[largeruk]

Anyone care to explain/posit a theory why there seem to be (to me, at least) wide variations in confirmed cases among larger northern conurbations?

The Public Health England figures as of today show:-

Sheffield (population 583k)
Confirmed cases 883
Cases per 1k of pop. 1.515

Liverpool (495k)
552
1.115

Newcastle (300k)
367
1.223

Manchester (548k)
361
0.660

Leeds (789k)
360
0.457

Bradford (537k)
222
0.413

Kingston upon Hull (262k)
38
0.145

Possible factors at play that have occurred to me:-
* Population size/density vary widely between cities which affects infection rates
* Hospital beds per head of population must skew the figures somewhat (Hull?)
* The boundaries of local authorities and NHS Trusts may not coincide that closely

Given that almost all testing is currently being carried out in hospitals, I assume that the no. of confirmed cases fairly closely correlates to CV-related hospital admissions - or is this not the case?

Anyway, as an utter non-stats, non-scientific person, I'd be glad to know others' take on this.

Sources
Confirmed CV cases: https://www.arcgis.com/apps/opsdashboard/index.html#/f94c3c90da5b4e9f9a0b19484dd4bb14
Population figures: https://www.ons.gov.uk/file?uri=%2fpeoplepopulationandcommunity%2fpopulationandmigration%2fpopulationestimates%2fdatasets%2fpopulationestimatesforukenglandandwalesscotlandandnorthernireland%2fmid20182019laboundaries/ukmidyearestimates20182018ladcodes.xls

[robertostallioni]

Sheffield were doing more testing before most others. Read it elsewhere recently as an explanation. I'll look for it...

https://www.theguardian.com/world/2020/apr/01/misleading-and-alarming-sheffields-coronavirus-figures#maincontent

edited to contain link

[AnaisB]

Also, the extent of staff testing varies between hospitals.

[largeruk]

Sheffield were doing more testing before most others.

Also, the extent of staff testing varies between hospitals.

Thanks both. Hadn't considered differentials in NHS staff testing. Makes sense.

[Steve R]

Just thinking aloud on nhs worker deaths due to covid-19... obviously dealing with horrible personal tragedies here but 'encouraging' how low this number still is?  ~15 dead from a frontline of ~500,000.  Comparison with stats on general uk population, ~6000 dead from ~60,000,000 gives 0.003% vs 0.01%.  So nhs death rate not drastically different from what you'd expect in any normal 0.5 million group of working age people.   Also this article, (small sample size at n=15) looks like older men disproportionately represented as you might expect.  But (again small sample caveat) the article appears to tally with data coming out that black or asian ancestry probably leaves you more susceptible to dying from covid. 

[mark20]

Wouldn’t NHS worker cases/deaths lag a couple of weeks behind, from when they first started coming into hospitals and exposing frontline NHS workers?

Interesting / alarming article on the massive over representation of BAME in the death stats
https://www.theguardian.com/world/2020/apr/07/bame-groups-hit-harder-covid-19-than-white-people-uk

[tomtom]

@largeruk

For Hull it’s partly as it’s at the end of the road.... (or motorway). But also - Hull is bordered immediately by large satellite villages/towns that are really part of Hull but count within East Riding of Yorkshire. Eg. Willerby, Anlaby, cottongham, Beverley. Hull infamously has a daytime population of 350k and a nighttime pop of 250k. Beverley was (15 years ago) the UK town containing the largest proportion of commuters.

In other words - it’s probably not lagging too much - just some of the numbers will be in East Riding - which is in the 600’s or so last time I looked.

Also the two large hospitals - HRI is in Hull, but Castle Hill in Cottongham (has infectious diseases unit).

[Oldmanmatt]

Wouldn’t NHS worker cases/deaths lag a couple of weeks behind, from when they first started coming into hospitals and exposing frontline NHS workers?

