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News

When was the first UK coronavirus case?

Over recent days the mainstream media have been vying with each other to reveal the identity of the United Kingdom’d Covid-19 “patient zero”.

According to The Guardian on June 1st:

In the UK, the first confirmed cases of coronavirus came on 31 January when two Chinese nationals staying in a hotel in York tested positive. But as the crisis has rolled on, and the virus’s range of distinctive symptoms become more widely known, many – some in letters to the Guardian – have asked themselves if they or their loved ones could have had it earlier.

The article reports that:

A day before the first confirmed fatality from coronavirus outside mainland China was reported on 2 February this year, the death of the influential guitarist and musician Andy Gill was announced. The 64-year-old, who fronted the post-punk band Gang of Four, died of pneumonia after two weeks in St Thomas’ hospital in London.

The trajectory of Gill’s illness, which took medics looking after him in January by surprise, is now familiar – sudden deterioration, low oxygen levels and organ failure. He had fallen sick after his band returned from a trip to China in late November.

Then on June 8th The Sunday Times published an article by their chief foreign correspondent, Christina Lamb describing her own Covid-19 like symptoms in early January and reporting that:

“Thousands of people have emailed me with classic Covid symptoms from late December and January,” said Professor Tim Spector, a leading epidemiologist at King’s College London, who runs the Covid-19 Symptom Study app to which 3.8 million people have signed up.

“Either there was another virus behaving in a similar way which has since disappeared or these were early cases.”

If so, why was it not reflected in a spike in hospital admissions or deaths? “That’s the medical mystery,” said Spector.

There were, he said, possible explanations. “People who got it were young and healthy and didn’t transfer it to the elderly, obese and so on. Many of those early cases were skiers coming back from holidays. Or the virus was in some way different and didn’t have that final stage which attacks the immune system.

Christina points out that:

Officially, the first case involving a Briton was Steve Walsh, 53, a businessman from Hove… On February 6 he was diagnosed and transferred to Guy’s Hospital in London.

Before suggesting that:

It now seems likely that Walsh was not the UK’s “patient zero”. A month earlier, Susannah Ford… had fallen ill after flying back from a skiing holiday in Austria. [She] became ill on January 6, two days after her return from a new year trip.

Ford had spent a week in the resort of Obergurgl, near the Italian border, with her husband and two teenage daughters, flying back into Gatwick on January 4. She was the only one in the family who fell ill and assumed it was something she had picked up on an earlier trip to Trinidad.

Last week Ford paid for a test that shows whether the patient’s blood contains the antibodies that form when a person successfully fights off the disease. It came back positive, confirming that she had had Covid-19, although not when.“I’m convinced it’s when I was ill in January,” she said. “I can’t prove it was then but I haven’t been ill since or come into contact with people with it.”

Is there any advance on early January? Not as far as I am aware in the UK, but there have been several reports that European athletes who attended the Military World Games in Wuhan, China in October 2019 fell ill with symptoms resembling those of Covid-19.

According to an article in The Times on May 8th:

A French athlete who fell ill after competing in Wuhan in October says she has been told by doctors that Covid-19 was the likely cause of her ailment.The claim by Élodie Clouvel, an Olympic silver-winning pentathlete, has bolstered speculation that the coronavirus may have been present in the Chinese city several weeks before it was declared and then carried around the world by those who had taken part in an international competition there.

However according to the Global Times on February 24th:

A Wuhan hospital clarified the clinical diagnoses of five foreign athletes at the 7th CISM Military World Games held in Wuhan, Central China’s Hubei Province in October 2019, saying that they contracted malaria and were not infected by the novel coronavirus.

And what of the science? According to a paper published in “Infection, Genetics and Evolution” in early May:

We observe an estimated time to the Most Recent Common Ancestor, which corresponds to the start of the COVID-19 epidemic, of 6 October 2019–11 December 2019 (95% CIs). These dates for the start of the epidemic are in broad agreement with previous estimates performed on smaller subsets of the COVID-19 genomic data using various computational methods.

It seems that it’s not beyond the bounds of possibility that several athletes brought the SARS-CoV-2 virus to Europe from Wuhan in late October 2019.

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News

UK “Covid-19 Hypoxia” Trial Announced

According to an article by Emily Morgan on the ITV News web site:

A month ago Robert Peston and I highlighted the worrying condition known as ‘happy hypoxia’ which has been affecting thousands of coronavirus patients.

