SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

Pogue Mahone

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When you have well known local gps standing on a soapbox in the middle of Derry’s shopping district spouting Facebook type nonsense about flu being a bigger danger, you can understand why people don’t give a shit. Plus Derry people travel for work to Belfast, Dublin etc
Don’t know if you saw Dr Black on RTE tonight live from Derry? He said people are continuing with communions etc, hugging each other with no masks in sight. The buck stops with the people
Feck’s sake.
 

Rado_N

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When you have well known local gps standing on a soapbox in the middle of Derry’s shopping district spouting Facebook type nonsense about flu being a bigger danger, you can understand why people don’t give a shit. Plus Derry people travel for work to Belfast, Dublin etc
Don’t know if you saw Dr Black on RTE tonight live from Derry? He said people are continuing with communions etc, hugging each other with no masks in sight. The buck stops with the people
Sounds like Derry Girls was more realistic than I first thought.
 

jojojo

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Well that's just bizarre, and very worrying. It may reduce Richmond's headline number but does that mean the Fallowfield (Manchester) number, fo example, is undercounting, in which case the universities need to go online sharpish and send the uninfected home - because it must be like living in a petri dish there right now.
 

McGrathsipan

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Cases per 1000 in Norn Iron are off the charts. Some of the very worst in Europe. Apparently nobody knows why. So much for this alleged advantage of being an island.
I've alot of friends in the border areas and they are all saying the same. Nobody cares there.
 

McGrathsipan

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I’ve heard similar stories. And geebs said the same thing. It’s weird though. Why are they being so reckless compared to the rest of Europe?
I dont know. Are they just a little arrogant?
My wife lived in UK for 10 years and has alot of friends there. At the start of this they were all part of the stuff upper lip brigade. You know the Keep Calm and Carry on types.

This is going to get bad.
We need to lock down again unfortunately.
feck it anyway.

Resilience is really going to be tested
 

Penna

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When you have well known local gps standing on a soapbox in the middle of Derry’s shopping district spouting Facebook type nonsense about flu being a bigger danger, you can understand why people don’t give a shit. Plus Derry people travel for work to Belfast, Dublin etc
Don’t know if you saw Dr Black on RTE tonight live from Derry? He said people are continuing with communions etc, hugging each other with no masks in sight. The buck stops with the people
Since the pandemic started, I've watched Mass online every week from lots of different Irish churches. They're all observing the measures of mask-wearing, distancing, hand-sanitising, they're not passing the collection around or having the congregation singing. No handshakes, either.

Mind you, these are the ones who broadcast the Mass online, so they know they're being watched!
 

Penna

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4.8k cases today from 30k tests, highest since pandemic started. We were on 4k yesterday with 44k cases so it’s getting much worse. 52 people dead today, almost 200 in the last 3 days. I fear to think what the numbers will be like in 2-3 weeks. I was wondering all Summer how cases were not going up with virtually no restrictions, probably was the weather or the fact people had been traveling all over the place so hardly in large groups at the same time. We will certainly surpass 100 deaths a day and people on the Internet are laughing about ‘fake pandemic’. I want to vomit.
It was very unfortunate that the end of the first wave coincided with the start of the summer months, at least in the northern hemisphere. It was just the wrong time, because warm weather and long daylight hours will definitely get people out, particularly if they've felt confined for a few months before that.
 

Stack

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Govts can be complete feckwits, actually I should replace the word can with the word are. This taking place here in NZ is awful https://www.nzherald.co.nz/nz/griev...peedboat-accident/3XF7JRON3STNIT4OXZQAV64QI4/
Awful for a number of reasons, the first is obvious of course, simple human compassion. But also awful because this family has been at sea and has long since gone past any 14 day quarantine type requirement. Awful because it feels like we are allowing people in based on how much money they have, there are still non NZ citizens coming here in small numbers and getting through the red tape because they have a lot of money are are seen to be providing employment opportunities. The Hollywood influx being the clearest example.
Of course this is in the world picture a tiny blip but it does show how hopeless govts can be at being able to think sensibly and adapt to situations that dont fit into a check box.
 

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Does anyone have any idea about the overall % of people that had it any country? I know some studies have been done on Stockholm, New York, certain regions of Italy, but nothing nation-wide.

The reason why I am asking is that, with this number of recorded cases again, surely the herd immunity has at least a chance of being accomplished before the vaccine arrives?

Or if not, what is the way out? It has been seven fecking months and I feel no closer to a resolution than in March - this is still something that no one is talking about.
I don't think even the worst hit places have a chance of getting to the HIT without collapsing the health systems on that sort of time scale. I think exact figures are hard to get but the UK has about 8% infected to date although it will be higher than that as not everyone with it will have been tested/diagnosed. Still miles off HIT though. It does gradually reduce Ro though but HIT is where R0 is below 1 which in effect prevents it spreading.
 

