Troubling chart from PHE’s National Influenza Report - maybe missed because of the title of the report
- Of 611 new “acute respiratory outbreaks” in England last week (way above grey trend line),
512 were in care homes, of which 230 tested +ve for Coronavirus

The number of newly reported acute respiratory outbreaks in care homes appears on these numbers to have surged - as the country has been shutdown (NB these are numbers for England up until April 2)

Other interesting thing about that chart is you can see the nasty Influenza A strain that was affecting many people in December (which some thought was early Covid19) - and how it was transmitting through schools. Few Covid outbreaks in schools before they were shut...

Gone back through the data for the equivalent week in past 5 years - influenza causing new acute outbreaks in a range of 5, 11, maybe 28 care homes at peak, not well over 500.

Lots of comparisons between UK and others on death numbers etc - just can’t see how until Government start publishing statistics about how many deaths are occurring in care homes...

This happens eg in France - official stats here - more than a third (4,889) at nursing/care homes

Also France has fewer care homes than the UK - 7,400 versus about 12,000 here. The last data point was the PHE one I spotted at top of thread that there had been 512 “acute respiratory outbreaks” at care homes the week before last.

New data due two days ago, not published yet..

I see plenty of people are pointing to per capita measures... but eg Italy has an older society, and also had a bigger critical care capacity...

Only focussing on hospital deaths only makes sense if the overwhelming aim of intervention is preventing NHS from falling over...

How can we even assert how much curve flattening & precise decimal point “doubling rates” when source of third of deaths elsewhere in Europe doesnt even count in stats here?

Also care homes really matter to know if infection actually under control in country, not just in NHS

Some say different approach in Scotland - but can only find same death certificate lagging stat - no clear number like France of care home deaths. HPS DID publish its weekly flu tracker this week (unlike PHE)..but no number for acute respiratory infections at care homes for Covid

Good Scot Gov daily stats on Covid-related NHS staff absence though...

About 5% generally and for nurses... and 1.5% for medical and dental staff.

Colleague trying to get hold of care home data for Scotland... https://twitter.com/bbcandrewpicken/status/1249021896177463297?s=21

Still no update to above “acute respiratory outbreaks” in care home statistics

This is a sobering account of how other countries have dealt with care home outbreaks vs UK guidance, including testing, isolation hospital discharges going into quarantine... https://ltccovid.org/2020/04/09/briefing-note-current-uk-guidance-on-admission-and-care-of-residents-during-covid-19-is-based-on-symptomatic-cases-ignoring-early-international-evidence-and-lessons-from-other-countries/

Care home Covid-linked mortality figures via LSE for 5 countries - as a % of total deaths 40-54% on official data...

https://ltccovid.org/2020/04/12/mortality-associated-with-covid-19-outbreaks-in-care-homes-early-international-evidence/

Update:

Scotland’s Health minister @JeaneF1MSP confirmed yesterday that Covid was in 37% of Scottish care homes - that’s 406 homes, via the @CareInspect ... last figures we had for England were from PHE 10 days ago above/ a figure at the presser of 9%. https://twitter.com/bbcnews/status/1249336993756127240?s=21

CMO Whitty says they are trying to speed up the non-hospital Covid death stats for England ...

Might be missing something here but CSO said that the COBR international stats chart were only hospital deaths because thats the international standards..but French number is at 14k on this chart, & according to France, that includes 5,140 in care homes, that it is counting daily

So someone asked the question about the 9% figure - Whitty says that is now 13.5% “cumulatively” of care homes... and in past 24 hours ..92 new outbreaks...

So we have data up until April 2nd. And then data for yday.

And number for England is well out of kilter with Scotland...

on France - UK graph...
we are 4 days behind French curve on Govts “days since 50 deaths” measure - on Day 28 12k French deaths compared to 11k for UK, so UK below French curve..

But 4,166 French deaths were in care homes, so in fact, UK (11k) wd be markedly above France (on 8k)

so again at top of thread, I spotted set of figures showing 512 “Acute respiratory outbreaks” in care homes, reported to PHE, in week to April 2... 230 officially tested for Covid.

figures werent published last week.

Today CMO said 92 Covid care home outbreaks in one day, yday

in week to April 2 average 73 new care home respiratory outbreaks/day, with 33 a day confirmed as Covid.. week before 40 a day

Then no data from 3rd to the 11th

Then 92 new in 1 day yesterday.

