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

[Howardh]

I really wish the three of them would just disappear. They're causing loads of us mental health problems, was ok at beginning of the month, now there's no sign of anything improving it's going downhill. How much longer before we see serious numbers of suicides, people being admitted for mental health problems, an even bigger problem with domestic violence etc. Why can they not see this? Opposition no better as not raising these issues.

Empathise. Sat here, staring out of the window, the kids are returning from school, also the commuters, but as Bolton's in lockdown with no bars open, nowhere to go tonight, no-one to meet, chat, play games etc. been like this now for nearly a month.

 

[Class 33]

7,108 cases today. Only a slight drop of 35 from yesterday.

And 71 deaths. Exactly the same as yesterday.

 

[adc82140]

7,108 cases today. Only a slight drop of 35 from yesterday.

No, 7108 infections. Not cases. Cases go to hospital. Why does it matter what we call it? Because there is also a figure called the case fatality rate, which uses the correct definition of cases, ie ones in hospital. Confusing isn't it. Also, how many of these infections are amongst university students who won't go on to bother the health service. Incidentally the amount of people in hospital in the South West and South East is falling.

 

[Class 33]

No, 7108 infections. Not cases. Cases go to hospital. Why does it matter what we call it? Because there is also a figure called the case fatality rate, which uses the correct definition of cases, ie ones in hospital. Confusing isn't it. Also, how many of these infections are amongst university students who won't go on to bother the health service. Incidentally the amount of people in hospital in the South West and South East is falling.

Indeed. But try saying that to Boris and the cabinet, and Whitty and Valance who'll be on in a minute with half hour or so of doom and gloom.

 

[Yew]

On the other hand, a report has just popped up in my Twitter feed (on MichaelYeadon3 if anyone wants to find it) indicating that, for the UK as a whole, we likely have already hit herd immunity and that, barring minor outbreaks in certain areas where there's less coverage than others which will naturally dissipate quickly, this is for all intents and purposes over

The report is here on medRxiv for anyone who's particuarly interested in it, a few highlights include:

Models that allow for heterogeneity favour build-up of herd immunity rather than 71 non-pharmaceutical interventions as the main factor underlying the early slowing and 72 reversal of the COVID-19 epidemic in Europe. This is consistent with observations that 73 epidemic curves in many countries reached a peak less than two months after the first 74 few severe cases appeared [8,9].

And this one, which suggests that models that take count for susceptability (pre existing cross immunity) and connectivity (some people have more close contact events per day than others), provide better insights to what's going on.

The release of the modelling code and dataset used by Flaxman et al is a valuable 93 contribution to transparent evaluation of infectious disease modelling. However once the 94 unrealistic assumption of no individual variation in susceptibility or connectivity is 95 relaxed, the model does not support their estimate that lockdown reduced the case 96 reproduction number R by 81% or that more than three million deaths were averted by 97 non-pharmaceutical interventions.

 

[Bletchleyite]

On the other hand, a report has just popped up in my Twitter feed (on MichaelYeadon3 if anyone wants to find it) indicating that, for the UK as a whole, we likely have already hit herd immunity and that, barring minor outbreaks in certain areas where there's less coverage than others which will naturally dissipate quickly, this is for all intents and purposes over

The graphs don't bear that out.

 

[trebor79]

The graphs don't bear that out.

I agree. Perhaps 20% of the population may have some sort of immunity, nowhere near enough to significantly suppress it.

 

[Richard Scott]

I agree. Perhaps 20% of the population may have some sort of immunity, nowhere near enough to significantly suppress it.

But that's ignoring the T-cells issue where many people are naturally 'immune'?

 

[trebor79]

But that's ignoring the T-cells issue where many people are naturally 'immune'?

Hmm. The experience of widespread transmission in certain care homes, workplaces and student residences would suggest that's relatively minor at this stage, certainly not widespread enough provide community immunity.
8% of the population infected so far was the number at the press conference last week, I've more than doubled it to account for t cells.
I'm not saying I agree with the approach being taken, but bandying about very sketchy claims of mass immunity doesn't help the cause.

 

[adc82140]

I agree. Perhaps 20% of the population may have some sort of immunity, nowhere near enough to significantly suppress it.

20% is a lot. That's 1 in 5 people. Not herd immunity, but a significant fire break for transmission nonetheless.

 

[Richard Scott]

Hmm. The experience of widespread transmission in certain care homes, workplaces and student residences would suggest that's relatively minor at this stage, certainly not widespread enough provide community immunity.
8% of the population infected so far was the number at the press conference last week, I've more than doubled it to account for t cells.
I'm not saying I agree with the approach being taken, but bandying about very sketchy claims of mass immunity doesn't help the cause.

Ok, I took your 20% to be people who were immune through having had the virus so I misunderstood there.

 

[takno]

Hmm. The experience of widespread transmission in certain care homes, workplaces and student residences would suggest that's relatively minor at this stage, certainly not widespread enough provide community immunity.
8% of the population infected so far was the number at the press conference last week, I've more than doubled it to account for t cells.
I'm not saying I agree with the approach being taken, but bandying about very sketchy claims of mass immunity doesn't help the cause.

