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Coronavirus: The Thread

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Coronavirus: The Thread

Old 18th Oct 2020, 11:04
  #10681 (permalink)  
 
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Originally Posted by D857 View Post
Well the end result of this decision should be fairly obvious to anyone

1. If at all possible do not get tested under any circumstances - just stay at home and feel ill and tell no-one.
2. The resulting testing/positives in the area will go down and the area if applicable can come out of the various stage lock downs.
Job done!

It's just like the Laffer curve is for finance, you increase the tax rate and at some point the amount of tax now collected goes down.
(most recent was the austerity rise in stamp duty by G.Osborne - the result was a reduction in the overall tax take from it not more)
I can add to this.

The partner of my daughters friend was suffering last weekend from a persistent dry cough and sore chest. He was terrified of going for a test because it was positive, he couldn’t work and receive pay as he receives no government support, so he battled on. On Wednesday he woke up struggling to breathe so an ambulance was called. He has had a heat attack and has blood clots on his lung. Because in the delay in diagnosis, his prognosis is now poor.

He is 40 years old.

i suspect this sort of scenario is being played out all over the UK.
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Old 18th Oct 2020, 14:54
  #10682 (permalink)  
 
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Originally Posted by SarcenStone View Post
I can add to this.

The partner of my daughters friend was suffering last weekend from a persistent dry cough and sore chest. He was terrified of going for a test because it was positive, he couldn’t work and receive pay as he receives no government support, so he battled on. On Wednesday he woke up struggling to breathe so an ambulance was called. He has had a heat attack and has blood clots on his lung. Because in the delay in diagnosis, his prognosis is now poor.

He is 40 years old.

i suspect this sort of scenario is being played out all over the UK.

I sincerely hope that he recovers OK.

One important lesson from this, and from Trump's miraculous recovery, seems to be that early diagnosis and treatment makes a significant difference to the outcome, and that delaying diagnosis and treatment could be life-threatening. The government's confusion, lack of clarity in what people need to do, together with the natural fear that many will have that isolation means losing income, seems to be to blame for much of the mess we now seem to be in. Rather than introduce a loans scheme, that seems to have been widely abused, with tens of millions of pounds being paid out to fraudsters, why couldn't the government have just given an income guarantee for anyone told to isolate? It stands to reason that, without this, many are going to feel they have to carry on working, even if they develop symptoms, so not only endangering their own life, but also the lives of others.
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Old 18th Oct 2020, 15:21
  #10683 (permalink)  
 
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There's another issue with the so-called Test and Trace system in the UK. Someone we know got symptoms on a Monday. They’d been to a city on the previous Friday to have lunch in a restaurant with their son. The train was crowded, the city was busy, but the restaurant was not too crowded. They assumed that they’d got the virus sometime on Friday, especially as their son also came down with the virus on Monday. After being tested and getting a positive result, they were contacted by Test and Trace. T&T were only interested in where they’d been on the Saturday and Sunday. T&T told them that those were the days when they were most likely to pass it on, which makes sense, up to a point. However, one might have thought T&T might have been interested in where/when they might have caught it. Also, T&T were not interested in the names and contact details of anyone they’d met, only where they’d been on Saturday and Sunday. The infected person took the trouble themselves to tell everybody they’d met in the last week that they’d tested positive: otherwise, their friends would not know because T&T wouldn't be contacting them. This seems to me to be somewhat short of "World-beating".
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Old 18th Oct 2020, 15:30
  #10684 (permalink)  
 
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Originally Posted by papabravowhiskey View Post
T&T were only interested in where they’d been on the Saturday and Sunday. T&T told them that those were the days when they were most likely to pass it on, which makes sense, up to a point. However, one might have thought T&T might have been interested in where/when they might have caught it
Yes - so called "backward" contact tracing to find out where someone became infected with the virus could really help us tackle the pandemic. As explained here...

https://www.theatlantic.com/health/a...ndemic/616548/

But as you've discovered, UK T&T are not doing backwards contact tracing - only looking for forward contacts.

"World beating"!!!!
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Old 18th Oct 2020, 15:33
  #10685 (permalink)  
 
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Originally Posted by stagger View Post
Yes - so called "backward" contact tracing to find out where someone became infected with the virus could really help us tackle the pandemic. As explained here...

https://www.theatlantic.com/health/a...ndemic/616548/

But as you've discovered, UK T&T are not doing backwards contact tracing - only looking for forward contacts.

