Covid-19 Discussion

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The veracity of the second sentence would be higher if the PCR assays had quantified, and acceptably small, false positive rates by comparison to the anticipated infection prevalence.

Unfortunately, the false positive rates are not adequately quantified, but they are thought to lie in a range that at its lower bound is at least an order of magnitude greater than the anticipated infection rate - which makes relying upon them absent clinical diagnosis of relevant symptoms at best precarious and at worse, very dubious.

Quite right.

This is from study published in Brazil in August:


'The accuracy of the PCR test for coronavirus diagnosis can change according to the prevalence of the disease.

We can simulate 3 situations:
  • With a prevalence of 50%, common among health professionals with respiratory symptoms, we found a post-test probability of 96%.
  • With a prevalence of 20%, the post-test probability was 84%.
  • With a prevalence of 5%, there is a 55% post-test probability.
As we can observe, even with high sensitivity and specificity of the PCR test for coronavirus diagnosis, we can obtain different results regarding its effectiveness.

We can interpret that when the test is applied in conditions of low prevalence of the disease, it allows a precise diagnosis in 55% of the cases.

Hypothetically, when carrying out a second consecutive test in the same patient, considering a prevalence of 96% (post-test probability of the first test with an initial prevalence of 50%), there is a post-test probability of approximately 100% (diagnostic accuracy).'

What they are saying is that depending on the prevalence, the accuracy is between 55% for low-prevalence (e.g. when mass-testing the population at random), to 96% for high-prevalence (e.g. when testing health workers or people with symptoms).

This is in line with a similar point that you have raised before.

Also, interestingly, it seems that 100% accuracy is achievable even in low-prevalence conditions with repeat testing - the NHS serological survey involves 5 consecutive weekly tests.
 
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Also, interestingly, it seems that 100% accuracy is achievable even in low-prevalence conditions with repeat testing - the NHS serological survey involves 5 consecutive weekly tests.

So you have a magic bullet that will hit it's target with 60% probability of a kill.

So fire 1 - 60% of targets killed. 40% survive.​
So fire 2 - We eliminate 60% of that 40% ... so we are left with 16% of the original targets to deak with,​
So fire 3 - We eliminate 60% of that 16% and we are left with 6.4% of the original targets.​
So fire 4 - And the number of targets left drops to 2.6%​
So fire 5 - And we have 1% left.​

So our 60% effective magic bullet manages to kill 99% of targets if you can shoot 5 times.

So if we have a medical test that has 40% false negatives then after 5 tests you will statistically get positive test on a candidate with the targeted condition. The underlying test may not be that effective at identifying postive cases on a one-shot basis.

But medical tests also can generate false positives. And this is where things get even more complicated if you are testing a population where the majority may not have the consdition targeed by the test. You can end up with more false positives than true positives in a large population where only a minority have the targeted condition.

So suppose we have a population where 1 in 200 have COVID and a test that generates 10% false negatives and 10% false positives.

We have 10000 people - 50 have the disease. Our test will identify 45. It will miss 5. Of the 9950 who do not have the disease it will identify 995 as having the disease.

So we test 10000 of the public who are asymptomatic and we end up with 1030 people told to self isolate unecessarily - of whom only 45 have the disease. We have 5 people who should self-isolate but are left free to wader.

Now in terms of disease conrtol that's actually not a bad outcome for society as a whole if the 1030 and 45 self isolate.

But once the public gets wind of the the fact that if they test positive it's 96% likely that they are actually OK then nobody will self-isolate.

So along with the models that should be explained we need some real numbers and explanation on the reliability of the tests.
 
Apparently the cases of covid in Bristol and I guess the rest of the country is a bloody App, not tests

The Covid Symptom Study is an app which tracks people with symptoms across the country and gives an estimate for the number of people with the virus on a given day.

Its data, from King's College London, indicates Bristol's figure has jumped from 2,314 on October 21, to 4,485 today (October 28).

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The suggested rise of 2,171 active cases is based on the app's latest estimate of 9,752 active cases per million people in Bristol – up from 5,031 per million last week.
The map indicates a massive surge in the last seven weeks. On September 7, Bristol was estimated to have only 431 symptomatic cases in total.
Last week, Bristol's rate per million surpassed 5,000 for the first time, putting it in the most worst-hit tier on the heat map.

