covid-19

That's interesting wiggin and the Catch 22 seems a real issue.

Over here my wife was booked in for her second jab a week or two ago for the end of February, so are planning weeks and months ahead even in some hospitals.

I understand the logistics are an issue but from what I've heard the logistics of the AstraZenica vaccine are much simpler, not requiring the supercold storage for instance, so hopefully they can cope with multiple dosing types going on at the same time. Can cope in normal circumstances with multiple diseases at the same time, though I understand this isn't normal circumstances nor normal volumes.

The issue isn't the storage conditions themselves, it's the differences in how each vaccine is handled, stored, dosed, etc. Making sure the right patient gets the right drug at the right time is surprisingly complex when you're talking about doing it to 1000+ patients a day (which they are). When you move more to a clinic kind of setting, which is by nature less controlled, it gets harder.

From a logistics perspective, the JNJ vaccine will be best (assuming they can secure an EUA in the next month or so) - storage conditions are quite mild and it's a single dose so no timed follow-ups needed. I just don't know if the added complexity (of yet another set of conditions) would be worth it unless they can get a huge increase in supply compared to current levels. Probably better to save that vaccine for care settings that are less sophisticated and focus on making what they have optimized for work.

There's frankly no a priori reason for a hospital to get Moderna or Pfizer; both have similar risk profiles and similar enough handling. But there's plenty of reason to keep each site specific to a single vaccine so you avoid the inevitable mix-ups.

The death figures in the UK are absolutely shocking.

Yeh indeed, new record high today of 1,610 deaths

https://live.staticflickr.com/65535/...49fa6481_o.jpg


Hospital admissions rising steadily too

https://live.staticflickr.com/65535/...11eeb444_o.jpg


Tide has been turned though, cases continue to fall. Fall will reflect on admissions next then deaths

https://live.staticflickr.com/65535/...19f6a3e2_o.jpg

Out of curiosity, how strict are the rules there (and since when)? Reason I'm asking is because here cases have been dropping recently.. but also the share of 'English variant"* is increasing and now 10%, and I'm wondering if I should be worried that with that mutation becoming dominant we can expect an increase again.

* is there a better name for that yet? As with 'China virus', I'm not digging this name.

I don't think our rules are strict, and never have been. To me it's never really felt like any of our 3 "lockdowns" were proper lockdowns.

Instead we rely on good old fashioned British common sense. Like skating hands with hospitalised covid patients.

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Originally Posted by Flixy

Out of curiosity, how strict are the rules there (and since when)? Reason I'm asking is because here cases have been dropping recently.. but also the share of 'English variant"* is increasing and now 10%, and I'm wondering if I should be worried that with that mutation becoming dominant we can expect an increase again.

* is there a better name for that yet? As with 'China virus', I'm not digging this name.

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lineage B.1.1.7, or "the English virus that went up a hill but came down a mountain"

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Originally Posted by gogobongopop

I don't think our rules are strict, and never have been. To me it's never really felt like any of our 3 "lockdowns" were proper lockdowns.

Instead we rely on good old fashioned British common sense. Like skating hands with hospitalised covid patients.

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Here they are more guidelines than rules, but basically now it's work from home if you can, no more than 2 guests from outside your household, and in actual rules masks are mandatory in stores etc., and non essential stores are closed. Which is actually the strictest we have had here (so far, rumours abound on a potential curfew). How about over there?

The first 'lockdown' felt stricter, mainly because people were scared and while the rules were less strict people were more anxious and therefore more strict.

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Originally Posted by Flixy

Here they are more guidelines than rules, but basically now it's work from home if you can, no more than 2 guests from outside your household, and in actual rules masks are mandatory in stores etc., and non essential stores are closed. Which is actually the strictest we have had here (so far, rumours abound on a potential curfew). How about over there?

The first 'lockdown' felt stricter, mainly because people were scared and while the rules were less strict people were more anxious and therefore more strict.

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Wait a second, you're officially 'allowed' to have guests inside your home?

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Originally Posted by Flixy

Here they are more guidelines than rules, but basically now it's work from home if you can, no more than 2 guests from outside your household, and in actual rules masks are mandatory in stores etc., and non essential stores are closed. Which is actually the strictest we have had here (so far, rumours abound on a potential curfew). How about over there?

