[mrjonathanr]

I saw Anthony Costello (former director of maternal and infant health in WHO) questioning the UK approach on Newsnight a few days ago. He was unconvinced by British strategy.

Here's some questions for the government in the Guardian:
https://www.theguardian.com/commentisfree/2020/mar/15/uk-covid-19-strategy-questions-unanswered-coronavirus-outbreak

and in a twitter thread:
https://twitter.com/globalhlthtwit/status/1238425621375651840

[highrepute]

I openly admit I was wrong there, however, I can't assess what is not public and its a real shame this advice wasn't released ages ago to recieve proper peer review.

The paper Pete is quoting from was released in 2013.

You are seriously conflating my stated concerns about the sources of government advice now (leading to what I saw as a dangerous aim to build herd immunity) being open to peer critique alongside WHO advice, with one 2013 paper from one group involved in informing government?

When you wrote "this advice" it seemed to me like you were referring to the paper Pete was quoting from. Were you not?

[tomtom]

Leaked govt report on predictions

https://www.theguardian.com/world/2020/mar/15/uk-coronavirus-crisis-to-last-until-spring-2021-and-could-see-79m-hospitalised

300k dead..

[highrepute]

Leaked govt report on predictions

https://www.theguardian.com/world/2020/mar/15/uk-coronavirus-crisis-to-last-until-spring-2021-and-could-see-79m-hospitalised

300k dead..

Almost seems like they've read this thread...

UK government spent £500 billion bailing out the banks. Let's see how much they commit to helping us plebs get through this.

[36chambers]

here are some interesting simulations showing infection rates and ways of influencing them. No idea if the article is reliable or whatever, but the graphics are good. Apologises if it's been posted already.

https://www.washingtonpost.com/graphics/2020/world/corona-simulator/?itid=sf_

[highrepute]

Spain has closed some climbing areas. Can't quite understand why as I thought being outside was quite a good place to be. 

[Doylo]

Spain has closed some climbing areas. Can't quite understand why as I thought being outside was quite a good place to be. 

To limit the potential of people requiring the emergency services/ hospitals.

[tomtom]

Leaked govt report on predictions

https://www.theguardian.com/world/2020/mar/15/uk-coronavirus-crisis-to-last-until-spring-2021-and-could-see-79m-hospitalised

300k dead..

The document says that: “As many as 80% of the population are expected to be infected with Covid-19 in the next 12 months, and up to 15% (7.9 million people) may require hospitalisation.”

[petejh]

You've gone all Trump from intially accusing others of exaggerating how bad this will be, to doing it yourself.

Offwidth. I thought this was total bullshit when I read it. But just to confirm, I've scanned back through the last 23 pages of this thread and checked every one of my posts. There isn't a single post made by me accusing anyone of exaggerating how bad this will be. Take 15 minutes and look for yourself, and when you're done please come back to me and apologise for characterising me that way. Yet more unsubstantiated bullshitting from you.

BTW it wasn't me who smote you for endless Guardian links, that was TB..

My posts give my view, as matter-of-factly as I can, on what I see happening and what looks most likely to my non-expert, non-medical-profession mind based on a reading of the facts as they emerge, and attempting to put them in historical context.

That leaked report is pretty much what the facts were suggesting middle of this week. Unfortunately, each time I've been correct in my predictions of how this will play out. Today in the climbing wall and elsewhere, most I spoke to were still in some state of denial about the long-term outlook, but the truth was dawning. Things will change next week.

[Adam Lincoln]

Spain has closed some climbing areas. Can't quite understand why as I thought being outside was quite a good place to be. 

A lot of these climbing areas are next to villages full of old people. Thats the reason margalef was first to stop climbing.

[petejh]

Ru, I was about to reply that you can't 'drip feed the medical professionals the whole truth' but keep it from the public as you suggest the government might do. They are one and the same thing, as this just proves.
Truth's out now, we can all prepare accordingly.

[tomtom]

Ru, I was about to reply that you can't 'drip feed the medical professionals the whole truth' but keep it from the public as you suggest the government might do. They are one and the same thing, as this just proves.
Truth's out now, we can all prepare accordingly.

What would Dom do Pete?

😃

[petejh]

Ha.Ha.

