Daily numbers, graphs, analysis thread 13

[PatriciaHolm]

Taking the liberty of starting a new thread as we've just bust the old one, with much thanks to @BigChocfrenzy and I will copy her header..

Welcome to thread 13 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 📈📶👍

@alreadytaken

boys3 I would hope that local authorities and whatever health authorities are called these days would be keeping a very sharp eye on their local area. They are supposed to be getting postcode level data - but I dont know how quickly they get it.

I do know that a number of local authorities have put plans in place in case of a local outbreak.

The local plans, if they have them, dont always seem to be working very well though. I'm getting everything as n/a now so have to clear cookies - but last time I looked Isle of Anglesey had one spike and they were clearly all over it quickly. Wrexham is on a second, lower, spike, Bradford didnt manage to stop a massive funeral.

I'm sure they are, although bearing in mind public health now sits within local councils and the funding challenges they've had over the last decade raises a question over adequacy of resources.

My point was more about proactive community testing in areas with low levels, as opposed to a primary focus on those where cases already starting to rise, to either give confidence that prevalence really is at low / close to zero levels, or highlight that lack of testing has given a misleadingly low picture.

However testing itself sits outside the control of local authorities I think (????), although the PH teams do now seem to be getting the data they need and at an improved frequency.

[quote MarcelineMissouri]www.thetimes.co.uk/article/coronavirus-driven-out-in-most-local-areas-rmllw92z2[/quote]
I was confused by this article. Is it talking about the Middle Super Output Area data here?

www.arcgis.com/apps/webappviewer/index.html?id=47574f7a6e454dc6a42c5f6912ed7076

or data from somewhere else? In the arcgis link, it says "Suppression: Numbers from 0 to 2 (inclusive) are suppressed." meaning that all those areas shown as white and looking as if they have had zero recent cases are really going to be a mixture of places with 0, 1 or 2 cases. Coincidentally the Times article has a table in it quite far down where you can look up your area - there are no areas listed as having 1 or 2 cases - only as 0, or 3 and greater. That makes it look as if they too are treating the 1 and 2 case areas as if they were zero, which might be fine in a map, but they actually seem to be talking about those areas as if they actually had zero cases and making a story out of saying covid has been eradicated there. This doesn't seem quite right.

@boys3 yes they are doing masses of testing in Luton. They have opened up for anyone in the worst hit postcodes to be able to get a test whether symptoms or not and it's had more bookings than slots and they were looking to open another centre last I saw

Luton is on none of those worst hit areas though 🤨 so I have no idea why what is happening there is happening in terms of the local lockdown compared to other places.

This was Luton coronavirus-staging.data.gov.uk/cases?areaType=ltla&areaName=Luton

so definitely looked like action was necessary but no worse than several other areas. Luton is not actually in local lockdown, though, it's just determined to avoid that. Local lockdown means closing non-essential shops, for example, whereas it's delayed reopening and closed playgrounds I think?

boys3 I think local authorities have to rely on things like the Zoe ap. They probably can request mobile testing centres from the government and they can leaflet/ use local publicity to encourage people to be tested. The problem is more likely to be with those most at risk of contracting the virus (the ones out and about most and ignoring social distancing) also being less likely to test. Unless testing starts to be required before you do certain things (fly, attend music events) then you cant be confident there isnt a reservoir of infection you are not finding in young adults living away from home.

It is a bit odd because Luton has always been below Bedford which just missed out on a local lockdown and never got offered any kind of mass testing.

Is the outbreak in Luton possibly more localised? In the MSOA map here www.arcgis.com/apps/webappviewer/index.html?id=47574f7a6e454dc6a42c5f6912ed7076 it looks like it's mainly just three MSOAs, which could justify more intensive local action than a similar number of cases over a larger area. Plus local councils have discretion to to their own thing a bit more now, so some may choose to intervene differently from others.

@ProfessorPootle

10 areas to watch ...

