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

[Howardh]

latest news from my town;

Hundreds of pupils isolating following coronavirus cases at Bolton schools

At Spindle Point Primary in Kearsley, seven year groups, including a nursery, are all having to self-isolate

www.manchestereveningnews.co.uk

Hundreds of pupils at Bolton schools are isolating due to confirmed cases of coronavirus.
Several schools across the borough are currently affected by positive tests.
At Spindle Point Primary, in Kearsley, only Year 4 children remain in school, with seven year groups, including a nursery, all now having to self-isolate.
Meanwhile, pupils in Years 7 and 10 at Ladybridge High School have also tested positive for the virus.

A Year 7 pupil at St James's C of E High School, in Farnworth, has also tested positive.
Headteacher Catherine Anderson wrote to parents to tell them that all year seven pupils must now isolate for 14 days. They will continue to be taught remotely.

I drove past Rivington school and noticed the usual string of buses were there far earlier than last year (always left the cafe to drive past them before chucking-out time) so are pupils being released in stages, if so is that a nationwide thing?

*As this is a rail forum, I wonder if staged release (if it happens) causes problems for pupils relying on rail services where the timetable is limited?

 

[Mag_seven]

Oh no, the cases have gone back over 3,000 again. It's 3,105 today. Not what I was hoping for, after three days in a row of new cases dropping. Expect the press and media will be up to their tricks again within minutes....

Surely a far more useful statistic would be the number of people out there who are actually infectious. Assuming they are infectious for 14 days max and that the number of new infections reported stays at roughly 3000 a day then at any one time there are 42000 confirmed infectious people out there. Now assuming all of them self isolate that only leaves those who are infectious and have not had a test yet or those who are asymptomatic and have not taken a test. What is that number I wonder?

 

[Bantamzen]

I don't know.

Trying to split the population into vulnerable and non-vulnerable and let Covid spread only through the non- vulnerable seems very hard to me.

Just vaccinating those who "need it" might be possible and I'd imagine if there is a vaccine there won't be enough for everyone straight away and the more vulnerable will be some of the first in the line.

But if the vaccine isn't so effective in the elderly, or it's too risky for a significant fraction of them to be given the vaccine, then that doesn't work so well.

Does it? I'm not so sure. We know older people are more vulnerable, so there's one group. Then we know that people with compromised respiratory and immune systems are also vulnerable. Basically we use similar parameters for prioritising flu vaccines.

 

[AdamWW]

Does it? I'm not so sure. We know older people are more vulnerable, so there's one group. Then we know that people with compromised respiratory and immune systems are also vulnerable. Basically we use similar parameters for prioritising flu vaccines.

I think we're in agreement on this - a vaccine can (and probably will at least initially) be prioritised to those who need it most.

With your suggestion of just protecting the vulnerable maybe you mean stopping at that point and just letting it spread through the remaining population?

I don't know. I think it would depend on what the risks of the vaccine are seen as, and how quickly you can make enough for eveyone. And also - as I said - how effective the vaccine actually is at protecting the vulnerable.

 

[Bantamzen]

I think we're in agreement on this - a vaccine can (and probably will at least initially) be prioritised to those who need it most.

With your suggestion of just protecting the vulnerable maybe you mean stopping at that point and just letting it spread through the remaining population?

I don't know. I think it would depend on what the risks of the vaccine are seen as, and how quickly you can make enough for eveyone. And also - as I said - how effective the vaccine actually is at protecting the vulnerable.

The reality is that if / when a vaccine reaches certification in this country, there won't suddenly be 65 million doses available. More likely we will receive batches over many months as countries around the world scramble for it. So we will have no choice, the most vulnerable & those that directly care for them must have priority. Only much further down the line can we hope to offer it further afield.

