Covid-19 Discussion

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In the absence of predefined parameters being required for supranational entities such as the World Health Organisation to declare an epidemic or even a global pandemic, such as more than 200 deaths per 10,000 of population for example, it is interesting to compare the deaths above the 5 yr average in week 16 2020 (approx +12,000) with the peak of winter deaths at week 3 2021 (approx +6,000).
Interesting to also note that winter deaths have peaked a week later than has been the norm for the preceeding 4 years (peak at week 2 post christmas). Bank holiday reporting issues possibly?
 
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In the absence of predefined parameters being required for supranational entities such as the World Health Organisation to declare an epidemic or even a global pandemic, such as more than 200 deaths per 10,000 of population for example, it is interesting to compare the deaths above the 5 yr average in week 16 2020 (approx +12,000) with the peak of winter deaths at week 3 2021 (approx +6,000).
Interesting to also note that winter deaths have peaked a week later than has been the norm for the preceeding 4 years (peak at week 2 post christmas). Bank holiday reporting issues possibly?
Both interesting points. I’d noticed that although the absolute death count is higher in this current wave, the excess death count is lower. Due, I suppose, to the timing alignment with the usual winter flu deaths, meaning that more people die at this time of year normally.

But perhaps more interesting is that the peak total deaths was higher in the Spring (see weeks 16-17 2020 vs weeks 3-4 2021) even though inApril the peak COVID death count was lower than that in January. There were a lot of excess deaths attributed to other causes last April. I’ve often wondered why.

On your second point about the later peak with COVID, I’m supposing that being an infection of a different nature, it is acting differently to the usual flu.
 
Blimey. Quiet few days for this thread.
 
Bobby , I think a lot of us are getting bored with it , This thread and Covid One and the same . Bit Like the Trump one we had on here 'Trump, is this the beginning of the end ?' I think it was started about a year before he finally went....

With a bit of luck one day we will have no use for a thread on Covid-19. Hopefully.
 
More real world travel drama(not! Just in case people think I'm moaning! I get paid by the hour 😉)
Well, I nearly got refused entry to Sweden from Norway on Friday due to new regulations that came in the previous Saturday.
It was the first day on covid duty for the swedish border guards and they knew less than me, so I bluffed and explained a few things I knew and I went from being a supervisor to a driver ,fortunately I was driving a heavy vehicle(crane) and I had a return flight ticket booked, otherwise I wouldn't have got through.
Finally got back to Stockholm and got a late covid test about half 5 last night, got the result this morning so changed my flight from to tomorrow to today 🥳🥳
Hopefully get to Heathrow via Frankfurt tonight, then see what commotion there is there!
So far so good.
On a plus, we can now get duty free products for outside the EU, so I managed to bag a few bargain whiskeys 😁
 
Well, it's either that people got bored of talking about COVID-19, or that the government has finally got it right and there's nothing bad to say about how they are dealing with the situation...? :D

On a serious note, I personally think that the way the second wave has developed - pretty much as predicted - and the fact that over 170m(!) vaccine shots have been administered around the world without any major repercussions, had the effect of pulling the rug under some of the non-mainstream views that were expressed here, invoking controversy and discussion at the time.

But of course, 'thread fatigue' must have played a part as well.....
 
Both interesting points. I’d noticed that although the absolute death count is higher in this current wave, the excess death count is lower. Due, I suppose, to the timing alignment with the usual winter flu deaths, meaning that more people die at this time of year normally.

But perhaps more interesting is that the peak total deaths was higher in the Spring (see weeks 16-17 2020 vs weeks 3-4 2021) even though inApril the peak COVID death count was lower than that in January. There were a lot of excess deaths attributed to other causes last April. I’ve often wondered why.

On your second point about the later peak with COVID, I’m supposing that being an infection of a different nature, it is acting differently to the usual flu.
Indeed during the April health crisis up to a quarter of all excess deaths were attributed to non covid. Contrast with now and all excess deaths are attributed to covid. Misdiagnosis (all respiratory disease now classed as covid) or as a consequence of the false positive rate for PCR tests?

covidexcess.png
 
Interesting article posted by CEBM's Professor Carl Heneghan on the concept of precision shielding, the ability to preferentially protect high-risk COVID-19 groups, as a metric to judge public health policy instead of the current PCR test case / infection rates.

"The most-widely used metric for the success of interventions against COVID-19 to-date has been the number of infections. This metric alone is problematic because the vast majority of infections remain unrecorded and the documented infections depend on how many tests are done. A more informative metric of success is the ability of different interventions to generate a most favourable shielding ratio for the most high-risk subgroups of the population. These subgroups may account for the vast majority of the potential deaths and, if properly protected, many deaths can be avoided."


 
Well I think we are all victims of expecting things to happen at once,all around us everyday we do things that happen at once,we are upset or angry if they do not,press the start button,nothing,anger the car is supposed to start,there are so many things be it the web or telephone where things happen in nano seconds,but faced with this virus with so many unknowns and the curtailing of things that many feel are a right,we have to learn that we need to give it time to sort out,we are now looking at the end of lockdown maybe,it will be a disaster if it ended too early,but we have the media once again shouting it is going to end,if we do not get this right we will break this country.
 
Indeed during the April health crisis up to a quarter of all excess deaths were attributed to non covid. Contrast with now and all excess deaths are attributed to covid. Misdiagnosis (all respiratory disease now classed as covid) or as a consequence of the false positive rate for PCR tests?

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This article covers it well:


As for how COVID-19-related deaths are counted, it says:

' How do the weekly deaths reported by the ONS relate to the daily reported deaths?
....
'Since 12 August, two measures have been published. Firstly, the number of people who died within 28 days of their positive test. Secondly, the number of people who either died within 60 days of a first positive test, or who died more than 60 days after a positive test but had Covid-19 mentioned on the death certificate.'

