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27 minutes ago, madwullie said:

Does there seem to be a better plan to deal with routine non-covid stuff this time round, or are they going for the same shitshow? 

We simply cannot do the same amount of routine, non-covid elective surgery and deal with escalating admissions.

Anaesthetic staff will be redeployed to staff intensive care and medical wards, as before. Surgical wards will be converted to medical wards. We have to run "hot" and "cold" sites, there just isn't the hospital real estate to do this without restricting non emergency admissions.

This is without taking into account the increased time any theatre case takes due to Covid precautions. We will attempt to keep some form of elective service running, but it is really only going to be cancer surgery and life/limb threatening surgery that will be realistically done.

Before anyone says "just open the Louisa Jordan": this is a field hospital in a conference centre. Staff will be redeployed from other areas. It is for when the shit really hits the fan. At this point all non emergency surgery and admissions will stop.

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5 minutes ago, welshbairn said:

They can't say when a vaccine will be proven to be safe and effective until all the testing procedures are complete, and they can't give a definite timeline on that while the transmission rates keep changing amongst the population groups they're testing them on. They need enough people in the group given the placebo to be infected to show that that the vaccine is working and safe for those given the real thing. And after all that it might not be viable, and even if it is they have to produce and distribute billions of them.

I get that it might eventually not be viable (although I've seen nothing after all this time to suggest that might be the case). 

But I don't get how there isn't an end date to the trials. You say the transmission rates keep changing - but that's always going to be the case. There's a lot of very clever, well paid people involved, and I can't for the life of me understand why the Phase 3 efficacy trials wouldn't have some kind of closing date / month / season.

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Spent a bit of time reading the new SG document for these tiered restrictions.
Unless I'm wrong, these are basically in place until a vaccine is well on the go? Yet it offers no estimation of when this might be? I struggle to understand why this is. Surely some approximation can be offered as to when these new restrictions will end. Surely those in the 'vaccine game' must know when these Phase 3 efficacy trials are due to be completed.

Both Pfizer and the Oxford/AstraZeneca trials will announce phase 3 results probably next month. Pfizer are slightly ahead and may even announce before the end of October, but early November is more likely. Moderna also on track to announce before the end of the year and then other candidates looking more like next year.

The first two candidates I mentioned are the most interesting because not only are they likely to apply for regulatory approval within literally weeks (assuming phase 3 trials are successful, which happens 85% of the time), but the UK government has literally tens of millions of doses on pre order and these have been manufactured in advance using cash provided by venture capitalists who have gambled on them being successful (usually with a vaccine trial, they don’t manufacture doses for the mass market until it’s been approved, in this case they have due to time sensitivity)

The problem is that vaccine approval is just the first step. Most boffins believe the first vaccine will be 60%-70% effective and will provide immunity for around 2 years. This would be enough to get the R number down to around 0.9-1.1 if everyone is vaccinated and we do return to pre-pandemic behaviour, but you need it fully below 1 for a herd immunity scenario. This implies that some form of NPI’s will still be required to prevent outbreaks, but this would probably take the form of case isolation of those who test positive plus their household and other contacts rather than population wide social distancing.
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7 minutes ago, Steven W said:

I get that it might eventually not be viable (although I've seen nothing after all this time to suggest that might be the case). 

But I don't get how there isn't an end date to the trials. You say the transmission rates keep changing - but that's always going to be the case. There's a lot of very clever, well paid people involved, and I can't for the life of me understand why the Phase 3 efficacy trials wouldn't have some kind of closing date / month / season.

They're all still at a relatively early stage and it's highly unlikely that any of them even if successful will provide 100% immunity.

They'd be shouting from the rooftops if they thought a foolproof vaccine was going to be imminently available.

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2 minutes ago, Steven W said:

I get that it might eventually not be viable (although I've seen nothing after all this time to suggest that might be the case). 

But I don't get how there isn't an end date to the trials. You say the transmission rates keep changing - but that's always going to be the case. There's a lot of very clever, well paid people involved, and I can't for the life of me understand why the Phase 3 efficacy trials wouldn't have some kind of closing date / month / season.

Any vaccine producer or Government who promised an end date to this would be lying, and mugs. From the statements being made there's unlikely to be an effective roll out till late Spring or Summer, but even that is optimistic. Some of the vaccines are already being produced at volume, but it's just as likely that the first one to be proven to be safe and effective will have to start mass production from scratch, which would add many months to roll out.

