UKC

Post 1 - Opening Waffle and Four Nations

Plotting #64 - I'm Done (but Never Say Never Again).

I’ll finish with some thoughts on why now is a good time to wrap up these threads, and what I’d like to see happen next.  My key thought is that whilst the pandemic is ending for most of us, it isn’t ending for all of us yet.

The various plots 6 show cases in decay everywhere, and plot 9x shows the halving times getting better everywhere, all-be-it in the provisional zone.

Link to previous thread: https://www.ukclimbing.com/forums/off_belay/friday_night_covid_plotting_63-...

Post 1 - England 2

All measures are falling.   

• They won’t fall for ever.

Covid isn’t going away; people are going to catch it every so often and some people are going to go to hospital from it, and some of those will die.  I hope the grim measures are falling more towards endemic levels; I don’t think we’ll truly find those until 2023 - as covered in my final post, which also covers why I don’t think these measures are so appropriate going forwards - particularly incidental numbers.  My final post gives some thoughts on how to reduce the grim impacts of another virus joining our pantheon of illness.

I expect the general shape of these measures is going to be falling through spring and summer and a spike in autumn/winter, hopefully with true infection:hospitalisation and infection:death rates lowering throughout the year and in to winter.  It will be hard to understand those ratios and their changes from the pandemic-era measures however, and a bad variant remains a wildcard for the next year, as covered in my last post.

Post 4 - England 2

Plot 18 shows cases in decay in all regions; we had some growth in a few regions and the demographics strongly suggested that was children then downstream household contacts and then downstream grandparent aged contacts, with less growth in each successive generational hop. 

As plot D1.c shows, that young growth has wrapped up and decay is emerging in the parental ages; hopefully it allows shortly after in older ages. 

Plot 18 shows hospitalisations  blipping up in the regions that saw cases rise, but they are generally in decay or heading for decay - and keep in mind more and more of these are “incidental” which however you look at it is better news I think than direct Covid induced admissions. 

Deaths are in to decay everywhere, and the halving times are really picking up.  I gave a couple of simple analyses on the previous thread that suggest ~20% of these in England are now incidental; don’ take my word on it as it’s a crude analysis, and they also miss this issue of lives shortened. Understanding Covid's impact on deaths moving forwards comes more down to the death certificate data which is not currently published regionally or demographically, and I think it has finally become an actuarial affair to understand how much Covid is shortening people’s lives rather than how many it eventually kills.  This is one of many examples where the really useful pandemic era measures lack the nuance needed to understand an increasingly endemic situation.

Plot 22 shows hospital occupancy having peaked at close to the first wave’s peak occupancy; and let’s not forget what a stressful level that was for the hospitals then; there’s been radical reconfiguration since but it’s still too high for comfort.  Whilst around 50% of this may now be incidental, those patients still bring additional infection control burden to hospitals.  Intensive care occupancy has peaked far, far lower than in previous waves.  As I sketched a couple of weeks ago, the exit from this wave is turning clockwise not anticlockwise, showing ITU occupancy reduction leads not lags general occupancy reduction.  One for someone else to puzzle out, although I dare say the segue to breakthrough infections just as zero immunity admissions were perhaps petering out, and the rise of incidental admissions aren’t unrelated.

Thanks**64

Wonders what to do on a Saturday night from here on in……..

Cheers WT, will buy you a beer next time I see you. A contribution to these forums which I don’t think will ever be matched. Chapeau.

Post 4 - Closing Waffle Part 1

This seems like a good time to wrap up the weekly threads.

• Not because "Covid is over" - it isn't; I expect at minimum a few weeks of wind down and then we start to learn what mostly-endemic Covid looks like.
• It's a good reason to stop I think because many of the measures used for these plots are becoming less appropriate as a way of understanding the situation. The hospitalisation and 28-day deaths measures are blunt instruments that don’t well separate “incidental” effects - people going in to hospital or dying from a cause other than Covid, but who have Covid. 
  • During the pandemic phases this bluntness really didn’t matter, as the carnage being writ large by the virus was a hundred times or more larger than the incidental components, but that is changing.  Indeed that bluntness brought very rapid, low reporting lag data which was the most useful attribute, rather than nuance at the level of 1% of the values reported.
  • Recent estimates have been that over 50% of hospital admissions now being incidental, and on the last thread I estimated perhaps ~20% of English deaths were now incidental as of a couple of weeks ago.

It’s not surprising that measures designed for rapid and informative understanding in a pandemic don’t translate well to the emerging endemic stage.  The question arrises as to what should be measured instead as we move forwards.  That in turn is informed by what the threats are going forwards.

As most of us move on to a world no longer defined by Covid restrictions it’s important to keep in mind that not all of us can safely move on, and to do what we can to support those left behind - be it as line managers, friends, people in service jobs or any other way.  These are the first people who will experience any threats that emerge over Covid, so thinking about them is a way to frame my thoughts.

Broadly speaking, I see two separate groups at risk, who remain floating in a sort of limbo between “pandemic Covid” and “endemic Covid”.  I’ll outline the two groups, then give my thoughts on how we might support these groups, which induces thoughts on what the future data sources should look like.

Group 1 are people who have, so far, only had immunity stimulated by vaccination and not live infection.  Ideally by infection after vaccination given the massive reduction in the order of magnitude of risk this brings to all adult ages  Why does this matter?

• The majority of vaccines used - and all used to date in the UK - induce immunity only against one compartment of the virus, the “spike protein”. 
  • This is also (perhaps by coincidence I think, driven by this critical part of the virus still adapting to people) where we’re seeing a lot of rapid changes as the virus evolves,
  •  Omicron has almost broken immunity-against-infection as induced by current vaccines, although immunity-against-serious-illness remains good.  Eventually the virus could evolve enough that both immunity-against-infection and immunity-against-serious-illness induced by current vaccines are broken.  That would be bad for people in group 1.
• Infection by the virus itself induces immunity against far more parts of the virus, making it much less likely that a new variant will escape all the different bits of immunity-against-serious-illness.
• So, people who have been infected are likely to be far more robust against serious illness form future variants in the next few years.  Those who got vaccinated first are far more likely to have survived that immune broadening process.
• Whilst Covid remains pandemic in parts of the world with more serious illness the, the risk of an escape variant emerging risk is probably higher.
• Conversely, those with only vaccine protection remain more at risk if a serious escape variant emerges.
• Key Point: I am not encouraging people to go out and get infected after vaccination. 
  • We all have to make our own judgements based on our medical history, and medical advice where appropriate. 
  • There are plenty of people for whom catching Covid is still likely to be bad news. 
  • As I've said on here before, I stopped trying to avoid it a couple of months back, and I finally caught it 3 weeks ago at a children’s birthday party.  I’ve felt like crap ever since, crashing out by 2 pm every day and needing afternoon naps.  Something like a fast-forward to my 80 year old self except without the deafness.
  • I know others who’ve shrugged it off with far less grief, and a couple who had it much worse. 
  • For many people there’s also an incentive not to catch it until isolation requirements are dropped.  Ride out the next couple of months and perhaps prevalence will remain low until the Autumn, giving a chance for understanding, therapeutics and perhaps vaccination to move on. 
  • It's a decision everyone has to make for themselves, although I appreciate that well qualified immunological and medical advice is not readily available in a tailored way.  Don't forget this is a hobby for me; mine is not well qualified advice.

