Coronavirus in the UK - news, lockdown and discussion

[kabbes]

Anyway, I remember something being said when Italy was first being hit hard that they had the 3rd oldest population in the world. Could this be a factor in that more of those who were dying in Italy may have reasonably been expected to die this year anyway?

That would barely make a dent. Even an 80 year old in moderately poor health only has a fairly small chance of death within one year.

 

[Teaboy]

I worry that opening up general retail is a lot riskier than food retail and outdoor activities. We know the virus is mostly spread by touch. People shopping for non essentials do a lot of picking things up for a look and then putting them back again. In an enclosed space. This can’t be good.

Clearly its primarily being driven by economic necessity. Just as the next phase of re-openings will be.

 

[littlebabyjesus]

I worry that opening up general retail is a lot riskier than food retail and outdoor activities. We know the virus is mostly spread by touch. People shopping for non essentials do a lot of picking things up for a look and then putting them back again. In an enclosed space. This can’t be good.

Tbh I suspect that having a hand cleaning station at the entrance to every shop and insisting that everyone use it is probably the best thing shops can do. More so than insisting on masks, which most won't do anyway for fear of losing customers. And there is solid evidence after all that hand washing is the single most effective preventative measure.

Also how you provide the facility matters. In Aldi near me they have a prominent, well equipped cleaning station that is pretty well used, more used than the more discreet facilities I've seen elsewhere e.g. in Waitrose. That lesson should have been learned by now tbh - bit like the fag butt trays on bins: make things easy for people and they will change their behaviour.

 

[teuchter]

We know the virus is mostly spread by touch.

Do we know this?

 

[maomao]

When you look at the deaths per head of population numbers, the UK is broadly similar to Spain and Italy. But these graphs show the Z-number which as I understand it is a way of measuring excess deaths. So why is Italy's peak less than half of the one for Spain or for England?

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from here Graphs and maps from EUROMOMO

Less care homes due to extended family households so less hidden deaths that weren't in the first lot of figures? Or a slower or less reliable statistic agency so not all deaths for that period added yet? Just guesses.

 

[teuchter]

Less care homes due to extended family households so less hidden deaths that weren't in the first lot of figures? Or a slower or less reliable statistic agency so not all deaths for that period added yet? Just guesses.

That would explain the "deaths from covid19" being under-reported but they seem to match the UK's. That's why it's strange that these "excess" deaths seem to be fewer.

 

[elbows]

When you look at the deaths per head of population numbers, the UK is broadly similar to Spain and Italy. But these graphs show the Z-number which as I understand it is a way of measuring excess deaths. So why is Italy's peak less than half of the one for Spain or for England?

from here Graphs and maps from EUROMOMO

Z-scores have their limits and their uses. I mostly prefer the raw data. I am not at all capable of properly explaining z-scores and their limitations, but here is an informative paper which is helpfully written in the context of this pandemic and discusses other options such as p-scores.

No. 2020-11 - Measuring excess mortality: the case of England during…

Excess mortality data avoid miscounting deaths from under-reporting of Covid-19-related deaths and other health conditions left untreated. According to…

www.inet.ox.ac.uk

Unfortunately when it comes to the raw numbers, public data from Italy lags behind, so there are some limits to what I can say. However they were around 40,000 excess deaths in Italy shown in the available data, compared to getting on for 60,000 for the UK, so I would not say that Italy is all that similar to the UK really. Timing of their peak and expected deaths in normal times for those weeks would also be expected to make a difference to z-scores, plus at no stage did Italy record over twice as many deaths in a week as normal, but the UK did. eg at the peak week Italy had 9441 excess deaths beyond the 11515 expected, compared to 11761 excess deaths on top of the 10589 expected for the UK. Thats just one week so I'm not trying to tell the whole story, but its an example of the sort of thing that would make a difference to z-scores.

I've been suspicious of some of that data for a while. There is a totally unexplained anomaly in England as well, not mirrored at all in Wales or Scotland, which makes me suspect some problems with these things - probably not comparing like with like. It's not a great time for reliable statistics anywhere, tbh.

What unexplained anomoly? The z-score in England for under 65s? I doubt that is a data error at all, it probably indicates a real phenomenon here. Probably a mix of reasons for it. And will show up more dramatically in z-scores because differences from the norm will show up a lot in such scores, perhaps resulting in more dramatic scores for that age range than you'd expect. I seem to recall producing a whole bunch of graphs some time ago that showed all deaths per week in a wide range of age groups (not lumping everyone from 15-64 together) from ONS England & Wales data and the pattern of pandemic death was on display quite obviously in these graphs as soon as we got to ages of 35+. Ah yes I've just found my old graphs of this, here are a couple of examples. I would find it much stranger if this data had not shown up in our z-scores!



