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.

Thanks @ShootsFruitAndLeaves Impressed that you get this done so quickly.

Are you able to do the excess deaths by age that you did last week? I found it really helpful in assessing relative risk.

Interesting articles about R0:

www.ncbi.nlm.nih.gov/pmc/articles/PMC3935673/

wwwnc.cdc.gov/eid/article/25/1/17-1901_article

Given that 2017/18 was within the last five years (the range used for comparisons) presumably it is factored into the normal/average with which current deaths are being compared. So “normal”, as an average and range, includes a suitable reflection of that bad flu year, and spring 2020 shows considerable excess even over that?

*Considerable excess over that - even after lockdown.

Puzzled That attitude is comparable to
"I took antibiotics for my infection and it cleared up, so I had no need to take antibiotics"

Those 50,000 flu deaths happened over several months - without lockdown
There have been over 50,000 "excess deaths" within a few weeks with lockdown

The UK locked down when Whitty, Valance & co looked at Italy and realised the UK was following their curves,
so their previous strategy of herd immunity could mena carnage

Whitty calculated a "reasonable worst case" of ½ million deaths from COVID
His figures were 80% being infected and death rate of up to 1%

No responsible government could gamble that their CMO's "reasonable worst case" wouldn't happen

Now doctors know more about treating COVID, the health service has been built up;
hopefully mass testing and contact tracing will be too

Cases are coming down - so we can look at ending lockdown once the 5 requirements are satisfied

Thanks, BIgChoc - that makes sense (and is why I asked if I was missing anything, knowing many understand more of this than I do!!)

Puzzled I'm a centrist and no particular fan of Boris and his govt
but imo with lockdown they did the bravest thing any UK govt has done post-war,
particularly since the necessary actions & subsidies went completely against their political ideology

The execution of strategy has sometimes been very incompetent and delayed,
but they made the moral decision to put saving a potentially huge number of lives above the economy.

Am I missing something here? Because the obvious question is why current excess deaths are causing such a disproportionate panic if they've been as bad or worse in past years

I discussed this in earlier threads, but essentially winter deaths occur in the 70+ age group with very little excess death in the under 60 group vs. summer.

Covid-19 causes excess deaths in the 40-60 age group which don't occur in normal times. These are 3,000 or 4,000 people, mostly men, which isn't that many compared to male suicide in the same age group, but it's still significant extra mortality which is NOT expected.

Plus of course now we are in effectively the 'winter deaths' phase of this, where those dying are now VERY old, but we're obsessing about the numbers so the thousands of very old people now dying will be given attention they don't normally get because of the earlier deaths of a slightly younger age group.

Note that the attached graph is slightly misleading in that care home deaths were being mostly not counted in earlier weeks (an issue with early covid-19/ethnicity studies), so the average age of death was probably a year later in previous weeks

the thousands of very old people now dying will be given attention they don't normally get because of the earlier deaths of a slightly younger age group

Another very valid point among many - thanks, Shoots

Now 70% of excess care home deaths are identified as covid-19.

The early weeks were presumably total bollocks.

Shoots imo, there are 2 scenarios we need to separate when talking about impact / concerns and comparisons to a flu epidemic:

1. Our current scenario, which is with lockdown
   Those 3,000 - 4,000 extra deaths are with lockdown aren't they, or have I misunderstood ?

2. Whitty's reasonable worst case, which is what caused the government to lockdown,
   where the vast majority of deaths would have been aged 80+ but maybe10% would be the under 65s

Those who keep asking why we locked down when the deaths - so far - are not much worse than the worst recent flu year
keep ignoring that the government actions were taken to avoid 2) and achieved 1)

Callous as it may sound, 1) is an "acceptable" result in the circumstances

I misspoke a little. Only 2500 deaths under 60 in E&W, 4000 under 65.

The first number especially will be quite accurate.

For comparison, the working age death rate from covid-19 is currently 10.9 per 100,000, which is slightly higher than the annual agriculture death rate of 8.2 100,000

i.e. the death rate from bulls, tractors, etc.

and suicide among farmers is sadly very high compared to other groups

Indicates how the government, who have known of this virus the longest, regard it as a danger:

zeynep tufekcii@zeynep*

They found six new cases in Wuhan so they’re planning to test eleven million people over the next ten days.
Neither number is a typo.

https://www.reuters.com/article/us-health-coronavirus-china-wuhan-idUSKBN22N24F

@shootsFruitandleaves

I'm confused - in 2018/19 there were 39 agricultural deaths, over half of these were over 60 and two were children (aged 3), what working age are you using?