In general, the people working harder at not catching Covid are those who are more at risk - this is born out I think by some of the serology data on immunity against parts of the virus other than the spike protein, for example the "Roche N" assay in recent vaccine surveillance reports - even accounting for its heavy caveating.

This group could be split in to two sub-groups;

• 1A being those who - due to elevated risk of themselves or close contacts, or due to other reasons are not going to stop trying to avoid Covid.

• 1B being those who are in principle not bothered by catching Covid, but just haven’t caught it yet.

Group 2 are those who have seriously weakened or suppressed immune systems, for example by disease, through extreme age, as a result of medication for cancer treatment or due to deliberate suppression to prevent transplant organ rejection.  I don’t have a good understanding of if someone who becomes immune suppressed after repeated immune exposure to Covid is more vulnerable to Covid than any other disease or not so this is a bit speculative.

There are some other groups but I discount them from some of the rest of this post for the reasons given.

• Group 3 are people who are at high risk from any respiratory virus through general age related frailty or other medical history.  For this group, endemic Covid is added to an existing list of threats.  I don't explicitly consider this gong forwards as  much of what helps groups 1 and 2 can help this group, and they're perhaps more defined by being themselves towards an endemic state but still at high risk.
• Group 4 are those with no immune exposure through either vaccination or infection, but I think that’s a pretty small group these days, almost certainly much smaller than group 1.  The solution is clear and obvious.  Get vaccinated and reduce their risk of whatever comes next.  In a UK context, the size of this groups is small enough not to warrant further consideration now I think.

For groups 1A and 2, not catching Covid remains their priory regardless of the next variants.  For group 1B, not catching Covid only becomes a priority if a bad news variant comes along.

Will most of group 1B catch Covid in the next few months? 

• Unclear; the 3rd dose induced immunity-against-infection is fading and it might fade quite fast as the vaccine/omicron mismatch likely means this immunity is relying on very high antibody levels.  Set against this, cases are falling and the weather is improving as we move towards spring (he says, to the welcome sounds of rain for the first time in 5 weeks… - but it drives people inside and in to more transmissive contact).  Bit of an open question what happens next - do cases crash down, or is there a long tail?  

Post 4 - Part 2

Moving on, the information needed to support those more at-risk groups is information that helps them to not catch Covid, and in the case of group 1A, an understanding of the risk of new variants.

So, what would I do?  Here’re my thoughts, and I think quite aside from protecting the at-risk groups they represent a good insurance policy against the kind of developments we expect whilst Covid remains a problem globally, and whilst we gain confidence that there’s no sucker punch waiting for us down the line.

• Get good quality, responsive, consistent data on the prevalence of Covid:
• Shut down pillar 1 testing completely (the main “Cases” data from symptomatic sampling of the population) in a couple of months assuming all goes well until then.
• Maintain testing of patients admitted to hospital for at least another year; likely needed to maintain infection control procedures for as long as they’re judged necessary.  Also a good sentinel for immune escape variants.
• Move some of the RT-qPCR and LFT resource from P1 testing to an expanded version of the ONS random sampling survey that enrols more people to allow twice weekly updates with good statistical power when broken down to 5 age bins at the level of the English regions.
• Consider using some of the freed up RT-qPCR to expand the Respiratory Datamart sentinel (swabbing of all consenting patients in to some GP surgeries I believe)
• Wastewater testing - this has been used successfully elsewhere to identify completely off-the-radar outbreaks and mike be quantifiable to some degree.

Escape variant detection:

• Maintain our sequencing capacity, and determine a prioritisation algorithm to feed it - e.g. pillar 2 detections with illness well beyond that expected for medical and vaccination history, rapid re-infections detected by the random sampling surveys.
• “Export” all available capacity to areas internationally that are likely variant generation hotspots .  There’s a few different criteria for such areas.

These two sets of information sources can be combined to give an understanding of the prevalence at a regional level perhaps about a week out of data (data collection and analysis lag), and with a bit of analysis of the rate constants and what we’ve learnt about the effects of the weather and schools modelled forwards by a week to give a “nowcast” of the prevalence.

With this prevalence, individuals can then determine their risk level based on their medical history and known risk factors.  I naively imagine that this can be implemented in the NHS information systems with the NHS App as a portal , with some system consuming medical records, individual serology assays where available (proscribed for potentially high risk individuals?), prevalence nowcasts and forecasts and giving the individual a risk score or a risk score forecast.

One could imagine some context for risk scores such as “Low - life as normal”, “Medium - wear PPE in high risk locations” and “High - avoid high risk locations, wear PPE in low risk locations” - give people the information they need to protect themselves in periods of high risk.

My suspicion having watched how fast the Omicron wave happened and how fast Alpha and Delta spiked at universities is that endemic Covid could hit hard and fast in the autumn, and that the high risk period is going to be pretty short.  We’ll find out I suppose!

A key part of this is good PPE for the medium and high risk periods.  For people who are medically vulnerable I’d like to see FFP2/FFP3 mask fitting, user (patient) training and masks provided by the NHS on proscription, along with occasional fit checking.   Some additional thoughts and supporting measures:

• This needs an ongoing acceptance of mask wearing by others, in particular none of the moronic attacks we saw on individual earlier on in the pandemic - and given the strength of the anti-scientific movements over Covid, anti-mask sentiment is likely to hang around.
• Kegal protections should be considered for the most vulnerable, including a legally protected right to wear PPE such as FFP2/FFP3 masks even (especially) in customer service roles, and a legally protected right to WFH where possible at times of medium or high risk (depending on the nature of the workplace).
• A proscription supply of LFTs and FFP2s/FFP3s with qualified fitting etc for the close contacts of the most vulnerable during times of high risk is something to consider.
• At times of particularly high risk, there is the possibility of giving MAB therapeutics to the most vulnerable; these are like granting a part of immunity (that prevents or moderates the initial infection) to people without the ability to mount that response to a vaccine or to live infection.  They’re also very expensive; Covid might be the force needed to drive innovation in animal free MAB production at volume, perhaps using a yeast or or other bioreactor friendly system with suitable post translational machinery.