Comparisons between UK and Italy were very useful for estimating the timing of our epidemic, but I wouldnt want to stretch the comaprisons so far. For example the story in Italy was very much one of regional outbreak, Lombardy dominates their stats in a way that no single region of the UK does.

 

[andysays]

Do we know this?

I was wondering this.

We know it can be spread by touch, as well as by air bourne particles from sneezes etc, but is there any data to suggest which of the two methods is more likely, in theory or in practice?.

Doesn't necessarily make a difference to the general point that opening shops without enough precautions may lead to a rise in transmissions.

 

[littlebabyjesus]

I was wondering this.

We know it can be spread by touch, as well as by air bourne particles from sneezes etc, but is there any data to suggest which of the two methods is more likely, in theory or in practice?.

Doesn't necessarily make a difference to the general point that opening shops without enough precautions may lead to a rise in transmissions.

There are three methods. Touch, direct airborne transmission from sneezes etc, and build-up over time of aerosols in the air in enclosed spaces. Shops should be ok with the last two tbh as long as they don't get very overcrowded. Supermarkets have been ok in that regard, after all. Was a big problem pre-lockdown cos of ignorance - I suspect aerosol transmission as the prime suspect for the deaths of bus drivers who contracted c19 pre-lockdown, for instance.

Regarding evidence, I don't know of too much, but one very solid piece of evidence for the power of aerosol transmission in crowded enclosed spaces was the mass infection caused by the Christian gathering in South Korea.

 

[andysays]

There are three methods. Touch, direct airborne transmission from sneezes etc, and build-up over time of aerosols in the air in enclosed spaces. Shops should be ok with the last two tbh as long as they don't get very overcrowded. Supermarkets have been ok in that regard, after all. Was a big problem pre-lockdown cos of ignorance - I suspect aerosol transmission as the prime suspect for the deaths of bus drivers who contracted c19 pre-lockdown, for instance.

That all sounds reasonable, but my question was more is there actually any statistical evidence to back it up?

 

[zora]

I worry that opening up general retail is a lot riskier than food retail and outdoor activities. We know the virus is mostly spread by touch. People shopping for non essentials do a lot of picking things up for a look and then putting them back again. In an enclosed space. This can’t be good.

My understanding is the complete opposite, and in fact, the emphasis on hand-sanitizing and hand-washing above face masks and looking at ventilation has been my pet gripe for a while now.
As I have said on several different threads already, the German virologist who has been doing the majority of the science education on this matter in Germany warned as early as March that he feared that too much attention was being given to wiping down keyboards and lift buttons at the expense of distance (this was pre-lockdown).

I am happy to stand corrected but in my understanding there are no proven cases of transmission via touching objects, at least in every day life/in the community (though of course absence of proof does not prove that it is impossible). High risk environments like hospitals might be a different matter.
The experiments that have shown the virus to survive for x hours on y surface were done under lab conditions and with huge amounts of virus, not replicating every day situations.

What was underestimated initially, was the aerosol transmission. Iirc initially it was assumed that you'd have to catch a larger droplet from an infected person (when speaking or sneezing), but since then, the aerosol transmission via build up over a prolonged period has become more of a focus. Which I believe is now also thought to be behind some of the "super-spreader" events like the choir rehearsal in Berlin in March when 60 out 80 people are thought to have become infected at one rehearsal. Hugging and chatting there may of course also have been factors, as well as the aerosol build up.

 

[littlebabyjesus]

That all sounds reasonable, but my question was more is there actually any statistical evidence to back it up?

Sure. I was clarifying the question rather than providing an answer.

I agree that we need much more evidence on this. Direct transmission via droplets - the thing we're all most paranoid about with our social distancing etc - is the only one of the three that requires direct proximity to the carrier in time and place, but I suspect it's probably the least important of the three in terms of ongoing risks.

 

[littlebabyjesus]

What was underestimated initially, was the aerosol transmission. Iirc initially it was assumed that you'd have to catch a larger droplet from an infected person (when speaking or sneezing), but since then, the aerosol transmission via build up over a prolonged period has become more of a focus. Which I believe is now also thought to be behind some of the "super-spreader" events like the choir rehearsal in Berlin in March when 60 out 80 people are thought to have become infected at one rehearsal. Hugging and chatting there may of course also have been factors, as well as the aerosol build up.

Singing was strongly implicated at the South Korea Christian thing as well. We should probably all be muttering to each other quietly atm.

And the week before lockdown, how many people caught it via aerosol on rush hour tube trains? I hate to think.

