Coronavirus outbreak

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roubaixtuesday

self serving virtue signaller
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I've been looking at the data, and it's showing something interesting. I've had to rely on using the number of deaths to track the epidemic, because I don't believe the testing in any European country is sufficiently reliable to give meaningful results. One issue with doing this is that deaths have a 2-3 week delay from infections, so this tells us what was happening two or more weeks ago.

First, let's compare what's happening in Italy, France and the UK for the data as of 25th March:

View attachment 510572

I've used the scientist's favourite - the log plot as it shows very clearly if the epidemic is increasing exponentially or not. A straight line means the epidemic is still growing rapidly. On the other hand, if the line curves to the right, the epidemic is slowing down. The data is plotted from the time that ten deaths were reported - this removes the noise present in the early stages so that the trends can be more clearly seen.

For the first two weeks, Italy showed a growth rate of 20% (doubling every 3.5 days). This has slowed to around 5%
(doubling every 2 weeks). It looks like Italy is turning the corner, at last: the growth is no longer exponential. I take marinyork's point that many deaths are likely not being recorded. There's no real way to account for that: the data is what we've got. I suspect that under reporting can't account for slow down, so the trend is likely genuine.

France looks grim. The number of deaths is doubling every three days - and there's no sign of this growth rate slackening off. I fear that France will turn out worse than Italy: if France continues on this trajectory, it'll overtake Italy in about a week.

The UK is just odd. A few days ago, I predicted that there would be over 1000 deaths by this weekend. I'm happy to say that I was wrong - it's going to be much less (and sad that I wasn't more wrong).

There are two ways I can explain this. The first is that there was a major change in behaviour at the start of the month. This was when people were being exhorted into washing their hands and paying careful attention to hygiene. Could these measures actually be working to reduce the number of transmissions? That would imply that the hand-oral route is the major infection route rather than aerosol.

The other explanation is that the case fatality rate has dropped. This most likely would be due to improved treatment protocols, so that the critically ill are more likely to survive. This is something I've no knowledge about - @Brompton Bruce, would the prof be able to shed some light on this?

The frustrating thing is that without a robust testing strategy in the community, we have no idea which is the more likely explanation. This lack of testing means we're essentially blind: it will take a long time before anything we do to reduce R0 will show up in the data (that's probably the reason behind BoJo saying that the restrictions will be reviewed in three weeks, as that's just about the time in which changes can be expected to show up).

There is one other sting in the tail: if the favourable decrease of death growth rate is down to improved treatment, this will rapidly unwind if the NHS becomes overwhelmed. A sharp increase could be expected at that point.

Interesting. And somewhat hopeful.

There was a piece on newsnight about how yesterday's low death rate was down to a change in reporting. But the decline in rate constant looks to have been over a longer time.
 

marinyork

Resting in suspended Animation
Location
Logopolis
Interesting. And somewhat hopeful.

There was a piece on newsnight about how yesterday's low death rate was down to a change in reporting. But the decline in rate constant looks to have been over a longer time.

Lombardia have actually had lockdowns for a long long time now.

The issue is Piemonte and where are the numbers going in the south. Numbers there are generally rising, but not by much. Liguria the scary numbers for a couple of days may be levelling off.
 

Rocky

Hello decadence
The other explanation is that the case fatality rate has dropped. This most likely would be due to improved treatment protocols, so that the critically ill are more likely to survive. This is something I've no knowledge about - @Brompton Bruce, would the prof be able to shed some light on this?
Interesting point......I think that earlier diagnosis of the people who are likely to need hospital admission may be one reason. There has been a huge rush in the development of diagnostic/treatment algorithms based on rapid reviews of the evidence coming out of China, Spain and Italy. The prof says she’s never seen such a level of cooperation between academics from different countries. She has been working on guidelines for remote consultations for GPs and is now turning her hand (and that of her team) to primary care treatment protocols. The idea is to keep as many patients away from hospitals as possible. One issue that she’s picking up is that almost every CCG (overseeing GPs in an area) has developed its own set of guidance. Some recommend automatic prescription of antibiotics and some don’t. The evidence supports the latter (as it is thought there’s a real danger of patients developing antibiotic resistance). But it will be really difficult to introduce one evidence based protocol across all general practice.
 

roubaixtuesday

self serving virtue signaller
Lombardia have actually had lockdowns for a long long time now.

