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Coronavirus in the UK - news, lockdown and discussion

Is there anything stopping me from going to Gibraltar? I've been there before and I actually quite liked it - one of the weirdest places I've ever been. Plus you can literally walk across to Spain.
Probably the small number of hotel rooms available. I think it is less than 600 but don't quote me on that.
 
This Q&A is worth a listen


I am so not on the same page as him in regards his first few answers.

This doesnt mean I'm confident that I will be right and that he will be shown to be wrong/overoptimistic. And I would much prefer it if it turns out his stance is compatible with reality and that my level of caution at this stage is unnecessary.

I suppose his current output makes me interested in what sort of stances and expectations he had at the start of the pandemic or at various other crucial moments later on.

I will resist getting into the 'was lockdown effective' stuff right now, but I'm sure I will revisit that subject at some later point and will have far too much to say about it. Again, I'm not on the same page as him at all, but there is lots of complicated detail involved that will bring out the most tedious aspects of me so no, no, nobody deserves that again from me right now.
 
Not sure where to put this but this seems one of the busier threads and I think it's important. Long read from wired about aerosol transmission and some of the mistakes, assumptions and what looks like arrogance that has prevented this from being taken as seriously as it should. Makes an interesting argument that Covid (and other coronavirus and flu) transmission may actually be largely driven by airborne particles rather than large droplets but because these particles are larger than 5 microns they are not recognised as aerosols despite the fact they can travel a lot more than 2 meters through the air. And this lack of recognition seems to be largely down to a fuck up.

“The physics of it is all wrong,” Marr says. That much seemed obvious to her from everything she knew about how things move through air. Reality is far messier, with particles much larger than 5 microns staying afloat and behaving like aerosols, depending on heat, humidity, and airspeed. “I’d see the wrong number over and over again, and I just found that disturbing,” she says. The error meant that the medical community had a distorted picture of how people might get sick.


I find it pretty persuasive, especially given there seems to be so little outdoor transmission despite people nattering into each other's faces outside just like they do inside. I've always found the large droplets thing a bit odd as the main driver of infection, and there seems to be some support for that.
Li’s elegant simulations showed that when a person coughed or sneezed, the heavy droplets were too few and the targets—an open mouth, nostrils, eyes—too small to account for much infection. Li’s team had concluded, therefore, that the public health establishment had it backward and that most colds, flu, and other respiratory illnesses must spread through aerosols instead.

Anyway I'm sure someone with more knowledge than me could pick it apart and scientists don't seem to all fully agree but there's certainly airborne transmission going on and I really don't think the ventilation advice has been taken on board. The vaccination centre I went to had really slick social distancing and sanitising procedures but no ventilation at all and lots of shops and places I've been in have seemed to be on the case with hygeine and distancing but haven't thought about ventilation. If the researchers quoted in that piece are right then this could be a game changer in how some infectious diseases are mitigated, and if not it's still probably a good idea to tell people to open the windows.
 
Without getting into the details, its a fair example of the sort of inadequacies and failings that put humanity deeper into the shit when it came to minimising this pandemic. Just the sort of thing loud gobby people like me fuelled their rants with over a considerable period of time. That particular one isnt one of the ones I've gone on most about, but there is no reason for that other than me having more to say about other failings of the orthodoxy/ But the subject has come up before and I think I've seen signs that plenty of people intuitively knew more about what the reality was likely to be on that front than some of the experts who really should have known better came out with in the past. This common wisdom manifests in various forms including skepticism about the governments ideas as to what really counts as a 'covid secure' business.

But having said that, even the likes of the UK government have 'fresh air' as part of their central public health message these days, but there are still limits as to how far they are willing to acknowledge the full picture on that stuff. Sadly thats not surprising, lots of the detail is inconvenient to them and potentially incompatible with how far they are willing to go with certain rules and recommendations.
 
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Whats this Yorkshire variant mumbling all about. Should we be worried about it? I'm in Yorkshire.

Depends partly on the person and their relationship with worrying, whether such pandemic worries are useful to them or damaging.

