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The dash for herd immunity

The home for all non-political Coronavirus (Covid-19) discussions on The Lemon Fool
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This is the home for all non-political Coronavirus (Covid-19) discussions on The Lemon Fool
gryffron
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Re: The dash for herd immunity

#426499

Postby gryffron » July 10th, 2021, 5:08 pm

zico wrote:AstraZeneca vaccine reduces infection rates by around 50%.... Currently, with only 50% of UK population fully vaccinated

What about prior infection? That must include millions of the UK population by now. Including many of the unvaccinated young.

Gryff

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Re: The dash for herd immunity

#426500

Postby Itsallaguess » July 10th, 2021, 5:20 pm

gryffron wrote:
zico wrote:
AstraZeneca vaccine reduces infection rates by around 50%.... Currently, with only 50% of UK population fully vaccinated


What about prior infection?

That must include millions of the UK population by now. Including many of the unvaccinated young.


From the ONS recently -

In the week beginning 14 June 2021, the estimated percentage of adults testing positive for antibodies continued to increase across all English regions, ranging from 86.6.% in the South West to 89.4% in the North West.

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/coronaviruscovid19infectionsurveyantibodyandvaccinationdatafortheuk/7july2021#percentage-of-adults-testing-positive-for-covid-19-antibodies-and-percentage-of-adults-vaccinated-against-covid-19-by-regions-in-england

On a separate note, there's a good interactive link here from today's Telegraph that shows either UK or more local geographical breakdowns of vaccination figures -

https://cf-particle-html.eip.telegraph.co.uk/2c82676b-d846-4802-aa71-3569d8796705.html

Source - https://www.telegraph.co.uk/global-health/science-and-disease/covid-news-coronavirus-delta-variant-cases-vaccine-self-isolate/

Cheers,

Itsallaguess

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Re: The dash for herd immunity

#426505

Postby Julian » July 10th, 2021, 6:02 pm

gryffron wrote:
zico wrote:AstraZeneca vaccine reduces infection rates by around 50%.... Currently, with only 50% of UK population fully vaccinated

What about prior infection? That must include millions of the UK population by now. Including many of the unvaccinated young.

Gryff

I think there is so much that is unknown. That's why the more I think about this the more uncertain I become. That's not meant to necessarily say the more negative I become, although that might or might not be the way I am heading, rather the more uncertain I am about how the next 3 - 6 months will pan out in the UK. With so many unknowns it is hard to view this as anything other than a massive gamble. If it pays off it just might have us entering this coming winter in better shape to get through it than we otherwise might have been but alternatively it could lead to hospitalisations and deaths escalating over the summer at an unacceptable level, severe long Covid consequences, and who knows what else.

I think the data on re-infections with the original strain following an initial infection of the original strain were quite encouraging; it could happen but was relatively rare. How able is the Delta variant able to re-infect someone with immunity gained via natural infection from either the original strain or the alpha strain (that's two separate questions) is something that I hope has, and still is, being researched but I am unclear as to whether any good data is yet available. Does anyone know?

- Julian

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Re: The dash for herd immunity

#426550

Postby 9873210 » July 10th, 2021, 9:40 pm

Itsallaguess wrote:
In the week beginning 14 June 2021, the estimated percentage of adults testing positive for antibodies continued to increase across all English regions, ranging from 86.6.% in the South West to 89.4% in the North West.


Since 14 June an additional 5.8% have been vaccinated and 0.7% have been infected. So well over 90% should now have antibodies. Yet we still have 35k new cases and an Rt >> 1. Either people with antibodies are still being infected or R0 >>10! Neither possibility is particularly comforting.

(Actually we know that single vaccinated people have antibodies but are not immune, so we also know that the number of people with antibodies has no particular relevance.)

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Re: The dash for herd immunity

#426558

Postby Steveam » July 10th, 2021, 10:26 pm

I now know of three people who were fully vaccinated who have gone on to catch COVID. In two cases it was quite mild (a couple of days in bed with a bad cough and feeling grotty. In the third case she was on the verge of hospitalisation but gradually recovered but is now (four weeks later) still suffering quite bad symptoms - difficulty getting to the top of the stairs without a pause and not being able to stand for more than a few minutes plus bouts of fatigue. This just anecdotal and I’ve no idea of the frequency of infection after being fully vaccinated.

Best wishes,

Steve

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Re: The dash for herd immunity

#426578

Postby Julian » July 11th, 2021, 1:41 am

9873210 wrote:
Itsallaguess wrote:
In the week beginning 14 June 2021, the estimated percentage of adults testing positive for antibodies continued to increase across all English regions, ranging from 86.6.% in the South West to 89.4% in the North West.


