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 📈 📉 📊 👍

and this is the same table but with the 30 LAs with the lowest cases per 100,000 in August

For example in this set East Lindsey in Lincolnshire has high levels of relative deprivation but some of the lowest levels of case rates - likely due to rurality; relative remoteness and poor transport links; high median age (so a more cautious population) and low population density.

and finally the 30 most deprived areas, column added to show their Aug cases per 100,000 rank (where 1 = highest).

Pendle, the sharp eyed will note, is not in the 30 most deprived LAs, being 33rd and with over 30% of its LSOA is the 10% most deprived nationally.

"low population density"

Poulation density is a dominant factor for cases

We see the differences between areas within the UK
and more obviously the consequent deaths between countries e.g. Scandinavia vs Belgium, Italy, France, UK

An ONS report compared different levels of density within the UK and reported that cities had 5 x deaths / 100,000 of sparsely populated hamlets

So I'm guessing this year's ski season will be cut short?

Thanks for all the scattergrams @boys3. They don't really look to be as very clear evidence for what the Guardian is saying though about it being strongly linked to deprivation - only a weak link is visible.

Is it possible to run that analysis at MSOA level do you think? (Just in case you or someone else has nothing better to do on a Sunday!) The problem with looking at LA level is that LAs are never just full of entirely deprived or wealthy people. Ideally you want to look at actual people of course, but I don't think there's any data published on income levels of people who test positive (though there has been data on ethnicity showing a strong link)

@boys3

then to follow the graphs this is the list of the 30 LAs with the highest cases per 100,000 in August with their deprivation score, score rank (1 would equal most deprived LA), and the percentage of their LSOA in the 10% most deprived nationally.

Trafford for example jumps out as 191 / 314 in terms of deprivation

Trafford is a very mixed borough with some extremely affluent areas ( Altrincham, Hale etc) and some less affluent ones ( Old Trafford) It also borders onto several less affluent boroughs and of course people regularly cross those for work/shopping etc

Thanks @boys3 those graphs are interesting. Well interesting is probably the wrong word. I agree that there is most likely a strong correlation to density of housing and within households. I am originally from an area with very high deprivation but the bit I was from more rural and levels there are not so high.

The question of how infection rates in these areas can be brought down is really challenging. I saw one of the commentators ( a member of ‘Indy’ SAGE which I must confess always makes me eye roll a little) mentioned removing to quarantine. I think that may be very difficult to do in practice for a significant minority at least. And isn’t as simple as it’s made out ( for example I am a single parent and don’t have family that could look after my children - if I thought I had to quarantine and that meant them being placed into some kind of temp social care I’d feel deeply unhappy about it).

A linked problem that worries me is whether we will see greater school closures in areas of deprivation - because community spread is higher so therefore will be replicated in schools. And so the cycle of inequality becomes even more embedded.

I don't think removal to quarantine is a nice idea at all, there is no way I want to be separated from my toddler. And what if anything did then go wrong with me or DH, we'd have just been taken apart with no goodbye - that's impossible. Giving an option for houses of high occupancy to send EITHER well or unwell to stay elsewhere might work and be humane.

@Firefliess - I know my borough in its tweets links to a DataWand for it and the next borough. As well as the infection rate etc it has the identified higher risk areas within the borough for Covid ( so ones with higher elderly, areas with greater deprivation). I also live in a very mixed borough so areas of high deprivation and areas of wealth ( although here it appears the rate is rising in the affluent areas). I think it’s almost this level of info that is needed ( and I assume is being used if the report in the Observer is correct).

A linked problem that worries me is whether we will see greater school closures in areas of deprivation - because community spread is higher so therefore will be replicated in schools. And so the cycle of inequality becomes even more embedded.

Yes I'm concerned about this.

Also if tests are becoming challenging to access, esp distance wise. I hope schools in those areas are given more.

I completely agree @MRex. I suspect we don’t have the resources to quarantine using a more human approach in this country. I can’t imagine government ever doing it and it would be extremely difficult to do for only certain areas ( as opposed to a country wide approach).

Having said that I did read a really heartbreaking article about families living in multi occupancy buildings, 6 to a bedroom with shared facilities who were desperate to be able to quarantine away from loved ones. So it’s never as simple - as ever.

Apologies I’ve definitely veered away from data now!

Probably the government leak is testing the water for reverting to "herd immunity" in some areas. Testing is expensive so lets cut it back and let the virus rip in deprived areas. "Lab capacity" will be the excuse. You move the most vulnerable to hotels, children go with a parent if necessary, and let others take their chances.

The more young people who contract the virus before winter the better the chance of avoiding a high level of deaths this winter will be, if you can keep the vulnerable away from them. If I was in government I might decide to promote infection in young people now (schools and universities back) to try and avoid them infecting others in winter. It's a fairly high risk strategy and if you are adopting it unis should have been encouraged to go back a couple of weeks early then have a Christmas break that stretched further into January.

My teen dd and I usually do a Halloween tour with actors every year

I've looked at 3 options. All cancelled 😩. I expect bonfire and Christmas events cancelled too. It's going to be a loooong winter.

"Testing is expensive so lets cut it back and let the virus rip in deprived areas. "Lab capacity" will be the excuse"

Isn't it more likely that test capacity is overinflated by creative accounting like counting one glove as a separate item of ppe to hit targets. For instance is posting out a kit that's never seen again still counted as a test?

Interesting graphs @boys3

The local lock down in trafford doesnt seem to be very effective. If I had to guess, and based on what bigchoc said earlier, the rising rates in trafford are probably due to holidaymakers. Not gatherings in homes/gardens. Not due to high population density living as in some neighbouring councils.

