Daily numbers, graphs, analysis thread 19

[BigChocFrenzy]

Daily numbers, graphs, analysis thread 19

Welcome to thread 19 of the daily updates

Resource links:

Welcome to thread 18 of the daily updates

Resource links:

Uk dashboard deaths, cases, hospitals, tests - 4 nations, English regions & LAs
Imperial UK weekly LAs, cases / 100k, table, map, hotspots
Modelling real number of infections February to date
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
Zoe Uk data
UK govt pressers Slides & data
ICNRC Intensive Care National Audit & Research reports
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
Alama Personal COVID risk assessment

⏭ Our STUDIES Corner ⏮

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

stuart mcdonald@ActuaryByDay

Latest COVID-19 hospital admissions and deaths data for England has been published.

This is more up to date than the graph of cases used in the Downing Street briefing today.

Daily admissions have been quite flat for the last few days, but the average is still rising rapidly.

Impact of baseline cases of cough and fever on UK COVID-19 diagnostic testing rates: estimates from the Bug Watch community cohort study

Extrapolates & estimates the diagnostic testing rates required July 2020 - June 2021, under 4 x 2nd wave scenarios.

Assuming that 80% of baseline cough or fever cases require testing,
testing demand in the UK would exceed current capacity for all of the period October 2020 to February 2021, peaking in December 2020.

https://www.medrxiv.org/content/10.1101/2020.09.03.20187377v1

That is a very clear and rapid switch to growth after what looks like a period of steady, flat low levels.

What's the average period between infection and hospitalisation? Is it three weeks? If so, what happened at the beginning of August?

Pausing of shielding? Period of poor weather sending everyone indoors? Or is it earlier changes finally working their way through to older populations? I'd love to see some analysis of this.

@Yummyoldbag ha ha that's ok!

It's a shame it's only updated once a month. So currently up to start September. Would be good if it was weekly or at least fortnightly.

(However my auditing husband went through it an remarked their numbers most definitely don't add up on some days. Most definitely some fat finger moments going on!)

If so, what happened at the beginning of August

My judgement of time in general is completely thrown off this year, but isn’t this approximately when cancellation of air bridges and quarantine regulations on return from other countries started being announced?

In general I never really agreed with announcing these in advance since either these countries numbers are too high or they’re not but the desperate rushes back to the UK to avoid quarantines would suggest a risk to me.

@BigChocFrenzy

Although I have no time for the Covid-is-over or Covid-is-the-same-as-flu merchants, I thought the letter was broadly reasonable. I generally have a much higher opinion of Heneghan than I do of Gupta and Sikora.

Given the likely time-scales and efficacy of any vaccine, I think it is reasonable to review our approach, and a strategy that is more relaxed about infection in low risk groups should be actively considered. Such a strategy would be problematic and there are significant challenges in implementing it successfully whilst minimising the harm to vulnerable groups, and it’s certainly couldn’t be a “let it rip” plan, but it may be less bad than the current alternative. I’m not saying it is ‘less bad‘, just that it shouldn’t be written off given our current predicament.

@BigChocFrenzy
Did you see my question about language used in germany for social distancing?
I'm perfectly okay if you want to skip it :) just don't leave me hanging pls.

@QueenStromba

It's anticipated (by those developing the Oxford vaccine at least) that the vaccine will produce a better and possibly longer lasting immune response than natural immunity.

The adenovirus used in the vaccine (which is the driver behind the immune response) typically induces a stronger immune response that the coronavirus.

I would anticipate that once a country is able to roll out full vaccination (and assuming uptake is high enough) it won't be necessary to have any SD measures in place except possibly very large scale indoor events and quarantining when returning from countries where widespread vaccination has not yet been achieved.

I'm at work so haven't had an opportunity to review the full report on reinfections but the individual who unfortunately suffered from severe disease the second time, does the proximity to the two positive tests combined with his severe illness not suggest an immune issue in that individual?

Obviously we don't know how widespread immune issues of that nature might be but it doesn't seem to present as a typical response. Again, apologies if I have missed something in the full report.

[quote TheSunIsStillShining]@BigChocFrenzy
Did you see my question about language used in germany for social distancing?
I'm perfectly okay if you want to skip it :) just don't leave me hanging pls.[/quote]
...
sorry, missed it - can you repeat pls

@BatSegundo

That is a very clear and rapid switch to growth after what looks like a period of steady, flat low levels.

