COVID-19 UK & Beyond

[Freggyragh]

From today’s stats Sweden, has 899 deaths. It has a slightly smaller population than Norway and Denmark combined, who have a combined death rate of 401. Still a proportionately far lower rate than the U.K., but they were able to test and trace very early on and limit the initial spread. Once community transmission occurred they switched focus to protecting and testing the most vulnerable and, of course, their healthcare system is still far from being overrun as it is in some regions of the U.K. 

[P.K.]

5 hours ago, Manximus Aururaneus said:

I'm sorry but those 'facts' are a gross distortion of the truth for nothing more than your own personal political aims.

The '16,000 or so beds lost in MI' are actually a tiny fraction of a process first proposed in 1956! ( Guillebaud) and are not the main reason for bed-blocking you suggest.                   

The process has gone under different names since then but most people would have heard of it as 'Care in the Community' - a program that initially came about not because of government (of any party) cuts, but as a result of public pressure for liberalisation of the rights of the mentally ill to be de-institutionalised and of various horror stories emerging about treatment inside the huge, mostly Victorian, mental hospitals. It was pursued for a decade prior to Thatcher, during Thatcher, during Blair and Brown, and continues today.

Simon Duffy 'The hero of deinstitutionalisation' was awarded the Albert Medal for the same in 2008. The 'NHS and Community Care Act of 1990' was in full swing in 1993.

Not far from you, Winwick Hospital (just off the junction M6/M62) - one of the largest MH's at 7,000 beds was closed in March 1997 as a specific part of the scheme.

The NHS can be sorted, and now is as good a time as any, but for that to happen some people are going to have to come to terms with the fact that the required improvements will have to take priority over vested interests and party politics. 'Make your mind up time' fast approaches. Good decisions cannot emerge from ideological bunkum.

Sorry, but I don't have "personal political aims" so try and think of some other excuses for simply not caring...

ETA - good luck with that one...

Edited April 12, 2020 by P.K.

[GD4ELI]

8 hours ago, Freggyragh said:

From today’s stats Sweden, has 899 deaths. It has a slightly smaller population than Norway and Denmark combined, who have a combined death rate of 401. Still a proportionately far lower rate than the U.K., but they were able to test and trace very early on and limit the initial spread. Once community transmission occurred they switched focus to protecting and testing the most vulnerable and, of course, their healthcare system is still far from being overrun as it is in some regions of the U.K. 

Sweden is more sparsely populated, many single people living alone, less social contact. You'll find this has been explained in the previous few weeks.

[P.K.]

19 hours ago, woolley said:

It will be interesting to watch events in Sweden who have been following a much looser lockdown than anyone else.

This simply isn't true. Places like Singapore have not really had any lockdown at all. Same with South Korea.

The background to Covid-19 coming to the UK just has to be that the NHS was underfunded, undervalued, short of facilities and staffing and very very demoralised...

The first detected cases in the US, the UK and South Korea all came at about the same time - around the 20th January.

See where those countries are now:

                                           No of cases        New cases       Fatalities      New fatalities

USA                                    564,317               +4017                22,850          +745

UK                                         88,621                +4342                11,329         +717

South Korea                        10,537                 +25                     217              +2

Germany                              127,916               +62                    3,022             0

As you can see massive disparities with the UK number of cases just a big, and therefore unmanageable, unknown. Germany added as a benchmark.

So what is making the difference?

Testing. Testing. Testing.....

Edited April 13, 2020 by P.K.

