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PPG Applied in France

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  • If the language offends them these numbers certainly should.

    Yesterday the World Health Organisation said 332 new daily deaths from coronavirus were officially reported by the 27 EU countries in the most recent period to June 3 - while the UK recorded 324 Covid-19 fatalities.

    Yet yesterday our PM repeatedly dismissed Kier Starmer‘s questions, accused him of being negative and blustered to his cheering benches that he is proud of our response.

  • And the Eu27 has a population of over 400M compared with our what 60M?

    It seems that we need to kick start the economy now and keep the GDP loss below 10% to give us enough wriggle room to swallow a no deal (it’ll be called an Australian-style deal) and the associated additional fall that will follow. It’ll all be bundled in together and blamed on CV.

  • edited June 2020

    @Right_in_the_Middle said:

    @Username said:

    @Right_in_the_Middle said:

    @Username said:

    @chairboyscentral said:
    The way things are being eased, we'll be allowed back in stadiums by autumn. Obviously whether people go back or not is another matter.

    Not a chance unfortunately, it's one thing the govt ignoring science advice now while the numbers are still reducing, it's another thing once the body count starts rising again and it becomes even more clear how inept the response has been compared to the rest of Europe if they manage to maintain deaths at 1% the rate we have.

    Using the term 'body count' is both inflammatory and lacking in empathy for the current human crisis. I happen to agree with @chairboyscentral on this. It will be a risk though.

    All a point of view, playing down the scale of the failures and negligence is lacking empathy to me, as is the recent up tick in people using terms like "any government would make mistakes" to excuse political decisions made.

    We seem to have accepted that we will have 100s of deaths a day while the rest of Europe has a tiny fraction of that, that is directly the fault of the government and I don't regret my use of body count, other teams make it seem like the deaths couldn't have been avoided

    See I'd argue the term 'body count' does exactly what you claim to not like. It's a battle term reducing a person dying to a number. I agree with everything else you are saying but find that term a bit Trumpian if you see.

    It's a term that would be used to describe the actions of a murderer. I'm not saying that's what it is, but the concept that they couldn't know their actions would lead to thousands of unnecessary deaths is entirely false, it was a choice, and one that in any other role could lead to criminal charges for negligent manslaughter rather than have a good portion of the country scrambling to defend them .

    The world is just a bit mad at the moment.

  • edited June 2020

    On the football, the premier league meeting could have big implications if they do try and remove relegation - which is what a lot of clubs want if the league restart is re-interrupted

  • The virus has not ‘lost potency’ and for any doctor to suggest this without peer reviewed evidence is, frankly, a reckless position. There is no genetic scientific evidence at all, worldwide, that the virus has significantly changed genetically since its discovery. There are distinct familial lines, but these are not significant changes to the virus. A good analogy would be to think of dog breeds. The virus is undergoing small genetic changes, as all viruses do in every generation. But these are the equivalent of a small change in marking, colour of length of hair for a particular dog breed. A significant genetic change would be the dog changing (over many, many generations) into a distinctly different breed.

    The virus has slowed to very lower levels of transmission in Italy, Spain, France and Germany due to the successful lockdown. The warmer, higher humidity summer air furthers slows the transmission from that low base (as with every other respiratory virus with the phenotypic characteristics of this particular coronavirus). Here, we have not reached very low levels of transmission as the lockdown was released at least 3-4 weeks too soon, so the epidemic will smoulder on at a higher level here throughout the summer. Summer temperatures absolutely will hinder transmission of this virus, but as it is a novel virus with no innate population immunity, if no other successful mitigations are taken, it will spread regardless (just at a slower rate than in cooler temperatures).

    Without a vaccine by late Autumn (which may well be possible - I work in the Pharmaceutical industry. Of course, it may not be possible by then, or may never be possible, although that seems unlikely based on current knowledge), there is absolutely no chance whatsoever of fans being at football matches as weather turns colder until mass vaccination (or a majority of people have had the disease to achieve herd immunity - this could be anywhere from 60-80%, currently we have 6-8%) has been achieved.

