UKC

From what I can gather restrictions etc in France are not a lot different to U.K. Similarly some other European countries. Why then is our continuing infection rate so much higher? It is somewhat comforting that hospitalisation seems to have turned in the right direction here and from a personal viewpoint I am not particularly fazed by the Covid situation generally but  I am curious about some kind of reasoned argument: is it to do with amount of testing, (i.e. more tests means more cases found)or greater restrictions than are apparent or what? 

There are those on here who follow this Covid thing a lot more closely than I do and I'd value their opinions. 

Thanks in advance. 

Ps whilst you're at it - what's the forecast for January in Austria and Switzerland cos I am planning a skiing trip 😊

Not quite. In France for example masks are still compulsory, and that's mask, not face covering. If you are not wearing a surgical mask or better you are not getting anywhere, using transport, etc. Indoor spaces still have strict restrictions on numbers, and they also have vaccine passports which are needed for any indoor leisure, and the most important thing, the businesses enforce these rules religiously.

In comparison in England is like there's no covid anymore. No masks, no distancing, no limits on capacity or crowds. in fact i can't think of a single covid 'restriction' England has at the moment?

Thought i'd point out, Switzerland is also running vaccine passports for anything indoors, and they only accept Swiss or EU covid pass, i.e. the UK/NHS one is not accepted. This may change between now and January, but as it stands you are not allowed inside any bars, cafes, restaurant, etc (Unless you got a Swiss/EU covid pass that is)

The UK maritime climate may affect transmission rates. The UK appears to get more flu deaths per head per year than other countries with more continental climates.

For example, UK - 10,000 - 25,000 flu deaths per year [1]

France, 10,000 - 15,000 flue death per year, almost identical population to the UK [2]

Australia, flu deaths measured in the 100s, half the population of the UK [3]

Of course, there is no definitive proof that the climate is solely to blame for these flu death discrepancies, or that these differences are even real, recording standards could vary between countries. I have also selected a very small list of countries, this hasn't been cherry picked but it could do with being a loner list to draw any real conclusions. And finally, it is not that clear how much the climatic factors that affect flu transmission are the same for Covid. A lot of disclaimers but this may explain part of the difference in apparent coronavirus rates between the UK and other countries

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1676118/

[2] https://www.pasteur.fr/en/medical-center/disease-sheets/influenza

[3] https://www1.racgp.org.au/newsgp/clinical/australia-records-zero-flu-deaths...

The Tories have decided that everybody can catch Covid once or twice a year because now we are jagged it'll only kill a hundred people a day when the weather is good and low hundreds when its sh*t.

They're not trying to stop people catching it any more and pretty soon they'll start to make people pay for tests so its less obvious how many people have it and there's no excuse not to go to work.

Maybe they are right, and if they are wrong they'll probably get a lockdown in before more than 10,000 or 20,000 people die.

The Europeans are still trying to keep it under control.  Which is pretty smart, they can wait and see if the Tories gamble pays off.

To the Tories, COVID is like Brexit. Whatever you do, don't mention it, no matter how bad things get.

Andy F

I’ve just returned from Travelling in Italy and France. In Italy, most people wore masks, even outside. I even saw a workman told off by a member of the public for not having his mask on, he duly complied. You couldn’t go in a supermarket without having your temperature taken. Obviously you had to wear a mask. Even in high mountain refuges masks had to be worn, and groups were kept distanced at mealtimes. Everyone seemed supportive and compliant with the rules. France was only a little more relaxed. England is terrifying me.

Imagine that in the UK? And I mean all the UK, not just England. You'd get a stern response in return. Even when COVID was at its peak and you challenged some tool in a supermarket, they would likely tell you to feck off. Considering our population, and taking worldometer as truth, I have no pride that we are 4th for cases globally, the only slight satisfaction is that Russia has significantly higher deaths and daily deaths* and they are much more populous. (but much more distributed, which is counterintuitive). Perhaps poverty is playing a part.

*Of course Im not satisfied literally about the deaths, I'm just referring to the stats.

Seems to me, our terrible govt has decided c100 deaths per day is worth it to satisfy the backbenchers and our selfish, thick, Brexiteer nation and he's scared to do anything he sees as increasing restrictions. He's banking on vaccinations,  which many won't take and he's lost control.

Although you're displaying your usual cynicism, I think a lot of it in that post might well be justified.

From personal experience and according to the Swiss rules, this is not true: the NHS pass is accepted. Naturally there are various conditions and the situation is fluid. Check bag.admin.ch

Comparing cases between countries doesnt really tell you much in my opinion, it just broadly tells you how good the testing capacity is really. I would imagine the deaths per 1 million people would likely be a better measure, but even that is going to be open to variations in reporting and other statistical wrangling.

I do feel that it wouldn't take much to reduce our r number to below zero, as we seem to be hovering around 1 recently, even with everything pretty much open. Unfortunately I cant see the government asking for a minor change in rules (eg more mask wearing) any time soon. Too many noisey backbenchers raging about oppression of freedoms. Which is a shame as I imagine the majority of people would likely comply if it meant the nhs got through the winter a bit easier.

