You are reading it correctly, though whether the data is robust I don’t know.

The high blood pressure one is interesting, you are actually at less chance of dying if you have high blood pressure vs having normal BP. That might be due to blood pressure meds. I remember there was concern at the start of the pandemic they could increase your risk but have subsequently been found to reduce your risk of death from CV.

https://theconversation.com/blood-pressure-medications-decrease-death-and-severe-disease-in-covid-19-patients-144921

Edit:- maybe I need to take up smoking again!

Not having a go. Just trying to reassure you @tpbiker.

I quoted the figures for mild and severe Asthma. Clearly you would come under severe but the relative risk isn’t that high, but point taken every case is different.

I have a relative in her 70’s with bad asthma and when I found out she had covid I really thought she wouldn’t make it, but in the end she had a very mild illness that she managed at home.

@tpbiker

Actually I don’t think Asthma is a big risk factor for death from covid.

Mild asthma basically has no effect, severe asthma has an increased risk but less than being Black or Asian.

https://www.nature.com/articles/s41586-020-2521-4/figures/3

Bearing in mind that is a log scale the overriding risk factor is age

https://www.ox.ac.uk/news/2021-02-02-oxford-coronavirus-vaccine-shows-sustained-protection-76-during-3-month-interval#

From the link above…..

“They report that the effect of dosing interval on efficacy is pronounced, with vaccine efficacy rising from 54.9% with an interval of less than six weeks to 82.4% when spaced 12 or more weeks apart.

They also detail that a single standard dose of the vaccine is 76% effective at protecting from primary symptomatic COVID-19 for the first 90 days post vaccination”

Can anyone explain why a single dose can be 76% effective but 2 doses with a 6 week spacing has an efficacy of only 54.9%

Only thing I can think is maybe their definition of efficacy vs effectiveness at preventing symptomatic COVID-19 is different. I thought that was how efficacy was defined but maybe I’m mistaken?

It seems longer term mRNA vaccines could be the best option both in terms of efficacy and speed to scale up for new emerging strains. Are the production requirements significantly different for mRNA? ie would we have capability at vmic and the other UK vaccine manufacturing locations to produce mRNA vaccines?

https://www.gov.uk/government/news/large-scale-coronavirus-vaccine-manufacturing-begins-in-scotland

Well that’s news to me, I’ve not heard this vaccine mentioned before.

I think the site in Wrexham just puts the vaccine in vials, so I think we could be impacted by the 60% reduction in capacity

@Tired – Agreed it’s not ideal. We do have 450K+ who have had the correct 2 doses, so hopefully they are monitoring the proportion of 2 dose vs 1 dose vs no dose on hospital admissions and new positive tests.

I would have tested it in a UK open-label clinical trial. We would know in two months and that would have significant implications world-wide.

Surely they are monitoring the 5M people who have had a single jab to see how effective it is?

And for the record, I fundamentally disagree with the decision on extending the vaccine interval for the Pfizer vaccine. The data does not support it. And it’s my day job to use data to make those decisions at work. It does not pass the “bare-faced cheek test” for me if sat in front of the FDA (my usual test is could I defend this at a face to face regulator meeting).

Somewhat more encouraging news from Israel on single dosing….

https://www.ft.com/content/4d9fe80d-e604-4bbe-b0f8-fd4b8df9b7f1

Edit, link stopped working, but if you google “FT Israel” it should come up. Basically 93% had a strong antibody response after 21 days

A single shot of the BioNTech/Pfizer vaccine produces a robust antibody response within weeks, according to Israeli data that could help inform whether scarce global supplies can be stretched by delaying second doses.

At the Rambam Health Care Campus in northern Israel, 91 per cent of the 1,800 doctors and nurses that received the two dose vaccine showed a major presence of antibodies 21 days after their first shot, before receiving the second dose, according to Michael Halberthal, chief executive of the hospital. A further 2 per cent showed a moderate presence of antibodies.

“If 93 per cent had a major response three weeks after the first injection, this raises a good question, that you might rather be using the first injection on more people” said Dr Halberthal.

At the Sheba Medical Center, similar serological tests at different intervals showed at least 50 per cent of staff with a level of antibodies “above the cut-off point” two weeks after the first jab, said Arnon Afek, the associate director-general of the hospital chain.

Is it beyond science to engineer and unleash a new Covid variant that is 100 times more infectious but completely harmless to speed up the vaccination process?

Possibly, but dire implications if they nail the 100x more infectious, but screw up the less harmful bit.

4 weeks @ 0.1 is actually about 100x MORE effective (in terms of end result) than 40 @ 0.9.

I corrected that original statement as below after I posted…

Realised my maths is wrong, 4 weeks of R=0.1 would have a bigger effect than 40 weeks at R=0.9

0.1^4 < 0.9^40

You’ve got to be some sort of god-awful arsehole to both be flying during the pandemic and also deliberately not wearing your mask right though.

