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

[CassiusClaymore]

Can't help but laugh at the guardian readers in here. Such a fair and balanced newspaper hehehe.

None of them are fair or balanced. What's your point? Presumably you either a) don't believe there's any wrong doing taking place or b) don't care.

I assume you can still see from under that boot so I'll go with (b) with a sprinkling of (c) "what about when Labour did X, Y and Z" thrown in for good measure.

Stuff like this should be above party politics and any left v right culture war bullshit. These people are corrupt and are stealing unprecedented amounts of taxpayers money. If you're not angry about that then there's something wrong with you.

 

[Fluctuation0161]

Can't help but laugh at the guardian readers in here. Such a fair and balanced newspaper hehehe.

If there are any facts in the article you dispute then feel free...

 

[Dr. StrangeHate]

Billions for an app but only 22 million for a major population center? Sounds fair.

That app has been a great success though.

The luxury yacht industry is thriving.

 

[F-Red]

An interesting article on the second waves in Europe, worth reading if you're interested in data - https://www.ft.com/content/b3801b63-fbdb-433b-9a46-217405b1109f

 

[calodo2003]

That app has been a great success though.

The luxury yacht industry is thriving.

Make super yachts great again.

 

[Pogue Mahone]

An interesting article on the second waves in Europe, worth reading if you're interested in data - https://www.ft.com/content/b3801b63-fbdb-433b-9a46-217405b1109f

Behind a paywall.

What’s the tl;dr?

 

[Santos J]

Behind a paywall.

What’s the tl;dr?

If you search the article link in the bottom box on http://archive.is/ it may or may not come up for you to read.

 

[F-Red]

Behind a paywall.

What’s the tl;dr?

Shouldn't be, they're hosting their articles on covid for free. I don't have a subscription to them.

TL;DR:

- Autumn resurgence more muted than spring, due to social distancing etc. Lose that & transmission accelerates
- Mortality rates down in some contexts, but due in part to reduced pressure on healthcare system
- To keep pressure down & outcomes up, gotta control transmission

 

[F-Red]

UK figures - 191 deaths, 26,668 new cases

 

[Berbaclass]

 

[11101]

For those interested in how the disease might be changing/progressing, Italy has published death comparison statistics between the first months and the last.

It's fairly encouraging to see how the stronger and younger you are the better, even moreso than before.

	March - May	June - August
Median Age	77.8	81.7
Women	32.8%	51.8%
Comorbidities:
0	4.2%	0.6%
1	14.2%	8.6%
2	21.3%	14.2%
3+	60.2%	76.5%
Complications:
ARDS	97.3%	90.8%
Renal failure	22.7%	24.5%
Cardiac	10.9%	7.4%
Superinfection	15.2%	47.9%
Treatments:
Antibiotics	87.1%	89.4%
Antivirals	60.9%	39.4%
Steroids	40.7%	66.3%
Tocilizumab	4.3%	7.7%

	Then	Now
Symptom onset to death	12 days	38 days
Symptom onset to testing	5	3
Symptom onset to hospitalisation	4	3
Hospitalisation to death	6	26

 

[Ananke]

Can't help but laugh at the guardian readers in here. Such a fair and balanced newspaper hehehe.

I mean I know @CassiusClaymore stated someone would be along to defend it... but put some effort in lad.

I bet you've not even read it, checked the linked sources or actually...even clicked it.

 

[Sarni]

Blimey is Poland really that bad?! Think U.K was estimated at 30% of people who were reluctant to take a vaccine for whatever reason.

I have checked recent polls. 37% say they would get vaccine if it was available. I think with 63% unvaccinated we would still be in trouble.

 

[Arruda]

For those interested in how the disease might be changing/progressing, Italy has published death comparison statistics between the first months and the last.

It's fairly encouraging to see how the stronger and younger you are the better, even moreso than before.

