One-*** efficacy questions

[RobinBHM]

But what are the symptoms? If 1.1 million people are suffering from a bit of fatigue or a loss of taste, is that really a big issue?
I suffered some kind of illness last year and had persistent symptoms for over 3 months but the symptoms were mild, didn't really affect my day to day activity, should I be making a fuss about that?

1.1 million people are not just suffering "a bit of fatigue"
Quote from the British Heart Foundation:

Just for you Rorschach, I've made the relavent bit nice and big, I am trying to help with your total inability to absorb facts.


"1.1 million people in the UK were reporting long Covid symptoms in the four weeks to 6 March 2021. These were defined as symptoms that had lasted more than four weeks from initial infection, though for more than two thirds of these people the symptoms had lasted more than 12 weeks. A fifth said their symptoms limited their daily activities a lot"

 

[RobinBHM]

Post viral syndrome isn't unique to covid

Dishonest debating.....classic strawman.
Nobody was saying it s unique to Covid.

What we are saying is long Covid is serious and many people are suffering.

 

[RobinBHM]

Do you realise virtually no one is dying of covid in the UK at the moment?

I never said they were.

Plenty of people suffering long Covid though.

 

[RobinBHM]

And yes without a doubt the NHS have definitely been fearmongering over Covid

In your opinion.....which is wrong

Oh perhaps you are right, it's so bad, the NHS are opening 80 long Covid clinics - just for fearmongering

"More than 80 new clinics to assess patients suffering with symptoms of long Covid are to be opened by the NHS by the end of this month"

It's terrible the way 850 healthcare workers have died from Covid, just for fearmongering


My niece has a colleague suffering heart problems from Covid and can't workmfull time now......maybe that's all lies and it's just fearmongering.

 

[Jonm]

Masks don't work because on a practical level they just don't. Frequently dirty, reused, not fitting, round chins etc. They do nothing on a practical level .....

There are two different reasons for mask wearing
1. to reduce the risk of the wearer catching Covid, as in a clinical setting.
2. To reduce the risk of the wearer passing on the virus to others. This is the purpose of the requirement to wear masks worn by the general public when indoors in shops etc.

I think you are deliberately muddling the two. With regard to the general public, a mask being dirty or re-used has no effect on its ability to reduce the risk of onward transmission. Not fitting could affect its ability to prevent onward transmission, worn around the chin it is useless.

 

[Rorschach]

In your opinion, which is wrong.

Stop stating opinions as fact, it is dishonest.

Like you you mean? I back up my facts with evidence as do you, the problem is we both have different evidence

 

[Rorschach]

In your opinion.....which is wrong

Oh perhaps you are right, it's so bad, the NHS are opening 80 long Covid clinics - just for fearmongering

"More than 80 new clinics to assess patients suffering with symptoms of long Covid are to be opened by the NHS by the end of this month"

It's terrible the way 850 healthcare workers have died from Covid, just for fearmongering


My niece has a colleague suffering heart problems from Covid and can't workmfull time now......maybe that's all lies and it's just fearmongering.

"My Niece" Anecdotes aren't evidence, wicker man!

 

[Rorschach]

There are two different reasons for mask wearing
1. to reduce the risk of the wearer catching Covid, as in a clinical setting.
2. To reduce the risk of the wearer passing on the virus to others. This is the purpose of the requirement to wear masks worn by the general public when indoors in shops etc.

I think you are deliberately muddling the two. With regard to the general public, a mask being dirty or re-used has no effect on its ability to reduce the risk of onward transmission. Not fitting could affect its ability to prevent onward transmission, worn around the chin it is useless.

Problem is, neither 1 or 2 works unless you use a proper grade of mask, for an aerosolised virus you need a full hazmat suit with air scrubber to actually do anything useful.

 

[sometimewoodworker]

I'm not sure I'm confusing anything, am I?! That's how the PHE research is presented. As far as I can tell (quick search of the internet), first and second doses take different periods of time to become effective - about 3 weeks for the first dose, 2 weeks for the second? Tho that seems to vary according to the type of vaccine.

It may be your sources are also confused if not you.

The first question is what do you understand effective to mean? This is not an argumentative question as there are many possible answers.

the first vaccinations provide some protection measurable about 12 days after vaccination. So you can compare vaccinations with a first dose some number of days, preferably over 21, after vaccination to a different vaccine the same number of days after it’s first dose has been given.
However since the protection increases reasonably quickly for several weeks (AZ is around 12) that is the only sensible comparison with 2 dose (almost all) vaccines.
You can compare protection after the second dose (again 21days or more) between different vaccines.
Both of these comparisons will give sensible results.

However any comparison between 1st dose protection of 1 companies vaccines and 2nd dose protection of another’s will not be useful and impossible to draw logical conclusions from that data.

protection is a sliding scale 12 days after the first dose you have virtually no more protection than before getting vaccinated. 91 days after (with AZ) your protection is very much better, get your second dose and your protection will continue to improve.

There is no study I have heard of that says at what point your protection plateaus. Current protection is at 8 months because that’s the maximum time people have been vaccinated for. Protection is going up by 1 month every month at the moment.

