[Johnny Brown]

Unfortunately Gav, the proven response to pandemic threat is to over-react, and over-react early. Wishful positive thinking only leads people not to take the simple basic steps that could control it.

I'm pretty sure a month ago you have scoffed at the number of cases and deaths we have now. The speed things are now accelerating should surely be concerning. Everyone still carrying on as normal is only contributing to the body count.

[petejh]

To counter all the news about how bad it is in hospitals at the minute i have family working in hospitals in north east, a doctor and a buyer. The buyer is manic busy spending millions on stuff in prep for what ever happens, they have re opened old wards and got more beds etc. However they both say the hospitals are really quite, way quieter than normal and all is calm. There is a sense that something is about to happen but at the minute its quiter than a normal March.

Silvia Stringhini, an italian doctor on twitter ten days ago:

4/ I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly "emptied", elective activities were interrupted, intensive care were freed up to create as many beds as possible.

5/ All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.

6/ I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least.

7/ The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace.

8/ The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia.

11/ Cases are multiplying, we arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.

13/ Someone already to be intubated and go to intensive care. For others it's too late... Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before.

Yet again i love how you can really bring any positivity down to earth with a bang. I really hope i never get stuck in a lift with you.

225000 cases, 9277 deaths and 81000 recovered world wide still is so far away from what people are saying will happen, so i am still trying to sort out real stuff and look on the bright side.

I think one way to get a realistic idea of what's likely to unfold this year in the UK is to take a look back to fatalities in UK from last Sunday, and the week before that, and the week before that, and the week before that. Then look at today's fatalities. Two weeks ago 2 fatalities wasn't looking too bad compared to Italy, last week 11 fatalities wasn't looking too bad relative to Italy. Today 104 fatalities isn't looking too bad relative to Italy. We're doubling every 3-4 days. It's at the point of rapid acceleration, firstly in London then in other large population centres.

That isn't being pessimistic or doom-mongering it's just the reality of what's happening and what will happen given the behaviour of the virus.

Then research what the models say about how long the virus will be around for and when it will peak. Research the difference for total lock-down versus no action taken. Then add in some guesstimates for overwhelmed or not overwhelmed health care.

Then look at the same retrospective fatality figures for the 'best' countries: S.Korea, Taiwan, Singapore; versus the 'worst': Italy.

According to our CSO the UK is looking most likely to have an outcome worse than S.Korea and better than Italy. Which covers a lot of different outcomes! He's suggested 20,000 excess dead will be a good outcome, but I'm sure I either heard him say or saw it written somewhere (will check) that this is by August. This won't be finished by August. I think many people haven't picked up on that or are in denial, and the media haven't pressed that point.

[gme]

There's positivity and there's wilfully ignoring the facts for the sake of positivity. Looking on the bright side is great but it sounds like (I may be wrong) you're saying its all a fuss over nothing.

You are wrong.I have not ignored any facts and only state the ones i am given. I am dealing with this on an hourly basis both here, in Holland and in belgium trying to keep 250 people employed, A lot of them are really scared, not of the virus but of loosing there jobs so if i took the negtive approach many have it doesnt really help them all.

However i still think the deaths and infection numbers people are quoting are vastly overstated but only time will tell. If i am wrong i will happily admit it but i am confident im not. 300-600 thousand people die from flu each year and so far we have 8000 from this. Not convinced it will reach anywhere near our normal figures plus a lot of the deaths will be from people who possibly would have died from something else.

[gme]

Unfortunately Gav, the proven response to pandemic threat is to over-react, and over-react early. Wishful positive thinking only leads people not to take the simple basic steps that could control it.

I'm pretty sure a month ago you have scoffed at the number of cases and deaths we have now. The speed things are now accelerating should surely be concerning. Everyone still carrying on as normal is only contributing to the body count.

A month ago i would have thought the situation was going to be much worse and the deaths way higher, hence my sceptisim of the higher end figures coming out.

