Coronavirus in the UK - news, lockdown and discussion
- Thread starter Sasaferrato
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elbows
Well-Known Member
When people say that its usually because they are comparing child admissions now compared to all previous stages of the pandemic.
Meanwhile I was just about to comment on the reinfections stuff coming to the UK dashboard soon, but it appears that the announcement has been deleted!
Meanwhile I was just about to comment on the reinfections stuff coming to the UK dashboard soon, but it appears that the announcement has been deleted!
elbows
Well-Known Member
Given the current phase and some themes that keep coming up, including in a propaganda context, I am paying attention to twitter thread like the following ones.
Since flu is often dragged into the mix I am also revisiting my past reading on notable flu epidemics in the UK and how they were reported at the time. I will have something to say about that later today or perhaps tomorrow if I run out of time.
Since flu is often dragged into the mix I am also revisiting my past reading on notable flu epidemics in the UK and how they were reported at the time. I will have something to say about that later today or perhaps tomorrow if I run out of time.
littlebabyjesus
one of Maxwell's demons
From initial reports I've read, hospital admissions of young children are up with omicron (from almost zero), but the majority of the cases are not of serious illness and hospital stays are brief, which hopefully is reflected in the death figures there - one baby that week, by the looks of it, but nobody else under 15.
I would still argue that covid-19 remains a very minor threat to the health of the under-18s, whether they are vaccinated or not, but that it is making some very young children ill is new.
I don't know how that compares to flu. I suspect it may not be very different. Flu can also make young children very ill. Also, there is a possible behaviour change here. I haven't had the flu since I was a kid, but I remember being flattened by it for many days. I didn't go to hospital despite running a fever and feeling like death, but I suspect that, at the moment, parents are (understandably) more likely to take their kid to the hospital if they get that sick with covid.
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elbows
Well-Known Member
Such discussions are hampered by the low numbers in absolute terms. And the attitudes people have towards deaths that primarily occur in people already classed as vulnerable. There is also an association between certain ethnicities and child death risk.
In terms of covid, see this stuff I posted yesterday: #46,061
In terms of influenza, those complications exist too, but there are some additional ones. Firstly the 2009 swine flu pandemic gave us a strain that affected children more than normal. For some details on numbers and risk factors, see articles like this one:
Child swine flu deaths analysed | NICS Well
“The flu pandemic in England killed 70 children in 2009,” The Guardian has reported. The newspaper says that “most of those who died had pre-existing health ...
www.nicswell.co.uk
Part of my planned talk about flu and attitudes and reporting during large, deadly flu epidemics in this country in the last 40 years will address another big issue with flu data. I may as well mention it now - there has been no mass testing, so much is left to opinion which distorts the figures and leaves us reliant on other measurements such as excess mortality and all cause mortality, or broader sentinel indicators such as 'influenza-like illness'. The sort of thing that causes arguments whenever we try to come up with realistic number of flu deaths in both normal years and epidemic years.
Take for example the really bad UK flu epidemic of late 1989/early 1990. That epidemic came after quite a number of years without an epidemic, and acted as a wake up call which helped sponsor a vastly larger flu vaccination programme in subsequent decades. But when it comes to collective public memories, such epidemics tended to hardly leave a mark. And I would suggest that a big reason why is down to the nature of influenza death numbers reporting during the epidemics. Lack of mass testing and the fact that even stuff like death certificate causes are heavily influenced by local attitudes towards whether a flu epidemic has arrived there, means the number of confirmed flu deaths reported in the media at the time were an absolute disgrace that was entirely divorced from reality. Unfortunately various links I saved last night are not showing up on my computer right now, but I will return later with some vivid examples of what I am on about in this regard.
Most of what I've just ranted about in regards flu involves older adults, but it obviously has consequences for data regarding the smaller number of deaths involving children too.
Another thing to consider is how poor our typical awareness of paediatric health system pressures from other respiratory infections are, including ones that are considered to disproportionately affect children. An obvious example is RSV. RSV resurged last summer, at about the same time as there were Delta pressures, and was responsible for quite a chunk of the prolonged strain the health system was placed under during that period. It was quite widely reported on at the time, but did not generate too much discussion here. Some of the way it presents may have much in common with the way Omicron has been leading to greater hospitalisations of children recently.
danny la rouge
More like *fanny* la rouge!
This is my BBC News app today.
