Main Coronavirus / Covid-19 Discussion Thread

Bozza · Dec 4, 2021

The Mole said:
I don’t think we know how many cases there are in the UK yet. They can only test a small sample for variants. We don’t know where it came from - just that it was discovered in South Africa. Many countries don’t have the genome technology to identify variants. South Africa has now identified two of the five main variants.

If you scroll up a page or two, I posted a link to a tweet which, if opened, is a thread of tweets from UKHSA's Meaghan Kali which lists key points from UKHSA's Omicron technical briefing yesterday.

Meghan talks about taking S-gene dropout from PCR tests as a proxy for Omicron prevalence, as it's about as good a guide as we have right now. In doing so we can see that's started to grow quite quickly, but caveated with this is all small numbers right now, so changes in relative terms can appear more significant than they may be.

Bozza · Dec 4, 2021

A few pages ago I said that a more transmissible virus can be worse than a virus that causes more severe illness/death. It's quite a counter-intuitive outcome that takes some thought to try and understand, at least for me.

Anyway, this graph probably does a better job than my words did.

If Omicron is far more transmissible, it also needs to be significantly milder to not present a possible large healthcare problem.

[tweet]1467077019645067265[/tweet]

And with that, it's sunny so I *AM* going outside now!

Rodney Thomas · Dec 4, 2021

Bozza said:
A few pages ago I said that a more transmissible virus can be worse than a virus that causes more severe illness/death. It's quite a counter-intuitive outcome that takes some thought to try and understand, at least for me.

Anyway, this graph probably does a better job than my words did.

If Omicron is far more transmissible, it also needs to be significantly milder to not present a possible large healthcare problem.

[tweet]1467077019645067265[/tweet]

And with that, it's sunny so I *AM* going outside now!

I am I right in thinking that the above graph doesn't really(or at all) take into account vaccination protection (or percentage vaccinated)?

beorhthelm · Dec 4, 2021

Bozza said:
A few pages ago I said that a more transmissible virus can be worse than a virus that causes more severe illness/death. It's quite a counter-intuitive outcome that takes some thought to try and understand, at least for me.

Anyway, this graph probably does a better job than my words did.

If Omicron is far more transmissible, it also needs to be significantly milder to not present a possible large healthcare problem.

[tweet]1467077019645067265[/tweet]

And with that, it's sunny so I *AM* going outside now!

vaccines solve this. good job most have had theirs.

hosptialisation and deaths continue to fall.

Kinky Gerbil · Dec 4, 2021

beorhthelm said:
vaccines solve this. good job most have had theirs.

I read that as it will get to the unvaccinated quicker, also quite an arrognat tweet - "How many doctors get it?"

Billy the Fish · Dec 4, 2021

Bozza said:
A few pages ago I said that a more transmissible virus can be worse than a virus that causes more severe illness/death. It's quite a counter-intuitive outcome that takes some thought to try and understand, at least for me.

Anyway, this graph probably does a better job than my words did.

If Omicron is far more transmissible, it also needs to be significantly milder to not present a possible large healthcare problem.

[tweet]1467077019645067265[/tweet]

And with that, it's sunny so I *AM* going outside now!

Quite a bit of scaremongering in that post. Had a quick look at his twitter feed, he's very much pushing a zero covid agenda, file in the extremist section!

Bozza · Dec 4, 2021

Billy the Fish said:
Quite a bit of scaremongering in that post. Had a quick look at his twitter feed, he's very much pushing a zero covid agenda, file in the extremist section!

It's not an account I follow nor have seen before - I just came across the graph earlier, and knew it was a better representation of a theoretical point I made a few days back.

But the point stands, and it's one that I came across when Delta appeared on the scene: a more transmissible variant can be significantly more damaging to healthcare systems than one that retains the same level of transmissibility but results in more bad outcomes.

So, IF (caveat, caveat etc etc) Omicron is more transmissible, we need it to result in less severe illness or things could get pretty ugly for some.

Bozza · Dec 4, 2021

beorhthelm said:
vaccines solve this. good job most have had theirs.

hosptialisation and deaths continue to fall.

So, every expert out there is saying we don't know how vaccines will help with this, but you know that they will stand up exactly as they have to Delta?

Current hospitalisations and deaths in the UK are from people who got infected 2-4 weeks ago, on average, ie before Omicron.

We were well on our way to kicking Delta's arse with vaccines and boosters. We don't know if that position is going to remain the same with Omicron's apparent increased transmissibility.

Note: I am absolutely NOT saying Omicron will **** us over, but I'm also not saying "nothing to see here - it's all good."

Bozza · Dec 4, 2021

That's handy timing. Some tentative early positive data on South African hospitalisations...

[tweet]1467172016918773775[/tweet]

Kinky Gerbil · Dec 4, 2021

Bozza said:
That's handy timing. Some tentative early positive data on South African hospitalisations...

[tweet]1467172016918773775[/tweet]

76 percent are in for something that isn’t Covid.

