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

[Bletchleyite]

But also, if you're having a house party and there's a knock at the door everyone runs out into the garden (then back into the house once they've gone). Which makes enforcement difficult.

 

[Yew]

But also, if you're having a house party and there's a knock at the door everyone runs out into the garden (then back into the house once they've gone). Which makes enforcement difficult.

Given current police provision, enforcement is already basically impossible

 

[scotrail158713]

In which case rule of six indoors, rule of 30 outdoors (including gardens) would make more sense.

I completely agree. I’m annoyed it applies outside as well.
I do to a certain extent agree with the point @Bletchleyite has made as well though.

 

[Howardh]

Our new "spike" started 3 - 4 weeks ago. By now there should be a corresponding spike in deaths, or at least hospital admissions. Every graph I have seen shows death rates and admissions low and stable.
In the Downing Street public briefing I didn't notice any mention of deaths and I didn't see any graphs for hospital admissions (I may have missed them?). If they weren't shown, would it be because the evidence doesn't back up the lockdown?

 

[Richard Scott]

Our new "spike" started 3 - 4 weeks ago. By now there should be a corresponding spike in deaths, or at least hospital admissions. Every graph I have seen shows death rates and admissions low and stable.
In the Downing Street public briefing I didn't notice any mention of deaths and I didn't see any graphs for hospital admissions (I may have missed them?). If they weren't shown, would it be because the evidence doesn't back up the lockdown?

And this is the issue, I may be supportive of the new imposed measures if there was a reason but currently there isn't. If admissions do start to rise then problem will be people will already have had enough and much less likely to follow them.

 

[Bikeman78]

It's house parties and family gatherings that are being mostly implicated.

They are all but impossible to clamp down on. From my observations, people were flouting the rules within weeks of lockdown starting. Neighbours both sides are in their 70s. They both had family round to visit.

 

[Domh245]

In the Downing Street public briefing I didn't notice any mention of deaths and I didn't see any graphs for hospital admissions (I may have missed them?). If they weren't shown, would it be because the evidence doesn't back up the lockdown?

English Hospital admissions have near enough doubled in the last week for which the data is complete, and have been on the up even before then

Official UK Coronavirus Dashboard

GOV.UK Coronavirus dashboard

coronavirus.data.gov.uk

26th Aug: 56
2nd Sep: 79
9th Sep: 136

Deaths thankfully remain stable, although this could be down to any of: improved treatments, 'harvesting' effects, and the current demographic of infected people (or more)

 

[Bletchleyite]

Deaths thankfully remain stable, although this could be down to any of: improved treatments, 'harvesting' effects, and the current demographic of infected people (or more)

Or just the fact that they lag admissions by about 2-3 weeks.

 

[Howardh]

English Hospital admissions have near enough doubled in the last week for which the data is complete, and have been on the up even before then

Official UK Coronavirus Dashboard

GOV.UK Coronavirus dashboard

coronavirus.data.gov.uk

26th Aug: 56
2nd Sep: 79
9th Sep: 136

Deaths thankfully remain stable, although this could be down to any of: improved treatments, 'harvesting' effects, and the current demographic of infected people (or more)

https://www.bbc.co.uk/news/uk-51768274 shows a still airly stable low line, and a seven-day average of 146, not including Scotland (poss NI too?). To me - as it stands today, that doesn't look much of an issue and is hardly putting the NHS under stress. Clearly zero would be better, but if in the next month there's no significant increase...can we start to get back to normal? *Also note after inspecting the graphs in Domh245's kind link, the number of patients in the moste derious condition, ventilators, has barely risen over the previous 5 weeks or more.

 

[Meerkat]

Without being sure why deaths aren’t following cases (yeah I know lots of could bes and maybes.....) this argument whiffs a bit of the falling man saying “still ok, still ok, still ok”

 

[bramling]

Without being sure why deaths aren’t following cases (yeah I know lots of could bes and maybes.....) this argument whiffs a bit of the falling man saying “still ok, still ok, still ok”

There sure are a lot of unknowns, however it's pretty clear from America where no doubt we all shuddered when infections went through the roof, yet a couple of months further forwards it *is* quite clear deaths haven't risen correspondingly.

It really would be helpful to understand why this is. Shielding? Health services becoming more adept at treatment? Virus now less virulent? Virus already "got" those who were most susceptible?

