Daily numbers, graphs, analysis thread 20

[BigChocFrenzy]

Welcome to thread 20 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 reports & LA Local Watchlist Maps by LSOA
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 GB test positivity etc, DIY country graphs
FT DIY graphs compare deaths, cases, raw / million pop
Alama Personal COVID risk assessment
Local Mobility Reports for countries
UK Highstreet Tracker for cities & large towns Footfall, spend index, workers, visitors, economic recovery

⏭ Our STUDIES Corner ⏮

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

Request to posters giving a link:
Please do so in full, so people can see in advance what they are clicking
Also at least a brief title so we know what the link is about

london admission figures are just wierd - and not really believeable. the number in hospital is rising faster than the admissions figures. So it's either spreading madly in hospital ( I dont believe that) or they are not getting test results fast enough and probably Covid cases are not counted until they do (more likely).

London also has a higher percentage of those in hospital in ICU beds.

Inpatient and ICU numbers have got a longer lag than hospital admissions. They do not provide the most current view.

Even if admissions have started to fall, the numbers for people in hospitals will not go down until discharges finally start exceeding admissions. This usually happens in around 7 days after the initial decline in admissions.

@wintertravel1980 inpatient and icu numbers are dated with today's date the the info says that it is reported daily from info given at midnight the previous night. So no apparent lag.

Weekend numbers for patients in hospitals (in London) are often low because some hospitals do not submit the figures. I would discount 188 reported on 26/9 and 213 reported on 27/9.

The change from 221 on 25/9 to 257 on 28/9 seems plausible. There may be some (limited) hospital spread since we are now starting to see hospital outbreaks in the weekly surveillance reports.

Do we know our recovery rate?

I know the UK was one of only a few countries not publishing the figures. Has this now changed?

@PrayingandHoping

No, there is no lag in reporting but there is lag in decline.

The number of patients in hospital at the end of today = the number of patients yesterday + admissions for today - discharges for today

There may be an adjustment for hospital spread but let us ignore it for simplicity.

As long as admissions exceed discharges, the number will continue to grow.

The discharges for today would be patients admitted to hospital some time ago. Both North West and North East have gone through a period of rapid growth in COVID cases so the admissions have quickly surpassed discharges. Now, even with admissions (potentially) falling, we will not see the drop in hospital numbers until more patients recover and discharges begin to increase.

Tuesday deaths have always been highest due to many hospitals and especially care homes not reporting over the weekend. That aside 71 is still very high sadly.

London

R + 1.2 - 1.5
daily growth rate of infections = 4 - 9 %
which is the the highest growth rate in the country, slightly higher than even the NW

So I'd expect Khan and Westminster to be pro-active about a densely-packed population of 9.3 million

wonder if there's any follow up on how many who are isolating get symptoms

I really hope there's research on this, and stratified by age. The actual infection risks need to be identified

I actually think it's highly unlikely there is any follow up on this. We received a letter from PHE yesterday exhorting parents to ONLY test for high fever, continuous cough or loss of taste and smell (even though the Zoe study says 52% of positive children don't have any of those symptoms).

There was a clear undertone to the letter (IMO) that parents were testing unnecessarily and that it was parents causing the system to fall down. Given PHE are essentially sending parents letters saying 'please don't test so much, you're making the testing system look bad!' I can't see that they're following up on asymptomatic contacts. In fact the letter does specify that close contacts shouldn't test unless they too develop one of these three symptoms.

So you could in theory have a child who's been sitting in class next to someone who's tested positive, who has a rash, fatigue, sore throat, headache and gastro symptoms within the isolation period, and the PHE advice is NOT to test that child.

covid.joinzoe.com/post/back-to-school

Sorry - report on zoe symptoms for positive children

1. Even most private schools with big grounds didn't opt for portacabins.
2. Their smaller class sizes mean 25 kids, not that lower. At least the big from 6-18 schools. the Prep schools 6-11 tend to have smaller classes, but they also tend to be in old buildings. (looking for stats, will post if I find)

I did find general stat, which is interesting. Secondary class size is 21.7 in state schools. I thought it would be higher. Primary is 27, which is terrible (assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/812539/Schools_Pupils_and_their_Characteristics_2019_Main_Text.pdf)

@wintertravel1980

Re: the North - hospital admissions in both North West and North East may be plateauing. In fact, North West might even be going down although it is too early to say if It is a blip or a real trend.

