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
📈 📉 📊 👍

Happy World Statistics Day everyone!

Two things from listening to R4

Andy Burnham spoke well about the high cost and mh crisis looming

Prisoners stuck in cells 23 hours a day described as ‘saving many lives‘

Reinforces that lives saved is not our best measure if we are to make better decisions

More or Less Tim H spoke well on rules of using statistics on R4. Maybe we need them ;

@SheepandCow Am I being stupid... shouldn't it be the same amount of money everywhere? It is madness isn't it. Every area doing negotiations, what a waste of time and of course more setting people against each other.

Report on Sky this morning about a Welsh town, Wales going into lockdown and this town has one road that is in England. That is also stupid, how can a lockdown work like that?

I think that tweet above about tiers more or less sums up what i think. Its been so badly mishandled that its causing more problems than it solves. And i almost get a sense of a lack of awareness of this.

In terms of the nhs being overwhelmed i largely think it is impossible to avoid no matter what you do because we have such little bed capacity. All we can do is crisis management covid cases. And in that sense i think in terms of lives lost our long term underfunding of the nhs means a certain number of deaths and long term health problems are now baked in however we handle this - our only choices are about what the cause of death is, what long term health issues we pick and the cost to the economy. We cannot prevent this happening at this point now.

I think thats why i find it so frustrating. The missed opportunities to avert that.

We also now will end up with additional long term political divisions along the lines that already existed but these have been amplified - and in no small measure by deliberate political decisions made.

It does feel that the interests of the public have also always been secondary to political interests and that certainly doesnt help either the mood nor the outcomes of this crisis.

Its hard to see much good at at all which can come as a byproduct of what has happened. The whole spring shoots stuff. On this occasion i fear they aren't for us as a country though. Bleak times ahead.

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

In effect, the parents that agree

Would Gillick competence be used if parent objects and pupil wants the test? Just thinking of letter we got when DD was at school telling us if child wanted to go to a sexual health clinic they would arrange it and support them with things like the morning after pill, pregnancy test or contraceptives and would not inform parents, although at the same time they would refuse to give said child a paracetamol if they had a headache. So not sure if a covid test would be more likely to be equivalent to the pregnancy test or a paracetamol.

Leading a country during this crisis imposes the duty not only of reducing the cost in lives and to the economy,
but of doing so in a way that keeps the country together, not driving divisions

The country needs to be in a functioning state socially, economically and politically after Covid is finally subdued by a vaccine rollout

That's why when people push Sweden, or New Zealand, the "extreme" approaches, they overlook what imo the most important positive longterm characteristics of both:

. Honest competent governments
. A coherent strategy against Covid, communicated clearly and transparently
. Obtaining widespread public consent to this strategy
. With adequately funded measures and public services
. Enabling a well-functioning country after Covid by creating consensus, avoiding deepening existing divisions or creating new ones

@ancientgran

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

In effect, the parents that agree

Would Gillick competence be used if parent objects and pupil wants the test? Just thinking of letter we got when DD was at school telling us if child wanted to go to a sexual health clinic they would arrange it and support them with things like the morning after pill, pregnancy test or contraceptives and would not inform parents, although at the same time they would refuse to give said child a paracetamol if they had a headache. So not sure if a covid test would be more likely to be equivalent to the pregnancy test or a paracetamol.

.... Gillick competence is intended for treatment directly beneficial to the child, not for the public good not for something that may be very much against the interests of other family members

I'm very much in favour of high participation, but totally against overriding the wishes of parents in this
They know their financial situation and can better balance the needs of the family vs the community
Not every teen will know if their family finances are precarious

The long term interests of the teenager are for a functioning economy and a functioning health service. IME teenagers are very often aware of the state of the family finances, more so if those are worrying.

Schools should be teaching young people to think for themselves and sometimes that may involve over riding parental wishes. Where that goes wrong is when the schools pressurise young people.

Suthampton was supposed to be trialling saliva tests, still havent heard how that has gone.

I think it is arguable if giving the pill to a 13 year old is beneficial to the child but the point I was making was would they use Gillick competence, I don't think that has been tested. As an example an anxious teenager might have MH benefits from regular tests, do we ignore that? It could be interesting if a teenager insists they want the test but parent won't agree.

alreadytaken, I agree the school shouldn't be using pressure with pupils, giving them unbiased information is key isn't it.

Are the school tests primary, secondary or both?

May have missed this

If secondary, I wonder if the take up would higher or lower for mid to older teens if they decided not parental consent.

@MarshaBradyo

Are the school tests primary, secondary or both?

May have missed this

If secondary, I wonder if the take up would higher or lower for mid to older teens if they decided not parental consent.

It's secondary. Parental consent is required for those under 16, those over have their own form to fill in.

The main concern from parents so far is that despite being initially told otherwise it is an invasive throat swab rather than a saliva test. If child tests positive another test will be administered and be sent to a lab.

The studies I’ve read about are for all ages including nursery. I think as tests evolve and become even more rapid they’ll be a requirement in many situations including school for everyone. You wouldn’t be allowed to send a child in with chicken pox so why Covid? Mass testing and possibly vaccination certification will be a requirement for many day to day activities.

Sorry to ask such a basic question - but can anyone link me to the overall, current infection rate for England overall? The dashboard is great for breaking down and I've found it for my local area but I'd like to see how it compares to England overall and I can't find that anywhere but I'm sure it must exist somewhere??

I've found that current estimate for cases over last 7 days is 14,732 but not what that represents per 100,000??

Thanks Wave yes it’s much easier if just saliva. I’d feel the same.

