Covid

[alec]

johntel - don't know. All we know is that once you've been infected with this version of Omicron, you have a higher chance of getting reinfected.

This matches other data which previously showed those with more vaccine shots had higher risk of subsequent infection, although the additional risks were less dramatic. It could be immune imprinting, for which we have some evidence is occurring, after both vax and infection.

There are likely to be some individuals with a natural immunity, and I did see one study that suggested around 10% of people have a set of genes that makes them more resistant to covid, but this comes at the cost of having a higher risk of high blood pressure. But also bear in mind that variants change, and this changes the immune landscape.

[leftieliberal]

Getting covid and influenza vaccines together produces higher levels of antibodies than getting them separately
www.theguardian.com/world/2023/nov/15/covid-flu-vaccine-same-time-study

[Danny]

Nov 16, 2023 7:36:10 GMT alec said:

Danny - Jesus H Christ!

You cannot be serious, as they say. 100 extra deaths in a tiny town like Hastings from a mystery virus wouldn't have been national news - it would have been a very big global story,

Population of combined urban area with Bexhill about 100,000. Annual death rate 1% of this, 1000. Death rate in each wave of covid, about 0.1%, or 100. So a 10% increase, but surges of deaths are normal during the winter season. As I said, hospitals might well have noticed a surge in grannies dying, but thats just normal. There would have been no surge in younger people dying, which would have been a red flag. If it had been 100 40 year olds, then certainly...but thats not possible with covid.

There is also the possibility that the interventions conducted by government made the epidemic worse! The death rate critically depends on how easily older people get infected, so for example the national call to stock up in preparation for lockdown forced older people to enter massively crowded supermarkets shoulder to shoulder with snuffling youngsters who would already have had covid. Thus creating a mass spreading event infecting exactly the high risk group. The change between before and after lockdown was astonishing. One week we were rammed together in the shops. The next we were all spaced 2m apart and queued in then open air so that hardly anyone was in the shop at the same time. If government really believed that was necessary, then what was happening the week before was practically criminal and guaranteed to have caused extra deaths.

When government under advice called the lockdown, they believed the epidemic was at a far earlier stage than it really was (not least, if it started months earlier and had been spreading). So they would have discounted risk of spread from crowded stores. Whereas in reality this was a huge risk. Nor did they realise at that time covid doesnt kill or serverly sicken even relatively old people - they didnt understand what they needed to do was protect the old. So they actually did something which increased their risk.

[Danny]

Nov 14, 2023 13:29:58 GMT leftieliberal said:

Perhaps you should have read this article: www.theguardian.com/world/2020/sep/05/everyone-was-drenched-in-the-virus-was-this-austrian-ski-resort-a-covid-19-ground-zero before you commented on my post.

And skiing, Von der Thannen points out, keeps you healthy. In late April, a group of virologists came to the valley to mass-test the population and found that while more than 40% had developed Covid-19 antibodies, only 15% had had any symptoms.

or alternatively, the disease had been present for months, so people had a cold a couple of months ago, which was officially discounted as being too early, but actually it wasnt. My guess is that covid is hard to spread between two people 1m apart. That was also the WHO advice on distancing. Its when you get real close it spreads. Directly shared breath close. Holiday resorts..partying with strangers. Game on.

“A tough people, very resistant,”

We also know other corona viruses create resistance to covid. If the locals were busy spreading covid, then in earlier years they were also busy spreading all the other corona viruses around. So it may be they were especially immune before it ever arrived. Given what we now know, this would have created an unusually high number of asymptomatic or very mild cases. And demonstrate the advantages of regular infection.

Nov 14, 2023 16:38:24 GMT leftieliberal said:

So 25% of local residents had had covid but were symptomless. That is important because it is quite likely that a similar proportion of tourists had caught covid but were symptomless too.

See above, maybe not. If bar staff were habitually repeat exposed to all sorts of diseases because they were working with tourist, then they would be expected to have high levels of immunity to just about every disease going. Whereas tourists presumably normally only mix with a small social circle at home.

[lens]

Nov 16, 2023 15:18:46 GMT Danny said:

Nov 16, 2023 7:36:10 GMT alec said:

Danny - Jesus H Christ!

You cannot be serious, as they say. 100 extra deaths in a tiny town like Hastings from a mystery virus wouldn't have been national news - it would have been a very big global story,

Population of combined urban area with Bexhill about 100,000. Annual death rate 1% of this, 1000. Death rate in each wave of covid, about 0.1%, or 100. So a 10% increase, but surges of deaths are normal during the winter season. As I said, hospitals might well have noticed a surge in grannies dying, but thats just normal.

But what about my point, Danny? What about the 1,000 or so extra hospitalisations that would also have been expected? And I know quite a few people who did catch it skiing at the time, and from what I've heard in about 1/3-1/2 of the cases it wasn't just like a couple of days off work with "normal" flu - it was laid up for a couple of weeks. Wouldn't all that sick leave have rung a few bells?

And care to tell us exactly how many hospital beds there are in total in Hastings? Those 1,000 or so hospitalisations would have been likely for a lot more than just a day or so - and you mean to say that wouldn't have been noticed? Espacially with a lot of cases at the time requiring ventilation?

[lens]

Nov 16, 2023 10:07:02 GMT alec said:

johntel - don't know. All we know is that once you've been infected with this version of Omicron, you have a higher chance of getting reinfected.

This matches other data which previously showed those with more vaccine shots had higher risk of subsequent infection, although the additional risks were less dramatic. It could be immune imprinting, for which we have some evidence is occurring, after both vax and infection.

But I don't see if that is correlation or causation?

