Oh, right. We're still in the middle of a deadly pandemic.

I feel super guilty for sending the kids in this week. They asked students to stay home where possible. I don't know how to evaluate if it's "possible" or not.

It's well established now that it is more transmissible although the exact reason why isn't clear yet- better able to bind to cells? Causes more viral load in carriers? And I've seen mixed reports on how much more transmissible. Some say it increases the baseline Ro by about 0.5, others say it's a 50% percent increase in Rt. The thing I'd really like to see is an assessment of how that impacts risks in common situations. If you have a 10% chance of getting infected when shopping, if it were the prevalent strain would you now have a 15% chance?

That's specifically talking about the UK strain. There are reports that a South Africa strain can evade immunity more effectively but I don't think that's proven yet.

Viruses constantly mutate. Fact. But as far as I remember almost nobody in authority saw fit to mention it until about Christmas. Interesting judgement call.

I asked about this on a reasonably reliable site in about October and was told that SARS-CoV-2 was strikingly stable, but that was obviously not predictive.

Mutation can make a virus more or less transmissible and or more or less likely to cause symptoms Which may or may not be the same as those caused by the pre-existing form. In the case of this beastie the mutation identified in Britain and South Africa seems to be considerably more transmissible but otherwise indistinguishable in its effects. It also appears to be vulnerable to at least some of the vaccines coming on stream.

This is modestly good news. It could easily have been a lot worse, and the next mutation may still be.

Get the shot if you can, and anybody you care about too. If it only immunises you for six months, that's precious time for the people working on treatments.

I'm very worried because I'm worried about hospital capacity. The UK has a lot more tools with lockdowns than the US does and even so I honestly don't see how their hospitals are going to continue to deliver care without aggressive rationing over the next few weeks. I'm worried about the quality of care we'll see here even with rationing. As far as I can tell, in February or March every state is going to have a crisis worse than the fall/winter crises we've passed through/are passing through now. It may be possible, if it's March, that vaccinations will impact hospital capacity a bit because health care workers and people over 75 won't be getting sick as much.

Not-really OT: thoughts on the Sinovac efficacy results?

0%-to-70% more transmissible - holy error bars, Batman!

Local modelling I've been hearing about says that we'd be at or just past the peak now (based on NYE parties, roughly), but if the new strain is fully 70% more transmissible cases will keep going up until mid-February.

Pretty fucking nervous. Pretty fucking nervous. We might be peaking in new cases here, but the rate is very high, the healthcare system has been operating at capacity, and we're going to be hit with a wave of deaths soon. It isn't good. And that's with a fairly intense lockdown, more so than what almost anywhere in the US has seen.

Viruses constantly mutate. Fact. But as far as I remember almost nobody in authority saw fit to mention it until about Christmas. Interesting judgement call.

I dunno, I felt like it was all over the media. A quick search shows that The Fauch was talking about mutations in July. Changing that search to "uk coronavirus mutation" but keeping it in the same time period has British media in October talking about risks from "the Spanish mutation," which I don't even remember.

7: MC MC! Promising. From what I read, not as good as the other ones, but having companies making more vaccines is great. If it's effective enough and China wants to do vaccine diplomacy to bolster its image, that's net good for the world (in the short/medium term obvsly).

Even though I'm not in the US I'm far more nervous about the fucked-up vaccine rollout.

In the US that is.

I feel as though I was hearing pretty regularly about mutations and potential future mutations going back to late spring, but I don't remember where exactly, so I'm not sure how mainstream it was. I'm not reading science journals, though, so it wasn't too buried.

I'm oddly not any more worried about the mutations than I am about the virus generally. The virus is quite worrisome all on its own, though.

One piece of good news this week: Due to a freezer malfunction, Walgreens had to vaccinate way more people than planned at my father's facility. So ALL of the staff (including healthcare, administrative etc.), ALL of the nursing home residents, ALL of the assisted living residents, and 3/4 of the independent living residents got their first dose of vaccine last week.

My dad (76) was in the 1/4 who *didn't* get vaccinated, but we're hopeful that he'll get his dose in a few weeks when they come back to do the second dose for the others. Meanwhile, I'm just incredibly grateful that so many people around him are now vaccinated. He's super cautious already, but it just feels like one additional layer of protection (albeit not likely to kick in for 14 days or however long it takes for the vaccine to start to take effect).