There are many other steps we can take to reduce the risks to these groups, and some of these steps better prepare us for the next pandemic.

Therapeutics

• The UK and other countries are continuing to evaluate the approved anti-virals.   Having effective antivirals would make a significant different to the at-risk groups moving forwards, and they’re likely to be manufacturable more cheaply than MABs.  These do however need to be used with care as early serial passage experiments have shown an ability for the virus to evolve around at least one of them, and given the mechanism of action of the current anti-virals (key non-structural proteins), forcing an antiviral resistant strain could perhaps drive some of the worse escape from infection acquired immunity.

Further vaccination:

• If we don’t see a change in variants, another dose of current vaccines is likely to spike neutralising antibody levels to the point they offer short term immunity-against-infection for those in group 1; timed right to the next winter wave this could make a material difference to their risk.  The difficulty is in predicting the right time and mobilising both the customers and the vaccinators on the right time scale. 
  • Crazy off the wall thinking would be to try and control when it spikes to give better planning.  Somehow I suspect this is both a dangerously foolish and deeply unethical idea…. 
• Ideally, we’d use a booster dose targeted to the in-circulation variant.  It’s worth keeping doses of different variants on ice; I suspect we’re going to see a round-robin pattern, or at least a hoping around a limited pool of options, in successive years between different RBD configurations driven by sequential immune evasion and the timing of antibody fade.  Perhaps we see hints of this in the oscillating SGTF nature of successive waves...  Some vaccine manufacturers have I think been safety and efficacy testing vaccines adapted to different variants but not doing mass production. 
• I’d get some clever people on gazing at the crystal ball for winter 22/23 and deciding which ones to stock the fridge with, based on the size of group 1 and group 3.

Post 4 - Part 3

More diverse vaccines

• There’s an incredible diversity to the delivery mechanisms and self- or external adjuvanation of the Covid vaccines to date, but almost all target the spike protein only which is what means group 1 remains at an elevated risk for now.
• Valneva stands out to me as a vaccine that covers many structural viral proteins and uses an adjuvant that is associated with strong T-cell protection in other vaccines; and for their claims (no published data last I looked) that their virus produces a broad T-cell response.  There’s a lot there to suggest its use as an additional dose would significantly bridge the gap from group 1 to those who’ve survived their first live infection.  As you may recall, the health secretary took an apparently unprecedented step of making un-evidenced comments on the efficacy of the vaccine under parliamentary privilege, during multiple ongoing clinical trials.  That was when I gave up personal hope of getting Valneva as an additional dose any time soon.  We wait to see which if any if vaccines are going to be available at the individual level on a commercial or proscription bases as we move to the endemic phase.  If I was still in group 1, I’d buy that for a dollar.
• There’s no obvious reason why other viral proteins (Dave Garnett has suggested promising candidates a couple of times) can’t be engineered in to some of the other vaccine platforms as a way of bridging the gap from group 1 to endemic levels of immunity.   Unlike tweaking the genetic code of current vaccines to track variants however, this is a ground-up new product that’s going to need extensive testing.  There is no longer the expediency, nor the market size, nor the government incentives to do this in the record time that the first tranche of vaccines came together in.  I reckon there’s a business opportunity in selling serology assays to wealthy, older westerners to help them understand which risk group they’re in and using that money to develop such a vaccine - with the first approved doses going to those who funded it.  Kickstarter, anyone?

Air handling. 

• One of the big lessons I’ve had in offline experiences in the last 18 months is the lack of understanding in terms of what is practicably and affordably achievable through active air purification indoors and air handling.  I have found the HSE and CIBSE documentation on this re: Covid quite lacking, and contributing to some serious institutional inertia.
• Good advice on air filtration with portable HEPA could make a big difference to vulnerable households - likely with high overlap with those in fuel poverty and so unwilling to heat and open windows in winter.

Critical Point: The measures I give mostly seem to me like really sensible precautions to be ready incase there is a sucker punch waiting for us as we relax in to a post-pandemic world.  Looking at the scale of carnage writ in blood and misery over the last two years, I think it wise to keep a precautionary stance - returning to normal, but with sentinels watching and the most vulnerable protected by systems that can rapidly expand out if needed. 

In terms of hospitalisation and fatality rates going forwards, I don’t think the next 9 months will represent truly endemic levels.

• The last 9 months were largely I think about some people getting the infection without prior vaccination (highest rates of bad outcomes), and some of those in group 1 getting their first post-vaccination infections (~10x lower rates of bad outcomes for any adult age).  Now, almost everyone who survived those 9 months has some form of immunity.  I think it’s reasonable to expect a lower fatality rate when these people get their next live infection; it’s the second live infection that really starts to resemble an endemic situation as it’s the first one that happens against an immune response against a broad set of viral proteins.  The vaccines are a great way of taking most of the risk out of getting to that point, but as I’ve said before they’re the start of the journey to a truly endemic state, not the end.

So, in terms of “are we there yet” - no, I don’t think we are.  To all intents and purposes, for most of us I hope 2022 is basically “back to normal”, but we’re approaching the final destination in ever smaller steps and there’s some yet to be taken. With each step, the at risk group shrinks dramatically.  For most people it doesn’t matter, but I hope this rather long winded and rambling post has given some thought about those people who are going to be slower in exiting the more pandemic side of the picture, and how we might support them.  

Much of what we do to support them could I think also reduce the horrific burden some past pre-Covid winter respiratory seasons have placed on the NHS which, in my politically naive world, means more resources for the rest of the year and a chance for staff to decompress a bit more over Christmas.  

Of course, if we could successfully reduce a lot of other causes of respiratory death beyond endemic Covid using these approaches, it raises rather awkward question about what people are going to die from instead, and if that is going to cost the NHS more or less.  The whole issue of preserving lifespan more than healthspan and the associated costs for society is a whole other debate however, and one with no easy answers other than investing in a healthy population.  (He says, eyeballing the Emergency Tin Of Condensed Milk as he’s pushed through the mid-afternoon energy cliff without a nap).

Beyond all this, helping the world continues to help us.