READ MORE​

Now Bath & North East Somerset (B&NES) has joined it in that category, with a rate of 7,190 – compared to 4,258 a week ago.
The research suggests B&NES now has 1,367 cases, up from 809.
Surrounding areas have also seen increases in the last week, according to the study.
It indicates North Somerset has 658 active cases, which has risen from 515 in seven days.

0_Heat-map.png

The coronavirus heat map for October 28; darker areas indicate more active cases
And in South Gloucestershire, the figure is estimated to have increased from 1,127 to 1,340.
Here is each area’s rate of estimated active cases per million, as of October 28:
Bristol: 9,752 (up from 5,031 last week)
B&NES: 7,190 (up from 4,258)
South Gloucestershire: 4,782 (up from 4,022)
North Somerset: 3,113 (up from 2,440).
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People across the country are using the app to report their health. The study also uses data from swab tests.
It indicates 556,901 people in the UK currently have symptomatic Covid-19, compared with 435,517 a week ago.
Bristol’s data is based on reports from 11,336 people, South Gloucestershire’s from 5,650, North Somerset’s from 5,283 and B&NES’ from 5,985.
A Bristol City Council spokesperson said last night: "Bristol's rate of 340.7 new cases per 100,000 population [in the seven days up to October 23] is considerably higher than for the previous 7 days (227.9 per 100,000).

"The reported rate represents 1,579 positive cases reported for Bristol over the past seven days within a population of over 463,000 people.
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"The trend is very clearly moving upwards and the Bristol rate remains above England rate of 222.8 per 100,000 and is now ranked 34th among 149 English local authorities.
"We are closely monitoring the situation with the NHS, police and the Department of Health and Social Care and will be taking further local targeted action to try to contain the spread of the virus, including whether moving out of Tier 1 is necessary.
"Bristol is now at a critical point. We need everyone to be extra careful – the virus spreads when people are in close proximity to one another."

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So along with the models that should be explained we need some real numbers and explanation on the reliability of the tests.
I'm not holding my breath on that, because...
But once the public gets wind of the the fact that if they test positive it's 96% likely that they are actually OK then nobody will self-isolate.
Those who are reasonably good at maths have already worked that out.

However, that same group have probably also made a reasonable assessment of their personal risk profile, and therefore are likely to adopt a lifestyle strategy that minimises their risk of exposure to infection. Note: "minimise", not "eliminate", because they're not stupid.

They also don't buy National Lottery tickets.
 
A lot of it is down to personality types (MBTI has me as INTP); I'm very open to people's opinions (probably too open) but also have a trait of not being able to let contradictions pass unchallenged and this thread is chock full of them, mostly by the people who are the most certain of their beliefs "There are none so blind as those who will not see" - John Heywood.

I think someone's viewpoint on the Covid "debate" can be blurred by how financially secure they are; I know people who are really, really struggling at the minute mentally & financially and who will be massively affected by the financial aftershocks (taxes will rise and wages will drop) yet they are young, fit and healthy and have almost zero chance of dying from the virus so when I read posts on here from middle class folk with cushy pensions and/or plenty in the bank who could ride this out forever calling the aforementioned "selfish" then it certainly rankles and I actually find it ten times more selfish...

That's not to say if someone is financially secure that they shouldn't have the opinion that we should be in a semi-permanent state of lockdown, just that it would be less hypocritical if they didn't drive the "do as you're told" and "government knows best" line when it's those who are the ones actually at risk!
I haven't visited this thread for a few days because I've been too ill to take it all in, let alone respond. Incidentally, I'm waiting for covid test results because I had a fever, but now recovering. Anyway, this is why my response as one of the "middle class folk with cushy pensions" is a few days late.

I don't think I used the word "selfish" to describe the young, fit and healthy who are struggling financially and mentally because of the restrictions, but if I did I apologise. I can totally understand why those people feel aggrieved at what they're having to go through when it's highly unlikely to provide them with any benefit whatsoever, it's not their lives at risk. Indeed, with me being selfish I want the young folk out there working and earning the money for themselves and the country, and to contribute to my pension for which I'm grateful.

