Coronavirus - worldwide spread and control

[Sasha]

Article by Anthony Costello in The Guardian (Friday 10 April):

https://www.theguardian.com/comment...ft-lockdown-uk-east-asia-coronavirus-pandemic

 

[Sasha]

Just caught a guy on BBC Radio 4 saying that the exit strategy (?) in the UK would involve more wearing of masks. He was talking about the bluetooth contact-tracing idea, among other things. Didn't catch his name.

 

[Sly Saint]

But doesn't the whole 'herd immunity' thing depend on how long people are immune for? If it turns out to be say three years that's fine, but what if it's only a year or less? Would that be enough time before the next 'cycle' ?
(obviously not applicable if a vaccine is produced)

 

[Wonko]

But doesn't the whole 'herd immunity' thing depend on how long people are immune for? If it turns out to be say three years that's fine, but what if it's only a year or less? Would that be enough time before the next 'cycle' ?
(obviously not applicable if a vaccine is produced)

My understanding is that it's exactly the same thing if a vaccine is produced - a vaccine is simply an artificial way of obtaining herd immunity with, hopefully, a lower death rate.

 

[Barry]

The challenge is scale-up. Flu vaccine grows in chicken eggs, but #COVID19 does not.

Best wait for a few days after Easter

For a moment I wondered if you were about to suggest Covid 19 might grow in Easter eggs .

 

[Cheshire]

Half of coronavirus deaths happen in care homes, data from EU suggests

Figures from Italy, Spain, France, Ireland and Belgium suggest UK may be underestimating care sector deaths

About half of all Covid-19 deaths appear to be happening in care homes in some European countries, according to early figures gathered by UK-based academics who are warning that the same effort must be put into fighting the virus in care homes as in the NHS.

Snapshot data from varying official sources shows that in Italy, Spain, France, Ireland and Belgium between 42% and 57% of deaths from the virus have been happening in homes, according to the report by academics based at the London School of Economics (LSE).

Published official data for care homes in England and Wales are believed to significantly underestimate deaths in the sector, with the Office for National Statistics only recording 20 coronavirus-related deaths in all care homes in the week ending 27 March. New figures are due out on Tuesday, but are unlikely to be up to date.

https://www.theguardian.com/world/2...hs-happen-in-care-homes-data-from-eu-suggests

 

[large donner]

Bill gates BBC interview on a vaccine for covid...

Its news to me that he is a health expert...

there is the period when I and other health experts

there will be a trade off the vaccine will have less safety testing than we typically would have and so governments will have to decide do they indemnify the companies and really say lets go out with this when we just don't have the time to do what we normally do so eighteen months is about what we would expect we are doing everything we can .....we will write cheques for those factories faster than governments can

If you want to see if aside effects turn up later that takes two years so....there will be a trade off...

.

governments working on a co operative basis will be involved in the decision to say hey the regulator said go ahead even though you haven't take the normal time period.....

 

[lunarainbows]

Half of coronavirus deaths happen in care homes, data from EU suggests
https://www.theguardian.com/world/2...hs-happen-in-care-homes-data-from-eu-suggests

From Channel 4 News tonight:



Here are my notes on what the Channel 4 news reporter says was alleged by a whistleblower:

Deaths due to suspected COVID-19, or even deaths actually due to Covid-19, are not being recorded as COVID-19. This is in England.

The chief scientific adviser has said there are 3 separate epidemics in the UK: in the hospitals, in the community, and in care homes. But only hospital deaths are being counted.

The whistleblower said dozens and dozens of errors are being made. The whistleblower is deeply involved with the registration of deaths in the South of England. He is saying the number of deaths in care homes is not reflected in any of the official statistics (not even the ones released by the ONS). He said some deaths in care and community, covid-19 are being left off the death certificate entirely.

GPs are under pressure and are not recording actual cause of death, they are recording old age dementia, Alzheimer’s as they are “easy” causes of death. There’s a telephone conversation with a GP where he has logged cause of death of Alzheimer’s, even though they suspected COVID-19, but because they didn’t go to see the patient, they put Alzheimer’s because he was over 80.

Care homes deaths considerably up from last year - from 25% of all deaths last year April 2019, to 41% now April 2020. Suspicions around those not logged as COVID 19- ie if they had lower respiratory tract infection, pneumonia, bronchopneumonia.

