Chris Worfolk's Blog

They say that the necessity is the mother of all invention. With the impending COVID-19 crisis looming, we decided it was finally time to make virtual appointments part of Leeds Anxiety Clinic’s offerings.

That was easier said than done. Because of the social distancing recommendations already in effect, and Amazon having halted warehouse shipments, the few webcams that were available had all been panic-bought by other people. Luckily, we were able to beg and borrow the equipment we needed until we could get our own.

We’re still playing around with how to produce the best quality experience, both in terms of the technical setup and the differences between delivering therapy face-to-face, where you can easily scribble a diagram or analyse holistic body movements, and delivering it digitally. Early efforts are working well, though.

At first glance, yesterday’s figures do not look too bad. Both Italy and Spain seemed to have stopped shooting up. But the provisional figures from today (Friday) mean that they are both going to set new heights tomorrow.

It’s a bad day for France and the UK, too, who both had record days.

Here is the other big change: I have also started tracking Netherlands. Why? Because Netherlands are sticking hard to the herd immunity strategy. This was mentioned in the UK and, depending on who you believe, was always a side-effect of the plan, or the plan until Johnson’s critics spooked him into adopting the current approach. Tracking Netherlands may provide some evidence as to how effective the lockdowns are.

Let’s look at total deaths.

The first thing to explain: I have now capped this at 60 days, rather than expanding it as the dataset grows. This makes it easier to see the curves in the early days. It does mean we are now missing the past five days from China. But the line is basically flat (they are still having a handful of deaths per day, though).

Second thing: I have included the UK’s provisional figures from today in the report. That makes the graph look much scarier. We are the blue line. Until this point, we could hold out some hope that our line would follow the green line (China) and not the red line (Italy). But at this point, it looks like we are accelerating on “the European trajectory” as we could call it.

And, to state again, the UK is ahead of almost every other country was on day 15. This includes Italy. Spain is the only exception, who are way ahead of everyone. Ignore the single dot from Netherlands, that is erroneous data. Currently, they are roughly in line with other European countries.

I’ve been working super hard on my front crawl since September: getting in the pool three times a week, every week, and relentlessly doing drills. It’s going well. In February, I reached 3km continuous.

Unfortunately, now all the pools are closed so everything has come to a halt. Lakes are too cold, and there are movement restrictions anyway. Let’s hope that better times are on their way soon.

It was a bad day for Spain yesterday who reported more deaths than Italy. Italy, on the other hand, maybe showing signs of levelling off. The UK had a fairly good day, but that may be due to underreporting: the BBC said the timeframes were chopping and changing, which might explain why we had few deaths yesterday but over one hundred today.

Here is the new graph for today. It shows cases across England broken down by NHS region, with the separate nations (Scotland, Wales, Northern Ireland) also getting their own slice of the pie.

A third of the cases are in London. But that is not abnormally high: they have 13% of the population and the most international travellers passing through. Still, might make you think twice before taking the tube. Otherwise, it is fairly well spread out across the country.

I mean, we have definitely had better days. Spain, France, the UK and the United States all had their highest ever death count yesterday. And bear in mind that I am only tracking seven countries. But there is a silver lining: although Italy had a bad day, too, it was not as bad as two days ago.

It is still too early to say whether the UK is going to follow Europe or China. But it would seem odd if it did follow China given we have been taking at best similar, and at worse, much more lax measures than the rest of Europe, while China went into lockdown early and did a lot of testing.

The problem is that we are still earlier on in this than everyone else. We’re on day 12. Italy is on day 29, Spain is on day 17 and France is on day 18. At this stage, everyone except Spain was behind us. Early indications from the NHS is that today wasn’t too bad, but it’s only 9pm, so we’ll have to wait and see.

I’ve updated the graphs for today. WHO report on what happened yesterday, so when I say today, I mean the data the WHO published today, but it’s actually yesterday’s data. And yesterday wasn’t too bad. Italy continued to decline for the second day in a row. And when I said the borderline for good for the UK was 331 deaths, we came in at 335, so pretty close.

That said, based on today’s media reports, we know that the UK, Italy and Spain are all having a really bad today. So, tomorrow the graphs are likely to look terrible.

Anyway, onto today’s graphs. I took the figures from Imperial College London on the likely mortality rates of COVID-19. These are adjusted based on many cases not being reported, and for a UK/US healthcare system.

I want to preface the following by sating: just because you have a low risk of dying, does not mean you can go around doing whatever you like. You can spread the virus without knowing and you could end up spreading it to someone with underlying health conditions, who are much more likely to die. And that would make you a murderer, morally, although not legally.

Ok, the graphs. First, your risk of dying is low.

Even if you are in the 80+ age category, you only have a 27% chance of needing hospital treatment and a 9% chance of dying. That is much higher than the everyday life of course! This is a serious thing that kills people. A lot of people.

But, for an individual’s risk, you have a 3/4 chance of being able to cope at home, and a 10/11 chance of surviving. Certainly not a Russian roulette game any of us would want to play. But it is good to know that our grandparents having a fighting chance.

Below, is the same graph but zoomed in. The X-axis only runs to 30%. This is not representative of your overall chances but means we can see it better.

In the lower age categories, the outcome looks rosy. If you are in your 30s, for example, you have a 3% chance of requiring hospitalisation and a one in a thousand chance of dying.

I don’t know what percentage of the population have underlying health conditions. But I imagine it increases with age and maybe around 3% for someone in their 30s and may well be 9% for someone in their 80s. If so, that would mean that COVID-19 typically only kills when you have underlying conditions. But I don’t have those figures, I’m speculating. The WHO has stressed that younger people are not invulnerable and they are literally the World Health Organisation, so we should listen to them.

