Daily numbers, graphs, analysis thread 9

[Barracker]

Welcome to thread 9 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.

Could someone explain to me why we are moving to the next phase when the R is still estimated to be up to 0.9, which I think has been the case for several weeks without a further drop, the chief scientist seems to think we’re in a fragile state and coronavirus infection still ‘significant’ and we have an as yet not fully functional up and running track and trace ? It feels like just waiting a couple of weeks wait here could make a huge difference and save money in the long run. Hoping for an evidence based answer for why the stats are at a point where we can as would be depressing if it were just a case of govt ploughing on regardless.

BigChocFrenzy

I am not sure about your theory that countries that allow children more freedom like this are less worried at the idea of school return, as they are used to judging small necessary risks is quite right.

For me, the key numbers when thinking about how safe it is to return to school is the number of active cases of COVID in the community, and the number of new community infections each day.

This is because each school is part of a community, and that community is linked by a virus transmission through contact that the children have with each other in school (even if there is no physical contact, studies of patterns of infection in restaurants, an open plan office and a choir indicate that sharing the same air for 6 hours in an enclosed classroom is a way of sharing the infecion).

If there are a couple of hundred new cases in the entire country each day (Germany / Denmark), the chances that anyone in the community around a school is carrying the virus is very small, and therefore the theoretical risk of virus transfer within the school is fine - there is no virus to transfer.

In England at the moment, from the random sampling, 1 in 400 people are currently carrying the virus, and there are multiple thousands of new cases per day. It is therefore statistically very likely that there is someone carrying the COVID virus in the immediate community of pretty much every school returning on Monday, and therefore the risk of virus transfer from that person to someone else in the community (who may be more vulnerable) via school children (who may well be asymptomatic).

That is why I am nervous. The risk of serious illness and death for the children is miniscule. The risk of serious illness and death for teachers is dependent on their ag , but is something of a concern due to the the 'shared classroom air' issue meaning a long period of exposure, no PPE and no social distancing within each bubble. However my main concern is for those who are vulnerable in the community around the school.

Hoping for an evidence based answer for why the stats are at a point where we can as would be depressing if it were just a case of govt ploughing on regardless.

I am not sure that an evidence-based answer is possible. My understanding is that we are doing this 'despite' and not 'because of' the R data.

I dont trust it at all to be honest. I think the track and trace will fail and they will have swapped it for the hospital testing so we wont get any kinds of numbers to work with at all. The deaths and cases will swept under the carpet and only the data from ONS will show anything, but they will switch to relying on their own 'tested positive' figures rather than including the ONS

The goalposts will be moved so as to justify what they are doing.

Exactly. The '5 tests' that have been 'met' are not the same as the 5 tests originally announced, as a starting point. In particular, Boris's original 5th test was for R to not go over 1. It has been replaced by 'there not being a second wave that will overwhelm the NHS' As the NHS, despite all, was not overwhelmed even at the peak - though frighteningly overstretched, the 5th test as now stated only means that the second peak should be no bigger than the first, whereas keeping R below 1 meant that there wouldn't be a second peak at all....

It was Raab who initially announced the 5 tests when Boris was ill. The first day it was announced ( I think the 17th) it didn't say on the slide about overwhelming the NHS. I remember looking at the slide and thinking that we'd have to lockdown forever, because how can you ever know that numbers won't go up. However, in news reports on the day, the part about overwhelming the NHS was included. I've tried to find a non Tory, non DM source:

www.birminghammail.co.uk/news/midlands-news/government-names-five-tests-must-18103479

On the 28th they added the caveat to the actual slides. Whether it's the right caveat is up for debate but there had to be some qualifying comment, it was too open the day before.

I don't think the R has been on the slide, however the aim to keep it below 1 has been clearly stated repeatedly.

cantkeepaway The general public level of anxiety about children and risk has for many years seemed lower to me in Germany,
e.g. being expected to make their own way to school from age 6, playing outside

Helicopter parenting is much rarer

When schools first opened here, infections were around 1,000+ and deaths 100-200

Then when the R0 officially went above 1.0 for a few days, this received more publicity and angst in the UK than in Germany

Lockdown was a necessary pause button for a "Novel" Coronavirus:

to build up testing and contact tracing systems
to find out more how to treat COVID
to determine which groups were at risk, especially risks to children

However, it is now difficult to justify continuing when children and adults under 45 are at such low risk
and will be paying heavily for the educational / career and economic consequences

The UK has the advantage of observing other European countries who started relaxing lockdown 3-4 weeks ago,
reopening schools and shops without significant problems
The UK can see what systems were used, how they worked

If the UK can't follow soon, the government should have some very serious questions to answer about why it is not in a fit state to do so.

