Covid 19 Part XXII-30,360 in ROI(1,781 deaths) 8,035 in NI (568 deaths)(10/09)Read OP

darjeeling wrote: »

ICU doctors understand medicine and how to diagnose and treat the patients in front of them. They can recognise changing patterns in patient profiles and symptoms, but there are a whole lot of factors that determine who ends up in intensive care and I wouldn't expect ICU doctors to have the background or the data to infer that viral evolution is responsible for any of these changes. For that you would need to look at viral genome sequences over time and, if appropriate, to do in vitro or - better - in vivo infection studies.

The UK ICU doctor quoted above said this:


... all of which is factually incorrect.

Even as the number of tests carried out has increased, test positivity rates have been rising in Spain and France. That means that more people are getting infected. Since the 2nd week in July the positivity rate has risen in Spain from 1.4% to over 8% and in France from 1.1% to 3%.

Hospital and ICU admissions and deaths in Spain have been rising exponentially over the last ~7 weeks, doubling every 2 weeks. Weekly covid hospital admissions were around 140 the 2nd week in July, and as of yesterday stood at 1,500.
Six days ago the Spanish govt started releasing daily bed occupancy numbers. There were 4,636 covid in-patients a week ago and yesterday there were 5,903, a rise of 27% in six days.
A week ago there were 522 covid ICU patients and yesterday there were 697, a rise of 33% in six days.

Numbers in France are not rising as fast, but hospital admissions have more than doubled from 60 a day seven weeks ago to 140 as of yesterday, and ICU admissions have risen from around seven a day to 26.

A likely reason for the faster rise in Spain is that a higher proportion of older people are being infected, as revealed by positive test rate stats for each age group in the two countries.

darjeeling wrote: »

There's a very good reason for looking at what's happening in Spain.

Spain has the biggest outbreak in western Europe right now, and is the country where new infections have spread furthest into older age groups.

Most countries in western Europe, including Spain, seem to me to be pursuing the same strategy. This is a return to 'flatten the curve' from the suppression strategy pursued during lockdown. As we open up further and we enter into winter, I expect cases to rise and I expect this to lead to more hospital cases, including severe ones. Preventing infections among vulnerable people when the virus is circulating at high incidence would be very difficult and would require frequent rapid testing of lots of care facility staff and residents, and I don't know that any country is geared up for that.


As for the virus becoming 'weaker', my arguments there are based on looking at patterns of evolving viral genomes in different countries over time, and I can see no evidence for a major change in the populations of viruses out there now from what was there a few months ago.

darjeeling wrote: »

I'm talking as someone with quite a lot of experience of working in genetics, which is very relevant to the point I was making.

And I haven't said anything like 'truly horrific'. I don't expect governments to allow things to go that far. If I am right, I expect they will have to reimpose social distancing each time hospital occupancy gets above a critical level. This was the whole 'flatten the curve' idea laid out in March before we realised how bad things had become already.