To question the stats and facts

[Yolo2]

I'm puzzled by several stats/ facts related to death rates and the R rate.

(1) Death rates - we do tens of thousands of tests a day. Let's say 80,000 average. Generally you need to have symptoms to be tested. About 6000 a day are positive. So the vast majority of people with symptoms do not have the virus. So why are doctors allowed to put Coronavirus as a cause of death on death certificates of untested people just because they had Covid symptoms? Seems mad.

(2) Surely factors like number 1 will contribute to us having one of the highest death rates in Europe? In addition, it sadly has been reported that BAME people are far more vulnerable to dying from covid. Isn't the UK one of the most diverse countries in Europe? Should this not also be considered as a factor in our high death rates? Same with obesity. Why all the outrage at the government without a proper analysis of this. I think the government have made mistakes but we didn't run out of beds and lockdown comparatively early compared to other countries. Is it really the government's fault if we do have a higher number of deaths at the moment (I really am not a fan of the government at all by the way. Just don't see they have done anything worse than other countries. Other countries are blaming their governments for the same failures as ours so it's not unique to UK)

(3) The R rate. In Scotland, it's been reported that the R rate is likely to be higher than the rest of the UK, apparently because its at an earlier stage on the curve. I don't understand this. It therefore locked down at an earlier stage in the spread of the disease as it locked down at same time as UK. Aren't we being told countries which locked down earlier would be able to control the rate of infection and the spread much more easily, and therefore the R rate? So why would Scotland's R rate now be higher?

AIBU to be puzzled by all of the above? Or am I missing something here?

This isn't intended to be a debate on how well the government have handled the crisis. Genuinely interested in what I see as either anomalies or missing information in the debate.

I find all the figures confusing.
I still can't understand the people dying 'with' Covid as opposed to 'from'.
Surely the ones dying 'with' it were likely to die anyway? I understand they have tested positive but that doesn't necessarily mean it has contributed to their death, does it?
How many have actually died 'from' it ????

What matters in the end is the number of excess deaths that occur during the pandemic - i.e. how many more people die this year than is typical for the UK.

This won't be fully clear for a while but preliminary stats are published weekly here...

www.euromomo.eu/

If you look in the graphs section you'll see that the overall death date in England has been way higher than normal during the past month.

I am a nurse. I have never read/seen/been told anything like you stay at home till your lips are blue. This is not the case. Where is this documentation/advice please?

Place marking to see if anyone can answer question 3 which I've been wondering too.

I've also heard "we're two weeks behind London".

But as we locked down at the same time we should really be 2 weeks ahead of london as we locked down at a much earlier point.

A lot of people are dying as a consequence of CV and will continue to do so for a year or so (untreated cancer etc). It seems a lot of deaths of older people are being put down as CV or certified without correct procedure which seems to inflate the figures somewhat

In the five weeks between 20th March and 24th April, 90,392 people died (of all causes). The five year average for the same period is just 51,910.

A difference of 38,482.

This isn't a case of Covid-19 being 'slapped on' death certificates willy nilly, quite the opposite. Over 38,000 people have died in the space of five weeks as a direct or indirect result of this virus. By indirect I mean increased suicides, not seeking help for heart attack/stroke in time, delayed treatment for cancer, increased domestic violence etc etc.

I don't think it helps anyone to compare our stats to other countries, and regardless of whether we have the worst death rate in Europe or not, the ONS figures speak for themselves and the wider impact of this virus and the deaths it (and lockdown) is causing indirectly needs to be looked at imo.

