NEW: the latest UK data is out, and it’s not good.
London is into Tier 3, but that’s only a small part of the wider story of UK’s looming Covid winter.
Case rates rising fast in London, SE & E, but also now rising in Midlands, NW and SW, and decline has halted in NE.
Regrettably, it’s also clear only tough restrictions suppress transmission.
During national lockdown, case rates either went from rising to falling, or from falling slowly to fast, in all English regions.
Since restrictions eased, all declines have either flattened or reversed.
The picture in Wales is even more stark:
During the 17 days of their "fire-break" lockdown, the weekly case rate fell from 295 per 100k to 184. In the first 17 days after restrictions eased, it rebounded to 301.
In the 6 days since then, the rate has increased by 45% to 440.
Like clockwork, this resurgence is feeding through from cases into more serious metrics.
Numbers of Covid patients in hospital are rising — and accelerating — in London, SE, E & Wales, also appear to be rebounding in Midlands.
UK occupancy could easily pass mid Nov peak again.
And this is far from a uniquely British phenomenon.
Right across Europe, declines have stalled. Positivity rates were falling in Italy, France and Austria; not any more.
They were falling fast in Belgium & the Netherlands, but are now barely falling at all.
Again this is feeding into other metrics:
Hospital occupancy rising again in UK as a whole, and stopped falling in Netherlands.
Hospitals had emptied before autumn wave, but far from empty now. Christmas resurgence would be starting race with the virus already half a lap ahead.
All of this puts the UK in a very uncomfortable position. In 9 days time, restrictions will be waived to allow households to gather for Christmas.
Data from the US shows that infections surged after Thanksgiving, with growth rates hitting their highest levels since March (!)
If the UK (or indeed any other European country) sees a marked uptick in household mixing, case are going to rise.
If cases rise among vulnerable populations, hospital beds will fill again, and will start from a much higher base than they did in either March or September.
I, like many, want to gather with family at Christmas. But this is going to be really tough.
Resurgence isn’t just a London thing. It’s not just a UK thing. It’s a seasonal thing, and a restrictions-have-been-relaxed thing.
We’ll all have to make tough decisions in coming weeks
Another area where tough decisions will have to be made, is schools.
Case rates among children and the student-age population have risen especially steeply in recent weeks.
Thus far, they’re lower and rising more slowly among the elderly. Household mixing could threaten that.
But the data on the role of schools in outbreaks is far from conclusive.
In most European countries, reopening schools in the spring did not spark a resurgence. In the autumn, most countries halted and reversed their outbreaks while keeping schools open.
The difference now may be that with only a week or so of term remaining, decision-makers could feel the trade-off between the negatives of closed schools for kids, and the positives of reduced transmission for the vulnerable, has shifted.
Final thoughts:
I’m skeptical London resurgence due to new strain.
Strain was already known and not noted as unusually infectious. Could still be true, but UK resurgence is widespread. What of Wales?
Occam’s razor says resurgence due to relaxed restrix
Numbers of Covid patients in hospital beds are currently rising in 36 states, and the rate of increase in accelerating in 13 of those.
Credit as ever to the wonderful folks at @COVID19Tracking for putting together this data.
Links to some stories for further reading:
• Yesterday @VJMallet & @GuyChazan wrote in depth on Europe’s challenge in avoiding a Christmas resurgence ft.com/content/83c24e…
• Last week we wrote about the best evidence of schools’ roles in outbreaks ft.com/content/7e1ad5…
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Genuinely amazed that we aren’t able to get data on the number of people who have been vaccinated.
Such a huge own goal.
Not only is it really important to know this for public health reasons, it would also be a "good news" number to track, and may show the UK in a good light.
I suspect (and certainly hope) we will start getting this data in the near future, but that it wasn’t planned for and published from the outset suggests that once again this stuff is being made up as we go along.
It also sows distrust at a time when this could not be more crucial.
Distrust fuels vaccine hesitancy, and people project their distrust from one domain onto vaccine safety.
Hailing vaccination successes while unable to point to any evidence is a complete shambles.
NEW: it’s expected (but not yet confirmed) London will go into Tier 3 when England’s Covid restrictions are reassessed next week, so what do the data show?
Let’s dig into all 6 metrics the govt is using.
First, new case rates:
• High in much of London, well into old T3 levels
But with cases, *growth rate* is also a key consideration, and this could be the big one for London.
Rates are rising in the vast majority of London boroughs, increasing by 50% per week in many places, and rising faster than almost all current Tier 3 areas.
Sticking to cases, government is also looking at rates specifically among those aged 60 and over.
As with the pattern in the general population, London boroughs send that Tier 2 slope steeply upwards on the left, with case rates among the 60+ well into former Tier 3 territory.
The picture isn’t as clear-cut as one might think, so here’s a short thread on the key details:
At first glance, it seems pretty clear that London should go into T3. Overall, London case rates are currently roughly at the T3 average, with several boroughs showing rates that would be high even in the top tier.
but ...
... the question is not necessarily how case rates compare between the tiers *now*, but how current rates compare to *when tiers were introduced*
On that basis, London as a whole is still at very low end of T3 when it came in (grey circles), and most boroughs exceptionally low
Let’s set aside that ONS series, and instead look at:
• Imperial REACT study
• Covid symptom tracker
• ONS’s model-free weighted estimates (not subject to revisions)
• The dashboard
Each as it stood when lockdown was announced.
All pointed to rapidly increasing infections
tl;dr
The way ONS models incidence can a) give a misleading shape to recent days of the outbreak, and b) cause confusion where estimated prevalence is retrospectively altered.
But there’s no doubt the virus was spreading rapidly in late October when lockdown was announced
Our job is to communicate clearly to people. If they are confused, that's on us much more than on them.
And no, this doesn't mean we should change our definition of things like unemployment and GDP to match what people [mis]understand, but it does mean we should provide explainers if we're using these terms when speaking to a mass audience.
It's the same in #dataviz. If someone doesn't understand my chart, that's mainly on me.
This is why we always included log scale explainers when sharing our trajectory trackers, for example.
We're hear to communicate, not to make pronouncements from on high and then walk away.
NEW: here’s the definitive chart on which parts of England have been hard-done-by or "let off" by the new tiers.
This one combines all the metrics the govt says it’s using:
• Cases (overall rate, rise or fall, and over-60s)
• Hospital occupancy & admissions
• Positivity rate
In summary:
• Tiers seem correct for majority of places. All high-risk areas are in highest tier
• "Harsh" decisions like Stratford typically areas whose neighbours have high risk
• Outer London has been "let off", but difficult to have outer & inner London in different tiers
The question some might ask is:
If places like Stratford were bumped up a tier because of high risk in surrounding areas, why was inner London not bumped up to tier 3 where parts of outer London appear to belong?
I think there are valid reasons, but it’s worth pondering.