Probably looking into best way to jerry-mander ventilator technology in the short term and showing non-experts how to run them for when the experts are off ill or not available. Advance proper ventilator tech in the medium-term - if we can make iphones do the things they do then we can make ventilators do things better with billions to spend. Problems will obviously be resources, predict some mining jurisdictions will withold.  That will be one thing among hundreds of actions to look at. Global co-operation required, but global selfishness will be more likely at certain points in time during next 2 years for those with the resources.

My back of the envelope estimation the middle of this week was 650,000 deaths in the UK.  That's what I meant when I was saying the government was, quite wisely, drip-feeding this to the public.

[Ru]

Ru, I was about to reply that you can't 'drip feed the medical professionals the whole truth' but keep it from the public as you suggest the government might do. They are one and the same thing, as this just proves.

I quite purposely didn't suggest the government might do that. I said that whilst reducing panic in the general public is a wise aim, vagueness, contrary statements and statements that appear to be incorrect after scrutiny won't achieve that. I then said that drip feeding any plan to medical professionals was a bad idea. At no point did I suggest that the government could successfully tell the public one thing and the professionals another.

[tomtom]

Frankly - drip feeding information to the people is an excuse not a reason.

If you have no firm plan - don't know what is going on - are making it up as you go along - then you get a drip feed of information.

People can make rational decisions about how to plan for events that will reshape our world over the next 12 months - if you provide them with a plan, or a sequence of what is expected to happen. This should be backed up by the data, the reasoning why so people can (a) belieive the decisions and (b) make more nuanced decisions based on the wider analysis. If we are not getting this - its because IMHO the government don't have it.

To address this - I see today that #10 and BJ are going to have daily press briefings. This is a good idea in general. But please, put up the CSO and CMO instead of the blonde cluster fuck who will just give a simplified headline driven version of what the scientists are saying. AND CSO and CMO - please give some references/data.

I find it DEEPLY ironic that we knew so much about this virus SO early because the Chinese scientists posted all their findings online/open access. From data about its spread to its sequencing. YET, our own government hide their data and their analysis (presuming they actually have any aside from back of fag packet scribbles) from the rest of the world. If we have a great way of dealing with things - why are we not sharing this with everyone else? This alone leads me to believe our decision is basically interpretation (e.g. oppinion) rather than numbers. 

[eastside]

Spain has closed some climbing areas. Can't quite understand why as I thought being outside was quite a good place to be. 

From what I understand Spain has basically closed everything other than medical services, pharmacies, grocers, and other essential services. My friends in Albarracin aren't allowed to leave their apartment for any other reason

[Offwidth]

You've gone all Trump from intially accusing others of exaggerating how bad this will be, to doing it yourself.

Offwidth. I thought this was total bullshit when I read it. But just to confirm, I've scanned back through the last 23 pages of this thread and checked every one of my posts. There isn't a single post made by me accusing anyone of exaggerating how bad this will be. Take 15 minutes and look for yourself, and when you're done please come back to me and apologise for characterising me that way. Yet more unsubstantiated bullshitting from you.

BTW it wasn't me who smote you for endless Guardian links, that was TB..

My posts give my view, as matter-of-factly as I can, on what I see happening and what looks most likely to my non-expert, non-medical-profession mind based on a reading of the facts as they emerge, and attempting to put them in historical context.

That leaked report is pretty much what the facts were suggesting middle of this week. Unfortunately, each time I've been correct in my predictions of how this will play out. Today in the climbing wall and elsewhere, most I spoke to were still in some state of denial about the long-term outlook, but the truth was dawning. Things will change next week.

[Offwidth]

Offwidth. I thought this was total bullshit when I read it. But just to confirm, I've scanned back through the last 23 pages of this thread and checked every one of my posts. There isn't a single post made by me accusing anyone of exaggerating how bad this will be. Take 15 minutes and look for yourself, and when you're done please come back to me and apologise for characterising me that way. Yet more unsubstantiated bullshitting from you.

The Trump thing was a pretty obvious joke for exaggerated effect (for the record I think you are nothing like the orange one).   On March 5th on one of your first serious posts on the data you clearly implied the death rate that I and others were worried about was exaggerated, being likely 1% (as the CMO said so)  and argued this through several posts.  (WHO maintained throughout it is 3% or more when the health system can't cope). You clearly implied my concerns over the government stopping daily release of data were exaggerated.  You also said some of the twitter posts on that link were bordeline hysterical when the worst then seem to me similar to you current position now. You said China we aren't... China released huge amounts of data to help the world, despite being an information dictatorship ....we as a democracy seem to be struggling still.