	March - May	June - August
Median Age	77.8	81.7
Women	32.8%	51.8%
Comorbidities:
0	4.2%	0.6%
1	14.2%	8.6%
2	21.3%	14.2%
3+	60.2%	76.5%
Complications:
ARDS	97.3%	90.8%
Renal failure	22.7%	24.5%
Cardiac	10.9%	7.4%
Superinfection	15.2%	47.9%
Treatments:
Antibiotics	87.1%	89.4%
Antivirals	60.9%	39.4%
Steroids	40.7%	66.3%
Tocilizumab	4.3%	7.7%

	Then	Now
Symptom onset to death	12 days	38 days
Symptom onset to testing	5	3
Symptom onset to hospitalisation	4	3
Hospitalisation to death	6	26

Any idea for an explanation for that difference in gender?

I'm guessing older victims ---> Bigger share of women at more advanced ages, but still quite a jump.

Overall most of that data seems to indicate better care... Not only better knowledge in how to treat it, but weren't most hospitals in Italy absolute chaos by that first period? Lenght of time to death is suggestive of that, you can hold on to patients for longer when there is no pressure upstream from more patients.

 

[Pogue Mahone]

For those interested in how the disease might be changing/progressing, Italy has published death comparison statistics between the first months and the last.

It's fairly encouraging to see how the stronger and younger you are the better, even moreso than before.

	March - May	June - August
Median Age	77.8	81.7
Women	32.8%	51.8%
Comorbidities:
0	4.2%	0.6%
1	14.2%	8.6%
2	21.3%	14.2%
3+	60.2%	76.5%
Complications:
ARDS	97.3%	90.8%
Renal failure	22.7%	24.5%
Cardiac	10.9%	7.4%
Superinfection	15.2%	47.9%
Treatments:
Antibiotics	87.1%	89.4%
Antivirals	60.9%	39.4%
Steroids	40.7%	66.3%
Tocilizumab	4.3%	7.7%

	Then	Now
Symptom onset to death	12 days	38 days
Symptom onset to testing	5	3
Symptom onset to hospitalisation	4	3
Hospitalisation to death	6	26

Why “even more so than before”?

All I’m seeing in the data is a trend towards fewer people with co-morbidities getting infected. Which is driving a fairly slight improvement in outcomes.

We always knew that having one or more co-morbidity increased the chance of doing badly. What’s changed?

EDIT: Actually co-morbidity stuff not that simple. Higher % with 3+ and fewer with zero but fewer with 1 or 2. So, hard to interpret.

Time to death is also a lousy way to work out if the outcomes really are better. Might just be a higher chance of getting on a ventilator. Any mortality %?

 

[11101]

Any idea for an explanation for that difference in gender?

I'm guessing older victims ---> Bigger share of women at more advanced ages, but still quite a jump.

Overall most of that data seems to indicate better care... Not only better knowledge in how to treat it, but weren't most hospitals in Italy absolute chaos by that first period? Lenght of time to death is suggestive of that, you can hold on to patients for longer when there is no pressure upstream from more patients.

I'm just presenting the numbers. The published research doesn't attempt to explain the why. I suspect its a combination of many factors from better treatment to the most unhealthy patients already being dead.

Why “even more so than before”?

All I’m seeing in the data is a trend towards fewer people with co-morbidities getting infected. Which is driving a fairly slight improvement in outcomes.

We always knew that having one or more co-morbidity increased the chance of doing badly. What’s changed?

EDIT: Actually co-morbidity stuff not that simple. Higher % with 3+ and fewer with zero but fewer with 1 or 2. So, hard to interpret.

Time to death is also a lousy way to work out if the outcomes really are better. Might just be a higher chance of getting on a ventilator. Any mortality %?

That data is purely deaths. There is nothing about mortality rates in there.

 

[Fluctuation0161]

That app has been a great success though.

The luxury yacht industry is thriving.

World beating. Well, City beating, in terms of funding at least.

 

[Arruda]

Why “even more so than before”?

All I’m seeing in the data is a trend towards fewer people with co-morbidities getting infected. Which is driving a fairly slight improvement in outcomes.

We always knew that having one or more co-morbidity increased the chance of doing badly. What’s changed?

EDIT: Actually co-morbidity stuff not that simple. Higher % with 3+ and fewer with zero but fewer with 1 or 2. So, hard to interpret.

Time to death is also a lousy way to work out if the outcomes really are better. Might just be a higher chance of getting on a ventilator. Any mortality %?

