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

[Pogue Mahone]

Given that the majority of initial infections are mild or asymptomatic and thus produce antibodies less often than more severe infectioms we would probably expect reinfections to be worse on average.

I certainly hope that’s not the case. Because if reinfections are worse on average we’re in a shit-load of trouble.

 

[TheGame]

I see, thanks, in that case I have overestimated the gains by 'the mayors'. Be interesting to see if they have much to say tomorrow.

This was the Liverpool Mayors response:

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[Wibble]

There goes your herd immunity plan.

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I don't think a total of 5 worldwide means that at all. Rather it point to the opposite.

 

[Wibble]

I certainly hope that’s not the case. Because if reinfections are worse on average we’re in a shit-load of trouble.

I don't think they are and what little data we have seems to confirm that (for what it is worth) but you might expect it as the majority of initial infections are mild or even aysmptomatic so in the immortal words of Jazz and The Plastic People "The only way is up".

 

[Pogue Mahone]

I don't think a total of 5 worldwide means that at all. Rather it point to the opposite.

Eh? Come on, Wibs. Why are you such a zealot about this? All available evidence points towards viral eradication being a pipe dream. Have you seen the end-points in the vaccine studies? Even the manufacturers are less bullish than you about sterilising immunity.

 

[Stactix]

Government ignoring the science again, not even a surprise at this point.

 

[UnrelatedPsuedo]

Well how would you do it?

There’s probably a way to suit your agenda (for example total number of cases vs deaths which boosts it to like 2/3%) but clearly the number getting tested isn’t everyone who has the virus. There’s no way to get an exact figure. I suppose if someone has the data of September UK cases vs deaths that’s something I’d listen to.

It has nothing to do with an agenda.

You just may as well have used two numbers you made up is all.

You did some math on two completely unlinked numbers. The 50 deaths had nothing to do with the positive tests. They’re different data points.

 

[Fluctuation0161]

There goes your herd immunity plan.

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If reinfection occurs, doesn't that mean any vaccine would ultimately be ineffective aswell?

 

[Wednesday at Stoke]

If reinfection occurs, doesn't that mean any vaccine would ultimately be ineffective aswell?

With vaccines, you can give immunity to a wider swath of people in shorter time with less pain than waiting for the virus to infect a majority at the same time.

 

[jojojo]

If reinfection occurs, doesn't that mean any vaccine would ultimately be ineffective aswell?

In itself it doesn't mean much, but it's part of a pattern that means that people will probably need an annual top-up of any vaccine (unless the virus mutates to a milder or less infectious form).

Ineffective means different things in different situations though. With the vaccines under test, most researchers suggest that the vaccines won't necessarily stop all people taking it from catching the virus. The hope is that the vaccines will also make the disease milder in people that do catch it.

The general view is that vaccines will let us live with rather than eradicate the virus. If the vaccines also stop you being infectious even if you do catch it, it'll have a big effect on transmission rates and case numbers as well as on the vaccinated individual's health though.

 

[Wibble]

Eh? Come on, Wibs. Why are you such a zealot about this? All available evidence points towards viral eradication being a pipe dream. Have you seen the end-points in the vaccine studies? Even the manufacturers are less bullish than you about sterilising immunity.

I meant that reinfection being at such low levels (if it continues to be true) isn't a significant barrier to reaching a very high level of worldwide immunity or even HIT, not that it says anything about eradication directly. I actually think vaccine resistance silliness might be the biggest barrier, even assuming we can produce,manufacture and distribute a vaccine quickly enough.

Sterilising antibodies would be great but many hugely successful vaccines deal with post cellular infection processes. I suspect that if we get a highly effective vaccine soon (or even eventually if the first cab off the rank isn't) we might need monoclonal antibodies and anti-virals to control it.

I can see a world where places like NZ and Australia have 95% vaccination rates (stated government aim with the vaccine being free) and antibody/anti-viral treatments widely available, who effectively eradicate, with many other countries lagging behind. Which then makes opening up again an even bigger challenge.

Of course that could look very different without a vaccine.

 

[esmufc07]

The problem is vaccine uptake if and when one is developed. Anti-vaxers seem to have exponentially grown over the last few months.

