Coronavirus Sars-CoV-2/Covid-19 Megathread

[Grey Fox]

Are you guys testing asymptomatic vaccinated people?

[mongers]

This delta variant has checkmated our current exit strategy. The plan was to vaccinate, achieve herd immunity and relax all control measures as soon as possible. Which we did but instead of the bug disappearing, this fourth wave we're in now will very likely be the biggest one yet. Almost 500 people have been infected in less than a week here, overwhelming majority of which had been fully vaccinated. Less than a handful of these require direct medical intervention, much less a stint in the ICU, but we'll know in 10 days or so how bad it'll get. All the large summer festivals in the country which were to be held over the next weekend have been cancelled, gatherings of more than 200 people are forbidden, etc. The mood is one of huge disappointment and frustration but also quiet determination to kill this wave off as well like we did all the rest.

Against the delta variant, transmission protection starts excellent but rapidly fades over 3-4 months. Protection against symptoms, serious illness and death remains very good it seems. 

50.000 people who were vaccinated with the Jansen type will be offered a second booster jab, what we'll do for the rest remains to be seen.

We'll most likely get an updated booster shot in time for winter.

That's reassuring, Leggy.

In UK, the country seems to be evenly divided between those still wary of infections and the half who are largely ignoring it and just want to party like it's 2019.

Here the infection rate in the nearby conurbation (population of Iceland) has more than doubled in a week:

Here are the latest rates of cases of Covid-19 in Dorset.

The figures are the number of coronavirus cases per 100,000 people in the seven days up to and including 18 July compared with the week before, shown in brackets.

The breakdown of the figures by local authority area is:
Dorset - 289 (up from 156)
Bournemouth, Christchurch and Poole - 557 (up from 270)

For comparison, the figure for England is 538 (up from 361).

[Legbiter]

Are you guys testing asymptomatic vaccinated people?

Close contacts like friends, family and coworkers of infected people are quarantined and tested, yes. Even if vaccinated. We don't know what will happen to our vaccinated oldies and people with underlying conditions who are catching this now and won't for 10 days or so. It's an uncomfortable question to have to ask.

[Josquius]

https://www.bbc.co.uk/news/blogs-trending-57928647

I found this interesting. SOMEBODY, who wants to remain anonymous (I think its clear where he lives...), is paying big money for youtubers to spread anti-vax disinformation.
Interesting to see it focussed on the non-English speaking world.

[celedhring]

Numbers are starting to trend down again over here (current R number is 0.9). I don't think the new restrictions have had time to make much of a difference (and they aren't that strong), so I'm assuming the virus is just running out of people to infect   

[Syt]

Over here the daily numbers bounce between 300-something and 400-something. There was a quick rise to that level but then it kinda ... stopped.

[Sheilbh]

This is pretty sad, the son of the "Nuremberg Trials" former nurse:
https://twitter.com/bbcr4today/status/1419599993124671488?s=21

[Legbiter]

The vaccine hesitant here come around when they encounter people who've got long term symptoms or their loved ones get ill. We do have a wealthy woman here just sitting at home with too much time on her hands who's been buying ads on social and print media to rail against vaccines but uptake has been extremely good nonetheless.

[Sheilbh]

The vaccine hesitant here come around when they encounter people who've got long term symptoms or their loved ones get ill. We do have a wealthy woman here just sitting at home with too much time on her hands who's been buying ads on social and print media to rail against vaccines but uptake has been extremely good nonetheless.

Yeah and the truth is that these guys have been doing it all pandemic and can reliably get a few thousand people to turn out. But lockdown and restrictions have been the most universally supported government policy since the war, with incredibly broad compliance. Now we're in the vaccine stage all surveys show that about 95% of people are willing to get vaccinated which is very much at the top end of what I expected.

It's true that vaccine take-up is plateauing among the young, but their willingness to be vaccinated is still high so I think the issue is around the roll-out/easy availability - plus they are less at risk from covid so feel it's less important/urgent to get it as soon as they can.

But the people at these protests or worrying about vaccines being some sort of infection or whatever their theory is are an extreme majority. It's at most the 5% who are always crazy. Still a lot of people but I think in the UK especially there is more coverage of their protests than their underlying support justifies.

[mongers]

The English during the pandemic have gained a total of approximately* 50,000,000 kg in weight.   

https://www.bbc.com/news/health-57968651

Lockdown weight gain averaging half a stone - survey

More than 40% of adults in England have gained weight during the pandemic, a survey suggests, with the average gain being half a stone (just over 3kg).

Public Health England (PHE), which surveyed 5,000 people, says Covid lockdowns and disrupted daily routines have made it challenging for people to eat healthy and keep fit.

Snacking and comfort eating were given as the main contributor by about half of those who said they were fatter.

PHE recommends a summer fitness drive.

*My back of fag packet estimate, say 45-50 million adults in England, for 40% of whom have gained 3kg in weight, so between 54-60 million kgs. All other things being equal.

[Josquius]

I saw this one earlier today. And yep. Definitely gels with me.

[Sheilbh]

In terms of SAGE people - and moving away from the behavioural scientists - very interesting piece by the chair of the modelling sub-group. This is probably not the last peak - even then we won't know until we're able to look back and that actually the next few months will probably be when individual risk of infection is highest (I think this is also just epidemiological theory about "exiting" a pandemic).

