UK might not be over the worst, scientists warn, as Covid case numbers stay high
Inoculation programme must be stepped up before the onset of winter
General Coronavirus (COVID-19) chat
- Thread starter phillm
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elbows
Well-Known Member
UK might not be over the worst, scientists warn, as Covid case numbers stay high
Inoculation programme must be stepped up before the onset of winterwww.theguardian.com
Since Woolhouse often got on my nerves much earlier in the pandemic for saying things I considered to be unwise that didnt reflect the magnitude of the situation, it is worth noting when even he has concerns about the future.
The extent to which emphasis on vaccination to improve the situation is misplaced depends on how much difference we think boosters are going to make.
Because although the media and experts focus on vaccination is understandable, I dont think its doing justice to the current picture. This picture was always expected because vaccines arent 00% effective and those who have been vaccinated make up such a large percentage of the population these days. But the media are failing to describe the current picture on that front properly, and are reliant on data that stretches over a very large part of 2021, or reports from individual hospitals or trust areas, to tell a story that does not reflect the current reality.
Since I always have an emphasis on telling the stories media etc arent, here is my data summary using official data that covers weeks 34 to 37 of 2021:
Of the 3158 deaths within 28 days of a positive test that the official vaccine surveillance report contains:
33 were unlinked (they couldnt link that persons death to vaccine status data)
730 were unvaccinated
111 had one dose
2284 had two doses
There is also a version for deaths within 60 days of a positive test but I'm not covering those this time.
Data is from https://assets.publishing.service.g...992/Vaccine_surveillance_report_-_week_38.pdf
I will repeat this exercise for hospitalisations and cases shortly.
These diminishing returns may be one reason the authorities dont seem to be as bothered about maintaining vaccination momentum these days. I am bound to say that we need to focus on other ways to reduce the number of infections.
Although please note that vaccines still work, and thats reflected in other versions of this data where the numbers are expressed as rates per 100,000 people.
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elbows
Well-Known Member
8255 cases in the data that required overnight hospitalisation between weeks 34 and 37:
95 unlinked
3220 unvaccinated
383 one dose
4557 two doses
Certainly the burden on hospitals could be reduced if more unvaccinated adults got vaccinated. Its questionable as to how many of those people actually will at this stage though. And under 18's account for 478 of the 3220 unvaccinated in those figures.
Same data source as previous post.
95 unlinked
3220 unvaccinated
383 one dose
4557 two doses
Certainly the burden on hospitals could be reduced if more unvaccinated adults got vaccinated. Its questionable as to how many of those people actually will at this stage though. And under 18's account for 478 of the 3220 unvaccinated in those figures.
Same data source as previous post.
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elbows
Well-Known Member
Now when it comes to positive cases, the numbers are heavily skewed by the very high number of cases in younger age groups. So I better post the full table for those in addition to my totals. Actually since previous data for deaths and hospitalisations tended to be skewed in the other direction, towards older people, I probably should go back and add the full tables to my previous posts about those too.
Again this covers weeks 34 to 37.
680,582 of which:
60,046 unlinked
275,845 not vaccinated
67,187 one dose
277,504 two doses
Same source, https://assets.publishing.service.g...992/Vaccine_surveillance_report_-_week_38.pdf
Again this covers weeks 34 to 37.
680,582 of which:
60,046 unlinked
275,845 not vaccinated
67,187 one dose
277,504 two doses
Same source, https://assets.publishing.service.g...992/Vaccine_surveillance_report_-_week_38.pdf
Yup ^ someone at PHE told me the same.
Winter is slowly arriving and inaction is not a viable option. Are they hoping for a spike in revenue across business sectors? Seems to have been the main aim. But it will no doubt cause more long term costs, increase avoidable deaths and drag this whole thing out for longer
More masks, especially in schools. More focus on social distancing. Try to actually measure the impact/spread all these large events, like the Marathon today.
elbows
Well-Known Member
Yeah, though I dont currently have a prediction as to whether they will start to take any of that stuff more seriously again. It will depend which way the data goes, and its still a mixed picture on that front. Whether the school-aged spike diminishes and the extent to which it causes spread upwards into older age groups are things I will keep an eye on. If they start to see really strong signals in regards waning immunity in the data then this may also lead to a change of tone. And they will have gotten party conference season out of the way soon.
I'm hoping to take a fresh look at cases by age group in the main UK thread later today.
I'm hoping to take a fresh look at cases by age group in the main UK thread later today.
Buddy Bradley
Pantheistic solipsist
Niece (13) and sister-in-law (Teaching Assistant) have both got Covid now - it was only a matter of time really, if you're in a school environment.
cupid_stunt
Chief seagull hater & farmerbarleymow's nemesis.