The issue is Piemonte and where are the numbers going in the south. Numbers there are generally rising, but not by much. Liguria the scary numbers for a couple of days may be levelling off.

We're at cross purposes. The Newsnight piece was about UK numbers yesterday
 

tom73

Guru
Location
Yorkshire
Interesting point......I think that earlier diagnosis of the people who are likely to need hospital admission may be one reason. There has been a huge rush in the development of diagnostic/treatment algorithms based on rapid reviews of the evidence coming out of China, Spain and Italy. The prof says she’s never seen such a level of cooperation between academics from different countries. She has been working on guidelines for remote consultations for GPs and is now turning her hand (and that of her team) to primary care treatment protocols. The idea is to keep as many patients away from hospitals as possible. One issue that she’s picking up is that almost every CCG (overseeing GPs in an area) has developed its own set of guidance. Some recommend automatic prescription of antibiotics and some don’t. The evidence supports the latter (as it is thought there’s a real danger of patients developing antibiotic resistance). But it will be really difficult to introduce one evidence based protocol across all general practice.

Not the only area that after all this will need a rethink. Much of the local knows best for local need has made a right patchwork.
Not helped by national guidelines lacking much teeth added to the mix making it even more disjoined.
 

mjr

Comfy armchair to one person & a plank to the next
I'd expect a UK poll to give broadly similar results. Well, without the chute libre, of course. My faith in the good sense of the UK electorate has been badly shaken.
Today's Swiss (RTS) news gave more detail: Macron has sent the army in to help hospitals and police, plus announced a major healthcare investment plan.

RTS led with international news (which is why I started listening to it before all this): Has Charles infected the Queen? Did Prince Albert of Monaco infect him despite him trying to remember to "Indian salute" rather than shake hands? Worries that c19 is running wild in the migrant camps in Greece.

Meanwhile, the previously-mentioned Geneva waiving of the "actively seeking work" requirement for unemployment benefit has gone nationwide. Swiss pharmacies are "crumbling" under a surge in requests for delivery - pharmacy students have been mobilised but it's not enough - it sounds like deliveries involve extra checks and admin. No mention of the current stats for Switzerland today, which seemed a bit odd.
 

deptfordmarmoset

Full time tea drinker
Location
Armonmy Way
Today's Swiss (RTS) news gave more detail: Macron has sent the army in to help hospitals and police, plus announced a major healthcare investment plan.

RTS led with international news (which is why I started listening to it before all this): Has Charles infected the Queen? Did Prince Albert of Monaco infect him despite him trying to remember to "Indian salute" rather than shake hands? Worries that c19 is running wild in the migrant camps in Greece.

Meanwhile, the previously-mentioned Geneva waiving of the "actively seeking work" requirement for unemployment benefit has gone nationwide. Swiss pharmacies are "crumbling" under a surge in requests for delivery - pharmacy students have been mobilised but it's not enough - it sounds like deliveries involve extra checks and admin. No mention of the current stats for Switzerland today, which seemed a bit odd.
Swiss figures here: https://www.worldometers.info/coronavirus/country/switzerland/
 

Unkraut

Master of the Inane Comment
Location
Germany
Other reports welcome.
The major press briefing I watched this morning said 'pregnancy test' type kits for the virus are not yet reliable enough. The margin of error is too great for them to be useful. They didn't specifically mention Spain though.

They seemed unable not to take a poke at Trump's America, with its lack of comprehensive healthcare, and apparently if you want/need a test there you have to pay for it. Presumably the very poor won't bother.
 
The Nurse who because of selfish panic buyers was bought to tears making people sit up and notice.
Has now self-isolating after developing coronavirus symptoms. :sad:
Get well soon Dawn. :okay:
Has she been tested? Do we know it’s actually CV-19? No we don’t, nor does she. I’d be wary of jumping to too many conclusions just yet.
 
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