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1 minute ago, Stan Hope said:

if it helps, Macron has told the French they'll be dealing with it at least until the summer, personally, i see very little change for ourselves between October 2020/October2021

https://www.bbc.co.uk/news/world-europe-54669060

https://uk.news.yahoo.com/no-breakthrough-treatments-coronavirus-dont-140702229.html

Yes and Catalonia heading for "full" lockdown now along with various other parts of Spain.

Forget all that though as some seem more concerned about their Christmas shwalley session being spoiled........

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19 minutes ago, Cyclizine said:

We simply cannot do the same amount of routine, non-covid elective surgery and deal with escalating admissions.

Anaesthetic staff will be redeployed to staff intensive care and medical wards, as before. Surgical wards will be converted to medical wards. We have to run "hot" and "cold" sites, there just isn't the hospital real estate to do this without restricting non emergency admissions.

This is without taking into account the increased time any theatre case takes due to Covid precautions. We will attempt to keep some form of elective service running, but it is really only going to be cancer surgery and life/limb threatening surgery that will be realistically done.

Before anyone says "just open the Louisa Jordan": this is a field hospital in a conference centre. Staff will be redeployed from other areas. It is for when the shit really hits the fan. At this point all non emergency surgery and admissions will stop.

Thanks for taking the time to answer 👍 

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32 minutes ago, Steven W said:

Spent a bit of time reading the new SG document for these tiered restrictions.

Unless I'm wrong, these are basically in place until a vaccine is well on the go? Yet it offers no estimation of when this might be? I struggle to understand why this is. Surely some approximation can be offered as to when these new restrictions will end. Surely those in the 'vaccine game' must know when these Phase 3 efficacy trials are due to be completed.

Most models seem to show the 2nd wave (2nd wavers COME ON! 🤘) ending in February-ish, so I presume at this point they will revisit assuming everything erhklse remains the same 

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I get that it might eventually not be viable (although I've seen nothing after all this time to suggest that might be the case). 
But I don't get how there isn't an end date to the trials. You say the transmission rates keep changing - but that's always going to be the case. There's a lot of very clever, well paid people involved, and I can't for the life of me understand why the Phase 3 efficacy trials wouldn't have some kind of closing date / month / season.



A phase 3 trial works as follows:

You get a sample of 30,000 volunteers selected to broadly represent a cross-section of society

An independent adjudicator splits them into two groups, 15000 people get vaccinated and the other 15000 get a placebo. Neither the volunteers nor the scientists know who’s in each group.

Then the 30000 are sent back into society and told to behave normally. They’re tested regularly.

You need to wait for 150 (1%) of people in the placebo group to test positive. After that, you review how many people in the vaccinated group test positive. Suppose that number was 30, then you’d say the vaccine is 80% effective. It needs to be at least 50% effective to have any chance of being approved by the regulators.

They will also consider the severity of the illness among those who were vaccinated but still tested positive as opposed to the severity in the 150 members of the placebo group who tested positive. If you had 75 cases in the vaccine group but all were mild/asymptomatic, it would likely be approved because we’d say that the vaccine is 50% effective at providing immunity, but also appears to lessen symptoms in those who do catch the virus.

They also do some interim readings if the vaccine is looking like it’s very effective. So if you have 50-60 positive cases in the placebo group and none at all in the vaccine group then it might get approved early without reaching that 150 threshold, but that’s unlikely unless the vaccine was performing considerably better than expected.

The long-and-short of it is that it takes longer when community transmission rates are low because you need to wait for 1% of the placebo group to test positive. That’s why areas with high virus prevalence are specifically chosen for the trial.
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10 minutes ago, Stan Hope said:

if it helps, Macron has told the French they'll be dealing with it at least until the summer, personally, i see very little change for ourselves between October 2020/October2021

https://www.bbc.co.uk/news/world-europe-54669060

https://uk.news.yahoo.com/no-breakthrough-treatments-coronavirus-dont-140702229.html

Well, however painful this continuing into Summer 2021 is, at least Macron has offered some kind of timeline (which is presumably based upon some kind of info / knowledge). Reading the SG document this morning, my over riding feeling was that this could conceivably be the case for years and years.

