Coronavirus in the UK - news, lockdown and discussion

[littlebabyjesus]

It's hard to get a grip on what the risks are now that the country is opening up again. If you look across the Channel Europe seems to be opening up without a major second spike in infections, even if there's local flare ups here and there. But look in the other direction across the Atlantic and things don't look to be going so well.

With the proviso that this is in no way proven, the patterns of infection worldwide, including what is happening in the Americas now, are still consistent with the development of some form of population-level resistance being a factor in play during recovery from a severe outbreak. There is one possible candidate contributory reason for this - the presence of certain T cells that recognise covid proteins in perhaps half the population, discovered in a study looking at vaccines last month.

Not knowing if or how much this is a factor means you can't just thrown doors open again, but I would suggest that it is at least something that should be considered when working out what to try reopening. Much of the UK is in the 'coming out of a severe outbreak' category. A bit more honesty wouldn't go amiss - ie we don't know what the risks are exactly (or even approximately, really), so we're going to try this and monitor the effects and then reverse the decision swiftly if it doesn't work.

 

[Raheem]

Worried more about the tone rather than the re-opening per se. Other European countries have done similar to what we are doing with infections at a comparable level. But our government doesn't seem to be sounding the same level of caution, or at least not in the same way. i.e. they don't seem to be preparing for the possibility of a second lockdown. I wonder if we're going to get a repeat of resisting it and resisting it and then doing it a bit too late.

 

[littlebabyjesus]

Worried more about the tone rather than the re-opening per se. Other European countries have done similar to what we are doing with infections at a comparable level. But our government doesn't seem to be sounding the same level of caution, or at least not in the same way. i.e. they don't seem to be preparing for the possibility of a second lockdown. I wonder if we're going to get a repeat of resisting it and resisting it and then doing it a bit too late.

We have a government that never admits mistakes and never apologises.

 

[Raheem]

Mongering scareds is pretty lucrative right now, mind you

Or merchanting doom, if you have a bit of capital behind you.

 

[elbows]

Even if we are in a better position than we were a few months ago (which we all know isn't saying much), health leaders are still expressing concerns that we may not be properly prepared for the real risk of a second wave, according main story on the BBC website.

There are a bunch of areas where I have no particular reason to believe we are much better off than before.

The best improvement is if we are actually sincere about tackling infection in all manner of ways that we simply werent the first time around due to the crap orthodox approach that dominated until mid-March.

Fundamental healthcare system capacity hasnt really changed, although the reconfigurations done and the experience gained should help.

Unclear whether PPE situation will be worse, better or similar. Likewise various drug & consumable supply issues, could be worse than last time.

Testing situation is improved and that should make a difference to hospitals, although things can still be messed up on this front if not careful.

Healthcare staffing situation might be considered to be a bit different, given the antibody testing they are doing on NHS workers and what they could in theory choose to use the results of this for in practical staffing terms during any subsequent wave.

Unclear how much hospital infection control has improved and whether all of the lessons from this are sustainable. I will hopefully get a better sense of this in the next few months as the local hospital infections that are still ongoing, as in my local hospital, stick out more in the death stats and will presumably get tackled more as a result.

Treatments - they were keen to hype this stuff up a bit recently and I wouldnt go so far myself, but there is still a bit of time left for some progress on this front before the seasons of concern arrive.

 

[elbows]

Worried more about the tone rather than the re-opening per se. Other European countries have done similar to what we are doing with infections at a comparable level. But our government doesn't seem to be sounding the same level of caution, or at least not in the same way. i.e. they don't seem to be preparing for the possibility of a second lockdown. I wonder if we're going to get a repeat of resisting it and resisting it and then doing it a bit too late.

Its a mixed bag.

They actually do acknowledge the possibility of futre reimposition of restrictions, and stuff like local lockdowns. Even Johnson was not allergic to acknowledging such things in yesterdays press conference.

However such details do not influence the mood music they are trying to play at the moment, which is very much like you say. And certainly when it comes to future instincts and timing of this government, I would be stupid to place too much faith in them, given their past mistakes. I can hope that those past mistakes make it much less likely they will repeat them, but I wouldnt bet on it.

