UKH

Friday Night Covid Plotting #44

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 wintertree 18 Sep 2021

The Four Nations Plots

Cases in Scotland, England and Northern Ireland are clearly decaying; if the very provisional right edge of plot 9 holds up then Wales is decaying too, but I’d want to see a few more days of data to believe it.

When it comes to controlling the spread of the virus much is now against us - seasonality, dropping restrictions and the return of schools for example, but cases are turning to decay everywhere. 

  • It’s tempting to jump to the conclusion that we’re at the point immunity levels are high enough to drive symptomatic Covid in to decay; that’s the optimistic hat I’ve got on for now.  
  • Comparing the curves for England and Scotland on plot 9, they're at least not incompatible with the idea of growing immunity being what's tempering things; Scotland got less during the football vs England and paid that debt instead; in terms of hospital pressuring going in to winter that's worked out in England's favour I think.
    • This has been discussed a few times in the context of "exit wave" timing and potential winter pressures.  I think it's a bit optimistic to call any of this an "exit wave" but it is I hope moving us forwards.  At a very real cost. 
  • Infections and vaccinations continue to raise the quantity of immunity and the booster program is firing up, so hopefully things keep going in this direction indefinitely.  Or until the next nasty variant emerges somewhere in the world and sails in through our increasingly porous borders.

My forwards looking optimism is tempered by how full hospitals are getting, and ongoing deaths which I’ll come back to in my last post.   Hopefully the changing wind for cases signals a draining of pressure from healthcare.

On the seasonality front - I've been enjoying writing these up watching sunset out of the windows; this week it's pitch black and I just see my reflection. Decades in to my life and it still surprises me how fast things change around the equinox.


 wintertree 18 Sep 2021
In reply to wintertree:

Scotland - Part 1

  • It's two weeks since the Scottish cases data started looking like it was going to decay, now it’s clear that it has been in decay for a good week solid in the data.
  • The decay has translated in to admissions and perhaps deaths, and occupancy looks to be levelling out - none too soon for all hospital related measures to stop growing and hopefully start decaying if the news stories from the last week are anything to go by.  
  • The next post looks at the demographics a bit
Post edited at 20:56

 wintertree 18 Sep 2021
In reply to wintertree:

Scotland - Part 2

Demographic cases - D1.c 

  • I’ve changed the left side plot from absolute numbers to population normalised - more important than for the English D1.c as the daft age bins in the Scottish data make the absolutes look odd and I think may have led some down a blind alley when interpreting some previosu plots.   
  • The rate constants plot (right side) has a solid blue band down the right hand side - all ages are in decay. 
  • The line plot shows the rate constants vs time for recent weeks.
    • The age band 20-24 that peaked hardest of all ages after the nightlife reopening is now in the consistently fastest decay; that’s the sort of thing that feels compatible with some rising antibody levels following the peak…
    • Children ages 0-14 is interesting; this initially lagged the young adults suggesting children were downstream of infections spread by the adults;  look at this more with some English data in a few posts time…  Then after the spike in adults collapsed, the school aged band was the slow to return to decay but eventually did. 
    • (The 15-19 band is difficult to interpret being mixed school/adult but perhaps unsurprisingly tends to fall between those on either side of it by age.).
  • The differences with ages have shifted the centroid of cases down in age and the bottom right of D1.c shows how they’re concentrating in under 20s; hopefully this demographic shift means that hospitalisations fall faster than one would expect from top level cases alone
  • Tentatively, at the national level not only did adults exceed and lead over children in terms of growth rates when things reopened, the return to schools is not driving growth in cases either in the school demographic or at the top level. 
    • Good

Rate Constant Plot - Week-on-week method

  • The most recent halving time is about 10-days; we've only seen that in the most extreme outliers so far in 2021.  Typically decay phases have been having around every 14-days; we'll see where this goes...

 wintertree 18 Sep 2021
In reply to wintertree:

England - Part 1

  • All measures in England are falling except occupancy, and that’s about to turn to decay. 
  • Last week I said cases looked to be pointing downwards; what we see now is great news but it’s too big a set of changes considering typical lags from cases to admissions and admissions to deaths.  This leads us to a question:

Have infections been in decay for 3 weeks?  Read on for my take, best served with a pinch of salt.

  • Last week I noted there was some oddities in the data perhaps related to the return of schools.  I think that was indeed the case with the switch on of more testing around schools returning (including  LFTs for adults in to workplaces as schools return) presented as growth in cases, hiding what should have been good news last week.The right side of 6e looks strange, there’s a big diagonal of falling cases near the right side, then they jump up a bunch in one go and resume a falling diagonal.
  • I’ve commented in past weeks about a similar odd looking plateau in the week-on-week rate constant plots.   There's also similar behaviour in past school terms.
  • I’m more or less convinced that this is where an increase in testing associated with the return to schools meant there was a jump in the fraction of actual infections being detected as cases, and so this recent rise in cases does not accurately reflect a rise in infections. 
  • This seems to fit with plot 9 - if we look at where different measures cross the axis (y=0) on this plot it gives us an idea of the lag between measures, cases - cases cross (blue), then about 10 days later admissions (orange)  then another 10 days later its deaths (red) - they peak and change direction rising and falling in sequence over about 3 weeks as the lags involved play out.  
    • Now however in plot 9, admissions turn to decay at the same time as cases and deaths about 6 days later.  This makes a lot more sense if we interpret infections has having been falling for a couple of weeks before cases…. 
  • I went in to this towards the end of the last thread here - https://www.ukhillwalking.com/forums/off_belay/friday_night_covid_plotting_43-739033?v=1#x9518180

So, I think we’ve probably had infection falling in England for a few weeks but masked by a switch on of testing, which means we should see admissions and deaths continue to fall for another couple of weeks at least.  Normally when cases start falling the focus moves to opening up more stuff, showing something of a failure to recognise that cases were falling because things were closed.  Now however most things are back to normal from traffic levels to school operations, with the biggest reaming shift of working from home more apparently here to stay.  So....  Fingers cross for weeks of decay in hospital and death measures ahead.  The gods know we need it.


 wintertree 18 Sep 2021
In reply to wintertree:

England - Part 2

Plot 18 - Regional Rate Constants (England)

  • Cases are in decay in all regions. 
  • Hospitalisations and deaths are in decay in most regions, if the others don’t change to decay in a few days that’ll become a bit of an emerging red flag.

Plot D1.c - Demographic English Cases 

  • Decay is in all ages (blue band on the right edge of the rate constants plot) although weakest in school aged children.
    • Looking at the rate constants for ages 0-14 and 15+ (D1.c re-binned time series plot) shows that even cases in school aged children are in decay.
    • Tentative signs that decay is going to be robust against the return of schools...?

English Cases Rate Constant (week-on-week method)

  • We've had 9 days of week-on-week decay in a row now.  
  • Not halving as fast as Scotland
  • The data points wobble around in a way that looks a lot like previous weather associated changes.  The baseline decay is low enough that normal weather stuff should leave it in decay.
  • Here's hoping...

English Demographic Rate Constant (week-on-week method)

  • A new one-off plot this week 
  • The rate constant plots in D1.c and plot 18 etc are made by using my noddy de-weekending algorithm to reduce the strength of day-of-week effects in reporting, then doing some exponetial fitting to the data before polynomial filtering the result.  Not the most methodologically satisfying way of doing things, but the cyclical and random noise in cases is very, very high. 
  • The “week-on-week” method is much cleaner; it looks at the fractional change in case over 7 days which absorbs day-of-week effects, then expressed this as a rate constant and a characteristic time.  I’ve applied this analysis to the demographic data binned in to ages 0-14 and 15+.  (Demographic Week-on-week plot). 
    • Lot of stuff for both data nerds and epidemiologists to think on in this.
    • When absolute cases are low this plot is very noisy. 
    • Looking at the recent high cases period from June, it’s really interesting - every change inages  0-14 lags that in 15+ - the football rise around 07-10, the return to rise after the football around 07-31, the two weather associated wobbles after that, and then the onset of decay 08-21 to 0828.  After that things go bonkers as we have the sudden switch on of additional testing around the return to schools, and then the return to the decaying baseline.  This persistent lag strongly suggests to me that during the school holidays the main source of infection in children is household contacts rather than their peers - despite a lot of peer socialisation happening this summer.  Perhaps if government messaging had prioritised ventilation including in the household over the last year, this curve would look different.  The pattern emerging after the spike I think is the switch on of more testing looks to me like there is some disruption to the leader/follower pattern by the addition of more transmission in the 0-14 band but not enough to set R>1.   This seems really promising for sustained decay against the return of schools.  Schools have guidance and rules over ventilation, households don't.  Children are more separable in the data than other household members but it doesn't seem a stretch to imagine lots of adult-adult household transmission as well.  Ventilate and purify; we have a big portable HEPA unit to use when the central heating is on and we don't want to spill all that heat.  Keep the viral load down and all that.

 

Post edited at 21:20

 wintertree 18 Sep 2021
In reply to wintertree:

Last post, and a chance for some reflection.

Over the last couple of weeks, it's really felt to me like most people and most places have moved on as if Covid was in the past.

There've been some suggestions that pressure on healthcare is not being as emphasised as it could be from within those organisations, but it's still looming and there's more and more media coverage of this.

Pressure on healthcare is one way of looking at this, there's also the individual way.

A plot I don't normally put in the lead on these threads, but that has come up a couple of times is my noddy mortality plot.  

  • This is a basic model I  made that takes the demographic ONS all-cause mortality data from 2019 and uses that and the demographic English Covid cases data to answer the question “If Covid had no association with lethality, how many people would die of other causes within 28 days of their positive Covid test?”.  This is the red line.  The black line shows the actual number of people dying within 28 days of their test.
  • The ratio between the two  lines has come down from around 100 to around 10; if Covid genuinely had no association with mortality we’d expect the ratio to be 1.
    • Some of the PHE reports discussed over the last couple of weeks make it clear that a lot of people without vaccination are still catching Covid; at some point we’re going to run out of people without antibodies to catch Covid, and then the increased lethality of antibody-free infection is going to be removed and this ratio will hopefully drop some more - indeed with a hopeful eye on it’s at one of it’s lowest ever values and is trending downwards.
    • About a month ago the first “monoclonal antibody” treatment for Covid was approved in the UK and it’s going to some patients from next week [1].  This will go some way to helping those who catch Covid and become hospitalised without prior vaccination or infection granted immunity, and those who are immuno-compromised.
  • I've a hopeful hunch that this plot is going to change for the better quite significantly over the next two months.   I’ll not borrow trouble from the future thinking about the alternative, but if it doesn't improve some difficult questions arise.
  • There are a lot of simplifications in this model - for example it includes no seasonality in the all cause mortality, and different years have very different seasonality based on their flu seasons etc.

One interpretation of the plot is that a person who receives a positive Covid result is about 10x more likely to die in the next month than a person who receives a negative Covid result.  (This is something that could I think in theory be tested longitudinally and demographically from the corpus of data the state has out of the public domain...?).  So, getting Covid still sucks - we really are not in a post Covid era either from the perspective of individual health or of the spectre of healthcare overload.  Falling Covid cases don't make this plot better - improved immunity levels and improved clinical care do.  At some point we run out of adults without any prior immunity, and there are more compounds making their way through the clinical trials pipeline; but a factor of 10 is still a big gap to close.

[1] https://www.bbc.co.uk/news/health-58602999

Post edited at 21:32

In reply to wintertree:

Couple of points I'm not quite sure on...

1. the noddy mortality plot, the red line's at about 0.2 for 3rd Oct 2020 - Gov dashboard shows 9,700 cases for that day. That's (if I've understood this correctly) effectively saying that only 1 in 50,000 (1,000 in 50,000,000) people died of non-Covid causes within 28 days from then. This seems a bit low.

2. your England deaths plot shows a decay, but the Gov dashboard doesn't appear to be showing a reduction in deaths which seem to still be in the 130-140/day across the UK. Are using a different source?

 wintertree 18 Sep 2021
In reply to Michael Hood:

1. I think you’ve understood correctly bar one detail I didn’t spell out, and I’m pleased to see you running the mental math to check the analysis, the world needs more of that kind of thinking as applied to data and plots!  A data point on the red line is derived from forwards projections of all cause mortality from the demographic distribution of cases by specimen in date over the previous 28 days to match the reporting criteria of the deaths metric.  That lead isn’t shown on the plot, but at the start of that period cases were closer to 3000 a day.  If you go back and take the average number of cases over that period it probably gives about 2.5x the mortality rate, which fits about right with annual deaths.

2. Same source, different trendline algorithm.  Perhaps the most recent data point is subject to more reporting lag than normal; but these numbers have a lot of statistical noise.  If you look at the trendline on the government dashboard for England - link below - it’s also pointing down.  Always good to treat the leading edge of the trendlines as provisional.  Almost certain that deaths aren’t growing however when the discussion is about level vs decay.

https://coronavirus.data.gov.uk/details/deaths?areaType=nation&areaName=England

In reply to wintertree:

> 1. I think you’ve understood correctly bar one detail I didn’t spell out, and I’m pleased to see you running the mental math to check the analysis, the world needs more of that kind of thinking as applied to data and plots!  A data point on the red line is derived from forwards projections of all cause mortality from the demographic distribution of cases by specimen in date over the previous 28 days to match the reporting criteria of the deaths metric.  That lead isn’t shown on the plot, but at the start of that period cases were closer to 3000 a day.  If you go back and take the average number of cases over that period it probably gives about 2.5x the mortality rate, which fits about right with annual deaths.

Got it - cases on 5th Sep "only" 2,189, etc. I always think that "back of an envelope" calculations are useful checks to see whether detailed analyses might actually be rubbish - should certainly lead to questioning if they don't "agree".

