Omicron variant and the measures implemented in response to it

[Eyersey468]

Although strictly speaking, even that wouldn't as it now exists in various animal populations.

Fair point I should have been more specific, if everyone starved to death it would stop the spread in humans. I agree with @nw1 that zero Covid is fantasist nonsense.

 

[kristiang85]

Thanks for the clarification. My observation, given my reading your views on how Covid has been handled, was that (rightly) upping the priority given to TB would have unwelcome side effects.

How can increased research and funding in cheaper and more accessible diagnosis for the poor have unwelcome side effects? I'm not advocating COVID-style NPIs to deal with TB; my point was that we never used them for TB, which is more serious, so we certainly shouldn't be using them for COVID. However, the emphasis on COVID has set back progress in reducing the global TB burden by a decade or more.

TB is actually pretty easy to treat; it is the diagnosis that is the problem (and the BCG vaccine is woeful in comparison to modern equivalents for other illnesses). Also the long term consequences of surviving TB make so-called "long COVID" seem like a walk in the park (you are much more at risk of long-term damage from TB than you are from COVID). As it is a disease of the developing world, most survivors are just left to rot with the catestrophic cost consequences.

 

[35B]

How can increased research and funding in cheaper and more accessible diagnosis for the poor have unwelcome side effects? I'm not advocating COVID-style NPIs to deal with TB; my point was that we never used them for TB, which is more serious, so we certainly shouldn't be using them for COVID. However, the emphasis on COVID has set back progress in reducing the global TB burden by a decade or more.

TB is actually pretty easy to treat; it is the diagnosis that is the problem (and the BCG vaccine is woeful in comparison to modern equivalents for other illnesses). Also the long term consequences of surviving TB make so-called "long COVID" seem like a walk in the park (you are much more at risk of long-term damage from TB than you are from COVID). As it is a disease of the developing world, most survivors are just left to rot with the catestrophic cost consequences.

My point was that the results might be the NPIs, not the investment in research and diagnosis.

 

[kristiang85]

My point was that the results might be the NPIs, not the investment in research and diagnosis.

No academic or policy maker I know would seriously advocate that for TB.

Much of the blame for the invasive NPIs on our lives regarding COVID lies with social media whipping up the frenzy and forcing governments' hands (a kind of mass hysteria reaction to it all). TB doesn't hold that kind of fear in the 'West' as it is almost invisible, and in the developing world they have been living with it for so long, nobody would suddenly want a different (and ineffective) way of dealing with it.

 

[nw1]

Although strictly speaking, even that wouldn't as it now exists in various animal populations.

Depends which type of animal I guess. If insects can spread it, then yes, no chance at all

Starmer has tested positive again and is isolating for what must be the 1000th time now or something:

Sir Keir Starmer tests positive for Covid for a second time

Labour's leader misses Prime Minister's Questions, with deputy Angela Rayner filling in for him.

www.bbc.co.uk

So has he got it twice (which would be very unlucky just 3 months later I suspect) or is this a false positive from his previous infection, I wonder? I guess if he tests very often, the latter is quite likely.

 

[Simon11]

So has he got it twice (which would be very unlucky just 3 months later I suspect) or is this a false positive from his previous infection, I wonder? I guess if he tests very often, the latter is quite likely.

Hopefully it will knock some sense into him and he get realizes that a lot of people who are isolating are actually fine and may not be infectious in the first place!

 

[bramling]

Hopefully it will knock some sense into him and he get realizes that a lot of people who are isolating are actually fine and may not be infectious in the first place!

So the latest thing being reported in the media is asymptomatic people who test positive on a LFT won't have to take a PCR.

If this is correct, expect the staff shortages to get worse if such people still have to isolate. Total free reign for people so inclined to take a week off work whenever they want.

 

[MikeWM]

So the latest thing being reported in the media is asymptomatic people who test positive on a LFT won't have to take a PCR.

If this is correct, expect the staff shortages to get worse if such people still have to isolate. Total free reign for people so inclined to take a week off work whenever they want.

Well, yes. Maybe I've missed the point, but I can't work out how this is supposed to improve the current outbreak of staff shortages.

 

[bramling]

Well, yes. Maybe I've missed the point, but I can't work out how this is supposed to improve the current outbreak of staff shortages.

