Summer Solstice Unlockdown

[lpm]

Suggests the main risks of reopening might be long-term illness in the poor and young, rather than hospitals and death for traditional Tory-voting groups.

Again, no. The severity of illness matches the fatality profile - in 2020 the elderly got vastly more ill than the young.

It will be a childhood illness. With 14 million under 18s the tiny percentage of serious illness will add up to a large numerical number. The battle over 19 July is lost - it makes sense to move to a new fight of pressuring the govt to vaccinate 16-17 year olds and then 12-16 if expert agree vaccination is safer than infection.

I suppose immunocompromised people can just keep up isolation forever?

As it's an endemic disease, every unvaccinated person will catch Covid at some point. Say over the next 5 years. Covid will continually be there at a background level and it's when not if for the unvaccinated.

Obviously we can't stay in lockdown measures for years so I'm not sure how we can protect people who genuinely can't be vaccinated. Better treatment in a well resourced NHS? Far more deaths will come in the voluntarily unvaccinated and imperfectly vaccinated categories though.

[Bird on a Fire]

Suggests the main risks of reopening might be long-term illness in the poor and young, rather than hospitals and death for traditional Tory-voting groups.

Again, no. The severity of illness matches the fatality profile - in 2020 the elderly got vastly more ill than the young.

Yes, but most of the elderly are double-jabbed by now, whereas the youngsters have had 0-1 doses (and in many cases probably have greater exposure in work and educational environments).

[bob sterman]

A single dose is fine for young people.

Do we have trials showing long-term acceptable efficacy of single doses of the Pfizer or AstraZeneca in young people???

[Tessa K]

It's more dangerous to be a fully vaccinated 85 year old than an unvaccinated 21 year old.

More dangerous for them as individuals but the 21 year old is far more likely to have mild to no symptoms and be a spreader.

[lpm]

I said a couple of months ago: "There needs to be a forum rule banning any blatant ignoring of the huge age differential for Covid hospitalisations/deaths." I wasn't joking. Everybody seems to forget this basic fact.

I'll try once more then I'll start handing out permabans.

Our natural instinct is to imagine the age bias of Covid as a sloping playing field. It goes steadily upwards so that the risk to the elderly is substantially higher.

It isn't a sloping playing field. It's a cliff face.

I don't know the gradient of the White Cliffs of Dover. Let's assume they are incredibly vertical - they rise to 350 feet and, say, go back only 1 foot.

The Covid age gradient is steeper than this.

An 18 year old on the beach below the cliffs has a very small risk of Covid. They gaze up to an 85 year old at the top of the cliff, 350 feet above them. The risk to the 85 year old towers above, an unimaginable multiple in height.

Anyone who isn't always remembering this basic fact of the cliff face is liable to talk nonsense. Factors like "youngsters probably have greater exposure in work and educational environments" are like the 18 year old at the foot of the White Cliffs of Dover raising their risk by standing on a shoebox.

[Bird on a Fire]

We're not just talking about hospitalisations/deaths, though.

[FlammableFlower]

Amusingly, last week the local Director of Public Health has been leaning on my institution to cancel it's planned (strictly low number and socially distanced) graduation ceremonies which were planned to start on the 19th July; apparently the reasoning was the steep rise in cases in the local area and the fear of an influx of people bringing more cases to the ceremonies. It was very much along the lines of "we're not telling you to do this... but..."

The uni finally conceded to do so last Friday.

However, this firmly flies in the face of the government's "everything goes from 19th July". It also is weird considering this is a very tourist-focussed city, so if we are having a major unlockdown, then there will be a big increase in people and exposure anyway. The additional numbers at the many, smaller, ceremonies that had been planned to happen across two weeks would be tiny in comparison.

[lpm]

We're not just talking about hospitalisations/deaths, though.

Would you like to try and define what we are talking about?

Nobody seems to know any more.

It was clear in March 2020 - we needed to lockdown to prevent hospitalisations and deaths. It was clear in October 2020 - we needed to lockdown to prevent hospitalisations and deaths. It was clear in December 2020 - we needed to lockdown to prevent hospitalisations and deaths.

Are you saying there's now a new reason to lockdown?

[lpm]

This is the kind of stupidity that has infected Twitter in recent weeks - lockdown is needed because the alternative is PEOPLE UNABLE TO FINISH A BOTTLE OF BEER.