[Offwidth]

Roy Lilley's latest post (I disagree with a fair bit but it wouldn't be fair to only post what he says when I agree

https://ihm.org.uk/roy-lilley-nhsmanagers/


"Spread it... News and Comment from Roy Lilley

The 15 Puzzle, the Five-Room Puzzle, the Three-Cups problem... as nothing, compared to the Corona-Triangle. How to reconcile balancing the numbers and the NHS coping, with; creating herd immunity with protecting the vulnerable and saving the economy.

Herd immunity? Normally, if about 60% of people catch the virus and survive they can get-on with keeping things ticking over and we'll have immunity when the virus pops-up, again, in November or next year.  We don't know if COVID-19 will behave 'normally'. 

The plan?  Let people infect each other to the point when the NHS is reaching capacity... balancing the numbers going into hospital, with the ones going home, recovered or not survived. Timing a ban on large gatherings and school closures enables them to throttle up, or down, infection rates.  However, it's been kicked-into-touch.  The public and the sports authorities have done it.  Bang goes a chunk of herd immunity assumptions? I can envisage families, that can, taking their kids out of school.  Head teachers and governors will be in a tricky spot to enforce attendance. Italiano-lock-down is ok but when you open up again, the infection comes back.  Like snuffing out a forest fire.... a wind will reignite it.  We are alone in our strategy.  If it works... we'll come out immune and streets ahead. BoJo is following sophisticated science.  Public opinion mustn't force him to abandon it and follow politics.

Protecting the vulnerable?   There are 120,000 vacancies for social-care workers.  Frankly, it's broken.  Care Homes have already imposed a lock-down.  Who will look after yer granny or the disabled at home?  Enter Deliveroo, Just Eat, Uber Eats, Meals-on Wheels bolstered with student volunteers and Army kitchens.Cocooning Granny, means volunteers, training, police-checks and more time than we have.  Er, when we close the Uni's we'll have lots of volunteer students. 

The economy?  Supermarkets can't deliver their 'no-shortages', promise.  They're blaming us and are naive. Naivety is dangerous.  Of course customers stock pile and empty shelves reinforce mistrust.  Of course families, faced with self isolation, will buy bog rolls and everything else. Behavioural science, the study of why we do, what-we-do, isn't complicated.  We rat run the traffic, walk across the grass and do what's easy and in our best interests. If we cut our number of contacts in half, we halve the risk, so we don't go to restaurants, bars, shopping and the cinema.If we see empty shelves, we'll stock-pile. Airlines aren't taking off and the high street is in nose-dive.  The economy losing traction.

The numbers?  Here's a guess; In simple terms; if someone dies today, assume they were in the NHS for ten days and before, for 7 days, asymptotic/symptomatic.  If we assume a death rate of 1%, that means 17 days ago 100 people were alive and had Covid-19.Assume the numbers double every 4 days... that means, from 100, we go to 200, 400, 800 in 17 days... but it's my guess.  We haven't counted them. We know, 21 people have died and when, so we can forecast, by tracking-back, make assumptions and some guesswork.  That is all it is...  I'll leave you to explode your calculator, to create a spread sheet.  It's not rocket-science.  The variables; the death rate, one, two percent or more and the compounding effect, four days, three or two?   Tiny adjustment give huge variations. Einstein said; compounding is the eigth wonder of the world... it redefines avaricious.   Virologists plan the 'stages' of disease and a virus rips them up.
  
The NHS? Add a dose of Corona to  'normal' sickness rates, about 4%, people self isolating and painting the kitchen... there might be two million days lost a month?  More? Corona' gives us pneumonia, hospitalised patients need ventilators.  The very sick, kit to support kidneys, liver and heart.  We are ranked 24 out of 31 for the number of IUC beds.  We might be facing a seven-fold-plus, increase in demand.  We know the NHS is in competition with every other healthcare system in the world, to buy more ventilators... they're all struggling. By all accounts Germany has bought 10,000. Hence, BoJo is asking for engineering companies to make more.  Good luck with getting around international patents.  Here's how to make them, via open source, to avoid patent problems.  My guess, we'll need at least 30,000.

All this and it's only Monday!  My advice; wash yer hands, pretend you have the virus and behave like you don't want to spread it."

