Daily numbers, graphs, analysis thread 7

[Barracker]

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.

If they are finding more cases and they are self isolating, surely that's a good thing? Fewer people out and about with it infecting others.

Well I assume so daisy, can't think why it wouldn't be? If you test more you find more cases.

With the new cases it’s worth looking at the graph that shows the blue and orange bars that they show in the daily briefing. The blue bars are the testing we’ve always done and that is coming down. The orange is the extra testing and that is where there seem to be more new cases being found. It seems likely therefore that the increased testing is capturing more cases rather than cases are necessarily increasing. That’s how I read it anyway!

thanks sunshine, didn't know about the orange and blue! that's helpful to know.

Those additional orange cases would have always been there, but before extra testing they would never have been identified. Now they know they have it then can take steps to isolate, which hopefully stops them spreading it as much.

My fear is that it is still very much live in the community despite lockdown. People who are infectious and yet to show symptoms, people who are asymptotic or mildly symptomatic. If we lift too much too quickly we could risk a second wave.

Some of the extra testing is being done in places like care homes where it would be expected to find many people infected.

I think if cases were still spreading very rapidly in the community we would be seeing a sustained or increased number of people going into hospital and we’re not seeing that. The wider testing must be capturing cases in places like care homes and also some of the milder community cases.

I think all key workers can request a test now if they have symptoms - that's a lot of people, most of whom would have previously gone undiagnosed unless they were so ill they ended up in hospital.

I think if cases were still spreading very rapidly in the community

I agree, it doesn’t seem to be spreading rapidly. However, cases are still at a level where things could easily get out of hand quite easily.

I think all key workers can request a test now if they have symptoms - that's a lot of people, most of whom would have previously gone undiagnosed unless they were so ill they ended up in hospital.

The list is now even wider:

all essential workers including NHS and social care workers with symptoms (see the full list of essential workers)
anyone over 65 with symptoms
anyone with symptoms whose work cannot be done from home (for example, construction workers, shop workers, emergency plumbers and delivery drivers)
anyone who has symptoms of coronavirus and lives with any of those identified above

Additionally, we are testing:

social care workers and residents in care homes (with or without symptoms) both to investigate outbreaks and, following successful pilots, as part of a rolling programme to test all care homes (see below for information on testing in care homes)
NHS workers and patients without symptoms, in line with NHS England guidance

Wasn't there talk at one point the virus replicates best in 5-11° temperatures?
It may explain why it spread different places at different times and slowly sometimes and faster others?

Just noting that NHS England's latest daily death file includes a note they duplicated 32 deaths
www.england.nhs.uk/statistics/statistical-work-areas/covid-19-daily-deaths/

They claim that they do not expect to uncover further such errors

I find this a bizarre claim given that I emailed them pointing out that their data are wrong and that deaths that occurred on 31 March were incorrectly assigned to 29 & 30 March, and while I got a reply to my first email , which missed the point I was making, I have received no further reply even though I would stake my life on their data being incorrect.

Does anyone know what the criteria for testing is in other countries? Eg Italy or Spain, who can get a test? I see From worldometer they have both done significantly more testing per million than us and more so than Germany as well!

Daisy What I know about in Germany:

Everyone - if you have symptoms, you phone either your GP or a central hotline
Then you get assessed and if it's plausible that it could be COVID, you are given a test slot

• that's either a drive-thru or a home visit (for those who can't drive there)

As with the UK, anyone who goes to hospital for any reason is tested

Hospital staff and care home staff are tested frequently
I heard they are also aiming to test all care home residents

Test summary for Germany
Just over 2¾ million tests done so far

@Derbygerbil yes & it's even broader than that list too! Dh & I were both tested on Sunday, we aren't in any of those groups.

I had a fever and went through the online 111-covid service - they directed me to the test site self-referral.test-for-coronavirus.service.gov.uk/test-type and said just click 'request a home test' and then click 'clinical referral' on the next page. As simple as that - we got our results on Tuesday.

Getting tested was a really simple process (assuming you get past the verify me thing for home tests) - you can request up to 5 tests per household.

In Ireland anyone who calls their gp and says they are showing symptoms can get a test. Anyone living with or in direct contact with anyone who has a positive test is also tested.

This has been going on for over a month now; the UK is just starting to follow the test-and-contact-trace routine that many countries have followed from the start.

They are currently testing all staff and residents of all care homes and other residential centres, and also testing in group accommodation for example those in direct provision or homeless in hotel or hostel accommodation.

Encouraging for Germany is that poitive % of tests has been falling for some weeks now

• I wonder if that will start rising again now we are relaxing measures

R0 today, however reliable that may be, is 0.65 (95%: 0,53-0,77)

A graphic on positive tests for 15 of the 16 German states over the weeks
(the 16th has v few cases)

Daisy The additional tests being done are mostly on health/key workers and care home residents so I wouldn’t regard them as being ‘in the community’ in the same way as the majority who are staying home 90% of the time (obviously care home residents aren’t out and about but once the virus is present in a care home it seems almost unavoidable ) It stands to reason that there would still be reinfection happening to those individuals, driving positive test numbers up. The hospital admission/ICU figures would reflect general population more accurately as Sunshinegirl said.

Watching Germany with great interest Bigchoc, hopefully our government will take a lesson this time it has the opportunity

Can I ask a testing question? The media are making a big deal out of the missed deadline of 100000 daily tests, but does anyone have a sense of is this just because there aren't 100000 a day needing tests, or are people unable to get tests that need them? I haven't seen any explanation of the missed target, but if everyone who wants a test, is offered one, then it isn't really a problem is it?

Experts' answers to questions about COVID-19 and viral load

Several answers, but I found this the most useful one:

https://www.sciencemediacentre.org/expert-reaction-to-questions-about-covid-19-and-viral-load/

Professor Willem van Schaik, Professor in Microbiology and Infection at the University of Birmingham, said:

“The minimal infective dose is defined as the lowest number of viral particles that cause an infection in 50% of individuals (or ‘the average person’).

For many bacterial and viral pathogens we have a general idea of the minimal infective dose
but because SARS-CoV-2 is a new pathogen we lack data.

For SARS, the infective dose in mouse models was only a few hundred viral particles.
It thus seems likely that we need to breathe in something like a few hundred or thousands of SARS-CoV-2 particles to develop symptoms.

This would be a relatively low infective dose and could explain why the virus is spreading relatively efficiently.

As far as missing the test numbers is concerned the issue is of mismatch . Those eligible are gradually being increased but of course Ill hospital and care home patients and hcps of all sorts are a priority and thus need available capacity. Making testing user friendly is not straightforward eg couriers required or postal system or driving whilst feeling ill to hang around a testing centre. I am a hcp and if I was symptomatic would really want to know if I was positive for my family but more for my employers and planning getting back to work. If the work issue wasn't there I would probably not bother with testing. The system is hard to apply evenly.

It's ok for HCPs to home test, but I have doubts about the rest of us knowing to stick swabs sufficiently far up / down

From what I gather from those who have been tested here, the swabs go in further than one expects