Coronavirus Sars-CoV-2/Covid-19 Megathread

[celedhring]

Over here some bands are trying to salvage the summer festival season with a series of shows at the Camp Nou. They are selling just 800 tickets per show to comply with virus safety rules, the Camp Nou holds nearly 100.000 people on footie days...

This is an extreme example, but many businesses just can't survive with social distancing in place.

Yeah. Thing that I find worrying is the businesses that are least able to survive are the ones that make a city most worth living in.

This is part of the move to drop our guidance to 1m (which is the WHO recommendation - and followed in France, Denmark, Singapore) or 1.5m (Germany, Austria, Italy) instead of 2m. Because it will help some businesses, especially hospitality. But the truth is whether its 2 or 1m a lot of businesses just won't be able to survive.

I don't know when we'll get back to things like gigs, shows, bars

Over here it was cut from 2 to 1.5m, for that reason. But even with 1m that means theaters, concert halls, cinemas, etc... have to cut seating to 1/3. That won't work for them.

[Sheilbh]

Yes, I think the financial side of things has been handled quite well; of course Johnson may well now regard Sunak as a threat 

Yeah I wonder if they regret getting rid of Javid now. Becuase Sunak's handled things well and comes across as competent and details-minded (ie the opposite of Johnson). But also I wonder if there's some appeal in a post-Brexit figure. I think he was a leaver but he'd been an MP for one year at that point, so was nowhere near the main campaign. I don't think he's been defined by Brexit as much as every other senior politician because he's a new man.

From what I've read he's been on manoeuvres building up his network/supporters among Tory MPs, because being Tories there is always the possibility of a leadership fight

The difficult bit, financially, will come later when we try and stop the tide of ever rising debt.

Yeah. We've hit 100% of GDP, which I'm fairly comfortable with and hope we don't make the same mistakes of Osborne (). But it's amazing the revisions being made - from the ONS on public spending: "Borrowing estimates are subject to greater than usual uncertainty because of their partial reliance on forecast data, with April 2020 being revised down by £13.6 billion to £48.5 billion; this is largely because of stronger than previously estimated tax receipts and National Insurance contributions along with lower than previously estimated expenditure on the furlough schemes."

It seems crazy that you have revisions of over £13 billion in a month - but things are very uncertain

Edit: Just seen that the new Joint Biosecurity Centre have recommended and Chief Medical Officers for England, Wales, Scotland and Northern Ireland have reviewed and accepted moving from alert level 4 to alert level 3 - this is what that's supposed to mean:


Of course the level of lockdown was supposed to reflect the alert level, but that didn't last the very first review by the JBC when they recommended no change, but the (English) government started easing lockdown anyway. But it's still useful, I suppose.

[Tamas]

SO the alert level will be lagging government policy by circa two weeks, which in turn lagged reality on the grounds by at least a week.

[Josquius]

Looks like Wales is opening up soon. May go down to visit my sister since going to proper abroad is out.
Still waiting on Ireland to open for a road trip though. Need to get that done before brekshit makes it complex.

Yeah. Thing that I find worrying is the businesses that are least able to survive are the ones that make a city most worth living in.

Definitely. The whole situation does seem perfect for sending us back to the 90s. Everyone in their cars driving out to big warehouse retail parks and returning to isolated little towns.
Exactly the pattern of development we should be discouraging.
It's depressing to think what corona has given a boost to. Especially when you consider the reactionaries who don't want the world to be a better place will be welcoming it.

[Duque de Bragança]

New clusters in the "Greater" Lisbon area. I guess the population there is old, poor and not too educated.

[Sheilbh]

So fascinating details about test and trace from a public health director and fellow:

Stats from week two of the 'NHS' Test and Trace programme also out today, covering 4/6/20 - 10/6/20.
https://www.gov.uk/government/publications/nhs-test-and-trace-statistics-england-28-may-to-10-june-2020/experimental-statistics-weekly-nhs-test-and-trace-bulletin-england-28-may-to-10-june-2020
Having been buried in local complex cases during this period, has been interesting to try and make sense of the macro picture (mini-thread)

Says 5,949 cases referred to programme, 4,366 were contacted (73%), (8,096 referred previous week, with 72% contacted)

And given the importance of timeliness, 78% reached within 24hrs of referral compared with 75% week before.
44,895 contacts identified - this is 10.2 contacts per case. Significantly up from 8.9 per case the week before.

Both weeks, 90% of those contacts were reached and asked to isolate.

That's 9.3 contacts reached per case this week 8.1 the week before (hear me out)
But here's the interesting bit - 3,572 contacted cases were non-complex, those contacted by tier 2 of test and trace.

These cases were responsible for 4,715 contacts that were reached (contacted by tier 3).

That's 1.3 contacts reached per case.
The week before it was 4,392 contacted cases and 5,282 contacts reached.

That's 1.2 contacts reached per case. Basically the same.
Also, is says in the methods document that those contacts not reached ONLY relates to non-complex cases. Meaning that the percentage of contacts reached for complex cases (tier 1) is - by default - 100%.
The percent not reached for tiers 2 and 3 is therefore 47% (4,205 not reached, 4,715 reached).

Down from 48% the week before. This would be a much more genuine way of presenting the %age contacts not reached data.
Now, just 794 cases were complex - managed by those of us in local PHE teams.

These cases were responsible for 35,975 contacts reached - 45.3 CONTACTS REACHED PER PERSON (I would use bold rather caps given the option).

