Daily numbers, graphs, analysis thread 8

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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.

and I have cancelled all my plans for day cruises, bus sightseeing trips, museums etc

Even when governments relax all rules, the significant reduction in Grey Euro or Grey Pound

• and indeed the nervous younger Pound / Euro - consumer spending will continue to affect economies until probably there is an effective vaccine

Yep, there is not really a single "UK" R0, but a set of different R0 values for the various regions

John Burn-Murdoch@jburnmurdoch (FT)

Two models from leading epidemiologists
put Covid-19 R number below 1 in many parts of UK.

Models from @LSHTM and @MRCBSS UU/@PHEE_uk

put R below 1 in London, South East and East.
May be slightly above 1 in Scotland, N. Ire

Story -> https://ft.com/content/a3145dc2-edff-4c86-bdfd-fedde6fbc2a2

Notes:

1. ❗️Uncertainty ranges!
   ❗️ We’re deliberately not plotting central estimates or indeed any hard numbers here, because the models produce ranges not precise numbers.

2. Why do the two models look different?

LSHTM (blue) based mainly on cases data, hence steady evolution.

^Cambridge/PHE (pink) includes data on mobility levels & lockdown,giving a more sudden step-change.

These are methodological differences.^
Neither necessarily more "true".

3. Regional differences.

Some reports today that UK R number could be creeping back up towards 1.
As you can see, the concept of a UK-wide R number is misleading.

Like outbreaks themselves, the reproduction number also varies from place to place.

4. Things can change quickly. R may be ticking back up due to change in lockdown guidelines this week.

This is very possible, and it’s both wrong and dangerous to assume R crossing below 1 is the end.
What goes down very much can go up.

< but so far reasonably stable on the continent, which is promissing for the UK >

www.theguardian.com/world/2020/may/15/weird-hell-professor-advent-calendar-covid-19-symptoms-paul-garner?CMP=share_btn_link

Seems to produce range of problems

Alzheimer’s , or any kind of dementia , is a terminal illness. So people will die from it - if they don’t die from another illness first .
For females, the number of deaths caused by the dementia and Alzheimer disease has increased since 2001. In 2011, this became the leading cause of death, accounting for 16.5% of all female deaths in 2018. This is a quote from the office of national statistics

expert reaction to study reporting the suggestion that 25% of people in the UK are likely to have already been infected by the COVID-19 virus

www.sciencemediacentre.org/expert-reaction-to-study-reporting-the-suggestion-that-25-of-people-in-the-uk-are-likely-to-have-already-been-infected-by-the-covid-19-virus/

"There are several problems with this study"

Says it all, really

"In 2011, this became the leading cause of death"

And now the ONS upthread illustrates the scale of what has happened:

"COVID was by far the leading cause of death in April – ASMR 587 per 100k (Eng); 481 (Wal)
2nd was Dementia & Alzheimer Disease – ASMR 209 per 100k (Eng); 168 (Wal)"

Even though "Dementia & Alzheimer have increased very significantly"

Yes, @BigChocFrenzy it does seem that for example, young people could rationally go backpacking in Thailand in July, but it would be less sensible for the typical elderly passenger to book a cruise holiday, both because why risk infection + death and also because why risk being trapped on a quarantined cruise ship.

I’ve been increasingly frustrated by the quality of scientific coverage in the media, but the extract (ok from the Mail) about Covid in Africa is beyond belief:

“Approximately 140,000 people would express severe COVID-19 symptoms, with 89,000 becoming critically ill. Some 150,000 lives would be lost as a result, but this figure could be as high as 190,000, the estimates indicate.”

I wonder if the writer gave any thought as to how 10,000-40,000 people could die as a result of Covid without having severe, let alone critical, symptoms.

@strictlybakeoff
It is not the Alzheimer’s that kills people though. It’s usually secondary and complications eg pneumonia or vsed.

@derbygerbil that study is bmjgh-2020-002647 and it appears to have been deleted/retracted.

Is it dementia as a comorbidity itself that's the problem? Or a correlation with more people who have dementia being in care homes?

For females, the number of deaths caused by the dementia and Alzheimer disease has increased since 2001. In 2011, this became the leading cause of death, accounting for 16.5% of all female deaths in 2018. This is a quote from the office of national statistics

That's quite possibly more scary than the pandemic.

