Covid-19

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Originally Posted by pineapple stu

It's the slope back up again that I'm more worried about.

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A 2nd peak or 2nd wave?

We don't know what will happen afterwards should this situation be managed well and the contagion threat peters out, but you'd have to think that some important lessons to protect the elder citizens will have been learned even if the economy turn to (Pol) pot.

Here's a 'you never would have thought would happen'
if you do a web search on smoking and corona infection risk, the bells ring all over the WWW warning of the high susceptability of smokers , what horrible fate they are or will suffer etc.etc. In France some investigation shows that smokers "are less likely to catch the disease." Now they want to do tests with prescribing nicotine patches.

There's also some numbers that suggest that infected smokers have a higher mortality rate

Well it does attack the lungs. Stands to reason smokers would be harder hit

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Originally Posted by geysir

A 2nd peak or 2nd wave

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A second peak particularly.

We went from 2 to 17000 cases in six weeks.

It's almost impossible to get to a situation with no cases again given some people are asympyomatic.

So if things go back to normal - with football and holidays and stuff - then there's no reason cases wouldn't rise every bit as quickly

Can I ask what people think about vaccines on this subject?
I understand that some will be completely pro- and anti-vaccination in general and the arguments for both.
I am vaccinated, and get the flu-jab every year due to an underlying condition. kids all have had the mmr and bcg's and what-not.

But if a vaccine is offered for covid-19, I have to be honest, I'd think twice. I'd much prefer to continue practising self-isolation, e-working etc, than getting a vaccine that couldn't have been put to the same sort of testing standards that other vaccine's would have subjected to (over a period of time).
That said, I do believe in listening to medical advice, but I'd be interested to hear opinions from those a bit more clued in than me.

Just as an aside, here in Brussels, there does feel like the foot is off the pedal somewhat. More cars on the streets. more clusters of people in the evening time. Even a leaked suggestion of the relaxing measures which annoyed a lot of people (assumed it was leaked by those against the prospects), while it seems that there is a bit more complacency too in Ireland listening to some friends from home?

After the Swine flu vaccine was rushed through and the subsequent narcolepsy links I'd certainly have some worries about being in the first wave to receive a new vaccine. I'm fully pro vaccine too, although I haven't had a flu one of any kind yet.

Seems to be a little bit of complacency but not too much, definitely a lot more anecdotal reports about more traffic, and I get the impression more people are doing little visits to family etc. that wouldn't have been considered a week or two ago. Met two groups of lads yesterday, clearly heading for a game of ball, while out for a walk.

I though RTE’s report about increased seismic activity this week due to more people on the streets was hilarious , using seismic activity as evidence is a new one in Ireland.

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Originally Posted by tetsujin1979

There's also some numbers that suggest that infected smokers have a higher mortality rate

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And just to really feck with you, French researchers are theorising that nicotine could reduce risk. Fun times!

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Originally Posted by tetsujin1979

There's also some numbers that suggest that infected smokers have a higher mortality rate

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I doubt if there is anyone arguing against that there is a higher mortality rate of smokers who do get infected and develop symptoms.
The French experience was that in proportion, fewer smokers get infected in the first place, therefore fewer get to the serious stage, therefore their experiment with the nicotine patch.
Perhaps it's just the repellent aroma of Gitanes and Gauloises that has the hitherto unknown virus repellent effect.

I heard a report from a HSE homeless spokesperson (bias alert) on radio this morning, nevertheless it was very positive report on the pro active policy of HSE in assisting the needs of the homeless. Not one has died yet, despite (his words) a homeless person is likely to be 10 years older, many with preexisting conditions and obviously living in poor unhygienic conditions.

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Originally Posted by pineapple stu

A second peak particularly.

We went from 2 to 17000 cases in six weeks.

It's almost impossible to get to a situation with no cases again given some people are asympyomatic.