"World beating"!!!!
To be fair most counties in the world are doing forward tracing and not back tracing. They both have benefits and the ideal would be to do both but I imagine logistically that might be impractical.
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Old 19th Oct 2020, 13:38
  #10686 (permalink)  
 
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Originally Posted by Peter H View Post
Am I alone in thinking that -- with a false negative rate of ~30% and cases increasing -- this may be a sub-optimal strategy?
Originally Posted by Mr Optimistic View Post
Hi. Is the false negative rate really of the order of 30% ? Didnt know that. Wouldnt that mean you need 3 or more tests to have a degree of confidence? Not sure where such a high level could come from, would 3 consequtive swabs sent to different labs give 3 independent results?
Originally Posted by VP959 View Post
As I understand it, the test itself is very much better than that, and has nothing like a 30% false positive rate, off the top of my head I think it's something like 98% accurate. There can be issues with poor swab technique, particularly with self-administered tests, because the swab needs to be taken from the very back of the nose or throat, something that is a bit uncomfortable. However, if the swab's been used correctly, then from then on the test should be very accurate.
I used a figure I remembered being widely used earlier, but I would like to know a better figure for the end-to-end false negative rates of the swab tests currently in use.

As I understand it this can be influenced by things such as:
When in the infection the sample is taken
What is sampled
The experience and training of the sampler
The skill with which this sample is taken
Avoidance of contamination
Use of any pre-culturing or amplification of the sample
The accuracy of the actual in-vitro testing of the sample

Looking at Interpreting a covid-19 test result https://www.bmj.com/content/bmj/369/bmj.m1808.full.pdf (with my emphasis)

A systematic review of the accuracy of covid-19 tests reported false negative rates of between 2% and 29% (equating to sensitivity of 71-98%), based on negative RT-PCR tests which were positive on repeat testing. The use of repeat RT-PCR testing as gold standard is likely to underestimate the true rate of false negatives, as not all patients in the included studies received repeat testing and those with clinically diagnosed covid-19 were not considered as actually having covid-19.

Accuracy of viral RNA swabs in clinical practice varies depending on the site and quality of sampling. In one study,sensitivity of RT-PCR in 205 patients varied, at 93% forbroncho-alveolar lavage, 72% for sputum, 63% for nasal swabs,and only 32% for throat swabs.7

Accuracy is also likely to vary depending on stage of disease and degree of viral multiplication or clearance. Higher sensitivities are reported depending on which gene targets are used, and whether multiple gene tests are used in combination. Reported accuracies are much higher for in vitro studies, which measure performance of primers


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Old 19th Oct 2020, 15:23
  #10687 (permalink)  
 
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Originally Posted by stagger View Post
But as you've discovered, UK T&T are not doing backwards contact tracing - only looking for forward contacts.
Surely the principal requirement at the present time is to find out why the current measures are not functioning - and you do that by backward contact tracing.
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Old 19th Oct 2020, 15:47
  #10688 (permalink)  
 
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One unemployed graduate made an interesting point about everyone making decisions about the Virus in the UK.
They are all in the public sector with job security, pensions and etc. The vast majority of them do not need to worry about losing their jobs/pensions and so on.

However, the majority of people that their decisions impact are lower paid private sector workers.

I do not know what the solution is, but "risk" must seem different to the different sectors.
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Old 19th Oct 2020, 16:00
  #10689 (permalink)  
 
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Originally Posted by Ancient Observer View Post
One unemployed graduate made an interesting point about everyone making decisions about the Virus in the UK.
They are all in the public sector with job security, pensions and etc. The vast majority of them do not need to worry about losing their jobs/pensions and so on.

However, the majority of people that their decisions impact are lower paid private sector workers.

I do not know what the solution is, but "risk" must seem different to the different sectors.
That graduate is spot on there.
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Old 19th Oct 2020, 16:03
  #10690 (permalink)  
 
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Originally Posted by occasional View Post
Surely the principal requirement at the present time is to find out why the current measures are not functioning - and you do that by backward contact tracing.
Although I haven't seen the maths, that does sound intuitively reasonable. Presumably you would still get significant info if you backtraced only a sample of cases? (Aiming for insight rather than quarantining.)

Again unsure of the maths but if k (dispersion) is high would backward tracing give you more information on the nature of high-spreaders?
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Old 19th Oct 2020, 16:13
  #10691 (permalink)  
 
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Originally Posted by Ancient Observer View Post
One unemployed graduate made an interesting point about everyone making decisions about the Virus in the UK.
They are all in the public sector with job security, pensions and etc. The vast majority of them do not need to worry about losing their jobs/pensions and so on.

However, the majority of people that their decisions impact are lower paid private sector workers.

I do not know what the solution is, but "risk" must seem different to the different sectors.

There's probably a lot of truth in this. It's human nature to put things into a personal frame of reference, even if only subconsciously. How many times have we seen government decisions that have clearly been made from the viewpoint of someone living in London, and take little or no account of those living elsewhere in the UK?

The point about pay and job security certainly applies to those at more senior positions within the public sector, especially those with "grandfather rights", who may not be affected by the changes in things like pensions and job security that have been made over the last decade or so. I would hope that some of the "fast stream" people making some of the decisions would be on the newer terms and conditions, though, and may be a bit better placed to consider some of the issues affecting others.