[the stinking enigma]

I still csnt make sense of these severe and critical numbers.the uk has been on exactly 1559 for 3 days now, even including boris re-emerging. A quarter of the amount of any similar country. Yet the highest daily deaths in europe. Has there been a change in the criteria for putting people in icu? Also, we seem to be following the us model of teasing a relaxation of lockdown just as deaths are at their highest

[TheTeapot]

35 minutes ago, the stinking enigma said:

I still csnt make sense of these severe and critical numbers.the uk has been on exactly 1559 for 3 days now, even including boris re-emerging. A quarter of the amount of any similar country. Yet the highest daily deaths in europe. Has there been a change in the criteria for putting people in icu? Also, we seem to be following the us model of teasing a relaxation of lockdown just as deaths are at their highest

They've completely given up on recoveries now, reported on here as n/a

https://www.worldometers.info/coronavirus/country/uk/

 

[wrighty]

On 4/12/2020 at 5:09 PM, Chinahand said:

I'm still trying to understand why Germany is fairing so much better.  Is it just statistics and luck or is there something systematically better which they have done?  I suspect it is more quickly getting testing and contact tracing into action.  I realise the Tories-are-evil-set will say the systematic destruction of the nhs is the reason, but the nhs hasn't been systematically destroyed.

Germany has troubled me too. Spain, Italy and the UK seem to be converging onto the same per capita deaths, Germany about 15% of that total. 
 

There are 3 explanations (or 4 if you’re mental)

1. Better testing/contact tracing/quarantine 
2. More disciplined social distancing
3. better ITU facilities - 25 beds per 100000 compared with 6 (UK)

 

 

And 4 - they bought the cure that China have developed and not generally released 

[John Wright]

1 minute ago, wrighty said:

Germany has troubled me too. Spain, Italy and the UK seem to be converging onto the same per capita deaths, Germany about 15% of that total. 
 

There are 3 explanations (or 4 if you’re mental)

1. Better testing/contact tracing/quarantine 
2. More disciplined social distancing
3. better ITU facilities - 25 beds per 100000 compared with 6 (UK)

 

 

And 4 - they bought the cure that China have developed and not generally released 

There’s a much simpler explanation and it boils down to cause of death recording differences for death certificates, national statistical reporting etc.

Think about a death certificate for someone who dies with influenza and several Co morbidities. It’s the most serious/senior/proximate Co morbidity that’s listed first. Is influenza even listed. 

Surely 1 & 2 would contribute to higher numbers of diagnosed. Not necessarily deaths. As for 3 are either health systems at overload point?

[ecobob]

10 minutes ago, wrighty said:

Germany has troubled me too. Spain, Italy and the UK seem to be converging onto the same per capita deaths, Germany about 15% of that total. 
 

There are 3 explanations (or 4 if you’re mental)

1. Better testing/contact tracing/quarantine 
2. More disciplined social distancing
3. better ITU facilities - 25 beds per 100000 

They certainly have far more critical care beds. They’ve taken a large number of Spanish and Italian infected to ease the burden on their countries’ hospitals. 

Social distancing is strictly observed but only by 18+ and over. The kids are till partying. 
 

 

[P.K.]

7 minutes ago, John Wright said:

There’s a much simpler explanation and it boils down to cause of death recording differences for death certificates, national statistical reporting etc.

Think about a death certificate for someone who dies with influenza and several Co morbidities. It’s the most serious/senior/proximate Co morbidity that’s listed first. Is influenza even listed. 

Surely 1 & 2 would contribute to higher numbers of diagnosed. Not necessarily deaths. As for 3 are either health systems at overload point?

It seems to be breaking down that of those infected 80% have mild symptoms and can self-isolate at home, 15% have severe symptoms and 5% are critical so some 20% need to be in hospital.

Taking the data from Germany and South Korea it looks like the fatality rate is around the 2% mark whereas the WHO were saying it's 1%. Which is still ten times worse than seasonal flu....

[wrighty]

9 minutes ago, John Wright said:

There’s a much simpler explanation and it boils down to cause of death recording differences for death certificates, national statistical reporting etc.

Think about a death certificate for someone who dies with influenza and several Co morbidities. It’s the most serious/senior/proximate Co morbidity that’s listed first. Is influenza even listed. 

Surely 1 & 2 would contribute to higher numbers of diagnosed. Not necessarily deaths. As for 3 are either health systems at overload point?

