Covid-19 (vaguely non-political thread!)

Discussion in 'UK Wine Forum' started by Alex Lake, Feb 24, 2020.

  1. My understanding about SARS (disclaimer: not an epidemiologist but I did live through SARS in Singapore) is that as Po says the lack of asymptomatic transmission was key. But the high case mortality rate (10-11%) was also a factor in it being able to be controlled — the virus basically burned itself out.

    My feeling is that Covid is insidious in that the asymptomatic transmission makes it hard to find, and the 1% death rate is dangerous enough to lock things down but not enough to really scare people or burn itself out.

    But as I said, I’m no expert!

    I do remember though that despite SARS being 10x as deadly, my life was much less impacted in Singapore than it is now!
     
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  2. Jonathan.

    To study the vaccine’s efficacy you need two trial arms – one with the vaccine and one without so you can compare the two.

    However you then need the participants to be exposed to the virus to see if the vaccine provides protection. It is not ethical to deliberately expose people to the virus so you need them to encounter it in everyday life. The problem is if you have suppressed the virus in the general population and introduced methods to prevent transmission then there isn’t enough circulating to infect the trial subjects and to give you a significant outcome.

    I think they were also looking to test the vaccine in places like Brazil where there may be potential for higher rates of exposure to the virus.
     
    Last edited: May 27, 2020
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  3. Because the virus is disappearing due to maybe social distancing, or just weather getting hot, or also some people are immune for now, etc. If we want to go back to 'normal life', or to prevent a winter peak, or to protect people from their hard-earned immunity fading out, we need a vaccine.
     
    Last edited: May 27, 2020
  4. Totally agree. Covid-19 is very annoyingly in between, not lethal enough to burn out itself, also not mild enough to be ignored....
     
  5. Why can't this coronavirus burn itself out just like all the others? If it can't spread, it can't survive. There are various ways to stop it spreading. Mass vaccination is only one of those ways. If you look at New Zealand, they are pretty much back to normal with no vaccination because their quarantine and tracing measures have reduced the number of infections to levels where it can't ramp up again. Why can't that scenario be replicated in other countries to the point where the whole world has isolated the virus into a minute number of hosts?

    There seems something very ethically wrong with the idea of trialling a vaccine on infected populations in Brazil, where the virus has been allowed to run rampant for political aims, in order to create a vaccine for the inhabitants of wealthier nations who care more about their people.
     
  6. It seems pretty alarming to me too, Jonathan, but I was assuming I hadn't understood it properly.
     
  7. Why is it ethically wrong? The conduct of a clinical trial isn’t adding to the infection rate and you have to conduct the trials on populations where the virus is present. The only thing that would be ethically wrong is if people were forced or induced into the trial or the trial oversight was reduced in some way. But there is no reason to suggest that is the case or would be needed

    Access, production, distribution and cost of the vaccine– if the trial is successful – is an issue regardless of where it is trialed.
     
  8. I think the answer to your question Jonathan is that the cat is out of the bag. But there may be a more technical explanation!
     
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  9. 1)
    We don't know if it will naturally burn out yet without many more death. Great if it will, but can we sit and hope for that to happen?
    If we follow herd immunity strategy, in the end it can't spread. But as we talked about too many times maybe, it's a bad idea.
    Traveller to New Zealand need to do 14 days quarantine, not sure that's really back to normal.
    Saying that, of course we want every country to replicate NZ's example, so that all the countries with similar condition can maybe travel among themselves. Just that it's not in our hands. Even our own country condition we can't fully control, can we?

    2)
    "There seems something very ethically wrong with the idea of trialling a vaccine on infected populations in Brazil, where the virus has been allowed to run rampant for political aims, in order to create a vaccine for the inhabitants of wealthier nations who care more about their people."
    a. The fact that virus was allowed to run in Brazil, has nothing to do with potential vaccine development. That government didn't mess up the situation to get vaccine for us. I am sure we are all happy to see Brazil has pandemic under control very quickly even that means no vaccine trial would happen, but again that's not in our hands.
    b. The potential vaccine will help people there as much as people here, if not actually more there. Once the vaccine safety is more or less established here, the larger scale of trial there will either have benefit, or no effect. Not sure what part of that is ethically wrong.
    c. The only arguable part is that there suppose to be two branches, so there will be a group of people not receiving vaccine. Ideally that should be double blind but I don't think many vaccine do that, for exactly the ethical reason. Some people will receive vaccine out of their will, and they will be compared with other people who don't. Of course there are other ethical issues need to be addressed but it's really not as simple as rich countries getting benefit from poor countries.
     