So if things go back to normal - with football and holidays and stuff - then there's no reason cases wouldn't rise every bit as quickly

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There are reasons, a rational process a country can follow to manage a return to a stable form of "normalcy".
The virus tests reveal confirmed cases which also happen to be asymptomatic.
It stands to reason that after existing cases have recovered and tests show there are no new cases, that also means there should be no new asymptomatic cases.
And in a transition period from a level 3 lock down to a level 2 lock down, any hidden asymptomatic cases would have revealed themselves should they be troublesome.

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Originally Posted by geysir

It stands to reason that after existing cases have recovered and tests show there are no new cases, that also means there should be no new asymptomatic cases.

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How do you show there are no cases? The only way is to test everyone, and then test every single person entering the country. That's not practical, even for a small country like Iceland.

"Any hidden asymptomatic cases would have revealed themselves" is a sentence which contradicts itself. Do you think the virus will jump up and say "Hello" like a kid who's won at hide-and-seek? The only way it would reveal itself is indirectly, by making someone else symptomatic, and then you're back to square one.

I don't see anything in your post to cause me to share your optimism I'm afraid.

South Korea kept a lid on this for a while with aggressive contact tracing and testing. It only really got out of hand when that cultist spread it to hundreds of people. They might be able to keep it bubbling under for a while - at least stretch the gaps between lockdowns - that way.

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Originally Posted by geysir

I doubt if there is anyone arguing against that there is a higher mortality rate of smokers who do get infected and develop symptoms.
The French experience was that in proportion, fewer smokers get infected in the first place, therefore fewer get to the serious stage, therefore their experiment with the nicotine patch.
Perhaps it's just the repellent aroma of Gitanes and Gauloises that has the hitherto unknown virus repellent effect.

I heard a report from a HSE homeless spokesperson (bias alert) on radio this morning, nevertheless it was very positive report on the pro active policy of HSE in assisting the needs of the homeless. Not one has died yet, despite (his words) a homeless person is likely to be 10 years older, many with preexisting conditions and obviously living in poor unhygienic conditions.

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I think the most likely thing is that there is a far greater proportion of smokers in rural communities, and the virus is obviously going to spread a lot more slowly in places with lower population density (potentially another reason why Ireland has done okay compared to some of our European neighbours)

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Originally Posted by pineapple stu

How do you show there are no cases? The only way is to test everyone, and then test every single person entering the country. That's not practical, even for a small country like Iceland.

"Any hidden asymptomatic cases would have revealed themselves" is a sentence which contradicts itself. Do you think the virus will jump up and say "Hello" like a kid who's won at hide-and-seek? The only way it would reveal itself is indirectly, by making someone else symptomatic, and then you're back to square one.

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I mentioned testing. It is by way of testing in that 4 week transition period that any viral activity is revealed, thousands of tests carried out even though there are no new cases, that's how any medical authorities can decide to very confident level whether the virus is still an active threat or not.

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I don't see anything in your post to cause me to share your optimism I'm afraid.

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I am not necessarily optimistic, I am stating the the case for a recovery of sorts as I understand how the process can happen.
There is another type of optimism, a foolish optimism, believing that a magic bullet an effective vaccine will appear (against all odds) and be the solution, there are people who claim nothing can proceed in society until the vaccine appears. To me that's defeatist and irrational. Irrational in the sense that enormous efforts have already failed to discover an effective vaccine for this type of virus and defeatist in that nothing of substance can be achieved with old fashioned manual labour.

Today I listened to a podcast with Prof Paddy Mallon. I came back to this tread to give you the link as he explains the practicalities of how Ireland can recover to some decent functioning level.
episode 705 where Dunphy talks to Prof Paddy Mallon,

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Originally Posted by peadar1987

I think the most likely thing is that there is a far greater proportion of smokers in rural communities, and the virus is obviously going to spread a lot more slowly in places with lower population density (potentially another reason why Ireland has done okay compared to some of our European neighbours)

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Most probably there is some other reason to explain the lower rate of smokers being affected by the virus than their nicotine levels.
Nevertheless, I'm a little curious to read about the results of the nicotine patch trial. I would be more curious if it was some other substance, like pure extract of organically grown cannabis leaf (high potency without the down side) grown in the clean atmosphere of the Andes or the Himalayas.

