What REALLY accounts for the surge in Covid cases since April?

[WaveHunter]

 

From the start of the pandemic up until the start of 2021, the total confirmed case count per capita of Covid in Thailand was remarkably low but starting this year the cases steadily rose and then literally began to skyrocket in April and May.  The big question in my mind is "why"?

 

I know that most will say it is the virus variants that are responsible.  Some will simply say that officials in Thailand "dropped the ball",  but these are just unsubstantiated opinions, not science-based evidence backed up with empirical data.

 

Even if you discount the recent prison counts as skewing the numbers, the rise in cases is still staggering.

 

It would seem that this would be a well studied topic with articles appearing in publications like The Lancet, Science, Journal of Clinical Epidemiology, Nature or briefings from WHO,  but 've done due diligence by googling and I can find no credible answers.  All I find are biased political commentary and general suppostions but no real science-based facts,

 

Does anyone on here have links to credible and objective information about the cause of this remarkable surge in the last two months?

 

Edited May 29, 2021 by WaveHunter

[brewsterbudgen]

They started to do more testing.

[WaveHunter]

47 minutes ago, brewsterbudgen said:

They started to do more testing.

Perhaps it contributed to it, but for such a dramatic spike to occur in such a short time frame, there must be a whole lot more involved than just increased testing.

 

I mean if you look at Thailand's history of dealing with this pandemic all through 2020 and right up to April of this year, something dramatic had to have happened in April, and I'm not really sure exactly what that was:

Edited May 29, 2021 by WaveHunter

[internationalism]

to the previous mutations in wave 1 and 2 thai population was immune.

But not to the UK one.

Let's see what the indian mutation will do, it's already in the south.

Throw to it secrecy of thonglor clubs, names "the second government house" and songkran.

A perfect set up for a s.itstorm

 

Edited May 29, 2021 by internationalism

[WaveHunter]

15 minutes ago, internationalism said:

to the previous mutations in wave 1 and 2 thai population was immune.

But not to the UK mutations.

Let's see what the indian mutation will do, it's already in the south.

Throw to it secrecy of thonglor clubs, names "the second government house" and songkran.

A perfect set up for a s.itstorm

 

Yes I hear a lot of talk about the variants being the cause.  I also "feel" that is the cause but it is only speculation, not fact.  I'm looking for objective, science based information that supports that notion.

Edited May 29, 2021 by WaveHunter

[internationalism]

the uk variant is 1.7 more contagious. That's why the second wave in the uk was larger and longer than the first wave (that despite strong measures, cancelled xmass).

possibly part genetic immunity of thai population even to the UK mutation play role - in the UK there were up to 1500 dead per day. Despite songkran travel and home partying there were only 20 dead per day at the end of April.

There is a theory that some 15k years ago there was a similar coronavirus in the south east of asia.

But also oriental infections, like dengue, might stimulate immune system. In tropics statistically everybody catches dengue every 9 years.

They have also here vaccinations which are abandoned in  the west. Tuberculosis being one

Edited May 29, 2021 by internationalism

[Sheryl]

I am not sure you are asking the right question.

 

What we are seeing now is no more than what would have been reasonably expected a year ago. So the real  question may be: why were there so few cases in 2020?

 

And this is not  just Thailand. Pretty much all of SE Asia and also the Indian subcontinent.

 

2020 proved much milder than could logically have been expected given known travel from China and Europe. Together with measures put in place in  2nd/3rd  quarters of 2020, it quickly began to look like the region was over it. Measures then relaxed, vaccination did not start, and come 2021 we are seeing the surges that were originally expected in 2020, aided by more infectious variants.

 

There was a lot of speculation last year in why cases were comparatively few and also comparatively mild in Asia but no studies that I know of.  Some of the hypothesized reasons have clearly not panned out given the second surge (i.e. warm, humid weather and demographics - it is just as hot and humid now and demographics haven't changed).

 

The most likely explanation IMO is that in 2020 there was significant cross-immunity in SEA and India, and that this immunity has either subsided with time or is not effective against newer variants, or a combination of both.

 

Cross-immunity (a cellular immune response due to past exposure to a different pathogen) has been demonstrated in other parts of the world from blood samples taken from people prior to the introduction of COVID, with prevalence of a response ranging from 20-40% depending on the place.  So it is known to happen and to provide at least partial protection.

 

Simply put, the populations of SEA Asia and the Indian subcontinent may have benefitted in 2020 from widespread recent exposure to other viruses (colds, flu) that primed  the immune system to more readily recognize and attack the COVID-19 virus and now no longer does.

 

Just a guess but given that other hypothesiozed reasons are pretty much rueld out by what is happening now, I think the most likely hypothesis.