Since 14 June an additional 5.8% have been vaccinated and 0.7% have been infected. So well over 90% should now have antibodies. Yet we still have 35k new cases and an Rt >> 1. Either people with antibodies are still being infected or R0 >>10! Neither possibility is particularly comforting.

(Actually we know that single vaccinated people have antibodies but are not immune, so we also know that the number of people with antibodies has no particular relevance.)

I also wonder how many might be waning antibodies acquired through natural infection during previous waves maybe as far back as the first wave when we really don’t know how big that wave was because testing levels were a fraction of what they are now. Of course some of those people will now be vaccinated but not all of them.

Do these antibody tests give any indication of the levels of antibodies? That is possible to test for of course, many clinical trials and lab research measure absolute levels, but I wonder if this more mass observation data might be using a test that gives a simple yes/no result indicating whether antibodies at or above a certain minimum level have been detected in a sample.

- Julian

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Re: The dash for herd immunity

#426585

Postby Itsallaguess » July 11th, 2021, 6:09 am

9873210 wrote:
Itsallaguess wrote:
In the week beginning 14 June 2021, the estimated percentage of adults testing positive for antibodies continued to increase across all English regions, ranging from 86.6.% in the South West to 89.4% in the North West.


Actually we know that single vaccinated people have antibodies but are not immune, so we also know that the number of people with antibodies has no particular relevance.


I'm of course quite happy to accept that positive antibody tests are no guarantee of immunity, and I don't think anyone has proposed that this is the case, but I also certainly wouldn't go so far as to say that they have 'no particular relevance' either...

Cheers,

Itsallaguess

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Re: The dash for herd immunity

#426593

Postby redsturgeon » July 11th, 2021, 7:43 am

Julian wrote:
9873210 wrote:
Itsallaguess wrote:
In the week beginning 14 June 2021, the estimated percentage of adults testing positive for antibodies continued to increase across all English regions, ranging from 86.6.% in the South West to 89.4% in the North West.


Since 14 June an additional 5.8% have been vaccinated and 0.7% have been infected. So well over 90% should now have antibodies. Yet we still have 35k new cases and an Rt >> 1. Either people with antibodies are still being infected or R0 >>10! Neither possibility is particularly comforting.

(Actually we know that single vaccinated people have antibodies but are not immune, so we also know that the number of people with antibodies has no particular relevance.)

I also wonder how many might be waning antibodies acquired through natural infection during previous waves maybe as far back as the first wave when we really don’t know how big that wave was because testing levels were a fraction of what they are now. Of course some of those people will now be vaccinated but not all of them.

Do these antibody tests give any indication of the levels of antibodies? That is possible to test for of course, many clinical trials and lab research measure absolute levels, but I wonder if this more mass observation data might be using a test that gives a simple yes/no result indicating whether antibodies at or above a certain minimum level have been detected in a sample.

- Julian


The antibody tests in general use are lateral flow tests. When I tested my antibodies a couple a weeks ago a got a faint line showing the presence of antibodies. When Mrs RS tested hers at the same time the line looked as though it had been drawn on heavily with a Sharpie. I guess she has more antibodies then I do. She had the Pfizer vac while I had the AZ.

When/if things open up on July19th I for one will still be taking precautions and I will not be eating or drinking in any crowded indoor establishments and I will still be wearing a mask in shops etc...I will not be using public transport.

John

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Re: The dash for herd immunity

#426594

Postby Lootman » July 11th, 2021, 8:12 am

9873210 wrote:
Itsallaguess wrote:In the week beginning 14 June 2021, the estimated percentage of adults testing positive for antibodies continued to increase across all English regions, ranging from 86.6.% in the South West to 89.4% in the North West.

Since 14 June an additional 5.8% have been vaccinated and 0.7% have been infected. So well over 90% should now have antibodies. Yet we still have 35k new cases and an Rt >> 1. Either people with antibodies are still being infected or R0 >>10! Neither possibility is particularly comforting.

Given a UK population of 65 million, then if 10% have no antibodies that still leaves 6.5 million people. In that context 35,000 cases is about one half of one percent of those who are susceptible. Not that much, and even lower if some of those new cases are amongst those with antibodies.

redsturgeon wrote:When/if things open up on July19th I for one will still be taking precautions and I will not be eating or drinking in any crowded indoor establishments and I will still be wearing a mask in shops etc...I will not be using public transport.

