Covid

[leftieliberal]

A Guardian article on the nocebo effect.

www.theguardian.com/science/2022/jan/18/nocebo-effect-two-thirds-of-covid-jab-reactions-not-caused-by-vaccine-study-suggests

To be clear, these are the common, minor, side effects not the rare, serious, side-effects.

[lens]

Jan 18, 2022 14:22:11 GMT matt126 said:

With regards to masks they did do experiments and they showed that worked and ranked them in order of effectiveness. However in the real world they probably make a very small difference if any.

As far as I'm aware, the experiments were just to see how effective various materials were at stopping droplets coming through, using an artificial "mouth" and simulating a sneeze. That is not the same as an experiment to investigate how effective they may be at limiting Covid cases. (It assumes nothing else - such as covering the face during a sneeze - happens, so effectiveness at stopping droplets doesn't correlate to infection transmission.) Which may help explain why cases in Scotland and Wales were no better than in England during late summer and autumn, despite the former mandating masks.

That's not to say masks are of no use - period. They can certainly make a difference in clinical settings, but that's coupled with strict protocols around such as removal precautions, and in high risk areas using a full spec mask and possibly in conjunction with a face guard. Worthwhile for staff on a Covid ward - hardly practical or desirable for a shop worker on an 8 hour shift.

Far more sensible would be for anyone classed as vulnerable to wear such as an FFP3 mask when outside their home, and to remove restrictions for the rest. In line with protecting the people who most need it and (after vaccinations) worrying far less about the rest. Unfortunately far too many people now see them as a talisman to protect from harm.

[Deleted]

Saj is rightly being 'cautiously optimistic'. He has a few more days to decide and IF the large drop in the flawed cases data is being matched by a significant drop in actual infections (notably in the most at risk groups) then we should see that in hospital data in the next few days. What is currently a very small drop in patients in hospital 'with' Covid should start to accelerate downwards in the next few days. If it doesn't then 'somethings up' (as they say).

www.standard.co.uk/news/uk/sajid-javid-health-secretary-government-philip-david-nabarro-b977346.html

PS In advance then I'd also highlight that a lot of 'voluntary' social distancing might well have been behind the lower than expected Omicron peak. SPI-M do model that up but given how many other variables might be impacting the situation then we won't know until we know and by then it is of course too late (in either direction). So whilst I hope to see the next few days data confirm we've 'peaked' then we might well move back to 'rolling hills' as we fill in the 'area under the curve' required (and that will obviously be lots of mini hills and valleys at the same time in different more localised populations)

[jib]

Jan 18, 2022 14:22:11 GMT matt126 said:

With regards to masks they did do experiments and they showed that worked and ranked them in order of effectiveness. However in the real world they probably make a very small difference if any. Even in some countries using FFP2 masks they have high rates of infection. In general the public perception seems they are the main tool in controlling infection when in practice they make a very small difference . In the real world though they are more often than not not used correctly and if worn by someone for long period of time like at school they become less effective . For example How many people have a stash of disposable masks in their coat pockets that they use for months in end.

Masks do work, and there is plentiful evidence out there that they very significantly reduce the risks.

I wash our disposable masks in the washing machine and reuse, no use adding to the plastic mountain and they seem fine after, I've even opened a few up to check the integrity.

[lens]

Jan 18, 2022 20:08:22 GMT jib said:

Masks do work, and there is plentiful evidence out there that they very significantly reduce the risks.

"Plentiful evidence", where? Mostly evidence seems to suggest exactly the opposite in general (non-clinical) usage - any risk reduction seems to be slight, certainly not "very significantly". As example: www.bbc.co.uk/news/health-59895934

Quote: "The government admits the evidence for using masks in schools to reduce spread of Covid is "not conclusive".
.........
The government's own study in the autumn did not provide proof of a statistically significant impact."


And I come back to what happened to cases in the UK from July onwards. General mask wearing remained compulsory in Wales and Scotland but not in England. It's about as close to an official controlled experiment as could be realistically hoped for! And it showed no evidence to support general mask wearing had any benefit - certainly not "very significantly reduce the risks"!

I find it astonishing that on one hand some people can't accept the benefits to vaccination, in spite of all the evidence that vaccines are highly effective - whilst on the other hand other people ascribe great benefit to general mask wearing, in spite of all the evidence being that any benefit is slight.

[Deleted]

As someone who is partially deaf, masks are an absolute nightmare because they immediately remove my superhero ability to lip-read, which I have subconsciously acquired since childhood. It's especially useful in noisy or crowded situations and has caused many communication problems since the pandemic at shop counters etc (usually resulting in people having to shout or remove their mask which renders the entire exercise useless).

