[Oldmanmatt]

It’s not really fair to try and say “we had no choice because we’re not an authoritarian regime like China, so none of this can be helped”;

Pretty sure I'm not saying that.


I agree there'll be no shortage of questions and answers.

Not in those words. You did say “or if a political system like China does.... then we could done things differently” so I just sddressing that point.

[Oldmanmatt]

Anyway, it’s late, so here’s a bedtime story.

N’night.

[Offwidth]

It would however, have been doable to impose a lockdown a week to 5 days earlier, and I think it would have got traction - that would certainly have saved a lot of lives, but it's hindsight, and I don't think the gov have been that bad with the timings.

The lack of test and trace, on the other hand is a fucking scandal and once this is over there should be some consequential questions asked of those responsible.

Why are people insisting on comparisons to China - it's clearly not a good fit. S Korea is much better in size and liberties - they have the huge advantage of experience of SARS and MERS (Covid is basically SARS2 as I understand?), but we should have been looking to them from the start

I don't think any significant earlier lockdown was likely possible by this government. In the 6 days preceeding the first serious social mobility curtailment on March 18th the deaths had increased from 10 to 104. This clearly caught the government and their models out. Despite this slightly late call, with really scary increases in numbers, the foolish section of our country still saw the Sunday following that announcement as a final chance for some kind of mass holiday. Elsewhere, mobile phone data was showing a million leaving Paris, which makes me think what might have happened in London if Boris had called a lockdown on 35 deaths, just 3 days earlier.... it must have risked causing mass panic (Madrid and Lombardy had a similar exodus).

As I said at the time, almost every scientist I knew and trusted when looking at that data was saying we were close to 2 weeks behind Italy and the government relied on modellers who said 4 (then only recently down to 3 and now pretty much 2). Despite this I don't think the government timing was so bad, as it seems that it was more based on that quick increase in deaths. I'm saying this even though I wanted them to lockdown earlier. The government relied too much on mathematical models (the wrong ones it seems)  and behavioural science (which I think seems to have been about right)  and too little on public health  expertise and on doctors experienced with fighting virus outbreaks ... to scare them away from complacency ((see the Guardian links below).

The testing has been a shambles and is THE major scandal, with PPE not far behind. There is no joy in being proved right that our government were so wrong on this (and on the other factors). Again see the Guardian links below. I think this goes well beyond the politicians, as indicated by hospitals trying to gag staff who were reporting testing and PPE issues. I also think its crass to call this political point scoring when it has unnecessarily cost so many public lives and added a lot of risk to our health and care workers (and sadly some deaths).

https://www.theguardian.com/world/2020/apr/01/absolutely-wrong-how-uk-coronavirus-test-strategy-unravelled
https://www.theguardian.com/commentisfree/2020/apr/01/public-inquiry-coronavirus-mass-testing-pandemic

I have pointed out several times that although S Korea have done well they were also initially unlucky... they had a superspreader in a cult church; so they started the early part of their outbreak in a worse state than anyone else.

Still many people on social media are clutching at straws, be it the laxer situation in Holland and Sweden (following our data by over a week, maybe slightly worse given per capita infection rates), the Oxford paper, the Spectator articles. However, when something this scary and horrible happens anyone can be forgiven for seeking false solace. The scariest thing to me is what will happen in the US in terms of deaths, what happens to their poor and homeless and the potential depth of world recession it might induce.

On the plus side most people have behaved well after that Sunday blip and some amazing ideas, coordination, and action has happened on the edges of the outbreak response (linked on the positive thread). Maybe we can come out of this with less attachment to the worst excesses of global capitalism and in that help avert a climate disaster that, just a few months back, seemed almost certain to be coming.

[tomtom]

Morning everyone - hope you’re all well.

Aside from the PPE/Testing coronashambles that’s unfolding - one article in the Indy caught my eye - https://www.independent.co.uk/news/uk/home-news/coronavirus-uk-cases-nhs-symptoms-111-update-death-toll-a9440246.html

Where 1.75 million 111 (online and phone) enquiries were flagged as being potential CV19. Whilst many of these could/were have been other viruses/colds it provides an upper limit on how wised spread it could be..

