Covid-19 #16: Not Waving, Loop-de-Looping

[Fragile Bird]

4 minutes ago, Heartofice said:

I have heard that it’s the same in the US as well, except in both countries they have a 31 day cut off where that doesn’t apply any more. Not sure that is the case in the UK.

Does it matter? Well it’s not helpful to understanding the actual death figures and how Covid is progressing. 
 

and sure, Excess Deaths is still pretty much the only important figure to be paying attention to. Even then it doesn’t always tell you about the number of Covid deaths, how many excess deaths are cancer patients not seeking treatment etc 

Yes, but you have an enormous reduction in road accident deaths. And in the US, I bet gun deaths are down as well.

[Luzifer's right hand]

12 minutes ago, Heartofice said:

I have heard that it’s the same in the US as well, except in both countries they have a 31 day cut off where that doesn’t apply any more. Not sure that is the case in the UK.

Does it matter? Well it’s not helpful to understanding the actual death figures and how Covid is progressing. 
 

and sure, Excess Deaths is still pretty much the only important figure to be paying attention to. Even then it doesn’t always tell you about the number of Covid deaths, how many excess deaths are cancer patients not seeking treatment etc 

At least around here we had fewer sport, traffic and work related deaths during the proper lockdown. Do they outweigh the number of deaths because people waited too long to get treated? Difficult to tell.

Edit: Alpine accidents kill more people than traffic accidents here in Austria and they dropped close the zero because it is just hobby stuff. There was a heavy spike in gardening and home improvement related deaths though. 

[Zorral]

Shooting deaths are rapidly increasing in number in the US.  Rage of all kinds from all sorts.

Cops pretty much are on strike too, about anything except Protesters.

 

[Galactus]

11 minutes ago, Heartofice said:

I have heard that it’s the same in the US as well, except in both countries they have a 31 day cut off where that doesn’t apply any more. Not sure that is the case in the UK.

Does it matter? Well it’s not helpful to understanding the actual death figures and how Covid is progressing. 
 

and sure, Excess Deaths is still pretty much the only important figure to be paying attention to. Even then it doesn’t always tell you about the number of Covid deaths, how many excess deaths are cancer patients not seeking treatment etc 

 

Excess death is also much lower than Covid deaths because of other factors (eg. we've had basically no deaths from the usual seasonal influensah, or many other similar diseases, because the people who are vulnerable to those die from Covid 19 instead)

 

 

[Zorral]

Death rates rising too, with the explosion of new cases. Every day the numbers are higher than yesterday.

https://www.nytimes.com/2020/07/17/world/coronavirus-updates.html?

 

Quote

 

Sound Alarm After U.S. Daily Record of 75,600 New Cases
The number of deaths in the country is increasing, and more than half the states have enacted mask orders. Brazil surpasses 2 million total cases, and India has hit a million.

RIGHT NOWSenate Republicans plan to propose sweeping liability protections for businesses, schools, hospitals, charities, government agencies and front-line medical workers as a centerpiece of the next round of coronavirus relief.

 

 

[Mudguard]

3 hours ago, Mexal said:

This is good news. Think 3/4 drugs that enter phase 3 trials end up getting approved. I know some people pretty close to biotechs and the science and they believe in what Moderna is doing.

 

The FDA has relaxed the clinical trial guidelines for coronavirus vaccines, so the 3/4 number is not applicable.  Normally, the process would take a lot longer and there would be much more data available before a decision is made to go forward with the next phase.  Now, they are fast tracking and almost rubber stamping everything through to phase III if there is any promise whatsoever.  The bar is currently set very low, and there will be many vaccines going into phase III by the end of the year.  We'll see whether the Moderna vaccine, and the others, actually provides protection in phase III. 

For the record, I'm still very skeptical about Moderna's vaccine and the many other vaccine candidates as well.  Moderna's technology (as well as others like the Oxford vaccine which is based on different technology) has never resulted in an approved vaccine that has been delivered to the market.  I was skeptical months ago, and my skepticism has only deepened which the recent research that appears to show that the antibody response in many recovered patients is transient.  There is also some past research that suggests that immunity to common coronavirus tends to be short term, possibly only on the order of months, not years.  In addition, the virus is mutating, including mutations in the spike protein which is one of the primary targets of the newer RNA or DNA vaccine technologies.  I'm not sure how Moderna and others are addressing this, if at all.

