COVID19 and Audax UK

[Davef]

I'm hoping to run Upper Thames this year (Nov 7th) and am well advanced in post-Covid planning. The numbers thing remains the one major unknown. I normally have about 100 starters, though this year expect rather less. But even 50 starting together would be driving a coach and horses through current guidance. My current thinking is to allocate multiple time-slots for starting between 0700 and 0830 (we normally start at 0730), with small groups setting off every 10 minutes. Groups will quickly break up (and possibly re-form) down the road, so I'm not concerned about numbers except at the start.

Otherwise planning is well advanced in terms of how I manage the depart and arrivee, including the use of bar-code scanning to determine actual departure time of each rider so I can properly measure ride elapsed time.

Unfortunately it doesn't look as if we'll be able to provide food at start or finish, though I'm hoping hot drinks will be possible.

Groups of 6 riders at 5 minute intervals would give over a 100 participants between 700 to 830. A 5 minute interval  corresponds to well over a kilometre on the road.

Edit: putting faster riders in earlier groups will reduce coalescing

[FifeingEejit]

I keep seeing "post-covid", were still right in the middle of it.
Any post state is still a long way off.

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[Karla]

Right in the middle?  Ummm ...



Source: CEBM

[Davef]

Deaths, clearly the peak was back in April. Measures to reduce transmission will still be in place next summer, so in terms of mask wearing etc still a long way to go. That is why it is important to find low risk ways of running events.

[mattc]

I keep seeing "post-covid", were still right in the middle of it.
Any post state is still a long way off.

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It should be obvious from Phil's post that he doesn't think we're out of this.

[Karla]

Deaths, clearly the peak was back in April.

... and they've been indistinguishable from any other year s for two and a half months.

[Davef]

Deaths, clearly the peak was back in April.

... and they've been indistinguishable from any other year s for two and a half months.

Yes, the deaths dropped because our behaviour changed, not because the virus has changed. Returning to our old behaviour and infections will rise nearly as quickly as before. Nearly but not quite as quickly because 6% of the population may be immune.

[Karla]

Deaths, clearly the peak was back in April.

... and they've been indistinguishable from any other year s for two and a half months.

Yes, the deaths dropped because our behaviour changed, not because the virus has changed.

Evidence?

Returning to our old behaviour and infections will rise nearly as quickly as before. Nearly but not quite as quickly because 6% of the population may be immune.

Evidence?

[LittleWheelsandBig]

The USA for one.

[Davef]

Deaths, clearly the peak was back in April.

... and they've been indistinguishable from any other year s for two and a half months.

Yes, the deaths dropped because our behaviour changed, not because the virus has changed.

Evidence?

Returning to our old behaviour and infections will rise nearly as quickly as before. Nearly but not quite as quickly because 6% of the population may be immune.

Evidence?

Based on the weekly deaths the basic reproduction number R0 changed from a little above 3 to somewhere around 1. The basic reproduction number is a feature of both the virus and our behaviour and the environment. There are I believe over 200 variants in the genome of sars-cov-2 but the measured R does not vary across these variants which are often distributed geographically. The only significant variations are related to effectiveness of therapeutics. Our behaviour clearly has changed. In scenarios where we have reverted back to similar to previous behaviour for example in pubs the basic R appears to be close to 3 again. The case fatality ratio has improved dramatically- there is much improved treatment. The 6% historical infection rate came from the Imperial college antibody testing results published last week.

If it is not the change in behaviour, social distancing, wearing masks etc, what has caused the reduction in reproduction number ?

[phil d]

I keep seeing "post-covid", were still right in the middle of it.
Any post state is still a long way off.

Sent from my BKL-L09 using Tapatalk

It should be obvious from Phil's post that he doesn't think we're out of this.

Thank you Matt. Yes, of course we're not out of this, and won't be for a long time yet. Perhaps I should have more pedantically said "post-covid-outbreak"

[FifeingEejit]

It's a term I've seen in lots of places and it's pissing me off just as people acting normally are and getting their towns locked down as a result. 
The government, laws and public services are still set up for dealing with covid and for as long as that's the case "post" is miles wrong.
It's the same as saying we're in a post-HIV world.

Were only "post" when either it no longer poses a threat, or we've given up caring about the deaths and long term Conditions it causes.

One of the primary reasons deaths are down is due to the main carriers being in age groups with low risk of death because they're the ones going back to pubs and not giving a shit about distancing.