The first 'lockdown' felt stricter, mainly because people were scared and while the rules were less strict people were more anxious and therefore more strict.

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No guests in homes (except for "support bubbles"), no pubs or other hospitality open, work from home if you can, masks in shops and public transport, can be fined for being out of your house without a valid reason but the reasons are so many (exercise a popular one to cover all) that so long as you're not a hundred miles from home or with a group of people you're unlikely to be questioned.

Can currently meet up with other at a social distance outside, but just one other household/bubble. They were thinking about scrapping that but given the fall in case numbers and the vaccine rollout I don't think they will now.

There's also a strong weekend effect with the data. Worst data in the week tends to come Tuesday for death, Wednesday for cases. I wouldn't be surprised for tomorrow's case numbers to be 45-50k which would still be a big week-on-week fall but the media will mistakenly play as a rise from today, just as they mistakenly talk about falls on the weekend. How hard is it to control for day of the week. :rolleyes:

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Originally Posted by wiggin

Wait a second, you're officially 'allowed' to have guests inside your home?

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Yes, but not more than two per day and while keeping distance. And of course we're asked to limit contacts anyway (bubbles are recommended). Kind of a moot point anyway since this rule cannot be enforced.

Forgot to add: schools are closed, and bars/restaurants (except takeout and delivery).

Hospitality can trade for takeaway and delivery here too.

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Originally Posted by wiggin

Long story short? Local distribution can always be better, but better guidance/distribution from central authorities can dramatically help with local logistics.

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Looks like that guidance and coordination will ramp up fast with the new administration. :up:

PA just expanded its criteria today -- took about 20 mins to follow links on pa.gov to get my appt. for first dose on Friday. Had some minor glitches on the provider's website (time slots filling up fast) but it was easier than I'd expected. :D Here's hoping it will be smooth on the administrative side too, for people like your sister.

Also, Biden's National Covid-19 Memorial was a beautiful and moving tribute....as we hit the 400,000 death mark. Long overdue. :)

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Originally Posted by Flixy

Yes, but not more than two per day and while keeping distance. And of course we're asked to limit contacts anyway (bubbles are recommended). Kind of a moot point anyway since this rule cannot be enforced.

Forgot to add: schools are closed, and bars/restaurants (except takeout and delivery).

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Huh, I'm not sure what the official guidance is in my state right now, but I don't think I've been in anyone else's home since March, nor has anyone outside of immediate family (and our summer nanny) been in ours. Two a day seems awfully lax, especially if schools are closed - frankly it's much easier to control the school environment, and the risks are rather lower.

I wonder how much of the variety in Covid protocols/recommendations from place to place have more to do with cultural weighting and spending risk budgets rather than a sober assessment of best practices and risk/benefit ratios based on the best data to date. I'm certainly not excluding my state here; they have absolutely silly travel/testing rules and a super weird mix of things that are open vs. closed.

*notices wiggin's signature* :bulb:

That's a pretty old sig, GGT. I think I added it while I was working on a team that had people trying to develop computational models for blood flow in complex situations (e.g. aortic regurgitation), and they unearthed the quote for a bit of gallows humor. Turbulence is hard, even if the quote may be apocryphal.

Relativity is hard, too. ;) I think your sig is great because it's about human challenges (not meeting God at the end of your life tho). :)

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Originally Posted by wiggin

Huh, I'm not sure what the official guidance is in my state right now, but I don't think I've been in anyone else's home since March, nor has anyone outside of immediate family (and our summer nanny) been in ours. Two a day seems awfully lax, especially if schools are closed - frankly it's much easier to control the school environment, and the risks are rather lower.

I wonder how much of the variety in Covid protocols/recommendations from place to place have more to do with cultural weighting and spending risk budgets rather than a sober assessment of best practices and risk/benefit ratios based on the best data to date. I'm certainly not excluding my state here; they have absolutely silly travel/testing rules and a super weird mix of things that are open vs. closed.

