SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

Pogue Mahone said:
Haven’t you been vaccinated already? I assumed that meant they had rattled through the older age groups before you. So you’re getting there, albeit a bit more slowly than the rest of the world.

There are some really tough decisions ahead for Aus/NZ. The virus is here to stay and the vaccines will never be 100% effective. So it’s a big call to open your borders up again knowing that many will die as a result.
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In my humble, uneducated opinion it seems like a better strategy to hold back on opening your borders until the vaccine programme is complete and you’ve offered your population the best level of immunity you can without exposure to the virus rather than accepting very early on that it’s going to inevitably rip through your population, cause thousands upon thousands of deaths and still have to intermittently go into tough lockdowns that last for weeks or months on end.

If Australia and New Zealand do hold out until their populations are sufficiently vaccinated, then cautiously open the borders with the right checks in place why would they be in any worse position going forward than if a percentage of their population had already contracted the disease? Surely it’s better to get your immunity from a vaccine anyway?
 
Pogue Mahone said:
Haven’t you been vaccinated already? I assumed that meant they had rattled through the older age groups before you. So you’re getting there, albeit a bit more slowly than the rest of the world.

There are some really tough decisions ahead for Aus/NZ. The virus is here to stay and the vaccines will never be 100% effective. So it’s a big call to open your borders up again knowing that many will die as a result.
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I got my AZ with the second shot due in August. The problem is that we will have vaccinated the over 50's quite soon but have nowhere near enough of anything else and the government is downplaying the need to vaccinate quickly.

We have also fecked up things like vaccinating disabled people and retirement homes. The Libs would rather tank the economy than admit their feck ups, so I fully expect them to lock the borders until after the next election. They are a moral vacuum and I hate them with a passion.
 
Penna said:
True (I removed the pic as it was rather big) - but right now seems a bad time to have mass protests in Bolton.
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But on the plus side, they are unlikely to have had people travelling in to Bolton for the protest, and as it was held there, it meant people weren't travelling from Bolton, to Manchester perhaps, to protest.
 
Pexbo said:
In my humble, uneducated opinion it seems like a better strategy to hold back on opening your borders until the vaccine programme is complete and you’ve offered your population the best level of immunity you can without exposure to the virus rather than accepting very early on that it’s going to inevitably rip through your population, cause thousands upon thousands of deaths and still have to intermittently go into tough lockdowns that last for weeks or months on end.

If Australia and New Zealand do hold out until their populations are sufficiently vaccinated, then cautiously open the borders with the right checks in place why would they be in any worse position going forward than if a percentage of their population had already contracted the disease? Surely it’s better to get your immunity from a vaccine anyway?
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It’s definitely better. They had an opportunity to rid their country of the virus and it was the right decision to take at the time. Their death toll will be considerably lower as a result.

Doesn’t make it any less of a head feck for whoever has to decide to open their borders. Another big challenge ahead of them is around changing the way society behaves. For countries that have been living with covid it almost feels normal to maintain a degree of social distancing. Do more work from home. Don’t send sick kids to school etc etc That’s a learning curve that’s all ahead of Australia.
 
Pogue Mahone said:
It’s definitely better. They had an opportunity to rid their country of the virus and it was the right decision to take at the time. Their death toll will be considerably lower as a result.

Doesn’t make it any less of a head feck for whoever has to decide to open their borders. Another big challenge ahead of them is around changing the way society behaves. For countries that have been living with covid it almost feels normal to maintain a degree of social distancing. Do more work from home. Don’t send sick kids to school etc etc That’s a learning curve that’s all ahead of Australia.
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I really don't understand what is hard for them. Once the people are vaccinated you open the borders. At that point it really is just a flu.
 
Pogue Mahone said:
It’s definitely better. They had an opportunity to rid their country of the virus and it was the right decision to take at the time. Their death toll will be considerably lower as a result.

Doesn’t make it any less of a head feck for whoever has to decide to open their borders. Another big challenge ahead of them is around changing the way society behaves. For countries that have been living with covid it almost feels normal to maintain a degree of social distancing. Do more work from home. Don’t send sick kids to school etc etc That’s a learning curve that’s all ahead of Australia.
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Fair enough but it seems a bit of a moot argument based on the notation that the “zero COVID” is some sort of ideologically absolute position when really the approach was never “no COVID ever” and more “no COVID until it can be reasonably managed”.