No one is currently publishing stats on how many people have long term Conditions post infection, that's something that the younger age groups are at high risk of having, there is however significant scale up of services to deal with life long respiratory, renal, kidney and neurological conditions.

The load on services in Aberdeen is such that people have been transfered to Edinburgh. Stuff like that doesn't come out in the stats because they still count as Grampian rather than Lothian.
What's interesting about that is ARI has Scotland's ECMO unit.

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[Karla]

It's a term I've seen in lots of places and it's pissing me off just as people acting normally are and getting their towns locked down as a result. 

It's them who are getting their towns locked down, is it?  How very convenient, you've got someone to blame. 

Is this like the beaches, parks, BLM protests and countless other episodes that the prophets of doom were saying would result in mass infection, but did no such thing. 

Have they learned?  Have you learned?  Has Davef learned?  Nope. 

Your idea of how this infection is spread is mostly wrong.  You might like to think you understand it but you don't - and neither does anyone else. 

Were [sic]only "post" when either it no longer poses a threat, or we've given up caring about the deaths and long term Conditions [sic] it causes.

Ooh look, you've now added "long term conditions" onto deaths.  Now that our death count is back to normal, we've got to find something else to worry about and to keep flagellating ourselves.  First it was hospitals getting overwhelmed, then it was anyone dying at all, now it's anyone getting post-viral fatigue.  You want to stop life because you won't accept that illness is a part of life.

One of the primary reasons deaths are down is due to the main carriers being in age groups with low risk of death because they're the ones going back to pubs and not giving a shit about distancing.

Long may they continue    If you don't want to join them because you're too scared to accept a completely normal level of risk, please stay in this dusty and inconsequential corner of the internet and don't ever venture out.

[Davef]

Is this like the beaches, parks, BLM protests and countless other episodes that the prophets of doom were saying would result in mass infection, but did no such thing. 

Have they learned?  Have you learned?  Has Davef learned? 

Throughout most scientists have said the chance of infection outdoors is minimal.

[FifeingEejit]

Is this like the beaches, parks, BLM protests and countless other episodes that the prophets of doom were saying would result in mass infection, but did no such thing. 

Have they learned?  Have you learned?  Has Davef learned? 

Throughout most scientists have said the chance of infection outdoors is minimal.

Yep, the contact tracing results are showing this too, all the clusters here are linked to workplaces, pubs or house parties.

It was people Ignoring distancing in pubs that caused the Aberdeen cluster and lockdown.

For those late to the party this stuffs part of my day job.

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[simonp]

It's a term I've seen in lots of places and it's pissing me off just as people acting normally are and getting their towns locked down as a result. 

It's them who are getting their towns locked down, is it?  How very convenient, you've got someone to blame. 

Is this like the beaches, parks, BLM protests and countless other episodes that the prophets of doom were saying would result in mass infection, but did no such thing. 

Have they learned?  Have you learned?  Has Davef learned?  Nope. 

Your idea of how this infection is spread is mostly wrong.  You might like to think you understand it but you don't - and neither does anyone else. 

Were [sic]only "post" when either it no longer poses a threat, or we've given up caring about the deaths and long term Conditions [sic] it causes.

Ooh look, you've now added "long term conditions" onto deaths.  Now that our death count is back to normal, we've got to find something else to worry about and to keep flagellating ourselves.  First it was hospitals getting overwhelmed, then it was anyone dying at all, now it's anyone getting post-viral fatigue.  You want to stop life because you won't accept that illness is a part of life.

One of the primary reasons deaths are down is due to the main carriers being in age groups with low risk of death because they're the ones going back to pubs and not giving a shit about distancing.

Long may they continue    If you don't want to join them because you're too scared to accept a completely normal level of risk, please stay in this dusty and inconsequential corner of the internet and don't ever venture out.

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)

https://jamanetwork.com/journals/cardiology/articlepdf/2768916/jamacardiology_puntmann_2020_oi_200057.pdf

60% including mild and asymptomatic cases had myocarditis. Average of patients 49. Didn’t make any difference how severe the illness was. So we do know that covid frequently damages the heart, even in relatively young and healthy people. Pretending it’s some sort of scare tactic is asinine.

[Karla]

It's a term I've seen in lots of places and it's pissing me off just as people acting normally are and getting their towns locked down as a result. 

It's them who are getting their towns locked down, is it?  How very convenient, you've got someone to blame. 

Is this like the beaches, parks, BLM protests and countless other episodes that the prophets of doom were saying would result in mass infection, but did no such thing. 

