UKC

Friday Night Covid Plotting #60

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 wintertree 08 Jan 2022

Thread 60.

I remember thinking "I should start writing these posts offline, then proof read them a few hours later.  If I also collect all the plots in a folder it'll streamline things and keep a record".  I nearly didn't do it because I then thought "Well, I did so many straight in to the UKC editor, what's the point in changing now?".  I just checked my records and that was thread #7.  Turns out this has been dragging on for a long time... 

Post 1 - Four Nations (Cases)

Cases in all four home nations look to be turning to decay; more than just an over-enthusiastic trendline and it’s unlikely to be due to limited testing capacity, as the most recent days with the lower values have the highest ever daily number of tests conducted [1] - over 2 million tests/day.  But the data is coming out of a pretty messed up period from Christmas and the New Year.  Best to see what the next week brings.

Plot 9x shows the rate constant (exponential growth rate) for cases as having peaked for all 4 nations just berfore Christmas, and to  moving towards decay ever since; the peak is out of what I’ve traditionally considered the provisional window, the turn to decay is still provisional.  So, again it needs a few more days to really confirm this.

Provisional as they are, pretty promising developments I think; later posts dive in to a few more details but infections seems to have peaked.  

If I was looking to poke holes in this apparent decay...

  1.  I'd note it's strange to see all nations turning to decay at such a similar time given how desynchronised this wave has been - yet the rate constant behaviours in plot 9 don't look that similar.
  2. I’m wary of the scope for  a new year rebound from returning work places and schools raising R, temporarily overcoming the building levels of immunity-against-omicron-infection, probably another 1.5 weeks before we could look at this data and be really certain that that’s it...

Link to previous thread:
https://www.ukclimbing.com/forums/off_belay/friday_night_covid_plotting_59-742608

[1] https://coronavirus.data.gov.uk/details/testing


 wintertree 08 Jan 2022

Post 2 - Four Nations (Admissions)

Healthcare has historically been the limiting factor for the pandemic; isolation orders are vying for first place now it seems, including with healthcare staff.  A good (worrying) link towards some plots on this at the end of the last thread [1].

A note on admissions data -  some discussion over the last couple of weeks has been on  “incidental admissions” - numbers recently reported in the press are that up to 40% of admissions are now “incidental” - people testing positive for Covid but not admitted for Covid.  These patients still represent extra load as they require the same protection/control measures as Covid admitted patients so their significance to healthcare is still somewhat related to Covid, but not as related as a direct Covid admissions.  Another poster shared this link at the end of the last thread [2]

Admissions in all nations except Wales look to be peaking, ready to head for decay.  It’ll need a few more days to really confirm this.  They’re turning at about the right kind of time from cases.

Something strange is happening in Wales with admissions - it’s going up, quite fast - plot 9w shows the characteristic times for Wales.  The provisional doubling time for admissions is shorter (worse) than for cases, bucking the trend everywhere else.  I haven’t looked in to what this is all about, but if the trend doesn’t break very soon, that becomes a clear concern.

[1] https://twitter.com/VictimOfMaths/status/1479484966232862726
[2] https://nitter.1d4.us/VictimOfMaths/status/1479396101803638786#m
 


 wintertree 08 Jan 2022

Post 3 - Four Nations 3

A slightly different plot this week; these are cases and deaths per million for the four home nations.

From June until November, England had generally had lower cases and deaths than the other nations.  As always, I’m not looking to make comparisons about where was doing “better” based on numbers at one moment in time.  Total infection is loosely conserved over time - subject to nowhere pushing for elimination - so more at one point could be balanced by less at an earlier or later point.  I say “loosely” because so may factors are always changing...

The last 10 days or so of deaths data are standing out as unexpected- they’re continuing to fall in Scotland whilst rising in the other home nations.   This despite cases having risen a lot in all the nations under omicron. Something interesting going on three….

Looking at the demographics on Travelling Tabby [1] I think it might be that omicron is arriving later in older people in Scotland, so this may be demographics at work, and lags may be playing out soon.  Other explanations / suggestions welcome...

Very interesting if it’s a more fundamental difference in pathology or care standards however.  I don’t think I have the data to really address this.

So far, there isn't clear water between the reasonable bounds for a rolling case fatality rate between Scotland and England, but they are diverging.

[1] https://www.travellingtabby.com/scotland-coronavirus-tracker/


 wintertree 08 Jan 2022

Post 4 - England 1

Cases - stopped rising about a week ago in the data, looking like they’re going to start going down.  Growth could rebound from lots of things returning post-festive break.  I’m optimistic any rebound will be specific and limited…

Admissions - maxed out, looking  like they're about to go down.  Hopefully the start of a beautiful trend…

Occupancy - starting to level off for a peak, following the levelling of of admissions.

Deaths - these have risen since Christmas as the increased numbers of omicron cases work through, but not by much.

Plot 9 shows all the rate constants except deaths as having maxed out - albeit in the provisional leading edge - and heading for decay.


 wintertree 08 Jan 2022

Post 5 - England 2

Plot 18 - Regional Rate Constants

  • Cases - The rate constant is heading for decay in all regions now, having reached it in London and the East of England.  This is a pretty consistent trend over several days and feels pretty real to me.  Things happen very quickly with this new variant - infection is spreading much faster and so immunity thresholds are going to be reached much faster.
  • Hospital Admissions - the rate constants are also heading for decay for all regions (except London which is already in decay).  Good confirmation that the decay in cases is largely representing a real decay in infection levels, it’ll be a few weeks before that flushes through the “carrying live virus” period tested by the ONS random sampling survey including their reporting lag, but it looks promising.
  • Deaths - the rate constants are clearly trending towards growth but much less aggressively than hospitalisations.  Hopefully turning to decay soon enough as the lags in the pipeline play out.  Quit significant decay, perhaps, given what's starting to develop in ITU data...

Plot D1.c - Demographic Cases

  • As with recent weeks, this is showing the demographic case numbers and rate constants for all of England except London, as London’s timing in this wave is substantially ahead of elsewhere.
  • The data is a bit messed up with an artefact-band running vertically on Dec 25th - a “false” decay signal from under-sampling on Christmas Day.  There’s a second artefact-band on Jan 1st with a “false” growth, where the massively under-sampled Christmas Day data is compared with the less-but-still under-sampled New Year’s Day data.  (This band is most visible on youngest ages)
  • The artefacts make the usual filtering a bit twitch, so I’ve put raw and smoothed plots in so interested readers (all 3 of you at this level of detail...?) can compare the two to make your own judgement.  It looks like the last couple of days have seen week-on-week falls in case numbers for all ages over 20. 
    • This data lags the data used for plot 18 by 2 days, and as plot 18 shows continued week-on-week decay I expect great things over the next 2 days at least.
  • So - now we look for rebounds in case rates from workplaces returning, then schools, then universities.  Hopefully the oldest ages are more sheltered from rebounds, and they're not exactly in a rush to happen which is promising...

Plot 22 - Hospital Occupancy

  • The last couple of red data markers have stopped moving right, meaning that occupancy isn’t going up across England any more; too soon to call it as having levelled off as there’s quite a lot of jitter in this data.  More interesting is that ITU occupancy is starting to fall…

Rolling Case Fatality Rate (CFR) Plot

  • This continues to show the ratio of deaths to detected cases falling; as we expect more omicron cases to be asymptomatic the true infection fatality ratio is presumably falling faster.  The fall has so far come through in the earliest ages, where omicron landed first.  The lower edge of this plot (shorter possible lags) is falling down on all ages now; hopefully the upper edge (longer possible lags) falls as those lags play out. 

 wintertree 08 Jan 2022

Post 6 - London

Plot D1.c

  • As with England, this shows a turn to decay - all ages over 15 for London - and a more marked decay than at England; which fits as London peaked earlier. 
  • As with the Enblish plots, there’s artefact bands from Christmas Day and to a lesser degree from New Year’s Day. 
  • If the decay holds up for another week solid that’ll be a big development...

London Hospitals Plot

  • - both kinds of hospital occupancies are falling…

Final thoughts on the UK, and England in particular.  So….  Omicron seems to be running out of steam, ITU occupancy is barely touched by it and hospital occupancies seem to be maxing out at below or well below (depending on region) the level of previous peaks.  Two questions on my mind:

  • Is this because Delta really was almost over and we were almost out of immuno naive people, and omicron sped up the remains process, or is it because omicron has a much lower intrinsic severity?  In a few weeks, event in Europe will shed more light on this I think.
  • This is the biggie...Did the cabinet know with high confidence that this would be the outcome of the last month of policy?  Unless they’re getting another source of high quality advice separate to the SAGE minutes, it’s far from clear to me that they did.  Not a comforting thought.  

 wintertree 08 Jan 2022

Post 7 - International Quick Look

A few plots made from Ourworldindata.org's daily download.  

Raw Data Scrutiny

  • Cases/million for the last 7 weeks for a bunch of European nations and a few international locations of interest.  The red line is raw data, black the trendline.  Y-axis scales 0 to maximum value independently for each nation.  Useful for understanding the trend but not scale on a per-nation basis, and for looking for artefacts in the trendline cased by day-of-week weirdness.
    • (Normally I'd never "join the dots" on a curve like the red one when presenting data, it's a total faux-pas for sound reasons, but it works really well specifically for hi-lighting the day-of-week structure rather than the values themselves)

International Phase Space

  • Cases/million on the x-axis vs rate constant and characteristic time on the twin y-axes.
  • This plot is a real dog's dinner, it's not a good plot but interested people can squint to determine a lot.  Really it needs an interactive dashboard with clicky buttons to turn nations on and off.
  • Control measures from the weak to the stringent have all fallen to Omicron across this plot.  Almost everywhere is now in growth with about half the nations doubling in less than a week.  Places not in rapid growth are all headed for it by their trajectories.

Rolling CFRs

  • This shows what I consider reasonable bounds for the instantaneous case fatality rate - deaths over the most recent days divided by cases 7-, 14-, 21- and 28-days before, averaged over a 3-day window as well as a 7-day rolling average applied to the input data sets.
  • This is critical context for interpreting the case reates.  This plot has a log-x axis (!).  CFR estimates differ by a factor of about 70x between Portugal and Romania.
  • CFRs are likely changing - and changing differently for each nation - with the transition from delta to omicron, and I don't think they're fully reflecting omicron yet so use with a liberal pinch of salt to contextualise different nations. 

 Si dH 08 Jan 2022
In reply to wintertree:

> Rolling Case Fatality Rate (CFR) Plot

> This continues to show the ratio of deaths to detected cases falling; as we expect more omicron cases to be asymptomatic the true infection fatality ratio is presumably falling faster.  The fall has so far come through in the earliest ages, where omicron landed first.  The lower edge of this plot (shorter possible lags) is falling down on all ages now; hopefully the upper edge (longer possible lags) falls as those lags play out. 

Am I right that you are using a range of 7-28 days for case/death lag in this plot, or is the upper end longer than 28 days?

I'm wondering what it looks like if the maximum delay is set as the duration back to the date at which Omicron became dominant in older ages. It would be helpful to try to remove the influence Delta cases from the equation to get a better image of the likely Omicron impact, and this might be a crack handed way of doing it. Without combing past data I guess this was around the middle of December? Thinking as I type, it might be easier to just wait a week..

 wintertree 08 Jan 2022

 In reply to Si dH:

> Am I right that you are using a range of 7-28 days for case/death lag in this plot, or is the upper end longer than 28 days?

7-28 days; a longer lag would be nonsensical as it’s using the “deaths within 28 days of first positive test” measure.  The recent look I took at 28- and 60-day deaths suggests 28 tracks death certificates very well.

