Mutating Corona Virus

[brassnecked]

They seemed to forget all about the impact on Care Homes for sure, now they are finding out.

Some useful pointers as to where UK Gov are messing up in Dr Richard North's blog today, all of it common sense that the tech blinded Hancock and co seem to lack.

 

http://www.eureferendum.com/blogview.aspx?blogno=87586#disqus_thread

[tobyjugg2]

 

UK coronavirus death toll more than double hospital figure, new analysis suggests

More than 40,000 people believed to have died – twice the total once described as ‘a good result’

 

https://www.independent.co.uk/news/uk/politics/uk-coronavirus-death-toll-latest-update-new-analysis-covid-19-a9477761.html

 

 

 

Staggering and monstrous if true

 

I had estimated that the death total from Coronavirus was being under-reported by somewhere between about 10-25% (as near as I could figure) when Bazzas noticed that 50% discrepancy with the testing figures,

but when I looked agian at what generated my very rough estimates, I couldn't see where a 50% error in deaths or testing number could possibly come from other than including people who were already at deaths door being nudged that final step, just as a case of more ordinary flu 'could'.

Relevant,and utterly horrible for those families and loved ones affected,  but arguable.

 

 

Then 7% under reporting hit the headlines and I thought - mm that seems a little conservative.

 

Then 15% under-reporting hit the headlines and I thought - my higher end is looking more possible.

 

Then this.

Which if even just half way true, it would seem that the under reporting can only be by design IMO.

Rank incompetence simply doesn't cut it.

 

Edited April 23, 2020 by tobyjugg2

[honeybee13]

BN, before I read the article. This government thinks it can solve any problem with tech [or sometimes with maths if Cummings is involved]. Like the Irish border, I could never see how that would work, certainly in the time frame. Another country that uses tech as one of their counter-measures said something like you can't big tech your way out of something that has no tech.

 

The UK is going to train contact tracers 'within weeks'. Better late than never. I wonder if it's possible to use some of the 750,000 NHS volunteers who don't seem to have a lot to do. At the very least they could do the phoning part of the follow up, I'd have thought.

 

https://www.thetimes.co.uk/article/army-of-thousands-to-help-trace-coronavirus-victims-bhhdbtwgj?shareToken=6387881cd92488d86f3dc66eeb7601a1

 

ETA: From the article:

'The NHS is developing a smartphone app that logs contact through Bluetooth. However, Allyson Pollock, a professor at Newcastle University, insisted that “we don’t need fancy expensive apps”, telling the BBC that even San Francisco was deploying a “low-tech model using people and telephones”. She estimated that training courses for volunteers, teachers or students could be done in a few days.'

 

 

[tobyjugg2]

Who the heck is going to give Pritti Patel access to their movements.

 

Walk 10 feet past someone on her vast undesirable list (probably 90%+ of the population) and you'll be deported whether your families lived here since the Magna Carta or not.

 

and all that data would undoubtedly end up in US security databases and US biotec firms at the very least.

 

'We have evidence that you were in the company of abdullah the bad, known terrorist sympathiser"

"What evidence"

"We can't divulge that in the interests of National Security, but our judge has been shown indisputable evidence that you were an arms length from him"

 

Edited April 23, 2020 by tobyjugg2

[tobyjugg2]

or even that the data is handed over to the parking charge lobby to ensure they dont have to rely on sending out charges to nurses legitimately using closed pub car parks

(not that they will stop that - but its simply not enough income)

 

'We have evidence you were out of your house for more than an hour, and/or more than once a day

 

Here is your 27 fines for breaking the lock down rules over the last 6 months.

Thats 27 * £60  or  £1,500 if paid with 21 days.

Edited April 23, 2020 by tobyjugg2

[brassnecked]

As they are using Zoom, and Chinese tech, its probably going to end up in Beijing as well, TiKTok  is a noted data miner for China.

