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See if you can spot August Bank Holiday further along.
I was going to ask that in tge same post but when I put a pic in it seems to stop me writing. Big drop in deaths over xmas too. Followed by massive rise in Jan.
spot when things get a bit spiky
Excess deaths are very sensitive to covid deaths (it's not a linear model), so I hope this may be useful. But the necessary delay in the registration and reporting process means data is a week old. Calls to 111, hospital admission spikes, these may be more useful. But I believe that looking at weekly rather than daily timescales is now valid (daily was needed in March when things were faster).
Simon Clarke MP has put a statement out on his Facebook.
Broadly he regrets that the fuss wasn't cleared up before the weekend but Dom has behaved responsibly and the media are all nasty.
Absolutely brass neck the lot of them. Feel sorry for the police, basically we can all do whatever we like as long as we follow our paternal instincts.
Worldometer has us on >4000 new cases reported in the last 24 hours.
Cases and deaths have some decoupling now, most likely due to increased testing. Yesterday's data - I model cases and deaths simultaneously, note the separation for UK.
TiRed - have you backdated all your data to include care home deaths, as they weren't included in announced data until well past the peak.
Worldometer has us on >4000 new cases reported in the last 24 hours. Had to go back to 8th May for last time that happened.
The small print explains that a little.
TiRed do you think it's increased testing or lag between case and outcome?
have you backdated all your data to include care home deaths
No, ECDC data is hospital deaths only ( https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-daily-deaths/). I predict excess deaths from this number and historic mean from 2010-2019 for each NHS region, then sum up for England and Wales.
Increased testing will decouple cases from deaths (including the lag) slightly, the data from ECDC shows that. One could standardize by number of daily tests. If it were my day job, I'd do that, but one ends up hunting down lots of datasets and writing the code to post-process them to create analysis datasets. I do that already for cases, deaths, ONS deaths and previously the UK population (for deaths/100k) and of course I analyzed the previous 10 years if weekly deaths to get a control dataset (ONS only include 5 years, so prediction intervals aren't as precise).
Yeah can see how increased testing will decouple it. Wonder how we will know of actual case increases in real terms if indeed that does occur?
I believe the point of the lockdown was to slow the spread and "save the NHS" now this has happened theres not much point keeping us on house arrest (legally questionable anyway but we have complied out of a sense of civic duty).
This was never about eliminating the virus, quite the opposite in fact as the tactic from the beginning was correctly herd immunity. So long as we can keep the reproductive rate at 1 or less, we are good. People are dying from cancer and other cancelled surgeries and we have to understand that cannot continue indefinitely.
Speedster,
Maybe with a bit of difficulty as the tracking app idea looks toast and do we really trust the gov't to be on top of any spikes should they occur given their performance so far. That's the worry for many I think
The move out of lockdown is going to be a faltering one. Like the consensus here I feel the current infection rates will peter out by July though a nagging doubt regarding our ability to cope with any recurrence will hinder the opening up of the economy as we still don't have any commonly understood protocols in place like those described by Edukator in France (or pretty much any other country to be fair)
Anyway, I predict this thread will turn into the coronomics thread by the end of the month if not earlier. Perhaps TiRed can apply his modelling skills to economics for us?
Perhaps TiRed can apply his modelling skills to economics for us?
Back of an envelope - assume lockdown has prevented approximately 2x as many deaths as one predicts, which is a pretty conservative guess, that's about 150,000 lives, and a life expectancy of, say 3 years (average nursing home residency is 4 years, I read somewhere), and QALY value of £30k/year equals... about £13.5bn. Cost will be perhaps 10x this value. So society has valued the intervention ten times higher than typical treatment interventions. Given the severity of the situation for a population, this does not seem unreasonable. I could be out by a factor of 3, in any of those numbers, but 10x is a conservative estimate.
So long as we can keep the reproductive rate at 1 or less, we are good
I do not disagree, provided daily INCIDENCE is also low enough to be managed effectively by testing, tracing, and eventually treatment. That is a capacity issue.
Yeah can see how increased testing will decouple it. Wonder how we will know of actual case increases in real terms if indeed that does occur?