We don't even know if the test are accurate.
"Magufuli said on Sunday the imported test kits were faulty as they had returned positive results on a goat and a pawpaw — among several non-human samples submitted for testing, with technicians left deliberately unaware of their origins."
Tanzania suspends laboratory head after president questions coronavirus tests

www.reuters.com/article/us-health-coronavirus-tanzania/tanzania-suspends-laboratory-head-after-president-questions-coronavirus-tests-idUSKBN22G295
"State recalls 12,000 COVID-19 test kits due to possible contamination
CAMP MURRAY, WA — On April 17, 2020, the Washington State Department of Health was alerted by UW Medicine to discontinue use of a recently-procured batch of COVID-19 specimen collection kits that UW Medicine believed may have a quality control issue"
www.doh.wa.gov/Newsroom/Art...ID-19-test-kits-due-to-possible-contamination

"CDC’s failed coronavirus tests were tainted with coronavirus, feds confirm
A federal investigation found CDC researchers not following protocol."
arstechnica.com/science/2020/04/cdcs-failed-coronavirus-tests-were-tainted-with-coronavirus-feds-confirm/

"Faulty Virus Tests Cloud China’s European Outreach Over Covid-19"
www.bloomberg.com/news/articles/2020-04-01/faulty-virus-tests-cloud-china-s-european-outreach-over-covid-19

@Pippa12 - I’m also a nurse and I would like to see it too. I’ve only ever seen it on Mumsnet!

To the nurses: it's always on Twitter too, usually accompanied by someone having a lengthy telephone conversation whist "unable to breathe".

Based on the figures so far, we don't have the highest death RATE, because that's per 1000 population.

Having the highest recorded deaths isn't all that surprising as a populous, densely populated country, with strong internal and external links, and exacerbating factors such as age, ethnicity and underlying health issues. It seems the virus is well suited to the weather conditions we were experiencing in February and March allowing it to spread easily in the first phase before lockdown.

Dying with Covid means that Covid is present and is likely to be a contributing factor. But in the case of conditions like heart attacks and strokes, the person was already at high risk of dying at some point from that condition. Dying from Covid suggests that it was the primary cause of death.

It is still early days. Our goalposts on data have already shifted. It is subject to time lags, so figures currently being released make our current situation sound worse when a significant proportion of those deaths were weeks ago. Reporting is not standardised between countries.
The UK sounds bad, but it is quite transparent on reporting, so it may be worse in other European countries than we currently know.

The real test is how many people have died not just weeks or months early, but years, and that data is not avaliable yet and won't be for many months.

But you are only considering the stats that make it look better here, for example, Italy has an older population on average, so that would be to our advantage

of course better analysis is needed, but isolating just a couple of factors is not enough to affirm it is not as bad as it looks

The hospital deaths, which make up the majority are only those who tested positive, whether they died from it or not.

With BAME groups research is ongoing. It could be linked to the makeup of the workforce, poverty etc. We know some BAME people are more prone to obesity/ diabetes.

The only thing that seems odd to me is our number of serious critical has always been low compared to the high number of deaths, when compared with other countries. So it looks like we haven’t admitted as many people to hospital compared to other countries yet have more deaths.

Spain and Italy have more cases yet less deaths.

I’m very uncomfortable with how the U.K. has dealt with it.

So, is this right - you only get Covid19 recorded on a death certificate if the person was tested and the result was positive?

As for dying with and not of Covid19, we are definitely hearing how the virus attacks more than just the lungs, so Covid19 patients are suddenly diabetic when they weren't before they got the virus or they go into kidney or other vital organ failure. I'd call this dying of, not with myself, i. e. kidney failure linked to Covid19 infection. Deaths like that should be counted.

It worries me that people are unwilling to believe the death toll and woukd rather think doctors are putting Covid19 falsely on every other certificate they sign without any concrete evidence.

Other countries have their own ways of deciding what to record and what evidence is needed, but it's not a contest! Minimising our figures or accusing other countries of minimising theirs is fiddling while Rome burns, surely?

So, is this right - you only get Covid19 recorded on a death certificate if the person was tested and the result was positive?

The policy right from the start was that all inpatients with symptoms are tested.

Community deaths will have it recorded on death cert if either confirmed by test or suspected by certifying doctor.

Ultimately we’re only going to know the real picture when we can look back at excess deaths for the same period, in each country, compared to their averages.

