Coronavirus

[Metalmicky]

30 years ago, you know people would have taken the advice on board and society would have continued to operate. Now social media knows better, people on it have more credence than official channels because they have more followers and likes.

If Stormzy started giving out COVID-19 advice it would resonate more with some people.

[SydneyRover]

apologies if already posted

''Scientists and medics are using this phrase a lot, and it means the highest potential rate of cases. For the UK, the peak is expected to fall in three months’ time, likely in the summer months, and tail off throughout the autumn, the government said. Vallance said that the UK is around four weeks behind Italy, where there have been 1,000 deaths and more than 15,000 cases. The peak also brings the biggest period of challenge for the NHS. There are 5,000 ventilated beds but the service is looking to increase that number. Without a cure, the main treatment is oxygen therapy, which can be provided through a mask, and the NHS is looking to increase supplies''

https://www.theguardian.com/world/2020/mar/12/uk-governments-coronavirus-advice-and-why-it-gave-it

[Metalmicky]

apologies if already posted

''Scientists and medics are using this phrase a lot, and it means the highest potential rate of cases. For the UK, the peak is expected to fall in three months’ time, likely in the summer months, and tail off throughout the autumn, the government said. Vallance said that the UK is around four weeks behind Italy, where there have been 1,000 deaths and more than 15,000 cases. The peak also brings the biggest period of challenge for the NHS. There are 5,000 ventilated beds but the service is looking to increase that number. Without a cure, the main treatment is oxygen therapy, which can be provided through a mask, and the NHS is looking to increase supplies''

https://www.theguardian.com/world/2020/mar/12/uk-governments-coronavirus-advice-and-why-it-gave-it

I wonder..... could this oxygen therapy be administered at home.... my Mum (now dead God bless her) spent many years using a nebuliser at home to breath in various drugs - this was twenty years ago, but the one she had was linked to a tank of oxygen...   

[Metalmicky]

Number of cases up to 798......

[big fat yorkshire pudding]

apologies if already posted

''Scientists and medics are using this phrase a lot, and it means the highest potential rate of cases. For the UK, the peak is expected to fall in three months’ time, likely in the summer months, and tail off throughout the autumn, the government said. Vallance said that the UK is around four weeks behind Italy, where there have been 1,000 deaths and more than 15,000 cases. The peak also brings the biggest period of challenge for the NHS. There are 5,000 ventilated beds but the service is looking to increase that number. Without a cure, the main treatment is oxygen therapy, which can be provided through a mask, and the NHS is looking to increase supplies''

https://www.theguardian.com/world/2020/mar/12/uk-governments-coronavirus-advice-and-why-it-gave-it

I wonder..... could this oxygen therapy be administered at home.... my Mum (now dead God bless her) spent many years using a nebuliser at home to breath in various drugs - this was twenty years ago, but the one she had was linked to a tank of oxygen...   

Fairly easy to have a nebuliser at home, I havent needed mine for 10 years now as my health is better, so it's also now defunct, but easy to use at home.

[Copps is Magic]

The case fatality rate from some countries based on existing data.

UK - 1.25%
South Korea - 0.84%
Netherlands - 0.62%
Germany - 0.22%

One of the things that has struck me so far is how the case mortality rate can differ based on location and time. In Wuhan as of Feb 1st it was 5.8% but 0.7% across the rest of China. Last I heard Italy is hovering at 5%. Demographics explain part of the difference, but it seems localised healthcare systems capacity to cope also make a significant difference.

Also read that at the height of the epidemic in China, only 5% of cases were recorded and diagnosed. The scientific lit seem to suggest around 80% of cases are mild (some undetectable) but alot of country specific data is suggestinging its much higher than that.

[Donnywolf]

Number of cases up to 798......

.... and does anyone know how many of the 798 have been cured and moved on

798
-10 (dead unfortunately)
------
788
- ??? ("got over it")
------

------

[Copps is Magic]

You aint 'cured', you build up an immunity and move on. I read something about the recovered rate a few days ago (forget where) but apparently most countries don't actually measure that, so don't be waiting.