[galpinos]

In light of H1N1 and SARS, the our government and public health bodies put quite a bit of effort into modelling/analysising what might happen in the UK if we had an Influenza-type pandemic. This was looked at as medics have no answer to a viral infection like this, there is no cure, there is no vaccine, they can just support/help the patient fight it off themselves. The medical outputs of these sessions, especially the 2016 one was:

• We need to test test test
• We have insufficient ventilators for the respiratory support required
• We have insufficient PPE to contain in hospital infections and should start a stockpile

It's pretty depressing that we were well aware of this but the government now claims it has taken them by surprise. At the end of Jan, Matt Hancock's statement to the Commons said the risk to the UK was low and that, though there was a small chance of people in the UK getting infected, we are, "well prepared and well equipped to deal with them".

Re an earlier lockdown, though it seems like we should have locked down earlier, I'm not sure whether the public would have bought into it. We were told it was a bit like getting the flu, Boris was joking about shaking hands with everyone in a hospital with patients with Covid-19 and we, the nation, are already looking for loop holes to get out of it.

I also think that if we start antibody testing, so people who've had it can start to go out/work etc as I have seen proposed, that will be the absolute end of the lockdown.
 

[tomtom]

I also think that if we start antibody testing, so people who've had it can start to go out/work etc as I have seen proposed, that will be the absolute end of the lockdown.

That’s a super important point. Controlling the return back to work could be really hard... if you let a few back there will be all sorts of shit going on. People doing tests for their mates, people not wanting to go back. People who’ve not had it being really nervous / resentful of those returning...

Hard to see how you manage it other than an all back or no one back scenario.

[galpinos]

That’s a super important point. Controlling the return back to work could be really hard... if you let a few back there will be all sorts of shit going on. People doing tests for their mates, people not wanting to go back. People who’ve not had it being really nervous / resentful of those returning...

Hard to see how you manage it other than an all back or no one back scenario.

I agree, a partial return for the "immune" will lead to people looking at those out and about and just thinking, sod it, I'm going out too, people trying to get infected in order to recover and then go out and find work, it could only be policed bif we bring in some draconian rules, there will be no end of issues.

There doesn't seem to be a plan to end the lockdown. I would like to say that obviously the government will have a plan but my confidence in them isn't exactly soaring at the moment.

[Oldmanmatt]

I’ve woken to a world where both the Mail and the Telegraph have turned on Boris. Both their front pages are pretty scathing.

https://www.bbc.co.uk/news/blogs/the_papers

[chris j]

There doesn't seem to be a plan to end the lockdown. I would like to say that obviously the government will have a plan but my confidence in them isn't exactly soaring at the moment.

I'm not sure any non-communist dictatorship country has a feasible plan in place to gradually reverse their lockdown so i wouldn't think too badly of the government for not having figured it out yet...

[duncan]

Holland - Economy tiking along nicely, little disruption to the constrution industry, far fewer rules and regulations, no lockdown.

How is there curve flattening more than ours and daily new cases dropping. I still cant help but think we are doing something wrong here.

https://www.worldometers.info/coronavirus/country/netherlands/

It's understandable but misleading to look at what other countries are doing now and relate it to their reported spread of Covid-19

It's unwise to pay much attention to infection rates: many countries are not testing with anything like the intensity to give a remotely accurate figure. The more valid figure is reported deaths. Death rate is not a perfect measure, it depends on age and health of populations, quality of health systems, and variation in recording (eg UK folk dying outside hospitals and Russians recorded as having pneumonia). Death rate reflects what was happening 3-4 weeks ago. So current UK deaths doubling every ~3 days reflects a time when few here were taking this very seriously. Spain and Italy look bad now but their rate of increase - the important figure - is now much lower than UK, Netherlands or US. 

This is all a huge and gruesome experiment in different strategies of disease control.  The East Asian countries that shut down hard like Taiwan and South Korea seem to be doing best job so far. I'm suspicious of whats happening in Japan and China and not sure we're getting the whole story there. Taiwan is interesting as it has tiny numbers, not coincidentally they have a strong public health service and their Vice President is a former epidemiologist with previous experience with SARS. Rather unlike the shower of chancers and bullshitters running the show in the UK and US.

