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 📈 📉 📊 👍

Are the canaries still doing better than spai as they would get much more sun. Even if not going out in summer they would likely get vit d all year round.
I also wonder if some ethnicities/rationalies etc have higher rates of asymptomatic. So say british sun seekers. (Especially if they use sun beds too).
I havent paid attention to devon and cornwall did they ever get an increase from all the tourism.

I imagine island air is clearer than city.

Although it's definitely mostly younger people getting it now, I can't help wondering if all that sun helped too, impacting hospital admissions.

there have been small increases in Cornwall and some parts of Devon. Plymouth had an increase due to teenagers returning from abroad. There have also been small increases in some other tourist locations, nothing massively significant (Great Yarmouth looks bad but was a factory outbreak).

The vitamin D study did have more diabetics and more males in the non calcifediol group but the treated group were slightly older. perhaps ought to give a warning about not overdosing on vitamin D, though, after reading that.

I imagine we will now, finally, get a uk study.

If the UK only has 1% or 3% of the cases it had at peak, that would be far more important for hospital admissions than Vit D

Interesting that Sweden is not seeing the rise in cases in other countries and now has fewer cases per 100,000 than Norway and Denmark. Apologies for the Daily Fail link, but I find the graph on the fall in Swedish cars really interesting - once the cases started to fall, it was quite dramatic. It will be interesting to see if cases pick up when people return from summer holidays, but if not, it is really positive.

www.dailymail.co.uk/news/article-8698925/Lockdown-free-Swedens-coronavirus-case-rate-lower-Nordic-neighbours-Denmark-Norway.html

Summer / Vit D may well have considerable effect, but difficult to see it when cases are comparatively so low
Difficult to find something to compare with, other than studies of sick people.

We really need to know if it reduces the number of people going to hospital in the first place,
maybe studies on Vit D as a prophylactic on well people - difficult to set up.

[quote Eyewhisker]Interesting that Sweden is not seeing the rise in cases in other countries and now has fewer cases per 100,000 than Norway and Denmark. Apologies for the Daily Fail link, but I find the graph on the fall in Swedish cars really interesting - once the cases started to fall, it was quite dramatic. It will be interesting to see if cases pick up when people return from summer holidays, but if not, it is really positive.

www.dailymail.co.uk/news/article-8698925/Lockdown-free-Swedens-coronavirus-case-rate-lower-Nordic-neighbours-Denmark-Norway.html[/quote]
...
Well, they had to pay for it with 5-12 x total deaths / million of their neighbours

They even had 5.5 x deaths / million of Germany - who still have a lower 7-day incidence of cases

A policy that has as step 1: let a lot of people die
doesn't impress me with step 2 - fewer cases, when few people are dying anywhere

Spain releases its figures in a surveillance report, here is the latest: www.mscbs.gob.es/ca/profesionales/saludPublica/ccayes/alertasActual/nCov/documentos/Actualizacion_200_COVID-19.pdf.

Issues started roughly when the UK and other governments were first considering adding quarantine. First a few seroprevalence results were added and Spanish ministers kept repeating it was mostly old cases, even when new cases were over 2000 and low figures of seroprevalence on top. There used to be a note just saying there were gaps for the last 7 days due to central confirmation, several journalists were commenting that there were unexplainable gaps from the figures reported by the regions. Then as it became obvious there was a stall on figures and nothing added up, this joined the report:
"Las discrepancias que puedan aparecer respecto a los datos de casos totales notificados previamente son resultado de la validación de los mismos por las comunidades autónomas y a la transición a la nueva estrategia de vigilance."
Roughly - there are discrepancies because regions are still switching to the new surveillance method.

I've no idea what's going on, whether the regions were all doing something different that needed clean-up (like PHE deaths and like Wales should do with admissions), or whether there is some dodgy amalgamation and deliberate subterfuge to try to protect tourism. The Spanish government definitely know that the numbers don't add up though.

On thing to gamble with a very low population density Scandinavian country with a non-huggy culture and a high number of single-occupant countries

Quite another when applied to e.g. the UK, with 12 x the population density
and containing London, a "world city" of 9 million - nearly the population of Sweden

Applied to the UK, no lockdown and multiples of current total deaths would have been a disaster
BJ and SAGE looked at the death curves in mid-March ... and the UK was following Italy, not Scandinavia

True, but that all depends on whether there is a vaccine/effective treatment soon. If there is one by the end of the year, then Sweden’s strategy looks wrong. If however, it takes a few years, then there may be a different answer as no country can sustain lockdown for long/not educate its children.