 

[AdamWW]

The reality is that if / when a vaccine reaches certification in this country, there won't suddenly be 65 million doses available. More likely we will receive batches over many months as countries around the world scramble for it. So we will have no choice, the most vulnerable & those that directly care for them must have priority. Only much further down the line can we hope to offer it further afield.

Yes I don't think you'd get many people to disagree with that. I certainly wouldn't.

 

[adc82140]

I think cases were artificially low yesterday because of the testing backlog. This is just a bit of statistical adjustment. You shouldn't take away anything from the day to day figures. I find there's more perspective in the local maps listed underneath the main figures on the dashboard that aggregate cases over the previous 5 days. My area was highlighted yesterday, then promptly un highlighted today indicating an aggregate of less than 2 cases and falling. You'll see from the map that most cases are still in the hotspots in the Midlands and North West.

 

[talldave]

Is your objection to attempting to vaccinate the majority of the population in order to only project the vulnurable?

Yes. My parents get the flu vaccine annually, I don’t.

But that wasn't the original point you were making - you were just complaining about a vaccine for a non fatal illness.
And you are starting to sound too close to anti-vaxers for my liking, especially the talk around "emotional blackmail".
What would be your objection about the vaccine?

I'm complaining about the Facebook Karens of this world believing that everybody should be vaccinated. It's not necessary and I won't have it because I don't need it.
I'm not anti-vax. Anyone who wants it I fully support them having it and have no objection to my taxes funding it. My elderly parents might well have it. Anyone who thinks I should have it "for the greater good" can forget it.
My only objection is "the greater good" crap being used to guilt trip people who see no reason to have it.

In any case, back to the flu vaccine we were talking about, I assume you have never been involved with a vulnerable person around winter when it comes to the flu vaccine then? Because there certainly is a fairly large amount of pressure on you to have the vaccine if you are in regular contact with a vulnerable person. Certainly when my and my parents cared for my gran before she passed away we were basically told that we had to get it. And even away from vulnerable people, many workplaces are now encouraging their staff to get the vaccine and are even paying for it privately in order to reduce time and money wasted with staff off sick!

As stated previously, my parents get flu jabs. Nobody ever suggested I do so. But I'm not at the full-on level of care yet.

 

[AdamWW]

I'm complaining about the Facebook Karens of this world believing that everybody should be vaccinated. It's not necessary and I won't have it because I don't need it.
I'm not anti-vax. Anyone who wants it I fully support them having it and have no objection to my taxes funding it. My elderly parents might well have it. Anyone who thinks I should have it "for the greater good" can forget it.
My only objection is "the greater good" crap being used to guilt trip people who see no reason to have it.

As stated previously, my parents get flu jabs. Nobody ever suggested I do so. But I'm not at the full-on level of care yet.

Let's say we get a vaccine that is very good at preventing people from getting Covid-19 symptoms and from passing it on.

But the older you are, the less effective it is, such that a significant number of lives would be saved by vaccinating the population as a whole.

Would you be against a mass vaccination programme on principle?

Of course it's not as simple as that because healthy people having the vaccine still benefit if the (small) chance of anything bad happening from contracting Covid-19 may well be larger than the (also small) chance of a problem from having the vaccine.

 

[nlogax]

Sky's Ed Conway has been referenced before now in this thread, but his piece on Sky News this evening is a positive and hugely informative look at the differences between waves 1 and 2 and the context of new case numbers we're seeing. Great info throughout all of this fourteen minute analysis.

Despite a rise in cases, daily COVID-19 deaths are the lowest they’ve been since the start of the pandemic. The number of cases is as high as it was at the height of the pandemic, but that’s because the #UK is testing more people. A lower proportion of people who test positive for #coronavirus appear to be dying, suggesting that the second peak may not be as bad as the first. At the height of the pandemic, coronavirus deaths were multiplying quickly – but so far, that’s not happening in Spain or France, who are ahead of the UK’s trajectory by about three weeks. Ed Conway analyses the data.

