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1 minute ago, Badger said:

The Guardian's article may well have been wrong - if the reports about Cummings trying to hurry the committee are correct, it certainly is. However, if the Cummings article is correct, it also means that the govt's case that is was merely "following the science" was deliberately misleading.

To my mind, the govt telling lies about whats guiding its actions is a bigger story than a newspaper getting "an exclusive" wrong. Of course, it is just as possible that the Cummings story is incorrect. We don't really know yet and might not for years, if ever.

This whole “following the science” is a convenient soundbite Badger but that really is all it is and I wouldn’t get too hung up about the phrase, the science, particularly in this pandemic is inexact and comes from a range of different potentially conflicting disciplines. 

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11 minutes ago, Van wink said:

This whole “following the science” is a convenient soundbite Badger but that really is all it is and I wouldn’t get too hung up about the phrase, the science, particularly in this pandemic is inexact and comes from a range of different potentially conflicting disciplines. 

I tend to agree that it was just a "convenient soundbite."

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14 hours ago, Van wink said:

Very interesting analysis of hospitalised patient outcomes which I have pasted in full as its behind a paywall. If you told people that for those hospitalised it was as lethal as Ebola there may be less willing to ignore social distancing

Covid-19 death rates are comparable to ebola for hospital cases, NHS finds

 
Rhys Blakely, Science Correspondent
Wednesday April 29 2020, 5.00pm, The Times
Ebola was first identified in 1976 in what was then Zaire and is a rare but highly dangerous and much-feared virus
Ebola was first identified in 1976 in what was then Zaire and is a rare but highly dangerous and much-feared virus
BAZ RATNER/REUTERS

More than a third of NHS patients ill enough to be admitted to hospital with Covid-19 have died, a rate comparable to that seen in ebola wards in Africa, scientists said today.

Researchers gathered data from almost 17,000 patients admitted to 166 NHS hospitals between February 6 and April 18.

By that time 49 per cent had been discharged alive, 33 per cent had died and 17 per cent continued to receive care. The study is continuing and the scientists behind it said they had found Covid to be a complex disease quite unlike other respiratory viruses. The details of how it kills people were still unclear, they said.

“It's a common misconception, even today, that Covid is just a bad dose of the flu,” Calum Semple, a professor in outbreak medicine at the University of Liverpool who is leading the study, said. “I'm going to choose my words very carefully here: Covid is a very serious disease.

“Despite the best supportive care that we can provide, the crude case fatality rate for people who are admitted to hospital – that is, the proportion of people ill enough to need hospital treatment who then die – with severe Covid-19 is 35-40 per cent, which is similar to that for people admitted to hospital with ebola.

“People need to hear this and get it into their heads because the reason the government is keen to keep people at home, until the outbreak is quietening down, is that this is an incredibly dangerous disease.”

The study followed patients for 14 days. Some of those receiving care were expected to die, bringing the case fatality up from the 33 per cent reported in a paper released yesterday to somewhere between 35 and 40 per cent, Professor Semple said.

He stressed that Covid-19 was not as dangerous as ebola for everyone who caught it. The vast majority “do not come into hospital and will be at home with a very unpleasant flu-like illness with a severe chesty cough and myalgia [muscle pain] and a runny tummy,” he said.

However, he said that social distancing remained necessary for the time being and he had been frustrated by “egregious examples of selfishness, where people think it’s okay to meet up in the park”.

Ebola, first identified in 1976 in what was then Zaire (and is now the Democratic Republic of Congo), is a rare but highly dangerous virus. It can cause fever, body aches, diarrhoea and sometimes bleeding. Professor Semple said that cases could also be mild.

The new study, the largest conducted in Europe, confirmed several previous findings: Covid-19 is more dangerous for older people and men fare worse than women. However, it found symptoms to be far more diverse than the cough and fever that the public had been asked to look out for.