Have they learned?  Have you learned?  Has Davef learned?  Nope. 

Your idea of how this infection is spread is mostly wrong.  You might like to think you understand it but you don't - and neither does anyone else. 

Were [sic]only "post" when either it no longer poses a threat, or we've given up caring about the deaths and long term Conditions [sic] it causes.

Ooh look, you've now added "long term conditions" onto deaths.  Now that our death count is back to normal, we've got to find something else to worry about and to keep flagellating ourselves.  First it was hospitals getting overwhelmed, then it was anyone dying at all, now it's anyone getting post-viral fatigue.  You want to stop life because you won't accept that illness is a part of life.

One of the primary reasons deaths are down is due to the main carriers being in age groups with low risk of death because they're the ones going back to pubs and not giving a shit about distancing.

Long may they continue    If you don't want to join them because you're too scared to accept a completely normal level of risk, please stay in this dusty and inconsequential corner of the internet and don't ever venture out.

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)

https://jamanetwork.com/journals/cardiology/articlepdf/2768916/jamacardiology_puntmann_2020_oi_200057.pdf

60% including mild and asymptomatic cases had myocarditis. Average of patients 49. Didn’t make any difference how severe the illness was. So we do know that covid frequently damages the heart, even in relatively young and healthy people. Pretending it’s some sort of scare tactic is asinine.

Average 49, quartiles 45-53. 

So if you're aged 50 and you get C19, you have some scarring on your heart a few months later. 

It's hardly bodies piling up in the streets, is it?  Expecting everyone to pause their lives because some patients who are a decade older than the UK's median age have got ongoing symptoms of unknown severity is a hideously selfish.

[simonp]

It's a term I've seen in lots of places and it's pissing me off just as people acting normally are and getting their towns locked down as a result. 

It's them who are getting their towns locked down, is it?  How very convenient, you've got someone to blame. 

Is this like the beaches, parks, BLM protests and countless other episodes that the prophets of doom were saying would result in mass infection, but did no such thing. 

Have they learned?  Have you learned?  Has Davef learned?  Nope. 

Your idea of how this infection is spread is mostly wrong.  You might like to think you understand it but you don't - and neither does anyone else. 

Were [sic]only "post" when either it no longer poses a threat, or we've given up caring about the deaths and long term Conditions [sic] it causes.

Ooh look, you've now added "long term conditions" onto deaths.  Now that our death count is back to normal, we've got to find something else to worry about and to keep flagellating ourselves.  First it was hospitals getting overwhelmed, then it was anyone dying at all, now it's anyone getting post-viral fatigue.  You want to stop life because you won't accept that illness is a part of life.

One of the primary reasons deaths are down is due to the main carriers being in age groups with low risk of death because they're the ones going back to pubs and not giving a shit about distancing.

Long may they continue    If you don't want to join them because you're too scared to accept a completely normal level of risk, please stay in this dusty and inconsequential corner of the internet and don't ever venture out.

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)

https://jamanetwork.com/journals/cardiology/articlepdf/2768916/jamacardiology_puntmann_2020_oi_200057.pdf

60% including mild and asymptomatic cases had myocarditis. Average of patients 49. Didn’t make any difference how severe the illness was. So we do know that covid frequently damages the heart, even in relatively young and healthy people. Pretending it’s some sort of scare tactic is asinine.

Average 49, quartiles 45-53. 

So if you're aged 50 and you get C19, you have some scarring on your heart a few months later. 

It's hardly bodies piling up in the streets, is it?  Expecting everyone to pause their lives because some patients who are a decade older than the UK's median age have got ongoing symptoms of unknown severity is a hideously selfish.

“Some”. 3-4 million people in the uk have had covid. 60% in this example have cardiomyopathy. This is not a few isolated cases. Even if by some magic the cardiomyopathy only happened to people over 40, you’re looking at more than a million people with heart involvement. By comparison seasonal flu does this very rarely.

This is in addition to scarring on the lungs also seen in asymptomatic cases. It’s in addition to the changes on brain MRIs seen in Chinese research. It’s the TrainerRoad user who hasn’t been able to train effectively for 5 months. 20 minutes light exercise and they’re in the ER.

And you have the gall to talk about selfishness on a thread about frivolous bike rides during a pandemic.

[Jaded]

Exactly.

[Davef]

Average 49, quartiles 45-53. 

So if you're aged 50 and you get C19, you have some scarring on your heart a few months later. 

