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

[WelshBluebird]

There’s a different level of mitigation used for flu which is several orders of magnitude smaller and less damaging on the economy than the current COVID mitigations.

True - but we certainly don't just let flu take its natural course without any intervention as some people are suggesting we should do for COVID.

And of course - the main mitigation for flu is the annual vaccine, which we don't have a COVID equivalent of yet. And indeed my reply about the flu vaccine was specifically in reply to a point about the "obsession" with a vaccine for a largely non fatal illness - yet I suspect the same person doesn't have an issue with the time, money and effort spent on the flu vaccine ever year by the NHS, private individuals and private companies alike.

And while we are talking about it - imagine for a second we didn't have a flu vaccine. The mitigations we'd have to use each year would be very different and would likely be much more like the mitigations we are doing for COVID - though obviously much less invasive to everyday life, but would likely still involve better hygiene practices like having hand sanitiser and hand cleaning facilities more available (don't get me started about how this must be a big kick up the backside to some places who before COVID had a habit of not providing adequate hand washing facilities for people - in my time going to pubs I have lost count of the number of places where even the basic water taps were not working in their toilets - actually this is an issue with trains toilets too!) and potentially include wearing masks if you are ill - just like is more common in Asian countries.

 

[AdamWW]

Maybe, but remember that the NHS basically shut down a lot of treatments, ops etc. So in a growing backlog of cases, some routine cases may have moved into the urgent stage, meaning that the possibility of more covid-positive cases entering the system.

It would be nice to actually have some numbers, rather than this speculation.

If I were in charge (thankfully I'm not, both for my sake and probably also the country's) that's something I would really, really, want to know.

And while we are talking about it - imagine for a second we didn't have a flu vaccine. The mitigations we'd have to use each year would be very different and would likely be much more like the mitigations we are doing for COVID - though obviously much less invasive to everyday life (but would likely still involve things like better hygiene practices like having hand sanitiser and hand cleaning facilities more available and potentially include wearing masks if you are ill - just like is more common in Asian countries).

And it would also quite likely involve some level of 'shielding' from the categories of people who currently qualify for a free vaccine.

(Not children, of course).

 

[Bantamzen]

It would be nice to actually have some numbers, rather than this speculation.

If I were in charge (thankfully I'm not, both for my sake and probably also the country's) that's something I would really, really, want to know.



And it would also quite likely involve some level of 'shielding' from the categories of people who currently qualify for a free vaccine.

(Not children, of course).

Somewhere someone will be looking at exactly this. However it is my experience that sometimes the telling data is overlooked, or worse ignored in favour of simplified versions by decision makers. It might not be the case of course, but its not unheard of that sometimes data gets politicised.

 

[AdamWW]

Somewhere someone will be looking at exactly this. However it is my experience that sometimes the telling data is overlooked, or worse ignored in favour of simplified versions by decision makers. It might not be the case of course, but its not unheard of that sometimes data gets politicised.

Yes I'm sure.

It annoys me that some people seem very quick to jump to the conclusion that politicians and scientists are being stupid (I usually find that when I look into what looks like a silly decision there is a good reason for it). However, it's clear that sometimes the obvious does get overlooked, and clever, educated people certainly can make silly mistakes.

 

[Bantamzen]

Yes I'm sure.

It annoys me that some people seem very quick to jump to the conclusion that politicians and scientists are being stupid (I usually find that when I look into what looks like a silly decision there is a good reason for it). However, it's clear that sometimes the obvious does get overlooked, and clever, educated people certainly can make silly mistakes.

Those clever people <cough> Cummings <splutter> might also see stock in keeping the whole picture, well out of the picture. Covid has become a very useful tool for keeping other serious matters largely out of the public's thinking.

 

[jtuk]

Where was that reported?

One of Sky's hacks

https://twitter.com/EdConwaySky/status/1305564195962880001

Important: while Spain’s #COVID19 cases are still rising at a rate of about 10k a day, the official measure of its reproduction rate is now down to 0.48 - the joint lowest on record. If this R0 reading is to be relied on it implies the disease is coming under control rapidly

 

[Bletchleyite]

What measures does Spain presently have in place?

 

[nlogax]

One of Sky's hacks

https://twitter.com/EdConwaySky/status/1305564195962880001

That's interesting, thanks. Also surprising considering as of last week Spanish cases were on a fairly steep upward trend beyond 10,000 new cases per day. My source is Google News' own stats which are sourced from a variety of locations: https://news.google.com/covid19/map?hl=en-GB&mid=/m/06mkj&gl=GB&ceid=GB:en

 

[jtuk]

Not sure why it is surprising - that's how a supposedly highly infectious virus works. It spreads quickly, runs out of people to infect, then it's done. We saw this six months ago, it's not new news

 

[brad465]