... I wouldn't really believe even a levelling off, let alone a fall, until the averaged R and growth rate for that region drop towards 1 and 0% respectively

Yes, the calculations for R use data from up to 2 weeks ago, so there is a clear lag
However, it won't suddenly drop in that time to 1.0 from 1.2 - 1.5

Currently the positivity rate for children under 10 is 1% which suggests that young children are indeed being over tested.

49% of young children with COVID (according to Zoe) develop fever so using it as the main criteria makes a logical starting point.

It is true that we may indeed miss some cases but what NHS/PHE/DfE have to do is to maximise the “hit rate” using the available (pretty large) testing capacity. Trying to identify every single asymptomatic child with COVID would be a failed mission from the very start.

DD is 3.5. I will only test her if I absolutely have to, i.e. if she develops any of the official symptoms.

Having said that, DD had all the symptoms listed by Zoe back in early March. Back then I convinced myself it was roseola although I was a bit puzzled by the loss of appetite. Who knows....

The Whitty/Vallance chart
presented in their 21st September briefing had a possible scenario of cases doubling every 7 days if no action was taken.

21 Sept had 4,368 new cases
22 Sept had 4,926

So today's 7,413 cases indicates doubling period is now significantly longer than 7 days
considering this was probably a post-weekend high and also the values of the last few days

==> recent measures have worked and / or scenario was pessiminstic

Yes I realise it takes longer to filter through but I honestly just don't hold much weight in admission alone as it doesn't show the real picture of the patients on the ground. Some patients can be admitted and discharged same day. It's meaningless.

Inpatient numbers and ICU IMO show how good/bad the situation in severity of patients are.

You have to look at the picture as a whole IMO.

Seven day average by date of specimen should hopefully be starting to show a more gentle incline/flattening in terms of cases I would have thought.

Testing children needs to be targeted more at those with keyworker parents
e.g. teachers, NHS staff

(FT paywall) NHS hit by staff shortages due to lack of Covid tests for children

The Faculty of Intensive Care Medicine and the Royal College of Emergency Medicine told the Financial Times that doctors with families were having to take time off work if their children had been sent home from school, either because they were sick or because a classmate had Covid-19 symptoms.

“The children are not being tested, or there is a very long lag between getting them tested and results being returned,
so there are large numbers of staff having to remove themselves from work, and often isolate for two weeks,”

said Alison Pittard, dean of the Faculty of Intensive Care Medicine.

“That is having a huge impact on our ability to staff intensive care.”

www.ft.com/content/8c5f27ac-000d-432f-ab98-40fb59317d9a

Yes that was a glaring omission when the govt published the list of those who'd get priority testing a couple of weeks ago.

No "or a member of their household" for any of the key staff listed. It also names "teachers" which presumably excludes other school staff, eg cleaners, site staff, pastoral etc etc etc.

UK cases doubling every 12-13 days according to Ed Conway (Sky News):

^Based on past week, UK cases are currently doubling every 12-13 days.
Trajectory is still broadly in line with France & Spain. ^
mobile.twitter.com/EdConwaySky/status/1310967801943920648

Apologies for the anecdote, but I think the student figures may be severely undercounting. My friend’s son is isolating in halls and has classic COVID symptoms, but is not getting a test. He has no transport, he knows others in the halls are positive and whatever he tests, he can’t go out regardless, so what’s the point? There certainly isn’t the incentive to test for this group - they’re not missing work or school and they’re not likely to get seriously ill. Why would they bother testing?

I'm a teacher. It took me 3 days to get a test closer than 60 miles. By which time I felt better. Test was negative so all good but meant I was off 2 days that I needn't be. If it hadn't gone over a weekend then it would have been 4 days. No priority whatsoever.

He wants to tell us something:

Adam Parsons@adamparsons (Sky News, Brussels)

To everyone citing the success of the “10pm Belgian curfew”.

There has been no national curfew since lockdown finished
There is no national curfew now

There was one in Antwerp, which kicked in at 11.30pm for a relatively short while.

THERE IS NO CURFEW IN BELGIUM

There certainly isn’t the incentive to test for this group - they’re not missing work or school and they’re not likely to get seriously ill. Why would they bother testing?

But so long as they isolate, then it's all fine - there's the same no testing for household contacts of any other positive test, it doesn't matter if you live alone or live with 5 others, it's still just one positive test. The important thing is managing transmission, not identifying every case with a test, it'd just be a waste of a test.

So long as they isolate.

Attached is the graph from RP131 on Twitter showing actual cases v the possible scenario graph published by Whitty, Valance et al on the 21st. Seems broadly positive.