Symptoms came in three clusters: respiratory (cough, sputum, sore throat, runny nose, ear pain, wheezing and chest pain); systemic (myalgia, joint pain and fatigue); and enteric (abdominal pain, vomiting and diarrhoea).

The study has not yet been peer-reviewed but Professor Semple said a preliminary analysis of the data suggested that worse outcomes seen among some ethnic minorities could probably be attributed to social deprivation rather than underlying biological causes. “Ethnicity in itself is not what's causing poor outcomes, but rather people from black and other ethnic minorities are having poor outcomes because of their social circumstances,” he said.

The analysis also showed that a large number of Covid-19 patients admitted to hospital died on a ward and had not been taken to an intensive care unit. More than 80 per cent of those admitted had remained on a ward. Of those, 31 per cent had died.

“The purpose of intensive care is to give people a chance of meaningful survival, of returning to a quality of life that they would want. And in many cases intensive care simply isn’t able to offer that,” Kenneth Baillie, of the Roslin Institute at the University of Edinburgh, said.

Decisions had been made by weighing the needs of each patient and had not been dictated by the availability of intensive care beds, the researchers said.

The median age of the patients included in the study was 72 and for those who died it was 80. The median duration of symptoms before admission was four days. The median duration of a hospital stay was seven days.

The most common underlying health conditions were chronic cardiac disease (seen in 29 per cent of patients), uncomplicated diabetes (19 per cent), non-asthmatic chronic pulmonary disease (19 per cent) and asthma (14 per cent). However, almost half of the patients had no reported underlying illness.

“Hospitalised cases of children under the age of 18 account for less than 2 per cent . . . those under the age of five account for far less than 1 per cent,” Professor Semple said.

Peter Openshaw, professor of experimental medicine at Imperial College London, and co-lead of the study, said: “From the point of view of the immunology, the disease is a rich and complex one. Every day we’re learning new things about it, new tricks that it seems to deliver, new ways in which it challenges our management.”

Coronavirus in numbers
Study of NHS patients

72 — The median age of patients admitted to hospital

80 —The median age of those who died

0.8 per cent of patients were were aged under five and 1.4 per cent were under 18

60 per cent of patients were male. “Those who have poor outcomes are more often elderly, male and obese,” the report says.

88 per cent of those who died had an underlying illness

But 47 per cent of those admitted into hospital had no underlying condition

For patients who received care on a general ward, 55 per cent were discharged alive, 31 per cent died and 14 per centremained in hospital.

For those admitted to critical care 31 per cent were discharged alive, 45 per cent died and 24 per cent continued to receive care.

61 — median age of those on ventilation. Only 20 per cent had been discharged alive by April 4, 53 per cent have died and 27 per cent are still receiving care. By contrast, for influenza patients ventilated in ICUs in 2009 the death rate was 31per cent

The case definition of cough and fever, if strictly applied, would miss 7 per cent of hospitalised patients

4 per cent of patients presented with only stomach problems or other intestinal symptoms

Pregnancy was not associated with a higher risk of mortality, unlike influenza. The share of pregnant women mirrored the proportion in society.

Very interesting read. Thanks for posting it VW.

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16 minutes ago, Herman said:

Well done Vietnam. 

What have they done? Certainly were being successful in the fight against CV19 with limited resources and a poor health care system. Isolation and vigorous military and social enforcement seemed to have been working.

 

 

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11 hours ago, Rock The Boat said:

They send a letter to the PM saying ' I resign' 

(1) Does the PM choose the members then? You must know more than the rest of us. 
 

(2) If we go along with your plan, then why would you know about it anyway? Do they make every letter to the PM public? 
 

(3) What exactly are they resigning from? It’s not a permanent committee , the members aren’t permanent. If the government asked a question about coronavirus that required different expertise then the members of sage would change anyway.

It would be like you giving me a call and asking if I could fill in on your five a side team for a one off game on Tuesday, then me handing in my resignation on Wednesday. What exactly am I resigning from?

