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I'm not so sure about that @DrJ.....the article gives an estimate of R at 0.37 for the South West of England, so clearly the lockdown is working there. I guess up here in the North we're lagging behind by a few weeks again.
In case folk are not sufficiently depressed, seems that the new variant may be spreading too fast to cope with via lockdowns 🙁
Oh, come on. There's no way that the "lockdown" we're under at the moment is in any way comparable to the one we experienced in April.
Garden centres and DIY palaces still open, large families in supermarkets, underground / buses still packed, families going out for a walk and stopping for long chats along the way with other families, people being unable to go for a walk without clutching a takeaway coffee, kids mixing in large groups, house buying, car sales, racing, professional sport, and in general people just ignoring the lockdown because they don't give a shit and know there's no chance to punishment.
Correlation does not imply causation.
We need to wake up to the idea of containing and starving the virus of hosts, not just using social measures and partial vaccine rollout to try and prevent hospitals being full of Covid patients.
Agree with this. A phycologist on the news a few weeks ago said a lockdown is the bluntest tool we can use to stop the spread of the virus and the mental health impacts are huge and also the economical impact. I know the economy shouldn't be the biggest concern but it has knocks on loss of jobs, poverty and all that.
The vaccine rate falling isn't really a surprise there is no way the pharma companies can produce enough to keep up with demande they will need time to ramp up just like vaccine program does.
In case folk are not sufficiently depressed, seems that the new variant may be spreading too fast to cope with via lockdowns
I would say currently (at least in my corner of london) cases seem to be dropping but obvs, that decline wont be felt in hospitals for a few weeks. I guess whats happening now is what happened last year it's going to spread up the country.
Oh, come on. There’s no way that the “lockdown” we’re under at the moment is in any way comparable to the one we experienced in April.
No. It’s a different lockdown to the one last April, but its having similar results.
The % positivity of test results is dropping significantly.
Data for the 18th says positive cases were ~7% of tests.
Its reducing at ~0.3 percentage points a day, so at that rate the prevalence in the wider community would be minimal by mid February. (similar to where we were last summer)
The Government know that this will be the last opportunity to have a National Lockdown, as the public are starting to get fed up with things. With this in mind they will be wanting to keep it going for as long as possible.
Although today, they have said that they will give schools 2 weeks notice to open back up, so guess whats coming?
My the end of Feb, we should see the benefits from the vaccine programme, so I’d be expecting Schools to open in early March, with other parts of society following in due course.
But there will be a new normal – masks and hand hygiene will become more commonplace
You wont have football stadiums packed with individuals wearing masks or airplanes full with mask wearers.
The general public wont tolerate it long term I suspect.
masks and hand hygiene will become more commonplace
There is a reason the phrase 'the great unwashed' exists, humanity being conscious of hygiene is not it.
masks and hand hygiene will become more commonplace
Bradford folk working hard to encourage this:
https://www.examinerlive.co.uk/news/west-yorkshire-news/teenagers-offer-free-squirts-hand-19654287
Can someone explain to me the significance of "covid-related deaths"? From my understanding, anyone who tests positive for C19 and then dies is considered a covid-related death, presumably like someone who takes cocaine and then falls off a Balcony is a 'drug-related' death, but it doesn’t mean C19 killed said patients any more than cocaine did the man falling from the balcony.
The media is fascinated with "death counters" but do we know how many of these patients would have died regardless? For example, they had terminal cancer, but happened to contract C-19 (presumably a lot of patients in hospitals would have contracted c19, given their location?) and then they died but the death is recorded as 'covid-related'? In this way, how valid are these statistics? Here, it seems the old truism of correlation does not imply causality has been misplaced? Am I missing some vital part of the picture here?
I'm looking at the death rates for the UK annually (source ONS).
In 2018, there were 541,589 deaths registered in England and Wales, an increase of 1.6% compared with 2017 (533,253); this is the highest annual number of deaths since 1999.
