COVID19

[kukushkin88]

The public talking about strategy is vital. There will be a choice that needs making, when does the lockdown end?

In reality there is going to be a trade off, lower deaths, but decreased economic activity, or more deaths but a better economy.

100k deaths and 5m unemployed or 500k deaths and 1m unemployed.

A Goldilocks solution of heathy economy and low deaths is probably not possible.

The public and politicians should be talking about the real options that the country faces not distractions.

I agree but lots of what does get discussed is linked. The length and extent of the lockdown will shape the release. The capacity to test will shape the release, the ability to provide adequate PPE will shape the release (53 healthcare workers have died now), the ability to get money to business to enable them to survive, will shape the release and the recovery.

The discussion to be had is which outcome are we aiming for, all of the above is important irrespective of the goal.

Talk about ventilators has gone quiet, the nightingale hospitals seem to be solving a problem that has not / maybe will not happen.

There are lots of interesting questions to await the answers of:

Why are smokers not being affected?
What is the role of il-6 gene, and given its prevalence in the black / Asian community, what effect will it have on healthcare workers, where minorities make up so much of the staff.
Will any commentator in the media actually change there mind on any subject following CV19, or is that impossible.

I agree with that - the outcome so far is as good as was aimed for but leaves more questions than it answers in many ways.

Is that true about smokers - my mum sent me something showing smokers were more at risk to try and get me to stop - naturally I resisted as I fear nothing....and am quite stupid too.

Reading up about smoking and anything is like going down a rabbit hole, anyone who says anything positive about smoking is assumed to be being paid by the tabcco lobby, but anyway.

In the USA only 1.3% of CV19 hospitalisations smoked when 15% of the population smokes (n=7162)

Other counties have similar results.

Smoking kills 7m people a year so net net probably best not to.

https://mobile.twitter.com/klauskblog/status/1245544033272938496

I'd say it is far more likely to be bad data than the truth.  If they had put together data from multiple clinical trials and only one had asked about smoking habits then you can get this kind of odd result.   There might have been a chance that something about smokers that led to reduced risk, but this is so far removed from this kind of effect that I think it can be assumed to be bad analysis.

He is a reference to a study of smoking outcomes.  I am sure I can find more.

https://www.livescience.com/coronavirus-covid-19-risk-and-smoking.html

A lot of the other causes of rising mortality in COVID are linked to smoking too.  I think it is safe to assume that smoking isn't going to help for now.

The Government has been understating nursing home deaths simply because they weren't asking about them until just over a week ago.

https://www.theguardian.com/society/2020/apr/15/uk-care-home-inspectors-did-not-ask-about-covid-19-deaths-until-april

I don't think it is worth the sensationalism, as it can take time to catch up with the new reality, and care home data isn't going to be as quick or accurate as hospital data..   I just think it is a good example of how you can get misleading results if your data is incomplete.

It certainly helps makes sense of the ONS data, with the 2500 excess deaths to the 5 year average, that had no explanation.

Faisal was on the case:

https://twitter.com/faisalislam/status/1250418370664529922?s=21

The story was about the Quality Care Commission not being given data on COVID19 deaths.

But the ONS don't get their data from the QCC.

They get it from death certificates.

And doctors and coroners have been given guidance from early on that if they think COVID19 was the cause, or could be the cause, or could be a contributory factor then they should put it on the death certificate (tests were then run on those people and it can be confirmed or not after).

Also, if doctors were getting it wrong - the deaths would have been put down as some kind of respiratory disease/pneumonia, and there was no corresponding leap in deaths caused by those either.

OK, thanks for the clarification. What do you think the explanation is for deaths outside hospitals being much lower (as a percentage) in England and Wales than Scotland, France, Italy and Spain? It can’t just be lag on the ONS reporting, especially when the ‘all mortality’ number, which Whitty says is the best indicator, is huge, there are still 2,500 excess deaths in a week, with no explanation . The end of this article is interesting:

https://www.channel4.com/news/factcheck/factcheck-can-we-trust-the-covid-19-death-toll

The start is stuff we’ve already already been over many times.

Any ideas on the 2,500 extra deaths? Other than those attributable to people not seeking medical help because of Covid, you’d surely expect them to go down while we’re mostly locked down safely at home.