 

[AdamWW]

A lower proportion of people who test positive for #coronavirus appear to be dying, suggesting that the second peak may not be as bad as the first.

I think it would be extremely worrying if the proportion had stayed the same, given that at the start it was almost impossible to get a test unless you were ill enough to be admitted to hospital, whereas now you're asked to get a test no matter how mild the symptoms are. (Well up to a few days ago you were, anyway).

 

[adc82140]

Sweden's cases are now the lowest since March. I'd say the one to watch now would be France, who seem to have started adopting the light touch approach.

 

[talldave]

Would you be against a mass vaccination programme on principle?

Yes, if it was being proposed by the ignorant muppets running the country. The couldn't even grace us with any justification or evidence as to why we're meant to be wearing masks.

Even the WHO has succumbed to political pressure ffs! That doesn't really leave anyone to trust does it?

 

[Camden]

Note for the timings on the graphs, if someone is going to die from Covid the average length of time is about 18 days and here are the infection rates and death rates for France to the 17th August (Spain follows a similar pattern) :

Could one of these people who think there will be a second wave please explain to me why, as our lockdown was eased off (unofficially at first - from only a few weeks into it - but then officially) our death rate has not only failed to go up, but has actually fell, and has continued to fall despite even the pubs being reopened ! :

Bear in mind the timing and emergence of the "first wave" is still under question.

Suggestions are are that this was in circulation from as early as December, when people were oblivious. The symptomless incubation period exacerbated this further.

By the time people were made aware, for many vulnerable people it was already too late and they had either already contracted it or realistically had no way of avoiding it without immediately undergoing a deep clean of themselves and everything they might touch, and isolating.

Months on, the efforts to suppress the disease and the preventative actions of older and vulnerable people will mean there is (or was) less virus in general circulation, and vulnerable people can take care to reduce their risk of exposure.

Should the virus become more widely prevalent, that will come undone bit by bit as avoiding infection is a numbers game.

In short, this would explain why the death rate is currently low: We are currently in "December". Whether actual December looks more like March would then depend on the actions of the non-vulnerable.

Those that don't do what they can to reduce the transmission need to be aware of the brutal choice they might be making, as a segment of society, against those who are weaker.

 

[takno]

Yes, if it was being proposed by the ignorant muppets running the country. The couldn't even grace us with any justification or evidence as to why we're meant to be wearing masks.

Even the WHO has succumbed to political pressure ffs! That doesn't really leave anyone to trust does it?

I didn't much trust the WHO to start with tbh. They were too weak to declare a pandemic until it was both obvious to everyone and too late to be useful, and then they immediately overreacted and started demanding lockdowns. Their advice has been consistently poorly-timed, poorly-evidenced and poorly-delivered throughout

 

[MikeWM]

Yes, if it was being proposed by the ignorant muppets running the country.

It also depends on whether we're talking about a voluntary or mandatory 'mass' program (where 'mandatory' includes 'voluntary but your life will be impossible if you don't').

My only objection to a voluntary program would be the unnecessary cost - though given the way we're throwing around hundreds of billions all over the place anyway, then maybe that's a fairly minor concern in comparison.

A mandatory program however would irrevocably and horrifically rewrite the contract between the individual and the state. *The state does not own my body* and has no right to act in any way that assumes it does.

(I have a similar problem with organ donation now. I'm strongly in favour of organ donation, and I've been on the register for many years. *But* the recent change to make it an opt-out policy rather than opt-in is very wrong - it changes the *default* from my being an individual who decides to help the state for the good of all, to my being the property of the state for it to do with as it will.)

 

[WelshBluebird]

It also depends on whether we're talking about a voluntary or mandatory 'mass' program (where 'mandatory' includes 'voluntary but your life will be impossible if you don't').

My only objection to a voluntary program would be the unnecessary cost - though given the way we're throwing around hundreds of billions all over the place anyway, then maybe that's a fairly minor concern in comparison.