In 2019, there were 530,841 deaths registered in England and Wales, a decrease of 2.0% compared with 2018 (541,589 deaths). Taking into account the population size and age structure, age-standardised mortality rates (ASMRs) in England and Wales decreased significantly, by 3.7% for males and 4.7% for females.
In England, the number of deaths up to 11 December 2020 was 543,335, which is 65,251 (13.6%) more than the five-year average. Of these, 68,341 deaths (12.6%) mentioned COVID-19.
So, is that 12.6% what forms the basis for the "death counters" we see in the Media? Assuming yes, then what significance does "mentioning Covid-19" have? Does that just mean someone who died that tested positive for Covid-19 within a certain time frame (I think 28 days?). If this is such a deadly pandemic, then what happened in 2018?
I've also been looking into hospital admissions:
Can someone please correct me if I'm wrong here, but they look stable throughout most of 2019/2020 (2nd quarter) at around 1.5 million per quarter. So, when the media talks about covid admissions, how are they getting their data?
https://www.statista.com/statistics/504012/number-of-nhs-hospital-admissions-england-uk/
If, then, we think of hospitals in terms of admissions related to covid-19, are these also by association? I.e. I break my leg and get admitted to hospital, but also happen to catch C-19 on the way there - would I be counted as a covid-related admission?
It's purely anecdotal, but last year (01/2019) my elderly father was admitted to a large hospital in the NW of England. He waited 16 hours for a bed. It looked like pandemonium in there. I'd be interested to know how the above statistics bear out in reality (i.e. admissions are stable, but of course, those who test positive for C-19 would obviously spike, but that does not imply they actually went to hospital for C-19, they would have gone anyway etc.).
If admissions are then not really different, is the crisis in the NHS simply the difficulty of dealing with C-19, rather than a sudden massive spike in admissions? In other words, admissions are similar to 2018/19 for this time of year, but treating someone with a broken leg and covid-19 is more difficult than treating a patient who only has a broken leg?
Finally, to what extent is this crisis in the NHS, not so much an issue with C-19, though I presume it's not exactly helping, but a serious lack of funding, a lack of staff, and mismanagement? There were lots of warnings in 2018 about a chronic shortfall of staff, namely nurses. So in that sense, the authorities are shifting the blame onto a novel coronavirus, that is pushing an chronically understaffed health system into chaos (rather than a chronic virus pushing a well-staff and resourced health system into chaos). That year, Kingsfund reported:
'the staffing gaps emerging in the 1.2 million-strong NHS workforce. It predicts an increase in NHS staff shortages from over 100,000 at present to almost 250,000 by 2030, warning that this could mean that over one in six health service posts are short of an appropriate staff member by the end of the next decade.'
'Unless the government and system leaders take radical action and prioritise the NHS workforce, staffing shortages will more than double to almost a quarter of a million by 2030. The NHS can’t sustain current services, let alone improve, with such a large and growing gap between the staff it needs and the people available to provide care.'
https://www.kingsfund.org.uk/press/press-releases/staffing-shortfall-major-risk-nhs-long-term-plan
I know some of you are statisticians and no doubt there are some experts floating around who might be able to help me better understand this data and the current situation (as I no longer have any faith in our media or government).
Thanks in advance,
FM.
...do we know how many of these patients would have died regardless?
All of them. I hate to break it to you... but everyone dies. Would they lived longer? Yes.
to what extent is this crisis in the NHS, not so much an issue with C-19
The NHS always struggles this time of year... understaffed and underfunded... but that is not causing the huge numbers of hospital admissions due to this epidemic, which is real, and is of the scale you are reading about. The government and media are not using numbers to bamboozle you... there is a very real problem happening in hospitals right now... ...as a result of this virus... it is not some statistical slight of hand... ask yourself this... why would the government want to make things look worse than they really are by inflating figures?
Can someone please correct me if I’m wrong here, but they look stable throughout most of 2019/2020 (2nd quarter) at around 1.5 million per quarter.
