Coronavirus - worldwide spread and control

That report was from Holgate:

https://acmedsci.ac.uk/file-download/51353957

OT, but this was of interest to me:

This too:

The 'expert advisory group' included Matthew Hotopf.

Claire Bithell, who did a lot of the worst Science Media Centre spin, also played a role as Head of Communications at the Academy of Medical Sciences

Mod note: post copied here for discussion not related to Covid-19 spread and control. UK-Preparing for a challenging winter 2020/21, 2020, Academy of Medical Sciences, Holgate

 

This looks to me like a complete lame duck. The four proposals are the basic minimum that nobody even needs to be told about. What we need are some real changes. For instance sending all Covid19 cases to dedicated fever hospitals not ordinary hospitals. Enforced quarantine. Shutting down air traffic. Like the sorts of things they do in New Zealand and Australia. All these establishment cronies are equally culpable. In comparison to Independent SAGE it is little better than a whitewash.

 

We'll brook no criticism of the Senescent And Geriatric Elimination advisers.

 

Whatever you do in the U.K. make sure it is different from what Florida has done. Today's news just showed the state reported 10,161 new cases and 112 deaths. The deaths were naturally caused by infections that typically started weeks ago. There is usually a weekly dip in reporting new cases. I expect the case numbers to rise by Friday.

Arguments about lower mortality rates are mostly based on hypotheses. Some are deliberate deception, like confusing the infection mortality rate with the case mortality rate. The bulk of cases in our current surge remain unresolved, and that tends to distort statistics. Politicians touting current statistics are hoping nobody will remember what they said a month from now. In far too many cases that has worked in the past.

I've only started analyzing data on hospitalizations first available last Friday. I'm not even certain it is still possible to isolate patients in special hospitals, because those previously treating such cases are full.

 

It is perfectly possible, if like some countries have done, you build the hospitals afresh. The absurd thing about the UK is that we built the Nightingale hospitals and then did not use them. This is a measure of just how scatterbrained the approach has been.

 

Yes and it is proudly proclaimed that the NHS was not 'overrun', and that they therefore hardly used the Nightingale hospitals; but this was only achieved at the expense of a lot of non-covid patients not being treated.

 

And a vastly greater number of people with ordinary serious illnesses not being treated.

 

I had thought part of the reason for the Nightingale hospitals being underutilised was that hospitals were to send their own staff ?

Would have been ideal facilities to discharge the elderly to instead of care homes

 

https://www.nytimes.com/2020/07/15/...&nl=coronavirus-briefing&emc=edit_cb_20200715

 

https://twitter.com/user/status/1283425087585222657

 

At the current rate, the USA is going to overtake Sweden, Spain, Italy and France in deaths per million in a matter of 2-3 months!

 

Fortunately it should make little difference, everyone was already relying on the Johns Hopkins data, who already bypassed the CDC because they were failing at it from the start.

I'm sure this will have some repercussions but at least the raw data are still available, the CDC was already irrelevant in this matter.

https://twitter.com/user/status/1283792012001468416

 

And, as they said on the news the other night, that hot weather/sunlight kills the thing off


Meanwhile, Contact tracing won't curb COVID-19 spread if testing is too slow

http://www.msn.com/en-gb/health/med...s-too-slow/ar-BB16PSDO?li=BBoPWjQ&ocid=ASUDHP

 

Yes. I'm also worried about India.

Edited to add today's graph from https://coronavirus.jhu.edu/data/new-cases

 

Another report from Florida, where officials apparently don't realize the virus is out of control. Predictably, Florida had 13,965 new cases today. Unfortunately, we also set a record of 156 reported deaths in a day. Here in Orange County (Orlando/Disney World) we had 1,390 new cases. Australia would be appalled by this if it applied to their entire continent.

Why do I say this was predictable? Because a number of good models predicted it. There are big variations caused by delays in reporting (cases from one day land on another, there is a dip followed by a spike,) but the 7-day average is fairly smooth. My favorite at the moment is by PolicyLab at Children's Hospital of Philadelphia which collects data, and makes weekly predictions for select counties. They use anonymized data from mobile phones to estimate mobility and social interactions. (This data can be bought for marketing purposes.) They also take weather into account. Here's an account of their methods. I wish the predictions were updated daily.

At the state level I recommend the site Rt-live, which uses a very different algorithm to estimate an R value, (as in SIR or SEIR models,) with the code available on Github. I wish their estimates were available for counties, or other countries. R values have tended to be leading indicators of surges.

Aside: If you take the R value, subtract 1.0, and multiply by 100, you get the percentage increase in each case reproduction period. Think of this as compound interest, with a period under a week. This is what will happen if nothing else changes. When epidemics are out of control, things do change, and with competent decision makers they change for the better.

The momentary R for Orange County is 1.59, which I expect to drop to about 1.3 as people realize things are not normal. This still leaves us with the equivalent of 30% interest in cases compounded in less than a week.

Aggregate statistics for entire nations or states can mask a local outbreak until it becomes large enough to dominate the total. We have had multiple politicians in many countries try to deny the reality of outbreaks, and several means of delaying upsetting numbers have been employed. If no action is taken promptly the local outbreak will become a spreading center for a larger outbreak.

What I find outrageous is that modern technology for testing for the virus has been used to delay reported numbers by about a week, saying this is to validate those numbers. No daily count of symptomatic individuals or excess deaths is available. We had to fight to get numbers hospitalized. We seem to have gone backwards since 1918.

I've attached two graphs, one showing Florida cases by week, another showing Orange County cases by day. This is what a surge looks like. A third graph shows the PolicyLab prediction several days ago.

 

At that rate (per day), they'll achieve herd immunity in 4 years!

 

A purely anecdotal report:

Orange County, Florida is still trying to reopen schools with face-to-face classes and no masks.
(Why? Because no money has been allocated for anything else. This also applies to Jonathan Edward's proposal to build new hospitals. )

There was a contentious school board meeting Tuesday which failed to settle the matter. Another meeting is scheduled Friday. After the last meeting a teacher I know decided to retire rather than risk her health. She went to file her retirement papers on-line, but found this down. She needed to arrange an in-person meeting with county school officials. It turned out the virus had run through that floor of the office building, and many people were in isolation or quarantine.

She is still trying to file her retirement papers.

Knowing this person the way I do, I don't think those officials realize the hornet's nest they have blundered into.

 

You mean the survivors will. Don't worry, the numbers will go up. This is the magic of exponential increase.

The problem is that mortality will also go up, and that is delayed by weeks. Before successful immunization or fully effective treatment, we will have about 1% mortality if hospitals are not overwhelmed. I've provided private estimates to local people I know of what that means. All have said this is politically unacceptable.

Locally, we are in fair shape with 20% available ICU capacity. South Florida is not in such great shape. Here's a report from a hospital CEO who is also a registered nurse, and is working two jobs.