It has become apparent over the course of the pandemic that some patients appear absolutely fine and apparently not in distress but have oxygen levels so low they would normally be unconsciousness or even dead.

We highlighted it because medics raised the alarm that many people were getting to hospital too late and should be brought in much sooner.

We’d noticed the mention of what we called ‘Covid-19 hypoxia’ in the medical literature rather more than a month ago, which was one of the reasons why in the middle of April we applied to Innovate UK, the UK’s innovation agency, for R&D funding to develop a “Covid-19 eHealth Data Acquisition Unit:

Today we are delighted to be able to announce that our application has been successful! We’ll be making a formal announcement in the near future, but getting back to Emily’s article for now:

NHS England told me exclusively they were looking at changing guidelines for 111 call handlers and they were looking at giving patients devices that could monitor their oxygen levels at home.

For the families of those who have died it was a small victory.

Today the NHS has made good its pledge to look at it.

A pilot is now underway in 11 hospital trusts where some Covid-19 patients and at risk patients are being given oximeters.

A “pulse oximeter” is one of the sensors we will be connecting to the “domestic” version of our Covid-19 data acquisition unit, which will use “Artificial Intelligence”, or perhaps more accurately “Machine Learning”, to infer the state of a person’s health from the information it receives from its assorted inputs.

Emily continues:

These are really simple devices which clip on your finger and give you a quick and easy reading of oxygen levels in your blood.

The results are pinged via an App back to doctors who can keep an eye on them.

It’s so simple and so clever that Dr Andy Barlow from Watford General Hospital says it will absolutely save lives.

Here’s a picture of one such “life saving” device:

A picture of our very own Covid-19 eHealth data acquisition unit will be available in due course!

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News

UK Excess Deaths Due to Covid-19 Hypoxia?

The UK’s Office For National Statistics has just released a report which “Examines death registrations not involving coronavirus (COVID-19), to understand the apparent increase in deaths”. It nonetheless suggests that a significant number of the UK’s recent “excess deaths” that make no mention of Covid-19 on the death certificate might well have been caused by the SARS-CoV-2 virus. In section 5 concerning “Deaths due to dementia and Alzheimer disease” the ONS point out that:

The sudden rise in deaths due to dementia and Alzheimer disease is so sharp that it is implausible that the full increase observed could have happened by chance. The absence of large rises in deaths due to this cause that mention conditions that could exhibit similar symptoms to COVID-19 suggests that if COVID-19 is involved in the increase in deaths due to dementia and Alzheimer disease, the usual symptoms of COVID-19 were not apparent. This could fit with recent clinical observations, where atypical hypoxia has been observed in some COVID-19 patients. In someone with advanced dementia and Alzheimer disease, the symptoms of COVID-19 might be difficult to distinguish from their underlying illness, especially with the possibility of communication difficulties.

The terms “Covid-19 Hypoxia” and “silent hypoxia” have been used in the medical literature for quite some time, amongst other things to suggest that “overuse of intubation” for Covid-19 patients should be addressed.

We await further news on the attribution of UK deaths to the many effects of the SARS-Cov-2 virus with interest.

Categories
Testing

The UK Government’s Covid-19 recovery strategy

Fresh from some very mixed messaging in the United Kingdom’s mainstream media, yesterday the UK Government announced the release of their “Covid-19 recovery strategy”:

This document describes the progress the UK has made to date in tackling the coronavirus (COVID-19) outbreak, and sets out the plans for moving to the next phase of its response to the virus.

The strategy sets out a cautious roadmap to easing existing measures in a safe and measured way, subject to successfully controlling the virus and being able to monitor and react to its spread. The roadmap will be kept constantly under review as the epidemic, and the world’s understanding of it, develops.

The section of the roadmap of most interest to us is 5.6, “Testing and tracing”. There we learn that:

Mass testing and contact tracing are not, in themselves, solutions, but may allow us to relax some social restrictions faster by targeting more precisely the suppression of transmission. The UK now has capacity to carry out over 100,000 tests per day, and the Government has committed to increase capacity to 200,000 tests per day by the end of May.

