COVID-19

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lpm
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Re: COVID-19

Post by lpm » Fri Jun 11, 2021 7:29 am

Obviously a conventional heat map will fail to detect movement upwards. Can no longer have case numbers divided by population of a cohort.

We need a map showing cases per unvaccinated population in a cohort.
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Re: COVID-19

Post by Bird on a Fire » Fri Jun 11, 2021 8:58 am

lpm has had both doses and wants to go to the pub ;)
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lpm
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Re: COVID-19

Post by lpm » Fri Jun 11, 2021 10:17 am

Huh?

I think it's fairly easy to construct a spreadsheet for a simplified country of 20 million young people unvaccinated but with tiny hospitalisation rates, 2 million unvaccinated and vulnerable with high hospitalisation rates, 40 million totally immune.

Invent a third wave where 10% of unvaccinated get Covid. It's immediately clear that the 200,000 vulnerable causes far more problems than the 2 million young. The fatality rates etc are in the 100s times, easily swamping the 10x numbers.

The coming problem is going to be vulnerable, same as the first and second waves, because the vaccination program doesn't compensate for the huge age effect. The only questions are if the 40 million immune act as a firebreak to stop the heat map spreading upwards to the elderly, and whether we should say f.ck the unvaccinated vulnerable and let them take their own chances, they were offered protection and they turned it down.
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Re: COVID-19

Post by jimbob » Fri Jun 11, 2021 10:47 am

lpm wrote:
Fri Jun 11, 2021 7:16 am
Delta is still heading up the heat map. We've been here before - fires at the bottom with school age and <30, slow spread upwards over many weeks. We've seen twice that you can't shield the vulnerable when cases are very high in the young.

The vulnerable now are the 2 million unvaccinated over 50s, rather than the 25 million unvaccinated young. A tenth of the size, but anything from 30x to 300x higher fatality rates.

Plus another 2 million where we can assume the vaccine only partially works, hospitalising instead of killing.
And the COVID-ZOE data looks very similar to September/October
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September 2020
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October 2020
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June 2021
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Re: COVID-19

Post by OffTheRock » Fri Jun 11, 2021 6:34 pm

lpm wrote:
Fri Jun 11, 2021 7:16 am
Delta is still heading up the heat map. We've been here before - fires at the bottom with school age and <30, slow spread upwards over many weeks. We've seen twice that you can't shield the vulnerable when cases are very high in the young.

The vulnerable now are the 2 million unvaccinated over 50s, rather than the 25 million unvaccinated young. A tenth of the size, but anything from 30x to 300x higher fatality rates.

Plus another 2 million where we can assume the vaccine only partially works, hospitalising instead of killing.
Third time lucky though. No way the government could possible foresee what’s about to happen next just because it happened twice before.

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Re: COVID-19

Post by sTeamTraen » Fri Jun 11, 2021 10:27 pm

The FT is reporting that reopening in England is likely to be put back by a month (behind a paywall, but the FT's paywall is really crap).
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Re: COVID-19

Post by lpm » Fri Jun 11, 2021 11:09 pm

Obviously, with R>1 currently and rising cases, delaying Stage 4 is insufficient.

R can be brought down either by a bit of lockdowning or more vaccination (or some of both).

Unfortunately vaccine supply appears insufficient for this to be the answer. The timing of Delta hasn't worked out. And the opportunity for local firebreaks is probably passed.

There needs to be something, but clearly this government won't impose anything till too late. It needs to be voluntary. Some good weather coming up will hopefully take UK life outdoors - May cases were presumably boosted by the month of rain.
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Re: COVID-19

Post by lpm » Sat Jun 12, 2021 10:09 am

I done a spreadsheet model.

Assumed we're currently at R=1.4 lockdown level.

Because they cut transmission, assumed continued vaccine rollout of 1st doses strengthens lockdown by 0.1 units every two weeks, i.e. lockdown level R=1.3 end June, level R=1.1 end July, R=0.9 end August. (Need to do 12-18 year olds to maintain this lockdown strengthening.)

Gives new cases rising to 60,000 a day and basically at a plateau for several months (R of 1.1 is so slow upwards, R of 0.9 is so slow downwards). Only 3 doublings from the current position, because the doubling time gets longer and longer.

Obviously going to Stage 4 on 19 July is better than 21 June, but cases are still rising at this point. Hard to know how many units of R this unlockdowning causes, but my guess is it doesn't make much difference because school holidays probably compensates the other way. There might be a problem for school return in September because if Delta has a natural R=8 it's challenging to get to herd immunity with <12s unvaccinated.

60,000 cases in vaccinated-UK is a bad wave but very different to 60,000 in unvaccinated-UK. I think we get away with it. I don't really understand by what people mean by "decoupling" in this context. If you decouple the chain, the pedals on your bike don't turn the wheel. It's actually more like gearing we're talking about. The relationship between cases and hospitalisations/deaths is unchanged, just at a very different ratio.

