Coronavirus COVID-19 Thread

[NaffNaffBobFace]

COVID Corner - Some reports from some news outlets from today, Monday 28th of November:

- World: Global Confirmed 261,862,513 Global Deaths 5,204,346

- WHO: Omicron Covid variant poses very high global risk, says WHO

- Omicron: new variant now also recorded in Spain, Sweden and Canada

- South Africa: South African scientists explore vaccines’ effectiveness against Omicron

- UK: UK’s minimum gap for Covid booster jabs to be halved to three months

- UK: All UK adults to be offered Covid booster jab

- UK: Wear a mask or be fined, London mayor says

- China: China pledges one billion Covid jabs for Africa

- Australia: Australia delays reopening over Omicron variant

- Netherlands: Dutch police arrest Covid quarantine escapees

- France: Big jump in coronavirus cases recorded in France

 

[Bambooza]

Have you had a chance to take a look at that report on the efectiveness of masks yet? I think things which provide that kind of new perspective could play a big part in what becomes mandatory and what becomes advisory.

I did find the regional study which is a great start to an aggregate of multiple studies. But the effectiveness of mask-wearing as stated in the research document calls out that while the studies included in the aggregate have a high risk of bias (6 studies) and are heterogeneity between the studies was substantial. Other studies were rejected because the meta-analysis had substantial differences in the assessed outcomes. So the conclusion was that the risk of bias across the six included studies ranged from moderate to serious or critical. While the study authors attempted to compensate for the bias there are many caveats and more high-level evidence is required.

Mask wearing and covid-19 incidence—Six studies with a total of 2627 people with covid-19 and 389 228 participants were included in the analysis examining the effect of mask wearing on incidence of covid-19 (table 1).364357606366 Overall pooled analysis showed a 53% reduction in covid-19 incidence (0.47, 0.29 to 0.75), although heterogeneity between studies was substantial (I2=84%) (fig 5). Risk of bias across the six studies ranged from moderate36576066 to serious or critical4363 (fig 2).

The question comes in with the bias of the studies being so high especially when you look at several studies where one says a 45.7% fewer covid019 related mortality in countries where mask-wearing was mandatory and another shows only a 2% reduction in transmission after the introduction of mandatory mask-wearing.

Overall effectiveness of these interventions was affected by clinical heterogeneity and methodological limitations, such as confounding and measurement bias. It was not possible to evaluate the impact of type of face maks (eg, surgical, fabric, N95 respirators) and compliance and frequency of wearing masks owing to a lack of data. Similarly, it was not feasible to assess the differences in effect that different recommendations for physical distancing (ie, 1.5 m, 2m, or 3 m) have as preventive strategies.

Overall effectiveness of these interventions was affected by clinical heterogeneity and methodological limitations, such as confounding and measurement bias. It was not possible to evaluate the impact of type of face maks (eg, surgical, fabric, N95 respirators) and compliance and frequency of wearing masks owing to a lack of data. Similarly, it was not feasible to assess the differences in effect that different recommendations for physical distancing (ie, 1.5 m, 2m, or 3 m) have as preventive strategies.

Previous literature reviews have identified mask wearing as an effective measure for the containment of SARS-CoV-2104; the caveat being that more high level evidence is required to provide unequivocal support for the effectiveness of the universal use of face masks.105106 Additional empirical evidence from a recent randomised controlled trial (originally published as a preprint) indicates that mask wearing achieved a 9.3% reduction in seroprevalence of symptomatic SARS-CoV-2 infection and an 11.9% reduction in the prevalence of covid-19-like symptoms.107 Another systematic review showed stronger effectiveness with the use of N95, or similar, respirators than disposable surgical masks,108 and a study evaluating the protection offered by 18 different types of fabric masks found substantial heterogeneity in protection, with the most effective mask being multilayered and tight fitting.109 However, transmission of SARS-CoV-2 largely arises in hospital settings in which full personal protective measures are in place, which suggests that when viral load is at its highest, even the best performing face masks might not provide adequate protection.51 Additionally, most studies that assessed mask wearing were prone to important confounding bias, which might have altered the conclusions drawn from this review (ie, effect estimates might have been underestimated or overestimated or can be related to other measures that were in place at the time the studies were conducted). Thus, the extent of such limitations on the conclusions drawn remain unknown.

