There are multiple genetic mutations that can lead to coagulation disorders. One of the most well-known is Factor V Leiden. Sadly one test for this is a pulmonary thrombosis rapidly after initiating oral contraception. My cousin is homozygous and you can guess how we know this. She almost died but for her GP. My mother was heterozygous. My wife has another Leiden mutation that is rarer but has the same issue and she cannot take OC. She’s heterozygous and that was discovered after a clot (unrelated to OC). I’ve been tested and don’t carry any Leiden mutations, so children are in the clear from at one side and 50% chance of both - hence my test.
Rare events may later come to be understood by underlying biology. Sadly this is often the way biology reveals itself. We have much to learn, but the pharmacovigilence of process is working as intended.
If this vaccine had been tested over the usual period would they have picked it up given they would need 1m test vaccinations for every 4 clotting cases?
The British figures are lower than quoted elsewhere.
12 cases from the first 2 million doses in France and 31 from 2.7 million in Germany:
Bei 2,7 Millionen verabreichten Erstdosen und 767 Zweitdosen von AstraZeneca sind nach aktuellem Stand des Impfmonitorings des Robert-Koch-Instituts (RKI) 31 Fälle von sogenannten Sinusvenenthrombosen aufgetreten.
Vaccination strategies changed in both countries as a result with AZ for over 55s in France and over 60s in Germany. Edit: the cases disproportionately hit medical and care home workers who were the first young people to be given AZ. The overall figures don't look to bad but when you separate the medical workers from the oldies who'd also been given AZ the problem was highly visible and clearly demonstrated the threat to younger people and especailly women.
But 4/million, 6/million and even 11.5/million - they're broadly the same number.
It's not like anywhere else is reporting 100/M or 1000/M
I did wonder initially if it could even be batch or plant specific, but that seems to be off the table now.
2 cases from a few hundred staff in one hospital was the wake up call. In young women " 100/M" is plausible. You'll find out when/if AZ is used to vaccinate 30-year-old women. It would be unwise IMO. In Nancy CHU vaccination was stopped until Pfizer was available.
yes, that's also what the data is starting to reveal.... this is increasingly age and possibly gender specific
In england, are we allowed family sleepovers at the moment?
My nasty neighbour has his son staying tonight. Just another reason to dislike him
Is thrombosis via Az more common than dvt after a long haul flight? So are you stopping all flights over say 8hrs as the dvt risk is real then. Just a thoght.
Thanks for that edukator. As a fit, healthy, low covid risk 39 year old taking oc for medical reasons I'm currently weighing up the risk/benefits. I'm thinking by the time im offered a jab it may well have changed to avoid az anyway but we'll see.
It seems the younger you are the stronger the immune reaction you have to the jab which possibly explains the greater prevalence of clotting events with decreasing age. That being the case I wonder if that could be mitigated by reducing the vaccine dose for younger people? That would also help to solve the vaccine shortages, e.g. if we gave 1/2 dose for under 50’s that may still give a sufficient immune response for protection with less side effects and mean we could jab the under 50’s in half the time.
That is why we have had three months of Stay At Home provision. Whether one agrees with this policy or not, the outcome (together with rising immunity and vaccination) has been a 95% reduction in COVID transmission pressure.
This is the bit I just can't get my head around. People are claiming that lockdown is the answer to reduce deaths when all the data from around the world show no correlation between lockdown stringency and Covid-19 mortality as can be seen from the plot here:
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Also we were told that keeping schools shut was essential to keep cases down, and SAGE modelled the return of school kids as having a big impact, partly because school children were not vaccinated. Yet schools have gone back and the surge of infections has not happened. Is it possible that SAGE have got their assumptions as to what measures work or not wrong in their modelling because the data on the ground does not seem to support it?
I agree, Mudmuncher. Vaccines like other medication tend to be one size fits all. Whether you're a 45kg female or 100kg+ male they put the same amount in your arm. Age 30 or 80, same dose. I hadn't thought about it from the shortage point of view but you're right, the vaccination could potentially be achieved faster.
