International Statistics - UK's record on testing

[AdamWW]

and you would include deaths caused directly and indirectly by lockdown, along with deaths due to people unable and/or unwilling to seek treatment for other illnesses as a result of either policies, or patient decisions, to reduce the spread of the virus, right?

Well that's included in the excess death figures, and I'd argue that's a good thing to use when comparing countries.

Although I find it hard to see how the health service would have done any better treating non Covid cases if we hadn't had a lockdown.

The vast majority do not get seriously ill if infected; we already know this!

OK serves me right for using vague phrases. Depends on your definition of vast.

How about this - we can let coronavirus spread through the UK unchecked if we have good evidence that the number getting seriously ill or dying would either:
- Be such as to not overwhelm the health service, or
- Be not significantly worse than in a bad flu winter?

 

[talldave]

I think most people here are aware that not everyone infected has symptoms, and not everyone with symptoms needs hospitalisation or dies.

That's why some us are getting a bit fed up with the economy and society being destroyed for what is the equivalent of a bad flu year, whilst the figures are conveniently assembled in such a way to make even car crash victims a Covid statistic.

 

[AdamWW]

That's why some us are getting a bit fed up with the economy and society being destroyed for what is the equivalent of a bad flu year, whilst the figures are conveniently assembled in such a way to make even car crash victims a Covid statistic.

I do understand the sentiment, and it seems to be the majority one here.

But some of us think that that all the evidence (from the UK and abroad) points to the fact that the lockdown had a huge impact and it's only been the equivalent of a bad flu year because of the lockdown. I have pointed out in other threads what I think some of the flaws are in the logic that interprets the data otherwise.

Fortunately for me, the government appears to share my view.

 

[Ken H]

1. we have to understand how bodies fight an infection
Once some infection gets into our body, we have a first line of defence that will try and kill it.
only when the infection starts to get a hold do we start to make antibodies.
So testing for antibodies will not tell us how many have had it in the past.
(Thats even if an antibody test is accurate - I hear some may detect common cold antibodies)

2. on differing reporting in different countries mentioned above. In UK, the requirement of death reporting were relaxed for CV19. These requirements were put in after mass murderer Dr Shipmans conviction. So now we accept a death cert with CV19 on it when the certifying doctor hasnt seen the patient and no CV19 test has been done. Making Cv19 a notifyable disease hasnt helped.
I have a contact in Germany who is a hospital doctor equivalent to a UK registrar, currently working in A+E. She is quite clear. to get CV19 on a death cert the doctor has to be sure Cv19 was a contributing factor in the death.
Clearly comparing DE and UK stats is a nonsense.

3. The Italian health department has done a study of a sample of Cv19 deaths. They found that only 12-14% of deaths recorded as CV19 were actually OF CV19, the rest were WITH CV19

The statistics surrounding this have been rubbish, and the media have not questioned them but have just detached bare headline numbers from the stats and published them.

The Centre for Evidence based medicine at university of Oxford has been checking the numbers and has published some papers on this - see https://www.cebm.net/

 

[yorkie]

But some of us think that that all the evidence (from the UK and abroad) points to the fact that the lockdown had a huge impact and it's only been the equivalent of a bad flu year because of the lockdown. I have pointed out in other threads what I think some of the flaws are in the logic that interprets the data otherwise

This is just a re-run of arguments made in previous threads, isn't it? In which case I refer you to our previous discussions!

Does anyone have anything further to contribute regarding testing and the issues raised in the original post specifically?

 

[AJW12]

and you would include deaths caused directly and indirectly by lockdown, along with deaths due to people unable and/or unwilling to seek treatment for other illnesses as a result of either policies, or patient decisions, to reduce the spread of the virus, right?

The vast majority do not get seriously ill if infected; we already know this!