Ironically this minority seem to be the ones that moan loudest about lockdown yet sacrifice the least, prolonging the misery of the silent majority that just get on with it.

4 weeks of proper lockdown with R=0.1 has the same effect as 40 weeks of R=0.9

Realised my maths is wrong, 4 weeks of R=0.1 would have a bigger effect than 40 weeks at R=0.9

0.1^4 < 0.9^40

Regarding alternative strategies….

If everyone could isolate in a tent on their own for 2-3 weeks covid would be eradicated.

Not possible I know, but now we have a vaccine maybe we could vaccine all the key workers – nhs staff, police, food shop workers (a lot of the NHS had already been done).

Then have a super strict mother of all lockdowns for 4 weeks to break the transmission. E.g All shops closed. Borders closed. Food shops delivery or click and collect only, 1hr outside the house per day in family groups only. Get infection down to a level where we might have a chance to contain it and stop the ongoing risk of new variants.

4 weeks of proper lockdown with R=0.1 has the same effect as 40 weeks of R=0.9

^^As ever Kelvin says what I’m thinking in his last post.👍

+1

The thing that is concerning me is the R for the new variant.

Overall new+old is 0.8-1.0, but the more infectious higher R variant will be averaged down by the old variant. E.g we might have R=0.5 old, R=1.4 new. Average R with 50/50 split is 0.95.

This could lead some to think things are under control, but as the mix changes to favour the infectious variant, R will go above 1 and at these infection levels the hospitals could be in real trouble very quickly.

I wish the media would ask these kind of questions at the briefings. I personally think we should throw the kitchen sink at this to get it down as much as possible.

Also on the subject of risk, a few weeks back I was getting a bit stressed about covid so to get things in perspective I checked the stats for my 45-49 male demographic. From memory there were 400 odd covid deaths last year and around 3-4X that for cancer in that age group. It certainly made me feel a bit better, I’m sure most people in my age group don’t spend their waking hours stressing about the cancer risk even though it is significantly more likely to get you than covid.

I don’t think you mean that, you mean 1.9% of cases are in the 80s age bracket.

I suspect the 1.9% in the second column relates to the percentage of people in that age group. Nothing to do with infection rates

@ebennett – 24 years is pretty good! Were you cleaning with floss where it sits on the gum everyday, or just normal brushing? I suppose the colour change would happen with implants too over time. The other option could be to have some tooth whitening to match the colour back in to the bridge rather than replacing.

Great, thanks for the advice, much appreciated. Had a ballpark price for braces and bridges of 5K. Might have to put that new bike on hold, though interesting about the 70% back to normal for NHS contracts.

Thanks for info guys. Daughter is already 13 so didn’t want to leave it too long. The nhs ortho is just treating his private patients and hasn’t seen an nhs case since March due to COVID so has a big backlog so we are thinking about going private – assuming it’s not good to leave it too long. I did send some pics to a private ortho and he though closing the gap wouldn’t be an option due to the cross bite.

@ceepers, @crewlie – the adhesive bridge sounds like a good option, minimally invasive etc. However is there a risk of bone loss in the jaw due to the missing tooth that might affect her gum line or cause an issue if she wants implants in later life?

She hasn’t had an X-ray. Dentist is confident they are missing and said the orthodontist would do one anyway so didn’t want to expose her to the radiation. The only issue is that with covid it’s a years wait to see one on the nhs.

I sold a similar one a few months back for £250, so you might be under pricing a touch!

Records broken again today….
1325 deaths and 68K infections.
We need to close those garden centres!

I think the added risk at the moment is nhs capacity. I have a horrible feeling we’ll see some terrible scenes in the coming weeks of hospitals running out of oxygen/beds and people dying who may have survived with adequate treatment. It really is worth trying to avoid catching this at the moment just in case you need hospitalisation.

That’s the theory and people do build more complex models but the results end up being pretty similar. I suspect there’s a bit of a network thing going on where we are all just a couple of connections from lots of people and so individual-level variability doesn’t have quite the effect you might hope. A superspreader will give it to lots of people who think they haven’t really met anyone recently…just this one person…it’s really hard to cut contqcts down below a few per day for most working-age families etc.

But I’m not an epidemiologist, just a modeller who has done better than a lot of the experts throughout this outbreak.

Incidentally, Manaus in Brazil is having a second wave, after more than 50% of them caught it in the spring.

My gut feel is your result is pretty much in the ballpark, I think you mentioned you didn’t account the for the extra virulence of the new strain as it becomes more dominant so that will swing it the other way. That’s worrying about manus, I’d hope once you have 50%+ infection things would be calming down. Is this a result of reinfection of does it just pour water on the lower level of infection idea I proposed for immunity?

@thecaptain

I’m not an epidemiologist or a modeller but I struggle to see how a simple SEIR model can give an accurate result in this case. The SEIR model would rely on the same number of contacts for each subject so might work well for say a population of rabbits that have similar behaviour or even to some extent a less lethal human disease like a cold where people don’t modify their behaviour.