Help me out here. I work in education in Scotland. I’m tired. So very tired. What am I supposed to do with this information?
Help me out here. I work in education in Scotland. I’m tired. So very tired. What am I supposed to do with this information?
elbows
Well-Known Member
So then, reporting of the really bad influenza epidemic of 1989/90, and the ridiculous undercounting of deaths:
December 1989:
www.upi.com
In my next post I will deal with the actual number of deaths and some of the professional attitudes towards testing, sentinel surveillance etc.
December 1989:
English flu' rages in Britain - UPI Archives
Scores of nurses are among the latest victims of an influenza epidemic sweeping through Britain, straining the resources of hospitals throughout the country,...
www.upi.com
In my next post I will deal with the actual number of deaths and some of the professional attitudes towards testing, sentinel surveillance etc.
elbows
Well-Known Member
The picture of the 1989 epidemic via this paper which uses surveillance via the weekly returns service of the Royal College of General Practitioners:
I will only quote a couple of bits, the paper is quite short and worth a look if interested in graphs, sentinel surveillance methods and attitudes towards illness classification.
Hence my rants not just about bad influenza death data, but also the traditional attitude towards actually testing patients rather than guessing, a phenomenon that persisted right up until the current pandemic forced mass diagnostics testing onto the agenda in a massive way!
As for massive death undercounting:
So contrast the picture revelaed by that report to the stupidly low numbers that featured in the press articles I mentioned from December 1989.
I rather suspect that public attitudes towards those epidemics of influenza would have been idfferent if we'd had ass testing and daily death figures widely reported back then.
Just to illustrate the true burden, here are daily deaths from all causes graphs for England and Wales that year, as well as another year I often go on about in regards flu epidemics that people dont remember, and an early version of the same figures for 2020. I moved the 1989/90 and 99/00 months on the x axis so that the winter fell in the middle of the period rather than being chopped off mid-peak by the year-end boundaries. No such adjustment was required for 2020 since that first wave didnt happen in winter.
I will only quote a couple of bits, the paper is quite short and worth a look if interested in graphs, sentinel surveillance methods and attitudes towards illness classification.
Hence my rants not just about bad influenza death data, but also the traditional attitude towards actually testing patients rather than guessing, a phenomenon that persisted right up until the current pandemic forced mass diagnostics testing onto the agenda in a massive way!
As for massive death undercounting:
So contrast the picture revelaed by that report to the stupidly low numbers that featured in the press articles I mentioned from December 1989.
I rather suspect that public attitudes towards those epidemics of influenza would have been idfferent if we'd had ass testing and daily death figures widely reported back then.
Just to illustrate the true burden, here are daily deaths from all causes graphs for England and Wales that year, as well as another year I often go on about in regards flu epidemics that people dont remember, and an early version of the same figures for 2020. I moved the 1989/90 and 99/00 months on the x axis so that the winter fell in the middle of the period rather than being chopped off mid-peak by the year-end boundaries. No such adjustment was required for 2020 since that first wave didnt happen in winter.
andysays
Love and solidarity
littlebabyjesus
one of Maxwell's demons
Figures for England show that covid is on the rise in young children - quite sharply in those under 10, and a bit less sharply in 10-14. It's also rising slightly in their parents' age group. It is still falling among other age groups. The overall effect in England is that total case numbers are more or less flat, and have been for the last two weeks, at about half their peak.
The govt website doesn't give age breakdowns for Scotland or Wales, but both of these have seen sharper overall falls than England. I suspect that the child-related surge is either smaller there or hasn't happened yet. The timing of these things varies across the country - for instance, Scotland saw a school-related surge in Delta in September, a few weeks before England and Wales. So Scotland might be about to see a similar rise in children. I wouldn't rule it out. tbh people working at home or in the office isn't likely to make much difference. The dynamic is that it's spread at school then the kids come home and give it to their parents.
There is good news. Cases in the most vulnerable groups are well down and hospitalisations and deaths should fall over the coming couple of weeks. All politicians have form for announcing successes prematurely, though, including Sturgeon.
Sorry don't even know if that helps. Probably not.
elbows
Well-Known Member
A final though on my recent flu posts:
Frankly the amount of testing for influenza and the nature of sentinel surveillance, and almost non-existent surveillance of the other existing human coronaviruses means that I cannot even be sure that every bad epidemic and wave of death this country experienced in the last 50 years was actually a straightforward story of influenza epidemics. I'm not going to make wild claims about whether we had a bad wave of coronavirus deaths as part of the real picture of those years, but neither can I entirely exclude the possibility.
