Categories
News

Covid-19 in the UK in June 2020

Today is a Tuesday, which means that The Office for National Statistics have just released their latest weekly “death certificate” data, which brings us up to May 22nd. The “main points” are:

  • A total of 43,837 deaths involving COVID-19 were registered in England and Wales between 28 December 2019 and 22 May 2020 (year to date).
  • In England, including deaths that occurred up to 22 May but were registered up to 30 May, of those we have processed so far, the number involving COVID-19 was 42,210; the comparative number of death notifications reported by the Department of Health and Social Care (DHSC) on GOV.UK was 32,666 and NHS England numbers, which are deaths in hospitals only, showed 25,875 deaths.
  • In Wales, including deaths that occurred up to 22 May but were registered up to 30 May, of those we have processed so far, the number involving COVID-19 was 2,122; the comparative number of death notifications reported by the DHSC on GOV.UK was 1,260 and Public Health Wales (PHW) numbers, which come from the same source as the DHSC figures but are continuously updated, showed 1,275 deaths.
  • In England, the number of deaths involving COVID-19 in care homes that were registered by 22 May was 12,142, while in Wales the number of deaths was 591.
  • The Care Quality Commission (CQC) provides numbers of deaths involving COVID-19 in care homes in England that were notified between 10 April and 29 May, which showed 11,186 deaths, of which 531 occurred in the week up to 29 May.
  • The Care Inspectorate Wales (CIW) provides the number of deaths involving COVID-19 in care homes in Wales that occurred between 17 March and 29 May, which showed 462 deaths, of which 35 occurred in the week up to 29 May.

Here’s the “graphic” representation of those numbers:

Here is an alternative view on weekly “death occurrences in England and Wales” over recent years from EuroMOMO:

Publishing the number of death occurrences is outside EuroMOMO’s terms of reference, but their “Z-scores” provide a graphic illustration of how badly England in particular has been doing over the course of the 2020 Covid-19 epidemic.

[Edit – June 9th]

The latest weekly data from the ONS has been released:

  • The number of deaths registered in England and Wales in the week ending 29 May 2020 (Week 22) was 9,824; this was 2,464 fewer than in Week 21 but 20.2% (1,653 deaths) higher than the five-year average.
  • Of the deaths registered in Week 22, 1,822 mentioned “novel coronavirus (COVID-19)”, the lowest number of deaths involving COVID-19 in the last eight weeks; this accounts for 18.5% of all deaths and is 767 deaths fewer than in Week 21.
  • People aged 90 years and over continued to have the highest number of COVID-19 deaths in Week 22.
  • In Week 22, the proportion of deaths occurring in care homes decreased to 25.5% while deaths involving COVID-19 as a percentage of all deaths in care homes decreased to 28.2%.
  • In Week 22, the number of deaths in care homes was 819 higher than the five-year average, while in hospitals the number of deaths was 30 fewer than the five-year average; the total number of excess deaths involving COVID-19 continued to decrease.

Here’s a graphic representation of the overall “excess death” numbers:

By way of explanation:

The number of deaths was around or below the five-year average up to Week 12. The number of deaths increased between Weeks 13 and 16 before decreasing between Weeks 17 and 22, with the exception of Week 20 where the deaths increased.

The number of death registrations in Week 20 was impacted by the early May Bank Holiday, which took place on Friday 8 May 2020 (in Week 19). The number of deaths registered on the early May Bank Holiday fell to 88 deaths compared with 2,950 deaths registered on the previous Friday (Friday 1 May 2020). Trends seen in Week 19 and Week 20 should therefore be interpreted with caution, as deaths not registered on the early May Bank Holiday were likely registered in the following week (Week 20). Week 22 also included the late May Bank Holiday but as this was on a Monday, we have seen less of an effect on death registrations.

The number of death registrations involving the coronavirus (COVID-19) decreased from 2,589 in Week 21 to 1,822 in Week 22. Of all deaths registered in Week 22, 18.5% mentioned COVID-19; this is down from 21.1% in Week 21.

Similar patterns can be seen for England and Wales separately, with the number of deaths in England decreasing from 11,586 in Week 21 to 9,228 in Week 22, which was 1,621 deaths higher than the Week 22 average. Of the Week 22 deaths, 18.6% (1,715 deaths) involved COVID-19 in England.

In Wales, the number of deaths decreased from 692 deaths in Week 21 to 587 deaths in Week 22, 41 deaths higher than the Week 22 average. Of these Week 22 deaths, 17.9% (105 deaths) involved COVID-19 in Wales.

[Edit – June 10th]

Today’s Downing Street Briefing was somewhat unusual. Boris Johnson was master of ceremonies, and what’s more he was accompanied by some scientists! Boris began by referring to “the progress we as a country have made against our 5 tests for adjusting lockdown”

Instead of listening to what was said, let’s take a look at some of the data that was referred to shall we?


The overall aim is evidently to “reduce the rate of infection to manageable levels” whilst “not risk[ing] a second peak of infections that overwhelms the NHS”. Boris hopes that the latest lockdown “adjustments” will be “underpinned by NHS Test and Trace”, so let’s also see how that’s coming along shall we? As luck would have it the Independent Sage committee also reported this yesterday:


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

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?

