MERS Coronavirus warning

[amazing__lobster]

But not only that patients aren't being treated in ITU , but that the hospital wasn't admitting many covid patients at all.
I on,y went down to have some allergy testing done .
Yet in another hospital local to me they treat you for covid whether you have evidence of it or not . Crazy. It is polarising folk this covid malarky.

It's strange - I went to my local hospital for an issue I've currently got (central serious retinopathy - or alpha male disease as my optom called it) and the hospital also seemed dead. No idea how many COVID patients they had in, but generally it was quite.

However my friends partner is a nurse in another hospital in a nearby city and apparently they were having to flip wards into COVID wards because they were running out of capacity to treat existing cases.

And yes - your final point, I don't understand why a pandemic has been polarised to such an extent that it's sent some previously normal people into claiming things like its a political conspiracy etc etc, and also drawn up clear dividing lines.

 

[Archibald]

The Oxford/Astra Zeneca vaccine. Only £3 a pop. The world needs a vaccine in large numbers.

So next years UK Foreign Aid budget - might one suggest it isn't in cash, it's in vaccine doses. A bit rough on turd world rulers who are accustomed to skimming off "a little" UK cash into their Swiss bank accounts but better our aid actually gets put to use?

AZ / Oxford are going to produce this at cost

Pfizer and Moderna are doing it at their usual mark up

With the fact that the AZ / Oxford logistics will be broadly similar to the present Flu vaccine pipeline I expect in the UK at least the AZ / Oxford that will be rolled in preference to the other two

Archie

 

[Norsemaid]

The Oxford/Astra Zeneca vaccine. Only £3 a pop. The world needs a vaccine in large numbers.

So next years UK Foreign Aid budget - might one suggest it isn't in cash, it's in vaccine doses. A bit rough on turd world rulers who are accustomed to skimming off "a little" UK cash into their Swiss bank accounts but better our aid actually gets put to use?

HHa ! Then watch them fade to a whiter shade of pale !
The companies who have produced the vaccines are saying that More vaccines from other labs and companies are needed if the world is to be vaccinated against covid not just money given to pooorer countries.

 

[Whey_Aye_Banzai]

The Oxford/Astra Zeneca vaccine. Only £3 a pop. The world needs a vaccine in large numbers.

The company says - according to the Beeb - that they're not going to make a profit on it from poorer countries.

From that I assumed they'd increase the cost of it for the more wealthy countries to make a profit; or at least break even.

Edited to add: Big Pharma need to make a profit to cover the costs of the expensive - but unsuccessful stuff - they attempt to produce.

So capitalists tell me.

 

[Nick Dipples]

In my own line of work the hospitals have not stopped giving cancer patients needed therapy - including stem cell transplants and other intensive stuff. This is in the USA though and they probably have more capacity as the cancer hospitals are somewhat self-contained, with their own ICUs and that kind of thing.

We had about 3 months when we couldn't enrol new patients onto my study, though that was the company being risk-averse.

 

[Nick Dipples]

The company says - according to the Beeb - that they're not going to make a profit on it from poorer countries.

From that I assumed they'd just increase the cost of it for the more wealthy countries to make a profit; or at least break even.

They are also charging "at cost" for 1st world countries "while the pandemic lasts", though I understand they have taken a fairly liberal approach to that definition. Not really looked into the detail though.

 

[terminal]

Do you have to?

Let's recap:

1. No-one knows how effective masks are in non-clinical settings.
2. Asymptomatic types aren't likely to be that contagious.

So we need some science on how contagious pre-symptomatic types are.

From Nature:

Although many factors are involved with transmission efficiency, it appears that asymptomatic/presymptomatic transmission measured by direct contact tracing studies is lower than that predicted by COVID-19 transmission models.

Is presymptomatic spread a major contributor to COVID-19 transmission?

www.nature.com

So the science doesn't know either, but 'is lower than predicted by the models' (no surprise there with regards the models).

In short, no-one knows but we ought to wear masks anyway. Filling your pockets with posies may also help reduce transmission in community settings.

Did you actually read the paper, or are you just going by what someone who sent it to you on Facebook said? Because it says nothing about asymptomatic cases not being able to transmit infection. It's simply a discussion of whether the 44% number (or that asymptomatic cases are roughly half as likely to infect other people as symptomatic ones) should be higher or lower, and how hard it is to pin that down precisely.

