Coronavirus outbreak

[Wobblers]

I was quoting the BBC, but I don't know their source.

That said, I've also read a number or reports like the WHO's that put the percentage of symptomless infections much higher.

I suppose one reason for the difference could be how you define a symptom, for example whether you include something like loss of sense of smell, which is reportedly very common, or just count the classic fever/headache/breathing symptoms.

It's a big issue. We still don't know with any certaincy about how this virus affects people - or, just as importantly, why the consequences for some are so much so severe than others. The papers I've looked at and posted links to a few weeks ago (seems a lot longer now!) had data which suggested that at least 90% of infections were going unnoticed by the authorities. The lowest figure, 67%, was used by Neil Ferguson in modelling the consequences of the epidemic in his paper that changed government policy back in March. This means that only the most severe infections are noted, and that most are mild or asymptomatic. Which is a good thing - it means the actual case fatality rate is lower than the published figures.

What is relevant here is that these people with mild symptoms are still infectious. We need to get those people into quarantine. We can't test everyone, but testing those with the obvious symptoms -and isolating them! - is an essential first step. This is where contact tracing comes in - to test those that have been in contact with the overtly infected and isolate those which test positive. Note that there is no country which has succeeded in stemming this virus by use of an app alone. In every case it's been through the use of testing, contact tracing and quarantine.

An app that misses 90% of all potential transmissions is of little use. The case of Singapore amply demonstrates this. They did well in the beginning, containing the virus using testing and contact tracing. Unfortunately, CV19 cases have risen sharply - seemingly at the same time that they failed to adequately test their migrant worker communities. The Singapore contact tracing app has had little effect in slowing the spread of the virus.

 

[Wobblers]

I've tried to offer some suggestions on the way forward.....in summary:

Face coverings for the public
Get the PPE procurement portal sorted
Get the army or a team of logistics experts to iron out the shortages (and gluts) of PPE across the country
Fix the testing chaos that I experienced at Coventry Ricoh stadium on Saturday (again put the army in charge of this)
Listen to the critics on the contract tracing app.....they might help prevent major problems and another NHS IT failure - work more closely with Google and Apple (it's their platforms this thing is going to have to work on).

To this I'd add get a large organisation of contact tracers on the ground before ending lockdown so that those people who've been exposed to those who test positive can be tracked down, tested and if necessary isolated. This'll help reduce transmission by people who're asymptomatic.

 

[Joey Shabadoo]

View: https://www.youtube.com/watch?v=6ETnBooCYSg


Sickening

However -

 

[stowie]

It happens.

People break the rules/guidelines, not just the people next door, but Princes, politicians, Medical Health Officers and Government Advisors working on lockdown guidelines.

You can only limit it by public censure because the only way to stop it is to become the sort of autocracy that is so far away from the freedoms we take for granted.

The Daily Mail is running an entire spread on the lifting of the lockdown. Activity details, dates the full works.

Where does this information come from? Do journalists make it up? Is the government leaking information? Is the Tory party?

It is collapsing the resolve of people and sending out such dangerous messages. If it will be alright to sunbathe and chill outside on Monday why not during the lovely bank holiday weekend? After all, it is only a couple of days early. I expect this weekend will see widespread flouting of current restrictions.

This is dangerous stuff. We walking a tightrope between more and more economic damage due to lockdown and potentially catastrophic resurgence of the disease - which will in itself be hugely damaging to the economy even ignoring the human and healthcare aspects.

I refuse to believe our national character somehow makes us weaker to accept restrictions than other countries. We need clear messages backed up by enforcement. The government's strategy seems to be falling apart.

 

[Wobblers]

There's copying Germany and copying Germany. For me this means not focussing on PCR which is a useful, but flawed technology in it's early form, which is ultimately where most of the arguments come in.

I think the government needs to iron out issues with PCR and then stop focussing on that so much. For PCR aspects carry on working on tech and logistical innovations that'll make it run better/more local.

The government needs an antibody plan over the summer. There are over the summer easily available packages that can be sent to laboratories on a mass scale compared to what's gone on till now. The government need to do more immunity research (I believe they have been doing it, but kept it almost completely secret), pass legislation to stop people discriminating on the virus (this was in the SPI-B stuff and the scariest bit as the government don't seem to have listened to any of it).

Germany has already done some studies on percentage of the population that's had it (worryingly for much of Europe one study suggested 2%). We haven't, although IPSOS Mori teaming up with researchers are supposed to be doing that this week - results when? These studies are only the start we'll have to do wave after wave of them the next 12 months.

It looks like antibody testing is of limited use.

