UKH

Ive just listened to Stuart Rose of various retailers fame this morning; he is a staunch proponent of getting folks back in action, back to the office and treat the virus as background noise and something we need to 'live with'.

Looking at the figures on Worldometer yesterday, the reported infections was the greatest single day since this started. France had another shocker, we have reduced figures but still over 100k. Over 300 deaths from COVID from the last 28 days reported infection. The UK economy has bounced back, if the headline figures are to be believed.

I'm conflicted. We as a family have been pretty sensible throughout but we have seen many others be the complete opposite. I had my second trip to London since Jan yesterday. The train to London, usually packed at that time, 6am, was almost empty. That said, me and the others I saw were mask wearing. Apart from a moment of drinking my coffee, I was masked up from entering the national rail station until leaving Moorgate station. Most on the tube were wearing masks but the carriages were nowhere near capacity. I walked around near the office in central London to get lunch, many shops were closed and up for rent, many offices were partially empty and available for rent. In the cafes etc, 30% mask wearing.

I went out after work for a few (non-alcoholic) drinks in Leadenhall Market. The pub itself was rammed, not a single mask. The tube, 50% masks, the LNER train back at 9pm which is normally quite busy, almost empty, 50% masks. Irrelevant really, given I was sardined in the pubs/restaurants.

When the infections kicked off, we would have be shocked that more than 300 deaths had occurred and more than 100k cases, especially on consecutive days. This barely gets a mention now. France's cases are massive, as is the rest of the EU and the world, hardly a mention.

All restrictions are to be removed next week across all UK nations. We need to get people back into offices for city centre cafes and shops to survive and reopen, for rail services to be sustainable. Central London shouldnt be like I have seen it on my last two journeys.

As I said, I am conflicted and just trying to reconcile the background figures to where we are now. Are we at the point where we are now going to have to live with this and the NHS is no longer under pressure. Are we supposed to accept the deaths now. The govt, the opposition, Stuart Rose, are all saying we must crack on, which seems to be what will happen after next week. Compliance to measures is now patchy and inconsistent at best. The economy is 'healthly'. I want normality but dont want my elderly mum to die, to be collateral damage in 'living with the virus'. And this is while our govt is all over the place and Putin is limbering up for a scrap. And Meat Loaf is brown bread- RiP.

Im not looking for answers, just making sense of a weird week. 

My take on this.

Part of moving on is going to be understanding the context for where Covid deaths now fall.  

Part of the trouble with gaining this understanding is that the initial viral infection leading to a pneumonia infection and death has not been robustly measured and recorded for most victims of winter respiratory deaths  pre-covid.  

A few hundred deaths a day from respiratory illness isn't at all unusual looking at past winter seasons from the last 20 years. It's also not unusual that the impact of this stresses the NHS to the point that normal service delivery levels are quite impacted.

I doubt many people reading this thread felt at all bad about going to the pub in a flu season when hospital patients were being kept in beds in corridors and - a few times - plans were being drawn up for tent based treatment centres in car parks, and when several hundred people a day were dying eventually of pneumonia.

It turns out we could have used weaker control measures than for Covid to prevent much of this - some social distancing, isolation of infectious individuals, some masks, improved ventilation etc.  Perhaps half a million lives could have been significantly lengthened over the last couple of decades through this.  

So, we sit at a crossroads:

• Do we go back to how it was, and add endemic Covid to the list of things most of us pretend don't exist except when struggling hospitals make the news (as they have in many winters pre-Covid)
• Do we collectively move the other way, and put other respiratory viruses on to the list of diseases we try and control more?

In terms of this question:

The NHS is under far more pressure than Covid; various different measures of service delivery have been worsening for around a decade now.  The causes of those problems aren't going to go away when Covid does.  Covid has massively accelerated the effects of some of those pressures I think.  IMO the focus needs to rapidly shift from blaming Covid to looking at other sources of pressure over which we have far more control, and that have far more scope for improvement,

You took the words right out of my mouth

The concern is we're just past the absolute peak *with* restrictions in place. "Letting it rip" now, in mid-winter just feels to me like a very very crap idea.

I’m struggling to reconcile everything and reckon Covid has had quite a big negative impact on my mental health. Some stuff:

1. Wigan has been badly hit with high death rates.  2. My work has meant Ive been dealing with it. 3. My mum is top level vulnerable. 4. My children have suffered - both at Uni when it kicked off, one jacked it in (probs wasn’t cut out for it tbh but he’s admitted he’s had stuck at it if it wasn’t for Covid). 5. Saw my brothers and their children and their children over Xmas - first time in 2 years - and it felt very odd, like we’ve grown apart coz we’ve not seen each other. 6. Similar with my in-laws in Scotland (and Sturgeon has done a good job of frightening the hell out of some people resulting in them making stupid rash decisions based on fear). 7. I know organisations and individuals who are still mainly/solely working from home but they are no where near as effective. 8. And as a total guess I reckon we will be living with daily covid deaths in the very low hundreds during peak times (and I reckon one reason many of us have become battle hardened to this is because we think the vast majority of these people are voluntarily in-jabbed so limited sympathy). 
 

Edit: and I’ve taken too many photos !

My other conflicted thinking with the "end of the pandemic", whether that is now or in the future, is do we want to go back to normal? I get that for the economy, under the model we had built it to be previously, we need people in offices and coffee shops etc. However, people have gained much more free time/ time with family and pets etc without having to commute and many are happy working from home. It is healthier for people to have more time in their day to exercise, cook properly and eat with their loved ones. Coffee shops and cafes are not healthy places to be eating every day. I never have, and never will, do an office job. I can sit at home and do computer work (I have done for various different jobs), but an office would be my actual idea of hell!!

So towns feel pretty dire just now, but even pre-covid the non-food shops were going bust anyway. I think there needs to be a radical rethink about what we actually need in town centers, what sort of businesses and economy works for us with where we are now and how can people actually live more fulfilling lives. I don't have the answers, but I know a lot of people have used the pandemic to reflect on what they were doing before and what they actually want out of life now. 

Trying to bring in rolling mandates for distancing and masks to control every transmissible, endemic illness forevermore is ridiculous. I'm not putting up with being told to mask up every winter (or more) because it might conceivably protect someone, somewhere from something I may or may not have.

Back to normal thanks. The farce has gone on long enough. People are welcome to protect themselves as they see fit, but enough with forcing person A to do something to protect person B, when person B has plenty of options to protect themselves. I knew this faulty thinking would permeate with the 'protect others not yourself' messaging.

You always get just to the cusp of accepting the situation, making perfect sense with the need to accept endemic status and allow natural infection/immunity cycles, then come out with this sort of suggestion. I don't actually want to spend the rest of my life thinking about, and having constant reminders of, mostly mild transmissible diseases. One day I will be in the more vulnerable category myself, and I will not expect people around me to keep distance and mask to potentially extend my life. It's a ridiculous way to think and an unreasonable expectation.

I have some  empathy with this. But, whilst it is imperative that I don't walk into a busy road to protect myself from being killed, it is also incumbent upon drivers not to traverse the paths where pedestrians walk so as not to kill them when they are taking their own sensible precautions.

When I'm older and vulnerable, is it just common decency that people try their best to protect me or do I have to exclude myself from society. Is that reasonable?

Then again, I went to rammed bar yesterday and I could feel some of my colleagues spitting on me as they strained to speak to me above the noise. I don't like this at the best of times but now (plus I was on alcohol free in a pub).....yet I was personally annoyed that I wore my mask in an almost empty shop the day before when others were mask-less. I am fully aware of the obvious hypocrisy/ridiculousness of this. As I say, very conflicted about a lot of stuff at the moment, and I echo Clingers post above who said that their mental health and other personal circumstances have been affected by stealth as a result of COVID.

If I had to place my current view, I am probably (and sadly) at 51/49 for cracking on whereas this time last year I would have been 90/10 for maintaining restrictions.

Did I say we should have rolling mandates for distancing and masks?

No.  I did not.  

You just made that up.

I've never had a problem with accepting where we have to go - I've been clear on this against people pushing always for more control measures, regardless.  I've just had no time for people pushing for us to get there way, way, way too fast by misrepresenting the risks as being only direct/immediate.

Yes, it's the only way forwards

No, I did not come out with this sort of suggestion.  You made it up.  

I gave a question with two opposing solutions.  These are the options on the table, the directions we could move in.  I posted it as a question.  I didn't suggest one answer.