@whatsnext2

www.hse.gov.uk/agriculture/pdf/agriculture-fatal-injuries-1718.pdf

yes, it does seem that half the agriculture deaths were in fact over 65.

I am using a working age of 65, which is the standard for these purposes. It does seem these statistics might be misleading.

re Ghana "superspreader" who reportedly infected 533 people at his factory:

Maia Majumder, PhD@maiamajumder (Harvard Med faculty)

Regarding the apparent superspreading event of #COVID19 in Ghana, I wanted to resurface this infographic.

Even if one person infects 533 other people,
R0 can still (for example) be 2 so long as 265 other people infect no one else.

Why? Because R0 is a population average.
.........
An R0 of 2 doesn't necessarily mean that every case will infect 2 other people.

In fact, here are 3 (non-exhaustive) scenarios in which R0 = 2.

Just trying to make sense of the care homes data

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

It is quite a poor quality piece of work:

the data is by date of report to CQC, yet alternative data sources are by date of death and/or death certificate, so none of the dates match up.

What it does show is that for the latest week, to 8 May by report date, the total of deaths in care homes minus those with covid-19 was 2,000, which is below the England average around 2300. The week to 17 April had 3500 deaths by the same measure, and the week to 10 April would have been even higher, but the report doesn't start till 11-17 April, so it's a bit shit tbh.

It's also not possible to see what the normal number of deaths of care home residents by place of death (i.e. WHERE they are dying as in hospital vs care home - the ONS weekly death stats only cover the place of death, not the place of residence)

What IS however apparent is that the care homes appear to be achieving herd immunity, in that the deaths for week of report to 8 May are way below the deaths by week of occurrence in the latest ONS release, at 3500 by CQC week of report to 8 May vs 6100 by week of occurrence to 1May.

This 3500 is bollocks in that we had VE Day on Friday, so there are straightforwardly 400 deaths missing from the data for the sole reason of the bank holiday, however even so it's 20% down on the previous week.

So there can't be too many care home residents left to catch covid-19. Antibody tests would be interesting.

Breakdown of the ONS excess deaths by age and sex.

twitter.com/VictimOfMaths/status/1260127745864019968

Being male is riskier the younger you are, interestingly. Frailty and co-morbidities overtake sex differences as you age?

"So there can't be too many care home residents left to catch covid-19"

iirc there are 400,000 in care homes

Assuming even in care homes that over 90% recover from COVID,
we could multiply the number of care home deaths by 10 to get a v rough number of those infected - who had symptoms

A minority even among the very elderly may have no symptoms, or none that anyone noticed

So ==> is there a significant amount of herd immunity there now ?

There are now more deaths in women over 85 than men- 6,780 deaths cf 6,434- BUT not as many more as you would expect bearing in mind there are proportionately many more women in that age range. According to England and Wales population projections there are 939,000 females compared with 564,000 males.

I believe that one figure quoted for herd immunity for Covid was 70%. However this was based on numbers needed to be vaccinated to obtain even resistance throughout the population. I’ve seen some research that suggested that the percentage needed for herd immunity when immunity developed by disease was less as there is more resistance in pockets where exposure to infection more likely.

Being male is riskier the younger you are, interestingly. Frailty and co-morbidities overtake sex differences as you age?

No.

Does that bloke really do this for a living?

The left side and the right side of the graph are not the same. The 85+ age group is mostly women. You need to normalise by the size of the population.

Also there are covid-19 deaths in the younger age groups but negative excess deaths - excess deaths are not the right measure here. Up to 60 use covid-19 deaths, over 60 use excess deaths.

Note that the younger age group is very noisy - if you consider for example the 59 deaths of women aged 40-44, then that is going to be +-25% just because of the nature of the small number of deaths, so it would be wrong to interpret a certain difference as conclusive evidence of some structural sex difference in that age gap.

However as you go up 50+ then the numbers will become much more certain in terms of the size of the risk.

Note that it's quite unlikely that there is a strict exponential relationship between age and death count, in that while the risk by infection will indeed grow exponentially, there will be structural, job, leisure differences between populations that might make, for example ,the 65-69 age group much less at risk relative to the 60-64 age group than the 70-74 age group is relative to the 65-69. Especially if you consider that all the 'clap for the NHS' stuff is likely misguided, and the real risk is people working in certain relatively low-status jobs, who, I'm assuming, retire at 65 or earlier (accountants and lawyers are at very low risk, minicab drivers very high risk, bus drivers high risk).