What I find harder to understand is why we all as fellow humans can't help each other. Like most old folk I'm going out of my way not to go out any more than absolutely necessary. When I do venture out once a week for luxuries like food I correctly wear a mask, I keep well away from others as much as I can by going to the supermarket at the quietest time (too early in the morning), I sanitise my hands before going in yet still touch things as little as possible, and do all the other things necessary to help protect others. It's a total PITA and I don't even know if it helps, but it's worth a try. Unfortunately I also see too many of my peers being far less considerate - a sight that must really vex the young who are unable to properly work, study and play because they've been told to help protect the vulnerable.

Of course it works both ways. Whilst worrying about our own mortality, we older folk can't help taking umbrage at the messages we hear from the young implying that they consider us as being of no further use, something to throw away with the old engine oil. It would be reassuring to hear more of the young voicing and demonstrating some concern for those of us who worked hard all our lives, not just for ourselves but for future generations, whilst concurrently raising and caring for those very youngsters. Not going out in large groups may or may not reduce the spread of the virus, but at least it would let us think that you do care.

This isn't a hard time just for the old and vulnerable at risk of dying. This isn't a hard time just for those who are struggling financially. This isn't a hard time just for those who are missing the social side of their lives or other aspects resulting in mental trauma. One of the characteristics of my ISFJ-T personality type is that I care about others. Why is it so difficult for us all to care about everyone else?
 
I haven't visited this thread for a few days because I've been too ill to take it all in, let alone respond. Incidentally, I'm waiting for covid test results because I had a fever, but now recovering. Anyway, this is why my response as one of the "middle class folk with cushy pensions" is a few days late.
First off; I hope you continue to feel better and make a full recovery. 👍
I don't think I used the word "selfish" to describe the young, fit and healthy who are struggling financially and mentally because of the restrictions, but if I did I apologise. I can totally understand why those people feel aggrieved at what they're having to go through when it's highly unlikely to provide them with any benefit whatsoever, it's not their lives at risk. Indeed, with me being selfish I want the young folk out there working and earning the money for themselves and the country, and to contribute to my pension for which I'm grateful.

What I find harder to understand is why we all as fellow humans can't help each other. Like most old folk I'm going out of my way not to go out any more than absolutely necessary. When I do venture out once a week for luxuries like food I correctly wear a mask, I keep well away from others as much as I can by going to the supermarket at the quietest time (too early in the morning), I sanitise my hands before going in yet still touch things as little as possible, and do all the other things necessary to help protect others. It's a total PITA and I don't even know if it helps, but it's worth a try. Unfortunately I also see too many of my peers being far less considerate - a sight that must really vex the young who are unable to properly work, study and play because they've been told to help protect the vulnerable.
I think your experience is common and it wouldn't surprise me if their behaviour has inadvertently made it easier for those at almost zero risk to justify their own actions (however wrong both groups may be).
Of course it works both ways. Whilst worrying about our own mortality, we older folk can't help taking umbrage at the messages we hear from the young implying that they consider us as being of no further use, something to throw away with the old engine oil. It would be reassuring to hear more of the young voicing and demonstrating some concern for those of us who worked hard all our lives, not just for ourselves but for future generations, whilst concurrently raising and caring for those very youngsters. Not going out in large groups may or may not reduce the spread of the virus, but at least it would let us think that you do care.
I can only speak of my own children and they do care about their elderly relatives and the risks they face and have adapted remarkably well to the situation of having their childhoods massively restricted and their education fundamentally changed. Others I know have not been so lucky with their children from obesity rocketing to the mental anguish they're experiencing to the catastrophic affect it'll have on their future career choices.
This isn't a hard time just for the old and vulnerable at risk of dying. This isn't a hard time just for those who are struggling financially. This isn't a hard time just for those who are missing the social side of their lives or other aspects resulting in mental trauma. One of the characteristics of my ISFJ-T personality type is that I care about others. Why is it so difficult for us all to care about everyone else?
There is very little to disagree with in all of your post and, in fact, it's essentially the point I'm trying to make.

