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CG.
Wrong timing. When this shitshow is over or even partly over, people will be so relieved that they will practically be falling over themselves to kiss his shoes.
The time is when this is still rumbling on in the background and we are looking down the barrel of a No Deal Brexit with all the loss of support and solidarity that will bring. The increased dependence on the US will look very dumb by then as Trump will have made a total bollocks of dealing with covid-19. China will be ahead in their recovery and solidarity with European nations will look more appealing.
For those unsure if they had it, read the Cambridge Independant article on page 153 that BillMC posted. A cambridge prof suggests there was a flu earlier this year with very similar symptoms but influenza b is on it's way out now so such symptoms now more than likely to be Covid19.
Thanks slowpuncheur, I'll look that up.
Wasnt worried before, worried again now 😷
So do we have a clearer idea of why deaths in Italy haven't dropped off yet? Is the lag between catching it and carking it much longer than we think; is there a lot of transmission still happening on shopping trips; are Italians failing to follow the rules or is it something else?
@Tired, French deaths will include retirement homes from Monday according to news channels.
So the latest Imperial paper (in response to the Ferguson one)that said 5700 deaths, reckoned there'd be a (2nd) peak peak early April with 260 deaths, that's not looking likely at all.
We had around 260 deaths yesterday
So do we have a clearer idea of why deaths in Italy haven’t dropped off yet? Is the lag between catching it and carking it much longer than we think; is there a lot of transmission still happening on shopping trips; are Italians failing to follow the rules or is it something else?
The countries that got on top of it, china & Korea (& it seems Germany)
China (eventually) were testing, tracking & quarantine very strictly
Korea (& Germany) had a huge test & trace effort .
I'm not sure Italy has managed to get close to that, & worryingly I don't think the UK is close either
I'm still waiting to hear back about testing centre near me I volunteered for, as i understand it it's still not ready, a week after they nabbed all the qpcr machine from my work
It’s the only game in town until there’s a test and/or a vaccine.
If herd immunity is the solution what's the problem?
For those unsure if they had it, read the Cambridge Independant article on page 153
I've read it already, but to save anyone else looking for the link, this is the article referred to:
This seems like a well-reasoned discussion of the likely duration of our confinement.
“The Four Possible Timelines for Life Returning to Normal” by The Atlantic https://link.medium.com/Bes4tuGof5
Well-reasoned and the internet are not usual bedfellows. I try. I don’t do twitter and I seldom do facepalm.
As I have maintained, China was able to dramatically reduce transmission by contact. The EU is not as effective. The slope of the curve in Italy has a modest downward trend. But the curve in China and SK, also predicted by my model are dramatically different. I see no trends elsewhere.
I don’t like guessing, so prefer not to, but given the uncertainties in the models from Imperial (and everyone else), I am not confident that we will be out in three months. With these models, it is easy to be wrong, and wrong BIG! Always to be wrong by over-prediction.
Stay inside.
The Atlantic published an article about the US response. It's equally grim and compelling reading
https://www.theatlantic.com/health/archive/2020/03/how-will-coronavirus-end/608719/
Kimbers, re-Germany,just an alternative thought to consider -
Their early action and capacity for testing has had many scratching heads over their death rate numbers with many reports jumping to conclusions based on simple testing/death ratio numbers.
Germany are currently following a very similar pattern to Italy (from 100 deaths - 450 deaths in 5 days), have the testing numbers muddied their timeline?? Are they actually a few days behind the UK.(with UK a few days behind France/Spain)
Do their testing numbers give us all a better picture of spread rather than showing any sort of control at this early stage?
Do their testing numbers give us all a better picture of spread rather than showing any sort of control at this early stage?
yeah, quite possibly
they have a decentralised health system too which may not help , even if they do have many more beds per capita than other countries
So I saw recently roughly 1000 deaths and 17 000 cases. If death rate is 1% that suggest 85 000 cases doesnt it and if its 0.1 death rate that suggests......850 000 doesnt it? I find the lower death rate numbers more scary tbh...