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Originally Posted by geysir

I mentioned testing. It is by way of testing in that 4 week transition period that any viral activity is revealed, thousands of tests carried out even though there are no new cases, that's how any medical authorities can decide to very confident level whether the virus is still an active threat or not.

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The reality is that that can't be practical though. Iceland has done more testing than anywhere else in the world per capita, but it's still only tested 13.5% of the population. 86.5% haven't been tested. Yes, you can conduct thousands of random tests per day, but it only takes a couple of people to be missed and the thing will start to creep up again, at least to the stage where some restrictions are required. And that's ignoring foreign visitors, and delays between testing and results of course.

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Originally Posted by geysir

There is another type of optimism, a foolish optimism, believing that a magic bullet an effective vaccine will appear (against all odds) and be the solution

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I don't understand this logic. Why would it be "against all odds" that a vaccine (or a cure - which is different, but would have the same ultimate outcome, so I'll group them here) be found? We have found vaccines/cures for lots of things, and there's probably more focus on a vaccine for this than there has been for any other illness in history. It will take time of course, but it will hardly be "against all odds" if/when it's found.

Testing appears to be very important, but it seems impossible to test to the stage where the infection level is nil, and that's what would be required. Continual testing without a vaccine is pretty much an impossible win. The two together is what's going to turn the tide on this, as far as I can see.

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Originally Posted by pineapple stu

The reality is that that can't be practical though. Iceland has done more testing than anywhere else in the world per capita, but it's still only tested 13.5% of the population. 86.5% haven't been tested. Yes, you can conduct thousands of random tests per day, but it only takes a couple of people to be missed and the thing will start to creep up again, at least to the stage where some restrictions are required. And that's ignoring foreign visitors, and delays between testing and results of course.

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Listen to the interview with Prof Paddy on the podcast I linked.
Continued testing after the rate of new infections drops to zero would reveal asymptomatic cases and over a 4 week period one would get a fair idea of the amount (if any) of so called hidden cases in the population, any potential troublesome hidden cases would have emerged and become an issue before taking the decision to transition towards a level 2 lock down.

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I don't understand this logic. Why would it be "against all odds" that a vaccine (or a cure - which is different, but would have the same ultimate outcome, so I'll group them here) be found? We have found vaccines/cures for lots of things, and there's probably more focus on a vaccine for this than there has been for any other illness in history. It will take time of course, but it will hardly be "against all odds" if/when it's found.

Testing appears to be very important, but it seems impossible to test to the stage where the infection level is nil, and that's what would be required. Continual testing without a vaccine is pretty much an impossible win. The two together is what's going to turn the tide on this, as far as I can see.

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"against all odds" if/when it's found." IF/ When ?? If an effective vacccine is found then no problem, but I wrote it's against all odds that an effective vaccine will be discovered for this particular type of virus, and become the magic bullet solution to the current serious dilemma. So far, this type of virus had avoided all exhaustive efforts to discover an effective vaccine.

Do you envisage keeping a population in a permanent lock down while gambling for a theoretical effective solution somewhere down the line?
A modern version of Waiting for a Godot? :)
Listen to the podcast I linked, the professor who is deeply involved in vaccine research explains in more detail why keeping a total lock down in the hope for an effective vaccine magic bullet to appear is a long shot gamble. He outlines a way forward that has more practical steps and should an effective vaccine appear after 18 months, then all the better.

The link is timing out.

The reality is that every indication so far is restrictions will continue until a vaccine or cure is found. The CMO is saying it ("it might not be possible to produce a vaccine against this virus, although that's unlikely" - Anthony Staines, Professor of Health Systems at DCU), it's the cornerstone of the WHO's activities, the BBC are noting three ways for this to end, and mass testing to reduce cases to zero isn't one.

The reality is that the rate of new infections isn't going to reach zero any time soon. It hasn't reached zero in China yet for example.

Can we reach - with a lot of testing - a stage where we catch a re-surge in the bud? Maybe - but we're hoping to get up to 100k tests per week, so it would take a year to test the whole country for example. And that's not counting the 10m tourists that visit each year. Is that level of testing enough to keep this thing down? I don't see how it can be. And it surely must assume social distancing - no pubs, no sports events, no festivals, controls on public transport - to keep transmission low. Is that really such a big difference from what we have now?