You have decided I want to do one of the answers and not the other.  I did not state a view either way.  You even went as far as quoting only one of my two possible directions for us to move in.

I was illustrating that we have an increasingly unintegrated view of Covid vs other diseases, and that we need to integrate our approach as we move to the endemic status.  I noted that this could go in one of two ways.  I did not specifiy which direction I think we should move in.

You have then gone further down a rabbit hole of deciding how you think I want to implement that one solution.

What I've actually said on other threads is

1. How I think we can use the viral surveillance infrastructure built for Covid and technology to give high risk individuals a much better understanding of their local (regionally and in time) risk factors to allow them to take much more informed control of protecting their health against the whole gamut of endemic winter reapers, in to which we fold Covid.
2. How ventilation can be improved in various locations to better protect the vulnerable without requiring NPIs like masking etc.

There is no conflict between accepting endemic Covid and wanting to do more to protect the more vulnerable - and indeed healthcare - and to extend this to all endemic diseases.  I've not once called for adopting measures like masks or social distancing for control of endemic diseases beyond Covid.  That's in your head.  Still, I think we could all be accepting that if a vulnerable person wants to wear an FFP2/FFP3 mask in a shop or on a bus, that's their - highly effective - choice.  
 

I said we *could* have used some of these measures against flu in past years to frame the question and to point out to the OP that the situation we are moving to is one we always accepted before now.  I didn’t say we should, going forwards.  I left an open question.

From a personal point of view, I want my children to grow up without the restrictions: having trips and camping and residentials and all the things they would have had before covid starting closing things down. I want them to learn to naturally hug their friends when they all feel like it, and go into places with crowds. My Mum's not alive anymore, but my Dad and my in-laws (in their 80s) agree that this is their priority too.

That said, I trust the experts and follow the rules & guidelines that are given. I don't feel in any way qualified to say which approach we should be taking now so I am just going along with it.

Edit: and I’ve taken too many photos !

Aye, but some of them were real crackers.

If people can get away with it, I think a majority wouldn't wear masks. Now they're no longer compulsory I'd wager a 95% drop in their usage as we saw previously. 

They were supposed to be worn in the climbing walls I go to when you weren't climbing but no one did. People would find any old excuse not to wear them. It ended up being that you had to wear a mask unless you were climbing, belaying, actively recovering, eating or drinking. Sooooooo never then?

It must have been while you were kissing me 💋

(Apologies. Just seemed apt today).

glad someone picked it up

I think you have fairly well summarised a lot of people's feelings of unease. This phase of the pandemic seems very odd and uncomfortable as you realise the rules are probably not really going to keep you totally safe and now it really is just down to your own personal appetite for risk and what you want to do.

Personally, we are in a fairly safe position being a household of 2 homeworkers with no kids. With the high case number, we could choose to hide away but have kind of taken the attitude of let's keep the minimal protections measures, hope our vaccines are effective, and get on with life. So yes I have been to a few reasonably busy pubs but we do still put our masks on public transport. Yes this sometimes feels a bit silly as have been in a pub (risky for Covid) but then take the precaution of masking up on the train (probably less risky). My take is that it just lowers my overall risk by a bit, by making my interactions with the people on the train safer. On a societal level this lowers R a bit and so the spread protecting others and on a personal level decreases my risk of getting ill. I could choose to reduce my risk further by not going out (self-imposed lockdown) but that wouldn't be much fun. To put it another way, I'm happy to put up with the minor inconvenience of wearing a mask on the train but draw the line at straining my pint through it.

I am hoping others have similar attitudes and we can generally keep the level of respiratory viruses down which in turn will protect the vulnerable and health service but not at the detriment of all activities. 

I think your approach is sensible but more so because it's not selfish. 

If one was in a shop or on public transport, they should wear a mask not for themselves but for others. Steve who lives 5 miles away from his minimum wage job doesn't have much choice to work from home and he doesn't have a car so he's on the bus. It's not really fair on him for other people to be applying their own 'personal appetite for risk' to him. Same in shops (and really, any staffed venue). 

I think a lot of people forget that some people don't have a choice whether they're in those places or not. 

"It turns out we could have used weaker control measures than for Covid to prevent much of this - some social distancing, isolation of infectious individuals, some masks, improved ventilation etc."

"Do we collectively move the other way, and put other respiratory viruses on to the list of diseases we try and control more?"

Let's not be overblown, you are suggesting this is a potentially viable and acceptable alternative or you wouldn't have mentioned these points in the same post. I'm not accusing you of saying "this is definitively the way we should go". It's a bit ridiculous to try and make it seem like I'm pulling things out of thin air. You posed two options and didn't say which you prefer, suggesting you'd be potentially on board with either. I'm clearly against the latter option. I'm not trying to misrepresent you, that's what I inferred that you were getting at in terms of doing more to control non-covid diseases.

Then we are largely in agreement; as long as the viral surveillance isn't mandated and invasive. These are ideas we could have brought in far earlier than we did. I was personally arguing for use of FFP2 and FFP3 masks to get us out of the first lockdown, but I was promptly shouted down by the UKC mob because "non-medically trained persons can't be trusted to fit them properly and as such they would be even less effective than cloth masks". Now they are "a highly effective choice", *sigh*

Then you have grossly misunderstood my intent, and jumped to a wrong conclusion, and then said I called for future measures that I most definitely did not.

It's ironic how badly you're going off the deep end in the wrong direction to what my intent actually was...

By making the point that we could have done more in the past to prevent a similar level of deaths on a regular basis, I am also making the case that we did not.  I am making the case that people who are not comfortable with the current situation used to be perfectly comfortable with something analogous happening year, after year, after year.  The consequences for healthcare would be reported in the news, and people continued to not care.  In getting people to contemplate those two opposing ways forwards, I hoped some people might think a bit about how disproportionate it would be to use more control measures now to reduce deaths, compared to what they have been happy to do for the last 20 years pre-covid.

But you didn't look at the two options I gave - one very aligned to your way of thinking, you just went overboard on the other one that's opposed to it.  

Of course, the real way forwards sits somewhere in the middle of the two options I posed.  There are lessons from each side that we can use to find a new path forwards.  As girlymonkey said, for many people more WFH brings a lot of quality of life improvements and indeed health improvements.  Sorting out bad air in workplaces, households and hospitals etc seems like an absolute no brainer.  

It's worth thinking about endemic circulation.  Endemic exposure too many things becomes an increasingly bad idea as people become increasingly old and especially as they accumulate other morbidities along the way, and is a major accelerator of all cause mortality.  Scientifically and medically we're a long way from it being sane or safe to stop endemic circulation of many "mostly harmless" viruses in younger people, but that's not to say we can't control them to our advantage.  It turns out we can shift the season that what were previously assumed to be "winter" viruses like RSV land it, it turns out we can create areas with much safer air handling, it turns out we can allow the vulnerable to protect themselves far better than typically they have.  Control doesn't mean "eliminate" or "hold low".    There's a world of middle ground.

I don't recall that discussion; I think early on in 2020 household mixing outside of rules could have been a major problem if the strict lockdown was lifted; and I seem to recall availability of FFP2/3 masks was almost non existent.  Thee is now robust evidence - that there wasn't at the time - comparing poorly fit FFP2/3 masks and cloth masks which is a big step forwards.  

I also think we could rethink our approach to normal respiratory infections without too much disruption. Maybe we could me more willing to stay at home with bad colds, or wear a mask if you have to go out when you have a cold?

I remember being really annoyed, long time pre-covid, when I got a bad cough and cold from a child in the climbing wall who should just never have been there. Due to her cold, she wasn't able to concentrate as well as normal so I had to work much more closely with her than normal. So she didn't have a fun session because she felt crap, she was less safe because she felt crap, and she passed it onto me so I felt crap and also couldn't go to see my dad who had asbestos cancer so couldn't help my mum out!! If her parents had just kept her home that week, it would have been better for everyone! 

I hope this time will have us re-evaluating whether turning up somewhere just because you are not physically incapable of doing so is a good idea. 

As you say, it doesn't need to be full lockdowns every winter, but a change in attitude towards our own and other people's wellbeing as well as changes to working habits and environments could all make a huge difference.

We should all remember that the level of controls (before Wednesday) was to avoid the potential complete overload of the NHS. Once that danger was considered gone, those controls could be removed. The purpose of the controls was NOT for our personal safety (this Tory government have never been bothered about other people's personal risk), and individual risk with Covid still remains even though the societal risk now seems to be very much on the wane.