No doubt many people with perfect hearing also have some ability to read lips and other facial expressions which is all lost when others wear masks.

[Danny]

Jan 18, 2022 20:08:22 GMT jib said:

Masks do work, and there is plentiful evidence out there that they very significantly reduce the risks.

Can you cite a real world study which compared two identical regions at the same stage in an epidemic and after the epidemic was over compared cases and deaths in both?

Suppose today you go out, wearing a mask, and it prevents you catching covid. That means that tomorrow you will still be susceptible to the disease. Your choice is to keep wearing that mask for the rest of your life, or give in and just catch covid.

Neither masks nor lockdown nor testing has been able to prevent covid spreading until enough people have caught it. as soon as you stop the measures it springs up again. Until enough people have caught it. And thats how the first two waves in the Uk died out without benefit of vaccines - because the measures failed and enough people caught covid anyway.

Its hard to imagine anything more stupid than preventing kids and younger adults catching covid so as to end outbreaks quickly and thus protect older people. That has always been how to end outbreaks. Even now it is clear vaccination does not stop people catching covid and passing it to high risk people anyway. There was nevr any benefit from this mass vaccination policy except to the profit margins of multinationals and politicians claiming they saved everyone when they didnt. South Africa ended their epidemic only vaccinating 30% of the population, which sounds about right.

The good news is omicrin may be the vaccine we needed to largely suppress further serious illness. Remember vaccination means deliberately catching a disease to protect you from a worse one later.

[Deleted]

ONS latest infection survey data, to 12Jan (changes v 3Jan). % of people with Covid

England: 5.47% (-1.38%)
Wales: 3.69% (-1.87%)
Scotland: 4.49% (-1.16%)
NI: 5.68% (+0.27%)

www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/coronaviruscovid19infectionsurveypilot/19january2022

The reporting lag in that data roughly matches up with the more current hospital admissions and although a bit choppy then that is starting to drop faster. The patients in hospital 'with' Covid (England) is now 8% below it's peak at 15,742 (-1,696)

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

Back to Plan A (England) next week is supported by the data (and FWIU then Wales and Scotland have ended some of their lockdown restrictions)

[Deleted]

WRT to vaccines+boosters then on antibodies. Whilst there are other factors to the immune system (eg T-cells) and antibodies are not 'perfect' protection and somewhat less effective for new variants then just FWIW the impact of boosters can be seen in:

www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/articles/coronaviruscovid19latestinsights/antibodies#antibodies-by-concentration-threshold

Note
- the older age groups, who 'higher threshold' antibody levels had been dropping (and fairly quickly) in late 2021 and how they sharply recovered with the boosters. Immunity wanes faster in older people but can be quickly boosted back up.
- a smaller and slower drop in younger age groups (eg those under 50 but especially those up to 35). Immunity wanes slower in younger people.
- the overall very high %s who have 'higher threshold' of antibodies

ONS will hopefully continue to track this data and its impact as it will be vital info in the decision of who and when to further boost the population (eg maybe all over 50s/high risk once a year, maybe very high risk every six months?

[Deleted]

Jan 19, 2022 10:11:55 GMT @sotonsaint said:

Good point and the 'social' factors of masks need to balanced with the risks to overwhelming NHS. I'll clarify and explain my view that, as part of 'Living with Covid' then there will times and places when masks should (IMO) be used (and see #3-4)

1. When. At certain times of year (more likely to be Winter) when transmission risk of viruses is high. If the virus in circulation is highly concerning then you increase #2 and #3 but even if just to reduce common colds and flu then we might well see a lot of folks voluntarily use masks in the future (similar to Asian countries)

2/ Where. Higher risk settings with higher risk people. So 'essential' places like London Underground, Hospitals/Care Homes/Social Care where higher risk people might come in fairly prolonged contact at close distances with people they wouldn't normally meet. Less so in schools, shops and 'voluntary' places likes pubs. Testing in specific settings should also be continued IMO (and that could extend to certain high risk settings such as meat processing plants, but the taxpayer can't afford £6bn to offer free testing too everyone all the time)

3/ 'Encouraged' v 'Enforced': Will depend on a combination of #1-2 (and I'm not naive to the politics or the difficulties in Police enforcing the rules or the problems of businesses if they have 'anti-maskers' who refuse to wear masks)

4/ Other: One issue with changing the guidance/rules too often is the confusion and messaging and some views on 'consistency' so changes should be rare and explained (preferably by someone people trust, such as medical experts not Boris).

