Coronavirus in the UK - news, lockdown and discussion

[elbows]

And the missing Scotland data is very annoying becauce it should cover a crucial period - it was already taking rather a long time for Scotlands hospital admissions to show an obvious peak compared to when their positive case numbers peaked. There are some standard assumptions about peak hospitalisation timing relative to case peaks that I am not willing to fully rely on in this wave, and so I need the actual hospitalisations data to shime light on what might be a quite messy picture. For example if the largest case number drops are in younger age groups, then have to be careful to establish that theres actually been the sort of peak and drop that would make the crucial different to the health care system in a pandemic wave.

 

[elbows]

Plus its especially pressing that I learn more about whats happened in Scotland given what the case numbers for England are doing this week.

The following is part of the England cases graph on the dashboard that is roughly equivalent to the sort of colour-coded deaths graphs I used to produce to demonstrate the difference between deaths by report date and where they fit in by actual date of death. Except this is for cases and just covers where todays reported case numbers belong in terms of specimen date, by showing them in yellow.

If a lot more cases dont end up getting added to the days after July 15th, then is that really the peak? And if it is a peak in terms of positive cases detected and reported, how does this relate to the underlying reality of case numbers, and what we expect from hospital admissions in the next two weeks?

 

[elbows]

I dont know, for example, whether there is a reporting issue that means some data is missing. Its happened in the past, but I wont make any assumptions about whether thats happened this time, that might not be the explanation at all, and I've certainly gone on about peaks a lot recently so I dont exclude the possibility it is a real peak.

Meanwhile I see that yesterday they found a lot of historical positive tests down the back fo the sofa:

PCR tests from pillar 1 in England and the UK reported from 20 July 2021 include tests carried out within NHS Trusts that host a PHE lab. 28,214 historical test samples dating from November 2020 onwards have been added to the total figure.

That quote is from the updates section of the dashboard.

 

[elbows]

When I say reporting issue, I include the possibility that some specific parts of the testing system might have become overwhelmed or are running low on key supplies used in the testing process.

Certainly whatever is responsible was rather abrupt, although actual cases picked up by testing can genuinely abruptly change too around the peak.

So I'm none the wiser, I dont think there is anything barring news of a problem, or subsequent data that fills in the gaps, that can give me further clues other than the passing of time.

Plus I was anticipating seeing some things of interest in this period, due to schools breaking up and the football being further behind us and the amount of disruption due to self-isolation and behavioural changes due to the changed mood music.

 

[elbows]

Also ZOE hasnt been much help checking this because in recent weeks they showed various flattening off of numbers too soon and so have had to change their methodology again now to get their results to better fit other data sources.

 

[Cloo]

Also ZOE hasnt been much help checking this because in recent weeks they showed various flattening off of numbers too soon and so have had to change their methodology again now to get their results to better fit other data sources.

I've noticed that and thought it can't be right.

I'm currently wondering whether I should put money on the government deciding to vaccinate 12-17 year olds around mid December or thereabouts when it'll probably be too late for it to do much good in winter

 

[elbows]

Well Tim Spector from ZOE has put out a video explaining the change, except its mostly a load of waffle and some awkward references to the elephant in the room and blah blah blah.

 

[miss direct]

So worrying that people are being asked to test and go (and ignore isolating). Mum was negative on Monday and positive on Wednesday...A negative test following exposure doesn't mean a person doesn't have it, or might not develop it.

 

[Chz]

We were definitely told to isolate The Boy for 10 days regardless of what his tests (all negative) say.

 

[gentlegreen]

Vincent Racaniello and Amy Rosenfeld continue to be laid-back about the risk of infection to the double-vaccinated and stating that they always remove their masks when meeting other double-vaccinated people and that the unvaccinated should wear masks to protect themselves ...
With regards the UK it seems to be "hard luck if you chose not to get vaccinated" ...
They are very obviously getting weary after so many months of being diverted from their core interests ...

 

[elbows]

Well from what I've seen there is a lot more binary thinking about vaccines in the USA, at least from sections of their media and experts.

Other differences include the USA making a far greater deal of the number of young people and children who have been hospitalised in the pandemic.

I have not had time to study these differences properly, but it means their vaccine drive has been more simplistic and I dont know what will happen to the messages there as Delta really gets going.

 

[wemakeyousoundb]

Well from what I've seen there is a lot more binary thinking about vaccines in the USA, at least from sections of their media and experts.

Other differences include the USA making a far grater deal of the number of young people and children who have been hospitalised in the pandemic.

I have not had time to study these differences properly, but it means their vaccine drive has been more simplistic and I dont know what will happen to the messages there as Delta really gets going.

