Coronavirus - the new strain XIX

[paulfromcamden]

Oh Jesus. This is some amazing vicarious gatekeeping.

Honestly Sean my first thought was along the line of Tony's. I've never heard of the guy. His bio says he's a History lecturer. Most importantly the tweet doesn't link to any reputable source (or any source).

I'm not saying he's wrong (I've no idea) just that as it stands it's an unreferenced tweet by someone I don't know claiming to be a History lecturer. I don't consider that a great source is all.

 

[Seanm]

Honestly Sean my first thought was along the line of Tony's. I've never heard of the guy. His bio says he's a History lecturer. Most importantly the tweet doesn't link to any reputable source (or any source).

I'm not saying he's wrong (I've no idea) just that as it stands it's an unreferenced tweet by someone I don't know claiming to be a History lecturer. I don't consider that a great source is all.

Fair enough, a link to an article might have been nice, and I'm a bit too online right now so I forget that Twitter has its own system of credentialisation that might not mean much to normies (apart from the guy's strong academic bona fides he's followed by many public health experts and often engages in dialogue with them: he's got Twitter capital).

I just find this insistence that only biological scientists are in any way qualified to comment on phenomena that are clearly social, political, sociological, historical, and mass-mediated really bizarre. It would be less irritating if the people following this line actually paid any attention to epidemiologists etc. other than the two or three fairly unrepresentative ones that the news outlets have on speed dial.

 

[PsB]

That is a misunderstanding. There is a 5 day test to release option.

And you can quarantine for these 5 days at any address with your daughter. And she does not need to quarantine.

Hardly a huge barrier when it is family.

Yes, well the original idea was to go and explore some of Scotland with her: not compatible with quarantine. Anyway, by the time I realized there was a test & release option we had missed the slot when she had positioned a short holiday, so we will see her later this summer in neutral territory, and hope HMG doesn't freeze travel to and from the Nordics in the meantime.

 

[IanW]

Yes, hadn’t noticed that. That “rapid response” I shared the other day argued that successful mutations are much more likely to occur in really ill people so children are less of a risk, but hc did a pretty good job of discrediting that source so I don’t know how seriously to take that. Personally I’ve concluded that if people really GAF about variants they’d be demanding equitable global distribution and manufacture of vaccines 24-7. Most of the focus is definitely on other things.

Sean, many of us have made statements multiple times, along the lines of the following: The more instances there are of the virus, the greater the likelihood of a mutation to something more serious.

It therefore follows that anything that can be done, to reduce the number of instances of the virus, will reduce the likelihood of a more serious mutation happening and taking hold.

It should therefore be self evident that this must include priority 1 items, such as world wide vaccination.

 

[Seanm]

Sean, many of us have made statements multiple times, along the lines of the following: The more instances there are of the virus, the greater the likelihood of a mutation to something more serious.

It therefore follows that anything that can be done, to reduce the number of instances of the virus, will reduce the likelihood of a more serious mutation happening and taking hold.

It should therefore be self evident that this must include priority 1 items, such as world wide vaccination.

Thanks, I do understand the point, I think, and the sense of exasperation too. But what's self-evident in the abstract is less so in the real world of trade-offs, limited resources, opportunity costs and so on. If the goal is to reduce the likelihood of dangerous mutations, and the means is to reduce the number of instances of the virus, we still have to ask, Which instances? Where? Should our limited stock of vaccines go on children, or on bringing forward second doses for adults, or on helping poorer nations? If that's self-evident to you, good on you: I've no real clue, just some intuitions.

The letter I'm referring to, by the way, raised a point I've not seen made elsewhere, which is that "instances of the virus" can be thought of not just in terms of cases but on the cellular level, in terms of how many times the virus replicates inside individuals. On the whole it tends to replicate much, much less in children than in adults (another way of saying that children get less sick). Is this pertinent to the decision as to where to "spend" the vaccines? Again I've no idea but it seems a question worth asking.

It's important to think in terms of limited resources and opportunity costs not just in relation to vaccines but attention. ISage, The Citizens and their acolytes are going to spend the next couple of weeks trying to pressurise the JCVI and government on their vaccine decision by hosing us down with scary-looking data about long covid in children, hospitalisation of children etc. Is this the best use of their time/our attention/government attention? As with masks and the timing of Freedom Day, I''m going to suggest "No", and not only because the real risk of mutation might well lie elsewhere than 12-17 year olds in the UK.

 

[tonerei]

For the @Colin Barron 's and fellow fun loving Brexiteers Irelands fully vaccinated rate is now at 64% compared to the latest UK rate I see of 56%. Not crowing but I do remember the noise about how somehow the speed of vaccine roll out was somehow because of Brexit. I advised at the time that this was a long road with many twists and turns and here we are today with things having levelled up very quickly.

My tuppence worth, If I were Spain, Greece and Italy I would have banned family holidays. Anybody with young children who feels they have to bring them to the Costa's this year are irresponsible.

