Plan if cases increase exponentially again

[BlueBlancmange]

Cases appear to be rising rapidly again. If deaths start increasing dramatically again too, how we will be able to contain things again, as surely another national lockdown is not feasible? Also since it's looking like there is long term damage in a high number of cases, there could end up being a lot of people with ongoing, possibly permanent physical issues.

I am optimistic about a vaccine, but I am starting to worry it might not arrive quickly enough to prevent a large scale disaster as things spiral out of control again.

Another reason the death rate is lower is that hospitals tend not to intubate as they once did, but use CPAP and also steroids - there was some 50p/day drug they found really helped relieve symptoms.

What I will say about ‘long Covid’ is that it can’t be that long can it? The peak was March/April. So yes it may take 5 months for some to recover which is a long time but this can apply to other illnesses; Pneumonia, sepsis, flu all can take months to get better or can leave you with some inflammation, tiredness.

We aren’t years down the line yet. So we don’t know if these after effects will last for years do we?

@Delatron

What I will say about ‘long Covid’ is that it can’t be that long can it? The peak was March/April. So yes it may take 5 months for some to recover which is a long time but this can apply to other illnesses; Pneumonia, sepsis, flu all can take months to get better or can leave you with some inflammation, tiredness.

We aren’t years down the line yet. So we don’t know if these after effects will last for years do we?

Yes exactly. I had long Covid which I have now, 5.5 months later, recovered from entirely.

Pleased you’ve finally recovered @kaktus
I think it’s also promising that the reports today are showing the lung damage some people were suffering from was healing after 3 months.

I just get annoyed with all the catastrophising. All this talk of ‘ permanent lung damage’. How do we know when the virus has only been around in the country since about Feb? It will take years to make those types of conclusions.

Serious respiratory illnesses can and do take months to recover from. You often get post-viral fatigue. This isn’t unique to COVID-19.

@Isitisntit

There are not a high number or percentage of people with long term issues from covid-19. For most people, it is mild. Don't catastrophise

Apparently 10% of cases will go on to have long Covid. According to the BMJ, cited in this BBC news article. That sounds like a lot of people to me.

www.bbc.co.uk/news/uk-england-norfolk-54016357

I cant think of many illnesses that produce such high rates of pvf though Delatron. Its not just about pneumonia and lungs either. I'm 5.5 months in and my symptoms are neurological. A friend of mine is now borderline diabetic (her blood sugar levels pre COVID were fine).

I guess some of us are are a bit nervous of the "oh it'll be fine" narrative, as you point out we are some years away from knowing what the final reckoning will be. Apart from which, being off work for months might be no big deal for you, but for many people it can spell financial ruin.

@Redolent

Cases are already increasing exponentially (as soon as R is above 1). They’re just increasing at a slower rate (doubling every three weeks instead of every three days).

They’ll tell people to ‘shield’ (a much wider category - the obese etc). Of course this will be ignored. Then the media will report no more hospital beds (the typical winter flu chaos but magnified) and people will be scared of their own accord, and minimise contact. That’s the best case scenario for the government.

In the meantime they’ll use this ruckus to push some Brexit monstrosity.

So we have had a 40% increase from Saturday to Sunday. it might in fact have been higher as so many people couldn't get access to testing.

We have gone fro 972 cases on 24th August to 2988 cases on 6th September.

It is possible to cut the figures different ways, but it doesn't look like it is taking 3 weeks to double, to me.

972 24th August
1184 25th August
1048 26th August
1522 27th August
1276 28th August
1018 29th August
1715 30th August
1496 31st August
1295 1st September
1508 2nd September
1735 3rd September
1940 4th September
1813 5th September
2988 6th September

The curve is looking especially steep for early September and this includes a weekend period with the testing failure, so numbers probably higher.

"Apparently 10% of cases will go on to have long Covid. According to the BMJ, cited in this BBC news article. That sounds like a lot of people to me."

Like someone said up thread, there is no definiton of long covid. I read an article yesterday (will try and find it) that said there is two criteria being lumped into one. One is symptoms more than 3 weeks which was thought to be about 10% and the other was actual long covid which lasts months and that was thoight to be 0.5%. Will try and dig out where I read it

Interesting change of tone from Matt Hancock on LBC this morning - apparently “Long Covid is prevalent among under 25s” & “young people can get really sick”.
Also quoted figures for fast rising hospitalisations in France & Spain.
What happened to mild?!!
Another schools u-turn is looming. Mask up!!

Anyone who advocates herd immunity should also say what they think the herd immunity threshold is (the percentage of the population who need to get infected in order for herd immunity to be achieved) and how long immunity lasts for.

@roses2

Three months ago *@AlternativePerspective* posted this on another thread. I personally think it is still spot on:

=============================================
www.mumsnet.com/Talk/_chat/3940273-2-new-Covid-cases-in-New-Zealand

This potentially controversial, but I think that it’s actually possible that some countries shut down too early, as much as people want to blame our’s and other governments for not shutting down early enough. New Zealand and China have both had reoccurences of COVID, although relatively small outbreaks.

Not shutting down as early does mean that some people will have been exposed to COVID and may even have had it a-symptomatically without knowing and developed some immunity. If you cut that off before it has even spread a little bit, then you run the risk that when you re-open, you have an entire population who haven’t been exposed at all and who are all still as vulnerable as they were before the initial shutdown.

I had wondered whether the countries who shut down so quickly and who were praised for it were being a bit too confident about saying that they had eradicated the virus when other countries were still in the stages of fighting it. It was inevitable that some people would have gone back into those countries and taken COVID with them, and with an entirely untouched population this would spread.

