Westministenders: Peak something

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Westministenders: Peak something

The story so far

COVID has changed the world for the next few years, like a slowly exploding nuke:

• killed well over 100,000 people
• made many people afraid to leave their home
• caused a Global Depression

Countries locked down because they needed the extra time to

Raise the Line while Flattening the Curve:

1. Flatten the curve of the numbers needing healthcare to a level the system can manage

2. Raise the capacity of their health services and public health systems - their testing and tracking process

Also, scientists desperately needed time to find out more about COVID:
how to avoid it, how to treat it

What happens next ?

Research teams around the world are working to produce a vaccine,
will become hopefully available within the next couple of years

In the meantime, treatment procedures are being developed to better treat COVID sufferers.

Also in the meantime, countries will need to gradually exit lockdown to rescue their economies from complete catastrophe.

Timing & measures for each country will be dependent on:

Death rate after peak,
health service capacity,
testing & tracing capacity etc

....and also what their govt and public deem an "acceptable" level of extra deaths & serious illness.

Possibly some countries will need to cycle in and out of lockdown,
whereas others will be able to accept the death toll with lesser social distancing measures.

The first few countries are already relaxing lockdown,
so the UK will watch, wait and hopefully learn what works and what doesn't

..... then copy these the correct way round

It is the ethical side that bothers me too MIsti. Bad enough that I already feel we are being treated as guinea pigs for herd immunity without consent, without being shoved a dodgy vaccine just so Boris can say "I win!" to the world.

This is where politics really doesn't help medical science re trust. This govt really shot itself in the foot with the Brexit rants about not trusting experts and then trying to blame scientists for the herd immunity "strategy".

I don't think there is any risk of the U.K. testing a "dodgy vaccine" while other countries wait or give their population a vaccine that works.

Firstly the vaccine probably won't be produced in the U.K. and it will go through EMA and FDA approval processes. Secondly the risk is that the UK gets it later than other countries because of Brexit, not earlier.

Thirdly, the NHS and its medical staff are not devoid of ethics even if your politicians are. Giving a vaccine will require buy-in from medical professionals. It won't be political. No one sane is going to go to their MP or local councillor for a jab.

Labour have a theme they're going to push in the coming weeks: Dunkirk Spirit, Britian At Its Best. Little Ships. Where are the Little Ships? Govt. obsessed with giant tanker like Rolls-Royce, Airbus and Burberry, who take twenty miles and three weeks to turn around. The smaller nible SMEs could have had the PPE in the hospitals by now.

Little Ships.

Just looking through a bunch of research.

There was the Icelandic study before that seemed to show that under 10s weren't spreading covid-19. There is now one from Vo in Italy which tested most of a town. No child under 10 tested positive. What's more is this was the case in households where family members had it, and it bucked the trend of family members being at very high risk of getting it.

That's reassuring, but still doesn't stop the risk of adults on the school run...

Also asthma seems to be proving far less of a risk factor than feared

And this might be consistent with reports that covid-19 isn't merely a respiratory disease but a vascular one. Indeed the underlying conditions which seem to pose most risk for mortality seem to be mainly vascular in nature.

It's intriguing.

Still the research is in early stages so lots of salt needing to be pinched.

Other problem going forward is asymptomatic and presymptomatic cases are going to be a problem for stopping a second wave... And that's why testing is essential. If our testing ability (and crucially quick universal access to it - so more than just drive thrus) isn't up to scratch we are fucked. If we leave lockdown without it being good enough we will have a problem.

Which means early May end to lockdown is too soon. Mid to late May is earliest viable in UK I suspect. Keep your eyes on this for politics over science... Hawks hold balance of power in cabinet atm.

I also think that big businesses putting pressure on people to return to work should pay for their staff to be vaccinated if needed

I guarantee you that many big businesses will already be planning for how to do this. My employer has for a number of years offered free flu jabs to any U.K. employee who wants one and will undoubtedly offer the CV vaccination as soon as it can (but I don't expect businesses to be able to do this until priority NHS patients have had their turn).

Shh! We have to whisper this. Dunkirk was a rout, a disaster, militarily.

In reality, I suspect that getting so many people back, did mean that they were available for war work, instead of being killed early on, which may have helped the longer term success.

There is now one from Vo in Italy which tested most of a town. No child under 10 tested positive. What's more is this was the case in households where family members had it, and it bucked the trend of family members being at very high risk of getting it.

It's interesting for sure but the numbers are tiny. They tested around 3k people but the prevalence rate was low so in many age groups there were only single digit positives eg 3 cases from 10-19 years. In that context a 0 for young children looks hopeful but not conclusive evidence.

So - it's encouraging but the data we have is either based on samples that are way too small or way too biased.

