Friday 6 January 2023

COVID-19 Coronavirus and other virus UK and World News Update 6th January 2023

COVID-19 Coronavirus and other virus UK and World News Update 6th January 2023

World COVID Statistics: 667,528,972 reported cases and 6,707,791 losses of life.

"Please don’t let the government gaslight you into thinking it’s ‘normal’ for patients to be dying in their droves at home, in ambulances, in corridors, in cupboards. Excess deaths are 26% higher than usual. This isn’t normal, it’s grotesque.
A humanitarian crisis, yet Sunak does nothing."
Dr Rachel Clarke, responding to yesterday's lack of acknowledgement from the Government as to the state of the NHS. 

060123 9,125 covid patients via will quince MP

“For staff working in the NHS or any patients desperately trying to access care, No 10’s refusal to admit that the NHS is in crisis will seem simply delusional. To try to reassure us that ministers are confident the NHS has all the funding it needs, at a time when families are seeing relatives left in pain at home or on trolleys in hospital, is taking the public for fools.
Moreover, the attempt to portray this winter’s crisis as the result of the pandemic and not the result of more than a decade of political choices to reduce investment in the NHS and its workforce is little more than an attempt to rewrite history.” 
Dr Vishal Sharma, the chair of the consultants committee, as quoted in Nursing Notes.

“It seems likely that the next three months will be defined by further critical incidents needing to be declared and the quality of care being compromised.”
Matthew Taylor, chief executive of the NHS Confederation, with a stark warning that you can't fix something so severely broken overnight. 

060123 3,746 flu patients via will quince mp

“We continue to ask China for more rapid, regular, reliable data on hospitalizations and deaths, as well as more comprehensive, real-time viral sequencing.
WHO is concerned about the risk to life in China and has reiterated the importance of vaccination, including booster doses, to protect against hospitalization, severe disease, and death.”
Dr Tedros, Head of WHO, in Geneva on Wednesday. Reiterating that China's unique methods of counting COVID cases (specific symptoms plus positive test) is not really giving us the figures we would expect from the evidence. 

060123 excess deaths covid actuaries modelled date of death vs 5 year average

It's hard to know where to start, but I'm going to begin with the worst bit and get it out of the way. We've been watching 'excess mortality' for a while, and it's persistently and increasingly grim. 
In the week before Christmas, in England and Wales, almost 3,000 people died over and above the number we might expect. I am so sorry to anyone who has lost someone they care about over Christmas.
Summary from the COVID Actuaries:
"ONS deaths data has been released for week ending 23 Dec. 
2,982 more deaths were recorded in-week compared to the 2015-19 average. That’s 26% more, the largest excess we’ve seen all year.
Year-to-date there have been 567,379 deaths recorded which is 8% more than 2015-19 avg."
Far too many people. 
For the previous week (w/e 16 Dec) there were 1,639 more deaths compared to the 2015-19 average. 15% more.
The Continuous Mortality Investigation takes these numbers and attempts to adjust for an aging population, population growth etc., and is generally a less negative view.  Their report on Thursday still found 18% more deaths week ending 23rd Dec (and 7% more the previous week) than if death rates were the same as in 2019. 

Medics have had enough.
- Dr Adrian Boyle, the President of the Royal College of Emergency Medicine, (on Times Radio on New Year's Day) said 300 - 500 extra people a week are dying in England because of delays accessing emergency healthcare.
Official response from NHS England is that he's exaggerating. Logic and evidence says he isn't.
He's used generally available to anyone data. The NHS has all the raw data available to them, they literally employ people to count all of this stuff. If we can all see it from the outside, it is clearly visible from within, and has been for some months.
- The Munching Medic has an excellent post on Instagram explaining the realities of being an A&E doctor right now. It is hell. They are working flat out attending to a sea of patients which never ends. Those patients and their loved ones are increasingly frustrated and worried, which often makes it even harder for our medical professionals. IT IS NOT THEIR FAULT THAT THERE ARE NOT ENOUGH STAFF. The blame for that lies with those in charge. 
- Dr Tim Cooksley, president of the Society for Acute Medicine, said on Sky News: 
"There has never been a greater recognition amongst all staff that our current situation is worse than it has ever been. 
And I know that people watching this will say, 'well every winter you have doctors on that say that this winter is terrible, that it's normal winter pressures'. 
But there is a complete acceptance from all colleagues now that this is different from all previous winters - and we need urgent action now."
Why is nothing being done? Why aren't the Government asking the public for help? Volunteers? Dare I say it, Nightingale hospitals for recovered people who need social care? Wider use of recovery hotels? Decent pay and conditions for nurses and social care workers? 
Why keep blaming missed statins, health checks and appointments, like it's all our fault? South East Coast and East of England ambulance services have had warnings to conserve oxygen because it is running out. Whose fault is that? The people who couldn't breathe? 
There should be a level of urgency and panic, and I may be wrong, but it feels like the Government are literally turning their heads as the NHS and it's patients die. Everybody look at the shiny... (Purely coincidentally Prince Harry's book was leaked early, did you see how many news articles there have been about that?)