    Personally, I believe without a reasonably efficacious and safe vaccination, or very effective therapeutic drug, the chance of a completely full 20/21 season is nil, with or without fans. As with anything scientific, the argument is far more nuanced than that statement though (a fact the media does not want to, or is not capable of, effectively communicating). There are many provisos to my statement - for example, if it is found a higher proportion of the population have had this virus, above the 6-8% currently thought, that would be great news. This is possible as we now know the virus elicits both antibodies and T cells in immune response, sometimes independent of each other (I.e., an individual may not have antibodies, but has T cell immunity). Additionally, there may be additional therapeutics (above Remdesivir) or combinations of therapeutics (an anti viral with an immune modulating drug, for example) that prove effective which would improve the situation.

    For everyone’s sake, let’s hope and pray for some good news on these fronts to minimise the suffering of everyone affected as we progress this Summer.

  • @WanderingDays said:

    @prufrock_91 said:
    I don't really want the play-offs, because the only sane point D. McA and Talksport Drive have made is that it's a bit hypocritical to vote against the season carrying on, but be willing to play a few extra games to get promoted.

    Also, do we really want to see us play in the Championship in empty stadiums for the best part of half the season?

    I've seen lots of people with this opinion, but it's a strange argument

    1) It's better to be playing in empty Championship stadiums for half the season than empty League One stadiums for half the season

    2) We'll get far more TV money in the Championship, which will help keep us afloat

    3) We've got a far better chance of being in the Championship when we are eventually allowed to attend matches again than by staying in League One

    It's a no-brainer

    These are all great points, and you're right.

  • I’ve just had to pop over to Paris today. If you want to know what Europe (well France) thinks of the British response...

    I haven’t yet been handed a bell and told to go around ringing it and shouting “impur” to everyone but it feels like it’s only a matter of time.

    I think if any British teams were still in the Champions league (I’m assuming we were all knocked out) they’d win it easily. No-one would go near us

  • Excellent post @Quarterman

  • We’ll learn a lot about Covid in the next couple of weeks won’t we? Either there will be a spike in infections among those who participated in recent protests, or there won’t.

  • @Right_in_the_Middle said:
    One thing our scientists should do is contact, trace and track the Hyde Park protesters from yesterday. The horrible sight of a roving mob in the current lockdown is a perfect test for how the virus would move now around a large outdoor crowd.
    Could lead to proper sanctioned outdoor gatherings if the transmission rate is low.

    Chances of any of this happening? Zero

    Should get around to them after they've been round to all the people on Dorset beaches at the weekend.

  • I think they may be as well checking the idiots (sorry, I mean to say esteemed representatives of our community) queuing up in Parliament the other day...

  • @Floyd In all honesty, we are learning more about SARS-nCOV-2 all of the time, and that will continue. What we know today, compared to even 2 months ago, is night and day really.

    It will be very interesting to see (purely from an academic point of view, although it isn’t forgotten the horrendous toll on individuals and their families this awful virus has) what does happen over the next several weeks. All things being equal, I would not expect a huge spike of cases and deaths, but rather a continuation of the current plateaud trend with perhaps some more modest increases. Is that because of the warmer summer weather keeping transmission in check, which it will do to an extent (and would be the most obvious explanation), or is that because there is another pressure keeping numbers down?

    For example, there is a peer reviewed paper in France showing a proportion of people (16%) have immunity to Covid-19 without ever having been infected or having antibodies. They are thought to be protected by T Cell immunity from a different previous coronavirus infection (I.e., a normal cold). This is just one paper with a relatively small sample size, but it does ask the question - are we all even susceptible to this disease, even though it is novel? We already know a significant proportion of those infected are asymptomatic (but can pass on the disease), why is this? Other statistical models looking at infection numbers and rates across countries with large outbreaks seem to point to a much larger proportion than 16% of ‘immune’ individuals within society. To exemplify this point, two countries with extremely similar mortality figures are Sweden and France (450 and 445 deaths per million population, respectively). Sweden have never locked down, while France implemented one of the strictest global lockdowns. Of course, the differences could be explained by differing population densities and the relative rates of international travel seeding the epidemics in the first place, but it does raise the question, is there another factor of innate immunity we don’t fully understand yet? Is that from a previous coronavirus infection or infection with SARS-nCOV-2, who knows at this stage?