For this variant we are mostly at early, nerdy detail stage. Its got rather a lot of mutations of potential concern, but what implications of that actually turn into in practice, if anything, remains to be seen.

Whats tended to happen so far is that the variants which actually end up making a difference to the picture in a way that everyone really needs to know about and keep in mind tend to eventually get highlighted by the government and talked about a lot including in their central press conference messages, and not just for a short period of time. The media will also highlight such concerns but again I'd use whether the messages are sustained or not sustained as part of the guide.

In other words, if there is something really big to worry about then you'll hear all about it in a new and urgent way at some point, and I dont think we are at that point with that variant yet, and any prediction I could offer at this moment would be foolish. And it can take a while for that moment to arrive or for the threat to recede - we've heard a lot about the Indian variant and the government have had reasons to highlight that one and give people some clues about what some of the unhappier implications could be, but in other ways its still early days for that one too, still plenty of unknowns.

Also I dont think the way we are able to track a significant chunk of the evolution of this virus is something we've had so much of in the past. If I claim this is totally uncharted territory that would probably be going to far. But I'd certainly say we are still learning about how this picture of mutations and details of concerns translates into the crucial details in practice - whether they do or do not end up translating into the stuff that matters in each case, eg a new large wave, a strain becoming the new dominant strain etc.
 
Heads up everyone! The Guardian today goes with the headline "Dominic Cummings evidence could settle Boris Johnson’s fate". The story is that Cummings will provide evidence to MPs on Wednesday. He'll 'spill the beans on key Covid decisions'. The article gives no details on what might happen to Johnson after that. It ends with a quote from a pro-Cummings MP: "The public don’t want to hear it." So..bollocks. We might as well be in Putin's Russia.

 
Thanks elbows

I am prone to anxiety but like to be informed especially as a balance to most of those around me who are ecstatic to be "back to normal."
In a way I envy the ecstatic people, but such a stance would not work for me at all at the moment. There will come a time when I can move somewhat in that direction, but that time is not now. It is an inevitable part of my cautious approach that I will be late rather than early in terms of when I get to claim that the really heavy and huge part of the pandemic is behind us.

My stance works for me because I do not need to be optimistic at this stage, without suitable substance to back it up. My stance is compatible with my broader attitude in life.

Take for example that Tim Spector video that I gave some thoughts on earlier. If he has got it wrong then it will be a disaster, both for his credibility and for everyone having to put up with more pandemic horror. When I am wrong, it will be wonderful. I will be so happy to be wrong, and to be able to move with the times and reality and make a significant adjustment to my sense of future risk. And any loss of my credibility will be moderated by the fact that somewhat hedging my bets and maintaining a high degree of uncertainty is baked into my stance. And also it wont really matter if my pandemic credibility takes a hit at that point because we'll have reached a stage where the worst of the pandemic will be behind us and any help my words can provide to people will be somewhat obsolete anyway.
 
Although there is one obvious risk with the cautious approach. If some of the current fears do not translate into bad things happening in a big way, then the optimists and certain agendas will use it to get everyone to listen less to those with a cautious view. Which will probably mean that if things go bad again at some later point, the shits will be able to avoid taking the necessary measures in a timely fashion. So my previous comment about the lack of implications from loss of credibility of those with with a cautious approach were not spot on, if the future is bumpy and messy with false dawns that are not actually sustained over a long period of time.

Meanwhile I am very happy with the expansion of sewage testing, I consider this to be a useful weapon in our surveillance arsenal. I'm delighted that its gone from a fringe topic early in the pandemic to something that this country has embraced big time.

 
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I felt the need to revisit this since you said it less than a week ago and since then we have seen the authorities fiddling with the time between first and second doses. Perhaps you have some thoughts on the changes on that front or something I've drawn attention to in my last 2 posts. Perhaps not.

It's clear for Pfizer and AZ that 12 weeks+ between doses gives the best protection as measured 2 weeks after the second dose. The indications are that especially with Pfizer, protection might reduce slightly in older people from 10 weeks. Bringing the second dose forward is therefore a strategy indicated only when prevalence is increasing or otherwise of concern.