That data is just about the dead. So co-morbidity number makes sense. A bigger percentage of the dead are higher-risk patients (3+ commorbidities, older, etc). Which means you're saving more of the ones with less co-morbidities.

I think all data in that table points in the same direction. Hospitals are working normaly in the second set. Longer time to die is not a better outcome per se, but indirectly means you're investing more in patients so more are being saved. Can almost guess mortality is lower, even if not mentioned.

Superinfection is telling. Those are long hospital stays, probably a large number having had access to ICU. In the first data more died sooner of respiratory failure without access to ventilator support.

 

[Pogue Mahone]

That data is purely deaths. There is nothing about mortality rates in there.

That data is just about the dead. So co-morbidity number makes sense. A bigger percentage of the dead are higher-risk patients (3+ commorbidities, older, etc). Which means you're saving more of the ones with less co-morbidities.

I think all data in that table points in the same direction. Hospitals are working normaly in the second set. Longer time to die is not a better outcome per se, but indirectly means you're investing more in patients so more are being saved. Can almost guess mortality is lower, even if not mentioned.

Superinfection is telling. Those are long hospital stays, probably a large number having had access to ICU. In the first data more died sooner of respiratory failure without access to ventilator support.

Gotcha. So the median age of people dying has increased and there’s a higher % of multi-morbid deaths.

Combine this with the longer time to death and super-infections etc it all points towards better access to ventilators. Fewer people dying for lack of a vent. That reflects well on how the Italian health service is coping with the second wave (so far) but wouldn’t make me feel any more confident about a better outcome as a young person, with no co-morbidity (which would bump me up the queue for a ventilator anyway)

 

[Sparky Rhiwabon]

Gotcha. So the median age of people dying has increased and there’s a higher % of multi-morbid deaths.

Combine this with the longer time to death and super-infections etc it all points towards better access to ventilators. Fewer people dying for lack of a vent. That reflects well on how the Italian health service is coping with the second wave (so far) but wouldn’t make me feel any more confident about a better outcome as a young person, with no co-morbidity (which would bump me up the queue for a ventilator anyway)

I assume that the UK would have set up a shedload more ICU beds with vents in the last six months, knowing that a second wave was likely in the winter, and ICU / vents being key to survival rates?

 

[Arruda]

@11101 Do you have a link for the source of those numbers? I wanted to discussed them in a group, but would need to source them.

 

[UnrelatedPsuedo]

My guess is that they don't like how much coverage Burnham gets and how loud his voice is on futher devolution to the regions. They want to devalue him politically.

They’ve literally made this their goal though.

 

[Brwned]

I assume that the UK would have set up a shedload more ICU beds with vents in the last six months, knowing that a second wave was likely in the winter, and ICU / vents being key to survival rates?

Haven't they said that ventilators did more harm than good in the early stages, and the less invasive techniques have led to better outcomes in the majority of patients? Not that ventilators aren't important in some severe cases, but actually one of the factors in improved survival rates and recoveries in general has been figuring out when not to put them on ventilators?

 

[Sparky Rhiwabon]

Haven't they said that ventilators did more harm than good in the early stages, and the less invasive techniques have led to better outcomes in the majority of patients? Not that ventilators aren't important in some severe cases, but actually one of the factors in improved survival rates and recoveries in general has been figuring out when not to put them on ventilators?

I don’t know but I thought that ICUs getting filled up was one of the main worries?

 

[Pogue Mahone]

Tweet

— Twitter API (@user) date

@Wibble

 

[11101]

@11101 Do you have a link for the source of those numbers? I wanted to discussed them in a group, but would need to source them.

https://www.epicentro.iss.it/

Analisi sui decessi is the deaths data, its updated twice weekly.

 

[Brwned]

I don’t know but I thought that ICUs getting filled up was one of the main worries?

Oh yeah definitely, I was just making a side-point / query. I think we stocked up on ventilators and we've probably got more than we need because we're using it in a smaller proportion of serious cases, but we still need the ICU beds. We can't suddenly ramp up the number of ICU doctors so if things really kicked off there's not a whole lot we could do to prepare for that, but that seems unlikely at a national level. Could happen in somewhere like Manchester though.

Tweet

— Twitter API (@user) date

@Wibble

That guy's a bit of a downer. Good info though.

