Coronavirus in the UK - news, lockdown and discussion

[ignatious]

A study started here (in Oxford, London, Southampton and Bristol) on Thursday just. Runs until May 2021.

I think the suspicion is that we export such trials so as to avoid potentially endangering our own population. I’m not sure that is justified, but that was my reading of the question.

Is it a valid concern or are there other reasons (genetic, for example) why testing in multiple areas of the world would be beneficial?

 

[butchersapron]

Every single person named or posting in the above exchange went to oxbridge.

 

[teqniq]

A Labour peer said this today:



Now I have no love of either regime but regardless of where the outbreak started, with the UK and US set to be amongst the higherst death tolls to suggest that capitalism had no part to play in that is disingeneous to say the least

 

[killer b]

It depends where the new infections are coming from. Are they a result of the crumbling lockdown, or are they a result of the ongoing failures of the testing and ppe regimes? Or a combination of both, and if so, what combination?

The next steps the govt needs to take have not changed now for more than a month. They desperately need to sort out ppe and hospital infection control in general, and, related to that because it's impossible to do without it, they need to sort out a test-trace-isolate regime.

I think a focus on the crumbling at the edges of lockdown is a distraction, tbh. Those countries that have seen infection rates drop - what is it they have done that the UK hasn't done? The answer is almost certainly to do with ppe, infection control and testing.

I think you misunderstand me: I don't think the lockdown crumbling round the edges now will be showing in the new infections yet. But I think it crumbling while infection rates are still very high, before the numbers are low enough for a test/trace/isolate regime to be effective without being totally overun, and while trust in their abilities to deal with things is rapidly dropping makes their future options - even if they manage to sort out hospital infection control, PPE etc - pretty limited.

 

[treelover]

Johnson is quoting Cicero, 'the health of the nation is supreme', looks like his NDE may have had an effect, not sure unlock is coming.

 

[smokedout]

I think this story and this story in the graun today, taken together, are very bad news for the government. As discussed elsewhere, diligent observation of the lockdown is crumbling, but if a) the lockdown has yet to have a significant impact in the hospitalisation figures, and b) trust in the government is plummeting, it's difficult to know what the next steps are.

Both Spain and Italy locked down non essential production and both have had shorter peaks than the UK has had so far. I think the reason the decline here has been so slow here is that half the country is still going to work. And rather than do anything about that it looks like if anything we'll get some stupid pointless rules about how far away from your hosue you can walk that won't make any difference as they are dong in Wales and will only build resentment. All the evidence seems to show that face to face contact is the main driver of transmission, you are far more likely to get it from a friend, someone you live with or a colleague than in the street or the supermarket. Tinkering around with the least effective drivers of transmission whilst ignoring or even escalating the most likely by insisting people get back to work is only going to make everyone miserable and pissed off and prolong the time it takes to bring infections down - if that can even be achieved when construction sites, unnecessary call centres and many other workplaces are still open.

 

[treelover]

Scotland should consider social and economic reform post-virus, Sturgeon says - The Courier

Scotland should “look seriously at social and economic reform” in its planning for recovery from the coronavirus pandemic, Nicola Sturgeon has said.

www.thecourier.co.uk

Nice to see this being said.

The right are also planning a different future

 

[treelover]

It depends where the new infections are coming from. Are they a result of the crumbling lockdown, or are they a result of the ongoing failures of the testing and ppe regimes? Or a combination of both, and if so, what combination?

The next steps the govt needs to take have not changed now for more than a month. They desperately need to sort out ppe and hospital infection control in general, and, related to that because it's impossible to do without it, they need to sort out a test-trace-isolate regime.

I think a focus on the crumbling at the edges of lockdown is a distraction, tbh. Those countries that have seen infection rates drop - what is it they have done that the UK hasn't done? The answer is almost certainly to do with ppe, infection control and testing.

Package on BBC news about South Africa, despite being poor country, hard to observe S/D, they have kept cases well down, by employing thousands of community nurses, we have district nurses, a substantial if fraying regional/local public health ecology, why haven't they use it?

