Coronavirus - the new strain XVIII

[Amber Audio]

There seems to be quite a bit of opposition from politicians in Bolton/Greater Manchester to more local lockdowns. The Bolton Labour MP has spoken out against them and so has Andy Burnham, the Labour GM mayor.

I think you’ll come to a point where when everyone has been vaccinated where people won’t understand the need for lockdowns, masks, social distancing etc. It becomes a much harder sell and I think the government know that.

I’m really pleased that the government are going down the ‘ramping up the vaccinations’ route to deal with these outbreaks in Bolton rather than the local lockdown route or delaying step 3 on the roadmap. Using vaccinations as a tool and replacement to combat the virus should be the way forward rather than more damaging lockdowns.

If you do some background reading you’ll find that people who have been vaccinated, some of them twice, are catching the Indian and other variants, some even ending up in hospital. They are not dying, some show no symptoms, but they are transmitting the disease to other people who are getting very ill or dying. Going ahead with the relaxation of rules before the severity of the Indian variant is fully assessed is pure folly just cos some folk want a pint inside or a beach tan. If an extra 5 weeks of lockdown saves just 1 life are you against it, 100 lives or a 1000? I hope there is a proper impartial investigation into why so many people have died in the UK.

The UK Gov needs to stand up and be counted, block foreign inbound travel and put in place an effective, monitored and aggressive quarantine plan, from what I’ve read it’s a joke at present? They were/are far too worried about their popularity with voters and dosh than human lives. All IMHO.

 

[mandryka]

What gets me is the unwillingness to shut down flights from emerging hotspots! Surely that would be a highly effective relatively simple action to reduce new UK infection rates!

In the case of this Indian variant, the point you're making seems interesting, because Pakistan and Bangladesh were red listed before India. Sam Coats from Sky News asked a question to the Prime Minister about this yesterday and got this specific reply:

On the borders issue what the relevant committee was looking at was the threat of variants of concern coming from abroad and at that stage India was not identified as having a variant of concern, so that was why the decision was taken. Pakistan, for instance, had three times as much variants of concern, they had in particular, the South African variant. So that was the reason for that decision. But don't forget that everybody coming from India or indeed anywhere else had to face tough quarantine rules . . .

Boris's reply effectively says that the responsibility is the scientists for not identifying the India variant as a variant of concern. (I'm not sure how a VOC is defined.) I haven't checked the details. Did Bangladesh have VOCs at a high level? Did India not have VOCs at a high level?

More generally I want to say that it looks to me as though the UK has been more pro-active about shutting down borders than many EU countries. I don't know which EU countries have hotel quarantine (France doesn't as far as I know.)

 

[paulfromcamden]

That’s why I say that the most interesting thing in yesterday’s presser was this

I guess it depends how you define "unsustainable pressure" on the NHS.

We already know the toll it's exerted on NHS workers with a large proportion reporting thoughts of suicide or symptoms of PTSD.

We know some critical treatment for non-covid patients hasn't happened. Non-critical treatment is being delayed by months and years (I just had an appointment pushed back to December).

Unless there are bodies piling up in the car park we'll continue to be told the NHS is 'coping'. I don't think it is.

 

[Bob McC]

What gets me is the unwillingness to shut down flights from emerging hotspots! Surely that would be a highly effective relatively simple action to reduce new UK infection rates!

There are legal implications of banning all travel.
British citizens can still return from red countries.
Blimey, you can even still go to Red countries for funerals or visit ill relatives and return.

 

[h.g.]

I’m really pleased that the government are going down the ‘ramping up the vaccinations’ route to deal with these outbreaks in Bolton rather than the local lockdown route or delaying step 3 on the roadmap. Using vaccinations as a tool and replacement to combat the virus should be the way forward rather than more damaging lockdowns.

Local vaccination isn't a tool to combat outbreaks since it requires several weeks to have an effect after which the outbreak will almost certainly be largely over. If local vaccinations happen then it would almost certainly be principally a PR stunt for the local population so that they feel something is being done. It also isn't particularly wise in an outbreak to bring everyone together in a rush in one place to get vaccinated if you don't want to help the outbreak spread. Lockdowns on the other are without question effective against outbreaks so one needs pretty compelling reason not to use them and accept avoidable deaths and illnesses.

