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"Why are COVID cases rising and what can we do?"
by Dr Dominic Pimenta
Full article here: https://tinyurl.com/yxg8wmhh
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"Why are COVID cases rising and what can we do?"
by Dr Dominic Pimenta
Full article here: https://tinyurl.com/yxg8wmhh
Read on for thread:
@MSIUK_
Over the last two days new COVID cases in the UK have hit 2988 on 6th and 2948 on 7th of September, while deaths within 28 days fell to just 2, and the number of new admissions has remained stable.
So what is going on? /1
Over the last two days new COVID cases in the UK have hit 2988 on 6th and 2948 on 7th of September, while deaths within 28 days fell to just 2, and the number of new admissions has remained stable.
So what is going on? /1
TL:DR?
The most likely scenario is a rise in true cases as the virus spreads once more, with relaxed social distancing measures.
However, there are many popular theories out there to dispute this - so let's take apart each in turn. /2
The most likely scenario is a rise in true cases as the virus spreads once more, with relaxed social distancing measures.
However, there are many popular theories out there to dispute this - so let's take apart each in turn. /2
1) We are just doing more tests. More tests = more cases. Simple?
No. While there has been a significant increase in testing since April to August. However between 1st August and 6th September tests process rose by only 25%, compared to a 293% increase in cases in the same time.
No. While there has been a significant increase in testing since April to August. However between 1st August and 6th September tests process rose by only 25%, compared to a 293% increase in cases in the same time.
2) We are doing more targeted testing, and getting better at finding the cases. Right?
While there are hotspots of infection the rise is seen in general across the country. This isn't a single isolated area driving up the numbers. It's a national issue https://www.arcgis.com/apps/webappviewer/index.html?id=47574f7a6e454dc6a42c5f6912ed7076
While there are hotspots of infection the rise is seen in general across the country. This isn't a single isolated area driving up the numbers. It's a national issue https://www.arcgis.com/apps/webappviewer/index.html?id=47574f7a6e454dc6a42c5f6912ed7076
3) The tests are just picking up old virus, these are false positives. Right?
This report suggested PCR swabs could be picking up 'dead virus'. This analysed studies that tried to grow live virus from positive test swabs, a marker of infectivity. https://www.bbc.co.uk/news/health-54000629
This report suggested PCR swabs could be picking up 'dead virus'. This analysed studies that tried to grow live virus from positive test swabs, a marker of infectivity. https://www.bbc.co.uk/news/health-54000629
However interesting this might be, there hasn't be an obvious change in the way we are conducting swab tests in the last few weeks that correlates with the rise in cases we are seeing.
CONCLUSION: the tests are accurate and these ARE new cases of COVID-19.
CONCLUSION: the tests are accurate and these ARE new cases of COVID-19.
So what if cases really are going up, if deaths and hospitalisations aren't?
There are several explanations:
1) There is a lag between tests, hospitalisation & death.
Exposure > Symptoms (5 d)
Symptoms > Hospital (~5-7d)
Hospital > ICU (~7 days)
Symptoms > Death (~2.4wks)
There are several explanations:
1) There is a lag between tests, hospitalisation & death.
Exposure > Symptoms (5 d)
Symptoms > Hospital (~5-7d)
Hospital > ICU (~7 days)
Symptoms > Death (~2.4wks)
2) The increase in cases seems to be predominantly in the younger population currently
If cases are being driven by younger people in the first instance, who are much less likely to become seriously unwell and die, this would explain the trend.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/914813/Weekly_COVID19_Surveillance_Report_week_36_FINAL.pdf
If cases are being driven by younger people in the first instance, who are much less likely to become seriously unwell and die, this would explain the trend.
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/914813/Weekly_COVID19_Surveillance_Report_week_36_FINAL.pdf
3) ...and subsequently it seems likely that the older population continue to shield themselves, while the younger population has gone back to normal life.
Despite opening everything from schools to pools, many appear to still be staying at home, especially the vulnerable.
Despite opening everything from schools to pools, many appear to still be staying at home, especially the vulnerable.
4) But wait, hasn't the virus mutated?
Not clinically significantly, Dr Emma Hodcroft laid it out amazingly here: https://twitter.com/firefoxx66/status/1296080772810637312?s=20
Not clinically significantly, Dr Emma Hodcroft laid it out amazingly here: https://twitter.com/firefoxx66/status/1296080772810637312?s=20
5) But wait, isn't this because we are all immune now?
There is very little evidence of widespread immunity, although it may be possible that there is a different type of immunity, known as T-cell immunity, that we can't detect with antibody tests. But this is a guess at best.
There is very little evidence of widespread immunity, although it may be possible that there is a different type of immunity, known as T-cell immunity, that we can't detect with antibody tests. But this is a guess at best.
6) But who cares? If no one is dying or going to hospital?
Looking at Florida, France and Spain that had similar trends in the young are now seeing rises in hospitalisation and ICU admissions.
We also don't know the long-term effects in young people https://www.bmj.com/content/370/bmj.m3218
Looking at Florida, France and Spain that had similar trends in the young are now seeing rises in hospitalisation and ICU admissions.
We also don't know the long-term effects in young people https://www.bmj.com/content/370/bmj.m3218
So the bottom line:
- Cases are genuinely rising
-Mostly in younger people, who won't require hospital or get unwell in the acute illness, but are likely to eventually pass it on to a vulnerable population that will
-Without intervention this will continue
- Cases are genuinely rising
-Mostly in younger people, who won't require hospital or get unwell in the acute illness, but are likely to eventually pass it on to a vulnerable population that will
-Without intervention this will continue
So what can we do about it?
- we cannot continue to open up the economy without control of the virus
-keeping schools open must be the priority
- close down all non-essential services again
-support the economy to do so and to make self-isolation financially viable
>>
- we cannot continue to open up the economy without control of the virus
-keeping schools open must be the priority
- close down all non-essential services again
-support the economy to do so and to make self-isolation financially viable
>>
-bolster the track and trace system and make it practical to use
-mitigate the risk in schools with increased social distancing, separation of classes & distance learning for older kids
-reinforce the message to RESPECT the virus - keep 2m apart, wear a mask, wash your hands.
-mitigate the risk in schools with increased social distancing, separation of classes & distance learning for older kids
-reinforce the message to RESPECT the virus - keep 2m apart, wear a mask, wash your hands.
Without any change in the parameters as they stand cases will continue to rise. This is inevitable. Everyone must do their bit - avoid unnecessary travel, make space, wash your hands, cover your face.
And stay safe.
And stay safe.
This was a Rapid Response written by Dr Dominic Pimenta for the Modern Society Initiative.
Find out more here http://modernsocietyinitiative.org - if you would like to read more urgent and evidenced-based content like this consider supporting MSi here: https://www.crowdfunder.co.uk/the-modern-society-initiative
Find out more here http://modernsocietyinitiative.org - if you would like to read more urgent and evidenced-based content like this consider supporting MSi here: https://www.crowdfunder.co.uk/the-modern-society-initiative
Rapid Response (Video) from Modern Society Initiative ( @msiuk_)
Why are COVID cases rising and what can we do?
By Dr Dominic Pimenta
http://modernsocietyinitiative.org
Why are COVID cases rising and what can we do?
By Dr Dominic Pimenta
http://modernsocietyinitiative.org