Hopefully, individual risk is also rapidly decreasing but it has not yet gone.

Of course, the fact that the lifting of controls announcement was in the middle of Boris's leadership crisis and that this might have helped increase support amongst wavering Tory MPs is entirely co-incidental. I have not even a smidgen of suspicion that this was the aim of announcing at that time (why has my nose just grown longer - I'm a real boy 😁) 

Sigh all you like, you're grossly misrepresenting the argument from early 2020.

PPE standards for clinical staff treating suspected covid patients were downgraded from FFP3 to surgical masks because there were no FFP3 or FFP2 masks to be had. The arguments you refer to were people pointing this out and suggesting what stocks were available should be reserved for clinicians.

On a personal level this is no problem, I mean who wants to drag themselves to work when they feel under the weather? However you have a cohort of people looking for any excuse to not come into work, I could see a lot of people taking advantage of this new found acceptance of staying home.

As long as this is down to individuals, fine, no more forcing though.

Definitely the 'drag yourself into work no matter what' culture we had pre-covid wasn't really very beneficial to anyone and I'd welcome a bit of a re-adjustment in the other direction, on a purely voluntary basis of course. We don't need mandatory 5 days off for the sniffles.

No I'm relaying an exact argument that was used against me on several occasions to my suggestion of dropping lockdown in favour of using PPE. I'm not going to rehash the whole argument again, but there's no-way it would have cost more to get the vulnerable a FFP3 mask over locking down more or less the whole country.

I understand and remember vividly the "unavailability of PPE" argument, that was a separate issue.

And just as its meant to be safer, I catch bloody Covid.....

It wasn't a separate issue. You can't drop lock down by simply issuing non-existent supplies of FFP3 respirators. 

No no, keep taking them and posting them, they do me good and doubtless others too.

Yes you make a very good point about the rules not being for personal safety but protecting healthcare. However, I think most people took some comfort in following them felt like they were doing the right thing. Now with the obvious political influences on some of the changes, it feels more confusing on what to do for the best both personally and for society. I certainly feel a little angst about are my actions the right ones.

Anyway obviously spoke too soon as just got pinged from the app (who knew that still worked) from Wednesday's Pub trip. Thankfully fully jabbed up so just more lateral flow testing.  Managed to avoid getting pinged previously so this is my first personal vaccine challenge trial, lets hope I build some decent immunity.   

3 minutes until you replied- you were like a bat out of hell with that post!

Mixed feelings here too.

Having lived like hermits for nearly two years we've been gradually starting to have the odd meal and beers out. Kinda figure 3 jabs and as we're just over & under 50 life is too short to hide away forever.  Plus we both get so much out of seeing other humans I just feel the risk is very much worth it.

I've two very vulnerable family members, one with multiple health issues and another that's immunosuppressed due to cancer treatment. I'll remain very very paranoid around them and test before visiting or avoid other humans before seeing them if free testing stops.  

Personally I'll continue to wear a mask in crowded areas when/if we're ever allowed not to wear them in Scotland. Right now it's still law here. It's a really very minor inconvenience though. I'll definitely be wearing a mask on public transport, flights etc and probably for the rest of my life. 

Personally,  I don't think anything will ever be totally "normal" again.

Without covid I'd still be working in an office and living in a city.  We moved last year and both now have permanent WFH contracts and live in the Highlands where had we wanted to be for a long time. It's not all bad 😀

Foe crying out loud. That's fast.

Thank you for this rational and proportionate response.

Yes, now that there is no capacity for unconstrained exponential growth of infection in many people highly susceptible to severe illness, hospitalisation and death at 10x (or more) their pre-covid all cause rates, entirely thanks to widespread public engagement with a highly successful vaccination program that moved people out of the dangerous immune-naive regime without the disproportionate mortality risk of a “virgin” covid infection, things have moved on and it’s finally proportional rather than incredibly dishonest to start comparing the situation with pre-covid endemic viruses.

Just to be 100% clear.

Edit: the situation still isn’t fully comparable as the oldest people now alive will never mount as strong and enduring a response to the virus as if they’d been exposed 20 years younger, I think.

There is also now much more clarity over the nature of COVID 19. People are increasingly aware of the evolutionary potential of this virus and the fact that selective pressure can only ever favour more transmissible (and therefore probably more benign) variants. This allows a more rational, less emotional public response. There is also a better understanding of the essential role of natural immunity and the limits of a globally effective vaccination campaign. 

And there is a growing realisation that vulnerable people have always faced risk from respiratory diseases and that health services have always periodically struggled to contain them.

As such, the paranoia which accompanied the early stages of the pandemic thankfully seems to have subsided in the UK (although it is still apparent elsewhere in Europe). 

I'm glad to see your posts increasingly reflect these realities. It gives me hope for the future.

You appear to be suggesting that preserving universal healthcare and avoiding 500,000 deaths and several million debilitating illness and hospitalisation in 3 months was “emotional” and not “rational”.

What a strange world you must inhabit.

I see you’re as full of absolute shit as ever. 

I have always recognised the reality.  

You can tell because my interpretation and thoughts on what is appropriate at any one moment have changed as the reality changes - particularly in terms of the data on the effects of vaccination.  I haven’t forgotten the various nonsense reasons and spectacularly misinformed takes on statistics you have used to argue against vaccination.

You on the other hand have consistently denied the reality.  The day was always coming when you would be right, just like a broken clock, but it doesn’t make your views of the past accurate or rational.

I don’t have all that much control over the future, certainly not over public health policy…

True, but when someone who has decided to devote a very large part of their life to documenting and commenting the COVID pandemic starts to provide reassurance to people you are still anxious, it feels hopeful that we may be approaching the end of this crisis.

I am delighted that you no longer view this as a weakness to be exploited!

I hate to break it to you, but this hasn't been a large part of my life.  If I look back on the time since Covid landed, I've devoted 10x as much energy to another new endeavour in life, and I'm happy with what that's achieving.  I've also spent more time gardening than on Covid...  

I have no idea what you think you're on about here.  I can't make head nor tail of it.

It's clear to anyone with eyes that the situation now is utterly incomparable to the situation 22 months ago, and I would hope it's clear to anyone paying attention that the correct policy choices in a given moment depend significantly on the situation in that moment, and it's trajectory.

Cmon Wintertree, you have consistently been number 1 poster on UKC for well over a year (perhaps less in recent weeks, I haven't been connecting) and have spent a significant amount of time analysing the situation and providing us with graphics. We're now on thread number 60-something. A lot of people appreciate your considerable efforts.

The situation has been evolving continually over that period as more and more data has become available. My arguments have evolved accordingly. I think you used the term 'shape-shifting' to describe this.

That said, all the points made in my 15.14 post have been true since the start of the pandemic. 

While taking on board your general point about being over protective. I would say that the whole point of a society is to protect others. We already have MOT's for cars stop us killing others with dodgy vehicles as an example. The onus should not always be on the vulnerable to protect themselves, that's a very selfish way of thinking.

I've not consistently been number 1 - and I think my post count is well below what would have fallen as top 5 a few years ago.

Like I said, I've put far, far more effort in to other endeavours than I have in to Covid data over the last 2 years;' endeavours that have a useful future unlike the Covid stuff, and that have consumed far, far more of my time.  The Covid data is something of a downtime activity when I need a break.

You said:

Claiming this held at the start of the pandemic is utter bullshit.  Uncontrolled Covid would have been orders of magnitude worse in terms of individual risk and healthcare pressure than the occasional bad influenza season.  You can tell, because influenza hasn't killed half a million people in a few months in over a century, and we know how many died of Covid in wave 1, and we know what fraction of the population was exposed (from seroprevalence) and we can do the maths and see just how bad this would have been.

I don't understand how you can build a bubble so utterly impenetrable of even the most basic fag-packet arithmetic.

You do shape shift.  You appear to have argued against control measures, vaccination, you name it, from the start.

The reason I say that you "shape shift" rather than recognise that evolve your position on what is right in present state  is that you shed accounts and crop back up with new ones, dissociated from what you've previously said, protecting yourself from the consequences of your previous views having been shown to be utter garbage by the evolving situation.  You've gone as far as admitting you've deliberately solicited bans to end some accounts, but you won't tell us which previous identities were yours, so I am left making some supposition here.  Help me out and let me know your previous account's identities and the content of any deleted threads and I'll be only to happy to apologies here if I'm wrong.