Can we keep a permanent lockdown? Of course not, and I'm not arguing that. But the reality, given how quickly this all erupted in Ireland in the first place, has to be that a lift of lockdown will sooner or later result in an increase of cases and another lockdown. I think a second wave is inevitable, and talk that this has reached its peak, as you suggest, is wide of the mark. In my opinion of course. But I can't come to the same optimistic conclusion as you have.

John83 posted here a chart from an MIT study which I put in the main forum, and have put here as well. I think it's a very logical possibility.

https://cdn.technologyreview.com/i/i...cw=1245&ch=762

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Originally Posted by pineapple stu

John83 posted here a chart from an MIT study which I put in the main forum, and have put here as well. I think it's a very logical possibility.

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Just to note, the article was on MIT's Technology Review, but I think it was based on work from Imperial College London.

If this on-off pattern for the lockdown is what we'll get in the future (and I also think that's a possibility), I would hope that we learn over time which measures are helpful and which are useless, so that they can be adjusted based on what we learn,which would hopefully lessen the negative impacts on economy and society.

A friend of mine's mum died of it this morning.

She wasn't terrible old, but suffered from pretty severe CPOD. Pretty heavy smoker in years gone by apparently, but for all that it wasn't her time yet.

She had moved in with my friend and they had been isolating since this began, but somehow it got her.

I only found out that she had it last night so it's all been a bit of a shock. Obviously all the usual stuff of wake and funeral are out of the question so I've no idea what I'm supposed to do now. Every human instinct wants you to go the house to pay respects and offer a sympathetic face, but that exactly what the virus wants us to do.

Powerless to offer even that most modest way. Utterly powerless.

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Originally Posted by backstothewall

Every human instinct wants you to go the house to pay respects and offer a sympathetic face, but that exactly what the virus wants us to do.

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I'm sure your friend will be inundated with texts and calls over the next few days. Make sure to check in with them next week though. I expect it is much tougher for some people when things get quieter again.

Was reading through the new guidelines for pubs to open and reckon they aren’t workable or viable. I’d like the opinion of someone from the bar trade on here. I’d say they won’t allow half to even attempt to reopen and those they do won’t be for long as I can’t see how they can make a profit.

I came across an article from mid March reporting that the deCode Gentic institution in Iceland had discovered 40 different variants of the virus. Allowing for my knowledge in these matters is virus sized, of interest (to me) was that each variant left a fingerprint of sorts allowing easier traceability.

One of the variations was found on 7 people who attended a football match in England (Liverpool v Atletico), the Anfield mutation - perhaps complete with a scouse accent?

Kári Stefánsson, director of DeCode Genetics, said, “We can see how viruses mutate. We have found 40 island-specific virus mutations … We found someone who had a mixture of viruses.”

Stefánsson added, “Some came from Austria. There is another type from people who were infected in Italy. And there is a third type of virus found in people infected in England. Seven people had attended a football match in England.”

Hi everyone, I just thought I'd drop in and revisit my question about why the number of cases is so high in Ireland (still per capita higher than the US, the UK and Italy, and around the same as Spain), although I am hugely relieved to see new cases finally dropping towards a manageable figure. Thanks for all your thoughts on the various factors, but having looked at the numbers in more detail, I would have to point at the "Delay Phase" from March 12-27, when businesses were allowed to stay open and the number of cases went from 70 to 2121 before the "Stay at Home" phase was implemented, which meant that the high figures Ireland has seen became locked in. https://en.wikipedia.org/wiki/COVID-...%80%9327_March

This is how three similarly-sized countries dealt with it:
New Zealand's equivalent of the "Delay phase" lasted two days and they were locked down from when they had 205 confirmed or probable cases. They have been in single-figures for new cases for a couple of weeks now and their total case load stands at 1147
In Croatia, by March 19th, all non-essential services had been shut down - their caseload at this point was 105 - they now have 2200 cases total and are already opening up.
Slovenia, which shares a land border with Italy, had gone into lockdown mode by March 16th when it had 253 cases. It now has 1460.

