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

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AdamWW

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Have they? I've been to quite a few since July and I've seen pretty much none of this. Of course the media will always dig out a few exceptions, but from my observations most people are sticking to it.

My anecdotal evidence is that people aren't bothering so much - people trying to hand me deliveries rather than putting them on the doorstep than standing back, for example.
 
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DannyMich2018

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My anecdotal evidence is that people aren't bothering so much - people trying to hand me deliveries rather than putting them on the doorstep than standing back, for example.
Exactly. Even in Asda and other shops and out and about many people seem to be making less of an effort to keep a distance. People seem to think face coverings are a substitute for SD. Let's hope today's new cases are lower.
 

gingerheid

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I'd like to remind you that that person had no symptoms or other adverse effects.

I'm not sure what you mean by "that person" (are you maybe referring to the first case?) as it's now many people. Some reinfections cases have been asymptomatic or not severe, and some have been more severe than the original infection. It's something else to add to the long list of "we don't knows", but whatever the answer is it's not good for the concept of herd immunity :(
 

takno

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Since pubs etc reopened many people (particulary younger ones) have the mindset "oh yes the death rates and number of cases have gone down let not bother with social distancing its ok now". Sadly this is still paramount. While not highest the number of people in Hospital in the UK has been creeping up recently with as know cases have rocketed. No one wants a 2nd UK lockdown so it's really important people act responsibly to prevent a 2nd wave which with Autumn/winter around the corner could be worse than the 2nd.
If it's a choice between the government attempting a second lockdown and this endless creeping of extra restrictions keeping day to day life miserable for many months ahead then I'm not really sure which I prefer tbh.

Given the lack of any structure to the government's thinking process, I doubt any amount of social distancing will prevent them having one if Hancock decides he fancies one anyway. Maybe he thinks he might get furloughed next time.
 

mralexn

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Since pubs etc reopened many people (particulary younger ones) have the mindset "oh yes the death rates and number of cases have gone down let not bother with social distancing its ok now". Sadly this is still paramount. While not highest the number of people in Hospital in the UK has been creeping up recently with as know cases have rocketed. No one wants a 2nd UK lockdown so it's really important people act responsibly to prevent a 2nd wave which with Autumn/winter around the corner could be worse than the 2nd.

Where is the evidence of hospital admissions going up? I work in a hospital and we have never been quieter!

This is my source for the graph below. https://coronavirus.data.gov.uk/healthcare
 

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AdamWW

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Where is the evidence of hospital admissions going up? I work in a hospital and we have never been quieter!

This is my source https://coronavirus.data.gov.uk/healthcare

Well the right hand side of that graph seems to be showing a small rise.

I don't know how statistically significant it is, but coming alongside an increase in infections that is statistically significant, I'd say it's something worth keeping an eye on.

If the numbers are being dominated by certain parts of the country, most hospitals wouldn't be seeing anything anyway.
 

mralexn

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Well the right hand side of that graph seems to be showing a small rise.

I don't know how statistically significant it is, but coming alongside an increase in infections that is statistically significant, I'd say it's something worth keeping an eye on.

If the numbers are being dominated by certain parts of the country, most hospitals wouldn't be seeing anything anyway.

You have a point indeed, and it is certainly worth keeping an eye on.

There is a small rise on the right hand side of the graph, but then it drops again.

Sadly with the damage that is currently being done to our economy, I wonder how long it will be until there are massive cuts in our NHS.
 

Domh245

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Some reinfections cases have been asymptomatic or not severe, and some have been more severe than the original infection. It's something else to add to the long list of "we don't knows", but whatever the answer is it's not good for the concept of herd immunity :(

I thought we'd only recently had the actual first confirmed case of reinfection - the first reported one(s) were in fact just detection of dead viral material. It's clearly nowhere near as high a concern as it is presented, otherwise we would have seen far more cases

Where is the evidence of hospital admissions going up? I work in a hospital and we have never been quieter!

Subtract the welsh figures, which as they legend says includes suspected rather than confirmed (and cut the x axis so you're not getting skewed by the peak figures from April) and there's a very noticeable increase

1600093056350.png

If the numbers are being dominated by certain parts of the country, most hospitals wouldn't be seeing anything anyway.

A very valid point, infections seem to be currently concentrated in a few locations (North West/Birmingham/West Yorkshire. The Gov dashboard is reporting 884 patients in hospitals with COVID, compared to a reported 1257 hospitals across the UK - less than one on average, before even considering 'hotspots'
 

greyman42

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My anecdotal evidence is that people aren't bothering so much - people trying to hand me deliveries rather than putting them on the doorstep than standing back, for example.
Your not going to catch Covid by being handed a parcel.
 

gingerheid

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I thought we'd only recently had the actual first confirmed case of reinfection - the first reported one(s) were in fact just detection of dead viral material. It's clearly nowhere near as high a concern as it is presented, otherwise we would have seen far more cases

There's been quite a few confirmed reinfections since.

