Coronavirus - General Chat - No statistics

[Sunnypad]

Hello
i hope this is the right place to ask

I had my first vaccine.

I was in a state so only now am I hearing that it's licenced for emergency use and proper trials don't finish till 2023. Is that correct?

[Bouleversee]

Hello
i hope this is the right place to ask

I had my first vaccine.

I was in a state so only now am I hearing that it's licenced for emergency use and proper trials don't finish till 2023. Is that correct?

Which vaccine did you have?

[Sunnypad]

Bouleversee - i had the AZ.

[Mike4]

Hello
i hope this is the right place to ask

I had my first vaccine.

I was in a state so only now am I hearing that it's licenced for emergency use and proper trials don't finish till 2023. Is that correct?

I'm no expert but my understanding is yes this is broadly right, but don't think this means your vaccine wasn't properly and thoroughly tested with excellent results.

The thing is, no matter how much testing you do, there is always more that can be done and when there is no hurry for a new medicine, trials may go on for 10 or 15 years perhaps gathering ever more data to support an approval decision, but at what point do you stop?

With coronavirus vaccine, a different balance had to be drawn and with a mountain of supporting data already obtained, 'emergency' approval was granted.

Edit to add: Forgot to say, I very much doubt 'trials' finish in 2023, but it depends what you mean by 'trials'. Trials continue for ever, using data from the ever-growing cohort of people being vaccinated, AIUI. No-one ever says "Ok we're done now. No more monitoring of this particular medicine".

[onthemove]

Hello
i hope this is the right place to ask

I had my first vaccine.

I was in a state so only now am I hearing that it's licenced for emergency use and proper trials don't finish till 2023. Is that correct?

In normal times, 'proper trials' are also considered to include the period after a medicine / vaccine / etc has been initially authorised for wider use, to obtain data from that wider roll out. It's basically emphasizing that the medicine developer's job isn't over the moment approval has been given. They are still required to monitor for less common side effects, longer term side effects, etc.

It's a process of building up confidence. They're now at the point where they have enough confidence to approve it, but with the caveat that it still must be properly monitored with the option to suspend authorisation if the real world data subsequently shows any cause for concern.

So while it may(?) be technically correct that 'proper trials don't finish till 2023', just be aware that quite a few people on the internet seem to be pushing that line in order to try and sow doubt and uncertainty and undermine the vaccines, portraying it as though it is something to be concerned about.

It isn't anything to be concerned about.

If they weren't to release the medicine for general use, they wouldn't be able to conclude those trials - they need the public roll out to be able to complete the 'trials'. You can't wait for 'all trials' to complete before rolling out a medicine; you need to roll it out to complete the trials.

[Sunnypad]

Onthemove "You can't wait for 'all trials' to complete before rolling out a medicine; you need to roll it out to complete the trials."

Yes, thanks.

[murraypaul]

Where is the evidence that the situation in India today is worse than the situation in the UK in April 2020 or February 2021? I think Indians will look at the UK figures and pray it does not get that bad.

Assuming equal levels of reporting in each country, the current case rate in India, at ~0.026% of the population per day, is much lower that the peak seen in the UK of ~0.1% of the population per day.

However, that assumption is almost certainly not correct.

That is number of cases though. The situation in India is much worse that it ever was in the UK, because the healthcare system has completely broken down. Is there any question in your mind which situation you would rather be in as a normal member of the population, UK in Jan 2021 or India now?

[Lootman]

You're overlooking the fact that the vast majority of people who die with CV in the UK are elderly. The `death rate' for under 70's is about 1 in 2,000 as against 1 in 35 for those over 70.

Average life expectancy in India is 70, compared to 82 in the UK. You're therefore not making a valid comparison between the two countries, as far fewer people in India survive long enough to die of covid.

If Indian people had the same life expectancy as people in the UK the death rates would be far higher than even the estimated figures, let alone the official ones, and almost certainly far higher than in the UK.

That's a very very good point; same goes for the terrible surges seen in Tanzania and Brazil
- and it serves as a good reminder as to why the risk to many "developed" nations from a virus of this nature is/was far higher

It must have been a full year since I read somewhere that the simple explanation for Africa having relatively benign Covid fatalities was because of the low life expectancy there, meaning that other things kill people off before they reach the age of high susceptibility to Covid. The cause of all those deaths is everything from malaria to TB to AIDS to death in childbirth. Average life expectancy in Africa is a little over 60, although lower in many areas.

Sometimes the simplest answer is the best.

[zico]

You're overlooking the fact that the vast majority of people who die with CV in the UK are elderly. The `death rate' for under 70's is about 1 in 2,000 as against 1 in 35 for those over 70.

Average life expectancy in India is 70, compared to 82 in the UK. You're therefore not making a valid comparison between the two countries, as far fewer people in India survive long enough to die of covid.

If Indian people had the same life expectancy as people in the UK the death rates would be far higher than even the estimated figures, let alone the official ones, and almost certainly far higher than in the UK.

