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7 minutes ago, soapdragon said:

Nothing concrete here yet....noises being made about schools going back after the Whitsun half term so at least they'd get the last half term. ES, who is year 10 so first GCSE year, has already been told that his year won't be able to cover the full GCSE syllabus😫.

That will surely be the case for ALL year 10 students right?

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Probably not the private sector or those who had been doing more structured work online. Since schools closed ours were just told to revise for year 10 exams. Other schools have had online lessons and lessons set during that period so have been active learning rather than 2 weeks + of unstructured revision.

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Glimmer of good news. My son said yesterday was the first day in ages without a single coronavirus call. Just the usual stuff you'd expect. 

Also, is anyone else sick to death of experts giving conflicting advice? Everyone spouts out different 'facts' some of which turn out to be outright lies. I'm feeling very manipulated. 

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Someone posted a brilliant piece on our village facebook page that was written by a qualified, experienced working statictician (sp?) actually dealing with Covid cases. It was about a page and a half long and detailed many reasons why the numbers that we are all quoted during 'Hancock's Half Hour' are WRONG and SKEWED and basically cannot be relied upon. It was brilliant; I'll see if I can linky it somehow (but don't hold your breath!) Otherwise it's on Chalgrove Villlage Facebook page somewhere!! 

It is clear that not all countries are using the exactly the same criteria when collating figures and so there is no way that a 'like for like' comparison can be made between countries and so the comparisons are meaningless. Equally our own figures are not consistent; for example as deaths take days to be registered or hospital admissions are late being submitted by some Trusts, sometimes so called 'daily' figures include deaths/admissions that are up to a week old! The lack of testing and tracking in the care sector is going to increase numbers massively too. 

Apparently it will take some time (possibly well over a year) after the pandemic is over to disentangle figures and put them into some kind of 'legitimate' order so that a true picture of the progression of Covid in this country can be shown. So, too damn right PL, we are ALL being manipulated and mislead.  

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I think I've managed it! A bit much to wade through but pour a coffee and go for it........interesting reading!

Meaghan Kall

18 April at 13:47

Back today with a Covid-19 post 😊

I want to talk about DATA.... and why not to trust it. At least, not right now.

I see a lot of people arguing about which countries are getting it right or wrong based on the numbers of cases and deaths.

Stop it. You cannot compare countries. At least not yet. Even if the data were reliable (which they aren’t), it will take months - actually years - to truly compare outcomes.

I’m a data nerd, an epidemiologist working at national level on the UK COVID response. I trust the UK data more than most countries but I also know enough about the limitations to briefly summarise the main issues below:

1️             Reporting delay: depending which test you use, it takes 0-5 days to get a coronavirus result. Depending on your data systems, it may take 1-30 days to report a COVID case or death. So - totally apart from the latent period of the virus - the picture you’re seeing today does not represent the epidemic today. It represents a mixture of yesterday and days and even weeks ago.

2️             Underreporting: This is pretty obvious right... Nobody really believes a national reporting system can be created in a few weeks that captures ALL COVID cases or deaths. As if someone presses a button and a number magically appears? Please. It’s just not feasible. Even where reporting systems are fully electronic (which btw is not everywhere- some countries still require deaths to be certified on paper forms or in person), a huge effort is needed to clean and deduplicate records, follow up missing or incorrect data (usually typos by a rushed-off-their-ass doctor, nurse or hospital administrator), and sometimes merge/triangulate multiple data sources. Scale this effort up exponentially in big countries and countries without national health systems like the US (collating data from 50 states each with its own health system). To put it into perspective, we are producing on a DAILY basis what my normal team of 15 people (in National HIV surveillance) does ANNUALLY. The effort behind the scenes to do all this is staggering and we have some of the best scientists I’ve worked with on the job, but it is extremely challenging. I could go on about this for ages but instead I’ll just give a shout out to all the analysts, programmers, data scientists and epidemiologists out there busting their behinds to produce these numbers each and every day.

3️        Poor hospital/laboratory data systems: related to point 2 but more to do with developing countries. Mainly in Africa, Southeast Asia, Eastern Europe, South America... countries where health data systems are underfunded, outdated or nonexistent. Testing is not happening to scale due to lack of resources/capacity. COVID data from these countries should be viewed very cautiously for now, and should represent a lower bound of the true figures.