> 2. Same source, different trendline algorithm.  Perhaps the most recent data point is subject to more reporting lag than normal; but these numbers have a lot of statistical noise.  If you look at the trendline on the government dashboard for England - link below - it’s also pointing down.  Always good to treat the leading edge of the trendlines as provisional.  Almost certain that deaths aren’t growing however when the discussion is about level vs decay.

Hadn't looked at the different geographical splits, at least they all seem to have (at worst) levelled off and all the other measures indicate that they'll be going down in the future.

If they don't then it's going to mean that the relationship between the various measures has fundamentally changed which would be worrying as it would likely imply the introduction of some new factor to be found and considered.

 elsewhere 18 Sep 2021
In reply to wintertree:

Lots to think about (THANKS!) and mostly good (EVEN BETTER!).

 Si dH 19 Sep 2021
In reply to wintertree:

Thanks again.

I like the idea about true infections having been falling for three weeks and being offset for a fortnight by increased testing.... but is it supported by the data? I think it can only be valid if we have seen:

1) falling cases outside of school ages and parents for three weeks

2) an increasing number of positive LFTs over the last three weeks

From demographic data it looks like (1) might be close to true but I'm not convinced about (2)? A look at the dashboard cases data doesn't really show much change in the number of positive LFTs... having said that, PCR positivity has been falling since about 23 August, with just a brief uptick as LFTs turned on (which loads more likely positives in to PCR tests). See image.

The obvious next point of interest will be how many major outbreaks we get when universities return. There will surely be some, but last year we got them in every university city and I think the rules were tighter then than now?  So if we don't see large outbreaks in many university cities I think that will be a very good sign. I don't suppose anyone has a convenient list of university return dates that we could use in a few weeks to see where cases might be expected to rise first?

Post edited at 08:21

In reply to Si dH:

> The obvious next point of interest will be how many major outbreaks we get when universities return. There will surely be some, but last year we got them in every university city and I think the rules were tighter then than now?  So if we don't see large outbreaks in many university cities I think that will be a very good sign. I don't suppose anyone has a convenient list of university return dates that we could use in a few weeks to see where cases might be expected to rise first?

A few weeks ago I didn't buy wintertree's theory about nightclubs and thought it was more likely school term related.  I live right in the middle of Edinburgh and I wasn't seeing any big change in behaviour at that point.

The last week was fresher's week and it has been nuts, back to p*ssed people making a racket in the street, groups of people obviously out on the p*ss and dressed for nightclubs etc.  From what I hear from my daughter who's a fresher all the fresher's events are packed, lots of her school friends have been out in the pub/parties etc.   Yet the Scottish case data are falling like a stone this week.   

If we get through next week and the cases line isn't pointing up like a rocket as a result of what has been going on this week it looks encouraging.

 wintertree 19 Sep 2021
In reply to Si dH:

Re (2), the LFT data never rose enough to explain the increased number of cases at the top level - I think the LFTs themselves are a red herring in this.  But, there was a big rise in the number of PCR tests and a smaller drop in positivity so I think it was a change in testing behaviours associated with the return.  (That’s the jump in tests starting the gray hump on the right edge of the figure you post) All a bit wolly around the edges but it just about hangs together.

In terms of “an increasing number of positive LFTs over the next few weeks” - look at 6e and the pair of diagonals in the raw markers far right; one week’s decay just about cancelled out the sudden jump (I think from increased testing); so we expect to see one positive disinclination in the data but not 3 weeks of higher counts.   This is all cases but LFTs should reflect that rapid drop in underlying infections.

> There will surely be some, but last year we got them in every university city and I think the rules were tighter then than now? 

Restaurants were pre book and table service only at fresher’s week last year, and night clubs were shut.  There was almost no in person teaching.  This year it’s all open and lots of in person teaching.  I suspect sub standard accommodation remains one of the worst venues for transmission.  Pre vaccine and pre delta, our local one managed a 4-day doubling time this time last year; I’m morbidly curious about what delta would have done for that doubling time without vaccination but thankfully we’ll not find out,

> So if we don't see large outbreaks in many university cities I think that will be a very good sign. 

Indeed - if we get through that with decay in the 15-20 and 20-25 demographics, that’ll be quite something.  If we don’t, spread out of those bands is probably going to be worse than last time given reopenings in hospitality and in person teaching.

In reply to tom_in_edinburgh: 

> A few weeks ago I didn't buy wintertree's theory about nightclubs and thought it was more likely school term related.  I live right in the middle of Edinburgh and I wasn't seeing any big change in behaviour at that point.

We had a burst of activity of people ramming clubs around the reopening of clubs in England that rapidly faded.  I haven’t seen data either way in Scotland on “opening night” but it’s beyond clear to me that the giant spike after the last dropping of restrictions in Scotland was driven by adults aged 20-25 and not school aged children and not demographics of most parents on school aged children.  It could be something else but if it was the school term I’ll eat my hat.  To no great surprise, cases didn't have a massive spike in young adults in England after schools returned, and the rise was stronger in school aged children not in adults.  Any transmission from our club opening night would have been obscured by the big changes in the other direction following the football.  Perhaps it was that other part of the Scottish night time economy to reopen…. Whatever caused the giant spike in young adults in Scotland, the data on the event doesn’t look like schools by either past terms in Scotland or England or the same term in England.  Young adults got a lot more covid for a period, and then it turned to decay.  Which is good.  

 Si dH 19 Sep 2021
In reply to tom_in_edinburgh:

Right, need to keep an eye on Edinburgh this week then! I didn't realise Scottish universities started back earlier than those in England.

 kirsten 19 Sep 2021
In reply to wintertree:

> Over the last couple of weeks, it's really felt to me like most people and most places have moved on as if Covid was in the past

 

I’ve noticed the case numbers are getting harder to find in the media - updated on the front (web) pages every afternoon. Now have to make a bit of an effort to find them. 

 mik82 19 Sep 2021
In reply to wintertree:

> Over the last couple of weeks, it's really felt to me like most people and most places have moved on as if Covid was in the past.

> There've been some suggestions that pressure on healthcare is not being as emphasised as it could be from within those organisations, but it's still looming and there's more and more media coverage of this.

Working in healthcare, a lot of patients seem to think it's all over. Many are positively surprised that their cough, fever and loss of sense of smell is probably covid, as they have been in work the entire week and thought they had "the flu". 

In reply to wintertree:

> We had a burst of activity of people ramming clubs around the reopening of clubs in England that rapidly faded.  I haven’t seen data either way in Scotland on “opening night” but it’s beyond clear to me that the giant spike after the last dropping of restrictions in Scotland was driven by adults aged 20-25 and not school aged children and not demographics of most parents on school aged children.  It could be something else but if it was the school term I’ll eat my hat.  

It may be things were different in Glasgow and that was what was driving it.

The other interesting data from Edinburgh is the districts which have the worst Covid rates for the last few weeks - it isn't the young flat dweller / student neighbourhoods in the centre which is where it was with the Uni spike last year.  Posh middle class areas with detached houses are bad as are housing schemes.

https://www.edinburghlive.co.uk/news/edinburgh-news/covid-scotland-only-one-edinburgh-21610647

 wintertree 19 Sep 2021
In reply to mik82:

> Working in healthcare, a lot of patients seem to think it's all over. Many are positively surprised that their cough, fever and loss of sense of smell is probably covid, as they have been in work the entire week and thought they had "the flu". 

So much for my hope that there would be better support and encouragement to help obviously sick people (regardless of the cause) stay out of the workplace.

Indirectly, that doesn’t bode well for the potential flu season.

 mountainbagger 19 Sep 2021
In reply to mik82:

> Working in healthcare, a lot of patients seem to think it's all over. Many are positively surprised that their cough, fever and loss of sense of smell is probably covid, as they have been in work the entire week and thought they had "the flu". 

Interesting. I've met a few people who are convinced they have a cold and not Covid. Possibly due to not feeling that bad, "it can't be Covid". I edge away just in case!

Some at least took an LFT (to be fair most of them were negative) but the assumption is generally that it isn't Covid until it is.

On the other hand, my mid-70s mother-in-law had a routine PCR (part of ONS study) and it was positive! It was a surprise but she isolated. She never had any symptoms at all.

What am I saying? It's been said before I think, but possibly the only reliable metric is hospitalisations now.

 mik82 19 Sep 2021
In reply to mountainbagger:

The LF tests are part of the problem, probably as the communication regarding their use hasn't been the clearest. A typical story is "I've got a cough and fever, but it can't be covid as I've done a test". The test is usually a LF, and there's often several other people at their school/workplace off with a similar "mystery" illness. Even when there's people off with confirmed covid it's assumed that a negative LF rules it out. (Not to mention other issues like workplaces saying people can go to work with these symptoms. One even saying they could come to work with a positive PCR, so long as they wore a mask. I'm not even joking).

In reply to mik82:

yes the LFT's have really muddied the waters in most peoples heads around which test to use when - its a real shame.

In reply to Dr.S at work:

I can understand why - it's not straightforward, my understanding of it (which I'm sure better informed people will correct if I've got this wrong) is...

  • Covid takes 2 weeks from catching until you become infectious.
  • You're then infectious for 2-3 weeks (longer if you become seriously ill?).
  • PCR testing will "accurately" determine whether you have Covid through most (nearly all?) of that infectious period.
  • LFT will "moderately" determine whether you have Covid for only a particular few days during that infectious period. I don't know which days those are in the 2-3 weeks but that's not necessary to understand the principle.
  • So the LFT has little chance of detecting Covid unless it is taken in the correct "window of time" within your infectious period.
  • That's why it's best to take LFTs every 2-3 days or maybe even every day (if you need to take them at all) - that way, there's a much higher chance that the LFTs will detect that you have Covid. Maybe not as reliable as a PCR, but way more so than a single LFT.
  • This is why a lot of regimes (like Care homes) are using weekly PCR + daily LFT.

I've no doubt got the numbers wrong but the principle is there.

Post edited at 15:54
 mik82 19 Sep 2021
In reply to Michael Hood:

It is straightforward. The communication has been the problem. The correct usage should be:

LF test if no symptoms of covid

PCR test if symptoms of covid

The LF tests should essentially be used as screening to try and pick out asymptomatic but infectious cases.

 wintertree 19 Sep 2021
In reply to mik82:

> It is straightforward. The communication has been the problem.

I've spoken with u/g students who were getting regular LFTs.  None of them had any idea about false negative rates or what the intended purpose of an LFT was (finding some symptom free cases) or how to correctly interpret their LFT result. Basically they thought it told them if they had Covid or not.

The messaging around these test has been very poor and I wonder if they actually have a net negative effect under some circumstances.  Somewhat flippantly, perhaps the results should have been labelled "You probably have Covid, now go for a PCR test" and "You might have Covid, you might not.  Do you feel lucky, punk?"

In reply to thread:

Day 10 of week-on-week decay in the cases data for Scotland and England.  Scotland is shaping up with some really impressive halving times.  Not a moment too soon...  I should probably accept that the decay is really setting in; at the moment I feel like if I don't check it every day it might go away...


 Si dH 19 Sep 2021
In reply to mik82::

> LF test if no symptoms of covid

> PCR test if symptoms of covid

... which in itself is ambiguous because of the ambiguity in what counts as a covid symptom. Sore throat, runny nose? Advised to get an LFT. New continuous cough, fever, loss of sense of smell/taste? Told to get a PCR. Sore throat, runny nose, feel terrible, coughing a couple of times a day or a bit more than usual but not continuous, or maybe your temperature is half a degree up but doesn't meet the fever criterion - what do you do?  It's seems reasonable to assume that as the general attitude to covid changes post vaccination and post lockdown, far fewer people will get PCR tests in those circumstances than might have previously.

Back on the general point made about it seeming like people think it's over - the most obvious thing for me is lack of masks. Almost no-one is wearing them in shops around here now, I'm really surprised how fast it dropped off.

 mik82 19 Sep 2021
In reply to Si dH:

Where I am in Wales, all of those symptoms would get you a PCR test. Sore throat and runny nose are definitely covid symptoms that people report commonly. Criteria locally:

Flu-like symptoms including any or all of: myalgia (muscle ache or pain); excessive tiredness; persistent headache; runny nose or blocked nose; persistent sneezing; sore throat and/or hoarseness, shortness of breath or wheezing;

Generally feeling unwell and a history of being in contact with a known COVID-19 case

Any new or change in symptoms following a previous negative test

 girlymonkey 19 Sep 2021
In reply to Si dH:

Tim Spector of the Covid study app (Zoe), constantly complains that the government still aren't taking notice of the change in symptoms. For a long time now it is been headache, runny nose, sneezing sore throat and loss of taste and smell. Any of these should trigger a PCR test. This has been reported to the government repeatedly for a long time now and they still won't change advice. 

 Si dH 19 Sep 2021
In reply to girlymonkey:

> Tim Spector of the Covid study app (Zoe), constantly complains that the government still aren't taking notice of the change in symptoms. For a long time now it is been headache, runny nose, sneezing sore throat and loss of taste and smell. Any of these should trigger a PCR test. This has been reported to the government repeatedly for a long time now and they still won't change advice. 

To be fair to the Govt on this, Spector's findings have had a lot of press but Sage have run at least one study looking at Delta symptoms that gave counter advice to Spector's and Sage's opinion was that the indicators for testing should remain unchanged. I've shared it before on these threads. The vast difference in PCR positivity shown in the PHE surveillance reports between people who report one of the three 'classic' symptoms when booking a test (~40% quite recently) and people who don't also tends to support this view. I was quite taken aback by this.

