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

Norman Brownbutter said:
Can someone explain to me like Im 5 how herd immunity works with a mutating virus and a vaccine that loses effectiveness over 6 months?
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It may not do - we aren't going to reach zero covid or anywhere close. We can get to a point through vaccination and infection where it doesn't spread fast and most outbreaks fade out again quickly.

I think we have to look at in flu terms, at least for now. Past infection and/or past vaccination (any flavour) will make it less serious for most people. Boosted vaccinations will make it less deadly for the most vulnerable. Some people will still get it, some still get ill, and some will die.

That said, there is still a good chance of us getting illness, hospitalisations and deaths down further over time, because unlike flu it doesn't mutate rapidly, and the massive investment in vaccine, testing and genome sequencing technology might let us target both it and flu far better and faster than we've ever been able to do before... but I've already gone way past that "like I'm 5" limit now :smirk:
 
Over 32.5K new cases today in the UK. I can't help think that the "open and be damned" approach is a grave mistake - and that hasn't even happened yet.
 
Need a bit of advice guys. Just had a ping from the NHS app telling me I need to self isplate for 6 days cause I have come in to contact with somebody with Covid etc etc.

I cant really afford the time off work though so if I do one of them lateral flow tests and it comes back negative do I need to isolate still?
 
JTW95 said:
Need a bit of advice guys. Just had a ping from the NHS app telling me I need to self isplate for 6 days cause I have come in to contact with somebody with Covid etc etc.

I cant really afford the time off work though so if I do one of them lateral flow tests and it comes back negative do I need to isolate still?
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Yeah afraid you do, which isn’t what you want to hear
 
jojojo said:
It may not do - we aren't going to reach zero covid or anywhere close. We can get to a point through vaccination and infection where it doesn't spread fast and most outbreaks fade out again quickly.

I think we have to look at in flu terms, at least for now. Past infection and/or past vaccination (any flavour) will make it less serious for most people. Boosted vaccinations will make it less deadly for the most vulnerable. Some people will still get it, some still get ill, and some will die.

That said, there is still a good chance of us getting illness, hospitalisations and deaths down further over time, because unlike flu it doesn't mutate rapidly, and the massive investment in vaccine, testing and genome sequencing technology might let us target both it and flu far better and faster than we've ever been able to do before... but I've already gone way past that "like I'm 5" limit now :smirk:
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Thanks for the reply. :)
 
JTW95 said:
Need a bit of advice guys. Just had a ping from the NHS app telling me I need to self isplate for 6 days cause I have come in to contact with somebody with Covid etc etc.

I cant really afford the time off work though so if I do one of them lateral flow tests and it comes back negative do I need to isolate still?
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Yeah, you do, sadly. Same goes even if you do the much more reliable PCR test and it comes back negative. The reason is that Covid has an incubation period of up to 10 days before you have symptoms, but you could still potentially spread the virus before you have symptoms.
 
JTW95 said:
Need a bit of advice guys. Just had a ping from the NHS app telling me I need to self isplate for 6 days cause I have come in to contact with somebody with Covid etc etc.

I cant really afford the time off work though so if I do one of them lateral flow tests and it comes back negative do I need to isolate still?
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Worth checking if you can apply for the £500 support payment
 
Norman Brownbutter said:
Can someone explain to me like Im 5 how herd immunity works with a mutating virus and a vaccine that loses effectiveness over 6 months?
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The more infectious a virus is the higher HIT. It is that simple. If enough people can have a decent immune response either due to getting ill or vaccinated a virus will naturally die out. So for example if a person with covid would infect 5 people on average we would need more than 4 out of every 5 people to be able to mount an immune response so that for every infection less than one other person would be infected on average.

There are other factors that effect that a bit but that is the main way it works.

And what makes you think covid vaccines only protect for such a short time? New variants might not be protected against as well as against Alpha but so far the length of immune response doesn't seem to be a problem as far as I'm aware.
 
