...
  If you are in hospital 29 days after testing positive for Covid then there seems a pretty good chance your death was Covid related.  ...

They are recording all deaths that have COVID19 on the death certificate.

They're also recording the excess mortality rate.

The deaths in hospital after 28 days is pretty much just a statistical tool to get consistency.

When deaths in hospital have been used as the official rate for previous epidemics nobody has batted an eyelid; it's only because it's now affecting us that anybody cares.

This might lead to an international discussion about standardised measurements, but for planning I would have thought as much data as possible and consistency with presenting it are probably the most important things.

That's what your post reminded me of at least, differences in attitudes of large populations might be reflective of their attitutudes to authority but also to how they handle luck maybe?

Or how f**king stupid they are?

...

John was talking about how 'sensible' people come up with different views.

For example there are those that would think that socially distancing in a pub or a gym is a low risk activity, and others who would think it's massively irresponsible - that's differences of opinion at the sensible end of the scale.

Obviously when it gets to the end of the scale where people think it's okay to travel around to massive house parties and the like it's a lot easier to see the underlying cause.

I am further along the 'more careful' line re Covid than just about anyone I know. My friends are going to restaurants and bars, and into each others' houses, even in groups of three or four, none of whom live together. They would literally be having quiet drinks, definitely not involved in any of the raucous behaviour. I haven't been anywhere, though I have met with friends outdoors, and had a friend to visit tonight for the first time.

I haven't been back to my family in Dublin since the start of the year, and I spoke with my brother and sister tonight to say I might fly over for a couple of days this week, mainly with a view to having a window-visit with my mother. To say they weren't keen is an understatement. My brother just went quiet, so I could tell he didn't approve, and then he just said I should wait a few more weeks. He didn't offer for me to stay, which he always does. My sister said I could stay with her, but I would have to go straight to a bedroom when I arrive and stay there, and she would bring meals to my room. She also said I have to hire a car, as I mustn't travel on public transport. When I suggested that it would be okay to use the sitting room if we kept apart, and that I might use a bus, she said it's not negotiable.

Ireland has had few Covid deaths lately (though infections have started increasing again) - 5 Covid deaths in the last two weeks, 14 in the two weeks before that and 46 in the month before that. Pubs and restaurants are still closed. It has divided the world into Red and Green countries, though countries can move up or down - five countries were demoted to Red last week. The UK is Red, which means people arriving from this high-risk country have to quarantine for two weeks.

That's what your post reminded me of at least, maybe different

I was taken aback by how the mind-sets are so different. My family is completely persuaded of the requirement to still be ultra-cautious, despite being in a lower-death country, whereas people here who I regard as sensible have slipped into fairly casual habits, without any visible adverse reaction. Portsmouth, where I live (pop 238,000), has had no Covid deaths for over two months. Both groups can't be right, can they? My family's attitude seems excessive to me, but I assume it's representative of the population in Ireland, and I suspect I have been drawn along with the general relaxation in attitudes here, without realising it, even if I haven't been participating. If my family is right, then I definitely shouldn't be allowing anyone into my house here, and going to a pub or restaurant should remain out of the question. I feel like I don't agree with either group, yet I can see how their position looks reasonable from their perspective.

I could tell that my brother and sister thought my attitude was reckless, while I know people here who think I am being excessively cautious. I suspect that people reading this in the UK will be surprised at how my family sees it and would side with my friends. But how do reasonable people in one country mostly come to one conclusion and those in another country think the opposite? Is it that we are so suggestible that we can be made to think whatever our government wants, while thinking that we are making our own decisions? I don't know what I think any more.

Something I mentioned early on which plays a significant part is luck.

There are some countries which have had super strict lockdowns - but still have had plenty of infections
There are some countries who have been relaxed - and have had hardly any

I think this filters down to the personal level.

The UK might have a lot higher infection rate than Ireland, but it's absolute value is still low. People can go out and socialise and ignore social distancing and there's a reasonable chance that you'd just never come into contact with anyone to catch COVID19 from - but on the other hand, you might. The difference between a super spreader event and a non event can be just timing and luck.

That's what your post reminded me of at least, differences in attitudes of large populations might be reflective of their attitutudes to authority but also to how they handle luck maybe?

You can have a private account on twitter, but I would have thought two accounts would probably be what you're after.

You can target privacy on facebook - which is generally the easiest to control; but you could have a facebook account for family stuff and a twitter account for 'laddish' stuff it would be much easier to remember what to post where.

This reminded me I saw the people behind the Great North Run have developed this challenge

https://www.greatrun.org/virtual-running

Basically a donation to charity and you get a medal from them after logging a screenshot of your times.

7k or 7 miles in a week and a range of options from 50k to 280k in a month are the distances available.