I think the argument for 'Herd Immunity' or the Sweden option will be met with a little bit more interest should we see any sort of second increase now. Back in March, you'd be 'heartless' or 'not caring about people dying' for saying so, but what these pro-lockdown activists don't realise is that restrictions like this come with a host of by-products. You have domestic abuse incidents up 50%, thousands of people dying at home because they don't want to burden the NHS, suicides up.... and that's not even mentioning the deaths to come because their operation got cancelled or because they don't want to waste NHS time asking them to look at that lump they just found. We're already potentially seeing reports that locking down had a much bigger consequence than thought; maybe even bigger than not locking-down.

Furthermore we know a lot more now than we did before. We know the impact on younger and healthier people (next to none) and we know that somewhere in the range of 80% of people walk round with it, with no symptoms and therefore no clue they have it. This does kinda undermine any test/trace strategy (and, in fact, case numbers).

There are no signs yet here of a second wave, only small local increases; but we have to remember context. The WHO today are saying some of the European increases are down to higher numbers of infections amongst the young. Higher numbers of cases in younger people aren't actually a problem; very very few of them will need any kind of treatment and very, very, very few of them will get into any serious bother. However it's a reminder of the need to bare individual responsibility- those young people pass it on to their grandparents and it's a very different matter.

 

[Ken H]

I do understand the sentiment, and it seems to be the majority one here.

But some of us think that that all the evidence (from the UK and abroad) points to the fact that the lockdown had a huge impact and it's only been the equivalent of a bad flu year because of the lockdown. I have pointed out in other threads what I think some of the flaws are in the logic that interprets the data otherwise.

Fortunately for me, the government appears to share my view.

This can never be resolved. Did we get a fall in CV19 cases because or lockdown, or would it have happened anyway? How can we ever know?

 

[AJW12]

This can never be resolved. Did we get a fall in CV19 cases because or lockdown, or would it have happened anyway? How can we ever know?

Anyone interested - I'd recommend having a look at this thread https://twitter.com/stevebrown2856/status/1280067312071122945

(1/13) The curious case of COVID-19 trends in London vs the rest of England, and the case for resistance in the population: A thread. The graph below shows the trend of COVID cases in London, March to May. The orange line is a centred 7-day moving average. So far, so normal:

We can estimate a crude R(t), by comparing the change in the moving average over 4-day periods. Note that, by this crude measure, R(t) was already falling by the beginning of March:

Here’s the same graph for the North West region. For the benefit of those reading from outside the UK, social distancing measures were implemented on 16th March and a moderate lockdown from 23rd March. The measures were uniform across England:

Let’s compare the early trends, London vs. North West, normalising using cases / 1000 population:

With a relatively small percentage of the population affected, what trend might we expect to see with uniform lockdown measures? Something like this, maybe?

Let’s look at the actual trends. Now this is odd. What’s going on here then? Testing capacity increased enormously through April, which explains the apparent flat-lining in the North West, but what’s going on in London?
https://twitter.com/stevebrown2856/status/1280067319214071813/photo/1

Ok, maybe the North West is unusual. What about the other regions? Wowser, this is getting really odd, London peaks first but then falls away (again, note the effect of increased testing):

If we normalise against the peak in each region, the trend is even more stark. London was hit early and hard, but then cases plummet while others regions catch up:

So, once London was hit early on (probably with lots of undetected cases), the epidemic faded, even though social distancing is much more difficult in a huge city and with many key workers still using public transport. Pretty much all over by the end of May:

So, something else was in play. Cambridge University has estimated the attack rate (% of people infected) in London at 18% (https://mrc-bsu.cam.ac.uk/now-casting/) and this is supported by seroprevalence data:

Intriguingly, this is a similar level of prevalence to not-locked-down Stockholm, where the outbreak is also fading fast, https://folkhalsomyndigheten.se/contentassets/e1702f53eea144cdb1ca2ef854b45c35/estimates-peak-day-infected-during-covid-19-outbreak-20103.pdf and New York City https://6sqft.com/new-york-covid

So, we can see from the data that, once prevalence approaches 20%, the epidemic seems to burn out. Otherwise, why would cases fall in London before anywhere else in England? Even though R would naturally tend to be higher in a huge city?

