Daily numbers, graphs, analysis thread 11

[BigChocFrenzy]

Welcome to thread 11 of the daily updates

Resource links:

Slides & data UK govt pressers
NHS England stats including breakdown by Hospital Trust
ONS UK statistics for CV related deaths outside hospitals, released weekly each Tuesday
Financial Times Daily updates and graphs
HSJ Coronavirus updates
Worldometer UK page
Covidly.com to filter graphs using selected data filters ONS statistics for CV related deaths outside hospitals, released weekly each Tuesday
Plot COVID Graphs Our World in Data

We welcome factual, data driven, and civil discussions from all contributors 💐

In case anyone is interested, this report is on excess deaths in the US, good data on which has previously been unavailable afaik. It suggests that the recorded COVID death toll of approx 95,000 at 30 May was underestimated by around 28%, excess deaths figure was about 122,000 at that point.

jamanetwork.com/journals/jamainternalmedicine/fullarticle/2767980

You only need look at this thread to see how strong the desire can be to knock the NHS - comments about empty hospitals, when they were not, and the like. Look elsewhere on mumsnet and you'll see more of it.

The reality of what the NHS has been dealing with is a chronic shortage of resources, staff with the virus off sick and more staff who didnt have the virus but couldnt get a test for a cold so had to be off.

The Guardian has been quite good at real stories from the front line e.g. www.theguardian.com/commentisfree/2020/apr/08/icu-doctor-covid-crisis-hospital

and www.theguardian.com/world/2020/apr/14/coronavirus-i-worry-about-my-colleagues-an-nhs-junior-doctor-describes-the-challenges-she-faces

www.theguardian.com/society/2020/jun/18/nurse-deprived-area-uk-sinister-truth-covid-inequality

www.theguardian.com/society/2020/jun/25/physiotherapist-seeing-impact-covid-survivors-haunt-forever

or another junior doctor, not so fortunate as they were not a mild case onlinelibrary.wiley.com/doi/full/10.1002/anr3.12052

Read all of them and see if you are quite as happy to start bashing the NHS again.

"better healthcare?"

Far more likely is the much lower population density in most USA states,
330 million people living on a vast continent

The IFR in New York City looks higher than London

There are many millions of people in the USA without full healthcare,
too high co-pays to access healthcare,
losing healthcare when they lose their job
Some GOP states have deliberately not fully implemented Obamacare which would protect some of the most vulnerable.

Disproportionately it is African Americans who miss out on healthcare
and there are reports from states like Atlanta that they are 85-90% of the seriously ill and dying.

Lower population density would explain differences in new cases per capita, but why would it also explain differences in mortality?

For the record - I’m not bashing the NHS, I have huge respect for all NHS staff, especially those that have been on the front line through this crisis and appreciate the strain they are under. Any issues are systemic ones that politicians need to take responsibility for, not NHS staff.

The NHS has almost no spare capacity, except some in summer

On the subject of beds, frontline staff, etc, this is perfectly true
However, at least in my own area it's most definitely not true where management and admin spending is concerned ... and these are the areas where I'd rather questions continued to be asked

38 deaths in English hospitals today. Hopeful that the UK total deaths could be below 100 again.

puzzled That keeps getting trotted out
In every large organisation - including profitable private multinationals where I've worked - you'll find some examples of massive waste

As far as financial efficiency is concerned, the NHS comes near the top in the international stats

The problem is that countries like France & Germany invest 11-12% of GDP annually in their health service,
whereas the NHS, which tries to perform the same tasks, gets only 8- 9% of UK GDP

• and the NHS is subject to continual stop-go and reorganisations as different governments come into office

In Germany for example, all major parties have agreed for decades that the health service and schools should receive consistent investment - out of taxation -
so there have never been actual cuts even during recessions

bylinetimes.com/2020/07/02/lifestyle-company-with-no-employees-or-trading-history-handed-25-million-ppe-contract/

No sure how efficient the contracts mentioned in this article are.

It’s been said here before but it’s not really a good comparison to have UK figures vs US figures, the US is made up of all of its different states, spread over such a vast area. They are all at different stages of the pandemic and approaching it differently. Some Northern states are barely affected (yet), NY was battered by it, it’s looking fairly calamitous in states like California, Florida and Kentucky right now. Reports seem to be that average age of patients in ICU - most of which seem to be heading towards full - has dropped in the latter states from 65+ to much younger (maybe the elderly have sensibly locked themselves away?) - whether that translates into lower mortality rates remains to be seen and may depend on the capacity for hospitals to treat patients as they would wish.

New positive cases and deaths

Friday 3 July - 544 / 137
Friday 26 June - 1,247 / 184
Friday 19 June - 1,216 / 173
Friday 12 June - 1,392 / 202
Friday 5 June - 1,491 / 357

Decent figures again today. Obviously, I wish deaths were much lower but things are still going in the right direction.

Second day with cases below 600 as well.

