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The Science. It's not vaccine hesitancy. It's was imported by travel but it is the transmissibility that matters.

(26 Posts)
PippaZ Wed 19-May-21 09:14:54

Radio 4 "Today" (7:21 a.m.)
Interviewer: Why are some places, like Bolton in Lancashire, seeing higher levels of Indian variant, as it's known, of Corona Virus. Well, lots of different theories have been suggested. That the outbreak was caused by people travelling from India, or that there have been lower levels of vaccination in the hotspots. So can we really say this? Let's talk to Christina Pagel who is a mathematician who specialises in health data. She is director of the Clinical Operation Research Unit of University College London and a member of the Sage group of Scientists. Good morning.

(CP) Morning

(I) Let's examine a couple of these things. First of all the reason the variant is getting hold in certain places is because people, who are eligible to have vaccines are resisting them. Is there any evidence of that?

(CP) No, not really. If you actually look at it by age profile, then both Bolton and Blackburn have almost the same uptake, age for age as the whole of England. Also, in both places, cases are concentrated in school-age children and young adults who haven't had the opportunity to be vaccinated yet. So, I think you trying to say that it's about people being vaccinated it just doesn't hold up when you look at the evidence.

(I) And looking at the evidence again, what about the idea that these are areas where people have been travelling from India?

(CP) Certainly, we imported this variant by travel from India but it's now spreading through the community far beyond the original traveller cases. If you look at the data that's been coming out of the UK Covid Genetics Consortium, which sequences date, you can see that week on week the number of traveller cases has been steady but the number of community cases has been going up. So, it's definitely spreading in the community and it's not just about importation into certain communities.

(I) But is that how it was originally spread?

(CP) Yeh, I mean, yeh, in the same way that the dominant variant here, what we call the Kent variant, has now spread globally and through exportation from us.

(I) And early days of course, in your people are still looking at the data but what do you think we know about the transmissibility of the Indian variant at the moment?

(CP) So this is the really key thing that you need to pin down. We are pretty sure that it is more transmissible than our current dominant variant, the B117 or the Kent variant which to date has been the most transmissible variant in the world so we are pretty sure it's more transmissible. Sage said in its minutes from last week that it could be up to 50% more transmissible. We are seeing that in India and Nepal it's now rapidly become the dominant variant there. In all the countries it's been detected in, it's spreading rapidly. So we can see similar patterns across the world but exactly how much of that is because it's more transmissible is yet to be determined. But it does matter because of the Warwick models for the Sage Modeling subcommittee. So if it's 50% more transmissible that could lead to a surge that's equivalent to what we had in January even if the vaccines work just as well. Whereas, if it's only 20% more transmissible then it will peak at a much, much lower level, so it really matters that we try and pin down how much more transmissible it is

(I) Christina Pagel from UCL, thank you.

This is my transcript of the programme so I apologise for any errors but I have checked against the programe several times. I have used itelligent verbatim so there may be the odd err or um missing.

Alegrias1 Wed 19-May-21 09:23:54

Article by Nick Triggle that's based in science, not catchy headlines.

www.bbc.co.uk/news/health-57150871

Interesting to note that "realistic possibility" means a 50:50 chance.

Oopsadaisy1 Wed 19-May-21 09:40:36

Unless you totally lock the country down the virus will get in, whether or not you have been vaccinated.

Sounds obvious to me.

No one had or will have the appetite to close our borders, unlike Australia.

PippaZ Wed 19-May-21 09:45:52

Oopsadaisy1

Unless you totally lock the country down the virus will get in, whether or not you have been vaccinated.

Sounds obvious to me.

No one had or will have the appetite to close our borders, unlike Australia.

Who is "no one" Oopsadaisy1 you seem to be talking for others without their permission or agreement.

It's not just about closing boarders, it's about not having what has now been described as "joke" boarders. It's about not making a pigs ear or the messaging too.

It might also be about reading the science and then not blaming "anyone but Boris".

PippaZ Wed 19-May-21 09:50:41

Thanks for the link Alegrias1. Very balanced, I thought. This was a bit stark though. "This situation was entirely expected. In six months time I'm sure we will be talking about another variant,"

GrannyGravy13 Wed 19-May-21 09:54:59

If we were to / had totally lockdown the U.K. there is absolutely no guarantee that the virus which was already here would not have mutated, it’s what viruses do after all.

PippaZ Wed 19-May-21 10:09:43

GrannyGravy13

If we were to / had totally lockdown the U.K. there is absolutely no guarantee that the virus which was already here would not have mutated, it’s what viruses do after all.

A straw man argument: an informal fallacy having the impression of refuting an argument, whereas the real subject of the argument was not addressed or refuted, but instead replaced with a false one.

