One-*** efficacy questions

[Rorschach]

How are you going to enforce a local lockdown? We can't even enforce a national lockdown (thank goodness).

 

[RobinBHM]

If you can't see that covid spanned two winter seasons then there really is no hope

Interesting

here are the facts:

1. There are 80% more lung disease admissions in the winter months of December, January and February then there are in the warmer spring months of March, April and May.

2. first Covid wave in UK was March till May with peak hospital admissions and deaths around 2nd week April.

perhaps you would like to provide your interpretation, as I am sure you are right...........

 

[Jonm]

I must say i'm a bit confused. We have an effective vaccine (even against the Indian variant), most of the elderly and very vulnerable have been vaccinated. So why such concern about overwhelming the NHS and worry that it could be more severe than January? I can rationalise/synthesis the points with a few assumptions:
a) there are still a number of vulnerable, although not highly vulnerable, but nevertheless vulnerable people in the 16+ to 38 age group, COPD, asthma etc
b) 5% who haven't taken up the vaccine in the vaccinated groups
c) the vaccines are only 92% effective, and less for the first *** and its less effective against the Indian variant (data is emerging in this area)
d) you add/multiply these first three risk factors together with the fact the virus's R0 is 1.5 times that of Kent (1.7time that of Wuhan) giving a 2.5 times infectivity vs Wuhan.
e) transmission is very high in the young, could so long covid and other complications in that age group be the concern?.
f) the virus is circulating in the south Asian community in Bolton and Darwen etc, there may be less vaccine update in that community
.
So is the concern about local NHS being overwhelmed or is it the whole country as in January? or is it long covid, seem to be still a few too many unknowns.

Personally I'd prefer to see a very vigorous PH response to this variant virus, take extreme TTI measures for 3 weeks or so, and ring vaccination on each outbreak, to hold this variant at bay until all adults have had the offer of a vaccine. Short sharp local responses. Its only about 3to 4 months before all adults will be vaccinated, by which time the population (and the NHS) should be safe.
My worry is that the government will muddle along into another national lock-down mid summer. My colleagues in the NHS are exhausted and looking forward to the summer to re-charge ready for the usual winter rush.

Here are the minutes of the Sage meeting of 13 May

https://assets.publishing.service.g...e/986564/S1236_Eighty-nineth_SAGE_meeting.pdf

Here is the warwick university modelling report which may be behind sage’s comments. Looks at lots of scenarios, I have had a quick look through it but cannot justify the time to actually understand what it is saying.
https://assets.publishing.service.g...p_Scenarios_and_Sensitivity_Steps_3_and_4.pdf

On an earlier post I worked out that one dose of the vaccine reduced transmission by 80% so higher for two doses. Sage seems to be saying that increased transmission alone could result in the nhs being overwhelmed.

Similar to yourself, I am currently not understanding what the logic is.

 

[sometimewoodworker]

Personally I'd prefer to see a very vigorous PH response to this variant virus, take extreme TTI measures for 3 weeks or so, and ring vaccination on each outbreak, to hold this variant at bay until all adults have had the offer of a vaccine. Short sharp local responses.

Your abbreviations are rather confusing.

While vaccination of everyone in the vicinity of an outbreak certainly can’t do any harm, for at least 6 weeks, even at the shortest vaccination interval, it’s not going to provide very much protection.

If you are going by the standard 3 months between shots you at are much longer than 6 weeks

Do you think that a 6 week strict lockdown is going to fly?

3 weeks would only work if you can isolate all infected people and get them into strict quarantine & I am wary of thinking that that will function.

 

[TominDales]

Your abbreviations are rather confusing.

While vaccination of everyone in the vicinity of an outbreak certainly can’t do any harm, for at least 6 weeks, even at the shortest vaccination interval, it’s not going to provide very much protection.

If you are going by the standard 3 months between shots you at are much longer than 6 weeks

Do you think that a 6 week strict lockdown is going to fly?

3 weeks would only work if you can isolate all infected people and get them into strict quarantine & I am wary of thinking that that will function.

Apologies for the abbreviations, I was coping an earlier post. Track, Trace and Isolate.