Post edited at 19:27
 Offwidth 20 Sep 2021
In reply to Si dH:

Isn't that inevitable (people with classic covid symptoms are more likely to be positive)? Spector wasn't asking for those classic symptoms to be removed from the list .... just others adding. If your link was right, as a minimum they should have added something saying a significant percentage of covid positives had different symptoms. This lack of action compared to other countries, where delta public health symptom information has a wider list, smacks of more UK exceptionalism.

Since we need some unambiguous good news: NZ almost have their outbreak under control (and first dose vaccines upto 71% of those over 12 who are eligible!). A feat many claimed was impossible.

https://www.theguardian.com/world/2021/sep/20/new-zealand-covid-update-new-cases-outside-auckland-could-delay-lockdown-easing

 wintertree 20 Sep 2021
In reply to Offwidth, Si dH and girlymonkey:

The story over symptoms is very interesting; the changes following vaccination are quite big and at times surprising. 

I can see a logic for keeping the symptoms used to gate PCR testing aligned to "zero immunity" infections, but we're hopefully leaving that world behind soon, at which point the whole shape of messaging over symptoms, testing, contact tracing and isolation orders is going to need a big restructure.  

I'd be happy to see a much wider list of symptoms including those of flu and post-vaccination Covid delta infection forming a non-statutory basis for remaining out of the workplace when symptomatic, with a statutory requirement on employers to provide up to X days a year of fully paid leave if they can't support working from home during those periods.   (This is where symptoms fall short of people often considering themselves or being considered too sick to work)  

Link to some ZOE content on symptoms: https://covid.joinzoe.com/post/new-top-5-covid-symptoms

In reply to Offwidth:

> Since we need some unambiguous good news: NZ almost have their outbreak under control

They really went for it - great to see it again proven that outbreaks can be controlled even with delta.  I gather sewage sampling was used to identify at least one infection not found by contact tracing.  Will sewers start becoming a public health sentinel in a wider sense?  Makes me wonder about sentinel air analysis in key public transport locations, chuck in some word soup around aerogel biosensors and carbon nanotubes...

 wintertree 20 Sep 2021
In reply to wintertree:

>  I should probably accept that the decay is really setting in; at the moment I feel like if I don't check it every day it might go away...

So, turns out it can go away even if I check in...  Updated plots below.

Scotland remains in good decay in top level cases.

England, not so much...

  • There's a sudden jump in rate constant back to stagnation for PCR positives.  That last offending data marker is still a bit provisional so could end up turning to growth.
  • A demographic breakdown of England's results for all tests is also below; this stops 3 days short of the PCR data so we can't (yet) see what's contributing to the stuttering of decay, but the days before are quite telling - faster and faster decay in 15+ and hovering around growth/decay for <15s.  
    • As adults decay ever faster (in exponential terms) and <15s stagnate or grow, they rapidly take over the majority of cases; by the end of the demographic plot <15s with over 1/3rd of all cases.  Anecdotes suggest school isolation is rising a lot, so it may be that's turning to growth.
  • Tune in on Thursday or Friday to see what lies behind the top level change, but if it's a continuation of the trends in the demographic plot - rapidly falling adult cases and growth in <15s - then it's not going to reflect in the hospitalisation data very much.  

 Offwidth 21 Sep 2021
In reply to wintertree:

An amusing story of an NZ covid restriction breach arrest, where the food wasn't fast enough.

https://www.theguardian.com/world/2021/sep/21/new-zealand-police-arrest-pair-trying-to-enter-auckland-with-large-amount-of-kfc

 AdJS 22 Sep 2021
 Offwidth 22 Sep 2021
In reply to AdJS:

That's up with my favourite ever new acronyms

The key question is will we end up with hospital capacity problems like Scotland did recently. As Christina rightly points out on that twitter link this level of risk wasn't neccesary. Other countries vaccinated teens earlier and funded improved school ventilation and have mask mandates. The risk of long covid for kids is less than adults but its still not low. Plus kids infect families who may include individuals at much higher risk of hospitalisation.

 Offwidth 22 Sep 2021
 AdJS 22 Sep 2021
In reply to AdJS:

Lawrence Gilder’s daily update on Twitter is worth a look to see how the % of cases for young people relative to the total has risen rapidly since the start of September.

https://mobile.twitter.com/lawrencegilder?lang=en

Age Distribution of English Cases [21-09-21] n=24,470

0-9: 13.14% (3216)

10-19: 38.64% (9454)

20-29: 7.10% (1737)

30-39: 10.63% (2601)

40-49: 13.22% (3235)

50-59: 8.84% (2162)

60-69: 4.56% (1116)

70-79: 2.55% (623)

80-89: 1.08% (264)

90+: 0.25% (62)

Over 50% of total cases in England yesterday were in the 0-19 age range!

 AdJS 22 Sep 2021
In reply to AdJS:

Lawrence Gilder’s daily update on Twitter is worth a look to see how the % of cases for young people relative to the total has risen rapidly since the start of September.

https://mobile.twitter.com/lawrencegilder?lang=en

Age Distribution of English Cases [21-09-21] n=24,470

0-9: 13.14% (3216)

10-19: 38.64% (9454)

20-29: 7.10% (1737)

30-39: 10.63% (2601)

40-49: 13.22% (3235)

50-59: 8.84% (2162)

60-69: 4.56% (1116)

70-79: 2.55% (623)

80-89: 1.08% (264)

90+: 0.25% (62)

Over 50% of total cases in England yesterday were in the 0-19 age range!

In reply to wintertree:

The school where my daughter teaches has 55 covid cases; every member of staff and students did a PCR test on Monday; all the abandoned restrictions have been brought back in.

If the (entirely predictable) rise in school cases this month has the eeffect of reintroducing sensible precautions in schools, perhaps for the winter, that must be a good thing. (Not saying the rise in cases is good, obvs, but a good side-effect).

 Offwidth 22 Sep 2021
In reply to BusyLizzie:

Latest:

https://www.standard.co.uk/news/uk/chris-whitty-covid-vaccine-children-jabs-b956720.html

There is already speculation about if this is to pressure Boris.

 girlymonkey 22 Sep 2021
In reply to wintertree:

Interesting Covid treatment being trialled.

https://www.bbc.co.uk/news/science-environment-58628689

 wintertree 22 Sep 2021
In reply to AdJS, Offwidth & BusyLizzie:

I've been waiting for today's data release to reply.

We now have 3 sequential days of week-on-week growth in the top level rate constant for English PCR cases. The doubling time is getting shorter.

The demographic data stops 3 days earlier than the PCR data, and is showing a clear turn to growth in under 15s, and the rate constant rising towards growth for 15+.   With adult infections still falling quite fast and child infections rising increasingly rapidly (exponentially speaking), household transmissions is going to start anchoring cases in adults; perhaps that's why we already see the decay there faltering.

The absolute number of school aged cases looks to be at an all time high and rising rapidly - in past waves healthcare overload would have forced the breaks on now; absent that immediate pressure things continue to grow.

From anecdotes, outbreaks are changing from one or two people in a class being infected to much larger numbers; more than a little concerting from a viral load perspective.  The disruption from isolation orders is going to get silly very soon.  Case rates in some young ages must be reaching close to 1% a day soon.  Not a situation that can continue for long one way or another.

We should see at least one halving of adult case numbers before the decay potentially runs out of steam if household transmission proves to be strong enough.  That's got to be welcome news for healthcare as that plays out as a reduction in admissions and in occupancy.  So far, the slackening of the exponential decay in adults seems to be mostly in under 60s  which is promising for hospitalisations again, although not as much as it once was with demographics around vaccines.

I'm ventilating the family house more than normal at the moment, and running the portable HEPA filter in the common space when the windows are closed or it's a still day.  Can't do any harm to take the worst out of any viral load to come home from school...

Closely related news - Pfizer are preparing a regulatory submission to the FDA for the use of a single, smaller dose in children aged 5-11 [1].  Assuming they then make an MHRA submission, it will be very interesting to see what JCVI's take on this is.  

News I missed at the time a few weeks ago is that Robert Dingwall has left JCVI [2]. Well, well...  

[1] https://arstechnica.com/science/2021/09/kids-5-11-appear-safely-protected-by-small-doses-of-covid-vaccine-pfizer-says/

[2] https://www.nottinghampost.com/news/nottingham-news/ntu-professor-speaks-out-over-5841246


 wintertree 22 Sep 2021
In reply to girlymonkey:

I had to resort to google there - the term "Nanobody" seems like a massive stretch (or should that be squeeze) but that's marketing departments for you...  Still, very cool stuff.   Sent me down a rabbit hole reading papers around computational design of antibodies.  The LLNL/GSK collaboration and platform looks very interesting; won't want for lack of CPU time either...

In reply to wintertree:

Death rates / million:

England: 2,102

Wales: 1,840

Scotland: 1,542

Northern Ireland: 1,382

Irish Republic: 1,062

Within the British isles the less connected to England the lower the death rate.

7
 wintertree 23 Sep 2021
In reply to tom_in_edinburgh:

When making political points its important to give fully qualified physical units so others know what you’re talking about.  Per million what?  Bananas?  Cases?  Head of population?

> Within the British isles the less connected to England the lower the death rate.

Do you have a quantified scale of how “connected with England” each nation is, to back up your assertion, or are we back to pulling correlations out of somewhere the sun doesn’t shine to back up a pre conceived idea?

I was aghast at the way we reacted in March 2020; I increasingly think think there should be criminal charges over the failure to lock down as the Kent variant spread in late 2020.  I think the central government response squandered years of public health planning and a strong industrial/academic base at the start of the pandemic.  But I’m not going to start making politically motivated conclusions from a few numbers without any attempt to control anything, lest it undermine my point rather than support it.

In reply to thread:

Article on the hospital crisis in Idaho

https://arstechnica.com/science/2021/09/idaho-covid-crisis-hospitals-overflowing-with-sicker-younger-patients/

Of the patients hospitalized with COVID-19, 90 percent are unvaccinated, as are 98 percent of ICU patients.

It sounds like delta is clobbering the unvaccinated far worse than previous variants.  

 Stichtplate 23 Sep 2021
In reply to tom_in_edinburgh:

> Death rates / million:

> England: 2,102

> Wales: 1,840

> Scotland: 1,542

> Northern Ireland: 1,382

> Irish Republic: 1,062

> Within the British isles the less connected to England the lower the death rate.

Population density:

England: 434 people per square kilometre

Wales: 151.4 persons per square kilometre

Scotland: 65 persons per square kilometre

Northern Ireland: 133 persons per square kilometre

Irish Republic: 72 persons per square kilometre

So looked at through the lens of population density (a considerably less spurious lens than "connected to England") It's clear that death rate ranking follows density with only Scotland's poor performance standing out as an anomaly.

Post edited at 07:58
1
In reply to wintertree:

> When making political points its important to give fully qualified physical units so others know what you’re talking about.  Per million what?  Bananas?  Cases?  Head of population?

Per million population obviously.

> > Within the British isles the less connected to England the lower the death rate.

> Do you have a quantified scale of how “connected with England” each nation is, to back up your assertion, or are we back to pulling correlations out of somewhere the sun doesn’t shine to back up a pre conceived idea?

Don't be obtuse.  It is obvious that Wales has a long land border with England near major population centres in England and a lot of people cross that border.  Scotland is a much longer journey from the larger cities in England.  Northern Ireland means a boat or plane.  Ireland is an international border and a boat or plane.

All I am saying is it is a hell of a coincidence and it pretty much lays to rest any doubt about whether Scotland would have been better off during Covid as an independent country in the EU like Ireland.

10
In reply to Stichtplate:

> So looked at through the lens of population density (a considerably less spurious lens than "connected to England") It's clear that death rate ranking follows density with only Scotland's poor performance standing out as an anomaly.

This sh*t again.

Population density of the whole country is irrelevant.  Scotland has a low population density because there are huge areas like the Cairngorms with hardly anyone in them.  The population density of the country as a whole tells you nothing about the population density in the cities where most people live and that's what matters from the point of view of Covid spreading.

8
 wintertree 23 Sep 2021
In reply to tom_in_edinburgh:

> Per million population obviously.

You say “obviously” but an unqualified “rate” has been a source of a lot of confusion recently.  Using implicit units because they’re “obvious” to you has some staggering consequences over the years, from a spaceship crashing in to Mars to a passenger jet running out of fuel over the ocean.

> Don't be obtuse. 

I’m not being obtuse.

> It is obvious that Wales has a long land border with England near major population centres in England and a lot of people cross that border.  Scotland is a much longer journey from the larger cities in England.  Northern Ireland means a boat or plane.  Ireland is an international border and a boat or plane.

You’ve just rattled off a bunch of stuff that’s a bit random and riddled with supposition.  It doesn’t lend credibility to your view, it makes it look like you’re diving in to a grab bag for anything you can chain together in an anti-English / pro Scottish independence shape.

You seem to be implying the difference is all about physical / travel distance from major English cities.   Simply having more travel distance from importation events followed by a coordinated 4-nation lockdown is not a sign of better governance, it’s a sign of luck, so I don’t actually have that much time for the point you’re making here.  There are other, good points about some aspects of the devolved points.  There are others that mirror all the negatives from Westminster.

 Stichtplate 23 Sep 2021
In reply to tom_in_edinburgh:

> This sh*t again.

Yeah, I know. It's still considerably less of a bullshit factor than "connected to England"

1
In reply to wintertree:

> You seem to be implying the difference is all about physical / travel distance from major English cities.   Simply having more travel distance from importation events followed by a coordinated 4-nation lockdown is not a sign of better governance, it’s a sign of luck,

Degree of political independence from Westminster also tracks difficulty of travel.  Wales being the least devolved, then Scotland, then NI which also has no land border to England, then the republic which is a separate country.

