Coronavirus - worldwide spread and control

[Hutan]

A number of posts about the impact of quarantining on personal well-being, especially for people with ME, have been moved here:
COVID and its consequences on disabled/sick people's care

 

[large donner]

As much as I have tried I have been unable to find basic statistics for the UK in terms of total deaths for years 2015 2016 2017 2018 2019 and so far in 2020.

I am looking for a breakdown for each month in each year like the one previously posted in this thread for Spain.

All I keep getting when I go to the office of national statistics site is some vague statement about how the "death rate was considerably slower in the first few months of 2020 potentially due to a milder winter until the coronavirus deaths kicked in".

 

[Jonathan Edwards]

This is the website's summary:

To me there are several major flaws in the argument.

Health service capacity is not there. In order to achieve what has been achieved staff have had to work with inadequate protection and have died. Normal healthcare has more or less come to a standstill. People wanting treatment for other conditions are also routinely getting infected with Covid19 in hospitals because isolation units are not separate. He appears to have no understanding of health care practicalities.

If the death rate is 0.9% then presumably about 2 million people have been infected - or 3% of the population. That means that to allow the epidemic to play out with the impact on the health service already scene, and not more, would take about 60 months. We have no guarantee that a vaccine will be practicable in less.

So yes, maybe lockdown cannot be sustained but why was it not foreseen that the only way of preventing too long a lockdown was to put in very tight measures early on to keep cases well below levels with a knock-on effect. I do not understand the attribution of cancelled treatments to lockdown. The cancelled treatments are due to the pressure on the service from Covid cases due to lockdown not being enforced.

So I think it likely that all epidemiologists will agree that we have to keep tight restrictions at present but any epidemiologist with any sense would not agree with his logic otherwise or with his earlier modelling conclusions.

After all his decision making has led to about the worst outcome for any country except USA.

 

[Adrian]

There is something a bit disturbing about that graph. The cases going to intensive acare are going down much more sharply than the number of reported cases AND the number of deaths. There a lots of unknowns but one possible explanation is that fewer patients going in to hospital are being offered intensive care. That may indicate a better judgment on who needs it but then why is the death rate not falling? The more troubling possibility is that fewer are getting in to intensive care because there are not many beds left.

The twitter poster seems a bit gung ho in a way that even the government advisors seem to have stopped being.

Deaths are a lagging indicator so I would expect hospital admissions to go down prior to death rate. Testing has increased a bit which could be a factor on the reported cases (I don't think they report via symptoms but not sure). But the data does seem strange. (I also think we are poor at data collection in the UK so it could just be missing data).

My first thought was that it could be because the most vulnerable were better at isolating and hence the infection rate is skewed. But I hear things in care homes are very bad so perhaps they are not taking patients from there into hospital which would again skew the figures (especially due to age ranges). I'm not sure how age ranges have changed over time. I had a glance through the full report https://t.co/sB4BjabUw9?amp=1 and it doesn't say and this may help explain what is happening.

 

[alex3619]

My state of Queensland, Australia will be relaxing some distancing rules in just under a week, allowing non-essential shopping and some other activities. This follows only three cases in our state in the last day or so, and zero a few days ago. We also have the launch of a mobile phone app which will allow tracing of contacts, everyone who came near you, provided they also have the app and its active. This will allow some automation of contact tracing. I do not think basic social distancing has been lifted.

 

[Barry]

I do not understand the attribution of cancelled treatments to lockdown. The cancelled treatments are due to the pressure on the service from Covid cases due to lockdown not being enforced.

Absolutely. If you were to consider a theoretically perfect lockdown (impossible in practice of course) then after a due lag there would be negligible Covid 19 pressure on the NHS, not the other way round.

 

[Esther12]

To me there are several major flaws in the argument.

Health service capacity is not there. In order to achieve what has been achieved staff have had to work with inadequate protection and have died. Normal healthcare has more or less come to a standstill. People wanting treatment for other conditions are also routinely getting infected with Covid19 in hospitals because isolation units are not separate. He appears to have no understanding of health care practicalities.

