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Travellers' questions that don't fit anywhere else This is an opportunity to ask any question, and post any notice you wish that doesn't fit into one of the other sections.
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  #16  
Old 28 Mar 2020
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And yet there's always that worrisome little caveat: "... we don’t yet know if recovering from the disease confers any immunity at all, let alone lifelong immunity..."

I have a close friend and professional colleague who believes that things will never be "normal" again--that this is the beginning of an entirely changed world in which all we've ever taken as true will be voided. I'm not so glum as all that, but I'll offer it as a possibility.

Personally, I think there will continue to be a lot of death and suffering but that we'll muddle through eventually. It will leave durable scars and be inarguably traumatizing for some, as has been true for past pandemics, wars, and other large-scale disasters. I'm hopeful that predictions of 6 to 18 months are accurate, but I'm definitely hedging my bets.

Mark
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  #17  
Old 28 Mar 2020
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Yes, a lot of people seem to be pinning their hopes on the fact that once you have COVID-19 once, you can't get it again. Hopefully that will be the case, but I haven't seen much in the way of evidence to back it up.

Since other common viral diseases (the common cold, the flu, etc.) don't confer immunity against future infections, I'm not sure why people seem so confident that this one will?
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  #18  
Old 29 Mar 2020
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The hope of a durable immunity is not totally without support. Many viruses can give you long-term immunity, whether by contracting the disease itself or by vaccination--smallpox, measles, yellow fever, mumps, polio, etc. etc. etc.

It's my understanding that the same goes for the influenza virus except that it mutates readily, and immunity to an earlier mutation doesn't necessarily imply immunity to a more recent one. It's also my understanding that this particular new coronavirus is believed to be far less prone to mutation than the influenza virus. Note that word "believed." If true, long-term immunity would be a reasonable prediction.

Common understanding is that the common cold is caused by at least a couple of hundred different known viruses--including some coronaviruses, many rhinoviruses, and a bunch of others--plus a large number of unknown viruses. You'd have to catch each one before you'd have any chance of lasting immunity to colds.

You can look into all of this yourself if you're interested. I'm no expert, but it's not difficult to learn as much as you can stomach. Our very human tendency to opinionate loudly without adequate supporting information doesn't really serve us very well in times of crisis.

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  #19  
Old 29 Mar 2020
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Originally Posted by markharf View Post
You can look into all of this yourself if you're interested. I'm no expert, but it's not difficult to learn as much as you can stomach. Our very human tendency to opinionate loudly without adequate supporting information doesn't really serve us very well in times of crisis.
hmm, actually I have looked into it, and don't agree with your rather condescending assertion that I'm "opinionating loudly without adequate supporting information" any more than anyone else on this thread.

The fact is that currently there is much that is not yet understood about the coronavirus, including whether or to what extent it confers immunity and the extent to which it is subject to mutation. At this point, any definite assertion on these issues simply can't be considered to have "adequate supporting information," only informed conjectures, at best.
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  #20  
Old 29 Mar 2020
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Not actually aiming that at you, but I see that it appears that way, for which I apologize. I don't know if your internet feeds are as full as mine with unreasoned assertions and scams expressed at high volume, but I'm trying to figure out how to separate myself from a lot of it.

It does seem to me that I offered some answers to your question about why people believe this virus will confer immunity. If you want to call that "informed conjecture," I'm not going to argue. I was merely filling in some information which you didn't state that you knew about; if in fact you knew it all along, but chose not to say so, that's fine--maybe someone else finds it interesting. Or not.

I'll welcome any form of rejoinder if you want, but I think I'll go silent unless I've got something really important to say--an unlikely prospect at best.

Mark

Last edited by markharf; 29 Mar 2020 at 19:49. Reason: insert two missing words for clarity
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  #21  
Old 29 Mar 2020
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Originally Posted by Tim Cullis View Post
<good stuff>
Herd immunity is certainly the long term answer, but the problem is how you acquire it. Vaccination would be the best way, as it generally doesn't kill hundreds of thousands in the same way that allowing the infection to spread through 80% of the population will do. But you're right that this would be hard or impossible to halt altogether. When it first escaped from China the ship had sailed. In that case the key is managing it, so that healthcare providers can cope with the pressure and provide top quality care to all who need it. The horrendous situation in Italy shows what happens when healthcare systems are overwhelmed - intensive care denied to the over-60s in favour of saving younger patients with a better survival prognosis, people dying in the corridors of makeshift hospital tents, etc.

The UK strategy has been deeply suspect from the beginning, starting with a decade of cutting the NHS, 17,000 beds eliminated for "efficiency" and a shortage of 40,000 nurses relative to what it needed. The NHS failed the government's own pandemic preparedness test 3 years ago and the results were hidden from the public they were so bad. More recently the government's strategy was leaked (and denied) as “herd immunity, protect the economy, and if that means some pensioners die, too bad.”. Well, they would deny that wouldn't they.