I see it having the opposite effect, especially with LFTs being handed out like confetti.

The only saving grace may be that fewer people are inclined to want bonus time off in January.

I'm not sure what planet this govt are on, but it's not this one, that's for sure.

 

[WelshBluebird]

but I can't work out how this is supposed to improve the current outbreak of staff shortages.

At the moment if you test positive on an LFT without symptoms your 7 day isolation doesn't start until you get the following positive PCR test. With PCR tests being hard to get at the moment that adds at least a day onto peoples isolation, and in reality potentially 2 or 3 days given how long it can take to book one and get the results back. As such some people are isolating for say 10 days when it could be say 7 days.
With the change, their isolation starts right away and so no waiting around for a PCR test to start the clock which in theory means anyone testing positive without symptoms isolates for less time than what they currently have to.
Sounds like I was wrong so apologies! Not really sure of the reason for the change then, apart from maybe "protecting" PCR test slots for those with symptoms instead!

especially with LFTs being handed out like confetti.

I can only assume you haven't tried to get any recently then, because it is a lot harder than what it was!
I think it isn't too bad right now, but certainly over the last few weeks getting some online has basically been impossible unless you were lucky enough to jump on at the exact time they refreshed the availability and most pharmacies near my are all out.
It has got to the point in some places where the "test negative on an LFT on day 6 and 7" part of self isolation to be released early" is actually impossible due to the lack of tests available.

 

[kristiang85]

So the latest thing being reported in the media is asymptomatic people who test positive on a LFT won't have to take a PCR.

If this is correct, expect the staff shortages to get worse if such people still have to isolate. Total free reign for people so inclined to take a week off work whenever they want.

Kier Starmer is already doing that

 

[MikeWM]

At the moment if you test positive on an LFT without symptoms your 7 day isolation doesn't start until you get the following positive PCR test. With PCR tests being hard to get at the moment that adds at least a day onto peoples isolation, and in reality potentially 2 or 3 days given how long it can take to book one and get the results back. As such some people are isolating for say 10 days when it could be say 7 days.
With the change, their isolation starts right away and so no waiting around for a PCR test to start the clock which in theory means anyone testing positive without symptoms isolates for less time than what they currently have to.

Ah, thanks for that - I've not delved too deeply into the intricacies of what happens if you do a LFT and it is positive and you report it. That does seem silly.

However, while I'm certainly not advocating more testing, it does seem that a better fix to that problem would be to just start the clock at the time you did the positive LFT, whenever you finally get the PCR?

 

[danm14]

At the moment if you test positive on an LFT without symptoms your 7 day isolation doesn't start until you get the following positive PCR test.

It doesn't.

[Withdrawn] [Withdrawn] Stay at home: guidance for households with possible or confirmed coronavirus (COVID-19) infection

www.gov.uk

"Your isolation period starts immediately from when your symptoms started, or, if you do not have any symptoms, from when your positive LFD or PCR test was taken, whichever test was taken first."

 

[greyman42]

Also, another question: how does Omicron compare with the 1958 and 1968 flu outbreaks in terms of death and serious illness rate? Again, I don't know the answer to this - just posing it.

Did we not have a large flu outbreak in 2015 and nobody blinked an eye?

 

[WelshBluebird]

It doesn't.

[Withdrawn] [Withdrawn] Stay at home: guidance for households with possible or confirmed coronavirus (COVID-19) infection

www.gov.uk

Fair enough then ignore what I said!
Does make the change a bit pointless then!
Wonder in that case if the change is more to do with protecting PCR test slots for symptomatic cases?

 

[greyman42]

Bad though the Tories are, at least they were human enough to allow us out for exercise once a day. Imagine how even more miserable that first lockdown would have been (with the nice weather as well) if we hadn't been even able to go for local walks of around an hour.

I don't think in reality we were only allowed 1 hour once a day. I went out for as long and as many times as i wanted.

 

[35B]

No academic or policy maker I know would seriously advocate that for TB.

