Infection fatality rates - can we live with this?

[PuzzledObserver]

Apparently there's going to be an update to MP's shortly about the latest data and how things look for unlocking.

I confess I have been concerned by how quickly cases have risen, already we are nearly a quarter of the daily cases we peaked at in January. However, very reassured by this report which says that the infection fatality rate now is only 1/20th of what it was in the winter wave (which itself I think was lower than the first wave, as we have got better at treating it.)

0.08% of cases now result in death - for every 10,000 people infected, 8 are likely to die. That's 8 too many, but hugely better than it was.

Yesterday there were 14,876 cases reported, which would mean 11-12 deaths eventually. IF maintained at that rate year round, that would be around 4,400 deaths per year - less than seasonal flu.

Is that the sort of level the public will tolerate in return for removing restrictions, do you think?

I appreciate it's not as simple as that - hospitalisation rates, long Covid and the risk of new variants arising are also relevant. But purely on the death rate, do you think we can live with it?

It would depend on how confident they are in those numbers staying around that rate given they’re surging WITH restrictions in place.

Depends on what it looks like when it peaks.

I’d be happy to tolerate that if it stayed at those levels, I guess we don’t know how high cases are going to get.

I’m really interested to hear what Sajid Javid says today.

If it was purely on deaths rate then yes, we probably could live with it. Providing no new variant with significantly more vaccine escape came along.

But unfortunately it isn’t just about death rate. Transmission rates are important too. You need to take everything into account. No point getting the IFR low if deaths then suddenly shoot up because all those people are ill at once and people start dying of Covid because they can’t get treatment for it.

AS there is still a sizeable proportion of adults who haven't had their second dose of vaccine, or even their first, I would assume that rate to drop further as long as the vaccine carries on working.

How does that death rate compare with say flu (hard to guess I suppose as there is no testing to see how many people may actually have flu in a bad year).

Probably yes, but the error bars are pretty large around that number at the moment, so a lot of sums will need doing with the emerging data in the next couple of weeks.

I think as you’ve kind of already said in your OP, it’s not just death rates … for me, long covid is a big concern and also potentially unknown long term effects of the virus on the heart, brain etc. Appreciate we cannot lock down forever though.

I'd think I'd like to see a drastic reduction in infection rates before the country unlocks however even with restrictions in place it doesn't mean people are following them.

I don't want to live in a world where masks and isolating because of exposure is a way of life.

70 kids were sent home this morning at my kids school because they've been exposed to a positive case;this needs to stop so that these kids can have a proper education.

I wish more people would take up the offer of the vaccine;I had some awful side effects but I'd do it again if necessary

@PuzzledObserver

Apparently there's going to be an update to MP's shortly about the latest data and how things look for unlocking.

I confess I have been concerned by how quickly cases have risen, already we are nearly a quarter of the daily cases we peaked at in January. However, very reassured by this report which says that the infection fatality rate now is only 1/20th of what it was in the winter wave (which itself I think was lower than the first wave, as we have got better at treating it.)

0.08% of cases now result in death - for every 10,000 people infected, 8 are likely to die. That's 8 too many, but hugely better than it was.

Yesterday there were 14,876 cases reported, which would mean 11-12 deaths eventually. IF maintained at that rate year round, that would be around 4,400 deaths per year - less than seasonal flu.

Is that the sort of level the public will tolerate in return for removing restrictions, do you think?

I appreciate it's not as simple as that - hospitalisation rates, long Covid and the risk of new variants arising are also relevant. But purely on the death rate, do you think we can live with it?

Yesterday there were 14,876 cases reported, which would mean 11-12 deaths eventually. IF maintained at that rate year round,

That's the problem right there.

How to maintain that rate? Numbers are climbing rapidly right now even with all the testing, isolating, restrictions etc

In short, there are only two devices to keep infection numbers to that level - vaccines and restrictions. We don't yet know if vaccines alone will be sufficient, indeed they certainly won't be enough to keep infections as low as they are currently.

So your question is Is that the sort of level the public will tolerate is a false one.

NB If vaccines DO let us get back to something close to normal, then it's quite likely that covid will simply take over from flu as a killer of the very old and at a greater rate. I think 50-100k deaths in an average year is not unlikely. Aside from the deaths, that will also mean the NHS will need significantly more funding to cope as they already struggle in a bad flu season.

I think it depends the flu deaths are generally in the older population these deaths are in the younger generation - perhaps when fully vaccinated this will drop.

@Seeline

AS there is still a sizeable proportion of adults who haven't had their second dose of vaccine, or even their first, I would assume that rate to drop further as long as the vaccine carries on working.

