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.

Thanks for this thread. Long time lurker. Information on here has massively helped reduce my anxiety.

BigChoc just a note on the ICU admission stats, it's noted that age (80+) and dementia (which is surely a proxy for age 80+) predict NOT being admitted to ICU. Presumably this was partly a rationing issue at some point, given that death rates were

Thanks @Barracker. Love these threads.

Shoots thanks for that. Very good explanation. I've been trying explain that some of our deaths now could also include those infected before lockdown but no where near as succinctly as you!

Rationing is an incorrect term. There have been plenty of ICU beds throughout but careful patient assessment based on years of ICU experience and statistics guides the medics on how best to treat individual patients. It’s not a case of put everyone on a ventilator and hope for the best. There was a very good documentary on BBC2 “Hospital” following ICU in the first week of lockdown which is distressing but essential watching to see the human aspect of the ICU statistics.

Rationing might not be the correct term, but there seems to be an unconscious bias against treating the oldest, as seen in their higher survival rates relative to the younger group, both in pneumonia, and covid-19. Some of this might come from the patients themselves, as the older might be more mentally prepared to die.

Thanks for the new thread Barracker.

Thank you for the new thread

Outcome for any organ support Table 12 shows poor outcome for any renal support. Significantly more deaths than in viral pneumonia. This may be a factor in protocol for admission of 80+ into ICU. Covid does appear to create a more aggressive multi organ complication than other viral pneumonias.

"Rationing is an incorrect term"

There certainly was "rationing" of hospital admission in some regions for all patients before Easter
Not exactly "Careful patient assessment" there, just artificially keeping the number of admissions down - likely resulting in a higher death rate at that time:

https://www.bbc.com/news/health-52317781

"Some seriously-ill Covid-19 patients in London may not have been taken to hospital by ambulance because of a system temporarily used to assess people, a BBC investigation suggests.
....
Medical professionals use a scoring system, called 'NEWS2', as one way of identifying patients at risk of deteriorating, a check normally used for sepsis patients.

Under normal circumstances, ambulance teams would blue-light anyone with a score of five or above to hospital.

But on March 18, LAS workers were told to apply the NEWS2 check to suspected Covid patients -
and that many of those with a score up to seven could be "suitable for community care",
even if there were issues with breathing rate, oxygen supply and consciousness.
.....
Over the Easter weekend, the LAS changed its guidance to say suspected coronavirus patients with a wider range of symptoms

and a much lower NEWS2 score of three to five should be taken to A&E for assessment.

We were talking about ICU admission though, not pre-hospital triage. Even if the older patients were more likely to be kept out of hospital (which certainly does seem to be true), that doesn't mean those that made it there would be denied ICU care

It's interesting that the higher death rate vs. viral pneumonia might legitimately affect such decisions. Fewer people are now dying in hospital than in normal winter, but with the higher death rate perhaps it legitimately doesn't make sense to hospitalise certain care home patients who might be hospitalised for viral pneumonia.

I was just pointing out that rationing can occur in a very arbitrary way, not due to the careful consideration of cases by medical staff

@NewAccountForCorona
I am trying to watch hospital admissions, as that seems to be (a) accurate and (b) a good indicator as to how things are going.

Do you know if these are available by region or just as a whole for England, as I've only found the latter?

On the previous thread, I was asking about the possibilities of testing non-symptomatic people prior to planned increase in social mixing (like testing all teachers, potentially families returning to school, or people going to a funeral) because no-one really knows for sure if they are infected even if they are asymptomatic, so it'd nip any potential cases in the bud. I guess I'm interested as to whether this is ever in the plan to reduce infection as much as possible, or whether we don't have the testing capacity or public/political will to do this. Otherwise our strategy is always to react to symptoms, however early they appear. The obvious Q is then how frequently would we 'want' to test.
I'm afraid I haven't kept up with who they are testing - are all healthcare workers getting tested regardless of whether they have symptoms, or are symptoms a requirement?

Please let me know/ ignore me if this isn't within the scope of this data thread - I don't want to derail!

Do you know if these are available by region or just as a whole for England, as I've only found the latter?

The details are on page 14 of the PHE weekly report:

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/886864/Weekly_National_COVID19_Surveillance_w21_FINAL.pdf

Unfortunately, it is a graph rather than a table but it gives the high level trends.

Doh, thanks winter, I was looking at the datasets not the graphs!

So 4 outbreaks in schools.
If we kept over 45 in for a few months most of the desths chart would be gone.
Agree it does look like over 70 are being held in hospitalised rather than icu.
Looks like we have 8k + hospitalised still.
I dont like the age groupings under 5 then 5-15? But the age rsnges are all over the place so children is obviously the 2 groups.

On the previous thread, I was asking about the possibilities of testing non-symptomatic people prior to planned increase in social mixing (like testing all teachers, potentially families returning to school, or people going to a funeral) because no-one really knows for sure if they are infected even if they are asymptomatic, so it'd nip any potential cases in the bud.

I was thinking something similar earlier today... However, it’s not much use if you have to wait days for the result. The 15 minute tests being developed would be useful for that, and don produced in enough numbers and cheaply enough could be revolutionary... For instance, you could go to the cinema, you’d get there a bit early to take the test they gave you. If you tested negative you’d be allowed in!

If we kept over 45 in for a few months most of the desths chart would be gone.

Not sure how that would work...

Also, people don’t need to be locked down to be a greatly reduced risk. If people are consistent with social distancing when out, then the risk is minimal.

I suspect there will be quite a few over 45 with primary age kids. My friend just had a baby at 41. So will be at least 45 by reception even. My dsis is 45 with a 6yo and 7yo.
BJ will be 60 by the time this dc goes to school.

Antibody tests for all the hcp and go from there with frequently testing them for currently having it.
If 40% have antibodies say thats a lot less to keep testing.

Although if we have antibodies do we then ignore the symptoms and dont have to SI??
Could people like with the vax stll shed it though?

"If 40% have antibodies"

HCP death rates seem about the same as the general population
So probably antibody rates are as well,
i.e. about 5%, as in Spain, France with similar deaths / million

I found this quite fun

covid19-phenomics.org/PrototypeOurRiskCoV.html

Aim is to let people try to understand their risk from covid

I played around with excess deaths tab assuming mitigation to get to the excess death rate overall that seems to reflect where we actually are heading. This seems to be much higher than the default setting. and then used it to look at the risk for my age/condition group

So probably antibody rates are as well

Absolutely.

Some jobs spread covid-19 because of close contact with others and no PPE. HCP is not one of these.

HCPs have higher rates than the lowest possible, which is desk-based professionals who have been sitting at home, but average for the population as a whole.

We know that HCPs are as likely to be infected as the population as a whole, roughly 1 in 400 currently infected

www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/coronaviruscovid19infectionsurveypilot/latest

Here is the icu admission decision tool recommended by NICE

NICE ICU tool

I know this has been shared before but I thought worth sharing again in the context of discussions above

attackedbycritters I can't get that page to work. The link from the BBC News website wouldn't work either. Don't know if its my laptop restricting access as it not secure?
What does it tell you about the risk?