That's a very very good point; same goes for the terrible surges seen in Tanzania and Brazil
- and it serves as a good reminder as to why the risk to many "developed" nations from a virus of this nature is/was far higher

It must have been a full year since I read somewhere that the simple explanation for Africa having relatively benign Covid fatalities was because of the low life expectancy there, meaning that other things kill people off before they reach the age of high susceptibility to Covid. The cause of all those deaths is everything from malaria to TB to AIDS to death in childbirth. Average life expectancy in Africa is a little over 60, although lower in many areas.

Sometimes the simplest answer is the best.

I've attached an interesting report from Sky (complete with pretty graphs)
To summarise, the article has the following main reasons for the apparent lower death rates.
- Very early lockdowns in Africa (at a far earlier stage than most first-world countries)
- Younger demographics
- Higher general temperatures, leading to more outdoor working and more outdoor socialising.
- Under-reporting of Covid infections & deaths (plenty of evidence to show %age of population with anti-bodies is massively larger than reported Covid infections)

I'd add another factor which is that people in African countries are much less likely to fly between countries, and long-distance commuting is far less prevalent, so it would be more difficult for Covid to spread from region to region. (South Africa is more "Western" in this respect, and notably the worst-affected African country).

https://news.sky.com/story/covid-19-in- ... w-12236347

[9873210]

You're overlooking the fact that the vast majority of people who die with CV in the UK are elderly. The `death rate' for under 70's is about 1 in 2,000 as against 1 in 35 for those over 70.

Average life expectancy in India is 70, compared to 82 in the UK. You're therefore not making a valid comparison between the two countries, as far fewer people in India survive long enough to die of covid.

If Indian people had the same life expectancy as people in the UK the death rates would be far higher than even the estimated figures, let alone the official ones, and almost certainly far higher than in the UK.

That's a very very good point; same goes for the terrible surges seen in Tanzania and Brazil
- and it serves as a good reminder as to why the risk to many "developed" nations from a virus of this nature is/was far higher

It must have been a full year since I read somewhere that the simple explanation for Africa having relatively benign Covid fatalities was because of the low life expectancy there, meaning that other things kill people off before they reach the age of high susceptibility to Covid. The cause of all those deaths is everything from malaria to TB to AIDS to death in childbirth. Average life expectancy in Africa is a little over 60, although lower in many areas.

Sometimes the simplest answer is the best.

The answer should be as simple as possible, but no simpler.

There are several confounding things here.

Life expectancy is not the same thing as the average age of the population.
Life expectancy at birth is not a good measure of the frailty of the elderly.
If you are correcting for population composition you need to look at at the entire composition of the population.

In particular I believe you have misunderstood the argument about African demographics. The issue is the relatively young population, not the low life expectancy. Half of Africans are under age 25 and thus assumed to be relatively resistant to severe COVID outcomes. Life expectancy and average age are not closely related, you have to throw in other variables like fertility rate, infant mortality, and population growth to get a connection.

It would also be better to use the life expectancy at advanced age, say age 70, rather than population life expectancy. Population life expectancy is far more sensitive to infant mortality than to the health of the elderly. This has been important historically, a life expectancy in the mid twenties did not mean most people died in their mid-twenties. It meant half of infants were died before age 5 and many people were living into their fifties or later.

It is not clear that severe COVID is a result of chronological age rather than "frailty". If the life expectancy of UK 80 year old's is the same as the life expectancy of Indian 70 year old's I would not assume the UK 80 year old's are more likely to die of COVID. I could argue the two populations are equally frail and perhaps therefore at equal risk. Actual data would be nice.

[Bouleversee]

https://www.medicalnewstoday.com/articl ... 6de74a4f1c

Who knew (about all the other things it can cause as well)?

[dealtn]

https://www.medicalnewstoday.com/articles/gum-disease-linked-to-severe-covid-19-outcomes?utm_source=Sailthru%20Email&utm_medium=Email&utm_campaign=newsAlerts&utm_term=coronavirus&utm_content=2021-04-28&apid=34270109&rvid=f35dcf758e52b53f2b7e8aaa0865b04cc02c6ec4fd581b57d09da76de74a4f1c

Who knew (about all the other things it can cause as well)?

I presume the "it" you refer to is Covid?

Covid doesn't cause periodontitis.

Or were you referring to some other causality?

[Bouleversee]

No, I wasn't referring to Covid. I was referring to the gum disease the article was all about, periodontitis, which apparently can cause lots of serious problems, including a severe reaction to Covid infection, as you would have seen if you had read to the end of the article. I doubt if many people know about this connection; I certainly didn't.

[Lootman]

No, I wasn't referring to Covid. I was referring to the gum disease the article was all about, periodontitis, which apparently can cause lots of serious problems, including a severe reaction to Covid infection, as you would have seen if you had read to the end of the article. I doubt if many people know about this connection; I certainly didn't.

I see a periodontist every 3 months. He has twice performed gum surgery on me, grafting tissue from the roof of my mouth to rebuild my eroded gumline.

He is always banging on about how gum health is related to various other diseases. He was teaching me that gum health is vital for general health long before Covid came along. So this news does not surprise me.

I never economise on that part of my body. And so far I still have a full set of gnashers with no root canals, implants or bone erosion.

