Naked Science Forum
Life Sciences => Physiology & Medicine => COVID-19 => Topic started by: nudephil on 10/06/2020 17:38:28
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Here's a question sent in by John:
Are the "better" COVID death rates in Australia and NZ simply down to the fact that they are in their summer period and the virus is sensitive to UV light, especially UVC which is most intense in high summer? As they move into their winter period will they have a spike in death rates?
Any thoughts on how big a role UV plays?
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There are many factors. Notably this
https://www.telegraph.co.uk/news/2020/06/10/prof-neil-ferguson-uk-would-have-halved-coronavirus-death-toll/
Are the "better" COVID death rates in Australia and NZ simply down to the fact that they are in their summer period
It is currently Winter in the antipodes.
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And of course UV makes vitamin D, there is nowhere near enough in our diet.
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And of course UV makes vitamin D, there is nowhere near enough in our diet.
So, you are saying that, since it's Winter in NZ and so the UV levels are low, so the Vit D levels are also low, and they just shook off the virus, low Vitamin D protects against Covid?
Or are you getting to grips with correlation not being causation?
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The death rates are probably no different from anyone else's: about 4% of those infected. But the infection rates were controlled from the outset by proper lockdown and quarantine - politics - and probably by not transferring infectious patients from hospitals into nursing homes with no capability of isolating patients or protecting staff - politics.
Fact is that the UK government consistently underfunded and mismanaged the care system beforehand, made no preparation for any kind of epidemic, then, when the balloon went up, did everything wrong and continues to do so, for reasons known only to whoever is actually in charge.
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It is currently Winter in the antipodes.
The outbreaks in the Northern Hemisphere in February-March occurred in the coldest winter months, when people are most likely to be huddled indoors.
Officially, winter in Australia begins on 1st June, with the coldest month being August. So winter has only just started (and is fairly mild compared to winter in many parts of Europe). With little snow in Australia, warmth returns rapidly in September.
Because Australia and New Zealand are islands, people arriving have their passports checked, so they can be identified later (most of the COVID-19 cases in Australia originated on a single cruise ship). There is greater vehicle flow within Europe and North America.
I do expect that while Europe is coming into warmer weather, restrictions may be reduced, with another wave as colder weather sets in around November-December.
I am guessing that restrictions in the southern hemisphere will need to be tightened by August.
the virus is sensitive to UV light
It's true that genetic material is damaged by UV.
- I've heard claims that some wavelengths of UV-C can disable the virus without harming humans - but I want to see evidence of safety; in general, higher-energy photons do more damage to organic molecules.
But it probably has a lot to do with human behavior, too:
- In cold weather, we tend to huddle indoors with the windows shut, so we are locked inside with an accumulating viral load
- In warmer weather, we tend to open the windows and go outside more
- Even within Italy, Milan is fairly close to the alps. But the severity of COVID cases to date has been less severe towards the warmer parts of southern Italy (their turn will come, but let's hope they are better prepared than Milan)
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I'm now waiting for all the people who said that it was somehow related to 5G- of which NZ has plenty- to admit that they were conned.
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And of course UV makes vitamin D, there is nowhere near enough in our diet.
So, you are saying that, since it's Winter in NZ and so the UV levels are low, so the Vit D levels are also low, and they just shook off the virus, low Vitamin D protects against Covid?
Or are you getting to grips with correlation not being causation?
This may be a bit difficult for you to inderstand Bored Chemist. Vitamin D levels depend on how much vitamin d a person has rather than how much they're gtting and vitamin D is stored in the body, so maximum leves are reached at the end of summer and slowly decrease over the winter.
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This may be a bit difficult for you to inderstand Bored Chemist.
Well, next time, correct the typos.
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The death rates are probably no different from anyone else's: about 4% of those infected. But the infection rates were controlled from the outset by proper lockdown and quarantine - politics - and probably by not transferring infectious patients from hospitals into nursing homes with no capability of isolating patients or protecting staff - politics.
Fact is that the UK government consistently underfunded and mismanaged the care system beforehand, made no preparation for any kind of epidemic, then, when the balloon went up, did everything wrong and continues to do so, for reasons known only to whoever is actually in charge.
Rates of infected ? They are known to decreace over summer
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Rates of infected ? They are known to decreace over summer
In the northern hemisphere. And exactly the opposite in the southern. All we know is that the export of COVID from Wuhan really began in earnest at the end of the northern winter.
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Can I just check on something...
Brazil is equatorial- very sunny all year.
So it should have low rates of covid.
Is that right?
