Daily numbers, graphs, analysis thread 14

[BigChocFrenzy]

Welcome to thread 14 of the daily updates

Resource links:

Uk dashboard deaths, cases, hospitals, tests - 4 nations, LAs, English regions
Slides & data UK govt pressers
[[https://www.gov.uk/guidance/coronavi
rus-covid-19-information-for-the-public UK stats]] list of reports added daily by PHE & DHSC
PHE Surveillance report infections & deaths released every Thursday with sep. infographic
ONS England infection surveillance report ONS UK statistics for CV related deaths, released weekly each Tuesday
Daily ECDC report UK & EEA
Worldometer UK page
Plot FT graphs compare countries deaths, cases, raw / million pop
Covidly.com world summary & graphs
Plot COVID Graphs Our World in Data additional data

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

@meercat23 I think the 98 is from yesterday, they probably haven’t updated it

Sorry yes 55 today, 98 yesterday! Got my dates mixed.

Thanks PatriciaHolm I knew about the overcounting but was puzzled by the difference between what the government site said and what was shown on Worldometers. Worldometers have now changed the death figure to 55.

[quote MarcelineMissouri]Sweden. Can I ask for peoples views on what’s going on there? I was reading this article from a Swedish dr in Stockholm saying life is pretty much back to normal for them, cases are low, hospital admissions and deaths virtually nothing now.....

sebastianrushworth.com/2020/08/04/how-bad-is-covid-really-a-swedish-doctors-perspective/[/quote]
.....
Scandinavian countries have v low population density, so they are all look "back to normal" atm

e.g. Norway had zero deaths in the second half of July and under 100 daily cases
Sweden has deaths mostly in single figures and low hundreds of cases

The issue is that Sweden had one of the highest cumulative deaths / million in Europe, because they didn't go into lockdown

Sweden had 5-12 x deaths / million of their Scandi / Nordic neighbours with similar low population density and culture

Even though their central bank predicts a similar drop in GDP to their neighbours

• and to high population Germany, which had only ⅕ deaths/ million

The theory being touted is that IFF there is a massive 2nd wave,
then maybe Sweden would be the only European country not to experience it
and hence maybe deaths / million won't look so different

However, personally I do NOT really expect a huge 2nd wave anywhere and certainly not in such low density population countries as in Scandinavia

The other issue is the perennial argumaent with those who continue to obssess that the UK lockdown was wrong

Well, the UK is a highly populated country with curves that follow Italy - which was facing carnage before it locked down.
It seems likely that continuing with lockdown would have multiplied the UK deaths by some factor, as it has multiplied Sweden's so much

Personal opinion only :
Sweden's deaths, even 5-12 x higher than their neighbours, are still "acceptable"
However, 5 or more x UK deaths clearly wouldn't be

Hence UK lockdown was necessary - the problem is that it was too late, lasted too long
and the NHS had to shut down far more non-COVID services than health services in many other European countries, because the NHS is always running too near to full capacity

Especially now the virus is not so "novel", different countries probably need different strategies:

AGE:
Developing countries have v few very elderly people - some African countries have mean age < 20 !
Also they don't have the resources to support people for months not to work or go out

POPULATION DENSITY
This really matters espeially in an aging population for infection spread and the limits of exponential growth

Just looking at Europe - typical Western aging populations with high obesity T2 etc:

# People / km2
_
https://en.wikipedia.org/wiki/Listofcountriesanddependenciesbypopulation_densityy_
_
23 Sweden
17 Norway
135 Denmark

280 UK
200 Italy
233 Germany
376 Belgium

Deaths / Million population

https://www.worldometers.info/coronavirus/#countries

568 Sweden
47 Norway
106 Denmark

680 UK
581 Italy
110 Germany (a total anomaly due to Merkel's v early lockdown & v effective public health services)
849 Belgium

[quote whatsnext2]@ChristmasinJune
No the point is they are all being decommissioned..

The opposite of being prepared.[/quote]
Oh my mistake sorry, that'll teach me to comment when I'm in the queue at Tesco!!

It doesn't seem to make much sense to decommission them now. Why not leave them mothballed until it is clear whether cases will spike in the winter?

@meercat23

It doesn't seem to make much sense to decommission them now. Why not leave them mothballed until it is clear whether cases will spike in the winter?

Maybe they're still hoping to hold some larger events in them and are more concerned about boosting the economy than being well prepared?

Or maybe they actually weren't really a very good idea in the first place?

My nurse friend tells me that the nightingale hospitals were only really built to cope with Covid patients needing high levels of care and aren't really suitable for much else. I think she means there's no specialist equipment needed for any other conditions, no operating theatres and they're also not suitable for patients who aren't bed-bound.

I don't know how feasible it would be to convert some of them to at least some other NHS uses. I gather there are huge waiting lists now for non urgent (but nevertheless necessary care) and that they're still not seeing the normal numbers of patients due to social distancing. Longer opening hours may be a solution for outpatients, but for inpatients they need more physical space - so converting some of the nightingale hospitals to general hospitals might help.

The Nightingales were a political exercise - the Chinese built a hospital in ? days so we can do something similar. There never were people available to staff them, they would have been warehouses to die in. It can take 7 people to turn someone on a ventilator. It's not just a matter of sticking them on oxygen and just leaving them to see if they survive.

I wouldnt believe anything the government says about nightingales.

The NHS could do with extra beds but they are pretty much useless without other things, most importantly staff. A change of government might help with that.

As for the Swedish "doctor" - anyone able to check if he really is one? He didnt know how to put on his gas mask and it hasnt occurredd to him that lockdown was to enable time for new treatments. He's not very bright.