One of Sky's hacks

https://twitter.com/EdConwaySky/status/1305564195962880001

That's interesting, thanks. Also surprising considering as of last week Spanish cases were on a fairly steep upward trend beyond 10,000 new cases per day. My source is Google News' own stats which are sourced from a variety of locations: https://news.google.com/covid19/map?hl=en-GB&mid=/m/06mkj&gl=GB&ceid=GB:en

Not sure why it is surprising - that's how a supposedly highly infectious virus works. It spreads quickly, runs out of people to infect, then it's done. We saw this six months ago, it's not new news

This is the current graph for daily cases in Spain:



I should point out what they appear to do in Spain is log cases initially as the day they were reported, but then make revisions that suddenly increases values about a week later, or something like that, hence why there's a big dip recently. However even without this dip cases do appear to be starting a downward trend. Deaths below show there certainly hasn't yet been a marked increase in response to high cases:

 

[nlogax]

It spreads quickly, runs out of people to infect, then it's done.

Those figures don't suggest in any way that the infection has 'run out of people to infect'.

 

[jtuk]

Those figures don't suggest in any way that the infection has 'run out of people to infect'.

Relatively speaking

 

[adc82140]

What measures does Spain presently have in place?

Limits on big gatherings, nightclubs being forced to close a bit earlier(!)

 

[Jamesrob637]

Limits on big gatherings, nightclubs being forced to close a bit earlier(!)

What, 7am rather than 9am?! many a morning of going home in Madrid when some people are already at work or going to work, or would be if it were a weekday. How the Spanish do their routine and still live to a ripe old age is beyond me. Must be all the chorizo and serrano!

 

[Bletchleyite]

What, 7am rather than 9am?! many a morning of going home in Madrid when some people are already at work or going to work, or would be if it were a weekday. How the Spanish do their routine and still live to a ripe old age is beyond me. Must be all the chorizo and serrano!

You just don't go out (to a club) during the week unless you're a student or something. If you work, go out Saturday and sleep Sunday. That's how it is in most of Europe, our typical early closing/going home to get to bed is an English speaking country thing. Germany is the same, I remember from when I studied there going out midweek was really quiet as only really students were out.

 

[Silverlinky]

This is the current graph for daily cases in Spain:

View attachment 83557

I should point out what they appear to do in Spain is log cases initially as the day they were reported, but then make revisions that suddenly increases values about a week later, or something like that, hence why there's a big dip recently. However even without this dip cases do appear to be starting a downward trend. Deaths below show there certainly hasn't yet been a marked increase in response to high cases:

View attachment 83558

Those two graphs are very interesting! Cases to deaths first time round shows a very similar pattern with a lag in the dates of around two weeks, cases started at the end of February and deaths started around the middle of March. Cases tailed off beginning/middle of May and deaths tailed off end of May.....
What is obvious is that the second wave/spike has not followed anything like the same pattern. You can not translate one country for another obviously, but we sort of followed Spain and Italy first time round and saw similar figures...with a similar new case/death picture.
There's plenty there to give us hope that the current rise in cases in this country will not produce a substantial rise in death figures.........thus rendering the "two week lag" argument pointless. Time will tell of course.

 

[AdamWW]

Those two graphs are very interesting! Cases to deaths first time round shows a very similar pattern with a lag in the dates of around two weeks, cases started at the end of February and deaths started around the middle of March. Cases tailed off beginning/middle of May and deaths tailed off end of May.....
What is obvious is that the second wave/spike has not followed anything like the same pattern. You can not translate one country for another obviously, but we sort of followed Spain and Italy first time round and saw similar figures...with a similar new case/death picture.
There's plenty there to give us hope that the current rise in cases in this country will not produce a substantial rise in death figures.........thus rendering the "two week lag" argument pointless. Time will tell of course.

In all cases the changed case/death ratio may be due to much higher testing now.

It would certainly be good to not see a substantial rise in deaths, but I don't think it makes the "two week lag" argument pointless. Let's say the ratio has changed by a factor of 100. That would still potentially lead to a fair number of deaths (with the lag, of course) if infections carried on rising.

Also, of course, if due to better treatment the hospitalisation/death ratio gets better, that's also good, but you still have the potential problem of running out of hospital capacity.

 

[talldave]

Do you include flu with that comment then?
We spend a considerable amount of time and money on the annual flu vaccine. Are you suggested we shouldn't bother with that either?

No because the flu vaccine isn't emotionally blackmailed onto the entire population as a mitigation against killing granny.

 

[AdamWW]

No because the flu vaccine isn't emotionally blackmailed onto the entire population as a mitigation against killing granny.

Is your objection to attempting to vaccinate the majority of the population in order to only project the vulnurable?

Incidentally I think the main reason that children are routinely given the flu vaccine in the UK is to protect the vulnurable they come into contact (the very young and the elderly), not so much to protect themselves.

 

[MikeWM]

https://www.cebm.net/covid-19/is-scotland-overcounting-the-number-of-patients-in-hospital-beds/

The conclusion is that the 'number of people in hospital in Scotland with Covid' figure is probably far too high.