After experimenting with my asthma meds I've found a child's dose suits me better, same benefit, less side effects. I'm 64kg BTW. There must be an optimum vaccine dose for each personal profile, I hope they are working on it.
Is thrombosis via Az more common than dvt after a long haul flight? So are you stopping all flights over say 8hrs as the dvt risk is real then. Just a thoght.
But hopefully you are more concerned about being badly hurt or killed in a car accident, or struck by lightning*, or any of the other unpleasant things more likely to happen to you than to have a blood clot after having the vaccine.
flippant comments like this are really unhelpful. fear isn't rational and it sorta belittles peoples thoughts, fears and experience. Try coming from a place of understanding you might get a better response from people.
In england, are we allowed family sleepovers at the moment?
My nasty neighbour has his son staying tonight. Just another reason to dislike him
He sounds like an absolutely awful bloke having his son staying over so he can see him and be a dad. Phone the police if you're that concerned.
The guidance on face coverings in schools has changed, Curleywhirly. French schools have remained open until very recently and will only close for a slightly extended holiday thanks to face coverings. When contamination happens in French schools it's generally in the canteen when masks are taken off to eat. No inter-student contamination in Madame's school since mask wearing started as far as she knows.
As for lockdowns not working, check out France, the declines in infections perfectly match lockdowns.
https://www.worldometers.info/coronavirus/country/france/
flippant comments like this are really unhelpful. fear isn’t rational and it sorta belittles peoples thoughts, fears and experience. Try coming from a place of understanding you might get a better response from people.
You have no idea what anxieties and fears I've dealt with over the last 12 months, for myself, elderly parents, disabled wife, teenage kids being back at school. Been trying so hard to avoid going back on the meds for anxiety and depression.
If using "flippant" comments or maybe inappropriate humour has helped me put things into perspective so I can get a handle on the actual risks, it might help others. It might not. Sorry if it's upset you, but it's the way I'm wired to react.
fear isn’t rational and it sorta belittles peoples thoughts, fears and experience.
Yet it’s only there because of the way this has been reported and managed in the media and several European governments. It doesn’t matter now that the AZ vaccine is essentially safer than most of your day to day activities, the damage has been done, vaccine rates have slowed and people are asking for change or avoiding a jab. Risk of serious illness and the impact of the virus will be extended as a result.
TDLR, we might not be having several pages of tense banter if it’d been managed rationally in the first place.
The guidance on face coverings in schools has changed, Curleywhirly. French schools have remained open until very recently and will only close for a slightly extended holiday thanks to face coverings. When contamination happens in French schools it’s generally in the canteen when masks are taken off to eat. No inter-student contamination in Madame’s school since mask wearing started as far as she knows.
As for lockdowns not working, check out France, the declines in infections perfectly match lockdowns.
I could just as easily come back and say that the infection curves in Sweden (without lockdown) roughly mirror the UK curves with lockdown which implies perfectly that it is not lockdown that has cased the decline. Similarly North Dakota v's South Dakota in the USA. Almost identical increases and declines in their infection rates, one with mask mandates and lockdowns, the other without. From memory, in the UK cases had already started to decline roughly a week BEFORE the first lockdown was announced.
But correlation is not causation, and I am wrong to point out those countries in isolation, so rather than picking individual countries, a choice of which can always be made to fit a specific point of view, far better to look at all countries.
My (unscientific) hunch is that lockdown makes very little difference, and might even make Covid issues worse since by locking down whole populations, relative mobility between the age groups becomes much more aligned. People have been conditioned to think that lockdown is the answer. In reality I suspect we have been lead up the garden path.
It's a case of damned if you do and damned more if you don't, Kryton. And it wasn't the media and governments in Europe, it was the medical profession. The first clotting victims in Italy, Germany and France were nurses and care workers because they were the first young people to be vaccinated as front line workers and they went public in the public interest. The first I knew of it was (Italian IIRC) nurses being interviewed on German TV.
That meant the authorities had no choice but to be transparent, and personally I think that was the right choice. That transparency means I can be confident in the stats and make a choice. Less transparency and I'd be doubting the figures, in fact for one country I do doubt the figures. 😉
Interesting questions curlywhirly.
