Main Coronavirus / Covid-19 Discussion Thread

Bozza · Sep 22, 2020

Back to your boy David.

Purely by chance I just went to his account again, and I know the "lots of false positives" has been one of his themes, in the hope that it meant positive case numbers per day are far lower than stated, which would be good.

He's been taken to task somewhat, by someone who actually works in the field of testing and it looks like he may have been completely wrong in what he's been saying about false positives (follow Rupert Beale's input into this thread:

[tweet]1308506274959691777[/tweet]

I know he's been a great source of information over the last six months but from what I can tell, he's got no more subject matter knowledge than you and I, but has devoted a lot of time to dig into data and present it back to people. Really useful. But when it comes down to the actual underlying science, it's not his field.

Guinness Boy · Sep 23, 2020

Harry Wilson's tackle said:
First, the 'this' came with the health warning that there has to be the proviso to protect the vulnerable. Quite often the 'back to normal' contingent made no mention of that, which made my piss boil. The chap to whom I replied did add the priviso. He may not have done so in past posts and if so I would have dug him out for it at the time. Now, credit where it's due.

I also think that looking across the world, numbers seem to go up and down regardless of 'steps'. I think that having only 6 contacts, or whatever Swansman does at the weekend, is irrelevant. It isn't what, it's who (the yoof, now, go for it, but geriatrics like me, stay safe). With a mutated virus (see below) the new 'steps' are just silly. They wouldn't have been in April with a more lethal virus, though. But back then HMG were slow to act (understandable) then inept when the data screamed 'killer virus'.

My thinking now is this. Covid is about 1/200th as lethal as it was in April (cases to deaths at first peak vs now). All the numbers suggest this is now a different strain (much less lethal - as I have opined frequently recently). But those 20 a day who are dying now are humans that need to be kept safe. We know who they are (roughly - so we can protect them and others too - nealy all of them are retired). Meantime everyone else should be back at work....with the proviso not just yet - we must watch the death numbers like hawks for 1-2 weeks to be sure there isn't some sort of lag artefact due to earlier case identification, now vs Spring.

And yes, it is always right to change a view, when circumstances and data change. In Spring at peak we had 5000 new cases a day and 1000 deaths. It is now 4000 and 20. If it is 200 deaths a day next week I will change my mind again. But it thrills me not to see my mind is swifter than HMG's. I have a lifetime of being right (sadly I don't always follow my own best advice) and am sanguine about being wrong, and will admit so when the data prove it. Presently I think I am right to consider that livelihoods, homes and futures are now about to be needlessly lost because HMG can't see its arse from its elbow.

All that aside, I hope you are recovering. I heard a poor woman on the radio today who was ill weeks ago and is still in a shocking state. If only we had gone draconian in early March Instead, dither then, dither again, hubris when the sun shone, and Corporal Jones style panic now. We should all be angry (if we are still alive and well enough, or well paid enough, or still being paid).

Edit: I was a bit taken aback by your comments. Reading my post back, you may have read this: "Protect the vulnerable, everone else back to work! " to mean that I was saying this is HMG's plan. It isn't. This is my suggestion. Apologies for any ambiguoty.

Sorry, in a little feet first on you. I'd read your posts on this and Dan's and you seemed absolutely miles apart. All the above is sensible if the virus is weakening and I'm happy to agree with it, if the virus is weakening, with two exceptions. Firstly if we still have Covid and a particularly bad flu season then we need to lock down immediately or risk overwhelming the NHS with the death of 1000 cuts. This is why I find flu jab refusal to be irresponsible and wrong. Secondly, we need to keep up research into long Covid and the long term outcomes of these patients. Thank you for your kind words, I have now stopped coughing but still have days when making a coffee knackers me out. I'm in my late 40s and have run three marathons. I was on 40 miles a week in March (ironically this may have been what weakened my immune system. Look at the long Covid stories on line. Pretty much every one I have read involves a runner. Should people stop exercising? No.). If we get an increase in people with lung or other organ issues that lead to death or life changing problems over the next year or two that is an effect that is currently hidden from the stats.

