Daily numbers, graphs, analysis thread 4

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Welcome to thread 4 of the daily updates.

Resource links:
Worldometer UK page
Financial Times Daily updates and graphs
HSJ Coronavirus updates
Johns Hopkins Coronavirus Resource Centre
NHS England stats, including breakdown by Hospital Trust
Covidly.com to filter graphs using selected data filters
ONS statistics for CV related deaths outside hospitals, released weekly each Tuesday

Thank you to all contributors for their factual, data driven, and civil discussions.

Thanks v much for oximeter info, looking into it

Re contact tracing - Ireland has drafted all sorts of people into contact tracing; they are using the army, medical and nursing students, and volunteers. They are also keeping in contact with everyone by phone, often with doctors/final year medical students/nurses from non-urgent areas etc to ensure that not only do people know they have been in contact, but to ensure that early symptoms are caught and those people are isolated/treated/contacts traced.

There's massive amounts of time going into this in Ireland. I don't know if this is behind a paywall www.irishtimes.com/life-and-style/health-family/coronavirus-the-inside-story-of-ireland-s-contact-tracing-operation-1.4225900

💎💎💎💎💎 @Hermanhessescat 💎💎💎💎💎

thank you so much ,I honestly can't begin to imagine what it must be like working in ICU with so mamy and such poor outcomes .And having to wear full PPE 🔥🔥🔥🔥

Germany's early intervention is only possible because of the massive resources involved in health teams closely monitoring cases

and visiting them at home - teams sometimes called the "corona taxis" ! -
treating mild cases there
and bringing cases with breathing difficulties into hospital v early on

• so that also requires a high number of doctors and beds, including critical care ones

Those resources weren't built within a few weeks, but from decades of a policy agreed by all parties that taxes must pay for a high minimum standard of public services

The German health system does not have rationing in its model

• it is an expensive deluxe model with all bells & whistles

e.g. when a colleague had cancer, he was treated immediately including psychological counselling - which I think often happens in the UK too -
but then to recover and detox after chemo, he was given a month's stay at a health clinic in the Alps, with super-healthy food, exercise program and walks, nothing for him to pay,

NewACcountFor Corona Contact tracing soon becomes the most manpower-intensive task.
Ireland and Germany seem to have adopted a similar strategy, basically following the WHO recommendations for all countries (not just developing ones as a certain UK minister claimed)

Germany also brought in thousands of student volunteers, but as cases rise the number of contacts grows exponentially

Deaths have risen a lot recently and we were warned beforehand by the RKI (public health aithority) this would happen, because too many infected people would be missed as time went on

However, slowing the curve growth for several weeks is still paying off now in the comparatively low daily totals

BigChoc interesting all good points.

It’s a huge flip and probably not doable but if people can access their own oxygen levels at home we could have better results (pie in sky but we have the capacity, we have the media attention, and maybe an app as per pp). I know long shot. Bugs me though.

Ventilators are sounding more like last extreme resort which takes huge amount of resources.

I'm not convinced that the system would pay attention to home monitoring of oxygen levels. I'm severely asthmatic and I was monitoring my peak flow (so lung function effectively) from home and it was lower than it has ever been. For context, I've been admitted to hospital with pneumonia 3 times before with better readings. The whole system is set up on the basis that we don't have the resources - and to turn people away until the last possible minute. People being able to monitor at home doesn't change that. If anything, I think more people will be turned away.
I have a friend with a heart condition monitoring it at home whose heart rate dropped dangerously low. She was told to sit it out and hope it went back up.
Hospital care is excellent when you get it, but it seems that so many people are having their access to care that they need blocked by the system to prevent overcrowding.

Yes, it's unbelievably man-power intensive, but it's using many people who would otherwise just be at home, because in Ireland there are no schools, no universities, exams cancelled, police and army recruits were passed out early, most civil services offices (passport office etc) are all closed. These are the people being used, and currently fewer are needed than expected because the restriction of movement means that fewer and fewer contacts are being found for new cases.

It started early; had Ireland waited 2 weeks it could never have caught up. I still think Ireland may struggle in the long term, as may the likes of NZ who have caught it "early" - when things go back to normal, will it be possible to keep this up or will a second wave mean a second lockdown?

Anecdotally, the belief is that Leo Varadkar is looking at this from a medical point of view only; Ireland has survived massive depressions in the past and everyone knows that loans can eventually be repaid, so the economy is being ignored. The hope seems to be that a true blood test will come out, so early testing with quick results and a continuation of contact tracing will keep on top of it. But it will be necessary to mount a huge operation at airports etc and probably test everyone coming in to the country. The immunity rate in Ireland will be much lower than in the UK.

Numbers in Ireland are still going up though which is why there is another 3 1/2 weeks of serious lockdown.

Yes and I think its that model of 111 and waiting until you cant breathe that is what is causing all of this. And really they should be changing the advice because Boris shows what early intervention means

Exactly. This is why Germany's deaths are 1/4 of ours. Because everyone in Germany gets the Boris treatment, but here, only Boris gets the Boris treatment.