Interesting / alarming article on the massive over representation of BAME in the death stats
https://www.theguardian.com/world/2020/apr/07/bame-groups-hit-harder-covid-19-than-white-people-uk

Total Noob musing, but either the infections have been going on longer than first thought and the NHS staff succumbing were early infections and pre any PPE, or it’s a viral load thing?

The BAME thing is really getting the white supremacists excited across the pond, there’s rumours of them carrying out (or at least encouraging their infected comrades to) intentional infections in ethnic communities.

[SA Chris]

In fierce contradiction to the myth going around that they are immune to it. Hope this is not a fall out from that.

[Oldmanmatt]

If the BAME susceptibility proves genetic, what’s going to happen when this really takes root in Africa?

It’s autumn in the south now, even if this is seasonal, the timing is bad.

[Falling Down]

I think that’s dangerous speculation (genetics) that can fuel all sorts of sinister agendas.  The article is pretty clear about potential root cause and it’s all socio economic. 

[tomtom]

I think that’s dangerous speculation (genetics) that can fuel all sorts of sinister agendas.  The article is pretty clear about potential root cause and it’s all socio economic.

👆✅👏👏

[Oldmanmatt]

Genetics is highly probable to have a hand in susceptibility, regardless of it’s racial origin or otherwise. It would be ridiculous to ignore it’s potential role or make the discussion of it taboo.
Do you think I’m, somehow, delighting in it?
Those socio economic factors, will apply across the genetic/racial divide, in different areas and, later, we’ll see if the same factors, had the same effects, in similarly structured communities, independent of racial predominance.
There are, for instance, poor and overcrowded white communities across the American south.

[petejh]

I've no idea on the BAME thing other than as FD says the article makes clear socio-economic factors likely to be at play.
But there is a hypothesised genetic susceptibility to covid19 and it's thought to be in the HPA genes. There are a few papers out there on the matter.

[Wil]

Genetics is highly probable to have a hand in susceptibility, regardless of it’s racial origin or otherwise. It would be ridiculous to ignore it’s potential role or make the discussion of it taboo.

The genetic diversity within the world's black population is more than all other groups put together. Add in other British minority groups and you can see why associating "genetics" and "BAME" is at best dodgy. No doubt there is a genetic factor in susceptibility to all illnesses, but it's vastly more nuanced than racial lines (which don't have easy genetic parsing anyway).

[sdm]

Wouldn’t NHS worker cases/deaths lag a couple of weeks behind, from when they first started coming into hospitals and exposing frontline NHS workers?

Interesting / alarming article on the massive over representation of BAME in the death stats
https://www.theguardian.com/world/2020/apr/07/bame-groups-hit-harder-covid-19-than-white-people-uk

Total Noob musing, but either the infections have been going on longer than first thought and the NHS staff succumbing were early infections and pre any PPE, or it’s a viral load thing?

I would guess there will be a big lag in healthworker deaths because of the timing of when they started to be exposed to large viral loads.

[Muenchener]

Read a couple of things in the local news this morning that made me think about the amount of collateral damage/deaths.

Fire brigades handing over their breathing apparatus to hospitals. So now if you're in a house fire in Bavaria - which you're already more likely to be anyway, because you're (a) spending more time at home and (b) doing a lot more cooking than usual - your survival chances just dropped significantly.

And a consultant worried about a dramatic drop in A&E visits for things like minor heart attacks & strokes. People aren't getting treatment that they actually need because they're scared to go to hospitals. Or because they think they're doing the right thing by not burdening the system.

[SA Chris]

I'd be surprised if Fires Services were allowed to hand over all their kit, even if they were allowed to. I'd like to think they'd have surplus, but kept enough to maintain their own safety if needed.

I've seen similar things from Children's A&E about parents not wanting to take kids in for ailments when they normally would, assuring them that it's business as usual there.

