welcome as always it's Tuesday the 2nd
of June now the situation in the United
States is is of course alarming in its
own terms but it's also alarming because
people have been emailing me saying what
are you talking about covered 19:4 don't
you realize we've got other problems and
of course
regrettably I do realize that but of
course the pandemic hasn't gone away
these virus has not the rights are not
going to affect the virus the virus are
just going to carry on so I guess what
my appeal would be would be don't forget
that you're in a pandemic if you if
you're in the United States and carry on
with all the day-to-day measures that
you've been doing with a great deal of
success
so the social distance in carrying that
on the good hand hygiene carry that on
the mask-wearing carry that on carry on
all the good things you've been doing
don't just say the whole thing's
hopeless no to need to keep on carrying
on doing these things because when these
demonstrations and riots finish the
pandemic is still going to be here so
the note I've made here is the focus is
shifted in the United States and of
course that's that's understatement but
the pandemic has not gone away and just
to reinforce that I talked to some
figures this morning and all these
states have increasing number of new
cases not deaths the number of new cases
the deaths of course follow on Later so
Alabama Virginia Wisconsin Arkansas
California South Dakota the numbers of
cases are all currently increasing and
regrettably I think we can probably see
we'll probably see an increase in these
cases as a result of the current
situation I do hope not because
obviously most of the demonstrations and
writing are outside but there is
increased risk of aerosolization and
droplet infection by people being
physically close together by people
shouting and protesting making noises
with their with their vocal cords and
all the droplets that come out as a
result of that and of course just the
pure physical contact
has got the significant risk of
increasing cases even Louis outside on
the good point states with decreasing
new cases Massachusetts Connecticut
Rhode Island Delaware and North Dakota
are actually reducing at the moment but
even in areas like New York where
there's been a very high incidence of
the disease has been very badly affected
even in New York City according to the
data that we have which is limited still
only about 20% of people have had the
disease so we are not at the herd
immunity stage yet and in these areas
that the level of immunity is going to
be way less that or presumed immunity is
going to be way less than in New York
City so these areas could easily have a
resurgence a continuation or what people
sometimes referred to as a second wave
so I would just say try not to be too
discouraged on the covered 19 fronts and
keep doing what you're doing and have
been doing successfully in terms of all
the basic precautions that you are
taking now the United Kingdom I'm going
to look at some of the office for
national statistics data from the UK and
then mode the news is mostly good in
terms of death so let's look at this
look at some of that now now this is the
number of deaths register by weakening
in the Wales from the 28th of December
2019 way back then seems a long time ago
now all the way up to the 22nd of May
which is the latest week that the Office
for National Statistics have collected
full data for so these are the numbers
this is the number of deaths here and
the red line is the number of covered
deaths so we see that the number of
covered deaths has decreased sharply
this data here is confused by the bank
holiday weekend but the number of
covered deaths are decreasing quite
sharply which is good news and as a
result of that the total number of
deaths have also decreased so definite
downward trend there now this line here
you might remember this graph is useful
this is the average here the 5-year
average along that line so the Green
deaths and uncovered deaths and the blue
deaths are covered death
here we can see that the deaths were
slightly below average because it
actually wasn't too bad a flu and
influenza season this year so over the
flu season things weren't too bad but
then of course all the covered deaths
are above average because normally we
have had no covered deaths in the past
five years and as we expressed a lot of
concern about at the time there was
increasing non-covered deaths during
this period the the increase in covered
death who would expect with the increase
in non-covered deaths was that partly
due to deaths by covered 19 which
weren't attributed or was it due to the
fact that people weren't accessing
health care and we now think it was
because people weren't accessing health
care the success of deaths occurred but
in this in this last week the weekend in
the 22nd of May that we see their
weekend in the 22nd May the deaths from
other causes are actually slightly below
the five-year average and the deaths
from covered 19 is receive started to go
down as the lockdown measures have taken
effect albeit with a delay so this graph
is actually showing three things it's
giving us the age demographic of the
population which is useful for
comparison in blue it's showing us all
deaths and as you would expect the older
people are the more likely they are to
die so we can see the increase in deaths
with increasing age but we also see a
clear trend with the covered 19 deaths
in yellow and again we see that quite
clearly that as age increases the
likelihood of death also increases and
it's good to compare that against the
population demographics over comparing
the number of covered deaths in the
older age group with the number of