And yet the infection rate is higher in Scotland than England. 

Seems like the UK is testing more then others.

https://www.statista.com/statistics/1104645/covid19-testing-rate-select-cou...

They do mention it. Every time there's a question about supply chain issues (which simply cannot be anything to do with brexit, no siree)

Or it was last week.

If you want to make a Scotland to England comparison the fair one is number of deaths per million population over the course of the pandemic.

Scotland has 1/10 the population of England which means the national case numbers bounce around more with local outbreaks and it also has events like back to school and back to uni at different times from England.   

That will be the end game everywhere, as the only other option is restrictions forever - the elimination ship sailed back last March.  The thing in question is whether now is too soon, and the answer to that may be yes.

Sweden only ended most restrictions yesterday,  but most establishments aren't rushing to go back to full seating in bars and restaurants, distancing in shops etc remains etc.. vaccine uptake is 84% of over 16. 

iIn't this in part a conscious decision by government to accept a period of higher transmission so that we are nearing 'herd' immunity going into winter? That will come from vaccination and booster jabs in adults, and through letting infection happen between young children.

All of this intended to stop a large spike in the winter and further lockdowns/ restrictions. The risks of serious illness are lower because of vaccination so they can now pursue this strategy. 

It's a fine line! 

The headline number of infections isn't a great comparator as different countries test at different rates. As you mentioned - in the UK we do a lot of tests, so will pick up more infections. The proportion of tests coming back positive is one indicator that could be better but this too will be affected by testing policy and who is eligible for testing: we're in the middle of the Western European countries, but then the headline figure will be affected due to us doing a lot of lateral flow tests. Stripping them out, our PCR test positivity is currently nearly 8% so the highest in Western Europe.

Another metric to use would be recent deaths/million - currently double the majority of Western Europe - but this would be affected by testing policy, healthcare and vaccination rates

Hospitalisations per day are also much higher here - again comparisons affected similarly to deaths.

Bringing it all together, although the total of positive cases is misleading, I think you can be fairly confident that we are currently the worst affected major European country.

I work in healthcare and a lot of patients have got the message that "it's all over" People are going to work and on public transport as normal with "colds" and "chest infections" and not even thinking that it's covid. 

I get this but as a headline figure, this is the one most people look at.

Personally I think differences due to testing strategy between major western European countries are now small enough that the effect on case numbers won't be giving a significantly false picture.

As others have said, in the UK restrictions have now been almost entirely removed and society is mostly back to normal; in other countries it seems there are still far more efforts ongoing to restrict transmission. The climate may also play a part when comparing the UK with significantly hotter and drier areas, but I think it would be false to give the impression that was mostly to blame.

As others have said, spread of the virus amongst younger ages is now effectively government policy - in all UK nations - alongside vaccination of adults and boosters for those at more risk. This will eventually lead to a long term state under which almost everyone is protected from severe disease but a background level of cases continues (magnitude TBD) and a small number of people continue to die; the hope is obviously that this is at a low level, perhaps comparable to flu death rates, but we don't yet know for sure.

It's important to recognise that all European nations will also have to go through this phase at some point, because there is no prospect of elimination. It will be interesting to see which strategy eventually works best and whether any of them can achieve a sustainable long term position without high case numbers. We are currently doing a canary-in-the-coalmine job for them.

As ever the Johnson Govt aims to be 'World Class' - at last they have a clear case of success!

That's my take.  

One that's being very misunderstood, not least because it's never been spelt out in plain language to all, and because some will interpret literally any possible situation as a way to criticise the government.  For sure, there is plenty to criticise but that doesn't mean everything is wrong.

The countries that have more restrictions and lower infection and death rates are slower in raising their population immunity levels - which is the only way this ends now newer variants take elimination off the table.  

• With vaccines online and reaching saturation in uptake, and with many gains in clinical care realised, there's less and less reason to stall for time and delay the inevitable by continuing on with strong restrictions.  
• On the other hand, there's a set of other reasons piling up why going in to winter with lower immunity levels (more "pandemic potential" in the population as it were) could be a bad idea.

It's more or less impossible to reach a definitive, rational view on which approach is better IMO, but my alarm bells aren't gong off over where the UK is at the moment.

In England, it seems the potential isn't there to sustain growth in symptomatic Covid in adults any longer, and it's growing now only because it's being driven by the explosion of cases in school aged children; we probably won't have a better time than now for that process to happen in the next 4 months and I hope/think it's starting to wind down.  We'll see if that hope makes it through the sudden change in the weather.

In reply to Arcturus:

We're at the tail end of a solar cycle, so I'm hoping for a split polar vortex driving a wobbly jet stream, and for luck to put us on the right side of the resultant omega block for an epic winter, the likes of which haven't been seen since since 09/10 and 10/11.  The vortex is certainly weakening.  Mind you, given the number of supply issues arising I should probably hope for mild dross....

