International COVID-19 Megathread

[palandio]

New "Profil" magazine poll:

By a 64-29 margin, Austrians want ALL ski areas closed (even a majority of FPÖ-voters).

https://www.profil.at/oesterreich/umfrage-64-sind-dafuer-die-skigebiete-zu-schliessen/401173123

Isn't the problem so called Après-Ski and social gatherings afterwards rather than just being out in the snow? Since gastronomy is closed, I'm not sure this will have an impact.

Yeah, as I've said a few times in this thread already the skiing itself is not a problem at all.

It's out in the vast space with fresh air on the lifts and gondolas and an infection risk doesn't exist there.

The problem is more the ski instructors from the UK, Netherlands and Eastern Europe who are still allowed in here and who organize "private parties" on their own during the night in garages or somehwere, therefore being real dicks.

There have also been several cases of younger UK, Danish, Polish, Dutch etc. tourists coming here to their secondary homes in winter tourism areas and giving a damn about COV rules.

Yesterday, there was a massive police raid in Tyrol, in which more than 100 of them were rounded up and fined more than 2000€ each for breaking quarantine measures.

Austria doesn't need those dicks and they should be sent home from where they came from.

What we need is responsible ski tourists, who buy their stuff at the supermarkets, go skiing with masks on and leave some money here (without the aprés ski excesses).

It's easy though to blame only the fake skiing instructors.
Hotels and landlords have some responsibility regarding whom they accomodate and how.
Politics has to provide a legal framework that doesn't encourage breaking the rules.
Local authorities must intervene when rules are broken (and I'm glad they actually do, as pointed out by you).

Yes, I know, you can't guarantee that all people follow the rules, but you can at least try to provide an environment where rule-breaking is less likely. I acknowledge that many hotels are acting responsible and that many local authorities are trying their best, but I don't like that some deny any responsibility at all.

[palandio]

Germany is likely to once again continue the lockdown today. Numbers continue to decline, but the virus mutations from the UK and South Africa are a source for major concern. Experts are warning that lifting restrictions could quickly lead into a third wave. Merkel is definitely on the hardline here and doesn't see any room for taking measures back.

If you trust the models that basically add two exponential curves (one with negative exponent for the "old" virus type, one with positive exponent for the "new" mutated type) then it is understandable that our leading politicians try to delay the spread until spring will hopefully prevent an explosion. The big problem is communication, though. After almost one year of pandemic the main slogan remains "not now". This worked until even the more trustful part of the population found out that the state had to a significant degree failed to deliver its part of the deal to end the bad situation: Fast vaccination, protection of nursing homes and effective testing and tracing (because we do not only need to bring numbers down but to keep them there).

Meanwhile, a state court in Baden-Württemberg has suspended the nightly curfew from 8 p.m. to 5 a.m., agreeing with a woman who filed a lawsuit. The court ruled that the current situation no longer justifies the measure. However, the state government wants a reinstate nightly curfew in counties with more than 50 cases per 100k in seven weeks, starting at 9 p.m.

Interesting that they would change that from 8 p.m., the earliest time of all German states (most don't even have a curfew), to 9 p.m. (like in Bavaria). Maybe the 8 p.m. curfew (and the resulting crowded supermarkets at 7 p.m.) had become an example for a particularly pointless measure that many people brought up when talking to their local representatives a month before the state elections.

[palandio]

Austria already has weekly mortality numbers into the first 5 calendar weeks of 2021:

January had about +10% more deaths than a typical January 2016-2020.

But in the first week of February, the overmortality was down to 1.4% - with women having a 5.3% decline and men a 9% increase.

https://www.statistik.at/web_de/presse/125413.html

Which means that overmortality is back within the MoE. Assuming an expected number of 1.600 deaths per week (to make calucations simple), you get a standard deviation of 40 deaths (=2.5%) by chance alone. Due to various additional effects like registration irregularities, the real standard deviation is almost certainly higher. The 95% confidence interval would then be at least ±5%, probably more like ±6%. For one sex alone it's at least ±7%, probably up to ±9%. For a whole month and both sexes together it's at least ±2.5%.

Germany's curve seems to lag ca. one month behind Austria's and to remain overall slightly (but only slightly) lower. Excess deaths peaked in the last two calendar weeks of 2020 with 33% and 32% respectively and have since then decreased to 9% in the 4th calendar week of 2021. (In Germany the 95% confidence interval is at least ±1.4% for one week, probably closer to ±2%.

[palandio]

We should always remember that while test results are de facto used as a statistic for the spread of the virus, the current testing strategies in most countries are not suited for that. There is no valid representative random sample nor is there any valid statistical method to make up for its lack.

Different countries have different testing strategies. Germany for example recommends testing for contact persons five days after the last contact, but there is no automatism (for asymptomatic people). Personally when a person I had contact with was tested positive, I didn't take the test because I was in quarantine anyway, had no symptoms and had exactly the same contacts, so I didn't see the point.

This difference per se is not problematic if your main goal is to find and isolate infectious persons. The bigger problem is that the German testing strategy is insufficient to contain the virus. It was developed at a time when test availability was scarce and has not seen major revisions since then. The recommendation to test contact persons only after five days means that there still is the fictitious assumption that the first positively tested person could have infected its contacts, but not the other way round. There is no effort whatsoever to detect the eventual source of the original infection and eventual clusters are difficult to detect.