 

[RobinBHM]

Problem is, neither 1 or 2 works unless you use a proper grade of mask, for an aerosolised virus you need a full hazmat suit with air scrubber to actually do anything useful.

That's your opinion, Please don't state it as fact unless you can back it up with evidence

Here's evidence which proves you are wrong. I have posted it previously, but you are incapable of accepting evidence
https://jamanetwork.com/journals/jama/fullarticle/2776536

 

[Rorschach]

That's your opinion, which is wrong.

Here's evidence which proves you are wrong. I have posted it previously, but you are incapable of accepting evidence

As I said, I don't accept your evidence, just like you don't accept mine

 

[TominDales]

How about a change of covid topic.

The government has had a lot of criticism for its reluctance to put India on the "red list". It is being touted as the reason why "Step 4" return to normality may not happen as planned.

The link below is to a report in the Guardian 5 days ago showing that 21 countries have sequenced the Indian variants including 486 in the US and 85 in Australia (held in high regard for effective border control) , 156 in Singapore and 29 in Japan.

Guardian - India variant

Whilst the Guardian often demonstrates a clear political bias, it tends to be fairly reliable in its factual content.

Questions

• do these figures demonstrate that trying to control borders is ultimately futile
• is criticism of the government justified or simple political point scoring
• UK has the highest number of cases outside India. Is this simply the result UK capacity enabling more cases to be sequenced.

I think controlling borders can only slow the spread on new variants, unless we adopt a china or New Zealand style border & TTI regime it will in the end get in. Australia and New Zealand will probably stamp out the Indian variant as they have with all the others, in Europe I think the best we can hope for is to slow it down and keep R low.

Slowing the spread is extremely valuable as it allows time to ***** how dangerous the new variants will be. We have data demonstrating that the vaccine is effective against the Indian variant and so can relax a bit. But that wont always be the case.
In my view, we should be quick to close borders to new variants to buy time; time is vital early on, it is needed to ***** how dangerous the variants are, and give us valuable time for mount a proper response. If a variant escapes vaccines and proves to be deadly and transmissible we will have to react quickly or we there have a repeat of last years lockdown and casualties.
New variant vaccines can be produced quite quickly, - same manufacturing plant as existing covid vaccine, just tweaked to produce a different protein, so there is a good rational to slow down the spread of new variants.

 

[Chris152]

It may be your sources are also confused if not you.

The first question is what do you understand effective to mean? This is not an argumentative question as there are many possible answers.

the first vaccinations provide some protection measurable about 12 days after vaccination. So you can compare vaccinations with a first dose some number of days, preferably over 21, after vaccination to a different vaccine the same number of days after it’s first dose has been given.
However since the protection increases reasonably quickly for several weeks (AZ is around 12) that is the only sensible comparison with 2 dose (almost all) vaccines.
You can compare protection after the second dose (again 21days or more) between different vaccines.
Both of these comparisons will give sensible results.

However any comparison between 1st dose protection of 1 companies vaccines and 2nd dose protection of another’s will not be useful and impossible to draw logical conclusions from that data.

protection is a sliding scale 12 days after the first dose you have virtually no more protection than before getting vaccinated. 91 days after (with AZ) your protection is very much better, get your second dose and your protection will continue to improve.

There is no study I have heard of that says at what point your protection plateaus. Current protection is at 8 months because that’s the maximum time people have been vaccinated for. Protection is going up by 1 month every month at the moment.

I cited the source, it's here:
https://www.bbc.co.uk/news/uk-57214596If you see confusion (I don't, you seem to want to take issue with the method described, but that's not confusion) maybe BBC or PHE have made an error.

 

[RobinBHM]

"My Niece" Anecdotes aren't evidence, wicker man!

Perhaps you didn't read the whole of my post, as it also included quotes and links, ie evidence.

I am happy to post again if it helps

 

[TominDales]

Genuine question, not attempt to argue with either side:
do we NEED the virus to circulate amongst the young? Doesn't vaccination achieve immunity for them as, or more effectively, but without X (insert percentage here), getting ill, or have I missed the point?

This is being debated, its quite a nuanced subject. Unlike flue the young (ie bellow age 11 or so) don't get dangerously ill with the Kent variant, and there is a risk of side effects from the vaccine, so the equation is not so in favour of vaccination. However the young could become a reservoir for continued spread of covid and hence potential new and more deadly variants. The other issue, is some variants, the Indian one included, seem to be more dangerous to the young.
The other factor is whilst vaccines are in short supply, it may be both more effective and more ethical to ship vaccines to developing countries ahead of vaccinating our own children. Note, though, many developing countries don't have covid outbreaks, but those that do are probably a priority for the vaccine. I think we need to wait a bit this debate to settle. As with most things to do with Covid, the circumstance could change quite radically if a new variant emerged, so the policy may have to flex to cope with new information.
Right now I'd be in favour of prioritising India and south America with vaccines ahead of our own children, to get the global R rate down, but that view would change if a variant emerged that was dangerous to children.