Quibbling over the exact number though is not the same as saying that it's zero.

 

[Whey_Aye_Banzai]

Did you actually read the paper, or are you just going by what someone who sent it to you on Facebook said? Because it says nothing about asymptomatic cases not being able to transmit infection. It's simply a discussion of whether the 44% number (or that asymptomatic cases are roughly half as likely to infect other people as symptomatic ones) should be higher or lower, and how hard it is to pin that down precisely.

Quibbling over the exact number though is not the same as saying that it's zero.

Which paper are you referring to? In the one you quoted I was talking about pre-symptomatic cases.

With regards to asymptomatic cases I specifically referred to the Chinese one that Nature published:

Post-lockdown SARS-CoV-2 nucleic acid screening in nearly ten million residents of Wuhan, China

Large-scale population screening can provide insights to levels of ongoing SARS-CoV-2 transmission. Here, the authors report a citywide screening of ~10,000,000 residents of Wuhan and show that SARS-CoV-2 infection prevalence was very low five to eight weeks after the end of lockdown.

www.nature.com

To make things easy for you:

A total of 1174 close contacts of the asymptomatic positive cases were traced, and they all tested negative for the COVID-19.

 

[terminal]

That's probably my fault.

I was using 'pre-symptomatic' to describe that subset of 'asymptomatic' PCR cases who go on to develop symptoms. It may be the wrong terminology in which case my bad.

I have been repeatedly explaining to a certain site member (not you) the difference between asymptomatic and pre-symptomatic. A truly asymptomatic case is one that never develops noticeable symptoms. A pre-symptomatic case is one that hasn't developed noticable symptoms yet, but will later. The incubation period is variable, and could be anywhere from a few days to a couple of weeks.

Many cases recorded as "asymptomatic" however were simply people who were tested prior to developing symptoms and were actually pre-symptomatic. According to the reports that I have read there's no exact data on the relative proportions of these, as doctors have been too busy dealing with the seriously ill to worry too much about people with mild symptoms.

The key point though is that for someone who has just tested positive there is no way to tell in advance if someone is actually going to be asymptomatic or whether they are presently simply pre-symptomatic and will develop symptoms later. You would need a time machine to look several weeks into the future to see how their case develops in order to tell the difference.

What this means is that even if there were reason to believe that asymptomatic cases won't transmit the virus to other people (although most studies say they can and do infect other people), that isn't an argument for saying they don't need to wear masks unless you are also claiming the ability to foretell the future. Because there is no way at present to distinguish between asymptomatic and pre-symptomatic cases except to wait and see if they develop symptoms before they fully recover.

 

[Whey_Aye_Banzai]

I have been repeatedly explaining to a certain site member (not you) the difference between asymptomatic and pre-symptomatic. A truly asymptomatic case is one that never develops noticeable symptoms. A pre-symptomatic case is one that hasn't developed noticable symptoms yet, but will later. The incubation period is variable, and could be anywhere from a few days to a couple of weeks.

Many cases recorded as "asymptomatic" however were simply people who were tested prior to developing symptoms and were actually pre-symptomatic. According to the reports that I have read there's no exact data on the relative proportions of these, as doctors have been too busy dealing with the seriously ill to worry too much about people with mild symptoms.

The key point though is that for someone who has just tested positive there is no way to tell in advance if someone is actually going to be asymptomatic or whether they are presently simply pre-symptomatic and will develop symptoms later. You would need a time machine to look several weeks into the future to see how their case develops in order to tell the difference.

What this means is that even if there were reason to believe that asymptomatic cases won't transmit the virus to other people (although most studies say they can and do infect other people), that isn't an argument for saying they don't need to wear masks unless you are also claiming the ability to foretell the future. Because there is no way at present to distinguish between asymptomatic and pre-symptomatic cases except to wait and see if they develop symptoms before they fully recover.

Yes, I know the difference; I understand it perfectly.

However:

A total of 1174 close contacts of the asymptomatic positive cases were traced, and they all tested negative for the COVID-19.

That's a heck of a lot of close contacts who all tested negative.

If you think that some of these asymptomatic types were actually pre-symptomatic, given that their close contacts all tested negative, what do you think would be the consequences of that?

