Worried About Coronavirus- thread 38

[TheStarryNight]

New thread

Would I need to wash my mouth out if I suggested this (series of) thread should perhaps merge with the Data, Graphs thread(s). They have often been discussing the same issues, sometimes even with the same articles and graphs, at the same time.

Both wonderful at this time, but annoying to have to check them both all the time.... Or am I the only one?

I think they should all end up somehow preserved for posterity, on MN if not in the National Archive!

Keep meaning to go back and re read the first few threads, I imagine it would be sobering/amusing/thought-provoking.....

Thanks so much to all educated contributors, I know many of us are so grateful. 👋🦚

I meant "Daily Numbers, Graphs, Analysis" of course... but you knew that.

I know the two threads were initially different and served different purposes, I just wonder if they are now?

Thankyou @TheStarryNight

Good news

Mainly lurker here, I check both threads and would find it easier for one, but I’m happy for whatever.

Ive been on analysis too.

I'm on both but the other thread is very fixated on only looking at the numbers rather than the wider discussion around research articles & reports etc which I find v interesting even if they do go off on a tangent sometimes.

Just going to have a little rant about the gov figures for care homes. So i thought at last we will get some clarity on this. However if you only count those who have been tested when we know testing has been limited then what happens to those who did not get tested ( especially earlier on in the month)? So their death certificate says covid 19 but they want be counted because they did not have a test? These numbers dont appear to add up, goverment undercounting to compare favourably with others on europe?
Hopefully someone can tell me these will be counted?

DH: "You know they've planned keeping care home and hospital deaths separate until now for a strategic reason don't you?"
Me: "Oh?"
DH "Yes for psychological reasons. Now when they give out the numbers for the daily deaths, the numbers are staying high and close to when we were at peak"
Me: "You mean most people don't pay attention to the detail of the data do they. They won't notice the reporting criteria have changed"
DH: "Nope... So public pressure to keep the lockdown for longer will be maintained".

Now I don't know if he's right or got a point but its a good argument for why they've now decided to finally have combined reporting.

That's a very good point

@RedToothBrush he does have a valid point but it's also true to say this change to reporting is an obvious one to make, and much called for.

But if they don't count those with COVID on the certificate but who haven't been tested, that's going to cause all kinds of confusion and data that don't add up. So they died of the coronavirus but they don't count?

www.itv.com/news/anglia/2020-04-29/frightening-or-funny-police-seek-norwich-walker-in-plague-doctor-outfit/

Apologies if this has already been mentioned. Haven't had a chance to catch up.
www.bbc.com/news/amp/health-52478783
Promising results for remdesivir. Early days of course but it's something. It seems the Chinese trial (suggesting the drug was ineffective) was incomplete. Their lockdown and other measures meant they ran out of patients!

Interesting also about the possibilities of immunosuppressants. They think these might help at later stages. Remdesivir seems to work best when given early. I wonder if people on immunosuppressants are in fact at slightly less risk than everyone else? We've seen high mortality rates in people with vascular and cardiac related conditions. I'm not sure about autoimmune diseases?

Helena I love that! It's the first time I've laughed all day in. Thanks for posting.

I see it as the perfect oppurtunity for parents to use his sartorial choice to teach their kids about that time in history.

Also DH: "So how do you go about a soft end to lockdown without everyone going slightly nuts? You don't tell the public. Instead you say what you can do within the lockdown regulations as long as you are observing social distancing."

Guess what Newsnight have just said the PM is going to stress in an upcoming speech?

Yep. What you can do under restrictions.

I suspect we are easing restrictions without announcing we are easing restrictions. Therefore its politically more pallatable and people gradually push the boundaries without everyone rushing to do x, y or z on the same day.

The Conservative Party have very much been about gradual pushing of boundaries and messaging creep for the last few years, so are masters of it. Under these circumstances there are positive aspects to this (normally I personally find it an alarming skill).

but it's also true to say this change to reporting is an obvious one to make, and much called for.

Definitely.

But its a good way to deal with a politically toxic piece of information and use it to practical advantage.

Interesting also about the possibilities of immunosuppressants. They think these might help at later stages. Remdesivir seems to work best when given early. I wonder if people on immunosuppressants are in fact at slightly less risk than everyone else? We've seen high mortality rates in people with vascular and cardiac related conditions. I'm not sure about autoimmune diseases?