The Government has appointed Baroness Harding to lead the COVID-19 Test and Trace Taskforce. This programme will ensure that, when someone develops COVID-19-like symptoms, they can rapidly have a test to find out if they have the virus – and people who they’ve had recent close contact with can be alerted and provided with advice. This will:
● identify who is infected more precisely, to reduce the number of people who are self isolating with symptoms but who are not actually infected, and to ensure those who are infected continue to take stringent self-isolation measures; and
● ensure those who have been in recent close contact with an infected person receive rapid advice and, if necessary, self-isolate, quickly breaking the transmission chain.

This cycle of testing and tracing will need to operate quickly for maximum effect, because relative to other diseases (for example SARS) a proportion of COVID-19 sufferers almost certainly become infectious to others before symptoms are displayed; and almost all sufferers are maximally infectious to others as soon as their symptoms begin even if these are initially mild.

For such a system to work, several systems need to be built and successfully integrated. These include:
● widespread swab testing with rapid turn-around time, digitally-enabled to order the test and securely receive the result certification;
● local authority public health services to bring a valuable local dimension to testing, contact tracing and support to people who need to self-isolate;
● automated, app-based contact-tracing through the new NHS COVID-19 app to (anonymously) alert users when they have been in close contact with someone identified as having been infected; and
● online and phone-based contact tracing, staffed by health professionals and call handlers and working closely with local government, both to get additional information from people reporting symptoms about their recent contacts and places they have visited, and to give appropriate advice to those contacts, working alongside the app and the testing system.

All of this begs several questions, from our perspective at least:

  • Why the sole emphasis on “widespread swab testing”? Why not so called “saliva tests” for example?
  • How is the “new NHS COVID-19 app” going to work? Not least because the most vulnerable people in our communities are unlikely to be the proud possessors of a recently released smartphone.
  • How will the “valuable local dimension to testing, contact tracing and support” be integrated with the eventual NHS Covid-19 app?

Watch this space to discover if we ever get answers to these and other questions!

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News

Easing the UK Covid-19 lockdown

The hints are dropping with greater frequency. My Member of Parliament writes to tell me that:

The Prime Minister has said today during Prime Ministers Questions that he will be setting out the next steps that the UK will take this coming Sunday. I await his comments with bated breath – as I am sure many others do.

I certainly have my breath bated! The note continues:

On the subject of tracing and tracking cases, the Health Secretary Matt Hancock said this yesterday:

We are developing a new test, track and trace programme to help to control the spread of covid-19, and to be able to trace the virus better as it passes from person to person. This will bring together technology through an app, an extensive web of phone-based contract tracing and, of course, the testing needed ​to underpin all that. The roll-out has already started on the Isle of Wight, and I pay tribute to and thank the Islanders for the enthusiasm with which they have taken up the pilot. I hope that we learn a lot from the roll-out, so that we can take those learnings and roll the programme out across the whole country.”

He added that “…the more people who download the app, the more people will protect themselves, their families and their communities.”

Here’s a recording of this evening’s Covid-19 daily briefing in Downing Street, hosted on this occasion by Robert Jenrick, Secretary of State for Housing, Communities and Local Government:

At 49:30 Keith Rossiter, representing the Western Morning News and Cornwall Live, asks some South West specific questions. One of his questions was:

Sir Patrick Vallance suggested on Tuesday that regions with fewer cases of Covid-19 could come out of lockdown early. How would that work and, if it were to be implemented, what support might there be for Devon and Cornwall Police – already over-stretched – to prevent a large scale invasion of the Westcountry?

Robert’s answer?

We’re providing additional funding to forces and the Home Secretary is speaking with national police chiefs to ensure they have the right guidance and consistent messaging they can use to enforce the lockdown rules when that’s required. As we’ve seen so far the vast majority of members of the public have chosen to do so and adhere to the messaging and most police forces have been able to support the lockdown measures through consent which is the way we want to do things in this country but in the isolated number of cases when this has not been possible they’ve had tools at their disposal to fine and enforce the lockdown.

So no confirmation that easing of the UK lockdown will start in South West England, but no denial either. Whilst we wait for Sunday’s announcement, here’s what Sir Patrick Vallance had to say yesterday. According to Cornwall Live:

England’s chief scientific adviser has hinted that rural regions, such as the Westcountry, might have their Covid-19 lockdown eased sooner than big cities.

Sir Patrick Vallance told MPs on the Health and Social Care Committee that the disease was more prevalent in cities and densely populated places than in rural areas.

But he acknowledged that a regional approach would require the flow of people between regions to be controlled.