Is this cold war steves best work?
zoom in for the full picture
https://twitter.com/Coldwar_Steve/status/1244028189501988864
That piece from the Atlantic makes me feel sick
So the latest Imperial paper (in response to the Ferguson one)that said 5700 deaths
Author has now revised to 20-30k.
5700 figure needs to be dropped ASAP.
@grahamt1980 - I agree, it's very disturbing even more so when you consider Trump changes his policy on a daily basis. If the US gets hit,even half as hard as this article suggests, we're in for a huge economic downturn.
If the US gets hit,even half as hard as this article suggests, we’re in for a huge economic downturn.
It seems pretty obvious that the support currently in place for the hospitality sector is unsustainable. If pubs, restaurants, music venues, hotels etc can't reopen soon (ie by the summer) then they'll have to be written off. Millions will lose their jobs and the economic rebound will not happen. That's when this will get very scary in economic terms. I think we'll end up with a universal basic income in some form as the alternative is mass bankruptcies, homelessness and poverty on a scale that will make the virus look like childs play.
And in other news, following nationalisation of the railways, and an end to the tories NHS reforms (CCGs have been brought under central control), another much derided labour policy is on it's way...
https://twitter.com/jimwaterson/status/1244152346504040448?s=20
@grahamt1980 – I agree, it’s very disturbing even more so when you consider Trump changes his policy on a daily basis. If the US gets hit ,even half as hard as this article suggests, we’re in for a huge economic downturn.
This is the defining moment that I think historians will view as being the beginning of the end of America as a global hegemon and the end of the west as the dominant political sphere. We look like complete idiots to the developing world, who's influence with and business we are vying with China for. Have you seen the journalists travelling into China to check out how professionally they are running things now? The journalists look totally bewildered as if they're uncontacted tribes people who have seen an airliner for the first time, the cognitive dissonance is almost visible on their faces. Their airline stewardesses have better PPE than our own doctors on the front line of this.
It might have started in China, but China, Taiwan, Singapore etc are showing us all how this is done.
The fast east will rebound from this quickly, the west will have been fast tracked into a long term period of recession and then economic stagnation. This is like the cold war, the United States was able to outspend Russia into economic ruin, it's just been reversed now and the war is against a virus.
^ Absolutely this.
Having just watched a news report from India and their idea of a lock down (10,000's of people running home from the cities, in a mass stampede) it's clear they are going to have numbers that make the US look like it's by invitation only.
The fast east will rebound from this quickly, the west will have been fast tracked into a long term period of recession and then economic stagnation.
They may have the internal transmission at a stand still. Running along but still a self contained 'safe' island. I would have thought bringing back anything close to global trade would require a vaccine first. As soon as the borders open the risk of virus entry increases. All it has to do is come in create a hotspot and we're back to all stop full stop.
From the no particular expertise arm chair pundit one time foot and mouth watch perspective - I can see local 'normalisation' but a global return? You could argue oh well we are going into summer - indeed but half the planet is heading for winter. There is going to be a virus reservoir somewhere and without being contained somehow it's not going to sit there.
Putting the brakes on was the easy part - a structured reboot is much more difficult. I'm going for global restrictions to some extent until vaccine. Even then, it has to be administered to the entire planet. Who decides who's front of the queue and how long does it take?
Whilst the dynamic between East and West existing and emerging economies is interesting. The defining ones may be between exploiters and the exploited?
They may have the internal transmission at a stand still.
Doesn't matter. China can downplay their numbers and keep their population more oblivious to what's going on. They will simply ban foreigners/westeners from travelling there - effectively contact trace those with real need to travel to China and then carry on selling shit loads of goods to the developing world regardless of whether we are in recession or not.
Where as the west will have a fit and throw an absolute **** tonne of money at the problem, because we have a free press and half a million dead grandparents isn't going to go down very well in that environment.
On top of that, they have economic advantages - cheaper cost of goods, centralised government used to running a command economy with huge amounts of spending power making them able to stop SME's going into recession, an already growing economy to act as a buffer to negative growth. etc etc etc
China is simply more agile.
I saw the Sky report on this today. Seriously, who wants to live like that? If that is our future, the cure is definitely worse than the disease.
Who decides who’s front of the queue and how long does it take?
There's a tried and tested process for solving such questions. I fear that's where we're heading in the years ahead.
the cure is definitely worse than the disease.
I'm actually coming round to this. I think behind closed doors western governments always had this view. The current lockdowns are emergency actions to get the public on side. Once they've got on top of managing the PR of tens of thousands of premature deaths and public fatgue sets in herd immunity will be top of the agenda again.
^^^ Scary to see a future resembling the current situation in China, if that Sky report is anything to go by.
We've already signed away our freedoms, albeit temporarily, to combat a virus. Amazing how,
seemingly, easy it has been for us to discard our civil liberties over this.
Not saying it's a nice way to think but the Venn diagram of people likely to die in the foreseeable future (remember, UK has 600K deaths per year on average) and those likely to be killed by CV19 has a substantial overlap. Yes, there are some in the non-overlap section, who would have been expected to have long and productive lives but will not, and every life lost for any reason is a tragedy at an individual level.
There are also very real fears of how many will be massively affected by the economic impact of this situation. A quick google of reports (E3G, NEA, etc.) suggest 10's of thousands of people die each year due to fuel poverty and the resulting health impact of unheated homes. Add in homelessness, hunger / impact of bad (cheap) diet, and the knock on could be easily similar or higher magnitude to the virus itself.
I don't know the solution, and this is not a suggestion to let it run riot through the population - far from, I personally have people in that non-overlap section at risk and have elderly parents who are most definitely in the overlap. I do know I wouldn't want to be in the decision seat (and I'm sure this isn't what Boris thought being PM was going to be like)
The countries that got on top of it, china & Korea (& it seems Germany)
China (eventually) were testing, tracking & quarantine very strictly
Korea (& Germany) had a huge test & trace effort .
This is what I'm mulling on this morning - but the government is so smug about its 10,000 tests per day (including sending people away who have very clear symptoms of covid19) and nobody in the media is pressing them on the fact that it'll take 20 years at this rate to test everyone.
Did someone mention `Trump?
Was he signing that with a felt tip pen?
Ladies and gentlemen, I bring you the most powerful man in the world.
We're doomed. Doomed I tell ya!
Meanwhile police drones threaten sole walkers in the Peak District.
One drone? It wasn’t exactly armed. How did it “threaten” anyone? The government has absolutely screwed up when it comes to basic measures for incoming flights… but what has that whataboutery got to do with the risk of spreading the virus to rural communities, full of old people, and miles from hospitals with ICUs?
I much prefer this post of hers:
https://twitter.com/berniespofforth/status/1243913838224965632?s=21
Here's a good resource:
... put together by some folks in Berlin and tweeted by Tricia Greenhough, so good enough for me.
Not saying it’s a nice way to think but the Venn diagram of people likely to die in the foreseeable future (remember, UK has 600K deaths per year on average) and those likely to be killed by CV19 has a substantial overlap.
As I understand it, the numbers of flu deaths that are mentioned are based on "excess" deaths, over and above what would be expected within the population normally. I guess it will be a couple of years before experts can look back and truly assess how devastating the epidemic has been on that basis. Presumably that will also account for additional deaths from otherwise preventable causes that could not be treated due to the strain on the health system created by the virus.
The aim is not to overwhelm ITUs not stop the infection in its tracks in this country. The herd immunity picture always acknowledged hundred's of thousands would die in the UK. The Chinese and South Korean's are aiming to stop it completely resurfacing and seem to be doing a pretty good job so far. Our government had a shot at it and found it economically unpalatable then had to shut it down anyway to prevent a runaway ITU disaster. I know where i'd currently prefer to be a citizen of.
I normally find anything in the spectator far too swivel eyed, but I can't find anything in this article too disagreeable, I'm happy to be corrected though
Link
My fear is if this lockdown goes on longer than 3 weeks the economy will never recover. I don't care about shiny new things and nice holidays, just need to keep a roof over my head and feed my family . If my industry doesn't recover, that's 40000 jobs gone in a region that isn't exactly booming to start with.