Maybe I'm being daft, but isn't Q2 2019/2020 entirely before the pandemic? Surely that's July - Sept 2019...?
It is "too early" to say whether England's Covid restrictions will be able to end in the spring, Prime Minister Boris Johnson has said.
and
Bars and restaurants should not open before May, a scientist who sits on a sub-group of Sage (the government's scientific advisory committee) suggests.
oh dear,
No surprise though, really... as many kids as possible back in the classroom should absolutely take priority over opening pubs and restaurants... and it would be reckless in the extreme to do both at the same time. So do the schools, and see what the following month brings before reopening hospitality. The government needs to be planning the appropriate support to get hospitality though the next six months right now, and announcing asap, so owners, managers, staff and suppliers can make their own plans.
I wonder when self-catering accommodation will re-open. I can imagine the are lots of businesses built to serve this sector that are itching to re-open.
It would need relaxation of travel and overnight stays though.
How do the hotels that stayed open for people working away function currently?
The government needs to be planning the appropriate support to get hospitality though the next six months right now, and announcing asap, so owners, managers, staff and suppliers can make their own plans.
Agreed Kelvin, unless we go into essentially a war footing the economic effects of playing whack-a-mole with Covid and any vaccine resistant variants are going to be intolerable. At the moment we are fighting this as if everything will be fine and dandy once the vaccine is rolled out, we need to be thinking about how we fight this on a 5-10 year timescale and how we can rapidly build nurse capacity in the NHS as an alternative to more strict lockdowns. I'm starting to view the strict lockdowns whilst we're waiting for a vaccine as a symptom of our short term thinking as opposed to something that is in spite of our short term planning.
I'm getting the feeling that we're suffering from the same type of thinking that Netflix's "The Vietnam War" documentary series highlighted in regards to President Johnsons fallacious sunken costs thinking.
I've not made my mind up on this but I'm not entirely convinced by some of my colleagues that the pharmaceutical industry can keep pace with this, I'm on very good personal and professional terms with a top R&D microbiologist who's been muttering much the same to me as well. But then again, we also get on because we're both pessimists - and I'm actually paid to essentially be a pessimist/devils advocate. I wonder if there are any groups that have red teamed the current vaccine response?
ask yourself this… why would the government want to make things look worse than they really are by inflating figures?
To make people scared and so comply.
It is a valid question, deaths with/of Covid. There should be clear stats on this by now.
And just to counter some of the doom and gloom above: I know of two major central banks that are fully expecting restrictions to end in the summer and life to get back to normal across Europe due to vaccination, and they're not prone to hysteria.
The with/of thing has been covered multiple times in this thread, including in direct replies to you.
And just to counter some of the doom and gloom above: I know of two major central banks that are fully expecting restrictions to end in the summer and life to get back to normal across Europe due to vaccination, and they’re not prone to hysteria.
https://en.wikipedia.org/wiki/Optimism_bias
Most humans have it.
Anyway, I'm not advocating for further lockdowns into 2022/23.
Sad reality is that across the world it will only be when the tally of excess deaths over the 10 year average is given that we will know the true cost of the pandemic.
But still those deaths will be a mix of direct and indirect covid deaths
And just to counter some of the doom and gloom above: I know of two major central banks that are fully expecting restrictions to end in the summer and life to get back to normal across Europe due to vaccination, and they’re not prone to hysteria.
Similarly I have spoken today to two sources in Scottish Government about education issues - both shared a 'August '21 schools will be back in and pretty normal' view. The discussion was about how we support schools and pupils back to a normality without ignoring the significant mental, physical and social health issues our children now face...
It is a valid question, deaths with/of Covid. There should be clear stats on this by now.