They even draw the same conclusion in their comparison with other studies that far more high level evidence is required, that the studies they did use were prone to confounding bias that might alter conclusions as well as the possibility that other measures in place at the same time might be the source of the conclusion. Thus the authors state that the limitations son the conclusions drawn are still unknown.

This review has some limitations. Firstly, high quality evidence on SARS CoV-2 and the effectiveness of public health measures is still limited, with most studies having different underlying target variables. Secondly, information provided in this review is based on current evidence, so will be modified as additional data become available, especially from more prospective and randomised studies. Also, we excluded studies that did not provide certainty over the effect measure, which might have introduced selection bias and limited the interpretation of effectiveness. Thirdly, numerous studies measured interventions only once and others multiple times over short time frames (days v month, or no timeframe). Additionally, the meta-analytical portion of this study was limited by significant heterogeneity observed across studies, which could neither be explored nor explained by subgroup analyses or meta-regression. Finally, we quantitatively assessed only publications that reported individual measures; studies that assessed multiple measures simultaneously were narratively analysed with a broader level of effectiveness (see supplementary material 3, table 3). Also, we excluded studies in languages other than English.

And here is their listing of limitations.

Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis

Objective To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. Design Systematic review and meta-analysis. Data sources Medline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and...

www.bmj.com

So the conclusion is that it's a great first step as is needed to start finding out how effective if at all mask-wearing is but the BBC is wrong in saying the study concludes that mask-wearing is 57% effective in reducing the spread of covid. The truth is the study shows that there is the potential for mask-wearing has a statistically significant impact on the spread of covid especially in highly contaminated areas like hospitals. But that the study is limited due to the limited studies to build upon.

 

[Bambooza]

You should already be able to be back to your daily life, just be prepared to wear a mask while you're doing it. But we're paying for an overreaction our governments collectively had. They stopped global trade. You can't do that, because we depend on trade to do everything, including having a place to work. We're still seeing the repercussions.

I think we are only starting to see the repercussions. But my question was more a broad scope as to the reaction over covid, the delta variant, and now the omicron variant. At what point do the masses just give up on attempting to follow regional covid restrictions and revert back to pre covid behaviors?

We’re never going to get a normal like pre covid. We’re going to have a new normal whether we like it or not. The sudden rush to remove masks was premature, I’ll give the uk gov it’s due that this time they’re not waiting for it to get bad and are trying to get ahead of it.

I am not sure I agree with you on this. It seems there is a significant rift within regional populations as to their desires and how they want to proceed. While most places seem to have people just disregarding and no enforcement of such actions there has been widespread riots over covid restrictions and laws.

 

[Vavrik]

I think we are only starting to see the repercussions. But my question was more a broad scope as to the reaction over covid, the delta variant, and now the omicron variant. At what point do the masses just give up on attempting to follow regional covid restrictions and revert back to pre covid behaviors?

As far as I know, any time you want to, depending on your individual state. We're back to that in Texas already, except for businesses that have mask rules for employees. That might actually be most businesses - but I can't tell I only know the area around Houston and Austin. Houston it's not popular and customers in a store don't but employees do almost everywhere. Austin is a little bit different. I mean well over half of everyone I saw this past week was wearing or carrying a mask, but a high percentage of those people were also smoking a joint (It's still illegal in Texas.)

