Beware of alarming leaked reports about the state of our hospitals

Good morning Millers - welcome to this week’s Monday briefing. As usual, it includes the latest Covid data for Greater Manchester, where hospital deaths have risen modestly from 17 per day to just under 21 per day in the past week. It also makes the case - at the end of the newsletter - for being wary of anonymous leaks in the media about the state of our hospitals, and why we should focus a bit more on actual published figures.

Before we get to that: We would really like to speak to a few readers who are shielding or have spent a lot of time isolated at home in the past six months because of their health situation. If that’s you, please hit reply, and if you know someone in that position please forward on this newsletter and ask if they would be willing to speak to us ([email protected] is the email). You won’t need to be named or identified in the story if you don’t want to be.

And the usual request: if you find this briefing useful, please forward it to a friend and tell them why you read The Mill. Your sharing is the main reason why we have more than 5,000 people on our email list and more than 500 paying members after just 5 months of publishing, so thanks very much. You can also use the button below.

Lockdown | In the end, the ill-tempered negotiations over Tier 3 lasted longer than the restrictions themselves. From midnight on Wednesday night, we will be living under the same lockdown as the rest of the country. Hospitality businesses and non-essential shops will close, as will museums, galleries and gyms. Everyone who can work from home will be required to so. The government has published a bit more detail about the restrictions, which you can read here. They are supposed to end December 2nd, although last time the lockdown lasted much longer than planned. The 80% furlough scheme is back (despite being impossible a few weeks ago when it was just northern localities who needed it) and it’s being reported that Boris Johnson will announce details of support for the self-employed when he addresses the Commons later today.

Closing schools | Andy Burnham’s response to the announcement of a national lockdown has been to call for schools to close. The Mayor of GM says he wants “a true circuit break and not a halfway house approach.” When the Prime Minister announced the lockdown, he said schools and universities will remain open because "we cannot let this virus damage our children’s futures even more than it has already." But yesterday Burnham responded by saying: "It's my view we do need to have a period of closure in our schools if we are to get those cases right down and avoid a scenario where large parts of the North West are simply put back into tier 3.”

Pride of Moston | A 92-year-old grandmother from Moston has been recognised by the Pride of Britain Awards for her work with young offenders. Dena Murphy runs a community allotment where she has taught hundreds of the youngsters how to grow fruit and veg, and from which she produces weekly meals for local pensioners too. Somehow she’s also found time to operate a food delivery service for elderly residents who are housebound. After being given the Community Hero award last night, she said: “It’s not like me to be speechless, I never expected this. It’s the first time in 30 years I’ve actually cried.”

Dena Murphy holds one up one hand as she explains some advice she was given years ago. “A very wise man once said to me, ‘how many hands do you have?’ Two I replied. ‘And which one do you use most?’ he asked. My right, I replied. ‘In that case, that leaves you with your left hand to help others.’ I have never forgotten that.” Watch an interview with her here.

Lost walker | On Thursday afternoon, a walker in the Peak District called police to say she was lost, somewhere between Crowden and Black Hill. Search teams were rapidly sent out to the summit of the hill, while others from Glossop, Oldham, Bolton and Holme Valley were put on standby. After the woman didn’t answer her phone, all five teams were deployed. The five-hour search was only called off when the woman’s car registration was picked up by an automatic recognition camera as she drove home to Lincolnshire. It’s not known why she didn’t alert authorities that she had found her way to her car.

Worth a listen: The Financial Times has a great weekly podcast called Payne’s Politics (it’s hosted by the paper’s Whitehall correspondent Sebastian Payne), which often gives you a bit more depth and nuance on the week’s Westminster news than daily reporting. This week’s episode features a discussion about Jeremy Corbyn’s suspension from the Labour Party, and an interview with Andy Burnham about devolution and why a bus ticket in Wigan costs more than one in London.

Worth a follow: If you are on Twitter, Sunday Times northern correspondent and Mill member David Collins is a great journalist to follow. He regularly breaks big stories in Manchester (including some superb reporting on the city’s courting of overseas property investors) and also advocates for a less London-centric media and government. His tweet this morning is a campaign we can get behind:

Things to do this week

Film | Head to The Light Cinema in Stockport tonight to see Phil Lynott: Songs for While I'm Away. It’s a feature doc “telling the story of how a young black boy from working class 1950s Dublin, became Ireland's Greatest Rock Star.” Book your tickets here, and remember cinemas will be closed from Thursday.