I think it is arguable if giving the pill to a 13 year old is beneficial to the child but the point I was making was would they use Gillick competence, I don't think that has been tested.

Schools have no place in determining if a child is gillick competent. It is unique to each child and for each procedure. Teachers are not trained to assess competence in this context and any child requesting medical treatment against parental wishes (whether that be contraceptive pill or taking part in a clinical study) should be referred to an appropriate HCP. And any information kept by the school can be requested by (and must be released to) the parent unless releasing the info would harm the child.

Back to the point, I’m glad the trial requires parental consent for under 16s, though it may mean the data is somewhat skewed. There’s a serious lack of data for schools and it would be good to have something (rather than nothing) to base the analysis on.

Dh was doing medical research (early MRI scanning) for his doctorate. He said the running joke was that it was easier to test on children than animals.
Children you only needed parental consent. Animals you need a licence. So he could use children but not animals in his research. They generally used each other as the easiest of all. 🤣

www.newstatesman.com/science-tech/coronavirus/2020/10/how-england-s-covid-19-test-and-trace-system-collapsing
How England’s Covid-19 test and trace system is collapsing
The latest data suggests the system is being overwhelmed by the rising number of cases.

Since then September SAGE meeting which was critical of track and trace , the situation has only worsened. The most recent ONS pilot survey estimates 336,500 people in England had Covid-19 in the week to 8 October. This compares to NHS test and trace figures showing 89,874 people tested positive in the week to 7 October. This would mean nearly three-quarters of infected people are not entering the testing system.

And

Statistics show the number of tests carried out in the UK has not risen by the same degree as cases. Meanwhile, the country’s case-positivity rate continues to rise. The World Health Organisation has said that a rate of under 5 per cent is a sign that the virus is under control, but the UK has surpassed that level – indicating the testing system is struggling to cope.

And

Testing isn’t the only – or indeed the main – issue with the system. Figures released on Thursday 15 October for the latest week of NHS test and trace in England suggest the system is in deep trouble and overwhelmed by the rising number of cases.

Some 62 per cent of identified close contacts were followed up with and told to self-isolate in the week to 7 October – the lowest level recorded since the system was established.

In the last few weeks there has also been a drop in the percentage of contacts being traced within 24 hours – meaning any infected person could transmit the virus over days without being aware they had contracted it. In the week to 7 October, less than 39 per cent of close contacts in non-complex cases who were reached were informed within 24 hours of the case being entered into the system.

And

And even if people are contacted and told to self-isolate, it is not clear that they will. A pre-print study from researchers at King’s College London and University College London, released last month, found that between March and August 18 per cent of people with Covid-19 symptoms reported that they had self-isolated, while only 12 per cent said they had requested a test. Worse still, only 11 per cent of those who said they’d been alerted by the NHS contact tracing that they had been in close contact with a confirmed Covid-19 case admitted they had stayed at home or quarantined for 14 days.

Naismith added: “I very much doubt the system can recover and run effectively in a timely manner. It will be almost impossible to fix it with cases rising. More likely it will become increasingly irrelevant, but unfortunately increasingly costly.

www.bbc.com/news/amp/health-54604354?__twitter_impression=true
Covid: Burn-out fears of 'exhausted' unpaid carers

Almost 6,000 unpaid carers completed a Carers UK online questionnaire.

Eight in 10 said they had been doing more, with fewer breaks, since the pandemic began - and three-quarters said they were exhausted.

And

In the Carers UK survey, 58% of carers said they had seen their physical health affected by caring through the pandemic, while 64% said their mental health had worsened.

People also said day centres and reductions in other services meant the help they once got had reduced or disappeared, leaving many feeling worn out and isolated.

A friend is a doctor and one of her interests has been geriatrics. She describes Christmas Period as 'Granny Dumping Season' in which there is an increase in older people with care needs being effectively abandoned to the system. She has some heartbreaking stories of people literally being dumped at A & E and the family wanting no more to do with them because their health conditions have got too much to cope with.

If that carers survey is reflective of how bad things are for carers then you can't help but think that in the coming weeks and months theres going to be a lot of desperate families who can't cope anymore. Perhaps more than usual.

@alreadytaken

The long term interests of the teenager are for a functioning economy and a functioning health service. IME teenagers are very often aware of the state of the family finances, more so if those are worrying.

Schools should be teaching young people to think for themselves and sometimes that may involve over riding parental wishes. Where that goes wrong is when the schools pressurise young people.

Suthampton was supposed to be trialling saliva tests, still havent heard how that has gone.

.... What if the study is to investigate the effects of ventilation - and one group has to be in the same class all day with no ventilation ?

What if the governent decides that for a functioning economy they need to study herd immunity - using teenagers because they are at much lower risk of harm than adults

What about testing a vaccine - and also testing its effectiveness by infecting kids with the virus

red If cases continue to rise, at some stage they will start to exceed the capacity of t&t
That's not just in England / UK; it's every country
e.g. Germany's t&t system in the first wave stated that in the peak weeks they could only process a minority of cases passed to them and were definitely missing multiples of the contacts they could trace
However, even tracing a minority of contacts helps

The issue is whether t&t is as good as it can be, which with Dido, Queen of Carnage in charge does not seem the case

@BigChocFrenzy what are you talking about? You seem to be coming up with completely ridiculous scenarios.

re isolation:

nearly 90% not isolating as they should, indicates non-compliance is about a lot more than than just financial worries

The reasons need to be analysed and addressed as far as possible

Has anyone thought about the likely numbers if we end up with a vaccine with 50% efficacy and say 30-40% uptake over the next year? This is why I think testing will be a requirement in day to day life. Vaccines at least not the early ones won’t give a big enough dent.