I believe now that this delay in Ireland was absolutely instrumental in leading to infection rates that are far higher than were necessary and that the rationale behind it by the government, along with possibly the attitude of the general population when it comes to taking threats like this seriously, should be the focus of serious scrutiny in the very near future. Ireland needs to be better prepared, logistically and in attitude, to react to a potential second wave and future pandemics because, unfortunately, both are likely to occur.

I think you should be referring to the "reported cases" in the US and UK in particular in fairness.

Not to say that your other points doesn't have merit, and obviously the nature of things is that pretty much every reported figure is wrong to some extent, but I don't think comparing reported figures here against the US/UK is really comparing like with like.

Partly it’s testing: we’re testing more per capita than a lot of other countries. Three factors may have contributed to our numbers: not cancelling flights from Italy for the rugby, Cheltenham and clusters in nursing homes. Four, when you realise we have the second lowest number of hospital beds per 100,000 of population in the EU (I read a few years ago that we had fewer hospital beds for a then population of c4.6m than in the late ‘80s, with a population of c3.5m).

We won’t know for maybe a year the full effect. But: as PS said you need to look at reported numbers of infections/deaths versus actual, and what is signed on a death cert. The US is a grim joke, the UK is perilously close to disinformation as policy. Mrs Grise (still front line, but so far dodging bullets, though there was one hairy moment…) read somewhere yesterday day the UK’s excess mortality for this period is c.52,000 more than the average of the last five years; their reported deaths from Covid-19 yesterday was c.32,000. That 20k won’t all be Covid-19 – it’s a worry that people with other conditions are not going for treatment, or may not be getting it – but a high percentage will be.



This is from RTE last week on our excess mortality. Might help add context to your figures. Your point on NZ is good, but remember: they don't share a porous land border with a country that doesn't know its ar5e from its elbow and had an ideological (idiotological?) attachment to herd immunity. The others you mention seemed to have acted very decisively and hopefully will reap the benefits long term.

It's very hard to know what's good or bad, right or wrong in so many of these cases. There's so many inconsistencies in the data too, especially when it comes to categorising Covid deaths. NZ stopped it getting in but can they keep it out if there's still no vaccine or cure? How long can they stay locked down enough? Sweden may see a 'benefit' in terms of not being as badly impacted by a second wave, as might other countries who delayed lockdown. In many ways we seem to have managed it well, we had extremely limited capacity in ICU and we reached close to it but didn't get overwhelmed, the community spread in residential care facilities has been the single biggest mistake. Unfortunately, we're probably looking at two years down the line before we can see who got it right or wrong, in terms of mortality and spread and even longer to see the long term impacts on economies, employment, mental health and secondary mortality due to delays in treatment of other illnesses. It's a strange world we're living in. I terms of ongoing management mass testing and a 24 hour turn around appears to be key, with contact tracing within 72 hours.

One of the pluses that might hopefully emerge is much more trust and flexibility from office based employers in terms of working from home and alternative working options. Most places seem to have adapted much better than they ever would have anticipated.

I can see the logic in delaying lockdown as long as possible- especially because as it goes on you can see it starting to slip. It's noticeable there are more groups around, especially younger folks (no doubt the leaving cert cancellation played a part here). Overall compliance has been really good but every time I do the shopping I see more evidence it's not being taken as seriously as it was at the start.

i'm a bit worried about that, when the restrictions are lifted, it'll be like a dam bursting. Where I live, it's been more or less adhered to, but I still see more people on the street some days.
If they're given an inch, will people take a mile?

It's slipped, and it's still slipping. I think that's one of the reasons the government was keen to get that roadmap out, to stay on top of it and basically endorse a loosening of restrictions before people just stop adhering to them.

When the 2k limit was expanded to 5k it just so happened my workplace fell within my circle, so I walked out one afternoon to have a check of the building, going down the Royal Canal into the city centre. I shouldn't have been surprised really, but I was astonished by the amount of people out, especially down near the Dorset Street area. The canal path was actually clogged at points, loads of groups of people drinking, kids swimming in the canal.