You seem to be interpreting it as the latter (correct me if not) - that being infected with Omicron on top of vaccination actually makes a subsequent infection more likely. (Causation)

But could it be as simple as anybody who caught Covid post vaccination is simply more likely to catch it at all - and that same pre-disposed likelihood is what makes it more likely for them to catch it again? (So correlation, even if no causation.)

[alec]

lens - I don't know is the honest answer. I was very puzzled initially to data from multiple sources that showed the more vaccinations people had the greater the likelihood of infection/reinfection, but these were teased out from official data that was looking at other things. Initially I put this down to behavioural considerations - 'vax and relax' or whatever. I also mentioned on here a long time ago a consistent signal from ICU monitoring that showed those with a single vax were less likely than those with two or two + boosters to need ICU admission. Again, I assumed that these were being more careful through not being fully vaxxed. Same with infections in many ways - less cautious people get infected and so are more likely to be reinfected as they are less cautious.

But as more and more data comes is it does start to get difficult to argue that this is just because some are more prone to infections. The scale of the additional risk is large, and these groups were averaging similar risks of infection prior to the first infection, and then the risk profiles change very dramatically. The key here is that we're actually looking at the risk of reinfection, not the risk of infection after vaccination. And there really does appear to be a big effect.

Whatever the cause, the central point remains sound, I think; getting infected as a means to develop immunity isn't working.

[lens]

And new weekly figures for hospital admissions for covid, and numbers in hospital in England. And both show another distinct downturn - down 8% for admissions, the fifth weekly fall in a row, and now not much more than half of what they were at the last peak a few weeks ago.

[alec]

lens - yes - figures good, although I suspect it won't be too long before we see this reversing. The 8% fall compares to an 18% drop last week, and the CMI analysis actually increased their imputed R value based on this weeks data (although still just below 1). JN.1 is on the rise, with a hefty growth advantage. This is the Pirola descendant, and it's normal to see cases start to rise once a new variant with large growth advantage gets towards the 50% of total cases threshold. Might be a couple of weeks before that happens here, and then there might be another weeks lag for hospital cases, but I don't think we're far away now. Could even be sooner than that, as some regions saw hospital admissions rise this week.

And the latest deaths data shows a small rise in covid deaths and excess deaths back up to 4% above the pre-pandemic level. Whatever the reason, hundreds more people are dying every week than should be.

And another paper out this week showing a significant drop in testosterone in males after covid infection, with impacts on fertility. We've now seen substantially elevated cardiovascular risks after covid become established as an accepted medical fact, cognitive impairment is rapidly following suit, and I suspect the next domino to fall will be a general acceptance that covid creates a fertility problem in men.

Such fun.

[alec]

lens - worth noting that Iceland appears to have a large proportion of JN.1 and are reporting ER departments becoming very busy, a similar picture in Limerick, Ireland, where there looks to be a JN.1 outbreak and their health system is under intense pressure. The Netherlands also reported a BA.2.86 outbreak (forerunner of JN.1) with a relatively high death rate. One or two snippets that could signify we're entering more difficult times again, but limited data and too early to draw any firm conclusions as to whether JN.1 is markedly more pathogenic.

[lens]

Nov 16, 2023 18:57:44 GMT alec said:

lens - I don't know is the honest answer. I was very puzzled initially to data from multiple sources that showed the more vaccinations people had the greater the likelihood of infection/reinfection, .....................

But as more and more data comes is it does start to get difficult to argue that this is just because some are more prone to infections. ............. The key here is that we're actually looking at the risk of reinfection, not the risk of infection after vaccination. And there really does appear to be a big effect.

Well, I did make a couple of enquiries after raising the question and was directed towards one report from the BMJ - www.bmj.com/content/381/bmj-2022-074404 . The simple answer seems to be that the answer to my original question ("but is it correlation or causation?") is best put as "nobody knows for certain"! I did wonder initially if I was asking a naive question, but it appears not, and if I understand the BMJ article correctly they seem to come out that there is no solid evidence to support immune imprinting at all, even if it is not completely disproved. From the article, my emphases:


"The findings of recent observational studies in Qatar show an increased risk of reinfection with omicron in people vaccinated with three doses of monovalent vaccines compared with two doses,4 and no increased risk of omicron reinfection in unvaccinated individuals.6 These findings have been interpreted as supporting the immune imprinting hypothesis, which has raised concern among authorities in charge of vaccination policies worldwide.

Here we propose an alternative explanation to the findings of the observational studies: that the increased risk of reinfection in individuals vaccinated with a vaccine booster compared with no booster is the result of selection bias (owing to conditioning on a collider) and is expected to arise even in the absence of immune imprinting."



Personally, I'm more inclined towards the "correlation" theory, if for no other reason than Occam's Razor. It equally seems to support the known facts - whilst being simpler than any immune imprinting theory. I seem (hope) to be in the group who Covid seems to have passed by, as johntel refers to. And that in spite of must having been heavily exposed when my wife had it . (With a LFT test giving an inaccurate result meaning no isolating precautions were taken for days.) If johntel is correct in thinking that one group have such a "natural covid immunity", is it too much of a leap to think that others may have the opposite? Something making them far more likely to catch it - even when vaccinated - than average?

Nov 16, 2023 18:57:44 GMT alec said:

Whatever the cause, the central point remains sound, I think; getting infected as a means to develop immunity isn't working.

Well, yes. Such a policy sounds a little bit like giving all your money away so you don't have to worry about being robbed! Isn't the whole point of immunity to prevent any infection in the first place? And surely it's better to acquire as much immunity as possible through vaccination first? Any hybrid immunity from any subsequent infection then just being seen as a silver lining to the covid cloud?

