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 📈 📉 📊 👍

If we look back at the 30th March reasonable worst case scenario, it got to 50,000 covid deaths by September, which is actually frighteningly close (it excludes excess deaths from anything else). What varies was it shows a much less severe peak, but also less compliance meaning deaths were higher but dropped faster. I think.
www.gov.uk/government/publications/reasonable-worst-case-planning-scenario-29-march-2020

Presumably the new report has learned about expected compliance, though I think compliance may be going down it was better than expected? Many other figures will have adjusted based on new facts. It looks like the government are getting very hard to keep the peak flatter this time, but this virus has wiggled through many countries' control measures. Hard to know how "reasonable" it is really as a worst case, it isn't the worst possible outcome.

Aren't the policy measures to "reduce non household contacts to half of their pre March 2020 levels" already in place? I'm certainly not seeing a tenth of the people I normally would in a week - no choir, no parties, no crowded pubs, no office, no commuting, etc. Even my GP won't see me in person. Is that Sage report already modelling in the current restrictions, or is it implying that we'd need new ones?

Just out of interest, wasn't it said that SAGE were to be sidelined a bit in favour of the new Joint Biosecurity thing?

www.instituteforgovernment.org.uk/explainers/joint-biosecurity-centre

"If we look back at the 30th March reasonable worst case scenario, it got to 50,000 covid deaths by September, which is actually frighteningly close"

Yes, the ONS has iirc 56,000 deaths from COVID
but I expect modelling can't really (politically) include government cockups, institutional incompetence etc

@JayDot500
Sorry for the delay - only just saw your question. It's this Twitter account - they publish the tables on a daily basis after the figures are released

@Farlow
Hope my post 2 mins ago helps with your question as well!

Aren't the policy measures to "reduce non household contacts to half of their pre March 2020 levels" already in place?

Current policy measures reduce household contacts to more than half their pre march 2020 levels, so I that's possibly saying a lessening of restrictions, or a belief in guidelines (as opposed to rules) being less adhered to that level?

@MRex

I’d not seen that report, thank you.

The most striking thing about it is that even for early April, it’s forecasts for deaths were way off. Their predictions were for far fewer deaths but with a very shallow drop off. When in fact, the peak was far higher in April, with a much steeper decline, so although the end number is correct, the route there is vastly different, undermining the model’s credibility and indicating the extent to which the Government are shooting in the dark, which is concerning.

If we look back at the 30th March reasonable worst case scenario, it got to 50,000 covid deaths by September, which is actually frighteningly close

As per my previous post, this seems to be more by luck than judgment.

@Shitfuckoh

From that same BBC page it says:

''It also states that by November "policy measures would be put in place to reduce non-household contacts to half of their normal pre March 2020 levels". In other words, restrictions to mitigate the impact - other than school closures - could be put in place.''
So are we likely to be told to reduce social contacts even more than we already are doing?

I don't know if you remember a little while ago something about pubs etc closing to keep schools open. Whitty I think?

Given that most cases locally have been linked to bars and restaurants and younger people, I would hope that that is want would happen on local scales.

I am concerned about the 50,000 uni students returning soon to our city, as I'm sure the teaching hospitals and school training placements are too. It's a very popular drinking and party city.

trying to predict the future when you are dealing with an unknown disease is pretty much guesswork. The models should have been refined now to take account of better information. However it is difficult to know 1. how much this government will dither, the delay to lockdown inflated deaths considerably and 2. the extent to which public behaviour will compensate for 1.

So the model was out because the government dithered but out again (in the opposite direction) because people were more sensible than the government and started acting sooner/ were more compliant.

I dont expect the next wave to be as bad as the worst case modelling for the following reasons

1. Treatment has improved. That isnt just about a couple of drugs that help, it's a lot of smaller things like discovering what organs you need to support and what position helps people breathe. There are markers that help you identify who is going to be hit badly.

1. A lot of health care staff now have antibodies/ some T cell protection and those who dont have to be the ones good at using PPE, which is more available than it was.

1. Care homes are better equipped and informed.

1. More people will take this seriously as deaths start to rise again. They are better able to protect themselves with masks available and more home delivery services.

1. A non-negligible number of people have had the virus and that will slow spread, giving time to bring in mobile testing units/impose new measures.

1. Testing is better, so better able to locate problem areas.

1. A possible impact of more people supplementing with vitamin D in winter. There is a strong link between vitamin D deficiency and severe disease. Correlation is not causation but many people will, like me, decide to supplement anyway because there is a plausible biological mechanism (T cells dont activate when vitamin D levels are low). There are intervention studies underway but I suspect the only one that was due to report by now ran into delays because low levels of infection mean you cant get an answer. There is little downside to supplementation between October and March if you stick to a small dose. www.nhs.uk/news/food-and-diet/the-new-guidelines-on-vitamin-d-what-you-need-to-know/

We drove through a few outer areas around 10:30 last night.

