Coronavirus & stuff

When I checked the last ONS data said that only 2500 people died of flu in the 2018 season. A few back it had been much higher a few years before.

Flu seasons can vary massively, from a few thousand deaths on a good year to horrible seasons where tens of thousands lose their lives to it.

At the time of writing this article in March, Public Health England told Full Fact it estimated that on average 17,000 people have died from the flu in England annually between 2014/15 and 2018/19 - with the yearly deaths varying widely from a high of 28,330 in 2014/15 to a low of 1,692 in 2018/19.

https://fullfact.org/health/coronavirus ... influenza/

Isn't a bad 'flu season less likely this year anyway just from the shift in people wearing masks and distancing?

Cuttooth wrote:Isn't a bad 'flu season less likely this year anyway just from the shift in people wearing masks and distancing?

Also many that would die from it are probably dead from COVID-19.

It's also likely that more folks will be getting the flu jab too.

Cuttooth wrote:Isn't a bad 'flu season less likely this year anyway just from the shift in people wearing masks and distancing?

For sure. Transmissions will be reduced.


We got flu jabs last week. First time ever but figured wouldn't hurt.

Tomous wrote:

Cuttooth wrote:Isn't a bad 'flu season less likely this year anyway just from the shift in people wearing masks and distancing?

For sure. Transmissions will be reduced.


We got flu jabs last week. First time ever but figured wouldn't hurt.

Did you need to book or just a walk in? I'd heard that doses were scarce because they'd extended who could claim a free one.

Rex Kramer wrote:

Tomous wrote:

Cuttooth wrote:Isn't a bad 'flu season less likely this year anyway just from the shift in people wearing masks and distancing?

For sure. Transmissions will be reduced.


We got flu jabs last week. First time ever but figured wouldn't hurt.

Did you need to book or just a walk in? I'd heard that doses were scarce because they'd extended who could claim a free one.

Did it at a pharmacy in Asda. Had to book. My wife is NHS so hers was free, mine cost £8

Cuttooth wrote:Isn't a bad 'flu season less likely this year anyway just from the shift in people wearing masks and distancing?

It'd be interesting to see if illness is down in general. I've not had a cold or stomach bug since lockdown began and I'd usually get at least one in that time!

Mine cost £12, at my pharmacy it was just a case of turning up and filling out the consent form.

I did wonder if there was a consensus here, but it doesn't seem like there is. And I don't know either and am very happy not having to make the decisions. It just is very easy to criticise any decisions that are made, particularly when it seems everyone is guessing anyway. Though, I do think many things have been bungled.

I suppose that I wonder about is, at what point do we have to accept that the disease is out there, not going away, and we need to just carry on?

There may be a vaccine, there may not. There may be an effective treatment, there may not.

How long do we give it, given the other definite downsides of lockdown etc?

It was definitely the right thing to do first time round. But this appears to be a highly infectious disease, with relatively low mortality for most. Which may sound harsh, but has gone through the world before, and will again.

Even saying that other illnesses like flu etc are likely to be less this year doesn't give me much comfort.

For one thing, getting ill helps build your immunity to worse strains of existing illnesses or to new ones by keeping your immune system fighting fit. I may be wrong on that point having no idea other than what I read, so happy to be corrected.

The danger is, I am thinking this way because I just want to say 'sod it', and get back to normal. And it's amazing how your own logic warps to be able to let you justify that doing what you want is the 'right' thing.

The problem is that, as viruses go, it absolutely tears a new arsehole through the elderly, particularly if they already have a condition. There's no way to carry on as usual without causing that to happen.

There is also the danger of long covid, which appears to be having a substantial, long-term, serious impact on lives and no one knows yet how long it will last, if it will develop further etc.

Abacus wrote:I did wonder if there was a consensus here, but it doesn't seem like there is. And I don't know either and am very happy not having to make the decisions. It just is very easy to criticise any decisions that are made, particularly when it seems everyone is guessing anyway. Though, I do think many things have been bungled.