But is the virus weakening? Again, I trusted your statistics as that's what you do. But we are comparing numbers of cases in the first peak where only the hospitalised were tested to now where mass testing is available. It's not apples and apples. Whitty and Valance categorically state it is not weakening. So did a virologist on BBC news the other day who'd actually studied both instances of the virus.

My common ground with you, with Dan, with beorthelm and everyone on the good news thread is that I believe we need to be looking at hospitalisation and death numbers now, not cases. That seems only sensible. But both are heading for an exponential increase as per Bozza's posts yesterday.

highflyer · Sep 23, 2020

Mustafa said:
A more lethal strain of the virus will naturally become less common than a less lethal one, as making its host critically ill or killing them will result in fewer transmissions of that particular strain.

As a result, the coronavirus will naturally become less dangerous through natural selection.

This factor is almost certainly contributing to why we are seeing fewer deaths. It will also be the final factor, before the virus is as common and as "harmless" as the common cold.

So...'bad news, good news' on that. And with the clear proviso that nothing is certain. Or even close to certain.

But recent studies (I think on the good news thread?) seem to suggest that this virus has a relatively low level of genetic variation, meaning it will be slow to mutate. Most scientific opinions seems to be that, while it is possible that a significant (eg in terms of becoming less harmful) mutation may have occurred, it is unlikely in the short time it has been around. This seemed to be a general opinion in advance of the finding mentioned on genetic variation, which seems to make it more solid as an assumption.

The good news is that it is also unlikely to get any deadlier. And more importantly, it means that the work going on to find effective treatments won't end up behind the curve of the virus mutating and (most important) any treatment or vaccination is much more likely to effective across multiple populations, and effective in the longer term.

The Wizard · Sep 23, 2020

So, Raab admits PCR tests have a high false positive test rate which makes airport testing pointless, so why the hell are we basing nationwide restriction decisions on an ‘exponential growth rate’?

Are the government blindly ignoring the obvious data errors? And if so, why?

https://twitter.com/skynews/status/1308655561081225217?s=21

beorhthelm · Sep 23, 2020

The Wizard said:
So, Raab admits PCR tests have a high false positive test rate which makes airport testing pointless, so why the hell are we basing nationwide restriction decisions on an ‘exponential growth rate’? Are the government blindly ignoring the obvious data errors? And if so, why?

https://twitter.com/skynews/status/1308655561081225217?s=21

because there's a different demographic sample, airports are near random, national testing is symptomatic people or contacts.
its unfortunate he used this reason. the real reason is they dont want to swamp testing capacity on tourists and business travellers.

The Wizard · Sep 23, 2020

beorhthelm said:
because there's a different demographic sample, airports are near random, national testing is symptomatic people or contacts.
its unfortunate he used this reason. the real reason is they dont want to swamp testing capacity on tourists and business travellers.

I don’t believe this is random testing, is it not to stop people having to quarantine for 2 weeks on return from travels? At least, I believe that’s what the telegraph campaign was about, particularly a few months ago when we had the apparently massive testing capacity and barely even half the tests taking place.

Regardless, if he’s saying PCR tests have a high false positive rate, he’s acknowledging the data we are currently getting on COVID is highly inaccurate, yet I haven’t seen anyone else in goverment mention that lots of the current positive tests, could be false positives. Even if the false positive rate is 1% from 250k tests thats 2500 incorrect test results.

The last general population random sampling I saw from ONS did show an increase but nowhere near the level that the cases have increased at.

Bozza · Sep 23, 2020

highflyer said:
So...'bad news, good news' on that. And with the clear proviso that nothing is certain. Or even close to certain.

But recent studies (I think on the good news thread?) seem to suggest that this virus has a relatively low level of genetic variation, meaning it will be slow to mutate. Most scientific opinions seems to be that, while it is possible that a significant (eg in terms of becoming less harmful) mutation may have occurred, it is unlikely in the short time it has been around. This seemed to be a general opinion in advance of the finding mentioned on genetic variation, which seems to make it more solid as an assumption.

The good news is that it is also unlikely to get any deadlier. And more importantly, it means that the work going on to find effective treatments won't end up behind the curve of the virus mutating and (most important) any treatment or vaccination is much more likely to effective across multiple populations, and effective in the longer term.

