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Coronavirus in the UK - news, lockdown and discussion

Most people just want to know when things will get back to normal. Of course there is no answer, but it’s still a reasonable thing to want to ask

The answer to that question has been given to that many, many times and the reality is getting 'back to normal' is a long time off, but exactly when depends on a load of variables, until then we need to adjust to this.

It's shit, but constantly asking the same question isn't going to get any different answers for a while. It's like kids asking "Are we there yet?" incessantly when you've only just left the house.
 
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But the headline figures are still quoted as hospital deaths, and I think it has been those on the comparison graphs between countries, no? The figure the guardian gives for UK deaths in their counter box is just over 20k. I don't understand why. Sorry if this has been covered already, but just trying to work out what it means that care home deaths are not included in the main count and whether the death numbers are actually comparable between countries.

The problem has been the lag in collecting data, there's under 300 NHS trusts that are feeding figures into their system daily, whereas IIRC there's over 50,000 care settings, and there was no reporting system, so the ONS had to wait for deaths to be registered & collate data that way, as they are still doing with community deaths.

Someone I know that runs a care home told me last week, the Care Quality Commission had rolled out a new portal, for care homes to start reporting daily, which I guess is why the new ONS figures are for only up to 17/4/20, to include care homes AND community deaths, whereas the CQC announced care home deaths up to 24/4/20.
 
The problem has been the lag in collecting data, there's under 300 NHS trusts that are feeding figures into their system daily, whereas IIRC there's over 50,000 care settings, and there was no reporting system, so the ONS had to wait for deaths to be registered & collate data that way, as they are still doing with community deaths.
The lag is an issue for if you're trying to look at the trends over time. It's an issue if you want to report x number died per day. It's not an issue for reporting a total. I just find it strange the total known deaths aren't being reported very much. In fact, I don't know the total reported deaths up to now, even though that is clearly a figure both government and journalists have access to. I understand why the government wouldn't jump to report it, less clear on why journalists aren't.

Edit to add: of course there are always problems in definitions. But the point of this whole line of thought is that it is looking like hospital deaths is a poor proxy for full figures. Hospital deaths plus care home deaths would get closer, and if we have any decent figures on people who have died at home it should be hospital deaths + care home deaths + home deaths.
 
The press are against the lockdown generally as it presents a pretty immediate threat to their livelihoods. Keeping numbers low is in their interests too.
Not sure guardian gets much of its income from shops, and their website income has probably risen during lockdown. I don't really think it's a conspiracy or anything. I think it's just sloppiness in taking the figures the government offers them rather than doing a bit of work of their own. It's a really shit thing to be sloppy about.
 
It would just be brushed off with the usual guff tho. Without an option to follow up, pin down and tease out the contradictions between answers, they’re all going to be a bit rubbish really.
Sure, it would be brushed off, I'm not naive enough to think it would be answered by the minister saying "of course, Andy, we will immediately and completely rethink and revise the way work and workers are valued in the way this crisis has conclusively demonstrated we should do".

But that doesn't mean it isn't worth asking, even if only so we could all see them attempt to brush it off.

I doubt anyone will be allowed to put that question or a similar one to the relevant minister, for reasons already discussed.
 
Catching up with some reading - an interesting blog from the LSE on the role of experts at the start of the crisis and going forward...

Science in inaction – The shifting priorities of the UK government’s response to COVID-19 highlights the need for publicly accountable expert advice.

See even if you accept their concerns about people not accepting lockdown or it being unpopular then the answer to that would have been to start the 'messaging' earlier. They could have been putting out regular messaging in February for instance that companies should be putting plans in place to have some or all employees working from home at some point in the coming weeks. Depending on company decision-makers' attitudes to the risk loads more people could have been working from home part or full time in the weeks before official lockdown with little or no adverse effect on the economy, but a potentially large reduction in transmission. Many employers did this in the previous week despite the messaging not being there. Again depending on individuals' risk appetite stockpiling might have started earlier and been less panicked. That last minute panic probably increased transmission. etc etc.
 
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Not sure guardian gets much of its income from shops, and their website income has probably risen during lockdown. I don't really think it's a conspiracy or anything. I think it's just sloppiness in taking the figures the government offers them rather than doing a bit of work of their own. It's a really shit thing to be sloppy about.

One of the problems is that data journalists who want to cover this side of things properly are rather aware of lag and issues with historical comparisons.