Surely it's just not as simple as that though? There will be plenty of people who came in with COVID, had nothing else majorly wrong with them, and died with no real doubt that COVID was the only valid thing to describe as the cause. There will also be some people who pretty clearly died as a result of injuries sustained in a car crash, but happened to also have COVID. But there will also be loads of people who are a bit in between, especially given the mortality rate in the elderly. If someone has cancer and a dodgy heart, but was doing OK until they got COVID and they tipped over the edge, then do they count? And that's not even factoring in people who died without a positive COVID test because they couldn't get the treatment that they needed. It's all a bit tricky, and to some extent to monitor how it's going, it's more important to have a consistent measure than to have a measure that tries hard to cover all scenarios.
It is a valid question, deaths with/of Covid. There should be clear stats on this by now.
it’s more important to have a consistent measure than to have a measure that tries hard to cover all scenarios
Look at the excess death figures.
A death is rather binary (you're either dead or not), but the cause can be rather complicated/vague.
Look at the deaths in 2020 vs the 5 year average.
You'll see theres a big increase, so something is causing it.
Similarly I have spoken today to two sources in Scottish Government about education issues – both shared a ‘August ’21 schools will be back in and pretty normal’ view. The discussion was about how we support schools and pupils back to a normality without ignoring the significant mental, physical and social health issues our children now face…
Remember "Eat out to help out!", we got dragged into some kind of mass hysteria of optimism.
I'm not going to commit to betting on this, as I'm still on the fence - but I might just might be able to do a "called it 8 months ago" post on STW in August.
Let's pose the question, what if - hypothetically - the vaccines turn out to be an abject failure because the logistics of the effort cannot keep up with the rate of change within the virus - what is plan B? Do we lockdown again, in an effort to roll out a vaccine program that can vaccinate 7 billion people in even less time than we are attempting to do it this time?
Groundhog Day alert - we are using a consistent method of counting, it's the one the rest of the world are using.
There will also be some people who pretty clearly died as a result of injuries sustained in a car crash,
The chances of someone dying in a car crash within 28 days of testing positive are pretty slim - isolation for one thing, generally being too poorly to go out, travel restrictions/lockdowns for quite a lot of the last 10 months. It's a pretty tiny hook to be hanging Covid whataboutery on.
Edit - and presumably if medical improvements can keep them going for 29 days, they don't get counted? Or have the improvements not been that great?
A potential mismatch between vaccine supply and demand “is not a commercial risk efficiently mitigated by the market or the MDBs,” the Citi advisors wrote, referring to multilateral development banks such as the World Bank.
Look at the excess death figures. A death is rather binary (you’re either dead or not), but the cause can be rather complicated/vague.
It’s all a bit tricky, and to some extent to monitor how it’s going, it’s more important to have a consistent measure than to have a measure that tries hard to cover all scenarios.
Yeah, fair points.
I still think including clearly non-Covid deaths in the Covid death statistics undermines them.
And with excess deaths, isn't the appropriate comparison with the worst of the past 10-20 years rather than the 10-year average?
In other words, how much worse the current situation is than the worst situation we have previously considered acceptable.
March to March, we will break all 20 year records.
I know of two major central banks that are fully expecting restrictions to end in the summer and life to get back to normal across Europe due to vaccination
Sounds good, but even major institutions are reliant on the predictions of individual health economists and statistical experts who have the same access to data as the rest of us. They don't have an oracle stuffed in the vault. It's a reasonable assessment but relies on a few assumptions about vaccine uptake, efficacy and the absence of vaccine-proof variants in the next six months.
Sounds good, but even major institutions are reliant on the predictions of individual health economists and statistical experts who have the same access to data as the rest of us. They don’t have an oracle stuffed in the vault. It’s a reasonable assessment but relies on a few assumptions about vaccine uptake, efficacy and the absence of vaccine-proof variants in the next six months.