> Thinking as I type, it might be easier to just wait a week…

Funnily enough that's just what I was thinking as I read your post.  In theory I can do this plot for London data, but when you break deaths down by age and region, the noise skyrockets.  

 Si dH 08 Jan 2022
In reply to wintertree:

By the way, your biggie about the cabinet...no way did they know confidently what was going to happen. I think since late November we have seen Johnson's cautious side throughout. Although measures have been weak, they have been more stringent than many in his party wanted and it would have taken significantly rising death rates or ICU occupancy above that of last winter, IMO, to take him beyond 'plan B'.

Basically all nations I've bothered following (really just Western Europe) have taken the same high level approach in autumn/winter 2021. They have continued to stick with whatever their strategy was from the summer, hoping it would work, until (where applicable) it was totally obvious that the shit had hit the fan. The summer strategies varied, but the hesitation to change tack in response to clear data, and the determination to show their original strategy could still work, have been common everywhere. We in the UK have just, it now seems, been lucky that it (the strategy set out in Johnson by July, including 'plan B') does seem to have worked (at least in terms of limiting the impact of a winter wave in deaths and with the aim to be able to relax winter measures sooner rather than later.)

Assuming the data doesn't change a lot by next week and we really do turn out to have rolled a few sixes... what do you think is the best strategy, from a public health point of view, to minimise the impact of Pi? That becomes the big question. I don't really have a clue but we know it will come along.

Post edited at 22:42
 wintertree 08 Jan 2022
In reply to Si dH:

Play Russian roulette enough times with other peoples’s lives and one day you won’t loose.

> Assuming the data doesn't change a lot by next week and we really do turn out to have rolled a few sixes... what do you think is the best strategy, from a public health point of view, to minimise the impact of Pi? That becomes the big question. I don't really have a clue but we know it will come along.

That’s a good question.  Kind of open ended, and good answers involve a time machine with at least a decade’s reach. After tonight’s battle with the clematis-of-doom I’m passed answering it.  Mañana.

1
 AdJS 08 Jan 2022
In reply to Si dH:

> We in the UK have just, it now seems, been lucky that it (the strategy set out in Johnson by July, including 'plan B') does seem to have worked (at least in terms of limiting the impact of a winter wave in deaths and with the aim to be able to relax winter measures sooner rather than later.)

So since “Freedom Day” on the 19th July in the UK according to the government’s data we’ve had around an additional 9 million covid cases and 20 thousand deaths (pity about those) and you say the plan has worked! Bollocks!

I hate to think what would have happened if the plan hadn’t worked.

11
In reply to wintertree:

Interesting to note the CFR for South Africa is way higher than the UK - one can only assume our vaccinations are keeping ours down, as we should be seeing higher CFRs than SA due to their lack of old people to kill. If it's easy for you to calculate, is their CFR the same as it was for Delta? If so, that would cause trouble for the 'Omicron is milder' theory.

 Si dH 09 Jan 2022
In reply to AdJS:

Did you read the bit where I wrote "at least..."?

 AdJS 09 Jan 2022
In reply to Si dH:

> Did you read the bit where I wrote "at least..."?

I did!

Do you really think the strategy of letting the virus run wild has limited the pressure on the NHS and will reduce the overall number of deaths?

Post edited at 00:26
11
In reply to wintertree:

Your analysis is a lot more optimistic than an "on the face of it" look at the government dashboard provides; hospital admissions and occupancy are rising quite strongly, and deaths rising again but slowly. What it does show most strongly is that the link between hospital occupancy and MV beds is broken - either all these Omicron cases are producing much fewer serious cases (🤞), or MV is no longer used on as wide a range of cases.

I hope your analysis is correct - I think you're "ahead" because you're basically doing a lot of looking at 1st & 2nd order differentials, and splitting into London and elsewhere. Also hopefully we've got past any possible distortions from all the bank holidays that might lead us astray.

Personally, I don't think I'll start to feel comfortable until:

  • Hospital admissions, occupancy and deaths are all consistently falling
  • There's no new variant spreading across the visible horizon

With a bit of luck we'll be in that position within a month or two - keep up the good work.

In reply to Si dH:

> Assuming the data doesn't change a lot by next week and we really do turn out to have rolled a few sixes... what do you think is the best strategy, from a public health point of view, to minimise the impact of Pi? That becomes the big question. I don't really have a clue but we know it will come along.

Well, it looks like the Tories played Russian Roulette and won fifty bucks.   I don't think it actually matters what the best strategy is for the next variant of Covid.  The Tories always wanted to do the 'take it on the chin' thing, now they've actually done it and got away with it they're pretty much sure to try it again.   If the next variant is nastier than Omicron and evades immunity we will be f*cked because those guys are not going to take their time and make sure before letting it rip.

13
In reply to Michael Hood:

There are a couple of reasons to be more optimistic than the raw numbers show. Not much, but a little.

The MV beds number, if I understand right, is patients in MV capable beds, whether it's in use or not. I might be wrong but that's my interpretation. So there'll be some small percentage there.

The other is the 'with, not because of' admissions figures are for acute admissions only, so that raw number is necessarily a bit, maybe not much but a bit, pessimistic too.

In reply to wintertree:

Press here are reporting Cypriot variant, combining delta and omicron, which 'appears' to be putting nearly half in hospital. It's thin on details though. 

2
 AJM 09 Jan 2022
In reply to AdJS:

> Do you really think the strategy of letting the virus run wild has limited the pressure on the NHS and will reduce the overall number of deaths?

Fundamentally that depends on whether you think control measures reduce the number of deaths or just defer them, right. 

Its obviously the case that control measures which defer infections from pre vaccination to post vaccination save lives because it moves them to a far lower risk environment.

Deferring them from this summer to a point where theraputics are widely available and common use (a couple of months time before it becomes widespread enough?) probably does the same.

But where the medical landscape isn't changing that's less obviously the case. Perhaps you could say the booster is the landscape-changer between now and 4-5 months ago - but then how many of the people who died would have already been double vacced and in the original scope of the booster program, I don't know.

What would you have done instead, for how long, and what price do you put on any stronger control measures contained within that alternative?

- for clarity, I am genuinely curious and I am not wedded to a particular answer being right

 girlymonkey 09 Jan 2022
In reply to AJM:

Spreading cases out more means that the serious cases don't all hit hospitals at the same time so they can actually get the best care available. Obviously, some will still die even with the best care, but some won't. All hit at the same time, that level of care isn't there and some who would have survived with the best care will die instead with the lower level of care available.

In reply to AJM (well, AdJS really):

I had a response along similar lines but didn't post it because it'll just lead to accusations of Tory sympathy. But in response to posts like AdJS' I'm always tempted to point out that you can write that same text whatever the number, and the number was never going to be zero. It's not really an argument for right or wrong unless accompanied by an alternative narrative where fewer people die (and not just die at some later time). 

Edit to clarify: I'm a strong supporter of control measures and not long ago would have advocated for doing more this time around. But the purpose of such measures is narrow and well defined (and for the sake of all we value it really needs to remain narrowly bound to that), and if their objective is to prevent one thing and one thing only, I was losing faith in my argument to do more as recent events unfolded.

Post edited at 08:18
 AJM 09 Jan 2022
In reply to girlymonkey:

Well yes - that was the idea of timing the exit wave and any winter wave at different times.

To spread it out further you need control measures all the way through to spring, I would have thought.

1
 rurp 09 Jan 2022
In reply to wintertree:

> Play Russian roulette enough times with other peoples’s lives and one day you won’t loose.

So in the words of our great leader;

’We are now beginning to turn the tide. If this virus were a physical assailant, an unexpected and invisible mugger, which I can tell you from personal experience it is, then this is the moment we have begun together to wrestle it to the floor.’ April 2020

Or in alternative words it’s killed pretty much everyone it can. Thanks for the data and analysis over the last few years. Looks like we can finally give our NHS teams a little bit of hope. Couple of weeks of plateau then things get less 💩
 

4
 Šljiva 09 Jan 2022
In reply to AJM:

Government policy aside, I’d like to raise a glass to us, well most of us.  I just got back from somewhere where there are zero control measures, barely any testing and nobody cares at all. By the official figures their rate was <100/100k and no Omicron.  Ten people in a bar Jan 1, 10 people sick Jan 4.  Partner does LFT - positive, others (all but 2 unvaccinated) maintain they have a cough /cold (definitely not covid),  crack on with their lives after a day or so in bed, lots of family mixing as it’s that time of year and Christmas fell this Friday.  One couple go to the extent of forging a vaccine certificate (badly) and head off to France skiing. ( I ‘m hoping that works out really badly for them, as it surely will for anyone they come into contact with).  Almost everyone you meet has “a bit of a cold”.  They also have one of the highest per capita covid death rates in the world (this may or not be true as CRP is the main test when you can get one rather than PCR) 

Whatever the UK govt does / doesn’t do, most people here are aware, seem to take some care, LFT is more or less a part of daily life now. Responsible adulting I guess. I don’t know any other country where it’s quite so easy to test yourself on a regular basis.

Meanwhile, I’ve continued to test negative despite being holed up with an infected one. As for testing capacity now, took up the T&T offer of a PCR y’day and there wasn’t a single other soul at the test centre. 

Post edited at 09:30
 AdJS 09 Jan 2022
In reply to AJM:

> Fundamentally that depends on whether you think control measures reduce the number of deaths or just defer them, right. 

> Its obviously the case that control measures which defer infections from pre vaccination to post vaccination save lives because it moves them to a far lower risk environment.

> Deferring them from this summer to a point where theraputics are widely available and common use (a couple of months time before it becomes widespread enough?) probably does the same.

> But where the medical landscape isn't changing that's less obviously the case. Perhaps you could say the booster is the landscape-changer between now and 4-5 months ago - but then how many of the people who died would have already been double vacced and in the original scope of the booster program, I don't know.

> What would you have done instead, for how long, and what price do you put on any stronger control measures contained within that alternative?

> - for clarity, I am genuinely curious and I am not wedded to a particular answer being right

While I can see the logic behind allowing the virus to spread in order to build immunity on the whole I think the downsides (not just in terms of health but also societal and economic) have far outweighed any overall benefits.

It’s been clear from the start of the pandemic that strong control measures work. You only have to look at China to see what can be done.

https://www.bmj.com/content/375/BMJ-2021-066169

If China, a country with a population over 20 times that of the UK, had followed our strategy they would have had well over a million covid deaths by now instead of under 5000. Would that have been a better outcome for them?

I’m not saying what the Chinese have done is perfect, or that such aggressive tactics could be easily implemented in western democracy (although NZ shows it can be done), just that what they have done has worked so far (no national lockdowns and the only major economy that grew in 2021). What would have happened if countries had worked together and followed China’s example?

Has China just deferred it’s deaths and future economic pain? Or, will it’s control measures, vaccination programme and better therapeutics see it through in the long run? 

Only time will tell, but my hunch is that they’ll achieve at better outcome in the end.
 

7
In reply to AdJS:

> While I can see the logic behind allowing the virus to spread in order to build immunity on the whole I think the downsides (not just in terms of health but also societal and economic) have far outweighed any overall benefits.

Not sure what you mean here. You seem to think it was 'either/or', rather than 'when, not if'. Pushing back the when makes sense to a point (eg until after vaccination), but that's not a route to endemic without something else happening. How does the pandemic end in your ideal scenario?

> It’s been clear from the start of the pandemic that strong control measures work. You only have to look at China to see what can be done.

How's that going?

https://m.dw.com/en/how-chinas-zero-covid-pursuit-is-stoking-anger-public-shaming/a-60327210

https://www.bbc.co.uk/news/world-asia-china-59871325

> If China, a country with a population over 20 times that of the UK, had followed our strategy they would have had well over a million covid deaths by now instead of under 5000. Would that have been a better outcome for them?