Not just your fear mdavids - the gov't is sh*tting bricks about that too. More broadly, if lockdown goes on for much more than a month, they may struggle to keep it enforced, as people will only go along with it for so long...
Nicko74 re- testing. This is my take fwiw.
Europe just hasn't had the capacity or resources for the combined testing, tracing contacts and isolating procedure to gain control. Germany were initially testing 4 or 5 times the capacity of UK, Spain and France but were still reporting their capacity wasn't enough to catch all the spread.
UK couldn't test,trace,isolate enough people in the community to have any impact (early testing capacity was 2.5k) so the testing focused on the hospitalised cases (similar to France and Spain). The testing is increasing but the spread is quicker.
Testing, tracing and isolating will be a big part of the control phase after the initial peak/wave so we will need a considerable increase in capacity in coming months to have a second go at control.
I believe UK testing capacity is now 10k a day with plan to increase to 25k a day but testing is only 1 part of the combined test,track,isolate procedure needed. Best use of resources will be key.
What is important to recognise and what Richard Horton has been saying repeatedly time after time is that we had time to prepare. We knew at the end of January there was probably a pandemic coming and had ample time to ramp up our resources. We didn't because our government chose the herd immunity path that was recognised from the outset to end in hundred's of thousands of deaths although this was assumed to follow the modelling based on Influenza epidemics. By the time they started listening to the evidence that the Lancet had been stating from the beginning that the mortality and morbidity rate was far greater than that model could ever accommodate, the time for tracing and containment was well and truly behind us. Some people will say this isn't the time for politics but if those who made these decisions aren't held to account eventually at least at the ballot box then what purpose democracy?
The spectator article is fair, however we will only know the death rate vs definite infections once we get a very high level of antibody testing.
then and only then will they be able to assess the overall mortality rate
The only issue I have with the spectator article is that the flu deaths are despite the vaccinations available, where with covid there is no vaccination.
Once they test the majority of the population I suspect like the Iceland study that the death rate vs infections will actually turn out to be lower (but still bad).
Honestly though there is an element of the world has to go through this to get a real appreciation of what could happen if something like hantavirus or a haemorrhagic viral infection becomes pandemic as this would be nothing in comparison to those.
I spent £6k I didn't need to at the start of Feb. I'm usually extremely cautious with money and I'm lucky enough to have a decent disaster fund - it should be £6k bigger though.
At the time there were no indications we were heading for economic lockdown. How on earth did we go from "a slightly more virulent strain of flu" to worldwide disaster in seemingly a couple of weeks, despite the data coming out of China. Were China lying about the true scale, did western governments completely drop the ball despite having all the data or have our governments been lying and always knew a disaster was coming?
So, has anyone had it yet?
My wife and I have had most of the, albeit mild, symptoms bar the temperature though I have had a couple of disturbed nights sleep due to being too hot or cold.
Can’t work out if it’s the standard winter lurgy or Covid, though we both suspect the latter.
Thankfully, I work from home and she’s got 2 weeks of annual leave so we’re not likely to pass it to anyone.
With all due respect whilst I understand these are more severe infections, by their very nature they don't tend to travel as well due to their severe mortality rates. I am not sure we should be more worried about these viruses affecting us in the Northern Hemisphere although i'm happy to be corrected? The virus we are seeing currently does to a large degree seem to be a perfect storm for us.
Some people will say this isn’t the time for politics but if those who made these decisions aren’t held to account
It definitely isn't, and we have no way of knowing if any other government would have listened to other experts and taken a different path.
Rather than rushing to blame, we need to be rushing to learn, improve and prepare.
So, has anyone had it yet?
Separate thread for that
So, has anyone had it yet?
I think we are just on a few definite from tests and a collection of yes seem to meet but not sure.
MoreCashThanDash
Some people will say this isn’t the time for politics but if those who made these decisions aren’t held to account
It definitely isn’t, and we have no way of knowing if any other government would have listened to other experts and taken a different path.