Pogue Mahone

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Govts can be complete feckwits, actually I should replace the word can with the word are. This taking place here in NZ is awful https://www.nzherald.co.nz/nz/griev...peedboat-accident/3XF7JRON3STNIT4OXZQAV64QI4/
Awful for a number of reasons, the first is obvious of course, simple human compassion. But also awful because this family has been at sea and has long since gone past any 14 day quarantine type requirement. Awful because it feels like we are allowing people in based on how much money they have, there are still non NZ citizens coming here in small numbers and getting through the red tape because they have a lot of money are are seen to be providing employment opportunities. The Hollywood influx being the clearest example.
Of course this is in the world picture a tiny blip but it does show how hopeless govts can be at being able to think sensibly and adapt to situations that dont fit into a check box.
Jesus that’s a tragic story. Hard to understand why they can’t let them in. Even if they’re unsure about quarantine at sea, they could let them anchor up offshore, with enough food for a couple of weeks to be 110% sure they won’t bring the virus with them.
 

Pogue Mahone

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I don't think even the worst hit places have a chance of getting to the HIT without collapsing the health systems on that sort of time scale. I think exact figures are hard to get but the UK has about 8% infected to date although it will be higher than that as not everyone with it will have been tested/diagnosed. Still miles off HIT though. It does gradually reduce Ro though but HIT is where R0 is below 1 which in effect prevents it spreading.
I think serology surveys are going to be an enormous underestimate of true exposure , considering we know that the mildest cases often don’t generate any antibody response at all and even severe cases can stop producing antibodies after a few months.

Of course, this might also mean herd immunity is off the table regardless. In which case working out the % previously exposed is just an academic exercise.
 

Wibble

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Govts can be complete feckwits, actually I should replace the word can with the word are. This taking place here in NZ is awful https://www.nzherald.co.nz/nz/griev...peedboat-accident/3XF7JRON3STNIT4OXZQAV64QI4/
Awful for a number of reasons, the first is obvious of course, simple human compassion. But also awful because this family has been at sea and has long since gone past any 14 day quarantine type requirement. Awful because it feels like we are allowing people in based on how much money they have, there are still non NZ citizens coming here in small numbers and getting through the red tape because they have a lot of money are are seen to be providing employment opportunities. The Hollywood influx being the clearest example.
Of course this is in the world picture a tiny blip but it does show how hopeless govts can be at being able to think sensibly and adapt to situations that dont fit into a check box.
Same here. First class passengers are getting home at the expense of economy passengers because the airlines are so restricted in the numbers allowed per flight that they have to try to at least break even. There are 20-30,000 Australians starnded iverseas at the moment but that figure is far higher because most don't bother registering and aren't going to try to get home.

And we also have the Hollywood type exceptions. The again it is hardly a surprise to find out that a government containing Scotty from Marketing and Peter Dutton are evil incompetent clowns.
 

Wibble

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I think serology surveys are going to be an enormous underestimate of true exposure , considering we know that the mildest cases often don’t generate any antibody response at all and even severe cases can stop producing antibodies after a few months.

Of course, this might also mean herd immunity is off the table regardless. In which case working out the % previously exposed is just an academic exercise.
We are pretty much guessing at the moment. Although I read somewhere this week that antibodies were frequently being detected in asymptomatic/low symptomatic cases. I know we detected an asymptomatic case this way very recently - probably 3 months after infection. Still just a single data point of course.

What did you make of this? https://www.theguardian.com/austral...id-specific-therapy-says-australian-scientist
 

Pogue Mahone

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We are pretty much guessing at the moment. Although I read somewhere this week that antibodies were frequently being detected in asymptomatic/low symptomatic cases. I know we detected an asymptomatic case this way very recently - probably 3 months after infection. Still just a single data point of course.

What did you make of this? https://www.theguardian.com/austral...id-specific-therapy-says-australian-scientist
I read that a few days ago. Monoclonal antibodies might well have a role to play but they’re expensive and have to be given by injection. It’s also hard to know when to give them. They can mop up viruses in the blood but that’s probably most useful early on, before people get very sick, after which point it seems to be your own immune response that messes you up, rather than the virus itself doing any damage. And giving a very expensive injectable treatment to everyone with early/mild disease is a health economic no no (unless we’re talking about the POTUS, evidently)
 

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I read that a few days ago. Monoclonal antibodies might well have a role to play but they’re expensive and have to be given by injection. It’s also hard to know when to give them. They can mop up viruses in the blood but that’s probably most useful early on, before people get very sick. And giving a very expensive injectable treatment to everyone with early/mild disease is a health economic no no (unless we’re talking about the POTUS, evidently)
If he is suggesting it maybe the cost will be much better on such a big scale. I think read somewhere that they were like digital media. The first one is very expensive but if you sell millions the unit cost is very low.