Somewhat more than tripling is a credible estimate based on t-cells and untested antibodies. That gives you 25% in the community, and possibly a lot higher in places like nursing homes.

It's very unevenly distributed though - London has much higher levels, as do cities generally, and people who were out and about during lockdown. The point is that 25% plus basic precautions may be enough to block community spread from continuing exponentially.

It's definitely not enough to prevent asymptomatic outbreaks amongst people who come from areas and households with low exposure into areas with high exposure, such as, um, students, but since it stops them from going exponential you would probably not even notice them except for the fact that we have an unhealthy obsession with testing people who aren't particularly ill.

 

[Yew]

It's very unevenly distributed though - London has much higher levels, as do cities generally, and people who were out and about during lockdown

Indeed, I don't think it's a coincidence that we're not really seeing outbreaks in London, when the tube is the perfect Covid spreading machine. The level of herd immunity in the big smoke may not yet be enough to allow full opening up, but I think you could open further without a major increase in cases.

 

[takno]

Indeed, I don't think it's a coincidence that we're not really seeing outbreaks in London, when the tube is the perfect Covid spreading machine. The level of herd immunity in the big smoke may not yet be enough to allow full opening up, but I think you could open further without a major increase in cases.

Certainly there appears to be absolutely nothing to support Khan's wild and panicky lockdown demands from last week. I'm start to wonder if it's too late to drop him as the Labour candidate for mayor tbh

 

[Bletchleyite]

Indeed, I don't think it's a coincidence that we're not really seeing outbreaks in London, when the tube is the perfect Covid spreading machine. The level of herd immunity in the big smoke may not yet be enough to allow full opening up, but I think you could open further without a major increase in cases.

London will be interesting to watch. Sadiq seemed to think it was about 3 days behind the curve, but thus far there has been no evidence of that at all - cases remain low. If anywhere in the UK has got anywhere near herd immunity, it will be London, I'd say.

What's quite interesting about cases now is that despite the very large local lockdown areas, it's very small specific areas that are affected - and the really badly affected ones are, as you might expect, those with lots of students! It certainly, if you look at a map, seems difficult to justify the Lancashire local lockdown's extent, as there are fairly large chunks of it with lowish cases.

That said, low cases doesn't necessarily mean herd immunity. Milton Keynes has had low cases throughout and continues to do so.

 

[trebor79]

I think a lot of the recent step up in numbers is asymptomatic students, who are unlikely to come close to grannies for a fee weeks. Indeed, I think this was alluded to when they went through some of the graphs and figures in the press briefing today.
As such, nothing to panic about.

 

[adc82140]

The South West is still very case light, except for a university outbreak in Exeter, and a meat processing plant in Camborne. It also got off lightly the first time round. Is this just down to a lower population density?

 

[DB]

Milton Keynes has had low cases throughout and continues to do so.

Could that be because the unusual design of the place inhibits the spread to an extent?

 

[Bletchleyite]

Could that be because the unusual design of the place inhibits the spread to an extent?

I think it's because of (in no particular order):
- Very low density
- Transient population (mostly for work reasons) with few extended households
- Little public transport use

 

[DannyMich2018]

The South West is still very case light, except for a university outbreak in Exeter, and a meat processing plant in Camborne. It also got off lightly the first time round. Is this just down to a lower population density?

I'd say so, few major cities in Devon and Cornwall with only Plymouth and Exeter of any significant size, in fact Devon and Cornwall account for only around 2% of the UK's total population.

 

[Jamesrob637]

I'd say so, few major cities in Devon and Cornwall with only Plymouth and Exeter of any significant size, in fact Devon and Cornwall account for only around 2% of the UK's total population.

Possibly even less than 1.5 per cent. Many people down there have/reside in primary properties up country.

 

[Meerkat]

Interesting how restrictions are slated for not having enough science and data behind them, but things like herd immunity levels can be pretty much pulled out of posteriors and used as evidence against said restrictions.

 

[Richard Scott]

Interesting how restrictions are slated for not having enough science and data behind them, but things like herd immunity levels can be pretty much pulled out of posteriors and used as evidence against said restrictions.

Don't think anyone is saying herd immunity can be used against restrictions. The restrictions are based on next to no science so need nothing to stand up against them as they don't even hold up on their own. What's the point of restrictions? If it's to suppress the virus then we'll be doing this for years and a number of the people we are supposedly protecting will die of other causes long before be we've sorted it out but with addition that they had almost no quality of life for their last few years. Restrictions are not a quick fix. What suggestions do you have for moving forward that doesn't involve going around in circles like we are now?

 

[Meerkat]

Apart from suppression the “moving forward” suggestions seem to be to go back to normal and hope too many people don’t die. Not sure I am comfortable with that.
Suppress over the risky winter season and by the end of that we should know more about vaccine viability and know much more about Covid transmission and lethality.

