[JR1664]

France going through the roof with 13,000 new cases.

[JustChris]

Worthless without Mashins opening comment.

[robbiep]

Originally Posted by thescouselander

Everyone talks about an exponential growth and if that were true it would be scary - there are no exponential curves in the data from the previous wave though.

Given there was no effective testing we'd need to go on deaths - looking at the profile of the death numbers it follows a sigmoid curve rather than an exponential one - specifically it follows a Gompertz curve. What this means is instead of deaths rising exponentially they actually started up on a very steep curve whos growth rate was decaying right from the start. Heres a curve I fitted earlier - day 1 is 2nd March 2020. Actually data from most countries does the same regardless of containment measures.


Also if we make some assumptions about the case fatality rate, say 0.5% to pick something out of the air, that could mean there were in excess of 8 million infections last time. The numbers we're seeing now are less than a rounding error.

That's the whole point though.

In your graph, the UK went into full lockdown on day 24.

So, take the first 24 days of data, and imagine that the UK doesn't go into lockdown - there is no significant change made to how we live our lives, and extrapolate that out for another 4 or even 6 weeks. The 'top out' and downward curve only happen because of the lockdown.

Now look at ICU beds nationally - you've got (in your example) a 0.5% mortality rate, and a lot of the patients that go into ICU you hope come out alive, rather than in heading for the mortuary.
Let's say 10% of your critical care patients die. So for every death, you've got 9 more people in ICU. Some for considerable periods of time, they don't all go home on the day the 1 patient dies. Some of your patients that die will also linger for days, weeks, before dying.

Now, some of your patients won't make it to ICU. We had 2 ourselves, brought into A+E on the same day, arrangements had been made for them to be transferred up to ICU, a couple of hours later ICU phone down to say that everything is sitting there, all ready ... both patients died in A+E, in spite of aggressive measures.
On that basis, if you have 10 deaths, you have ... let's say 50 people in ICU - for several weeks. Because the other 40 people don't make it to ICU. Plus your 'future deaths' lying in the ICU too.
There are usually about 3000-3500 (depending on how you count them, and what level they are, from 1 to 3, 3 being the most intensive care spaces) ICU beds in the UK, though that number is higher now.

But the beds are only half the story. You've got to staff those areas. You've got to monitor those patients. You've got staff in full PPE, in incredibly tough working environments, who've got to have their days off. So you need a lot of highly trained staff just to run those expanded ICU spaces.
And, surprising as it may seem, the NHS doesn't have those highly trained staff just sitting around, waiting for the next global pandemic.

And that's without looking at the 'practical' aspects of the deaths (which most people try to not think about, understandably). For example, mortuary spaces. Our hospital, for example, has 2 refrigerated containers in the mortuary car park (1x20 foot long, 1x40 foot long). Those weren't there back in March, we had capacity. You've got graves to be dug, crematoria that have to run (one conversation I was involved in back in March / April, it was discussed how 'fortunate' we were that a new crematorium had opened 2 miles down the road last year), you've got things like body bags and shrouds needed (lots of hospitals ran out of shrouds, and the UK stock of body bags was almost nil at one point)

'Rounding error' ? You want to try being at the sharp end of it all.

[HighlandPete]

Originally Posted by robbiep

You want to try being at the sharp end of it all.

I don't envy any of you guys at the sharp end, having to prepare for another 'round' of what we saw in spring.

Having listened to the experiences of the medical staff, some so heart wrenching and hard to absorb, describing what some of you have gone through, I really hope folks will take what's happening more seriously.

Clapping for the NHS can be so empty, even hypocritical. Let's think of the stress and anxiety on the medical staff, they do not want a repeat of the first wave.

Plus, what of the families losing loved ones? If it does happen as the signs are leading us, this time around it is likely going to be, in part, due to selfishness and not taking this virus seriously.

[335dMSport+]

Originally Posted by mikeoz

From Police statement..
Police believe the attack was prompted by the victim moving away from his attacker who was not wearing a mask on public transport

Exactly, they 'believe'. I haven't got a dog in this fight btw, just thought it was really strange when reading the article that they blamed it on a mask dispute (which was the headline) but then backtracked saying that he had no recollection. So unless there was a witness or CCTV, I'm unsure why they're blaming it on a mask dispute.

[sahajesh]

Originally Posted by thescouselander

Everyone talks about an exponential growth and if that were true it would be scary - there are no exponential curves in the data from the previous wave though.

Given there was no effective testing we'd need to go on deaths - looking at the profile of the death numbers it follows a sigmoid curve rather than an exponential one - specifically it follows a Gompertz curve. What this means is instead of deaths rising exponentially they actually started up on a very steep curve whos growth rate was decaying right from the start. Heres a curve I fitted earlier - day 1 is 2nd March 2020. Actually data from most countries does the same regardless of containment measures.


