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Tuesday 19 May 2020

Superspreaders

Evidence continues to emerge about the way in which the Wuhan virus spreads. There's good news and bad news. The good news is that instead of 60% of us having to be infected to achieve herd immunity, we could do it with 10% - 20% in combination with behaviour modification. The bad news is that the behaviour modification could knock the arse out of our lives. 

The key is that not all of us are infected equally, and those who are infectious are not all equally infectious. It's nothing to do with individual physiology and everything to do with location and positioning, as the Telegraph reports today -
By applying a mathematical model to reported outbreaks of the disease outside China, they estimated that 80 per cent of all secondary transmissions were caused by a small fraction of infected individuals - around 10 percent.
The risk is in strenuous or energetic activities with more rapid, deeper breathing in crowded closed or indoor situations. A mosh pit is very high risk, the Bodleian library much less so. Groundworkers, brickies and scaffolders (provided they don't crowd into the mess rooms) are safe on site, second fix joiners, sparkies and painters less so. And if you want to get around London, I'd suggest the upper deck of one of those open-top tourist buses.

But for most of us, it's our most common and uniting experience that may never be the same again - the pub. They've re-opened here, but table service only, not more than four to a table and bookings are needed. The whole point about going to the pub is (a) it's spontaneous and (b) the opportunity to meet new people, expose yourself to social interaction and to strengthen bonds of identity and community. We have to pin our hopes on a vaccine to get back to anything like normal. 

Post-Wuhan gasthaus

20 comments:

Span Ows said...

...singing and shouting was the main differnet point re superspreaders sports events and pubs etc. More exhaling and powerful lung activity (a) if you havethe virus you spread it more and/or (b) if you don't hav ethe virus all that heavy breathing (ooh matron!) makes you more likely to get it. Hence, the sports events/concerts just before they were cancelled would have seen massive spreading.

We'll be in lockdown for ever waiting for an effective vaccine.

DeeDee99 said...

Since when has sitting in a pub, or even standing by the bar resulted in "strenuous or energetic activities with more rapid, deeper breathing?"

Large concerts at the O2 qualify; so do stadium concerts and festivals such as Glastonbury (although the kind of small festivals where everyone brings a chair, don't). Gyms and exercise classes are obviously risky as are large Sports meeting.

But there's nothing very energetic or strenuous about raising a glass to your mouth and chatting to someone.

Are we REALLY going to let the Government and Wuhan Bedwetters change our way of life forever, for fear of a VIRUS?

Raedwald said...

DeeDee - they're not very obedient here, and only obey the rules when they're being photographed. They reckon if you can stand next to a chap at the urinal, it's pointless not also to visit their table for a chat.

As usual, the point here is making the rules. No one usually bothers enforcing them unless someone complains. Unlike the UK.

Nigel Sedgwick said...

Public confidence is also an important issue. Modelling superspreaders and stepping round them will, I doubt, give a sufficiency of that.

Remember, the primary purpose of lockdowns is to delay most of the infections until means are found to stop people dying (or acquiring and suffering serious long-term morbidities). This is wider than not overloading ICU positions.

In the current circumstances (ie vaccine not available, probably continuing for some time, and anyway not guaranteed possible) we should be looking hard and fast for anti-virals and non-pharmaceutical interventions (NPIs).

Also, given the importance of timing with such a fast-acting infection, early-stage treatments should be applied - rather than waiting until hospitalisation becomes necessary to suppress the worsening symptoms (eg through oxygen). It should be remembered that the early-stage treatments are to assist the patient's immune system in winning - rather that those reinforcements turning up after the battle is lost or too far gone for saving.

Then the recovered patients become part of the immune division of the herd; eventually enough being immune for the disease to die out, or become a very minor probably somewhat seasonal thing for which vaccination helps maintain long-term suppression.

Moving on, it is interesting to note that the general public are getting increasingly desperate for good news; also good news soon (which rather leaves immunisation out in the cold). POTUS Trump seems to be making use of this great desire with his current personal choice of prophylactic, which is not that of the Swamp.

As well as saving lives and reducing serious future morbidities, more public confidence through actually effective early-stage (in fact mid-stage too) treatments and also prophylactics would make ending lockdown easier - and seriously mitigate the risk of it bouncing back very badly (because the UK is a northern hemisphere temperate zone) in November (or even latish October) as the IRD (Infectious Respiratory Disease) season starts again.

If people are not dying much and not suffering much from serious long-term morbidities, the social, entertainment and tourist industries are more likely to recover - and sooner.

Keep safe and best regards

Poisonedchalice said...

Commercial airliners have to be the worst. Much as I love flying to warmer places, I always get vaguely ill, either on the holiday, or after we return home. Passenger airliners are just high-speed cylindrical petri dishes, with a sound method of virus redistribution through the air-con. Ho-hum.

On the other side of the pond, the race hots up to get the first vaccine to market. Moderna have rushed straight though to human trials, ignoring the usual niceties of lab / animal testing. The injury rate is said to be 20%. Isn't that a bit like saying "it's fine sir, the brakes on your car are guaranteed to work 80% of the time."

Dave_G said...


When we start treating Covid-19 as a simple (albeit more serious) influenza with the same chance of infection/transmission and the same end result (for those with various co-infections/illnesses) as any 'normal (and annual) influenza' the sooner we'll get past this ridiculous assumption that we can find a cure for a VIRUS.

Remind me how the search for a cure for the common cold is going.......?

BTW I now have a t-shirt that states 'anti Covid protection' that is just as effective as any face mask.