But you have been able to do all those things (and I have been doing all those things, plus traveling overseas) since May. So July 19th isn't really changing that. What will change is the possibility of larger groups of people congregating.

So I will continue to do the things you are not doing. But will not be attending theatres, concerts, nightclubs (not that I do much anyway).

As for masks I will do what I do now, which is wear a N99 mask if I feel concerned for my immediate environment, but otherwise not wear one. It is not that I am an anti-masker, and more that I keep forgetting to take one with me. People have only rarely reminded me to wear one in places where I should. I also end up removing my mask if my glasses steam up, which happens a lot if it is humid and/or there is a temperature change going from outdoors to indoors. I figure it is safer to be able to see than to avoid the small risk of infection. :D

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Re: The dash for herd immunity

#426599

Postby redsturgeon » July 11th, 2021, 8:29 am

Lootman wrote:
redsturgeon wrote:When/if things open up on July19th I for one will still be taking precautions and I will not be eating or drinking in any crowded indoor establishments and I will still be wearing a mask in shops etc...I will not be using public transport.

But you have been able to do all those things (and I have been doing all those things, plus traveling overseas) since May. So July 19th isn't really changing that. What will change is the possibility of larger groups of people congregating.

So I will continue to do the things you are not doing. But will not be attending theatres, concerts, nightclubs (not that I do much anyway).

As for masks I will do what I do now, which is wear a N99 mask if I feel concerned for my immediate environment, but otherwise not wear one. It is not that I am an anti-masker, and more that I keep forgetting to take one with me. People have only rarely reminded me to wear one in places where I should. I also end up removing my mask if my glasses steam up, which happens a lot if it is humid and/or there is a temperature change going from outdoors to indoors. I figure it is safer to be able to see than to avoid the small risk of infection. :D


Yes I have done all those things when the cases were much lower than now and much lower than they will be on July 19th without the Delta variant. Also the removal of the mask wearing mandate for others around me and the removal of social distancing have changed the maths. The risks have just become too high for my own risk/benefit assessment.

I not complaining on my on behalf, these things are trivial for me to avoid...less easy for some others though, people will get ill and some will die who did not need to.

John

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Re: The dash for herd immunity

#426678

Postby 9873210 » July 11th, 2021, 1:14 pm

Lootman wrote:
9873210 wrote:
Itsallaguess wrote:In the week beginning 14 June 2021, the estimated percentage of adults testing positive for antibodies continued to increase across all English regions, ranging from 86.6.% in the South West to 89.4% in the North West.

Since 14 June an additional 5.8% have been vaccinated and 0.7% have been infected. So well over 90% should now have antibodies. Yet we still have 35k new cases and an Rt >> 1. Either people with antibodies are still being infected or R0 >>10! Neither possibility is particularly comforting.

Given a UK population of 65 million, then if 10% have no antibodies that still leaves 6.5 million people. In that context 35,000 cases is about one half of one percent of those who are susceptible. Not that much, and even lower if some of those new cases are amongst those with antibodies.



That's the R0 >> 10 case. Consider what that will do to everywhere with an immunity of much less than 90%? I do not take comfort in the suffering of people some distance away.

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Re: The dash for herd immunity

#426730

Postby Julian » July 11th, 2021, 4:06 pm

redsturgeon wrote:...
When/if things open up on July19th I for one will still be taking precautions and I will not be eating or drinking in any crowded indoor establishments and I will still be wearing a mask in shops etc...I will not be using public transport.

John

Thanks for the info on antibody tests.

I intend to take a similar approach to you if things open up on 19th July, at least for a few weeks until I see how the infection rate changes. In fact in a few ways I will become more cautious during that time. The ways I will become more cautious are...

1 - Although throughout all of the pandemic I have tried to get get outdoor seating in pubs I have on occasion, when we have been between waves, sat indoors if there were no outside tables available or if the weather was bad, and if the pub was not too crowded. I will be far more hesitant about going inside for the next few weeks at least, especially since masking isn't in my view particularly effective in pubs and restaurants anyway because people only wear them when moving around so most people are unmasked for at least 95% of the time when in a pub or restaurant. Maybe that was still of some use for the original and even the Alpha strain but with the even more increased transmissibility of the Delta variant with, it is thought, fewer viral particles able to cause infection and infectious people shedding more viral particles, the chances of infectious levels of viral particles propagating from a single table to most of the rest of the indoor space seems to me to be higher with the Delta variant.

2 - I will attempt to find a suitable mask that allows me to upgrade the level of protection it gives to me to improve on what I have now. If a large number of people in supermarkets for instance stop wearing masks I will put a higher priority on my mask protecting me especially if infection rates do soar.