They haven't got away with it yet. 

> I’m not saying what the Chinese have done is perfect, or that such aggressive tactics could be easily implemented in western democracy (although NZ shows it can be done), just that what they have done has worked so far (no national lockdowns and the only major economy that grew in 2021). What would have happened if countries had worked together and followed China’s example?

Then we would still be going from lockdown to lockdown, because you would never achieve simultaneous elimination everywhere. That's before you even consider animal reservoirs.

> Has China just deferred it’s deaths and future economic pain?

Very possibly.

> Or, will it’s control measures, vaccination programme and better therapeutics see it through in the long run? 

Maybe, but it's a big maybe. But what's their next move? It's not like they can throw open their borders now. The whole world is teeming so free travel in or out is a non starter. China can arguably live that way. Could the UK?

> Only time will tell, but my hunch is that they’ll achieve at better outcome in the end.

They probably will, but only because they can lock people in their tower blocks. Australia/NZ is the only remotely fair comparator for how we could have handled it, and they'll most likely have far fewer deaths than the UK, but the final scores aren't in yet so we don't know by how much.

Post edited at 10:45
In reply to AdJS:

After 2 years and seeing how the UK has pretty much shrugged off Omicron with the lightest of light touch restrictions how can you honestly believe anything you’re writing.

China is f’ed.

Crappy vaccine. No natural immunity. It’s a recipe for carnage in 2022 unless Omicron is significantly less inherently lethal than Delta.

The Winter Olympics will be the beginning of the end for their Zero Covid strategy and they will be f&cked.

Have you not read the news reports about people trading their possessions for food in the cities that have been locked down? I’m glad that I’m the UK I don’t have to sell my car to get a couple of bags of pasta.

Of course this will have a serious impact on you and I. Serious inflation due to supply chain issues. Potentially an economic crash if the real estate bubble bursts at the same time they’re having to implement the same measures as we’ve done over the past 2 years.

7
 elsewhere 09 Jan 2022
In reply to VSisjustascramble:

When a city the size of London goes into lockdown in China, it's a tiny proportion on the population. The other 99% (yes 99%) of the population and economy is open as usual.

Not that it changes my opinion of the CCP.

Post edited at 12:32
In reply to VSisjustascramble:

They'll just lock down as much and as hard as necessary. The end result will be (comparatively) few Covid deaths but lots of individual hardship and "knock-on" deaths.

But, the number of knock-on deaths will never be seen outside of China so it will appear to be a successful strategy overall. We are very unlikely to ever be able to determine how successful it really will be.

In reply to Michael Hood:

In the short term maybe.

But the long term end game is the same for China as it is for the UK I.e. broad population level immunity.

You can only defy gravity for so long.

They are not going to be locking down cities in 2030 while we’re back living a normal existence.

How does China get to the same excellent immunity position we (UK) have? That’s the key question and I suspect that whilst they’ll handle it in an effective manner, there’s no easy path to get there.

Of course things will look better to the outside world when you have a state controlled media and can censor the internet, but unless Omicron is significantly less inherently lethal than delta then they’ll need the same measures we used I.e. social distancing, localised lockdowns, work from home orders ect.

Not great when the country in question is making most of the stuff you buy on a day to day basis.

 Jon Stewart 09 Jan 2022
In reply to VSisjustascramble:

Yeah, working from home and SD are the end of the world, aren't they? How could an economy possibly function with sporadic local behaviour adaptation? It's unimaginable! 

4
 girlymonkey 09 Jan 2022
In reply to Jon Stewart:

Especially since work from home reduces congestion on roads, gives people more free time/ time with family, more chance to cook healthy meals at home etc etc. 

I'm not saying there are no downsides to WFH but there are many positives!

2
 Jon Stewart 09 Jan 2022
In reply to girlymonkey:

Unless you own a sandwich shop in town, it's obviously a massive improvement on how we live (with downsides too of course).

1
 wintertree 09 Jan 2022
In reply to Jon Stewart, girlymonkey:

I don't think WFH translates so well to China. Industry is a much larger fraction of their economy than Western Europe, as is agriculture for that matter.  

In reply to VS: (& sort of in reply to Michael Hood)

I'm not sure about your predictions re: China If omicron does turn to to be a similar intrinsic lethality to alpha.  They are less demographical vulnerable than us, and some other nations with similar demographics and purported democracies have already done very little at the policy level other than opting for mass graves.  

I can't see many people in China raising a public fuss over this if it happens - state control of information through the media and social media, and urban populations who understand all to well the importance of keeping their party record clean if they want their factories to continue, or if they want their children to get their exit visas for a year's jolly to the UK or USA for their token master's degree abroad.  

Post edited at 14:52
In reply to Jon Stewart:

To be fair I think the post was concerned with China's economy, which might not be quite as easy to pivot to home working as ours.

 Jon Stewart 09 Jan 2022
In reply to Longsufferingropeholder:

Fine. I just think the economic collapse we suffered was because we didn't have a clue what we were doing. China is a million times better prepared and won't collapse - I find this story  of economic collapse because China was not as brilliant as us at all catching covid to be absolutely preposterous.

Post edited at 15:03
1
 wintertree 09 Jan 2022
In reply to Si dH:

> Basically all nations I've bothered following

Sounds like you've followed more of the political/news side of it; I've been surprised at how similarly it's going almost everywhere.  We really could do with a reset where it's understood that government's changing policy to respond to a changing situation and/or changing evidence is not a U-turn but a basic part of good governance...

> Assuming the data doesn't change a lot by next week and we really do turn out to have rolled a few sixes... what do you think is the best strategy, from a public health point of view, to minimise the impact of Pi? That becomes the big question. I don't really have a clue but we know it will come along.

The next big question.  Re-stocking the tinned food and shotguns, obviously.  Beyond that...

I think to depends on what Pi turns out to be.  

  • If it's downstream of omicron on the phylogenetic tree and has a bunch more changes on the spike protein, I think the worry factor is going to start rising over the increasing mismatch between the T-cell epitopes from the wild type (original virus) vaccine and an omicron-descended Pi.  I think the risk from this is going to fade pretty rapidly, as the efficacy-against-infection of a 3rd dose fades (excepting more vulnerable people getting a 4th dose or an omicron adapted vaccine) and lots of people get an omicronic update in the next couple of months...  But if this  landed next week and we no longer had vaccine efficacy against transmission, and a bunch of people have had no broader immunogenic exposure than the wild type vaccine [1] it's pretty bad news.  Potential mitigations:
    • Get an omicron adapted vaccine ready and in volume production ASAP -
      • Use it as a booster for our most vulnerable at the optimism timing estimated by JCVI to protect during the long wind down of the winter 21/22 wave if that happens (I'm expecting a long wind down for reasons we've been through on the last thread). 
      • Send the rest abroad to places needing 1st and 2nd doses to help them and so reduce the variant risk for all, including ourselves, but be prepared to roll out a December 2021-scale local booster program prioritised by age and lack of past detected infection status should a bad son-of-omicron land.
    • Get omicron adapted MAB therapeutics ready ASAP 
    • Offering people over 40 or so a dose of Valneva - pending the data on its efficacy against severe illness.
  • If Pi turns out to be a descendant of something further up the phylogenetic tree with less or similar divergence to omicron, how bad news this is depends on why we're seeing such reduced consequences now.  If things are better because of a wall of immunity then fine, we're basically good... Some mitigations:
    • Be ready to offer an additional dose for them more vulnerable timed to provide immunity-against-infection as the wave spikes
    • Be ready to get existing MAB cocktails into the immunocompromised at times of high prevalence (the wind down now, and going in to winter 22/23?)

One proximal issue for strategy is how testing and isolation change going forwards; Zahawi is floating 5 day isolations today.  At some point, symptomatic and asymptomatic PCR and LFT testing for the general public has to stop.  If things keep moving in the right direction that time could be before spring.  When this happens I'd like to see some of the capacity shunted to expanded the ONS random sampling survey to increase its sample size to the point good regional and demographic data can be released twice a week; I think this will give a much better picture of the situation and help spot any rising problems early on in their exponentials.      Then there should be some scoring system for randomly detected infections and hospital detected ones that keeps sequencing running at capacity with the most worrying infection and hospital admissions in terms of medical history.  I'll be much happier if there's a lot of vigilant study going on for the next year or two so we don't get blindsided, as time goes on hopefully we build up solid evidence that it's staying in its new box.

I'd also use the twice-weekly ONS data to produce regional risk factors for Covid to help inform the more vulnerable about their risks.  I'd like to see that move to integrating surveillance on influenza etc from the random sampling swabs (there's so much more data in them than on just Covid...), and ideally integrated in to the NHS App to give personalised scores including medical history.  Does this level of awareness help to stop waves of influenza crushing healthcare as with some past years?  Especially if fitted with an FFP2/FFP3 mask fitting service provided by the NHS for the clinically extremely vulnerable? 

[1] https://nitter.42l.fr/pic/media%2FFIQe2A8XEAUroll.png%3Fname%3Dorig

Edit: Should have read the whole thread first. Re: Suumo's Deltacron post - if omicron is less lethal because of changes to the membrane fusion part of the virus changing the fusion mechanism and so moving the centre of infection up the respiratory tract, then if some recombinant stuff or some convergent evolution produced a virus with omicron's RBD changes (high vaccine evasion for transmission) with delta's membrane fusion mechanism (nullifying the posited reduced lethality), well, that would be bad.  I've wondered if the fusion sub-domain is also a target for sterilising antibodies (seems likely as those bits can't do their thing if gunked up with antibodies); if it is, the vaccine escape on Deltacron should be less bad than that of Omicorn.  Mitigations might include 4th doses for the vulnerable, MAB therapeutics pre-emptively in to the extremely vulnerable and a lot of swearing, and some rapid tests of the omicron adapted vaccines to see what they do.

Post edited at 15:22
1
In reply to Jon Stewart:

I'm with you in doubting that they'll let their economy tank, but how they'll do it I'm not sure. As it stands they're that one kid in class who never had chicken pox. How to get from there to whatever you'd call normal isn't obvious.

 Jon Stewart 09 Jan 2022
In reply to Longsufferingropeholder:

> I'm with you in doubting that they'll let their economy tank, but how they'll do it I'm not sure.

They've got options we wouldn't dare dream of!

In reply to wintertree:

Yeah the news was vague on if these 11 out 25 in hospital with deltacron were vaxed, so it's possibly just scaremongering. 

In reply to Jon Stewart:

> Yeah, working from home and SD are the end of the world, aren't they? How could an economy possibly function with sporadic local behaviour adaptation? It's unimaginable! 

Can a steel mill function if everyone has to work from home?

Will boots still have glasses to sell if the frames and lenses all come from China? Of course yes - will the price go up if a third of the steel mills are shut down? Yes. Boots might be okay - but will the smaller optometrists manage?

It’s not just steel, it’s everything. Your house will be equipped with the latest Chinese stuff. So will everyone else’s.

I hope I’m wrong about China. But as I see it they’re massively leveraged (real estate), have no real friends and have limited levers to pull if shit really hits the fan. And shit will hit the fan unless Omicron is less lethal than wild type.

From an economic perspective even the most basic Covid control measures are significant. My top tip is to buy commodities - I’ve given up with the sane diversified portfolio theory- I’m all in on inflation hedges.

In reply to Jon Stewart:

> They've got options we wouldn't dare dream of!

Exactly, if China makes vaccine mandatory, they won't be protesting with purple ribbons there! 

1
 Jon Stewart 09 Jan 2022
In reply to VSisjustascramble:

I rather expect that the Chinese will prioritise the manufacturing output over ensuring everyone has the access to healthcare they might otherwise desire.

