The only reason flu changes so much is because it’s genome is segmented so the virus undergoes reassortment.
I hope there is a vaccine, but it has to be against a stable target antigen and also must not cause any auto immune response.
the antibody tests so far performed have shown a level of cross reactivity with existing known strains but these are non neutralising at present it seems. Plus it would have to be a long lasting response rather than a short term one as this thing seems likely to be hanging around for a while

The question I have is containment even possible though? It’s rife, Places like China and tbh even South Korea I’m fairly suspicious of their reported numbers, but even if they are true, their methods are unlikely to widly adopted in the ‘west’.

That’s before we even get to countries like India, chances do they even have of containing it, number of 5,480 cases and 164 deaths in india? Aye sure…

So do we lock our borders while it rips through these countries?

Talk of exist strategies above, but how can ‘a’ country have an exist strategy here that doesn’t involve long term isolation of the entire nation?

If there’s an exist strategy it needs to be worldwide.

This.

I do trust South Korea’s numbers (they had very localised epidemics that they could keep a grip on.) But now what? They build a Trumpesque wall and wait for 12-24 months until the rest of the world gets our CV resistance?

Plus it would have to be a long lasting response rather than a short term one as this thing seems likely to be hanging around for a while

I’m not sure it would.

If you had to inject everyone every three months that would still be better than people dying and closing the entire world down.

Goods can cross borders without mass movement of people.

International travel will be heavily restricted for some time to come, no matter what path we take.

Wife’s Nursing team is currently at 30% infection rates, with 10% being hospitalised (bare in mind it’s a team of 10, not thousands).

That’s about the percentage rate of 3% needing hospitalised even for 1000s , it’s a shitty situation though and using ppe can hopefully help reduce it further.

What sort of accuracy is required for a good standard, or useful standard of test?

It depends upon how many people have caught it in the population as well as how accurate it is. A 95% accurate test with 3% of the population having the antibody would mean just over 60% of those testing positive for the antibody will not have it. The equivalent number of a 99% test would be 25%.

Thanks mefty, yes I follow those figures. I guess in part, what I’m wondering is how useful is a test which is say 80% accurate, when there are more false positives than true positives? And how accurate are the tests we are buying/using. I get the impression from the way they talk about the available tests, that they are not as accurate as usual/desired.

…and if even 25pc of people have resistance that R0 still drops helpfully. We’re not hoping for perfection, we just don’t want a gazzilion people turning up at hospital on the same day.

and in my layman’s understanding; dropping the R0 and having a small manageable number show up each day for the long term future at A+E for their ventilator is a better solution than 3% of the country showing up in an ambulance on the same day needing to be given the cure when there is one available.

seosamh77
Subscriber

Yes I find it baffling people seem keen to disprove immunity..

Honestly, think about the ramifications of there being no immunity…..

I don’t think anyone’s “keen to disprove immunity”. But if it’s not a useful factor- ie if immunity gained from infection is too short to be useful- then it’s absolutely essential that we know that as quickly as is possible. Unfortunately, right now it’s not a knowable thing, but some people still want to hitch the cart to it in the hope that it works.

Re herd immunity the basic issue is knowing the difference between “immunity is growing in the community”- which it is “immunity has grown in the community to the point that it’s making a useful difference”- which it certainly hasn’t- and “we have attained herd immunity” which we are absolutely miles from.

(I am not a doctor, but this stuff is obvious- or should be)

Thanks mefty, yes I follow those figures. I guess in part, what I’m wondering is how useful is a test which is say 80% accurate, when there are more false positives than true positives

I can’t resist guessing:

I reckon for for the antibody test false positives are a disaster.

An antibody test that gave false negatives would be fine. Even if it was was large number. As long as you get a positive that person can get on with their life and they might be a key worker. The fact you missed some (even 50pc) doesn’t render it useless.

Latest figures for UK reported on BBC.

6483 (England) + 366 (Scotland) + 245 (Wales) + 78 (NI) = 7172

1013 up from yesterday, 16%.

We seem to be following the Spanish course on death toll, not the Italian one.

I reckon for for the antibody test false positives are a disaster.

An antibody test that gave false negatives would be fine. Even if it was was large number. As long as you get a positive that person can get on with their life and they might be a key worker. The fact you missed some (even 50pc) doesn’t render it useless.

I’m getting myself all befuddled. I was thinking positive and negative for illness. But, similarly I was thinking people falsely being told they do not have Covid19 when they are infectious would be hugely problematical. I’d be interested to know how this works in reality.

I don’t think anyone’s “keen to disprove immunity”. But if it’s not a useful factor- ie if immunity gained from infection is too short to be useful- then it’s absolutely essential that we know that as quickly as is possible.

Re herd immunity the basic issue is knowing the difference between “immunity is growing in the community”- which it probably is, but we don’t really know- “immunity has grown in the community to the point that it’s making a useful difference”- which it certainly hasn’t- and “we have attained herd immunity” which we are absolutely miles from.

