COVID19

[Mellsblue]

The scariest thing to take from that is that our lives are in the hands of someone called DJ Darwin R. Bandoy.

[morepork]

Bandboy in the MF houuuuusssssseeeee

[canta_brian]

Antigenic drift. Vaccine design just got harder:

https://www.ucdavis.edu/coronavirus/new ... rus-spread

I hope they are wrong.

Will that make immunity to any strain pointless against the next version?

[morepork]

Antigenic drift. Vaccine design just got harder:

https://www.ucdavis.edu/coronavirus/new ... rus-spread

I hope they are wrong.

Will that make immunity to any strain pointless against the next version?

I wouldn't say pointless. The immediate issue is a range of antigens are going to have to be considered to account for variation. Like a seasonal flu vaccine.

[Son of Mathonwy]

Antigenic drift. Vaccine design just got harder:

https://www.ucdavis.edu/coronavirus/new ... rus-spread

I hope they are wrong.

Will that make immunity to any strain pointless against the next version?

I wouldn't say pointless. The immediate issue is a range of antigens are going to have to be considered to account for variation. Like a seasonal flu vaccine.

If enough get infected the virus might get enough variation to produce multiple strains running simulatiously across the world, and no one will know if their previous brush with the disease has given them immunity to the next one they happen to run into.

And still the UK shows no interest in contact tracing (even in the absence of tests this can be done for those showing symptoms). Betting everything on herd immunity or a magic vaccine.

[morepork]

Will that make immunity to any strain pointless against the next version?

I wouldn't say pointless. The immediate issue is a range of antigens are going to have to be considered to account for variation. Like a seasonal flu vaccine.

If enough get infected the virus might get enough variation to produce multiple strains running simulatiously across the world, and no one will know if their previous brush with the disease has given them immunity to the next one they happen to run into.

And still the UK shows no interest in contact tracing (even in the absence of tests this can be done for those showing symptoms). Betting everything on herd immunity or a magic vaccine.

Easy Plath. Herd immunity with such an unknown quantity such as this particular virus is too big a gamble. The vaccine thing however, will materialise at some stage soon. The genome of this virus has already been sequenced, and once the most antigenic viral proteins encoded for by that sequence are documented, a vaccine will be forthcoming. Again, like influenza, small gradual changes in the coronavirus genome will produce subtle changes in antigen amino acid content and maybe structure. That's why we get a cold more than once in our lifetimes. In practice this means a vaccine based on a specific part of a single viral antigen may be rendered ineffective because the antibodies raised by vaccination are not correctly targeted to changes in the actual antigen in the current viral population. The antigen is still a legitimate target for a vaccine, but the vaccine will have to be tweaked occasionally in response to changes in the viral genome. This is done every year for the flu.

[Son of Mathonwy]

I wouldn't say pointless. The immediate issue is a range of antigens are going to have to be considered to account for variation. Like a seasonal flu vaccine.

If enough get infected the virus might get enough variation to produce multiple strains running simulatiously across the world, and no one will know if their previous brush with the disease has given them immunity to the next one they happen to run into.

And still the UK shows no interest in contact tracing (even in the absence of tests this can be done for those showing symptoms). Betting everything on herd immunity or a magic vaccine.

Easy Plath. Herd immunity with such an unknown quantity such as this particular virus is too big a gamble. The vaccine thing however, will materialise at some stage soon. The genome of this virus has already been sequenced, and once the most antigenic viral proteins encoded for by that sequence are documented, a vaccine will be forthcoming. Again, like influenza, small gradual changes in the coronavirus genome will produce subtle changes in antigen amino acid content and maybe structure. That's why we get a cold more than once in our lifetimes. In practice this means a vaccine based on a specific part of a single viral antigen may be rendered ineffective because the antibodies raised by vaccination are not correctly targeted to changes in the actual antigen in the current viral population. The antigen is still a legitimate target for a vaccine, but the vaccine will have to be tweaked occasionally in response to changes in the viral genome. This is done every year for the flu.

Good, although a lot hinges on what your "soon" means.
Phase I safety trials of a potential vaccine have already begun, but of course many questions need to be answered:
https://www.nature.com/articles/d41586-020-00798-8

Kind of sad that the idiots running most countries in the west have allowed this to get out of control so we even need a vaccine.

I haven't read any Plath; is that a reference to depression? Suicide?

[morepork]

We will always need vaccines chief. We are stuck with them now. This won't be the last global public health crisis caused by a virus.


I wouldn't like to label anyone suicidal, just saying a bit of optimism tempered with a pinch of cynicism would be the way to go.

[Son of Mathonwy]

We will always need vaccines chief. We are stuck with them now. This won't be the last global public health crisis caused by a virus.

I wouldn't like to label anyone suicidal, just saying a bit of optimism tempered with a pinch of cynicism would be the way to go.

Sure, we will always need vaccines, but we didn't need one for SARs.

[Sandydragon]

You could argue that if the Chinese government had acted more decisively sooner, then the rest of the world wouldn’t need vaccines. I’m not suggesting the British response has been perfect but I think your criticism of western government might be a bit one eyed.