[BillyStubbsTears]

I just can't see how non-intervention does anything other than increase the rate of infection in the near term.

This has the effect of bringing the peak forwards, when the objective is to delay the peak, and extend it over a longer period to give relief to the NHS.

Johnson is being led by Cummings and his nudge theory unit. The big idea is that "herd immunity" will be achieved , and the virus will peter out as more become resistant.

We have no idea that this new virus will behave in this way. The evidence to date is that strong interventions at the earliest point have delivered measurable results in China, South Korea and Singapore.

Why we should ignore the emerging evidence base to test an ungrounded theory is just perplexing.
For your consideration;
https://www.youtube.com/watch?v=GUzGVw_iacs

I respectfully disagree with most of that.

1) The primary aim is not to slow down the arrival of the peak. There IS some benefit to that (pushing the peak into a time when the weather is better so there are fewer other respiratory illnesses) but that is secondary. The primary aim is to SPREAD the peak. There will be a huge spike in cases at the time of the peak and the crucial thing is to try to spread that glut over as many weeks as possible. If we are going to end up with tens of millions of cases, you spread the peak by taking drastic action when the total number of cases is starting to rise towards 1million plus. Taking drastic action now won't help that. But it will stretch our stamina. Impose drastic measures for two months and maybe we can bear it. Impose them for 6 months and we'll break.

2) No-one that I have seen is taking about herd immunity. If they are, they want putting in a sealed box for the duration. Thereis no way of getting immunity to this virus short of getting the virus. In the absence of a vaccine, you are not going to get herd immunity without people succumbing to the virus, so that is self-defeating. Cummings is a megalomaniac, but he's not stupid on basic science, and that would be a very, very stupid thing to propose.

3) Yes, strong action has halted the spread of the virus. But as I say, can you keep that up for the long haul? I'm not convinced that China, Taiwan and Singapore can keep this under control when it is on the loose in the rest of the world. If they CAN, it will be by essentially isolating themselves from the world for a very long period (at least 12 months until there is a vaccine). Do you think we have the social or political will to do that, or the economic resilience to cope with the consequences of doing it?

4) As for your video, I gave up after 45 seconds. I have no axe to grid for Johnson, but a video that takes his words on "taking it on the chin" totally out of context (he went on to say that that is not what we should do) is not helping. It's playing politics. This is absolutely NOT the time for that. For the record, I'd say it was a very clumsy thing for Johnson to say and a sensible politician would not have said it. But to imply that this is our policy is, frankly, disgraceful. https://fullfact.org/health/boris-johnson-coronavirus-this-morning/

Albie

I apologise about point 2 above. I was wrong on that. I'd missed the herd immunity discussion. I've just heard the CSA talking about it on the radio. He seems to be saying it is possible to use that to slow and spread the peak.

Like you, I'd be very concerned if that is a result of Cummings pushing the CSA into taking that stand.

[BillyStubbsTears]

The case fatality rate from some countries based on existing data.

UK - 1.25%
South Korea - 0.84%
Netherlands - 0.62%
Germany - 0.22%

One of the things that has struck me so far is how the case mortality rate can differ based on location and time. In Wuhan as of Feb 1st it was 5.8% but 0.7% across the rest of China. Last I heard Italy is hovering at 5%. Demographics explain part of the difference, but it seems localised healthcare systems capacity to cope also make a significant difference.

Also read that at the height of the epidemic in China, only 5% of cases were recorded and diagnosed. The scientific lit seem to suggest around 80% of cases are mild (some undetectable) but alot of country specific data is suggestinging its much higher than that.

Copps.

Two points. Which act in opposite directions.

1) It's mostly inaccurate to base conclusions on fatality rates on recorded deaths/recorded cases. Because, as you say, the number of recorded cases is in general, a big underestimate of the actual number of cases. So if you DO do it that way, it tends to overestimate the death rate.