Cases/100k deaths will tell the true story now.
TiRed, what leads you to think that this won’t just spike again as lockdown eases? Societal change in terms of social distancing?
Societal change in terms of social distancing?
Sweden tells us what the future looks like in terms of social distancing. With a lot more screening of people in healthcare and nursing homes.
For me, the big question is what happens when London goes back to work on public transport. Nowhere else in the country has that dynamic. A slow steady rise in contacts, with an absolute understanding that not going to work if you are feeling off is a good thing. Hence I'll be working from home for a long time.
The epidemic in London climbed and declined faster than the other regions. Public transport must have played a part.
with an absolute understanding that not going to work if you are feeling off is a good thing. Hence I’ll be working from home for a long time.
Did they ever follow up using your plasma, TiRed? And have you ever had a test?
Because if you are sure you contracted Covid months ago why do you feel the need to continue working from home: the risk to yourself or the risk to others? Is there any evidence you could still be infectious? They're all questions that anyone who thinks they may have had it needs to ask themselves and your pharma background means you're better placed than most to answer.
Curious because Madame thinks she's in a similar situation to you with just a bit residual fatigue but is going to work (with a mask).
why do you feel the need to continue working from home
Because our office will be closed 😉 . Labs are open and of course manufacturing has never closed. I am a non-essential worker so won't be back for a long time. Even then, the open plan nature makes any distancing troublesome. Son2 won't be back to LHR for some time either.
Not heard back yet on the plasma front. Middle-aged men who had serious disease are their target source, I'll go back again if positive and asked.
French news (FR3) has just answered one of the questions: people who've had even a mild case of Covid have antibody protection for at least 40 days. 98% of 160 health workers who had even mild Covid had anitbodies present at 39 days. Study by Institut Pasteur and Strasbourg hospital.
So to protect Cummings, Hancock has just announced that fines will be reviewed ?
Doesn't that make lockdown completely unenforceable ?
Between that and no one wanting to download the app , I'm not sure what the way out of this mess is.
I believe the point of the lockdown was to slow the spread and “save the NHS” now this has happened theres not much point keeping us on house arrest (legally questionable anyway but we have complied out of a sense of civic duty).
We have shut down many NHS services to cope with high levels of the virus in our communities. It was not about saving the NHS, it was about avoiding a peak that the reorganised NHS could not deal with, there by giving those falling seriously ill the best chance of being saved. We now have a choice of accepting a high level of infection, and the associated deaths and damaged lives, and keeping much of the NHS in a state of reduced operational status… or we drive the infection rate still lower, to a point where we can track/trace/isolate new fare ups, and get the NHS back to a more normal operational status.
This was never about eliminating the virus, quite the opposite in fact as the tactic from the beginning was correctly herd immunity.
You can’t get natural herd immunity without killing (up to) half a million people. We’ve already sacrificed more people than necessary on the alter of mistimed intervention, let’s learn from that mistake and do better as we move to more lax social distancing measures.
We need to get and keep the virus under control via our short term modified behaviours, until better treatment and/or prophylactics are available to us.
So long as we can keep the reproductive rate at 1 or less, we are good. People are dying from cancer and other cancelled surgeries and we have to understand that cannot continue indefinitely.
No, to get NHS services back to normal, so that people are getting the care and operations they need, we need this virus under control, not spreading through the population across the whole country.
What does "under control" mean? Currently many diseases are not being treated beacause the sick have been made afraid to seek treatment- why are the inevitable consequential deaths more important than Covid deaths?
we need this virus under control, not spreading through the population across the whole country
I think the main way to do that is through education. Inform people in which situations people are getting infected and they can avoid them. The Germans are very good at this. Use Google translate on this article and you won't be keen to sing in church without a mask on but you won't worry about swimming in the sea, walking in the park, MTBing with you mates, going shopping.
https://www.zeit.de/wissen/gesundheit/2020-05/coronavirus-infektionsrisiko-gastronomie-parks-baden
Inform and educate should be the mission of the press in crisis, compare Zeit with the sensationalist but useless dross in the Guardian let alone the red tops which seem keener on publishing stuff on Dom than useful advice.
why are the inevitable consequential deaths more important than Covid deaths?