If you want someone to make sacrifices for you, it won't happen by using the stick - it needs to be the carrot - and that's why I find this attitude of "the young are all selfish" etc etc extolled by a certain few on here as being counterproductive to the points you quite rightly raise.

And ultimately, if nothing is done to help the young get through this and try and remedy the problems that they'll encounter due to the sacrifices they've had to make, then I wouldn't be surprised if they started to revolt in time if there isn't more support because everyone has their breaking point..
 
Thank you @knighterrant for your thoughtful post.

To put it bluntly, my concerns are that:
(a) 'Shield the elderly and the infirm' is impractical, unfeasible, and financially unaffordable - it is simply paying lip service to the idea of protecting those members of society who are most vulnerable, and in fact translates to 'dump the elderly and the infirm'. I can't avoid getting the uncomfortable feeling that we will be throwing them under the bus so that the steamroller of economic prosperity can continue unhindered.
(b) The Great Barrington Declaration is the ultimate manifestation of the 'I'm alright Jack' mentality.
 
To put it bluntly, my concerns are that:
(a) 'Shield the elderly and the infirm' is impractical, unfeasible, and financially unaffordable - it is simply paying lip service to the idea of protecting those members of society who are most vulnerable, and in fact translates to 'dump the elderly and the infirm'. I can't avoid getting the uncomfortable feeling that we will be throwing them under the bus so that the steamroller of economic prosperity can continue unhindered.
"Impractical and unfeasible" are subjective so I wouldn't argue with them if you feel that way but "financially unaffordable" contradicts your point that we should allow "the steamroller of economic prosperity to continue unhindered" - if it's financially unaffordable then how can would this steamroller carry on? It's either one or the other?
(b) The Great Barrington Declaration is the ultimate manifestation of the 'I'm alright Jack' mentality.
I'm afraid those so keen to shutdown *everyone* for the sake of the few are the ones coming across as "I'm alright Jack" - because they're having to make sacrifices everyone has to... As I've said earlier, if I was "at risk" I'd be more than comfortable to make massive sacrifices for my children (or their children) to carry on as unaffected as possible but that seems a scarce idea with some on here.
 
And ultimately, if nothing is done to help the young get through this and try and remedy the problems that they'll encounter due to the sacrifices they've had to make, then I wouldn't be surprised if they started to revolt in time if there isn't more support because everyone has their breaking point..
The kids are already revolting ;)
 
"Impractical and unfeasible" are subjective so I wouldn't argue with them if you feel that way but "financially unaffordable" contradicts your point that we should allow "the steamroller of economic prosperity to continue unhindered" - if it's financially unaffordable then how can would this steamroller carry on? It's either one or the other?

The Great Berrington Declaration says (in a nutshell) that we will direct our financial resources at protecting the elderly and the infirm, while everyone else get on with their lives as usual.

My point is that it has always been nothing more than lip service to the cause of protecting the vulnerable - the fact that it is unaffordable is simply proof that the part about 'protecting the elderly and the infirm' was never going to happen - instead, only the part where 'everyone else get on with their lives as usual' will materials, much to the detriment of the vulnerable.
 
I'm afraid those so keen to shutdown *everyone* for the sake of the few are the ones coming across as "I'm alright Jack" - because they're having to make sacrifices everyone has to... As I've said earlier, if I was "at risk" I'd be more than comfortable to make massive sacrifices for my children (or their children) to carry on as unaffected as possible but that seems a scarce idea with some on here.

I am not suggesting that lengthy lockdowns are the only way to deal with the pandemic, just that whatever measures that we do put in place to deal with the COVID-19 risk, should be applied equally and withiut prejudice - we're all in it together.
 
"Impractical and unfeasible" are subjective so I wouldn't argue with them if you feel that way but "financially unaffordable" contradicts your point that we should allow "the steamroller of economic prosperity to continue unhindered" - if it's financially unaffordable then how can would this steamroller carry on? It's either one or the other?

