Covid : Infection rates v death rates and a possible second wave

[Domh245]

I think that the whole talk about herd immunity would probably be a good reason to test the entire population (i.e. everyone getting a test at some point). I think that would gauge just how many people got the virus at some point. Although there definitely isn’t enough capacity to do this at the moment, maybe this would be worth doing when sufficient 20 minute tests become available, something that would be very useful at Schools and offices.

The current tests (and AFAIK the spit tests) don't test for if you've had the virus, only if you have the virus at the time of the test (although in some cases it is picking up dead viral material from cleared infections). All that testing the entire population does is tell you who has the virus during that week you've tested everyone

You can't even test for immunity with any degree of reliability as antibody levels fall the longer it is after the infection, and there isn't a T-Cell test.

 

[Scrotnig]

i am surprised by this forum - elsewhere the government are getting slaughtered for not locking down early enough.

That's because on this forum, by and large, we are not hysterical, terrified types who live on Facebook and Twitter 24/7.

Instead, we live on trains 24/7 And when we're not on trains, we're on here talking about trains.

 

[Bantamzen]

I think that the whole talk about herd immunity would probably be a good reason to test the entire population (i.e. everyone getting a test at some point). I think that would gauge just how many people got the virus at some point. Although there definitely isn’t enough capacity to do this at the moment, maybe this would be worth doing when sufficient 20 minute tests become available, something that would be very useful at Schools and offices.

Testing for the virus won't tell you how many people have had it, just how many had it at the time of the test, or potentially earlier. The same could be true of anti-body tests, some people won't be producing anti-bodies any more, others may never had produced them. In short there is no firm way of knowing how many people have had, or will likely get the virus now or in the future. So the best politicians can do is estimate, and it seems now that they may have been horribly over-doing so.

The time for fixating on individual figures is over, we now have to look at the bigger picture. Not only how people have the virus, but how many people need medical assistance and how many do not.

 

[adc82140]

Can anyone explain why the outbreak

There has to be a rational reason why Stockholm isn't experiencing a rise. (The international media has completely lost interest in Sweden since the outbreak subsided.)

It seems that countries with less draconian measures are better off now, as the virus was allowed to silently spread and therefore a level of immunity has been achieved. It may be far from herd immunity but even 1 in 5 who are immune can lessen the chances of infection. Countries with tougher lockdowns like France and Spain stopped it from spreading, but as soon as society reopened, along came more cases.

 

[MikeWM]

It seems that countries with less draconian measures are better off now, as the virus was allowed to silently spread and therefore a level of immunity has been achieved. It may be far from herd immunity but even 1 in 5 who are immune can lessen the chances of infection. Countries with tougher lockdowns like France and Spain stopped it from spreading, but as soon as society reopened, along came more cases.

Even Neil Ferguson (!) pointed this out at the start of all this - a lockdown just delays the inevitable. The *only* argument for lockdown is that hopefully in the meantime you can find better treatment options to improve outcomes in those delayed cases - though for that to work it would involve the medical establishment working off evidence rather than politics and money (see the hydroxychloroquine debate).

 

[DB]

I think that the whole talk about herd immunity would probably be a good reason to test the entire population (i.e. everyone getting a test at some point). I think that would gauge just how many people got the virus at some point. Although there definitely isn’t enough capacity to do this at the moment, maybe this would be worth doing when sufficient 20 minute tests become available, something that would be very useful at Schools and offices.

Not sure that's possible, is it? It wouldn't show T-cell immunity as I understand it, or immunity resulting from exposure to other coronoaviruses - and those are thought to be increasingly important factors.

 

[Silverlinky]

2948 new cases today.....that's more than double the amount reported last Monday.... (although that was a bank holiday)

 

[adc82140]

Even Neil Ferguson (!) pointed this out at the start of all this - a lockdown just delays the inevitable. The *only* argument for lockdown is that hopefully in the meantime you can find better treatment options to improve outcomes in those delayed cases - though for that to work it would involve the medical establishment working off evidence rather than politics and money (see the hydroxychloroquine debate).

