New coronavirus in/from China

[Little John]

They include ALL respiratory illnesses INCLUDING Covid19

Don't believe me? Check the ONS stats for yourself.

But, of course, we both know you wont be doing that don't we.

[PS_RalphW]

I believe you LJ. It just emphasises how efficient the lockdown has been at reducing serious airborne respiratory disease.

The question is, is it still sufficient now a more infectious variant appears to be spreading throughout the country and probably the rest of the world?

[PS_RalphW]

The tier 4 extension from Boxing day has been confirmed for several more counties. Also, the South African strain has been identified in UK samples.

By mid January we will know how bad it will be getting.
The more infectious the virus, the more people need vaccination to gain herd immunity. At 70% effective, the Oxford vaccine by itself may not be enough even with 100% vaccination rate.

Covid is looking like the new normal.

[Little John]

Meanwhile:

The BMJ ponders how it is that the poorest nation in Europe, Belarus, and the only one not to have had any lockdowns has one of the lowest death rates in Europe.

Funny that, isn't it. Oh aye, it's f***ing hilarious.

Belarus’s beleaguered government remains unfazed by covid-19. President Aleksander Lukashenko, who has been in power since 1994, has flatly denied the seriousness of the pandemic, refusing to impose a lockdown, close schools, or cancel mass events like the Belarusian football league or the Victory Day parade.

Yet the country’s death rate is among the lowest in Europe—just over 700 in a population of 9.5 million with over 73 000 confirmed cases.

https://www.bmj.com/content/370/bmj.m3543

[clv101]

It's not funny at all, it's expected for the reasons explained in the article. Beating covid is not down to magic or luck, there are a set of pretty straightforward responses that work, have worked. The UK and most of the west have, unfortunately, failed to take appropriate action.

[Little John]

It's not funny at all, it's expected for the reasons explained in the article. Beating covid is not down to magic or luck, there are a set of pretty straightforward responses that work, have worked. The UK and most of the west have, unfortunately, failed to take appropriate action.

Do you know what the average annual death by all causes is in Belarus?

Do you know what the annual average death rate by all causes is in the UK?

Do you know what the death rate, by all causes, thus far this year, is in Belarus and, by extension, what the excess death rate by all causes, thus far this year, is in Belarus?

Do you know what the death rate, by all causes, thus far this year, is in the UK and, by extension, what the excess death rate by all causes, thus far this year, is in the UK?

Wanna take a wild guess on the last two questions?

[Catweazle]

Meanwhile:

The BMJ ponders how it is that the poorest nation in Europe, Belarus, and the only one not to have had any lockdowns has one of the lowest death rates in Europe.

Funny that, isn't it. Oh aye, it's f***ing hilarious.

Belarus’s beleaguered government remains unfazed by covid-19. President Aleksander Lukashenko, who has been in power since 1994, has flatly denied the seriousness of the pandemic, refusing to impose a lockdown, close schools, or cancel mass events like the Belarusian football league or the Victory Day parade.

Yet the country’s death rate is among the lowest in Europe—just over 700 in a population of 9.5 million with over 73 000 confirmed cases.

https://www.bmj.com/content/370/bmj.m3543

From the article you have linked to:

Although the low death numbers are encouraging, some experts fear that many coronavirus related deaths are registered as cases of pneumonia—UN data show a difference of 5605 between April-June 2019 compared with the same period in 2020.11 And the deaths per capita ratio remains one of the highest in Europe. Nilson is cautious, “Until we have the figures for excess deaths, I don’t want to praise Belarus too much.”

[Little John]

I'd lay money on Belarus' excess deaths per million this year being the same as the UK's, which is the same as the several other Western countries I have looked at.

Non existent

[kenneal - lagger]

You seem to place great store in the honesty of rulers with totalitarian tendencies, LJ. It hasn't usually been a great way to go for most countries.

I hope you all have a very Happy Christmas despite everything going on. I know I will.

[Little John]

My Christmas will be a quiet one this year.

My dad, following a short illness that was grossly mismanaged due to the shitty lock-down regulations leading to him ending up in hospital, his biggest fear given the ban on family visits, having been not allowed to see his family until right near the end of his life by which point he was barely conscious of us even being there and, in the end, surrounded by strangers in masks without his family around him, died alone.

His funeral was this morning.

[Little John]

From the BMJ

Evidence of asymptomatic spread is insufficient to justify mass testing for Covid-19

https://www.bmj.com/content/371/bmj.m4436/rr-10

Whilst we would take issue with Lateral Flow tests being the main culprit, Mike Gill is absolutely correct to criticise mass testing programmes.

His ire should really be directed, though, at PCR testing. Data from PCR testing – for which there is no proper determination of an end-to-end operational false positive rate – has almost exclusively dictated tier restrictions and lockdown policy in the UK.

PCR’s fingerprints can in fact be found all over the entire global response to this pandemic. Testing with Lateral Flow, other antigen tests and bedside PCR tests are all finding far fewer cases than diagnosed by PCR testing. Even a low sensitivity for all these other tests could not account for the size of the discrepancy.