All through the pandemic Scotland's attempts at caution have been undermined by the open border with England and by the unionist UK media.  Travel to and from England for work was definitely a factor as was people travelling from English airports to avoid Scottish rules.

4
 Offwidth 23 Sep 2021
In reply to Stichtplate: 

That's a dumb argument (and at least he's stopped claiming the Ireland rate is far less than the England rate). Most people in all those countries live far far closer together than those relative population densities would indicate.

What Tom needed to say was 'far from the policy in England', which was further from the scientific advice than any other country in the British Isles and which, in part, led to the highest death rate. It's a certainty the England death rate would be tens of percent lower if Boris had responded faster to the scientific advice in September and December 2019, that cost the lives of tens of thousands in England (and through the extra unchecked spread, almost certainly more than there needed to be in the other home nations).

1
In reply to Offwidth:

>  

> That's a dumb argument (and at least he's stopped claiming the Ireland rate is far less than the England rate). Most people in all those countries live far far closer together than those relative population densities would indicate.

> What Tom needed to say was 'far from the policy in England', 

I think there are two aspects.  One is distance from the policy and the other is ease of travel because when there is a lot of to-and-fro travel people can get round the policies with a short journey and infections cross the border.

2
 wintertree 23 Sep 2021
In reply to thread:

Article from the BBC on the colds going around at the moment.  Lots of anecdotes from people that this is the "worst cold ever" etc, despite testing negative for Covid (aside: often by LFDs not PCRs......).  The likely cause of the worsening being people's exceptionally low exposure to the underlying viruses over the last 18 months, leading to weaker than normal natural immunity going in to cold season. 

All anecdata, but In terms of debilitating effects it sounds like there's a similar scale of effect between post-double-vaccinated Covid infections in some and these colds.  Something of a meeting in the middle?  No reason not to expect colds to go back in their box as exposure levels ramp up, will Covid go along with them?  

https://www.bbc.co.uk/news/newsbeat-58624295

 Fat Bumbly2 23 Sep 2021
In reply to Stichtplate:

Population density is misleading in Scotland. We get this from defenders of the Keep Out culture too. The place is either empty or high density with the population concentrated into small areas often with communal stairways etc. Most of us live next to lots of other people even though wide open spaces are nearby

1
 Stichtplate 23 Sep 2021
In reply to Offwidth:

> That's a dumb argument (and at least he's stopped claiming the Ireland rate is far less than the England rate).

Yes, I know. I'd already acknowledged that when Tom wrote:

This sh*t again.

and I replied:

Yeah, I know. It's still considerably less of a bullshit factor than "connected to England"

Perhaps you might want to read what I actually post before jumping down my throat as you seem determined to make a habit of it.

No need to apologise, it was tiresome enough dragging a "sorry" out of you the last time.

1
 Offwidth 23 Sep 2021
In reply to tom_in_edinburgh:

I can only think you do this on purpose as a wind-up. English policy choice has led to tens of thousands of avoidable covid deaths in England and UK government policy mistakes has probably led to similar numbers across the UK. Open internal borders were a problem but are little to do with distance.

 Offwidth 23 Sep 2021
In reply to Stichtplate:

I started a reply and got delayed and so missed the second one by the time I posted. It makes no difference really......

Population density is not considerably less of a bullshit factor than being connected to England . If the English government had followed the science it would almost certainly have significantly reduced deaths across the home nations as well as England. National level population density is almost entirely irrelevant to relative covid effects in the home nations.

3
 joem 23 Sep 2021
In reply to wintertree:

Or it’s just covid with a false negative, especially if its not a pcr…

 wintertree 23 Sep 2021
In reply to joem:

> Or it’s just covid with a false negative, especially if its not a pcr…

Well, that’s the increasingly large elephant in the room…. 

 joem 23 Sep 2021
In reply to wintertree:to be fair I only know not to trust lateral flow tests too much from following these threads so its hardly suprising.

 wintertree 23 Sep 2021
In reply to wintertree:

> All anecdata, but In terms of debilitating effects it sounds like there's a similar scale of effect between post-double-vaccinated Covid infections in some and these colds.  Something of a meeting in the middle?  No reason not to expect colds to go back in their box as exposure levels ramp up, will Covid go along with them? 

In terms of asking if Covid is going to go and live in the same nuisance-level box as previously circulating colds, some comment from members of the Oxford vaccine team in the link below along with a separate analysis from Nick Triggle.  I've pasted the article text as there's not a URL to that specific part. 

https://www.bbc.co.uk/news/live/uk-58662328

Covid-19 could resemble the common cold by spring next year as people's immunity to the virus is boosted by vaccines and exposure, according to a leading expert.

Prof Sir John Bell, who was part of the team that developed the Oxford-AstraZeneca vaccine, tells Times Radio the country "is over the worst" and things "should be fine" once winter has passed.

He was speaking after Prof Sarah Gilbert, who designed the Oxford vaccine, said Covid was likely to become like other seasonal coronaviruses that cause common colds, as immunity in the population grows and the virus evolves. 

Speaking to Times Radio, he says: "If you look at the trajectory we're on, we're a lot better off than we were six months ago.

"So the pressure on the NHS is largely abated. If you look at the deaths from Covid, they tend to be very elderly people, and it's not entirely clear it was Covid that caused all those deaths.

"And I think what will happen is, there will be quite a lot of background exposure to Delta (variant), we can see the case numbers are quite high, that particularly in people who've had two vaccines if they get a bit of breakthrough symptomatology, or not even symptomatology - if they just are asymptomatically infected, that will add to our immunity substantially, so I think we're headed for the position Sarah describes probably by next spring would be my view.

"We have to get over the winter to get there but I think it should be fine."

The question I haven't really seen tackled quantitatively is if the breakthrough infections in working aged adults are proving more brutal than other typical seasonal illnesses.  Personal experiences shared on here and elsewhere suggest it is worse, but there's also a lot of Covid about given the large pool of unvaccinated people that have been sustaining a pandemic phase and driving breakthrough infections in a way that shouldn't be possible by next year.

It's really interesting to see a convergence with Covid decreasing in seriousness through vaccination (a good thing) and prior exposure (not a good thing) and common cold causing virus decreasing in seriousness through reduced prior exposure.  To me this shows how interconnected the spread of common cold causing viruses and human health are, and how important their continued circulation is to avoiding catastrophic pandemic potential.  After the pandemic phase of Covid is truly passed, we're going to have some interesting questions about our future relationship with viruses; for a long time there's been general observations on the failure of medical science to eliminate the common cold, but given the presence of unknown reservoirs the various viruses behind it, and seeing the pandemic potential of one virus without any prior human exposure or immunity, perhaps it's just as well that there's not been a previous successfully attempt to eliminate "the common cold".  We're going to have a lot more tools and experience to make that viable post-Covid, but it's not something I think we are anywhere near ready to try in terms of wider consequences...

 Offwidth 23 Sep 2021
In reply to wintertree:

I think the view of the two Profs ignores the elephant in the room plus any potential vaccine escape. I'd be delighted if the future confirms their view but I think it's wishful thinking for spring 2022 and goes against taking public health messages as seriously as I think we still need to right now. The immuno compromised and all those older people who haven't been jabbed nor infected still risk hospitalisation and death and that is still probably millions in the UK. My local hospital's capacity problems have hit the news now despite the NHS press blocks (and staff knowing for weeks).

https://www.nottinghampost.com/news/nottingham-news/nottingham-hospitals-under-extreme-pressure-5931748

Platitudes from the Board that almost normalise OPEL 4, which  should be an exceptional emergency situation in normal times ... let alone in the context of the mental pressure hospital staff have been working under for the last 18 months. 

Post edited at 13:30
1
 wintertree 23 Sep 2021
In reply to Offwidth:

I think their comments can be looked at in very different ways in terms of the undeniable and unrelenting pressure on healthcare.  

One way to look at the pressure staff have been under is that, for many, this will be less personally destructive if they have genuine hope there's an end in sight, rather than just facing overload without end.  At this point we are where we are, and we've no real "big picture" choice but to see this process through.  In terms of your concern over undermining people taking public health messaging with appropriate concern, I've a lot more criticism for that messaging itself than for a couple of domain experts giving their assessment of where we are in the process of normalising this virus; I think they've bided their time until an appropriate moment.  They're as clear as they can be that Covid is still a big issue for the coming winter.

Hospital occupancy in England is seeing the first significant fall since mid-May; at worst I hope there's a couple of weeks of that to come, at best - months.  

I'm not sure their view does ignore the elephant in the room so much as extrapolate from it.  

Vaccine evasion - not likely to be a binary process, and the further we get through the current stage of things perhaps the more pandemic potential we take out of any such variant if it appears.  

I'm still keeping the optimistic hat on.  We'll see what happens with adult case rates over the next week in particular.

> and all those older people who haven't been jabbed nor infected still risk hospitalisation and death

One way and another that pool of people is shrinking.

In reply to Offwidth:

>  Open internal borders were a problem but are little to do with distance.

They are to do with distance and travel expense/convenience because these factors influence how much traffic will cross the border.  When there are major population centres close to an open land border  you will get more cross border traffic for work and leisure and more use of different policies on the other side of the border to evade restrictions on your side.

Post edited at 16:03
2
 wintertree 23 Sep 2021

In reply to thread:

Another day of data on both rate constant plots for England; remember that the demographic data stops a few days short of the top level data.

About as promising as today's update could be that this isn't taking off badly and that adult cases are still falling...

Two days now without healthcare updates for England due to a systems meltdown.  ("Because of a major incident with the data collection system used by NHS England to collect daily data, there is no update to hospital data in England.")


 Offwidth 23 Sep 2021
In reply to tom_in_edinburgh:

You are not just thinking this through as all sorts of other factors will be involved (outside restrictions): to complicate your unevidenced distance arguments. I suspect if you just look at deprived populations as well as comparative government actions, it will explain the majority of the national differences. Your arguments look like a classic example of mistaking correlation for causation.

1
 Offwidth 23 Sep 2021
In reply to wintertree:

The same crap gets rolled out by some senior management in Universities.. too many of these top managers just don't give a shit. In the case of Nottingham hospitals if they really listened and cared they would have fixed major problems way before they led to the death of way too many kids in their maternity wards. Doing the government bidding is part of their gravy train, until something breaks.

https://www.independent.co.uk/news/health/nottingham-nhs-maternity-cqc-warning-b1905194.html

Telling medical staff things might be better with covid in the spring is maybe going to be too late for many of them, ill health retirement or resignation is a real imminent issue for some. Plus, as I suspect, if it soon becomes obvious that it will take months longer, to reach the point we are talking about, how will that bad news after false hope go down? Outside covid there are years worth of covid delayed backlogs on treatments to clear with massive vacancy levels already and no obvious cover recruitment routes given government intransigence on immigration.

If forced to guess, I'd expect hospitalisations to dip then grow again and be fairly high (significant compared to current levels)  for at least a couple of months, as people, who have been careful, gradually let down their guard based on bogus good news; and then put it up a bit again as hospitalisations go the other way after any spread from schools, unis and work becomes obvious; just as the weather gets colder. My guess isn't pessimism...SAGE worst case scenarios are much worse and I see their mid range predictions as (I hope) unduly pessimistic, based on dubious modeling due to high complexity.

Yes the few millions who may be still susceptible to hospitalisation are decreasing but the numbers are not shifting fast because in any rapid 'move to herd immunity' scenario a few % of them would be hospitalised (tens of thousands) and about 0.5% will die.  Numbers right now are too low for us to be seeing to such a surge, so this indicates behaviour is still probably restricting spread and the rate will likely be highish for some time. As time goes on a small percentage may become newly susceptible, as their immunity wanes.  I hope you are right and I am wrong but any current prediction beyond the next few weeks is a mugs game.

Post edited at 17:50
In reply to Offwidth:

> You are not just thinking this through as all sorts of other factors will be involved (outside restrictions): to complicate your unevidenced distance arguments. I suspect if you just look at deprived populations as well as comparative government actions, it will explain the majority of the national differences. Your arguments look like a classic example of mistaking correlation for causation.

Sure, many factors are involved.  But I find it striking that the death rates reduce with 'connectivity' to England and that the differences in death rate are quite large.   England > Wales > Scotland > Northern Ireland > Ireland.    That ordering doesn't correlate with deprivation.  I keep hearing England is richest and subsidises everyone else so much that nobody could survive without it.

3
 Offwidth 23 Sep 2021
In reply to tom_in_edinburgh:

That order is exactly what you would expect in the UK with England being the high outlier due to noticably poorer covid response and given the comparative poverty levels.

https://www.jrf.org.uk/data/poverty-levels-and-trends-england-wales-scotland-and-northern-ireland

Post edited at 17:47
In reply to Offwidth:

> That order is exactly what you would expect in the UK with England being the high outlier due to noticably poorer covid response and given the comparative poverty levels.

I don't really understand their definition of poverty as being less than average earnings, by that definition you could be in poverty and living on a yacht in Monte Carlo if your yacht was smaller than the average in the harbour.  They don't even say whether the comparison is with the average earnings for the UK as a whole or the average earnings for your region/country.  

Let's look at actual money because in my view poverty is about not being able to buy stuff you need not how much the guy next door can buy.  England is richest, then Scotland, then Wales then Northern Ireland.

https://digitalpublications.parliament.scot/ResearchBriefings/Report/2021/2/19/32a8c620-b227-4951-b642-44fe823009d1#Appendix-A

2
 elsewhere 23 Sep 2021

We should look outside the UK for far more significant differences in vaccination uptake, deaths and policies to learn things. The differences between the four nations are probably in the noise.

