COVID-19

Discussions about serious topics, for serious people
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headshot
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Re: COVID-19

Post by headshot » Sat Oct 16, 2021 11:18 am

bob sterman wrote:
Sat Oct 16, 2021 11:17 am
headshot wrote:
Sat Oct 16, 2021 10:18 am
Anecdata: My theatre company cancelled its 2020 output on March 13th 2020, two weeks before the first UK lockdown. That's the same day my wife formally requested to work from home too.
Bigger Anecdata: On March 13th, many UK universities announced plans to stop face-to-face teaching - and then actually stopped face-to-face teaching around March 16/17/18

E.g. UCL, Southampton, Sheffield, Liverpool on the 16th. Newcastle on the 17th, Manchester on the 18th.

And prior to this attendance at lectures had already started to dwindle - following the March 13th announcements.
Frau HS works at a university and she was the first to ask for home working because she has chronic asthma. The uni followed suit by the end of the following week, so yeah...

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Re: COVID-19

Post by OffTheRock » Sat Oct 16, 2021 2:28 pm

headshot wrote:
Sat Oct 16, 2021 11:18 am
bob sterman wrote:
Sat Oct 16, 2021 11:17 am
headshot wrote:
Sat Oct 16, 2021 10:18 am
Anecdata: My theatre company cancelled its 2020 output on March 13th 2020, two weeks before the first UK lockdown. That's the same day my wife formally requested to work from home too.
Bigger Anecdata: On March 13th, many UK universities announced plans to stop face-to-face teaching - and then actually stopped face-to-face teaching around March 16/17/18

E.g. UCL, Southampton, Sheffield, Liverpool on the 16th. Newcastle on the 17th, Manchester on the 18th.

And prior to this attendance at lectures had already started to dwindle - following the March 13th announcements.
Frau HS works at a university and she was the first to ask for home working because she has chronic asthma. The uni followed suit by the end of the following week, so yeah...
I’ve got colleagues with partners in the Met office. They were already preparing to get as many people as possible working from home the week before lockdown. I think they were aiming for getting everyone at home by 18th March, which turned out to be the day they announced the school closures. Although school attendance down here was around 50% by that point.

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Re: COVID-19

Post by sheldrake » Sat Oct 16, 2021 4:40 pm

headshot wrote:
Sat Oct 16, 2021 10:44 am
Mmm, because it's a well-known fact that children never mix with vulnerable adults when asymptomatically carrying a potentially deadly virus that has killed millions world-wide.
It's easier to isolate the vulnerable adults than all of the children

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Re: COVID-19

Post by plodder » Sat Oct 16, 2021 6:53 pm

yeah but vulnerable adults don’t typically spend several hours a day playing tig with hundreds of other vulnerable adults

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Re: COVID-19

Post by Bird on a Fire » Sat Oct 16, 2021 7:52 pm

Yes. The asymptomatic and very high transmission change the equation a bit from things like flu. Basically everyone a few years retired is vulnerable, which is a lot of folk, many of whom depend on younger folk for care, or live with them.

So people like GPs who work in close quarters with vulnerable people can't risk exposure. Which means other arrangements need to be made to inspect patients thoroughly - one of the reasons for locking down hard was to prevent overwhelming the healthcare system. The need to isolate personnel as much as possible made capacity much lower than usual, and there was no flab in the system.

I could easily believe there were huge problems accessing NHS services during the pandemic. While I think they generally did an excellent job, I know they'll already have been poring over mistakes and trying to see what lessons could be learned, and I don't see why we shouldn't speculate a bit to.

But I'm not sure the best solution to improve access to GPs would have been even less lockdown than the UK did, which was low by European standards. (I got weekly updates on family Skype, and was shocked at how lax it all was).
We have the right to a clean, healthy, sustainable environment.

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Re: COVID-19

Post by sheldrake » Sat Oct 16, 2021 8:10 pm

plodder wrote:
Sat Oct 16, 2021 6:53 pm
yeah but vulnerable adults don’t typically spend several hours a day playing tig with hundreds of other vulnerable adults
Indeed they don't. They can also have food delivered by people wearing PPE if needed, without trying to squeeze through the front door to play french cricket with their mate when his BMX rolls past.