Also my brother developed type 1 diabetes in the wake of the 1989 wave so I have a special interest in the subject and try to keep as many angles open as possible, given that his son developed type 1 diabetes in the current pandemic.
Frankly the amount of testing for influenza and the nature of sentinel surveillance, and almost non-existent surveillance of the other existing human coronaviruses means that I cannot even be sure that every bad epidemic and wave of death this country experienced in the last 50 years was actually a straightforward story of influenza epidemics. I'm not going to make wild claims about whether we had a bad wave of coronavirus deaths as part of the real picture of those years, but neither can I entirely exclude the possibility.
Also my brother developed type 1 diabetes in the wake of the 1989 wave so I have a special interest in the subject and try to keep as many angles open as possible, given that his son developed type 1 diabetes in the current pandemic.
littlebabyjesus
one of Maxwell's demons
That thought has occurred to me as well.
If the initial wave had been of a virus that affected the population in the way omicron is affecting the population now, tests for it wouldn't have been developed. It would just have been 'a bad cough that's going around', I would have thought. We might well not ever have identified it, especially given the speed at which it spreads.
littlebabyjesus
one of Maxwell's demons
Not really that surprising, tbh. If the peak ends up being 15 Jan, that's almost exactly two weeks after the peak in cases at the end of last year, which is more or less what you'd expect.
elbows
Well-Known Member
I know what you mean and I dont need to pick it apart because you were careful to say 'the way omicron is affecting the population now', which is a combination of the intrinsic properties of omicron along with the high levels of infection from previous strains and the massive number of vaccines given (ie population not naive to this virus in its broadest sense).
We can apply some of these concepts in regards surveillance and what signals are strong enough to trigger alarm and proper investigation to the original detection of the pandemic too. Actually spotting it in Wuhan required a combination of: an unusual and large number of severe cases within a narrow timeframe, someone to actually notice this, with quick discovery of the underlying cause likely being helped by it taking place in a country with SARS awareness, in a city with specialist SARS-like viral research institutes.
Other countries further demonstrated that point by still not managing to notice what stage of wave they were at until they broadened their testing criteria for the severely ill and then actually noticed they had already started seeing deaths from this virus. I do wonder quite how many deaths we missed before the first wave fully exploded. And we could also consider the possibility that if early phases of seeding and spread involved younger people who were much less likely to require clinical attention, the failure to notice something was happening at all could have been really quite prolonged regafdless of whether we were armed with the info from China at all.
Although I moan about sentinel surveillances limitations compared to massive routine diagnostic testing, sentinel surveillance systems are good enough to spot epidemics and trends, albeit with a bit of lag. But that only applies when the disease in question is actually the subject of sentinel surveillance in the first place. Unlike influenza, RSV, Rhinovirus, etc, I've seen precious little indication that we have the same systems in place for the 4 known human coronaviruses that predate the current pandemic virus. We do have the much broader surveillance categories of 'influenza-like illness' and 'acute respiratory infection', but these can end up being part of the picture of assumtions, conflation and complacency.
I still hope that if this pandemic achieves anything long-term, its that attitudes towards mass diagnostics testing in this country will be permanently changed.
elbows
Well-Known Member
Yes and the prolonged plateau isnt unexpected either, given differences in regional timing, the possibility of outbreaks in certain settings coming a bit later (eg care home and hospital outbreaks were often a bit later in the first waves, not sure about this time). Also when we see incredibly sharp spikes in the daily positive case number. peaks, I tend to assume these are a bit of a distortion of the actual picture, which still has pronounced peaks but probably not quite as abrupt in reality.
brogdale
Coming to terms with late onset Anarchism
I get that, and your rational, level analysis is always welcome.
That said, in the context of the tory triumphalism, and vibe that it's all over...439 is a bit "fuck", no?
elbows
Well-Known Member
Not really because thats deaths by reporting date, as in:
As opposed to deaths by date of death which is the data I prefer to look at otherwise we get the same pattern of alarm after every weekend when the above are doing their regular catch-up act.
elbows
Well-Known Member
As for the tories, yes they like to promote a sense of the worst being over whenever they can, but even Johnson has to go on about it not actually being all over.
