CM11 wrote: Tue Aug 25, 2020 7:29 pm
Camroc2 wrote: Tue Aug 25, 2020 7:21 pm
Which leads to the question why ?
If the virus is in the wild in Ireland, which it is, have those susceptible to its worst effects mostly got it already; or has the virus subtly changed so that it doesn't affect people so badly ?
Infection control for the most vulnerable has possibly worked as intended?
Meanwhile everyone else has relaxed to the extent that it's slowly spreading through the healthy population.
In related news, our youngest has cold symptoms and mild fever.
Our first illness in the house since Jan. Just before returning to school.
Not having the GP consultation until tomorrow lunchtime so if they send him for test, won't be until the weekend before we know. Fun.
The virus arrived in Spring and has cut a swath thru Europe. A huge spike in additional deaths in March/April/May. The median age of death in Ireland was 84, 90% had existing illnesses of various kinds, ~60% passed away in old folks care homes and only 88 died in ICUs ... they never got that far.
So the virus took the most infirm in our society and at 84 already above the average life expectancy in Ireland of 82 years.
Social distancing certainly should have impacted the rate of transmission of the virus but all in all very few folks are dying of Covid since the start of June.
Once the highly susceptible have been impacted (and many susceptible will still remain in society if they were properly cocooned), there are other factors such as seasonality rise in Vitamin D, sunshine, etc) that mean the impact of certain respiratory viruses is less in dry, warm conditions.
This pattern is mimicked across all of Western Europe and the temperate climates of the US. Once the initial wave of infection passes thru, the level of sickness and pathology is hugely reduced.
So how do we explain the rise in positive Covid test results across Europe in July/August but with no associated jump in sickness, hospitalisation and fatality?
The RT-PCR test recognises sequences of the RNA from the SARS-CoV-2 virus and translates it into DNA using Reverse Transcriptase (RT). That DNA is massively amplified by Polymerase Chain Reaction (PCR) which allows us to measure the DNA signal and decide whether the virus is present. This is an immensely powerful analytical tool but they always come with a downside. In this case, you are typically infectious with Covid19 for 7-10 days, but the PCR test will give you a positive result over 20-30 days. This means you will test positive for a lot of folks who are not infectious ie, capable of spreading the disease.
We have already seen that around 85% of folks are "asymptomatic" ... a new word that many have learned this year. It means that they are testing positive, but are not showing any symptoms. Now the jury seems to out whether the asymptomatic can or cannot spread the virus, but lets just note that China will not count a positive test result as a Covid case unless they are showing symptoms of the disease. And since yesterday, the CDC in the US have advised that those who are not showing symptoms of Covid19 infection (cough, temperature, loss of hearing/taste, etc) should not be send for a PCR test.
These RT-PCR diagnostic kits have been rolled out amazingly quickly, but there is a problem with that. Materials, kits and reagents are coming from various sources. Nevermind that there will variation in competency , method transfer and training between different labs. So the use case data is likely to have a lot of measurement variation associated with it, especially if we compared where positive and negative results are coming from and whether they are associated with a specific lab. I am not arguing that the Covid rise is false; just that there is likely to be a lot of measurement noise which will make it hard to discern what is really happening. It would be good to know the level of false positives and negatives by test sites and see what the inter-lab variance was in that regard.
As communities opened up in June/July/Aug across Europe, we expected to see a rise in positive test results. This is also coincidental with a huge rise in testing capacity. As you test more, you will find more (validating somewhat the Donald in this regard ...

) , but we are not seeing a corresponding rise in sickness, pathology and death. The current public health advice in Ireland is that we need to hold firm to avoid a dangerous second wave, but there is barely a tick-up in hospitalisation across Europe as the number of positive PCR test results increases. The level of Excess Deaths (we saw a huge spike in such deaths in Mar-May this year assumed to be Covid related) is now identical to 2017, 2018 and 2019, which suggests that the pandemic wave associated with Covid 19 has passed.
The virus is still in the community so we still need to protect the vulnerable - the aged, those with co-morbidities (diabetes, chronic respiratory conditions, etc) - but the young and fit should be allowed to back about their business as long as we continue to maintain physical distancing and good personal hygiene. The young are generally unimpacted by Covid19 unless they have a pre-existing condition and allowing the rest of the community to be exposed to the virus will ultimately protect the remaining vulnerable in our society until a vaccine is available. Then we vaccinate the vulnerable as the rest do not appear to need it.
This pattern of infection followed by a complete reduction in pathology is consistent around the world, except there are differences in the profiles whether you are in the northern or Southern Hemispheres. With New Zealand for example, they have done a great job to protect their society so far. But those who are susceptible to the virus are still there and at risk if the virus now takes hold in the same way it has in less isolatable countries around the world.
This should come as good news as most of us in Ireland have kids returning to school this week. The young are more likely to be struck by lightning than to die to Covid19. But we still need to worry about kids, teachers and relatives with co-morbidities so that they are protected appropriately.