GrannyGravy13 Wed 19-May-21 10:26:03

PippaZ are you refuting the fact that viruses mutate? I am sure SAGE or the unofficial SAGE would be interested to hear your evidence.

My post might have been simplistic, but it is neither a fallacy nor a straw man argument, in fact it was not an argument in any shape of form.

Alegrias1 Wed 19-May-21 11:11:25

Sorry, this is the BBC again. But there is a definite change in the mood around this variant. Maybe not the Armageddon that was first thought?

www.bbc.co.uk/news/health-57157496

We're going to have variants for ever more. If we panic about all of them we're going to wear ourselves out.

PippaZ Wed 19-May-21 11:21:27

Don't be sorry Alegrias1. It seems the BBC are going for balance without accusation which is always a good read.

PippaZ Wed 19-May-21 11:41:19

GrannyGravy13Wed 19-May-21 10:26:03
in fact it was not an argument in any shape of form.
argument: a reason or reasons why you support or oppose an idea or suggestion, or the process of explaining these reasons.

PippaZ are you refuting the fact that viruses mutate?
A straw man argument: an informal fallacy having the impression of refuting an argument, whereas the real subject of the argument was not addressed or refuted, but instead replaced with a false one.

Jaxjacky Wed 19-May-21 12:11:15

news.sky.com/story/covid-19-danger-of-unrest-in-bolton-if-local-coronavirus-lockdown-measures-imposed-council-leader-warns-12310645

Another view

growstuff Wed 19-May-21 12:26:44

Thank you Pippa for transcribing the interview with Christina Pagel and Alegrias for the BBC link, although I'm not sure everybody will understand the maths or the implications of the term "realistic possibility".

My view is that, of course, viruses will continue to mutate and, no, the UK can't keep its borders closed forever. However, I don't think its a black and white (either/or) situation. We're not all going to be attacked by the "Indian" variant and be back to square one, but nor is it insignificant and can be ignored.

The UK is at the forefront of genomic sequencing. More than just about any other country, we have the ability to identify new variants. Now that the infection rates and hospital admissions are relatively low, we should have the ability to know what's going on and where and contain any outbreaks, but we need to ask fast and decisively. The test, track and isolate system needs to be on the ball and do its job.

I think the borders should have been closed to arrivals from the whole Indian subcontinent the moment the variant was identified, as a precaution and maybe only temporarily. If necessary, whole planes could have been met and all the passengers escorted to paid quarantine. All future arrivals should have been banned, until the situation was clearer. I don't really care if Modi had been upset.

I am concerned about the dog whistle racism which has crept into the debate about the "Indian" variant. Yes, it would appear to be more prevalent amongst communities of Indian origin, but there's no evidence that they are generally more vaccine hesitant than others. It could be that, having inadvertently brought the variant into the country from India, these communities live in crowded housing and have jobs with more face-to-face contact - and that's been an issue in some communities for the past year.

Even on GN we've seen people call out irresponsible travellers from India. It could be that the variant has been present in the UK for longer than thought and came in at a time when India's infection rate was quite low. We just don't know. To be honest, we don't even know if the original mutation happened in India.

It's not cause for panic, but nor is it a reason for complacency.

PS. I was watching a documentary about the eradication of smallpox yesterday. Apparently, Bangladesh proved to be a sticking point, but the country employed 150,000 door knockers (yes, 150,000) to find the unvaccinated people and encourage them to take up the vaccine. The last person to have smallpox was a small child, who responded to the vaccine and survived.

I don't think that scale of contact tracers is needed in the current situation in the UK, but shows what can be done if there's a will.

Alegrias1 Wed 19-May-21 12:32:43

Really interesting and well thought out post growstuff.

Its been one of my hobby horses through this whole affair that the media in general are just stirring up panic and fear. Whether that's to support the government's approach, or because it makes a good headline, I couldn't say, but I do believe that there is irresponsible reporting.

Triggle is an exception. I tend to believe what he says because he analyses what things really mean - the "realistic possibility" for instance. I hope the response of the press is part of the enquiry we've been promised.

growstuff Wed 19-May-21 12:39:41

PS. I knew there'd be a typo somewhere. Should be "act" not "ask".

growstuff Wed 19-May-21 12:44:50

My impression is that the government has had its eye on public opinion rather than "following the science" and doing what's needed doing. Most of the media just follows government PR releases. Inducing panic has been used as a means of controlling people rather than rational explanation about what's needed to be done.

Alegrias1 Wed 19-May-21 13:03:57

Agreed 👍

PippaZ Wed 19-May-21 13:34:33

The thanks will go back and forth at this rate growstuff. That was a really useful post. I agree with you and Alegrias about the media reporting and the attempt to shake off responsibility.