With a UK daily total being the sum of a portion of daily deaths over the previous week, data is always out of date

So decisions are being made based on what happened a week ago, which is a similar situation for all countries.

We need to remember that "the" peak day is actually the "peak rolling total"
which is also why we really need to be a week past peak before we can be sure it has happened

This coming Wednesday & Thursday will probably look like a jump after the holiday lull,
so let's ignore any screaming Headlines Of Doom then and keep cool.

Probably we'll have to wait until the following Wednesday before we can say - hopefully - that the UK peak has passed.

Is at-home oxygen something that could be provided by outreach teams or is it not practical? I know it's part of palliative care, could that be ramped up?

Quarantine I agree we are in a situation of overcrowding atm

But in a couple of weeks the lock down may give us space to reassess. I would love to see a flip on this to a new approach if possible medically.

Home outreach sounds good.

Hospital care is excellent when you get it, but it seems that so many people are having their access to care that they need blocked by the system to prevent overcrowding

Yes, but it's the NHS way, isn't it? You're a malingerer until you're proven not to be. Even the online 111 service is opaque, you have to answer the questions to find out what it says. Nowhere does it say "when you have these symptoms you need hospital help". Or if it does, I can't find it.

I think we did lock down early enough, and we do have the staff and resources to provide care. But we stop people accessing the care early enough.

Cologne agree with you absolutely

Wonder if any journos are reading this. Come on! Get yer pen out.

can I ask, does anyone have any more information about countries outside Europe? I've been watching India, South Africa and Iran, just as sort of sample countries and I'm struggling to believe the numbers. Are people not dying in SA and India?

And it seems very strange that Iran has basically has between 120 and 140 per day pretty much every day since March 15th. It's unlike any other graph.

"I think we did lock down early enough, and we do have the staff and resources to provide care"

Sorry, but I disagree

The UK locked down too late, which is part of the reason for the UK curves being like those of Italy's, which made a similar mistake

Also, the reason for rationing access to healthcare, not just with this COVID crisis but before,
is that the NHS doesn't have the resources to treat everyone fully

Treating at the last moment saves the previous weeks' care .... from the bean-counters' pov
(and some patients may die off before ever reaching hospital)

The Scandinavian or German health staff are no "kinder" than than NHS staff - it's just they have the hospital beds to admit patients as soon as it would help their condition.

NewAccount The FT Geek John Burn-Murdoch is dubious about the South African stats,
also thinks China have lied massively about their deaths & cases.

Iran being a theocratic dictatorship can / will lie - and has done far worse things than that in the past.
Also, losing several politicians & military chiefs to CV early on will have added to the lack of organisation there

Generally in Africa and Asia, comparatively poor or developing countries don't have the facilities for mass testing,
often don't even have much of a monitoring system to pick up if even hundreds of people are dying per day but deaths scattered among thousands of rural villages.

They will have a lot more deaths from other diseases and accidents than the West has, so CV deaths might not even be noticed, let alone tested for.

Lockdown is probably not survivable for much of their populations
They need a vaccine even more desperately than we do.

There are exceptions to the gloom:

I hear Ghana's President realised the emergency early on, organised and made excellent use of his country's medical resources
This is he, speaking very wisely:

For anyone reading this and thinking about buying a pulse oximeter, Argos have one in stock for home delivery (£19.99 + 3.99 scheduled delivery available within a week) and one that is slightly more expensive but only available for pick up in some stores.

These are very simple, just follow the instructions and they set off an alarm if the levels are too low.
Suitable for adults and children over the age of 4/5 (based on finger tip size). You can buy paediatric models on Amazon for babies/preschoolers.

If you are speaking to 111 or 999 and you are able to give the patient’s blood oxygen level and temperature, you will be able to get more accurately triaged than if you are just describing symptoms.

Worth making a daily note of temperatures/ oxygen levels and other symptoms on old fashioned pen and paper when a person is in the self isolating stage. Hopefully that’s where it will stay, but if you or a family member need medical attention it’l be really useful to be able to say ‘this is day x of cough and day y of fever and current readings are a and b’.

10,612 has just been announced as today's combined figures.

Good advice Lang. i have my medical information written down for ds so he has a piece of paper to hand to ambulance staff if necessary!

I agree with all that, BigChoc. I wasn't sure if I was missing something or if my presumption that many those countries don't have the time or money to monitor Covid was unfair. In some countries there are just so many people dying of everything else, this is just one more thing

NI had 11.

.

Some detailed stats and data for Scotland here: www.travellingtabby.com/scotland-coronavirus-tracker/

• • • DAILY UPDATE * * * Sunday, APRIL 12th

Total UK cases: 84,279
New UK cases: 5,288
Total UK Deaths: 10,612
New UK Deaths: 737

A CDC paper calculates that the COVID R0 could be as high as 5.7,
double the earlier estimates

So that would require a herd immunity of 85% or more

Note: R0 of flu is only about 1.3
So COVID is very infectious indeed