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 UK's numbers - as given by ONS - are not fudged; they are as complete as possible,
given that some deaths may take weeks to be registered.

I posted before that in Germany, doctors are instructed to include as COVID deaths cases where the victim of a crime or accident tested positive before / after death

This is a v small number of cases, that does not affect overall results,
but follows RKI (germany public health) policy to include all deaths with COVID, not just those definitely from COVID

Probably one reason why the "excess" total deaths from all causes compared to previous years - not the bad flu year - is v low here, only 6%

Of course, the low deaths have brought out the fuckwits here questioning why lockdown a country of 83 million to save 8,000 people

• same as the fuckwits in the UK who can't understand that deaths without lockdown would have been very much higher

and that back in mid-March no responsible politician wanted to gamble with those 83 million on how a novel Coronavirus would behave

I think about 65 people working in schools have died, but I don't know how this breaks down into infections caught before or after lockdown.

Those 65 are not all teachers
and statistically don't show increased risk compared to others of same age, sex etc in the general population.

The UK's numbers - as given by ONS - are not fudged; they are as complete as possible, given that some deaths may take weeks to be registered.

Yes our numbers are compiled by diligent professionals who are committed to producing the most accurate possible data according to scientific method.

To call them fudged is ignorant and insulting to those involved with this work.

What IS true is that doctors would not necessarily order a covid-19 test on granny dying in a nursing home and she might not get that on her death certificate, but this is not a fudge in any sense.

TAs and lunchtime supervisors also come into lots of contact with children.
Is there an article I can read about school workers not being at increased risk statistically as I would be really interested in this.

Puzzle there have been a few cases here and there and of course children are more likely to be asymptomatic. Staff have commonly been on weekly Rotas of 2-3 weeks. Risks have been so far well managed like that. Bubbles usually 3-4 children.

Staff have been infected but we won't necessarily always be able to prove it's in school.

The jump to max 15 (I think most schools are keeping to 10 if possible though) will obviously mean it can't be compared.

Denmark has had much smaller bubbles of children.

I don't doubt for one second there are studies ready to analyse what will happen.

The study below works out an estimation, reckons Uk was 7.8% at around 26 April.

Estimation of the true infection rate and infection fatality rate of COVID-19 in the whole population of each country

www.medrxiv.org/content/10.1101/2020.05.13.20101071v1

BigChocFrenzy
The UK's numbers - as given by ONS - are not fudged; they are as complete as possible, given that some deaths may take weeks to be registered.

Indeed, but I have seen three studies comparing excess deaths in France for example, only with 2018/2019 (2 year average rather than 5 year average) - and France is one of the countries with raised mortality levels for weeks 12-15 in 2018 - this would seem to be an unfair comparison with UK estimates for those weeks.

There are all sorts of little caveats in your link from last night, for example;

^"For countries with smaller populations, the death data are likely to be noisier.This might contribute to an explanation of why the Z-scores for many smaller countries look quite benign. Note that in the
EuroMOMO analysis, Germany is represented by Berlin and the state of Hesse, rather than the whole country of 82 million, and so is also in the smaller population category. England’s larger population
could also be part of the reason why it looks so much worse than Wales, Scotland and Northern Ireland."^

Generally, there was a collective failure in preparedness across the public health system, especially for testing capability and adequate supplies and distribution logistics of personal protection equipment for health workers. [Your post from last night quoting the comparison between the UK and Germany in the link.]

Whilst acknowledging Germany's relative success compared to other European countries, staff working in medical facilities in Germany are testing positive for COVID-19 which perhaps suggests problems with PPE in Germany as well - the figures don't appear to include staff working in care homes;

"MAY 15 Until now, 11,688 cases with a SARS-CoV-2 infection have been notified among staff working in medical facilities as defined by Section 23 IfSG. Among the cases reported as working in medical facilities, 73% were female and 27% male.The median age was 41 years, 18 persons died."

www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/2020-05-15-en.pdf?__blob=publicationFile

The numbers of fatalities for staff in German health services is remarkably low, only 18,