4️             Case/death definitions: it is my ongoing frustration that WHO has not issued standard COVID case or death definitions. So right now - countries are making it up. “Case” can be defined as lab confirmed test result and/or linked to an outbreak/lab confirmed case and/or based on symptoms. “Recovery” can be defined as surviving 28 days post-test, 31 days, or up to 2 months. “Death” can be defined as a death in anyone with a positive test (regardless of cause), a death in anyone with COVID symptoms (suspected), or only those where COVID is listed as the main underlying cause of death (MCCD). This leaves a pretty wide spectrum. This alone can make it impossible to compare countries (or in fact one country’s own data over time if they change definitions - see China, France, Belgium etc...)

5️             Lag in outcomes: My previous points were about reporting issues, but this is about the clinical life course of COVID - and what we still don’t know. Firstly, recall the 28 day definition of “recovery” - is this too conservative when we know people can stay on ventilators for up to 6 weeks? It is also possible that people with severe COVID have an increased risk of hospitalisation and death for months or longer as their immune system recovers or due to permanent organ/immune damage. These are all unanswered questions but suggest we may not understand the true impact of COVID for a very long time.

6️             Demographic differences: we know COVID disproportionately affects older people, and recent reports suggest it also affects people of non-white ethnicity (especially in those aged under 50). The causes are yet to be teased out (poverty, household density, urban/rural residence, occupation, smoking, comorbidities, biological mechanisms [eg people of Asian descent have higher ACE2 receptors/expression]). In any case - this is why you can’t compare Italy (old population) with Iran (young population), or compare the UK (an ethnically diverse population) with Ireland (a homogenously white population)

7️             Population density: viruses spread more efficiently in densely populated areas. This is why cases are concentrated in cities and in densely populated countries. For example, the UK is 10x more densely populated than the US, and 20x more densely populated than Canada, Australia and New Zealand. I really like Jacinda, but the fact is she governs an isolated island in the Pacific that has more sheep than people that’s just coming out of summer: that NZ has relatively few cases of COVID should be as much due to geography & population as her government policies....

8️             Political Corruption - i suppose I should include this; although I think all the points above contribute data issues much more than this. But there are some countries who will cover up, suppress and delay data releases for political reasons. I know of maybe 4-5 countries where it may be happening, and it’s not the UK or USA or Europe. So chill out with the conspiracy theories.

9️             Government response: these are all the measures a government takes to fight COVID. Of course, of course, of course this will be important. But it is practically impossible to truly evaluate this now only a month in - as I see so many people doing - for all the reasons I Iisted above. Hence it’s last on the list...

Over the coming months, a lot of retrospective data will come out. Just yesterday, 4 months after their first death Wuhan City revised up their death toll by 50%. FIFTY PERCENT. 1,259 people in one city. There is also data from Italy that shows only about half of excess mortality has been attributed to COVID & half is (as yet) unexplained - suggesting under-ascertaiment of COVID as a cause of death. These are all signs of things to come...

The daily stats are best thought of as indicative not final, as a lower bound of the truth, and should be critically appraised on a country-by-country basis.

I hope this provides insight into what it takes to produce these numbers & how to interpret them. And next time you see a headline like “Why Germany/New Zealand/Switzerland is winning the fight against Covid” you give it a hard pass ➡️ or at least an eye roll 🙄 before reading...

N.b. references for much of what I’ve said above can be provided on request.

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I was puzzled as to why the number of deaths here in France remains high on a daily basis, but the number of people in 'reanimation' ,as they call intensive care here, has dropped from 7200 to 5200. Delays in reporting could explain that to some extent. For some reason they have now stated that the number of reanimation beds is up from 5,000 to 10,000, which is a bit late to mention but I think they are looking for positives to report. Another issue here is the separation between hospital deaths and those in private hospitals or care homes. Turns out that 13,000 have died in hospital and 7,500 in other places, but some days the daily figures are added together and some days they are not. There are now 30,000+ hospitalised and the numbers are surprisingly increasing, but 37,000 left hospital 'cured' and are facing a long convalescence because of the residual effects. Masks remains a big issue as does medical PPE, so it's not just the UK struggling. All in all, whilst the lockdown measures should have worked they don't seem to be anywhere near as effective as expected and I am left in the dark as to why?