Interesting article about false negative tests, should be more publicised?

www.google.co.uk/amp/s/amp.theatlantic.com/amp/article/613246/

I don't think a lack of NHS staff is the main factor with making use of the nightingales currently @already. It would have been at the peak, yes. But now they have very few patients in hospital with Covid. The problem they're having is that they are trying to physically distance all the patients. That means some of the consultation rooms cannot be used as they are too small, and they can't fit as many patients as usual in a ward - and ward capacity is a key factor in determining the number of operations they can do. They have sufficient staff to look after the normal number of patients but need more space to put them in. So they could move some of the existing staff to the nightingales if they had the right facilities there for the non-covid patients.

[quote JulyBreeze]Interesting article about false negative tests, should be more publicised?

www.google.co.uk/amp/s/amp.theatlantic.com/amp/article/613246/[/quote]
Only skimmed it but seems to confirm current uk policy wrt tests. If you have symptoms (and haven't been in contact with a known case) you can get a test to rule out covid and if it's negative go about your life once you feel better. However if you are in quarantine due to either contact with a known case or return from a high risk country then a negative test isn't a get out of jail free card as you could still be incubating (hence why we aren't testing everyone coming back from high risk countries or as part of track and trace as it's no use)

Ireland has locked down the midlands region - high rates linked to direct provision centres and meat factories. It is for two weeks starting today.

Especially now the virus is not so "novel", different countries probably need different strategies I agree @BigChocFrenzy - we can learn from other countries still, however we have to take in our own situation. NHS capacity, age make up, population density. We are still an Island and we haven’t really made the most of this yet I feel. This could really to our advantage.

Yes @Littlebelina but there are other factors to consider too:

"For individuals, however, the FDA cautions that negative results do not rule out infection. It asks that asymptomatic tests include this statement: “Negative results must be considered in the context of an individual’s recent exposures, history, presence of clinical signs and symptoms consistent with COVID-19.” And this, in the face of imperfect COVID-19 tests, is key to interpreting a negative result. It depends on your probabilityy_ of having COVID-19 in the first place.
Consider again the decision to visit elderly relatives after a negative test. “If you have symptoms or you work in a place where you’re at high risk for exposure, then even with a negative test, you might want to think really hard about it,” Steven Woloshinn_, a co-director of the Center for Medicine and Media at the Dartmouth Institute, explained to me. “If you’re at low risk because you live in some remote area, you’re practicing social distancing, you always wear a mask, and you feel fine,” a negative test is probably a true negative"

Had typed reply but it crashed, anyway that seems like common sense (avoiding elderly relatives when ill seems sensible even in non covid times ditto if you work in a high risk area). If people need telling that I'm not sure being told that false negatives are possible (which is fairly widely known as far as I'm aware) will make much difference to their actions

Can I ask for peoples views on what’s going on there? I was reading this article from a Swedish dr in Stockholm saying life is pretty much back to normal for them, cases are low, hospital admissions and deaths virtually nothing now.....

All countries outside China had very low case numbers in January... By March it was out of control. Irrespective of population density, if countries go back to normal if numbers are very low, they need to maintain extensive testing regimes to stamp down on outbreaks as and when they do occur. If a country believes “it’s over” and has “beaten” Covid, it will come back to bite it. Just look at Australia.

@alreadytaken

As for the Swedish "doctor" - anyone able to check if he really is one? He didnt know how to put on his gas mask and it hasnt occurredd to him that lockdown was to enable time for new treatments. He's not very bright.

.... iirc his article was on the blog of Dr Robert Kendrick who is noted for having unconventional / alternative views - he was deleted from Wiki after disagreeing with the high cholesterol / heart attack risk mainstream

I also have issues with the low fat dogma btw and I'd want to know more about the reasons for deletion, but can only find Dr K and his supporters, who are hardly neutral observers

I'd presume Dr K could easily check his guest writer was an ICU doctor
However, they are both very obviously pushing a particular pov and
e.g. don't address the fact that Sweden the 5-12 x the deaths / million of its neighbours

imo, there is an excellent case to be put for very low pop density countries not to have locked down,
because their low pop density in itself "flattens the curve" of infections

• something high pop density countries, facing an N Italy situation, could only really address via lockdown until more was known about COVID

Although Sweden hasn't really benefited wrt its economy & GDP - because e.g. customers won't behave the same, regardless of whether a government allows / forbids some things,

there are other important benefits they had, such as greater personal freedom and the state not increasing its powers

However, those two writers don't make a good case at all, because it seems all about showing how superior their pov is and what idiots the rest of the world are

Also, the idea that Sweden will end up with not many more deaths than others will only be the case if other countries suffer a massive 2nd wave,

which as I've said I don't believe is that likely, certainly not for their low pop density Scandinavian neighbours

That Swedish doctor is suddenly being quoted all over MN, which is "interesting"

However, Sweden's deaths / million compared to its neighbours are not - until I add the comment !

Just heard on the news that they're trialling budesonide inhalers as a treatment option.

Possibly from this?

www.cebm.net/covid-19/inhaled-corticosteroids-a-rapid-review-of-the-evidence-for-treatment-or-prevention-of-covid-19/

Actually from that it's seems contradictory!

That is odd, it looks like ciclesonide had a positive outcome, but budesonide did not, although only trialled in one case, so fairly small study. Perhaps they want to quickly rule it out in comparison with ciclesonide.

"Both in vitro studies indicated that ciclesonide has anti-viral properties against these respiratory viruses and the clinical study showed favourable outcomes in the three patients presented, however these clinical results should be treated with caution.
Inhaled ciclesonide is expected to reduce viral replication and pulmonary inflammation, whilst having lower immunosuppressive effects when compared to systematic corticosteroids.
A single in vitro study that investigated the antiviral potential of budesonide observed no reduction in viral replication in cells treated with budesonide and no reduction in inflammatory cytokine release."