Covid : Infection rates v death rates and a possible second wave

[birchesgreen]

Is there currently a centralised public list of the restrictions for each area? I only know of the "score" in our local area because of one of the local councillors posting on Facebook!

Gov.uk's covid site, they have localised lockdown details. Its the only place i bother looking.

 

[AdamWW]

The purpose of national lockdown was to buy time to sort out healthcare and testing capacity. "flatten the curve". It did that. For some reason it now seems to be the opinion in many circles that it can be used to make Covid go away. It won't.

It presumably did buy time, but if you're suggesting that the belief was that the intention was that we could build up sufficient capacity to cope with all restrictions removed, I don't think that's true.

It could be used to knock cases down to a level where they would be controllable by way of traditional, highly invasive contact tracing.

This is what (part of) SAGE appears to have been telling the Government in August:

SPI-M-O’s view is that it would be highly likely that elimination would only be a transient state, as recent cases of community transmission in New Zealand and Vietnam have shown how difficult maintaining elimination would be. In general, it will be easier to achieve and maintain elimination in countries with smaller populations and lower levels of connectivity to the rest of the world. The UK is far more interconnected both internally within the country and internationally than either of New Zealand or Vietnam.

The public health benefits of zero cases versus very low incidence are small, but the costs (in terms of the impact of social distancing measures) of achieving and maintaining zero cases are much larger.

Despite the difficulties of elimination, the lower incidence becomes, the easier it will be to keep the virus under control using testing, tracing, and local interventions.

The testing shortage now is due to every Tom Dick and Harry with a cold asking for one. And it's not their fault, it's the messaging. New continuous cough? Get a test. Should be "new continuous cough with no runny nose or sneezing-- get a test"

With sufficient test capacity the above seems correct - you might have a cold and Covid-19.

Given where we are, though, it sounds like it would be a good move.

 

[Bantamzen]

It presumably did buy time, but if you're suggesting that the belief was that the intention was that we could build up sufficient capacity to cope with all restrictions removed, I don't think that's true.



This is what (part of) SAGE appears to have been telling the Government in August:




With sufficient test capacity the above seems correct - you might have a cold and Covid-19.

Given where we are, though, it sounds like it would be a good move.

Specifically it should be "new continuous dry cough, without sneezing or runny nose". As the people turning up at and A&E in Bolton for covid tests have shown, if you do not give people good, meaningful information and advice, you will cause more problems than you will solve. Now that SAGE have got over themselves a little and accepted that elimination is not going to happen (hope they've let the Scottish First Minister know!), maybe its time for them to accept that lockdown after lockdown, be they local or national simply act to delay, and that we now need to start considering the actual risk levels to the majority of us & get the government focused on the real issue of helping those at risk. Just as we should have done at the very start.

 

[AdamWW]

Now that SAGE have got over themselves a little and accepted that elimination is not going to happen (hope they've let the Scottish First Minister know!), maybe its time for them to accept that lockdown after lockdown, be they local or national simply act to delay, and that we now need to start considering the actual risk levels to the majority of us & get the government focused on the real issue of helping those at risk. Just as we should have done at the very start.

As for SAGE have previously aimed at elimination, that's not something I've come across in any of the documents I've read.

If you read through them you will, though, find lots of discussion looking at the "whole picture" rather than just assuming that any strategy must be based around keeping the number of reported infections as low as possible.

 

[Bantamzen]

As for SAGE have previously aimed at elimination, that's not something I've come across in any of the documents I've read.

If you read through them you will, though, find lots of discussion looking at the "whole picture" rather than just assuming that any strategy must be based around keeping the number of reported infections as low as possible.

Well if they weren't aiming for a zero-covid scenario, then why do they insist on lockdown after lockdown. The initial government objective was to "flatten the curve" to give time to factor extra NHS capacity, and this was achieved. But this doesn't seem to satisfy SAGE so suppression to allow capacity increase doesn't seem to be their end-game, so even though they may not have specifically detailed it, elimination does seem to have been at least one of their targets.

 

[AdamWW]

Well if they weren't aiming for a zero-covid scenario, then why do they insist on lockdown after lockdown. The initial government objective was to "flatten the curve" to give time to factor extra NHS capacity, and this was achieved. But this doesn't seem to satisfy SAGE so suppression to allow capacity increase doen't seem their end-game, so even though they may not have specifically detailed it, elimination does seem to have been at least one of their targets.