Obviously this is a serious life or death matter, but locking up the children for months on end, amongst all the other things, is an extraordinary step to take for a risk that's a bit less severe than the lifetime risk Americans face from road accidents

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Re: COVID-19

Post by bob sterman » Sat Oct 16, 2021 8:37 pm

sheldrake wrote:
Sat Oct 16, 2021 8:10 pm
plodder wrote:
Sat Oct 16, 2021 6:53 pm
yeah but vulnerable adults don’t typically spend several hours a day playing tig with hundreds of other vulnerable adults
Indeed they don't. They can also have food delivered by people wearing PPE if needed, without trying to squeeze through the front door to play french cricket with their mate when his BMX rolls past.

Obviously this is a serious life or death matter, but locking up the children for months on end, amongst all the other things, is an extraordinary step to take for a risk that's a bit less severe than the lifetime risk Americans face from road accidents
Many of those vulnerable people also need washing, dressing, medication etc etc. Not just a Deliveroo visit.

A bit of UK context is needed...

In the UK children were not "locked up" for months on end. During the first "lockdown" in England Primary school children generally missed 2 weeks of school in late March / early April before the Easter holidays. Then 5 weeks of school after Easter before they started a phased return in early June. From early May kids were out playing in parks etc with few restrictions.

In the UK we have about 1750 road fatalities per year. In January 2021 the second wave of COVID deaths peaked with 1,414 deaths in a single day (that's deaths with COVID on the death certificate).

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Re: COVID-19

Post by sheldrake » Sat Oct 16, 2021 8:53 pm

bob sterman wrote:
Sat Oct 16, 2021 8:37 pm
sheldrake wrote:
Sat Oct 16, 2021 8:10 pm
plodder wrote:
Sat Oct 16, 2021 6:53 pm
yeah but vulnerable adults don’t typically spend several hours a day playing tig with hundreds of other vulnerable adults
Indeed they don't. They can also have food delivered by people wearing PPE if needed, without trying to squeeze through the front door to play french cricket with their mate when his BMX rolls past.

Obviously this is a serious life or death matter, but locking up the children for months on end, amongst all the other things, is an extraordinary step to take for a risk that's a bit less severe than the lifetime risk Americans face from road accidents
Many of those vulnerable people also need washing, dressing, medication etc etc. Not just a Deliveroo visit.

A bit of UK context is needed...

In the UK children were not "locked up" for months on end. During the first "lockdown" in England Primary school children generally missed 2 weeks of school in late March / early April before the Easter holidays. Then 5 weeks of school after Easter before they started a phased return in early June. From early May kids were out playing in parks etc with few restrictions.

In the UK we have about 1750 road fatalities per year. In January 2021 the second wave of COVID deaths peaked with 1,414 deaths in a single day (that's deaths with COVID on the death certificate).
Covid is an acute risk (i.e its expressed over a short space of time) but your risk of dying from Covid if you catch it unvaccinated is lower than your lifetime risk of dying in a road accident in the US

Eta: and your risk of dying from covid the first time you catch it unvaxxed is a decent proxy for your lifetime risk due to the strength of natural immunity and its relatively low mutation rate. People find acute and chronic risks unintuitive to compre, which is something the financial services industry exploits all the time

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Re: COVID-19

Post by bob sterman » Sat Oct 16, 2021 9:08 pm

sheldrake wrote:
Sat Oct 16, 2021 8:53 pm
Covid is an acute risk (i.e its expressed over a short space of time) but your risk of dying from Covid if you catch it unvaccinated is lower than your lifetime risk of dying in a road accident in the US
If you're a 60 year old male facing an IFR of about 1% if you catch COVID unvaccinated - I'm not sure how much reassurance you'd get by comparing it to the risk of dying in a road accident during the previous 60 years when you didn't die in a road accident.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7721859/
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Re: COVID-19

Post by sheldrake » Sat Oct 16, 2021 9:11 pm

bob sterman wrote:
Sat Oct 16, 2021 9:08 pm
sheldrake wrote:
Sat Oct 16, 2021 8:53 pm
Covid is an acute risk (i.e its expressed over a short space of time) but your risk of dying from Covid if you catch it unvaccinated is lower than your lifetime risk of dying in a road accident in the US
If you're a 60 year old male facing an IFR of about 1% if you catch COVID unvaccinated - I'm not sure how much reassurance you'd get by comparing it to the risk of dying in a road accident during the previous 60 years when you didn't die in a road accident.
Sorry I wasn't clear, when I talk about IFR I mean the average IFR for the population. Risk of dying in an auto-accident is about 1 in 103 in the US, but it's a chronic rather than acute risk so people find the idea that it's actually a larger risk counterintuitive. Ofc, Media coverage has an enormous impact on perception here.

