Coronavirus in the UK - news, lockdown and discussion

[elbows]

The winter wave featured periods where for England approximately 60% of the daily hospital admissions for covid were in people aged 65 and over. Around the time of the mid July 2021 peak, the picture was indeed quite different, peoples aged 65 and over were down to about 30% of daily admissions. But ever since then that has been creeping up again, and in the most recent data those aged 65+ are getting close to accounting for 50% of daily hospital admissions.

I think this is probably one of the larger stories not being told at the moment. I have told it here before via some graphs, and the trend has continued since I last did that.

Since the monthly NHS England data which involves a more detailed number of different age groups was published today, I can now post a graph about this.

Sorry that some of the colours repeat. The youngest age groups are at the bottom of this chart. So the yellow, green and grey parts at the top of the chart represent those aged 65 and over. We can see that during the July peak the younger age groups made up a greater proportion of daily admissions/diagnoses than is now the case.

Data is from the spreadsheet linked to at the very bottom of this page Statistics » COVID-19 Hospital Activity

 

[elbows]

I havent had a chance to look at this properly:

 

[elbows]

To protect my own mental health I have not spent a lot of time this year seeing what foul shit the Great Barrington pandemic arseholes have been spewing. But I saw this on twitter and thought I better mention it.

Hopefully my own stance is clear enough that I can go on and on about some of the limitations to vaccines, and the risks that remain, without using that to reach incorrect conclusions or to pedal inappropriate policies. Generally speaking, ignore shit that relies on crude binary thinking. eg the fact that vaccines dont prevent all transmission doesnt mean they have an irrelevant impact on transmission.

 

[elbows]

Even though I knew this period would be messy and much harder to predict, I seem to have managed to surprise myself in regards quite how uncertain I currently am about the prospect of cases in England seeing a rapid and massive spike in case numbers as a result of the return to schools.

Itt appears that no matter how much I might have claimed to have be keeping an open mind about that sort of thing, there was still some expectation in my mind of seeing signs of such a spike in the data by now. Perhaps my sense of timing is off and we will still see this in the next week or so. Perhaps it will be a slower affair that grinds on without a huge spike on top of whats already there. Perhaps an entirely different pattern will emerge, surprising people in much the same way the July drop caused some surprise. Perhaps what happens next will offer some strong clues about what actually happened in July to result in the pattern we've seen since reopening/removal of restrictions.

I never had crystal balls in this pandemic, but if that impression was sometimes given then I have to report that my balls have shrunk!

 

[IC3D]

To protect my own mental health I have not spent a lot of time this year seeing what foul shit the Great Barrington pandemic arseholes have been spewing. But I saw this on twitter and thought I better mention it.

Hopefully my own stance is clear enough that I can go on and on about some of the limitations to vaccines, and the risks that remain, without using that to reach incorrect conclusions or to pedal inappropriate policies. Generally speaking, ignore shit that relies on crude binary thinking. eg the fact that vaccines dont prevent all transmission doesnt mean they have an irrelevant impact on transmission.

The vaccine (dubious name) doesn't prevent infection or onward transmission. It does wonderfully prevent serious illness and death for the individual. Laying it on thick in the hope it will reduce transmission in society is wishful and looking increasingly poorly evidenced. Transmission of SARS-CoV-2 Delta Variant Among Vaccinated Healthcare Workers, Vietnam

 

[elbows]

Your claim is dangerously close to misleadingly suggesting that vaccination doesnt reduce infection and transmission at all.

All year I have doned on about the dangers of asking vaccines to carry too much pandemic weight alone. That doesnt mean I have any interest in denying the impressive amount of difference they can make.

 

[2hats]

The vaccine (dubious name) doesn't prevent infection or onward transmission.

Infection and transmission are not simple binary outcomes. There are degrees in reduction of each and that varying as a function of time (since seroconversion), as well as prior exposure to antigen.