 

[MikeUpNorth]

If the vaccine gives a short term (1 year) immunity at the least we would see a slow down in infection rates and once infection rates get low enough the whole track and trace routine becomes manageable. That said I suspect that even with a vaccine the world is going to have to get used to a new style of socialisation. Asia has already been using masks for years, one part of that was it became impolite in society to be in public without a mask on if you had even a slight sniffle. The rest of us will need to change to that type of thinking. Its not just masks though, we will also need to be able to take time off work if we feel ill, either by more acceptance from employers of sick leave or also less stoic behaviour when even slightly ill. There are more of these things but the sooner the whole world changes habits the faster this thing becomes controlled. Sadly habits are very difficult to both break and form.

I think this is right. I see a lot of people thinking something like 'ok, maybe it'll take a few years for us to get on top of this virus, but then it's back to normal'. I doubt it. Not least because there will be similar new viruses with pandemic potential coming down the track and we're going to need to adapt our behaviour to live with them.

 

[Pogue Mahone]

I meant that reinfection being at such low levels (if it continues to be true) isn't a significant barrier to reaching a very high level of worldwide immunity or even HIT, not that it says anything about eradication directly. I actually think vaccine resistance silliness might be the biggest barrier, even assuming we can produce,manufacture and distribute a vaccine quickly enough.

Sterilising antibodies would be great but many hugely successful vaccines deal with post cellular infection processes. I suspect that if we get a highly effective vaccine soon (or even eventually if the first cab off the rank isn't) we might need monoclonal antibodies and anti-virals to control it.

I can see a world where places like NZ and Australia have 95% vaccination rates (stated government aim with the vaccine being free) and antibody/anti-viral treatments widely available, who effectively eradicate, with many other countries lagging behind. Which then makes opening up again an even bigger challenge.

Of course that could look very different without a vaccine.

I think the most likely outcome is a mish mash of different vaccines, with varying degrees of efficacy and varying degrees of uptake (and varying dates of roll out) making this thing gradually easier to live with over the next several years, as it becomes endemic. With the increasing evidence that infection doesn’t give lasting immunity (something we already knew was the case with common cold coronaviruses) my hopes of a durable and effective sterilising vaccine are fading. I had hoped that prior infection would at least mean reinfection would be a very mild illness (as per common cold cov) so it’s a worry if this isn’t the case. Likewise reinfections happening so soon. I was hoping they wouldn’t start turning up until next year.

In the medium term, I would be putting my eggs in the effective treatment basket as the most likely way we can get back to a life that is close to normal. This whole rapid and severe reinfection thing is a crushing disappointment.

 

[Stack]

The problem is vaccine uptake if and when one is developed. Anti-vaxers seem to have exponentially grown over the last few months.

Even with ani vaxxers being a problem a vaccine will help make it harder for the virus to spread, it will slow down transmission. I dont see anti vaxxers in this being a major concern, more of a cause of argument.

 

[Wibble]

This whole rapid and severe reinfection thing is a crushing disappointment.

Of the 5 cases 2 have been worse and 3 mild or milder. Of the 4 in the Lancet article all 4 produced antibodies after reinfection. As this is better than you would predict, and there are so few cases, I don't think there is anything that suggests the need to be too downbeat.

 

[Wibble]

Even with ani vaxxers being a problem a vaccine will help make it harder for the virus to spread, it will slow down transmission. I dont see anti vaxxers in this being a major concern, more of a cause of argument.

My worry is that countries like the US, Poland, the Balkan countries and most of Africa (and no doubt lots of other places) where there is significant vaccine resistance, will help to massively slow the world's recover from this even if we get a highly effective vaccine.

 

[africanspur]

The problem is vaccine uptake if and when one is developed. Anti-vaxers seem to have exponentially grown over the last few months.

Anti vaxxers obviously are a bunch of total nincompoops but I fear in this instance, some people have a bit of inadvertent logic below their heaps of total BS.

I will of course take the vaccine when it comes, especially as a healthcare worker, but with some slight apprehension about how quickly its being pushed through.

I've said from the beginning of these processes that a vaccine that ends up being used and either being total shite or having intolerable side effects will do more long term damage to how vaccines as a whole are viewed. And let's not forget that there are a whole host of other infectious diseases that we've mostly gotten under control with vaccines that could flare up again if more people become averse to them.