1
In reply to Stichtplate:

I think your original point is a worthwhile one:

Taking the top ten most populated areas, Greater Glasgow comes fifth with a population of one million and a density (people per square km) of 3396. But this is still the lowest density of the top ten, all areas in England, with a total population of these areas of 20.5 million. (From wiki, using ONS).  In fact, greater Glasgow has one of the lowest densities, the seventh least densely populated in the whole list of nearly 78 areas. Motherwell, Dundee, Aberdeen are in the list but are less densely populated than after Glasgow. Only other Scottish area in the list is Edinburgh which is more densely populated. 

In reply to elsewhere:

> We should look outside the UK for far more significant differences in vaccination uptake, deaths and policies to learn things. The differences between the four nations are probably in the noise.

Indeed - and the data for English regions re enforces that point:

Yorkshire and The Humber 214.9

West Midlands240.3

South West 129

South East194.6
north West 260.9

North East 242.6

London 181.5

East of England 223.1

East Midlands 220.6

all death rates per 100,000 population, and bouncing around those for the nations with a very poor correlation with distance from westminster

 Stichtplate 23 Sep 2021
In reply to Bottom Clinger:

I don’t think it holds up any more than “contact with England” does. It’s just too complicated. There’s just loads of demographic and socio-economic stuff tied in with an area having a high population density, all of which will have a bearing on infection rates, transmission and reporting.

 elsewhere 23 Sep 2021
In reply to Dr.S at work:

There are about a dozen European democracies with vaccine uptakes as much as TWENTY percent higher than in the UK. Looking within the UK ignores a bigger picture.

1
 rlrs 23 Sep 2021
In reply to elsewhere:

> There are about a dozen European democracies with vaccine uptakes as much as TWENTY percent higher than in the UK. Looking within the UK ignores a bigger picture.

I get eight european democracies with up to 17% higher vaccine uptake (at least one dose), from the Our world in data site: Portugal, Spain, Denmark, Norway, Finland, Italy, France & San Marino. 7 of them have up to 9% higher uptake.

Edit: add Belgium with 2% higher, so 9 countries in total.

Post edited at 21:02
 elsewhere 23 Sep 2021
In reply to rlrs:

9 vs "about a dozen" - not far out!

1
 MG 23 Sep 2021
In reply to elsewhere:

Is the percentage of those offered, or total population?  Since we aren't vaccinating many children, our numbers will belower as a total.

 elsewhere 23 Sep 2021
In reply to MG:

Percentage of total population as vaccination not offered or declined does not reduce viral transmission.

1
 rlrs 23 Sep 2021
In reply to elsewhere:

It was the "as much as 20%" that Mr Picky was mainly taking exception to

In reply to elsewhere:

Absolute game changer for deaths and hospitalisations though

 wintertree 23 Sep 2021
In reply to MG:

> Is the percentage of those offered, or total population?  Since we aren't vaccinating many children, our numbers will belower as a total.

Taking ourworldindata (OWID) as the source; that says “Share of people”; that sounds like total population but I struggle to understand that 87% for Portugal as of “total population” as they’re vaccinating 12+, with around 11% of their population aged under 12 meaning they’d have to have nigh on 100% uptake in everyone aged 12+.

Reuters are estimating 77% - https://graphics.reuters.com/world-coronavirus-tracker-and-maps/countries-and-territories/portugal/

Elsehwere, I’m looking at the “ourworldindata” page on vaccine uptake with a quizzical eye…

Edit:  The OWID data on at least one dose is consistent with the WHO page for Portugal, and Reuters give an estimate based on two doses per person so there isn't necessarily a discrepancy there.  But if they really are at ~87% of the whole population at 1 or more doses, that implies almost 100% uptake in all eligible ages.   Very,  very impressive if that's the case.

Unrelated - looking for age distribution for Portugal I was very surprised to see how rapidly their population is shifting - population per year of age has almost halved from 40 year olds to newborns - https://www.populationpyramid.net/portugal/2020/

Post edited at 22:15
In reply to Dr.S at work:

> all death rates per 100,000 population, and bouncing around those for the nations with a very poor correlation with distance from westminster

Who said anything about distance from westminster?

The English cities are highly interconnected with many motorways, railways and other roads, people move between them all the time.

There is a degree of separation to Scotland due to distance - you've got to drive all the way through the lake district and the borders to get eg. from Manchester to Glasgow.   Less so to Wales and more so to Northern Ireland because the sea is in the way.

This isn't even controversial, the simulations of virus spread across the UK they did for pandemic modelling take connectivity into account.

3
 elsewhere 23 Sep 2021
In reply to rlrs:

You are precisely right!

In reply to anyone as bored as me:

Coz I’m bored, from world in data:

UK:  73% 67%

Finland: 76% 60%

Denmark: 77% 75%

Portugal: 87% 83%

France: 74% 64%

Italy: 74% 66%

Norway: 77% 67%

Spain: 80% 77%

In reply to tom_in_edinburgh:

My point really is that England had one set of Covid rules, Wales another, Scotland another etc etc - but the variability across the UK by nation is similar to the variability across England by region, so whilst the rules applied could explain some difference between nations other factors are clearly important, and it could be that the differences in regulations have had little impact as in fact they are quite similar -  as elsewhere suggested.

 Misha 23 Sep 2021
In reply to tom_in_edinburgh:

I haven’t checked the numbers but assuming they are correct, I agree with your point re proximity to England. I would just note that RoI could possibly count deaths differently but even if that is the case, it’s very unlikely to account for all or even most of the difference.

I also think Stichtplate’s point about population density isn’t really valid given that Scotland has huge areas which are very scarcely populated, which distorts the numbers.

However your comment that Scotland would have been better off alone is not a given. There are many different factors behind the Covid death rate. One of them is the furlough scheme and other government support schemes which were critical to lockdown compliance. Would an independent Scotland would have been able to borrow it’s equivalent of the c. £300bn spent by Westminster?

There is also the question of borders and control measures. Would the border have been harder if Scotland was independent? I doubt it - Nicola more or less closed it at times and more or less opened it at other times. She already had and exercised that power. She also imposed or relaxed measures based on a separate timescale and the measures were similar but not the same. Again, she already had and exercised the power for Scotland to go its own way.

What I’m saying is, if Scotland were independent, I doubt that the border would have been harder or the measures more stringent. So whilst it’s best that the death rate is lower, I doubt it would have been much lower than if Scotland were independent. 

Edit - wintertree’s point about Scotland’s geographic separation benign (obviously) a matter of geological chance rather than political judgement is also well made. I agree with your point about distance vs rate but I wouldn’t use that to then make a political point. Not least because distance is not dictated by politics.  

Post edited at 23:27
 Misha 23 Sep 2021
In reply to Dr.S at work:

You would have to look at the average for the country but flex it for deprivation levels and various other factors. It gets pretty hard to compare things scientifically and you could probably cut it different ways depending on what you wanted the numbers to show! However it’s fair to say that the 4 Nations are fairly similar, so comparing the average death rates for each nation is not unreasonable. 

 Misha 23 Sep 2021
In reply to wintertree:

If I were ourreeed, I would jump on your post to misinterpret it as a call for immunity through infection. Of course that’s not what you’re suggesting. What I would say though is I don’t think it’s wise to compare Covid to the common cold. It could be that the cold isn’t that serious due to repeated exposure but (1) it’s never that serious in the first place - I don’t suppose anyone dies from the cold even on first exposure; (2) we all sometimes get bad colds which are a lot worse than what we had last time / previously; and (3) we’ve lived with the cold for thousands of years presumably, so the host has had time to evolve (then again, if it was never that serious, there would presumably be little pressure for the host to evolve - the fact is that we just don’t know was the common cold was like in 10,000 BC). I don’t necessarily disagree with what you’re saying about Covid (though it is on the optimistic side) but I would be wary of comparing it to the common cold.

 wintertree 23 Sep 2021
In reply to Misha:

More than the odd thought doesn’t get posted out of worry of misunderstanding or misrepresentation.

>  I don’t suppose anyone dies from the cold even on first exposure

Humans will suffer a raft of “common cold” infections before they’re five.  Almost nobody in that age range has died of covid either.  If adults were getting exposed en mass to common a cold causing virus for which all prior immune exposure had been deleted, how pandemic would it go?  The worsening symptoms on common colds this autumn show what the first step down that road to immune forgetting looks like.  That’s why it’s so interesting to see the changes in both directions across different viruses.

That’s the critical question to me - is covid actually intrinsically worse than a raft of other nuisance level viruses, or is the problem that adults are catching it without any prior exposure to any part of the virus during their lives, and that it’s happened very rapidly due to lack of any prior immunity to moderate transmission?

> then again, if it [the common cold] was never that serious

Put it this way, if you offered to wipe all immune memory from my body of other long circulating coronaviruses my answer would be a hard no.  

> but I would be wary of comparing it to the common cold.

It’s obviously still far from being comparable.  But that comparability is a best case take on where this could all end up.

Post edited at 23:54
In reply to Misha:

> What I’m saying is, if Scotland were independent, I doubt that the border would have been harder or the measures more stringent. So whilst it’s best that the death rate is lower, I doubt it would have been much lower than if Scotland were independent. 

OK - but my view is that Ireland is the obvious comparator for Scotland if it was independent and in the EU.  It has a roughly similar population and culture.  Ireland is at roughly 1,000 Covid deaths per million where Scotland is at 1500 and England is at 2000.  Based on what Ireland achieved I reckon Scotland could do significantly better on Covid outside the UK but within the EU and I reckon that if Ireland could fund it then so could Independent Scotland.

2
In reply to wintertree:

> That’s the critical question to me - is covid actually intrinsically worse than a raft of other nuisance level viruses, or is the problem that adults are catching it without any prior exposure to any part of the virus during their lives, and that it’s happened very rapidly due to lack of any prior immunity to moderate transmission?

My view is it is several years too early to ask this kind of question.

We are only 1.5 years in and in the era of rapid technical and scientific progress with regard to Covid so it makes no sense to rush into catching it.   If it became clear that progress had stalled and things weren't going to be any better next year than this year that's the time to start thinking about hard choices.

Post edited at 03:34
In reply to wintertree:

> Elsehwere, I’m looking at the “ourworldindata” page on vaccine uptake with a quizzical eye…

Deeeee   nom    in      ay       torrrrrs

Irt various:

https://theconversation.com/how-will-the-covid-pandemic-end-167244

In reply to tom_in_edinburgh:

Its unquestionably the case that all of the British and Irish countries could have done better on Covid. I think that Ireland has done best of all of them, but I suspect that’s down to having a doctor in charge at the start and probably lower initial seeding rather than any EU effect. 
 

think that the restrictions imposed by Scotland where better than those imposed by England, and I know I would have preferred Nicola Sturgeons leadership on this over Boris Johnson’s - but it’s going to take some pretty good stats supported by the type of detail that Misha mentions to come close to proving that the differing choices made in the five countries had an impact.

 elsewhere 24 Sep 2021
In reply to Longsufferingropeholder:

You reckon Portugal has mislaid 5, 10, 15 or 20% of their population boosting vaccination uptake rates?

In reply to elsewhere:

10% is by no means unreasonable. The UK has 'misplaced' something like 8% of its population between the two ways of measuring it, so yeah.

What I've learned from looking at vaccination stats is that even developed nations with offices for national statistics have no idea how many people live in them.

Post edited at 07:43
 wintertree 24 Sep 2021
In reply to Longsufferingropeholder:

Could be the denominator, but I’m wary of invoking that to explain away any number I don’t like when it has to work in different directions for different countries to do so.

Re: that article - yes, having immunity from severe disease fade more slowly than immunity from symptomatic infection is the signpost saying “way out”.  Big leap of faith to run blindfolded down that path in the dark though, which is more or less what policy seems to be.  First couple of times we tried it we ran in to a cliff face and went back to bear the start.  Despite knowing that www likely. Third time’s the charm…?

In reply to tom_in_edinburgh:

> My view is it is several years too early to ask this kind of question.

> We are only 1.5 years in and in the era of rapid technical and scientific progress with regard to Covid so it makes no sense to rush into catching it.   If it became clear that progress had stalled and things weren't going to be any better next year than this year that's the time to start thinking about hard choices.

You seem to be massively mis-interpreting my question.  I’m asking what for the next 5 years remains a 100% hypothetical question (unless your solve-all rapid technological progress includes a time machine?).  I’ll put the question a different way.  

If all adults had previously caught the virus before they were 6 years old, and then been re exposed occasionally from then on, would it be any worse for adults than other common cold viruses?

This question doesn’t imply “hard choices”.  Doesn’t seem to soon to start asking this question - lots of relevant data is emerging and it starts to tells us what the default endgame to all this looks like.  

In reply to wintertree:

> Could be the denominator, but I’m wary of invoking that to explain away any number I don’t like when it has to work in different directions for different countries to do so.

You'd kind of expect that, extrapolating what we see with uni towns to international migration. But more realistically it's extreme noise on some very big numbers. Turns out there's no good way to count people.

In reply to Dr.S at work:

> I think that the restrictions imposed by Scotland where better than those imposed by England, and I know I would have preferred Nicola Sturgeons leadership on this over Boris Johnson’s - but it’s going to take some pretty good stats supported by the type of detail that Misha mentions to come close to proving that the differing choices made in the five countries had an impact.

It's not about mathematical proof or even scientific proof to a confidence level it is about balance of probabilities.  You almost never get scientific proof on social/political issues but you still have to decide which way to vote.

England 2,000 deaths/million, Scotland 1500 deaths/million and Ireland 1,000 deaths/million is plenty of evidence to make a decision on balance of probabilities.

2
In reply to wintertree:

> You seem to be massively mis-interpreting my question.  I’m asking what for the next 5 years remains a 100% hypothetical question (unless your solve-all rapid technological progress includes a time machine?).  I’ll put the question a different way.  

