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 📈 📉 📊 👍

@BigChocFrenzy

"it started BEFORE the schools went back"

Returning from holiday ?

Possibly. But why those areas and not others?

The thing that comes up in my mind is socio-economic differences and poor access to testing / less willingness or ability to isolate when a problem does arise.

Returning from holiday ?

That's my hypothesis (at least, for London).

I have read recent SAGE minutes and the members seem to think the numbers of imported infections are not the main driver. However based on my personal experience all the people I know in real life who tested positive over past few weeks have had a link to foreign travel. They either went on holidays themselves or they caught COVID from someone who has recently been away on foreign holidays.

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[quote TheSunIsStillShining]@itsgettingweird
I can't take credit, it was @Piggywaspushed who posted the original, this is just an addition :)

@BigChocFrenzy
do you know anything/have data about german holidays? How many went, where? How big was the drop in going abroad for a holiday? What mode of transport was used?

I posit (always wanted to use this word) that the regions where there was big influx from elsewhere, like spain, croatia got things out of control and then as a secondary result countries where these are popular destinations (eg croatia for hungarians) are driving up the numbers. I actually will go and check non-touristy stats, come to think of it....[/quote]
...
I posted on a previous thread some charts from the RKI, compiled using detailled track & trace data,
of how many infections in those weeks were thought to have come from which countries

School holidays are staggered across the 16 German states from 3 August - early September
so holidaymakers return was mostly staggered from July to late August
and there have been much fewer new infections from returning holidaymakers recently

These are the most recent reports of infections tracked from abroad

This is good data @RedToothBrush, what are your theories?
To me it looks possible that there are multiple versions of the two infection "types" playing out on different timeframes: sudden peaks = superspread events affecting the area (from dodgy factory in Leicester to travel + pub crawl in Bolton), plus ongoing high / low positivity driving case numbers. There are other threads asking "why" to the second point. The different maps show that superspreaders hit hard and fast, but they also fade away. Handling the endemic positivity rate is much harder.

I agree with @wintertravel1980 about travel, the manner of little spots of 2/ 3/ 4/ 5 popping up in London areas that had no infections for months suggests travel. German figures there (thanks @BigChocFrenzy) 14k within Germany (including from those infected overseas) plus 10k from overseas - the vast majority is linked very clearly to overseas travel.

In the north of the UK there are airports that primarily do package holiday tours straight to places that had open nightclubs and were not enforcing any distancing. People can fly from Manchester, or Newcastle, or Liverpool to a limited number of resorts; an issue in just a few of those resorts will trickle back until a superspreader turns up. That still doesn't explain Bolton. It surely has to be people not socially distancing, for whatever reason.

You can only deal with superspreaders if you do so quickly. That means you spot the problem and trace people promptly. Ideally you need to get tested and get a result within 48hours, preferably 24hrs.

Warrington (sorry to keep coming back to it, but I think its a useful case) has a really low capacity for local testing. During August they only had one shared mobile tracing centre which was located in Halton at the time an outbreak appeared.

It means the town was heavily reliant on home testing kits - which have a longer turn around time. That means delays in tracing people. That means you are always lagging behind chasing the virus more than in other areas. That just means the virus has more time to infect people and for them to infect others before the system identifies them. That equal greater expendential growth than in places which have better access to local testing.

Knowsley has one of the very highest levels of deprivation in the country. It has the least ability for residents to get into a car and get to a test centre. It SHOULD shoot off as soon as you get cases going up. I don't know the NE too well, but I think the same is true there.

We KNOW that the NW has 30% of cases but only 15% of testing capacity.

We are NOT seeing greater capacity to test in terms of testing sites being opened. Its not just the lab issue and delays with labs. Its people who can't travel to test sites which are not located on a bus route. Its people who can't book a test because the testing centres are fully booked. Its problems with centres which aren't open when people turn up. Or people who have booked appointments who are turned away.

We are seeing this pattern in the places with the highest rates of growth.

Yes, much easier to tackle a few large clusters than a large number of very small clusters / single cases

Red i've heard it mentioned many times that NW came out of lockdown to early although I have never really understood that. Shops / pubs were closed for the same amount of time as everywhere else. OK i know cases weren't as high as London when lockdown happened but why were cases per 100000 not the same if not lower?

Which then makes me wonder if the area was less compliant with lockdown?

And i know a superspreader is being blamed in Bolton - but really? If people were following the rules then the impact would be much less?

Obviously population density plays a part. My city is pretty good with regards to cases, but we not as densely populated as many cities.

Is it because its generally a Labour area? Did that increase the mistrust of the message coming out of Westminster. Was it because of Cummings - I'm sure he thinks he's played a blinder.

You mentioned Birmingham has maybe slowed down a bit. Its more densely populated than Bolton for example. Although it also got hit 1st time around so perhaps people take more notice.

I do hope that there's enough pressure locally in the NW to get this under control a bit.

There are strong advantages in a system like Germany and some other countries have,
where everyone phones their GP or a central line, to request & book a test at a time & place they can manage.

Those genuinely not mobile / too ill to travel would have an HCP make a home visit to test

Of course, that requires sufficent GPs and an adequate central line - resources

and also tests carried out by professionals leads to fewer inconclusive tests
i.e. wastes fewer tests

@Timeforanotherusername

Red i've heard it mentioned many times that NW came out of lockdown to early although I have never really understood that. Shops / pubs were closed for the same amount of time as everywhere else. OK i know cases weren't as high as London when lockdown happened but why were cases per 100000 not the same if not lower?

Which then makes me wonder if the area was less compliant with lockdown?

And i know a superspreader is being blamed in Bolton - but really? If people were following the rules then the impact would be much less?