I think there is a good chance that many of the vaccine candidates will give at best very mediocre protection, like a poorly matched influenza vaccine which may only provide around 10-20% protection.  That said, the good news is that there are over 100 vaccine candidates in development worldwide, so hopefully, at least one, or better yet a handful, will provide good protection.  I'm just not sold on any particular one right now.

[Fez]

So this is an optimistic tweet about the Oxford vaccine:

My question is, assuming the vaccine actually works, is an 80% effectiveness rate actually good? Doesn't that mean that 1-in-5 people could still get seriously ill? Which, isn't that roughly where we are already? Am I missing something?

[S John]

8 minutes ago, Fez said:

So this is an optimistic tweet about the Oxford vaccine:

My question is, assuming the vaccine actually works, is an 80% effectiveness rate actually good? Doesn't that mean that 1-in-5 people could still get seriously ill? Which, isn't that roughly where we are already? Am I missing something?

I think it’s partly that 80% resistance would represent a lot of ‘dead ends’ for the virus and would in itself be a protection for that other 20%.  Assuming everyone gets the vaccine, which won’t happen, but widespread vaccination even at 80% effectiveness should enable a return to normal life I would think.

[Fragile Bird]

I saw Dr. Fauci say he'd be happy with a vaccine that was 75% effective.

[Mudguard]

2 hours ago, Fez said:

So this is an optimistic tweet about the Oxford vaccine:

My question is, assuming the vaccine actually works, is an 80% effectiveness rate actually good? Doesn't that mean that 1-in-5 people could still get seriously ill? Which, isn't that roughly where we are already? Am I missing something?

It's a trash tweet to be honest.  AstraZeneca has not pledged to produce 2 billion doses this year, as he admits in a later tweet.  The 80% number is also not based on results from the phase 3 trial, but is instead appears to be based on a paragraph in the Bloomberg article he linked:

Quote

Gilbert has voiced remarkable confidence in her chances, saying the Oxford vaccine has an 80% probability of being effective in stopping people who are exposed to the novel coronavirus from developing Covid-19. She has said she could know by September

The wording in the Bloomberg article is not clear precisely what the 80% effective number means.  It's not quite worded in the standard way you would discuss vaccine efficacy.  If a vaccine was 80% effective, it would reduce the incidence of disease by 80% as compared to an unvaccinated population.  80% efficacy, if used in the traditional sense, would be fantastic, and would potentially allow us to get to herd immunity easily, assuming most people take the vaccine, immunity is long lasting, and mutations don't result in loss of immunity.  For comparison, a good influenza vaccine is around 60% effective.

As far as I can tell, the number appears pulled out of Gilbert's ass and is not supported by hard data.  She admits that she won't know until September, but is willing to offer up a number anyway. 

Again, let's just wait for the phase 3 data to come out.  Right now, there's been a ton of science by press release in order to raise money, either from the public in stock offerings or from grants from governments.  There a huge incentive for these companies to oversell positive early results in order to get these hundreds of millions to billion dollar grants.  It's another reason why I'm skeptical about all the early results.  I'm going to need to see phase 3 data before I believe anything.

[williamjm]

6 hours ago, Heartofice said:

I have heard that it’s the same in the US as well, except in both countries they have a 31 day cut off where that doesn’t apply any more. Not sure that is the case in the UK.

Does it matter? Well it’s not helpful to understanding the actual death figures and how Covid is progressing. 
 

and sure, Excess Deaths is still pretty much the only important figure to be paying attention to. Even then it doesn’t always tell you about the number of Covid deaths, how many excess deaths are cancer patients not seeking treatment etc 

I was reading an article about this recently which said that in Scotland deaths within 28 days of a positive test would be counted as a covid-19 death but in England there was no upper limit. The article did suggest that this meant if someone tested positive for covid-19 then got knocked down by a bus a couple of months later they could be counted as a covid-19 death under that system. I suspect that sort of scenario is rare enough that it doesn't make much different to the stats. There could be far more ambiguous (and common) cases where a frail elderly patient gets covid-19, initially recovers but then dies a few weeks later - deciding whether the long-term impact of covid-19 contributed to that death could be difficult. Writing this out I'm coming around to the view that it is useful to track and report on how many people die after recovering from a covid-19 infection (perhaps first taking out accidents), although there might be an argument for reporting them separately from people who died while they were still testing positive.

[The Anti-Targ]

16 hours ago, Fragile Bird said:

Surely the major difference between SARS/MERS and COVID-19 is the infection period? COVID-19 is unlike the other two because it is very infectious early, even before symptoms appear, whereas with SARS and MERS, the sicker the patient got the more infectious they got.