Span Ows said...

20% is crazy bat-shit bad. Plus they have to wait until another corona or flu comes along to see if there is any adverse/enhanced reaction (which is very likely - see prof Dolores Cahill)

Dengue 50/60s - vaccine approved 2019
Ebola 70s - no vaccine
Aids 80s - no vaccine
Marburg 90s* - no vaccine (*last outbreak)
SARS1 00s - no vaccine
MERS 10s - no vaccine

I see no reason whatsoever to believe a vaccine is anywhere near

Mark The Skint Sailor said...

The problem with computer modelling is how do you model a virus that behaves unlike any other virus before it?

The biggest issue with this virus is asymptomatic spreaders. You can't legislate for someone who is spreading the virus and shows no symptoms.

At least SARS had the decency to show it's hand by giving the carrier a temperature before being infectious. COVID-19 is just plain sneaky.

You either unlock and live with the virus and suffer the consequences or you continue lockdown of some kind indefinitely and keep paying those at high risk of mortality to stay at home. I'm not sure the second option is viable long-term.

This virus is quite nasty in the areas it infects. Any cell with an ACE-2 receptor seems fair game: not only the lungs but it also causes bowel issues, mucus membrane issues, skin issues, the thing even causes blood clots as the lining of the arteries are infected and lose their teflon-like ability. So it can cause heart attacks and strokes and the victim may not even know they are infected.

The best bet is not to get infected in the first place. But doing that in a modern mobile society is virtually impossible.

I'm not sure relaxing the restrictions while there are potentially many asymptomatic spreaders out there is such a good idea.

Thud said...

span owls, wrong on ebola, they were close on sars etc but it died out too quickly, aids...who really cared? at the moment the best and brightest with unlimited budgets are at work so we will see first treatments oct/nov.

Dave_G said...


Enforced lock down should have been restricted to the VULNERABLE ONLY. Or by personal choice.

The current policies are NO NECESSARY and have only been used to deflect from other issues.

Anyone know how much the banks have been bailed out with since the Covid plandemic was started?

Me neither.

Anonymous said...

One of your fellers was all for nicotine patches. Why not force all punters to smoke and then reopen the pubs?

They could offer Lysol chasers. Snake oil sangria too.

Oh, and don't forget "I shook everybody's hand" Boris for when you are heading home.

mikebravo said...

Nonny 13:59.
Why not go back to the shower and push some more root vegetables up your rectum?

DeeDee99 said...

@ Raedwald. We're not that obedient down in Dorset either .... unless we're being "policed."

It's been interesting to note that Dorset Police, who have complained for years that they have insufficient resources to maintain a presence in, or patrol my small town regularly, have magically found those resources in the past two months and have been patrolling regularly.

Jack the dog said...

THe key point, that cannot be stressed often enough is that most people who catch don't even notice, and for most of the rest, treatment has moved on enough that they will be cured.

So while you don't want to catch it, it's not a major disaster if you do.

The whole lockdown made sense at the very beginning as a reasonable sounding emergency measure to prevent overwhelming healthcare facilities.

But it should never have lasted more than 2-3 weeks.

THey seem to have gone quite mad.

And, as has been pointed out elsewhere, they way the government have approached this whole thing shows louder than words how little trust they have in the native good sense of the populace and I am disgusted.

This is by far the biggest failure of government in my lifetime, if not ever.

FrankS said...

"We have to pin our hopes on a vaccine"…
Or maybe learn that a risk-fee life is impossible

Span Ows said...

Thud, 12:52, "span owls, wrong on ebola

You're right, good news: the only one approved at the end of 2019, was fast-tracked by WHO and is still 'conditional' status I believe in EC, although FDA approved, I'm clearly out of date...but it sort of highlights my point: look how long it took.

Smoking Scot said...

We saw the effect of just one superspreader in Korea. Gay guy who visited a bunch of bars in one night. Not an issue for most of us, but I'm going to steer clear of gyms and public swimming pools for a while.

Agreed about flying; funnily not the plane itself because I always chose aisle. Rather it's those buses Jet2 insist on using to get us to the plane; there crowding can be far worse than London underground.

Pubs are not an issue with me. I only sit inside if I'm eating (invariably lunch) and sit outside with a fag and ashtray at all other times.

Problem for pubs in Scotland is the fishwife has made it clear that they will be the last to open. All will have to chuck their keg beer and some of their fancy bottled ones as well. Then they have all the protocols to observe, meaning their capacity limits will be about 1/3 of normal. Add the gloves, masks and sanitizer for staff and customers and in a lot of cases it won't make sense to restart.

Those in Edinburgh have to cope with a dearth of tourists and the lack of the Festival (the latter hitting Airbnb like a brick) and it looks pretty awful for the whole leisure sector in Scotland. And it was only a few months ago they were screaming to impose a bedroom tax because they were cheesed off at having so many visitors!

But looking on the bright side, those that survive will make a killing at Hogmanay!

Anonymous said...

@mikebravo

Naughty!

No need to adveritise your peccadilloes.

Anonymous said...

Yeah, those countries that based their approach on such guff have scores of thousands of dead, whereas those which followed WHO advice have just a few tens in some happy cases. Those, like Italy, which acted late in that way have still turned the tables on this scourge too.

I think that the conclusions are self-evident.

Greg T said...

Dave G
FUCK RIGHT OFF
I am technically "vulnerable" ( I'm 74 )
But, I'm still taking the same size trouisers I was buying nearly 40 years ago ( 34" waist ) I'm fit & healthy & active & I WANT A BEER