You keep saying that.

That's not my understanding.

From reading the documents from the start of all of this, the aim of flattening the curve was to reduce the load on the health service. Not as a temporary measure to somehow create enough capacity to cope with the impact of having no restrictions, but as a way of getting through the epidemic while maintaining capacity.

By the way, I just found this in a recent SAGE document - it looks a little critical:

SPI-M looks forward to a time when detailed test and trace data will be available to inform the national modelling effort. The pillar 1 and 2 testing data are available and informative. They would be substantially more informative if they included the reason the subject had come for a test – this is critical information for interpretation of the incidence of positive tests.

 

[talldave]

It seems to be a recurring theme that local lockdown areas go into lockdown when rates are already declining. Has anyone questioned why the rates are declining, when unchecked infection apparently leads to catastrophic exponential increases in infection levels?

 

[Howardh]

At current rates, of around 3400 testing positive daily, it would take around 50 years to infect the whole population (very roughly).

 

[Richard Scott]

At current rates, of around 3400 testing positive daily, it would take around 50 years to infect the whole population (very roughly).

If we're lucky and get close to French figure of 10,000 a day may even get down to around 15-20 years! Sure we can all put up with these restrictions for a little longer.......

 

[Jozhua]

I don't agree with everything in this video, but it puts some interesting ideas forward:
YouTube - Viral Issue Crucial Update September 8th

The pattern of deaths is Incredibly similar, I've got data from primary government sources and plugged it into the spreadsheet and the pattern of deaths was virtually the same across Europe - impressive, when you also consider the methods of counting will vary somewhat.

Antibody testing in Sweden would suggest a death rate of around 0.5%, according to my napkin maths. A death rate of 0.5% would mean 12.5% of the UK population has had Coronavirus.

EDIT:
My personal prediction is a case fatality rate of 0.1 - 0.4%. Worse than a flu, but not completely world ending. I think about 15-60% of the population has had it.

Furthermore, this rate will be dependent on how well protected vulnerable groups are and the numbers of people who live with disorders that, without medical intervention could otherwise result in death. So this is cancer, asthma, HIV, diabetes, etc. You could therefore expect the proportion of Coronavirus deaths to be lower in countries that have less effective health systems.

Also worth considering, is the fact London has not seen the same spikes as the regions have. Considering that hospitals were full to capacity as it was the hardest hit by Coronavirus in the beginning, this would suggest higher levels of immunity.

Herd immunity is not a binary state either. The higher proportion with immunity, the lower the reproduction rate.

To that extent, the fact that infections are mostly hitting younger people now is probably a positive thing. As a group, we are considerably less likely to be badly affected and can offer some protection for the general population, as long as those with symptoms isolate when they occur.

 

[AdamWW]

Herd immunity is not a binary state either. The higher proportion with immunity, the lower the reproduction rate.

And...the growth in infections depends both on immunity levels and opportunities for transmission.

So in a sense, any area where infections are level could be said to have herd immunity for the current level of restrictions (I don't know if that's how the term is generally used though).

So presumably London may have sufficient immunity to keep things on an even keel given what is currently being done to reduce transmission, but not neccesarily if it was all dropped.

 

[jtuk]

At current rates, of around 3400 testing positive daily, it would take around 50 years to infect the whole population (very roughly).

Of course, if everyone who has it infects two people daily, it'd be all over in a month

 

[Bantamzen]

You keep saying that.

That's not my understanding.

From reading the documents from the start of all of this, the aim of flattening the curve was to reduce the load on the health service. Not as a temporary measure to somehow create enough capacity to cope with the impact of having no restrictions, but as a way of getting through the epidemic while maintaining capacity.

By the way, I just found this in a recent SAGE document - it looks a little critical:

I can only assume that you weren't paying full attention back in March. Why do you think there was a scramble to build Nightingale hospitals, why do you think all but essential NHS services were limited or unavailable, why do you think even patients looking for cancer screenings were knocked back? It was because they wanted time to build NHS capacity for covid based on forecasts that groups like SAGE worked to. Forecasts that ended up looking terribly wrong.