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It would be stupid if they didn't include a measure of "these rules/ guidelines will actually be followed" in there. Otherwise what's the point? And as said it can't be enforced anyway, and the guideline is to just limit any contacts, the fewer the better.
Either way, numbers aser dropping consistently which implies this combination is okay- for now.

I have met some people, but limited to a small number of different people and not 2 a day for sure. On the 'bright' side the person i see most often is pretty safe since she had covid and still has the antibodies (plasma donor). PB the less fun side I couldn't attend my sister's wedding since for that 4 people were allowed.

I do have to say that living on my own and working mostly from home (there's the occasional day I need to be in the office), I'm happy I'm allowed to see some people, even if it's limited.

Late night riff on just getting an appointment for the covid vaccine: It's the first time since last March that I've felt hope (vs impending dread and doom). But I'm still worried and anxious about the whole damn thing.

I don't really know why I'm feeling so anxious, or why I have to look at my smallpox scar to be reminded that vaccinations DO work. The odd thing about social distancing is that it warps our perception of almost everything else. Maybe that's another viral thing we don't fully understand or appreciate?

Anyway, I just wanted to say that getting vaccinated isn't a panacea, but I hope it's a good beginning.

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Originally Posted by Flixy

It would be stupid if they didn't include a measure of "these rules/ guidelines will actually be followed" in there. Otherwise what's the point? And as said it can't be enforced anyway, and the guideline is to just limit any contacts, the fewer the better.
Either way, numbers aser dropping consistently which implies this combination is okay- for now.

I have met some people, but limited to a small number of different people and not 2 a day for sure. On the 'bright' side the person i see most often is pretty safe since she had covid and still has the antibodies (plasma donor). PB the less fun side I couldn't attend my sister's wedding since for that 4 people were allowed.

I do have to say that living on my own and working mostly from home (there's the occasional day I need to be in the office), I'm happy I'm allowed to see some people, even if it's limited.

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Over here living on your own would be number one example of what is called a support bubble.

It means you pick one other fixed household and for the purposes of all other rules, you live with them. So you can go to their house, they can go to yours, anytime that a household rule applies that is your extended household. But it should be fixed.

I'm not in a support bubble with anyone but from memory other examples are if someone needs assistance due to being vulnerable, for childcare etc

I believe but am not sure living on your own means as an adult. So a single parent is entitled to a support bubble as they're the only adult.

That sounds reasonable. Over here that is not a rule, while I've limited contacts it is with more than 1 household (not many though, and not often). While I'd be bummed if we get a stricter rule, I assume if it's implemented it's done for a reason and will suck it up.

Anyway, government is expected to propose a curfew later today, which is essentially to prevent people visiting each other in the evening. So that'd tackle these kind of contacts (as said, the number of people meeting indoors cannot be enforced).

Twitter Link

Israel still absolutely smashing this, and still a very remarkable difference in daily figures between countries.

Quote:

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Originally Posted by Flixy

It would be stupid if they didn't include a measure of "these rules/ guidelines will actually be followed" in there. Otherwise what's the point? And as said it can't be enforced anyway, and the guideline is to just limit any contacts, the fewer the better.
Either way, numbers aser dropping consistently which implies this combination is okay- for now.

I have met some people, but limited to a small number of different people and not 2 a day for sure. On the 'bright' side the person i see most often is pretty safe since she had covid and still has the antibodies (plasma donor). PB the less fun side I couldn't attend my sister's wedding since for that 4 people were allowed.

I do have to say that living on my own and working mostly from home (there's the occasional day I need to be in the office), I'm happy I'm allowed to see some people, even if it's limited.

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Flixy - I want to be clear, I wasn't critiquing you personally, I was more surprised that explicit guidance allowed people into other's homes, rather than having a recommendation of zero overlap, with 'but if you do it, keep distant/limit numbers/etc.' Pretty much any of these social distancing guidelines are unenforceable, but once you explicitly allow something, people often think that it's an acceptable risk and entirely sanctioned, rather than a regrettable concession to reality that carries with it very substantial risks of transmission.

I can certainly appreciate the position you're in, and I have no doubt that you value your ability to have at least 'some' human contact. Outside of work and my immediate family, I really only see humans when we get together for socially distanced/masked meetups outdoors. The thing that really fascinates me is how different public health authorities are coming up with different mixes of recommendations in a bid to contain spread, and it seems like raw risk metrics are not always the guiding principle.

