Covid

[Danny]

Sir John Bell interviewed on R4 today program just advised that symptoms of covid have now changed to much more like a typical cold, although he specifically mentioned a new symptom of muscle aches, especially in the back. Referred to the work done by Zoe in analysing and tracking symptoms and how they have changed.

Another item mentioned failure of lateral flow tests to detect some variants. This seems to apply to some makes of test.

Personally I can report a bad cold incuding an unprecedented backache in my upper back for no obvious reason, which tested negative for covid. Others also reported backache and in general there was a modest wave of positive lateral flow tests. Amongst a wave of bad colds testing negative. The joke in fact was the sick stayed at work while the healthy were sent home.

Omicron was yesterday reported as having reached 40% of cases in London and SE yesterday by Campbell, quoting Boris Johnson. With the caveat it woud be the majority within a day or two. Zoe data shows a rise both in London cases from about mid November, and a resurgent rise in the 20-29 age group from about the same time. Their wave of delta cases fell back in the summer but resumed in November.

Taken together this looks like omicron started to dominate in some UK groups mid November and must have been building before that to have reached significance at that time. Obviously we know it evades S gene detection, but the R4 interview denying there was a problem with detection in general acnowledged a localised one. Oops.

Interesting.

Bell also observed it is likely there is no benefit to people who have had two doses of vaccine already in terms of reducing their risk of serious disease by having a booster, because it looks likely the protection against this is durable.  It seems protection due to past infection is likely to be similary protective.  Bell observed the vaccination program was completed by March in terms of protection it could deliver to individuals. He regarded it as a great success. He also however, seems to agree with me in questioning why in light of that success restrictions were not lifted at that time.  Trying to continue the vaccine program to create herd immunity has failed. He argued better vaccines will be developed, but they arent here yet. 

[lens]

Dec 14, 2021 9:02:18 GMT Danny said:

Another item mentioned failure of lateral flow tests to detect some variants. This seems to apply to some makes of test.

There is a Guardian article regarding the inaccuracy of lateral flow testing: www.theguardian.com/world/2021/dec/13/can-you-trust-a-negative-lateral-flow-covid-test?xtor=ES-208-[49128_NEWS_NLB_ACT_WK52_Tue_14_dec]-20211214-[Guardian]

Some weeks ago my wife had "mild cold" symptoms, but none of those connected with Covid (cough, sore throat etc), and as an LFT was negative was required to go back to work (in a school). A few days later another LFT was positive which was confirmed with a PCR test. In our case the lateral flow test was worse than nothing - it served to lull into a false sense of security.

The Guardian article concludes by saying: "But with infection levels sky high, Covid symptoms that too often resemble the common cold, and waning immunity from vaccines, perhaps it’s time to reinstate a degree of caution and stay home if we feel unwell – at least until we’ve done a PCR test, or had several days of negative LFTs. Who wants someone else’s cold, anyway?" Maybe such would be useful advice given formally by the government? Schools certainly seem to have a "the show must go on" mentality - not the best in a pandemic!?

Dec 14, 2021 9:02:18 GMT Danny said:

Trying to continue the vaccine program to create herd immunity has failed. He argued better vaccines will be developed, but they arent here yet. 

May depend how you define "herd immunity"? Vaccines may not have stopped transmission altogether, but they certainly seem to have greatly minimised hospitalisations and deaths? Strict lockdown was effective, but hardly sustainable in the long term, but was useful in stopping the initial case load from overwhelming the health service.

[Danny]

Dec 14, 2021 9:19:26 GMT wb61 said:

I hesitate to post this given Mark's admonitions on Covid matters being raised, however I am posting because I think at least some posters have a misunderstanding of evolutionary theory. So here goes: evolution of any organism (even viruses where there is a debate over whether they amount to "life") is environment dependent, there is no typical course of development which would automatically lead to a predictable outcome.  

As an example: 

Virus A is deadly resulting in death within days of infection. Community X is a small isolated village, the virus wipes them out and then is unable to be transmitted and so that strain disappears. However community Y is a trading community with regular contact with other communities virus A despite being deadly is able to continue because the environment is different. If community X is large enough and Virus A mutates into a milder form it can then continue to infect, however there is no environmental pressure for Virus A to mutate in community Y. Virus B is also deadly but is dormant for a time before symptoms develop so that there are weeks where uninfected individuals can try to leave to avoid disease and transmit it more widely, again there is no pressure for the mutation to survive.

It is all much more complex than this but the example demonstrates that, in a global world with regular travel and billions of people to infect,  there is no absolute process by which viruses become less deadly.  The 14th century plague wiped out approaching half the population of England and Wales, the end came about because those that were left had survived and gained immunity or had a natural immunity of some sort. 

Hi WB6, maybe better we discuss evolution here?

There are at least two mechanistic  issues with one virus replacing another. One is whether  virus A spreads faster than virus B, which is what is being measured by R numbers. If thats true then over time while both will spread, a bigger and bigger percentage of the whole epidemic will become A because it is growing faster. Even though the total quantity of B also increases.

However if it happens that the two are competing for the same group of victims, then one spreading faster will deprive the other of new victims by reaching them first. So the existence of A will cut the  R of B. By definition a new strain arises because in some way it is out competing any previous strain, and eventually it will reach this point where it almost entirely deprives its predecessor of victims and its predecessor's total cases fall away. The more immunity there is in a population already, the sooner this will be observed. In SA omicron seems to have very rapidly completely displaced delta, lets hope it does here too. In SA almost everyone is considered to have immunity before omicron, either 30% by vaccine or 70% by infection (ok, small percentage wont which could account for things like residual hospital admissions. Seems most likely it does).