JTW95 said:
Need a bit of advice guys. Just had a ping from the NHS app telling me I need to self isplate for 6 days cause I have come in to contact with somebody with Covid etc etc.

I cant really afford the time off work though so if I do one of them lateral flow tests and it comes back negative do I need to isolate still?
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Lateral flow tests are close to useless for negative results as the false negative rate can be as high as 50%.
 
Pogue Mahone said:
@Wolverine @africanspur

What’s the NHS policy for vaccinated staff who are close contacts? HCPs having to self isolate has been a big problem in previous waves. Any plans to relax this approach for this wave?
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I'm not sure there is an NHS wide policy to be honest. Sometimes the approach seems to differ to some extent based on the circumstances and team, even within the trust.

Roughly though, as long as you're wearing 'adequate PPE' (which by pitiful PHE standards is a surgical face mask, an apron and gloves) and haven't performed an AGP procedure, then you're fine with regards to carrying on with work.

We did have a heart sink moment about a month ago though when a patient arrested and the entire junior team were in there doing CPR etc.....only to find out that the patient had been Covid positive in the community about 11 days previously. Until her result ended up coming back negative at the hospital, we were discussing whether everyone would have to isolate, whether they'd come in and do daily lateral flows with 2-3 PCR tests over a month etc etc.

Will be interesting to see what they say for it soon.
 
decorativeed said:
The reason is that Covid has an incubation period of up to 10 days before you have symptoms, but you could still potentially spread the virus before you have symptoms.
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14 days. The UK government have just decided they only need to catch 90% (ish) of infections.
 
Wibble said:
Lateral flow tests are close to useless for negative results as the false negative rate can be as high as 50%.
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lynchie said:
Worth checking if you can apply for the £500 support payment
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decorativeed said:
Yeah, you do, sadly. Same goes even if you do the much more reliable PCR test and it comes back negative. The reason is that Covid has an incubation period of up to 10 days before you have symptoms, but you could still potentially spread the virus before you have symptoms.
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Thanks for the replies guys. No way out of it I guess I'm just gonna have to suck it up.
 
Wibble said:
The more infectious a virus is the higher HIT. It is that simple. If enough people can have a decent immune response either due to getting ill or vaccinated a virus will naturally die out. So for example if a person with covid would infect 5 people on average we would need more than 4 out of every 5 people to be able to mount an immune response so that for every infection less than one other person would be infected on average.

There are other factors that effect that a bit but that is the main way it works.

And what makes you think covid vaccines only protect for such a short time? New variants might not be protected against as well as against Alpha but so far the length of immune response doesn't seem to be a problem as far as I'm aware.
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https://www.cell.com/immunity/fulltext/S1074-7613(20)30445-3 Says those infected retain effective antibodies for 5-7 months.

https://news.wttw.com/2021/07/01/how-long-does-covid-19-immunity-last Says vaccine should last at least 6 months, but that its unknown beyond that. However there is a study underway to find out.

My question was based on the above being true, and that the covid variants would continue to show up. As in Delta plus and now Lamda. A variant that is the dominant variant in Peru. As of last week I believe there are 8 cases of Lamda in the UK.

Early non peer reviewed research says the mRNA vaccines will protect against Lamda. But in another pre print paper Lamda was found to have mutations that allowed it to escape antibodies created by CoronaVac.

One of the mutations in Lamda is T859N, which is found in the IOTA variant that is currently making the rounds in New York which has the E484K spike mutation that may help the virus avoid antibodies. It also has S477N mutation that may allow the virus to bond more tightly with human cells. And thats just one variant. In the UK, wiki says we have 8 being monitored with 4 being labelled as variants of concern. You look to Europe and they are looking at 30 variants. 4 of concern, 9 of interest and the rest monitoring.

Now I dont know what a lot of this means, because Im 5 :) , but you can see why I would ask how herd immunity is going to work with a short immune window and a virus that is mutating relatively quickly. And seemingly towards being vaccine resistant.
 
