Covid - coming out of Lockdown 3 - no politics, less opinion and more facts and information.

[woodenhead]

My understanding of these Virtual Wards was to allow people to go home to recover but still be under close scrutiny, what you've described here is keeping them out of hospital whilst infected.

 

I wonder where these patients are classed as being when it comes to hospital numbers, and just how many people are being monitored like this whilst still in the infectious stage.

[didcot]

After 18 months of dodging the bullet, it finally hit home yesterday. My eldest complained of a sore throat and aching whilst at work Saturday evening. Sure enough a LFT gave a faint positive trace. We did a second a bit later and it was more pronounced. Within an hour and a half a PCR had been done. Got the positive result in about 18 hours. Track n Trace has pinged us and his friends/colleagues. 

I have to say it's been very efficient. Just need to keep us safe, he's the only fit one in the house!

[beast66606]

31 minutes ago, Bernard Lamb said:

I know that we have a hawk or two on here and that stories like this will not make you change you mind.

I just hope that you never have an experience like this.

 

I wish your family a speedy recovery.

 

Hawk* or two ? - jeez

 

My son has just recovered from Covid, well nearly, he was very ill on 16 July and I nearly drove the several hundred miles to be with him but didn't, he improved enough on the 17 to mean we dropped the idea of hospital and I was less worried, his mother, who is within a few miles, and a nurse, made sure he was ok and attended to their (his girlfriend was also isolating because of him and caught it, but only mildly) basic needs until yesterday when their isolation finished. He initially tested negative, the PCR was the first positive test.

 

By the way, I've had asthma for many years and have to take steroids every DAY that doesn't mean I can demand everyone else has their life put on hold just because of my situation.

 

* for those who don't know a hawk in this context "is someone who favors war or continuing to escalate an existing conflict as opposed to other solutions"

[didcot]

Just spent 72 minutes on the phone with Track n Trace. Had to go through movements, people met, contact details, likely place of infection. I think I need an early night. They are very thorough. 

[Reorte]

19 minutes ago, didcot said:

Just spent 72 minutes on the phone with Track n Trace. Had to go through movements, people met, contact details, likely place of infection. I think I need an early night. They are very thorough. 

Good to know they're being thorough. Heaven knows what I'd say if I was called, wouldn't have a clue when it comes to contact details.

[Markwj]

I was trying to recall this time last year (but struggle to recall this time last week) but did we experience this same drop in cases last year only for it to spike again in the autumn. I am aware the vaccine is a factor this year which it wasn’t last year. So where do we think we will be in autumn? Cases low or on the way to a forth spike?

[APOLLO]

Over in Thailand, cases are increasing rapidly and Hospitals are getting full, they have started a monitored home isolation scheme.

 

The home isolation scheme, where asymptomatic and mild COVID-19 cases are asked to stay home, with online care from medics, started today (Wednesday) under the “Warm Community Clinic” banner, with as many as 1,283 medical volunteers in support. The scheme is to provide a solution to the current hospital bed shortage, caused by continuously rising infections and deaths in the country.

 

https://www.thaipbsworld.com/thailands-covid-19-home-isolation-scheme-kicks-off-with-over-1200-medical-volunteers/

 

I was told today that a neighbour of my Brothers is in Wigan Hospital on a ventilator with Covid, 50 yr old, jab status not known.

 

It is out there and causing harm to some.

 

Brit15

[Oldddudders]

Of course it is still out there. And no-one has ever claimed that vaccination would make us immune, merely that it would make us a lot less vulnerable. But we are not machines, and our personal makeup is each different from the next. So a % of people, even though double-jabbed, will still find themselves ill, very ill or even at death's door. Thus common-sense adherence to the lessons we have all learned over the last 18 months continues to make enormous sense.

 

Sherry was at a minor outdoor event yesterday. A man introduced himself, and proffered a hand. Sherry pointed out she hadn't shaken hands with anyone in 18 months, whereupon he said "Oh we can forget all that now!" Apparently he thinks that Government easing of restrictions has told the virus to stop being a nuisance. At the same event, an acquaintance gave Sherry the third degree about vaccine, and said the whole thing is a scam. This, mind you, is a graduate lady who has previously been a journalist with a leading Sunday broadsheet - and I think maybe the NY Times, too. Well into her seventies, but neither she nor husband have had a jab, nor will they. It has to be said they have form. They moved from leafy Chiswick to Torbay (they own a very expensive house) because they hated hearing foreign tongues in the supermarket. You may guess how they voted in the Referendum....