Delta was already in a bad position before omicron arrived, but experience in the UK suggests covid typically does not die out after a wave of infection. Instead it continues bubbling along at a low level. Here we meet the phenomenon which you dont address in your example, of people previously infected and immune, who over time become susceptible again even to the exact same strain. However if there are two strains about, even in this low residual level the one best able to spread is going to out compete the other over time and tend to eradicate the less infectious strain. The point though is such diseases as this are never eradicated, they always persist in the community at very low levels until an opportunity arises again for big spread. Thats a very important factor in long term survival. You have to be able to survive while immunity is very high until it drops back.

I think I linked above an internet doctor talking about strain replacement, about how where both viruses reach the same person at the same time, internally this competition is likely to occur too, so that person might end up spreading both sorts but more each time will be of the new variant. people are not infected with just one strain, and it is misleading to think that this is the case. New minor variants are spun off in every single person, and maybe it is more acurate to think of omicron more like a swarm of variants acting and transmitting together.

So to your example. In the case the virus kills everyone, obviously long term it cannot remain dormant in tht population. Dormant isnt quite accurate for covid, because it cannot simply sit still. It can only continue to exist by repeat infections which last a couple of week and then on to the next. But it can do this very low level without noticeable symptoms.  I would argue survivla in lean times is a critical element of longer term viral survival. All strains which kill all their hosts die out. To survive at all, there must be survivors so there will be future victims. Even your example where people travel a lot is heading for ultimate extinction unless it ceases killing everyone. It is an absolute requirement of any infectious disease that it does not kill all its host species.

The next problem with the analogy is history. We might be able to bio engineer  a virus totally from scratch, but nature cannot. Evey pathogen is the result of millions of years of evolution and cohabitation, often symbiotic cohabitatation, with a host species. Covid didnt come from nowhere it came from bats or something. Diseases swaping species is relatively common.

It is possible to hypothecate a virus which switches species and becomes deadly in the process. Obviously it wasnt deadly for its previous host, otherwise it would have been extinct and not spreading to anything. The rules of needing to not kill your host always apply everywhere and all existing pathogens must obey them. So the disease which spread to man was already adapted by those millions of years of evolution to not killing bats, and since it spread between species, before that it didnt kill rabbits, before that cats before that mamoths, who knows how many species how many repeat crossovers. On each iteration there has been evoutionary pressure to not kill your host, and not kill other potential hosts. Being adapted so you can readily move from one to another sounds a fantastic plan.

So anyone worrying aout this for fear of covid bat diseases coming to man, or indeed avian flu, needs to remember that we probably already had that covid and that flu in the past. The adaptations it made then to not kill us remain in place. Although there may have been randomm drift, there is no especial pressure to de evolve them while in another host. But also,  animals share the majority of physiological funtionality. The details vary, but evolutionary pressure is probably mostly the same between species to keep it mild. So its actually unlikely a fatal variant will emerge, even when a disease crosses to man.

Now, humans had immunity to covid before it arrived. That was proven in 2020 and links to the research exist on UKPR from that time. I think the carolinska institute had some early papers on it? The attributed reason for this is beause there are related corona virus readily in circulation around the world whic cause colds. Immunity to covid also seems to work against them. I have no doubt our covid eperience would have been much worse except for this existing immunity.

This ilustrates a second string of human immunity. It really isnt in our interest to exterminate covid either. The benefit we got from all those colds over the years was added immunity now when it mattered, and a new poorly adapted strain came back into the human population Over time we can be assured it would adapt to be milder because that benefits it, but short term there is likely to be a hit when this reintroduction occurs. But our keeping related strains in circulation mitigated that hit a lot. As discussed in the past, it seems highly likely pacific rim countries had a lot more immunity to covid than Europe, and thats how they managed to suppress it with physical interventions when we could not. China, origin point of covid has had hardly any deaths. Well obviously, if as the home of covid there has been much more exposure there to related corona viruses in the past. China has probably been keeping the lid on this crossover for decades or centuries. A wave of corona virus is supposed to have happened around 1890, no idea where it originated.  Might have been somehwere entirely other than china. Maybe we exterminated our local coron host species and now have reaped the reward of lower local immunity when this one came round from China.

[Danny]

Dec 14, 2021 10:36:49 GMT lens said:

There is a Guardian article regarding the inaccuracy of lateral flow testing: www.theguardian.com/world/2021/dec/13/can-you-trust-a-negative-lateral-flow-covid-test?xtor=ES-208-[49128_NEWS_NLB_ACT_WK52_Tue_14_dec]-20211214-[Guardian]

Some weeks ago my wife had "mild cold" symptoms, but none of those connected with Covid (cough, sore throat etc), and as an LFT was negative was required to go back to work (in a school). A few days later another LFT was positive which was confirmed with a PCR test. In our case the lateral flow test was worse than nothing - it served to lull into a false sense of security.

As I mentioned above, I am beginning to wonder if I might have had covid again, despite a negative lateral flow. Though it would be despite several such negative tests, though again all from the same batch supplied through the workplace in bulk. A key moment i concluded retrospectively that I had covid in 2019 was when it was announced loss of taste and smell was the most definitive symptom. There is quite a bit of circumstantial evidence confirming my diagnosis, but that news was a damascus road moment. This morning Bell mentioned a new symptom of muscle aches, which I have heard before recently, but he said 'especially back muscles'. Thats curious because several people in the workplace i caught my recent covid negative cold had back pain with it. And certainly there was covid present because some people tested positive. It wasnt normal pain either, i get lower back pain. This was upper and accompanied by other cramping muscles.