    There are still so many unknowns at the moment, and anyone that claims to definitively have all the answers is not to be believed at this stage. But, I’m sure we’re all hoping for some definitive better news soon, which would help us all, amongst many other things, get back to supporting the mighty Wycombe Wanderers!

  • Thanks @Quarterman very interesting.

    I've long wondered whether Covid is actually far more contagious, and (therefore) far less deadly than we've assumed. But your initial conclusion, that we don't really know and won't for a while, seems to be the one most clearly borne out by the facts.

  • Excellent posts @Quarterman and chimes with a lot of what I've been hearing about transmission rates over the summer and the likelihood of the virus returning with a vengeance when the weather turns cooler (I'm afraid, @chairboyscentral, what you suggest about crowds returning to stadia come October is unsourced poppycock. Let's save that for the David Ickes of this world). What you had to say about T-cells and the study in France is new to me and very interesting. Glad to know we have an expert working in pharma among the support-base. If you have the time and the willingness, might be worth emailing the board and offering to provide advice if they have any specific queries in your area of expertise.

  • Got the normal flu season to come yet people...and then the economic bonus of the Brexit deal for the new year. I think the last six months has brought into sharp focus what a great team we've got going into that negotiation.

  • @floyd said:
    Thanks @Quarterman very interesting.

    I've long wondered whether Covid is actually far more contagious, and (therefore) far less deadly than we've assumed. But your initial conclusion, that we don't really know and won't for a while, seems to be the one most clearly borne out by the facts.

    There have been reasonably large studies (in Italy and S Korea) where random groups have been tested for antibodies, with this data used to determine the actual spread of the virus not just people who had symptoms - which in turn obviously affects the fatality rate, so the information is out there to make reasonable estimates.

    One other very important factor, and one that makes the Govts initial response borders on the criminal, is that herd immunity might not even be possible to achieve - naturally immunity for other coronavirus' can last as little as weeks and at most a couple of years, there's no real way knowing yet until people start getting reinfected. To start out with this plan was completely reckless

  • @Username said:

    @floyd said:
    Thanks @Quarterman very interesting.

    I've long wondered whether Covid is actually far more contagious, and (therefore) far less deadly than we've assumed. But your initial conclusion, that we don't really know and won't for a while, seems to be the one most clearly borne out by the facts.

    There have been reasonably large studies (in Italy and S Korea) where random groups have been tested for antibodies, with this data used to determine the actual spread of the virus not just people who had symptoms - which in turn obviously affects the fatality rate, so the information is out there to make reasonable estimates.

    One other very important factor, and one that makes the Govts initial response borders on the criminal, is that herd immunity might not even be possible to achieve - naturally immunity for other coronavirus' can last as little as weeks and at most a couple of years, there's no real way knowing yet until people start getting reinfected. To start out with this plan was completely reckless

    There was at least one study in the States, maybe in Massachusetts, that showed large numbers of people with antibodies and very few who had suffered from symptoms. To my uneducated mind that sounds like good news.

  • To be fair, I've heard that apparently most of the rest of the world have used a one metre social distancing guideline?

  • @floyd I think the mortality of the virus as we currently understand it is thought to be 0.5 - 1% overall (ranging from 0.002% in children to up to 10%, probably more like 7-8%, in those over 80).

    The evidence I have read in many scientific papers would suggest closer to 0.5% overall, and that is quite a confident prediction based on current knowledge. But that is 0.5% of susceptible individuals, so if a proportion of the population is immune, that would obviously mean the mortality rate is indeed less than 0.5%, maybe slightly, potentially significantly, depending on the levels of innate immunity within that specific population.