There is absolutely nothing to suggest the virus has mutated in a significant way that makes any difference to us, which is both good news (we know what we're dealing with) and bad news (pinning hopes on it being less bad now are misplaced)

https://theconversation.com/coronavirus-mutations-what-weve-learned-so-far-145864

TL;DR - While adaptive changes may yet occur, all the available data at this stage suggests we’re facing the same virus since the start of the pandemic. Chris Whitty, chief medical officer for England, was right to pour cold water on the idea that the virus has mutated into something milder than the one that caused the UK to impose a lockdown in March. Possible decreases in symptom severity seen over the summer are probably a result of younger people being infected, containment measures (such as social distancing) and improved treatment rather than changes in the virus itself. However, while Sars-CoV-2 has not significantly changed to date, we continue to expand our tools to track and trace its evolution, ready to keep pace.

Bozza · Sep 23, 2020

The Wizard said:
I don’t believe this is random testing, is it not to stop people having to quarantine for 2 weeks on return from travels? At least, I believe that’s what the telegraph campaign was about, particularly a few months ago when we had the apparently massive testing capacity and barely even half the tests taking place.

Regardless, if he’s saying PCR tests have a high false positive rate, he’s acknowledging the data we are currently getting on COVID is highly inaccurate, yet I haven’t seen anyone else in goverment mention that lots of the current positive tests, could be false positives. Even if the false positive rate is 1% from 250k tests thats 2500 incorrect test results.

The last general population random sampling I saw from ONS did show an increase but nowhere near the level that the cases have increased at.

With respect chap, you don't believe much at all.

I imagine hospitalisation data is pretty key in reckoning right now. Looking forward to seeing how you bat this away:

August 28th-31st: 44-52-38-52
Last 4 days (17-20/09): 199-205-204-237

What about those on the front line?

Lots of people still not convinced that events this week are any big deal. Some think this is just increased testing etc. To explain, you can test positive for the virus SARS-CoV2 and feel completely well. Most people do. Being ill with COVID-19 is a very different thing.

Hospitals are seeing a substantial rise in COVID admissions. We haven't seen this many patients coming to hospital with COVID since May. This is new and it is real. NHS staff have no reason to make this up. Our lives are on hold just like everyone else's.

So if you hear 'experts' say hospitals are 'empty', ask yourself if they actually work in a hospital (they won't), and if they ever looked after a patient with COVID (they haven't). NHS staff are fed up with people using the pandemic to further their careers. Call them out.

https://twitter.com/rupert_pearse/status/1308463679382355971?s=20

I guess they're re-opening Covid wards just to keep up the pretence of the sham, right?

London's biggest hospital is set to reopen its Covid intensive care ward as evidence mounts of the capital being hit by a second wave of coronavirus.

A total of 206 patients with Covid have been admitted to London hospitals in the last seven days – more than double the 96 in the previous week. Thirty-one are on ventilators.

Barts Health, the capital’s biggest trust, has seen inpatients increase from near zero at the end of the summer to 32 yesterday morning.

Its main hospital, the Royal London, in Whitechapel, is due to bring its 15th floor Covid critical care ward back out of mothballs within days.

This will allow Covid patients to be isolated and keep the rest of the hospital, and the trust’s other hospitals - St Bartholomew’s, Whipps Cross and Newham - “covid secure” and able to treat non-covid patients.

The 15th floor, an empty shell since the hospital opened in 2012, was fitted out in May with £24m from the NHS Covid fund. It treated 30 patients at the end of the first peak. It has capacity for 120 to 150 ventilated patients, and may delay any need to reopen the Nightingale field hospital at ExCeL.

https://www.standard.co.uk/news/hea...=Social&utm_source=Twitter#Echobox=1600784927

Still, I note it is False Positives month for those so inclined, so keep on keeping on...