Some reading this might argue it just makes me sound all the more insane, but I'm just shaking my head at the idea I could have twice had covid but measures to track it have been so useless both cases were missed. In both case though it would be work place related with a high risk.

perhaps it’s time to reinstate a degree of caution and stay home if we feel unwell – at least until we’ve done a PCR test, or had several days of negative LFTs.

Sweden's original advice was exactly this. Stay home if you have symptoms. But otherwise dont. Saved a fortune in testing and the outcome was better. Fundamentally...do what you would normally do but a bit more cautious. See above as to why catching colds is a good thing. Doctors have aways said catching colds is good for you, at least while you are young(ish) fit and otherwise well.

May depend how you define "herd immunity"? Vaccines may not have stopped transmission altogether, but they certainly seem to have greatly minimised hospitalisations and deaths? Strict lockdown was effective, but hardly sustainable in the long term, but was useful in stopping the initial case load from overwhelming the health service.

Lockdown was not effective. Or at least, it did what WHO would have expected from the start, it slowed cases. But that only helps if there is some benefit you get from that extra time. So April 2020 the NHS was overloaded in a way it is nowhere near now. But cases fell 90% in 1 month from peak, and after that the overload was essentially over and has never recurred. Since then lockdown has never achieved 90% fall in a month and in fact the kent strain took off during lockdown, and plateaued here in hastings in the interregnum last year when restrictions were temporarily lifted. Apparently lockdown's effect was to make it spread more!(that isnt actually impossible, but another long argument. most likely it just didnt have much effect) There is evidence from deaths data that lockdown wasnt imposed March 2020 until the epidemic had pretty much peaked naturally in the S of England. It hung on longer after lockdown in the N, were it had begun later. As you would expect if in the S it was already faltering from lack of victims. In the autumn after restrictions were lifted it resumed in schools in the N of England but not in the S. The southern epidemic only restarted once kent came along. Also in that first wave i cannot see but pre lockdown mesures made matters worse by creating a mass spreading event in supermarkets, where it could reach grannies and thus create a surge of hospital cases at the start of April. An epidemic amongst 20 year olds goes unnoticed because its just a cold. Amongst 80 year olds, they end up in hospital. So in fact it wasnt lockdown but a return to normal shopping habits would have done the trick. (in fact I wouldnt be surprised sage know this perfectly well by now and realise masks and chatter about distancing in shops is a lot more useful than a legally enforced lockdown.)

Covid spreads readily within groups. Hence mass spreading events from one infected person. Hence why care home or hospital gets it. That spring, government changed peoples socialising patterns and created a new one of 'crowded supermarket'. Even sending people home from work risks their creating new socialising patterns which will create new routes of spread whereas their customary ones might have already been exhausted. People were told not to share a car into work so took the bus! Instead of sharing with a colleague you work with all day so not much real risk, you go mix with strangers.

I would love to ask SAGE their reasoning for imposing permanent restrictions. I am certain though they thought lockdown worked so well it dropped cases 90% in one month and this would be repeatable It was a major mistake. deaths just continued racking up more slowly to the same total or in fact to a higher one. They took away the relative protection old people naturally enjoy because they dont get out much. They forced young people to stay in too, so it took much longer for the waves to die down. During that time random opportunity allowed more old peple to be infected. We killed them with lockdown.

[leftieliberal]

An article on covid in New Statesman: www.newstatesman.com/long-reads/2021/12/how-the-battle-against-covid-became-a-forever-war

The UK Government's decisions to drop their contract with Valneva and to put up for sale a vaccine manufacturing facility in Oxfordshire, are inexplicable when you consider haw important vaccine manufacturing is (not just for covid).

[Danny]

Dec 13, 2021 18:26:32 GMT leftieliberal said:

www.bbc.co.uk/sounds/play/p0b98hzl 'More or Less' on Covid. Busting the claim that catching the disease give you better protection than vaccination.

Further to my reply above about the more or less link. I  have found anther paper just published here www.medrxiv.org/content/10.1101/2021.12.10.21267534v1.full.pdf

This reports immunity in persons 1 month after having two doses of vaccine who had no evidence of a past infection.  They found sera samples were x30 less efective in neutralising omicron than against  the original 'victoria' strain for those vaccinated with pfizer.  For astra zenica they dont seem to have been able to establish neutraliation of their test omicron sample at all.

 I think this isnt quite as bad as it sounds. These tests define a baseline antibody level enough to neutralise a defined quantity of virus. So what it means is AZ immunty fell below that threshold. But that doesnt mean it wont protect you from serious illness, just infection.

This work was carrid out in the Uk rather than Israel in the previous report.

This means that a booster vaccine is going to have to boost immunity x30 to achieve the same neutralising level as 2 doses of the better vaccine achieved against the original strain. Although it may be delta too was better at evading this immunity than the original.