I add that the only sensible thing to do in re the new strain would be to get cases down as low as humanly possible now so that we have as much healthcare capacity as possible when it hits, but of course here in Minnesota the governor literally just reopened indoor dining, even though our case counts are about 1500/day above where they were pre-surge.

I don't really blame him because there's been so much GOP/rural/wingnut/deeply stupid people revolt against this. The options were not "intelligently keep everything shut down" and "reopen like a big stupid"; they were "yield now in the hopes that you'll have political capital to shut down again later when the new strain is prevalent" versus "try to keep things shut and literally have to send police to arrest people, risking violence and all kinds of insubordination".

This is an awful country full of selfish and malign people. I'm in my forties with a pink collar job so it's too late to really retool and try to go to Canada or New Zealand, but I think that even now I could repolish my old language-teaching credentials and find a job somewhere in Asia. Not the kinds of plum jobs that were easy to get twenty years ago, but the truth is I'd kind of like to go somewhere other than the big fancy cities anyway. My dad and my brother are here so I'd have to be confident that I could fly home a couple of times a year which is the big worry with political instability. But I am starting to wonder if I should make some kind of last-ditch attempt to leave. I thought about it in my mid-twenties and couldn't really make myself leave my family.

I've been seriously alarmed at what's happening here in the UK, where the last few weeks have seen a dramatic increase in numbers with the new variant almost certainly being a major factor.

According to UK test & trace data*, for those with the new variant 15% of their contacts get infected compared with 11% for those with the 'old' version. So an estimated 30-50% higher attack rate. I'm no mathematician but if you add that into your exponential growth formula I don't think you get a happy result.

My main worry is that the NHS is very close to running out of beds and medical staff to deal with the numbers needing hospital treatment, and the death rate will spike massively if they are overwhelmed.

My personal risk (and behaviour) hasn't really changed because I was already avoiding any situation with a more than minimal risk of transmission. So I'm not nervous for myself unless I get hospitalised for something other than Covid.

*Link to twit thread with some recent relevant stats:
https://twitter.com/kallmemeg/status/1347555411940028417

9: That was variant D611, which seems to have arisen in southern Spain during the summer and then became the major variant across Europe during the autumn outbreak.

||
Alex/GY/whoever, thoughts on the Ericsson/Samsung case?
|>

Not from me. Haven't followed it, to be honest, but at first glance it seems to be a pretty bog standard negotiation by patent lawsuit, with a bit of a jurisdiction shopping twist.

What got my my attention is that one the shopped jurisdictions is Chinese.

This was the Zeynep Tufekci piece about transmissibility from ~2 weeks ago: https://www.theatlantic.com/science/archive/2020/12/virus-mutation-catastrophe/617531/ You can skim it; the key bit is here:

Kucharski compares a 50 percent increase in virus lethality to a 50 percent increase in virus transmissibility. Take a virus reproduction rate of about 1.1 and an infection fatality risk of 0.8 percent and imagine 10,000 active infections--a plausible scenario for many European cities, as Kucharski notes. As things stand, with those numbers, we'd expect 129 deaths in a month. If the fatality rate increased by 50 percent, that would lead to 193 deaths. In contrast, a 50 percent increase in transmissibility would lead to a whopping 978 deaths in just one month--assuming, in both scenarios, a six-day infection-generation time.

Fauci's due to talk about current status later today, public link will be available within 24 hrs, I'll share. for whatever it's worth, my 80yo dad got the Pfizer version yesterday at a regular doctor's office in Prague.

16: I'm afraid I haven't been following it now I work on the robot brains, so I don't have much to offer.

Pretty nervous yeah. Zeynep in 19 is all over it as she's been all over all the most important Covid-related things (masks good, indoors

This may be a sign of my defective character, but I have a finite capacity for worrying about things, and I reached it a while ago. If a new, higher-priority thing comes to worry about, then lower-priority things drop off. So I barely worry about COVID at this point, and I definitely am ignoring this new strain. I comply with COVID rules out of a duty to society, rather than because I worry about getting sick.

Thank you for the Atlantic link. That confirms my fear about gearing up the exponentiality. The maths is just brutal.