On vaccinations, I think it's reasonable to assume more people would get it than the normal flu jab. 90%+ of people aged 55+ are saying they would take it, albeit a much smaller group (~ 60%) are ready to take it as soon as it's available. Seems there's a fair amount of vaccine hesitancy though. Older people are going to get it because it's a legitimate life saver, so even if they're not sure, they'd be pretty silly not to. Young people feel like it's more of a choice, so only 25% would take it straight away. A similar number are at the other end of the scale, saying they would only take it in exceptional circumstances (e.g. a significant local outbreak). But the majority just want to wait a bit and see if any after-effects develop. So it's definitely possible that vaccination rates could be significantly higher than his baseline...but he has some reason to be pessimistic about adoption rate, never mind effectiveness.

EDIT: Following on that link, I was surprised to read this from the FDA:

In its guidance, FDA said it expected sponsors to demonstrate a vaccine is at least 50% effective in a placebo-controlled trial, with an adjusted lower bound of >30%. (RELATED: FDA issues COVID-19 vaccine guidance, setting 50% effectiveness threshold, Regulatory Focus 30 June 2020).

During a teleconference with the Alliance for a Stronger FDA on Wednesday, Marks explained that the 50% figure is based on what the agency could tolerate for efficacy. “Can we show you some calculation of how we got there? No,” he said, noting that the agency does not typically set specific efficacy targets in its vaccine guidance.

“If you go much lower than 50% then the lower bounds of things start to get to a place where vaccines may have very little efficacy,” Marks added. “On the other hand, if we held that number at 70% to 80% … we may not have a vaccine until there’s herd immunity that’s occurred naturally.”

I pretty much assumed vaccines worked almost all the time. If 70-80% is a stretch then his pessimism makes a bit more sense.

 

[Pogue Mahone]

Oh yeah definitely, I was just making a side-point / query. I think we stocked up on ventilators and we've probably got more than we need because we're using it in a smaller proportion of serious cases, but we still need the ICU beds. We can't suddenly ramp up the number of ICU doctors so if things really kicked off there's not a whole lot we could do to prepare for that, but that seems unlikely at a national level. Could happen in somewhere like Manchester though.



That guy's a bit of a downer. Good info though.

On vaccinations, I think it's reasonable to assume more people would get it than the normal flu jab. 90%+ of people aged 55+ are saying they would take it, albeit a much smaller group (~ 60%) are ready to take it as soon as it's available. Seems there's a fair amount of vaccine hesitancy though. Older people are going to get it because it's a legitimate life saver, so even if they're not sure, they'd be pretty silly not to. Young people feel like it's more of a choice, so only 25% would take it straight away. A similar number are at the other end of the scale, saying they would only take it in exceptional circumstances (e.g. a significant local outbreak). But the majority just want to wait a bit and see if any after-effects develop. So it's definitely possible that vaccination rates could be significantly higher than his baseline...but he has some reason to be pessimistic about adoption rate, never mind effectiveness.

EDIT: Following on that link, I was surprised to read this from the FDA:



I pretty much assumed vaccines worked almost all the time. If 70-80% is a stretch then his pessimism makes a bit more sense.

There’s loads of speculation about uptake but the gist of it confirms what I’ve been telling @Wibble for ages.

Within the next few years we won’t vaccinate everyone (whether through manufacturing/distribution limitations or people refusing vaccination) and the vaccination will only work on a % of people who get the jab (possibly as low as 50%) All of which means it’s completely implausible that we’ll eradicate the virus. It’s going to remain endemic all over the world. Realistically, some sort of immunity due to past exposure to the disease is going to play an important part in keeping transmission rates down (and/or reducing the severity of second and subsequent infections).

Which is going to create a host of really significant challenges for countries that went for an eradication policy and extremely tight border controls to maintain that status. How do you function when the rest of the world is riddled with a highly contagious virus that you’re determined to indefinitely keep outside your country?

Going through these waves is horrible but we can comfort ourselves that a consequence is a population becoming gradually less vulnerable. Ultimately, living with the virus will involve living with the virus. Choosing to keep it at arm’s length might be a poor long-term strategy.