Oh, definitely. Economic forecasters are never right about anything, ever. (Quickly checks avatar doesn't include real name)
Just saying that other experts are drawing less apocalyptic conclusions than the STW experts. This thread does tend to get bogged down in worst-case scenarios. (And I understand to some extent why. And I'm not saying you won't all be right.)
does tend to get bogged down in worst-case scenarios
Go back and read the thread from middle of last year... we are now exactly where people said would be a reasonable winter outcome giving the (lack of) measures we were putting in place. And we have avoided worst-case scenarios... we are nowhere near them... that doesn't mean that the UK is doing well, or couldn't have avoided doing as badly as we have.
I still think including clearly non-Covid deaths in the Covid death statistics undermines them.
And with excess deaths, isn’t the appropriate comparison with the worst of the past 10-20 years rather than the 10-year average?
In other words, how much worse the current situation is than the worst situation we have previously considered acceptable.
Pretty sure this was done quite thoroughly a few pages back when excess deaths stats for the calendar year were released.
But here we go again, same questions, same people.
Pretty sure this was done quite thoroughly a few pages back when excess deaths stats for the calendar year were released.
I'm surprised I missed that, as I have been monitoring this thread. Any idea what date that was?
But here we go again, same questions, same people.
Same unwarranted hostility, same people...
Go back and read the thread from middle of last year… we are now exactly where people said would be a reasonable winter outcome giving the (lack of) measures we were putting in place. And we have avoided worst-case scenarios… we are nowhere near them… that doesn’t mean that the UK is doing well, or couldn’t have avoided doing as badly as we have.
Christmas doesn't seem to have brought as big a spike as predicted?
Sorry, just how big a spike did you expect? Around 1200 deaths a day currently.
In case folk are not sufficiently depressed, seems that the new variant may be spreading too fast to cope with via lockdowns
Don't get too pessimistic, here I think the evidence is less strong. And will analyse their data later. The ZOE app data showed clear evidence that symptom-reported cases turned over earlier in London and South East. ONS shows the same. REACT has some different methodologies for reporting delays. But the effect is not huge and the number of data points is actually modest.
It is “too early” to say whether England’s Covid restrictions will be able to end in the spring, Prime Minister Boris Johnson has said.
No it isn't and they won't. Schools most likely off all term, some contact restrictions - maybe Tier 3 level. Probably my most optimistic call.
Bars and restaurants should not open before May, a scientist who sits on a sub-group of Sage (the government’s scientific advisory committee) suggests.
Not me, but I would concur on this. Will be some time before I have a trip to the cinema.
Go back and read the thread from middle of last year… we are now exactly where people said would be a reasonable winter outcome
Thanks. My predictions for winter were 30k excess deaths or thereabouts, but I did say that influenza deaths would be replaced by COVID deaths. That appears to have come to pass. Tier 4 before Christmas will have helped, and I think the earlier decline in London/SE was driven by this. In the North things are turning over. Lockdowns do have the intended outcome of reduced spread. The other aspects are out of my expertise, but the system look (sadly) pretty deterministic now.
TiRed how much work has been done on mutation rates and viral fitness/ability to thrive? Covid has a low to moderate mutation rate and you have used this as evidence to back up your optimism.
However
https://journals.plos.org/plosgenetics/article?id=10.1371/journal.pgen.1007324
It's on e-coli so not directly related but this caught my eye
v In contrast, some populations at the highest mutation rates showed reduced adaptation during evolution, and failed to thrive in all of the 90 alternative environments. In addition, they experienced a dramatic decrease in mutation rate. Our work demonstrates that the mutation rate changes the global balance between deleterious and beneficial mutational effects on fitness. In contrast to most theoretical models, our experiments suggest that this tipping point already occurs at the modest mutation rates that are found in the wild.
So whilst Covids mutation rate is according to some, lower than influenzas - is it possible that the mutation rate is in a golden zone in terms of the tipping point between beneficial and deleterious mutations?
