Commentary on the @thesundaytimes story 'How the Eldery Paid the Price of Protecting the NHS from COVID-19'.

A Thread.

thetimes.co.uk/article/reveal…
The Sunday Times cover the first wave of the virius, up to May 2020. But the question remains - could it happen again? And what is the Government doing to prevent this?

Let's look at the number of cases in the over-80s
Eight weeks ago, there were 9 Covid cases per 100,000 over 80s.

Last week, there were *114*
This is predictable. I predicted this on 8 September. Data from France and Spain was showing cases starting in 20-somethings and then rising through the age groups. duncanrobertson.com/2020/09/08/sho…
But why does this matter? It matters because older people are more likely to die from Covid.

We represent this by the Infection Fatality Rate. Which means: if you are infected with Covid-19, how likely are you to die?

There are various studies on this
nature.com/articles/d4158…
Here's the Infection Fatality Rate (also called IFR) estimate from July 2020 from a report commissioned by @uksciencechief and published by @acmedsci
.

The main point is - the older you are when you catch Covid, the more likely you are to die.
The whole Academy of Medical Sciences report is worth reading. It's basically the public warning from scientists as at 14 July. Really - if you have a moment, read it. It makes sobering reading.
Cases can lead to hospitalizations which can lead to intensitve care / ICU / HDU which can lead to death.

Here are hospitalizations from @PHE_uk for the second wave. We can see 63 per 100,000 population of over 85-year olds being hopsitalized last week.
Here's a chart from @PHE_uk (only some NHS trusts, slightly different age groupings and this is numbers of patients, not proportions of patients in each age group).

As you may expect, older people have been hospitalized more than younger people.
But compare the shape of the left hand chart (hospitalizations) to the *right hand* chart (ICU cases)

(This is over the course of the whole epidemic and is a subset of cases.)

The right hand chart is ICU cases. It doesn't have the same shape as the left hand chart.
The @thesundaytimes article covers the first wave.

The question remains - what has the Government done in the intervening time - around half a year - to prevent this happening again in this, the second wave?
My @TimesRadio interview this morning

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More from @Dr_D_Robertson

22 Oct
Matt Hancock told the Commons today, placing Stoke, Coventry & Slough into Tier 2

"In all those areas, there are more than 100 positive cases per 100,000 people, cases are doubling approximately every fortnight and we are seeing a concerning increase in cases among the over-60s"
So, it appears that we now appear to have criteria for placing local authorities into Tier 2:
- more than 100 cases per 100,000 people
- cases doubling approximately every fortnight
- concerning increase in cases among the over-60s
100 cases per 100,000 seems arbitrary, especially considering it doubles the previous rate for interventions:
Read 11 tweets
22 Oct
Here is the latest heatmap of COVID-19 cases in England. There are now *114* cases per 100,000 in the over-80s, a 28% rise since last week.

These are not just cases, hundreds of these are deaths to come in the next few weeks.
Monochrome heatmap of England COVID-19 cases.

*114* cases per 100,000 in the over-80s, a 28% rise since last week.

@CMO_England said that Tier 3 restrictions by themselves will not reduce R below 1. Increasing cases and more deaths to come under this policy.

Winter is coming.
Positivity for Males.

Real problem with not doing enough testing for men. Espeically as men are more likely to die from Covid.

Over 5% indicates not enough testing. Which covers 10-80 year old men.
Read 6 tweets
22 Oct
Public Health England have today (22 October) released their latest (Influenza and) COVID-19 surveillance report.

It is for week 43 and includes data up to week 42.
Cases tested remained roughly constatnt. This may be due to limited availability of tests.

Positivity has increased to over 8% in pillar 2 indicating not enough testing is being done.
Here is the map of COVID-19 cases detected this week. Most of the country is now above 50 cases per 100,000
Read 12 tweets
9 Oct
Here is my latest heatmap showing how cases are travelling through the age groups.

It is very concerning.
"The first thing to note is the more-than-doubling in the rate of Covid cases in 10-19 year olds. Many of these will be university students, but it's not clear how many of these are schoolchildren.
“Studies in Spain, France, and the US have all shown that although the second wave may start in young people, it will inevitably move to older people.

“The remarkable thing about this disease is that the death rate increases massively with age.
Read 12 tweets
9 Oct
Commentary on the Slide Pack shown to MPs

'COVID-19 TaskForce: Data briefing 8 October 2020'

Here it is:
assets.publishing.service.gov.uk/government/upl…

h/t @robpowellnews and @Smyth_Chris
Slide 1
Comment: The ONS survey does not include students in halls of residence so will underestimate due to outbreaks in halls of residence

But, yes, everything points to the epidemic not being under control

See:
Slide 2

Shows cases above 50 per 100,000. This is good. However, note several colour shades above this - not just the dark purple (and why no scale?)
Read 32 tweets
9 Oct
Here endeth the National COVID-19 surveillance reports series.

gov.uk/government/pub…
These have been replaced with the National flu and COVID-19 surveillance reports. So, that's good.

And I'll be providing weekly updates on these.

But - a few things.
The new reports don't show hospitalizations by NHS trust. These were useful for showing e.g. the 5th highest hopsital trust with admissions per 100,000 population was in London, not the north of England
Read 7 tweets

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