Pyser Testing

Cases

NHS Told to Differentiate Between Patients in Hospital “For Covid” and Those in Hospital “With Covid” – and Not Before Time

After almost 15 months of various forms of lockdown, hospitals have finally been told to change the way they collect data on patients who test positive for Covid. They have been instructed to differentiate between those who are actually sick with Covid symptoms and those who test positive but are actually ill with something else. The Independent has the story.

NHS England has instructed hospitals to make the change to the daily flow of data sent by NHS trusts and told the Independent that the move was being done to help analyse the effect of the vaccine programme and whether it was successfully reducing Covid sickness…

One NHS source said the new data would be “more realistic” as not all patients were sick with the virus, adding: “But it will make figures look better as there have always been some, for example stroke [patients], who also had Covid as an incidental finding.”

In a letter to hospital bosses on June 7th, shared with the Independent, NHS England’s Covid Incident Director, Professor Keith Willett, said that from now on NHS England wanted “a breakdown of the current stock of Covid patients into those who are in hospital with acute Covid symptoms (and for whom Covid is the primary reason for being in hospital); and those who are primarily in hospital for a reason other than Covid (but for whom the hospital is having to manage and treat the Covid symptoms alongside their primary condition)”.

He added: “In lay terms, this could be considered as a binary split between those in hospital ‘for Covid’ and those in hospital ‘with Covid’. We are asking for this binary split for those patients newly admitted to hospital and those newly diagnosed with Covid while in hospital.”…

NHS England data on hospital admissions is published daily at a regional level and several days later on the Government’s dashboard. An internal daily dashboard of Covid data tracks infections across hospitals but is not made public.

Professor Ian Douglas from the London School of Hygiene and Tropical Medicine said: “I think there are good arguments for presenting these data separately – people in hospital ‘with’ vs ‘for’ Covid, as it does partly address the burden to health services due to the virus. Not completely though, because people in hospital with Covid will presumably also need to be treated differently to avoid further spread, which places some extra burden on the hospitals.

“I’ve got no idea what the split is like at the moment, and importantly we won’t know retrospectively what the trend is. Following on from that, there are only a few days before any announcement about June 21st, which may not give us long enough to be sure about what direction the ‘for Covid’ numbers are going.”

This change resembles the recent shift in the definition of a “case” by the CDC in America, where an infection in a vaccinated person is now only a “case” when the person is hospitalised or dies, whereas with the unvaccinated any positive PCR test still counts as a “case”, no matter how mild or asymptomatic.

Now, I’m all in favour of a more restrictive and conventional definition of case that gives a more realistic picture of the impact of the disease. But one can’t help suspect it’s more about politics than science when the kind of change many of us have been calling for since the start only comes once it helps to create the impression that the vaccines are working.

The Independent report is worth reading in full.

Link Between Positive Covid Tests and Covid Deaths Has Been Broken, Says NHS Leader

The vaccine has broken the link between positive Covid tests and Covid deaths, according to the Chief Executive of NHS Providers, Chris Hopson, who last week criticised the scientific modelling seen by the Government through much of the pandemic as “crude” and unreliable. Chris says that viewed alone, the raw number of positive tests does not tell the full story: “It is a much younger population that is coming in [for hospital treatment now], they are less clinically vulnerable” and much easier to treat. The MailOnline has the story.

Chris Hopson… said today that the surge in cases and hospital admissions in the Greater Manchester town was manageable for its hospitals.

Patients were generally younger and less sick, he suggested, than in the crippling second wave over the winter, and the numbers of people coming in were lower and significantly fewer of them are dying.

Vaccines appear to be doing a lot of the heavy lifting, Mr Hopson said, adding that they have broken the link between infections and “very high” levels of hospital admissions and deaths in earlier waves of the virus…

Bolton has been overtaken by nearby Blackburn as the country’s Covid hotspot after cases surged there driven by the Indian variant, which accounts for almost all infections in the town. Hospital admissions rose shortly after, to a peak of 49 people on wards with Covid and 14 admitted in a day, but these appear to be falling now, too, with 42 reported in patients on June 1st.

Mr Hopson said: “If – and it is a big if – if Bolton has gone through its complete cycle and if other areas follow Bolton, the view from the hospital there was that they were able to cope with the level of infections.”

His comments come as pressure is building towards Boris Johnson’s speech next Monday when he is expected reveal whether June 21st’s “Freedom Day” end of social distancing will go ahead. Current trends look as though he will prolong lockdown laws for a few more weeks or until the summer holidays to buy more time for vaccinations.