This week, last week, next week, we can all pick dates, figures and numbers to suit any argument. The simple fact is that Scotland isn't faring much better than England. Therefore the Nats are doing no better a job than the Conservatives. 

Not necessarily. The uk unlock from April, may, June... were dates set in stone, Boris trying to be popular. Many other countries are unlocking based on vaccination rates, cases, hospitalisation etc.. 

In spring 2021 the UKs high jab rate, high levels of infection acquired immunity and Covid measures meant we had some of the lowest case rates in Europe. Then, because we have a useless government, Delta came in and spreaded like crazy. But the government stuck (apart from the odd backtrack) with its road map of easing measures. During this time, Europe started to catch up with our jab rates (Spain and Portugal overtook us - I read that this may be due to the high level of trust they have on their NHS and messaging to get jabbed). My opinion is that whilst many other European countries have less trust in their respective governments than we have in the UK, many European countries have a greater sense of doing the right thing for their community/society, so are better are sticking to Covid restrictions (and I think this part explains why for instance Scotland has done better than England etc). We also have more indoor mixing (weather related).  I also reckon that the rapid spread of Delta was in part due to our lack of sense of community (compared to other countries ) - there was lots of examples of people not following Covid rules. Made ‘easier’ by our policing methods (less enforcement, more encouragement, which in normal times I agree with).

For the record, the point I make about UK society being less bothered about looking after each other I trace back to the Thatcher era and the hegemony thrust upon us, which didn’t take as strong a grip in other parts of the uk. 
Forgot to add: deciding to jab children, and jabbing them after schools went back (rather than in the school holidays so they would have some immunity before they went back), was a bit nuts. 

Our govt did flex these dates, not a lot, but they did. Think it was the main one in June, delayed by a month to get more people jabbed. 

Here the link:

https://www.bag.admin.ch/bag/de/home/krankheiten/ausbrueche-epidemien-pande...

Short summary: After Oct 4th you will have to transfer your NHS pass to the Swiss one.

Is the UK climate that different compared to the climate in the westernmost 100km of countries on the other side of the North Sea? Is there a gradient in cases across France corresponding to climate variations?

In pretty much everything to do with Covid, virus & variants is secondary to human behaviour. For example lockdown in March 2020 was followed by falling cases & deaths (it's almost as if transmission requires proximity rather than witchcraft, it really is that basic). Delta is tougher but it still responds to human behaviour (see Auckland now for how much tougher).

I think the differences between nations are mostly human rather than anything else.

They will still need to go through the same transition as remaining restrictions are relaxed with a certain portion of society lacking immunity (for whatever reason.) It's possible, not yet knowable, that by doing it more gradually they can reduce the case numbers and/or deaths that arise along the way, but we don't know yet - that was the point of my next sentence after the one you quoted.

Which is why I said the metric of interest is deaths per million over the course of the pandemic because that smooths out the noise and gets rid of the cherry picking.

England is about 2,000 deaths per million, Scotland is about 1,500 and Ireland is about 1,000.

The simple fact is Scotland is fairing a lot better than England but not as well as it would be fairing if it was independent.

The other specific factor I didn't mention above is the difference in schools policy. A large proportion of English cases are now directly in school ages and more still are in their parents' age groups. Other countries still have policies in place to restrict cases in school children. Eg in France, they still close a class if there is a positive case and they are all wearing masks (even primary school I think.) They also started vaccinating teens earlier.

The ‘Covid on death certificate’ rate per 100,000 is 241 England, 198 Scotland. England has done miles worse. 100% with you  that one. Whether it would have done better under independence, probably  ‘yes’.  The UK government has made a shambles in nearly every way, I struggle to see how independence would have made it worse. And as I stated earlier, Sturgeon would get better ‘buy-in’ with Covid rules which would help keep a lid on things. 

Changes in the weather has a clear and significant effect on case rate constants (R values if you like) on the timescale of weeks.

Other viruses transmitted in similar ways are known to have large seasonal effects and large geographic differences in their mechanics.

It seems clear that there weather does affect this a lot.  During a pandemic phase it changes how fast the virus spreads which makes little difference when controlling measures kick in to regulate that spread; post-pandemic it could change the sign of R at different times of year for example which makes a much larger difference.

But it is not that basic.

How proximal two people need to be (in space and time) for transmission is a strong function of ventilation and air turnover.   Ventilation and air turnover are a strong function of climactic and social differences.  I've stayed in houses designed to keep the inside air inside to a high level, another in another house where there was a half foot gap between the top of the walls and the roof.

In a pandemic phase where nobody has any immunity, these factors are secondary and the virus is going to spread like wildfire, and other measures will limit the rate. (Human response)

As things settle down to a low level of transmission in a population with high levels of immunity, these effects are going to affect big differences to what the steady-state post pandemic era looks like in different countries.  As are levels of healthcare provision, levels of poverty, the general state of the public's health, social conventions around attending schools or work when visible unwell, levels of social buy in to NPIs for "flu season", dozens of other things,.  Post-pandemic Covid deaths may well be much higher in South Africa for the same reasons their pneumonia deaths are so high, for example.

