COVID-19: LFT 101 - THE EXPERIMENT CONTINUES

LFT 101 on 13 May 22

Back in April I recorded my 100th daily negative Lateral Flow Test result since catching Omicron variant BA.1 at Christmas. Indicating I have not been infected enough to be contagious. at any point since 28 December 2021. 

How?

Well:

• I have had all three jabs, two Astra-Zeneca and the Pfizer booster
• The Omicron infection

Seemingly enough immunity to fight off any variant of Covid to which I have been exposed.  The experiment had been successful.

Since then I've been out and about at plenty of potentially super-spreader events.  Nightclubs, gigs, group rehearsals.  But as free testing had ended, I've been waiting for a sign of symptoms before using any of the few tests I have held back.

Yesterday gave me a sore mouth, consistent with Omicron.   This morning LFT 101.  Negative.  Hurrah!  

Especially as I'm being relied upon to play in a concert this weekend, and I'm hoping to get out to Ibiza next Thursday.

Fingers crossed for more negative tests in the coming days!

 

COVID-19: LONG COVID SUFFERERS NOW OVER 1.5 MILLION IN UK

Long COVID cases rising per ONS

On 3 March, the Office for National Statistics (ONS) published a report suggesting that at 31 January 2022 "An estimated 1.5 million people living in private households in the UK (2.4% of the population) were experiencing self-reported Long COVID."  That's "symptoms persisting for more than four weeks after the first suspected coronavirus (COVID-19) infection that were not explained by something else."  

Whilst there are several caveats about these figures, whether they are under-stated or over-stated, that is a monstrous figure.  Lives blighted, and employment often restricted.  Employers and the economy seriously affected.

That 1.5 million reflects infection from Delta or one of the earlier variants prevalent in 2020 and 2021.  The onset of Omicron in December 2021 will begin to be reflected in the imminent report for February, given at least a 4-week delay due to the definition of Long COVID.  Though the current wave of Omicron BA.2 won't affect figures until March and April that are reported a month after the end of each month.  In other words we won't know much about the long COVID affects of the Omicron variants in the UK until early May or June.

The same goes for experience of Omicron in other countries, given waves of infection at similar times.

In the meantime the British Medical Journal published this article on 18 March, suggesting:

• "...nothing is certain regarding Omicron and Long COVID, mainly because the variant roared on to the scene so suddenly in December that too little time has passed to detect a strong Omicron signal in the ongoing stream of Long COVID cases"
• "...most cases appear to stem from infections that did not require hospitalization, and they are starting to see Omicron-related cases and have little reason to think the variant will differ from earlier versions of the virus in its ability to generate Long COVID."
• Concluding "Because there are so many people infected with Omicron, we expect those cases, unfortunately, will lead to more cases of Long COVID with more suffering and more economic costs."

In other words, we might expect to see ONS reporting far higher numbers than 1.5 million in the next couple of months.  Let's hope not, but looks likely.

 

RAISING THE ISSUE IN PARLIAMENT

Today Layla Moran, who is the MP who chairs the APPG for Coronavirus, started a debate in Westminster titled "The impact of long COVID on the UK workforce".  The full transcript is available here and can also be watched here.  

The stories in the transcript are heart-breaking.  

But it is also the affect on businesses and other organisations ability to function with a reduced workforce, and the adverse affect that has on the economy and our daily lives.  Even when we ourselves are not affected by Long COVID, let alone those that are.

 

THESE HIGH NUMBERS OF LONG COVID SUFFERERS WEREN'T WITHOUT WARNING

Here's some tweets I published earlier today in response to Layla's excellent interview on BBC Radio.

These tweets show that I and many others were encouraging the Government to do more to suppress infection numbers from as early as the summer of 2020.  That it wasn't just about deaths and the pressure on hospitals, important as they are, but also the impact of Long COVID on individuals and society.  We couldn't take the risk.  Yet the Governments of the UK did.

(1) "Long Covid? My blog covered Long COVID repeatedly: https://covidcourier.blogspot.com When identified that Covid-19 produces long life-changing debilitation, should have been a key factor in Government policy. Not just deaths."

(2)  "One and a half million already. To which will likely be added a proportion of this latest wave, who have not been ill long enough yet. Diabolical consequences for individuals, the economy, and short-staffing."

(3) "My first blogpost focused on Long Covid was in August 2020, just 5 months after the first lockdown started: https://bit.ly/longcv19 The conclusion being "... infections. Preferably below 2 per day per hundred thousand" per day.

(4)  "That first blogpost focused on Long COVID affecting individuals. This was followed up in other posts, including last July after a set of ONS stats: https://bit.ly/cv19longcovidons "Does that mean removing ...mitigations ...?" Now?"  Now in March 2022?  What if Delta or further nasty variants make a comeback?

(5) "There's also societal consequences. This blogpost in April 2021: http://bit.ly/ons_longcovid "Not just the risk of death. As a nation, Long Covid has been an important reason to take action to reduce infection rates.""

Do you think the Governments of the UK countries did enough to reduce infection rates?

COVID-19: 1 IN 15 PEOPLE HAD COVID IN UK RECENTLY. WHAT'S GOING ON?

The Office for National Statistics run a regular Covid Infection Survey across the UK.  Today's report, 25 March, for the week ending 19 March suggests 1 in 15 people had Covid.  That's over 4 million, up 30% on the week before and 54% up on the week before that. Rising in all four countries. Now mainly the highly transmissible Omicron BA.2 variant.

That is resulting in increased hospitalisations, plus widespread disruption in general life.  

It is disruption that is just as much a worry.  For example, I'm a member of a volunteer group, and the volunteer numbers are being decimated. with people going down with Covid or in contact with people who have it.  As we have contact with people who are Clinically Extremely Vulnerable, volunteers have no choice but to keep away, with obvious consequences on the service we are able to provide..  Many employers are finding similar issues, with examples of whole shifts being struck down ill with Covid for an extended period.  A pal who has been very careful, enough to escape Covid for two years, has just gone down with it.

On the right expands the most recent weeks

So what's going on?  Is it us or the virus?

 

WHAT WE ARE DOING

Focusing on England, all restrictions have been lifted.  Supermarkets and public transport are recommending masks are still to be worn, and some people do.  But many don't, and other legal restrictions have been completely lifted, such as checking before entry to care homes, nightclubs, and other events.  

The whole attitude from Government is to treat Covid like influenza.  For most people, 'flu normally means a couple of days in bed, and soon back to work,. The new Omicron BA.2 which is now dominant, is milder than Delta, but is keeping people ill and off work for 10 days or more.  Much longer than the original Omicron.  Likely to have greater adverse long term LongCovid consequences too. 

Indeed the arrival of Omicron BA.2 is fuelling the rise in infections compared to Omicron BA.1 before it. 

 

IS IT SENSIBLE TO STOP FREE TESTING?

Free Lateral Flow Tests are being withdrawn after the end of March.  But around here in East Oxford it's effectively happened now.  You can't get a test kit delivered, and the pharmacies are out of stock for collections, with no expectation of further supplies.

That's fine if we can just get on with life.  But we can't.  For the sake of vulmerable people, and for groups not to be struck down, we need to be taking tests.  Test packs need to continue to be provided free of charge.

ARE THE VACCINATIONS STILL WORKING?

On the positive side, I have now gone 88 consecutive days with negative Lateral Flow Test results.  That's as at 25 March - click here for update.  That is since having Omicron at Christmas, which would have been the milder BA.1 variant.  

However there is evidence that:

• The three main jabs (two jobs plus booster) were good for Delta and previous variants, for which the vaccinations were designed, but are of limited help for Omicron.  Preventing serious disease, but doing littel to stop Omicron infections
• Effectiveness of the jabs is reducing.  Hence the new booster for the over 75s and others.
  

Whilst we can live more easily with Covid as a result of vaccination, we cannot rely on it completely.  The high rates of Omicron are not acceptable.

WHAT SHOULD WE DO?

The big question!

My view throughout thsi pandemic is that we need to take action to reduce infection levels for several reasons:

• Reduce deaths and serious disease, especially amongst clinically vulnerable people
  
• Reduce long term LongCovid consequences, which can result in people being unable to work or function normally
• Avoid the disruption arising from a high proportion of workers being absent ill.  Especially in the food supply chain and amongst teachers.  
• Avoid the disruption to education from pupils being absent from school ill
  
• Reduce strain on hospitals, GPs and other health professionals involved in initial and longer term care
• Give clinically vulnerable people the confidence to go shopping, use public transport and do other daily activities
  
• Reduce risk of new 'variants of concern' emerging, and more quickly tackle them when they inevitably do arise
  

That means continuing to take the threat of Covid seriously. Keeping businesses open, including the places inherently more likely to have transmission such as nightclubs.  But taking all reasonable precautions, which can include:

• Compulsorily wear masks on public transport, in shops, and in other indoor public places.  This protects others if you are unknowingly contagious, as well as protecting the wearer
• Improve ventilation in schools and other public places
• A general attitude of looking after each other

None of these things are happening adequately.  The Government is letting us all down with the wrong attitude, wrong advice to the public, and the absence of necessary regulations.

COVID-19: WHY IS IT TAKING LONGER TO RECOVER FROM OMICRON?

A positive LFT result

We've discussed the possibility of more troublesome variants of Covid cropping up.  We must be prepared for the worst.

This week my doctor pal told me "... we don't have a single ventilated omicron patient on ICU in my hospital right now.".  Yet Covid cases are rising again, and people I know are still going down with it, despite being fully jabbed.  The comedian Al Murray, for example.  Milder disease, but causing disruption to schedules and workplaces.

There's then the problem that people are taking longer to recover.  I had a negative LFT for Omicron at Christmas only two days after showing positive.  Now it's typically 6-10 days, such as for Professor Alice Robert still positive on day 7.

SO WHAT'S GOING ON?

We know that Omicron B.1 has morphed into B1.1 and B.2.  There is also the new 'DeltaCron' combination of Delta with the more transmissible spike protein from Omicron, now confirmed as being in the UK.

The Government dropped formal restrictions too early.  The vulnerable still need to be protected, so formal isolation should continue, for example. Masks should still be worn in shops and other public places where the vulnerable need to be. 

WHY THE LONGER RECOVERY?

What exactly is causing this longer recovery?  Which variant or variants?  We need to know.  

We also need to know that the country is prepared for a variant that is worse.  Is it?  Sadly that's a QTWTAIN.

COVID-19: HOW WORRIED SHOULD WE BE ABOUT "DELTACRON"?

There has been concern that a new variant of COVID could arise.  Such as having the potency of the Delta lineage with the high transmissibility of Omicron.

Institut Pasteur has now provided  the raw sequencing of the new 'Deltacron' variant, showing:

• Core backbone derived from Delta
• Spike protein of Omicron, which is what makes Omicron so transmissible
  

Recombinant viruses like this can arise when someone is infected with two variants at the same time, and the viruses then replicate together.

On the face of it, this 'Deltacron' cross-variant could be a major problem.  Fortunately it is believed to have originated in January, without it spreading uncontrollably.  So we can rest easy for now.  But we must remain vigilant for this or some other worrying variant taking hold.

