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.

Whatever they think seems an incredible coincidence just as the beaches get packed 1-2w later infected hospital.
That is the only beach for a very long way especially bearing in mind not going ito wales. At that pointb1/375 in england had it. So many of the people on the beaches.
Who would have been getting food on the beach. Petrol. Supermarkets etc. Logically it is the flood of people from outside!!
So maybe locals working at the hospital walked along the promenade went in the supermarket s etc.
Also i guess likely families met up there and maybe with wsm locals.
It has then spread round the hospital as it has everywhere it's just the staff there had little immunity and the ability now to be tested.
It's because i dont think the only issue with mass gathering is the event (someone pointec this out with Cheltenham its the other socialising pubs etc but PT and other local amenities).
I really do think people visiting places even outside need to consider the residents so even more hand washing or gel.
I think someone said the pier and toilets are open.
I think i said somerset is also going orange and thats minehead.
I notice probably unsurprisingly people wont risk their own parents with their grandkids but would send them to a 60yo teacher etc. It seems people also dont give a crap about local areas/tourist attactions. As long as they get their cruise or skiing or beach day

Logically it is the flood of people from outside!!

Lol.

They don't even have a full time a&e. We are talking about how many infected staff exactly?

Is "logic" the new "common sense"?

Just looking at worldometer I didn't realise how bad it was in Brazil.

35,957 deaths - I'm shocked.

My brother lives in Brazil, he told me yesterday that's there's no social distancing but a lot do wear masks, schools are closed & shops mainly deliver or bring what you want to the door, no one goes inside.
Him & his wife both work from home & get their food delivered so they don't have to leave the house because they're too scared.

The favelas though. They don't even include those in official maps of the city of Rio. Who knows if they'll even count them as infected?

They're testing the vaccine made here, in Brazil.

BBC news are now reporting that the Brazilian government have removed previous data on cumulative number of deaths from their websites and are now only giving daily totals. What a terrible situation.

Just coming to post that. I know a little of Brazil; the structural racism and structural poverty there is beyond belief.

Coronavirus: Hard-hit Brazil removes data amid rising death toll www.bbc.co.uk/news/world-latin-america-52952686

I believe the outbreak in North Somerset was 55 people so not surprising that a small hospital was overwhelmed. No EVIDENCE on whether the patients brought it in and infected the staff, the staff infected patients or they all caught it on the beaches. Clearly determination on this thread to minimise the effect of loosening lockdown and undermine the NHS by suggesting it was lax infection control.

Brazil removing past data, our government ceases to publicise data at weekends.

Surely you're not comparing Brazil and the UK weekend data? The UK figures were released as normal yesterday, they were tweeted, they were covered on all news outlets.

www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public

I felt the press briefings needed to be scaled back somewhat, so that they had more impact when there was something important to say/change.

@alreadytaken

This article was posted on another thread

www.bristolpost.co.uk/news/bristol-news/health-officials-confirm-source-north-4193110.amp

Clearly determination on this thread to minimise the effect of loosening lockdown and undermine the NHS by suggesting it was lax infection control

This thread is about the statistics, the data and the research. In general it has been measured and avoided the panicky hyperbole on other threads. I've found it very helpful as a source of calm analysis and discussion during the pandemic.

Clearly determination on this thread to minimise the effect of loosening lockdown and undermine the NHS by suggesting it was lax infection control.

No, the primary "determination: on this thread is to unemotionally discuss facts, numbers and trends.

There are plenty of other topics where posters can exchange their opinions formed by the Daily Mail headlines (while refusing to admit they ever look at that horrible tabloid website ).

BBCONE I’m not trying to trivialise deaths as obviously every life is someone’s loss, but if you take Brazil’s reported death toll in the context of their population (over 210 million) their numbers are actually quite low.

Sadly, it’s not showing any sign of slowing and likely get far worse, my guess is the numbers are vastly under reported and the governments removal of data is appalling. I agree it’s a terrible situation.

cathy and winter. I agree. I’ve always found this thread a reliable and non-emotive analysis of the data.

I am curious about the impacts of VE Day / heatwaves / beach visits / protests / schools etc on the R number and potential spikes. The more we know about this virus the better.