Mr Hopson told Times Radio: “It’s important not to just focus on the raw numbers here… you also do need to look at who’s being admitted into hospital and how clinically vulnerable and what level of acuity [illness] they’ve got.

“What chief executives are consistently telling us is that it is a much younger population that is coming in, they are less clinically vulnerable, they are less in need of critical care and therefore they’re seeing what they believe is a significantly lower mortality rate which is, you know, borne out by the figures.

“So it’s not just the numbers of people who are coming in, it’s actually the level of harm and clinical risk.”

Worth reading in full.

Zero Daily Deaths Announced In the Whole Of the U.K. for First Time

The U.K. has reported zero deaths within 28 days of a positive Covid test for the first time since March 2020 amid calls from Government advisors for lockdown to be extended past June 21st. Sky News has more.

The UK has reported zero daily coronavirus-related deaths for the first time since the pandemic began, but the Health Secretary has warned “we haven’t beaten this virus yet”.

According to the latest government data, 3,165 new COVID-19 cases were also recorded in the latest 24-hour period.

Matt Hancock tweeted that although the “whole country will be so glad there were no COVID-related deaths recorded yesterday… we know we haven’t beaten this virus yet”.

The latest figures come after a bank holiday weekend when the number of deaths and cases can be lower due to reporting lags.

Yet the suffering caused by the lockdowns continues.

Worth reading in full.

Stop Press: A reader has compiled a table showing the total daily tests, the number of cases, the percentage of tests that are positive and the number of Covid deaths recorded in each month dating back to March 2020. As you can see, there’s been a steady decline in the number of deaths since their peak in January 2021.

Some Parts of Scotland May Be Left Behind When the Rest of the Country Unlocks Further Next Week

Lockdown restrictions will be partially eased in Scotland next week, but Health Secretary Humza Yousaf says that stricter rules are likely to remain in parts of the country where the number of positive tests is increasing. BBC News has the story.

Under the lockdown easing roadmap, areas in level two are scheduled to move down to level one on June 7th. 

But Humza Yousaf said this may not be possible for areas where Covid cases are giving “cause for concern”.

He said this could affect locations outside Glasgow, which is the only part of Scotland still in level three.

The rest of mainland Scotland is in level two, while some islands have already moved down to level one.

First Minister Nicola Sturgeon has said she is hopeful Glasgow can move down a level at the end of this week, which would allow people to meet inside homes and gardens, and alcohol to be served inside bars and restaurants. 

She is due to announce on Tuesday whether the rest of Scotland can move down to level one on June 7th, a step which would allow greater numbers of people to socialise and venues such as soft play centres to reopen.

Mr Yousaf told the BBC’s Good Morning Scotland programme that while the impact of new variants on the NHS was still being assessed, it may be necessary to hold some areas back. 

He said: “It may not be the entire country moving to level one.

“I think people would understand where there are rising case numbers, where there is rising test positivity… it may be the case that parts of the country move to level one but actually other parts of the country we decide to keep in level two.”

Asked if he was referring to Glasgow, he replied: “Glasgow – but also, I must be quite frank, there are other parts from the data that continue to give us cause for concern.”

The Scottish Government is focusing particularly on the spread of the Indian Covid variant in parts of the country. This has also been at the centre of considerations in England on whether lockdown should come to an end on June 21st. A decision is expected here on June 14th.

Worth reading in full.

25 Million Brits Fully Vaccinated Against Covid – and Just Six Deaths Are Recorded on Sunday

The U.K. has passed the milestone of fully vaccinating 25 million adults against Covid, with the figure for first doses nearing 40 million. Also on Sunday, the slight increase in positive Covid tests has been offset (yet again) by the low number of reported deaths (just six).

Despite all this, uncertainty remains about whether the country will unlock on June 21st. Sky News has more.

Another 3,240 coronavirus cases were recorded [on Sunday] and the latest statistics showed 39,259,168 people have had a first dose of a Covid vaccine.

A total of 25,332,851 have had two jabs.

The latest coronavirus R (reproduction) number is estimated to be between 1.0 and 1.1 – up from between 0.9 and 1.1 last week.

This means that, on average, every 10 people infected with Covid will infect between 10 and 11 other people.

The Government is now considering making Covid vaccinations compulsory for NHS workers, while an expert has warned there still remains “an awful lot of uncertainty” over whether England can proceed with its planned relaxation of Covid restrictions on June 21st.