[tobyjugg2]

and this in the context of supposedly 100,000 tests a day by next week

 

https://www.theguardian.com/world/2020/apr/23/uk-plans-to-test-300000-for-immunity-to-coronavirus

 

 

and this figure

"18,516 deaths recorded in England and Wales in the seven days to April 10 makes it the deadliest week since the winter of 2000. It was almost 8,000 higher than the five-year average for the time of year."

 

Thats in a week.

Edited April 23, 2020 by tobyjugg2

[hightail]

1 hour ago, tobyjugg2 said:

Who the heck is going to give Pritti Patel access to their movements.

Not me. 

[honeybee13]

There's a blistering article from John Ashton today on how HMG has dealt with Covid.

 

https://bylinetimes.com/2020/04/23/the-coronavirus-crisis-who-is-the-government-trying-to-fool-us-or-itself/

[maroondevo52]

 

We were told yesterday at work we had delivered and collected round 30,000 tests last week but they say it will shortly be 100,000 per day.

I find that hard to believe.

[unclebulgaria67]

Apparently when you have the tests done at one of the stations set up, they take a swab from the throat so it makes you gag and the swab from the nose is also uncomfotable as they penetrate to the top of the nose.

 

I guess that this is to get the best sample possible.   People taking the samples at home may not be as thorough and therefore you wonder about accuracy.

[BazzaS]

It isn’t “the top of the nose”.

 

There are also differences between what should happen with a swab taken by:

a) a healthcare provider, and

b) Self-taken

The highest quality site to swab to maximise getting positive results from people with upper respiratory symptoms is the “nasopharynx”

 

The ideal is to use a fine enough swab (most aren’t) to go BACK (not up!) through the nose to the bit in continuity with the throat (the naso-pharynx). It is hard to get these (even when taken by healthcare professionals!!), [Given the experience they have with swabbing for pertussis (whooping cough), where it is essential to get naso-pharyngeal].

 

For those who doubt noses (and swabs thereof) can go “back more than up”:

https://www.gloshospitals.nhs.uk/our-services/services-we-offer/pathology/tests-and-investigations/pernasal-swab-whooping-cough-pertussis/
 

OK, that is for a whooping cough swab, but it shows “nasopharyngeal”. This is the ideal for testing by trained staff, but most swabs are too large, and have a non-flexible shaft, so is only used where available / safe.

 

Most swabbing by healthcare staff, (using swabs which are larger And / or have a non-flexible shaft), going backwards, are “mid-turbinate”, which is next best to naso-pharynx

 

The technique (used by healthcare staff) is shown at https://www.hps.scot.nhs.uk/web-resources-container/covid-19-obtaining-an-upper-respiratory-tract-diagnostic-sample/

 

My supporting evidence for which sites (nasopharyngeal > mid-turbinate > anterior nares) are best is at 

https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html

Yet, there are concerns that the public might use too much force, crunching the (delicate!) turbinate bones.

 

So, for the PUBLIC, Self-testing.... they are using the front (still not “the top”!) of the nose.

 

The ones at the front of the nose (“anterior nares”) are next best, but poorer sites to retain test quality, while “up the nose” is the worst, and that is one of the concerns about self-testing ......
 

As a trade off of ”safety vs widespread self-testing vs test sensitivity”, they are accepting self-testing, with “front of nose”, 

 

https://www.gov.uk/government/publications/covid-19-guidance-for-taking-swab-samples/how-to-use-the-self-swabbing-kit-for-a-combined-throat-and-nose-swab-video
 

This stresses “front of nose”, not “top of nose”.

 

 

 

[brassnecked]

A look at the UK Gov  rersonses to Covid, not good for sure  http://www.eureferendum.com/blogview.aspx?blogno=87589#disqus_thread

[unclebulgaria67]

@BazzaS excellent detailed response.

 

If reports are correct, there will be mobile testing units touring the country and where necessary home visits for testing.  My current nearest testing station is over an hours travel away.

 

Self testing given the points you raise,  does appear to be a least credible option.

