Covid 19

[pwhole]

Channel 4 News is running a story right now about serious concerns about this 12-week delay, and they've just mentioned a care home where nearly everyone has had their first injection and three weeks later there are three symptomatic cases. It'll be on Channel 4+1 (15 on Freeview) if anyone misses it now. And Devi Sridhar just laid it down again and recommended 80% of salary payments for self-isolation.

[mikem]

Vaccination doesn't stop you catching covid, it (hopefully) reduces the effects.

[droid]

Ooops again....

[droid]

Vaccination doesn't stop you catching covid, it (hopefully) reduces the effects.

Clearly the virus has to get inside you to spark the immune system, but since the vaccine 'prepares' the immune system for that virus it's cleared before the virus load causes symptoms or shedding.

Maybe that's what you meant...

[PeteHall]

Will the vaccine protect you?
The COVID-19 vaccine that you have had has been shown to reduce the chance of you suffering from COVID-19 disease. Each vaccine has been tested in more than 20,000 people in several different countries and shown to be safe.

It may take a week or two for your body to build up some protection from the first dose of vaccine. Like all medicines, no vaccine is completely effective, so you should continue to take recommended precautions to avoid infection. Some people may still get COVID-19 despite having a vaccination, but this should be less severe.

Can you give COVID-19 to anyone if you have had the vaccine?
The vaccine cannot give you COVID-19 infection, and a full course will reduce your chance of becoming seriously ill. We do not yet know whether it will stop you from catching and passing on the virus, but we do expect it to reduce this risk. So, it is still important to follow the guidance in your local area to protect those around you.

To protect yourself and your family, friends and colleagues you still need to:

practice social distancing
wear a face mask
wash your hands carefully and frequently
follow the current guidance

Source: https://www.gov.uk/government/publications/covid-19-vaccination-what-to-expect-after-vaccination/what-to-expect-after-your-covid-19-vaccination#:~:text=The%20vaccine%20cannot%20give%20you,to%20reduce%20this%20risk.

[mikem]

https://www.nhs.uk/conditions/rabies/vaccination/

But even if you have been vaccinated, you should still get urgent medical help if you're bitten or scratched by an animal that may have had rabies

[droid]

Yes. No vaccine is 100% effective and what they're saying is that you shouldn't assume you are immune. That's my reading anyway.

The relevence of a disease with just about 100% fatality rate eludes me.

[mikem]

Your first comment was that you didn't know any vaccine that wasn't effective (or something along those lines)

[Fjell]

Andrew Pollard and his team are going to get some big gongs. The guy at the top of that list.

Here is his cv. It’s sobering to consider it includes some Himalayan first ascents. Some people really do fill the day don’t they.

https://www.ovg.ox.ac.uk/team/andrew-pollard

[mikem]

If you want a job done, give it to a busy person (although it was whilst at / shortly after uni)...

[droid]

Your first comment was that you didn't know any vaccine that wasn't effective (or something along those lines)

Effective, yes. 100% effective no, never claimed that.

[Duck ditch]

At least on this thread no one is advocating to ignore the lockdown anymore. I suppose the equivalent of 3 to 4 jumbo jets falling out of the sky daily just from this country is quite sobering. 

It’s a global problem that requires global success.  Conspiracy, fake news, lies and cover ups from a Wuhan to Washington are the worlds enemy, along with jingoism. 
Time to work together. 

[Speleofish]

What follows is speculative and hugely oversimplified (but there is reasonable evidence to support it).

If you encounter a respiratory virus (common cold, flu, covid), the first part of your body it invades is the surface of the respiratory tract (anywhere from the nose and throat to the lower airways). Your immune response to the virus is mediated by immunoglobulin A (IgA), which is located primarily in the mucous membranes which line the airways. If the IgA response is sufficient, you will experience no or few symptoms and the virus will be eliminated (though it may take a day or two).

Virus that penetrates beyond this will cause a more generalised infection. This produces a response by immunoglobulin G (IgG). Most people having such an infection will experience some symptoms (anywhere from mild to overwhelming).