It also seems likely that the stats for underlying health conditions are much higher than those percentages and that most people with underlying conditions are also fine. Or as fine as you can be when you have a nasty flu. As Chris Whitty keeps reminding us, the vast majority of people, even in “at-risk” categories, will get over it.

That’s all for today. See you tomorrow to talk about Black Tuesday :(.

Yoga for Athletes is a book by Ryanne Cunningham. It provides an introduction to yoga and makes some suggestions as to how athletes can use yoga. But, to be honest, it all felt pretty vague. More like a general book of yoga with a nod given to the idea that the reader may also be an athlete and that yoga could be useful for that.

The various poses are explained, but not in a manner I found completely clear. The routines may be more useful, but only make up a few pages at the back of the book.

The WHO has now released today’s situation report. Here are some of the headlines:

• China and South Korea are still seeing deaths, but not many.
• Italy recorded 649 deaths, compared to 795 yesterday. It has dropped before and then continued to rise, though.
• The US has reported 201 deaths today, doubling their total. As none were reported yesterday, could just be delayed figures?

Let’s update the graphs.

Deaths per day

Let’s hope today’s result is a sign that Italy is turning the tide and not just an anomaly. On the other hand, let’s hope the US result is an anomaly based on delayed data and goes back to normal tomorrow.

My previous graph showed the incorrect figure for the UK yesterday, which I have now corrected in this graph.

Cumulative deaths

Nothing terribly important to report here, I think. Italy and Spain are still on scary trajectories. It’s too early to say what is going on in the UK. We might follow China. But it is important to remember that Italy weas behind China until day 15. We’re only on day 10, so there is plenty of time for it to accelerate on Italy’s path.

Massively simplistic rules of thumb are a bad idea. But let’s make some anyway. It’s unlikely to start magically dropping at this point (see below), so anything below or around 331 cumulative tomorrow would be a good result. Anything significantly above that would be a bad result. And anything around the 381 mark would be a terrible result.

Social distancing has a delayed effect

One final thought: there is probably at least a 14-day delay between implementing social distancing and seeing any benefit. The virus has an incubation period, then five days of fever and coughing, then the respiratory issues kick in.

We implemented our first set of social distancing (telling people to work from home and not gather in groups) on Tuesday 15 March. That’s six days ago.

We implemented our second set, closing schools and telling people “seriously, stay away from each other” on Saturday 21 March. That was two days ago.

That means that we have 8-12 days of nobody was social distancing damage before we even get to the “we told you all to distance, not cough on each other in the royal parks” damage, which may or may not be resolved. What you do today affects what happens in the ICU two weeks from now.

Fed up of your 2020 races being cancelled and lacking motivation? Let me introduce you to the Covidman triathlon.

Triathlon training is hard. It requires a lot of dedication. Ideally, it requires a goal. That is why so many of us pick some big A races each year and work towards them. But the 2020 season is not giving us any of that. Early races, as far as World Triathlon Leeds in June, have already been cancelled. Many more cancellations are likely to follow.

So, how do we stay motivated when there is nothing to train for?

I’m proposing Covidman. It is an unsupported one-person race you do by yourself. Pick your distance and swim, bike and run as appropriate.

This is a tricky proposition in itself. Namely, where does one swim? If the pools remain closed, it is unlikely there will be organised swim sessions. Let’s hope the North Sea is nice and warm this year, if so. And certainly worth investing in a tow float.

The bike course should be less of a problem as there are very few cars on the road. On long format, toilet breaks might need to be rather natural, and some homemade aid stations might become necessary. Short format could be done on a turbo, although I find anything more than an hour of indoor cycling to be deeply uncomfortable on my bottom.

Finally, the run. Even in short format, most people appreciate an aid station by this point, so perhaps laps around our houses might be the best option.

It should be clear by this point that I don’t really have a plan. Just a rough outline and an ironic name. But I am no longer training aimlessly: I’m training for Covidman.

I’ve been running some numbers based on the situation reports provided by the World Health Organisation. It is not a fun read. But the situation should improve once the first shipment of thoughts and prayers arrive in Europe.

I’m happy to take feedback on these. I’m not a statistician (although there is a lot of stats in psychology), and if you are one and think my graphs are terrible and misleading, I’m open to being corrected.

Deaths per day

China has the most deaths because they have been dealing with this for a long time. People have been dying for 7 weeks now. But not many people and their levels have been going down. The deaths per day in Italy and Spain is far out-racing anything than China saw.

To clarify, this is not cumulative. Even a flat line represents a lot of people dying. A line going up suggests the problem is getting a lot worse.

China still has a problem

This shows the number of deaths per day in China over the past two weeks.

The media are reporting that life in China is going back to normal and that any remaining cases are from people arriving in China. It is true that life is starting to return to normal and people are going outside again. Emergency hospitals have closed and travel restrictions have gone.

However, people are also still dying and the World Health Organisation still reports local transmission.

How far in are we?

This shows the cumulative number of deaths since the 10th death. I followed the Financial Times’s lead on adjusting it this way as, for example, France had one death very early on and then none for a long time. Once you reach the tenth death, you get a far more accurate picture to compare against. Unlike the FT graph, it is not logarithmic. Their graph is just better, to be honest.

At this stage, it is pretty difficult to predict what the UK curve is going to do. We’re only on day 9, compared to day 26 for Italy, day 14 for Spain and day 60 for China.