This was more looking at SARs, MERs and COVID-19 as a single group of particularly lethal coronavirus diseases distinct from the common cold varieties rather than looking at differences between those 3 diseases. But yes a key difference between COVID-19 and SARS/MERs is the pre- / asymptomatic infectious characteristic. SARS and MERS were very containable and highly unlikely to ever get to the level of spread of COVID-19 because of this difference.

Some other interesting articles starting to come out saying herd immunity via infection =/= herd immunity via vaccination. The suggestion is that yes you can get to herd immunity by quickly vaccinating ~60% of the population (plenty of room for anti-vaxxers to stick to their whacky views and still be protected by the sensible majority). But for getting there by infection, because of the way the disease moves through a population effective herd immunity won't really happen until 90% of the population has been infected. The lunacy of going for herd immunity without a vaccine is probably why no govt epidemiologist has said it's an official reason for relaxing lockdowns or for not having a substantial lockdown from the start.

RE the death statistics discussion: the counting of deaths is so different between countries it's going to take decades for medical historians to try to land on an agreed final death tally, if they ever do. Best case scenario I reckon is X million +/- a few million. Just as hard will be trying to determine the true case fatality rate. I think most epidemiologists agree it;s <1%, but beyond that I think it's going to be hard to nail down.

[RhaenysBee]

*sigh* 

New infections are soaring in neighboring countries, but the borders are still open. This exact same thing happened in March, we waited too long to close the borders and let travelers bring in the virus from abroad. And why? Because irresponsible and spoiled people would make a tantrum if they couldn’t go on holiday. 

So what’s it going to be? Everybody’s out in the cold to watch their own backs and we aren’t closing anything to keep the economy alive? Or we are shutting back down to keep people safe? Or somewhere inbetween which will neither keep people safe nor preserve the economy. 

It’s frustrating. The calm before the new storm was supposed to last till September. But with number of daily new infections climbing back to spring numbers at a steady rate, we’ll be back to 50-100 in two weeks and we can be thankful if it doesn’t get worse than that. Oh well. 
 

(And yes, I do realize that we have it relatively easy with 0.1% of the capital’s and 0.045% of the entire population’s having been infected. And I do feel for badly hit parts of the world. But unfortunately I’m not rational enough for this to substantially decrease my virus related fear and worry.) 

[rotting sea cow]

12 hours ago, Mudguard said:

It's a trash tweet to be honest.  AstraZeneca has not pledged to produce 2 billion doses this year, as he admits in a later tweet.  The 80% number is also not based on results from the phase 3 trial, but is instead appears to be based on a paragraph in the Bloomberg article he linked:

The wording in the Bloomberg article is not clear precisely what the 80% effective number means.  It's not quite worded in the standard way you would discuss vaccine efficacy.  If a vaccine was 80% effective, it would reduce the incidence of disease by 80% as compared to an unvaccinated population.  80% efficacy, if used in the traditional sense, would be fantastic, and would potentially allow us to get to herd immunity easily, assuming most people take the vaccine, immunity is long lasting, and mutations don't result in loss of immunity.  For comparison, a good influenza vaccine is around 60% effective.

As far as I can tell, the number appears pulled out of Gilbert's ass and is not supported by hard data.  She admits that she won't know until September, but is willing to offer up a number anyway. 

Again, let's just wait for the phase 3 data to come out.  Right now, there's been a ton of science by press release in order to raise money, either from the public in stock offerings or from grants from governments.  There a huge incentive for these companies to oversell positive early results in order to get these hundreds of millions to billion dollar grants.  It's another reason why I'm skeptical about all the early results.  I'm going to need to see phase 3 data before I believe anything.

Thanks for your insights. It seems like a potential disaster in the making. What would happen in one of these vaccines cannot deliver? How would stakeholders, politicians and the general public will react? Because perfectly one of these avenues may get to a dead end. This happens often in science but it's not generally understood by others, specially politicians and businessmen who think than by simply doubling the resourses you double the science output.

[rotting sea cow]

4 hours ago, The Anti-Targ said:

Some other interesting articles starting to come out saying herd immunity via infection =/= herd immunity via vaccination. The suggestion is that yes you can get to herd immunity by quickly vaccinating ~60% of the population (plenty of room for anti-vaxxers to stick to their whacky views and still be protected by the sensible majority). But for getting there by infection, because of the way the disease moves through a population effective herd immunity won't really happen until 90% of the population has been infected. The lunacy of going for herd immunity without a vaccine is probably why no govt epidemiologist has said it's an official reason for relaxing lockdowns or for not having a substantial lockdown from the start.