    But interestingly, in the UK, antibody testing shows about 7% have antibodies. With 50,000 deaths to date that would point to just over 1% mortality in the UK. That does not look right when looking at the other information available, so as I mentioned previously, there may well be several potential reasons for this, such as an immunity modulated not only by antibodies, but also by T cells. As you suggest, perhaps a much larger number have been infected than we currently think, and immunity is modulated by T cells and not antibodies in every case, and thus the infection numbers are much higher and mortality a lot lower. Conversely, and just as possible, the number of deaths in UK (around 50,000) in the UK includes all individuals that have tragically died both directly of Covid-19, and also those who died with Covid-19. Just as an example, an 80 year old man has advanced Prostate cancer, receiving palliative care at home, develops a UTI (which can often be deadly in vulnerable groups). He is admitted into hospital, contracts Covid-19 and tests positive. He dies a few days later. Did he die of Covid-19? Or Cancer? Or the UTI? Or a combination of some or all? That type of scenario, while irrelevant for that particular tragedy for the man and his family, is probably skewing the mortality rate higher.

    With regards to the transmissibility of the virus, again SARS-nCOV-2 is a strange virus. It seems to be very contagious, with a R number of around 3 (compared to 1.2-1.4 for flu), but often does seem to be a lot higher than that in some studies (7 is the highest I have seen to date). But, even so, it is not close to many other viruses with R numbers over 10 (Measles and Mumps, for example). But where it is potentially unusual is it seems to have a very lower K number. This basically means a small proportion of those infected, pass the virus onto a very large number majority of other people. In English, basically that means that most people infected with the virus will not pass onto many, if any, other people, whereas a small number of infected individuals will pass the virus onto a huge number of people (several dozen or more). There really isn’t a way to know who will be a ‘super-spreader’ in that sense and often it doesn’t have as much to do with the individual’s movements as you might imagine. Basically, it’s one of the reasons why SARS-nCOV-2 will likely be endemic globally for many years, possibly decades, conceivably indefinitely.

  • @floyd said:

    @Username said:

    @floyd said:
    Thanks @Quarterman very interesting.

    I've long wondered whether Covid is actually far more contagious, and (therefore) far less deadly than we've assumed. But your initial conclusion, that we don't really know and won't for a while, seems to be the one most clearly borne out by the facts.

    There have been reasonably large studies (in Italy and S Korea) where random groups have been tested for antibodies, with this data used to determine the actual spread of the virus not just people who had symptoms - which in turn obviously affects the fatality rate, so the information is out there to make reasonable estimates.

    One other very important factor, and one that makes the Govts initial response borders on the criminal, is that herd immunity might not even be possible to achieve - naturally immunity for other coronavirus' can last as little as weeks and at most a couple of years, there's no real way knowing yet until people start getting reinfected. To start out with this plan was completely reckless

    There was at least one study in the States, maybe in Massachusetts, that showed large numbers of people with antibodies and very few who had suffered from symptoms. To my uneducated mind that sounds like good news.

    In terms of the fatality rate being lower than the "confirmed cases" against fatalities, yes. But in terms herd immunity, the problem is how long the immunity lasts in a person. So it's all well and good getting to 60% of people being infected, but if immunity only lasts 3 months the concept doesn't work.

  • @Quarterman At this point i'm not sure if i'm more impressed by your understanding of the data or your typing speed!

    One of the many (many, many) problems with the way Covid is being dealt with and reported on in the States is the conflation of 'died from,' with 'died of,' and in some places even 'assumed to have died from or of.' As you say, this is irrelevant for the most important people related to any death, but arguably the most important factor when it comes to determining when and on what basis normal life can resume.

  • @Username with regards to immunity. This is an absolutely vital area and one in which the media has reported very poorly.

    To add the bottom line first, immunity is not completely understood and will probably never be as it is such a complex bodily process. There are no guarantees and absolutes - we do not definitively know the length of any immunity for this new virus and there will always be occasional exceptions, but there is already a great deal of evidence to be optimistic.

