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Corona / Covid-19 Virus - General Discussion (politics go to the Off Topic / Politics thread)

Personally I find it unlikely that the current strain of the virus was widespread well before it was recognised (more than a few weeks).

In Italy, Spain, London we have seen a rapid rise in sickness and mortality, which followed a reasonably predictable pattern. Locally (rural UK) we have been lucky enough to have just a dozen or so cases that needed to be hospitalised. Of those who died, most were frail and had it not been for the awareness of COVID their deaths would have been thought fairly unremarkable. But there have also been some very sick younger people (40s and 50s) who would almost certainly have died without hospital care. We get people like this sporadically, but in a small rural hospital to have several at once would have raised eyebrows. I would be surprised if you could have an outbreak in any reasonably sized city without the intensive care staff noticing, and in any developed country there would be an attempt to find out why.

So the question is why or how it might have been spreading without being recognised. One possibility would be if it were spreading slowly in a very sparsely populated area where the really sick people wouldn’t turn up regularly enough to be noticed. I guess this is possible, but we probably meet that definition by any reasonable standards, yet saw a rapid rise in cases until the lockdown effect kicked in. You still have to answer why in the months preceding the recognised outbreak, nobody from the countryside infected somebody from a town setting off an outbreak that would have been more obvious. Another possibility is that the virus was for some reason less lethal or spread less quickly. Had we just moved from summer to winter, this might be an explanation.

I could believe that related strains of the virus might have circulated for a while before suddenly mutating to something that spread more rapidly or was more virulent. The genetic studies I read early on suggested a last common ancestor of the currently circulating strains in November or December.

Early on in the outbreak we tested all the COVID swabs for influenza and many of them came back positive for influenza A or B – i.e. lots of people think they have mild or not-so-mild Covid but actually turn out to have other viruses. I think there have been lots of epidemics of viruses that were making people mildly to moderately ill. Many healthcare staff like to think that they have probably had COVID and may therefore be able to stop worrying about it, but for most I fear that may be wishful thinking.

Over the past few weeks, one of the new discussions in terms of treatment has been to do with thromboses. Patients seem very prone to blood clotting disorders and they are having lots of big clots (pulmonary emboli) and small clots (microvascular thrombosis affecting the small blood vessels in the lungs and elsewhere). This was not something that was very widely discussed earlier on, but should hopefully be something that we can prevent. Some of the early hopeful treatments seem fairly ineffective and we are getting a handle on whether we need ventilators for all, or whether simpler CPAP machines might be able to help most. Then, there are approaches such as these COVID cards that might revolutionise contact tracing. So personally I am starting to be optimistic that the lockdown may have been really beneficial. Perhaps we will be able to lift it, use contact tracing to stamp out inevitable further outbreaks, and offer better treatment to those who do still become unwell. For contact tracing to be effective we would really have to reduce the number of cases to a very low level.

Sadly, Ecuador seems to be providing an example of a country that is developed enough to record deaths but not developed enough to take any effective measures to prevent its spread. Guayas province has suffered about 5 times the expected mortality since the start of March and I am guesstimating that it will probably be twice that and rising, at present.

There’s antibody tests available in online stores here in PL. 640 EUR for 20. Would be nice to test positive and reduce fear. Any reasons not to test oneself?

LPFR, Poland

Is it actually in stock?

If so I would do it.

There is also talk of the antibodies lasting only a few months. But of course nobody really knows because this thing has not been around for long enough. The internet is full of “professors” and you can find a video of a “professor” (which in much of the world is just any college or univ lecturer) saying anything you want. Also it’s been reported that under-40s don’t develop much in the way of antibodies since their body kills the virus directly.

The UK govt seems to be saying that none of these are reliable, but we don’t know whether that is just the NHS central purchasing body not having any of the manufacturers on their approved supplier list

Administrator
Shoreham EGKA, United Kingdom

I looked at th epage of NHS workers who have died. I don’t at all buy that they were mostly obese. A few were a bit chubby but many were perfectly normal. In today’s world a BMI of 30 is probably about the median. It’s just plain daft to place a lot of faith in a metric made up on the spot in the 1830s, especially considering it’s fundamentally flawed (depends on height squared instead of cubed).

I’ve whiled away most of this week putting together a fairly complex epidemiological model (maybe I’ve drunk too much to type that) that takes into account physical clustering (i.e. if I get sick I’m a lot more likely to infect my friends and family than someone 3000 miles away in South Carolina). It shows is that life is tough for a pathogen. Even a modest increase in community immunity defeats it. The idea that it has to reach 0.5 only applies in the classic SIR model which ignores clustering.

Community immunity of 20% coupled with sensible precautions (wash your hands, everyone wears a mask, don’t touch people) is almost certainly enough to hold it at bay.

github.com/harper493/epidemdia if you want to play with it, you’ll need Python 3.8 and a bunch of well known packages like matplotlib.

LFMD, France

One has to remember the UK NHS employs over 1M people, so a number (corresponding to their health, local community, demographic, socio economic group, etc) will die of the virus anyway. The only meaningful metric is how many working in high exposure areas got it.

In the UK, about 200ppm have so far died, so in the NHS you would expect about 200, with any additional hospital exposure related deaths being on top of that. Here it states 27 have died, which is much less than one might expect.

Looking at the report kwlf posted some days ago which showed the BMI-mortality relationship, IIRC it didn’t show that “BMI will get you” until it was well over 30. This is because much of the population is obese so you would expect the same profile in those who get ill.

Administrator
Shoreham EGKA, United Kingdom

loco wrote:

Would be nice to test positive and reduce fear

There is a 99.99% chance or more you will test negative. IMO it’s a waste of money. All these tests are really only good for widespread statistical analysis or at doctors and hospitals. A much better proscription for a GA pilot is to get out and do some flying

The elephant is the circulation
ENVA ENOP ENMO, Norway

Ahh @leSving if only we could get out there and do some flying:)

France

There used to be a television series called “Gladiators” and someone used the body mass index calculation to show that all the gladiators would come out as obese.

France

Regarding home tests: The question is what you do on the basis of the test results. If you have been isolating and test positive then you’re likely to relax your isolation. If the test was a false positive and you haven’t had the disease then you’re putting yourself and everybody else at unnecessary risk.

In a hospital setting, if someone tests negative (with a test for acute infection) then you might put them on a ward full of elderly people rather than the COVID isolation ward. If it is a false negative you might kill other patients and staff.

So, somebody needs to check that the tests are up to par. Everybody is very keen to get started with antibody tests and my understanding is this hasn’t happened because there are no reliable test kits available.

When you’re testing yourself you might relax your standards a bit, compared to when you are taking responsibility for other people. So at what level of inaccuracy will you start to consider that the test is not useful?

There’s also a huge potential for fraud. Someone could easily produce fake kits which gave a random reading or tested something else (e.g. pregnancy or cannabis use!). In the third world a high proportion of all medicines are counterfeit and I would be surprised if there aren’t fake test kits knocking around.

Last Edited by kwlf at 18 Apr 08:43

LeSving wrote:

There is a 99.99% chance or more you will test negative. IMO it’s a waste of money. All these tests are really only good for widespread statistical analysis or at doctors and hospitals. A much better proscription for a GA pilot is to get out and do some flying

With the recent study from Santa Clara showing a rate of 50-85 infected to 1 diagnosed I am not so sure about that. If that rate applied in Poland, it would be half a million people. Having done multiple trips in Feb and March (Italy 2x, France and USA) I’d give myself a higher chance than 0,01%.

Agree to the flying part. Did 5h in last two days.

Last Edited by loco at 18 Apr 09:05
LPFR, Poland
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