 

[terminal]

I agree with your point about RCTs and observational studies.

However, strongly disagree with your 'Highly likely to prevent a negative health outcome is unethical. '.

The latest science says 'There is uncertainty about the effects of face masks.' If it was 'highly likely' that they worked, they wouldn't have used that word 'uncertainty'.

Stuff that's highly likely isn't usually called uncertain.

https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub5/full

Did you actually read this study? They didn't even look at whether non-medical masks reduced the risk of infected people spreading infection to others. It wasn't even part of the study. So what relevance does this have to your argument?

 

[Whey_Aye_Banzai]

Did you actually read this study? They didn't even look at whether non-medical masks reduced the risk of infected people spreading infection to others. It wasn't even part of the study. So what relevance does this have to your argument?

Yes, I read it and they concluded 'There is uncertainty about the effects of face masks.'

My argument is that it is not 'highly likely that face masks are effective at reducing transmission'.

I got that from the latest meta-analysis on respiratory illnesses.

You'd best take the tack that the researchers didn't do a 'covid specific' study.

 

[terminal]

This is an interesting twitter thread on COVID admissions and ICU capacity. It's a bit of a chicken / egg situation, the ICUs are a bit under their normal occupancy, but that is because the lack of elective procedures requires less ICU, docs are getting better at treating it, and people are getting less sick.


It's a good thing ICUs are not at capacity (unlike other places in Europe) as the situation is likely to get worse over winter.

What are you in hospital for by the way? I appreciate it will be very frustrating if you are having even more delays than usual.

There were news reports in Canada about how ICU resources are allocated. In normal times a certain proportion of ICU beds are reserved to cover scheduled surgeries in case some of them turn out badly and need ICU care. This includes things like cancer surgeries.

If community infection levels are high, then those beds get used up to cover expected COVID-19 complications, and scheduled surgeries (including for cancer) get bumped.

There are finite ICU resources. Even if you bought more beds, ventilators, and other equipment, that doesn't get you more trained staff. And a building full of beds and equipment without staff isn't a hospital, it's a warehouse.

So, rising community infection rates have a direct impact on treatment for other medical conditions which might need ICU space as backup for complications.

 

[pc supa]

Just been speaking to my step daughter, she is / was in a romance with an American from Ohio. She had not even met him in the flesh, was planned for next year, an internet romance if you like. Anyhoo, he's just pegged it in the last few hours. Had been in hospital since Friday, 40 fit and healthy. Had symptoms of diarrhoea with blood, vomiting, breathlessness, knackered and a dodgy cough. I've just looked at the charts for Ohio, canny steep line, was a place called North Royalton. Not sure as to cause of death, if I were a gambler, I'd be lumping on the corona.

 

[terminal]

Which paper are you referring to? In the one you quoted I was talking about pre-symptomatic cases.

With regards to asymptomatic cases I specifically referred to the Chinese one that Nature published:

Post-lockdown SARS-CoV-2 nucleic acid screening in nearly ten million residents of Wuhan, China

Large-scale population screening can provide insights to levels of ongoing SARS-CoV-2 transmission. Here, the authors report a citywide screening of ~10,000,000 residents of Wuhan and show that SARS-CoV-2 infection prevalence was very low five to eight weeks after the end of lockdown.

www.nature.com

To make things easy for you:

A total of 1174 close contacts of the asymptomatic positive cases were traced, and they all tested negative for the COVID-19.

You linked a paper. You claimed to derive answers from it. I pointed out that you couldn't have read the paper because it didn't support what you claimed.

Now you are trying to switch to another paper. I'm pretty sure that if a wrote a reply that showed that you hadn't that paper either you would then try to switch papers again.

 

[Whey_Aye_Banzai]

You linked a paper. You claimed to derive answers from it. I pointed out that you couldn't have read the paper because it didn't support what you claimed.

Now you are trying to switch to another paper. I'm pretty sure that if a wrote a reply that showed that you hadn't that paper either you would then try to switch papers again.

Stop crying.

I posted about that paper - and linked to it - about asymptomatic infections (the lack of) yesterday after JCC posted a snippet of it.

Now keep up and dry your eyes.

 

[terminal]

Yes, I know the difference; I understand it perfectly.