[Nearholmer]

11 minutes ago, Oldddudders said:

Thus common-sense adherence to the lessons we have all learned over the last 18 months continues to make enormous sense.

…… to many people, but very clearly not to others, who feel perfectly at liberty to jettison all precautions.

 

One way of putting it is to say that the mental make-up of people is as varied as their physical make-up. Another way is to say that a few people are actually bonkers.

 

(I’m in a grumpy mood following a visit to the most masked-up supermarket, where I noticed that now c5%, very definitely thirty-somethings, who stand-out by their youth in said shop, have decided that masking is too yesterday.)

[iL Dottore]

I, and my colleagues in practice, know full well how lethal the virus can be and the terrible consequences of “long CoVID” in those who are susceptible to that form of the disease. But, If I may be blunt, the biggest problem with the SARS-CoV-2 (CoVID-19)  virus is that it is not lethal enough in the right age groups! 
 

Let me explain: the Infection Fatality Rate (IFR) is a metric calculated by dividing the total number of deaths from the disease by the total number of infected individuals. Under the age of 64 it is 0.75% or less, from 65 to 75 it rises to 2.5%, from 75 to 85 it is 8.5% and over 85 it is 28.3%! (data from the European Journal of Epidemiology. 35 (12): 1123–1138).  So, I would argue that this means that firstly, a huge percentage of fatal cases are basically in a population (pensioners and the elderly) that has very low visibility in society; and secondly, this in turn means that if you are under 64, if you don’t have an elderly relative who succumbs from the virus (or know one of the unlucky under 64s) the pandemic will only touch you through the media, the lockdown and the so-called “inconvenience“ of mask wearing, social distancing and basic hygiene.
 

However, if COVID-19 had the same IFR amongst the under 64s as it does in the over 85s (almost 30%) you could be pretty damn sure that it would be a completely different picture: those who are currently very cavalier about pandemic precautions would certainly take a very different point of view (as Samuel Johnson opined “when a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully”). And in that sort of environment, with a third of the population facing the very real prospect of an early (and terrible) death, anti-vaxxers and conspiracy theorists would be very likely to have an extremely short shelflife indeed.

 

One final thought: we have been relatively lucky with the SARS-CoV-2 virus. Having worked in infectious disease for a while, interacting with top epidemiologists, bacteriologists and virologists, I have learnt that there are viral and bacterial diseases out there that - if they develop a gain of function, becoming more infectious, jump species and spread through the human population, they would make COVID-19 look like Kindergarten sniffles.

Edited July 26, 2021 by iL Dottore
Typo, update of quote.

[Nearholmer]

1 hour ago, Markwj said:

So where do we think we will be in autumn?

 

I was pondering that yesterday.

 

There seems to be a realsitic prospect that c90% of adults will be double-jabbed by then*, which will leave the residual 10%, plus <18yo, who I think make-up c15% of the population, so roughly a quarter of the population within which the bug can propogate freely. The bug will also make some headway among even the fully vaccinated. What Dr Fauci in the US yesterday called "a pandemic among the unvaccinated".

 

So, it feels to me as if the number of cases will fall, but not to a super-low level, merely to a low level, with a flare-up when schools restart, only decreasing further as the 10% + <18yo get "vaccinated by catching it" ......... a long, slow, painful for many, burn-down, during which plenty of double-vaccinated people will catch it, and some of those will become very badly ill.

 

That is provided that the barely constrained virus breeding programme that is underway right now doesn't throw three double sixes in a row, and produce a mutation that is both an immunity-beater, and a fast-spreader. If it does, we could be back to square one for a while.

 

Odds on there needing to be lockdowns over the winter to control the combination of covid plus resugent 'flu and resurgent everything else? My guess is that there's at least a 25% chance of that, although it is very difficult to guess sensibly without proper numbers.

 

*I'm struggling a bit to square some of the figures TBH, because the way vaccine acceptance decreases with decreasing age, I can't see how we will get to c90%, but the daily dashboard suggests that we probably will, in that 88%+ are already single-shotted, and will preseumably go for their second.

[boxbrownie]

39 minutes ago, iL Dottore said:

I, and my colleagues in practice, know full well how lethal the virus can be and the terrible consequences of “long CoVID” in those who are susceptible to that form of the disease. But, If I may be blunt, the biggest problem with the SARS-CoV-2 (CoVID-19)  virus is that it is not lethal enough in the right age groups! 
 

