Daily numbers, graphs, analysis thread 8

[Barracker]

Welcome to thread 8 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.

The ONS has released a snapshot of infection prevalence in England. It showed 148,000 in England infected with coronavirus in the last two weeks, which equates to 0.27% of the population is positive- Antigen not antibody testing.

www.theguardian.com/world/2020/may/14/148000-in-england-infected-with-coronavirus-in-last-two-weeks

I don't suppose there is any study that has gone back to the people who tested positive at the beginning (back in February in Italy, or early March in the UK) and tested them for antibodies?

AS far as I can see most of the antibody testing is done on randomly selected samples, which is obviously the best way to look at the population as a whole.

Faisal Islam @faisalislam
NEW: Over a third - 36% of care homes in England, 5,546 out of 15,514 have now reported an acute respiratory outbreak of COVID-19 in past two months.

47% of care homes in North East. 42% in London. 41% in North West.

NB - this is the same data - on outbreaks, not deaths, that I’ve been following on this long thread since early April... (See this thread)

2 issues...

1. Number of outbreaks peaked. But how are hundreds of care homes (418) reporting new outbreaks even last week?

The data is broken down by week - which shows fewer infections than a month ago, but still plenty of care homes newly reporting outbreaks just last week... mainly in shires...

Actually many council areas with highest proportion of infection, now returning zero - so this shows how the infection has spread across the country’s care homes, & still does.

percentage affected ranges from just 16% in Torbay and Devon to over 100% in Hammersmith & Camden...

I think his overall point is that they really have not got a grip on outbreaks in care homes and the question here is definitely, how is it spreading? And how do we identify the people spreading it?

The other thread he links to has this gem from two days ago:

Faisal Islam @faisalislam
Care home infection outbreak data (until end April) also available by council, v helpful - very big differences across country on percentages, remember average is a third of homes with outbreaks... Top 25 by % care homes reporting outbreak - Camden 100%.. Oxfordshire 55%

Obviously fewer care homes in London, but higher percentages...

This is the bottom 25 council areas reported outbreaks in care homes, by percentage. Obviously absolute number still high in Kent, & e Sussex. But ranges from 9% to 22%, versus 33% average in England...

Perhaps most important part of data tho, is where most recent care home outbreaks are - and you can sort by latest week (last in April), and perhaps get an idea where it is most recently arriving... v diff picture... many of worst affected reported zero outbreaks end April

But some of the least hit council areas overall were in last week of April seeing significant number of newly reported outbreaks in care homes... shire counties... perhaps a reporting issue, or a measure of how far and when virus spread...

"how is it spreading?"

1. staff or visitors who are infectious before / without symptoms

2. Low-paid care staff with symptoms, who don't get full pay when sick - maybe no pay at all -
   and come in because the alternative is not being able to pay rent / food

Yep, NewAccount It would be useful to go back and test the early infected - most people would presumably cooperate ?

Also to check if those on the various cruise & navy ships, who didn't get it at the time, still haven't got it

• might give an idea about the % with partial or full inborn resistance to COVID

Of course, if only 5% or so of the population has been infected, following up the ships still might not tell us much

I not Faisal Islam posts:

"Other interesting thing about that chart is
you can see the nasty Influenza A strain that was affecting many people in December (which some thought was early Covid19)

• and how it was transmitting through schools."

I note

www.gov.uk/government/statistical-data-sets/covid-19-number-of-outbreaks-in-care-homes-management-information

This is the data set that Faisal is referring to btw.

Guardian have a good interactive map today

https://www.theguardian.com/world/2020/may/14/coronavirus-uk-latest-deaths-confirmed-cases-and-which-regions-are-hardest-hit?CMP=ShareiOSAppp_Other

There's a good table of infections per 100k people too from PHE. The places I listed earlier along with south Tyneside are the top 4 areas. So they are pushing the R0 up for the whole of the NE and Y area. York actually has less than half what Gateshead, the top infection area, has.

Interesting observation.

Brent appears to have the 10th highest number of reported cases in the country a rate of 430.2 per 100,000). And yet, it appears to only have outbreaks in 21.3% of care homes there. Why? What is going on? Particularly since its more densely populated than some of these other places in the top 10.

Borough / case rate per 100,000 (percentage of care homes that have reported cases)
Barrow-in-Furness 823.7 (58.3%)
Lancaster 537.3 (28%)
Ashford 496.6 (21.7%)
South Lakeland 488.8 (33.3%)
Gateshead 482.5 (52.6%)
Sunderland 481.9 (40%)
South Tyneside 457.9 (50%)
Middlesbrough 449.0 (52.1%)
Carlisle 431.8 (37%)
Brent 430.2 (21.3%)

Interesting info from NHS England about comorbidities in people dying with Covid-19. 26% had Diabetes and 19% had dementia.

www.independent.co.uk/news/health/coronavirus-deaths-diabetes-england-covid-19-a9514761.html

The proportion of people with diabetes is more than 4 X higher than those diagnosed in the population, which is around 6%.

That map is interesting. Places in the NW which early in the outbreak had really low rates per 100,000 now are looking like they have the higher rates. Conversely (if memory serves me correctly) places like Derby and Derbyshire were disproportionately high early on, but are now much more middle ranking in terms of cases per 100,000. Cumbria has strangely remained high throughout.

Yes @cathyandclare - I work in diabetes care. We are having minimal interaction with patients eg new Type 1's seen once face-to-face then remote care delivered thereafter.

I do not think we will see any patients in our consulting rooms for 1-2 years. Care will be delivered remotely.

Place marking.

I think this the data from the independent article:

www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2020/05/COVID-19-total-announced-deaths-14-May-2020-1.xlsx

I wonder if in some areas like Cumbria where the population is extremely spread out, that people felt less at threat and so took less notice of warnings early on than densely packed cities?

@GlassofProsecco - that must be a steep learning curve for everyone. Don't know if you will be interested but I've worked with a company that produce short diabetes education films for new patients in conjunction with Diabetes UK/Wales and the NHS. The films are all usually 'prescribed' by GPs but for the reasons you describe are now available to everyone during the crisis. pocketmedic.org/links/

@cathyandclare - thanks- I'll take a look. We're on the lookout for resources!

I'm in Salford which has a high rate, but I believe that it is just a certain section of the city which is particularly high. It coincides with a very orthodox Jewish area. A friend went for a walk in a park in that area and there were lots of notes left by a Jewish GP asking people to abide by the rules.
I don't know that this community is the reason for the high rate but they are extremely used to being very counter-cultural and may not have been as affected by the nudge theory media presentations.

I find it fascinating that Brighton and Hove and Devon have some of the lowest class when initially they were more of a hotspot.

That doesn't sound particularly likely. Salford 3.3% Jewish. Not all Orthodox. That's far too small a % of population to inflate death rates as we saw already weeks ago.