IOM Covid removing restrictions

[Roger Mexico]

2 hours ago, rachomics said:

Not necessarily, there are numerous reports (even on the Island, if I may be so bold) of people testing positive at day 14+. It's all about risk mitigation. Even a 14 day isolation won't stop all community cases. The problem with no testing at all is that the first anyone will know about community spread is when a patient comes into the hospital as a severe COVID19 case and tests positive on admission. That's not when you want to find out it's in the community. 

I've not seen many cases where people have gone on to test positive after 14 days isolation, when they weren't testing positive at 13/14 days.  There are a lot of people in the New Zealand cases in isolation who don't test at 3 days but do at 12/13, though most of those would probably have tested positive earlier.

The only exceptions seem to be in certain circumstances:

Cross-contamination - either from someone they are co-isolating with or from others in a shared environment (there's been a few New Zealand cases like that)

or Developing Covid-19 and still being infectious.  There's a particular variety of this with some elderly patients where they test negative (often after testing positive before), but clearly have the disease and are found to be positive later, say on postmortem.

Edited November 1, 2020 by Roger Mexico
Clarity

[Nom de plume]

15 minutes ago, rachomics said:

Well, knowing that, for example, 2% of returning travellers test positive at day 7 versus 20% of returning travellers testing positive at day 7 informs the isolation periods and the travel policies in place for various groups. There's a big difference. 

Manx people who travel across are far more likely to be careful while they're in the UK as they don't want to be "the person who brings it back", especially with some people being entirely asymptomatic. 

Data is only as useful as what you use it for, but if you have no data at all then you're flying blind. 

Hi Rachel,

I’m interested to know what your thoughts are on the IOM mitigating risk (gradual reopening & testing regime) or trying to adopt a policy of eradication at all costs?

[WTF]

57 minutes ago, rachomics said:

 

Data is only as useful as what you use it for, but if you have no data at all then you're flying blind. 

that's how it works over here most of the time,  the rest of the time they just invent the data to justify a course of action that suits the right people.

[Gladys]

BBC2 now has a very interesting documentary on the US response.

[TheTeapot]

37 minutes ago, Gladys said:

BBC2 now has a very interesting documentary on the US response.

I've been watching it. What a mess.

[Banker]

46 minutes ago, WTF said:

that's how it works over here most of the time,  the rest of the time they just invent the data to justify a course of action that suits the right people.

And invent a letter to try & smear Rachel & the media at same time

[Gladys]

12 hours ago, John Wright said:

 

One story was it had been bought to analyse genes in dog poo, but wasn’t used. 

Please tell me that has no foundation whatsoever.

[Gladys]

1 hour ago, TheTeapot said:

I've been watching it. What a mess.

Frightening, but you can parallels with how the UK have dealt with covid. 

One if the messages was an effective test and trace system and it would seem that our (IOM)  testing regime is somewhat impaired. 

[NoTail]

I don't see how you can assess our system as impaired when there are no actual cases to track and trace. 

[TheTeapot]

6 minutes ago, Gladys said:

Frightening, but you can parallels with how the UK have dealt with covid. 

One if the messages was an effective test and trace system and it would seem that our (IOM)  testing regime is somewhat impaired. 

I think the US is going to have an incredible winter. It's going to get much worse there. Right towards the end it had a former CDC director saying something like 'don't listen to politicians, listen to the scientists'. Lots of people outright refuse to though, and there's always the chance the scientists are wrong too. I like Dr Bright (the camp guy who got fired for speaking out), I've read or heard quite a bit from him.

It's been pretty clear for quite some time now that an ability to test properly, track contacts and isolate people has been the best way to handle things. That's why the UK so utterly failing in that is so so depressing. They had a great chance there in the summer, its obvious from the numbers and graphs that they had the transmission right down. You can't successfully track and trace 100000 infections or whatever it is a week, its just too hard. 

I really hope our leadership has spent the time putting plans in place. That 'case' from the office the other week sort of suggests that plans are in place and that they are ready to jump into action, but we'll see. 

[Gladys]

8 minutes ago, TheTeapot said:

I think the US is going to have an incredible winter. It's going to get much worse there. Right towards the end it had a former CDC director saying something like 'don't listen to politicians, listen to the scientists'. Lots of people outright refuse to though, and there's always the chance the scientists are wrong too. I like Dr Bright (the camp guy who got fired for speaking out), I've read or heard quite a bit from him.

It's been pretty clear for quite some time now that an ability to test properly, track contacts and isolate people has been the best way to handle things. That's why the UK so utterly failing in that is so so depressing. They had a great chance there in the summer, its obvious from the numbers and graphs that they had the transmission right down. You can't successfully track and trace 100000 infections or whatever it is a week, its just too hard. 

I really hope our leadership has spent the time putting plans in place. That 'case' from the office the other week sort of suggests that plans are in place and that they are ready to jump into action, but we'll see. 

I suspect the tracking is easier here, but what about testing? 