The only area in which I can forgive their current mood music is that they probably have various data, polls etc that tell them that no matter how positive their mood music, actually getting people to go back to 'normal' in terms of economic activity is a big challenge. They are probably trying to compensate for that.

It reminds me in that respect of when they first announced their school reopening plans. On paper I did not like the plans, I thought they went too far. But I decided not to freak out about it because I considered that the government probably knew that nowhere near as many kids as were theoretically eligible to return would actually do so. And that local decisions would be made about particular schools. And how many people you have gathered inside is quite a big element of the risk picture, so this stuff makes a difference to how comfortable I am with certain reopenings. If I think the government are trying to compensate for how many people still have their feet firmly planted on the brake pedal, then I can moderate my concerns on this stuff a bit, their stance makes more sense.

Dropping the daily press briefings seems likely to be a part of this too, as was the desire to get some televised sports going again. Attempts to redefine the new normal again, and influence where peoples heads are at. If they go too far then it may be appropriate to suggest they are lulling people into a false sense of security, but I wont quite make that claim just now, and I will probably only be able to do so in future with the benefit of hindsight.

 

[2hats]

I really wonder how much winter/summer is the decisive factor on whether deaths are waxing or waning here. And if so, why? Vitamin D?

Likely increased outdoor activity, increased natural airflow/air exchanges (open windows) and significantly higher levels of UV all contribute to varying degrees.

 

[andysays]

Likely increased outdoor activity, increased natural airflow/air exchanges (open windows) and significantly higher levels of UV all contribute to varying degrees.

You would also need to factor in that for many people, likely predominantly those most at risk, the past three or four months have actually seen decreased outdoor activity, and this at a time when the weather has been unusually good in terms of hours of sunshine etc.

 

[littlebabyjesus]

tbh I keep hearing about vit D as a major player, but I've never seen any solid evidence for it.

There has been a study finding no measurable benefits, though, and casting some doubts on the significance of past findings of correlations.

High doses of vitamin D supplementation has no current benefit in preventing or treating Covid-19

Then there is a lot of this kind of stuff.

Vitamin D affects Covid-19 mortality Pharmaceutical Technology

The article is titled 'Vitamin D affects Covid mortality', but the study does not demonstrate a causal effect, merely a correlation, as likely to be due mostly or entirely to other causal factors - the old and ill are low in Vit D as well as all the other things that leave them vulnerable. This kind of article really annoys me - a science writer should know the basic 'correlation does not necessarily mean causation' rule.

ETA: I'm also a bit suspicious of some of the attention VitD has been getting in some sections of the press, given the paucity of real evidence. It provides a convenient non-social explanation for the BAME death rates here, for instance, one that means you don't have to look so hard at the structural inequalities that are the most likely cause.

 

[Sue]

We have a government that never admits mistakes and never apologises.

That's because they're always right.

 

[elbows]

Likely increased outdoor activity, increased natural airflow/air exchanges (open windows) and significantly higher levels of UV all contribute to varying degrees.

Yes. Some of the seasonal differences are down to seasonal behavioural differences, and assuming our behaviour remains quite a bit different to normal this winter, it will be very interesting to see what happens.

I think I've done a good job so far of not becoming the boy who cried 2nd wave. It wasnt too hard so far, although it can get more complicated at times when I bump heads with people who would rather believe lockdown was unnecessary or pointless in the first place.

Given the conventional wisdom about respiratory viruses and winter, it is difficult for me not to develop a sense of the future which involves such things, but there are very definite limitations to this stuff, the concept should not be taken too far. We should not for example assume that it is the current season which has allowed our numbers to dwindle. It may well have helped, but we are now starting to see plenty of examples elsewhere that do not simply follow these crude calendar assumptions. California, Texas, Arizona, Florida, these states are all providing fresh reasons for people to dwell more on the idea that its our behaviours that make the single biggest difference. And thats not unique to this virus, the swine flu pandemic first wave in the UK was in summer.

 

[elbows]

Oh and on that last note, I shouldnt leave out South Korea:

“We originally predicted that the second wave would emerge in fall or winter,” Jeong said. “Our forecast turned out to be wrong. As long as people have close contact with others, we believe that infections will continue.”