It's not much but I get a lot of motivation from being promised that I'll get a shiny medal at the end of it so maybe other people would appreciate that as well

a 6am re-open for pubs tomorrow is stupefyingly daft isn't it?

starting on a Saturday was odd enough, but people are going to be in a state with no chance of acting responsibly?

They're doing as much as they can to set up the public to take the blame when it all goes to shit. I can't see what else the strategy can be.

My guess is that they figured if they said they could re-open from some point in the afternoon or evening (or even lunch) then a large crowd would congregate just before opening time.

Opening from 6am means people entering and leaving at different times.

A similar logic to getting rid of last orders but to try and distance people rather than because of drunken behaviour.

If that is the case then I don't understand why they wouldn't choose a random mid week day to do so.

And I also think it severely over estimates the general public.

- - - -

What will be interesting will be the extent of any second wave.

Historically and analytically the fewer people who get infected in the first wave the more will get infected in the second.

But we've never had this level of communication and technology before, we haven't had a pandemic on this scale for a long time either.

- if the second wave is negatively correlated to the first wave then the government's action could take on another perspective.

The analysis suggested that the second wave would be 'due' pretty close to flu season - if you could kick start it early, then we could be in a downward trend when flu season kicks in and spread out the burden on the NHS.


For what it's worth I don't think the government are any where near smart enough to strategise this.

I think, at some level, they decided that the general public were going to increasingly start breaking lockdown restrictions after 3 months anyway so they might as well try and control how it's eased rather than leave it to the whim of the mob.

...

A huge breakthrough came when they intercepted a regular message from a quiet dessert outpost. Once every 24 hours he would send, "Nothing to report today".

I meant to reply to this before but forgot until Rod's post bumped you back to the unread posts board.

Time was always key to cracking the codes, as in if it takes too long to crack it's no longer useful.

It wasn't the most decisive realisation but one of the early boosts to cracking German codes was they realised that so many of the German messages ended with the phrase 'Heil Hitler', a pretty big leak for the Nazi's not to have thought about themselves

[Think we should hold back on making conclusions based on something some random off facebook has posted.]

Has it for the second time in three months.

https://www.facebook.com/photo.php?fbid=10221346964400403&set=a.3736400205377&type=3&theater

Would this lead us to a point where we have to just crack on with masks/distancing then?

Can't stay locked down forever, and unless you do it properly like NZ etc. it's never going to be fully effective anyway.

Unless the plan was for us to just slowly go for herd immunity, which may not be possible, if that case you posted is universal.

Think we should hold back on making conclusions based on something some random off facebook has posted. 

I think the plan here is to try and keep it lowish and under control rather than do a New Zealand.  Though it is still guesswork and I am not even convinced that many of the people in power know the long term plan.

On this point a more accurate statement would be, "Has [tested positive for] it for the second time in three months."

This has some good commentary on it despite the lightness of the source: https://people.com/health/dallas-woman-tests-positive-for-coronavirus-again/

The most relevant parts being:
"It's possible that people could shed remnants of the virus for some period of time. That doesn't mean anything is wrong with them or that they are contagious," Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center in Nashville, told NBC 5.

Similarly, Dr. Ania Wajnberg, associate director of medicine at the Icahn School of Medicine at Mount Sinai in New York City, told the outlet that they are finding that second positives are not strands of live virus.

"What we're finding more and more is that the fragments of virus that are being picked up on these swabs weeks later are not able to replicate," she said. "They're not live virus."

The part about it not being live virus is most important.

The virus is SARS-CoV-2 - when it makes you ill you get the disease COVID19 - if you have the virus in your system you might test positive for it but you won't have the disease if the virus it's detecting isn't live.

This was what I thought of from the facebook post because she said she didn't have symptoms. Although that article also suggests her doctors think that  her case might be caused by the virus going dormant and then re-activating. That's a theoretical possiblity - it's why you can get shingles in later life if you have measles when you're younger (the measles virus hides until it re-activates later) - I don't see anywhere they've given any reason why they think this is the particular case here though.  But that also emphasises Doobs' point about you can only ascertain so much information from a facebook post.

I'm very critical of the governments response but I smell a big whiff of Aftertime Ansell in his comments

I don't think it is.   The doubling every 3 days was known very early.  You can definitely make a case that lockdown was effectively happening before the announcements, some pubs/restaurants, many offices had effectively shut and many parents had withdrawn their kids from school before they were told to. 

So it is debatable how much extra lockdown would have happened.   So I'd say half the deaths by now is probably about right, rather than at least half.   But given we don't know the endgame, it is hard to say if they would have been saved or if we would have just delayed then until wave 2/3. 

I did some maths on the numbers.

From when the lockdown was introduced (roughly speaking) the number of infections doubled 6 times followed by roughly a 50% increase.

If you did 6 doubles plus a 50% from the 16th instead you end up with very close to 50% of the current infection number.