I think it would do no harm to at least make it known that these measurements will not be in place forever

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14 minutes ago, Stan Hope said:

if it helps, Macron has told the French they'll be dealing with it at least until the summer, personally, i see very little change for ourselves between October 2020/October2021

https://www.bbc.co.uk/news/world-europe-54669060

https://uk.news.yahoo.com/no-breakthrough-treatments-coronavirus-dont-140702229.html

Well, he's got to say something when the only next step in escalation is another full national lockdown in France. Promise jam tomorrow and hope the French don't go out and do what they normally do when they get pissed off. 

Remember when Sturgeon was telling us our sacrifices would be rewarded and Johnson was telling us social distancing would be gone by November? 

They're just trying to buy time. If the vaccine doesn't work, they are all utterly fucked. 

Edited by Michael W
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3 minutes ago, Donathan said:

 

 


A phase 3 trial works as follows:

You get a sample of 30,000 volunteers selected to broadly represent a cross-section of society

An independent adjudicator splits them into two groups, 15000 people get vaccinated and the other 15000 get a placebo. Neither the volunteers nor the scientists know who’s in each group.

Then the 30000 are sent back into society and told to behave normally. They’re tested regularly.

You need to wait for 150 (1%) of people in the placebo group to test positive. After that, you review how many people in the vaccinated group test positive. Suppose that number was 30, then you’d say the vaccine is 80% effective. It needs to be at least 50% effective to have any chance of being approved by the regulators.

They will also consider the severity of the illness among those who were vaccinated but still tested positive as opposed to the severity in the 150 members of the placebo group who tested positive. If you had 75 cases in the vaccine group but all were mild/asymptomatic, it would likely be approved because we’d say that the vaccine is 50% effective at providing immunity, but also appears to lessen symptoms in those who do catch the virus.

They also do some interim readings if the vaccine is looking like it’s very effective. So if you have 50-60 positive cases in the placebo group and none at all in the vaccine group then it might get approved early without reaching that 150 threshold, but that’s unlikely unless the vaccine was performing considerably better than expected.

The long-and-short of it is that it takes longer when community transmission rates are low because you need to wait for 1% of the placebo group to test positive. That’s why areas with high virus prevalence are specifically chosen for the trial.

 

 

Thanks for that. Very informative post.

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40 minutes ago, Steven W said:

Spent a bit of time reading the new SG document for these tiered restrictions.

Unless I'm wrong, these are basically in place until a vaccine is well on the go? Yet it offers no estimation of when this might be? I struggle to understand why this is. Surely some approximation can be offered as to when these new restrictions will end. Surely those in the 'vaccine game' must know when these Phase 3 efficacy trials are due to be completed.

I have asked this before, based on various noises from various places. I find it almost impossible to believe that Astra Zeneca (and therefore the govt) aren't already sure that their vaccine passes the tests required and its just a matter of doing the necessary legals. I understand why this hasn't and wont be announced in any meaningful way until it is literally available to go into someones arm, but we a rein late October and there are folk talking about the vulnerable list beginning vaccination before year end.I would assume you cant leap from "we don't know if we are going to get the nod on this" to actually dishing it out in 2 months. This is why I don't get those who keep saying "we don't know if we will get a vaccine". I'd bet good money on AZ plus maybe others being approved for use before 2020 is out.

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1 hour ago, bennett said:

Sensible decision by the Welsh to stop contamination by people lifting cards and putting them back down or come on to fcuk?

 

 

 

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Somebody finally outdid Nicola on attempting to create a Nanny State rather than treating people like responsible adults. Can only assume something psychotropic got into their leeks... 

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1 hour ago, Steven W said:

Spent a bit of time reading the new SG document for these tiered restrictions.

Unless I'm wrong, these are basically in place until a vaccine is well on the go? Yet it offers no estimation of when this might be? I struggle to understand why this is. Surely some approximation can be offered as to when these new restrictions will end. Surely those in the 'vaccine game' must know when these Phase 3 efficacy trials are due to be completed.

The AstraZenica trial is due to finish in early 2022

Edited by Todd_is_God
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56 minutes ago, doulikefish said:

This is because small retailers which sell   other products (no food or medicines  ) were complaining the last time that supermarkets could continue to sell clothes etc

So becuase they have been closed the supermarkets have had to stop selling everything but food and medicines

^^^this. I don't really see why they're closing other shops anyway so long as they're enforcing strict masks and distancing rules.

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28 minutes ago, WATTOO said:

Yes and Catalonia heading for "full" lockdown now along with various other parts of Spain.........

While strangely in Sweden there is no discernible second wave on deaths yet. That will no doubt be dismissed with a cherrypicked comparison to Denmark though.

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