Wintertree, please don't argue just for the sake of it. Remember I started this exchange by thanking you for your initial post.

You said: "A few hundred deaths a day from respiratory illness isn't at all unusual [...]. It's also not unusual that the impact of this stresses the NHS [...]."

I replied: "there is a growing realisation that vulnerable people have always faced risk from respiratory diseases and that health services have always periodically struggled to contain them."

Now you are contesting my statement, despite the fact that we so obviously agree!

Admittedly, a year ago, these very same statements would have had us labelled as COVID-deniers and perhaps even warranted us a ban. Thankfully times have changed.

I'm not.  I disagree with you, because I feel strongly that you are as wrong as you ever were.  You are however trying to present yourself as right by selective quoting.   Let me illustrate what I mean - unusually you're selectively quoting yourself this time...:

I am not contesting your statement.  You only gave one of the two paragraphs.  I clearly replied to both.  Let me repeat them

I've put a bit in bold.  The risk of illness, death and pressure on healthcare in the early stages the pandemic was completely off-the-scales incomparable to the usual risks for vulnerable people and the usual pressure that puts on healthcare.  Utterly, utterly incomparable.  We were facing a situation more than 10x worse than the worst flu seasons, which themselves put healthcare under immense pressure.  

Thankfully vaccination - something I suggest you and your previous accounts have sought to undermine - has delivered us from that world of unmanageable risk to one we can manage.  

A year ago, claiming that the situation as-was in any way resembled typical winter respiratory pressures on healthcare was to deny the reality of our situation.  Clearly one might be labelled accordingly.  Of course, you won't tell us who you were back then, will you?  Seems rather cowardly and dishonest to me to make claims about conversations you won't reveal your hand in.

I suspect your bans were on conduct grounds rather than what you said.  Tell us your previous account names and prove me wrong.

I once had an unfortunate patient who was very ill as a result of weeks and weeks of chronic constipation, to the extent that their breathing was restricted by upwards pressure on their diaphragm and a scan showed their kidneys as flattened discs.

They still weren’t as full of shit as you evidently are.

The old normal has gone; doesn't matter how much people want to return to it.  There will be a new normal but the problem we have now is that we don't know what it will be.  It's going to take time to get there and the process can't be hurried.  It can, and will, be slowed down; another variant might yet have offices empty, people working from home, the economy tanked again and several political careers gone with it.

If you you're going to follow the science, you can't pick and choose which bits you listen to.  Except, that seems to be what's happening; don't like what it's telling us and we're all bored with it now, let's ignore it and rush back to where we used to be.  It'd be pathetic if it wasn't simultaneously so risky.

I'm not going to stop wearing a mask anytime soon.

T.

Remember back in the early days of Oureed when one of my posts was taken down because I said that mob dynamics were at play in that particular thread (and they most definitely were!). In the same thread someone accused me of lying about my son being disabled and I actually had to contact the mods before they acted upon it. I have always been genuinely surprised at what merits a ban and what is deemed acceptable...

It’s hard to know without access to the site owner’s privileged view and without knowing your previous identities, but I’m pretty confident your past bans are not for the reasons you think.  

>  and I actually had to contact the mods before they acted upon it. 

Yes, that is how it works.  UKC is not a massive organisation, and the forums are but one small part of it.  Forum content is reactively moderated, and if nobody reacts…

I don’t recall the accusation you mention - but then I wouldn’t if it was deleted.  I do remember a poster really rather misunderstanding the context of someone else’s comment and randomly bringing their disabled son in to it, but we all have Those Days.

I guess your kids aren't "mouth-breathing imbeciles" then! I am happy for you.

Not my argument, not my thread, not my post.  I’ve just gone back to re read it all, a very bizarre direction it took there.  You’re the one that brought your child in to the thread, nobody else did.  You’ll not that I had a post deleted and I haven’t once (let alone ten times) complained that it was an Orwellian attempt to silence me.

Never said it was. Just suggested that if you don't realise how offensive "mouth-breathing imbecile" can be, it's probably because your kids would never be described in that way. I'm genuinely happy for you. I do realize that it's become a popular and cool insult to throw around, but maybe people should think about what they're saying, that's all.

Good point. There are too many snowflakes around nowadays for an honest discussion.

The problem I have is that the seemingly soft call to "change our attitude to our own and other's wellbeing" seems to have become a license to call anyone who doesn't wish to conform with these impositions a cvnt.

Be it having the label of anti-vaxer attached to you, general social opprobrium for being seen without a mask or uttering a cough, threatened with having your job taken away, or accused of "killing grandma", this supposed collegiate and benign measure looks to have been seized by many to behave like monsters themselves.

When this all started there were near guarantees there would be no vaccine passports or mandatory vaccinations. And look where we have ended up?  We've set a precedent that has far-reaching consequences.  

I don't want anyone who is slightly ill to be treated a lepper or for us to behave in a way that marks them out. While I understand what you are hoping for, as an approach to the perfectly animal condition of being a little under the weather, I think the quantifiable positive impacts may well be diminished by the scale of unquantifiable qualitative detrimental impacts.  While subtle, masks, exclusion, fearfulness, paranoia, suspicion, and simply even lack of exposure, may be far more harmful to society at large.

Mondite, you are a pathetic, gobby bag of shite. Is that honest enough for you?

If true, it's easy to prove... just search and link the thread; speaking as someone who had flak here for promoting masks, I'd have some sympathy. You must at least have misremembered the timing, as given there were no large supplies of FFP3 masks available at the start of the pandemic, it would have been a pointless suggestion then.

In reply to wintertree

I doubt you have wasted any time on your hobbyist covid work... forum regulars will remember you for decades with gratitude for that. However, I am mystified why you are still bothering to spend time with detailed replies to oureed.

The situation has been evolving because a) societies took measures to control the virus spread and b) we got lucky in the speed of development and roll out of vaccinations.

Without these, any amount of extra data would only confirm that a lot, lot more people were suffering. 

'Are we at the point where we are now going to have to live with this...'

That would be my preferred approach!

Maybe when you were kissing him.

Oh, hang on. Wrong thread

I couldn't agree with you more.

During Boris's Brexit campaign, he swanned around in a bus which advertised the millions being spent each day on the EU.  He inferred that this money could be spent on funding the NHS.  Apart from the extra money which has been spent on PPE, overtime, and extra staffing etc.,  I wonder what money he has spent/invested  in  the NHS on capital projects.  Or was it all lies and bluster?

Me, myself and I...?

Graham, I've been travelling over 4 continents for the past 3 months for work. Some of the places I've visited have much lower vaccination rates than UK and have adopted very different containment strategies. The situation has been evolving everywhere. Many places are completely back to normal.

Ironically UKC's great guru of Covid is presently testing positive and isolating in his shed while wishing for a 'collective Darwin award' on the unvaccinated. My son also tested positive a couple of weeks ago and isolated with me, in my home, living life normally. I have yet to catch the disease.

There is no unique, proven strategy for dealing with Covid, neither on a societal level nor an individual level. 

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30457-6/...

You’re such an arsehole at misrepresenting me and implying things that aren’t true.  I wouldn’t normally call you an arsehole but after your comment to mondite…

As I was clear on the other thread, I’d been isolating at home for one reason only - to avoid the disruption caused by both adults in the house testing positive and having isolation requirements at the same time.  I could still enjoy lots of family time in the garden throughout, and it allowed us as parents to put the welfare of our children first, by always having an adult able to take them to school, to the park and so on.   That was our decision for our situation. I would never say it’s the appropriate option for others; everyone has to make their own call for their own situation.

There’s nothing ironic about me catching covid.  I guess you’ve had your usuals selective reading glasses on for the last six months.

> Some of the places I've visited have much lower vaccination rates than UK and have adopted very different containment strategies. The situation has been evolving everywhere. Many places are completely back to normal.

De-mo-gra-phics.  Of course many places have exited the pandemic phase; they have younger populations far less susceptible to Covid than ours, some have seen excess deaths that - demographically adjusted - would have meant over a million dead in the UK; some places have seen healthcare totally overwhelmed with people driving their dying partners round looking for hospital beds, begging and offering all the money they could.  Estimates for one place are now that 90% of deaths weren’t recorded things got so bad.

Your article is only about "reducing transmission of SARS-CoV-2". Isolating everyone in a glass tube with a controlled air supply and feeding them intravenously would get the best results. When "dealing with Covid", there are many other factors to take into consideration, immunity being one of these.