 

[talldave]

English Hospital admissions have near enough doubled in the last week for which the data is complete, and have been on the up even before then

Official UK Coronavirus Dashboard

GOV.UK Coronavirus dashboard

coronavirus.data.gov.uk

26th Aug: 56
2nd Sep: 79
9th Sep: 136

Deaths thankfully remain stable, although this could be down to any of: improved treatments, 'harvesting' effects, and the current demographic of infected people (or more)

Well discharges must have doubled too because the number of people in hospital hasn't doubled. In fact reduced by 8 today.

That's Project Fear vs Project Reality for you......

 

[yorkie]

If someone is asymptomatic with Sars-Cov-2 but is simultaneously infected with another virus, such as 'flu, and becomes ill with 'flu, would they count as a hospital admission under Covid19, even if they have not developed any Covid symptoms? I hope not, but I'd like some reassurance if possible, as this could cause all sorts of problems if it does count...

Also if someone does have Covi19 symptoms but is in hospital for an unrelated reason, e.g. cancer, a heart attack, etc would they contribute to the Covid19 hospitalisation stats?

I would like to see stats for people who are hospitalised with 'flu on a like-for-like basis with Covid19, so that we can make comparisons.

 

[6862]

I would like to see stats for people who are hospitalised with 'flu on a like-for-like basis with Covid19, so that we can make comparisons.

I very much doubt such information would be made easily publically accessible, as it would only require admissions to be on a similar order of magnitude to coronavirus admissions for people to recognise that the threat is much diminished. And of course the government wouldn't want us to think that, as it would undermine public compliance. They need a second wave (real or exaggerated) to keep compliance.

 

[Bantamzen]

There sure are a lot of unknowns, however it's pretty clear from America where no doubt we all shuddered when infections went through the roof, yet a couple of months further forwards it *is* quite clear deaths haven't risen correspondingly.

It really would be helpful to understand why this is. Shielding? Health services becoming more adept at treatment? Virus now less virulent? Virus already "got" those who were most susceptible?

Or the simplest answer, that we are testing more people including those who are not requiring medical attention for the virus?

 

[Bletchleyite]

If someone is asymptomatic with Sars-Cov-2 but is simultaneously infected with another virus, such as 'flu, and becomes ill with 'flu, would they count as a hospital admission under Covid19, even if they have not developed any Covid symptoms? I hope not, but I'd like some reassurance if possible, as this could cause all sorts of problems if it does count...

Also if someone does have Covi19 symptoms but is in hospital for an unrelated reason, e.g. cancer, a heart attack, etc would they contribute to the Covid19 hospitalisation stats?

I would like to see stats for people who are hospitalised with 'flu on a like-for-like basis with Covid19, so that we can make comparisons.

Given that deaths are "died within 28 days of a positive test", I suspect similarly hospitalisations are "admitted to hospital with a positive test on admission". So yes.

 

[AdamWW]

Given that deaths are "died within 28 days of a positive test", I suspect similarly hospitalisations are "admitted to hospital with a positive test on admission". So yes.

Yes that is the most important bit of information I'd like to have and can't find.

If we're including all the people admitted for other reasons who get a positive result when admitted to hospital, they are inevitably going to go up as infections increase.

Remember though that much as people like to claim that all the Covid death figures are of people who died within 28 days of a positive test, some figures use that, others use what is given on the death certificate. (And yes that's a can of worms in itself).

As before, it seems to me that the only truly reliable meausure we have is whether excess deaths start going up or not.

 

[Domh245]

Well discharges must have doubled too because the number of people in hospital hasn't doubled. In fact reduced by 8 today.

That's Project Fear vs Project Reality for you......

Northern Ireland hadn't reported for yesterday, which explains the drop, the trend otherwise does show a slight increase, England especially. It would have been impressive if the number hospitalised based on the admissions doubling as there were 400 odd people in English hospitals on the 2nd. Think of the bucket analogy (pouring water into a bucket [admissions] which then trickles out [discharged]) - if you double the flow into the bucket, the amount of water in the bucket doesn't double in the same time frame

It is good though that the numbers are only trickling up at this point. 'Project Reality' is to realise that that number will only go up though, rather than ignoring all the other data indicating the trend because one of them isn't growing at the same rate yet.

Also if someone does have Covi19 symptoms but is in hospital for an unrelated reason, e.g. cancer, a heart attack, etc would they contribute to the Covid19 hospitalisation stats?