• There’s been a lot of talk about helping those countries with least vaccination, but by now some of those have “let it rip” to the point the most vulnerable are dead and everyone else has lots of immunity.  They could generally do this by having a 10x (or more) lower proportion of their population being vulnerable to hospitalisation than us, and by having populations more used to death and with lower exceptions on healthcare as manifested in some really horrific times shown to us through the news.
• Perhaps the bigger risk right now are the countries with a mix of zero immunity people (generates lots of chronic cases driving variation) and highly immune people (provides a selective amplification of any variants that escape immunity).  Where vaccine supply is the limit we can help, but often demand seems to be the limit...
• People smarter and better informed than I should think this one over and decide where best we can send all the surplus vaccine that we can pay for to reduce the variant risk - which equates to helping those most at risk.  A productive intersection of helping the vulnerable and acting in our own enlightened self interests.  Something of a generality that helping others helps us in a global pandemic.
• We can also “export” some of our formidable sequencing capacity by determining high risk hot spots for bad variant generation and importing samples.

So, what next?

For me, I hope a corking spring with long, dry, sunny days without a cloud in sight bracketed by mild night rains, lots of great pub lunches, some children’s birthday parties and a Great British Summer with long walks and river swimming galore.  

Exit Stage Left: youtube.com/watch?v=rDyb_alTkMQ&

Thanks for all of it WT. A little oasis of sanity in these strange times. (Apart from occasional barbarian invasions.) 🍺🥃

Hear hear. 

Or here, hare here

Thank you for all of these posts. I hope you never have to do a sequel.

As for your good thinking about how to deal with the future, I fear that sometime this summer, the government are going to basically go "well that's Covid all finished with" and we are going to be in a not much better position than March 2020 when the next nasty variant or nasty virus comes along.

+1. They couldn't give a tinier shit if they tried.

I can't thank you enough. I have read your posts avidly for the past year and have been comforted by your objectivity and wisdom. Information amd understanding went a long way to helping me make sense of a difficult time. 

I wish you a good year ahead with many outdoor days.

Let's hope some lessons will be learned from this real world experience, unlike the ignored lessons from previous exercises.

As a very basic minimum, reinstate the rolling buffer for essential medical supplies, such as PPE. So we don't have to send our front line medical staff into battle woefully lacking protection.

Thanks for all the time you've put in to this over the last 15 months or so. For those who just want to know what's going on with the pandemic, you've provided a lot of very useful information and for those of us who like to nerd out a bit on the data or enjoy critiquing others' work, it's also been an interesting way to waste a few hours every so often. I hope I didn't criticise parts of your analysis too much! I agree it's a good time to stop for all the reasons you give.

Sorry to hear you're currently still suffering the after-effects of covid yourself - get well soon!

And by the way, it seems to have been pissing down here all the time, maybe I should move to the north east.

Heartfelt thanks here too. Who would have imagined two years ago that the best sources of knowledge on epidemiology for the serious non-specialist would be Private Eye and UKClimbing. 

I look forward to your future posts in other fields, energy supply included.

Thanks for all your efforts - A most unexpected but excellent resource this has been on UKC over what seems like a lifetime!

I think we are well beyond thanks now... maybe UKC should do an interview with you.....

...and I guessed that exit Youtube correctly!?

I will mourn the (lower number but still significant) covid deaths and disability to come, be they due to the vaccine hesitant affected by criminal distribution of lies and misinformation or lack of protection for the vulnerable. I hope intelligent swing voters think on what the last couple of years have shown us about the state of our NHS and Public Health and Care systems, about populism and the abuse of social media, and push for proper change.

Many many thanks Wintertree for all the time and effort that you have put into theses excellent posts over the last 64 weeks. I, like many others I suspect, have looked forward to reading your most informative weekly analysis of the situation which I personally did not have the skills required to provide for myself.  Once again - Thank You!

Thanks Wintertree! You have been an amazing source of information all of this time. My boss has looked at me suspiciously a few times when I have quoted a climbing website as one of my main sources of covid information (along with the Zoe app)! The information and surrounding chat you have provided has often been much more useful than the official channels that are available to the care home!! (I have been wearing my FFP2 mask in the home this week due to a covid contact. My boss knew nothing about them vs surgical ones, but by this stage she knows that I have good information on this so trusted me when I said it was safer for everyone so was happy to let me). 

Much appreciated! Hope you don't get bored without all of these posts to create every week!

Another voice of appreciation for all your contribution Wintertree - it's been an essential part of my covid understanding and sanity checking.

I've also enjoyed the relentless but calm savaging of the waves of sock puppets, trolls and general dimwits. Ta muchly! 

Bravo, WT. You've more than earned a break. These threads have been a tour de force of open science, and every (well, nearly every) contribution and comment and discussion has been amazingly productive in terms of increasing the understanding of a very motley collection of people, all of whom were caught up in the same sudden emergency, who had initially come for the climbing and then stayed for the science.

Beyond their analytical value, these threads have beenamong other things and at various times a barometer of crisis, an early warning system, a guide to individual action, and a source of reassurance and disambiguation at a time of crisis when public health messaging has been cryptic at best and reckless at worst. You'll never hear about the countless small gains: the workplace risk assessments that were improved or the policy decisions that were informed by your data analysis and the discussion thereof.

Echoing the offers to buy you a beer. Tan Hill? We could get Rom along: he'll need cheering up now that he's about to be unemployed.

Thanks for all your time and efforts, I've used your work to good effect to dispel misinformation on the social media I'm on - you've no doubt saved someone some harm .

It was a good run. Thanks for all your hard work

Bringing Rom would be a great idea, he'd need to get in about 10 rounds before it was anyone else's turn to buy.

We'd need a bigger pub!

I'd like to say a huge thank you, Wintertree. When the media has been jumping from one sensationalised headline to the next, your weekly "plotting" have provided a very level headed take on the current situation. Always my go to thread on Monday morning!

Many thanks and I hope you recover swiftly.

Giving away your preferred programming language there!  You’re welcome^64.  Spotted the 2^x then - just as well I hope we’re not going to see this carry on as a major news event for another 64 weeks…

In reply to Šljiva:


Rumour has it that it involves plums...  My Deniston's Superb and other gauge-like trees are coming in to their 3rd spring; the Superb was the first to yield fruit.  3 pieces last summer, so high hopes for this summer...

In reply to ablackett:

Thanks.  I can pick your brains, perhaps.  I'm reliably informed you're the one to speak to about contacts for making (or even sampling) the Good Stuff.  Birch syrup, that is.  I reckon it's almost time to tap one of our birches now...

In reply to David Alcock:

Thanks David; I always keep an eye peeled for your posts.

In reply to John Stuart:

Just imagine how much slower I'd be if I'd devoted all the requisite grey matter to learning the details of a fundamentally broken written language!  Interestingly from an ophthalmic perspective there's some evidence emerging that dyslexia/dysgraphia might have one origin in the development of the eyes and the lack of some developmental divergence that normally drives a single dominant eye.