 

 

[Klonko]

Quote

 

1. There were outbreaks in some prisons but not all. Prisons without outbreaks seem to have separate douches, while prisons with outbreaks have central water dispensers for multiple inmates to be used simultaneously. They are now refurbishing the bathroom facilities. Could be a similar issue for workers’ camps.
2. Apart from Bangkok area, hospitals (Chonburi) are not running over capacity anymore and the outbreaks have hopefully been contained.

Edited May 29, 2021 by Klonko

[WaveHunter]

1 hour ago, Sheryl said:

I am not sure you are asking the right question.

 

What we are seeing now is no more than what would have been reasonably expected a year ago. So the real  question may be: why were there so few cases in 2020?

 

And this is not  just Thailand. Pretty much all of SE Asia and also the Indian subcontinent.

 

2020 proved much milder than could logically have been expected given known travel from China and Europe. Together with measures put in place in  2nd/3rd  quarters of 2020, it quickly began to look like the region was over it. Measures then relaxed, vaccination did not start, and come 2021 we are seeing the surges that were originally expected in 2020, aided by more infectious variants.

 

There was a lot of speculation last year in why cases were comparatively few and also comparatively mild in Asia but no studies that I know of.  Some of the hypothesized reasons have clearly not panned out given the second surge (i.e. warm, humid weather and demographics - it is just as hot and humid now and demographics haven't changed).

 

The most likely explanation IMO is that in 2020 there was significant cross-immunity in SEA and India, and that this immunity has either subsided with time or is not effective against newer variants, or a combination of both.

 

Cross-immunity (a cellular immune response due to past exposure to a different pathogen) has been demonstrated in other parts of the world from blood samples taken from people prior to the introduction of COVID, with prevalence of a response ranging from 20-40% depending on the place.  So it is known to happen and to provide at least partial protection.

 

Simply put, the populations of SEA Asia and the Indian subcontinent may have benefitted in 2020 from widespread recent exposure to other viruses (colds, flu) that primed  the immune system to more readily recognize and attack the COVID-19 virus and now no longer does.

 

Just a guess but given that other hypothesiozed reasons are pretty much rueld out by what is happening now, I think the most likely hypothesis.

 

 

I was wondering about cross immunity too BUT if that were the case, surrounding countries like Laos and Vietnam for instance would also reflect that in their new daily case per capita curves, (as compared below) but they do not. 

 

 

Thailand's curve is curiously similar to Malaysia, Cambodia and India, but still if it were cross immunity, all the curves of surrounding countries would more or less mimic each other, so there must be something else at play that accounts for this spike in April/May.

 

Edited May 29, 2021 by WaveHunter

[Sheryl]

4 hours ago, WaveHunter said:

I was wondering about cross immunity too BUT if that were the case, surrounding countries like Laos and Vietnam for instance would also reflect that in their new daily case per capita curves, (as compared below) but they do not. 

 

 

Thailand's curve is curiously similar to Malaysia, Cambodia and India, but still if it were cross immunity, all the curves of surrounding countries would more or less mimic each other, so there must be something else at play that accounts for this spike in April/May.

 

Laos also spiked in April and May. Quiet similar pattern. And VN spiked in May.

 

It does not work well to try to plot countries with very differing scales on the same graph. Better to do them each separately

 

Spiking April-May of this year throughout SE Asia and Indian subcontinent

[Puccini]

Are perhap the tens of thousand cases found in prisons being distributed in the statistics over several days?

https://forum.thaivisa.com/topic/1218731-over-22000-inmates-in-thailand-found-infected-with-covid-19/

 

[mtls2005]

Yeah, if you pull out prisons, factories, migrant labor camps, fresh markets, offices...what surge?

 

17 hours ago, Sheryl said:

Simply put, the populations of SEA Asia and the Indian subcontinent may have benefitted in 2020 from widespread recent exposure to other viruses (colds, flu) that primed  the immune system to more readily recognize and attack the COVID-19 virus and now no longer does.

 

So keeping it simple, why does the immune systems of a billion people suddenly "now no longer" work as effectively as before?

 

Feel free to guess.

 

 

[cmarshall]

17 hours ago, Sheryl said:

The most likely explanation IMO is that in 2020 there was significant cross-immunity in SEA and India, and that this immunity has either subsided with time or is not effective against newer variants, or a combination of both.

 

Cross-immunity (a cellular immune response due to past exposure to a different pathogen) has been demonstrated in other parts of the world from blood samples taken from people prior to the introduction of COVID, with prevalence of a response ranging from 20-40% depending on the place.  So it is known to happen and to provide at least partial protection.

 

 

However cross immunity presumably from the four coronaviruses would be surprising since, the coronaviruses that cause 30% of common colds do not produce immunity even against themselves.  This is in contrast to the flu viruses which do produce immunity against themselves with the result that the threat each year comes from not from last year's flu virus, but only from new variants.  What I have understood about the coronaviruses that cause colds is that the same virus can reinfect you year after year.  

