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

[Bletchleyite]

But lockdowns are not a normal state of life, many people just want to return to a more normal life, as someone on the radio said this morning we are social animals, that is what we are and that cannot be changed. Majority will want to return to a social society, for some that can't come soon enough.

I'm sure absolutely everyone does, pretty much. However, some of us are realistic and recognise that there's a pandemic going on, and others wishfully think we can ignore it and wish it to go away.

 

[bramling]

In fact I'd say the majority of the working class would probably support lockdown for any length of time if it meant they got full pay throughout.

Yes just like anyone would be happy to be paid to sit at home, just like many were (and in some cases still are being). Will they, however, be so happy to see their taxes rise in the future to pay the costs?

Of course many in roles like manual factory work will have continued working through the last lockdown.

 

[hwl]

Surely a meta analysis of track and trace data would help to answer that? Did this person who tested positive but was asymptomatic pass it on to anyone else? Etc.
But I suspect it isn't that joined up...

In the Uk it isn't that joined up most of the time.

The problems is we only do forward tracing in the community in the UK and not that well either. to do decent useful metadata analysis we need forward and backward tracing as they do in lots of other countries.
One overseas learning from forward and backward tracing was that ~70% of infected people don't pass it on to any one (given distancing, isolation etc so current R values), 10% only pass it on to 1 person and 20% pass it on to between 2 and 50 people. (Very different in March though!)

 

[trebor79]

Because they're not? Lockdown would be no great problem for the working class if they were paid while unable to work.

In fact I'd say the majority of the working class would probably support lockdown for any length of time if it meant they got full pay throughout.

It's clear the country can't afford to endlessly pay millions of wages. And it'll be the working classes hammered through tax increases and service cuts to pay it back in the future.

As someone who is being paid multiples of the average wage to sit at home and twiddle my thumbs for a lot of the time (not particularly to do with COVID, I work from home for a very disorganised company though covid hadn't helped) I can tell you it's absolutely soul destroying.
People want to do meaningful things with their lives, not just exist and sit at home in their underpants all day.

 

[Bikeman78]

Unfortunately even the German system is not effective enough to keep the disease contained.

It cannot materially effect the outcome, all it does is buy a handful more weeks.

Agreed. Either we lockdown forever, perhaps alternative months, or we just get on with life. All the pointless Covid secure nonsense over the past few months clearly hasn't worked.

The Guardian hasn't really cared about the working class for many years now (pretty much like most of the Labour party, sadly).

The Mail seems to have gone fairly sceptic over the last few weeks. See this Twitter thread for example, with lots of supporting graphs.
https://twitter.com/DailyMailUK/status/1317019322003447808

Wales only really opened up late July, later than England. Most of it was back in local lockdown two months later with full lockdown rumoured for next week. What exactly did opening up later gain us?

 

[kristiang85]

The Guardian hasn't really cared about the working class for many years now (pretty much like most of the Labour party, sadly).

The Mail seems to have gone fairly sceptic over the last few weeks. See this Twitter thread for example, with lots of supporting graphs.
https://twitter.com/DailyMailUK/status/1317019322003447808

Yes, as I said in another thread I'm worryingly agreeing with the Mail a bit too often for my liking... that article in question was very measured and realistic. But, again, because it's in the Mail many will quickly dismiss it! However, I think this is now going onto territory covered by the media thread.

Agreed. Either we lockdown forever, perhaps alternative months, or we just get on with life.

This is the crux of it all really. It's a binary option - you go down full lockdown route (e.g. like NZ), and stick to it and hope to heaven the vaccine comes before your country is bankrupt. Or you go down the more relaxed route and manage the course of the virus, and stick with that (like Sweden) and hope to heaven your predictions are right and you don't get the excess deaths as opposed to other strategies. It is quite clear strategies in between are not working.

Even worse, we in the UK are just flip flopping with no real consistent strategy it seems, and everything is suffering. And its important that the debate over which way to go isn't stifled in any way, which unfortunately the government is doing. I could cope with that I guess, but they can only get away with that if they have a firm, transparent and solid plan - however, don't know what they are doing at all, which is just angering people.

 

[Richard Scott]

I'm sure absolutely everyone does, pretty much. However, some of us are realistic and recognise that there's a pandemic going on, and others wishfully think we can ignore it and wish it to go away.

And some of us are realistic realising that the reaction is causing more issues than the virus itself. At first it was allow NHS to cope, now it's virus numbers must come down at all costs. There's no actual vision here of what we're trying to achieve.

 

[AndyY]

I think it's telling that we've not really seen major spikes in London, but in areas that were less-exposed the first time around. Perhaps the level of immunity down there is playing more of a part than some people give it credit for.