In reply to Michael Hood:

Indeed, but hopefully some of the slightly more devolved agencies are going to keep an eye on the ball for a while, and at least there's "recent living memory" experience if another one does land soon.  

In reply to BusyLizzie:

Thanks; trying to understand this was a key motivator in going down a data rabbit hole; life is better with some understanding.  The first lockdown was a real trigger for rumination on The Past; I recall that one of your posts on a totally unrelated topic helped me deal with some of that past.

In reply to captain paranoia:

Indeed.

The key lesson to me is that we simply can't have science and government diverge as they have been doing for my whole adult life.  The importance of this is only going to rise in the future - trust, mutual respect, scientists understanding the realties of politics and politicians having a good understanding of the powers and limitations of science and scientific advice.  It's hard to see scientists respecting politicians who can't garner widespread public respect.  That feels like an important point to me right now...  

As I understand it, we're still waiting for institutional recognition of what constitutes PPE up to ALARP for Covid.  But, yes, a rolling PPE buffer seems like a no-brainer frankly.  There's been some reporting out over recent PPE purchases; bit to political for these threads but I think having some framework in place governing standards and transparency in crisis purchasing needs some thought as well.

In reply to Si dH:

Rather the opposite; your picking through a couple of the methods and giving counter points to some of my interpretation has been vital I think; as several people have noted the strength of the threads was as much in the input from various people from different backgrounds that were nucleated around the first few posts each week.

Key Point - far more than just my input made these threads so useful

I'm always blown away by the difference in the rainfall numbers for opposite sides off the pennies.  Bad time to move - the fallout of the pandemic has sent rural house prices through the roof around here.  (Meaning they're no longer significantly below many other regions). 

In reply to RSC:

Now we all need to go and find an epidemiology forum and start arguing about climbing on there.  The Eye have had some really on-point takes on aspects of this. 

In reply to Hardonicus:

For some of our little ones it has almost literally been a lifetime.  I imagine you're looking forwards to that changing as much as me, although I did enjoy a break from birthday parties at soft play centres in favour of running around outdoors in the muck.  I've been saddened to see how quickly play parks and honeypot locations emptied of children as things returned to normal.  Coming home exhausted with cuts/scrapes/bruises and covered in mud needs to be a key part of childhood, pandemic or not.

In reply to Offwidth:

As Wintertree, Sr used to observe "Great minds think alike.... As do fools"

Populism is the key for me; I commented above about the disintegrating relationship between science and government; fundamentally, populism seems to me completely incompatible with evidence based thinking and the two can never meet in pursuit of productive outcomes.

In reply to Grumpy Old Man:

Thanks!

In reply to girlymonkey:

Your boss isn't the only one...

Chance would be a fine thing!  

In reply to Jock:

Everyone needs a hobby....  Probably time to move on; will be interesting to see what the less honest pop-up types adopt as their next cause.  My money is on the role of privatised healthcare in dealing with the backlog from Covid, although energy remains on the bingo card...

In reply to Bruxist:

It takes a lot of people to make a good Stone Soup.  Thanks to you for many excellent contributions and indeed to all.

I think Tan Hill could happen.  I'll need to get my pedal-bike mended and get some endurance back!  It's not even downhill all the way home as I have to traverse a number of valleys...

Mumsnet doesn't know what's coming.

In reply to Toerag:

Thanks; it's been very interesting to hear how it's gone down your way throughout.

In reply to Duncan Bourne:

I certainly learnt a thing or two in the process...

In reply to sdw7300:

Getting jostled around by an endless hammer of reports in the news that didn't all make consistent sense is a big part of what pushed me in to trying to understand it all.  Once you go down that slippery slope...  I think some of the reporting has really improved as time went on; Nick Triggle of the BBC in particular.  John Burns-Murdoch of the FT has excelled himself as well; I think he should be rewarded by a stint as a scientific data interpreter to the government.  If there was one take home I'd suggest from these threads it's that there's often a lot more in the data than people think...

In reply to all:

Thanks.
 

Rumour has it that it involves plums...  My Deniston's Superb and other gauge-like trees are coming in to their 3rd spring; the Superb was the first to yield fruit.  3 pieces last summer, so high hopes for this summer...

harvest was non existent this year, and left gathering apples too late but none the less managed a few litres. Happened upon some  “Kleka” - turns out to be juniper, but fortunately tastes nothing like gin!

Thanks WT.....

Some news of the complexity of covid passports in the EU. With luck this might boost the booster take-up a bit.

https://www.theguardian.com/travel/2022/feb/06/bucket-spade-and-a-pile-of-r...

I noted on my FB page this morning that the backlog recovery plan had got stuck in a backlog...

My sister suggested they had realised any plan would involve finding more staff.

I hypothesised that the solution to this would turn out to be outsourcing to private health providers. Purely 'temporarily', you understand...

And that the report backlog was due to the need to negotiate contracts with donors. Sorry, I meant 'providers'...

Same problem in the end: there are currently no extra medical staff except those already working in the NHS.

You know that, and I know that. So where will the staff come from? Hollowing out the NHS, perhaps?

Well, Javid has just revealed the 'plan'.

Doesn't sound like much of a plan.

That won't work either. The NHS footsoldiers bust a gut and put up with all sorts of shit for the NHS, they won't for the private providers. Worst still, all the staffing estimates show a decline overall, so all the extra places Javid boasts about are not even breaking even let alone growing staff capacity, and there is a bulge on the verge of retirement and much better opportunity elsewhere (better pay for less stress).  The only mid-term answer is a massive overseas recruitment effort and that still takes time and training and will piss off their populist voter base.

I think you're missing my point.

I'm not convinced this is a genuine desire to resolve the backlog. I fear there are other motives.

This won't happen, the private providers will entice them in with promises and money. Plenty of people leave healthcare to go and earn more money doing something else in order to pay their mortgages. Private providers will simply lure them in with more money, the same as healthcare labour agencies do now.  There are loads of agency nurses in the UK, both UK bred and imported.

I was making a point about things like lower grades' regular bits of unpaid overtime and flat rate pay (often long hours) cover for ill/isolated colleagues in the NHS. The private providers can pay them as much money as they like but the cost of the outsourced NHS services will be more than in-house (NHS) and work will happen slower as private providers don't function in the same way. Some consultants will obviously have great opportunities to make more money but even that capacity on the large scale is fairly saturated. I simply can't see how things can improve with or without more use of the private sector without a change in visa regs for way more medical staff (especially so for nurses).

Thank you for all the great data analysis and commentary. It’s great to be able to have a bit more of an insight than simply ogling the dashboard would suggest.