My thoughts (not the answers, just first pass theories)
1/ I'm not sure what lockdown severity means, and how that is turned into a number scale. I don't know exactly what other countries did, and they're not all listed anyway but in eg: the UK we have have periods of pretty severe lockdown, and periods of free for all. Our cases / deaths have increased in the aftermath of eat out to help out, and the Christmas shenanigans, and the severe lockdown periods have then brought them down again. I don't think our 'medium to high' severity number, as an average of what we have done, shows sufficient granularity to enable a claim that lockdown doesn't work.
As Ed said, I think there is far better data that shows the impact that lockdown and open up has on death rates; eg: my old colleagues blog again; https://protonsforbreakfast.wordpress.com/category/covid-19/
2/ The x-axis is lockdown severity, but does not show adherence to those lockdowns - how hard were they enforced / what is the population response to it. Do you have a link to the actual report?
3/ Might be stretching the data fitting but if I squint could I show clustering, even linearity in the regions on that graph - are all the Western World nations in the same area of the plot, the Asia Pac nations are in a different area? What I could possibly also draw is a line, it would be incredibly scattered, but would suggest the harder the lockdown the higher the death rate. So while I 'follow the data' I really query the result at that point (part of the scientific method is to have an idea what answer you'll get, and if you don't get it query why including checking the data, before screaming eureka. If I weighed myself and the scales said 60kg, I wouldn't immediately stop my diet, I'd check if my scales are knackered!). Check, recheck and then review and if the answer's still the same, then it's very interesting.
Following on from the previous points. If my theory that draconian lockdowns followed by free for alls - scored as medium to high severity in the chart - are not sufficiently granular to show what lockdown does, is there a clue there - the reason we all go mad when lockdown ceases is BECAUSE lockdown is severe. Is the actual right answer to genuinely have a less restrictive but sustainable lockdown in perpetuity, to avoid the extremes, given it's the extremes that spike deaths.
4/ Re the not (yet) seen increase in cases from school reopening. Maybe the Gov was right and schools are safer than we thought? Maybe the case rate is very low and the distancing measures / LFT and remove from the pool before it has a chance to spread. I don't know but you're right, the pick up has not yet happened, and while it's still IMHO too early to claim that the modellers got it wrong, there is some understanding to do.
wooaa there cowboypud
I was only raising a point that long haul air travel can also cause clots
Yet we accept this as a low rosk / low odds effect of doing something we want to do. See also base jumping/ hangliding/ free fall skydiving etc.
I am possibly the least educated person on here , and I do not know the statistics /million of passenger numbers getting clots , but its , in my opinion a risk assessed situation. A few people will have a reaction outside the vast majority to a Vacciation , and a few people have had a reaction outside of the vast majoority to air travel
No flippancy or gallows humour intended , just an observation thats all
As for my neighbour , It was just a question. No need to get your pants all up your arse and turn it into an excuse for a personal attack. Jesus.
It’s a case of damned if you do and damned more if you don’t, Kryton
True. And even the best news would cause anxieties in many people, but facts that have been reported to try to rationalise the real danger of the AZ vaccines are not belittling, they are facts.
If using “flippant” comments or maybe inappropriate humour has helped me put things into perspective so I can get a handle on the actual risks, it might help others. It might not. Sorry if it’s upset you, but it’s the way I’m wired to react.
I guess if you make flippant or attempt inappropriate humour don't be surprised if you get frosty responses or called out. have a good day im off to get coffee.
No flippancy or gallows humour intended , just an observation thats all
Yeh... sure it was. good day.
At first glance your friend makes many assumptions there, not least that a recent rate of the decline in cases slowing is due to schools being back. Yet we know that since schools being back, testing levels are through the roof and with the disease now at a very low level in society, the false positive issue comes back into play.
Of concern in this area is the recently announced mass testing programme that the BBC reported here:
https://www.bbc.co.uk/news/uk-56632084
Which says that:
"The latest data shows that, of the 4.2 million lateral flow tests taken in schools and colleges in the week from 18 to 24 March, 4,502 returned a positive result."
and also:
"The government said that for every 1,000 lateral flow tests carried out, there was less than one false positive result, and the rapid tests were particularly useful at detecting high levels of virus."