Something like this, is the only thing that really makes sense:
(It’s a bit tenuous at this stage but there aren’t many other explanations, are there?)

https://twitter.com/jolyonmaugham/status/1250731649152811008?s=21
(another quite divisive figure)

The first paragraph doesn't make a whole lot of sense.   Accidental deaths aren't a big contributor of deaths overall (though they are at young ages), and they don't all happen away frok home.  There is evidence of increased suicides which probably means the overall effect is around neutral, and likely just hidden by nornal variation and more serious stuff (bad weather, bad flu etc.)

The second paragraph is just wrong.  Reporting delays and just general reporting problems make sense too, and seem far more likely to me.  My Dad had dementia and had all sorts of issues by the time he died.  They had to put something on the certificate so they put dementia and one other, but really it was a multitude of things and lots of parts of his body had been failing at the time.   Basically he just died and they weren't really sure why.  His was a death in a hospital where he was getting regular checks by doctors, not at home on his own. 

There are bound to be grey areas and different reporting in different places. You can't expect exact reporting of something that isn't exact.   I think we have 12,000 or so deaths (not checked today)  in the daily numbers.  We know delays and bad reporting means it is likely to be 20,000 or so already.   We don't need to know there have been 21,462 exactly right now, ballpark is fine.  They have a lot of info (hospital admissions, daily reported deaths, ONS etc), so should be able to see or project when the turn is, and modelling will improve over time.

All of my response here is with the caveat that I know this is a subject you understand really well and I don’t. I’m interested to learn.

There seems to be quite a bit bigger difference than I would expect could be explained by normal variation. 6,000 extra deaths out of 16,000 is huge. 3,500 Covid related, 2,500 not explained still seems huge. Highest weekly death total since 2000 and lowest A&E attendance since we started recording would suggest my first paragraph isn’t entirely without merit.

https://www.google.co.uk/amp/s/www.telegraph.co.uk/news/2020/04/09/ae-attendances-lowest-point-since-records-began-amid-coronavirus/amp/

[Doobs]

The public talking about strategy is vital. There will be a choice that needs making, when does the lockdown end?

In reality there is going to be a trade off, lower deaths, but decreased economic activity, or more deaths but a better economy.

100k deaths and 5m unemployed or 500k deaths and 1m unemployed.

A Goldilocks solution of heathy economy and low deaths is probably not possible.

The public and politicians should be talking about the real options that the country faces not distractions.

I agree but lots of what does get discussed is linked. The length and extent of the lockdown will shape the release. The capacity to test will shape the release, the ability to provide adequate PPE will shape the release (53 healthcare workers have died now), the ability to get money to business to enable them to survive, will shape the release and the recovery.

The discussion to be had is which outcome are we aiming for, all of the above is important irrespective of the goal.

Talk about ventilators has gone quiet, the nightingale hospitals seem to be solving a problem that has not / maybe will not happen.

There are lots of interesting questions to await the answers of:

Why are smokers not being affected?
What is the role of il-6 gene, and given its prevalence in the black / Asian community, what effect will it have on healthcare workers, where minorities make up so much of the staff.
Will any commentator in the media actually change there mind on any subject following CV19, or is that impossible.

I agree with that - the outcome so far is as good as was aimed for but leaves more questions than it answers in many ways.

Is that true about smokers - my mum sent me something showing smokers were more at risk to try and get me to stop - naturally I resisted as I fear nothing....and am quite stupid too.

Reading up about smoking and anything is like going down a rabbit hole, anyone who says anything positive about smoking is assumed to be being paid by the tabcco lobby, but anyway.

In the USA only 1.3% of CV19 hospitalisations smoked when 15% of the population smokes (n=7162)

Other counties have similar results.

Smoking kills 7m people a year so net net probably best not to.

https://mobile.twitter.com/klauskblog/status/1245544033272938496

I'd say it is far more likely to be bad data than the truth.  If they had put together data from multiple clinical trials and only one had asked about smoking habits then you can get this kind of odd result.   There might have been a chance that something about smokers that led to reduced risk, but this is so far removed from this kind of effect that I think it can be assumed to be bad analysis.