Feb: It’s just the flu
Mar: most have already had it
Apr: will go away in summer
May: died with or of?
Jun: everywhere is the same
Jul: herd immunity @20%
Aug: ‘casedemic’! 1!
Sep: false positives
Oct (proj): virus is weaker
Nov: it’s the flu not C-19
Dec: lockdowns made us weak

The Wizard · Sep 23, 2020

Bozza, I think you’ve made your views very clear but it’s statistical fact that 1% of PCR tests produce false positives, the point of my post is, why are the government not acknowledging that false positives are going to become a massive issue, particularly with the nonsense tests per day target? It seems they’ll acknowledge false positives are a problem, but only when it suits them?

I’m not saying cases aren’t going up, I’m not saying hospitalisations aren’t going up, that much is clear not once did I say that wasn’t the case, but I will question the decisions being made. This virus is endemic, It isn’t going to go away, and so as soon as you loosen restrictions cases will rise, I don’t see a concrete plan to defeat the virus, I will never back any decisions that put all the chips on a vaccine.

Harry Wilson's tackle · Sep 23, 2020

Guinness Boy said:
Sorry, in a little feet first on you. I'd read your posts on this and Dan's and you seemed absolutely miles apart. All the above is sensible if the virus is weakening and I'm happy to agree with it, if the virus is weakening, with two exceptions. Firstly if we still have Covid and a particularly bad flu season then we need to lock down immediately or risk overwhelming the NHS with the death of 1000 cuts. This is why I find flu jab refusal to be irresponsible and wrong. Secondly, we need to keep up research into long Covid and the long term outcomes of these patients. Thank you for your kind words, I have now stopped coughing but still have days when making a coffee knackers me out. I'm in my late 40s and have run three marathons. I was on 40 miles a week in March (ironically this may have been what weakened my immune system. Look at the long Covid stories on line. Pretty much every one I have read involves a runner. Should people stop exercising? No.). If we get an increase in people with lung or other organ issues that lead to death or life changing problems over the next year or two that is an effect that is currently hidden from the stats.

But is the virus weakening? Again, I trusted your statistics as that's what you do. But we are comparing numbers of cases in the first peak where only the hospitalised were tested to now where mass testing is available. It's not apples and apples. Whitty and Valance categorically state it is not weakening. So did a virologist on BBC news the other day who'd actually studied both instances of the virus.

My common ground with you, with Dan, with beorthelm and everyone on the good news thread is that I believe we need to be looking at hospitalisation and death numbers now, not cases. That seems only sensible. But both are heading for an exponential increase as per Bozza's posts yesterday.

Cheers for that. As always I wish you the best and hope your health turns around. My understanding is that the log lasting effects of a virus represent slow recovery rather than slow exacerbation so hopefully it will 'just' be a matter of time.

I also agree with all your other points. As for virus weakening, it is my hypothesis, based on evidence, but the evidence may be flawed (discussed elsewhere) and I am not absolutely certain about this and we won't know for sure for another couple of weeks.

Ironically, even though I am an argumentative sod, I do prefer to find common ground with people and the complete odds I was at with Dan a while back could, I thought, be due to a misunderstanding. Keeping people alive and well, and stopping the economy tanking are both essential (I would always put the first first), but when folk focus on only the one thing it can seem as though thay aren't bothered about the other. I absolutely dug out a poster a couple of weeks ago for promoting the economic argument based on a premature assessment of covid's lethality. I was livid. Still am when I think back....but hey. So...when the 'protect the vulnerable' argument is brought in I feel inclined to rebuild bridges. Hopfully we can all now agree that a team needs a defense as well as an attack.

Regarding you suggestion about instant lockdown to protect the NHS, I agree if the virus is much as it was first time, but again I am encouraged by the Ryanesquely (nay, Lamptyvially) small increase in hospitalizations this time around versus first time around. But I agree with you, hospitalizations is going to be the key indicator (it will change before deaths) and it is changing a bit, so over the next 2 weeks this will show us whether covid really has mutated or not. It's the only game in town really - everything else for the next 2 weeks, football, rules of six etc is all 'noises off'.

I note elsewhere that [MENTION=6886]Bozza[/MENTION] thinks Covid probably hasn't mutated. I am not sure whether he thinks there is evidence it hasn't mutated or whether he thinks (as I do) that the is not yet enough data to conclude that it has. Two rather different things. Apologies Bozza if you did explain your reasoning and I missed it.

