Daily numbers, graphs, analysis thread 12

[BigChocFrenzy]

Welcome to thread 12 of the daily updates

Resource links:

Slides & data UK govt pressers
UK dashboard sub-national data, local authorities
Beta Uk dashboard deaths, cases, hospitals, tests, partially sub-national
UK stats updated daily by PHE & DHSC
ONS UK statistics for CV related deaths, released weekly each Tuesday
PHE surveillance report infections & deaths released every Thursday with sep. infographic
NHS England stats including breakdown by Hospital Trust
FT Daily updates
HSJ Healthcare updates
Worldometer UK page
Plot FT graphs compare countries deaths, cases / million pop. / log / linear
Covidly.com filter graphs compare countries
Plot COVID Graphs Our World in Data

We welcome factual, data driven, and civil discussions from all contributors 📈📶👍

That's encouraging news, but even German schools are wearing masks!

Why is our country so against it?

I think the only thing I would say if the study was done during lockdown is that yes, pupil numbers have been much less than half and if it's an air borne virus I'd wonder about transmission in a more crowded, hot, stuffy environment as many especially older classrooms with low ceilings and limited windows can be in the winter. Resp viruses are rife either side of Xmas in schools.

Baring in mind classes of up to 34 in this country. Much lower in Germany.

just loooking at the cases update today in a bit more detail and comparing, in terms of cases per 100,000 for the 149 upper tier local authorities, the 7 days to 3rdJuly and then the 7 days to 10th July.

Putting the case ratios into increasingly broad bandings eg 0; 01.to 0.99; 1 to 2.99; 3 to 4.99; 5 to 9.99 etc we can see the general improvement or deterioration between the two seven day period.

Positive news is that more upper tier local authorities are seeing their cases per 100,000 coming down than going up, and for all those in the same banding in the higher bands again more coming down than going up.

Caveat is that although almost 400 cases confirmed for 10th July now the second set of seven day probably still a bit of the light side.

and the upper tier county councils will hide a multitude of sins :) within their constituent districts.

That's an interesting article @whatsnext with the infection fatality ratio - and a lot of other useful data (albeit with a US focus) A fatality ratio of 0.65% would suggest that at least 10m people in the UK have caught it though (using the latest excess deaths figure of around 65,000 as the best proxy for actual number of deaths). That's about 15% of the population - which is considerably higher than the data on antibodies would suggest. However that's reported on in the news today suggesting that most people lose antibodies (or at least they fall too low to be measured) after a few months would fit with those estimates - they only developed a good antibody test some months into the outbreak in the UK so tested people well after the peak - therefore quite likely that a lot tested negative even though they did have Covid previously.

It's interesting to know this because even more/undetectable levels of antibodies are likely to give some degree of protection, so may contribute to a degree of herd immunity - especially in London where the proportion with antibodies detected was about 15% so potentially more like 30% who had it.

What I want to know though is whether there is research going on to count people who catch Covid for a second time - surely if we want to know whether people are immune or for how long for, we should be doing this?

@Firefliess don’t think there has been a proved case of reinection. Plenty suggested then retracted eg
www.businessinsider.com/coronavirus-south-korean-reactivated-cases-not-reinfected-experts-2020-4

As antibodies wane it is inevitable it will happen but probably less severe infection due to T cell immunity

A fatality ratio of 0.65% would suggest that at least 10m people in the UK have caught it though (using the latest excess deaths figure of around 65,000 as the best proxy for actual number of deaths).

No, because that's a average IFR over all the population, and it will be much higher in older age groups. If infections are concentrated in older age groups, we could easily get, say, 60,000 deaths with a much lower rate of infection amongst the population as a whole.

Say, for example - IFR is more like 20% for the over 80s. We have around 24k deaths in the over 80s in England and 17k in the under 80s.

For the 24k over 80s deaths, at an IFR of 20%, we would require 120,000 over 80s to be infected - given around 400,000 care home residents in England , that's not unlikely I don't think, given 40% of care homes have had an outbreak.

That leaves us with 17k deaths under 80; at a crude IFR of 0.65%, that suggests 3 million of us in the wider population under 80 have had it. Not unlikely, I think.

@PatriciaHolm

A fatality ratio of 0.65% would suggest that at least 10m people in the UK have caught it though (using the latest excess deaths figure of around 65,000 as the best proxy for actual number of deaths).

No, because that's a average IFR over all the population, and it will be much higher in older age groups. If infections are concentrated in older age groups, we could easily get, say, 60,000 deaths with a much lower rate of infection amongst the population as a whole.

Say, for example - IFR is more like 20% for the over 80s. We have around 24k deaths in the over 80s in England and 17k in the under 80s.

For the 24k over 80s deaths, at an IFR of 20%, we would require 120,000 over 80s to be infected - given around 400,000 care home residents in England , that's not unlikely I don't think, given 40% of care homes have had an outbreak.

That leaves us with 17k deaths under 80; at a crude IFR of 0.65%, that suggests 3 million of us in the wider population under 80 have had it. Not unlikely, I think.

That is a great explanation @PatriciaHolm. What are they basing the IFR on? Antibody screening?

That's true @patricia. Though didn't the data on antibodies suggest there weren't huge differences between different age groups?

Care home residents are a rather particular group - much higher risk of dying (being both very old and often with other health conditions) and also at higher risk of catching it because of the difficulty in distancing in care homes. Other old people, however, have generally been very good at not catching it (as they are retired so don't need to work, and most don't live with children), so that would probably offset the higher risks for those in care homes.

Also @patricia If the iFR overall is 0.65% and the death rate is very much skewed by age (which it is) then it isn't 0 65% for the under 65s, it's very much lower.