Last month former health secretary Jeremy Hunt, who is now chair of the Health and Social Care Select Committee, named Cornwall as an area that could have its restrictions lifted before the rest of the UK.

[Edit – May 7th]

Does this retweet tell this morning’s horror story adequately?

Watch this space!

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News

Sir David King convenes Alt SAGE Covid-19 committee

Idly perusing the online version of The Sunday Times in anticipation of more BoJo bashing I instead stumbled across some discreet Dom bashing from an illustrious source. According to an article by Caroline Wheeler, Deputy Political Editor of the Sunday Times:

The government’s former chief scientific adviser is convening a rival panel of experts to offer advice on easing the lockdown.

Tomorrow Sir David King will chair the first meeting of the group, which is designed to act as an independent alternative to the government’s Scientific Advisory Group for Emergencies (SAGE).

The move comes after weeks of unease about the transparency of SAGE decision-making. It has emerged that 16 of the 23 known members of the committee, which meets in secret, are employed by the government.

The independent group will broadcast live on YouTube and take evidence from global experts. It aims to present the government with “robust, unbiased advice” and some evidence-based policies to tackle the Covid-19 pandemic.

The committee will formally submit its recommendations to the health and social care select committee, heaping pressure on Boris Johnson as he draws up the government’s lockdown exit strategy.

The whole idea sounds crazy, until you consider how the official Covid-19 daily briefings are already spinning like crazy!

Sir David also has his very own Twitter feed, via which he announced:

Getting back to Caroline, she added:

Speaking before tomorrow’s meeting, which will be followed by a news conference, King said: “Science is fundamentally a system based on peer review. When it comes to scientific advice of any kind, transparency is essential.”

He added: “I am not at all critical of the scientists who are putting advice before the government . . . but because there is no transparency the government can say they are following scientific advice but we don’t know that they are.”

Dominic Cummings, a top aide to the prime minister, has attended the secret meetings of SAGE.

“Cummings is an adviser to the prime minister. And the chief scientific adviser is an adviser to the prime minister. So there are two voices from the scientific advisory group and I think that’s very dangerous because only one of the two understands the science,” King said.

The committee has a draft agenda and is seeking to end the pandemic “with the fewest casualties possible”.

Currently the YouTube URL at which tomorrow’s Alt SAGE meeting will be broadcast has not been revealed, so…..

[Edit – May 12th]

The Independent SAGE committee have just published their recommendations. We “retweeted” them forthwith!

To summarise the committee’s recommendations to Her Majesty’s Government concerning “Transitioning from lockdowns and closures”:

Four key components to managing transitions and modulating restrictive measures

  1. Public health and epidemiological considerations must drive the decision-making process.
  2. Available capacity for dual-track health system management to reinstate regular health services, while at the same time continuing to address COVID-19.
  3. Leveraging social and behavioural perspectives as tools for responsive engagement with populations.
  4. Social and economic support to mitigate the devastating effects of COVID-19 on individuals, families and communities.

Six conditions should be used as the basis to implement/adapt transitioning of measures

  1. Evidence shows that COVID-19 transmission is controlled.
  2. Sufficient public health and health system capacities are in place to identify, isolate, test and treat all cases, and to trace and quarantine contacts.
  3. Outbreak risks are minimized in high vulnerability settings, such as long-term care facilities (i.e. nursing homes, rehabilitative and mental health centres) and congregate settings.
  4. Preventive measures are established in workplaces, with physical distancing, handwashing facilities and respiratory etiquette in place, and potentially thermal monitoring.
  5. Manage the risk of exporting and importing cases from communities with high-risks of transmission.
  6. Communities have a voice, are informed, engaged and participatory in the transition.

Four cross-cutting mechanisms that are essential enablers throughout the transition process

  1. Governance of health systems.
  2. Data analytics to inform decisions.
  3. Digital technologies to support public health measures.
  4. Responsive communication with populations.

We “tweeted” a question to the powers that be:

We haven’t received an answer as yet.

Watch this space!

Categories
Testing

Covid-19 testing in the UK

On April 2nd 2020 (not the first!) the UK Government’s web site published a press release stating that:

The UK will carry out 100,000 tests for coronavirus every day by the end of this month, Health Secretary Matt Hancock pledged today.

Increased testing for the NHS will form part of a new 5-pillar plan, bringing together government, industry, academia, the NHS and many others, to dramatically increase the number of tests being carried out each day.