Can they only be used as a treatment? Or would there be benefit in giving them to everyone at the same time as a vaccine?
 
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Pogue Mahone

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If he is suggesting it maybe the cost will be much better on such a big scale. I think read somewhere that they were like digital media. The first one is very expensive but if you sell millions the unit cost is very low.

Can they only be used as a treatment? Or would there be benefit in giving them to everyone at the same time as a vaccine?
They’re already used long term, to treat chronic illnesses. Stuff like RA and Crohns. An injection or infusion every few months. So I guess they could be used to prevent infection. Cost would be off the charts though. They’re already worried about the cost of a vaccine that needs a booster, versus a single jab. Can’t imagine any government willing to pay for multiple jabs every year for (almost) every citizen.
 

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They’re already used long term, to treat chronic illnesses. Stuff like RA and Crohns. An injection or infusion every few months. So I guess they could be used to prevent infection. Cost would be off the charts though. They’re already worried about the cost of a vaccine that needs a booster, versus a single jab. Can’t imagine any government willing to pay for multiple jabs every year for (almost) every citizen.
Our will or at least have said they will. Not that I trust Scotty from Marketing and his evil clown posse.
 

jojojo

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I read that a few days ago. Monoclonal antibodies might well have a role to play but they’re expensive and have to be given by injection. It’s also hard to know when to give them. They can mop up viruses in the blood but that’s probably most useful early on, before people get very sick, after which point it seems to be your own immune response that messes you up, rather than the virus itself doing any damage. And giving a very expensive injectable treatment to everyone with early/mild disease is a health economic no no (unless we’re talking about the POTUS, evidently)
If the Eli Lilly commentary is right and they can produce 1m of their single antibody monoclonal by year end, and ramp up production of their cocktail mix to similar levels early next year then we're looking at a massive leap in capacity. Who else could do the same (if they had guaranteed sales even if their product wasn't used) I don't know, I do suspect the cost may be a drop in the ocean compared to the broader economic costs (never mind the human ones). I don't think it's unreasonable to think that the cost will rapidly drop below £1000/patient and could hit £100 at volume once we know which product we want. Though boring things like patents and copyright will doubtless intervene when it comes to price.

Using it on all 70+ patients with symptoms might have the biggest impact. But in reality that's still one for some mix of clinical trials, statistics, and cost/benefit analysis to prove. I'm hopeful though - I think in the first half of next year, we'll have antibodies for stopping the virus early, vaccines for reducing the numbers of infections and some more treatments for the ones who become seriously ill. Oddly, despite the absolutely miserable numbers of new cases etc, I'm having one of my more optimistic days today.
 

Pogue Mahone

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If the Eli Lilly commentary is right and they can produce 1m of their single antibody monoclonal by year end, and ramp up production of their cocktail mix to similar levels early next year then we're looking at a massive leap in capacity. Who else could do the same (if they had guaranteed sales even if their product wasn't used) I don't know, I do suspect the cost may be a drop in the ocean compared to the broader economic costs (never mind the human ones). I don't think it's unreasonable to think that the cost will rapidly drop below £1000/patient and could hit £100 at volume once we know which product we want. Though boring things like patents and copyright will doubtless intervene when it comes to price.

Using it on all 70+ patients with symptoms might have the biggest impact. But in reality that's still one for some mix of clinical trials, statistics, and cost/benefit analysis to prove. I'm hopeful though - I think in the first half of next year, we'll have antibodies for stopping the virus early, vaccines for reducing the numbers of infections and some more treatments for the ones who become seriously ill. Oddly, despite the absolutely miserable numbers of new cases etc, I'm having one of my more optimistic days today.
Heh. Good on you! I have good days and bad days too. Currently VERY worried about next few months but am about as optimistic as you are about next year. We just need one or two really big breakthroughs in vaccine or treatment development to get on top of this fecking thing. And there’s so much money and effort being thrown at this. The breakthroughs should come.
 

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Someone my Mum works with currently has COVID. She’s had a positive test. The interesting thing is that her husband who she lives with had it in April and tested positive at the time. She had a test at the time which was negative.

Either she’s had it twice (worrying) or she somehow managed not to catch it off her husband months ago.
 

Skills

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My mum tested positive this time last week. She's still not clear yet as her fever is still there and just won't go away. The rest of us are self isolating and not sure if we're out of the woods yet - its been 7 days since we last saw her and haven't had any symptoms yet. If another one of us gets symptoms now, it would suck balls as we'd be in for another 14 days on top.