They're also not treated as confirmed reinfections unless both the original and subsequent viruses are sequenced and are different strains, which means that there will always be very few *confirmed* reinfections (the great majority of people infected with covid in the UK more than four months ago were of course not even tested, let alone sequenced). In the UK most early sequencing was done as part of trials attempting to trace spread through hospital wards and care homes, which also gives a substantially lower chance of known sequenced cases from more than 4 months ago being around to be sequenced again.

The only thing clear is that this is not good news for the hope of herd immunity.

Your not going to catch Covid by being handed a parcel.

Even if fomite transmission (catching it from infected objects) isn't that big a deal, being close enough to someone to pass an object over definitely is :(. Life does and has to include some element of risk, but unnecessary ones such as that shouldn't be one of them.
 
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Richard Scott

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We aren’t trashing the economy etc - the current policy is suppression with the lightest, focussed, restrictions possible, and those restrictions are focussed on reducing economic and social damage.
We aren't trashing it now as already done that.
 

Domh245

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There's been quite a few confirmed reinfections since.

They're also not treated as confirmed reinfections unless both the original and subsequent viruses are sequenced and are different strains, which means that there will always be very few *confirmed* reinfections (the great majority of people infected with covid in the UK more than four months ago were of course not even tested, let alone sequenced). In the UK most early sequencing was done as part of trials attempting to trace spread through hospital wards and care homes, which also gives a substantially lower chance of known sequenced cases from more than 4 months ago being around to be sequenced again.

The only thing clear is that this is not good news for the hope of herd immunity.

I see. I find it odd that there hasn't been much reporting of these confirmed reinfections then. I also find your comment about "not good for the hope of herd immunity" alarming - what's your alternative? Because if 'natural' herd immunity won't work, neither will vaccine based, and therefore we ought to accept that we just have to live with this and open up..
 

gingerheid

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I see. I find it odd that there hasn't been much reporting of these confirmed reinfections then.

Google finds them with a search for confirmed covid reinfection. You can tell them apart by the countries named in the previews. There were 8 within a week of the first confirmed one (which across the world isn't a huge number in itself, but of course we're dealing with an unknown factor and at one point there were only 8 cases of Covid)

I also find your comment about "not good for the hope of herd immunity" alarming - what's your alternative? Because if 'natural' herd immunity won't work, neither will vaccine based, and therefore we ought to accept that we just have to live with this and open up..

The good news is that it's more feasible to give a vaccine every year or so (as a successful one will probably produce a stronger immune response than the virus https://theconversation.com/why-a-v...tter-immunity-than-an-actual-infection-145476) than it is to "give herd immunity" repeatedly :)

I believe that we will have a vaccine some time early next year, and that until then we have a careful balancing act of living with an acceptable amount of risk on one hand, while not denying that the problem exists and ignoring it on the other.

We have an interesting numbers game until then, and we should remember that very small things can make a big difference. Taking the most recent example in this thread - handing a parcel to someone: In some cases there'd be no risk as there'd be a strong wind blowing the wrong way. In other cases (no or unfavourable wind, or inside a block of flats there'd be a bigger risk). In percentage terms it would be easy to make the risk look tiny - lets say it's just half a percent. However the delivery person probably easily has contact with 200 residents before they *might* realise they were infected, so even that 0.5 of a percent suddenly gives us R=1, and anyone infected living with other people probably gives us R of over 1. This is why we should carry on doing the small things that even might help, even if only so we can use the breathing space those things give us to do more obviously dangerous things!
 
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Bantamzen

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I thought we'd only recently had the actual first confirmed case of reinfection - the first reported one(s) were in fact just detection of dead viral material. It's clearly nowhere near as high a concern as it is presented, otherwise we would have seen far more cases



Subtract the welsh figures, which as they legend says includes suspected rather than confirmed (and cut the x axis so you're not getting skewed by the peak figures from April) and there's a very noticeable increase

View attachment 83535



A very valid point, infections seem to be currently concentrated in a few locations (North West/Birmingham/West Yorkshire. The Gov dashboard is reporting 884 patients in hospitals with COVID, compared to a reported 1257 hospitals across the UK - less than one on average, before even considering 'hotspots'

That graph would be more useful if dated back to the start of the lockdown period, if not before.
 