All that aside, I maintain that since the first week of 'wait and see' (that was wrong in hindsight but understandable) HMG has handled this really poorly, and that the desperate but half-arsed attempts to 'get us back to normal' have done nothing more than facilitate a second wave. With furlough ending soon I fear for people, with possibly a second wave that (against my instincts) really is leathal while, at the same time, sudden loss of income for thousands of poor buggers. We will surely then see yet another U turn and furlough re-introduced (in time for the no deal Brexit).

Anyway....take care of yourself :thumbsup:

beorhthelm · Sep 23, 2020

The Wizard said:
I don’t believe this is random testing, is it not to stop people having to quarantine for 2 weeks on return from travels? At least, I believe that’s what the telegraph campaign was about, particularly a few months ago when we had the apparently massive testing capacity and barely even half the tests taking place.

Regardless, if he’s saying PCR tests have a high false positive rate, he’s acknowledging the data we are currently getting on COVID is highly inaccurate, yet I haven’t seen anyone else in goverment mention that lots of the current positive tests, could be false positives. Even if the false positive rate is 1% from 250k tests thats 2500 incorrect test results.

The last general population random sampling I saw from ONS did show an increase but nowhere near the level that the cases have increased at.

the *sample* of people through an airport is near random - anyone, everyone can show up. the false positive for a large random sample might be 1%. however, for a sample that is self selecting, i.e. have symptoms and going to a test centre, the false positve % will far far lower, because there will be more positives in the group.

government doesnt mention there are false positives as the method and data is the best we have, and we dont go on about false positives for other diseases. very little in medicine is 100%.

The Wizard · Sep 23, 2020

Boris going the ‘blame the public’ route

pb21 · Sep 23, 2020

The Wizard said:
Bozza, I think you’ve made your views very clear but it’s statistical fact that 1% of PCR tests produce false positives, the point of my post is, why are the government not acknowledging that false positives are going to become a massive issue, particularly with the nonsense tests per day target? It seems they’ll acknowledge false positives are a problem, but only when it suits them?

I’m not saying cases aren’t going up, I’m not saying hospitalisations aren’t going up, that much is clear not once did I say that wasn’t the case, but I will question the decisions being made. This virus is endemic, It isn’t going to go away, and so as soon as you loosen restrictions cases will rise, I don’t see a concrete plan to defeat the virus, I will never back any decisions that put all the chips on a vaccine.

There are a couple of points that false positives don’t explain:

1. The percentage of test undertaken coming back positive is increasing (I think it has ~doubled recently from ~1% to ~2%?).
2. Hospital admissions are increasing.

In addition I would suspect (I don’t know), that the fact that the specificity of the test is known (it is higher than 99%) means that false positives can be taken into account when analysing the data.

Also, a 1% false positive rate (assuming a specificity of 99%) would only be the case for when you take a completely random selection of the population (such as at an airport). In reality what is happening is that people with symptoms are self presenting and are being tested (in theory), so the false positive rate would be lower.

The Wizard · Sep 23, 2020

pb21 said:
There are a couple of points that false positives don’t explain:

1. The percentage of test undertaken coming back positive is increasing (I think it has ~doubled recently from ~1% to ~2%?).
2. Hospital admissions are increasing.

In addition I would suspect (I don’t know), that the fact that the specificity of the test is known (it is higher than 99%) means that false positives can be taken into account when analysing the data.

Also, a 1% false positive rate (assuming a specificity of 99%) would only be the case for when you take a completely random selection of the population (such as at an airport). In reality what is happening is that people with symptoms are self presenting and are being tested (in theory), so the false positive rate would be lower.

Good post with valid points, hospital admissions are increasing but not at the exponential rate of cases, time will tell though. I would argue your final paragraph however has been argued against by the government themselves, who just a few days ago claimed too many people without symptoms or not actually needing a test have been getting tested and so there has been a strain on testing capacity. Things just don’t add up do they?