If missing days went up in straight line - looking at 1500 care home outbreaks

CMO did say 13.5% of care homes had virus - if that is England, then according to CQC - there are 11,333 residential homes - which would also make around 1500 acute respiratory outbreaks of Covid in English care homes...

They must have some data for the missing 8 days... all care homes, and schools (if they were open) have to report any occurrence of 2 or more cases of acute respiratory infections occurring within 7 days, to PHE using this form...

Lastly for now, totally different numbers for Scotland, where through its Care Inspectorate, the Scottish Govt say Covid present in 37% of care homes.

English figure is v different to that at 13.5%, in a way that raises reasonable qs - but perhaps CQC might have equivalent stats

weekly data revealing explosion in acute respiratory outbreaks, esp at care homes, is now fortnightly... “A summary report is being published once a fortnight while influenza activity is low”.

Tho didnt happen in any previous April since 2014 listed here: https://www.gov.uk/government/collections/weekly-national-flu-reports#2019-to-2020-season

In theory though that means we should get two weeks worth of numbers on Thursday...

On the care home deaths, the new ONS stats till April 3rd are that 217 deaths from COVID-19 occurred in care homes, 136 in private homes, and 33 in hospices... versus 3,716 in hospitals....

so that is far lower than normal pattern from all cause mortality..

If English public health system truly kept number of Covid-related deaths at 6% of hospital deaths (vs 40-50% in other European countries), despite lack of testing, and in only 13% of homes (vs 37% in Scotland) then its huge public policy success.

Or not being measured properly.

It would be interesting to know which of these Government thinks is most likely explanation for considerable difference in Covid care home stats in England... vs Scotland, and other European nations.

At yesterday’s press conference the statistic “90% of Covid deaths” are in hospitals was used - so presumably this is being treated as the reality, and therefore being used to set priorities, judge performance.

What we do definitively know - there are WEEKLY stats above that gave number of acute respiratory outbreaks in care homes, & showed them rising exponentially...& whereas its said we’ll get stats more quickly, in fact, for first time on record last month they were made fortnightly

And it is highly significant that the former Chief Scientist Sir David King has broken cover with criticism on exactly this issue of the measurement of deaths outside hospital: https://twitter.com/mattuthompson/status/1250299264497942535?s=21

Health Sec just said virus in 15% of care homes - which must be ref to an numbers I’ve been tracking above... was 13.5% on Monday.

Need to establish whether this is officially tested number - which was at 230...or total of acute outbreaks - 512 last time figures released April 2

In theory we get the update to this today, now that the weekly figures for the first time are produced fortnightly. Should be the best source on number of outbreaks in care homes...

Hancock confirms to @bbcnickrobinson that 15% care home number measure above - where outbreak is declared by two or more cases within a week - low by international indicators.

Now what matters is whether 15% is Covid tested version or wider unexplained respiratory outbreaks

The last time we got the weekly numbers a a fortnight ago - there were 230 care home outbreaks officially tested for Covid but even more, 282 “acute respiratory outbreaks” totally inconsistent with normal trend, but not confirmed as Covid. So it really matters what 15% refers to.

Interesting context from Belgium, which is including suspected cases in care homes - and now reports officially more Covid fatalities in total in its care homes than in hospitals https://twitter.com/brunobrussels/status/1250715812597575681?s=21 https://twitter.com/BrunoBrussels/status/1250715812597575681

NEW we have last fortnights numbers On acute respiratory outbreaks...
Ordinarily 5-20 a week

last week (week 15) 824 outbreaks, with 770 from care homes, of which 446 confirmed Covid

Week before (week 14) not detailed?? ... tho reading off chart it appears around 700 outbreaks

Again reading from blue bars off the chart that shows around 2000 acute respiratory outbreaks officially reported by English care homes to PHE... taken with April 2nd release we know 800 officially tested Covid+ - which is its own story, but that is omitting the week 14 test data

Pointed out 9 days ago CQC England might have care home Covid death stats as equivalent in Scotland had provided then... today a statement saying last week’s care home deaths “could be double” those reported yday by ONS - so 2000+

https://www.cqc.org.uk/news/stories/joint-statement-dhsc-cqc-yesterdays-ons-figures https://twitter.com/faisalislam/status/1249813138142347266?s=21

CQC has been contacting care homes directly for their statistics - more consistent with the PHE outbreak data pointed to at top of this thread.
ONS has been taking numbers from references on death certificates....

https://www.cqc.org.uk/news/stories/joint-statement-dhsc-cqc-yesterdays-ons-figures