shamelessly stolen off twitter

‘All orders were now issued through Squealer or one of the other pigs. Napoleon himself was not seen in public as often as once in a fortnight.’

George Orwell, Animal Farm

#wheresBoris

All joking apart he really ought to be doing waaay more of the daily briefings.

There’s not much leadership on display on a time it’s needed.

The Cummings far e is detracting from another excellent analysis of the government’s initial.’dither & delau’

Cummings will dominate, but this @thesundaytimes Insight investigation documenting how the government were too slow in taking Covid-19 seriously is truly damning. It led to 1.5m people being infected by the time of lockdown and cost thousands of liveshttps://t.co/FBZObYyGhp pic.twitter.com/2tMKBZPuMz

— Sam Joiner (@samjoiner) May 24, 2020

The times article is really worth reading

It lays out how badly Johnson’s dithering got things wrong

If u sign up u get free articles

https://www.thetimes.co.uk/article/three-weeks-of-dither-and-delay-on-coronavirus-that-cost-thousands-of-british-lives-05sjvwv7g

no other large European country allowed infections to sky-rocket to such a high level before finally deciding to go into lockdown. Those 20 days of government delay are the single most important reason why the UK has the second highest number of deaths from the coronavirus in the world.

Looks like CQC has been handed the sticky end of the stick over care homes deaths.

https://www.theguardian.com/society/2020/may/24/cqc-under-fire-from-care-home-body-for-failing-to-report-true-death-toll-to-ministers

I’m not sure the Times article really helps much at this stage.

First, you have to ask whether an earlier lockdown would have been as effective. Plenty of people now are calling for an end to lockdown even though daily deaths are still higher than they would have been at the point that some people now claim we should have started. Hindsight is always good and although plenty of people were calling for a lockdown earlier, plenty weren’t.

Second, it assumes that the game is over and we can see who did best. Maybe there won’t be further waves and those countries that locked down earlier will have lower overall deaths. But maybe there will be and maybe those countries that did best first time round will do worst next time. Who knows? Personally I’m not sure we’ll get a vaccine any time soon, but we may get better at treating the symptoms, so those countries that suppressed the first wave most effectively will still do better overall, but that’s just a guess at this stage.

I’m not sure the Times article really helps much at this stage.

First, you have to ask whether an earlier lockdown would have been as effective. Plenty of people now are calling for an end to lockdown even though daily deaths are still higher than they would have been at the point that some people now claim we should have started. Hindsight is always good and although plenty of people were calling for a lockdown earlier, plenty weren’t.

Second, it assumes that the game is over and we can see who did best. Maybe there won’t be further waves and those countries that locked down earlier will have lower overall deaths. But maybe there will be and maybe those countries that did best first time round will do worst next time. Who knows?

You can always unlock/relock in a 2nd wave etc. but what you can never do is roll back and bring back the dead.

The problem is our government has at every point possible taken a decision that precludes options.

Personally I’m not sure we’ll get a vaccine any time soon, but we may get better at treating the symptoms, so those countries that suppressed the first wave most effectively will still do better overall, but that’s just a guess at this stage.

I agree…and we also understand more, who is vulnerable and not and how different people may require different treatments. We don’t know HOW MUCH more or how useful knowing more is but it would be nice to have options like NZ.

The CEO of AZ on the Marr show was very confident that:

1. The vaccine works. It certainly stops people getting Pneumonia, even if they catch a small dose.

2. It will be ready for mass vacc in uk from Sept.

The Oxford teams worry was about lAck of cases to test efficacy. He said they are also testing it in Brazil & Russia where the case levels are higher.

The reason we aren’t unlocking now is because we failed to act earlier. Too bad. Once cases are down to, say, 100’s/day, we can have some. Unlocking and a slow burn with R close to 1. That’s what Sweden have achieved. The choices taken by other countries have put them in a better position. That’s what decisive action looks like. Fast up, slow down. Earlier action means you don’t go up so high. I’m surprised that this is not obvious.

I have very little confidence in an efficacious vaccine. I’d love one to be found, but there are issues with protection vs worsening the infection. The preclinical monkey study did not protect against SARS-COV2 infection, but did reduce morbidity.

In the meantime, I’ve done my bit for therapeutic agents this morning for the NHS convalescing plasma trial. One day antibodies will come from inanimate bioreactors instead.

Thanks for the donation TiRed!