There was a podcast by the guy who runs ZOE the other day suggesting that the reduction in cases is due to the change in policy whereby positive LFTs no longer need to be confirmed by PCRs and as a result some people might no longer be bothering to record positive LFTs. However I’m not convinced as the number of pure PCR positives has also been reducing (looking at the data on the England dashboard). The number of tests has also reduced but that could reflect lower prevalence as much as behavioural change.

I wouldn’t be in favour of abolishing mass testing until spring next year. On a human level, lots of people want and deserve to know if they have Covid or just a cold. Not least because they might be considering whether to meet with elderly parents or go to the pub (although it would be nice if people didn’t do either with a cold, never mind Covid).

I like your idea of personal risk ratings. I think we all know whether that’s going to be implemented…

Not sure group 1 divides neatly into A and B. I think there’s a significant group in the middle who take some precautions in some situations. For example, I got to the wall because that’s important to me but I’m keeping away from the office and indoor hospitality (with the very occasional exception of a quiet pint if it’s virtually empty) and I’ll wear a mask in the supermarket. However I’ll make an occasional appearance in the office once cases have reduced to more reasonable levels. I suspect a lot of people fall in this category - still taking some precautions in some situations.

Seems Javid has said he will recruit 15,000 healthcare workers from abroad by March including 10,000 nurses. A good start.

What he doesn't say is it will take quite a while to train them and assess safe standards, nor is there much about the 40,000 and growing current vacancy level in nursing. When the tory coalition came in, after the crash, the number was a few thousand.

https://nursingnotes.co.uk/news/workforce/figure-reveal-sharp-rise-in-numbe...

Thanks; over to you know!  Understanding the real impact of Covid seems almost entirely beyond the death figures as we move forwards and in to solidly actuarial territory.  

In reply to Misha:

Disengagement can only go on for so long as a cause of falling numbers; and I'm skeptical that's the cause here given the downstream measures.  I'm not convinced either!

That doesn't need mass testing though, that needs good availability of test kits to those who want them or benefit from them.

Indeed.  I'd like to see LFTs made available to those who want them, but once isolation rules are dropped (more on that below...) I don't see the point in obligatory mass testing.

Indeed.  I'm not sure things will change as much as we'd both like following Covid, more a return to the old ways.

Sure; but the write up ran to requiring 4 posts without getting in to the nuance...  It's always a spectrum with risk aversion and people.

In reply to thread:

Didn't see this coming - PM announces plans to review dropping all remaining rules including self isolation a month early - https://www.bbc.co.uk/news/uk-60319947 - that's not going to land well with those of a nervous disposition...

Re ZOE thing, https://nitter.pussthecat.org/PaulMainwood/status/1491122745211781121#m

Also, obviously, as others have already said, massive thanks and wish you every success in whatever you choose to do with all those hours you'll get back on Saturday afternoon.

I'll be honest - it was a lot easier to see continuation of the self isolation rules as a good idea when they were mostly happening to other people! Having had a gradual circa 3 week spell of various people at home as one after the other gradually got infected (if I were to characterise it - a day of cold symptoms, testing positive after becoming asymptomatic, then 5+ days of childcare&work combo whilst being stuck at home perfectly fine climbing the walls), I am far more ready to be done with them now. 

Squirrel...?

ps. Thought you might have seen the 5 second JET burn...

Indeed; some cadence that, when was the last one, 1997?  I’ve not got any faith in the big Tokamaks JET feeds in to, as impressive as JET and the new burn are.  The nearby MAST Upgrade is interesting, and other things are afoot in the general (geographical) area…

> Squirrel...?

It just could be…

Snap.

As far as I can tell, mandatory stay home level isolation (rather than stay out of other properties, say) just creates a punishment lottery for people who do what appears to be their role in the not quite spelt out plan of moving to endemic status.  Stay-home level isolation is a logistic nightmare.  I was lucky enough to have a partner who could do the school run etc, but I can see how it causes massive headaches for some people who can’t even walk a kid to school.

Not sure how allowing people back in to the workplace is going to go with covid still being a noticeable disease…

They went for a long time without campaigns running tritium, obvs reasons if you want to be changing things and iterating. There's actually some whole life discharge limit that will ultimately be what spells the end of jet iirc. Which seems insane.

Agree that mast and super-x are some of this decade's most exciting things that nobody's heard of.

Uncle Jeff's molten metal piston engine though??? Really??!

We always had someone to do school runs, thankfully, but neither of our children get on well with LFTs at all, and it creates extra disruption to routine...

Yes, I suppose that's my other reflection, which is that I'm lucky to have reasonable control over where I work which means I don't need the legal protections to be able to do a more "sensible" (no indoors) level of self isolation should I need/choose to. For those who have less choice, I can see aspects of this being far less appealing.

My understanding is that this JET campaign has been repeatedly delayed as they kept raising the targets for these burns, as they know this campaign will be the end of the device.

Somewhere buried in the code inside the MAST facility there may even still be a few lines I wrote.  

It deserves a Nobel Prize for sheer off-the-wall lunatic thinking, and I really hope they get it to work.  It's just mad.  I can't think of anything quite like it; perhaps a Huygens' engine.  The Nazi Lippisch P.13a deserves an honourable mention for similar technological mismatches - a ramjet powered interceptor that would have burnt coal dust.

But there's a heck of a lot of other stuff going on that's not based around giant steam driven pistons, and the private investor money has moved up from 7-digit to 9-digit numbers over the last decade.  I gather the MIT gang had a 9-digit number agreed - in principle - with investor if their coil test article passed its tests, which I think it has.   Quite a few other private parties with more compact devices are plugging away; I think there's now two superconducting compact tokamak businesses in the UK....  Exciting times.

Something that's gone pretty quiet in the reporting - but not the data - in the second year of Covid is the stark links between being on the wrong side of inequality in Britain and the outcomes of Covid.  

In reply to thread:

The death certificates daily count is starting to plateau as its extra reporting lag plays out.  It's still becoming a smaller fraction of the 28-days dashboard measure, suggesting perhaps that the amount of "incidental" deaths under that measure continue to increase.

One thing I didn't cover in my "what would I do next" posts is to work on reducing the latency of death certificate reporting, and to give it age and regional dimensions to better supplant the dashboard measure.

A plot 18 update shows all measures in decay in all regions with an accelerating pace of decay (exponentially speaking - but applied to ever smaller absolute numbers).  A hypothetical "from Covid" version of this plot would likely be falling faster for hospitalisations and deaths, as the incidental component rises.

At these kind of rates, it's another month or so before everything might settle down to the kind of low numbers seen last summer; at that point wanning of immunity-against-infection will I think contribute quite a lot to the behaviour of infection; who knows what cases will be if isolation requirements are dropped...  

