Experiences of Teh Plague

[Kim]

Anecdotally, it's rife among our employees and at the local hospital but the tests aren't picking it up until about the 6th day after symptoms start.  My mother has it (she is fine).  I have a bit of a cough but test is very negative.

Your irregular reminder that the lateral flow tests had poor sensitivity back when the circulating variants were still the ones they were designed for... 

I guess it depends on where you get your information from, or how you define "poor".

https://www.ox.ac.uk/news/2020-11-11-oxford-university-and-phe-confirm-lateral-flow-tests-show-high-specificity-and-are#:~:text=It%20has%20an%20overall%20sensitivity,in%20symptomatic%20and%20asymptomatic%20individuals.

23% false-negative rate is poor for diagnostic purposes.  It's still useful for mass screening (picking up asymptomatic cases), which is what that article from 2020 implies, and how the LFTs were originally used (the high selectivity means that if you have a positive LFT, you almost certainly have covid).  We seem to have forgotten this as the government abandoned PCR testing, and LFTs started to be used for diagnosis.

Practically, if you've got the lurgy, there's a decent chance that it's covid, and you should behave accordingly^[1].  A negative LFT doesn't change that.


_{[1] Ie. make sure you go into work/school and spread it to your cow-orkers.  Got to keep inflating that property bubble.  Any effects of sickness on productivity can be handled in the traditional BRITISH manner, with disciplinary processes.}

[Regulator]

Anecdotally, it's rife among our employees and at the local hospital but the tests aren't picking it up until about the 6th day after symptoms start.  My mother has it (she is fine).  I have a bit of a cough but test is very negative.

Your irregular reminder that the lateral flow tests had poor sensitivity back when the circulating variants were still the ones they were designed for... 

I guess it depends on where you get your information from, or how you define "poor".

https://www.ox.ac.uk/news/2020-11-11-oxford-university-and-phe-confirm-lateral-flow-tests-show-high-specificity-and-are#:~:text=It%20has%20an%20overall%20sensitivity,in%20symptomatic%20and%20asymptomatic%20individuals.

Meanwhile we haven't had a case a work for several weeks, looks like the local wave has passed.

I'd just point out that the Innova tests so lauded by PHE were withdrawn from use in the USA after it emerged they'd lied about the test results...

https://www.fda.gov/medical-devices/safety-communications/stop-using-innova-medical-group-sars-cov-2-antigen-rapid-qualitative-test-fda-safety-communication

The PHE assessments at Porton Down were basically flawed.  But the government insisted on carrying on using the Innova tests - nothing to do with links certain ministers and their spouses had with the company, I'm sure...

[rogerzilla]

I was quite ill last night, with a high fever.  Didn't really sleep.  The bottom end was not right, either.

Today the fever has gone.  Did another negative LFT.  I think this is a violent winter bug, not Covid.

[nikki]

It's still useful for mass screening (picking up asymptomatic cases), which is what that article from 2020 implies, and how the LFTs were originally used (the high selectivity means that if you have a positive LFT, you almost certainly have covid).  We seem to have forgotten this as the government abandoned PCR testing, and LFTs started to be used for diagnosis.

Practically, if you've got the lurgy, there's a decent chance that it's covid, and you should behave accordingly^[1].  A negative LFT doesn't change that.

Hard agree on that last bit in particular.

If ~40% of covid cases are asymptomatic^[1], then that's a lot of covid cases not being detected simply because they're never being tested under LFTs-for-diagnosis modes of operation. (I don't particularly want people's colds or winter bugs either.)


I'm also aware that, following this year's heat waves, there's a non-zero probability the LFT tests I have have spent some time at greater than the 30°C specified on the packet. I've no idea how that affects the reliability of my tests, but I'm definitely not starting from a point of assuming they're particularly reliable.


[1] What Independent SAGE were reporting a few months ago, so I think this is probably derived from the ONS infection survey.

[Auntie Helen]

I am off work today with sore throat, achy limbs and tiredness.

Corona test was negative but I know they can take a while to detect.

It feels like a cold so I’m hoping it will clear up tomorrow as we have a weekend away planned.

[rogerzilla]

Well, this has rapidly subsided to snottiness, so I'm sure it wasn't Covid.  Just a winter shitting bug.

[ian]

Stinky cold subsided and I got my covid jab, then I came down with a monster cough which two weeks later is persisting (now in that lingering hypersensitivity phase, so please really just fuck off). None of it appears to be covid and I'm not blaming the vaccine despite its proximity. The hypersensitivity thing might belong to the previous lurgy. I have previous for post-viral cough. Self-medicating with a corticosteroid inhaler, the thought of negotiating to see a GP at the moment really isn't enticing.

[andrewc]

I've been achey, tired & lethargic for the last week. An unproductive chesty cough as well.  Today these symptoms have been joined by a constant low level headache.  Several covid tests done, but all negative.   Do those things have a "best before" date on them ?

[Wowbagger]

I've heard it suggested that there are more variants around than there used to be and that could be confusing the tests, which are expecting something specific. No idea if there is any scientific basis for this hypothesis.

[Cudzoziemiec]

There are plenty of bugs which make you achey, tired and lethargic with a chesty cough. Some of them might be worse than Covid...

[JonBuoy]

I've been achey, tired & lethargic for the last week. An unproductive chesty cough as well.  Today these symptoms have been joined by a constant low level headache.  Several covid tests done, but all negative.   Do those things have a "best before" date on them ?

Best before date is printed on the box.

Seems to be 2 years after date of manufacture.

[hellymedic]

Suggest you also swab the inside of your cheek...

[ian]

There are hundreds - if not thousands - of respiratory viruses an other sundry infections floating around. And a two year immunity debt.