 

[IanW]

Thanks, I do understand the point, I think, and the sense of exasperation too. But what's self-evident in the abstract is less so in the real world of trade-offs, limited resources, opportunity costs and so on. If the goal is to reduce the likelihood of dangerous mutations, and the means is to reduce the number of instances of the virus, we still have to ask, Which instances? Where? Should our limited stock of vaccines go on children, or on bringing forward second doses for adults, or on helping poorer nations? If that's self-evident to you, good on you: I've no real clue, just some intuitions.

To really answer your questions, requires epidemiologist expertise. At a more generic level, the resources exist to make enough effective vaccines, but governments need to decide that this needs to be done.

The letter I'm referring to, by the way, raised a point I've not seen made elsewhere, which is that "instances of the virus" can be thought of not just in terms of cases but on the cellular level, in terms of how many times the virus replicates inside individuals. On the whole it tends to replicate much, much less in children than in adults (another way of saying that children get less sick). Is this pertinent to the decision as to where to "spend" the vaccines? Again I've no idea but it seems a question worth asking.

Again this really requires epidemiologist expertise. At a very simple level, in a similar sense to more instances of the virus means more chance of mutation, the longer the virus lives in a host, the greater likelihood of mutation (apologies to PFM virologists and health experts for my comments which may miss something important!).

It's important to think in terms of limited resources and opportunity costs not just in relation to vaccines but attention. ISage, The Citizens and their acolytes are going to spend the next couple of weeks trying to pressurise the JCVI and government on their vaccine decision by hosing us down with scary-looking data about long covid in children, hospitalisation of children etc. Is this the best use of their time/our attention/government attention? As with masks and the timing of Freedom Day, I''m going to suggest "No", and not only because the real risk of mutation might well lie elsewhere than 12-17 year olds in the UK.

I have always understood your point, but looked at it from a different angle. What areas can we actually influence as opposed to what might give the greatest return on our resource investment.

With children at school, the evidence suggest that this has been an effective pathway that the virus has used to spread across school and to parents of these children (i.e. there are bigger consequences than just some children being admitted to hospital). With schools now shut for summer holidays (all of them?), then we have Freedom Day and another set of virus pathways opening up.

Just to be clear, I would not want to be the PM and have to make these big decisions, as there are only very difficult choices, with no one having the full picture.

 

[gavreid]

With schools now shut for summer holidays (all of them?)

Not yet - end of the week in most schools in England.

 

[hc25036]

Thanks, I do understand the point, I think, and the sense of exasperation too. But what's self-evident in the abstract is less so in the real world of trade-offs, limited resources, opportunity costs and so on. If the goal is to reduce the likelihood of dangerous mutations, and the means is to reduce the number of instances of the virus, we still have to ask, Which instances? Where? Should our limited stock of vaccines go on children, or on bringing forward second doses for adults, or on helping poorer nations? If that's self-evident to you, good on you: I've no real clue, just some intuitions.

The letter I'm referring to, by the way, raised a point I've not seen made elsewhere, which is that "instances of the virus" can be thought of not just in terms of cases but on the cellular level, in terms of how many times the virus replicates inside individuals. On the whole it tends to replicate much, much less in children than in adults (another way of saying that children get less sick). Is this pertinent to the decision as to where to "spend" the vaccines? Again I've no idea but it seems a question worth asking.

It's important to think in terms of limited resources and opportunity costs not just in relation to vaccines but attention. ISage, The Citizens and their acolytes are going to spend the next couple of weeks trying to pressurise the JCVI and government on their vaccine decision by hosing us down with scary-looking data about long covid in children, hospitalisation of children etc. Is this the best use of their time/our attention/government attention? As with masks and the timing of Freedom Day, I''m going to suggest "No", and not only because the real risk of mutation might well lie elsewhere than 12-17 year olds in the UK.

I did start a reply along these lines earlier on but tied myself up in knots and still haven't had time to do any research, so this is off the top of my head. In principle, mutations (and this is much better known for bacteria) are more likely to arise in sick, but partially-treated individuals. Way back, possibly in the first thread, there was a link to a report about a woman who was hospitalised for months, nearly died a couple of times and was treated multiple times with antibodies from COVID survivors. As I recall, she survived and was found to have a variant, but not one of the current ones of concern. I'm not aware of any variant being tracked back to a child, but the principle of minimising the number of replications of COVID on the planet to keep the statistics on the side of not producing more variants does still apply. That's not something I would want to be responsible for finding a way to achieve.

The point about replications in children being at a lower number is the one I started typing this morning (honest!) as part of an observation that I still have problems with the ethics of treating children with a vaccine that is known to cause them - on average - more problems than COVID infection, and supporting the JCVI idea of vaccinating those close to 18 years old, vulnerable children (at higher risk from COVID) and children with vulnerable parents. I think that is masterly.

 

[Burrrrrton]

I still have problems with the ethics of treating children with a vaccine that is known to cause them - on average - more problems than COVID infection

Vaccination is still less dangerous than the infection itself. In addition, the child must be examined and examined before the vaccine is administered. If the risk of complications after vaccination is high, then the vaccination should be abandoned. But let's not forget that it was mass vaccination that helped stop diseases such as mumps, whooping cough, tetanus, and smallpox.

