Worried About Coronavirus- thread 38

[TheStarryNight]

New thread

RTB thanks for your thoughts. Always interesting.

I remain convinced Germany will continue to handle this far better than us. I also believe a longer initial lockdown would go a long way towards limiting the number of lives lost short and long-term. Limited spread under lockdown makes contact tracing and testing (once it's lifted) far easier and more achievable. I suspect the lives of the poor won't be valued by the government (or at least their donors) unfortunately. It's less likely to hit areas like Redcar, etc in the first place with relatively little travel to and from those areas. I suspect it will continue to hurt the deprived communities in London and Birmingham the most. Those cities being most affected also means it's likely to continue disproportionately affecting BAME communities. That's if lockdown is eased too soon. The government has a choice.

Re the priority on economy. It's my view easing lockdown too early is a shortsighted approach. The impact of stop, start, stop, start seems more disruptive than waiting a little longer before lifting restrictions. I'm aware some will disagree with me.

What do you think about China? Apparently their death rates have been very low since they started easing their restrictions. Do you think they've contained it (they're quarantining New arrivals) or improved treatment? Or do you think they're lying?

The austerity measures implemented in 2010+ will have contributed to economic inequality.

I know we are on a massive learning curve with this virus and knowledge is power, but it's making me nervous every time I hear something new and worrying. I have seen some specialists saying that the pace of release of this new information and the pressure to get it out there is sometimes at the expense of accuracy. Inevitable I guess.

What do you think about China?
Apparently their death rates have been very low since they started easing their restrictions. Do you think they've contained it (they're quarantining New arrivals) or improved treatment? Or do you think they're lying?

Yes, yes and yes.

The is apparently a big outbreak in the North Close to the Russian border and there was talk that the region was about to undergo a Wuhan style lockdown as they were particularly worried about a large city there.

Meanwhile the government is busy saying that virtually all cases are imported and not locally transmitted (which doesn't tally up with what's happening in the North).

For the most part they have got it under control in the big Western facing cities. Though again there are rumours of more locally transmitted cases than the authorities are willing to admit to.

There was a BBC reporter questioning why all but a handful of Beijings cases were labelled as foreign imported when there were currently no direct flights from outside the country to Beijing. There were flights to other cities but upon arrival there's an mandatory 14 day quarantine. And to then enter Beijing you have to undergo another 14 day quarantine. And yet somehow almost all the new cases in the city were foreign imports. How is this possible?

I'm not sure that entirely tallies up with the government being truthful.

I tend to lean towards Germany handling the crisis better but its a very different situation. Its easier to handle the outbreak if your country isn't so centralised and dominated by 1 or 2 cities. It's easier to handle if your population is generally less obese and thus therefore at risk for example. It's easier initially if you manufacture certain things domestically rather than being reliant on imports.

I think I saw how this now becomes a problem because of the paradox of appearing to handle it better than elsewhere: more political pressure to unlock faster and less willingness to adhere to rules that 'aren't necessary' because success in restricting the spread has created this false sense that the risk has been overblown. Lots of psychology and behavioural science here.

Longer term this could be a problem. Apparently Polling is showing that Brits are happier with a longer lockdown if it is effective than risking opening earlier more than other European nations. This could see us better placed for the second wave.

I don't know. I do think we need to be cautious about what is happening in terms of assessing our success / failure long term.

It's worth pointing out the British scientific advice early on stressed how they didn't want a second lockdown because they 'only had one shot at it' for both economic and psychological reasons.

It could yet be a tortoise v hare scenario. And we have no idea if this is the case until after the fact with the benefit of hindsight.

Thanks again RTB. Everything you say makes a lot of sense. I wish I was in the future studying this period instead of living (hopefully!) through it.

Helena I agree.

I have been invited for a covid19 test this morning and part of the zoe app. I have had a sore throat and hoarse voice for the past few days and logged that and then received an email this morning telling me to book a test.

I thought it was spam at first but it is legit.

