8-Dec-2021 : LAB: 40 / CON: 34 / LDEM: 10 / GRN: 4

[steve]

Neil
The population was younger there six months ago where the delta variant surge in the middle of winter was killing 400+ a day.

Similarly the population was younger 11 months ago where in the middle of the summer the South African Varian was killing 550+ a day.

By all means compare South African data to South African data the conclusions are the same.

The combination of increased protection from passed exposure and vaccination and the distinct possibility that this variant is simply not as severe make the outcomes from infection far less concerning.

All the same elements excluding age profile apply in the uk.

[Danny]

Dec 23, 2021 8:01:43 GMT neilj said:

The latest study, while still relatively good news, 'found that the risk of any attendance at hospital was 20% to 25% lower with Omicron versus Delta, and 40%-45% lower when the visit resulted in admission for at least one night.

But you notice the reduction is greatest against the worst outcomes.  Had they gone further and tabulated separately short admissions and long admissions, the info from SA suggest the bad, long, admissions are the most reduced.  But see below, their data set is poor.

Looking at the actual report at www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2021-12-22-COVID19-Report-50.pdf

It contains tabulated results for pillar 1 (hospitals and NHS staff) and 2 (general community), showing delta and omicron cases and admissions for each day at the start of december. Best I could say about this is its really odd. For example, pillar 1 NHS, on 4 dec 17,000 delta cases resulted in 372 admissions, Whereas on 13 December 17,000 delta cases resulted in 109 admissions. Similar major discrepancies in proportion of people being admitted exist throughout the data. Its possible this implies admission criteria have become stricter so fewer mildly ill people are being admitted. For most of the table omicron admissions are too few to make statistical comparison possible. EG again, 12 dec 7000 omicron cases, 40 admissions, 14 Dec 16,000 omicron cases 36 admissions. Seems it became half as dangerous across those two days?

Taking the last day of data, (ie with the greatest number of omicron cases), looking at pillar two community, they differentiate all cases and symptomatic cases, and it would seem more than half of all cases are asymptomatic. Amongst all cases roughly half as many omicron are resulting in hospitalisation as amongst delta. Amongst symptomatic cases, only 1/3 as many with omicron result in hospitalisation.

I assume the finding that half of cases are asymptomatic is an under estimate, because  having symptoms is what would encourage many people to get a test.  So its likely the great majority of cases are asymptomatic. (probably always true, of course)

[steamdrivenandy]

As a mod on www.caravantalk.co.uk/community/discover/unread/ I'm able to move posts to alternative sections where they're more appropriate and should achieve a wider exposure/more specific interest. Many members post everything in 'Caravan Chat' which clutters up that section, when, say, they're posting about a plumbing or electrical issue. I just wonder if Mark has the same sort of capability on this board? Asking for a friend.

[neilj]

Steve, look at the figures for the UK, compare hospitalisations/deaths in winter compared to summer, there is no comparison

In relation to age in the UK, the number of people aged 70 years and over is 8.769 million
In South Africa in the UK the number of people aged 70 years and over is 1.897 million

At the moment it appears that omicron is circulating mainly in the younger population, we just don't have the data yet to see what happens when we have large scale transfer to the older population
It may be alright, but even if we have only 55% - 60% of hospital admissions compared to the delta variant, it may not end well
In my opinion we need to be a little cautious until we have more data

[neilj]

Dec 23, 2021 8:12:51 GMT Danny said:

Dec 23, 2021 8:01:43 GMT neilj said:

 For the small percentage of people who had neither been previously infected with Covid nor vaccinated, the risk of hospitalisation was about 11% lower for Omicron versus Delta.'

Just how many are there left neither vaccinated nor infected? Not many? And cut that further by discounting people who are anyway young, just how many at risk are left?

Vaccine passports or closing nightclubs isnt going to reach the at risk group.

Danny I have listened to your anti-vax nonsense for too long on here, you are an enabler, along with thousands of others who just will not listen/understand the very clear data that vaccines do help prevent both the spread and severity of the infection. You, among other vaccine sceptics, are partly responsible for the problems with Covid going on longer than they need to

[crossbat11]

Isn't the problem with amateur epidemiology, and the attachment to layman pet theories that inevitably goes with it,is that there is a tendency to seize on whatever evidence, however sketchy it may be, to prove the wisdom and foresight of the said theory?