Though doesn't a lot depend on age? Statistically, the death rate from Covid varies hugely with age, whereas the (very small) risk from vaccines doesn't seem to. Consequently, the older you are, the more it should be a no brainer to be vaccinated. But the younger you are.......? Certainly with Astra Zeneca there seems to have been a crossover age where vaccine risk starts to outweigh covid risk.

[lens]

Nov 16, 2023 22:20:41 GMT alec said:

lens - yes - figures good, although I suspect it won't be too long before we see this reversing. ...........

No doubt. Which is why the graphs are so revealing. A pattern of peaks and troughs, with the peaks getting steadily lower each time, and now seemingly with the time period between peaks getting longer. I'd put my money on a few more weeks of lower figures still before any reversal - but once they get to a certain point the only way to go is up!

To another peak - and a few weeks later start to decline again. 

And this seems the pattern in other countries as well, which is why I can't get too worried about snapshots of any increase at the moment in time. It's the longer term trend that's important, not any snapshot showing a single rise. (Or fall for that matter.) But let's see what next week brings......

[alec]

lens - you could be w=right on the vaccine/infection theory, but it's important to note that it's now pretty well established that infection intervals are getting much shorter, so aside from vaccination issues, the idea of immunity building from infection is weakening.

What troubles me is that we are increasingly seeing the evidence of long term harm from even mild infections, across a wide range of organ systems. We knew this was the case with SARS1, where most recovered victims still have multiple health issues today, seventeen years later, but everyone chose to ignore this with SARS2. It still remains perfectly possible (some say likely) that we'll see very substantial population scale impacts from SARS2. The data from health systems around the world, plus excess deaths, suggest this is already happening, but we aren't registering this because of our misleading focus on the acute phase only.

In due course I expect we'll end up accepting that viruses are actually far more damaging over the longer term than in the initial phase, where a minor sniffle is not an uncommon first response. We already know this though - HIV being the classic example.

[Danny]

Nov 13, 2023 22:14:18 GMT alec said:

Danny - "And then we would all die in a few years when it came roaring back but we had no immunity."

I don't think you appreciate just how barking mad you've become on this. In a single post, you're literally saying we would all die of covid through waning immunity if we don't keep catching it, before then going on to say that Hastings had it's first wave - with zero immunity - and no one died.
Can't you see how utterly stupid that is?

erm, I was quoting yourself, its you who claims covid is so deadly. Who still claims its still a mass killer. The bottom line is that when covid entered the human population there was no alternative but we suffer the attrition it would cause. Happily that was much less than official estimates. You however are still arguing the death toll will rise, not fall. The situation we have now is one of strong immunity to covid and covid variants. Thats obvious, else there would still be surges of deaths (ie on the scale of April 2020). We got this immunity partly by vaccine but for most of us by infection. Your argument is try to stop being reinfected, mine that reinfection simply tops up immunity. And that deliberately ending reinfections runs the risk that in a few year we will all have minimal immunity again, and it will come roaring back. The 1918 strain of flu is still with us circulating, 100 years later. It just doesnt kill many any more.

And dont forget everyone dies. It makes a real difference if a disease is seeing off mostly 80 year olds, or mostly 18 year olds.

[johntel]

Nov 17, 2023 0:09:34 GMT lens said:

Nov 16, 2023 18:57:44 GMT alec said:

Personally, I'm more inclined towards the "correlation" theory, if for no other reason than Occam's Razor. It equally seems to support the known facts - whilst being simpler than any immune imprinting theory. I seem (hope) to be in the group who Covid seems to have passed by, as johntel refers to. And that in spite of must having been heavily exposed when my wife had it . (With a LFT test giving an inaccurate result meaning no isolating precautions were taken for days.) If johntel is correct in thinking that one group have such a "natural covid immunity", is it too much of a leap to think that others may have the opposite? Something making them far more likely to catch it - even when vaccinated - than average?

This seems highly likely to me lens. 

I'm pretty sure I haven't had Covid, despite going to supermarkets and shops several times a week, looking after our granddaughter, going to the gym three times a week, sometimes to the cinema and packed theatres , and neither has my wife. What have we got in common? - we are both very healthy  - never ill, no flu and very rare minor snuffles. Which I also put down to Vitamin C - we have freshly squeezed orange juice every morning. 

I doubt if anyone is 100% immune - but everyone must have a different threshold of resistance to covid, and other viruses. So I'm resisting it with my current level of exposure, but no doubt if I was exposed to very high levels, for example if I'd worked in a  hospital at the beginning of the epidemic , then I would have got it. And it takes some people longer than others to recover from a virus and in that time they are more susceptible to reinfection. And some virus strains are  stronger than others...

[leftieliberal]

A couple of points from this morning's Covid inquiry questions to Chris Whitty ( BBC live text )

11:46
Back from the break, Sir Chris Whitty is taking questions from Pete Weatherby KC, who is representing the Covid Bereaved Families for Justice.

He's asking Whitty about a diplomatic report, sent in January 2020, detailing the asymptomatic transmission of Covid in Wuhan, China.

Weatherby questions whether the impact of asymptomatic transmission - when a person with Covid does not present symptoms but passes the virus on - was "underplayed" during the pandemic's early days.

Whitty replies: "At this point we were probably thinking it wasn't a major driver of pandemic".

11:55
Whitty is asked about the Diamond Princess - a luxury cruise ship where Covid took hold in February 2020 - an analysis of which showed that asymptomatic transmission was having "a real impact".

He is asked if they should have understood asymptomatic transmission better at that point.

Whitty says there should have been more urgency either way, not only predicated on asymptomatic transmission.

He says the scaling of testing should not have been dependent on asymptomatic transmission, neither the need of PPE.

Whitty also says there is still no confidence now about the number of asymptomatic transmissions at the time but acknowledges it was a major issue.

