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.

@midgebabe You may want to read the thread below and re-assess whether the NHS is overwhelmed.

www.mumsnet.com/Talk/coronavirus/3886452-The-hospital-I-work-in-is-so-quiet

@Eyewhisker this is what I'm hearing from medical friends outside of major urban ITUs. Even those within critical care are saying that admissions are reducing and things are a little more manageable. I think the measures have successfully stopped the NHS being overwhelmed, now is the time to reopen to encourage other admissions- plus get on with the normal, vitaL business of the NHS.

wintertravel - it does seem to be working now, but was too little too late; hence the death rate. Also, I have no idea how they can calculate the R-O in the UK as they aren't testing and contact tracing, as far as I can see, unless people are so unwell they have been admitted to hospital.

I suspect the ICU and CCU wards are up to their eyes (that's where my dd is, and she certainly isn't sitting around chatting), but that other areas of the hospitals are. I would like to see them (a) admitting more Covid patients earlier - testing and following up on contacts and (b) resheduling some other urgent medical care. The trouble is that operating theatres have been turned into ICUs and patients needing ICU after operations would be a problem.

I’d love to see numbers to back up the empty hospitals thread.

If we relax without mass testing won’t we be right back where we were though? If we’re now under control that’s one thing, but there are still more cases around than pre lockdown so how can we release. Unless it’s very limited maybe just parks etc , outdoor spaces ok (esp with vit d issue)

Sweden have the right approach. We have massively overreacted and now indirect deaths will dwarf direct deaths from covid

https://www.ft.com/content/853e3929-1810-33f5-9974-ef5286e0f909

Early studies using Covid-19 antibody tests indicate that only a “relatively small percentage of the population” appear to have been infected

said Dr Tedros Adhanom Ghebreyesus, director general of the World Health Organisation,
at a press conference on Monday.

Even in “heavily affected areas” the early data suggest that “not more than 2-3 per cent” of a population had been infected with the virus.

Antibody tests screen for whether someone has recovered from the disease.

However, since the disease is so new, it is not yet clear whether previously infected people will be immune from future infection.

Antibody tests will help improve our “understanding of the extent of the virus” in a population, said Dr Tedros,

but diagnostic tests are the “core tool” for diagnosis and treatment.

"Sweden have the right approach."

Sweden's approach worked for them:

different population density, culture naturally has greater social distancing, higher number of people living along, high level of Vit D, ...

Italy was being totally overwhelmed until they just had to lock down

Imperial College estimated ¼ million extra deaths in the UK if comparable measures

• well short of lockdown - were used instead of lockdown

They estimated 20,000 deaths with lockdown and the UK will be around that ballpark

Imperial college are wrong.

Accepting the differences between Sweden and the UK, Sweden should be suffering exponential increases in their number of covid deaths.....they’re not.

All those claiming the Uk could just shrug off an extra ¼ or ½ million deaths

• because those would be mostly of the old or vulnerable -

keep overlooking the fact that the young and middle-aged only have such a low risk of death within a functioning health service - which there wouldn't be u der such circumstances

They also assume people would keep working during this carnage, knowing they probably wouldn't get medical care,
keep sending their kids to school
that teachers, about ¼ of whom are in the vulnerable category, would keep teaching,
that consumers would feel secure enough to keep buying big ticket items and high discretionary consumer spending, which the UK economy relies on.

Just wouldn't happen.

You can't throw in a massive killer Black Swan and then expect everything else to keep paddling along as normal

The hospital where I work is running at about 80% capacity just now - it's normally near 100%. And that's with cancelling all routine cases; we would never have coped with covid-19 had there not been a major reconfiguration of services in a short timescale.

If the NHS isn’t overwhelmed then surely the deaths will be the same, lockdown or not? As Sunshine has said on previous page. Lockdown only protects resources. If we had longer lockdown it only slows the rate in which the virus moves through the population. It’s not going away anytime soon.

Vaccine or herd immunity is the only way out. We can’t hide from it forever through lockdown. Though better treatments going forward will improve survival rates I’m guessing,

That’s just how it seems to me. Maybe I’m reading it too simplistically.