I fully agree that climate differences are not significant in the pandemic phase of the virus, but they'll be one of many factors that differentiates how the virus spreads in the post-pandemic era, and we're closer to a post-pandemic than a pandemic state now IMO.

It is too early to conclude there is no prospect of elimination and way too early to conclude there is no prospect of further substantial mitigation.   In fact it is a completely stupid bet to think that the people who made such incredible progress starting from scratch in a year and a half can't do even better in the next year and a half now they are up and running.

The Valneva vaccine is an inactivated whole virus so even if there was a reason to expose your immune system to the whole virus rather than just spike protein you could potentially get that with a vaccine technology.  Of course the Tories killed the contract with Valneva and Javid said in parliament it wasn't effective even though the clinical trial results haven't even been unblinded.  The problem with Valneva for the Tories is it kills their narrative that everything that can be done has been done and you may as well rush out and catch Covid.

Which is a mugs game.  The smart move is to stay safe and let somebody else be the canary.

But if a greater proportion of population is vaccinated, you won't have a death rate that's so high. 

I was going to give a detailed response - I've typed it out, with references - on why I think you are commenting from a position of ignorance when you claim these vaccines were developed "from scratch". But then I remember that you've not read or acknowledged any of it the last 3 times and are going to keep beating the same old drum regardless of what anyone says to you.

Because too many people have thrown caution to the wind and are failing to act sensibly when out and about in public. Eg The train I was on yesterday, not overcrowded but maybe a couple of dozen, perhaps a few more in the carriage compartment I was in. Less than half were wearing masks despite a polite request from the train operators for people to do so out of respect for their fellow passengers. Then the train stopped at a station where about 20  teenagers boarded on their way home from school. Not a single one was wearing a mask, and they were constantly moving around in the carriage generally ragging about and shouting amongst each other and their fellow passengers.

You see patterns like this developing everywhere including in supermarkets and pubs where more are going mask less than masked.

No wonder the virus is spreading in Britain. It seems that other counties have  a better sense of social responsibly, and this is reflected in relatively lower rates of infection.

Do other countries have the same "soldiering on" culture we have here? I had hoped one of the outcomes of the pandemic would be a change in that but it seems that everyone's back to going into work if unwell but "it's not covid" (i.e they've done a lateral flow test).

Thanks for saving me the lecture.

I've heard your argument before and my view has not changed.   My view is based on observation of regular and substantial progress and the only thing that will change my view is if progress actually stops.  If we are here next year and all the vaccines and medicines are pretty much the same as this year I'll review my opinion.   

You can keep your references, I'm not interested because this isn't that kind of argument.   In my field I could give you a ton of references about why semiconductors have to stop shrinking or why clocks are going to need to go asynchronous and I could give you some from every single year I've been in the industry starting in the 1980s.  It's simpler than that.  If you have a problem which people have a basic handle on and a few hundred billion dollars and tens of thousands of smart people working on it the chances are you can make progress,

As for 'from scratch' - what was the base level of funding and number of people working on SARS/Covid before it became an international emergency compared with the number working on it now.  Most of the people working on it now were probably doing something else a few years ago.

On a slight tangent I know but...

Are cases and deaths in China really as low as reported?

They did some very severe lock downs but I find it hard to believe that such a populous country with so many densely packed cities has only had 4636 deaths (Worldometers figures) and under 100K cases.

Many countries will have vastly underreported case numbers but China would seem to be taking the proverbial.

Probably not as low as reported but nothing like what has happened in the UK.

You can't hide the amount of death and illness experienced  in the UK.  People have smartphones with cameras and there are satellites looking down on the cities and business travellers going to and fro and lots of e-mail and phone contacts.   If large numbers of people were dying it would get out.  China isn't North Korea it is the biggest manufacturer on the planet and has a correspondingly lareg amount of international contacts.

We saw that lockdowns can get a country to very low incidence, we did it ourselves.  The Chinese just did it more rigorously.

That's a very good point. 

Quite apart from Covid, I think we are or have become, a very selfish nation when it comes to considering our fellow citizens. For example panic buying and hoarding when it's not strictly necessary at the expense of those who really do need items, a general lack of courtesy and consideration in our driving habits eg lane hogging, speeding through built up areas, poor/dangerous overtaking of cyclists and pedestrians etc etc. 

Other examples include littering, which is not just selfish, but environmentally unfriendly and thoughtless. We have become one of the worst littering counties amongst other so called first world counties I have visited.

There are times when I feel ashamed of what we are becoming as a nation.

I'm disappointed (and a bit mystified) by the Valneva decision but I'm pretty cynical about the motivation behind it.  An inactivated virus (Valneva) or a recombinant spike protein subunit vaccine (Sanofi-GSK) would be my preference for a booster shot.  Certainly preferable to just catching the virus as the next step in my immunological education. 