Norman Brownbutter said:
https://www.cell.com/immunity/fulltext/S1074-7613(20)30445-3 Says those infected retain effective antibodies for 5-7 months.

https://news.wttw.com/2021/07/01/how-long-does-covid-19-immunity-last Says vaccine should last at least 6 months, but that its unknown beyond that. However there is a study underway to find out.
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Antibodies always decline. It is the memory cells that leap in to action later when the virus is experienced and new antibodies are made much much faster. I read a study recently that seemed to confirm that this was happening as expected with covid. I'm not sure if this was it or if this is a different study. https://science.sciencemag.org/content/371/6529/eabf4063

Due to the brief time SARS-CoV-2 has been around you can't say to a scientific what will happen in the long term but we are close to being able to say that an annual booster will be the very most we need in the future. We may need boosters to beef up responses to new variants but once the world is largely vaccinated variants will become very rare if not stop. So if I had to bet I think we will be looking at annual boosters to address variants for a year or three and by then we will know how often, if at all "normal" boosters are needed.

My question was based on the above being true, and that the covid variants would continue to show up. As in Delta plus and now Lamda. A variant that is the dominant variant in Peru. As of last week I believe there are 8 cases of Lamda in the UK.
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https://www.news-medical.net/news/2...nes-are-effective-against-Lambda-variant.aspx

Variants are a function of the levels of infection as they occur very rarely. Once the world is vaccinated variants will be of far less concern and if they occur can be accounted for with tweaks to vaccine booster shots.

Early non peer reviewed research says the mRNA vaccines will protect against Lamda. But in another pre print paper Lamda was found to have mutations that allowed it to escape antibodies created by CoronaVac.
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Lamda seems to be like many variants. Vaccines work but slightly less effectively with the best mRNA vaccines. Less so with the already not that great Sinovax but still not to the point that it should prevent vaccination being the solution.

One of the mutations in Lamda is T859N, which is found in the IOTA variant that is currently making the rounds in New York which has the E484K spike mutation that may help the virus avoid antibodies. It also has S477N mutation that may allow the virus to bond more tightly with human cells. And thats just one variant. In the UK, wiki says we have 8 being monitored with 4 being labelled as variants of concern. You look to Europe and they are looking at 30 variants. 4 of concern, 9 of interest and the rest monitoring.

Now I dont know what a lot of this means, because Im 5 :) , but you can see why I would ask how herd immunity is going to work with a short immune window and a virus that is mutating relatively quickly. And seemingly towards being vaccine resistant.
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So far the variants, even Delta, haven't been as bad as we feared in terms of vaccines and the mRNA vaccines will be tweaked to address the variants very soon apparently. Vaccine supply, delivery and vaccine resistance are far bigger worries in my opinion as we really need the world vaccinated.
 
Wibble said:
Antibodies always decline. It is the memory cells that leap in to action later when the virus is experienced and new antibodies are made much much faster. I read a study recently that seemed to confirm that this was happening as expected with covid. I'm not sure if this was it or if this is a different study. https://science.sciencemag.org/content/371/6529/eabf4063
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This is promising, thanks for that. Last time I remember seeing anything about our immune memory for covid, it wasnt looking good. So this is something to happy about.

Vaccine supply, delivery and vaccine resistance are far bigger worries in my opinion as we really need the world vaccinated.
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Very true. Very, very true.
 
Norman Brownbutter said:
https://www.cell.com/immunity/fulltext/S1074-7613(20)30445-3 Says those infected retain effective antibodies for 5-7 months.

https://news.wttw.com/2021/07/01/how-long-does-covid-19-immunity-last Says vaccine should last at least 6 months, but that its unknown beyond that. However there is a study underway to find out.

My question was based on the above being true, and that the covid variants would continue to show up. As in Delta plus and now Lamda. A variant that is the dominant variant in Peru. As of last week I believe there are 8 cases of Lamda in the UK.