[petejh]

Some other giveaways of the magnitude of this one are:

a. The markets aren't dumb, they don't' react this way to a bad flu year or even a doubling of a bad flu year, or Ebola/SARS/etc.
b. Government epidemic plans which state that, for very serious pandemics, total lock-down is 'probably impractical' and not likely to be effective in the long-term. Then square that fact with the fact that governments worldwide are anyway choosing the 'probably impractical in the long term' option to try to reduce the numbers of fatalities.
c. Then square that 'probably impractical in the long-term' bit with the economic destruction governments are wilfully inflicting on their nations, to try to reduce the numbers of fatalities.

[Falling Down]

Quick report from London town:

I ventured out for the first time this morning after ten days in self isolation following symptoms last week.  Walked down to Harrow Road to do some food shopping as I was worried about the rumoured/confirmed (and by midday denied) lockdown.  Lots of people out in masks and gloves, buses looked half full. There was a massive scrum of people outside Iceland at 08:30 waiting for it to open. It was orderly and quiet in the Co-Op with restrictions on key items.  The good thing about round here is all the middle eastern, Indian and Caribbean shops so I was able to get fresh fruit and veg and fish.  The guy on the stall said the wholesale market was a bit chaotic this morning. The pharmacy had a one-in-one-out policy and a two metre no-go zone in front of the till.

Labourers and builders are doing their thing down the road and the construction sites are operating. Tradesmen going around doing jobs.

At our place, we're all working remotely now including loads of our clients too.  At work we have 19 in self-isolation and one quite ill (with pneumonia) in their early 40's.  I have clients at the two biggest supermarkets and they're all working hard to keep the shelves stocked (everyone from head office doing shifts in stores like at Christmas time) and are ramping up the click 'n collect capabilities across the board to address the shortage of home delivery slots and the volume of people in stores.  Supply chains seem OK and one said that it was tougher early on for non-food items when China was closed down.

W is still working at the beer and wine shop although they have stopped on-sales (they have a small bar) and they're doing loads over Deliveroo.  She's expecting restrictions to come in over the next few days.

Outside of work, I'm seeing my therapy clients over Zoom sessions and our training college is shut.  I have a little backyard that's a real blessing to be able to go and sit in the quiet and do some weeding and stuff.

Anyway, thought that might be of interest to some.

[robertostallioni]

cheers for the update FD

[Oldmanmatt]

Some other giveaways of the magnitude of this one are:

a. The markets aren't dumb, they don't' react this way to a bad flu year or even a doubling of a bad flu year, or Ebola/SARS/etc.
b. Government epidemic plans which state that, for very serious pandemics, total lock-down is 'probably impractical' and not likely to be effective in the long-term. Then square that fact with the fact that governments worldwide are anyway choosing the 'probably impractical in the long term' option to try to reduce the numbers of fatalities.
c. Then square that 'probably impractical in the long-term' bit with the economic destruction governments are wilfully inflicting on their nations, to try to reduce the numbers of fatalities.

Reports of Italy’s badly hit areas being overwhelmed. Hospitals with critically ill people, not just the dead. Morgues over run.
But not outside of those areas, yet.
So, surely it’s reasonable to conclude that the measures taken have mitigated the worst effects (hopefully).

Even without doing an iota of statistical analysis or even very much reading, that “overwhelming” of the system is not a typical feature of seasonal flu, even in a bad year. Add to that, the very short time frame (what is it now, 3 weeks? What’s a flu season? Almost 6 months?) and this is bloody obviously much worse.
Then add in everything Pete just pointed out.
Then consider that this is not “media driven hype”, it’s “Top Expert driven” Government intervention, which leads the media’s reporting by several hours (in the main) despite it’s apparently dynamic, change by the minute, nature.

It’s probably reasonable to say “it’s not the Black Death”, but it’s a damn few tens of notches up from even a bad flu season.

[abarro81]

This won't be finished by August. I think many people haven't picked up on that or are in denial, and the media haven't pressed that point.