people that are actually alive in that
older age group we see there's a
disproportionate number of older people
dying as a result of covered 19 compared
to younger people so that's very much
confirming the trends we've been looking
at for for some time now
now this is the number of deaths
involved covered 19 was highest in
females aged 85 so this is this is it
all right let's look at this so blue is
the obviously we have the age group here
at the bottom blue is men the yellow at
color is female so we see more men in
that age group dying more money in that
age group dying more men in that age
group dying more men in that age group
dying but in the 85 year olds and older
we see more women dying and I think this
is because men tend to die at a younger
age than women normally so there are
more women in this demographic grouping
normally so there's more women available
to die as it were in that group I think
that's what probably accounts for that
apparent discrepancy now we've looked at
this graph for a few weeks now we'll got
used to this one I think so these are
the number of covered deaths only
looking uncovered deaths and this is
where people die so this the in the blue
we see the number of deaths in hospital
and in the red we see the number of
deaths in care homes and there we see
the number of deaths in people's homes
and the blue is deaths in other places
so first of all we see the number of
deaths going down there so the total
number of covered deaths is going down
but we still see that quite a good
proportion or quite a high proportion of
which so rather of those deaths do occur
in care homes so even though the numbers
are improving still more work to be done
there in the care home situation in a
sense you would expect more deaths in
hospital because people go to hospital
when they're they are more poorly but
still more work to do they're in in the
care homes but good to see that this
number is coming down really quite
dramatically as a result of the lockdown
measures filtering through less
infections equaling less severe cases
going on to less deaths the number of
deaths registered in the UK decreased in
week 21 which is here this is the we
begin at ending
22nd to May so this is a the blue line
is total deaths and the yellow line here
is covered death so again we see the
number of conv deaths going down which
is is good so that was some interesting
things from the UK now other things that
caught my attention from the UK near
Ferguson that you might remember he had
to leave his government position as a
result of breaching the terms of the the
lockdown
but he wasn't dismissed through lack of
technical competence or anything like
that much as people will argue with him
but he's been saying some interesting
things now the first thing he says I
haven't noted here but I think it I
think he's made a very good point what
he said his that what he would expect
and this is kind of a gut feeling I
think he's expressing but I must say
I've been thinking along similar terms
and I know a few other people have that
even though we're lifting the lockdown
measures now in the UK I don't really
expect the number of cases and deaths to
go up dramatically now this is despite
their goat there's going to be more
social contact as shops reopen and
things like that and the reason that
don't expect the cases and deaths to go
up dramatically over the summer is
because in summertime people have good
ventilation they do a lot of things
outside and there's plenty of fresh air
around we're not all huddled together
over radiators or whatever it is to keep
warm with the window shut and we know
that a big factor in getting this
infection is the viral load that gets
into your lung so that is so much lower
outside with good ventilation and also
in summer we get more sun exposure so we
make more vitamin D which we know is a
muni illogically protective molecule so
over summer I think these things are
going to kind of balance out the tend to
increase the number of cases and
filtering through to the number of
deaths as a result of the increased
social contact that we're now going to
have but unfortunately what this means
is that come next winter when the
influenza season star so we're thinking
next
by December particularly people are
going to start closing the doors and
huddling themselves in again and then as
well as the influenza virus spreading in
those more confined non-ventilated
situations
Kovach 19 virus is going to spread as
well so I think we're going to see a
great increase as winter starves because
we're not going to have herd immunity by
anything else when the cases are going
to start so we've had a quite a few
cases now that's going to level off I
think and then it's going to go up again
towards the end of the year and the
reason that is so concerning is people a
proportion of people will get influenza
and covered 19 at the same time and
that's bad now it's got a bad prognosis
so I think I agree with what Neil
Ferguson saying here that we may well
see a flattening over summer but the
second wave is more going to be autumn
and into earlier winter so I think
that's probably what we're going to see
in the UK at least now he also reports
to the House of Lords that genetic
analysis shows that strains in the UK
come from Spain in Italy and the
thousands many thousands of infected
people came into the country in February
and early March from Spain acutally so a
lot of these were caused by people
popping over to Italy for a bit of
skiing if only would close the flights
down earlier we wouldn't have had this
outbreak in the UK that's where nearly
all of it came from is from Spain and
Italy that's where our spread came from
that's looking at phylogenetic analysis