Further writeup in the Guardian. www.theguardian.com/world/2021/dec/13/can-you-trust-a-negative-lateral-flow-covid-test?xtor=ES-208-[49128_NEWS_NLB_ACT_WK52_Tue_14_dec]-20211214-[Guardian]

That article mentions a further problem with testing, that lateral flow tests are not perfectly reliable in detecting positive cases. I dont know the details of how they work, but in principle they contain an antibody type molecule capable of identifying specific segments of covid by binding to it. It has to be an exact match and it will allmost certainly be looking at part of the spike. If this has changed then the tests will have the exact same problem as the vaccine generated antibody in binding to covid in the sample. In fact, potentially worse because natural antibody will contain a variety of dfferent forms whereas the tests are probably constructed with just one or at bst just a few. So they might fail totally in the face of some variants.

[Danny]

Dec 14, 2021 22:25:19 GMT James E said:

Mixed news from South Africa.

www.msn.com/en-gb/health/familyhealth/dr-coetzee-omicron-is-mild-and-admissions-almost-all-unvaccinated/vi-AARNLSW?ocid=msedgdhp&pc=U531

South Africa has only around a 25% vaccination rate, and this is concentrated in the older part of the population - hence the hospitalisations being 70% in the under 50s. In the early waves, UK hospitalisations were less then 10% under 50s.

The spokeswoman said they dont actually know whether people are dying from omicron, or the ones dying are people who still got delta. They also dont know what proportion of people who die infected with covid were sick with covid or car crash victims with a covid cold. Aside from that, the total of  hospitalisations and in particular intensive care demand is within capacity.

As to the headline, I have posted about that before in the UK. On the one hand evidence is unvaccinated people in the UK are no more or maybe even less likely to catch covid than vaccinated ones. On the other hand, most of those who die from covid or are seriously ill in hospital are not vaccinated.

These figures are reconciled by stating the statistical chance of your catching covid if you are one of the unvaccinated people in the UK is no worse than if you have been vaccinated. Thats simply the fact. But amongst those unvaccinated people there is a small subset who get more seriously ill. This data doesnt differentiate on what other risk factors those people might have, which would probably be the same as they have always been for making covid worse. It probably comes down to the same things it always has, you are safe from covid if in a low risk group and vaccine wont make much difference for those people. But if you are high risk then...you are high risk, and a vaccination will improve your chances.

The striking part of this evidence is that vaccinating low risk people is pretty pointless and always has been.  They might just as well have caught covid two years ago and avoided a year's worth of lockdowns. We should have introduced covid passports 18 months ago for everyone low risk or having had covid already and allowed them to live normally. Whether its morally right to lock up the rest against their will is another matter, and it really isnt.

So all in all, what we have done is completely wrong. Sweden got it right from the start, to intervene strictly only where necessary.

[leftieliberal]

Exclusive: NHS faces third wave of Omicron mid-January in London – at half the second wave’s impact
NHS executives have been briefed that the maximum number of Covid surge beds in London hospitals will be full by the beginning of January.

www.newstatesman.com/politics/health/2021/12/exclusive-nhs-faces-third-wave-of-omicron-mid-january-in-london-at-half-the-second-waves-impact

[Danny]

Dec 15, 2021 14:05:09 GMT leftieliberal said:

Exclusive: NHS faces third wave of Omicron mid-January in London – at half the second wave’s impact
NHS executives have been briefed that the maximum number of Covid surge beds in London hospitals will be full by the beginning of January.

www.newstatesman.com/politics/health/2021/12/exclusive-nhs-faces-third-wave-of-omicron-mid-january-in-london-at-half-the-second-waves-impact

Acording to govrnment omicron is already 50% of london cases and doubling every 2-3 days. At which rate it will be pretty much 100% of cases within a week. Since cases have been around a millon nationally for a month or two, I can't see how that wont be the omicrno wave starting immediately.  Cases amongst the old continue to fall currently, so there will obviously be a considerable delay before any significant rise in serious cases. That could take a few weeks, but then we are defining the wave by hospitalisations. The data so far still suggests these coud fall rather than rise if omicron replaces delat and is less dangerous.

In SA there was a big percentage rise in cases when omicron replaced delta, because there werent many cases at that time. So a small number was a big percentage.  But in the Uk current delta cases are quite high. Eliinating them and their higher risk of death should free up hospital places.

[leftieliberal]

@danny "In SA there was a big percentage rise in cases when omicron replaced delta, because there werent many cases at that time. So a small number was a big percentage. But in the Uk current delta cases are quite high. Eliinating them and their higher risk of death should free up hospital places."

We don't know that omicron has a lower CFR than delta. That's an assumption based on the early South African data. We will only know what the CFR for omicron is in a month or so when those who are catching this variant now are hospitalised and we can see how many of them have died. A 'milder' variant can fill more hospital beds if it means that those who survive have to stay in hospital longer.

[Deleted]

Dec 15, 2021 14:05:09 GMT leftieliberal said:

Exclusive: NHS faces third wave of Omicron mid-January in London – at half the second wave’s impact
NHS executives have been briefed that the maximum number of Covid surge beds in London hospitals will be full by the beginning of January.

www.newstatesman.com/politics/health/2021/12/exclusive-nhs-faces-third-wave-of-omicron-mid-january-in-london-at-half-the-second-waves-impact

It is appropriate that NHS 'plan for the worst' and don't just 'hope for the best' but the future is not set and still too early to know how the Omicron wave will pan out (and I know your not predicting certainty of outcome)

For behaviour side then a bit of 'Fear' (I won't call it scare mongering) can be a good thing as it raises awareness and hopefully increases vaccine uptake, basic hygiene/mask wearing adherence, some reduction in 'unnecessary' person-person contact, etc (ie lots of 'behavioural' ways Rt might reduce without having to go back into harsh lockdowns).