There are several obvious issues with the 'overall excess deaths' figure, though.

Firstly, it incorporates also the reduction in deaths from road traffic accidents, violent crimes, workplace accidents, non-COVID infectious diseases (both home and abroad), etc, meaning that the actual number of deaths that can be attributed to COVID-19 is actually greater than the overall access deaths figure.

Then, there's obviously no control group, or in plain English, we can never know if 2020/2021 would have been an average year or not - i.e. either year might have been a year with higher-than-usual - or lower-than-usual - deaths, simply by chance, which will obviously skew our access deaths count.

BUT - 'overall excess deaths' is still the best we've got. I know that academics like to research and publish... but sometimes the simple explanation is the best there is. Prof Whitty and Prof Vallance said very early on that the best measure of the COVID-19 deaths that we can achieve will be 'overall excess deaths, of all cause mortality, at the end of the pandemic, and even that won't be accurate'. This is still the case.
 
BTW, another issue with counting deaths by COVID-19 diagnosis, is that there were few COVID-19 tests in the first half of 2020 (during the first wave), and also the guidelines have changed in August - so using the COVID-19 on death certificates as a measure has the obvious disadvantage of not being able to provide a full picture of the scale of the pandemic over its full lifetime. This is another reason while the 'overall excess deaths, of all cause mortality, at the end of the pandemic' approach remains the best one yet.
 
Tweeted by Sir David Spiegelhalter / derived from source data stated.

Wretched over 75's still grabbing all the action.





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The graph isn't a great surprise, but is excellent to demonstrate to who the risk is highest.

In the age ranges that have fewer actual numbers within our population the actual numbers of deaths are greatest.
So that demonstrates that risk to the older is disproportionally higher than might have been perceived. That is, there is a much higher 'percentage' of the older actually passing from this.

This is clear when you consider that the age group that encompasses a whole 64 years age group, in other words the vast majority of the population, see a drastically lower number of actual people passing.
It is reasonable to assume that this trend is very similar if looking at serious debilitating results from contracting covid.

Now we are at close on 25% of our population vaccinated, and the strategy has been to vaccinate the most vulnerable first, there can't be many left that are at high risk from covid.

I read that 65 year olds are being vaccinated. So that surely means pretty much all our higher risk, more vulnerable, have been offered protection.
Additionally there is the natural immunity that many countries are basing some reliance on.

The fire 'aint out, but to me it suggests that we are well on the right side of this.
As hospital loading is eased toward being able to offer normal service again easing up on lockdown seems reasonable.
 
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Interesting article posted by CEBM's Professor Carl Heneghan on the concept of precision shielding, the ability to preferentially protect high-risk COVID-19 groups, as a metric to judge public health policy instead of the current PCR test case / infection rates.

"The most-widely used metric for the success of interventions against COVID-19 to-date has been the number of infections. This metric alone is problematic because the vast majority of infections remain unrecorded and the documented infections depend on how many tests are done. A more informative metric of success is the ability of different interventions to generate a most favourable shielding ratio for the most high-risk subgroups of the population. These subgroups may account for the vast majority of the potential deaths and, if properly protected, many deaths can be avoided."



The relevance of this article will depend on the success of the vaccination programme. Where I live the NHS have started vaccinating the 60+ age group a couple of weeks ago (ahead of the government's rollout).

If indeed we can get the majority of over 60s (and other vulnerable individuals) vaccinated with ~80-90% efficiency, we may not need to shield these people any more.

Interestingly, when the 'Immunity passport' is finally introduced, it will be the elderly who will be able to travel first with few restrictions......
 
If indeed we can get the majority of over 60s (and other vulnerable individuals) vaccinated with ~80-90% efficiency, we may not need to shield these people any more.
The UK has not been shielding the at risk demographic. This is demonstrated in the BMJ article using the shielding metric which shows people who were institutionalised in nursing homes were approximately two times as likely to be infected than the non-institutionalised population in the UK.
 
Interestingly, when the 'Immunity passport' is finally introduced, it will be the elderly who will be able to travel first with few restrictions......

Another moral hazard.

You restrict the youngsters who were not much at risk to protect the oldies - and then prioritise vaccinations to the oldies and then free the oldies before them.

I'm guessing this issue of fairness is one of the reasons that the government is not really wanting to talk about vaccine passports and certificates.

Of course the media have a perfect opportunity to stir no matter what happens.
 
The UK has not been shielding the at risk demographic. This is demonstrated in the BMJ article using the shielding metric which shows people who were institutionalised in nursing homes were approximately two times as likely to be infected than the non-institutionalised population in the UK.

It's also demonstrated by the numbers catching Covid in hospital.

That reinforces the problem of people with underlying health issues. Assuming that they are more likely to visit hospital then they are more likely to catch Covid through that route.
 
The UK has not been shielding the at risk demographic. This is demonstrated in the BMJ article using the shielding metric which shows people who were institutionalised in nursing homes were approximately two times as likely to be infected than the non-institutionalised population in the UK.

Be it as it may, my point was that going forward the at risk demographic will be protected via the vaccination programme, which - if successful - will render previous targetted shielding proposals irrelevant.
 
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Interestingly, when the 'Immunity passport' is finally introduced, it will be the elderly who will be able to travel first with few restrictions.....

I would suggest that when the vulnerable are protected we will no longer need to consider the risk of infections to the lesser risk categories.
Other countries with a slower roll out of vaccination might consider that risk for longer.

Those lesser affluent countries will be less aware of the actual covid numbers in their populations anyway, but hopefully by then us rich lot will be helping them vaccinate.
 
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