 

[hc25036]

Vaccination is still less dangerous than the infection itself. In addition, the child must be examined and examined before the vaccine is administered. If the risk of complications after vaccination is high, then the vaccination should be abandoned. But let's not forget that it was mass vaccination that helped stop diseases such as mumps, whooping cough, tetanus, and smallpox.

You'll need to show me some data to support that. The vast majority of children have no or few issues with COVID and there are documented serious events like cardiac damage with (roughly) known rates of incidence. No examination before vaccination (probably 2 minutes of a hassled nurse looking at the child) is going to pick up whether they are likely to have a cytokine response that will take out chunks of their myocardium, however rare that is.

You are spot on about mumps etc, except they are all diseases that kill children predictably and at a decently high rate. Childhood vaccination against those is a no-brainer, whereas vaccinating children against COVID potentially offers more protection to adults at a risk:benefit ration that is at best marginal for the children.

 

[gavreid]

You'll need to show me some data to support that. The vast majority of children have no or few issues with COVID and there are documented serious events like cardiac damage with (roughly) known rates of incidence. No examination before vaccination (probably 2 minutes of a hassled nurse looking at the child) is going to pick up whether they are likely to have a cytokine response that will take out chunks of their myocardium, however rare that is.

This report suggested that almost half of all infections in children lead to lasting symptoms

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927578/

while the impact of long covid on the developing brain is unknown but of some real concern

 

[Seanm]

I did start a reply along these lines earlier on but tied myself up in knots and still haven't had time to do any research, so this is off the top of my head. In principle, mutations (and this is much better known for bacteria) are more likely to arise in sick, but partially-treated individuals. Way back, possibly in the first thread, there was a link to a report about a woman who was hospitalised for months, nearly died a couple of times and was treated multiple times with antibodies from COVID survivors. As I recall, she survived and was found to have a variant, but not one of the current ones of concern. I'm not aware of any variant being tracked back to a child, but the principle of minimising the number of replications of COVID on the planet to keep the statistics on the side of not producing more variants does still apply. That's not something I would want to be responsible for finding a way to achieve.

The point about replications in children being at a lower number is the one I started typing this morning (honest!) as part of an observation that I still have problems with the ethics of treating children with a vaccine that is known to cause them - on average - more problems than COVID infection, and supporting the JCVI idea of vaccinating those close to 18 years old, vulnerable children (at higher risk from COVID) and children with vulnerable parents. I think that is masterly.

Thanks. This business of mutation in the partially-treated is something that's bothered me a little in relation to long covid, especially as a sufferer. Maybe that's completely different? (Leading question: I mean, "Please tell me that's completely different").

 

[hc25036]

This report suggested that almost half of all infections in children lead to lasting symptoms

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927578/

That's interesting Gav. A quick read around shows growing concern about long COVID in children with wildly-varying rates and proposals (except for more studies which the NHS seems to be starting up). My point is mostly about acute hospitalisations, severe illness and death which are all very rare in children, but are worse with the delta variant. I'm still hesitant about calling the ethics of vaccinating children when the main beneficiaries will be adults

 

[Tony L]

This report suggested that almost half of all infections in children lead to lasting symptoms

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927578/

That is very disturbing, especially given how many children and young people are showing up as hospital admissions at present.

I’d like to see what percentage of hospital admissions of all ages later equate to ‘long covid’ or other lasting symptoms. I suspect that would be an interesting/worrying figure.

 

[hc25036]

Thanks. This business of mutation in the partially-treated is something that's bothered me a little in relation to long covid, especially as a sufferer. Maybe that's completely different? (Leading question: I mean, "Please tell me that's completely different").

That's different! Long-COVID is usually after infection had cleared and is due to the body's response to the infection. I can't recall seeing figures, but I have seen reports of patients with active infection after several weeks being rare.

 

[gavreid]

That's interesting Gav. A quick read around shows growing concern about long COVID in children with wildly-varying rates and proposals (except for more studies which the NHS seems to be starting up). My point is mostbly about acute hospitalisations, severe illness and death which are all very rare in children, but are worse with the delta variant. I'm still hesitant about calling th eethics of vaccinating children when the main beneficiaries will be adults

I think this will become much clearer as large numbers of children become infected - but by then it's all too late.

 

[gavreid]

Here's an article on how covid damages the brain

https://www.nature.com/articles/d41586-021-01693-6

 

[gavreid]

44 104 cases today, 73 deaths and 752 admissions (19th). 730 admissions is where 15 day doubling would have us, 520 for 20 day. I clearly don't agree with Whitty's assessment of 3 weeks.

 

[Enfield boy]

Not following closely but the trend of cases seems to be falling slightly the last few days while deaths and hospitalisations are rising. As case numbers have been focussed on by the media recently has Boris been reviewing Trump's instruction to reduce testing? Perhaps it's the only part of the equation that he can, or is interested in, controlling.