To be honest that's so close to what Professor Ferguson said that I think he has just calculated it mathematically on the assumption exactly the same thing would happen if you implemented it on the 16th as happened on the 23rd.

I think the big, big problem with that is the government support.

We had about 85% of people abiding by lockdown rules - if a full lockdown was introduced a week earlier, would all the same support have been in place? I could definitely see a much lower number than 85% if the furlough scheme hadn't been in place (to take one example).

[was]

I think it points towards the likelihood that closing borders is one of the key steps to restricting Covid 19.

was one of the key steps.

The article is interested in the period around March, so yes 'was'.

I think you are right that there are assumptions that may be inaccurate.
I don't believe it fundamentally changes the general point that the virus entered the country from a number of different places over a period of a few weeks, which could be good info to inform future strategy.

This also would reinforce the point that having a travel hub (London, New York, Paris etc...) would give greater challenges in a pandemic such as this one.

The general epidemiological lessons from previous outbreaks has been that restricting people 'out' of epidemic areas is how you control it rather than restricting people coming 'in' to non-epidemic countries.

It might be that this needs more nuance, that the travel hubs might be structural 'super spreaders' along the same lines that individuals could be, for example.

The genetic analysis that's available now that wasn't available in the past should definitely help with learning new lessons in how to approach it.

I don't think lockdown measures were politically at all likely at that point though. The question around the February half term were  more about whether there should be travel restrictions to Italy.

This suggests that may have been an opportunity missed, but I don't recall any suggestion of anything similar for Spain and France though.

This is interesting.
'Coronavirus was brought into the UK on at least 1,300 separate occasions, a major analysis of the genetics of the virus shows.
The study estimates 80% of those initial cases arrived in the country between 28 Feb and 29 March - the time the UK was debating whether to lockdown.'

https://www.bbc.co.uk/news/health-52993734

Although it was really the 11th of March to the 23rd March when the debate was really happening (IIRC).

I haven't looked back at the news reports from then but I don't think there was any real option of a complete lockdown until after the 11th March.

It would be handy if they could narrow those dates down a bit more. If 600 of them came in before the 11th and a few hundred came in after the 23rd that would suggest the exact date of the lockdown made very little difference.

There is a great deal of inequality in the UK but have to agree that it isn't down to racism.

South asians, in general terms, show that being from a different part of the world or being brown isn't as big an issue as culture.

If you look at the relative success /progress in economic terms of British Indians, Pakistanis, and Bangladeshis it's pretty obvious that race / colour isn't the issue

Good morning

There’s so much wrong with this. The stand out is probably the assertion that people can’t be more racist toward some minority groups than others.

People seem to tolerate racism against Gypsies pretty well.

When did you last see a protest, or even a piece in a newspaper about that?

Perhaps I'm imagining it.

There is racism in the UK.

There is less racism in the UK than the US, and probably less than most of the EU countries.

That is something to mark as some kind of achievement - but it doesn't make the racism that still exists here any better.

Just because we've done well at tackling racism, particularly in the latter part of the 20th century, doesn't mean that there isn't still more left to do.

[Spillover]

Continuing in Science Wife's part of the library, another book about epidemics is:

Spillover by David Quammen

This book much more focuses on epidemics rather than pandemics; but a pandemic is only an epidemic that gets spread to another country so basically the same thing.

I think this is a much better book than 'The End of Epidemics'; it's written much more in the style of telling you a series of stories (a story for each epidemic it covers) but while doing so it probably covers more factual information than the other book.

If you were usually interested in reading general non-fiction I'd imagine there's a good chance you'd enjoy this book - it definitely doesn't need the addition of current relevance to make it a worthwhile read.

A solid 8/10 - packed full of information but still managing to be really very readable

EDIT: also after reading about the first SARS pandemic in 2002-2003 I can really understand a lot more why the asian countries are so big on masks and have all systems ready to go for combatting 'the next one'

Click to see full-size image.

...
On the wtfside, another "oh look, that stable door is open where is my horse?" moment with the compulsory order to wear masks on public transport from 15th June, the prospect of which was something dismissed by the government/SAGE in April as an irrelevance

When public transport use was down by 80 to 90% how much difference do you think the 10-20% still using it wearing a mask would make?

The answer would still be a net positive effect, albeit a tiny one.

However, if they had introduced compulsory wearing a mask on public transport earlier, it could have lead to only a 50 or 60% reduction on public transport use because of people feeling safer going out.

Those 40-50% then using public transport might not bothered so much with social distancing, because everyone was wearing a mask so why would they need to.

The net effect could be a higher rate of transmission as a result of making mask use compulsory.

- is the "kind" of logic they had in mind.

As with other details in the epidemic response, just because something isn't appropriate at one point in time - it doesn't mean that it will never be appropriate at another point in time.

----

All that with the proviso though that the government response does seem to be getting more and more political and less and less 'science-y'