Daily numbers, graphs, analysis thread 25

[BigChocFrenzy]

Welcome to thread 25 of the daily updates

Resource links

UK:
Uk dashboard R, deaths, cases, hospitals, tests - by postcode, 4 nations, English regions, LAs
Interactive 7-day rolling cases map click on map or by postcode
UK govt pressers Slides & data
SAGE Table Interventions with impacts and R
Imperial UK weekly tables & extrapolations LAs, cases / 100k, table, map, hotspots
School statistics Attendance - Tuesdays
ICNRC Intensive Care National Audit & Research reports
UK testing and NHS England track & trace - Thursdays
ONS Roundup deaths, infections & economic reports
ONS England, Wales & NI Infection surveillance report - Fridays
ONS Datasets for surveillance reports
Our World in Data UK test positivity
R estimates & daily growth UK & English regions - Fridays
Modelling real number of UK infections February in first wave

England:
NHS England Hospital activity
NHS England Daily deaths
PHE COVID Clinical Risk Factors Non-respiratory by region, area, district etc
MSAO Map of English cases
Cases Tracker England Local Government
PHE surveillance reports Covid, flu, respiratory diseases - Thursdays
CovidMessenger live update by council district in England

Scotland, Wales, NI:
Scot gov Daily data
Scotland TravellingTabby LAs, care homes, hospitals, tests, t&t
PH Wales LAs, tests, ONS deaths
NI Dashboard

Miscell:
Zoe Uk data
ECDC rolling 14-day incidence EEA & UK
Worldometer UK page
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 analytical contributions
Please try to keep discussion focused on these
📈 📉 📊 👍
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Links added to OP:

• SAGE Table of Interventions with impacts and R
• PHE COVID Clinical Risk Factors by region, area

Links changed

• PHE Covid surveillance is now Covid & flu

www.lancashiretelegraph.co.uk/news/18795139.lancashire-greater-manchester-set-move-tier-3-lockdown/
Lancashire and Greater Manchester set to move into Tier 3 lockdown

Lancashire and Greater Manchester could be placed under stricter coronavirus restrictions as early as tomorrow, according to reports.

Local leaders are set for talks with Downing Street tomorrow morning (Thursday) ahead of health secretary Matt Hancock updating the Commons at 11.30am.

The tougher rules could be imposed on the North West within a matter of hours – if the decision goes ahead.

Andy Burnham tweeted: “We’ve just concluded a briefing with the Deputy Chief Medical Officer. We are expecting a further meeting with the PM’s team in the morning.”

I hate to wonder, but:

Death rates have come down a lot in ICU, which is brilliant
BUT
does that mean longer stays in ICU,
or the same /shorter length of stay before being moved to another ward ?

I don't think in ventilation beds necessarily means being ventilated, otherwise it would say ventilated patients. I imagine it means in a bed that is set up for ventilation should it be required (basically in intensive care), if a patient needs ventilation that isn't the time to be transporting them across the hospital to a suitable location. Obviously a subset of these patients will be being ventilated, what proportion I have no idea.

news.sky.com/story/coronavirus-uk-may-have-missed-the-boat-for-circuit-breaker-lockdown-govt-scientist-warns-12104153
Uk may have missed boat for circuit breaker lockdown govt scientist warns.

Looking at numbers, think that probably not wrong...

The rumour has always been that, if they were to do it, they wanted it to coincide with half term in schools, thereby causing a pretty damaging delay. Now it looks like it won't happen at all.

@Piggywaspushed

The rumour has always been that, if they were to do it, they wanted it to coincide with half term in schools, thereby causing a pretty damaging delay. Now it looks like it won't happen at all.

Gov seem to think that this virus will:

• wait for half term, so it's more convenient.
• won't infect anyone before 10pm
• stay outside school gates

They are giving it a lot more credit than it deserves.

WHO study:

Conclusion The infection fatality rate of COVID-19 can vary substantially across different locations and this may reflect differences in population age structure and case-mix of infected and deceased patients and other factors. The inferred infection fatality rates tended to be much lower than estimates made earlier in the pandemic

Link to follow

www.who.int/bulletin/online_first/BLT.20.265892.pdf

It's peer reviewed meta analysis. Good news, lower infection rates than initially thought?

@bigchoc Ventilation beds is beds which are capable of mechanically ventilating a patient. In critical care, patients may be HDU (require some stabilising treatment, supplementation of oxygen, may be in for post op observation) or may be ITU or level 3, requiring organ support, and (currently, whilst we still have the staff) 1:1 nursing. The most common organ support is mechanical ventilation for respiratory support.