Annecdotal:
I see a lot of parents asking on how to get their children vaccinated in the USA on a vaccine discussion group on facebook, so there are worried people out there.

 

[ska invita]

Az is a bit shit on this stat


Three to six weeks after full vaccination with Pfizer, antibody levels typically stood at about 7,500 units per ml, but more than halved to 3,320 units per ml after 10 weeks. For AstraZeneca, antibody levels peaked at about 1,200 units per ml and typically fell to 190 units per ml after 10 weeks. Since publishing the results in a letter to the Lancet, the researchers have seen the same trend in a further 4,500 participants in the study.

While antibody levels are important for protection, the immune system has other defences that are built up after infection or vaccination. It is normal for antibody levels to wane over time and for the immune system to “remember” the infection with memory B cells. Should the virus invade, these cells rapidly churn out antibodies targeted at the virus. Further protection comes from T cells, which destroy infected cells and limit the severity of disease.

...

If the government don't get a grip we're going to be having a lot of jabs every year

 

[gentlegreen]

Az is a bit shit on this stat

I can't help continuing to wonder if it's a coincidence that AZ alone chose not to stabilise the spike ....

 

[elbows]

Fans of vaccine percentage stats on the dashboard should note that they are switching to use newer population estimates today, so if you want to compare how the percentages look for a particular area before and after this change, you have a few hours left to record the current numbers.

I dont know how much difference it will make so I have grabbed a few.

 

[bimble]

Az is a bit shit on this stat


Three to six weeks after full vaccination with Pfizer, antibody levels typically stood at about 7,500 units per ml, but more than halved to 3,320 units per ml after 10 weeks. For AstraZeneca, antibody levels peaked at about 1,200 units per ml and typically fell to 190 units per ml after 10 weeks. Since publishing the results in a letter to the Lancet, the researchers have seen the same trend in a further 4,500 participants in the study.

While antibody levels are important for protection, the immune system has other defences that are built up after infection or vaccination. It is normal for antibody levels to wane over time and for the immune system to “remember” the infection with memory B cells. Should the virus invade, these cells rapidly churn out antibodies targeted at the virus. Further protection comes from T cells, which destroy infected cells and limit the severity of disease.

...

If the government don't get a grip we're going to be having a lot of jabs every year

I don’t understand what this means. If you only have 190 thingies then are you protected from getting seriously ill or not?

 

[prunus]

I don’t understand what this means. If you only have 190 thingies then are you protected from getting seriously ill or not?

Yes, probably, but in a slightly different way. Having a high antibody level circulating means that any virus that attempts to get going can immediately be swamped (with luck).

A lower level might mean that the virus has about 12 hours to get going while the immune system recognises it and gets underway producing the antibodies from the original template.

It’s a bit like the difference between having a large standing army and a smaller army of scouts with a large reservist army ready to be mobilised when the scouts spot the enemy - and for a similar reason - keeping large standing armies ready to fight all the possible pathogens/enemies that might turn up is very expensive, so to be avoided.

As time passes without infection the immune system thinks “maybe the risk had passed, let’s stand down and go into watch mode”.

 

[Storm Fox]

This Kurzgesagt Video helps to explain the various parts of the immune system

 

[bimble]

Yes, probably, but in a slightly different way. Having a high antibody level circulating means that any virus that attempts to get going can immediately be swamped (with luck).

A lower level might mean that the virus has about 12 hours to get going while the immune system recognises it and gets underway producing the antibodies from the original template.

It’s a bit like the difference between having a large standing army and a smaller army of scouts with a large reservist army ready to be mobilised when the scouts spot the enemy - and for a similar reason - keeping large standing armies ready to fight all the possible pathogens/enemies that might turn up is very expensive, so to be avoided.

As time passes without infection the immune system thinks “maybe the risk had passed, let’s stand down and go into watch mode”.

Why does one company’s vaccine give you a so much smaller standing army though? Does that matter ?

 

[teuchter]

One approach to differing feelings about risk

 

[existentialist]

One approach to differing feelings about risk

Pragmatic

 

[Supine]

Az is a bit shit on this stat


Three to six weeks after full vaccination with Pfizer, antibody levels typically stood at about 7,500 units per ml, but more than halved to 3,320 units per ml after 10 weeks. For AstraZeneca, antibody levels peaked at about 1,200 units per ml and typically fell to 190 units per ml after 10 weeks. Since publishing the results in a letter to the Lancet, the researchers have seen the same trend in a further 4,500 participants in the study.

While antibody levels are important for protection, the immune system has other defences that are built up after infection or vaccination. It is normal for antibody levels to wane over time and for the immune system to “remember” the infection with memory B cells. Should the virus invade, these cells rapidly churn out antibodies targeted at the virus. Further protection comes from T cells, which destroy infected cells and limit the severity of disease.