However, if Omicron is more transmissible than Delta (which seems v.likely) then we'll unlikely be able to suppress Rt below 1. OK, still possibly worthwhile to 'flatten the peak' but with new drugs, the high level of vaccines, etc then I'll keep my fingers crossed this is a short wave and we avoid Plan C. IF (and still an IF) Omicron does not cause too much severe disease or death then my 2c would be to 'get on with it' where the only objective for NHS is to ensure they are not overwhelmed and can get back to normal asap. We have to start living with Covid and new variants - especially if the variants are 'weaker' and our existing Pharma Interventions (vaccines and drugs) are enough to protect NHS from collapsing.

[Danny]

Dec 15, 2021 14:32:14 GMT leftieliberal said:

@danny "In SA there was a big percentage rise in cases when omicron replaced delta, because there werent many cases at that time. So a small number was a big percentage. But in the Uk current delta cases are quite high. Eliinating them and their higher risk of death should free up hospital places."

We don't know that omicron has a lower CFR than delta. That's an assumption based on the early South African data. We will only know what the CFR for omicron is in a month or so when those who are catching this variant now are hospitalised and we can see how many of them have died. A 'milder' variant can fill more hospital beds if it means that those who survive have to stay in hospital longer.

CFR...how do you define that?  Serious question because while we can count the bodies fairly well, just how many cases have there been? I suggest..no one knows.

If you take the definition of the number of cases as the number officially recorded after testing, then what you may count is simply what the system of testing allows you to count.  For example, if omicron was half as severe in its symptoms, you might miss many more of the cases which are much milder.

I reckon the best metric has always been the death rate per million population.  About 0.1% in the UK in the first wave. About 0.01% has historically been regarded as too small for any special intervention. In Japan for example, deaths have always been lower than this. In China they have been way lower. Irony there.

[Deleted]

Over 19k of today's cases were in London (only partially explained by increased testing)

coronavirus.data.gov.uk/details/cases?areaType=region&areaName=London

London has by far the lowest vaccination rate in England/UK but also the youngest population.

Travelling Tabby or twitter.com/RP131? are useful sources of objective analysis. There is of course a lag between testing +ve and potentially ending up in hospital and reported cases are not the same as actual infections but for now hospital admissions and patients in hospital in hospital WITH[1] Covid are within the 'rolling hills' range we've seen since 'Freedom Day' (but are slightly on the climb). Too early to know if the new drugs being used are having a significant impact but allowing for a 7day lag then admissions are down as a ratio of cases but that will increase as the 'future' catches up to the 'present' in 7days time. 

coronavirus.data.gov.uk/details/healthcare?areaType=nation&areaName=England

[1] The ratio of 'Primarily Covid' has stayed around 75% (ie 25% of folks in hospital who have Covid are 'primarily' in there for a different reason). Also we expect more folks in hospital with respiratory diseases this time of year. So 'concerning'? Yes. Panic. No. Going into lockdown until late Spring? Please no, not again. Sadly we only know for sure if NHS can cope with hindsight but dragging the Omicron wave out will do huge socio-economic harm - that would be for certain!

[Deleted]

NHS hospital data link for previous post. Lags infections but folks can (and have) run the relationships to reported cases (or the lagging infection survey data from ONS). Several plausible explanations and too early to know the Omicron impact but vaccines and drugs will likely have a significant effect in keeping this wave below the original and Alpha-Delta wave, but might well make a higher peak in the ongoing 'rolling hills' of the exit wave (TBC or course)

www.england.nhs.uk/statistics/statistical-work-areas/covid-19-hospital-activity/

[Deleted]

Dec 15, 2021 19:46:51 GMT colin said:

Dec 15, 2021 19:38:38 GMT shevii said:

Comres snap poll on lockdown:

comresglobal.com/polls/lockdown-snap-poll-december-2021/

51% supporting a 2 week lockdown (they talk about "December" rather than "Christmas") 32% opposed but rising to 38% of Tory voters. I imagine as the news gets worse these figures might rise.

Steve Baker and Gang take note !

Moved this to the Covid thread.

What purpose would a 2week lockdown serve? It would IMO very likely drag into several months, as we've seen in the past so the question is 'naive'. IMO then 'awareness' has been raised and folks can decide on their own behaviour. I'd like to see the 'refuseniks' have less access to society but looking at countries like France then it's unclear significant use of vaccine passports has much effect anyway (although it did likely ensure an increase in vaccination) 

Can someone find and post a 'tracker' equivalent of similar polling conducted last year. IIRC 'support' for circuit breakers were a lot higher back then. 32% 'opposed' implies much higher 'behavioural fatigue' and would put huge pressure on Police to enforce. No one is forced to go the pub or meet family+friends 'in person' but many will simply meet in private venues if the pubs/etc are shut down. There would also then be a need to bring back furlough and the enormous cost of lockdowns. 

So I'd be vehemently opposed to a 2 week lockdown as it achieve very little at huge socio-economic cost. Pretty sure Boris won't adopt Plan D as the CON MP rebellion against that would be enormous with high ranking payroll resignations as well (IMO, high confidence)

[jib]

@tw

We all hope Omicron is the mild manifestation of SARS-CoV-2 that becomes relatively benign, at least for those immunised or infection survivors.

Nonetheless, if Boris is pushed to have a 2 week lockdown, he will get through with Labour support. It might be terminal for him though.

