Coronavirus outbreak

[roubaixtuesday]

And when we have 100% vaccinated, then, given that no vaccine is perfect, 100% of the (very few) cases will be vaccinated.

We crossed!

 

[lane]

It's a lot more complex that that.
Depending on which Vaccine you have had, and when you had it, your likely immunity will vary. For example, your first dose gives you a likely 76% efficacy rising to 82% after the second dose and time for that to take effect. This means that you are a lot less likely to get Covid than if you had not been vaccinated, but you can still get it.

If you have been immunised and you *do* get Covid, then you have another bonus which is that your body is already primed for it, so in most cases you will get a much milder infection than had you not been immunised.

But, the majority of people who have had serious hospitalisation have had co-morbidities. In other words, they were already ill with something else. This can alter how they are able to respond to infection. Some people were just unlucky and there is something in their genetic makeup which means that they have proved much more susceptible than others. We do know that obesity and breathing related illnesses (e.g. asthma) increase risk with Covid.

It may be that many people admitted to hospital with Covid, would have been admitted for something else anyway - due to age, comorbidities etc.

Then we have another factor which is that Covid mutates. The immunisations were based on the first variants isolated. As Covid changes, it may be that newer strains such as the Delta or Lambda are not as well protected against. It could also be that they cause less or more likely damage.

A simpler way to put it is this:-

You can reduce your chances of becoming seriously ill with Covid by getting immunised and by taking reasonable safety measures such as wearing a mask when in an area with poor ventilation and many people - e.g. shops. Good air flow can really help, but you want to avoid inhaling other people's breath.

There is no 100% protection other than staying in your home, not having any visitors and creating an airlock and quarantine process for delivered goods.

At the moment the UK Government (unlike some other countries) is not trying to eradicate Covid, just to mitigate the effect and reduce the risk of death and serious illness. No-one knows whether this is the right approach. It is however a bit of an outlier compared to many other countries.

We were an outlier initially as well in March 2020. Lets hope this is now better thought through. However it is the same people making the decisions - politicians and and scientists - that f up first time.

 

[DaveReading]

A nice graphical illustration of why 40% vaccinated in hospital is, entirely counterintuitively, a good thing.

Bearing in mind, of course, that "40% vaccinated in hospital" means

40% of those in hospital with Covid have been vaccinated

and not

40% of those who have been vaccinated are in hospital

Some seem to be conflating the two scenarios.

 

[mjr]

There is no 100% protection other than staying in your home, not having any visitors and creating an airlock and quarantine process for delivered goods.

I doubt even that is 100% from what I've read. "Five nines" 99.999% maybe.

At the moment the UK Government (unlike some other countries) is not trying to eradicate Covid, just to mitigate the effect and reduce the risk of death and serious illness. No-one knows whether this is the right approach. It is however a bit of an outlier compared to many other countries.

I think that's far too kind. It seems like the policy is merely to keep serious illness below hospital capacity and deaths below politically toxic levels, motivated by some misconception that businesses prefer the uncertainty of high case numbers, consequent isolations and looming lockdown and rule change possibilities to the certainty of regulations and circuit breakers.

 

[PK99]

But, the majority of people who have had serious hospitalisation have had co-morbidities. .

I've avoided this as a discussion point for some time but...

Friends who are Senior Medics, in various hospital disciplines, tell me that:

• By far the majority of COVID ICU patients they have had have been obese to seriously obese. Not all, but most.
• In March 2020, an ICU consultant at one of the big London hospitals looked around at the patients in his unit and put himself on a diet, and lost 3 stones in short order.

Friend, who is a just-about-to-qualify medical student, is volunteering as part of her course at a multi-disciplinary Long Covid clinic. A very significant proportion, not all, of the patients presenting, have a very high BMI.

Now clearly, there are many who have been badly affected by COVID to whom the above does not apply - but I have been startled by the frankness of their advice on this issue.

 

[PK99]

Bearing in mind, of course, that "40% vaccinated in hospital" means

40% of those in hospital with Covid have been vaccinated

and not

40% of those who have been vaccinated are in hospital

Some seem to be conflating the two scenarios.

YES!

In particular, some journalists seem not to have appreciated the difference.

 

[PK99]

I doubt even that is 100% from what I've read. "Five nines" 99.999% maybe.


I think that's far too kind. It seems like the policy is merely to keep serious illness below hospital capacity and deaths below politically toxic levels, motivated by some misconception that businesses prefer the uncertainty of high case numbers, consequent isolations and looming lockdown and rule change possibilities to the certainty of regulations and circuit breakers.

"seems" doing heavy lifting again, it seems!

See, it is a useful shorthand!

 

[roubaixtuesday]

I've avoided this as a discussion point for some time but...

Friends who are Senior Medics, in various hospital disciplines, tell me that:

• By far the majority of COVID ICU patients they have had have been obese to seriously obese. Not all, but most.
• In March 2020, an ICU consultant at one of the big London hospitals looked around at the patients in his unit and put himself on a diet, and lost 3 stones in short order.

