Daily numbers, graphs, analysis thread 16

[BigChocFrenzy]

Welcome to thread 16 of the daily updates

Resource links:

Uk dashboard deaths, cases, hospitals, tests - 4 nations, English regions & LAs
MSAO Map of English cases
[[https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/909430/Contain_framework_lower_tier_local_authority__14_August_2020.pdf
Slides & data UK govt pressers
UK added daily by PHE & DHSC
R estimates UK & English regions
PHE Surveillance report infections & watchlists every Thursday
ONS England infection surveillance reports
ONS UK death stats released each Tuesday
ECDC rolling 14-day incidence EEA & UK
Daily ECDC country detail UK
WHO dashboard
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 test positivity etc

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

Population age is important, e.g. death rates developed countries vs Africa

Population density is a major factor in Europe, where countries have a lot of similarities
e.g. the Scandinavian countries all did well

The exception there being Sweden, which had 5-12 x deaths / million of its neighbours which locked down
and with similar GDP drop predicted by EOY 2020
Sweden is a clear example of how government policy can drastically change the number of deaths

Many analyses of European countries by e.g. the FT showed that date of lockdown, related to the progress of the epidemic in each country, was the critical factor in Europe, for countries of similar population density which locked down

We can see in graph 1 that the UK locked down at a later stage in the epidemic than other European coubtries
and in graph 2 estimates of how exponential growth punished that week or more delay with nearly 300,000 infections

Boris dithered over when to lock down. I imagine the advice he got was to lock down sooner - since anyone with sense was calling off sporting events, telling staff to work from home and so on even before lockdown.

When people feel unsafe they dont go out spending money. Therefore it isnt surprising that countries where people feel safer take less of a hit. Boris has also been really stupid over what was and was not permitted - no good reason to keep garden centres and outdoor attractions like zoos or self catering accommodation shut as long as they did.

Add to that ignoring advice to stockpile PPE and then throwing money at incompetent mates, not just for PPE but track and trace. Boris and Cummings could hardly have made a bigger mess of this.

Also it could have been worse. Many people, my older relatives included, all started shielding effectively on around the 13th/14th March in the UK. I haven’t seen any data on this, or any surveys.

However if people had acted exactly the same, the numbers would have been greater still.

[quote IceCreamSummer20]@BigChocFrenzy yes the Government were also saying that there was only a 12 week compliance window, and that doing it too early would result in a second wave.

In my view two assumptions not based on real evidence or numbers. Even now it looks like there are not ‘second waves’ but a continual tidal flow.

And on compliance, hundreds of academics wrote an open letter to SAGe and the Government in March saying that there was no evidence at all to back up that people would only adhere to a 12 week period of compliance for lockdown.

It was based on assumptions, and unlike this thread, not a critical impartial analysis of evidence, numbers or data.[/quote]
....
This recent rise in cases is only producing very few deaths and countries do not have excess deaths in this period

In fact, there are atm only a tiny %, probably about 3% in the UK & Germany, of the cases seen at peak
That is the major reason
The other reason is that it is mainly the young & middle-aged being infected, not the elderly

This winter, governments may again have to act competently to avoid a large number of deaths, as young & old mix indoors
and immune systems are lower in winter.

However, far more is known about what measures work, so European countries are likely to have very similar policies
So it may well be that the March-April 1st wave is the one with the greatest difference in death rates / million

Yes, some people of all ages stayed home across Europe as reports came in from N Italy,
without waiting for their governments

This had some effect on the spread and also had considerable effect on some leisure businesses which often only break even when at least 90% of their customers are spending as usual

Most European governments took some measures ahead of lockdown
e.g. BJ with hand-washing
and I remember Merkel cancelling large events and imposing some restrictions from 10 March

However, lockdown caused a far greater % of people to strictly SD, not just the more nervoius / cautious ones

Yes I do believe that this is a likely scenario - and shows the weakness in the early models - which did not take into account psychology - that younger people would feel freer, mix more, and would make up the majority of cases once out of lockdown which translates into a different kind of increase than the one in March. Like you said with less deaths, and possibly different clusters, locations, type of spread.