[servodude]

It is not clear that severe COVID is a result of chronological age rather than "frailty". If the life expectancy of UK 80 year old's is the same as the life expectancy of Indian 70 year old's I would not assume the UK 80 year old's are more likely to die of COVID. I could argue the two populations are equally frail and perhaps therefore at equal risk. Actual data would be nice.

That's a good question

The "correlation" with age though seems quite strong ---

At the risk of running foul of the no stats here's two articles that lead me to say that
- one from the BMJ https://gh.bmj.com/content/bmjgh/5/9/e003094.full.pdf
- one from medrix https://www.medrxiv.org/content/10.1101/2020.07.23.20160895v7.full

And here's one addressing the age v frailty explicitly https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afab026/6128535

--- now perhaps that is because humans as a species, on average, over the globe, collect conditions over their lifetime that mean "frailty" and "age" end up being analogues for the purposes of considering this data

- sd

[zico]

Interesting study published in the Lancet, comparing "Covid elimination" strategies against "Covid mitigation".
"Covid elimination" has better outcomes for health/deaths, economy and freedoms (judged on length/severity of restrictions) though the authors warn there's no causal link. Not overly technical and has three graphs comparing the above 3 outcomes.

https://www.thelancet.com/journals/lanc ... 40-6736(21)00978-8/fulltext

[jfgw]

The link in the above post should be https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00978-8/fulltext


Julian F. G. W.

[dealtn]

Interesting study published in the Lancet, comparing "Covid elimination" strategies against "Covid mitigation".
"Covid elimination" has better outcomes for health/deaths, economy and freedoms (judged on length/severity of restrictions) though the authors warn there's no causal link. Not overly technical and has three graphs comparing the above 3 outcomes.

https://www.thelancet.com/journals/lanc ... 40-6736(21)00978-8/fulltext

How did they select the 5 countries they label "Covid Elimination"? There is no descriptive methodology, and it could simply be the case this is hindsight bias selection. A study that used the groups "islands" and "non-islands" (selected with hindsight bias) would produce similar results (although the UK would skew this so it would be worse than the 25X outcome in this case).

[servodude]

Interesting study published in the Lancet, comparing "Covid elimination" strategies against "Covid mitigation".
"Covid elimination" has better outcomes for health/deaths, economy and freedoms (judged on length/severity of restrictions) though the authors warn there's no causal link. Not overly technical and has three graphs comparing the above 3 outcomes.

https://www.thelancet.com/journals/lanc ... 40-6736(21)00978-8/fulltext

How did they select the 5 countries they label "Covid Elimination"? There is no descriptive methodology, and it could simply be the case this is hindsight bias selection. A study that used the groups "islands" and "non-islands" (selected with hindsight bias) would produce similar results (although the UK would skew this so it would be worse than the 25X outcome in this case).

Perhaps because they tried for elimination
Let's see:
https://www.mja.com.au/journal/2020/213/5/new-zealands-covid-19-elimination-strategy

On 23 March 2020, New Zealand committed to an elimination strategy in response to the coronavirus disease 2019 (COVID‐19) pandemic

Doesn't sound like it happened by accident?
Do you imagine it could?

-sd

[dealtn]

Interesting study published in the Lancet, comparing "Covid elimination" strategies against "Covid mitigation".
"Covid elimination" has better outcomes for health/deaths, economy and freedoms (judged on length/severity of restrictions) though the authors warn there's no causal link. Not overly technical and has three graphs comparing the above 3 outcomes.

https://www.thelancet.com/journals/lanc ... 40-6736(21)00978-8/fulltext

How did they select the 5 countries they label "Covid Elimination"? There is no descriptive methodology, and it could simply be the case this is hindsight bias selection. A study that used the groups "islands" and "non-islands" (selected with hindsight bias) would produce similar results (although the UK would skew this so it would be worse than the 25X outcome in this case).

Perhaps because they tried for elimination
Let's see:
https://www.mja.com.au/journal/2020/213/5/new-zealands-covid-19-elimination-strategy

On 23 March 2020, New Zealand committed to an elimination strategy in response to the coronavirus disease 2019 (COVID‐19) pandemic

Doesn't sound like it happened by accident?
Do you imagine it could?

-sd

No it didn't happen by accident. No I don't imagine it could.

But neither were those my questions.

The authors don't explain how they categorised the countries they did, be that the ones in the elimination group, or the other. Even then there is still huge potential hindsight bias.

For it to be useful scientifically, and useful predictively, a list of the "best" (in hindsight) with an analysis showing they are the best isn't enough.

They themselves admit "no causal link". Maybe someone else should produce an almost identical report for "Australasian countries" with no causal link.

It is hard to know whether the largest factor here was countries "able to eliminate" rather than "wanted to eliminate". Before being quick to argue alternative governments were good or bad, it would be ideal to know how the governments in NZ or Australia would have coped in the UK or France, and vice versa. An experiment you will never be able to run though. It may well be the NZ would have been better than the UK outcome, but still a lot worse than the NZ outcomes. Similarly Johnson or Macron might have been worse than NZ but still a lot better than the UK or France outcome.