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.

BigChoc, that has definitely been Ireland's route; the ICU capacity in Ireland was low. By bringing in private hospitals (with their staff), expanding usual ICUs, adapting operating surgeries, drafting in specialists from other areas etc etc there is still capacity in Irish ICUs. And people are, it seems, being admitted when less ill.

@NewAccountForCorona I've been wondering who will be staffing all these extra hospitals, I read that cabin crew are being called to support nurses & doctors, but the medical staff are expected to come from the current pool.

If the actual hospitals are struggling for staff I don't see how the nightingale hospitals are actually going to be much use.

The Nightingale hospital in Manchester is not for ICU patients. It is for those who still need nursing care but have come out of ICU

Its my understanding that the NEC was the same.

I would also hope (although I may be wrong) that some patients may go direct to Nightingale and get earlier intervention before they get to ICU. So oxygen treatment

It’s a massive task from a staffing perspective; the only positive is you are treating a broadly predictable clinical picture-acute respiratory failure and requiring similar interventions e.g use of proning teams etc.
It’s all hands on deck, professional boundaries have been demolished and traditional roles thrown away. Skill mix is a real concern but people are being incredibly supportive.
There has often been flex in ICU capacity, use of theatre and recovery spaces as ICU is not uncommon.

• • • DAILY UPDATE * * * Monday APRIL 13th

Total UK cases: 88,621
New UK cases: 4,342
Total UK Deaths: 11,329
New UK Deaths: 717

Re staffing capacity, I gave up my nursing registration just over 3 years ago so wasn't included in the first wave of those invited to re-join the register.

The Nursing & Midwifery Council wrote to me the week before last, saying they would be calling for nurses like me who had been out for between 3 & 5 years next & would be contacting us by the end of the following week. (Now the week just gone).

I haven't received a letter to date, so wonder if they believe they have enough staff for now?

Yes, using the NIghtingales for early intervention and oxygen support would seem like an excellent use of resources.

Here is today's volcano. It's possible that the Easter weekend may have impacted the data process. It may take a few days to iron that out if it's the case.

That's interesting about staffing of ICU beds. Even Germany has some issues with that Spiegel International. That is a couple of weeks ago now, and the testing, tracking, isolation route have presumably avoided needing so many ICU beds anyway. They've been able to take some patients from France and Italy as well I believe. A bit shocked at the reference (albeit from a journalist) about ICU beds being "lucrative". Perhaps something is lost in translation.

Thanks @Barracker! Yes I was thinking that surely this long weekend (Fri - Mon) is going to distort the reporting, we may not see a true current picture (such as it’s ever current) until at least Wednesday if not much later.

Thanks for the latest volcano, barracker

Although I'd love to believe the lower figures the last few days in both the Uk and Germany,
I'm expecting a high compensatory blip for each on Wed / Thur,
as the missing Easter numbers are added in to official figures

We'll probably only see the reliable trend late next week, by which time the peaks should hopefully have happened

I know this sounds utterly bizarre, but I don't suppose someone somewhere put March in as a 30 day month? It looks as though some of the 31st March figures have been bumped to the 30th, giving a very peculiar peak/dip.

Looking at the volcano, it does look as though deaths are being recorded (mostly) a bit more quickly; there aren't the huge numbers being backdated that were were a week or so ago.

Barracker, are you adding in the English ONS data? Someone was doing something useful with that, but it's so far back on the threads I can't remember what or who it was.

My understanding of the Nightingale hospital in Scotland is that it will be for patients for whom ICU/aggressive treatment in a normal hospital has been ruled out - ie for those who are having symptom management. So not ventilated patients. It may be different in England though.

@peoplepleaser1 yes, you are correct, that is a big difference between the UK and NZ lockdown. No one is allowed to work here apart from key workers. Also no schools are open, key workers have to manage their child care within their bubble. Dog walkers would definitely not be allowed to operate. We have been told not to allow our dogs to mix!

Current lockdowns extended so far;

Italy to 3 May
Ireland to 5 May
France to 11 May - when school will start to reopen

UK ? Looks like an extension too:

https://www.theguardian.com/world/2020/apr/13/raab-suggests-uk-lockdown-could-last-at-least-another-month

Patrick Vallance said he expected the number of deaths from coronavirus to continue rising this week before hitting a plateau that could last for up to three weeks

Only when the UK was “firmly on the other side” would it be safe to relax some of the restrictions,
Vallance told the the daily Downing Street press briefing,

implying that the lockdown measures in place could easily last another month.

