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.

@FATEdestiny

It’s clearly very good news, but those at greater risk include a significant number of under 70s too. When you factor in their immediate families, there are too many people for us to simply go back to normal just yet, though I think we need to ease things and I’m in favour of children returning to school.

Put crudely, and these numbers are illustrative only, assuming the fatality rate is 0.8%... and 90% of the population have 0.01% chance of death and can essentially carry on as normal with minimal risk... but the 10% “at risk” have a 8% chance of death.

Say the 10% live with 2.5 other people on average, then we’d effectively be asking a quarter of the population to place themselves or their close relative at significant risk by going back to normal... that doesn’t seem a viable proposition to me.

@oralengineer. Thanks interesting paper. Only 24 new infections a day in London, hope not over positive.

@whatsnext2

I think the 24 figure was debunked quite quickly... there are significantly more than 24 Covid hospital admissions in London per day, so it follows the number of cases are far higher, though much lower than they were.

It’s clearly very good news, but those at greater risk include a significant number of under 70s too. When you factor in their immediate families, there are too many people for us to simply go back to normal just yet, though I think we need to ease things and I’m in favour of children returning to school.

If I was in charge I would aim for

• over 70s
• those younger but on the medically vulnerable groups,
• those with covid-19 positive result (assuming the test is good) or while waiting for results
• Plus all those in the same household of any of these catagories

to be strongly advised to self isolate for their own safety. So continue the financial support for those. But move the responsibility on to the vulnerable to keep themself safe (rather than the responsibility of the public to keep the vulnerable safe).

But I'd aim for anyone who lives in a household where everyone is under 70, not medically vulnerable and without symptoms - to start returning to normality.

Re: school return. But I'm slightly concerned that there isn't the caveat that children with medically vulnerable members of their household should still go back to school.

I have a fully healthy household so intend to send my children back to school. But if I or my DH was in a vulnerable category I'd be less sure about sending the children back.

@BigChocFrenzy

Thanks for your answer yesterday. I am a stats person as it helps me evaluate risk in my mind, which those figures do.

FATE I've been trying to make a decision there. I'm clinically vulnerable and wfh as a teacher. He's y2 so may not anyway but we've been asked. But he's also got mild asthma (with inhaler) the guidance is unclear.

I do think what you've described is the model that the gov are working towards longer term. I think it's set out in the road map?

There's a note in the ONS figures that around 1/6 of deaths are registered on a typical Friday of a week whereas because of VE Day we had virtually none.

So there are probably 2000 missing registrations from the weekly registration figures.

Friday is the last day of the week.

So I'm inclined to say that we should be tracking covid-19 deaths in the 0-60 group by week of occurrence (as ONS isn't publishing deaths by week of occurrence) and see where they are going.

Not quite as down as we'd hoped.

Deaths to age 60 with covid-19 170 for week 19, which is down from peak of 555 in week 16.

That translated into around 100% excess mortality around that time, so we are looking probably more like 30% excess mortality now and indeed a death figure still well down week 18's 18k, but more like 15k than the 12.7k being reported.

It would be interesting to know how high the risk is for the young but clinically vulnerable. There seems be millions in that category but given the low deaths in the under 45s, it isn’t clear that this group have a high risk, even if they are ‘vulnerable’

In terms of how many of the covid deaths would have died within the year, a good estimate of that is the care home deaths. Care home residents live an average of 2 years from admission so a very high proportion would have been expected to die over the course of the next year, but died in the last 6 weeks due to covid.

That wouldn't be a very good estimate in that while virtually none of the care home deaths would have lived more than 5 years, clearly some of the younger deaths would have survived for several decades

If residents in care homes live an average of 2 years then lots of them live longer, I have a relative who has been in a care home with advanced dementia for 4 years, she has also survived Covid 19.

Sure but other residents live only a few weeks. The mean is 26 weeks and of course there are exceptions but many care home residents die each year. They account for a high proportion of overall deaths but less than 1% of the population. Those care home residents who live for years are probably less likely to die of covid (though some will) if they are more robust.

Don't know how my aunt survived, as I said she was diagnosed with advanced dementia 4 years ago, is skin and bone, when they told me she had Covid I cried as I "knew" that for her it was a death sentence. In fact she wasn't as ill as she was a couple of months earlier with a cold. It is such an unpredictable condition.

Looking again at excess mortality comparisons (for specific weeks/months) with other European countries, a couple of observations:

Several studies/websites suggest that the typical influenza peak occurs earlier in the UK than elsewhere in Europe;

"Influenza epidemics typically peak during the northern hemisphere winter (November to March) in the WHO European Region. Earlier research found that the timing of influenza activity moves across Europe, frequently travelling from west to east and, less frequently, from south to north, suggesting that there may be some heterogeneity in the timing of influenza epidemics among countries of the WHO European Region."