[BazzaS]

20 minutes ago, unclebulgaria67 said:

 

Self testing given the points you raise,  does appear to be a least credible option.

I deal with stats, and practicalities.

 

I’ll start with the stats, apply that to the testing, and then intersect that with the practicalities.

 

I often use one of Churchill’s quotes when trying to explain the limitations of stats (people are usually already aware of “there are lies, damned lies, and statistics”)

 

Churchill is quoted (amongst many of his one liners!) as saying “Democracy is the worst form of government, except for all the others”

It is likely the same for self-testing (long explanation follows .........)

 

I point out the same for stats. They are a scientifically based form of guesswork.

The most common analysis is trying to assess if 2 populations are actually different or not. The best stats can do is say that there is a 95% (called “statistically significant”) chance or 99% (“statistically highly significant”) chance that any apparent difference between the 2 populations didn’t arise by chance alone.

 

So, when they say A is a better choice than B, based on the stats, it is still “A looks better than B, based on the stats, which still might have occurred by chance, it is just not that likely it was just by chance”. Like democracy being the worst other than all the others, the stats aren’t truth, they are just more information than not having stats!

 

They also depend heavily on the question being asked of them, such as “Is medicine (or test!) C better than D”. As an example, the FDA when considering medicine / test C ask a slightly different question .......

 

contrast “Is test C better than D?” with “Is test C not worse than D?”

One is “superiority” the other “non-inferiority” (the answer changing from No to Yes if they are of equal performance!)

 

So for stats:

a) look at the actual question being asked

b) healthy skepticism

c) rely on the stats, but knowing / accepting their limitations.

 

This then for testing : I’ve mentioned before that “Test negative” and “Test positive” mean to most people “not got Covid” or “has covid”, but it isn’t that simple.

 

in the lab (not in the real world!) when evaluating a test, they can asses for 100 tests, split them into positive and negative results, and  ONLY WHERE THEY KNOW what the ACTUAL test result SHOULD be, split those into true positive, false positive, true negative and false negative test results. This then gives both ‘sensitivity’ and ‘specificity’ values : but this still only tells them how the test performs in the lab against the “true” result you are hoping to get.

 

This then is likely why the raft of promised tests got rejected because the test performance was too poor : “Mr Hancock has said that 15 of the most promising antibody tests had been tested, but none was good enough.”

https://www.bbc.co.uk/news/amp/health-51943612
 

Then comes the real kicker. What counts in the real world isn’t “sensitivity” and “specificity” on their own (bearing in mind these are “lab” values!, but where they intersect with “prevalence” : how much of the disease is actually out there!

These then map into what really counts to an individual: “positive” (or negative!) “predictive value”.

These are what matter, especially if moving from testing “people we think could be positive” to “testing everyone”. The detailed maths would likely switch most people off, but if you want,

https://www.wired.co.uk/article/coronavirus-antibody-tests-uk-accuracy

gives a model for 95% sensitivity, 95% specificity (sounds good, yes?), with 5% prevalence..... result: 47 true positives, 47 false positives, PPV of 50%.

0f those being told : positive result, only 1/2 will have truly been positive.

 

Another factor is that we don’t truly know the population prevalence yet, so when I’m asked to comment on a PPV (or NPV), my first question is “how do I trust this : did they know the prevalence?” (Back to ‘lies, damned lies, and ........)

 

Yet, there is a need for testing.
which tests, too?

NAAT (which is what most people mean when they say ‘PCR’), antigen, or antibody tests? 

 

The science behind the tests (and what a test result actually means, for which test type, which sample, and the individual test kit) is essential to interpret the “result” and how much credence to give it.

Self testing is fraught with risk, but on a practical basis might be the only realistic option for large scale testing (a bit like democracy, “the worst, excepting all the others which are even more bad”).

 

Ensuring people take the sample correctly AND that it is used for the “symptomatic” not the “worried well” might help retain its predictive values, but this is where the science and understanding of the importance of prevalence over sensitivity / specificity interacts with the politics : and the clamour for “test everyone”.