However, for a balanced 'Live with Covid' new/near normal then IMO masks (the good ones that really work) will have a place some of the the time, in some settings - not all the all of the time, in all settings.

[lens]

Jan 20, 2022 10:36:15 GMT @tw said:

I'll clarify and explain my view that, as part of 'Living with Covid' then there will times and places when masks should (IMO) be used ................
2/ Where. Higher risk settings with higher risk people. So 'essential' places like London Underground, Hospitals/Care Homes/Social Care where higher risk people might come in fairly prolonged contact at close distances .......

In principle yes. My own opinion has been for a long time that rather than enforcing mask wearing on everybody, it makes more sense to target those at higher risk and very strongly encourage them to wear "proper" masks in an effective manner. As the evidence mounts that general "face coverings" for everybody don't really have much effect (eg the government report re school usage:

assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1044767/Evidence_summary_-_face_coverings.pdf )

surely it's time to switch to a policy of effective mask use just for those who will most benefit?

Jan 20, 2022 10:36:15 GMT @tw said:

However, for a balanced 'Live with Covid' new/near normal then IMO masks (the good ones that really work) will have a place some of the the time, in some settings - not all the all of the time, in all settings.

Having previously said I'm in favour of proper effective masks for those who need them, a valid question may be "why not for everybody then"? And to such it comes down to the negatives associated with them. It's one thing to wear an ordinary face covering for 20 minutes in a shop - another for a member of staff to wear such for an 8 hour shift 5 days a week. And then to insist on a far more restrictive FFP2 mask for all that time......?

It's a case of risk/reward. An operating theatre is one thing, Sainsburys quite another. But in principle, anyone who considers themselves very vulnerable should be encouraged to wear a high performance mask in public (and yes, find out how uncomfortable they can be) but not worry about everybody else.

Unfortunately, so many people have invested a lot of their life into mask culture, on a basis of "it's what keeps me safe!", that to find out what they've believed for 2 years doesn't really do much practical good is very very hard. Like snatching away the comfort blanket from a child.

[Deleted]

Jan 20, 2022 14:03:03 GMT lens said:

I had hoped I'd covered "why not for everybody (everywhere) then?"

WRT to 'mask culture' and 'comfort blanket' then I'll offer some examples (and note neither of us will be making the guidance/rules, we're just discussing a 'sensible' new/near normal for masks as part of 'live with Covid' that balances the risks for the broader socio-economy.

1/ Supermarkets. As you point out any staff wearing those for a whole shift will be relieved to not have to wear them. It's possible the current perspex screens at checkout come back at certain times. For customers then I can't see anyone ripping off someone else's mask if they choose to wear one when they don't have to. For the extreme 'coronaphobics' who might then be too scared to go to a supermarket then they can get their groceries delivered. 

2/ High risk settings (eg Care Homes). Given these are 'controlled' settings where folks just can't wander in/out willy nilly then at certain times of year signs are popped up on the entrances saying 'masks mandatory' with staff able to police that. Staff can also check it's the 'good' masks and they are being worn properly, etc. Offering advice if needed (and given who is entering those kinds of settings I expect the advice will be welcome and adopted)

Personally I think most people are capable of understanding the different risks to different people in different settings and the info that at some times of the year then some measures will be needed to reduce risk of overwhelming NHS will be understood and welcomed (for peace of mind and ability to move to a new/near normal). The trickier settings will be places like London Underground which is essential setting (eg commute to work) for a lot of people and where enforcing a masks policy at certain times of the year might be tricky given there are some hard-core 'anti-maskers'. However, if the vast majority adhere then 'social pressure' then boost that to very high %s of adherence so a few 'refuseniks' won't make much difference. 

[lens]

Jan 20, 2022 17:33:01 GMT @tw said:

I had hoped I'd covered "why not for everybody (everywhere) then?"

You are missing the point I was making - that it shouldn't be a case of everybody wearing a mask at certain times, but rather the vulnerable should be wearing high protection masks, and don't worry about everybody else. To take your supermarket example, then I've no problem with high risk people in high protection masks - I've no urge to tear such off - but in such a case there's little point in everybody else wearing face coverings at all. Masks are serving to protect the vulnerable, and not restrict the non vulnerable.

Jan 20, 2022 17:33:01 GMT @tw said:

2/ High risk settings (eg Care Homes). Given these are 'controlled' settings where folks just can't wander in/out willy nilly then at certain times of year signs are popped up on the entrances saying 'masks mandatory' with staff able to police that. Staff can also check it's the 'good' masks and they are being worn properly, etc.