IgM is only detectable 7 days after symptoms develop. For IgG, this is 10 days. Antibody testing will thus miss presymptomatic cases and those in the early stages of the disease - which is probably also when they're at their most infectious. These are the people you most need to track down and isolate. Additionally, people still shed virus even after symptoms subside, so IgM / IgG is not a reliable marker of when someone is no longer infectious.

At the moment, the only test we have that will serve both purposes is PCR, for all its dismal false negative rate. We need a more reliable, easier and quicker test than PCR, especially for contact tracing. Sadly, I don't think that antibody testing will pass muster: the adaptive immune system just takes too long to make the immunoglobin. Do you know of anything on the horizon?

 

[Wobblers]

The Daily Mail is running an entire spread on the lifting of the lockdown. Activity details, dates the full works.

Where does this information come from? Do journalists make it up? Is the government leaking information? Is the Tory party?

It is collapsing the resolve of people and sending out such dangerous messages. If it will be alright to sunbathe and chill outside on Monday why not during the lovely bank holiday weekend? After all, it is only a couple of days early. I expect this weekend will see widespread flouting of current restrictions.

This is dangerous stuff. We walking a tightrope between more and more economic damage due to lockdown and potentially catastrophic resurgence of the disease - which will in itself be hugely damaging to the economy even ignoring the human and healthcare aspects.

I refuse to believe our national character somehow makes us weaker to accept restrictions than other countries. We need clear messages backed up by enforcement. The government's strategy seems to be falling apart.

I'm becoming increasingly pessimistic about the chances of there not being a second, larger wave . We still don't have any of the necessary testing contact tracing infrastructure in place that's needed to ensure community transmission doesn't take off again once restrictions are lifted.

I also have noticed a significant increase in traffic over the past week or so here. In fact, the roads are almost as busy now as they were before the lockdown. I now fear that any attempt to reinstate a lockdown if there is a second wave will be widely ignored - many people will reason that if it didn't work last time, why bother now? This will lead to a far larger number of deaths than we've had so far as a result.

I hope I'm very wrong.

 

[randynewmanscat]

Some light for me, unless things change drastically my playpen is to be expanded on the 11th of May. The detail is to be fleshed out in the days before the 11th but I will have to stay in my department and the bars, cafes and restaurants that make life social will not be considered until June. I personally doubt they will be allowed to open in June. The south west has largely dodged the horror that was visited on the north east, Paris, Grand Est.
View attachment 519071

Next Monday I get a longer leash, I think I will let others get out before me, I'm no early adopter. The numbers for my department on 30/04 and on 06/05. The green and red map of France no longer has the orange departments of uncertainty to the centre east as the government finalised its plan to ease restrictions.
Its a late night for me, I've been out planting vegetables, yes in the middle of the night.

 

[Joey Shabadoo]

From the BBC, a reason why we're screwed https://www.bbc.co.uk/news/live/uk-scotland-52494254

The head of the Scottish Chambers of Commerce has defended the decision by many small businesses, such as shops and coffee bars , to re-open despite the lockdown being extended. He said there were many businesses out there who were dismayed at the first minister's announcement of a further three weeks of restrictions. But he said it was unfair to say they are taking the law into their own hands.

That's exactly what they're doing and I would hope any business doing this is closed down permanently.

Some businesses have now learned how operate effectively under Covid-19 with social distancing with an entirely responsible approach to business. The guidance is quite loose, the legislation quite broad, so businesses can interpret themselves what is possible and what is safe to do in this environment.
Tim Allan President, Scottish Chambers of Commerce

Great. So Beryl who runs a coffee shop is now a medical expert, specialising in virology is she?

 

[kingrollo]

I dreamt last night that Nigel Farage had organised a lift the lockdown campaign....

.....I mean what are the chances !

 

[marinyork]

It looks like antibody testing is of limited use.

IgM is only detectable 7 days after symptoms develop. For IgG, this is 10 days. Antibody testing will thus miss presymptomatic cases and those in the early stages of the disease - which is probably also when they're at their most infectious. These are the people you most need to track down and isolate. Additionally, people still shed virus even after symptoms subside, so IgM / IgG is not a reliable marker of when someone is no longer infectious.

At the moment, the only test we have that will serve both purposes is PCR, for all its dismal false negative rate. We need a more reliable, easier and quicker test than PCR, especially for contact tracing. Sadly, I don't think that antibody testing will pass muster: the adaptive immune system just takes too long to make the immunoglobin. Do you know of anything on the horizon?

Antibody tests as said for the nth time is trivially is currently being used to work out who has had the virus and how immunity varies from person to person.
I'm not sure how anyone can be any clearer than that.