That’s potentially some serious infection control problems.

beorhthelm · Dec 4, 2021

Bozza said:
So, every expert out there is saying we don't know how vaccines will help with this, but you know that they will stand up exactly as they have to Delta?

even if the vaccine doesnt prevent infection it reduces illness, because thats part of what vaccines do. they prime the immune system. the other factor is the absense of any panic from those involved in creating the vaccines. they have to wait until they have evidence to say the continued efficacy, however they dont/wouldnt have to wait if they know efficacy would be dramtically impacted. the chart shown is a hypothetical one assuming no mitigations, either vaccine or natural immunity or treatments, over undefined time frame.

Joey Jo Jo Jr. Shabadoo · Dec 4, 2021

Kinky Gerbils said:
76 percent are in for something that isn’t Covid.

That’s potentially some serious infection control problems.

It seems more likely that they are people who have been admitted for another reason and then find out they have asymptomatic covid when they are tested in hospital on admission. Rather than catching it while in hospital. If there is that much transmission in hospital I’d go as far as saying infection control is almost non existent.

There seems to be a lot of symptomless cases. Two of my pre teen kids have had covid both were symptom free and it’s only been picked up by testing for school. Without testing we’d have never known and they’d have carried on going to school, youth clubs etc without any second thoughts.

highflyer · Dec 4, 2021

Bozza said:
You correctly say there is very little reliable data and highlight many in the field are guarded on making calls at this time, yet go on to promote purely positive-sided viewpoints.

I'm very much an optimist glass half-full kinda guy, and I approach pretty much all I face with a positive mindset. However, I'm also guarded with regards searching out what I WANT to find, confirmation bias I suppose, and try to be a bit more even-handed. As such, I'm not sure your run-down there is particularly balanced.

However, it doesn't matter what I think, what I read nor what I write on here - what will be will be. And we all want that to be as positive as possible, involving minimal health impacts, few lives lost and us all just being able to get on with living properly. Fingers crossed...

Hmm, I genunely didn't think I WAS being particularly positive. So maybe some unconscious bias built in to how I've written it, which is probably as much about trying to cheer myself up as anything.

dsr-burnley · Dec 4, 2021

Bozza said:
A few pages ago I said that a more transmissible virus can be worse than a virus that causes more severe illness/death. It's quite a counter-intuitive outcome that takes some thought to try and understand, at least for me.

Anyway, this graph probably does a better job than my words did.

If Omicron is far more transmissible, it also needs to be significantly milder to not present a possible large healthcare problem.

[tweet]1467077019645067265[/tweet]

And with that, it's sunny so I *AM* going outside now!

The point of this graph is nothing to do with vaccinations. What this graph is saying is that cases will rise to unbelievable levels pretty quickly.

At present there are estimated 1.1m people with active coronavirus in this country. This graph is estimating that if we get a virus that is 50% more transmissible, then within 5 "cycles" of the disease (usually interpreted to have approx. a fortnightly cycle, so 10 weeks) there will be 10 million people in this country with active coronavirus.

Obviously this graph is a vast oversimplification, though it doesn't say so. Certainly if you extrapolate another 5 cycles to get 100m people in this country with the disease, then it's into the realms of fantasy - but in fact Dr. Berger, who does declare himself an absurdist to be fair, only takes it through 5 cycles. We don't know when his projection would take the inevitable downturn.

But 10 million cases simultaneously? That would be (if recording continues at the same rate) 500,000 new cases per day? It really doesn't seem likely. He's just scaremongering, using an absurd figure to illustrate what might become serious (or might not) but certainly won't do what the graph says.

Bozza · Dec 5, 2021

dsr-burnley said:
The point of this graph is nothing to do with vaccinations. What this graph is saying is that cases will rise to unbelievable levels pretty quickly.

At present there are estimated 1.1m people with active coronavirus in this country. This graph is estimating that if we get a virus that is 50% more transmissible, then within 5 "cycles" of the disease (usually interpreted to have approx. a fortnightly cycle, so 10 weeks) there will be 10 million people in this country with active coronavirus.

Obviously this graph is a vast oversimplification, though it doesn't say so. Certainly if you extrapolate another 5 cycles to get 100m people in this country with the disease, then it's into the realms of fantasy - but in fact Dr. Berger, who does declare himself an absurdist to be fair, only takes it through 5 cycles. We don't know when his projection would take the inevitable downturn.

But 10 million cases simultaneously? That would be (if recording continues at the same rate) 500,000 new cases per day? It really doesn't seem likely. He's just scaremongering, using an absurd figure to illustrate what might become serious (or might not) but certainly won't do what the graph says.

No, on all counts - you've barked up about 34 wrong trees there.

This is theoretical, explaining how a virus that is more transmissible can be more damaging than a virus that causes more severe illness/death.

The Clamp · Dec 5, 2021

Get vaccinated, take precautions, wear your mask, stay away from crowded places if you’re vulnerable. Beyond that? Keep calm and carry on.
I think some people are having trouble leaving Covid restrictions behind. Some have seen life at a slower pace and don’t want to go back to normal life.
New Covid scares sell papers and keep the lights on.
Take a step back from the news and the analysis and give yourselves a break from the scaremongering.