Also if we make some assumptions about the case fatality rate, say 0.5% to pick something out of the air, that could mean there were in excess of 8 million infections last time. The numbers we're seeing now are less than a rounding error.

Rounding error - funniest thing I have seen for a while.

[thescouselander]

Originally Posted by robbiep

That's the whole point though.

In your graph, the UK went into full lockdown on day 24.

So, take the first 24 days of data, and imagine that the UK doesn't go into lockdown - there is no significant change made to how we live our lives, and extrapolate that out for another 4 or even 6 weeks. The 'top out' and downward curve only happen because of the lockdown.

Now look at ICU beds nationally - you've got (in your example) a 0.5% mortality rate, and a lot of the patients that go into ICU you hope come out alive, rather than in heading for the mortuary.
Let's say 10% of your critical care patients die. So for every death, you've got 9 more people in ICU. Some for considerable periods of time, they don't all go home on the day the 1 patient dies. Some of your patients that die will also linger for days, weeks, before dying.

Now, some of your patients won't make it to ICU. We had 2 ourselves, brought into A+E on the same day, arrangements had been made for them to be transferred up to ICU, a couple of hours later ICU phone down to say that everything is sitting there, all ready ... both patients died in A+E, in spite of aggressive measures.
On that basis, if you have 10 deaths, you have ... let's say 50 people in ICU - for several weeks. Because the other 40 people don't make it to ICU. Plus your 'future deaths' lying in the ICU too.
There are usually about 3000-3500 (depending on how you count them, and what level they are, from 1 to 3, 3 being the most intensive care spaces) ICU beds in the UK, though that number is higher now.

But the beds are only half the story. You've got to staff those areas. You've got to monitor those patients. You've got staff in full PPE, in incredibly tough working environments, who've got to have their days off. So you need a lot of highly trained staff just to run those expanded ICU spaces.
And, surprising as it may seem, the NHS doesn't have those highly trained staff just sitting around, waiting for the next global pandemic.

And that's without looking at the 'practical' aspects of the deaths (which most people try to not think about, understandably). For example, mortuary spaces. Our hospital, for example, has 2 refrigerated containers in the mortuary car park (1x20 foot long, 1x40 foot long). Those weren't there back in March, we had capacity. You've got graves to be dug, crematoria that have to run (one conversation I was involved in back in March / April, it was discussed how 'fortunate' we were that a new crematorium had opened 2 miles down the road last year), you've got things like body bags and shrouds needed (lots of hospitals ran out of shrouds, and the UK stock of body bags was almost nil at one point)

'Rounding error' ? You want to try being at the sharp end of it all.

No, I think you've missed the point. It takes an average of 18 or so days to die from COVID so the growth rate of infections started to decay well ahead of lockdown. The point being that something (I’m not sure what) limited growth of the virus besides lockdown. If we extrapolate from there the mystery limiting factor from the last wave will likely still be there which means there’s a good chance the current increase will be a damp squib or at least the outbreak will likely be not as severe.

Lots of assumptions in there of course but the numbers are too low at the moment to declare a second wave. After all we wouldn't have detected it without all the testing going on.

[HighlandPete]

Originally Posted by thescouselander

No, I think you've missed the point. It takes an average of 18 or so days to die from COVID so the growth rate of infections started to decay well ahead of lockdown. The point being that something (I’m not sure what) limited growth of the virus besides lockdown. If we extrapolate from there the mystery limiting factor from the last wave will likely still be there which means there’s a good chance the current increase will be a damp squib or at least the outbreak will likely be not as severe.

This illustrates the problem, IMO, with trying to interpret data. If there is something missing, it can read completely different. Can include assumptions.

My observation from pre lockdown. Some of us were acting 'ahead' of the government restrictions. Watching the news for other countries ahead of us on the curve, already checking and changing behaviour in many folks I know.

How widespread, who knows? There won't be any specific data on that lead in, as it was a voluntary and self administered discipline.

[Lincoln61]

There is a simple reality in that infections and positivity rate are increasing. You can speculate and procrastinate all you like, but facts are facts.

We have got better treatments now, so death rates will probably be lower, but that doesn't mean a whole load of people aren't going to die if infected.

There is no sane or science based argument against social distancing or mask wearing (it's hardly invasive) I cant see a total lockdown again, but there does need to be something put in place to hold things back over winter.

[robbiep]

Originally Posted by thescouselander

No, I think you've missed the point. It takes an average of 18 or so days to die from COVID so the growth rate of infections started to decay well ahead of lockdown. The point being that something (I’m not sure what) limited growth of the virus besides lockdown. If we extrapolate from there the mystery limiting factor from the last wave will likely still be there which means there’s a good chance the current increase will be a damp squib or at least the outbreak will likely be not as severe.