I guess it depends what you mean by mass testing. Sounds like we’re on the same page that testing should be accessible to those who want it. So I’d opt for LFTs being easily available and the ability to mail order a PCR. We don’t need as many walk in / drive in centres, though it seems sensible to mothball them in case they are needed again and leave a few in places where there is still sufficient demand.

Ending self isolation a month earlier doesn’t feel like a great idea. Late March would be more sensible as there should be less Covid around by then and we would be out of the winter spell (though doesn’t feel like we’ve had a winter this year - just as well!). I don’t think it would be disastrous given where we are but it seems a bit unnecessary to rush this.

Edit - I always thought that the absolute stay at home rule was a bit barmy. If someone lives in a separate house, I can’t see any issue with them going for a walk somewhere quiet (potential issue for someone like myself living in a block of 400 flats but even then the risk seems limited if wearing a face mask). I guess they wanted to be absolute on this to avoid grey areas and people increasingly pushing the boundaries. Yet it could have discouraged some people from getting tested in the first place and those who really wanted to break the rules in a significant way did so anyway… 

What a piece of luck that he's got a mate who's father in law runs an outsourcing business in a country with lots of English speaking doctors and nurses that get paid far less than in the UK.

Yes. For all I have been a massive advocate of playing everything cautiously and sticking to the rules, I have always reckoned that if I had to isolate then I would still go for walks and runs. I have plenty of places to go away from others. I have also delayed testing when I thought there was any vague chance of being positive until after my run or cycle. If someone has access to outdoor space away from others, then I don't see any issue

There has never been an issue. It was obvious from before the first lockdown that social distanced exercise with good hand hygene was a vanishingly small risk. That aspect of the isolation rules was always plain wrong.

The fundamental problem with dropping isolation rules too early is it exposes those (generally the most disadvantaged) who know they have covid but are being forced into to work by bad employers. Plus of course their work colleagues and anyone near them on public transport. It's the exact opposite of an appropriate public health response.

Another vote of thanks here, Wintertree! Your weekly threads have, as others have said, been an oasis of sanity in a desert of misinformation and hidden agendas. The amount of work you've put in has been phenomenal. Have a well-earned rest.

Funnily enough a PR puff piece just landed on the BBC for Tri-Alpha.  This appears to have emanated from a November 2021 press release.

https://www.bbc.com/news/science-environment-60319398

Forbes have recently run a piece on the increased scale of fund raising going on in the world of commercial fusion development (which is entirely devoid of giant Tokamaks, some are smaller high field versions and others are entirely different reactor designs). Interesting titbit I'd missed is that TAE and CFS are cross-licensing technology including CFS' magnets which is one of their really big developments. 

https://www.forbes.com/sites/mergermarket/2022/01/19/fusion-power-businesse...

Helion are starting to make big claims about electrical net positive by 2024.  There's $ 0.5Bn through the door with another $1.7 Bn investment lined up on milestones.

https://www.heraldnet.com/business/can-fusion-powered-helion-energy-change-...

Compare ITER, estimated total budget on the order of $50 Bn.  It's doing little technological pathfinding for the investor driven programmes, and it's never going to have power generating capability.  DEMO, the downstream project intended to show electrical net positive is set to start around 2051.

Very exciting times - after 15 years of fascinating progress and ever increasing prototype capabilities, staff size and funding it's make or break is approaching for the private fusion world in the next 5 years.

If someone does succeed, ITER is going to be the most expensive elephant in the room.   Well, it already is when you look at cost scaling models of ITER > DEMO > power generation and compare it to where renewables would be by the time of the first commercial plant around 2070.   It's just a question of what's going to obviate the need for ITER first, half a century of development in renewables, or the next half decade of commercial fusion?  At which point it seems the plug on ITER should just get pulled.  Perhaps the French will end up farming mushrooms in the reactor building, as happened with the Superconducting Super Collider tunnels in Texas...

The most exciting part of the renaissance in non-tokamak designs are the doors these open towards viable fusion powered or fusion boosted rockets.  Just as the right sort of orbital launch capability starts to look viable.

The flip side of all this is that the emerging step change in orbital launch costs and capability's combined with practical superconducting cables is the emergence of space-based geostationary orbital solar farms for terrestrial power.  Something the UK Space Agency (yes, it's a real thing) is starting to take an interest in.

We're dropping all 'emergency measures' as from the 17th i.e. complete relaxation of all restrictions, both on island and travel. LFTs will be freely available, as will PCR confirmations. Jersey's doing similar from the end of the month.

Report that the ONS infection survey will be scrapped in April: 

https://inews.co.uk/news/politics/covid-testing-gold-standard-ons-testing-s...

I suppose the UKHSA weekly flu surveillance reports would continue, but that would be it for publicly-available data on covid. Given the purpose of the ONS, stopping the funding would be a very strange (and quite obviously politically-motivated) curtailment of their remit.

Excuse me whilst I go and scream very loudly in to the void.

That's the one part of the whole shebang that we should both keep and improve as a sentinel for the next year. The sheer quantity of scientific understanding that can come out of it would be worth the cost alone, let alone it's role in understanding how we're normalising this virus in to our viral pantheon.  A once in 5 generation chance to instrument the way a novel virus moves from pandemic to endemic and to look at how external forcing, seasonality, weather and big events affect it - absolutely priceless information for a country that has aspirations to be a global knowledge economy.  I honestly don't think I can rant enough.  Nothing to be gained, everything to be lost.  Both in terms of sentinel capability and learning.  Which we need, because biosecurity in a degenerating climate is an increasingly big thing.   Rant rant rant.

And breath.

Indeed.  

Which in terms of community cases is going to become garbage-grade once the isolation requirements are dropped I suspect.  

La la la, fingers in ears, I'm not listening.

Got Brexit done.

Got covid done.

etc.

Of course, the answer is to outsource ONS testing to a mate. Then you can bung as much spending as you like on it. Just be careful not to put too much faith in the resulting data...

Don't they have something called the space catapult involving using knicker elastic to fling small satellites into orbit.

https://sa.catapult.org.uk/

You jest, but I reckon that non-rocket space launch is going to become a big thing from 2030 or so onwards.  Lack of demand has been the main barrier to its existence.  With an order of magnitude increase in humans and tech launched in to space looming large, the demand for energy, propellant, food and water in orbit (and beyond) is going to rise accordingly, and catapult launches are a ~100x less energy intensive and far less materials intensive way of putting these things in to orbit than chemical rockets.  The Quicklaunch space gun people have gone dormant (for now), but Spin Launch are dong some crazy things.  Who knows what else is in stealth mode.