If the death rate is 0.9% then presumably about 2 million people have been infected - or 3% of the population. That means that to allow the epidemic to play out with the impact on the health service already scene, and not more, would take about 60 months. We have no guarantee that a vaccine will be practicable in less.

So yes, maybe lockdown cannot be sustained but why was it not foreseen that the only way of preventing too long a lockdown was to put in very tight measures early on to keep cases well below levels with a knock-on effect. I do not understand the attribution of cancelled treatments to lockdown. The cancelled treatments are due to the pressure on the service from Covid cases due to lockdown not being enforced.

So I think it likely that all epidemiologists will agree that we have to keep tight restrictions at present but any epidemiologist with any sense would not agree with his logic otherwise or with his earlier modelling conclusions.

After all his decision making has led to about the worst outcome for any country except USA.

That summary misses a lot out, so it probably isn't fair to judge Ferguson on that. Ferguson was actually emphasising the strain that hospitals had been under, saying that there were a few individual hospitals that had reached the point where they could not admit anyone else. My impression was that the interviewer was playing down that immediate strain (perhaps playing devil's advocate not very well, perhaps reflecting his own instincts, that could then have shaped his summary). The interviewer (Freddie Sayers) seemed really out of his depth, and as if he was trying to hid the fact he was out of his depth.

It was really hard to judge Ferguson on future plans for Covid-19 as he wasn't getting particularly challenging questions. One worry I got from the interview was the impression that he's very much a team player within the systems of the Establishment, but then I guess that shouldn't be a surprise for someone in his position.

 

[spinoza577]

As much as I have tried I have been unable to find basic statistics for the UK in terms of total deaths for years 2015 2016 2017 2018 2019 and so far in 2020.

I am looking for a breakdown for each month in each year like the one previously posted in this thread for Spain.

All I keep getting when I go to the office of national statistics site is some vague statement about how the "death rate was considerably slower in the first few months of 2020 potentially due to a milder winter until the coronavirus deaths kicked in".

In most countries it was, as far as I have seen.
A board form "facts about covid-19" a-swiss-doctor-on-covid-19
the graph is a bit difficult to perceive, but it seems that mortality was rather a bit high (like in the Netherland).

I tried to find a statistic about Belgium, but I couldn´t find any that would include this year.

 

[JaneL]

Yes the German study was 9 cases, the other linked one from HongKong 94 cases (my post was written confusing, sorry).

Thanks Leila, that was my mistake. When I first read your post I saw that you had mentioned another study but during the time in took me to read the first study I’d forgotten all about the second study (ME brain)!

I’ve now had a chance to read through Hong Kong study too which is interesting. The science seems pretty clear that infectiousness is highest around the time of symptom onset or soon before and it in then declines over time. However the only thing they say in relation to length of infectiousness is: “Infectiousness was estimated to decline quickly within 7 days”. I might be missing something but I don’t see how they were able to estimate that from the available data and there is no explanation or discussion about it in the paper. Even then it’s only an estimation. So I’m still not satisfied we have enough evidence to support the UK recommended 7-day isolation period.

 

[JaneL]

There is an interesting interview with Dr Charlotte Houldcroft (virologist at the University of Cambridge) on The Guardian website looking at the question of whether the UK’s recommended 7 day isolation period is long enough:

Covid-19: is seven days in isolation enough?

https://www.theguardian.com/world/audio/2020/apr/21/covid-19-seven-days-isolation-enough-podcast

In the interview Charlotte Houldcroft discusses a recent study which came out in Germany. She explained that the study found that after 7 days from symptom onset, you can still find fragments of the virus in people’s nose and throat but you can never grow virus from those samples. Charlotte says “What that suggests is that after 7 days people are not infectious to those around them any more but they might still test positive”

[My bolding]

After taking another look at this paper I noticed that Charlotte Houldcroft made a small but crucial mistake in this interview for The Guardian. The study actually found live virus up until day 8 (not day 7 as stated) suggesting that the subjects in this study were infectious for 8 days after symptom onset. So this study doesn’t actually support the UK recommended 7-day isolation period.