 

[NaffNaffBobFace]

I did find the regional study which is a great start to an aggregate of multiple studies. But the effectiveness of mask-wearing as stated in the research document calls out that while the studies included in the aggregate have a high risk of bias (6 studies) and are heterogeneity between the studies was substantial. Other studies were rejected because the meta-analysis had substantial differences in the assessed outcomes. So the conclusion was that the risk of bias across the six included studies ranged from moderate to serious or critical. While the study authors attempted to compensate for the bias there are many caveats and more high-level evidence is required.



The question comes in with the bias of the studies being so high especially when you look at several studies where one says a 45.7% fewer covid019 related mortality in countries where mask-wearing was mandatory and another shows only a 2% reduction in transmission after the introduction of mandatory mask-wearing.








They even draw the same conclusion in their comparison with other studies that far more high level evidence is required, that the studies they did use were prone to confounding bias that might alter conclusions as well as the possibility that other measures in place at the same time might be the source of the conclusion. Thus the authors state that the limitations son the conclusions drawn are still unknown.




And here is their listing of limitations.

Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis

Objective To review the evidence on the effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality. Design Systematic review and meta-analysis. Data sources Medline, Embase, CINAHL, Biosis, Joanna Briggs, Global Health, and...

www.bmj.com

So the conclusion is that it's a great first step as is needed to start finding out how effective if at all mask-wearing is but the BBC is wrong in saying the study concludes that mask-wearing is 57% effective in reducing the spread of covid. The truth is the study shows that there is the potential for mask-wearing has a statistically significant impact on the spread of covid especially in highly contaminated areas like hospitals. But that the study is limited due to the limited studies to build upon.

So what's your opinion?

 

[Bambooza]

So what's your opinion?

That an N95 mask worn correctly in a highly contaminated environment offers protection to the wearer along with proper PPE and frequent handwashing. The same goes for the general public that a properly fitted N95 mask that is not touched, frequent hand washing, and glasses offers great protection against infection. The issue comes in that this is not what is happening while wearing a face-covering might help in reducing the size, spread, and concentration of fomites it's not eliminating their creation. Add on the number of times people touch their mask to adjust it and take it on and off while it's moist with virus-laden particulates and then not washing their hands allows a higher concentration of fomites on high contact surfaces like doorknobs. This doesn't count for the fact that lots of face mask material are inadequate if it's even worn covering one's mouth and nose at all.

Some of the studies they excluded talked about the possibilities of mask concentration leading to a spike in touch surface transmission. There was another study that showed while the common disposable surgery mask does reduce the size of virus-laden molecules aerosolization it does nothing to protect the wearer from inhaling aerosolized virus molecules. This ties into another study that was looking into the correlation between initial virus infection load and the severity of the immune response.

So my opinion on the study is that it's going in the right direction but I am very cautious against their findings due to both the small accepted sampling (6 studies) combined with their tweaking the data based upon their own estimates of the studies bias through effect estimates. They also correctly stated that the studies were unable to separate the effect mask-wearing had from other preventative measures like social distancing and hand washing as well as if the mask were worn correctly nor their frequency of use.

I find no fault with the study nor the authors as it's a great first step in digging into a complex topic and I am sure more will build off it successfully. The biggest issue I have is the media reporting that this study unequivocally shows mask usage reduces covid transition by 59% which is untrue.

 

[Vavrik]

The biggest issue I have is the media reporting that this study unequivocally shows mask usage reduces covid transition by 59% which is untrue.

This conclusion is true. Some masks may reduce exposure by 59%, some by 95%, and some by 10% or even nothing. By the way if you have a full beard, don't bother with N95 or N99... your beard makes them no better than a strip of burlap.

But wearing a mask is also a package, that cannot be separated from other behaviors, such as hand washing, not scratching your face, wearing gloves if necessary, keeping the mask over your mouth and nose, etc. Do it all, you get more protection than that guy at the grocery store with his n99 respirator pulled over his nose even if your mask is made from an old cotton shirt. By the way, until the 1990's all masks were just layers of cotton.

