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 📈 📉 📊 👍

@Humphriescushion

@ 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.

... Ah thanks, so it is partly a reporting issue and partly cases rising

Thanks Humphries

This is why I concentrate more on the 7-day rolling averages for both cases & deaths,
which also accounts for weekends and bank holidays

I'm interested in the reason why cases are increasing and doing so rapidly. Is it schools? People mixing after the summer holidays? Holiday makers coming back from both domestic and international destinations and spreading it around? Lack of due diligence to social distancing, mask wearing and hand washing? People socialising more especially the young? All of the above? Surely to implement change the powers that be need to know the why?

@sirfredfredgeorge - Your explanation could work, that the child gets symptoms first from both being infected by a third party. It could also be that the seed infection came from an asymptomatic third household member, who was recovered by the time the family was tested. The third member infected the child first (more hugs) and the adult a couple of days later.
Another option that's hard to know at this stage - it's very difficult to measure initial viral load, but a poorly child is likely to be physically attached night and day sharing virus, so IF a higher viral load causes symptoms to come on quicker, that could explain it.

Illustrating the importance of being proactive:

Miguel Hernán@_MiguelHernan (Prof. Harvard)

New York and Madrid had similar epidemics until they spectacularly diverged.

In March, both cities were caught by surprise and shut down because of #COVID19.
In September, the situation is under control in NY and alarming in Madrid.

Why?

Let’s start with the similarities: two big, dense cities with a large network of public transit and lots of visitors.

An explosive outbreak of #SARSCOV2 overwhelmed their contact tracing system and their hospitals.
A lockdown was required to reduce the public health disaster.
3/
By June, both places had succeeded in bringing down the number of new cases.
That's precisely what lockdowns do.

In July, new cases started to increase in Madrid until reaching one of the highest incidences in Europe.

New York has not seen any increase in new cases yet.
4/
We could argue that number of new #COVID19 cases isn't the best metric for the severity of the #SARSCOV2 epidemic. Perhaps most cases are asymptomatic or mildly symptomatic?

Let's then look at hospital occupation. No problem in New York. Serious trouble brewing in Madrid.

So what happened?

#NewYork and #Madrid had significantly different responses in terms of contact tracing, number of tests, and speed of reopening.

Let’s review each of these elements.

This comparison is a case study on epidemic management in hub cities around the world.

6/
CONTACT TRACING
New York state aimed at 30 contact tracers per 100,000 people before reopening. Minimum.

That translates into 6000 contract tracers in New York and 2000 in Madrid.

Madrid had about 200 contact tracers in July (maybe 700 now). An order of magnitude difference.
7/

TESTING
In April, >70% of PCRs were positive in both New York and Madrid.

^New York aimed at achieving

@sirfredfredgeorge Is another possible explanation related to the fact that children have more adults to catch Covid from them than adults do within a household? Eg if an average household contains 2 adults and 2 kids then a sick child has two adults who might catch it from them, and we know adults are much more vulnerable to Covid, so if they catch it they'll probably be ill, and be recorded in as having done so. But the one of the adults in this average household is the primary case, they have only one other adult to infect. So children could appear to be infecting more people within households because they live with an average of about twice as many adults as their parents do. (The parents of course have more children they can infect, but we know that a lot of children do not easily catch Covid or do not become ill enough to notice, so might not get picked up in all studies)

Even more extreme with single parents who have no other adults to infect.

@Firefliess I don't know if you're right, but what a simple and sensible point!

@Bercows

I'm interested in the reason why cases are increasing and doing so rapidly. Is it schools? People mixing after the summer holidays? Holiday makers coming back from both domestic and international destinations and spreading it around? Lack of due diligence to social distancing, mask wearing and hand washing? People socialising more especially the young? All of the above? Surely to implement change the powers that be need to know the why?

I think there's some differences depending on demographics of an area.

There's an high number of younger people catching it. I keep noticing that more women than men are too; no idea how that would be.

Holidays and going out and about? Socialising?

I know in Newcastle the council blamed younger age groups and a number of outbreaks linked to bars and restaurants.

I can't find it now but I did read a report by one of the better known epidemiologists who said a big flaw in early testing and investigation was an assumption that children weren't an asymptomatic primary case (or even when symptomatic never considered as the primary case), which led to the oft repeated 'children don't get it or spread it' mantra. It seems they are now at least looking into this.

www.dw.com/en/coronavirus-digest-germany-warns-over-rapid-vaccine-approvals/a-54890795

German Health Minister Jens Spahn has warned against a premature approval of coronavirus vaccines.

Rapid approvals are "irresponsible" because such vaccines are intended to treat millions of people,
he told the magazine Focus on Friday. "Safety must have top priority."

Spahn's comments coincided with reports from Russia that more than 1 billion people could receive its COVID-19 vaccine Sputnik-VV^ in 2020-2021.
< 1 billion people. If that has serious side effects .... >

@Piggywaspushed

I can't find it now but I did read a report by one of the better known epidemiologists who said a big flaw in early testing and investigation was an assumption that children weren't an asymptomatic primary case (or even when symptomatic never considered as the primary case), which led to the oft repeated 'children don't get it or spread it' mantra. It seems they are now at least looking into this.