What you’re suggesting is that Australia is going to have the same sort of behavioural adjustment period most other countries have had... only under massively more favourable conditions?
 
massi83 said:
I really don't understand what is hard for them. Once the people are vaccinated you open the borders. At that point it really is just a flu.
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You’re asking a country that’s had less than 30 deaths to accept 200-1000 deaths a year from now on.

It’s sensible and understandable if it’s truly under control. But it’s a political hand grenade that’s glued to your hand.
 
UnrelatedPsuedo said:
You’re asking a country that’s had less than 30 deaths to accept 200-1000 deaths a year from now on.

It’s sensible and understandable if it’s truly under control. But it’s a political hand grenade that’s glued to your hand.
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Yes. Good luck convincing non-boomers otherwise. I have behaved in a better way than 95% of people under 40 until there are vaccines. But after that, if we don't go back to normal I would be protesting, so I have no idea who the people would be, who would accept the restrictions at that point.
 
Im in NZ. We are expecting to have everyone (barring those who cant or wont ) vaccinated by the end of the year, the plan is for end of August.
In many respects we got lucky here and we know it. Lots of us are keen to travel but life here has been pretty normal for the majority of this whole thing so far. We wouldnt change what we have done and in general everyone is pretty relaxed with how slow the vaccination schedule is, we understand why its slow.
With respect to what happens once we finally open up we also understand the virus will appear and there will be a portion of the population that gets sick etc. However we are also pretty sure its going to be nowhere even remotely close to what would have happened if we hadnt gone down the elimination path. Its a no brainer.
The main worry is how effective the vaccines are against the variants.
I do think we will see preferred countries not having to quarantine and countries with difficult numbers having to quarantine for a while or some sort of similar control method. I do wonder about any covid passport thing, doubt we will go that far and hope we dont.
Im looking forward to heading overseas soon with work and on holiday but lets say the worst case happens and we have to stay closed for another year or 2, I wouldnt see it as a major catastrophe, we are coping quite happily here.
 
massi83 said:
Yes. Good luck convincing non-boomers otherwise. I have behaved in a better way than 95% of people under 40 until there are vaccines. But after that, if we don't go back to normal I would be protesting, so I have no idea who the people would be, who would accept the restrictions at that point.
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Agree with you on both points. Once the population is fully vaccinated I don’t see any big concerns for a country like Australia or New Zealand. The vaccines don’t prevent everyone from getting covid but they are near perfect at reducing serious cases, and I think the vast majority of the population will be fine with near-perfect prevention + seasonal flu levels of serious cases. Only thing that changes that equation is a particularly virulent new strain, maybe one that is particularly dangerous for kids, but that will throw up most of the same problems in any country that’s fully vaccinated their population. At that point I don’t see the political will being there to start all over again. It’ll be time for plan B. Seems an unlikely scenario in any case.
 
massi83 said:
Yes. Good luck convincing non-boomers otherwise. I have behaved in a better way than 95% of people under 40 until there are vaccines. But after that, if we don't go back to normal I would be protesting, so I have no idea who the people would be, who would accept the restrictions at that point.
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I agree with you. My point is, how do you tell a country that’s eradicated, to now let the wolf in the door, while you tell them that 500 people dying a year from now is going to have to be ok.

Its an enviable position of sorts. But not an easy one to navigate.

“We stopped people dying... now we’re going to have to accept hundreds of people dying, because we need to live full lives”.

It’s really hard. To pretend otherwise is silly.
 
UnrelatedPsuedo said:
I agree with you. My point is, how do you tell a country that’s eradicated, to now let the wolf in the door, while you tell them that 500 people dying a year from now is going to have to be ok.

Its an enviable position of sorts. But not an easy one to navigate.

“We stopped people dying... now we’re going to have to accept hundreds of people dying, because we need to live full lives”.

It’s really hard. To pretend otherwise is silly.
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Yeah, exactly my point.

It’s also going to divide opinions about how to time their reopening. What % of the population should be fully vaccinated? Plus it looks as though some vaccines might protect better than others against the sort of variants likely to be dominant when they let the virus into the country. How will Australians who get AZ feel when they read about ‘only’ 60% efficacy against the Indian variant? Will they argue they should keep borders closed until they’ve had a chance to get an mRNA booster? When Aussies start dying the inevitable backlash against whatever decision they make will be something every politician will be desperate to avoid.

Tough decisions ahead anyway. Actively choosing to expose your citizens to a lethal virus - with associated changes to the way they live - is in a completely different ball park to the various mitigation strategy decisions that governments everywhere else have been making this last couple of years.
 