He is a reference to a study of smoking outcomes.  I am sure I can find more.

https://www.livescience.com/coronavirus-covid-19-risk-and-smoking.html

A lot of the other causes of rising mortality in COVID are linked to smoking too.  I think it is safe to assume that smoking isn't going to help for now.

The Government has been understating nursing home deaths simply because they weren't asking about them until just over a week ago.

https://www.theguardian.com/society/2020/apr/15/uk-care-home-inspectors-did-not-ask-about-covid-19-deaths-until-april

I don't think it is worth the sensationalism, as it can take time to catch up with the new reality, and care home data isn't going to be as quick or accurate as hospital data..   I just think it is a good example of how you can get misleading results if your data is incomplete.

It certainly helps makes sense of the ONS data, with the 2500 excess deaths to the 5 year average, that had no explanation.

Faisal was on the case:

https://twitter.com/faisalislam/status/1250418370664529922?s=21

The story was about the Quality Care Commission not being given data on COVID19 deaths.

But the ONS don't get their data from the QCC.

They get it from death certificates.

And doctors and coroners have been given guidance from early on that if they think COVID19 was the cause, or could be the cause, or could be a contributory factor then they should put it on the death certificate (tests were then run on those people and it can be confirmed or not after).

Also, if doctors were getting it wrong - the deaths would have been put down as some kind of respiratory disease/pneumonia, and there was no corresponding leap in deaths caused by those either.

OK, thanks for the clarification. What do you think the explanation is for deaths outside hospitals being much lower (as a percentage) in England and Wales than Scotland, France, Italy and Spain? It can’t just be lag on the ONS reporting, especially when the ‘all mortality’ number, which Whitty says is the best indicator, is huge, there are still 2,500 excess deaths in a week, with no explanation . The end of this article is interesting:

https://www.channel4.com/news/factcheck/factcheck-can-we-trust-the-covid-19-death-toll

The start is stuff we’ve already already been over many times.

Any ideas on the 2,500 extra deaths? Other than those attributable to people not seeking medical help because of Covid, you’d surely expect them to go down while we’re mostly locked down safely at home.

Something like this, is the only thing that really makes sense:
(It’s a bit tenuous at this stage but there aren’t many other explanations, are there?)

https://twitter.com/jolyonmaugham/status/1250731649152811008?s=21
(another quite divisive figure)

The first paragraph doesn't make a whole lot of sense.   Accidental deaths aren't a big contributor of deaths overall (though they are at young ages), and they don't all happen away frok home.  There is evidence of increased suicides which probably means the overall effect is around neutral, and likely just hidden by nornal variation and more serious stuff (bad weather, bad flu etc.)

The second paragraph is just wrong.  Reporting delays and just general reporting problems make sense too, and seem far more likely to me.  My Dad had dementia and had all sorts of issues by the time he died.  They had to put something on the certificate so they put dementia and one other, but really it was a multitude of things and lots of parts of his body had been failing at the time.   Basically he just died and they weren't really sure why.  His was a death in a hospital where he was getting regular checks by doctors, not at home on his own. 

There are bound to be grey areas and different reporting in different places. You can't expect exact reporting of something that isn't exact.   I think we have 12,000 or so deaths (not checked today)  in the daily numbers.  We know delays and bad reporting means it is likely to be 20,000 or so already.   We don't need to know there have been 21,462 exactly right now, ballpark is fine.  They have a lot of info (hospital admissions, daily reported deaths, ONS etc), so should be able to see or project when the turn is, and modelling will improve over time.

All of my response here is with the caveat that I know this is a subject you understand really well and I don’t. I’m interested to learn.

There seems to be quite a bit bigger difference than I would expect could be explained by normal variation. 6,000 extra deaths out of 16,000 is huge. 3,500 Covid related, 2,500 not explained still seems huge. Highest weekly death total since 2000 and lowest A&E attendance since we started recording would suggest my first paragraph isn’t entirely without merit.

https://www.google.co.uk/amp/s/www.telegraph.co.uk/news/2020/04/09/ae-attendances-lowest-point-since-records-began-amid-coronavirus/amp/

I didn't say it was normal variation, I said accidental deaths would be hidden by other deaths and any change would be masked by normal variation.  So you wouldn't expect a noticeable fall in normal deaths because everybody was at home.

