COVID19

[Banquo]

Bit of transparency from NHS E is helpful- the deaths they report as a headline are not the deaths in the last 24 hours as often stated, but those reported as CV19 deaths in that period, and some date back over a month. It looks like they are now restating daily deaths when they report.

Presumably this would be the data epidemiologists et al need most, even if not 100% real-time..the other figure would be more relevant for broader NHS analysis. One would hope all regions are reporting in the same way ?

not even hospitals report in the same way, in the same timescales. Suspect reporting isn't top of their list tbh, plus (again) my experience of local reporting is a tad on the shambolic side.

[morepork]

Hope:

https://www.pluristem.com/wp-content/up ... ELEASE.pdf

These placenta-derived mesenchymal stem cells have been touted as a treatment for nearly every disease known to medicine based on anti-inflammatory properties from secreted cytokines. They are very last century. If you need acute anti-inflammatory treatment, mainline the cytokines. Square peg, round hole.

[Banquo]

Hope:

https://www.pluristem.com/wp-content/up ... ELEASE.pdf

These placenta-derived mesenchymal stem cells have been touted as a treatment for nearly every disease known to medicine based on anti-inflammatory properties from secreted cytokines. They are very last century. If you need acute anti-inflammatory treatment, mainline the cytokines. Square peg, round hole.

Morepork....guaranteed to deflate hope worldwide.

[morepork]

Meh. I’m a pragmatist not a PR guru.

[Digby]

Something interesting about this disease is it seems to be hitting men harder, which I'm drawn to when big pharma have for many years refused to test/trial products properly for women, even where they do include women in the trials it's too often that they split the required numbers 50/50 and that means we get insufficient data about how it impacts men and how it impacts women. Testing for women is a complication owing to menstrual cycles varying how they react more than men, and big pharma is pro profits not good health, so normally women end up on the fuzzy end when it does increasingly seem immunology can work differently across the sexes, but this time it's the blokes having to take one for the team.

[morepork]

On a more positive note, there is some indication, much of it admittedly anecdotal, that people that had the BCG TB vaccine seem less susceptible to severe symptoms of COVID. Relatives in Italy have been saying there are far fewer recent immigrants going down with symptoms than the general population and some are noting that immigrants get the BCG before being released into the wild. Japan has a mandatory TB vaccine program, as did NZ and Oz for anyone going to school in the 70’s and 80’s. Oz have readministrred the BCG to hundreds of frontline health workers in a randomized trial, that includes placebo (I.e. is blinded).

[Banquo]

Meh. I’m a pragmatist not a PR guru.

I'm a leg puller not a writer

[morepork]

Something interesting about this disease is it seems to be hitting men harder, which I'm drawn to when big pharma have for many years refused to test/trial products properly for women, even where they do include women in the trials it's too often that they split the required numbers 50/50 and that means we get insufficient data about how it impacts men and how it impacts women. Testing for women is a complication owing to menstrual cycles varying how they react more than men, and big pharma is pro profits not good health, so normally women end up on the fuzzy end when it does increasingly seem immunology can work differently across the sexes, but this time it's the blokes having to take one for the team.

All pre clinical animal studies for an investigational new drug are compelled to avoid gender bias as it can turn a modest statistically significant effect into no effect. It’s not as simple as menstrual or not, but pre clinical gender bias has lead to some avoidable failures in the clinic.

[morepork]

Meh. I’m a pragmatist not a PR guru.

I'm a leg puller not a writer

Ha!

I’m a lover not a fighter

[Digby]

Isn't BCG for use in infants through to teenagers? Maybe even young teenagers. So does it work well in adults or are we going with Trump's idea around what's the worst that can happen?

I realise I've missed off the possibility there that Oz healthcare is entirely provided by 13 year olds

[Sandydragon]

On a more positive note, there is some indication, much of it admittedly anecdotal, that people that had the BCG TB vaccine seem less susceptible to severe symptoms of COVID. Relatives in Italy have been saying there are far fewer recent immigrants going down with symptoms than the general population and some are noting that immigrants get the BCG before being released into the wild. Japan has a mandatory TB vaccine program, as did NZ and Oz for anyone going to school in the 70’s and 80’s. Oz have readministrred the BCG to hundreds of frontline health workers in a randomized trial, that includes placebo (I.e. is blinded).

Interesting, if it can reduce the worst effects like you say then it could be a route out of this.

[Digby]

Something interesting about this disease is it seems to be hitting men harder, which I'm drawn to when big pharma have for many years refused to test/trial products properly for women, even where they do include women in the trials it's too often that they split the required numbers 50/50 and that means we get insufficient data about how it impacts men and how it impacts women. Testing for women is a complication owing to menstrual cycles varying how they react more than men, and big pharma is pro profits not good health, so normally women end up on the fuzzy end when it does increasingly seem immunology can work differently across the sexes, but this time it's the blokes having to take one for the team.

