Friday April 17th

Headlines

• There have now been 148,651 deaths worldwide
• Confirmed cases are now 2,206,420 worldwide
• The UK confirmed cases figure (based on people tested) is 108,692
• Tests have now been carried out on 341,551 people
• The number of deaths (in hospital) in the UK is 14,576
• The adjusted number of deaths is 16,113 (this is an attempt to account for deaths in care homes etc)
• At least 37 NHS workers have died as a result of Covid-19
• Many NHS and care workers still do not have adequate PPE
• The UK lockdown has been extended until May 8th at the earliest
• If the lockdown is removed it could lead to 120,000-450,000 deaths in the UK (based on a calculation at the end of this post)
• Any "exit strategy" will have to factor in the increase in infection and deaths that it will inevitably cause if the virus is still circulating and no vaccine has been found
• Claims that the curve is flattening may be a little premature (see chart below)
• The number of hospital deaths for the last 7 days are: 917, 746, 708, 778, 761, 861, 847
• The highest figure recorded was 980 on 10th March.
• Whether this was a genuine number of deaths over the past 24 hours or was a consequence of recording we have no way of knowing

Quotes of the Day

"There was an evidence review carried out by the World Health Organisation which came to the same conclusion that we did... The advice on wearing masks was looked into by the World Health Organisation last week. The reason we follow the scientific advice is that it is really important to get this right because masks are globally in short supply" Matt Hancock to Robert Peston on whether masks were a suitable defence against the virus

"We've just heard from the British Health Secretary Matt Hancock who says the science shows that the masks don't really yield a benefit. Why do you disagree with him?" Robert Peston to Jeremy Howard

"Because I'm a scientist who has just led the world's first cross disciplinary international review of the evidence for this with nineteen of the World's top experts. And actually, the evidence does not at all show what he claimed. The evidence looks a lot like this could be one of our most important tools. ..Professor David Haywood (of the WHO) said, I think, that wearing a mask is equally as valuable as distancing." Jeremy Howard, Data Scientist

NHS Staff Who Have Died From Covid-19

Number = 37

Amrik Bamotra, 63, Radiology support worker, King George hospital, Goodmayes
Lourdes Campbell, Healthcare assistant and first-year student mental health nurse, Bolton NHS foundation trust
Andrew Treble, 57, Theatre assistant, Wrexham Maelor hospitalAde Raymond, 48, Healthcare assistant, Barnet, Enfield and Haringey (BEH) mental health trust in London
Maureen Ellington, Healthcare Assistant, Southmead Hospital
Mary Agyapong, 28, pregnant nurse, Luton and Dunstable Hospital

Amarante Dias, Weston General Hospital, North Somerset

Sister Leilani Dayrit, Rugby’s Hospital of St Cross

Barbara Moore, 54, Aintree University Hospital

Kevin Smith, Doncaster Royal Infirmary

Melujean Ballesteros, 60, Queen Mary's Hospital, London

Sara Trollope, 51 Matron, Hillingdon Hospital

Donna Campbell, Velindre Hospital, Cardiff

Oscar King Jr, John Radcliff Hospital, Oxford

Elsie Sazuze, 44, Birmingham

Elbert Rico, John Radcliff Hospital, Oxford

Donald Suelto, Hammersmith Hospital, London

Gareth Roberts, University Hospital of Wales in Cardiff

Alice Kit Tak Ong, the Royal Free HospitalLeilani Dayrit, 47, St Cross Hospital, Rugby
Glen Corbin, Brent, north west London
Liz Glanister, Royal Liverpool University Hospital
Areema Nasreen, Walsall Manor Hospital
Prof Mohamed Sami Shousha, London
Lynsay Coventry, Mid Essex Hospital Services NHS Trust
Aimee O’Rourke, Queen Elizabeth The Queen Mother Hospital, Margate
Dr Alfa Sa'adu, Whittington Hospital
Thomas Harvey, Upper Clapton
Amged El-Hawrani, Glenfield Hospital, Leicester
Pooja Sharma, East SussexDr Habib Zaidi, Southend Hospital
Dr Adil El Tayar, West Middlesex University Hospital
Julie Omar, 52, Alexandra Hospital, Redditch