 

[RobinBHM]

I think controlling borders can only slow the spread on new variants, unless we adopt a china or New Zealand style border & TTI regime it will in the end get in. Australia and New Zealand will probably stamp out the Indian variant as they have with all the others, in Europe I think the best we can hope for is to slow it down and keep R low.

Slowing the spread is extremely valuable as it allows time to ***** how dangerous the new variants will be. We have data demonstrating that the vaccine is effective against the Indian variant and so can relax a bit. But that wont always be the case.
In my view, we should be quick to close borders to new variants to buy time; time is vital early on, it is needed to ***** how dangerous the variants are, and give us valuable time for mount a proper response. If a variant escapes vaccines and proves to be deadly and transmissible we will have to react quickly or we there have a repeat of last years lockdown and casualties.
New variant vaccines can be produced quite quickly, - same manufacturing plant as existing covid vaccine, just tweaked to produce a different protein, so there is a good rational to slow down the spread of new variants.

It would be interesting to see more data on this.

It certainly seems logical that closing borders can slow the rate new variants arrive. However my guess is that by the time variants are sequenced and known about, the variant will already have escaped the source country.

The Kent variant was the dominant strain in UK from Dec, but it didn't become the dominant strain in France till much later - I wonder how much closing borders would have slowed that more. I've no idea.

 

[RobinBHM]

This is being debated, its quite a nuanced subject. Unlike flue the young (ie bellow age 11 or so) don't get dangerously ill with the Kent variant, and there is a risk of side effects from the vaccine, so the equation is not so in favour of vaccination. However the young could become a reservoir for continued spread of covid and hence potential new and more deadly variants. The other issue, is some variants, the Indian one included, seem to be more dangerous to the young.
The other factor is whilst vaccines are in short supply, it may be both more effective and more ethical to ship vaccines to developing countries ahead of vaccinating our own children. Note, though, many developing countries don't have covid outbreaks, but those that do are probably a priority for the vaccine. I think we need to wait a bit this debate to settle. As with most things to do with Covid, the circumstance could change quite radically if a new variant emerged, so the policy may have to flex to cope with new information.
Right now I'd be in favour of prioritising India and south America with vaccines ahead of our own children, to get the global R rate down, but that view would change if a variant emerged that was dangerous to children.

Thats very interesting.

Europe is now getting on with vaccine roll out and it seems likely most of the big EU countries will have vaccinated most adults by July....and EU has potential for high levels of vaccine manufacture - so we may see vaccines being distributed to these risk countries such as India towards the summer

 

[TominDales]

Actually natural infection is more effective than vaccination for immunity.

That as a generalisation is not true, certainly not supported by the data we have for Covid.

My understanding is the vaccine for covid has a massive concentration of spike protein and induces a very effective and long lived responses, far higher than even severe disease in patents monitored so far, post mortem of victims to covid show low accumulation of memory B cells in lymph notes.

Note the AZ and Pfizer vaccines are very concentrated whereas Sinovac is not is more old school and weaker so may not provide such long lasting protection. To my knowledge, the latest mRNA (Pfizer) and viral vector (AZ) vaccines are more effective than the disease. Its true that some of the early vaccines notably Polio were developed to prevent polio not to prevent infection and the latest understanding about measles vaccination is the vaccine prevent infection for several years, but then is suspected to prevent disease later on. This is emerging science and there is no simple rules. Modern vaccines eg HPV for Papillomavirus is highly effective and far more effective at preventing cancer than natural infection.
The argument for natural infection is the patient develops immune response to more than one protein. However for Covid, where the spike protein is key to infection that is the obvious protein to target. It almost certainly why the variants have not escaped the vaccine so far.

 

[Terry - Somerset]

The working assumption must be that virus mutations will arrive here - to assume otherwise would be complacent. It would run counter to the evidence from Australia and NZ where, despite border controls and quarantine, the Indian variant has arrived.

The real challenge is the much maligned (with some justification) track and trace system. It should be workable with (say) less than a few thousand cases a day. But at the peak in January, 60,000 cases a day were being identified from a lower level of tests than currently.

For any system, to flex capacity by a factor of 20-30 over the space of only a few weeks is an unreasonable expectation (in my view). The key must be in maintaining cases at sufficiently low a level that new variants are quickly identified, and appropriate action taken.

Finally, if we accept that variants will arrive on our shores irrespective of how robustly border controls are applied, why control the borders anyway. If the variant is materially resistant to the vaccine we have a problem anyway. If the vaccine is effective - why worry.

Like alway running into the cinema shouting "fire" - eventually no-one will take a blind bit of notice having heard the cry so many times before!

 

[Selwyn]

I am not talking about deaths from Flu. I am talking about the number of people who have contracted flu. There were far fewer occurrences of flu because we eliminated the conditions that help it spread. Things like poor hand hygiene, people being in close contact and preventative interventions such as masks have prevented flu from being spread.

That has helped stop the spread of COVID. Why do you think we have isolation wards for infectious diseases ?

That funny because there are an awful lot of nosocomial covid cases. It was a massive driver in the number of cases