The issue of failing to understand asymptomatic transmission is a major factor in explaining why the early response to Covid went wrong. I don't think there are that many diseases where asymptomatic transmission is as important as it is for Covid, which is probably why it was thought not to be a major driver in the early days.

[alec]

leftieliberal - I think you are correct in highlighting the misunderstanding of the consequences of asymptomatic spread, but I don't think we can give too much leeway to the experts in charge on this. It was known well before covid that many diseases spread silently. Flu has 75%+ asymptomatic spread (https://www.nicswell.co.uk/health-news/three-quarters-of-people-with-flu-have-no-symptoms) and HIV is well known to spread without symptoms for years and then it kills you.

I just think the expert community was so sure it knew what to do because they'd dealt with flu in the past, and they blindsided themselves. China was telling the world about asymptomatic spread very early, but we chose not to listen.

[Danny]

Nov 22, 2023 18:26:26 GMT alec said:

I just think the expert community was so sure it knew what to do because they'd dealt with flu in the past, and they blindsided themselves. China was telling the world about asymptomatic spread very early, but we chose not to listen.

I dont recall any media talk about asymptomatic transmission before maybe summer 2020. After the disease failed to respond to maintained lockdown by decaying to nothing as predicted. It led to all sorts of questioning just what was going wrong. The reported early news from China all supported a disease with few cases and many deaths, probably meaning they had completely missed the existence of all asymptomatic cases, and probably most of the symptomatic ones too.

[Danny]

Thought it a good idea to copy here the enquiry reporting from the main thread. so..

Chris Whitty being interviewed by covid enquiry. A curious thing is that behind the questioning barrister are rows of desks with computers. When I saw civil servants being interviewed before, these were all empty. Now they are full.

First off, he stressed his own role as being to represent the advice being generated by Sage to government, rather than it being his advice.

However he talked about how some of this evolved, based on what was known at that time. That most information about the disease was coming from the Chinese. So it was no better or worse than what they were willing to make public. He stressed from time to time how covid was not being transmitted within the UK in early 2020, and that this was part of the information feeding into advice and decisions.

Which brings us all back to covid already transmitting within the UK starting in Hastings, and then logically feeding into London on a timescale which would account for the surge of internal transmission which was evntually identified.

His and other experts reactions are being argued as logical based upon the evidence as they knew it. Had they known covid had gone through Hastings with little to show, all before they decided to call a lockdown, you have to wonder whether they would have completely reconsidered that choice.

Also reporting he and sage saw their role as reporting international consensus on what to do. Something of a world 'group think' took place with only a few exceptions such as Sweden. Which noteably did not have a lockdown in the Uk and most of the world sense but had better outcomes. Sage only reported what most agreed upon, it just happened to be wrong.

Whitty confirming that national lockdown was a policy never used before in history.

Interestingly Whitty is saying that the published SAGE recommendations were not exactly the advice government received. The printed advice summarised the consensus of meetings, but did not include dissenting views. However Whitty briefed ministers personally and conveyed to them alernative views. He reports some ministers relied on his briefings, others on reports. Thus far anyway, he has not explained what those dissenting views might have been and how their advice which reached ministers might have inclined them towards a course of action other than the consensus recommendation. He noted he was always happy for ministers or advisors to attend to listen, though not intervene. (not that many did). Whitty was also responsible for informally advising SAGE what government wanted the to concentrate on. He noted there was a risk in this of creating a circular debate where government prodding directed SAGE, which then moved in that direction and did not explore other possibilities, instead feeding back to government what it wanted to hear.

Whitty also seems to have been significantly responsible for choosing who composed SAGE, which obviously influenced the sort of consensus they were likely to arrive at. So his position in the nature of advice obtained and what was highlighted to government seems to have been absolutely key.

Fascinating Whitty is downplaying the reliability of modelling, saying it was useful to indicate the general effects of certain interventions, but not for reliably predicting the real outcome of the epidemic. And yet modelled results were widely taken as accurate predictions, and still are.

He also noted modeling by Ferguson which indicated China must have had many more cases at the start of all this than it was reporting. One email concerned a report of unidentified pneumonia in China 2 Jan 2020, and Whitty noted concern at that time that the disease would already be spreading around the world. Which is only a couple of months after it reached Hastings. Coupled with the simple fact most covid never got reported as anything unusual, or to medics at all, this is all consistent with a wide scale outbreak well before it was identified.

Whitty commented on possibly different types of disease, one which spreads readily but few cases reach medical attention, and another with relatively few cases but many of those are serious. Also that some diseases can be mild if the infection dose itself is modest, but eg for health workers in very close contact with sick people, they may get a large dose infection and therefore become severely ill. They did not know which might apply.

Overall, Whitty said he believed they acted as expediciously as any could or should have, given that crying wolf on every possible report which might be a serious new disease would ultimately be counter productive. But the health staff had already noted this was one to watch from the very start of Jan 2020. (remembering of course that earlier incidence of disease came to light later, such as the choir which visited china and came back to the UK with covid that christmas, the old sample later analysed in Paris, the detection in stored sewer samples)

Whitty interestingly said the national flu epidemic plan seemed to him inadequate for what might happen, but equally he considered it would have been inadequate for the 1918 flu, or the two other flues the UK experience around 1960. It wasn't uniquely inadequate because of anything special about covid. He noted that since the inception of the NHS the total number of beds has shrunk dramatically, and whereas once much of its business was infectious diseases, the proportion has shrunk and shrunk. So its simply did not have the facilities it once had for such diseases.(Its clear to see from this why attention moved to limiting peak number of cases.)