It's hardly bodies piling up in the streets, is it?  Expecting everyone to pause their lives because some patients who are a decade older than the UK's median age have got ongoing symptoms of unknown severity is a hideously selfish.

I can’t see anywhere within the paper the correlation between age and heart scarring which would be a fairly major thing to withhold so the implication was it was distributed evenly over the range so about 25% were 45 or under but I will check. If the 25% that get breathless doing normal household chores remain that way the lost QALYs will disproportionately burden the younger rather than the close to retirement. That said all the subjects were German so we are ok.

[pangolin]

It's a term I've seen in lots of places and it's pissing me off just as people acting normally are and getting their towns locked down as a result. 

It's them who are getting their towns locked down, is it?  How very convenient, you've got someone to blame. 

Is this like the beaches, parks, BLM protests and countless other episodes that the prophets of doom were saying would result in mass infection, but did no such thing. 

Have they learned?  Have you learned?  Has Davef learned?  Nope. 

Your idea of how this infection is spread is mostly wrong.  You might like to think you understand it but you don't - and neither does anyone else. 

Were [sic]only "post" when either it no longer poses a threat, or we've given up caring about the deaths and long term Conditions [sic] it causes.

Ooh look, you've now added "long term conditions" onto deaths.  Now that our death count is back to normal, we've got to find something else to worry about and to keep flagellating ourselves.  First it was hospitals getting overwhelmed, then it was anyone dying at all, now it's anyone getting post-viral fatigue.  You want to stop life because you won't accept that illness is a part of life.

One of the primary reasons deaths are down is due to the main carriers being in age groups with low risk of death because they're the ones going back to pubs and not giving a shit about distancing.

Long may they continue    If you don't want to join them because you're too scared to accept a completely normal level of risk, please stay in this dusty and inconsequential corner of the internet and don't ever venture out.

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)

https://jamanetwork.com/journals/cardiology/articlepdf/2768916/jamacardiology_puntmann_2020_oi_200057.pdf

60% including mild and asymptomatic cases had myocarditis. Average of patients 49. Didn’t make any difference how severe the illness was. So we do know that covid frequently damages the heart, even in relatively young and healthy people. Pretending it’s some sort of scare tactic is asinine.

Average 49, quartiles 45-53. 

So if you're aged 50 and you get C19, you have some scarring on your heart a few months later. 

It's hardly bodies piling up in the streets, is it?  Expecting everyone to pause their lives because some patients who are a decade older than the UK's median age have got ongoing symptoms of unknown severity is a hideously selfish.

“Some”. 3-4 million people in the uk have had covid. 60% in this example have cardiomyopathy. This is not a few isolated cases. Even if by some magic the cardiomyopathy only happened to people over 40, you’re looking at more than a million people with heart involvement. By comparison seasonal flu does this very rarely.

This is in addition to scarring on the lungs also seen in asymptomatic cases. It’s in addition to the changes on brain MRIs seen in Chinese research. It’s the TrainerRoad user who hasn’t been able to train effectively for 5 months. 20 minutes light exercise and they’re in the ER.

And you have the gall to talk about selfishness on a thread about frivolous bike rides during a pandemic.

Well said.

Edited to add: @Karla, there is a whole spectrum of behaviour between hiding under your bed sheets for the rest of your life and carrying on as if there is no pandemic. Pretending that everyone who doesn't do the latter automatically must be doing the former is disingenuous.

Continuing with life with some additional precautions is not 'flagellating ourselves' it is just sensible. We learn new stuff all the time and change our behaviour. Otherwise we would never have started wearing seat belts, or sterilising surgical equipment, or giving a toss about safety in the workplace.

[Wycombewheeler]

It's a term I've seen in lots of places and it's pissing me off just as people acting normally are and getting their towns locked down as a result. 

It's them who are getting their towns locked down, is it?  How very convenient, you've got someone to blame. 

Is this like the beaches, parks, BLM protests and countless other episodes that the prophets of doom were saying would result in mass infection, but did no such thing. 

Have they learned?  Have you learned?  Has Davef learned?  Nope. 

Your idea of how this infection is spread is mostly wrong.  You might like to think you understand it but you don't - and neither does anyone else. 

Were [sic]only "post" when either it no longer poses a threat, or we've given up caring about the deaths and long term Conditions [sic] it causes.

Ooh look, you've now added "long term conditions" onto deaths.  Now that our death count is back to normal, we've got to find something else to worry about and to keep flagellating ourselves.  First it was hospitals getting overwhelmed, then it was anyone dying at all, now it's anyone getting post-viral fatigue.  You want to stop life because you won't accept that illness is a part of life.