I suppose you can argue that this happened. During the course of the lockdown the medical profession discovered that Dexamethasone worked, and that sticking someone on a ventilator probably wasn't the best thing to do in every instance of serious respiratory problems. Also the nightingale hospitals are ready to go (staffing permitted). We are therefore now in a much better position than we were in April. Hancock's granny killing speech just proves that he's as thick as school custard.

 

[Bletchleyite]

2948 new cases today.....that's more than double the amount reported last Monday.... (although that was a bank holiday)

They appear, looking at the graph of when the tests were taken, mostly to be from last week...I wonder if that means the schools reopening is affecting things?

 

[adc82140]

Doubt it. The schools have only been open half a week. If a kid caught it on Wednesday, they won't have felt ill till Saturday, test on Sunday, result tomorrow. Possibly.

 

[Class 33]

Well, another day of very high number of new cases. 2.948 today. But after initially being a bit shocked at yesterday's figures, I'm not too worried about this. As it seems the daily testing has been ramped up even further over the last few days. I'm pretty sure I just heard Grant Shapps in his statement in The House of Commons mention that yesterday there were 250,000 tests done. This is a LOT more than the 175,000 showing on the Gov Coronavirus dash board, which for some reason the testing figures are only updated weekly now rather than daily. As indeed the daily testing has been increased significantly again, it's obvious there are going to be a lot more positive tests found than in recent weeks!

Today's deaths only THREE.

No reason for any concern yet in my opinion. But I expect the press - in particular The Express, will soon be up to their scaremongering antics again!

 

[adc82140]

So in fact the percentage positive figure has barely risen.

 

[MikeWM]

I suppose you can argue that this happened. During the course of the lockdown the medical profession discovered that Dexamethasone worked, and that sticking someone on a ventilator probably wasn't the best thing to do in every instance of serious respiratory problems.

True - though we could and should know more by now. At least we should have a better idea of whether HCQ works for example, but as lamented in this article I've posted a few times, due to politics we don't.

https://www.dailymail.co.uk/news/ar...ens-thousands-lives-Covid-19-politicised.html

British researchers behind the only large global trial testing hydroxychloroquine as a prophylaxis say their work is in jeopardy because it has become too politicised.

They have warned dropping the drug will block science from finding out if the medicine can really stop coronavirus from entering the body, potentially saving thousands of lives.

Also the nightingale hospitals are ready to go (staffing permitted).

True, though those were ready 'in time' anyway if they had been needed. The efficient way they were constructed is one of the very few success stories of this whole mess.

We are therefore now in a much better position than we were in April. Hancock's granny killing speech just proves that he's as thick as school custard.

I'd say we should be much better still. As for Hancock, well, yes, but 'killing grannies' may be a new low (especially given the number of grannies *he* is responsible for killing due to the care home policies in March and April).

 

[Domh245]

They appear, looking at the graph of when the tests were taken, mostly to be from last week...I wonder if that means the schools reopening is affecting things?

For England at least - 1127 of those announced today were sampled on Saturday, 776 on Friday, 218 from Thursday and 347 on Wednesday (those 4 days accounting for 97% of all tests announced today). That is well within the normal sort of distribution that I'd expect. Of interest (but not necessarily surprising) are the historical corrections occurring, for example today's figure includes 10 cases from the 6th of April as well as a reduction of 7 on the 20th of June

As for schools, given that children generally seem to be able to shrug it off asymptomatically and that most only returned mid week, I think it's too early for any rise to be attributable to that, in England at least. It'll take a while for it to spread from child to someone who'll develop symptoms (both with incubation periods), and then for them to actually get hold of a test!

Today's deaths only THREE.

No reason for any concern yet in my opinion. But I expect the press - in particular The Express, will soon be up to their scaremongering antics again!