Rather than rushing to blame, we need to be rushing to learn, improve and prepare.
Do Germany, South Korea and China not count as governments?
@speedstar
The trouble is that with more and more zoonosese (not sure on plural of zoonosis) emerging we simply don't know what could come out next.
My comment is not meant to worry but we need to get away from this attitude of these viruses only being present in non developed countries, with the huge level of rapid transport world wide these diseases or variants / mutations of them could spread and become pandemic.
viruses are inherently unstable and effective mutations could appear and spread rapidly. I only used hanta and the haemorrhagic ones as examples, there are plenty more options around, just look at how terrified India is of yellow fever becoming established.
this attitude of us and them is exactly what causes these issues to become as big as they can sadly
Were China lying about the true scale, did western governments completely drop the ball
China, probably
The West, definitely
Definitely agree. On reflection it's an error of thinking to assume because they haven't previously they won't in the future as this virus is already showing. Showing my own prejudices badly there. Chat in the GP forums that we might not be able to say "it's just a virus" ever again...
I think we are all learning a lot from this. And def challenging our own preconceptions on a lot.
Am a virologist working in pharma and this has made me reassess my views repeatedly.
the only thing we know is that with these little buggers is that they can and do change rapidly
Do Germany, South Korea and China not count as governments?
Not potential UK governments as of the last election, no. I think that's what MCTD meant.
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Looking at that, currently as of today, we;re sitting at, 1.5 per 100k, day we went into official lock down, we were at. 0.5%. so probably on course for starting at the 0.2 given incremental measure were started before that..
I believe UK testing capacity is now 10k a day with plan to increase to 25k a day but testing is only 1 part of the combined test,track,isolate procedure needed. Best use of resources will be key.
Our regional lab was expecting to test 500-1000 samples per day, however I believe they've chosen a platform which is capable of no more than 200 even if it's run 24 hrs per day.
Our hospital is sending 40 per day to them, any extras will be sent to Manchester. I believe they are already over capacity though and there's already a back log.
There'll be plans in place I'm not party to though.
I have seen the mention of these hypothetical leaders. But yet when we have other leaders to compare ours to - Merkel vs Trump - can we not simply state that Johnson followed the Trump model initially then realised Merkel's was right after all? That to me seems purely fact without castigating other potential leaders who aren't in power
Were China lying about the true scale, did western governments completely drop the ball despite having all the data or have our governments been lying and always knew a disaster was coming?
The west dropped the ball. China might be covering up a second wave but they were pretty open about the disease after the initial fumbling in early January. We didn't listen to what Chinese experts were saying and assumed that we could cope - hence the complacency.
Do Germany, South Korea and China not count as governments?
Well, Sweden seem to be following our lead as well. I'm not saying our government did the right thing, but if they were listening to British based experts, I'm not sure any other British government would have gone against them.
Anyone heard from Franksinatra?
Jaw dropping levels of stupidity. A scene no doubt repeated across the UK
*waves*
I'm doing okay. Night three on COVID ward tonight and, honestly, I've been to a pretty dark place but hopefully turning the corner now. There have been some false hope before so will see how tonight goes before proclaiming myself to be over the worst of it.
It is a properly horrible illness, it is not an Internet argument, stat or headline. It's just a grotty, foul indiscriminate illness
Can we pin your last paragraph to the top of the forum?
Glad to hear you're hopefully on the up 🙂
Lots of talk now of late May, early June at the earliest, the fact that most businesses, people and the country could be bankrupt in less time than that will be what drives the way this is dealt with after April!
@franksinatra hope you get well soon.
My dad (in his 70's) was admitted last Friday with breathing issues - prior to that he had a cough for 3 weeks, and aches for 1.5 weeks - in the last few days before he was admitted he was sleeping lots (like proper flu). The breathing issues came on then, along with coughing up gunk.
He has just tested positive for it. I've also had similar symptoms but not breathing issues (I've been isolating for about 3.5 weeks now).