Mass testing and accompanying harmful lockdown policies are justified on the assumption that asymptomatic transmission is a genuine risk. Given the harmful collateral effects of such policies, precautionary principle should result in a very high evidential bar for asymptomatic transmission being set. However, the only word which can be used to describe the quality of evidence for this is woeful.

It is important to carefully distinguish purely asymptomatic (individuals who never develop any symptoms) from pre-symptomatic transmission (where individuals do eventually develop symptoms). To the extent that the latter phenomenon - which has in fact happened only very rarely - is deemed worthy of public health action, appropriate strategies to manage it (in the absence of significant asymptomatic transmission) would be entirely different and much less disruptive than those actually adopted.

Many early studies which purported to demonstrate the phenomenon of asymptomatic transmission were from China, yet the fact that Chinese studies are only published following government approval must bring into question their reliability (1). Nevertheless, the high volume of these studies spawned significant salience of the issue within the medical community, and an assumption of the likelihood of asymptomatic transmission being an important contributory factor. There then followed a number of meta-analyses examining the issue of asymptomatic transmission which tended to aggregate and give equal weight to studies regardless of origin or quality. In this way, these meta-analyses, given undue credibility by their association with reputable universities, amplified minimal evidence of asymptomatic spread to an importance the data did not warrant.

As reported in a manuscript submitted to this journal and also to medRvix on 16 Dec 2020 (the latter available for download shortly), we examined the papers most frequently cited in support of the existence of asymptomatic transmission. Even despite our criticisms of the sources of the data above, we did in fact find only 6 case reports of viral transmission by people who throughout remained asymptomatic, and this was to a total of 7 other individuals, however all of these were in studies with questionable methodology.

Moreover in all these studies, confirmation of “cases” was made via PCR testing without regard to the possibility that any of the cases found might be false positives. The case numbers found, are, in any event extremely small and certainly not sufficient to conclusively determine that asymptomatic transmission is a major component of spread.

It is also notable that, in what would seem to represent an abrupt volte face by the CCP, a further (presumably government-approved) study from China was recently published (2) which entirely contradicts the earlier conclusions regarding the phenomenon of asymptomatic transmission, which had been driven by Chinese data in particular, early in the pandemic.

Some might conclude that that study lacks the credibility one might expect for a paper published in Nature; it is claimed, for example, that they PCR-tested 92% of Wuhan’s population (~10m individuals) over a 19-day period at the end of May, and found just 300 positive PCR tests, implying a FPR of no greater than 0.003%. Further, it is claimed that while 100% of the 300 PCR positive cases were asymptomatic, there were zero symptomatic PCR positive cases out of ~10m tested during a period only a few weeks after the epidemic had peaked in Wuhan.

If this seems incredulous, then surely that has serious implications for the way in which earlier studies from China - data from which formed a significant part of the worldwide evidence base for asymptomatic transmission - should be regarded.

Jonathan Engler MBChB LLB

Clare Craig BM BCh FRCPath

Silver, Andrew, and David Cyranoski. 2020. “China Is Tightening Its Grip on Coronavirus Research.” Nature 580 (7804): 439–40.

Cao, S., Gan, Y., Wang, C. et al. Post-lockdown SARS-CoV-2 nucleic acid screening in nearly ten million residents of Wuhan, China. Nat Commun 11, 5917 (2020). https://doi.org/10.1038/s41467-020-19802-w

[Catweazle]

From the BMJ

Evidence of asymptomatic spread is insufficient to justify mass testing for Covid-19

https://www.bmj.com/content/371/bmj.m4436/rr-10

Whilst we would take issue with Lateral Flow tests being the main culprit, Mike Gill is absolutely correct to criticise mass testing programmes.

His ire should really be directed, though, at PCR testing. Data from PCR testing – for which there is no proper determination of an end-to-end operational false positive rate – has almost exclusively dictated tier restrictions and lockdown policy in the UK.

PCR’s fingerprints can in fact be found all over the entire global response to this pandemic. Testing with Lateral Flow, other antigen tests and bedside PCR tests are all finding far fewer cases than diagnosed by PCR testing. Even a low sensitivity for all these other tests could not account for the size of the discrepancy.

Mass testing and accompanying harmful lockdown policies are justified on the assumption that asymptomatic transmission is a genuine risk. Given the harmful collateral effects of such policies, precautionary principle should result in a very high evidential bar for asymptomatic transmission being set. However, the only word which can be used to describe the quality of evidence for this is woeful.

It is important to carefully distinguish purely asymptomatic (individuals who never develop any symptoms) from pre-symptomatic transmission (where individuals do eventually develop symptoms). To the extent that the latter phenomenon - which has in fact happened only very rarely - is deemed worthy of public health action, appropriate strategies to manage it (in the absence of significant asymptomatic transmission) would be entirely different and much less disruptive than those actually adopted.

