Northern Europe during Pandemic -- Summers 2020 & 2021 & onwards

[El Pinguino]

I'm getting mixed messages, these say 'one day before'
https://abcnews.go.com/Politics/cdc-...ry?id=81491308
https://www.forbes.com/advisor/trave...united-states/
Everything else I am finding says 'within 24 hours'
https://www.nytimes.com/live/2021/11...-variant-covid
https://www.cnbc.com/2021/12/02/omic...-mandates.html

Went to the source
https://travel.state.gov/content/tra...to-the-us.html
which says 'within one day' which is a bit ambiguous.

Its an issue if flying from South America or Australia to the US as most flights leave in the evening. Take Melbourne/LA - departure is 2200, you have to check in 4 hours before ie 1800, it a four hour train ride from mi casa to the airport. And no one up here in the bush does a full test with a one day turnaround on the result.

I hope you are right.

[Paul L]

From the CDC website and published by various US Embasdies

The 1-day period is 1 day before the flight’s departure. The Order uses a 1-day time frame instead of 24 hours to provide more flexibility to the air passenger and aircraft operator. By using a 1-day window, test acceptability does not depend on the time of the flight or the time of day that the test sample was taken.

For example, if your flight is at 1pm on a Friday, you could board with a negative test that was taken any time on the prior Thursday.

https://www.cdc.gov/coronavirus/2019...s.html#general

[Dockhead]

Originally Posted by El Pinguino

We live in hope.
Thes graphs from https://www.worldometers.info/corona.../south-africa/
look very promising.

In the previous surges 'deaths' have followed close behind 'cases'.
Now two weeks after the rise in cases in SA we still aren't seeing a rise in deaths. . .

The lag is typically two weeks, so I still think it's early, but who can help hoping?

Also, it's worth being skeptical about the statistics from South Africa, which give less than 1500 covid deaths per million whereas excess death is 3845, so that's another grain of salt we need to take this with.

However, so far everything does line up with mild cases only. I guess it will start to be clearer in a week or two when we can start to study cases in other countries as well as S.A.

Meanwhile, back to our cruising grounds:









This is not looking as bad as it could have.

Particularly good is the UK where deaths have actually been falling for the last 6 weeks, as have hospitalizations. Ireland, despite a huge wave of infections, and despite fairly high hospitalization rate, has not had any big increase in death rates. Death rates are well below 2 per million in both UK and Ireland.

In Germany, the infection rate levelled off at a high level, but death rates continue to slowly increase, presently 3.69, which is far from the 15 -- 20 and more we saw in other countries in previous waves, but still none too low. Germany has a very high rate of ICU patients, but Germany has a large number of ICU beds per capita so may be using them generously.

Among the Nordic countries, Sweden and Finland still have moderate infection rates, a little below and a little above 200 respectively, and Sweden has practically no deaths and empty hospitals, no doubt a benefit of greater total immunity in the population. So Sweden has been really lucky during this wave with negligible death and relatively little infection. Finland's luck has also held up pretty well during this wave. The death rate in Finlnd is 4x higher than Sweden's, but it's still only 1.35 and not increasing, hospitals not under strain.

Norway and Denmark are having considerably more infection, both over 500, and Denmark almost touched 800, so higher than the UK for over a month. Although the death rate in Denmark is the highest in the Nordics, it's still under 2.

So altogether not looking too bad up here, even if the pandemic is not "over" here as we wrongly thought a couple of months ago. Starting to think about cruising plans for next spring -- cross the North Sea to the UK for a bit? I haven't been in UK waters since the pandemic started.

[GordMay]

Originally Posted by Dockhead

The lag is typically two weeks, so I still think it's early, but who can help hoping? ...

I think the death lag may be closer to 8 weeks after infection, but that’s very difficult to ascertain, accurately.

“Lag Between COVID-19 Cases and SubsequentDeaths” ~ by Sara Donovan, David Brett-Major & James V. Lawler
“... Results: The analysis performed demonstrates a considerable, consistent lag between a surge in COVID-19 cases and the subsequent rise in attributable deaths, with approximately a month-long lag observed.
Conclusions: The time lag identified must be incorporated in health emergency decision making in order to avoid the pre-mature de-escalation of disease mitigation measures...”
➥ https://assets.researchsquare.com/fi...f?c=1631881835


“How Lagging Death Counts Muddled Our View of the COVID-19 Pandemic” ~ by Kara W. Schechtman
“... In general, the CDC’s date-of-report data follows a simple pattern: the CDC’s count under-reported deaths during upswings, as states struggled to keep up during periods of rising volume. During downswings, the CDC data over-reported deaths as death counts caught up.
However, lagging death counts distorted trends differently for each surge ...
... Any kind of lag in deaths is consequential because surging numbers of deaths, more than any other metric, tend to change people’s minds and behavior when we most need them to ...”
Policymakers and institutions respond with regulations and precautions when they see an uptick in deaths. Researchers have even studied the possibility that individual changes in social distancing behavior motivated by rising death tolls can change epidemic curves.
More ➥ https://covidtracking.com/analysis-u...f-the-pandemic