Loads of young men in large groups, horsing around in the streets near off licenses and pubs.

A dr friend informed me last night that the vaccine is due to be "delivered" In October. But that it's not going to be distributed via gps etc as the flu vaccine is. They're setting up a new central body to do that.

He's furious as obviously all the structures already exist. I have no idea why - I did wonder if it's to not add extra pressure to gps? Or yet more contracts for mates.

Well so far my Gp practice cannot send out appointments for the nhs flu jab as they say they cannot work out how to do it and be COVID safe. Bearing in mind they are only seeing a handful of patients between a team of 7 dr’s a day and no booked phone appointments - every apt involves a receptionist deciding you deserve a triage appointment, then a random Gp phoning you at a random time in the working day, who may not know you at all ( no continuity of care for patients that it benefits). Still cannot see a Gp unless you give the right symptoms over the phone, are confident to do this, have no hearing issues, and it meets their stringiest list to be seen. Dread to think how many patients are not reporting symptoms they may “mention” to a trusted medical person if they saw in person.

Yet big chains like Boots are taking appointments for the flu jab already.

So not sure all areas have the ability to do a mass vaccination in an organised, time efficient and safe way.

As a ECV person, I am tempted to book a paid for flu jab to make sure I get one.

Gp’s will want to do the vaccine as it will be paid for, like the annual asthma check ups etc.

Christ. These are doctors and they can't work out how to administer a jab safely. Ffs. It's bloody obvious.

Our practice literally see the patient for a total of 10 seconds- jab and out.

Just add full ppe for nurses and mask for patients.

How the hell do the tests get done by health professionals then. My lord. I've really heard it ALL now.

Some GPs are good at vaccines, our is like a military operation with 2 min time slots on Saturdays and everyone arriving joins a queue to be marked off. A gazebo in the tiny car park with everyone filing through at a safe distance and in masks could probably work just the same. I'm aware of one other GP where an elderly neighbour was waiting in November still for a nurse appointment for his flu jab (I suggested Boots, who had a same day appointment)! I would have thought people might as well get flu + covid together, by the time their arm is out and PPE is all together, but perhaps that increases risk?

I am not one for handwringing about stuff because I can also see some of the health benefits of the last few months (anxiety dropped in some, better worklife balance, fewer road accidents and stabbings etc) and don't like to opine on other people's jobs (since I get so much of that from the layperson about teachers!) BUT I will admit to being slightly concerned that things like smear tests and flu jabs are not going ahead in many many places, let alone people not making or ebign able to make GP appointments.

Today's battleground : universities.

My parents who live in a Covid hotspot currently under extra restrictions got notifications this week to book in for a flu jab.

The appt is in a few weeks at a precise time - 9.54am - to reduce queues in waiting room and apparently the vaccination room is being given some level of cleaning after each appt.

It's ludicrous if some GPs are saying they haven't worked out how to give the flu vaccine safely in the current times.

@NeurotrashWarrior

Yes I remember that.
I'm also in a University City & the students will be arriving back shortly.
When they first arrive everything is hectic from public transport & traffic to queues to all the supermarkets surrounding the city. That's before we even get started on what the city (pubs/bars etc) is like from late afternoon that first arrival day for about a week!

Not looking forward to it at all.

gs have PPE, they can put a gazebo in the car park. Anyone who has not worked out how to do a flu jab safely should be retiring. Mine has not contacted me yet, I'll go and see the pharmacist if they dont do so soon.

@alreadytaken

gs have PPE, they can put a gazebo in the car park. Anyone who has not worked out how to do a flu jab safely should be retiring. Mine has not contacted me yet, I'll go and see the pharmacist if they dont do so soon.

I had to pick up a prescription made via my dentist (tooth infection!) from the local pharmacy. They aren't allowing anyone in, they've got a little alley way down the side of the building & are using a window to the building to take / give the fulfilled prescription etc. They usually offer lots of things but no idea how they'll work it with that set up.

As a ECV person, I am tempted to book a paid for flu jab to make sure I get one.

If you go to boots or elsewhere you still get it free if you would get it at the gps. You just give your nhs number.

I've got mine booked into boots in October. I couldn't get one earlier on a Friday (last year it knocked me for 6 and I had to take a few days off work.) not heard from Gp. They usually do start advertising it from now.

I really hope the government works with the private sector when they do have a Covid vaccine to roll out - Boots and Superdrug look to be a much better bet than either existing GP services or some new centralised body in getting it done efficiently. I have my flu vaccine booked up at boots already, for late September. DH needs to be persuaded to do likewise rather than wait for his invite from the GP (he gets it in the NHS due to medication he was on about 5 years ago - shouldn't technically be entitled to it free any more but they don't seem to take you off the free list once you're in it!)

Anyone know what happens with toddler flu vaccines, do they come under GP or pre-school?