When the SHTF the plan is to move the HDU and non ventilation patients into repurposed covid overflow ITUs to put the most severe patients on the proper ventilators. The covid loan programme had been dishing out ventilators (mostly no brand, made in China vents) which staff have no familiarity with/training on. We will only use these when we run out of our usual vents as the patient safety risks are higher. We also used our theatres anaesthetic machines to ventilate patients off licence, and these worked pretty well and have the added benefit of familiarity to the team. That is another key reason elective operating stopped, we needed the breathing machines to keep patients alive for days/weeks instead of the usual 2-3h in surgery.

"The average is now more than 48% higher than it was about a month ago, when it dipped to as low as 34,354. And hospitalizations have been increasing nationwide. More than 36,000 Covid-19 patients were in US hospitals Tuesday, the highest number since the end of August." — CNN

US following Europe again by the look of that.

One NHS source said the option for a new Nightingale was being kept under review, while a Whitehall source said there were “no active plans for a Liverpool Nightingale at this stage” but that the possibility could not be ruled out.

However the major problem with any Nightingale, existing or new, is staffing. There are already staffing issues at permanent hospitals in the city: 7 per cent of hospital staff in Liverpool are currently off sick due to coronavirus or issues relating to it, such as needing to stay in self-isolation.

inews.co.uk/news/politics/liverpool-nightingale-hospital-covid-cases-beds-shortage-tier-3-restrictions-719145

25!!! Cheers

[quote RedToothBrush]One NHS source said the option for a new Nightingale was being kept under review, while a Whitehall source said there were “no active plans for a Liverpool Nightingale at this stage” but that the possibility could not be ruled out.

However the major problem with any Nightingale, existing or new, is staffing. There are already staffing issues at permanent hospitals in the city: 7 per cent of hospital staff in Liverpool are currently off sick due to coronavirus or issues relating to it, such as needing to stay in self-isolation.

inews.co.uk/news/politics/liverpool-nightingale-hospital-covid-cases-beds-shortage-tier-3-restrictions-719145[/quote]
Yep! And the medics I know who don't currently do clinical work for whatever reason (retired, usually do locum work, work in non-clinical medicine etc) are now not very keen to volunteer themselves for Covid work as they have seen how badly the government treated medics last time -- inadequate PPE; blamed for "wasting" PPE etc. So I suspect they will really struggle to fill those hospitals with staff.

Thanks re humidity op.

Stephen Reichert (Sage subcommittee advising on behavioural science) has written a few articles before, savaging the government,
so SAGE are definitely not just govt glove puppets

Here he claims they refused to follow SAGE advice on 21 Sept and now the UK is in real trouble:

www.theguardian.com/commentisfree/2020/oct/13/johnson-ignored-science-second-wave-sage-advice

No data seems available on whether hospital stays are shorter. It would be useful to know. Several drug trials seemed to have indicated 3 or 4 less days of treatment required. That would be huge on a numbers basis for increasing capacity in hospital.

Anthony Costello of UCL on circuit breaker and need for reform of test and trace in the Guardian

www.theguardian.com/commentisfree/2020/oct/14/circuit-breaker-england-test-and-trace-reform-lockdown-sage

Including this:

"The government’s position rests on a false dichotomy: delaying restrictions would allow the virus to spread and cause greater economic damage in the long term."

@RedToothBrush - You mentioned Nicola Sturgeon advising against visiting Blackpool earlier. There have been lots of complaints on local social media recently about visitors to the town not distancing or wearing masks, etc. and suggestions that many of the cases are due to coach travel rather than to the town itself.

Blackpool Council have released a statement tonight
Following the First Minister's briefing, Dr. Arif Rajpura, Director of Public Health, Blackpool Council has issued the following statement: “Blackpool has long had an association with visitors from Scotland, in excess of 1 million visitors from Scotland enjoy Blackpool and all its attractions every year.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
“The rate of COVID 19 in Blackpool currently stands at 218 per 100,000 which is one the lowest in the North West of England, and is also lower than parts of Scotland.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
“As mentioned by The First Minister, evidence suggests that many of these current cases are linked to coach parties and coach travel. We are asking everyone not to travel when they are symptomatic. We are also reminding everyone when visiting, people should only be coming with those they live with, and should not mix with other households at all when in Blackpool.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
“Evidence across the country suggests that the virus is spreading most quickly within social groups, which is why it is essential that people act in a COVID secure way when they are here. We get 18 million visitors a year to Blackpool and have not seen outbreaks in the rest of the UK from visitors to Blackpool, nor are we experiencing outbreaks within our tourism businesses.⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀⠀
“Blackpool has stringent COVID secure measures in place. The council visits its hotels, venues and attractions on a regular basis to ensure all are COVID compliant.
"Blackpool was one of the first places in the country to establish a team of 60 COVID stewards. Their job is to ensure people are socially distancing, wearing face coverings, alleviating pinch points in queues and advising and supporting the public and businesses.⠀⠀⠀⠀⠀⠀⠀⠀⠀
“We want everyone to stay safe in Blackpool and urge people to follow our local restrictions, wash hands regularly, wear a face covering and stay 2 metres apart when possible”.

