The statistician in me (and I hate fecking stats) always gets a bit irked by these excess deaths calculations, without confidence intervals.
The yearly average is exactly that, an average. With a wide range, year on year. So talking about an “excess” of 17 deaths in any given months based on the yearly average just seems silly.
There’s bound to have been months in years gone by with a similar, or even greater, number of “excess deaths” - as compared to the average - which never even got a mention.
For sure it could do with some +/- deviation bars sat on those graph averages - because as you say, averages are just that. It's more that as you move around Greater Manchester authorities you see different patterns that intrigues me - as Manchester as a whole probably does wobble up and down together (based on weather, flu, holiday timing and all those other tangible risk factors).
As you say though, isolating datasets too much doesn't help, something completely different may happen in May, and we won't see the big picture until we've got many more months (and regions) of data on the charts. I'm more curious about whether doctors writing death certificates are getting policy advice on characterising cause of death, and if so from what source.
The statistician in me (and I hate fecking stats) always gets a bit irked by these excess deaths calculations, without confidence intervals.
The yearly average is exactly that, an average. With a wide range, year on year. So talking about an “excess” of 17 deaths in any given month based on the yearly average just seems silly.
There’s bound to have been months in years gone by with a similar, or even greater, number of “excess deaths” - as compared to the average - which never even got a mention.
Indeed. The amount of shoddy reporting of statistics that has gone on the last few weeks and months is frustrating. It doesn't surprise me mind, but it's still frustrating. Confidence intervals are generally so easy to get and add so much more than a point estimate, but I suspect a lot of the time they're left out as they provide the sort of info that the person reporting doesn't want to show.
For sure it could do with some +/- deviation bars sat on those graph averages - because as you say, averages are just that. It's more that as you move around Greater Manchester authorities you see different patterns that intrigues me - as Manchester as a whole probably does wobble up and down together (based on weather, flu, holiday timing and all those other tangible risk factors).
As you say though, isolating datasets too much doesn't help, something completely different may happen in May, and we won't see the big picture until we've got many more months (and regions) of data on the charts. I'm more curious about whether doctors writing death certificates are getting policy advice on characterising cause of death, and if so from what source.
Regional mortality differences are interesting. With this pandemic we’ve all got used to seeing how some areas get really badly effected, while others seem to dodge the bullet. Previous outbreaks of illnesses like swine flu probably followed a similar pattern. Super spreaders or care home outbreaks causing localised mortality. Apart from a few PH specialists and research virologists, most of use were blissfully unaware!
Based on that the claim is wrong though. The study discovered that kids weren't the main source of transmission within 31 households studied but they still represent around 10%. To even suggest that they aren't infections at all is an exaggeration. They are seemingly less contagious some studies believe that it's around three times less contagious than adults but they still are.
So my road has thought it’s a good idea to have a street party... no social distancing being undertaken whatsoever. I can’t believe how people can be so ignorant.
I found it really weird that BBC news were reporting from a “street party” this morning. People sitting outside their front gardens on the pavement, others walking past. A couple of weeks ago they were shaming people (who probably live in small flats in London) for walking in parks.
My partner wasn’t allowed to come to my grandads cremation, but everyone’s allowed to prance around to celebrate something that can be done annually.
Based on that the claim is wrong though. The study discovered that kids weren't the main source of transmission within 31 households studied but they still represent around 10%. To even suggest that they aren't infections at all is an exaggeration. They are seemingly less contagious some studies believe that it's around three times less contagious than adults but they still are.
Authors' Summary: In this cluster, 12 Covid-19 cases (one asymptomatic) were linked to one single index case. One child, co-infected with other respiratory viruses, attended three schools while symptomatic, but did not transmit the virus, suggesting potential different transmission dynamics in children.