"We found a notable coincidence in peak times: all countries (except the UK) had their primary peaks in February and March. Influenza epidemics usually peaked at the end of January in the UK - earlier than in the remaining countries."

If some European countries typically have their influenza peak in March, their average excess death rate is likely to be higher in March (and perhaps early April) than the UK? Obviously this still doesn't reduce the number of excess deaths in the UK, but perhaps something to consider when comparing specific weeks/months between countries?

www.ncbi.nlm.nih.gov/pmc/articles/PMC5587899/
www.ecdc.europa.eu/en/publications-data/weekly-influenza-update-week-1-january-2020

Unusual influenza report from Ireland here - March 2020??

www.ecdc.europa.eu/en/publications-data/weekly-influenza-update-week-12-march-2020
www.ecdc.europa.eu/en/publications-data/weekly-influenza-update-week-13-march-2020

Also, have any European countries had April/May heatwaves in recent years - which might have raised their average mortality rate in April/May compared to the UK?

Another thought - reading headlines such as this from the Times last year; "Pensioners set to swamp NHS after no-deal Brexit as 260,000 expats return from Europe for healthcare."

The article is behind a paywall but do we know whether in fact there has been an increase in the number of pensioners (with underlying health conditions?) returning to the UK because of Brexit - or perhaps because of coronavirus fears in Italy, Spain, and France?

www.thetimes.co.uk/article/pensioners-set-to-swamp-nhs-after-no-deal-brexit-as-260-000-expats-return-from-europe-for-healthcare-h3qhfx0nl

I can’t believe how much the numbers have came down.

Also, do you think it’s not in the news as much atm?

@Eyewhisker I think a problem with the data here for the under 70s group in particular is that - of course at this stage - the data is predominantly around risk of death which is low, even for clinically vulnerable.
But this isn't the only risk of covid. Those under 70s in the 'clinically vulnerable' but not shielding group may well be at high risk of lengthy illness lasting a few months and/or hospital admission. A few months illness is not insignificant if you have parenting and work responsibilities. There also isn't data yet on long-term effects of covid. If you are someone who already has lung damage/heart problems/kidney problems then further long-term damage is not only more likely, but also more likely to tip people into being unable to work longterm. That isn't a risk of death, but it is a risk. As far as I know there isn't data on this yet because it's early days - unless anyone has seen any?

Eye I suppose it's not about death though but about impact on the condition. So in asthma could damage be done?

"perhaps because of coronavirus fears in Italy, Spain, and France?"

More likely net emigration in the other direction - EU citizens leaving because of how the NHS / UK dealt with COVID.

You seem obessed clav with finding data to prove compare the uk favourably to other countries? Think you are going to have go through every country and find reason why they are less than the uk ( england) will be busy then.

"have any European countries had April/May heatwaves in recent years "

I'd believe that more possivble for July / August, but not in Spring / v early summer

Anyway, you'd see that immediately in those graphs of total deaths from the FT, Economist etc, which show several years, not just the 5-year average

@Eyewhisker

I partially agree, though I think self-isolation of a large proportion of the population is unnecessarily draconian. If they socially distance sensibly, that should be sufficient. They should be able to meet with family in open spaces and go to shops with a
mask etc.

I agree that now the Coronavirus is not so "novel" as it was in March, that schools and a lot of businesses can resume,
as soon as the govt decides its 5 tests have been satisfied

• probably once the mass testing and contact tracing systems are working properly.

Govts now know who is at risk if there is a 2nd wave and - more importantly who is hardly affected at all: the young
Doctors have a better idea how to treat it.

In my area, schools have been open pt for a few weeks now;
all seems calm and organised, some staff & pupils choosing to wear masks, some not:
no related upsurge so far in cases among teachers or family members

I've been to the gym since Friday,
just back from the hairdresser - and now sporting a very cool undercut if I say so -
and am about to go to eat outdoors at a nearby restaurant.

There is still v clear social distancing - I had to keep my mask on at the hairdresser, wash hands first etc.
both gym and restaurants have really spaced out everything.
Some women of all ages - but almost no men - wearing masks outside

So, people are back at work and leisure pursuits too, but it is not the previous "normal"
However, the economy is getting back into gear, kids are playing outside, people are doing hobbies;
it is a decent quality of life that we can maintain longterm, if need be until there is a vaccine

I expect that is the route the Uk will follow shortly - although I'm not sure if people would wear masks ?

I really don't get the UK opinion on masks.

Whether they do any good or not in stopping you catching CV is irrelevant.

Peopme shout they are not needed and they won't wear them, yet want some normality back. Wear them and you get your 'mortality

Some want lockdown to be tightened and last forever. People wearing masks may help to allay their fears and help them slowly build their confidence that its OK to go out for a walk.

I've not actually worn a mask much yet (but got some face coverings ready - I think it's a confidence thing, but i will do it. I need to.

*normality. Bad autocorrect