Global report: South Korea has Covid-19 second wave as Israel ponders new lockdown

New infections in and around Seoul; Spain reports 36 new outbreaks; New Zealand strengthens borders

www.theguardian.com

Not that the level of infection required in South Korea for them to call it a second wave resembles the level that I would consider to be a proper use of the term 2nd wave in the UK, but thats because I consider it to be something of a relative thing. Our first wave was so much larger than South Koreas, what they call waves would barely be a blip by our shitty standards.

 

[Teaboy]

I've just been out for a lunchtime stroll and I saw a couple a couple of arguments between strangers and there was a fair bit of tension in the air generally. I think the fear and frustration of the last few months is coming to a head. This is combined with everyone operating to different rules means we're in a very different place to where we were a few weeks ago.

There is a lot of people out and about as well. Really noticed for the first real time how busy it is if few kids are at school and lots of people are working from home or on furlough. We've also seen a lot of anger out of the streets in the form of protests as well.

Its fully convinced me that I won't be going to the pubs for a while and if I was running one I'd give it a couple of weeks. There is trouble brewing I reckon. I'm also very sceptical about the idea that locaslised lockdowns can be enforced without serious heavy handed policing.

 

[LDC]

I'm also very sceptical about the idea that locaslised lockdowns can be enforced without serious heavy handed policing.

Yeah, I'm wary that given these localized lock downs will need to happen quickly and they'll be limited national coverage of the details I can't see how they'll be communicated and be enforced very well at all. With the national one it was obvious it was coming in some way, and then was everywhere in the media, and it still took a while to sink in around me (inner city, high non-English speaking population, poverty, bad web access, etc.), so what with that and the council being shit here it could be imposed with loads of people not aware.

 

[elbows]

Its fully convinced me that I won't be going to the pubs for a while and if I was running one I'd give it a couple of weeks. There is trouble brewing I reckon. I'm also very sceptical about the idea that locaslised lockdowns can be enforced without serious heavy handed policing.

I know what you mean. It is tempting to suggest that all those negative, gloomy predictions about how crappy people would behave in lockdown, that turned out to be rather far wide of the mark in the first few months, might have more truth to them later on. I'm not sure though, its certainly something to keep an eye on. Something changed in terms of overall mood in May, and it might take some time to play out.

The thing about local lockdowns is that lockdown has become such an all-encompassing term. Its really not clear how much actual lockdown it might involve. So far it seems that the response to localised outbreaks is to close specific things in that area - for example close and clean a hospital department, close and mass-test staff at a large local employer (eg meat processing), keep schools closed in an area of higher infection. There is limited evidence for how a full on draconian lockdown would look at any level in the UK, let alone the local level, and its not clear whether we will end up in a situation where one is attempted in that way either. If things get really bad again at some point, it could quickly escalate beyond clearly identifiable local outbreaks anyway, and then we'll be back to national considerations again before the idea of a draconian local lockdown had a chance to be acted upon.

 

[Supine]

tbh I keep hearing about vit D as a major player, but I've never seen any solid evidence for it.

There has been a study finding no measurable benefits, though, and casting some doubts on the significance of past findings of correlations.

High doses of vitamin D supplementation has no current benefit in preventing or treating Covid-19

Then there is a lot of this kind of stuff.

Vitamin D affects Covid-19 mortality Pharmaceutical Technology

The article is titled 'Vitamin D affects Covid mortality', but the study does not demonstrate a causal effect, merely a correlation, as likely to be due mostly or entirely to other causal factors - the old and ill are low in Vit D as well as all the other things that leave them vulnerable. This kind of article really annoys me - a science writer should know the basic 'correlation does not necessarily mean causation' rule.

ETA: I'm also a bit suspicious of some of the attention VitD has been getting in some sections of the press, given the paucity of real evidence. It provides a convenient non-social explanation for the BAME death rates here, for instance, one that means you don't have to look so hard at the structural inequalities that are the most likely cause.

There is a large and growing number of studies into vitamin d & covid throughout the world. It’s benefit is based on clinical knowledge of the role vitamin d plays with the immune response and not just a random correlation.

I’m taking a d supplement and I’d recommend anyone who is worried about covid should talk to their doctor about taking it.