Professor John Newton the Director of Health Improvement for Public Health England, has been appointed to help deliver the new plans and bring together industry, universities, NHS and government behind the ambitious testing targets.

So how is Matt’s pledge and John’s delivery plan looking at the end of April? According to the Department of Health and Social Care‘s latest daily update:

As of 9am 30 April, there have been 901,905 tests, with 81,611 tests on 29 April.

Not quite there yet then, though there is still one more April update to come! Much more recently another Government press release on April 28th announced that:

Anyone in England with symptoms of coronavirus who has to leave home to go to work, and all symptomatic members of the public aged 65 and over, will now be able to get tested, the government has announced today.

This will mean people who cannot work from home and those aged 65 and over can know for sure whether they have coronavirus and need to continue isolating.

Members of their households with symptoms – a new continuous cough or high temperature – will also be eligible for testing.

Anyone eligible can book a test using an online portal.

The government also announced that NHS staff, care home staff and care home residents will be eligible for testing whether or not they have symptoms.

How’s that coming along do you suppose? I’m over 65 and I’d very much like to know for sure whether I have had coronavirus. I even have some of the symptoms! However there is evidently a problem. The Government’s online testing portal told a familiar tale yesterday evening:

Today I discovered via Twitter that somebody else managed to get further through the process than I did, only to discover:

I myself am also forced to wonder why on Earth a United States credit checking agency such as TransUnion should be involved in the process of obtaining a long overdue test for a UK citizen suffering from the symptoms of Covid-19?

Answers on a virtual postcard in the space provided for that purpose below! Should I receive an answer to that question I’ll pose another one:

What does the UK Government make of this proposal in the British Medical Journal for “Mass periodic testing” of the citizens of this sceptred isle?

At the end of (say) 3 weeks of lock-down all households and care homes would return self-taken swabs taken on that date from all residents. All residents would test negative in most homes, so most people could resume normal life within a month of starting the lock-down.

Meanwhile on the NHS front line:

[Edit – May 1st]

Here is the BBC’s video of this evening’s Covid-19 daily briefing from Downing Street, hosted by Matt Hancock:

Fast forward to 36:40 where Channel 4’s Victoria Macdonald asks:.

There was a report in the HSJ that a sample would only be counted once it had been processed, but that testing has been changed and it’s counted once it’s been posted out. Is that the case?

Matt swiftly passed that buck to Professor John Newton, and it’s not until 38:40 that Victoria receives an answer:

There’s been no change to the way that tests are counted. As we’ve developed new ways of delivering tests we’ve taken advice from officials as to how this should be counted.

So, the tests that are within the control of the programme, which is the great majority, are counted when the tests are undertaken in our laboratories. But any test which goes outside the control of the programme, they’re counted when they leave the programme, so that is the tests that are mailed out to people at home and the tests which go out in the satellite. So that is the way they are counted, have always been counted, and the way we were advised to count them by officials.

So that’s the way they are counted, have always been counted, and the way we were advised to count them by officials.

According to Matt Hancock:

That’s all set out on gov.uk

Whilst according to the BBC:

The total testing figure includes 27,497 kits which were delivered to people’s homes and also 12,872 tests that were sent out to centres such as hospitals and NHS sites. However, these may not have been actually used or sent back to a lab.

According to my hasty mental arithmetic:

122,347 – 27,497 – 12,872 = 81,978

Those mysterious “official” bean counters have a lot to answer for!

[Edit – May 8th]

The UK Government’s Covid-19 “contact tracing” smartphone app created by NHSX is now available to residents of the Isle of Wight as part of an initial trial. Here’s an initial review of the app:

Isi’s Dad’s thoughts? Here’s a brief summary:

The app is named NHS COVID-19, and is described by the NHS as “an automated system for rapid symptom reporting, ordering of swab tests, and sending targeted alerts to app users”. It’s one of three parts of the trial which has just started here, the other two being:

  • “web-based Contact Tracing and Advisory Service (CTAS) and increased capacity to provide tailored alerts to all contacts by phone.”
  • “widespread availability of rapid swab testing kits to make sure confirmed cases remain in isolation, and support rapid detection and isolation of higher-risk contacts.”

This is quite different from what has been generally reported: the NHS sees the app primarily for rapid symptom reporting and the ordering of swab test kits.