 

[Stack]

.

Which is going to create a host of really significant challenges for countries that went for an eradication policy and extremely tight border controls to maintain that status. How do you function when the rest of the world is riddled with a highly contagious virus that you’re determined to indefinitely keep outside your country and your whole population has no natural immunity?

This is something we are going to have to work out in the next couple of years. I for one think the vaccine roll out will have a slower impact than many are hoping for. For example NZ is lined up to receive an initial vaccine roll out of roughly 1.5 million doses for around 750,000 people but we have a population of 5 million. Thats not nearly enough to provide any sort of meaningful protective layer, its mostly going to possibly help the vulnerable.
So with respect to the speed of improvement to life with a vaccine rollout if from our point of view down here in NZ most other countries experience similar proportions of initial vaccine to population we are surely going to be looking at a number of years before there is any sort of semblance of "normality".
With respect of NZs ability to be isolated with respect to tourism etc I dont think many of us here see it as the worst case scenario, we can cope, we still are doing well as an export nation but the difficulties in overseas travel for us as a country thats citizens like to travel its going to become an issue. Also are right now experiencing issues of not enough foreign seasonal workers with our Fruit and Vege industries as well as Fisheries really struggling. Thats when our exports of food and produce are in more demand than usual.
We have kicked the can down the road but the good news is we have given ourselves time to work out solutions whilst protecting the vulnerable and retaining within our shores a normal way of life. Most of us are happy with that choice but the bad news is I think this is going to drag on for a few years and within 12 months people here are going to be pushing for the ability to open the borders up a lot more.
I have relatives in the UK and Im watching whats going on in Europe and the US and dont think I can imagine the real pressures there. I think my experience and that of other NZers is so far removed from the reality overseas that we are not able to see some things with the context of a bigger picture. Right now Im perfectly happy but I do think in a year or 2 the mood here will be quite different.

 

[Wibble]

There’s loads of speculation about uptake but the gist of it confirms what I’ve been telling @Wibble for ages.

Within the next few years we won’t vaccinate everyone (whether through manufacturing/distribution limitations or people refusing vaccination) and the vaccination will only work on a % of people who get the jab (possibly as low as 50%) All of which means it’s completely implausible that we’ll eradicate the virus. It’s going to remain endemic all over the world. Realistically, some sort of immunity due to past exposure to the disease is going to play an important part in keeping transmission rates down (and/or reducing the severity of second and subsequent infections).

Which is going to create a host of really significant challenges for countries that went for an eradication policy and extremely tight border controls to maintain that status. How do you function when the rest of the world is riddled with a highly contagious virus that you’re determined to indefinitely keep outside your country?

Going through these waves is horrible but we can comfort ourselves that a consequence is a population becoming gradually less vulnerable. Ultimately, living with the virus will involve living with the virus. Choosing to keep it at arm’s length might be a poor long-term strategy.

It will be interesting to.see what happens. The stated plan here is 95% vaccination rate, international borders closed until late 21 or early 22 and all inbound people to be tested/vaccinated/quarantined with badly affected countries like the US/UK possibly banned for longer.

All rather speculative at the moment and given that they have moved away from compulsory vaccination (a shame) 95% is hugely optimistic but a lower rate combined with other measures will hugely improve things. As for returning to normal that is going to take years particularly in Europe and the Americas, but a hugely improved normal should happen sooner if we get a vaccine or vaccines due to its reducing R as it is rolled out.

 

[Sparky Rhiwabon]

There’s loads of speculation about uptake but the gist of it confirms what I’ve been telling @Wibble for ages.

Within the next few years we won’t vaccinate everyone (whether through manufacturing/distribution limitations or people refusing vaccination) and the vaccination will only work on a % of people who get the jab (possibly as low as 50%) All of which means it’s completely implausible that we’ll eradicate the virus. It’s going to remain endemic all over the world. Realistically, some sort of immunity due to past exposure to the disease is going to play an important part in keeping transmission rates down (and/or reducing the severity of second and subsequent infections).

Which is going to create a host of really significant challenges for countries that went for an eradication policy and extremely tight border controls to maintain that status. How do you function when the rest of the world is riddled with a highly contagious virus that you’re determined to indefinitely keep outside your country?