Winter will be quite a critical time... I do hope that we collaborate more and take best practice.

The minority of cautious people staying home probably reduced the upwards slope of the exponential curve,
but it still had a very high gradient at that stage, in the available data for all countries before lockdown.

Even if we are cautious about modelling, the data shows deaths following a couple of weeks later and continuing at a high level well after R had fallen below 1.

The UK had 22 consecutive days of > 1,000 daily deaths, with a peak of 1,445 deaths on 8 April
This was not published at the time, as the daily UK figures did not include care home deaths until the end of April

@IceCreamSummer20

Yes I do believe that this is a likely scenario - and shows the weakness in the early models - which did not take into account psychology - that younger people would feel freer, mix more, and would make up the majority of cases once out of lockdown which translates into a different kind of increase than the one in March. Like you said with less deaths, and possibly different clusters, locations, type of spread.

Winter will be quite a critical time... I do hope that we collaborate more and take best practice.

.... The models may well have taken that into account but younger people mixing leads to v few deaths and it was essential to restart the economy during summer

As Spiegelhalter wrote in this recent article,
5,000 30-year-olds catching COVID would only result in 2 or 3 deaths

Lockdown was a much bigger impact you are right.

I do wonder about many of those with really serious underlying conditions who shielded before lockdown though. I don’t know how many there are but anecdotally of my own friends / family 5% shielded at least a week before they had to. They are now taking some low level risks, and may well stay like that until a vaccine is found. What is going to happen to them? I wish I had some data, or numbers, to know how big an issue this is and how to long term protect them.

5,000 30-year-olds catching COVID would only result in 2 or 3 deaths puts it very clearly. Spiegelhalter is so good at presenting risk and can always be relied on.

For winter, we only have the "reasonable worst case" of 80,000 deaths or whatever

I really would like to see their most likely 2 or 3 scenarios
and their "reasonable best case" too

@BigChocFrenzy your graph is so clear. Wow 1000 a day deaths is quite humbling.

Yes I’d like to see different scenarios too. The comparison with best and worst case would be much more useful than one or the other.

I would like to see this compared to a European wide view too. And also scenarios looking at how effective or not local responses are, how good our data is locally in triggering different levels of response.

I wonder what the rough risk criteria for shielded is

e.g. a risk say equal to someone aged 80+ ?
That would mean about a 10% risk of death ... but only if they actually catch the virus, which with only 1 person in 500 / 1,000 / 2,000 or whatever it is in winter,
is still a very small risk unless (unlikely imo) we return to near the case levels of March-April

It depends on whether they can stay home and just go out at quiet hours for a walk

One very sensible measure when opening schools in Germany was to allow the most vulnerable teachers, about 3% of them, to WFH - that's the equivalent of the UK shielded - to e.g. teach the shielded children online.
I hope the Dept Ed will instruct the same, but at least individual heads might do so in the meantime ?

Most large businesses at least are allowing the most vulnerable to continue WFH, even if everyone else returns
and I hope that small businesses will too, even those who have no online work, since the equivalent of furlough here is running for at least 24 months
Many businesses have ramped up their existing early retirement schemes too, since age is such a major factor, especially combined with not quite as serious conditions

WFH is one very important way of enabling someone to continue to shield. Germany sounds so sensible on so many levels. I have heard suggestions that vulnerable teachers team up with vulnerable children to teach them online.

It seems a good idea to enable those who want to continue to WFH anyway. I know people are worried about inner cities, however I do think climate change wise too it’s a good thing if people do not commute every day, use less big office spaces.