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Re: COVID-19

Post by Woodchopper » Sat Oct 16, 2021 9:45 pm

sheldrake wrote:
Sat Oct 16, 2021 9:11 pm
bob sterman wrote:
Sat Oct 16, 2021 9:08 pm
sheldrake wrote:
Sat Oct 16, 2021 8:53 pm
Covid is an acute risk (i.e its expressed over a short space of time) but your risk of dying from Covid if you catch it unvaccinated is lower than your lifetime risk of dying in a road accident in the US
If you're a 60 year old male facing an IFR of about 1% if you catch COVID unvaccinated - I'm not sure how much reassurance you'd get by comparing it to the risk of dying in a road accident during the previous 60 years when you didn't die in a road accident.
Sorry I wasn't clear, when I talk about IFR I mean the average IFR for the population. Risk of dying in an auto-accident is about 1 in 103 in the US, but it's a chronic rather than acute risk so people find the idea that it's actually a larger risk counterintuitive. Ofc, Media coverage has an enormous impact on perception here.
You seem to be mixing two things up.

The lifetime odds of dying in a car accident in the US is one in 107. Whereas the odds of dying in one during 2019 was one in 8393.
Source: https://injuryfacts.nsc.org/all-injurie ... a-details/

You need to compare the odds of dying of Covid in 2020 or 2021 to the odds of dying in a car accident in a single year - ie about one in 8393.

No one knows the lifetime odds of dying of Covid.

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Re: COVID-19

Post by bob sterman » Sat Oct 16, 2021 9:48 pm

sheldrake wrote:
Sat Oct 16, 2021 9:11 pm
Sorry I wasn't clear, when I talk about IFR I mean the average IFR for the population. Risk of dying in an auto-accident is about 1 in 103 in the US, but it's a chronic rather than acute risk so people find the idea that it's actually a larger risk counterintuitive. Ofc, Media coverage has an enormous impact on perception here.
Well that's not the case in the UK - here the lifetime risk of dying on the road is closer to 1 in 500 (0.2%). The average IFR for COVID in the UK prior to vaccination was at least double this. Both substantially higher than the chances of John Ioannidis writing a new article about COVID and him not including a comparison with the risks associated with driving in the US.

I knew what you meant - but the example I gave was to show that the concept of the "lifetime risk" of something is not so important to people who've already successfully avoided that thing for many years.

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Re: COVID-19

Post by sheldrake » Sat Oct 16, 2021 9:56 pm

Woodchopper wrote:
Sat Oct 16, 2021 9:45 pm

You need to compare the odds of dying of Covid in 2020 or 2021 to the odds of dying in a car accident in a single year - ie about one in 8393.

No one knows the lifetime odds of dying of Covid.
Your immunity the first time you survive it is extremely strong (much lower chance of reinfection and massively reduced risk of needing hospitalization if you are reinfected)

https://jamanetwork.com/journals/jamain ... le/2780557

and likely to be as durable as that for measles.

https://pubmed.ncbi.nlm.nih.gov/33064680/

I still think that the right comparison is IFR as a proxy for lifetime risk in the unvaccinated.

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Re: COVID-19

Post by sheldrake » Sat Oct 16, 2021 9:58 pm

I knew what you meant - but the example I gave was to show that the concept of the "lifetime risk" of something is not so important to people who've already successfully avoided that thing for many years.
I do understand that's people's perception, but people are mislead in their assessment of risk by this psychological mechanism all the time, it's how they're missold pointless types of insurance.

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Re: COVID-19

Post by Woodchopper » Sat Oct 16, 2021 9:58 pm

sheldrake wrote:
Sat Oct 16, 2021 9:56 pm
Woodchopper wrote:
Sat Oct 16, 2021 9:45 pm

You need to compare the odds of dying of Covid in 2020 or 2021 to the odds of dying in a car accident in a single year - ie about one in 8393.

No one knows the lifetime odds of dying of Covid.
Your immunity the first time you survive it is extremely strong (much lower chance of reinfection and massively reduced risk of needing hospitalization if you are reinfected)

https://jamanetwork.com/journals/jamain ... le/2780557

and likely to be as durable as that for measles.

https://pubmed.ncbi.nlm.nih.gov/33064680/

I still think that the right comparison is IFR as a proxy for lifetime risk in the unvaccinated.
Only by making enormous assumptions.

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Re: COVID-19

Post by sheldrake » Sat Oct 16, 2021 10:04 pm

Woodchopper wrote:
Sat Oct 16, 2021 9:58 pm

Only by making enormous assumptions.
What enormous assumptions? We have good data on reinfection rates for those who've previously survived Covid and have studied the disease's mutation rate.