All pre clinical animal studies for an investigational new drug are compelled to avoid gender bias as it can turn a modest statistically significant effect into no effect. It’s not as simple as menstrual or not, but pre clinical gender bias has lead to some avoidable failures in the clinic.

I was assuming there were two broad issues, sex and then within the one sex variance from the menstrual cycle. And I was of course assuming big pharma are gits

[Puja]

Meh. I’m a pragmatist not a PR guru.

I'm a leg puller not a writer

Ha!

I’m a lover not a fighter

Dammit Jim, I'm a doctor, not an epidemiologist!

Puja

[morepork]

I'm a leg puller not a writer

Ha!

I’m a lover not a fighter

Dammit Jim, I'm a doctor, not an epidemiologist!

Puja

I have a better haircut, normal ears, and like a drink every now and then.

Excellent work geek boy.

[morepork]

Something interesting about this disease is it seems to be hitting men harder, which I'm drawn to when big pharma have for many years refused to test/trial products properly for women, even where they do include women in the trials it's too often that they split the required numbers 50/50 and that means we get insufficient data about how it impacts men and how it impacts women. Testing for women is a complication owing to menstrual cycles varying how they react more than men, and big pharma is pro profits not good health, so normally women end up on the fuzzy end when it does increasingly seem immunology can work differently across the sexes, but this time it's the blokes having to take one for the team.

All pre clinical animal studies for an investigational new drug are compelled to avoid gender bias as it can turn a modest statistically significant effect into no effect. It’s not as simple as menstrual or not, but pre clinical gender bias has lead to some avoidable failures in the clinic.

I was assuming there were two broad issues, sex and then within the one sex variance from the menstrual cycle. And I was of course assuming big pharma are gits

Estrogen is really what it’s about. Many behavioral experiments use only males to avoid your menstrual confound, but for a disease treatment analysis...all variables need accounting for to avoid bias. Big pharma are bound by the same peer reviewed assessment of scientific vigour as any other sponsor.

[Galfon]

BoJo out of ICU.

[Galfon]

Isn't BCG for use in infants through to teenagers? Maybe even young teenagers. So does it work well in adults or are we going with Trump's idea around what's the worst that can happen?

I thought the TB jab was part of a compulsory programme back in the day - we all had it soon after starting secondary educ...now we are told our age take up most of the ICU spots, so must be recent jabees, which you might think has some credence.Wonder what the correlation with Winter flu jab is..

[Son of Mathonwy]

This is becoming far too difficult to reply point by point on my phone.
Yes, I’m fully aware that S Korea are far more successful than the European countries. For someone who a few days ago was predicting the death of all U.K. residents within weeks your sudden superiority of the maths of this is astounding. My point is that, on the graph I provided, Holland and Sweden were tracking below the U.K. at relative points despite having less stringent regimes. That is not to say I agree with their approach, I’ve consistently said on here that I don’t, but that it’s far too early to say definitively who/what is right and who/what is wrong. For example, everyone is putting Germany’s lower death rate down to testing but a senior respiratory disease consultant over there is claiming that the tests are unreliable and the treatments path for those admitted to ICU are the main reason for the lower number of deaths.

The lack of context when comparing countries seems to be ignored.
A) Europe is a liberal part of the world not used to and not happy with govt interference in their lives. The Facebook comparison is a false equivalence based on an app that you chose to download and that many people don’t even realise tracks you compared to a govt command to download the app. I’ve not doubt large numbers would do it but, as seen with flouting lockdown rules, a decent proportion wouldn’t.
B) S Korea has first hand knowledge of a respiratory virus epidemic. Europe doesn’t and the U.K. playbook for this, going back years and years, was based on a influenza pandemic.
C) Europe is highly transitory both internally and externally. S Korea less so. Seoul airport deals with 58 million passengers a year, the four European hub airports process just under 300 million passengers a year. S Korea has no land borders (that you can cross) whereas Europe has free movement, for the vast majority, and, highlighted by yesterday’s resignation, very poor cross border cooperation.
D) If you believe everything coming out of the mouth of Chinese Communist Party then good luck to you. If you believe they’ve only arrested the spread by contact tracing and European style lockdowns then, again, good luck to you.

Finally, as you agree, it’s an 18 month sprint and I’m glad that, despite this being unprecedented, you’re certain that S Korea will gently stroll through it. I’ll wait for a vaccine successfully distributed across the world, or at least alot closer to that date, before deciding such things.