The UK failed to close schools, pubs, venues etc until a late stage and still runs crowded public transport with many businesses (including building sites) allowed to stay open. This isn't lockdown, this isn't going to slow the spread, the infection rates are already going exponential and that's as a result of infections that were acquired 14 days ago. If that's strategy it smells to me frankly like mass murder.

Returning to the OP, other countries will see what has happened in Italy, Spain, the UK etc, and react strongly at the prospect of such carnage ever happening in their own country. At the moment the picture as I see it for travel is even gloomier than I considered up there.

Not pointing a finger at any particular country but we are already seeing an uptick in xenophobia
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  #22  
Old 29 Mar 2020
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Originally Posted by Tim Cullis View Post
This was written ten or twelve days ago before the recent moves to encourage self-isolation...

The UK government is being criticised for its approach to tackling the pandemic, yet Netherlands is now following the same route. This is an explanation from Prof Ian Donald who is an expert in behavioural factors in anti-microbial resistance and it makes interesting reading...
________________________________________________

The [UK] govt strategy on Coronavirus is more refined than those used in other countries and potentially very effective. But it is also riskier and based on a number of assumptions. They need to be correct, and the measures they introduce need to work when they are supposed to. This all assumes I'm correct in what I think the govt are doing and why. I could be wrong - and wouldn't be surprised. But it looks to me like. . .

A UK starting assumption is that a high number of the population will inevitably get infected whatever is done – up to 80%. As you can’t stop it, so it is best to manage it. There are limited health resources so the aim is to manage the flow of the seriously ill to these. The Italian model the aims to stop infection. The UK wants infection BUT of particular categories of people. The aim of the UK is to have as many lower risk people infected as possible. Immune people cannot infect others; the more there are the lower the risk of infection.

That's herd immunity. Based on this idea, at the moment the govt wants people to get infected, up until hospitals begin to reach capacity. At that they want to reduce, but not stop infection rate. Ideally they balance it so the numbers entering hospital = the number leaving. That balance is the big risk. All the time people are being treated, other mildly ill people are recovering and the population grows a higher percent of immune people who can’t infect. They can also return to work and keep things going normally - and go to the pubs.

The risk is being able to accurately manage infection flow relative to health case resources. Data on infection rates needs to be accurate, the measures they introduce need to work and at the time they want them to and to the degree they want, or the system is overwhelmed.

Schools: Kids generally won’t get very ill, so the govt can use them as a tool to infect others when you want to increase infection. When you need to slow infection, that tap can be turned off – at that point they close the schools. Politically risky for them to say this.

The same for large scale events - stop them when you want to slow infection rates; turn another tap off. This means schools etc are closed for a shorter period and disruption generally is therefore for a shorter period, AND with a growing immune population. This is sustainable. After a while most of the population is immune, the seriously ill have all received treatment and the country is resistant. The more vulnerable are then less at risk. This is the end state the govt is aiming for and could achieve.

BUT a key issue during this process is protection of those for whom the virus is fatal. It's not clear the full measures there are to protect those people. It assumes they can measure infection, that their behavioural expectations are met - people do what they think they will.

The Italian (and others) strategy is to stop as much infection as possible - or all infection. This is appealing, but then what? The restrictions are not sustainable for months. So the will need to be relaxed. But that will lead to re-emergence of infections. Then rates will then start to climb again. So they will have to reintroduce the restrictions each time infection rates rise. That is not a sustainable model and takes much longer to achieve the goal of a largely immune population with low risk of infection of the vulnerable. As the government tries to achieve equilibrium between hospitalisations and infections, more interventions will appear. It's perhaps why there are at the moment few public information films on staying at home. They are treading a tight path, but possibly a sensible one.

This is probably the best strategy, but they should explain it more clearly. It relies on a lot of assumptions, so it would be good to know what they are - especially behavioural. Most encouraging, it's way too clever for Boris Johnson to have had any role in developing.

Things are of course developing - I understand that the Govt are saying the idea of 'herd immunity' isn't part of their policy. It might have been better to call it community resilience. Large gatherings are being stopped and I understand the vulnerable will be quarantined.

The idea of school kids being used to spread the virus is badly expressed earlier in the thread. I don't think the govt are "weaponising" our children, but that at this point given they mild symptoms, infection levels and so on, there is currently no need to close schools.
________________________________________________