 

[Seanm]

Local vaccination isn't a tool to combat outbreaks since it requires several weeks to have an effect after which the outbreak will almost certainly be largely over. If local vaccinations happen then it would almost certainly be principally a PR stunt for the local population so that they feel something is being done. It also isn't particularly wise in an outbreak to bring everyone together in a rush in one place to get vaccinated if you don't want to help the outbreak spread. Lockdowns on the other are without question effective against outbreaks so one needs pretty compelling reason not to use them and accept avoidable deaths and illnesses.

Vaccine induced immunity builds more quickly in young people, apparently: 10 days. Combined with ramped up test and trace, support to isolate and public comms, on the face of it it looks more likely to yield results than a blanket local lockdown - that would definitely be PR: pretty clear by now it doesn’t work.

 

[mandryka]

They’d know what to do in China! Use the army to implement a ring of steel and curfew in Bolton for a fortnight, and get everyone vaccinated quick. Get the vaccines from some clean place like Exeter. Simples. Can I be leader please?

 

[tqineil]

More generally I want to say that it looks to me as though the UK has been more pro-active about shutting down borders than many EU countries. I don't know which EU countries have hotel quarantine (France doesn't as far as I know.)

I’ve heard a number of reports on R4 from travellers arriving into Heathrow from the affected areas .... 6 hours in queues with no social distancing, mingling with other passengers from other flights before clearing border control - a recipe for disaster

 

[h.g.]

Vaccine induced immunity builds more quickly in young people, apparently: 10 days.

Even with few effective measures to combat the outbreak here it is looking like it will be past the peak and well down the other side after 10 days + a day or two to get vaccinations organised. It would have had almost no effect on the outbreak itself but might help stamp it out.

Combined with ramped up test and trace,

Test and trace is all but broken in the UK. How would you propose implementing it today, here in the UK with the conservative party in power?

support to isolate and public comms, on the face of it it looks more likely to yield results than a blanket local lockdown - that would definitely be PR: pretty clear by now it doesn’t work.

This appears to be an absurd statement. Are you intending to say lockdown doesn't reduce the rate of covid infections or something else?

 

[deej92]

As I've posted many times before, its a numbers game and a small percentage of a very big number is still a big number. Even at 95% effective that leaves 5% of the 36million vaccinated (1.8 million) plus 100% of those not vaccinated and at risk of significant illness (say another 8million or so) having the possiibilty of being hospitalised, long COVID and dying at a possibly enhanced rate compared to the Kent variant due to the higher transmissability.

Not as bad as before vaccination, but by no means something to be complacent about.

A question though - at what percentage of the population does herd immunity kick in?

Remember some will have immunity from having had Covid and other studies have shown that others have pre-existing T-cell immunity having not been exposed to the virus.

 

[deej92]

Local vaccination isn't a tool to combat outbreaks since it requires several weeks to have an effect after which the outbreak will almost certainly be largely over. If local vaccinations happen then it would almost certainly be principally a PR stunt for the local population so that they feel something is being done. It also isn't particularly wise in an outbreak to bring everyone together in a rush in one place to get vaccinated if you don't want to help the outbreak spread. Lockdowns on the other are without question effective against outbreaks so one needs pretty compelling reason not to use them and accept avoidable deaths and illnesses.

As another poster has mentioned, vaccine induced immunity builds more quickly in young people, of which the majority of the virus is spreading in towns such as Bolton.

Do local lockdowns really work? Another poster mentioned that people just travel from these areas to places where pubs, shops etc will be open, thus spreading the virus further. We had months of local lockdown/tier measures and the virus come back even stronger during the second wave over the winter.

Vaccinations are surely therefore a far more effective tool in dealing with these outbreaks and preventing further ones. Our leaders have already told us vaccines are our way back to normality and a replacement for lockdowns, so I think the government are absolutely right to proceed with Step 3 of the roadmap and avoid the local lockdown route in Bolton, Blackburn etc.