 

The two lethal coronaviruses, SARS-Cov and MERS-Cov, might produce immunity or even cross-immunity, but they were never widespread in Asia, unlike the four cold-causing coronaviruses.  Thailand, for example, had nine cases of SARS-Cov while Viet Nam had sixty-three.  Since SARS-Cov had a 30% case fatality rate, its spread is not likely to have been underestimated. 

 

To my mind government response better explains the difference between 2020 and 2021 in Thailand, for instance.  Last year the government was more diligent, about borders, for instance, and bars and clubs favored by hi-sos.  This year there is a marked dropoff in discipline.  By contrast Taiwan has had an outbreak recently against which it is responding vigorously enough that it looks like they will contain it effectively.

[WaveHunter]

15 hours ago, Sheryl said:

Laos also spiked in April and May. Quiet similar pattern. And VN spiked in May.

 

It does not work well to try to plot countries with very differing scales on the same graph. Better to do them each separately

 

Spiking April-May of this year throughout SE Asia and Indian subcontinent

The graphs are "new daily cases per capita", so they can be compared on the same scale. 

 

I agree they all spike in April/May but the spike in Thailand is far, far more dramatic than in Laos and Vietnam. 

 

My point is simply that something dramatically happened during this time frame, and I don't think that cross immunity explains it.  The emergence within Thailand of the Indian and African variants is a more likely explanation but I'm just surprised that there is no science-based data to verify just what caused this spike to occur.

[placeholder]

44 minutes ago, WaveHunter said:

The graphs are "new daily cases per capita", so they can be compared on the same scale. 

 

I agree they all spike in April/May but the spike in Thailand is far, far more dramatic than in Laos and Vietnam. 

 

My point is simply that something dramatically happened during this time frame, and I don't think that cross immunity explains it.  The emergence within Thailand of the Indian and African variants is a more likely explanation but I'm just surprised that there is no science-based data to verify just what caused this spike to occur.

It might just be that Thailand has a better public health reporting system than does Vietnam or Laos. Almost certainly better than Laos. 

Edited May 30, 2021 by placeholder

[WaveHunter]

2 minutes ago, placeholder said:

It might just be that Thailand has a better public health reporting system than does Vietnam or Laos. Almost certainly better than Laos. 

That could be the case, but I'm just surprised that when I google for an explanation of what I think is an extraordinary spike in new cases, I can find no credible, science-based explanation being discussed at all.  A lot of people have opinions, but it just seems curious that established journals (i.e.: The Lancet et al) are not addressing it as far as I can see.

[Sheryl]

4 hours ago, mtls2005 said:

So keeping it simple, why does the immune systems of a billion people suddenly "now no longer" work as effectively as before?

 

Feel free to guess.

 

 

 

Specific cellular immunity (T cell sensitization to a pathogen that the host was recently exposed to) can and often does decrease with time.  This does not in anyway imply  that the immune system is not working. Just that specific immunities are often of short duration.

 

When you have had a cold, you do not usually get another one right away, even though you may be exposed to a different cold virus. Give it 6-12 months or so, and exposure to the same thing will give you a cold.  Same reason.

 

The immune response to coronaviruses is typically not very long lasting.

 

Entirely plausible that, due to recent widespread infection with a different coronavirus, a high percentage of the SEA population had cross-immunity to COVID-19 in 2020 and that this response has decreased with time, because such immunities are not long lasting. Does not in any way mean their immune systems "no longer work effectively".

 

Also entirely possible that the cross-immunity was more robust with original variants than it is with newer variants.

 

There has been quite a bot of research ion this type of cross-immunity.

https://www.bmj.com/content/370/bmj.m3563

https://www.nature.com/articles/s41392-021-00490-x

https://pubmed.ncbi.nlm.nih.gov/32758887/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673860/

 

 

 

 

 

[Sheryl]

1 hour ago, WaveHunter said:

The graphs are "new daily cases per capita", so they can be compared on the same scale. 

 

 

Only if you want to compare the reported number of cases per capita. (Note that the  % of actual cases that get identified/reported almost certainly differs across these countries since the strength and reach of their public health systems and reporting is so different to start with. )

 

To compare curves, since the overall number of reported cases differs in each country throughout this time period , you cannot do it on one scale.  Plot the curve for each country separately and put the graphs side by side. You will see the same pattern.

 

 

[WaveHunter]

13 minutes ago, Sheryl said:

 

Specific cellular immunity (T cell sensitization to a pathogen that the host was recently exposed to) can and often does decrease with time.  This does not in anyway imply  that the immune system is not working. Just that specific immunities are often of short duration.