 Si dH 09 Jan 2022
In reply to summo:

There have been a few of these 'x mixed with y' type stories that have caused brief panic amongst those looking for them. Alpha mixed with E484K springs to mind. Then there was Delta with E484K too, and something else. I think until there is some evidence the new variant they have found is spreading, it's not much of a story... hopefully they are monitoring it well though.

 wintertree 09 Jan 2022
In reply to VSisjustascramble:

I’ve been hedging today.  It made a nice break from the ditching.

I’m not so worried about China and covid as they have other, less fluffy ways of handling the fallout of a big wave of infection if they judge that to be the least bad way forwards for them.

I’m more worried about the ROC situation and the amount of distraction/division ratcheting up along the Russian border.   I was going to invest in British semiconductor fab capacity but China is buying it up…

 jimtitt 09 Jan 2022
In reply to VSisjustascramble:

> I hope I’m wrong about China. But as I see it they’re massively leveraged (real estate), have no real friends and have limited levers to pull if shit really hits the fan. And shit will hit the fan unless Omicron is less lethal than wild type.

Your ideas of the vulnerability of the Chinese economy are as bonkers as many of your other theories. 

4
In reply to Si dH:

If Rom is still in Cyprus it shouldn't be long before they appear with one username or another. 

In reply to wintertree:

>  I was going to invest in British semiconductor fab capacity but China is buying it up…

LOL

You should thank them for saving your money.

Successive UK governments are responsible for the death of the UK semiconductor industry and it is not coming back after Brexit.   It is clear what the shape of the semiconductor industry will be: mega fabs operated by TSMC, Samsung and Intel in the US, EU, Korea and Taiwan. China will eventually control Taiwan or use military leverage to force TSMC to operate leading edge processes in China.

1
In reply to jimtitt:

> Your ideas of the vulnerability of the Chinese economy are as bonkers as many of your other theories. 

That’s fine if you think that. It’s my money on the line and not yours.

I smell echos of 2007. I don’t think I’ve actually been wrong on Covid yet… When everyone was screaming freedumb day I was urging harder and faster. I had an interesting debate with wintertree at the time (who’s much smarter than I am) who thought there was still the potential to tip healthcare over the edge in June. I also argued we should let our wall of immunity deal with omicron - it has.

In terms of China I see an over exposed economy who’ve yet to take a significant economic hit. This is close to my day job and my spidey senses are tingling.

If I’m wrong the world still needs copper and gold. I think I’m on to a winner.

Post edited at 16:10
5
 elsewhere 09 Jan 2022

When (not if) Pi to Omega come along, the platform technologies will be well practiced at preparing variant specific vaccines.

https://www.nature.com/articles/d41586-021-02854-3

In reply to VSisjustascramble:

> If I’m wrong the world still needs copper and gold. I think I’m on to a winner.

If Chinese manufacturing is shut down like you think will happen the first thing they will do is stop ordering commodity raw materials...

 wintertree 09 Jan 2022
In reply to tom_in_edinburgh:

Yes, I was being flippant, to make the point China is buying up (what little, outdated) capacity the UK has.

I’ve worked with some rather niche parts out of a smaller UK fab before, and I’m well aware of the gulf between the volume and feature size capabilities of UK plant and TSMC, and indeed the growing lead of TSMC over the likes of Intel.  Scotland seems like a good place for some leading edge fab plants, geologically stable, backup power for the cleanroon systems and a stable supply of process water from hydro.  A shame there’s been no real UK investment in this.  I’d be more interested in getting Samsung in than Intel these days…

Post edited at 16:20
In reply to tom_in_edinburgh:

> If Chinese manufacturing is shut down like you think will happen the first thing they will do is stop ordering commodity raw materials...

Who has copper smelting capacity… I’ve done my homework. 

 wintertree 09 Jan 2022
In reply to elsewhere:

> When (not if) Pi to Omega come along, the platform technologies will be well practiced at preparing variant specific vaccines.

The proof of that pudding will be in the eating.  It’s not predictive like flu vaccines, it’s reactive.  Scaling up the production and QA takes time, mammalian safety testing takes time, human testing takes time, as does the process of getting all the vulnerable doses.  I didn’t see an estimate for variant emerges to vaccines going in to arms time in that article; I’d be amazed if it’s under two months.  Human safety testing is done for a reason, and that reason is that it’s always possible for a vaccine to flunk it - we mustn’t assume they’ll all pass (if that was known to sufficient confidence, they’d not be doing the tests…)

What’s missing from this picture are legal and practical mechanisms to help the more vulnerable shield away until vaccinated.  But then if we do that for Covid, we should do that for flu too, which has had far higher death rates than we’re now seeing in past bad seasons.

 Si dH 09 Jan 2022
In reply to VSisjustascramble:

Re: China.

I've spent most of my job working with the Chinese for the last two and a bit years - specifically nuclear engineering design and analysis bods. I was supposed to visit them a few times but of course it was all done remotely. Clearly this isn't quite the same as a shop floor environment. However, they proved very resilient through the early stages of the pandemic when one might have expected them to shut up shop - even immediately after Chinese NY in Feb 20 when they got stuck all over the country. I had videocons with them where some of them were in the office (masked/distanced etc of course) and some were spread all over China via VPN even though they had no preparation time, and over the next few months they managed to deliver everything I asked of them. Despite the reported severity of the lockdown in China it really seemed to have little impact on their output. I can only really speculate as to why, but I think their working culture is stronger than ours and they are more willing to put themselves (individually) through a difficult time for the good of their organisation than most Europeans are. They seemed very dedicated to their teams' goal and rather than using the pandemic as an excuse to reduce output, they just worked around it. Clearly if the CCP do a big lockdown for a long period then this can't be replicated everywhere. However, I tend to think that the CCP will act in a sufficiently strategic way, and that the individuals and organisations are sufficiently well motivated to work through regardless, that their major industries and economy will not suffer much. Whether the population has a good time and whether the vulnerable are well looked-after are different questions or course.

I also wonder about the sense of comparing China to Western nations rather than to Japan and South Korea (as the two advanced economies with, I think, the greatest in common culturally and geographically.) They in general seem to have been much better able to limit covid cases with relatively mild restrictions in place - it looks from OWID like South Korea's latest wave is already turning over without anything close to what most of Europe has had to do, despite a lower historical case load. It may be that the CCP think they are able to do something similar in the medium term.

 jimtitt 09 Jan 2022
In reply to VSisjustascramble:

Hmm, I've invested my pitiful fortune in commodities for the last 20 years, specifically metals. Agricultural are too volatile and require day to day trading, precious metals are speculative but industrial metals are slow to react so I stick to the rarer ones that also cover my material requirements for my business. Price drops my investment drops but material is cheaper and the converse. The main requirement is to know what end products are selling i.e the end demand. Short-term speculation it isn't but long term it pays off.

The property bubble in China has been known for a long time and isn't really a threat to their economy, more to the stability of their political system. The central government could swallow Evergrande's debt without blinking BUT their population might not believe in Communism if speculators were bailed out. The "houses are for living in not speculation" pronouncement and the three red lines policy would probably get Labour a few more voters!

In reply to tom_in_edinburgh:

> Successive UK governments are responsible for the death of the UK semiconductor industry and it is not coming back after Brexit.   It is clear what the shape of the semiconductor industry will be: mega fabs operated by TSMC, Samsung and Intel in the US, EU, Korea and Taiwan. China will eventually control Taiwan or use military leverage to force TSMC to operate leading edge processes in China

They'll take over by fair means or foul, like when ARM China went independent/rogue, effectively stealing and controlling the IP.

In reply to jimtitt:

I'm a long time holder of REM, now cadence metals, not the most exciting ride, but they'll be fine in time. (I do jump partially in and out, when ramping pushes price up sufficiently). 

 wintertree 09 Jan 2022
In reply to thread:

The fall incases across the English regions continues.  Being so sudden, strong and synchronised I've got a voice in my head screaming "Glitch/Artefact".  Still, the hospital admissions data continues to bear it out, and testing numbers continue to be at the highest ever level, so things seem to check out.  Still, that glitch warning light is flashing away...

I'm wondering if a bunch of people delayed going for tests until after the Christmas weekend, pushing the peak in cases forwards in time from where it really was, accentuating the fall.  This might explain the closeness in time of the peaks for cases and admissions....?

The top-level rate constants for England look really glitchy for the last week or so; not surprising given all the sampling issues over the Christmas/New Year period.

Whatever the data is doing, it's not moving in the wrong direction...


1
 elsewhere 09 Jan 2022
In reply to wintertree:

Pfizer chairman says 100 day timescale.

https://www.cnbc.com/2021/11/29/first-on-cnbc-cnbc-transcript-pfizer-chairman-and-ceo-albert-bourla-speaks-with-cnbcs-squawk-box-today.html

By the time Pi etc comes along, it will be the fourth or so variant vaccine so the different platform technologies will hopefully know how reliable the scale up for new variants is likely to be.

If they really are platform technologies the scale up problems were solved in late 2020 and early 2021 for the first/current generation vaccines.

Fingers crossed Pi to Omega won't even need a new vaccine.

Post edited at 17:24
In reply to wintertree:

>   A shame there’s been no real UK investment in this.  I’d be more interested in getting Samsung in than Intel these days…

The UK has no chance, it had a position 20 or 30 years ago both in manufacturing and design and threw it away. When push comes to shove and an industry located outside of London needs heavy duty support from government to keep up with international competitors the UK government will let it die.  If the UK had invested like other countries who wanted to stay in the semiconductor game and had stayed in the EU then Scotland might well have beaten Ireland to be a preferred site for a megafab.

There's no way a country the size of the UK can buy its way back in, even the US is getting sticker shock at the price of taking semi manufacturing back from Taiwan.   The EU's leading edge fabs will almost certainly go to Germany and Ireland.

 wintertree 09 Jan 2022
In reply to elsewhere:

> Pfizer chairman says 100 day timescale.

Thanks; so if the next major variant emerges in the run-up to winter (as with Omicron), the entire winter wave will be over and done before the updated vaccine is online (likely as with Omicron), hence the need to offer improved support for vulnerable people to shield through winter.

 mountainbagger 09 Jan 2022
In reply to wintertree:

Is it tearing through the schools (who are less likely to end up in hospital) and:

- people aren't noticing their child's very mild symptoms

- people are deliberately ignoring their child's mild symptoms because they don't want to or can't afford to stay at home to look after them, or can't be faffed getting hold of a test

- people are testing using LFTs and isolating as required but not bothering to register the result or go for a PCR, to avoid the hassle of driving ( in a confined space with your infected child) to a test centre as you can't get a home PCR test anymore. And to avoid the hassle of a call from T&T.

Would that explain it?

 wintertree 09 Jan 2022
In reply to mountainbagger:

One could certainly speculate over the return of schools and all the competing going on, but but the turn to decay is emerging in adult ages, with moderate growth in child ages, so it's probably not driving the top level decay; I say probably as the demographic data lags the other plots by a couple of days.

>  to avoid the hassle of driving ( in a confined space with your infected child) 

Reminds me of a news story I saw the other day - https://www.bbc.co.uk/news/world-us-canada-59919105 - people, huh?

If you ever happen to have been locked in the trunk of a car sold in the USA, you'll know that they have a special glow in the dark handle to allow anyone shut in it to open it themselves, presumably an anti-kidnapping deice.  The frunk on a Tesla Model-3 has one despite being to small to kidnap anyone in; I'm kind of surprised Musk hasn't gone on a Twitter meltdown/rampage over unnecessarily burdensome federal legislation over that...


In reply to wintertree:

If planning to kidnap someone, would it not be trivial to remove that handle anyway? Asking for a friend...