 

[killer b]

I don't think the district nurses have been sat idle this last month tbf

 

[treelover]

beneft bashing was pretty high during the new labour period as well.

 

[SheilaNaGig]

Johnson is quoting Cicero, 'the health of the nation is supreme', looks like his NDE may have had an effect, not sure unlock is coming.

Well they need to fucking police it properly then, and pay people so we can stay home, and test and trace, and provide PPE to carers and hospital staff.

 

[treelover]

I don't think the district nurses have been sat idle this last month tbf

of course, i am talking about scale.

 

[Thora]

Package on BBC news about South Africa, despite being poor country, hard to observe S/D, they have kept cases well down, by employing thousands of community nurses, we have district nurses, a substantial if fraying regional/local public health ecology, why haven't they use it?

I imagine district nurses are pretty busy at the moment, especially as lots of their patients were discharged from hospital at the beginning of this.

 

[Marty1]

Driver clocked doing 134mph in a 40 zone in London!!

 

[killer b]

of course, i am talking about scale.

there has been attempts made to increase the healthcare workforce by appeals for ex-healthcare workers to return to healthcare, and via early graduation, with some success. I'm not sure where else we'd find any fully trained nurses to increase the scale of the operation though, any ideas?

 

[Taphoi]

Deaths-per-Day continues to tell a fascinating story. The attached chart uses NHS England statistics from Statistics » COVID-19 Daily Deaths

Analysis is based on a 25-day interval between infection and death (with a standard deviation of just over a day) which is based on a Lancet study. Several facts emerge:

• Until mid-March there was under-reporting of deaths related to Covid-19 in English hospitals
• The initial unchecked spread-rate was such as to double deaths-per-day every 3.5 days
• In early March the government instructed people with symptoms to isolate at home. This immediately reduced the spread-rate of fatal infections to doubling every 8.7 days, which was manifested in the trend of deaths-per-day from 29th March
• On the weekend of 14th-15th March the government instructed high-risk groups (over 70’s plus those with health conditions) to isolate at home. This caused deaths-per-day to peak 25-days later on 8th April and to start to decline such as to halve every 38 days
• The early evidence is that the broad lockdown caused a slight increase in the rate of decline of deaths-per-day to halving every 17 days, such that deaths-per-day in hospitals in England should fall below 100 in mid-May (the relatively small impact of the broad lockdown is probably due to unchecked spread within care homes and poor PPE in hospitals causing them to act as spread centres to some extent; also, it is hard for locking down low-risk people to influence fatal infections very much, because statistics continue to show that at least 99% of all deaths are in defined high-risk groups)
• The broad lockdown did not save hospitals from being overwhelmed, because that had already been achieved by the isolation of high-risk groups
• The only merit of the broad lockdown is to reduce virus incidence in the community at large to a level where a substitute test-and-trace policy can practicably replace it
• If the broad lockdown were stopped tomorrow, but isolation with symptoms and isolation of high-risk groups were maintained, fatal infections would continue to decline
• If the broad lockdown were replaced by a policy of promptly testing everyone with symptoms, isolating positive cases and tracing and isolating their contacts, then deaths-per-day would fall much more rapidly from 25-days forward of the implementation of that policy

(The 7-day weighted average is calculated as [(0.25*day-3+0.5*day-2+0.75*day-1+day+0.75*day+1+0.5*day+2+0.25*day+3)/4])

 

[2hats]

I think the suspicion is that we export such trials so as to avoid potentially endangering our own population. I’m not sure that is justified, but that was my reading of the question.

Is it a valid concern or are there other reasons (genetic, for example) why testing in multiple areas of the world would be beneficial?

You'd would ideally want to test in as wide and as varied samples of the global population as possible. Identify/control for/remove societal/cultural/genetic variables. In this instance time is of the essence so being able to call upon pre-existing networks, infrastructure, relationships is clearly going to help that.