What else can they do? You can’t just not develop a vaccine because a few nutters on an cycling forum don’t believe immunity will last very long!

Equally in the time before a vaccine is developed some people *will* catch CV. …and when they do they will probably get some kind of resistance.

In the long run the world *will* end up with herd immunity.

What percentage of people gain resistance from catching it and what percentage of people will develop resistance from a vaccine will depend entirely on how long a vaccine takes to release in large numbers and how fast the disease spreads.

I’m getting myself all befuddled. I was thinking positive and negative for illness. But, similarly I was thinking people falsely being told they do not have Covid19 when they are infectious would be hugely problematical. I’d be interested to know how this works in reality.

In reality the anti-gen test biases toward false negatives. The disadvantage of that seems to be that they often have to test symptomatic people a couple of times to get a positive which wastes kit.

(Or so I heard on the news.)

Here is an article that explains the antibody test percentage accuracy thing – be they false positives or negatives:

How far away are ‘immunity passports’?

Do the UK figures now include care homes like the French ones or is it still just hospital deaths? That added about 50% to some days in France and significantly raised the overall curve.

The herd approach fans should take a look at the “Healthcare workers – how you feeling…” thread.

It’s not just the fatalities we should be concerned about it’s the 55-55% that survive intensive care. Kidney failure, heart conditions, neurologiacal consequences. Dealing with the survivors is going to be as tragic as the losses for some. When a nurse refuses to be ventilated if she gets that bad there’s a message in there for all of us.

I’d like to inform the person who adds ‘sic’ when quoting things I’ve written with typos/spelling errors that I no longer have to worry about how good or bad my English is so I don’t.

@outofbreath a few nutters?
wind your neck in mate, no one has suggested not developing a vaccine just that there are inherent risks and significant challenges to be overcome.
a palliative drug is the fastest option to reduce the damage with a hopeful vaccine coming along mid 2021 who knows though vaccine research is always a challenge.

I don’t think anyone advocates unrestrained transmission in an attempt to ‘get herd immunity’ rather that herd immunity will occur. By one means or another.

We are all fans of herd immunity.

No one is a fan of killing hundreds of thousands of people to achieve it. Can you please stop that assertion.

Matt

@Edukator

just hospital, as far as I know

Natural herd immunity is a solution to nothing but people are speaking like it is.

The herd approach fans should take a look at the “Healthcare workers – how you feeling…” thread.

They’d probably feel a lot better if there was a vaccine. Which is what I’m seeing from those talking about Herd Immunity as an exit strategy on this thread.

Do the UK figures now include care homes like the French ones or is it still just hospital deaths? That added about 50% to some days in France and significantly raised the overall curve.

The Scottish figures have included Care Homes, but with a lag over the weekends. The new Scottish figures will also now include (on a weekly basis ATM) cases where CV19 has been recorded as a “contributory cause”. I can see the value in these, but I’m wary that they perhaps over-estimate. We know that the majority of folk test negative – even though they have enough of the symptoms to pass the hurdle for testing in the first place. We’re now asking GPs to determine whether or not CV19 was a contributory cause, without any testing of the deceased (and I can see why we don’t want to “waste” testing on those already passed away).

Question for the room: What is the likelihood of 111 giving a correct diagnosis over the phone (unlikely to be a thermometer present in the house it was given to).

Reason for asking, it’s my father in law, he lives alone, has bladder cancer (under control at the moment), heart has had a quad bipass and has been spiking in heart rates over the last year, believed fixed at the last count with a minor surgery. Essentially he’s in his 70’s pretty strong still and aside from dodgy joints which limit his walking.

My expectation that even with a hint of symptoms they will ask him to self isolate just to be on the safe side.

He’s being sent some anti-biotics as well which given we have no treatments as yet I don’t understand. Wife spoke to him for a while and he wasn’t coughing, but I guess isn’t feeling 100% hence the call to 111 in the first place. He’s been limiting trips out and wearing gloves etc, but it’s possible he has come into contact with someone carrying it, or one of many other things around that would impact a 76ish year old.

Essentially just trying to work out how bad this may or may not be, any expert information?

Thanks torsoinalake, that was interesting and was along the lines of what I have been thinking.

outofbreath
Member

What else can they do? You can’t just not develop a vaccine because a few nutters on an cycling forum don’t believe immunity will last very long!

Equally in the time before a vaccine is developed some people *will* catch CV. …and when they do they will probably get some kind of resistance.

In the long run the world *will* end up with herd immunity.

OK, I really think you just need to reread my post, everything I said was about immunity through infection and survival, I said nothing at all about vaccines.

The problem with attaining herd immunity via that route is maths, basically. We don’t know how long survivors will gain immunity for, or how reliably. But it needs to be very long and very reliable, it’s the only way it works- because the rate of infection has to be kept low to avoid overwhelming hospitals, which makes the volume of survivors low. So the rate of loss or failure of immunity needs to be even lower so that the level of immunity can rise at all, let alone rise to the levels required, otherwise we’re basing all our hopes on filling a bowl that leaks faster than we can fill it. Even the most optimistic infection rate figures still rely on a long and strong immunity- a big bowl that doesn’t leak much.