 

[elbows]

Infection and transmission are not simple binary outcomes. There are degrees in reduction of each and that varying as a function of time (since seroconversion), as well as prior exposure to antigen.

Given the choice of which healthcare workers me and my loved ones would interact with, I would choose people who had been both infected and vaccinated, because on paper they have the best protection.

Ideally I would like anyone who doesnt want to get vaccinated in response to this sort of pandemic to leave the health service. Although that wouldnt be ideal for years because it would cause staffing issues that would take a long time to fix. But given the choice when pushed, thats which way I lean.

 

[IC3D]

Your claim is dangerously close to misleadingly suggesting that vaccination doesnt reduce infection and transmission at all.

All year I have doned on about the dangers of asking vaccines to carry too much pandemic weight alone. That doesnt mean I have any interest in denying the impressive amount of difference they can make.

Yet a completely different statement at the same time. The degree to which infection is prevented by the current vaccine seems to be decreasing and I think massively overstated in the first place.

 

[elbows]

Such estimates were expected to diminish because early estimates at a time where prevalence was reducing were inevitably on the high side. The real test was going to be how well vaccines did when other measures were relaxed and a new wave emerged. Plus early anaysis involved a previous variant and Delta is a trickier foe.

But these sorts of things change the numbers game in a manner that makes authorities more desperate to increase proportion of population that are vaccinated, not less. And I agree, these things are all reasons to get more people vaccinated.

 

[2hats]

Given the choice of which healthcare workers me and my loved ones would interact with, I would choose people who had been both infected and vaccinated, because on paper they have the best protection.

Interestingly, studies are currently underway to investigate if vaccination then infection yields a similar "supercharged" hybrid immunity response as that arising from infection then vaccination.

 

[elbows]

Interestingly, studies are currently underway to investigate if vaccination then infection yields a similar "supercharged" hybrid immunity response as that arising from infection then vaccination.

Good, I'd been meaning to ask you if it was expected to work the other way around. Fingers crossed.

 

[IC3D]

Seems pretty likely Covid is here to stay doesn't it

Adults who have been fully vaccinated against SARS-CoV-2 can carry the same viral load of the delta variant as those who are unvaccinated, a preliminary analysis of UK data suggests.1

Covid-19: Fully vaccinated people can carry as much delta virus as unvaccinated people, data indicate

Adults who have been fully vaccinated against SARS-CoV-2 can carry the same viral load of the delta variant as those who are unvaccinated, a preliminary analysis of UK data suggests.1 The latest results from the UK’s national covid-19 infection survey show that having two vaccine doses remains...

www.bmj.com

University of East Anglia’s Paul Hunter noted, “There is now quite a lot of evidence that all vaccines are much better at reducing the risk of severe disease than they are at reducing the risk from infection. We now know that vaccination will not stop infection and transmission, [but it does] reduce the risk. The main value of immunisation is in reducing the risk of severe disease and death.”

 

[Artaxerxes]

Your claim is dangerously close to misleadingly suggesting that vaccination doesnt reduce infection and transmission at all.

All year I have doned on about the dangers of asking vaccines to carry too much pandemic weight alone. That doesnt mean I have any interest in denying the impressive amount of difference they can make.

Perfect is the enemy of good - I won't take the vaccine or trust it because it's not perfect just means you or your loved ones will catch it and catch it hard

 

[elbows]

Seems pretty likely Covid is here to stay doesn't it

Covid-19: Fully vaccinated people can carry as much delta virus as unvaccinated people, data indicate

Adults who have been fully vaccinated against SARS-CoV-2 can carry the same viral load of the delta variant as those who are unvaccinated, a preliminary analysis of UK data suggests.1 The latest results from the UK’s national covid-19 infection survey show that having two vaccine doses remains...

www.bmj.com

Part of that quote says "[but it does] reduce the risk". On that basis I am very much at odds with your stance.

I didnt expect Covid to go away so there is no great revelation on that front.

