CV19 - Cure worse than the disease? (Vol 3)

CV19 - Cure worse than the disease? (Vol 3)

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pneumothorax

1,312 posts

232 months

Tuesday 7th July 2020
quotequote all
panholio said:
BBC on top scary form today with Australia kicking off and UK pubs with positive tests...

The Spanish study they are reporting is interesting though, and I would welcome the comments of our resident experts:

https://www.bbc.co.uk/news/world-europe-53315983

"Spanish study casts doubt on herd immunity feasibility"

I enjoyed this as Herd Immunity has been regularly used as a phrase to deride the evil Tories for wanting to kill us all

"Around 70% to 90% of a population needs to be immune to protect the uninfected"

presented as fact, although lots of evidence to the contrary from what I have read

"Despite the high impact of Covid-19 in Spain, prevalence estimates remain low and are clearly insufficient to provide herd immunity," the study's authors said in the report.
"This cannot be achieved without accepting the collateral damage of many deaths in the susceptible population and overburdening of health systems.
"In this situation, social distance measures and efforts to identify and isolate new cases and their contacts are imperative for future epidemic control."

Feel like a narrative with an agenda to me, although they are quoting a study in the Lancet so fair enough. The study has shown that antibodies are at 5% with around 3% in coastal areas.

Interestingly no mention in here of what I have again repeatedly read that:
Not everyone develops antibodies
The test may not be perfect
There may be some innate immunity from other coronaviruses
The "dark matter" theory


Feels an unbalanced article to me, but interested in your views.
Panhoilo

I think that the herd immunity thing has been overplayed on my side (cure is worse than the disease) as I simply think that it's not as relevant as people think or can prove.

I am now boring myself with my position, but will restate it one more time. COVID went ballistic in March in London and I have never seen anything like it in my work. Many of the cases I triaged were certainly from folk caught up in the hysteria but I would say 50% had it, so many had returned from the alps for example.

Many Patients that I am convinced had this are returning negative antibody tests, I am. I have been significantly exposed to active cases throughout the period as have many of my colleagues.

This (in London) has disappeared from my working life since Easter Bank holiday, I am convinced that we have, and that we are continuing to react hysterically to this.

The collateral damage to other essential NHS functions continues, Panorama last night is quite an eye opener and tallies well with what I am seeing on a nightly basis.

RTB

8,273 posts

259 months

Tuesday 7th July 2020
quotequote all
panholio said:
BBC on top scary form today with Australia kicking off and UK pubs with positive tests...

The Spanish study they are reporting is interesting though, and I would welcome the comments of our resident experts:

https://www.bbc.co.uk/news/world-europe-53315983

"Spanish study casts doubt on herd immunity feasibility"

I enjoyed this as Herd Immunity has been regularly used as a phrase to deride the evil Tories for wanting to kill us all

"Around 70% to 90% of a population needs to be immune to protect the uninfected"

presented as fact, although lots of evidence to the contrary from what I have read

"Despite the high impact of Covid-19 in Spain, prevalence estimates remain low and are clearly insufficient to provide herd immunity," the study's authors said in the report.
"This cannot be achieved without accepting the collateral damage of many deaths in the susceptible population and overburdening of health systems.
"In this situation, social distance measures and efforts to identify and isolate new cases and their contacts are imperative for future epidemic control."

Feel like a narrative with an agenda to me, although they are quoting a study in the Lancet so fair enough. The study has shown that antibodies are at 5% with around 3% in coastal areas.

Interestingly no mention in here of what I have again repeatedly read that:
Not everyone develops antibodies
The test may not be perfect
There may be some innate immunity from other coronaviruses
The "dark matter" theory


Feels an unbalanced article to me, but interested in your views.
The serology data was touted as the game changer but it's rapidly become apparent that all you can say for the data is that at least 5% of the population have had the virus with no clear idea as to what the actual number is, other than it's at least 1 in 20 people have generated detectable antibodies against it.

It is an unbalanced article in so much as it disseminates certainty where there isn't any.