Importantly, giving an injectable vaccine bypasses your initial IgA response and only causes an IgG response. This will protect you from severe, generalised infections but won't do much for your initial mucosal defence. Therefore, it is perfectly possible for you to get a local infection in your airways and for the virus to replicate there without causing you to become seriously ill. Your IgG response will prevent it from turning into a generalised infection but won't have much effect on the virus in your mucosal cells. While the virus is replicating in your airways you can shed it to the outside world (ie you are infectious) even if you don't become ill yourself. 

The other implication of this is that some people who have asymptomatic infections probably eliminate the virus because they have a powerful IgA response. Such people may not be picked up by antibody testing because these only test for IgG.

[maxf]

At least on this thread no one is advocating to ignore the lockdown anymore. I suppose the equivalent of 3 to 4 jumbo jets falling out of the sky daily just from this country is quite sobering. 

It’s a global problem that requires global success.  Conspiracy, fake news, lies and cover ups from a Wuhan to Washington are the worlds enemy, along with jingoism. 
Time to work together.

A couple of jumbo jets worth a day is normal for this time of year, there may be around one extra jumbo jets worth than normal right now

[PeteHall]

At least on this thread no one is advocating to ignore the lockdown anymore.

I think very few people have advocated ignoring lockdown on any thread on this forum, however quite a number of people (myself included) have stressed the importance of protecting your mental health through low risk, high benefit activities such as caving. I strongly suspect that those who were caving before to protect their mental and physical health are still doing so now, but have given up talking about it on here, to protect their mental health; you could say they've been driven underground 

[ZombieCake]

Don't forget that about a jumbo jet's worth of cancer patients fall out of the sky each day on the UK as well.

[pwhole]

What follows is speculative and hugely oversimplified (but there is reasonable evidence to support it).

That's the simplest and most useful explanation of the actual mechanism that I've read since last March, so thank-you for that 

My last few caving trips have definitely been damaging to my mental health 

[andrewmc]

A couple of jumbo jets worth a day is normal for this time of year, there may be around one extra jumbo jets worth than normal right now

This: https://fingertips.phe.org.uk/static-reports/mortality-surveillance/excess-mortality-in-england-latest.html#comparisons-to-other-measures-of-excess-deaths-in-england

Specifically the first few graphs, is pretty good evidence that the number of people listed as a 'Covid death' is very similar to the number of excess deaths (currently the number of 'Covid deaths' is slightly higher than the number of excess deaths, but only slightly) which strongly implies that the presented death rates are broadly accurate.

Week ending 4th January: estimated excess deaths 4045, registered Covid deaths 5596 (earlier months don't show as much of an excess over the expected excess deaths, and that wasn't seen in the first lockdown either).

You do expect that some people who died of Covid would have died of something else, and lockdown can mean fewer car accidents etc. It's also perfectly plausible that the Covid death rates are just 40% out - but that's all.

[droid]

I have to point out that one paper regarding IgA response did note an increased amount of IgA specific to Covid, peaking 28 days after injection of killed adenovirus vector.

I only found one. My brain started hurting. Sorry.

[Duck ditch]

At least now on this thread only a few people are advocating that the coronavirus is something and nothing.  One or two jumbo jets falling out of the sky daily is not too bad.   

[AR]

There's a good BMJ article on the public perception of restriction breaking and its actual impact on spread, as opposed to failure to isolate by those possibly or actually infected, and flagging up that failure to provide good support to those people is a massive fail on the government's part...
https://blogs.bmj.com/bmj/2021/01/07/pandemic-fatigue-how-adherence-to-covid-19-regulations-has-been-misrepresented-and-why-it-matters/

[Alex]

I have heard that Borris says the lockdown might go on into the summer!

I am not putting my life on hold until summer though, once the vulnerable and over 65s are vaccinated, I see no reason for us to stay in lock-down anymore, so once the pressure is off and the vulnerable are vaccinated I am going caving again and resuming my life, lockdown or no lockdown. I know small minority of under 65s can get it quite badly but it should be at a level the NHS can handle, we will never succeed in wiping this thing out so we will have to live with it, the vaccines help us do this, but life has to get back to normal too for all our sanitises. Lock down is correct at the moment, but should be the very last resort due to the dreadful damage it is doing to people's mental, financial, children's education and even physical well being, so should be released once the 65s and vulnerable are vaccinated and vaccine has had a little time to take effect, so early march at the latest, presuming we keep vaccinating at the current rate.

If they don't feck it, they can fine me, they can't guilt trip me anymore if the vulnerable and old are vaccinated.