Putting the SAC to one side, the UK actually does quite a lot of satellite stuff - more than most people realise.  The government over-egg it by including satellite TV revenues in their headline numbers for the UK space sector, but even so it's a pretty active area.  SSTL is the obvious example but there are many more.  

Then there’s Reaction Engines.  

(One can't fling satellites in to orbit, only in to space.  All orbits are closed, meaning the satellite will return to the launch point with a big kaboom as the planet gets in the way .  You have to have some small rocket stage included in the catapult payload, to modify the orbit once above the atmosphere to the desired, non-lithobraking orbit)

They've come a long way from a control centre run by BBC micros (the UOSAT days...).

Now that was before my time… But, yes, SSTL have come a long way.

The last and only time I did science with a BBC was doing gas liquid chromatography on soap extracts in the mid 90s; this was to assay the glycerine content in the quest for a better transparent soap.  We moved from analog chart plotters to digitised DAQ; a bit of analogue electronics later and the two channels’ flame ionisation detectors went to analogue amplifiers converting them to the range of the analog joystick input port on a BBC model B.  These got logged to a 5.25” floppy disc and then processed in Visual Basic on a PC.  One of the great things about recent years is that Arduino type stuff and the Raspberry Pi have seen a return of the highly accessible analog and digital IO that drove a wave of innovative, in-house DAQ automation in the 80s and early 90s.  It’s mad how great home computers were for this and then how difficult it became without serious investment in hardware and software development.  

I don’t think people can be forced into work if they have sick pay (if they don’t or it’s limited to statutory, that’s a different issue). There’s nothing to stop someone who tests positive to take several days off even if they feel well enough to come in. They can just say they’ve got Covid and not well enough to come in. A doctor’s note is normally required for more than five days off but five days plus at least one weekend is long enough for most positive cases with mild symptoms to get better and become a lot less infectious. Whereas if it gets worse they can obviously get a doctor’s note. 

Yeah. I used my little Jupiter Ace for my final year project to control and ultrasound range detector and stepper motor scanner drive. Piss easy to add a PIO and write some Forth words to control it all. Having to save to tape not so great. So I added a battery-backed RAM* and figured out how to re-connect the stored words into the vocabulary.

I'd added a real keyboard (from a Camputers Lynx...) during my industrial year, by re-coding the scan, and hacking the EPROM. Finding an EPROM programmer these days...

* I dug it out a few years ago. The code was still there... Keyboard had disintegrated, though...

I suppose I ought to port the VHDL ACE I wrote some time ago to a cheap FPGA dev board; a Cyclone or something...

I once visited a bipolar IC fab owned by Plessey and they were doing the test on packaged parts with a homebrew system based on a BBC micro.

Which reminds me:  

Q: What's the difference between INMOS and Plessey?

A: One has a chip full of skips, the other has a skip full of chips.

https://www.spinlaunch.com/

Not knicker elastic, but no less surprising

They had the spin launch device on the BBC tech news "Click" show a couple of weeks back. A truly amazing thing.

youtube.com/watch?v=8dYwzC2qaDQ&

Yes those in insecure employment can always choose (others emphasised that choice here before...I don't see it as a real one) and possibly not get paid or possibly even risk their employment and yes nice middle class people won't be much affected (other than maybe being more likely to end up on a HR sickness policy if they have other conditions). Covid was always a very strongly class and co-morbidity biased illness.

The NHS has useful tips which don't include don't be someone with a poor immune response.

https://www.nhs.uk/every-mind-matters/coronavirus/tips-to-cope-with-anxiety...

Welsh minister on the BBC breakfast news just now pointing out there was no meeting with welsh health ministers, Welsh CMO etc and no scientific evidence they are aware of to justify removing the legal requirement to self isolate as yet.

Stopping the ONS work is up there with the Cygnus debacle.

150,000 person study in the US says there is a large increase in cardiovascular risk after Covid infection.

"People who had recovered from COVID-19 showed stark increases in 20 cardiovascular problems over the year after infection. For example, they were 52% more likely to have had a stroke than the contemporary control group, meaning that, out of every 1,000 people studied, there were around 4 more people in the COVID-19 group than in the control group who experienced stroke.

The risk of heart failure increased by 72%, or around 12 more people in the COVID-19 group per 1,000 studied. Hospitalization increased the likelihood of future cardiovascular complications, but even people who avoided hospitalization were at higher risk for many conditions."

https://www.nature.com/articles/d41586-022-00403-0

I almost posted the Ars write up of this.  The sample uses data from March 2020 to mid January 2021, so it almost entirely pre-dates vaccination, and so studies the effects of zero-prior-immunity covid infections.  I was pretty disappointed that Ars didn’t spell that point out.

For obvious reasons, that’s as recent as recent as they could go for infections and cover a year of medical history post-infection.

Given how much the infection:hospitalisation and infection:death rates have dropped since then as immunity levels rise across the population, I don’t expect we’ll see anything like this level of effect from current infections. Immunity levels are going to keep rising for some time yet.

What’s missing to help us understand the context for the risks of a high immunity coved infection is comparable data on illness in the year following other respiratory infections; I’d love to see the voluntary ONS survey test for other infections and link to medical records to start getting this data set; both for context to help understand endemic covid and to start understanding the true cost of the respiratory viral pantheon.  Doesn’t look like I’m going to get my wish come true...

well, the Oxford/ONS survey is not testing for other infections, but they did recently email me to say they want to access my medical records for the next ten years, so it sounds like they are doing half of that…

I didn’t know you were donating your blood for science - excellent. Another poster said last week they’d been asked to give permission to link records for a decade.  Expanding this to many other pathogens would be awesome. There’s literally billions of dollars being spent on longevity drug research yet there’s comparatively little being spent on studying the way diseases weaken us towards an earlier death.  The random sampling Covid surveys show what’s possible.  

It’s bonkers, but much more easily aimed than a Gerald Bull style supergun. Rumour has it that the prototype sends about 90% of its projectiles horizontally onto a nearby USAF test range.  Testing both hypervelocity impactors and protection against hypervelocity impactors is of great interest of late. So, unusually for a space launch business, Spin Launch should be able to serve an additional, non-space market throughout their development cycle.  That’s a pretty big boon.

OK but if it increases risk of stroke by 50% and risk of heart failure by 70% and that's based on 150,000 people then minimising cases with masks etc is prudent until somebody gets enough data for the post-vaccination infections to show that it is all OK.  

Mr Wintertree, just about everything that could be said has been said above so I'm just going with a heart felt thank you very much. 

Cripes!

do you think you could fit one on a zumwalt?