Where they do have a sense of it being all over is in terms of the wave and the trigger points that force even them to impose restrictions. Which largely boils down to concerns about ever higher daily hospital admissions figures, and in this wave we've gone past that point of concern. Which is not to say that the situation cannot deteriorate again in future, including in the future of the current wave. But for now they've done their usual, just a bit sooner than in previous waves because the scale of things was lower this time, and they arent even trying to drive cases down to very very low levels, unlike what they were trying to get to via the prolonged restrictions in the first two waves.
And yes this approach is not without risk. But Im not going to be able to muster the energy to go on about that risk endlessly, I'll just have to wait like everyone else and see if it all starts to go wrong again in the coming months (or doesnt finish going wrong in terms of current levels of death etc persisting).
Where they do have a sense of it being all over is in terms of the wave and the trigger points that force even them to impose restrictions. Which largely boils down to concerns about ever higher daily hospital admissions figures, and in this wave we've gone past that point of concern. Which is not to say that the situation cannot deteriorate again in future, including in the future of the current wave. But for now they've done their usual, just a bit sooner than in previous waves because the scale of things was lower this time, and they arent even trying to drive cases down to very very low levels, unlike what they were trying to get to via the prolonged restrictions in the first two waves.
And yes this approach is not without risk. But Im not going to be able to muster the energy to go on about that risk endlessly, I'll just have to wait like everyone else and see if it all starts to go wrong again in the coming months (or doesnt finish going wrong in terms of current levels of death etc persisting).
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elbows
Well-Known Member
Pandemic shithead Nick Triggle spinning the scene for a long Omicron tail:
From 17:08 of the BBC live updates page.
From 17:08 of the BBC live updates page.
littlebabyjesus
one of Maxwell's demons
Yep that. And also, while the average between testing positive and death may be around 2 weeks, that covers a wide variation from a few days to a couple of months. That will also flatten the peak compared to cases.
elbows
Well-Known Member
Also there was quite a lot of sync between intensive care numbers and deaths in earlier waves. The pattern this time seen with ICU numbers has exceeded even 'Omicron mild' and 'incidental covid' fans expectations so far, I would guess. Especially if we look at regions other than London, which often didnt even have the rise initially seen in London. I do need to look at deaths per region more to get a better handle on how these two forms of data compare this time, whether it diverges in the manner we might predict.
I know too much emphasis on 'incidental' hospitalisations and deaths provokes rants from me, but I dont deny that they are likely a larger proportion this time due to the very high case rates and different severe disease impact. Due to ONS deaths reporting lag theres never quite a perfect time to use differences between ONS death certificate death figures and 28 day positive test death figure to explore 'incidental' deaths further, but once the ONS data gets properly filled in for the period right up to that which covers some initial decline in deaths in this wave I'll take another look at that.
Although any conclusions I reach will have to be tempered by a subject not entirely unrelated to what I was talking about with flu earlier - recording cause of death is not a perfect science, and it would be especially easy to reach some wrong conclusions if the mechanisms of death are slightly different, or in different proportions, with Omicron compared to earlier variants. For example death certificate based forms of recording death reasons are influenced by attitudes, and attitudes are influenced by factors that include whether death comes via obvious respiratory distress compared to some of the other modes of covid death such as strokes and heart attacks. Much of the potential to make errors in that regard have been limited by the presence of a large testing system, and a huge amount of pandemic awareness/assumptions in the minds of those filling in the death certificates. But those attitudes will probably start to evolve at this stage or sometime later this year. And then when we come to try to use differences between death certificate death figures and deaths within 28 days of a test numbers, to spot differences that could be attributed to 'incidental' deaths since those are inevitably fully present in 'deaths within 28 days of a test' figures, we might go too far. As if we want to try to exclude some of the 'incidentals' showing up via formal testing, we'll inevitably be reducing the weight of such tests in a manner that starts to strip away the protection the testing system has offered against underreporting on death certificates. All of which means I expect we wont get perfect answers, we'll end up with a somewhat plausible range of deaths in the figures that may be 'incidental' in that they would have happened anyway even without the pandemic.