...and the answer is 'yes', and they've now changed the methodology of how these are counted.

Figure for today is corrected from 262 to 48. Bit of a difference!

 

[AdamWW]

...and the answer is 'yes', and they've now changed the methodology of how these are counted.

Figure for today is corrected from 262 to 48. Bit of a difference!

Weren't these the people that spotted the fact that the PHE figures were including everybody who had ever had a positive test as a Covid death?

 

[MikeWM]

Weren't these the people that spotted the fact that the PHE figures were including everybody who had ever had a positive test as a Covid death?

Yes, and that the Welsh admissions figures were wrong. They're doing a decent job of pointing out these things - though you'd hope the people responsible for actually publishing the figures could work these things out for themselves.

That there was a problem was pretty clear. Not to blow my own trumpet but *I* spotted the Welsh and Scottish issues myself three weeks ago...

I'm trying to make some sense of the government dashboard on hospitalisations (at https://coronavirus.data.gov.uk/) and I'm more confused than when I started.

Wales seems to have much higher daily figures than England, for example, but the *total* number of people in hospital in Wales with Covid is only slightly higher than the daily admission numbers...

Conversely admissions in Scotland are effectively zero, but they still have a lot of people in hospital which doesn't appear to be decreasing at all.

The numbers for England are the only ones that look to make any rational sense.

 

[AdamWW]

Yes, and that the Welsh admissions figures were wrong. They're doing a decent job of pointing out these things - though you'd hope the people responsible for actually publishing the figures could work these things out for themselves.

You would indeed.

But I suppose second best is to be in a position where others can spot them, point them, out and have action taken.

 

[bramling]

You would indeed.

But I suppose second best is to be in a position where others can spot them, point them, out and have action taken.

Not a wonderful situation though. Whilst one hopes government decisions aren’t being made off the back of dubious figures, such figures continue to feed a scared subset of the population, so hardly helping people to make informed judgements.

 

[WelshBluebird]

No because the flu vaccine isn't emotionally blackmailed onto the entire population as a mitigation against killing granny.

But that wasn't the original point you were making - you were just complaining about a vaccine for a non fatal illness.
And you are starting to sound too close to anti-vaxers for my liking, especially the talk around "emotional blackmail".
What would be your objection about the vaccine?

In any case, back to the flu vaccine we were talking about, I assume you have never been involved with a vulnerable person around winter when it comes to the flu vaccine then? Because there certainly is a fairly large amount of pressure on you to have the vaccine if you are in regular contact with a vulnerable person. Certainly when my and my parents cared for my gran before she passed away we were basically told that we had to get it. And even away from vulnerable people, many workplaces are now encouraging their staff to get the vaccine and are even paying for it privately in order to reduce time and money wasted with staff off sick!

 

[MikeWM]

Because there certainly is a fairly large amount of pressure on you to have the vaccine if you are in regular contact with a vulnerable person. Certainly when my and my parents cared for my gran before she passed aware we were basically told that we had to get.

For whatever reason (I'm not entirely sure), my grandmother was adamant she didn't want it, and my mother (her carer) has never been particularly keen on seeing a doctor unless she was really ill - so they always managed to resist the pressure but I do agree it is there.

And even away from vulnerable people, many workplaces are now encouraging their staff to get the vaccine and are even paying for it privately in order to reduce time and money wasted with staff off sick!

Ours has for the last few years, yes - though I'm on the NHS list anyway for various medical reasons.

 

[Bantamzen]

Is your objection to attempting to vaccinate the majority of the population in order to only project the vulnurable?

Incidentally I think the main reason that children are routinely given the flu vaccine in the UK is to protect the vulnurable they come into contact (the very young and the elderly), not so much to protect themselves.

Here's an out-of the-box thought, how about prioritising the most vulnerable? Isn't that a better way?

 

[Class 33]

Oh no, the cases have gone back over 3,000 again. It's 3,105 today. Not what I was hoping for, after three days in a row of new cases dropping. Expect the press and media will be up to their tricks again within minutes....

 

[GRALISTAIR]

I get the flu vaccine each year anyway. I am most definitely NOT an anti-vaxer. My wife is a lifelong asthmatic and is considered high risk so she also gets it each year. I assume when/if a Covid Vaccine becomes available she will be quite high priority especially if she happens to be back in the UK at the time.

 

[AdamWW]

Here's an out-of the-box thought, how about prioritising the most vulnerable? Isn't that a better way?

I don't know.

Trying to split the population into vulnerable and non-vulnerable and let Covid spread only through the non- vulnerable seems very hard to me.

Just vaccinating those who "need it" might be possible and I'd imagine if there is a vaccine there won't be enough for everyone straight away and the more vulnerable will be some of the first in the line.

But if the vaccine isn't so effective in the elderly, or it's too risky for a significant fraction of them to be given the vaccine, then that doesn't work so well.