It is absolutely NOT a given that sooner or later we attain herd immunity. I’m sorry if this is something that’s important for you to believe, but it’s not true. It may not be mathematically possible for it to happen naturally, and finding a vaccine is not certain. Of course we hope for it and work for it.

But if you can’t develop a vaccine then that just leaves you with eradication. Possible worldwide? Think not.

Thanks for the replies, Scotroutes and mrmonkfinger.

We are all fans of herd immunity.

I’m not, Matt, I’d rather go for erradication.

In the long run the world *may* end up with herd immunity. We have had to defeat lots of viruses without that luxury before. There is not enough yet known about this virus to adopt any strategy that is depending on herd immunity as the only way forward, it is just one of many possible routes. The word *will* cannot be used yet.

Not sure about deaths outside hospital but if they’ve been in contact with a health care professional then it’ll be down as recent confirmed or suspected covid. So I’d say yes but might be a day or two longer than a hospital death before it appears on the stats.

When a nurse refuses to be ventilated if she gets that bad there’s a message in there for all of us.

Not really as it’s anecdotal many people pick not go through various treatments for personal reasons or medical.

Toby1 I’ll reread your post but any feedback I give will be only an opinion not medical advice.

Defeat is a strong word for how badly we would lose trying to ‘win’ that way.
the most dangerous viruses took am awful lot of people before they were controlled. Smallpox was an awful disease, measles which can be controlled is now having a come back.
and ask an Indian with virus knowledge what would happen if yellow fever got into the sub continent.
you don’t defeat viruses you only mitigate their affects

I’m with you there edukator.

Herd immunity isn’t a strategy, unless you call doing nothing a strategy.

Erradication could have been an option if the West had acted promptly, still my preference though. Now it looks like a long period of containment before we reach either eradication, vaccine or effective treatment.

Mitigating is probably the wrong word as well. That suggests to me reducing the symptoms and impact with drugs and treatment, rather than stopping people catching it.

Defeat could mean lots of things, agreed, I was suggesting “controlled” or “eradicated” might be what has to happen, I suppose, rather than assuming that anti-bodies *will* save us (although that is still the most likely route, if the scientists pull it off).

They build a Trumpesque wall and wait for 12-24 months until the rest of the world gets our CV resistance?

Testing everyone on the way in is a viable option.

I don’t think anyone advocates unrestrained transmission in an attempt to ‘get herd immunity’ rather that herd immunity will occur. By one means or another.

The seriousness of the infection (permanent lung damage in many cases) suggests to me that this is not a good idea. The “most people had it without symptoms” brigade has gone very quiet over the last week.

@kelvin I understand, I used mitigation in terms of reducing the overall disease burden across a population, not the affect of the disease on an individual.
as someone just said the extent of the potential long term damage means we have to find a cure, whether that is a palliative drug or vaccine cure it is critical. Simply because our disease surveillance worldwide is not good enough to eradicate this, smallpox was the last one eradicated and that required a damn good vaccine and massive surveillance

Toby1 it won’t be an accurate diagnosis and would also depend if they spoke to a clinician. As they’ve been prescribed antibiotics that suggests they have. He’d be given them based on symptoms there must have been enough to prescribe them. He should have been given worsening advice on what to do.

Edit too slow

smallpox was the last one eradicated and that required a damn good vaccine and massive surveillance

Which is probably the way this will have to go

Mrs Inkster is in Kenya at the moment, has been for a while, looking after her very old and not very well father.

It’s been incredible to see how the government there and in some other African states has acted quickly and decisively in confronting the pandemic.

They instituted a lockdown when cases (not deaths) were in single figures.

Then they made everyone flying into the country go into forced 14 day quarantine either in a hotel at their own expense or a government centre. I’m watching planes flying in to Manchester Airport as I type this.

A politician flying in from Germany gave the quarantine the slip but they caught up with him and forced him into 14 days isolation, when he came out of isolation a couple of days ago they arrested him. I think they sanctioned a religious leader similarly. (Are you listening Nicola Surgeon?)

They’ve installed hand washing stations at bus stops. Everyone is wearing face masks.

If you said the words ‘herd immunity’ to anyone in Kenya they’d think you were talking about cattle, not human beings. If you said it too loudly they might even lock you up.

When I worked in West Africa a few years ago they had Ebola going on and there was a lot of controls at airports and in cities and certain borders were closed etc. They have a cultural memory of what serious infectious diseases can do that we don’t anymore, hence we have wacko anti-vaxxers and many people were treating CV-19 as a bit of a laugh. We got complacent.

They instituted a lockdown when cases (not deaths) were in single figures.

That is good to hear.

Maybe they looked at Europe and thought **** that

hence we have wacko anti-vaxxers and many people were treating CV-19 as a bit of a laugh. We got complacent.

I’ve seen an increasing number of people share “it’s a hoax” links on ****book.