Daily numbers, graphs, analysis thread 17

[BigChocFrenzy]

Welcome to thread 17 of the daily updates

Resource links:

Uk dashboard deaths, cases, hospitals, tests - 4 nations, English regions & LAs
MSAO Map of English cases
Cases Tracker England Local Government
ONS MSAO Map English deaths
CovidMessenger live update by council district in England
Scot gov Daily data
Scotland TravellingTabby LAs, care homes, hospitals, tests, t&t
PH Wales LAs, tests, ONS deaths
NI Dashboard
UK govt pressers Slides & data
NHS t&t England & UK testing Weekly stats
R estimates UK & English regions
PHE Surveillance report infections & watchlists each Thursday
ONS England infection surveillance report each Friday
Datasets for ONS surveillance reports
ONS Roundup deaths, infections & economic reports
ECDC rolling 14-day incidence EEA & UK
Worldometer UK page
Our World in Data test positivity etc, DIY graphs
FT DIY graphs compare deaths, cases, raw / million pop
Covidly.com world summary & graphs

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

I'd say the R number increasing to 1.7 would also be a factor in test positivity rising

twitter.com/sarahcpr/status/1261085326887604224?s=12

Like this @Ecosse?

The virologists have said that this is an actual rise? Not just a case of more testing = more cases

@BraveBill

Of course there has been a rise in cases, but it is nowhere near where we would have been in March and April had community testing taken place.

The key point though is that this has not leas to an increase in hospital admissions or deaths- these are the indicators we need to focus on.

The other positive thing is that France and Spain are apparently 6 weeks ahead of us and have large numbers of cases. Yet neither are seeing huge numbers of deaths or hospitals being overwhelmed.

Hospital admissions have increased in Greater Manchester. They have doubled in the last 11 days.

Let's hope the new restrictions make a difference reasonably quickly. I am in the SE where cases are still low, often no recorded cases at all in my LA and 7 day average of less than 2 a day.

Certain geographic areas are clearly driving the current increase. Would there be an argument for putting those areas into a very strict, short sharp lockdown? Rather than weeks and weeks of a sort of semi lockdown? If we could pull numbers back in those areas with rising cases it seems to me it would level off again quite quickly?

There is some suggestion that where the primary case is a child,*
household SARs are higher and the serial interval is shorter.

There's a problem with this, which they don't seem to discuss, but I feel they should, they defined the primary case as first to show symptoms, with a shorter serial interval (time between the second and first case having symptoms) then that increases the chance that the actual primary case was a 3rd party outside of the house, and simply that the child showed symptoms quicker than the adult.

jamanetwork.com/journals/jamapediatrics/fullarticle/2770149
"Presymptomatic children remained symptom free for a median (range) of 2.5 (1-25) days before exhibiting any symptoms,"
vs
pubmed.ncbi.nlm.nih.gov/32150748/
"The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days)"

So if a child and adult get it at the same time, then those suggest (no comment on to the quality of the data, but different incubation periods for adults and children appears common in other viruses) then there's still a strong chance that the child would get the data first. With children also likely to accompanied much of the time, there's a good chance I'd say that those results could also apply to misidentified primary case.

[quote Ecosse]@BraveBill

Of course there has been a rise in cases, but it is nowhere near where we would have been in March and April had community testing taken place.

The key point though is that this has not leas to an increase in hospital admissions or deaths- these are the indicators we need to focus on.

The other positive thing is that France and Spain are apparently 6 weeks ahead of us and have large numbers of cases. Yet neither are seeing huge numbers of deaths or hospitals being overwhelmed.[/quote]
...
The oriiginal point was that a genuine rise in cases and a rise in R, while the number of tests is about the same, obviously means test % positivity rises - it's not just a matter of more targetted testing
(if that has even gone through into the stats yet)

We are nowhere near the real case levels of March-April (probably then ~ 100,000 daily) and also the average infection age now is much younger than then
Hence, deaths are very low atm

However, this can change if cases continue to rise and the virus spreads more to the elderly, especially once the winter weather set in
We can already see hospitalisations rising to significant levels in France & Spain, with deaths rising in Spain

I think we need to remember how critical it is to keep the r number as small as possible.

@BigChocFrenzy

The UK is still well under the 3% limit that the WHO give, but it is the rapid rise that is concerning: Positivity has risen from 0.6% to 1.3% in a comparatively short time

So how long to go from 1.3 to 3% ... hopefully most people will comply with the Power of 6, so infections level off again

The positivity rate announced by NS in scotland today was 2.7%, which is getting pretty close.

Is that 1.3% the uk as a whole? Are these measured the same way? Seems like a big difference.