 

[IC3D]

Perfect is the enemy of good - I won't take the vaccine or trust it because it's not perfect just means you or your loved ones will catch it and catch it hard

You're both making a straw man here. I've not insisted on a perfect vaccine or deny it saves lives. It is clear though it won't stop or possibly effect transmission greatly. I just find it interesting how things are or may evolve

 

[Supine]

You're both making a straw man here. I've not insisted on a perfect vaccine or deny it saves lives. It is clear though it won't stop or possibly effect transmission greatly. I just find it interesting how things are or may evolve

Not sure what point you are trying to make tbh.

 

[elbows]

You're both making a straw man here. I've not insisted on a perfect vaccine or deny it saves lives. It is clear though it won't stop or possibly effect transmission greatly. I just find it interesting how things are or may evolve

Well I'm pretty sure that earlier in the year I warned about overselling vaccines abilities in public health messaging because of how messy it can get when people realise the picture is more nuanced than that. So I always watch with interest to see how things evolve on that front.

But you seem to have combined that interest with your views about whether healthcare workers need to be vaccinated, and have been leaning towards a 'why bother' attitude to justify that stance. The cherrypicked evidence you present is getting right on my tits.

 

[andysays]

Seems pretty likely Covid is here to stay doesn't it

Covid-19: Fully vaccinated people can carry as much delta virus as unvaccinated people, data indicate

Adults who have been fully vaccinated against SARS-CoV-2 can carry the same viral load of the delta variant as those who are unvaccinated, a preliminary analysis of UK data suggests.1 The latest results from the UK’s national covid-19 infection survey show that having two vaccine doses remains...

www.bmj.com

I'm not a doctor or a statistician, but even I know that the word "can" in this sentence

Adults who have been fully vaccinated against SARS-CoV-2 can carry the same viral load of the delta variant as those who are unvaccinated, a preliminary analysis of UK data suggests

could mean that the worst/highest levels of viral load in vaccinated adults are the same or similar to the best/lowest cases in unvaccinated adults

 

[StoneRoad]

Even though I knew this period would be messy and much harder to predict, I seem to have managed to surprise myself in regards quite how uncertain I currently am about the prospect of cases in England seeing a rapid and massive spike in case numbers as a result of the return to schools.

Itt appears that no matter how much I might have claimed to have be keeping an open mind about that sort of thing, there was still some expectation in my mind of seeing signs of such a spike in the data by now. Perhaps my sense of timing is off and we will still see this in the next week or so. Perhaps it will be a slower affair that grinds on without a huge spike on top of whats already there. Perhaps an entirely different pattern will emerge, surprising people in much the same way the July drop caused some surprise. Perhaps what happens next will offer some strong clues about what actually happened in July to result in the pattern we've seen since reopening/removal of restrictions.

I never had crystal balls in this pandemic, but if that impression was sometimes given then I have to report that my balls have shrunk!

To go back to this point about a potential rise in cases as schools etc go back in September.

The school my OH used to teach at was running pre-return testing (pre-booked) in the first few days this week. Which may, or may not pick up some cases. I don't recall if it was mandatory. Monday was inset / test admin training plus some actual testing.
This school has well over 1000 pupils to test, even with pre-booking that's some target.

What I do expect is that even with such pre-term screening, once the new term gets underway, there will be a spike in cases. Purely from the degree of social mixing in the schools setting.
All it needs is for a pupil zero to have an infection but with insufficient virus to be detected on testing day(s) and for the virus to then develop enough to be infectious to others who are susceptible before they get detected by the next test.

 

[elbows]

Yes there isnt much doubt about transmission opportunities. But I'm still unsure how much difference it will make to the overall picture.

These uncertainties for me are also sponsored by the fact that if I try to use Scotland as a guide as to what happens in England, there are some other differences. For example they relaxed certain restrictions much later than England, and its probably not so easy for me to tell how much of their huge spike in cases was down to those relaxations as oppsoed to schools going back.