Many people I know still shielding are worried about the long Covid - either it’s Covid long term effects or getting Covid triggering a worsening of their existing condition, such as Cystric Fibrosis or severe COPD, where any bout of flu or bad cold often leads to more damage, or immune deficient, and struggling as they are. All are WFH or retired but some have kids, going back to school, or there is pressure to meet up with other family.

Can anyone comment on the assertion that COVID is primarily spread through surface contact?

Everything I've been reading recently seems to indicate the opposite.

@NeurotrashWarrior I’m interested in this too as 90% of the measures at dds school are focused on surface cleaning only.

If vulnerable staff are allowed to tutor shielded children from home, it poses too many logistical difficulties, even though it sounds a good idea :

Who replaces the teacher in school ? There is a recruitment crisis.

At secondary, teachers have specialisms. Three , let's say, vulnerable teachers in a large secondary won't cover all - perhaps not even any - of the subjects the student(s) might be studying.

I do think medical needs tuition funding and provision should be increased to allow medically vulnerable children to stay home. As someone with a DH with a heart condition , I wish he could stay home. But its not practical-and, at the end of the day, DS and I will still be at schools and could bring things home. It is difficult not to feel fatalistic.

Spiegelhalter is very wise. However, he does mean 2 or 3 deaths of those 5000 who mix, which kind of ignores vectors and transmission onwards to older people, doesn't he?

@Reastie it was in relation to the fact that a lot of children and staff are catching normal colds.

I queried why that would be given measures; so perhaps those particular viruses are more infectious via air (and sneezes) whereas CV is close air contact and surface contact?

I feel I should know by now!

Unfortunately I have a specialism in an sen school. It would take me a while to get to grips with a group of shielding children, though it's possible this will be the plan.

little evidence that Covid is transmitted from surfaces. It's pretty hard to be sure because if a surface is contaminated it is usually because someone has been breathing/coughing/sneezing over it - and therefore also possibly over the people who became infected. However the virus does not survive more than hours on soft surfaces, a day on cardboard. It lives longer on plastic and metal. Cleaning surfaces is precautionary, avoiding people is essential.

Long term protection of the most vulnerable means not putting pressure on them to meet other people, not using them for childcare, ordering food online for them if needed and not leaning over them in the supermarket. You could also help by seeking out the virus now so that come winter you are not taking up a hospital bed - few people are that altruistic. But life is about balance and minimising risk, you can never eliminate it and if they wish to take risks, e.g. to meet family, that is their choice. I have a friend at risk who is taking his grandchildren out for meals and to attractions because he would rather a shorter life but a happier one. Another is about to go on holiday, but will isolate on return.

The behavioural scientists were right to say that social restrictions can only be applied for a limited time, they underestimated the time and over estimated the number of deaths to achieve significant compliance. Reapplying restrictions, if needed, in winter will be far more difficult.

As for the hospital admissions - my take on this is that people were admitted with suspected coronavirus, it was confirmed after admission. So not counted as a Covid admission but soon after included in the bed count.

Yes I’ve tried to find my up to date information on surfaces, no couldn’t.

The behavioural scientists were right to say that social restrictions can only be applied for a limited time, they underestimated the time and over estimated the number of deaths I honestly don’t think that this was a behavioural science decision. Huge numbers of behavioural scientists asked to see what evidence they based this on, and SAGE never produced any.

Typical colds are aerosol, the particles are much smaller than covid particles so they stay in the air for longer.

There are no proven cases of surface transmission, just some suspected cases; petrol pumps. Cleaning hands and surfaces is easy however and people have all been anti-bac heavy since March, so it's possible that's just because people are being careful. Door handles and public buttons can be grim at the best of times, even if the risk is tiny then the virus would get through on those surfaces first.

Have the WHO and govt accepted that airborne transmission is a source of infection or is it still a case of not enough evidence but highly likely? I notice my dds school is having large lunch sittings for many bubbles simultaneously but it’s ok because they have some flimsy office type screens between bubbles in the hall (which I imagine will do very little if airborne)