Coronavirus - worldwide spread and control

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Anders Tegnell om munskydd: ”Kunskapsunderlaget är extremt svagt”
https://www.svt.se/nyheter/inrikes/darfor-tror-inte-fhm-pa-munskydd-underlaget-ar-extremt-svagt

"Anders Tegnell on oral protection: "The knowledge base is extremely weak"

The debate over whether oral protection should, can or will be used in Sweden has intensified during the past week. As other countries such as Spain, France and Belgium have introduced compulsory mouth protection in, among other things, public transport, so have the questions as to why Sweden does not do so more.

- The reason it looks so different is because the knowledge base is extremely weak, says Anders Tegnell in Aktuellt.

During Thursday's press conference, the Public Health Authority opened up to the use of oral protection and visor in the elderly care.

- Despite the meager scientific evidence, we see that you can consider adding mouth protection or visor as an extra measure. This is a trade-off that one has to make locally and according to the conditions one has, said Malin Garpe, the Public Health Authority's unit manager for health hygiene, at the press conference.

"Does not fit well with what we are trying to do in Sweden"

But there is still no clear recommendation. In Current Affairs, state epidemiologist Anders Tegnell answered the question of why Sweden's line differs from some other countries.

- The reason it looks so different is because the knowledge base is extremely weak. There is only one study in the world that has tried to look at this, says Tegnell.

- It fits badly with what we are trying to push in Sweden, that if you are ill you should stay at home and not go out on the town with a mouthguard on you."
 
Yesterday Al Jazeera English said that Singapore and Qatar have a case fatality rate of 0.07 and 0.093%, two small, well equiped countries. They added that experts would say that it would be important not to overburden the health care system.

Though, I think, there might be still some other factors at work as well.
 
JaneL said:
All the members of (the actual) SAGE group have now been published, except for two members who did not give permission for their names to be released.

You can read the full list of names here:
https://news.sky.com/story/coronavi...ed-after-criticism-over-transparency-11982941

Simon Wessely isn’t on the list.
Click to expand...

It turns out that the above list was only for members of the main SAGE group and didn’t include all the many names of those in subcommittees, including SPI-B (the subcommittee on behavioural and social interventions). Simon Wessely is still not on the list but take note that four participants of SPI-B have not given permission to be named!

You can find the full membership list for SPI-B as well as the other subcommittees here:
https://www.gov.uk/government/publi...-pandemic-influenza-group-on-behaviours-spi-b

SAGE have also published more documents this week (including from SPI-B) that they used as evidence to support the government’s response to Covid-19. You can find all the evidence here:
https://www.gov.uk/government/group...mergencies-sage-coronavirus-covid-19-response
 
I’ve been looking at the SAGE modelling group document “Consensus view on the impact of mass school closures” dated 19th February 2020

One of the conclusions of this document that surprised me was:

Any impact from school closures on the total number of cases is likely to be highly limited.
Click to expand...

I can’t understand understand how they came to that conclusion. Is anyone able to explain?

I was also surprised to see that the document ended with this comment:

Detailed forecasts of the likely impact of school closures will be possible once there has been several weeks of sustained transmission of COVID-19 within the UK.
Click to expand...

Did they think they had the luxury of several weeks to watch how the pandemic played out before advising further about school closures?

https://assets.publishing.service.g...iew-on-the-impact-of-mass-school-closures.pdf

I also had a look at the SAGE modelling group document “Consensus view on public gatherings” dated 11th February 2020. I thought that the conclusion in first sentence of the document was also a bit dubious:

The direct impact of stopping large public gatherings on the population-level spread of the epidemic is low, because they make up only a small proportion of an attendee’s contacts with other people.
Click to expand...

https://assets.publishing.service.g...i-m-o-consensus-view-on-public-gatherings.pdf
 
JaneL said:
I’ve been looking at the SAGE modelling group document “Consensus view on the impact of mass school closures” dated 19th February 2020

One of the conclusions of this document that surprised me was:



I can’t understand understand how they came to that conclusion. Is anyone able to explain?

I was also surprised to see that the document ended with this comment:



Did they think they had the luxury of several weeks to watch how the pandemic played out before advising further about school closures?

https://assets.publishing.service.g...iew-on-the-impact-of-mass-school-closures.pdf

I also had a look at the SAGE modelling group document “Consensus view on public gatherings” dated 11th February 2020. I thought that the conclusion in first sentence of the document was also a bit dubious:



https://assets.publishing.service.g...i-m-o-consensus-view-on-public-gatherings.pdf
Click to expand...

I think it’s all based on their model. And the model uses influenza as a starting line. In that paper on school closures, they say this; (when they say 2009 that refers to the swine flu influenza pandemic) (my bolding)

“3. For the purpose of this paper, we assumed that children have a role in transmission similar to that of influenza. The results below are very sensitive to this assumption. The smaller the role of children in transmission, the lower the impact of school closures.

