Increasing number of cases

[AutumnAlmanack]

Could anyone please explain to me why it is that the UK is recording such a high number of daily cases, and rising, whereas the rest of Europe and elsewhere seem to be showing a steady decline in numbers? It really baffles me!

And yes, even in NW we will continue to see local outbreaks throughout winter. However the 7 day case rate for the whole region is likely to have peaked last week - unless we have to face new variants or deal with rapidly waning immunity from vaccines/historic infections.

@wintertravel1980

The biggest problem with SAGE (SPI-M-O Consensus) modelling has always been the underlying assumption that the past can be used to predict the future. In the current situation it simply can’t.

FWIW, the latest numbers no longer show “the rapid increase in cases”. North West (and possibly East Midlands?) almost certainly peaked last week. North East seems to be peaking this week. London is a mixed bag. Covid here is “nearly” endemic but West (e.g. Richmond) needs to “catch up” with East (e.g. Barking and Dagenham). South West and South East will continue to go up before they go down. The estimated historic attack rate for these 2 regions is significantly lower than across the rest of the country (33% - SW, 35% - SE, 58% - London, 52% - NW - according to the latest Covid forecast published by MRC Biostatistics Unit on Oct 20).

Hospitalisations, unfortunately, will continue to rise even in NW. They are a lagging indicator in comparison to cases. However, as of today, England boosted more than 50% of 80+ year olds, 37%+ of 75-79 year olds and almost 20% of 70-74 year olds. This should start reducing pressure on healthcare over coming weeks.

👍🏻 Thanks for this detailed breakdown and measured analysis.

@wintertravel1980

The biggest problem with SAGE (SPI-M-O Consensus) modelling has always been the underlying assumption that the past can be used to predict the future. In the current situation it simply can’t.

FWIW, the latest numbers no longer show “the rapid increase in cases”. North West (and possibly East Midlands?) almost certainly peaked last week. North East seems to be peaking this week. London is a mixed bag. Covid here is “nearly” endemic but West (e.g. Richmond) needs to “catch up” with East (e.g. Barking and Dagenham). South West and South East will continue to go up before they go down. The estimated historic attack rate for these 2 regions is significantly lower than across the rest of the country (33% - SW, 35% - SE, 58% - London, 52% - NW - according to the latest Covid forecast published by MRC Biostatistics Unit on Oct 20).

Hospitalisations, unfortunately, will continue to rise even in NW. They are a lagging indicator in comparison to cases. However, as of today, England boosted more than 50% of 80+ year olds, 37%+ of 75-79 year olds and almost 20% of 70-74 year olds. This should start reducing pressure on healthcare over coming weeks.

Yes thanks for this, good post

A projection is not a prediction.

It's an "if things continue at this rate this is where they'll be then"

Like this from the latest projections from September 29th:

The red dot 🔴 is England's 894 October 19th reality.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachmentdata/file/1025239/SAGE95ddSPI-M-OMediumTermProjections.pdf

At the current stage of the pandemic any analysis assuming that historic trends might continue for the foreseeable future is not particularly helpful. I fully agree SPI-M-O papers both overstated and understated hospital admissions over past few months. Arguably, they are now a distraction.

Any real time trends can be picked up by breaking down reported daily numbers by date of specimen. Numbers reported today, for instance, make it pretty clear NW is on the way down.

Like every other wave the numbers will begin to fall again. Anyone thinking they will just continue to rise is way off the mark. We had a huge spike in Scotland....guess what?

@Bizawit

Do nothing and see thousands having to be turned away from hospitals

This is what I think is scaremongering. If this is happening, it’s not because of Covid prevalence. The data just doesn’t support such a view- certainly not at the current time. The modellers have consistently exaggerated the capacity threat posed by Covid. See here for the latest discrepancy between predictions and actual, these predictions were used to argue against lifting restrictions over the summer. Hospitalisations were supposed to be somewhere between the green and blue lines.

Do you also think that the Royal Belfast Hospital for Sick Children having to postpone surgery on kids is scaremongering? Or that yesterday's critical incident at Truro Hospital, when 25 ambulances were waiting up to 12 hours because A&E was overwhelmed was just scaremongering? Meanwhile bed-blocking has returned with record numbers of patients stuck in hospital because of a worsening staffing crisis in care homes.

Professionals in a position to know, such as the NHS Confederation and the British Medical Association have clearly not convinced the armchair "experts", including those in government, if they think this is just scaremongering. Of course it's not just covid prevalence. The NHS is already stretched to capacity - 8000 new covid admissions a week means that patients in the long backlog of surgery, cancer care and other urgent need cannot be treated.

@Pootle40

Like every other wave the numbers will begin to fall again. Anyone thinking they will just continue to rise is way off the mark. We had a huge spike in Scotland....guess what?

Was it the start of the winter period?

@Pootle40

Like every other wave the numbers will begin to fall again. Anyone thinking they will just continue to rise is way off the mark. We had a huge spike in Scotland....guess what?

Guess what? Waiting times at Accident and Emergency departments in Scotland have worsened again, including a new record low for the percentage of patients seen within four hours at any one hospital.

Waiting times at Accident and Emergency departments in Scotland have worsened again, including a new record low for the percentage of patients seen within four hours at any one hospital.

So what does that suggest about how effective Scotland’s current restrictions are at avoiding this?

You can’t reasonably say “we need to institute Plan B in England, otherwise we’ll end up like Scotland, which never stopped doing all the Plan B measures in the first place.”