Could you please post some of these articles. I'm serving of translator of scientific articles for some people who have a say in local politics so is good to keep them informed. There is so much distrust in my country with the central government than local governments are looking how to make informed decisions.

[Filippa Eilhart]

3 hours ago, RhaenysBee said:

*sigh* 

New infections are soaring in neighboring countries, but the borders are still open. This exact same thing happened in March, we waited too long to close the borders and let travelers bring in the virus from abroad. And why? Because irresponsible and spoiled people would make a tantrum if they couldn’t go on holiday. 

 

There’s been plenty of research indicating closing borders is the least effective tool in halting spread. Here’s a recent article I saw.

https://www.liser.lu/?type=module&id=104&tmp=4471

Instead, we find no effects for international travel controls, public transport closures and restrictions on movements across cities and regions.

[RhaenysBee]

47 minutes ago, Filippa Eilhart said:

There’s been plenty of research indicating closing borders is the least effective tool in halting spread. Here’s a recent article I saw.

https://www.liser.lu/?type=module&id=104&tmp=4471

Instead, we find no effects for international travel controls, public transport closures and restrictions on movements across cities and regions.

That completely goes against my common sense, but I do hope the research is correct.

[rotting sea cow]

4 hours ago, RhaenysBee said:

*sigh* 

New infections are soaring in neighboring countries, but the borders are still open. This exact same thing happened in March, we waited too long to close the borders and let travelers bring in the virus from abroad.

Austria already forbids travel to a large number of eastern european and balkan countries, except for specific cases.

1 hour ago, Filippa Eilhart said:

There’s been plenty of research indicating closing borders is the least effective tool in halting spread. Here’s a recent article I saw.

https://www.liser.lu/?type=module&id=104&tmp=4471

Instead, we find no effects for international travel controls, public transport closures and restrictions on movements across cities and regions.

I tend to doubt that.  This virus was spread through air travel and most of the countries which have succeeded in containing it were those which closed early. I saw the same article some days ago and they point to the closure of schools as being effective, but some recent research points towards the opposite direction.

Beside the article I posted before comparing Sweden and Finland, I've seen these

No evidence of secondary transmission of COVID-19 from children attending school in Ireland, 2020

Novel Coronavirus 2019 Transmission Risk in Educational Settings

COVID-19 Transmission and Children: The Child Is Not to Blame

Plus news articles from Austria and Germany

[The Anti-Targ]

2 hours ago, rotting sea cow said:

Could you please post some of these articles. I'm serving of translator of scientific articles for some people who have a say in local politics so is good to keep them informed. There is so much distrust in my country with the central government than local governments are looking how to make informed decisions.

Yeah, I'm sorry I haven't linked the last few articles I've read. I read them on my phone's news feed and then a few hours later when I try to find the article again to link it on here I can't track it down. I did another search just now and here's the specific article I was reading, but there are several articles from various newspapers saying similar things, though perhaps not the 90% thing.

https://www.newsroom.co.nz/ideasroom/herd-immunity-a-misunderstanding

 

[The Anti-Targ]

1 hour ago, Filippa Eilhart said:

There’s been plenty of research indicating closing borders is the least effective tool in halting spread. Here’s a recent article I saw.

https://www.liser.lu/?type=module&id=104&tmp=4471

Instead, we find no effects for international travel controls, public transport closures and restrictions on movements across cities and regions.

It's worked extremely well here. And to a slightly lesser extent in Australia, though they let it leak out of quarantine hotels and it's been bubbling away within Australia the whole time as well. Maybe less effective when there is already active community spread in the destination country. Theoretically if you allow people in from countries that have a similar or lower case/million then you are not changing the overall risk profile for current residents becausw the proportion of incoming people with infection will be about the same. If you allow people in from countries with significantly higher case/million then you are slightly increasing the risk profile. But by how much? Not much considering you are only letting in hundreds of people at a time only some of whom will have the infection, whereas active cases in most countries is in the 10s of thousands.

The greatest risk is for those who are not infected traveling on the same plane/train/bus/ship as the people who are infected if there is any laxity in distancing, hygiene and mask wearing.

Back to Australia, I would say it is very wise of QLD, WA, Tas, NT and SA to shut borders to NSW and Vic. The former states have near eliminated the virus whereas the latter are experiencing a resurgence. Just one infected person crossing the border substantially raises the risk profile for the destination state.