All 5 symptomatic confirmed cases were first tested between 6 to 10 days after symptoms onset. For 4 cases, a low viral load detected (often under the limit of quantification of 1 log10 copies/1000 cells) (Figure 3-4). All confirmed cases stopped viral excretion within 17 days after onset of illness (median 11 days; range 5-17) (Figure 4). Case 4, the asymptomatic case, had the same natural history of viral excretion as symptomatic case 3 with a viral shedding of 7 and 6 days respectively. Cases 2 and 6 (child) had similar shedding patterns, with virus load close to the limit of quantification for several days before being negative, much lower than those observed in cases 3 and 4. Case 13 had an endotracheal aspirate (ETA) positive at D4 with SARS-CoV-2 (viral load of 2.4 log10 copies/1000 cells), while negative in the nasopharyngeal swabs (NPS) collected since admission (8 days). The NPS of the same day and the following days remained negative. The daily follow-up revealed a short-lasting excretion with only two successive ETA with a lower viral load (2.4 log10 and 1.1 log10 copies/ 1000 cells, respectively, Figure 4), the subsequent ETA remained negative. All cases were negative for other viruses except for the pediatric case, who had a SARS-CoV-2 + picornavirus (rhinovirus or enterovirus) + influenza A(H1N1)pdm09 co-infection. His two siblings were negative for the SARS-CoV-2, but had an Influenza A(H1N1)pdm09 infection, and an Influenza A(H1N1)pdm09 + picornavirus co-infection.
Because of the large number of contacts of the pediatric case (case 6), particular attention was paid to detect tertiary cases in children in the three schools the child attended while symptomatic. On 08/02, a public meeting was held to inform the parents of two schools (A and B); the parents of school C were informed by telephone. As a precaution, the first two schools were closed for two weeks and the third for one week (end of follow-up period; the pediatric case visited that school on 31/01). On Sunday 09/02, infectious disease specialists and epidemiologists evaluated the risk of 112 school contacts. All children and teachers who were in the same class as the symptomatic pediatric case were considered as high risk contacts and were isolated at home (Table 2). All hospitals in the region implemented emergency plans to accommodate potential tertiary cases.
Overall, 172 contacts were identified; 84 (49%) were classified as high/moderate risk and 88 (51%) as low risk (Table 1). Of those, 98% (n=169) were contacted; 70 (41%) had respiratory symptoms during the investigation and were thus classified as possible cases; 73 were tested; all tested negative for SARS-CoV-2 except for case 13 who tested positive during hospitalization. No additional cases were identified within the 14-day follow-up period of all the contacts. The movement history of the confirmed cases during their stay in France and their contact tracing is presented in the Supplementary material. Briefly, contacts of the other 5 cases that were monitored included teachers in another school, apartment staff and cleaners, staff in shops and restaurants, and passengers in four buses and three airplanes.
Except for case 13 (tertiary case), no SARS-CoV-2 virus was detected in any of the contacts monitored. However, other seasonal respiratory viruses were detected in 64% (n=46) of the tested contacts, representing 62% and 67% of high and low risk contacts, respectively (Table 1). Overall, 33% of the viral infections detected were due to influenza (75% of influenza A (H1N1)pdm09 virus and 25% of influenza B virus) and 18% were due to a picornavirus (rhinovirus or enterovirus). At school C, 30% (3/10) of contacts of the pediatric case had a picornavirus infection (Table 1). In addition, “classical” human coronaviruses such as HUK1 and NL63 were detected in 16% of contacts without any cross reactivity with SARS-CoV-2 molecular diagnostics.
Particularly, the infected child, despite interactions with a large number of contacts in different schools, did not transmit the disease, as evidenced by the large number of negative results of his tested contacts. However, the high proportion of picornavirus and influenza infections among his contacts at the schools indicated transmission of those viruses within those settings. Similarly, we observed that the family cluster allowed the dissemination of picornaviruses or influenza A viruses in the 3 children, while SARS-CoV-2 was detected in only one child. These two observations suggest that picornavirus and influenza infections are more easily transmitted than SARS-CoV-2. It is possible that viral interference in the host may impact the individual susceptibility to another viral respiratory infection as observed during the 2009 influenza pandemic and other winter seasons between A(H1N1) influenza virus and RSV (26-27). It is also possible that the very low viral load of the pediatric case and the subsequent lack of transmission might be related to his co-infection and the co- circulation of respiratory viruses. Viral load was only tested 8 days after his onset of symptoms. The child continued his normal activities and interactions as his symptoms were mild. Current evidence indicates that children develop Covid-19 less often than adults and the clinical manifestations of the disease are milder (28-30). The above suggest that children, being less likely to be infected and more likely to develop mild disease, may play a less important role in the transmission of this novel virus.
