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Coronavirus in the UK - news, lockdown and discussion

Sunray said:
The problem with that thinking is we don't yet know if there is any reduction in the effectiveness of the vaccines on the Indian variant.
What if it's less than 80%? Vaccines aren't perfect.
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There's no evidence that any variant, including those first identified in South Africa and Brazil, is able to evade vaccines such that they only give 90% protection against deaths.
 
Sorry to hear that Cloo

It's not selfish at all. It's an important event, one of those that you really want to make a good celebration of and you've planned carefully (probably more than once) and now it might not happen as you've planned....again.

Everyone wants to do the right thing but at the same time there's a real urge for some semblance of normality and FUN - it's been so long I'm not sure I know how to do fun any more!
 
bimble said:
Why are they doing it so wrong then? (I don't know 'what we know')
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I have no idea, they use some very early data from Israel, almost as if they did this model back in February and didn't bother to update their assumptions before publication with data from the UK mass rollout.
 
platinumsage said:
There's no evidence that any variant, including those first identified in South Africa and Brazil, is able to evade vaccines such that they only give 90% protection against deaths.
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I don't understand what you're saying (which is not your fault) - do you mean the vaccine will make deaths more than 10 x less likely, whatever the variant, so that if everyone in UK had both shots of a vaccine then even if case numbers surge with the new variant, we'd still have only up to a max 10% of the deaths seen previously?
If thats what you're saying i'm still stuck on why you're so sure and they're so worried.
 
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Clearly government is counting on vaccines managing hospitalisation and hoping that the 'worst case scenario' is not going ahead with 21 June changes as they seem to be laying groundwork for this evening.

Our BM arrangements are based around 30 people celebrating outdoors, with the possibility of more if things are relaxed and I don't mind if we just have the 30 people, but I'll be gutted if we don't even get that, and it sounds like anyone with any sense is predicting serious issues within a few weeks which could and preclude it (and should if things are that bad)
 
Cloo said:
Clearly government is counting on vaccines managing hospitalisation and hoping that the 'worst case scenario' is not going ahead with 21 June changes as they seem to be laying groundwork for this evening.

Our BM arrangements are based around 30 people celebrating outdoors, with the possibility of more if things are relaxed and I don't mind if we just have the 30 people, but I'll be gutted if we don't even get that, and it sounds like anyone with any sense is predicting serious issues within a few weeks which could and preclude it (and should if things are that bad)
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It depends what you mean by serious issues within a few weeks. The modelling doesnt show a wave that causes health service problems till quite a bit later than that, eg July. What we might get within a few weeks is better data on quite how much of a transmission advantage this strain has, and we may have signs of it taking off in more places by then.
 
platinumsage said:
The Warwick modelling assumes vaccines are only 80% effective at preventing deaths and hospitalisations after one dose and 90% after two doses. This is nonsensical given what we know, and if figures even slightly closer to reality are used the 6000 hospitalisations a day quickly drops away.
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I'm not a fan of your stance on these matters this week, very far from it.

Meanwhile I've been looking through the SAGE modelling groups paper from yesterday, Interesting bits include:

SPI-M-O is therefore confident that B.1.617.2 has a significant growth advantage over the UK’s currently dominant strain, B.1.1.7. The difference in growth rates between B.1.617.2 and B.1.1.7 is consistent with the former having a transmission advantage of more than 50%; this is based on observed growth that has already happened and it is unclear whether this same growth advantage would apply to sustained wider community transmission regionally or nationally. Resolving this question of the applicability of this growth advantage to the wider population will be difficult while the number of cases are small and relatively focussed.
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Considering this, it is a realistic possibility that this scale of B.1.617.2 growth could lead to a very large increase in transmission. At this point in the vaccine roll out, there are still too few adults vaccinated to prevent a significant resurgence that ultimately could put unsustainable pressure on the NHS, without non-pharmaceutical interventions.
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SPI-M-O would become more confident in this assessment of increased transmissibility advantage if any of these four possible situations were to arise. Any of these could happen extremely quickly, potentially even within days:
  • Any emerging evidence of vaccine escape, such as more S-gene positive cases than expected in vaccinated people.
  • More rapid increase in hospitalisations in areas with high or rising S-gene positivity compared to elsewhere, or higher than expected levels of B.1.617.2 cases in hospital.
  • Other parts of the country reflecting similar situations to the North West cluster that cannot be easily identified as being linked to either that cluster or travel.
  • If the North West cluster has another consistent doubling at the same speed (i.e. less than 1 week).
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(S-gene positive stuff is used as a rough guide to cases being this variant or certain other non-Kent variants, without having to wait for ages to get the proper genomic sequencing done)

