12It exercises all the authority of the first beast in its presence, and makes the earth and its inhabitants worship the first beast, whose mortal wound was healed. It had two horns like a lamb and it spoke like a dragon. Listen to the Passage Read the PassageДЎ1Then I saw another beast rising out of the earth. The views expressed in this commentary represent the views of the authors and not necessarily those of the host institution, the NHS, the NIHR, or the Department of Health and Social Care.This article is part of the Tough Passages series. Jason OkeВ is a Senior Statistician at the Nuffield Department of Primary Care Health Sciences and Module Coordinator for Statistical Computing with R and StataВ (EBHC Med Stats), and Introduction to Statistics for Health Care ResearchВ (EBHC), as part of the Evidence-Based Health Care Programme.Д¬arl HeneghanВ is Professor of Evidence-Based Medicine and Director of Studies for the Evidence-Based Health Care ProgrammesВ (Full bio and disclosure statement here)Дisclaimer : the article has not been peer-reviewed it should not replace individual clinical judgement, and the sources cited should be checked. This will allow us to better determine if deaths related to COVID are trending up or down. The 28-day definition brings the definitions into line with the other UK countries and provides a more accurate, and sensitive measure, of the immediate impact of COVID on deaths. In terms of the definition with a longer time frame вЂ“ beyond 28 days вЂ“ we consider this is important but should be used to perform in-depth analyses of the long term problems caused by COVID. PHE uses two definitions of death in a person with COVID-19 in England, one broader measure and one measure reflecting current trends:ДЎ) A death in a person with a laboratory-confirmed positive COVID-19 and either: died within 60 days of the first specimen date or died more than 60 days after the first specimen date, only if COVID-19 is mentioned on the death certificateДў) A death in a person with a laboratory-confirmed positive COVID-19 test and died within (equal to or less than) 28 days of the first positive specimen date. When it comes to deaths per million (ie., adjusting for the population size) it means the UKвЂ™s death rate is similar to Italy and Spain and above France, whereas EnglandвЂ™s death rate per million remains higher. In terms of total deaths, the UK (and England) remain in the same position above Italy. The change in definitions means the current moving average, as of the 12 August, is down to approximately ten deaths per day. We have illustrated this effect on the 7-day moving average for July. As opposed to 100 deaths on the 11th of August, 11 would now be reported today, whereas 72 were reported, only 15 will be reported under the new system. The last two days illustrate the difference this change makes to the deaths by reporting date. When you observe this difference you can see it is more marked in June, July and August.ДЇor example, under the old PHE system, 2,086 deaths were reported in England in July by date of death, with the 28 days cut off this number is 574 вЂ“ nearly a quarter of what was previously reported. What this means is that England has had 36,695 deaths using this definition as opposed to the previous reported 42,072 вЂ“ a difference of 5,377. The new definition is now death in a person with a laboratory-confirmed positive COVID-19 test and died within (equal to or less than) 28 days of the first positive specimen date will now be reported Public Health England has changed its definition of deaths. Public Health England has changed its definition of deaths: hereвЂ™s what it means

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