Probably:  I got the idea based on the previous methods in the thread you were starting to talk about immunity through infection as a strategy or it being reasonable to stop trying to catch it.

My point is that for as long as scientific/technical progress is rapid and we expect things to be significantly better next year than this year in terms of vaccines, medicines and other control technologies we should try and avoid catching it.

1
 Stichtplate 24 Sep 2021
In reply to tom_in_edinburgh:

> It's not about mathematical proof or even scientific proof to a confidence level it is about balance of probabilities.  You almost never get scientific proof on social/political issues but you still have to decide which way to vote.

One stat that's pretty much universally accepted as a good indicator of a government's success in providing effective health provision is life expectancy at birth.

> England 2,000 deaths/million, Scotland 1500 deaths/million and Ireland 1,000 deaths/million is plenty of evidence to make a decision on balance of probabilities.

Male life expectancy: England- 79.33, Scotland- 76.79

and those are post covid figures. In fact, Scotland has the lowest life expectancy for both men and women out of all four home Nations. So there's plenty of evidence that, on the balance of probabilities, the SNP has been consistently failing to provide comparably effective health care.

https://www.bbc.co.uk/news/uk-scotland-58663991

Post edited at 08:16
1
In reply to Stichtplate:

> So there's plenty of evidence that, on the balance of probabilities, the SNP has been consistently failing to provide comparably effective health care.

You realise what you've just said is "please explain at length why that's England's fault" don't you?

 Stichtplate 24 Sep 2021
In reply to Longsufferingropeholder:

> You realise what you've just said is "please explain at length why that's England's fault" don't you?

I'm pretty sure that if Tom tripped on a curb while traversing The Royal Mile, he'd mutter "Bloody English!" under his breath as he went on his way,

In reply to Stichtplate:

> One stat that's pretty much universally accepted as a good indicator of a government's success in providing effective health provision is life expectancy at birth.

If you look at the graph of life expectancy for all countries of the UK one thing leaps out at you.  It was increasing steadily for decades, and increasing fairly fast in Scotland, and then it flatlines and stops improving at the point the Tories got elected in about 2015 and introduced austerity policies.

https://spice-spotlight.scot/2020/01/22/stalling-and-declining-life-expectancy-in-scotland/

Scotland's budget is set by England, the SNP can move stuff around at the margins but if Westminster decrees austerity they can't avoid it.   To do that they'd need to be able to borrow, or to cancel sh*t the English want like Trident or to rebalance taxes in radical ways rather than just tinkering with income tax by a percent.

2
In reply to Stichtplate:

Thing is, the current life expectancy figures are related to policies/measures put in place way before SNP came into power. That’s why governments fail to address health inequalities - they won’t see the impact of their measures until decades after the next election so can’t be arsed investing. 

In reply to tom_in_edinburgh:

I reckon a key factor why Scotland has fared better is that the virus entered the UK in south east England, spreading northwards. Scotland had a head start on their decision making, and this head start combined with better measures had a big impact. Johnson had a head start (it was just a matter of time before it hit us) as well but he is such a dimwit he locked down weeks too late. So your idea of ‘being farther away to Westminster’ is true, in my view. 
And there is research about population density and Covid:  more dense = more Covid, but guess this would not have as big an impact as the above. 

 Offwidth 24 Sep 2021
In reply to Stichtplate and LSRH:

Oh for the happier days when ad hominem attacks were the angry response of those who had lost or had no arguments.

3
 wintertree 24 Sep 2021
In reply to tom_in_edinburgh:

> Probably:  I got the idea based on the previous methods in the thread you were starting to talk about immunity through infection as a strategy

It is a strategy.   It always has been and always will be a strategy. It would be madness to pretend otherwise.  It's not the same strategy it was however, as our situation changes:

  1. At the start of this pandemic it was a strategy of "immunity through virgin infection"
  2. Now, with widespread vaccination and significant infection acquired immunity the strategy is two pronged
    • Refreshing/updating prior immunity through booster jabs for the more vulnerable and through (breakthrough or re)-infection
    • First immunity through infection for the unvaccinated who have not had past infections

To follow (1) would have been unwise to say the least.  (2) Has apparently been the de-facto strategy we have been subject to for some months now.

>  you were starting to talk [...] it being reasonable to stop trying to catch it.

I think that's perfectly reasonable think to discuss thus given where we are.  To repeat what I said to Misha, some topics get avoided I think because it gets tedious when others jump to conclusions.  

Let's consider what people are doing first:

  1. Plenty of people long ago decided it was reasonable for them to stop trying to catch it and are back to living pre-pandemic lifestyles. 
  2. Plenty of people are - like me - no longer avoiding trying to catch it at all costs, but are avoiding worse perceived risks
  3. Plenty of people are still to avoid catching it at all costs.

Right now, with R in adults staying < 1 and hospital occupancy reducing, there is no great societal pressure to put aside people's own choices and I am not going to judge any of the above as reasonable or unreasonable given where we are now.  I'm somewhere in the middle and that's not bothering me.

> My point is that for as long as scientific/technical progress is rapid and we expect things to be significantly better next year than this year in terms of vaccines, medicines and other control technologies we should try and avoid catching it.

You've been putting your faith in "new technology" on this for some time; the magic contact tracing badges never happened, the magic side-effect free high pressure contactless injectors never happened; the winter boosters are going ahead without a variant adapter vaccine.  I hesitate to say it, but your techno-optimism-ometer might need a gentle recalibration? 

In terms of control measures - no new technology is needed I think to make significant improvements to the spread and to reducing high viral load situations.  HEPA filtration of air dates back in concept by about 80 years.  The problem isn't the technology - it's getting the understanding, funding and commitment to overhauling air handling in institutional estates from a variety of eras and getting people at home to open their windows or to install air filtration or mechanical heat recovery positive pressure ventilation etc. 

Therapeutics are coming on and will continue to improve the odds for some people, but they don't to me seem like a way of avoiding the endgame, but of softening the blow for individuals of getting to it.  That gives motivation for delaying an "exit wave" - timescales of mutation and the uncertainties over the seasonality of Covid in a world without significant control measures and the uncertainties over the flu season give a pressure in the opposite direction.  I'm glad I'm not making policy choices on all this as it's very difficult now to see a clear "better" direction.  The worst ones remain as clear as ever.  

I'm certainly not encouraging people to rush out and get Covid, as I said to someone asking a question I the pub last week:

We're not really out of the woods yet in terms of getting past the point a lot of people without immunity are catching and spreading the virus; stalling the answer to your question until we get to that point is not a bad plan...

 wintertree 24 Sep 2021
In reply to tom_in_edinburgh:

> England 2,000 deaths/million, Scotland 1500 deaths/million and Ireland 1,000 deaths/million is plenty of evidence to make a decision on balance of probabilities.

Okay, so you have used some numbers to draw a conclusion "on balance of probabilities".  Can you show us your workings for those probabilities?  Can you give us a P-factor?

 Stichtplate 24 Sep 2021
In reply to Offwidth:

> Oh for the happier days when ad hominem attacks were the angry response of those who had lost or had no arguments.

Given Tom’s decade long posting history, highlighting his anti English bias is about as much of an ad hominem as accusing him of being called Tom and living in Edinburgh 😂

Post edited at 10:10
In reply to wintertree:

> > England 2,000 deaths/million, Scotland 1500 deaths/million and Ireland 1,000 deaths/million is plenty of evidence to make a decision on balance of probabilities.

> Okay, so you have used some numbers to draw a conclusion "on balance of probabilities".  Can you show us your workings for those probabilities?  Can you give us a P-factor?

Have you ever in all your years of voting in elections ever had a manifesto with a p factor attached?

What about when you were buying a house or a car or being on a jury?

The very large differences in mortality is way better evidence than most of the evidence these decisions are taken on.

3
 wintertree 24 Sep 2021
In reply to tom_in_edinburgh:

So, to be clear, when you said:

>  is plenty of evidence to make a decision on balance of probabilities.

It turns out you did not look at the probabilities, let alone their balance?

Dressing an opinion in scientific language to attempt convey a level of certainty you haven not shown is bullshit, regardless of the veracity of the conclusion you're looking to shore up.

 I rally against this when it comes to anti-vax and Covid-skeptic posts, so I can't very well sit here and let it slide if it happens to be in the other direction.  That's my interpretation of balance.

> manifesto

A promise about what someone is going to do is entirely unlike reaching a conclusion over causal factors on past events.

> buying a house 

Buying a house is entirely unlike reaching a conclusion on causal factors over past events.  I would not use the term "balance of probabilities" in relation to buying a house unless I had some defensible probabilities at my back.

> or being on a jury?

I have never been on a jury, but my understanding is that qualifying ones degree of certainty is of paramount importance there.

1
In reply to wintertree:

> You've been putting your faith in "new technology" on this for some time; the magic contact tracing badges never happened, the magic side-effect free high pressure contactless injectors never happened; the winter boosters are going ahead without a variant adapter vaccine.  I hesitate to say it, but your techno-optimism-ometer might need a gentle recalibration? 

So the virus appeared around December 2019 and by September 2021 we have given out billions of doses of fairly effective vaccine, we are doing testing on an unprecedented scale, we are making fairly effective masks on an unprecedented scale and we have fairly reasonable contact tracing and vaccination status checking apps.  We also have better treatment protocols and promising new medicines on the way.

That is a lot of progress in less than two years and a lot of knowledge which can be built on.  It is crazy to think that if we sustain the effort things won't be better next year and better again the year after.

There's nothing magic about contact tracing badges you could build them with off the shelf components, nobody has done so because they prefer the phone solution.  My view is they are wrong and badges are a better approach than phones.  Very likely a country like China will do badges in the future if they feel the need to control it with public health measures.

The injector things exist and have been available for years.  I provided a link to the company that makes them at the time.   I still think that some vaccine hesitancy is actually needle hesitancy and a jet injector could help convince some people even if it was actually slightly more painful.

Your techno-pessimism needs recalibration, we are less than two years in.  Most of the things we could do haven't been done yet.  We didn't get integrated circuits within 2 years of William Shockley making a transistor.

1
 wintertree 24 Sep 2021
In reply to tom_in_edinburgh:

> So the virus appeared [...]

Yes, I've said all these things many different times in many different ways.

> That is a lot of progress in less than two years and a lot of knowledge which can be built on.  It is crazy to think that if we sustain the effort things won't be better next year and better again the year after.

It's far from clear that vaccination is going to get much "better" as you have previously claimed, because it's reaching the limits of what the system it primes can do when ideally variant matched.  It's been such a spectacular success there's almost no room for improvement.

It's also far from clear that we should continue going for vaccination that's as effective as possible against transmission once the worse is passed - the path to the future quite likely lies in curtailing suffering and death, not stopping all transmission.   

> There's nothing magic about contact tracing badges 

Didn't happen though, did they?  That's my point - you invented magic future technology, and it didn't happen.  Doesn't matter if it's perfectly possible, it might as well be magic because it didn't happen.

Would have been better off putting HEPA filtration in schools and other venues.

> The injector things exist and have been available for years. 

Didn't happen though, did they?  Also didn't address a core problem.......  Or a problem at all, really...

IMO, your techno-optimism is totally out of calibration to both where new solutions are needed, to the viable timescales of roll out and to what is going to happen.

> Your techno-pessimism needs recalibration

I disagree vehemently.  

You've been consistently inventing magic future technology solutions to solve problems that were not on the critical path.

> we are less than two years in.  Most of the things we could do haven't been done yet. 

And most of the reasons we haven't done the things we could do are political and social, not technological.

  • The virus is mutating faster than adapted vaccines are making it through regulatory approval.  I don't see any magic future technology or rash policy changes that are going to speed up the process when it comes to another variants rising to dominance before an adapted vaccine is out.  
  • I don't expect any magic advances in vaccination, and if they did happen it's not clear we should use them universally vs just for the more vulnerable given what a sustainable end game might look like - and that's where my earlier question about the intrinsic lethality of this virus becomes so important - to understanding if what we're aiming for is what we think.
  • The therapeutics in the pipeline are many and varied, and interesting, and hold a lot of promise.  But they're not just going to "switch off" the consequences of immunity free infection any time soon, and they're not going to render the most vulnerable immunised adults "safe".

> We didn't get integrated circuits within 2 years of William Shockley making a transistor.

Very bad analogy, because in the mean time a virus wasn't running around building secret IC factories inside the global population.

You're absolutely right that it takes a long time time to produce all these technological solutions.   

It's not that I doubt the potential for incremental improvements across the board from policy through ventilation and vaccination to therapeutics to create a world in which we could live more normally with a high pandemic-potential virus in circulation, it's just I like to think I've got a realistic understanding of the speed at which these processes move and I hope/think with the big helping hand we've given already, the problem will fade away soon enough, just so long as we keep pushing and pushing at it.  With this expected to happen before the raft of technology you propose holding out for comes through.  

It's clear many people are back to pre-pandemic lifestyles now so it's an entirely academic debate other than for individuals who wish to continue holding out at all costs against catching Covid.  If they have the freedom of being able to structure their lives in that direction, that's great for them.  Many other people don't.  They may or may not be making a "better" decision with regards their health from Covid.  There are pros and cons IMO and I couldn't quantify those probabilities enough to balance them.

Post edited at 11:02
 Offwidth 24 Sep 2021
In reply to Stichtplate:

If you were just highlighting where and why Tom was wrong I wouldn't have any issue. Personal attacks have no place in scientific debate threads, however infuriating the other side of the debate becomes.

5
In reply to wintertree:

> It's far from clear that vaccination is going to get much "better" as you have previously claimed, because it's reaching the limits of what the system it primes can do when ideally variant matched.  It's been such a spectacular success there's almost no room for improvement.