[Duma]

Thanks Duma. They seem to expect the initial delayed distancing to have a big impact on exponential growth.
From the Guardian:

The Institute for Health Metrics and Evaluation (IHME) in Seattle predicts 66,000 UK deaths from Covid-19 by August, with a peak of nearly 3,000 a day, based on a steep climb in daily deaths early in the outbreak.
...
The analysts also claim discussions over “herd immunity” led to a delay in the UK introducing physical distancing measures, which were brought in from 23 March in England when the coronavirus death toll stood at 54. Portugal, by comparison, had just one confirmed death when distancing measures were imposed.
...
Looking at the measures taken by the UK to curb the spread of the disease, the institute says the peak is expected in 10 days’ time, on 17 April. At that point the country will need more than 102,000 hospital beds, the IHME says. There are nearly 18,000 available, meaning a shortfall of 85,000.
...
The IHME said its model was designed to be updated from day to day as the pandemic goes on. For a country such as the UK, which is quite early on in its outbreak, the uncertainty was higher and the headline numbers might change over the next few days as more data is collected.

The high predicted numbers of UK deaths were driven by three factors, the IHME said: what had happened in other countries that are ahead in their epidemics, such as Italy and Spain, what had happened so far in the UK, and when physical distancing measures were put in place.

In the early stages of the UK outbreak, deaths climbed steeply, which the IHME says is a major driver of predicted deaths. The flirtation in government with the idea of “herd immunity” as a way out of the epidemic meant there was a delay in implementing physical distancing until 23 March, when there were already 54 deaths a day.

Important to say Ferguson and Imperial strongly dispute the figures.

Ferguson said he did not think the predictions could be relied on. “This model does not match the current UK situation,” he said, adding that the numbers used by the IHME were at least twice as high as they should be for current bed usage and deaths in the NHS. “Basically, their healthcare demand model is wrong, at least for the UK,” he said.
 

Further to this, the current update has peak daily deaths down to ~1700 and total down to 37000
I'd expect that to drop further soon as their health system assumptions still look way too pessimistic.

In contrast anyone got any idea what's gone wrong in Belgium? Daily numbers horrible for a country that size.

[Duma]

Reply to self: looks like Belgiums really bad numbers on the 7th and today are backdated deaths from March in retirement homes.

[Duma]

Also, anyone got a link to decent daily data for France? Jwi? I look at https://www.worldometers.info/coronavirus/
Which gets its numbers from
https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-et-infections-respiratoires/infection-a-coronavirus/articles/infection-au-nouveau-coronavirus-sars-cov-2-covid-19-france-et-monde
Which is very messy as it seems random when they include deaths outside hospital, and there's no historic record of the daily hospital deaths so it's hard to see how the country is doing.

[tomtom]

Re:curve flattening.

Both Italy and Spain have levelled off after c.10k deaths. We’ll pass that total today or tomorrow - and I really hope it signals the crest of the hill

[Oldmanmatt]

Re:curve flattening.

Both Italy and Spain have levelled off after c.10k deaths. We’ll pass that total today or tomorrow - and I really hope it signals the crest of the hill

I am (trying) to take heart from the totals being below the 1250 or so the less hopeful models anticipated at this point. Which I hope means the social distancing, prior to lockdown, is already influencing matters and that we should see some more pronounced effects soon.

This was supposed to be the point at which it would start to show, so, fingers crossed.

[galpinos]

It is worth bearing in mind that the UK deaths are only those that died in hospital, and it’s only the registered deaths in the last 24hrs. Hence we already get lower numbers at the weekends. Also, no care home/community deaths are included in the figures so when Belgium looks bad, they are including those numbers in their figures.

It’s complicated, and not a great picture. Anecdotally from London, some hospitals have ICU capacity but some don’t and transfers between hospitals are tricky. Also, morgues are full so bodies are, in some cases, blocking ICU beds.

[Oldmanmatt]

 

https://www.salomon.com/en-int/blog/doctor-mountain-guide-and-covid-19-survivor?fbclid=IwAR37eS6zWidvk5uXmuW7lRTrhRp_X3k7p6UDyQIzZS6om7EH_RgdUgZJywM