[tom p]

You seem to forget that every adult in the UK has been vaccinated, or has an appointment for a vaccine this week, or has not yet responded to offers of a vaccine, or has refused a vaccination.

There's no point in regurgitating sentences that would have been all valid points in April 2020 and thinking they are valid points in July 2021.

You seem to forget that, despite this, the Delta variant is spreading rapidly through the population.
There's no point in regurgitating sentences that would have been all valid points in March 2021 and thinking they are valid points in July 2021.

[Bird on a Fire]

We're not just talking about hospitalisations/deaths, though.

Would you like to try and define what we are talking about?

Nobody seems to know any more.

It was clear in March 2020 - we needed to lockdown to prevent hospitalisations and deaths. It was clear in October 2020 - we needed to lockdown to prevent hospitalisations and deaths. It was clear in December 2020 - we needed to lockdown to prevent hospitalisations and deaths.

Are you saying there's now a new reason to lockdown?

Well for example, I was talking about "the main risks of reopening" and suggested that they "might be long-term illness in the poor and young, rather than hospitals and death for traditional Tory-voting groups":

Suggests the main risks of reopening might be long-term illness in the poor and young, rather than hospitals and death for traditional Tory-voting groups.

You replied with "No," so I assume you think the main risk is still hospitalisation and death of the elderly?

That level of risk (per 100,000 affected) is certainly far lower than the pre-vaccine risk of serious illness in the elderly, and may well be worth taking (not that many young people will have the choice). While a large chunk of the population is still unvaccinated it would make sense to me to continue with basic precautions like indoor masks and distancing, even if economic activity is largely allowed to resume, because the costs of doing it are so low and long covid is nasty.

[tom p]

Just to say, I'm not talking about some form of complete lockdown. I'm suggesting only making facemasks on public transport mandatory for a bit longer. The sort of place where a single thoughtless a..eh.le can infect vast numbers of people, that's all.
I can't see any logical reason for not doing that.

[Bird on a Fire]

This is the kind of stupidity that has infected Twitter in recent weeks - lockdown is needed because the alternative is PEOPLE UNABLE TO FINISH A BOTTLE OF BEER.

I don't think he's suggesting that being unable to finish a beer is his only symptom, but if someone is too "flattened" to drink 330ml of liquid in 2 hours that does suggest they're a bit ill (unless he just doesn't like Peroni, which would be fair enough). And I also can't see where he says lockdown is needed.

To me it just looks like he's saying even vaccinated people can get a nasty illness from covid, which is fair enough, but one of us must be stupidly misinterpreting it.

[lpm]

We're not just talking about hospitalisations/deaths, though.

Would you like to try and define what we are talking about?

Nobody seems to know any more.

It was clear in March 2020 - we needed to lockdown to prevent hospitalisations and deaths. It was clear in October 2020 - we needed to lockdown to prevent hospitalisations and deaths. It was clear in December 2020 - we needed to lockdown to prevent hospitalisations and deaths.

Are you saying there's now a new reason to lockdown?

Well for example, I was talking about "the main risks of reopening" and suggested that they "might be long-term illness in the poor and young, rather than hospitals and death for traditional Tory-voting groups":

Suggests the main risks of reopening might be long-term illness in the poor and young, rather than hospitals and death for traditional Tory-voting groups.

You replied with "No," so I assume you think the main risk is still hospitalisation and death of the elderly?

That level of risk (per 100,000 affected) is certainly far lower than the pre-vaccine risk of serious illness in the elderly, and may well be worth taking (not that many young people will have the choice). While a large chunk of the population is still unvaccinated it would make sense to me to continue with basic precautions like indoor masks and distancing, even if economic activity is largely allowed to resume, because the costs of doing it are so low and long covid is nasty.

This is hopelessly confused and vague.

Try again.

It's obvious the main risk is still hospitalisation and death of the elderly, both vaccinated and unvaccinated. What else is it that you are worried about? High case numbers meaning that Plague Island Brits are banned from going for their annual sunburning in the Med? Lots of children getting mild symptoms? A small number of children getting Long Covid? Loads of potential for new variants?

Spell out your worries.

[lpm]

This is the kind of stupidity that has infected Twitter in recent weeks - lockdown is needed because the alternative is PEOPLE UNABLE TO FINISH A BOTTLE OF BEER.

