Do people actually realise how few are dying from coronavirus now?

[Mrschickpeabody]

It’s all still doom and gloom on the news as normal regarding coronavirus. Loads about cases going up, local lockdowns, negativity regarding schools going back but nothing about the fact that hardly anyone is actually dying from coronavirus or being admitted to hospital. Can we not hear about positive things for once?

"A libertarian dream... A nightmare for the vulnerable."

I was reading an article about community immunity which explained that the idea is the opposite of that. The vulnerable need to protect themselves in the short term while the strong go out and catch the disease and develop a level of immunity which reaches a point where the virus doesn't spread, so the vulnerable are safer. As he put it: it's the strong protecting the vulnerable.

"Well hospitals in London almost ran out of oxygen. Seems pretty dire to me."

Running low on particular supplies, including oxygen, isn't particularly uncommon for hospitals. Just occasionally a taxi has to be despatched to borrow supplies from elsewhere. It is generally more common at times of high demand if ordering/supply gets out of kilter. And they didn't actually run out of oxygen because the systems to prevent that worked.

That only really works if immunity lasts ( which they are sure it doesn't ) and the vulnerable is a small enough fraction of the population ( it isn't)

@midgebabe

That only really works if immunity lasts ( which they are sure it doesn't ) and the vulnerable is a small enough fraction of the population ( it isn't)

We really do need that vaccine.

I feel positive we’ll have one though. Even if I’ve heard vastly different timelines just this week.

"Stop panicking – it’s over

Whilst everyone is panicking about the ever-increasing number of cases, we should be celebrating them. They are demonstrating, very clearly, that COVID is far, far, less deadly then was feared. The Infection Fatality Rate is most likely going to end up around 0.1%, not 1%."

Superb article. Inpossible to sum up in a couple f sentences but largely the worldwide panic was caused by confusing the infection fatality rate and the case fatality rate and contrary to previous practice of a case being someone showing symptoms a case being a positive test even the the subject was completely healthy.

drmalcolmkendrick.org/2020/09/04/covid-why-terminology-really-matters/

"Superb article."

It really isn't, it's dreadful! Full of errors, omissions and contradictions and written by someone who was a speaker at today's "anti lockdown" protest in Edinburgh which was organised by a Facebook group populated by people posting false information and conspiracy theories, describing the pandemic as a hoax and with anti vaccination views.
m.facebook.com/groups/2012190098915859

The other speaker at the Edinburgh event was this person, whose false claims have included saying that people who have had coronavirus are immune for life. www.irishtimes.com/news/education/ucd-school-of-medicine-disassociates-itself-from-professor-s-views-1.4283774?mode=amp
(She was also a speaker at the protest in Trafalgar Square last weekend along with anti semitic conspiracy theorist David Icke and Piers Corbyn).

The other speakers at an event have no bearing on the accuracy, of otherwise, of the article linked

Superb article. Inpossible to sum up in a couple f sentences but largely the worldwide panic was caused by confusing the infection fatality rate and the case fatality rate and contrary to previous practice of a case being someone showing symptoms a case being a positive test even the the subject was completely healthy

Yes and no.

It's a numbers game.
Indeed, and particularly now with good testing, we are getting close to what is an infection fatality rate.
However, from the start, it was closer to a case fatality rate, as most people tested were showing symptoms.
The comparison with other infections is also unfortunate as it is rare that all infections are detected or tested for. An example would be HIV.

Finally, the sheer number of deaths becomes a problem when infection spreads so rapidly and we don't know who's infected and spreading it (which was a big issue at the start).

To conclude, yes, it's not a horribly deadly disease (like ebola our aids) but it spreads fast enough to be a serious threat and a problem, without control measures.
With control measures we should be able to deal with this, without panicking. But complacency will lead to problems.

I don’t think you can take any article about the hospitalisation rate that fails to mention the age profile of the current outbreaks in Europe seriously. And I believe the hospitalisation rates in France and Italy are starting to rise this week which might turn out to spoil his argument a bit.