Comedy | Spanish comedian Ignacio Lopez - who describes himself as “Spain's Best Export. UK's Favourite Import (citation needed)” - is recording a comedy special at the Frog and Bucket on Wendesnight night, at 6.30 and 8.30. “Get tickets, it’s your last opportunity to laugh for a month,” he says. You can do so here.

Art | Given the dystopian flavour of the world we are living in, you might want to spend your last day of freedom in the Whitworth’s exhibition about Utopias. The exhibition probes “how Britain's literary and visual culture has perpetuated an idea of a utopian society that fosters nostalgic yearnings for a seemingly lost past.” Your window is narrow - 11 am to 4 pm on Wednesday. Booking details here.

Theatre | The lockdown will wipe out most of this month’s Greater Manchester Fringe Festival - or at least the in-person shows - but tonight and tomorrow night you can catch an experimental show at The King’s Arms in Salford. The Delirium of Phobos is “based on the genres of fantasy, nonsense and absurdity as well as utilising different performance genres including circus and dance,” the listing says. Book here.

Latest Covid data

Deaths: This time last week we said that around 17 people per day were dying in Greater Manchester’s hospitals after testing positive for Covid. Thankfully that number hasn’t risen hugely - it’s now just under 21 deaths per day (that’s for the week ending last Thursday). If it’s useful as a frame of reference, Greater Manchester has 10 hospital trusts, each covering multiple hospitals, so 21 deaths per day equates to about two per trust per day.

The number of deaths per day has doubled over the past fortnight, which represents slower growth than we saw in the run-up to the peak in April. The daily death rate is now just past a third of the Spring peak, when we saw a week where deaths averaged 57 per day. As always, we have to note that some of these deaths will be people who tested positive for Covid but for whom the disease is not the main reason they are dying. The graph below shows deaths per day since the start of the pandemic.

Hospital capacity: There are now 100 patients with Covid in critical care beds in Greater Manchester's hospitals, up from 62 the week before, we learned on Friday. Andy Burnham told reporters that overall critical care occupancy is “not necessarily unusual for this time of year” and reiterated that capacity is not fixed at its current level and can expand.

67 people were hospitalised with Covid last week, which is up from 39 the week before but pretty similar to the 60 we saw the week before that. It equates to just under 10 people hospitalised per day or just less than one person hospitalised per hospital trust per day. One number that is rising fast is patients diagnosed with Covid who are already in hospital for something else - that was 649 last week, up from 493 the week before. We don’t know a huge amount about these patients and how badly they are suffering from Covid, so will try to find out more this week.

Click on our tweet above to see all the hospital figures going back into September.

Infection rates: When it comes to new positive tests, the picture is broadly similar to last week: infection rates are very high in Greater Manchester but aren’t growing rapidly anymore. Oldham has secured the coveted first place with a rate just under 700 new infections per 100,000 residents, followed by Wigan (665), Salford (615) and Rochdale (576). Trafford is bottom (403), and Stockport is also in the drop-zone (446).

If tracking infection rates is your thing, the MEN is very good at calculating them every day and putting them in a clear graphic - see their latest post here. As we’ve written many times, rates are highly contingent on how much testing a borough is doing and where various mobile testing units are popping up, so you can’t read too much into small variations.

The Mill Take: The problem with leaked warnings

By Joshi Herrmann

If you made a one-month sales forecast for your boss at work and by the end of the month it was out by a factor of 20, you might expect to get an earful for it. Even if you didn’t, your boss would be forgiven for thinking you were an unreliable forecaster and might be wary the next time you made a similar projection.

That’s what accountability is. You are being held to account by your boss for being bad at forecasting. But it only works if your boss knows you are the one you made the forecast. If they don’t - if your forecast is anonymous and is picked out of a hat - then next time a forecasting task comes up, your boss might give it to you again.