2) On the other hand, people don't die immediately when they get the virus. There's a delay of several days. So, when the number of cases is expanding rapidly, even if you know the actual number of cases now, you shouldn't calculate the death rate on recorded total deaths today/actual cases today. You should base it on recorded total deaths today/actual number of cases maybe a week ago. So the denominator is a lot smaller and the actual death rate a lot higher.

South Korea has tested a higher proportion of its population than anywhere. So they probably have the best estimate of total actual cases. And if you look at their recorded deaths/number of recorded cases a week ago, you get a death rate of about 1.1%. Accepting that they won't have picked up every case, that's probably a bit high. But it more or less agrees with what the experts are saying, that something around 1% or a bit less is what they expect. (And they will be doing FAR better modelling than my fag packet calcs here.)

It makes sense to plan for 1% and hope like hell that is pessimistic.

[albie]

BST,

Fair enough....it is changing rapidly and sometimes the news is behind the curve.

Cummings was meeting the big tech companies (the ones not clobbered in the budget) like Google to discuss working together on Coronavirus. This was just after Johnson did his press conference yesterday.

Cummings has been seeding the idea in soft media sources for the past few days (such as Robert Peston on Twitter).

Herd immunity is a reasonable observation applied to virus infections that behave like Flu. We do not know that is the case with Covid.

The issue is whether you think an early crossover to herd immunity is worth more than reaching that point at a later date. If you are smearing the peak and flattening the curve, you could argue that the later you reach that point, the better the management of the crises has been.

I agree with you about Johnson being quoted out of context in the video, but that was not the reason for posting it. The point is whether or not the UK is in front of the disease, or reactive.

BTW, when a link is posted it does not mean I agree with all of it. I rarely do, but sometimes there are other points of interest raised for debate.

[Copps is Magic]

The case fatality rate from some countries based on existing data.

UK - 1.25%
South Korea - 0.84%
Netherlands - 0.62%
Germany - 0.22%

One of the things that has struck me so far is how the case mortality rate can differ based on location and time. In Wuhan as of Feb 1st it was 5.8% but 0.7% across the rest of China. Last I heard Italy is hovering at 5%. Demographics explain part of the difference, but it seems localised healthcare systems capacity to cope also make a significant difference.

Also read that at the height of the epidemic in China, only 5% of cases were recorded and diagnosed. The scientific lit seem to suggest around 80% of cases are mild (some undetectable) but alot of country specific data is suggestinging its much higher than that.

Copps.

Two points. Which act in opposite directions.

1) It's mostly inaccurate to base conclusions on fatality rates on recorded deaths/recorded cases. Because, as you say, the number of recorded cases is in general, a big underestimate of the actual number of cases. So if you DO do it that way, it tends to overestimate the death rate.

2) On the other hand, people don't die immediately when they get the virus. There's a delay of several days. So, when the number of cases is expanding rapidly, even if you know the actual number of cases now, you shouldn't calculate the death rate on recorded total deaths today/actual cases today. You should base it on recorded total deaths today/actual number of cases maybe a week ago. So the denominator is a lot smaller and the actual death rate a lot higher.

South Korea has tested a higher proportion of its population than anywhere. So they probably have the best estimate of total actual cases. And if you look at their recorded deaths/number of recorded cases a week ago, you get a death rate of about 1.1%. Accepting that they won't have picked up every case, that's probably a bit high. But it more or less agrees with what the experts are saying, that something around 1% or a bit less is what they expect. (And they will be doing FAR better modelling than my fag packet calcs here.)

It makes sense to plan for 1% and hope like hell that is pessimistic.

Which is why I said case morality rate. They will work out the crude death rate eventually, and it will settle on a number.

The point for me is there are clear spatial and temporal differences case morality rates. I would defer to experts on why that is the case but it appears to be combition of a) evironmental/background factors (age, rate of smoking, underlying conditions etc.) and b) a peak in cases (i.e. Northern Italy, Wuhan) overwhelming the ability of healthcare services to offer intensive care.

Which seems to be justification for the flattening the curve approahcch.