I'm afraid those so keen to shutdown *everyone* for the sake of the few are the ones coming across as "I'm alright Jack" - because they're having to make sacrifices everyone has to... As I've said earlier, if I was "at risk" I'd be more than comfortable to make massive sacrifices for my children (or their children) to carry on as unaffected as possible but that seems a scarce idea with some on here.
I disagree that 'impractical and unfeasible' are subjective, if shielding is to be achieved to a sufficient level whilst the rest of the world carries on as normal. Unless the vulnerable are to be detained within their own bubble(s) with no possible contact with anyone or anything that has been exposed to the outside, there would be a plethora of opportunities for the virus to board the Trojan horse and join them. So impractical. Unfeasible would be the alternative of sealing every vulnerable person into airborne infection isolation rooms with extensive environmental controls and ultraviolet germicidal irradiation of all food and water. Providing such facilities for all the vulnerable would be financially unaffordable for any country.

Your second paragraph comes across as you'd only make massive sacrifices for your children if you were at risk. Does that mean that you'd only risk your life for your children if there's was already the strong possibility that you were about to die? Surely you'd sacrifice anything for their health and well-being anyway? Why not the same sacrifices for your parents' health?
 
"There has been a 98% plummet in flu infections this year, dispelling fears of a Covid and flu ‘twin-demic’ about which many had warned. Experts say we can thank masks and social distancing. But does this really add up?
Although there is no mass testing for flu as there is for Covid, the WHO says that surveillance of data from around the world shows flu rates collapsing everywhere. Australia essentially ‘skipped’ their flu season this year, with not a single case reported since July (their peak). In fact, flu has more or less vanished throughout the Southern Hemisphere, and early indicators suggest it will follow suit north of the equator. What can explain this unprecedented decline?

Where did it go?​

To my mind there are three possibilities.

The first is that it only seems like the flu has disappeared because doctors and scientists have been wrongly classing other respiratory diseases as Covid. Please note that the boffins are already treating this suggestion as something akin to flat-Earth theory.

The second is that Covid has ‘crowded out’ the flu. It does seem to be the case that you cannot be sick with two viruses at once. A recent study from Yale University found that of 13,000 patients admitted to in a major hospital with respiratory diseases, practically no one ever had both a cold and the flu at the same time. In fact, lung tissue that had been previously exposed to the cold virus was immune to the flu virus.

But the scientists say that this solution doesn’t add up: no more than a fifth of the population has been exposed to Covid, and so everyone else should be fertile ground for the flu. But if they are wrong, and Covid is actually far more widespread than the scientists think, ‘virus crowding’ could be contributing to flu’s downfall. (The question is why Covid would have won this battle so completely, for there to be essentially zero flu cases and millions of Covid ones – surely the flu would have gotten to some people before Covid did?)

The third possibility is the scientists’ explanation. Before I give it, please note that either of the first two possibilities, if correct, would render ridiculous the entire response to Covid, not least because it would mean Covid is far less dangerous than has been widely asserted.

The verdict is in​

The scientific establishment is quickly forming ranks behind the theory that the flu has gone away because of Covid restrictions – especially masks, social distancing and lockdowns. They “overwhelmingly agree” that this is so; their certainty is remarkable at this early stage.

But why would these measures have worked so unintentionally well for flu, which has been with us for millennia, but Covid cases are still skyrocketing? Do masks let one particle through and stop another?

The proponents of this theory have an explanation. They claim that people with Covid are more contagious than those with flu. It has a longer ‘incubation period’ than flu does, and its ‘R rate’ is three times higher than that of flu. But even if all of these estimates were right, there is still the unanswered question of why flu would have been eradicated so completely.

Magic masks​

In my opinion, this hand-waving explanation might just be the most awesome act of cognitive dissonance of this entire saga. Experts are claiming, with a straight face, that a laxly enforced hodgepodge of restrictions, which varies wildly between countries and regions, has overnight eradicated an ancient scourge of humanity from the face of the Earth. And in the next breath, they warn that the incidence of another identically transmitted virus is through the roof.

Much more likely in my opinion is that the flu has been confused for Covid in the vast majority of cases. Is it really so hard to believe that flu sufferers could have been confused for Covid cases? After all, we know that lung cancer patients were. In any case, and irrespective of the explanation, one wonders if the flu’s disappearing act means that the largest-ever flu vaccine rollout slated for this winter will be cancelled. Somehow, I think not."

The above is from this article...