A mandatory program however would irrevocably and horrifically rewrite the contract between the individual and the state. *The state does not own my body* and has no right to act in any way that assumes it does.

(I have a similar problem with organ donation now. I'm strongly in favour of organ donation, and I've been on the register for many years. *But* the recent change to make it an opt-out policy rather than opt-in is very wrong - it changes the *default* from my being an individual who decides to help the state for the good of all, to my being the property of the state for it to do with as it will.)

But doesn't the state already interfere in that way when you have a child (in terms of both vaccines and the general health and care of the child), or when someone is deemed incapable of looking after themselves for a variety of medical reasons?
I am not saying it would be the same at all - but there is already precedent for the state making decisions that go against a persons wishes if those decisions are deemed to be in the best interests of the person or wider society. To suggest that there exists this line that would be crossed doesn't reflect reality because the state crosses that line all of the time in specific situations.
As for organ donation - sorry but I can't disagree more. You would be dead. There would be no individual anymore so the organs are no longer yours at that point.

 

[nlogax]

My only objection to a voluntary program would be the unnecessary cost - though given the way we're throwing around hundreds of billions all over the place anyway, then maybe that's a fairly minor concern in comparison.

The money's already been spent. As of mid August the UK had purchased 340 million doses of multiple candidate vaccines.

 

[AdamWW]

As for organ donation - sorry but I can't disagree more. You would be dead. The organs are no longer yours at that point.

Also, relatives still have to give consent.
(Though I don't know what happens if there are not relatives to do so, or they can't be contacted).

== Doublepost prevention - post automatically merged: 16 Sep 2020 ==

The money's already been spent. As of mid August the UK had purchased 340 million doses of multiple candidate vaccines.

That won't neccessarily include sufficient doses of a licensed vaccine for the entire population.

And also they could presumably be sold on....

 

[kristiang85]

Sky's Ed Conway has been referenced before now in this thread, but his piece on Sky News this evening is a positive and hugely informative look at the differences between waves 1 and 2 and the context of new case numbers we're seeing. Great info throughout all of this fourteen minute analysis.

This is excellent. Finally, one of the mainstream outlets actually looking at the data as a whole and telling the actual story rather than the embellished narrative.

I am more confident than ever that by November we will be able to relax a lot more, but we just need that time to let the data come in.

But he makes a good point about the home deaths - I think in the next 12 months other conditions are going to have a horrendous rise in mortality. Even someone I know, in their 40s, has just been diagnosed with incurable cancer, which the doctors say could have been sorted had it been detected earlier (and she's had symptoms since the beginning of the year but was unable to get tested until recently). It's going to be a running scandal in 2021, I think.

 

[MikeWM]

But doesn't the state already interfere in that way when you have a child (in terms of both vaccines and the general health and care of the child), or when someone is deemed incapable of looking after themselves for a variety of medical reasons?
I am not saying it would be the same at all - but there is already precedent for the state making decisions that go against a persons wishes if those decisions are deemed to be in the best interests of the person or wider society. To suggest that there exists this line that would be crossed doesn't reflect reality because the state crosses that line all of the time in specific situations.

Of course - there are rarely absolutes in such matters, there is a spectrum. We each have to decide where the line is to be drawn on that spectrum.

Clearly there are extreme cases where the state has to intervene. Forcing a medical treatment on a healthy person is not such a case.

As for organ donation - sorry but I can't disagree more. You would be dead. There would be no individual anymore so the organs are no longer yours at that point.

So you think the state *by default* should just be able to pull them from your body? I understand the argument, but I don't agree with it one bit. My property doesn't become the property of the state even after death, assuming I have legal successors. The same should apply to my body.

Also, relatives still have to give consent.

Do they? All that the Government say is that 'specialist nurses will always discuss donation with families so an individual’s wishes are respected' (see here). A 'discussion' doesn't sound like formal consent.

