Daily numbers, graphs, analysis thread 26

[BigChocFrenzy]

Welcome to thread 26 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
NHS Triage Dashboard Pathways - triages of symptoms
NHS Triage Dashboard Progression - # people pillar 1&2, # triages

⏭ Our STUDIES Corner ⏮

We welcome factual, data driven and analytical contributions
Please try to keep discussion focused on these
📈 📉 📊 👍

This might help explain the thinking in Wales. gov.wales/sites/default/files/publications/2020-10/technical-advisory-group-fire-breaks_2.pdf

NW LAs 7-day incidence

Cutting their NW table to the Top 10, we see the encouraging drop in Manchester and slowing of increases elsewhere

@BigChocFrenzy

(yes, I know Eton is in Windsor ! They are just the only school I heard that are doing regular tests of all)

I've posted before, four state schools are testing from Wednesday. It's meant to be non invasive but it's going to be a throat swab administered by a nurse. Weekly tests of all teachers and pupils that agree to it

Wales

626 new cases
1 new death

LAs 7-day incidence
Some sharp increases there

"Weekly tests of all teachers and pupils that agree to it"

In effect, the parents that agree
and the ones who can't afford to isolate, or don't want to, will refuse participation - as must be their right - but may have the highest incidence

However, that is as good as we can get, so let's hope for very high participation

@MRex

The UK government cannot vote to simply remove the Welsh executive for making laws within it's own remit, they would lose all demcratic credibility. I'd also be on one of the protest marches *@SheepandCow* gets so irate about (in a mask, distanced, with millions of others).

I am very anti-protest atm, but even I would stand by this protest.

[quote Frazzled2207]A very interesting article about the actual situation in GM hospitals.
Not about data per se but the secrecy around it
www.manchestereveningnews.co.uk/news/greater-manchester-news/secrecy-spin-surrounding-greater-manchesters-19131905.amp?__twitter_impression=true[/quote]
The question about the data and who owns it is a REALLY interesting one.

The M.E.N. understands trusts have been told by both regional NHS England and the Greater Manchester system specifically not to issue their own figures to the media today.

Especially when looking around the NW papers today, I came across this:

www.warringtonguardian.co.uk/news/18805188.100-coronavirus-patients-warrington-hospital/
More than 100 coronavirus patients at Warrington Hospital trust

The latest figures released by Warrington and Halton Teaching Hospitals NHS Foundation showed that as of this afternoon, Monday, there are a total of 109 inpatients across the two sites who had tested positive for Covid-19.

And 14 of these are in intensive care.

During the first wave, the trust saw the total of covid-positive inpatients peak at 124 on April 12, a figure it could reach by Friday if hospitalisations continue to rise.

If anyone wants to they can check the number of covid patients directly on the Trust website:
whh.nhs.uk/patients-and-visitors/important-update-about-coronavirus-covid-19/covid-19-current-status

(Warrington has 20 intensive care beds and I'm not sure how many Halton has - they have capacity across the two hospitals).

Sky were last week reporting that Warrington (which is the covid hospital) had only got two ICU beds left as other bed were occupied for other reasons. At the time of this report there were only 12 Covid Cases in ICU at the Trust...

So someone really is playing political silly buggers here. I've heard no rumour or word on whether when Warrington will go into T3 despite the figures after last weeks debacle over it not being part of Liverpool or Merseyside. Its just not come up in the speculation over where next - despite the numbers and the situation at the hospital (making a point that Halton which Warrington shares an NHS Trust with - is in T3).

Health Secretary Matt Hancock told the House of Commons this afternoon that talks were planned for this week.

He said: "Following the successful introduction of measures in Liverpool and Lancashire, talks are continuing this afternoon, led by the Communities Secretary, with Greater Manchester.

"This week further discussions are planned with South Yorkshire, West Yorkshire, Nottinghamshire, the North East and Teesside.

Now maybe they have already agreed this (a councillor said the other day they hadn't heard anything from Westminster since last Monday and the Warrington South MP did a column in the newspaper yesterday which said the last time he spoke to anyone was last Tuesday). So it doesn't look like its currently on the cards.

So surely this can't be about the hospitals...

We also have the example of Dr John Wright, who works at Bradford Royal Infirmary who has been doing a diary for the BBC since March.

www.bbc.co.uk/news/health-54499758

Dr John Wright of Bradford Royal Infirmary looks ahead to the difficulties to come this winter, and considers how much has changed since March.

The hospital remains in its own Narnia, locked down from visitors, with monastic corridors and deserted shops and coffee bars. The wards by contrast are busy and our A&E department is back to pre-pandemic activity with over 400 patients per day. The number of patients with Covid-19 has stabilised at around 80, 10 on ICU, not far off our peak in April, but unlike the first wave we are doing our best to keep all our services running as much as we can.