 

[kalidarkone]

Yeah, I was thinking maybe it depended on what type of massage. Sports/physio maybe OK, oily with a happy ending maybe not so much.

I'm.pretty sure the oily with a happy ending type have continued all through lock down.

 

[littlebabyjesus]

There is a large and growing number of studies into vitamin d & covid throughout the world. It’s benefit is based on clinical knowledge of the role vitamin d plays with the immune response and not just a random correlation.

I’m taking a d supplement and I’d recommend anyone who is worried about covid should talk to their doctor about taking it.

We should all make sure we get the right amount of Vitamin D, and the best way to get it is via the sun cos then you can't overdose. But its link to Covid-19 prevention/recovery is not as secure as you make out in your opening statement here.

 

[Supine]

But its link to Covid-19 prevention/recovery is not as secure as you make out in your opening statement here.

I could respond with a page of peer reviewed studies but I’m at work. Believe what you want.

 

[kalidarkone]

We should all make sure we get the right amount of Vitamin D, and the best way to get it is via the sun cos then you can't overdose. But its link to Covid-19 prevention/recovery is not as secure as you make out in your opening statement here.

Were not able to get enough vit D is this hemisphere from the sun alone as well as a vit d rich diet.

 

[littlebabyjesus]

Were not able to get enough vit D is this hemisphere from the sun alone as well as a vit d rich diet.

I'm not understating the importance - and potential difficulty - of getting enough vitamin D. Something like a third of Britons are deficient in it. I am questioning the centrality of VitD to patterns found in the covid pandemic, though. Its use in high doses has proven ineffective (and risks causing damage), while evidence for a causal link between low levels of VitD and illness/death rates is flimsy at best.

 

[sojourner]

I think a lot of people are actually scared rather than scaremongering.

I'm really scared that I'll get it if I get forced back into work. Two of my mates, same age as me, had it and they've been left with some horrible lingering symptoms, like arrhythmia, visual problems, breathing problems, intense pains in weird places. I've already got a bit of a dicky ticker, nowt diagnosed but I have arrhythmia a fair bit, and absolutely do not want to get fucking ill

 

[maomao]

You can get enough Vit D here for 3 or 4 months of the year and if you're lucky you can build up a store for another three or four but should definitely take a supplement for the dark half of the year and if you're not getting enough sun for other reasons the rest of the year (I ended up with a deficiency after a year of night shifts).

I reckon in a few years there'll be a skin cancer spike because there's a lot of furloughed workers sitting in their gardens right now.

 

[Wilf]

I'd have to say I was surprised how much the govt spent on the first wave (whilst of course they fucked up just about every aspect of testing, ppe and the timing of the lockdown itself > resulting in 20,000 extra deaths). If there's a second wave I don't see them spending the same amount again or locking down everything that has opened up. Maybe the odd local lockdown, perhaps a return to 2m, certainly back to focusing the nhs on the virus, but nothing like the shutdown of March.

 

[kalidarkone]

I'm not understating the importance - and potential difficulty - of getting enough vitamin D. Something like a third of Britons are deficient in it. I am questioning the centrality of VitD to patterns found in the covid pandemic, though. Its use in high doses has proven ineffective (and risks causing damage), while evidence for a causal link between low levels of VitD and illness/death rates is flimsy at best.

Know one knows yet. However there are plenty of other good reasons to take a vit d supplement and if turns out to be a factor in preventing infection from covid then great! Many people have inadequate Vit D levels many people could benefit from supplements and you have to take an awful lot to overdose ie 60000 and above IU daily. My levels are normal but that is because I take 2500 iu daily and then raise it to 5000 in September and then 10000 when the clocks go back for 6 months. I do this because I'm dark, work 12 hours shifts and nights, can be reclusive and im in menopause so I need it along with the vit k and magnesium for my bone density and mood.

 

[Roadkill]

And if we are unlucky, they shut again. I do think it is time to take calculated risks here. It's also way past time to become far more localised in the response. The UK is held back to an extent by the insistence that all these decisions need to come from the centre.