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1 hour ago, Van wink said:

This whole “following the science” is a convenient soundbite Badger but that really is all it is and I wouldn’t get too hung up about the phrase, the science, particularly in this pandemic is inexact and comes from a range of different potentially conflicting disciplines. 

Agree with this VW, but the issue is that sound bites need to be called out when they are misleading the public. Otherwise you end up with Donald Trump as president....

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Looks like Germany may tighten up the lockdown again after relaxing a few restrictions as a second wave looks on the cards.

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Just now, Aggy said:

Agree with this VW, but the issue is that sound bites need to be called out when they are misleading the public. Otherwise you end up with Donald Trump as president....

As I said to Badger, I wouldn’t get too hung up about it. It’s not some sort of grotesque misrepresentation as we see with Trump, it has some basis, the only issue is that the science isn’t always unambiguous.

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2 minutes ago, TIL 1010 said:

Looks like Germany may tighten up the lockdown again after relaxing a few restrictions as a second wave looks on the cards.

Just shows how hard this is going to be when a country like Germany that has been so successful so far is struggling to find the balance. 

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13 minutes ago, Aggy said:

(1) Does the PM choose the members then? You must know more than the rest of us. 
 

(2) If we go along with your plan, then why would you know about it anyway? Do they make every letter to the PM public? 
 

(3) What exactly are they resigning from? It’s not a permanent committee , the members aren’t permanent. If the government asked a question about coronavirus that required different expertise then the members of sage would change anyway.

It would be like you giving me a call and asking if I could fill in on your five a side team for a one off game on Tuesday, then me handing in my resignation on Wednesday. What exactly am I resigning from?

As nobody has resigned, we can file this under hypothetical

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7 minutes ago, TIL 1010 said:

Looks like Germany may tighten up the lockdown again after relaxing a few restrictions as a second wave looks on the cards.

I think this shows why restarting ANY team sport is very very bad idea. 

I'm expecting in a week or two at the next review garden-centres and DIY shops only to be allowed to open (DIY can already) with appropriate social distancing. Schools (phased) possibly after 1/2 term.

Absolutely no restaurants, pubs , cafes etc.

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2 minutes ago, Yellow Fever said:

I think this shows why restarting ANY team sport is very very bad idea. 

I'm expecting in a week or two at the next review garden-centres and DIY shops only to be allowed to open (DIY can already) with appropriate social distancing. Schools (phased) possibly after 1/2 term.

Absolutely no restaurants, pubs , cafes etc.

I’m surprised Germany opened up as much as they did. But for the scientific community they will be providing some good data

Edited by Van wink

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Just now, Yellow Fever said:

I think this shows why restarting ANY team sport is very very bad idea. 

I'm expecting in a week or two at the next review garden-centres and DIY shops only to be allowed to open (DIY can already) with appropriate social distancing. Schools (phased) possibly after 1/2 term.

Absolutely no restaurants, pubs , cafes etc.

That is exactly how i see it Yellow Fever. I expect the lockdown to continue at the next review and if we are stuck at home gardening and decorating could well be a stimulus for mental well being. I have read that 25% of kids are not receiving home education and that cannot be good.

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I think you are spot on about Sound Bites VW. That is all the briefings are. Certainly many of the more involved questions from the Media have been side stepped with the usual politicians obfuscation.

It is too easy to say what people want to hear. I think that is why Boris will have to be very careful when he emerges, which I believe might be this afternoon.

People like Tim Martin, Branson etc have tried to push, guide, steer the Government into relaxing their policy. And these are some, not all of the people who put him into power so he has to be mindful and strong. Of course he will be PM for 10 years if he wants so he doesn't need to "reward" these people anymore. That is politics.

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1 hour ago, Van wink said:

Just shows how hard this is going to be when a country like Germany that has been so successful so far is struggling to find the balance. 