There was a ludicrous position within the Civil Service years ago, where once someone was promoted to senior principal level (in NATO military rank terms roughly mid-way between OF-5 and OF-6) they joined what was jokingly called the "golden parachute club". This made them virtually unsackable (apart from gross negligence or committing a criminal offence, perhaps). It also gave enhanced early retirement rights, which were stupidly generous. This no longer applies, though; I was one of the last to benefit ten years ago, when I retired, and there can't be many, if any, left in that category now. There are still a fair few around that will have retained the old pension rights, though, but the number of those will be decreasing every year now.

I think many of the more divisive decisions may well have been made by politicians, who now have a great deal more in the way of financial security than pretty much any public sector employee. MPs pensions are probably the most generous, although they were reduced in 2015, along with the Civil Service, so that, like their pension is now based on career average pay, rather than final salary. MPs and ministers do have the benefit of only a fairly short period of qualifying service. Although, like the Civil Service, their pension is now contributory, it bears little resemblance to any normal private sector pension. MPs often seem to gain a leg up into other lucrative private sector posts, too.
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Old 19th Oct 2020, 16:19
  #10692 (permalink)  
 
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Anecdotal example

Originally Posted by Peter H View Post
Although I haven't seen the maths, that does sound intuitively reasonable. Presumably you would still get significant info if you backtraced only a sample of cases? (Aiming for insight rather than quarantining.)

Again unsure of the maths but if k (dispersion) is high would backward tracing give you more information on the nature of high-spreaders?
This is just one example from Ireland:
https://www.irishexaminer.com/news/arid-40067250.html
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Old 19th Oct 2020, 16:33
  #10693 (permalink)  
 
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Originally Posted by occasional View Post
Surely the principal requirement at the present time is to find out why the current measures are not functioning - and you do that by backward contact tracing.
The current measures are working (well they were, but read on) but they stopped working when schools and most importantly universities went back in. Amazingly it doesn’t seem the government figured on this being a problem. Had they made universities online learning only we would still be back at very manageable levels and no need for what we have now and what is most assuredly coming. That was the critical mistake.
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Old 19th Oct 2020, 16:50
  #10694 (permalink)  
 
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I do think that less effort on testing/tracking the young, but with more effort on backward tracking the sources would give us much more info.
Where should I not go to?
Whilst we are not likely to prevent students from getting sozzled and bonking, it is their method of dating, - and causing kerfuffles, - it is baloney to think that we can, telling folk where infections came from would help many folk.
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Old 19th Oct 2020, 17:08
  #10695 (permalink)  
 
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Originally Posted by highflyer40 View Post
The current measures are working (well they were, but read on) but they stopped working when schools and most importantly universities went back in. Amazingly it doesn’t seem the government figured on this being a problem. Had they made universities online learning only we would still be back at very manageable levels and no need for what we have now and what is most assuredly coming. That was the critical mistake.
Absolutely agree with you. Back in August I passed a banner (which is still there) outside the entrance to the University of Nottingham welcoming students back. I couldn't believe what I was reading as the potential consequences were obvious to all but the totally dim. Whilst I accept that some politicians aren't that bright, I did credit universities with a degree (pardon the pun) of common sense.

Sadly I mijudged them.
​​​
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Old 19th Oct 2020, 17:56
  #10696 (permalink)  
 
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I’m puzzled as to why, despite all the hand sanitising, mask wearing and social distancing, there seems to be no shortage of coughs, sniffles and sore throats already doing the rounds. As the common cold is also a coronavirus I would have assumed that the barrier measures in place to defeat Covid would have had more impact on the more minor versions as well.
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Old 19th Oct 2020, 18:00
  #10697 (permalink)  
 
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Originally Posted by highflyer40 View Post
The current measures are working (well they were, but read on) but they stopped working when schools and most importantly universities went back in. Amazingly it doesn’t seem the government figured on this being a problem. Had they made universities online learning only we would still be back at very manageable levels and no need for what we have now and what is most assuredly coming. That was the critical mistake.
So perhaps we need backward tracing just to rub the point home.
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Old 19th Oct 2020, 18:07
  #10698 (permalink)  
 
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ATNotts you sadly underestimated the power of naked greed.....
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Old 19th Oct 2020, 18:11
  #10699 (permalink)  
 
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One of the ways used in China to try and "encourage" what the state sees as good behaviour is to name and shame those who do things that are counter to the state's view of the way people should behave. They do this with billboards, video screens ets, I believe.

Perhaps if we were to adopt backward tracing, and start naming those whose irresponsible actions infected many others, they might just start to realise that they are to blame for making people ill, even, perhaps, causing some to die. At the moment, it seems as if those who are refusing to take this seriously may think that if they get the disease it's of no consequence to anyone other than themselves.
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Old 19th Oct 2020, 18:20
  #10700 (permalink)  
 
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mmm.....that idea is 'after the event'. It's too late.
.
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