Also, if your mask says KN95 anywhere on it, it is NOT and N95 mask. You're in the territory of unregulated masks that are better than a surgical mask but not N95.

 

[NaffNaffBobFace]

That an N95 mask worn correctly in a highly contaminated environment offers protection to the wearer along with proper PPE and frequent handwashing. The same goes for the general public that a properly fitted N95 mask that is not touched, frequent hand washing, and glasses offers great protection against infection. The issue comes in that this is not what is happening while wearing a face-covering might help in reducing the size, spread, and concentration of fomites it's not eliminating their creation. Add on the number of times people touch their mask to adjust it and take it on and off while it's moist with virus-laden particulates and then not washing their hands allows a higher concentration of fomites on high contact surfaces like doorknobs. This doesn't count for the fact that lots of face mask material are inadequate if it's even worn covering one's mouth and nose at all.

Some of the studies they excluded talked about the possibilities of mask concentration leading to a spike in touch surface transmission. There was another study that showed while the common disposable surgery mask does reduce the size of virus-laden molecules aerosolization it does nothing to protect the wearer from inhaling aerosolized virus molecules. This ties into another study that was looking into the correlation between initial virus infection load and the severity of the immune response.

So my opinion on the study is that it's going in the right direction but I am very cautious against their findings due to both the small accepted sampling (6 studies) combined with their tweaking the data based upon their own estimates of the studies bias through effect estimates. They also correctly stated that the studies were unable to separate the effect mask-wearing had from other preventative measures like social distancing and hand washing as well as if the mask were worn correctly nor their frequency of use.

I find no fault with the study nor the authors as it's a great first step in digging into a complex topic and I am sure more will build off it successfully. The biggest issue I have is the media reporting that this study unequivocally shows mask usage reduces covid transition by 59% which is untrue.

Thanks for your interpretation. As I'm just copying the headlines over I don't need to read the articles any more so that's very helpful, cheers.

 

[NaffNaffBobFace]

COVID Corner - Some reports from some news outlets from today, Tuesday 30th of November:

- World: Global Confirmed 262,440,676 Global Deaths 5,212,252

- Europe: Omicron variant in Europe earlier than thought

- UK: Scotland: All nine Omicron cases linked to single event

- Netherlands: Escaped couple fight Omicron quarantine in TB ward

- Greece: Greece to fine over-60s who refuse Covid vaccine

- World: Global markets fall after Moderna Omicron warning

- UK: Booster offer for England adults by end of January

- Israel: Boosters may protect against Omicron, says Israel's health minister

- US: US agency evaluating effectiveness of vaccines against Omicron

- Ireland: All travellers entering Ireland will have to show negative Covid tests

 

[Bambooza]

This conclusion is true. Some masks may reduce exposure by 59%, some by 95%, and some by 10% or even nothing. By the way if you have a full beard, don't bother with N95 or N99... your beard makes them no better than a strip of burlap.

But wearing a mask is also a package, that cannot be separated from other behaviors, such as hand washing, not scratching your face, wearing gloves if necessary, keeping the mask over your mouth and nose, etc. Do it all, you get more protection than that guy at the grocery store with his n99 respirator pulled over his nose even if your mask is made from an old cotton shirt. By the way, until the 1990's all masks were just layers of cotton.

Also, if your mask says KN95 anywhere on it, it is NOT and N95 mask. You're in the territory of unregulated masks that are better than a surgical mask but not N95.

All very true. And to think I used to shave to go scuba diving.

As I said over a year ago mask-wearing as it has been implemented was more a political conveniences show of action than anything else. And it might help a little in reminding people to be diligent about not touching their faces and keeping apart. But like all things for political gain, it's been corrupted and turned into a visible party affiliation.

While we do know that a properly fitted N95 mask as part of a medical staff's PPE is very effective in greatly reducing the spread of the virus from the patent to the medical professional. While it does not 100% eliminate the risk it does help.