“On the lag between deaths and infections in the first phase of the Covid-19 pandemic” ~ by Piotr T. Chruściel, & Sebastian J. Szybka
“... Key Messages
The lags between the maximum daily infections and casualties during the first phase of the Covid-19 pandemic differ widely between countries.
These lags are clear for some countries, but impossible to determine confidently for most.
In some countries the day at which the maximal number of daily deaths is attained precedes the day of the maximal number of casualties, indicating a failure to protect the most vulnerable part of the population.
The lags can serve as an objective quantitative measure of the effectiveness of the measures taken to contain the epidemic...”
➥ https://www.medrxiv.org/content/10.1...1249115v1.full


A new data visualization [1], created by Harvard T.H. Chan School of Public Health researchers, depicts the connection between COVID-19 case rates and deaths, and illustrates clearly the time lag between the two.
The new visualization, described in a July 10, 2020 working paper [2], shows the cumulative cases and death rates by state, with rates per capita from January 22, 2020 through July 8, 2020.
The animation shows that deaths often occur 2-8 weeks after the onset of COVID-19 symptoms.

[1]“Data Visualization: COVID-19 Cumulative Cases and Deaths per Capita”
➥ https://github.com/ctesta01/animated...s_animated.gif

[2] "Visualizing the lagged connection between COVID-19 cases and deaths in
the United States: An animation using per capita state-level data (January
22, 2020 – July 8, 2020)” ~ by Christian C. Testa et al
➥ https://cdn1.sph.harvard.edu/wp-cont...with-cover.pdf

[Dockhead]

Originally Posted by GordMay

I think the death lag may be closer to 8 weeks after infection, but that’s very difficult to ascertain, accurately.. . .

Thanks, very useful. So we should be even more cautious.

[GordMay]

Originally Posted by GordMay

I think the [reported] death lag may be closer to 8 weeks after infection, but that’s very difficult to ascertain, accurately...

Clarification:
I should have said that the time lag, between REPORTED infection, and REPORTED death, might be as much as 8 weeks.
Of course, this is what we must rely upon, to estimate current trends, and determine actions/behaviour.

ACTUAL time lags will be much more difficult to determine; and then, only in retrospect, if at all.

Originally Posted by Dockhead

Thanks, very useful. So we should be even more cautious.

I agree, with prudent caution [for now]; but also [for other reasons], some optimism.

[Zippee]

As for the situation at your large US city's local hospitals, this is indeed alarming and if it's predominantly the unvaccinated creating the problem then this would also be important to highlight.

It is predominately the unvaccinated, no surprise really.


As for Omicron taking over, nobody knows the impact of so much of the population becoming infected. But another potential, alternative scenario to the one you (quite reasonably) fear is that Omicron could actually relieve rather than overburden health care systems now struggling to manage patients with severe illness as a result of Delta.

Anything is possible in the extreme. Keep in mind that Campbell's new and VERY preliminary findings were based on 166 hospitalized patients. For those who listened past the first 4 minutes, these patients still required admission, steroids and some oxygenation, although deaths and ICU interventions were in general, not. This would not support any hospital relief.


While I've read that vaccine mfgs are already working to tweak their vaccines to try and provide stronger immunity from Omicron, the consensus still seems to be that current vaccines will reduce severity of symptoms regardless. Especially important for the vulnerable who will remain vulnerable regardless, hence why annual flu shots are recommended for the elderly.

I am aware of no such "consensus". What consensus there is centers around a VERY rapid escalation of Omicron infections. It will be at least 2 to 4 weeks before we can determine the question in re real severity or of the extent of vaccine escape. Consensus, if any, will have to wait

Already the vaccine manufacturers have announced that the delay of "tweaked" vaccines - that delay has increased from their earlier statements of say two months, to now become 4 to 5 months. Add in issues of manufacture, distribution, prior commitments, reluctance to release the patents etc. and we cannot be terribly confident that the essential worldwide unified response in ALL countries (but particularly the southern sectors) will happen.

Not only this, the real problem may be the immuno-compromised, untreated poor people with HIV, etc., who allow the Covid a large fertile population and the time to develop and mutate. This is a VERY real concern, and one we hear almost nothing about.

My purely personal opinion: unless Covid itself solves the problem, we can look forward to yet more and even more dangerous variants. So far it's been profit before people.

