Daily numbers, graphs, analysis thread 7

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Welcome to thread 7 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.

That's just NHS deaths. Is there a source of daily care home deaths somewhere?

Health ministers in Scotland and Wales were barred from seeing thousands of coronavirus results from rapid testing sites for weeks because of data restrictions imposed by the UK government.

The Department of Health and Social Care (DHSC) began setting up rapid testing centres across the UK to test hospital staff and key workers for Covid-19 in early April, but Scottish and Welsh ministers were given the data for the first time late last month

The DHSC hired the accountancy firm Deloitte to run the programme. The DHSC’s very narrowly drawn data disclosure policies meant the results could not be shared with the Scottish and Welsh governments, or the hospitals those staff worked for, even if it was anonymised.
As a result, none of the positive test results detected in Scotland and Wales were included in their daily updates on Covid-19 cases in April, and could not be factored into those governments’ planning for the pandemic. The devolved governments were told each day how many tests had been carried out at the rapid testing centres, but not what those tests uncovered.

In contrast, the Scottish government had been giving the UK government a full daily breakdown of all its testing programme data from March onwards, including the number of tests, the number of people tested, the results of those tests and its total testing capacity.

www.theguardian.com/world/2020/may/04/rapid-coronavirus-test-site-data-was-not-shared-with-scottish-and-welsh-ministers

I've been hunting for care home deaths too, SHoots

We could start a separate chart from when the govt started announcing those deaths

• but even then we won't know the exact date of death

I just had a brief look at the COVID-19 deaths by local area/deprivation release

www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/deathsinvolvingcovid19bylocalareaanddeprivation

The interesting features:

Table 1 - age-standardised (which essentially divides the age profile of population of the area by the death profile of the country as a whole) almost exactly double for males as females (since covid-19 is correlated with age, failing to adjust for this is dangerous as it will falsely understate the risk to males, since there are more older females).

If we treat the 'background deaths' as weekly averages, then over the 48 days considered in Table 1, the expected number of male deaths is 37,810, and for females 37,306. That is with NO corona.

The actual excess deaths (non-age-standardised) are therefore 8,222 males and 6,894 females. This, one would suggest, is rather odd given that they are saying there were 12,039 male covid-19 deaths, and 8,244 female deaths (note that, strangely they are including deaths to 17 April, but only those registered by 18 April, which is nonsensical)

The NHS data DO support the double male risk theory in that they finally got round to adding SEX (coronavirus doesn't care about your 'gender' you stupid fucks) to their death chart, which show almost double the male deaths in ages 40-79, and not 80+ (by which age most men are already dead). BUT it strikes me that the REAL death tool of corona-virus contains many more females, but because they are dying in nursing homes, nobody even bothers to test them.

I believe around THREE IN FOUR of nursing home residents are women. But they are not being counted here.

In Table 3 we see that they provide age-normalised death rates, which rise with deprivation, however the raw number of deaths is largely constant between 0-70%. The implication (they don't provide deaths per population) is that the poorer areas have younger population (who get covid-19 death certificates) whereas the richer areas have older people dying without such a certificate. We can see here the disproportionate effect of one person aged 50 dying of covid-19, in that only 1 in 300 50-year-old men will die in a year, whereas 1 in 10 87-year-old women will die in a year. So the killing of younger people by covid-19 will push the age-normalised death rate up.

To the extent that it's an urban condition, therefore the fact of larger conurbations having the highest rates AND the youngest populations, means that cities will end up with higher age-normalised death rates without necessarily having the most deaths, insofar as covid-19 kills people younger than average OR if covid-19 is more prevalent in areas with younger populations (which are also more deprived). The extent to which correlation is causation is not at all clear.....

Table 5 is not all that interesting without considering the population of the sub-area and again the age. Again, here if an area contains NO nursing homes we expect very few deaths on a weekly basis, as the population is young, and those deaths that DO occur we expect to have a covid-19 certificate because they will almost necessarily occur in hospital. Thus in London many areas have over 50% deaths from covid-19, but this isn't terribly meaningful unless we know WHERE the deaths occurred, in that 10 extra deaths in care homes are likely from covid-19 but only 2 or 3 will have that on the death certificate, whereas for 10 extra deaths in hospitals 12 (!) will have that on the death certificate.

So as a mapping exercise it seems to be quite misleading without considering NORMAL death totals and WHERE the deaths occurred. AKA not that useful. We do know a MSOA has a population averaging 7500, and we COULD derive age profiles for each MSOA (if the data are available at that granularity) and then work out the expected deaths from that and hence calculate the excess - but as it is, hmm....

I won't pretend to understand all you're saying @ShootsFruitAndLeaves, but it all seems very interesting! The part about female deaths being undercounted as in care homes, is really quite obvious when you think about it, isn't it?

I was reading Shoot’s post and hoping the data could be turned into a graph to help me understand it!

The sun are reporting 204 uk deaths. Has anyone seen numbers elsewhere?

I've been trying to follow all that Shoots, and I think it comes down to the fact that we may never know exactly how many people died of Covid, how many died from other conditions exaccerbated by Covid, which makes little difference to the families (if my mum, aged 85, died and had Covid, I'd want that acknowledged as her other likely cause of death would be heart failure which she has been living, quite happily, with for over 30 years).

I think this is similar to the way early cases and early deaths were counted. Looking at London, it seemed cases were stacked in certain areas, until I realised that in fact they were stacked in 3 or 4 major hospitals, and that borough numbers were influenced by the size of the hospital and the way they were dealing with Covid in the early stages. Similar may apply, a few weeks later to care homes - which ones were on the ball, tested, isolated etc, and which ones were caught on the back foot and overwhelmed.

Sky saying 204 hospital deaths in England, plus five deaths in Scotland and 14 in Wales. No figures for deaths in all settings yet.

newaccountforcorona your mum has been living with heart failure for 30 years? Sounds pretty stressful . But I understand what you mean .

At what point do we think actual care home deaths will come out, if ever? Think it has been said before but aren't around 50% of deaths in other European countries in care homes whereas ours appear to be around 20%? Seems unlikely. Apologies for anecdote but a friend who owns a care home in the South East has had 14 residents (and 2 staff) die in the last 6 weeks, but only 4 residents' deaths have been recorded as CV19. Typically the death rate in the home is approx 5 per year, it is a facility that tends to have residents long term, rather than end of life care.

I know there were suggestions that there are people dying of non covid-19 causes in home/care homes that would normally die in hospital.

In other words care home deaths could be considered based on their type of residence not just their venue of death to ensure that the excess deaths are not deaths that would normally happen in hospital.

However if you consider 300k care home residents living 26 months, that's 2600 deaths per week , and the pre covid-19 death total was 2550, so that doesn't seem to be a significant effect. In other words the excess care home deaths probably really are mostly all from covid-19 hence the. Age data are wrong.

However from a public policy perspective the younger deaths really are 2/3 men, so that seems to be a reasonable basis to proceed from, even if you are excluding a lot of women in their 80s/90s

Very interesting Shoots re London and age

Just reading a report that says Sweden has reduced its R to approx 0.85, amazing.

www.medrxiv.org/content/10.1101/2020.04.15.20067074v2.full.pdf+htm
Sorry know this is a study but its interesting. It uses excess deaths data from different regions in italy to work out the infection fatality rate. Strangely it doesnt give info for undetlr 40s but suggests for 40-50 year olds its as low as 0.04% getting higher for each age group. It also says deaths in italy gor over 70s are massively under reported

www.medrxiv.org/content/10.1101/2020.04.15.20067074v2
Sorry the above link doesnt work

The Sweden R is amazing. The Imperial college report in March estimated that their measures would lead to an R of 3

@Jrobhatch29

Many pages ago I produced this.

I should re-do it based on excess deaths, but it follows that if there is an IFR of 0.04% for age 40-50, that risk doubles with every 7 years, and probably in fact more quickly for that than that in that the age-risk profile should be a combination of certified covid-19 deaths for younger age groups and excess deaths for, say, over 70s.

Also an IFR of 0.04% for 40-50 seems like far too wide an interval in that if the risk is more like double per six years, then a 50 year old will have almost FOUR times the risk of a 40 year old.

Also therefore an IFR of more like 5%+ in older age groups.

I find the IFR quite an interesting number in that we heard scary numbers before for SARS of 10%, but it turns out that was CFR, which is a very different thing.

Yeah it goes up quite significantly per age band. I do agree the age bands should be smaller.

27ShootsFruitAndLeaves

So nice to have you back.

Thank you.

Deaths down by 60%+ now from the peak

It was around 12 days to reach the peak from 200+ deaths per day, and more like 28 days to get back again.

This long tail is one thing in that each group of 1000 infections on a given day will kill people not on one day but over an extended period but also because the virus spreads much faster than we can slow it down, so to speak. It follows that if you start from a point of letting shitloads of people get infected with Crufts, Stereophonics concerts, football, etc., then it will take much longer to shut things down, whereas eg. Australia, NZ, etc. have already got things under control. They had the advantage of isolation but there was nothing stopping us locking down a week earlier.

It will be interesting at some point to work out the cost of this in terms of:

1. the cost of Boris not shutting things down till late March, cf. say Black Wednesday (or whatever) in terms of the extended recovery time
2. the total economic damage from the lockdown itself compared perhaps to the worst case scenario of deaths and the usual approved cost per year of life.

I'm imagining that deciding if a death is Covid or not could be a real challenge in the elderly. Using the example of heart failure someone mentioned, if an unwell patient had this as a co-morbidity, you would have to think did Covid directly cause the death or worsen the heart failure so that caused it where a healthier patient might have survived? I can't quite get my head around the definitions

That's why some public health analysts are saying that looking at the "excess deaths" over the weeks is probably the best - not perfect, but best - measure of the COVID toll

the cost of Boris not shutting things down till late March, cf. say Black Wednesday (or whatever) in terms of the extended recovery time

The cost of the additional lockdown and social distancing time will absolutely dwarf the loss to the economy of locking down a week earlier. Those in racing who worried about losing business if Cheltenham was cancelled, will lose many times more as a result of it being allowed, along with everything else, to continue.

Apologies for anecdote but a friend who owns a care home in the South East has had 14 residents (and 2 staff) die in the last 6 weeks,

Omg this is shocking about the staff