North south divide in covid outbreak

[weepingwillow22]

I was struck by this map on the zoe app showing the number of current infections per million people.

There is such a marked divide between the north and south of the UK, from the Highlands of Scotland where there are 2900 cases per million to the north of England where it drops to an average of around 2000, to the midlands which are at about 1500 and then to the south east which is around 500 to 1000 and then finally the south west which is below 500.

Does anyone have any views on the reasons for this regional disparity. I am wondering if it is climate related as an earlier autumn in the north means faster spread of the virus.

If this is the case though it does not bode well for all of us heading into winter. Any views?

[Thneedville]

There has been speculation right from the beginning that vitamin D was beneficial.

I’ve always been surprised that the south east has never been that badly hit compared to other regions. London hit first and bad, so neighbouring regions more cautious? I was travelling by train into London until Lockdown officially started, and my trains were empty in that last week. Most people commuting that distance can WFH, ditto a higher proportion of jobs in SE generally I’d guess.

It could all change in the coming weeks though!

[BadPoet]

Much as I am enjoying people coming up with 'theories' about the dark red 'cold north' and our working, mask-wearing and socialising habits, again - the map is wrong. Here's a better one www.theguardian.com/world/2020/sep/16/coronavirus-uk-map-confirmed-covid-cases-and-deaths-today

[HeIenaDove]

@feesh Maybe this will give you some food for thought.

I wear one but hate it. Im really starting to resent it though because some of the ones ive seen on here who are really gung ho about masks and banging on about how we are all in it together have spent the past ten years voting for the opposite. Along comes Covid and their want for individualism goes out of the window.
Having seen their attitudes to single parents, disabled people , social housing tenants over the years i cant help getting a distinct whiff of people in these groups being expected to wear masks to protect their "betters"

One of the most gung ho about it was absolutely incredulous when i suggested low income families should get them for free.

"You think people should get them for free?! she replied. Yep all in this together eh!

Tells you all you need to know.
People were being told to make masks out of old socks.

Meanwhile the construction industry are allowed to carry on as normal ( we had ELEVEN WEEKS of a roof renewal and its been hell as well as including a visit from the fire brigade but fuck us eh, we are only tenants) and the workmen have a tiny site office on our estate No masks in sight.

So yes i wear a mask But am really starting to resent it when i know others wouldnt give me the steam off their piss if i was sat homeless in the street yet want me to wear a mask to protect others.

[HeIenaDove]

Im in the South East

[2bazookas]

There's a big demographic difference. London /SE has a much higher population of young people (less susceptible to covid) than most of the UK.

Scotland's population has a high proportion of retired people (more susceptible age group)

[weepingwillow22]

[quote BadPoet]Much as I am enjoying people coming up with 'theories' about the dark red 'cold north' and our working, mask-wearing and socialising habits, again - the map is wrong. Here's a better one www.theguardian.com/world/2020/sep/16/coronavirus-uk-map-confirmed-covid-cases-and-deaths-today[/quote]
Is it better though or simply a different method of collecting the data. The map I linked to is from The COVID Symptom Study which is the second method discussed below.

Here is an overview of the differences.

1. The number of lab confirmed cases

This is the rawest form of data that includes records of all the swab positive tests on any given day in the UK, including hospital cases.

Things to consider
Many cases of COVID are not recorded. So lab confirmed cases are just a fraction of the total story.This data is the most immediate and only includes a small lag, which makes it suitable for spotting outbreaks, especially in hospitals.The recorded cases come from a variety of sources, predominantly constitute tests from hospitals, care homes, care workers, healthcare professionals and other communities at high risk of infection. The reported numbers can offer crude estimates but are sensitive to testing patterns, test availability and other changes in government policies.


The COVID Symptom Study figures
How do we calculate incidence rates?

We have a two step process. First we identify app users who log new symptoms after being healthy for at least 9 days, and estimate the proportion of newly sick app users. These individual users are then invited to have a COVID swab test provided by the Department of Health taken within 24 hours and are asked to continue logging their symptoms in the app.

The results of these tests allow us to identify the proportion of newly sick individuals who test positive for COVID-19. This two step process enables us to do more targeted swab tests focussed on sick users, who are more likely to be positive. We scale the proportion of sick users with the proportion of those testing positive to get the incidence rate and then generalize it to the wider population to give the estimated number of daily new cases across the UK.

How do we calculate prevalence rates?

We now have a better picture of how long it takes to recover from COVIDand as a result we have built a recovery model that tells us how many people recover within a specific number of days from symptom onset. For example, we observe that only 52.2% of people recover within 13 days. We have combined this recovery model with our daily new cases model to produce our prediction of the number of daily active cases.

In a nutshell, our prevalence is:

Yesterday’s active cases + today’s new cases - today’s recoveries = Number of active / symptomatic cases.

Things to consider:Our targeted testing strategy enables us to record more positive tests. For example, last week ONS published estimates based on 10 positive tests, whereas we published estimates using 56 positive tests. The higher number of positive tests makes it possible to estimate incidences at a regional level, which permits us to reliably compare and comment about the different regions in the UK.The app uses all the test results that we receive and estimates incidence for the entire UK. ONS surveys are for England only at present.We are only able to invite those who are using the app for COVID testing, and our user base is not fully representative of the entire country. So, our estimates are slightly biased towards the demographic and behavioural characteristics of our app users, although we adjust for age and deprivation when extrapolation to UK population This means that although users can log for relatives, our estimates don't include many cases in hospitals, care homes and other communities where the app usage is subpar or non-existent.The app is not able to monitor asymptomatic users (i.e. those without any symptoms) and thus our estimates don’t account for them. So, our estimates will be lower than ONS estimates, which include asymptomatic cases, although they don't screen for the same number of symptoms as we do.The incidence estimates are updated everyday, but we have a four day lag to provide ample time for our users to get tested and log their test results. The prevalence estimates also use the symptoms logged by 3 million users in the UK to predict how likely someone is to test positive on each day.