I wonder if it would be feasible a bit further down the line to use convalescent plasma to protect a decent proportion of the most vulnerable demographics? Would take a lot of donors, but with enough testing out in the wild, it might be feasible, right?

Thanks Tired.

Fast up, slow down. Earlier action means you don’t go up so high. I’m surprised that this is not obvious.

It is obvious. And it was obvious months ago, when government inaction was decried by many, but defended by the very people now complaining loudest that we are going to have to be slower out of “lock down” than other countries because of that inaction early on.

TiRed, looking at that sample you definitely need to drink more water!

In all seriousness, thanks for taking the time to post on here. More appreciated than a lot of us anxious numpties can express in words.

It is obvious. And it was obvious months ago, when government inaction was decried by many, but defended by the very people now complaining loudest that we are going to have to be slower out of “lock down” than other countries because of that inaction early on.

Precisely. It’s not a matter of whether it is obvious now, it’s whether it was obvious enough then for enough people to have gone along with a lockdown As you’ve just pointed out, there were plenty of people then who were arguing against it. It’s all academic now though.

It’s interesting that Sweden are being held up as a country that has achieved the slow burn as I’ve heard the experts there claim that their strategy is basically what the UK was trying before it was spooked by the UCL study into a full lockdown. Not sure that’s really true though and not convinced that their strategy will look all that good when this is finally over, but time will tell.

Changing the subject a bit, have those that are following the data from other countries detected any evidence for a second wave yet?

Seemed fairly clear to me that the country was well ahead of the govt. Football and rugby were already off on the 13th, care homes locked down. I had a race cancelled on the 11th and events were being cancelled all over the place. It was the govt that had to be persuaded, not the people.

Fair point @thecaptain and my memory of events is far from perfect. It did seem to me that events moved quite quickly and the government were only a few days behind the majority. Of course a few days would have helped at that point (exponential growth and all that), but I’m not sure that we could have gone as early as some folk now claim that we should have. It’s a largely pointless argument though, so I’ll shut up about it.

I guess we will never know if it would have worked, but we can be certain that they should have tried.

“Dither and delay” rings a bell – wasn’t that the Tories’ slogan at the time?

If we’d gone into ‘lockdown’ three or four days earlier surely that could have stopped infections doubling at that point – on 16th March we were advised to avoid non-essential travel and not to go to pubs, gyms etc. but that meant those businesses were still open (albeit losing money). It took til 20th March before those businesses were ordered to close and the public instructed to stay at home.

That was a pivotal week and the half-hearted message on the 16th was the worst of both worlds in some respects.

Changing the subject a bit, have those that are following the data from other countries detected any evidence for a second wave yet?

Localised flare ups in most countries (Germany & France spring to mind first), followed by localised action (closing schools in areas with new cases etc).

That’s what we need to be ready for before ‘opening up’ more.

That was a pivotal week and the half-hearted message on the 16th was the worst of both worlds in some respects.

It was one pivotal week, FFS NZ was isolating riders at Crankworx on the 1st March.

TiRed, looking at that sample you definitely need to drink more water!

I was thinking it looks like he has gravy in his veins. Perhaps you don’t plasma the way I thought.

I think there is room for debate over how quite soon we could have clamped down, and what the endgame would be (and will be). I don’t think there is any room to disagree that the govt could have at least tried to provide some leadership and that if it had managed to suppress the epidemic a mere week sooner than it did (by which time many major organisations had already acted), that would have prevented a large majority of the deaths to date. Somewhere between 70-90% in fact, meaning that instead of being the embarrassing sick man of Europe, we’d have been up there with Germany as one of the best.

But if people vote for a work-shy fraud who lies as easily as most people breathe, together with a government full of half-witted jingoistic zealots whose only visible talent is waving a flag while chanting three word slogans, I’m afraid competent leadership isn’t really on the cards.

I’m sure everyone can find someone else to blame, so that’s alright then.

Would take a lot of donors, but with enough testing out in the wild, it might be feasible, right?

Not as silly as you might think. What biotechnology is doing, is finding good antibodies from humans, cloning the DNA from the cells that made it, then putting that DNA into other mammalian cells to be grown in bioreactors. The only difference being my antibodies are not all the same (polyclonal). In biotechnology, we pick the best one or two (Monoclonal) and just make lots of those. And when we find the right one, we’ll be using BIG (20000L+) reactors and making kilos of antibody at a time. My day job is designing some of these trials.

