Coronavirus Sars-CoV-2/Covid-19 Megathread

[Sheilbh]

Sure and I imagine the covid deniers will take it that way, and we'll see if it stands up but at the minute it is two professors of medicine querying this. But evidence from everywhere is that the IFR is somewhere between .5-1% (with huge variations by age) so it doesn't feel right to say if someone has corona that's probably the cause of death now we're looking at a six month period.

At the minute the ONS release their figures which include anyone who has coivd on their death certificate, so attending doctors make judgements even if there's no positive test. The doctor might know that person has covid but, as you say, also know they've been hit by a lorry and probably not put covid on the death certificate.

This is the daily tally for non-hospital deaths and basically says if you tested positive and you die, you get counted. Given that there's been about 300,000 positive tests since February (and a lot of them are elderly) that seems a bit broad. It may be that PHE have no way of tracking this on a daily basis, which is annoying but they should probably stop and we can just go off the ONS data now. If they can't distinguish between your example and a covid death, then I'm not sure the stats are that valuable.

This is the PHE explanation of how they compile the figure:
"Linking data on confirmed positive cases (identified through testing by NHS and PHE laboratories and commercial partners) to the NHS Demographic Batch Service: when a patient dies, the NHS central register of patients is notified (this is not limited to deaths in hospitals). The list of all lab-confirmed cases is checked against the NHS central register each day, to check if any of the patients have died."

As the authors note basically no-one recovers. Even if they tested positive in February, never went into hospital because it was a mild case, this counts as a covid death.

Maybe they're wrong and PHE do some additional digging but at the minute it feels like it's probably worth just accepting a lag and using the ONS data which is able to check the death certificate.

Edit: Incidentally you're right this is only a recent isue, but basically the issue is between the red line and blue bars/trend line:


The blue line is the ONS figures and it's the best data we have on deaths - it includes all death certificates in all settings, so doesn't require a test at any point and isn't limited by setting. The gov.uk data is basically people who tested positive and died in hospital (the NHS England data) and the PHE data which is apparently people who have tested positive and died. So at the peak the gov.uk data were missing deaths because there were people being registered as dying because of covid who never had a test. Now the gap is the other way, there are fewer people being registered with covid deaths and the hospital deaths are now very low but the number of people who have ever tested positive and are dying is fairly steady (which makes sense given that 300k people have been tested and we know this disease has been prevalent in high risk communities like the elderly).

I generally think the ONS figures are better so it seems likely that the gov.uk data was missing deaths at the peak and is overstating them now.

[Tamas]

Is it really conceivable tat somebody gets, say, release from hospital as having recovered from covid, die a month later, and statisticians would still register that as a covid death? Surely that cannot be so.

[Sheilbh]

Is it really conceivable tat somebody gets, say, release from hospital as having recovered from covid, die a month later, and statisticians would still register that as a covid death? Surely that cannot be so.

That's what it sounds like from PHE's description of how they collect data. They are apparently just cross-checking all positive cases with all deaths.

It's not registration - that's in the hands of the attending doctor. So that death wouldn't have covid on the death certificate and it wouldn't be included in the Office of National Statistics figures because they look at death certificates rather than just the database of notified deaths.

And as I say we've got three data streams: NHS England daily updates of deaths of people in hospital who have tested positive; ONS weekly updates of all death certificates that mention covid; and PHE daily updates of deaths of people who have tested positive in all other settings (i.e. not hospitals). This issue is only with that last batch of data, the NHS England and ONS figures are still good just slightly more limited because NHS England is hopsitals only and the ONS figures are on a weekly basis and lag a little bit.

[celedhring]

Barcelona metro area re-enacts restrictions (no gatherings of over 10 people, night clubs/discos closed) and population has been advised to remain at home unless necessary.

I had a few friends over for lunch from the affected area (I am outside of it), and we've just canceled. I was looking forward having social life again...

[Sheilbh]

I had a few friends over for lunch from the affected area (I am outside of it), and we've just canceled. I was looking forward having social life again...

I have been to a friend's birthday party in a park (with an excessive number of people  ) and in the beer garden of a pub with a small group.

It has been an absolute delight. Really weird not touching people though - to give a hug or a kiss etc. And still trying to be slightly careful around sitting little bit distantly.

Interestingly spoke to my friend who works on the science of this in the NHS - she said treat covid transmission like if everyone was smoking. So if you're in a park or the back garden and you're all sat at a little distance that's probably comfortable. If you go into a dive bar even if it's a little bit more empty it's probably less comfortable etc.

