Coronavirus thread

[Mandryka]

[MusicTurner]

Basically all media here in DK having the 1200 international experts warning against the UK re-opening on Monday as a danger to the world, as front page news, considering the 51,000 daily British cases.

[Mandryka]

Basically all media here in DK having the 1200 international experts warning against the UK re-opening on Monday as a danger to the world, as front page news, considering the 51,000 daily British cases.

The 51K is not cases, it's positive test results. That's not a guide to cases because not everyone gets tested and the tests include false positives. By the way, just to make you feel better, the doubling time is 14 days so we'll be at 100K positive test results by the end of the month. Growth in August may be less rapid because schools have just closed here, and anyway, possibly the virus is running out of fuel.

The "danger to the world" is from the emergence of an undesirable uncontainable new variant which has attributes which make it dominant. I have not found any information on the probability of this happening and for all I know it may be vanishingly small. And my understanding of risk management isn't sufficient to help me judge whether the UK is doing the best thing for themselves or the best tout court. The most I can say is that it's complex.

[Irons]

The 51K is not cases, it's positive test results. That's not a guide to cases because not everyone gets tested and the tests include false positives. By the way, just to make you feel better, the doubling time is 14 days so we'll be at 100K positive test results by the end of the month. Growth in August may be less rapid because schools have just closed here, and anyway, possibly the virus is running out of fuel.

The "danger to the world" is from the emergence of an undesirable uncontainable new variant which has attributes which make it dominant. I have not found any information on the probability of this happening and for all I know it may be vanishingly small. And my understanding of risk management isn't sufficient to help me judge whether the UK is doing the best thing for themselves or the best tout court. The most I can say is that it's complex.

Correct. An interesting correlation between positive tests and hospital admissions.

https://coronavirus.data.gov.uk/

[MusicTurner]

Got interested in the UK press coverage of the 1200 experts letter of warning in The Lancet; as of now, The Guardian, FT, and The Express introductory websites cover it, whereas The Times, The Telegraph and The Daily Mail apparently don't.

[Mandryka]

Beta variant anyone?

https://www.theguardian.com/world/2021/jul/16/quarantine-to-remain-for-vaccinated-uk-travellers-returning-from-france

[Que]

The "danger to the world" is from the emergence of an undesirable uncontainable new variant which has attributes which make it dominant. I have not found any information on the probability of this happening and for all I know it may be vanishingly small. And my understanding of risk management isn't sufficient to help me judge whether the UK is doing the best thing for themselves or the best tout court. The most I can say is that it's complex.

The combination of a lot of vaccinated (immune) with a high number of infections propagates possible vaccine-resistant strains. This is the natural selection process that makes us catching the flu every year again. And this is why it is so important to keep the number of infections low untill group immunity is reached and the virus dies out. But there are many other places  in the world where this could occur, notably the US where a large portion of the population is refusing to be vaccinated. Much depends on the mutation rate of the virus, which doesn't seem to be low and is excellerated by hundreds of millions of infections worldwide.

Apart from this, the UK govt is willfully exposing the young and those not (fully) vaccinated to serious health risks. With the current knowledge of the effects of the virus, focusing on hospitalisations doesn't give the full picture. The long term costs in health care and reduced productivity of those affected will be substantial.

The UK govt is going to regret this, I think...

[Que]

Beta variant anyone?

https://www.theguardian.com/world/2021/jul/16/quarantine-to-remain-for-vaccinated-uk-travellers-returning-from-france

Yes, I noticed that as well. The irony....

[Pohjolas Daughter]

More from the "Show Me" state:

Missouri Asked to Help Contain Outbreak (10:43 a.m. NY)

Health officials in southwest Missouri asked the state to set up an "alternate site" to handle overflowing hospitalizations caused by a spike in new virus cases. The state is one of the worst hit by the delta variant, particularly around the city of Springfield and surrounding Greene County.

"Today, there are 231 patients being treated in Greene County hospitals with Covid-19, 104 of those are in critical care and 61 are on ventilators," read a statement released Wednesday night by officials from the city, county and three health care networks. "Greene County is averaging more than 196 cases per day, and the increase in severe illness is projected to outpace hospital capacity."

https://www.springfieldmo.gov/CivicAlerts.aspx?AID=8442

Are there any large music/sports stadiums that could be used?

PD

[Que]

Trouble ahead in Spain and Portugal and, as we now know, The Netherlands...

And let's not forget the UK: rising numbers in the run up to "Freedom Day" (cough, cough)

So, there we go. The Netherlands have turned deep red... Our southern brethren in Belgium turned orange. Luxemburg red as well.