[Dockhead]

Originally Posted by GordMay

Clarification:
I should have said that the time lag, between REPORTED infection, and REPORTED death, might be as much as 8 weeks.
Of course, this is what we must rely upon, to estimate current trends, and determine actions/behaviour.

ACTUAL time lags will be much more difficult to determine; and then, only in retrospect, if at all.

I agree, with prudent caution [for now]; but also [for other reasons], some optimism.

Fauci, interviewed this morning on NPR, says that it's too early to draw conclusions from the hospitalization rates in South Africa, as the outbreak there has been disproportionately among younger people. We have to "wait for the outbreak to mature" before we can really make any conclusions.

[Exile]

Originally Posted by Exile

While I've read that vaccine mfgs are already working to tweak their vaccines to try and provide stronger immunity from Omicron, the consensus still seems to be that current vaccines will reduce severity of symptoms regardless. Especially important for the vulnerable who will remain vulnerable regardless, hence why annual flu shots are recommended for the elderly.

Originally Posted by Zippee

I am aware of no such "consensus". What consensus there is centers around a VERY rapid escalation of Omicron infections. It will be at least 2 to 4 weeks before we can determine the question in re real severity or of the extent of vaccine escape. Consensus, if any, will have to wait

To be clear, my reference to expert "consensus" was based on uniform recommendations from Fauci, the CDC and the US Surgeon General (thus far) for people not to forego getting vaxxed & boostered based on early reports of vaccines not protecting people from getting infected with Omicron. Even if this reduced or lack of immunity proves definitive, the message is that vaccines are still effective at reducing severity of symptoms, whether from Delta or Omicron. So the "consensus" on encouraging vaccinations & boosters remains the same.

[Zippee]

Originally Posted by Exile

To be clear, my reference to expert "consensus" was based on uniform recommendations from Fauci, the CDC and the US Surgeon General (thus far) for people not to forego getting vaxxed & boostered based on early reports of vaccines not protecting people from getting infected with Omicron. Even if this reduced or lack of immunity proves definitive, the message is that vaccines are still effective at reducing severity of symptoms, whether from Delta or Omicron. So the "consensus" on encouraging vaccinations & boosters remains the same.

Here, especially the President's USC, the CDC and to a bit lesser degree Fauci, these spokespeople have a record of being politically sensitive, and a bit too reassuring, as they were with Delta. Their job is to keep the natives happy. When 40% of our population rejects vaccination, of course the jabs are encouraged, if only for Delta. Our ability to even detect variants is poor, unlike S. Africa and Denmark for example.

The explosive introduction of Omicron in the US does not support this perceived "consensus". We have gone from a couple of isolated cases to over 15 states in a couple days. Their consensus will remain the same, until it doesn't, nicht wahr?

Personally, I'd pay much more attention to Campbell, who details the lack of consensus and cites the widely differing expert opinions at this far too early date....

[Zippee]

As much as we all may want consensus on this unprecedented and massively mutated new variant - to an already seriously mutated novel virus, it's simply way too soon to predict anything beyond the fact that Omicron is explosively infectious.

The US has failed to even vaccinate our public, and is the last country we should look to for guidance. Our key spokespersons - all beholden to the President - have a record of hedging and stalling. The results are clear: record daily numbers, et al. The claim that there is a consensus of these parties that our vaccine is "effective" (whatever that means) is not accurate.

Quotes from yesterday....


Dr. Anthony Fauci:

“Well, we have to take is seriously, because the virus that was isolated and characterized by our South African colleagues — and, I must say, kudos to them for being so transparent and so helpful in collaborating and giving us the information in real time — it displays a constellation of mutations, Judy, that would be suggestive that it has a high degree of transmissibility advantage."

"And it could, in fact, evade some of the immunological parameters that we follow, like monoclonal antibodies and convalescent plasma, and even vaccine-induced antibodies. We don't know what the ultimate impact of that. It might not be a big deal at all, or it might turn out to be something that we are really going to have to address. So there are a number of unanswered questions. But, fortunately, we likely will have the answer for them in a matter of a couple of weeks.”


CDC’s Walensky

Walensky told This Week co-anchor Martha Raddatz that the CDC is still uncertain how transmissible the new variant is and how effective approved COVID-19 vaccines will work against it.

“We know it has many mutations, more mutations than prior variants,” she said. “Many of those mutations have been associated with more transmissible variants, with evasion of some of our therapeutics, and potentially evasion of some of our immunity, and that’s what we’re watching really carefully.”

The main concern right now, according to Walensky, is the dominant delta variant in the U.S. and the thousands of cases being diagnosed each day.


Surgeon General Murthy

“So to the question of whether the increased spread is being driven by greater transmissibility or whether it's being driven by a different sensitivity to our vaccine protections or protection from prior infection, the exact mix there of contributors is not known.”