My reasoning is this. I sense that BJ is very wary of quick interventions, he likes to wait until he feels he has the populous on his side, ie when the NHS is creaking before he acts. In my view this is a flawed policy as it allows the infection to get out of control and we suffer an extended lockdown over months and we suffer the deaths and disease. So I'm proposing the very opposite to this, the shortest possible lockdown. Ie lock down very very locally in a dynamic way ie hit just the places where the variant is being recorded - his wack-a-mole analogy. Surge test and area and lockdown all the streets in the areas with where new variant covid is detected and give everyone a 1st vaccine dose. Lockdown for 3 weeks immunity to builds in the group and then immediately unlock. The combination of a lockdown and ring vaccination should snuff out the outbreak., or at least bring R down to low levels. If it flares up again in a nearby place, repeat the 3 week treatment. Do this while continuing to role out the national vaccine.
I wasn't thinking of waiting 3 months for the booster, just a sharp intervention to really get the R rate down and so confine the outbreaks to localities, what I think we must do is stop this spreading to a national problem.

To some extent I'm thinking ahead, getting good practice established as preparation for the possible onset of a dangerous new variant, say one that escapes the current vaccines. If that were to occur we can quite quickly introduce a new booster vaccine, but it will be in small volumes to start with. We therefore need measures to slow or suppress a new variant from escaping into the whole population while stocks of the booster were built up.

.

 

[Rorschach]

Once again, how do you intend to enforce this?

 

[sometimewoodworker]

Surge test and area and lockdown all the streets in the areas with where new variant covid is detected and give everyone a 1st vaccine dose. Lockdown for 3 weeks immunity to builds in the group and then immediately unlock.

Do you think it would work? Personally I rather doubt it unless you also accompany it with reasonably frequent universal mandatory testing and state quarantine of all infected people.

 

[TRITON]

Seems to me this needs to be a world effort or we're going to be getting worse and worse mutations springing up..
It appears that when the virus is rife amongst a population, it has more of an ability to mutate into something stronger, more virulent or with a greater degree of resistance to vaccines.

So currently, India with its large population and lack of resources and lack of vaccine resources the virus has mutated to the point that it is now a danger to other mostly western countries, that have a high degree of inoculations.
Is this the fault of the Indian government or the fault of the western countries who seem intent on hoarding the available vaccine for themselves.

 

[Chris152]

Apologies for the abbreviations, I was coping an earlier post. Track, Trace and Isolate.

My reasoning is this. I sense that BJ is very wary of quick interventions, he likes to wait until he feels he has the populous on his side, ie when the NHS is creaking before he acts. In my view this is a flawed policy as it allows the infection to get out of control and we suffer an extended lockdown over months and we suffer the deaths and disease. So I'm proposing the very opposite to this, the shortest possible lockdown. Ie lock down very very locally in a dynamic way ie hit just the places where the variant is being recorded - his wack-a-mole analogy. Surge test and area and lockdown all the streets in the areas with where new variant covid is detected and give everyone a 1st vaccine dose. Lockdown for 3 weeks immunity to builds in the group and then immediately unlock. The combination of a lockdown and ring vaccination should snuff out the outbreak., or at least bring R down to low levels. If it flares up again in a nearby place, repeat the 3 week treatment. Do this while continuing to role out the national vaccine.
I wasn't thinking of waiting 3 months for the booster, just a sharp intervention to really get the R rate down and so confine the outbreaks to localities, what I think we must do is stop this spreading to a national problem.

To some extent I'm thinking ahead, getting good practice established as preparation for the possible onset of a dangerous new variant, say one that escapes the current vaccines. If that were to occur we can quite quickly introduce a new booster vaccine, but it will be in small volumes to start with. We therefore need measures to slow or suppress a new variant from escaping into the whole population while stocks of the booster were built up.

.

Makes sense to me, assuming there's adequate compensation for lost earnings etc. (as I think you indicated in an earlier post). The cost of that would be tiny compared to potential cost of a vaccine-evading variant running through the country, assuming measures are taken early. Our govt seems averse to taking early action, which has cost us dearly (health and money).

Triton - from what I've seen a key contributor to the spread in India was their government's failure to impose restrictions and instead, allowing political and religious gatherings/ festivals (rather than being starved of vaccines - tho clearly more vaccines would have been a good thing); as for wealthy countries getting a disproportionate % of the vaccines, I'd imagine if they were spread equitably around the world, nowhere would have it anything like under control?

 

[RobinBHM]

I guess the govt announcement is about "messaging" to encourage people to be continue with social distancing.

The 21st June roadmap date was always speculative and the govt has always said it will be based on the data.


My guess is social distancing will continue for a fair bit longer.

 

[doctor Bob]

I reckon we are not out of it, hospitals are gearing up for forth wave amoungst the young, only word on the "street" so could be BS.

 

[Rorschach]

I reckon we are not out of it, hospitals are gearing up for forth wave amoungst the young, only word on the "street" so could be BS.

Considering nowhere in the world has seen any kind of significant problems among the young this does sound like BS.