 

[AdamWW]

Do they? All that the Government say is that ' ' (see here). A 'discussion' doesn't sound like formal consent.

We're going a bit off topic here but I hope this is just sloppily phrased.

You quoted part of a line. The full line was: "There will also be strict safeguards in place and specialist nurses will always discuss donation with families so an individual’s wishes are respected".
(my bold).

They also say:
" Currently, less than half of families give consent for their loved one’s organs to be donated if they are unaware of their wishes. When families know what their loved one would have wanted, they are much more likely to honour these wishes. "

I am more confident than ever that by November we will be able to relax a lot more, but we just need that time to let the data come in.

I hope so.

I'm glad I'm not the one trying to decide whether it's OK to let infections start to rise or whether it will lead to another rapid increase which becomes difficult to control. It seems to me you can find evidence from other countries supporting whichever view you want to take.

 

[MikeWM]

We're going a bit off topic here but I hope this is just sloppily phrased.

You quoted part of a line. The full line was: "There will also be strict safeguards in place and specialist nurses will always discuss donation with families so an individual’s wishes are respected".
(my bold).

Yes, but that's just meaningless verbiage unless there is some explanation as to what those safeguards are.

They also say:
"Currently, less than half of families give consent for their loved one’s organs to be donated if they are unaware of their wishes. When families know what their loved one would have wanted, they are much more likely to honour these wishes."

Which is true - but a change to the default, especially one enacted in the middle of a pandemic when no-one is really paying attention to other things, isn't going to make a big change as to whether people have had this discussion or not.

The law itself says

The person concerned is to be deemed, for the purposes of subsection (6)(ba), to have consented to the activity unless a person who stood in a qualifying relationship to the person concerned immediately before death provides information that would lead a reasonable person to conclude that the person concerned would not have consented.

I'm not a lawyer and this isn't very straightforward, but I think that is the relevant part, so *consent* by the family is not required, and they can only *legally* block the donation by 'providing information' as described. That doesn't mean in practice that this is what would happen, but that would appear to be the (very limited) legal protection.

 

[Meerkat]

The reality is that if / when a vaccine reaches certification in this country, there won't suddenly be 65 million doses available. More likely we will receive batches over many months as countries around the world scramble for it. So we will have no choice, the most vulnerable & those that directly care for them must have priority. Only much further down the line can we hope to offer it further afield.

UKG has already ordered tens of millions of doses of several candidate vaccines. Unless none of them work but one that hasn’t been preordered does work prioritisation will be about the infrastructure and people to deliver and administer the vaccine, not the availability of it.

 

[adc82140]

There are plans afoot to use the network of polling stations to get any vaccine distributed to the population in short order. If the infrastructure is there, it makes sense to use it.

 

[AdamWW]

UKG has already ordered tens of millions of doses of several candidate vaccines. Unless none of them work but one that hasn’t been preordered does work prioritisation will be about the infrastructure and people to deliver and administer the vaccine, not the availability of it.

Have they ordered an entire populations worth of each candidate? I didn't think so. Could be wrong.

And of course more than one may be successful.

 

[Bletchleyite]

Have they ordered an entire populations worth of each candidate? I didn't think so. Could be wrong.

And of course more than one may be successful.

They have of several of them, yes.

 

[Meerkat]

Being a huge pessimist I can’t help feeling that if there ia more than one working vaccine it would be better to spread the use across the working versions.
Dystopian plot synopsis. Rushed vaccine testing leads to unexpected mass infertility....

 

[AM9]

Being a huge pessimist I can’t help feeling that if there ia more than one working vaccine it would be better to spread the use across the working versions.
Dystopian plot synopsis. Rushed vaccine testing leads to unexpected mass infertility....

So that kills two birds with one stone.

 

[greyman42]

Well duh, London got its protection before Boris bottled it, the rest of us have to wait, one rule for London and one rule for everyone else as usual

What protection are you referring to?