But it's 60,000 cases a day for a long long time, rather than the temporary peaks seen in waves 1 and 2.

I'd need to be a proper age breakdown, but at a guess this wave would only kill 10,000 people which is nothing to Johnson. Maybe 5,000 from the 2 million unvaccinated and vulnerable pool, 4,000 from the 40 million imperfectly vaccinated pool, 1,000 from the unvaccinated young.
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Re: COVID-19

Post by bob sterman » Sat Jun 12, 2021 10:31 am

lpm wrote:
Sat Jun 12, 2021 10:09 am
I don't really understand by what people mean by "decoupling" in this context. If you decouple the chain, the pedals on your bike don't turn the wheel. It's actually more like gearing we're talking about. The relationship between cases and hospitalisations/deaths is unchanged, just at a very different ratio.
Yes - I've found all this talk about "decoupling" and "breaking the chain" to be odd.

The gearing analogy is much more appropriate.

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Re: COVID-19

Post by raven » Sat Jun 12, 2021 4:31 pm

lpm wrote:
Fri Jun 11, 2021 10:17 am
The only questions are if the 40 million immune act as a firebreak to stop the heat map spreading upwards to the elderly, and whether we should say f.ck the unvaccinated vulnerable and let them take their own chances, they were offered protection and they turned it down.
I've been keeping an eye on the Bolton data and if you look at their heat map you can see the 2 & 3rd outbreaks there (Oct/Nov and Jan/Feb) definitely flumed up into the elderly. But the current one isn't doing so. (see here)

Current outbreak seems to have more cases in 5-9 and 10 -14 yr olds though. Not sure if that's just because we're doing more LFTs in school children though, and were missing asymptomatic cases in them before.

From that page, the current Bolton peak is almost as big as the January one in terms of cases, but from here hospital admissons are about half as high. But I'm not sure if Bolton NHS Trust covers just Bolton the area or if some patients from Bolton might get sent somewhere bigger.

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Re: COVID-19

Post by jimbob » Sat Jun 12, 2021 7:07 pm

raven wrote:
Sat Jun 12, 2021 4:31 pm
lpm wrote:
Fri Jun 11, 2021 10:17 am
The only questions are if the 40 million immune act as a firebreak to stop the heat map spreading upwards to the elderly, and whether we should say f.ck the unvaccinated vulnerable and let them take their own chances, they were offered protection and they turned it down.
I've been keeping an eye on the Bolton data and if you look at their heat map you can see the 2 & 3rd outbreaks there (Oct/Nov and Jan/Feb) definitely flumed up into the elderly. But the current one isn't doing so. (see here)

Current outbreak seems to have more cases in 5-9 and 10 -14 yr olds though. Not sure if that's just because we're doing more LFTs in school children though, and were missing asymptomatic cases in them before.

From that page, the current Bolton peak is almost as big as the January one in terms of cases, but from here hospital admissons are about half as high. But I'm not sure if Bolton NHS Trust covers just Bolton the area or if some patients from Bolton might get sent somewhere bigger.
They were reportedly trying to send patients into Greater Manchester
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Re: COVID-19

Post by Beaker » Sat Jun 12, 2021 11:03 pm

jimbob wrote:
Sat Jun 12, 2021 7:07 pm
They were reportedly trying to send patients into Greater Manchester
Bolton is part of Greater Manchester.

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Re: COVID-19

Post by Herainestold » Sun Jun 13, 2021 4:12 am

Beaker wrote:
Sat Jun 12, 2021 11:03 pm
jimbob wrote:
Sat Jun 12, 2021 7:07 pm
They were reportedly trying to send patients into Greater Manchester
Bolton is part of Greater Manchester.
What constitutes lesser Manchester?
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Re: COVID-19

Post by bob sterman » Sun Jun 13, 2021 6:23 am

Herainestold wrote:
Sun Jun 13, 2021 4:12 am
Beaker wrote:
Sat Jun 12, 2021 11:03 pm
Bolton is part of Greater Manchester.
What constitutes lesser Manchester?
These days I'm sure City fans would say United.