Not true. Best to look at local officaila souces as always.Per RKI today  the rate of new infections is still declining with current lifting of restrictions . Latest R is 0.75. There is Govt talk of extendings existing restrictiions by another week to 10 May. Opening up schools with distancing is recommended. Immunity passes not recommnded given dont know extent and duration of immunity. Opening offices with distancing is being worked on but home office will continue to be the norm. Economy expected to start to recover in Q4 and a fuller recovery in 21.   Personnally I expect the weather also has an impact  as well as the restrictions as impacts the amount of people out and about 

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The whole thing stinks

you are telling me this virus is everywhere now and we are getting higher death rates than practically anywhere? The slums of Bangladesh? The favellas of Brazil? It’s in there and it’s not killing more people? You can talk about PPE but it’s in countries and areas that don’t have running water and indoor toilets.

 

it stinks, everyone knows it.

Edited by The Real Buh

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19 minutes ago, T said:

Not true. Best to look at local officaila souces as always.Per RKI today  the rate of new infections is still declining with current lifting of restrictions . Latest R is 0.75. There is Govt talk of extendings existing restrictiions by another week to 10 May. Opening up schools with distancing is recommended. Immunity passes not recommnded given dont know extent and duration of immunity. Opening offices with distancing is being worked on but home office will continue to be the norm. Economy expected to start to recover in Q4 and a fuller recovery in 21.   Personnally I expect the weather also has an impact  as well as the restrictions as impacts the amount of people out and about 

Thanks for the update, thats good news, I read that R rose to 1 on Monday, perhaps that was fake news.

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10 minutes ago, Van wink said:

Thanks for the update, thats good news, I read that R rose to 1 on Monday, perhaps that was fake news.

Does anyone know how many positive tests there have been reported in the UK, vs deaths reported? Presumably death figures are including a lot of suspected covid cases?

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9 minutes ago, Van wink said:

Thanks for the update, thats good news, I read that R rose to 1 on Monday, perhaps that was fake news.

You are right. It got reported as 0.95 but was subsequently revised down. This is first week of gradually lifting restrictions so really need to see next weeks figures given delay being lifting restrictions and infections. Accordingly the govt reviewing restrictions every 2 weeks. External travel ban extended to mid June.

I fully appreciate that people are not interested in Germany per se but it is the same virus and impact of lifting restrictions not known so U.K. made clear that will look at what is happening in other countries in forming policy. 

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UK 26k reported figure only includes confirmed cases. ONS are picking up suspected cases from death certificates. John Hopkins reporting 266k confirmed cases in U.K.  

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1 minute ago, T said:

UK 26k reported figure only includes confirmed cases. ONS are picking up suspected cases from death certificates. John Hopkins reporting 266k confirmed cases in U.K.  

I suppose there could be an argument that some of the official figures might include people who died from other things but had coronavirus (died “with” rather than “from”)? If so if you took the ONS suspected cases into account and removed some of the “died with” numbers they might balance out? 

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17 minutes ago, Aggy said:

I suppose there could be an argument that some of the official figures might include people who died from other things but had coronavirus (died “with” rather than “from”)? If so if you took the ONS suspected cases into account and removed some of the “died with” numbers they might balance out? 

Fully agree. What you are saying actually is the concept of excess deaths over the normal level. The  FT estimated it was 40k for the UK. That is horrendous but it should be remembered that average age of deaths is around 80 so the reduction in average life expectancy from Covid  19 is probably not dramatic. Still before their time as Boris would rightly point out. 

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52 minutes ago, T said:

You are right. It got reported as 0.95 but was subsequently revised down. This is first week of gradually lifting restrictions so really need to see next weeks figures given delay being lifting restrictions and infections. Accordingly the govt reviewing restrictions every 2 weeks. External travel ban extended to mid June.

I fully appreciate that people are not interested in Germany per se but it is the same virus and impact of lifting restrictions not known so U.K. made clear that will look at what is happening in other countries in forming policy. 