The whistleblower thinks deaths from care homes same as hospitals, last week.

 

[dreampop]

1/4 of the world's population is being tested at rates .0003 per capita but seem to have actively spreading COVID- India, Pakistan, Indonesia, Phillipines, Mexico, Brazil. Several of these countries began their lockdown relatively late - end of March and are very population dense. However, their death rates are very low and you would expect that number to be higher if there were a large number of untested active COVID. Could this be a result of temperature/sunlight, lower average age?

Nature has a little bit about India's already existing detection strategy w/o mass testing, although they will need that eventually.

India was well placed to send scores of public-health workers into villages, towns and cities to trace contacts and quarantine people in this outbreak. Its existing national surveillance network, called the Integrated Disease Surveillance Programme (IDSP), already monitors people across the country for communicable diseases, and has previously been used to track H1N1 influenza and measles.

The network started watching out for COVID-19 cases soon after the first case arrived in India in late January, and is now monitoring hundreds of thousands of people. In areas where workers identify clusters of disease, a containment zone is set up and everyone inside is ordered to stay at home. Social workers then go door to door to find people with suspected infections. If a person has symptoms, they are tested for the virus, along with members of their household and close contacts. People who test positive are taken to isolation units or hospitals.

For the current strategy to work, it needs to capture all infections — a Herculean task, says Ronojoy Adhikari, a mathematician at the University of Cambridge, UK. He has co-authored a preprint that estimates the virus’s spread in India with and without measures such as the lockdown1. His model, which has not been peer-reviewed, says that if even 100 infected people escape detection and re-enter the population after the lockdown, which is highly likely, cases will resurge quickly.

Modelling paper: https://arxiv.org/pdf/2003.12055.pdf (2020). It suggests either a 3 period 21/28/18 day lockdown periods or one long 49 day lockdown is needed.

 

[spinoza577]

Sweden´s number of fatal cases are currently declining.
Below what is/was forbidden or recommended, and since when. From the Swedish wiki.

På folkhälsomyndighetens inrådan har regeringen endast genomfört följande förbudː

• Icke-medborgares inresor från icke EU/EES-länder stoppas. (17 mars 2020)
• Alla folksamlingar och sammankomster med över 500 deltagare, inklusive kultur- och idrottsevenemang, förbjuds tills vidare. (11 mars 2020)[39] Förbudet utsträcktes vid ett senare regeringssammanträde till att omfatta alla allmänna sammankomster över 50 personer. (27 mars 2020)[40]
• På restauranger och barer tillåts enbart bordsservering. (24 mars) [41] allowed only when having table service
• Besökrestriktioner på sjukhus har införts av landsting och i äldrevården av vissa kommuner. Nationellt besöksförbud i äldrevården infördes av regeringen den 31 mars 2020.[42]visiting hospitals restricted in some areas, forbidden in care homes

Därutöver har en rad rekommendationer, och beslut som underlättar efterföljandet av dessa, meddelats av olika myndigheter och regeringen:

• Icke-nödvändiga resor avråds till delar av Kina (26 januari, 17 februari),[43] Iran (3 mars), Italien (6 mars) och överhuvudtaget utomlands (14 mars). Personer som återvänder från dessa länder har fått spendera två veckor i frivillig karantän i hemmet, med smittbärarpenning.[44] Icke-nödvändiga helgresor och andra resor inom Sverige avråds (19 mars).[45]
• Personer även med minimala symptom på vad som kan vara covid-19 rekommenderas att stanna hemma. Karensdagen avskaffas tillfälligt för att säkerställa att personer som känner sig lite sjuka stannar hemma från arbetet. Tiden man kan sjukskriva sig utan läkarintyg förlängs från 7 till 14 dagar (11 mars 2020).[46]
• Personer som är över 70 år gamla rekommenderas att stanna hemma, men kan ta promenader på avstånd från andra. Arbetsgivare i synnerhet i Stockholm rekommenderas att uppmana sina anställda att om möjligt arbeta från hemmet.(16 mars)[47]
• Distansundervisning rekommenderas för gymnasier, komvux, yrkeshögskolor, högskolor och universitet. (18 mars)[48] Skolor får möjlighet att förlänga terminen. Högskoleprovet i april ställs in (13 mars)[49] liksom nationella prov vårterminen 2020. (23 mars)[50]