[Danny]

Dec 15, 2021 18:34:43 GMT @tw said:

Over 19k of today's cases were in London (only partially explained by increased testing)

I couldnt find a total for the number of tests conducted so hard to say how much an incease in that total might explain more cases detected.

[1] The ratio of 'Primarily Covid' has stayed around 75% (ie 25% of folks in hospital who have Covid are 'primarily' in there for a different reason).

I couldn't find that mentioned in the source either?

So neither of those two critical parameters seems to exist?

[Deleted]

Dec 15, 2021 21:51:32 GMT jib said:

Nonetheless, if Boris is pushed to have a 2 week lockdown, he will get through with Labour support. It might be terminal for him though.

Has Starmer taken up the 'popular' view yet? He usually does - safe in the knowledge he's not the one actually taking the decisions. 

I'd agree that if Boris did try to pass a 2week lockdown then with Starmer-LAB backing, it would pass and that in doing so it would quite possibly speed up the B-Exit (so a 'silver lining' there perhaps) as CON rebellion would explode. My strong concern is 2weeks becomes 4months and the damage that would do to the socio-economy. Omicron isn't going to vanish in a 2week lockdown, behavioural fatigue is likely worse now than previous lockdowns and Omicron is v.likely more transmissible. 'Zero Covid' is a fool's dream.

It would likely be 3mths+ before a 'tweaked' vaccine was any better than a booster dose so as harsh as it sounds then what socio-economic cost is worth maybe saving a few additional lives (and mostly those who have had their opportunity to be vaccinated and refused)?

For immunocompromised folks then I'd like to see 'shielding' return and as much as possible done to 'cocoon' Care Homes, max screening in hospitals and Social Care, etc. but we can't keep locking down the socio-economy for the 'many' every Winter (IMO and a significant minority of folks in the polling question and amongst MPs).

Within polling and perhaps many MPs answers then we might be seeing some 'virtue signalling' (and hyperbolic discounting) as few folks will say the 'long-term+many' outweigh the 'short-term+few' when it comes to decisions, although for the majority of folks with decades left to live then they'll be the ones spending decades paying off the socio-economic cost of return to lockdowns. 

NB I'm not some DANNY type nutter. Vaccines and various drugs seem to be fairly effective at reducing risk of severe disease from Omicron. Obviously we all hope Omicron is also inherently less severe as well but if it's not then that is where 2weeks drags into the entire Winter as once you've locked down the data is unlikely to turn into a position of looking good enough to reopen (hence why I called the '2week' question 'naive')

[1] en.wikipedia.org/wiki/Hyperbolic_discounting

Also note in most x-breaks there is an 'age' bias in lockdown type answers although its less obvious in ComRes poll:
comresglobal.com/polls/lockdown-snap-poll-december-2021/

 

[Deleted]

PS I do note Austria has come out of it's 'circuit breaker' lockdown and did see cases drop a lot during that 3week period BUT it's 15Dec so they are likely going back in the 'wave machine' of On/Off lockdowns (they entered their last lockdown before Omicron which is believed to be more transmissible). Austria did need to improve on their vaccine %s and have done so. So IF and only IF any circuit breaker was purely for the purpose of ensuring as many people as possible received a booster dose then I might tone done my 'anti-lockdown' (for vaccinated folks) view. For unvaccinated folks without a genuine medical reasosn then F-'em, they've had plenty of time and I'm all for mandatory vaccines and extensive use of vaccine passports for 'refuseniks'.

[Deleted]

Dec 15, 2021 22:55:27 GMT bantams said:

I can't confirm this so does anyone know if ITV are correct in their assertion that the 78000 plus infections announced today don't include any reinfections?

Peston's twitter feed link:

of course that also means all the ratios WRT to hospitalisations and deaths will exaggerate how severe Omicron is. I hope and expect the 'actual' experts in SAGE are taking account of that even if the 'Zero Covid' fanatics still think we can get to Zero Covid with lockdowns (when we never achieved that in the past)

NB I've moved the Q&A to the Issue Specific section

[Deleted]

Also a reminder that 'reported cases' has always been much lower than 'actual infections'. ONS infection survey[1] is 'better' data on actual infections but it lags. Since we're under reporting even further due to 'methodology' then we won't know the current 'actual infection' rate of today until Xmas (or be able to see the 'ratio' which jumps around so much as to make the reported cases of minimal use beyond 'trend')

Independent SAGE latest (courtesy of 'Zero Covid' twitter feed) state:

Christmas is 10 days away – that’s 5 doublings at its current growth rate, making the situation potentially 32 times worse by then

www.independentsage.org/emergency-statement-on-omicron-15-december-2021/

That is 5 doublings (in their view) from today but almost two weeks (up to 6 further doublings using their view) have occurred since the last infection survey (ie up to 11 doublings in total). A 'gold star' to who can spot the problem with the maths. (ie what would 1.64% ^ 11 = X. In fairness to them they did say 'current' (which strictly should have been slightly past tense)).