And all the holiday destinations are warming up infection wise. With the French Côte d 'Azur, Croatia (Dalmatian Coast) and Greece joining in with Portugal, Spain, Malta and Cyprus. Somehow Italy is still managing to keep infections low.

https://www.ecdc.europa.eu/en/covid-19/situation-updates/weekly-maps-coordinated-restriction-free-movement

[Que]

The combination of a lot of vaccinated (immune) with a high number of infections propagates possible vaccine-resistant strains. This is the natural selection process that makes us catching the flu every year again. And this is why it is so important to keep the number of infections low untill group immunity is reached and the virus dies out. But there are many other places in the world where this could occur, notably the US where a large portion of the population is refusing to be vaccinated.

Like I said....

Unvaccinated could be breeding ground for Covid variants, US officials fear

[Mandryka]

The long term costs in health care and reduced productivity of those affected will be substantial.

We will create a culture where people are expected to work with the symptoms of long covid. Don't forget Britain's proletariat are on zero hours contracts and state sick pay is the lowest in the European continent (I think -- you may have the stats to hand.) 

The UK govt is going to regret this, I think...

It is being presented, perhaps rightly, as the least bad of a series of bad alternatives. Part of the thinking is that opening later will produce an exit wave with a very long tail  which peaks later -- and the NHS is likely to be under more pressure then from seasonal respiratory diseases. Of course the later you open, the more people are vaccinated. But the models suggested now is better than any other time this year. I can let you have links to the modelling if you want.

One thing to be stressed is that the models were very sensitive, a small change makes a huge difference. And hence everything is complicated and uncertain. It's about risk management.

What was off the agenda, never investigated by the epidemiologists, was removing all NPIs in Spring or Summer 2022.  That's effectively what the signatories to that Lancet letter mentioned above wanted de facto. (I think their position is half baked, by the way.)

[T. D.]

https://www.economist.com/united-states/2021/07/17/the-republican-anti-vax-delusion

[Que]

It is being presented, perhaps rightly, as the least bad of a series of bad alternatives. Part of the thinking is that opening later will produce an exit wave with a very long tail  which peaks later -- and the NHS is likely to be under more pressure then from seasonal respiratory diseases. Of course the later you open, the more people are vaccinated. But the models suggested now is better than any other time this year. I can let you have links to the modelling if you want.

One thing to be stressed is that the models were very sensitive, a small change makes a huge difference. And hence everything is complicated and uncertain. It's about risk management.

I think they're trying to sell the British public a bogus story. The whole "exit wave" theory doesn't make any sense. By the end of the summer vaccinations will have reached their maximum numbers. Which means that after lifting restrictions the number of infections will be very low, or, if group immunity levels can be reached, practically zero.

If you are managing serious risks, you better stick with what you know that works - vaccinations & restrictions - untill dangerous conditions subside. Instead of taking risks with uncertain consequences, like lifting restrictions in the midst of a vaccination exercise.

[Mandryka]

[when] vaccinations will have reached their maximum numbers. [t]his means that after lifting restrictions the number of infections will be very low, or, if group immunity levels can be reached, practically zero.

I think you're wrong to say this. The latest information I have is that vaccinations reduce infections by 75% -- so if R0=8 in an unvaccinated population, R0=2 in a vaccinated population. That means that infections will be growing exponentially after the whole population is vaccinated, if all NPIs are removed. Furthermore not all the population is protected by the vaccine and there are breakthrough cases needing hospital care. This all mounts up when considering a whole country's population. A small percentage of a very large number is a very large number.

If infections peak, all that means is that R≤1. Therefore the people who are already infected will continue to infect, just less than one person (you know what I mean by that!) And then those newly infected people will infect some more . . . . This is an exit wave with a very long tail.

(We've all had to become amateur epidemiologists  )

If you are managing serious risks, you better stick with what you know that works - vaccinations & restrictions - untill dangerous conditions subside. Instead of taking risks with uncertain consequences, like lifting restrictions in the midst of a vaccination exercise.

Well, they can always reinstall NPIs -- the important thing is to be measuring what is going on and to react if you need to.  I am prepared to bet you a barrel of the finest maatjesharing that Britain will reintroduce NPIs by the start of October, probably earlier.

[Irons]

I think they're trying to sell the British public a bogus story. The whole "exit wave" theory doesn't make any sense. By the end of the summer vaccinations will have reached their maximum numbers. Which means that after lifting restrictions the number of infections will be very low, or, if group immunity levels can be reached, practically zero.