However:

A total of 1174 close contacts of the asymptomatic positive cases were traced, and they all tested negative for the COVID-19.

That's a heck of a lot of close contacts who all tested negative.

If you think that some of these asymptomatic types were actually pre-symptomatic, given that their close contacts all tested negative, what do you think would be the consequences of that?

Now tell us how this is in any way relevant to your argument on whether people should wear masks, because that's what your trail of posts goes back to. If you are going to claim that you have a machine that can see weeks into the future in order to separate the asymptomatic from the pre-symptomatic, can I ask you to give me next week's lottery numbers then?

 

[Whey_Aye_Banzai]

Now tell us how this is in any way relevant to your argument on whether people should wear masks, because that's what your trail of posts goes back to. If you are going to claim that you have a machine that can see weeks into the future in order to separate the asymptomatic from the pre-symptomatic, can I ask you to give me next week's lottery numbers then?

You're still crying, mate.

Dry your eyes; shoulders back, chin up.

There's a good lad.

 

[Whey_Aye_Banzai]

in order to separate the asymptomatic from the pre-symptomatic,

In the Chinese study, published by Nature, over 1000 close contacts of asymptomatics did not test positive for corvid.

But let's just say - as a thought experiment - half of the asymptomatics who were in contact with this '1000' were pre-symptomatic.

What would you deduce from that?

Can you see it yet?

(I'd say that shows pre-symptomatics aren't a major driver of the coronavirus either (I don't believe that to be the case btw).)

 

[terminal]

Here's a story on the Oxford-AstraZeneca vaccine.
AstraZeneca says late-stage trials of its COVID-19 vaccine were 'highly effective' in preventing disease

The vaccine trial tried using two different doses. One method used a half dose followed by a full dose a month later. The second method used two full doses given a month apart. The first method (half dose then full dose) was 90 per cent effective. The second method (two full doses a month apart) was 62 per cent effective. The combined average was 70 per cent.

The trial looked at two different dosing regimens. A half dose of the vaccine followed by a full dose at least one month apart was 90 per cent effective. A second regimen using two full doses one month apart was 62 per cent effective. The combined results showed an average efficacy rate of 70 per cent.

Given that the half dose followed by full dose was more effective, it's likely to be the method that will be used in practice.

Unlike some other vaccines, the Oxford-AstraZeneca one doesn't need very low temperatures and can be stored between 2C and 8C.

While the AstraZeneca vaccine can be stored between 2 C and 8 C, the Pfizer and Moderna products must be stored at freezer temperatures. In Pfizer's case, it must be kept at the ultra-cold temperature of around –70 C.

The Oxford-AstraZeneca vaccine is also cheaper than the ones from Pfizer or Moderna.

The AstraZeneca vaccine is also cheaper.

The Oxford-AstraZeneca vaccine is based on a weakened form of the common cold virus with the COVID-19 "spike" added onto it. This is a proven technology and different from the Pfizer or Moderna vaccines, which use a new technique based on RNA.

The vaccine uses a weakened version of a common cold virus that is combined with genetic material for the characteristic spike protein of the virus that causes COVID-19. After vaccination, the spike protein primes the immune system to attack the virus if it later infects the body. (...)

Dr. Anand Kumar, an infectious disease expert and intensive care unit physician in Winnipeg, said AstraZeneca used a proven vaccine technology.

Because the Pfizer and Moderna vaccines have to be stored at very low temperatures, they may be used in institutional settings while the Oxford-AstraZeneca vaccine is used in more distributed community settings.

Labos said he suspects because the Pfizer/BioNTech and Moderna vaccines need to be stored at low temperatures, they are probably going to be reserved for institutions, while the Oxford/AstraZeneca one might be rolled out in the community.

AstraZeneca say they can supply millions of doses starting in January.

AstraZeneca has been ramping up manufacturing capacity, so it can supply hundreds of millions of doses of the vaccine starting in January, chief executive Pascal Soriot said earlier this month.

The UK have ordered 100 million doses of the Oxford-AstraZeneca vaccine. Canada has ordered 20 million (Canada has ordered vaccines from 7 different companies).

Britain has ordered 100 million doses of the Oxford vaccine, and the government says several million doses can be produced before the end of the year if it gains approval from the regulator. Canada has ordered 20 million doses, enough for 10 million people.