Before human trials, though, vaccines are usually extensively tested on animals for efficacy and safety. That’s being expedited here, to run in tandem with human trials in the cases I’ve read of. If the trials in animals were to indicate the vaccine(s) was not effective, then human trials would likely be paused as there’s no point exposing humans to risk with no evidence of efficacy.

I wouldn’t personally want to be in the first swathe of human volunteers.

Either way I doubt vaccines will get out fast enough to slow the current outbreak.

Before human trials, though, vaccines are usually extensively tested on animals for efficacy and safety. That’s being expedited here

That's true, but a lot of what is being tested in current first-in-human trials has been effectively copy-pasted from work on other vaccines. So I don't think that patient safety is being sacrificed here.

The bigger ethical issues will come later on, when they start testing how it works. You can speed that testing process up by deliberately exposing subjects to the virus ... but that comes with obvious risks.

There are also other potential risks with new vaccines (i need to go to work now but anyone who is interested in this can google the Sanofi dengue vaccine, there seems to be concern that this sort of potentiation might be an issue in corona virus vaccines).

I'm optimistic for a vaccine but you still have to be honest about the risks involved.

Dunkirk was defeat snatched from the jaws of disaster. The troops got back, but left all their kit behind. And most of them came off the harbour wall in big ships. Not the point. It's tapping into a national myth.

In other news, govt cannot take decisions with BJ absent, which is odd because he was never there in the first place. Angry 10DS spoke calls the Sunday Times report of his truanting from early COBRAs as 'grotesque,' but not false because it is a matter of record.

Agree mistrigri

It does not show under 10s can't get covid-19. It suggests they may be at less risk of catching it and then therefore spreading it, but that's as far as the research goes at this point.

It's encouraging but definitely not conclusive.

To make big decisions off the back of that would be somewhat foolhardy.

Waiting to see what happens in places with extensive testing and schools reopening will be an experiment in itself.

I imagine one of the main issues with this vaccination is the wide range of comorbidities patients may have that makes them at risk.

Looking at Sonifi it seems viral load is possibly a risk with any vaccination for COVID (ultimately increasing severity of any infection) and efficacy vs. effectiveness questions?

Also before I go, here in France now it does seem that positive cases are occurring mainly in particular settings. Two thirds (!!!!) of the sailors on board a French navy ship are now positive. The ship has docked once in about six weeks, in early March, and the first positive cases were detected until April. Strongly suggests significant asymptomatic spread in young healthy populations, which means you don't even know you have a problem right up till the moment you have a BIG problem.

Bet you have a massive massive issue in U.K. prisons that no one is talking about.

www.statnews.com/2019/05/01/fda-dengue-vaccine-restrictions/
Regulators have sought to restrict access to Dengvaxia following post-marketing research by Sanofi that showed that, while the vaccine offers protection for people who have already had at least one bout of dengue, it increases the risk of severe infection in children who were dengue-naïve — that is, never infected — when they were vaccinated.

That's true, but a lot of what is being tested in current first-in-human trials has been effectively copy-pasted from work on other vaccines

Covid is a novel pathogen though, and in addition you can’t copy and paste new science. - While all vaccines work on the same principle, some research is using old approaches (and there is existing work on coronaviruses from previous epidemics) - and some research is using new technology.

In other news, govt cannot take decisions with BJ absent, which is odd because he was never there in the first place.

Mistigri
www.theguardian.com/society/2020/apr/18/uk-coronavirus-prison-plan-suspended-after-six-mistakenly-released

On another thread I learn that young children are less affected because they have fewer ACE2 receptors, which the virus exploits to enter cells.
But children get older, and if they haven’t been infected (or if they have, but have fought it off at the cellular level rather than via the immune system), they could/will become vulnerable, presenting a new cohort to be infected. (Of course, I may have misinterpreted the information.)
Also, the fact that not everyone develops antibodies surely makes antibody testing somewhat unreliable?

I see it's come from labour re. Boris skipping the cobra meetings.
I can't get worked up about it. He delegated others to go and he made all the main decisions.
Meh

Anybody else hear on R4 news that Johnson is improving and is increasingly "taking back control"?

Johnson failed to call Cobra meetings on time, and then skipped then before he was ill. What is the point of his being PM if he can't be bothered to do the job?

I see the consignment of PPE from Turkey due today and announced with fanfare at yesterday afternoons press briefing is 'delayed'.
At least the consignment from China has landed in Scotland.
Let's hope it is what was ordered (and that that was of sufficient quality)

Yes, I've heard rumours that murmers that Johnson should be back soon.

With A Plan, to appease the rumblings, hastily scribbled on the back of a fag packet.

Boris Saves The Day, Hurrah.

Unfortunately, the virus is not political and its going to be damn hard to pretend everything's going well with the death toll rising fast.

RTB wasn't the Icelandic test flawed for some reason I can't recall ; I think it was done while schools were closed, so the had had very few 'opportunities' to catch it.