Going through these waves is horrible but we can comfort ourselves that a consequence is a population becoming gradually less vulnerable. Ultimately, living with the virus will involve living with the virus. Choosing to keep it at arm’s length might be a poor long-term strategy.

So, do you think that the UK's strategy is to put measures in place that let as many people get it as possible, but whilst staying just within what the NHS can cope with?

 

[Wolverine]

In the aggregate, a 50% vaccine efficacy would be great in preventing transmission chains and substantially reducing community transmission. I've wondering also how the vaccine even if doesn't prevent a significant number of people catching the infection whether it might still result in a less severe version of the disease clinically which will also help. Although not sure I can cite a precedent for that.

Based on the ridiculous enthusiasm I've seen in a significant number of people regarding flu vaccine (with my patients in clinic citing covid as a reason for them getting the flu vaccine) I think vaccine hesitancy will be a factor if there is a major scandal/scare story around any potential upcoming vaccine that is widely reported (along the MMR wakefield lines) but barring that I think the hesitancy is a internet/comment section thing without too much of an implication in terms of population health.

But we will need to supplement vaccinations in the long run with rapid turnaround diagnostics, still do track and trace. At the moments the sheer volume of cases, community transmission makes containing this thing so difficult, the one challenge will be behavioural fatigue and non-adherence to distancing rules in households but I think the hospitality sector at least should be able to make a come back with their current set ups in place for a while. Not sure about nightclubs and sporting venues though.

 

[Pogue Mahone]

It will be interesting to.see what happens. The stated plan here is 95% vaccination rate, international borders closed until late 21 or early 22 and all inbound people to be tested/vaccinated/quarantined with badly affected countries like the US/UK possibly banned for longer.

All rather speculative at the moment and given that they have moved away from compulsory vaccination (a shame) 95% is hugely optimistic but a lower rate combined with other measures will hugely improve things. As for returning to normal that is going to take years particularly in Europe and the Americas, but a hugely improved normal should happen sooner if we get a vaccine or vaccines due to its reducing R as it is rolled out.

Why “particularly in Europe and America”? If anything, the ongoing spread will see Europe and America come out the other side before countries that are entirely reliant on vaccines for immunity.

It’s annoying the way so many people see this as so binary. You have “let it rip” at one extreme and “zero covid” at the other and there are obvious pros and cons to both approaches. Yet the zealots at either extreme stick their fingers in their ears and go “la la la” whenever anyone tries to mention any upside from an approach that differs to the one they’ve nailed their flag to.

At the end of the day, humans have adapted to novel pathogens like this before. And the way we adapt is by our immune system evolving to cope with the new challenge. And immune systems evolve through exposure to the pathogen. Vaccines will help but they’re only part of the picture. Allowing any country to become 100% reliant on vaccines for all of the immunity in their population is a problem that zero covid extremists don’t want to talk about.

I actually do regret that the whole world didn’t follow NZ/China’s approach and eradicate the virus completely through early, extreme measures. But we are where we are and I don’t see an end game that doesn’t involve huge swathes of people in every country on the planet catching the virus. So I’d rather live in a country that is already a long way down that path than one that hasn’t even started. Even though life in NZ and Aus is undoubtably better than life in Europe right now.

 

[Mickeza]

There’s loads of speculation about uptake but the gist of it confirms what I’ve been telling @Wibble for ages.

Within the next few years we won’t vaccinate everyone (whether through manufacturing/distribution limitations or people refusing vaccination) and the vaccination will only work on a % of people who get the jab (possibly as low as 50%) All of which means it’s completely implausible that we’ll eradicate the virus. It’s going to remain endemic all over the world. Realistically, some sort of immunity due to past exposure to the disease is going to play an important part in keeping transmission rates down (and/or reducing the severity of second and subsequent infections).

Which is going to create a host of really significant challenges for countries that went for an eradication policy and extremely tight border controls to maintain that status. How do you function when the rest of the world is riddled with a highly contagious virus that you’re determined to indefinitely keep outside your country?

Going through these waves is horrible but we can comfort ourselves that a consequence is a population becoming gradually less vulnerable. Ultimately, living with the virus will involve living with the virus. Choosing to keep it at arm’s length might be a poor long-term strategy.