One of the things that angers me (there are a few) about how the pandemic has been handled is that the implications of the higher transmission rate weren't communicated. I'm sure most people thought "50% worse, that's not so bad" and went on as they were. But if they'd been told it could result in an eightfold rise in deaths ...

This bit near the end of the article: "we've had a year to learn to not wait when faced with threats with exponential dynamics but to act as early and as decisively as we can". That was written about some parallel universe, wasn't it?

Walt: If we all did our duty to each other, this virus would be suppressed. You're doing your duty, and for precisely the right reasons, so don't feel like you're in any way defective. Thank you.

To those who are sending their children to school: you should stop doing so. Ditto day care. The evidence is now here: before we had no evidence either way, but now, we have the evidence, and even pre-B117-strain it's clear that these communal child care situations spread the bug. With B117? It'll be carnage. The evidence is clear about colleges, too: those that went to in-person education initiated spread in their host towns; those that stayed remote-learning did not.

Every single activity indoors has to be re-evaluated for risk. I read an article talking about the rate of air-replacement needed to make indoors safe: ten times an hour. It's unachievable, esp. in winter. Another rule of thumb was: if you can smell somebody's smoke, then their covid aerosols are getting to you.

Our city, which I thought was being reasonable early on, is reopening in person schools next month. It optional and our kids are fine with remote so we said hell no. They are of course way beyond their initial metrics that said it was dangerous to open, so they just keep changing the metrics. They should just admit they're going to open and stop pretending there are any objective criteria they're using to judge whether it's safe to do so.
We are considering sending one kid back to hockey because we found a program that only uses an outdoor rink. I'm not sure how to judge that risk.

: if you can smell somebody's smoke

I'm not parsing this. Do you mean someone's body odor? Not a lot of people walk around with tobacco breath.

California isn't the world.

In hell everyone smokes, but not in a way the non-infernal can understand.

If the CDC is to be believed, only 17% of Pennsylvanians smoke.

14. It depends what you mean by "running out of beds." I'm on a rehab ward and they could kick us all out tomorrow if they had to. It would be a nightmare for everybody's family and friends, but probably nobody would die in the short term. And bingo! 36 more beds. But the real problem isshortage of trained IC staff. I see no work around for that..

I'm now wondering if at some point putting together factors of (a) medical workforce burnout increasing and (b) this being the case more or less nationwide so you can't fill the gap by pulling in people from elsewhere, we'll have to take some kind of drastic measures like training up new staff from zero qualifications in six weeks.

(Not ICU staff, but maybe something like that would help other existing staff move into ICUs.)

Minivet: Sorry, I was .... well, y'know how it gets when you're writing without proofreading. Sigh.

If you can smell the smoke from somebody's cigarette across the room, then you're inhaling their covid aerosols. That was the metaphor someone wrote. I think it's pretty apt.

SP: The problem with "outdoor rinks" is that there will still be all the shared facilities. And exercise involves heavy breathing, which means people need to stay further apart, but hockey involves getting up-close -- checking, fighting over the puck, etc. It seems pretty unwise to me.

Look at this https://twitter.com/DrTomFrieden/status/1348761507480416257

And consider that Ireland wasn't exactly a mask-free party. Whatever mitigations they had in place, were entirely inadequate to this new variant. At the very least, at the very least, we should be acting like we were in March, when we knew very little and were pretty damn scared. B/c that's where we are.

A friend told me in February: "Humans are constitutionally incapable of fully understanding the power of exponential growth".

To which I can only add: "once bitten, twice shy".

My thoughts have been about rural areas with lots of mask-free assholes and covid. They already gave trouble holding medical staff.

To those who are sending their children to school: you should stop doing so. Ditto day care. The evidence is now here: before we had no evidence either way, but now, we have the evidence, and even pre-B117-strain it's clear that these communal child care situations spread the bug. With B117? It'll be carnage.

This is instilling a panicky feeling in me.

mask-free assholes

Huh. I thought the lungs were the primary entry point for the virus.

I don't tell you how to breathe.

If you can smell the smoke from somebody's cigarette across the room, then you're inhaling their covid aerosols. That was the metaphor someone wrote. I think it's pretty apt.

Sounds correct, but not something I have much instinctive feel for - living as I do in a 10%-smoking county.