His comments .... were backed by the foreign secretary, Dominic Raab,
who said it was “absolutely crucially important” not to let up at this point

NewAccountForCorona
Re the March 31 blip, I think that there has been some error in compiling all of the trusts' data. It looks like a significant number of deaths from the 31st have been loaded into the 29th and 30th.
I took a look at all the individual trusts on the spreadsheet, and it was noticeable that they each had a heavy increase on 29/30 and a dip on 31st.
It is highly unlikely that there would be a simultaneous blip like this in the hospitals around the country. Something has gone wrong in the data collection system. But until a data geek in NHS reporting notices, this weird peak/ trough remains.
It does undermine confidence in the reliability of all the data though.

Not a very convincing argument, I’ll admit, but just wondering if the weekend of 28th/29th when we changed the clocks & Sunday the 29th only had 23 hours could have had any impact. I’m not really putting it forward as a theory, just trying to think what else might have had an effect.

The reason I was thinking of a 30 day month is that I remember an Excel project I marked once which was really odd because it was set for all months to be 30 days. The 31 day months skewed things a little, but when we got to February it destroyed all the date completely, I couldn't understand how the author (ok, the student ) seemingly hadn't noticed.

The Irish extension will be beyond May 5th. Simon Harris said today that social distancing might become a thing of the future. He specifically said things would not be anywhere near normal after that date.

I presume that people might be able to travel a little further than 2 km, a few more shops (garden centres and online shops perhaps) may open, but schools certainly won't go back, social distancing in supermarkets will go on, there'll be no gatherings or pubs or weddings or travel etc until late summer at the earliest.

John Burn-Murdoch@jburnmurdoch (FT stats geek)

NEW: Sun 12 April update of coronavirus trajectories

Daily deaths:
• US & UK still trending up, Italy the only other to slope up at same stage
.....
cumulative deaths:
• US death toll now the highest worldwide, approaching 22,000 and still rising fast

• UK curve still matching Italy’s, but death toll could end up higher
....
subnational region daily deaths:
• Early signs that NY daily deaths may be peaking, but need to wait and see

• Same in London, though Easter weekend reporting is having a big downward effect on UK numbers

Germany -just my musings:

Current lockdown runs out on Sunday 5 April

I'd expect Merkel to wait until peak deaths have passed before ending this

She might also wait longer, until cases drop to a level where track & trace teams can handle it

• deaths started rising here after sheer numbers of cases meant the teams couldn't cope, so too many further infections were undetected and then spread.

Politically, she might also want to coordinate with Macron and lift lockdown on 11 May

BUT....
Some country has to end lockdown, so everyone can watch and see what happens

Germany is probably in the best position to be the guinea pig for this:
. low death rate all along
. still very high spare capacity in ICU
. many tracking & monitoring teams trained

So if cases start to rocket again, the system can probably handle it,
at least for long enough to slam on the brakes again if need be.

There is speculation that on Wednesday / Thursday,
Merkel and the leaders of the 16 German states may decide not to extend lockdown.

This was recommended by Leopoldina (the German National Academy of Sciences):

reopen primary & middle schools,
also pools, gyms, cinemas, restaurants, pubs

• but large public gatherings would remain banned.

This relaxation might be combined with mandatory wearing of masks whenever social distancing cannot be maintained
e.g. on public transport

• that could be another reason to extend delay though:

German is frantically building up domestic capacity to build PPE for all residents, to avoid being dependent on imports again, but afaik that's not ready yet

Although Italy's lockdown has been extended to 3/5 (always on the cards especially as before then there are another 2 big bank holidays, so to prevent mass gatherings lockdown would be maintained) as of tomorrow lots more industries and shops can re-open. It's looking pretty much as predicted, that things are opening (stringent distancing and hygiene rules in place) to get the economy moving, but individual lockdown (still no exercising or dog walking or going shopping as a family, or taking the car out unless necessary) will be maintained.

twitter.com/fergalbowers/status/1249777764531687426?s=21

Ireland has reported 365 Covid deaths. If there 199 have been in community settings of which 167 were nursing homes.

This might give an indication of the likely number of community/nursing home deaths in countries that don’t report these.

“Of these” not “if these”

Bigchoc thankyou fir that. I have asthma but not admitted to hospital, and v high bmi. According to that I'm well under 8 do would get treatment? ? I guess the high bmi might gi against treatment actualky working... but the score doesn't actually rule me out then trying...