than every three days. (Hospital admissions were doubling every 8 days in February, then 7, then about two weeks before Lockdown it sped up to every 3.)

There's no evidence that anything has significantly changed with the virus. The thing that's changed is our behaviour and awareness.

That's why misinformation and covid denial are so dangerous, and it's a mark of how bad they are for our country that the scientists and the PM had to address some of the things Covid deniers say in their briefings.

[WiseUpJanetWeiss]

As far as I know, hospitals are doing OK

Well, they are doing OK right now , but numbers of inpatients are increasing, and the number of patients in ICU beds are increasing, and staff absence owing to self isolation and confirmed cases are increasing.

I very much hope we won’t see deaths increasing at the same rate now we have some new treatment pathways (although they are also increasing slightly), but we’re clearly heading for a very rough winter in terms of bed occupancy and staff shortages.

[Needcoffeecoffeecoffee]

And care workers and general fatigue and exhaustion among frontline health and social care staff along with the usual winter pressures.
But some of the people who stood and clapped them a few months ago from the comfort of their home wont bother complying with any measures as they have "had enough and are fed up"

[AnyFucker]

Another part of the problem is absenteeism in NHS staffing (due to more community transmission among families) which will affect all services, not just Covid-related ones

[DinosApple]

I hope the death rate will be lower.
Everyone is more aware. And
hopefully Covid positive patients are no longer being discharged to care homes!
Plus we are testing much more, however much of a shit show that is. It's not just those in hospital already who get the tests.

[Sirzy]

Death numbers and hospital admissions are increasing.

We are also beginning to realise that “long Covid” is equally as much of a problem so need to stop the spread to reduce the amount of people who even though their infection was seemingly mild end up with long term debilitating side effects

[MoggyP]

What I am saying is that, it would seem that this second round is quite different from the first one, so it might need to be dealt with differently?

Not really, it's still a readily transmissible virus which causes severe enough illness to knock adults off their feet for 3 or so weeks (typical case) hospitalises many, leaves others with long term consequences (stroke, lung damage) and of course is directly lethal to some.

We have some improved treatments, so the death rate might be a bit lower - which will look good (as it is one of the main countable things). What we don't count is the full range of effects.

How readily it passes between people is a characteristic of the virus, and that hasn't changed. All we can do to control the spread is to reduce the amount of contact between people

[weepingwillow22]

Here is another graph from worldometer, UK projections. Exponential growth with cases (and deaths) doubling every week means we will be up to March levels of deaths in December. The purple line is based on a lockdown in December, red is a continuation of current restrictions.

Spain which is a few weeks ahead of us is currently recording 150-250 deaths a day. The case curves for March for Spain and the UK will not be accurate as testing was substantially lower so it is not accurate to look at the ratio of cases to deaths over time.

[wafflyversatile]

In march we were comparing people who got tested because they were hospitalised. What you were seeing was what proportion of hospitalised patients went on to die. Now we are comparing people who have tested positive non hospitalised cases with people who go on to die.

[IamAporcupine]

but ChavvySexPond - look at the curves for Spain, if this second wave was exactly the same as March/April, shouldn't their number of deaths have gone up much more by now?

[ChavvySexPond]

[quote IamAporcupine]@ChavvySexPond - well obviously not, see the above graph.

Also, in April doctors had no idea how to treat a case, whereas now there is more knowledge and resources[/quote]
New cases happen a month or so before new deaths.

So we can only see the cases now.

And we know what's going to happen because we all lived through it in March and April.

And yes the doctors know more now.

But the deaths will still happen as a result of those cases going up.

It's "the iron law of geometric progression"as the PM puts it.

Exponential curves always look like nothing. Until they're not.

[IamAporcupine]

Thanks @MoggyP, when looking at those graphs I posted I could not see any increase in mortality, hence the question.

I definitely do not want another lockdown, and I am not ignoring a second wave which is clearly happening. What I am saying is that, it would seem that this second round is quite different from the first one, so it might need to be dealt with differently?

[Needcoffeecoffeecoffee]

Also, in April doctors had no idea how to treat a case, whereas now there is more knowledge and resources
I think that's doing drs and nurses a disservice. They know how to treat respiratory illness but not when the hospital if full to capacity.
There is still no treatment/cure and we are approaching winter. The NHS struggles every winter due to cuts and so we also need to slow things down to take that into account.
The ons said for every 1 diagnosed case here are 4 not tested so it shows community transmission is happening fast