It's far too early to assume it isn't going to get better.  Give the guys a chance!  If after five or ten years they aren't getting anywhere then maybe you are right.  But assuming no progress is possible after one product generation is just stupid.

> It's also far from clear that we should continue going for vaccination that's as effective as possible against transmission once the worse is passed - the path to the future quite likely lies in curtailing suffering and death, not stopping all transmission.   

Maybe it does but it is far too early to conclude that.  The default assumption should be that the guys who got us this far in a year and a half will be able to do better if you give them another year or so and a lot of money.

> Didn't happen though, did they?  That's my point - you invented magic future technology, and it didn't happen.  Doesn't matter if it's perfectly possible, it might as well be magic because it didn't happen.

The jet vaccinator obviously did happen because they have been in use for years!

As for the badge 'didn't happen yet' would be more accurate.  There is a huge difference between 'didn't happen within a year and a half' and 'isn't going to happen'.

2
 wintertree 24 Sep 2021
In reply to tom_in_edinburgh:

>> It's far from clear that vaccination is going to get much "better" as you have previously claimed, because it's reaching the limits of what the system it primes can do when ideally variant matched.  It's been such a spectacular success there's almost no room for improvement.

> It's far too early to assume it isn't going to get better.  Give the guys a chance! 

It's not been one generation.  The technology platforms behind these vaccines were not invented for Covid, not one of them.  

There's also a limit to how much the immune system can be primed.

Diminishing returns.  It's a thing.

> If after five or ten years they aren't getting anywhere then maybe you are right.  But assuming no progress is possible after one product generation is just stupid.

If after five years we're depending on better vaccines than we have now, we'll have completely screwed the pooch and be living in some perpetual lockdown dystopia.

Do you suggest people hold out against catching the virus for another five to ten years on the off chance a much better vaccine will come out?

>> It's also far from clear that we should continue going for vaccination that's as effective as possible against transmission once the worse is passed - the path to the future quite likely lies in curtailing suffering and death, not stopping all transmission.   

> Maybe it does but it is far too early to conclude that. 

Which is why I raise the question you disagreed with.  That question is all about that conclusion.  I'm keeping an open mind on what is best, and you're responding to that by jumping to conclusions the other way based on predicting the future through totally inappropriate parallels to fundamentally different areas. 

> The default assumption should be that the guys who got us this far in a year and a half will be able to do better if you give them another year or so and a lot of money.

I disagree vehemently for reasons I have already stated several times over various threads and that you just ignore.

Variants are out-pacing the roll out of variant adapted vaccines.  

> The jet vaccinator obviously did happen because they have been in use for years!

Now you're being obtuse. Mass high pressure jet injection did not happen for Covid vaccination, and nor was it needed.

> As for the badge 'didn't happen yet' would be more accurate.  There is a huge difference between 'didn't happen within a year and a half' and 'isn't going to happen'.

Isn't going to happen.

 mondite 24 Sep 2021
In reply to tom_in_edinburgh:

> There's nothing magic about contact tracing badges you could build them with off the shelf components, nobody has done so because they prefer the phone solution. 

There are plenty of social issues though especially in the UK with its adversion to ID cards etc. This is also leaving aside the chip shortage and general disruption in the supply chains for spinning up an entire new product line.

I would agree the Chinese would probably love badges for tracking but not for any valid anti pandemic reason.

> The injector things exist and have been available for years.  I provided a link to the company that makes them at the time.   I still think that some vaccine hesitancy is actually needle hesitancy and a jet injector could help convince some people even if it was actually slightly more painful.

This hits the exact same supply and social issues. Supply is self explanatory but social needs a bit more. Yes some people might go "okay its better than a needle" but I suspect in many cases the jet injector would trigger the same response as a needle (personally i dont like needles but have the solution of looking over the other shoulder since its a visual thing for me. I think if it was the feeling the jet wouldnt be any better) and it would also feed into the 5g/unproven technology/why are they not using normal needles eh? is it to to inject the chips/random other conspiracy theories paranoia.

 elsewhere 24 Sep 2021
In reply to Longsufferingropeholder:

> 10% is by no means unreasonable. The UK has 'misplaced' something like 8% of its population between the two ways of measuring it, so yeah.

When you mean the two ways do you mean the normal ONS/census population estimate versus the number of people with an id in NHS/NIMS?

The purpose of ONS/census population estimates is to measure population. 

The purpose of NHS/NIMS is to retain health records.   

An 8% discrepancy is in the noise of the decision on when to stop counting dormant records.

Presumably retained dormant records of people who might come back make up more than 8% but are only counted by the DB admin. 

https://commonslibrary.parliament.uk/research-briefings/sn06077/ - emigration 200-400k pa for 55 years but when you add overseas students (500k pa?) and overseas workers (no idea) leaving UK there might be 1M UK health records going dormant every year. Many of those will be for people who will never return to live in the UK and may already be deceased overseas.

Anecdata - the NIMS estimate for my immediate blood family may be 200% out if all three of us are still counted when I'm the only one in the UK.

Post edited at 11:45
 Stichtplate 24 Sep 2021
In reply to Offwidth:

> If you were just highlighting where and why Tom was wrong I wouldn't have any issue. Personal attacks have no place in scientific debate threads, however infuriating the other side of the debate becomes.

Lets have a look at this ad hominem, this vile "personal attack" 

"I'm pretty sure that if Tom tripped on a curb while traversing The Royal Mile, he'd mutter "Bloody English!" under his breath as he went on his way "

That's a personal attack is it? Don't clutch on to your handbag quite so tightly there Chief, you're in danger of breaking a fingernail

Edit: Oh shit! Did I just do it again? Have I just launched an unwarranted personal attack on you?

Hmmm...maybe in your World, but absolutely not in mine. In my World that sort of stuff comes firmly under the heading of humorous discourse. In my World actual verbal abuse and threats of violence are common currency (and frankly water off a duck's back).

Post edited at 11:47
 elsewhere 24 Sep 2021
In reply to mondite:

> I would agree the Chinese would probably love badges for tracking but not for any valid anti pandemic reason.

People do social media, surfing & communication on the phone so phones fulfil the the malign political/social control function far better than a badge.  

In reply to elsewhere:

That's kind of what I'm getting at. After the last couple weeks' discussion we're all acutely aware of the errorbars on the UK population. Safe to assume we're not the only country that has those. Not unreasonable to assume we're not the worst.

 Offwidth 24 Sep 2021
In reply to Stichtplate:

Yes discourse in science is generally held to a much higher standard than some of the shit you get in your job from scum. Using insult as a rhetorical tool does your generally sensible arguments on these covid data threads no good service. I'd expect anger from you on what you have to deal with at times in your job but what has Tom done that's really so bad (in making mistakes, providing biased arguments and intransigence, this arguably comes from a human response of lashing out too far from a core of genuine reasons for grievance).  There are plenty of opportunities to use bitter humour on other political threads and real benefits to be had from not putting them here. Tom has also provided some common misunderstandings that if faced off with facts and logic help others understand those and why they occur. 

6
 elsewhere 24 Sep 2021
In reply to Longsufferingropeholder:

The uncertainty in ONS/census is NOT the difference between ONS/census and the count of records in a database designed for another purpose.

If something like ONS census correction for illegal immigration is a bit off (eg 3% rather than 2%) it's not going to make much difference, eg UK is only 64% fully vaccinated rather than 65% fully vaccinated or antibodies in blood 92% rather than 93%.

The remainder lacking immunity is not 7 or 8%.

Those lacking immunity are 7 or 8% plus a effectively a large chunk of the rest who have immunity ranging from good (mostly) to poor. Not one single person can be identified (so far) as having complete immunity.

Post edited at 12:59
1
 Offwidth 24 Sep 2021
 wintertree 24 Sep 2021
In reply to Offwidth:

I'm not sure science was on their mind when they dismissed the well balanced input from a dozen posters as coming from "a bunch of tw*ts who want to believe UK government propaganda" and moving on to discrimination in writing off the views of people because they are "English" and pre-judging others for being "Indian d*cks".

On the whole I think the ad-homs have highly asymmetric - but they tend to get lost in the noise when people still engage on the actual content as they have done with remarkable patience despite and good faith despite the abuse thrown at them.

In reply to Stichtplate:

> One stat that's pretty much universally accepted as a good indicator of a government's success in providing effective health provision is life expectancy at birth.

> Male life expectancy: England- 79.33, Scotland- 76.79

> and those are post covid figures. In fact, Scotland has the lowest life expectancy for both men and women out of all four home Nations. So there's plenty of evidence that, on the balance of probabilities, the SNP has been consistently failing to provide comparably effective health care.

Not necessarily true. Life expectancy is dependent on healthcare, living environment, poverty etc., but also behaviour - dangerous pastimes, and dangerous jobs. People being killed at work or doing dangerous things (climbing, class A drugs etc.) lower life expectancy.  Scottish healthcare could actually be better than English healthcare, but because many Scots work offshore and in the fishing industry (the most dangerous occupation in Britain since the demise of coalmining) and some places have a massive drug problem, their life expectancy could be lower.  We need more detail to make an informed statement.

Edit - first link I found whilst googling 'why is scottish life expectancy lower'

https://www.newstatesman.com/politics/scotland/2019/06/scotland-effect-why-life-expectancy-lower-north-border

2
 Offwidth 24 Sep 2021
In reply to wintertree:

I dislike ad homs from anyone on these threads. I'd expect such inappropriate comment from sweary covid deniers; scientists and those supporting the scientific position should behave better.

Post edited at 13:42
1
In reply to Bottom Clinger:

I win!

Guernsey 91% of adults vaccinated.  New cases pootling along at around 2-5 'community seeded' cases a day plus 5-10 from travel and 2-10 as contacts of cases. Completely unrestricted society unless you're a traveller or contact of a case, and even then vaccinated contacts don't have to self-isolate unless symptomatic. they do have to do LFTs and/or the odd PCR though.

 Stichtplate 24 Sep 2021
In reply to Offwidth:

> I dislike ad homs from anyone on these threads. I'd expect such inappropriate comment from sweary covid deniers; scientists and those supporting the scientific position should behave better.

I think you've walked in the wrong door mate. This isn't an editorial meeting at The New England Journal of Medicine, it isn't high tea with the master of Trinity, it's not even the uni bar at Scumbag College. This is Off Belay on UKC and despite Wintertree's Über professional input and your own academic credentials, it's still predominantly just a bunch of windbags united by an overdeveloped fascination with geological features and a desire to have a natter. 

On top of which, I frequently enjoy inappropriate comments and find the odd bit of swearing is entirely justified. So there!

In reply to Stichtplate:

> On top of which, I frequently enjoy inappropriate comments and find the odd bit of swearing is entirely justified. So there!

Too f*cking right !

 Offwidth 24 Sep 2021
In reply to Stichtplate:

I think you have the wrong door on this. I've nothing against a bit of swearing where it's appropriate. I'm a windbag interested in movement on rock and the environments in which this happens (physical and social) but just as I know In some circumstances climbing humour has its moments, at other times (especially bad times), so does more serious conversation and camaradarie for the greater good. These threads are special in my view, dealing with the data of a horror thrust upon us, a highly emotive subject in itself, and deserve better than the petrol of personalised attacks. Nothing stops you believing what you do or saying what you do, these are just my opinions.

2
In reply to wintertree:

I see the Guardian today has articles about pressure on hospitals, ambulance waiting times etc. There have been comments here recently about news blackouts imposed on the NHS, and I wonder if that is now changing, or being defied. It all sounds very bad, at any rate. Not a time to get ill with anything serious!

 wintertree 24 Sep 2021
In reply to BusyLizzie:

It's not good - at all - that apparently higher powers have been trying to suppress news on the effects of the sustained pressure on healthcare; if the pressure doesn't abate something more is going to be needed, and nobody up top seems keen to talk about what that could be.

> It all sounds very bad, at any rate. Not a time to get ill with anything serious!

Indeed.  

On the brighter side, Covid hospital occupancy in England is enjoying a sustained fall, and has dropped by about 20% in the last 12 days.  Hopefully at least another two weeks of falling occupancy to come; more perhaps more depending on how the next week of demographic cases data pans out...

In reply to Bottom Clinger:

> I reckon a key factor why Scotland has fared better is that the virus entered the UK in south east England, spreading northwards. Scotland had a head start on their decision making, and this head start combined with better measures had a big impact. Johnson had a head start (it was just a matter of time before it hit us) as well but he is such a dimwit he locked down weeks too late. So your idea of ‘being farther away to Westminster’ is true, in my view. 

But if you look at the English regions data you see that as you go further North the case rate is higher - it’s only really the South West that would back the concept that the further you are away from the S East of England you are the better the outcome. 

 

 Stichtplate 24 Sep 2021
In reply to Dr.S at work:

> But if you look at the English regions data you see that as you go further North the case rate is higher - it’s only really the South West that would back the concept that the further you are away from the S East of England you are the better the outcome. 

Is this still the case? (I've not looked at the figures) wasn't there an enormous post August spike in the southwest? I certainly remember figures for Newquay indicating a 1:100 positive rate following the board masters festival. 

 Stichtplate 24 Sep 2021
In reply to wintertree:

> It's not good - at all - that apparently higher powers have been trying to suppress news on the effects of the sustained pressure on healthcare; if the pressure doesn't abate something more is going to be needed, and nobody up top seems keen to talk about what that could be.

There's an ongoing disaster unfolding in primary care at the moment. Some branches of health care have taken several steps backwards in the face of the pandemic leaving primary care of last resort to bear the brunt. There's been widespread feeling in the ambulance service in particular that other health care professionals have been treating us as covid meat shields for some time now. Pressure is ridiculous and Winter flu season doesn't really kick in for a couple of months yet.