Still feeling tentatively positive!

www.gov.uk/guidance/the-r-number-in-the-uk

R rate creeping up in London and the SW not looking great either. I'm assuming this is due to such low numbers.

Yes, encouraging numbers today. The “double-counting” rectified in yesterdays numbers and taking 30,000 off the UKs cumulative total, would have ensured before yesterday, numbers were overstated by hundreds every day... which partly explains the extent of the fall from this time last week.

Is there a way of finding where abouts in the south west the R is increasing?
The figures overall are looking much better this week.

@FurForksSake

www.gov.uk/guidance/the-r-number-in-the-uk

R rate creeping up in London and the SW not looking great either. I'm assuming this is due to such low numbers.

Yes, I would imagine so - numbers are now so small that R is very hard to calculate, and I notice the intervals they are giving are now wider (e.g. it was "-2 to -4" now its "-6 to 0" which is a huge range!)

These guys say R is "very likely" below 1 in every region, but "The data used are only weakly informative on R over the last two weeks. Therefore, the now-cast for current incidence and the forecast of deaths are quite uncertain."
www.mrc-bsu.cam.ac.uk/now-casting/

At this point, tracking daily infections and other early signs (e.g. NHS 111 calls/online triage) is more informative.

Thank you, everyone who has contributed to this thread and answered my questions about the nebulous and incomplete data!

You are all the reason that I am finally daring to breathe a little sigh of relief over all of this. My Reception-age child is back in school and we are slowly finding a bit of normality, while being v cautious.

I've got a copy of the previous cases csv, latest download from 27 June, which I'm keeping as a comparison.

@FurForksSake yes, lower case numbers do skew the r rate quite a bit.

Australia had 254 cases today, meaning it’s infection rate per head of population is now higher than the U.K.! Obviously it’s just one day’s data so perhaps not entirely fair, but still...

@Realitea

You can find where infections are increasing/decreasing on coronavirus.data.gov.uk/
and downloading the latest cases data....You’ll
need some basic Excel knowledge though.

"Latest growth rate range for the UK
-6% to -0%"

this is not the R number! This is surely the % decrease per day, which is heading downwards slowly.

@Realitea

Is there a way of finding where abouts in the south west the R is increasing? The figures overall are looking much better this week.

This is the graph I did yesterday based on changing infection rates per 100,000 over the past 2 weeks.

Note, this isn't necessarily anything to worry about; at very low levels of infection, small changes from week to week would be expected, and one identified incident (such as the Merthyr factory outbreak) can swing things from week to week. For example, the North Somerset increase appears to be an increase in actual positive tests from 3 to 8.

I don't think there is any indication that people are unduly worried about any of the areas on this graph. For contrast, Leicester is tracking at 141/100,000, and the next highest, Bradford, at 45.8.

@herecomesthsun

"Latest growth rate range for the UK -6% to -0%"

this is not the R number! This is surely the % decrease per day, which is heading downwards slowly.

Yes, I explicitly said it was growth rate range, to illustrate the increasing margin of error, and reduction in confidence in R overall.

Apologies, I didn't state that explicitly, I meant to. Sorry for confusion.

@AprilLady

Our mortality rates do seem much worse than elsewhere, not only when compared to France and Germany, but also to most other developed countries. And this difference persists even now when the NHS is no longer under such a strain. As an example, comparing the UK and US, and assuming around a 3 week lag between new cases and deaths I get the following:

US: 7 day rolling average new cases 3 weeks ago: c20,500
UK: 7 day rolling average new cases 3 weeks ago;
c1,100
So 18.6 times higher case numbers in US
US 7 day average deaths currently: c550
UK 7 day average deaths currently: c110
So about 5 times higher

That is a huge difference in mortality. Possible explanations include:

• higher testing in the US? Possible, but given the positive test rates in each I don’t think this is a primary driver
• underreporting of US deaths vs UK? Latest ONS data does suggest the UK is now fully reporting deaths, whereas I think US still had unexplained excess deaths - but not of an order that explains the difference.
• profile of cases? This must be a big part of it, with the US cases mostly among the young and healthy
• better healthcare? It’s hard not to conclude that this is a contributing factor.

Any other ideas that explain it?

You need to remember that most of the US cases are coming from states at the start of their wave so can’t be compared to UK when we are coming back down. This means:

1. deaths in the UK are still coming from people infected 60 or 90 days ago who have managed to survive longer than average
2. A lot of the reporting is delayed. So some of the “new” deaths today will be from people who died many weeks ago. Someone on this thread used to have a really helpful ‘volcano’ graph that showed this

Recent figures are also good news for hopeful UK holidaymakers:

The EU agreed to let in tourists from countries with < 16 / 100,000 cases in 7 days

16/100,000 for the UK pop of approx 67 million = 10,720 weekly
= 1,531 daily

UK is comfortably below the limit to avoid quarantine / entry ban