I think I said elsewhere that I thought they should take the vaccine into the areas where it's needed. However, I will now take into greater account the fact that those needing vaccination had not, up to the last couple of days, been offered it and this seems to have been an "on the ground" decision rather than a government one.

The one thing I am finding difficult to pin down is what exactly transmissibility means when talking about the transmissibility advantage of B.1617.2. If I find an "Idiots guide to ..." I will post it. If anyone else finds one I would be grateful to see it.

GrannyGravy13 Wed 19-May-21 13:38:07

Try Professor Neil Ferguson, he was speaking about the variant earlier.

PippaZ Wed 19-May-21 13:55:16

Thank you GrannyGravy13 I saw that and tried to get back to it on line so I could take it down and give myself more time to go over it. There was another chap from one of the unversities who I thought made sense, i.e., I could understand, but they both see to have disappeared off the iplayer. I will be busy for a while but when I can I will look up Neil Ferguson and see if he has writen anything.

growstuff Wed 19-May-21 14:07:03

Pippa This article was written in response to the "Kent" variant, but it applies in principle to all variants.

www.bmj.com/content/372/bmj.n504

There are a few other articles explaining the phenomenon and the issues.

In layman's talk, my understanding is that the virus, which is actually mutating all the time but some variants make it less successful, mutates in a way that makes transmission more successful. Even if somebody is exposed to the virus, it doesn't mean that it's inevitably transmitted. For some reason or other, the spike proteins don't "latch on" to receptors and the virus dies a natural death. Variants emerge which mean that the "latching on" is more successful. In the case of the "Kent" variant, there was a mutation to the spike proteins. I don't know what the mutation is with the "Indian" variant. What happens is that the more successful variants infect more people, who in turn go on to infect more people. The original virus isn't killed off by new variants, but eventually runs out of hosts to attack. Viruses (unlike bacteria) are actually quite fragile and die very quickly if they don't have a host. That's why identifying and isolating infected people is crucial.

JustMe Wed 19-May-21 14:23:02

Very interesting thread. And agree on lots of it.

From what I've read, Little Matty Hancock (as I call him) is very wrong to insinuate that this is spreading because the people in hospital weren't vaccinated.
I read some figures somewhere that this was not true. A large proportion had had their first vaccine but it all depends on 'when' given that antibodies can take at least 3 weeks to appear (and I know this to be case because I am tested regularly as part of a study and it was 4 weeks for me before antibodies appeared after Pfizer)

My impression is that the government has had its eye on public opinion rather than "following the science" and doing what's needed doing. Most of the media just follows government PR releases. Inducing panic has been used as a means of controlling people rather than rational explanation about what's needed to be done

So agree with this.
This Government have a lot to answer for.

PippaZ Wed 19-May-21 18:28:28

Right. The reason we use "transmissibility" instead of "infection" is because we may not become infected but the opportunity to transfer the infection is greater because the little s*d is better at entering our system(?)

We could use the much more obvious word and say this variant can be "transmitted" from one person to another much more effectively because of its mutation.(?)

If this is right - and the variant B.1617.2 has now crossed the Pennines, as it appears it may have done, I may not be wrong (not right but not wrong either) to have decided not to take up all the freedoms on offer (?)

Please don't use red pens grin but do tell me if I'm still missing the meaning.

growstuff Wed 19-May-21 18:49:17

As I understand it, it's difficult to know whether a virus is genuinely more transmissible or whether it exists in circumstances where it's more likely to be transmitted.

The "Indian" variant was first identified in India, so it's probably reasonable to assume that it mutated there (although that can't really be proved). If a traveller from India brought it back to the country (and let's assume they did), he/she might not have been aware of it and could have infected family and friends before even showing symptoms.

As we know, many families of Indian origin live in close communities and often in overcrowded housing. They tend to have jobs which can't be done at home, so they travel to work and possibly are in close contact with others. Such an environment is conducive to rapid spread. The majority of cases in Bolton have been in younger people, who weren't eligible for vaccination. That could be why it appears more transmissible. Nobody really knows. There haven't been any experiments to test whether the mutated virus is stronger or anything. The only way scientists can tell is by looking at case incidence rates.

PippaZ Wed 19-May-21 19:56:14

I think we are seeing that more and more with the main players saying we need to wait. They are also surge testing and vaccinating in Bedford, Burnley, Hounslow, Kirklees, Leicester and North Tyneside, while the Scottish government is doing the same in Glasgow and Moray. At least this time they do seem to have got ahead but it is still something no one really knows about - even those who know a great deal in this area.