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Daily numbers, graphs, analysis thread 16

999 replies

BigChocFrenzy · 28/08/2020 18:44

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 📈 📉 📊 👍

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Thread gallery
90
sunseekin · 05/09/2020 07:47

@MRex

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.

I was thinking about this yesterday. The same pattern here, Spain were desperately saying it was just localised controlled outbreaks as we added them to our quarantine list.

Also keep wondering about the ONS survey. Do they get their sample with population density in mind - or would a square mile of a highly populated city get as many surveillance tests as a square mile of a rural, more sparsely populated area?

If they sample due to area rather than population density, surely it’s going to take longer for the results to show up? Maybe they do sample according to population density....

sunseekin · 05/09/2020 07:52

It’s probably perfectly stratified, I’m just wondering, there seems to be a lot of conflict in the data at the moment, maybe we are just on the cusp of something.

Gwynfluff · 05/09/2020 07:54

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. )

They stopped red flag cancer screening for months. It’s going to take months to catch up (they have fewer patients per screening session due to distancing and cleaning).
NHS is just not in a good place to pick it all back up.

PrayingandHoping · 05/09/2020 07:58

It wasn't blanket across the nhs. Every trust reacted differently

My mum had a cancer scare mid pandemic and was dealt with within the normal time frame (she's had cancer before so we know how it usually works)

My baby has had all her appointments face2face where needed or over phone until August and now my trust is running all face2face again.

Firefliess · 05/09/2020 08:03

@sunseeking ONS take a random sample ofpeople So if two areas are the same size but one has twice the population then the one with twice the population will (on average) have twice as many people in their study.

That's assuming that the random people they ask too take part are all equally likely to do so of course. In reality more anti-authority or chaotic people may be more likely to fail to take part (though they are offering them a £25 shopping voucher per swab I believe, which should help the response rate)

I'm wondering s someone upthread did how they're going to increase their sample significantly, as planned, if the labs can't cope with all the tests they have to do currently though?

MRex · 05/09/2020 08:04

@sunseekin - ONS spread is defined by Ipsos Mori running sampling against everyone alive in the NHS database over the age of 5; the intention is to have even spread. Covid-Zoe know their spread is very uneven and make adjustments accordingly. In both cases, as @Redolent pointed out earlier in the thread, testing is biased to the type of people who agree to respond. It will miss the raft of people who aren't willing to take a test but might still spread the virus, as well as care home / hospital cases. With cases running so close to test numbers, the UK may have reached some limits on the usefulness from the surveillance testing because we can see almost everyone who agrees to get tested with symptoms will be identified. If numbers start to stabilise and then go down, the gap of those unwilling to be tested was small. If numbers keep going up, then the methodologies snd sociological approaches will have to change to account for the non-reporting group. Expensively, I think this will indicate a clear need for higher SSP payouts - for zero hours contracts and self-employed. Also, enter - The Sewage Reports... to identify areas of high risk without testing any individual. I'm very excited to see the results, I think it will be a game-changer.

sunseekin · 05/09/2020 08:08

[quote MRex]**@sunseekin* - ONS spread is defined by Ipsos Mori running sampling against everyone alive in the NHS database over the age of 5; the intention is to have even spread. Covid-Zoe know their spread is very uneven and make adjustments accordingly. In both cases, as @Redolent* pointed out earlier in the thread, testing is biased to the type of people who agree to respond. It will miss the raft of people who aren't willing to take a test but might still spread the virus, as well as care home / hospital cases. With cases running so close to test numbers, the UK may have reached some limits on the usefulness from the surveillance testing because we can see almost everyone who agrees to get tested with symptoms will be identified. If numbers start to stabilise and then go down, the gap of those unwilling to be tested was small. If numbers keep going up, then the methodologies snd sociological approaches will have to change to account for the non-reporting group. Expensively, I think this will indicate a clear need for higher SSP payouts - for zero hours contracts and self-employed. Also, enter - The Sewage Reports... to identify areas of high risk without testing any individual. I'm very excited to see the results, I think it will be a game-changer.[/quote]
Thanks so much for this, makes sense and what you have described about participation makes a lot of sense. Although I thought there were vouchers??
And yes I’d forgotten about the sewage reports! When is that data out again please?

MRex · 05/09/2020 08:13

I don't know about the sewage report dates; the programme officially started on something like 3/4 August, so I was hopeful results would come yesterday and they didn't. I'm longing to find out!

There are vouchers, but £25 a time won't make up the risk of 2 weeks lost wages.

sunseekin · 05/09/2020 08:22

Something about the sample still bothers me, maybe it’s just that everyone lives such different lives so an average doesn’t seem very helpful.
I guess I’d like to see studies done separately on a city with lots of cases, a medium sized city with moderate number of cases and a rural, outdoorsy area with low covid numbers.
I know they admit themselves that their survey can’t detect local trends; it would just be nice to see a few add-on surveillance studies, covid must be behaving so differently across the country.