The 5 tests announced by Boris on 10th May in his TV address (copied and pasted from gov.uk) were:

"1. We must protect our NHS.

1. We must see sustained falls in the death rate.

1. We must see sustained and considerable falls in the rate of infection.

1. We must sort out our challenges in getting enough PPE to the people who need it, and yes, it is a global problem but we must fix it.

1. And last, we must make sure that any measures we take do not force the reproduction rate of the disease - the R - back up over one, so that we have the kind of exponential growth we were facing a few weeks ago"

reopening schools and shops without significant problems
The UK can see what systems were used, how they worked

If we were re-opening schools at the same point in terms of community infection, in the same way and with the same resources (half empty schools, masks, older children, sinks in playgrounds etc) as other countries have done, then as a teacher I would feel a lot more confident.

It is the fact we are NOT reopening schools in the same way and with the same precautions as these other countries that I am concerned about.

As far as I can see, there is no European country that has re-opened its schools at 7000 new cases per day, and none that has done so in any greater way than some partial opening to small groups from some year groups.

This is really interesting thank you. I thought I was going mad about them changing the goalposts and tests because I was sure it had been changed but I can’t work out why the media aren’t picking up on this (although I guess they’ve been told not to?)

It seems to me that the R rate and a second wave are intrinsically linked. If R stays below 1 there cannot be a second wave as I see it as infection numbers will continue to decrease. If there is a second wave (ie another period of exponential growth) the R value must have climbed above 1. I’m not sure that they are two different points, rather the same point expressed in 2 ways.

That’s my understanding in any event. Happy to be corrected if I have misunderstood.

Sunshine, i think it is the caveat 'will not risk a second peak of infections that overwhelms the NHS' that is the issue.

Had it stopped after 'second peak of infections' I agree with you.

The current wording allows R above 1, and in fact allows a second peak as high or higher than the first, just as long as this doesn't overwhelm the NHS.

But any sustained period of exponential growth will overwhelm the NHS. Localised outbreaks (with the overall R value remaining below 1) are manageable.

Patrick Vallance was very clear in the briefing yesterday that R needed to remain below 1.

Yes, but that is different from Boris saying that he will postpone the next stage in loosening the lockdown because the risk of going above 1 is too high so the last test is not met.

Because they have made the decision (rightly or wrongly) that the measures they plan to take will not push the R value above 1 thus causing exponential growth leading to a second peak that overwhelms the NHS.

Personally I would have separated the measures out a bit. I think the risk now is that if there is a significant uptick in cases that is sufficient to be concerning it will be difficult to work out if one measure in particular is responsible for that uptick or if it’s the combination. Hopefully it won’t be an issue, we shall see.

I just think that in fact they are not convinced R won't go over 1, and know that it will in some cases. However, they will have 'won' by opening schools on the 1st, and will be able to present the schools and local authorities who don't open or have to re-close due to local rises in R or outbreaks as 'the bad guys'

Does anyone know how busy and overworked/exhausted frontline NHS workers are atm? It has gone quiet on this front atm and presumably if they are still working under extreme pressure, this won’t be sustainable over the coming months as there will be further peaks as people try going back to a new kind of normal.

As in 'we opened the schools for you....but the LA / individual schools are closing them'. I think they will very cleverly avoid any 'centralised' announcement of closures or re-tightening of lockdown and will treat and discuss those as strictly local matters - 'someone else's fault / decision'

There will be some localised closures every now and then, that is to be expected. If all we end up getting are fairly infrequent localised closures then test and trace will be working as expected and the overall R value should be suppressed.

Sunshine, at the moment there is, on average, 1 person currently carrying Covid in every 400 according to randomised testing. I am not convinced that closures will be 'infrequent'!

Hence my use of the word “if”.

@Reastie

Does anyone know how busy and overworked/exhausted frontline NHS workers are atm? It has gone quiet on this front atm and presumably if they are still working under extreme pressure, this won’t be sustainable over the coming months as there will be further peaks as people try going back to a new kind of normal.

I can only comment on London frontline services. The hospitals went quiet some weeks ago. ITUs are much quieter and mostly back to below pre covid levels. All our redeployed staff are back in their normal jobs, they are busy as we need to catch up with backlog, cancer surgery, chemo etc, not to even get started on non urgent elective surgery. The number of patients being admitted with covid is tiny.

Does anyone know how busy and overworked/exhausted frontline NHS workers

Quiet in Yorkshire too, something like 850 empty beds in the local large hospital trust. The challenge is safely opening routine services. GPs are busier now, so hopefully people are starting to get more help for non-COVID issues.