Without vaccines, these areas would be going into a local lockdown now, so we're already seeing the benefits of the vaccination programme. Vaccines have already saved 11,700 lives and 33,000 people becoming seriously ill with Covid, according to Public Health England, and they will save many more the quicker we get jabs on arms.

So let's get on with vaccinating people in these areas, bringing second doses forward and doing what the local NHS in Blackburn wanted to do and opening up vaccines to anyone over 18.

 

[Seanm]

Even with few effective measures to combat the outbreak here it is looking like it will be past the peak and well down the other side after 10 days + a day or two to get vaccinations organised. It would have had almost no effect on the outbreak itself but might help stamp it out.



Test and trace is all but broken in the UK. How would you propose implementing it today, here in the UK with the conservative party in power?



This appears to be an absurd statement. Are you intending to say lockdown doesn't reduce the rate of covid infections or something else?

On the 10 day thing, presumably there are underlying reasons why hotspots are hotspots, so a vaccine surge ought to help even beyond the current outbreak.

On test and trace your position seems fatalistic: I’ve no idea if the system’s as broken as you say it is, I suspect not, but even if it’s struggled nationally during peaks, the concentration of resources in local areas ought to yield results. How would I organise it? I couldn’t organise the proverbial. But broad strokes: throw money at it, engage local public health and council expertise, combine with massive comms campaign informed by that expertise, and combine also with very generous (and well publicised) support to isolate.

On my absurd statement, what can I say. Blanket local lockdowns were tested to destruction last year: entire regions were locked down for months without bringing the virus under control locally or nationally. National lockdowns work very well, but given the harms involved, local (non-lockdown) interventions would seem to be a better way of dealing with localised outbreaks.

Of course we may already be beyond the point at which it makes sense to talk about localised outbreaks, and in that case all this is pretty academic.

 

[Seanm]

A question though - at what percentage of the population does herd immunity kick in?

Remember some will have immunity from having had Covid and other studies have shown that others have pre-existing T-cell immunity having not been exposed to the virus.

My understanding is that the herd immunity threshold goes up with the transmissibility of the virus, and in a non-linear way. So, 10% more transmissible: no big deal, HIT goes up only a little. 30%? Still no big deal. 35%? Uh-oh. (I just pulled these numbers out of the air, by the way, but the modelling has been done and real figures are out there.)

 

[deej92]

If you do some background reading you’ll find that people who have been vaccinated, some of them twice, are catching the Indian and other variants, some even ending up in hospital. They are not dying, some show no symptoms, but they are transmitting the disease to other people who are getting very ill or dying. Going ahead with the relaxation of rules before the severity of the Indian variant is fully assessed is pure folly just cos some folk want a pint inside or a beach tan. If an extra 5 weeks of lockdown saves just 1 life are you against it, 100 lives or a 1000?

I was reading that The Bolton NHS Foundation Trust medical director said a majority of the sick patients had not been vaccinated but would have been eligible for jabs. This would maybe suggest a problem with getting people in some communities of towns such as Bolton and Blackburn to take vaccines, maybe for religious and cultural reasons (both have high Muslim populations) and issues of trust with the authorities.

Yes some people who have been vaccinated are catching the Indian and other variants and ending up in hospital. That is a worry and will be further if this variant is a lot more transmissible than say the Kent one. I think we need to see some firm data before we can see what we're dealing with. So far we don't have any concrete data on transmissibility and how well the vaccines work against the Indian variant.

I'm all for saving lives, the vaccines have saved thousands already and there's absolutely no evidence any variant is changing that, hence why Step 3 should go ahead.

 

[deej92]

My understanding is that the herd immunity threshold goes up with the transmissibility of the virus, and in a non-linear way. So, 10% more transmissible: no big deal, HIT goes up only a little. 30%? Still no big deal. 35%? Uh-oh. (I just pulled these numbers out of the air, by the way, but the modelling has been done and real figures are out there.)