I accept that I'm certainly going to get infected at some point - ideally, I won't notice.  

I only just got back from spending time there and the way it works is they scan your QR code with an app, if it goes green you are golden, if it goes red you are sitting outside in the rain. The NHS pass goes red and will only go green when/if the government brokerages it for it to be.

For people with the NHS pass, there is the option to apply for a Swiss covid pass, the bureaucracy varying depending on canton

From the bag.admin.ch page:

COVID certificate for people vaccinated abroad

The Federal Council also addressed the issue of COVID certificates for people vaccinated abroad. Currently, only certificates issued by countries participating in the EU Digital COVID Certificate are technically compatible with the Swiss system. Under this proposal, anyone who has been vaccinated abroad with a vaccine approved by the European Medicines Agency (EMA) and who resides in or travels to Switzerland would be able to obtain a Swiss COVID certificate. As in neighbouring countries, certificates are not to be made available for all WHO vaccines. Each canton must define a contact point for people who have been vaccinated abroad.

https://www.bag.admin.ch/bag/en/home/das-bag/aktuell/medienmitteilungen.msg...

and more detailed here https://www.bag.admin.ch/bag/en/home/krankheiten/ausbrueche-epidemien-pande...

However i just found this in there

In a transitional phase until 10 October 2021, all foreign vaccination certificates for EMA-approved vaccines will be valid for access to events or facilities requiring a COVID certificate.

To find out what conditions must be met and what documents you need to show, please see the page Use of the COVID certificate.

Which might explain the fluidity. The area i was staying in either they weren't aware of this transitional phase or the canton might have chosen to forgo it, as they were all operating the green/red rule with the app 

I'm very disappointed that Valneva has been cancelled, I'd very much wanted it as my bridging step to eventual infection.   Do you think we could rock up at the production plant's side door with an envelope of cash and leave with a couple of doses?  

In terms of the cancellation, I'm significantly more concerned by the consequences of an MP giving evidence free comment anticipating the output of an independent regulatory body, in a way that casts doubt on the efficacy in the middle of a live phase 3 clinical trial.  That's just a staggeringly awful thing to do from so many angles around professionalism and the integrity of the trial.  I'm disappointed to see that the MP hasn't been nailed over this.  

Neither the cancellation nor the comment in parliament strike me as the way the government should be conducting themselves if they want the UK to have a growing role as a leading location for knowledge economy / biotech / pharma stuff.

All other things being equal, of course - but it also depends on (1) which groups of the population are vaccinated and (2) how much the immunity of more vulnerable populations has declined when infection rates are high.

Yes, I was waiting for the (justified) outrage from the benches opposite... nothing.  Nobody seemed to notice that the minister for health (with no relevant qualifications whatever) had just pre-empted a clinical trial and the decision of the MHRA on data no-one has actually seen yet.

I was vaguely sympathetic to Javid over the way he was treated as chancellor (he does at least have a degree in economics) but it turns out he's an objectivist neo-con true believer whose hero is Ayn Rand and who attends the AEI's annual conference. 

I'm sticking to my criticism of government on the English level of restrictions. SAGE have clearly advised a more cautious position that the government are taking, so they are clearly less sanguine than you (and that's based on a lot more than just the faulty modelling).  That a hospitalisation crisis has only 'tickled us at the edges' in late summer doesn't mean risk has gone now the weather is getting worse. In the UK of the order of 1000 people are dying of covid each week: on per capita levels, much higher than elsewhere in western Europe. Several thousands are getting long covid each week. Our NHS is in bigger trouble than health systems in those countries with way too many trusts still at OPEL 4, partly down to covid. It's still a big and worrisome gamble to me and maybe the fact that ONS say 45% are still taking precautions (ie we are not really fully open yet) is what is keeping us on the edge of infrastructural safety.

It's really not necessary for nearly everyone in those other countries to catch covid in the near future: if you have clear public health messaging trusted by the population, proportional restrictions, and a functional track and trace system when infection levels are low you can keep the worst at bay at high vaccination levels until vaccination is complete and opening up fully when that's best... at the start of summer. England is the stand-out exception in western nation's covid policy. I still think our risk levels might be like the punk at the end of Dirty Harry's barrel but with Boris feeling lucky.

Yes I think the rules were put in at short notice and the QR code scanning was not 100% reliable, actually not for the Swiss covid pass either: all establishments we visited were happy to let us in nevertheless.

The impact of weather hasn't produced anything comparable to the decline in cases or deaths after the March 2020 lockdown. It remains secondary to human behaviour such as a lockdown.

Any idea if the impact of weather is impact on human behaviour, impact on human physiology or impact on the virus?

Proximity - it really is that basic. If we were not a social species and lived as hermits miles apart except for a once only mating ritual on reaching sexual maturity we would not have a Covid pandemic. We'd probably have very under-developed immune systems. Or an immune system well adapted for that level of sociability. 

