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 📈📶👍

@Cornettoninja

Thanks *@AprilLady*.

I think it’s a pretty common suspicion that we’re over reporting but then I remember Germany getting criticism for not counting covid deaths where it didn’t appear as the primary cause on a death certificate. It’s a tricky balance particularly given the short time span all of this has occurred and the sudden interest in these particular sets of data.

I can’t decide which is more harmful - over or under reporting, but either way excess deaths will add another facet but like you say - this all takes considerable time to iron out.

Germany counts all deaths with COVID, within 28 days of test

The RKI (German public health) have explained that includes even deaths from accidents and the few (too few to matter afaik) from suicide or murder

The low deaths are due to:

. lockdown at a v early stage of the epidemic in Germany - main cause
. v effective & early mass testing, track & trace
. early treatment of cases without delay, due to high spare capacity in the health services
. existing health conditions treated fully, because there is no rationing in the health system

A good guide to whether a country under-reports is to examine the difference between official COVID deaths
and the excess of total deaths from all causes compared to the historical average

The UK has a gap of about 20k deaths
Belgium (v high COVID deaths) but small gap
Germany (low COVID deaths) but small gap

Public health experts and governments around the world - including the UK - agree that excess deaths are the gold standard for assessing the impact of an epidemic, including for COVID

@Cornettoninja France reporting is fairly accurate. They include tests and certifates i believe. If you look at the excess death rate the it is much closer to the figure France gives - last time i looked around 3000 difference as opposed to the uk figure of 65,000 excess deaths and 45,000 government figure. The ONS figure is much closer to the truth for uk.
Belguim also has a very wide count and in fact their covid death figure was higher than the excess deaths. They include tests, certificates and suspected ( sorry i get annoyed when people on other threads say Belguim is worse - no they just count better)

Just to clarify this 28 days thing, then. If Kate Garraway's poor husband now dies, or Michael Rosen had died what would be their cause of death? We can't say neither of these would be in hospital and very very ill due to any other reason.

The likely 2,200 extra deaths out of 45,000 - or 65,000 excess deaths - is completely trivial compared to the main factor in determining deaths in European countries:
lockdown timing:

The modeller James Annan calculated what would happen

if lockdown dates had been just 1 week different:

1. UK 1 week earlier
   ==> deaths 11k instead of 43 k (as of the date of his calculation)

2. Germany 1 week later:
   ==> deaths 34k instead of 9k

https://bskiesresearch.wordpress.com/2020/05/12/the-human-cost-of-delaying-lockdown/
https://bskiesresearch.wordpress.com/2020/05/14/why-cant-the-germans-be-more-like-us/

@Piggywaspushed

Just to clarify this 28 days thing, then. If Kate Garraway's poor husband now dies, or Michael Rosen had died what would be their cause of death? We can't say neither of these would be in hospital and very very ill due to any other reason.

That's why a rigid 28-day cutoff is also wrong I expect / hope that the PHE update is more sophisticated than just that and will consider doctor's diagnoses and CoD on death certificates

Any sensible public health authority would include deaths after this cutoff for "active" cases.

One problem with UK data is that the UK is almost the only country in the world not to provide recovered or active cases.
This data may not be readily available to the authorities for some reason ?

The vast majority of cases will have recovered before the 28 day limit, so this would only be a small % of cases

e.g. Germany approx 202k cases, Recovered 188k, Deaths 9k, Active 6k, ICU 250
Deaths among those 6k active cases would be included for the v small number that remain "active" after 28 days

[quote alreadytaken]Baaah Covid-19 does nasty things to the body that increase clotting of the blood. Therefore if he had had a positive test and then died it would be quite likely that Covid-19 had accelerated his death. Whether his doctor would have put that as the main cause of death only they could say.

This is just nonsense “ between 40% to 70% of the population were immune before the epidemic started . " All the information we have on areas that have been badly hit shows this is nonsense.

