Daily numbers, graphs, analysis thread 9

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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.

Oralengineer Carl Heneghan has an agenda here:

he has been prominently against lockdown, with articles in newspapers
and has declared that lockdown is worse than the virus

I also think it's time the UK left lockdown,
but imo he is twisting the statistics to affect political decisions, which as a fellow scientist I find disgraceful

Excess deaths isn't perfect, but public health officials in most countries - and UK govt ministers - agree that it is the best measure of comparison we have.

I can't read the 2nd set of graphs (visual disability and zoom distorts a poor quality graphic)

However, COVID excess deaths are March-May, which should not be a period affected much by a bad winter
2020 winter was lower than average, so carrying forward the "minus" would reduce the later excess deaths, but is not relevant as a measure for the COVID period

Also, when comparing with an average of several data points, a freak high or low data point cannot be used for a fair comparison

The Covid spike (the bit of the virus that attaches to our cells) shares a third of its biochemical structure with the common cold. This may be significant with T cell immunity particularly in the age groups that seem to have low infection rate. Children have far more daily social contacts than any other age group particularly with regard to the common cold. They probably have far more active memory T cells capable of cross reactivity than older age groups.

I strongly advocate relaxing lockdown in stages, due to economic necessity and the effect on the young,
but I don't hide the fact that this may cause some extra deaths

We should be honest about this
Politicans spin; scientists should NOT

I find it infuriating when those whose aims I approve of in this, resort to minimising of the excess deaths that have occurred,
or claim they were almost all those who would have died within a few months anyway.

BigChoc in the same way that comparing data of excess deaths in April-May 2020 with other years is bad science. We cannot look at excess deaths until we have a full years data. A big negative drop later this year and into the winter season will further skew the figures.
There will be a much bigger increase in non covid excess deaths if we don’t return to normal health service.
If you put 25 scientists together (SAGE) you will always get 25 opinions. We are talking about individuals who are in the top 1% of the country re intelligence and not known for their ability to quietly agree. The ability to think laterally and analytically doesn’t work well in committees.

"Covid was behaving far more like a late seasonal flu"

I strongly disagree with the whole "bad flu" approach, because the diseases are too different

A big reason for the inadequate government response to COVID in the UK - and most Western countries - is that their existing pandemic plans were based on a bad flu.

Countries with previous experience of SARS epidemics did much better than Western countries.

The UK's earlier pandemic planning included a short section on SARS-type viruses,
but this was reduced in later versions and then completely removed.

However the strategy for SARS-type viruses needed to be different:

• infected people are infectious for days before symptoms
  This changes everything

• care homes in particular needed to be protected more effectively - and differently - to a flu epidemic

• the fatality rate of COVID is much higher than flu
  Yes, I know when we look at the estimated cases it drops to about 0.4 %,
  but then we look at the fatality rate for flu in the same way, the fatality rate has been calculated by scientists in the field at 0.044%

• The % of patients requiring hospitalisation - in particular ICU - is much higher for COVID

• Doctors know how to treat bad flu, but didn't have meds for COVID and had to learn about O2

• the flu pandemic strategy was to ride it out a few months until a flu vaccine could be tweaked
  This doesn't work when it is likely to be at least 18 months before a vaccine

• this long period without a vaccine is why PPE became a problem and stocks were so inadequate

• mass testing & contact tracing is needed for COVID, but the systems for this were not in place, because they are not normally used in flu epidemics

Hi, I've lurked and occasionally posted since the beginning ... amazed by the brain power analysing what's going on, and helping those of us who are keen by not quite as able, to understand!
I've come across this app on Twitter, can you have a look and tell me how scientifically based this is? Is it a good way of tracking safety issues locally with the r? app.deckzero.com/deck/UK-Local-R-value-Tracker-MTM4MjE2NjgyMTk

Oh Lord , yes, BCF, and you see this repeated on various threads here. It's a basic (wilful) misunderstanding of 'underlying health conditions'.

OralEngineer I agree we will know more in a year or two.
However, we need to use the data we have and not invent data we don't

The excess deaths are deaths that have actually occurred

We will only get a big negative later in the year if those deaths were mostly of people who would have died anyway within the year

Several of us have already discussed on these threads why we think that is not so
Many of the dead had several years normal life expectancy

I am firmly in the camp of ending lockdown, restarting schools and the economy,
but totally against the minimisation of COVID deaths.
That is politics, not science - we need to keep the two separate

I have no problem explaining that economic depression causes deaths over several years and can damage the careers of a generation

However, we must recognise that deaths spread out over years have far less impact than crammed into 3 months
Indeed, we have seen that the deaths from several years austerity have hardly been noticed.