It's interesting that the tory government characterised by a belief in the market,  red in tooth and claw/devil take the hindmost, feels it has a mandate to drive workers back into the city so that office block real estate values are maintained and shops selling plastic, sugar, fat and salt can thrive. 

They really couldn't give a damn about the public's health. It's all about the money. 

They don't have my permission. 

Which begs the question: why do you think young people deserve a Darwin award for not wanting to get vaccinated?! We know that vaccines are effective at protecting against serious disease, but not against transmission. Why be so zealous?

There you go with your usual misrepresentation.  I don’t really care if younger people get vaccinated or not; I’ve taken a minority view (and flak on here) for arguing against those pushing to vaccinate children ahead of JCVIs precautions developments.  Young adults are still about 10x less likely to die if vaccinated before their first infection; low odds either way but much lower with.  They’re not going to quake healthcare with their choices.

I want a Darwin Award for the ones vocally arguing against vaccination.  I regard many of those who have died through their choice not to be vaccinated as victims; as I have said on here many times.  Those arguing against it - blood on their hands.  The data on hospitalisations and deaths in the unvaccinated is stark. At least it is if you don’t spectacularly misunderstand it.

YWe also know it’s severe disease that kills people, and we know that the sustainable endgame is to enable transmission without severe disease to move towards an endemic state.  We also know that doing this without vaccination would have killed over half a million people, and we know that doing this without vaccination and control measures would have killed them in a matter of months, with another 1.5 million or so suffering serious health damage and a total overloading of hospitals.

We also know that vaccination has reduced transmission at critical times; particularly early 2021. Significantly reduced it.

People advocating against vaccination have convinced a substantial number of folks to decline vaccination.  My family have spent the last 9 months impacted by control measures that were required to preserve healthcare against a backdrop of constant pressure as the remaining unvaccinated got their first dose of immunity the hard way.  Tragic for some of them, difficult for all of us.  

Moving on should not mean trying to get back to where we were, it should mean trying to get to a new and better long term stable condition.

No, but before they introduced smog laws large numbers of people dying of lung problems during high-pollution periods were also not unusual.  'Not unusual' is not the same as 'acceptable' when you know how to prevent it.

Diseases like TB and Smallpox were once endemic, Malaria is still endemic in many countries.  Endemic seems to be used by Tories to mean 'trivial'.  That's not what it means.  An endemic disease can be horrifyingly bad.

In 2021 there were three major Covid mutations which spread across the world and displaced the previous one - Alpha, Delta and Omicron.  That's about one every four months.  It is pure wishful thinking to think Omicron is going to be the last of it.  You could equally argue that because Omicron infects so many people its more likely to result in mutations and the next one could come faster.   Just because there's a general trend towards more infectious and less severe if you look over long time periods and multiple viruses doesn't mean the next Covid might not mutate into something really bad.  Short term randomness could easily be a far more important factor than long term trends.

In the course of my life I've only caught flu twice that I know of but I catch the cold two or three times most years and probably one of those is going to get on my chest and be fairly nasty for a week or two.   If endemic Covid turns into a once in thirty years nasty infection that's one thing, if it turns into a twice a year nasty infection with a chance of long Covid that is quite another. 

Plenty of Asian countries have a culture of mask wearing on public transport.  Maybe the new normal should be more like Japan and stay off work when we have symptoms and wear a mask more.

That's what the Tories want because they want to protect the money their backers have invested in London and the London economy and London real estate prices are threatened by people working from home.

What we should be doing is accelerating technology transitions which are going to happen anyway to create a better 'new normal' more quickly.  Working from home where possible should be the default - not only does it reduce Covid risk, it also reduces CO2 pollution and creates more leisure time.   Minimising travel for face to face meetings should be the new normal. Home delivery rather than in person shopping or restaurant dining should be the new normal - again, it is lower risk, it is more convenient and it saves carbon compared with moving people to a physical shop.  

We should also be further developing the technologies which have been successful against Covid -  vaccination, test, trace, masks, ventilation - and extending their use to other diseases rather than abandoning them.  And we definitely should not be giving up on trying to develop sufficiently powerful technologies that we can eliminate or almost eliminate Covid, at least in rich countries.

I guess the problem is that the term 'anti-vaxxer' had been used widely on these forums to tar anyone who has made a case against mass-vaccination of the population. ('Covid-denier' has also been used very loosely to stoke division.)

Personally, I have always argued that it is vital to protect vulnerable people, but that non-vulnerable people shouldn't be coerced into getting vaccinated by discriminatory restrictive measures, or any other kind of societal pressure. This is based on our shared view that: "Young adults are [...] not going to quake healthcare with their choices." 

I have also repeatedly said that it is in everyone's personal interest to get vaccinated. As for what is beneficial for society, you have already made the point that some countries are no longer in the pandemic phase because their younger populations are not as susceptible to Covid. Perhaps we shouldn't view our own population as one homogenous mass of people.

There's a non statement the government would be proud of.

If you are trying to make  any sort of valid point, you probably need to be more specific.

You also gave several reasons you thought infection before vaccination was good based in some spectacularly unclear and bananas ideas about immunity, and in ignorance of the clear data that vaccination reduces deaths by an order of magnitude for all adult ages. 

In terms of gaining immunity we shouldn’t, but when it comes to controlling transmission pre vaccination to preserve universal healthcare, it’s one highly interconnected mass of people, and that’s unavoidable in terms of breaking transmission.  

Really? Can you remind me of these ideas. The only person I remember making this point was Longsufferingropeholder who had been reading scientific papers on the theory.

Yes, really.  For several months you were drip drip drip about the benefits of natural immunity, and considering if that's better than vaccination for younger people - despite the data on fatality rates at all adult ages.  You made un-evidenced claims about the places most robust against Covid being so because of high levels of "natural immunity".  It's all there; I've just read through it.  

Yes, I remember that poor attempt at misrepresentation from the time.

I don't think anyone has claimed Omicron is the last of it... ?

Yet there are many endemic diseases that we've lived and died with for centuries whilst barely lifting a finger.   Covid is falling more towards those than it is towards TB or Smallpox.

I think the technological focus needs to be on those who can't reach a personal endemic immune status; in particular the very old and the immune suppressed.  They'll retain health protecting immunity from earlier in life against other diseases but may never form it well in response to vaccination, for them the disease remains a risk far more similar to what everyone experienced in early 2020.  Surveillance to help them understand their risk in real time (updates every half a week or so), proscription FFP2/3 masks with trained fitting, pre-emptive MAB therapeutics in very high risk times (some work would be needed to lower the cost of the MAB production!)

Early on I said this pandemic is going to raise massive questions about the future relationship between humanity and disease.  You're right that we're approaching the point we could start to try and eliminate diseases significantly less impactful than Smallpox.   It would be a Manhattan project for the world.

But, as with many things in science, because we can try and do something doesn't make it a good idea. 

Covid has only been a problem because the entire population (*) was immunonaive to it.  We aren't now.  It's the third novel coronavirus to come at us with some shared genetic components otherwise unseen.  There's a reservoir out there.  In terms of lethality, this virus is a kitten compared to the other two that have come out of the reservoir.  If we stopped circulation of a whole bunch of diseases in the whole of humanity, they'd keep evolving in their hidden reservoirs, diverging from our vaccines and therapeutics, and they'd keep jumping out as endless pandemics.

I don't think we're anywhere near ready to take that step.

Really ties back up with the classic Asmiov "Robots and Empire" novels, the contrast between the disease free spacers and the disease ridden earth people. 

(* - well, almost the entire population; SARS-nCov-1 and MERS-nCov survives may have some prior immunity.  Be interesting to see if there are any follow up studies on the subset of them who had pre-vaccination SARS-nCov-2 infections...)

This has just been confirmed by the CDC for the Delta variant!

By the way it's not the same thing as the argument about whether "infection before vaccination" is better or worse. Pretty sure I've ever voiced an opinion on that. Maybe you can cite some examples. The CDC maintains that vaccines are the safest way to get immunity and I've always said it's in people's personal interest to get vaccinated.

This is a a bit like when someone opens a conversation with "I'm not racist, but..."

From the archives:

In other news, the latest research from Israel suggests that immunity after infection is far greater than any vaccine-induced immunity.

Infection followed by vaccination appears to give greater immunity still.

Let me know your previous posting identities and I'll get back to you on that.

As I said, this has all recently been confirmed by the CDC!