Djgr

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I thought we'd only recently had the actual first confirmed case of reinfection - the first reported one(s) were in fact just detection of dead viral material. It's clearly nowhere near as high a concern as it is presented, otherwise we would have seen far more cases



Subtract the welsh figures, which as they legend says includes suspected rather than confirmed (and cut the x axis so you're not getting skewed by the peak figures from April) and there's a very noticeable increase

View attachment 83535



A very valid point, infections seem to be currently concentrated in a few locations (North West/Birmingham/West Yorkshire. The Gov dashboard is reporting 884 patients in hospitals with COVID, compared to a reported 1257 hospitals across the UK - less than one on average, before even considering 'hotspots'

That's quite a lot of data distortion going on, through not including part of the United Kingdom and through not including certain weeks, in order to make the data fit your viewpoint.
 

takno

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Google finds them with a search for confirmed covid reinfection. You can tell them apart by the countries named in the previews. There were 8 within a week of the first confirmed one (which across the world isn't a huge number in itself, but of course we're dealing with an unknown factor and at one point there were only 8 cases of Covid)



The good news is that it's more feasible to give a vaccine every year or so (as a successful one will probably produce a stronger immune response than the virus https://theconversation.com/why-a-v...tter-immunity-than-an-actual-infection-145476) than it is to "give herd immunity" repeatedly :)

I believe that we will have a vaccine some time early next year, and that until then we have a careful balancing act of living with an acceptable amount of risk on one hand, while not denying that the problem exists and ignoring it on the other.
8 is pretty good - it's not zero, but it's still an absolutely tiny proportion of the people we would be able to detect it in. You'd expect the lifetime of immunity to run along a fairly long curve, and if we are only just starting to see a few outliers then that suggests that typical immunity could be well over a year. As the infections have been spread over a good few months it's fair to assume that, even with some level of reinfection, natural herd immunity would be able to bump along at a manageable level over time.
 

Bantamzen

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8 is pretty good - it's not zero, but it's still an absolutely tiny proportion of the people we would be able to detect it in. You'd expect the lifetime of immunity to run along a fairly long curve, and if we are only just starting to see a few outliers then that suggests that typical immunity could be well over a year. As the infections have been spread over a good few months it's fair to assume that, even with some level of reinfection, natural herd immunity would be able to bump along at a manageable level over time.

To be honest it is way too soon to be talking about average immunity. Much of the data so far is based on antibodies, but these are not the only sources of potential immunity. The real test will be in B & T-cell detection, these are the cells that carry the genetic memory for anti-bodies & are the ones that identify when a cell is infected. It is perfectly possible to have immunity without ever producing anti-bodies.
 

gingerheid

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8 is pretty good - it's not zero, but it's still an absolutely tiny proportion of the people we would be able to detect it in. You'd expect the lifetime of immunity to run along a fairly long curve, and if we are only just starting to see a few outliers then that suggests that typical immunity could be well over a year. As the infections have been spread over a good few months it's fair to assume that, even with some level of reinfection, natural herd immunity would be able to bump along at a manageable level over time.

We all wish it showed that, but it really doesn't. We, and nobody, did enough testing (let alone sequencing) at the peak to be able to say that. We're monitoring a few thousand people with confirmed sequenced first wave infections for reinfection and for immunity level, and that's not really enough to get good answers. (And we're also monitoring more people with unsequenced first wave infections just for immunity level. It starts to fall after 3 months, to as yet unknown effect. [Edit: for the reasons Bantamzen gives.])

The very idea of reinfection being possible is however, as unfortunate as it is, very bad news for herd immunity as a concept.
 

Crossover

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I'd say public tolerance of social distancing and generally being barked instructions at has run out. Humans are naturally sociable animals. People have tolerated being apart from friends and family for quite a while.

I'd agree with this - the whole 'hokey cokey' nature of the restrictions just boggles the mind. I was discussing earlier with a colleague that if any of us said one thing one day and then said something else the day after and so on, eventually people would just do it anyway, either because they couldn't remember exactly what they were meant to be doing or in some cases to stick two fingers up at those making the rules, seemingly for the sake of rules
 

gingerheid

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And for a vaccine, to be fair. If significant reinfection is possible, then we will need to live with protective measures basically forever.

Really, no. If a vaccine needs to be given every year... that's... a bit inconvenient? Not much more.
 

Bantamzen

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Let's not get too excited about re-infections yet. The numbers are way too small to be sure they aren't just errors in testing. And even if there is the possibility, it doesn't mean doom & gloom or a lifetime of vaccines. Re-infection tests are simply proof that thee virus has produced enough to be detected, not necessarily that it will cause symptoms or make someone infectious.
 

Domh245

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The good news is that it's more feasible to give a vaccine every year or so (as a successful one will probably produce a stronger immune response than the virus https://theconversation.com/why-a-v...tter-immunity-than-an-actual-infection-145476) than it is to "give herd immunity" repeatedly :)

I believe that we will have a vaccine some time early next year, and that until then we have a careful balancing act of living with an acceptable amount of risk on one hand, while not denying that the problem exists and ignoring it on the other.