But again, from an infection control point of view, it would be better if the residents - the vulnerable - wore the masks during such contacts, more so than the visitors. Staff also need to be thought about - and we're back to practicalities of forcing such to wear a face covering (let alone a proper mask) all day every day. On top of compulsory vaccination (which I broadly support) for such staff, and low wages, we could get into a situation where wearing an FFP2 mask all the time just makes the job not worth doing.

Another problem is that apparently elderly people with a degree of dementia can find visitors in masks at best confusing and at worst threatening. Do we really want that?

I don't know if I can attach it, but one of the stupidest things I've seen in the entire pandemic was a photo in a newspaper from when care home visits started to be allowed, subject to a negative lateral flow test and masks being worn.The photo showed a visitor finally being able to kiss their elderly and vulnerable relative - through a mask! Any benefit the mask may have had obviously being totally thrown away. But - a good example of the "comfort blanket" mentality.

"I've got my mask on, so that's all right then."

Attachment Deleted

[Danny]

Jan 19, 2022 18:52:34 GMT @tw said:

Back to Plan A (England) next week is supported by the data (and FWIU then Wales and Scotland have ended some of their lockdown restrictions)

Based upon the data, there was never any need for plan B. Before christams the available data suggested the omicron outbreak would be mild, and that has been the experience of it. Any MPs who opposed the additional restrictions were absolutely correct.

Inidentally, the ONS agreed with Zoe that the sharpest rise now is amongst under 10s. 10-19s have had a modest rise since schools returned, but pretty small in comparison. Hence presumably the decision to abandon mask use in secondary schools.

[Danny]

With the masks thing, and indeed any other measure, most seem to be missing the point. If a mask cuts the risk of infection by 50% on the day it is worn, it does not cut your overall risk of infection by 50%.

First off the risk of infection is non linear, and is way higher the closer you are to an infected person. So at 1m it may be reducing your risk by 50% of nothing, so no benefit. At 1 ft it may cut it 50%, but its reducing a certainty of infection by a high dose to a high risk of infection at a big dose. So you'll probably still catch it. Precise distances approximate, but I hope illustrate the problem.

Second this isnt a one-off risk, but a recurring one. If you went into a burning building wearing a suit which reduced your chance of a burn by 50%, you might risk it. But if you are a fireman and go into burning buildings every day, then every single day you repeat that risk and it is additive. No matter how small the daily risk because you are wearing the suit, if you keep going into burning buildings, one day you will be burnt. and thats the problem with masks and covid. Maybe the daily risk is smaller, but if you keep running that risk forever, then eventually you will catch it. So masks will not stop people catching covid.

So imagine a mask cuts risk by 50%, but in so doing extends the duration of an epidemic x2. net chance of being infected 1/2x2=1= the same. And those are precisely the interactions we would expect because if you slow the rate of infection you increase the duration pro rata.

The risk in extending the epidemic duration is that it remains circulating for longer, and anyone who might have been taking especial care because they are at much higher risk than the average, has their risk increased proportionately. The general restrictions are much more effective at cutting cases amongst people who socialise a lot - not the the high risk. This must cause a higher proportion of cases to be amongst the high risk.

[Deleted]

Jan 20, 2022 20:56:44 GMT lens said:

Jan 20, 2022 17:33:01 GMT @tw said:

I had hoped I'd covered "why not for everybody (everywhere) then?"

You are missing the point I was making - that it shouldn't be a case of everybody wearing a mask at certain times, but rather the vulnerable should be wearing high protection masks, and don't worry about everybody else. 

I politely disagree. The person wearing the mask does so to prevent the risk they exhale the virus into their near surroundings. Whilst the really good ones can also limit the chances you inhale the virus then my concern in the high risk settings is the virus coming in from outside so those entering from outside should IMO be the ones who primarily wear masks at certain times, when the risk level is high. There can be levels of 'alert' status and there will almost certainly also be a very important role for vaccines, treatments and testing. Analogy:

Some folks die in car crashes every year: We're not going to get zero covid deaths

To reduce accidents and deaths then

1. Safe cars with MOTs = internal protocols in Care Homes to ensure they are as safe as realistically possible, good hygiene, ventilation, etc.
2. Seat belts = vaccines (ie mandatory for staff and residents (unless they have genuine exemption))
3. Air bags = treatments (ie if you do crash then the air bag/treatment is deployed and you're injury/death risk reduced)
4. Don't drink drive = testing1 (ie screening of staff and residents to keep Covid out)

The above is the 'background' stuff that should be ongoing the whole time but occasionally then also:

5. Check road conditions = testing2 (ie if you spot a case then you can rapidly adjust your policies on everything else to 'lock down' the care home)

If the 'alert' level is high enough (road conditions are really bad) then
6. No passengers and essential journeys only = limited visitors and ensure those who do enter wear masks and test -ve

Just an example, I'm sure someone can pick fault in that with 'what about X' but covering every scenario would require a 40page document (which I hope is produced as 'best practise'). Even that would have to be flexible, given the future is uncertain. However, the main point is that masks are just one of several ongoing ways we can minimise the risks, in the most high risk settings, for the most high risk people, SOME of the time (and for 1-4 then those would be all of the time as that it the way we 'live with driving and less than perfect drivers'.

 

[Danny]

Jan 21, 2022 8:18:40 GMT @tw said:

.....
2. Seat belts = vaccines (ie mandatory for staff and residents (unless they have genuine exemption))

Hospital doctor recently attacked the legal requirement for staff to be vaccinated. he stated protection against infection only lasted 2 months, so unless you re-vaccinate everyone every two months its pointless. This isnt about protecting those being vaccinated because one way or another they are probably safe (most hospital staff must have had covid by, probably repeatedly). Its about the high risk patients. But if vaccination cannot guarantee - or even significantly reduce- the risk a worker gets infected, then its useless.

[lens]

Jan 21, 2022 8:18:40 GMT @tw said:

Just an example, I'm sure someone can pick fault in that with 'what about X' but covering every scenario........

As analogies go, then I for one think it's a pretty fair example.

But I think it also shows that in the main the best accident prevention measures are those that are the least obtrusive to the driving experience, and least difficult for a driver to adhere to. As example, such as crumple zones, collapsible steering columns, and safety glass in the windscreen. A driver likely doesn't even think about such when they step in the car - but they have all had a huge effect on casualty figures.

Next may probably come seat belts, and whilst they do require a driver to buckle up, inertia belts have removed much of the objections to when they were first introduced. But in particular, the hard statistical evidence is overwhelmingly that they had a huge positive impact on safety.

But moving down, it becomes a question of where lines have to be drawn. Reinstating every car to be preceded by a man on foot with a red flag would undoubtably cut road deaths to almost zero - but does anyone see it being adopted? Even (say) a speed limit of 10 or 15 mph on urban roads?

And as far as Covid goes, then the evidence seems to be that vaccination is head and shoulders the most effective tool. Not only does it seem to greatly reduce the likelihood of catching the disease, it seems to make it less serious if you do, and there's evidence that vaccinated people are less likely to pass it on. But the real beauty is that to the user it's simple - only takes a few minutes, and the only downside is a sore arm the next day and possibly feeling a little rough. Effective (albeit not 100%), but with minimal inconvenience.

Whereas masks are the opposite. Maximum inconvenience, with what evidence there is pointing to low (albeit not 0% in this case!) effectiveness.

I don't want to come across as a total "anti-masker" - I do believe they have a place. But I'd just like to shift the balance onto the people who consider themselves vulnerable wearing effective masks, and in general not worrying about everyone else. 

It also needs to be remembered that masks are only a tool, and a not very effective one at that. Which is what I found so unbelievable about the picture I did manage to attach before. Look closely at the caption, and it's credited to the manager of the home with a comment "The picture says it all" (!!!!)

Yes, it does. (Though maybe not as was intended.) It says a person in charge who is just following the rules in a box ticking manner, without any concept of the realities of what is safe and what is not. And to publish it on Twitter (and get picked up on a national newspaper) just compounds their stupidity. Perhaps it helps to explain some of the problems that care homes experienced at the start?

[Danny]

Jan 21, 2022 11:29:35 GMT lens said:

And as far as Covid goes, then the evidence seems to be that vaccination is head and shoulders the most effective tool. Not only does it seem to greatly reduce the likelihood of catching the disease, it seems to make it less serious if you do, and there's evidence that vaccinated people are less likely to pass it on. But the real beauty is that to the user it's simple - only takes a few minutes, and the only downside is a sore arm the next day and possibly feeling a little rough. Effective (albeit not 100%), but with minimal inconvenience.

First off, vaccine didnt achieve anything until it was available to be used. It didnt do any good for anyone catching covid before about christmas 2020. Since we just had christmas 2021 and covid is still with us, it failed to end the problem, as many believed or claimed  it would.  Before vaccines arrived, there isnt any evidence we managed to materially slow the deaths rate despite all the restricitons. The idea seems to have been to suppress covid until after  we had vaccinated, but we could not do it. Two whole strains came and went naturally, after infecting all they ever would have. Probably more high risk were infected because we tried to slow it down. Equally true after vaccination was done, we still deliberately kept it going such that whoever was still high risk might have a bigger chance of catching it.