But given that you were against anything other than a 4-week period between doses from the start, and were ramping concerns about a 12-week gap leading to loads of nasty mutants arising, even to the extent that we shouldn't be vaccinating widely at all when prevalence was so high, then I don't expect you to agree with anything the JCVI or MHRA are recommending.
 
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Spain to allow travellers from UK and Japan in without Covid tests​

A quick snap from Reuters here that Spain will allow travellers from Britain and Japan into the country without a negative PCR test for Covid-19 from 24 May, according to an order published this morning in the state gazette.
Spain is on the UK’s “amber” list, so UK restrictions still require travellers returning to Britain from Spain to isolate upon arrival. Ministers have said that people should not travel to “amber” list countries for holidays.

What could possibly go wrong?

I do find that odd, Germany has gone totally in the other direction.

Germany's Public Health Institute has designated the UK as a virus variant area of concern.

From Sunday 23 May, people travelling to Germany from England, Wales, Scotland and Northern Ireland may only enter the country if they are a German citizen or resident. Spouses and children under 18 of a German citizen or resident can also enter, as long as the household are travelling together. Those with an urgent humanitarian reason such as an immediate family bereavement are also able to enter.

But anyone entering the country from the UK will have to quarantine for two weeks, even if they test negative for the coronavirus.

 
I do find that odd, Germany has gone totally in the other direction.



This is incredibly bizarre that the UK are welcome in one country at the same that another country says no to travellers from the UK.
edit: I guess it’s the motivation of the countries. My guess is that Spain needs the tourism and Germany is keen to keep variants away
 
From the Telegraph's live updates...

Two doses from either the AstraZeneca or the Pfizer Covid-19 vaccine are over 80 per cent effective in preventing infection from the Indian variant, a new Government study has found.

Data published by Public Health England also revealed that the two doses provides 87 per cent protection from the Kent variant discovered earlier this year.

The study's findings were presented to a meeting of the Government’s New and Emerging Respiratory Virus Threats Advisory Group (Nervtag).

So, a bit less effective in preventing infection from the India variant compared to the Kent one, I suppose we'll have to wait and see how effective they are in preventing severe infection & deaths, but seems reasonably positive.

It comes after a genomic sequencing expert warned that Indian variant, known as B. 1.617.2, could be 50 per cent more transmissible than other variants in a "worst case scenario".

Dr Jeffrey Barrett, director of Covid-19 genomics at the Sanger Institute, told BBC's Today programme: "I think it's clearly growing, which anyone can see from the numbers as they are reported week by week.

"If I had to put a guess today it would be 20 or 30 per cent rather than 50 per cent (more infectious than the Kent variant). But there is still uncertainty, 50 per cent might be a reasonable worst case scenario."

 
Would we ever be able to know whether or not increasing to 12 weeks has had an effect on number of mutants arising?
Probably not, but we can know if it led to a material difference. I would say that the evidence just from the UK is that it didn't lead to any significant mutations. We're now well into our programme, with 20 million 12-weekers, and all the indicators were positive until a variant from abroad came in.

I read a couple of things warning about the dangers of vaccinating during a pandemic, but thus far I would suggest that the worst fears have not happened. Jury is still out on what the Indian variant will do to us, but if it doesn't wreak havoc, that will be down to having vaccinated during a pandemic.
 
From the Telegraph's live updates...



So, a bit less effective in preventing infection from the India variant compared to the Kent one, I suppose we'll have to wait and see how effective they are in preventing severe infection & deaths, but seems reasonably positive.



Those numbers for the vaccines are still very positive to me. For az, Urban's main vaccine of choice, the figures are quite a bit higher than we were initially led to expect. Council jab's not so bad after all.

Also very good news for India! And for the Covax scheme.
 
It's clear for Pfizer and AZ that 12 weeks+ between doses gives the best protection as measured 2 weeks after the second dose. The indications are that especially with Pfizer, protection might reduce slightly in older people from 10 weeks. Bringing the second dose forward is therefore a strategy indicated only when prevalence is increasing or otherwise of concern.