of the back T of the viral particles so
I mean to be fair it is what we were
saying on this on this video for example
back in February
everyone just carried on flying carried
on go into football matches this whole
thing in the UK could have been could
have been virtually prevented it would
still be there to some degree but but
nothing like as much now let's move on
to some good news and good news comes
from the Antipodes
Australia New Zealand and this is the
bulletin board from Australia so the
total cases haven't gone up much the
total des is 102 and the recovery case
is going up now if we look at the
current cases in intensive care in
Australia we have two in Victoria one in
Queensland one in New South Wales an
intensive care and if we look at the
number of pages in hospital we have
eleven in New South Wales two in
Queensland two in Tansley
and nine in Victoria so the trends are
looking very good for Australia and
that's confirmed by the graph a daily
number of reported cases and we see that
still way down now do notice it hasn't
gone away it's just way down and we did
see a similar situation in South Korea
where the cases were virtually gone and
then they were odd clusters coming back
so Australia is not completely out of
the pandemic yet but it is it's looking
very promising and this is just the
cumulative deaths by age group and it's
a very similar pattern to the one we've
just seen in the UK with more deaths and
amongst men at virtually every age group
more they're about the same the same
they're slightly more women perhaps more
men there more men there more men there
but more women there because these men
have already died and there's more women
left in the demographic so overall
pretty good news there from Australia
really pleased about the Australian
situation and New Zealand I think is
gonna lift some of its final lockdown
measure so the virus has almost gone
from New Zealand they've done remarkably
well now while we're looking at the
graphics I think I'm just gonna show you
Sweden which to put it mildly has been
interesting we've talked about it many
times I've had quite a lot of feedback
on it and this is the new confirmed
covered 19 deaths seven-day rolling out
to give an average figure and we see
that Sweden the death rates and remember
this is that these are logarithmic
scales so that's 110 a hundred so this
is a lot lot lot higher than that some
algorithmic scale so we see the deaths
in Sweden are higher than Denmark
Finland and Norway so from that it would
appear that the Swedish policy has
failed relative to the countries around
about it but of course the population in
Sweden is about ten and a half million
you know just over ten million I think
whereas in Denmark Finland and Norway
it's about half that because Sweden is
the most populated country in
Scandinavia so let's look at that now
adjusted for population and again you
have to remember that this is a
logarithmic scale and we see that
there's a nice flattening out now let's
go in a bit yeah their figures and
remember on a log scale here so we see
the new cases new deaths decreasing
Norway's pretty well flat Finland pretty
well flat slightly up there maybe
Denmark again pretty well flat slightly
up Sweden more of an upward trend so the
trend is still more upwards and sweet
and compared to the countries around
about it and of course the number is way
way higher because remember this is a
logarithmic scale so that isn't that
number there is way way higher than that
and I think that's a fair comparison
because these are the other countries in
Scandinavia so I think that
a fairly fair comparison so just to
summarize there I feel fear for greatly
increasing cases in the States over the
next weeks and months or to the UK looks
like it's going to flatten out through
the summit then pick up again in autumn
and of course that's it that situation
applies to the states as well the virus
isn't going to go away from the United
States by autumn and there could also be
a synergistic effect in the United
States with the the increase in cases of
influenza and covered 19 at the same
time which is going to be a bad
combination
you
so they took 176 observational studies
that they're able to find in the
literature 16 countries on all
continents apart from Antarctica and the
total number of patients or subjects
they're able to come up with was over
25,000 the number was over 25,000 and
this included data from the covered 19
the severe acute aspire to syndrome and
the Middle East respiratory syndrome
which are the three types of coronavirus
main path ologies that we've had trouble
with now no randomized controlled trials
were detected in the literature now this
is incredible no randomized control
trials so governments are pairing
universities and academics a lot of
money to do research and nowhere in this
whole wide world is any academic group
decided to study the effects of
transmission of corona virus using a
face masks or eye covering or physical
distancing they just haven't bothered to
do it it really makes you wonder why
we're paying them this money anyway this
group of academics has put together what
we've got so so we'll go with what we've
got
first one physical distancing not just
before I go on to these results we have
to realize that the risk of transmission
when you are close to someone depends on
two factors there we are it depends on
two factors it depends on how close you
are to someone and how long you are
close to them they're the two factors so
the closer you are for the longer the
greater the risk but this study was
unable to take into account the period
of time but it was able to take into
account the distance and what they found