Categories
News

How Britain sleepwalked into disaster

It’s not often that I praise the reporting in the assorted organs of News UK. Usually quite the reverse! However this morning I commend to you this frankly shocking article by the Sunday Times Insight team, including on this occasion Jonathan Calvert, George Arbuthnott and Jonathan Leake:

Coronavirus: 38 days when Britain sleepwalked into disaster

I strongly suggest that you read the article from start to finish, always assuming that you have a strong enough stomach. Here are a few brief extracts:

On the third Friday of January a silent and stealthy killer was creeping across the world. Passing from person to person and borne on ships and planes, the coronavirus was already leaving a trail of bodies.

The virus had spread from China to six countries and was almost certainly in many others. Sensing the coming danger, the British government briefly went into wartime mode that day, holding a meeting of Cobra, its national crisis committee.

But it took just an hour that January 24 lunchtime to brush aside the coronavirus threat. Matt Hancock, the health secretary, bounced out of Whitehall after chairing the meeting and breezily told reporters the risk to the UK public was “low”.

This was despite the publication that day of an alarming study by Chinese doctors in the medical journal The Lancet. It assessed the lethal potential of the virus, for the first time suggesting it was comparable to the 1918 Spanish flu pandemic, which killed up to 50 million people.

Unusually, Boris Johnson had been absent from Cobra. The committee — which includes ministers, intelligence chiefs and military generals — gathers at moments of great peril such as terrorist attacks, natural disasters and other threats to the nation and is normally chaired by the prime minister.

Johnson had found time that day, however, to join in a lunar-new-year dragon eyes ritual as part of Downing Street’s reception for the Chinese community, led by the country’s ambassador.

It was a big day for Johnson and there was a triumphal mood in Downing Street because the withdrawal treaty from the European Union was being signed in the late afternoon. It could have been the defining moment of his premiership — but that was before the world changed.

Over on the “Consequences” section of the Arctic Sea Ice Forum we have been discussing the “Chinese coronavirus” since January 25th, and before that in other threads on the forum. By way of just one example:

Judging by footage from a hospital in Wuhan, it is a serious problem over there.

An epidemic would also overwhelm healthcare here in Sweden. Which patients would be given the few available respirator beds when there are too many very sick people?

Since he obviously didn’t heed that early warning signal I can only assume that BoJo isn’t too concerned about an Arctic sea ice tipping point either?

The Insight team continue:

Sure enough, five days later, on Wednesday January 29, the first coronavirus cases on British soil were found when two Chinese nationals from the same family fell ill at a hotel in York. The next day the government raised the threat level from low to moderate.

On January 31 — or Brexit day, as it had become known — there was a rousing 11pm speech by the prime minister promising that withdrawal from the European Union would be the dawn of a new era, unleashing the British people, who would “grow in confidence” month by month.

By this time there was good reason for the government’s top scientific advisers to feel creeping unease about the virus. The WHO had declared the coronavirus a global emergency just the previous day, and scientists at the London School of Hygiene and Tropical Medicine had confirmed to [Professor Chris] Whitty in a private meeting of the Nervtag advisory committee on respiratory illness that the virus’s infectivity could be as bad as Ferguson’s worst estimate several days earlier.

It sounds as though Boris Johnson had his eye firmly fixed on just one ball. Juggling two was beyond him. “Get Brexit Done” now belatedly reads “Stay Home, Save Lives” on his Twitter feed:

Please do read the entire article, but for now let us skip to the conclusion of the Sunday Times cautionary tale of staggering incompetence in high places?

A Downing Street spokesman said: “Our response has ensured that the NHS has been given all the support it needs to ensure everyone requiring treatment has received it, as well as providing protection to businesses and reassurance to workers. The prime minister has been at the helm of the response to this, providing leadership during this hugely challenging period for the whole nation.”

Merely business as usual in the age of “Fake News” and “Truth Decay“.

[Edit – April 20th]

Last night the Department of Health and Social Care “tweeted” a response to the Sunday Times article:

Clicking through to the DoH blog we read:

A Government spokesman said: ‘This article contains a series of falsehoods and errors and actively misrepresents the enormous amount of work which was going on in government at the earliest stages of the Coronavirus outbreak.’

‘This is an unprecedented global pandemic and we have taken the right steps at the right time to combat it, guided at all times by the best scientific advice.

‘The Government has been working day and night to battle against coronavirus, delivering a strategy designed at all times to protect our NHS and save lives.

‘Our response has ensured that the NHS has been given all the support it needs to ensure everyone requiring treatment has received it, as well as providing protection to businesses and reassurance to workers.

‘The Prime Minister has been at the helm of the response to this, providing leadership during this hugely challenging period for the whole nation.’

Followed by a long list of rebuttals of specific points in the Sunday Times article. How about this one for starters?

Claim –  ‘This was despite the publication that day of an alarming study by Chinese doctors in the medical journal The Lancet. It assessed the lethal potential of the virus, for the first time suggesting it was comparable to the 1918 Spanish flu pandemic, which killed up to 50 million people.’

Response –  The editor of the Lancet, on exactly the same day – 23 January – called for “caution” and accused the media of ‘escalating anxiety by talking of a ‘killer virus’ and ‘growing fears’. He wrote: ‘In truth, from what we currently know, 2019-nCoV has moderate transmissibility and relatively low pathogenicity. There is no reason to foster panic with exaggerated language.’ The Sunday Times is suggesting that there was a scientific consensus around the fact that this was going to be a pandemic – that is plainly untrue.

Here’s one interpretation of these events:

Will Michael Gove shortly become our next Prime Minister?