 

[Terry - Somerset]

There are many difficult to quantify variables associated with these projections that almost any outcome can be modelled. I quote:

We predict that Step 3 only can lead to a third wave with 9100 (CI 2430-26,400) hospital admissions and 1160 (CI 240-3870) deaths; Step 3 and 4 combined (generating a higher transmission after 21st June) are projected to generate a larger third wave with 34,900 (CI 10,100-96,400) hospital admissions and 7250 (CI 1450-24,300) deaths.

In context

• actual figures for covid thus far - aggregate deaths are 127,000 and hospitalisations 465,000
• averagely 20,000 deaths a year associated with flu, and 10,000 deaths a week from other causes.

There is a risk in opening up as planned on 17th May - a balance of the damage caused by continued lockdown vs a difficult to quantify number of hospitalisations and deaths. Continuing the roadmap as planned and reviewing step 4 over the next month seems very sensible.

 

[Petehpkns]

No countries have an effective T&T system for Covid, what they have was a start from an incredibly low base and probably high levels of natural immunity.

Singapore has an effective track and trace system, I lived there for ten years including the period of SARs in 2003. The response to that was staggering and allowed the agility in responding to COVID. Of note is the lack of credible data on herd immunity - SARS v COVID……

 

[Rorschach]

Singapore has an effective track and trace system, I lived there for ten years including the period of SARs in 2003. The response to that was staggering and allowed the agility in responding to COVID. Of note is the lack of credible data on herd immunity - SARS v COVID……

It's easier to do T&T when your peak infection rate was 1k a day and only for a few days. I am certain there is some kind of herd immunity going on though, every country that had some exposure to SARS has done much better in terms of SARS2, coincidence? I think not.

 

[Jonm]

Seems to me this needs to be a world effort or we're going to be getting worse and worse mutations springing up..
It appears that when the virus is rife amongst a population, it has more of an ability to mutate into something stronger, more virulent or with a greater degree of resistance to vaccines.

So currently, India with its large population and lack of resources and lack of vaccine resources the virus has mutated to the point that it is now a danger to other mostly western countries, that have a high degree of inoculations.
Is this the fault of the Indian government or the fault of the western countries who seem intent on hoarding the available vaccine for themselves.

You are correct about a world effort being required to combat Covid.

India, 5th largest economy in the world, larger than us. Space programme, looking to land a rover on the moon and build a space station. Have nuclear weapons and and own great chunks of uk like Jaguar Land Rover. They are hardly a third world country being exploited by the wicked west. They also have the largest vaccine manufacturer in the world, Serum Institute and we have given them the information to produce AZ vaccine, they even sent some to us until they realised they needed it themselves. So we have given them the ability to help themselves in terms of vaccine.

 

[Rorschach]

You are correct about a world effort being required to combat Covid.

India, 5th largest economy in the world, larger than us. Space programme, looking to land a rover on the moon and build a space station. Have nuclear weapons and and own great chunks of uk like Jaguar Land Rover. They are hardly a third world country being exploited by the wicked west. They also have the largest vaccine manufacturer in the world, Serum Institute and we have given them the information to produce AZ vaccine, they even sent some to us until they realised they needed it themselves. So we have given them the ability to help themselves in terms of vaccine.

Facts like that don't fit the MSM narrative though. They like to purport that either India is too poor to take charge of the Covid situation or too stupid when the reality is that they have a different outlook on life and how to run their country. It will be very embarrassing for the west if India manages to do a reasonable job of dealing with covid without severe impacts on it's economy or liberty of it's citizens, therefore the media demonises them and creates hysteria. I have friends in India, they are less worried about covid and more worried about government corruption, an ongoing theme in Modi's government (dictatorship to some).

 

[RobinBHM]

They like to purport that either India is too poor to take charge of the Covid situation

Certainly their healthcare system is far too poor to cope.

India is a poor country, similar GDP to UK with 20x the population.

 

[RobinBHM]

I've just seen a post on another DIY forum, somebody has posted he has been very ill with Covid, he lives in Formby Liverpool, a region with the Indian variant. His wife has also caught it, she had the *** 8 weeks ago, but it's still making her ill.

the vaccination programme means any future wave will be very different, but we aren't out of the woods just yet.

 

[Jake]

Singapore has an effective track and trace system, I lived there for ten years including the period of SARs in 2003. The response to that was staggering and allowed the agility in responding to COVID. Of note is the lack of credible data on herd immunity - SARS v COVID……

There are quite a few Asian countries which had impressive track and trace due to experience from SARS. Vietnam and South Korea spring to mind.

Outside that, it was pretty key to Germany's response too.