[tomtom]

That’s a super important point. Controlling the return back to work could be really hard... if you let a few back there will be all sorts of shit going on. People doing tests for their mates, people not wanting to go back. People who’ve not had it being really nervous / resentful of those returning...

Hard to see how you manage it other than an all back or no one back scenario.

I agree, a partial return for the "immune" will lead to people looking at those out and about and just thinking, sod it, I'm going out too, people trying to get infected in order to recover and then go out and find work, it could only be policed bif we bring in some draconian rules, there will be no end of issues.

There doesn't seem to be a plan to end the lockdown. I would like to say that obviously the government will have a plan but my confidence in them isn't exactly soaring at the moment.

I had a text discussion with sloper about this (I think) and my view was because we don't have any national ID system it would be nigh on impossible to administer - let alone police...

[tomtom]

@duncan - the Taiwan story is being somewhat obscured by China's (powerful) insistence that it is treated as part of China.. Wifes cousin is a teacher there and from FB posts looks like a happy (as in population content) lockdown of sorts...

[SA Chris]

There doesn't seem to be a plan to end the lockdown. I would like to say that obviously the government will have a plan but my confidence in them isn't exactly soaring at the moment.

I'm not sure any non-communist dictatorship country has a feasible plan in place to gradually reverse their lockdown so i wouldn't think too badly of the government for not having figured it out yet...

I'll hazard a guess;

1) Resume as much industry / manufacturing as possible, possibly on low output, maintaining social distancing as well as possible
2) Reopen retail, with social distancing rules
3) Reopen restaurants and pubs, at limited times only.
4) reopen school / let people go back to offices
5) release travel restrictions, first locally, then internationally
6) reopen schools
7) reopen tertiary ed
Allow small gatherings; cinemas etc
9) allow larger gatherings; concerts and sports events

And if infection numbers start to rise, go back to lockdown and start again.

A guess anyway.

[mrjonathanr]

Tedros Ghebreyesus stating the WHO's advice, March 16. till we can implement this, I can't see much changing:
http://www.youtube.com/watch?time_continue=19&v=3GqhApWmFtA&feature=emb_logo

[gme]

Re my point about Holland. I am well aware of the stats and the fact that they are 5th worse in the world for deaths per population. And am aware they are following exactly the same curve as us.
However there approach is very different and as of yesterday they have no intention of changing officially announcing the restrictions are to stay in place until 28th April but not tightened. My business partner is very good friends with a minister there so the info is not via the media but straight from the horses mouth.
Most on here just seem to dismiss that there are other options other than either a full lockdown or mass testing but ignore the facts that other places are doing less without damaging there economy as much as we are.
And for all those on here that seem to think that this will somehow move us away from capitalism as we know it I fear you couldn’t be more wrong and I think it will properly fuck up the EU project.

[gme]

There doesn't seem to be a plan to end the lockdown. I would like to say that obviously the government will have a plan but my confidence in them isn't exactly soaring at the moment.

I'm not sure any non-communist dictatorship country has a feasible plan in place to gradually reverse their lockdown so i wouldn't think too badly of the government for not having figured it out yet...

I'll hazard a guess;

1) Resume as much industry / manufacturing as possible, possibly on low output, maintaining social distancing as well as possible
2) Reopen retail, with social distancing rules
3) Reopen restaurants and pubs, at limited times only.
4) reopen school / let people go back to offices
5) release travel restrictions, first locally, then internationally
6) reopen schools
7) reopen tertiary ed
Allow small gatherings; cinemas etc
9) allow larger gatherings; concerts and sports events

And if infection numbers start to rise, go back to lockdown and start again.

A guess anyway.

Would have thought this is pretty accurate but think the big business sporting events will come earlier than pubs restaurants and climbing walls/gyms. Money talks.

[Ru]

Re my point about Holland. I am well aware of the stats and the fact that they are 5th worse in the world for deaths per population. And am aware they are following exactly the same curve as us.

They are only following the same curve as us because the death rates are 2-4 weeks behind infections. If lockdowns work, our curve will start flattening off in a couple of weeks, whereas Holland will still have an exponential rise. In other words, we can't say whether Holland's approach works, or will prove to be a catastrophic misreading of the situation, for another few weeks.