The uptick from the last few days should be a cause for concern, and I'm saying that as someone very much in favour of a light touch approach. Looking at the hospital admissions (and deaths) indicators are a poor choice of metric now because of the lag (although notably ventilated patients and admissions have shown a slight uptick the last few days) - both the absolute number of cases as well as positive ratio are rising, it is only a matter of time before hospitalisations and deaths begin to follow, assuming that we see spread in the same way we did at this stage of the first wave (well before we were doing any testing)

 

[43066]

The uptick from the last few days should be a cause for concern, and I'm saying that as someone very much in favour of a light touch approach. Looking at the hospital admissions (and deaths) indicators are a poor choice of metric now because of the lag (although notably ventilated patients and admissions have shown a slight uptick the last few days) - both the absolute number of cases as well as positive ratio are rising, it is only a matter of time before hospitalisations and deaths begin to follow, assuming that we see spread in the same way we did at this stage of the first wave (well before we were doing any testing)

I suppose the point then becomes that, absent a vaccine or effective treatment, this was inevitably going to happen when we started to open up (as we must). All the government’s dithering and blundering around in the dark over the last few months has merely delayed the inevitable.

If we are not following an elimination strategy (and we cannot be) we are going to need to live with an increase in both cases and deaths, the key thing is how this is managed so as not to overwhelm the NHS. It’s just unfortunate that the government has so spectacularly failed to manage expectations on this, so that many people in this country seem to believe the virus will somehow magically disappear, if we remained locked down for long enough.

 

[Howardh]

I've been noting that although cases generally are rising (I've just had a test myself as part of tracing) the number of deaths, save for a few countries worldwide, has decreased and is cosistently low, including the UK. However over the weekend I have noticed an one-day spike in Spain where there has been an increase of deaths, back to mid-May levels, which is worrying. I hope that's a one-off and deaths will fall again, but it's one to watch.

 

[DB]

If we are not following an elimination strategy (and we cannot be) we are going to need to live with an increase in both cases and deaths, the key thing is how this is managed so as not to overwhelm the NHS. It’s just unfortunate that the government has so spectacularly failed to manage expectations on this, so that many people in this country seem to believe the virus will somehow magically disappear, if we remained locked down for long enough.

And flu season coming up in a couple of months as well...

That said, it seems highly unlikley that the NHS will have any serious capacity issues.

 

[MikeWM]

I've been noting that although cases generally are rising (I've just had a test myself as part of tracing) the number of deaths, save for a few countries worldwide, has decreased and is cosistently low, including the UK. However over the weekend I have noticed an one-day spike in Spain where there has been an increase of deaths, back to mid-May levels, which is worrying. I hope that's a one-off and deaths will fall again, but it's one to watch.

Spain apparently reports deaths in an odd way (can't remember in what specific way it is odd though, sorry!) so a one-day spike is unlikely to be alarming in itself.

uptick from the last few days should be a cause for concern, and I'm saying that as someone very much in favour of a light touch approach. Looking at the hospital admissions (and deaths) indicators are a poor choice of metric now because of the lag (although notably ventilated patients and admissions have shown a slight uptick the last few days) - both the absolute number of cases as well as positive ratio are rising, it is only a matter of time before hospitalisations and deaths begin to follow, assuming that we see spread in the same way we did at this stage of the first wave (well before we were doing any testing)

There are some nice graphs (too many to post here) on this twitter post:

https://twitter.com/FatEmperor/status/1302929077054189569

In particular look at the Netherlands and France. Large increase in cases going back 7 or 8 weeks, little or no impact on ICU or deaths seen yet.

 

[bramling]

I suppose the point then becomes that, absent a vaccine or effective treatment, this was inevitably going to happen when we started to open up (as we must). All the government’s dithering and blundering around in the dark over the last few months has merely delayed the inevitable.

If we are not following an elimination strategy (and we cannot be) we are going to need to live with an increase in both cases and deaths, the key thing is how this is managed so as not to overwhelm the NHS. It’s just unfortunate that the government has so spectacularly failed to manage expectations on this, so that many people in this country seem to believe the virus will somehow magically disappear, if we remained locked down for long enough.