@Firefliess

Also *@patricia* If the iFR overall is 0.65% and the death rate is very much skewed by age (which it is) then it isn't 0 65% for the under 65s, it's very much lower.

I thought that too! There could have been alot more infections than 3 million with the IFR being so skewed and being much lower in kids and young adults

The antibody prevalence surveillance is from blood donors isn’t it, so under 70 year olds? (and all healthy)

I havent looked at the whole country - but unless they are all in the areas where data is not available I dont see 100 places with anything very much going on.

Cases increased in Luton. Something going on in Northampton, Nuneaton only a couple of extra cases but from a very low base, Pendle already mentioned, something in Peterborough but not massive, Rochdale not showing the same improvements as elsewhere, Rugby up but on tiny figures still, Salford needs a look, Sandwell up on low numbers, Sefton had 10 in one day, South Cambridgeshire a recent handful, Southampton a few extra recently, St Albans has had a couple of not great days - and now I'm getting lots of not available!

IFR in some N Italian towns was calculated at over 1%
and I saw a calculation for NYC nearly 1% as well.

In that N Italian area with 37% antibodies, 1% of the entire population reportedly died, so IFR >> 1% there

I suspect IFR is affected by population density, efficiency of public health & heath services,
as well as obviously whether the health service is overwhelmed,
the % aged 80+ in a population / how well they are shielded.
Maybe also family culture, customs or adoption of measures like mask wearing.

Streeck's (Uni Bonn) study calculated for Gangelt, an early German epicentre, that IFR = 0.36 %

However, the authorities there sprang into action as soon as the first cases were found, protected the elderly & vulnerable, ramped up public health measures, track & trace, advocated masks etc

The RKI antibody study in Germany on blood donors found only 1.3% of them had antibodies

The much lower average age now of infections for several weeks indicates that the elderly are staying home more
and hence are quite likely to have a lower level of antibodies than the general population

However, iirc there was a much earlier study that estimated 4% in Germany had been infected

• I don't know if the discrepancy is because the RKI study took actual blood samples rather than estimating, or whether many people have lost their antibodies

I wonder too how much the low German death rate is due to fewer people catching COVID than in some other European countries
fewer infections because of the v early mass testing, track & trace systems
and of course the early lockdown

The 1.3% for Germany is about the same as found for Denmark (also Norway), who have much lower population density,
but about the same deaths / million for COVID

"then it isn't 0 65% for the under 65s, it's very much lower."

We already know that age makes a vast difference

Spiegelhalter calculated that for the UK the risk of death after catching COVID doubled for about every 6 years of additional age
and that
an 80-year-old has about 500 x the risk of dying as a 20-year-old

Germany has had over 9,000 deaths from COVID, but only 35 of those were aged 0-39

• in a population of 83 million

The IFR for the under-40s is really tiny

However, any Western population contains a large % of elderly and very elderly,
who can't just be written off,
morally or politically

So we have to look at whole-population IFR

which may well vary somewhat between countries

@bigchoc Those IFRs for the N Italian village and in Germany both sound quite plausible - the Italian village may well have had an older population, and we know this was early in the pandemic and their hospitals were overwhelmed. Whereas the German example may have had a younger age profile, and better healthcare. They sound quite compatible with an overall population estimates of IFR at .65%

www.google.com/amp/s/www.telegraph.co.uk/news/2020/07/09/scientists-hail-stunning-results-show-areas-new-york-may-have/amp/
Has anyone seen this?! 68% antibodies in Queens in New York

[quote whatsnext2]@Firefliess don’t think there has been a proved case of reinection. Plenty suggested then retracted eg
www.businessinsider.com/coronavirus-south-korean-reactivated-cases-not-reinfected-experts-2020-4

As antibodies wane it is inevitable it will happen but probably less severe infection due to T cell immunity[/quote]
There have been a few reports from the USA too:

This is (posted by EmMac7 on another thread) from the CMO of a hospital, hence credible:

particularly concerning is that
their patient was much more ill with the 2nd COVID infection:

https://www.vox.com/2020/7/12/21321653/getting-covid-19-twice-reinfection-antibody-herd-immunity

"the trajectory of a moderate initial infection followed by a severe reinfection

suggests that this novel coronavirus might share some tendencies of other viruses such as dengue fever,

where you can suffer more severe illness each time you contract the disease."

@BigChocFrenzy am dubious about Vox credibility as am others. Clickbait I suspect. There is this which has been described as ‘speculative unsubstantiated nonsense with no place in a serious journal. ‘ which sounds about right

gh.bmj.com/content/5/6/e002564

www.theguardian.com/education/2020/jul/13/deaths-special-needs-children-kent-raise-concerns-over-school-closures

This is a desperately sad if unsurprising statistic.

I guess we will begin to see the deaths as a result of lockdown.

For children sadly, more will have died due to the decisions taken rather than the disease itself.

whatsnext The author sounds pretty well qualified and experienced:

"D. Clay Ackerly, MD, MSc, is an internal medicine and primary care physician practicing in Washington, DC.
He has served both as a faculty member of Harvard Medical School and as assistant chief medical officer at Massachusetts General Hospital.
He has also held positions in the government and private sector, including the White House, the Food and Drug Administration, and, most recently, as chief medical officer of Privia Health"

Your link is about Italy - I don't see the connection

I am surprised that the author of the Vox article has not mentioned a perfectly plausible scenario - the possibility of a false positive the first time round.

The specificity for C19 antigen tests is much higher than sensitivity but it is not 100%. The estimates I have seen previously are around 98% which is high for diagnostics of individual cases but will result in occasional errors at the population level.

Timeofranotherusername Vulnerable children and those with SEN were entitled to go to school throughout lockdown

The report author states that it was parents' fear of COVID, not lockdown rules, that meant only 10% of these children took up their school places