This time we know what we are doing; we have learnt hard lessons. Our treatments are better and we are managing patients with Teutonic efficiency and insightful compassion. The chaos of PPE shortages is a distant memory with scrubs and visors laid out in the ward donning rooms like a bespoke tailor's shop. (Having said that, the number of patients on oxygen did briefly cause oxygen shortage alarms earlier in the week.)

But there is another change. This time we are no longer heroes. This is the new normal.

His full list of articles for the BBC can be found here

He previously detailed the capacity that Bradford could be extended to for covid (though this is at the expense of other treatments) and numbers they had at peak.

The thing was with the North was that in the first wave, no where exceeded what they could cope with and needed to declare an emergency and divert patients to other hospitals. Which DID happen in London.

So its very strange that the MEN couldn't get a trust by trust breakdown on current numbers and there is this weird secrecy going on.

And its fairly obvious that the government are playing a game over the figures by saying they are really really high, in a manner which doesn't necessarily reflect whats on the ground - and seem to be completely over looking Warrington... (again).

Meanwhile here's another one over in Whiston:
www.sthelensstar.co.uk/news/18806176.whiston-hospital-opens-fifth-coronavirus-ward/
Whiston Hospital opens fifth coronavirus ward

St Helens and Knowsley Teaching Hospitals NHS Trust does not regularly publish admission or intensive care data, so the exact numbers are unknown.

However, a spokesman for the trust confirmed that Whiston Hospital still has capacity.

The trust spokesman said: “Admission numbers are still increasing but we continue to have capacity across the trust, as well as in ICU (intensive care unit), and we are continuing with a full elective programme.”

Last Monday, the trust confirmed that it had seen admissions at Whiston Hospital jump from 66 to 90 over the weekend.

At the time, nine coronavirus patients were in the hospital’s intensive care unit, although two people were moved onto the ward on Tuesday.

So just why is this data not publically available for Greater Manchester? And just why is it not something that can be in the public domain? Its clearly not 'owned' by the government or some kind of massive secret, because other trusts are freely giving out similar information.

Jennifer Williams (as usual) is asking all the right questions. And I am highly dubious about what the fuck the government are playing at.

In effect, the parents that agree
and the ones who can't afford to isolate, or don't want to,

Agreed, although the school are really pushing for all to take part, interestingly (as in these schools have been chosen) they are schools which are not populated by areas of deprevation, and have high instance of parents that can wfh. I should be able to update with numbers later in the week.

(FT paywall) Manchester united as mayor fights London over virus

A local leader disagreeing with central govt policy, but without the devolved powers of the 3 smaller nations
GM population of 2.8 million is 1 million more than NI

<a class="break-all" href="https://www.ft.com/content/beb57271-e359-4a21-bcc4-77fa5099015c" rel="nofollow" target="_blank">https://www.ft.com/content/beb57271-e359-4a21-bcc4-77fa5099015c</a>

Mr Burnham is backed by all 10 borough council leaders in Greater Manchester, most of the conurbation’s Conservative MPs, and much of the business community.

But the government has the power to impose tier 3 restrictions and Mr Johnson has said he is ready to take this step if necessary,
although he would like the support of local leaders to legitimise the measures and try to ensure public compliance.

Please do update Wave when you have the data

I think the lack of transparency re the hospitals is particularly concerning considering the testing shambles.

Many people who need a test (across the country) were struggling to get one. It was a particular issue for home tests. There's also the delayed results, giving out used test kits (in Birmingham), and false negatives. And we know testing was focused in already known hotspots, leaving other areas vulnerable to a surprise increase.

Hospital figures are vital in giving a clearer picture.

Here is the Echo from earlier today also reporting on Warrington:

www.liverpoolecho.co.uk/news/liverpool-news/hospital-trust-nears-coronavirus-peak-19130642

The sudden rise in admissions at Warrington and Halton Hospitals saw the total number of positive patients reach 109 on Monday morning (October 19).

The figure is 50% higher than it was last week. If admissions continue rising at the same rate, the trust could pass its previous peak within days.

During the first wave, the trust saw the total of coronavirus-positive inpatients peak at 124 on April 12, a figure it could reach by Friday if hospitalisations continue to rise.

There are currently 14 patients in ICU with coronavirus, up from nine last Monday but still some way off the peak of 22 seen on April 9.

So this is public information.

Anyway this is an article about the current situation in Liverpool, which does sound bad. There's no numbers but there is plenty of detail on what options are realistically available - along with a point about Liverpool's geography problem.

www.liverpoolecho.co.uk/news/liverpool-news/liverpools-hospitals-dangerously-close-being-19127081

“The focus will be on trying to maintain cancer and other urgent surgery as much as possible, but even that is under threat if hospital admissions in Merseyside and Cheshire continue at current rates.