I think that our shutting down later might actually end up being to our benefit in the long run. And before anyone jumps on me and suggests I think that the number of deaths is a good thing, of course it isn’t. But while shutting down early might have prevented deaths this time round, if we had done that and then opened up too early the number of deaths could have been far worse.

As for the vaccine, things have gone very quiet on that score for a number of reasons. Firstly because it’s perceived the numbers are actually dropping so quickly that it’s impossible to test the efficacy of a vaccine, and secondly because while there have been a number of trials, none of them have been effective in creating immunity against the entire virus.

The key is going to be effective treatment and herd immunity, so that less people are likely to catch it. But that is going to be a long-term thing. And in the meantime we as a world population are going to have to learn to live with COVID, or hope that it burns out, which is still a possibility.

====================================================

Wishful thinking im afraid. 'Herd immunity' does not work that easily without vaccination. We also are not protecting the vulnerable, quite the opposite at the moment I'm ashamed to say. The US, followed closely by the UK are not going to come out of this well. We have one of the highest death rates along with one of worst economic dips. We locked down too late and the guidance is so ridiculous and wishy-washy that hardly anyone is following it anymore. I dread to think what is going to happen.

Florida deaths & hospitalisations with covid are both trending down?

So we have had a 40% increase from Saturday to Sunday. it might in fact have been higher as so many people couldn't get access to testing.

The positive testing figures are really hard to interpret. What we need is either:

• The percentage of tests that are positive
• The number of hospitalisations.

I think both those numbers are available somewhere.

Totally agree with @SallySeven - people have often had long tails from viral illnesses in the past, but the NHS never took it seriously. In 2008 I had a bad stomach bug lasting 3 days and was unwell for two years after with all kinds of symptoms. Needed almost three months off work initially and took me ages to build back to regular health.
So I am glad that long covid is being taken seriously as it might mean perception of long term viral damage changes and all people who report long standing symptoms are supported, covid positive or not

Cases are not massively rising

We are testing more

If you look you will fine

Testing has increased a lot last few weeks

Test positivity has only gone up 0.3% so hardly a ‘massive rise in cases’ at all

Find

Anyone who advocates herd immunity should also say what they think the herd immunity threshold is (the percentage of the population who need to get infected in order for herd immunity to be achieved) and how long immunity lasts for

I’m not advocating it, just pointing out that if R0 is about 3 we need at least 2 in 3 people to have immunity to keep R at 1 or below.

It’s currently unknown how long immunity lasts for but in cold-causing coronaviruses it is a matter of months.

Agree with @Egghead68

For a disease which has an R0 of 2-3 (without precautions) you need a herd of 60% or over that is immune.

If it is vaccine immunity, then you can keep all parts of the herd topped up at all times. If no vaccine, then it it will flare every time enough of the herd is vulnerable (either by immunity waning or because new people are born)

@lifesalongsong

Except they are not working

We need to be doing as much as possible to find out why the populations in some areas aren't complying with local lockdowns, the problem isn't the approach imo it's not knowing why residents are ignoring the risks

Interesting Hancock specifically referenced 17-21 year olds in affluent areas. Holidays etc. presumably.

@scaevola

Agree with *@Egghead68*

For a disease which has an R0 of 2-3 (without precautions) you need a herd of 60% or over that is immune.

If it is vaccine immunity, then you can keep all parts of the herd topped up at all times. If no vaccine, then it it will flare every time enough of the herd is vulnerable (either by immunity waning or because new people are born)

If we end up with no vaccine and immunity doesn't last, then the outlook for the future is rather grim. We could essentially be dealing with an illness that comes around like a common cold but unlike the common cold leaves many dead and many others with long term damage. And even if you got off lightly with the first infection, who is to say you would on subsequent ones? I don't really see how we could 'just live with' repeated bouts of Covid, so I very much hope there will be a vaccine and also that immunity does not generally wane rapidly.

Very unlikely we will have no vaccine whatsoever. Huge research efforts are going into vaccines and preliminary signs are encouraging.

However it seems likely that the initial vaccines (at least) will be far from perfect and will need to be given regularly.

@mac12

Interesting change of tone from Matt Hancock on LBC this morning - apparently “Long Covid is prevalent among under 25s” & “young people can get really sick”. Also quoted figures for fast rising hospitalisations in France & Spain. What happened to mild?!! Another schools u-turn is looming. Mask up!!

He's got the stats for that of course?

God, yes, I totally believe anything Matt Hancock says .

@ChanceChanceChance I'm so glad I noticed your comment about myocarditis!

Just before lockdown my daughter and I suffered a horrendous cough that the GP couldn't help with. We were tested for whooping cough at one point but not covid because it apparently wasn't in the UK yet. It took me another 2 months to feel remotely better again.

At the same time my other daughter was a bit under the weather and had a weird rash which wouldn't go away.

My husband felt under the weather but not majorly. He is very fit and athletic. A few weeks after we all felt a bit better he was incredibly ill. With myocarditis. It was terrifying.

Anyway, my point was just to say the reports on the athletes in America are really interesting.

Matt Hanjob trying to scare the young people with that perhaps, as they are in the majority of new cases. Noticed he also told them 'don't kill granny. Hmm.

On the immunity, some studies have shown people have immunity already from other viruses (T cell immunity) may be up to 45%. So need to add this to the others immune from covid, brings the 60% figure down doesn't it.

directorsblog.nih.gov/2020/07/28/immune-t-cells-may-offer-lasting-protection-against-covid-19/

No-one mentions Sweden anymore, but their rates are really low now - lower than other countries next to them..