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Brazil has an idiot president. 'Nuff said.
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Brazil has an idiot president. 'Nuff said.
So has the USA.
It's as if there's a theme here.
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Vitamin D in Brazil's population
Sufficient.......27%
Insufficient....45%
Deficient.......28%
according to this meta-study https://pubmed.ncbi.nlm.nih.gov/29420062/
Sorry I'm probaby going to keep banging on about it, like I did with masks, until it's recognised for the major comorbidity it is.
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Are you going to show that it's not a proxy for poverty/ being well fed?
Or are you not bothering with science?
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Are you going to show that it's not a proxy for poverty/ being well fed?
Or are you not bothering with science?
It has little to do with diet, practically nobody, rich nor poor gets even a quarter of vitamin D from their diet. Not quite true - some countries do a half decent job adding it to food, many more make a feeble go at this.
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Damned if I know how homo sapiens has survived this long. Or even manged to evolve in the first place. Thank goodness for supplement salesmen - the new messiahs.
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It has little to do with diet, practically nobody, rich nor poor gets even a quarter of vitamin D from their diet. Not quite true - some countries do a half decent job adding it to food, many more make a feeble go at this.
Did you not understand my point, or did you ignore it?
Vitamin D status is so strongly correlated with other factors that it is difficult to say if it is causal.
Do you have any evidence that the observed relationship between vitamin D and covid survival is causal?
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Damned if I know how homo sapiens has survived this long.
Most of the things we do that keep the species alive are not governed by the "sapient" bits of the brain.
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In a trial in Spain, of 76 covid patients admitted to hospital, all treated the same except 50 were given calcifediol (25-hydroxyvitamin D3) 26 were not (radomly) results:-
Vitamin D group 1 admitted to ICU, 0 died
No vitamin D group 13 admitteg to ICU, 2 died
https://www.sciencedirect.com/science/article/pii/S0960076020302764
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Several fundamental aspects were considered when evaluating admission to the ICU: Presence of comorbidities,....
How strange that only one of the active group had significant comorbidities compared with 50% of the untreated controls.
the randomization did not achieve a homogeneous distribution of all the variables investigated between the two comparison groups (with and without calcifediol (Table2). A statistically significant difference was identified for the variable hypertension (26 had a history of hypertension of which 11 (42%) received Calcifediol [11/50 = 22%] and 15 (58%)[15/26 =58%] not (CI: −0.58 to −0.13; p: 0.002) and close to statistical significance for diabetes 3 (6%) versus 5 (19% ).
an honest admission that the VitD result is inconclusive but, if you do the maths correctly (my figures in red) hypertension and diabetes are significant comorbidities.
Which we already knew.
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How strange that only one of the active group had significant comorbidities compared with 50% of the untreated controls.
The 1 v 50% was the number admitted to the ICU - an outcome not the starting point.
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But read the next paragraph - "randomisation" was very far from random, and the strongest correlation seems to be with pre-existing hypertension and/or diabetes, as expected from observations elsewhere.
there was no significant difference in subjects with at least one risk factor, except for high blood pressure and diabetes mellitus, known risk factors for unfavorable disease progression [2], which were more frequent in patients not treated with calcifediol.
we did not collect the BMI, which would have allowed us to add obesity
Serum 25OHD concentrations at baseline or during treatment are not available
In other words the study proved nothing beyond what was already known, ignored the known most important risk factor, and does not demonstrate the efficacy of VitD in treatment for COVID. Pity, because a cheap and simple treatment is always desirable, but false hope can be damaging.
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But read the next paragraph - "randomisation" was very far from random, and the strongest correlation seems to be with pre-existing hypertension and/or diabetes, as expected from observations elsewhere.
there was no significant difference in subjects with at least one risk factor, except for high blood pressure and diabetes mellitus, known risk factors for unfavorable disease progression [2], which were more frequent in patients not treated with calcifediol.
we did not collect the BMI, which would have allowed us to add obesity
Serum 25OHD concentrations at baseline or during treatment are not available
In other words the study proved nothing beyond what was already known, ignored the known most important risk factor, and does not demonstrate the efficacy of VitD in treatment for COVID. Pity, because a cheap and simple treatment is always desirable, but false hope can be damaging.
Of course there will be differences between the groups, that's what happens when you randomise patients. They are taken into account -
Therefore, a multivariate logistic regression analysis was performed to adjust the model by possible confounding variables such as hypertension and type 2 diabetes
This is all standard stuff.
This is a science forum and you're a moderator Alan, I would have expected you to know this.
