Fuji_Abound wrote:
The second in the UK was not to lock down again two or three weeks ago. There are the same signs of inevitability and the experiment of regional restrictions will probably not work. Probably most western european economies will be forced to follow the same path sooner rather than later.
On this I think you are correct. I don’t suppose what happens in Ireland get’s much coverage elsewhere, but essentially this has already happened here. Our health system has fewer ICU beds than most other EU countries (and our hospitals tend to get overwhelmed this time of year anyway) which probably brings the difficulties here sooner than many other EU countries.
Three weeks ago, our public health advisors advised the government to go into a full lockdown immediately. The government reacted very angrily. Our deputy prime minister even went onto a TV chat show and said that the advisory team hadn’t properly thought through their recommendations! The health advisors were castigated in public for their recommendation (mainly because another lockdown would not be popular). For the first time since the start of the crises the government decided not to follow the public health advice and did not start a lockdown. The public health team made their predictions for how bad things would be after 2 week, and after 4 weeks if their recommendation was not followed. It was dramatic at the time.
1 week later and the cases were already approaching the 2 week prediction! The government had to start talking about how the time was now right to consider more restrictions! (Just 1 week after rejecting that advice!)
2 weeks after the public health team advised the government to start a lockdown which the government rejected, they were forced to implement those recommendations in full to avoid our hospitals being overwhelmed.
But this full lockdown is not like the first one at all. Schools stay open, and many more businesses are deemed essential which were not the first time. People are less scared and more inclined to ignore the rules. First time around, the roads were deserted (Sunday type traffic everyday). This time the roads are busy and there isn’t all that much of a difference before and after the lockdown (but still a lot less activity than pre covid). It will be interesting to see if the second lockdown in other EU countries is less severe than the first one, as it is here.
Fuji_Abound wrote:
The vaccine will be along on the Christmas shoulder and will probably be in time to prevent another Spring or Janaury lockdown, although that may be touch and go.
Be careful how you understand this. It seems very likely that at least one vaccine will be approved before the end of the year. Probably more than one. But from what I hear it will be a long time before even a majority of the population are vaccinated. The plans seem to be to vaccinate healthcare staff first (and rightly so. Those people put themselves in harms way to help the rest of us. They deserve the best protection that we can give them). Then next will be those at risk (underlying conditions or elderly). Then next those over a certain age. Only after that will the vaccine be available to the general population. Many of the drug manufactures are saying that it will be the end of next year or well into 2022 before everyone is vaccinated.
The optimistic predictions seem to be healthcare workers and at risk groups in Q1 2021 and others in Q2-Q3 2021.
So while vaccines will hopefully be approved soon, and you’ll probably see people getting the first vaccinations on the news in December/January, most of us might not see it for the best part of another year. Maybe longer. The drug companies seem to be saying around 2B vaccines next year (but many of them require 2 doses, so only 1B people vaccinated). It’s not clear to me if that’s all vaccines combined or just those for that particular company.
Maybe with a bit of luck, once they are approved, attention can turn to ways to speed up the roll out.
I also take hope that with nearly 50% of people here saying they won’t take the vaccine until it’s already in widespread use, I’m hoping I might get it a bit earlier than I otherwise would! 
Dp I agree with all your comments on the vaccine.
Entirely being an optimist I think the vaccine may be manufactured in volume a little more quickly (and I mean little) than is being suggested, and I think mass vaccine is also easier to implement than might be thought but I didn’t intend to portray an expectation of mass vaccine herd resistance quickly. Never the less as the more vulnerable are protected for the politicians for the same reasons I outlined earlier will find the choices more appealing, if still gambling with the lives of some.
One thing that occurs to me… if indeed antibody resistance has a short life, then this will apply to the vaccine too. In other words, in that case a vaccine will be worthless, unless people are willing to get themselves revaccinated every few months.
My own feeling is that sooner or later this will fall into the “noise floor” of acceptable risks (just like car accidents, other widespread diseases such as influenza, being attacked by lions if you happen to be a Masai). Given what has happened in SE England, I suspect that will take another 6-12 months.