Some more data for everyone:
For England only, but doubt its significantly different elsewhere
https://coronavirus.data.gov.uk/details/deaths?areaType=nation&areaName=England
Age - % Cases Probability of Death
0-4 - 2.2% - 0.8%
5-9 - 7.7% - 0.0%
10-14 - 2.1% - 0.0%
15-19 - 2.8% - 0.0%
20-24 - 4.9% - 0.0%
25-29 - 8.9% - 0.0%
30-34 - 9.8% - 0.0%
35-39 - 9.6% - 0.1%
40-44 - 8.7% - 0.2%
45-49 - 7.9% - 0.4%
50-54 - 7.9% - 0.6%
55-59 - 8.5% - 1.0%
60-64 - 5.5% - 2.3%
65-69 - 3.1% - 7.7%
70-74 - 2.5% - 13.5%
75-79 - 2.1% - 27.1%
80-84 - 1.9% - 37.5%
85-89 - 1.9% - 50.8%
90+ - 2.0% - 62.2%
So as some examples, a typical STWer of 45 years of age is making up 7.9% of cases, but if they so catch it, its only a 0.4% chance of death. (normal chance of death would be ~0.3% in a typical year)
For your typical 80 year old parents, its currently a 1.9% chance you'll contract Covid, but a 37.5% chance they will die (compared to the usual ~15%)
(sure TiRed may have something better, but it gives you the general idea)
Also apologies for the poor formatting...
TiRed how much work has been done on mutation rates and viral fitness/ability to thrive?
A lot. By anyone with psudovirus and access to serum from infected or vaccinated humans.
My expectation is that a small increase in binding affinity to ACE2 leads to more transmissible, easier to generate symptoms and perhaps increased morbidity and mortality. But the overall effect will be small. For reference, the R for measles is 12-18. the increase in R for new variants looks like from 3 to 4. Escape from antibody neutralisation is being monitored and I would say, is expected for most of the clinical antibodies.
Papers of interest
https://www.medrxiv.org/content/10.1101/2021.01.13.21249721v1 more infectious
https://www.biorxiv.org/content/10.1101/2020.11.04.355842v1 resistance and evasion
https://www.biorxiv.org/content/10.1101/2020.11.04.355842v1 Pfizer vaccine sera potency
It's a coronavirus. There will be cross-reactivity for new strains, how much is moot. Protection from morbidity not infection is what will matter. Vaccinations will build that protection. It won't be eradicated. It's not smallpox.
I'd like a 3rd column added to Chew's data indicating chances of 'long covid' too. At my age I might not die, but what are the odds of having impaired health longer term?
Do we have studies that can show evidence of immunity mediated reduction in morbidity despite complete evasion of monoclonal and significant evasion of polyclonal antibodies?
Because I suspect that we're dealing with a new question here that hasn't been adequately answered by science yet, happy to be proven wrong though.
There is a lot in the media about how hospitals are struggling - but no mention of the Nightingale hospitals.
Are they still a thing?
(sorry if this has been covered elsewhere)
For your typical 80 year old parents, its currently a 1.9% chance you’ll contract Covid
I don’t think you mean that, you mean 1.9% of cases are in the 80s age bracket.
I don’t think you mean that, you mean 1.9% of cases are in the 80s age bracket
Same kinda thing, but you’ve worded it better.
So those in the 5-9 year group won’t be social distancing at all hence the high numbers, and those in the 30-35-40 age groups being high too (parents)
With it being lower in the higher age groups as they have generally retreated from society
@dawson I think that it's fairly widely accepted that there are zero staff available for the nightingale. I've seen several people now dismiss them as basically publicity stunts from lockdown 1 to make it seem like the government was doing something useful.
There is a lot in the media about how hospitals are struggling – but no mention of the Nightingale hospitals.
The Scottish equivalent has been busy with other procedures, freeing up the normal hospitals for Covid cases.
There is a lot in the media about how hospitals are struggling – but no mention of the Nightingale hospitals.
You can have as many hospitals and beds as you like, but if you haven't got enough doctors and nurses to staff the regular hospitals, it's pretty academic.