Let me explain: the Infection Fatality Rate (IFR) is a metric calculated by dividing the total number of deaths from the disease by the total number of infected individuals. Under the age of 64 it is 0.75% or less, from 65 to 75 it rises to 2.5%, from 75 to 85 it is 8.5% and over 85 it is 28.3%! (data from the European Journal of Epidemiology. 35 (12): 1123–1138).  So, I would argue that this means that firstly, a huge percentage of fatal cases are basically in a population (pensioners and the elderly) that has very low visibility in society; and secondly, this in turn means that if you are under 64, if you don’t have an elderly relative who succumbs from the virus (or know one of the unlucky under 64s) the pandemic will only touch you through the media, the lockdown and the so-called “inconvenience“ of mask wearing, social distancing and basic hygiene.
 

However, if COVID-19 had the same IFR amongst the under 64s as it does in the over 85s (almost 30%) you could be pretty damn sure that it would be a completely different picture: those who are currently very cavalier about pandemic precautions would certainly take a very different point of view (as Samuel Johnson opined “when a man knows he is to be hanged in a fortnight, it concentrates his mind wonderfully”). And in that sort of environment, with a third of the population facing the very real prospect of an early (and terrible) death, anti-vaxxers and conspiracy theorists would be very likely to have an extremely short shelflife indeed.

 

One final thought: we have been relatively lucky with the SARS-CoV-2 virus. Having worked in infectious disease for a while, interacting with top epidemiologists, bacteriologists and virologists, I have learnt that there are viral and bacterial diseases out there that - if they develop a gain of function, becoming more infectious, jump species and spread through the human population, they would make COVID-19 look like Kindergarten sniffles.

You sound just like my Son……I’ve given up trying to pass the message on to unbelievers, it is so very frustrating!

[Nearholmer]

1 hour ago, iL Dottore said:

Under the age of 64 it is 0.75% or less, from 65 to 75 it rises to 2.5%, from 75 to 85 it is 8.5% and over 85 it is 28.3%!

 

To get a feel for what they mean, those figures are.perhaps best viewed against the background, "all causes, pre-covid", probability of death within one year for those age groups, which are only very slightly lower numbers.

 

So, very roughly, catching covid if unvaccinated multiplies your probability of dying within the next year by something above two, possibly approaching three in the case of the Delta variant, almost irrespective of your age.

 

A man in the UK hits 28% background probability of death within the next year at about 95yo. At 80yo his background probability is 5.5%; at 70yo it is 1.9%; at 60yo it is 0.8% etc.

 

 

[APOLLO]

12 minutes ago, Nearholmer said:

A man in the UK hits 28% background probability of death within the next year at about 95yo. At 80yo his background probability is 5.5%; at 70yo it is 1.9%; at 60yo it is 0.8% etc.

 

Well if I get to 95 years old a 28% probability of death in the next year would be very, very acceptable !!!!!!

 

Brit15

 

 

 

 

[Nearholmer]

Well, if you look at detailed actuarial tables as used by insurers, you can probably find out, pretty accurately, the probability of getting to 95.

 

EDIT: Well, the ONS has an on-line calculator that gives a pretty fair idea! https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/articles/lifeexpectancycalculator/2019-06-07 It doesn't ask all those "insurance questions" about diet, drinking, smoking, etc, so can't be super-accurate, but it might (or might not) cheer you up.

Edited July 26, 2021 by Nearholmer

[APOLLO]

Seventeen years to go then - I'll crack open a can and have a pie - oops, sixteen !!!!!!!!!!!!!!!!!!!

 

Brit15

[Andy Hayter]

5 hours ago, Markwj said:

I was trying to recall this time last year (but struggle to recall this time last week) but did we experience this same drop in cases last year only for it to spike again in the autumn. I am aware the vaccine is a factor this year which it wasn’t last year. So where do we think we will be in autumn? Cases low or on the way to a forth spike?

 

 

Autumn?  I am struggling to guess what will happen in August.

 

WE rejoice in a 21% drop in infections in a week, but as ADB warned a few days ago the numbers are likely to be skewed.  Testing dropped 10.5% in the same week,  If that drop in testing is largely down to school children now no longer having to test before going to school, then we have a large group of untested likely asymptomatic carriers and spreaders.  That will cause infection rates to go back up.  Probably a bit slowly over the next fortnight but then gathering speed.

If however the extreme infection peak was due to the Euros then we should feel more comfortable about the drop - even if it is not as good as it looks.  But then that in turn could mean that underlying case rates have not really fallen that much and the impact of children and testing might just be a stronger influence than I suggested above.