@GoldenOmber

Waiting times at Accident and Emergency departments in Scotland have worsened again, including a new record low for the percentage of patients seen within four hours at any one hospital.

So what does that suggest about how effective Scotland’s current restrictions are at avoiding this?

You can’t reasonably say “we need to institute Plan B in England, otherwise we’ll end up like Scotland, which never stopped doing all the Plan B measures in the first place.”

I'm not saying that. I am saying that the NHS Confederation and the BMA know more about the situation than armchair "experts".

I am saying that the NHS Confederation and the BMA know more about the situation than armchair "experts".

So what are they calling for - Plan B, or measures beyond Plan B?

If they’re calling for Plan B, why are you using pressure on Scottish hospitals as an example of why that’s needed?

@GoldenOmber

I am saying that the NHS Confederation and the BMA know more about the situation than armchair "experts".

So what are they calling for - Plan B, or measures beyond Plan B?

If they’re calling for Plan B, why are you using pressure on Scottish hospitals as an example of why that’s needed?

I've said nothing about pressure on Scottish hospitals. The hospitals that I mentioned which are currently being overwhelmed are in Cornwall and Belfast.

I really don't see why people are so against a simple precaution such as mask wearing - most western countries are still mandating masks in crowded areas as an adjunct to vaccinations and have very much lower infection rates than the UK.

I've said nothing about pressure on Scottish hospitals.

Was that not your post about worsening waiting times at A&E departments in Scotland?

most western countries are still mandating masks in crowded areas as an adjunct to vaccinations and have very much lower infection rates than the UK.

But 3 out of the 4 UK countries are still mandating masks in crowded spaces as an adjunct to vaccinations, and are still seeing high infection rates. Even higher than England for a lot of the past few months. And while NI’s might be explained by lower vaccination rates, that isn’t the case in Scotland and Wales.

Masks may well help a bit. But doing what Scotland and Wales are already doing will not be enough to avoid the infection rates Scotland and Wales are already seeing.

Cases will fall 30% by winter:

mobile.twitter.com/tomhfh/status/1451492703208869898

There are also a lot of Western countries not mandating masks anywhere and seeing low infection rates, and a lot of Western countries with really heavy restrictions in place seeing very high infection rates.

I get that it is very tempting to think there’s One Simple Trick to end the pandemic and all those sensible countries have cracked it better than us. But that’s not the reality.

@PrincessNutNuts

A projection is not a prediction.

It's an "if things continue at this rate this is where they'll be then"

Like this from the latest projections from September 29th:

The red dot 🔴 is England's 894 October 19th reality.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachmentdata/file/1025239/SAGE95ddSPI-M-OMediumTermProjections.pdf

Masks may well help a bit.

Exactly. Anything that helps a bit needs to be adopted since a number of virologists have said that vaccine alone is not enough. Goldenomber is correct in saying that "One Simple Trick" will not end the pandemic.

As for Scotland, the ONS survey today tells us that one in 90 people are estimated to have Covid-19, compared with one in 55 people in England.

As for Scotland, the ONS survey today tells us that one in 90 people are estimated to have Covid-19, compared with one in 55 people in England.

It was 1 in 43 a few weeks back. Scotland is really not a good example to use for how Plan-B-type measures can keep cases below England’s.

I increasingly feel like people are totally unaware that different parts of the UK have different rules, and totally unaware that our case rates are different. I don’t expect people to be following Welsh health boards’ data 24/7 or anything but at least a little bit of awareness that there’s a world outside England’s borders?

Yes, the rate of infection in Scotland is improving. The rate in England needs to improve, too. Wearing masks is a simple measure which is likely to help. It is not a case of following Scotland's measures, or Wales, it is a case of doing what virologists recommend rather than watching politicians repeat all of the mistakes they made last year.

Wearing masks is a simple measure which is likely to help. It is not a case of following Scotland's measures, or Wales, it is a case of doing what virologists recommend

But wearing masks is what Scotland is doing. We never stopped. And it didn’t help enough to stop that massive spike in cases we had very recently, which went even higher than England ever has.

Wales, right now - masks, higher cases than England’s.

You mentioned hospitals in Belfast earlier as a reason why politicians should listen to the calls for plan B. But Belfast has its own politicians, who already have the plan B restrictions in place, and is still seeing those pressures!

You’re talking about bringing back masks as a hypothetical that might stop cases getting higher. But you’re living next to countries that have been doing it all along and seen it hasn’t done. We could probably get UK cases lower through restrictions alone, but it is obviously going to take harsher restrictions than the things we are already doing, given that we are already doing them and they aren’t achieving that.

Wasn’t the big spike in Scotland mostly in school children? Do they wear masks in class?

@IndigoC

Wasn’t the big spike in Scotland mostly in school children? Do they wear masks in class?

It started off in early 20s age group, then in mid-late teens which was the biggest peak, and then younger kids.

Secondary students wear masks in class, yes.

@IndigoC

Wasn’t the big spike in Scotland mostly in school children? Do they wear masks in class?

Today SAGE, led by Sir Patrick Valance, has joined the BMA and the NHS Confederation in saying that Covid restrictions need to be deployed now, in order to avoid stricter measures over a longer timeframe and "to avoid an unacceptable level of hospitalisations".

I really don't know how many more warnings from scientists and medics the nay-sayers need before they realise that the government are repeating the errors of 2020 all over again.

www.bbc.co.uk/news/health-59011321

Unbelievable that this government still don't learn from their mistakes and refuse to listen to the advice by scientists and medics.