In reply to wintertree:

> > Pfizer chairman says 100 day timescale.

The way I read it, they can develop the vaccine in 90-95 days and have already done so twice for unreleased Beta and Delta vaccines which they decided weren't needed because the original one was good enough.

Then they have capacity to manufacture 1 billion doses a quarter and they know how to switch the lines over to the new product almost instantly.

So the time from a variant appearing to the UK getting everybody jagged with a new vaccine is probably closer to six months - 3 to develop the vaccine and another 3 to get deliveries and get it deployed.  Even if you jag a million people a day it would still take 60 days to jag 60 million people.

> Thanks; so if the next major variant emerges in the run-up to winter (as with Omicron), the entire winter wave will be over and done before the updated vaccine is online (likely as with Omicron), hence the need to offer improved support for vulnerable people to shield through winter.

The Pfizer guy reckons one jag a year to deal with fading immunity and track mutations.  I guess that if you are jagged with this year's jag for mutation n - 1 or n - 2 you are more likely to be in good shape for mutation n than if you were jagged with last years jag for mutation n - 6.

The challenge for countries is to be able to mitigate a new Covid wave for six months or to develop capability to do jags at a much faster rate to minimise the time between the new vaccine being available and it being effective.

2
 wintertree 09 Jan 2022
In reply to tom_in_edinburgh:

> Even if you jag a million people a day it would still take 60 days to jag 60 million people.

I suspect moving forwards, we're only gong to be vaccinating the more vulnerable people; a small fraction of 60 m people.  A fraction that probably gets smaller every year as future old people will probably never be as vulnerable as current old people, having had broader exposure to the virus earlier in their lives.

> I guess that if you are jagged with this year's jag for mutation n - 1 or n - 2 you are more likely to be in good shape for mutation n than if you were jagged with last years jag for mutation n - 6.

I'm not so sure; the variants aren't all following a sequence - I've put a simplified family tree in from the WSJ (note: I'm assuming it's accurate, haven't checked...).  The variants are jumping all over the place, and this tree is expanding all the time...

The big question is if the virus is going to jump around a fixed size pool of different RBD configurations, or if it's going to keep finding new ones...

  1. If there ends up being a relativity small pool, it's likely that one of the approved and tested vaccine produced against each major variant that's already seen is going to induce good immunity-against-infection (and corresponding MAB therapeutics will be potent for the immunocompromised).
  2. If it keeps finding new configurations, we'll always be playing 100-day catch-up.

It would take a few years of variants not progressing significantly further away from the wildetpye before we could be confident it was (1).  

I think the obvious next step would be to produce some DNA and/or mRNA vaccines targeting fundamentally different, potent targets in the virus and to offer these to vulnerable people who have avoided exposure to date, in order to broaden their immunity-against-severe-illness in a more variant proof way - although the antivirals may drive coincidental immune escape for things targeting the non-structural proteins as they drive antiviral resistance.  This however is a fundamentally new vaccine, not 100-day job.  Not much profit motive in it for the pharmaceutical given the policies of various western governments.

I've started to wonder about the business possibilities for a firm that offers "bespoke immune optimisation" for rich, old Americans - full blood work up to understand their wider immune picture and then start offering a menu of top-ups to make them more pre-emptively Covid variant proof.  Get half a million rich, old Americans to sink $1k each up-front and that'd cover the development costs of a protease+polymerase mRNA vaccine development program.  Needs some small print about the possibility of it not making it through clinical trials...  How hard can it be to run that kind of business?  Answers on a postcard to "Bankrupted By Legal Bills, 1 Wintertree Towers"...  Heck, might was well screen them for immune holes against everything else as well - could get plenty of potent testimonials from men who caught chicken pox for the first time in their 50s.  The ones that lived, anyhow.  (~25x more lethal than catching it as a child, and a surprising number people manage to avoid it until later adulthood.)

Post edited at 18:01

 wintertree 09 Jan 2022
In reply to Longsufferingropeholder:

> If planning to kidnap someone, would it not be trivial to remove that handle anyway? Asking for a friend...

I think perhaps the average person whose plan includes kindnapping someone in their boot isn't thinking the details through....   Although there is that cases of the NASA astronaut setting out with an exceptionally high level of forethought and preparation.  950 miles without even a toilet break...

Post edited at 18:07
In reply to wintertree:

Love the direction this thread went!  COVID plotting > Semiconductor industry and rare metal commodity trading : )

 mountainbagger 09 Jan 2022
In reply to Bobling:

> Love the direction this thread went!  COVID plotting > Semiconductor industry and rare metal commodity trading : )

To kidnapping!

 mountainbagger 09 Jan 2022
In reply to wintertree:

Thanks for your reply. My daughter has it currently (she's fine). We've been all over her as she's quite young and we've considered the risk of infection against her emotional well-being.

My son had what I assume was a delta infection just before Christmas (because I think it was just about more prevalent then, so just going on the odds) and we're recently triple vaccinated. My wife and I have so far caught neither infection off our children, and my son hasn't caught it off his sister and she didn't catch his when he had it (again, we didn't stay away from him and didn't drive him to the test centre locked in the boot!).

I'm so glad for the vaccines as this is, I assume, why we're able to look after our children without getting ill. I'd hate to be in the situation in March 2020 when my friend's family of four all caught it and he was actually worried about who would take care of the kids after he and his wife died (they were in and out of consciousness and barely able to move for a couple of days followed by months of painfully slow recovery). His GP friend told him he should have called an ambulance.

1
 Šljiva 09 Jan 2022
In reply to wintertree:

> I think perhaps the average person whose plan includes kindnapping someone in their boot isn't thinking the details through....  

Well, that’s why they get arrested, the smart ones on the other hand… 

 Si dH 09 Jan 2022
In reply to mountainbagger:

> Is it tearing through the schools (who are less likely to end up in hospital) and:

> - people aren't noticing their child's very mild symptoms

> - people are deliberately ignoring their child's mild symptoms because they don't want to or can't afford to stay at home to look after them, or can't be faffed getting hold of a test

> - people are testing using LFTs and isolating as required but not bothering to register the result or go for a PCR, to avoid the hassle of driving ( in a confined space with your infected child) to a test centre as you can't get a home PCR test anymore. And to avoid the hassle of a call from T&T.

> Would that explain it?

I think this happened before Christmas with Delta - at least in primary ages when they get loads of colds and a test is such an ordeal.

In reply to wintertree:

> > Even if you jag a million people a day it would still take 60 days to jag 60 million people.

> I suspect moving forwards, we're only gong to be vaccinating the more vulnerable people; a small fraction of 60 m people.  A fraction that probably gets smaller every year as future old people will probably never be as vulnerable as current old people, having had broader exposure to the virus earlier in their lives.

Maybe in the UK.  I wouldn't have thought other rich countries especially those with health insurance where people expect service would necessarily go that way.  The Pfizer CEO says he thinks it will be an annual jag for a while and they've built factories capable of making 1 billion doses of mRNA a quarter.  That's a lot of manufacturing if there isn't going to be ongoing demand.

> I've started to wonder about the business possibilities for a firm that offers "bespoke immune optimisation" for rich, old Americans - full blood work up to understand their wider immune picture and then start offering a menu of top-ups to make them more pre-emptively Covid variant proof.  Get half a million rich, old Americans to sink $1k each up-front and that'd cover the development costs of a protease+polymerase mRNA vaccine development program.  

I think this kind of thing is going to happen and also mRNA vaccines for many other diseases and I think Pfizer sees the mRNA vaccine opportunity as long term or they wouldn't have built capacity for 4 billion doses of mRNA a year.   It's even better for them if they sell through the private sector at $100 a dose rather than to governments at $10 a dose.  Or $1,000 for a multi-disease vaccine and you get $1K off your health insurance if you've got this year's jag.

Post edited at 21:00
2
 wintertree 09 Jan 2022
In reply to mountainbagger:

> I'm so glad for the vaccines as this is, I assume, why we're able to look after our children without getting ill. I'd hate to be in the situation in March 2020 when my friend's family of four all caught it and he was actually worried about who would take care of the kids after he and his wife died (they were in and out of consciousness and barely able to move for a couple of days followed by months of painfully slow recovery). His GP friend told him he should have called an ambulance.

I know a couple of families who had really rough times back at the start.  Just thinking about it is the sort of thing that keeps you up at nights as a new parent.  

Hope your little one picks up soon.  I'll be amazed if we don't get it coming home through ours in the next couple of weeks.  Will the 3rd dose hold against infection?  Tune in soon to find out...

 Šljiva 09 Jan 2022
In reply to wintertree:

> Will the 3rd dose hold against infection? 

thankfully seems to have done for me. Lft test to release for Mr Šljiva gives 3 different results on three different brands! Negative, squint and it might just be positive, and definitely mildly positive. Hmmmm 

 wintertree 09 Jan 2022
In reply to Šljiva:

> thankfully seems to have done for me.

Domestic crisis averted then?  If there is a significant rebound from schools it's going to start showing in the data pretty soon...

 Misha 09 Jan 2022
In reply to wintertree:

Thanks. Whilst I’d want to see another week or two of hospital data, it tentatively looks like we might get away with it without totally breaking healthcare. I doubt the government had any secret modelling advice saying this is what would happen as there would be no sense in keeping it secret. Seat of your pants stuff. Q

 Misha 09 Jan 2022
In reply to Si dH:

Depends what Pi will look like…

1
 Misha 10 Jan 2022
In reply to tom_in_edinburgh:

I think your political analysis is right that having got away with it this time they will try the same thing again. The real question is how serious will future variants be (infectiousness vs vaccine escape vs outcomes).

 Misha 10 Jan 2022
In reply to Michael Hood:

> But, the number of knock-on deaths will never be seen outside of China so it will appear to be a successful strategy overall.

The numbers will never be seen in Chine either…

1
 Misha 10 Jan 2022
In reply to wintertree:

Re 7 day rate constants - you can see in the raw data that cases bunched in the second half of last week so now it’s looking like cases are falling relatively quickly. I think cases data, especially week on week comparisons, will be a bit all over the place until later this week (there would have been some bunching after NY). Admissions are he better guide foe now.

 Si dH 10 Jan 2022
In reply to Misha:

> Re 7 day rate constants - you can see in the raw data that cases bunched in the second half of last week so now it’s looking like cases are falling relatively quickly. I think cases data, especially week on week comparisons, will be a bit all over the place until later this week (there would have been some bunching after NY).

This is definitely true and I'm sure Wintertree's rate constant analysis overstates the speed of the change a bit. However cases have definitely turned over. You can tell independently in two ways:

1) if you look at the raw cases graph on the dashboard and mentally fill in the Christmas, boxing day and new year lows with the following days' highs, it's very clear there that cases aren't going up any more and have started to fall

2) if you look at the cases by test type graph for England, you can see that positive cases from both test types have fallen. LFTs do not suffer the same lag problems as PCRs and have fallen consistently over the last fortnight. You can also see elsewhere on the dashboard that the number of LFTs reported has not dropped, rather the positivity is reducing.

Post edited at 07:48
 Šljiva 10 Jan 2022
In reply to wintertree:

> Domestic crisis averted then?  

yeah, but moral high ground somewhat eroded  

 wintertree 10 Jan 2022
In reply to thread:

The Storybots teach about viral infections, the different time of immune cells and responses, and how they interact with each other -  youtube.com/watch?v=0ECPrtjnoCg& 

Post edited at 16:27
 wintertree 10 Jan 2022
In reply to thread:

Updates to plot 18 and a top level plot of English cases rate constant

As per comments from myself, Misha and Si dH, the turn to decay in infections was probably more gradual than the cases plots suggest, due to an apparent forwards displacement of testing around Christmas mucking up the data.  Testing numbers don't suggest the decay relates to disengagement form or overloading of testing.