I'm also starting to see ambulances flash past my window every night again. Hasn't happened for a while. - was a regular thing in the middle of lockdown.
 

Wibble

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Someone my Mum works with currently has COVID. She’s had a positive test. The interesting thing is that her husband who she lives with had it in April and tested positive at the time. She had a test at the time which was negative.

Either she’s had it twice (worrying) or she somehow managed not to catch it off her husband months ago.
Most likely she didn't get it the first time.
 

Skills

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Most likely she didn't get it the first time.
Honestly interested to know how it actually transmits most of the time. Do we know anymore than we did in April?

I know a few couples, who've managed to avoid passing it onto each other - when you'd think its almost a given you'd think it's almost a given passing it onto someone you share a bed with?
 

Wibble

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Honestly interested to know how it actually transmits most of the time. Do we know anymore than we did in April?

I know a few couples, who've managed to avoid passing it onto each other - when you'd think its almost a given you'd think it's almost a given passing it onto someone you share a bed with?
I'm sure we will get more detail as this progresses but it seems the main transmission method is by virus laden droplets from coughs, sneezes, singing, talking as well as direct contact like kissing which is why it is thought that masks and good ventilation are so important, mainly to limit an infected person's ability to transmit it to others in the cases of masks. It is likely that transmission by touching surfaces with virus laden droplets does occur but i think it is assumed that this is not as important.

Aerosol transmission (airbourne microdroplets) was initially thought to not be significant but we now know it does occur but I'm not sure we know to what extent it occurs or under what circumstances yet.

I'm only going on the things I remember reading so others may well be more informed or up to date.
 

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Also tend to be less compliant towards government directives too.

My step dad's a Derry man and he went up there for a weekend break over the summer and said he was honestly a little embarrassed with how lax everyone was. Similar in Donegal. Didn't think much of it at the time when there were single figure case numbers but surely they'll wise up now.

Still, it's strange how they went from single figure cases for such a long time despite there being no real change in attitudes / approach over that time. Maybe folks moving in from the beer gardens to the pubs has made a big difference with the change in weather? I guess all you need is a couple of big super spreader events to kick things off and that just wasn't possible outdoors.
 

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The pandemic has decimated elective surgery.

In the UK there are now 2.15 million patients waiting more than 18 weeks for an operation. The current national target is that 92% of patients should be operated within the 18 week target which is currently running at 48%.

There are 83000 waiting more than a year compared with just over a 1000 a year ago. There used to be a penalty of around £5000 for any single breach which I guess has now been scrapped.

Most hospitals only at 50% capacity for elective surgery

An interesting statistic is that there has been a loss of 80000 beds over 20 years and 45000 less beds over last 10 years. Quite rightly there was a move to bring care back into the community but we have clearly gone too far. The "new normal" of less face to face consultations and remote monitoring may help also to reduce the costs in the future.

As the winter season approaches this will put more pressure on the system. This needs a completely different and smarter way of working and planning as I wrote in a blog 5 years ago

With the current model it will take years to get through the massive waiting list.

https://lnkd.in/ddHZSu5
 

Pogue Mahone

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Honestly interested to know how it actually transmits most of the time. Do we know anymore than we did in April?

I know a few couples, who've managed to avoid passing it onto each other - when you'd think its almost a given you'd think it's almost a given passing it onto someone you share a bed with?
Big study in India shows that there’s only a 9% chance of catching it from someone in your household and 78% of people who catch it don’t infect anyone else. I’ve seen similar numbers from studies in other countries. However it gets passed on, it seems as though some people are a hell of a lot more infective than others. Either that or susceptibility is extremely variable.

Hard to work out what’s the most important factor but there’s been loads of super spreader events, so former more likely than latter.
 

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Also tend to be less compliant towards government directives too.

My step dad's a Derry man and he went up there for a weekend break over the summer and said he was honestly a little embarrassed with how lax everyone was. Similar in Donegal. Didn't think much of it at the time when there were single figure case numbers but surely they'll wise up now.

Still, it's strange how they went from single figure cases for such a long time despite there being no real change in attitudes / approach over that time. Maybe folks moving in from the beer gardens to the pubs has made a big difference with the change in weather? I guess all you need is a couple of big super spreader events to kick things off and that just wasn't possible outdoors.
Ha! I always thought that you are English for some reason.

yeah they don’t like taking directions from government here, a fallout from history.
Derry people are very sociable, they like to go and meet others and they all have an attitude that it would never happen to them. they need to stop and think because Altnagelvin hospital will not have the capacity to ramp up too much for hospitalisations