Then comparatively me and the GF walked to the Phoenix Park one evening, and I was fairly apprehensive about that, but the place was deserted. Helps that they've barred some entrances of course, but you could have walked for a half-hour in parts and not seen another person. So I guess it all depends? Time of day certainly a factor.

One thing which has started gaining popularity recently is the idea that this may have struck months before we thought it did - Nov/Dec for example. Hearing stories now of people who came down with a really bad dose over the winter and are sure they had coronavirus.

But if that were the case, surely we'd have seen it in terms if ICU spikes, etc? Instead, the modelling from the first known case seems to have come true - exponential increase, followed by gradual reduction on full lock-down.

Anyone more knowledgeable than me able to give any info on that - are people imagining things from earlier? Or is our understanding of the disease based on a March arrival date fundamentally wrong in some way?

I think that's all just baseless speculation, pineapple. Given how infectious it is, if it were here without any distancing measures, we're have been flattened by it. There are all sorts of wild rumours floating around, and that's just one more.

At the time, doctors didn't know what to search for, so any cases from that time were probably misdiagnosed, and the patient told to rest. A pneumonia case in France in December was recently retested and confirmed as coronavirus - https://www.bbc.com/news/world-europe-52526554

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Originally Posted by John83

I think that's all just baseless speculation, pineapple. Given how infectious it is, if it were here without any distancing measures, we're have been flattened by it. There are all sorts of wild rumours floating around, and that's just one more.

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Originally Posted by tetsujin1979

At the time, doctors didn't know what to search for, so any cases from that time were probably misdiagnosed, and the patient told to rest. A pneumonia case in France in December was recently retested and confirmed as coronavirus - https://www.bbc.com/news/world-europe-52526554

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But the question then is how to reconcile these two posts?

If coronavirus arrived in France in December and is as infectious as everyone says it is, why did France's curve take off in a perfectly normal way in March? OK, doctors didn't know what to test for - but why wasn't there a spike in ICU admissions or deaths? The RIP analysis, for example, only shows a spike in April, which correlates with the data we currently have - i.e. it arrived here in March and took off in April.

I can't square these two posts off.

My wife and I came down with an atrocious 'flus' at Christmas (my wife was hospitalized due it exacerbating her asthma), our families are convinced it was Covid but I'm a bit more skeptical because as John83 said surely the country would be in a much worse state than we are currently, but it's probably impossible to know as it would all be based on anecdotal evidence.

Yeah, I remember that flu around Christmas, my wife had a brutal dose, couldn't even get out of bed on new years eve, was close enough to bringing her to A&E, and there was a spike in hospital flu admissions, but I'm fairly sure it was confirmed at the time that it was a know strain of flu, it just happened that it wasn't one of the strains covered by the seasonal vaccine. There may have been a few cases, but as the trends confirm the spike in community transmissions only really started in March.

i got flu around christmas time. but then i also got sick in february, everyone in my apartment did - and it had all the symptoms of covid-19. the tightness in the chest and difficulty breathing was what i found different from anything else. but it was about 1 week (or 2) before there was a confirmed case in ireland. i'd say there's over 50% chance it was covid-19.

i got flu around christmas time. but then i also got sick in february, everyone in my apartment did - and it had all the symptoms of covid-19. the tightness in the chest and difficulty breathing was what i found different from anything else. but it was about 1 week (or 2) before there was a confirmed case in ireland. i'd say there's over 50% chance it was covid-19.

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Originally Posted by pineapple stu

But the question then is how to reconcile these two posts?

If coronavirus arrived in France in December and is as infectious as everyone says it is, why did France's curve take off in a perfectly normal way in March? OK, doctors didn't know what to test for - but why wasn't there a spike in ICU admissions or deaths? The RIP analysis, for example, only shows a spike in April, which correlates with the data we currently have - i.e. it arrived here in March and took off in April.

I can't square these two posts off.

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I think the most likely explanation is a false positive test.