Do you mean less important? They are not. But a low rate of infection will enable NHS services to return towards normal and give people the confidence that they can use them. We can’t see a GP here, so often the starting point for most NHS patient journeys. Getting the virus under control so that people can see their GP face to face should be a prerequisite for moving towards more lax measures in less essential areas.
Yes I did mean less important. I'm still not clear what "under control" means, Covid 19 is not especially infectious, is there any reason why GP's should not resume normal service with any suitable PPE that they deem necessary?
It would seem a bit strange if we all had to self-certify as disease-free and fit-as-a-fiddle before being allowed to visit the doctor.
so that people can see their GP face to face
Whatsapp video in these parts for anyone with a smart phone. If the doc needs to examine you then you make an appointment and the doc kits up thereby using up another of his quota of PPE so best avoided.
Under control means manageable contact tracing. Suppose 15000 tracers in teams of five. Perhaps they can handle two to three cases per day. That would imply cases down to 1000/day across the country. Testing is not limiting in that situation. About another four weeks, given the current half-life. Should have the teams up in place by then. Forget the app(s), it will be manual with phone contact.
the media have been at it for ages and it has negated much of what they say in my view
What Tired said.
As for the GP stuff, it’s simple… the priority should be to get this virus under control enough for as many people as possible to be able to see their GP face to face, and feel that doing so is not a risk for them or the staff at the GP. We are only a few weeks away from the numbers being low enough for that. The rush to open up elsewhere before that is driven by politics not science, and will result in the reduced use of NHS services carrying on much longer than is necessary. It is those that are rushing to open up fast and early that will be stopping people without Covid19 seeking and getting the care they need, not those calling for a steady return paired with low infection numbers and in place track/trace/isolate measures.
Thinking that an app could get us out of the mire was always a silver bullet solution, like hoping for a digital vaccine. Contact tracing has worked since biblical times and has been employed consistently by the countries that have dealt best with this pandemic.
As you imply TiRed, it's a question of capacity and given our current and projected numbers of trained testers well be waiting for a month untill contact tracing can be deployed effectively. For the next month, we've got to pray there isn't a spike, else it'll be harder to deploy the contact tracing.
Sorry to be the masked crusader again but surely enforcing mask wearing on public transport should be the absolute priority as this is the place where there is the greatest potential for further spreading, and as such, it presents the clearest hazard in getting to a point where contact tracing is possible and effective?
We should still be in a race to get daily infections down as soon as possibly possible.
A days delay, a week you'll pay. As true then as it is now.
Numbers questions...
In the 10 households I know on ours and the neighbouring street, four are shielding - of which one is older so basically three working households are staying at home to ensure the safety of one member. At least one of them can’t work from home at all (electrician).
Is this a normal percentage? Has anyone looked at the economic impact of those people having to stay home? I guess the quicker the rest of us unlock, the longer it’ll take for it to be safe enough for them to emerge.
The other numbers question is about severity - everyone looks at death rates because that’s cut and dried, but is anyone looking at how many people take more than two weeks to recover and how many people have longer term issues emerging?
What do you object to opening up, Kelvin? Swimming pools are now open in Italy with limited numbers, 24 in the pool they showed on TV. We're off to the beach tomorrow. Gyms opening in Italy with distances increased between the kit. Adapt to reduce risk from what's been learned and open what's proven to be possible without contaminating people. It's not a question of rushing it's being objective about risks.
Imposing quarantine on people arriving from les contaminated countries was daft and just spite for Barnier refusing to back down on a level playing field. You need measures for the current situation, after the horse has bolted stuff is daft and letting people onto busses without masks equally daft. Fining people for having a few neighbours around for an outdoor bar-b-que won't stop the virus spread. Not enforcing masks on public transport is ****ing stupid given its a proven vector of transmission with several driver victims among the dead.
This from from the beeb:
"Governments in England, Scotland and Northern Ireland have also recommended people wear face coverings on public transport.
The Welsh government has said people can choose to wear them, but adds the evidence is "not strong enough" to make them mandatory."
demostrates what a shambles the current inconsistent and non-fact based measures are. How much evidence from around the world does the Welsh government need? Idiots.