What could this say, given that there isn´t that much restriction?
I think:

• there could be another parameter determining the illness (e.g. air pollution)
• there is only a certain number of susceptible persons, which happen to be low in Sweden, but to be high in some other countries, this year or so.
• numbers are wrong
• to make a lockdown is wrong, at least under certain - though unknown - circumstances

 

[Woolie]

Rosalyn J. Moran et al. Estimating required ‘lockdown’ cycles before immunity to SARS-CoV-2: Model-based analyses of susceptible population sizes, ‘S0’, in seven European countries including the UK and Ireland: https://www.fil.ion.ucl.ac.uk/spm/covid-19/Moran_arXiv_2020.pdf

I'd recommend reading all of Anthony Costello's summary of the paper by clicking on the Twitter thread above - 23 posts in all.

Its taken me ages to work out the entire point of this paper. Erring on the side of generosity, I've decided to interpret it as a demonstration of how stupid the target of "herd immunity" would be if we don't have a vaccine, even if we keep infection rates to levels that are manageable within the healthcare system.

The model, which is based on the assumption that herd immunity will be achieved once 60% of the UK population is infected, suggests that to achieve this end, while keeping the daily incidence of acute cases to a manageable level, the UK would need 8-10 lockdown-and-release cycles. This is based on the estimate of the proportion of people that have been infected in the hardest hit countries, which is still quite low (they mention the figure of 6%).

They also estimated that a cyclic lockdown-and-release scenario would halve the UK death rate, when compared to a free-for-all, but a heck of a lot of people, some 250,000, would still die (which makes sense, because ICUs and ventilators, even if available, will only save some).

So I'm guessing their key message is that multiple lock-down-and release cycles designed to "flatten the curve" are a damp squib: they will be costly, they will not achieve herd immunity for a long, long time, and a lot of people will still die. So the UK must utilise other strategies, such as elimination ones (border control, track-and-trace), and vaccine development.

I hope that's what they're aiming for. Because when I read "herd immunity" in the absence of a vaccine, I hear "let people die". Because that's what it will require.

 

[Sean]

So the UK must utilise other strategies, such as elimination ones (border control, track-and-trace), and vaccine development.

I am genuinely shocked at how long it is taking for this to be understood. It is Infection Control 101.

 

[mango]

Sweden´s number of fatal cases are currently declining.

It's too early to draw conclusions. According to the public health authority, the "decline" the last few days is most likely a result of delayed reporting during the Easter holiday.

For example, the government usually gets no numbers at all from nursing homes or other care homes during the weekends. Bank holidays = less hospital staff working = they probably don't have time for administrative stuff.

We will know more in a few days.

To get the whole picture re: recommendations and restrictions in Sweden, especially when comparing to other countries, do also read up on what people in Sweden are actually doing/not doing. Because the official recommendations are so loose, a lot of people are being much more careful than is currently being asked of them, while lots of others keep going about their life as usual: holiday trips, hanging out at busy shopping centers, crowded cafés etc...

And remember that where other countries use the law to control these things, the Swedish government and health authority choose to put the responsibility on the people/individuals and our "common sense" by calling it "advice" or "recommendations". One of the reasons is they believe it gives people a greater sense of freedom and that it therefore will be more sustainable in the long run (less people breaking the rules).

ETA: In case some of you have been reading the American president's comments on the so called "Swedish situation" lately, here is a thread with facts in response to the disinformation that is currently being spread:

 

[Cheshire]

WHO officials say it’s unclear whether recovered coronavirus patients are immune to second infection

• World Health Organization officials said not all people who recover from the coronavirus have the antibodies to fight a second infection.
• This raises concerns that patients don’t develop immunity after surviving Covid-19.
• “With regards to recovery and then reinfection, I believe we do not have the answers to that. That is an unknown,” said Dr. Mike Ryan, executive director of WHO’s emergencies program.

https://www.cnbc.com/2020/04/13/who...-patients-are-immune-to-second-infection.html

 

[spinoza577]

The model, which is based on the assumption that herd immunity will be achieved once 60% of the UK population is infected, suggests that to achieve this end, while keeping the daily incidence of acute cases to a manageable level, the UK would need 8-10 lockdown-and-release cycles. This is based on the estimate of the proportion of people that have been infected in the hardest hit countries, which is still quite low (they mention the figure of 6%).

