UKH

Seem to have maxed out the previous thread...

In reply to willgriggsonfire:

Today's numbers:

Nationally: 82.9% 1st, 60.9% 2nd

Bolton: 75.3 and 55.0%

Birmingham 60.2% and 42.8%

Unfortunately there are places far behind Bolton, which isn't even that far below average now...

I was looking at the dashboard heatmap for England and 'by eye' it suggests that cases started rising first among people in their 20s but I guess that's an optical illusion of sorts. If I've understood it correctly, what your graph shows is cases tipped into growth around the same time in most age groups. It's just that the 'pre-growth' base rates were highest among younger people. II guess this makes sense given Delta importation was (presumably) through adults of all ages.

Wow.  One things for sure, drawing Covid conclusions is a mad guessing game at times. I think Grter Manc as a whole has tried hard on vaccinations. 

And from the archived thread: NHS do indeed need a break. I’m in regular contact with public health, CCG and NHS - staff, including management, have done brilliantly in keeping motivation going etc. 

From the previous thread

I thought it might be interesting to put this into some sort of perspective.

Uk population = 68,238,124

Less 21% (estimated under 18 years) = 53,908,118 adult population (call it AP)

60% of AP is 32,344,871 (rounded up)

which gives us 21,563,247 adults not yet had two jabs

83% 0f AP is 44,743,738 (rounded up)

which gives us 9,164,380 adults not yet had one jab

Total COVID cases in UK according to world meters = 4,255,434

9,164,380 unvaccinated adults – 4,255,434 COVID cases (this will include those under 18) = a rough potential of 4,908,946 future cases

This is a rough calculation and doesn’t cover people getting it twice or who have had and still been vaccinated but it gives a vague idea of how much of the adult population (not counting those under 18) could still catch it.

I think you're presuming that all historic covid cases are in people who haven't yet been vaccinated.

4,255,434 covid cases, 68,238,124 population = 6.2% of the pop have have covid.

9,164,380 unvaccinated adults. Knock 6.2% off this, and you've got a rough potential of 8,592,875 future cases.

I did say that my back-of-a-matchbox calculation didn't differentiate people who have had COVID but still had a vaccine. So you could knock 6.2% off and still potentially double the cases already recorded but that doesn't include children who could potentially get it

This is that thing that gets mentioned all the time but never quite seems to land; you don't get herd immunity by vaccinating adults. Wasn't that many posts ago wintertree and others implied (maybe even straight out said?) this. It essentially means an exit wave, with all that brings, is the next step in the process.

There's also innate immunity. We know some of us had some level of protection from covid so you can't count anyone unvaccinated as future cases (blood bank testing).

Obviously greater risk than those vaccinated.

Your numbers are rather precise

More than 6.2% or 4.2m have had it though. Hardly any testing in the first wave and not everyone got tested thereafter. I suspect it’s closer to 15%. Still leaves plenty of infection capacity though. Of course not everyone will get infected and only a small % will end up in hospital. 

It's how far down we have to go.

Young kids don't mix like teenagers (and also don't seem to get the same viral load), so vaccinating down to 12-13 year olds would really help in slowing the spread. Teenagers are all over the show, mixing schools, clubs, parties etc. 

Important to qualify that it’s just a spitballing opinion however.  I don’t have the level of data or modelling to reach a qualified position.  I’m not sure the modellers really have the network effects down enough either, but they can bound the possible futures sufficiently well I think.

For the estimates others have posted, remember that most wave 1 infections were not detected as cases, and total infections in later waves outstripped detected cases by about 2x.  Naturally induced immunity will tend to land in the sub populations most at risk of being transmissive links for the virus as well; I think this may have been involved in progressively moderating each successive wave to ever increasing degrees.  There are periodic studies of antibody levels across the whole population covering all causes and they’re pretty high now.  I think this and vaccination is why we’re seeing “outbreak” style behaviour in cases at a far higher level than when outbreaks coalesced into an exponential phase late last summer. 

In reply to misha:

Exactly - as soon as you have differential growth rates, cases rise faster under one growth rate vs the other and hit every threshold sooner than the other, making it look like a leader/follower situation, but you get that behaviour even with no communication between the separate bands.  It’s really hard to pull any detailed tests out of that data on cross-band flow of cases, but as absolute numbers diverge wildly, if the exponential rate in the slow growth bands remains low, it suggests a significant number of cases are not being cause by the high growth bands.  I can see how the dashboard heat maps are very easy to intuit wrongly.  

Sort of. Hypothetically, if you vaccinated all adults, the exit wave would be mostly among children, which wouldn’t be a massive issue in itself (still an issue due to less than 100% vaccine efficiency). Of course we won’t vaccinate all adults.

Everything is rounded up and you could probably divvy it up in different ways. And as you say not every case will end up in hospital. But it gives a very rough idea of how it looks in terms of people.