However, you are accusing me of giving "several reasons [I ] thought infection before vaccination was good based in some spectacularly unclear and bananas ideas about immunity."

I vaguely remember asking a question about this, which I see you've decided not to include in your examples! Can you cite any of the "several reasons", or is this simply a shameless attempt to defame me?

Yes, in a shocking twist only obvious to everyone, the more immunogenic events someone has, the more immunity they get.  If they don't die, that is.

However, when it's done by live infection first, you also get a lot of dead bodies and overloaded hospitals.  There is no adult age for which the equation works out better for live-infection-first.  None.

It's all there in the archives.

Of course, until you tell me which other accounts you've used, I'm left making some suppositions about what you've said over your full posting history.  

"It's all there in the archives" 😂😂😂 Is that really the best you can do?!

No.  I went and read it all but I can’t be bothered playing chess with pidgins.  Anyone else interested (0.0 people) can go read it all.

Going to tell us your previous identities seeing as you put so much store in what you’ve had to say?

I draw the opposite conclusion from those facts.

As you say Covid is actually the third novel Coronavirus to come out in recent years.  The other two were much more serious but they were shut down by public health measures before going pandemic.  We've also had four major strains of Corona so far.

My conclusion is we should expect more novel Coronaviruses (and other viruses) and for it to happen every few years.  It's got to do with increasing human population, increasing longevity meaning more of the human population has weaker immune systems and increased global travel. 

If the assumption is that something like Covid could be a once in 5 or 10 years event under modern circumstances not a once in 200 year event then you want to get really good at dealing with it so as to be ready for the next one.  Especially since the first two SARS viruses were shut down before they went pandemic and we had a good chance of doing the same to Covid.

If the systems and technologies we develop to deal with Corona can also deal with flu/cold/Norovirus and we end up getting ill less frequently then great.

Sure; whatever the undiscovered reservoir is, it's probably still there.  There's a bunch more in the animal kingdom all over the planet now, as well as the human populations.  They're going to keep coming, but we'll never be fully immunonaive to them any more.  

Well, not something like Covid because we'll have immunity against it, meaning there's no "pandemic potential".

It could be another virus made out of another set of proteins entirely unknown to humanity, and as you say there's a lot of rising pressures that raise whatever unknown probability posed by those.  We'd be foolish to let the technology and preparedness lapse against those rising pressures.

No worries there.

https://www.ft.com/content/2986f544-b3b6-4fa5-9dff-fea9132be466

oh.

That's true, it is possible that something bad might arise, maybe as a result of a recombination between different strains in a coinfection (although the scary recent 'Deltacron' variant turned out to be a testing artefact). 

However, my feeling is that the general level of broad coronavirus immunity now present in the population is making a serious outbreak (in terms of mass hospitalisation) increasingly unlikely.  Bad as the first wave was back in 2020, I think it would have been truly devastating had there not been a background level of immunity to other coronaviruses with some degree of cross-reactivity (indeed, there was a small subset of people who seemed to be pretty much immune to COVID-19 from the start).  I think it's unlikely that many people are going to escape contact omicron at some point in the next few months, if they haven't already and, as long as they are fully vaccinated and/or have already been infected with a previous strain, that's probably a good thing.

The surface antigens, like the spike protein, can vary quite a bit but there are constraints - it still needs to work as an ACE2 receptor.  The functional viral proteins expressed during replication, like the RNA polymerase, are much more highly conserved (because they are complicated and don't have so much scope for changing the sequence without screwing up their complex recognition, binding and enzymatic functions).  Immunity to these is what will really control endemic COVID and currently this can only be acquired by infection (until we design a new vaccine including them).  And infection can only be safely contemplated after vaccination with the current vaccines. 

Of course, you can point at things like smallpox, which remained pretty nasty as a primary infection (although survivors did have life-long immunity) but measles might be a better comparison.  In our population, the long-established endemic measles strains were not an existential threat.  Certainly, children did die of giant cell pneumonia or complications like SSPE, which is why vaccination is important, but populations never previously exposed (like the indigenous North America populations in the 15th century or Pacific islanders in the 18th and 19th centuries) were devastated.

I expect that, pretty quickly, we'll settle down to the over 50s getting an annual combined influenza/coronavirus vaccination, targeting the prevalent strains.  Of course, sooner or later, something else really nasty will turn up.  Maybe a hybrid avian influenza, or perhaps an exotic human transmissible zoonosis.  Or (and this really is scary) a highly infectious, multi-antibiotic resistant version of some ubiquitous staphylococcus or pneumococcus. 

Only if a more harmful variant kills or incapacitates people fast enough to reduce the amount they transmit by because they're in bed or in a coffin instead of being out spreading.  If it doesn't incapacitate them but kills them after a month then there is no difference to that selective pressure.

It's not ridiculous when you consider the aims of government - reduce peak load on NHS whilst not killing the economy.  The simple fact is that masks in shops, cinemas, schools and public transport doesn't stop those things from happening but reduces cases enough to stop the NHS being overwhelmed, whereas masking in hospitality scenarios kills that industry and reduces caseload by more than is necessary. Personal risk - you are correct in that the rules don't protect a person from being infected, they'll catch it sooner or later if they go into hospitality, but societal risk - reduced.

It depends how many people are immune  - if the pool of infectable people who will trouble healthcare is too small to trouble healthcare, then it's no problem to let it rip from that perspective.

So you read my supposed posts in which I apparently give "several reasons" why it's better catching Covid naturally before being vaccinated, but then decide only to quote me on a different topic. When challenged to post the quotes you purport to having read, you say you can't be bothered and that other people can go look for themselves, although nobody should be interested!

My laughing face emoji response is then deleted and I am left as perplexed as ever about UKC's moderation policies. Meanwhile the mob of likers and dislikers demonstrate their overwhelming support for this state of affairs.

It feels like we have descended into a world where truth is subjugated by a desire to justify everything that has been said and done over the past 2 years. 

For the record, I have never said it is better to catch Covid naturally before being vaccinated. To my knowledge the only person who has suggested that this might be the case is Longsufferingropeholder who read some scientific research papers on the subject. 

That's true, but do you know of any diseases that kill people after a month without incapacitating them beforehand? 

HIV/aids, syphillis, TB, rabies, vCJD, yellow fever

Actually, as a long-term home worker, I find it harder to exercise, because if I go to London I cycle to the station and do a lot of walking at the other end, if only up and down stairs in the Tube if it's tipping down.  You get zero built-in exercise from a day at home.

The best exercise is in many ways the exercise you do without noticing.

McDonald's isn't, but I don't see what is unhealthy about a sandwich made for you than one made yourself.  It's a sandwich.

It costs money but it's not specifically unhealthy.

I think that is probably true.

The whole selective pressure driving less lethal variants is such utter bullshit when applied to a virus one of whose characteristics is being highly infectious well before serious illness develops, and when the lethality - whilst high enough to break society - is low enough to present a minimal barrier to viral transmission when it does happen, long after the downstream infections have been sewn.

But working from home, you have no time commuting, and so have more time to do other exercise. For many people, this will be a type of exercise of their choosing, such as running, cycling or going to the gym, rather than the limited choices you describe, some of which is in an unhealthy environment with elevated levels of air pollution. 

The time I lost the most weight I was doing both, FWIW.

Depends where you live, and I can only speak for myself, of course.

But that's not most people! The reality for many people is that there is no meaningful public transport, so they drive the kids to school en route to work where they park up and walk all of 10 steps into their office to sit behind a computer (Obviously, these are the people who can alternatively work from home. Plenty of people don't go and sit behind a computer, and they can't be home workers either!!) Your's is a very London-centric example.

If I was to work in an office in Glasgow, then I would use the train, so I would cycle about 1km from home to the station - so absolutely nothing of any benefit, then I wouldn't be doing any great distance at the other end either. But the travel both ways would waste about 2 hours of my day, if not more! (I did this for a year when I did a masters at Glasgow uni - it was dire!) With that 2 hours, if I was home working, I could do a proper length of cycle or run and I wouldn't have to endure boring train journeys.

Some would argue that sandwiches aren't the best anyway, but that's not relevant for this thread! If you make a sandwich at home, it tends to just be bread and cheese/ chicken/ tomato etc. Sandwich shops tend to add more stuff to sell better. Then many places have "meal deals", which are cheaper than just buying what you need. I have had arguments with checkout staff in boots because I didn't want to grab some crisps to make my sandwich and bottle of water cheaper!!! Buying lunch in town is designed to make you buy more than you need. Some people will resist this and just buy what they need, but we are hard wired to want to get the "good deal", or to be attracted to the other stuff that is sold alongside the sandwiches. 