What was that Chinese curse involving interesting times?

 wintertree 24 Sep 2021
In reply to Stichtplate:

I keep wondering if I should start a thread on GPs and in person appointments (or not), but I thought I’d leave it to someone else.  It keeps bubbling up in the news.

The dentists - who face far more flying bodily fluids than GPs - seem to be managing.

 Stichtplate 24 Sep 2021
In reply to wintertree:

> I keep wondering if I should start a thread on GPs and in person appointments (or not), but I thought I’d leave it to someone else.  It keeps bubbling up in the news.

I've had some horrendous dealings myself but I keep biting my tongue on here and telling myself there must be plenty of good GPs out there but I'm not aware of them because they're not the ones who keep sending me out to do their job for them (while still being paid for assessing and treating their own patient, who is on their own books). 

Post edited at 18:59
In reply to Stichtplate:

> Lets have a look at this ad hominem, this vile "personal attack" 

> "I'm pretty sure that if Tom tripped on a curb while traversing The Royal Mile, he'd mutter "Bloody English!" under his breath as he went on his way "

To be fair that's probably true.

 Stichtplate 24 Sep 2021
In reply to tom_in_edinburgh:

> To be fair that's probably true.

One thing I really appreciate about your posts is the deadpan delivery while keeping your tongue firmly in your cheek. Keep up the good work.

In reply to wintertree:

> Diminishing returns.  It's a thing.

Yes, it is a thing.  But calling diminishing returns long before there are actually diminishing returns is also a thing.    People have been saying semiconductors would level out for decades.  Maybe they are starting to approach a limit now but if the people with the money had listened to that argument 30 years ago instead of keeping going we wouldn't be where we are now.  

You figure out when it is actually diminishing returns by assuming it isn't and pushing as hard as you can.

> If after five years we're depending on better vaccines than we have now, we'll have completely screwed the pooch and be living in some perpetual lockdown dystopia.

That is total speculation.   There are many groups doing vaccine research and many classes of vaccine, only one of them needs to work out.   Or maybe what will happen is there is no huge breakthrough but the process and tools of vaccine development become optimised so they can tweak vaccines and get them in production really fast to respond to variants.  Maybe we'll get mucosal vaccines instead of injected ones.   There's so many avenues that need explored.  It is way too early to give up and assume it isn't going to improve.

The dystopian outcome would be several hundred deaths a week in the winter and catching it two or three times a year like playing Russian Roulette until it gets you.   You want to speculate that won't happen, I reckon we should be cautious until we are sure that won't happen.  Some other country will can give it a go, we can sit back and see if it works for them.

> Do you suggest people hold out against catching the virus for another five to ten years on the off chance a much better vaccine will come out?

No.  What I think will happen is there will be continuous improvement over those five years not just in vaccines but also in medicines, social adaptation (such as working from home and online ordering), ventilation, masks and tracking. 

And 'off chance' is the wrong word.  'Near certainty' would be better.

> >> It's also far from clear that we should continue going for vaccination that's as effective as possible against transmission once the worse is passed - the path to the future quite likely lies in curtailing suffering and death, not stopping all transmission.   

It may well turn out that Covid can't be eliminated.  But that shouldn't be the starting assumption, you'll never get anywhere if you assume you can't do better after a year and a half.

> I disagree vehemently for reasons I have already stated several times over various threads and that you just ignore.

Because speculating that technology is not going to improve when you throw money at it is almost always a bad bet.

> Variants are out-pacing the roll out of variant adapted vaccines.  

But that is something to work on, it doesn't have to stay that way.   We can get software tools and improved processes to speed things up and we can cut the number of infections to slow the arrival of new mutations.

Post edited at 19:32
In reply to Stichtplate:

> Is this still the case? (I've not looked at the figures) wasn't there an enormous post August spike in the southwest? I certainly remember figures for Newquay indicating a 1:100 positive rate following the board masters festival. 

Well, not enormous by Scottish standards:

https://www.bbc.co.uk/news/uk-51768274

regional U.K. graphics towards the bottom of the link.

Up until July this year SW England and Scotland track quite closely, Scotland diverges significantly after this point - and not in a good way.

 wintertree 24 Sep 2021
In reply to tom_in_edinburgh:

I can’t really disagree any more clearly than I have.

>> Variants are out-pacing the roll out of variant adapted vaccines.  

> But that is something to work on, it doesn't have to stay that way.   We can get software tools and improved processes to speed things up and we can cut the number of infections to slow the arrival of new mutations.

I’m curious, have you ever worked in the life sciences? I could give a detailed and nuanced view on why I think what you’ve said here is ignorant of the reality almost to the point of comedy, but it’s not like you’ve engaged with any of the other views I’ve given on anything here.  Hint: you can’t speed up longitudinal testing for safety and efficacy in humans without a time machine.   I’m probably better aware than you as to just how much money and technology is being thrown at accelerating different parts of the pipeline.  It’s phenomenal what’s going on out there.  But we’re nowhere near being able to accelerate some of the key parts.  

> The dystopian outcome would be several hundred deaths a week in the winter

Compared to some winter “flu seasons” that’s a highly optimistic outcome. Around two thousand people die each week in the UK, biased towards winter.   A bad outcome IMO is not defined by how many people die due to covid, but how much life they loose to covid vs a world without covid.  That’s what we need to know - is it going to go in the same box as other respiratory killers, or is it going to remain a much worse killer?  That’s why I thought the comments from the Oxford profs were notable; they seem to think it’s going in the box.   If it’s going in the box within the next six months as they think, there’s no imperative to throw money at magic future technology to eliminate it, and indeed eliminating it could carry great risk when the virus hidden in its reservoirs diverges from our vaccines and comes back with elevated pandemic potential, again. 

Let’s reset the conversation.  The view of the Oxford vaccine profs - you clearly think they’re wrong about the effects of this virus dropping in severity over the next 6 months; can you tell me *why* you think that, with reasons based in science of evidence, rather than crap analogies?   

> and catching it two or three times a year like playing Russian Roulette until it gets you. 

Have you looked at the reinfection analyses in the weekly PHE surveillance reports?  Yours seems a very OTT take, especially as immunity builds through vaccination and post vaccination infection we might even expect symptomatic reinfection rates to drop rather than raise going forwards… 

Post edited at 21:01
 Offwidth 24 Sep 2021
 Misha 24 Sep 2021
In reply to tom_in_edinburgh:

As you’ve said, RoI is more separated geographically from England than Scotland. Nothing to do with independence. I think the Irish movement restrictions were heavier than anything in the UK. Couldn’t go further than 5k from home for quite a while. They also restricted cross border travel quite heavily. Something the SNP could have done but did not.

In reply to wintertree:

> I can’t really disagree any more clearly than I have.

OK, so you disagree.

> >> Variants are out-pacing the roll out of variant adapted vaccines.  

> I’m curious, have you ever worked in the life sciences? I could give a detailed and nuanced view on why I think what you’ve said here is ignorant of the reality almost to the point of comedy, but it’s not like you’ve engaged with any of the other views I’ve given on anything here.  Hint: you can’t speed up longitudinal testing for safety and efficacy in humans without a time machine.   I’m probably better aware than you as to just how much money and technology is being thrown at accelerating different parts of the pipeline.  It’s phenomenal what’s going on out there.  But we’re nowhere near being able to accelerate some of the key parts.  

They already massively reduced the schedule to get a vaccine out.

What a war or a pandemic does is not just increase funding it also gives the political impetus needed to change process and remove regulations which slow things down.

Most industries have switched from lab experiments which are very time consuming to simulations.  That's a megatrend which sooner or later will come to life sciences.  We need to speed it up. We need CAD for biotech and we need to get the thinking from electronics and computing into life sciences.   

> That’s what we need to know - is it going to go in the same box as other respiratory killers, or is it going to remain a much worse killer?  That’s why I thought the comments from the Oxford profs were notable; they seem to think it’s going in the box.   If it’s going in the box within the next six months as they think, there’s no imperative to throw money at magic future technology to eliminate it, and indeed eliminating it could carry great risk when the virus hidden in its reservoirs diverges from our vaccines and comes back with elevated pandemic potential, again. 

Again with 'magic' to describe things which are almost certain to happen.  You sound like a social scientist rather than a technologist.

> Let’s reset the conversation.  The view of the Oxford vaccine profs - you clearly think they’re wrong about the effects of this virus dropping in severity over the next 6 months; can you tell me *why* you think that, with reasons based in science of evidence, rather than crap analogies?   

That's their view.  Plenty of other highly qualified people disagree.  I'm not a domain expert so I'm not able to argue on substance.  However, I understand tech industry and I give people zero extra credence because they are English or work for Oxford.   My guess is the next breakthrough will come from the US, EU or China.

> Have you looked at the reinfection analyses in the weekly PHE surveillance reports?  Yours seems a very OTT take, especially as immunity builds through vaccination and post vaccination infection we might even expect symptomatic reinfection rates to drop rather than raise going forwards… 

I think you may be right and hopefully you are *but* I'm in no rush.  My view is we should assume this isn't happening and stay cautious until it there is no doubt.   Who cares if we keep precautions 3 or 6 months longer than theoretically necessary, the risk on the other side of the equation is millions of people catching Covid and tens of thousands dying.

And no matter what we should keep going with the technical development.  I'd like to live in a world with far fewer diseases and maybe we can do that if we push hard down the paths that are starting to open up.   Being human is about doing engineering and getting more and more control over nature.

2
 Offwidth 24 Sep 2021
In reply to Misha:

Latest Indie SAGE... more data this week... some evidence the big school age rises are breaking through into rises in parental ages...a useful international comparison on vaccination versus case outcome for school ages. After the data they introduce their winter plan (looks broadly sensible.but doomed to be ignored).

youtube.com/watch?v=mTYwtN7VZ6Q&

https://www.independentsage.org/wp-content/uploads/2021/09/WeeklySlides_24September2021.pdf

https://www.independentsage.org/nine-point-covid-winter-protection-plan-a-vaccine-plus-approach/

Post edited at 23:21
1
 Misha 24 Sep 2021
In reply to Offwidth:

This is to be expected. Moderated by the fact that a lot of parents would be vaccinated (overall - clearly some groups would not be). Then it will bleed through into the wider population via work colleagues etc. Again, moderated. The question is how much billed through there will be. We will find out in the coming weeks. 

 kirsten 25 Sep 2021
 wintertree 25 Sep 2021
In reply to tom_in_edinburgh:

> OK, so you disagree.

I think you’re basing your views on analogies that are totally flawed.

> Most industries have switched from lab experiments which are very time consuming to simulations.  That's a megatrend which sooner or later will come to life sciences. 

How did simulations work for Boeing validating their Starliner?  Terribly.  I work directly with a part of that megatrend coming to the life sciences.  Human in the loop testing isn’t going away any time soon.

> We need to speed it up. We need CAD for biotech and we need to get the thinking from electronics and computing into life sciences.

It’s like you have absolutely no idea what’s going on in the fields you’re talking about.  

> Again with 'magic' to describe things which are almost certain to happen.  You sound like a social scientist rather than a technologist.

No, I’m just dismissing your ideas as magic because I’ve half a clue how much money and talent is being poured in to all this, and the various disconnects between what you think is going to happen and what’s happening.

> That's their view.  Plenty of other highly qualified people disagree

I’d be interested if you share the view of some other domain experts that this is not going to go in a box with common respiratory viruses. Please do share it.  That’s the interesting thing.

> However, I understand tech industry

Which is incredibly different to the life sciences

> and I give people zero extra credence because they are English or work for Oxford.   

Nor do I, and if pains me that you once again seem to be jumping to conclusions about me for being English.  You’re also critically misinformed, Prof John Bell is Canadian.  

> My guess is the next breakthrough will come from the US, EU or China.

Any particular reason for not including the UK on that list?  Either way it’s 30% of the global population and a much larger fraction of global wealth. 

> And no matter what we should keep going with the technical development.  I'd like to live in a world with far fewer diseases and maybe we can do that if we push hard down the paths that are starting to open up.   Being human is about doing engineering and getting more and more control over nature.

Well it’s boom time in biotech and I expect developments to continue.  But to me this pandemic shows just how dangerous it could be, how unready we are, to start eliminating “nuisance level” diseases if we become able to.  We exist in some kind of low level immune war with a host of diseases; they only really come to the fore as the winter reaper.  Disrupt that war and immunity forgets, then one gets loose and whammy - pandemic potential.  We’re nowhere near ready to become a disease free species.  There’s really big questions opened up by this pandemic about the future direction of our species.  

 wintertree 25 Sep 2021
In reply to kirsten:

Nice work!

I keep wishing I’d done a cloud server and daily updating dashboard, problem is I bloody hate web development, web frameworks, graphic design and so.  I’m also very very unmotivated about doing things I don’t enjoy.  I look at that or travellingtabby and the effort blows me away, but the idea of doing it is not appealing. Plus there’s the danger someone would end up writing a newspaper article about me...

n reply to Misha:

> The question is how much billed through there will be. We will find out in the coming weeks

You and Offwidth just covered the interesting development for this evening’s waffle.  A lot is really clear in the data now and I hope all should be resolved to clarity in another week or so.

In reply to Offwidth:

Indie SAGE’s 9-point winter plan is very sensible, and the barriers to doing much of it very low.  Don’t hold your breath.  Or maybe do hold it if you’re in an indoors venue not following their points on masks and ventilation.

Post edited at 08:40
 Offwidth 25 Sep 2021
In reply to Offwidth:

> I dislike ad homs from anyone on these threads.

Massively biased, partisan politics isn't science. If you bring such ideas to a 'science' thread, expect to get ad homs.


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