Early non peer reviewed research says the mRNA vaccines will protect against Lamda. But in another pre print paper Lamda was found to have mutations that allowed it to escape antibodies created by CoronaVac.

One of the mutations in Lamda is T859N, which is found in the IOTA variant that is currently making the rounds in New York which has the E484K spike mutation that may help the virus avoid antibodies. It also has S477N mutation that may allow the virus to bond more tightly with human cells. And thats just one variant. In the UK, wiki says we have 8 being monitored with 4 being labelled as variants of concern. You look to Europe and they are looking at 30 variants. 4 of concern, 9 of interest and the rest monitoring.

Now I dont know what a lot of this means, because Im 5 :) , but you can see why I would ask how herd immunity is going to work with a short immune window and a virus that is mutating relatively quickly. And seemingly towards being vaccine resistant.
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The short answer is that herd immunity is off the table. Even if we never get a more transmissible variant than delta, we won’t be able to vaccinate enough people to eradicate the virus unless we somehow invent a vaccine that is a hell of a lot more effective than what we have now (which is unlikely)
 
africanspur said:
I'm not sure there is an NHS wide policy to be honest. Sometimes the approach seems to differ to some extent based on the circumstances and team, even within the trust.

Roughly though, as long as you're wearing 'adequate PPE' (which by pitiful PHE standards is a surgical face mask, an apron and gloves) and haven't performed an AGP procedure, then you're fine with regards to carrying on with work.

We did have a heart sink moment about a month ago though when a patient arrested and the entire junior team were in there doing CPR etc.....only to find out that the patient had been Covid positive in the community about 11 days previously. Until her result ended up coming back negative at the hospital, we were discussing whether everyone would have to isolate, whether they'd come in and do daily lateral flows with 2-3 PCR tests over a month etc etc.

Will be interesting to see what they say for it soon.
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Interesting. Thanks. So if you’re a fully vaccinated doctor/nurse and one of your kids tests positive you still have to self-isolate? Or if the app pings you after a night out? That’s going to cause havoc over the next few months.
 
Pogue Mahone said:
Interesting. Thanks. So if you’re a fully vaccinated doctor/nurse and one of your kids tests positive you still have to self-isolate? Or if the app pings you after a night out? That’s going to cause havoc over the next few months.
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Not as of the 16th of August as far as I'm aware (in England anyway)

Double vaccinated people won't have to isolate after this date even as a close contact.

Main gripe at the moment is the gap between the opening up on 19th July and the date this comes into effect
 
Pogue Mahone said:
Interesting. Thanks. So if you’re a fully vaccinated doctor/nurse and one of your kids tests positive you still have to self-isolate? Or if the app pings you after a night out? That’s going to cause havoc over the next few months.
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I believe so, though sometimes management gets involved and asks if perhaps you're asymptomatic, whether you can think about coming in and doing daily lateral flows/ isolating if you show symptoms etc.

I wonder whether more trusts will move to that kind of hybrid approach to try to avoid the mass isolations of the first wave.

One of the few good changes I hope comes out of this in the medical field is that we start treating our own staff with more care and dignity. For a profession supposed to be caring, we don't half run each other into the ground and treat any illness as some kind of weakness. The attitude of you should come in regardless needs to change.
 
africanspur said:
I believe so, though sometimes management gets involved and asks if perhaps you're asymptomatic, whether you can think about coming in and doing daily lateral flows/ isolating if you show symptoms etc.

I wonder whether more trusts will move to that kind of hybrid approach to try to avoid the mass isolations of the first wave.

One of the few good changes I hope comes out of this in the medical field is that we start treating our own staff with more care and dignity. For a profession supposed to be caring, we don't half run each other into the ground and treat any illness as some kind of weakness. The attitude of you should come in regardless needs to change.
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So true. I have so many memories of various poor bastards on call absolutely wrecked with viral illnesses but turning up anyway because they’d be shitting on their colleagues otherwise. An absolutely crazy situation thinking back to it.
 
