Coronavirus - worldwide spread and control

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Jonathan Edwards said:
I suspect the real long term problem for Covid19 is going to be those who have suffered sufficiently severe organ failure to require high level supportive care for years. Some may need dialysis or transplants.
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This report is suggesting an ICU in london is running short on other things then ventilators including dialysis machines. Suggesting other organs are being damaged as well as respiratory issues
https://www.ft.com/content/e26524a5-c868-451c-a7d7-a91627a1722c
 
Wellcome, the global independent foundation, has today launched an initiative, COVID-Zero, to help raise at least $8 billion by the end of April to cover a global funding shortfall for vaccines, treatments and testing for coronavirus.

This funding gap has been identified by the Global Preparedness Monitoring Board, an independent body convened by the World Health Organization and the World Bank. Wellcome said that securing this funding now was "the world’s best exit strategy" for tackling coronavirus and would save lives, protect jobs and get the global economy moving again faster than any other option.

An initial $8 billion – a fraction of what governments have found to protect their economies – would provide the resources needed both to develop drugs and vaccines and to start to scale up production across the world.
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https://wellcome.ac.uk/press-releas...nched-fill-8bn-shortfall-coronavirus-response
 
The UK ONS (Office of national statistics) have been collecting stats at a slower rate than announcements but probably with a higher degree of accuracy. They are looking at death rates from death certificates rather than hospital reports and they are doing so in batches. It seems to show a higher death rate than the reported figures which is to be expected since reported figures are just from the hospitals.

https://blog.ons.gov.uk/2020/03/31/counting-deaths-involving-the-coronavirus-covid-19/

Latest update to deaths registered by 1st of April.
https://www.ons.gov.uk/peoplepopula...landandwalesprovisional/weekending27march2020

This was the graph in their first report:
DeathRateONSUK.jpg

It seems to show the death rate being higher than the daily stats.

Then in the latest update they have this graph
Figure 1_ The cumulative number of deaths involving COVID-19 in England up to 27 March 2020.png
Which I' not sure I can tell which line is which but think it is saying the death rate on the gov.uk is lower than actual deathrates. Suggesting a mix of reporting delays and non hospital deaths. They then have figures of 15 dying at home 20 in care homes and 2 in hospices from Cov019.
 
Snow Leopard said:
Maybe, if the UK adopts strict quarantine (eg forced isolation in hotels) for all international travellers.

But I doubt (and hope not) that so many people will be infected that herd immunity will be achieved, instead, downtrending infection rates due to the various restrictions in place is the best way to move forward.
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Yea but you guys (Australia) tested (to identify the infected/infectious), traced contacts and isolated those with the virus ---- not simply -- stay at home.
 
FMMM1 said:
Yea but you guys (Australia) tested (to identify the infected/infectious), traced contacts and isolated those with the virus ---- not simply -- stay at home.
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Yes, and have police out enforcing isolation in some popular public areas, first by warnings but with a few fines. We also banned a lot of travel, and put international travellers in empty hotels with a quarantine order. If you come from overseas you will be quarantined. Its not a prison-style quarantine, but there are heavy fines and imprisonment if you break it.
 
They don't use paired sera in virology any more. They are only used if the first test is negative but the patient is still showing symptoms so a later test is done.

For quite a few years now, antibody tests have been done from single blood samples for Hepatitis ABC and HIV as well as others.
 
alex3619 said:
Yes, and have police out enforcing isolation in some popular public areas, first by warnings but with a few fines. We also banned a lot of travel, and put international travellers in empty hotels with a quarantine order. If you come from overseas you will be quarantined. Its not a prison-style quarantine, but there are heavy fines and imprisonment if you break it.
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Thanks @alex3619 Seems like a pretty good system; particularly if it's only for a couple of years i.e. until they (hopefully) come up with a vaccine.
 
Mithriel said:
They don't use paired sera in virology any more. They are only used if the first test is negative but the patient is still showing symptoms so a later test is done.

For quite a few years now, antibody tests have been done from single blood samples for Hepatitis ABC and HIV as well as others.
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Hepatitis (at least B and C) and HIV are atypical because you are much of the time looking for antibodies at a point distant from any obvious acute illness. There are no fixed points for acute and convalescent samples. It may well be that labs have lost interest in paired sera in general having been outsourced to commercial outfits that are not really interested in keeping an eye on epidemiology. But in the context of an acute illness a single sample is much more likely to be unreliable. In the context of a new illness for which assays have not been refined a single test is highly unlikely to be reliable - as seems to be the case.
 
Adrian said:
Some model predictions for deaths are reported here
http://www.healthdata.org/covid/updates

Predictions for the UK seem very high (66,000) in relation to other countries (say 20,000 for Italy) but I'm not sure why.
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A scary thought (amongst so many of the other scary thoughts about this!), from the graph and other comments made up-thread, is what if a lot of the severely affected patients who don't recover, actually (and i'm sorry, but I can't think of a gentle way to say this) take a long time to die, with steadily and inexorably declining health until the end, but significantly longer than a week or two. There would then be a significantly longer time lag between contracting the disease and dying from it, and then a sudden rise later on, as a proportion of the higher infection rate from some time previously.

