Coronavirus - worldwide spread and control

Thank you for the reminder.

The paper wants to specify:
Instead to say: If somebody has died from covid-19, he has lost his life.
They now say: If somebody has died from covid-19, he has lost 11.8 years (on average).

11.8 years, if I am allowed mix the numbers of women and men. They make even some more particulars. E.g.
If a 80 years old woman has died from covid-19 and had one morbidity, she has lost 8.92 years (on average).
If a 80 years old woman has died from covid-19 and had six morbidies, she has lost 2.6 years (on average).
They used ten year time frames, so for a 89 year old woman it´s the same, but one gets the idea.

So, in this manner they say that the statements, that people have lost only one or two years, are wrong.
They drew their numbers from a given WHO table and the new Italian deaths.
But is this really an accurate telling? I this capturing the empirical reality?

E.g. it could be that the deaths have occured not over the whole distribution of possible deaths, but at the side where they die quite soon. And because there is to date no data - if I am not wrong (they don´t elaborate) - which can tell if this is the case or not, their conclusion cannot reflect such an input either. If this were the case, they should have elaborate, though the paper is not very clear anyway.

But in accordance, they simply can compare their results with a table from the UK, which says for instance:
If one has died from asthma, he has lost 21.6 years (on average).
If one has died from pneumonia, he has lost 13.1 years (on average).
If one has died from chronic obstructive pulmonary disease, he has lost 8.2 years (on average).

Asf. If one has died from a car accident - probably even far worse!

https://en.wikipedia.org/wiki/Years_of_potential_life_lost

 

I wonder.... if severity is all to do with the amount of viral inoculation received, then could many of us have had tiny inoculations of viral particles that subsequently help our resistance to the virus without us ever developing COVID-19?

I’m not talking about the type of immunity gained from actually developing a full blown infection, but rather a sub-threshold readiness? Can the immune system even work like this?

If it can, could this be one of the reasons that endemic viruses become less virulent over time?

Perhaps it’s not that the virus is any different, only that the general population, even if never fully infected, have mostly encountered particles of that virus and have had some immune response to it? Not perhaps an immune response sufficient to be ready to totally squash any subsequent infection, but perhaps sufficient to make the body more prepared?

Might this mean that over time individuals at large would need a greater initial inoculation to actually develop COVID-19, and if they do develop the infection, it is less severe?

I had been thinking that if virulence were an evolution of the virus itself (rather than a change in the human population) that the tendency would be in the other direction. Ie that the virus would tend towards increasing virulence because of the way we move people who become severely affected.

My thinking goes like this: It’s the most severely ill that end up in hospital where they potentially spread their severe version of the virus to medical staff, carers, cleaners, etc, each of whom can potentially take it out to the wider population. Yet the less severe are asked to isolate at home, and perhaps therefore don’t spread the virus so far. If this were the case then the more virulent forms would become more widespread.

Yet it seems that severity is dependent on how great the initial inoculation is. (I don’t really have evidence for this... it’s just what I have picked up from reading.... so bear with me). So perhaps over time we will all become partially exposed, and so develop some resistance (if not full immunity) to the worst effects of the virus??

Or am I indulging in wishful thinking and unsubstantiated optimism?

 

I don't know if it's wishful thinking but it sounds implausible. In order to mount an immune response to a virus the immune system has to muster all sorts of co-operative forces in response to a danger signal (or three). A bit of virus hitting the throat and wandering in to the bloodstream without replicating will not raise a danger signal. T cells will not have pieces of virus presented to them. B cells will not get any encouragement to make antibody. Low level exposure to foreign proteins if anything may tolerise (i.e. block an immune response making it easier for the virus to invade).

I am a bit sceptical about the mantra that when infections become endemic they are milder. The reasons why historically infections taken to new continents caused catastrophic elimination of indigenous people are complex. And I suspect any loss of virulence is very much dependent on which virus. In fact with flu endemic virus repeatedly throws up more virulent forms (as well as less virulent ones), not just antigenically new forms.

 

Ah well, the thinking amused me for a moment. Thanks for taking the time to explain @Jonathan Edwards - any immunology modules I took at Uni were a long time ago.

 

SVT Nyheter -
Infektionsläkaren: Vi måste granska de höga dödstalen i Sverige

https://www.svt.se/nyheter/inrikes/infektionslakaren-vi-maste-granska-de-hoga-dodstalen-i-sverige

 

How do we know this? It is frequently hypothesised, but never demonstrated.

(note, it is important not to misinterpret raw test results without considering sensitivity and specificity...)

 

I think the shift in virulence is a microevolutionary dance between the viruses and their hosts - as the hosts change their behaviour (and use treatments etc.) and develop immunity from exposure to prior versions of the virus, the virus adapts. This can lead to oscillatory patterns.
I think there is strong evidence to suggest shift in virulence of Influenza seems to be proportional to the level of genetic shift over time.

 

Not listened but thought it may be of interest
https://twitter.com/user/status/1256285972679077889

 

https://www.irishtimes.com/news/wor...dvice-here-s-what-happened-1.4242167?mode=amp

https://twitter.com/user/status/1256694173341802502


Moderators are aware that this post has lodged itself at the end of the thread out of time order. This happens occasionally on fully moderated threads, and usually sorts itself out eventually.

 

Very interesting:

https://twitter.com/user/status/1256836119355895808


The article is paywalled but the first bit is interesting. Livestreaming! Transparency!