As I've maintained all through this thread, making reliable antibody tests that give a true picture of what is going on is very very difficult, I've spent enough years in labs trying to detect all sorts of bimolecules; drug targets, biomarkers, metabolites, circulating tumour cells, antibodies, antibody fragments etc etc to know that even the most robust test has it's limitations. The greatest limitation is always our understanding of the physiology of the individual we're trying to detect these things in and the biology of the biomarker we're trying to detect and how that interacts with everything else.

Cold

15,253 posts

91 months

Tuesday 7th July 2020
quotequote all
[redacted]

pneumothorax

1,312 posts

232 months

Tuesday 7th July 2020
quotequote all
RTB said:
The serology data was touted as the game changer but it's rapidly become apparent that all you can say for the data is that at least 5% of the population have had the virus with no clear idea as to what the actual number is, other than it's at least 1 in 20 people have generated detectable antibodies against it.

It is an unbalanced article in so much as it disseminates certainty where there isn't any.

As I've maintained all through this thread, making reliable antibody tests that give a true picture of what is going on is very very difficult, I've spent enough years in labs trying to detect all sorts of bimolecules; drug targets, biomarkers, metabolites, circulating tumour cells, antibodies, antibody fragments etc etc to know that even the most robust test has it's limitations. The greatest limitation is always our understanding of the physiology of the individual we're trying to detect these things in and the biology of the biomarker we're trying to detect and how that interacts with everything else.
RTB

Agreed. My understanding of the human immune system, formally, goes back to Medical school in 1997. Since then I have always continued to marvel at, but not truly understand it.

But I do know that it works in many ways that are not possible to prove on a blood test or an assay, because I see Patients that recover from things that "should" kill them.

It is amazing.

Covid penetrated our most at risk Patients in my area and killed many, it has been devastating. Since this happened it has been quiet on the Western Front.

Thankfully.

pneumothorax

1,312 posts

232 months

Tuesday 7th July 2020
quotequote all
Cold said:
Doesn't bode well as this means it will just be ignored with minuscule funding being directed towards trying to find a solution. The sufferers will just get labelled as lazy or work shy.
Cold

I do not think that post COVID Patients with after effects will be ignored.

But there is little in the way of "funding" for people who suffer all manner of illnesses that people suffer with and who recover. The NHS is not focused on this part of recovery.

As an aside, and I do appreciate this is anecdotal really, but the large majority of people I know who have had this, both colleagues and Patients have just, thankfully, been able to get on with their lives.

EddieSteadyGo

11,998 posts

204 months

Tuesday 7th July 2020
quotequote all
[redacted]

markyb_lcy

9,904 posts

63 months

Tuesday 7th July 2020
quotequote all
[redacted]

vixen1700

23,023 posts

271 months

Tuesday 7th July 2020
quotequote all
markyb_lcy said:
Really good post, Eddie.
Seconded.

Leithen

10,941 posts

268 months

Tuesday 7th July 2020
quotequote all
vixen1700 said:
markyb_lcy said:
Really good post, Eddie.
Seconded.
Yep, bang on the money.

Elysium

13,851 posts

188 months

Tuesday 7th July 2020
quotequote all
RTB said:
panholio said:
BBC on top scary form today with Australia kicking off and UK pubs with positive tests...

The Spanish study they are reporting is interesting though, and I would welcome the comments of our resident experts:

https://www.bbc.co.uk/news/world-europe-53315983

"Spanish study casts doubt on herd immunity feasibility"

I enjoyed this as Herd Immunity has been regularly used as a phrase to deride the evil Tories for wanting to kill us all

"Around 70% to 90% of a population needs to be immune to protect the uninfected"

presented as fact, although lots of evidence to the contrary from what I have read

"Despite the high impact of Covid-19 in Spain, prevalence estimates remain low and are clearly insufficient to provide herd immunity," the study's authors said in the report.
"This cannot be achieved without accepting the collateral damage of many deaths in the susceptible population and overburdening of health systems.
"In this situation, social distance measures and efforts to identify and isolate new cases and their contacts are imperative for future epidemic control."

Feel like a narrative with an agenda to me, although they are quoting a study in the Lancet so fair enough. The study has shown that antibodies are at 5% with around 3% in coastal areas.