I couldn't agree more, but of course there's no sign of that happening, aside from a bit of lip service being paid to it. Only this morning the Graun was reporting - not for the first time - that councils aren't being given access to the data on which Whitehall decisions are (ostensibly) based. Nor do they have the power needed to enforce localised lockdowns of the kind that have just happened in parts of North Rhine-Westphalia in response to an outbreak there. Much of this is a result of Britain's long-term overcentralisation and cannot be reversed quickly - local government has effectively been gutted since the 70s, at least in terms of capacity for independent action - but when the government's strategy for the coming months seems to include localised lockdowns the fact that councils don't have either the information or legal powers they are likely to need shouldn't give us any confidence...

On the broader point at hand, I've come to think I've been one of the overly cautious 'second wave incoming' types. The fact is that lockdown has been slowly breaking down for a few weeks, and yet infections have kept on dropping overall. As you say, it's time to start taking a few more risks. That said, I have no confidence that if we do see renewed outbreaks either locally or more widely the response will be any more effective than first time around.

 

[Wilf]

Worried more about the tone rather than the re-opening per se. Other European countries have done similar to what we are doing with infections at a comparable level. But our government doesn't seem to be sounding the same level of caution, or at least not in the same way. i.e. they don't seem to be preparing for the possibility of a second lockdown. I wonder if we're going to get a repeat of resisting it and resisting it and then doing it a bit too late.

I go back to the clip of johnson being all bullish and brexity, posted by brogdale below. They went from that straight ideological bluster to shitting themselves over the UCL (?) report pretty sharpish and imposed the lockdown. Way too late, to the cost of 20,000 extra deaths, but that's where they ended up. At least in public they'll never go back to the bullish 'fuck the virus, just wash your hands' position, but it's a reminder of where their instincts sit.

Apols if posted elsewhere...but this clip of Johnson speaking just 73 days ago is quite instructive when attempting to understand the early, recent history of the government's response to Covid-19:

 

[elbows]

I'd have to say I was surprised how much the govt spent on the first wave (whilst of course they fucked up just about every aspect of testing, ppe and the timing of the lockdown itself > resulting in 20,000 extra deaths). If there's a second wave I don't see them spending the same amount again or locking down everything that has opened up. Maybe the odd local lockdown, perhaps a return to 2m, certainly back to focusing the nhs on the virus, but nothing like the shutdown of March.

That will be a question of numbers. If things reach the scale where the healthservice threatens to be overwhelmed again, then I doubt they have much choice but to act in big ways again. But I'm not making predictions about that because I'd rather wait and see what actually happens, I suppose I'm just saying that I dont rule these things out again although they will of course avoid such measures if they possibly can.

See thats the other thing to keep in mind regarding winter concerns - its not even just concerns about this virus, its concerned about that picture being mixed in with all the other seasonal illness and NHS pressures. Battling a large covid wave at the same time as a flu epidemic would not be good. And at that time of year they wont be able to rely on the 'if they have these symptoms, assume its covid they've got' like they could from March onwards, because at some stage there will be flu and other things around in significant numbers. (unless our ongoing behavioural changes are strong enough to thwart these viruses too. Which is possible, if we end up going into winter with extreme caution).

I go back to the clip of johnson being all bullish and brexity, posted by brogdale below. They went from that straight ideological bluster to shitting themselves over the UCL (?) report pretty sharpish and imposed the lockdown. Way too late, to the cost of 20,000 extra deaths, but that's where they ended up. At least in public they'll never go back to the bullish 'fuck the virus, just wash your hands' position, but it's a reminder of where their instincts sit.

Imperial College rather than UCL. As for 20,000, I dont want to moan at you for repeatedly using that number because its obviously a reasonable choice. But I'd rather that number not stick, and that we be vaguer and say tends of thousands of deaths instead, because it is hard to say exactly how many deaths were preventable except that its bound to have been a fair proportion of those we ended up having. And since the excess deaths is now around 65,000 (and ONS etc COVID-19 deaths mentioned on death certificate seems likely to reach around 55,000), 20,000 sounds too low to me, I would probably treat 30,000 as a minimum, and would tend to use a much larger number still personally.

 

[wemakeyousoundb]

Tattoos generally take longer than a haircut, the amount of people doing and getting them is small, and they can wait, it's hardly a necessity is it?

Neither is a haircut.

 

[elbows]

Daily NHS England deaths with positive test data from recent days makes the problem at my local hospital more apparent