Asked if better planning would have allowed a more speedy response, he replied that the limiting factor was not planning, but data to suggest that the epidemic had already spread much further than they had believed back in January. Testing could have provided that data, but he detailed earlier why that was impossible- the countries which did manage to test quickly and plentifully were either like S Korea, which set up a national testing system after it caught MERS years before (which incidentally would also have given the country cross immunity to covid), or Germany where its large national industrial base allowed it to co-opt private resources. Further delays were incurred because of the time required for politicians to make decisions amongst options.

Whitty just explained the possible course of this epidemic as he saw it in January 2020. He outlined two possible scenarios to government, one where it remained largely confined to China and didnt spread much elsewhere, just a bit of mopping up needed. The other where it spread massively, with possible 2% deaths rate. He expressly stated he wanted to avoid government believing there might be a middle path of somewhere between these two, which he believed could not happen (but of course, that is exactly what really happened.)

Interestingly he just outlined the difference between China and the UK in the case it turned out as the mild option, was that it had time to spread widely in its country of origin before it was ever noticed. Then something which might have been stopped by modest interventions could no longer be stopped that way. (This seems entirely analogous to what really happened in the Uk and many other western countries, we tried to stop it at borders, but it was already here and so such measures could never have worked. This where the evidence of its early establishement here at least in Hastings becomes very important)

Asked about closing borders, he considered and still considers this would not have stopped covid entering the UK. Because of the difficulty with making such measures sufficiently effective. However he also noted he is aware of examples where governments closed borders, not to prevent spread but to generate public confidence they were taking effective action (even though it wasnt).

Interesting little document from the time, very few cases reported in under 20s. Mortality mostly over 60s. A very good observation which held true. (assuming the under 20s certainly did catch it, just didnt get ill enough to be recorded)

Whitty was questioned about the credibility of the 'worst case scenario' used in modelling. In a number of papers he was reported as estimating its likelhood of ever happening as 10-20%. Whitty explained that as with all modelling, this was a notional number used as a benchmark rather than a realistic prediction. It was on the assumption no one did anything to mitigate the outbreak, and even without government intervention then people themselves might act so as to mitigate it. (my own problem with this benchmark is that in practice it has never ever happened anywhere on earth, so it never was in any way realistic. Its like saying if you walk down the centre of the road you are at risk of being run over, but hardly anyone ever would do that)

Closing mass gatherings outdoors was unlikely to have much reduced spread of covid, and if instead people had gone to pubs to watch a match, then its likely that would have increased not reduced spread. However, Whitty feels that had such outdoor gatherings been closed (presumably earlier), it would have given an impression the government was seriously concerned, and so people would have been more cautious, and this would have reduced spread.

[Danny]

Nov 21, 2023 16:25:15 GMT alec said:

I'll tell you what 'actually' happened.

Eat out to Help out started on Aug 3rd 2020, and ran to 31st Aug. On the 3rd August the 7 day case average in England was 796. Prior to this it had been relatively stable since mid July, but it immediately started to climb after the 3rd, increasing every day until 31st, when it had reached 1,904. It then carried on increasing every day, reaching 21,000+ on 5th November. It carried on rising until 10th November , reaching 22,564, after which it started to fall.

okay, so here are the figures for Hastings. I first suggest to you that looking at national figures is pretty meaningless because they average together figures for all regions of the UK, for which very different covid risks applied based on past history. The epidemic happened at different times in different places, so you have to disentangle what happened in each locality, ie did it soar ahead as expected, or did it sputter out with minimal damage, but by then had spread to other regions, which were increasing the numbers and so adding to the national total.

As you can see, nothing much happened summer 2020 until November, when the Kent strain arrived. All this is entirely consistent with Hastings being immune to the original wuhan strain after winter 19/20 when it got infected.

So now here is London.

Where you can see there was some rise which started 16 september. Even on this graph you can see a clear discontinuity from that date, when schools resumed. Bugger all happened in the summer when eat out was happening. As I documented at the time, the actual evolution of the renewed waves varied from place to place. Broadly the SE and SW fared best. 

As you went north across england there was less immunity. Heres Birmingham for comparison.

Its quite different what happened there, although there is still no section of the graph which can be described as exponential growth between july 2020 and November. There is again little growth in Jul, it actually tails off in august, and then linear rise from september to November, approx in line with schools opening. This falls off again, but resumes with the new kent strain peaking in January as in many other places uincluding Hastings. All three have the kent strain spike, but its far more isolated and peaks earlier in hastings than points north (again spreading from the south).

What most people seem to do is simply look at the national picture. But this is the sum of different location, each of which needs to be considered by itself. If you look at individual places, you still dont get very good exponentials, as per here in Birmingham with a linear rise after schools resume. There is some exponential rise for the actual new kent strain when it arrives, but as we all know it never, ever, anywhere, proved as deadly as claimed. You will remember the national announcement by the medical officers of the new, exponentially rising kent strain...which was ridiculed even at the time because on the latest data they had conveniently ignored for the briefing, the exponential had already stopped being exponential.

The absence of exponential rise for most of the epidemic is itself evidence the modelling has mostly been plain wrong.

[Danny]

Nov 21, 2023 22:51:25 GMT alec said:

Quick heads up on covid in Scandinavia; Finland currently experiencing the second highest number of hospitalised cases due to covid of the entire pandemic, with huge rates of covid detected in wastewater.

You mean, in the same way it was detected in waste water in Italy from 2019?

Sweden has also recorded some eye watering record levels of wastewater counts, as has Estonia, and is also experiencing a surge of hospitalisations.

Not sure what you consider eye watering? The UK has had a million symptomatic, concurrent cases of covid every day for the last two years, with regular spikes every few months double that. Its the new normal, but with the exception of yourself no one seems to believe there is any reason to alter how society works because of it. Its really a case of, so what?