I’m certain that Europe and the US will come out if this badly and with serious questions to be answered. However, I’ll wait until more than 3 months in to make definitive statements and I certainly won’t agree you can just look at total deaths without even the slightest nod to cultural, historical and logistical differences.

Do me the courtesy of actually reading my old post before you misrepresent it.

A) So we agree that large numbers would allow the government to track them on their phones. That's all that's needed, it doesn't need to be 100%, it's just one of the contact tracing methods.
B) S Korea's experience with SARs is public knowledge. Their approach to Covid 19 was public knowledge. We had time, the situation was more advanced there.
C) Great Britain has no land borders either. We could easily have had special checks for arrivals from high-risk locations or indeed any location.
D) OK, you tell me which repressive methods the Chinese used which made the difference between success and failure. And how did South Korea succeed without them?

So we agree that Europe (large parts of it, at least) and the US will come out of this badly. I'm sure some peer will perform an inquiry several years from now and we'll learn as much from that as we learn from any inquiry, and its advice will save zero lives. And right now, as daily deaths approach 1,000 our government is ignoring what - prima facie - appears to be best practice for dealing with the virus - as advised by the WHO and practiced by South Korea.

[Mellsblue]

This is becoming far too difficult to reply point by point on my phone.
Yes, I’m fully aware that S Korea are far more successful than the European countries. For someone who a few days ago was predicting the death of all U.K. residents within weeks your sudden superiority of the maths of this is astounding. My point is that, on the graph I provided, Holland and Sweden were tracking below the U.K. at relative points despite having less stringent regimes. That is not to say I agree with their approach, I’ve consistently said on here that I don’t, but that it’s far too early to say definitively who/what is right and who/what is wrong. For example, everyone is putting Germany’s lower death rate down to testing but a senior respiratory disease consultant over there is claiming that the tests are unreliable and the treatments path for those admitted to ICU are the main reason for the lower number of deaths.

The lack of context when comparing countries seems to be ignored.
A) Europe is a liberal part of the world not used to and not happy with govt interference in their lives. The Facebook comparison is a false equivalence based on an app that you chose to download and that many people don’t even realise tracks you compared to a govt command to download the app. I’ve not doubt large numbers would do it but, as seen with flouting lockdown rules, a decent proportion wouldn’t.
B) S Korea has first hand knowledge of a respiratory virus epidemic. Europe doesn’t and the U.K. playbook for this, going back years and years, was based on a influenza pandemic.
C) Europe is highly transitory both internally and externally. S Korea less so. Seoul airport deals with 58 million passengers a year, the four European hub airports process just under 300 million passengers a year. S Korea has no land borders (that you can cross) whereas Europe has free movement, for the vast majority, and, highlighted by yesterday’s resignation, very poor cross border cooperation.
D) If you believe everything coming out of the mouth of Chinese Communist Party then good luck to you. If you believe they’ve only arrested the spread by contact tracing and European style lockdowns then, again, good luck to you.

Finally, as you agree, it’s an 18 month sprint and I’m glad that, despite this being unprecedented, you’re certain that S Korea will gently stroll through it. I’ll wait for a vaccine successfully distributed across the world, or at least alot closer to that date, before deciding such things.

I’m certain that Europe and the US will come out if this badly and with serious questions to be answered. However, I’ll wait until more than 3 months in to make definitive statements and I certainly won’t agree you can just look at total deaths without even the slightest nod to cultural, historical and logistical differences.

Do me the courtesy of actually reading my old post before you misrepresent it.

A) So we agree that large numbers would allow the government to track them on their phones. That's all that's needed, it doesn't need to be 100%, it's just one of the contact tracing methods.
B) S Korea's experience with SARs is public knowledge. Their approach to Covid 19 was public knowledge. We had time, the situation was more advanced there.
C) Great Britain has no land borders either. We could easily have had special checks for arrivals from high-risk locations or indeed any location.
D) OK, you tell me which repressive methods the Chinese used which made the difference between success and failure. And how did South Korea succeed without them?

So we agree that Europe (large parts of it, at least) and the US will come out of this badly. I'm sure some peer will perform an inquiry several years from now and we'll learn as much from that as we learn from any inquiry, and its advice will save zero lives. And right now, as daily deaths approach 1,000 our government is ignoring what - prima facie - appears to be best practice for dealing with the virus - as advised by the WHO and practiced by South Korea.

This is boring. You are just black and white. If we could follow S Korea we would probably be more successful. Nobody on here is arguing any differently. The argument is that you can’t just pick up stuff from elsewhere and transplant it wholesale and say it will work just as well here. See my attachment, even within England you have different areas under different conditions where the virus is spreading differently. If you think S Korea is so similar to Europe and you can just transplant and have the same success then, as with your views on China, good luck to you. Again, nobody is arguing that S Korea haven’t nailed it, at least for now, just there are various reasons why Europe has struggled.