[morepork]

We will always need vaccines chief. We are stuck with them now. This won't be the last global public health crisis caused by a virus.

I wouldn't like to label anyone suicidal, just saying a bit of optimism tempered with a pinch of cynicism would be the way to go.

Sure, we will always need vaccines, but we didn't need one for SARs.

We would if it was as virulent as it's current coronavirus cousin. 8000 odd cases for SARS versus what, a million for the current beast?

[morepork]

You could argue that if the Chinese government had acted more decisively sooner, then the rest of the world wouldn’t need vaccines. I’m not suggesting the British response has been perfect but I think your criticism of western government might be a bit one eyed.

Maybe stop dismissing the expertise of the WHO as some sort of elite social club and actually preparing for the worst by listening to them would be good advice for every country at the moment. We've had rolling the dice on herd immunity, bravado and bluster over social distancing, lobbying from corporate wankers who want their drones back out in the fields, and threats of summary execution in the street from various leaders.

I'm thinking not many will come out of this smelling of roses.

[Banquo]

In the UK there has been a huge failure of PHE and the (central) NHS to do anything at pace; its because they are highly centralised bureaucracies with control freaks at the centre. Ultimately the government of course is accountable for letting that condition prevail; though the German race is not yet run, their 'federal' health system has proved the most effective to date. The senior individuals at PHE and NHSE are pretty well known as paranoid micromanagers, which may be ok in 'peace time' but makes them utterly unfit for this situation- they have just told Hancock what he wants to hear, and you can now see the consequences; the 'fortunate' thing is that we should be ok for beds and ventilators (local mobilisation to free up beds has actually been impressive)in the short term, but have messed up on NHS staffing (sickness rates) especially. There is plenty of PPE out there, its just stuck in the NHS supply chain, and a lot in the wrong places- the non London Trusts have a lot of spare stock for example. There will be a reckoning, and I think not only govt heads will roll.

On a separate note, when did Italy introduce mass testing- they've actually done more tests per capita than Germany; so presumably they have been much less effective at isolate and trace....or is it a function of their population and/or health system that has lead to so many deaths?

[Mellsblue]

Some good news coming out of Italy as numbers in ICU drop for the first time.
Latest graph on death rates. There seems little correlation with more stringent social distancing equalling a shallower line. If anything the two best European performers have the loosest rules in place. One thing you can say is that the US is in deep do-do.

[morepork]

Italy have been chasing shadows. They have reacted after an event probably initiated by one of those floating Petri dish cruise ships in Somewhere like Venice. They have been triaging rather than containing. The model for track and trace remains South Korea and Taiwan. Unlike these two places, Italy did not have the benefits of the SARS drill to hone a response.

Banquo, is this true:

There is plenty of PPE out there, its just stuck in the NHS supply chain, and a lot in the wrong places- the non London Trusts have a lot of spare stock for example.

If so, that is a shocking failure of market philosophy in a public health setting.

[morepork]

Some good news coming out of Italy as numbers in ICU drop for the first time.
Latest graph on death rates. There seems little correlation with more stringent social distancing equalling a shallower line. If anything the two best European performers have the loosest rules in place. One thing you can say is that the US is in deep do-do.

I’m going to call you out on that one. It is a virus transmissible by close contact. Distance is the best possible way to avoid transmission. The data at the end of the day will bear this out.

[Mellsblue]

Some good news coming out of Italy as numbers in ICU drop for the first time.
Latest graph on death rates. There seems little correlation with more stringent social distancing equalling a shallower line. If anything the two best European performers have the loosest rules in place. One thing you can say is that the US is in deep do-do.

I’m going to call you out on that one. It is a virus transmissible by close contact. Distance is the best possible way to avoid transmission. The data at the end of the day will bear this out.

I don’t disagree with you. Was just pointing out that there is no correlation at this point. Both Sweden and Holland are behind most others so far too early to take anything from it.

I’ve read a couple of bits that domestic arrangements may explain severity of spread. Italy have multigenerational living arrangements whilst Sweden has the most single occupation homes per capita in Europe.

[morepork]

Some good news coming out of Italy as numbers in ICU drop for the first time.
Latest graph on death rates. There seems little correlation with more stringent social distancing equalling a shallower line. If anything the two best European performers have the loosest rules in place. One thing you can say is that the US is in deep do-do.

I’m going to call you out on that one. It is a virus transmissible by close contact. Distance is the best possible way to avoid transmission. The data at the end of the day will bear this out.

I don’t disagree with you. Was just pointing out that there is no correlation at this point. Both Sweden and Holland are behind most others so far too early to take anything from it.

I’ve read a couple of bits that domestic arrangements may explain severity of spread. Italy have multigenerational living arrangements whilst Sweden has the most single occupation homes per capita in Europe.