What's the average period between infection and hospitalisation? Is it three weeks? If so, what happened at the beginning of August?

Pausing of shielding? Period of poor weather sending everyone indoors? Or is it earlier changes finally working their way through to older populations? I'd love to see some analysis of this.

.... Commonly quoted is 8 days between infection and hospitalisation - if it is going to happen at all

Here's Johnson. Coherent so far!

@BigChocFrenzy
What language/wording is used in Germany (in german) to describe social distancing?
I'm interested if other languages use the literal "do physical distancing" or the euphemistic "social distancing" phrases (or equivalents).

Anyone else with other language examples - pls. chime in.

THANKS! :)

I think a lot of damage is done by using incorrect language as it massively gives way to changing the narrative.

@Bercows

Here's Johnson. Coherent so far!

Yep

"and a strategy that is more relaxed about infection in low risk groups should be actively considered"

This is exactly what we have had - and it hasnt worked. Hospital admissions are rising because it has not been possible to protect the vulnerable - and some younger people prove more vulnerable than they realised.

Other strategies need to be considered, but not those suggested by idiots who (a) have been consistently wrong in their views previously - and (b) focus disproportionately on deaths and not at all on the need to keep admissions down so that other health care continues.

8 days BigChoc? That's much shorter than I was expecting. So not early August. Be interesting to look at the age groups of people in hospital to see if it's just that enough people in younger age groups are infected to put a small percentage of these into hospital or if it's older people who have not been well-enough protected due to high levels of community transmission. I have seen anecdotes of it being in care homes again but also anecdotes of ICU beginning to fill up with people in their 40s and 50s. Have we got that data? (apologies if I've missed it, this thread moves fast!)

Although KS questions were erect I didn’t find Johnson’s answers direct.

Fauci is at the pessimistic end of the scale - but imo more realistic - talking of the first vaccines being only 50% effective. That would still be a huge advance

It would be a big advance, but not enough to neutralise the threat of Covid to flu-like levels. Instead of 500,000 deaths in an unmitigated scenario, we have 250,000.... Even if these figures are overstated by a factor of 2, or even 3, that’s still bad.

This is why I’m increasingly leaning to allowing population-wide immunity to build up in non-vulnerable groups. Admittedly this poses huge problems, and is no silver bullet, but it may be the only realistic way through.

I had, perhaps naively, hoped that suppression of the virus since the Spring would - coupled with effective test and trace - enable us to keep a lid on infection levels whilst allowing us to open up as a society, albeit retaining some social distancing measures and restrictions, until an effective vaccine could begin to be rolled out at the end of this year, or the start of next. Implicitly I had presumed - again perhaps naively - that the vaccine would be sufficiently effective to allow social distancing measures to be dispensed with once the vulnerable had been vaccinated.

For me, the scales are now beginning to tip in favour of a managed herd immunity approach. However, my mind isn’t made up, and I’m open to persuasion and strong arguments!

I haven't read the reinfection report but I'm wondering how many of the six they have identified could be errors...?

Is it possible that occasional errors creep in? Person A's swab (which is actually negative) gets mislabelled/put in the wrong machine/contaminated by another swab and they end up getting Person B's (positive) result...?

Subsequently, person A then actually gets COVID and it looks like they've been reinfected when they haven't. (Or the reverse of course - correct positive first time round, followed by false positive second time).

I've never worked in a lab, so I don't know how possible these errors are, but I've worked in lots of other environments run by humans, even very competent ones, and mistakes do just creep in.

Even if mistakes are incredibly rare - say 1 in 100,000 swabs, then worldwide that would mean there would now have been over 300 errors like this (Worldometers reckons over 30 million positive tests worldwide). Of those 300 people, it's entirely plausible that 6 have, at some point, caught COVID and returned a genuine positive test.

[quote TheSunIsStillShining]@BigChocFrenzy
What language/wording is used in Germany (in german) to describe social distancing?
I'm interested if other languages use the literal "do physical distancing" or the euphemistic "social distancing" phrases (or equivalents).

Anyone else with other language examples - pls. chime in.