1. The ONS figures

The ONS randomly invites around 8,000-9,000 households in England to participate in its testing program and uses these test results to estimate incidence and prevalence. The ONS publishes an estimated prevalence and incidence every two weeks based on their infection survey test results.

Things to consider:As it is a random invitation survey, ONS can test people across all ages with enough representation from various regions and communities in England. So, its estimates are more representative of the population, although will still have some biases. For example, it will only measure people who are willing to engage in a repeated survey for the government.The randomness of inviting people ensures that both symptomatic users and asymptomatic users are tested, unlike our app.It is a small sample - only 8-9,000 households vs the millions in the UK. It cannot see hotspots in particular areas therefore.The estimates are not updated daily. It is once a week with an extra four day lag. This means that the figures are not as sensitive to sudden changes/outbreaksThe ONS publishes numbers only for the whole of England (and not for regions) because of small numbers, though numbers may increase.It only accounts for private households, it can not account for the number of cases in hospitals and other care situations.

The lab confirmed cases is a standalone figure, which is not comparable to the prevalence and incidence rates from the other two survey sources. The ONS and COVIDSymptom Study app provide roughly the same estimates over the last month which is reassuring.

The results over the past few weeks of surveys have suggested that the rates have been falling over time, though our app has shown regional differences.

We will be continuing to release weekly updates on the data on Thursday each week and we hope that this blog has helped outline the differences between the data and what each figure is telling us about the current COVID situation in the UK.

covid.joinzoe.com/post/ons-covid-comparison

[ListeningQuietly]

The Zoe App is entirely voluntary and where is the evidence that its self selecting data set is in any way representative of each area ?

Round my way it is being used by less than 1 in 1000 people
and they are mostly older ones with iphones
= missing out huge chunks of society

I'll stick to te ONS data thankyou

[weepingwillow22]

@listeningquietly All methods have their limitations. The ONS sample size is so small it is not robust at the regional level, let alone the local level.

How many people round your way responded to the ons survey? If it is only 8000 nationally it will not be very many.

[BadPoet]

@weepingwillow22 I mean, believe their prevalence estimation if you like. I'll continue in the knowledge that it just doesn't work for large, sparsely populated areas like the Highlands where the actual cases are low and therefore not statistically significant using measures like that. What does it actually tell you? There aren't a million people in the Highlands and there aren't 2500+ cases.

[ListeningQuietly]

The ONS sample size is so small it is not robust at the regional level, let alone the local level.
10 versus 56
neither is statistically valid

My key point is that Zoe users are not representative

[EducatingArti]

@AlecTrevelyan006

It was rife in London before lockdown and as a result now London is, at or very close to, herd immunity.

London is absolutely nowhere near herd immunity. It would involve 60 to 80% of people being immune!

[EarlGreywithLemon]

Re herd immunity, it’s unlikely that’s possible with Covid. Reinfections have already been documented, albeit thankfully mild ones so far.

[OnceUponAThimble]

It's been up on 30 degrees here (London), the past 3 days. So if it's 20 up North, that's quite a disparity. Shorts and t-shirt weather here still.

[InsaneInTheViralMembrane]

Zoe’s talking shite hen. Where I live we’ve had 7 cases out of 140,000 people putting us at approx. 49 per million. Zoe says we’ve got fahsands.

[annabel85]

In reality, it's still the first wave up north in many areas. The London area was battered in March when rates were low in most of the rest of the country when we locked down. We had a national lockdown when it was mostly London that was badly affected. The north west is badly affected now.

[annabel85]

@OnceUponAThimble

It's been up on 30 degrees here (London), the past 3 days. So if it's 20 up North, that's quite a disparity. Shorts and t-shirt weather here still.

That's the other main factor with north and south. The south have had a hot summer, it's a lot cooler up north and much less sunshine on average.

Londoners have been socialising a lot more outdoors and the south in general on beaches.

[crystaltips98]

London had it worse at first. Now its in the North Boris doesn't care . Oh wait, he never cared.

[littlemsattitude]

Where do Waitrose stop?

Exeter and Esher

[Inkpaperstars]

i have heard nothing to suggest London is at or near herd immunity. As far as I know nothing like that many are thought to have been infected, and in any case re infection seems to sadly be a thing.

[feelingverylazytoday]

@Inkpaperstars

i have heard nothing to suggest London is at or near herd immunity. As far as I know nothing like that many are thought to have been infected, and in any case re infection seems to sadly be a thing.

New infections dropped once around 20% of population had antibodies. This has been noted in other countries as well. It seems to be enough to slow infection significantly, at least for a while.

[x2boys]

Yes it was 80 odd degrees yesterday in Bolton ,plus we have also had a nice summer ,and yet we have the highest rates of infection in the UK.

[Bellamybells]

Weather!!

[OnceUponAThimble]

What are you doing differently in Bolton?

[RedToothBrush]

Also.

Towns where everyone knows every other fucker or at least their mate.

[MinesAPintOfTea]

Bolton had a cool and damp July/August. Socialising outside hasn't really appealed since early August (until this week)

Also when it was endemic in London we shut the whole country down. Now London is doing ok, that is over and instead we have a confusing mess of local restrictions.