Much of the blame for the invasive NPIs on our lives regarding COVID lies with social media whipping up the frenzy and forcing governments' hands (a kind of mass hysteria reaction to it all). TB doesn't hold that kind of fear in the 'West' as it is almost invisible, and in the developing world they have been living with it for so long, nobody would suddenly want a different (and ineffective) way of dealing with it.

Judging by much feedback, that might have been expected to be said for Covid. Fear is a strange thing, and if the political pressure to deal with TB were enough to persuade governments to take action, I'd put a small bet on fear being involved. At which point, my earlier observation applies - beware what you ask for. Because if you get it, you may not get it in the form you hoped for.

 

[MikeWM]

Did we not have a large flu outbreak in 2015 and nobody blinked an eye?

There was a fairly major one over the 'millennium' too, this is from January 6 2000 and pretty much could have been written today. I don't however remember the country shutting down and actually I remember a massive party taking place at some dome or other, with everyone holding hands and stuff.

http://news.bbc.co.uk/onthisday/hi/dates/stories/january/6/newsid_2477000/2477943.stm

In Liverpool hospitals have cancelled all non-emergency surgery to try and cope with a shortage of beds.

Some patients have had to stay overnight on trolleys while they wait for treatment.

In London all the capital's 275 intensive-care beds are full.

Health experts also say that the outbreak has been made worse by the fact that vulnerable people such as the elderly have not been vaccinated.

 

[BRX]

There have been 437 cases of Omicron so far in the UK, and so far not one of them has ended up in hospital.

If there is a hopsitalisation rate of less than 1 in 500 cases, then the numbers ending up in hospital will be well within the capacity of the NHS to cope, especially if milder disease leads to a shorter stay in hospital.

Let's say there are currently 437 cases (there will be more in reality), the doubling rate is 3 days and there's a hospitalisation rate of 1 in 500.

Day 0: 437 cases
Day 3: 874
Day 6: 1,748
Day 9: 3,496
Day 12: 6,992
Day 15: 13,984
Day 18: 27,968
Day 21: 55,936
Day 24: 111,872
Day 27: 223,744
Day 30: 447,488
Day 33: 894,976
Day 36: 1,789,952
Day 37: 3,579,904
Day 40: 7,159,808

7,159,808 / 500 = 14,319 hospitalisations per day. So after a bit more than a month you are already at nearly 4 times the number of people being admitted to hospital as was the case at the peak of the last wave. But that was the peak of a wave during lockdown restrictions, and we are looking at this scenario as if there are no restrictions, so we can't be confident about when it's going to peak. It could peak any time up until nearly everyone in the country had been infected. If day 40 isn't the peak, then on day 43 we will be looking at more people having been admitted to hospital in the past three days than was the peak occupancy last time round.

I'm not saying this is going to happen - I am just illustrating how the numbers work.

Thought I'd just drop in to quote myself from the 8th of December. To be precise, 28 days ago.

What I'd posted there was just illustrative of what could happen with a doubling rate of 3 days (which was a conservative consensus estimate at the time) and then the number of hospitalisations that might result if 1 in 500 cases led to hospitalisation. Wasn't intended as a prediction.

Anyway, ONS have just published estimates that last week 1 in 15 people in England had Covid. That means about 3.7 million people. A bit can be added to that for Wales and Scotland, but I'd like to point out that this is above my "day 37" number even though last week was only about day 23 relative to Dec 8th.

After I posted that, there was a lot of scepticism that numbers would get anywhere near this. Of course, it looks (hopefully) like hospitalisation rates for Omicron are relatively low, but if they had been not much higher, we'd already be having a very big problem right now. In fact we *are* having a bit of a problem right now, with some people unable to access ambulances in places, just not a visibly catastrophic situation and I hope that continues.

There were also some comments about how this would extrapolate to the whole population being infected by day 60 or so (something I never suggested would happen). However we do now have some idea where things might peak, because it looks like London peaked a week or two ago, and the ONS estimates are that 1 in 10 Londoners had Covid last week. If we extrapolate that 10% to the entire UK, then we are looking at a peak of 6 or 7 million people with covid. That is unlikely to happen because peaks are happening at different times across the country ... but nonetheless, hospital pressure is driven by the case rate locally, and it seems plausible that in places we'll see 10% of the population with Covid at any one time.