I'd say big-city-centric, yes (but also elsewhere - most people will use public transport into the centre of Liverpool, Manchester, Brum etc as driving in big cities is grim and parking expensive).  But big cities are what is in question here.  If you drive to your office in a middle-of-nowhere office park and don't leave it all day, then the effect of that on the economy (and your exercise) isn't much different from working from home.

But in most big cities, the active travel at either end of your public transport is negligible. My Glasgow example can't be too unusual! Glasgow is, after all, a big city!

Even a ten-minute walk is better than the literally nothing at all you get as a home worker.  I reckon if I don't leave the house on a given workday I do about 100 steps if that.

It'll all depend on how well-motivated you are to exercise, I guess.

That's hilarious. Literally none of those diseases "kill people after a month without incapacitating them beforehand".

What is so special about a precise period of one month?

Disease Y kills people a month after infection without incapacitating them, making it a huge threat due to apparently heathy people spreading the illness.

Disease X kills people 2 months after infection without incapacitating them, allowing far more people to be infected but it's not precisely a month so it's relatively benign?

I was replying to Toerag. It's his condition.

Again Toerag's condition. I think he was trying to argue against a point I made by imagining a Coronavirus-type disease which kills people after a month without incapacitating them. On UKC you can just make shit up if you don't have a counter-argument, weren't you aware?

I was wondering if you were going to be your normal self demanding everyone else is ultra precise whilst you vomit rubbish everywhere.

However I did you the credit of being not quite so moronic but sadly you failed that test. All of these diseases meet the lack of evolutionary pressure requirement by not killing quickly.

Since we are setting such high standards I dont suppose you would provide your evidence for "only ever favour more transmissible (and therefore probably more benign) variants."

Where is the evidence for more transmissible and benign. Please give the detailed examples supporting this claim.

Just to weight in and say I get Toerag's point, and I get what mondite and Ridge are saying.  I also agree entirely with them.

Immune-naive Covid kills some time after it is highly transmissive, which means your "selective pressure" argument is not applicable.

I think it's patently obvious that Toerag was using "a month" as an example and that there's nothing special about that actual length of time between a carrier becoming highly infectious and dying, just that when there is a significant interval, there is no selective pressure against that eventual lethality.

Hare and the tortoise type stuff. 

He gave an example:

I don't think asking for a list of diseases that kill people exactly one month after infection, not a day more nor a day less, invalidates that point

Well here's a topical example. Delta is more transmissible than Alpha. Omicron is more transmissible than Delta. The relative virulence of these variants is yet to be established but - as I said several months ago - Covid-19 is not actually serious enough to make virulence a strong selective pressure. 

However, I would put more value in Dame Sarah Gilbert's opinion than mine.  She has said: “We normally see that viruses become less virulent as they circulate more easily and there is no reason to think we will have a more virulent version of Sars-CoV-2”.

Also, please note that I actually wrote "probably more benign". While long-term selective pressure will always favour less harmful variants, there is also a potential for a short-term, random mutant variant which is even more transmissible than Omicron but also more virulent.

Bollocks. I saw first hand how covid ripped through care homes, killing the most vulnerable and mostly bed bound first. Note bed bound. Asymptomatic carriers have been an established medical fact since way before Typhoid Mary and the extreme virulence displayed by covid has meant it's entirely capable of killing millions while only incapacitating and severely impacting a fraction of its victims.

Of course they've always faced the risk of respiratory disease. So what? The salient points with covid are that it is massively transmissible and has presentations commonly far more severe than comparable diseases. Hence "Worst Pandemic Since Spanish Flu". It's not f*cking rocket science and its not hard to get your head round. It's very basic and it's been headline news for two years now.

Yeah. Not "paranoia". Reality. It's only prats like you still pushing the "it's only flu" line.

You are consistently a pompous, lying, disingenuous arse Rom. 

excellent so no evidence. Lets move on.

Nice appeal to authority. However there are plenty of researchers who arent convinced by the "law of declining virulence". There are plenty of diseases which look to have retained their lethal potency throughout generations and even for some of the others when you look at the impact of disease on the new world the question is did the diseases evolve to become less lethal or did we evolve to survive them better by virtue of all those with particular genetic vulnerability getting killed off.

Simply because you state something doesnt make it true. After all less harmful to whom? We might just be an unfortunate victim of a disease well suited to living in other organisms quite happily as just one casual example.

.

Don't you remember the panic buying, the Covid Marshals and the hazmat suits on aeroplanes! Many people still won't go to the supermarket. Paranoia like I've never experienced before.

This is why I don't reveal my previous identities. There is nothing more inglorious than an ill-informed witch hunt.

I haven't followed the C19 science anywhere close to how some UKCers have, but ...

A lot of what you say maybe true, with hindsight and vaccines, but I remember way back to Spring 2020, when infections, hospitalisations and deaths were on a STEEP exponential curve.  Without the (delayed) hard lockdown, God knows what horrors would have unfolded. But you seem to be the kind of guy who would throw the weak and vulnerable under a bus before your breakfast.

Indeed; and if we look at the other nCovs that share some heritage with this one, it's clear that it's the kitten of the litter.

What if they state it 50 times from a clutch of different accounts over 2 years?

Having got in to home grocery shopping and having the WFH granted flexibility to be in to receive it, it's bloody brilliant.  I've always detested supermarkets, and if I never see the inside of one again it'll be too soon.  Nothing to do with Covid.

I'll make a note of this post because I'm sure you'll be back to misrepresent it as another example of my "Covid paranoia" at some pint - just like you did with my similar comments about not intending to go back to crowded lecture theatres - comments which were about the respiratory clobberings I was getting pre-Covid.

Ahh, so that's what you meant by paranoia is it? "panic buying, the Covid Marshals and the hazmat suits on aeroplanes"??? You said, and I quote "although it is still apparent elsewhere in Europe". If this is what you actually meant by paranoia, please do tell us where  "it is still apparent elsewhere in Europe" ???

If you can't (and I know you can't), I'll stand by my earlier assertion that you're a lying, disingenuous arse, forever obfuscating, shifting goal posts and posting utter bullshit while consistently adopting a "who? poor me?" demeanour which would be utterly laughable if it weren't so nauseating. 

No. The reason you won't reveal your previous identities is because you're an inveterate, lying, disingenuous arse. No matter what name you're using this week, on this particular thread.

We certainly won't evolve to better resist Covid as almost everyone who dies is beyong reproductive age anyway. A more valid comparison for Corona/influenza viruses is: did the diseases become less lethal, or did we develop immunity to them?

However, all that is actually by the way. My point is that selective pressure will always favour the individual that produces the most offspring. Respiratory disease viruses require live, active hosts in order to pass between them. Therefore, selective pressure must always favour mutations which encourage this tendency. The best evolutionary strategy is obviously to keep your host as healthy as possible.

On a sidenote, there are plenty of bacteria out there which have evolved to actually strengthen the health of their host. Viruses might be too simplistic organisms for this to be possible. Anyone got any ideas?

Such an over-simplistic take that you've stuck with.

Critical point: Once a population stops being immuno-naive, the lethality of this particular virus ceases to be a source of significant selective pressure.  Given this,  I am at a loss as to why you insist it "must" encourage a lower lethality.  Are you familiar with the concept of a "noise floor"?  As immunity increases it looks like all-cause-mortality becomes a noise floor that sits above the effective lethality of the virus in a highly immune population.

Thankfully we have the option of vaccination to get people past being immune-naive to the point where the selective pressure on the virus from its lethality is minimal.

The order of magnitude difference in lethality we needed has come from the vaccines.

If we hadn't had vaccines, and we'd "stretched the peak" through control measures to the point healthcare could give every sufficiently ill person a good level of medical help, the process of gaining sufficient immunity to exit the pandemic phase might have taken a few years, and the population loss would have been on the order of 1%.  I don't get a sense that the dynamics of a 1% change to a virus with an R0 of around 6 is going to put a meaningful selective pressure on things; perhaps over centuries it might, but the pandemic phase exits long before that can happen.