 

Very much a case of watch the numbers.

Edited July 26, 2021 by Andy Hayter
error correction

[Reorte]

59 minutes ago, Andy Hayter said:

 

 

Autumn?  I am struggling to guess what will happen in August.

 

WE rejoice in a 21% drop in infections in a week, but as ADB warned a few days ago the numbers are likely to be skewed.  Testing dropped 10.5% in the same week,  If that drop in testing is largely down to school children now no longer having to test before going to school, then we have a large group of untested likely asymptomatic carriers and spreaders.  That will cause infection rates to go back up.  Probably a bit slowly over the next fortnight but then gathering speed.

If however the extreme infection peak was due to the Euros then we should feel more comfortable about the drop - even if it is not as good as it looks.  But then that in turn could mean that underlying case rates have not really fallen that much and the impact of children and testing might just be a stronger influence than I suggested above.

 

Very much a case of watch the numbers.

Drops in testing can happen due to more than one reason; there's some degree of correlation between tests and positive cases, which either means that the increases were due to testing picking up more, or that fewer people take tests when they've got less reason to believe they might be infected (whether due to developing symptoms or being in contact with someone positive).

 

Looking at the England numbers, which show above and below 60s lines, the under 60s has definitely peaked. The over 60s line, which won't be affected by school testing anywhere near as much (possibly a little via family member exposure) is less definite but I'd label it as "probable." In the under 60s the numbers on the heatmap (which aren't easy to see, need to hover the mouse over them or download the data) show drops in above school age groups. Also remember that schools have only just broken up, so that won't have had any impact on detected cases yet (or did the reduce the amount of testing during the last couple of weeks in school - I genuinely don't know).

 

Children not getting tested at school will be somewhat balance by them not being together in the same classrooms.

 

So overall I feel reasonably confident that the numbers will broadly represent the number of cases. We should see very shortly whether the lessening of restrictions will have a noticeable negative impact; although you can't read too much in one day (and Tuesday's always an increase after the weekend numbers) a very large number tomorrow will be an indication that it did. If it doesn't it'll still be best to wait another week just to give any first weekend effect time to show up.

 

The thing that bothers me right now is the big slowdown in vaccine takeup.

 

Edited July 26, 2021 by Reorte

[iL Dottore]

7 hours ago, boxbrownie said:

You sound just like my Son……I’ve given up trying to pass the message on to unbelievers, it is so very frustrating!

Sorry, did you actually read my post?

In my very first paragraph I pointed out that both I and my colleagues who are practising medicine (I am in research) are very much aware of the lethality of the CoVID virus, how it is spread, how patients die from it and how it causes (probably permanent) long-term damage to more than just the respiratory system. Both I, and my colleagues, are very much in favour of vaccines - (some of my colleagues being both involved in the mRNA vaccine research and being volunteer subjects). Being in research, I can quote chapter and verse how vaccines are made, trialed and approved (and believe me no corners were cut, the patient population was utterly enormous [running into the thousands], the regulatory agencies worked in an incredibly expedited and efficient manner - following the laws, regulations and guidelines to the letter) and the resulting CoVID vaccines are as safe and as effective as any well-established vaccine (if not more so).

 

But as soon as I point out the differences in Infection Fatality Rate (data from a respected, peer reviewed, medical journal) and point out the differences between the different age groups, make an opinion that because of the lower IFR in these age groups, it is not taken as seriously as it should be by these same age groups, then suddenly I am an “unbeliever”. 
 

I am as far away from a CoVID denier/anti-vaxxer/conspiracy theory nut-job as you can possibly be. So, quite frankly, I find being called an “unbeliever” insulting!

 

And as for my last point about us being relatively lucky with the CoVID virus,  just consider what would happen if Ebola became transmittable through airborne droplets - as CoVID-19 is

[iL Dottore]

7 hours ago, Nearholmer said:

 

To get a feel for what they mean, those figures are.perhaps best viewed against the background, "all causes, pre-covid", probability of death within one year for those age groups, which are only very slightly lower numbers.

 

So, very roughly, catching covid if unvaccinated multiplies your probability of dying within the next year by something above two, possibly approaching three in the case of the Delta variant, almost irrespective of your age.

 

A man in the UK hits 28% background probability of death within the next year at about 95yo. At 80yo his background probability is 5.5%; at 70yo it is 1.9%; at 60yo it is 0.8% etc.