But given that you were against anything other than a 4-week period between doses from the start, and were ramping concerns about a 12-week gap leading to loads of nasty mutants arising, even to the extent that we shouldn't be vaccinating widely at all when prevalence was so high, then I don't expect you to agree with anything the JCVI or MHRA are recommending.

Thanks for reponding. I did have concerns about those things, they made me uneasy, but I didnt invent those concerns myself, some people I respect had them too and I was inclined to agree.

If every single concern I've had during this pandemic came true, then it would have been a worse pandemic than the one we've actually had. And I do understand the difficult balancing act that various advisers and authorities have to make judgements about. Sometimes there are no perfect choices and there are inherent theoretical risks, and I'd rather at least talk about them than proceed as if there is more certainty around these matters than is actually the case.
 
I'd also like to expand on the mutation risk point by splitting it into two different things. Certainly I shared concerns about what the risk might be of full on escape mutants having opportunities to emerge and gain an obvious advantage during vaccination phases of the pandemic. I was pleased that the subject came up and that authorities had a chance to explain their feelings about this risk and the rationale of proceeding anyway.

But then I'd say there is also a milder version of that - the concerns about strains that the vaccines can still be expected to offer some protection against, but reduced protection. In this area it is important to study the current language used by government etc - if they simplify things down to a binary level where they can say things like 'the vaccine is still effective' or words to the effect of 'the vaccines arent useless against that strain', then something is lost from the picture. If efficacy is somewhat reduced then there is still a great purpose to vaccination, but it does have an impact on calculations about how much of a third wave we might expect. And those calculations are important right now. So I will continue to watch this area closely and point out when overly reassuring language is being deliberately used.

A completely different concern I had about the giddy vaccination phase during times of relatively high viral prevalence involved people getting infected during the process of vaccination, or as a result of changing their behaviours to soon or too much after receiving a dose. I believe I have probably pointed out before what was said about this in a SAGE meeting in March, but here are some relevant quotes again:


The vaccination programme is continuing at pace. CO-CIN analysis shows that of those people who have been hospitalised and tested positive for COVID-19 after being vaccinated, the majority of these developed symptoms before immunity would be expected to have developed, with few developing symptoms more than 2 weeks post-vaccination (with at least a first dose).

The observation that a significant number of people developing symptoms within a few days of a first dose may suggest some behaviour change following vaccination (and before immunity has developed). It is important therefore that communications around vaccination reinforce the need for safe behaviours to be maintained. It may also be the case that some infections occur during the end-to-end process of vaccination (i.e. including journeys to and from vaccination). The low number of people in the study with symptom onset in the days prior to vaccination is expected, as most people with symptoms would not attend their vaccination appointments. Many of those included in the study would have been vaccinated at a time when community prevalence was very high.

Although the COVID-19 vaccines in use in the UK are highly effective, no vaccine is 100% effective, and some people will be hospitalised with COVID-19 even after completing their full vaccination schedule (high confidence). It will be particularly important to monitor the prevalence of different variants present in this group by sequencing to understand any potential immune escape. This is underway by PHE.
 
It's clear for Pfizer and AZ that 12 weeks+ between doses gives the best protection as measured 2 weeks after the second dose. The indications are that especially with Pfizer, protection might reduce slightly in older people from 10 weeks. Bringing the second dose forward is therefore a strategy indicated only when prevalence is increasing or otherwise of concern.

But given that you were against anything other than a 4-week period between doses from the start, and were ramping concerns about a 12-week gap leading to loads of nasty mutants arising, even to the extent that we shouldn't be vaccinating widely at all when prevalence was so high, then I don't expect you to agree with anything the JCVI or MHRA are recommending.
I also think you are missing out the fact that my concerns were also based on the data, or lack of data, available at the time. I will not accept the view that it was wrong to consider what time periods were used in the original trials that provided most of the actual data available at the time. We have better real world data now which would enable me to form a somewhat different opinion.

it may be that experts in the field had prior knowledge which enabled them to believe that increasing the timing between doses might have a positive effect, even before such data was actually in place. I did not have that prior knowledge, and I dont recall hearing much about it at the time. The official reason given was they they weighed various things up and decided the potential upside, in terms of the vaccine rollout schedule, outweighed the risks. Thats fair enough, but was still worthy of discussion.
 