Expectation management is key, but clearly something we’re not going to see from this government.

Social media is depressingly predictable today, and worst of all is the BBC’s have your say. Hancock has successfully managed to ignite a “blame the young” fire, whilst there was one comment on there which really took the biscuit - “if we go back to a full and harsh lockdown now then it might all be over in time for our Christmas”.

We might as well all just bang our heads against the hardest brick wall we can find.

 

[43066]

Social media is depressingly predictable today, and worst of all is the BBC’s have your say. Hancock has successfully managed to ignite a “blame the young” fire, whilst there was one comment on there which really took the biscuit - “if we go back to a full and harsh lockdown now then it might all be over in time for our Christmas”.

We might as well all just bang our heads against the hardest brick wall we can find.

It’s utterly depressing. I’m starting to think this country deserves everything it gets, frankly!

 

[DB]

Expectation management is key, but clearly something we’re not going to see from this government.

Social media is depressingly predictable today, and worst of all is the BBC’s have your say. Hancock has successfully managed to ignite a “blame the young” fire, whilst there was one comment on there which really took the biscuit - “if we go back to a full and harsh lockdown now then it might all be over in time for our Christmas”.

We might as well all just bang our heads against the hardest brick wall we can find.

Why are so many people unable to grasp the fact that it's impossible to stop a fairly infectious airborne disease which has already spread globally? It might be possible to slow it down, but that's of dubious benefit and the measures required are likely to cause more problems than they solve.

 

[Domh245]

I suppose the point then becomes that, absent a vaccine or effective treatment, this was inevitably going to happen when we started to open up (as we must). All the government’s dithering and blundering around in the dark over the last few months has merely delayed the inevitable.

If we are not following an elimination strategy (and we cannot be) we are going to need to live with an increase in both cases and deaths, the key thing is how this is managed so as not to overwhelm the NHS.

Delaying the inevitable is one view on it, 'buying time' is the other - compare the situation now in terms of track & trace infrastructure, treatments, understanding of transmission, etc with March and we are in a place where we can afford to have similar sort of levels of infection but hopefully avoid the death toll. An increase in cases is definitely tolerable, a (large) increase in deaths would be a shame. Exp

I've been noting that although cases generally are rising (I've just had a test myself as part of tracing) the number of deaths, save for a few countries worldwide, has decreased and is cosistently low, including the UK. However over the weekend I have noticed an one-day spike in Spain where there has been an increase of deaths, back to mid-May levels, which is worrying. I hope that's a one-off and deaths will fall again, but it's one to watch.

This is where the time lag factor comes in. From memory it was something like 2 weeks on average between infection and dying for people during the peak, the death numbers represent the infection situation ~2 weeks ago, which was lowish and amongst healthy/younger individuals for most countries. Deaths are definitely one to watch, but during the 'build up' phase of a spread it's the worst metric to use - by the time it's showing anything useful it's far too late

 

[Scrotnig]

The massive jump yesterday seems inexplicable though. It simply doesn't make any sense.

Unless this is the 'doubling every two or three days' exponential growth thing, in which case expect cases to top 5,000 within a day or two.

 

[trebor79]

The massive jump yesterday seems inexplicable though. It simply doesn't make any sense.

Unless this is the 'doubling every two or three days' exponential growth thing, in which case expect cases to top 5,000 within a day or two.

But then you'd expect hospital admissions to have increased similarly. They haven't.
It is very odd.

 

[adc82140]

The massive jump yesterday seems inexplicable though. It simply doesn't make any sense.

Unless this is the 'doubling every two or three days' exponential growth thing, in which case expect cases to top 5,000 within a day or two.

We are now testing 250000 a day, if the Transport Secretary is to be believed. Last week we were testing 160000. That's your increase accounted for.

 

[Scrotnig]

But then you'd expect hospital admissions to have increased similarly. They haven't.
It is very odd.