I think this highlights the problem of making future predictions. There are many variables that are impossible to account for so we can only ever have a vague idea of how things might pan out long term.

Absolutely. I often wonder where we would be now if Delta hadn’t arrived? A month ago I did not think the UK would be top of the Europe Covid Case league.  Again. 

In reply to Misha:

Well, yes and no. The exit wave instills immunity by infection in (or removes from the susceptible population the other way) those that don't have it already, for whatever reason, up to the HIT. That includes kids, can't haves, won't haves, haven't hads, and those it wasn't effective for. 

Some estimates of the attack rate are as high as 20-30%, and yes that will be concentrated on the ones who are most likely to be repeat-exposed, so we might not have as far to go as the rough numbers above would have you think. But it still is what happens next.

What I meant was I’d be rounding all those numbers to the nearest 1m... doing numbers to the nearest k, never mind the nearest single digit, suggests a degree of precision which even the best modellers could not attain, never mind a back of a fagpacket calculation.

Also I feel like I'm in the minority in questioning whether the best way to immunise kids is by giving them covid, but that's one for immunologists and mumsnet to figure out between them.

Indeed. The other factor being geographic. I suspect vaccinating 70% of the total population may be sufficient in an isolated rural area but wouldn’t be in a large urban area. 

There are multiple lenses.

1. Which kind of immunity is better in the long term, for the child and for society?  Immunity is most definitely not a binary status, and live-virus and vaccine induced immunity are very different things.
2. What are the morals - and eventually the looped back practicals - of immunising our children vs donating the doses to vulnerable adults in foreign countries?
3. What is the legal liability angle and how does that change between courses of action when actively vaccinating vs passively stepping back?
4. How much will systematic vaccination of children empower those people who drive general anti vaccination sentiment, to the net long term detriment?

These are only some of the issues I see.  There are others.

Depending on how I approach the question I can reach basically any answer under the sun.  The barrier to criticising the state response to this crisis is low IMO, but I recognise that the decision over children is almost insolvably complicated and I suspect that if I was the PM, even with direct access to all the credible experts out there and with the means to understand them well, I would struggle to make any sort of decision here.  Sometimes you have to roll the hard six.  It’s very hard to criticise a decision made in such a position, all the more so if it’s accompanied by honest and frank communication…..

The sensible middle ground is perhaps to allow parents to opt in to vaccination for the ages where any vaccines have been approved by the MHRA whilst not being sanctioned for mass role out by JCVI, but for there to be no legal grounds for the vaccination status of children to be considered or requested in any way by any organisation other than when giving healthcare.

I think the Doctors have it right "first do no harm".

As long as it looks like primary age and younger kids are not badly affected by Covid I think we should try and shield them from Covid with public health precautions and by vaccinating adults and give it another year of research and trials with limited numbers of people so we can be surer of the science before vaccinating millions of children.

If it becomes clear there are more serious health consequences for children from catching Covid than we currently think  then switch policy at once.

We also have another classs of vaccine in the pipeline - inactivated whole virus vaccines like Valneva.   Maybe an inactivated whole virus will give you the same kind of immune response as catching the active virus.

Ah! I see what you mean.

Arstechnica chimed in on this today on this subject - https://arstechnica.com/science/2021/06/heres-all-the-data-on-myocarditis-c...

Kind of a variation on what I said before, but while it's easy to see the hard questions about vaccinating kids, I think that a plan of "don't vaccinate the kids, let them acquire immunity by catching the virus" needs reasonably careful thinking about too. Do we still act like we're trying to control it? Do we just get individual cases to self-isolate, or do we still send whole "bubbles" home from schools and holiday clubs and so on with all the knock-on issues that that would have? And if we're just getting the symptomatic cases to self-isolate, would anyone feel comfortable sending a kid into school knowing that there's an outbreak and there are almost certainly a lot of infectious asymptomatic and pre-symptomatic cases wandering around? And can we expect teachers and childcare staff, even if they're fully vaccinated, to go to work in what are essentially giant virus incubators?

If we're not all barking up the wrong tree, those are all very good questions and all deserve official answers.  The roadmap appears to involve a big blank area with clearly marked entrances and exists.

I missed replying to Toerag's post on the now closed thread, but he noted that on a near by bailiwick, they're not going to be requiring double vaccinated close contacts to isolate.

Interesting in terms of risks to children that the news today is on the number of parents taking them to hospital for symptoms of non-Covid respiratory diseases; nature playing catch up after long periods of social distancing?  Interesting that Covid is not surging in the children along with these other diseases - https://www.bbc.co.uk/news/health-57583733 - although it's possible that some of the infections are primings the immune systems to the point they respond to Covid in a timely manner swaying it off its usual path.