Also that the estimate of R for delta is 6. At the minute R is estimated to be 1.4 (though another week of data and it may be that R is below 1 given the trend of cases at the minute, Oliver Johnson's estimate is that R in Scotland is at 0.77). That's a combination of people's behaviour - we're apparently at 50% of "normal" social contacts plus vaccines:

Has England reached a peak in Covid infections?
Graham Medley
The trajectory of the pandemic might look more like a range of hills rather than a single mountain
Mon 26 Jul 2021 15.25 BST

While the government's decision to remove most lockdown measures in England was widely expected to result in a large wave of infection and disease, the number of new cases of Covid-19 has been falling over the last five days. Many hope this could mean that we're past the peak. Yet the reality is more complicated. This is the first time an epidemic has taken place in a highly vaccinated population without control measures in place, so we are in uncharted territory. There is considerable uncertainty about what the next two months hold.

The big questions are how high the current wave will get and how long it will last. The number of people in hospital and dying of Covid-19 is directly linked to the number of infections. It's impossible to accurately predict when we'll reach the peak of infections, or how long it will take to come back down from this (if I had a pound for every time I'm asked "are we there yet?", I'd be able to give away a lot of money).

Unfortunately, we will not be able to know if we are at a peak until we have passed it, probably by a few weeks. There are several reasons for this. Though a peak is measured by the number of infections, we don't observe this number straight away. We only see the outcome of infections. One or two days of low numbers can easily be followed by another day or two of high numbers, so it takes at least a week to establish a trend.

Moreover, a change in one data stream might not be echoed in others. Reported, diagnosed cases are the earliest data collected during a pandemic, but these lag a week behind infections. A drop in cases might indicate a fall in infections, but it might also indicate there are problems with testing. If the prevalence of infection continues to rise, it's likely that we may see problems with people getting tested, who therefore don't appear as positive cases. And even if there are tests available, people might not use testing as much, or in the same way, in the future.

Hospital admissions are a more reliable data stream. These lag a week from cases. Even then, a change in hospital admissions might be related to a change in who is getting infected. Younger people, for example, are less likely to end up in hospital. Office for National Statistics (ONS) and Real-time Assessment of Community Transmission (React) data, which is collected from random samples, takes a couple of weeks to be processed and published. Once these show falling numbers of infections, we will have confirmation that prevalence is falling.

So when we have a day with lower cases, and people ask "are we there yet?", I will say wait a week. If cases have fallen during the week, I will point to rising hospital admissions. But if they fall, and ONS and React data show a fall in prevalence the following week, then we will be able to say that the day with lower cases three weeks earlier was just after the peak, but actually the peak in infections was a week before that.

An even bigger challenge is that the rate of increase of infections (the R number) is determined by two things: contact rates and immunity. At any peak of a wave, R = 1. As immunity increases, due to infection and vaccination, R falls. As we change our behaviour and make more contacts, R increases. It's a balance. There might be enough immunity to keep R below 1 if we are meeting three people per day, but not if we each meet five people every day.

If nobody had immunity to Covid-19, and everyone was still socialising at pre-pandemic levels, the R number for the Delta variant would be about 6. Currently it is 1.4. Recent contact surveys suggest that we are having about half the social contact now compared with pre-pandemic levels.

It's quite likely that we will reach a peak, and that, as behaviours change and social contact increases, we will have another peak to climb. And, again, the delays will matter, because we can't immediately see the effects of increased socialising on case numbers. If the removal of all restrictions in England on 19 July has a big effect on transmission, we won't be able to see this until the week beginning 2 August. So in the next couple of months it's unlikely there will be a rise to a single peak and then a fall. It will be more like going over a range of hills, with many peaks in different places, than it will be climbing a single mountain.

The epidemic is going to go up and down in the coming weeks. The number of cases will jump around a lot. It's only by looking backwards that we can see clearly where we have been. So we will never be able to answer "are we there yet?". We will only be able to say when we were there. And that might have only been temporary.

The consequence of all this is that our individual risk of infection is going to be higher in the coming months than it has been at any point during the pandemic, because the number of infections will likely be higher than at any other point. Vaccinations will prevent many deaths and keep many people out of hospital. But the risks to individuals still exist. If one thing that is clear from all this, it's the importance of getting vaccinated.

    Graham Medley is a professor at London School of Hygiene & Tropical Medicine and chairs the Sage sub-group on pandemic modelling

[Sheilbh]

Amazing chart on the gender difference in recent covid cases:


It does feel like young men watching the football at each other's houses or in the pub.

On a separate note I am devastated to discover I now fall outside the FT's definition of "young"

Also positive comments from Neil Ferguson (he's the Imperial model guy):"the effect of vaccines is hugely reducing risk of hospitalisations and death, and I'm positive that by late September or October we'll be looking back at most of the pandemic". I barely dare hope (Obviously he means looking back in the UK/rest of the developed world - there's still a huge effort needed to vaccinate the world.)

Edit: Also found this chart on NYC employee vaccination rates interesting:

It's not happened in the UK yet - but I feel like there's a very strong case on mandatory vaccinations in prisons, care homes and hospitals. If you don't want to get vaxxed you don't need to work in that sector.

[The Larch]

So prison workers and policemen in NY are the less likely to get vaccinated?

[Sheilbh]

So prison workers and policemen in NY are the less likely to get vaccinated?

Yeah - with prison officers especially that's a huge issue. But I also think it might be a bit to do with the Trumpiness of the police/prisons?

Separately - these were all the concerning looking countries in Europe and they all appear to be on the turn or plateauing - so maybe little bit Euros. But also something else is going on here. Some re-confined a bit like the Netherlands but I'm not sure about the rest