Coronavirus - worldwide spread and control

Article by Anthony Costello in The Guardian (Friday 10 April):

https://www.theguardian.com/comment...ft-lockdown-uk-east-asia-coronavirus-pandemic

 

Just caught a guy on BBC Radio 4 saying that the exit strategy (?) in the UK would involve more wearing of masks. He was talking about the bluetooth contact-tracing idea, among other things. Didn't catch his name.

 

But doesn't the whole 'herd immunity' thing depend on how long people are immune for? If it turns out to be say three years that's fine, but what if it's only a year or less? Would that be enough time before the next 'cycle' ?
(obviously not applicable if a vaccine is produced)

 

My understanding is that it's exactly the same thing if a vaccine is produced - a vaccine is simply an artificial way of obtaining herd immunity with, hopefully, a lower death rate.

 

For a moment I wondered if you were about to suggest Covid 19 might grow in Easter eggs .

 

Bill gates BBC interview on a vaccine for covid...

Its news to me that he is a health expert...

.

https://www.youtube.com/watch?v=ie6lRKAdvuY

 

From Channel 4 News tonight:

https://www.youtube.com/watch?v=j6Z2RvoR1Wg

Here are my notes on what the Channel 4 news reporter says was alleged by a whistleblower:

 

1/4 of the world's population is being tested at rates .0003 per capita but seem to have actively spreading COVID- India, Pakistan, Indonesia, Phillipines, Mexico, Brazil. Several of these countries began their lockdown relatively late - end of March and are very population dense. However, their death rates are very low and you would expect that number to be higher if there were a large number of untested active COVID. Could this be a result of temperature/sunlight, lower average age?

Nature has a little bit about India's already existing detection strategy w/o mass testing, although they will need that eventually.

Modelling paper: https://arxiv.org/pdf/2003.12055.pdf (2020). It suggests either a 3 period 21/28/18 day lockdown periods or one long 49 day lockdown is needed.

 

Sweden´s number of fatal cases are currently declining.
Below what is/was forbidden or recommended, and since when. From the Swedish wiki.


På folkhälsomyndighetens inrådan har regeringen endast genomfört följande förbudː

• Icke-medborgares inresor från icke EU/EES-länder stoppas. (17 mars 2020)
• Alla folksamlingar och sammankomster med över 500 deltagare, inklusive kultur- och idrottsevenemang, förbjuds tills vidare. (11 mars 2020)[39] Förbudet utsträcktes vid ett senare regeringssammanträde till att omfatta alla allmänna sammankomster över 50 personer. (27 mars 2020)[40]
• På restauranger och barer tillåts enbart bordsservering. (24 mars) [41] allowed only when having table service
• Besökrestriktioner på sjukhus har införts av landsting och i äldrevården av vissa kommuner. Nationellt besöksförbud i äldrevården infördes av regeringen den 31 mars 2020.[42]visiting hospitals restricted in some areas, forbidden in care homes

Därutöver har en rad rekommendationer, och beslut som underlättar efterföljandet av dessa, meddelats av olika myndigheter och regeringen:

• Icke-nödvändiga resor avråds till delar av Kina (26 januari, 17 februari),[43] Iran (3 mars), Italien (6 mars) och överhuvudtaget utomlands (14 mars). Personer som återvänder från dessa länder har fått spendera två veckor i frivillig karantän i hemmet, med smittbärarpenning.[44] Icke-nödvändiga helgresor och andra resor inom Sverige avråds (19 mars).[45]
• Personer även med minimala symptom på vad som kan vara covid-19 rekommenderas att stanna hemma. Karensdagen avskaffas tillfälligt för att säkerställa att personer som känner sig lite sjuka stannar hemma från arbetet. Tiden man kan sjukskriva sig utan läkarintyg förlängs från 7 till 14 dagar (11 mars 2020).[46]
• Personer som är över 70 år gamla rekommenderas att stanna hemma, men kan ta promenader på avstånd från andra. Arbetsgivare i synnerhet i Stockholm rekommenderas att uppmana sina anställda att om möjligt arbeta från hemmet.(16 mars)[47]
• Distansundervisning rekommenderas för gymnasier, komvux, yrkeshögskolor, högskolor och universitet. (18 mars)[48] Skolor får möjlighet att förlänga terminen. Högskoleprovet i april ställs in (13 mars)[49] liksom nationella prov vårterminen 2020. (23 mars)[50]

What could this say, given that there isn´t that much restriction?
I think:

• there could be another parameter determining the illness (e.g. air pollution)
• there is only a certain number of susceptible persons, which happen to be low in Sweden, but to be high in some other countries, this year or so.
• numbers are wrong
• to make a lockdown is wrong, at least under certain - though unknown - circumstances

 

Its taken me ages to work out the entire point of this paper. Erring on the side of generosity, I've decided to interpret it as a demonstration of how stupid the target of "herd immunity" would be if we don't have a vaccine, even if we keep infection rates to levels that are manageable within the healthcare system.

