Coronavirus Pandemic

[Deckard]

Well I’m still optimistic and so is my dog who had a lovely walk in the sun on the beach earlier so boo sucks to the new S.S (stay safe)

[Barney]

For fuck's sake, people. It's not the flu.

This is NOT the flu. This is SARS.

Quite literally, its official name - "COVID-SARS-2" - is telling us that this is "SARS mark 2". Its closest relation is the original SARS virus, not the fucking flu.

And yet we didn't take anything like the steps we have for this when we were knee-deep in SARS. And we were knee deep, I was working as a trained nurse in both A&E and Respiratory during the outbreak. We used minimal PPE for that too. And zero panic. Nothing shut down, no lockdowns.

SARS was given an r0 by the WHO of between 2 and 4, same as COVID-19, but was 10x more deadly by all accounts.

So are they really exxagerating with all this ? Or are they doing what they should do ? Or are they NOT doing enough in your opinion ?

"If it's so contagious you want people locked down" then why not to protect better people that are more exposed ?

Really makes you think "if that's the level of protection sufficient, is this lockdown really a good thing to do ?".

That's just it. I don't think they're doing enough - certainly not in the UK at least - given what I hear and see every day on the news. This this is spreading faster than SARS, though it's classed currently as equivalent in infectious potential. It's not as deadly as SARS either, by a long shot. There's a disconnect in what I'm seeing now versus what I saw first hand back when I was nursing. It's like I'm missing something and I don't know what.

[PFVA]

Well I’m still optimistic and so is my dog who had a lovely walk in the sun on the beach earlier so boo sucks to the new S.S (stay safe)

I don't think a walk in the beach is a bad idea.

The problem for us here is living in a metropolitan area of 2 million people, and lots of those deciding to go to the narrow beaches which results in people literally on top of each other. If they hadn't build up pratically on top of those beaches probably by now we could safelly be walking on them.

[Harlequin]

That's just it. I don't think they're doing enough - certainly not in the UK at least - given what I hear and see every day on the news. This this is spreading faster than SARS, though it's classed currently as equivalent in infectious potential. It's not as deadly as SARS either, by a long shot. There's a disconnect in what I'm seeing now versus what I saw first hand back when I was nursing. It's like I'm missing something and I don't know what.

Could this virus be at the higher end of the 2–4 r0 range and SARS-CoV-1 at the lower?

[Under 'Is COVID-19 the same as SARS?']

SARS was more deadly but much less infectious than COVID-19.

[Emphasis mine]

Two factors possibly affecting this might be SAR-CoV-2's apparent asymptomatic transmission and its "barbs" having around four times the "grip" of its predecessor.

[KlaxonCow]

And yet we didn't take anything like the steps we have for this when we were knee-deep in SARS. And we were knee deep, I was working as a trained nurse in both A&E and Respiratory during the outbreak. We used minimal PPE for that too. And zero panic. Nothing shut down, no lockdowns.

Harlequin's given the numbers.

But I think the basic difference here is the long asymptomatic incubation period.

With the original SARS - looking it up on Google and finding the CDC's description of it - then victims would start displaying acute symptoms within 2 to 7 days. Initial symptoms can occur before that. Most patients had pneumonia. Basically, within a week, you were fighting for your life in an ICU bed. There was no stealthy subtle-ness to SARS 1, because it was, indeed, much more aggressive.

Whereas, with this new SARS 2, it's developed this nasty long incubation period. Someone could be wandering around asymptomatic / very mildly symptomatic for at least 5 days and up to two weeks, before displaying any symptoms at all. Before giving any clues to anyone, including the patient themselves, that they've even got it.

It's exactly because SARS 2 is less aggressive that it's proving near impossible to contain - and the comparative numbers have sky-rocketed, compared to SARS 1 - as someone with it could have spent a whole week unknowingly spreading it around, before there's any indication (even to the person themselves) that they've got it.

This is what justifies the lockdowns. Because we could have a whole week of asymptomatic spread before we even realise that there's a problem - and every person that it was passed onto in that week will likely have their own whole week of further passing it on - then we've got the wild exponential spread for a whole week, before any symptoms start manifesting.