That's why it is worrying that the British Government has scaled back anti-Covid measures too hastily.

 

https://twitter.com/macroliter/status/1501260671576539143?s=20&t=STrmnSGF-NY84R_b54J7HA

COVID-19: THE FREEDOM EXPERIMENT updated

Buzzcocks in Oxford

As previously reported, I succumbed to Omicron on Boxing Day.  Despite being triple-jabbed.  Two brands of Lateral Flow Tests showing positive, confirmed by a PCR.

In this previous article, we note that Omicron's spike protein is physically different from that of Delta and earlier variants, and infects cells through a simpler mechanism.  As a result Omicron infects different cells, and produces different symptoms.  Escaping immunity to those earlier variants.  Really a different disease.

THE BIG QUESTION / THE BIG EXPERIMENT

Can immunity to the various Covid variants be provided by the combination of triple vaccination and Omicron infection?  Does that combination provide freedom - at least until a new nasty variant appears. Such as this 'Deltacron'?

Let's experiment.  The advantage of living in Oxford is plenty of low-cost but high quality musical opportunities.  

Over the first 9 weeks of 2022, I've been to 36 music gigs and nightclubs, that would be regarded as 'super-spreader' events.  Yes, 4 a week.  Plus pubs and 11 ensemble rehearsals.  

With so many people I know locally going down with Covid in recent weeks, there's been plenty of Covid about.  Every opportunity to catch one variant or another.

 

 

THE RESULTS ARE IN !

Let's dance!

No control, and only a sample of one.  But by doing a Lateral Flow Test every morning, the results are in:

• Now 71 consecutive daily negative results since 28 December (4 + 31 + 28 +8) - see latest update below
  
• A day or two feeling lousy in February, as if fighting off infection.  Though that could have been anything

I'd call that result freedom.  Wouldn't you? 

UPDATE 6 April 2022

Make that 100 consecutive daily negative LFT results, 4+31+28+31+6.  Even after attending potentially super-spreader events nearly every day since New Year.  More than three full months of 'out out' living since New Years's Eve.  Freedom!

But this article in the Guardian warns "We are at the start of the 90-day period for possible reinfection with BA.2 following a BA.1 infection".  BA.2 is the variant now most prevalent in the UK, with BA.1 being the variant around in late December when I was infected with it.  

So how long before I go down with Omicron again?  The experiment continues, though my supply of LFTs is limited.  Test kits became unavailable for delivery or collection around here at least 10 days early, in mid March.

 

COVID-19: WHAT DO WE KNOW NOW ABOUT OMICRON?

In late December 2021 I published a report from Glasgow University suggesting that Omicron attacks cells through a different mechanism than that used by earlier variants.  As a result different cells are more susceptible, and the symptoms are very different.  I went as far as to suggest the disease should be called COVID-21 rather than the original COVID-19.

Since then I have been waiting for confirmation of the science, and acknowledgement that we are fighting two different diseases.  Similar but different, like cousins.  

THE LATEST RESEARCH

Further work, including by Imperial College London, has confirmed a simpler entry mechanism:

• Delta and earlier variants require both the ACE2 and TMPRSS2 receptors on cells to gain entry
• Omicron only requires ACE2
  

 

The article provides further detail, and suggests that Omicron can evade immunity to the earlier variants.  My own boosted triple-vaccination immunity certainly didn't stop me catching Omicron over Christmas.

The original Omicron BA.1 has spawned troublesome sub-lineages such as BA.1.1 and BA.2.  The latter is even more transmissible than the BA.1s, which in turn are far more transmissible than earlier variants.  We know the spike protein of the Omicron variants is physically very different from the other variants of concern such as Alpha and Delta.  A couple of weeks ago the World Health Organisation published an update on Omicron, but still regards it as variants of the SARS-COV-2 virus, rather than say SARS-COV-3.  No mention of a new disease name such as COVID-21.

WHAT DOES THAT MEAN FOR US?

I think regarding Omicron as a variant of the same disease is missing a trick.  From personal and public health perspectives, we should be regarding Omicron and the earlier variants as two different diseases.  For example:

• Omicron causing different and generally milder symptoms, with existing vaccination and natural immunity offering little protection from infection
• Good immunity from future COVID infection effectively requires triple jabs plus a dose of Omicron itself (see my own personal experiment)
• Uncertainty as to whether a dose of Omicron provides any protection against Delta and earlier variants. Early indication are that it does, at least to some extent.  But it is too early to rely on protection being adequate, especially against any new variants
  
• Therefore public health policy based fundamentally on Omicron ignores the strong possibility of a resurgence of Delta and similar variants.  Removing isolation rules and scaling back testing so harshly are mistakes.  SAGE should continue to monitor developments
  

IN CONCLUSION

We should publicly acknowledge that there are two different coronavirus diseases, and live our lives individually and collectively with that understanding.  My concern is that the more dangerous Delta, and future variants of it, is waiting to really bite us in the posterior!

COVID-19: THE FREEDOM EXPERIMENT [Updated 1 Mar 22]

LFTs to 22 January

How immune can you be?  Is the Booster enough?  Here is the experiment.

On Boxing Day I tested positive for Covid using two brands of Lateral Flow Tests.  Symptoms were mild and consistent with Omicron, such as a gravelly voice.  The Booster not enough to stop catching it. 

On 28 December the test was negative, and daily morning tests since have all been negative.  That's 43 consecutive days apparently not infectious.  4 + 31 + 8 [Update 1/3/22: 4+31+28+1 = 64 days].  A slight concern on Thursday 3 February, with a slight cough and feeling groggy. But an extra LFT that evening proved negative.