is even less than one meter away your
risk of getting infection from an
infected person is 13% risk more than
one meter away goes down to three
percent and if you for every other meter
that you're further away so if you're
two meters that would have again every
three meters that would have again so we
see this huge distance when we go over
one meter distance and two meter
distance will be half that again
so I say fairly safe distance is going
to be two meters
more than 1 meter is a lot better but
that's just the way they could analyze
this data so 2 meters is is a safe tis a
safe distance reducing your chances of
getting infection to about one and a
half percent compared to about 13% of
you closer than a meter so that kind of
ends the debate on physical distance so
the greater the distance the less the
chances of getting the infection
I suppose that's fairly intuitively
obvious anyway buts nice grab the data
on it face masks they were able to
analyze data from 2647
and they found that wearing a mask if
you're in close contact with someone
than you are wearing a mask this is you
to protect yourself wearing a mask you
have a 3% risk of infection if you're
not wearing a mask your chances of
getting infected go up to 17% now for
ages of course we've been saying that if
I'm infected and I wear a mask
I'm protecting other people from me
that's true but this also shows that me
wearing a mask is going to protect me
from infected people and the risk is
that if I'm not wearing a mask I've got
a three percent risk so here I'm wearing
a mask about a 3% risk if I'm not
wearing a mask I've got a 17 percent
risk so do you want to reduce your
chances of getting infection from 17
percent down to 3 percent if the answer
to that is yes then wear a mask so
that's interesting on protecting people
wearing masks I was quite surprised by
the difference there because I mean as I
say for ages we've known that wearing a
mask is good and it's a big effect if
I'm infected to protect you but this
also means I can protect myself from you
if you are infected to this degree 3
percent versus 17 percent risk if I'm
not wearing a mask and there was a
stronger association with n 95 s or
similar respirators of course as you
would expect as you might wear for
example in the healthcare situation
where they're much greater risk an eye
protection was associated with less
infection as well this was interesting
because the infection can also get in
through the eyes of course and that
showed up to a 22% the odds ratio of
adjusted odds ratio of point two two
which is a twenty two percent level of
protection by wearing eye protection and
again the risk of getting infection
through your eyes is going to be
increased with increasing physical
distance but that's that he couldn't
really account for that
so interpretation of this quantitative
estimates for models and contract
contact tracing policy so this can be
fed into the way that we adjudicators
who is at most risk of being infected
from an infected person but we do need
robust randomized trials and so far we
haven't got any despite all this money
we're paying to academics so
disappointed but we haven't gone in so
this systematic appraisal of current
best practice is the best thing we have
available and the World Health
Organization who currently say one metre
distancing is enough need to reappraise
their guidelines up to two I would say
now I just want to show you a few
pictures of receive from lazier that was
interesting this is just one of someone
who's written to me with them contacts
contact in Malaysia who went for a trip
to the post office so they had to queue
outside with a good social distancing so
that was good and then they have the
temperature checked on the way in and
inside most of the seats were a lot of
the seats were closed off to ensure
physical distancing and there was good
lines for waiting and physical
distancing so I just saw that was of
course this is happening all around the
world now this is what has to happen as
we seek to reduce the level of spread
all I've got to do now is show you some
of my favorite people for Tuesday and
here they are this is Alan who watches
in New Zealand
that's quite a while back 20 sorry about
the delay there Islands and another 20th
of May good see washing in New Zealand
anyway
this is Anna who watches from the
Ukraine over there in the east of Europe
good to know you're watching over there
two thousand international units of d3
sounds good to me
this is a other this is Anna Marie who
watches in New York so interesting
fairly typical New York see now think
out the window enough but thank you for
sending that in a thank you for watching
in New York another Anna in Tasmania
south of Australia
thank you for watching Anna in Tasmania
Antonette who's watches in Sydney
also in Australia homemade masks
Antonette excellent that will protect
you and it will protect others according
to current data Arthur who watches in
Perth a lot of people seem to be in
Australia today good to know you're
watching out there in waa Arthur Arvind
who watches in Ontario in Canada good to
know you're watching in Canada and ash
and Adrienne also in Australia great to
know I have people watching on the other
side of the world thank you for watching
I shan't Adrienne and this is Bernhard
who watches in Singapore good to know
you're watching this Singapore and this
is a Betsey who I believe opens Nessie
and Betsy is too shy I believe so she's
quite reasonably put in Nessie and this
is in I think this might be in
Pennsylvania and this is the net who
watches in California and I think the
net is a lab tech
mission from what I remember the great
snow you're watching in California then
head