Covid-19 - where are we now?

I wrote this article on another platform and it got lots of interest and some engaging comments as well - please like and share and comment if it gets the juices flowing!

We have short memories and we want yes or no answers.

This is problematic and one of the reasons why life can be tough. Solving problems can be tough. Knowing what to do can be tough. Life isn't yes or no.

This post might upset a few people. People like to pin their colours to the mast. I prefer to switch and update my position when I become aware of new information and stay open-minded. Never a flag-waver for either side - rather, criticised by both sides who try and put me in a box when I just don't belong in one.

The corona post last week was timely and a week on we need a bit more revision and debate I think from the posts I'm seeing and the info I'm seeing/what the data is telling me.

Relevant updates

1) we shouldn't forget we were a few weeks behind Spain, Italy and France before - back in March. Of those three countries, two are having significant problems again. We must remember - deaths will lag 3-4 weeks behind case spikes. Spain are back to 250 a day dying from 900 a day at the peak in late March/early April. The scarier thing is the trend going upwards at such a fast pace - like before. French deaths however are not rising much if at all. There may be a technical reason I.e. what's getting counted as a covid death but perhaps it is better to give this data another week to play out and see what it looks like next weekend.

Italy new cases are on the rise for sure but currently behind the UK. Not easy to interpret.

2) there are some pretty silly and some pretty damn good arguments out there that need some airtime. A big one is "we are testing more widely so there are more cases". Yep - an element of truth. The best way to look at case numbers (it is still desirable to look at them because of the 3-4 week lag in deaths - if we wait 3-4 weeks the consequences COULD be severe) is combined with looking at what percentage of tests are positive. At the moment UK wide that is about 2.5%. Yep - of every 40 people tested one is positive. This is compared to nearly 40% in early April when there were just not enough tests and you only got one if presenting multiple symptoms or were being admitted to hospital (or worked in a hospital). That's obviously a massive difference.

3) there is wider potential "T-cell" immunity. I can't comment from a medical perspective. There seems to be some credibility to this argument but it would be unwise to put all our eggs in any one basket at this point. Massive bonus if true.

4) there are massive downsides to lockdown. Since April I've talked about the economic damage and resulting loss of life. I've even braved the phrase "acceptable level of death" before. We are facing that reality again. No consolation if you've lost loved ones as many have this year, to covid or anything else. It seems reasonable to believe we will avoid national lockdown again at almost all costs. Undiagnosed cancer alone is being talked about as claiming tens of thousands of lives that it otherwise would not have done. That's equivalent to the current death rate.

5) not locking down was not a silver bullet. Those on the sceptical side are obsessed with Sweden it seems because of their "great results". They don't tend to look at the actual data it seems. Even in Sweden there was a significant contraction in the economy and there was already a far greater rate of unemployment than the UK. I.e. People locked THEMSELVES down, started saving, stopped spending etc. So many people controlled themselves. Sweden's unemployment rate is worse than ours after the financial crisis of 2008. Don't sit thinking Sweden know all the answers - they really don't. Their first wave also amplified until mid August so the fact figures look OK today is a misnomer when compared to UK, Spain, France, Italy.

6) communications are rubbish. 27% of people testing have no symptoms at all. Some are testing for selfish reasons I.e. been on holiday or going on holiday. Pretty disgusting. Some are testing because they don't know they shouldn't be testing I.e. they've had a track and trace text. That system is a total mess.

7) Japan still interests me an awful lot. The April cases had significant London concentration, and back then it was already obvious that confined spaces were an issue. Things that got very bad press in March were the Cheltenham festival and a stereophonics concert. However I'm convinced that the root of an incredible number of cases will in time be proven to be the tube and public transport in general. It moves so many people around - pre-pandemic declaration it was a deathtrap. Tokyo has a more dense population and similar/busier mass transit systems but the whole of Japan have seen only 1500 deaths. No lockdown. Better economic performance than Sweden. Much more relevant example just from a data perspective. The differences - 100% wearing masks on the aforementioned deathtrap public mass transit systems. Better hygiene. Better awareness and epidemic experience. They had a wobble and got things right back under control. Incredibly well managed. Should we not learn from Japan instead of being obsessed with Sweden if we are going to be sceptical?

