COVID 2019 Comorbidity with Diabetes

With regards to antibody tests. If such a test shows you have had covid, presumably you will have survived it relatively intact as those who were significantly sicker would have had hospital testing for the actual virus.

As such my hope is that if you have to rely on these tests (for those with less severe, uncertain cases) even if reinfection is possible then the fact you were able, biologically, to fight it off the first time is hopeful for any subsequent exposure.

Not such a positive outlook for those hospitalised I know but immunity isn’t being disproved at this point - just not proved.

It can’t be proved until recovered people are re-exposed. The length of time a person might be immune can’t be established until some time has passed since first infection and even for patient zero that is only a few months. So it’s hard to prove anything right now.

Not so different to where low carb for type 2 diabetes was a few years ago.

Bluetit1802 said:

In the UK the doctors treating Covid patients will have full access to the person's GP medical records (I assume). Smokers will have their smoking details on these medical records. We are asked about smoking when we have health check ups. It is one of the tick box checks, and used when they do the Q-Risk scores. Of course, not everyone tells the truth.

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Yes, but the studies being quoted are from China and the CDC in America.
I think we need to wait for better data.

It was interesting how John Campbell felt that virus was probably being passed on when shopping in supermarkets and this made a case for wearing masks while shopping to protect others.
D.

Brunneria said:

Yes, but the studies being quoted are from China and the CDC in America.
I think we need to wait for better data.

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There is all these studies going on and we just get the occasional press statement like the Oxford one, taken at face value its good news but when unwrapped it may not be what it seems be.
Any vaccine couldn't be produced in enough quantities in the uk.
It would be nice to get more info, for eg on the Porton Down tests, but we will have to wait till when this peak is over, I think.
D.

therower said:

Yes . I appreciate that. Fortunately or unfortunately I’m in a position of knowing a bit more than a lot of others regarding what is happening in the hospitals at the moment, especially regarding covid.
This isn’t the platform to talk about what is happening and the decisions being made.
Decisions are HAVING to be made in a lot of instances.

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We are being asked to do a lot of things and have laregly complied and I udnerstand that those in charge have to make a call one way or the other without perfect data (to say the least) but we are not in China and should question whether the current lockdown is necessary or even effective. Afterwards it will be legitimate to ask how our public health in the UK and the overburdening of the NHS due to the same co morbidities rendered us so fragile. That is not to denigate the NHS but it cannot be treated as a sacred cow either.

NicoleC1971 said:

We are being asked to do a lot of things and have laregly complied and I udnerstand that those in charge have to make a call one way or the other without perfect data (to say the least) but we are not in China and should question whether the current lockdown is necessary or even effective. Afterwards it will be legitimate to ask how our public health in the UK and the overburdening of the NHS due to the same co morbidities rendered us so fragile. That is not to denigate the NHS but it cannot be treated as a sacred cow either.

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This is a very interesting interview:

https://unherd.com/thepost/coming-up-epidemiologist-prof-johan-giesecke-shares-lessons-from-sweden/

It all hangs on whether people develop immunity, and for how long that immunity lasts
(different viruses produce different immunity periods.
This link discusses the norovirus’ roughly 6 month immunity https://theconversation.com/your-bl...to-norovirus-the-winter-vomiting-virus-129125
This link discusses current understanding of COVID-19 immunity https://news.sky.com/story/coronavi...19-survivors-have-immunity-who-warns-11975011
This link looks at general coronavirus immunity, and speculates that other coronaviruses may give a month to a year or two of immunity, on average
https://www.webmd.com/lung/news/20200414/will-coronavirus-exposure-mean-lasting-immunity#1 )

Sweden are making assumptions about the rate of reinfection and the extent of immunity.
They may be justified in those assumptions. They may not be.
Too early to say.

Personally, I believe that without the current lockdown in the UK, the nhs would have been overwhelmed.
The current infection/death rates suggest the UK has achieved a very fragile balance between ingoing infection (and hoped-for immunity) and maxing out resources to cope with the sick.
The current PPE shortage shows how terribly fragile that balance is.

I don’t know how resilient Sweden’s healthcare system is, or how well their vulnerable population is protected.
But at the moment, I think I would rather be here in the UK, with the aforementioned fragile balance, and plenty of spare hospital beds in the pop up hospitals, rather than being in Sweden.

I reserve the right to change my mind on that at any time though.

Goonergal said:

This is a very interesting interview:

https://unherd.com/thepost/coming-up-epidemiologist-prof-johan-giesecke-shares-lessons-from-sweden/

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That was indeed very interesting. The professor may well be correct but when people are dying the public expect politicians to do something (even if in the long term it doesn't make any difference). There was a furore when the concept of herd immunity was first mentioned, which was part of the reason for the U-turn the professor mentions. It remains to be seen if the population of Sweden still support his policy if the deaths keep rising.

A

Bill_St said:

Apply those ratios to a country.

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A lot of the deaths here in Australia are from cruise ships, I have no official figures though off hand.