Pretty sure actual infection has been in decay for a while now given the likely displacement and the signals over hospital admissions.  These have now hit decay in about half the English regions and look like they'll hit it for the rest in the next day or two of data.  The decay isn't looking very powerful compared to that of cases - partly I think due to the confused signal for cases over-egging decay there, and partly due to cases peaking last in the the oldest ages, so some worsening demographics mean more of the later cases are going to hospital.

The D1.c for London has a lot going on:

  • Decay is now building strongly in the oldest ages.  
  • Growth in ages 5-20, centred around ages 10-15.  Probably school associated; if growth doesn't break soon we'd expect to see a secondary peak emerging around ages 35-45 as with some past terms.
  • A much milder turn to growth ages 20-35, centred on 25-30.  This was the leading age at the start of omicron, so it makes sense it's where we'd see the first signs of a rebound as the festive break fades in to memories.

So, now it's seeing how the rebound goes - promising that it's tip-toeing in rather than thudding.

Post edited at 16:58

In reply to wintertree:

> The Storybots teach about viral infections, 

I obviously have an attention span shorter than a child...

 AdJS 11 Jan 2022
In reply to wintertree:

> Growth in ages 5-20, centred around ages 10-15.  Probably school associated; if growth doesn't break soon we'd expect to see a secondary peak emerging around ages 35-45 as with some past terms.

Some interesting comments here about the government’s attitude to covid in schools.

https://www.theguardian.com/education/2022/jan/10/government-is-getting-it-wrong-again-in-schools

Sorry I sidetracked this thread earlier by suggesting how things might have worked out better if we had followed the Chinese approach. I could have used S.Korea, Japan, Vietnam, Singapore as an example but I have no doubt the usual suspects would have disagreed with that as well. The Asian approach of respect for others seems to be beyond them. We are where we are.

It will be interesting to see if the high covid rates in schools with Delta during the Autumn term will reduce the Omicron spread this term. I suspect any gained herd immunity will not follow through. I may be wrong but hope that disruptions to schools aren’t significant.

.

3
 Misha 11 Jan 2022
In reply to Si dH:

Agree, cases are starting to fall. That might or might not stall with the return of schools and some workplaces. I was just commenting on the week on week data. I think that will become a useful measure again from Wed / Thur this week.

I’m wondering if there will be another uptick in Feb if WFH gets lifted. Apologies if this got discussed last week, I was mad busy working (FH) and didn’t read the whole thread. I saw WT referring above to discussions about a long tail last week. 

 Misha 11 Jan 2022
In reply to wintertree:

What should help moderate the rebound is that January is traditionally quiet for hospitality.

In reply to wintertree:

They've picked up what they are calling a sub group of omicron here BA.2, slightly more mutations than the original, spreading out from Denmark in the last two weeks ( + or - a little for the lead in time for infection & analysis).

In reply to AdJS:

> Sorry I sidetracked this thread earlier by suggesting how things might have worked out better if we had followed the Chinese approach. I could have used S.Korea, Japan, Vietnam, Singapore as an example but I have no doubt the usual suspects would have disagreed with that as well. The Asian approach of respect for others seems to be beyond them. 

Respect for others reinforced by intrusive mass surveillance and life-altering levels of fine or imprisonment for non-compliance? That's a bit different from our situation of having some sympathy for people who can't afford to self isolate. There was never any sympathy over there.

Note also that Singapore is billing the unvaccinated for their care now.

I'd support some but far from all of their policies. When you actually look at how they did it (I'm not convinced you really have), it would have been a bit of a hard sell.

Post edited at 06:57
1
 Si dH 11 Jan 2022
In reply to summo:

I think BA.2 was found in SA in early December. The potential problem I believe is that it gives S gene target positive so you can't use SGTF to distinguish from Delta. However it doesn't initially seem to have out competed 'original' Omicron (BA.1), so if it does turn out to be more transmissible, it can't be by much.

(There is also a BA.3 which does give SGTF. Again, found in early December. They are all briefly mentioned in the UKHSA variant report from 17/12.)

Post edited at 07:36
In reply to Si dH:

 Ok, thanks.

In reply to summo:

> Yeah the news was vague on if these 11 out 25 in hospital with deltacron were vaxed, so it's possibly just scaremongering. 

Possible good news:

https://p.dw.com/p/45M64

Edit to add: Science unscripted: The deltacron 'variant' https://www.dw.com/en/the-deltacron-variant/av-60380192?maca=en-podcast_spectrum-31485-xml-mrss

Haven't listened to it yet but will do on my way to work.

Post edited at 07:47
In reply to Longsufferingropeholder:

Indeed, can't be beyond them to take new samples from those the original cases have likely infected and double check. 

 wintertree 11 Jan 2022
In reply to thread:

Sturgeon's current briefing is sounding pretty confident...  Same sort of "live with Covid" language as leadership from south of the border.

https://www.bbc.co.uk/news/live/uk-scotland-59940847

  • Ms Sturgeon says she wants to speak about how we can learn to live with Covid. 

    She says plans are being drawn up for how we might adapt in the medium and longer term to mitigate harm without the need for restrictions.

     "Hopefully, we are on a path from Covid being an epidemic to it becoming endemic - in other words, existing at more manageable and consistent levels." 

    A revised framework is being prepared and the Scottish government will consult with parliament, business organisations and other partners across society.

    The new framework will be published within the next few weeks, Ms Sturgeon adds.

Also seems to be taking a very similar line to those south of the border on other issues...

Nicola Sturgeon warns “difficult choices” such as pausing or reducing social care services may need to be taken in the coming weeks.  The first minister says this is being driven by the “significant impact” of staff absences as a result of the Omicron wave.

  • Not using NPIs to slow the spread and so reduce impact on staffing, seems the Scottish government would rater have a rapid, high peak as well.

Ms Sturgeon also announces an additional £5m to improve ventilation in schools and nurseries.

  • Better late than never, ey?  
Post edited at 15:21
 wintertree 11 Jan 2022
In reply to thread:

The rate constants for cases continue to move to faster decay for all regions.  

For hospital admissions, they're still falling in all regions as well with everywhere except the North East and Yorkshire now in to decay and we look set to follow soon enough.

The D1.c plots show the rebound to growth in young adults in London is not being sustained, and the other that under 20s, growth looks established in all ages - particularly strongly in older adults in London.

The London hospitals plot continues to look about as "good news" as could possibly have been expected.  ITU occupancy is also falling at the top level for England.

Interestingly, the divergence I noted in the OPs for Wales is continuing - their hospital and ITU occupancy are both continuing to rise quite significantly despite admissions levelling off; perhaps cases there are more serious for some reason?  The data for Scotland looks similar.

https://coronavirus.data.gov.uk/details/healthcare?areaType=nation&areaName=Wales
https://coronavirus.data.gov.uk/details/healthcare?areaType=nation&areaName=Scotland


 elsewhere 11 Jan 2022
In reply to wintertree:

Covid loses 90% of ability to infect within five minutes in air – study
Exclusive: findings highlight importance of short-range Covid transmission

https://www.theguardian.com/world/2022/jan/11/covid-loses-90-of-ability-to-infect-within-five-minutes-in-air-study

Looks like humidity is key.

 elsewhere 11 Jan 2022
In reply to wintertree:

The London hospital graph looks too good to be true. This is not a criticism! It's great to see.

Is the alignment purely by shifting D0 and by scaling axes? If so, vertical alignment of two black lines with each other and two red lines with each in days 0-10 suggest they each have a baseline that hasn't changed. What would that (non-omicron?) baseline represent and will it remain after Omicron decays?

Post edited at 18:16
 wintertree 11 Jan 2022
In reply to elsewhere:

Humidity - that goes in the opposite direction to the weather link then, as warmer weather has higher humidity.   

My immediate thought was "what are the droplets made from"?  Skimming the paper -"The infectivity of SARS-CoV-2 contained in MEM 2% FBS was measured over [...]"

This is a cell culture medium derived from slaughterhouse blood and then augmented.  It's not obvious to me that this medium in any way resembles the liquid that will form respiratory droplet. Presumably the liquid on the droplets comes from the fluid inside our lungs which is going to have quite different properties to serum, including I suspect surfactant content - that and other differences probably have big effects on how the droplets behave in air... 

Wish I could read the reviewers comments on that paper once they're in!  

(Edit: Not to knock it - it looks like really cools science, and it advances the state of understanding significantly.  But, getting more authentic respiratory droplets is a good next step, I'd think.  An unrelated cool experiment I've wanted to do for a decade with a droplet trapping system is to see how far liquid water can be supercooled when it's in isolated droplets - the probability of a nucleation event happening in a droplet should become very low...)

> Is the alignment purely by shifting D0 and by scaling axes? If so,

The plot aligns by D0 but does not scale axes etc.  More or less a coincidence (I assume) that the two waves start with such similar baselines and dynamics for the general occupancy curve.

> vertical alignment of two black lines with each other and two red lines with each in days 0-10 suggest they each have a baseline that hasn't changed. What would that (non-omicron?) baseline represent and will it remain after Omicron decays?

I decided it's impossible to understand the mix of cases from this data.  I also don't know if "incidental" occupancy is higher or lower in ITU.  Sage minutes 100 or 101 suggested nosocomial infection may also be a significant factor for Omicron in mental health facilities (affecting general but not ITU occupancy then I assume...)

I've put in some Lissajous figures for London occupancy, looking over longer and shorter periods of time.  It looks to me like ITU occupancy is now turning to decay - this turn has in the past typically lagged the turn in general occupancy by a week or so, and it's this phase-shift like behaviour that opens the plot out from a diagonal in to an ellipse of sorts.  It'll be interesting to see what's coming next.

Post edited at 18:48

1
 elsewhere 11 Jan 2022
In reply to wintertree:

More graphs too good to be true - I like that a lot!

 wintertree 12 Jan 2022
In reply to thread:

A quick update to the rate constants plot.

The exponential decay rates for both cases and hospital admissions look to be continuing their trend of getting more negative in all regions.  Cases should be well beyond the point now where the festive sampling issues led to deceptive effects, so this is hopefully pretty real.  It'll probably be another 2-3 weeks before the decay in cases translates to the ONS random sampling data (because of that being live infections not new infections, and because of reporting lag).  Still the behaviour of hospital admissions leaves little room skepticism about the fall in cases being anything other than real.

It looks like a big backlog of reporting was released today on deaths data and we're starting to see the impact of the omicron wave working its way through to this measure.


 Misha 12 Jan 2022
In reply to wintertree:

ONS numbers today up overall but down for London so that’s a good sign. 

In reply to wintertree:

> Sturgeon's current briefing is sounding pretty confident...  Same sort of "live with Covid" language as leadership from south of the border.

She was pretty clear she didn't mean 'living with the virus' in the way the Tories use it and that 'living with the virus' meant adapting our behaviour not pretending it no longer existed.

https://www.gov.scot/publications/coronavirus-covid-19-update-first-ministers-statement-11-january-2022/

The key piece of information we do not have yet is how many new Long Covid cases have been caused by letting Omicron spike out of control.  

Post edited at 03:00
17
In reply to tom_in_edinburgh:

> She was pretty clear she didn't mean 'living with the virus' in the way the Tories use it and that 'living with the virus' meant adapting our behaviour not pretending 

a' fuireach le covid? 

Or was it said in a strong piffle free manner? 

The reality is every country will be looking to do something similar after this relatively large covid wave. She is just going with the crowd. 

Conversely the danes are planning 4th doses! 

2
In reply to summo:

> The reality is every country will be looking to do something similar after this relatively large covid wave. She is just going with the crowd. 

