Daily numbers, graphs, analysis thread 5

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Welcome to thread 5 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
Google mobility stats

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

There appears to have been guidance given to Dr's deterring them from recording covid on death certificates. Not widely reported on yesterday, but here's a link to an article.

uk.news.yahoo.com/coronavirus-death-certificates-guidance-petition-095005492.html

Today’s slides
www.gov.uk/government/publications/slides-and-datasets-to-accompany-coronavirus-press-conference-18-april-2020

• • • DAILY UPDATE * * * Saturday APRIL 18th

Total UK cases: 114,217
New UK cases: 5,526
Total UK Deaths: 15,464
New UK Deaths: 888

Given the under reporting, would it be a conservative estimate (forgive the pun) to say we are plateauing now in excess of 1000 deaths per day in the UK?

Add on the care home deaths, est, 7,500 so far

1200, 1300 ?

That's terrifying for the total loss of life, especially considering the downward slope is expected to be less steep.

John Burn-Murdoch@jburnmurdoch (FT stats geek)

• Hospitals in London & Midlands now have fewer covid patients with each day

• Rate of increase slowing elsewhere across UK

• Suggests UK is at or near peak for new infections, though too early to say,
and care homes of course absent from this view

And tonight I’m adding hospitalisations in Stockholm:

• Remember Sweden has not locked down like most places

• But signs suggest a steady deceleration in new hospitalisations

• Daily hospital beds occupied still rising, but currently on course for net reduction soon

Scotland's figures showed only 62% of deaths in hospital. So if the UK has 15,464 hospital deaths then the likely a real figure is in the 21,000 region. Following the same logic the daily figure is plateauing around the 1200s.

I failed maths though, so if someone could check that I'd be grateful.

@BigChocFrenzy where do you find that information? Its always interesting x

DIvGirl My estimate was 1200-1300 daily deaths

We can't even tell COVID deaths by comparing total deaths to the same period last year,
because deaths during lockdown will be lower for RTAs, work accidents, flu etc

It's only after lockdown has been mostly lifted that we can better judge the extra COVID deaths;
the NHS can cope better with COVID over summer - provided deaths don't rise much again

This was 3 weeks ago, but helps clarify Imperial predictions:

neil_ferguson@neil_ferguson
......
Indeed, if anything, our latest estimates suggest that the virus is slightly more transmissible than we previously thought.

Our lethality estimates remain unchanged.

3/4 - My evidence to Parliament referred to the deaths we assess might occur in the UK
in the presence of the very intensive social distancing and other public health interventions now in place.

4/4 - Without those controls, our assessment remains that the UK would see the scale of deaths reported in our study (namely, up to approximately 500 thousand).

The dangers of a 2nd wave after relaxing COVID measures

• which Japan is now experiencing

https://www.bbc.com/news/world-asia-52336388

Doctors in Japan have warned that the country's medical system could collapse amid a wave of new coronavirus cases.

Emergency rooms have been unable to treat some patients with serious health conditions due to the extra burden caused by the virus,
officials say.

One ambulance carrying a patient with coronavirus symptoms was turned away by 80 hospitals before he could be seen.

Japan, which initially appeared to have the virus under control, passed 10,000 confirmed cases on Saturday.

Jesus

"the mayor of Osaka appealed for people to donate their raincoats, so they could be used as personal protective equipment (PPE) for health workers whom he said were being forced to fashion PPE out of rubbish bags."

10,000 doesn't seem that many cases for Japan to be as overwhelmed as reports suggest they are. Have you seen any reports on their testing approach?

Any thoughts on the S Korea reinfections? Of the reinfected, 61 had symptoms. It’s unclear what’s happening but If this thing is biphasic, then how do we get out of this mess??

twitter.com/drericding/status/1251520856083312644?s=21

The dangers of a 2nd wave after relaxing COVID measures which Japan is now experiencing

Japan has had a tenth of the cases and an eight of the deaths that the UK has, despite having a much larger population. They are doing much better than us

I was always a bit suspicious about Japan; they seemed to have very few cases until the Olympics were cancelled

I would like to see more people in hospitals earlier. Fewer in ICU is good, fewer in general wards is, in my opinion (and I know I'm biased here as I'm convinced oxygen early is the answer) not a good idea. Get everyone into hospital, treat them aggressively with oxygen, antibiotics if needed, give them vitamin D if that helps, look after them and maybe they will never get to ICU.

@BigChocFrenzy

Something about Japan’s stories don’t add up. Unless cases and being severely underreported, I don’t understand why a developed country like Japan is experiencing such a crisis.

Though have just read Japan’s practice is to hospitalise everyone with CV and showing symptoms...

"Japan has had a tenth of the cases and an eight of the deaths that the UK has, despite having a much larger population.
They are doing much better than us"

Not if their health system can't cope now
One of the key aims in a pandemic is to keep cases within the health service capacity, whatever that is

When people can't get hospital treatment

• like that bloke taken to 80 hospitals - then the whole population feels unsafe

Especially when asked to donate raincoats because health workers are using bin bags for PPE

"Something about Japan’s stories don’t add up"

The BBC would be careful writing a report like this

imo, during the 1st wave, Japan was distracted by desperately wanting the Tokyo Olympics to go ahead on time.
So they didn't plan ahead properly for handling the pandemic

Japan lifted measures, but then didn't follow the recommended strategy of test & trace.

In fact, they have tested comparatively little all along
and they should have rapidly built up test capacity, but they don't seem to have done this.

They should have used the time to build up hospital capacity v quickly too, as e.g. the UK did,
but if so, it was obviously not enough.

If the problem is admitting too many patients with minor symptoms, then they should have organised a system of treating those at home,
as with Germany's teams of visiting medics

Now, Japan needs to reimpose social distancing measures, build up testing, build up their hospital capacity - and buy a huge amount of PPE.

They've had a nasty shock, but this should be brought back quickly under control^

This for me illustrates the need for the UK to massively build up its track & trace system,
before stopping lockdown

• it must be done quickly though, because I don't know how the public would react to a further extension

I'm bothered that Hancock kept talking about the damn phone App
and kept ignoring questions about organising track & trace teams

• these could be led by public health staff, local environmental health officers etc, of whom there are several thousand that could be pulled in for this emergency

An app would be fine if the tech works as it should and if enough people cooperate,
but human staff are also important in this

The numbers are too high though for a track and trace, aren't they?

Ireland is doing a massive track and trace. They think they have pretty much followed up every case; they know where the clusters are, with everyone being completely at home now for over a month they are pretty sure they can trace all contacts of new cases.

They are finding upwards of 700 new cases a day, and the next thing on the list is to test every care home resident in the country. They have done 3 times the tests (proportional to population) than the UK has done.

That simply isn't possible in the UK, where there are (at least) ten times the number of cases. Unless of course they put in ten times the number of tests, tracers, follow ups etc etc. Which they could do, but obviously have no intention of doing.

Ireland as a country is broke, but because Leo is a doctor he's following the medical not economic path, something that the UK government doesn't seem to be prepared to do.

Friends in Japan have been saying for a number of weeks that there's going to be a huge problem there.

They've not understood why it's not been taken seriously nor active measures been brought in.

@pocketem

Japan has had a tenth of the cases and an eight of the deaths that the UK has, despite having a much larger population. They are doing much better than us

Japan has had 222 deaths with double the UKs population

That's 1/70 of the UK death toll.

Japan had their first tested and hospitalised case of covid 19 on 6th January.