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The maths fell apart in the previous sentence, and
The dependent variable considered was the need to be treated or not in ICU
Now since the "control" group had roughly 3 times the incidence of hypertension and/or diabetes, it is hardly surprising that a greater proportion were deemed to require ICU admission - the implication being that this was precautionary, not reactive, and therefore a matter of opinion, not fact.
It is interesting that the control group had a mean D-dimer of twice the active group, with a range up to 4 times that value*, so at least some of the control group were indeed in a very serious cardiopulmonary condition on entry, whilst the active group were all in the normal range. But this was not considered a prognostic bad risk factor.
Yes, it is all standard stuff, which makes it surprising that anyone would take the result as indicative of VitD benefit. I have no doubt that the intention was sincere, but whether by bad luck or skewed judgement, the trial turned out to be of dubious value. There's always a risk of spurious findings with small numbers and it always pays to look at the small print, and asking what have they not recorded (BMI) or recorded and ignored (D-dimer).
And like it or not, the essence of science is disproof. If, of the zillion available molecules, you choose to test the effect of A on B, it means that you hope it will produce a desirable effect. With the best will in the world, and particularly when dealing with life and death, it is very difficult to avoid bias in favor of your hypothesis.
Unlike drinking Lysol, frying yourself with ultraviolet, or participating in a mass pray-in, adding a bit of vitamin D to your diet won't do much harm, but neither will chicken soup, and I remain to be convinced that either will lessen the impact of COVID.
* Whilst 650.92 +/- 405.61 is just credible for the active group, how do we interpret 1333.54 +/- 2570.50 in the control group? Can anyone actually have a negative D-dimer score? Or do we not understand statistics? The minimum implication of these figures is that at least one of the control group scored over 3900 which would suggest a pre-existing pulmonary embolism or serious inflammation whereas all the active group were in the range of normal for age. Remember that most COVID-related deaths are due to inflammation or cardiovascular insufficiency.
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As for the original question, both Oz (3 persons per sq km) and NZ (19) have much lower population densities than the UK (280) and far less regular travel between conurbations. The worry is that USA (34) is doing almost as badly as the UK, despite having pretty much the same ethnic mix and overall standard of living as the others.
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If a journal contains 20 reports of positive findings at the p=0.95 level, it's quite likely that at least one of them is wrong.
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As for the original question, both Oz (3 persons per sq km) and NZ (19) have much lower population densities than the UK (280) and far less regular travel between conurbations. The worry is that USA (34) is doing almost as badly as the UK, despite having pretty much the same ethnic mix and overall standard of living as the others.
Japan has a population density (347/km^2) rather higher than the UK.
The UK has 612 death per million of population
Japan had 11 deaths per million of population.
It's hard to escape the conclusion that incompetent government is a major factor.
(So is poverty, which is a lot harder to fix).
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I've not visited Japan but the impression I get from colleagues who have, and from Japanese colleagues I've met elsewhere, is also of social norms and compliance that make British "reserve" look positively savage in comparison.
Ben Elton put it succinctly in a novel, where an American enters a British burger joint and discovers that however much you train a British teenager and put him in a uniform, "Have a nice day" still sounds like "F**k off".
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This also supports the "having a liar in charge" hypothesis.
https://god.dailydot.com/trump-covid-19-interviews/?fbclid=IwAR13tZHb8PUY0Tl2b6Uk2CFpMxzzAyDv6DwJOVzic4r1PC7w8-Z2TOdHy6s
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What surprises me is that anyone took any notice of what Trump said, when plenty of people who know what they are talking about were telling the truth and reporting it for all to see. Blame surely lies with journalists and broadcasters who give airtime and print space to the ignorant ramblings of politicians.
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A journalist can hardly not report what the president said.
However, a good one can add editorial comment.
Unfortunately, that system breaks down if the President only ever talks to people who will support him.
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I disagree. A free press can report or ignore anything it chooses to. The public (apart from Daily Mail readers) expects to learn what has happened and what is going to happen. What a politician thinks or says is of no significance to anyone unless he is announcing a forthcoming action or passing on actual intelligence that has previously been an official secret (Tony B Liar please note - a PhD thesis is not an official secret or credible intelligence. House of Commons please note: you are elected to hold the executive to account, not to cheer the prime minister on to an election victory).
Editorial opinion is no more valid than that of the politician, though pointing out inconsistencies and probable consequences of announced policy may be considered due diligence.
The president can talk to whoever he likes, but Goebbels was only quoting a historical fact when he pointed out that a lie repeated becomes a truth, and any journalist who knowingly broadcasts a lie or treats politics as an arm of entertainment is doing Goebbels' work. Party propaganda should be paid for by the party, not the viewer.