I assume people are going less to A and E because they'd rather not expose themselves to Covid19.  Guess Covid works wonders on reducing the idiots that normally rock up with minor complaints.

I have explained the rest and am busy

[Ironside]

lockdown in Scotland as expected extended 3 more weeks

[Cf]

lockdown in Scotland as expected extended 3 more weeks

How do you know that? The daily briefing hasn't been on yet

[Ironside]

lockdown in Scotland as expected extended 3 more weeks

How do you know that? The daily briefing hasn't been on yet

oh yes it has :-)

[Doobs]

The public talking about strategy is vital. There will be a choice that needs making, when does the lockdown end?

In reality there is going to be a trade off, lower deaths, but decreased economic activity, or more deaths but a better economy.

100k deaths and 5m unemployed or 500k deaths and 1m unemployed.

A Goldilocks solution of heathy economy and low deaths is probably not possible.

The public and politicians should be talking about the real options that the country faces not distractions.

I agree but lots of what does get discussed is linked. The length and extent of the lockdown will shape the release. The capacity to test will shape the release, the ability to provide adequate PPE will shape the release (53 healthcare workers have died now), the ability to get money to business to enable them to survive, will shape the release and the recovery.

The discussion to be had is which outcome are we aiming for, all of the above is important irrespective of the goal.

Talk about ventilators has gone quiet, the nightingale hospitals seem to be solving a problem that has not / maybe will not happen.

There are lots of interesting questions to await the answers of:

Why are smokers not being affected?
What is the role of il-6 gene, and given its prevalence in the black / Asian community, what effect will it have on healthcare workers, where minorities make up so much of the staff.
Will any commentator in the media actually change there mind on any subject following CV19, or is that impossible.

I agree with that - the outcome so far is as good as was aimed for but leaves more questions than it answers in many ways.

Is that true about smokers - my mum sent me something showing smokers were more at risk to try and get me to stop - naturally I resisted as I fear nothing....and am quite stupid too.

Reading up about smoking and anything is like going down a rabbit hole, anyone who says anything positive about smoking is assumed to be being paid by the tabcco lobby, but anyway.

In the USA only 1.3% of CV19 hospitalisations smoked when 15% of the population smokes (n=7162)

Other counties have similar results.

Smoking kills 7m people a year so net net probably best not to.

https://mobile.twitter.com/klauskblog/status/1245544033272938496

I'd say it is far more likely to be bad data than the truth.  If they had put together data from multiple clinical trials and only one had asked about smoking habits then you can get this kind of odd result.   There might have been a chance that something about smokers that led to reduced risk, but this is so far removed from this kind of effect that I think it can be assumed to be bad analysis.

He is a reference to a study of smoking outcomes.  I am sure I can find more.

https://www.livescience.com/coronavirus-covid-19-risk-and-smoking.html

A lot of the other causes of rising mortality in COVID are linked to smoking too.  I think it is safe to assume that smoking isn't going to help for now.

The Government has been understating nursing home deaths simply because they weren't asking about them until just over a week ago.

https://www.theguardian.com/society/2020/apr/15/uk-care-home-inspectors-did-not-ask-about-covid-19-deaths-until-april

I don't think it is worth the sensationalism, as it can take time to catch up with the new reality, and care home data isn't going to be as quick or accurate as hospital data..   I just think it is a good example of how you can get misleading results if your data is incomplete.

It certainly helps makes sense of the ONS data, with the 2500 excess deaths to the 5 year average, that had no explanation.

Faisal was on the case:

https://twitter.com/faisalislam/status/1250418370664529922?s=21

The story was about the Quality Care Commission not being given data on COVID19 deaths.

But the ONS don't get their data from the QCC.

They get it from death certificates.

And doctors and coroners have been given guidance from early on that if they think COVID19 was the cause, or could be the cause, or could be a contributory factor then they should put it on the death certificate (tests were then run on those people and it can be confirmed or not after).

Also, if doctors were getting it wrong - the deaths would have been put down as some kind of respiratory disease/pneumonia, and there was no corresponding leap in deaths caused by those either.