Maybe I’m missing something but I don’t really get this. The estimates are 10% of the population will have had the disease. If and when a vaccine comes in January having an extra 10% that have had it seems rather negligible to us being at a big advantage over a country where only 1% have had it especially considering we still have no idea what immunity with mild/asymptomatic looks like it or how long it lasts. Ultimately it’s here to stay and the strategy for dealing with it is using a vaccine to protect/reduce transmission in as many people as possible who are at risk whilst improving treatments for those who then catch it. Surely that strategy is still the same strategy regardless of whether your initial approach was not to let it in - it isn’t dependent on a proportion of your population having it? I’d have thought the whole eradication thing was just a short to medium-term plan to bide time until a viable vaccine and treatments are available before then switching to the vaccination and treatment strategy. Ultimately even the places where it has taken hold you’re still potentially looking at minimum 90% not having any immunity to this thing.

 

[groovyalbert]

This is something we are going to have to work out in the next couple of years. I for one think the vaccine roll out will have a slower impact than many are hoping for. For example NZ is lined up to receive an initial vaccine roll out of roughly 1.5 million doses for around 750,000 people but we have a population of 5 million. Thats not nearly enough to provide any sort of meaningful protective layer, its mostly going to possibly help the vulnerable.
So with respect to the speed of improvement to life with a vaccine rollout if from our point of view down here in NZ most other countries experience similar proportions of initial vaccine to population we are surely going to be looking at a number of years before there is any sort of semblance of "normality".
With respect of NZs ability to be isolated with respect to tourism etc I dont think many of us here see it as the worst case scenario, we can cope, we still are doing well as an export nation but the difficulties in overseas travel for us as a country thats citizens like to travel its going to become an issue. Also are right now experiencing issues of not enough foreign seasonal workers with our Fruit and Vege industries as well as Fisheries really struggling. Thats when our exports of food and produce are in more demand than usual.
We have kicked the can down the road but the good news is we have given ourselves time to work out solutions whilst protecting the vulnerable and retaining within our shores a normal way of life. Most of us are happy with that choice but the bad news is I think this is going to drag on for a few years and within 12 months people here are going to be pushing for the ability to open the borders up a lot more.
I have relatives in the UK and Im watching whats going on in Europe and the US and dont think I can imagine the real pressures there. I think my experience and that of other NZers is so far removed from the reality overseas that we are not able to see some things with the context of a bigger picture. Right now Im perfectly happy but I do think in a year or 2 the mood here will be quite different.

But surely if you have a vaccine rolled out to those statistically most vulnerable to the worst effects of the virus, the virus itself would have to be reconsidered? Hypothetically, if those 80+ had a vaccine, as did those with the more severe underlying health issues, then you get to a point where the virus is less of a black cloud hanging over society as a whole.

With those groups protected, the risk to overwhelming health services would be drastically lower.

 

[Bebestation]

I'm sorry to ask such a basic question but does England look like it's going for a circuit breaker thing soon?

Doing so maybe the only way they balance out the frustration shown by the individual cities effected whilst at the same time it ends up showing that the parliaments initial decision was wrong.

 

[Wibble]

Why “particularly in Europe and America”? If anything, the ongoing spread will see Europe and America come out the other side before countries that are entirely reliant on vaccines for immunity.

It’s annoying the way so many people see this as so binary. You have “let it rip” at one extreme and “zero covid” at the other and there are obvious pros and cons to both approaches. Yet the zealots at either extreme stick their fingers in their ears and go “la la la” whenever anyone tries to mention any upside from an approach that differs to the one they’ve nailed their flag to.

At the end of the day, humans have adapted to novel pathogens like this before. And the way we adapt is by our immune system evolving to cope with the new challenge. And immune systems evolve through exposure to the pathogen. Vaccines will help but they’re only part of the picture. Allowing any country to become 100% reliant on vaccines for all of the immunity in their population is a problem that zero covid extremists don’t want to talk about.