That’s what I mean by “passive” vaccination. It works for Anthrax, Ebola and maybe COVID19.

As for drinking – I had a pint of jasmine tea before bed, a pint of water and tea in the morning and 500ml of isotonic drink before donation. Two trips to the loo before and another after. That’s what my plasma looks like! And it’s fat free as I declined a fatty dinner and fasted this morning. If I’m positive, I’ll donate again.

I think there is room for debate over how quite soon we could have clamped down, and what the endgame would be (and will be).

We definitely had a whole week. That was two doubling times. We could have been Germany. They were not testing either at the time we could have closed shop. Even the Friday would have helped (one doubling time).

The (admittedly very limited) additional restrictions advised by ScotGov in advance of Westminster don’t appear to have had any significant effect on infection rates north of the border, but then Jason Leitch was also parroting the Herd Immunity line for a while too.

Some good news on Vaccines from an American Lab:

Loving this guy’s vids on CV, explaining the detail in layman’s terms, quotes all his sources.

Obvs I’m interested if people want to provide better sources for that kind of thing.

I used to work with the Chief Medical Officer of Moderna (Tal Zaks). There about 70 vaccine candidates in the running. The question is really whether Coronaviruses are vaccinable at all. Maybe, but maybe not. Also it is possible that efficacy studies may not be possible if the epidemic has really closed down. That will be interesting from a drug and vaccine development perspective, because we will definitely have to develop something this time. Previous SARS died away along with the development of vaccines.

We won’t need a vaccine at this rate!

https://news.sky.com/story/coronavirus-disappearing-so-fast-oxford-vaccine-has-only-50-chance-of-working-11993739

There about 70 vaccine candidates in the running.

90 according to the ITV Corona Virus podcast.

The question is really whether Coronaviruses are vaccinable at all. Maybe, but maybe not.

According to the vid above two studies from Beth Isreal Deaconess Medical indicate pretty strongly it is in primates:
https://www.bidmc.org/about-bidmc/news/2020/05/covid-19-vaccine

(The ‘oxford’ vaccine didn’t work so well, but still reduced the symptoms which might be enough.)

90

Yes. I thought 90 but couldn’t be bothered to check on my phone. Apologies. I think there about as many antibodies too.

As for “lasting”, one cyno study of acute challenge does now make a summer. We will see, but the coronavirus track record is particularly poor. And that’s not including issues such as making people worse (see RSV vaccine trials).

Everyone will be chasing COVID19 patients. One idea is “platform trials” where multiple new treatments are tested against a single placebo (or standard of case). Those are ongoing now.

Is anyone looking at longer term issues arising from Covid? The number of people who seem to take months to get better or have potential long term lung damage, ME type disorders or damage from blood clots?

Whilst the death rates among the younger / healthier cohort imply we should (try) not to worry too much, I can’t find the rates for longer term impacts. Is this going to be like polio or TB for our generation?

May I ask a question of the maths fans in here ? (you may feel it’s related to another thread but I suspect the better answer may lie here – I think I “know” but I only really do sums, not maffs)

I realise there’ll be some confidence intervally stuff but:

What are the chances of BOTH partners in a marriage becoming incapacitated (let’s call that ill to the point of requiring hospitalisation) by COVID-19?
Let’s assume that they both have it and they’re simultaneously infected
They can be, ooooh, white and in their 40s and for simplicity let’s say they have no relevant comorbidities

Speaking as a mathematician, I’d say it’s … oooh, about the square root of **** all.

Women tend to get it much less seriously than men.

Isn’t that the point of the Spectator article that’s now been withdrawn. From that, it sounds like Dom’s wife was fine.

The lack of cases to prove a vaccine works is an interesting one and I read articles about challenge studies, of directly infecting patients to see if it works.

If the whole point of signing up to a vaccine trial is to see that you don’t get infected (as well as seeing if the vaccine doesn’t kill you), surely the challenge trial is the best way now and as those as individuals who signed up to the trials in the first place, it had to have already been accepted that they’re willing to try and get Covid19.

So what’s the problem, why aren’t we doing that. You know like on Contagion where the scientist was a hero and injected herself with the disease!

Previous SARS died away along with the development of vaccines.

Back in mid 2000’s, the lab I was working in was contracted to make several intermediate compounds for one of the Big Pharma companies who were then doing further in-house reactions to create a potential vaccine for SARS. Normal process for pharma was to outsource one intermediate per company to minimise the risk of industrial espionage but the speed required meant they threw it all our way along with several dozen NDAs.