@whatsnext2. That’s the mode of death in some cases . But dementia is a terminal illness. As the brain deteriorates it affects other vital systems and so people become very frail and often develop pneumonia. And because of people’s age they can get other conditions such as cancer . But it is one of the leading causes of death-

Worth listening to radio four's 'more or less' unpicking the UK's daily tests number. It sounds like we're not any where near the capacity being reported each day.

www.bbc.co.uk/programmes/m000j2r7

Maybe I'm completely of in my understanding, but I'm not sure that dementia figures are all bad - after all in many cases dementia occurs in people who have survived into old age; in ye olden days they would have died of something else before succumbing to dementia. The rise in diagnosis of dementia may simply indicate better survival rates for other diseases.

I've spent some time trying to find updates of what happened to cruise ships after everyone went ashore. I can only find suggested (possible) asymptomatic numbers, and definite death rates. I can't understand why these very specific populations weren't followed up with tests to see how many people of those infected developed immunity, and how many (if any) of those NOT infected were infected at a later date having gone home.

It seems to me this would be an ideal population to follow up to work out who was possibly naturally immune and who developed immunity after infection, but I can't find anything at all

off, not of, obviously

Yes this from your linked guardian article is particularly concerning. Makes you wonder if oxygen would help or aspirin etc

According to the latest research, about one in 20 Covid patients experience long-term on-off symptoms. It’s unclear whether long-term means two months, or three or longer. The best parallel is dengue fever, Garner suggests – a “ghastly” viral infection of the lymph nodes which he also contracted. “Dengue comes and goes. It’s like driving around with a handbrake on for six to nine months.

Also re the linked article about SSE
I note that before xmas dd was doing her xmas show -singing .on the sunday beforehand she fell out of bed 10+ times overnight and got a cough. She did the show monday then developed a fever in the evening. Thurday supposed to do singing but wouldnt just sat still and wanted to go home afterwards(continuing cough). That day i got fever chills and sore throat and dd1 started coughing. Felt so tired i couldnt wake up for xmas day.

If people are getting lon term consequences maybe they will find an antiviral to get rid of it.

Anyway im not saying it was covid but the timing is interesting in terms of getting ill after they were probably doing singing practise at nursery.
And actually could explain why dd1 always goes odd at end of term as they do a singing show every half term. (She reacts to flu jabs too).

Maybe glad i never get front seat at shows now.

Surely the concert in wales would be a SSE due to all the crowd singing along.

www.mdpi.com/2072-6643/12/5/1359/htm

New study on vit D benefits for covid outcomes.

I would imagine the number of people with Alzheimers i care homes is quite significant. And normally people would not go into a care home until their dementia is quite far advanced.

I have a DP with Alzhiemers and i don't think his chances of dying are significantly increased due to the Alzhiemers. (I may be wrong of course). He is otherwise healthy. He is younger than many Alzhiemers sufferers. But he is shielding and will continue to shield as it would be such a horrible virus for him to have and not understand.

Sadly I think the closure of day centres and other social groups will impact the expected life expectancy of Alzhiemers. Its unavoidable as they had to close. But lockdown is i imagine increasing the rate of deterioration with many who suffer from Alzhiemers.

Then there is the question of treatment. Even if offered, we would not want invasive treatment e.g. ventilation as the distress would be too great.

The ONS has in fact released two monthly reports on mortality causes

www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/datasets/deathsinvolvingcovid19englandandwales

Here's a pie chart showing pre-existing conditions for age 0-44.

It doesn't look particularly like any large number of these people were terminally ill and due to die within a year or so.

This is the MAIN condition - people might have multiple, here only ONE is counted.

It's not clear whether 'obesity' is simple obesity, which isn't particularly hazardous, or we are talking about people who are grossly massively obese.

Also the influenza and pneumonia category seems like it might be a synonym for 'symptoms caused by covid-19', but I might be wrong on that.

Note the total deaths we are talking about is 400, so not very many people.

If we look at the 45-64 group, for whatever reason obesity is a smaller main other cause - either because it wasn't really relevant to the death in the first place, or because after some decades

The underlying condition for 90+ yo looks as you'd expect 90 year olds to be really. This is the point that dishonest people were ignoring months ago - yes, the 50-something-yo British woman who died in Bali in March of covid-19 did have various underlying conditions, but she didn't fly off to Bali about to drop dead, she probably had 15 years of life ahead of her.

Covid-19 deaths are NOT people dying of cancer. There deaths are directly caused by covid-19.

Alzheimers - it may be put as a cause of death and as a disease leads to death without a doubt,

www.alzheimers.org.uk/get-support/help-dementia-care/end-life-care-dementia-life-limiting-illness

However, unless tested for Covid, as many of the immediate causes of death are the same, it may be difficult to separate.