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Pogue Mahone said:
Doesn’t make it any less of a head feck for whoever has to decide to open their borders. Another big challenge ahead of them is around changing the way society behaves. For countries that have been living with covid it almost feels normal to maintain a degree of social distancing. Do more work from home. Don’t send sick kids to school etc etc That’s a learning curve that’s all ahead of Australia.
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The return to work has been far from universal. I still haven't returned to the office. And our place is at a max of 50% capacity but rarely over 25%. With masks it is only the last week where they aren't required on public transport (but most still do wear them) and we have had to wear them every time there is a case of community transmission so a return won't be that difficult (well no more than usual). Social distancing is still legislated in bars and cafe's and encouraged else where with shops limiting the density of customers.

The hard bit is going to be how we decide to open up as our vaccine rollout is glacial and our government are cowards and by the sound of them will happily keep the borders locked so their vaccine feck ups don't costs a single life before the next election. There is a vague chance that they will allow vaccinated Australian's back in as long as they home quarantine but they are also talking about also having to have a negative covid test and positive antibody test within 72 hrs of flying home. If you have both I'm not sure why the home quarantine is really necessary though. Maybe there is a very very small chance that you could test negative for covid, have a decent antibody level and still import and spread covid. So if that is a good reason fair enough but with this government I doubt it. I wouldn't let them buy my car in case they set it on fire because it was the wrong colour. If they told you that night followed day I'd stay up all night to double check.
 
Does anyone know what's going on in Japan? Apparently Covid is rife, 80% of their population don't want the Olympics to happen and only 5% of their population has had at least one jab.
 
I've been looking at international travel and in particular test requirements. Now, whatever you think of the broad principle of pre-travel testing, can someone explain the value of a three day old PCR test? Why isn't an on-the-day (preferably supervised) lateral flow test a more useful measure?

I'm just curious if anyone knows the underlying analysis behind the idea. Is it because you get too many false positives on LFT - and that might mean chucking a couple of passengers off every flight? For the purposes of this question I'm taking the broad principle that a PCR test is perfect (which it isn't) and just wondering why a three day old result is more useful than the less precise but more up to date LFT - particularly if it's true that the LFT does a decent job of spotting the currently most contagious.

Is it to give people time to cancel/rebook flights/accommodation? Is it just to increase the costs/hassle as a way to discourage travel? Or are LFTs just useless really?
 
jojojo said:
I'm just curious if anyone knows the underlying analysis behind the idea. Is it because you get too many false positives on LFT - and that might mean chucking a couple of passengers off every flight? For the purposes of this question I'm taking the broad principle that a PCR test is perfect (which it isn't) and just wondering why a three day old result is more useful than the less precise but more up to date LFT - particularly if it's true that the LFT does a decent job of spotting the currently most contagious.
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Aren't they far less accurate? Only just over 50% in the second week of infection if I remember correctly. So false negatives rather than false positives are the issue I think.
 
Wibble said:
Aren't they far less accurate? Only just over 50% in the second week of infection if I remember correctly. So false negatives rather than false positives are the issue I think.
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The issue is one I've struggled with too. There just seems to be a lot of time for things to happen in 72 hours, so much so that a 3 day old PCR rest may no longer be relevant even if it was negative at the time.
 
Surely the 3 days is to cover transit time as well? Especially for those travelling longer distances, my other half's relative had an issue where his PCR test had expired after a nightmare journey coming from the USA to the UK.
 
jojojo said:
I've been looking at international travel and in particular test requirements. Now, whatever you think of the broad principle of pre-travel testing, can someone explain the value of a three day old PCR test? Why isn't an on-the-day (preferably supervised) lateral flow test a more useful measure?

I'm just curious if anyone knows the underlying analysis behind the idea. Is it because you get too many false positives on LFT - and that might mean chucking a couple of passengers off every flight? For the purposes of this question I'm taking the broad principle that a PCR test is perfect (which it isn't) and just wondering why a three day old result is more useful than the less precise but more up to date LFT - particularly if it's true that the LFT does a decent job of spotting the currently most contagious.

Is it to give people time to cancel/rebook flights/accommodation? Is it just to increase the costs/hassle as a way to discourage travel? Or are LFTs just useless really?
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PCR has always been the gold standard for the detection of virus. LFTs, on the other hand, are known for their poor sensitivity (though some demonstrate acceptable performance) and huge variations among different kits. I agree the "three-day" gap is not ideal, and it is possible someone gets infected during that period, but it's much more reliable than LFTs.
 
I get that PCRs are the best tests, I'm just wondering about the value of a test done on Tuesday for a flight on Friday.

From what I've read on infectiousness - people are reckoned to be at their most infectious +/- two days from symptoms onset. Hence the relative inaccuracy of the LFT (picking up about 50% of cases) in week two doesn't necessarily make it useless, especially as week one it's thought to be 70%

It's how to calculate that trade off between testing people on the day versus testing them too early that I'm curious about. I just wondered if anyone has seen some actual modelling on it, or is it just the broad principle of "PCR better" that makes the decision, despite the test being done at the wrong time.
 
jojojo said:
I get that PCRs are the best tests, I'm just wondering about the value of a test done on Tuesday for a flight on Friday.

From what I've read on infectiousness - people are reckoned to be at their most infectious +/- two days from symptoms onset. Hence the relative inaccuracy of the LFT (picking up about 50% of cases) in week two doesn't necessarily make it useless, especially as week one it's thought to be 70%

It's how to calculate that trade off between testing people on the day versus testing them too early that I'm curious about. I just wondered if anyone has seen some actual modelling on it, or is it just the broad principle of "PCR better" that makes the decision, despite the test being done at the wrong time.
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For what is worth in my case during the onset of symptoms the antigen test that I did came back negative, after 2 days I went to do a PCR (since symptoms were not going away) which has detected virus.
 
jojojo said:
I get that PCRs are the best tests, I'm just wondering about the value of a test done on Tuesday for a flight on Friday.

From what I've read on infectiousness - people are reckoned to be at their most infectious +/- two days from symptoms onset. Hence the relative inaccuracy of the LFT (picking up about 50% of cases) in week two doesn't necessarily make it useless, especially as week one it's thought to be 70%

It's how to calculate that trade off between testing people on the day versus testing them too early that I'm curious about. I just wondered if anyone has seen some actual modelling on it, or is it just the broad principle of "PCR better" that makes the decision, despite the test being done at the wrong time.
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I think @F-Red is right. It’s a test within 72 hours you need, which gives a bit of wriggle room. If it was within 24-48 hours you could get people being sent home from their destination due to delays or stop-overs that take longer than planned.

On the day supervised LFT would also be useful but logistically much more complex if we’re asking people to do it at airports. The PCR is consistently accurate and it’s up to the traveller to arrange it at their own time/expense.
 
jojojo said:
I get that PCRs are the best tests, I'm just wondering about the value of a test done on Tuesday for a flight on Friday.

From what I've read on infectiousness - people are reckoned to be at their most infectious +/- two days from symptoms onset. Hence the relative inaccuracy of the LFT (picking up about 50% of cases) in week two doesn't necessarily make it useless, especially as week one it's thought to be 70%

It's how to calculate that trade off between testing people on the day versus testing them too early that I'm curious about. I just wondered if anyone has seen some actual modelling on it, or is it just the broad principle of "PCR better" that makes the decision, despite the test being done at the wrong time.
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"The sensitivity of antibody-based rapid diagnostic testing increased with duration of illness, from 26.8% sensitivity (18.3-36.8) in week one to 76.4% (70.1-82.0) 14 days after symptom onset." https://doi.org/10.1016/S1473-3099(21)00152-3

Another analytical concern is that there are plenty of LFT kits in the market with varying performances. Some countries are using kits with very poor sensitivity. It is impossible to standardize and create a model for it on an international level.
 
hmchan said:
"The sensitivity of antibody-based rapid diagnostic testing increased with duration of illness, from 26.8% sensitivity (18.3-36.8) in week one to 76.4% (70.1-82.0) 14 days after symptom onset." https://doi.org/10.1016/S1473-3099(21)00152-3

Another analytical concern is that there are plenty of LFT kits in the market with varying performances. Some countries are using kits with very poor sensitivity. It is impossible to standardize and create a model for it on an international level.
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That's the antibody test though - presumably a blood test - where you'd expect to have to wait for the antibodies to develop. The ones I was thinking about were the swab type antigen tests like the LFTs being used for rapid testing in the UK.

From the same report:
Antigen-based rapid diagnostic test sensitivity was 80·0% (95% CI 71·0–88·0) in the first 7 days after symptom onset, but antibody-based rapid diagnostic tests had only 26·8% sensitivity (18·3–36·8).

It's noticeably weaker on asymptomatic cases, and the antigens fade as the antibodies rise - but it still feels like a useful "on the day" measure compared to a 3 day old test.

I think I'd feel safer with someone who tested (supervised) LFT antigen negative on the day sat next to me on the plane, rather than someone PCR negative three days ago - though obviously a "do both" or a "don't travel" plan is better. But if someone has fed the data into some kind of statistical model, I'd be intrigued to see it.
 
jojojo said:
That's the antibody test though - presumably a blood test - where you'd expect to have to wait for the antibodies to develop. The ones I was thinking about were the swab type antigen tests like the LFTs being used for rapid testing in the UK.

From the same report:
Antigen-based rapid diagnostic test sensitivity was 80·0% (95% CI 71·0–88·0) in the first 7 days after symptom onset, but antibody-based rapid diagnostic tests had only 26·8% sensitivity (18·3–36·8).

It's noticeably weaker on asymptomatic cases, and the antigens fade as the antibodies rise - but it still feels like a useful "on the day" measure compared to a 3 day old test.

I think I'd feel safer with someone who tested (supervised) LFT antigen negative on the day sat next to me on the plane, rather than someone PCR negative three days ago - though obviously a "do both" or a "don't travel" plan is better. But if someone has fed the data into some kind of statistical model, I'd be intrigued to see it.
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"Data on the sensitivity and specificity of currently available Ag-RDTs for SARS-CoV-2 have been derived from studies that vary in design and in the test brands being evaluated. They have shown that sensitivity compared to NAAT in samples from upper respiratory tract (nasal or nasopharyngeal swabs) appears to be highly variable, ranging from 0-94% but specificity is consistently reported to be high (>97%)." https://apps.who.int/iris/bitstream...HO-2019-nCoV-Antigen_Detection-2020.1-eng.pdf

I'm sorry for my mistake, yet the analytical issue on rapid antigen tests remains unsolved. I'd feel safe if all LFT kits have a sensitivity of 80%, but unfortunately plenty of kits do not offer such a high sensitivity and it's hard to tell which kit is adopted by other countries.

You've got a point about the three-day gap, but I think same-day LFTs can only act as an adjunct to the PCR.
 
F-Red said:
Surely the 3 days is to cover transit time as well? Especially for those travelling longer distances, my other half's relative had an issue where his PCR test had expired after a nightmare journey coming from the USA to the UK.
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72 hrs isn't much by the time you get the test results back.and travel.
 
stu_1992 said:
The issue is one I've struggled with too. There just seems to be a lot of time for things to happen in 72 hours, so much so that a 3 day old PCR rest may no longer be relevant even if it was negative at the time.
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All a numbers game. Some people could test negative despite being infected because the viral loads was still building but still far better than the worst performance of the rapid tests (2nd week of infection). If you want to stop importing any covid you need a quarantine system as well.
 
Wibble said:
72 hrs isn't much by the time you get the test results back.and travel.
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I think the PCR timeline is set by the sheer practicality of taking a test and getting a result in time to fly. It's just what that does to it's actual usefulness that I'm wondering about.

From https://www.gov.uk/guidance/how-to-quarantine-when-you-arrive-in-england
"You must take the test in the 3 days before the service on which you will arrive in England departs. For example, if you travel directly to England on Friday, you must take the test on the Tuesday, Wednesday or Thursday."
 
jojojo said:
I think the PCR timeline is set by the sheer practicality of taking a test and getting a result in time to fly. It's just what that does to it's actual usefulness that I'm wondering about.

From https://www.gov.uk/guidance/how-to-quarantine-when-you-arrive-in-england
"You must take the test in the 3 days before the service on which you will arrive in England departs. For example, if you travel directly to England on Friday, you must take the test on the Tuesday, Wednesday or Thursday."
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Yes and there's nothing wrong with that.
 
Rado_N said:
Avoiding Bolton is always a good idea tbf.
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My sister and BIL recently had to leave their rented house in Bolton after living there for many years, and I did all the online searching for a new place for them (I have time on my hands). I found them a nice place in the countryside near Chorley. Bolton is grim, in my opinion.
 
Penna said:
My sister and BIL recently had to leave their rented house in Bolton after living there for many years, and I did all the online searching for a new place for them (I have time on my hands). I found them a nice place in the countryside near Chorley. Bolton is grim, in my opinion.
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Nice, there’s some lovely areas around Chorley.
 
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