  10. [​IMG]

    Caveat: Spain not listed on the source I was sent
     
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  11. surely the major caveat is the one they themselves have put at the top?
     
  12. Even so Chris, we're right up there without any doubt. A bit of misjudgment and a bit of bad luck.
     
  13. No question uk is high, just a question of if this chart uses properly comparable data, which it doesn’t. I suspect that other countries, were we to have the same criteria, would be as bad or worse.
     
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  15. Despite not understanding even the basics of the articles mentioned in this tweet I want to share it here if any of experts of the forum would like to comment them. Just sounds somehow promising to the very layman's understanding of the issue.

    Eric Topol on Twitter
     
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  16. Am I right in reading that is just the latest 7 days average deaths? If so, it might mislead people into thinking that's the overall death rate 'table', rather than a point in time rate.
     
  17. The numbers are all over the place. It’s a comparison of Apples to Oranges.
    I understand that in Italy many people with the virus who were sent away from hospitals over run with patients, without being admitted, and who subsequently died elsewhere were not officially logged amongst the Corona victims.

    Belgiums figures as reported elsewhere are far worse than that graph shows.
     
  18. https://www.euromomo.eu/graphs-and-maps#z-scores-by-country

    that's the cleanest way to look at the data: excess death vs seasonal averages by country. European top 4: 1. England, 2. Spain, 3. Belgium, 4. Italy
     
  19. I don't think much is served by comparing national scorecards as if this were an athletics meeting. Apples vs. oranges, d'accord, but other than Germany no country in Western Europe seems to have handled this as skilfully as they should have done. I'd rather know what's happening with this virus now, today, than what happened in March and can't be changed, and I don't think accumulated death totals help at all with this..people dying today for the most part caught this thing several weeks ago, an eternity in the evolution of this catastrophe.
     
  20. The only point Johnny would be (a) an evaluation of this government's performance and its fitness for office and (b) to learn any lessons from this disaster
     
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  21. I think this is the best way to look at the data. The really disturbing thing, from an English perspective, is when you select the age group 15-65. Every other country managed to reduce deaths in that age group back down to a normal level in mid April. England is still way higher and appears to be increasing again.

    Why do I think it is concerning? Because that age group represents the working population and those directly responsible for other family members.

    Why is England so much higher than elsewhere? Is it due to a higher rate of infection, an inability to treat enough cases effectively, poorer levels of underlying health or deaths of key workers?
     
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  22. Might also reflect health service being locked down, causing people to stop seeking/ no longer be able to obtain treatment for other things
     
  23. Agree, that England statistic is pretty worrying Jonathan
     
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  24. We need to know (ASAP) what did other countries do right so if the (God forbid) the second peak comes we are better-prepared. What happened in March can't be changed, true, but what's coming can be, and are we ready for that?
    To know that we need to first accept that other countries are doing better. If we don't accept we are doing worse than others, there is no learning to do.
    Plus, I think there are West European countries other than Germany we can learn from; Protugal? Austria? Greece?

    And of course, at same point, we will need to review why and how all these happened. Some people/departments need to be hold accountable, and lessons can be learned for any future crisis, not just future pandemic.
     
  25. I am not a reader but I was sent the link this morning by a British friend.
    UK 'suffers highest excess death rate in world' during coronavirus outbreak
    My understanding is the UK administration has 3 statistics it publishes:
    - HMG statistics indicate circa 37- 38000
    - ONS indicates 45000-50000
    - weekly deaths (momo) data is also provided by UK and the excess rate (compared to previous years) for the last couple of months reaches about 60000 above average. (Momo was put in place in 2016 by over 20 EU countries and segregate UK into the 4 nations)
    Most EU countries have lower excess deaths and higher covid related deaths, UK is the exception with higher excess deaths than covid related as monitored by the administration which may indicate there is another problem (epidemy or otherwise)
     

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