Its not a bad flu season – Covid myths debunked with data

FT data journalist John Burn-Murdoch examines the coronavirus stats, and explains why the UK’s Covid-19 death rate is likely to rise further. Read more here:

If anyone says to you that the conditions we’re seeing in england’s hospitals at the moment are no different to what we get in a bad flu season this video is what you should show them what i’ve done is i’ve taken data on the numbers of people being admitted to icus in england with flu over the last few years in a typical winter first of all we’re going to look

At the year 2013-14 so on the vertical axis you’ve got the number of people admitted with flu per week per million people to put that into more context england has about 56 million people as a whole in the country so when the number is one person per million per week that’s about 56 people per week so let’s start in the winter of 2013-14 where the flu season

Peaked at around about 1.5 people per million per week if we then moved to the following winter it was a bit worse and things got up to about 2.5 per million per week the subsequent winter was worse still 2016-17 was a bit more mild but then 2017-18 was a relative record one of the worst blue seasons we’d seen in about 40 years 1819 also bad 1920 not quite

As bad but what we’ve seen this winter in 2020 21 with covid is a completely different picture it’s an order of magnitude different whereas the worst flu seasons in the past were peaking at about six people per million per week admitted to icus what we’ve seen this winter and of course the numbers are still developing still in fact rising we’ve seen a peak so

Far of about 17 people per million per week and that translates into around 980 people admitted to icus in england per week with covid to put that 980 new admissions into context the total icu capacity across all of england that’s the number of icu beds typically available even in winter is about three and a half thousand so that’s more than a quarter of all

Available icu beds taken up just by new admissions in one week now of course not all patients admitted into icu stay there some are discharged some unfortunately lose their lives but it just shows you quite how full and in fact overwhelmed england’s icus have been this winter relative even to bad flu seasons in the recent past now some people will look at that

Last chart and say well we’ve not been testing everyone including asymptomatic people for flu in the past in the same way that we’re doing for covid this winter now there are a couple of things to say about that first of all the vast majority of tests being done are on people with symptoms so to say that the lack of asymptomatic testing in the past is different

Is not really true we test the flu in normal years when people are ill we test for kobit this year when people are ill but the second and perhaps more definitive response to that kind of criticism is we can look at the total numbers of people in england’s icu for any reason now if the spike in that last chart for covid is simply due to the fact that we’re doing

More testing for respiratory illnesses this year than in other years and what we’re really seeing is people who got admitted to icu for other reasons perhaps a broken leg perhaps a heart attack and then tested positive for covid then the total numbers of people in england’s icus shouldn’t be any different it’s just that covert is spreading among people who are

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Already in hospital so let’s see if that is in fact the case the chart here looks again over the winter months from november december through to february march and we’re looking here at the total numbers of people in icu beds in london for any reason at all doesn’t matter whether they’re in for flu for covid broken ankle anything like that if we look at 2013-14

The same winter we started with last time the numbers start rising as you come into winter now that’s not unexpected but they then level off at around 650 people in icu beds in london and that stays roughly the same as winter plays out now let’s pan through the years again so here’s the following winter 1415 around 700 people in icu beds in london all the way

Through similar the year after that similar in 2016-17 even in 1718 that year that was especially bad for flu the numbers never got above 750 people in icu beds in london for the whole winter 2018-19 again around 700 1920 the same but here’s 2020 2021 and once again just as in the last chart we see that covid is completely different to what we’ve seen before

Instead of the typical number of about 750 people in icu beds that number is shot up above 1000 and again the line has only been growing steeper when the data is updated it’s almost certain that this will have risen even further the peak of that red line for this winter is at 1074 patients in critical care in other words icu beds in london that’s a 40 increase

On that record bad flu season in 2017-18 so this is again a completely different scenario that we’re dealing with putting doctors and hospitals under immense pressure and when you look at this the only reason that doctors and hospitals are able to accommodate 1074 patients in icu beds when they typically have about 700 to 750 is their moving beds from elsewhere

And they’re moving staff from elsewhere to care for these patients so the care that patients receive in this case really is a zero-sum game for every additional patient being treated in icu for covid a patient elsewhere is receiving either a lower quantity of care or a lower quality of care we now know that in many icus in london one doctor or one nurse is having

To deal with four patients in icu whereas typically even in a bad winter that number would be one or two patients so people are more stretched resources are more thin and it’s likely the outcomes may become worse now of course the outcome after you see a huge surge in the numbers of patients in hospitals and especially in icus is that unfortunately we also see

The numbers of deaths start to climb but there have been a lot of confusing numbers bouncing around online over the last couple of weeks about whether death this year are indeed higher than they normally would be in a typical winter one piece of information that some of those who don’t think this winter is any different to normal have been using is data from the

European mortality monitoring website euromomo now what they’ll do is they’ll point to a chart that looks a bit like the one you see in front of you here which is tracking whether or not deaths occurring in different countries in europe are roughly normal for the time of year or above what we’d normally expect they’ll focus on this period right at the end of

