Thread by @EdConwaySky

It's official: the UK has overtaken Italy to have the highest #COVID19 death toll in Europe - at least on the basis of the daily figures we get from govts each day. But is this as significant as it really sounds? And can these numbers really be relied upon? A thread:

First tho, how helpful are these comparisons? There was def value early on comparing trajectories of different countries. Why? They gave a hint of where we may be heading. Recall how sceptical many were early on that UK cld follow Italy. These charts showed us heading that way

But trying to measure up countries against each other - who has the "worst" outbreak?? - is both difficult & not altogether helpful. Let me explain why: there are three main ways of measuring the public health toll of COVID19:
1. Death tolls we get each day from govt, eg:

Worth pointing out that one of the many ways in which these daily death tolls are an incomplete picture is that they don't adjust for population. Adjust that chart above by population and look: Belgium at the top, the US at the bottom. And the UK back below Italy

Two other measures:
2. Official #COVID19 statistics from statistical agencies. These tend to be more comprehensive than the daily figs.
3. Excess deaths. These are ALL deaths above the average for a given period of the year.
Here are these three different tolls for the UK:

Which of the three is the "best" measure? Excess deaths. Why? Consider what's going on in UK care homes.
16k excess deaths since March.
Only 6k of them down on register as #COVID19.
So a lot of unexplained EXTRA deaths that DON'T show up in even the official (eg no 2👆) CV stats

So better to focus on excess deaths. Prob is they aren't v timely. @ONS among fastest to publish & because of this UK figs may end up looking bigger & worse before others.
But yday Italian statistical agency produced figs for Q1. What did they tell us…? istat.it/it/files//2020…

Among the takeaways: those daily Italian figs were a LOT lower than the ultimate excess deaths figs.
By endMar, Italy’s official daily figs put the death toll at 11.6k. But Istat’s figs show actual excess deaths were 118% higher. UK also undercounts excess deaths but by less.

Now it doesn't necessarily follow that Italian daily death toll (the one we've just overtaken) is STILL 100% or so below the eventual excess deaths. But that analysis suggests there's a bigger gap between Italian headline figs and excess deaths than in UK. That's important...

For even tho the headline stats show UK has biggest death toll in Europe, it's quite possible the eventual picture is different.
Still.
Let's not forget what really matters:
These numbers are grisly and horrible for many of us.
But let's remember they're also far from definitive.

Here's a wee video explaining why Britain both is and isn't facing the worst #COVID19 toll in Europe. Lots of 📈📊, if you like that kind of thing

Something from the mortality statistics is haunting me.
Since March there have been nearly 9,000 excess deaths in domestic settings (eg 9k above“usual" level).
Only 15% of them were counted by @ONS as #COVID19 deaths.
So: 7.5k “unexplained" excess deaths in people's homes.

On basis of what we know anecdotally from care homes, many if not most of these deaths were prob undiagnosed #COVID19. But we don't know for sure; we may never know for sure.
We are rightly focusing a lot on care homes but excess deaths in domestic settings are also awfully high.

Care homes are a separate category. Same issue there too tho: only some of the excess deaths are formally put down to #COVID19 by the @ONS.
But in care homes “unexplained" excess deaths are 62% of all excess deaths. In domestic settings it's 85%

https://twitter.com/BryceElder/status/1258098292044562432

https://twitter.com/BryceElder/status/1258098292044562432