Yes that is the most important bit of information I'd like to have and can't find.

Under the 'about' tab on the healthcare data page:

England data include people admitted to hospital who tested positive for COVID-19 in the 14 days prior to admission, and those who tested positive in hospital after admission

. Inpatients diagnosed with COVID-19 after admission are reported as being admitted on the day prior to their diagnosis. Admissions to all NHS acute hospitals and mental health and learning disability trusts, as well as independent service providers commissioned by the NHS are included. Data are reported daily by trusts to NHS England and NHS Improvement. Full NHS definition can be found in the estimated admissions section of the Publication Definitions document available on the NHS COVID-19 Hospital Activity website. Reporting dates reflect admissions and new in-patient diagnoses for the previous day. On 21st August a 1 day lag behind NHS reporting was corrected.

Northern Ireland data include confirmed COVID-19 admissions by admission date.

Data for Scotland include admissions into hospital for patients who tested positive for COVID-19 in the 14 days prior to admission to hospital, on the day of their admission, or during their stay in hospital. The data are published weekly by Public Health Scotland.

Wales data include confirmed and suspected cases, and are the numbers of admissions to the hospital in the previous 24 hour period up to 9am. The numbers of admissions are not comparable with other nations.

It is only Wales that will include patients for suspected COVID, all others require a positive test. Still susceptible to the "positive test but unrelated hospitalisation" but my suspicion is that such numbers will be small, those with COVID symptoms should be self-isolating and those then presenting to hospital will likely be as a result of complications from the symptoms than anything else.

 

[Meerkat]

There sure are a lot of unknowns, however it's pretty clear from America where no doubt we all shuddered when infections went through the roof, yet a couple of months further forwards it *is* quite clear deaths haven't risen correspondingly.

Have you got the data for this?
Looking at the below the new deaths curve for Florida seemed to roughly follow the new cases curve, delayed by about a fortnight.
https://coronavirus.jhu.edu/data/state-timeline/new-deaths/florida/0
And this says French deaths are rising
https://www.thelocal.fr/20200904/covd-19-deaths-and-hospitalisations-in-france-begin-to-rise-again

There are now 461 Covid-19 patients in intensive care, up from 380 two weeks ago. While this is not a massive rise, the general trend has been for slight increases on most days over the last fortnight.

Similarly the daily death rate is also showing a small but steady increase, with 21 people dying in hospital in the previous 24 hours, compared to 17 two weeks ago. While the increase is not large, there has again been a general trend of slight increases over the last week.

France reports its hospital deaths daily and, after encountering logistical problems, releases a weekly total for deaths in nursing homes. A weekly average of total deaths also shows a small rise, standing at 18.5 for the last week against 13.2 for the week before and 10.5 for the week before that.

Not dramatic rises, but certainly not true to say there hasn’t been a rise

 

[takno]

Or the simplest answer, that we are testing more people including those who are not requiring medical attention for the virus?

Obviously the rate of people testing positive is going up as well, but perversely that could be because we are correctly identifying hotspots and track and trace is getting better at its job. Earlier on when there were fewer tests, more of them were going to health workers and other people who are massively unlikely to have it after the initial wave simply because they will have been exposed and had it without symptoms months ago.

 

[Howardh]

Or the simplest answer, that we are testing more people including those who are not requiring medical attention for the virus?

I've been tested, not because I felt ill or had any of the symptoms, but because someone my local got infected. If the message got out to everyone in the pub that night, then 20-odd would have gone for a test.

 

[yorkie]

Not dramatic rises, but certainly not true to say there hasn’t been a rise

But how much of a rise?

A rise of some magnitude is inevitable if people are counted as dying with Covid despite dying of something else when asymptomatic or witl mild symptoms.

And how does this compare to people with 'flu?

 

[Meerkat]

But how much of a rise?

A rise of some magnitude is inevitable if people are counted as dying with Covid despite dying of something else when asymptomatic or witl mild symptoms.

And how does this compare to people with 'flu?

That’s a fair question but the lack of an answer makes me more cautious about reducing restrictions, not less, as you seem to be.

 

[AdamWW]

Under the 'about' tab on the healthcare data page:

Yes so this is including people with positive tests, which is what I would have thought.

What I meant (and is not what I wrote) is that until I've seen a breakdown of how many of these people were hospitalised because of Covid-19 and how many with, I don't think I can offer a reasoned opinion on whether these numbers are a concern or not.