This seems the most hard to fathom part of this from the selfish point of view of direct impact to my life (until/unless parents get ill)... A month back I was thinking I'd still be going to France at Easter. 2 weeks back I was thinking it was unlikely but you never know. My current working assumption is that we wont be leaving the country for recreational purposes during 2020.

[JamieG]

Just as a counter example to the old versus young taking it seriously debate.

I have a PhD student that is asking for special permission to carry on going into uni (its basically closing on Friday except for very specific cases). Since working from home is not ideal! Apparently so are a couple of the postdocs. One of whose main work is modelling on his laptop. FFS!

I have basically told him "don't be ridiculous" in a not so subtle round about way. I would have really thought our graduate students were more sensible.

[Oldmanmatt]

https://www.dispatchlive.co.za/news/2020-03-19-italy-orders-army-to-take-bodies-from-coronavirus/

An example of “overwhelmed”.

Anyway, to add another point for consideration to why the Governmental response might seem excessive, compared to the current casualty figures. Both here and other affected nations.

I expect they are better informed about the prognosis of a good few people, under care, not yet added to the final list.

[Oldmanmatt]

The primary school of my two youngest, just sent us a letter.

The school has been instructed (their words) to remain open to provide child care for key workers, throughout what would have been the Easter holidays.
All staff have had leave canceled.

They have said they will provide a list of key employments, tomorrow, when they receive it.

Anyone else hearing this or similar?

[Stu Littlefair]

Gav,

Both your pessimism a few weeks ago and optimism now aren’t supported by the numbers. Case rates and deaths in Europe have followed a very predictable growth rate with little sign (yet) of suppression methods helping. You could have predicted today’s numbers with some confidence 2 weeks ago.

If you extrapolate that trend forwards it ain’t good I’m telling you.

We will only avoid an all out cluster fuck (hundreds of thousands in the UK dead) IF the social distancing works and people take it seriously. If people can be made to stick to that then you’ll be right and this will look like a bad flu year from a health standpoint.

However, I’m more optimistic than Barrows and Pete. The grimmest scenarios painted by, for example, the UCL doc suggest we’ll have to keep this going all year, but there are some possible end games.

1) Antiviral drugs might be found that would reduce the hospital stay of a critical sufferer. If this can come down from 15 days to 5 we could let infections rates triple and the amount of time we’d be stuck in special measures would come down by the same amount.

2) There’s an alternative model that combines massive testing programs with mobile phone tracking that would allow governments to successfully isolate the currently infected and those they come into contact with.

This would require a massive effort to speed up testing and people accepting a major infringement of privacy though.

3) if a test can be developed to detect those who have recovered and probably immune they can go back to work and keep things going.

Some combination of these three might offer a way to avoid lockdown till 2021

[TobyD]

This won't be finished by August. I think many people haven't picked up on that or are in denial, and the media haven't pressed that point.

This seems the most hard to fathom part of this from the selfish point of view of direct impact to my life (until/unless parents get ill)... A month back I was thinking I'd still be going to France at Easter. 2 weeks back I was thinking it was unlikely but you never know. My current working assumption is that we wont be leaving the country for recreational purposes during 2020.

I would probably agree with that. For a start quite a few airlines will likely be out of business. And sterling will be so devalued that we won't be able to afford to buy fuel or food if you were abroad

[mrjonathanr]

The primary school of my two youngest, just sent us a letter.

The school has been instructed (their words) to remain open to provide child care for key workers, throughout what would have been the Easter holidays.
All staff have had leave canceled.

They have said they will provide a list of key employments, tomorrow, when they receive it.

Anyone else hearing this or similar?

We will be open for key offspring over Easter- staffed on a volunteer basis. I will go in a bit.

Lessons here will continue, as normal, but remotely. Registers, homework, same timetable etc.

Stu- the test to identify antibodies alone would change things immeasurably. I’d guess this is the most achievable?

[tomtom]

The primary school of my two youngest, just sent us a letter.

The school has been instructed (their words) to remain open to provide child care for key workers, throughout what would have been the Easter holidays.
All staff have had leave canceled.