Though when more people are affected, the virus will spread more slowly. E.g. when 15% are immune (for a while), every fourth cannot become a target for the virus anymore.

In addition, there is to some extent the possibilty that high initial viral loads will cause a more severe illness, compared to small initial viral loads. Given that some countries didn´t slow down the initial spreads (from a new virus), this might be inline with the desasters seen. Other countries might have act - more or less by chance and accident - more luckily, and may have already a comparable number of people that have been in contact. We will see, in in so far that not other circumstances matter.

For example, the government usually gets no numbers at all from nursing homes or other care homes during the weekends. Bank holidays = less hospital staff working = they probably don't have time for administrative stuff.

Yes, this is quite likely. ME brain at work ...

To get the whole picture re: recommendations and restrictions in Sweden, especially when comparing to other countries, do also read up on what people in Sweden are actually doing/not doing. Because the official recommendations are so loose, a lot of people are being much more careful than is currently being asked of them, while lots of others keep going about their life as usual: holiday trips, hanging out at busy shopping malls, crowded cafés etc...

And remember that where other countries use the law to control these things, the Swedish government and health authority choose to put the responsibility on the people/individuals and our "common sense" by calling it "advice" or "recommendations". One of the reasons is they believe it gives people a greater sense of freedom and that it therefore will be more sustainable in the long run (less people breaking the rules).

Here in Germany it came out in a somehow smart manner, may it be by accident or Angela Merkel at her best (apart that it´s rather the regions that makes the laws here). In a first week there was only options, and since then it´s essentially forbidden to gather with more than two persons in public, and almost all shops and all restaurants are closed. Otherwise there is still rather freedom, you can go out whenever you want (in most of the states/counties), and you still rather have to work. Parks may look crowded, but the utmost of people behave intelligent. It´s a bit surreal.

 

[Leila]

Regarding reinfection/reactivation our main scientific advicer posted this study.

From what I understand his stance is that later PCR tests become less "reliable" and can switch from positive to negative and vice versa.

So if people have a positive result again after having been discharged with two negative results it's due to the method, not reinfection.

 

[Wonko]

Regarding reinfection/reactivation our main scientific advicer posted this study.

From what I understand his stance is that later PCR tests become less "reliable" and can switch from positive to negative and vice versa.

So if people have a positive result again after having been discharged with two negative results it's due to the method, not reinfection.

That's all right then.

Procedures and testing are discharging potentially large numbers of people with active covid-19 from hospital and/or isolation and telling them, and everyone else, that they are now immune and it's safe to resume normality.

Such people, after a brush with death, may decide that a celebration is in order.

Which is clearly perfectly fine.

 

[Leila]

From what I understand he's only refering to the confusing positive/negative PCR results afterwards, not necessarily immunity which needs antibody testing, I think.

Also, a positive PCR result later might not mean that the tested person has enough viral load to still be infectious.

But I don't understand enough to really interpret his paper or if his conclusions make sense.

 

[FMMM1]

Because when I read "herd immunity" in the absence of a vaccine, I hear "let people die". Because that's what it will require.

Not just you, Doctors were highlighting the potential death toll (particularly among the elderly) early on. Also, recall the open letter signed by many eminent scientists in this field, i.e. highlighting the potential loss of life if the UK pursued the herd immunity strategy.

 

[Cheshire]

Some social distancing may be needed into 2022 to keep coronavirus in check, new study says

A modeling study on the new coronavirus warns that intermittent periods of social distancing may need to persist into 2022 in the United States to keep the surge of people severely sickened by Covid-19 from overwhelming the health care system.

The research, published Tuesday in the journal Science, looked at a range of scenarios for how the SARS-CoV-2 virus will spread over the next five years. Those scenarios included variables like whether people who are infected develop short-term immunity — less than a year — or longer-term protection. But, overall, the research concludes it is unlikely that life will return any time soon to the way it was before the virus’s emergence.

The researchers, from Harvard University’s T.H. Chan School of Public Health, acknowledge the economic fallout from the response to the virus has been profound.

https://www.statnews.com/2020/04/14...-to-keep-coronavirus-in-check-new-study-says/