Going shopping tomorrow and again dreading it! i have no confidence whatsoever that the security measures being applied here will actually protect me.

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That was incredibly interesting, thanks Soapdragon.  I used to use a lot of ONS and other stats in my job, so I had to understand them properly to explain them to others.  I found the people working in data to be extremely single minded and focused and reliable and eager to help.  Its always good to go direct to sources and avoid all the spin we seem to be getting.  As time goes on, I am finding it harder and harder to believe what I am being told, and am slowly realising that nobody has all the answers anyway!   I have just caught up with today's conference and the headline seems to be that some of us might be in social distancing measures, to some extent, until the end of the year.   That's going to be a real challenge, putting it mildly.

Good for you DM, I am finding remote online shopping on behalf of my aged mother stressful enough, and she lives in a village and drives (although she doesn't at the moment).  I don't have to get up in the middle of the night to find a slot anymore, but on the other hand its never clear what she is going to end up with - or more accurately, not end up with. 

I don't blame you for feeling nervous Beantree, I haven't set foot in a shop for a month as my OH has done it all.  Its not that I don't trust the measures, its more pure fear that if I did get covid-19 (having had something akin to pneumonia recently) then it might be quite bad.  I realise this is very selfish, but its how I feel and luckily OH doesn't want me in a shop either.  On a lighter note, our stocks of things are a bit bizarre as a result, as OH keeps going 'off list'!

 

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You are right to avoid going out Daphne; your lungs may still be impaired by the other nasty virus that you had ..... are you sure it wasn't Covid? Apparently it has been in the UK since the last quarter of 2019.

I must just point out that I wasn't one of those folks who sat up all night to get the shopping delivery slots and preventing vulnerable folks from having them. I have a monthly paid pass with this online store and usually use it every week as I am a) usually at work and b) can't abide shopping. As a pass member, they emailed me to say that I could have a fortnightly slot during this debacle - I am not bothered as I can easily go to one of my local supermarkets, which isn't too busy, or buy meat from the butcher, so I donated it to my friend. It was a bit of an uphill struggle to teach him how to use the ordering site, but he's onto it now and will at least be able to get what he wants, and just wire me the money.

My friend who was treated last year for Lymphoma is still having ongoing 'maintenance' chemo - this has been cancelled, and in a call with his oncologist he was advised to isolate until October!

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So it does sound like I had it then over the new year, amazingly my mum didn't get it!  I got it from number one son, who had it from school, then we both saw my mum as a pit stop on the way back here.  My son reckoned it was because I was shut in the car for 3 hours with him.  I eventually gave it to OH.  Both son and husband had it fairly mildly and I was knocked for 6.  I have always thought it may have been the virus before one of its many mutations.  I have definitely got into a routine of my brown inhaler because I was pretty lackadaisical up till then with it.  I agree - I really don't want to go out now, especially as I'm overweight (and it's dropping down gradually - whoohoo), 62 and not quite as wheezy as I was.  But I miss the freedom to see family. 

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My son was taking advantage of one of the designated supermarket times for NHS workers but realised when he went in that he was in an old people slot. He said he felt so guilty that he tried to make his basket look like he was shopping for an old person and added Branston Pickle and kettle descaler to his basket! I don't know if he got the things he popped in for. He's moved out for a few weeks just in case. I'm not fond of the idea but he said he would feel pretty bad if we got unwell. 

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Folks, if you are isolating, vulnerable or know people who are, and need a delivery slot, Tesco’s is the easiest to get on the priority list that I’ve found.  I’ve recommended it to a few people struggling to get a slot, and it has worked every time.  

You go on their website or google delivery slot for vulnerable and it will come up with a free phone number.   When I tried it about 3 weeks ago I had to hang on for half an hour, but I gather it is easier now to get through.  You speak to an actual person, which is always nice!  Once on the list, you wait 24 hours then go back on the shopping site and you will find you have a special button labelled priority slots.  This will give you a choice of delivery dates. 

Pass the information to any one still struggling to find online delivery. 

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