She's going with the crowd of cautious people not the small breakaway group of morons.

There's absolutely no reason to rush this except bragging rights 'we were the first to emerge from the pandemic' far more sensible to go a little slower and collect more data before letting it rip.

Maybe you will get to the same place.  The guy that puts the revolver to his head without checking how many bullets are in it and gets lucky ends up in the same place as the guy who carefully checks it isn't loaded but one process for reaching that place is a hell of a lot more sensible than the other.

If it turns out that 10% of the people who catch Omicron are getting Long Covid, then the Tories are going to look fairly stupid despite the death rate being low.

10
 Si dH 13 Jan 2022
In reply to tom_in_edinburgh:

The only people I thought relaxed restrictions this week were the Scots..?

1
In reply to Si dH:

> The only people I thought relaxed restrictions this week were the Scots..?

Isn't it about hosting the 6 nations? Just like when travel for football was acceptable, they have special Scottish rules for sport, and concerts, and climate change events, and funerals sturgeon attends... 

1
In reply to summo:

> Isn't it about hosting the 6 nations? Just like when travel for football was acceptable, they have special Scottish rules for sport, and concerts, and climate change events, and funerals sturgeon attends... 

It's about 3 weeks more data on Omicron and three weeks more 3rd jags going in to arms.

Starting out cautious and relaxing a little if the information supports it is a lot smarter than just assuming everything will be fine.  Also, letting things go a little is a lot fairer after everyone who wants a jag has got one than when there's a lot of people haven't had a chance to get theirs.

Post edited at 09:26
10
In reply to summo:

> Isn't it about hosting the 6 nations? Just like when travel for football was acceptable, they have special Scottish rules for sport, and concerts, and climate change events, and funerals sturgeon attends... 

There's this thing called the Scottish Government and its job is making up the rules for Scotland.

The funerals thing is bullsh*t.  She stood up from the table at a funeral meal and forgot to put her mask on for a minute.  Call Police Scotland if you want.

6
In reply to tom_in_edinburgh:

> There's this thing called the Scottish Government and its job is making up the rules for Scotland.

Of course. But which is it, Scotland tough measures, or relaxing to allow the 6 nations, you can't really complain about London relaxing to 'let it rip', if Scotland is doing the same? 

In reply to summo:

> Of course. But which is it, Scotland tough measures, or relaxing to allow the 6 nations, you can't really complain about London relaxing to 'let it rip', if Scotland is doing the same? 

You are saying they are relaxing to allow six nations.  I am saying they were extra cautious at first and are now relaxing some but not all measures based on more information about how serious Omicron is and a higher proportion of the population with 3rd jags.   

The politically damaging thing was restrictions at Christmas and New Year, they took the hit on that because it was the right thing to do.  If you set policy according to data then your policy will change over time.

9
 wintertree 13 Jan 2022
In reply to tom_in_edinburgh:

> I am saying they were extra cautious at first 

Which is total nonsense; Scotland basically welcomed omicron in with open arms the same as England, and had nothing like sufficient levels of precaution to keep growth slow early in the exponential process - just like England.  Scotland had an early surge of cases far in excess of any English region beyond London - with a steps concert likely being a key - and entirely predictable - super spreader event early on.

Luckily for London and Scotland, they got away with it.  Luckily for the English regions we got to see a week in to the future by looking at London and Scotland.

1
 Offwidth 13 Jan 2022
In reply to wintertree:

More NHS records broken: latest on the number on hospital waiting lists in England (November) is 6 milliion (1 in 20 waiting more than a year) and are known to be worsening; for waits in A&E, of the million users in December, 73% missed the four hour target; for those who needed a bed on a ward, 120,000 admitted spent more than four hours waiting (about a third); 13,000 waited over 12 hours (another record); 12.5 thousand bed blocking in the week to Jan 9th (due to failure to arrange care) up 20% on the week (BBC news 24 @ 11.13).

Demand for ambulances were just down from the October records: 9 minutes to reach an 'immediately life-threatening' call-out (the target is 7); for strokes and heart attacks more than 53 minutes on average (target is 18).

Post edited at 11:50
4
In reply to Offwidth:

I even started a thread for you...

 mountainbagger 13 Jan 2022
In reply to MG:

> I even started a thread for you...

To be fair, he did post the same thing on that one just after posting on this thread but before your reminder!

 Offwidth 13 Jan 2022
In reply to MG:

....and I even posted the same thing on both threads. The NHS thread isn't going well in my view but I'll continue to post data on both.

3
 Offwidth 13 Jan 2022
In reply to mountainbagger:

I don't know how many times I have to be clear what my opinion is and why.... the most important covid response data IMHO is now NHS general data. I do want to get the message across, so will post elsewhere as well (if new NHS threads start).

There is also an archive issue: on the other channel I can see verbatim what I posted throughout the decades. On here I struggle to find stuff I posted less than two years ago.

7
In reply to Offwidth:

> I don't know how many times I have to be clear what my opinion is and why....

Zero. Zero more times. The number is zero.

I don't know how many more times we all have to be clear that WE F***ING KNOW!

2
 Offwidth 13 Jan 2022
In reply to Longsufferingropeholder:

Pot kettle black.

4
In reply to Offwidth:

I think we know what your opinion is and the esteem you hold it in, however, perhaps glance at the forum guidelines

"..don't post duplicates of your topic in more than one forum."

In reply to Offwidth:

> Pot kettle black.

What??
I don't think you're using that phrase right.

What, exactly, do you want to happen? What are you expecting to achieve? What are your criteria for deciding you've said it enough times?

 Offwidth 13 Jan 2022
In reply to MG:

Fair point for once. I apologise to the mods. I will link next time, even though I see the bad news as important as any we have faced. 

7
 Si dH 13 Jan 2022
In reply to Longsufferingropeholder:

> Zero. Zero more times. The number is zero.

> I don't know how many more times we all have to be clear that WE F***ING KNOW!

Bit unfair.

Offwidth's NHS gripes are often a bit off-topic but it's far less irritating than a lot of other BS that gets posted.

In reply to Si dH:

> Bit unfair.

Possibly was

> Offwidth's NHS gripes are often a bit off-topic but it's far less irritating than a lot of other BS that gets posted.

This is true

 Ramblin dave 13 Jan 2022
In reply to wintertree:

Somewhat more on topic, do we have to start being careful with case numbers now, with the change in the rules about PCR confirmations?

 wintertree 13 Jan 2022
In reply to Ramblin dave:

> Somewhat more on topic, do we have to start being careful with case numbers now, with the change in the rules about PCR confirmations?

I've been more skeptical on case numbers for a while now - but generally the effect of a point-like change on the infections:cases ratio "flushes through" the week-on-week rate constants in a 7-day period, and then measures of change from cases re-couple to change in infections; and I mainly look to cases to understand how the spread of infection is changing.

In a few weeks we'll be able to look if this latest change had much impact on the P1/P2 cases vs ONS data plots.

Edit: The issue of not reporting re-infections in dashboard data apparently remains.  

Post edited at 16:39
 wintertree 13 Jan 2022
In reply to Offwidth:

> I don't know how many times I have to be clear what my opinion is and why.... the most important covid response data IMHO is now NHS general data. I do want to get the message across, so will post elsewhere as well (if new NHS threads start).

Today's dashboard update is uncomfortable on first glance, but it needs some careful thought.  I've reached beyond healthcare data I'm familiar with, so I hope one of several familiar faces can chime in to confirm or correct me!

The rate of admissions is hovering around constant in most regions now - the rate constants have stopped plunging for negatives and are levelling off.  This isn't the behaviour we'd expect following the cases curve, nor is it the behaviour that's really needed.

Now, it's worth thinking about the numbers a bit.

Thinking about the behaviour of cases and the forwards projected uncertainty shading from yesterday's ONS update [1] we probably have about 7% of people infected with Covid now.  In a recent pre-Covid year, there were 17.1 million "admissions episodes"in the year to English hospitals [2], or about 47,000 per day (ignoring seasonality).    

If we assume I've found a reasonable source for hospital admissions and that all admissions are PCR tested (I await correction if I'm wrong)....Take those pre-covid daily admissions and give 7% of them incidental Covid, that gets us to ~3,300 incidental covid admissions per day.

Now, that's interesting because we're seeing ~2,000 covid admissions a day in England.  

I expect there's some anti-correlation between having high-immunity omicron infection and going to hospital, as infection has spiked harder in younger people and older people are more vulnerable to all-cause hospitalisation.

So, perhaps we don't expect to see much more decrease in the admissions data on the dashboard as we move to endemic circulation and incidental admissions?

This also ties with the primary data LSRH cited above and linked to further plots thereof, which shows that in several regions including London, about half of all Covid admissions are now incidental admissions (patients are not primarily being treated for Covid)

Evas as things move towards" with Covid" not "of Covid", the problem remains of people in hospital having Covid, and of this requiring more isolation measures (for now), but as Covid itself puts fewer and fewer people in to hospitals, suppressing its spread by population-wide NPIs to help with infection control in hospitals becomes a thorny issue, because such suppression starts re-charging the pandemic potential in the population; it seems to me that more sustainable solutions are required, and given that there are many other respiratory diseases it seems that better control measures against nosocomial transmission are a key part of this; I hadn't appreciated until a discussion with minimike on another thread that some Blair era PFI hospitals are basically air-tight boxes and potentially far worse than older parts of the estate in terms of spread of Covid.

Two other thoughts the data and estimates on incidental admissions raise:

  • Incidental deaths - harder to bound I think.  Death in 2019 were ordered of 530,000, which with a 7% Covid prevalence applied uniformly across the population gives incidental deaths (with Covid) of ~100/day.  It's only the subset of these that occur in hospitals that I would expect to be detected as Covid cases.  Again anti-correlation may emerge from the demographics of infection.
  • The next big question becomes what the endemic prevalence of Covid will be, and how much that will phase-lock to seasonality in the weather over the next couple of years.

I think at this point, interpreting the dashboard data is rapidly teetering towards being a fool's errand.  Well, for England at any rate.  Poster maggot shared a link on this subject the other day on another thread [4]

[1] https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/coronaviruscovid19infectionsurveypilot/12january2022

[2] https://digital.nhs.uk/data-and-information/publications/statistical/hospital-admitted-patient-care-activity/2018-19

[3] https://www.ons.gov.uk/aboutus/transparencyandgovernance/freedomofinformationfoi/deathsintheukfrom1990to2020

[4] https://www.independent.co.uk/news/uk/uk-end-covid-pandemic-b1991297.html

Post edited at 17:06

In reply to wintertree:

Remember the caveat.... primary diagnosis supplement covers acute trusts only

 wintertree 13 Jan 2022
In reply to Longsufferingropeholder:

> Remember the caveat.... primary diagnosis supplement covers acute trusts only

What's excluded by that definition, and which way do you think their exclusion will bias the measures?

In reply to wintertree:

Not gonna lie here; I have no idea. It's easy to find out what an acute trust is but it's less easy to find out what isn't one. I'm googling but not winning.

Edit: https://en.wikipedia.org/wiki/NHS_trust#types

So maybe doesn't exclude much

Post edited at 17:23
In reply to wintertree:

> Which is total nonsense; Scotland basically welcomed omicron in with open arms the same as England, and had nothing like sufficient levels of precaution to keep growth slow early in the exponential process - just like England.  Scotland had an early surge of cases far in excess of any English region beyond London - with a steps concert likely being a key - and entirely predictable - super spreader event early on.

What a lot of sh*te.  Scotland has mask rules, it had work from home if possible advice, it shut down hospitality and still hasn't reopened, it has stronger self isolation rules, it stopped new year celebrations and it has done more third jags.   