Second, it does not reduce your chance of catching covid except temporarily. Suggestion is about for 2 months. It does reduce severity, and this seems a long lasting effect, probably not significantly improved by boosters. By reducing severity it probably reduces the amount someone spreads, but physical factors (ie physical proximity) are probably much more important than the absolute amount being emitted. If it causes a higher proportion of asymptomatic cases, this might make matters worse not better, because  people do not change their behaviour as they might once they realise they are ill.

There must be a significant number of people for whom vaccination is medically not advised, and this may well by now constitute the majority of people remaining unvaccinated, especially in high risk groups. I have not seen any analysis whether the disproportionately high deaths amongst unvaccinated people can now be explained because they are people at high risk for whom vaccination wasnt helpful. Its clear the unvaccinated being admitted to hospital with covid are not representative of the unvaccinated as a whole, they are for some reason high risk.

[Deleted]

lens Masks are not perfect but let's agree to disagree to their effectiveness (and note we're specifically talking about the 'good' masks being used properly for certain settings). Where we do agree is that they will likely be used far less often and in far less settings in the future. Possibly we get to a situation where they are not mandatory, anywhere, any of the time - I hope[1] that becomes the case.

WRT to crumple zones, etc then at risk of over stretching the analogy then there are possibly many ways to make the individual (car) safer. c-a-r-f-r-e-w is possibly the better person to offer some input but improving people's 'natural' immunity to not just Covid but all viruses, etc would be beneficial.

So stuff like Vit D supplements (especially into/over Winter)
www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/free-vitamin-d-supplements-for-people-at-high-risk/

Whilst none of the measures we've discussed are 'perfect' then for sure we want the new/near normal to be as least intrusive as possible (ie the car is as safe as possible), for mental health and broader socio-economic reasons. So if we have lots of 'background' methods of reducing risk, which combined add up to quick significant reduction in risk, then hopefully masks and lockdown measures will only be used IF/when things get very worrying and only in limited settings for as brief a period as possible. 

[1] Hope for the best but plan for the worst!

[Deleted]

Good to see the patients in hospital 'with'[1] Covid starting to drop fairly quickly in the last few days (change from previous day). Certainly validates the decision to go to back to Plan A:

18Jan: 16,218 (-403)
19Jan: 15,742 (-476)
20Jan: 15,302 (-440)
21Jan: 14,865 (-437)

[1] Latest data on 'Primary Diagnosis' (18Jan) shows only 7,605 people in hospital 'Primarily' due to Covid which is just 52% of the total, a further drop from 56% the previous week and closer to 80% pre Xmas.

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

[lens]

Jan 21, 2022 11:52:01 GMT Danny said:

It {the vaccine} didnt do any good for anyone catching covid before about christmas 2020. Since we just had christmas 2021 and covid is still with us, it failed to end the problem, as many believed or claimed  it would. 

Danny, pre vaccine I knew many people who caught Covid and were very. very ill for periods of up to about two weeks, and in a couple of cases ended up in hospital. I know one person who suffered life changing effects due directly to a Covid case, and is extremely lucky still to be alive at all. And this is someone who was previously in extremely good health, not old, and not overweight etc. Yes, the experience may have given them all anti-bodies for the future - but I don't know anyone who thinks it's a good way to gain such protection.

Post vaccines, then amongst people with no prior exposure, then whilst I know of some who still caught it, it's typically been a much milder illness. In my wifes case it would (in previous times) have simply passed off as "a bad cold", the worst effect meaning she spent one day in bed feeling somewhat sorry for herself. Because a lateral flow test gave a false result (in spite of her having some symptoms) we didn't initially take isolation precautions, but in spite of that I never caught it myself. I suspect that if we hadn't been vaccinated events may not have turned out so well.

No, vaccines didn't "end the problem", if you mean by that we still have ongoing cases - but it *DID* mean many fewer cases and fewer still serious illnesses, let alone deaths. As previous posts have indicated, I'm sceptical of some measures that we've seen (eg masks, LFTs, and (especially) the app) but vaccines are the outstanding success.

They may not 100% ever stop me getting Covid - but they make it far less likely, and far more likely it won't be serious if I do. To me that makes it a no brainer.

[lens]

Jan 21, 2022 12:09:43 GMT @tw said:

lens Masks are not perfect but let's agree to disagree to their effectiveness (and note we're specifically talking about the 'good' masks being used properly for certain settings).