But this is not the general public mandate (nor do I think the general public would be as religious about washing their hands as the medical professionals are, heck I was pretty lax when handling cadavers and then going out to eat a snack).

But we are not talking about this level of protection we are looking at the general public who is wearing disposable surgical masks incorrectly fitting.

or washable cloth masks

Or just not caring

So back to the origional question. At what point do we stop pretending we are ahearing to the mandate and just allow things to run its course? We are already seeing the 6 month booster request being implemented which I am not sure is substainable either.

 

[Vavrik]

So back to the origional question. At what point do we stop pretending we are ahearing to the mandate and just allow things to run its course? We are already seeing the 6 month booster request being implemented which I am not sure is substainable either.

I saw a bunch of pictures of idiots at the end of that. They deserve what they get. All of them, and I realize who is in the list. Bad example to set. not to worry, the former president also did the same.

The problem with the vaccines is that they are created for the Alpha variant, and it happens to manage reasonably well against the Delta variant. Omicron is currently under investigation. I can't speculate on that. The vaccines are targeting a specific trait of the virus spike protein. That's going to become a problem eventually, maybe now. When I say "Wear a mask" that does not say just "wear a mask", the statement means "Do the Needful", all of it. For a very long time if required to be safe, and keep others around you safe.

The virus itself will eventually punish anyone who thinks they're special, or tired of masks and the rest. That punishment has a chance to last for months, or be the end and it is not a pleasant way to go. If you've ever seen someone on a ventilator you'd know what I mean. Not where you want anyone to end up.

EDIT: BTW there is some very preliminary evidence that Omicron may have traded potency for high transmissibility. More on that will take some time to get, they have done only limited testing, and only in one fairly high vaccine update area.

 

[Bambooza]

I saw a bunch of pictures of idiots at the end of that. They deserve what they get. All of them, and I realize who is in the list. Bad example to set. not to worry, the former president also did the same.

I was going to include the former president as well as other countries' politicians, actors, and others in the limelight especially if they have in any way preached about mask-wearing, but I grew bored and so only posted a few of the current ones.

The problem with the vaccines is that they are created for the Alpha variant, and it happens to manage reasonably well against the Delta variant. Omicron is currently under investigation. I can't speculate on that. The vaccines are targeting a specific trait of the virus spike protein. That's going to become a problem eventually, maybe now. When I say "Wear a mask" that does not say just "wear a mask", the statement means "Do the Needful", all of it. For a very long time if required to be safe, and keep others around you safe.

The virus itself will eventually punish anyone who thinks they're special, or tired of masks and the rest. That punishment has a chance to last for months, or be the end and it is not a pleasant way to go. If you've ever seen someone on a ventilator you'd know what I mean. Not where you want anyone to end up.

EDIT: BTW there is some very preliminary evidence that Omicron may have traded potency for high transmissibility. More on that will take some time to get, they have done only limited testing, and only in one fairly high vaccine update area.

You are right that there is a need to do all of the needful things and correct mask-wearing of a correctly fitted rated mask can be a part of that. But by the same logic, this could also have been applied to the yearly flu which also had free yearly vaccines with no stigma or political theater involved. And while influenza's death rate is less than 1% compared to this novel strain of coronavirus they still have lots of similarities. This does ask the question if immunity either archived by needle or cold reduces ones future probability of death to a level on par with the common cold which was ignored by the vast majority of the population at what point do we say ok our reaction was debatable but it's no longer a global pandemic and we should move onto the next dumpster fire? And maybe the answer is until there is another dumpster fire this is the current focus and will remain so for another year or two if nothing else comes along or the actions of governments will provoke enough people that it grows beyond the current riots into something more government changing.

At what measure do the global pandemic end and we are allowed to return to our regularly scheduled programs?

 

[Vavrik]

At what measure do the global pandemic end and we are allowed to return to our regularly scheduled programs?

As far as I know, any time you want to, depending on your individual state.

As far as the rest of the globe is concerned, I don't even know about Canada, and I'm from there.