The Tory apologists going on about the early stages are full of it.  The numbers involved were tiny compared with the last few weeks and the Scottish government reacted relatively promptly to case numbers rising where the English government just hoped it would be fine and ignored them.

The death graph for Scotland does not have the massive spike of the one for England because of this.

> Luckily for London and Scotland, they got away with it.  Luckily for the English regions we got to see a week in to the future by looking at London and Scotland.

The English regions don't set their own Covid rules.

The Tories got lucky partly because a lot of sensible people and organisations refused to go along with their death cult and took their own decisions and because the isolation rules acted as a circuit breaker and shut the country down anyway - so naturally their response is to weaken the rules to make sure it spreads more and think about charging for tests.

Post edited at 17:46
11
 wintertree 13 Jan 2022
In reply to tom_in_edinburgh:

> The numbers involved were tiny compared with the last few weeks

Amazing how you’ll argue either side of something for your transparent agenda.

Yes, early on in exponential growth the numbers are tiny.  It’s by being precautious at that stage one delays the large numbers and buys time to evaluate the threat level.  In terms of measurable outcome Scotland did worse than much of England at delaying the tiny numbers > potentially disastrously large numbers.  They lucked out like the rest of us.

 Offwidth 13 Jan 2022
In reply to wintertree:

I'm thinking as much about NHS data we don't even have in a timely manner. The poor data quality is another part of the national scandal. One of the points made by the shadow health secretary today (picking up the reality after Javid finished highly selective boasting about the tory running of the NHS) was when the government get embarrassed by data targets and reporting they try to change them.

The NHS staff are too often knackered, several percent are off sick with covid, NHS workforce departures and early retirements are growing. There is also demographic bulge that means the recruitment figures the government boast about won't even touch the sides of the workforce gap, let alone improve things.

Also reported today was how the care sector is really struggling with finance on one side (due to the parsimonious funding levels) and staff shortages and illness absence on the other (mainly covid infected/isolating)

https://www.theguardian.com/society/2022/jan/13/staffing-at-uk-care-homes-30-less-than-needed-survey-finds

I'd expect Javid to act on this as the national emergency it is... instead he uses covid as a cover and rearranges deck chairs.

4
In reply to tom_in_edinburgh:

> , it shut down hospitality and still hasn't reopened, 

Bollocks.

1
 Misha 13 Jan 2022
In reply to Ramblin dave:

It impacts PCR vs LFT split but would have only a minor impact on total case numbers given that LFT false positives are rare. 

In reply to tom_in_edinburgh:

> What a lot of sh*te.  Scotland has mask rules, it had work from home if possible advice, it shut down hospitality and still hasn't reopened…

…apart from pubs and theatres it did shut hospitality down, correct,  Oh, and restaurants stayed open.
Nearly forgot: cinemas could stay open as well.  So yes, apart from pubs, theatres, restaurants and cinemas, hospitality was shut. Just wait, bowling and snooker could stay open.  But apart from that, hospitality was shut.  

Post edited at 20:18
1
In reply to Offwidth:

> I'm thinking as much about NHS data we don't even have in a timely manner. The poor data quality is another part of the national scandal. 

I'm not having this. Pick a country and compare their reporting to ours.

Pouria Hadjibagheri and colleagues deserved to be in the new year honours list.

 wintertree 13 Jan 2022
In reply to Offwidth:

>  instead he uses covid as a cover

Yup.  Every day, this is becoming more about the long running, systematic failure to maintain the NHS hitting home and less about direct impacts of Covid.  

> There is also demographic bulge that means the recruitment figures the government boast about won't even touch the sides of the workforce gap, let alone improve things.

Yes; a point I often make on these threads about the Covid data is that the devil is all-to-often in the demographic details, and that's also the case it seems for the healthcare staff - even before we consider some potentially perverse incentives over early retirement coming online.  All of which has very little to do with Covid, and most of which was set in motion in the years before Covid; as with so much else this ******** virus is accelerating the pace of change for better and for worse; with healthcare definitely for worse.

But none of this is going to go away when pandemic Covid goes away.  

It deserves a clarity of focus separate from Covid, otherwise the blame just gets transferred to the virus.

> several percent are off sick with covid,

Are they all "sick", or are a lot of them asymptomatic and isolating?  Nit picking, but increasingly important nit picking as we - eventually (not yet) - move to integrate our handling of endemic SARS-nCov-2 with our approach to other viruses.  Which could, for example, eventually involve some relaxation around this virus and some increased control over others now we know how effective various measures are.

 wintertree 13 Jan 2022
In reply to Bottom Clinger:

... but what have the Romans ever done for us?

In reply to Bottom Clinger:

> …apart from pubs and theatres it did shut hospitality down, correct,  Oh, and restaurants stayed open.

> Nearly forgot: cinemas could stay open as well.  So yes, apart from pubs, theatres, restaurants and cinemas, hospitality was shut. Just wait, bowling and snooker could stay open.  But apart from that, hospitality was shut.  

And nightclubs if they switch to table service. But yes, apart from pubs, theatres, restaurants and cinemas, bowling, snooker and nightclubs if they do table service, hospitality was shut.  

 wintertree 13 Jan 2022
In reply to Longsufferingropeholder:

> And nightclubs if they switch to table service. But yes, apart from pubs, theatres, restaurants and cinemas, bowling, snooker and nightclubs if they do table service, hospitality was shut.  

I've been trying to determine if "adult entertainment venues" in Scotland were allowed to remain open subject to table service and distancing measures.  Attempts to answer this may need to be devolved to the UKC field team in Scotland as google is not forthcoming.  

(I passed up several bad pun opportunities in that sentence in the interests of decorum).

In reply to Longsufferingropeholder:

> And nightclubs if they switch to table service. But yes, apart from pubs, theatres, restaurants and cinemas, bowling, snooker and nightclubs if they do table service, hospitality was shut.  

Correct. And it’s remained shut, apart from being allowed to be open Monday, Tuesday, Wednesday, Thursday, Friday, Saturday and Sunday. 

 lithos 13 Jan 2022
In reply to Longsufferingropeholder:

hotels ?

In reply to wintertree:

This is interesting - excess deaths in SA are running 30% in excess of normal, pointing to a large under-reporting of cases - Omicron isn't as mild as people thought. More excess deaths than the Delta wave in the Eastern Cape region too.

https://twitter.com/DrEricDing/status/1481020158151991298?s=20&fbclid=IwAR1MuWXYGF7BTA_26zokKRwfNjltoG7KfN0O8uV4hdeHk09v8K9ITQufOnI

Post edited at 01:45
4
In reply to Bottom Clinger:

> Nearly forgot: cinemas could stay open as well.  So yes, apart from pubs, theatres, restaurants and cinemas, hospitality was shut. Just wait, bowling and snooker could stay open.  But apart from that, hospitality was shut.  

The Scottish Hospitality Action Group, their mates in the BBC and DRoss and the Tories are continually telling us Sturgeon has shut down hospitality and she needs to be like England because they are all going bankrupt.

https://www.thetimes.co.uk/article/omicron-variant-hospitality-slams-nicola-sturgeon-shutdown-scotland-p3gjxmwlv

https://www.glasgowtimes.co.uk/news/19784082.pub-trade-bosses-say-shut-stealth-seek-funding/

12
In reply to wintertree:

> ... but what have the Romans ever done for us?

Actually, I think "nobody expects the Spanish inquisition" fits better; just read the script of the whole episode, it's brilliant 😂

 wintertree 14 Jan 2022
In reply to thread:

The fall in cases on the raw dashboard data scarcely seems believable - but testing numbers are not falling as rapidly...  The way this fall is so strongly synchronised across all regions when the rises weren't is setting off yet more alarm bells.

 It's where I start to have thoughts like "did omicron just mutate in to something that breaks testing?" and "are a lot of Excel files getting lost down the back of the sofa?"

Always with the negative waves, Moriarty.  

Still, best to wait for confirmatory signals from healthcare and the ONS survey before really committing to the implications of what this rapid fall suggests.

On that front, hospital admissions are plateauing it seems, as indicated by rate constants hovering around zero; but we know from other data that "incidental" admissions are rising as a fraction of the total, so it seems likely "admitted for Covid" is still falling.  The incidental admissions will have a different dynamic I think - with the wave decaying much more slowly in these, as with ONS random sampling data, as it detects "live" infections and not "new" infections.  That data seems to be published weekly; so we'll see what the next update brings around the middle of next week.

Deaths are still rising as the increased admissions work their way through.

I've been wondering what comes next.  For people who've not received a vaccine dose in the last 9 months or so and who hasn't caught delta, if they get omicron it's induced immunity-against-catching-delta  is I think going to fade a lot faster than it's induced-immunity-against-recatching-omicron.  If there's a more or less total dropping of restrictions over the coming couple of months, I wonder if we'll see a follow on delta wave, assuming it's still out there enough to rebound?  But it will be a wave in people with high immunity-against-severe-illness.


 elsewhere 14 Jan 2022
In reply to wintertree:

> I've been wondering what comes next.  For people who've not received a vaccine dose in the last 9 months or so and who hasn't caught delta, if they get omicron it's induced immunity-against-catching-delta  is I think going to fade a lot faster than it's induced-immunity-against-recatching-omicron.  If there's a more or less total dropping of restrictions over the coming couple of months, I wonder if we'll see a follow on delta wave, assuming it's still out there enough to rebound?  But it will be a wave in people with high immunity-against-severe-illness.

I was wondering if we end up bouncing between Alpha, Delta, Omicron and whatever limited set variants which might be "fixed" by a periodic Alpha, Delta, Omicron and whatever combined booster, or do we end up with a diverse set of variants more like flu that is too variable to be reliably "fixed" by the flu vaccine?

My highly ill-informed impression is that Covid does not produce such diverse variants as flu, but then give it another 100 years... 

Fingers crossed for "a wave in people with high immunity-against-severe-illness" but eventually it might be something that hits us like flu in old age

Post edited at 18:31
In reply to wintertree:

> The fall in cases on the raw dashboard data scarcely seems believable - but testing numbers are not falling as rapidly...  The way this fall is so strongly synchronised across all regions when the rises weren't is setting off yet more alarm bells.

Our cases have peaked on the 4th, and Jersey's look to have on the 10th. However, from the demographics it's very obvious that in mid-December it was all schoolkids and their parents, then over xmas it was the 20-30s partying, and that's all died out with kids still being on holiday and the young stopping partying. Kids went back to school last week on 2 LFTs a week and a little bit of masks for secondary school, but no extra-curricular activities or trips. Next week it's LFTs 3 times a week and masks for secondaries in exchange for getting the fun stuff back.  Ventilation is being pushed and kids are told to take warm clothes / coats to wear in the classrooms.  I think cases will start to ramp back up again in schools and their parents but the rest of the adult population won't increase until dry January is over and socialising restarts.  Jersey hit a peak case rates of 4440/100k (7 day rate) and 6491 (14 day rate) which is interesting considering they were between us and the UK until we peaked.

 Offwidth 15 Jan 2022
In reply to Toerag:

This patent free vaccine development work sounds hopeful...

https://www.theguardian.com/us-news/2022/jan/15/corbevax-covid-vaccine-texas-scientists

2
 wintertree 15 Jan 2022
In reply to Offwidth:

My first thought was "what's their adjuvant?" - if they had something patent free and reproducible with "low" tech levels that adjuvanted this well that would be quite something.

A quick google later and it's  CpG 1018 as with Valneva.  I wonder what the cost and licensing terms of that are?

In reply to wintertree:

This was news 2 weeks ago 

https://en.m.wikipedia.org/wiki/Corbevax has some actual information, if you want more than just cut and paste from a press release. Or https://www.bbc.co.uk/news/world-asia-india-55748124


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