Other European countries that started schools back 4 weeks ago and now have all shops, hairdressers, gyms etc open
have not seen significant rises in cases

In fact cases and deaths have continued to decline

That is far more relevant - and much better justifiction - for relaxing lockdown than trying to minimise 60,000 excess deaths in the UK

@BigChocFrenzy

Would be interested to know where you get the 0.4%.... had thought it was more like double that.

Derby The 0.4% is the lowest number I've seen from reputable scientists, e.g. Streeck of Bonn Uni, estimating the real number of cases, including asymptotic

(Streeck always opposed lockdown, but although he has been criticised for getting into politics, imo his science remains sound)

If we just look at the confirmed cases, then it's about 1%

As with flu, the real number of cases is a very fuzzy estimate

However, all the evidence is that COVID has at least 10 x the fatality rate of flu

@BigChocFrenzy

Completely agree with your 10:19 post. The countries that are furthest ahead with re-opening are generally the ones who have treated Covid more seriously and earlier. Those that dragged their feet or were half-hearted are lagging behind.

The irony is that the more Covid-minimisers are able to persuade people that the threat of Covid is exaggerated, the more people will engage in activity that will cause it to spread, and the longer our economy and our freedoms will be constrained - the very thing they want to end!

Even if the UK population collectively agreed and said “screw social distancing, let’s just get back completely to normal and embrace herd immunity”, we’d destroy ourselves economically in the process as we dealt with 100,000s of deaths and being a disease-ridden world pariah who no one would want to do business with...

BugChocFrenzy
We have (Berlin) reopened some things but with restrictions. (Our neighbour used to run a small pup with live music. He is out of work, the musicians are, too.)
Wearing a 'nose and mouth covering' of some description to reduce risk (not eliminate it) is compulsory and as far as I can see people follow this rule. I travel to and from work by underground and about 99% wear masks and avoid being close together. My hairdresser, physio, dentist are open and working. Schools (DS is in year 11) are back with reduced hours and hygiene plans. They made sure the exams took place. Pups may open to a percentage of their capacity only - which usually means if they can move outside they will.
Libraries are opening up again in a more old fashioned manner (you ask for the book you need and they get it for you - Grimm Zentrum).
DD's uni course ist still completely online.

Using statistics at this stage of the pandemic to lay the blame for excess deaths firmly at the feet of politicians is politicising your argument.
I don’t seek to minimise excess deaths but having actually lived in the UK throughout this pandemic we are not all running around in major panic mode. Deaths are spread evenly through the country it does not feel like a country hit by a tidal wave unless you are in London. The medics are not happy at the lifting of lockdown because they fear a second wave. Behaviour is not that of a population in fear of their lives, we know the risks but the fear of job loss and economic failure is now a greater risk than death. We can’t go on living like this forever.
If you want to blame the government, blame them for being too polite and accommodating in their requests to lockdown and not locking us down Wuhan style.

@BigChocFrenzy re your 10.13 post.
What the T cell research shows is how little accurate data we have. If people have gotten over Sars2 using innate T cell or igA antibodies these are localised so won’t show up in blood tests like the igM or igG antibodies. As they have gotten over the virus Pcr tests won’t test positive either. IgA antibodies specific for SARS 2 were inversely correlated with age. This means there could be a large section of the younger Population that has a level of immunity that we don’t know about. As they are less vulnerable they would not show up in hospital admissions or deaths except as inflammatory over reaction or cytokine storms.

Prokup I'm in Hessen, right on the Rhine bank, retired so can choose my risk
I choose the gym and hairdresser (!) but haven't been inside a supermarket since mid-march
Both are very strict on hygiene measures

Restaurants are open outside, but I still only collect takeaway - masks are mandatory for that
Even my tiny local outdoor farmer's shop requires her customers to queue with masks and spaces
I don't know if the masks are legal requirments or just to protect staff / owners

Social distancing is pretty good here, nearly everyone - except some teens ! - holding conversations outside at 2-3m distance,
walking, sitting on benches, picnicking, sunbathing all with SD

Whatsnext We already knew that the young are at v v low risk from COVID, which is reflected in their low number of hospital admissions and deaths.

We now need population sampling with blood tests that include innate T cell and igA antibodies, to get a better idea of immunity levels.

However, whatever theories or estimates are produced, whatever R0 numbers,
I'm sure that most countries e.g. Germany won't be locking down again unless there is nationwide exponential growth.
The R0 rising above 1.0 again recently has had no political impact here and is not concerning.

Lockdown was a temporary pause button that gave us time:

to find out about a novel Coronavirus - who is vulnerable, how better to treat them
to put in place mass testing and contact tracing systems
to build up the health system - already massive spare capacity in Germany

@BigChocFrenzy
Agree about more wider test parameters. In the UK an awful lot seems to be based on R numbers, in the media anyway.

oralengineer It's not politics to criticise serious mistakes that have caused thousands of extra deaths

Protecting the reputation of any government should have no place in examining mass deaths in a disaster
We need to learn lessons, to avoid a repeat in any 2nd wave, or indeed a future Epidemic X.