@tw - Actually I think we may be in closer agreement on that than you may think! Where we may have to agree to differ is that IMO it's more important to focus the mask wearing ("good" ones, yes!) on those at risk, and worry less about everybody else, even within restricted settings.

And at least acknowledge the downsides of their use, and acknowledge that wearing such for a quick visit to a supermarket is very different to wearing one for a full day shift whilst working. And if that's true for a simple face covering, it's more so for such as an FFP2 mask.

Unfortunately, exaggerations about their effectiveness (basic face coverings) have led to mandates turning into box ticking exercises. Even though official reports show little benefit in schools (but communication and other problems), there are reports today of headteachers still insisting on their use, and it's difficult to interpret that as other than "just in case back covering". At least the UK has never gone so far as to mandate their use outdoors as some other countries have. If anyone is in any doubt to how ineffective that is, then todays figures show France with over 4x the case rate of the UK.

[lululemonmustdobetter]

The really frustrating thing about the government’s approach overall is that announcements and their timings are being driven primarily by political considerations and with very little thought to the disruption sudden changes with little advance warning have on many people lives. For me and many others the challenge is after school childcare. Having got used to wfh for the past two years the places/arrangements we had have gone and it’s very difficult and/or prohibitively expensive to arrange at short notice.


Both of us now have to go into central London for work next week and it’s been a right royal pain trying to sort everything out. Any they wonder why people are pissed off with them, and as this responsibility primarily falls on women to sort out I can see this and other similar issues contributing to what appears to be a gender difference emerging in VI!

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

Jan 21, 2022 12:09:43 GMT @tw said:

WRT to crumple zones, etc then at risk of over stretching the analogy then there are possibly many ways to make the individual (car) safer. c-a-r-f-r-e-w is possibly the better person to offer some input but improving people's 'natural' immunity to not just Covid but all viruses, etc would be beneficial.

So stuff like Vit D supplements (especially into/over Winter)
www.nhs.uk/conditions/coronavirus-covid-19/people-at-higher-risk/free-vitamin-d-supplements-for-people-at-high-risk/

A rather torrid time in hospital did predispose toward an interest in health, and in particular, toward the stuff the experts don’t tend to mention too often. (Which includes various potentially useful things about taking vitamin D as it happens).

[leftieliberal]

'Long Covid' linked to low levels of IgM and IgG3 (two of the many immunoglobulins)

www.theguardian.com/society/2022/jan/25/doctors-find-antibody-signature-long-covid

Unfortunately it doesn't help them identify people at risk before they are infected, but could lead to new treatments.

[leftieliberal]

Jan 24, 2022 20:30:21 GMT c-a-r-f-r-e-w said:

Jan 21, 2022 12:09:43 GMT @tw said:

A rather torrid time in hospital did predispose toward an interest in health, and in particular, toward the stuff the experts don’t tend to mention too often. (Which includes various potentially useful things about taking vitamin D as it happens).

I've been taking 1000 IU vitamin D3 tablet daily, winter and summer, for a number of years. Some people argue that everyone should take 4000 IU daily, and this is certainly regarded as safe by the NIH in the USA. The difficulty is that the concentration of 25-OHD in the blood serum (the active form that vitamin D is converted into) increases with the logarithm of the dose and the variation in concentration from person-to-person in trials is not insignificant, so it may well be that 400 IU (recommended by the NHS) is sufficient for most people. Unfortunately, we just don't know because unless you have clinical vitamin-D deficiency, it's quite difficult to find symptoms that you can unambiguously relate to 25-OHD levels.


 I remember many years ago, the Nobel Prize-winner Linus Pauling making arguments for taking megadoses of vitamin-C; because in animals that make their own vitamin-C (like dogs) the concentration in their blood is up at saturation level. Nowadays no-one really talks about it and the best trials show insignificant benefits (https://www.cochrane.org/search/site/vitamin%20C) This is what Cochrane have to say about vitamin D (https://www.cochrane.org/search/site/vitamin%20D). The trouble, as always, is a lack of good-quality trials, which is why elsewhere I have criticised the RECOVERY trial for not including a vitamin D arm (4000 IU/day during hospitalisation should have been sufficient to test if it really made a difference).

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

Jan 25, 2022 17:52:33 GMT leftieliberal said:

Jan 24, 2022 20:30:21 GMT c-a-r-f-r-e-w said:

A rather torrid time in hospital did predispose toward an interest in health, and in particular, toward the stuff the experts don’t tend to mention too often. (Which includes various potentially useful things about taking vitamin D as it happens).