He's been very selected on the comparisons, there are counties that have done worst than the UK, including the US, Italy, Belgium, Mexico and at least 20 other countries.
It is based on Europe, sorry should have said.
cupid_stunt
Chief seagull hater & farmerbarleymow's nemesis.
Japan & Singapore are in Europe now?
Not that I am defending the fuck-ups by our government, just pointing out some have actually managed to fuck-up even more.
OoopsJapan & Singapore are in Europe now?
Not that I am defending the fuck-ups by our government, just pointing out some have actually managed to fuck-up even more.
Yossarian
⏭️
It makes sense to compare the UK to equally wealthy countries where ability to afford vaccines etc. hasn't affected the death rate - and, if you're looking at what went wrong, to focus on what other countries did right instead of looking at the handful of comparable countries that did worse.
teuchter
je suis teuchter
He might be right but he doesn't really present any evidence for what he's saying.
For example - on number of critical care beds, I can find this table
link.springer.com
or more up to date this one
and I can see that the UK (or England) has quite a low number, but Belgium has a higher number of beds (yet higher number of Covid deaths) and Sweden has fewer beds and fewer deaths. Denmark has a much lower number of Covid deaths than the UK... but appears to have a similar (or lower) number of critical care beds.
And he tells us that the UK has a very different triage approach but no detail to back this up.
So it just seems like someone on twitter with their personal hunches about why the UK did so badly.
For example - on number of critical care beds, I can find this table
The variability of critical care bed numbers in Europe - Intensive Care Medicine
Purpose To quantify the numbers of critical care beds in Europe and to understand the differences in these numbers between countries when corrected for population size and gross domestic product. Methods Prospective data collection of critical care bed numbers for each country in Europe from...
link.springer.com
or more up to date this one
and I can see that the UK (or England) has quite a low number, but Belgium has a higher number of beds (yet higher number of Covid deaths) and Sweden has fewer beds and fewer deaths. Denmark has a much lower number of Covid deaths than the UK... but appears to have a similar (or lower) number of critical care beds.
And he tells us that the UK has a very different triage approach but no detail to back this up.
So it just seems like someone on twitter with their personal hunches about why the UK did so badly.
elbows
Well-Known Member
Did you really pay so little attention to this aspect that you can seriously question this?
People didnt question me when I went on about the 'die at home' aspect of the UK approach. Because it was bloody obvious it was happening, and there was no system to check on the health of people who caught it. It was a deadly form of hospital demand destruction, and it was blatant at the time.
People were not educated about all the key warning signs to look out for. People were encouraged not to be a burden to the NHS. There were some limited forms of telephone triage that were entirely inadequate and further suppressed demand. In some areas at certain moments the criteria for when emergency responders should admit very ill patients was changed. And in the first wave there was such a lack of testing that plenty of people died at home without even knowing whether they had covid or showing up in the official covid deaths, which is one of the reasons we saw so called 'non-covid' excess deaths reach extremely high levels at just the same time as confirmed covid deaths (=people who were admitted or otherwise tested) reached stunning levels in the first wave.
There are probably a few other aspects to this sorry picture which Im not aware of yet, and the other reason I am ill equipped to make comparisons to other countries in this respect is that I never had the time to check the detail of how other countries approached this.
Here are a couple of his tweets on this matter. And kindly spare us the form of bullshit where experts are reduced to just being some person on twitter with an opinion. Because in this case his research interests involve health systems, with a particular focus during this pandemic on Covid-19 clinical care!
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elbows
Well-Known Member
One good excuse people have for not understanding that aspect of the UK approach is that the UK press did a great job of not drawing too much attention to it. Its a topic that up and down the system is considered too embarrassing to dwell on, it brings our authorities into disrepute. Easier to hide behind peoples desire to only say positive things about the NHS. This is one of the reasons I always went in hard by twisting their messaging into 'protect the NHS, die at home', the lack of attention to it drove me potty so I thought I'd shout about it in a vulgar manner.
Not that the press paid no attention to it at all, it just never became the central narrative or headline. So they did cover specific tragic stories of people who died at home, especially during times when authorities wanted people to take the threat seriously, eg when we were in lockdowns. And there were a few reports here and there about the criteria for admittance being lowered for a time in some regions. Later, somewhat related topics have occasionally come up since, eg simplistic reliance on home blood oxygen level monitoring when it turned out that people with darker skin tones may not get the right results from the monitoring equipment.
This stuff will form quite a chunk of what I use to judge how much of a whitewash the public inquiry turns out to be. If there isnt much focus on how the health system did on this front then I will cry foul.
