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.

www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/datasets/coronaviruscovid19infectionsurveydata

Help with the child ages of current infected. 2-19 but next category is overlapping??

Listening i think I'm just still a bit sensitive and cross about some comments another thread about Hypertension.

Someone implied you were basically screwed with CV if you had Hypertensiom and another said it was Heart Disease.

I know it is normally associated with other conditions but in DH case and yours it's not at all. And there are probably a significant number of others.

Along with difficulties in articulating illness, those with autism are more likely to have needs that require a carer and be less able to socially distance so that may increase risk of contracting illnesses relative to the general population.

For ADHD I'd be surprised if there was evidence of an increased risk, largely because the population of adults considered to have adhd is so small. But again much more likely than the general population to take risks. Both ADHD and Autism are genetic (mostly) so its possible that on there own there is some inherent risk, those with autism are more risk of ehlers danos it seems.

In general those with learning difficulties will be more likely to have poor health.

I have pregnancy induced hypertension that never went away (baby is now 1). Cardiology have checked me out and heart seems in good shape.

I don’t consider myself vulnerable or high risk at all to be honest. My BP is controlled I’m healthy otherwise. I do shopping for my mum and my pregnant friend. My DC will be returning to childcare as soon as possible.

That might just be me though, I have almost the opposite of health anxiety when it comes to my own health!

Anyone read or partially read the published sage documents. I'm still on the ones pre lockdown (so pre any measures beyond hand washing).
But so far it is very clear why decisions were made at what time and what combinations of interventions can have the greatest impact. Lots of modelling with regards how the impact will manefest and it's very much geared towards lowering the peak but extending the epidemic. There's a very interesting model which recited the leak being pushed back so far it co coincided with the flu season. There is also a prediction of realistic worse case sensation of 820k excess deaths.
The behavioural science reports are very interesting especially because they can't be data driven (do use statistics is estimating percentage of compliance).
Also we discussed a leaked media report with the use of cocooning and this term is used earlier on. The shielding came from behavioural scientists saying cocooning is basically too twee and isolation/quarantine has negative Connotations.

Reading this against all the fabulous data I've been able to read that's been shared here is really illuminating.

Wonder that's a very valid point re not understanding social distancing. Especially those with autism who seek sensory input and pressure from carers. I think that's why this group are classed as more vulnerable and therefore contacts should be limited.

wonderstuff
That's a valid point and may increase the likelihood of getting CV but not of dying with it. Being a nurse or a bus driver isn't excused as an "underlying condition" even though it makes one more likely to catch CV.

DS isn't shielded or more vulnerable - as in, we haven't had a doctor's letter. He doesn't get a free flu jab (Dh does, but again, no letter...congenital heart disease).

@ShootsFruitAndLeaves

I’ve looked at stats and you’re correct... About 8% over 70 in London compared to 15% of UK - that would make a significant difference to Covid death rates.

I’m not sure I followed on ethnicity. I had thought that people of white ethnicity were less at risk than other BAME groups that are prevalent in London.

I'm not sure if that's true at a regional level.

In general it seems that death risk is related to age, employment, location (Hastings , for example is almost covid-19 free), and health.

Ethnicity is likely not to be a risk factor in itself.

However non-white British people are much younger than white people, so if for example nearly all the jobs involving lots of contact with others are done by non-white British in areas where they are numerous, then that will give those not white British people a higher risk relative to white British people on that area.

However it's largely zero sum in that the same jobs need doing elsewhere, so it's simultaneously possible for ethnic minorities to be more likely to die than white people of the same age, because of their employment, and for the young age of those ethnic minorities to substantially cut the raw death rate.

Because as observed above, the BBC claimes Newham had the highest death rate in the UK, when in fact it was 75th, and it only appears high when you adjust for the lower risk due to age.

Essentially ethnic minorities are LESS likely to die, for certain, as a population, but that's because they are much younger than white British people.

