Coronavirus - worldwide spread and control

Refugee camps in Europe could be a big problem.

 

Yes. Much has been made of the fact that Matt Hancock / the U.K. govt did over 80,000 tests today. However some scientists were on the news today making the point that, there’s no point to the tests if you’re not tracing. If there’s no localised or coordinated action on this, no monitoring and no tracing.

Ok, we did 80,000 tests today (on around 50,000 people) - all this tells us is how many people tested positive.

I dont understand the point of the app especially, in conjunction with the 18,000 contact tracers, that is going to be rolled out. The app will alert some people. But then what will the tracers do? They will have to trace and look at all contacts anyway, because otherwise they may miss someone, so won’t they just be doing the job the tracing app has already done, and then some extra work as well? perhaps the tracing app might add some extra contacts that they might not have known about otherwise. But it doesn’t negate the need for a large number of tracers.

Or is the point not to actually trace everyone but just to trace “enough” people? I.e. to keep their R0 below 1, as they’ve been talking about recently. But that wouldn’t be a good strategy. Because if they even miss 1 case, the whole thing could explode again .. remember how South Korea’s outbreak was based on 1 person.

so what’s the strategy of the U.K. in terms of testing and contact tracing, And how are they going to do it? There’s a lot that needs to be done. It’s going to have to be up and running very quickly. I think they understand that it’s needed though.

Also, what is the strategy in the rest of Europe? Because other countries are also talking about a very similar tracing app too.

 

The U.K. had 6,032 new cases today.

https://www.gov.uk/guidance/coronavirus-covid-19-information-for-the-public

 

Thanks, @JaneL, I worked that out in the end!

Yes, what he means is that if we apply containment measures "then we won't be able to keep the problem secret". There's a good dose of paternalism there - pretend all is okay, people won't get scared. Lots of people will die, but mercifully, those who live will not have to go through the horror of being scared.

This whole COVID saga strongly highlights the narrative that we have been creating as a society about human psychological fragility. We are increasingly framing ourselves as fragile creatures who, if exposed to any sort of unpleasantness at all, will likely develop some terrible chronic disease or worse. Its increasingly hard to recognise our species in these descriptions - isn't that one that survived centuries of wars, famines, natural disasters, and countless other unpheavals with apparently enough able-bodied (and sane) members each time to pick up the pieces?

Is not that I don't believe that people should be educated about mental health, or that we shouldn't try to identify those especially at risk of mental health problems. Its just the way that these conclusions are extended to the general population. And the way in which mental health risks are overblown, and given greater weight than physical health - with absurd conclusions, like these here.

 

A newspaper is reporting that 61% of the people with suspicious symptoms and/or contact with confirmed cases in two of the hardest hit towns in the Bergamo province had positive serological tests. A second lab found a rate of 59%.

At one hospital in Bergamo, the percentage of healthcare workers with a positive serological test was 23%.

The article says that the case for mass testing is becoming stronger.

https://bergamo.corriere.it/notizie...vi-85e8e36c-8a6b-11ea-94d3-9879860c12b6.shtml

 

Medecins Sans Frontiéres (sp?) are on the ground in Europe for the first time because of this - according to a podcast I listened to. They are working in many countries, focusing on the areas the governments aren't managing. They are such a good charity.

ETA: Done some quick research and they have been at refugee camps in countries like Greece for a long time obviously but this is the first time they are helping with 'normal' EU country services, ie care homes, the homeless.

 

Your in good company Prof Allyson Pollock pointed out that California decide to go low tech not hi-tech! Possibly Allison was commenting here Covid Report 2 [

https://www.youtube.com/watch?v=XY3sEIB7pJY

]

I think the point about "not much point testing if you're not tracing" was made in that video.

Possibly 80K tests/1 day (can it be maintained?) is a good headline --- it works from a political perspective.

 

https://twitter.com/user/status/1256131350870007808

Bonus point to the first person who manages to include ipsedixitism in a paper or letter on Covid-19 or ME/CFS. Extra bonus point to anyone who manages to combine the two!

 

I think you mean R, not R0.

If/when things start to turn, numbers can drop quite a lot in a month, but the key is getting the rates to turn.

I think part of the problem is the narrative that we're merely 'flattening the curve', rather than trying to lower numbers as much as possible. (and half-hearted actions as a result).