[Oldmanmatt]

Re my point about Holland. I am well aware of the stats and the fact that they are 5th worse in the world for deaths per population. And am aware they are following exactly the same curve as us.

They are only following the same curve as us because the death rates are 2-4 weeks behind infections. If lockdowns work, our curve will start flattening off in a couple of weeks, whereas Holland will still have an exponential rise. In other words, we can't say whether Holland's approach works, or will prove to be a catastrophic misreading of the situation, for another few weeks.

Plus, how does losing a more significant % of your population (which is what is happening in the Netherlands) actually affect your economy, in the long term?

How will the Dutch public respond, should their death rate continue to climb, steeply, when the rest of Europe starts to plateau?

How will others view a nation, unwilling to sacrifice to preserve it’s vulnerable?

You alway focus on the economic impact GME,do you want to convince us all that it’s unnecessary?

If our lockdown, flattens that curve and people who don’t need to die, don’t, then it’s worth it.

We can’t predict what will happen, not really, only act on the best modelling  and (what are) educated guesses.

Since almost every model, without strict(ish) measures leads to exponential growth, overwhelmed medical facilities and people dying (even of things unrelated to COVID), how, how, does doing anything other than playing safe, make sense.

[SA Chris]

There doesn't seem to be a plan to end the lockdown. I would like to say that obviously the government will have a plan but my confidence in them isn't exactly soaring at the moment.

I'm not sure any non-communist dictatorship country has a feasible plan in place to gradually reverse their lockdown so i wouldn't think too badly of the government for not having figured it out yet...

I'll hazard a guess;

1) Resume as much industry / manufacturing as possible, possibly on low output, maintaining social distancing as well as possible
2) Reopen retail, with social distancing rules
3) Reopen restaurants and pubs, at limited times only.
4) reopen school / let people go back to offices
5) release travel restrictions, first locally, then internationally
6) reopen schools
7) reopen tertiary ed
Allow small gatherings; cinemas etc
9) allow larger gatherings; concerts and sports events

And if infection numbers start to rise, go back to lockdown and start again.

A guess anyway.

Would have thought this is pretty accurate but think the big business sporting events will come earlier than pubs restaurants and climbing walls/gyms. Money talks.

Sadly you may be right. Plus big sports events are a panacea to entertain the masses. Maybe they will be behind closed doors and televised only, that's where the big bucks are, not gate receipts. And all players tested before matches. I just think they will do what they can to prevent a repeat of this https://news.sky.com/story/coronavirus-champions-league-match-a-biological-bomb-that-infected-bergamo-experts-say-11963905

[duncan]

Most on here just seem to dismiss that there are other options other than either a full lockdown or mass testing but ignore the facts that other places are doing less without damaging there economy as much as we are.
And for all those on here that seem to think that this will somehow move us away from capitalism as we know it I fear you couldn’t be more wrong and I think it will properly fuck up the EU project.

Apologies if I was being patronising. What Ru said. I have not much idea what the best approach is. I take my lead from work colleagues (in a medical school public health department) who think UK decision-making has been influenced far too much by theoreticians and not enough by public health people with on-the-ground experience. But I suppose they would say that.

[gme]

Re my point about Holland. I am well aware of the stats and the fact that they are 5th worse in the world for deaths per population. And am aware they are following exactly the same curve as us.

They are only following the same curve as us because the death rates are 2-4 weeks behind infections. If lockdowns work, our curve will start flattening off in a couple of weeks, whereas Holland will still have an exponential rise. In other words, we can't say whether Holland's approach works, or will prove to be a catastrophic misreading of the situation, for another few weeks.

Plus, how does losing a more significant % of your population (which is what is happening in the Netherlands) actually affect your economy, in the long term?

How will the Dutch public respond, should their death rate continue to climb, steeply, when the rest of Europe starts to plateau?

How will others view a nation, unwilling to sacrifice to preserve it’s vulnerable?

You alway focus on the economic impact GME,do you want to convince us all that it’s unnecessary?

If our lockdown, flattens that curve and people who don’t need to die, don’t, then it’s worth it.

We can’t predict what will happen, not really, only act on the best modelling  and (what are) educated guesses.