 

[DB]

And...the growth in infections depends both on immunity levels and opportunities for transmission.

So in a sense, any area where infections are level could be said to have herd immunity for the current level of restrictions (I don't know if that's how the term is generally used though).

So presumably London may have sufficient immunity to keep things on an even keel given what is currently being done to reduce transmission, but not neccesarily if it was all dropped.

It's difficult to see why transmision in London should be any less than other cities if behaviours was an important factor - it would actually be expected to be worse given the number of people and reliance on public transport. The fact that it isn't does strongly suggest a higher level of existing immunity.

 

[Yew]

It's difficult to see why transmision in London should be any less than other cities if behaviours was an important factor - it would actually be expected to be worse given the number of people and reliance on public transport. The fact that it isn't does strongly suggest a higher level of existing immunity.

Indeed, it'd be great to see some t-cell surveilence testing to get an idea of what the rates are like across the country.

 

[Howardh]

It's near 4000 confirmed cases according to yesterday's figures on https://www.worldometers.info/coronavirus/country/uk/ so that's up, yet the number of deaths is down again (20) from 27 the previous day, albeit 21 is slightly higher than the 7-day average.
Even so, the rise upon rise of new infections started mid-to-late August, so should now be reflected in (a) intensive care unit admissions and (b) deaths.
If we did go back into total lockdown, yet the daily death rate remained less than 3% of the peak, can a lockdown really be justified?

 

[Bletchleyite]

3395 according to: https://coronavirus.data.gov.uk/

 

[AdamWW]

It's difficult to see why transmision in London should be any less than other cities if behaviours was an important factor - it would actually be expected to be worse given the number of people and reliance on public transport. The fact that it isn't does strongly suggest a higher level of existing immunity.

This certainly sounds reasonable to me.

 

[brad465]

The WHO have said weekly cases in Europe have now passed the March peak:

Coronavirus: WHO warns Europe over 'very serious' Covid surge

New figures show "alarming rates of transmission across the region", the UN body says.

www.bbc.co.uk

New weekly coronavirus cases in Europe have exceeded the numbers reported when the pandemic first peaked in March, the World Health Organization has said.

Speaking on Thursday, WHO regional director Hans Kluge said 300,000 new infections were reported last week alone.

"We have a very serious situation unfolding before us," he said.

Some European countries, including the UK and France, have recorded their highest daily tallies in months.

Testing capacity has increased across Europe since the pandemic began, meaning that cases are now more likely to be identified and recorded.

But Mr Kluge said the new figures also showed "alarming rates of transmission across the region".

While they've acknowledged higher testing capacities, we will soon find out if the higher number of cases really is of the same level of concern as back in March, where death rates and hospitalisations are not anywhere near those levels as things stand.

 

[Freightmaster]

The WHO have said weekly cases in Europe have now passed the March peak:

Coronavirus: WHO warns Europe over 'very serious' Covid surge

New figures show "alarming rates of transmission across the region", the UN body says.

www.bbc.co.uk

How on earth can they claim that????

In the UK at least:

- peak infections back in March/early April: 100,000-150,000 a day
(90% or more of which were not picked up due to a lack of testing outside hospitals)

- positive tests now: 3,000-4,000 a day (most of which are false positives),
so the number of true infections will be in the hundreds per day.



Unless I am mistaken, the WHO seem to be indulging in rabid, tabloid-style scaremongering,
based on grossly distorted figures (massively underreported infections in March vs. vast numbers
of false positives now)


What are they up to??





MARK

 

[Bletchleyite]

How on earth can they claim that????

Because the claim is simply that it exceeds the numbers reported (i.e. positive tests). That's rather less than the actual numbers.

It's probably not false but it is grossly misleading.

 

[Freightmaster]

Because the claim is simply that it exceeds the numbers reported (i.e. positive tests).

It's probably not false but it is grossly misleading.

That's my point - I can understand a tabloid newspaper knowingly posting a
"grossly misleading" Covid article to get more 'clicks', but why would the WHO
do exactly the same - what is their motive??

That's rather less than the actual numbers.

A hundredfold less now than in march, but they claim that the current figures are higher - madness!!