I've been taking 1000 IU vitamin D3 tablet daily, winter and summer, for a number of years. Some people argue that everyone should take 4000 IU daily, and this is certainly regarded as safe by the NIH in the USA. The difficulty is that the concentration of 25-OHD in the blood serum (the active form that vitamin D is converted into) increases with the logarithm of the dose and the variation in concentration from person-to-person in trials is not insignificant, so it may well be that 400 IU (recommended by the NHS) is sufficient for most people. Unfortunately, we just don't know because unless you have clinical vitamin-D deficiency, it's quite difficult to find symptoms that you can unambiguously relate to 25-OHD levels.


 I remember many years ago, the Nobel Prize-winner Linus Pauling making arguments for taking megadoses of vitamin-C; because in animals that make their own vitamin-C (like dogs) the concentration in their blood is up at saturation level. Nowadays no-one really talks about it and the best trials show insignificant benefits (https://www.cochrane.org/search/site/vitamin%20C) This is what Cochrane have to say about vitamin D (https://www.cochrane.org/search/site/vitamin%20D). The trouble, as always, is a lack of good-quality trials, which is why elsewhere I have criticised the RECOVERY trial for not including a vitamin D arm (4000 IU/day during hospitalisation should have been sufficient to test if it really made a difference).

Yes, as Danny has noted before now, there’s possibly not so much money to be made from Vitamin D trials!

It would make sense that the concentration of Vitamin D varies a lot, because of things like the research I found digging around, indicating that the obese might need two or three times the dose of Vitamin D (which is fat soluble as you no doubt know). So that’s one thing to consider.

(Another thing to think about, is if you don’t happen to take vitamin D with food - I wondered how much difference that might make, and found some research that suggested you may only absorb about two thirds of it, and might have to allow for that too). 

Another problem, is that Vitamin D depends to some extent on Magnesium levels for its efficacy. Your doctor might measure Magnesium levels in the blood, and levels seem fine, but looking into that it turns out a problem is that you may be short of Magnesium in the cells. And high concentrations in the blood don’t necessarily guarantee that. (Indeed, if you don’t have enough in the cells, you might have more in the blood).

Further issues are that a common Magnesium supplement is Magnesium Oxide, but then when you check it out, you discover that Magnesium in that form is supposedly only about 4% bioavailable. Which means that on the bottle it says you are taking your recommended daily allowance, but in practice, you might not be actually absorbing very much of that Magnesium…

A further issue. Alongside immune function, Vitamin D also can assist with getting calcium into your bones, indeed it’s often a traditional reason for taking it. But it can also wind up coating your arteries with calcium, which is not necessarily so good! Some people take Vitamin K2 to help make the body deposit the calcium in the bones, and the “MK-7 form” of vitamin K2 is supposedly more bioavailable. 

Obviously, I’m not a doc and folk should check these things out for themselves, but I’m just saying, it might be worth checking…

(P.s. It occurred to me to try and find out the best time of day to take Vitamin D, and there’s a suggestion it might be better taking it in the morning rather than at night. Because we often get vitamin D from sunlight, and the body might use the increase in Vitamin D as an indicator that the sun has risen, so it sets the body clock accordingly. Taking it at night might confuse your body clock). 

 

[alec]

c-a-r-f-r-e-w - "P.s. It occurred to me to try and find out the best time of day to take Vitamin D, and there’s a suggestion it might be better taking it in the morning rather than at night."

That's interesting. (As was the rest of the post!).

Dr A found some data last year that suggested that covid vaccine efficacy varied with diurnal cycles, with jabs in the morning leading to better immune responses. It was hypothesised that this was because the body is more active and less fatigued in the mornings, with a stronger immune response. Apparently the immune system starts to wind down after dark, so getting jabbed in the evening isn't such a good idea.

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

Jan 25, 2022 22:39:57 GMT alec said:

c-a-r-f-r-e-w - "P.s. It occurred to me to try and find out the best time of day to take Vitamin D, and there’s a suggestion it might be better taking it in the morning rather than at night."

That's interesting. (As was the rest of the post!).

Dr A found some data last year that suggested that covid vaccine efficacy varied with diurnal cycles, with jabs in the morning leading to better immune responses. It was hypothesised that this was because the body is more active and less fatigued in the mornings, with a stronger immune response. Apparently the immune system starts to wind down after dark, so getting jabbed in the evening isn't such a good idea.

Thanks Alec. I keep chipping away at this stuff. As do you, I can see! I didn’t know about the timing of the vaccines, useful to know. Has your partner been able to keep getting reduced doses ok?