There are apparently suggestions that the elderly could be locked up for a year in the uk, whilst the younger members of society are given more freedom to work and move around.
This would not answer the problem of the obese and ethnic minorities being more vulnerable. Not to mention if one has two xx's makes one half as vulnerable those with xy!
D.

Tipetoo said:

A

A lot of the deaths here in Australia are from cruise ships, I have no official figures though off hand.

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There has got to be something seriously cross contaminating about the air conditioning on cruise ships.
It seems to be passed on whilst they are locked up in their cabins.
D.

lindisfel said:

There has got to be something seriously cross contaminating about the air conditioning on cruise ships.
It seems to be passed on whilst they are locked up in their cabins.
D.

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I thought it was established that the crew(s) weren't being too careful with the way they moved between cabins to deliver food and other supplies?

Brunneria said:

Hi All,

Anyone able to unpick the mathematics below? My poor wee brain simply isn't up to grasping it, so if anyone can do a Maths Translation for Dummies, I would be very grateful!

Aseem Malhotra referenced a study in this article https://www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/
He made the statement that
Public Health England have said now is the best time to quit smoking, citing research from China concluding that smokers were 14 times more likely to get severe disease after contracting COVID-19. (13)

So I followed his reference to here:
https://journals.lww.com/cmj/Abstra...f_factors_associated_with_disease.99363.aspx#
and found this:
Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study. Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients (14.1%) had deteriorated, and 67 patients (85.9%) had improved/stabilized. The patients in the progression group were significantly older than those in the disease improvement/stabilization group (66 [51, 70] vs. 37 [32, 41] years, U = 4.932, P = 0.001). The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χ2 = 9.291, P = 0.018). For all the 78 patients, fever was the most common initial symptom, and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group (38.2 [37.8, 38.6] vs. 37.5 [37.0, 38.4]°C, U = 2.057, P = 0.027). Moreover, the proportion of patients with respiratory failure (54.5% vs. 20.9%, χ2 = 5.611, P = 0.028) and respiratory rate (34 [18, 48] vs. 24 [16, 60] breaths/min, U = 4.030, P = 0.004) were significantly higher in the progression group than in the improvement/stabilization group. C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group (38.9 [14.3, 64.8] vs. 10.6 [1.9, 33.1] mg/L, U = 1.315, P = 0.024). Albumin was significantly lower in the progression group than in the improvement/stabilization group (36.62 ± 6.60 vs. 41.27 ± 4.55 g/L, U = 2.843, P = 0.006). Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χ2 = 16.01, P = 0.001). Multivariate logistic analysis indicated that age (odds ratio [OR], 8.546; 95% confidence interval [CI]: 1.628–44.864; P = 0.011), history of smoking (OR, 14.285; 95% CI: 1.577–25.000; P = 0.018), maximum body temperature at admission (OR, 8.999; 95% CI: 1.036–78.147, P = 0.046), respiratory failure (OR, 8.772, 95% CI: 1.942–40.000; P = 0.016), albumin (OR, 7.353, 95% CI: 1.098–50.000; P = 0.003), and C-reactive protein (OR, 10.530; 95% CI: 1.224−34.701, P = 0.028) were risk factors for disease progression.

So, is Malhotra's statement that that smokers were 14 times more likely to get severe disease after contracting COVID-19
bourne out by the mathematical hieroglyphs quoted above?

I do, of course, appreciate that there is a lot of other stuff going on too - CRP, albumin, degree of temperature, age and all the other co-morbidities we are familiar with discussing regarding COVID-19.

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Basically, it is saying that 'multivariate logistic analysis' ( a technique for working out the relative contribution of each factor when there is more than one factor involved) was used and it shows that the odds ratio for smoking is 14.285 (i.e. the disease was 14.285 times more likely to progress in smokers than non-smokers.

The abstract doesn't include the maths involved in the multivariate logistical analysis and, for most of us, it wouldn't help anyway. We just have to hope that those working in the field, who do understand it, will check on our behalf.

Dark Horse said:

Basically, it is saying that 'multivariate logistic analysis' ( a technique for working out the relative contribution of each factor when there is more than one factor involved) was used and it shows that the odds ratio for smoking is 14.285 (i.e. the disease was 14.285 times more likely to progress in smokers than non-smokers.

The abstract doesn't include the maths involved in the multivariate logistical analysis and, for most of us, it wouldn't help anyway. We just have to hope that those working in the field, who do understand it, will check on our behalf.

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Thank you!

urbanracer said:

I thought it was established that the crew(s) weren't being too careful with the way they moved between cabins to deliver food and other supplies?

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You mean like people shopping in supermarkets?
Sounds like blaming the crew not the ships that would have to be re engineered.
D.

urbanracer said:

So doctors advising the WHO now state that there's no evidence for the presence of antibodies after having had Covid-19.

Maybe explains why the antibody tests are reportedly not working very well.

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If that was true then it would be strange that this testing was going ahead.....
BBC News - Coronavirus: Plasma treatment to be trialled
https://www.bbc.co.uk/news/health-52348368