26: Hockey is something I've been wondering about, because I read somewhere that being on ice makes germs hover at head height longer, so it's generally the least safe sport. I've been wondering about going recreational skating at Lars Anderson park which is outdoors, and I think that's probably fine, but I wondered if being on ice makes it slightly less safe than being outside on a field.

It's been so warm that I am wondering whether we are going to be able to use outdoor rinks.

I'm not worried, possibly because of the imminent collapse of the government, but also because while the new strain is more transmissible, it's kept in check by the same precautions I'm taking already. I'm teaching in-person, and if the virus is 1.5 times more transmissible it really doesn't matter to my risk in the classroom. Everyone is distanced (15 people in a small auditorium), wearing masks, and wiping down their desks on the way in and out. While community transmission is high, there doesn't seem to be a lot of evidence for transmission within the classroom (as opposed to at the campus bar or in the dorms.) We're not going to restaurants or gyms or visiting my family, but we weren't doing that already. The kids are in school and daycare, and while I don't trust the evidence that says that little kids don't spread it, it's also again true that we're not typically seeing the virus sweep through classrooms, which suggests that it's relatively low risk. Utah is vaccinating teachers in the next wave.

We have two big risks. Our church -- and our priest died of COVID, found alone, and I am so damned angry over this. And skiing, which is outdoors (we're not going into the lodges at all to the extent possible) and everyone is masked and muffled. I'm not sure what to do about either of those.

27: I saw somebody on my bike path walk smoking. It definitely went through my mask even with a filth filter.

Not sure the smoking thing is correct from first principles: scent is from volatile organic compounds which are much smaller/lighter than virally contaminated aerosoles or ash particles. HEPA filters and N95s impede both but cloth masks only (partially) impede the latter. Any cites of empirical studies?

The program we're looking at is outdoor rink, no shared facilities (arrive and leave dressed), no games (practices only), masks at all time. Our kid is wearing an N95 under a plexi hockey mask/shield. But it's little kids who tend to fall all over each other even when only doing drills.
We have been doing recreational outdoor skating in small (less than 10) groups with pre-registration required. We're also going to go skiing again which seemed pretty safe.

I shared the tweet in 34 myself, but I wish I could see it on a log scale. I couldn't find the controls to pull it up on the Hopkins site after 5 minutes of trying, then I got lazy.

So sorry to hear about the priest, Cala. I would be furious too.

I'm quite worried about the new variant myself and have barely left the house since the numbers in SoCal started to get really, really bad. I am predictably completely insane now, but also confident that I haven't infected anyone, except with insanity!

I'm scared for the US, seeing what's happened here.

As I've stated elsewhere, we got infected. Just in case it's helpful for others, this was our situation.

I left the house on average 2 times a month since last March, as I could isolate myself and so I did. My husband - who owns a retail shop - opened with the strictest possible social distancing for customers, and followed social distancing and mask wearing in the shop with his coworkers, and errands 1-2 times a week (masked visits to shops). The third member of our bubble was careful as well as he's over 75, but more open to being out in society than either of us - so masked visits to grocery store, some golf, I think a handful of meals out during the summer, eating outside, that sort of thing. More than I was comfortable with but well within rules/guidance.

None of this changed in December; if anything, we were more constrained as we'd been seeing the news regarding the new strain and because of local lock downs, and then my husband must have got it the very last day they were at work. I'm fairly certain the coworker got it through their children as he was also extremely careful but the kids were in school. With the exception that my husband can't work from home, I felt that we were extremely conservative in our approach and very careful, and we still got it...

We were with my father-in-law for about 10 hours across two days, indoors and maskless, just before symptoms started to show, however, and he's managed to get through without it, so that's mildly hopeful!

(Just to be clear, the third member of our bubble is my father-in-law, who we treated as a member of our household and why we were being so careful otherwise, and he was not out eating in restaurants or golfing in December, those were summer only activities!)

The kids are in school and daycare, and while I don't trust the evidence that says that little kids don't spread it, it's also again true that we're not typically seeing the virus sweep through classrooms, which suggests that it's relatively low risk.

I don't think this is true of the new variant in the UK, but this is based primarily on Twitter threads by public health people so may be incorrect. I am fairly certain our case came from school-aged children as it was running through our local schools before they closed.