...

If the government don't get a grip we're going to be having a lot of jabs every year

Analysing the real world effectiveness of vaccines on real patients is a much better way to determine how good the vaccines are. You need to be pretty expert to understand what that units per ml actually means in the real world.

 

[elbows]

Analysing the real world effectiveness of vaccines on real patients is a much better way to determine how good the vaccines are. You need to be pretty expert to understand what that units per ml actually means in the real world.

Yeah, I dont attempt such things myself.

2hats posted some interesting news from Israel on that front here #1,415 but we still have to consider factors like Israel sticking to a shorter gap between doses than the stretched out schedule the UK went for.

 

[bimble]

yeah i've read the article now and it basically says, we won't really know what it means until double vaxxed people turn up in hospital.

 

[IC3D]

One approach to differing feelings about risk

I love the I always swim on the no pissing side of the pool comment regarding wearing a mask to go to the bogs. Sums up how I feel about that precaution.

 

[IC3D]

yeah i've read the article now and it basically says, we won't really know what it means until double vaxxed people turn up in hospital.

There will always be x2 vaxxers in hospital due to age and comorbities. I don't find hospital data that clear. Is it admissions for covid or they have it on admission? elbows?

 

[elbows]

yeah i've read the article now and it basically says, we won't really know what it means until double vaxxed people turn up in hospital.

Plenty of vaccinated people have turned up in hospital so far but then it takes time for the data to accumulate and for analysis to be done.

Certainly have a look at the Israeli stuff I just mentioned.

 

[elbows]

There will always be x2 vaxxers in hospital due to age and comorbities. I don't find hospital data that clear. Is it admissions for covid or they have it on admission? elbows?

The figures tend to include anyone thats tested positive, even if they are in hospital for a different reason. Hospitals in England were asked some time ago to start collecting info on which cases were hospitalised because of Covid, but I think this data has remained private management info for now, not published.

And the daily hospital admissions figures are actually described as admissions/diagnoses so these figures suffer from the same limitation.

For vaccine-specific stats we tend to get figures for things like number of Delta cases by vaccine status and whether they were hospitalised or died. But these figures tend to come out once every few weeks and tend to end up being a subset of cases rather than the whole picture (due to lag but also because it only includes cases that had genomic sequencing done to determine the strain was Delta).

Modelling etc means they have always expected a significant proportion of hospitalised cases to have been vaccinated at this point. Because of a combination of the vaccines not being 100% effective and that a huge proportion of adults in the country are vaccinated.

Signs of waning immunity would come from analysis that demonstrated the proportions getting worse over time in ways that cant be accounted for by other factors, the estimated risk of hospitalisation increasing in the vaccinated over time, etc.

 

[IC3D]

Reflects my understanding. My trust in London published numbers in weekly emails which I didn't share as I'm sure it's breaking some condition of employment but have now stopped so I just ask doctors im freindly with last week it was 28 covid, I'll be asking again next week for sure.. It's going up and covid are slipping in causing major hassles which is why I'm angry that triaging is not done off site after all this time and think money could have been spent protecting frontline services, staff Inc.

 

[prunus]

Why does one company’s vaccine give you a so much smaller standing army though? Does that matter ?

The actual mechanism by which different vaccines lead to different immune responses is going to be an extremely complicated one so at that level I don’t know we’ll ever know for sure ‘why’ - but at a higher level the ‘why’ is that the strength of the immediate immune response (and hence short- and possibly longer-term ‘standing army’) is based on how serious the immune system ‘assessed’ the threat from the infection to be. One can therefore surmise that the mRNA vaccines present a more dangerous-looking scenario, hence the increased response. Why or how they do that - not known (as far as I know). I would guess that the proliferation of induced spike proteins is faster and/or higher in magnitude. But that’s a guess.

Does it matter? A bit, but not much, at least not yet, in terms of serious results (severe disease/death) - we’re seeing about the same levels of protection from both in these terms so far. As time passes we may see both ‘standing army’ levels tail off to about the same, and both equally effective at protection by reservists, or we might see the differential maintained, and at some point AZ-immunised people needing a reminder (booster). Or everyone needing it. We shall see.

Higher circulating antibody levels are likely to mean a response closer to sterilising immunity however, and this might be relatively more important - ie with a high antibody titre an infected individual might be less likely to get to a level of viral load where they are likely to pass it on.

All the above is informed speculation based on the science I know and have seen to date. Future (or indeed already published) results may mean some of the above is wrong for this virus (or may support it). But there you go.