Daily numbers, graphs, analysis thread 4

[Barracker]

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.

No, nothing gets added onto the UK figures except the daily total of hospital deaths from each member country (although, as discussed above, they aren't actually daily totals - they are the number of deaths reported during the last 24 hours).

The care home and community deaths ONLY get recorded on the ONS figures..

Ah ok that is what i thought.Thanks

Appuskidu I was going to say look back on this thread but I can’t see it (only a quick look at last 24 hrs’posts though). S/he’ll be on here soon to post for today I imagine though, check later!

@peoplepleaser1 the only problem with following infection rates is how you define this. Positive tests? Well only people who are admitted to hospital and, I believe, front line staff who become symptomatic are tested. So it’s no indication of what the real number of infected people is. Then add this to the fact that there are people in hospital showing all of the symptoms including very telltale chest X-rays that would indicate that they have the virus, despite lab tests coming back negative.

The problem with going on death figures is that in the uk the daily reported deaths are only for those in hospital tv are to have tested positive. So deaths at home or in care homes are not included in those numbers.

It’s hard to track with any accuracy.

@Appuskidu here is one of Barracker's volcano charts

Peoplepleaser, I'm new to all this but I'm of the opinion that infection rate is a more important number than deaths?
I agree, but we can't find out the infection rate as our testing regime (for lack of it) doesn't afford this. Whilst we can review the number of positives reported each day in line with the number of tests administered, access to tests has been so haphazard so much caution needs to be applied.
I am fascinated by the Icelandic study - upon testing 5% of their population, they found that 50% of those who tested positive were asymptomatic. This aligns with the cruise ship findings. Our government were, the last I heard, thinking that the percentage of those who have been infected and been asymptomatic was in the low single figures. I really hope that the figure is nearer to 50% - this would be really positive (assuming immunity can be sustained for some time)

Oakmaiden thank you very much for the links and explanations

Stats aren't my strong point but I much prefer a more accurate picture of what's going on rather than the numbers released in the press daily.

Just my opinion but i don't think it's anywhere near 50% anywhere in the UK. I suspect 10% in London, maybe similar in Birmingham ? 5-7 % in SE, NW and 1-3% elsewhere. (From Covid tracker)

The Uni of Bonn study in Heinsberg gave a preliminary figure of 15% community infection.

I would say that is plausible in big cities, 40-50 % " asymptomatic" although I read somewhere else that on closer questioning these people did have very subtle symptoms.

imperialcollegelondon.github.io/covid19estimates/#/details/United_Kingdom

Estimate from Imperial. Less than 5% infected. Doesn't break it down into regions but actually quite similar to what you mention quite possibly

Although if you look at it per country UK has more infected % than Italy which seems surprising.

Also suggests high infection in Sweden which again is surprising

imperialcollegelondon.github.io/covid19estimates/#/totalinfected

As a proportion of the population Spain has suffered quite a few more deaths than Italy.

France appears to be doing better than both by quite a long way.

I think of these countries as all being the same amount "further along" than we (the UK) are although I may be mistaken.

If 20% of all recognisably symptomatic cases reach hospital then symptomatic infection in my London borough would be around 1.1% of the population (roughly 221 cases per 100k of population are in hospital). So I think it is unlikely that asymptomatic would be low single figures. So I think 10% in London is a credible estimate.

Thank you to the posters who have kindly explained things further to me.

50% of cases being asymptomatic doesnt mean 50% infected though does it.

Yes I would say 10% in London sounds feasible as the study doesnt break it down into area

NHS Covid-19 Decision Support Tool

FT
http://prod-upp-image-read.ft.com/765d3430-7a57-11ea-af44-daa3def9ae03

3 domains, each of which defines a separate points score:

⏺ Age
⏺ Clinical Fraily
⏺ Comobordity

These are summed to give a points total for the 3 domains
The higher the score, the worse the prognosis

There is in effect a 4th Domain:

⏺ Sex

Women are given the advantage of subtracting 1 point
Presumably taking account of v different male / female survival rates across the world

ABOVE 8 points, a patient is not treated in ICU
(clinical discretion remains)

To calm fears often seen on MN, high BMI is not included in this decision process

This is a very interesting timeline of the British “response” to the Corona Virus.
It is not very complimentary about the PM and the Government so if you think the UK Government has done a good job of talking the virus read with one eye closed!
A couple of quotes
Early-mid March 2020: In the face of government inaction, large numbers of institutions, organisations and individuals across the UK move to cancel or postpone public events, or hold them remotely, including the Six Nations Championship and the Premier League. (Independent)

And

10 March 2020: “The government was accused of playing roulette with the public by the editor-in-chief of the Lancet medical journal. Dr Richard Horton called for the ‘urgent implementation of social distancing and closure policies’.” (Guardian)

bylinetimes.com/2020/04/11/a-national-scandal-a-timeline-of-the-uk-governments-woeful-response-to-the-coronavirus-crisis/

Talking, I meant tackling.
But Talking might be appropriate!

Thanks for that BigChoc, that answers a lot of our questions. At least describes the current situation anyway.

I’m guessing that if and when pressure on IC gets worse, then effectively the threshold could move from 8 points to 7, or even lower?

Or I wonder if it’s the earlier stage, hospital admission, that will get more rationed, so fewer cases even get to the stage of making IC admission decisions. Interesting discussion on R4 earlier this afternoon about why we seem to still have spare ICU capacity when Italy at the same stage had nowhere to put cases. Apparently one thing the NHS did do well to prepare was greatly expand ICU capacity.

Rising the line while flatwening the curve

Gaining time to rapidly expand ICU capacity - buy equipment, bring back retíred / moved staff, retrain others etc -
is a big reason for lockdown, in every country that chose this

The trouble is it depends what you mean by ICU capacity - one London hospital has apparently quadrupled or more its ICU capacity, but has the same number of proper ICU nurses - the rest are bumped from elsewhere in the hospital after a 4 hour ICU crash course. So ICU beds per se isn't the issue, it's easy to call beds ICU, but if the staff isn't there to man them then are they ICU? Many patients on ordinary wards on oxygen at various rates, they are only called ICU patients when they are intubated as far as I can see. Apart from Boris of course. Similar in the Nightingale hospitals - how can they have ICU beds without qualified staff?

There is definitely a block at hospital admission stage; very few patients are transferred from care homes; you only have to look at posts on here to see that very ill people are triaged by ambulance staff and told they aren't sick enough for hospital (or if taken to hospital often sent home).