Pogue Mahone said:
So true. I have so many memories of various poor bastards on call absolutely wrecked with viral illnesses but turning up anyway because they’d be shitting on their colleagues otherwise. An absolutely crazy situation thinking back to it.
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Yep horrific. I was reading of an O&G trainee who left medicine permanently relatively recently after her consultants and managers gave her a torrid time for having hyperemesis gravidarum when she was pregnant. Imagine! From O&G no less. You'd think of all the specialties they would be most sympathetic to a pregnant woman's plight.

Instead, she got a whole load of you're letting the team down, you're letting your patients down, are you resilient enough for medicine, why don't you just get a shot of anti-emetic and then come to work anyway, why don't you go vomit in between seeing patients.

Bunch of cnuts.
 
FireballXL5 said:
Experts...remember them?

Experts sign letter condemning Government’s ‘dangerous and unethical experiment’

https://www.itv.com/news/2021-07-07...overnments-dangerous-and-unethical-experiment
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Well yes, and I agree with them that it's a massive public health gamble. The question is whether it's a bigger gamble to do it one hit through summer, or a whole string of hits over the next 12 months.

The modelling said that delaying the changes by a month (from June until July) would save lives and protect hospitals because of the need for second doses in the 40+ and at least first doses in the over 18. The answers are a lot less clear cut when you look at delaying until late August (second doses complete) or September when the kids go back to school and students return to college.

Obviously there's a question of whether we can vaccinate ourselves through it further (reducing case numbers and saving some people from illness and death) by vaccinating the 12-18s and giving booster shots to the oldest/highest risk.

I'm speaking as someone who could happily live with the current restrictions/guidance for the rest of the year (though I hate the travel restrictions). However I can see that a lot of people have already stopped following the rules, and the businesses who are still shut etc are hurting.

I would like them to continue some mitigations for longer - so the at risk can still do the essentials rather than go back into lockdown. I'd like to see masks on public transport, essential shops and similar places for example. And personally, I'll be more willing to go to a pub/restaurant saying they'll stick to current distancing and table service arrangements - so I'm hoping that some of them will do it.

In terms of what's going to happen though. Like they say, this is a massive gamble and all the stats/models are on a knife edge right now. It's going to be a massive gamble whenever it happens in terms of where it leaves the unvaccinated and the vulnerable though.
 
JTW95 said:
Argh that's annoying :(

Trust this to fecking happen when England are on the verge of a Euro final!!
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I’d imagine there will be a lot of people who went to last nights game, and planning to go to the final, who get pinged by Saturday.
 
Pogue Mahone said:
Interesting. Thanks. So if you’re a fully vaccinated doctor/nurse and one of your kids tests positive you still have to self-isolate? Or if the app pings you after a night out? That’s going to cause havoc over the next few months.
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My experience is junior doctors (house officers and middle grades) asked to take daily lateral flow tests and don't need to self-isolate unless symptomatic. Not sure regarding nurses, HCAs etc. Based on what I've read online forums for HCPs, huge variation in interpretations.

That's based on my hospital locum post. In my GP practice, its working from home doing virtual clinics and isolating. But that's through community spread, hospital wise as long as PPE worn then its usually LFTs and ignore.

Consultants have managed to get 10 days isolation though. And I don't know about other trusts and what policies are.
 
africanspur said:
Yep horrific. I was reading of an O&G trainee who left medicine permanently relatively recently after her consultants and managers gave her a torrid time for having hyperemesis gravidarum when she was pregnant. Imagine! From O&G no less. You'd think of all the specialties they would be most sympathetic to a pregnant woman's plight.

Instead, she got a whole load of you're letting the team down, you're letting your patients down, are you resilient enough for medicine, why don't you just get a shot of anti-emetic and then come to work anyway, why don't you go vomit in between seeing patients.