As far as I know Austria uses more antigene tests to identify infectious persons even if they are not suspicious otherwise. A positive antigene test then needs to be confirmed by a PCR test (so no wonder they have more PCR tests). In Germany the general opinion was "antigene tests have a too high false negative rate, they will lead to people behaving imprudently". Eh, but people are out there, infectious, nobody knows, and we aren't even seriously trying to find them? It seems that Germany is now liberalizing access to antigene tests starting on March 01. Austria got this one better at an earlier point in time, I have to admit, and I'm generally not willing to sing the song of praise for Austria's lackluster performance during the pandemic, but credit where credit is due.

Generally my impression is that Germany has been slow to readjust strategies after they had been established. Public attention has been focused on restrictions and closures (or the opposition towards them) and apart from that for a long time we have been hearing what was not possible: More tests, antigene tests for nursing homes, schools, enterprises and private persons, financial compensations, compatible software for local health authorities... So much complacency from politicians and aligned experts.

Scaremongering about masks (in spring 2020), certains vaccines etc. is only the icing on the cake.

[palandio]

It should be mentioned again that the conference of chancellor and governors is not an institution designated by any constitution or law. It's resolutions are non-binding. That doesn't mean that the conference is unconstitutional, on the contrary chancellor and governors are free to coordinate their actions if they think that it would make sense. Still, if the outcome is a compromise that leaves everyone unsatisfied, then people should be reminded that the compromise is legally not necessary.

Berlin mayor Michael Müller (SPD) called the resolution a "change of paradigm" into the direction of testing and vaccinations. It that is the case, then the general communication with the repeated focus on closures and restrictions is a total failure.

I don't expect that the new "tightenings" have any significant effect on the pandemic other than annoying the population. What could have an effect are school closures from 27 March to 11 April due to Easter holidays.

[palandio]

It should be mentioned again that the conference of chancellor and governors is not an institution designated by any constitution or law. It's resolutions are non-binding. That doesn't mean that the conference is unconstitutional, on the contrary chancellor and governors are free to coordinate their actions if they think that it would make sense. Still, if the outcome is a compromise that leaves everyone unsatisfied, then people should be reminded that the compromise is legally not necessary.

Berlin mayor Michael Müller (SPD) called the resolution a "change of paradigm" into the direction of testing and vaccinations. It that is the case, then the general communication with the repeated focus on closures and restrictions is a total failure.

I don't expect that the new "tightenings" have any significant effect on the pandemic other than annoying the population. What could have an effect are school closures from 27 March to 11 April due to Easter holidays.

Germany's federalism worked reasonably well as long everyone could agree on what needs to be done. Since this is not the case anymore and our political elite has increasingly become divided into hardline restrictioners and restriction lifters our political system has at the same time become increasingly dysfunctional. We're kind of resemblingthe EU now, only on a smaller scale.

I fear that I disagree with some of your premises.

Yes, sometimes there is an overlap of responsibilities or there are other reasons for coordination. But in cases like the one on hand the competence to enact most restrictions explicitly is at the state level. The federal government should try to do its homework (digital infrastructure, coordination with the RKI and international institutions, testing strategies, vaccine orders) instead of wasting time and energy on the attempt to force detailed unitary restrictions onto the states. If federalism means that everyone has to agree, then there is no need for federalism.

Delegating the vaccine orders to the EU is another example where a task was delegated to a political level that was not adequately equipped to fulfill the task. Letting 27 members decide on a question like this automatically means that politics will follow the most hesistant and reluctant members like Poland and Bulgaria. And it hurts particularly because it was unnecessary.

[palandio]

Well, as a total number it's actually not that many. There were 31 cases reported in Germany so far. Nine of them died. Almost exclusively women under the age of 60. However, I think it's the right decision to pause AstraZeneca for them as a precautionary step even though there is no final confirmation the thrombosis were actually caused by the vaccine (but it's likely).

You might not have noticed, but there is a pandemic of a highly infectious disease that has a relatively high mortality rate presently raging. The precautionary principle in this case is to keep on vaccinating.* And what do you base the latter on? Remarks from your public health officials who have repeatedly lied about this subject? How gullible are you?

_{*Incidentally even were this all true the risk would be substantially lower than from taking, for instance, the contraceptive pill.}

If the government lets this go and more cases occur, they would be in much bigger trouble. It's just the public communication that was every unfortunate here for a while, to put it mildly.

Well far more people have already died of covid as a result of this sort of idiocy and the delays in the vaccination programme so caused than ever could have from this cock-and-bull cowardly fantasy.

In my opinion (and as far as I know that opinion is wide-spread in medical ethics) the cure mustn't be worse than the disease, even more so when it's not a cure for the sick but a preventive measure for the healthy. And this should hold on the level of the individuum. In over one year only 21 women aged between 20 and 29 years have died from COVID-19 in Germany, some of them probably with pre-existing conditions. If (big if) the causality implied between the AstraZeneca vax and deaths from thrombosis is true and if the risk reaches the same order of magnitude as the risk from COVID-19 in a certain sub-group, then in my opinion it becomes irresponsible to recommend the vaccination to individuals of the sub-group, e.g. 20-29-year old women without pre-existing conditions that take the contraceptive pill. In other sub-groups the balance between risks might of course already be different.

After all this is a deeply philosophical question. Should people be treated even if their individual risk balance is negative but the risk balance for the whole society is very positive. Personally I don't think so despite not repudiating utilitarian thoughts generally.