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.

More or less on R4 a few weeks ago said they project via hospital admissions and mobility (or similar.)

So that's probably an area we need to watch more closely. They knew the massive peak was coming 3 weeks before it did. Though also, it's possible treatment is getting better.

Can I add some anecdotal evidence for you all to mull over.

It seems that treatment paths have changed since March, with fewer people being ventilated. More are now being treated with C-PAP or tracheotomy and so spend much less time in ICU (more in CCU). So watching ICU numbers isn't a fair representation of numbers in hospital any more. Also, watching "spare ICU capacity" isn't accurate, as hospitals are turning ordinary wards into ICU and vice versa - capacity is changing all the time.

Secondly, people are spending less time in hospital - either before getting better or, sadly, dying. It's becoming clearer which patients aren't surviving, so patients being ventilated for weeks and weeks at a time is less common.

So the only accurate way of assessing this is by deaths. I think it's maybe time to separate out the care home and community/hospital deaths again. Care home deaths must, surely, be reducing purely due to the fact that in most homes many of the vulnerable have already died; those who remain may be immune/have had it/be strong enough to survive it.

Closely watching hospital admissions (all, not just ICU) and deaths outside care homes will give an indication of how much virus is in the community, and as this doesn't seem to be going down as quickly as in other European countries, and as lockdown is being reduced more quickly than in other countries, I think it will be a while before we know whether the UK is "winning" this.

Just thoughts from a London ICU nurse, not facts, sorry!

Interesting Newaccount .There was a great graph that compared location of death over time. It was shown in the daily briefings- but I can't find an up-to-date version. Has anyone seen it?

I've found May 1st but not since then

Re Risk factors: age risk: alongside the increasing likelihood of co-morbities, the reduced efficiency of the immune system (especially T cell production), there is also evidence now that adipose fat may have a role too, especially visceral, which may well influence the sex difference too. Genetics, epigenetics and behaviour (which can be linked) are all big factors too for example:
www.medrxiv.org/content/10.1101/2020.06.03.20120998v1

Those graphs make sense, cathy, later ones would be great to see. If deaths in hospital are still going down, that (presumably) means community spread is reducing).

It would be interesting to know when/if they stopped transferring people from care homes to hospital. Anecdotally that was early on - few care home residents died in hospital in the early days of the pandemic, they died in the homes - and indeed it seems many were actually transferred from hospital to home to die

In theory, more patients should be transferred to hospital for treatment now that the "bulge" is over; hospitals should have more space. I wonder if that is happening?

In Ireland, patients are, and always have been, transferred from care homes to hospital for treatment if necessary (not intubation, but other treatment), and many are surviving.

This a chart from the ONS data, shown on 2nd June briefing.

www.theguardian.com/world/2020/jun/03/covid-19-surgisphere-who-world-health-organization-hydroxychloroquine

I started a thread about this but the title is a bit vague so thought I would add it in here as this is data related.

Apologies if it has been covered elsewhere but would appreciate the opinions of the statistically minded. It's making me wonder if there can ever be a non-biased or agenda free analysis of this virus and its treatment.

Wow, how bizarre.

Peer reviewed as well.

That's embarrassing for The Lancet.

Maybe I'm naive but that Guardian article was jaw-dropping to me.

"Ellis, the chief data scientist of Nous Group, said it was unclear why Desai made such bold claims about his products given how likely it was that the global research community would scrutinise them."

Yes... but why the feck didn't the Lancet or the peer reviewers scrutinise them, like they are supposed to?

That's not a surprise. A lot of studies are being hurriedly published without peer review. It's good that despite the apparent charlatans behind this, and the glee at Trump being wrong, that this egregious issue has been spotted

It's good that despite the apparent charlatans behind this, and the glee at Trump being wrong, that this egregious issue has been spotted

^it irks me when people suggest that 'science' and 'scientists' are any more apolitical than any other part of society.

I'm becoming cynical about "peer-review" nowadays. Although I would expect better from the Lancet, it seems to me that there is no reviewing of the "peers" who are doing the reviewing in many smaller scientific journals.

The weekly PHE surveillance data has been published

www.gov.uk/government/news/weekly-covid-19-surveillance-report-published

It irks me when people suggest that 'science' and 'scientists' are any more apolitical than any other part of society

I think they are but they don't have to be. There are lots of fields where this is true. Obviously if you (to use a real example) take two psychologists specialising in sexuality, one of whom is an older Christian, and the other a BDSM afficionado, then it's likely their existing prejudices or cultural contexts will colour their beliefs. For example in societies where homosexuality was almost universally condemned, your expect that to colour any work.

So you do have to look at WHO is doing the work.

There is an interesting feature here, and that is that conservative people will NOT work in fields like psychology in countries where there is a liberal perspective, because they are likely to have colleagues regard their views as offensive. Clearly if you were in the US and had conservative views you could find a right-wing university and be happy. But I doubt such a faculty exists in the UK.

The corollary is that if you are conservative then you are disproportionately likely to be in harder sciences, since your views are unwelcome in many places.

So I would expect drug studies in general to be towards the more conservative side in terms of the politics of those employed, but of course that doesn't preclude specific people with agendas from perhaps doing things like this.

Off topic though really

North east and north west both have the highest infection rate and death rates.

Hospital admissions appear to have stabilised over all though.

Lancet did subsequently offer expression of concern:

www.thelancet.com/journals/lanpub/article/PIIS0140-6736(20)31290-3/fulltext?utm_campaign=lancet&utm_source=twitter&utm_medium=social

The antibody levels seem to have upped a bit (now at an average of 8.5%) still miles away from herd immunity levels but still nudging up.

The change to Pillars 1 or 2 is noticeable.

When the Pillars were first described they were defined as:
‘Pillar 1’ : Scaling up NHS swab testing for those with a medical need and, where possible, the most critical key workers
‘Pillar 2’: Mass-swab testing for critical key workers in the NHS, social care and other sectors.

Now they are:
Pillar 1: swab testing in Public Health England (PHE) labs and NHS hospitals for those with a clinical need, and health and care workers
Pillar 2: swab testing for the wider population, as set out in government guidance.

So does that mean that health and care staff have moved from being in Pillar 1 and 2 to just Pillar 2?

i've confused myself there

Has anyone who has the COVID app had a message to say "you can help to stop a hot spot in your area..."

Just wondering if they're putting that our nation wide or just my area

I just got it! I’m in the South East.

What do you have to do? I notice that the number of cases according to the app has gone down, which is encouraging.

Is there any actual evidence behind headlines saying it is unlikely there is a second way?

Or of that Italian doctor saying the virus is now "clinically non existent" in Italy?

second WAVE