[Kim]

immunity debt

Isn't that just antivax conspiraloon-speak for "we did stuff that stopped people getting infections for a while, and now we've stopped doing the stuff they're getting the infections again", rather than an actual thing that immune systems do?

[rafletcher]

immunity debt

Isn't that just antivax conspiraloon-speak for "we did stuff that stopped people getting infections for a while, and now we've stopped doing the stuff they're getting the infections again", rather than an actual thing that immune systems do?

I read it as more than that - that the 2 years we spent not getting infections have made us more vulnerable to a greater range of infections now we are getting them again, because our immune systems haven't been challenged as much.

[JellyLegs]

Eighty eight year old, fully vaccinated, FiL with early stage heart failure has gone down with it over the weekend.  Only symptom so far is a sore throat. Fingers crossed it stays that way.  FiL does seem amazingly bombproof, still doing a heavy hands on the tools job until very very recently.

[Lightning Phil]

immunity debt

Isn't that just antivax conspiraloon-speak for "we did stuff that stopped people getting infections for a while, and now we've stopped doing the stuff they're getting the infections again", rather than an actual thing that immune systems do?

I read it as more than that - that the 2 years we spent not getting infections have made us more vulnerable to a greater range of infections now we are getting them again, because our immune systems haven't been challenged as much.

Nope, immune systems are as good as ever

[ian]

immunity debt

Isn't that just antivax conspiraloon-speak for "we did stuff that stopped people getting infections for a while, and now we've stopped doing the stuff they're getting the infections again", rather than an actual thing that immune systems do?

Immunity will wane if not regularly challenged (which it is routinely is, we all the usual rota of colds and infections – most people don't realise that any given moment, they're probably fighting off several infections, the majority of things we catch are minor or asymptomatic). All these challenges refresh and build immunity. I certainly didn't have a single notable cold for two years. Now I'm a month into my latest one (though I suspect it's mostly just a post-viral hypersensitivity rather than an infection at this point). There have been massive upticks in all kinds of respiratory viruses (such as childhood RSV).

One of the key things that holds covid in check is the mix of vaccine- and exposure-related immunity we've built up (there's no difference in practice between the two, immunity is immunity - though exposure to actual virus will likely built a wider immune repertoire, since there's more to the actual virus than just a single spike protein).

[Regulator]

Part of the issue with the whole 'immunity debt' argument is that it's partially based on a misunderstanding of what went on during Covid.

We still got infections.  Bugs were still circulating (particularly amongst the young in schools).  Strep A and RSV numbers were high in both 2020 and 2021.  In fact, levels of iGAS in England are *lower* that they were pre-pandemic.

Most of the clinicians I talk to - including several very respected epidemiologists - say the way the term being used by some is misguided and, to a greater extent, nonsense. 

Worth looking at what people like Dr. Deepti Gurdasani, Anthony Costello, Kit Yates, and Eric Feigl-Ding (Amongst others) are saying...

Interesting article in the FT is worth a look.

[ian]

I think that if the measures to prevent the spread of covid worked, then it is reasonable to assume they were effective against other infections. It seems odd to be arguing in 2022 that exposure to infections doesn't have an effect on immunity and a lack of exposure doesn't create an effective debt (I know, we can argue about semantics, but debt is the word most people use). This obviously varies by infection, but there's certainly been a shift in respiratory infections.

I'm not sure you can cite anyone on independent SAGE as any kind of authority at this point, as for panicker-in-chief Eric Feigl-Ding, seriously, just don't.

[chrisbainbridge]

Whilst strep A and RSV numbers may have been high (I have no data) the incidence of seasonal flu fell sharply during the pandemic.  There was therefore in adults at least a significant reduction in exposure to airborne viral pathogens.

[chrisbainbridge]

We still got infections.  Bugs were still circulating (particularly amongst the young in schools).  Strep A and RSV numbers were high in both 2020 and 2021.  In fact, levels of iGAS in England are *lower* that they were pre-pandemic.

Actually RSV numbers were low during the pandemic and then as expected showed a rebound when lockdowns stopped

Interpretation
The extraordinary absence of RSV during winter 2020–21 probably resulted in a cohort of young children without natural immunity to RSV, thereby raising the potential for increased RSV incidence, out-of-season activity, and health-service pressures when measures to restrict SARS-CoV-2 transmission were relaxed.

https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00525-4/fulltext

[Lightning Phil]

I've been achey, tired & lethargic for the last week. An unproductive chesty cough as well.  Today these symptoms have been joined by a constant low level headache.  Several covid tests done, but all negative.   Do those things have a "best before" date on them ?

I was quite surprised when mine came back positive and how quickly.  It just shows that for some you can’t tell difference between Covid and a cold without testing. I don’t get headaches, so if that ever turned up I’d know something wasn’t quite right before testing.

[Kim]

Whilst strep A and RSV numbers may have been high (I have no data)

The Strep A thing is weird.  It's ISO standard sore throat lurgy.  You'd expect it to spread rapidly and cause a lot of sore throats and the occasional rash when the kids went back to school without any protective measures in *checks notes* September 2020.

Perhaps there could be something affecting people's immune response.  Possibly (and I'm clutching at straws here) a new, widespread, viral disease?  Or maybe it was because they were kept off school for a couple of months two years previously...

[CrazyEnglishTriathlete]

If I count the days when I have at least one Covid symptom (loss of taste, smell, sore throat, runny nose, headache, fatigue) then I'd probably be off work more often than on.  Part of that is cyclist hypochondria.  Part of it is that there aren't a unique set of symptoms.

We had a debate in the office about how you know whether you had cold or the flu?  That makes it hard to correlate between symptoms and the presence/absence of a line on a Covid-test.  Since March 2020 I have had 4 lurgies, one of which had a positive line on the test, the other three didn't.  The symptoms were generally the same each time.