LFTs to 31 January

Whilst a negative test isn't a guarantee of not being infected, it is a very good indication that not infectious.

How has [64] negative days been achieved?  By keeping indoors away from other people?  Quite the opposite.

LFTs to 8 February

From New Years Eve to this last weekend, I have attended over 30 potentially super-spreader music events of at least 3 hours each. Every weekend evening plus often mid week. [Update: Lost count, frankly]  Mixing closely with hundreds of other people, with no additional precautions.  The result has been no Delta infection, no repeat of Omicron.

There's no control, and a sample of only one.  But this represents an experiment suggesting that Covid immunity is provided by a combination of:

• Triple-vaxed against Delta and earlier variants (which didn't stop Omicron)
  
• Natural immunity from Omicron infection

Dare I say freedom?

COVID-19: HOW MUCH HAS JAVID ACTUALLY REDUCED THE ISOLATION PERIOD?

Today, 13 January 2022, Health Secretary Sajid Javid announced a reduction of the self-isolation period nominally from 7 days to 5 days.  That is subject to two consecutive negative daily Lateral Flow Tests and not having a temperature  A reduction of 2 days you might think. Really?

Part of my usual professional role is to examine the rules applicable to a situation and optimise the way an organisation can operate better within those rules.  This requires understanding the rules in detail, and then thinking of how to take advantage.  Much like Formula 1 teams leverage their regulations, but without pushing the limits quite as hard.

SO WHAT'S HAPPENED?

Here we looked at the change from the 10 Days rules to the 7 Days rule. just before Christmas The definitions changed, which effectively reduced the isolation period by 4 days rather than 3, being the combination of:

• 3 days change from nominally 10 days to 7 days
  
• Being able to exit isolation on day 7 rather than waiting until day 8.  The NHS website clearly said "on or after" Day 7)
  

The new 5 Days rules change the definition, such that you have to wait until day 6.  Only 1 day earlier than under the 7 Days rules.

OMICRON OR DELTA?

Delta symptoms are the now 'classic' ones listed on the NHS website, including a continuous cough,  loss of teste/smell, and a high temperature.

Omicron is effectively a 'cousin' of Delta, with very different symptoms and faster infection.  The symptom I noticed the day before my first positive LFT was a crackly voice, which is Omicron not Delta.  The day after the date I believe I was infected.

It takes longer to recover from Delta, and often requires the full 10 days in isolation.  The shorter isolation period is primarily relevant for Omicron.  The need for two consecutive negeative LFTs covers the possibility of Delta or another earlier variant.

SO WHAT DOES THAT MEAN OVERALL?

Here's a summary of the three sets of rules:

Note that for the 10 Days rule, which applies if cannot produce two negative LFTs, the NHS says that isolation ends at 2359 hrs on day 10.  Hence not being able to get out and about until early on day 11.

 The overall result is as follows:

• The Day5 rule is a misnomer.  It's 5 full days, so effectively release from isolation is on Day 6
  
• Which is only one day earlier than under the 7 Days rules
  

Furthermore, if you don't appreciate that Omicron has different symptoms, you will potentially stay in isolation a day longer than you need to.  That's the same under either the 5 Days or 7 Days rule sets.

Here it is argued that it is safe to bring exit from isolation 2 days earlier than under the 7 Days rules, subject to negative LFTs and low temperature.  That would apply for those infected by Omicron.  Delta will usually mean longer isolation.

Yet Javid has missed this trick, only making half the change that would have been feasible.  Another day could have been cut from the isolation period, subject to LFT and temperature checks.  Huh?  

The worry is that people get out into the community whilst still infectious.  The issue is primarily a communication one:

• So far the Government has been very unclear as to when exactly people can leave isolation.  This new rule would be better called the 6 Days rule.  Too late?
• People shouldn't think leaving isolation on Day 5 or 6 is automatic.  It's 10 days unless the specific conditions are met.
  

COVID-19: 10 DAYS, 7 DAYS, OR 5 DAYS SELF-ISOLATION. WHAT'S WISE?

We have a problem.  As forecast, the high rate of COVID infection means a high proportion of the workforce is off ill, and otherwise having to self-isolate.  That is adversely impacting many organisations, which are having to close or reduce services.  NHS and trains, and potentially food supply.  Getting people back to work is a critical objective.

Reducing the self-isolation period would help to get people back to work, if that is medically prudent.

In England, the self-isolation period has already been reduced to 7 days, provided certain conditions have been met.  Now 5 days is being considered, as is happening in other countries such as the USA.  

Is 5 days wise?  Let's investigate.

THE OMICRON DIFFERENCE

We now know that Omicron infects cells through a different mechanism to earlier variants.  That lets Omicron spread more quickly, both between people and within a person.   Plus different symptoms.  Generally more moderate disease, but potentially serious enough for some people to require hospital treatment, just like flu.

We're effectively got a different disease, that I'm calling COVID-21.  The 'cousin' of COVID-19, with family similarities such as PCR and LFT tests for earlier variants also working for Omicron.  

But differences that make dealing with it a different proposition. As Omicron has become the dominant variant, we need a self-isolation strategy that focuses on Omicron, but doesn't forget Delta and earlier variants.  And also is well prepared for sons of Delta and Omicron, and indeed any other new Variants of Concern.

 WHAT DO WE KNOW ABOUT DELTA INFECTION?

The speed with which early variants up to Delta spread within a person depends upon each individual.  But is broadly like this, where:

• It takes around 3 days after infection to be LFT positive 
• It takes around 8 days to then become LFT negative, but could be infectious longer.  Hence the original 10-day self-isolation period
  

The American CDC (Centers for Disease Control and Prevention) confirms that of being infectious "the majority of  transmission occurs early in the course of illness, generally in the 1-2 days prior to onset of symptoms and the 2-3 days after".