8) excess deaths have been interesting thus far from an unbiased data perspective but are losing their edge. There will be these trailing excess deaths too from cancer as mentioned above. Does that make them covid's fault or the government's fault/the lockdown's fault? Probably the latter. So we need to search for other solid metrics. People on ventilation is a solid one, hitting a low of 50 around the UK in August, now back up to 120. Once again this will lag behind cases but by 1-3 weeks rather than 3-4 for deaths. So it is "faster".

9) is the viral load per case being received lower now? Does that result in less serious cases? Again very possible but medically I can't tell you. Seems it might be possible. More time and evidence needed there. Distancing and masks potentially contributing positively here.

10) what are these nonsense rules with all their exemptions? Can I really not see friends at my house but we are OK in the pub? That's currently the case in our local lockdown in Solihull, fully nuts i know but keeps the cash registers chinging.....

11) curfews. Looks a definite. Nightclub industry fully decimated. Should not take much off pubs and restaurants though and be a lot of noise about it but limited economic impact.

12) masks. It is OK to dislike them or even hate them and still wear them. It doesn't make you a sheep. It is for those not medically affected a bit of an inconvenience we just need to get on with at the moment in my opinion. It isn't "oppressing your freedom". There's serious human rights issues that COULD be on the table in the near future thanks to covid/the coronavirus act. This isn't one of them. Save your breath and energy for when you really might need it. Cry wolf on the piddly stuff and it will dilute the message on the much bigger stuff if and when it becomes an issue.

13) some smart people i know are betting decent money on "no second wave" but more the continuation of the first wave. I.e. this is the "dance" in the Pueyo viral article from back in march (have reshared it below). Right at this minute the dance isn't going well and the R rate needs to come down IF the virus is as deadly (back to loads etc) as it was in March/April. The next 3-4 weeks will tell.

14) the average age of those with the virus is lower than it was. A few explanations. A) the older are taking many more precautions B) the young are irresponsible and some are even trying to get it. C) those in key worker roles are younger as a rule and are the most exposed versus those working from home.

15) there is a false positive rate on the tests. The more tests the more false positives. Not all the positives have the virus. This is an interesting argument but can only be presented in light of the false negatives too of course. Articles about this tend to be one-sided. It seems a weak argument. The best data is showing that there are as many false positives as false negatives and the number is under 5%. This is still way too high and tells you how quickly tests have had to move without being anywhere near perfect. The failure rate on both ends is much more relevant than the one sided discussion which looks to be a red herring.

16) treatment overall has moved on. Better PPE and no ventilator shortage. We learn fast and the April hospital scenario has been learnt from.

17) IF we needed the extra capacity which still looks unlikely - nightingale hospitals can reopen within 48 hours. This is excellent excess capacity if needed.

18) school closures look to have been a poorly informed mistake which caused much more harm than good. These mistakes are still being made on a smaller level. Until we don't panic about 1 or 2 cases we won't move on from here. The issue is the lack of evidence that children are transmitting the disease a lot if at all. Particularly younger ones.

19) going into autumn looks less problematic than first thought according to some experts. One very balanced but sceptical expert who I've enjoyed listening to is prof. Carl Heneghan who is a very credible one. Doesn't go as far as the anti-maskers would like but asks all the relevant questions and has a great day to day relevant job/brief/experiences to put him in position to comment. Even so he released a paper today which looks like it has been released too quickly talking about Spanish cases so it will be interesting to see how he handles that. One really good point he has made is that early September normally sees a 4fold increase in respiratory infections/coughs and colds as kids return to school and seasons change. Nothing to do with Covid but 4x the people coughing and sneezing when everyone is already paranoid.....won't help regarding those taking tests at the drop of a hat. Prof Heneghan suggests the end of winter will be more susceptible to more fatal covid cases than the start of autumn.

20) we need a reset. We need to live with some covid deaths. We can't be looking at things saying "covid deaths up 50% locally" and it goes from 2 a week to 3 a week. There's a long and tragic list of things that kill more people than covid if things just stay somewhat sensible.....life has to move on for the sake of life itself.

Please like, love, share, comment and debate - well done if you got to the end!

86

Sue Sims, Patrick Alan Sullivan and 84 others

135 comments

13 shares

Like

CommentShare