 

 

I think we are talking about two different things. Infection Fatality Rate (which is similar to Case Fatality Rate [the proportion of deaths from a certain disease compared to the total number of people diagnosed with the disease for a particular period], but IFR takes into account the proportion of deaths among all infected individuals, including all asymptomatic and undiagnosed subjects), is best viewed as an assessment of the lethality of a disease, not as how that illness will contribute to all-cause mortality. Rabies, which has a CFR of 100% in untreated individuals, barely impacts on all cause mortality, if at all.

 

And as to the lethality of CoVID-19, the CFR for the virus is roughly 2.5% whilst for Zaire Ebola it’s 100%, for Smallpox (hemorrhagic variant) it’s 95%, for Marburg Virus Disease it’s 90%. So, yes we have been lucky with CoVID-19 (to put things into perspective, the bubonic plague [Black Death] which decimated the population of Europe in the 14th century is estimated to have a CFR of “only” 60%!)

[Nearholmer]

2 hours ago, iL Dottore said:

think we are talking about two different things

We are.

 

You are talking about IFR for Covid-19.

 

I am seeking to compare that with background, “all causes pre-Covid”, probability of death in the next year.

 

I seek to make that comparison in order to get a feel for how great a risk is posed by catching Covid-19 when unvaccinated, compared with all the other risks we run, cancer, heart failure, stroke, getting run over by a bus etc.

 

The answer is that, pretty much irrespective of age, catching Covid-19 when unvaccinated poses something like the same risk of death as everything else added together, plus a bit.

 

 

[2750Papyrus]

"Under the age of 64 it is 0.75% or less, from 65 to 75 it rises to 2.5%, from 75 to 85 it is 8.5% and over 85 it is 28.3%! (data from the European Journal of Epidemiology. 35 (12): 1123–1138)."

 

That's a bit worrying!  Plse was any distinction made between those who have been vaccinated and the remainder?

[iL Dottore]

18 minutes ago, 2750Papyrus said:

"Under the age of 64 it is 0.75% or less, from 65 to 75 it rises to 2.5%, from 75 to 85 it is 8.5% and over 85 it is 28.3%! (data from the European Journal of Epidemiology. 35 (12): 1123–1138)."

 

That's a bit worrying!  Plse was any distinction made between those who have been vaccinated and the remainder?

Not according to my quick review of the paper (which can be found here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721859/)

 

A sobering table in the paper is one that compares IFR for CoVID-19 with auto accident fatalities and other accidental fatalities: In the 35-44 year age group for CoVID it's 0.068, for auto accidents (UK) it's 0.002 and for other accidental fatalities it's 0.017 (UK)

[boxbrownie]

4 hours ago, iL Dottore said:

Sorry, did you actually read my post?
In my very first paragraph I pointed out that both I and my colleagues who are practising medicine (I am in research) are very much aware of the lethality of the CoVID virus, how it is spread, how patients die from it and how it causes (probably permanent) long-term damage to more than just the respiratory system.

Yes I did, my Son is a Doctor who was on a Covid ward during the first and second peaks and has lost several colleagues and friends working in the NHS to this virus.

 

I was agreeing with your points and pointing out how frustrating it is when I hear people who don’t take it seriously enough.

 

So I am not quite sure what you mean by replying in such a way.

[hayfield]

On 25/07/2021 at 08:49, Hobby said:

 

Glad someone actually saw the point I was making! Yes I would agree that "lies" is probably too strong.

 

 

Going back a few posts about school kids breaking up, in Scotland they broke up two weeks earlier so that should give us some idea what to expect. Are any of you data analysts checking out the position north of the border? Though we could have the issue of different regulations also having to be taken into account!

 

We are seeing claims that this third (looking at the graphs its the fourth) wave is on the wane, in fact rather than looking at the daily headline numbers, the confirmed (and un confirmed) date of cases data clearly shows the rise and decline far better than the 7 day average.

 

There is a very good piece on the BBC's website today giving a clear insight into the data and thinking. Three things should be taken into consideration, Infections, hospital admissions and deaths. The former is declining, admissions may be peaking deaths so far are rising, but these latter two figures are a week out of date

 

If we look at Scotland, they seem to be 2 weeks ahead of us with the curve, all 3 measures are on the decline

 

Another piece of data/information in todays paper, over half of covid  hospitalisations tested positive for covid after being admitted to hospital, that only 44% tested positive prior to being admitted. 

 

Clearly headline figures do tell a story, but you need to drill down to find accurate info. This is why ZOE seems far more accurate and informative