So you’re saying the Germans are under-reporting deaths? I very much doubt that. Their increased testing leads to better targeting of self-isolation and contact tracing. When you get to the Italian situation of only testing those who turn up at hospital you’ve no chance of containing the disease. 
 

I’m pleased to say that IOM testing is more akin to German levels (we do more than them even) than UK. Which might be why our cumulative growth rate is 8.5% since our lockdown compared with something like 33% at the start of the Italian outbreak. 
 

Regarding overload - the UK is in a perpetual state of near overload. It has at least prepared by building its new hospitals and freeing up elective capacity. Perhaps the Germans didn’t need to. 

[wrighty]

4 minutes ago, P.K. said:

It seems to be breaking down that of those infected 80% have mild symptoms and can self-isolate at home, 15% have severe symptoms and 5% are critical so some 20% need to be in hospital.

Those were initial estimates that are not standing up. Take the IOM experience so far - 242 positive cases, about 5% have needed admission and 3 needing ITU. And there are undoubtedly further cases here that haven’t been identified despite us being in the world’s top ten (or 11 or 12 - league position changes daily) for testing. 

[John Wright]

14 minutes ago, wrighty said:

So you’re saying the Germans are under-reporting deaths? I very much doubt that. Their increased testing leads to better targeting of self-isolation and contact tracing. When you get to the Italian situation of only testing those who turn up at hospital you’ve no chance of containing the disease. 
 

I’m pleased to say that IOM testing is more akin to German levels (we do more than them even) than UK. Which might be why our cumulative growth rate is 8.5% since our lockdown compared with something like 33% at the start of the Italian outbreak. 
 

Regarding overload - the UK is in a perpetual state of near overload. It has at least prepared by building its new hospitals and freeing up elective capacity. Perhaps the Germans didn’t need to. 

No, I’m suggesting that they are using different criteria. It’s as likely that U.K. are over reporting, as Germany under reporting. It’s not standardised. It’s probably somewhere in between .

Is there any evidence that mass testing reduces the death rate per thousand tested  as opposed to increases the detection rate and then allows more effective control of transmission? Of course, long term that should reduce the total number of both infections and deaths.

If IoM had used the Spanish and Italian and U.K. testing criteria we would have had 13 positives and 2 deaths. 

[wrighty]

4 minutes ago, John Wright said:

No, I’m suggesting that they are using different criteria. It’s as likely that U.K. are over reporting, as Germany under reporting.

Is there any evidence that mass testing reduces the death rate per thousand tested  as opposed to increases the detection rate and then allows more effective control of transmission? Of course, long term that should reduce the total number of infections and deaths.

If IoM had used the Spanish and Italian and U.K. testing criteria we would have had 13 positives and 2 deaths. 

Death rate per thousand tested is irrelevant, and nobody is talking about that. Nobody is testing simply to increase the denominator of that particular fraction. Look instead at deaths per head of population. 
 

UK are likely under reporting as they don’t include community deaths. Death reporting criteria is an important issue, and it is difficult to determine the difference between ‘died of’ and ‘died with’

Your last point is just wrong. Are you suggesting that Prince Charles and Matt Hancock aren’t included in the UK positives, and they’re only counting admissions? If that’s the case their death rate of 12% or so is remarkably low isn’t it?

[P.K.]

30 minutes ago, wrighty said:

Those were initial estimates that are not standing up. Take the IOM experience so far - 242 positive cases, about 5% have needed admission and 3 needing ITU. And there are undoubtedly further cases here that haven’t been identified despite us being in the world’s top ten (or 11 or 12 - league position changes daily) for testing. 

Well, to be honest, I made those numbers up.

Actually they're the numbers I've seen mooted in various places.

So what are the numbers for mild, severe and critical?

Plus the WHO put out that the fatality rate was 1%. I looked at the numbers for Germany and S Korea (modern societies, excellent healthcare facilities, big on testing) and their numbers are 2% plus.

How do the WHO figure out the 1%?