In terms of schools, I did wonder how much the delay from June 21st was about pushing things beyond the end of term as a way of side-stepping some policy decisions here with the summer holiday approaching.   

A couple of posters have mentioned their hope for a change to social attitudes over going places when clearly ill.  Reflecting on what the exposure to a student cohort drawn from around the world has done to myself and many colleagues each winter, it's a long overdue change in attitudes - but take it too far and perhaps we get to where Covid has forced us with flu, which appears to be an unusually vulnerable position going in to the coming winter.  Becoming too detached from viruses may make us healthier but it also raises our pandemic susceptibility.  We're not yet sufficient masters of biotechnology to move to a fully augmented approach to immunity, eliminating pandemic potential whilst also suppressing illnesses.  Some real ethical and practical questions cutting right to the core of our species' future are much closer to the table after this pandemic.  The best exploration I've seen of this was in fiction in Asimov's Elijah Bailey novels.

Yeah it’s constantly moving. The one thing we can do is get vaccinated and keep being sensible. i wished we didn’t go on about reduced effectiveness of vaccines with these variants but rather frame It that the vaccines are still very effective. 
 

I thought the data is getting clear that vaccine induced immunity lasts longer than natural immunity.

Well yeah. I mean the current roadmap, such as it is, has even bigger blank areas - they aren't just proposing to get all the adults fully vaccinated and then not worry about schools, they seem to be not even worrying about people under thirty or so. Which raises all sorts of further questions about whether it's practical to close businesses and expect people to self-isolate and so on as the case rates keep going up, or conversely whether it's fair to expect partially-vaccinated people to keep going in to work, going shopping and so on under the same circumstances.

Again, that might be the least worst option compared to returning to control measures, but I currently don't get the impression that people are even thinking about it...

re the flu I've heard two opposing views.

1. There are fewer flu strains therefore the chance of a successful vaccine is greater, some years they are 50% effective.

2. We've lost immunity having not had the flu for 2 years so are therefore more susceptible.

Is 2 correct though? Each year only a small % get the flu. Between 5-20% of the US population (a greater % in kids) get the flu each year (we each get the flu about 1-2 times a decade on average). Will that have a considerable impact on population immunity?

I'm hoping a strong uptake of a flu/Covid vaccine will severley hit flu and covid numbers going forwards.

The importance of significant figures.. 

My wife is an MD, finished her internal med residency, now in her final year of Hem Onc (so works closely with the immunologists), she's heard some pretty bad stories of covid in kids and long covid complications.

We'll vaccinate our 5 year old as soon as possible. Two of my wife's vaccinated colleagues got covid* and so did their unvaccinated kids and the young daughter developed diabetes afterwards - this has been seen quite a lot.

* If you know hundreds of people who are vaccinated then 10's of them will still be susceptible to the virus, so it's not unexpected.

Well, that could be true for immunity based on the spike protein (opinions differ on durations and it seems to be descending in to a misinformation war?) , and the immunity from current vaccines is frozen against an increasingly distant variant of that spike protein.  

re: re: the flu - I don't know enough to chose between the different expert opinions out there, but it seems to be a growing focus of concern.  I need to dig out a link Jon Read shared some time ago to the obscure location the UK's report on the antipodean flu season was going to be published at.  One of the concerns as I understand it is that the lack of a "pilot" flu season leading ours makes it very hard to know what strain(s) will dominate this winter.  Starting from a very low prevalence, there could be a much larger element of chance than normal to what gets amplified to prominence.  On the other hand, it seems we've shown that not going to work when sick and basic social distancing might be kryptonite to the flu; a shame there's not been more moves towards recognising this with changes to statutory sick pay to better support contagious people otherwise well enough to work in isolating

Do you think any of the vaccines are going to be approved down to that age?  Are trials even underway to seek the requisite data?

In reply to Ramblin dave:

It would be reassuring to be presented with the data, models and interpretation justifying it as the least worst option, it's rather difficult to take that on faith after the last 18 months.

I've been thinking about it with a business continuity hat on, and it's fair to say I would appreciate more overt policy more clearly aligned to the near future.  It's not clear to me how much engagement with testing is changing as this process continues

Update on that - we've now decided to do it here too. If you're double-jabbed+2 weeks soak time and are identified as a contact then you just need to do a test and day 7 test, no self-isolation.  People can come into the island from the CTA with no testing or quarantine provided they're equally double-jabbed.  Probably can't go into healthcare places and care homes unannounced though. Our vaccination rates are slightly higher than the UK, although we didn't push to get 2nd jabs in early as much as the UK did.  Even though our healthcare capacity is lower than the UK's government is confident it won't be crashed.

How do you think things are going to go in the US now the Delta variant is becoming established in a number of states (look at covariants.org)? A red state with it could result in a lot of pain! (unless of course, they've already all had other variants in the past and a degree of herd immunity).