 

[Orang Utan]

Won't someone think of the wealthy, so cruelly ignored during these difficult times?

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www.ft.com

 

[Doodler]

From quite early on the official sceptical line about masks seemed suspect. When Xi Jinping wore a mask during a visit to Wuhan that appeared as a pretty good recommendation. General widespread use of masks throughout east Asia was worth taking note of - why not learn from those who are more experienced than you? But some Westerners thought they knew better.

 

[littlebabyjesus]

From quite early on the official sceptical line about masks seemed suspect. When Xi Jinping wore a mask during a visit to Wuhan that appeared as a pretty good recommendation. General widespread use of masks throughout east Asia was worth taking note of - why not learn from those who are more experienced than you? But some Westerners thought they knew better.

Hmmm. People in East Asia have worn masks when ill for years. But in a normal year, you still see a rather large number of people around the place in masks. It clearly doesn't work that well.

 

[teuchter]

Understanding of the relative transmission risks is something that I might have expected we'd have quite a lot more of than we apparently do - now nearly six months into this thing from the first cases in China. But it still seems very vague and uncertain.

I don't know if that's because the information is there but isn't being communicated - or because research is focused on medicines and vaccines instead - or because it's something that's very hard to identify and which lab type tests don't really help with.

 

[andysays]

Understanding of the relative transmission risks is something that I might have expected we'd have quite a lot more of than we apparently do - now nearly six months into this thing from the first cases in China. But it still seems very vague and uncertain.

I don't know if that's because the information is there but isn't being communicated - or because research is focused on medicines and vaccines instead - or because it's something that's very hard to identify and which lab type tests don't really help with.

I suspect that there is a significant element of the third of those, ie the difficulty of actually measuring in any realistic way by what means it's most frequently spread.

 

[two sheds]

Indeed - in an enclosed environment with people who are infected you're liable to breathe stuff in directly or indirectly that's hung about in the air, or touch stuff that they've touched and then stick your finger up your nose.

 

[Teaboy]

From quite early on the official sceptical line about masks seemed suspect. When Xi Jinping wore a mask during a visit to Wuhan that appeared as a pretty good recommendation. General widespread use of masks throughout east Asia was worth taking note of - why not learn from those who are more experienced than you? But some Westerners thought they knew better.

Its not really about some Westerners knowing better though is it? In the UK the Government and Government scientific advise is still very luke warm on masks and gloves, to say the least. You can't really blame people for not wearing face coverings when the people at the top (including the really qualified ones) are far more concerned with social distancing and regular hand washing and are still really loathed to come out in support of face coverings except in specific situations.

 

[Doodler]

Hmmm. People in East Asia have worn masks when ill for years. But in a normal year, you still see a rather large number of people around the place in masks. It clearly doesn't work that well.

The WHO and in the United States the CDC both reversed their initial opposition to public use of masks. They must have had good reason. CNBC reports how some people took on board the anti-mask message and disregarded the subsequent reversal:

Why scientists change their minds

No problem finding online references to studies supporting mask use. The South China Morning Post has some informative pieces, one headed with an illustration of a dim-looking European at odds with a Chinese woman.

WHO makes U-turn

 

[littlebabyjesus]

The WHO and in the United States the CDC both reversed their initial opposition to public use of masks. They must have had good reason. CNBC reports how some people took on board the anti-mask message and disregarded the subsequent reversal:

Why scientists change their minds

No problem finding online references to studies supporting mask use. The South China Morning Post has some informative pieces, one headed with an illustration of a dim-looking European at odds with a Chinese woman.

WHO makes U-turn

Yeah we did all this pre-lockdown tbh. Studies showing that wearing a mask makes no difference except when combined with regular hand washing and when masks are worn correctly. Wearing a mask incorrectly and fiddling with the damn thing all the time could easily be counterproductive.

And on the broader point, there has been a massive long-term real-life 'study' going on in Japan and elsewhere whereby people with colds wear masks in public. That study's results don't point to such a practice being all that effective in preventing the spread of colds.

 

[Doodler]

Its not really about some Westerners knowing better though is it?

Yes it was. There were influential people who began by stating that masks were pointless then mounting evidence compelled them to reverse that view. Exception: there may have been a Machiavellian motive (which would at least show signs of intelligence) in dissuading public use so hospitals could still obtain stock.

 

[Raheem]

Understanding of the relative transmission risks is something that I might have expected we'd have quite a lot more of than we apparently do - now nearly six months into this thing from the first cases in China. But it still seems very vague and uncertain.

I don't know if that's because the information is there but isn't being communicated - or because research is focused on medicines and vaccines instead - or because it's something that's very hard to identify and which lab type tests don't really help with.