Interestingly there are numerous posts from hoteliers on local FB groups saying there has been a surge in bookings from Liverpool. If you didn't have a reason to avoid Blackpool already...

One of the trials reported "Those who received remdesivir had a median recovery time of 10 days " Remdesivir is given as a 5 day IV so requires people to be in hospital. It has shortened the average stay but that is still not just a few days. Those needing intensive care will be in longer, sometimes months.

Eli Lily has paused its monoclonal antibody trial. This is said to be "similar to" but not the same as, the treatment given to trump. edition.cnn.com/2020/10/13/health/eli-lilly-pauses-trial-monoclonal-antibody-coronavirus/index.html

@Baaaahhhhh

No data seems available on whether hospital stays are shorter. It would be useful to know. Several drug trials seemed to have indicated 3 or 4 less days of treatment required. That would be huge on a numbers basis for increasing capacity in hospital.

... I was wondering if more people surviving meant those people saved stayed for weeks in ICU, instead of dying Hence ICU places might be reduced

Alternatively, new meds send some people out of ICU more quickly,
freeing up space

We need to know if average ICU stay - or indeed ventilator stay - has changed
Maybe in next ICNARC report

[quote Eyewhisker]@marshabrady

‘A paper by members of the Scientific Advisory Group for Emergencies (Sage), obtained by The Times and due to be published today, challenges his position. It shows that a two-week full lockdown, with stay-at-home orders and school closures, from October 24 could reduce deaths for the rest of the year from about 19,900 to 12,100. Hospital admissions could be reduced from 132,400 to 66,500.’

I’m positively surprised that the ‘continue as now’ scenario is 19,000 covid deaths by the end of the year. That is in the realms of flu levels, where we do not lockdown. At the risk of sounding heartless, 130,000 people are expected to die between now and the end of the year of all causes. I am not advocating letting it rip by going back to normal (which would presumably be a higher total), but frankly there is a legitimate debate as to whether those numbers justify additional restrictions, and if they do, why half-term and Christmas are not cancelled every year to protect the vulnerable/elderly.

It also really bodes i’ll for what happens with a partially effective vaccine. If any deaths from covid are seen as unacceptable (though other illnesses are fine), can any government just end the restrictions?[/quote]
20,000 flu deaths is an estimate only because it is not a notifiable disease whereas Covid is. We are measuring actual Covid deaths , so would need to compare that with actual measured ( not estimated) flu deaths which would be much much lower than 20,000- more like a thousand or two at the most., though that is not a good comparison either Comparing annual flu deaths with Covid ones is an apples and pears situation ,it just isn't possible.
Also as others have pointed out, even using 20,000 a year deaths for flu, we have already had over twice that number of Covid deaths in 6 months (March to July). You would be comparing estimated annual flu deaths of 20,000 with actual Covid deaths of 3x that at least in a year, probably closer to 4x in a full year

Examples showing that Covid is much more deadly than flu

Sweden Covid (with limited SD) vs flu years (no SD) - lab-confirmed cases only

2020 Covid so far
5,907 deaths of lab-confirmed Covid

2018-2019 flu season
505 deaths lab-confirmed flu

https://www.folkhalsomyndigheten.se/publicerat-material/publikationsarkiv/i/influenza-in-sweden/?pub=63511

2017-2018 flu season
1,021 deaths lab-confirmed flu

https://www.folkhalsomyndigheten.se/pubreader/api/download/54559

2017-2018 flu season
734 deaths lab-confirmed flu

Berlin mask ad - from tourism bureau:

Some stuffy politicans are complaining, but this sassy grey-haired woman is getting laughs further afield than Berlin

[quote BigChocFrenzy]Stephen Reichert (Sage subcommittee advising on behavioural science) has written a few articles before, savaging the government,
so SAGE are definitely not just govt glove puppets

Here he claims they refused to follow SAGE advice on 21 Sept and now the UK is in real trouble:

www.theguardian.com/commentisfree/2020/oct/13/johnson-ignored-science-second-wave-sage-advice[/quote]
There’s no love lost there. Wondered who he was so looked at his Twitter he’s been quite anti the whole time plus quite a few articles.

His advice feeds into Sage, he probably can get away with it more.