 

By all means test, but people need to understand that “negative” and “positive” test absolutely do not mean “hasn’t got it” / “has it” (for the NAAT), and that “negative” and “positive” (for the antibody test) does not mean “hasn’t had it” / “has had it”.

 

Test wisely. Know the limitations of the test, who is being tested and why, and interpret the results with care. Don’t fall into the fallacy of “test everyone, it is the only way” : if people are asking for that, get them to explain the PPV and NPV to you and be wary of trusting them if they can’t ...

 

 

 

[honeybee13]

Who saw the Panorama report last night? It looks like upsetting viewing.

 

https://www.bbc.com/news/newsbeat-52440641

[brassnecked]

Might be worth reading Dr North's blog today,  the media are catching up with the mistakes made.

 

http://www.eureferendum.com/blogview.aspx?blogno=87591#disqus_thread

[honeybee13]

Richard North doesn't mince his words, does he?

[brassnecked]

No he doesn't I think hew has nailed it that UK Gov are useless and are now trying to squirm out of it. Thing is he knows his stuff, and has shown exactly where why and how mistakes have been made.

[tobyjugg2]

22 hours ago, honeybee13 said:

Who saw the Panorama report last night? It looks like upsetting viewing.

 

https://www.bbc.com/news/newsbeat-52440641

 

Are we all forgetting who we needed to protect the NHS from before Johnson et al stole the 'Protect our NHS' statement?

 

https://metro.co.uk/2019/12/09/boy-4-forced-sleep-hospital-floor-no-beds-11413718/

 

Boy, 4, forced to sleep on hospital floor because there were no beds

 

 

 

 

 

 

and lets not forget the tory response to this

https://www.theguardian.com/uk-news/2019/dec/09/tories-accused-lying-distract-photo-boy-hospital-floor

 

"With just days to go until polling day, the Tories suffered one of their worst days of the campaign as Johnson refused on camera to look at a picture of the poorly child and pocketed the phone of the reporter who tried to show it to him."

 

"The incident escalated when Matt Hancock, the health secretary, was dispatched to Leeds General Infirmary in an effort to show that the party was taking the case seriously. But Johnson’s team ended up trying to deflect the story on to Labour by wrongly briefing that a Tory aide was “punched” outside the hospital by a leftwing activist."

 

Edited April 29, 2020 by tobyjugg2

[brassnecked]

Here is the Government Action Plan from March 3rd.  All well and good for Flu but not SARS.  Mainstream Media have failed to grasp what the realities are and construct a biff-bam conflict from what should be a clinical analysis of what is going on https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/869827/Coronavirus_action_plan_-_a_guide_to_what_you_can_expect_across_the_UK.pdf

[tobyjugg2]

I'm still waiting for the Tories to turn on the NHS and start trying to blame them for everything.

 

Hand-cock was rather premature, and got burned with his 'Theres no shortage - nhs staff are wasting stuff' rubbush

 

What with all the Tories privatised  bits failing miserably and the NHS shining, they've got to turn that around haven't they ...

 

 

... Let alone the reports of vast quantities of apparently missing stuff that has presumably been charged to NHS budgets ...

Edited April 30, 2020 by tobyjugg2

[brassnecked]

Problem is Labour would have had the same plan and PPE for the wrong disease just like the Tories. None of the Parties would be better or worse than another.

[honeybee13]

Labour would have had access to the Exercise Cygnus report though, wouldn't they? From what I've read, senior Tories looked at it, decided it was too scary and didn't do anything.

 

Cygnus was about a respiratory virus.

[tobyjugg2]

The 'government' is choosing scientists to match its requirements, and ensuring the 'scientific' recommendations stay in line.

 

I see little evidence of those requirements being scientific or common sense requirements of addressing the pandemic past, present or future.

 

I expect more and more pressure from the ERG to protect their own business interests at whatever cost to everyone else.

(and yes I do largely understand the national finances)

Edited April 30, 2020 by tobyjugg2