Being less aggressive - and having a longer asymptomatic incubation period - is what's making this one much worse, in terms of the numbers.

When acute symptoms are already occurring by day 2, the ambulance has already been called. They've had much less chance to have passed it on - particularly because when people get symptoms, that's when they go to their bed to recover, so they tend not to be out and about in public, as they're feeling poorly.

With SARS 1, because it's more aggressive, "containment" and "isolation" kind of naturally happens relatively quickly, naturally keeping the spread down.

But because this one is less aggressive and someone can be wandering around happy as Larry for a whole week before any symptoms show, they're unknowingly spreading it - and spread of any virus is exponential growth - before there's any indication that there's an issue, much less before the "containment and isolation" of going to hospital occurs. Worse, as it's relatively "mild symptoms" for most people - because the majority of people will actually have this one and get over it, only feeling like they had a mild / heavy flu - then many might soldier on, continuing to spread it, exactly because it's not debilitating enough to floor them and send them to their recovery beds, or bother phoning the ambulance (where a natural "containment and isolation" occurs, as hospitals recognise what they've got and can do testing and can put people into isolation relatively quickly).

It's because SARS 2 is less aggressive than SARS 1 that it's proving a bigger problem, and requires lockdowns.

Because, basically, as anyone could be an asymptomatic carrier - passing it on to others - for potentially a whole week or more before even they know they're poorly, this is what justifies the lockdowns. It's basically treating everyone as a potential carrier and getting everyone to aggressively cut the possibility of spread, whether they are or not. Because the basic problem is that any of us could be a carrier without realising it for many days.

If we wait for symptoms before doing anything, then it's already had about a good week of wild exponential spread. It's already far too late to contain.

And, again, we can look to South Korea and it's aggressive testing regime, kicked off rapidly and immediately, to see an alternative to tackling it. Because if you test, then you can potentially find those carriers and stop them passing it on, even before those people themselves realise they've got it. Why the "test, trace and isolate" regime worked so well for them. Because if someone presents symptoms, then they're tracing contacts and discovering who they could potentially have passed this on to, and those people are tested - even if they're still asymptomatic right now - and, if they have it, they're isolated to stop them passing it on further.

South Korea (and Germany to some degree) have dealt with this far better because they've been using aggressive testing to get ahead of the spread. To find those asymptomatic carriers before they can pass this on, to "contain and isolate" it before it kicks off. The long incubation period can, in this instance, work in our favour. But it requires that WHO's "testing, testing, testing" to be applied aggressively - as we can't pick up these people by symptoms for a whole week of exponential spread, we need the tests to pick them up sooner to cut the lines of transmission earlier.

Put another way, imagine we had 60 million antibody tests ready to be sent out to the entire UK population tomorrow. Folks would do the test - taking about 15 minutes - and then we'd have, immediately, a complete "snapshot" of the whole population, knowing who's not had it, who's had it and, to some degree, who's got it right now (because one of the antibodies - IGM - starts getting produced early on and these tests can pick that up, apparently - so such tests do have some ability to detect those who have it right now, as well as those who've already had it. Combined with an antigen test on those who come out positive from the antibody test, you can then differentiate between the two. Or, indeed, if someone's been feeling poorly previously, with all the symptoms, but feels much better now and they've come back with a positive antibody test, we can deduce that it's very likely they're in the "had it and got over it" category. Because displaying symptoms is itself, of course, a form of diagnostic test as well). With such a "snapshot", we could then isolate everyone who needs isolating, to kill the spread stone cold dead. Just like that.

Of course, we don't have that yet. We have only antigen testing and, in the UK, nowhere remotely near enough to make an impact - so much so, that it's being reserved, so far, to "medical necessity" and only hospital testing. But this means there's no "getting ahead of the curve" at all. Because you're not tested unless you've already got acute symptoms that has hospitalised you. In a sense, all the tests are doing right now is confirming what we already deeply suspect symptomatically - because if anyone arrives at hospital with "severe acute respiratory syndrome" right now, the odds are very good that, yeah, you've got someone with COVID-19. The "medical necessity" test is just rubber stamping as positive what you've already surmised is deeply likely from their symptoms (and if someone has severe and acute respiratory problems, then whether it's covid-19 or not, you're going to be putting them into an ICU bed and likely hooking them up to a ventilator anyway - confirmation of it being COVID-19 that's causing their SARS doesn't really change the immediate necessary treatment).