I thought Liverpool was fairly badly hit in the first wave also (Spanish fans attending the Liverpool vs Atlético Madrid match on 2020-03-13 spread it all over the place), yet now hospitals are starting to get overwhelmed. In any case, I am doubtful about this herd immunity theory if there are people who managed to get it twice.

 

[Domh245]

In any case, I am doubtful about this herd immunity theory if there are people who managed to get it twice.

The absurdly small number of cases of reinfection really isn't a concern, particularly as herd immunity as a concept also doesn't rely on 100% immunity

 

[Richard Scott]

I thought Liverpool was fairly badly hit in the first wave also (Spanish fans attending the Liverpool vs Atlético Madrid match on 2020-03-13 spread it all over the place), yet now hospitals are starting to get overwhelmed. In any case, I am doubtful about this herd immunity theory if there are people who managed to get it twice.

Can you quantify these statements with numbers, please? 'Starting to get overwhelmed' is a somewhat vague statement.

 

[trebor79]

Can you quantify these statements with numbers, please? 'Starting to get overwhelmed' is a somewhat vague statement.

Indeed. A bit like earlier in the week when it was announced that Blackpool hospital was "full" with COVID cases. A journalist did a little digging and discovered that what that actually meant was that the 8 designated covid beds out of 700 and something in the hospital were occupied.

 

[Bletchleyite]

It's clear the country can't afford to endlessly pay millions of wages. And it'll be the working classes hammered through tax increases and service cuts to pay it back in the future.

They've got 2 choices - pay the wages or pay the Universal Credit. At least in the former case there'll be a job to go back to.

And some of us are realistic realising that the reaction is causing more issues than the virus itself. At first it was allow NHS to cope, now it's virus numbers must come down at all costs. There's no actual vision here of what we're trying to achieve.

I would suggest it's now about minimising deaths while not totally knackering the economy pending a vaccine.

 

[kristiang85]

Can you quantify these statements with numbers, please? 'Starting to get overwhelmed' is a somewhat vague statement.

Well when some politician said that Liverpool's hospitals were at 95% capacity, they were fact checked and it turns out its only 80%, which is lower than average for this time of year.

 

[trebor79]

They've got 2 choices - pay the wages or pay the Universal Credit. At least in the former case there'll be a job to go back to.

Maybe not. Companies still go bust with no cashflow even if some of the wage cost is covered.
Or the owners think "Stuff this for a game of soldiers, I'll have a quiet life and enjoy my fortune. Liquidate it."
Or the owners spot something less subject to whatever this week whim is, liquidate the business and invest in something else (possibly abroad or online and employing far less people).

I would suggest it's now about minimising deaths while not totally knackering the economy pending a vaccine.

Hancock has said as much. I'm not convinced that's doable with the lockdown approach, for both financial and public opinion reasons.
And I don't believe there is any hope of a vaccine until the middle of 2022 at the very earliest, and that would be pushing it. If you read up on vaccine development and trialling, that's about how long it's going to take to get eg the Oxford vaccine approved.
If it works. That's the other problem with the assumed current approach. What if you expend the national resource of capital and public forbearance and either the vaccine isn't ready, or there just isn't one. What then?
The only vaccine is the actual moonshot, not the mass testing Johnson introduced (which has gone very quiet). We're betting the farm on a vaccine. That is not sensible and in any case there are better things than lockdown for protecting the vulnerable until we get to that point.

 

[30907]

His major points are backed up by sources.

I'm not convinced by his suggestion that around 1 in 3 of us have had Covid, for a start. That's 10x higher than is evidenced in any major country

 

[trebor79]

I'm not convinced by his suggestion that around 1 in 3 of us have had Covid, for a start. That's 10x higher than is evidenced in any major country

He uses two methods to arrive at roughly the same result. One is a bit of a finger lick and could easily be gamed, the other depends on what the IFR is and is less ready to be gamed, but still needs to be approached with caution.
I think it's fair to say that a very large proportion of the infection and death in the first wave was amongst the elderly and vulnerable, due to daft decisions that seeded infection in care homes. Therefore the IFR for the first wave cohort will have been much larger than the while population IFR that he uses.
It would be better if he'd used only deaths outside of a care setting and applied the IFR to that to derive an infection rate.
I think the true number will be somewhere between SAGEs 8% and his 30%, but probably towards the lower bound.
The rest of his criticism stage up to scrutiny a bit better. I agree with his overall stance but I find myself sceptical at the notion that the epidemic is all but over. That said, infection certainly isn't increasing exponentially and there are early signs that it may have plateaued.