One of the primary reasons deaths are down is due to the main carriers being in age groups with low risk of death because they're the ones going back to pubs and not giving a shit about distancing.

Long may they continue    If you don't want to join them because you're too scared to accept a completely normal level of risk, please stay in this dusty and inconsequential corner of the internet and don't ever venture out.

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)

https://jamanetwork.com/journals/cardiology/articlepdf/2768916/jamacardiology_puntmann_2020_oi_200057.pdf

60% including mild and asymptomatic cases had myocarditis. Average of patients 49. Didn’t make any difference how severe the illness was. So we do know that covid frequently damages the heart, even in relatively young and healthy people. Pretending it’s some sort of scare tactic is asinine.

Average 49, quartiles 45-53. 

So if you're aged 50 and you get C19, you have some scarring on your heart a few months later. 

It's hardly bodies piling up in the streets, is it?  Expecting everyone to pause their lives because some patients who are a decade older than the UK's median age have got ongoing symptoms of unknown severity is a hideously selfish.

“Some”. 3-4 million people in the uk have had covid. 60% in this example have cardiomyopathy. This is not a few isolated cases. Even if by some magic the cardiomyopathy only happened to people over 40, you’re looking at more than a million people with heart involvement. By comparison seasonal flu does this very rarely.

This is in addition to scarring on the lungs also seen in asymptomatic cases. It’s in addition to the changes on brain MRIs seen in Chinese research. It’s the TrainerRoad user who hasn’t been able to train effectively for 5 months. 20 minutes light exercise and they’re in the ER.

And you have the gall to talk about selfishness on a thread about frivolous bike rides during a pandemic.

But that 60% is 69% of people in the trial  people who had been hospitalised, not 60% of all people infected.

Estimates of total cases far exceed recorded cases, as the majority don't need hospitalisation, and some never realise they even had it. I dont think its correct that 60% of 3million are now living with significant heart issues.

The numbers who have trouble exercising part covid are also very small.

This is not to say that we should not be taking steps to reduce transmission and suggestions that deaths are down so we are in the clear and measures are wrong and oppressive are equally extreme and definately less helpful.

As to calling frivolous bike rides selfish,  all the evidence is that transmission outdoors is rare,  so going for a solo bike ride is extremely low risk.

[TimC]

This all seems to have got a bit personal and blown up out of proportion. As fars as I see it, if you want to go for a long bike ride in UK, there is nothing to stop you. If you feel that the risk is too high for your personal circumstances, that's fine and is your decision - though you shouldn't try to impose that judgement on others so long as the laws and guidelines permit what they're doing.

Audax UK may have been slower than some would like in reopening their processes, but their guidance is evolving and it's fair to assume that it will eventually return to pre-Covid conditions, though possibly with some additional precautionary measures. For those in England, there has pretty much been no legal limit on how far or how long you can ride a bike throughout this mess, though there were temporary limits on overnight accommodation and practical limits on being able to source supplies while out.

I'm not a big-ride fan, though I am a member of AUK. I've had some wry moments of amusement watching the passions displayed in this thread, but I think that the contortions people are going through to justify their positions are obscuring the basic point which is that you can ride if you want to (you always could, in England), and you now have a reasonable assumption that most Audax-stylee stuff will be returning fairly soon. Chill.

[frankly frankie]

As to calling frivolous bike rides selfish,  all the evidence is that transmission outdoors is rare,  so going for a solo bike ride is extremely low risk.

Doesn't feel like it actually, to a pedestrian on the pavement when an energetic cyclist rides by along the edge of the road.

[simonp]

But that 60% is 69% of people in the trial  people who had been hospitalised, not 60% of all people infected.

If you're going to "correct" someone on the content of a paper, it would be a good idea to read it.

"Most patients recovered at home (n = 67), with severity of the acute COVID-19 illness ranging from asymptomatic (n = 18) to minor to moderate symptoms (n = 49)."

Only 33% required hospitalisation. This is probably higher than the proportion of people in the general population but the study found little difference in the parameters between mild and serious cases. All of these cases recovered within two weeks of initial diagnosis. Given the relatively small numbers more needs to be done to expand on this research, but given this is seen even in asymptomatic cases, it should be very concerning. Particularly to anyone who does strenuous exercise, that also can damage the heart, such as ultra endurance cycling.