Not that the press paid no attention to it at all, it just never became the central narrative or headline. So they did cover specific tragic stories of people who died at home, especially during times when authorities wanted people to take the threat seriously, eg when we were in lockdowns. And there were a few reports here and there about the criteria for admittance being lowered for a time in some regions. Later, somewhat related topics have occasionally come up since, eg simplistic reliance on home blood oxygen level monitoring when it turned out that people with darker skin tones may not get the right results from the monitoring equipment.
This stuff will form quite a chunk of what I use to judge how much of a whitewash the public inquiry turns out to be. If there isnt much focus on how the health system did on this front then I will cry foul.
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teuchter
je suis teuchter
But I have no way to compare this with what happened in other countries. Was the UK unique in taking this approach?
Can we find other countries where they also had high case numbers, where they encouraged people to go into hospital more than the UK did, and we can see some sort of evidence that this improved their outcomes? Or did it lead to hospitals performing even worse, because they were overwhelmed with patients a greater proportion of whom didn't necessarily need to be there?
I'm not commenting on whether or not the UK's policy was the right one, nor am I ignoring the fact that such approaches would not have been necessary if we had higher capacity in the first place. I'm just commenting on the ability to come to conclusions without actually being able to compare the approaches of different countries.
I expect the reasons some countries did worse than others will be incredibly complex and it might never be possible to come to a lot of definitive conclusions. He is making some plausible suggestions about things that, if the UK had a different approach, it might have seen a better outcome, but without giving us comparisons I don't see how we can judge how major these factors were in the context of the bigger picture.
He asks "why has the UK mortality been so high?" and then concludes the thread with two factors (hospital capacity and triage approach). That implies that these were the most significant of all the factors involved. Maybe they were but I don't see that such a conclusion is backed by clear evidence. I am not saying that I think they weren't factors.
Dogsauce
I’ve got Skol but I’m not a Scholar
Remember a couple of weeks back when I tested positive on lateral flow and not PCR and reported the same happening to a lot of other people locally? Seems to have now been recognised and is being investigated:
I did test positive on PCR no.3, other half on her second one after first was inconclusive.
It won’t be a lateral flow fault as I used different batches from different manufacturers (ones I get from work and a pack from the pharmacy) and both types positive. Could be a PCR issue as the negative tests were from the walk-in centre, positive (mine and other half’s) from mail-in ones. Both have been symptomatic and still quite unwell.
I did test positive on PCR no.3, other half on her second one after first was inconclusive.
It won’t be a lateral flow fault as I used different batches from different manufacturers (ones I get from work and a pack from the pharmacy) and both types positive. Could be a PCR issue as the negative tests were from the walk-in centre, positive (mine and other half’s) from mail-in ones. Both have been symptomatic and still quite unwell.
elbows
Well-Known Member
Well certainly we first need to unpick a conflation of two different questions in his first two tweets in that thread:
There is overall level of covid mortality across the entire population.
There is the chance of dying if you caught it.
The former will be affected by every pandemic failing, late and inadequate lockdowns etc etc. The latter, which is what he is actually focussing on, eliminates some of those areas and allows us to zoom into what sort of care people who caught it received. It is entirely reasonable to expect that the things he focusses on are a great match for the latter question. Still not quite the whole story though, since we would expect the case fatality rate to be affected by some things beyond the level of clinical care they received, things like the age and prior health of those who caught it.
As for comparisons to other countries, some of his tweets in that thread indicate that he is aware that many other countries focussed on basic capacity (as opposed to ICU capacity) and he explains why this would be expected to make a big difference.
So can I find some things to pick at in the way he expressed himself on this topic? Yes. Do I think these minor criticisms should distract from the failings he is trying to draw attention to? No.
I will try to draw attention to more detailed analysis of these failings whenever I find suitable studies.
elbows
Well-Known Member
Loads of detail here:
"Restricted access to the NHS during the COVID-19 pandemic: Is it time to move away from the rationed clinical response?"
There is much else quotable in that article, but I will skip ahead a bit because one way we can take shortcuts but still gain clues about how our response compares to other nations is to look at international guidelines.
There are a large number of references to other sources which support the claims made in the above quotes but I have removed them for formatting reasons.
"Restricted access to the NHS during the COVID-19 pandemic: Is it time to move away from the rationed clinical response?"
There is much else quotable in that article, but I will skip ahead a bit because one way we can take shortcuts but still gain clues about how our response compares to other nations is to look at international guidelines.
There are a large number of references to other sources which support the claims made in the above quotes but I have removed them for formatting reasons.
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elbows
Well-Known Member
Although I have to say there is at least one mistake in that document. They mention that early in the crisis people were advised to "book a SARS-CoV-2 test" but in the first months there was entirely insufficient testing capacity so even getting tested was not an option for many, and was not part of what the masses were told to do. This didnt change until the first wave was well past its peak.
teuchter
je suis teuchter
Yes I noted that conflation when I reread the thread.