I have been wondering about this, and if it depends on which stage of the illness you are at. If you are prone to autoimmune problems and inflammatory response then you'd think you would be at more risk of a cytokine storm. But maybe the risk of a cytokine storm only comes into play for anyone, autoimmune prone or not, once the disease reaches a certain stage of infection that prompts the system to over respond. If so then you wouldn't want any immune suppression at the first stage because then you could hopefully fight it off before it gets to that point.

I have no scientific or medical insight and am just speculating as a total layperson. I do have an autoimmune condition and I intend to ask my specialist about this when I speak to them. It may also depend on whether the specific autoimmune disease you have causes damage that plays into other risks with covid...clotting, inflammation etc.

news.sky.com/story/coronavirus-warning-as-major-study-finds-most-elderly-victims-would-not-have-died-otherwise-11980675
Coronavirus: Warning as major study claims most elderly victims 'would not have died otherwise'
Coronavirus is "proving a much more complex disease than we initially thought", scientists behind research say.

Professor Calum Semple, who is leading the largest study of coronavirus patients in the UK, said it showed more than a third of those who had been admitted to hospital had died.

"That's the same for those admitted to hospital with Ebola," he told a virtual news conference.

and

The study, which has not yet been peer-reviewed, found:

Death rates were high among elderly patients, and most of those who did not survive were admitted to hospital with symptoms of COVID-19 and "would not have died otherwise"
Of the 6,628 patients who required hospital stays of 14 days or more, the study shows half (49%) have been discharged, with a further 17% still being treated. 33% died.
Pregnant women are not at an increased risk of death
Obesity is associated with mortality, even after adjusting for other health conditions

Although the study backed up the conclusions of previous research on COVID-19, the findings on the deaths of elderly people would appear to contradict a widely held belief that a large proportion of those older victims would have died imminently anyway.

and

But Professor Semple said obese people, who had a BMI over 30, also had a higher risk of being admitted to intensive care and dying.

"Fat cells secrete chemicals that increase the inflammatory state in the body," he said.

"If you are a big person you are also more likely to have had a tough childhood and a tough life, brought up in an environment where you are exposed to multiple deprivations.

and

"There are anecdotal reports of people starting off with a cough and shortness of breath, then seeming to get better, and then returning with a more systemic (whole body) disease, inflammation in the blood vessels and a tendency to form blood clots in different parts of the body.

"So it's proving a much more complex disease than we initially thought. It is remarkable to see a new disease unfolding in front of our eyes."

"Together they make it a very tough ride for these people when they catch COVID-19."

RTB That's very concerning. What does the Labour Party have to say about that, I wonder.

We're already set to have the highest death rate in Europe, possibly the world. Germany is seeing a rise in cases after it's states eased their lockdowns (despite Merkel urging caution). They, at least, are starting from a much lower number of deaths than us. They have more capacity in hospitals, have tested far more than us, and they've already ensured the public have masks to wear in public. Heaven help us when our (half-hearted in the first place) restrictions lift - officially or not.

I wonder how the world's media is reporting on our response (and very high death rate)? Has the disproportionate affect on the BAME community been noted? And indeed has it been taken into account when considering the right time to start easing lockdown?

I have been wondering about this, and if it depends on which stage of the illness you are at.

Seems logical... see above post about apparent recovery and relapse pattern.

www.telegraph.co.uk/politics/2020/04/29/link-coronavirus-premature-birth-highlighted-scientists/?utm_content=telegraph&utm_medium=Social&utm_campaign=Echobox&utm_source=Twitter#Echobox=1588192274
Link between coronavirus and premature birth highlighted by scientists

Downing Street declined to say whether the baby was preterm and a spokesman was unable to provide details of the weight

www.sciencemediacentre.org/expert-reaction-to-possible-association-between-covid-19-and-premature-birth-re-birth-of-boris-johnsons-baby/
expert reaction to possible association between COVID-19 and premature birth (re birth of Boris Johnson’s baby)

There have been questions form journalists regarding any possible association between COVID-19 and premature birth. This is in light of the Prime Minister, Boris Johnson’s, son being born.