Proximity has multiple measures  - it might be distance, ventilation, wind speed, time, dilution of somebody else's crap in water supply, flying range of a mosquito or sharing needles. But without proximity of a type relevant to a specific disease that allows physical transmission of an infectious agent there is no transmission. It really is that basic unless we deny science and accept disease transmission at a distance by witchcraft.

It's not just basic, it's stuff we learn as children (maybe not needles).

"levels of healthcare provision, levels of poverty, the general state of the public's health, social conventions around attending schools or work when visible unwell, levels of social buy in" - these are mostly human behaviour

I'm trying to make a point that I think you're missing.  I'm not sure how to be more clear.

The pandemic phase of an emerging virus is not comparable to where it ends up.

Weather and seasonality is secondary to behaviour during the pandemic phase.  Because the virus is spreading very fast, and behavioural measures kick in (individually, through businesses and at government level) to moderate that.   Some of the worst exponential growth we saw pre-delta was around the nicest/hottest part of late summer 2020.  Pandemic potential trumps all other factors. 

In a pandemic phase, the "pandemic potential" of the virus in the population sets R >> 1.  Changes made to R by the weather of say ±0.3 are inconsequential.

Once we exit the pandemic phase, over a long enough time, R~1.  At this point changes made to R by the weather (of say ±0.3 ) become significant in terms of the behaviour of the non-pandemic virus.  Sometimes they make cases rise, sometimes they make cases fall.  I think we've already seen this emerging in the recent data.

You are being disingenuous.  I am not arguing against proximity in some sort of anti-science denialism and I have been very clear on that.  

I said this:

How proximal two people need to be (in space and time) for transmission is a strong function of ventilation and air turnover. 

You both contradict me painting my take as denialism (quotes above) and then go on to agree with what I actually said in the same paragraph.  This is not a sensible basis for a discussion.

I literally just said that in sometimes identical words.

I said that as part of giving my take on why climate makes a difference after we exit the pandemic phase (the point S Ramsay was making in part IMO).

Because post-pandemic we will have a somewhat steady state where the rates of becoming susceptible and of being re-infected match over a long enough timescale.  By then the set point of the steady state (daily number of infections) and the seasonality in R (<1 sometimes, >1 others) both derive from factors like distance, ventilation, and time as applied to how people engage in proximal interactions, and those factors are strongly affected by the climate.  As you yourself have effectively acknowledged by stating that proximity is defined by distance, ventilation and wind speed - there are direct physical effects of the climate and indirect effects of it in terms of peoples behaviour, which you also recognise as contributing to proximity.

I can see how climate is a direct contributor to this steady state, as S Ramsay was suggesting.  Some people never open their windows, others never close them, due to differences in climate.  As you recognised, airflow is a critical part of proximity.   It's clearly a factor in respiratory spread of permanent, non-pandemic viruses and IMO comparisons with a pandemic phase virus are not an appropriate retort to this.

I'm not sure what the problem in communications is here; I'm trying to be very clear.

I don't disagree with you that there are many other factors around humans and human behaviour, but if the weather had no effect, why is seasonality such a strong factor in many respiratory diseases?  Given the strength of historic records over the seasonality of infection and death from influenza and pneumonia it would be an outside bet that we're not going to see something similar emerge with Covid.  I

t seems likely that many of the effects of the weather and seasons are through behaviour, because we've seen this last year that respiratory viruses can become desynchronised from their usual schedule with society wide behavioural change.  If those effects apply over the seasonal change within one country, they are going to apply over larger changes in climate.  Mostly I suspect through human behaviour and building design - climate differences are one of the reasons we have different ways and means of living in different parts of the world.

Let's flip the question with a plot below to frame it.

1. Why do you think flu has such an incredibly strong seasonality?
2. Why do you think post-pandemic Covid won't show similar behaviour?

All the more reason to be careful in England....

More good news and another reason why more caution in England might be a  better plan:

https://www.theguardian.com/world/2021/oct/01/covid-antiviral-pill-halves-h...

Not really true any more, northern England is higher, also Scotland numbers are dropping dramatically but going up in the UK as a whole.

https://covid.joinzoe.com/data

Is this a new thing?

I was in Switzerland a month ago and this wasn't happening then.

I have given up trusting the output from the Zoe study unfortunately. The trends it shows have several times been out of step with other data since Delta came along. The reason it's particularly bad now is presumably that cases are dominated by under 18s, very few of whom will be using the app and logging symptoms.

Over the last 7 days, case rates were 401 in Scotland, 360-odd in the North East and North West of England. As you say though, Scotland is dropping fast and will probably be below those areas in another week.

Contrast this with my experience in Germany a fortnight ago on a morning commuter train - all the schoolkids milling about on the station platform, just under half with their (FFP2) masks on even though they weren't required to wear them by any rules. They all pile onto the train and all are fully masked up for their journey (as per the rules), and head into their school still fully masked up (as per the rules). The commuter train home in the evening was similar, but with adults behaving properly. You'd see some rip their masks off with relief as soon as they were off the train, but everyone wore them on the train.  Their societal ethic is much stronger than that of the UK's.

