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Don’t believe the claim that only 17,371 people have died from COVID in England and Wales

A freedom of information request is only useful if you know how to read the data.

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There is no doubt that the pandemic has led to many deaths; however, in the past week, new claims have emerged that the true number of people who have died from COVID in England and Wales is much lower than previously thought. These claims have been widely shared on social media and even amplified by a senior MP. Can it really be true that new data shows that COVID has killed far fewer people than we previously thought?

To arrive at an answer, we first need to delve into the various ways that COVID deaths are counted in England and Wales. There are two main sources of this data: the first, published by the UK Health Security Agency (UKHSA) and featured prominently on the government’s coronavirus dashboard, is a simple count of all deaths that occur within 28 days of a positive COVID test.

The second, published by the Office for National Statistics (ONS) is based on death certificates that list COVID as a cause of death. Being based on a medical assessment of the circumstances of each individual death, the ONS figures represent the gold standard.

The UKHSA figures will include some deaths that are clearly unrelated to COVID – for example, somebody who has a mild case of COVID and is involved in a car accident three weeks later – and exclude some COVID deaths where someone is in hospital for more than 28 days. The UKHSA data gives us a picture of what is happening now – albeit an imperfect one – while the ONS data takes several weeks to process.

We also need to understand how death certificates work in England and Wales. When somebody passes away, a medical professional completes a death certificate. This includes a field for the “disease or condition directly leading to death” – often called the “underlying cause”. It also includes the option to list one or two diseases or conditions that were not the underlying cause, but which contributed to the death (“contributory causes”).

The data that the ONS publishes shows that, in 2020 and 2021 combined, 157,889 deaths were registered where COVID was mentioned on the death certificate. Of these, 139,839 listed COVID as the underlying cause. In almost 90% of cases where COVID was a factor in somebody’s death, it was considered by medical professionals to be the primary reason they died. So where does the figure of 17,371 COVID deaths come from?

Freedom of information request

This figure originates from a freedom of information request to the Office for National Statistics that asked for the number of deaths where COVID was the only cause of death recorded. This is complicated by the fact that often COVID itself can cause complications, such as severe respiratory difficulties or organ failure, which will then be listed alongside COVID on the death certificate.

To exclude these deaths, the ONS responded by giving the number of deaths where no “pre-existing conditions” were listed on the death certificate. Which comes to 17,371 for the period up to the end of September 2021. But what is a “pre-existing condition”?

Pre-existing conditions and their International Classification of Diseases (ICD) codes

Office for National Statistics

This list is extensive, including high blood pressure, asthma, COPD, diabetes and a wide range of other common conditions. The argument being made by some is that 17,371 is the true number of COVID deaths, because people with these pre-existing conditions, who make up the vast majority of deaths that list COVID on the death certificate, were already sick. But even a cursory glance at the list makes it clear that this will be incorrect for a great many people.

Over a quarter of adults have high blood pressure, 4 million people in England have diabetes and a similar number have asthma. Having one of these conditions is neither a death sentence nor a sign of being in poor health. You almost certainly know several people with one or more of them, or are living with one yourself.

The idea that people with a pre-existing condition are at death’s door is simply untrue. Over half of people aged 50 and over have at least one long-term health condition. But if someone with one of these conditions is unlucky enough to catch COVID and subsequently die, all it takes is for the condition to have some impact for it to end up being listed as a contributory cause on the death certificate.

Let’s take asthma as an example. COVID frequently attacks victims’ lungs, leading them to require ventilation. As a respiratory condition, asthma may well exacerbate these difficulties and will therefore be listed on the death certificate if the person dies. It would be bizarre to claim that the person died of asthma on this basis. Perhaps they would not have died if they didn’t have asthma, but they certainly wouldn’t have died if they hadn’t got COVID.

The vast majority of people who get seriously ill with COVID were living full, independent lives before they were hospitalised. And reasonable estimates suggest that the average number of years of life lost per COVID death is around ten. The idea that people who died from COVID are all extremely ill and would have died soon anyway is not borne out by the facts.

To argue that the deaths from COVID of people with pre-existing conditions don’t count as true COVID deaths is to say that people with pre-existing conditions don’t matter; that their lives are expendable and shouldn’t be considered when assessing the impact of the pandemic. Over 140,000 people with pre-existing conditions have died of COVID in the last two years. We should be mourning this tragic loss of life, not minimising it.

Colin Angus does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

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Lab, crab and robotic rehab

I was in Berkeley a couple of months back, helping TechCrunch get its proverbial ducks in a row before our first big climate event (coming in a few weeks,…

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I got previews of a number of projects I hope to share with you in the newsletter soon, but one that really caught my eye was FogROS, which was just announced as part of the latest ROS (robot operating system) rollout. Beyond a punny name that is simultaneously a reference to the cloud element (fog/cloud — not to mention the fact that the new department has killer views of San Francisco and frequent visitor, Karl) and problematic French cuisine, there’s some really compelling potential here.