Whitty gave evidence how the NHS has changed since it was created and now has far fewer beds, not least because in the past it used to deal with more epidemic diseases, so it needed more beds for surges. Now it could be a mistake it has cut so many beds, or maybe it suggests we have been living through a golden age with a distinct lack of epidemics, for whatever reason. Even covid was a damp squib which failed to deliver on expected deaths.

What sticks in my mind from what he said is that at one point he presented government with two scenarios of what might now happen. One where the disease turned out to be fairly mild and was mostly containable within China. The other where it was very severe causing the levels of death we are now familiar with as predictions, 1-2% in one wave, which never have happened anywhere. Covid seems to have achieved about 0.5% in maybe 4 waves over four years by now, Flu apparently averages 13,500 deaths a year, so we would have expected that to account for 50,000 deaths in that time. Which is hardly negligible compared to covid. Covid simply isnt killing enough people to warrant more than the normal precautions about respiratory disease.

[Danny]

Nov 22, 2023 11:04:58 GMT alec said:

Danny - if you think that the result of the recent Japanese covid wave was "nothing" then you clearly don't read Japanese news reports or bulletins from their health service.

Obviously I didnt, any more than I regularly read them from all the nations on earth.

Since you alerted me to this, I just had a look at the stats on our world in data, which are fascinating. Unfortunately, also clearly unreliable. For example the UK results for daily cases seem to be taken from official government stats, but the main reason these are so low is because we stopped doing population testing. Who can say what similar issues apply in different countries? What I can say is that zoe having continued their series of case estimates still has around 100,000 new cases a day. At approx june 22, WID has the UK covid cases tumbling, probably reflecting our lack of testing, compared to Japan cases soaring to record levels for the entire epidemic. Perhaps you can advise whether this is due to Japan doing the exact reverse of the UK, and ramping up testing because of the media scare you were reporting?

In terms of deaths the numbers are more equal. The real noticeable difference is that Japan retains more a classical plot for an epidemic with huge peaks and then deep troughs, whereas the Uk has bumped along with a steady, somehow averaged out deaths rate, ever since our policy of multiple vaccination. Overall for the entire epidemic, Japan still stands at 1/4 the UK total deaths, and actually has had no significant deaths since Feb 23. That figure is worse than it looks for us, because it seems to be total number, not per million population. So actually you need to halve the japanese rate compared to us, so its 1/8 the Uk death rate. If I was them, I would be celebrating they have ended covid deaths on such a small total, whereas in the Uk the cumulative total is still creeping slowly upwards! Doing something similar for Finland comes in at about 1/2 the uk death rate.

What i do find interesting is that looking at Japanese deaths across the whole epidemic, quite a lot have happened rather late, after eg the UK had already had most of its deaths, say after feb 22. Something changed in Japan, even after vaccinations were readily available, which sharply increased the death rate. An obvious explanation would be that at the outset Japan was already pretty highly immune to covid, because of past exposure to other corona viruses. But as covid has changed, so this has become outdated allowing infections to take hold rather later in the process than in those nations which did not start out with such immunity. There is just the same pattern in South Korea, a nation lauded for its success in halting covid at the outset. But this again confirms the suggestion it didnt really do a better job than europe, it simply had an easier task because much of its population was already immune.

Whatever the UK did, it has ended up pretty badly placed compared to similar developed nations. Sweden of course, still stands at half our death rate despite having no lockdown.

[alec]

Danny - "I dont recall any media talk about asymptomatic transmission before maybe summer 2020."

No, you probably don't. That's the trouble you keep getting into when you refuse to follow the evidence. Just because you didn't hear something or have forgotten it, you seem to think gives you an excuse to pretend it never happened.

This was published on April 2nd 2020. Asymptomatic transmission had been discussed well before this - see here, from March 2020 www.nature.com/articles/d41586-020-00822-x and here, from February - www.ncbi.nlm.nih.gov/pmc/articles/PMC8392929/ .

You're free to keep spouting nonsense about this - it's a free country - but I'll keep to the facts and will continue to call out the rubbish you spout.

"After the disease failed to respond to maintained lockdown by decaying to nothing as predicted."

Minor technical correction, but I think you meant to "After the disease responded to maintained lockdown by decaying to nothing as predicted", because saying the opposite would be to actually lie about what really happened. It must have been a typo.

"The reported early news from China all supported a disease with few cases and many deaths, probably meaning they had completely missed the existence of all asymptomatic cases, and probably most of the symptomatic ones too."

Again, I'm left wondering why you continually trott out such shite, when we have the internet to check up on actual facts. If you look at just one of the links I've given you above, you'll see how they describe;
- rapid spread
- asymptomatic spread
- high numbers of cases
- a high mortality rate

"COVID-19 epidemic has spread very quickly taking only 30 days to expand from Hubei to the rest of Mainland China. With many people returning from a long holiday, China needs to prepare for the possible rebound of the epidemic."

from www.ncbi.nlm.nih.gov/pmc/articles/PMC8392929/

So can we agree that the idea that the Chinese outbreak was typified by low case numbers is just a bit of bollocks that you've just made up?

Try following the evidence, reading the data, incorporating the facts within your analysis. It's generally better that way.

[lens]

Nov 24, 2023 8:30:23 GMT Danny said:

Nov 22, 2023 18:26:26 GMT alec said:

I just think the expert community was so sure it knew what to do because they'd dealt with flu in the past, and they blindsided themselves. China was telling the world about asymptomatic spread very early, but we chose not to listen.

I dont recall any media talk about asymptomatic transmission before maybe summer 2020.

Really, Danny? You don't remember the very early pre-lockdown advice, even before testing became widespread?