Yes and six in ten adults have antibodies against Covid 19, according to this report. https://www.itv.com/news/2021-04-28/covid-one-in-six-uk-adults-estimated-to-have-antibodies

 

[gavreid]

On my absurd statement, what can I say. Blanket local lockdowns were tested to destruction last year: entire regions were locked down for months without bringing the virus under control locally or nationally.

That simple isn't true. They saved many, many lives - here's a local report from Burnley as they emerged from lockdown last August

https://www.burnleyexpress.net/heal...s-efforts-lockdown-restrictions-eased-2955828

What didn't work was the tiers later on.

 

[Amber Audio]

I was reading that The Bolton NHS Foundation Trust medical director said a majority of the sick patients had not been vaccinated but would have been eligible for jabs. This would maybe suggest a problem with getting people in some communities of towns such as Bolton and Blackburn to take vaccines, maybe for religious and cultural reasons (both have high Muslim populations) and issues of trust with the authorities.

Yes some people who have been vaccinated are catching the Indian and other variants and ending up in hospital. That is a worry and will be further if this variant is a lot more transmissible than say the Kent one. I think we need to see some firm data before we can see what we're dealing with. So far we don't have any concrete data on transmissibility and how well the vaccines work against the Indian variant.

I'm all for saving lives, the vaccines have saved thousands already and there's absolutely no evidence any variant is changing that, hence why Step 3 should go ahead.

By the time you procrastinate and wait for the numbers/graphs to say OK the shit has hit the fan, with this bug it's too late and more people are dying. There are enough smart guys on this worldwide to provide advice and extrapolate the data ahead of the final results, Leeds up 7 nil with 10 mins to go is a safe bet they will win, from what I read some pre-emptive measures make sense. Follow the science is a heap of BS sound bite cop out, they follow it when suits and manipulate the hell out of it, someone in charge needs to use their brains. Not red flagging India early doors was stupid/negligent even, they waited until 23rd but Pakistan/Bangladesh was 9th - who called that and WHY? No way should Step 3 proceed, it should be put back 5 weeks. IMHO.

 

[h.g.]

Of course we may already be beyond the point at which it makes sense to talk about localised outbreaks, and in that case all this is pretty academic.

An increase in infection rate of several orders of magnitude in a few days is a localised outbreak. In my town the localised outbreak began with 170 positives at a school (the figure has been revised upwards from 100+ to 150 and now 170) with no variants of concern. In the town itself both the South African and Indian have been found. Presumably these are from other sources and possibly part of what one might think of as the background level present throughout the country. The infection rate rose from somewhere around the lower quartile throughout the country to the highest in the country in a matter of days and today, thankfully, reduced. It is a large localised outbreak just like in Market Harborough, Bolton and Blackburn.

 

[Seanm]

That simple isn't true. They saved many, many lives - here's a local report from Burnley as they emerged from lockdown last August

https://www.burnleyexpress.net/heal...s-efforts-lockdown-restrictions-eased-2955828

What didn't work was the tiers later on.

“Burnley worked, tiers didn’t” doesn’t sound like an overwhelming endorsement of a local lockdown strategy. IIRC there were many places that were locked down all summer without ever really driving cases down: no doubt lives were saved relative to doing nothing, but there were probably other strategies that would have worked better and there certainly are now. Why jump straight to lockdown? Why not do the other things first? There are things that locking down just doesn’t address no matter how hard you press that button. It’s specifically in the hotspots that lockdown has failed to be as effective as it was elsewhere: how can the answer be to lockdown harder in these specific areas?

 

[Seanm]

An increase in infection rate of several orders of magnitude in a few days is a localised outbreak. In my town the localised outbreak began with 170 positives at a school (the figure has been revised upwards from 100+ to 150 and now 170) with no variants of concern. In the town itself both the South African and Indian have been found. Presumably these are from other sources and possibly part of what one might think of as the background level present throughout the country. The infection rate rose from somewhere around the lower quartile throughout the country to the highest in the country in a matter of days and today, thankfully, reduced. It is a large localised outbreak just like in Market Harborough, Bolton and Blackburn.

What I mean is, what started as localised outbreaks may now be out of control, I.e not something that can be stamped out locally.