 

[ladycatlover]

New article, currently free to read, in the FT. John Burn-Murdoch is one of the authors. It's chilling.

Global coronavirus death toll could be 60% higher than reported

Mortality statistics show 122,000 deaths in excess of normal levels across 14 countries analysed by the FT

https://on.ft.com/2VF4Bfi

 

[Jonathan Edwards]

It was really hard to judge Ferguson on future plans for Covid-19 as he wasn't getting particularly challenging questions. One worry I got from the interview was the impression that he's very much a team player within the systems of the Establishment, but then I guess that shouldn't be a surprise for someone in his position.

I get an increasing feeling that decisions are being dictated by events now in the way they should have been originally. The establishment team is still trying to present a united front but whistling in the wind with it. Mark Walport was on the radio saying that the government was doing a Stirling job. He is now sounding like a caricature of the establishment blimp (we were once close colleagues) and I suspect even the average listener would pick that up.

What I found encouraging though, was the statement on BBC News that Boris Johnson was going to try to persuade dissenting voices in the party on Monday that easing lockdown was a bad thing because it would do far more damage to the economy. It actually sounds as if the penny has dropped (or one of them)

 

[FMMM1]

I get an increasing feeling that decisions are being dictated by events now in the way they should have been originally. The establishment team is still trying to present a united front but whistling in the wind with it. Mark Walport was on the radio saying that the government was doing a Stirling job. He is now sounding like a caricature of the establishment blimp (we were once close colleagues) and I suspect even the average listener would pick that up.

What I found encouraging though, was the statement on BBC News that Boris Johnson was going to try to persuade dissenting voices in the party on Monday that easing lockdown was a bad thing because it would do far more damage to the economy. It actually sounds as if the penny has dropped (or one of them)

Yea I listened to a program on Radio 4 "The Inquiry" [https://www.bbc.co.uk/programmes/m000hmzl] and they looked at a parallel fromthe 1918 pandemic; cities which locked down early and hard fared better than those that didn't --- they're economies recovered quicker ---

Shortly after that there was a profile of Matt Hancock [https://www.bbc.co.uk/programmes/m000hmxq]; his friends did their best to muster a defence --- one commentator said that when there's a crisis and you reach for the levers and find them broken --- hardly his fault. However, there was talk of Conservative MPs who reckon he's undermining the Governments credibility (announcing 100K tests/day, when he can't deliver that +++). So yes perhaps some changes are afoot!

 

[lunarainbows]

Coronavirus: Johnson faces lockdown dilemma as scientists warn over grim data

“The number of new cases of Covid-19 being diagnosed is still much too high to allow any easing of the lockdown soon, leading scientists have warned, as the virus death toll in UK hospitals passed 20,000 on Saturday.

Professor Keith Neal of Nottingham University agreed that the number of patients being taken to hospital with Covid-19 remained far too high. “This daily figure peaked on 5 April with 5,903 cases. This Saturday it stood at 3,583,” he added. This latter figure was boosted by an extra 1,330 new cases of infected care and health workers, which brought Saturday’s overall total to 4,913.

“It has therefore taken three weeks for numbers of hospitalised Covid-19 patients to decline from a daily total of 5,903 to 3,641.”

Professor Paul Hunter, of the University of East Anglia, added: “There is no doubt this rate of decline is disappointing. Certainly it is far too high to consider lifting lockdown restrictions at present. We need to get numbers down to a few hundred new cases a day before we can do that. Such a decline could take months.””

____
Note the numbers quoted above are only new cases in hospitals.. not new cases everywhere. So how are they going to get *total* new cases down low enough to actually lift lockdown?