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Re: COVID-19

Post by Millennie Al » Sun Oct 17, 2021 3:02 am

sheldrake wrote:
Fri Oct 15, 2021 4:06 pm
My contention is that the measures employed in the UK were stricter than they needed to be
The number of deaths shows that the measures were inadequete, not excessive. The first lockdown was too late, letting so many people get infected that test, trace, and quarantine efforts were unable to cope. The initial restrictions on entering the country were inadequate, letting many more infectious people in to spread the disease. As an island (well, a set of islands) we should have done far better than neighbouring countries.

To have got this wrong at the time was bad enough, but you have the benefit of hindsight, so there's no excuse.

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Re: COVID-19

Post by mediocrity511 » Mon Oct 18, 2021 12:32 pm

It clearly isn't just the SW that have had dodgy PCR tests. It turns out mine a couple of weeks back was and I'm in the East Midlands.

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Re: COVID-19

Post by jimbob » Mon Oct 18, 2021 1:22 pm

sheldrake wrote:
Wed Oct 13, 2021 7:19 pm
bob sterman wrote:
Wed Oct 13, 2021 7:17 pm
This may sound reassuring to a certain extent - but you have to bear in mind that triage, admission and discharge practices were and are dynamic - changing as hospitals start to get close to full occupancy.

So when a hospital is getting close to full occupancy - you can be sure that some patients are not being admitted that would be admitted during more normal times. While others are being discharged early (notoriously into care homes).
I haven't yet seen good evidence that hospital admissions were abnormal against a background of 20 years or more, but I absolutely agree with you about the disaster of discharging into care homes. People should be held accountable for that.
Have you actually looked?

https://www.gov.uk/government/statistic ... ce-reports

and look at the 2021-22 report for flu ICU admissions. fig 45 of the wk 41 report.


0.88/100k is very high

then compare to COVID and flu ICU admissions which peak at about 2.5/100k
Screenshot 2021-10-18 141832.png
Screenshot 2021-10-18 141832.png (148.76 KiB) Viewed 3044 times
Screenshot 2021-10-18 141802.png
Screenshot 2021-10-18 141802.png (248 KiB) Viewed 3044 times
You can look through and see that indeed it is very high
Have you considered stupidity as an explanation

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Re: COVID-19

Post by jimbob » Mon Oct 18, 2021 1:31 pm

shpalman wrote:
Thu Oct 14, 2021 11:30 am
sheldrake wrote:
Wed Oct 13, 2021 10:33 pm
shpalman wrote:
Wed Oct 13, 2021 10:10 pm
So for example the worst week in the first wave was that of the 17th of April in which there were 21144 deaths when normally about 10000 would have been expected; only about 8000 were even attributed to covid on the death certificate, but there were only about 5000 deaths per week in the covid stats just because someone won't count as a covid death unless they tested positive for covid, and the testing capacity just wasn't there yet. So yeah some of those tens of thousands of deaths might have been avoided by locking down earlier.
1) 'Excess deaths' depend on what you take as a 'normal' level of deaths. Previous 5 years we had unusually low age-adjusted mortality compared to the norms going back to 1990. You can't assume that all, or even most, deaths above the previous 5-year average were really the result of untested Covid.


Do you have week-by-week data going back to 1990 showing how it was 'normal' for 20,000 people to die per week at the beginning of April only as compared to more like 10,000 per week the rest of the year?
sheldrake wrote:
Wed Oct 13, 2021 10:33 pm
2) Deaths that occur even when somebody tests positive to Covid aren't necessarily primarily caused by Covid. I think the cause of admission to hospital (e.g. admitted for Covid, or unknown respiratory) would be the best thing to look at, don't know if it's possible to dig that out.
Well, there's whether or not covid was mentioned on the death certificate. But you can't really go by hospital admissions either, since in the first wave older people quickly went from "seem to be doing fine" to "too late to do anything" and there wasn't really considered much point in taking them to hospital. Doctors didn't really know what to do except prone intubation and older patients were considered not strong enough to survive it. Survival rates in intensive care were about 50% at that stage. They've since developed better protocols and with fewer patients being admitted have the chance to actually apply them.
No but I have data for all cause deaths for England and Wales going back to wk31 1999 showing how it was completely abnormal to then.