Many early studies which purported to demonstrate the phenomenon of asymptomatic transmission were from China, yet the fact that Chinese studies are only published following government approval must bring into question their reliability (1). Nevertheless, the high volume of these studies spawned significant salience of the issue within the medical community, and an assumption of the likelihood of asymptomatic transmission being an important contributory factor. There then followed a number of meta-analyses examining the issue of asymptomatic transmission which tended to aggregate and give equal weight to studies regardless of origin or quality. In this way, these meta-analyses, given undue credibility by their association with reputable universities, amplified minimal evidence of asymptomatic spread to an importance the data did not warrant.

As reported in a manuscript submitted to this journal and also to medRvix on 16 Dec 2020 (the latter available for download shortly), we examined the papers most frequently cited in support of the existence of asymptomatic transmission. Even despite our criticisms of the sources of the data above, we did in fact find only 6 case reports of viral transmission by people who throughout remained asymptomatic, and this was to a total of 7 other individuals, however all of these were in studies with questionable methodology.

Moreover in all these studies, confirmation of “cases” was made via PCR testing without regard to the possibility that any of the cases found might be false positives. The case numbers found, are, in any event extremely small and certainly not sufficient to conclusively determine that asymptomatic transmission is a major component of spread.

It is also notable that, in what would seem to represent an abrupt volte face by the CCP, a further (presumably government-approved) study from China was recently published (2) which entirely contradicts the earlier conclusions regarding the phenomenon of asymptomatic transmission, which had been driven by Chinese data in particular, early in the pandemic.

Some might conclude that that study lacks the credibility one might expect for a paper published in Nature; it is claimed, for example, that they PCR-tested 92% of Wuhan’s population (~10m individuals) over a 19-day period at the end of May, and found just 300 positive PCR tests, implying a FPR of no greater than 0.003%. Further, it is claimed that while 100% of the 300 PCR positive cases were asymptomatic, there were zero symptomatic PCR positive cases out of ~10m tested during a period only a few weeks after the epidemic had peaked in Wuhan.

If this seems incredulous, then surely that has serious implications for the way in which earlier studies from China - data from which formed a significant part of the worldwide evidence base for asymptomatic transmission - should be regarded.

Jonathan Engler MBChB LLB

Clare Craig BM BCh FRCPath

Silver, Andrew, and David Cyranoski. 2020. “China Is Tightening Its Grip on Coronavirus Research.” Nature 580 (7804): 439–40.

Cao, S., Gan, Y., Wang, C. et al. Post-lockdown SARS-CoV-2 nucleic acid screening in nearly ten million residents of Wuhan, China. Nat Commun 11, 5917 (2020). https://doi.org/10.1038/s41467-020-19802-w

You have missed two words off the front of quote. "Dear Editor" . Just for clarity.

[PS_RalphW]

So there may be some false positive PCR test results. If this was a significant number then the number of positive results would rise rapidly as testing was ramped up, then stabilise as testing rates reached their steady state. Currently there are over 400,000 tests per day.

In fact, in the period between July and October tests increased steadily from 100,000 to 300,000 but the number of positive results for most of this period flat lined at below 1000 a day, giving a maximum possible false positive rate of 1%. Probably much lower.
Starting in September the number of positives rose exponentially to 20,000 a day, for a positive test rate of about 7%. In October and November the number of tests stabilised at 300.000 a day, but the positive rate dropped as the second lockdown took effect.

In the last few weeks we have a new surge of positives from 10.000 to 40.000 whilst testing has only increased 25%. Positive rate is now over 10%

The inevitable conclusion is that any possible false positive tests are irrelevant to the overall progression and management of this pandemic.

The problem with some researchers is that they are so focused on their own narrow area of research that they cannot see the wood for the trees.

[Little John]

As "Covid19" deaths rise, other causes deaths fall.

In other words, in terms of all cause deaths, there was a bit of a bump in the spring and early summer, followed by bugger all since then. Which is why all cause deaths, for the year 2020, look set to hit the annual average or thereabouts.

That, in case you haven't worked it out yet, is known as a scam

[Catweazle]

As "Covid19" deaths rise, other causes deaths fall.

In other words, in terms of all cause deaths, there was a bit of a bump in the spring and early summer, followed by bugger all since then. Which is why all cause deaths, for the year 2020, look set to hit the annual average or thereabouts.

That, in case you haven't worked it out yet, is known as a scam

I checked the source of that graph ( @victimofmaths ), looks like a sensible source, good find LJ.

He has a few comments on the figures.

Now, we are seeing much lower than usual levels of respiratory deaths that aren't COVID-19 (see the Scottish Graph above, or here https://fingertips.phe.org.uk/static-re ... ying-cause for English data), almost certainly because measures against COVID are also effective against flu etc...

This means that, in the absence of COVID deaths, we would be seeing deaths at well *below* usual levels, so even if mortality rates look normal, that doesn't mean everything is ok.

And all the signs are that these numbers are going to get worse before they get better.

A clearer graph:
https://twitter.com/VictimOfMaths/statu ... 41/photo/1

Page of his graphs:
https://twitter.com/VictimOfMaths/statu ... 5403548676