UK coverage of the last US presidential election campaign was at least 80% about Trump, so the fact that the electorate still rejected him came as a bit of a surprise, but balance was restored by the electoral college which treated the popular vote as irrelevant.
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What a politician thinks or says is of no significance to anyone unless he is announcing a forthcoming action
Saying "covid isn't a real threat " is announcing a plan of action; a plan to ignore the virus (and a plan to tell further lies etc).
People need to be made aware of that policy.
If they think it's a stupid policy then they can vote for someone else next time. (by which time it's too late).
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Saying "covid isn't a real threat " is announcing a plan of action; a plan to ignore the virus (and a plan to tell further lies etc).
It's an announcement of personal belief and non-action. Why anyone would choose to broadcast it is beyond comprehension, particularly when the facts are freely available.
Broadcasters and newspaper editors run their staff and freelance reports through fact check and legal before publication, so why not apply the same standards to political speeches and simply reject anything that doesn't stack up?
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It's an announcement of personal belief and non-action. Why anyone would choose to broadcast it is beyond comprehension,
Because it's important to know what the President is doing. so why not apply the same standards to political speeches and simply reject anything that doesn't stack up?
great idea.
How do you anticipate getting it through parliament or congress?
I see there's a big song and dance at the moment about Boris and his latest impossible idea. Loads of testing daily for everyone by Xmas.
They say it would cost £100 B
Yes, £10^11
But that's not actually the problem. The govt can write (and honour) a cheque for that. The problem is to whom can you make it payable?
It's equivalent to roughly £ 300 B per year
If you pay people £30,000 per year that's ten million people
Where are they going to find 10 million people with the sorts of skills needed?
It's plausible that there are that many scientists, and technicians inteh world but it's not as if they are currently fly-fishing.
So, it's obvious that Boris is lying.
Yet his supporters still think he's doing well.
And that's not so much because they are fools, but because the media are not telling the truth.
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Because it's important to know what the President is doing.
In this case, nothing. No news is not news.
from: alancalverd on Today at 14:58:41]
so why not apply the same standards to political speeches and simply reject anything that doesn't stack up?
great idea.
How do you anticipate getting it through parliament or congress?
No need. Editorial policy is decided by editors, not government, in a free country. Which, for the next 8 weeks, includes the USA.
They say it would cost £100 B
Yes, £10^11
But that's not actually the problem. The govt can write (and honour) a cheque for that. The problem is to whom can you make it payable?
That's almost enough to cover the consultancy fees for 100 miles of railway that nobody needs. Cheque payable to Party supporters, spouses of personal friends, and whoever has the PM's balls in his hand, as usual. It's your money, so he can spend it any way he likes.
The test doesn't actually have to work anyway. All it tells you is that you may have or may have had a disease, which you may or may not know anyway. It doesn't stop you getting it or dying from it, which is what you want.
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No need. Editorial policy is decided by editors, not government, in a free country. Which, for the next 8 weeks, includes the USA.
If Boris makes a speech then the only relevant editor is Cummings.
There is a difference between reporting
"We have a world leading track + trace system"
and reporting
" Boris said ' We have a world leading track + trace system'"
An editor is only responsible for misleading the readers in the first case.
As you said
Editorial opinion is no more valid than that of the politician
The problem arises when the BBC decides to make Farage the most frequent Question Time "guest" in history.
That's when it turns into propaganda.
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The test doesn't actually have to work anyway. All it tells you is that you may have or may have had a disease, which you may or may not know anyway. It doesn't stop you getting it or dying from it, which is what you want.
It may stop you spreading it- which would be rather useful.
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Only if you have an enforceable quarantine system.
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Only if you have an enforceable quarantine system.
Not really.
People would be more likely to stay home if they knew they had the virus rather than they knew that had a sore throat which they didn't think was the virus because they had been round at their aunt Ethel and she said that the neighbour was talking to a nurse at the bus stop- well she thought it was a nurse; might have been the cook, but he worked in a hospital and he said that you can tell if you have it because the dog acts funny.
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There's a difference between "more likely" and doing it, and we can already see the effect of inadequate persuasion in the rising infection rate, driven by an incompetent approach to short-term economics and absurd sentimentality.
Where do the most vulnerable congregate? Weddings and funerals. Where do group limits not apply? Weddings and funerals.
There was an excellent rational, expert interview on Radio 4 World at One yesterday, persistently interrupted by a reporter asking "but won't that ruin Christmas?" as if overeating on some random day were more important than preventing endemic disability.