 

[DorkingMain]

I think a lot of the recent step up in numbers is asymptomatic students, who are unlikely to come close to grannies for a fee weeks. Indeed, I think this was alluded to when they went through some of the graphs and figures in the press briefing today.
As such, nothing to panic about.

Also they're testing far more than they managed at any point during national lockdown. If they'd managed to do so then they wouldn't have "record highs" to harp on about now.

The real people we need to blame for the current state of **** are our media. They have created this constant rift between those who believe that we're under far too many restrictions and those who believe the virus is basically a nuclear blast that's going to wipe out everything in its path. Their constant alarmist bull****, misuse of stats and footage of people coughing their lungs up on COVID wards drove us into an unplanned and unmanaged national lockdown and has continuously precluded any sensible restrictions or measures to ease them / tighten them.

We also totally need to shut down this silly idea of "Shutting everything down and destroying society is worth it if we save lives". We could all live to 120 if we were shut in padded cells and fed mashed banana and tuna all day but what sort of life is that? No consideration has at any stage been given to people's mental health or need to socialise, particularly if you're like me and are gay and live alone with your partner somewhere else - it's not a "happy times baking cakes together", it's soul destroying.

 

[bramling]

I really would't get so hung up on the figures. On average 85 people today will have died of viral pneumonia of a non Covid origin. It's September. Respiratory illnesses and associated deaths always surge about now.

Trouble is it’s hard not to get bothered about the figures, as we know there will inevitably be a Sturgeon “I’m being frank with you this is apocalyptic” press conference, to which Piffle then feels obligated to respond to with a tightening of restrictions in some way.

Apart from suppression the “moving forward” suggestions seem to be to go back to normal and hope too many people don’t die. Not sure I am comfortable with that.
Suppress over the risky winter season and by the end of that we should know more about vaccine viability and know much more about Covid transmission and lethality.

How many livelihoods and businesses is it acceptable to destroy in the meantime?

 

[Richard Scott]

Apart from suppression the “moving forward” suggestions seem to be to go back to normal and hope too many people don’t die. Not sure I am comfortable with that.
Suppress over the risky winter season and by the end of that we should know more about vaccine viability and know much more about Covid transmission and lethality.

In the meantime a number of people suffer mental health issues, economy goes even more down the pan so public services including NHS will suffer due to lack of funds as government will have run out of money. There will probably be increased suicides, still more undetected cancers etc so we can allow a few elderly people a few extra months. Sounds like a great plan.

== Doublepost prevention - post automatically merged: 30 Sep 2020 ==

We also totally need to shut down this silly idea of "Shutting everything down and destroying society is worth it if we save lives". We could all live to 120 if we were shut in padded cells and fed mashed banana and tuna all day but what sort of life is that? No consideration has at any stage been given to people's mental health or need to socialise, particularly if you're like me and are gay and live alone with your partner somewhere else - it's not a "happy times baking cakes together", it's soul destroying.

Agree, those calling for further restrictions have no idea how some people are being affected by this. The happily married with 2.4 children and work from home brigade (I realise not everyone in this category will feel like this) are in a much better place and some seem to be enjoying it. If you think it's all so appealing then try it living on your own and not seeing your family or close friends for months, may not feel quite the same way then

 

[Grecian 1998]

Possibly even less than 1.5 per cent. Many people down there have/reside in primary properties up country.

Other factors which appear to assist the SW are the relative lack of indoor industry to act as a spreader, and the fact the economy relies a lot on outdoor tourism, much of it not group based. On a more flippant note, the SW is full of people who moved to 'get away from it all' i.e. other people. Many of them don't get on with born and bred locals. Some people in the SW did social distancing long before it was ever named...

Even the larger population areas don't appear as badly affected as up country. Bristol's numbers have been tiny compared to similar sized cities further north. (Cue argument about whether the SW is just Devon and Cornwall, the official region which takes in Gloucester, Wiltshire and BCP, or something in between.)

Once again the outdoor factor does appear important though. Just as parts of Dorset were swarmed by day trippers from the SE when overnight stays were illegal, parts of Cornwall have had hordes of tourists this summer due to so many exotic destinations being subject to quarantine rules. I went to Tintagel on Monday 3 August and Padstow on Monday 7 September and both were absolutely heaving. The latter was particularly surprising given it was a school day. Doesn't seem to be causing any problems though.

 

[Class 33]

Seems like we've got at least another 6 months of these restrictions dragging on. Godknows how many more businesses will go under and how many people will be unemployed by the end of March, if this is indeed the case.

 

[Cowley]

I went to Tintagel on Monday 3 August and Padstow on Monday 7 September and both were absolutely heaving. The latter was particularly surprising given it was a school day. Doesn't seem to be causing any problems though.

We were there a couple of days after you and yes it was crazy busy!
I agree with a lot of your post by the way, and although I know a couple of people that have had it down here it’s very rare to meet someone that’s definitely had it confirmed by a test (quite a few more people think they have, including a village in Mid Devon that reckon they had an outbreak that swept through the whole population in January. I somehow doubt it though).