Think it's just something that it is practically very difficult. You can't observe how the transmissions are happening. You can surmise things by looking at the circumstances where transmission is happening, but probably only with limited confidence.

 

[Doodler]

Yeah we did all this pre-lockdown tbh. Studies showing that wearing a mask makes no difference except when combined with regular hand washing and when masks are worn correctly. Wearing a mask incorrectly and fiddling with the damn thing all the time could easily be counterproductive.

And on the broader point, there has been a massive long-term real-life 'study' going on in Japan and elsewhere whereby people with colds wear masks in public. That study's results don't point to such a practice being all that effective in preventing the spread of colds.

Colds make people sneeze, Covid-19 does not (yet).

 

[littlebabyjesus]

Exception: there may have been a Machiavellian motive (which would at least show signs of intelligence) in dissuading public use so hospitals could still obtain stock.

Quite plausible, I'd have thought. There could also be a similar motive in play now to encourage people back to work by reversing the decision and forcing mask-wearing, of course.

 

[Teaboy]

Yes it was. There were influential people who began by stating that masks were pointless then mounting evidence compelled them to reverse that view. Exception: there may have been a Machiavellian motive (which would at least show signs of intelligence) in dissuading public use so hospitals could still obtain stock.

Well, fwiw I come down on the side that they must do something useful. I also think their effectiveness can be way overstated. I would suggest the success (so far) in countries where mask wearing is commonplace is far more to do with their governments response having had their fingers severely burnt in the past.

I think they are a nice and polite thing and they probably help a bit. A functional and even half sensible government is whats really required. We can point to a lot of Europe wear no one was wearing face coverings and its still very patchy and the virus has not really had a massive impact.

 

[kabbes]

My understanding is the complete opposite, and in fact, the emphasis on hand-sanitizing and hand-washing above face masks and looking at ventilation has been my pet gripe for a while now.
As I have said on several different threads already, the German virologist who has been doing the majority of the science education on this matter in Germany warned as early as March that he feared that too much attention was being given to wiping down keyboards and lift buttons at the expense of distance (this was pre-lockdown).

I am happy to stand corrected but in my understanding there are no proven cases of transmission via touching objects, at least in every day life/in the community (though of course absence of proof does not prove that it is impossible). High risk environments like hospitals might be a different matter.
The experiments that have shown the virus to survive for x hours on y surface were done under lab conditions and with huge amounts of virus, not replicating every day situations.

What was underestimated initially, was the aerosol transmission. Iirc initially it was assumed that you'd have to catch a larger droplet from an infected person (when speaking or sneezing), but since then, the aerosol transmission via build up over a prolonged period has become more of a focus. Which I believe is now also thought to be behind some of the "super-spreader" events like the choir rehearsal in Berlin in March when 60 out 80 people are thought to have become infected at one rehearsal. Hugging and chatting there may of course also have been factors, as well as the aerosol build up.

Fair enough

 

[elbows]

Understanding of the relative transmission risks is something that I might have expected we'd have quite a lot more of than we apparently do - now nearly six months into this thing from the first cases in China. But it still seems very vague and uncertain.

Its on my quite long list of things I would have hoped humanity would have a good handle on long before this pandemic started, but we just dont. For a whole multitude of reasons it seems, including the difficulty in really discovering the answers to everyones satisfaction, but probably also a variety of avoidable crapness including crap priorities and a preference for lazily relying on existing dogma rather than inquisitiveness at all times on all matters.

Here is another recent example. I expected some greater attention to this aspect due to some of the tentative lessons from a few specific SARS outbreaks and the mode of transmission, but even when I was disturbing people by mentioning anal swabs I expected to see a sort of half-baked answer revealing itself in really frustrating slow motion. Constipation of the knowledge accrual bowels perhaps.

Flushing 'can propel viral infection 3ft into air'

Flushing the toilet with the lid up creates a cloud of spray that may spread infection, study finds.

www.bbc.co.uk

Flushing the toilet with the lid up creates a cloud of spray that can be breathed in and may spread infection, such as coronavirus, say researchers.

Chinese scientists calculate that flushing can propel a plume of spray up and out of the toilet bowl, reaching head height and beyond.

Droplets can travel up to 3ft - or 91cm - from ground level, according to the computer model used by the scientists from Yangzhou University.

Shutting the lid would avoid this.

 

[freakydave]

Hmmm. People in East Asia have worn masks when ill for years. But in a normal year, you still see a rather large number of people around the place in masks. It clearly doesn't work that well.

It's more common to wear masks in East Asia because of pollution than illness