@Eyewhisker

True, but that all depends on whether there is a vaccine/effective treatment soon. If there is one by the end of the year, then Sweden’s strategy looks wrong. If however, it takes a few years, then there may be a different answer as no country can sustain lockdown for long/not educate its children.

... Nobody now is considering a 2nd lockdown or keeping schools closed

Lockdown was when COVID was a "novel" virus and noone really knew what measures would work, so lockdown was a shotgun approach of everything at once

Now we know that about 90% of infections are from superspreaders, because COVID has a dispersion factor of only 0.1, but an R of about 3
That children are at v low risk, but the elderly must be shielded
We have mass testing, track & trace systems
We have 2 cheap steroids which help reduce deaths
We have O2 treatment which helps stop cases becoming critical

So of course we can apply targeted measures, test, track & trace
which will not be that different to what Sweden is doing - and they have also modified their strategy as knowledge is gained
I read that mask use there is rocketing - pharmacies reporting a year's sales within a couple of weeks

Sweden in the beginning had the luxury of SD from low population density itself, which flattened the curve a lot and reduced the pace of deaths
whereas N Italy's health service was overwhelmed and other densely populated countries were facing the same prospect

What do you think would have happened if Italy had just let people die ?
There was no public consent for the carnage that would have resulted

or in the UK
People won't just accept multiples of the deaths we had
There would have been civil breakdown

All the scientists actually working on vaccines predict they will be rolled out next year

They will probably need to be annual jabs

• which is another issue: that hardwon immunity of 7-20% (depending on study) of the Swedish population may not last more than a year anyway

and after all those deaths, Sweden's GDP is predicted to have about the same drop by the end of 2020 as the other Scandinavian countries and NZ, even near that of Germany too

because regardless of whether a government closes bars,restaurants and shops etc, many people don't behave the same when they are afraid of a pandemic
Non-essential businesses struggle to break even when a chunk of their customers stay home

I am not advocating letting people die and I was in favour of a short, sharp lockdown to get things under control/buy the health service time. However, once this is done, then a Swedish strategy to live with the virus is a good thing. This means social distancing, care with the elderly, those who are ill to stay home and isolate etc.

But it does not mean panicking that there are some asymptomatic cases in young adults, or shutting an entire school because there is one positive case. Obviously those who are ill should stay at home, but no need for constant local lockdowns, or to shut a school if there are a few cases.

If there is no effective vaccine (though I really hope there is one soon), then we have to learn to live with the virus. I can understand the NZ strategy of elimination (though probably only possible for them) and the Swedish strategy of living with the virus. I don’t really understand the UK strategy now. It is not based on elimination and it means a very disreputed society, economy, probably education if two cases closes an entire school. It has huge cost - still many non-covid medical service are not operating - but could last years without a vaccine as it prolongs the agony.

I find it interesting the possibility that the virus is not spiking in Sweden while it is elsewhere. If in 1-2 months cases stay low there, then it suggests that a policy of staying open and not shutting down for asymptomatic cases may be better.

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/914839/Contain_framework_lower_tier_local_authority_watchlist_-maps_by_LSOA-_04_September_2020.pdf

Quite a lengthy list in today's PHE report, although quite why all the Norfolk LAs appear is not immediately obvious Kate's quite happy taking the kids and CPOs to Kings Lynn Sainsbury's after all

The LSOA maps as attached show the positivity rate graphs for each LA on today's list. Several of the NW LAs around the 4% to 6% mark, with Bolton higher again

At the peak of the epidemic there were 4500 people in hospital, if 20% need hospital care that would be 22,500 cases, if only 10% 45,000 cases. According to the ONS surveillance study we currently have around 3,800 infections a day. Even if you worked on deaths and a 1% death rate you get 100,000 infections at the peak compared to 3,800 now - so maybe 3.8% of the infections but 0.1% of the deaths.

While this is mainly due to infections now being much younger vitamin D may be having an impact.