Just catching up now, so not sure if this has been covered already. Not sure how Blackpool can be in the top 10 areas to watch. There have been 7 cases confirmed in the last 7 days and that was an outbreak at the local hospital, its contained. When you look at how many cases other areas have had (leicester, Rochdale, Blackburn, chunks of Merseyside) 7 contained in a hospital doesn't exactly look like a huge concern for a population of around 140k.

It's v localised within Luton. It's postcodes in LU4 8 that is seeing the case load but the whole of Luton council area has been restricted. It's is on fairly long road that has the cases though.

The restrictions are more than gyms and playgrounds not reopening

further increasing testing capacity across the town (details will be available shortly)
• Keeping play areas closed
• increased enforcement against businesses that are not compliant with guidelines or that fail to show they are Covid-19 safe
• new guidance from the council’s Director of Public Health that people should not make social visits to other people’s homes

•	stay at home as much as possible
•	if meeting up with others, do so outside
•	don’t meet in large groups – people should not gather outside in groups greater than six individuals (unless they are from the same household)
•	keep a 2 metre distance from people outside of your household at all times
•	wash your hands regularly
•	wear a face covering in all enclosed public spaces where it is difficult to keep 2 metres apart
•	book at test at nhs.uk/coronaviruss_ and self-isolate if you have any symptoms, however mild

Just seems bizarre that the action is as it is when Luton isn't now even in the top worst list of effected areas.

@eeeyoresmiles I was wondering the same thing. I have not seen Council Ward level data - cases, testing, deaths - anywhere although if anyone has links to such data that would be great.

I think the Times "data" is MSOA level, with whole issue around suppressed numbers. Where I am we have 13 MSOAs but 11 council (county wards) and almost 30 district council wards. MSOAs and Council Wards are not the same thing. breaking news headline that the Times can go with tomorrow morning

That said the thrust of their conclusion - albeit possibly reached by luck rather than judgement - is reasonably sound. From the data available cases are in no way evenly distributed across the country. That does not mean though that recent low / zero case areas will necessarily stay that way with a highly communicable virus such as C19. For such areas the biggest risk is likely to be complacency, allied to a lack of local testing that would more accurately determine the local position.

I'm not sure it's all that helpful to look at very local levels tbh. It only really makes sense to look at the spatial scale at which people's lives operate - school catchments, nearest pub or high street, where people work, etc. I don't think many people live their lives within an MSOA - They are smaller than council wards or primary school catchments. And even if you did, your neighbours probably don't, so you can't really say you're at no risk of Coronavirus just because your neighbourhood hasn't had any cases lately. Yes there are clearly areas with local outbreaks, but there's also a lot of areas with just a few cases, and looking near me at least, these change day to day.

It's is on fairly long road that has the cases though

It's quite apparent that many of the new outbreaks are extremely localised. In our county, zero or few cases per area/ward, except one. The only area with several more cases is a ward where there happens to be a mosque, and a road with Muslim/Asian housing and multi-generational living. It's a possibly sensitive racial stereotype, but I do think and hope that the local councils focus on these areas, as they are also more prone to bad outcomes.

@Baaaahhhhh I didn't want to say it but it's the case on this road in Luton too...

Is it actually the case that all the local flare ups are either associated with one particular work place (like the Herefordshire farm) or in primarily Asian areas (East Leicester, specific areas of Luton and Bradford)? Does absolute priority need to be given to translating health advice - as it should have been all along - and disseminating the advice through local community leaders etc? Has the government just left these communities behind since March?

Also, are we starting to see spikes in death in places like Leicester. I know there are some reasons why mortality rates aren't as high now, such as hospital capacity and knowledge of the disease, but they may be counter balanced by higher risk in BAME patients anyway. Although iirc is that higher risk for infection and hospitalisation, not for mortality?

Sorry asking lazy questions here....

Diabetes Risk:

BAME are at higher risk of having T2 diabetes, which is proving a particular risk factor around the world

The CDC analyzed more than 10,000 deaths in 15 states and New York City from February to May.