The ones doing this properly are keenly aware that there is no point only looking at the deaths that actually ended up with Covid-19 on the death certificate. You have to look at excess mortality as a whole, because many deaths relating to pandemics and epidemics are never recorded as such, and this has been known for hundreds of years! So a better guide is to compare total deaths against the normal range of deaths for that time of year.

In recent weeks I immersed myself in historical data so that I could put current rate of death in context. Unfortunately there are issues with the format of historical data, so I am not always comparing like for like. I will explain a little using the latest number:

22,351 deaths were registered in England & Wales in the week ending 17th April. This compares to an average for that week over the previous 5 years of 10,497.

22,351 is a huge number for deaths registered in a week. But directly comparable, robust figures in that format only go back to 1993. And I currently only have such weekly figures going back to 1999. Using these, the highest I'd previously seen was 18,581 for the last week of 1999 when a nasty H3N2 flu epidemic was raging.

I do have daily death figures going back to the start of 1970. But these are based on actual date of death, not date of registration. I wont have equivalent daily total death figures for April 2020 for another month, so quite the wait to do a direct comparison. If I turn daily numbers into weekly numbers then I can get some clues, but still potentially misleading because the 2020 weekly figures I have are for registration date, not actual date of death. Even so, I can say that we are very much into the realm of the sorts of numbers of total deaths last seen when the H3N2 influenza pandemic of the late 1960s was doing its worst in England & Wales at the end of 1969 and start of 1970.

Anyway I am aware that this sort of historical analysis is just one way of looking at things, and it would be cause for single headlines, rather than ongoing front page news. There is nothing surprising about the fact that other, more readily accessible figures are being used daily, even though they dont come close to telling the whole story.

The actual picture in other countries also takes time to emerge. I dont even have equivalent numbers for Germany for March yet, let alone April.

Anyway, even though I prefer to look at all cause mortality, I still sometimes have to make do with Covid-19 specific ONS numbers instead when studying certain aspects. Because I do actually have daily numbers by date of death (not just date of registration) for those. For example here is an informative graph from the latest ONS release.


Screenshot 2020-04-28 at 12.48.38.png
This will be missing many deaths that were likely Covid-19 related but where it isnt mentioned ont he death certificate. So I use it more for a sense of proportions and timing rather than absolute magnitude.
 
They could say 21k hospital fatalities to make it more true. But really most people probably want to know how many people have died from covid-19 in the UK. Which is, what, 30k+ now? I'm just finding this approach odd.

Does it actually matter though?

Whether it's 20k or 30k or 40k - does this meaningfully affect anyone's decisions at present? What is important at the moment is the rate of change, and its direction.

The absolute numbers are useful in some extent to compare with what's going on in other countries, and I think you can come to some kind of useful conclusion when one country's number per capita is 10 or 100 times greater than another's - but beyond that, there are so many variables in how the numbers are reported, and in the implications of the numbers according to what ind of places the outbreaks are appearing in, that it's a fool's errand to try and extract much useful info from them.

The true numbers will undoubtably be important to establish in retrospect, and there will be a multitude of papers published which try and untangle some kind of meaning from the enormous amount of data that will come out of this crisis, and hopefully discover things that will be useful for future epidemics.
 
Am I right in thinking that people who are sadly dying in care homes won't actually be tested? I mean in that if they've not been tested already and they pass on no one is going to do an autopsy or anything? It'll just be the view of whomever writes up the death certificate, typically a local doctor?
 
Am I right in thinking that people who are sadly dying in care homes won't actually be tested? I mean in that if they've not been tested already and they pass on no one is going to do an autopsy or anything? It'll just be the view of whomever writes up the death certificate, typically a local doctor?

Thats one of the reasons I will ultimately use all cause excess mortality rather than cases that actually had Covid-19 on the death certificate.

Its always this way, including in normal times. Many people will have experienced a relative passing away in non-pandemic times and the cause being described somewhat vaguely as pneumonia, rather than the actual influenza-like-illness having been properly identified. And especially during pandemics, there are plenty of deaths which are caused by the virus but present in slightly untypical ways without major obvious lung involvement. In this particular pandemic, it seems rather likely that some people are dying via a stroke, for example.
 
Scotland again. This is from the BBC live updates page https://www.bbc.co.uk/news/live/world-52450742

Scotland's First Minister Nicola Sturgeon has announced that over 70s will now be tested for Covid-19 on admission to hospital. They will also be tested every four days throughout their stay.