Autism is such a wide group of individuals with individual needs that I think it's quite hard to see it as one homogeneous group in the same way as some other risk groups eg diabetes. Within the group there are certainly people with unique genotypes or phenotypes and other conditions. Behaviour of some people with autism will put them at risk; pica is common and I have taught pupils who lick or taste their environment a lot. Diets can be restricted and some prefer to stay indoors.

Another issue a small number of our pupils have is insomnia which means they can reverse their days and nights in extreme circumstances; sometimes screens make this harder sometimes it's just them and anxiety. Then eating and getting fresh air and exercise can be limited. Obesity and hypermobilty is common in the primary age range I teach and so likely to continue to adulthood. Then, as others have said, the communication barriers and ability to verbalise symptoms and accept treatment is extremely challenging.

At the same time I can think of a large number of very fit and healthy pupils I teach who would certainly be of no more risk than other children and so would become fit and healthy adults who would be of no more risk without age and other factors present.

Over all you'd consider them as a risk group strategically but I imagine it comes down to individual circumstances. A comment in the independent sage group was relevant regarding the fact that Gps haven't been involved in decision making around vulnerable individuals and their input would be valuable.

I'm particularly thinking of some pupils with autism who are never, ever ill too!

Neuro we mentioned before all this how it seemed odd our pupils with severe pica never got ill (well hardly ever!) which doesn't fit in with what we know about transmission of illness.

Could it be that those pupils mask mild illnesses due to hypersensitivity?

Hyposensitivity, maybe? Autism is such a broad spectrum, though. My DS2 has mild asthma, a hatred of going for a walk so probable low vit D but seems perfectly healthy otherwise. I can’t see why he would be particularly vulnerable to Covid.

I received an email from the ONS regarding the misallocation of deaths from 31 March to 29 and 30. This has now been corrected in the ongoing totals files, but they have not updated the original daily files for early April

Sorry that was from the NHS covid team, not the ONS I should say

Well done, Shoots.

Excellent news that they have responded, Shoots
That corrects a nagging data hole
Did they explain exactly how it happened ?

Sorry to slightly derail here, and sorry again if this is common knowledge or my assumptions are wrong. I was wondering if a reason has been given for testing only being available/required for people with COVID symptoms? AFAIK you have to be in a certain group (key worker etc) AND have symptoms, or even where they have opened it up to the wider public you still need to have symptoms.

The infection risk of CV is surely largely down to those spreading it who are asymptomatic. I would have thought a large social change such as sending loads of children back to school would prompt some kind of blanket testing initiative - perhaps in an ideal world all households with returning children, and staff, would be tested a week or so before return, as some sort of baseline? (and ideally, the antibody test as well as the currently-infected test). Do we not have the testing capacity or will? Are the likely infected numbers small enough as to not make it worthwhile?

I realise this raises the question of how regularly you would test but wouldn't even once be useful...?

Not much point testing to see if you have Covid unless you have symptoms. A reliable antibody test to see if you have had Covid would be more useful.

But surely if you have a week or two of being infectious before getting symptoms, and are intending to greatly increase your 'social mixing' by sending members of your household out to mix with others from their households, you'd want to know if you were posing a danger to everyone else? The point would be to stop any asymptomatic transmission, which is kind of the holy grail as i understand it.

It's the asymptomatic-but-infectious time that is mainly causing the spread in the first place and causing this to be such an unprecedented phenomenon?

Having a child who's returning to school - I've seen the schools plan. Its not risk free by any means but I consider it a well balanced approach and the risk of any infection is reduced. Yes its possible but the bubble is small enough so that even if widespread infection within bubble, it won't pose a significant risk.

And i don't see the point of testing people who are asymptomatic. I can see the point in care homes / hospitals but I don't really see the value in a school setting. I would expect a teacher to be clear of CV when returning to school and i imagine they would not have been on the KW rota recently to ensure they are not infected.

I would expect a teacher to be clear of CV when returning to school
Right, so how would you know or expect them to know?
The value would be to stop it spreading to another person or persons who would in turn likely spread it within their households.

I'm not specifically talking about schools here, it's just an example of a planned increase in social activity. Another example might be if you were going to a funeral, you could test all attendees in advance so people didn't need to worry so much about potentially catching it.