Probably another case of the government shifting the blame to the public, noticed the last few weeks the narrative has shifted towards the public being responsible.

Bozza · Sep 23, 2020

The Wizard said:
Good post with valid points, hospital admissions are increasing but not at the exponential rate of cases, time will tell though. I would argue your final paragraph however has been argued against by the government themselves, who just a few days ago claimed too many people without symptoms or not actually needing a test have been getting tested and so there has been a strain on testing capacity. Things just don’t add up do they?

Probably another case of the government shifting the blame to the public, noticed the last few weeks the narrative has shifted towards the public being responsible.

1. Exponential doesn't mean fast. Exponential can be very slow indeed - at least at first - but it's still exponential. £10 in a savings account earning 1%pa looks like a straight line if you look at the account balance from years 1-50. Extend that out to 500 years and you see the exponential curve kick in.

2. Regardless of the above, this looks exponential to me (England hospitalisations by day)

WATFORD zero · Sep 23, 2020

I understand that 'false positives' can effect the figures and that there could be a case for the Virus having mutated and being less deadly, impact of lockdown measures, improved treatments etc, but surely the biggest factor in the difference in hospitalisation (and following death rates) from the first to second wave, is that the vast majority of people currently being tested have self diagnosed symptoms or have been in contact with people with symptoms. As far as I am aware, testing wasn't available to any of these people throughout the majority of the first phase.

In the first phase, the vast majority of people tested were already hospitalised. I'm pretty sure [MENTION=6886]Bozza[/MENTION] has made this point with estimated numbers of infections against actual tested rate of infections from the first phase.

I can see other elements having an effect, but surely nothing of a similar magnitude. Unfortunately, if this is correct, I believe that this means we are still a few weeks off knowing the implications of the spread to date, as we are simply seeing the increase in infection far earlier in the cycle, with a far higher number of asymptomatic and 'minor' (if you can call it that) infections that will recover and not need hospitalisation.

Bozza · Sep 23, 2020

WATFORD zero said:
I can see other elements having an effect, but surely nothing of a similar magnitude. Unfortunately, if this is correct, I believe that this means we are still a few weeks off knowing the implications of the spread to date, as we are seeing the increase in infection far earlier in the cycle.

Indeed - that's the trying to stop/turn around a tanker effect. The next 4 weeks, possibly more, are already locked in - there's nothing we can do about them now.

Guinness Boy · Sep 23, 2020

Bozza said:
There is absolutely nothing to suggest the virus has mutated in a significant way that makes any difference to us, which is both good news (we know what we're dealing with) and bad news (pinning hopes on it being less bad now are misplaced)

https://theconversation.com/coronavirus-mutations-what-weve-learned-so-far-145864

TL;DR - While adaptive changes may yet occur, all the available data at this stage suggests we’re facing the same virus since the start of the pandemic. Chris Whitty, chief medical officer for England, was right to pour cold water on the idea that the virus has mutated into something milder than the one that caused the UK to impose a lockdown in March. Possible decreases in symptom severity seen over the summer are probably a result of younger people being infected, containment measures (such as social distancing) and improved treatment rather than changes in the virus itself. However, while Sars-CoV-2 has not significantly changed to date, we continue to expand our tools to track and trace its evolution, ready to keep pace.

That's what I was referencing in my reply to HWT.

To sum up your summary, there's a good argument for social distancing and masks reducing viral load as well as transmission - which is a very good reason for keeping both.

LamieRobertson · Sep 23, 2020

Guinness Boy said:
That's what I was referencing in my reply to HWT.

To sum up your summary, there's a good argument for social distancing and masks reducing viral load as well as transmission - which is a very good reason for keeping both.

Unfortunately one effect of mandating masks in shops ..the reduction of people maintaining sensible distancing ..just going by my experience

nicko31 · Sep 23, 2020

LamieRobertson said:
Unfortunately one effect of mandating masks in shops ..the reduction of people maintaining sensible distancing ..just going by my experience

Hard to disagree with that, people are more confident with masks on. Still more mask use is still better, still nothing for schools in England from yesterday. Its a ticking time bomb, it was 1 in 25 year group sent home last last week and rising fast

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