HOW IS OMICRON DIFFERENT?

My own experience, supported by experience of other people, suggests timescales are shortened with Omicron:

• LFT positive in only around 24 hours
  
• LFT negative as early as on day 4
  

SO HOW CAN WE CATER FOR BOTH DELTA AND OMICRON?

In shortening the self-isolation period from 10 days to 7 days, there are two important conditions:

• Two consecutive negative LFTs on days 6 and 7, at least 24 hours apart
• No symptoms such as a raised temperature

Otherwise self-isolation should continue.  That's appropriate for Delta, and in many cases the full 10 days would be required.

But do we really need 7 days for Omicron?  Provided those two conditions are fulfilled, with negative LFTs moved to days 4 and 5, it appears 'safe' (low risk) for people to exit self-isolation on day 5.  

With it being important for people to get back to work if they have recovered from Omicron, then a change to day 5 is an important improvement.

WHAT ARE THE MODELERS SAYING?

Professor John Edmunds, a member of Sage and an epidemiologist at the London School of Hygiene and Tropical Medicine, has just released experimental modeling results.  

As expected, this has confirmed that a 'test to release' scheme at 5 days produces no difference in the number of infectious days in the community from covid-positive cases than at 7 days.  

Provided each person has negative LFTs in the last two days.

 

 

WHAT ABOUT THE APPROACH IN USA?

The 5-day rules are somewhat different:

• "Isolate for 5 days and if [you] are asymptomatic or [your] symptoms are resolving (without fever for 24 hours)" - but otherwise continue self-isolating
  
• "Follow that by 5 days of wearing a mask when around others to minimize the risk of infecting people they encounter."

The requirement to wear a mask stops after 10 days.

The CDC has also adjusted the need for contacts to self-isolate, reflecting that masks are primarily to provide protection to other people, not so much the wearer:

• "Individuals who have received their booster shot do not need to quarantine following an exposure, but should wear a mask for 10 days after the exposure.  For all those exposed, best practice would also include a test for SARS-CoV-2 at day 5 after exposure. If symptoms occur, individuals should immediately quarantine until a negative test confirms symptoms are not attributable to COVID-19"
• "For people who are unvaccinated or are more than six months out from their second mRNA dose (or more than 2 months after the J&J vaccine) and not yet boosted, CDC now recommends quarantine for 5 days followed by strict mask use for an additional 5 days. Alternatively, if a 5-day quarantine is not feasible, it is imperative that an exposed person wear a well-fitting mask at all times when around others for 10 days after exposure."

 The UK approach is somewhat better:

• Adding the need for negative LFTs on two consecutive days
• An ongoing need to wear masks, in case get re-infected, and to reduce risk of being re-infected.  Bear in mind that Omicron can be caught by people who have immunity to Delta and earlier variants

IN CONCLUSION

We need an approach to ending self-isolation as early as possible that caters for all types of variants, especially Delta and Omicron:

• To let people get back to work, be they employed, self-employed on or zero hours contracts
• To let parents and carers get back to what they need to do
•  To reduce the strain on organisations struggling to stay open and provide a near-normal service.  That is especially relevant to the NHS and the food supply chain
  

With Omicron being the dominant variant now, with infection timescales shorter than Delta, it seems both reasonable and advantageous to reduce self-isolation to 5 days.  Provided the LFT and other conditions are met, which will cater for Delta and other variants.

The challenge is to ensure people are aware of the conditions, and not think 5 days is automatic.

Then to reduce risk of re-infection and passing it on, it's best to continue with basic precautions such as mask wearing beyond ending isolation, and indeed past ten days.

UPDATE 13 JANUARY 2022:  Sajid Javid has now announced a reduction to 5 days.  But is it?

 

COVID-19: FREEDOM? THE EXPERIMENT CONTINUES

Another negative, day 5

Having had Omicron over the Christmas period, being fully boosted, and not being clinically vulnerable, it looks like I have:

• Little chance of re-infection by Omicron (see footnote update)
  
• High immunity to Delta and earlier variants
• Little chance of serious infection should any of these variants be caught
  

The objective of this blog, as quoted in the header above, is "Applying business, scientific and IT expertise to get back to normality by defeating COVID-19 disease."

Subject to a future variant appearing which is serious and evades vaccination, this is the best immunity since the pandemic began.  Does that mean such normality has been achieved? Freedom?

FREEDOM?

For me, I'd say yes.  Freedom, at least whilst immunity lasts. The residual risk feels similar to the risk of crossing the road, or cycling, say.  That residual risk is being tested, as explained below.

How about for younger adults, who have not yet had chance to be fully-vaced and boosted?   Risks somewhat higher, but the chances of serious disease low.  Almost as much freedom.

Would I go to a crowded nightclub, as an example of a hi-risk environment?  Yes.  Done it already, multiple times, as below.  What about those not fully vaxed?  They need to assess the risk personally according to the number of jabs they have had, level of clinical vulnerability, and attitude to risk. 

Nightclubs and venues for similar events have been ensuring their premises are as safe as possible, to encourage patrons to attend.  My experience is that there's been clear thought about ventilation, and it has been improved.

EXPERIMENT UPDATE

As noted here, there was the opportunity at New Year to test my immunity:

• To get out to a major crowded event for New Year's Eve (NYE)
  
• To throw an 8-hour all-nighter in a crowded sweaty night club the night after

Two potentially super-spreader events.  Indeed I've heard of multiple infections at the NYE event.  No news yet from the other event.