Murthy said there’s much yet to be known about omicron. That includes whether the variant is resistant to current vaccines. Federal regulators are already aiming to speed up booster vaccines if needed.

“The important thing is, as we work hard to gain answers to the three critical questions about Omicron, about its transmissibility, its severity and its response to our vaccines and therapeutics...”


Bottom Line:

It is simply impossible to make such confident predictions beyond transmissability. Vaccine Escape or seriousness is simply not yet known, and will not be for up to a month or more. The data simply isn’t there, death and ICU statistics are lagging, and Delta is still dominant, if only for the present. There is no good consensus – only widely differing informed guesses. Laboratory studies are now in progress, while field observation – epidemiological studies - will need weeks or months to become meaningful.

The only real consensus (beyond explosive transmissability) is that it’s WAY too soon to have one.

[Dockhead]

Originally Posted by Zippee

As much as we all may want consensus on this unprecedented and massively mutated new variant - to an already seriously mutated novel virus, it's simply way too soon to predict anything beyond the fact that Omicron is explosively infectious. . .

I think most well-informed people would agree about that.

Originally Posted by Zippee

The US has failed to even vaccinate our public, and is the last country we should look to for guidance. Our key spokespersons - all beholden to the President - have a record of hedging and stalling. The results are clear: record daily numbers, et al. The claim that there is a consensus of these parties that our vaccine is "effective" (whatever that means) is not accurate. . . .

I don't really understand what this means.



The U.S. offered vaccines to everyone, long before almost the whole rest of the world except only for Israel and the UK. It's not the U.S. who failed to vaccinate our public, it's our public who failed to show up and get vaccinated, n'cest pas?

[El Pinguino]

Originally Posted by GordMay

Clarification:
I should have said that the time lag, between REPORTED infection, and REPORTED death, might be as much as 8 weeks.
Of course, this is what we must rely upon, to estimate current trends, and determine actions/behaviour.

ACTUAL time lags will be much more difficult to determine; and then, only in retrospect, if at all.



I agree, with prudent caution [for now]; but also [for other reasons], some optimism.

I'm using a very simple method.
I go here
https://www.worldometers.info/corona.../south-africa/
Select '7 day moving average '.
Pick a peak for infections - South Africa like most countries has had three peaks with a fourth on the way - and drop down to deaths and note the corresponding peak.
For most countries I have looked at deaths follows infections by plus/minus 2 weeks.
It doesn't work on all countries. Chile for instance has had about four peaks in infections but no corresponding jump in deaths with each one due to effective internal quarantine measures and an excellent vaccine rollout.
https://www.worldometers.info/corona...country/chile/

Yes its a simple method but I am but a simple sailorman.

What I would expect to see in South Africa if the new variant was very deadly and resistant to current vaccines would be people dropping dead in their homes and in the street as we saw in the early days last year in Guayaquil, Ecuador.

[goboatingnow]

Ireland has now shut nightclubs

[Zippee]

The U.S. offered vaccines to everyone, long before almost the whole rest of the world except only for Israel and the UK. It's not the U.S. who failed to vaccinate our public, it's our public who failed to show up and get vaccinated, n'cest pas?

Absolutely true. But perhaps this is a distinction without a practical difference, not to mention that it would now be both legal and appropriate to mandate vaccinations. It has gotten to the point that fading effectiveness has come to mean to consider that "fully protected" (whatever that is) requires a booster, easily available in the US (here) but which only 1 in 10 Americans have taken advantage of. Only 60% of Americans have even had both jabs, and even many of these are now aged and of greatly reduced efficacy.

As a result that the 7-day rolling average of new cases has increased 30% in just the past two weeks. The curve now is dang near straight up, and looks more like South Africa's. And all this in our country that has easily available free and FDA approved vaccines for everyone.

Instead politics and personal choice (to infect themselves and others) have resulted with a dangerous percentage of Americans refusing vaccination, and even attempting home remedies. Not to beat a drum but again in my larger city - ALL the major hospitals and ICU's are now full - mostly of the unvaccinated - emergency arrivals are being refused or diverted, and needed but not essential surgeries have been cancelled.

In less than a week Omicron has gone from "hasn't been found yet", to a couple of cases, to the spread of Omicron to 15, 17 yesterday and probably 20 or more by the time people may read this. And all this in the country probably best equipped to do otherwise!?

As I've said before - the world has failed to unify and act in concert, and we truly are at the mercy of this pandemic. The attempt to play whack-a-mole didn't seems to work. If it ends, it will likely only do so due to the virus itself. Let's hope for good data. If for any reason Omicron or the next variant becomes serious, escapes vaccines, defeats antibodies with the ADE effect, and/or continues the multiple reinfections of Omicron - all predicting more mutations - well...