Lots of assumptions in there of course but the numbers are too low at the moment to declare a second wave. After all we wouldn't have detected it without all the testing going on.

I wonder how many of your own elderly relatives lives you'd be willing to gamble on the second wave being a 'damp squib' ?

What happened with treatments was that hospitals - worldwide - were trying more and more unconventional treatments. The 'usual' treatments for influenza/cold-related illnesses weren't producing the results. Some people (and I've no idea where in the world it was), tried using mild steroids to 'damp down' the immune systems response (think allergic reactions and steroids like hydrocortisone), and that made a big difference. That information was widely disseminated, tested, and it worked.
The point is, however, that we still needed those patients in beds (often ICU beds) for considerable periods of time, they've got to be monitored, interventions made if needed.
You run out of those ICU beds, or run out of staff to monitor those patients, due to the sheer number of patients in the hospitals, then those mortality figures head skywards again. Because it isn't just 'give the patient a dose of steroids and send them home', they're still in hospital for weeks.
When the steroid (dexamethasone) test results were announced and the paper released, it took less than 6 hours for it to be included in the 'standard' NHS treatment for ventilated / oxygen supported patients. Hydrocortisone is now also a standard treatment for those patients too.

Oh, and the 'mystery limiting factor' ? FEAR. AKA 'caution'. Some people were changing their own behaviour before the lockdown came in, not carrying on as normal until it was announced.

[HighlandPete]

Originally Posted by robbiep

Oh, and the 'mystery limiting factor' ? FEAR. AKA 'caution'. Some people were changing their own behaviour before the lockdown came in, not carrying on as normal until it was announced.

I'm glad someone else has observed that factor, as well as me (my post above).

What the number crunchers would have to do, is look at other countries like Spain, Italy and France and see if they got caught out, or had different lead ins to the Covid wave. But there are so many variables for each country, could be meaningless.

[HighlandPete]

The other factor I think many of the public are forgetting, there are all the other treatments in back log for the NHS. They can't do everything, need to keep Covid numbers down, or the winter will be hard to cope with. No interventions, it will deteriorate into chaos if we are not acting responsibly.

[thescouselander]

Originally Posted by robbiep

I wonder how many of your own elderly relatives lives you'd be willing to gamble on the second wave being a 'damp squib' ?

What happened with treatments was that hospitals - worldwide - were trying more and more unconventional treatments. The 'usual' treatments for influenza/cold-related illnesses weren't producing the results. Some people (and I've no idea where in the world it was), tried using mild steroids to 'damp down' the immune systems response (think allergic reactions and steroids like hydrocortisone), and that made a big difference. That information was widely disseminated, tested, and it worked.
The point is, however, that we still needed those patients in beds (often ICU beds) for considerable periods of time, they've got to be monitored, interventions made if needed.
You run out of those ICU beds, or run out of staff to monitor those patients, due to the sheer number of patients in the hospitals, then those mortality figures head skywards again. Because it isn't just 'give the patient a dose of steroids and send them home', they're still in hospital for weeks.
When the steroid (dexamethasone) test results were announced and the paper released, it took less than 6 hours for it to be included in the 'standard' NHS treatment for ventilated / oxygen supported patients. Hydrocortisone is now also a standard treatment for those patients too.

Oh, and the 'mystery limiting factor' ? FEAR. AKA 'caution'. Some people were changing their own behaviour before the lockdown came in, not carrying on as normal until it was announced.

I dont think an appeal to emotion argument is particularly useful.

As for ICU beds all we know for certain now is that there are relatively few COVID patients in hospital - that may change.

I wouldn’t like to speculate on what the limiting factor might have been, it could have been lots of things. I was just pointing out that mathematically the curve was not exponential and growth of the infection rate appeared to be limited. If we're going to go back to the idea of unconstrained exponential growth overwhelming the NHS I'd suggest that needs a bit more evidence especially since previous predictions of this were wildly out.

[Goneinsixtyseconds]

Originally Posted by thescouselander

No, I think you've missed the point. It takes an average of 18 or so days to die from COVID so the growth rate of infections started to decay well ahead of lockdown. The point being that something (I’m not sure what) limited growth of the virus besides lockdown. If we extrapolate from there the mystery limiting factor from the last wave will likely still be there which means there’s a good chance the current increase will be a damp squib or at least the outbreak will likely be not as severe.

Lots of assumptions in there of course but the numbers are too low at the moment to declare a second wave. After all we wouldn't have detected it without all the testing going on.

As others have said, reading the data doesn’t always give the answer you’re looking for.