Basically I wonder how undetected or asymptomatic cases vary according to population density and cases in the local area (obviously we can see it in the positive pillar 2 but I wonder what’s behind the scenes).
I’m still not sure I’ve explained what makes me uneasy about the sample and results! 🤦🏻‍♀️

Eyewhisker · 05/09/2020 08:24

The NHS are definitely still shut for many services. NHS dental services are still often emergency only, but private surgeries are providing full services with reduced capacity. My Dad needs a hip replacement and was told that they were ‘hoping to start elective soon but there is a long backlog’ but he could see the exact same consultant privately.

There is a real contrast between private services which are paid per procedure and are operating and those where pay is not dependent on output.

MRex · 05/09/2020 08:29

I think you're right to feel uneasy, as actual cases have dropped the figures look to have strayed away from the facts. If you compare to regions now, sometimes there are more actual than estimated cases. You can see both regionally in the data reports, I'm much too lazy to create a table comparing them but perhaps someone could (and then send to ONS for comment).

I've emailed PHE about the sewage report. Would findings go through them though?

PrayingandHoping · 05/09/2020 08:33

@Eyewhisker it depends on your nhs trust. Routine appointments are happening at mine, partners allowed in for antenatal scans etc.

And my private dentist is still only seeing those with issues..... nothing routine

Eyewhisker · 05/09/2020 08:49

It does seem to depend on the trust, but that is crazy. Where Dad lives has very low infections, but still no elective surgery or only slowly starting. It is not a sustainable situation, not good for people’s health and really not frankly proportionate to the situation.

MRex · 05/09/2020 08:49

@Eyewhisker - Oddly enough a friend of mine works for a private hospital that she said is still only allowed to do NHS work and has been doing hip/ knee replacements. A few private patients go through if the consultant can call them an emergency, otherwise it's NHS getting the priority. The problem is that there has been a backlog for decades on some services, my relative was sent to a private hospital by NHS for a new knee back in 2008 when they were trying to meet targets and she'd been waiting over a year! The trusts never seem to get past those backlogs, so any brief pause in activity was always going to tip it into crisis mode. Improvement projects with the NHS always seem to lead to broken IT, high management consulting fees and threats of less nurses, as though our poorly paid nurses are what's driving the cost base. The NHS needs repair, but it's a big beast and so far fixes all seem to break other stuff, so I'm fearful of the attempts.
Sorry, not data, just anecdote and ranting.

BigChocFrenzy · 05/09/2020 08:54

[quote MRex]@BigChocFrenzy - found it for you, I think: www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/datasets/coronaviruscovid19infectionsurveydata[/quote]
...
Many thanks for your time, Mrex 💐
Just what I wanted

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BigChocFrenzy · 05/09/2020 08:58

I'm really looking forward to the sewage studies

< and that's not a sentence I ever expected to type ! >

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alreadytaken · 05/09/2020 09:01

Those complaining in the uk tend to complain to the wrong people. Complain about yourself, for not wanting to pay for a health system with spare capacity or complain to your MP for government underfunding/ constant reorganisation and interference.

The NHS treats on the basis of need and is not resourced to catch up with a massive backlog so those in biggest need get seen first. As with any organisation mistakes sometimes happen and they happen more often if you overwork and undervalue your staff. Add to that having lost some of your staff because they are dead or sick from the long term effects of Covid. You can still get private care if you are prepared to pay for it, the govrnments deliberately underfunds the NHS so people will do so and they can sell it off to their mates. You will then pay more for your health care - as they do in most of Europe.

To quote ONS "The UK spent £197 billion on healthcare in 2017, equating to £2,989 per person. This was slightly above the median expenditure for member states of the Organisation for Economic Co-operation and Development (OECD), which was £2,913 per person, but below the median for the EU15¹, which was £3,663 per person (Figure 1). " I expect it's got worse since 2017 but that came up on a 5 second google.

BigChocFrenzy · 05/09/2020 09:14

[quote MRex]@Eyewhisker - Oddly enough a friend of mine works for a private hospital that she said is still only allowed to do NHS work and has been doing hip/ knee replacements. A few private patients go through if the consultant can call them an emergency, otherwise it's NHS getting the priority. The problem is that there has been a backlog for decades on some services, my relative was sent to a private hospital by NHS for a new knee back in 2008 when they were trying to meet targets and she'd been waiting over a year! The trusts never seem to get past those backlogs, so any brief pause in activity was always going to tip it into crisis mode. Improvement projects with the NHS always seem to lead to broken IT, high management consulting fees and threats of less nurses, as though our poorly paid nurses are what's driving the cost base. The NHS needs repair, but it's a big beast and so far fixes all seem to break other stuff, so I'm fearful of the attempts.
Sorry, not data, just anecdote and ranting.[/quote]
....
Yes the problems with trying to change to a better system is that millions of people need to keep using the NHS
it would be like trying to repair a car while belting down the motorway

Most of us acknowledge that we would never build the NHS like this, if we had a clean slate

In Germany, there is a state system, plus a big collection of workplace, non-profit and private schemes
There are obviously richer and poorer areas in the country but there is NOT a postcode lottery - health services and hospitals are of a surprisingly uniform standard
BUT
of course we pay more for this in taxes and insurance - the UK public does not seem willing to do this.