I suppose that I wonder about is, at what point do we have to accept that the disease is out there, not going away, and we need to just carry on?

There may be a vaccine, there may not. There may be an effective treatment, there may not.

How long do we give it, given the other definite downsides of lockdown etc?

I can only give my personal opinions in answer to this, though they are rooted in being an armchair analyst (who isn't these days?).

A pandemic can end in two ways. Medically, or socially. Historically, pandemics which ended medically did so by running out of people to either infect or kill. Herd immunity is a similar concept to this. I would bet that Covid 19 has a social ending before it truly has a medical outcome. In other words, it will still be prevalent, but deaths will be minimal and therefore continuing with current restrictions will not be worth it, medically (growing waiting lists), or economically (future funds for the NHS and damage to wider economy).

In our country at least, I think the end to the social impacts of covid will and should come once vaccines become available, or as treatments improve further. Should vaccines become available early next year as is being suggested, then those who are most vulnerable will have the option to protect themselves. Some will see the vaccine itself as a risk and rather chance the disease, but so long as everyone who is at increased risk has had the option of a vaccine, then I think the argument to return to normal will be the one that wins out. In essence this would be a social end to the pandemic, life can get 'back to' normal, though I'm sure there will be changes in societal norms. I expect this to be around April 2021, based on vaccines already being in mass production awaiting clearance at stage 3 testing.

If vaccines do not become available in the suggested time frame, I guess judgements have to be made as to whether science can beat Covid, and what timescale this should be expected in. I certainly don't want to spend my entire life in and out of restrictions due to a disease which has a fatality rate of approximately 0.5% to 1%. I would expect that if we start next year with the realisation that all of the promising vaccine trials are not going to work, public opinion will sway to ending the restrictions we have in place and we'll need to beat it by allowing it to spread at a level which we can maintain. I would expect to see the Nightingale Hospitals being used at close to their capacity, but ideally not running out of capacity. This would need to continue until the pandemic does have a medical ending and it simply runs out of people to infect (if we retain immunity) or otherwise kill (those who are going to die from it have done so).

The particular problem with this virus is that the majority have no symptoms and yet can still be infectious. This is why it has spread so easily worldwide and why I expect it will still be in general circulation ten years from now, though with a significantly lower rate of infection. I don't believe we will retain complete immunity naturally, in the same way that we don't retain immunity to cold and flu. But I suspect that those who suffer the most severe symptoms will retain decent immunity and we will be able to live with it. Whether we have a successful vaccination program or not, I expect it will spread with other cold and flu viruses and many will be infected at some point, hopefully building up decent immunity before they move into a high risk group.

Edit # sorry, this was in response to Oblomov

But, I suppose, what can we do about that?

A new virus may hit tomorrow, that impacts some other group disproportionately. I'm not saying it's nice or fair.

Do we shut everything down, every time? And if so, for how long?

You're right, there is no way to let it go without it having bad consequences.

Still, the question is - shut everyone down with probably worse consequences the longer it goes on in the hope there's a vaccine someday? And if so, for how long?

It's an unfair question really, no-one knows.

SillySprout wrote:

Abacus wrote:I did wonder if there was a consensus here, but it doesn't seem like there is. And I don't know either and am very happy not having to make the decisions. It just is very easy to criticise any decisions that are made, particularly when it seems everyone is guessing anyway. Though, I do think many things have been bungled.

I suppose that I wonder about is, at what point do we have to accept that the disease is out there, not going away, and we need to just carry on?

There may be a vaccine, there may not. There may be an effective treatment, there may not.

How long do we give it, given the other definite downsides of lockdown etc?

I can only give my personal opinions in answer to this, though they are rooted in being an armchair analyst (who isn't these days?).