I don't think he's suggesting that being unable to finish a beer is his only symptom, but if someone is too "flattened" to drink 330ml of liquid in 2 hours that does suggest they're a bit ill (unless he just doesn't like Peroni, which would be fair enough). And I also can't see where he says lockdown is needed.

To me it just looks like he's saying even vaccinated people can get a nasty illness from covid, which is fair enough, but one of us must be stupidly misinterpreting it.

"People get ill sometimes" is not earth shattering news.

If society has a duty to prevent people from getting ill, locking down tobacco and alcohol will have a vastly higher benefit than locking down Covid.

Whatever we do, over 3 million unvaccinated adults will catch Covid at some point in the next 5 years because the vaccination level is never plausibly going to beat 95%. And there's maybe 10 million children as well, assuming the experts decide against vaccinating <18s. There's going to be a hell of a lot of mild "can't even finish a bottle of beer" illness, plus similar levels of illness from colds, food poisoning and flu.

[Bird on a Fire]

Well speaking as a fairly healthy but unvaccinated 30yo I'm certainly in no hurry to cram myself into an unventilated space with loads of other unvaccinated and partly vaccinated people while delta is on the rise. I like finishing bottles of beer.

Like Tom I think the "let's take zero precautions" announcement is a few weeks premature. Why not wait for better vaccine coverage (full doses for everyone eligible)?

[tom p]

Would you like to try and define what we are talking about?

Nobody seems to know any more.

It was clear in March 2020 - we needed to lockdown to prevent hospitalisations and deaths. It was clear in October 2020 - we needed to lockdown to prevent hospitalisations and deaths. It was clear in December 2020 - we needed to lockdown to prevent hospitalisations and deaths.

Are you saying there's now a new reason to lockdown?

Well for example, I was talking about "the main risks of reopening" and suggested that they "might be long-term illness in the poor and young, rather than hospitals and death for traditional Tory-voting groups":

Suggests the main risks of reopening might be long-term illness in the poor and young, rather than hospitals and death for traditional Tory-voting groups.

You replied with "No," so I assume you think the main risk is still hospitalisation and death of the elderly?

That level of risk (per 100,000 affected) is certainly far lower than the pre-vaccine risk of serious illness in the elderly, and may well be worth taking (not that many young people will have the choice). While a large chunk of the population is still unvaccinated it would make sense to me to continue with basic precautions like indoor masks and distancing, even if economic activity is largely allowed to resume, because the costs of doing it are so low and long covid is nasty.

This is hopelessly confused and vague.

Try again.

It's obvious the main risk is still hospitalisation and death of the elderly, both vaccinated and unvaccinated. What else is it that you are worried about? High case numbers meaning that Plague Island Brits are banned from going for their annual sunburning in the Med? Lots of children getting mild symptoms? A small number of children getting Long Covid? Loads of potential for new variants?

Spell out your worries.

2 key concerns with a complete removal of all restrictions right now:
1. There were vast numbers of people (my wife among them) who should have gone to hospital during the first wave; but the hospitals were full. Some died at home, others (such as my wife) luckily pulled through.
Being vaccinated seems to lessen the severity of the disease, even with the delta variant. That's good; but at the same time it may well lead to vast numbers of people who would have died merely ending up in hospital and overwhelming the health systems again.
2. Case numbers are rising rapidly. When there's rapid case number rises, that means massive amounts of viral replication, which inevitably will lead to another variant. Will it be epsilon or theta that completely defeats the vaccines? One greek letter will bear horrible gifts, and we should beware it.

Minor, sensible, measures, such as enforcing masks on public transport, seem a no-brainer to me. It's no different to banning smoking in enclosed public(ish) places - your risk-reward calculation rubs up against mine, his, hers & the lass over there who is working here. Your desire to smoke/not wear a mask doesn't trump our desire not to get cancer/COVID.

[tom p]

This is the kind of stupidity that has infected Twitter in recent weeks - lockdown is needed because the alternative is PEOPLE UNABLE TO FINISH A BOTTLE OF BEER.

I don't think he's suggesting that being unable to finish a beer is his only symptom, but if someone is too "flattened" to drink 330ml of liquid in 2 hours that does suggest they're a bit ill (unless he just doesn't like Peroni, which would be fair enough). And I also can't see where he says lockdown is needed.

To me it just looks like he's saying even vaccinated people can get a nasty illness from covid, which is fair enough, but one of us must be stupidly misinterpreting it.