I live alone. If I get it badly, there’s no way I’ll be waiting until my lips turn blue before ringing 999!

Aren't you starting from the wrong place with point 1? We haven't averaged 80k tests at all. The 100k figure achieved once included tests sent out rather than tests done. Until the very end of April the tests figure was much, much lower. To reach the 100k figure a huge number of symptomless (as opposed to just the asymptomatic) people were included. People checking they no longer had it would generate a negative but they may have had a positive a few weeks ago.

Re people not being taken to hospital early enough

<a class="break-all" href="https://www.bbc.co.uk/news/health-52317781?intlink_from_url=www.bbc.co.uk/news/topics/cx1m7zg01mwt/london-ambulance-service&link_location=live-reporting-story" rel="nofollow" target="_blank">https://www.bbc.co.uk/news/health-52317781?intlink<a class="break-all" href="https://www.bbc.co.uk/news/health-52317781?intlink_from_url=www.bbc.co.uk/news/topics/cx1m7zg01mwt/london-ambulance-service&link_location=live-reporting-story" rel="nofollow" target="blank">fromm<a class="break-all" href="https://www.bbc.co.uk/news/health-52317781?intlink_from_url=www.bbc.co.uk/news/topics/cx1m7zg01mwt/london-ambulance-service&link_location=live-reporting-story" rel="nofollow" target="_blank">url=www.bbc.co.uk/news/topics/cx1m7zg01mwt/london-ambulance-service&link_location=live-reporting-story

I don't think it can ever be unreasonable to question the stats. But I think you need to look at the sources rather than just question the numbers.

If you haven't been listening to More or Less on Radio 4, I highly recommend it to get under the skin of some of the numbers being presented in the media and look at what the numbers actually mean. Also it's very entertaining... The latest episode covered some of you points - e.g. the number of tests, the fatality rate, the impact of other factors such as obesity; previous weeks have looked at BAME vulnerability and comparing countries. I don't think it will answer your questions but might help to understand why they are questions...

The R rate in Scotland May appear higher due to more care home deaths being included in calculations.

Scotland is currently 50/50 deaths in hospital/care home and at home which is roughly in line with European countries.

www.travellingtabby.com/scotland-coronavirus-tracker

In England the estimate is 1/6 deaths are in care homes so likely a fairly large number of deaths not included so R number may look lower but is apparently increasing again:

www.independent.co.uk/news/uk/politics/coronavirus-uk-r-number-rate-deaths-cases-nhs-a9504496.html

www.bbc.co.uk/news/health-52284281

I think there is also more of a delay in reporting care home deaths in England just due to differences in reporting.

Excess mortality will be the only useful measure and will need to be adjusted for demographics, health and population density as a minimum.

Having said that I don't accept that it isn't possible to make some comparisions now when the differences in outcomes are so stark, for example, between London and Seoul.

LiveintheNow This is not a report, it’s media with a lots of maybe’s and could haves and one paramedics interpretation which she has been told. I’d platt sand if their policy said unless they are showing signs of cyanosis leave them be. It will say expect an increased temp, respiratory rate, pulse etc which will push up the NEWS2.

Just so we are clear, under no uncertain terms, have health care professionals once advised people to stay at home until your lips are blue. Good god... give us some credit. In fact daily news briefings have encouraged people to seek help!!!

Come on... this is scare mongering at its finest!!!

@Pippa12 The blue lips is in section 3.4 of the NICE guidelines below
www.nice.org.uk/guidance/ng165/chapter/3-Diagnosis-and-assessment

OP

Are you confused by the stats or the reporting of them?

The stats are much less alarming than the reports.

Also the NHS figures are important but never get shown.

NearlyGranny “So, is this right - you only get Covid19 recorded on a death certificate if the person was tested and the result was positive?“

No. Sir Patrick Whitty said clearly in the briefing that patients with covid 19 on the death certificate had not necessarily been tested or confirmed to have it.

I did post the video clip but cba to search.