i dont have time to find the article, but the suggestion for the delayed start to whatever the announcement tomorrow will be is due to (1) getting more 2nd doses in arms and (2) exactly what you mention, that the 4 nations will need time to make their determinations as well after the announcement.

Yes, an exit wave and increase in hospitalisations has been modelled by SAGE since the start of the year. There is no exit from lockdown which didn't involve increased hospitalisations.

Just for some more context, here is some recent modelling done by SAGE

https://assets.publishing.service.go...map_step_4.pdf

At this point in early July even the most optimistic model done had daily hospitalisations at 565, the central at 1004, and the most pessimistic at 1788.

Here is the last week's worth of daily admissions for England:

We are actually well below what was modelled, in fact over 25% below even the most optimistic model. It is actually very good news. So what we are seeing is in fact much better than what was predicted.

Also it is really good to see deaths continuing to remain very low

https://cimg1.ibsrv.net/gimg/www.fly...508c6b2f40.png

In the model the peak is mid august (assuming phase 4 opening the 19th July), not now. The peak correspond to after the final stage 4 opening. Current growth rate is doubling every 10 days for admissions. If current rate continues (and nothing say it will), at the planned date of the peak it will be around 1500-2000 admissions a day.

Yes the most pessimistic model does note that. As I have shown though we are nowhere near the most pessimistic model. We are not even above the most optimistic model. It is very good news so far.

Out of interest, are you able to point to a model which avoids any increases during an exit from lockdown? What happens in those models if you delay further relaxation of restrictions to autumn?

A bit late today because of a change in time zone. Daily data:

Cases 32,548 (26,068 last Wednesday)
Deaths 33 (14)
Patients admitted 386 (263 on the 26th)
Patients in hospital 2,446 (1,720 on the 29th)
Patients in ventilation beds 393 (283 on the 29th)
People vaccinated up to and including 6 July 2021:
First dose: 45,514,492
Second dose: 34,027,302

The rolling seven day daily average for cases is now up 42.8% on the previous week and the same measure for deaths is up 42.5%. The rolling 7 day daily average for deaths is 23.0 today.

Yes, unless we were willing to go into a sharp lockdown now, case numbers will rise, and hospitalisations will rise too. When 97% of those over 50 are showing antibodies to Covid (via vaccination or infection) declaring another lockdown just isn't going to happen. So we are down to managing an increased level of hospitalisation. The RVI is the largest hospital of its sort in the North East and currently has just 18 admitted patients (staying overnight). 12 are not showing on NIMS as having any vaccine, 6 have had one vaccine, 2 of them in the days before admission, just 1 has had both vaccines and the second vaccine was only recently given. The other person we haven't found out their real name yet. One patient is in intenisve care, mid 20s with no obvious underlying health conditions, unvaccinated. These are a fraction of the numbers we had in January, when we admitted patients taken by ambulance up the A1 from north London due London's hospitals being overwhelmed. We aren't using "bank" staff (zero hours staff who can be called in as and when) and normal holiday patterns are going ahead. And this hospital is about 10 minutes walk from one the worst infection spikes in Europe. with 7 day case rate in excess of 1,500.

When it comes to models, it's important to realise they are not forecasts as such. They are in place to assist with scenario planning. The NHS and HMG doesn't really need forecasts per se, but it does need to be able to respond if X, Y and Z happens plus a train falls off the King Edward VII Bridge all at once. Hence a number of assumptions are made, and outcomes then indicate what may happen to start a debate about what to do. So they are very valuable and help capacity and resouce planning, but they are not quite the same as forecasts.

That rolling 7 day average increase is slowly ticking down again (down to 42% from over 70%) .... fingers crossed it continues in the coming days

With the daily published hospital admissions - are there significant numbers of worried people who find it hard to breathe, go to A&E, get admitted out of an abundance of caution, then get checked over and told to recuperate at home, and get discharged after a few hours? Is the mechbed figures a better metric for the seriously ill?

I think the shock is that there is quite a big difference between the model from April (pre delta variant) where completing stage 4 would lead to a peak of between 4k and 10k hotel occupancy (in total, not daily admissions), and where we are today.

https://cimg8.ibsrv.net/gimg/www.fly...a9ca218ad8.png


https://assets.publishing.service.go..._Statement.pdf

I think it is understandable that many people are concerned about current plans (which are effectively herd immunity driven by infections in the unvaccinated). The good news is deaths are likely to be lower due to the success of the vaccination program. The concern is infections, hospitalisations (and the long-term effects of those in the minority of people) are likely to be much bigger than previously considered acceptable. It will be interesting to see the SAGE numbers and report used for the decision when they are published next week, and I think personally I don't want to pass judgment until I've seen these.

The Independent article on that NHS trust cancelling operations caused me to have quite a giggle. I know it's not their fault, but the NHS has been doing that for ages. I had a former teammate of mine who had a pretty serious operation (a fairly invasive one to a very private area of her body) cancelled 6 times, one of those as she was checking herself in at the hospital. And this was in the summer of 2018, by a Trust in Bucks, not Aleppo. The NHS lost half its beds since the late 1980s, and 34% of its intensive care beds: no surprise that the manure hits the spinning blades anytime something goes not quite alright.

Is 19 July still the date we are all expecting?

All will be revealed tomorrow. Unless it isn't.

You summarised the idea: the current numbers are already above models (because we are not at peak yet, 523 or whatever the optimistic number was is at peak). And yes reopening will lead to hospitalisations, but I thought the argument was that this should not impact other lives, i.e it should be manageable without cancelling major planned surgeries and so on. Otherwise this is again letting the NHS take the blunt of it and most of their ressources. Which is why all those effort were made: to avoid it. And this is still avoidable.

Well I hope you weren't watching the football, I think your head might explode! :)

I'm shocked at the result, too :)