I've lived mostly in Germany since late 1980s and I've always been able to
e.g. get a GP appointment that day if I phone by mid-morning and the next working day if I phone later
e.g. to choose my own specialist without going through the GP - I have a visual disability and googled for a local eye specialist; I scrolled through to find a clinic describing itself as "conservative", so not knife-happy etc

A few years ago, a colleague had cancer.
Diagnosis was v early and treatment immediate, but then he was sent on an all expenses paid 4 weeks recovery to a Swiss alps clinic to "detox" after chemo, with special diet, relaxation and exercise program
That was standard, recommended by his oncologist for all patients and he was on full pay
but of course a Mercedes costs more than a Trabant

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alreadytaken · 05/09/2020 09:16

The message I actually came to post - for those planning to take vitamin D this winter there is nothing wrong for most people in taking tablets. I had lowish vitamin D, took tablets and had a healthy level afterwards. OH tested too, also fine.

If you want to read up on bioavailability of different forms the detail is here www.ncbi.nlm.nih.gov/pmc/articles/PMC5643801/
but I know that we are OK with tablets.

For those who have severe digestive issues or difficulty swallowing you can get oral sprays www.sciencedaily.com/releases/2019/10/191015131440.htm

alreadytaken · 05/09/2020 09:23

To quote the ONS study again - Germany paid £4,432 per head compared to the uk £2989 per head. If the uk had been happy to pay nearly 50% more for health care over decades it could have a Rolls Royce instead of a mini.

Insurance based health care systems produce profits for its investors. They are inherently inefficient.

BigChocFrenzy · 05/09/2020 09:24

Similarly, unemployment pay is high - I think about 80% of pay - and regardless of savings amount,
BUT the compulsory monthly unemployment insurance is high too, to fund it
There really is no Magic Money Tree

I'd rather pay more for services that are the high standard I want, than have less tax to pay for inadequate services that mean I have to at least partially fund my own in addition.

However, the major parties here have always agreed on these basics - "the socail contract" - so there has been continual investment, instead of stop-go depending on election results

Bringing the NHS up to the desired standard would be an expensive and long process, which would require agreement by both the main UK parties.
Without that ..... it is what it is.

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MRex · 05/09/2020 09:35

I'd rather pay more for better services, but I'd like that money to go to clinicians, drugs, clinical buildings and equipment - not management consultants nor dodgy trust managers. Even in my area (a very good trust) the level of inefficiency is ridiculous in spending money to fill gaps from insufficient money e.g. multiple appointments over a year to go through a process to be allowed a scan instead of just doing a scan; adding additional equipment and radiologists/ sonographers would work out cheaper long term as well as leading to shorter delays.

BigChocFrenzy · 05/09/2020 09:36

@alreadytaken

To quote the ONS study again - Germany paid £4,432 per head compared to the uk £2989 per head. If the uk had been happy to pay nearly 50% more for health care over decades it could have a Rolls Royce instead of a mini.

Insurance based health care systems produce profits for its investors. They are inherently inefficient.

.... The myriad of workplace and other private schemes here are often non-profit and having a big number of smaller organisations gives more flexibility, more responsiveness than 1 huge one, providing all are required to provide a high minimum service The competition keeps them all on their toes
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BigChocFrenzy · 05/09/2020 09:42

@MRex

I'd rather pay more for better services, but I'd like that money to go to clinicians, drugs, clinical buildings and equipment - not management consultants nor dodgy trust managers. Even in my area (a very good trust) the level of inefficiency is ridiculous in spending money to fill gaps from insufficient money e.g. multiple appointments over a year to go through a process to be allowed a scan instead of just doing a scan; adding additional equipment and radiologists/ sonographers would work out cheaper long term as well as leading to shorter delays.
.... That is the advantage of being able to choose your own doctors & specialists - the lack of red tape:

I googled for a local eye specialist that did conservative treatment and phoned for an appointment, no gate-keeper; I just went

When I tripped on some steps (broke my ankle ligament), I phoned for a doctor to make a home visit the next day
and then he phoned from my home to make the appointment for an MRI scan locally (I could normally have done so, but my tinnititus had flared up, so I asked him)

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