3 - I will be more hesitant to go on public transport. I have not been too concerned about it this summer but as above, if lots of people stop masking at a time when infection rates are getting to much higher levels than now that is an environment that I would want to avoid as much as possible.

Yes, I'm fully vaccinated with plenty of time since my second dose for it to have reached full efficacy but if infection rates do get really high it feels to me somewhat similar to wearing an extremely good but not perfect bullet-proof vest. If I was a war reporter with great confidence in the quality of my bullet-proof vest I would go into a war zone to do my reporting but I would still prefer to stay in safe locations and behind cover; I would not stand up in the middle of a fire fight and shout "go on, shoot me in the chest; I dare you!". (The chest since obviously the vest won't help against bullets aimed at most other places.)

It's not a major inconvenience for me to do the above and, at a time when the government is taking a big risk, it seems prudent for me to at least do what I can to reduce some of my personal risk at least until we can get a somewhat clearer idea of which way this bet is likely to go. I suspect 4 - 5 weeks will be enough to at least see if it is going badly wrong.

- Julian

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Re: The dash for herd immunity

#426772

Postby jfgw » July 11th, 2021, 6:13 pm

Estimates for R0 for the delta variant seem to be about 5, for example,
Professor Cheng said last year's Wuhan strain had an R0 value of around 2.5, the Alpha strain was about 3.75 and the Delta strain was about 5.
https://www.abc.net.au/news/2021-06-04/what-do-we-know-about-delta-kappa-covid-variants/100190414

This gives an HIT of 80%.

This is equivalent to 80% of the population having a 100% effective vaccine (and the other 20% having no immunity). It is also equivalent to 100% of the population having 80% immunity.

This is a very high number and is very unlikely to be achieved with two jabs (even if they were all Pfizer), especially with the level of hesitancy there is and with children not being vaccinated.

Reaching the HIT is likely to involve people being vaccinated and infected; people getting a third jab (maybe of a different vaccine); and infection of refuseniks, people unvaccinated for sound medical reasons, and children.

I can certainly see some logic to opening up but share concerns that opening up before there is sufficient protection from vaccines may result in a meltdown. I can also see logic in letting this happen in the summer, however.

While we are a long way off from reaching the HIT, New Cases rates are starting to show signs of subexponentiality. This is clearly seen on a log graph where exponential growth is represented by a straight line. (The lines have wobbled in the past, however, so should be extrapolated with caution!)

Image
My graph. Contains public sector information licensed under the Open Government Licence v3.0. : https://www.nationalarchives.gov.uk/doc/open-government-licence/version/3/

We clearly still have a long way to go.


Julian F. G. W.

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Re: The dash for herd immunity

#427121

Postby 9873210 » July 12th, 2021, 5:37 pm

jfgw wrote:I can certainly see some logic to opening up but share concerns that opening up before there is sufficient protection from vaccines may result in a meltdown. I can also see logic in letting this happen in the summer, however.

Could you please explain this logic. I've heard several versions none of which make sense.

1) Individual cases are less severe in summer. A claim I have seen no evidence for and makes little sense.

2) School holidays. These are completely under our control. We have already massively disrupted everything. If school needs to be rescheduled for JAN-DEC 2022 so school is not open during NOV 2022 its not actually that hard. Far less disruptive that almost everything that has already been done. It's not like the current school calendar makes sense, it's just a bunch of historical accidents.

3) There are fewer cases in summer because we open windows and are outdoors. Almost certainly true, but only relevant if you are in the all or nothing camp. If you view non-pharmalogical interventions as a menu to choose enough of until you get cases down to an acceptable level this is simply an issue of degree, not a reason to remove all restrictions in summer.

4) Flu, avoid the double epidemic. Anything that suppresses COVID (except the vaccine) almost eliminates flu. We will not get a flu epidemic until we completely relax COVID restrictions. Even a minimal tapering (rather than abrupt end) to restrictions prevents this.

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Re: The dash for herd immunity

#427166

Postby jfgw » July 12th, 2021, 7:16 pm

I am not saying that this is the best strategy (although it may be), just that I see some logic to it. This is a complex matter involving psychology as well as epidemiology (a lower case count is likely to correlate with higher vaccine hesitancy, for example).

With the current vaccination programme, infections are necessary in order to reach the herd immunity threshold. It is better to have the vaccinations before getting infected, however, as the infection is likely to be less serious, but time is against us. If we have more infections in the summer, we will be better protected in the Winter when R0 is greater. This will make it easier to control the virus when we most need to.