... That was Ferguson iirc

@Augustbreeze It's the sort of thing you would hope a peer reviewer would pick up on. And it would be perfectly possible if you have the full data to look at the attack rate on adults and children separately to see if there's a difference. Having now read the article I should also point out for those in this thread that there were only in fact 10 under 19s in the study which is a very tiny number (and broad age range) to be basing any conclusions about children on.

This is one of the downsides in research getting published without peer review. It's a shame they don't instead accelerate the peer review process. I've done peer review myself (different field) and it rarely takes more than 2-3 hours to review a paper. The process takes much longer because academics are busy and need a lot of chivvying, and then the authors take time to make revisions. But there's absolutely no good reason why this whole process couldn't be shrunk into a matter of a few days if people really made an effort.

" keep noticing that more women than men are too; no idea how that would be.

Holidays and going out and about? Socialising?"

I've seen seen plenty of my female colleagues hug each other at work this week, (never mind on night's out ) and wondered whether this would realistically result in higher chances of self isolation if one of them later tested positive.

Or it could be that they are more likely to be carers for others?

I thought it was BCF. But he has said so many often contradictory things I wasn't sure!

@Neurotrash - the higher numbers of women them men testing positive is not new and has not been picked up on as much as I think it should have been. Three things to note: 1) Men, on average, get more severe illness, so it seems very unlikely that men would also be more likely to be asymptomatic/not catch it 2) Antibody tests find no difference between men and women. 3) The higher proportion of females testing positive does not apply in the under 15s. Putting all of this together tells me that the explanation is that men are less likely to get themselves tested when they have symptoms. We know that men generally go to the doctor less than women and are more likely to ignore symptoms of other diseases such this makes sense. And the only age group that the difference is not seen in is the age group whose mothers take care of their health for them! I'd like to see positivity rates for men and women reported separately to check this theory out. I suspect they're higher for men.

@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

This is apparently what Belgium to bring it back under control.

They had max 5.

It seems to have worked for them so with good compliance there is Hope we will start to see a downward trend at some point?

[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]
Hospital admissions on a daily basis have almost doubled this week.

2/9 76
11/9 136.

10/9 99.

The numbers now is hospital are 850 approx (cant remember exact no without going back in)

Deaths haven't risen but there's a lag so we need to keep a very careful eye on the next 2-3 weeks.

Im in Leeds and the following figures have been reported today

Latest position (period 31/8-6/9)
Leeds 7 day infection rate 66 per 100,000
Leeds 7 day positivity 6%
Leeds testing rate 156.4 per 100,000

But even though we are on the watchlist I still can’t get a test.

7-day rolling average of cases / million population:

Spain looks to be levelling off; France still increasing
UK too but at a lower level
Belgium has got their peak back down
Germany, Italy stable atm

WHO chief warning that the scramble for vaccines in 2021 is likely to be much worse than for PPE early this year:

Tedros Adhanom Ghebreyesus @DrTedros

... Several #COVID19 vaccines are in the final stages of their trials.
Factories are producing doses, in the hope they'll receive approval.

There's a chance that by the end of 2020, mass vaccinations could start for high-risk people.

“Vaccine nationalism” invites the same problems that were seen at the outset of lockdowns in March,
when different authorities scrambled for masks, gowns & sanitiser.

Once new vaccines, drugs & tests become available,
demand will vastly outstrip supply & things will get worse.

BigChocFrenzy reading about the differences between Madrid and New York, I had no idea that indoor dining had been shut all this time in New York...while the UK pushed Eat Out to Help Out.

Marseille is seeing increased hospitalisations:

With 95% of the southern Bouche du Rhone region's 80 intensive care beds set aside for COVID-19 patients now occupied, Rossi has dusted off his peak-pandemic playbook to deal with a jump in patients at the epicentre of the coronavirus' resurgence in France.

The Bouche du Rhone registered a positivity rate - the rate at which tests show an infection - of 14.2% on Wednesday, more than double the national rate. Health officials say a rate below 5% demonstrates control over the spread of the virus.

But if the virus continues to regain momentum through the autumn, it will become harder to protect the elderly.
At the Les Figuiers care home near Nice, staff using public transport must shower on arrival and all employees face twice-daily temperature checks.

"If we don't let the virus in, we won't have to lock down our residents," said Les Figuiers' director, Anne-Helene Perlo.

But the danger persists. Last weekend, more than 50 residents and staff tested positive in a single 75-bed nursing home in southern France.

www.google.co.uk/amp/s/uk.mobile.reuters.com/article/amp/idUKKBN26126P

In America dining out and universities have been linked to higher infection rates. www.cidrap.umn.edu/news-perspective/2020/09/close-case-contact-dining-out-tied-covid-19-spread

I had wondered how the Moonshot passed the professional sniff test - the professionals were not consulted:

https://www.theguardian.com/world/2020/sep/11/uk-health-screening-advisers-not-involved-in-moonshot-covid-plan-mass-testing-coronavirus

The National Screening Committee,which advises ministers and the NHS about “all aspects of population screening”,
has not been consulted on the £100bn plans for mass surveillance involving up to 10m coronavirus tests every day.

Made up of 23 doctors, academics, public health and patient representatives, the NSC normally rules on proposals for mass population screening for cancers as well as infectious diseases such as chlamydia, herpes and hepatitis B.
....
The NSC would weigh up issues such as how results, including false positives and negatives are handled, the implementation of any mass testing programme and questions around people’s informed consent