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Re: COVID-19

Post by Grumble » Sun Jun 13, 2021 6:58 am

Herainestold wrote:
Sun Jun 13, 2021 4:12 am
Beaker wrote:
Sat Jun 12, 2021 11:03 pm
jimbob wrote:
Sat Jun 12, 2021 7:07 pm
They were reportedly trying to send patients into Greater Manchester
Bolton is part of Greater Manchester.
What constitutes lesser Manchester?
Manchester.
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Re: COVID-19

Post by Martin_B » Sun Jun 13, 2021 9:48 am

Herainestold wrote:
Sun Jun 13, 2021 4:12 am
Beaker wrote:
Sat Jun 12, 2021 11:03 pm
jimbob wrote:
Sat Jun 12, 2021 7:07 pm
They were reportedly trying to send patients into Greater Manchester
Bolton is part of Greater Manchester.
What constitutes lesser Manchester?
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Re: COVID-19

Post by lpm » Sun Jun 13, 2021 9:54 am

Manchester, so much to answer for.
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Re: COVID-19

Post by Grumble » Sun Jun 13, 2021 10:53 am

lpm wrote:
Sun Jun 13, 2021 9:54 am
Manchester, so much to answer for.
Even some of Manchester’s suburbs are quite creative, like Stockport and Liverpool.
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Re: COVID-19

Post by jimbob » Sun Jun 13, 2021 11:05 am

Grumble wrote:
Sun Jun 13, 2021 10:53 am
lpm wrote:
Sun Jun 13, 2021 9:54 am
Manchester, so much to answer for.
Even some of Manchester’s suburbs are quite creative, like Stockport and Liverpool.
That's like the joke:

A survey asked people in Birmingham, Edinburgh, Glasgow, and Manchester what they thought was the second town in the United Kingdom.

The people in Birmingham said "Birmingham"
The people in Edinburgh said "Edinburgh"
The people in Glasgow said "Glasgow"
The people in Manchester said "London"
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Re: COVID-19

Post by Sciolus » Sun Jun 13, 2021 1:12 pm

What happens in Manchester today, happens in the rest of the world tomorrow.

So if you're in the rest of the world, tomorrow it's going to rain.

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Re: COVID-19

Post by jimbob » Sun Jun 13, 2021 7:35 pm

Phase plots (raw data) for NW England for new hospitalisations and MV bed occupancy against new cases and MV bed occupancy against hospitalisations

Image

The data's noisy, but it looks to me as though fewer are getting hospitalised per case, but of those, more are severely ill, so that overall it looks like the second wave in terms of MV beds vs cases.

But that is with a big caveat that the data's a bit too noisy like this. I wanted to use the NW as that is where the delta variant has had the longest severe impact.
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Re: COVID-19

Post by jimbob » Sun Jun 13, 2021 8:12 pm

The same but with rolling 7-day averages (centred on the date so date +/- 3 days)

Image

It's quite a bit clearer - the MV beds per case looks to be rising but better than 2nd wave.
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Re: COVID-19

Post by shpalman » Mon Jun 14, 2021 5:38 pm

Shock as prime minister announces thing which we'd been told he'd say.

Delaying the unlocking is really the least you can do, I mean, if all you do is maintain current conditions, how do you expect the past few weeks of exponential growth to stop and reverse?

Meanwhile Italy had fewer than 1000 cases "today" which I think is the lowest Monday number since late August. The case rate seems set to fall below 20/100,000/week. A whole load of Italy moves to "White" rules today so we'll see if that spoils things; deaths also look like they might finally drop properly, they were stuck at around 70 per day for a while even as cases came down.
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Re: COVID-19

Post by lpm » Mon Jun 14, 2021 6:25 pm

shpalman wrote:
Mon Jun 14, 2021 5:38 pm
Delaying the unlocking is really the least you can do, I mean, if all you do is maintain current conditions, how do you expect the past few weeks of exponential growth to stop and reverse?
Because vaccinations effectively add lockdownicity to current lockdowniness.

Although there's a mystery in India - why did their exponential spike and then suddenly plummet? They didn't officially lockdown much did they? It's a spectacular dive (going from official stats anyway) whereas previous UK and western spikes have needed a long, slow grinding down. Maybe because even India was lower in cases per million?
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Re: COVID-19

Post by shpalman » Mon Jun 14, 2021 6:31 pm

lpm wrote:
Mon Jun 14, 2021 6:25 pm
shpalman wrote:
Mon Jun 14, 2021 5:38 pm
Delaying the unlocking is really the least you can do, I mean, if all you do is maintain current conditions, how do you expect the past few weeks of exponential growth to stop and reverse?
Because vaccinations effectively add lockdownicity to current lockdowniness.

Although there's a mystery in India - why did their exponential spike and then suddenly plummet? They didn't officially lockdown much did they? It's a spectacular dive (going from official stats anyway) whereas previous UK and western spikes have needed a long, slow grinding down. Maybe because even India was lower in cases per million?
Or because they had a lot more cases than the official numbers, such that they really did reach herd immunity, at least in regions localized around outbreaks? Or because people take precautions when they see things getting terrible, even if rules aren't imposed? (And conversely, in the UK I'd expect that people have been lax about the rules because they felt like things were fine, and I'm waiting for something similar to go wrong here...)

The slope of their decrease on a log scale looks about right though according to this Our World In Data graph
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