I’ve been thinking about the potential impact of cloud-based processing quite a bit the last several years, independent of my writing about robots. Specifically, a number of companies (Microsoft, Amazon, Google) have been betting big on cloud gaming. What do you do when you’ve seemingly pushed a piece of hardware to its limit? If you’ve got low enough latency, you can harness remote servers to do the heavy lifting. It’s something that’s been tried for at least a decade, to varying effect.

Image Credits: ROS

Latency is, of course, a major factor in gaming, where being off by a millisecond can dramatically impact the experience. I’m not fully convinced that experience is where it ought to be quite yet, but it does seem the tech has graduated to a point where off-board processing makes practical sense for robotics. You can currently play a console game on a smartphone with one of those services, so surely we can produce smaller, lighter-weight and lower-cost robots that rely on a remote server to complete resource-intensive tasks like SLAM processing.

The initial application will focus on AWS, with plans to reach additional services like Google Cloud and Microsoft Azure. Watch this space. There are many reasons to be excited. Honestly, there’s a lot to be excited about in robotics generally right now. This was one of the more fun weeks in recent memory.

V Bionic's exoskeleton glove shown without its covering.

Image Credits: V Bionic

Let’s start with the ExoHeal robotic rehabilitation gloves. The device, created by Saudi Arabian V Bionic, nabbed this year’s Microsoft Imagine Cup. The early-stage team is part of a proud tradition of healthcare exoskeletons. In this case, it’s an attempt to rehab the hand following muscle and tendon injuries. Team leader Zain Samdani told TechCrunch:

Flexor linkage-driven movement gives us the flexibility to individually actuate different parts of each finger (phalanges) whilst keeping the device portable. We’re currently developing our production-ready prototype that utilizes a modular design to fit the hand sizes of different patients.

Image Credits: Walmart

This is the third week in a row Walmart gets a mention here. First it was funding for GreyOrange, which it partnered with in Canada. Last week we noted a big expansion of the retail giant’s deal with warehouse automation firm, Symbotic. Now it’s another big expansion of an existing deal — this time dealing with the company’s delivery ambitions.

Like Walmart’s work with robotics, drone delivery success has been…spotty, at best. Still, it’s apparently ready to put its money where its mouth is on this one, with a deal that brings DroneUp delivery to 34 sites across six U.S. states. Quoting myself here:

The retailer announced an investment in the 6-year-old startup late last year, following trial deliveries of COVID-19 testing kits. Early trials were conducted in Bentonville, Arkansas. This year, Arizona, Florida, Texas and DroneUp’s native Virginia are being added to the list. Once online, customers will be able to choose from tens of thousands of products, from Tylenol to hot dog buns, between the hours of 8 a.m. and 8 p.m.

Freigegeben für die Berichterstattung über das Unternehemn Wingcopter bis zum 25.01.2026. Mit Bitte um Urhebervermerk v.l.: Jonathan Hesselbarth, Tom Plümmer und Ansgar Kadura von Wingcopter GmbH. Image Credits: © Jonas Wresch / KfW

There are still more question marks around this stuff than anything, and I’ve long contended that drone delivery makes the most sense in remote and otherwise hard to reach areas. That’s why something like this Wingcopter deal is interesting. Over the next five years, the company plans to bring 12,000 of its fixed-wing UAVs to 49 countries across Sub-Saharan Africa. It will cover spots that have traditionally struggled with infrastructural issues that have made it difficult to deliver food and medical supplies through more traditional means.

“With the looming food crisis on the African continent triggered by the war in Ukraine, we see great potential and strong social impact that drone-delivery networks can bring to people in all the countries in Sub-Saharan Africa by getting food to where it is needed most,” CEO Tom Plümmer told TechCrunch. “Especially in remote areas with weak infrastructure and those areas that are additionally affected by droughts and other plagues, Wingcopter’s delivery drones will build an air bridge and provide food from the sky on a winch to exactly where it is needed.”

Legitimately exciting stuff, that.

Image Credits: Dyson

In more cautiously optimistic news, Dyson dropped some interesting news this week, announcing that it has been (and will continue) pumping a lot of money into robotic research. Part of the rollout includes refitting an aircraft hangar at Hullavington Airfield, a former RAF station in Chippenham, Wiltshire, England that the company purchased back in 2016.

Some numbers from the company:

Dyson is halfway through the largest engineering recruitment drive in its history. Two thousand people have joined the tech company this year, of which 50% are engineers, scientists, and coders. Dyson is supercharging its robotics ambitions, recruiting 250 robotics engineers across disciplines including computer vision, machine learning, sensors and mechatronics, and expects to hire 700 more in the robotics field over the next five years. The master plan: to create the UK’s largest, most advanced, robotics center at Hullavington Airfield and to bring the technology into our homes by the end of the decade.