4. In addition to this, the impact of school closures on COVID-19 is expected to be smaller than in 2009, because:

• The average time between symptom onset in primary and secondary cases (known as the serial interval) is longer than for influenza. As a result, schools would have to be closed for longer to have the same effect.
• The reproduction number in Wuhan in the early stage of the outbreak is higher than in 2009.
• In 2009, some adults had pre-existing immunity, so a higher proportion of transmission took place within schools.”

And they’re basing a lot of the paper on the model.

They do mention in the paper though that long duration school closures are more effective if started as early as possible..
 
The following is from the SAGE document “Potential effect of non-pharmaceutical interventions (NPIs) on a Covid-19 epidemic in the UK 26th February 2020” dated 26th February 2020:

An additional strategy would be to apply more intense measures on those age or risk groups at most risk of experiencing severe disease (e.g. household isolation of those over 65, special measures around care homes). The majority of the population would then develop immunity, hopefully preventing any second wave, while reducing pressure on the NHS.
Click to expand...

? (!)

https://assets.publishing.service.g...ons-npis-on-a-Covid-19-epidemic-in-the-UK.pdf
 
SAGE appear to have advised against very stringent interventions on the assumption that these would likely be followed by a large epidemic (which apparently wouldn’t happen with less strict interventions):

Very stringent behavioural and social interventions could have a similar scale of impact to Hong Kong and prevent a major epidemic. However, when lifted, a large epidemic would likely follow. Depending how long they were in place, this could peak in autumn.
Click to expand...

They were even so confident to state that “the scale and timings of the epidemic curves in this diagram are illustrative only, but their patterns are robust.”

(See figure 1 on page 2 of this document: https://assets.publishing.service.g...behavioural-social-interventions-04032020.pdf)
 
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JaneL said:
SAGE appear to have advised against very stringent interventions on the assumption that these would likely be followed by a large epidemic (which apparently wouldn’t happen with less strict interventions):



They were even so confident to state that “the scale and timings of the epidemic curves in this diagram are illustrative only, but their patterns are robust.”

(See figure 1 on page 2 of this document: https://assets.publishing.service.g...behavioural-social-interventions-04032020.pdf)
Click to expand...

This would only follow if they didn’t do any contact tracing / testing / isolation, which they don’t even mention let alone model...Ie the main thing the WHO has been saying to do all along.. it doesn’t really matter if the govt say they don’t have capacity to do it or not - shouldn’t their science and modelling of interventions be independent of that and give an idea of all possibilities?

The fact they didn’t model this shows that they took their cues from the govt.. which really shows up the claim that instead the govt is “following the science”.

Just bewildered.
 
JaneL said:
Did they think they had the luxury of several weeks to watch how the pandemic played out before advising further about school closures?
Click to expand...

It seems that they did. And yet anyone with common sense would know they didn't having read the news from China. Very clearly decisions have been made by clowns in ivory towers playing with computers while the public health professionals who normally deal with infectious diseases were told not to bother.
 
Ravn said:
Yeah, NZ is talking about significant reopening soon, too. The first easing from level 4 to level 3 restrictions was quite small and cautious - we're currently still in level 3 - but the next one down to level 2 will be a much bigger jump. At least the borders will stay closed. Still, makes me a bit nervous, not convinced our contact tracing ability is that great yet. Can only hope that our current community transmission truly is as low as they think it is, in which case we might just get away with it. :nailbiting:
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I'm in NZ too, and am worried about the small handful of cases that are still being identified most days. People seem to think because they were all somehow "connected" with a known case, then that's all okay. Not community transmission, so all is a-OK. But if we release to Level 2, and there are still some cases like this kicking about (people we haven't identified as cases yet), then THEY will also start mixing and spreading it around.

I would feel more confident if there was some way of restricting movements for anyone who's had contact with any case identified in the last two weeks. So they're not able to mix freely until they're well clear.
 
There's still a lot of focus on herd immunity in the Swedish media... :( Tom Britton and others from Stockholm University and Nottingham University are now claiming/speculating that "herd immunity can be obtained already at 40%" (earlier models say 60%), which they say could mean that "the spread of infection could stop in Stockholm in the middle of June". Chief epidemiologist Tegnell agrees, saying that it is "definitely possible".

https://omni.se/britton-flockimmunitet-kan-nas-vid-40-procent/a/LA7dBx

https://www.dn.se/nyheter/sverige/tegnell-flockimmunitet-betyder-inte-att-faran-ar-over/
 
On the Andrew Marr show (BBC1 this morning, watch on iPlayer) - ministers are told that 20,000 new people in the U.K. are catching coronavirus every day.

Yet We’ve been seeing on the news that more and more people are out and about now - in parks and not heeding lockdown. And more recently the street parties on VE Day.

Then today we have a new slogan. It’s no longer “stay at home”. It’s “stay alert. Control the virus”... what does that mean? At a time when we are already at the worst position in Europe and people are already not heeding lockdown due to the “leaks“ to the press saying lockdown would be lifted..this is not ok. Nicola Sturgeon seems to agree with me!

 
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