No Cause for Complacency

Monday's figures:

Since Friday 30 October, 21 individuals have recovered and 18 new cases have been identified (5 from inbound travel, 4 while individuals were seeking healthcare, 8 through contact tracing, and 1 considered an old case no longer active at time of detection). Number of direct contacts of cases: 491

The number of active cases in the Island is 71. 37 cases are symptomatic and 34 cases are asymptomatic. None are in hospital (-). Average turnaround time for test results received in the last 7 days: 14 hours

Six healthcare workers have tested positive for covid-19, while one case has been picked up at Granville School. The Government employees work in a single "care setting" supporting "independent living facilities" in the community. Number of direct contacts of cases: 631 Tuesday's figures

Since Monday 2 November, 4 individuals have recovered and 17 new cases have been identified (4 from inbound travel, 9 through contact tracing, 1 through planned workforce screening, and 3 while individuals were seeking healthcare). 

The number of active cases in the Island is 84.
39 cases are symptomatic and 45 cases are asymptomatic. None are in hospital. Average turnaround time for test results received in the last 7 days: 13 hours

Comments:

I'm never that worried about the travel stats, especially since they now require self-isolation until after the first test result. It's worth noting that Susan Turnbull in her recent interview in the JEP thought that that was brought in a week or so too late, and we may pay the price for that by more community cases seeded by travellers when allowed out before the first test result.

Recent heavy fines have I think sent an extremely strong message that breaking the rules is not tolerated, and also that people will be caught out and prosecuted.

What is alarming is the case of the six healthcare workers. This shows not only that it can rise with voracious rapidity, but also it can spread very easily in clusters. They all worked together. 

Tuesday shows a smaller rise, but still an rise from Monday, but what we don't know is whether there are any clusters. Obviously if it gets to one member of a family, or perhaps an office, it can infect almost everyone there very quickly. But that information is lacking.

The two classifications for Covid - "contact tracing" for new cases, and "in the community" for all cases other than hospital or care homes, are very blunt and not very useful in understanding the spread of the virus. If there is a jump in "contact tracing", is it related to a cluster like the six healthcare workers, and were the contacts already isolating before testing?  Understanding increases helps assess risks.

There are, for example, two cases which Dr Muscatt said no traced source of infection was detected. That needs to be shown separately, because as long as cases are tracked to links, the track and trace is working, but non-traceable cases show asymptomatic cases out there. If those rise significantly, then while we can track and trace their contacts, control on spread may become out of control. That's why we need those statistics. Placing those under "contact tracing" is misleading.

There are also ones "under review" which may turn out to be non-traceable. That's a statistic we also need to know, as we can see how many managed to be traced back to source, and how many didn't.

So far, we are still in a safe place, but that cluster of six shows how rapidly numbers can grow, and how quickly they could get out of control. The increased testing will help, but to gauge its effectiveness, we do need to have better statistics. 

This government has been singularly poor from the outset in supplying that information, and it is clear that in the early days, tests were marked asymptomatic whereas they were in fact  pre-symptomatic. I have had to elicit a lot of information via Freedom of Information requests, and that is a reflection of the inept handling of information about the pandemic. It is incredibly frustrating, especially when you see how Guernsey or the Isle of Man have from the start been far more transparent about the data. 

And at some level the obsession with confidentiality is breaking down - now at least, we are told which schools cases arise, but just a week or so, with St Michael's case, the government would not name the school, causing more uncertainty, more worry, and showed no understanding of what is in the public good. Within a small Island, the news gets out anyway, and so all this obsessive secrecy does is to make the government look ridiculous.

Insofar as Dr Muscatt is in charge of the medical aspects of the strategy, I have confidence, but he is not responsible for the reporting of the statistics, which falls upon the government. The Health Minister says that we should all assess our own levels of risk, but we can't do that if we don't have decent figures to base those risks on.  

I've often been asked if I could do better, and the answer, when it comes to knowing how to present the statistics - if I had all the figures I wanted - is yes!