The ongoing demographic shift and perhaps move (in the lagged measures) beyond initial outbreak zones is really showing through in the Lissajous plots for today.

Cases are rising in all 3 plots, but some of the other measures are stagnating or even falling.  ITU occupancy in the NW looks like it's going to start stagnating against rising cases, moving it off the same part of phase space as the last wave.

It's what I think a lot of us had been expecting but it's infinitely reassuring to see that actually start to come to pass.

Pucker factor remains high for the weeks ahead in the wintertree bunker, but it's still not a panic factor.  Some of these curves could well bend back towards the old ratio as the sudden spell of rapid growth in Scotland works its way through the lag in the system, but falling ITU occupancy and deaths against rising cases can I think only indicate a shift in the barycentre of cases towards less susceptible people, through some combination of age, health and vaccination status.

Yeah its about 20% last time I saw and increasing so will soon be the dominant strain.

I think the summer won't be too bad (but the southern states get so hot they spend more time indoors so maybe it will), but the fall and winter will be bad unless they start to increase vaccinations. At the moment they are ticking up at about 0.1% a day, which is similar to us but we're at 70% with at least one dose, they are at 35-40%.

One good thing is the cities are typically democrat so are vaccinated at a higher rate (in Louisiana New Orleans has much better uptake than the northern rural counties). 

The blue states and almost the whole of New England will be fine. We're at 80% adults vaccinated, hopefully lots of those that aren't (who weren't socially distancing or masking) will have had it so we should have a lot of immunity in the population. I'm very thankful to be living where I am.  

Yes, Pfizer have trials under way now for 2-5 and 5-11, they expect to get the EUA sometime this fall when all the trial data comes in. It will just be a much lower dose in each age group.

Stuff like this is the worry I'm most worried about. We have exactly zero data on what if any effect covid infection in childhood has on adult life or development. And that's on top of a year of being homeschooled by stir crazy alcoholics.

Not saying we have data on long term effects of the vaccines either, but we've been happy enough to go all-in on them being better than covid for every other age group. It really is coming down to which way would we feel more guilty about being wrong, rather than which is the better plan.

Yeah I’ve felt that as a parent almost the whole time. Make the least worst decision. Almost every decision is potentially the wrong one. 

I would expand that to say we don’t know what the long term effects of Covid might be.

more numbers: 

“According to another report by PHE, of the 92,029 cases of the Delta variant from 1 February to 21 June, 82,458 were in people aged under 50, of whom 52,846 were unvaccinated. Of the 1,320 hospital admissions within that period, 902 were among under-50s, of whom 695 were unvaccinated…

According to the figures for people who had received two doses of the jab, from 1 February to 21 June there were 190 hospital admissions, 163 of which were in the over-50s, and 50 deaths, all of which were in this older age group.”

Following on from kirsten’s post, a further report presented for the case against allowing infections to rise before vaccination is complete:

https://arstechnica.com/science/2021/06/even-mild-covid-in-young-people-oft...

I had a letter from the ONS Covid Study asking if I would donate some blood along with the swab test as they are increasing the numbers who give a blood sample to monitor how well the vaccines work in the real world. So perhaps mass data on effectiveness/longevity is on the way.

Sounds like the invitation my husband had ... he got a few moments in to the accompanying video of a guy taking his own blood sample and decided it was deffo not for him!

It’s actually almost painless but it is a major faff and it took me ages to get the sample, but as someone with a heart condition, blood tests and angiograms are a fact of life for me. I had to use both the supplied pin-pick devices to get close to the required amount. As I am on blood thinning meds I didn’t think it would be problem, normally I only have to look at something sharp to start bleeding, but on demand... The letter said there would be a ‘straw’ that could be used if I was having problems but there wasn’t so ended up having to scrape the congealed stuff off into the container to make up the volume which seems like a flaw to me.

Maybe next time I will use a clean knife to make a nick, as my contact rang me whilst I was getting the sample presumably to check that I hadn’t passed out during the procedure (which he seemed concerned about), although that was my first time so maybe I just need to work out a better method i.e. stick finger on worktop and jab with attitude.

I put my experience on another forum and received this helpful advice:

I found the following helped:
A few star jumps;
Wash hands in warm/hot water;
Rub hands together vigorously;
Squeeze finger tightly just below the chosen stab point (like a tourniquet);
Stab with enthusiasm.
Result - blood in the tube, all over the kitchen table, down my shirt and over the envelope!

Latest divide and conquer news ! 

They are telling you on gmb to unfriend anyone who hasn't had the jab !! 

In other new those who have had the jab give off harmful Proteins so stay well away !!! 

We covered this a while ago. Vaccinated people shed vaccinating particles, remember?
If you don't want to end up vaccinated you need to wear a face covering, wash your hands regularly and stay >2m away from people.

Cheers for the heads up !