Bunch of cnuts.
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They've treated us like shit. My wife is in third trimester around 30 weeks and still patient-facing and doing surgery as a derm registrar despite RCOG and occu health advising against (she chose to get double vaccinated despite confirmation of pregnancy after discussion, but they're treating her to say she's low risk). She's on daily promethazine for hyperemesis as well and has had two hospital admissions as needed IM. Also physio due to sacroilitis from doing long complex physically taxing surgeries

We would get BMA/ACAS involved but she didn't want to kick up a fuss in case it has implications for her future and being seen as "difficult" by the managers
 
Have schools now closed in Scotland? Interesting how their numbers are plummeting whilst England's grows.

Is there a potential Euros correlation? After last night/if England wins, it's going to be crazy this weekend.
 
Sparky Rhiwabon said:
Whitty and Valance, the Kings of all Experts, had the chance to express disagreement with the plan on National TV at the press conference and didn’t, that’s good enough for me.
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They did. They said the regulations were political decisions and not necessarily based on their recommendations.
 
groovyalbert said:
Have schools now closed in Scotland? Interesting how their numbers are plummeting whilst England's grows.

Is there a potential Euros correlation? After last night/if England wins, it's going to be crazy this weekend.
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Schools have closed in Scotland - which may have reduced the number of asymptomatic/low symptom cases being spotted in the U18s.

I'm not sure I'd describe their case numbers as plummeting though. From what I've seen the rates are very high in Scotland but have levelled out in recent days, which is a good sign. The Euros did give their numbers a huge kick upwards though, and the growth in the case numbers slowed again when the Scotland team got knocked out. Hopefully, as in the north west the curve may now be turning in Scotland and we'll see cases start to fall rather than just not rising as fast.
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Current numbers/trends:
https://coronavirus.data.gov.uk/details/cases?areaType=nation&areaName=Scotland
 
Tonight on the "well duh" files for the UK Government. They've just noticed that "freedom day" for some is "go back into a shielding/lockdown" mode for the summer for others.
 
SirAnderson said:
My test came back negative, and I have no desire to get that swab stuck back up my nose to confirm but I definitely have it.
No blocked nose and I have COMPLETELY lost smell, it is the worst ever, I can't enjoy a meal, it's depressing. How long did it take for you to get it back? How long for others who've had it?
I don't know how much longer I can take this, I love my food and not being to enjoy it is utterly depressing. I'd rather have the body pains and other stuff that to lose my smell and partially taste.
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Lucikly for me the loss of taste and smell only lasted roughly 2 weeks. A friend of mine went around with it for months. Now this indian variant is taking over and I'm honestly worried what direction this world is heading in. Vaccination has gone on for a pretty long while now and it's still spreading like hayfire and people are stil dying like flies.

Sadly this is going to be a part of the modern age. Worse things than covid will come. It's a mad era to live in. I've already lost my mother to MS 2 years ago and my old man has diabates and heart problems. People all across the globe are suffering from this and it's incredibly stressful. I wish everyone on here good luck and to stay safe.
 
SirAnderson said:
My test came back negative, and I have no desire to get that swab stuck back up my nose to confirm but I definitely have it.
No blocked nose and I have COMPLETELY lost smell, it is the worst ever, I can't enjoy a meal, it's depressing. How long did it take for you to get it back? How long for others who've had it?
I don't know how much longer I can take this, I love my food and not being to enjoy it is utterly depressing. I'd rather have the body pains and other stuff that to lose my smell and partially taste.
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Mine lasted about 6 weeks. I had no covid symptoms but i opened a bag of crisps and complained to the GF about it being a stale bag. She didnt think so but got another strong flavour bag to test it. Not a thing. Tried those gimmick strong sour ball sweets where my eyes watered but tasted nothing.
WHO should put that on their recommended test methods.
 
Feeling less and less like light at end of tunnel but just another partially open summer before another winter lockdown.
 
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