[petejh]

I find it DEEPLY ironic that we knew so much about this virus SO early because the Chinese scientists posted all their findings online/open access. From data about its spread to its sequencing. YET, our own government hide their data and their analysis (presuming they actually have any aside from back of fag packet scribbles) from the rest of the world. If we have a great way of dealing with things - why are we not sharing this with everyone else? This alone leads me to believe our decision is basically interpretation (e.g. oppinion) rather than numbers.

Assuming you're joking because I think it should be clear by now that there isn't a great way to deal with this..
 
The rest are all fair points, not disagreeing, but have you read the SPI-M document? If not I think you should, as should anyone wanting to understand more about the possible responses and their likely effectiveness. Looks to me that they're following the advice in SPI-M almost to the letter. Given that this advice is the summary from the group of people dedicated to modelling this kind of event then I think that's the best they can do. The maths modelling behind SPI-M hasn't been made widespread knowledge, AFAIK?, but at least one of the modellers involved in the group has been tweeting.

The obvious points are that covid19 will spread throughout the global population over the next year or so. No response anyone has in their arsenal can stop it - the only way to do that would be to put the entire UK/Europe/US into total lock-down for the next 12 months - not possible. We're only in the start of the rise, 16 weeks still to go until the peak and the infections double every 3-4 days. You don't need to be a maths professor to understand the numbers that will ultimately be involved here.
But we can delay the infection in the group most likely to need hospital i.e. over age-60 and/or underlying ill-health. And try to deal with the carnage best as possible, which at times won't be possible. 


edit: BTW, good info from French health minister. If you get covid19, don't use Ibuprofen. It reduces the effectiveness of the body's immune response by blocking inflammation, and increases risk of a more severe reaction to covid.(turns out it came from an article in Lancet dated March 11th, investigating drugs used in heart conditions and diabetes and their potential negative health impact in covid19.  Possible effects of ibuprofen came from that, but not proven.

[tomtom]

Not sharing our science findings is really shit.
Its nearly as shit as trying to buy out a vaccine company to ensure US exclusivity.
Not quite as wanky - but on the same page of shit things to do during a global pandemic.

Because they're not being shared - it makes me think its because they are
(a) crap and too embarassed to share or
(b) don't exist and are based on 'best professional judgement' which in my field is also called guessing.

[spidermonkey09]

Struggling to square the info not being released with my impressions of Vallance who seems a thoroughly reasonable and very competent guy. That said he clearly got the 'herd immunity' bullshit badly wrong/ communicated it badly at least.

[petejh]

Not sharing our science findings is really shit.
Its nearly as shit as trying to buy out a vaccine company to ensure US exclusivity.
Not quite as wanky - but on the same page of shit things to do during a global pandemic.

Because they're not being shared - it makes me think its because they are
(a) crap and too embarassed to share or
(b) don't exist and are based on 'best professional judgement' which in my field is also called guessing.

Gov has just announced that the modelling data is to be shared today or tomorrow.

edit: I don't see it altering anything about the outcome, it will just result in a lot of smart people feeling empowered to add their opinions along with all the dumb people like me. Open to hearing new info that changes everything.. But still fail to see how there are any other possible options open except:
a. 100% worldwide lock-down for 6-12 months. Surely impossible.
b. 100% worldwide lock-down of 4-6 weeks. Surely ineffective and more costly to health in the long-term.
c. various variations on 'carry on with no long-term lock-downs'. Possible but very costly to life.
d. targeted lock-down of most at risk. Possible, still costly to life, but less costly than 'c'.

[Fultonius]

Pete, What about b & d, then d?

I.e. massive lock down now, to curb the initial exponential increase globally. Then, total lock-down for those "most at risk", to prevent infection and to slow the rate of infection. This will go on for months.

Once the initial surge is over, life should go on while still trying to maintain distance and being extremely cautious mixing with "at risk" people. That way the healthy get it, not all at once, but spread over months, and transmission to the "at risk" is minimised.

Part if me wants to get it now, then I'm free (as far as most scientist seem to think...) to get back to work (somewhat essential job in energy, but not really) and get on with helping people in need.

[Fultonius]

Leaked govt report on predictions

https://www.theguardian.com/world/2020/mar/15/uk-coronavirus-crisis-to-last-until-spring-2021-and-could-see-79m-hospitalised

300k dead..

And, let's see if they "socialise" the losses of the rich again...

Almost seems like they've read this thread...

UK government spent £500 billion bailing out the banks. Let's see how much they commit to helping us plebs get through this.