A pandemic can end in two ways. Medically, or socially. Historically, pandemics which ended medically did so by running out of people to either infect or kill. Herd immunity is a similar concept to this. I would bet that Covid 19 has a social ending before it truly has a medical outcome. In other words, it will still be prevalent, but deaths will be minimal and therefore continuing with current restrictions will not be worth it, medically (growing waiting lists), or economically (future funds for the NHS and damage to wider economy).

In our country at least, I think the end to the social impacts of covid will and should come once vaccines become available, or as treatments improve further. Should vaccines become available early next year as is being suggested, then those who are most vulnerable will have the option to protect themselves. Some will see the vaccine itself as a risk and rather chance the disease, but so long as everyone who is at increased risk has had the option of a vaccine, then I think the argument to return to normal will be the one that wins out. In essence this would be a social end to the pandemic, life can get 'back to' normal, though I'm sure there will be changes in societal norms. I expect this to be around April 2021, based on vaccines already being in mass production awaiting clearance at stage 3 testing.

If vaccines do not become available in the suggested time frame, I guess judgements have to be made as to whether science can beat Covid, and what timescale this should be expected in. I certainly don't want to spend my entire life in and out of restrictions due to a disease which has a fatality rate of approximately 0.5% to 1%. I would expect that if we start next year with the realisation that all of the promising vaccine trials are not going to work, public opinion will sway to ending the restrictions we have in place and we'll need to beat it by allowing it to spread at a level which we can maintain. I would expect to see the Nightingale Hospitals being used at close to their capacity, but ideally not running out of capacity. This would need to continue until the pandemic does have a medical ending and it simply runs out of people to infect (if we retain immunity) or otherwise kill (those who are going to die from it have done so).

The particular problem with this virus is that the majority have no symptoms and yet can still be infectious. This is why it has spread so easily worldwide and why I expect it will still be in general circulation ten years from now, though with a significantly lower rate of infection. I don't believe we will retain complete immunity naturally, in the same way that we don't retain immunity to cold and flu. But I suspect that those who suffer the most severe symptoms will retain decent immunity and we will be able to live with it. Whether we have a successful vaccination program or not, I expect it will spread with other cold and flu viruses and many will be infected at some point, hopefully building up decent immunity before they move into a high risk group.

Thanks for taking the time to respond to that in such a considered way.

There is nothing I can really or would want to disagree with there.

Given that for most people, they won't have anything more than mild or hard to notice symptoms, I also can't see how this can be stopped. Because, right or wrong, most people won't keep doing things that might cause problems that won't affect them. Not because they're bad, but just because that's human nature.

In bats, it's fairly endemic, because most of them don't notice. Barring a vaccine, hopefully we get that way.

All I know is, people are losing their jobs, losing their mental health, their lives are being shortened in one or both of those two ways.

That's why I asked about a deadline for this, however heartless it seems to even ask.

Surely, if the becomes evident that the cost of taking action is higher than not taking action, that becomes time to stop the current approach. The problem is it's not an easy calculation to make.

People are dying from things like cancer as their treatment is delayed to prevent higher deaths from covid, but there is not a straight 1 life = 1 life formula. Listen to the arguments before any election and you'll understand that underfunding the health care system causes deaths. Unfortunately, the economic damage caused by covid is likely to hurt the NHS for many years to come. So you have to factor in peoples mental wellbeing, economic damage & other preventable deaths among other things. I genuinely think a year (from the start of the pandemic) is the right time scale to make that call. Curent medical science is not perfect, but by historical standards, it is absolutely phenomenal, and we will have a great idea by that point if a medical solution can be found.

Politically, I don't think society will accept the current restrictions long into next year without a clear route out. We live in a democracy where the majority are not scientists. Human desire and emotions will win over if science doesn't find a solution and above all, those in power will want to keep hold of it.

Concern over my own health is way down the list & it sounds like you feel the same. For me, first concern is vulnerable relatives, then the risk of me losing my job and the harm that would cause. My concern over my own wellbeing is minimal. Not zero, but I see it similar to crossing the road. It has it's risks, but if I am sensible the risks to me personally are minimal.