Indeed, there's a potential argument in there that we don't "waste" a test on those presenting with severe and acute respiratory problems. Rather, just treat them all as likely having COVID-19, in terms of isolation and PPE. And, in fact, do the testing on their contacts and NHS staff instead. The argument that "getting ahead of the curve" is more important than exactly confirming what the symptoms are already telling you is almost certainly the case (and wouldn't affect treatment, other than protecting NHS staff from getting it - which we should just be doing "by default" anyway, as they could just as well be contracting it on their Tube ride home after work as from the patients, when it's out and about in the community).

We need more tests. Way, way more tests. That's the root to "getting ahead of the curve" with a virus like this, which has got such an annoyingly good "stealth mode" to its spread.

The justification for the lockdowns is simply that, because of the long asymptomatic incubation period, then anyone could potentially have it - not to frighten anyone, but just to get the point across, you might be, like me, feeling perfectly fine right now but that doesn't necessarily mean you didn't unknowingly pick it up last Tuesday, it's just that the symptomatic phase hasn't kicked in yet - so the essence of the lockdown is for everyone to treat everyone else as a potential carrier across the board. Whether they are or not. Because if they are, then you're helping to stop transmission and, if they're not, then there was no transmission to be stopped in the first place. Either way, it stops this spreading.

The difference is that long asymptomatic incubation period. Plus, not having anywhere near enough testing going on.

It's like Battlestar Galactica - who's a cylon and who's human? We just don't know. And we can't just wait for symptoms to come along and tell us because, by that point, it's already too late, as they'e been passing this on for a good week or so.

Testing, testing, testing. It's how you get ahead of the curve.

Because a test can just directly tell you if someone's got it, symptoms or not (or, with the antibody test, if they've previously had it - but as antibodies are developed fairly early on with this, it has some ability to detect who's got it as well - and then you need the antigen test to tell the two apart. Indeed, as the antigen test is slower and less numerous, you can do the antibody test first and if that comes back positive, then you can reserve the antigen test only on those with a positive antibody test, just to differentiate between "had it" and "got it right now", making those tests go much further. Which is why we need those antibody tests yesterday, basically. With testing, we're always chasing the curve. But with major mass testing, we have the potential of getting ahead of it).

[Harlequin]

(Apologies for pernickety editing while KC was posting).

[KlaxonCow]

(Apologies for pernickety editing while KC was posting).

Ah, I do that all the time. Post my long post, then read it back and realise I've got typos or there's a vastly better way of phrasing something and go back to edit it. As long as no-one posts in the meantime, most people don't know. But I'm pretty much doing that every time I post something.

And, indeed, there is an annoying "it's / its" typo in the above right now, which I've spotted - annoying because I totally know the difference of when to use which, and know that it's wrong as it is - but it's going to have to stay there now, as further posting / the editing timeout expiring cuts off my ability to fix it.

[tufty]

Meanwhile in the Philippines, Duterte has said that those disobeying the lockdown should be shot. And although, so far, his police have disobeyed him, he has authorised lethal force.

[KlaxonCow]

With testing, we're always chasing the curve. But with major mass testing, we have the potential of getting ahead of it).

Whoops. Speaking of spotting typos after posting, this should, of course, have read "without testing, we're always chasing the curve. But with major mass testing, we have the potential of getting ahead of it". Just to dispel any confusion.

[gilesgoat]

Meanwhile it seems today, so I read, the WHO says "they think now the virus spreads in the air more than what they previously thought" so now they are thinking/evaluating about the face masks and how they should be used ... ...

[Barney]

You're all right, of course. It's the long incubation (while infectious) which is different this time around.