I am not sure if anyone has done the maths here but 1 in a 1,000 false positives out of 4.2 million tests is 4,200 false positives, out of a total of 4,502 positives. So 4,200 false positives and just 302 actual positives?
So does mass testing of asymptomatic (used to be called healthy) people still make any sense or is it just a huge waste of money and resource. Another huge transfer of public wealth to Hancock and his mates?
Facts. Facts are things that need caree and qualification. The philosophy of doubt and all that. Unqualified facts are a problem, especially when the fact has to be changed because it wasn't properly qualified when presented and has to be revised. The clotting cases is a good example. From single figures to 30 to 80 and I've no idea where we are today.
France and Germany have kept running totals and updated, that inspires confidence. Can anyone find me the UK equivalent of the German numbers I posted above, i.e. a number reported up to a date? I'm genuinely interested because the UK is the place that's used the most AZ. The problem is that between supply issues, contract arguments with blacked out lines and having to rely on CNN for something resembling the truth, and initially misleading reporting of clotting issues AZ has become a politicised vaccine. And that's why people are losing confidence, they are not being told the whole truths and have no reason to believe the "facts" because previous "facts" have been lies.
testing levels are through the roof and with the disease now at a very low level in society, the false positive issue comes back into play.
Everything I've seen says false positives are very low, 2% for PCR, but false negatives for all the tests are quite high, of the order of 20% for RCR IIRC. I faile to see how a false positive issue could play on anything.
the infection curves in Sweden (without lockdown
So people still believe that you can hold Sweden up as an example of non lockdown success?
I also had problems opening that link.
Without knowing what "lockdown severity " means it's a bit tricky to interpret. But a couple of thoughts
China had a severe lockdown and relatively low death rate. South Korea had no lockdown, low death rate, but it's well documented that they had ridiculously efficient track and trace from the start after their SARS experience a few years ago. It's generally agreed that properly efficient testing, track and trace would have reduced the severity of our lockdowns and death rates. Lockdown is what we've had to use cos nothing else was working.
A lot of the severe lockdown/high death rate countries introduced restrictions relatively late inititally, when the virus was already widespread. The high death rate was set up before the lockdowns could start to work. And several of us have done that mistake 2-3 times now. It's generally agreed that earlier harder lockdown is more effective at reducing deaths and impact on the economy.
A lot of the "no lockdown, low death rate" seem to be poorer African/Asian countries. As TiRed explained hundreds of pages ago, that may be because their lower life expectancy means that they don't have the high proportion of older people left to be killed by Covid, like more affluent Western nations have.
The Swedish comparison has been done to death. Their death rate is lower than ours with less severe restrictions. But it is much higher than the death rates in their Scandinavian neighbours who had strict lockdowns. And their government has faced internal criticism for the number of deaths arising from the easier restrictions.
If you want to see how effective a no lockdown approach is, look at Brazil at the moment.
I am not sure if anyone has done the maths here but 1 in a 1,000 false positives out of 4.2 million tests is 4,200 false positives, out of a total of 4,502 positives. So 4,200 false positives and just 302 actual positives?
My understanding is that if you get a +ve LFT then you have a confirmatory PCR, which I assume is what's done here (otherwise how do they know they were false +ves)
So 4502 positive tests, and 4200 false positives that were overturned by the PCR
[edit, actually <4200, the report says <1/1000, which could be 1/1001 or 1/10000000000 !! But let's go with 4200]
Now - that fact that almost half the +ve LFT's came back as false is another (very good and interesting) question.
As to my ex-colleagues's assumptions. Unfortunately what we are doing here is not lab or clinic based science, where you can adjust and control different variables and see what effect these have. We can't halve the country and let them run amok while the other half is locked down just to see which half has the worst death toll. We have to make best guess adjustments on the hoof - and accept as new data comes to light, we might need to adjust what we do without the yells of 'U-TURN!' Some bits will have been got wrong, the weakness is not to recognise that and adapt and simply plough on because we can't admit being wrong.