What I think we are seeing is about 1/3 of people have a lot of contacts – NHS staff, shop workers and of course covidiots, another 1/3 have pretty limited contacts and the final 1/3 have turned into hermits. Therefore the 1-1/R point required for herd immunity over estimates, because the first 1/3 might represent 75% of the contacts so once they’ve caught it you pretty much have your herd immunity. So I think you’d get more accurate results with a compound model representing the different groups. I also appreciate there is a feedback loop in all of this so as the perceived threat drops the other 2/3 of people increase their contacts.

Uptodateish hospital admissions…

https://coronavirus.data.gov.uk/details/healthcare

If you click into the data field it was last updated 22/12

The other thing that I hope they are taking into account is the mix of the old and new strain on the numbers. You could have a situation where for example you have 50:50 old and new with R of 0.6 and 1.4 respectively and a net R of 1 e.g. fairly static numbers as the growth in one is cancelled by the decline in the other, but as the mix changes to favour of the more infectious strain the R and hence numbers start to get a whole lot worse.

As usual looks like bozo already briefed Peston on the new restrictions….
Everywhere tier 4
Schools closed
No outdoor team sports

PM will be directly addressing the nation. It won’t be a press conference. Tier 4 restrictions will be imposed everywhere. Schools closed. No more team games in parks. But outdoor exercise will still be allowed. https://t.co/dhKbH2lkgC

— Robert Peston (@Peston) January 4, 2021

https://www.theguardian.com/world/2021/jan/03/it-makes-me-want-to-cry-voices-of-hospital-staff-on-the-covid-frontline?CMP=Share_iOSApp_Other

Sobering stuff.

I see Boris is still insisting on schools opening?

That’s pretty much a guaranteed u turn for sure isn’t it? I just can’t see how it’s even remotely viable with this new strain running through the population.

When you are accelerating down a hill and you aren’t sure if the brakes are strong enough to slow you down the first thing any rational person would do is hit the brakes as hard as possible. You can always take your foot off the pedal a bit but you can’t go back in time and retrospectively apply them.

Unfortunately we have a bunch of clowns in charge so don’t expect a rational response.

981 deaths today. That’s the (official) record, is it not?

I thought we’d nudged just over 1k in the first peak, but maybe that got adjusted down when they introduced the 28 day rule.

The deaths have been relatively low over Xmas so could be partly a bit of catch up in reporting.

Another 50K cases and 981 deaths today! The cases from the Xmas day mass mixing still won’t have have filtered through.

Think it will get pretty ugly in the next few weeks.

Just watched the vaccine briefing, once again the press failed to address some key questions to the panel.

The efficacy of AZ vaccine was quoted at 70% after 21 days for a single dose, but what would have been interesting is the data for the 30% who did develop covid, i.e. what proportion of these had mild, severe illness or died. It’s the reduction in death or very severe disease which we should be looking at. Has anyone seen this data?

You aren’t the only one…

https://www.gov.uk/government/news/at-risk-groups-to-receive-free-winter-supply-of-vitamin-d

Yes, I was aware of that, however from what I understand the dose they are giving is very low, really would need 10x that for several months to build up a good level of vit D.

Also I understand NICE has recently concluded vitD doesn’t have an effect, despite some pretty compelling evidence from several studies. From the icu stats there does appear to be an increase in obese patients as we move to the winter and vitD seems a plausible explanation so maybe it would add weight to the argument if the link could be confirmed. VitD is fat soluble so if you lose weight you’d likely boost your circulating blood levels considerably.

Of course. I am always happy to cite public sources as it happens the uk has run probably the oat comprehensive study of HDU/ITU in the world. It’s reported by ICNARC and can be found here

https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports

Some interesting stats there Tired

After losing a good few pounds recently I was reassured to see only 25.4% of people with a normal BMI (18.5-25) ended up in ICU. Reassured until I looked up the incidence of the population in the age category in ICU that are overweight/obese which is nudging 75% anyway – so not a significant reduction in risk.

What is interesting is this has dropped since September to 19.9% and the proportion of obese patients in ICU (BMI>30) has gone up from 39.4% to 46.4% since September. I’m wondering if this is related to vitamin D levels which drop in the winter months in the absence of sunlight. Overweight/obese people have lower vitD so are perhaps becoming deficient more readily reflecting the increase in ICU. Surely something that should be looked into?

You switch between the H/M/L modes with a tap or the button on the back (I actually really like the tap feature when it’s on my helmet, but it’s a pain if you use it as a flashlight). To change the program which is printed on the back of the torch you need to press the button on the back for a number of seconds and count the flashes, I use PGM1 which gives the highest brightness in the high mode – what you need to watch is that you aren’t on a program where the highest brightness isn’t available, which is most of them in fact.

Mine is pretty bright, a bit less than my 1600lm handlebar light so about right. The beam is a bit more spotty and focused than the bar mounted lights so you need to bear that in mind. Also the mode setting is a bit tricky so you might have it in one of the lower power modes maybe?