Jitendra Rathod, University Hospital of Wales in Cardiff

Dr Fayez Ayache, 76, GP, Sussex

Rebecca Mack, Newcastle

Janice Graham, 58, Iverclyde Hospital, Scotland

Dr Syed Zishan Haider, 79, Valance Medical Centre, in Dagenham, east London

Anton Sebastianpillai, Kingston Hospital

John Alagos, Watford

UK Stats

Date	Days since first death		Weekly comparison figures
17/04/2020	43
Deaths	14,576		4,701	deaths in the past week
New deaths	847		32	% of deaths in the past week
Death Rate*	13.41		803	Average new deaths each day (over past 7 days)
Increase in deaths over previous day (%)	4.3
Adjusted deaths	16,113		Adjusted figures include 10% that are excluded from hospital figures
Adjusted daily deaths	936
Total tests carried out (persons)	341,551		71,953	people tested in the past week
in last 24 hours	13,943		10,849	average of new tests (past 7 days)
average per day since first death	7,943
Negative (n/%)	68		-22	% negative tests
Positive (n/%)	22		38	% more positive tests
Percent population UK tested	0.50%		0.11	of the population tested since last week
*Please note that the death rate cited here is the number of deaths amongst those who have tested positive in tests. It should not be inferred from this that this is the proportion of the population who are likely to die.

4 Nations

	Cases	Increase in cases over prevous day (%)	Deaths	New deaths	Percentage increase in deaths over previous day
England	83,474	5	13,133	738	6
Scotland	7,409	4	779	80	11
Wales	6,645	4	506	11	2
N. ireland	2,338	2	158	18	13

English Regions

	Total confirmed cases	Increase over previous day (%)
London	20,215	3.61
South East	11,471	5.06
South West	4,222	7.90
North West	12,687	4.91
East	6,859	5.54
Midlandss	13,498	4.18
North East/Yorkshire	11,481	7.98

How widespread is the virus

It is important to point out that because we know so little about the spread of the virus in the UK, what follows is an estimate only and could be out by a margin of anything up to 30%.

What we know:

• The first death from Covid-19 in the UK was on March 5th 2020
• Britons were encouraged to "self-isolate" if they had symptoms from March 12th 
• Social distancing was encourage from March 16th
• School closures were ordered on March 21st
• A lockdown of all non-essential workers was ordered from March 24th

What we don't know:

• When the virus first started to circulate in the UK
• How many people each person with the virus is in contact with and how many of those contract the virus
• How much each intervention has reduced the contact
• The proportion of those who come into contact with the virus who go on to become infected

Assumptions used in this calculation

• If the first death was on March 5th, the virus probably entered the UK and started circulating on or around February 24th
• At this point there were no measures in place to restrict the transmission of the virus
• University College, London have estimated the reproductive rate (RO) at 2.6
• This means that each person who has the virus will pass it to a further 2.6 people 
• For this estimate I have taken a rather more conservative view and estimated RO at 2
• I have assumed that each intervention reduces the reproductive rate at the following levels
• Self-isolation brings it down to 1, as many people with the virus take themselves out of circulation
• Social distancing reduces it to 0.5 as the virus finds it harder to replicate as people are further from one another by design
• School closures reduce it to 0.1 because children are the main carriers of the virus, if not the main victims
• The initial lockdown reduces it to 0.01 as people stay home, avoid work and other social spaces
• The rate is reduced to 0.001 as the lockdown tightens
• Having contact with the virus does not mean that a person will test positive (if tested) and using the positive test data from the Government it is assumed that only a small percentage of those who come into contact with the virus will go on to develop symptoms. This percent ranges from 1 or 2% early on up to 31% as the lockdown continues (these figures based on positive tests from the Governments own figures)

Results

• By 12th March just over 8,000 people had the virus from the 118,000 who had been in contact with an infected person
• By 16th March as the government continued to pursue a 'herd immunity' strategy almost 100,000 people actually had the virus
• By 21st March when the lockdown was ordered almost 3.25 million had the virus (Imperial College calculate the figure at 2.7 million)
• As of today, 17th April, it is likely that something close to 12 million people have the virus
• This figure assumes a very low RO since the lockdown
• If the World Health Organisation estimate of a 3.8% death rate for those with the virus were to be correct, the UK could have over 450,000 deaths were it to ease the lockdown
• Even if the death rate is much lower, say 1% which would be closer to the South Korea rate, deaths could still reach 120,000
• By leaving the lockdown in place many of these deaths will be avoided, but it is a question of how long the lockdown can be left in place economically

Is the curve flattening?

There is much talk of flattening curves based on individual days death figures.

Given the problems of data collection and recording, a single days figures could go up or down without being an accurate reflection of what is really happening.

Therefore this chart shows the 7 day averages of deaths since the beginning of March.

It shows clearly that the curve is continuing to rise. The last data point is 14th April and therefore the next should be 21st April which could show a slight downward shift but that depends what happens over the next few days.