So yes - in an experiment he'd then control for these variables and prove his point or not. We don't have that luxury.
What I object to, vehemently, is that these brilliant people working day and night on this (including some in my own labs) are in some quarters being called propagandists, part of a conspiracy theory, and their work only given the same credit as some random with an opinion and an internet connection.
'My mate knows someone who says that.....' is not a credible source, but retweet it enough times and it starts to look like one.
The data is in there. It's not a daily report, but was updated as of a week ago's data.
@mctd
If you want to see how effective a no lockdown approach is, look at Brazil at the moment.
But on CW's chart Brazil are lockdown severity 75-80, cf UK at 65-70 ?!?
Without an understanding of what the X-axis is defined by, it's hard to really compare.
CW, your chart what you brung, can you unpack that a bit further please?
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curlywhirly
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Wow, Another recent joiner who only posts on this thread, haven’t we had a couple of these already who were the same person?
Who knew that STW was the bastion of COVID debate drawing in so many just to impart their views.
Joepud - You may think it's ok for Singletrackmind's neighbour to have his son round.
But actually it's not. The rules are OUTSIDE only.
There is a reason for this. The virus can spread more easily inside and it isn't just one neighbour with one son, it's happening all over the country. People now thinking this is over and having friends and family to stay over.
Most of the public who have been vaccinated think this is all over and need to read the rules.
curlywhirly. Definitely never ever been on here before. Nosiree.
Wrt az as we have established it's about risk/benefit as are they all. All the vaccinations are being monitored and hopefully we won't see complications with any of the others, or further complications with az. I very much doubt I'll get a choice of vaccine and I'll be happy with az. A year ago we'd have been overjoyed to hear the news that there was one vaccine with 50% efficacy and now we have enough different ones we can target them to age groups! It's amazing! Comparison with every day risks we take for granted is entirely reasonable. As I think one poster wrote on this thread some time ago - if you're worried about that I hope you don't get in a car...
😉
https://www.gov.uk/government/news/mhra-issues-new-advice-concluding-a-possible-link-between-covid-19-vaccine-astrazeneca-and-extremely-rare-unlikely-to-occur-blood-clotsThe data is in there. It’s not a daily report, but was updated as of a week ago’s data.
The data's not really there though is it, just an overview. @Edukator 's example of a couple in one hospital is worrying and I agree, I think for confidence to be re-instated we need transparent regularly data on the issue in the same way we've had daily/weekly detailed updates on case, hospital admissions and deaths. Is a decent dataset available to view anywhere with number of 1st doses, number of clots, number of low platelets and number of deaths per 5-10 year age band. @TiRed, do you know? I couldn't find it.
Given that the reported assumption is that incidences take up to 1 month to manifest and vaccination is moving so swiftly, we may be under estimating the issue in younger cohorts.
Thanks for the link, theotherjonv. That was published on 7/4, a couple of weeks after countries that started vaccinating a month later reported. What stil missing is the numbers vaccinated in each age group and the incidence for each age group calculated from that. They have the numbers and the maths is easy, but they know the stats wouldn't look good.
Joepud – You may think it’s ok for Singletrackmind’s neighbour to have his son round.
But actually it’s not. The rules are OUTSIDE only.
You're right I think it's perfectly acceptable for a father and son to spend time together even if that means staying over. And to be honest for that specific instance I couldn't care less about the rules!. Not everyone has the luxury of living with their kids and seeing them all the time. My brother is now a single father so his kid stays over a few times a week its basically the highlight of his week having breakfast and dinner together and just hanging out so thats why I take a particular issue with the initial statement. have a heart.
Anyway, this could be another classic hypothetical single track debate, we both said our bit and im sure we both have better stuff to do in our day.
Everything I’ve seen says false positives are very low, 2% for PCR, but false negatives for all the tests are quite high, of the order of 20% for RCR IIRC. I faile to see how a false positive issue could play on anything.
This video will show you the significant difference between false positives and false negatives when disease prevalence is low. The lower the disease prevalence, the more the results are skewed. As you can see, false negatives numbers are negligible. Hope this makes sense?