Not sure why there is so much emphasis on studies on keeping people out of hospital, if vitamin D genuinely has that sort of effect on ICU use/death rates it would be more significant than existing treatments.

High death rates are bad for the economy because a substantial part of the population will not go and spend money on services when they perceive the risk as too great.

Anyone have recent data on Finland? Last time I looked they were not seeing the same sort of rises as Europe and their economy is forecast to do better than Sweden's. They had a death rate well below Sweden's.

Viral load may also be a significant issue causing more deaths for more infected people, and the age of infected people is vastly different. There are no simple answers without detailed research and time.

We all take vitamin D3 every day anyway, but I always have because of low vitamin D in the past (did it levels get hammered by swine flu, or did swine flu hit harder because of low vitamin d?). Liquid or capsule forms only ladies, tablets are not as good.

Neither NZ or Sweden's strategy really work for densely populated European countries if there are a large number of cases,
especially not countries with a world city like London, 9 million people and massive international connections

We at least need to severely limit foreign travel if cases rise much more,
which is a great advantage of being an island with limited routes of access, instead of e.g. having 9 land borders, as Germany does

We'd be OK if cases stay under maybe 10,000 but if ever exponential growth takes off, then deaths will rocket again too.
The government is trying to avoid exponential growth - if they allow it to happen again, they'd be crucified
and the economy would be wrecked

I personally would not shut huge year groups or schools for 1-2 cases, but I don't have that responsibility hanging over me
imo, BJ hasn't recovered his nerve since nearly dying from COVID - and neither have some of his colleagues

The shutting down of so many NHS services baffles me, but it looks a specifically British problem - probably due to lack of resources and certainly should be corrected.

My doctor & dentist in Germany contacted me at the end May to resume normal checkups
I had my dental check, scrape & polish in mid-June
and I gather all important medical treatments continued throughout lockdown (unless the patient refused)

The shutting down of so many NHS services baffles me, but it looks a specifically British problem - probably due to lack of resources and certainly should be corrected.

Yep. Specialists were quiet here apart from some who made a natural move (anaesthetists who moved for Covid care to be intensivists - related sub specialisms).

But NHS has moved to a position of crisis/acute/red flag provision in such an embedded way over the last 10 years that they can only operate in this basis now. So they cleared (discharged) elderly out to free up already reduced numbers of beds to allow them to absorb the Covid cases.

And I’m a life long labour voter saying this.

Merkel stopped all elective surgery in March and through lockdown - that's tummy tucks, breast reductions, plastic surgery etc - but the important non-COVID work continued

and they've had a massive drive since to get in everyone who missed their regular smears, breast checks, blood tests etc

NHS services never shut down, the NHS continued to provide emergency care, maternity services and even did some elective work. (the stats were quoted on a previous thread, ironically by someone claiming the NHS had shut down when the data doesnt support that. ) However if some of your operating theatres have had to be turned into ICUs and your consultants are also in ICU (sometimes as patients) and your laboratories are engaged in processing tests they are not doing as much other work. ICU is intensive care - that means you need a lot more staff per patient and we dont have spare ICU staff. Other doctors had to be rapidly trained and then did the best they could. Junior doctors were doing nursing tasks for lack of trained ICU nurses.

I think you'll find in most countries that were hit hard a lot of more routine care stopped for a time - and that patients are staying away from health care. e.g. globalnews.ca/news/7213559/covid-19-healthcare-workers-us/ and www.nytimes.com/2020/03/12/world/europe/12italy-coronavirus-health-care.html

People in the uk maybe complain more about our health care system.

SAGE sounding caution:

www.theguardian.com/world/2020/sep/04/uk-police-deal-with-thousands-of-potential-covid-19-quarantine-breakers

“The question is whether that can be contained as controlled outbreaks or whether the infections become community wide again.
I would say that it is pivotal.
We either go in to the winter in a position where we feel confident that we have this problem on a string, or where it is still a wild beast which we can’t control.
I suspect it’s the latter.”

I think UK citizens do not complain enough

Finland:
An average of 24 new cases per day in the past two weeks. 2 deaths in the past two weeks. 10 people in hospital, 1 person in ICU.

www.helsinkitimes.fi/finland/finland-news/domestic/18031-coronavirus-isn-t-an-epidemic-in-finland-say-chief-physician-boss-at-thl.html