I actually do regret that the whole world didn’t follow NZ/China’s approach and eradicate the virus completely through early, extreme measures. But we are where we are and I don’t see an end game that doesn’t involve huge swathes of people in every country on the planet catching the virus. So I’d rather live in a country that is already a long way down that path than one that hasn’t even started. Even though life in NZ and Aus is undoubtably better than life in Europe right now.

Because they are in such shit shape now and I'd have no confidence either place could organise a quick vaccination program or persuade large portions of the population to vaccinate. I hope I'm wrong but they have been so bad so far I see no reason to think they will be any better with a vaccine rollout. Assuming places like NZ and Au have a decent vaccine I'd say their relative competency and smaller populations will put them well ahead of the game especially as they are are already opening up without mass spread - NZ isn't far from normal barring international travel. Australia is getting back to normal and I think all state borders will be open by Christmas - hopefully with close to zero local transmission.

 

[Pogue Mahone]

Maybe I’m missing something but I don’t really get this. The estimates are 10% of the population will have had the disease. If and when a vaccine comes in January having an extra 10% that have had it seems rather negligible to us being at a big advantage over a country where only 1% have had it especially considering we still have no idea what immunity with mild/asymptomatic looks like it or how long it lasts. Ultimately it’s here to stay and the strategy for dealing with it is using a vaccine to protect/reduce transmission in as many people as possible who are at risk whilst improving treatments for those who then catch it. Surely that strategy is still the same strategy regardless of whether your initial approach was not to let it in - it isn’t dependent on a proportion of your population having it? I’d have thought the whole eradication thing was just a short to medium-term plan to bide time until a viable vaccine and treatments are available before then switching to the vaccination and treatment strategy. Ultimately even the places where it has taken hold you’re still potentially looking at minimum 90% not having any immunity to this thing.

By the time we’re out the other side of this second wave there will be a hell of a lot more than 10% of people with prior exposure. The US came close to 10% with their first wave. And serological data is likely to be a significant underestimate because we know that antibody levels can drop within weeks (although it’s likely that some degree of immunity persists despite this because we know that’s what happens with other, less dangerous coronaviruses)

Even if we end up with one in four or one in five people having been exposed by the middle of next year (which is far from unlikely) it will augment the effect of a (likely partially effective, partially taken up) vaccine to get community transmission down to a manageable level. It will also be a big help in ensuring that the millions and millions of people who choose not to get vaccinated are less of burden on the health service in the years ahead.

 

[Wibble]

But surely if you have a vaccine rolled out to those statistically most vulnerable to the worst effects of the virus, the virus itself would have to be reconsidered? Hypothetically, if those 80+ had a vaccine, as did those with the more severe underlying health issues, then you get to a point where the virus is less of a black cloud hanging over society as a whole.

With those groups protected, the risk to overwhelming health services would be drastically lower.

It is interesting as modelling has suggested that perhaps targeting working adults (I forget the age range 30-60 ish I think) would be the most beneficial as younger people get it a bit less and suffer far fewer severe cases and because most old people get it from people in that younger demographic yet respond least well to a vaccine. This would allow the economy to keep going and minimise hospital admissions apparently. Of course there are probably models out there that suggest something else but I thought it was interesting.

I suspect we will in fact vaccinate front line workers and people with vulnerabilities for other reason first for obvious reasons.

 

[Stack]

But surely if you have a vaccine rolled out to those statistically most vulnerable to the worst effects of the virus, the virus itself would have to be reconsidered? Hypothetically, if those 80+ had a vaccine, as did those with the more severe underlying health issues, then you get to a point where the virus is less of a black cloud hanging over society as a whole.

With those groups protected, the risk to overwhelming health services would be drastically lower.

Yeah sure. The thing that makes me think its still going to be a slow process is that the vaccine isnt expected till April next year at the earliest and that initial rollout wont be enough to give a wide enough protection to the vulnerable. I think we will need at least 2 million people to have some level of vaccine protection accompanied by all the new mask wearing/hand washing/social distancing behaviours to be comfortable with opening up. Thats going to take further vaccine rollouts, its going to be a staggered situation over the course of a year or 2.
There is no doubt that at some point we will see the entire country having to deal with it, the virus will absolutely sweep through NZ but by that point in time treating of the virus will be improved (we are already seeing that), the vulnerable will be better protected. I just dont see any early get out point.