One of the unknowns is the R0 of future variants. If a variant were to emerge with an R0 of 10, say, the HIT would be 90%. We could be in very serious trouble if we did not already have a high level of herd immunity. Consider the current situation in New South Wales; there is a low level of herd immunity and the delta variant (R0 = 5 estimated — possibly much higher as it is Winter over there) is causing a rapid increase in cases.* There is a real risk that we in the UK could find ourselves in a similar position in six months' time, especially as our current immunity may have reduced effectiveness against some new variants.


Julian F. G. W.

*https://www.nsw.gov.au/covid-19/find-the-facts-about-covid-19#nsw-covid-19-statistics

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Re: The dash for herd immunity

#427206

Postby Mike4 » July 12th, 2021, 10:12 pm

jfgw wrote:I am not saying that this is the best strategy (although it may be), just that I see some logic to it. This is a complex matter involving psychology as well as epidemiology (a lower case count is likely to correlate with higher vaccine hesitancy, for example).


That's an interesting point. Maybe the guvvermint's reasoning in stoking up the infection rate, is to scare the hard of thinking into getting vaccinated.

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Re: The dash for herd immunity

#427228

Postby servodude » July 13th, 2021, 1:07 am

jfgw wrote:Consider the current situation in New South Wales; there is a low level of herd immunity and the delta variant (R0 = 5 estimated — possibly much higher as it is Winter over there) is causing a rapid increase in cases.* There is a real risk that we in the UK could find ourselves in a similar position in six months' time, especially as our current immunity may have reduced effectiveness against some new variants.


Interestingly there's "not much daylight" yet between the current NSW and last years VIC cases
I have been expecting that there would be a more obvious accelerated increase due to "delta" but that hasn't happened yet (yesterday's numbers out shortly)

hacked a comparison together in to this to demonstate:
Image

- there's probably a week or so's growth baked in (given that the 'mockdown' thus far includes having most shops open) so it might start to break away soon

What does however seem a change from last year is the demographic composition of those in hospital; it has shifted younger
- possibly because of improvements in protecting the really elderly
- or possibly because of the variant as it seems a trend that's been reported elsewhere in delta outbreaks

From yesterday's press conference (out of 664 currently active cases) there are:
- 63 people in hospital of which 18 are in ICU ( 4 ventilated)
- 25 of them are under 55
- 14 are under 35
(last year ~25% would have been under 55 and I do not remember reports of teens in ICU from them as there have been now)

One silver lining might be that it encourages an increase in uptake of jabs

Apparently the pfizer deliveries to OZ have been brought forward but it's really hard to tell how many are being stuck in arms
- the reported numbers (we're repeatedly told) only include those at govt hubs, which is not GPs and TBH I'm not sure if includes hospitals

There is a bit of latency however because it's up to you to make your appointment.
So it did take me a 5 minute phone call and a week of waiting to get my first jab at our local hospital; second one was booked at the appointment and performed 23 days later.

I could have walked up and got an AZ shot and saved that week (and phone call)
- but there's no-one doing that, literally no-one
- the wife's second shot was at the weekend and in the 20 minutes she was in the Royal Exhibition Building in Melbourne can you guess how many people walked in the AZ walk in queue? (OK yeah it's trick question)

They're trying all sorts of stuff to convince folk to vaccinate: https://www.theage.com.au/national/victoria/heavy-handed-prime-minister-backs-port-melbourne-pub-s-free-beer-for-jab-promotion-20210709-p58891.html
- it's a very strange time indeed

- sd

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Re: The dash for herd immunity

#427443

Postby XFool » July 13th, 2021, 5:25 pm


‘Cheers’: PM overturns ban on pub’s free beer for jab promotion

Well, if that's what it takes to motivate an Australian. :)

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Re: The dash for herd immunity

#427537

Postby servodude » July 14th, 2021, 1:43 am

XFool wrote:

‘Cheers’: PM overturns ban on pub’s free beer for jab promotion

Well, if that's what it takes to motivate an Australian. :)


Indeed, every little helps ;)

I think the motivation will appear when the virus kills more than the vaccine roll out

There have been two COVID deaths in the past few days due to the current Sydney outbreak; which means there have now been 3 in 2021
- i think that brings it about even with the Australian deaths caused by the AZ vaccine - so the perception of the risk balance might start to shift

It does seem like the pace of vaccination is picking up
- and with the proportion of the uptake which is Pfizer there shouldn't be a huge lag till it translates to double jabs

I doubt though that it will get to the level you would like in the first pass and we'll end up with the kind of situation Israel is currently seeing

-sd


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