[i_ateallthepies]

I was listening to a Radio 5 interview yesterday with some professor expert on disease and she spoke about herd immunity.  As I understand what she said was that herd immunity can't happen until the population at large has built up immunity from previous rounds of the disease and that with a new virus such as Covid 19 everyone in the population is 'naive' and has no immunity until they've had and recovered from the illness.  Herd immunity, therefore has no relevance to us for this crisis.

[ravenrover]

Can someone explain the difference between the symptoms of flu to those of  coronavirus?
Pre Christmas I had a temperature aches and a persistant cough and felt absolutely crap, I had had my annual flu jab in Octobe, lasted about 2 weeks put that down to flu or was I wrong?

[MachoMadness]

Coronavirus usually caused fever, a dry cough, and shortness of breath. Normal flu doesn't cause shortness of breath. It's when you get all 3 together that you should start to worry.

[Copps is Magic]

Can someone explain the difference between the symptoms of flu to those of  coronavirus?
Pre Christmas I had a temperature aches and a persistant cough and felt absolutely crap, I had had my annual flu jab in Octobe, lasted about 2 weeks put that down to flu or was I wrong?

The first recorded case outside of China was 14th Jan in Thailand.

[BillyStubbsTears]

I was listening to a Radio 5 interview yesterday with some professor expert on disease and she spoke about herd immunity.  As I understand what she said was that herd immunity can't happen until the population at large has built up immunity from previous rounds of the disease and that with a new virus such as Covid 19 everyone in the population is 'naive' and has no immunity until they've had and recovered from the illness.  Herd immunity, therefore has no relevance to us for this crisis.

Pies.

I'd also assumed that herd immunity couldn't be developed quickly enough to help out this time round.

If I understood the CSA today, I think the idea is that if enough fit and healthy people get C19 in the early days and develop immunity, they are not going to be vectors to transmit the virus later on. So that MAY slow the development of the inevitable peak,which is absolutely the outcome that we want.

It won't reduce the total numbers that get C19 but it is all about flattening the peak and I guess every potential gain helps.

[wilts rover]

A very worrying article on what might be the 'true' mortality rate - which I hope is wrong.

At the moment the mortality rate is taken as the percentage of people who die that day from the number of people who have the virus that day. The authors here have theorised that with an incubation period the 'true' death rate is the no of people who died compared with the no of cases up to 14 days earlier.

This gives a mortality rate of 5% to 20%. As I said I do hope they are wrong.

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30195-X/fulltext?fbclid=IwAR3OX6l3ZWRgecGAgZr0zGoBultIDZJnRa_w5aMulgy1G7NmuQZWeNwuirE

[Copps is Magic]

I mean, that is just one (extremely skewed in my opinion) way of looking at how you calculate a 'case morality rate'. The key is the last few lines of the first paragraph.

Notably, the full denominator remains unknown because asymptomatic cases or patients with very mild symptoms might not be tested and will not be identified. Such cases therefore cannot be included in the estimation of actual mortality rates, since actual estimates pertain to clinically apparent COVID-19 cases.

In plane speaking, this virus does not kill anywhere near 5-20% of people infected because we don't know how many people are infected.

[BillyStubbsTears]

Wilts.

That article is following the same principle that I said in point 2 here, albeit with a longer assumed time from infection to death.

https://www.drfc-vsc.co.uk/index.php?topic=275849.msg954585#msg954585

Two observations.

1) Since they ignore the issue I raised in point 1 of that post, their figures will be a gross overestimate.

2) Assuming the figures on deaths from China and SK, (which appear to have capped new cases) are correct, the MAXIMUM death rates there are about 1-4%. Not using that information in their analysis seems to me to be a gross oversight. To the point that that article is potentially dangerous. I regularly write and review technical papers and reports, and I do see some utter nonsense get through the review process. But in the current circumstances, I'm shocked that a journal as authoritative as The Lancet has allowed that article to be published.

It'll be interesting to see the responses it provokes from other epidemiology experts. 

[BillyStubbsTears]

I mean, that is just one (extremely skewed in my opinion) way of looking at how you calculate a 'case morality rate'. The key is the last few lines of the first paragraph.