You may disagree with the study or its conclusions, but don't shoot the messenger.
It wasn't a binary choice, of course. New Zealand have "in epidemiological terms" eliminated the virus, and they're going to re-open the economy far more successfully than the US. What the US are suffering from most is a poorly executed strategy. The notion that the US somehow forgot about the economy in all of this kind of ignores the most important part of the story - the initial exponential growth. Cases were doubling every three days and they had thousands of cases by the time they implemented social distancing. New Zealand were at 100 cases by the time they reached "level 3" - essentially what we've called lockdown - and Czech Republic had under 100 cases by the same stage. That's because they had the economy front-and-centre at that stage, as they have in every stage. They were forced into this approach when the scale of the public health crisis became overwhelming, not because they put public health above the economy.
Of course, I agree. However, looking at all the knock-on effects I'm wondering if the cure is indeed better than the disease. Nobody wants death, but the global economic implosion is increasingly concerning...
I found it really weird that BBC news were reporting from a “street party” this morning. People sitting outside their front gardens on the pavement, others walking past. A couple of weeks ago they were shaming people (who probably live in small flats in London) for walking in parks.
My partner wasn’t allowed to come to my grandads cremation, but everyone’s allowed to prance around to celebrate something that can be done annually.
My estate is half filled with fecking street parties, and then the private facebook group is full of people commenting that they are disappointed their aren't more (apparently those not doing so do not appreciate the sacrifice of those in WW2).
How hard was it for the government to say "hey we know alot of you want to do something but now is not the time." Useless lot.
Offices are far, far more productive than working from home in my experience.
I currently have 12 staff working from home. One is around 10% more productive working from home, one is around 10% less and the other 10 range between 20% and 70% their usual output despite having the workload available.
I've also tried to work from home myself and I get far more done including a 2 hour commute to go into the office (11 hours at home achieves less than 9 hours in the office).
If working from home was equally productive as well as being cheaper for the employer (an employer could pay staff less as they would have no commuting costs and more free time due to the lack of a commute); the biggest companies would already be taking advantage.
If my experience is anything like the country as a whole the best we can hope for is maybe 10% of people who can work from home being given the opportunity after this is all over (although the politics and legal aspect involved with allowing one person with an identical job title the opportunity but telling 3 others they can't would put me off).
Depends on the type of work and family situation of each employee.
I don't miss the commute or the random weekly travels to meet with clients when those things can be just as easily accomplished virtually.
If you know what you're doing and you've some latitude in your tasks, WFH is a boon. If you crave social interactions and/or need directions every 15 minutes WFH is impossible.
I found it really weird that BBC news were reporting from a “street party” this morning. People sitting outside their front gardens on the pavement, others walking past. A couple of weeks ago they were shaming people (who probably live in small flats in London) for walking in parks.
My partner wasn’t allowed to come to my grandads cremation, but everyone’s allowed to prance around to celebrate something that can be done annually.
I waked through my town centre today for the first time since lockdown started. Quite frankly I was appalled. Large groups of kids on bikes, people stopping to chat, loitering and literally nobody following a safe distance. People were literally laughing at me and my partner for zig zagging and stopping and starting our walk patterns to keep distance.
Not gonna do that again in a hurry. Honestly it was like a normal Friday.
It has been like this for a couple of weeks, plenty of kids waking around the village or just hanging around the shops like it's the summer holidays.