If it gets to the lungs, it's the breathing issues that seem to make it differ from general cold / flu...
Currently on oxygen, but said he's feeling a lot better each day which is positive.
What a nightmare this is, not being able to be near loved ones :/
Lots of talk now of late May, early June at the earliest,
If that turns out to be the case then welcome to the start of the next Great depression.
Good to hear you feel like a corner has been turned, keep us posted too.
We’ll only worry if you don’t.
My analysis of this study using predictions for each patient of their HCQ concentrations on the days they did not measure, show a highly statistically significant response. Tha analysis in the paper is naive, but they very kindly gave a table of all the raw data. My analysis is much more robust. I would – and I’d take a 1200mg loading dose on Day 1
Pretty mucky data, all the same TiRed (and still a really small sample - and don't forget the withdrawals if we're going all ITT). I'd prefer to "reject" the two asymptomatic patients, probably analyse the URTI separate from the LRTI, and also (esp in the HCQ only arm) there's a pretty good correlation between longer delay to staring therapy and negative swabs - this could well relate to later presentation implying more minor disease - or even later presentation meaning they're closer to resolution anyway (also quite a lot of folk think there's 2 points at which swabs are +ve, with a dip inbetween so we may not be seeing "real" resolution)
I agree on loading-up though. That stuff has a lonf half-life. Encouragingly, the recovery trial will use a substantially bigger load than 1,200mg
Edukator mentioned the French have been looking at this. But it also appears Australia is trialling a Tuberculosis vaccine, less to act as a vaccine but to boost the immune system.
I haven't seen the paper described by scaredypants and TiRed - what's the breakdown of the loading dose seeing as it's a combination therapy? The chloroquine derivative is a pretty well tolerated drug isn't so, so I'm not surprised they're loading an even higher dosage. Isn't this causing massive issues for lupus patients though?
Not a medic, just have a graduate degree in Biomed - 5 years in pharma and currently studying stats.
Pretty interesting time to me a mathsy/biosciencey person - suddenly all my old school biology graduate colleagues/former colleagues don't groan when I tell them I'm studying stats.
I feel like this might be a fleeting period in my life when I'm vaguely cool again.
Lupus patients are definitely starting to have issues with supply.
am hoping my cousin can switch to Benlysta as I know that doesn't have any supply constraints.
sadly it isn't right now that is going to be the issue, it is the ban on api that most countries have put in place that will stuff the supply chain
If it's any consolation Graham it makes me cross eyed with rage.
Drugs are of strategic importance, we shouldn't be in a place where we have to rely on a couple of the countries for the API.
Not sure of the ethics of say, stuffing young/working age lupus patients for 80 year old retirees either.
Sadly though the production of api for the generic or old (cheap) medicines will always go to the cheapest provider. But yes causing supply chain issues through protectionism is idiotic. But less of a consequence for them as they don't want or can't afford the ones we produce in the developed world
Ming, they played his speech at the ice hockey game on the radio earlier - with an accompanying translation. Words failed me as well.
rayban: https://www.sciencedirect.com/science/article/pii/S0924857920300996?via%3Dihub
HCQ is LESS toxic than chloroquine overall but neither is a clean drug. Most of the established use outside of malaria prophylaxis is for chronic conditions allowing for it to accumulate over weeks to steady-state.
There's quite some list of adverse effects but they're largely predictable and docs know what they're looking for. Much less experience at high doses (the lups dose is rarely over 400mg daily; the Marseille paper used 600mg. Recovery is going to load around 2g, split over the 1st 24hr and then drop down
Half-lives are over 24hr, hence the wish to load-up for a rapid effect
grahamt - I feel for your cousin. Shitty times
Words fail me
Don't read up on the Brazilian leaders opinions then. He should be ****in shot tbh.
Report on BBC News yesterday of a Russian doctor saying it was ok to go to church and mingle as you couldn't be infected on a church 🤦
dark age medicine :/
Does anyone actually believe we'll come out if this with sub 20k people lost?....
Found this very informative
This Leading COVID-19 Expert From South Korea