It's an interesting take on the data that questions exactly that.

 

[Ken H]

Anyone interested - I'd recommend having a look at this thread https://twitter.com/stevebrown2856/status/1280067312071122945

It's an interesting take on the data that questions exactly that.

 

[AdamWW]

Anyone interested - I'd recommend having a look at this thread https://twitter.com/stevebrown2856/status/1280067312071122945

It's an interesting take on the data that questions exactly that.

The article described here from Imperial College and Oxford comes to the opposite conclusion to the Twitter thread.

Like the Twitter thread referred to, it's too long to quote in full, but the summary is

There is no evidence that declines in transmission of the SARS-CoV-2 coronavirus in some countries are the result of herd immunity, says new analysis.

 

[yorkie]

The article described here from Imperial College and Oxford comes to the opposite conclusion to the Twitter thread.

Like the Twitter thread referred to, it's too long to quote in full, but the summary is

This was published 6 weeks ago when some people stubbornly or naively refused to believe that people can have immunity to Covid19 without detectable levels of antibodies.

For example, quoted from the above article:

Study author Dr Lucy Okell, also from Imperial, said: “We see huge variation between countries so far in COVID mortality rates and antibody prevalence (showing how many people have been infected in the past).

If she is saying that, then clearly the entire premise of what they are saying is flawed.

The role of T cells in the body's fight against Covid19 has been documented many times on this forum in recent weeks, so I am surprised you are citing this research which ignores these facts.

Also none of what they say counteracts the argument posted by Steve Brown, so I am surprised you think it does.

If you think Steve Brown is wrong, I'd be interested to hear your alternative theory.

 

[MikeWM]

If she is saying that, then clearly the entire premise of what they are saying is flawed.

Neil Ferguson is listed as an author of the paper, so that isn't entirely surprising!

 

[AdamWW]

This was published 6 weeks ago when some people stubbornly or naively refused to believe that people can have immunity to Covid19 without detectable levels of antibodies.

Their arguments do not seem to hinge on antibody tests (although they do talk about them as well):

The researchers reached their conclusions after looking at multiple data sources. They found that the cumulative mortality rate from COVID-19 plateaued at very different levels in different countries, whereas with herd immunity this might be expected to be broadly the same. For example, there are large differences in mortality rates between Germany, the Netherlands and Italy, which all have good quality health care and testing capacity.

Countries that went into lockdown early also experienced fewer deaths in subsequent weeks, according to the analysis, suggesting the differences in the timings and stringency of lockdowns and interventions explain the different COVID-19 death rates in these countries. The authors argue this would not have been the case if epidemics had faded out due to herd immunity being reached.

This looked to me as if it was a contradiction to the conclusion the twitter thread, based on looking at infection levels.

 

[Deerfold]

That's why some us are getting a bit fed up with the economy and society being destroyed for what is the equivalent of a bad flu year, whilst the figures are conveniently assembled in such a way to make even car crash victims a Covid statistic.

But it's not the equivalent of a bad flu year.
In a bad flu year we might have 20,000 die.

50,000 is the figure we've had having taken the most serious measures in a century to stop a disease spreading.

 

[jtuk]

But it's not the equivalent of a bad flu year.
In a bad flu year we might have 20,000 die.

50,000 is the figure we've had having taken the most serious measures in a century to stop a disease spreading.

That's a difference of 30,000, which is coincidentally the number that have lived longer than expected over the last two years due to mild flu seasons

 

[yorkie]

In a bad flu year we might have 20,000 die.

England alone had over 28,000 flu deaths in the 2014-15 'flu season.

However it is unlikely that these were counted in the same way as Covid19, so the figures are not directly comparable; there is a thread here about how people are counted towards Covid19 deaths even if they didn't die of Covid19 but merely tested positive weeks before dying.