But like I said, the matter of accurately recording death causes is not a perfect science at the best of times and is often a complicated mix of causes. The story of each persons death is often a story of their life, and of much more gradual decline in the years preceding the final curtain. And thats always the case, with or without the pandemic, which is one of the reasons I start ranting when people use 'incidental' stuff to make too strong a point. Yes such things affect perceptions, and certainly affect numbers we should have in mind when it comes to whats acceptable in regards long term living with this virus, at what levels restrictions are appropriate etc. But these details dont actually make much difference to the health care systems and death management systems, and their capacity to cope. Which is after all the bottom line as far as strong government decisions that affect all our lives dramatically are concerned. Without that heavy stuff we are back to the old status quo and indifference, punctuated only ineffectively by people like me ranting to a much reduced audience in very dusty corners of the internet.
I know too much emphasis on 'incidental' hospitalisations and deaths provokes rants from me, but I dont deny that they are likely a larger proportion this time due to the very high case rates and different severe disease impact. Due to ONS deaths reporting lag theres never quite a perfect time to use differences between ONS death certificate death figures and 28 day positive test death figure to explore 'incidental' deaths further, but once the ONS data gets properly filled in for the period right up to that which covers some initial decline in deaths in this wave I'll take another look at that.
Although any conclusions I reach will have to be tempered by a subject not entirely unrelated to what I was talking about with flu earlier - recording cause of death is not a perfect science, and it would be especially easy to reach some wrong conclusions if the mechanisms of death are slightly different, or in different proportions, with Omicron compared to earlier variants. For example death certificate based forms of recording death reasons are influenced by attitudes, and attitudes are influenced by factors that include whether death comes via obvious respiratory distress compared to some of the other modes of covid death such as strokes and heart attacks. Much of the potential to make errors in that regard have been limited by the presence of a large testing system, and a huge amount of pandemic awareness/assumptions in the minds of those filling in the death certificates. But those attitudes will probably start to evolve at this stage or sometime later this year. And then when we come to try to use differences between death certificate death figures and deaths within 28 days of a test numbers, to spot differences that could be attributed to 'incidental' deaths since those are inevitably fully present in 'deaths within 28 days of a test' figures, we might go too far. As if we want to try to exclude some of the 'incidentals' showing up via formal testing, we'll inevitably be reducing the weight of such tests in a manner that starts to strip away the protection the testing system has offered against underreporting on death certificates. All of which means I expect we wont get perfect answers, we'll end up with a somewhat plausible range of deaths in the figures that may be 'incidental' in that they would have happened anyway even without the pandemic.
But like I said, the matter of accurately recording death causes is not a perfect science at the best of times and is often a complicated mix of causes. The story of each persons death is often a story of their life, and of much more gradual decline in the years preceding the final curtain. And thats always the case, with or without the pandemic, which is one of the reasons I start ranting when people use 'incidental' stuff to make too strong a point. Yes such things affect perceptions, and certainly affect numbers we should have in mind when it comes to whats acceptable in regards long term living with this virus, at what levels restrictions are appropriate etc. But these details dont actually make much difference to the health care systems and death management systems, and their capacity to cope. Which is after all the bottom line as far as strong government decisions that affect all our lives dramatically are concerned. Without that heavy stuff we are back to the old status quo and indifference, punctuated only ineffectively by people like me ranting to a much reduced audience in very dusty corners of the internet.
Sunray
Its sunny somewhere.
Here is as accurate atomic image of the virus as humans can produce. Not sure how they produced it, it’s not clear. I know there are protein folding modelling simulations on super computers but I think accurate modelling is currently considered NP so I think it might be other methods.
commons.m.wikimedia.org
File:Coronavirus. SARS-CoV-2.png - Wikimedia Commons
elbows
Well-Known Member
The info about reinfections being counted on the dashboard from next Monday is back, looks like they just jumped the gun a bit when this first came up but then vanished. Well actually I wouldnt be surprised if they made changes to exactly what data this would affect, but right now I'm not sure if I will be able to figure out what changed compared to the original description of what would change, I'll investigate.
I guess I will do a 'before and after' graph for cases by specimen date when this change happens.
I guess I will do a 'before and after' graph for cases by specimen date when this change happens.
Dogsauce
I’ve got Skol but I’m not a Scholar
Would have thought reinfections were quite a significant proportion now, hearing of a lot of people having it twice, and may do myself if I ever get my PCR result back. Wonder how it will affect the slopes on graphs, whether it’s just a percentage increase consistent over time or shows something else such as cases not declining.
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