That anyone showing symptoms should completely isolate, but also that everyone else in the household should stay apart and not go out at all, precisely because that - even if not showing symptoms - there was considered a risk that they still may transmit it on. If that wasn't an awareness of possible asymptomatic spread, I don't know what is!

I remember it very well, and leading to a discussion in a pre-lockdown team meeting at work about whether the company would pay any employee who didn't come in because they were following the government advice to isolate because of a household case, even if no symptoms themselves. The matter went to HR - who came back with the advice that if anyone had Covid, they would get sick pay, but if it was a case of being off work due to a family member being ill then they would expect it to be either unpaid leave, or use up holiday entitlement.

Yeah, right. I'll let everyone guess what was thought of that and what nearly all my colleagues reckoned they would do if in the situation. Fortunately, I never had to put it to the test. It's popular to criticise politicians for their response  - that was the HR department of a large organisation.

Nov 24, 2023 8:30:23 GMT Danny said:

The reported early news from China all supported a disease with few cases and many deaths, probably meaning they had completely missed the existence of all asymptomatic cases, and probably most of the symptomatic ones too.

My memory is that China tried very hard to suppress as much mention of Covid as possible, and cover up deaths, cases, even measures being taken. I believe it's only due to a few individuals acting against government orders that a lot of very relevant information came out at all.

[lens]

Oh, and by the way, Danny - a few posts back I asked if you could tell us how many hospital beds there were to serve the Hastings area? Have you got an answer, or is it a question you find convenient to ignore?

[lens]

Nov 16, 2023 22:20:41 GMT alec said:

lens - yes - figures good, although I suspect it won't be too long before we see this reversing. The 8% fall compares to an 18% drop last week, and ..............

Well, another week, another set of figures - coronavirus.data.gov.uk/details/healthcare?areaType=nation&areaName=England .

And so far, still no sign of a reversal in the trend - quite the opposite in fact. This week a 12% drop compared to the 8% of last week, and I believe the 6th consecutive drop in the English patient admission figures in a row?

No doubt there will come a point when the trend reverses - the history has been of peaks and troughs - but they do show that the pessimism of a couple of months ago ("look how the figures are going up!!") was misplaced.

And I'm sure if you look worldwide you will find countries where they are currently increasing...... and others where (like the UK) they are decreasing. Which is why a single weeks figures for anywhere are pretty meaningless. You have to look at trends, which seem to have settled down to a series of peaks and troughs.

[alec]

lens - yes, the trend is good at present. I think it's greatly complicated now by the previous variant history, where different countries have had different variants dominating, and sometimes these seem to give more protection against the next one, sometimes not. What we are increasingly seeing from near neighbours is that once the new JN.1 variant reaches a critical threshold in terms of % of cases, then overall cases start to climb. It's early days on this, but France is showing very rapid growth in terms of the proportion of cases that are JN.1, and Finland has seen some very strong pressures emerge quite rapidly in terms of hospital cases, Sweden similarly. It would be a surprise if the UK bucks that trend, and I would currently expect to see a markedly worsening situation just around the festive season here - although pinning down timings for these things is a bit of a mugs game.

Take care. The new variants (JN.1 now joined by a JN.1/XBB recombinant, known as XDD) are starting to show as more pathogenic, although I think it's too early for firm conclusions.

[Danny]

Nov 24, 2023 9:19:20 GMT alec said:

"After the disease failed to respond to maintained lockdown by decaying to nothing as predicted."

Minor technical correction, but I think you meant to "After the disease responded to maintained lockdown by decaying to nothing as predicted", because saying the opposite would be to actually lie about what really happened. It must have been a typo.

It didnt. Whitty explained to the tribunal, if conditions stay the same then if the epidemic halves in the first week, it should halve in the second, then in the third, and so on. During April 2020 cases crashed. SAGE though great, and insisted to keep going for two more months, during which the same should have happened. So if we got to 10% in first month, it should be 1% end of second, 0.1% end of third. But it didnt. It plateaued. Thats the problem, it behaved then exactly as it has right now, though now we have 100,000 new cases a day and back then it was rather less. Maybe less, if we were actually finding the cases, which is questionable.

Again, I'm left wondering why you continually trott out such shite,

You sound just like Mclean talking about Heneghan. Good to use them as role models?

"The reported early news from China all supported a disease with few cases and many deaths, probably meaning they had completely missed the existence of all asymptomatic cases, and probably most of the symptomatic ones too."
Again, I'm left wondering why you continually trott out such shite, when we have the internet to check up on actual facts.

I was paraphrasing Chris Whitty giving evidence to the enquiry. I do remember an early report which suggested 20% death rate per case. Whitty mentioned Ferguson's modelling suggested the Chines official number of cases was far too small.

Nov 24, 2023 9:19:20 GMT alec said:

Danny - "I dont recall any media talk about asymptomatic transmission before maybe summer 2020."

No, you probably don't. That's the trouble you keep getting into when you refuse to follow the evidence. Just because you didn't hear something or have forgotten it, you seem to think gives you an excuse to pretend it never happened. This was published on April 2nd 2020. Asymptomatic transmission had been discussed well before this - see here, from March 2020 www.nature.com/articles/d41586-020-00822-x and here, from February - www.ncbi.nlm.nih.gov/pmc/articles/PMC8392929/ .

Taking your last link first, it reports 900 asymptomatic cases out of 72,000 or 1%. Dont think thats actually suggesting there is lots of asymptomatic spread? They also had a case fatality rate of 2.3%. Thats huge compared to the more typical 0.1% in a western country, and maybe 0.01% (or less) in Japan during the first wave. I AM assuming unlike Mclean that the epidemic pretty much exhausted the native population and so caused all the deaths it was going to before the population became protected by immunty. I begin to think the herd immunity numbers are wrong, Whitty suggested 80% when he was talking about it, but he also didnt commit to that being correct.