 

[alex3619]

More and more data is coming out of the USA that shows the virus has been spreading much longer, many more were infected, but the death rate is much lower than previously thought. The first death in US was in California (Santa Clara) on Feb 6, but when you take into account incubation and disease duration to death this person might have been infected early January.

My source is a youtuber who is usually reliable, but this is not a scientific source. I am hoping someone knows of better sources.

I also keep hearing that the infection rate is something like 30-50 times higher than we thought, which makes the death rate much lower, only somewhat more dangerous than a bad flu. However the infection rate of this virus may be much higher than we thought and we have no natural immunity. What complicates the infection rate data is the issue that we are presuming the infections started much later than they did.

 

[alex3619]

Global coronavirus death toll could be 60% higher than reported

This is quite plausible. Many countries will have limited testing and public health infrastructure. Many cases might be missed over much of the world. Its also likely infections started much earlier, and it spread much further, we just have not done the testing.

 

[Esther12]

I get an increasing feeling that decisions are being dictated by events now in the way they should have been originally. The establishment team is still trying to present a united front but whistling in the wind with it. Mark Walport was on the radio saying that the government was doing a Stirling job. He is now sounding like a caricature of the establishment blimp (we were once close colleagues) and I suspect even the average listener would pick that up.

I couldn't see any criticism of Walport anywhere.

There was this reporting of some of his comments at a few places, eg:

Asked whether he is concerned about Boris Johnson’s chief political adviser Mr Cummings sitting in, Sir Mark told BBC Radio 4’s The World This Weekend:

"No, I’m not worried actually. Sage is conducted, led by the chief scientific adviser, the scientists speak very, very freely.

There are a number of people on the phone, they don’t interfere and I’m absolutely confident it’s acting effectively to provide the science advice the government needs.

Churchill famously said that scientists should be on tap and not on top, and that in fact is the situation.

So the job of the researchers is to advise government, politicians on what is known and indeed what is not known, the uncertainties about research.”

https://www.manchestereveningnews.c...navirus-live-boris-johnson-returning-18151911

I also saw this older one:

 

[Esther12]

More and more data is coming out of the USA that shows the virus has been spreading much longer, many more were infected, but the death rate is much lower than previously thought. The first death in US was in California (Santa Clara) on Feb 6, but when you take into account incubation and disease duration to death this person might have been infected early January.

My source is a youtuber who is usually reliable, but this is not a scientific source. I am hoping someone knows of better sources.

I also keep hearing that the infection rate is something like 30-50 times higher than we thought, which makes the death rate much lower, only somewhat more dangerous than a bad flu. However the infection rate of this virus may be much higher than we thought and we have no natural immunity. What complicates the infection rate data is the issue that we are presuming the infections started much later than they did.

I had seen similar claims to this being made on the basis of a couple of studies that have now attracted a lot of criticism. Maybe this was one of them? https://www.salon.com/2020/04/26/sc...body-study-the-authors-owe-us-all-an-apology/

I've not really been following the details of those debates, and have just been assuming that in the time it would take me to properly understand a study new and more reliable data is likely to have come out anyway!

 

[Adrian]

One of the things that struck me about the experts on the group is how many of them have there expertise in influenza. This seems to include the virus people as well as the modellers. I've not seen anyone who has studied corona viruses in detail - one of the things I've noticed in TWiV on the episodes I've listened to is many exerts specialize in one particular type of virus - although they understand others.

I'm wondering if this bias towards influenza experts will have had a huge effect on the advice given. I think one of the early criticisms of the UK approach was that it was geared towards an influenza outbreak rather than what is happening.

I notice that one of the German advisors is a corona virus expert who also worked on SARS

https://www.theguardian.com/world/2...-drosten-germany-coronavirus-expert-interview

 

[Sasha]

Boris Johnson just gave a statement that sounded cautious about relaxing lockdown, with an intention to avoid a second wave. No detail.