Since almost every model, without strict(ish) measures leads to exponential growth, overwhelmed medical facilities and people dying (even of things unrelated to COVID), how, how, does doing anything other than playing safe, make sense.

I am not saying it’s unnecessary at all just pointing out that there maybe other options. I am towing the line completely both as an individual and as a business. We were actually the first to stop site works in our industry as we felt it was the correct thing to do.
I focus on the economy as I honestly think the long term damage we are causing will be far greater than the short term impact of the virus. If we think austerity was bad before it’s just got a whole lot worse.
I don’t have an answer just pointing out others are approaching it differently.

[gme]

Most on here just seem to dismiss that there are other options other than either a full lockdown or mass testing but ignore the facts that other places are doing less without damaging there economy as much as we are.
And for all those on here that seem to think that this will somehow move us away from capitalism as we know it I fear you couldn’t be more wrong and I think it will properly fuck up the EU project.

Apologies if I was being patronising. What Ru said. I have not much idea what the best approach is. I take my lead from work colleagues (in a medical school public health department) who think UK decision-making has been influenced far too much by theoreticians and not enough by public health people with on-the-ground experience. But I suppose they would say that.

A very pertinent point. We all get our ideas from those around us. I know lots of business people so I have an economic slant, others work in NHS, research, education etc so have different ideas, others use it to push politics and tell us how shit  torys are and what a bad job there doing.
The only thing we have in common is we all know we are right.

I like it on here due to this. Only place I discuss this stuff other than face to face ( well computer screen to computer screen at the minute. )

[petejh]

Gav, all you have to do to know the future is scale up Holland's total infections (not reported infections) to the hundreds of thousands (or a million). Why wouldn't this happen? In a population not in isolation why wouldn't the infection spread in people there the same as anywhere else in the world not in isolation, all other things being equal.
Then, apply an infection death rate of 0.1% - 0.26%* of all infections (not reported infections). Tells you all you need to know.


* infection fatality rate estimate from Center for Evidence Based Medicine

Taking account of historical experience, trends in the data, increased number of infections in the population at largest, and potential impact of misclassification of deaths gives a presumed estimate for the COVID-19 IFR between 0.1% and 0.26%.
This site

The site above is updated regularly with latest estimates of IFR and CFR based on updated evidence. Good for getting your head around the various fatality estimates and why they're constantly fluctuating.


About the economy I don't disagree that we'll have to change our thinking in the long term. I think the 'exit strategy' to lockdown can only follow one of two possible courses based on whether or not a vaccine is found.
Short-term: we're hoping for a vaccine, and in the meantime absorbing the economic damage. Large parts of the workforce aren't significantly out of pocket* while the government underwrites them, so the economy *can* bounce back. So lock-down for ~3months.
Long-term: if no vaccine is found then sentiment will shift towards acceptance that we have to get back to work. While mitigating as best we can for the most vulnerable. The original 'mitigate' policy.

An effective anti-viral might give us a fudge option.


* (I'm not making light of significant numbers who are out of pocket)

[petejh]

There are no human studies that show whether NAD replenishment will in fact have any effect on COVID-19 symptoms. The animal studies suggest that it might. The human studies only show that Vitamin B3s are safe and effective at replenishing NAD.

Good enough for me to buy some and give it a try if any of my family get symptoms

Another study hypothesising the role of B3 (NR, NMN or Niacin) - among other strategies - in protection against severe covid symptoms.
https://www.aging-us.com/article/102988/text

That's at least three papers now hypothesising a role for B3.

[Murph]

If the death rate is really in the 0.2% ballpark then I really cant see how this isnt a massive over reaction. We are going to be paying for this for years to come with ever decreasing living standards and hospital closures etc. That comes at a cost.

Theres some analysis to be done somewhere showing what lockdown policy is worth what death reduction and I'm not sure 0.2% justifies the current one.

Theres also the policy itself. I think a lot of countries have sort of followed china but not done a good job of it. If wuhan had a proper lockdown and lots of support from the rest of china to make that stick, then the uk lockdown is at best a minority fraction of it. Buses and trains are still running. By this stage in wuhan they had been cancelled for a fortnight.

An analogy with antibiotics - don't just take them every other day for two days, take the full dose for a week or dont bother.

Have I got this wrong still - is no cost too high to save 0.2%?