Epidemiology is reliant on thoroughly researched and proven data, not on journalism. That data takes time to amass and while the scientists are saying it's too early to draw too many conclusions about the threat posed by the Omicron variant of Covid, I think they may be worth listening too for now.

Early optimistic signs are encouraging, I agree, but the good thing about professional epidemiologists is that they have open minds governed by evidence. The amateurs tend to have pet theories and preferred outcomes they pursue with zeal.

Zealotry and science don't sit well together. Piers Corbyn demonstrates this truism.

[Danny]

Dec 23, 2021 8:47:33 GMT neilj said:

In comparisons with South Africa you need to take into account the much younger population and the fact it is the middle of summer there. Does anyone think if we had the omicron outbreak in the middle of our summer as opposed to winter, we would have the same level of hospital admissions?

keep getting this fallacy that their younger population invalidates their result. It doesnt - its the same population with omicron as delta. Given its mostly older people who are hospitalised anyway, the extra younger people might largely be irrelevant.

Yes, i think the season question is potentially significant. I dont think its going to prove a problem as we are already getting UK data confirming lower seriousness, but I did have this one flagged as a potential problem too.

As to the effect  if we had omicron summer or winter, my view would be other factors matter more. Past exposure to other strains, vaccines, measures. Its true we see seasonal variation in disease, but the actual effect could be quite small and still be sufficient to bias outbreaks to generally happening on an annual cycle in winter. Its  a  question of creating oscillation in a system which has a natural resonant frequency of one year. Think of those physics experiments you were taught with waves on strings.  Here in the Uk we were imposing restrictions into the summer which we arent now, kinda perverse.

[neilj]

You can see the effect of the age difference in South Africa in the death figures
South Africa and the UK have similar population levels, 60 and 67 million respectively. But when we look at the death figures at the worse outbreak in South Africa they were averaging 577 deaths a day over a 7 day period. In the UK that figure was 1,285, well over twice. While there will be a combination of reasons, it seems to me the difference in the ages of the respective populations will and have made a big difference in hospitalisations and deaths

[lululemonmustdobetter]

Good morning all, from a its back to grey in the PSRL.

www.theguardian.com/business/2021/dec/23/energy-bills-could-rise-by-50-amid-national-crisis-of-soaring-uk-prices

If this does materialise could be the nail in Johnson's coffin!

[Danny]

Dec 23, 2021 9:14:13 GMT neilj said:

Danny I have listened to your anti-vax nonsense for too long on here, you are an enabler, along with thousands of others who just will not listen/understand the very clear data that vaccines do help prevent both the spread and severity of the infection. You, among other vaccine sceptics, are partly responsible for the problems with Covid going on longer than they need to

A while ago now R4 interviewed the chap primarily responsible for the fight against smallpox using vaccines. He said you needed two kinds of vaccine to succeed. one which creates sterilising immunity, so people will never catch the disease. A second which creates immunity fast but maybe not lasting, which can be deployed immediately in an outbreak.

Its not clear we have either.

Anything which only reduces spread but cannot bring it to below sustainability is not going to reduce either cases or deaths in the long run. It just spreads them over a longer time and increases the duration of the emergency. Unless there is some other clear benefit, its just throwing away money.

We could have ended this epidemic last year by allowing it to follow a natural course, and in all likelihood had no more deaths, possibly fewer. Intervention is what has kept a relatively minor new disease going as long as it has. As new epidemics go, this one was minor. Classic historic new diseases killed high percentages of the population but this has never killed on anything like that scale, anywhere, under any circumstances. If you remember we were told of an awful new disease spreading fast in China. Yet the final death toll there is negligible, amongst the lowest in the world. China pressed the panic button and the world responded, but hardly anything happened in China!

I agree there is a fundametal divide here in what is the right policy. I would point out managed spread was the UK and other nations accepted response to an epidemic, because it has been proven over centuries to be the rigt action. Trying to delay the virus and use a vaccine was an experimental approach and it failed at two levels. First it was not possible to suspend the disease. It carried on slower but largely with the same effects despite attempted suppression. Second, the vaccine failed to achieve the necessary outcomes to end it.