By all means subtract a bit from that as Omicron hasn't yet achieved total dominance. However, point is, 'what is done is done'. Whilst the infection cycle might be a bit quicker with Omicron (ie time from catching it to being infectious is shorter so lags in the data are also shorter) then locking down now won't undo the infections that have already occurred and using I-SAGE maths then we'd be already be close to infecting over 100% of the population (yes, they fail to mention that in 'Zero Covid' twitterverse or 'behavioural factors' whereby a lot of folks have already started reducing contacts[2])

No one can be certain how many of the folks currently infected (many of whom probably don't even know either due to not yet '+ve' or asyptomatic and haven't conducted a test) will end up in hospital but the 'lag' means the horse has already bolted (and hence the Captain Hindsight 'outrage' in the 'Zero Covid' twitterverse)

[1] Most recent one suggesting 1.64% (1.54-1.73% confidence range) of population had Covid in w/ending 2Dec (see relevance in the 'maths')

[2] Which makes trying to estimate the variables incredibly difficult. We know Rt can be influenced by voluntary behaviour as well as enforced lockdowns but it's not easy to assign % to each. We also don't know the important variables of Omicron yet (transmissibility looks a lot higher but by how much?, IFR by demographic might be lower but we're not sure by how much) but we MIGHT already be at the inflection point in total infections and locking down now would hide that info which sadly we'll only know with hindsight if Boris+co. hold their nerve to find out. 'Squeaky bum time' is baked in and no predictions from moi but locking down now seems fairly pointless IMO and would likely cause more long-term damage than allowing the Omicron wave to do it's thing and pass. 

[Danny]

Dec 15, 2021 18:38:04 GMT @tw said:

NHS hospital data link for previous post.

Thank you Trevor. Obviously didnt see that when replying to your main post, and then it took a while to look at and think about. Your estimate of about 25% not ill with covid seems to be confirmed by the figures.

My concern after looking at said figures is that this proportion is remarkably consistent over the last six months. So I was puzzling over why this would be. It might be that most of this is no longer infection within hospitals, but simply reflects the prevalence of covid in the community so that about 20% of people being admitted to hospital with covid happen to have caught a covid cold. ( i did a quick calculation on the London figures which was more like 20%.) All the figures for incidental infection seem to move in step pretty much consistent with these proportions being about the general level in the community.

Maybe that means the problem of hospital induced infection has been overcome. Or possibly this is averaging out over the total of hospitals in a region. Last year certainly there were a number of reports of mass spreading events in particular hospitals. really needs more information.

[Danny]

Dec 15, 2021 22:38:45 GMT @tw said:

Has Starmer taken up the 'popular' view yet? He usually does - safe in the knowledge he's not the one actually taking the decisions. 

Throughout the epidemic every time an important decisions was made some tories would come on the media beforehand expressing pro and anti views. It certainly isnt just starmer testing to see if a measure is popular before introducing it.

My strong concern is 2weeks becomes 4months

You are being very generous. 2 weeks in April 2020 became 2 years (and counting)

It would likely be 3mths+ before a 'tweaked' vaccine was any better than a booster dose

Um. I think the reason there have been no updated versions is because there really isnt any benefit. The consensus seems to be the current vaccine will still work against serious disease and a new one wouldnt be much better. While neither would work to suppress repeat infections for more than a few months. Government has been criticised for not implementng a booster earlier, but the truth is it will only give a short term window of about 3 months reduction in new cases. So after 3 months start again There was no point doing it in the summer because it would already have worn off. You could only keep it ready to go fast.

For immunocompromised folks then I'd like to see 'shielding' return and as much as possible done to 'cocoon' Care Homes, max screening in hospitals and Social Care, etc. but we can't keep locking down the socio-economy for the 'many' every Winter (IMO and a significant minority of folks in the polling question and amongst MPs).

likely outcomes in this group are the least certain of all. However Zoe has reported cases falling quite steadily amongst 50+ for the last month while younger people have had ups and downs. That suggests something has improved their outcomes. This would fit the booster program.

I'm not some DANNY type nutter. Vaccines and various drugs seem to be fairly effective at reducing risk of severe disease from Omicron.

I never said otherwise. Where is the communication error claiming I did? I have said waiting for a vaccine was a mistake. I have said they have failed compared to original promises, and obviously completey failed to end the epidemic. I have said they dont make much difference for young people and the overall death rate would have been lower had we simpy therefore let young people go about their normal lives and catch it, creating immunity much faster. I have said natural immunity is as good as vaccine. I maintain anyone who has had covid is safer than someone who has only had a vaccine because if you have survived it once it means we now know you were never at high risk (or if you were you survived anyway). Someone only vaccinated may still be high risk despite that. All groups are getting repeat infections.

Obviously we all hope Omicron is also inherently less severe as well but if it's not then that is where 2weeks drags into the entire Winter as once you've locked down the data is unlikely to turn into a position of looking good enough to reopen

That depends on the reasoning. I accept that special measures to slow spread made sense in April 2020 because hospitals woud be overloaded. But as soon as that peak has been evaded or passed, then they should end. That was the original 2020 plan and should be the plan now. Constant lockdown doesnt reduce deaths.

[Deleted]

@tw

@"There would also then be a need to bring back furlough and the enormous cost of lockdowns. "

I feel sure that this is a major factor in yesterday's weird double act:-

Johnson-The Pubs are open
Whitty-don't go to them.

BJ is between Rock & Hard Place. The Public are fickle-supporting "tough measures" in OPs whilst going to the pub sans mask.

Politicians cannot win when trying to look like they are "managing" a contingency which "science" cannot ( yet) evaluate and quantify with certainty.

So the comfort zone is at the extremes :-

Either Steve Baker et al -or Whitty / Nabarro et al

[Danny]

Dec 15, 2021 22:57:18 GMT @tw said:

For unvaccinated folks without a genuine medical reasosn then F-'em, they've had plenty of time and I'm all for mandatory vaccines and extensive use of vaccine passports for 'refuseniks'.