Edit:

Is it really conceivable tat somebody gets, say, release from hospital as having recovered from covid, die a month later, and statisticians would still register that as a covid death? Surely that cannot be so.

Also just on this it strikes me as really plausible that there's basically a tension in producing these stats between quality of data, broadness of your dataset or being timely and you can kind of choose two. So the NHS is good quality and daily but limited to hospitals, the ONS is good quality and covers everything but there's a lag, and the PHE is everything but hospitals on a daily basis, but there's probably an issue with quality. I just don't think that was actually very clear.

And as I say this doesn't hugely change the overall picture. But it does slightly explain the difference identified in that chart between the ONS data which is the best and the daily running tally.

[alfred russel]

The Mayor of Atlanta has challenged him to enforce his idiotic decree.

Kemp can go fuck himself. The cities that are run by people who care about their communities won't listen to him and will continue to enforce the mandates. See ya in court.

"Continue to enforce the mandates"? I don't know what version of Atlanta you are in, but I see lots of people in indoor public spaces not wearing masks. The city can barely keep enough cops on the streets with them calling in sick and homicides last month were at a 17 year high; I'm not sure how you expect them to take on the 30% or whatever of people not wearing masks.

The mayor can go fuck herself. I don't care about a mask requirement but she is trying to shut businesses down again.

[mongers]

I had a few friends over for lunch from the affected area (I am outside of it), and we've just canceled. I was looking forward having social life again...

I have been to a friend's birthday party in a park (with an excessive number of people  ) and in the beer garden of a pub with a small group.

It has been an absolute delight. Really weird not touching people though - to give a hug or a kiss etc. And still trying to be slightly careful around sitting little bit distantly.

Interestingly spoke to my friend who works on the science of this in the NHS - she said treat covid transmission like if everyone was smoking. So if you're in a park or the back garden and you're all sat at a little distance that's probably comfortable. If you go into a dive bar even if it's a little bit more empty it's probably less comfortable etc.

.....

Welcome to my world. 

Also the point about smoking is a very good idea, thanks.

[DGuller]

Urgent review into PHE death statistics - if the two Oxford academics are correct, it's bizarre no-one in PHE queried this:

Hancock 'calls urgent review' into PHE coronavirus death statistics

Yesterday two Oxford university statisticians published an alarming article which said that there was a serious flaw in the way Public Health England has been recording coronavirus deaths: they say that PHE has been recording the deaths of anyone who has previously tested positive for coronavirus as a coronavirus death.

Yoon K Loke and Carl Heneghan wrote:

    By this PHE definition, no one with COVID in England is allowed to ever recover from their illness. A patient who has tested positive, but successfully treated and discharged from hospital, will still be counted as a COVID death even if they had a heart attack or were run over by a bus three months later.

If this is correct, it may mean that the number of coronavirus deaths in England has been significantly overestimated.

Basically they said that PHE gets the details of everyone who ever tested positive for covid on one spreadsheet, then they a spreadsheet of deaths. They then cross check and if anyone has died and has ever tested positive for covid then PHE consider it a covid death. I don't think this really matters for the overall numbers or the worst period (which have, in any event been confirmed by the ONS), but it possibly explains the weirdly still high death rate outside of hospitals in England and its weird lumpiness (so you'll go from 5 deaths one day to 160 the next).

Details of the (not yet peer reviewed) article here:
https://www.cebm.net/covid-19/why-no-one-can-ever-recover-from-covid-19-in-england-a-statistical-anomaly/

This doesn't really surprise me.  If people knew the amount of incompetence that goes on in data science, including such pretty obvious things in hindsight, they would view data scientists as charlatans.  That wouldn't be fair to the 20% of data scientists who actually aren't charlatans.

[Syt]

https://www.wthr.com/article/news/investigations/13-investigates/13-investigates-anti-mask-protestors-turn-to-mesh-yarn-crochet-masks-covid-coronavirus/531-5350260c-d6b1-4bd8-857e-860fe84e0f52

Anti-mask protesters' new weapon: wearing masks that offer no COVID-19 protection

Face masks made of mesh, crochet (yarn) or lace are now popular items being offered by online retailers.

INDIANAPOLIS — As more communities and businesses adopt mandatory mask orders, supporters of an "anti-mask" movement are looking to make a statement. They are wearing masks that cover their nose and mouth but provide no ability to slow the spread of disease.