So, I looked at a few countries' case rate per 100k population, and deaths per 100k population.
(I know that both numbers are subject to some unreliability when comparing between countries.)
For the UK deaths are at 205 for a case rate of 12k.
You can look at Sweden see that they have a lower death rate (144) for a similar case rate (11k). So they are doing better.
You can also look at Germany and find that their case rate is less than half of ours (5k) and yet their death rate (113) is more than half of ours. So on that particular measure it seems that Germany is doing worse than the UK - if you get Covid you are more likely to die in Germany than you are in the UK (unless I have messed up my numbers somewhere).
You can then look at Belgium and see that they are also doing worse than the UK because they have a slightly lower case rate (10k) and a higher death rate (222).
Finally you can look at Italy and see that they (appear to) have a lower case rate at 8k but they have a higher death rate at 217.
In fact I realise that you can plot "case fatality rate" on the website I often use and it looks like this for Europe. Again unless I have messed up, it actually looks like the UK is doing better than the EU average on that particular measure of how likely you are to die if you get Covid. I'm not saying this is the most important measure, but it's one that's pretty relevant to what he's looking at. Again, the graph contains no information about the different triage approaches in different European countries. If we find that many of the countries that did better than us, also had triage systems that didn't match what the WHO recommends - or we find that many of the countries that did worse than us, did have triage systems that matched what the WHO recommends, then isn't that significant? We need that information too.
elbows
Well-Known Member
Yes we need to know those things. But also one of the reasons I dont usually attempt this sort of analysis myself is that we also need to understand the differences between countries when it comes to things like how many of the actual cases each country manage to formally identify via testing, and also differences in how deaths are measured.
If my foreign language skills were better then I would have spent a small amount of time much earlier in the pandemic looking at what the official medical advice to people with suspected covid was like in different countries. I still did a tiny bit of this, and the most obvious difference was that I was more likely to find advice such as 'call your doctor' in non-UK countries.
If my foreign language skills were better then I would have spent a small amount of time much earlier in the pandemic looking at what the official medical advice to people with suspected covid was like in different countries. I still did a tiny bit of this, and the most obvious difference was that I was more likely to find advice such as 'call your doctor' in non-UK countries.
teuchter
je suis teuchter
It just seems to me that it's too easy to pick out some figures from other countries to support whatever theories someone has about why the UK has done badly, or how much better it would have been possible to do. There are just so many factors that it is very difficult to pull anything meaningful out. Maybe some statisticians will manage to do something useful in coming years.
It's notable that Sweden appears to have done better on overall deaths and also case fatality rate. Some could try and use this to say that the herd immunity approach worked and we should have done the same here. But I would say that would be a wrong conclusion to come to.
It's notable that Sweden appears to have done better on overall deaths and also case fatality rate. Some could try and use this to say that the herd immunity approach worked and we should have done the same here. But I would say that would be a wrong conclusion to come to.
elbows
Well-Known Member
I'd rather focus on the obvious failings and limitations of the UK approach, of which there are many to choose from. I've been happy to mention other countries approaches when its bloody obvious what they were doing better, or when I'm feeling the need to refute some anti-lockdown bullshit that dubious sections of the press have resorted to on numerous occasions. Shit that often involved entirely false narratives about other countries. And in the first year of the pandemic I certainly had to keep pointing out things such as having an adequate test & trace system not in itself being some tidy alternative to lockdowns, no matter how much the person making such claims wanted to believe that lockdowns were somehow unnecessary. The international comparisons that I have absolutely no regrets about highlighting tended to involve really obvious stuff involving case numbers in countries that acted early, in stark contrast to the late and half-arsed UK approach. Some countries that did well early on caught up with the UKs level of horror because they didnt stay the course, eg most of Europe rushed to reopen whenever they could.
It is indeed incredibly hard to fully unpick all of the different factors in any aspect of this pandemic. This does not dissuade me from pointing out the really obvious and shameful failings in detail.
It is indeed incredibly hard to fully unpick all of the different factors in any aspect of this pandemic. This does not dissuade me from pointing out the really obvious and shameful failings in detail.
elbows
Well-Known Member
Yes and they will add naunce and detail. But many of their conclusions will be stuff we could have come up with in less forensic fashion from the start. Most of what I've gone nuts about in the pandemic really isnt that hard to grasp and see the basic truth of, even when precise measurements elude us.
I like the detail, so for example I still find some value in public inquiries even when people roll their eyes at the 'no shit sherlock' non-revelations. What I dont like is when the lack of such firm detail is used as an excuse to look the other way and to quibble in a manner that reveals unpleasant truths about some peoples priorities.
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