Dr Mike Tildesley, from the University of Warwick and a member of the Scientific Pandemic Influenza Group on Modelling (SPI-M) Government advisory panel, was asked on LBC if the country was on track to reopen by that date.

He said: “I think at the moment there’s quite a lot of uncertainty around that.

“We are starting to see signs of course that cases are going up, but at the moment we’re still obviously reporting hospital admissions and deaths at very low levels.”

Vaccines Minister Nadhim Zahawi says that no final decision will be made (or, at least, announced) on the fourth and final step of the roadmap out of lockdown until June 14th.

The Sky News report is worth reading in full.

Positive Tests Pass 4,000 for the First Time Since April – but Covid Deaths Stay Flat

There was another rise in positive tests today, which passed 4,000 for the first time since April, but reported Covid deaths remained flat with just 10 victims. The MailOnline has the story.

Department of Health bosses posted another 4,182 positive tests, up by almost half on last Friday’s count. It is the most reported in a single day for nearly eight weeks, since the 4,479 on April 1st. Almost 75% of all new cases are now the Indian variant.

Ministers always expected cases to increase when restrictions were eased, and they believe vaccines will stop the NHS from being overwhelmed once again. 

But Number 10 has refused to rule out delaying plans to relax lockdown on June 21st and will have to hit the panic button if hospitals start to suffer spiralling admissions, or the mutant strain is found to be much more infectious than the Kent variant, which triggered the devastating second wave.

Cautious scientists have called for Number 10 to delay the final step on the roadmap back to normality for at least two months, giving the NHS more time to fully vaccinate millions more adults. Analysis suggests a single dose of the jab is only around 33% effective at blocking symptoms of Covid in patients infected with the Indian variant, compared to about 50% for the once-dominant Kent strain.

Professor Andrew Hayward, a member of the New and Emerging Respiratory Virus Threats Advisory Group, said there was “a good argument for caution until such time as we’ve got a much higher proportion of the population double-vaccinated”.

Admissions have started to creep up across Britain, rising by 30% in a week to 134. Figures will get even higher over the next few weeks because of the lag between getting infected and becoming severely ill.

But hospital bosses in the worst-hit towns insist jabs have changed the game, with barely any infected patients who need medical care having been fully vaccinated.

The Health Secretary appears to agree with Professor Hayward that the vaccination of millions of Brits (including the most vulnerable) is not enough, having said on Thursday: “Our vaccination programme has reached 73% of the adult population, but that means that more than a quarter still haven’t been jabbed. 43% of adults have had both jabs, but that means that more than half are yet to get the fullest possible protection that two jabs give.” A number of SAGE members have joined (or, in fact, are leading) the calls for lockdown to be extended because of the Indian variant, despite the increase in positive Covid tests still not being matched by an increase in deaths.

The MailOnline report is worth reading in full.

Average Age of Newly Infected Brits Drops to 29

The average age of Brits testing positive for Covid has fallen from 41 at the beginning of the year to just 29 – the lowest average age recorded yet. This decrease is being attributed to the success of the vaccine rollout (though increased testing of younger people could also have something to do with it) which has seen almost 25 million people receive two doses of a vaccine. The MailOnline has the story.

The median age stood at 29 for the week ending May 19th – down from 35 at the start of April and 41 at the beginning of the year.  

Compounding the apparent efficacy of the vaccine rollout, analysis now shows that two thirds of people admitted to hospital with the coronavirus are under 65, the Times reports.  

But despite Boris Johnson’s desire to announce an end to social distancing this week, this has been pushed back amid the ongoing threat of the Indian Covid variant.

The Prime Minister has said that he has not seen “anything currently in the data to suggest that we have to deviate from the road map”, but hinted that the Government would wait until the June 14th deadline before announcing a relaxation. 

The fast-spreading strain now makes up between half and three quarters of all cases in the U.K., Matt Hancock said yesterday. 

The Health Secretary told a Downing Street press conference it is now dominant in Britain, taking over from the Kent variant that had been the most common one since Christmas.

But official data has now revealed that just three per cent of Britons infected with the Indian variant had received two jabs. 

More than 38.6 million adults have received at least one dose of the vaccine, and 24 million have had two. 

While many people in hospital with the virus have not been fully vaccinated, reported Covid deaths continue to be very low (often in the single figures). Despite this, SAGE members insist that the Government’s roadmap out of lockdown could be “derailed” because of the Indian variant.

Worth reading in full.