OK, thanks for the clarification. What do you think the explanation is for deaths outside hospitals being much lower (as a percentage) in England and Wales than Scotland, France, Italy and Spain? It can’t just be lag on the ONS reporting, especially when the ‘all mortality’ number, which Whitty says is the best indicator, is huge, there are still 2,500 excess deaths in a week, with no explanation . The end of this article is interesting:

https://www.channel4.com/news/factcheck/factcheck-can-we-trust-the-covid-19-death-toll

The start is stuff we’ve already already been over many times.

Any ideas on the 2,500 extra deaths? Other than those attributable to people not seeking medical help because of Covid, you’d surely expect them to go down while we’re mostly locked down safely at home.

Something like this, is the only thing that really makes sense:
(It’s a bit tenuous at this stage but there aren’t many other explanations, are there?)

https://twitter.com/jolyonmaugham/status/1250731649152811008?s=21
(another quite divisive figure)

The first paragraph doesn't make a whole lot of sense.   Accidental deaths aren't a big contributor of deaths overall (though they are at young ages), and they don't all happen away frok home.  There is evidence of increased suicides which probably means the overall effect is around neutral, and likely just hidden by nornal variation and more serious stuff (bad weather, bad flu etc.)

The second paragraph is just wrong.  Reporting delays and just general reporting problems make sense too, and seem far more likely to me.  My Dad had dementia and had all sorts of issues by the time he died.  They had to put something on the certificate so they put dementia and one other, but really it was a multitude of things and lots of parts of his body had been failing at the time.   Basically he just died and they weren't really sure why.  His was a death in a hospital where he was getting regular checks by doctors, not at home on his own. 

There are bound to be grey areas and different reporting in different places. You can't expect exact reporting of something that isn't exact.   I think we have 12,000 or so deaths (not checked today)  in the daily numbers.  We know delays and bad reporting means it is likely to be 20,000 or so already.   We don't need to know there have been 21,462 exactly right now, ballpark is fine.  They have a lot of info (hospital admissions, daily reported deaths, ONS etc), so should be able to see or project when the turn is, and modelling will improve over time.

All of my response here is with the caveat that I know this is a subject you understand really well and I don’t. I’m interested to learn.

There seems to be quite a bit bigger difference than I would expect could be explained by normal variation. 6,000 extra deaths out of 16,000 is huge. 3,500 Covid related, 2,500 not explained still seems huge. Highest weekly death total since 2000 and lowest A&E attendance since we started recording would suggest my first paragraph isn’t entirely without merit.

https://www.google.co.uk/amp/s/www.telegraph.co.uk/news/2020/04/09/ae-attendances-lowest-point-since-records-began-amid-coronavirus/amp/

I didn't say it was normal variation, I said accidental deaths would be hidden by other deaths and any change would be masked by normal variation.  So you wouldn't expect a noticeable fall in normal deaths because everybody was at home.

I assume people are going less to A and E because they'd rather not expose themselves to Covid19.  Guess Covid works wonders on reducing the idiots that normally rock up with minor complaints.

I have explained the rest and am busy

Here are some old stats on causes of death.  The number of deaths a year is a bit higher right now, but the comparison is still valid.  There are only about 12,000 accidental deaths a year in the UK compared to a normal 500k+ of total deaths.  Given the 500k deaths each year can move around by tens of thousands a year due to different flu strains and different weather, then any change in accidental deaths is not going to be noticeable above normal noise.  


https://www.theguardian.com/news/datablog/2011/oct/28/mortality-statistics-causes-death-england-wales-2010

As an aside, you sometimes see life and other insurance policies that cover you for accidental deaths (sure it was fairly standard on PPI).  A cynic would suggest these don't exist because it is great cover to have (no family needs twice as much life cover if you drown in a bath than they'd need if you died of a heart attack), but a lot of people massively overestimate the likely beneift vs the cost.  

[StuartHopkin]

lockdown in Scotland as expected extended 3 more weeks

How do you know that? The daily briefing hasn't been on yet

oh yes it has :-)

I don't understand why they allow her to do this?

[Jon MW]

...
Any ideas on the 2,500 extra deaths? Other than those attributable to people not seeking medical help because of Covid, you’d surely expect them to go down while we’re mostly locked down safely at home.