Prof Phillip Bennett FMedSci, Director of Institute for Reproductive and Developmental Biology and Professor of Obstetrics and Gynaecology, Imperial College London, said:

“My understanding is that there is some evidence that COVID-19 is linked to preterm birth, but that it is not clear, at present, whether this is because it causes the onset of preterm labour, or whether women have been delivered to help with the management of their severe respiratory illness. It is the case that seasonal influenza does increase the risk of spontaneous preterm birth, and some evidence that babies born to mothers with ‘flu have worse outcomes (especially PVL brain injury and sepsis in the very early preterm births). But COVID-19 appears to effect pregnant women differently to influenzas, in that ‘flu causes a more severe illness in pregnancy whereas COVID-19 does not seem to do so (our own experience is that it is not a severe illness in pregnancy).

There are a pile more expert opinions on the possible link on the second article.

shows age as well

This is a relatively elderly population, with median age 72 years [IQR 57, 82; range 0, 104]
(figure 1). Only 239 patients (2.0%) are under 18 years and only 139 patients (1.1%) are
under 5 years old. More men (60.2%, n=7,715) than women (39.8%, n=5,097) have been
admitted to hospital with COVID-19 (missing data n=4,001). Fifty-five (6%) of women of
reproductive age (n=963) are recorded as being pregnant.

''Intriguingly, HCoV-NL63 infection was also found to be associated with Kawasaki disease (26), which can affect the coronary arteries and is a major cause for acquired heart disease in young children. The expression of ACE2 in coronary vessels (28) further supports a possible role of HCoV-NL63 in Kawasaki disease. In any event, diagnostic tests to detect HCoV-NL63 infection need to be developed, especially when considering the frequency of infection and the apparent similarities in HCoV-NL63 and SARS-CoV replication. In this regard, it is of interest that several patient sera potently neutralized NL63-S-driven infection but did not inhibit infection driven by 229E-S or SARS-CoV-S (data not shown), suggesting that neutralizing antibodies directed against HCoV-NL63 might not protect against infection with other HCoVs.''

Interesting known link to other coronavirus (2005) with Kawasaki.

We're already set to have the highest death rate in Europe, possibly the world. Germany is seeing a rise in cases after it's states eased their lockdowns (despite Merkel urging caution). They, at least, are starting from a much lower number of deaths than us.

You say it yourself - 'they, at least, are starting from a much lower number of deaths than us'.

Note this isn't over yet by a long shot.

I think we need to be slightly cautious about the focus on how we've had more excess deaths than anyone else. The key word here is 'so far'.

We don't know quite how this is going to play out yet.

What we do know is the UK is now expecting some level of second wave from their messaging. We know that Germany is expecting this - they have spelt it out by stressing that measures may have to be tightened in future. There are no guarantees at this point that anyone lifting restrictions will manage to keep a lid on this going forward. We don't know what excess mortality will be in 18 months time and thats actually what matters, not merely what it is like in phase 1 of the pandemic.

I also think its worth reflecting on the fact that what the government does / did during the course of this pandemic in terms of management might not have made a difference. The observation that it is having a more severe effect on people who are obese should ring alarm bells. If thats the case, the UK SHOULD have one of the highest excess death rates in Europe because we have one of the highest rates of obesity. And the US should be even higher. We have one of the highest levels of economic inequality and this has a significant affect on health inequality. Higher death rates for covid-19 could be this playing through with there being nothing more that the government could have done by the time the outbreak started as the underlying mortality risk was already long established.

The skynews article above pretty much is saying that poor fat people die more than better off people who tend to live an healthy lifestyle due to affluence. (To paraphrase it in blunt terms).

This isn't a surprise. The places that have been highlighted as those most at risk from covid-19 in the event of a more widespread outbreak are some of the most economically deprieved and with the worst levels of access to healthcare to begin with. Its your Hulls and your Stokes rather than you Kingston on Thames that are the worry.

Having read the research it says

The finding of independent associations of advancing age, male sex, chronic respiratory (though not asthma), chronic cardiac and chronic neurological disease with in-hospital mortality are in line with early international reports[10,11]. However, although age-adjusted mortality rates are high in the elderly, most of these patients were admitted to hospital with symptoms of COVID-19 and would not have died otherwise. It is notable that the enhanced severity in male patients is seen across all ages.

Which to me reads that COVID-19 was the infection that killed them and that they would not have died in the short term not that it is taking out healthy people