Half of those COVID deaths aged under 60 had diabetes

Nearly 40% of all COVID deaths had diabetes

The previous Coronavirus epidemics of SARS & MERS also found diabetes were a disproportiomate % of deaths

https://www.reuters.com/article/us-health-coronavirus-diabetes-insight/why-covid-19-is-killing-u-s-diabetes-patients-at-alarming-rates-idUSKCN24P1B4

A separate Reuters survey of states found a similarly high rate of diabetes among people dying from COVID-19 in 12 states and the District of Columbia.

Ten states, including California, Arizona and Michigan, said they weren’t yet reporting diabetes and other underlying conditions,
and the rest did not respond
....
(USA) Keeping diabetes under control - among the best defenses against COVID-19 - has become difficult as the pandemic disrupts medical care, exercise and healthy eating routines.

The high price of insulin has also forced some people to keep working - risking virus exposure - to afford the essential medicine.
And as the country grapples with an economic crisis, millions of Americans have lost their jobs and their employer-sponsored health insurance.

T1 is an even higher risk factor than T2, but it is T2 that minority ethnic groups are much more likely to have
and also those of all races with high deprivation / povrty

Risk factors for COVID - after the absolutely dominant factor of age:

Occupation
Diabetes - T1 or T2
High deprivation / poverty

I've never spent much time looking at death figures. However I just had a quick look and it's obvious than London's figures were high but dropped very rapidly while the rest of the country did not. ( I looked at time to get the weekly average down to half the peak level and also the general shape of the graph).

London has a very high minority population so while there are pockets (Hackney?) that were not getting the message the rest of the city clearly were. Perhaps the issue is that if you were not hit hard early you just havent taken it seriously enough?

747 cases today - down about 20 on yesterday, and up about 20 on a week ago, so reasonably steady. Admissions still falling quite fast - so either they're catching more cases now, or it's increasingly the young who're catching it.

And, FWIW, 14 reported deaths today, lowest Sunday since they started reporting.

Admissions and those in hospitals steadily down - latter is down 15% on a week ago for UK.

I think they are catching more cases now because it is easier to identify potential hotspots. Then testing is made widely available e.g. in Luton.

It's reassuring to see that admissions and numbers in hospitals/ventilator beds continue to decrease. That suggests that it's more asymptomatic cases/milder cases being identified?

@Firefliess

747 cases today - down about 20 on yesterday, and up about 20 on a week ago, so reasonably steady. Admissions still falling quite fast - so either they're catching more cases now, or it's increasingly the young who're catching it.

Countries which have relaxed lockdown have seen the average age of infection drop sharply, e.g. USA, Germany, as the young & middle-aged mostly resume their social lives, while the elderly tend to be more cautious and the frail elderly in care homes remain quite well protected

However, UK daily deaths / million still remain higher than other comparable European countries,
who have comparable or higher positive cases

So although UK testing is probably finding more milder cases, it may still not be finding as many milder cases as other countries ?

I hope all countries are going to test returning holidaymakers - to avoid a "post-vacation spike" -
and some have indeed announced they will test those from higher risk countries, now including Spain

WIll these quarantines actually have teeth, or will they be completely voluntary, without serious checks ?

mainly the same concentration of cases in known warm / hot spots in the case numbers released today.

Looking at the case added this week - eg from Monday July 20th for the top tier LAs 25 areas account for 50% of cases. First 40 shown on pic with cases added each day, total cases add this week so far, cumulative cases; cases per 100,000 and cuml cases per 100,000.

first 50 I should have said - next 50 and lowest 50 (well 49)

I think that's the dodgy death figures though @Bigchoc. Hospital deaths seem the most accurate right now, as they cover at least most of the actual deaths, and not a whole bunch from weeks and weeks ago, or of people who had Covid back in March and died of something else. There's also more of a lag on deaths at the best of times, so I'm thinking that hospital admissions are a better indicator of whether cases are actually increasing or just being better detected

I'm sure there are more young people catching it now than there were back in March. But not sure i'd expect the proportion of young people to be still increasing in the last few weeks - where I live it's the middle aged who have started socialising recently, once pubs opened. The teenagers and 20 sometimes have been partying for weeks!

Could be the care home outbreaks finally coming under control behind the fall in admissions though.