The UK is regarded internationally, by those of all or no political persuasion, as having blundered worse than almost all other countries

The UK had the advantages of observing other European countries at a more advanced stage of the epidemic
and also being an island with far fewer means of ingress

The key factor in deaths and number of cases - which also affects the length of lockdown and economic damage -
is when each government chose lockdown

If the UK had locked down 7-10 days earlier, then the deaths would be a fraction of what they are
If Germany had locked down 7-10 days later, then deaths would have been multiples of what they are now (and Merkel would be hammered)

There have been several calculations and graphs showing this.

The other dreadful decision was deliberately discharging infected elderly people into care homes,
sometimes strongarming the management to accept them

The government is having problems getting people back to school & work now, because they originally chose to use fear to impose lockdown

Other countries chose to explain the facts & seriousness to their people, without terrifying them
e.g. Merkel "this is serious, take it seriously" was very calm, clear and factual

Trust in competence and the belief that "we are all in it together" are important in leaving lockdown.

BigChocFrenzy If the UK had locked down 7-10 days earlier, then the deaths would be a fraction of what they are. If Germany had locked down 7-10 days later, then deaths would have been multiples of what they are now (and Merkel would be hammered)

There have been several calculations and graphs showing this.

The other dreadful decision was deliberately discharging infected elderly people into care homes, sometimes strong arming the management to accept them

Absolutely this. And now opening up too soon and too quickly risks making the situation even worse

Some of the UK's problems arise from previous decades of centralisation of labs and public health staff,
supposedly for efficiency and cost savings

This must be reversed, because we can expect future pandemics, epecially arising from misuse of animals / bad hygeine practices.

Even 10 years ago, the Uk had 10,000 environmental health staff based at nearly 350 local council offices.

Big mistake, after transfering all this public health function to Public Health England,
was to savagely cut this capability to 226 staff operating out of 9 offices.

This left almost no capacity for contact tracing and removed some options from govt in this emergency, e.g.

https://www.telegraph.co.uk/news/2020/05/30/revealed-test-trace-abandoned-system-could-cope-five-coronavirus/?lisource=LI&lii_medium=li-recommendation-widget

Newly-released papers from the Scientific Advisory Group on Emergenciess shows routine testing and tracingg of contacts was stopped because Public Health England’s systems were struggling to deal with a handful of cases.

At a meeting on Feb 18, advisors said PHE could only cope with testing and tracing contacts of five Covid-19 cases a^ week,^
with modelling suggesting it might only be possible to increase this to 50 cases

On the subject of Germany this seems interesting
www.theguardian.com/world/2020/may/31/covid-19-expert-karl-friston-germany-may-have-more-immunological-dark-matter
'We’ve been comparing the UK and Germany to try to explain the comparatively low fatality rates in Germany. The answers are sometimes counterintuitive. For example, it looks as if the low German fatality rate is not due to their superior testing capacity, but rather to the fact that the average German is less likely to get infected and die than the average Brit. Why? There are various possible explanations, but one that looks increasingly likely is that Germany has more immunological “dark matter” – people who are impervious to infection, perhaps because they are geographically isolated or have some kind of natural resistance'

makes me wonder if the UK's bad situation is in no small part due to poor underlying health and that this country functions as a central hub in a way that other countries don't 🤔

meercat Unfortunately, the UK has little time left before economic necessity forces it to take the risk
Also, morally imo, the Uk cannot continue to disadvantage the young,
even though the govt has cocked up protecting the mostly old and seriously vulnerable.

My disagreement with some posters is not on when / whether the UK should reopen,
but in minimising the COVID deaths to try to persuade people.
It is probably counter-productive anyway, makes many people even more suspicious

There may be some extra deaths, but imo the risk is acceptable in the face of the certainty of further economic damage.

"the low German fatality rate is not due to their superior testing capacity"

Well, mass testing does find more of the milder cases
However, "dark matter" sounds rather woo - or another excuse - and we can look at known differences Germany / UK:

• health rationing has never been a part of the German health system and wasn't for COVID either

• big differences in the emphasis on early treatment in Germany:

Monitoring mild cases, regularly checking for changes in symptoms or deterioration

Home visits - the "Coronataxis" - with health teams in spacesuits, for cases where people are in bed
They test Blood O2, BP, heart etc
This results in those not realising they have e.g. low O2, being admitted early to hospital

Hospital doctors here in articles and on TV stressing how important early admission is, so they can treat with oxygen to often avoid significant deteriroation
Contrast that to much "iller" UK patients by the time they end up in hospital

Also, with no health rationing here, people with health conditions would be fully medicated / operated on,
so those conditions would be as well controlled as possible.