As for the app argument, the virus transmits at such a rate that even a small percentage of non-compliant people refusing to use an app will seriously undermine its efficacy.

Like I said, I’ll leave you to your cast iron certainty roughly 1/6 of the way through our battle against it, on something even the experts are struggling to get a handle on. Let’s hope you do better with this incisive analysis than you did with your prediction we’d all be dead within weeks.

[Mellsblue]

U.K. relative deaths edging towards Italy but still below France and Spain. Sweden and Holland still below even Germany despite less draconian social distancing measures. That said, there must be some in Sweden who have a little wee wee in their pants at the trajectory they are on over the last few days.

[Banquo]

Meh. I’m a pragmatist not a PR guru.

I'm a leg puller not a writer

Ha!

I’m a lover not a fighter

you got it

[morepork]

U.K. relative deaths edging towards Italy but still below France and Spain. Sweden and Holland still below even Germany despite less draconian social distancing measures. That said, there must be some in Sweden who have a little wee wee in their pants at the trajectory they are on over the last few days.

If you mingle when the virus has a foothold in the population, you will transmit it. You can argue the semantics of social distancing until you are blue in the face, but increased contact = increased transmission. End of. It's fucking pointless tracking daily rates in an effort to argue this law of nature is not universal. The only mitigating factor would be if a population has innate immunity to it. Sweden and Holland will catch up, don't worry.

[Galfon]

Rolling average - for the most part the tailing off follows a pattern.UK to follow Spa, US next.
Sounds like Care homes had skewed some of the numbers for Fra.
There are many regions of the world around the 10 day mark, so just entering the surge.

[Son of Mathonwy]

Do me the courtesy of actually reading my old post before you misrepresent it.

A) So we agree that large numbers would allow the government to track them on their phones. That's all that's needed, it doesn't need to be 100%, it's just one of the contact tracing methods.
B) S Korea's experience with SARs is public knowledge. Their approach to Covid 19 was public knowledge. We had time, the situation was more advanced there.
C) Great Britain has no land borders either. We could easily have had special checks for arrivals from high-risk locations or indeed any location.
D) OK, you tell me which repressive methods the Chinese used which made the difference between success and failure. And how did South Korea succeed without them?

So we agree that Europe (large parts of it, at least) and the US will come out of this badly. I'm sure some peer will perform an inquiry several years from now and we'll learn as much from that as we learn from any inquiry, and its advice will save zero lives. And right now, as daily deaths approach 1,000 our government is ignoring what - prima facie - appears to be best practice for dealing with the virus - as advised by the WHO and practiced by South Korea.

This is boring. You are just black and white. If we could follow S Korea we would probably be more successful. Nobody on here is arguing any differently. The argument is that you can’t just pick up stuff from elsewhere and transplant it wholesale and say it will work just as well here. See my attachment, even within England you have different areas under different conditions where the virus is spreading differently. If you think S Korea is so similar to Europe and you can just transplant and have the same success then, as with your views on China, good luck to you. Again, nobody is arguing that S Korea haven’t nailed it, at least for now, just there are various reasons why Europe has struggled.

As for the app argument, the virus transmits at such a rate that even a small percentage of non-compliant people refusing to use an app will seriously undermine its efficacy.

Like I said, I’ll leave you to your cast iron certainty roughly 1/6 of the way through our battle against it, on something even the experts are struggling to get a handle on. Let’s hope you do better with this incisive analysis than you did with your prediction we’d all be dead within weeks.

I'll ask it again:
D) OK, you tell me which repressive methods the Chinese used which made the difference between success and failure. And how did South Korea succeed without them?

Where are you getting this stuff about the app? Don't you understand that the main part of contact tracing is simply asking the patient where they've been and who they were in contact with? The high-tech approach helps but it's just a small part of it.

You're still not getting my old post about the death rates. Can't tell if you're misremembering or just not understanding it.

[Son of Mathonwy]

U.K. relative deaths edging towards Italy but still below France and Spain. Sweden and Holland still below even Germany despite less draconian social distancing measures. That said, there must be some in Sweden who have a little wee wee in their pants at the trajectory they are on over the last few days.

Comparing countries on per capita deaths would be better.

The graph suggests Germany and Holland are at a similar level whereas, per capita, Holland's deaths are 4.7x Germany's. It makes the USA look worse than it is; China too, of course.
Ignoring tiny territories, Spain and Italy have the worst per capita numbers, followed by Belgium, France, Holland then UK.
Denmark looks like it's doing a great job but in fact, per capita, it's worse than Germany.