I messed up the quoting and I forget now who said this:

but my suspicion is that such numbers will be small, those with COVID symptoms should be self-isolating and those then presenting to hospital will likely be as a result of complications from the symptoms than anything else.

But not if they are asymptomatic, and the only reason anyone knows they are positive is because of a routine test on admission, I'd have thought.

Actually knowing the difference between 'tested positive within 14 days before' and 'tested positive on arrival' might be useful.
I presume if someone is booked for routine surgery, they're unlikely to get it if they test positive beforehand.

But if they are asympotomatic and get a positive test on arrival, does that count in the hospital admission figures?

 

[yorkie]

That’s a fair question but the lack of an answer makes me more cautious about reducing restrictions, not less, as you seem to be.

Just to be clear, you have no interest in excessing 'caution' when it comes to mental health issues and preserving peoples livelihoods; is that correct?

Do you realise and accept that the average age of a Covid19 death is 82 whereas the average age of people who have had their livelihoods ruined, or who have committed suicide, or who are suffering depression, as a result of the measures you advocate, will be far lower?

 

[Bantamzen]

Yes so this is including people with positive tests, which is what I would have thought.

What I meant (and is not what I wrote) is that until I've seen a breakdown of how many of these people were hospitalised because of Covid-19 and how many with, I don't think I can offer a reasoned opinion on whether these numbers are a concern or not.

but my suspicion is that such numbers will be small, those with COVID symptoms should be self-isolating and those then presenting to hospital will likely be as a result of complications from the symptoms than anything else.


But not if they are asymptomatic, and the only reason anyone knows they are positive is because of a routine test on admission, I'd have thought.

Actually knowing the difference between 'tested positive within 14 days before' and 'tested positive on arrival' might be useful.
I presume if someone is booked for routine surgery, they're unlikely to get it if they test positive beforehand.

But if they are asympotomatic and get a positive test on arrival, does that count in the hospital admission figures?

I would imagine that someone being tested as positive on admission but with symptoms would be treated exactly as someone with, as it would not be clear if they were yet to get them or if they would have none at all. And so I'd also imagine this would be reflected on the stats, i.e. they would be counted.

 

[AdamWW]

Just to be clear, you have no interest in excessing 'caution' when it comes to mental health issues and preserving peoples livelihoods; is that correct?

Do you realise and accept that the average age of a Covid19 death is 82 whereas the average age of people who have had their livelihoods ruined, or who have committed suicide, or who are suffering depression, as a result of the measures you advocate, will be far lower?

The figures we have in the UK for death rates vs age are based on a functioning health system, albeit one that was stressed in places during the peak.

If cases rise to the point that the health system can't cope, it won't be good for people of any age suffering from Covid-19 or anything else (such as winter flu).

You may think that's unlikely. You may be right.

But the last time I looked the government was being advised that this is a serious risk, so it's reasonable that they are acting cautiously.

 

[Meerkat]

Just to be clear, you have no interest in excessing 'caution' when it comes to mental health issues and preserving peoples livelihoods; is that correct?

Do you realise and accept that the average age of a Covid19 death is 82 whereas the average age of people who have had their livelihoods ruined, or who have committed suicide, or who are suffering depression, as a result of the measures you advocate, will be far lower?

We aren’t in lockdown, most businesses are open, the schools are open, and the government clearly is very keen on keeping it that way. Get opening up wrong and you will be pretty much forced into a hardcore lockdown though.

 

[317 forever]

Indeed, that's how I got the current average of 18.33, and hence including today we still have 4 remaining days of this week to get that average down much lower hopefully.

Otherwise, away from this I've always considered Saturday to be the start of the week.

I know this is digressing, but tv listing magazines and London buses treat Saturday as the start of the week. Even this millennium started on a Saturday.

 

[Howardh]

We aren’t in lockdown, most businesses are open, the schools are open, and the government clearly is very keen on keeping it that way. Get opening up wrong and you will be pretty much forced into a hardcore lockdown though.

I am. Can't go to the pub (they're forcibly closed) or have a sit-dowm meal in a cafe, can't make an unnecessary journey, can't play badminton, volleyball or snooker indoors with my chums. And, due to the risk of getting/passing on covid, I haven't had any nocturnal adult fun for months.

My life's ticking away, and I'm mentally stressed about it.