On the other hand, there is a selective pressure from the rapid host adaption phase for better receptor binding affinity.  Better RBD affinity gives an effective higher viral load on infection.  Viral load is not unrelated to lethality.  This might explain why we saw the intrinsic lethality and the infectiousness increase along the path wild type > alpha > delta.  It's now very difficult to separate the intrinsic lethality of omicron and the effect of built up immunity; it may well be less than delta as it's a very different branch on the phylogenetic tree.  As I've said to you before, I think we can reasonably expect successive variants that rise to dominance to come from different branches of the tree, given the variations developing across the RBD and the role of those epitopes in shorter term immunity-against-infection through neutralising antibodies.   So, I wouldn't be surprised if one of the next variants jumps back to the delta side of the tree.

I work from home and I get about 1 to 1.5 hours exercise a day in Hoyrood park.  No way I could find 1.5 hours a day for exercise if I was commuting to and from work.

It's just a matter of self discipline and being willing to say the time for exercise is part of your day and defend it against other calls on your time

Those were examples, others exist. A couple of weeks ago in France I saw a whole family who had gone to a pharmacy to get tested. The assistant asked if they had any symptoms. The mother replied that her daughter was feeling a bit tired. Sorry, but paranoia. Vaccine passports which must be checked by fellow citizens under threat of prosecution = paranoia. Many examples exist. Meanwhile in the UK I've been very much relishing the pleasures of English pub culture. No masks, no authoritarian checks, just people enjoying each other's company.

😘

You seem very keen to judge others you know.  Something incongruous about that.

Perhaps the family you were judging have an elderly relative who has listened to one-to-many crackpots on the Internet and has declined vaccination, and they don't wan't to kill their relative.

For example.

🤔

Lethality never was a source of significant selective pressure. You said as much a few posts above. 

"the lethality is low enough to present a minimal barrier to viral transmission"

This isn't the first time on this thread you're started arguing with yourself Wintertree. Maybe it's time to take a break.

Yeah, but none of the examples you actually listed up thread, just the incidental and the anecdotal to back up a position you've suddenly been forced to backtrack to. You see what I mean about goal shifting and obfuscating? You just can't help yourself.

English pub culture? In Edinburgh?

I'm sure you've witnessed it....

You always resort to playing silly little word games (like with “one month”) above when you can’t defend a point.  

Sloppy wording on my behalf I agree.  Significant does not mean large in scientific language it means measurable (with significance - meaning we’re reasonably sure it’s not noise).  Any significance the lethality may have had on selective pressure evaporates when it circulates in people with high immunity.  

 

I have to be quite ruthless on here because, as you can see, many people are out to lynch me. Telling people inconvenient truths does not make you popular!

In real life I'm the kind of lovely person who would stop to help a stranger even if they weren't wearing a mask...

I am not sure whether it is hilarious or just sad that you seem to think yourself as being victimised for speaking truth to power as opposed to being called out for being a dishonest actor.

"The virulence of the virus is possibly not great enough for that to constitute a significant selective pressure in itself but we certainly want to avoid creating conditions where we might facilitate the competitive advantage of a more virulent strain."

Oureed, 14th August 2021

Do you know that an example is just that. It doesn't have to cover every possibility. The examples I gave upthread do not have to be exactly the same ones that I recently witnessed in France. You're getting desperate now.

That said the Covid marshal example I used upthread is very similar to the French hospitality workers having to check the vaccine passports of their fellow citizens. It's all very sinister.

Yes, you said that in response to being challenged on your ealirer comment:

On this thread you have claimed that there is a long term selective pressure based in the virulence.  

So, what if you're retracting your earlier comments on this thread, what is the selective pressure guiding coronaviruses towards lower virulence?  

Speaking of the post you're quoting from August, that's one of many I see as falling in to the "I'm not racist, but..." category when it comes to vaccination.

https://www.ukhillwalking.com/forums/off_belay/friday_night_covid_plotting_38-...

I actually said: "Telling people inconvenient truths". You've turned that into "speaking truth to power". I've never thought of UKC posters as being in a position of power. But I agree, sad or hilarious, which is it?

Goal shifting. Obfuscation. Lying. 

You can swap your account a thousand times but you're still peddling the same old crap. It's embarrassing because you think you're being clever but the actual image you're projecting is increasingly desperate and foolish.

The game is up Rom. Nobody is buying your crap anymore. You obviously can't keep away from UKC to the point of obsession but really? all those internet addresses? all those new accounts? Just give it a rest. Stick to one account. Post honest opinions and debate in good faith. If not, carry on ploughing an increasingly pathetic path, contributing nothing, persuading no one, provoking nothing but exasperation and a mild sense of revulsion.

Love this! 😂😂😂 Have a like!

only one? I'm sure you could provide a dozen if you really wanted to.

There is a selective pressure for longevity in humans, because children that have grandparents helping to raise them have better outcomes.

As we supposedly return to "normal" can we spare a thought for those who don't have that option.

Last August we had to make the decision that my elderly mother would have to go into a care home.

Since then the occasions on which anybody has been able to visit her have been very limited, due to the home having to go into a series of lockdowns because of positive tests, mainly among the staff though some residents also. The last time we saw my mum was on Christmas morning, since then the home has been in continual lockdown. The lockdowns are imposed by Public Health England and are dependent on there being no further positive tests; the last positive was on the 23rd Jan so lockdown must continue until the 6th Feb assuming there are no further positive tests, these dates are set by PHE.

Given the seemingly prevalent attitude of living with the virus it is difficult to see when this situation will end. There must be many other institutions in the same position and I can't help thinking that in a kind of way they are paying for the rest of us enjoying our freedoms

My elderly relatives aren't in a home, but their situation is probably no better. One of them is on the vulnerable list for covid so I've had to take a host of time consuming measures to ensure they don't get infected. So, they basically have less human contact than if they were in a care home. Every time I get the winter sniffles I have to not visit, or ensure they are upstairs when I'm there with windows open, in case the lateral flow test I do before I go hasn't picked up covid that has defeated the three doses of vaccine I've had. And I have to be there regularly to sort medication. But I'm concluding now that they will get it eventually as it's so prevalent. The only reason control measures are in place is to prevent overload on hospitals, and sooner or later those measures imposed on care homes will be lifted I would think. Obviously people will still die, but if you're weak and elderly even a cold could kill you in certain circumstances if you develop some secondary infection. If you're up to date on vaccination I would hope the risk to an individual elderly person is not much different to that from flu (note to would-be dislikers: that's a hope, not a statement of my belief in it as fact).

Your post has got me to sit down and write up some thoughts I've been mulling over.

I think there're several groups who are never going to reach the kind of immunity needed for truly endemic Covid, because their immune systems are no longer able to form a broad and enduring health protective response either from infection or vaccination.  

People who end up on immune suppressing medication and the very elderly are two examples.  For these groups, Covid will always represent more of a threat as they will never enter the endemic world most other people are in, and with the pressure from healthcare removed there will be no interest in controlling it in the much later endemic group.

These groups are facing a choice between a much reduced quality of life (in terms of social contacts) going forwards, or I think a substantially reduced life expectancy.  For younger people on immune suppressing medication it's going to present barriers to employment opportunities.  I've seen a few news articles discussing this but I'm not aware of any policy discussions happening.

Estimates of the number of immune suppressed and immune compromised people in the UK are on the order of half a million.   That's a signifiant number of people who mustn't be left behind as everyone else moves on.

In terms of learning to live with the virus, investing resources in to understanding to help those who can't live with the virus is really important, and needs a focus of its own.

MAB therapeutics matched to the prevalent variant and distributed in anticipation of rising seasonal or new-variant driven waves could go a long way to restoring normality for these groups.  It's around £1000 per person for a course of MABs, or £0.5 Bn to help protect the whole vulnerable population from a wave with less stringent isolation requirements.  Making some egregious assumptions, that works out as about £30 on my annual tax burden; a small cost to help move the nation on; sadly an ever decreasing cost as people grow older and die; newer people will never be so uniquely vulnerable to Covid as they'll be much more likely to have caught it and produced immune memory responses before going on to loose the ability to mount a good immune response,

Care homes could create Covid secure meeting spaces with distanced seating, laminar air flow with HEPA filtered and temperature controlled air over the vulnerable person and extraction behind the visitor.  

As well as ventilation, the other low hanging fruit is PPE.  Properly fitted FFP2/FFP3 masks make a phenomenal difference to the risk of infection; there could be a service offering proscription masks and proscription fitting sessions and occasional fit checking sessions for people with compromised immune systems.  Better than hard isolation in times of high Covid prevalence.

None of these are great solutions, but taken together they start to restore quality of life to those for whom Covid is never really going away.