Cala: there have been a number of studies of indoor transmission events, and it seems pretty clear that without rapid and regular changes of air (which are pretty much impossible without massive renovation of HVAC) the "six feet + mask" stuff doesn't suffice. The point being, once covid is aerosolized, it drifts with air currents. So what matters at that point, is the -concentration- of virus particles. Regular air changes reduce that concentration.

Ile: the point of the cigarette smoke analogy is precisely that it drifts with air currents, as does aerosolized covid. search for the difference between droplet and aerosol transmission. Everybody thought it was only droplet, but then, well, bit-by-bit the evidence has accumulated that aerosols are really important: cruise ships, restaurants (what was it? 10ft away for 12min? was enough to infect?) buses, an entire apartment block (interior ducting), etc.

Re: small children, there was a der spiegel article about this very subject, and the evidence adduced there was pretty conclusive.

And all of this was from before B117 was prevalent. The point is, that with all the mitigations people are ALREADY taking, you can see that B117 exploded and ran like wildfire. Look at that graph from the tweet by Frieden: it goes vertical, and again, you can't say that these people weren't already taking massive precautions.

There's also the original journal preprint about B117 (I don't have the link) in the UK, where it's clear that
(a) in the areas of Southern England that had crazy resurgences, they were driven by B117 "outcompeting" the other strains
(b) the areas of England without resurgences (at the time) B117 was low

So one could posit that the areas that didn't see surges were taking better precautions. But then you have to explain why B117 didn't outcompete the other strains there. Oh, and in those #b areas, near the end of the window of data, B117 was surging, and so was the infection rate.

Yes: it's pretty frightening. I would avoid foreign buildings until we can figure out what the hell is going on. You need -both- your lungs, -both- your kidneys, etc.

I'll quote from that Frieden tweet: "I've never seen an epi curve like this. The B.1.1.7 variant is spreading like wildfire in the UK and Ireland. If it spreads here, it will make an already-bad situation even worse."

This guy is a serious epidemiologist. Used to run the CDC. Don't be one of the ones caught in that worse situation.

48: I'm not sure it wasn't true of the old variant either, to be honest. No one has ever been able to answer how they can be sure kids aren't spreading it when we don't test kids and there's massive community spread.

49: The HVAC system has been set so that a) the air cycles much more frequently and b) now my office is cold because of the refresh rate. I'm not sure what facilities management is doing but it is something to increase the air turnover. I'm not terribly worried about the classroom.

49 ah thanks. I thought aerosole was heavier than smoke.

Ile: So, uh, the definition I've read is:

Droplets are those things that are still governed by gravity. This is why they talk about 6ft -- b/c that's about how far they can get with the velocity they get exiting orifices, before they hit ground.

Aerosols are small enough, that they dry up before they hit ground, and thus are wafted by air currents from then on. The assumption being that the remnant after water dries up, is small enough that it's not going to drop like a stone.

This is a rough division: obvs. there's stuff in the middle.

The idea of "6ft + mask" indoors is that there isn't much aerosol. But this is turning out to be less and less true. And there are a number of cases of transmission showing that aerosols matter a *lot*. Now here's the thing: with aerosols, it matters a lot how long you stay in an enclosed space, and how often the air is replaced. B/c (and this should be obvious) if you replace the air often enough, the -concentration- of aerosols doesn't get very high.

So suppose we know all these parameters (which we do not) and we're satisfied with the risk level. Along comes B117, and suddenly, the risk level for any particular set of mitigation tactics goes up dramatically. We don't actually know how much it rises, b/c "completely new". But we -can- see that in places where B117 is measured to be spreading, case-rates go up near-veritcally. And the mitigation strategies haven't changed.

What should a careful person do? I argue: stay the fuck away from other humans as much as you possibly can for the next month until the doctors and scientists get a handle on this. Don't be the one who used last month's mitigation measures cheat-sheet, when the smarty-pants will come out with another one in a few weeks, telling you what is safe and what isn't.

I want to stress again that it doesn't require knowing the details of concentrations, dosages, etc, etc, etc of indoors exposure, how often air is replaced, etc,etc. We already know enough: we know that whatever was working in the UK, across broad swathes of the country, whatever was working against non-B117 variants, failed spectacularly against B117. We should want to not be in that cohort, who learn that our mitigations also don't work against B117.

I mean, unless you think that what your particular locality is doing, is vastly better than what was tried in the UK, you should be scared. I know I am.