Johnson and Johnson trial also now paused while they investigate an 'unexplained illness'. FFS.

 

[Ekkie Thump]

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[fergieisold]

There goes your herd immunity plan.

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I suspect that this is something that happens with all illnesses in people who are in some way prone to it (probably genetics). I'd hope it's incredibly rare though.

 

[Pogue Mahone]

Of the 5 cases 2 have been worse and 3 mild or milder. Of the 4 in the Lancet article all 4 produced antibodies after reinfection. As this is better than you would predict, and there are so few cases, I don't think there is anything that suggests the need to be too downbeat.

You can basically ignore the numbers. We’re so early in the epidemic it’s bad news to have any confirmed reinfections at all. Plus there’s absolutely no doubt in my mind that we’re only picking up the tiniest % of the real number here. In the early months we were ignoring reinfections because of the “persistent shedding of viral debris” hypothesis. No doubt hundreds, if not thousands, of cases worldwide missed on that basis alone. It’s only recently that the virus has mutated enough that we can confirm when people have become reinfected with a different version and we’re getting cases like the 5 discussed in the article in The Lancet.

Plus, if you think about it, the chance of identifying a reinfection is very unlikely. Especially if the first or second illness is very mild/asymptomatic. We’re not routinely testing very mild/asymptomatic cases so it’s going to be incredibly rare for someone to a) have a mild illness yet still be tested and b) become exposed twice to a virus that is still (thankfully) not very widespread.

All that really matters when it comes to understanding the significance of these cases is whether reinfection is possible (yes) how soon it can happen (within a few weeks, apparently) and whether previous infection consistently means subsequent infections are mild/asymptomatic (evidently not)

All of which is a bit of a downer, to put it mildly!

 

[berbatrick]

My worry is that countries like the US, Poland, the Balkan countries and most of Africa (and no doubt lots of other places) where there is significant vaccine resistance, will help to massively slow the world's recover from this even if we get a highly effective vaccine.

If the vaccine requires annual boosters etc. it will probably be out of reach for the majority of the world's population for financial reasons.

 

[RobinLFC]

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The stupidity is mind-boggling.

@KirkDuyt you there?

 

[Brwned]

I agree. Although, whilst other Governments have evidently done a better job, (as much as it pains me to say it, being very firmly left on centre) I'm not sure anyone has really done all that much better. Certainly, post-lockdowns, nobody has really got this cracked and we're all awaiting a vaccine to get back to any semblance of normality.

The contact tracing issue is a big one and if people don't co-operate then how can we expect it to succeed?

My opinion, as a society, we were largely willing to co-operate at the start in the face of an unprecedented threat, with warnings that half a million could die and stadiums being turned into hospitals with death on an industrial scale. The reality is, that (for whatever reason, and clearly locking down had a major impact) that never came to pass and I believe most (and especially the young) have no fear of the virus anymore since statistically they think they're very unlikely to suffer. The fear factor is gone, there is no force of will and without that you're into having to enforce with neither the resources, nor the mandate to do it. I suspect that is now the same the world over.

This seems to make clear that the government has been taken balanced choices which go against public health officials' recommendations to protect the economy (while also weighing up the health and social costs).

Released shortly after the announcement, minutes from the meeting of the Scientific Advisory Group for Emergencies (Sage) - which feeds into UK government decision making - stated the advisers had called for the immediate introduction of a short national lockdown three weeks ago.

The papers also showed the scientists suggested:

• banning all contact inside homes with members of other households
• closing all bars, restaurants, cafes, indoor gyms and hairdressers
• requiring all university and college teaching to take place online

Of all the measures proposed by the advisory group, just one - advising those who can work from home to do so - was implemented by the government at the time.

...

Cases are increasing across the whole of the country and the number of people in hospital is now higher than before the full lockdown in March. We are at a critical stage in the epidemic. It is at this moment the gulf between the official scientific advice and the decisions made by government has been laid bare.

It is the case that "advisers advise and ministers decide". When considering new measures to stop Covid, government must also take into account the harms they cause to our health and the economy. But there is some concern the government is doing too little, too late. And that we can either choose the terms for controlling the virus now, or wait and the virus will force our hand as it did with lockdown in March.