ONS's Nick Stripe analysing excess deaths to 1 May
(as almost all data for that period in now)

Nick Stripe@NickStripe_ONS

THREAD – “Non-COVID” excess deaths

Between 7 Mar & 1 May there were 130k deaths registered across E&W

This was 46.4k deaths above 5-yr averages

According to death certs 12.9k (28%) of this “excess” did not mention COVID

98% are now fully coded enabling detailed analysis 1/n

Possible explanations include:

1. COVID was present but undiagnosed, particularly in the presence of other co-morbidities and the absence of a positive test

1. Reluctance to seek care or a delay in receiving care for people with serious health conditions 2/n

1. Reduced hospital capacity affecting ongoing care for people with underlying conditions

1. An increase in stress related causes due to lockdown

1. An increase in death registration efficiency introducing a process effect 3/n

Our analysis shows:

• Many deaths where COVID was not mentioned were displaced from hospitals to care homes and private homes

• Age-standardised mortality rates (ASMRs) for “non-COVID” deaths were generally higher in regions with higher COVID ASMRs 4/n

• Excess deaths where COVID was not mentioned were predominantly in the very eldest

• Men accounted for more at first but from mid-April this switched to women

• Analysis by leading underlying causes of death shows all leading causes above or at their 5-yr averages 5/n

• Most notably, they show v significant increases in deaths due to Dementia & Alzheimer Disease and for deaths due to old age & frailty (“signs, symptoms and ill-defined conditions”)

Deaths with these causes account for two thirds of all “non-COVID” excess deaths 6/n

Dementia increases are so sharp it’s implausible that they are unrelated to COVID^

They generally affect the very old, they would tend to impact women to a greater extent than men simply due to pop structure.
Especially once care home epidemics took hold with ltd testing 7/n



People with dementia are more likely to have communication problems describing symptoms

Some evidence has been observed for atypical hypoxia in frail COVID patients
– well preserved lungs but severely compromised pulmonary gas exchange without signs of respiratory distress 8/n

No reason to believe that COVID-19 has been knowingly omitted from death certs.
Symptoms may not be apparent

But we cannot discount the impact of changes to normal routines for vulnerable care home residents following lockdown.
These could have had adverse consequences too 9/n

The balance of evidence so far points to undiagnosed COVID in the elderly being the most likely explanation for a majority of excess deaths that did not mention CV on certs

This fits:
demography, locations, esp where testing was sparse, causes of death & timings of peaks 10/n

Some potential evidence for a delay in receiving care

Normal care pathways have been disrupted
and we can see increases in deaths due to diabetes, sepsis and asthma outside hospital settings

But some of these are risk factors for CV so could also support under diagnosis 11/n

There is some evidence for deaths involving, for example, cancers and renal failure being displaced from hospitals

Little evidence yet of signif increases in overall deaths due to reduced capacity.
But these may increase over time as impacts of treatment delays emerge 12/n


For stress-related causes there is some evidence of increases due to e.g. hypertension

But due to the need for coroners’ inquests for deaths caused by drugs, violence or suicide,
any increases for these will not yet have been registered

Need longer to observe any changes 13/n


Some evidence of increased efficiency due to registration process changes

The % of deaths registered by coroners has reduced,
but within the context of many more deaths in total

Any effect is likely to be marginal and again this may change as more inquests conclude 14/n

Note- excess deaths during May are so far all accounted for by COVID being mentioned on death certificates

This may reflect improving knowledge of its complex effects, increased testing,
and the fact that some earlier deaths will have been brought forward by COVID

15/15 - ENDS

.

There is some evidence of spikes from mass events just before lockdown e.g. Cheltenham, Liverpool-Madrid football match
but afaik none since e.g. not for VE day

With BLM protests in several European countries, we should get an idea within the next couple of weeks
of the effect of mass outdoor protests during a period when community infection is at a much lower level than when Cheltenham etc took place.

Our government has ceased to publish numbers of people tested and it did not publish at the weekend figures on new admissions or bed usage. We should be able to get new admissions and bed use on Monday but they are critical date to see if relaxing lockdown is causing a problem or not. It is more than 2 weeks since the number of people tested has been reported. Brazil has continued to publish some information, it has removed historic data. The data that the two countries continue to publish is different - and ours is more comprehensive - but both countries have stopped publishing data.

Thank you for the evidence on the Weston outbreak being from asymptomatic staff at the hospital. Now that NHS staff are able to get tests all hospitals are likely to find some with asymptomatic infections. NHS staff have frequently not been able to get tests, even front line staff have been unable to get PPE. Eventually there needs to be a public enquiry. That enquiry will need to cover if it is feasible to maintain infection control without protective equipment.

By coincidence dr Mark Porter just tweeted Tim Spector asking about Weston too and possible Somerset spike. The reply was that that it was due to hospital testing staff so artefact.

It interesting though, given that really hot day when the beaches And parks were crowded was two weeks ago, there is no sudden surge in cases.

. We should be able to get new admissions and bed use on Monday but they are critical date to see if relaxing lockdown is causing a problem or not

What's the problem exactly? Weekend data are less valuable because they are incomplete due to lower staffing levels. We can all wait till Monday.

@whatsnext2

It interesting though, given that really hot day when the beaches And parks were crowded was two weeks ago, there is no sudden surge in cases.

How can you remember?

Time has lost all meaning for me.

But if so, then that is interesting to see if it is visible in the data.

I guess it would be localised?