Interestingly no mention in here of what I have again repeatedly read that:
Not everyone develops antibodies
The test may not be perfect
There may be some innate immunity from other coronaviruses
The "dark matter" theory


Feels an unbalanced article to me, but interested in your views.
The serology data was touted as the game changer but it's rapidly become apparent that all you can say for the data is that at least 5% of the population have had the virus with no clear idea as to what the actual number is, other than it's at least 1 in 20 people have generated detectable antibodies against it.

It is an unbalanced article in so much as it disseminates certainty where there isn't any.

As I've maintained all through this thread, making reliable antibody tests that give a true picture of what is going on is very very difficult, I've spent enough years in labs trying to detect all sorts of bimolecules; drug targets, biomarkers, metabolites, circulating tumour cells, antibodies, antibody fragments etc etc to know that even the most robust test has it's limitations. The greatest limitation is always our understanding of the physiology of the individual we're trying to detect these things in and the biology of the biomarker we're trying to detect and how that interacts with everything else.
One aspect of this study that is not being reported is the regional variance, with central areas like Madrid showing evidence of much higher levels of spread compared to less densely populated coastal regions. This seems aligned with the UK data showing much higher prevalence in London.

anonymous-user

55 months

Tuesday 7th July 2020
quotequote all
It’s just a rehash of the same conspiracy theory, moved to hospitals. “ Government know the right thing to do, but is not doing it for political reasons. They are keeping hospitals locked down for no reason.”

I was saying all the same stuff about Sweden NPIs since April but was dismissed as a loon because I didn’t tag on the ‘lockdown is bad, HI is good’ mantra as required by the T&Cs. Now the evidence is too clear to deny, and that reasoning is magically adopted and the defensive ‘lockdown is bad’ line is moved to another outpost.

Elysium

13,851 posts

188 months

Tuesday 7th July 2020
quotequote all
Another excellent twitter thread on Sweden:

https://twitter.com/HaraldofW/status/1280383235604...

Zoobeef

6,004 posts

159 months

Tuesday 7th July 2020
quotequote all
sambucket said:
It’s just a rehash of the same conspiracy theory, moved to hospitals. “ Government know the right thing to do, but is not doing it for political reasons. They are keeping hospitals locked down for no reason.”

I was saying all the same stuff about Sweden NPIs since April but was dismissed as a loon because I didn’t tag on the ‘lockdown is bad, HI is good’ mantra as required by the T&Cs. Now the evidence is too clear to deny, and that reasoning is magically adopted and the defensive ‘lockdown is bad’ line is moved to another outpost.
Thankfully that stigma has now gone...... laughlaughlaugh

bodhi

10,553 posts

230 months

Tuesday 7th July 2020
quotequote all
EddieSteadyGo said:
The government are in a tricky position. Initially they thought herd immunity was likely to be only realistic end-game (the virus was anticipated to spread too quickly and a vaccine would take too long to prepare).

Based on the information available in late Feb/early March, this was my view too at the time.

Then we saw the scenes from Italy, and many European countries introduced a lockdown as a result. So our government decided that politically it needed to follow suit. After all, if it turned out anything close to as bad as the hospital scenes from Lombardy, and the government were shown to have ignored it, it would be political suicide.

So they went with the lockdown, and they turned up the covid rhetoric to frighten people into compliance. The media was encouraged to revel in the fear of the "unseen killer". Lots of talk about "ground glass opacities" in the lungs of even the people who recovered and children suffering from potentially fatal covid-related "kawasaki disease".

The curtain twitchers were unleashed, asked to report people walking their dog more than once. Frightened people were encouraged not to analyse or read the science for themselves but just say shout at people "Stay at HOME!"

Except the science was becoming increasingly clear. Whilst the proportion of asymptomatic infections were very high, the number of infections in some countries hadn't exploded as predicted. Why not? Early action seemed to stop the virus in its tracks....(provided of course you didn't seed the virus into the most vulnerable population in care homes by moving infectious people from hospitals...)