Which is a long way of saying: you need to be careful when you read warnings and forecasts that have been leaked to newspapers. You usually don’t know exactly who made the forecast, so no one can ask them what their assumptions were or why it was made. You also don’t know who leaked it, so they can’t be asked why they chose to give this forecast to the media but not another, less scary one they saw two days before.

We’ve just seen a stark example of this recently. On October 7th, the MEN had a sensational and alarming story based on leaked projections about our hospitals. It was headlined: “Greater Manchester’s Covid hospital admissions projected to hit April peak in three weeks.” The story explained:

Journalistically, this was a brilliant exclusive and it was quoted prominently in The Times and by many other newspapers and news bulletins the next day. At that point, Covid hospital admissions were about 5 per day. The month of October ended this weekend, and as you’ve already read in this briefing, admissions last week were just under 10 per day. So the forecast was out by a factor of about 24.

Even for hard-to-predict numbers in the midst of a chaotic pandemic, that is way off-base (as some of us bravely predicted it would be). The story told us admissions were projected to grow by almost 50x in the space of a few weeks. In fact, they grew around 2x. Even if you count most of the in-patient diagnoses we’ve seen as admissions, the forecast is still way off.

So, who is accountable for it? Who has to explain why they were so wrong and how they have improved their methods to be more accurate next time so they don’t scare people unnecessarily about the availability of beds at their local hospitals? No one.

We are told it came from “Public Health England and the conurbation’s health and social care partnership” - so that narrows it down to two enormous organisations, and neither will admit they made this forecast and therefore have to explain it.

Equally, that same person who leaked it could choose another scary forecast from the many that have crossed their desk and leak it tomorrow, and we wouldn’t have any idea that it’s the same person. No one who will have to answer some tough questions about their credibility next time they go on telly.

This is not an eccentric point to be making. When Andy Burnham was asked on Friday to comment on another report about the situation in our hospitals based on an anonymous leak, he forcefully warned against relying on “speculative” stories and “leaked reports”. Instead, he asked the media to focus on the actual numbers that the NHS is reporting - the ones we publish every week in this briefing.

Two weeks ago we had another leaked report about Greater Manchester hospitals, this time reported on the front page of the Guardian. Thankfully on this occasion, it took 24 hours to clarify itself, rather than three weeks.

Based on a “leaked NHS document” it said the resurgence of the virus had left “hospitals in Salford, Stockport and Bolton at maximum capacity, with no spare beds to help the growing influx.” Again that story was widely reported, before being corrected 24 hours after it first appeared online. Now it only refers to some critical care wards being full - which is sadly very common at this time of year.

We don’t know what the leaked NHS document exactly said, and how it can have meant whole hospitals were full one day and then been re-interpreted to mean specific wards were full the next. We also can’t ask the person who made it about how it was defining “maximum capacity”, which is a surprisingly hard-to-define area when hospitals have surge capacity available. There is very little accountability with the source of the information.

How many people in Bolton, Salford and Stockport read that story - or the various stories which copied it without checking - and felt unnecessarily scared that their local hospital was full? Did anyone decide against going to the hospital as a result? It doesn’t bear thinking about.

This problem isn’t unique to leaked health reports in a pandemic - the same issue exists when you are reading off-the-record sources in any story. Stories that are full of anonymous officials and politicians making predictions about how a policy is going to end or how bad the second wave is going to be aren’t accountable for their rubbish predictions. That’s why it’s good to demand of journalists that they get as many of their interviews on the record as possible. But that’s a topic for another day.

For now, it suffices to say: we need to develop a healthy dose of scepticism about scary projections that are leaked to journalists. We have a difficult winter ahead, when the health service is going to be juggling Covid patients and the normal winter caseload which pushes the system to the end of its capacity every year. Leaked warnings and reports will abound - bouncing from newspapers to Facebook groups.

Scepticism doesn’t mean dismissing them. It means weighing them against the actual data published regularly by the NHS, Public Health England and the Office for National Statistics, and against the on-the-record briefings we get regularly from politicians like Andy Burnham and local health officials like Dr Jane Eddleston.

That won’t always mean you arrive at the most interesting conclusions or the ones that will get the most retweets or likes. But at least you will have the benefit of getting closer to the truth.

We will continue to report those sources every week in our briefings. If you think someone you know might find this post useful, please forward it on.

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