Installing and configuring the app is simple, provided that you have an iPhone running iOS 11 or later, or a compatible Android phone, about which I will say no more…

Early indications here are that this app protects the user’s privacy, doesn’t track users at all, doesn’t flatten batteries, and is unobtrusive to the point where you can’t even tell whether it is detecting contacts. It doesn’t appear to be the contact tracing app which was expected, though: it’s not ‘track and trace’ so much as ‘diagnose and test’, and may explain where Boris Johnson intends sending his promised 200,000 test kits a day.

Categories
News

Covid-19 in the UK in May 2020

We’re starting this thread a couple of days early, because here in the United Kingdom a variety of things have changed regarding the reporting of Covid-19 “statistics”.

First of all the daily reports from the Department of Health and Social Care: now include “all deaths where a positive test for COVID-19 has been confirmed”, not just those “in hospital”. As the explanation on the DHSC web site puts it:

From 29 April 2020, DHSC are publishing as their daily announced figures on deaths from COVID-19 for the UK a new series that uses improved data for England produced by Public Health England (PHE). These figures provide a count of all deaths where a positive test for COVID-19 has been confirmed, wherever that death has taken place. Figures for Scotland, Wales and Northern Ireland have already begun to include deaths outside hospitals, so this change will ensure that the UK-wide series has a shared and common definitional coverage. This updated statement explains what the new data are and how they differ from both the data series previously published by DHSC and the figures produced by the ONS.

Separately, to improve the timely availability of data on deaths in care homes involving COVID-19, the ONS and the Care Quality Commission (CQC) agreed to publish from 28 April 2020 provisional counts of deaths in care homes, based on statutory notifications by care home providers to CQC. A separate explanatory statement about these new data has been published jointly by the ONS and CQC.

In addition to that change there is now a new section of the UK Government web site devoted to “National COVID-19 surveillance reports“. The most recent report at the moment:

Summarises the information from the surveillance systems which are used to monitor the Coronavirus Disease 2019 (COVID-19) pandemic in England.

The report is based on week 16 (data between 13 April and 19 April 2020) and where available daily data up to 22 April 2020.

COVID-19 is the disease name and SARS-CoV-2 is the virus name.

The report includes sections devoted to UK “Community surveillance”, “Primary care surveillance”, “Secondary care surveillance”, “Virological surveillance” and “Mortality surveillance”. In the latter section it points out that:

In week 16 2020 in England, statistically significant excess mortality by week of death above the upper 2 z-score threshold was seen overall, by age group in the 15-64 and 65+ year olds and sub nationally (all ages) in all regions (North East, North West, Yorkshire & Humber, East & West Midlands, East of England, London and South East & West regions) after correcting GRO disaggregate data for reporting delay with the standardised EuroMOMO algorithm (Figure 18). This data is provisional due to the time delay in registration; numbers may vary from week to week.

The recent “spike” appears to be statistically significant! However despite that, this report and the rest of the virtual paperwork emanating from the UK Government still fail to address the question we posed last week:

How will the UK Government build on the amazing community solidarity we have seen in the past few weeks and reassure the citizens of the nation that lifting the lockdown won’t result in further out-of-control outbreaks?

Whilst we continue to wait for an answer, here are the new “positive test” daily death numbers from the DHSC:

They do of course beg the question of how many “untested” deaths due to Covid-19 are occurring. Regular readers will be aware that we have been following the modelled future death projections of James Annan. Here’s his first update using the DHSC’s new numbers:

[Edit – May 5th]

The Office for National Statistics have released their latest weekly “death certificate” data. Here are the “main points” from their report:

  • The provisional number of deaths registered in England and Wales in the week ending 24 April 2020 (Week 17) was 21,997, a decrease of 354 deaths registered compared with the previous week (Week 16); this is the first decrease in the number of deaths since the week ending 20 March 2020 (Week 12) but is 11,539 more than the five-year average for Week 17.
  • Of the deaths registered in Week 17, 8,237 mentioned “novel coronavirus (COVID-19)”, which is 37.4% of all deaths; this is a decrease of 521 deaths compared with Week 16 (39.2% of all deaths).
  • The number of deaths in care homes (from all causes) for Week 17 was 7,911, which is 595 higher than Week 16. The number of deaths in hospitals for Week 17 was 8,243, which is 1,191 lower than Week 16.
  • In London, over half (50.5%) of deaths registered in Week 17 involved COVID-19; the North West and North East also had a high proportion of COVID-19 deaths, accounting for 38.8% and 38.0%, respectively, of deaths registered in these regions.
  • In Wales, there were 413 deaths registered in Week 17 involving COVID-19, accounting for 36.7% of all deaths registered in Wales.
  • Of deaths involving COVID-19 registered up to Week 17, 71.8% (19,643 deaths) occurred in hospital with the remainder mainly occurring in care homes (5,890 deaths), private homes (1,306 deaths) and hospices (301 deaths).

