Coronavirus - worldwide spread and control

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This professor also posted this recently:






I feel worried by this. I agree we do need a lot more evidence. I don’t think we should yet be saying “it sounds promising and I hope it goes well”. If it doesn’t go well - who will die? The grandparents :/

I find it worrying that children are being encouraged to visit and hug grandparents right now, do we really have evidence that it’s completely safe? I understand the issue that for elderly people, social and physical contact is very important. But surely attempting to eliminate the virus first so that grandparents could hug and interact with people in safety, is the better idea.

Edit: I just read the BBC article posted earlier and it says this: “Sounding a note of caution, Germany's chief virologist Christian Drosten told Austrian broadcaster ORF that there was insufficient data to say conclusively that young children could not transmit the virus.

He said the question of whether children contracted the virus, and if so how they might pass it on, was answered differently in different studies.”

If so, why is Switzerland rushing ahead to allow children to hug their grandparents and also claiming as Koch did, that “Young children are not infected and do not transmit the virus...They just don't have the receptors to catch the disease."?
 
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Thanks, @JaneL for the list of articles. This one coauthored by Wessely is sort of the COVID version of "Air travel will never catch on".

The psychological effects of quarantining a city

https://www.med.uminho.pt/pt/covid19/Sade Mental/Rubin 2020 The psychological effects of quarantining a city.pdf

Not a single piece of research is referenced. Why use references - we can surely just rely on the high esteem in which the authors are held?

According to the piece, one must avoid quarantining because it makes people nervous and trapped, and these upset feelings can causes all sorts of illnesses, you see, because the mind and the body are SO heavily intertwined.

Instead, trust people to do it themselves.

Edit: I see @JaneL has already commented on this study.

Actually that’s a different study to the one I commented on (the names of the two studies have very similar titles so I can see how one could easily mistake them for being the same study)

I found this statement from the study you looked at interesting:

But while history reminds us that outright panic is unlikely, fear seems an almost certain consequence of mass quarantine.

Surely fear is a consequence of the threat of a deadly virus spreading uncontrolled through a population? I would therefore suggest that those populations who succeeded in controlling the spread with an early and strict mass quarantine would fare much better on the fear scale in the long run than those who countries didn’t.

.....

The study I commented on is more detailed, has more authors and even has references! I only scanned it so there’s probably more to uncover (if any one else has the stomach to read it!) Link here:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext
 
This is the study Drosten is refering to.

From what I understand children have sort of the same viral load as adults and Drosten concludes

"Based these results, we have to caution against an unlimited re-opening of schools and kindergartens in the present situation. Children may be as infectious as adults."

If children show far less symptoms and for example don't cough, doesn't that mean they are less infectious though? Because they, on average, don't spread as many infectious droplets?
 
They do infect most of the population, it just takes more time than you think. As I keep saying, it can take many years before "herd immunity" is achieved.



You are also rescuing the young who are not yet diseased with post-viral complications!!!!!

I agree i.e. about the young also dying @spinoza577 a very few from memory: a young (31 year old?) doctor in Wuhan i.e. who announced the outbreak, young twins (35 years old?) one of whom was currently working as a nurse ----.
 
Prof Karol Sikora is an Oncologist and ex director of the WHO cancer programme. Throughout this whole crisis, he has been posting saying things were “improving”, “looking positive” and so on. Now he says this. The reason I’m posting is because I would like to discuss this here. Is it true that we cannot compare the U.K. to other countries? Because that seems to be the latest defence that I’m hearing.

Sikora has always been somebody who makes a lot of noise. But one has to wonder what the motivation is for this sort of tweeting. As an oncologist I would have thought he would be horrified by the knock effects of how things are being handled.

Apart from anything else I would have thought that if infants were present the chances of transmission from prodromal parents to grandparents would be increased tenfold just because of the physical activities needed to control the infants. Why is it of any interest to an oncologist anyway?

Germany has a slightly larger population than UK and Spain a bit smaller, but anyone with any sense takes that into account. And although the media headlines are in terms of bald numbers I am pretty sure the sources warning on this have taken this into account. There are clearly reasons for thinking that the UK figure will be proportionately as well as actually the highest. Whether or not that proves the case I am baffled as to why Sikora should feel the need to take issue on this.
 
Regarding children and infection spread, a question please @Jonathan Edwards. Presumably virus can vary in potency, so that would presumably apply to the virus anyone exhales. Will the potency of exhaled virus be affected by how capable a person's immune system is at dealing with the virus? Or is the potency of exhaled virus completely independent of that?
 
Preparations may be in hand for a change of strategy. Someone I know, who is no more vulnerable today than two months ago, has just received a letter notifying of the vulnerable status and told to remain indoors for three months and, if sharing accommodation, to isolate from the other person. An announcement as to relaxation of lock down measures for the remainder cannot be far away.
This will be a result of them being picked up individually and flagged by their GP/GP records/other specialist rather than any change in national strategy. The shielded list is being updated each week as more people who were missed by the national NHS algorithm-based data trawl are added by their GP, hospital consultant or other specialist.
 
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This is the study Drosten is refering to.

From what I understand children have sort of the same viral load as adults and Drosten concludes

"Based these results, we have to caution against an unlimited re-opening of schools and kindergartens in the present situation. Children may be as infectious as adults."

If children show far less symptoms and for example don't cough, doesn't that mean they are less infectious though? Because they, on average, don't spread as many infectious droplets?

I think shouting is quite good at producing droplets and kids tend to shout a lot.