No wonder the general public is scared to death of the vaunted second wave.




MARK

 

[AdamWW]

How on earth can they claim that????

In the UK at least:

- peak infections back in March/early April: 100,000-150,000 a day
(90% or more of which were not picked up due to a lack of testing outside hospitals)

- positive tests now: 3,000-4,000 a day (most of which are false positives),
so the number of true infections will be in the hundreds per day.



Unless I am mistaken, the WHO seem to be indulging in rabid, tabloid-style scaremongering,
based on grossly distorted figures (massively underreported infections in March vs. vast numbers
of false positives now)


What are they up to??





MARK

The latest figures I can find from the ONS infection survey (which tests people at random so doesn't suffer from changes in test availibility) give a 95% confidence interval of 2000 to 4600 "cases" per day in households in England (not hospitals, care homes etc.)

"Hundreds" per day is quite a bit lower than that.

However...the devil is in the details and "cases" means positive tests, with no allowance for false positives. So far as I can make out they don't think false positives are making much difference. (I can't see it in this report but previously I saw an argument that if they were mostly seeing false positives they would expect to see far fewer houshold clusters than they do).

 

[brad465]

The latest figures I can find from the ONS infection survey (which tests people at random so doesn't suffer from changes in test availibility) give a 95% confidence interval of 2000 to 4600 "cases" per day in households in England (not hospitals, care homes etc.)

"Hundreds" per day is quite a bit lower than that.

However...the devil is in the details and "cases" means positive tests, with no allowance for false positives. So far as I can make out they don't think false positives are making much difference. (I can't see it in this report but previously I saw an argument that if they were mostly seeing false positives they would expect to see far fewer houshold clusters than they do).

Further to this ZOE thinks there are around 69,687 active symptomatic cases, with the latest daily increase of 6478. It is on the up fast but still a long way off the March/April peak. They also think there is a very strong North/South divide along the classic Severn estuary to the Wash line:

Latest Daily UK COVID-19 Data: Vaccines, Cases, Trends | ZOE

COVID infection & vaccination rates in the UK today, based on public data and reports from millions of users of the ZOE Health Study app

covid.joinzoe.com

 

[yorksrob]

Further to this ZOE thinks there are around 69,687 active symptomatic cases, with the latest daily increase of 6478. It is on the up fast but still a long way off the March/April peak. They also think there is a very strong North/South divide along the classic Severn estuary to the Wash line:

Latest Daily UK COVID-19 Data: Vaccines, Cases, Trends | ZOE

COVID infection & vaccination rates in the UK today, based on public data and reports from millions of users of the ZOE Health Study app

covid.joinzoe.com

View attachment 83635

View attachment 83634

That is very strange. I can't think of any circumstance that would cause that geographical distribution. It doesn't reflect income levels, population density, strength of lockdown measurers etc.

 

[Trackman]

I've given up with facts, figures and charts.

 

[farleigh]

I've given up with facts, figures and charts.

Apparently 34% of people have also given up with facts, figures and charts.

 

[AdamWW]

Further to this ZOE thinks there are around 69,687 active symptomatic cases, with the latest daily increase of 6478. It is on the up fast but still a long way off the March/April peak. They also think there is a very strong North/South divide along the classic Severn estuary to the Wash line:

Fascinating. I must confess my first reaction to seeing that chart is to wonder if something has gone wrong in the analysis somewhere.

As for the infection graph - interesting reading. I wonder how good they are at distingushing Covid symptoms from other things that are likely to spread at this time of year...and with schools back.

Apparently 34% of people have also given up with facts, figures and charts.

Adn 76% percentage of statistics are made up. Like this one.

 

[NorthOxonian]

That is very strange. I can't think of any circumstance that would cause that geographical distribution. It doesn't reflect income levels, population density, strength of lockdown measurers etc.

Not least because Bracknell, Ipswich, and London all have northern levels of infection despite being distinctly southern!

 

[yorksrob]

Not least because Bracknell, Ipswich, and London all have northern levels of infection despite being distinctly southern!

Well, I would have expected remote rural areas to have similar characteristics whether North or South, since they have similar demographics, similar levels of wealth, similar geographical characteristics and similar cultural norms but the opposite appears to be the case.