Here are those numbers in graphic detail:

[Edit – May 12th]

The latest weekly Covid-19 update has been issued by the Office for National Statistics. Here’s the summary on Twitter:

33,337 / 21,647 = 1.54

[Edit – May 19th]

The latest weekly update from the ONS has been published:

Plus some additional detail:

Deaths in care homes made up 36.0% of all deaths in Week 17, 35.7% in Week 18 and 33.6% in Week 19 (Figure 7). Between Week 18 and Week 19, the number of deaths in care homes decreased by 33.7% to 4,248. However, the proportion of care home deaths that involved COVID-19 continued to increase, and 39.2% of all deaths in care homes involved COVID-19 in Week 19.

Watch this space!

Categories
News

Matt Hancock’s “scientifically valid” answers

Yesterday evening Matt Hancock was behind the lectern for the latest of Her Majesty’s Government’s Covid-19 “daily briefings”. Here’s a recording of the whole show:

There follows our edited highlights. First of all note that at around 5:00 into the video Matt says:

Building on successful pilots, we’ll be rolling out testing of asymptomatic residents and staff in care homes in England and to patients and staff in the NHS. This will mean that anyone who is working or living in a care home will be able to get access to a test whether they have symptoms or not. I’m determined to do everything I can to protect the most vulnerable and we now have the capacity to go further still. So from now, we’re making testing available to all over 65s and their households with symptoms and to all workers who would have to leave home in order to go to work and members of their households, again, who have symptoms. So from construction workers to emergency plumbers, from research scientists to those in manufacturing. The expansion of access to testing will protect the most vulnerable and help keep people safe and it’s possible because we’ve expanded capacity for testing thus far.

However he doesn’t go so far as to commit to a time scale for that “roll out”! Allegedly front line NHS staff are having problems getting tested, so when will the necessary extra testing capacity for OAPs and care workers be rolled out? Matt didn’t say.

We have previously mentioned the New Scientist’s coverage of the coronavirus crisis, and their chief reporter Adam Vaughan asked the final question of the evening at ~56:15:

Hi, you said you were recruiting 18,000 contact tracers. I wanted to ask, how many do you have today, what date will you hit 18,000 and how important are those tracers as a strategy for controlling the virus after the lockdown? And secondly, we heard today that the NHS contact tracing out where will be ready within three weeks. What’s your goal for the number of people you want to download it and how will you incentivise them to do so?

After a brief(ish) hesitation Matt answered as follows:

I knew we’d get some tough questions from the New Scientist! The answer to your questions are as soon as possible and as many as possible. But I know that’s not exactly a numerical answer. We’re recruiting the contact tracers. I’m sorry I don’t have the information to hand as to exactly how many we’ve recruited, but that is underway. We hope to have the contact tracers who will help when we find a positive test to work out who they’ve been in contact with and make sure they do the appropriate thing. We hope to have the contact tracers in place before or at the same as the app goes live and you’re right on the app.

We’re expecting that to be ready by the middle of May and both of these things together, because they work together along with the testing and they’ll help us to keep the level of new cases down once we’ve used social distancing measures to get those new cases down. That’s the best thing for health and it’s the best thing for the economy. It’s a work in progress. I appreciate that, other than saying the middle of May, I haven’t given you numerical details. I don’t have the data to hand, but I’ll try to find that for you. And then on the how many people, the more people who download the app and keep their Bluetooth on, the more effective the app is going to be.

So there is no answer other than as many as possible because if everybody downloads it will just be more effective at spotting who people have been in contact with through contact tracing and helping alongside the human contact tracing for people to be able to keep the R down by catching those who they may have transmitted the disease to. It’s also of course tied with the rules around isolation because if you are … What really also matters is if you’ve been in substantial contact with somebody who’s tested positive, making sure we get the right rules around what that person is then required and asked to do is also a critical part of this, this infrastructure that we’re building.