Just sayin'! Seeing as when I posted that, there were questions about whether I'd come back and admit I was "wrong" when numbers failed to get anywhere near the ones I presented (they weren't supposed to be a prediction anyway).

 

[Aaron1]

With 1 in 15 people expected to have had Covid in the week after Christmas surely that means we must be very close to the peak of the Omicron wave, and within a few weeks (surely by Feb) that cases will begin to fall quite quickly?

 

[Towers]

....

In fact we *are* having a bit of a problem right now, with some people unable to access ambulances in places, just not a visibly catastrophic situation and I hope that continues.

In fairness, and in the interests of balance, the NHS has been having 'a bit of a problem' in that direction for years. A lack of ambulances, a lack of beds and a general lack of any ability to cope, have been hallmarks of the modern NHS for years. Whilst, in some areas, Covid will clearly be making things worse, it would be wrong to take something like a lack of ambulance coverage and suggest that it is directly due to the pandemic. My elderly Grandmother waited in excess of 12 hours for one having fallen at home, several years ago, and that is hardly an unusual story, sadly.

 

[yorksrob]

Thought I'd just drop in to quote myself from the 8th of December. To be precise, 28 days ago.

What I'd posted there was just illustrative of what could happen with a doubling rate of 3 days (which was a conservative consensus estimate at the time) and then the number of hospitalisations that might result if 1 in 500 cases led to hospitalisation. Wasn't intended as a prediction.

Anyway, ONS have just published estimates that last week 1 in 15 people in England had Covid. That means about 3.7 million people. A bit can be added to that for Wales and Scotland, but I'd like to point out that this is above my "day 37" number even though last week was only about day 23 relative to Dec 8th.

After I posted that, there was a lot of scepticism that numbers would get anywhere near this. Of course, it looks (hopefully) like hospitalisation rates for Omicron are relatively low, but if they had been not much higher, we'd already be having a very big problem right now. In fact we *are* having a bit of a problem right now, with some people unable to access ambulances in places, just not a visibly catastrophic situation and I hope that continues.

There were also some comments about how this would extrapolate to the whole population being infected by day 60 or so (something I never suggested would happen). However we do now have some idea where things might peak, because it looks like London peaked a week or two ago, and the ONS estimates are that 1 in 10 Londoners had Covid last week. If we extrapolate that 10% to the entire UK, then we are looking at a peak of 6 or 7 million people with covid. That is unlikely to happen because peaks are happening at different times across the country ... but nonetheless, hospital pressure is driven by the case rate locally, and it seems plausible that in places we'll see 10% of the population with Covid at any one time.

Just sayin'! Seeing as when I posted that, there were questions about whether I'd come back and admit I was "wrong" when numbers failed to get anywhere near the ones I presented (they weren't supposed to be a prediction anyway).

It's worth noting that according to the BBC, the number of people in hospital (I'm presuming with covid, although the graph doesn't specify) increased by 1003 yesterday: https://www.bbc.co.uk/news/uk-51768274

So while according to ONS there are a lot more people with COVID than your post predicted, by your modelling the numbers in hospital were projected to be increasing by over 7000 a day at this stage.

 

[BRX]

It's worth noting that according to the BBC, the number of people in hospital (I'm presuming with covid, although the graph doesn't specify) increased by 1003 yesterday: https://www.bbc.co.uk/news/uk-51768274

So while according to ONS there are a lot more people with COVID than your post predicted, by your modelling the numbers in hospital were projected to be increasing by over 7000 a day at this stage.

Please read my post - I explained twice that it was not a prediction but an illustration, and it was taking an example hospitalisation rate suggested by another poster (1 in 500, which they said would not cause problems). And as i said, it looks like we have been lucky with the hospitalisation rate of Omicron but had it been 1 in 500, there would be a very big problem right now.

With 1 in 15 people expected to have had Covid in the week after Christmas surely that means we must be very close to the peak of the Omicron wave, and within a few weeks (surely by Feb) that cases will begin to fall quite quickly?

Yes, it looks like this is probably the case.

Just have to hope that hospitalisation numbers don't start to look worse when it reaches older age groups (in London the case rates still seem to be climbing in over 60s even though they appear to have peaked in the lower age groups).