"People get ill sometimes" is not earth shattering news.

If society has a duty to prevent people from getting ill, locking down tobacco and alcohol will have a vastly higher benefit than locking down Covid.

Whatever we do, over 3 million unvaccinated adults will catch Covid at some point in the next 5 years because the vaccination level is never plausibly going to beat 95%. And there's maybe 10 million children as well, assuming the experts decide against vaccinating <18s. There's going to be a hell of a lot of mild "can't even finish a bottle of beer" illness, plus similar levels of illness from colds, food poisoning and flu.

And, as birdy rightly pointed out, being too weak to finish a bottle of beer is hardly mild.
There are vast numbers of people who are close to or actually bed-bound for a long time when they catch COVID. For very many it's a good few months of their lives gone. Spouses have to take time off to care for them. Children suffer a mental toll.
There's a good argument for allowing almost anything in the open air, especially in the summer (even a british summer), but we don't have to end everything all at once just because the Saj is back & Johnson wants to look jolly again.

[Woodchopper]

I said a couple of months ago: "There needs to be a forum rule banning any blatant ignoring of the huge age differential for Covid hospitalisations/deaths." I wasn't joking. Everybody seems to forget this basic fact.

I'll try once more then I'll start handing out permabans.

Our natural instinct is to imagine the age bias of Covid as a sloping playing field. It goes steadily upwards so that the risk to the elderly is substantially higher.

It isn't a sloping playing field. It's a cliff face.

I don't know the gradient of the White Cliffs of Dover. Let's assume they are incredibly vertical - they rise to 350 feet and, say, go back only 1 foot.

The Covid age gradient is steeper than this.

An 18 year old on the beach below the cliffs has a very small risk of Covid. They gaze up to an 85 year old at the top of the cliff, 350 feet above them. The risk to the 85 year old towers above, an unimaginable multiple in height.

Anyone who isn't always remembering this basic fact of the cliff face is liable to talk nonsense. Factors like "youngsters probably have greater exposure in work and educational environments" are like the 18 year old at the foot of the White Cliffs of Dover raising their risk by standing on a shoebox.

Here's an illustration of the cliff face that was.

Here's the IFR (infection fatality ratio) estimates from here.

4 January shows infections rising slowly and then hitting the cliff of the 0ver 75s.

4 Jan IFR.jpg (95.92 KiB) Viewed 2030 times

And here are the estimates from 25 June now that the older members of the population have been vaccinated.

25 June IFR.jpg (67.17 KiB) Viewed 2030 times

The question now is whether its desirable or politically feasible to have society wide restrictions to prevent the deaths of 2.1% of over 75s and .46% of 65-74 year olds.

Whatever the answer I would still advise anyone over 75 to be careful. The odds of survival are far greater, but still, 2.1% is a lot higher than many things we do take precautions to avoid.

[El Pollo Diablo]

Obviously it depends what percentage of each cohort can or will get infected at this point. But using those IFRs and population levels suggests a maximum of 178,000 people could still be killed by Covid. 2.1% of over 75s is 120,000 people. 0.46% of 65-74 year olds is 31,000 people. 0.13% of 45-64 year olds is 22,500 people.

I should say, as a single vaxer (so far) who had Covid, it's really not nice. I ended up with breathing difficulties and chest pains and got tested at hospital (thankfully everything was fine). If I was very overweight or diabetic or asthmatic or immunocompromised, I could've been in a lot more trouble.

[bob sterman]

lpm says...

People who generally exercise good judgement will exercise good judgement.

People who often don't exercise good judgement will not exercise good judgement.

You are kind of right that it's the cautious who survive. There will be a vast difference in death rates between the vaccinated majority and the small number of vaccine refusers. A modest amount of caution by us vaccinated people - masks, not cramming into a tube, avoiding a noisy indoor nightclub - is more than sufficient to protect ourselves. The same level of caution for the unvaccinated is nothing like enough.

In contrast, Dr Peter English, previously Chair of the British Medical Authority’s Public Health Medicine Committee says...

It is not a huge imposition to require mask-wearing in high-risk settings such as crowded, poorly ventilated public spaces such as public transport, and while case numbers remain high, this must continue.

Allowing people to make their own choices on this is, effectively, handing control of the safety of such spaces over to the least informed, least caring and indeed the most callous members of society.