Friend, who is a just-about-to-qualify medical student, is volunteering as part of her course at a multi-disciplinary Long Covid clinic. A very significant proportion, not all, of the patients presenting, have a very high BMI.

Now clearly, there are many who have been badly affected by COVID to whom the above does not apply - but I have been startled by the frankness of their advice on this issue.

Just from a quick google, no idea how authoritative, but point estimates for the obese of

49% more likely to be hospitalised
82% more likely to die

https://www.nature.com/articles/s41366-021-00771-z

 

[lane]

I've avoided this as a discussion point for some time but...

Friends who are Senior Medics, in various hospital disciplines, tell me that:

• By far the majority of COVID ICU patients they have had have been obese to seriously obese. Not all, but most.
• In March 2020, an ICU consultant at one of the big London hospitals looked around at the patients in his unit and put himself on a diet, and lost 3 stones in short order.

Friend, who is a just-about-to-qualify medical student, is volunteering as part of her course at a multi-disciplinary Long Covid clinic. A very significant proportion, not all, of the patients presenting, have a very high BMI.

Now clearly, there are many who have been badly affected by COVID to whom the above does not apply - but I have been startled by the frankness of their advice on this issue.

It can't do any harm to share that. Probably about time I got on the scales!

 

[lane]

I doubt even that is 100% from what I've read. "Five nines" 99.999% maybe.


I think that's far too kind. It seems like the policy is merely to keep serious illness below hospital capacity and deaths below politically toxic levels, motivated by some misconception that businesses prefer the uncertainty of high case numbers, consequent isolations and looming lockdown and rule change possibilities to the certainty of regulations and circuit breakers.

I don't think it's anything to do with businesses. It's what the backbench MPs prefer and what the Telegraph prefer. Also I don't think it is "seems" that is now the stated policy.

 

[PK99]

Just from a quick google, no idea how authoritative, but point estimates for the obese of

49% more likely to be hospitalised
82% more likely to die

https://www.nature.com/articles/s41366-021-00771-z

From that;

Obesity has emerged as a key risk factor for COVID-19 outcomes [2], with excess ectopic fat accumulation associated with higher chronic sub-clinical inflammation, functional immunologic deficit and a pro-thrombotic state potentially explaining the higher rates of disseminated intravascular coagulation and thromboembolism in severe COVID-19 patients [3]. Frailty has also been identified as a potential risk factor for severe COVID-19 [4], with early research showing it to be a stronger predictor of COVID-19 mortality than either age or comorbidities [5]. However, the interaction between measures of obesity and frailty in the association with COVID-19 outcomes has not been investigated.

And, from elsewhere: obesity increases clotting risk - DVT & PE

 

[mjr]

"seems" doing heavy lifting again, it seems!

See, it is a useful shorthand!

No, it is lifting nothing. Once again, it introduces my opinion and nothing further is supported by it.

Please try to remember that my objection was to the first paragraph being an "it seems" followed by a misrepresentation that the rest of the post was supported by, IIRC. I do not seek to ban posting all "seems" opinions! Maybe this is too subtle for some, so try this: introducing your own opinion with "seems" is fine, but introducing someone else's as an "it seems" and then spending the rest of the post arguing against it is a waste of everyone's time.

 

[mjr]

France requiring a "health passport" for access to cultural venues containing 50+ people. From 1 August, it will also be needed to access cafes, bars and restaurants, even on terraces, planes, trains, hotels and shared facilities on campsites. The state train operator was surprised by the presidential announcement. (source: tv news this lunchtime)

 

[icowden]

France requiring a "health passport" for access to cultural venues containing 50+ people. From 1 August, it will also be needed to access cafes, bars and restaurants, even on terraces, planes, trains, hotels and shared facilities on campsites. The state train operator was surprised by the presidential announcement. (source: tv news this lunchtime)

It'll happen here too, just probably not by parliamentary dictat (although they have already done the nightclub thing).
Want to go to the Theatre? Why should they let you in if you haven't been double jabbed if it risks their performances?

Want to go on holiday? Try getting health insurance without a double jab.
Want life insurance? It'll be expensive without a double jab.

etc
etc

 

[kingrollo]

I've avoided this as a discussion point for some time but...

Friends who are Senior Medics, in various hospital disciplines, tell me that:

• By far the majority of COVID ICU patients they have had have been obese to seriously obese. Not all, but most.
• In March 2020, an ICU consultant at one of the big London hospitals looked around at the patients in his unit and put himself on a diet, and lost 3 stones in short order.

Friend, who is a just-about-to-qualify medical student, is volunteering as part of her course at a multi-disciplinary Long Covid clinic. A very significant proportion, not all, of the patients presenting, have a very high BMI.

Now clearly, there are many who have been badly affected by COVID to whom the above does not apply - but I have been startled by the frankness of their advice on this issue.

Interesting. Maybe as aside but hasn't bmi been discredited as a health indicator ? - from memory it wasn't a good measure for people who had bulked up in the gym , they have a low fat % - but still score poor on BMI.

Theres also the deadly 'skinny fat' who are slightly built and sail though any BMI stats\measurements - but because of thin bones actually have a lot of fat !