88% of ALL CONTACTS reached from just 614 cases.
The week before, 1,434 complex cases, reached 41,667 contacts, at 29.1 contacts per person.

So vast majority of contacts are through tier 1 - complex cases. And this explains all of the increase in numbers of contacts from week 1 to week 2.
Why??

Is this a data problem (error/confounder/sampling) or is this real?

Before we all get cynical about tiers 2 and 3 doing any work - they have to follow up every contact individually one by one.

If we phone a care home, then immediately that might be 30 contacts. One call.
Importantly, we've changed to how we record contacts in the past 10 days or so.

Now it's recorded directly onto CTAS - the new PHE computer system for contact tracing whereas before it was recorded on our completely different usual disease surveillance tool.
Furthermore, we may locally record all other residents in care home (for example) as a contact, whether they were actually within 2m or not.

This makes sense from a public health perspective as in such a high risk setting they are potentially all at risk and may need to isolate
But that may not be what public/politicians think when we say 'contact'.

And if there's more than one resident in a care home affected, then their contacts are going to be counted twice (can't see whether that's dealt with in the methodology document).
And there are other considerations - changing numbers of cases in care homes and hospitals, schools opening up, it's busy (though not sure if 'busier'), the issues picked up by @TimHarford and folk on @BBCRadio4
More or Less the other week.
Where I want to get to with this is that we really SHOULDN'T try to draw too many conclusions from just two weeks of 'NHS' (PHE) T&T.

The data are too difficult to interpret without knowing the impact of all the operational changes that are going on behind the scenes.
My take is that T&T is probably getting better, it definitely will get better, and it'll take time.

It's a massive operation. New staff, new computer system, new protocols. Lots of orgs involved (PHE, NHS, local gov, social care etc)
I would definitely NOT use these data to draw conclusions about public engagement with it, success or not of social distancing, and impact on numbers isolating.

Instead, ignore these first 2 wks and probably go from now on when inferring something about COVID policy.
And I would definitely change how the data are reported - particularly the percentage of contacts reached.

That's a particularly useless analysis as it currently stands.

The thing that's really extraordinary is that difference between Tier 1 (complex) cases and the rest and that they have so many more contacts - I mean 88% of contacts from 600 cases. I've always been surprised by the stat that something like 80% of new infections come from about 10-20% of people.

Part of that must be these "super-spreader" locations - such as care homes or meat-packing plants.

Eg: Three meat factories in West Yorkshire, Wrexham and Anglesey shut down which (collectively) had over 100 positive results.

[Eddie Teach]

Looks like Wales is opening up soon. May go down to visit my sister since going to proper abroad is out.
Still waiting on Ireland to open for a road trip though. Need to get that done before brekshit makes it complex.

How do you take a road trip without a car?

[Tamas]

Thanks for the quote Sheilbh, good to know these numbers are public, I wasn't even sure.

I did notice he was writing 'NHS' as opposed to NHS, trying to shield the NHS from future blame.

[Sheilbh]

I think it's more that this is positioned as "NHS Test and Trace" - possibly deliberately by the government to give it buy-in from most people. But that's not quite right - part of the Lansley reforms to the NHS stripped public health from the NHS (and their budgets) and moved it to local authorities overseen by Public Health England. Part of it is being run by an outsourcer (Serco - who have ruined every public service they touch, such as the sleeper train to Scotland ), part of it is centralised PHE track and trace resources (the people who do this all the time for, say, an outbreak of norovirus or legionnaire's) and local authority public health teams (who are normally the front-line) for the "complex" cases.

So it's "NHS Test and Trace" but aside from doing some of the tests I don't think this touches the NHS at all.

It's all an example of what I mean about some of the structural issues since Lansley's reforms. In England healthcare seems to have all of the downsides of being over-centralised and fragmented, with none of the benefits of being actually either centralised or decentralised.

It's one of the things that still annoys me most about the coalition that, by all accounts, none of the Lib Dem ministers or Cameron really understood what the Lansley reforms were doing but just kind of let them happen.

Edit: Also on the numbers being public - based on the Spanish data journalist for El Pais's comments I think our data is pretty good. It's released fairly quickly and goes to a good level of detail/granularity so is helpful for data journalists/others to look at. And even for someone non-technical like me I find the ONS have something interesting up almost every day on the covid hub:
https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/articles/coronaviruscovid19roundup/2020-03-26

How the government uses and presents that data is possibly another issue

[Iormlund]

How do you take a road trip without a car?

Slowly.

[merithyn]

Barcelona-Palma de Mallorca is 35 minutes. But that one makes sense, at least 

Considering the ferry is like nine hours, yes. 

[Josquius]

Looks like Wales is opening up soon. May go down to visit my sister since going to proper abroad is out.
Still waiting on Ireland to open for a road trip though. Need to get that done before brekshit makes it complex.

How do you take a road trip without a car?

I have a car.

[The Brain]

The Coalmobile.

[celedhring]

Barcelona-Palma de Mallorca is 35 minutes. But that one makes sense, at least 

Considering the ferry is like nine hours, yes. 

There used to be a fast catamaran that did it in 3 hours but it was removed from the route due to fuel costs. I only took it once, it was a slightly rough sea and my stomach still has nightmares about it 

[Grey Fox]

Yeah, Montreal-NYC is a 50 minutes flight, 12 hours train ride & a 6 hour drive.