Something like this, is the only thing that really makes sense:
(It’s a bit tenuous at this stage but there aren’t many other explanations, are there?)

https://twitter.com/jolyonmaugham/status/1250731649152811008?s=21
(another quite divisive figure)

I'm a bit confused by that report/claim.

The tweet and topic is, "Leaked guidance from an NHS hospital trust reveals doctors are being told they are not required to put COVID-19 on death certificates.".

What a doctor puts on a death certificate is their professional opinion as to the most likely cause of death.

They quote the guidance as saying, ‘Doctors are asked to use the standard MCCD (Medical Certificate of Cause of Death) form to certify death. ‘Pneumonia ‘or ‘community acquired pneumonia’ are acceptable at 1(a) on the MCCD. There is no requirement to write COVID 19 as part of the MCCD. It may be mentioned at 1(b) on the form, should the doctor wish.’

Part a is what do you think is the direct cause of death
Part b is what else do you think might have contributed to the death.

I would read that as the trust making it clear that just because there is a pandemic doctors don't have to put COVID19 down for every respiratory/pneumonia death.

It is a bit 'wrong' as it is a slightly different emphasis to the government's central advice which is more like - if you think it's COVID19 you can put down COVID19.

What confuses me is that this so clearly leaves COVID19 on the death certificate that I don't understand why the "Good Law Project" that started the petition would go ahead with this complaint.

Also, as mentioned before, if doctors weren't putting COVID19 down they would be putting pneumonia down and those figures are only slightly higher than average - well within what you might expect the normal variance to be.

To clarify: if COVID19 is mentioned on any part of the death certificate then it is counted in the ONS figures, so putting it in part 1b wouldn't make a difference to putting it in 1a.

[kukushkin88]

...
Any ideas on the 2,500 extra deaths? Other than those attributable to people not seeking medical help because of Covid, you’d surely expect them to go down while we’re mostly locked down safely at home.

Something like this, is the only thing that really makes sense:
(It’s a bit tenuous at this stage but there aren’t many other explanations, are there?)

https://twitter.com/jolyonmaugham/status/1250731649152811008?s=21
(another quite divisive figure)

I'm a bit confused by that report/claim.

The tweet and topic is, "Leaked guidance from an NHS hospital trust reveals doctors are being told they are not required to put COVID-19 on death certificates.".

What a doctor puts on a death certificate is their professional opinion as to the most likely cause of death.

They quote the guidance as saying, ‘Doctors are asked to use the standard MCCD (Medical Certificate of Cause of Death) form to certify death. ‘Pneumonia ‘or ‘community acquired pneumonia’ are acceptable at 1(a) on the MCCD. There is no requirement to write COVID 19 as part of the MCCD. It may be mentioned at 1(b) on the form, should the doctor wish.’

Part a is what do you think is the direct cause of death
Part b is what else do you think might have contributed to the death.

I would read that as the trust making it clear that just because there is a pandemic doctors don't have to put COVID19 down for every respiratory/pneumonia death.

It is a bit 'wrong' as it is a slightly different emphasis to the government's central advice which is more like - if you think it's COVID19 you can put down COVID19.

What confuses me is that this so clearly leaves COVID19 on the death certificate that I don't understand why the "Good Law Project" that started the petition would go ahead with this complaint.

Also, as mentioned before, if doctors weren't putting COVID19 down they would be putting pneumonia down and those figures are only slightly higher than average - well within what you might expect the normal variance to be.

To clarify: if COVID19 is mentioned on any part of the death certificate then it is counted in the ONS figures, so putting it in part 1b wouldn't make a difference to putting it in 1a.

Good morning

Yeah, I put ‘tenuous’ to indicate that it felt a bit like they were clutching at straws and in part with an assumption that a more developed explanation would/will be forthcoming. The excess deaths will certainly be an interesting measure in the coming weeks:

Some really good data and analysis (early stages yet) from The Economist:

https://www.economist.com/graphic-detail/2020/04/16/tracking-covid-19-excess-deaths-across-countries

Thanks to Doobs for the explanation and really interesting linked info yesterday 🙏.