Returning to an earlier discussion, I don’t believe that the north/south discrepancy in England is due to greater affluence or education in SE England. Sure, there is a much higher proportion of well-off, educated people there than in say Tyneside. But there are still LOTS of poor people living in crowded, unsanitary accommodation.
Nice analysis Fuji_abound, I see a similar perspective.
It could be said therefore this virus is especially annoying and challenging.
Exactly. Its asymptomatic spread makes it infuriatingly tricky to contain in practice, relegating us to fairly blunt, broad & unpopular measures (masks, lockdowns, border closures etc) & while the virus is a “great deal worse than the flu”, a large majority won’t get affected too bad, so we’re not quite in spanish flu (or much worse) territory either.
Also this is clearly not a 12-18 month thing – getting to a final steady endemic state will take longer,…another 3-5 years? 1st gen vaccines likely won’t be as effective as subsequent ones, so we’ll need follow-up shots for years & in the meantime, restrictions will remain in place to some degree.
(Example: Masks will no longer be required on airlines in 2021, 2022,…2025?)
Which overall places the effects and our response on this particular virus firmly into the range of long term public policy & economics, sharing the stage with public health objectives.
This virus is indeed a massive change on so many levels…
@johnh don’t confuse antibody levels with immunological response. Antibody levels always rise after a viral infection and drop afterwards. That doesn’t necessarily jeopardise the immunological response – cf. effectiveness of MMR, polyo et al vaccines.
To the extent that the virus mutates – like influenza – there is a danger of the vaccine being less effective. But the Ig levels per se don’t mean an absence of immunological response.
johnh wrote:
if indeed antibody resistance has a short life, then this will apply to the vaccine too.
But antibodies are not the only immune mechanism with “memory”.
Silvaire wrote:
If you read the papers linked by @Malibuflyer, and I have, you may come to the conclusion that they aren’t very helpful in scientific terms.
Ok – that’s already a huge leap from “had no effect and arguably had a negative effect.”. It is, however, still a misrepresentation of the provided evidence.
The first paper clearly states, that the relative risk reduction is 6-80% (and explains that this range is so wide because they looked at a huge amount of studies that had very different methodologies, etc.).
The second paper not only states that: “Face mask use could result in a large reduction in risk of infection” but also show (figure 4) that most studies actually demonstrate a risk reduction of about 40% by wearing face masks – with only very few at lower ranges.
Interesting there: All of the studies with a comparatively low efficacy of masks are on SARS. The MERS related studies show a significantly better efficacy and the few already existing Covid related studies an even better one.
It’s absolutely clear that staying away from other people is the single most effective way to prevent infections – but if for some reasons you can’t, masks are the second best alternative to at least significantly reduce your risk and the risk of the people around you.
don’t confuse antibody levels with immunological response
Antibody schmantibody, what does it matter… the exact mechanism isn’t important.
Either:
a) prior infection provides a high degree of resistance, whether through antibodies, T-cells, or intravenous pizza dust. In that case herd immunity is real, and vaccines will help too.
or
b) prior infection provides little resistance. In that case, barring some unknown-to-medical-science mechanism, vaccines won’t help much either.
You can’t have it both ways.
John
Malibuflyer wrote:
It’s absolutely clear that staying away from other people is the single most effective way to prevent infections – but if for some reasons you can’t, masks are the second best alternative to at least significantly reduce your risk and the risk of the people around you.
Exactly. And a very cheap and easy to implement measure. Even if masks prevented only 10% of infections (a random number I just made up for this argument!), they would make a huge difference on a population level.
I’m getting increasingly angry with the doubters and naysayers who seem to think that if we pretend this disease doesn’t exist and resumed our pre-pandemic behaviour in full, everything would be alright except maybe for a few old people dying. That is NOT what is happening right now!
Intensive care patients with Covid-19 are currently doubling every 10 days in Germany. About 1500 now, in April we had 2500. Doubling every 10 days means we would be at 8x this number at the end of November. We, doctors and nurses, cannot cope with such numbers! Period! There is no arguing around this! The spread must be stopped, now, and that is why I welcome the “lockdown light” that our federal and state governments agreed on yesterday. It might even be too little, too late.