Yes and we also know that there are very high rates of asymptomatic transmission in adults so people can certainly be very infectious without any coughing. The study also points out that children also have greater physical activity and closer social engagement than adults.

The viral loads observed in the present study, combined with earlier findings of similar attack rate between children and adults (2 ) , suggest that transmission potential in schools and kindergartens should be evaluated using the same assumptions of infectivity as for adults. There are reasons to argue against the notion of adult-like infectivity in children, such as the fact that asymptomatic children do not spread the virus by coughing, and have smaller exhaled air volume than adults. However, there are other arguments that speak in favour of transmission, such as the greater physical activity and closer social engagement of children. We recommend collecting and evaluating more viral load data from testing laboratories to achieve more robust statistical assessments and independent confirmation of the present results. Based on the absence of any statistical evidence for a different viral load profile in children found in the present study, we have to caution against an unlimited re-opening of schools and kindergartens in the present situation, with a widely susceptible population and the necessity to keep transmission rates low via non-pharmaceutical interventions. Children may be as infectious as adults.

https://zoonosen.charite.de/fileadm...s-of-SARS-CoV-2-viral-load-by-patient-age.pdf
 
The other thing of course is that in addition to people sitting on a committee there are those people who rather than sit on the committee recommend that those people do sit on the committee. There is another layer of people hovering in the background. After all, someone has to recommend the committee members.. That seemed very much to apply to NICE. It applies to the MRC.

I think it highly likely that Chris Whitty is in regular conversation with this other layer of people. Maybe that is where he got the idea from?
You mean, like the sort of person who might be intimately involved with a clinical trial without actually being listed as a author; the sort of person who might advise on who should be on a research collaborative without actually being a member of the collaborative?
 
Regarding children and infection spread, a question please @Jonathan Edwards. Presumably virus can vary in potency, so that would presumably apply to the virus anyone exhales. Will the potency of exhaled virus be affected by how capable a person's immune system is at dealing with the virus? Or is the potency of exhaled virus completely independent of that?

Viral particles are all pretty much identical with no variation in potency, unless they have been degraded.
The immunological status of the host would not affect the infectious capability of the virus exhaled.
 
You mean, like the sort of person who might be intimately involved with a clinical trial without actually being listed as a author; the sort of person who might advise on who should be on a research collaborative without actually being a member of the collaborative?

You might think that but I could not possibly comment (or whatever Sir Humphrey said).
 
There have been a number of Swedish news articles lately, commenting on the growing number of people out and about in Stockholm.

Based on data collected and analysed by the mobile network operator Telia, there are "tens of thousands more" people out and about now, compared to at the end of March. They expect the numbers to rise even more in the coming days/weeks, because of the warmer, lovelier weather.

So, it seems that loose advice/recommendations maybe aren't so sustainable after all? What are the trends in comparable countries/places that are using stricter laws etc, do you know?

I can't help thinking, maybe the loose advice/recommendations in combination with the overall reassuring tone of the public health authority's messages ("everything is under control", a considerable focus on reassurances and reducing people's worry etc), is giving lots of people a false impression of how serious the situation actually is?
The amount of travel in Sweden keeps increasing, despite the government's recommendations.

Last week it increased on average with 10% compared to the week before. (Big differences between different parts of the country, between -2% to +25%.)

https://tt.omni.se/svenskarnas-resande-okar-trots-uppmaningar/a/3J0pML
 
I was looking at the Worldometer graphs again. It looks to me as if the restrictions in Italy are sufficient to get the epidemic down to fully controllable levels in 6 months (yes six months). The curve for the UK looks more like being sufficient to get the epidemic fully controllable in, er, maybe a few years.

I am all in favour of loosening restrictions that are not actually doing any good but it seems to me that some sort of quantum leap is needed to get R0 down not just a smidgin below 1 but seriously below 1. Face masks were mentioned by the Prime Minister...
 
I was looking at the Worldometer graphs again. It looks to me as if the restrictions in Italy are sufficient to get the epidemic down to fully controllable levels in 6 months (yes six months). The curve for the UK looks more like being sufficient to get the epidemic fully controllable in, er, maybe a few years.

I am all in favour of loosening restrictions that are not actually doing any good but it seems to me that some sort of quantum leap is needed to get R0 down not just a smidgin below 1 but seriously below 1. Face masks were mentioned by the Prime Minister...

I was wondering how they are estimating any values for R0 given the time lags in a lot of the data quoted. Which makes me wonder about their optimism. If data quality is poor then they could be misleading themselves.

Lots of the graphs do seem to show a peak has been reached but the way down does seem very gradual compared to the way up.

One of the things that one of the German scientists was saying is the R0 value for the hotspots really matters not just an average over the whole country.
 
BBC Seoul correspondent, very good news:


It is reported that South Korea have had their amazing results without a lockdown, but in a sense that is a bit misleading. What they did in practice was in effect a very intelligently controlled and highly targeted lockdown. They invested very early on in masses of testing and tracing, thereby primarily locking down those with the highest probability of needing to be locked down.
 
Lots of the graphs do seem to show a peak has been reached but the way down does seem very gradual compared to the way up.

Yes, I think there is a temptation to think that when you see a curve turning downwards it will steepen. But with such a long flat peak it seems likely that we already have the steepest part of the downward curve for the current R0. From now on reduction in numbers gets slower in that scenario. There may still be some hang over from before lockdown but for places like Italy and even UK that is getting unlikely.
 
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