If you are managing serious risks, you better stick with what you know that works - vaccinations & restrictions - untill dangerous conditions subside. Instead of taking risks with uncertain consequences, like lifting restrictions in the midst of a vaccination exercise.

I think Mandryka is making the valid point better to bite the bullet now in the high summer then later when other respiratory aliments take hold. Due to lockdown and other measures to fight Covid the population is going to be extremely vulnerable come the winter months. Speaking personally last winter was the first time in my life I have not succumbed to "man flue" otherwise known as the common cold. I have a feeling a price is going to be paid further down the line for this reprieve. As an asthma sufferer, albeit not too bad and there are many worse off, this has to be a consideration.     

[Que]

I think you're wrong to say this. The latest information I have is that vaccinations reduce infections by 75% -- so if R0=8 in an unvaccinated population, R0=2 in a vaccinated population. That means that infections will be growing exponentially after the whole population is vaccinated, if all NPIs are removed. Furthermore not all the population is protected by the vaccine and there are breakthrough cases needing hospital care. This all mounts up when considering a whole country's population. A small percentage of a very large number is a very large number.

If infections peak, all that means is that R≤1. Therefore the people who are already infected will continue to infect, just less than one person (you know what I mean by that!) And then those newly infected people will infect some more . . . . This is an exit wave with a very long tail.

(We've all had to become amateur epidemiologists  )

What you are basically saying is that vaccinations, even at their optimum in numbers, are insufficiently effective to stop the spreading of the virus. I'm not ready to accept this without any substantial evidence, though AstraZeneca is notably less effective than Pfizer or Moderna. And even assuming this could be true, the more people are vaccinated before infections rise in numbers, the more are protected to some extent or another. The entire narrative the UK govt is trying to sell is rather cynical and defeatist IMO.

[Mandryka]

What you are basically saying is that vaccinations, even at their optimum in numbers, are insufficiently effective to stop the spreading of the virus. I'm not ready to accept this without any substantial evidence, though AstraZeneca is notably less effective than Pfizer or Moderna. And even assuming this could be true, the more people are vaccinated before infections rise in numbers, the more are protected to some extent or another. The entire narrative the UK govt is trying to sell is rather cynical and defeatist IMO.

The datum of 75% reduction in infections is something I got from not the last UK presser, but the one before, either van Dam or Whitty, I think van Dam. R0=8 for delta.  But even if  R≤1 I have argued that there is inevitably a long tail, i.e. an exit wave.

[prémont]

What you are basically saying is that vaccinations, even at their optimum in numbers, are insufficiently effective to stop the spreading of the virus. I'm not ready to accept this without any substantial evidence, though AstraZeneca is notably less effective than Pfizer or Moderna. And even assuming this could be true, the more people are vaccinated before infections rise in numbers, the more are protected to some extent or another. The entire narrative the UK govt is trying to sell is rather cynical and defeatist IMO.

With the Alpha virus, herd immunity (R <1) was estimated to occur when 60% of the population was immune. With the Delta variant which is much more contagious, the Danish health authorities have calculated that more than 80% of the population must be immune to keep R below 1. And here the coverage of the vaccines also must be taken into account, so that if a vaccine covers only 90%, somewhat more of the population must be vaccinated to get a sufficient degree of herd immunity.This may be impossible to achieve.

The calculations are complicated by the fact, that vaccinated people may contract the virus and spread it to others - albeit probably to a lesser degree than unvaccinated people -also even if they have no symptoms themselves.

So if we can't stop the coronavirus our efforts must be directed towards the prevention of manifest disease (Covid19). So much more reason to get everybody vaccinated.

[Spotted Horses]

I've not seen any claims that delta variant has R0 as high as 8. I recall seeing claims that alpha is 2.5 and delta is 4.5, but that number is dependent on people's behavior. I.e., perhaps we are not going back to totally normal behavior yet.

I don't understand the UK's commitment to AstraZeneca. It is it a nationalist thing? It is clearly inferior to the mRNA vaccines in every measurable way (except for the storage requirements). There is no earthly reason anyone should be manufacturing it. The developed world should be producing mRNA vaccines at the fastest rate possible and giving it to everyone on the planet, including people in developing nations. If necessary the government should seize control of the IP and license it to any laboratory competent to manufacture it, on the basis of national security.

Reports I've read indicate that 99% of Covid-19 fatalities in the U.S. are unvaccinated people, and that in Los Angeles country 100% of hospitalized Covid-19 patients are unvaccinated. If we could get vaccine into everyone the pandemic would recede. Perhaps the virus would not be extinguished, but it would be reduced to an endemic nuisance like the flu.