Probably not, but we can know if it led to a material difference. I would say that the evidence just from the UK is that it didn't lead to any significant mutations. We're now well into our programme, with 20 million 12-weekers, and all the indicators were positive until a variant from abroad came in.

I read a couple of things warning about the dangers of vaccinating during a pandemic, but thus far I would suggest that the worst fears have not happened. Jury is still out on what the Indian variant will do to us, but if it doesn't wreak havoc, that will be down to having vaccinated during a pandemic.
The thing is,that it could, say, lead to a 60% risk that a dangerous mutant will arise in a population of X million, and we have just been lucky (so far) that it hasn't happened.
 
In terms of escape mutants I suppose its also possible that such mutants may also end up with disadvantages compared to other strains. And therefore we wouldnt expect to see them gain an overall advantage and thrive until we are in a situation where a very large proportion of people the virus will come up against have that sort of immunity, outweighing any other disadvantages the escape mutant variant has. But perhaps there is something missing from this picture that I havent considered.
 
I also think you are missing out the fact that my concerns were also based on the data, or lack of data, available at the time. I will not accept the view that it was wrong to consider what time periods were used in the original trials that provided most of the actual data available at the time. We have better real world data now which would enable me to form a somewhat different opinion.

I know exactly that's what yours and others’ concerns were based on, which I found very frustrating. There was literally no evidence from other vaccines that immunity would evaporate between 4 and 12 weeks. Insisting on going only by the arbitrary time period used in the trials was the risky move. Off-label use is so widespread in medicine I found it concerning there was such a furore coming from certain apparent experts, which if not motivated by political considerations seemed to be based on a certain tunnel vision and inability to see the full clinical picture.

I know there’s lots to fault in the UK’s response to the pandemic, but I struggle to muster any significant criticism where vaccines are concerned, perhaps because there aren’t the competing interests in government that are present with other aspects such as lockdowns, travel and comms.
 
My concern was not that immunity would evaporate between 4 and 12 weeks, it was mostly about a lack of data at the time as to what effect a longer gap might have on the levels of protection finally obtained after both doses.

Mistakes I may have made in terms of rigidity is that I like evidence-based decisions, and so I found it unhelpful that we were using timing that didnt match the timing used in the trials which provided the early evidence and data. I thought that introduced uncertainty, and I didnt know if it was safe to make assumptions.
 
In terms of 'competing interests' witin government, I'd mostly point to a different sort of balancing of priorities which is fair enough, and that the 12 weeks thing provides a good example of. They were trying to maximise protection/minimise death whilst taking account of actual supply availability, which involved some compromise and fiddling with certain parameters. I was concerned about whether they had made the right choices about that, and I was keen to draw attention to those sorts of compromises. Only the passsage of time offered certainty about that, and I was pleased to be wrong. I am also pleased when they maintain a flexible enough approach that they are prepared to change the rollout schedule again as circumstances change. I dont bank on them always managing to dodge unintended consequences, and I am bound to voice concerns when I have them, but I dont expect every single concern of mine to be fully realised.

I soppose my largest concern regarding vaccinations remains unchanged for now, the binary nature of many peopels thinking about it and the levels of protection on offer, and the potential effects on peoples behaviour that could result. ie all my waffle about the giddy nature of the rollout, the chances of a third wave, how much pandemic weight the vaccines can reasonably be expected to carry. Only the passage of time without a significant third wave can diminish those concerns for me, and I think our recent disagreement flared up because we have a different view about this stuff. I'd certainly much rather that it turns out that your stance on this works out fine, but in the meantime my concerns will remain.
 
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