Government ministers who have declared that they will not show consideration to vulnerable people by wearing a mask – and thereby encouraged others in this approach – have been hugely irresponsible, and shown a gross failure of leadership.

https://inews.co.uk/news/science/face-m ... ce-1087529

[Trinucleus]

I said a couple of months ago: "There needs to be a forum rule banning any blatant ignoring of the huge age differential for Covid hospitalisations/deaths." I wasn't joking. Everybody seems to forget this basic fact.

I'll try once more then I'll start handing out permabans.

Our natural instinct is to imagine the age bias of Covid as a sloping playing field. It goes steadily upwards so that the risk to the elderly is substantially higher.

It isn't a sloping playing field. It's a cliff face.

I don't know the gradient of the White Cliffs of Dover. Let's assume they are incredibly vertical - they rise to 350 feet and, say, go back only 1 foot.

The Covid age gradient is steeper than this.

An 18 year old on the beach below the cliffs has a very small risk of Covid. They gaze up to an 85 year old at the top of the cliff, 350 feet above them. The risk to the 85 year old towers above, an unimaginable multiple in height.

Anyone who isn't always remembering this basic fact of the cliff face is liable to talk nonsense. Factors like "youngsters probably have greater exposure in work and educational environments" are like the 18 year old at the foot of the White Cliffs of Dover raising their risk by standing on a shoebox.

Here's an illustration of the cliff face that was.

Here's the IFR (infection fatality ratio) estimates from here.

4 January shows infections rising slowly and then hitting the cliff of the 0ver 75s.

4 Jan IFR.jpg

And here are the estimates from 25 June now that the older members of the population have been vaccinated.

25 June IFR.jpg

The question now is whether its desirable or politically feasible to have society wide restrictions to prevent the deaths of 2.1% of over 75s and .46% of 65-74 year olds.

Whatever the answer I would still advise anyone over 75 to be careful. The odds of survival are far greater, but still, 2.1% is a lot higher than many things we do take precautions to avoid.

Yes but..... Boris says "If not now, when" which must be the clinching public health arguement

[WFJ]

In contrast, Dr Peter English, previously Chair of the British Medical Authority’s Public Health Medicine Committee says...

Government ministers who have declared that they will not show consideration to vulnerable people by wearing a mask – and thereby encouraged others in this approach – have been hugely irresponsible, and shown a gross failure of leadership.

This is just another part of the culture wars the Tories are trying to import over from the US. They are free thinkers who stand up for individual liberty. Unlike those nasty cancel culture controlling lefties.

[Herainestold]

I was talking with a friend a few days ago and we said that we'd carry on wearing a mask on public transport and in shops even though we've both been double-vaxxed, based on our own research, so it's interesting to hear the BMA say the same thing.

I dont even pay attention to the recommendations anymore. I double mask everywhere, shop at non peak hours, avoid the tube, crowds, pubs.
I have read a lot of memoirs of people who have survived the War, holocaust, killing fields etc. It is the cautious who survive.

How do *you* double-mask?
Are you actually putting on two face-masks?

Medical mask underneath a cloth face mask as recommended by CDC and the Indian authorities

According to recently provided guidance on masking based on two experiments, scientists found that wearing a cloth mask over a medical procedure mask was shown to substantially improve protection against exposure and transmission of the virus by about 95 per cent. The guidelines instructed that the outer cloth mask should push the edges of the surgical mask against your face and fit well on the face, preventing exposure to aerosols made by coughing and breathing. However, the study discourages the doubling of surgical mask over surgical mask, cloth on cloth or surgical mask over an N95 mask.

Sometimes I wear a plastic face visor over everything.

https://www.msn.com/en-xl/africa/other/ ... ar-AALCcSn

[bob sterman]

I double-masked once. Was wearing a KN95/FFP2 mask from Ebay. A cheap one that doesn't really seal that well around the face (not like a serious FFP3 mask).

Visiting a hospital the receptionist said that my own mask wasn't good enough and I had to wear one of their loose fitting blue surgical masks - so rather than take mine off I put theirs over the top.

It really seemed to improve the seal - and breathing felt more effectively filtered (couldn't feel drafts coming in and out the sides).

Like Biden here (although his first mask is probably a proper FFP3). The article posted above by Herainestold says the CDC recommend not putting a surgical mask over a KN95 - but Joe did it so I thought I'd give it a try!

2303.jpg (27.14 KiB) Viewed 1925 times