Brilliant post, and you're right in your surmises.

Again, don't disagree with a word, and it's good to know in this sometimes polarised world that there's a place in which people can talk like adults.

However, I am very concerned about a lot of people I know. I struggled myself, if truth be told, up till July. Really knocked me, this.

And I've got a house, a garden, a fairly secure job.

Fundamentally, we aren't designed to be solitary creatures. We are at our best when meeting others, it's how we've become the dominant species.That's how ideas spread and grow

It's also how viruses spread and grow, so it's kicked us right in the nuts

Reckon you're right about a year, though. Think that will be the critical point

I also think Grcade needs a CV-19 response plan.

It's always been one of the cleverest bits of the Internet, and the government could nick it, and probably not do much worse.

Be like fantasy pandemic league.

There is unlikely to be any long-term herd immunity to this virus. Much like other coronaviruses, there is growing evidence that the immune system does not form a permanent memory of SARS2. Reinfections can be as bad as or worse than the first infection. A laissez-faire approach could at best mean a "flu-like" annual cycle of a very large number of infections, with a virus that is less well tolerated and has a wider range of severe symptoms than influenza, not-uncommonly causing long-lasting effects.

From a medical perspective I think three key considerations are:

• Minimising the number of symptomatic infections, because they can lead to disability even in healthy young people
• Keeping the number of severe infections at one time below the number of available hospital beds and doses of antiviral drugs
• Avoiding a sustained exponential rate of transmission of the virus, as that will inevitably overwhelm healthcare and emergency infrastructure

I think there is a fourth consideration that is key to the implementation of public health policy in general:

• Ensuring that there is no personal financial impact to an individual following medical guidance

If the virus is spreading at an exponential rate, then new infections can be drastically decreased by asking everyone who is not a key worker to remain home. This should be done in order to protect existing infrastructure (such as testing centres or intensive care units) and to allow a period in which the government can intervene to build or expand further relevant infrastructure. I believe it's important for compliance - as well as clearly being the compassionate thing to do - that anyone financially impacted by remaining home is fully supported.

If the trajectory of new infections is logistically sustainable (i.e. not exponentially increasing), then policy should focus on minimising and controlling it while allowing people as much freedom to go about their lives as possible. There are four core approaches we can use: 1. Identifying remote working and learning implementations and pursuing them aggressively; 2. Ubiquitous mask usage; 3. Testing of symptomatic people, with isolation if positive; 4. Tracing of the contacts of infected people, who can be isolated.

Remote working and learning are important to reduce the number of people travelling around the country, both daily on public transport which is a vector for infection, and the admixture of populations such as during the seasonal student migrations. Office workers were explicitly encouraged back to the office, and schools and universities were encouraged not to pursue remote solutions for the September term, which was all counterproductive. By encouraging workers, students, and schoolchildren who are able to do so (they have a good laptop, their work/lessons are not "practical", and so on) to work from home, you can free up capacity for safe travel and socially distanced offices / lecture halls / classrooms for those who really need to go in.

Mask usage is particularly important because background exposure to very low viral loads seems to confer immunity. That is, if you are frequently exposed to a very small amount of virus - such as the reduced load that gets through a mask - your immune system has a chance to develop recognition of the virus without having to deal with a full infection. At the moment, compliance with advice on masks is relatively low. The government needs to conduct a large-scale public education campaign and then enforce compliance. Alternative kinds of covering should be used by people distressed by wearing a mask, but no-one should be fully exempt from wearing a covering (alternatives include e.g. snoods, face shields).

At the moment, it seems clear that we have not had sufficient leadership or investment in testing or tracing, and this infrastructure needs to be rapidly expanded. The contracts should clearly not remain with private sector companies who are unable or unwilling to fulfil them.

Finally, because large groups of drunk people are not known for their compliance with sometimes complex medical guidance, I believe nightclubs, bars, and pubs should be closed - or takeaway-only if they serve food - for the foreseeable future.