BBC just  explained how the R number needs 0.49 or under  for a dwindle, 0.5 to 1.0 as a constant and above 1.0 to rise.

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6 minutes ago, Essjayess said:

BBC just  explained how the R number needs 0.49 or under  for a dwindle, 0.5 to 1.0 as a constant and above 1.0 to rise.

These R numbers are an educated guess so I wouldn't get overly worked up by the second decimal point.  

If it's less than 1 it's in decline and will go away if this continues long enough.

Exactly 1 and its stable. On average one peraon comes down with it, passes it in to exactly one more and then recovers

Over 1 and it's growing.

0.99 and it's technically in decline but it'll take a hell of a long time to leave the system.

 

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I'm a little more alarmed by some of the R0 estimates.  Peston said yesterday it was 3.9.  That's a hell of a lot of people.to become immune before it goes away naturally. I cant see how Sweden is close to this figure yet

 

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1 minute ago, T said:

Fully agree. What you are saying actually is the concept of excess deaths over the normal level. The  FT estimated it was 40k for the UK. That is horrendous but it should be remembered that average age of deaths is around 80 so the reduction in average life expectancy from Covid  19 is probably not dramatic. Still before their time as Boris would rightly point out. 

Yes, especially if we look over a longer period of time into the future. We might see that over the course of the next couple of years the death rate balances itself out, especially if we develop a vaccine or treatment in the next 10-12 months.

Many of those who are dying now from covid are those most likely to die of something else in the next year or two. The risk to otherwise healthy younger people seems fairly low. So we might see a decrease in elderly people dying of other things (because covid has - still tragically - accelerated their deaths) without a massive increase in deaths of younger less at risk people.

That‘s where things such as the Spanish flu, Ebola etc are so much worse, because they kill/killed younger healthier people as well.

Still tragic to have anyone dying if it could have been delayed or avoided for longer, and it’s the sort of thing we won’t know until some time in the future, but hopefully when we look back in five years time it won’t have been as bad as we fear/feared.

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14 minutes ago, Essjayess said:

BBC just  explained how the R number needs 0.49 or under  for a dwindle, 0.5 to 1.0 as a constant and above 1.0 to rise.

Sorry BBC report I saw said if is is below 1 it declines which is logical. Maybe saying needs to be  significantly lower to be able to lift restrictions relatively quickly given the numbers in the UK already with infections. Ie you need to get the number of cases down to a few hundred to effectively test trace and isolate so U.K. is probably starting from a higher base and needs to reduce R more before it can lift restrictions compared to a country with a lower level of infections currently. 

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6 minutes ago, Barbe bleu said:

I'm a little more alarmed by some of the R0 estimates.  Peston said yesterday it was 3.9.  That's a hell of a lot of people.to become immune before it goes away naturally. I cant see how Sweden is close to this figure yet

 

Am I right in thinking though that the R0 is based on number of contacts. It doesn’t determine how quickly it actually spreads (ie; how quickly those contacts take place). So in Sweden where the population density is something like 60 people per square mile it will spread a lot slower than the Uk where the population density is something like 720 people per square mile. 
 

So they might just think it’s going to be easier to manage over there whilst building that immunity up.

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2 minutes ago, Aggy said:

Am I right in thinking though that the R0 is based on number of contacts. It doesn’t determine how quickly it actually spreads (ie; how quickly those contacts take place). So in Sweden where the population density is something like 60 people per square mile it will spread a lot slower than the Uk where the population density is something like 720 people per square mile. 
 

So they might just think it’s going to be easier to manage over there whilst building that immunity up.

R0 is a measure of how many people each carrier infects on average in a completely susceptible and freely mixing population. Its  not a rate.

To get the rate we need to also know how long we can infect for. 

HIV has a R0 of 10 in some popupations but that 10 are infected over the course of many years.

It does depend on circumstances though so I think that you are right Sweden could have a lower R0  if people just naturally mix less, so I guess this could be the thinking

 

 

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