Antibody tests is not of limited use in the sense that no strategy is much good on its own and all the others are of limited use. Knowing a more accurate percentage of of the population who've had the virus is useful. Knowing locally is useful as it seems to vary quite a lot on a intraccity/region level. Knowing how antibody levels change is going to be useful going towards winter. Germany is taking this very seriously. We've already got to the point that because PCR was in low numbers in March/April that there are many (a tiny UK population %) who've had the virus and for them it'll just keep on showing negative on PCR. In terms of shielders, what people now seem to be calling the carers - unpaid or not - shielding the people who are clinically vulnerable, antibody tests are another tool there.

There are noises of a few things on the horizon to make logistically running PCR better. We'll have to see.

 

[tom73]

It's hard to remember that in all this we still have many young people locked up in YOI's
Which are mostly 15-18 year olds though some are younger all male as we no longer lock up females.
I'm hearing from colleagues an increasing concern about the current situation within them.

Like adult prisons the only solution the government has come up with is just lock them up.
Being locked in for minimum 23 hours a day. Some are only getting out for 40 mins one site it's 3 hours
Staff are being proactive and going what they can but it's just so patchy as no-one has come up with national guidelines or advice.
Most social eating has stopped so food is delivered to each cell. Some are having to wait up to 16 hours between evening meal and breakfast.

One big area of concern is most basic mental health services are limited and all intensive support has been withdrawn. Violence is down and levels of self harm are best described as stable though longer this go's it can only go one way. Though health care is still in place and GP access is still possible but with limited face to face contact. Covid cases are low and measures are in place to deal with outbreaks. Communal cleaning is happening and on the whole is ok. Children have access to cleaning materials for their cells and themselves.

No national measures are in place to provide education which the government say's all vulnerable children should continue to have.
In cell work books are being used in some and some are doing social learning like cookery other stuff is coming as staff at some sites have found ways to do it safely but no universal provision is in place.

Another concern is contact with family visits have stopped. Children have been given extra phone credits. Some sites it's as little as £5 a week. Only one has video calling in place which was supposed to be in place at all sites weeks ago. Most have poor relationships with family as it is. Family relationships is a key factor in reoffending add in the already fragile mental health of most of them. We are building up a big problem not just now but into adult life maybe a whole life time. CAMHS, YOT's and other support services are going to need a heck of a lot of investment and in placers a total rethink.

One big up side is new admissions are way down with much better interventions within the community are being used. Something which many of us have been fighting for years.

 

[mjr]

It is collapsing the resolve of people and sending out such dangerous messages. If it will be alright to sunbathe and chill outside on Monday why not during the lovely bank holiday weekend? After all, it is only a couple of days early. I expect this weekend will see widespread flouting of current restrictions.

Why is discussing unlocking being left to the tabloids who love leaks and scandal? One day speculation, next the leak, then speculation about the leaker, then more about how the leaked plan might change, then a couple of days either condemning or defending people following the leaked restrictions instead of the current ones - it's a week of front pages!

I refuse to believe our national character somehow makes us weaker to discuss derestricting than other countries. We need clear messages backed up by consensus-building. The government's strategy seems to be falling apart.

 

[Low Gear Guy]

The printed media is one of the last bastions of influence without responsibility. If I used the sort of language they used in internal work communications I would expect to be facing a reprimand or even the sack. The newspapers are allowed to encourage breaking the lockdown without facing the consequences.

The good news is that the influence of the press barons is waning. Unfortunately other forces are spreading fake news on the internet and allowing people to evade the consequences of their actions.

 

[deptfordmarmoset]

It turns out that I misheard: they were actually saying they were furloughing the science....
https://www.theguardian.com/world/2...s-fury-over-attempt-to-censor-covid-19-advice

 

[marinyork]

It turns out that I misheard: they were actually saying they were furloughing the science....
https://www.theguardian.com/world/2...s-fury-over-attempt-to-censor-covid-19-advice

Interesting

In the version published on Sage’s government website, almost a page and a half of text was heavily redacted. The Guardian understands the blocked text related to SPI–B’s criticism about possible government proposals around that time.

These included the idea of reducing the amount of time Britons could spend exercising or shopping, and stricter financial penalties for those found to be breaking the lockdown. A third proposal involved requiring people to self-validate their movements, as was occurring in France, where citizens were required to complete permits before leaving home.

Experts on SPI-B, which includes professors in psychology, epidemiology and anthropology, said they felt the proposals were too punitive and more likely to result in unfair treatment among people in deprived economic circumstances.