...

The newly released Sage documents also showed advisers said NHS Test and Trace was only having a "marginal impact" and this would "likely decline further" unless the system expanded to keep up with the rise in cases and people were given support to enable them to self-isolate.

A separate document from 17 September stated that Sage believed curfews in bars, pubs, cafes and restaurants were also "likely to have a marginal impact". A 22:00 closing time was introduced for all hospitality venues in England from 24 September.

A Sage document from 21 September warned that "single interventions by themselves are unlikely to be able to bring the R below one" and both local and national measures are needed.

However, a document examining measures including a "circuit-breaker" of two to three weeks, said this step, if it was "as strict and well-adhered to as the restrictions in late May", could "put the epidemic back by approximately 28 days or more". "Multiple circuit-breaks might be necessary to maintain low levels of incidence," it added.

So when it seems like the government aren't doing enough to protect the economy, that should be contextualised against the fact that public health officials are recommending multiple circuit-breaks (aka short-term lockdowns) at a time when people are complaining about pubs being asked to close an hour earlier.

And while these conversations aren't happening in the public sphere in real-time, we shouldn't turn our nose up at the fact they release this level of detail while the pandemic is ongoing. It certainly doesn't happen everywhere.

I think there will be a big question in a few weeks why many of the Western governments have rejected recommendations to enact the circuit-break given the way things are going.

 

[Pexbo]

The problem is vaccine uptake if and when one is developed. Anti-vaxers seem to have exponentially grown over the last few months.

As long as we can make it compulsory for u18s and it’s safe for vulnerable people to take, I say we Darwin the anti-vaxx movement once and for all.

I do love how many middle aged anti-vaxxers are terrified they’re suddenly going to come down with Autism though.

 

[KirkDuyt]

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The stupidity is mind-boggling.

@KirkDuyt you there?

Yeah for sure, Willem Engel is my hero. This Covid hoax should come to an end. I refuse to stay inside, just because Bill Gates wants to inject me with his Nanobots. Damn those shadowcabal pedophile billionaire illuminati.

 

[fergieisold]

Of the 5 cases 2 have been worse and 3 mild or milder. Of the 4 in the Lancet article all 4 produced antibodies after reinfection. As this is better than you would predict, and there are so few cases, I don't think there is anything that suggests the need to be too downbeat.

I think this is the key point, we're trying very hard to find these re infection cases but we don't really see evidence of it on any meaningful scale. Pogue will know more than me but from everything we know about immunity we must end up with some protection long term? Or is our immune system based on constant exposure?

 

[Wibble]

You can basically ignore the numbers. We’re so early in the epidemic it’s bad news to have any confirmed reinfections at all. Plus there’s absolutely no doubt in my mind that we’re only picking up the tiniest % of the real number here. In the early months we were ignoring reinfections because of the “persistent shedding of viral debris” hypothesis. No doubt hundreds, if not thousands, of cases worldwide missed on that basis alone. It’s only recently that the virus has mutated enough that we can confirm when people have become reinfected with a different version and we’re getting cases like the 5 discussed in the article in The Lancet.

Plus, if you think about it, the chance of identifying a reinfection is very unlikely. Especially if the first or second illness is very mild/asymptomatic. We’re not routinely testing very mild/asymptomatic cases so it’s going to be incredibly rare for someone to a) have a mild illness yet still be tested and b) become exposed twice to a virus that is still (thankfully) not very widespread.

All that really matters when it comes to understanding the significance of these cases is whether reinfection is possible (yes) how soon it can happen (within a few weeks, apparently) and whether previous infection consistently means subsequent infections are mild/asymptomatic (evidently not)

All of which is a bit of a downer, to put it mildly!

You would expect that we would have found far more than 5 cases of reinfection with 38 million diagnosed cases to work with if reinfection was very widespread.

 

[Hound Dog]

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The stupidity is mind-boggling.

@KirkDuyt you there?

The more I read comments on here about this lasting forever the less stupid these people seem to me.

Also, I suspect that more and more people will start behaving like this when/if it becomes clear that this will go on for years/decades/etc. And rightly so.