The primary project highlighted is a robot arm with a number of attachments, including a vacuum and a human-like robot hand, which are designed to perform various household tasks. Dyson has some experience building robots, primarily through its vacuums, which rely on things like computer vision to autonomously navigate. Still, I say “cautiously optimistic,” because I’ve seen plenty of non-robotics companies showcase the technology as more of a vanity project. But I’m more than happy to have Dyson change my mind.

Image Credits: Hyundai

Hyundai, of course, has been quite aggressive in its own robotics dreams, including its 2020 acquisition of Boston Dynamics. The carmaker this week announced that part of its massive new $10 billion investment plans will include robotics, with a focus of actually bringing some of its far-out concepts to market.

Another week, another big round for logistics/fulfillment robotics, as Polish firm Nomagic raised $22 million to expand its offerings. The company’s primary offering is a pick and place arm that can move and sort small goods. Khosla Ventures and Almaz Capital led the round, which also featured European Investment Bank, Hoxton Ventures, Capnamic Ventures, DN Capital and Manta Ray.

Amazon Astro with periscope camera

The periscope camera pops out and extends telescopically, enabling Astro to look over obstacles and on counter tops. A very elegant design choice. Image Credits: Haje Kamps for TechCrunch

We finally got around to reviewing Amazon’s limited-edition home robot, Astro, and Haje’s feelings were…mixed:

It’s been fun to have Astro wandering about my apartment for a few days, and most of the time I seemed to use it as a roving boom box that also has Alexa capabilities. That’s cute, and all, but $1,000 would buy Alexa devices for every thinkable surface in my room and leave me with enough cash left over to cover the house in cameras. I simply continue to struggle with why Astro makes sense. But then, that’s true for any product that is trying to carve out a brand new product category.

A tiny robot crab scuttles across the frame. Image Credits: Northwestern University

And finally, a tiny robot crab from Northwestern University. The little guy can be controlled remotely using lasers and is small enough to sit on the side of a penny. “Our technology enables a variety of controlled motion modalities and can walk with an average speed of half its body length per second,” says lead researcher, Yonggang Huang. “This is very challenging to achieve at such small scales for terrestrial robots.”

Image Credits: Bryce Durbin/TechCrunch

Scuttle, don’t walk to subscribe to Actuator.

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Asymptomatic SARS-CoV-2 infections responsible for spreading of COVID-19 less than symptomatic infections

Based on studies published through July 2021, most SARS-CoV-2 infections were not persistently asymptomatic, and asymptomatic infections were less infectious…

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Based on studies published through July 2021, most SARS-CoV-2 infections were not persistently asymptomatic, and asymptomatic infections were less infectious than symptomatic infections. These are the conclusions of an update of a systematic review and meta-analysis publishing May 26th in the open access journal PLOS Medicine by Diana Buitrago-Garcia of the University of Bern, Switzerland, and colleagues.

Credit: Monstera, Pexels (CC0, https://creativecommons.org/publicdomain/zero/1.0/)

Based on studies published through July 2021, most SARS-CoV-2 infections were not persistently asymptomatic, and asymptomatic infections were less infectious than symptomatic infections. These are the conclusions of an update of a systematic review and meta-analysis publishing May 26th in the open access journal PLOS Medicine by Diana Buitrago-Garcia of the University of Bern, Switzerland, and colleagues.

Debate about the level and risks of asymptomatic SARS-CoV-2 infections continues, with much ongoing research. Studies that assess people at just one time point can overestimate the proportion of true asymptomatic infections because those who go on to later develop symptoms are incorrectly classified as asymptomatic rather than presymptomatic. However, other studies can underestimate asymptomatic infections with research designs that are more likely to include symptomatic participants.

The new paper was an update of a living (as in, regularly updated) systematic review first published in April 2020, which includes additional, more recent studies through July 2021. 130 studies were included, with data on 28,426 people with SARS-CoV-2 across 42 countries, including 11,923 people defined as having asymptomatic infection. Because of extreme variability between included studies, the meta-analysis did not calculate a single estimate for asymptomatic infection rate, but it did estimate the inter-quartile range to be that 14–50% of infections were asymptomatic. Additionally, the researchers found that the secondary attack rate—a measure of the risk of transmission of SARS-CoV-2 — was about two-thirds lower from people without symptoms than from those with symptoms (risk ratio 0.32, 95%CI 0.16–0.64).

“If both the proportion and transmissibility of asymptomatic infection are relatively low, people with asymptomatic SARS-CoV-2 infection should account for a smaller proportion of overall transmission than presymptomatic individuals,” the authors say, while also pointing out that “when SARS-CoV-2 community transmission levels are high, physical distancing measures and mask-wearing need to be sustained to prevent transmission from close contact with people with asymptomatic and presymptomatic infection.”