Bozza · Dec 5, 2021

Bozza said:
No, on all counts - you've barked up about 34 wrong trees there.

This is theoretical, explaining how a virus that is more transmissible can be more damaging than a virus that causes more severe illness/death.

...and just to follow up, it's something the FT John Burn-Murdoch has covered off in his recent thread looking at Omicron in South Africa.

C&P of the relevant bit here:

Even if far less than 25% of patients require ICU this time, a small share of a rapidly increasing number can still become a big number. And numbers are going up very, very fast.

And this is why Omicron remains worth taking very, very seriously in South Africa, in Europe, in the US and elsewhere.

With governments very reluctant to reimpose major restrictions, Omicron’s growth advantage (whether conferred by shorter incubation period, immune evasion and or something else) is bound to produce very rapid waves of infections when it takes hold.

So if we take the equation:

ICU beds filled = people infected x risk of needing ICU

"People infected" could get very big, very quickly, even with lots of vax and prior infection.

So race is now on to use third doses to get "risk of requiring ICU" as small as possible

Read the whole thread from here: [tweet]1467270450111787012[/tweet]

Green Cross Code Man · Dec 5, 2021

Bozza said:
...and just to follow up, it's something the FT John Burn-Murdoch has covered off in his recent thread looking at Omicron in South Africa.

C&P of the relevant bit here:

Even if far less than 25% of patients require ICU this time, a small share of a rapidly increasing number can still become a big number. And numbers are going up very, very fast.

And this is why Omicron remains worth taking very, very seriously in South Africa, in Europe, in the US and elsewhere.

With governments very reluctant to reimpose major restrictions, Omicron’s growth advantage (whether conferred by shorter incubation period, immune evasion and or something else) is bound to produce very rapid waves of infections when it takes hold.

So if we take the equation:

ICU beds filled = people infected x risk of needing ICU

"People infected" could get very big, very quickly, even with lots of vax and prior infection.

So race is now on to use third doses to get "risk of requiring ICU" as small as possible

Read the whole thread from here: [tweet]1467270450111787012[/tweet]

I think his threads are very good. Interesting analysis which is conveyed in layman's terms and I believe he is fair and impartial.

Sent from my Pixel 6 using Tapatalk

dsr-burnley · Dec 5, 2021

Bozza said:
No, on all counts - you've barked up about 34 wrong trees there.

This is theoretical, explaining how a virus that is more transmissible can be more damaging than a virus that causes more severe illness/death.

Theory that relates to the real world is useful. It may be right or wrong, but it has relevance. A theoretical graph that ignores the real world and posits a scenario that basically can't happen - what use is it? If someone posts nonsense figures to make a point, then it might successfully frighten people who don't understand that the figures are deliberately exaggerated, but it will also succeed in alienating people who don't want to believe the bad news and so will use false projections as a way of disregarding some truths.

Look at modelling generally. Several models have come up with ridiculously bad projections, some of which were called out as ridiculously bad before empirical evidence proved it so. It has made certain people very dubious about the benefit of modelling at all. They shouldn't produce false projections, that's all I'm saying, even if they think they are doing it in a good cause.

Bozza · Dec 5, 2021

dsr-burnley said:
Theory that relates to the real world is useful. It may be right or wrong, but it has relevance. A theoretical graph that ignores the real world and posits a scenario that basically can't happen - what use is it? If someone posts nonsense figures to make a point, then it might successfully frighten people who don't understand that the figures are deliberately exaggerated, but it will also succeed in alienating people who don't want to believe the bad news and so will use false projections as a way of disregarding some truths.

Look at modelling generally. Several models have come up with ridiculously bad projections, some of which were called out as ridiculously bad before empirical evidence proved it so. It has made certain people very dubious about the benefit of modelling at all. They shouldn't produce false projections, that's all I'm saying, even if they think they are doing it in a good cause.

I don't know why the bloke was using it.

I was recycling it because I've previously made the point that a virus that is more highly transmissible can still spell big trouble even if it results in milder illness. I've made that point a few times, but I think it's a tricky concept to understand. I think it's tricky to understand because I found it tricky to understand. I'm a simple layman, and I previously thought that....

"More transmissible and milder" was likely to be better for a population than "Similarly transmissible and more severe"

...but in many scenarios, and as may be the case with Omicron, it's unlikely to be a positive change.

So ignore the theoretical graph if you don't like it - work through JB-M's analysis that I've linked to since. Very much a Covid-centrist, he can see the big red flashing warning signs that Omicron's apparent transmissibility could mean for us all.

Moving on, Omicron seems to be displaying the same 3-day doubling rate in the UK that it has been in South Africa:

[tweet]1467497592741318666[/tweet]

...if that is the case, and it continues at that rate, Omicron would be the dominant strain in the UK around New Year.

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