[kukushkin88]

lockdown in Scotland as expected extended 3 more weeks

How do you know that? The daily briefing hasn't been on yet

oh yes it has :-)

I don't understand why they allow her to do this?

Good morning

For practical purposes, the power to announce and even call the lockdown is devolved. So there isn’t anyone who can dictate when they announce. In reality the nations have to coordinate on it. I’m sure there’s a small element of grandstanding in calling it before the U.K. government does.

[kukushkin88]

John Burn-Murdoch will be on the case with the new metric as well:

https://twitter.com/jburnmurdoch/status/1250904323195895810?s=20

[Doobs]

...
Any ideas on the 2,500 extra deaths? Other than those attributable to people not seeking medical help because of Covid, you’d surely expect them to go down while we’re mostly locked down safely at home.

Something like this, is the only thing that really makes sense:
(It’s a bit tenuous at this stage but there aren’t many other explanations, are there?)

https://twitter.com/jolyonmaugham/status/1250731649152811008?s=21
(another quite divisive figure)

I'm a bit confused by that report/claim.

The tweet and topic is, "Leaked guidance from an NHS hospital trust reveals doctors are being told they are not required to put COVID-19 on death certificates.".

What a doctor puts on a death certificate is their professional opinion as to the most likely cause of death.

They quote the guidance as saying, ‘Doctors are asked to use the standard MCCD (Medical Certificate of Cause of Death) form to certify death. ‘Pneumonia ‘or ‘community acquired pneumonia’ are acceptable at 1(a) on the MCCD. There is no requirement to write COVID 19 as part of the MCCD. It may be mentioned at 1(b) on the form, should the doctor wish.’

Part a is what do you think is the direct cause of death
Part b is what else do you think might have contributed to the death.

I would read that as the trust making it clear that just because there is a pandemic doctors don't have to put COVID19 down for every respiratory/pneumonia death.

It is a bit 'wrong' as it is a slightly different emphasis to the government's central advice which is more like - if you think it's COVID19 you can put down COVID19.

What confuses me is that this so clearly leaves COVID19 on the death certificate that I don't understand why the "Good Law Project" that started the petition would go ahead with this complaint.

Also, as mentioned before, if doctors weren't putting COVID19 down they would be putting pneumonia down and those figures are only slightly higher than average - well within what you might expect the normal variance to be.

To clarify: if COVID19 is mentioned on any part of the death certificate then it is counted in the ONS figures, so putting it in part 1b wouldn't make a difference to putting it in 1a.

Thanks Jon.

This is a useful explanation. 

I have sifted through death certificates in the distant past as Insurers monitor trends in mortality and causes of death.  It was a very manual process back then and we never had to do it quite so quickly.  There were always grey areas back then with causes of death, so this isn't a new thing. I am never really surprised about people overeact to.   Not everything you see is a Government cover-up, here it is clearly different people interpreting the same words in a slightly different way. 

I'll just add that up until very recently, I'd have been impressed by any insurer who was doing this a couple of months in arrears.   Speed and accuracy aren't going to be comfortable bedfellows.

[nirvana]

John Burn-Murdoch will be on the case with the new metric as well:

https://twitter.com/jburnmurdoch/status/1250904323195895810?s=20

It will be interesting to see the all cause mortality country by country

[StuartHopkin]

lockdown in Scotland as expected extended 3 more weeks

How do you know that? The daily briefing hasn't been on yet

oh yes it has :-)

I don't understand why they allow her to do this?

Good morning

For practical purposes, the power to announce and even call the lockdown is devolved. So there isn’t anyone who can dictate when they announce. In reality the nations have to coordinate on it. I’m sure there’s a small element of grandstanding in calling it before the U.K. government does.

I know, but I would just feed her a load of shit then do the real announcement at 5pm.

Probably not the best plan.... But definitely what I would do!

[Jon MW]

John Burn-Murdoch will be on the case with the new metric as well:

https://twitter.com/jburnmurdoch/status/1250904323195895810?s=20

It will be interesting to see the all cause mortality country by country

Speaking of which:

In the Guayas region of Ecuador, in the first two weeks of April 6700 people have died.
Normally they would expect about 1000 people to die in that time.

The official COVID19 deaths in Ecuador is 403