Covid-19

[geysir]

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

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.

[tetsujin1979]

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

[pineapple stu]

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

[pineapple stu]

A 2nd peak or 2nd wave

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

[Kingdom]

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?

[passinginterest]

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.

[D24Saint]

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.

[dahamsta]

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

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

[geysir]

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

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.

[geysir]

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

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.

[pineapple stu]

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.

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.

[John83]

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.

[peadar1987]

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.

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)

[geysir]

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 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.

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

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,

[geysir]

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)

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.

[pineapple stu]

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.

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.

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

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.

[geysir]

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.

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.

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.

"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.

[pineapple stu]

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.

[John83]

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.

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

[sidewayspasser]

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.