Traffic on the motorways has definitely gone up as well, I have still been going into the office a couple of times a weeks so I have noticed the change been now and what it was like on the first week of lockdown, guessing people have either gone back to work or don't give shit about the lockdown anymore.
Authors' Summary: In this cluster, 12 Covid-19 cases (one asymptomatic) were linked to one single index case. One child, co-infected with other respiratory viruses, attended three schools while symptomatic, but did not transmit the virus, suggesting potential different transmission dynamics in children.
All 5 symptomatic confirmed cases were first tested between 6 to 10 days after symptoms onset. For 4 cases, a low viral load detected (often under the limit of quantification of 1 log10 copies/1000 cells) (Figure 3-4). All confirmed cases stopped viral excretion within 17 days after onset of illness (median 11 days; range 5-17) (Figure 4). Case 4, the asymptomatic case, had the same natural history of viral excretion as symptomatic case 3 with a viral shedding of 7 and 6 days respectively. Cases 2 and 6 (child) had similar shedding patterns, with virus load close to the limit of quantification for several days before being negative, much lower than those observed in cases 3 and 4. Case 13 had an endotracheal aspirate (ETA) positive at D4 with SARS-CoV-2 (viral load of 2.4 log10 copies/1000 cells), while negative in the nasopharyngeal swabs (NPS) collected since admission (8 days). The NPS of the same day and the following days remained negative. The daily follow-up revealed a short-lasting excretion with only two successive ETA with a lower viral load (2.4 log10 and 1.1 log10 copies/ 1000 cells, respectively, Figure 4), the subsequent ETA remained negative. All cases were negative for other viruses except for the pediatric case, who had a SARS-CoV-2 + picornavirus (rhinovirus or enterovirus) + influenza A(H1N1)pdm09 co-infection. His two siblings were negative for the SARS-CoV-2, but had an Influenza A(H1N1)pdm09 infection, and an Influenza A(H1N1)pdm09 + picornavirus co-infection.
Because of the large number of contacts of the pediatric case (case 6), particular attention was paid to detect tertiary cases in children in the three schools the child attended while symptomatic. On 08/02, a public meeting was held to inform the parents of two schools (A and B); the parents of school C were informed by telephone. As a precaution, the first two schools were closed for two weeks and the third for one week (end of follow-up period; the pediatric case visited that school on 31/01). On Sunday 09/02, infectious disease specialists and epidemiologists evaluated the risk of 112 school contacts. All children and teachers who were in the same class as the symptomatic pediatric case were considered as high risk contacts and were isolated at home (Table 2). All hospitals in the region implemented emergency plans to accommodate potential tertiary cases.
Overall, 172 contacts were identified; 84 (49%) were classified as high/moderate risk and 88 (51%) as low risk (Table 1). Of those, 98% (n=169) were contacted; 70 (41%) had respiratory symptoms during the investigation and were thus classified as possible cases; 73 were tested; all tested negative for SARS-CoV-2 except for case 13 who tested positive during hospitalization. No additional cases were identified within the 14-day follow-up period of all the contacts. The movement history of the confirmed cases during their stay in France and their contact tracing is presented in the Supplementary material. Briefly, contacts of the other 5 cases that were monitored included teachers in another school, apartment staff and cleaners, staff in shops and restaurants, and passengers in four buses and three airplanes.
Except for case 13 (tertiary case), no SARS-CoV-2 virus was detected in any of the contacts monitored. However, other seasonal respiratory viruses were detected in 64% (n=46) of the tested contacts, representing 62% and 67% of high and low risk contacts, respectively (Table 1). Overall, 33% of the viral infections detected were due to influenza (75% of influenza A (H1N1)pdm09 virus and 25% of influenza B virus) and 18% were due to a picornavirus (rhinovirus or enterovirus). At school C, 30% (3/10) of contacts of the pediatric case had a picornavirus infection (Table 1). In addition, “classical” human coronaviruses such as HUK1 and NL63 were detected in 16% of contacts without any cross reactivity with SARS-CoV-2 molecular diagnostics.