The first minister said the tests would help show the extent to which the virus is being transmitted within hospitals.
 
I'm just not getting (understanding) some of this Welsh stuff. As I've mentioned, I live under the Hywel Dda health board. We 'appear' to have one of the lowest death rates in the UK. But as I've also mentioned, I don't trust the figures because a) they are so low and b) the same applied to Betsi Cadwaladr (north Wales) who then mentioned 84 deaths last week, up from 0 as they hadn't implemented the new computer system and nobody seemed to notice the anamoly in their zero figure.

Now for Hywel Dda we have this today.

"The Welsh health minister Vaughan Gething told a press conference there had been “challenges in communication” between Betsi Cadwaladr health board and Public Health Wales, and there had also been a “material under-reporting issue” in the Hywel Dda health board area, where 31 deaths were not reported and did not appear in Public Health Wales figures."

"Gething said “individual family communication” had not been affected, with those who had lost loved ones informed of the deaths at the time, and that figures would now be “fully up to date”.

So figures now fully up to date. So we're looking for a figure somewhere above 31 for Hywel Dda right?

Here's the latest figures.


That says Hywel Dda 5.

Figures now fully up to date eh?

Farce.
 
He ripped her a new one for sure.

She did say she remembered the exercise but not the name, but couldn’t give any info except about legislative blah blah.

As said, Morgan is a twat/annoying the best of times but it’s fantastic watching him rip these feckers apart.
In terms of showing up the powerful, yeah, I'll take what I can get in these shitty times. However I'm not really a fan of the 'ask cutting question... get 3 seconds of reply.... shout... rinse and repeat' technique. Sometimes it really works, like James O'Brien's evisceration of farage, which was a thing of beauty, but usually it ends up not much more than a score draw.
 
Hospital deaths are reported daily, other deaths much less regularly - I think it makes some sense to use the daily tally from hospital deaths as a guide (along with other metrics) to how we're doing - but it should be a lot more explicit that's what it's being used for.
This really. An honest presentation of data would present the daily hospital figures for what they are, but give more prominence to the 'all in' figure at the point it is presented (each week?).
 
Not that surprising really...

Key workers and NHS staff have raised concerns about the management of a national network of drive-in coronavirus testing centres, with doctors at one London hospital trust “actively discouraging” staff from using them.
The expansion in testing at the weekend has led to long queues at some facilities, with motorists – many of them already feeling unwell with symptoms of Covid-19 – stuck in their cars in hot weather for hours, forbidden from opening windows and unable to use toilets or find water.

The Guardian was contacted about multiple concerns, including queues of up to five hours, workers with appointments turned away because of delays, leaking test vials, wrongly labelled samples, and lost test results at Nottingham and Wembley.

A doctor at the Royal Free NHS trust, which operates three hospitals in north London, said they were so concerned about the drive-in facility located in the Ikea car park in Wembley that staff had been told not to use it.
People attending a number of drive-in facilities reported being left with no choice but to take their own swabs, having expected the procedure to be carried out by a trained professional.
 
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The following chart covering care homes is another example of why we should consider all cause mortality rather than just those identified as Covid-19 on death certificates.
Indeed - unseasonal deaths has to be CV19 - or flu - and presumably there's plenty of stats on flu deaths ?
 
Dead out across the sheffield suburbs today, middle class bits, rubbish weather though, did notice many more young people wearing masks, which is surprising.
 
Indeed - unseasonal deaths has to be CV19 - or flu - and presumably there's plenty of stats on flu deaths ?

Flu deaths are generally underreported too, which is one of the reasons we have winter excess mortality statistics every year, to compensate for the underreporting phenomenon.

What we do have is various flu surveillance systems which were able to tell us that our main flu season had passed before the Covid-19 deaths started to increase. That doesnt mean there are currently no flu deaths at all every week, but it would not be expected to be a significant part of the picture at this point in the year, so we can probably afford to assume that the excess deaths so far are largely from Covid-19. As time goes on, indirect deaths as a result of the lockdown and fear of attending healthcare facilities are likely to become more of the picture, but we will have to dig down into the various causes of death to get a handle on that. Whitty often goes on about the indirect deaths, its not something that will be overlooked when judging the pandemics toll as a whole.
 
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