The last couple of years have been very good years in terms of low levels of 'flu deaths; it's hard to believe this did not contribute to the high figures we've seen with Covid19.

 

[AdamWW]

If you think Steve Brown is wrong, I'd be interested to hear your alternative theory.

Sorry - didn't answer this.

I can't follow his reasoning.

He seems to be trying to calcluate R directly from the trend in the number of positive tests.

But these mumbers are very hard to interpret because testing capacity changes over time and so does the criteria to get one so I'm a bit hesitant to attempt to offer an explanation.

But try this: Initially you didn't just get a test if you had the symptoms, so I think this is probably tracking hospital admissions more than anything else.

Since it takes time to get that ill, and the time will vary and cluster around the mean value, this isn't going to track R, and so far as I can see you'd expect to see a peak, and the earlier that infections took hold in a particular area, the earlier the peak would be.

Where I would expect to see evidence of greater immunity in London changing the course of the pandemic would be in the growth numbers (or R if you like).

We now have infections at a low enough number that it's hard to get reliable values for individual areas of the UK, but the government figures from last Friday don't suggest any difference in London.

Region	R	Growth rate % per day
England	0.8-1.0	-4 to 0
East of England*	0.8-1.0	-3 to +2
London*	0.8-1.0	-5 to +1
Midlands	0.7-1.0	-5 to -0
North East and Yorkshire	0.8-1.0	-4 to -0
North West*	0.7-1.0	-5 to -1
South East*	0.8-1.0	-3 to +1
South West*	0.7-1.0	-5 to +2

[\QUOTE]

 

[talldave]

But it's not the equivalent of a bad flu year.
In a bad flu year we might have 20,000 die.

50,000 is the figure we've had having taken the most serious measures in a century to stop a disease spreading.

2018 was a 50k flu deaths year. And yes I know that's contrasted with lockdown Covid, but it was envisaged we needed a stack Nightingale hospitals with lockdown and we didn't, so how bad would no lockdown have actually been? An experiment we can't do.

Nobody batted an eyelid in 2018 at 50k deaths, nothing. So apparently 50k deaths doesn't warrant any action, so why is everyone horrified and running scared 2 years later, when total Covid deaths haven't yet reached bad flu year levels?

It all feels a bit disproportionate.

 

[corfield]

I really cannot see them sorting that now. It allows them to continue the scare tactics that filter down through the media. Anyone thinking that originally could have been accused of being cynical but not now, it's blatantly obvious.

This is what I dont understand.

Boris et al are going to be in a firing line for years after this for their managment and the outcome. Inquiriers galore and calls for criminal charges already from the Left. Why the hell have they not done everything they can do drive the numbers down?

I expected by now we’d be arguing about whatever their next outrageous tactic was to disallocate a death from Covid - not that they are still knowingly overcounting.

 

[corfield]

1. we have to understand how bodies fight an infection
Once some infection gets into our body, we have a first line of defence that will try and kill it.
only when the infection starts to get a hold do we start to make antibodies.
So testing for antibodies will not tell us how many have had it in the past.
(Thats even if an antibody test is accurate - I hear some may detect common cold antibodies)

2. on differing reporting in different countries mentioned above. In UK, the requirement of death reporting were relaxed for CV19. These requirements were put in after mass murderer Dr Shipmans conviction. So now we accept a death cert with CV19 on it when the certifying doctor hasnt seen the patient and no CV19 test has been done. Making Cv19 a notifyable disease hasnt helped.
I have a contact in Germany who is a hospital doctor equivalent to a UK registrar, currently working in A+E. She is quite clear. to get CV19 on a death cert the doctor has to be sure Cv19 was a contributing factor in the death.
Clearly comparing DE and UK stats is a nonsense.

3. The Italian health department has done a study of a sample of Cv19 deaths. They found that only 12-14% of deaths recorded as CV19 were actually OF CV19, the rest were WITH CV19

The statistics surrounding this have been rubbish, and the media have not questioned them but have just detached bare headline numbers from the stats and published them.