You’re right I think it’s perfectly acceptable for a father and son to spend time together even if that means staying over. And to be honest for that specific instance I couldn’t care less about the rules!. Not everyone has the luxury of living with their kids and seeing them all the time. My brother is now a single father so his kid stays over a few times a week its basically the highlight of his week having breakfast and dinner together and just hanging out so thats why I take a particular issue with the initial statement. have a heart
I thought the rules allowed for a child to go and stay with each set of parents if they are seperated anyway - so in this case no rule breaking has happened?
My (unscientific) hunch is that lockdown makes very little difference
The primary purpose of lockdowns, is not to slow the spread of the disease, but to try to ensure hospitals aren't overwhelmed.
What stil missing is the numbers vaccinated in each age group and the incidence for each age group calculated from that. They have the numbers and the maths is easy, but they know the stats wouldn’t look good.
Yes, thats what I want to see.
Also, I am mildly concerned that most other nations are saying not for below 50+s and the Uk is saying not for below 30s. I can't help think this is pragmatic in that we have so much of the AZ vaccine to use.
The primary purpose of lockdowns, is not to slow the spread of the disease, but to try to ensure hospitals aren’t overwhelmed.
Our hospitals are overwhelmed every winter in case you've missed the news over the last 20 years. But if that is indeed the case then why having closed the Nightingales, are we still in partial lockdown when the NHS said a month or two ago that it could cope perfectly fine?
So people still believe that you can hold Sweden up as an example of non lockdown success?
Please do not. We have had no lockdowns here, but we have also had some areas with hospitals at 100% capacity and far too high death rates amongst care home populations. As has been said above, the government have faced significant criticism and anyone saying that we made absolutely the right choice is, I think, being disingenuous.
We've had a really high infection rate and total number of deaths that is, I think at least, far too high for a developed nation with free healthcare. Hell, the only reason so many of the hospitalised survice is because our healthcare system has not been ****ed over like the NHS has in recent years.
We're vaccinating, but slowly. I'm 47 and i still have no idea when I will appear on some sort of vaccination schedule. My mother in law (72-ish I think) had her first jab yesterday. Is this really the model other nations should follow?
People were (and still are) asked to act responsibly, to stay apart, to not travel, to take precautions. People _STILL_ act like dicks and ignore that. People still die because of that.
So government now saying foreign travel back on post may 17th, prior to most under 50s having been vaccinated. Testing in place before and after travel but simple fact is many selfish cxxxs will simply ignore a positive result and fail to self isolate.
3rd wave of South African/Brazilian variant on its way and probably more lockdown. All because folks are desperate for a week's holiday in the midst of a global pandemic.
Madness
So government now saying foreign travel back on post may 17th, prior to most under 50s having been vaccinated. Testing in place before and after travel but simple fact is many selfish cxxxs will simply ignore a positive result and fail to self isolate.
3rd wave of South African/Brazilian variant on its way and probably more lockdown. All because folks are desperate for a week’s holiday in the midst of a global pandemic.
Madness
This^^
It seems these days a foreign holiday is some sort of human right
I thought the rules allowed for a child to go and stay with each set of parents if they are seperated anyway – so in this case no rule breaking has happened?
I think the issue very much depends on the age and care responsibilities for the child. If he's 14, its fine, if he's 24, its not.
Our hospitals are overwhelmed every winter in case you’ve missed the news over the last 20 years
Thats a bit simplistic. The scale to which hospitals have been overwhelmed through Covid is several degrees of magnitude higher. And I think there's an argument that Nightingales weren't necessarily there to help patients recover from it if it went properly tits up.
why having closed the Nightingales, are we still in partial lockdown when the NHS said a month or two ago that it could cope perfectly fine?
The PRIMARY purpose of lockdowns is to lower admissions to hospitals so that by spreading them out the NHS can cope better, the SECONDARY purposes is to slow the spread of the disease. Astonishing isn't it that by doing one thing, it has multiple good outcomes. The R rate is still pretty high, and the total infections are is still pretty high, if we simply ended lock down we'd very quickly be back into uncontrolled transmission.
Madness
This^^
It seems these days a foreign holiday is some sort of human right
All of this. My exact response was FFS