It seems Adam wasn’t entirely happy with that answer, so he asked a supplementary question:

From what you’ve just said, you said that the human contact traces and the app will work in tandem, and you’re saying if the app is coming in three weeks, does that mean the target for the 18,000 is in three weeks?

Mr. Hancock retorted, quick as a flash:

Before or at the same time as the app. Yeah.

Okay. Good stuff. Thank you very much indeed. Great to have the New Scientist at the Downing Street briefing and I hope my answer was scientifically valid. Thank you very much for joining us and no doubt see you again soon.

I paraphrase the Health Minister’s words only slightly:

“I know that’s not exactly a numerical or a scientific set of answers.”

Categories
News

Boris Johnson returns to work

Last night an article by Gordon Rayner in the online edition of the Daily Telegraph assured us that:

Boris Johnson is expected to announce plans for easing the lockdown as early as this week after he returned to Downing Street on Sunday night to take full-time control of the coronavirus crisis.

The Prime Minister will on Monday morning chair his first meeting of the Covid-19 “war cabinet” since he was taken to hospital more than three weeks ago, and is ready to resume his role hosting televised Number 10 press conferences.

I took a dim view of that suggestion on Twitter:

This morning the Prime Minister had returned to Downing Street from his country residence and gave this speech to the nation:

According to The Daily Telegraph’s Twitter feed this morning:

However according to The Independent’s Twitter feed:

Meanwhile according to The Times’ Twitter feed this morning:

Here are some of the Prime Minister’s actual words, transcribed from the recording above:

It follows that this is the moment of opportunity, this is the moment when we can press home our advantage. It is also the moment of maximum risk because I know that there will be many people looking now at our apparent success and beginning to wonder whether now is the time to go easy on those social distancing measures.

I know how hard and how stressful it has been to give up even temporarily those ancient and basic freedoms, not seeing friends, not seeing loved ones, working from home, managing the kids, worrying about your job and your firm.

So let me say directly also to British business, to the shopkeepers, to the entrepreneurs, to the hospitality sector, to everyone on whom our economy depends: I understand your impatience, I share your anxiety. And I know that without our private sector, without the drive and commitment of the wealth creators of this country, there will be no economy to speak of, there will be no cash to pay for our public services, no way of funding our NHS.

And yes I can see the long term consequences of lock down as clearly as anyone. And so yes I entirely share your urgency. It’s the government’s urgency. And yet we must also recognise the risk of a second spike, the risk of losing control of that virus and letting the reproduction rate go back over one, because that would mean not only a new wave of death and disease but also an economic disaster and we would be forced once again to slam on the brakes across the whole country and the whole economy and reimpose restrictions in such a way as to do more and lasting damage.

And so I know it is tough and I want to get this economy moving as fast as I can. But I refuse to throw away all the effort and the sacrifice of the British people and to risk a second major outbreak and huge loss of life and the overwhelming of the NHS. And I ask you to contain your impatience because I believe we are coming now to the end of the first phase of this conflict.

And in spite of all the suffering, we have so nearly succeeded. We defied so many predictions. We did not run out of ventilators or ICU beds. We did not allow our NHS to collapse. And on the contrary we have so far collectively shielded our NHS so that our incredible doctors and nurses and healthcare staff have been able to shield all of us from an outbreak that would have been far worse. And we collectively flattened the peak.

And so when we are sure that this first phase is over and that we are meeting our five tests – deaths falling, NHS protected, rate of infection down, really sorting out the challenges of testing and PPE, avoiding a second peak – then that will be the time to move on to the second phase in which we continue to suppress the disease and keep the reproduction rate, the R rate, down, but begin gradually to refine the economic and social restrictions and one by one to fire up the engines of this vast UK economy.

And in that process difficult judgements will be made and we simply cannot spell out now how fast or slow or even when those changes will be made though clearly the government will be saying much more about this in the coming days.

And I want to serve notice now that these decisions will be taken with the maximum possible transparency. And I want to share all our working and our thinking, my thinking, with you the British people. And of course, we will be relying as ever on the science to inform us, as we have from the beginning, but we will also be reaching out to build the biggest possible consensus, across business, across industry, across all parts of our United Kingdom, across party lines, bringing in opposition parties as far as we possibly can, because I think that is no less than what the British people would expect.

Which version of this Covid-19 “story” do you prefer to believe?