Particularly, the infected child, despite interactions with a large number of contacts in different schools, did not transmit the disease, as evidenced by the large number of negative results of his tested contacts. However, the high proportion of picornavirus and influenza infections among his contacts at the schools indicated transmission of those viruses within those settings. Similarly, we observed that the family cluster allowed the dissemination of picornaviruses or influenza A viruses in the 3 children, while SARS-CoV-2 was detected in only one child. These two observations suggest that picornavirus and influenza infections are more easily transmitted than SARS-CoV-2. It is possible that viral interference in the host may impact the individual susceptibility to another viral respiratory infection as observed during the 2009 influenza pandemic and other winter seasons between A(H1N1) influenza virus and RSV (26-27). It is also possible that the very low viral load of the pediatric case and the subsequent lack of transmission might be related to his co-infection and the co- circulation of respiratory viruses. Viral load was only tested 8 days after his onset of symptoms. The child continued his normal activities and interactions as his symptoms were mild. Current evidence indicates that children develop Covid-19 less often than adults and the clinical manifestations of the disease are milder (28-30). The above suggest that children, being less likely to be infected and more likely to develop mild disease, may play a less important role in the transmission of this novel virus.
You may disagree with the study or its conclusions, but don't shoot the messenger.
The above suggest that children, being less likely to be infected and more likely to develop mild disease, may play a less important role in the transmission of this novel virus.
Which is a bit more nuanced and the following tweet provides a good support which shows that kids are unlikely to be the primary source of household infections but are still infectious.
Also to be truthful, I asked you the initial question because you used the exact same sentence than The Spectator did, where instead of using the larger study, referenced an anecdotal example while making a conclusion that I believe is a bit misleading.
Nice of coronavirus to have the day off isn't it. It's tuned into a farce here a few streets up is rammed with people absolutely no social distancing going on at all.
My estate is half filled with fecking street parties, and then the private facebook group is full of people commenting that they are disappointed their aren't more (apparently those not doing so do not appreciate the sacrifice of those in WW2).
How hard was it for the government to say "hey we know alot of you want to do something but now is not the time." Useless lot.
We will have to be careful with the lockdowns easying, apparently a small german town saw spike in cases within a week and brought back the lockdown. At least they have the testing capacities, I'm not sure if we can do the same thing everywhere in France.
Unless the police enforce the shutdown of these things I give it a week before people just decide to go back to normal. Folk are selfish and lots of people will start to think "well, if they're doing it then I'm not just going to sit here missing out".
Unless the police enforce the shutdown of these things I give it a week before people just decide to go back to normal. Folk are selfish and lots of people will start to think "well, if they're doing it then I'm not just going to sit here missing out".
So my road has thought it’s a good idea to have a street party... no social distancing being undertaken whatsoever. I can’t believe how people can be so ignorant.
Whether you agree with this or not, this highlights the fact that the idea of people socially distancing (even ordinary, generally law abiding citizens) for months on end isn't going to happen.
Is this crash caused by the lockdowns, the pandemic or the collective insecurities and entitlement of people? Add a bit of sensationalist, divided media and you have a clusterfeck of opinions that feed all those horrid little insecurities. We've become soft.
Unless the police enforce the shutdown of these things I give it a week before people just decide to go back to normal. Folk are selfish and lots of people will start to think "well, if they're doing it then I'm not just going to sit here missing out".
A lot of people want to live their lives and are prepared to go about their business despite the risk. A few of the older people I know feel that way. One guy in particular is in his 70's and whilst he's being careful, his view seems to be that he'd rather take his chances and enjoy the time he has left which may not be all that long.
As I said above, seems to me that the longer this goes on for the less likely it is to be followed. Even putting aside the issues around having to work, the idea that people will accept a new normal, even for month just isn't viable because the majority of the population crave social interaction in the long term. People near me had congregated on their front lawns earlier today and were keeping a distance but when I went out later they were all mixing pretty freely.