I'm pleased to report another negative Lateral Flow Test, which I need before my daily voluntary work.  'Freedom' will continue.

ONGOING PRECAUTIONS

That doesn't mean ignoring sensible precautions.  Just like looking before crossing the road.

Masks, meeting outdoors, well-ventilated indoor spaces, and other basics worth continuing, even if no longer legally required.  For your own protection, and to protect others if you do perchance get infected.

Kissing?  That aunt who insists on it?  Why not?  Though the choice is yours.

 

UPDATE DAYS 6 & 7

Both day 6 and day 7 LFTs negative again, thankfully.  

The experiment continues.   Going in hard this coming weekend!

UPDATE DAYS 8, 9, 10 and 11

Day 7: First night done out clubbing, and enjoyed.  

Day 8 LFT again negative, though tomorrow's will be more telling.  

Day 9 negative.

Second night done out clubbing.  Oh yes!  Day 10 will be key.  

Day 10 negative!

Day 11 negative.  Experiment working, so far at least.  Haven't caught any COVID variant, despite attending four potentially super-spreader events in the last 2 weeks.

Day 12 negative.  We know positive results tend to occur within three days of infection, Looks virtually certain that neither Omicron nor Delta has been acquired from any of the four potentially super-spreader events attended in the last fortnight.  

Day 14 negative.

Experiment successful.  Immunity gained aginst Omicron and Delta by a combination of booster and having had Omicron.

FURTHER UPDATE

We're now into the third weekend.  Last night was the fifth potentially super-spreader event.

Day 15 negative.

Last night was the sixth such event.

Day 16 negative.

Day 17 negative 

Day 18 negative.

Day 19 negative

Another 2 hours at a potentially super-spreader event last night.  The 7th.  The experiment continues.

Day 20 negative.  

A heavy weekend planned.  Three hot sweaty super-spreader events done.  Now 10 so far this year..

Day 21 negative

Day 22 negative

Day 23 negative, even with a little blood.  But that's another story 

5 more hot sweaty potentially super-spreader events done.  Total of 15 so far in January since being back from Omicron infection on New Years Eve.

Day 24-33 negative

Days 34-36 negative, despite possibly fighting off second Omicron infection

If I die, I'll die happy.  Which reminds me.  Must get that Mini prepped for the RallyCross racing series.

UPDATE ON RE-INFECTION BY OMICRON

There is now evidence of people who have had Omicron being re-infected by it.  Does that matter?

In terms of illness, it is unlikely to be more serious than the first infection. The issue is a practical one. A positive LFT means self-isolating for at least five full days, to avoid passing it to others.  

Frankly that's a risk I'm prepared to take to get back to normal life.

COVID-19: A REACTION TO DOWNING STREET PRESS BRIEFING 4JAN22

This afternoon PM Johnson held a press conference, flanked by his most senior scientific advisors, Professor Sir Chris Whitty and Sit Patrick Vallance.

It was confirmed that Plan B would continue, and no further disease mitigations (restrictions) were anticipated.  Though this is kept under review.

The emphasis of the Government's strategy is to ask everyone to get boosted, or get their first jabs if not done already.  This is a good idea.  From a personal perspective:

• The Booster probably reduced the impact of my recent Omicron infection.  A negative LFT just 4 days after infection, unlikely to still be infectious
  
• Conversely a friend hadn't had her booster, and has just been badly ill for two weeks with Delta symptoms
  

The presentations and answers were much as anticipated.  But one matter to highlight.  Sir Patrick said that in London, for example, this has so far been an illness primarily amongst younger people. "As it moves up the age range, you'd expect to see more hospitalisations. Don't know for sure how that is going to manifest, and what degree of disease."

In other words hospitalisations and use of ICUs to date is not representative of the whole population, and would be expected to get worse.  When it will peak for the older age groups, and at what level, cannot yet be predicted any more accurately than it being in the next few weeks.

POST-PRESSER COMMENTS

Two key points emerged in BBC's coverage afterwards:

• Ione Wells spoke about the adverse impact that Omicron is having on staff shortages. That the Government officers are worrying not just about the NHS, but also the risk for the "food supply chain" amongst other essential services. Indeed 100,000 workers in England, "from food processing to transport to Border Force", will have to test every day they are working from 10 January.  

   

  The first I've heard or seen mention of food supply risks, despite highlighting them two weeks ago.  Why has nobody else in the media seen this coming?

   
• Nick Triggle pointed out that the official forecast modelling by Warwick University concluded this:
  
  In other words the levels of infection are effectively baked in.  If essential services begin to get closed down, or hospitals get overrun, it is effectively too late to do anything about it.
  

This 'too little, too late' government is again too late.  Taking risks that nobody sensible would contemplate.  'Hope for the best, prepare for the worst' is not a concept this Government understands. Let's hope it is not that bad.  But sadly, experience with Covid says outcomes are always at the worse end of expectations.

COVID-19: ALL THE POSTS SINCE TESTING POSITIVE

On Boxing Day I tested positive for COVID-19, likely infected Christmas Eve.  Here is the story to date in a thread of blogposts, including the New Year 'freedom' experiment.  Plus a bonus of why and how Omicron is different:

COVID-19: SHIT'S JUST GOT REAL
Boxing Day. So you've tested positive.  Now what?

COVID-19: THE POSITIVE PCR TEST (Updated for COVID-19 app)
The consequences.  Action now.
"As a former Computer Audit Manager for a Big4, the clowns who are responsible for developing and maintaining the app would not want to see my review!"

COVID-19: HOW TO CATCH IT (AND HOW TO AVOID IT)
Ventilate!