Obviously population density plays a part. My city is pretty good with regards to cases, but we not as densely populated as many cities.

Is it because its generally a Labour area? Did that increase the mistrust of the message coming out of Westminster. Was it because of Cummings - I'm sure he thinks he's played a blinder.

You mentioned Birmingham has maybe slowed down a bit. Its more densely populated than Bolton for example. Although it also got hit 1st time around so perhaps people take more notice.

I do hope that there's enough pressure locally in the NW to get this under control a bit.

.... The infection curves for different areas of the country had different timings and gradients

London was hit early and hard, peaked earlier
The NW curve started later, so peaked later

The ending of lockdown might have been a bit too late for London, but too earlier for some other areas further away

I was one of the killjoys who were against allowing the resumption of holiday flights,
precisely because of the increased infections I was sure would happen and their wide distribution among the country

• lots of tiny clusters, very difficult to stamp out soon enough to stop community levels rising sharply

BCF i still don't get it. Surely lockdown essentially broke the chain?

And the peak happened soon after?

Its possible the NW may have had more problems with outbreaks in hospitals / carehomes which is where a lot of cases were continuing to be transmitted after lock down. The NHS has fewer hospitals beds per head of population, so the pressure to push people into the community might have been maintained for longer. And there is a higher risk to the population because of underlying health being lower and deprivation higher. Just today I've seen a story about Stepping Hill Hospital discharging 29 people with unknown covid status into care homes. The Manchester Nightingale was open until July. So it strikes me the hospitals took longer to get back to normal.

You also have possibility that you have higher numbers of people (per head of population) who are employed by the public sector and therefore 'key workers' in the NW compared to London. Labour councils have traditionally had a higher number of employees compared to the Tory ones. So more people still working during lock down = more opportunity for the virus to continue to spread. I know that in two pretty affluent schools they had exceptionally high levels of key worker parents too - not all who are public sector (from what I know of the schools and what I've been told).

There is the possibly that compliance is a greater issue. But I think there are other factors going on, and its too easy to just blame northerners for being more rebellious or being more working class using rather lazy stereotypes.

Its possible that early on people in London were more likely to be directly affected and knew people who were infected might have been a factor in taking things seriously.

There is the possibly that compliance is a greater issue. But I think there are other factors going on, and its too easy to just blame northerners for being more rebellious or being more working class using rather lazy stereotypes.

When I mentioned mistrust of Westminster I was thinking how Scotland would have been without devolution.

I hope things start to get better soon.

@BigChocFrenzy are the German public generally happy with the process of going through GPs for testing? I’ve seen a lot of negativity around a similar process in ROI (including a lot of complaints from GPs). I can see the benefits of it and was surprised by the negativity, although the GPs seemed to have the main complaint of the amount of time spent discussing the lack of need for a test with the “worried well” and detracting from other work

[quote lurker101]@BigChocFrenzy are the German public generally happy with the process of going through GPs for testing? I’ve seen a lot of negativity around a similar process in ROI (including a lot of complaints from GPs). I can see the benefits of it and was surprised by the negativity, although the GPs seemed to have the main complaint of the amount of time spent discussing the lack of need for a test with the “worried well” and detracting from other work[/quote]
....
It seems to work well, maybe because there are far more GPs, iirc about 3 x the number / 100,000 in the UK
They know their patients, which can also help decide if some symptoms are normal for e.g. someone with asthma, allergy etc

Also, there is an alternative of phoning a central line

The advantages of the system are that it targets those who need to be tested
provides a time & local place that people can get to, or a visit to test for those who can't travel
and the actual testing by professionals reduces the number of tests producing neither negative nor positive, i.e. genuinely wasted

However, it only works because the resources and organisation are there, joined uip
and it is all done at a very local level

@Timeforanotherusername

BCF i still don't get it. Surely lockdown essentially broke the chain?

And the peak happened soon after?

... The difference between theory and pracvtice:

Lockdown can never be complete, because millions of people still have to go out to work

• and the ratio WFH : WOH may be different in different areas - people had to go out to buy groceries or medicines, or for essential medical appointments

Hence, lockdown reduces R, but is not a quick chain break and is not uniform
Local differences - endemic infection, mode of commute, infection epicentres like abbatoirs & other food processing plants, different types of industry, age demographics, different % of multi-generational households, cultural customs ... - including compliance
affects the gradient and timing of how the infection curve built up and hence how it drops off

It may well be that some areas had more infections than were realised - with such low testing, areas outside London were probably tested even less

Studies have shown how the curve of infections drops far more slowly than it built up

@BigChocFrenzy it seems that ROI has more GPs per 100,000 population than Germany so it’s interesting that it’s been seen as more successful in Germany than ROI, I can’t see anything to suggest that they have a central telephone number so that may be something to do with it

www.telegraph.co.uk/news/2020/09/22/nhs-provide-100000-in-house-tests-day-combat-staff-shortages/?utm_content=telegraph&utm_medium=Social&utm_campaign=Echobox&utm_source=Twitter#Echobox=1600795836

NHS to provide 100,000 in-house tests a day to combat staff shortages

Telegraph understands health service bosses keen to increase number of doctors and nurses given quick turnaround Covid-19 testing

Test turnaround being a problem here too... straight out says there is a problem with track and trace...

[quote lurker101]@BigChocFrenzy it seems that ROI has more GPs per 100,000 population than Germany so it’s interesting that it’s been seen as more successful in Germany than ROI, I can’t see anything to suggest that they have a central telephone number so that may be something to do with it[/quote]
...
May also be how well the system is organised, integrated locally with testing & labs

There needs to be enough tests available locally and quickly
also extra personel - not GPs - who can be sent to make home visits for those who are too ill / have a disability and can't travel

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