U.K. Records 3,000 Covid Cases for the First Time in a Month – but Deaths Stay in Single Figures

Professor Neil Ferguson says that the spread of the Indian Covid variant could result in lockdown restrictions needing to be “tightened” – but as Britain recorded more than 3,000 Covid cases today for the first time in a month, deaths remained in the single figures. This follows Professor Sunetra Gupta’s recent warning regarding fear being drummed up about variants due to an increase in cases.

What we’re trying to do is prevent people from dying. Whether or not infections go up with a new variant is not relevant. It is important that people don’t die.

We have protected vulnerable people now… I’m sure that [vaccines] will protect vulnerable people against this new variant from death. Maybe not from infection, but that’s not relevant…

The MailOnline has more on the most recent Covid figures.

Daily infections today (3,180) spiked by 18% compared to last Wednesday’s figure, reaching their highest level since April 12th (3,568).

But deaths remained in single figures, with nine fatalities today up slightly on the three posted last Wednesday. Day-to-day counts can fluctuate – but the overall trend remains flat.

And Britain’s mammoth vaccine drive continued at full steam ahead, with 387,987 top-up jabs dished out across the country yesterday. It takes the U.K.’s number of fully vaccinated adults to more than 23.6 million…

It comes as “Professor Lockdown” Neil Ferguson today said it was impossible to say whether the June 21st date for England’s last stage of easing restrictions will go ahead because of the Indian variant.

He warned the B.1.617.2 strain – which is now spreading in almost half of England’s 300-plus authorities – could hinder Boris Johnson’s roadmap out of lockdown and lead to measures needing to be “tightened”, if data showed it was much more transmissible. 

But the notoriously cautious academic struck a note of optimism, saying the huge vaccine roll-out means the U.K. is currently in a “much better place” than in December, when the Kent variant first began surging through the country before triggering a devastating second wave.

And Professor Ferguson… also suggested the nation could cope if the variant was proven to only be 20 to 30% more transmissible – which SAGE experts say is feasible.  

Worth reading in full.

Case Numbers Do Not Always Decline After Lockdowns

Lockdown proponents often argue that, although case numbers sometimes decline in the absence of a lockdown (as in SwedenSouth DakotaFlorida), case numbers always decline in the presence of one. Once you put a lockdown in place, they claim, the curve reaches its peak and the epidemic starts to retreat.

There are certainly many countries where a decline in case numbers has coincided with the imposition of a lockdown. However, this doesn’t necessarily mean that one caused the other. 

As the researcher Philippe Lemoine has argued, people start changing their behaviour voluntarily when they see deaths and hospitalisations rising. The government, meanwhile, feels an increasing need to “do something”, and the subsequent imposition of a lockdown happens to coincide with the peak of the infection curve.

Consistent with this account, there are several countries where a lockdown was imposed, but case numbers did not immediately decline; or if they did decline, they rose again while the lockdown was still in place. These examples constitute evidence against the claim that lockdowns have a substantial effect on the epidemic’s trajectory. Here I will present six. 

It’s important to note that some countries went into lockdown all at once, whereas others built up restrictions gradually over several weeks. This raises the question of exactly how to define a lockdown. For the purpose of this analysis, I will rely on the Oxford Blavatnik School’s COVID-19 Government Response Tracker. 

The dataset includes several measures of government restrictions. Each one is accompanied by a “flag” indicating whether the relevant restriction was applied to specific regions or the entire country. I will define the start of a lockdown as the first day on which there were mandatory workplace closures and a mandatory stay-at-home order in place for the entire country.

The first example is Israel, which went into lockdown on December 27th, but did not see the peak of its infection curve until January 17th.

The second example is Lebanon, which went into lockdown on November 14th, but did not see the peak of the curve until January 16th.

The third example is Slovakia, which went into lockdown on October 22nd, but did not see the peak of the curve until January 6th.

The fourth example is Slovenia, which went into lockdown on October 20th, but did not see the peak of the curve until January 10th.

The fifth example is Peru, which went into lockdown on March 16th, but did not see the peak of the curve until June 2nd.

The sixth example is Venezuela, which went into lockdown on September 28th, but did not see the peak of the curve until April 6th.

Note that, in every case, the lockdown measures were in place until after the peak of the curve. The fact that cases did not immediately decline, or proceeded to rise again (as in Venezuela), cannot therefore be blamed on the lifting of lockdown measures. 

The evidence presented here is consistent with the many empirical studies finding that lockdowns do not substantially reduce deaths from COVID-19.