COVID-19: OMICRON OR DELTA? (Updated for new Omicron symptom. which was my first)
Important to know
For me "99%+ chance it's Omicron"

COVID-19: ALREADY NEGATIVE
No longer infectious?

COVID-19: OR IS IT NOW COVID-21 ?
What we know about Omicron. The uncertainties.  How should the UK Government respond?

Surely there's a flaw in this logic?  My most contentious blogpost yet...
COVID-19: SO YOU’VE HAD OMICRON, WHAT NOW? (Plus notes if you haven't had it)
Living life freely? Continuing with precautions?

COVID-19: WHY OMICRON BEHAVES DIFFERENTLY
New research.  Different disease

COVID-19: THE EXPERIMENT.  SO YOU DON'T HAVE TO.
Could I catch COVID-19 again?  The result is in.

COVID-19: THE EXPERIMENT. SO YOU DON'T HAVE TO.

We noted before New Year that for someone fully-vaxed who has had Omicron, and is not clinically vulnerable, they are theoretically more immune to any variant of COVID-19 than at any time in this pandemic:

• Unlikely to be re-infected with Omicron
  
• Well immune to Delta and earlier variants
• Unlikely to be seriously ill, if do get infected
  

As a result, being 'free' to live life as if before the pandemic, subject to taking sensible precautions.  And being mindful that immunity can wane.

But we can't just say it.  We have to test it. In the spirit of many scientists of previous generations, making myself the subject:

• Passing the day 6 and day 7 Lateral Flow tests just in time to get out to a major crowded event for New Year's Eve (NYE)
  
• Throwing an 8-hour all-nighter in a crowded sweaty night club the night after

Inevitably being exposed to Omicron and Delta, despite the venues checking for negative LFTs or vaccination.  Some people would have been brewing one of the variants, and become infectious during the event.  

I had had 4 daily negative Lateral Flow Test before going out on NYE.  Well clear of infection, so no longer infectious.

Indeed I've now heard four people I met at the NYE event have since tested positive, likely Omicron, with that event the only feasible source of infection.  Two others remained negative.

So, what about my LFT result after these events?   

Omicron grows in the nose very fast.  On Monday 3rd, it's more than 24 hours since leaving that nightclub, more than 48 hours after NYE.  If I'd been re-infected, a Lateral Flow Test should show positive by now.  It's negative.  I've passed.  

So far so good.  But I'll be taking daily tests, which will monitor the situation daily to allow me to carry out my volunteer work.  Testing probably for weeks to come.  If I can get hold of tests.  First box secured!

UPDATE 4 JANUARY

Hurrah!  Negative LFT today.  So, 3 days after end of NYE event and 2 days after end of NYD event:

• I have not been re-infected by Omicron
• I have not caught Delta or any other variant
• Freedom
  

.Daily tests will continue to make sure on an ongoing basis.

COVID-19: WHY OMICRON BEHAVES DIFFERENTLY

STOP PRESS:  A paper just published by Glasgow University shows the evidence for Omicron infecting human cells by a different mechanism from Delta and earlier variants. 

In an earlier blogpost, we noted that the spike proteins of the COVID-19 virus (SARS-COV-2) bind to a receptor on human cells, which allows the virus to infect the host cell.  The receptor is called ACE2 "Angiotensin-converting enzyme 2" We also noted that other coronaviruses bind through a different mechanism.

The Omicron variant has a substantial number of changes to the spike protein, especially in the area known to bind to human cells.  

The work by Glasgow University shows that is enough to change how it binds to human cells:

SO WHAT IS HAPPENING?

The report says, in technical language:

"Entry of SARS-CoV-2, and related coronaviruses, can proceed via two routes 

• Cell surface fusion following proteolysis by TMPRSS2,or
• By the endosomal proteases Cathepsin B or L

The ability of SARS-CoV-2 to achieve cell surface fusion is dependent on its S1/S2 polybasic cleavage site; this is absent from most closely related sarbecoviruses, which are confined to endosomal fusion Given the reduced fusogenicity and replication kinetics of Omicron, we used HIV pseudotypes to evaluate entry route preference. We evaluated Wuhan D614G, Alpha, Delta and Omicron spike and as a control we included Pangolin CoV (Guangdong isolate) spike, which exhibits high affinity interactions with human ACE2 but lacks a polybasic cleavage site and, therefore, enters via the endosome only."

The key results show how Omicron closely matches Pangolin CoV, whereas Delta is entirely different:

WHAT DOES THAT MEAN?

Although the Delta and Omicron variants are clearly related, there are clear differences:

• The difference in the way they bind to human cells, as above.  
• Consequently Omicron causing different symptoms more like mild flu, but with the possibility of serious disease, much like flu
  
• Omicron escapes natural and vaccination immunity for Delta and previous variants
• Other differences set out in an earlier blogpost
• Differences in how we should respond to Omicron, including the UK Government's response.  Arguably the danger of hospitalisation is being eclipsed by the risk of closure of key organisations in society, even serious disruption to food supply.  As written over a week ago. 

The Government is now asking each public sector organisation to prepare contingency plans for staff absenteeism rates of up to 25%.  Private sector organisations need to plan likewise.  But what if that means you simply don't have the staff to provide a full service? What should be the priorities at that level of absence?  How can you keep the organisation open? 

It would have been better to prevent Omicron spreading at such high rate, as this blog has been advocating in several posts in the last couple of week.

The differences suggests Omicron should be regarded as a different disease.  The response from individuals, organisations and the Government being specific to Omicron.  Call the disease from Omicron  "COVID-21" ?  Maybe naming the virus "SARS-COV-3", rather than "-2".

Will the World Health Organisation do this?  When they do, you heard it here first !

 

COVID-19: SO YOU’VE HAD OMICRON, WHAT NOW? (Plus notes if you haven't had it)

Self-isolation almost over?

You’ve had a positive test for COVID-19.  But you haven’t been told whether it is Omicron. 

With COVID-19 cases in the UK now over 100,000 a day, in some areas over 95% Omicron, it's most likely an Omicron infection.  You’ve also read this blogpost, looked in detail, and have concluded that you've had infection from Omicron.  

What does it mean for you after self-isolation ends, having had Omicron?

• How freely can you live your life?
• Should you continue with basic precautions, such as using Lateral Flow Tests and wearing masks?

This depends on your wider circumstances. including:

• Have you had COVID-19 before, some time before Omicron reached your area?
• How many vaccinations have you had?  Most younger people won’t have had chance to have 2 vaccines and a booster.  Many children none.
  
• Are you deemed "clinically vulnerable"?
• Age and other factors that can affect the risks of serious disease

WHAT IF YOU HAVEN'T HAD OMICRON?

There's also a section at the end of this blogpost, relevant if you, your family and friends haven't had Omicron.  Yet.

WHAT DO WE NEED TO CONSIDER?

We need to consider these principles when assessing each person’s risks:

1. Omicron successfully bypasses almost all cases of 2 jabs, and can also partially ‘escape’ the booster, as confirmed by research work by Glasgow University:
   
   
   
   Which is why you caught it, if you are double- or triple-jabbed
   
2. Existing vaccines are very effective at stopping Delta and earlier variants, at least in preventing serious disease, as explained in this BMJ article
3. Having natural immunity from having had Omicron, it is extremely unlikely in principle to be re-infected by Omicron, though it is too early to know for sure.  Similarly unlikely to be reinfected by the same earlier variants.  But reinfection by a different earlier variant is possible.  (Best to regard Omicron and other variants as different diseases, albeit related)
   
4. It is unclear whether infection from Omicron reduces chance of infection from Delta and earlier variants
5. We should expect other variant(s) to appear that are different from both Delta and Omicron, and bypass immunity from vaccines or natural infection. Sooner rather than later, and you may be exposed to it before it becomes public

Let’s consider someone, fictional, who:

• Is older, could do with losing a few pounds, and deemed of ‘medium’ vulnerability by GP
• Triple jabbed, over 2 weeks ago
• Has had Omicron, but not disease from any other COVID-19 variant

RISK ASSESSMENT

That person:

• Is very unlikely to be reinfected by Omicron
• Has high immunity to Delta and earlier variants, and if catch it, symptoms are likely to be mild
• Is open to infection from any future new variant that can bypass vaccines and natural Omicron immunity.  

i.e.

• Very low risk of being re-infected with Omicron
• Very low risk of catching Delta or earlier variants
• Very low risk of catching a new variant before its existence is publicised, when behaviour can be adjusted
• At least until immunity fades
  

In each case with symptoms likely to be light, if COVID is caught.

Whilst risk can never be eliminated, this person has very low risk of catching any form of COVID-19 and for that to result in serious disease.

Life is all about risk, such as crossing a road or cycling down the road. The risk of COVID-19 to life and health is somewhat similar.  At a low enough level that the risk can almost be ignored, provided you take as much care as crossing the road or cycling..  

That means generally going about life as before the pandemic, attending any event, going to work, and.. living life ‘free’.  At least until the next nasty variant appears.

But there are people who ought to take more care:

• Those who are clinically vulnerable. It is up to them to assess their own risk/reward balance for specific situations, and what risk is worth taking.
• Those who have not been fully booster-vaxed, including children
  

WHAT ABOUT ONGOING PRECAUTIONS?

As there is a risk of catching COVID-19, and potentially passing disease on to other people, continuation of basic precautions is sensible.  This is mainly for protection of others, and should be regarded as a civic duty:

• Taking a Lateral Flow Test before prolonged contact with other people, if necessary daily
• As far as possible meet in outside or well-ventilated areas
• Wearing masks on public transport and other places where you could easily pass infection to others.  Pubs and restaurants where food and drink is consumed need to be a practical exception.
  
• Other basic precautions, such as washing hands
  

WHAT ABOUT CATCHING OMICRON DELIBERATELY?

If you, friends or family haven’t had Omicron, is it worth catching it deliberately?  Going to a 'COVID party', like 'chicken pox parties' perhaps.

In most cases, it looks like Omicron infection is milder than Delta.  But:

• It’s too early to tell how serious infection from Omicron is going to be, and how common especially in people who are inherently more vulnerable
• It’s too early to tell how bad LongCovid is going to be.  Probably more common than with earlier variants, due to the speed it can spread around the body to damage other susceptible organs

So no, it is unwise to atttempt to catch Omicron deliberately.  

But take a few more risks?  Frankly that’s how I caught it, when it was raining and I had the choice of sitting indoors in the pub or going home.  Knowing it was a risk to sit indoors, but feeling I was going to catch Omicron some time anyway, and knowing I had the protection of being triple vaxed against Delta.  Likewise taking risks is up to you.
 

IN CONCLUSION

If you've had Omicron:

• If you're triple vaxed, and not highly vulnerable, you may consider the risk of a further serious COVID-19 infection to be low enough to get back to living life 'normally'. Albeit taking basic precautions, pricipally to protect others
  
• But not fully vaxed, and/or vulnerable, continue to take care!

If you haven't had Omicron:

• Don't catch it deliberately
• But perhaps be willing to take a few more risks 

 

UPDATE 4 JANUARY 

New Year events provided the opportunity to test the 'live life normally' freedom proposition.  Here's what happened.