We need a road map out of this that encourages people to comply and to look ahead to when things can get back to normal.
Of course, I agree. However, looking at all the knock-on effects I'm wondering if the cure is indeed better than the disease. Nobody wants death, but the global economic implosion is increasingly concerning...
Yeah it's a huge concern! I just don't think you can really make the argument that the government haven't taken it into account. They knew when they were shutting down half the economy it would guarantee a short-term recession on an unprecedented scale. When we're talking about the cure and the disease we have to take into account what the aim of the "cure" is. From what I can tell the cure aims to protect both society (in the short-term) and the economy (over the longer term). That's operating on the assumption that there was always going to be short-term economic pain, and the lockdown is intended to shorten that pain while the economic policies protect it over that shorter period.
We don't have a lot of data on it but the opposite assumption - that the economy would've been ticking along in a pandemic without the lockdown - doesn't seem very likely. Here's the data from the Atlantic article mentioned above that shows the biggest decline in spending came between before the stay-at-home orders came in.
By 23rd March, only 11 states had issued the orders but overall spending had dropped by 21%. Clothes spending had dropped by 45%. They had already reached rock-bottom before half of the states had issued the orders. In somewhere like Texas, the stay-at-home order wasn't announced until the beginning of April, days after spending had bottomed out on clothes, entertainment, restaurants, hotels....social distancing and fear alone were already going to plunge the economy into a recession. The US was well on its way to being the epicentre of the pandemic, and that's at least in part because they put the economy first in the first place.
That's just spending. There were already over 9m unemployment claims and over 30% of small businesses had closed by the time just one fifth of the states had issued the orders.
The economic pain was coming, and it was always going to be a question of how to put the country in the best position to recover. Allowing the virus to spread uncontrollably is unlikely to go hand-in-hand with an economic recovery. The lockdown brings short-term pain but it prevents things from spiralling out of control, bringing with it the hope (and intention) of a much smoother recovery. A lot of countries have put forward significant economic policies so I don't think we can say they're overlooking it, they're just focusing on the recovery.
Yeah it's a huge concern! I just don't think you can really make the argument that the government haven't taken it into account. They knew when they were shutting down half the economy it would guarantee a short-term recession on an unprecedented scale. When we're talking about the cure and the disease we have to take into account what the aim of the "cure" is. From what I can tell the cure aims to protect both society (in the short-term) and the economy (over the longer term). That's operating on the assumption that there was always going to be short-term economic pain, and the lockdown is intended to shorten that pain while the economic policies protect it over that shorter period.
We don't have a lot of data on it but the opposite assumption - that the economy would've been ticking along in a pandemic without the lockdown - doesn't seem very likely. Here's the data from the Atlantic article mentioned above that shows the biggest decline in spending came between before the stay-at-home orders came in.
By 23rd March, only 11 states had issued the orders and the but overall spending had dropped by 21%. Clothes spending had dropped by 45%. They had already reached rock-bottom before half of the states had issued the orders. In somewhere like Texas, the stay-at-home order wasn't announced until the beginning of April, days after spending had bottomed out on clothes, entertainment, restaurants, hotels....social distancing and fear alone were already going to plunge the economy into a recession. The US was well on its way to being the epicentre of the pandemic, and that's at least in part because they put the economy first in the first place.
The economic pain was coming, and it was always going to be a question of how to put the country in the best position to recover. Allowing the virus to spread uncontrollably is unlikely to go hand-in-hand with an economic recovery. The lockdown brings short-term pain but it prevents things from spiralling out of control, bringing with it the hope (and intention) of a much smoother recovery.
Awesome response, thanks. The keyword, and perhaps the root of it all according to me, is FEAR. Is that fear misplaced? Overblown? Given the price we must pay... That's what I'm beginning to question. I hate the way I'm starting to think about this shite. I'm confronted by that age old question... Would I kill one person to save 5? I never thought I'd seriously consider answering it... And now I am.