GM has gone very quiet on what they believe the source of the increase to be.

We ought to have the capacity to offer isolation facilities to those who want them - either the sick or the healthy within a household who have only one bathroom, shared bedrooms or very vulnerable household members (eg over 70s) There are still plenty of hotels badly in need of customers, especially those who cater for the business/conference trade. Would make much more sense to put people up in them (on an entirely voluntary basis) than to be subsidising the hotel business in other ways (or letting it collapse) Better off people and NHS workers (paid for by the NHS) have been using hotels in order to separate those at most risk of catching it from vulnerable household members of their own accord. If it's just money needed to help others do the same that seems a good use of government money to me.

I've not followed the thread for ages, sorry but know this is the place to come for sense.

Things are not looking good in greater Manchester at all. Bolton is now at 104 cases per 100,000 and Salford is bad and in fact everywhere is creeping up in the area. We were at 8.something about three days ago and now at 12.something. Tameside isn't far off 50. Kids only went back to school 3 days ago so I don't know how it's expected to get better. I'm worried that school is not sustainable and dc are all so happy at school that they will be gutted to be back at home.

Just to interrupt and thank @MRez again for the link for hospital admittance data. I’ve done my homework! I would appreciate anyone telling me where I’ve gone wrong!

From what I can see looking at the numbers from 02/09 there were 129 new hospital admissions and 1295 new cases, comparing that to a similar new case figure of 1293 on 24/03 (which is reasonable to assume were most if not all hospital admissions due to testing criteria at the time) it tells me that we’re a long way off where we were in March. I know that there is a lag in between diagnosis and progression of illness to the point of hospital admittance but even so... That’s not to downplay the current rise in cases but it does reassure me that measures are helping and that at the very least it’s being taken seriously by those in power.

To add to the isolation accommodation debate it has crossed my mind a few times whether we’ll see a return of the old TB sanatoriums. As more elements of covid emerge it may be the best (unfortunately costly) solution to have dedicated buildings that offer specialised treatment alongside separation from the rest of the NHS population.

@Firefliess

Thanks for all the scattergrams *@boys3*. They don't really look to be as very clear evidence for what the Guardian is saying though about it being strongly linked to deprivation - only a weak link is visible.

Is it possible to run that analysis at MSOA level do you think? (Just in case you or someone else has nothing better to do on a Sunday!) The problem with looking at LA level is that LAs are never just full of entirely deprived or wealthy people. Ideally you want to look at actual people of course, but I don't think there's any data published on income levels of people who test positive (though there has been data on ethnicity showing a strong link)

@Firefliess, I think they give sense, with as the Liverpool DPH quoted in the Graun piece says with a big but

The overall LA level can, as you and others highlight, be a bit of a blunt tool - and that it before we get to local inter-connectivity in areas like Manchester- ; however absolute case numbers and, therefore cases per 100,000, are published at that level, the suppression of 2 or less at MSOA and LSOA levels makes things less straightforward.

Now with my own but, but deprivation is published at LSOA level, overall and for every deprivation domain, and domain level - health, barriers to housing and services etc - may be more relevant again.

LSOA numbers of cases by week are published, albeit with the suppression constraint, so that is probably the option to look at next.

The NHS already tries to separate Covid and non-covid patients and is constantly rearranging wards to allow them to do so. The problem with using some buildings just for Covid patients is how you staff them. Covid patients sick enough to be in hospital need a lot of nursing and a lot of machinery to support various organs, this is not simply a respiratory disease.

I recommend reading Duty of Care: One NHS Doctor's Story of Courage and Compassion on the COVID-19 Frontline by Dominic Pimenta

I don't think it would be a sensible use of resources to have hospital type care for the large majority of people with Covid who don't need it. Hotels are much better set up for isolation - room service, private bathrooms, good wifi, desk to work from (if you can work from home) And many of them sitting empty right now with employees on furlough and management struggling to keep afloat.

You could assign some level of medical care on hand if needed - eg to deliver paracetamol to people and visit any who get sicker, but the large majority of people are not ask that ill, but are just as infections as the ones in hospital being tended to by staff in full PPE, whereas people at home have to share bathrooms, etc with healthy people.

@boys3 Yes LSOA sounds the way to go. You don't need data that's the very latest to look at overall trends.

There are not vast numbers of NHS staff being put up in hotels either - that only happens when you are moved at short notice to provide extra staffing for another hospital. Normally they look to nearby hospitals first, too much paperwork to sort out if you are moving to a different health authority.

Many are putting their families at risk but are probably, like the author of that book, stripping off when they get through the door and going straight into a shower when they get home.

BigChoc interesting point about the "worried well* monopolising tests in Bavaria. I suspect there is an element of that here, tests are all booked online and no checks made on whether there is a legitimate reason.

@alreadytaken

Probably the government leak is testing the water for reverting to "herd immunity" in some areas. Testing is expensive so lets cut it back and let the virus rip in deprived areas. "Lab capacity" will be the excuse. You move the most vulnerable to hotels, children go with a parent if necessary, and let others take their chances.

The more young people who contract the virus before winter the better the chance of avoiding a high level of deaths this winter will be, if you can keep the vulnerable away from them. If I was in government I might decide to promote infection in young people now (schools and universities back) to try and avoid them infecting others in winter. It's a fairly high risk strategy and if you are adopting it unis should have been encouraged to go back a couple of weeks early then have a Christmas break that stretched further into January.

And what have we got?

No hotels. ha ha.

Dragooning the most vulnerable kids and teachers back to overcrowded schools.

Everyone take their chances and the weakest to the wall.