Even the harshest criticism of the herd immunity paper recognises that they have a point about the level needed for immunity probably being overstated - if herd immunity was possible (but we dont know if it is).

As for T cells - maybe they will give some protection from infection or severe infection, maybe not. They dont activate unless your vitamin D levels are sufficient and they are not reactive to the most common cold viruses. T cells also change with aging so not going to be much use to those most at risk. www.ncbi.nlm.nih.gov/pmc/articles/PMC3800142/[/quote]
Thats not true about them not reacting to common colds. These studies (one is peer reviewed) show that common colds caused by coronaviruses have strong T cell reactions

www.biorxiv.org/content/10.1101/2020.05.26.115832v1.full

www.nature.com/articles/s41586-020-2550-z

"Thus, infection with betacoronaviruses induces strong and long-lasting T cell immunity to the structural protein NP. Understanding how pre-existing ORF-1-specific T cells present in the general population impact susceptibility and pathogenesis of SARS-CoV-2 infection is of paramount importance for the management of the current COVID-19 pandemic."

"SARS-CoV-2 belongs to Coronaviridae, a family of large RNA viruses infecting many animal species. Six other coronaviruses are known to infect humans. Four of them are endemically transmitted and cause common cold (OC43, HKU1, 229E and NL63), while SARS-CoV (defined from now as SARS-CoV-1) and MERS-CoV have caused limited epidemics of severe pneumonia. All of them trigger antibody and T cell responses in infected patients: however, antibody levels appear to wane relatively quicker than T cells."

"These findings demonstrate that virus-specific memory T cells induced by betacoronanvirus infection are long-lasting, which supports the notion that COVID-19 patients would develop long-term T cell immunity. Furthermore, our findings also raise the intriguing possibility that infection with related viruses can also protect from or modify the pathology caused by SARS-CoV-2 infection."

Interestingly, both of these studies suggest that it isnt reactivity with a common cold coronavirus, but an unknown coronavirus or an animal coronavirus that is causing the cross reaction:

"This may suggest that perhaps not only human “common cold” coronaviruses, but other presently unknown coronaviruses, possibly of animal origin, can induce cross-reactive SARS-CoV-2 memory T cells in the general population"

Apparently, the reporting of the daily death figure is being paused because of the concern that figures may be exaggerated.

I wonder if they will ever start reporting it again

Smacks of cover up opportunity
Wonder how long before they stop reporting cases also

@feetfreckles yes I wonder if cases will stop being reported eventually as well. Particularly since Boris reckons things will be normal again in November!

@Piggywaspushed @BigChocFrenzy I thought the PHE figures were the out of hospital figures anyway, so if someone died after spending more than 28 days in hospital with Covid they would fall under the NHS figures and be reported as such.

And just heard from a friend who was asked by contact tracing to isolate, he then became unwell and phoned for a test to be told he didn't qualify

I also thought the PHE figures were out of hospital.

BigChoc, I agree that the possible overstatement is small in comparison to the total, but I actually think there are two very important questions:

• what has happened overall (and the total excess death figure is the most relevant available to assess)
• what is happening right now and what is the current trend for daily deaths

The second is a really important measure for future policy and public confidence, so it matters if is being overreported (which I do think it is currently in the U.K., based on the NHS hospital data and the latest available ONS data).

I don’t think pausing reporting is a cover up, and I am pretty confident ONS weekly data will continue to be made available.

While initially there was a big gap between reported deaths and ONS excess deaths, this has not been the case for some weeks and this really does matter.