None of this says what you seem to impute to me, that vaccines will not reduce cases or severity. But in this situation they were too late and too weak in effect to make much difference to the final outcome. SA has only vaccinated 30% of its population and others too see no reason to do more. This isnt a lot more than the criteria for Uk annual flu vaccinations.

meanwhile the opportunity cost of all these resources diverted to intervention will kill tens of thousands in the UK, probably has already killed tens of thousands, and this may rise to more people than succumbed to covid.  There was an NHS analysis last year which demonstrated the qualy (quality life years) cost of intervention was ridicuously expensive compared to investing the same money in normal health care and therefore getting far more saving of life. We werent prepared for the strategy we chose to adopt (all those ppe shortages) because all the careful study beforehand said it just didnt make sense to try what we did. It still dosent. 

[steve]

Neil
Japan has an older age profile than the UK and yet has experienced just 12% of the pro rata deaths with effectively no current issues at all.

Peru has an age profile 8 years younger than South Africa and yet nearly three times the covid deaths of the UK pro rata.




Latching on to age as a definitive factor isn't really confirmed by the data.

[steve]

Lululemon
Glad to have the confirmation on outside conditions I thought I might have gone colour blind for a moment.

[neilj]

Dec 23, 2021 10:05:19 GMT steve said:

Neil
Japan has an older age profile than the UK and yet has experienced just 12% of the pro rata deaths with effectively no current issues at all.

Peru has an age profile 8 years younger than South Africa and yet nearly three times the covid deaths of the UK pro rata.




Latching on to age as a definitive factor isn't really confirmed by the data.

Steve I did make the point age was not the only issue. I don't know enough about Peru, but for example I am aware mask wearing is a big thing in Japan
What I am certain of is the bigger the differences, in whatever the way, makes comparisons less useful between countries

[crossbat11]

The good Mr Kettle opines on a subject much discussed on these pages. When is a tipping point not a tipping point?

www.theguardian.com/commentisfree/2021/dec/23/humiliated-boris-johnson-history-failing-governments-tipping-pooint

Kettle thinks we might be there, but I'm less sure. Anyway, an interesting perspective from an experienced political commentator.

[lululemonmustdobetter]

Dec 23, 2021 10:08:43 GMT steve said:

Lululemon
Glad to have the confirmation on outside conditions I thought I might have gone colour blind for a moment.

Well I am a big fan of Public Service Broadcasting.

www.youtube.com/watch?v=wY-kAnvOY80


www.youtube.com/watch?v=_u4Md_aXVJE

[alec]

@danny - "5 days stay at 3000 cases a day would only leave 15,000 in hospital, which isnt much more than now."

By 'isn't much more than now' I assume you actually mean 'pretty much double what we have now, just about 10% of total normal NHS bed capacity'.

Daft. As. A. Brush.

[alec]

jib - "The use of the word "idiot" is entirely appropriate."

I'm going to politely disaree with you here.

If you suffered three months of ill health following an initial jab, and have been medically advised that subsequent jabs are likely to produce a similar or possible enhanced side effect response, and you have a lifestyle that provides you with a broadly minimal chance of contracting covid, and if second generation vaccines are coming through shortly that are expected to largely remove the risks of severe systemic side effects, then refusing a vaccine when offered is a sensible and pragmatic individual choice.

Far too much black and white here, and far too little attention being paid to the 5 - 10% of people who received one vaccine but not subsequent shots. Calling such people idiots, without knowing or trying to understand their views and reasoning, is not helpful.

[steve]

Alec
I think the point Danny was trying to make is that double the admissions with length of stay more than halved doesn't actually create an increase in overall hospitalization .

It's a bit of daft thing for him to say that 15000 is the same as now when it's around double.
But around double the admissions a day wouldn't have any significant impact on the current numbers in hospital if the stay is halved.

But it's also a bit alarmist to say " Given that all the data from the two UK studies into Omicron severity remain consistent with a surge of hospital admissions to 3000 per day, and a consequent swamping of the NHS, " as you did , when given a reduction in length of hospitalization of around 60% and less ill admissions  it wouldn't have any major significant impact and most certainly wouldn't "swamp" the nhs.

I think if we all keep to posts  on basis of available data we can probably have a more informed discussion.

This is probably getting a bit repetitive for those who would rather discuss politics or sports so will be my last contribution on covid for the day.

[neilj]

In fairness to Blair this is what he actually said
"Frankly, if you're not vaccinated at the moment and you're eligible, and you've got no health reasons for not being unvaccinated, you're not just irresponsible. You're an idiot.'

I think an adverse reaction would count as a health reason for not getting the vaccine

[jimjam]

Neil - did Blair really say this? ''no health reasons for not being unvaccinated'

Is it just me or is there a double negative in there? Not being unvaccinated means being vaccinated, does it not.