 

When you have had a cold, you do not usually get another one right away, even though you may be exposed to a different cold virus. Give it 6-12 months or so, and exposure to the same thing will give you a cold.  Same reason.

 

The immune response to coronaviruses is typically not very long lasting.

 

Entirely plausible that, due to recent widespread infection with a different coronavirus, a high percentage of the SEA population had cross-immunity to COVID-19 in 2020 and that this response has decreased with time, because such immunities are not long lasting. Does not in any way mean their immune systems "no longer work effectively".

 

Also entirely possible that the cross-immunity was more robust with original variants than it is with newer variants.

 

There has been quite a bot of research ion this type of cross-immunity.

https://www.bmj.com/content/370/bmj.m3563

https://www.nature.com/articles/s41392-021-00490-x

https://pubmed.ncbi.nlm.nih.gov/32758887/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673860/

 

Thanks for providing those links ????  I think what you say is pretty sensible but it still does not explain the how suddenly the spike occurred. 

 

It strongly points to the introduction of the new variants which were probably prompted by the recent illegal border incursions with Myanmar (Indian variant) and Malaysia (the recent African variant), and of course the UK variant that were all widely reported in the last month, since the timeframe for all coincides with the spike.

 

Your views and mine though are only educated guesses.  My point in this thread is simply why aren't more science-based reports exploring this specific topic showing up in Google searches

 

Edited May 30, 2021 by WaveHunter

[WaveHunter]

9 minutes ago, Sheryl said:

 

Only if you want to compare the reported number of cases per capita. (Note that the  % of actual cases that get identified/reported almost certainly differs across these countries since the strength and reach of their public health systems and reporting is so different to start with. )

 

To compare curves, since the overall number of reported cases differs in each country throughout this time period , you cannot do it on one scale.  Plot the curve for each country separately and put the graphs side by side. You will see the same pattern.

 

 

Good point for sure about differing effectiveness of reporting per country  ! ????  Even so, the pronounced spike in Thailand for such a short time-frame seems to be a real red-flag that indicates something about it is unique to Thailand.  I simply wonder what that "something" is.

 

Edited May 30, 2021 by WaveHunter

[Sheryl]

10 minutes ago, WaveHunter said:

Thanks for providing those links ????  I think what you say is pretty sensible but it still does not explain the how suddenly the spike occurred. 

 

It strongly points to the introduction of the new variants which were probably prompted by the recent illegal border incursions with Myanmar (Indian variant) and Malaysia (the recent African variant), and of course the UK variant that were all widely reported in the last month, since the timeframe for all coincides with the spike.

 

Your views and mine though are only educated guesses.  My point in this thread is simply why aren't more science-based reports exploring this specific topic showing up in Google searches

 

 

 

Actually declining levels of cross-immunity alone can lead to such spikes assuming (as is almost certainly the case) that the virus remained present in those countries.

 

New variants would then speed that up.

 

There is abundant literature discussing why the outbreak in Asia in 2020 was so mild. Which, as I said, is the real phenomena here not what is happening now.

 

It is still May. You would nto expect articles on an April-May phenomena to already be published.

[WaveHunter]

2 minutes ago, Sheryl said:

 

 

Actually declining levels of cross-immunity alone can lead to such spikes assuming (as is almost certainly the case) that the virus remained present in those countries.

 

New variants would then speed that up.

 

There is abundant literature discussing why the outbreak in Asia in 2020 was so mild. Which, as I said, is the real phenomena here not what is happening now.

 

It is still May. You would nto expect articles on an April-May phenomena to already be published.

Thanks for your guidance on all of this.  You are obviously pretty knowledgeable on such topics, and your comments are quite helpful in trying to understand this topic.  Most appreciated ???? 

[cclub75]

On 5/29/2021 at 1:15 PM, Sheryl said:

I am not sure you are asking the right question.

 

What we are seeing now is no more than what would have been reasonably expected a year ago. So the real  question may be: why were there so few cases in 2020?

 

Bingo. The pandemic started in Asia... and despite this (or thanks to it, see bellow)... nothing really happened in Asia (even in China... We had the circus in Wuhan... That's all. Pretty dramatic... but regarding the scale of the country.... nothing).

 

Meanwhile, America (north and south) and Europe were burning...

 

It doesn't make any sense.

 

We do have in Asia too a lot of old and sick people...

 

Immunity can explain such striking differences.

 

One study talked about it : "COVID-19 and Flu Pandemics Follow a Pattern: A Possible Cross-immunity in the Pandemic Origin and Graver Disease in Farther Regions"

 

Link : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568123/

 

In conclusion, the COVID-19 pandemic and the three main flu pandemics in the last centuries follow a similar pattern: the farther from the pandemic origin, the graver the disease.