So which of those contradictory answers is your view? The first, to allow people to do what they choose, or the second to force treatment upon them? If that treatment eventually proves to have been misguided, will they get compensation?

[Danny]

Dec 16, 2021 0:57:14 GMT @tw said:

[1] Most recent one suggesting 1.64% (1.54-1.73% confidence range) of population had Covid in w/ending 2Dec (see relevance in the 'maths')

Zoe reckon about 1.1 million people infected, so thats about the same. Been stable at the that sort of level for a month or two. Zoe, react and ONS tend to agree quite well, but zoe is the only one publishing daily numbers. If you want to track the latest data, look at that. Yesterday's didnt really show any indication of a sudden rise.

covid-assets.joinzoe.com/latest/covid_symptom_study_report.pdf

[Deleted]

Dec 16, 2021 9:58:34 GMT colin said:

@tw

@"There would also then be a need to bring back furlough and the enormous cost of lockdowns. "

I feel sure that this is a major factor in yesterday's weird double act:-

Johnson-The Pubs are open
Whitty-don't go to them.

BJ is between Rock & Hard Place. The Public are fickle-supporting "tough measures" in OPs whilst going to the pub sans mask.

Politicians cannot win when trying to look like they are "managing" a contingency which "science" cannot ( yet) evaluate and quantify with certainty.

So the comfort zone is at the extremes :-

Either Steve Baker et al -or Whitty / Nabarro et al

Lots of press highlighting the difference between the 'medics' and 'govt', eg

news.sky.com/story/covid-19-puzzling-disconnect-between-government-scientists-dire-omicron-warnings-and-their-advice-to-public-12497399

and CON MPs talking about 'lockdown by stealth' (and without the need to pay 'furlough' or 'grants' as no one is forced to shut)

Not an easy situation by any means! However, I hope most people can and do take a sensible middle-path:

1/ Cut back on 'some' contacts (each individual choosing their priorities) and try to go back to 'bubbles' (of your own choice) 
2/ For larger venues you either need a vaccine passport or should do a test in advance (both if possible)
3/ Support local businesses (eg your local pub and shops) but 'stay alert' and use #1 and #2

That seems fairly clear to me but then as an 'RoC' I don't expect to be spoon fed exactly how to live my life. I respect that Whitty+co have to their jobs to do and that Boris and HMG have to do theirs. I disagree with Baker and CRG folks on their 'anti-vaccine passport' and 'anti-mandatory vaccine' views and actually have a lot of empathy for Boris, Saj and Rishi taking a longer-term holistic view and avoiding the hugely damaging socio-economic costs of lockdown (although I would like to see some specific additional measures and messaging for higher risk folks/higher risk settings for both the safety of those folks and the expectation that means we can through the Omicron wave quicker with a lower peak in NHS admissions and deaths)

PS Good to see BoE not 'bottle it' (I/many pundits thought they'd use Omicron as an excuse for delay). Also good to see the £ didn't jump much as that was/is my only concern about UK moving aheads of 'others'. Next meeting not until Feb so plenty of time to see how the land lies going into that meeting but it was important to get the ball rolling.

finance.yahoo.com/news/fed-heads-exits-despite-omicron-060632193.html

[Deleted]

Covid specific article from YG

More Britons are wearing face masks following rule changes

yougov.co.uk/topics/politics/articles-reports/2021/12/16/more-britons-are-wearing-face-masks-following-rule

[Deleted]

Link for UKHSA who are publishing a lot of Omicron specific info daily:

www.gov.uk/government/publications/covid-19-omicron-daily-overview

and are the source for the 200k number: 'UKHSA estimates that, during the day of the 13 December, just over 200,000 people were infected with the Omicron variant' 
(the graph having a logarithmic scale)

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1041809/20211216_Omicron_daily_infection_estimation_modelling.pdf

and on the 'methodology' issue for the daily dashboard, then Peston will be pleased to see:

'Understood that UKHSA will in due course start including COVID reinfections in daily reported case numbers - reinfections currently reported separately in weekly surveillance report - early evidence suggests increased reinfection risk with Omicron'

[Danny]

Dec 16, 2021 16:27:07 GMT @tw said:

Lots of press highlighting the difference between the 'medics' and 'govt', eg news.sky.com/story/covid-19-puzzling-disconnect-between-government-scientists-dire-omicron-warnings-and-their-advice-to-public-12497399
and CON MPs talking about 'lockdown by stealth' (and without the need to pay 'furlough' or 'grants' as no one is forced to shut)

I placd a post about today's zoe data in the main thread because its a highly important issue. But essentialy they still have R=1.0 for england, R=1.1 in London but its been at that same level for 3 weeks. No sudden change in the data to 15 december. The only rise is for 20-29 age group nationally, whch could be showing exponential rise, but if so it looks to have started mid November before omicron officially arrived. Government testing will be a massive over estimate because there must have been a vast number of tests carried out in the last few days. How many is only published a few days later, but distrubution ran out of tests they were being taken so fast.

So... one very good reason for not introducing mandatory action would be there isnt any evidence to justify it. Whitty and Vallance must know basing anything on government preferred testing data is pants.

However, what is definitely shaping up is disaster for businesses expecting to be open at christmas, and collapse of essential services for the same reasons as the pingdemic. Healthy staff being sent home. At this point it must be just as likely the government has succeded in turning a crisis into a disaster.