 
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There has been a 98% plummet in flu infections this year, dispelling fears of a Covid and flu ‘twin-demic’ about which many had warned. Experts say we can thank masks and social distancing. But does this really add up?
Although there is no mass testing for flu as there is for Covid, the WHO says that surveillance of data from around the world shows flu rates collapsing everywhere. Australia essentially ‘skipped’ their flu season this year, with not a single case reported since July (their peak). In fact, flu has more or less vanished throughout the Southern Hemisphere, and early indicators suggest it will follow suit north of the equator. What can explain this unprecedented decline?

Where did it go?​

To my mind there are three possibilities.

The first is that it only seems like the flu has disappeared because doctors and scientists have been wrongly classing other respiratory diseases as Covid. Please note that the boffins are already treating this suggestion as something akin to flat-Earth theory.

The second is that Covid has ‘crowded out’ the flu. It does seem to be the case that you cannot be sick with two viruses at once. A recent study from Yale University found that of 13,000 patients admitted to in a major hospital with respiratory diseases, practically no one ever had both a cold and the flu at the same time. In fact, lung tissue that had been previously exposed to the cold virus was immune to the flu virus.

But the scientists say that this solution doesn’t add up: no more than a fifth of the population has been exposed to Covid, and so everyone else should be fertile ground for the flu. But if they are wrong, and Covid is actually far more widespread than the scientists think, ‘virus crowding’ could be contributing to flu’s downfall. (The question is why Covid would have won this battle so completely, for there to be essentially zero flu cases and millions of Covid ones – surely the flu would have gotten to some people before Covid did?)

The third possibility is the scientists’ explanation. Before I give it, please note that either of the first two possibilities, if correct, would render ridiculous the entire response to Covid, not least because it would mean Covid is far less dangerous than has been widely asserted.

The verdict is in​

The scientific establishment is quickly forming ranks behind the theory that the flu has gone away because of Covid restrictions – especially masks, social distancing and lockdowns. They “overwhelmingly agree” that this is so; their certainty is remarkable at this early stage.

But why would these measures have worked so unintentionally well for flu, which has been with us for millennia, but Covid cases are still skyrocketing? Do masks let one particle through and stop another?

The proponents of this theory have an explanation. They claim that people with Covid are more contagious than those with flu. It has a longer ‘incubation period’ than flu does, and its ‘R rate’ is three times higher than that of flu. But even if all of these estimates were right, there is still the unanswered question of why flu would have been eradicated so completely.

Magic masks​

In my opinion, this hand-waving explanation might just be the most awesome act of cognitive dissonance of this entire saga. Experts are claiming, with a straight face, that a laxly enforced hodgepodge of restrictions, which varies wildly between countries and regions, has overnight eradicated an ancient scourge of humanity from the face of the Earth. And in the next breath, they warn that the incidence of another identically transmitted virus is through the roof.

Much more likely in my opinion is that the flu has been confused for Covid in the vast majority of cases. Is it really so hard to believe that flu sufferers could have been confused for Covid cases? After all, we know that lung cancer patients were. In any case, and irrespective of the explanation, one wonders if the flu’s disappearing act means that the largest-ever flu vaccine rollout slated for this winter will be cancelled. Somehow, I think not.


Just to add two other possible explanations to your three:

4. The most vulnerable to Flu, those with the weakest immune systems, have already died from Covid-19. And before you do any maths, just to say that this is one of the established explanations among scientists.

5. While the anti-COVID-19 measures that we have in place are only partially effective in slowing down the spread of the highly-infectious SARS-COV-2, at the same time they have managed to completely stop the spread of other less-infectious viruses such as the Flu virus.

So one or more (or all) of the five explanations may apply.
 
Thanks - I see covid is 19th on the list.
Yes indeed, but hardly surprising, as very few people died of it during the summer. That doesn’t mean everything is fine and dandy now, though. Hospital admissions are almost at 50% of where they were in the April peak, and it won’t stop there.
 
But in April the Peak was nowhere near what was expected was it?. The Nightingales hospitals never got used did they?
Is 50% of what it was in April an unusual figure for hospital admissions? Then for this time of year a rise is to be expected?

These are questions, not accusations or anything else.
 
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