And then out of the blue after the initial “we need this urgently”, the work just stopped. End of project as SARS died off / was contained fairly dramatically, there was no longer a need for a vaccine.

not sure if the data is real or not but…

There is this graph. pic.twitter.com/BP2OTgWTqT

— Lady Κατερίνα 🇪🇺🇬🇷 #RejoinEU🕯⭐️🔶♻️🌼#3.5%🐟 (@kmqkatie) May 24, 2020

daily deaths are still higher than they would have been at the point that some people now claim we should have started.

Deaths lag infection by about a month. We’re objectively in a much better situation than when the lockdown was imposed. Infection rate is lower, active cases is lower, hospitals have adequate capacity and society has learned new tricks that mean we infect each other less.

Is anyone looking at longer term issues arising from Covid? The number of people who seem to take months to get better or have potential long term lung damage, ME type disorders or damage from blood clots?

Whilst the death rates among the younger / healthier cohort imply we should (try) not to worry too much, I can’t find the rates for longer term impacts. Is this going to be like polio or TB for our generation?

I think it’s probably too early for any definite conclusions and mostly the focus has been on prevention and treatment, but it is beginning to be raised as an issue, at least in the media and is being picked up by the ZOE Covid-19 tracker app as a significant issue.

This blog by an tropical diseases specialist at Liverpool University sparked a couple of Guardian articles:
https://blogs.bmj.com/bmj/2020/05/05/paul-garner-people-who-have-a-more-protracted-illness-need-help-to-understand-and-cope-with-the-constantly-shifting-bizarre-symptoms/

Like this:

https://www.theguardian.com/world/2020/may/01/lingering-and-painful-long-and-unclear-road-to-coronavirus-recovery-long-lasting-symptoms

Also, the ‘other’ covid thread on here, now has quite a few covid-19 sufferers who are recovering very, very slowly.

https://singletrackworld.com/forum/topic/have-any-of-us-actually-caught-the-coronavirus-yet-then/page/13/#post-11205103

On a personal level, I’ve had what seems likely to have been covid – anti-body test sample in the post to the lab – and am in my 11th week of getting over what started with mild gastric stuff on Friday 13 March. I’ve had a bewildering carousel of odd symptoms, but am now pretty much left with fatigue and a still elevated HR, though it’s 20bpm less than it was two weeks ago. The shortness of breath, mad tingling finges, chest pain, numb left arm, weird numb toes, deep muscle pain, odd metallic taste in mouth and more have all mostly gone. I still get weird random adrenaline surges, which seem to be triggered by sugar, but I’m much better than I was two weeks ago, which was being checked at A&E in case of blood clotting / stroke / cardiac potential. ECG bloods, chest x-ray all fine.
There’s a FB group referenced in that initial link with some 5000 members many of whom have slow recovery issues. Also, apparently, a community Slack group which is attracting attention from researchers.

Sorry, that was quite long. But I think the short answer is that yes, it looks like a potential problem, but it’s too early to be very specific. It’s a very weird virus and I think it’s still relatively early days in terms of understanding what its long term impacts might be.

And going back to that Times article. Yes, it matters that the government dithered for two weeks because there are a shed-load of people out there who were infected as a result of Boris’s failed herd immunity experiment who’ve not only had a really unpleasant illness unnecessarily, but may end up with chronic long-terms problems as a result. Personally I’m cautiously optimistic, I’m recovering at glacial pace, but I am improving. But of course, because our testing regime was so crap, right now I don’t even know whether I had covid or not. That’s what incompetent government looks like.

So what’s the problem, why aren’t we doing that.

It’s not seen as acceptable in clinical trials to actually deliberately expose patients to disease. Over the years I’ve been involved in them there has also been a growing questioning of whether it’s even ethical to use placebos on patients who have disease. I’m sure there probably would be people willing to go into a challenge trial but you’ve got the whole “first, do no harm” principal in the way

It’s not seen as acceptable in clinical trials to actually deliberately expose patients to disease

That makes sense on an ethical level but how is a study of this kind proven it works without direct intention to infect?

Sheer luck could be that all the individuals injected with trial vaccines (even in their thousands) could end up not getting infected through non contact, how do they quantify without purposeful infection that a vaccine has actually worked?

Those on the trial are they expected to still follow government rules to try and limit infection, basically purposefully avoiding getting it?