How does that death rate compare with say flu (hard to guess I suppose as there is no testing to see how many people may actually have flu in a bad year).

Seasonal flu IFR is estimated to be 0.039% (NZ study)

That'll include the impact of vaccinations of course. NZ vaccinates somewhere between 1/4 and 1/3 of their population. The UK rate is apparently around 70% which I find astonishing as I've never even thought about having it, nor been offered it!

So that means the flu IFR in the UK will be lower of course (more vaccinations mean more people are protected).

NB when people talk about a bad flu season, it probably pertains to case numbers more than a higher IFR. If twice as many people catch the virus, then twice as many will die.

You also have to look at long covid statistics - thousands are suffering with long covid, my ds included.
He is in his early 20s and before he caught covid he was very fit and healthy. He used to work out daily, now months later he can't even walk to his local shop.
Fatalities have come down but we need the statistics on how many are being left disabled and seriously ill with life long health conditions after x

In short, there are only two devices to keep infection numbers to that level - vaccines and restrictions. We don't yet know if vaccines alone will be sufficient, indeed they certainly won't be enough to keep infections as low as they are currently.
I would add there is another device - our own immune system - as part of the fight against the virus. (and of course our common sense in making sure we take what precautions we can while living with the virus in the short term)

The answer to your specific question is yes. 4400 deaths a year to avoid the horrible restrictions which are not only not sustainable but also responsible for a significant amount of human suffering (including projected loss of life running into the tens of thousands over the next 5 years) - are people seriously suggesting they wouldn’t take that?

In short, there are only two devices to keep infection numbers to that level - vaccines and restrictions. We don't yet know if vaccines alone will be sufficient, indeed they certainly won't be enough to keep infections as low as they are currently

Then infections will have to rise. I think we all know and expect that infections will rise when restrictions lift.

The answer to your specific question is yes. 4400 deaths a year to avoid the horrible restrictions which are not only not sustainable but also responsible for a significant amount of human suffering (including projected loss of life running into the tens of thousands over the next 5 years) - are people seriously suggesting they wouldn’t take that?

This.

Also, yes infections will rise but I’d also expect to see that FR fall further as more are DV. One would hope that advances in therapeutics will be coming through and will also help.

@SonnetForSpring

Depends on what it looks like when it peaks.

But as more people become fully vaccinated, there'll be fewer people who will become seriously ill/die. And given that those getting their first jabs now are under 40 so getting the Pfizer, which offers up to 94% protection against hospitalisation from one jab alone, we may be pretty close to the peak.

@justwanttodanceagain Thank you - interesting figures.

I am surprised at 70% flu vaccinations but I suppose it's offered to over 60's (or is it 65?), children under secondary school age, pregnant women, those with relevant health issues, NHS workers and probably others I've forgotten. I know some people also pay to have it at high street chemists etc.

Don't forget that therapeutics are constantly improving, too, which will impact death rates in the months and years to come.

In answer to your question, OP yes, we can. And at some point soon, we must.

It's not just fatality rates though. More infection, more people left with long covid, chance of mutation, etc, etc.

It's tricky though isn't it because it still hospitalises 5% of the population who catch it. I don't know what the answer is, but I don't want to have to be on hospital on oxygen

It's tricky though isn't it because it still hospitalises 5% of the population who catch it.

Is that the case among the double jabbed?

It's the case now, which includes double jabbed people, but yes I guess you assume it'll come down.

@Hopefullynamechanged935

It's tricky though isn't it because it still hospitalises 5% of the population who catch it. I don't know what the answer is, but I don't want to have to be on hospital on oxygen

No - the risk of being hospitalised is currently massively lower after full vaccination.

Your post is not stating some key data:

• what will the peak look like, as the rates you mention are for the last few days and where I live there is an explosion of cases and we're not even fully reopen yet
• the number of people who can get long covid even with two doses of the vaccine

And looking forward:

• the total unpredictability of the mutation of the virus, in this country and in other countries
• will teenagers be vaccinated, and how quickly can we double jab at least 80% of the adult population
• will a 'cure' be discovered (likely to be a cocktail of drugs that will prevent severe covid and/or long-covid)

@roguetomato

It's not just fatality rates though. More infection, more people left with long covid, chance of mutation, etc, etc.

It’ll mutate abroad and get imported whatever we do here.

Long covid is horrible and I feel for anyone who has it but it is not proportionate to keep the country under these very damaging restrictions to avoid long covid. It was one thing to do it to avoid an overwhelmed health service and a death toll into 6 figures, it’s another to suggest we do it to avoid long covid. People suffer badly with long covid but people suffer badly with social distancing and covid restrictions too. It can’t always be the covid factor that takes priority.