So it is in proportion to fatalities in the general population

This chart - with 2 red boxes - shows

1. 18 medical staff who died
2. 42 staff in care homes for all ages, all institutions, homeless shelters, prisons etc

Compare this to the UK where over 170 frontline NHS and care staff have died

Hospital doctors here have been saying for weeks that they have plenty of PPE and feel much safer in hospital than in the supermarket

However, doctors outside hospital in some specialities have been complaining they can't see non-urgent patients because of lack of PPE

e.g. My dentist won't yet do 6-month checkups because they involve spraying water and scraping off tartar for 15 mins
and nthat pink anti-bac poweder / spray that they squirt at high pressure onto gums every year or so

If you look at the FT graphs of excess total deaths, they have light grey lines for previous years, plus a dark grey curve which is the average

2020 is the red curve
It is very clear whatever basis you would wish to take that the UK has a sharp jump for the period representing the COVID pandemic

The FT graphs are simply curves of total deaths, not EUROMOMO analysis

The numbers of fatalities for staff in German health services is remarkably low, only 18

Yes, the number of fatalities for staff in German health services is remarkably low but not the number of infections.The outcomes for staff could indicate better/earlier treatment in Germany or a difference in the age/underlying health/ethnicity of the healthcare workers involved.

It is very clear whatever basis you would wish to take that the UK has a sharp jump for the period representing the COVID pandemic.

I am not disputing that - I am querying comparisons with other countries.

The FT graphs are simply curves of total deaths, not EUROMOMO analysis

Although your link from yesterday says this;

*Some of the FT’s published P-scores look unreliable as the data and graphics do not match.

I don't think that was my link ?
I don't know which country(ies) that link objects to

If you have doubts, then look at the curves, rather than the calculated percentage increase, for certain countries

I would trust the ONS as regards the UK figures
and the ONS has said there have been over 50,000 deaths more than would be expected over this period

I have looked at raw data of total deaths from Belgium and seen their increase

I have also looked at raw data of total weekly deaths from Germany and compared to 2019 for the same period - no noticeable difference, only really visible on graphs

"the number of fatalities for staff in German health services is remarkably low but not the number of infections."

Germany has been testing health staff intensively from the beginning of this crisis, disproportionately compared to the general public.
hence picked up a far higher % of cases

Some of the FT’s published P-scores look unreliable as the data and graphics do not match
I don't think that was my link?

Yes - the note about the FT's P-scores/data and graphics came from your link here;

BigChocFrenzy Sun 17-May-20 23:22:35
Measuring excess mortality: the case of England during the Covid-19 Pandemic INET Oxford Working Paper No. 2020-11

In all countries, the confirmed cases will only be a small fraction of the actual cases.
This is why increased testing in e.g. the UK can find more cases, despite what is certainly an overall fall in cases

Some people with mild symptoms cba getting tested
or assumed it was just a cold

Some of those who were self-employed, small business owners, workers relying on tips etc would not wish to be confined to their house and lose money.

UK care workers are an example of lowpaid workers who get v little sick pay
and might be choosing between working when sick vs not being able to pay rent / food

Some others don't trust the authorities and don't want their illness officially registered,
in case it leads to some disadvantage

Others are just selfish sods who prioritise continuing to go out for daily chocolate & crisps etc above the health of others.

@ShootsFruitAndLeaves The evidence for black people is more disturbing as it does seem to be coming in from multiple sources. It is unfortunate that 'BAME' is being treated as a monolithic group. We should likely be talking about black people. Do you know how it works for mixed race? My FIL was black, my husband mixed race and my children mixed again so they are one quarter black African, three quarters white european. Is there any research on how they are affected, I've tried looking but I couldn't find anything. If you know anything I would be grateful.

Oops yes, I forgot a footnote under a table.

The UK's performance is so bad, that all the various measurements and sources pick it up
It's not a statistical glitch, or a discrepancy in 1 paper

This is from that Oxford abstract:

"The UK now has the highest recorded number of deaths attributed to Covid-19 in Europe.