Finally, excess deaths are a better measure than any other available, but as I have said previously even they need careful interpretation, as underlying trends in longevity and population demographics will also affect what would, without Covid, have been the expected level of deaths this year.

sorry with regards to my previous post what is actually happening in Indonesia, slight correction:

• patient admits to hospital with any illness, and government health card
• hospital doesn't want to treat because they can't rip them off as they would private patients, orders antibody test
• antibody test shows igG but no igM antibodies.
• hospital tells patient to fuck off home or go to commandeered covid-19 hospital because 'test is positive'
• in fact patient is likely not ill with covid-19, because the igM antibodies are produced before igG, and the absence of the igM antibodies means likely 1 month+ after infection
• igM antibodies are not a terrible way to find sick patients, but igG is used for past infections
• then the second hospital orders PCR test, which of course comes back negative, a week or so later, by which time of course the patient might have died of something else

Neither the death, nor the case is counted as covid-19 in Indonesia. The case is not counted even though the antibody test means the patient WAS covid-19 infected, and the death is not counted because the PCR test came up negative.

Compare this with how other countries count deaths.....

13 hospital deaths today. What a shit show that we are not being told all settings. I smell a rat.

@oldbagface Hospital deaths are always announced earlier in the day than all settings. Let's wait and see what happens later. I don't think there is any rat to smell; if anything we are overstating deaths now.

It will be interesting to see what they decide to do, and whether they backdate it or not. If the latter, that will take longer I think.

I suspect a lot of people told to isolate by t&t will be lyinh to get a test saying they have symptoms thinking that it woulf mean they dont have to keep isolating.
But it would be crazy generally to not allow people to test if they do have symptoms (the main ones).

To be honest with the daily hospital deaths, admission numbers, cases and the weekly ONS figures we'll still get a good idea of the state of play even without the PHE info for a while.

The T cell reaction that the researchers are talking about when they talk about possible protection is not a reaction to the commonest cold coronaviruses - sorry I can see I wasnt clear enough on that, but it's been discussed on here before. They think the cells react to some sort of animal coronavirus. Unless they are clearly not animal viruses prevalent in China perhaps they are not protective at all.

There'd be no point lying saying you had symptoms in order to stop isolating sooner. It's not actually policed - if you were determined to ignore the advice you could do. Not testing is more likely an issue to do with what symptoms someone has I would have thought. I think they're still only recommending tests for a cough or fever or loss of smell or taste - not if you have sore throat, aches, fatigue, etc - which could be Covid but are still more likely to be something else.

@alreadytaken

The T cell reaction that the researchers are talking about when they talk about possible protection is not a reaction to the commonest cold coronaviruses - sorry I can see I wasnt clear enough on that, but it's been discussed on here before. They think the cells react to some sort of animal coronavirus. Unless they are clearly not animal viruses prevalent in China perhaps they are not protective at all.

I think there is cross reactivity to common coronavirus

www.cell.com/cell/pdf/S0092-8674(20)30610-3.pdf

13 hospital deaths reported and 827 cases. Cases is comparable to last sat, be interesting to see dates once the dashboard is updated

I think I have seen two different studies:

1. The study from the US indicating cross reactivity to common coronaviruses (the one above). It might not be peer reviewed so it is work in progress.

1. A peer reviewed paper from the Singapore research team that suggests reaction to other coronaviruses and, more specifically, SARS. One of the Singapore scientists also mentioned on twitter that pre-existing immunity might be the reason for Asia countries having much lower death rates that Europe. It was a by-passing comment but I thought it was interesting.

yes, that is a new study. However the fact that they detected the antibodies in "convalescent" Covid-19 cases doesnt suggest they were very protective, does it.

@Firefliess

There'd be no point lying saying you had symptoms in order to stop isolating sooner. It's not actually policed - if you were determined to ignore the advice you could do. Not testing is more likely an issue to do with what symptoms someone has I would have thought. I think they're still only recommending tests for a cough or fever or loss of smell or taste - not if you have sore throat, aches, fatigue, etc - which could be Covid but are still more likely to be something else.

I worry that not testing someone who has been asked by t and t to self isolate and is now showing symptoms is due to the Gov trying to suppress the number of positives.

If you want to look like a Gov successfully managing a pandemic you could avoid testing mildly symptomatic people esp if younger and unlikely to deteriorate to needing hospital care. Then you give an impression of a lower spread and public confidence builds so they venture out more and spend.