Image
Have you considered stupidity as an explanation

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Re: COVID-19

Post by jimbob » Mon Oct 18, 2021 1:39 pm

jimbob wrote:
Mon Oct 18, 2021 1:22 pm
sheldrake wrote:
Wed Oct 13, 2021 7:19 pm
bob sterman wrote:
Wed Oct 13, 2021 7:17 pm
This may sound reassuring to a certain extent - but you have to bear in mind that triage, admission and discharge practices were and are dynamic - changing as hospitals start to get close to full occupancy.

So when a hospital is getting close to full occupancy - you can be sure that some patients are not being admitted that would be admitted during more normal times. While others are being discharged early (notoriously into care homes).
I haven't yet seen good evidence that hospital admissions were abnormal against a background of 20 years or more, but I absolutely agree with you about the disaster of discharging into care homes. People should be held accountable for that.
Have you actually looked?

https://www.gov.uk/government/statistic ... ce-reports

and look at the 2021-22 report for flu ICU admissions. fig 45 of the wk 41 report.


0.88/100k is very high

then compare to COVID and flu ICU admissions which peak at about 2.5/100k

Screenshot 2021-10-18 141832.png
Screenshot 2021-10-18 141802.png

You can look through and see that indeed it is very high
https://assets.publishing.service.gov.u ... -FINAL.pdf

figure 17 helpfully adds in data from 2015 onwards
Screenshot 2021-10-18 143825.png
Screenshot 2021-10-18 143825.png (188.46 KiB) Viewed 3037 times
Have you considered stupidity as an explanation

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Re: COVID-19

Post by bagpuss » Mon Oct 18, 2021 4:29 pm

bob sterman wrote:
Sat Oct 16, 2021 8:37 pm

A bit of UK context is needed...

In the UK children were not "locked up" for months on end. During the first "lockdown" in England Primary school children generally missed 2 weeks of school in late March / early April before the Easter holidays. Then 5 weeks of school after Easter before they started a phased return in early June. From early May kids were out playing in parks etc with few restrictions.
While I agree broadly with your points , this is slightly misleading - the vast majority of primary school children did not return to school until September 2020.

Edit to clarify this refers to England. Scotland kids I assume returned at the start of their year in August.

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Re: COVID-19

Post by sheldrake » Mon Oct 18, 2021 4:41 pm

jimbob wrote:
Mon Oct 18, 2021 1:22 pm


Have you actually looked?
Yes. The evidence you posted doesn't seem to give a point of comparison? eta: Keep in mind I'm trying to understand this against a backdrop of much higher age-adjusted mortality for every year from 1990 to 2009
Last edited by sheldrake on Mon Oct 18, 2021 4:46 pm, edited 2 times in total.

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Re: COVID-19

Post by sheldrake » Mon Oct 18, 2021 4:44 pm

jimbob wrote:
Mon Oct 18, 2021 1:31 pm


No but I have data for all cause deaths for England and Wales going back to wk31 1999 showing how it was completely abnormal to then.


Image
I'd love to understand this plot more deeply. I have some questions about it

1) Is it showing all deaths, or all hospital deaths?

2) Is the bulge for week 18 of 2019-20 April/May of 2019. or does it represent some other date

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Re: COVID-19

Post by shpalman » Mon Oct 18, 2021 5:11 pm

@andymoz78 tweets...
This week in ICU, we’ve got a lot of COVID- currently around half our level 3 (ventilator) beds are filled with patients with COVID. A lot of the patients are double vaccinated, and pressures are rising from other conditions.
This is in significant part because we have high levels of community transmission - under conditions of high transmission even small percentage of vaccine-breakthrough infections will be severe, a small percentage of a very large number is still a large number
We’re seeing major rises in children- who due to decisions made earlier this summer are largely unvaccinated. We’re not seeing many of these kids in hospital, but they are helping maintain community infection rates, spilling over into more vulnerable who do end up in hospital

The patients with COVID are not patients we would have otherwise seen with other conditions- they are additional rather than displaced morbidity. Trying to manage both patients with and without COVID is tricky
When ICU is full, there is endless juggling of patients- admissions take longer tying up the outreach team on the ward, discharges happen earlier, again putting more pressure on the outreach teams and the ward teams

Access block keeps critically ill patients in other areas where they can be safely managed (Emergency Department, Theatres) slowing down movement in those areas.
But hey at least you don't need to show a massively discriminatory and privacy-violating QR on your phone in order to get into a nightclub, just to be wearing the right kind of trousers and shoes and to prove your age and of course if there's a big male group of you you're obviously going to start a fight so you can't come in.
having that swing is a necessary but not sufficient condition for it meaning a thing
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