Certainly in terms of number of tests each day in England, the school holidays show up pretty clearly. And this is another reason why I might have expected to see a more obvious spike in positive cases already.

So just to be clear, the following graph is for number of tests in England, not number of positives:



And its a similar story for the number of lateral flow tests graph for England that is available from the same source, the official dashboard. Note that the first graph above does already include such lateral flow tests as part of its overall totals.

 

[StoneRoad]

That peak on the 6th September appears to correspond with pre-term school testing (at least around here - Northumberland ; OH taught in Gateshead)

 

[elbows]

They were one of the later areas to go back then. A lot of places were the week before that. Leicestershire were even earlier back.

Its possible to see the same data per local area on the dashboard, and the school restart sends a strong enough signal in the data that such graphs of tests conducted probably allow us to figure out when term started in different places without even having to look the term dates up! But I cant really be filling this thread up with all of those. But just to give one example, the one below is for lateral flow tests in Leicestershire.

 

[Brainaddict]

A question for the data geeks. We know anecdotally that once restrictions relaxed, people began to (a) test themselves with lateral flow tests (and not pcr) when they have symptoms and (b) use the re-emergence of the common cold to convince themselves they had only a cold without bothering to test, even though both the delta variant and the vaccine made distinguishing between them almost impossible without a test. Is it possible to work out how much of the drop in positive test figures was due to those two factors?

 

[Supine]

A question for the data geeks. We know anecdotally that once restrictions relaxed, people began to (a) test themselves with lateral flow tests (and not pcr) when they have symptoms and (b) use the re-emergence of the common cold to convince themselves they had only a cold without bothering to test, even though both the delta variant and the vaccine made distinguishing between them almost impossible without a test. Is it possible to work out how much of the drop in positive test figures was due to those two factors?

Data geeks don’t work on a couple of anecdotes

As to (a) above - if people test lft and don’t pcr report wouldn’t this raise test positivity

 

[teuchter]

Things aren't looking great in Scotland. Although, it does appear that hospitalisations aren't really translating into deaths.

 

[Brainaddict]

Data geeks don’t work on a couple of anecdotes

As to (a) above - if people test lft and don’t pcr report wouldn’t this raise test positivity

Anecdotes aren't data but there's nothing wrong with using anecdotes to inspire you to go looking for something in data. Scientists often go looking for things based on 'instinct', personal experience and all sorts of 'unscientific' factors. In fact those factors are very much necessary for uncovering things that looking at data alone wouldn't have told you.

 

[Supine]

Anecdotes aren't data but there's nothing wrong with using anecdotes to inspire you to go looking for something in data. Scientists often go looking for things based on 'instinct', personal experience and all sorts of 'unscientific' factors. In fact those factors are very much necessary for uncovering things that looking at data alone wouldn't have told you.

Thanks for the science lesson

Put forward your hypothesis and we can test it

 

[Dogsauce]

They were one of the later areas to go back then. A lot of places were the week before that. Leicestershire were even earlier back.

Its possible to see the same data per local area on the dashboard, and the school restart sends a strong enough signal in the data that such graphs of tests conducted probably allow us to figure out when term started in different places without even having to look the term dates up! But I cant really be filling this thread up with all of those. But just to give one example, the one below is for lateral flow tests in Leicestershire.

View attachment 287585

Do these tests only include NHS tests? There will have been a lot of private testing towards the end of the summer break as people came back from holidays overseas. Where do those numbers go, are they excluded or differentiated somehow?

 

[Teaboy]

The vaccine (dubious name) doesn't prevent infection or onward transmission.

I have no idea why you would speak with such assured and ill-deserved confidence on a matter where there remains so many unknowns. Have the last 18 months taught you nothing?

What they have taught me is to be very distrustful of those who would claim to make bold absolutist claims during this pandemic.