The lockdown though was effective at reducing the spread of infection - in the same way banning all cars would reduce the number of car accidents.

But other countries like Sweden achieved a similar reduction in the rate of infection by far less draconian means. Focusing on isolating the sick from the healthy and minimising opportunities for large scale infection via groups has had pretty much the same effect on the R value (at a far lower social and economic impact).

So I believe many of the lockdown advocates in Public Health roles had the right motive (to save lives) but many are now too stubborn to reevaluate whether that was the right policy now they have more information.

The government of course are now reaping what they sowed. They can't easily admit lockdown wasn't necessary - as that would be to admit to the single largest act of economic and social vandalism in modern history.

So it needs people to read the science for themselves and understand why we are where we are. Otherwise it is going to take even more time to repair the self-inflicted damage.
Yep can't fault much with this, the only bit I'm not 100% in agreement with is that lockdown was any use at preventing infection, as the evidence in that seems limited at best. Analyses from the UK and Germany suggest that the R number was already below 1 before full lockdown was imposed, and Gov Cuomo went on record to say 2/3rds of patients in NYC hospitals had come from locked down homes. Throw in the number of countries which reduced infections without them (Sweden, Belarus, Japan, South Korea. Taiwan etc) and I'm not seeing too much compelling evidence in support of quarantining the healthy.

They are a blunt tool, with all sorts of unintended consequences, and the more we find out about, the more convinced I am that whilst it was a nice hypothesis, it should never be tried ever again.

However I can completely understand why it was put in place, given the panic and mass hysteria from the pictures ifrom Italy in March. It just needed to be unwound much more quickly once the facts became obvious.

2Btoo

3,429 posts

204 months

Tuesday 7th July 2020
quotequote all
bodhi said:
EddieSteadyGo said:
The government are in a tricky position. Initially they thought herd immunity was likely to be only realistic end-game (the virus was anticipated to spread too quickly and a vaccine would take too long to prepare).

Based on the information available in late Feb/early March, this was my view too at the time.

Then we saw the scenes from Italy, and many European countries introduced a lockdown as a result. So our government decided that politically it needed to follow suit. After all, if it turned out anything close to as bad as the hospital scenes from Lombardy, and the government were shown to have ignored it, it would be political suicide.

So they went with the lockdown, and they turned up the covid rhetoric to frighten people into compliance. The media was encouraged to revel in the fear of the "unseen killer". Lots of talk about "ground glass opacities" in the lungs of even the people who recovered and children suffering from potentially fatal covid-related "kawasaki disease".

The curtain twitchers were unleashed, asked to report people walking their dog more than once. Frightened people were encouraged not to analyse or read the science for themselves but just say shout at people "Stay at HOME!"

Except the science was becoming increasingly clear. Whilst the proportion of asymptomatic infections were very high, the number of infections in some countries hadn't exploded as predicted. Why not? Early action seemed to stop the virus in its tracks....(provided of course you didn't seed the virus into the most vulnerable population in care homes by moving infectious people from hospitals...)

The lockdown though was effective at reducing the spread of infection - in the same way banning all cars would reduce the number of car accidents.

But other countries like Sweden achieved a similar reduction in the rate of infection by far less draconian means. Focusing on isolating the sick from the healthy and minimising opportunities for large scale infection via groups has had pretty much the same effect on the R value (at a far lower social and economic impact).

So I believe many of the lockdown advocates in Public Health roles had the right motive (to save lives) but many are now too stubborn to reevaluate whether that was the right policy now they have more information.

The government of course are now reaping what they sowed. They can't easily admit lockdown wasn't necessary - as that would be to admit to the single largest act of economic and social vandalism in modern history.

So it needs people to read the science for themselves and understand why we are where we are. Otherwise it is going to take even more time to repair the self-inflicted damage.
Yep can't fault much with this, the only bit I'm not 100% in agreement with is that lockdown was any use at preventing infection, as the evidence in that seems limited at best. Analyses from the UK and Germany suggest that the R number was already below 1 before full lockdown was imposed, and Gov Cuomo went on record to say 2/3rds of patients in NYC hospitals had come from locked down homes. Throw in the number of countries which reduced infections without them (Sweden, Belarus, Japan, South Korea. Taiwan etc) and I'm not seeing too much compelling evidence in support of quarantining the healthy.