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The chart where it looks like the line is going downwards suggesting that deaths are falling back towards roughly normal levels for this time of year the problem is the way this data is processed means that the lines always trend downwards at the end because there is essentially a delay between when deaths occur and when they’re registered so if we look at the

Data for england for example if we visited this webpage about a week ago the data point for week 52 the last week of 2020 gave a value of 0.15 that means essentially deaths occurring in the last week of 2020 were no different to a normal year however we come back to this page today a week later and that value for england for the same week is now 5.98 almost

Six in other words it’s considerably higher than normal and in the range that euro momo says means significant excess deaths that’s the same week it’s just that a week later more of that data has been processed and the line has gone back up once again the final point of the line looks like it’s dipping down but we know from this experience from past experience

That that is a data processing issue and once all that data is fed through that point like the one before it will rise up significantly that’s just one of the ways that we can look at excess deaths and try to add some clarity to the data here but another way is to compare what we’re seeing this winter as we’ve been doing in those previous charts with what we’ve

Seen in other bad flu seasons so here’s a chart showing the total numbers of people whose deaths are registered in england and wales over the calendar year and we can see this figure for the years through from 2012 13 2014 all the way through to the last couple of years 17 18 19 and then here we have the data for 2020. now that huge spike that you see in march

April and into may in england and wales is the spike that we’re all grimly familiar with this was the huge access that we saw in the spring back when the virus was really out of control in england and wales and this peak was so high in part because until late march we’d all been mixing freely with no concerns for how this might be affecting viral transmission

That led to thousands and thousands in fact tens of thousands of excess deaths what has been more contentious is whether or not the numbers we’ve been seeing in the last few weeks in september into october november and latterly december have been especially abnormal for a winter but the simple fact is they have just as we’ve seen icu admissions far higher this

Winter than they would be even in a bad flu season the same has been true of death so the winter of 2017-18 as we mentioned earlier was a record bad flu season and one of the statistics that is used to measure exactly how bad a flu season is is this concept of excess winter deaths now that terminology has a lot of confusion when people are comparing the death

Tolls of different years because excess winter deaths and the general concept of excess deaths that we’ve been talking about this year are actually two completely different things excess winter deaths are defined as the number of deaths in the four months from december january february and march compared to deaths in the four months immediately before that so

The autumn and death in the four months after that the next spring so it’s about saying how many more deaths did we see over one year in winter than in the autumn before and the spring after that period it’s a way of measuring the impact of seasonal winter viruses like flu and of freezing temperatures which can themselves cause increased deaths but when we’re

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Measuring excess deaths during the kobit 19 outbreak what we’re doing is we’re seeing how many more deaths there have been this winter compared to previous winters so that measure is always going to give a smaller number because it’s comparing against a winter baseline where deaths are known to be high rather than against a spring and autumn baseline where deaths

Are known to be low as is the case with excess winter deaths so when people point to 2017-18 and say well there were about 50 000 excess winter deaths in that year but we’ve not seen 50 000 excess deaths this winter they’re actually comparing two numbers that cannot possibly be compared to completely different methodologies and the closest we can actually get to

A like-for-like comparison of excess mortality this winter versus 2017-18 is to compare deaths from september to december 2020 versus the same month in 2017. and the result the result is that autumn and winter 2020 has seen 15 000 more deaths than the same period in 2017-18 the final couple of problems we have when we try and deal with excess mortality this

Year relate to the fact that there are very very long delays between the occurrence of a death and that death appearing in death registration data so if we look at the very latest data that we have from the office for national statistics that was published on january the 6th and it refers to people whose death was registered in the week ending on christmas day

The 25th of december that’s a lag of 12 days between when the death was registered and when it is published in the official data there’s then another lag between when someone dies and when their death is registered that’s typically around five days in england and wales so the very latest data that we have on excess deaths in england and wales refers to people who

Lost their lives around the 20th of december now we know that it was in the immediate lead-up to christmas in the uk that the virus was spreading at its fastest it was from the 20th of december onwards that we saw case rates positivity rates surging up higher and higher towards those april levels and it’s only been in the last two weeks that we’ve seen hospital and

Icu admissions reaching and then in fact breaching those spring records so based on that we would expect most of the rise in death from this winter wave of the virus to take place long after the 20th of december so the fact that we’ve seen considerable excess mortality over the last few months is one thing but we actually fully expect and the data i’m sure will

Bear out the fact that we will now see an acceleration a steepening of that excess death curve as the data from people who lost their lives after the 20th of december filters through into the published data that we can actually use we’ve been tracking these statistics and many other metrics for covid not just in the uk but through dozens and dozens of countries

Around the world and you can find all of our data at coronavirus hyphen latest

Transcribed from video
'It's not a bad flu season' – Covid myths debunked with data By Financial Times