The Imperial college group are the government advisers, some of the best epidemiologists in the country
I'll believe them more than an anonymous random who doesn't post their qualifications as an epidemiologist

Advice for Sweden would be different

• ALL the Scandinavian countries had low death rates, but Sweden's were MUCH higher than their neighbours

France, Italy, Spain experienced carnage until they locked down
The UK was heading the same way

Different countries have different death rates, but the UK was NOT following the Scandinavian curve
The UK has consistently followed the curve of Italy

"Based on Imperial estimates, R0 in the UK is currently lower than in Germany, France or Spain"

I think that shows the UK is higher than France or Germany (but my eyes aren't good)

Anyway, R0 is calculated using complex equations plus best estimates for input data, so there is a margin of error there
We can only say they all look to be below 1

There is no reason to think that a Tory government is more eager to sacrifice the economy than governments elsewhere, of the left, right and centre

They estimated 20,000 deaths with lockdown and the UK will be around that ballpark.

They estimated a range from 8,700 to 39,000 in their core lockdown scenario but they have assumed baseline R0 of 2.4. If their baseline R0 had been understated (which it probably was), with other things being equal the number of deaths is, unfortunately, likely to be higher.

However the main Imperial assumption that can be challenged is what percentage of population is likely to get the virus. Are any of us naturally immune? I attended a large meeting in my office just before the lockdown. One of my colleagues who was there was diagnosed with C19 a few days later. Only 3 people in the room got symptoms and got their diagnosis confirmed through private testing. Everyone else (including me) might have been asymptomatic or did not get infected. Of course, it is only one small example that does not prove anything but it demonstrates that not everyone who has exposure to the virus gets it.

"If we had longer lockdown it only slows the rate in which the virus moves through the population."

It makes a big difference to the death rate - including for younger people -
if the health service can cope with the number of cases, or whether it is overwhelmed

winter You aren't suggesting anything that wasn't accounted for in the models

It would be pretty strange if any of us here spotted something that epidemiologists around the world had overlooked

neilferguson@neill_ferguson

Let me be clear.
This virus has a lethality substantially in excess of “seasonal” flu.

Yes, up to half of those infected might not show symptoms.
But that is accounted for in our estimates and always was.

There is no credible data supporting the idea that 90% are asymptomatic.

I think that shows the UK is higher than France or Germany (but my eyes aren't good)

The way I read it is that UK is the dark red/brown dot falling between 70 and 80% stringency index. Germany is yellow, France is dark blue, Spain is green. All those three dots are above the the UK and appear closer to 1. With R0, the lower the number the more effective is the lockdown.

I am not 100% sure about colours though so am very happy to be corrected.

• • • DAILY UPDATE * * * Monday APRIL 20th

Total UK cases: 124,743
New UK cases: 4,676
Total UK Deaths: 16,509
New UK Deaths: 449

Of course the death rate is different if NHS overwhelmed. I get that.
Not sure why you pointed that out, it’s obvious to me. Anyway.

But lockdown can’t go on indefinitely and assumed it was only in place to slow transmission and protect resources.

The new Imperial report is interesting.

It is so clear that mass testing, tracing, PPE and shielding need to be in place for any future strategy.

It's been very upsetting to see the UK go against WHO guidance and the experience of other European countries hit earlier.

It would be good to have some clarity - if there is any - around masks.

Imperial indicate masks as a way of reducing spread based on data from countries where people wear them.

I do get that masks can give a false sense of security, but intuitively they seem to make sense.

This website is mapping the different strains and is the source of the data from the PP above.

nextstrain.org/ncov/global

I read the chart differently and have the UK lower than both France & Germany, but really poor chart - we need a table of numbers

We need to relax lockdown at some stage,
but only on the basis of expert scientific - and economic - advice

AND also only when the measures are in place to enable this relaxation

One big problem is that the UK hasn't yet produced a plan, which the countries starting to relax lockdown have all done
Possibly having a caretaker PM without real authority means the government is unwilling to make major decisions atm ?

In particular, the UK has not yet the infrastructure for mass testing and contact tracing that is required to avoid unexpected peaks

https://www.theguardian.com/world/2020/apr/16/uk-needs-lockdown-exit-strategy-says-key-coronavirus-adviser

Ferguson said he would like to see the government move faster to put a plan in place for what happens when measures are partially lifted,
saying he did not see the same level of planning going on that was put into Brexit.

"Not sure why you pointed that out, it’s obvious to me."

Because you were asking what was the point of slowing down the length of time for people in the Uk to catch COVID

Also, if the vaccine is available within 2 years or so, slowing down the rate obviously means fewer deaths in total