Notably, the full denominator remains unknown because asymptomatic cases or patients with very mild symptoms might not be tested and will not be identified. Such cases therefore cannot be included in the estimation of actual mortality rates, since actual estimates pertain to clinically apparent COVID-19 cases.

In plane speaking, this virus does not kill anywhere near 5-20% of people infected because we don't know how many people are infected.

Precisely.

[ravenrover]

Coronavirus usually caused fever, a dry cough, and shortness of breath. Normal flu doesn't cause shortness of breath. It's when you get all 3 together that you should start to worry.

It does when you are asthmatic

[ravenrover]

Can someone explain the difference between the symptoms of flu to those of  coronavirus?
Pre Christmas I had a temperature aches and a persistant cough and felt absolutely crap, I had had my annual flu jab in Octobe, lasted about 2 weeks put that down to flu or was I wrong?

The first recorded case outside of China was 14th Jan in Thailand.

But of the symptoms are so flu like would they have known before that date? When did the Health Organisations identify it as a new strain of virus And do we really trust the Chinese Government as to when it all kicked off in China in the 1st place? Let alone the actual numbers of people suffering or carrying the illness?

[BillyStubbsTears]

This is an excellent summary of the dilemma for Government in trying to judge the right response.

https://mobile.twitter.com/sjwrenlewis/status/1238579640513564676

By the way, Wren-Lewis is in no way a patsy of this Government. He's been excoriating in his criticism of the economic policy of the past ten years (he's a globally leading macroeconomist). But this is essential reading for everyone. No-one knows what the "right" response is. There are too many variables that we don't understand to be able to say "do THIS and you will minimise the worst effects."

I hope and trust that our Govt and scientific advisers are making honest attempts to do the best they can.

[wilts rover]

Yesterday Johnson said there was no good reason for banning mass events and public gatherings as the science did not show this would be effective at halting the spread of the virus.

This evening Trump threatened to stop flights to the UK.

Johnson has just announced the UK will be banning mass gatherings from next week.

Good job he follows the evidence to make his policies ehh.

https://www.theguardian.com/world/2020/mar/13/uk-to-ban-mass-gatherings-in-coronavirus-u-turn

[SydneyRover]

Can someone explain the difference between the symptoms of flu to those of  coronavirus?
Pre Christmas I had a temperature aches and a persistant cough and felt absolutely crap, I had had my annual flu jab in Octobe, lasted about 2 weeks put that down to flu or was I wrong?

Major signs from contracting Covid 19 are your face turns bright orange and you start rambling and babbling   

[Bristol Red Rover]

One possible important factor to consider is the amount of infected people with no symptoms at all. I heard today on the radio via some doc that on that cruise ship it was around 50% of those testing positive that had no symptoms. And then many with mild symptoms. If true, and it makes sense, the death rates are currently very over estiimated. I'm guessing most of the current confirmed cases in the UK, and elsewhere, are ones that are fairly serious.

Still a heck of a lot of people will die.

[albie]

I have a difficulty with the assertion that policy is being "guided by the science" when that same policy is not open about the data which is informing decision makers.

The best way is to encourage discussion and potential disagreement by full disclosure. The scientific community can then make an informed view on the basis of common data assumptions.

Peer review is key to decision making in science. It is not a question of trust the CMO, or the CSO, it is a matter of critical assessment of the available evidence, as it changes across time and location.

Here is a pointer from Anthony Costello, ex WHO, about problem areas;
https://threadreaderapp.com/thread/1238425621375651840.html

No more briefings from Johnson, please......experts only, open about their disagreements.
BJ and Cummings have no democratic mandate for there current strategy devised inside a closed system.

[SydneyRover]

What a f***ing weasel, it's hard to believe this man belongs to the same species as the rest of us?

https://www.theguardian.com/us-news/video/2020/mar/13/coronavirus-trump-slams-reporter-for-nasty-question-over-pandemic-response-team-video

[wilts rover]

Lol

https://mobile.twitter.com/DailyMail/status/1238542657825263616