I have just booked it all. Very easy if a bit convoluted. I am going later on this morning to a local site. I am 99% certain I haven't got it. Just due to the symptoms I have. They are not typical symptoms other than a sore throat.

Guardian article: More cases of rare syndrome in children reported globally

Nearly 100 cases of the unusual illness linked to Covid-19 have emerged in at least six countries

I've read about kawasaki syndrome.
I would not be surprised if other autoimmune reactions are observed in the long run.
I know a dc with a form of osteomyelitis following a flu like illness. (some years ago, so not covid related)

@RedToothBrush yes all you say seems very pertinent.

My feeling is that we're still doing battle with the "It's only flu" brigades:
OK, so not many are still saying that, but people (from the woman in the Co op to big Tory donators) don't seem to be able to grasp that, if we ease restrictions too early, the death rate will soar miles higher than the current one. And then there's not a lot of benefit to having managed to keep your small or large business afloat, because 30% or your customer base and staff are dead and the rest are in severe shock.

I'm speaking figuratively - I have little idea of predicted stats - but I hope you get my point.

I agree RTB and I think that paradox is going to cause Germany some long term issues. They seem to have handled it pretty well but they need to continue to do so which means nerves every time R0 goes up. New York is going to be interesting as by all accounts it has ravaged through there

New York will be interesting if, as suspected, the r is R0.9 under lockdown.

That leaves them no where to go as they will have problems again at r1.2.

That said it depends on who is catching this and who is more vulnerable.

If more severe cases are found in poorer people due to obesity and long term poorer health, and those people have disproportionately stayed at work or socialising throughout lockdown then that will also distort early death rates. Healthy people who have stayed home may be less prone to a severe case.

These paradoxes are not normal.

This morning brings me back to the unusual nature of the disease - in particular how the virus may be killing T cells and causing long term immune deficiency in some people (there's been some talk of this before and how it has HIV like qualities)

This story is frightening:

www.reuters.com/article/us-health-coronavirus-china-patients-ins-idUSKCN2240HI
Recovered, almost: China's early patients unable to shed coronavirus

Those patients all tested negative for the virus at some point after recovering, but then tested positive again, some up to 70 days later, the doctors said. Many have done so over 50-60 days.

The prospect of people remaining positive for the virus, and therefore potentially infectious, is of international concern, as many countries seek to end lockdowns and resume economic activity as the spread of the virus slows. Currently, the globally recommended isolation period after exposure is 14 days.

So there are a number of patients few of whom have relapsed who have been stuck in a cycle of positive tests with no explanation and no idea what it means nor the implications globally which is causing concern.

This isn't a completely new phenomenon as there is apparently some precedent:

Paul Hunter, a professor at the University of East Anglia’s Norwich School of Medicine, said an unusually slow shedding of other viruses such as norovirus or influenza had been previously seen in patients with weakened immune systems.

In 2015, South Korean authorities disclosed that they had a Middle East Respiratory Syndrome patient stricken with lymphoma who showed signs of the virus for 116 days. They said his impaired immune system kept his body from ridding itself of the virus. The lymphoma eventually caused his death.

So if the virus causes an immune deficiency as well as taking a long time to shed its a double whammy of worry and concern and again raises this question of died of covid-19 versus died with in perhaps a more sinister way.

The article does not detail how severely I'll with covid-19 these patients were which is important. If it's doing that with asymptomatic or mild cases as well as severe it could be a ticking time bomb.

@woodencoffeetable my DS has osteomyelitis and discitus as a child. Do you think he would be at greater risk of catching the virus and could be vulnerable? We were always told that he may be susceptible in the future.

mumof I don't think so, aka 'knowbody knows quite yet'

I was just mentioning that sometimes/rarely systemic infections can lead to autoimmune reactions.

osteomyelitis sucks, I hope your ds has recovered from it and is pain free.

Fwiw I suspect our death rate will be higher long term than Germany's. It should be if covid-19 mortality is linked to obesity.

The trouble is that the political blame game needs to be open minded or it is self defeating in its ultimate objective.