 

Perhaps I am mistaken but I thought it had been demonstrated by this study?:

Temporal dynamics in viral shedding and transmissibility of COVID-19

https://www.nature.com/articles/s41591-020-0869-5

 

SARS-CoV-2 was circulating in France in late December.

https://www.bfmtv.com/sante/coronav...-19-en-france-des-le-27-decembre-1906757.html

Google translation https://translate.google.com/translate?sl=auto&tl=en&u=https://www.bfmtv.com/sante/coronavirus-le-professeur-cohen-affirme-qu-il-y-avait-un-cas-de-covid-19-en-france-des-le-27-decembre-1906757.html

 

https://www.theguardian.com/world/2...-19-transmission-is-understood-say-scientists

UK lockdown must not be lifted until Covid-19 transmission is understood, say scientists

Studies into spread of the disease will centre on those working in the health and social care sectors as cases continue to rise

Researchers say relaxing social distancing should occur only once it is understood why new infections of the disease are still being diagnosed in their thousands every day.

....

And last week, several groups launched studies aimed at providing answers. These include projects to analyse how virus-laden aerosols behave in the air in a bid to understand how the disease is passed between humans. In addition, other schemes will target healthcare workers to investigate how the virus is being spread to them from patients and then on to others.

The importance of this latter approach was revealed in recent figures for cases of Covid-19 which have shown a drop in numbers of new cases in hospitals but reveal significant rises among health and social care workers.

This point was stressed by epidemiologist Anne Johnson at University College London. She said cutting transmissions of Covid-19 to health and social care workers had now emerged as a major priority. “Half of all new infections reported last week were among healthcare workers,” she told the Observer. “This has now become the leading edge of the spread of the disease.”

This view was backed by infectious diseases expert Tom Wingfield of the Liverpool School of Tropical Medicine. “The numbers show that the rate of decline of new cases is slower in the UK than other European countries and that is likely to be down to transmission occurring within health and social care settings, transmission in the community despite social distancing and, to a lesser extent, chains of transmission that are still occurring within households, especially in larger households or shared accommodation.”

I think constant lack of PPE in care homes, community, downgrading of what PPE is needed, not knowing who’s infected and who’s not, lack of proper planning and not having as strong a lockdown as other European countries, has something to do with it..

 

Wallensten: Därför har Sverige betydligt högre dödstal än grannländerna
https://www.di.se/nyheter/wallensten-darfor-har-sverige-betydligt-hogre-dodstal-an-grannlanderna/

English Google translation :
https://translate.googleusercontent...derna/&usg=ALkJrhh-BG93IoTXuH_zNPM1MwbaF8yQQw

 

Hasn’t the WHO already released a statement saying *do not* go down the road of antibody passports?! Then why...
https://www.theguardian.com/politic...us-health-passports-for-uk-possible-in-months

Coronavirus health passports for UK 'possible in months'

 

Danmarks plan: 300 000 coronatester i veckan

https://www.svt.se/nyheter/inrikes/danmarks-plan-300-000-tester-i-veckan

"Denmark's plan: 300,000 coronate tests per week
UPDATED YESTERDAY 20:44
PUBLISHED YESTERDAY 18:48

Until last week, Denmark had tested more than twice as many for covid-19 as Sweden in relation to population size. And testing will be expanded even more to be able to control the spread of infection as the country now opens up more and more.

In Denmark, restrictions are now gradually being introduced to stop the coronavirus. Schools, hairdressers and preschools have reopened, while at the same time increasing the test capacity for each week.

Part of the infection tracking is also about people who have tested positive themselves to contact those with whom they have been in contact, so that they in turn should also go and test themselves.

- We need to keep the infection down now and we will do that with the help of more tests and more infection tracking, says Allan Randrup Thomsen, professor of virology to SVT's Agenda.

Tested far more than Sweden
In Sweden, people who are cared for in hospitals and elderly homes are primarily tested, but also more and more employees in care and care. Nevertheless, Denmark is one step ahead.

Last week, April 20-26, Denmark tested around 68,000 people, while 24,000 people were tested in Sweden.

This is despite the fact that the Public Health Authority hoped to test up to 100,000 a week in just a few weeks as early as April.

That was not the case and now the hope is that 100,000 Swedes will be able to be tested in mid-May instead.

In Denmark, the goal is to be able to perform 300,000 tests a week and that everyone who wants to be able to test themselves."

 

They did not measure viral shedding prospectively, it is merely "inferred" (hypothesised) as stated in the abstract.

 

This study found that children are at a similar risk of infection to the general population:

[My bolding]

They also found that 20% of cases were asymptomatic at the time of the first clinical assessment. @Snow Leopard I don’t think the relatively high rates of asymptotic cases being reported by this and other studies could possibly all be the result of false positive test results (which I understand should only be about 0.5% for the RT-PCR test)? This is from the discussion:

https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(20)30287-5.pdf

 

Yes, with 99.5% specificity, we would only expect 6-7 of the 98 positives to be false positives. (from Bayes' Theorem). The ratio of false to true positives of a study like this is likely to be lower because it is a selected population with a known risk factor.
But not reporting symptoms at the first clinical assessment neither demonstrates that these cases were infectious at this point in time, nor does it demonstrate that they did not subsequently develop noticeable symptoms. In that sense, I'd suggest they were tested in the narrow "presymptomatic" incubation period and suggestions of infectiousness during this time is still speculative.

I am glad the study provides good evidence to dispel the nonsense about children somehow having greater resistance to the virus.

 

I think by now the EU should have gathered statistics from different countries and impacts from different strategies, for trying to understand what´s up with this virus.

But this doesn´t seems to be the case, instead the EU website looks as unclear as other ones. There is no concept.


In Germany everything looks fine, corona-wise. But it seems that there is no strategy anymore.

Hospitals are quite empty, economy is going down, side effects on health are likely to take place.