 

[Tetchytyke]

But the challenge of managing the relatively low numbers of tests on a small island must be an order of magnitude lower

The issue on a small island is setting up the infrastructure. We did that- the testing station is in the TT pit lane. Beyond that, it's just about scale.

I don't think everything from a small island transfers to a big island, but I think this does.

 

[takno]

I'm not convinced by his suggestion that around 1 in 3 of us have had Covid, for a start. That's 10x higher than is evidenced in any major country

Not sure where you're getting 10x from. The lowest estimation for the UK was 8% in June based on reasonably robust population samples for antibodies, and it's widely acknowledged across the scientific community that t-cells and non-tested antibodies make this figure off by between 50 and 300%. His 30% IFR may be at the higher end of estimates, but very few people who aren't hell-bent on pushing an elimination strategy would be uncomfortable with saying that at least 15% of us have been infected

 

[Tetchytyke]

His major points are backed up by sources.

Is it peer reviewed? Are the sources peer reviewed?

I can use sources to show the Flying Spaghetti Monster is real...

I have no idea if he's right or wrong. But many epidemiologists say he is wrong. I am not an epidemiologist. Crucially, nor is he.

My opinion? If every country in the world is basically doing the same thing, then there must be something in it.

I'd dearly love for it all to be over too. But as we've seen, sticking our fingers in our ears and pretending that there's no pandemic doesn't work.

Yes just like anyone would be happy to be paid to sit at home, just like many were (and in some cases still are being).

The ones being "paid to sit at home" are the ones whose jobs are at risk. They are at home because there is no work for them. And if there is no work for them, either furlough money supports them or welfare benefits do.

Would you want to be at home on reduced pay, worrying about whether you have a job to go back to?

there are better things than lockdown for protecting the vulnerable

Such as?

 

[AndyY]

Can you quantify these statements with numbers, please? 'Starting to get overwhelmed' is a somewhat vague statement.

This is way out of order. Does one always need to include thorough internet research before one can make a post here? Do you stick to this standard with your every post perchance?
I know that you do not like what is going on, but denying ain't gonna make it go away.
Anyway, google is your friend.

https://www.bmj.com/content/371/bmj.m3977

Brant said that Liverpool’s hospital beds were already over 90% full, with covid-19 patients making up an increasing proportion of patients.

“Our acute hospital trusts have occupancy levels of covid positive patients of over 250,” he said. “At the current rate of increase, we would expect Liverpool to surpass the peak of the first wave probably within the next seven to 10 days.”

https://www.ft.com/content/53272e22-a42b-4f10-8744-004d0328fdfa

Liverpool is struggling to cope with a surge in coronavirus cases, with 95 per cent of intensive care beds in the city’s main hospitals full, according to two sources with direct knowledge of the situation.

Well when some politician said that Liverpool's hospitals were at 95% capacity, they were fact checked and it turns out its only 80%, which is lower than average for this time of year.

Source? I would trust the British medical journal much more than your facts checkers.

 

[takno]

This is way out of order. Does one always need to include thorough internet research before one can make a post here? Do you stick to this standard with your every post perchance?
I know that you do not like what is going on, but denying ain't gonna make it go away.
Anyway, google is your friend.

https://www.bmj.com/content/371/bmj.m3977

Brant said that Liverpool’s hospital beds were already over 90% full, with covid-19 patients making up an increasing proportion of patients.

“Our acute hospital trusts have occupancy levels of covid positive patients of over 250,” he said. “At the current rate of increase, we would expect Liverpool to surpass the peak of the first wave probably within the next seven to 10 days.”

https://www.ft.com/content/53272e22-a42b-4f10-8744-004d0328fdfa

Liverpool is struggling to cope with a surge in coronavirus cases, with 95 per cent of intensive care beds in the city’s main hospitals full, according to two sources with direct knowledge of the situation.



Source? I would trust the British medical journal much more than your facts checkers.

That's a BMJ article quoting without comment a politician from Liverpool City Council, who don't run the hospitals. You can trust who you want, but at the end of the day all you've done is reference an article that restates your original quote from the politician who appears to have got it wrong

 

[Bikeman78]

This is way out of order. Does one always need to include thorough internet research before one can make a post here? Do you stick to this standard with your every post perchance?
I know that you do not like what is going on, but denying ain't gonna make it go away.
Anyway, google is your friend.

https://www.bmj.com/content/371/bmj.m3977

Brant said that Liverpool’s hospital beds were already over 90% full, with covid-19 patients making up an increasing proportion of patients.