 

[Mation]

A study started here (in Oxford, London, Southampton and Bristol) on Thursday just. Runs until May 2021.

You said small trial here, then large scale trial abroad. I was wondering why the large one won't be here.

 

[Mation]

I think the suspicion is that we export such trials so as to avoid potentially endangering our own population. I’m not sure that is justified, but that was my reading of the question.

Is it a valid concern or are there other reasons (genetic, for example) why testing in multiple areas of the world would be beneficial?

Aye, this, including not being sure if this is likely.

 

[Doodler]

Driver clocked doing 134mph in a 40 zone in London!!

Saw some mad driving on a big dual carriageway in east London recently. High-performance BMWs, Mercs etc racing each other, jumping in and out of lanes, never seen so much of that before on one stretch. Half-empty roads are like a dream come true for them.

 

[spitfire]

Saw some mad driving on a big dual carriageway in east London recently. High-performance BMWs, Mercs etc racing each other, jumping in and out of lanes, never seen so much of that before on one stretch. Half-empty roads are like a dream come true for them.

Was it the A12? There are always complete fuckwits haring down there in normal times, can't imagine what they're like right now.

 

[Doodler]

Was it the A12? There are always complete fuckwits haring down there in normal times, can't imagine what they're like right now.

Yes, it was the A12, Hackney to Bromley-by-Bow. It was like being inside GTA, eye-popping stuff.

 

[spitfire]

Yes, it was the A12, Hackney to Bromley-by-Bow. It was like being inside GTA, eye-popping stuff.

That's the one. I drive back and fro from Leyton/Forest Gate quite a bit and it's mad what some of them think they can get away with, and do.

Our area is usually quite bad for dickheads but seems to be quieter since lockdown started.

 

[littlebabyjesus]

Deaths-per-Day continues to tell a fascinating story. The attached chart uses NHS England statistics from Statistics » COVID-19 Daily Deaths

Analysis is based on a 25-day interval between infection and death (with a standard deviation of just over a day) which is based on a Lancet study. Several facts emerge:

• Until mid-March there was under-reporting of deaths related to Covid-19 in English hospitals
• The initial unchecked spread-rate was such as to double deaths-per-day every 3.5 days
• In early March the government instructed people with symptoms to isolate at home. This immediately reduced the spread-rate of fatal infections to doubling every 8.7 days, which was manifested in the trend of deaths-per-day from 29th March
• On the weekend of 14th-15th March the government instructed high-risk groups (over 70’s plus those with health conditions) to isolate at home. This caused deaths-per-day to peak 25-days later on 8th April and to start to decline such as to halve every 38 days
• The early evidence is that the broad lockdown caused a slight increase in the rate of decline of deaths-per-day to halving every 17 days, such that deaths-per-day in hospitals in England should fall below 100 in mid-May (the relatively small impact of the broad lockdown is probably due to unchecked spread within care homes and poor PPE in hospitals causing them to act as spread centres to some extent; also, it is hard for locking down low-risk people to influence fatal infections very much, because statistics continue to show that at least 99% of all deaths are in defined high-risk groups)
• The broad lockdown did not save hospitals from being overwhelmed, because that had already been achieved by the isolation of high-risk groups
• The only merit of the broad lockdown is to reduce virus incidence in the community at large to a level where a substitute test-and-trace policy can practicably replace it
• If the broad lockdown were stopped tomorrow, but isolation with symptoms and isolation of high-risk groups were maintained, fatal infections would continue to decline
• If the broad lockdown were replaced by a policy of promptly testing everyone with symptoms, isolating positive cases and tracing and isolating their contacts, then deaths-per-day would fall much more rapidly from 25-days forward of the implementation of that policy

(The 7-day weighted average is calculated as [(0.25*day-3+0.5*day-2+0.75*day-1+day+0.75*day+1+0.5*day+2+0.25*day+3)/4])

That is certainly a plausible story. It contains a few assumptions such that being so confident as to call your bullet points 'facts' is a little too strong, but I agree that the evidence does seem to be mounting that ongoing infection is due to spread in hospitals and social care.