The model, which is based on the assumption that herd immunity will be achieved once 60% of the UK population is infected, suggests that to achieve this end, while keeping the daily incidence of acute cases to a manageable level, the UK would need 8-10 lockdown-and-release cycles. This is based on the estimate of the proportion of people that have been infected in the hardest hit countries, which is still quite low (they mention the figure of 6%).

They also estimated that a cyclic lockdown-and-release scenario would halve the UK death rate, when compared to a free-for-all, but a heck of a lot of people, some 250,000, would still die (which makes sense, because ICUs and ventilators, even if available, will only save some).

So I'm guessing their key message is that multiple lock-down-and release cycles designed to "flatten the curve" are a damp squib: they will be costly, they will not achieve herd immunity for a long, long time, and a lot of people will still die. So the UK must utilise other strategies, such as elimination ones (border control, track-and-trace), and vaccine development.

I hope that's what they're aiming for. Because when I read "herd immunity" in the absence of a vaccine, I hear "let people die". Because that's what it will require.

 

It's too early to draw conclusions. According to the public health authority, the "decline" the last few days is most likely a result of delayed reporting during the Easter holiday.

For example, the government usually gets no numbers at all from nursing homes or other care homes during the weekends. Bank holidays = less hospital staff working = they probably don't have time for administrative stuff.

We will know more in a few days.

To get the whole picture re: recommendations and restrictions in Sweden, especially when comparing to other countries, do also read up on what people in Sweden are actually doing/not doing. Because the official recommendations are so loose, a lot of people are being much more careful than is currently being asked of them, while lots of others keep going about their life as usual: holiday trips, hanging out at busy shopping centers, crowded cafés etc...

And remember that where other countries use the law to control these things, the Swedish government and health authority choose to put the responsibility on the people/individuals and our "common sense" by calling it "advice" or "recommendations". One of the reasons is they believe it gives people a greater sense of freedom and that it therefore will be more sustainable in the long run (less people breaking the rules).

ETA: In case some of you have been reading the American president's comments on the so called "Swedish situation" lately, here is a thread with facts in response to the disinformation that is currently being spread:

https://twitter.com/user/status/1249448312891224066

 

Though when more people are affected, the virus will spread more slowly. E.g. when 15% are immune (for a while), every fourth cannot become a target for the virus anymore.

In addition, there is to some extent the possibilty that high initial viral loads will cause a more severe illness, compared to small initial viral loads. Given that some countries didn´t slow down the initial spreads (from a new virus), this might be inline with the desasters seen. Other countries might have act - more or less by chance and accident - more luckily, and may have already a comparable number of people that have been in contact. We will see, in in so far that not other circumstances matter.

Yes, this is quite likely. ME brain at work ...

Here in Germany it came out in a somehow smart manner, may it be by accident or Angela Merkel at her best (apart that it´s rather the regions that makes the laws here). In a first week there was only options, and since then it´s essentially forbidden to gather with more than two persons in public, and almost all shops and all restaurants are closed. Otherwise there is still rather freedom, you can go out whenever you want (in most of the states/counties), and you still rather have to work. Parks may look crowded, but the utmost of people behave intelligent. It´s a bit surreal.

 

Regarding reinfection/reactivation our main scientific advicer posted this study.

From what I understand his stance is that later PCR tests become less "reliable" and can switch from positive to negative and vice versa.

So if people have a positive result again after having been discharged with two negative results it's due to the method, not reinfection.

 

That's all right then.

Procedures and testing are discharging potentially large numbers of people with active covid-19 from hospital and/or isolation and telling them, and everyone else, that they are now immune and it's safe to resume normality.

Such people, after a brush with death, may decide that a celebration is in order.

Which is clearly perfectly fine.

 

From what I understand he's only refering to the confusing positive/negative PCR results afterwards, not necessarily immunity which needs antibody testing, I think.

Also, a positive PCR result later might not mean that the tested person has enough viral load to still be infectious.

But I don't understand enough to really interpret his paper or if his conclusions make sense.

 

Not just you, Doctors were highlighting the potential death toll (particularly among the elderly) early on. Also, recall the open letter signed by many eminent scientists in this field, i.e. highlighting the potential loss of life if the UK pursued the herd immunity strategy.