THANKS! :)

I think a lot of damage is done by using incorrect language as it massively gives way to changing the narrative.[/quote]
..
Language is "Abstand" = literally "space"

It comes first in the slogan

"AHA":
Abstand
Hygeine
Alltagsmask

Abstand has always officially been 1.5 m

It is officially given in more detail as:
"Achten Sie auf einen Abstandnd_ von mindestens 1,5 Metern zu anderen Personen im öffentlichen Raum – beispielsweise auf dem Weg zur Arbeit, beim Einkaufen oder beim Spaziergang im Park.^"

www.infektionsschutz.de/coronavirus/alltag-in-zeiten-von-corona.html

tranlated as
"Keep a distance of at least 1.5 meters from other people in public spaces - for example on the way to work, when shopping or when walking in the park."

@Derbygerbil

I don't think the efficacy of the vaccine translates so directly to the number of deaths. If enough people had a vaccine that was 50% effective the R rate would be hugely reduced, it seems to me the impact would be much more significant.

@Derbygerbil

Fauci is at the pessimistic end of the scale - but imo more realistic - talking of the first vaccines being only 50% effective. That would still be a huge advance

It would be a big advance, but not enough to neutralise the threat of Covid to flu-like levels. Instead of 500,000 deaths in an unmitigated scenario, we have 250,000.... Even if these figures are overstated by a factor of 2, or even 3, that’s still bad.

This is why I’m increasingly leaning to allowing population-wide immunity to build up in non-vulnerable groups. Admittedly this poses huge problems, and is no silver bullet, but it may be the only realistic way through.

I had, perhaps naively, hoped that suppression of the virus since the Spring would - coupled with effective test and trace - enable us to keep a lid on infection levels whilst allowing us to open up as a society, albeit retaining some social distancing measures and restrictions, until an effective vaccine could begin to be rolled out at the end of this year, or the start of next. Implicitly I had presumed - again perhaps naively - that the vaccine would be sufficiently effective to allow social distancing measures to be dispensed with once the vulnerable had been vaccinated.

For me, the scales are now beginning to tip in favour of a managed herd immunity approach. However, my mind isn’t made up, and I’m open to persuasion and strong arguments!

... My objection is to a "herd immunity" approach without any vaccine, because of the 20-25% proven infection "overshoot" we've discussed before

The levels of 40-70% antibodies in some hard hit areas, such as an NYC borough, make that a high risk strategy

Impossible then to prevent large numbers of the vulnerable being infected

Also, how do we protect the 15 million vulnerable, some of whom are under 60, working & bringing up families,
normally with decades of life ahead of them

Some aged 60+ work in key roles oir have had to be called back in the crisis
e.g. consultants and senior nursing levels, some teachers

==> IF we are going to try herd immunity, then it would be much more feasible next spring / summer:

• Vaccinate the most vulnerable first and continue vaccinating the rest of the population, to gain much higher community levels than the current 8% (UK - likely a bit lower in several other European countries)

+That can avoid the overshoot from herd immunity without vaccine

• Health systems with good spare capacity at that time of year

• Immune systems built up too

• Testing system / labs not under such pressure from winter ailments

• Gains from developments of treatments over autumn & winter

@Derbygerbil
I have a few arguments against it. Well, not arguments, but questions more

• how long would it take to infect everyone?
• would there be enough non-vulnerable ppl to achieve this?
• how many additional deaths would that mean?
• how many would be left with long covid which we know little about, but doesn't sound fun?
• how long does natural immunity last?
• what happens if you get infected second, third... time?
• do you know of any virus that humanity has achieved natural herd immunity against?
• we don't know how co-morbidities are cross reactive. We know of some correlations, but not all have been mapped out (obviously)

I'd agree with herd immunity theory if:

• we knew that there is long term immunity, min 5 yrs
• we knew that it would not take more than 3-6(?) months to achieve it with actually actively infecting ppl and
• we had a plan on how to save/shield the vulnerable
• we knew much more about long covid and treatment options

. . .

@BigChocFrenzy THANK YOU!

[quote Sunshinegirl82]@Derbygerbil

I don't think the efficacy of the vaccine translates so directly to the number of deaths. If enough people had a vaccine that was 50% effective the R rate would be hugely reduced, it seems to me the impact would be much more significant.[/quote]
....
I'd also expect a considerable drop in R if the available population that can be infected increases

from [8+X] % to [8+X+Y] %

where

X = the unknown % with innate unfindable immunity
Y = the additional % with immunity from a vaccine
Y would be increasing as more people get vaccinated