For me, a very important question has to do with which bits of lockdown are the big ticket items wrt spread. I suspect that, in London, the ending of mass transit has been one of the biggest or the biggest factor. From what I understand of transmission, a packed tube train allows for at least three means of transmission - touching an infected surface then your face, being directly coughed/breathed at, and breathing in infected aerosol.

 

[2hats]

You said small trial here, then large scale trial abroad. I was wondering why the large one won't be here.

I probably should have been clearer. I meant widening the overall study, rather than size of sample in any one geographically constrained trial within the study. They haven't published participant numbers for any trial beyond the initial, current, UK based one (not least because they are yet to negotiate with various authorities how that might proceed).

Read more here.

 

[treelover]

My friend has just told me her neighbour had a barbeque yesterday with about 15 people there, not the first and where her partners boat is moored in Goole, every day is party day at the moment.

 

[littlebabyjesus]

Both Spain and Italy locked down non essential production and both have had shorter peaks than the UK has had so far. I think the reason the decline here has been so slow here is that half the country is still going to work. And rather than do anything about that it looks like if anything we'll get some stupid pointless rules about how far away from your hosue you can walk that won't make any difference as they are dong in Wales and will only build resentment. All the evidence seems to show that face to face contact is the main driver of transmission, you are far more likely to get it from a friend, someone you live with or a colleague than in the street or the supermarket. Tinkering around with the least effective drivers of transmission whilst ignoring or even escalating the most likely by insisting people get back to work is only going to make everyone miserable and pissed off and prolong the time it takes to bring infections down - if that can even be achieved when construction sites, unnecessary call centres and many other workplaces are still open.

Yep, totally agree. That said, we shouldn't overstate the differences between the UK's curve and those of Italy and Spain. UK deaths are still on a downward slide since the peak day of 8 April. Looking at the latest figures from today spread out over day of death, deaths in hospital are down by around a third from the peak week. In Italy at the same time after peak week, deaths in hospital were also down by about a third.

Latest totals allocated to day of death for England



We're still suffering sadly from the lack of testing. So we don't have any other reliable info on the current state of infection other than hospital admissions/deaths. In Italy and elsewhere, far more testing has been done and they can now see downward trends there as well.

 

[elbows]

Yep, totally agree. That said, we shouldn't overstate the differences between the UK's curve and those of Italy and Spain.

In order to attempt to compare like for like, I've had to use reported hospital deaths per day instead of the corrected data showing deaths on the actual day they happened. I've also left out the care home numbers for France, and stuck to their original hospital deaths figures for the duration instead, otherwise there are some huge bumps in their data.



My main conclusion is that its still a little early in the UKs epidemic to do this comparison.

I was hoping to use intensive care data to do a similar comparison, but the way the UK reporting of this changed (after a lengthy absence) and also some issues with Spains ICU data has somewhat thwarted this. I will still look into it and report back if there is something useful that can be seen.

The other factor I want to look into in regards the UK is the possibility that the broader spread of infection in this country changes the picture compared to Italy and Spain, for example. Some analysis of specific regions is therefore also on my agenda, not sure when.

 

[2hats]

Deaths-per-Day continues to tell a fascinating story. The attached chart uses NHS England statistics from Statistics » COVID-19 Daily Deaths

Deaths in hospitals (of those who tested positive) doesn't tell us much about the wider national situation (it doesn't even give us the entire picture in hospital). We have patchy data for community, care home and other institutionalised settings. The data are incomplete, some incorrectly binned. Each cohort has a differing effective reproduction rate at any given instance and each of those is time varying. It is going to take many more weeks, months to build a sound dataset for detailed analysis.

Analysis is based on a 25-day interval between infection and death (with a standard deviation of just over a day) which is based on a Lancet study

Which study?

 

[wayward bob]

just looking at your curves elbows (sorry, can't help it ) we look a lot flatter in the tail of the "peak" so far...