Once things start to turn, we'll hear the end of the "buuuuut Sweden!!!!11111oneoneoneeoneoen" arguments.

 

Lots of states in USA are re-opening. There are a few states where cases have gone down. However there are also quite a few states where after the stay at home orders / restrictions without stay at home orders, cases have actually continued increasing or pretty much stayed the same. And they’re still opening:
https://www.nytimes.com/interactive/2020/us/states-reopen-map-coronavirus.html

See Which States Are Reopening and Which Are Still Shut Down
By Sarah Mervosh, Jasmine C. Lee, Lazaro Gamioand Nadja PopovichUpdated May 1, 2020

 

Really good article

https://blogs.bmj.com/bmj/2020/05/0...ntact-tracing-to-stop-the-spread-of-covid-19/

We urgently need to start contact tracing to stop the spread of covid-19
May 1, 2020

“Mobile applications, such as one anticipated from NHSX, have been touted as a potential way-out of lockdown and a way to simplify contact tracing in the UK. However, there are concerns about privacy, acceptability, and whether individuals can legitimately be mandated to use an app to achieve adequate coverage. In Singapore, for example, only 17% of people have downloaded the official contact tracing app. Importantly, modelling studies suggest that a UK app will only be effective if 80% of the population who own a smartphone download and use it, meaning that it would have to be used in conjunction with the more established contact tracing methods we have discussed. In addition, a smart phone based solution will struggle to reach populations who are more likely to be severely affected by covid-19; the elderly, the isolated, those who are homeless or undocumented, and the poor, where smartphone ownership and usage is lower.

Locally led initiatives are essential in order to ensure rapid scale up of contact tracing. Sheffield is pioneering this with an initiative set up by retired doctors. This initiative, Community Contact Tracers, has trained local volunteers to trace through 5 hours of virtual training with supervision. Patients identified by a local GP practice are referred to a retired GP and then on to the volunteers. Index cases are supported and quarantine arrangements discussed in detail. The contacts of the cases are spoken to, encouraged to isolate, and provided with support. The initiative collaborates with a local development trust to ensure good social and organisational support and includes daily phone calls to monitor changes in symptoms, support the challenges of greater isolation, and provide practical support. Initial feedback from volunteers and recipients has been very positive. “

 

It´s now 12 days that Germany reopened shops. Until now there is no difference noticible:
new cases (absolute, not per testings unit).

new deaths (positive for covid-19)

When I recall that R0 steeply went down before the lockdown could excert its effect on R0,
I feel inclined to say that it will not change, and that the lockdown has almost no influence.

One must but say that R0 was and is drawn from officially reported numbers, which are hardly representative.

 

estimated R0 for Austria:

A lockdown was implemented on march 16th ("16.3").

 

Maybe a riddle
A difference to Germany (early tracing, lockdown) displays Sweden (no lockdown, and somehow soft measures):
new cases (absolute, not per any testing unit)

new deaths (positive for covid-19)

Whereas new deaths decline, new cases don´t but hold on at the level.
It would be interesting to have hospital admissions, e.g. the treatment could have become better (though this should also go for other countries including Germany).

 

Its a good sign, but maybe too early to celebrate? You'd only be seeing an increase now if a lot of people had been "successful" in contracting the virus quite rapidly. So if they'd stumbled upon an infected person, or infected air/surface within days of starting to move about. And that's probably not how its going to work. Even if there's a lot of infection still about, it'll take a while for people to circulate and interact before they have enough opportunities to get infected.

If people are being tested because they're symptomatic (rather than randomly tested) that will introduce a further delay factor, because it takes an average of one week from the date of infection for symptoms to develop.

I hope Germany have got things under control, and they do seem to have done a good job so far. But just saying, it may be too early to tell.

 

According to this website https://www.cebm.net/covid-19/when-...tion-to-viral-reproduction-numbers-r0-and-re/ and Patrick Vallance I seem to mean R0 if anything. Apparently it is no longer R0 if immunity is affecting spread - which so far I think can be ignored. The alternative given is Re, which might be more sensible (effective R) but it is defined in terms of skewing by immunity. I have not so far seen a version of R that takes into account changers in behaviour.

The whole nomenclature seems to me pretty unhelpful anyway. I get the impression that the modellers think that a virus has an R0 built in to it regardless of how people behave in different cultures and contexts. That seems pretty silly.