Ambulance time over target to end of year UK regions Paul Mainwood

It isn't just seasoned medics who have had enough. The worst paid and often with the worst conditions, Junior Doctors are going to take a vote on strike action. If the ballot says yes, they'll walk out for 72 hours. 'Cotton Wool Week' for everyone... 

Stats guy Paul Mainwood has done a chart for how much longer, on average, we waited for an ambulance beyond the target times. It's horrific (and above). For week ending 2nd Jan, across England targets were missed by a minimum of around 15 minutes, and an average of around 40 minutes. 
The South West ambulance service seems to have collapsed on 27th-28th December (also on 19th December), with people who needed an ambulance waiting an average 3 1/2 hours longer than they should.
The picture has been bleak across England and Wales for a while. Don't get complacent Scotland - you are currently experiencing an 'uptick' yourselves. 
Regardless, if someone is in danger of death always call 999. You will be triaged to determine who gets help first if it isn't immediately available to everyone. 
DO NOT attend A&E unless a life is in immediate danger or you have been directed there by 111.
If you are not actively dying, get advice from 111 (they sent us to urgent care in a different area, where my son waited less than 2 hours).
Only call an ambulance if a life is in immediate danger, or you cannot get to hospital in a taxi or someone else's car.
Take snacks, tissues and water, and leave the family at home.

060122 Coronavirus Infection Survey collage showing graphs for all areas with sharp rise at the end

This week's ONS random sampling isn't any better, I am sorry. For the week ending 28th Dec for England, Wales and Scotland, and 22nd Dec for Northern Ireland (comparison weeks vary slightly due to holidays too):
"The percentage of people testing positive for coronavirus (COVID-19) continued to increase in England and Scotland, and increased in Wales and Northern Ireland."
- England, estimate 2,463,000, equating to 4.52% of the population (an increase from 2.20% in the previous reference week), or around 1 in 20 people.
- Wales, estimate 173,200, equating to 5.70% of the population (an increase from 1.89% in the previous reference week), or around 1 in 18 people.
- Northern Ireland, estimate 118,100, equating to 6.43% of the population (an increase from 2.02% in the previous reference week), or around 1 in 16 people.
- Scotland, estimate 213,100, equating to 4.05% of the population (an increase from 2.49% in the previous reference week), or around 1 in 25 people.
We did expect a rise in cases as people mixed more over the holiday period, but not really so rapid. Bad news is that we should expect a continued rise as more people test positive after Christmas and New Year. 

There is some good news hiding here, and I think we need it. Figures do suggest that slightly less people are catching COVID in hospital, and total COVID admissions are also down slightly. It seems like a poor gift, and it could in part be a lag in testing or reporting, but don't forget total cases seem to have been rising rapidly. It looks really hopeful that the Autumn Boosters have done their job and kept people out of hospital.
Total numbers of people in hospital do also seem to have slowed, although it really is far too early to say the word 'peak'. So, shhhh, and cross your fingers. 