Coauthor Nicola Low adds, “The true proportion of asymptomatic SARS-CoV-2 infection is still not known, and it would be misleading to rely on a single number because the 130 studies that we reviewed were so different. People with truly asymptomatic infection are, however, less infectious than those with symptomatic infection.”

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In your coverage, please use this URL to provide access to the freely available paper in PLOS Medicine:

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003987  

Citation: Buitrago-Garcia D, Ipekci AM, Heron L, Imeri H, Araujo-Chaveron L, Arevalo-Rodriguez I, et al. (2022) Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: Update of a living systematic review and meta-analysis. PLoS Med 19(5): e1003987. https://doi.org/10.1371/journal.pmed.1003987

Author Countries: Switzerland, France, Spain, Argentina, United Kingdom, Sweden, United States, Colombia

Funding: This study was funded by the Swiss National Science Foundation http://www.snf.ch/en (NL: 320030_176233); the European Union Horizon 2020 research and innovation programme https://ec.europa.eu/programmes/horizon2020/en (NL: 101003688); the Swiss government excellence scholarship https://www.sbfi.admin.ch/sbfi/en/home/education/scholarships-and-grants/swiss-government-excellence-scholarships.html (DBG: 2019.0774) and the Swiss School of Public Health Global P3HS stipend https://ssphplus.ch/en/ (DBG). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


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Harsher COVID-19 restrictions associated with faster “pandemic fatigue”

Between November 2020 and May 2021, adherence to COVID-19 pandemic restrictions decreased in Italy, with the fastest decreases taking place during times…

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Between November 2020 and May 2021, adherence to COVID-19 pandemic restrictions decreased in Italy, with the fastest decreases taking place during times of the most stringent restrictions, according to a new study publishing May 26th in the open-access journal PLOS Digital Health by Laetitia Gauvin of ISI Foundation, Italy, and colleagues.

Credit: Ben Garratt, Unsplash (CC0, https://creativecommons.org/publicdomain/zero/1.0/)

Between November 2020 and May 2021, adherence to COVID-19 pandemic restrictions decreased in Italy, with the fastest decreases taking place during times of the most stringent restrictions, according to a new study publishing May 26th in the open-access journal PLOS Digital Health by Laetitia Gauvin of ISI Foundation, Italy, and colleagues.

Pandemic fatigue, the decreased motivation to adhere to social distancing measures and adopt health-protective behaviors, represents a significant concern for policymakers and health officials. In the time period spanning November 2020 to May 2021 in Italy, tiered restrictions were adopted to mitigate the spread of COVID-19, with regions declared red, orange, yellow or white depending on their health data. Restrictions ranged from a nighttime curfew in the yellow tier to general stay-at-home mandates in the red tier.

In the new study, the researchers used large-scale mobility data from Facebook and Google captured in all 20 Italian provinces in 2020 and 2021 to analyze the timing of pandemic fatigue. Facebook reports the change in a user’s number of movements over time, while Google data estimates the change in time spent at home.

People’s relative change in movements increased an average of 0.08% per day and their time spent outside the home increased by an average 0.04% per day, leading to a more than 15% increase in relative mobility over the entire seven-month study period. During times of red tier restrictions, individual mobility increased an additional 0.16% per day and time spent outside the home increased an additional 0.04% when compared to the average. This means that during every 2-week period spent in the red tier, there would be an additional average 3% increase in relative mobility.

The authors conclude that changes to pandemic restrictions are faster during periods characterized by the strictest levels of restrictions. However, they acknowledge that the data used are subject to bias since they include only Facebook and Google users who opted-in to location sharing. In addition, untangling the combined effects of vaccination and new pandemic variants on adherence to pandemic restrictions was not within the scope of the study and requires more work.  It is also important to note that the study did not investigate on the effectiveness of each tiered restriction against the spread of SARS-CoV-2.

Gauvin adds, “By analyzing mobile phone-derived mobility data in Italy, we investigated how adherence to COVID-19 restrictions changed over time, under different levels of increasing stringency. Our results show that adherence can be difficult to sustain over time and more so when the most stringent measures are enforced. Given that milder tiers have been proven to be effective in mitigating the spread of COVID-19, our study suggests policymakers should carefully consider the interplay between the efficacy of restrictions and their sustainability over time.”

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In your coverage, please use this URL to provide access to the freely available article in PLOS Digital Health: https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0000035

Citation: Delussu F, Tizzoni M, Gauvin L (2022) Evidence of pandemic fatigue associated with stricter tiered COVID-19 restrictions. PLOS Digit Health 1(5): e0000035. https://doi.org/10.1371/journal.pdig.0000035

Author Countries: Italy

Funding: The study was partially supported by the Lagrange Project of the ISI Foundation funded by the CRT Foundation. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.


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