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Revisiting this thread December 2022

Please note the graphics & data in the second post above were saved more because they helped us understand at the time how vaccinated hospitalisations would eventually rise more than unvaxed as vaxed became the majority

 a good updated overview of the UK Covid data & timeline is here https://www.kingsfund.org.uk/publications/deaths-covid-19  which was last updated August 2022

Remember the CDC data in the 2nd post was from July in the year when Vaccines had had maybe 5 months of introduction, & were starting to really reduce serious illness in older people (>30 years of age probably) but it will be useful to see some of the latest updated data reviews. (see King's Fund Explainer linked above & here

Again the point we were studying in this post was the anomaly of the Simpson's Paradox

& please remember this Covid database of research articles/links was set up at Pandemic onset (Feb/March 2020)when there were no tests or vaccines & we were trying to get information to help us decide how we would continue our Clinic work with Patients and best advise them.

Set up for interested Patients, other Practitioners & Friends to help us make decisions.

 Pls be aware some Articles may now be outdated or surpassed by more recent findings as the science evolves so  please take extra note of Posting date & read in context

C19 Notes Database / Re: A reminder why we have restrictions and wear a mask
« Last post by stog on March 03, 2022, 11:05:48 AM »
this medscape article has some info on the main Sub-Variant BA.2 that appeared in the Philippines and Denmark, with some initial info on how it does not show up on regular variant testing owing to its missing spike which is currently what is used to look for the sub variants

the original BA.1 variant was relatively easy to track due to a spike deletion (H69/V70), which provided a convenient target for testing, BA.2 does not contain this mutation. This means it is no longer possible to quickly distinguish between Omicron and other COVID-19 variants using PCR testing. Instead, monitoring requires additional genomic sequencing.

C19 Notes Database / Re: Long Covid Definition
« Last post by stog on January 13, 2022, 12:37:56 PM »
Deputy Chief Medical Officer on long covid
 Excellent and very helpful summary

Long COVID: emerging data and implications for health and care Dr Aidan Fowler, Deputy Chief Medical Officer

or pdf attached
C19 Notes Database / Re: A reminder why we have restrictions and wear a mask
« Last post by stog on January 06, 2022, 12:56:52 PM »
3 useful Nature articles from earlier on in the Pandemic that seem to be borne out by recent findings and the info in the previous post
Seasonal coronavirus protective immunity is short-lasting Published: 14 September 2020

We monitored healthy individuals for more than 35 years and determined that reinfection with the same seasonal coronavirus occurred frequently at 12 months after infection. Five reasons why COVID herd immunity is probably impossible (18 March 2021)

Even with vaccination efforts in full force, the theoretical threshold for vanquishing COVID-19 looks to be out of reach.  The false promise of herd immunity for COVID-19 (21 October 2020)

Why proposals to largely let the virus run its course — embraced by Donald Trump’s administration and others — could bring “untold death and suffering”.
C19 Notes Database / Re: A reminder why we have restrictions and wear a mask
« Last post by stog on January 05, 2022, 01:56:11 PM »
update Jan 2022

some more on Omicron & how herd immunity either by vaccine or previous infection is a misnomer

Omicron has been revealed as very different from previous variants, and the chart below which is a kind of composite grouping of viral traits between the different main variants so far by Yaniv Erlich

described by Alison Nolan as "a map of how similar each variant is to each other - points that are close are more similar to each other. Omicron is off doing is own thing because it's not very similar to anything else."

and his list of "Are we going to reach herd immunity after the Omicron wave?  I compiled a list of arguments that support or argue against this complex notion."
C19 Notes Database / Re: A reminder why we have restrictions and wear a mask
« Last post by stog on December 19, 2021, 11:57:07 AM »
Dec 19th 2021

the irony is the longer we put off interventions, the harder & longer the lockdown

 when R is >4 NPIs (mitigating factors to reduce transmission) cannot bring the R number below 1 quickly

 see http://epidemicforecasting.org/calc and input 5

every day, decision delay costs lives & livelihoods

C19 Notes Database / Re: The Multiplicative Power of Masks
« Last post by stog on December 19, 2021, 10:26:00 AM »
update Dec 2021

here are a couple more studies (among many)

but remember also this simple quote

"N95 mask  is extremely wonderful. The pores in the mask are 0.3 microns wide. The virus is 0.12 microns wide. So people ask how does it work? But you try having 3 big rugby players rush 4 lunch thro' a door -they're not going to get through."

1/ Lancet
Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

A rapid systematic review of the efficacy of face masks and respirators against coronaviruses and other respiratory transmissible viruses for the community, healthcare workers and sick patients

C19 Notes Database / Re: Transmission Duration and Peak
« Last post by stog on December 18, 2021, 11:41:10 AM »
December 2021

this transmission curve has been updated (thx James Hay for this)

but for symptomatics the peak transmission is still before and at about symptom onset? while of course for asymptomatics, they're happily going about as usual.. unless there are strong proceedures in place

here https://www.nature.com/articles/s41591-020-0869-5/figures/1
C19 Notes Database / Re: A reminder why we have restrictions and wear a mask
« Last post by stog on December 10, 2021, 07:07:05 PM »
Update (December 2021)

Now that we do indeed have a new more infectious variant Omicron, there is a greater risk of our Services being overwhelmed again and though we do have a good vaccine take up hospitalisation numbers are still sure to rise

Looking at the ourworld data it shows that the death rate of vaxed/unvaxed  at present to be 5x > risk being unvaxed

NHS pressure though comes thro' hospitalisations & long covid returns & as we get expected increased numbers with the new variant then masks & distancing become even more important

also increased hospitalisations will be from vaxed & unvaxed alike (see http://www.soul-trade.com/C19Notes/index.php/topic,93.0.html which means social distancing, masks & ventilation become even more important to reduce transmission which occurs in both vaxed & unvaxed

As I write it is estimated that Omicron has an R value of >4 which when you consider our worries at the beginning of the pandemic when R was > 1 is very worrying especially when our NHS is already dealing with high case numbers & hospitalisations and A& E trolley waiting times are off the scale (see graph below).

Add the fact that staff are wiped out from near on 2 years of this and

@GoughCJIntensivist & Anaesthetist
"Staggering data on Staff Wellbeing presented at #SOA21 :

 ~50% of ICU nurse respondents have probable PTSD.
~15% of ICU staff reported suicidal ideation.
Younger, females, & nurses reported the highest rates.

 I knew it was a problem, but this helps show it's a massive problem".
it's a difficult concept as more of us are now vaccinated and yet hospitalisations contain more vaccinated

here are some more useful graphics (thx SpookyHead!)

Simpson's paradox

and "absolute numbers [make] a mistake that’s known in statistics as a ‘base rate fallacy’: it ignores the fact that one group is much larger than the other" How do death rates from COVID-19 differ between people who are vaccinated and those who are not? "

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