If opposition parties focus on the cause of the higher death rate being PPE shortages, then they risk missing the far more important point about health inequality which already caused many more premature deaths than covid-19 has.

I suspect that if this is indeed what the science is suggesting, then the government will be quite happy for the opposition to think they have a good argument in focusing on PPE primarily.

BTW the cannonisation of the NHS with its front line martyrs feeds into the PPE failure story. And I fear the PPE scandal is one that's much more easily buried by authority over a couple of years.

If we can't find a vaccine quickly or one isn't effective for enough people (eg the most vulnerable can't have it, so if covid gets into a care home it still devastates it even post vaccine) or it doesn't last for long enough or there are long term issues with chronic health problems related to severe covid-19 (which disproportionately affect poorer communities) then the PPE scandal, I'm afraid does become almost a side show as infection at some point would be almost inevitable. All PPE would do is delay an awful inevitably we might have to live with long term and not really address the greatest risk factor out there at the same time.

This is a particularly grim possibility, but not one which is an extreme outlier of an outcome.

I don't think people have really worked this out - the idea of a vaccine being a magic bullet may not come to pass. In which case we are looking at needing to find how the virus works to create effective treatments which limit its seriousness but the speed of the disease means that there will be a high number of deaths which are unpreventable (especially in groups who do not respond as well to it due to age or other conditions).

Lockdown has fixed into everyone's minds that coronavirus will 'go away' in some shape or form and won't be a long term issue we have no choice but to confront head on in some form. It might be here permanently though.

@RedToothBrush yes yes yes.

Are you contacting major news outlets (apart from MN 😁)? Or in a professional position to influence decision makers? Sorry I can't remember if you've told us what your day job and/or credentials are.

Can we share your post outside MN??

I hear Bojo is giving an update later. Does anyone have any thoughts on what he might have to say?

Health inequality is what is happening in the US. I was reading an article in New York about teacher deaths and many were in what they call para professional (TAs) those who have little health insurance.

Can we share your post outside MN??

I can't stop you either way!

Does anyone have any thoughts on what he might have to say?

Newsnight said last night he was planning a personal message (lots of emotive stuff about his experience and contact with NHS over last couple of weeks - very good for winning people over with empathy etc etc)

And stressing what people could still do under lockdown (the soft lockdown lifting strategy playing out)

@Bercows someone on here reported last night that he was going to be talking about what we can do under lockdown restrictions, and surmising that this was a sneaky way of beginning to come out of lockdown.

I thought I heard on the radio that he was actually giving the daily briefing: is he not?

Must admit I thought this seemed a tall order given that he's just had a baby and it's his first one since he started self isolating, with all that followed for him.

@RedToothBrush yes you can if I choose to only do so with your permission!

Doesn't sound like anything to get excited about then. I'm hoping he will make things clearer for those who have trouble with comprehension of lockdown rules but I doubt he will be. He'll confuse them more and we'll see an increase in cases and deaths I think. We are coming up to 2 weeks after Easter weekend so the stats on Tuesday will be interesting. I don't pay much attention to those on Saturday, Sunday, and Monday as we usually get a Tuesday increase.

Thanks for the thread, all the insights are very helpful.

I find I am increasingly disliking Boris Johnson. To be honest I'm seething. I'm not a Tory fan anyway, but honestly that has nothing to do with why I'm angry.
I'm angry because we are in desperate need of professionalism and clear information during such a serious situation.
I'm sorry but I'm so fucking sick of him bringing anecdotes and nonsense language into it. Firstly it was him saying he was shaking hands with Covid patients (!!), then the "take it on the chin" comment, I'm glad he recovered but the emotional crap after was not necessary or useful - do we see other nations politicians who've been infected doing this??!!. If today's briefing is more of the same, peppered with a sneaky and unclear way of easing lockdown, I will despair!! Why not addressing the real issues.
Where is the professionalism??

Ranting moment aside, does anyone have the link to the WHO briefing where they discuss the possibly related syndrome in Children?? I can't find it anywhere.

Yes if you want to share, do so.