 

[onemanarmy]

Yeah for sure, Willem Engel is my hero. This Covid hoax should come to an end. I refuse to stay inside, just because Bill Gates wants to inject me with his Nanobots. Damn those shadowcabal pedophile billionaire illuminati.

Friends of mine who live in Holland told me that as of tonight all bars and restaurants will probably close for 2 weeks? I live about 5km from the border, it will be busy at our side of the border next few weeks...

 

[esmufc07]

As long as we can make it compulsory for u18s and it’s safe for vulnerable people to take, I say we Darwin the anti-vaxx movement once and for all.

I do love how many middle aged anti-vaxxers are terrified they’re suddenly going to come down with Autism though.

2 of my brothers and my sister are against vaccines and have already said they won’t get a covid one.....

 

[KirkDuyt]

Friends of mine who live in Holland told me that as of tonight all bars and restaurants will probably close for 2 weeks? I live about 5km from the border, it will be busy at our side of the border next few weeks...

Yeah, forecast is all bars and restaurants either close entirely or close at 18:00. Amateur team sports will be banned and you can only be 4 people in total with guests.

 

[Hal9000]

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I can see why the track and trace system is shit, also testing is terrible. I'm now into day 4 of waiting for my result. So these 3 days are a delay that anyone I've come into contact with, potentially having it and walking around.

 

[fergieisold]

Does anybody know of people not taking a test and getting a positive result? I thought it was bullshit at first but after doing some digging it seems to be a problem, particularly at drive thru style centres in the US. Bit like a fast food drive thru mix up. Someone leaves the line because they don't want to wait...gets somebody else results.

 

[Fluctuation0161]

People can just start drinking and attend earlier. Reducing opening hours by 1 hour will have minimal impact, if any.

In my opinion our scientists are being bullied by the government into accepting compromises in the name of the economy which are ineffective at controlling the virus.

@Pogue Mahone
@stepic

Looks like, as suspected, this post was accurate.
https://www.mirror.co.uk/news/politics/no-10-ignored-warning-10pm-22835774

"No 10 ignored warning that 10pm pub curfew would have 'marginal impact' on coronavirus spread
Documents from SAGE revealed that experts said the measure - which has been criticised by MPs, council leaders and business owners - would do little to contain the virus"

 

[Wibble]

I think this is the key point, we're trying very hard to find these re infection cases but we don't really see evidence of it on any meaningful scale. Pogue will know more than me but from everything we know about immunity we must end up with some protection long term? Or is our immune system based on constant exposure?

The jury is out but flu mutates far faster than SARS-CoV-2 is doing, antibodies only last up to 150 days yet the main reason the annual flu shot doesn't do a much better job is the very low takeup rate.

How long immunity is is highly variable with some vaccines producing almost lifetime immunity and others needing boosters at varying frequency. If I remember correctly infection with one of the recent Coronaviruses (I forget which one) has been found to produce long term immunity and certainly studies of SARS-CoV-1 have shown immunity lasting 2+ years. So there is some hope that SARS-CoV-2 vaccines (subject to all the usual caveats) will work long enough to do their job, even if a booster is required every year or two. Far from certain of course and we won't know for sure until we get a vaccine and roll it out.

 

[Wibble]

2 of my brothers and my sister are against vaccines and have already said they won’t get a covid one.....

Are they also against chemotherapy and antibiotics?

 

[Wibble]

@Pogue Mahone
@stepic

Looks like, as suspected, this post was accurate.
https://www.mirror.co.uk/news/politics/no-10-ignored-warning-10pm-22835774

"No 10 ignored warning that 10pm pub curfew would have 'marginal impact' on coronavirus spread
Documents from SAGE revealed that experts said the measure - which has been criticised by MPs, council leaders and business owners - would do little to contain the virus"

Are you suggesting that a Band-Aid isn't enough to stem the flow of blood when you have lopped a limb off with a Samurai sword?

 

[Pexbo]

2 of my brothers and my sister are against vaccines and have already said they won’t get a covid one.....

Sorry mate

 

[esmufc07]

Are they also against chemotherapy and antibiotics?

Yes to the former, latter has never come up I don’t think. But I just tend to switch off when they start spouting their agenda. They can’t be reasoned with.