[Pitlamp]

What follows is speculative and hugely oversimplified (but there is reasonable evidence to support it).

That's the simplest and most useful explanation of the actual mechanism that I've read since last March, so thank-you for that 

I'll second that; thanks Speleofish.

You're clearly very well informed on this subject, so could I ask your opinion on something?

In between lockdowns 1 & 2 in 2020 (summer) I was in contact with literally thousands of people, from all over the country, because of my job. Statistically, I must have met very many people who had the virus. I was fully expecting to go down with it but (firmly touching wood) I haven't knowingly had the virus. (It's possible I may have been asymptomatic, of course.)

I did use a mask or face screen and regularly washed or sanitised hands, etc. But even so I was probably at high risk and almost expecting the virus to sneak through in these circumstances.

But . . . like any diver, I am paranoid about catching the common cold (which I gather is caused by a virus which acts in a similar way to the one causing Covid-19). So I take Echinacea and cod liver oil capsules daily.

I understand why the medical profession has never been convinced as to the effectiveness of Echinacea, due to poor evidence. Normally, I'm not at all a fan of herbal "remedies". But I was told about it maybe 20 years ago and, rather sceptically, I tried it. Beforehand I would typically catch 2 or even 3 colds a year. After starting to use Echinacea my cold frequency went down to one every 12 - 18 months.

This is of course meaningless, from an epidemiological perspective. But there's on old saying "What works, works."

Also, there has been talk since March last year about the possible role of Vitamin D in maybe giving at least some protection against coronavirus.

My question is, do you think cod liver oil (Vitamin D) use, or daily Echinacea, might have helped give some protection? I'm finding it hard to believe I've not gone down with Covid-19, so far.

(I understand that this may be an impossible question to answer, simply due to lack of data.)

[Speleofish]

Some difficult questions here...

Regarding the probability of getting Covid over the summer, there are many reasons for possibly being protected from clinical disease.

1. Last summer, there was very little covid about. The prevalence in the community at the end of April 2020 was approx 0.4% (4/1000). This fell to 0.06% by the end of June before rising again during August. At the end of August it reached approx 1% (data from the Lancet, but I've lost the reference). There was some variation between the south and north of England but even in the northeast the numbers were probably only about twice those in the south. Therefore, there was a period when the likelihood of encountering Covid was low and, even without taking extreme precautions, you would be unlucky to catch it unless you were in a particularly high risk situation (multiple people in confined spaces with poor ventilation).

2. Warm weather during the summer encouraged people to open windows and thus improve ventilation. During the original SARS outbreak, the number of air changes per hour were important in protecting health workers from infection. The sweet spot was more than 16 exchanges/hour. Low numbers of changes were strongly associated with transmission. There's not much evidence for Covid (yet) but it would seem sensible to assume the same is true.

3. High levels of UV light inactivate the virus on exposed surfaces relatively quickly.

4. Taking even simple precautions (and avoiding very high-risk situations) will significantly protect you.

5. Many people have had Covid without knowing it.

6. Maybe Echinacea does work!

As far as Vitamin D and Echinacea are concerned, there's reasonable evidence that genuine vitamin D deficiency has all sorts of effects, including a worse response to infection. There's no good evidence that supplementing vitamin D in people with normal levels has any real value. Measuring vitamin D levels should only be done in healthy people. Blood levels fall in very sick people, even if they have no pre-existing deficiency. There is no convincing evidence that supplementing these people has benefit.

Echinacea is more complex. It's derived from a number of different species of coneflower so it's not a standard preparation (though any one manufacturer probably makes a consistent product). There have been several meta-analyses showing no or minimal benefit in a variety of respiratory conditions though there is a suggestion that it may reduce the duration and frequency of symptoms (which is what you describe). None of the studies suggest it is harmful. Meta-analyses cannot exclude the possibility that a proportion of the population experience a moderate benefit (someone else on the forum will be able to explain the statistics better than I can). In general, my advice would be that if something 'harmless' works for you, keep going. It may be a real effect, it may be a placebo effect - the important thing is that it makes you feel better. Only one caveat - echinacea does interact with some prescription drugs, the most important of which is probably amiodarone.

[Speleofish]

A seventh reason for you not getting Covid may have been good luck...