"they defined the primary case as first to show symptoms"

In practice, difficult to define it another way

Also, no evidence that children would get symptoms earlier,
since unlike many other viruses, COVID gets hold via the ACE2 receptors, which are much less expressed in children
Hence why children are less likely to catch or transmit it, or suffer severe symptoms

What's going on with the Spanish numbers? An hour ago the worldometer site has their new cases today at 12k+, now showing 4.7k

@sirfredfredgeorge

There is some suggestion that where the primary case is a child,* household SARs are higher and the serial interval is shorter.

There's a problem with this, which they don't seem to discuss, but I feel they should, they defined the primary case as first to show symptoms, with a shorter serial interval (time between the second and first case having symptoms) then that increases the chance that the actual primary case was a 3rd party outside of the house, and simply that the child showed symptoms quicker than the adult.

jamanetwork.com/journals/jamapediatrics/fullarticle/2770149
"Presymptomatic children remained symptom free for a median (range) of 2.5 (1-25) days before exhibiting any symptoms,"
vs
pubmed.ncbi.nlm.nih.gov/32150748/
"The median incubation period was estimated to be 5.1 days (95% CI, 4.5 to 5.8 days)"

So if a child and adult get it at the same time, then those suggest (no comment on to the quality of the data, but different incubation periods for adults and children appears common in other viruses) then there's still a strong chance that the child would get the data first. With children also likely to accompanied much of the time, there's a good chance I'd say that those results could also apply to misidentified primary case.

... "they defined the primary case as first to show symptoms"

In practice, difficult to define it another way

Also, no real evidence that children would get COVID symptoms earlier,
since unlike many other viruses, COVID gets hold via the ACE2 receptors, which are much less expressed in children
Hence why children are less likely to catch or transmit it, or suffer severe symptoms

As children are more resistant, possible they may in fact show symptoms later ?

Latest numbers for greater Manchester

ONS infection survey modelled estimates:

80 deaths in France today sadly.

This seems to be a bit of a jump from previous days?

ONS infection pilot indicate London & SE starting to catch up with the NW

Also, no real evidence that children would get COVID symptoms earlier,

The Korean child one showing a significantly quicker onset of symptoms, we obviously don't know if it was a fluke, but what is the alternative explanation of why if the child is the primary case, are adult incubation periods shorter? Remember for short times between cases then the transmission must have occurred when the primary case was pre-symptomatic so explanations involving distancing from sick adults or cuddling sick kids doesn't apply.

@Timeforanotherusername

80 deaths in France today sadly.

This seems to be a bit of a jump from previous days?

... It may just be a reporting blip Or it may be that such high cases now mean more elderly people infected, in absolute numbers, even though they are a small % of the total infected

BCF yes it could be that.

Although they do seem concerned about older people being infected. Copied this from Guardian live. Obv we don't know how serious these infections have been.

Castex expressed particular concern about a rise in cases, especially among older people, in Marseilles, Bordeaux and Guadeloupe.

@sirfredfredgeorge

Also, no real evidence that children would get COVID symptoms earlier,

The Korean child one showing a significantly quicker onset of symptoms, we obviously don't know if it was a fluke, but what is the alternative explanation of why if the child is the primary case, are adult incubation periods shorter? Remember for short times between cases then the transmission must have occurred when the primary case was pre-symptomatic so explanations involving distancing from sick adults or cuddling sick kids doesn't apply.

... Children get cuddled a lot even when not ill They may take longer to show symptoms - or to have them recognised - and we know asymptomatic or pre-symptomatic people can infect others

I suspect the French figure is an anomaly. Even if not, it’s still nowhere near where we were a few months ago.

We know too little, so I would keep an open mind, wait for more studies and keep re-evaluating the evidence on COVID, not on other diseases

@Ecosse

I suspect the French figure is an anomaly. Even if not, it’s still nowhere near where we were a few months ago.

why? It may be but what makes you think this?

@ time, care home deaths get added twice weekly now ( tuesdays and fridays) so 40 hosptial deaths and 40 care home deaths since tuesday. Numbers certainly increasing.

@Ecosse

I suspect the French figure is an anomaly. Even if not, it’s still nowhere near where we were a few months ago.

... Noone is saying we are at or near the danger level of March-April

However cases are rising in many countries and we must watch infection age - hence deaths - closely
All countries must avoid exponential case growth suddenly taking off, particularly as that inevitably means more absolute numbers of elderly infected

Cases are stable in Germany, Belgium & Italy too,
but many of the infected holidaymakers will inevitably have been missed, so cases could suddenly rocket in any country that is not very watchful.