Lockdown legally was a particular date at the end of March. But that’s not when most people and businesses acted. Home working was advised and acted on by most 2-3 weeks before that. People were also advised not to go to the pub or eat out. A lot heeded that advice.

These actions fit perfectly with your 18 day timeline. And what you’re saying doesn’t make sense. It wasn’t a steady slow decay, it was a steep drop. And if you look at countries who locked down more than us the drop was even steeper. That cannot be a coincidence.

[thescouselander]

Originally Posted by Goneinsixtyseconds

As others have said, reading the data doesn’t always give the answer you’re looking for.

Lockdown legally was a particular date at the end of March. But that’s not when most people and businesses acted. Home working was advised and acted on by most 2-3 weeks before that. People were also advised not to go to the pub or eat out. A lot heeded that advice.

These actions fit perfectly with your 18 day timeline. And what you’re saying doesn’t make sense. It wasn’t a steady slow decay, it was a steep drop. And if you look at countries who locked down more than us the drop was even steeper. That cannot be a coincidence.

I dont think you've understood the maths.

[Goneinsixtyseconds]

Originally Posted by thescouselander

I dont think you've understood the maths.

It seems like you’ve understood it better than pretty much every scientist and expert in this field. Impressive.

Why did countries who locked down harder than us and implemented face masks sooner see a much quicker decline than us?

[thescouselander]

Originally Posted by Goneinsixtyseconds

It seems like you’ve understood it better than pretty much every scientist and expert in this field. Impressive.

Why did countries who locked down harder than us and implemented face masks sooner see a much quicker decline than us?

Ok, lets see that, which countries were these then and what was the rate of decay?

[robbiep]

Originally Posted by HighlandPete

I'm glad someone else has observed that factor, as well as me (my post above).

What the number crunchers would have to do, is look at other countries like Spain, Italy and France and see if they got caught out, or had different lead ins to the Covid wave. But there are so many variables for each country, could be meaningless.

Yes - my apologies there, our posts crossed.

I don't get why some people can't (won't ?) see what is plainly coming towards us. It's like a huge firestorm, and waiting until it's 6 feet away from you before recognising that it's there, it's going to destroy everything in it's path, and when it gets to you 2 seconds later there is nothing you can do to stop it. What you can do, now, while it's still some distance away, is to start creating some firebreaks, slowing it down, weaken it. It's still going to get to you, but if it's smaller then you've got a chance. If it's a monster inferno then anyone who can't outrun it (the elderly, vulnerable) won't have any chance.

Maybe it's easier to be in denial, to pretend that the science isn't 'complete', that there may be some other reason for the previous reduction in cases, that lockdown wasn't responsible for that drop last time.

[HighlandPete]

Originally Posted by thescouselander

Ok, lets see that, which countries were these then and what was the rate of decay?

The problem I have with the graphs, what does it prove in helping Covid this week?

The more important question, what would you do with your interpretation of the figures? With it stated that hospital figures are going up (from government and hospital managers/representatives), what is your recommendation for the next few weeks?

Let us know your plan and we can then compare with the rolling data and see who's on the right track.

[MashinBenzin]

Originally Posted by Goneinsixtyseconds

As others have said, reading the data doesn’t always give the answer you’re looking for.

Lockdown legally was a particular date at the end of March. But that’s not when most people and businesses acted. Home working was advised and acted on by most 2-3 weeks before that. People were also advised not to go to the pub or eat out. A lot heeded that advice.

These actions fit perfectly with your 18 day timeline. And what you’re saying doesn’t make sense. It wasn’t a steady slow decay, it was a steep drop. And if you look at countries who locked down more than us the drop was even steeper. That cannot be a coincidence.

Ah, once upon a time there was a thread that listed all the actions that we were taking back in February and early March.

My last day in the office (I haven't been back yet) was 10 March. Thousands of us in my company did the same. I'd also perhaps only been in a couple of times the week before.

Iirc correctly, the supermarket home deliveries were kicking in. The gel routine was established for me in late January.

As you say, people were taking steps long before lockdown.

[Goneinsixtyseconds]

Originally Posted by MashinBenzin

Ah, once upon a time there was a thread that listed all the actions that we were taking back in February and early March.

My last day in the office (I haven't been back yet) was 10 March. Thousands of us in my company did the same. I'd also perhaps only been in a couple of times the week before.

Iirc correctly, the supermarket home deliveries were kicking in. The gel routine was established for me in late January.

As you say, people were taking steps long before lockdown.

There was also a graph showing how all the countries that locked down harder than us had a steeper reduction.

[Goneinsixtyseconds]

Originally Posted by thescouselander

Ok, lets see that, which countries were these then and what was the rate of decay?

I’m not engaging, your one voice against thousands of scientists is not going to change my opinion.