I think the messaging is key - the European nations were still below optimum vax levels and thus were still putting out the message of avoiding the virus. The UK has the message "we're all vaccinated, time to crack on with life".

I think we have become very polarised. Totally agree with the ‘selfish’ stuff, this has been gradually worsening over the last few decades. But we also have large amounts of volunteering and charitable activities (and fully get that this is often due to sh!t government policies etc).  We are polarised in many ways. 

Yes the swiss rule that requires double vaccination, recovery from infection or a negative test result to enter e.g. restraunts or gyms is relatively new, coming in 2 to 3 weeks ago.

I do wonder if you went to former East German states whether this would happen, as there is a lot of anti van sentiment etc in those areas.

I see it as mixed in the U.K.  some parts are very good and some hopeless. 

oh my that's a long thread

i'll just scroll down to wintertrees' response 

ah ok that makes sense

thanks for saving me so much time : )

one day my expertise will be useful ... lol

Judging by my daily experience in London, I'd say it's because people have near ubiquitously gone back to standing on top of each other everywhere they can. It's because there are hundreds of people coughing their lungs up, maskless, on the Tube and in other places, and it's because people still don't seem to realise that waving a hand vaguely in the direction of their face when they cough or sneeze does not, and never has, constituted covering your mouth. In short, I'd say it's because people are stupid.

Just a hunch.

Better comments and less side tracking from others on here…. As usual…

I'm not accusing you of witchcraft! You and covid tabby are my best sources of well presented data and you for analysis.

I just say that denying basics of disease control that we learnt as children such as clean water, fresh food, washing your hands after toilet & before eating plus keeping away from the vulnerable granny when you have a cold requires the belief in witchcraft, malign spirits or wrath of the gods to explain the spread of disease rather than physical transmission. 

Which of those precautions (so basic we learnt them mostly before we went to school or at school) depends on the disease.

Those mostly childhood basics or WW2 propaganda (coughs & sneezes spread diseases) of human behaviour work for covid. It really is that basic.

The recent changes to human behaviour work for flu - "Laboratory indicators suggest that influenza activity is very low." Human behaviour looks more significant than flu variants and flu seasonality.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/...

Weather - it cancels out on timescale of a month or so, not much longer term significance.

Flu seasonality - I thought human behaviour, UV & humidity but a quick google suggests not humidity. It's over a 13-26 week timescale so small changes in R build up over 13-26 weeks unlike weather (few weeks).

Although as I said, that seasonal flu pattern appears to have been obliterated since March 2020 so even flu seasonality is secondary to human behaviour. I don't think the climate has changed to that degree since March 2020.

Post pandemic Covid - I'm in two minds.

1. More than a half a dozen doubling or halving times is as good as infinitely far into the future. It's like predicting the future of the UK in 2300.
2. We are already in the post pandemic Covid era where rate constants move without any direction like an established disease. However I'm reluctant to accept we are stuck with tens of thousand of deaths in the next year and apparently not doing as well as other countries.

Presumably an endemic disease has R=1 for a long term equilibrium term so that the UK prevalence of endemic disease X in 2050-2060 will be about the same as it was in 2000-2010. Superimposed on that is impact of weather, seasonality and changes (often chaotic) in human behaviour. Jacinda Adhern and Andrew Wakefield are opposing examples of the chaos of human behaviour.

If the equilibrium is between immunity loss and immunity gain that does not bode well for flu in the future.

If the equilibrium in a post pandemic endemic era is between immunity loss and immunity gain** then the prevalence (rate of immunity gain by infection) is fixed by the rate of immunity loss determined by human physiology for the disease. R of the virus doesn't matter because in the long term R=1. Human physiology is pretty much the same worldwide so the would imply a universal prevalence of diseases worldwide where there is acquired immunity but no vaccination. I'm not aware of any disease like that so it's probably completely wrong.

If prevalence is not driven by human physiology of immunity gain/loss equilibrium I think I haven't got a clue about the future given that recent human behaviour was capable of trumping human physiology for both pandemic Covid & endemic flu seasonality. 

*immunity loss is shorthand for a gain in non-immune population which includes newborns

**immunity gain by vaccination or booster jabs usually (always?) a preferable alternative

A bit of a tangent, but not unrelated, there appears to be a promising looking therapeutic on the horizon. Here's hoping it's as good as it sounds and available soon if so!

https://www.bbc.co.uk/news/health-58764440

Thanks to everyone for your responses. Some very interesting comments. Many thanks in particular to Wintertree for the weather forecast(!) and to others for the references to the Swiss covid pass rules. It's all quite opaque and not easy to be confident regarding entry regulations to the country on the one hand and to restaurants etc on the other. I've spent a happy hour lol reviewing the uk gov. website and the Swiss authorities' websites; no doubt it will change again by January. 