I wonder how full hospitals are normally? When mum fell off her bike she started off in intensive care and then moved to other wards as she recovered. All of them were pretty much full every time I visited.

 

[HSTEd]

In any case, I am doubtful about this herd immunity theory if there are people who managed to get it twice.

If reinfection was a significant problem we would have many many cases of it by now.

In biology for almost all rules there are exceptions.

 

[RuralRambler]

I wonder how full hospitals are normally? When mum fell off her bike she started off in intensive care and then moved to other wards as she recovered. All of them were pretty much full every time I visited.

ICU beds aren't left empty. Those with highest clinical need will be moved there if there are ICU beds available and moved back to "normal" wards if a more needy patient needs an ICU bed. Likewise, if someone on a ward "needs" an ICU bed but they're already occupied by patients with greater need, then that patient will stay on the normal ward. It's a very fluid situation. There's no point at all in having loads of empty ICU beds, hence why less "needy" patients are moved in when there's place if the clinicians think it appropriate, even if it's just to relieve pressure on the ward as someone on a ward with high needs will soak up nursing staff time etc.

In your Mum's case, they may have moved her from ICU or a ward earlier or later according to whether her ICU bed was needed for someone else.

 

[Freightmaster]

Another graph comparing current death rates (for the past 28 days in this case)
with the equivalent 28 day period back in March/April:

But people think that the NHS is about to be 'overwhelmed' within the next 7-10 days by a tsunami of ICU patients????









MARK

 

[Huntergreed]

A very minor point, but I’ve noticed my local news always announces deaths on social media as deaths “due to” the virus. I’ve tried to explain in the comments section that it’s actually with (past 28 days) and I’ve been called heartless, selfish and other names I cannot repeat on here. People don’t even want to hear the truth because it’s against their agenda/beliefs. What on Earth is going on?

 

[Richard Scott]

This is way out of order. Does one always need to include thorough internet research before one can make a post here? Do you stick to this standard with your every post perchance?

No it's not out of order it's a request for information. If a statement like that is made I'd just like to know statistics behind it. If someone asked me the same then I'd provide the info.

 

[DustyBin]

A very minor point, but I’ve noticed my local news always announces deaths on social media as deaths “due to” the virus. I’ve tried to explain in the comments section that it’s actually with (past 28 days) and I’ve been called heartless, selfish and other names I cannot repeat on here. People don’t even want to hear the truth because it’s against their agenda/beliefs. What on Earth is going on?

I’ve been banging that drum for months, is it ‘of’ or ‘with’ as the two are very different....

 

[kristiang85]

Is it peer reviewed? Are the sources peer reviewed?

I can use sources to show the Flying Spaghetti Monster is real...

I have no idea if he's right or wrong. But many epidemiologists say he is wrong. I am not an epidemiologist. Crucially, nor is he.

My opinion? If every country in the world is basically doing the same thing, then there must be something in it.

I'd dearly love for it all to be over too. But as we've seen, sticking our fingers in our ears and pretending that there's no pandemic doesn't work.

Yes what you say is true, but I know for a fact that some of the sources were peer reviewed, but I haven't checked them all. However, we should be discussing the content, not technicalities on where the academic process is at.

He might not be an epidemiologist, but then again Prof Neil Ferguson is, and his predictions have been wildly wrong for 20 years. Critical thinking can be performed without deep knowledge of the subject matter, though if you look at Yeadons CV he is very much up there. I personally would say immunology knowledge should be far more relevant in the middle of a pandemic than theoretical epidemiology right now.

Why are countries all doing the same thing? Well, there are wild conspiracy theories I don't believe. But I think it is a case of, forgive the term, governments following the herd. If they are wrong, they can just say its what everybody else was doing anyway, so they can't be held too culpable. Personally I think many western European governments do realise that they overestimated this disease, but they just can't admit it, as come the next elections voters will remember the huge recession, job losses, decline in living standards, decline in health care from non covid causes, etc and render them unelectable for a generation. Their only way out is to wait for the vaccine and claim the end of the pandemic was due to that, rather than natural immunity, and hope to avoid being crucified in a public inquiry. Its the only thing that can explain the blatent disregard of many actual facts by some quite intelligent people at the top of all this.

 

[birchesgreen]

A very minor point, but I’ve noticed my local news always announces deaths on social media as deaths “due to” the virus. I’ve tried to explain in the comments section that it’s actually with (past 28 days) and I’ve been called heartless, selfish and other names I cannot repeat on here. People don’t even want to hear the truth because it’s against their agenda/beliefs. What on Earth is going on?

Yes very strange, normally newspaper website comments sections are a haven of reasoned and fair debate.