Yes, I felt Dr Bright was genuine and the health product salesman.  The handling of procurement of PPE in the early days was just unbelievable- to have the Federal Govt bidding against states was inexplicable.  Why were they procuring and for whom?  But Donald required one state health leader to ask him personally for PPE and then to thank him publicly!  I wonder if that documentary has been aired in the US yet. 

Edited November 2, 2020 by Gladys

[TheTeapot]

27 minutes ago, Gladys said:

I suspect the tracking is easier here, but what about testing? 

Yes, I felt Dr Bright was genuine and the health product salesman.  The handling of procurement of PPE in the early days was just unbelievable- to have the Federal Govt bidding against states was inexplicable.  Why were they procuring and for whom?  But Donald required one state health leader to ask him personally for PPE and then to thank him publicly!  I wonder if that documentary has been aired in the US yet. 

Well I don't know what to say about our testing here, or lack of it. I am obviously concerned with what's gone on recently, it's completely mental and will backfire. It's going to get back into the community, I'm amazed it hasn't already. I think that program made the point that if the first you know is when someone turns up ill at the hospital then you're already screwed. The vast majority of people travelling here must be taking their responsibilities very seriously. 

Edit - I've said before getting rid of the 7 day test was a mistake. I now think following the massive increase in the UK that ALL travelers should be offered one, for free.

It was gavin newsome, gov of california who had to debase himself in such a way, its absurd. There have been others, its like paying tribute, kissing the ring. The federal government have on the one hand said its down to individual states, and on the other you've got to go through us. And Trump politicizes everything, red or blue states, you've got to like him for help. Germany is a federation of states too, the difference is huge.

It must be pretty tough being a scientific advisor to a government. You could tell weeks ago that Whitty wanted to scream at Boris when the tier system was introduced, he diplomatically said it probably wouldn't work. Imagine working for Trump. Dr Fauci in the US looks now like he's had enough, he's a bit shorter with his words, still trying not to be political but sending out serious warning signals. The other one, Dr Birx, who was involved has also given up working with the White House, she's apparently gone out to work directly with states. That Atlas guy running the show now is a dangerous lunatic. 

 

Edited November 2, 2020 by TheTeapot

[BenFairfax]

6 hours ago, rachomics said:

Not necessarily, there are numerous reports (even on the Island, if I may be so bold) of people testing positive at day 14+. It's all about risk mitigation. Even a 14 day isolation won't stop all community cases. The problem with no testing at all is that the first anyone will know about community spread is when a patient comes into the hospital as a severe COVID19 case and tests positive on admission. That's not when you want to find out it's in the community. 

This is exactly my concern and number of actual community cases which have occurred when the first case is reported is a key risk metric. Guernsey was very fortunate with recent community case because individual needed a test before traveling, but I think traced 9 cases back to them and never discovered source. In my mind inter household transmission during 14 day isolation period to non isolation parties is bit of hole of our local protocols. Quick google search throw up this (refereed scientific article) entitled 'Household transmission of COVID-19-a systematic review and meta-analysis', see:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7446647/

which in first line states:

'Infection risk of household contacts is 10 times higher than other contacts.' 

With this aside and assuming when 350 students return rather than chatting with Mum they decide to lock themselves in shed for 14 days, even when emerge as Rachel tells us could still be infectious. 

Just to put some sort of metric on the risk of people still being infectious after 14 days I read through this article which summarizes data from several studies:

https://www.journalofinfection.com/article/S0163-4453(20)30651-4/fulltext#bib0032

and under section 'Analysis and interpretation of virus culture study findings' give as worse case (from that data set):

"As such, 6 patients amongst 217 patients (maximum proportion of approximately 3%) are estimated to have had samples containing replicative SARS-CoV-2 in vitro beyond day 10 post symptom onset."

The report goes on to detail that these patients are likely to be or become severe-to-critical patients, but could also just be immunocompromised. 

 

[thesultanofsheight]

8 hours ago, Gladys said:

Please tell me that has no foundation whatsoever.

I think it’s pretty accurate. If you go on her business website she seems to analyze a lot of poo.

https://www.taxagenomics.com/services/species-from-faeces/

And I seem to recall that there is a post way back in one of these threads that suggested the equipment was bought by government to identify the dishers out of dog poo and never used. So maybe our extreme petty mindedness in government spending a huge amount of money just to identify dog shit so they can fine dog owners has some unseen and unpredicted benefits. 

Edited November 2, 2020 by thesultanofsheight

[Gladys]

31 minutes ago, thesultanofsheight said:

I think it’s pretty accurate. If you go on her business website she seems to analyze a lot of poo.

https://www.taxagenomics.com/services/species-from-faeces/

And I seem to recall that there is a post way back in one of these threads that suggested the equipment was bought by government to identify the dishers out of dog poo and never used. So maybe our extreme petty mindedness in government spending a huge amount of money just to identify dog shit so they can fine dog owners has some unseen and unpredicted benefits. 

I do remember there were calls to DNA dog poo to fine owners, but never thought that that was a serious contender, far less that equipment had been purchased with that objective.