That just reinforces distancing as an effective response. Italy has tourist attractions that are respectfully more superficially attractive than tulips and Ace of Base. The virus was brought in to Italy by human traffic. Likewise, New York is one of the worlds great urban hubs, with vast numbers of domestic and international tourists. That is why it is an epicenter now. De Moines Iowa has fewer cases than NYC for this very reason, but if New Yorkers get an urge to sit this out and attend a celebration of corn event in Iowa, then De Moines is thrust into the infection front row.

[Which Tyler]

That just reinforces distancing as an effective response. Italy has tourist attractions that are respectfully more superficially attractive than tulips and Ace of Base. The virus was brought in to Italy by human traffic. Likewise, New York is one of the worlds great urban hubs, with vast numbers of domestic and international tourists. That is why it is an epicenter now. De Moines Iowa has fewer cases than NYC for this very reason, but if New Yorkers get an urge to sit this out and attend a celebration of corn event in Iowa, then De Moines is thrust into the infection front row.

Which is why the Scottish CMO's cockup was quite so huge, by setting such an authoritative example of "fuck it, I'll do what I wanna"

[Banquo]

Italy have been chasing shadows. They have reacted after an event probably initiated by one of those floating Petri dish cruise ships in Somewhere like Venice. They have been triaging rather than containing. The model for track and trace remains South Korea and Taiwan. Unlike these two places, Italy did not have the benefits of the SARS drill to hone a response.

Banquo, is this true:

There is plenty of PPE out there, its just stuck in the NHS supply chain, and a lot in the wrong places- the non London Trusts have a lot of spare stock for example.

If so, that is a shocking failure of market philosophy in a public health setting.

yes, or I made it up for the fun of it?- and its more a shocking failure of the NHS to distribute it properly. Its been stockpiled and not drawn down. There's a warehouse full near me. The centralisation of critical resources has been one of the standout stupidity moments, combined with the inability to inject urgency.

I'd also add that the useage of PPE has been very poorly advised, certainly locally, resulting in either very um...cavalier useage or scant useage.

I do twice weekly health and social care emergency CV 19 calls (twice weekly ffs....should be twice a day for 10 mins imo) for my local system, and everything is ...oh, we will have that sorted by a week on Tuesday. Without blowing my mobs own trumpet, we changed our entire model in 5 days and had redeployed majority of staff in the same period.

[Banquo]

Some good news coming out of Italy as numbers in ICU drop for the first time.
Latest graph on death rates. There seems little correlation with more stringent social distancing equalling a shallower line. If anything the two best European performers have the loosest rules in place. One thing you can say is that the US is in deep do-do.

I’m going to call you out on that one. It is a virus transmissible by close contact. Distance is the best possible way to avoid transmission. The data at the end of the day will bear this out.

I don’t disagree with you. Was just pointing out that there is no correlation at this point. Both Sweden and Holland are behind most others so far too early to take anything from it.

I’ve read a couple of bits that domestic arrangements may explain severity of spread. Italy have multigenerational living arrangements whilst Sweden has the most single occupation homes per capita in Europe.

Holland is pretty bad actually.

[morepork]

All hail the MBA. The golden calf of public health.

*apologies to MBA holders of integrity everywhere.

[morepork]

Italy have been chasing shadows. They have reacted after an event probably initiated by one of those floating Petri dish cruise ships in Somewhere like Venice. They have been triaging rather than containing. The model for track and trace remains South Korea and Taiwan. Unlike these two places, Italy did not have the benefits of the SARS drill to hone a response.

Banquo, is this true:

There is plenty of PPE out there, its just stuck in the NHS supply chain, and a lot in the wrong places- the non London Trusts have a lot of spare stock for example.

If so, that is a shocking failure of market philosophy in a public health setting.

yes, or I made it up for the fun of it?- and its more a shocking failure of the NHS to distribute it properly. Its been stockpiled and not drawn down.

Fair enough. Didn’t mean to imply that you did.

[Banquo]

Italy have been chasing shadows. They have reacted after an event probably initiated by one of those floating Petri dish cruise ships in Somewhere like Venice. They have been triaging rather than containing. The model for track and trace remains South Korea and Taiwan. Unlike these two places, Italy did not have the benefits of the SARS drill to hone a response.

Banquo, is this true:

There is plenty of PPE out there, its just stuck in the NHS supply chain, and a lot in the wrong places- the non London Trusts have a lot of spare stock for example.

If so, that is a shocking failure of market philosophy in a public health setting.

yes, or I made it up for the fun of it?- and its more a shocking failure of the NHS to distribute it properly. Its been stockpiled and not drawn down.

Fair enough. Didn’t mean to imply that you did.

sorry, was intemperate, see edit. I'm just fed up of the vox pop diet here that is calling out bollocks.

[Banquo]

All hail the MBA. The golden calf of public health.

*apologies to MBA holders of integrity everywhere.

great call. Deal with the dozy twats day in day out. The talented clinicians tend to stay on or near the front line- the rest are promoted to the level of their own incompetence, and then sit alongside the MBA's- their talents are fine for climbing the greasy pole- essentially over promise and then blame someone else- but sh&t for this serious stuff.