And yet some people with smartphones with cameras sneaked in to hospitals to take photos with those cameras to "prove" that the UK hospitalisations and deaths figures were fabricated: https://www.bbc.co.uk/news/55560714

well you can see the same trend on the Uk government site too

I thought about this a lot since the first lockdown etc. I have come to the conclusion it is a combination of:-

Climate, population density, politics, movement of population, habits within a population, effects of culture, effectiveness of control measures, whether of not you have a pet, genetics, etc

I'd imagine many normal treatment wards were empty, because all the patients and staff were in the covid related wards or itu, I'd expect there wasn't much demand for minor treatments etc... the debate could be should so many other treatments have been cancelled. 

An empty bed on the ingrowing toe nail ward doesn't prove folk weren't dying from covid. Maybe they should have gone around the back to where the doors are to the mortuary out of sight. 

Add in obesity, diabetes, existing illnesses related to air pollution...

Contrast this with my experience in Germany

Yeah, I totally forgot the medical mask requirement on my drive back home from further south I was very quickly left in no doubt of the disapproval towards me and my cloth mask at the first service station! 

one HUGE factor is that you now have to pay for tests in france (PCR and antigen), all of which used to be free. That is one sure fire way to bring case numbers down!

and to bring a sense of balance to what others have said. while yes mask wearing is still compulsory in a lot of places and there are the vaccine passports etc, compliance is way down on what it was even just a few months ago. apathy is high on this side of the channel too. even during the peak of the august tourist season, where back in spring 90% of people were wearing masks, now it was more like 50:50 on the highstreet.

not true. that may be the legal position but in practice its not the case. most of my masks are home made cloth ones and i have never been questioned or turned away from anywhere. indeed i have popped into the supermarket on a number of occasions with just my t-shirt or buff pulled up over my face.

and as for pass sanitaire enforcement thats just as hit and miss too. i went into mcdonalds yesterday and nobody stopped me to check. 

Well, that may have changed or be variable depending on the area. I spent a couple of weeks this month in the Sallanches/Chamonix area and on arrival i was prevented from entering premises 3 times out of 3 with my fabric mask. (Carrefour, Decathlon and a shop i was trying to enter to buy a mask. Talk about catch 22) At that point i caught the drift and got myself a box of them (Through a window on a pharmacy). Maybe if i had kept trying i'd have got lucky, but...

The covid pass, i was asked for it when ordering every single time. Again, you might get lucky here and there but my experience was that everyone asked for it.

And as for the Covid tests, again, it may have changed obviously, but as of Saturday last week they were still free (with the carte sanitaire) seeing i spent several hours and many miles trying to find somewhere where i could just pay for one.

everywhere certainly made made a point of enforcing to begin with when the rules changed, but it has definitely laxed, and quite rapidly. maybe you were just unlucky as i am talking from my experience of living in chamonix. and as for the catch 22, there is nothing the french love more than a catch 22! if anywhere is going to enforce the cloth mask rules its a shop selling propper masks! 

i have not tried to get a test since the rule changes, but i was sure one of the key pats of the announcement was that testing would no longer be free, to try and force people to get vaccinated and have the pass sanitaire? maybe i am wrong, or maybe there are loop holes, but the idea was that people couldnt just avoid the vaccine and take a test every day instead.

If you read the BBC news story I linked to, it pretty much says exactly that.  (For the avoidance of doubt: note that I did put "prove" in quotes/inverted commas, to indicate that I didn't believe the photos did any such thing.)

I think testing is free in France if you have symptoms, or it is a pre-requisite for a visit to hospital. I have had to pay for a PCR (a fixed, govt.-defined amount of EUR44) for my last 2 tests to allow me to travel. They were free prior to July.

In Toulouse airport yesterday absolutely everyone was wearing a mask. It was the same on the tram and walking around Montpellier on Tuesday (or at least 90%), and the proof of vaccination was required to get into any cafes/restaurants. Conversely, my daughter says that hardly anyone wears a mask on public transport in and around London now.

In Saudi I would have been fired by now if I wasn't already vaccinated (several anti-vax expats have already left the country for that reason alone), and the fines for not wearing a mask at work and in public are about GBP2000 a time. Hence the low rates (around 100 per day, country-wide) here. Sometime the "stick" approach can pay dividends, but society round these parts does tend to be more compliant...

Not sure, that's the reason. Here in Spain, we have one of the highest vaccination rates, but we still have masks compulsory indoors and on transport and outdoors when the distance of 2m cannot be kept. This is fairly strictly enforced. There are also still restrictions on the number of people allowed at events etc. The kids are required to wear a surgical mask all day in school, even in the schoolyard during breaks.

The message has best drummed home so much that people comply more than required by the rules. In town, most people just keep the mask on all the time. I suppose because it's easier than taking it off and putting it on all the time. I have gotten so used to it that this morning I forgot to take it off when riding my bicycle and only noticed when my glasses steamed up at the traffic light. 

I did an openwater swimming race and everyone was required to wear a surgical mask up to the point we lined up on the start line and was immediately given another surgical mask on crossing the finish line.