060123 covid admissions and hospital acquired
The UK Health Security Agency this week issued new advice.
For schoolchildren:
"It’s important to minimise the spread of infection in schools and other education and childcare settings as much as possible. If your child is unwell and has a fever, they should stay home from school or nursery until they feel better and the fever has resolved."
They also ask we remember good handwashing, and to catch coughs and sneezes in a tissue and bin it. 
For adults:
"Adults should also try to stay home when unwell and if you do have to go out, wear a face covering. When unwell don’t visit healthcare settings or visit vulnerable people unless urgent."
Anyone eligible should also get their flu and/or COVID jabs - it makes a huge difference to the numbers of people who end up in hospital. 
Mentioning face coverings indicates a real level of concern from Jenny Harris at least. Rishi, where are you?

Well, I'll tell you. Rishi was busy writing a plan for all pupils to study maths to age 18. Awesome. On Tuesday morning the official word from number 10 was that the NHS is getting the funding it needs and isn't having a crisis. 
By Tuesday evening Steve Barclay, our new current Health Secretary, was being interviewed in front of a massive 'History of the NHS' backdrop (he hasn't read it). He said the current problems are due to Flu, COVID and parents worrying about Strep A (yeah, sure, blame the parents Steve). 13,000 patients were in hospital with flu or COVID last week. 
Remember a couple or 3 years ago, when I told you:
"The total number of NHS hospital beds in England has more than halved over the past 30 years, from around 299,000 in 1987/88 to 141,000 in 2019/20".
Sheesh Steve, turn round and read the wall. The population is bigger now, we live longer and more treatments are performed, so maybe this current "pressure" isn't going to go away. Especially if you aren't going to urgently fix social care, maybe we need some more hospital beds? (and well paid nurses). 

On Wednesday Rishi Sunak, UK Prime Minister, addressed the public with his plans for the year. He had 5 points. A bunch of previously forecasted financial plans, including halving inflation - which is currently around 11% and predicted to halve within months. The NHS came in at 4th point, just ahead of drowning migrants:
"NHS waiting lists will fall and people will get the care they need more quickly."
Great. Looking forward to it. Starting with a low bar again though aren't we? Eye wateringly long waiting lists and response times. With your love of maths, you can surely work out a way to improve those stats Rishi. Nothing else to say about the state of UK healthcare? No? Okay then... 

Ambulance handover by region to end of year Paul Mainwood

The Liberal Democrats are apparently upset that people are turning to DIY medicines because they can't access their GP. 
Damn right they are. What else are they going to do? As soon as someone you love needs medical help and can't get it immediately, you understand exactly what is important in this life. Please be careful using Dr Google, and get advice from an actual qualified medical professional whenever possible. 
Pharmacists are incredibly good at advising on minor ailments and incidents, and the computer program at 111 online or on the phone is a good way to find out what you should do next. Best of luck to us all. 

Streptococcus A is still causing around 3 times as many cases of Scarlet Fever as we'd usually expect to see. If your child develops a high fever and any other symptoms, especially that tiny rough red rash, a nasty sore throat or weeping sore patches, get medical advice. Scarlet Fever, Impetigo and Strep Throat generally need antibiotics, and several varieties have now been authorised to combat regional shortages of liquid penicillin. 

Long COVID seems to be rolling along and thankfully not increasing as it was, although likewise it's not dropping significantly. 
"An estimated 2.1 million people living in private households in the UK (3.3% of the population) were experiencing self-reported long COVID".
Of those people, 1.2 million (57%) first tested positive for COVID at least one year previously and 645,000 (30%) at least two years previously.

060123 Canada number in hospital

This is the variant which the US CDC issued a warning about earlier this week. They project that it now accounts for 40.5% of all US cases, a meteoric rise. The professionals on Twitter are divided on how worried we should be. 
On the one hand, in lab tests it shows fantastic ability to avoid immunity and spread rapidly, and it binds onto our bodies really well, plus it looks especially good at developing mutations.
On the other hand, the real life data showing incredibly fast spread is skewed by holiday reporting, more COVID testing in areas where they're worried, and more genomic (family tree) testing in areas where they're worried. That can make it seem worse than it really is. 
Whatever the real story is, Omicron variant XXB.1.5 clearly needs to be watched. As yet there is absolutely nothing to imply it is any more deadly or harmful, but it may have the ability to fly, and the UK is not the only Northern Hemisphere country where healthcare is already overwhelmed. 