I'm sorry, I left out a crucial detail about aerosols: their movement is -independent- of gravity. That's part of the definition. That's why aerosol transmission in Korea (IIRC -- maybe it was China) could infect an entire column of apartments in a decently-tall apartment building, all thru the interior ducting connecting the bathroom air ducts: b/c the aerosol particles were not governed by gravity, but solely by air currents.

WHO is sceptical about the variant: https://healthpolicy-watch.news/increase-covid-cases-not-due-variant-who/

Feel also that the obvious has to be stated: it's in the interest of governments to hype the new variant. UK gvmt not, never, no chance an exception.

That said, I'm staying indoors on my own (OK with my 7 yo half the week) like never before.

re: 57

This is driving me crazy. I had to self-isolate over Christmas, and then being very constrained thereafter is causing a lot of stress in the house. It's especially hard on kids. My friends with older kids, their kids can go out and play football together, or even go for a walk. My friend's 12 year old daughter does this with her friend, for example.

7 year olds, they can't go out on their own, so how is that going to square with 'exercise only with one person from outside your household" rule? I'm not crazily keen on having my son have literally no social contact with another child for the next 6 months. That rule is going to get bent (in more ways than one).*

I was terrified that the stupid furore over Johnson's 7 mile bike ride was going to result in some pointless restriction on outdoor exercise which I'd have to just break, because, fuck that. I rode 20 miles yesterday morning before work. The increase in my exposure to COVID is basically nil. I'm on a road, metres away from any other person, travelling at speed. The exposure from walking near my house -- I live in London, not some leafy home counties village -- is vastly higher.

re: 56

Yeah. The infection rate is starting to fall again, which suggests the supposed increase in R is not so huge that increased lockdown measures can't combat it. Especially since the emergence of the new variant coincided with i) pubs being open, ii) concentrated outbreaks in schools and universities.

* by which I mean a sensibly socially distanced walk with one of his friends, chaperoned by a single adult. Not some kind of indoor playdate.

re: 48

Schools have been rife with COVID since September. Any confidence that schools aren't a nexus of infection is entirely misplaced.

Charlie W: Re: the new UK variant, here's a DailyKos article that extracts the key graphs from the (linked in post) journal preprint. The preprint is actually pretty readable, too.
https://www.dailykos.com/stories/2021/1/1/2005373/-Time-to-take-B117-UK-Covid-seriously

It seems pretty obvious that case rise in the UK at least was driven by this new variant outcompeting other variants. Time to look for similar clade-level data for Ireland, I guess.

58: My 7 yo 'plays near but not with' other 7 yos. That seems to work, kind of. All outside anyway. With the bike, I admit that my distances have come down, and now the rain has set in it's all about the indoor trainer. Hopefully cycling will remain unmolested though.

60: Not obvious to me, sorry.

re: 61

We don't have space for an indoor trainer, although if we were to have gone into some even more restrictive lockdown, I'd probably have considered it.

I don't do crazy miles. Almost zero by "cyclist" standards.* 50-70 miles a week, I guess. I try to get out 4 or 5 times a week. I don't especially mind getting wet, although I did have a problem the other day with a load of mud and crap that I needed to stop and clean out of the brakes.

* I'm just trying to keep myself fit and healthy when I can't go to the gym, although I do quite enjoy cycling.

We have a stupid indoor exercise cycle that I ride now. The weather isn't bad (for January), but my ankle is again not taking enough pressure that I can get my heart rate up by running.

I've been Zwifting on days when I'm not skiing. I don't mind riding in the cold but I'm not taking chances on the ice.

53,54: oh I am really fucking scared. In two.momths I have only left the house to go for walks and see the doctor. My partner works in a lab where they have staggered hours so people can avoid each other. My Dad's insistence on getting Desi groceries every few weeks is the main concern, but he's so profoundly depressed I can't fight him.on it, and he does all the things to be careful. But I wish I had N95asks for him.

62: Have tried to substitute intensity for mileage, with results yet to be determined. Supposedly indoor trainers can be more intense since there's no stopping. I just put it in the living room, on a mat, in front of the TV, and then tidy it away again afterwords. Might not work for every home situation!

64: have come to quite like the 'Jungle Loop' with its theme park Mayan temples, waterfalls, or what have you. Takes your mind off your redlining HR for a moment, anyway.