 

[NaffNaffBobFace]

COVID Corner - Some reports from some news outlets from today, Wednesday 1st of December:

- World: Global Confirmed 263,080,976 Global Deaths 5,220,467

- UK: Doctors gobsmacked by air filter's effect on Covid

- UK: PM under fire over No 10 lockdown Christmas parties

- UK: Man who glued lock of vaccine centre is jailed

- World: WHO: ‘Omicron is a variant of concern, not panic’

- EU: Ursula von der Leyen says mandatory jabs should be considered

- World: Omicron variant found around the world as countries tighten travel rules

- Israel: Israeli doctor believes he caught Omicron at London medical conference

- Evolution: Covid variants may not evolve to be less dangerous, says UK expert

- WHO: WHO advises vulnerable, unvaccinated and over 60s, against travel

- France New restrictions for non-EU arrivals in France

- Omicron: Information on the transmissibility of Omicron expected within days

- US: US airlines ordered to hand over names of all passengers coming from southern Africa

- Ghana, South Korea: Ghana and South Korea announce detection of Omicron

- Norway: Norway identifies first two Omicron cases

- EU: EU rollout of vaccines to children aged 5-11 will start week earlier than planned

 

[Jolly_Green_Giant]

I was just at the VA clinic a week ago or so. I asked about the booster (I had the 2 dose Pfizer in March) and they said I didn’t need it. I did however get My flu shot.

EDIT: just to add some more info, the VA still has people outside each entrance doing Covid screenings, making sure everyone uses hand sanitizer before they go in, and you have to wear a mask. Unless some place requires it for entry, I haven’t seen anyone wearing one. I don’t go out much so I’m not seeing the whole picture, but if anyplace would have mask enforcement, I would have thought it would be my dentist. Nope.

 

[Jolly_Green_Giant]

Have any of you seen any of the other variants shown here? I wonder what’s so exclusive about the omicron variant if these other variants still exist along side it. Obviously the alpha and delta variants have been front and center, but I’m wondering if I’ve just missed the news on the other variants all together.

EDIT: this might be a better snapshot

 

[Vavrik]

Have any of you seen any of the other variants shown here? I wonder what’s so exclusive about the omicron variant if these other variants still exist along side it. Obviously the alpha and delta variants have been front and center, but I’m wondering if I’ve just missed the news on the other variants all together.



View attachment 21977

EDIT: this might be a better snapshot



View attachment 21978

They mostly remain variants of interest (VoI is the lowest rating of a named strain), not variants of concern (VoC is the highest rating we've seen) or variants of high concern (VoHC is the highest) rating... we would be seeing extra 0''s on the deaths columns). They continue to watch all of these.

There are probably over 1000, maybe several thousand variants that have an alpha numeric code, but don't receive a name. Some of them may generate a VoI or VoC in the future, that's why they're tracked. But right now even though some are deadly there seem to be something keeping their population from growing. Usually its another variant.

Last I looked (yesterday evening), Omicron was a Variant of Interest but could become a variant of concern soon. None of the variants have become variants of high concern, which is a verry good thing .

 

[SoloPlayerZA]

 

[SoloPlayerZA]

I can start to say what I am hearing on the ground from friends and family, that this omicron is no joke compared to delta. Very very infectious and hits very hard. This seems likely to spread like wildfire… we will know by Christmas how rough it is.

 

[NaffNaffBobFace]

I can start to say what I am hearing on the ground from friends and family, that this omicron is no joke compared to delta. Very very infectious and hits very hard. This seems likely to spread like wildfire… we will know by Christmas how rough it is.

Thanks for the update in your area. The UK news where I am is passing on reports from medics in SA saying most infections they are seeing have only mild symptoms...

That said, for the vast majority of cases of original, Alpha and Delta cases were 'mild' with 250 million cases against 5 million deaths so semantics count for a lot...

Time will tell, indeed.