060123 Arrivals from China must test

"From 4am on 5th January 2023, anybody arriving in England on a direct or indirect flight from mainland China will have to provide a negative pre-departure test to their airline upon departure from China."
This is in response to the perceived "lack of data" from Chinese authorities, a valid concern about possible variants or mutations, and a smattering of racism. Chinese authorities are not happy that nationals are facing restrictions that no-one else is. Plenty of very poorly vaccinated countries give us less data than China, although the sheer size of the Chinese population is even making India twitchy. 
If a visitor tests positive for COVID after arrival in the UK, they will be subject to the same conditions as UK nationals - try and wear a mask when you cough on people. 
As of 3rd January 2023, according to WHO:
"No new variant or mutation of known significance is noted in the publicly available sequence data." 
Yes China has absolutely loads of COVID, but it doesn't seem to be anything unusual or scary at this point. 

Still with China, and Reuters are reporting that they have come to an arrangement with Pfizer, to manufacture their vaccine locally. Pfizer's Paxlovid (especially the bivalent, 2-pronged version) is far more effective against Omicron variants than China's current widely-used vaccines.
The situation in China seems to be worse than ever, with videos circulating online claiming to show families burning the bodies of their loved ones in the street. I have not watched, nor can I testify to their authenticity, but there are many more photos and reports, including from funeral homes, hospital workers and medics, which do seem to suggest it could be true. Horrendous for everyone. 

Bird Flu dos and don'ts plus what to report UK Gov

PPE Fraud:
Who said they could supply PPE and then (according to the UK Government) faked testing certificates and handed over a load of unusable rubbish? Hands up Tory Peer Baroness Michelle Mone.
The Department for Health and Social Care lawsuit claims PPE Medpro falsely submitted an Intertek safety accreditation.  Intertek agrees that they didn't issue one. The Government is attempting to claim back £133m, and policing authorities are also looking into it.

Vladimir Putin yesterday declared a temporary ceasefire in Ukraine from lunchtime today until midnight tomorrow - Orthodox Christmas Day. Although any ceasefire is a good thing, there are many reasons for Ukrainians and Russians not to be trustful or thankful - including 7 million displaced people and tens of thousands who have lost their lives during this pointless war. I wish you all continued peace. 

Dr Tedros Happy New Year 2023

It is the weekend, and the decorations are down, and the weather is glum. All the more important to treat yourself to something nice, and give yourself something to look forward to. A bath, a hair treatment, a new book, your favourite breakfast. A lie in... It doesn't have to be expensive or complicated, but it has to happen! We can't change everything, but we can at least make the most of what we do have. No new chainsaws just now though, eh... 

Stay Sensible, Get Outdoors, Save The NHS. 

Some people. They look like numbers here, but every single one is a person.

Countries / Cases / Losses of life (plus figures added YESTERDAY in the full 24 hours until midnight GMT):

World 667,137,056 (+481,862) 6,706,846 (+1,611)
Japan 29,798,835 (+226,904) 58,496 (+334)
S. Korea 29,363,272 (+64,106) 32,421 (+66)
Taiwan 8,979,695 (+31,510) 15,383 (+45)
USA 103,048,885 (+30,049) 1,120,804 (+220)
Brazil 36,456,156 (+28,049) 694,625 (+183)
Germany 37,496,370 (+20,922) 162,518 (+262)
Hong Kong 2,720,255 (+18,422) 12,149 (+68)
France 39,381,826 (+11,537) 162,643 (+143)
China 461,825 (+9,308) 5,259 (+1)
Australia 11,181,677 (+8,894) 17,248 (+36) 

(UK Government don't really report regularly, and UK nations report separately. Our World In Data has us around 24,135,084 cases and 198,937 losses of life at last report.)


Excess mortality U /England 

NHS & Social Care Collapse

Junior Doctors

Munching Medic
Tim Cooksley

Hospital Beds:
Possible soundbite

NHS Thread
YouGov voting intention



CDC Nowcast

UK Gov China

PPE Medpro

Happy new year WHO

Image Bird Flu 
ONS Deaths with events from 2022 marked on: COVID Actuaries

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