I guess he has no-one to proof read for him these days?

[davwel]

Just been looking at Denmark data on CV hospitalisation:

Oct 10 - 88
Oct 17 - 99
Nov 20 - 377
Dec 11 - 460
Dec 22 - 553

totals are 7-day averages, but the last for yesterday.

There isn`t a breakdown on omicron v delta etc, or by age, but saying Danish data shows that omicron is less severe is too hasty yet.

More data are needed.

[bantams]

On Covid my feelings now after reading expert opinion (& Batty) are we're into a short term numbers game & we need some restrictions for the New Year similar to Scotland. The everlasting problem are the unvaccinated eeejits who are going to continually boast the major share of hospitalisations going forward. The first American has died from Omicron, an unvaccinated 50 year old man who had had Covid previously before succumbing second time around.

[steve]

Neil
On that Britain elects prediction

Applying it to Spaffers Uxbridge seat that's a lose for the Tories!

No doubt if that's the likely outcome he'll be long gone to spend more time cheating on his current wife ( who ever that happens to be).

[steve]

Bantams
Unvaccinated , in his fifties , with other serious long term health conditions (obesity?).

Stupids got to stupid!

[Old Southendian]

Dec 23, 2021 10:17:28 GMT crossbat11 said:

The good Mr Kettle opines on a subject much discussed on these pages. When is a tipping point not a tipping point?

www.theguardian.com/commentisfree/2021/dec/23/humiliated-boris-johnson-history-failing-governments-tipping-pooint

Kettle thinks we might be there, but I'm less sure. Anyway, an interesting perspective from an experienced political commentator.

I think it's right that the article acknowledges that it's not clear this is the tipping point, I think the jury is still out.  But one sentence really jumped out at me: "It is hard to recover from the reputation-shredding stories – with more to come – that produced North Shropshire."  What does the "with more to come" mean?  Does he actually know of more problems that are about to be uncovered?  Or is it just that, on the balance of probability, more things will turn up?

[crossbat11]

@old Southendian

Yes, I thought that was an enigmatic phrase -"more to come" - from Kettle. He isn't my favourite political commentator by any means, but he isn't a journalist you'd normally associate with Westminster bubble tittle-tattle and gossip. He's either speculating that there must be more embarassing stories in the offing, on the law of averages, or he knows something we don't. Political journalism is a relatively small and closed world (that's it's problem really) and it's possible the it's abuzz with excited chatter about exposés to come. Kettle has picked this up presumably.

Watch this space, I suppose.

[alec]

Important thread here from Nick Davis on what exactly that 40% reduced severity figures actually means -

The explanation is tied up with the idea that Omicron is likely to infect different categories of more at risk people, and that this will mean the impact on reducing hospitalisations is less pronounced than a simple 40% cut. Under certain transmission dynamics, it would be theoretically possible for less severe Omicron to produce a higher rate of hospitalisation than delta.

Way more complex than many are making out this morning.

[jib]

alec

"Way more complex than many are making out this morning."

Definitely agree with that sentiment.

[davwel]

Thanks to Bantams, Barbara, Crofty, and more, for more details on accents Yorkshire to Northumberland.

I just wonder if Barbara`s Northumbrians with what wondrous changed r sound were in the North Tyne valley rather than the South Tyne.

The only person that I knew south of Alston having the special Norhumbrian r came from Bellingham, with phrases like "we`ll gan to the Dwagon for a dwap or two". The pub was in Garrigill. Maybe the sound is now spreading.

[c-a-r-f-r-e-w]

Those of you following the Covid debates may recall my pointing out a couple of months into the first lockdown, how having checked some syllabi, epidemiology was typically a very narrow field, mostly stats, not much lab work or studying of immunology or vaccines etc.*

And how the epidemiology modellers like Ferguson were using antibody data in a flawed way, ignoring other lines of immune defence. Notably memory cells (B cells) and T cells.

I thought from what he subsequently said, that they had corrected for this, albeit perhaps three months later. 

Well it seems they are still at it, making a similar error. Here is what the other more practical experts have been saying.

“It is bad science and I think they’re being irresponsible. They have a duty to reflect the true risks but this is just headline grabbing,” said Dr Clive Dix, former chairman of the UK Vaccine Task Force.”

* though Covid might be changing this!