Potentially a misquote out of context but seems the WHO might be thinking a second wave is looking less likely. I'd love to know how that work it out without knowing how each country is going to behave in future.
I guess the quicker the rest of us unlock, the longer it’ll take for it to be safe enough for them to emerge.
I’d guess the same.
What do you object to opening up, Kelvin?
Nothing at all. I’m talking about timing. And priorities in the order of when things open up.
Yesterday the WHO were warning of a second wave 🤷🏼♂️
Ed - don’t disagree with you on that lost post. Sadly we are led by donkeys fighting the virus by sound bite.
Is it time to admit lockdown is over?
Police break up illegal #lockdown birthday party at Tory MP's house
(tbf MP wasnt there at the time)
It depends what you unlock. And there are still things that desperately need locking down that aren't, such as the ability to breath and cough on people in confined public places without wearing a face mask. Workers need to use public transport to get to work, they shouldn't have to share confined space with selfish anti-social types who chose not to wear a mask because they're stil given the choice. You have to put clothes on in most situations, in some you now have to wear a mask - or that's how it should be.
Only 10% of transmission from surfaces according to that Zeit article I linked. The rest is airborne and reduced by distance, masks and ventilation.
And I'll rephrase my question to Kelvin. What do you object to unlocking right now (which was what I meant in the first place and I'm sure you understood). I wouldn't unlock theatres, cinemas and places where people sit in close proximity to the same people indoors for long periods for example.
Neira is quoted as saying "it is doing the geographical route expected of a virus that wants to survive" - ascribing agency to a virus is not consistent with science. Perhaps something has been lost in translation.
As for the GP stuff, it’s simple… the priority should be to get this virus under control enough for as many people as possible to be able to see their GP face to face, and feel that doing so is not a risk for them or the staff at the GP.
What?!?
Whilst I agree that being able to see a GP face to face is a good thing for everyone’s health, sending sick people to a single place of contact is the last thing you’d want to do to control things?
Who are the people who generally visit their GP?
The elderly or those with underlying health conditions....
...those who are at the most risk
Interesting debate on GP access so thought I'd give my take on real world decisions having to be made. I have my routine catch up with my haematology consultant next week due to my lymphoma diagnosis in early 2017. This had been changed to a telephone consultation and I have decided not to attend my GP for pre-appointment blood test. I am in complete remission and feel fit and well so rather than expose myself to the potential risk of Covid have decided to skip this blood test.
Good article about the Swedish approach here & some relevance to UK for ending lockdown too
https://thecritic.co.uk/live-free-and-die-swedens-coronavirus-experience/
Good to hear JK, best of luck mate. 🙏🏻
As the father of a son that’s shielding I’ve thought for along time we’ll be left to rot.
^^ Different family member for me but I've come to think that "this is it" till a vaccine is hopefully found.
Particularly hard on my partner as she doesn't live with me so we have just recently started to meet in a quiet scenic area, socially distanced so at least we can chat face to face.
She is struggling with it to be honest but totally understands why it has to be this way for.... I simply don't know how long to be honest.
Whilst I agree that being able to see a GP face to face is a good thing for everyone’s health, sending sick people to a single place of contact is the last thing you’d want to do to control things?
You have to get the virus under control first. That is the point. Allowing us to tick along with too high an infection rate without track/trace/isolate in place prevents the health service being able to act closer to normal, resulting in poor health outcomes for people not even touched by the virus directly. It also keeps whole industries closed for longer, the arts and music for example, and offers little hope to those shielding that they can have increased contact anytime soon.
So, this is, indeed, the gift that keeps on giving:
If you don’t have a sub:
Post mortem showing changes in brain tissue in some cases (however we only have a very few autopsies because of the danger of virus transmission).
Emergence of Guillaim-Barré syndrome in a small number of cases (although statistically about a thousand times more prevalent than in general population).
It’s not yet clear how much brain and nervous systems damage is due to the virus affecting the central nervous system directly and how much is oxygen starvation.
Obviously still early days but good to know people are looking at the longer term impacts.