They have said they will provide a list of key employments, tomorrow, when they receive it.

Anyone else hearing this or similar?

Yup. The school is waiting for the DFE letter with the info. MrsTT is an NHS worker and considers herself not completely essential - but her employer is insisting she comes in and doesn’t work from home. So she may well be essential.

Amongst her colleagues much confusion as to whether the NHS key worker school cover thing is of one partner is NHS and the other working? Or only if both are NHS keyworker etx...

[mrjonathanr]

Accirding to NASUWT update, only  if both ie if one parent at home to cover, then child stays with them.

[tomtom]

Accirding to NASUWT update, only  if both ie if one parent at home to cover, then child stays with them.

So not if they’re working from home... 🤦‍♂️

[Stu Littlefair]

As if someone up there is reading my UKB posts...

https://www.itv.com/news/2020-03-19/boris-johnson-says-mass-testing-for-coronavirus-is-now-official-policy/

[Paul B]

IF the social distancing works and people take it seriously. If people can be made to stick to that then you’ll be right and this will look like a bad flu year from a health standpoint.

Stopped at the top of a hill today to cram some sugar down my neck (Stu you'd really like cycling) and a car full of grey haired people having a picnic on the other side of the road jokingly shouted at me not to come any closer as they were self isolating. They said they were on their last trip out before perhaps they weren't allowed and then joked they'd be going out anyway.

I suggested I was doing the same in case recreational cycling wasn't allowed. They were fully outraged at the prospect of this especially when I pointed out that France/Spain had measures in place covering sport such as climbing. When I suggested it was to ease unnecessary pressure on our healthcare system the penny seemed to drop.

[BrutusTheBear]

I can report the info and action from the  secondary school I work at.

School will be open for children of key workers,  they will be split into year groups and primarily based in various IT suites around the school site.  Subject teachers have been asked to set work for their classes daily using an online system.  Pupils attending school will be supported with their work by the staff there but no formal lessons will be offered.  The same work will be set for pupils at home.

The school will be open for children of key workers over the Easter break.

I am not working and self isolated, I will not return to work to protect my wife whom is high risk. 
I have one member of staff whom is pregnant, one who’s partner is a key worker that will be looking after his children, one who has a daughter with SEN (that has been sent home from her residential school) and a husband whose recovering from a stroke.  This leaves 1 member of staff from my unit for pupils with autism.  Suffice to say we’re closing it.  Have arranged online support for my cohort and for my staff to ‘key work’ a couple of pupils/families each. 

[BrutusTheBear]

Meant to add, it would be ideal if I could get tested to confirm I’ve had it/my wife’s had it and then I can get on and help people at work and in the wider community.

[mrjonathanr]

Sounds difficult Brutus, good luck with that. I take it this means you are more or less isolating yourself indefinitely then?

Report on Bloomberg about dangers to young people:
https://www.bloomberg.com/news/articles/2020-03-19/coronavirus-in-young-people-is-it-dangerous-data-show-it-can-be

[BrutusTheBear]

Sounds difficult Brutus, good luck with that. I take it this means you are more or less isolating yourself indefinitely then?

Report on Bloomberg about dangers to young people:
https://www.bloomberg.com/news/articles/2020-03-19/coronavirus-in-young-people-is-it-dangerous-data-show-it-can-be

It is what it is and I am sure our situation is better than others.  I am self-isolating indefinitely.

We have all being ill to some degree or another, my son developed a temperature yesterday that peaked at 39C. Calpol every 4 hours and a good nights sleep has left him a normal temp and a cough today.  Scary moment though.
The idea that some youngsters won’t get very poorly is clearly a myth.

[mrjonathanr]

Accirding to NASUWT update, only  if both ie if one parent at home to cover, then child stays with them.

So not if they’re working from home... 🤦‍♂️

Apparently yes, now...
https://www.theguardian.com/world/2020/mar/19/children-to-attend-school-if-one-parent-classed-as-key-worker