    It has been shown definitively that this virus elicits both an antibody and T Cell immunity (Humoral and Cell Mediated immunity, respectively). That is brilliant news. Antibody immunity is more usually transient, but should last months and perhaps even years. T Cell immunity is much longer in action and should last years (potentially for life). As an example, patients who were infected with SARS in 2002 (as opposed to SARS2 of today) have been shown to still have very strong immunity almost 2 decades later. SARS-nCOV-2 is very, very similar to SARS so this is very encouraging from a population perspective.

    From an individual perspective, a further point to keep in mind is that at a very minimum, 96% of individuals will be asymptomatic or mildly symptomatic with Covid-19. So, to a large extent, their immunity is irrelevant from an individual perspective. We do not worry about having immunity to a cold virus. The other 4% affected more seriously will have a stronger immunity from their initial more serious infection, so should be immune for an easily sufficient period before a vaccine is developed and available widely.

  • Back onto PPG briefly, though I of course despite MK, Winkleman and everything they stand for, here's another wonderfully irritable rant from Durham on Talksport. The man has totally lost his head, great scenes.

  • Thanks @Quarterman. I think I've learned more about all this from your last few posts than I have from months of watching and reading the news.

  • Thanks Quartermaster, interesting stuff about the two types of anti bodies, and all the figures you've quoted match what I've been reading too.

    Bottom line is, we can't know everything about the virus for certain , but we can minimise risk.

  • Can I echo other peoples thanks @Quarterman. This has been some of the most focussed explanation and discussion on the subject I have read.

    Not wishing to overuse your knowledge, but one of the things I am slightly intrigued about is regarding any link identified with prolonged exposure and the seriousness of how the disease progresses in normally healthy individuals?

  • Thanks for people’s kind words, but it really is just what I do for a living so what I’m writing is nothing particularly ground breaking. I am glad to have been able to describe a few things though, as the quality of the journalism with regards to Covid-19 has generally been quite poor. As with everything really, science is a nuanced argument rarely with absolutes one way or the other. Shades of grey, rather than black or white.

    @bookertease That is a very good question and is certainly something I am interested in given my wife is a Nurse. It’s not an easy question to answer, but the one I can give you is only based on anecdotal evidence for Covid-19 specifically, but there is good evidence for other viruses which would suggest I can be a bit more confident in the answer.

    The idea of ‘viral load’ is one which describes the amount of virus you are exposed to, which then causes an infection. If you are exposed to one virion (virus particle) on one occasion, that is going to be easier for the body’s defence system to deal with than if it was exposed to thousands of virus particles on an ongoing basis over a long period of time.

    Thus, if all other things were equal (baseline health, pre existing conditions, genetic factors, diet, vitamin levels, fatigue etc) you are certainly more likely to be ill, potentially severely ill, if exposed to higher viral loads. So, how you are infected could well affect how ill you might become. It’s another reason why hand washing and social distancing is so important. You may still get infected, but it might mean the body has less virus to deal with. It is also another reason why doctors, nurses and other healthcare professionals, especially those in hospitals and care homes are to be admired so much, as they really are going to work in a much higher risk environment than many others. This is likely why the number of young healthcare professionals dying of Covid-19 is disproportionately high, compared to the regular population of the same age.

    But as always, this isn’t an absolute. Anyone, even at a young age, could theoretically be exposed to one virion, and die. Conversely, an older individual could be exposed to a massive viral load and be asymptomatic. There are simply no absolute rules with virology and our understanding of the human body’s response to infection.

  • Thanks @Quarterman. I am equal parts impressed by your depth of knowledge and skill at imparting that on a football forum s as bf depressed that I have learnt more from you on the subject in half a dozen posts than from listening to the government briefings, watching the news and reading the Guardian.

    I genuinely salute you Sir.

    Now if you can divert your attention from such trivial matters to sorting out the far more important issue of how to endure Peterborough get promoted as is their obvious right I am sure you will have the gratitude if ever fair-minded football follower in the land...

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