 

[yorksrob]

Please read my post - I explained twice that it was not a prediction but an illustration, and it was taking an example hospitalisation rate suggested by another poster (1 in 500, which they said would not cause problems). And as i said, it looks like we have been lucky with the hospitalisation rate of Omicron but had it been 1 in 500, there would be a very big problem right now.


Yes, it looks like this is probably the case.

Just have to hope that hospitalisation numbers don't start to look worse when it reaches older age groups (in London the case rates still seem to be climbing in over 60s even though they appear to have peaked in the lower age groups).

Well, it looks as though events have overtaken both yourself and the poster you quoted in that case.

 

[nw1]

There was a fairly major one over the 'millennium' too, this is from January 6 2000 and pretty much could have been written today. I don't however remember the country shutting down and actually I remember a massive party taking place at some dome or other, with everyone holding hands and stuff.

http://news.bbc.co.uk/onthisday/hi/dates/stories/january/6/newsid_2477000/2477943.stm

Don't I know it. Easily the most ill from a viral illness I have been since reaching adulthood. Christmas 1999 was the Christmas of the flu, but thankfully I'd shaken it off by the end of the year.

 

[BRX]

Well, it looks as though events have overtaken both yourself and the poster you quoted in that case.

Which is what I would have expected - at that point in time it was impossible for anyone to predict with certainty what was going to happen.

That's why I was rather concerned to see people on these forums, at that point, stating with absolute confidence that the numbers would never get anywhere near the ones I was presenting.

What we did know at that point in time was that Omicron had the ability to spread very fast. In fact it can spread even faster than what I posted.

What we didn't really know was where it would peak, or what proportion of cases would translate into severe illness. And the fact is, that if the hospitalisation rate were a bit higher than it looks like it is, we would now have very large numbers of people in hospital, because the speed of spread and the apparent level of peak have already been shown to be capable of producing millions of infections concurrently.

That's why some people think that not attempting to put in place any meaningful restrictions a month ago was a reckless gamble. The fact that it looks like we have probably got away with that gamble doesn't mean it wasn't a risky one.

 

[yorksrob]

Which is what I would have expected - at that point in time it was impossible for anyone to predict with certainty what was going to happen.

That's why I was rather concerned to see people on these forums, at that point, stating with absolute confidence that the numbers would never get anywhere near the ones I was presenting.

What we did know at that point in time was that Omicron had the ability to spread very fast. In fact it can spread even faster than what I posted.

What we didn't really know was where it would peak, or what proportion of cases would translate into severe illness. And the fact is, that if the hospitalisation rate were a bit higher than it looks like it is, we would now have very large numbers of people in hospital, because the speed of spread and the apparent level of peak have already been shown to be capable of producing millions of infections concurrently.

That's why some people think that not attempting to put in place any meaningful restrictions a month ago was a reckless gamble. The fact that it looks like we have probably got away with that gamble doesn't mean it wasn't a risky one.

Well, I would say (as many of us did at the time) that going by the evidence from South Africa, it wasn't that much of a gamble at all.

 

[greyman42]

That's why some people think that not attempting to put in place any meaningful restrictions a month ago was a reckless gamble. The fact that it looks like we have probably got away with that gamble doesn't mean it wasn't a risky one.

So are you saying that we should of had more restrictions?

 

[BRX]

Well, I would say (as many of us did at the time) that going by the evidence from South Africa, it wasn't that much of a gamble at all.

That's easy to say with hindsight, because the evidence from SA was very preliminary at that point, and there was a fairly wide scope of plausible interpretation. We were lucky that the severity component seems to have matched the more optimistic interpretations. It's worth noting that the evidence from SA at that point led to what turned out to be an under-estimate of the speed of spread in the UK though.

 

[yorksrob]

That's easy to say with hindsight, because the evidence from SA was very preliminary at that point, and there was a fairly wide scope of plausible interpretation. We were lucky that the severity component seems to have matched the more optimistic interpretations. It's worth noting that the evidence from SA at that point led to what turned out to be an under-estimate of the speed of spread in the UK though.

Maybe, but you'd have had to have believed that the virus would somehow be a lot more deadly in a much more highly vaccinated population. Even taking account of our older, larger demographic, that always struck me as being somewhat unlikely.