Taking the first link - its paywalled, so I have no idea what it says.

 I think the trouble is the model they are using. On the one hand both Whitty and mclean said the simple model was rubbish and could not be used to predict outcomes, but on the other implicit in claiming a population herd immunity of X%, or predicting exponential growth at all, is that this model really applies to the population, that it is a homogeneous whole. It totally isnt.  A more realistic model is that one sub group of the population is responsible for most spread. If that group gets herd immunity, then the disease ceases spreading to anyone. However we need to remember the WHO advice for how to not get covid. They couched this in statistical terms, saying it was the cumulative covid dose which determined if you got infected.  So even if the propagating segment of the  population is still catching covid and spreading it at the same case rate, if the quantity of covid being shed is reduced to 1/10, then it will be less infectious. And the people most likely not to get cases will be the ones who werent getting cases before, just more so. ie the old were unlikely to get infected at outset, and then become very much more unlikely to catch it as the dose  transmitted per contact lessens.

We also have to account for what Heneghan stressed, and curiously the enquiry barrister was trying to deny. That what we perceive for most endemic diseases is no cases in summer and severe cases in winter. Thats not actually possible. These disease need hosts to survive, so they must still be allaround all year round, repeatedly infecting people. This rather suggests the real model needs to account for asymptomatic spread in one season, and symptomatic in another. How does that work? It doesnt work at all in the models used by such as Ferguson to tell us what was going to happen.

Thats off the top of my head, of course. But the model still being pushed by Whitty and Mclean is rubbish and they admit themselves it simply doesnt work.  And yet they still insisted on presenting predictions based upon it, as if it did.  Thats unethical, frankly.  If they dont realise they are making this mistake, then its incompetent.

Heres a thought. Which way does causality flow? Do we have a group of older people susceptible to death from infections such as covid should they come along, or does society always automatically shield the old from exposure to infections, which allows them to survive even though they are highly susceptible to any disease which comes along?  Evolution has arranged so that the old are automatically protected by human behaviour patterns without which they would on average die younger. To intervene in this behavioural pattern is very likely to displace it from the optimum and cause more deaths.  

Heneghan said something of the sort, actually. He suggested that there really is no evidence what we did, in protecting the workers from infection much more than the old, did not  shift the proportion of cases into the older population, therefore killing more of them.  You get the point? What we did actually prevented far more infections amongst the younger population than the older. It was never going to end until the young block had had enough infections, so we just increased the number of older people catching it. Even McLean must have known that was what she was proposing. However she probably ignored that fact, arguing the total number of cases was always going to be small and unable to create any sort of herd immunity, so it didnt really matter. But if she was wrong, then what she did increased the death rate, and curiously we had a worse death rate than Sweden, which did not make this mistake. 

[Danny]

Nov 16, 2023 18:31:57 GMT lens said:

But what about my point, Danny? What about the 1,000 or so extra hospitalisations that would also have been expected?

yes I started to look into that, but found stats seemed contradictory. But here are some! www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2022/02/Covid-Publication-06-04-2021-up-to-200731-DQnotes.xlsx

So thats all covid admission for England up to 31 Jul 2020. The total is....25,000. For simplicity, lets say the population of England is 50 million, so that is 0.05% of the population. Interestingly thats a lot lower than the assumed 0.1% death rate from covid. Curious that. 5000 of them were over 85, 10,000 65-84. 400 under 18, 8500 16-64. (Which doesnt add up, but hey I didnt compile the figures)

But anyway, there werent enough admissions to the NHS to account for all the deaths, never mind account for extra beds being used up! Does that imply many died at home or in care homes?

The maximum number of beds occupied at any one time was 19,000, so thats out of the 100,000 or so total NHS beds. But pro rata that comes out as about a maximum of 38 beds for a hospital serving a 100,000 population.

These numbers are far, far below the scary numbers whitty and co were warning government about. Which is rather the point. Its an asumption the situation would have been worse without lockdown. Whereas in Sweden without lockdown, the situation was actually better. As it seems it may well have been in Hastings.

Whitty also talked about concern in particular that intensive care beds would run out. However we subsequently discovered that most patients were better off NOT being put on ventilators. What I recall we did have then was a crisis about supplying enough oxygen to ordinary beds, because the supply system hadnt been designed for so many using it at once.

[Danny]

Nov 16, 2023 22:20:41 GMT alec said:

lens - yes - figures good, although I suspect it won't be too long before we see this reversing.

Since the number of cases has been oscillating up and down between something like 1 million and 2 million cases at any one time with a periodicity of about 3 months, I would be amazed if it doesnt go up again. Then down. Then up. And so on. However if you go look at the latest zoe figures, it does look as if a bit of a winter surge is underway. Or at least, we just passed a summer minimum.

Its extraordinary how SAGE experts keep going on about exponential growth and decay once immunity establishes when what we have is blooming oscillator!

And another paper out this week showing a significant drop in testosterone in males after covid infection, with impacts on fertility. We've now seen substantially elevated cardiovascular risks after covid become established as an accepted medical fact, cognitive impairment is rapidly following suit, and I suspect the next domino to fall will be a general acceptance that covid creates a fertility problem in men.
Such fun.

Heneghan ws asked about this. I dont think he is the best public speaker. However, he argued that any similar infection is likely to have long term effects similar to covid. No one has quantified how much having a cold cuts your testosterone level, but would not in the least amaze me to find it does. Alec, its utterly unsurprising there are long term consequences of any kind of illness. Cut your finger, and you will have a scar for life. The point is there is no evidence it is worse for covid than anything else. If we never worried before, why do you want us to worry now?