“There have been far more ICU transfers over the last week than would be expected for even a bad winter. As pointed out, staffing is the main constraint, although some hospitals are also exceeding physical capacity and looking after ICU patients in operating theatres.

“As ICU capacity is expanded above normal “commissioned” or funded levels it is usually theatre staff who are redeployed to support this, so operating theatres have to be shut down. And sometimes the operating theatres have to be used as ICU areas.

“Staff absence is currently around 12% due to a combination of usual sickness rates and covid-related absence (self-isolation etc). Covid-related absence is a greater proportion than non-covid sickness. Staff who have symptoms and test negative can return to work.

“Staff who test positive can return to work after 7 days. Staff who have to isolate due to contact rather than symptoms have to isolate for 14 days currently, regardless of whether they negative, but generally asymptomatic contacts aren’t being tested.”

Dr Cope said the situation in Liverpool is ‘more severe’ than the North West average, with more than 25% of inpatient beds in the city now occupied by covid patients.

That is in the setting of hospitals that had more than 90% bed occupancy with non-covid patients before this surge began.

He explained that Liverpool hospitals now have a bed occupancy of more than 95% with additional beds opened, but with fewer staff, adding: “There isn’t capacity in other surrounding hospitals to divert general emergency admissions, at least not for more than an hour or so at a time.”

And I think the KEY line in everything I've read tonight on bed occupy is this one:

That is in the setting of hospitals that had more than 90% bed occupancy with non-covid patients before this surge began.

So when the government start going on about a problem with beds, THAT is the point that is the most relevant of all.

The BBC have reported tonight that G Manchester will be T3 if agreement not made by midday tomorrow.

The Government has given GM until midday tomorrow to reach an agreement on reaching tier 3 restrictions.

Just heard on LBC radio.

Bev Craig @bevcraig
Important statement from Manchester hospitals. It’s a serious situation in GM, the demands a serious response. Hospitals have been planning throughout the summer. Despite the Whitehall briefings, hospitals are still keen to emphasis that its safe to get help if you need it

I'm a slow typer, Red

The government has, in the past, threatened people with the loss of their job if they are honest about the situation in the NHS. There is also the fine line between encouraging people to follow the rules because bed capacity will be exceeded - and soon - if we go on at this rate and not discouraging them from getting treatment.

The NHS converted theatres to ICUs last time, used junior doctors as ICU nurses for a time and rapidly "trained up" anyone who might possibly be capable of helping. But it doesnt have an unlimited number of theatres to use in that way, there were staff shortages before this began and there are not unlimited supplies of oxygen either. Training normally takes years - the people drafted in are not properly trained. You cant magic up trained staff overnight.

The NHS was planning who would they would choose not to treat before the last wave and that is where we go if covid patient numbers continue to rise. It will break some of the staff.

At the same time as telling us how urgent it is Greater Manchester is in T3, No 10 (along with local authorities) are saying that up to 30 people can meet at the pub for work purposes over lunch.

[quote RedToothBrush]At the same time as telling us how urgent it is Greater Manchester is in T3, No 10 (along with local authorities) are saying that up to 30 people can meet at the pub for work purposes over lunch.

The government do not want to release hospital occupancy data as if anything it will reduce compliance with the restrictions.

From the way the media was going on about Liverpool, you’d think there were thousands of people dying in hospital corridors. There are actually 12 people in ICU, many of whom not with COVID.

It’s the same reason the government and media are not trying to correct public misconceptions about the death rate. On average, people think 7% of the U.K. population have been killed by COVID- the actual figure is less than 0.1%.

@Ecosse

The government do not want to release hospital occupancy data as if anything it will reduce compliance with the restrictions.

From the way the media was going on about Liverpool, you’d think there were thousands of people dying in hospital corridors. There are actually 12 people in ICU, many of whom not with COVID.

It’s the same reason the government and media are not trying to correct public misconceptions about the death rate. On average, people think 7% of the U.K. population have been killed by COVID- the actual figure is less than 0.1%.

Theres more than 12 people in ICU in Liverpool actually.

Things have gone quiet in the media on Long Covid. I expect with NHS so busy at present that's going to overlooked. For the time being.

Fast forward a few years and perhaps we'll be on a Long Covid data thread.

@SheepandCow

There’s no evidence that COVID patients will suffer symptoms for years. The vast majority of people who have extended symptoms have none after 3 months.

@Ecosse
this figure reminded me of experiment where in a survey in the US they found that 56 percent of Americans would like Arabic numerals banned in schools.

(on a data thread I have to add: 56% of all responders said and it was not a representative sample. But still.... )