No worries, didn't take it as criticism, just wanted to give how I interpret our rules and guidelines.

I have to say that your raw risk metrics might work for you, but in reality I think you need to include behavioral aspects as well (and communication of course). I'd guess the reasoning is here that if you set rules that people won't follow anyway, they're also less likely to follow other rules (I'm already not following rule A, why bother still following rule B). Whether that's the right approach, I don't know, but it doesn't seem outlandish. And I can imagine this is different between countries anyway - stereotypically the Dutch don't like to follow rules they don't see as reasonable. Which is probably also why the government banked for a long time on advice in most cases rather than rules (a bit too much if you ask me).

Anyway, now the rule/guideline is reduced to one person, and starting Saturday we'll have a curfew from 21 to 4.30.

BTW, don't want to give the impression I am having a particularly tough time. Sure, it's not great, but it isn't for anyone. I have a job, I'm healthy, so are my family and friends. I don't have to worry about combining kids and work, and don't have to worry about kid's education now schools are closed. And I can still go out to see some friends and get exercise, while others can't. If anything, I feel I'm pretty lucky/privileged. I may like to complain and moan every now and then, but I am aware I have it pretty good.

Twitter Link

New record in vaccine rollout, both for England and UK. Over 400k in a day UK-wide for the first time.

What's going on in Scotland though? They've been given doses pro-rata'd based on population so have the same doses per capita as England, but are rolling it out consistently much slower.

EDIT: Though Jeez Italy's stats have just been published and their daily injections are lower than Scotland's. Bit of a population difference between Scotland and Italy.

https://ourworldindata.org/coronavir...ickerSort=desc

Two bits of bad news today. The government have said their research now makes them think the B117 variant (the "British variant") not just has higher transmissibility but they now have reason to believe it is more deadly per case too now. That's terrible news if true.

This too from Denmark is concerning.

https://archive.vn/9kWbI

Washington Post: "Denmark is sequencing all coronavirus samples and has an alarming view of the U.K. variant

Like a speeding car whose brake lines have been cut, the coronavirus variant first spotted in Britain is spreading at an alarming rate and isn’t responding to established ways of slowing the pandemic, according to Danish scientists who have one of the world’s best views into the new, more contagious strain.

Cases involving the variant are increasing 70 percent a week in Denmark, despite a strict lockdown, according to Denmark’s State Serum Institute, a government agency that tracks diseases and advises health policy.

“We’re losing some of the tools that we have to control the epidemic,” said Tyra Grove Krause, scientific director of the institute, which has begun sequencing every positive coronavirus test to check for mutations. By contrast, the United States is sequencing 0.3 percent of cases, ranking it 43rd in the world and leaving it largely blind to the variant’s spread.

Depressing stuff.

I watched the briefing today. The first question from the public was superb - basically asking how the efficacy of the vaccine is impacted when the second dose is delayed. It's a perfectly reasonable question to ask and one the British public should know the answer to.

Johnson obviously passed it over. The only answer was one explaining the rationale behind the decision - which does seem to me make sense, but not how the approach impacts the efficacy. That really concerned me.

If vaccination fails because we didn't follow the instructions on the box and were more concerned about beating Europe - we're fucked.

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Originally Posted by RandBlade

Two bits of bad news today. The government have said their research now makes them think the B117 variant (the "British variant") not just has higher transmissibility but they now have reason to believe it is more deadly per case too now. That's terrible news if true.

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It makes sense and I'd be surprised if it wasn't true. Early studies suggested that the longer the exposure, the worse the condition. If this new variant spreads faster/easier that means that exposure times for it have become more efficient, therefore more deadly.

Covid: Gap between Pfizer vaccine doses should be halved, say doctors
https://www.bbc.co.uk/news/uk-55777084

Starting to worry about this now. Again, I'm concerned that Johnson is all about being #1 on the charts, as opposed to ensuring the vaccine rollout is done as effectively as possible.

Time will tell. I sincerely hope the current strategy proves to be the right one.