SPI-M-O considered the implications of different characteristics of variants of concern in modelling to support Roadmap Step 3 decision making4. Both Warwick and London School of Hygiene and Tropical Medicine (LSHTM) performed sensitivity analyses for a variant of concern that was more transmissible than B.1.1.7, but without escape from immunity, in their modelling. If Step 3 alone were taken with a variant circulating in the population that is more than 40% more transmissible than B.1.1.7 with no increase in severity, a further resurgence in hospitalisations similar in size or larger than those seen in spring 2020 and January 2021 is likely (Figure 2, top right plot). If Steps 3 and 4 are taken (Figure 2, bottom plot) with such a variant, peaks could be double that seen in January 2021 if no interventions were taken.
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Until more data accumulates it will be difficult for SPI-M-O to give a confident plausible range for the transmissibility of B.1.617.2 in the wider population beyond that is it more transmissible than B.1.1.7 and that 50% more transmissible cannot be ruled out. Whilst there are clear observations that B.1.617.2 is currently spreading very fast in some places, numbers are still low and SPI-M-O cannot yet tell if that pattern will pertain across the whole population.
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There is also a page or two on the details and merits of surge vaccination. I wont try to quote it all but here is an interesting bit:

There is an inherent lag between vaccination and the establishment of protection of the vaccinated individual, and B.1.617.2 has the potential to spread very rapidly out of areas where it is currently present. It will take some time before surge vaccination starts to break chains of transmission, and thus the variant could spread beyond the targeted area. For that reason, for surge vaccination to be successful it would need to be:
  • Started as soon as possible, while the absolute number of cases B.1.617.2 remains relatively low
  • Targeted at a wider geographical area than that where the variant is prevalent
  • Combined with short term non-pharmaceutical interventions covering the area in question, to allow for the surge vaccination to have time to take effect.
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Oh and theres another paragraph from that document which alludes to a detail of concern which I have put in bold:

  1. There is currently insufficient evidence to indicate that any of the variants recently detected in India cause more severe disease or render the vaccines currently deployed any less effective3. It is also too early to comment on the impact of B.1.617.2 on hospital admissions or deaths; reported COVID-19 hospitalisations in Bolton are concerning. Only accumulating more data on B.1.617.2 will provide this much needed clarity. If there were a time series of the total number of hospitalised B.1.617.2 cases according to their vaccination status, SPI-M-O would be much better placed to assess the threat that the variant poses.
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platinumsage said:
There's no evidence that any variant, including those first identified in South Africa and Brazil, is able to evade vaccines such that they only give 90% protection against deaths.
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https://www.bbc.co.uk/news/56801288 said:
The WHO said it appeared to have a higher rate of transmission and that there was preliminary evidence suggesting some vaccines may be less effective against it.
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I'm worried due to the timing.

If this was 3-4 weeks ago, It'd be ok. Everyone should just stay outdoors.
 
elbows said:
I'm not a fan of your stance on these matters this week, very far from it.
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Nice little jibe there.

I remember you weren't a fan of my support for JCVI lengthening the time between Pfizer jabs either. The baseless and widespread opprobrium that attracted here was one of the reasons I tried to ignore this forum for a while. I should try harder.
 
bimble said:
Anyone feel like reading something really depressing?