They are a blunt tool, with all sorts of unintended consequences, and the more we find out about, the more convinced I am that whilst it was a nice hypothesis, it should never be tried ever again.

However I can completely understand why it was put in place, given the panic and mass hysteria from the pictures ifrom Italy in March. It just needed to be unwound much more quickly once the facts became obvious.
I'll add to the congratulations for Eddie. Thanks Eddie.

I reckon that Bodhi's amendments are probably in line with my thoughts too.

grumbledoak

31,551 posts

234 months

Tuesday 7th July 2020
quotequote all
More children already died due to lockdown delayed treatment than due to COVID-19:
https://www.telegraph.co.uk/news/2020/06/25/nhs-tr...

poo at Paul's

14,153 posts

176 months

Tuesday 7th July 2020
quotequote all
Sunak's lining the pockets of the insulation companies again, (every time there is a grant, the prices rocket)!

Per BBC, "Under the Green Homes Grant, the government will pay at least two-thirds of the cost of home improvements that save energy, the Treasury said.
For example, a homeowner of a semi-detached or end-of-terrace house could install cavity wall and floor insulation for about £4,000 - the homeowner would pay £1,320 while the government would contribute £2,680."

There's me thinking, hmmm, maybe that quote for £911 for our house 4 years ago wasn't so bad after all......…
A quick google of cavity wall insulaltion costs gives this …

"The cost depends on the size of your property and the walls to be insulated, but a general rule of thumb is that it will cost around £200 per each two-storey wall. A mid-terraced house with only two external walls could cost under £400, while a detached property may be £800 or more. Bungalows are cheaper due to their height, with cavity wall insulation for a detached bungalow likely to cost around £400"...……….

Bring out the Cowboys, the Govt's giving money away...,

anonymous-user

55 months

Tuesday 7th July 2020
quotequote all
Zoobeef said:
sambucket said:
It’s just a rehash of the same conspiracy theory, moved to hospitals. “ Government know the right thing to do, but is not doing it for political reasons. They are keeping hospitals locked down for no reason.”

I was saying all the same stuff about Sweden NPIs since April but was dismissed as a loon because I didn’t tag on the ‘lockdown is bad, HI is good’ mantra as required by the T&Cs. Now the evidence is too clear to deny, and that reasoning is magically adopted and the defensive ‘lockdown is bad’ line is moved to another outpost.
Thankfully that stigma has now gone...... laughlaughlaugh
Ok here is a loony prediction for you, that you are welcome to quote. Measured from this date forward, over the next 12 months, England will have the longest period of social distancing in Europe, the longest hospital waiting lists, the worst cancer detection rates, the worst PISA scores, the most excess deaths, the largest second wave in winter, the lowest mask use, the worst hit economy, the most travel blacklists, and the steepest rise in anti vax sentiment.

And the second prediction is this thread will blame all this on lockdown.

markyb_lcy

9,904 posts

63 months

Tuesday 7th July 2020
quotequote all
"lockdown" did "work" especially for it's initially stated aims of protecting the NHS from being overwhelmed.

The real question I find interesting is considering if a less strict version of lockdown (or basked of NPIs - possibly more advisory and less legislative) would have had a similar (or "good enough" effect).

If course, we can never *really* know, but the results from Sweden suggest it is possible.

Zoobeef

6,004 posts

159 months

Tuesday 7th July 2020
quotequote all
sambucket said:
Ok here is a loony prediction for you, that you are welcome to quote. Measured from this date forward, over the next 12 months, England will have the longest period of social distancing in Europe, the longest hospital waiting lists, the worst cancer detection rates, the worst PISA scores, the most excess deaths, the largest second wave in winter, the lowest mask use, the worst hit economy, the most travel blacklists, and the steepest rise in anti vax sentiment.

And the second prediction is this thread will blame all this on lockdown.
Na, I blame people like you.

We should have stuck with flatten the curve.
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