So basically, until a vaccine is developed and mass immunisation can be given, the only safe way out of this is mass community resiliance (herd immunity). If you mange to totally suppress the virus by lockdown but don't have either immunisation or herd immunity it WILL start all over again when some 'super spreader' flies in from another country.
I believe the UK is still pursuing the Herd immunity theory/experiment. But it's too toxic to vocalise.
There are some serious risks/flaws. Without testing you don't have reliable data.
Without data you're unable to make the correct decisions.
I'm 58 and have, at times, thought "what the he'll, I'm going to get it. Let's get it over with. Having watched Italy and Spain I'm not in that mind set now!!
I maybe wrong here but Herd immunity is only a proven strategy when used in the context of "how many of the Herd do I need to vaccinate?"
And as a (maybe not) fictitious Government spokesman stated "it's really unfair to expect us to ramp up health care in a few days. It's taken us 12 years to degrade it" :-(
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  #23  
Old 29 Mar 2020
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I believe the UK is still pursuing the Herd immunity theory/experiment. But it's too toxic to vocalise.
There are some serious risks/flaws. Without testing you don't have reliable data.
Without data you're unable to make the correct decisions.
I'm 58 and have, at times, thought "what the he'll, I'm going to get it. Let's get it over with. Having watched Italy and Spain I'm not in that mind set now!!
I maybe wrong here but Herd immunity is only a proven strategy when used in the context of "how many of the Herd do I need to vaccinate?"
And as a (maybe not) fictitious Government spokesman stated "it's really unfair to expect us to ramp up health care in a few days. It's taken us 12 years to degrade it" :-(
I full agree that the UK Government is still trying to introduce herd immunity in every way, except by not giving it this (electorally toxic) name.

I hope it works!
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  #24  
Old 29 Mar 2020
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I no great fan of any of the current choice of politicians from any party, but you have to assume that the government's scientific advisors are making what they see as the best possible decisions based on the information they have. Why would they do otherwise?

To suggest they would they do anything else is close to a conspiracy theory.

Yes, to Chris, 'community resilience' is the new name.
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Old 29 Mar 2020
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I'm tracking various stuff to use in projections and the good news which nobody seems to have picked up on is that whilst the Italian newly declared cases are not declining numerically, the rate of increase has dropped, which implies the transfer rate from person to person is now only half what it was nine days ago.

I'm hoping today's results continue this trend. Spain is starting to show a similar trend over the last four days.
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Old 29 Mar 2020
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Originally Posted by Tim Cullis View Post
The good news which nobody seems to have picked up on is that whilst the Italian newly declared cases are not declining, the rate of increase has dropped, which implies the transfer rate from person to person is now only half what it was nine days ago.

CASES INCREASE PERCENT
20Mar 47,021 5,986 15%
21Mar 53,578 6,557 14%
22Mar 59,138 5,560 10%
23Mar 63,927 4,789 8%
24Mar 69,176 5,249 8%
25Mar 74,386 5,210 8%
26Mar 80,589 6,203 8%
27Mar 86,498 5,909 7%
28Mar 92,472 5,974 7%

I'm hoping today's results continue this trend. Spain is starting to show a similar trend over the last four days.
We need good news Chris!
It's so difficult to interpret the numbers (not yours above) due to the huge differences in testing numbers in particular.
The number of recovered patients is, up to now, worryingly low. But you've got to assume that curve is lagging infections and will climb over the coming weeks.
I'm pretty sure we've been sat in the house for the last 2 weeks with our son who has had the virus. But of course no way of knowing. We've been pretty focused on wiping surfaces down, hand washing etc. but still assumed we'd get it. But no. From what I can read if you're careful it's a low chance. Unfortunately, no matter how hard we try to social distance both he and our daughter who live with us are front line employees so it's only a matter of time I guess:-(
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  #27  
Old 29 Mar 2020
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Today's figures are in from Italy and the rate of increase has dropped again.

. DATE . . CASES INCREASE PERCENT
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  #28  
Old 29 Mar 2020
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We need good news Chris!
Perhaps good news from the UK:

Professor Neil Ferguson, Director for Centre for Global Infectious Disease Analysis, was interviewed by Parliament on Wednesday and apparently revised his initial warning of 500,000 deaths in the UK from the corona virus.

Now, Professor Ferguson, who has unfortunately himself tested positive for the virus, has apparently announced that the U.K. should have enough ICU beds and that the corona virus will probably kill under 20,000 people in the U.K.


The interview is here:

https://parliamentlive.tv/Event/Inde...e-1563e67060ee


Out beyond ideas of wrongdoing and rightdoing, there is a field. I’ll meet you there.' - Rumi

Last edited by Riel; 29 Mar 2020 at 22:52. Reason: remove potential ambiguity
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  #29  
Old 29 Mar 2020
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I guess that'll serve to highlight how much is unknown, perhaps unknowable--including by experts.

I just watched the Trevor Noah interview with our Dr. Fauci, director of infectious diseases in the US National Institutes of Health, who seems in general a straight shooter and not prone to exaggeration or self-aggrandizement. I was surprised to hear him say, about the development of immunity following initial infections, that he was very certain this would occur as it does in "every other virus that we know....it's never 100% but I'd be willing to bet anything that people who recover are really protected against re-infection."



You can see for yourself at 10:42 in this ~13 minute interview.

https://www.youtube.com/watch?v=8A3j...RwhRyzT67E2znY
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  #30  
Old 30 Mar 2020
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According to Adam Kucharski who I mentioned in an earlier post, there's a saying in his field, "If you've seen one pandemic, you've seen..... one pandemic." Each is different.

Dr Fauci's comment is echoed in the UK, albeit if the virus comes back in a slightly modified form next winter, all bets are off (one of the viruses causing the common cold is coronavirus).
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