It's too early yet though...hospital admissions typically lag confirmed cases by a couple of weeks.

We are now testing 250000 a day, if the Transport Secretary is to be believed. Last week we were testing 160000. That's your increase accounted for.

I hope that's true.

 

[trebor79]

It's too early yet though...hospital admissions typically lag confirmed cases by a couple of weeks.

I'm not sure that's the case. Looking at the government data website, if anything hospitalisation peaked slightly before the peak in confirmed cases.

 

[adc82140]

It's too early yet though...hospital admissions typically lag confirmed cases by a couple of weeks.

No, that's deaths. Hospital admissions are about a week.

 

[yorkie]

I think that the whole talk about herd immunity would probably be a good reason to test the entire population (i.e. everyone getting a test at some point). I think that would gauge just how many people got the virus at some point....

I don't think that is possible.

You could test for Sars-Cov-2 antibodies, but they may not be detectable if you didn't get particularly ill and/or had it a while back (that doesn't mean you can't produce those antibodies when required).

Based on antibody testing which took place between 20 June and 13 July it sounds like approximately 3.4 million people in England alone are likely to have antibodies (see article below), but that doesn't tell the full picture

https://www.theguardian.com/world/2...-population-may-have-had-covid-study-suggests

About 3.4 million people in England have had Covid-19, with infections more common among members of black, Asian and minority ethnic communities, according to the results of a large home antibody testing study.

The results from the study, known as React-2, are based on home finger-prick antibody test results from 100,000 participants across the 314 local authorities in England.

However it is very possible that a proportion of those exposed to the virus did not need to develop antibodies to fight off the virus, or did so successfully with low levels of antibodies that may not be detectable; furthermore antibody levels decrease over time, so the true number is likely to be higher.

Furthermore there is growing evidence that a sizeable proportion of the population have T-cells that can identify and destroy Sars-Cov-2 already, due to previously being exposed to other "common cold" coronaviruses. You can't easily test for T-cell immunity though; if someone could develop a quick, easy and cheap test for T-cell immunity that would be incredibly useful but that doesn't seem likely to happen anytime soon, if it's ever achievable.

I am regularly exposed to viruses and have a good immune system, so I will probably never get to know if I was infected with Sars-Cov-2 or not.

Social media is depressingly predictable today, and worst of all is the BBC’s have your say. Hancock has successfully managed to ignite a “blame the young” fire, whilst there was one comment on there which really took the biscuit - “if we go back to a full and harsh lockdown now then it might all be over in time for our Christmas”.

People like that are lacking in knowledge and intelligence. Fortunately we're better than that on this forum!

 

[43066]

Delaying the inevitable is one view on it, 'buying time' is the other - compare the situation now in terms of track & trace infrastructure, treatments, understanding of transmission, etc with March and we are in a place where we can afford to have similar sort of levels of infection but hopefully avoid the death toll. An increase in cases is definitely tolerable, a (large) increase in deaths would be a shame. Exp

The trouble is obvious question is then: “buying time for what?”. We were initially told that it was to prevent the NHS being overwhelmed - that was achieved in fairly short order and indeed the measures taken were arguably in excess of what was needed, that the Nightingale hospitals were never used.

Then over the summer period we’ve had a relentless focus on driving case numbers down, local lockdowns, the botched reopening, the cul de sac of masks etc. There was always an expectation that cases would rise in the autumn, but it seems that any rise in Covid deaths is still regarded as intolerable by the government, given Matt Hancock’s comments today about wanting to avoid a second wave.

We now have better understanding of the virus, the steroid treatment, and more hope of a vaccine, other than that we are back where we were in March. So what is the government’s exit strategy (other than hanging their hat on a vaccine)?!

We are now testing 250000 a day, if the Transport Secretary is to be believed. Last week we were testing 160000. That's your increase accounted for.

Apparently “test positivity” ie the proportion of tests generating positive results is also up, indicating that the rise in cases cannot be accounted for by the increase in numbers of tests.