It's a horrible, horrible thought.
 
@Adrian I’m thinking maybe because UK’s lockdown is not as strict as in other countries..What we class as essential and non essential work etc and who is still commuting into work. Schools as well; remaining open. Maybe other things like sanitisation of outdoor areas. Related to testing and tracing? Also we were perhaps later to lockdown (later on our “curve”) than other countries were?

Edit: I really really hope this doesn’t happen though. :( Maybe it might serve as a wake up call to the govt.
 
Adrian said:
Predictions for the UK seem very high (66,000) in relation to other countries (say 20,000 for Italy) but I'm not sure why.
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I wonder if it is simply that the UK was very slow and unwilling to rapidly enter full emergency mode? Given the nature of exponential growth, each day lost equates to a huge acceleration of final death toll figures. The longer you leave the fire to take hold, the disproportionately harder it becomes to contain.

I can imagine that when this is recent history, modelling will be done for all counties showing what could have reasonably been achieved, if governments had truly heeded genuine best science, compared to what actually happened. Not benefit-of-hindsight recriminations, but benefit of what was fully appreciated at the time, if only those in power would have listened. Some countries will have got things not too wrong, other horrendously wrong. I would be very disappointed if such analyses were not done.
 
There is some modelling of different approaches being done here in Canada. Being a geographically large country many things done at the federal level elsewhere are done provincially here. So different approaches to locking down.

See here for a discussion of how it's played out in the three most affected provinces; BC, Ontario and Quebec:

https://www.cbc.ca/news/canada/british-columbia/bc-ontario-quebec-covid-19-1.5524056
 
lunarainbows said:
@Adrian I’m thinking maybe because UK’s lockdown is not as strict as in other countries..What we class as essential and non essential work etc and who is still commuting into work. Schools as well; remaining open. Maybe other things like sanitisation of outdoor areas. Related to testing and tracing? Also we were perhaps later to lockdown (later on our “curve”) than other countries were?

Edit: I really really hope this doesn’t happen though. :( Maybe it might serve as a wake up call to the govt.
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I'm wondering if the model or results are just wrong for the UK. But it isn't clear to me what the different assumptions they are making are.
 
Adrian said:
I'm wondering if the model or results are just wrong for the UK. But it isn't clear to me what the different assumptions they are making are.
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I don’t know, I think it may end up being accurate. That is, I wouldn’t be surprised. I think like Barry said, we did enter lockdown much later than other countries had done - and even when we did enter lockdown; it wasn’t even strict - it still isn’t. Still quite a few differences between the UK and the rest of Europe even now.

Then there’s the problem with our health system. Compared to other countries, The fact we have far less ICU beds, ventilators, probably far less doctors & nurses as well, so our capacity will breached much earlier. After that i presume lots of people will die. If you look at the page with the modelling you quoted:

UK:The model shows that the UK will not have enough beds and ICU beds to meet demand, with the shortage peaking at 23,745 ICU beds on April 17,

France: The model shows that France is just passing its peak and will have a total of 15,058 deaths by August 4. The country is expected to have enough total beds to meet demand, but a shortage of 4,330 ICU beds. The forecasts predict 6,091 ICU beds will be needed for COVID-19 patients in France.

Germany: Deaths in Germany are forecast to peak in the third week of April, with an estimated 377 deaths on April 19. The model shows that Germany will have enough beds and ICU beds to meet demand, with the required number of total beds peaking at 12,222 on April 14, and predicts 8,802 total deaths in the country by August 4.

This is something that the UK govt knew. They knew we were starting from a much worse position than most other European countries with the state of the health system. But still they let the situation get worse than most other European countries.
 
Adrian said:
Predictions for the UK seem very high (66,000) in relation to other countries (say 20,000 for Italy) but I'm not sure why.
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That may simply be an artefact of following the curves as they currently are The Italian curves are already going down. The UK curve is trying to go down but has not managed it convincingly yet. If they are using a computer model the chances are they just churn out the 'best fit' for the curve so far. To me this is the idiocy of computer models.
 
Jonathan Edwards said:
That may simply be an artefact of following the curves as they currently are The Italian curves are already going down. The UK curve is trying to go down but has not managed it convincingly yet. If they are using a computer model the chances are they just churn out the 'best fit' for the curve so far. To me this is the idiocy of computer models.
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It could be I think it is more than a simple regression fit. They talk about the different controls in place and also the load on ICU so I assume there is a level of simulation within the model to follow forward but it could be based on current death, spread and ICU rates. Also the UK figures are worse per population than everywhere else including the US - not sure how the curves we have so far compare.
 
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