"Assuming the vaccines hold up, more people could be hospitalised than in the first wave – putting the NHS at risk – if the variant is much more than 30% more transmissible, University of Warwick models show. At 40% more transmissible, hospitalisations could reach 6,000 per day, far above the peak of the second wave, and 10,000 per day if the variant is 50% more transmissible."

www.theguardian.com

India variant could lead to serious third wave of Covid in UK

Analysis: If B.1.617.2 proves highly transmissible, hospitalisations could peak again, models show
www.theguardian.com www.theguardian.com
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fr
That is if we do nothing. If step three easing of restrictions in England on Monday is cancelled, the third wave will be far more modest, reaching 300 hospitalisations per day, even if the virus spreads 50% more easily than the Kent version. Holding off on step four on 21 June may be less effective: under that scenario a variant little more than 40% more transmissible could trigger more daily hospitalisations than seen in either UK waves so far.
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platinumsage said:
There's no evidence that any variant, including those first identified in South Africa and Brazil, is able to evade vaccines such that they only give 90% protection against deaths.
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There is very sadly evidence that the South African variant may be almost entirely resistant to the AZ vaccine. I'm sure the study's been posted here already, but here it is again.

https://www.nejm.org/doi/full/10.1056/NEJMoa2102214?query=featured_home

Those results - 23/719 vs 19/750 - are consistent with a coin toss, ie no protection at all. :(

It may be that the vaccine prevents some or all serious covid from the SA variant, but we don't know that, and I see no reason to assume it in absence of evidence. The vaccine in the study wasn't given after 12 weeks, so maybe that will help us. And the age cohort means it has little to say about deaths from covid. But all the same, those are not good results.
 
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They're doing surge testing in two very specific (and a couple of miles apart) areas of Hackney (discussed on the Hackney thread). It's interesting because the most recent figures show it's suppressed in one area and very low in the other. The testing's because they've found the SA and Indian strains -- does that mean they're expecting the number of cases/infections to rise rapidly..?
 
platinumsage said:
Nice little jibe there.

I remember you weren't a fan of my support for JCVI lengthening the time between Pfizer jabs either. The baseless and widespread opprobrium that attracted here was one of the reasons I tried to ignore this forum for a while. I should try harder.
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Well I dont know what figures you think the modellers should have used for vaccine protection from severe disease and death, but it is that detail which make me very much at odds with what you are saying recently. As for our history, I will take a look back and see where else I feel you fell well short of pandemic reality.
 
Sue said:
They're doing surge testing in two very specific (and a couple of miles apart) areas of Hackney (discussed on the Hackney thread). It's interesting because the most recent figures show it's suppressed in one area and very low in the other. The testing's because they've found the SA and Indian strains -- does that mean they're expecting the number of cases/infections to rise rapidly..?
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Not necessarily. There was surge testing in South London a few weeks ago in response to a cluster of SA variant. iirc they found about 40 cases relating to one person bringing it in (from a so-called 'green' country). Cases in those areas did not subsequently rise rapidly. The idea is that the surge testing helps to stop a rapid rise!

I think this is a pattern we're going to have to get used to living with, even in the best-case scenario.
 
Sue said:
They're doing surge testing in two very specific (and a couple of miles apart) areas of Hackney (discussed on the Hackney thread). It's interesting because the most recent figures show it's suppressed in one area and very low in the other. The testing's because they've found the SA and Indian strains -- does that mean they're expecting the number of cases/infections to rise rapidly..?
Click to expand...

I havent seen all the numbers but other analysis implies there is quite a wide area of concern.

The spatial risk surface is estimated by comparing the smoothed intensity of cases (variants of concern) and controls (PCR +ve, non-variants of concern) across a defined geographical area to produce an intensity (or risk) ratio. If the ratio is ~1, this suggests that the risk of infection is unrelated to spatial location. Evidence of spatial variation in risk occurs where the intensities differ. Ratio values >1 indicate an increased risk and values <1 indicate lower risk. Figure 9 highlights areas of significantly increased risk identified for VOC-21APR-02.
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Screenshot 2021-05-14 at 21.26.55.png
From https://assets.publishing.service.g...Concern_VOC_Technical_Briefing_11_England.pdf
 
glitch hiker said:
Can't really wrap my head around this.

Concerned that step 4 of the roadmap might not go ahead

So go ahead with steap 3 anyway and do nothing?
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Well I'll put it this way. A sensible government that was actually acting with an abundance of caution would have pressed the pause button now or a number of days ago, at least for a few weeks whilst some of the detail becomes clearer. Especially given some bits of what SAGE etc have told them this month. But we dont have that sort of government.
 
platinumsage said:
Nice little jibe there.