"I wore a mask that is designed for protecting your face in a paintball battle. You can easily breathe through it. I walked all around the store, talked to employees, and other shoppers, and every one of them could see my mouth," said a Florida man who posted a video showing him wearing a mesh mask to a Tampa Walmart. "It was almost like not wearing a mask at all. Nobody cared. That's because it's not about safety. It's all about compliance."

Other social media posts show anti-mask advocates wearing mesh masks intended to comply with the letter – but not the spirit – of municipal and corporate rules mandating face coverings.

And masks made of mesh, crochet (yarn) or lace are now popular items being offered by internet retailers. Most include warnings stating the items "are NOT intended for protection or COVID use." But protection is not what anti-mask protesters are looking for.

"Make your own Anti Mask!" said the seller of a pattern to create your own anti-mask. The description of the product states: "Stylish, breathable and don't protect you from a darn thing! Masks required? No problem! Breath free while making a statement."

"NO law requires a specific type or particulate rating of mask," said one protestor, posting a photo of a woman wearing a mesh face covering. "This is about compliance, not safety."

The public health officials and doctors recently interviewed by 13News disagree.

"Masks absolutely work. They're not perfect. They're not the only measure you need to take to keep this virus under control but they're very effective and they're very simple," said Dr. Christopher Belcher, who serves as the infection prevention medical director at Ascension St. Vincent Hospital in Indianapolis.

"The most important thing they do is if you're coughing, sneezing, singing, they contain all of those little droplets of saliva or mucus that come out of your nose and mouth, and keep them right there from spreading to other people," Belcher added.

Earlier this month, 13 Investigates and the IU Health Pathology Lab tested different kinds of masks. The test showed even very inexpensive masks are highly effective in preventing the spread of germs linked to viruses.

The science has prompted many cities and states to impose orders requiring face coverings in public places. (Indianapolis currently has a public order in effect but the state of Indiana does not.) Companies like Costco have been requiring customers to wear masks for months, and more businesses recently announced they will require face coverings, too. Walmart and Kroger, two of the largest retail/grocery corporations in the nation, will begin implementing mask requirements for customers next week.

The growing trend seems to be causing growing frustration among anti-mask advocates, who have been voicing their dissent at municipal buildings, statehouses and in online forums – and by wearing mesh masks intended to offer protest rather than COVID-19 protection.

Belcher says he does not mind people protesting over masks, as long as those protests are not putting others in danger.

"I need your help with this to keep from spreading the infection so the hospitals don't get overrun," he told 13News. "If you're going to go to the trouble of wearing a mask, please wear one that's going to do something for other people. I don't care if you write 'NO' on it. I don't care if you have a t-shirt that says 'I don't want to wear this mask,' but I need you to wear the mask. It's an important thing for our health."

Trend data released Thursday afternoon by the Regenstrief Institute shows positive COVID-19 cases, emergency room visits and deaths related to the coronavirus are all increasing in Indiana. That's why health officials continue to emphasize the importance of wearing a mask.

[Tamas]

[The Larch]

That's taking contrarianism to the extreme. 

[Tonitrus]

I thought about that the other day when I was reading an article on some thing or another involving the Anchorage, AK city council, and one of the council members was wearing a crochet mask with the typical large gaps one sees in crochet.

[HVC]

If you're wearing a mask to protest mask wearing do you ever just question your sanity?

[celedhring]

I have been to a friend's birthday party in a park (with an excessive number of people  ) and in the beer garden of a pub with a small group.

It has been an absolute delight. Really weird not touching people though - to give a hug or a kiss etc. And still trying to be slightly careful around sitting little bit distantly.

I have had several lunch/dinner with my family, but my parents have a large garden so we can eat and even BBQ the food outside. Besides that, I've had only a couple one-on-one meets with friends for a couple beers. This was going to be the first post-lockdown "event" with friends.

[Sheilbh]

So it looks like PHE have confirmed the main point:


Although that statement is so typical and annoying British state approach - "now is the right time to review" as if this was some unprompted decision they've just made on their own

By the looks of it, it looks like this method may have over-stated the total by about 2,000 (or 5%) based on the PHE comments (basically 90% of the deaths they've reported happened within 4 weeks of a postive test, so are probably covid related - of the remaining 10%, just under half are related to covid according to the death certificates). It's good it's been identified right now because as I say I don't think this necessarily matters for the actual bulk of the pandemic, but I think it's really important for the long-tail effect of this