The Centre for Evidence based medicine at university of Oxford has been checking the numbers and has published some papers on this - see https://www.cebm.net/

(2) and (3) are scary - we should be pushing to restore the Medical system’s integrity ASAP now the logic for those changes (understandable in emergency of being overwhelmed).

Do you have a link for (3) ?

Does anyone have any links to actually corroborate the points on death recording in the UK or elsewhere? I hear it and have repeated it but I really would like to see it written down somewhere authoritatvie by the people doing it.

 

[AdamWW]

1. we have to understand how bodies fight an infection
Once some infection gets into our body, we have a first line of defence that will try and kill it.
only when the infection starts to get a hold do we start to make antibodies.
So testing for antibodies will not tell us how many have had it in the past.
(Thats even if an antibody test is accurate - I hear some may detect common cold antibodies)

I wonder. If it's true that antibody tests are completely useless to tell if someone has had a disease, are they nevertheless being studied because:
1) Scientists are stupid?
2) Scientists want to fool us all?
3) In fact they are potentially useful and with many diseases antibodies do persist enough for an antibody test to be useful, though in the case of coronavirus it's possible that this is not so much the case?

For the avoidance of doubt, my money is on 3.

Scientists make mistakes, and sometimes stupid ones.

But it would be somewhat unusual to have a widespread failure to notice an error that is obvious to the layperson.

 

[Bantamzen]

I wonder. If it's true that antibody tests are completely useless to tell if someone has had a disease, are they nevertheless being studied because:
1) Scientists are stupid?
2) Scientists want to fool us all?
3) In fact they are potentially useful and with many diseases antibodies do persist enough for an antibody test to be useful, though in the case of coronavirus it's possible that this is not so much the case?

For the avoidance of doubt, my money is on 3.

Scientists make mistakes, and sometimes stupid ones.

But it would be somewhat unusual to have a widespread failure to notice an error that is obvious to the layperson.

Antibody detection is one route to understanding how the body reacts, and a potential way of confirming if someone has been exposed to the virus. But the absence of antibodies is not necessarily a signal that the person hasn't been exposed, as antibodies don't always remain in detectable numbers, and sometimes the body deals with infections without ever producing them.

 

[AdamWW]

Antibody detection is one route to understanding how the body reacts, and a potential way of confirming if someone has been exposed to the virus. But the absence of antibodies is not necessarily a signal that the person hasn't been exposed, as antibodies don't always remain in detectable numbers, and sometimes the body deals with infections without ever producing them.

Sounds a lot like my option 3 above.

 

[Deerfold]

2018 was a 50k flu deaths year. And yes I know that's contrasted with lockdown Covid, but it was envisaged we needed a stack Nightingale hospitals with lockdown and we didn't, so how bad would no lockdown have actually been? An experiment we can't do.

Nobody batted an eyelid in 2018 at 50k deaths, nothing. So apparently 50k deaths doesn't warrant any action, so why is everyone horrified and running scared 2 years later, when total Covid deaths haven't yet reached bad flu year levels?

It all feels a bit disproportionate.

If you're using the figures for Winter 2017/18 those are the excess death figures.

There was something of a furore as the vaccine seems to have been ineffective that year.

Using those figures, we're at 65,000 this year. So far. With lockdown, social distancing, bans on large gatherings...

 

[Yew]

If you're using the figures for Winter 2017/18 those are the excess death figures.

There was something of a furore as the vaccine seems to have been ineffective that year.

Using those figures, we're at 65,000 this year. So far. With lockdown, social distancing, bans on large gatherings...

That does imply that those measures were effective, but I don't think the case is clear-cut for anything apart from social distancing.

 

[Deerfold]

That does imply that those measures were effective, but I don't think the case is clear-cut for anything apart from social distancing.

It's certainly arguable how effective each measure has had. But few mainstream scientists are arguing that we should have had none of them.