I remember you weren't a fan of my support for JCVI lengthening the time between Pfizer jabs either. The baseless and widespread opprobrium that attracted here was one of the reasons I tried to ignore this forum for a while. I should try harder.
Click to expand...

OK as per my previous post I did go back and look at some of the history but both of us have posted a lot of useful thoughts during this pandemic so this task became too large.

Its much easier for me to apologise for my attitude towards you at times. But it is to be expected that we wont agree on everything, that our stance on particular matters, particular details, particular data and tentative estimates will vary. We dont need to agree on everything. I should spend less time being rude and more time trying to explore the detail behind our differences of opinion. It appears likely that we have been at loggerheads more in the vaccination era than in the prior phases of the pandemic, so maybe there is a fundamental difference in our view of how much burden vaccines should be expected to be able to carry in the pandemic. And/or differences about what sort of data and estimates should be used, and how much uncertainty to factor into that picture?

What sort of figures do you think they should have used in the modelling? And do you have the same criticisms of the London School of Hygience and Tropical Medicines modelling of early May? They have quite a lot of detail about the vaccine-related assumptions they've used through the document and especially in the final part of the document.


More broadly, I wonder if you could explain your overall feelings at this stage as to the risk from this variant and how seriously we should be taking it. Because I got the impression this week that we are on very different pages when it comes to this, and I'm afraid this is just the sorts of high stakes area where I am prone to lose my cool with people. And maybe I have misinterpreted your stance. Cheers.

I'll end with a fun fact, when I was doing some searching I found this post from you from March 24th 2020 in a thread about 'What you gonna do when the all clear comes'...

#5
I fear there won't be an all clear, but a "it's not so bad right now so you can do a few more things but be really careful" until there's a vaccine when it will be "this should 95% protect you, we think, unless the virus mutates a bit, so keep being very careful".
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littlebabyjesus said:
Those results - 23/719 vs 19/750 - are consistent with a coin toss, ie no protection at all. :(

It may be that the vaccine prevents some or all serious covid from the SA variant, but we don't know that, and I see no reason to assume it in absence of evidence.
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You quote the study as the final conclusion regarding its affect on mild covid but then say there is no evidence for serious covid. The study showed 100% protection against serious illness did it not?

SA has been circulating in the uk for a while. If AZ offered no protection against it why isn’t that showing up in the numbers?
 
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Supine said:
You quote the study as the final conclusion regarding its affect on mild covid but then say there is no evidence for serious covid. The study showed 100% protection against serious illness did it not?
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It had a median age of 31. Its participants were young, healthy people. Serious covid was probably not to be expected in that cohort anyway. The study isn't inconsistent with protection against serious covid, but it also doesn't provide any real support for it.
 
I am reading my local news since I am in a part of this town where they've detected the variant, and they have applied for funding to do surge testing here, including door to door stuff.

I really hope that its just the local newspaper that have mangled some of whats been said by the Warwickshire director of public health about this. If not, then I dont think much of some of the detail they've come out with at all, its at odds with the range of possibilities we've been told at the national level, and includes at least one statement that is simply wrong to claim at this stage ("it does not cause as much serious disease").

Dr Shade Agboola explained: "It started in a family, then contract tracing kicked in and we identified additional cases, and then more or less it multiplied."

When asked if she is concerned about a spike in more cases, she said: "We are not expecting to see a rise like we have with Covid in the past, mainly because of the vaccination programme is going so well.

"What we do know about this variant is that while it is more transmissable, between zero to 30 per cent compared to the predominant UK variant, it does not cause as much serious disease and there is no evidence that it evades vaccine, there is no evidence that it is vaccine resistance yet.

"I am hoping that even if we do start to see a rise, it will not be on the same scale as we experienced in the last six months."

Local health officials will be given daily updates from Public Health England in regards to 'sequence testing' of the PCR kits and this will help identify any further cases.

"We are hoping that more do not come in, but if that does happen, we are on top of it," she said.
Click to expand...

www.coventrytelegraph.net

Surge testing for 18,000 households after Indian variant outbreak

It will start door to door next week
www.coventrytelegraph.net www.coventrytelegraph.net
 
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