I can’t help thinking that the phrase - stop panicking it’s over - might come back to haunt him.

twitter.com/DiseaseEcology/status/1252844190070829056?s=20

This source seems to me to be a more useful / comprehensive discussion of case fatality rate Vs Infection fatality rate.

The Infection Fatality Rate is most likely going to end up around 0.1%, not 1%

Given a current number of deaths are significantly over 0.1% in a number of places, that rate is clearly too low.

I was reading an article about community immunity which explained that the idea is the opposite of that. The vulnerable need to protect themselves in the short term while the strong go out and catch the disease and develop a level of immunity which reaches a point where the virus doesn't spread, so the vulnerable are safer. As he put it: it's the strong protecting the vulnerable.

If a vaccine wasn’t a realistic prospect in the coming months then that would be the only way to manage Covid.... We clearly can’t live in this way for ever.

"Stop panicking – it’s over*

“Stop panicking” I’m not sure anyone is panicking at the moment!

“It’s over” Really?

www.aa.com.tr/en/europe/spain-over-920-covid-19-patients-hospitalized-in-a-day/1954262#

that would be the only way to manage Covid

But it would only work if people develop long-term immunity and it’s not thought that they do.

"But it would only work if people develop long-term immunity and it’s not thought that they do."

I don't see any evidence for the wonderfully vague 'it's not thought that they do' (by who? on what grounds?) but if that's the case there's no reason to suppose a vaccine would work either. Both rely on exposure to the virus causing an immune response.

No naturally-acquired immunity, no vaccine. Then what?

But it would only work if people develop long-term immunity and it’s not thought that they do.

That’s not the case. T cell immunity looks to be significant.

Very interesting article. We clearly need to be distinguishing between symptomatic and non symptomatic cases.

Treating case numbers like we treated them in March is clearly very problematic.

if that's the case there's no reason to suppose a vaccine would work either

Correct. It’s thought that vaccines are going to have to be readministered every 6 months or every year.

"It’s thought that ... "

Who is doing all this thinking and what are they basing it on?

1. Repeated tests and Studies of people known to have been infected show their antibody levels drop over time
2. Seroprevalence studies show that antibody levels in the same area seem to decline over time.

1. There is I think a question mark that some people can fight off infection with t cells etc but the vaccines will prompt an antibody response that will probably similarly decline over time

Here’s a recent review on immunity:

www.nature.com/articles/d41586-020-02400-7

Immunity to the common cold corona viruses doesn’t last long. Antibody responses to Covid-19 don’t last long in mild cases. Longevity of other components to the Covid-19 immune response is currently unknown.

Covid makes B cells forget but T Cells remember:
www.sciencedirect.com/science/article/pii/S0092867420311545

Robust T cell immunity in mild and asymptomatic covid patients:
www.sciencedirect.com/science/article/pii/S0092867420310084#:~:text=SUMMARY,immune%20protection%20against%20COVID-19.&text=Importantly%2C%20SARS-CoV-2,asymptomatic%20and%20mild%20COVID-19

But it would only work if people develop long-term immunity and it’s not thought that they do

But we can’t live in this way permanently. If there is no vaccine, then we will have no option but to blunt Covid as much as we can through having a level of herd immunity built up mainly in the young... This won’t be perfect, but it provides a much tougher environment for the virus to transmit itself... R will be far lower and the risk of widespread community infection will fade, even if there remains some rarer transmission as antibodies wane in certain individuals. The pressure we would have put on Covid would make it likely that a mutation would gain traction that is sufficiently different to the original to evade the antibodies, and replace the current version, with the potential for this to be (hopefully) less deadly and Covid-19 will have been superseded by a similar but different coronavirus, and so the endless battle between human and virus continues....

Here at around 41:20 lead immunologist Professor John Bell says that coronavirus vaccines will probably have to be seasonal: