How does this thing end?

[elbows]

Any vaccine that works will only have limited impact. Some will refuse (for all sorts of reasons) some will be shut out (for all sorts of reasons) etc and so on.

Even if we only had enough vaccination capability to cover healthcare workers, that in itself would be transformative.

 

[SheilaNaGig]

Eighteen months to two years for normality I reckon. And that will be with the economy in a worse position than the 1930s. They'll have to change the name of the great depression to the 'quite bad depression'.

What kind of normally though?

Even if no one were to die of C-19 ever again from this moment on, nothing will be the same again after this.

 

[SheilaNaGig]

I just watched 'The Flu That Killed 50 Million' which was on BBC last Tuesday. The 1918 'Spanish Flu' probably originated in America. The first person diagnosed, Patient Zero, was an Army cook in a Kansas Army training depot. It was carried by infected soldiers from there on troop ships taking soldiers to the battlefields of WW1, and spread from there by soldiers returning to their home countries.

The doctor talking about it said it ended eventually because it was too virulent. No point in killing your host if you want to multiply, so it eventually mutated to a milder version.
So that's how Covid-19 might end, if a vaccine hasn't been developed first.

This virus seems veeerrry tricky though.

Very contagious. hides before symptoms occur. Flits about causing intermitted fever. Shows up in the gut, blood, lungs, and some suggestion that it could also land in the nervous tissue too.

Its not yer common flu thing.

 

[elbows]

Interstitial pneumonia is mechanical. By the time it gets to that point it's too late for pharmaceutical intervention

Oh well you better call all the people doing clinical trials and giving drugs on compassionate grounds and tell them not to bother then, since you've already determined that there are no pharmaceutical answers.

 

[SheilaNaGig]

It is often the way - that milder strains become more prevalent simply because people are able to wander around and spread it, and the more severe strain renders people bedridden and kills the host - if contracting a milder strain confers immunity against the more severe strain then great, however that is an unknown at this point with COVID-19

Viral load seems to be signifiant here: those who are exposed to a greater viral load get sicker sooner.


But.


Over the years dangerous viral infections can become less danebrouds ( e.g. scarlet fever used to be a total killer, less so these days).


Edited to correct autocorrect corrections.

 

[SheilaNaGig]

Boris's Brepidemic - bringing new meaning to the phrase 'booster shot'.

Poor bloke lol etc. He's got such a hardon for Churchill. He wished for this, a chance to lead the nation through the wilderness and the dark blah blah bollocks.

 

[SheilaNaGig]

Oh well you better call all the people doing clinical trials and giving drugs on compassionate grounds and tell them not to bother then, since you've already determined that there are no pharmaceutical answers.

Thats not what I said. Is it?

 

[Epona]

Viral load seem stop be signifiant here: those who are exposed to a greater viral load get sicker sooner.


But.


One the years one dangerous viral infections can become less danebrouds ( e.g. scarlet fever used to be a toal killer, less so these days)

Er... scarlet fever is not viral, it is a bacterial infection (a particular type of streptococcus infection) - what has made it less dangerous now than in victorian times is antibiotics, it is that simple of an explanation. I have had scarlet fever and trust me it is no fucking walk in the park - the most ill I've ever been and lucky I didn't end up with lasting heart or other damage. Could have died even with antibiotics, certainly would have done if I'd lived before their discovery.

(Should probably add that all the antisocial fuckwits demanding antibiotics to try to treat viral infections is going to result in resistant strains that once again make scarlet fever and even less serious bacterial infections a death sentence once more - knowing what is viral and what is bacterial and getting the correct treatment or symptomatic relief is essential for public health in this day and age)

 

[SheilaNaGig]

Er... scarlet fever is a bacterial infection, what has made it less dangerous now than in victorian times is antibiotics. I have had scarlet fever and trust me it is no fucking walk in the park - the most ill I've ever been and lucky I didn't end up with lasting heart damage.

I know it can be seriously serious. I have seen it close up and personal.

I'm not downplaying it.

It's a streptococcal bacterial infection that can cause serious complications all through the body.

There was a period of time in the 90s and early 2000s when it seemed to be becoming a less serious infection. and that was odd and curious. It was less virulent. Why, was unclear.

Having just had a google look I see that it's resurged again recently as a more dangerous disease. So I've learned something since 2006, the last time I saw it. Every day is a school day.


Edit to respond to your edit : yes, I posted haste last night , you’re right to correct me: scarlet fever is not viral it’s bacterial. And improvements in population health and hygiene and treatments have made it less dangerous.

 

[discokermit]

this thing ends when we're digging up the dead from the plague pits for food.

 

[Jay Park]

Was looking at six days in New York, Virgin has a very special deal in business class, incredibly special in fact. But it is non-refundable and if we can’t go then I am not sure when we would be able to. But, meh, just feeling a bit sorry for myself right now as it is dawning that summer holiday won’t be happening and that could well have been the last time BB1 wants to go away with us. But as Frau Bahn has just pointed out, she’s not gonna get in to backpacking, far too used to flying at the front and five star hotels, having a travel agent dad won’t help her out when she’s on her own...

Poor you and your missed holiday, you’ve had a good run at relaxing getaways. Get real man.

 

[Epona]

this thing ends when we're digging up the dead from the plague pits for food.

Really you've been reading too much post-apocalyptic fiction - please try to dial it back to the vaguely rational for the sake of others - some people are genuinely anxious/frightened and I don't think it helps anyone (and may be counter-productive or damaging to the wellbeing of others) to over-catastrophise this - the meme thread is great for releasing a bit of over the top humour however, and there is a thread on nobbing and sobbing for support.

 

[elbows]

Thats not what I said. Is it?

Well you chose to answer someones broad hopes about pharmaceutical intervention with a strangely narrow point. Why did you go that narrow, perhaps just so you could claim that pharmaceuticals would be too late to help?

 

[elbows]

I wonder where it will end for Bolsonaro. He is still sticking with the original Trump type stance.

Brazil's Jair Bolsonaro says coronavirus crisis is a media trick

Far-right president has resisted strong measures to stop spread of what he calls a ‘little flu’

www.theguardian.com

 

[SheilaNaGig]

It’s hardly contravesrial. People are dying because we don’t yet have any effective agent.

I’ve not “determined that there are no pharmaceutical answers”.

There are as yet no determined pharmaceutical interventions.

Would that there were.

What are you trying to lay at my door?

 

[scifisam]

That is the plan isn't it, to enforce periodic lockdowns then relax them on and off - the aim is not to prevent everyone from getting it, it's to prevent everyone from getting it at once and overwhelming the NHS. And longterm to build up some herd immunity as those least at risk catch it.

"Periodic lockdowns" sounds like a scifi dystopia. Never to know if you can plan to see people even in the next town, because there might be another lockdown coming. No way to plan anything that involves groups of people, like gigs or museums or sports events, or weddings, funerals and elections. Never knowing if the lockdown has really ended, so that when it does and you're allowed to see each other, it could be the last time, but you're scared to hug because you're so used to social distancing.

We'd have all died of murder and suicide before the plague got to us after a couple of years of periodic lockdowns.

 

[Epona]

"Periodic lockdowns" sounds like a scifi dystopia. Never to know if you can plan to see people even in the next town, because there might be another lockdown coming. No way to plan anything that involves groups of people, like gigs or museums or sports events, or weddings, funerals and elections. Never knowing if the lockdown has really ended, so that when it does and you're allowed to see each other, it could be the last time, but you're scared to hug because you're so used to social distancing.

We'd have all died of murder and suicide before the plague got to us after a couple of years of periodic lockdowns.

Yeah I wasn't saying I thought it was great
I don't want the state having that much power even in an emergency - btw I do not think people are being careless because they don't care, it is an unprecedented situation that most will not have seen in their lifetime, it's a confusing and frightening time for most. I dunno if anyone has seen any psychological studies on what happens if an alarm goes off in a public place - if one person carries on as normal the majority of others will do so because acting in a different way to usual goes against most of our normal drives even if there is a fucking fire alarm going off right next to you. That is a bit of what we are seeing right now.

 

[scifisam]

Yeah I wasn't saying I thought it was great
I don't want the state having that much power even in an emergency - btw I do not think people are being careless because they don't care, it is an unprecedented situation that most will not have seen in their lifetime, it's a confusing and frightening time for most. I dunno if anyone has seen any psychological studies on what happens if an alarm goes off in a public place - if one person carries on as normal the majority of others will do so because acting in a different way to usual goes against most of our normal drives even if there is a fucking fire alarm going off right next to you. That is a bit of what we are seeing right now.

I don't think it would be possible, though. Telling people to lockdown every now and then, unpredictably, would literally lead to mass murder and suicide, huge levels of unemployment, and total collapse of society. So I really fucking hope that "periodic lockdowns" are not the plan.

 

[Jay Park]

It’s good to work our way through all that’s happening, helpful somewhat, encouraging, and showing a sense that we’ll do as much for each other as we possibly can. But fuck sake even the most knowledgeable of us on here (excluding myself cos thick) have got Bob Hope and no hope in determining how this ‘will end’

your all inclusive stay at a resort in a third-world country will end, but best to leave the conjecture alone.

 

[gosub]

The sun runs out of hydrogen and expands engulfing the planet.

 

[Jay Park]

The sun runs out of hydrogen and expands engulfing the planet.

Im sitting it out on my sofa waiting for it. Any idea how long?

 

[Epona]

My view on how it will end - we'll have some upheaval for a while, people will get sick in waves, most will come through it and some of our most vulnerable won't* - we'll do all we can to protect them. It's not going to be around forever - most likely once around 60-70% of the population has had it we'll have reached a point where enough immunity in the general population exists that it can no longer spread uninhibited, and it will no longer be the threat it is now. There will be an occasional outbreak here and there but we'll have learned better how to deliver symptomatic treatment, our health services won't be as stretched then, maybe there will be a vaccine.

We do know that plagues have come and gone throughout history. Nothing about this is entirely new apart from our ability to spread it through international travel in a few hours - maybe how tuned in we are to media and how connected we all are that can in some ways lessen the fear by providing a sense of community without so much need for face to face contact, and in some ways increase it with fake news and doomsaying.

*I don't say that lightly btw - pretty much everyone I care deeply about is in the high risk group and likely to die should they contract the virus. Just want you to know I have a stake in this, I am not talking from a dispassionate standpoint where it does not directly affect me. Just I cannot let that emotional response govern my rational understanding of the situation.

 

[Epona]

I don't think it would be possible, though. Telling people to lockdown every now and then, unpredictably, would literally lead to mass murder and suicide, huge levels of unemployment, and total collapse of society. So I really fucking hope that "periodic lockdowns" are not the plan.

Well that wasn't something I invented, that was what I saw a couple of weeks ago as how they intended to limit flooding NHS services with too many cases at once - so it isn't my suggestion, and don't hold me responsible for it. Just reporting my understanding of what is likely to be implemented in order to manage the situation over several months.

 

[elbows]

It’s hardly contravesrial. People are dying because we don’t yet have any effective agent.

I’ve not “determined that there are no pharmaceutical answers”.

There are as yet no determined pharmaceutical interventions.

Would that there were.

What are you trying to lay at my door?

I was trying to understand what you were going on about and why. There is no way I would have inferred your follow up stance from what you originally said.

 

[scifisam]

Well that wasn't something I invented, that was what I saw a couple of weeks ago as how they intended to limit flooding NHS services with too many cases at once - so it isn't my suggestion, and don't hold me responsible for it. Just reporting my understanding of what is likely to be implemented in order to manage the situation over several months.

Erm, I wasn't holding you responsible for locking the country down, because I'm aware you're not Boris Johnson. I was discussing the scenario you propose as likely.

 

[SheilaNaGig]

I was trying to understand what you were going on about and why. There is no way I would have inferred your follow up stance from what you originally said.

It worries me enormously that once the virus has triggered a particular cascade of physiological outcomes that leads to interstitial pneumonia, the lung tissue can then become fibrotic, and that’s something we currently have no drugs to counteract. The fibrosis is structural, mechanical. It’s scarring. After that point it’s management and support.

If we’re talking on this thread about end points and outcomes, one of my concerns is that those who recover from very serious symptomology may have to be dealing with fibrotic lungs on the other side, for the rest of their lives.

 

[sleaterkinney]

Boris's Brepidemic - bringing new meaning to the phrase 'booster shot'.

Virus Johnson.

 

[SheilaNaGig]

Interstitial pneumonia is mechanical. By the time it gets to that point it's too late for pharmaceutical intervention

I need to clarify what I was trying to say here and also to apologise.

SpookyFrank elbows

It was late, I’d had a drink and I was posting too hastily, jumping ahead in my thoughts and conflating several thoughts into inaccurate declarations. I’m sorry for that.

(I did the same thing in my reply to Epona )

Interstitial pneumonia is inflammation off the lung tissue. It’s really serious and at the moment there doesn't seem to be any way to control the inflammation. Some confusion about whether (certain) steroids are making things worse. It’s like a wildfire, like what was happening in Australia recently, too much too fast too widespread to be able to get on top of it or ahead of it.

We may be able to either repurpose existing drugs or develop drugs that can handle this kind of acute interstitial viral pneumonia but right now that’s beyond us.

The mechanical problem occurs when/if the tissue becomes fibrotic in response to the inflammation. That is, starts to form scar tissue in an effort to fix the immediate issue. Once the lungs become scarred, as with any other scar tissue, it’s fixed and - so far at least - we don’t have any drugs that can mend scar tissue. That will mean long term difficulties for survivors.

Not everyone who survives serious acute C-19 will develop pulmonary fibrosis but I fear it will be an issue for a significant number.

When this thread started I kinda collapsed into my fears. I should have stepped away from the internet at that point rather than posting.

Apologies all round.

 

[elbows]

Thanks for your further thoughts

I've been trying to cut people some slack because of the enormity of the situation, but it seems I am still rather twitchy about claims regarding medical matters. I do want to know about long term complications for some, but I would rather wait till the formal data is there, even if many of the underlying assumptions when predicting may be sound anyway.

The only thing I feel like predicting on this front is that the pressure for pharmaceutical interventions in the months ahead is going to be immense. I just hope they find something thats at least somewhat appropriate, and if not, that they dont kid themselves and go ahead anyway.

 

[SheilaNaGig]

Thanks for your further thoughts

I've been trying to cut people some slack because of the enormity of the situation, but it seems I am still rather twitchy about claims regarding medical matters. I do want to know about long term complications for some, but I would rather wait till the formal data is there, even if many of the underlying assumptions when predicting may be sound anyway.

The only thing I feel like predicting on this front is that the pressure for pharmaceutical interventions in the months ahead is going to be immense. I just hope they find something thats at least somewhat appropriate, and if not, that they dont kid themselves and go ahead anyway.

You were right to pull me up. I shouldn’t have have posted in the state I was in (tired, overstretched, overthinking, five or six fingers of rum...)

I’ve been having hard conversations with colleagues about outcomes. I let some of the residue spill over here. Lesson learned. I’ll be more circumspect in future.