Yes and no, if there are multiple strains about and reinfecting people, that means having to successfully develop vaccines for each strain, prolonging the time before any vaccine programme can be successfully implemented. The 'flu' vaccine is just a best guess mix of different influenza vaccines based on what strains they expect to be prominent that season

Skimming that article, it doesn't actually say that it will produce a stronger response, only that it could, with sentences like " they can be designed to focus the immune system against specific antigens that elicit better responses. "

Given the reportedly high levels of T-cell immunity both pre-existing and as a response to infection, and the closing sentence of the article " Of the roughly 320 vaccines being developed against COVID-19, one that favours a strong T cell response may be the key to long-lasting immunity. " there's no inherent advantage of a vaccine over actual infection, from an immunisation point of view at least.

That graph would be more useful if dated back to the start of the lockdown period, if not before.

Not for the purpose of showing a distinct increase in cases recently it isn't.

That's quite a lot of data distortion going on, through not including part of the United Kingdom

Only going by what the government themselves (and Carl Heneghan) say..

Daily and cumulative numbers of COVID-19 patients admitted to hospital. Data are not updated every day by all four nations and the figures are not comparable as Wales include suspected COVID-19 patients while the other nations include only confirmed cases.

The UK government’s website produces data on cases, admissions and deaths daily for the devolved nations of the UK (see Staging data)

Yet the data in Wales for patients admitted to hospital is concerning. The number of patients admitted in Wales is higher than in England on several days? (see the table)

How can this be? The population of England is 18 times greater (56 Million) than the 3.1 million people who live in Wales. Also, the number of patients in hospital in Wales is one-tenth that of England. (see the second table) Likewise, ICU beds in Wales are also one-tenth that of England. (see here for the data)

The gov.uk site informs me that the “figures are not comparable as Wales include suspected COVID-19 patients while the other nations include only confirmed cases.”

This weakness in the data makes comparisons impossible; it also creates concerns about the overall accuracy of the data provided by the gov.uk site. The number of patients admitted in Wales with covid is, therefore, inflated.

In the about section, we are told that “the numbers of admissions are not comparable with other nations.” Data should, therefore, not be combined if the criteria differ. But in the daily figure, it is. Does the problem highlight a lack of epidemiological understanding about creating accurate and consistent data?

Suspected COVID cases will vary substantially depending on the centre and the criteria used. Furthermore, admissions data would be more helpful if it provided a breakdown on numbers of new infections, past infections and those infected whilst an inpatient. It currently does not.

There is an urgent need to provide robust hospital admission data, not least because this information will be used as a future driver of mitigation strategies in local areas.

Given the flaws in the gov.uk data on patients admitted to hospital, the current reporting should come with a warning.

The welsh data is unreliable, non-comparable and therefore I've chosen to exclude it, not that it changes the message particularly - it flattens the moving average out but there is still an increase
1600102425455.png
edited - changed title on graph from "England, Northern Ireland, & Scotland" to UK

and through not including certain weeks, in order to make the data fit your viewpoint.

Only showing the last few weeks of data is to make the increase in cases clearer, which was my whole point. The request was to show evidence of an increase in hospital admissions - not "hospital admissions relative to the peak in april" or anything like that. Including the entire data series and consequently hiding the useful data would have been shockingly poor data presentation.
 
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Bantamzen

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Not for the purpose of showing a distinct increase in cases recently it isn't.

In the context of the overall pandemic it certainly is. From here it seems you have carefully chosen a start date that suits your agenda, rather than allowing the data to show the true picture.

Edit: Oh and you've omitted the fact that as hospitals have started to catch-up on a huge backlog of cases, there will be an noticeable increase admissions & with that comes the possibility of more people with, but not necessarily suffering from covid.
 
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Scrotnig

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If you can be reinfected a vaccine is useless.
Nope. Prof Sarah Gilbert, leader of the Oxford vaccine project, nailed that one some months ago when this scaremongering about reinfections first started.

In simple terms the vaccine works in a totally different way to any natural immunity.

And if there's one person in this entire shambles whose word I actually trust - it's her.
 

talldave

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If you can be reinfected a vaccine is useless.
If you can be reinfected, you don't need a vaccine because it obviously didn't kill you.

This obsession with vaccines for something that primarily only kills people who aren't in full health is so tiring.
 

adc82140

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Many of the reinfections have been in people who are immunocompromised. By definition they have no or a poor immune system. Therefore they are liable to get reinfected with any disease.

In addition there is no record of anyone re infected becoming seriously unwell.

It is generally accepted that you can only get Chickenpox once. But there is a very very small proportion of people who will get it a second time.

If you can be reinfected, you don't need a vaccine because it obviously didn't kill you.

This obsession with vaccines for something that primarily only kills people who aren't in full health is so tiring.
When actually did we last have a death of someone with no underlying health conditions?
 
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