The more robust data on excess mortality make even grimmer reading.
^
These excess mortality data can both overcome the problem of misdiagnosis or under-reporting of Covid-19-related deaths and pick up ‘collateral damage’ from other health conditions,
untreated because the health system might have been overwhelmed by Covid cases.

This article compares measures and analyses published excess mortality scores.

EuroMOMO produces the most systematic comparative tracking of excess mortality in Europe.
Of the 24 countries or regions covered,
England had the highest peak weekly excess mortality in total,
and also for the most vulnerable age group (the over-65s),
and, strikingly, for the 15-64 age group.

For the last group, which should be less at risk, the relative record for England is nearly 3 times worse than the next worst- ranked country, Spain
(German data suggest mortality well within the normal range).
...
Spot checks by the P-score measure support the conclusion that England has the most serious incidence of excess mortality of the comparator countries or regions analysed by EuroMOMO.^"

UK care workers are an example of low paid workers who get v little sick pay and might be choosing between working when sick vs not being able to pay rent/food.Some others don't trust the authorities and don't want their illness officially registered, in case it leads to some disadvantage.

Yes, there was a feature on BBC NewsNight recently - two healthcare workers (identified on camera, not obscured) who stated that colleagues were continuing to work with COVID -19 symptoms and avoided being tested. If I remember correctly, one healthcare worker said her colleague had tested positive and was continuing to work.

1forsorrow Table 1 gives increased risk ratios for different ethnic groups, but for mixed race, it just has um, mixed / multiple

I'm mixed race myself (English / Arab lapsed Christian) and I've not found anything for my specific mix
Aargh, we're not all the same !

www.ons.gov.uk/file?uri=%2fpeoplepopulationandcommunity%2fbirthsdeathsandmarriages%2fdeaths%2fdatasets%2foddsratiosforriskofcoronavirusrelateddeathsbyethnicgroupenglandandwales%2f2march2020to10april2020/reft2oddsratioscovidethnicityfinal2.xlsx

To be fair, COVID deaths are overwhelmingly among the very elderly, where even black or Asian are only a small %
So mixed race deaths are probably just too small a number for the ONS to be more specific than just the one group.

BigChocFrenzy

Although it is odd that the researchers have so many links to the Guardian in their research paper, e.g.

18 See “How poor planning left the UK without enough PPE”, The Financial Times, 1 May, 2020. 19 See “Britain had a head start on Covid-19, but our leaders squandered it”, The Guardian, 23 March, 2020. 20 See “COVID-19 and the NHS—“a national scandal”, The Lancet, Comment, 28 March, 2020. 21 See “Revealed: the inside story of the UK's Covid-19 crisis”, The Guardian, 29 April, 2020. 22 See “Britain had a head start on Covid-19, but our leaders squandered it”, The Guardian, 23 March, 2020. 23 See “How will country-based mitigation measures influence the course of the COVID-19 epidemic?”,
Anderson et al. (2020), The Lancet.
24 See “Coronavirus: Why You Must Act Now.’” Online blog, Tomas Pueyo, March 10, revised March 19, 2020. 25 See “Johnson under fire as coronavirus enters dangerous phase”, The Financial Times 12 March, 2020. 26 See “Coronavirus: science chief defends UK plan from criticism”, The Guardian, 13 March, 2020.

One wonders if there is a political bias in the work?
And they compare the lack of PPE in the UK with Germany - without commenting on the number of medical workers infected with COVID-19 in Germany.

"one healthcare worker said her colleague had tested positive and was continuing to work."

That is another major difference to Germany:

If anyone has a positive test, then they are officially given notice - with documentation - to stay home, no exercise or anything else outside
Shopping etc is delivered for them without contact

There is daily monitoring by phone and / or home visit
and if anyone is found absent,
then there are high fines ( €1,000s plus damages to any other person or business)
Prison sentences are possible for blatant or repeated offences

Of course, someone who plans ahead may choose not to inform their doctor of symptoms and hence avoid ever having any test
but no system is 100% and this does at least reduce the number of known infected roaming around.