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There's a difference between "more likely" and doing it, and we can already see the effect of inadequate persuasion i
A positive test result would be much more persuasive.
It doesn't have to be perfect to save lives, just " a bit better" will do.
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Where do the most vulnerable congregate? Weddings and funerals. Where do group limits not apply? Weddings and funerals.
That's because e have a Prime minister who thinks that having large wedding parties is more important than international law.
I can't see why any rational individual (other than the very rich) would have voted for him.
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As you have pointed out elsewhere, the only people who voted for him are a few citizens of Uxbridge, who probably aren't short of a few quid, and the paid-up members of the Conservative Party, who probably are short of a few neurons.
His 2017 majority in Uxbridge and South Ruislip of 5,034 votes was the smallest of any sitting prime minister since 1924.
His slightly larger majority in 2019 was entirely due to the absence of a Brexit policy among any of his rivals, their vote being split between a Liberal Antidemocrat sworn to ignore the result of a public referendum, and a Labour candidate whose European policy was to sweep Israel into the sea and embrace the IRA.
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His slightly larger majority in 2019 was entirely due to the absence of a Brexit policy among any of his rivals, their vote being split between a Liberal Antidemocrat sworn to ignore the result of a public referendum, and a Labour candidate whose European policy was to sweep Israel into the sea and embrace the IRA.
Thanks for demonstrating your clarity of thought there;
"the absence of a Brexit policy among any of his rivals"
They both had clear policies on the issue.
The Lib dems said that they would do what the majority wanted (at the time- rather than 3 years earlier) and ditch brexit.
Labour said that they weren't sure what the UK currently thought so they would ask.
So those are the democratic things to do.
Regrettably they split the "brexit sucks" vote so the minority view "brexit is great" liars got in.
The Labour candidate did much the same as Mrs T- actually talking to the IRA- a process that has done a lot to re-unite the people of Northern Ireland.
Boris is putting that at risk and will possibly end up rejuvenating the IRA.
It's hard for 1 man to have a European view on Israel. I know they are part of Eurovision; but that's really not the same as being part of Europe.
He has this unfashionable view that Israel should be subject to international law.
No wonder he doesn't agree with Boris.
And the major reason his party didn't win was the Tory press kept calling him "unelectable"- he was, of course, duly elected.
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The Lib dems said that they would do what the majority wanted (at the time- rather than 3 years earlier) and ditch brexit.
Thus claiming psychic powers in addition their previously demonstrated perfidy in government.
Labour said that they weren't sure what the UK currently thought so they would ask.
As previously demonstrated by the EU and SNP demanding that the Irish/Scots keep voting until they get the right answer.
I quite like the Swiss procedure of having a referendum on almost everything, but not the same question every year.
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Thus claiming psychic powers in addition their previously demonstrated perfidy in government.
No.
Just looking at the data.
https://en.wikipedia.org/wiki/Opinion_polling_on_the_United_Kingdom%27s_membership_of_the_European_Union_(2016%E2%80%932020)#/media/File:Brexit_post-referendum_polling_-_Right-Wrong.svg
You should try it.
I quite like the Swiss procedure of having a referendum on almost everything, but not the same question every year.
Perhaps you are right.
We had a referendum; we should stick to the result.
The vote was back in the 70s, and we decided to join.
No need for any further opportunities to see if things have changed.
Which option do you want?
The one where we can change our minds- in which case Brexit would be rejected by the people, or the one where we can't change our minds, in which case being in the EU was the option chosen by the people?
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Opinion polls are excellent space-fillers but irrelevant to democracy.
As has been demonstrated, jumping in and out of the EU is not a quick or a cheap process, so frequent changes of mind are not helpful. The EU we are leaving is very different from the Common Market we joined (against my better judgement) and the decision to leave was taken in the light of 50 years' experience of paying for the privilege of an ever-increasing trade deficit.
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As has been demonstrated, jumping in and out of the EU is not a quick or a cheap process
Indeed.
The process of leaving has cost more than 50 years of membership.
Perhaps we should have spent the money on the NHS instead.
against my better judgement
Is that based on conceitedness or on psychic powers?
Opinion polls are excellent space-fillers but irrelevant to democracy.
They are also the best available easy mechanism for finding out what people actually want.
What you seem to be saying is that almost every single poll in the last two years has been wrong, and you are right.
But you have a record of getting stuff wrong; you seem to think the Earth is hollow; and you don't believe in the conservation of angular momentum.