One thing I might add, is that this very much is influenza, at least in its effects on the body. Most people that think they've had the 'flu have had a very, very heavy cold. I've seen people die from influenza (my dad was one, back in january of last year having suffered a stroke but I've seen others) and it's really, really bad. Like, so bad you are lucky to remain conscious most of the time, and getting out of bed is impossible. IV fluid support is generally necessary to save life.

The mistake people are making is that they think the 'flu is a heavy cold. It's not. And by making that mistake, equating COVID-19 to the 'flu makes people think it's less deadly than it is.

[Deckard]

I dont think people think its less deadly than it is - I think most "lay" people think its far more deadly than it is...which suits the government fine for things like lockdown etc...

A much clearer picture of how deadly this is will present itself when this inept government start following the WHO advice and "test, test, test" and we get real figures rather than guesstimates of the number who have had it. Whether the government won't publish them quickly to keep the public on a high state of alert remains to be seen....

[tufty]

Lockdowns don't "suit" anyone, and certainly not governments. They have a massive cost, both immediately and, frankly, for the forseeable future. That's why pretty much all governments have had their heads stuck up their arses for so long; they have *only* locked down once it became obvious that their earlier dithering has left them no other option. It's no surprise that they have pretty much all decided to do it at about the same point on the curve. They have all hit the same "Oh, holy fucking shit, we're going to get blamed for this" moment as they realise they aren't immune to a worldwide, exponential explosion of infection, at about the same point.

So while it would be safe to say that they don't give much of a fuck regarding the number of deaths their dithering has caused except inasmuch as it affects their re-electability, it's tinfoil hat wackjob level conspiracy theorising to say lockdowns are happening because they somehow suit the political class.

[Deckard]

I didnt say that at all -I just said keeping the population more scared is a good thing for the people in power to achieve stuff like keeping off the streets and taking more precautions - if suddenly it came out it had a (plucked from thin air) 0.001 death rate can you imagine what the publics reaction would be ? I DONT believe in any conspiracies tbh as FFS Apple cant even keep their new iPhones a secret.

[gilesgoat]

*SNIP*

So while it would be safe to say that they don't give much of a fuck regarding the number of deaths their dithering has caused except inasmuch as it affects their re-electability, it's tinfoil hat wackjob level conspiracy theorising to say lockdowns are happening because they somehow suit the political class.

I've been listening to some tinfoils hats myself.

As usual "in all madness there's a TINY bit of truth",IMHO,I can be a bit of tinfoil hat myself

While there's NO doubt that "lockdown is a NECESSITY IMPOSED BY CORONAVIRUS" there's some "reasons to be concerned for the future" that "some things put in place shown/prove to be working that well that hey we may keep using some shit even after".

The fear is that some "instruments of control" could be proven "so effective" that "why not keep them for longer ?" There are already talks about this.

The fact to have "instruments" to know where individuals are moving, what they are doing, better face recognition and stuff like that is .. worrying .. when "everyone by default is going to be under surveilleance 24/24 7/7".

Let's talk "Minority Report" ? .. well "in more than just a movie" the "Precrime" actually EXISTS ALREADY I remember reading a while ago about can't remember any more the names but there are >1 and probably even >N "projects" in various countries, USA being one of them, where "data on people is constantly analyzed" and "profiles of potential criminals/troubled people" are created and eventually investigated.

Now all this opens "powerful phylosophical questions" about "free will" "freedom of committing mistakes" "redemption" and such ..

Which I think "condensating" literally boils down to "can men take the place of God in deciding/applying what is wrong and what is right" ?

Well "technically they can as God is not here on Earth now throwing bolts to the evil people" but I think "even most religions" would tell you "that is NOT the role of God" as well, God is NOT here to do that - assuming we believe .

So you get to a point where "some entities with LOT OF POWER, MORE POWER than anyone else" decide "what is wrong and what is right" and "make it apply" .. but here we go a bit into Clockwork Orange territory .. "can you be really something when you don't have a choice" ?

Short answer would say "NO", if you can't make anything wrong and learn from it other than "being IMPOSED not to do so" is that "correct" ?

Anyway back to Coronavirus but yes "there's some concern" that some stuff developing cause the Coronavirus situation "could be pretty comfy in the future" for someone else.