[Offwidth]

I don't agree with the idea that because we are going to overburden younger generations with footing the bill to save a few oldies the lockdown might not be worth it. Apart from some of the problematic ethics surrounding this idea and me not personally wanting to put my older relatives in the firing line, I think the idea the younger generation will need to pay is unfair. That is just the status quo of our economy and I feel it seriously needs dealing with.

It already is very hard for the young. Rising house prices, tuition fees, cuts to social security services. This country for a long time worked for the older generations and made it hard for the younger. Why can't the older generations help pay for it too? Loads of people are sitting on massively overvalued properties and land. Why don't we have much fairer tax system to help ease the burden? We used to have a fairer tax system that better supported the younger generations.

In summary, I think it is important to cut the number of deaths to as little as possible, but then we really need to make a fair tax system to get the country back on its feet. None of this 'all in this together' nonsense which was essentially an excuse to cut services but not change a thing regarding taxation.

Maybe I'm being naive.

It's not about saving more old people it's about keeping those infected from overwhelming the NHS when covid deaths will massively surge (some young people are dying now despite best NHS efforts and a much greater proortion will do so if the system is stuffed), as will subsequent deaths for all other conditions needing intensive care. In that, yes you are being naive.

I agree with your points on the lack of fairness in wealth between the old now and what the young can expect. As a result I despair that more of the young don't vote, so we can have a better chance of that fairer society through democracy.

[galpinos]

A couple more points:

I do think it's worth debating the "cost" of the lockdown. The general population might find these conversations hard but medical/NICE etc have these conversations everyday. It may sound callous, but we can't fix everything at what we can do, comes at a cost. Looking at the cost benefit is the correct thing to do, we will all differ on where we think that line is drawn.

It's worth bearing in mind, during this debate, that the mean time from onset of symptoms to death found by Verity et al* (who also put IFR at 0.66% (0.39%,1.33%)) was nearly 18 days. It's going to be while till we see the benefit of the lockdown.

Case reporting is all over the place. Anecdotal evidence from medics I know shows a lots of false negatives which will lead to under reporting of both cases and deaths, but also a reluctance to test, which will also lead to an under reporting of cases.

Spikes in deaths after the weekend are to be expected and are normally due to paperwork being filed on Monday afternoon which falls into Tuesday's count.

My mum (mid 70s) has already phoned me to say she doesn't want to take up a ventilator. I reassured her that she wouldn't get one anyway so not to worry.......

*https://www.medrxiv.org/content/10.1101/2020.03.09.20033357v1

[JamieG]

I absolutely agree with you Offwidth. Sorry I was being a bit facetious in my 'save a few oldies' comment. It is about stopping this becoming totally overwhelming to the NHS.

I have quite a few relatives and friends that work in the NHS (including on Covid wards) and I am as worried about what this is doing to their mental health, stress levels etc as much as anything else.

[SA Chris]

more than just that.

https://www.theguardian.com/world/2020/mar/28/first-working-nhs-surgeon-dies-from-coronavirus

the health risk on them due to viral load is massive.

[Murph]

When I said maybe the Dutch are right I didn't mean that they could get away with it but rather maybe they have done the maths and at 0.2% it's not worth a full lockdown.

There is - there has to be - a price that isnt worth paying or a cure worse than the disease. I'm not exactly clear who has been thinking through the consequential and emotions may be governing this.

JamieG - agree with a lot of that intergenerational divide stuff. Theres a lot of inequality in the way the spoils of the economy are shared and that's a big one. No guarantee whatsoever that it will be fixed tho. 

[mrjonathanr]

I'd urge caution with the figure of 0.2%. It sounds pretty minor. More meaningful would be the total numbers of people we expect will die as a result of different strategies. 0.2% of millions of people plus secondary deaths as a direct result of overwhelmed services is an awful lot of people. And that is without disputing the accuracy of the overall infection fatality rate, which will not be calculable with certainty at this point.

[galpinos]

When I said maybe the Dutch are right I didn't mean that they could get away with it but rather maybe they have done the maths and at 0.2% it's not worth a full lockdown.

The "maths" is currently guesswork and conjecture. In a month's time, we will see if our deaths have tailed off and their haven't? If they don't tail off because of social intervention we don't know at what point we will hit the peak, nor how high and wide that peak will be.

Italy and Spain are the only Euro/Western countries that no. of deaths are starting to flatten and they are the ones with the most draconian lockdowns.

[Will Hunt]

Does anyone else get bored of OMM not writing what he later says he means, and not reading other posts properly? 

I think you come across as rather cold.

You only wish to prove yourself correct and everyone else to simply agree with you.

If it makes you happy, yes, you irritate me.

Fight. Fight. Fight.

God I'm bored.

Is anybody else just so so ready to watch 15 stone of ex-navy meat and gristle go toe-to-toe with a 6-foot-tall tendon who wouldn't tip the scales to 8 stone? Get it on Youtube Live!

[tomtom]

Just watch for Barrows knees OMM... 😃

[tomtom]

Re: Murphy economics point - eg cost of lockdown greater than cost of not etc.. (grossly simplified - sorry).

It’s interesting that a country who has incarecetated well over a million people in one of its regions - and has a very bad human rights record chose a path of strict lockdown and treat everyone they could. None of this ventilator rationing - they simply got more to save people. My point (if it’s not already clear) is that China chose the path of contain, trace and treat rather than let it run wild... and continues to do so...

Why?

[petejh]

I'd urge caution with the figure of 0.2%. It sounds pretty minor. More meaningful would be the total numbers of people we expect will die as a result of different strategies. 0.2% of millions of people plus secondary deaths as a direct result of overwhelmed services is an awful lot of people. And that is without disputing the accuracy of the overall infection fatality rate, which will not be calculable with certainty at this point.

I get the impression from everything I'm reading* that Covid, if left to play out over say the next 24 months without a vaccine, is as lethal as Spanish Flu.
This is because Covid is highly contagious relative to SF, but with a relatively low infection fatality rate.
Whereas Spanish Flu was less contagious than Covid, but had far higher infection fatality rate.

The potential proportion of deaths per head of population (not per head infected) is similar over the long term.


I suppose back in 1918 because there was no vaccination the virus did what it did, eventually. Whereas today there is a hope of vaccine cutting short the natural progress of Covid.


*search for estimates of the infection rates of Covid versus spanish flu

[rich d]

Re: Murphy economics point - eg cost of lockdown greater than cost of not etc.. (grossly simplified - sorry).

It’s interesting that a country who has incarecetated well over a million people in one of its regions - and has a very bad human rights record chose a path of strict lockdown and treat everyone they could. None of this ventilator rationing - they simply got more to save people. My point (if it’s not already clear) is that China chose the path of contain, trace and treat rather than let it run wild... and continues to do so...

Why?

Is there any faith in the numbers coming out of China, I have no idea on this, but I've believed very little media output from the Chinese government over the decades and I can't see a world wide crisis making them suddenly trustworthy. 

[gme]

Maybe the Dutch are right. We wont know in a week or two but probably will know in a year or two.

I can't see how the Dutch can be right on deaths. We will see that by two weeks anyhow, as if the numbers follow the same trends, deaths will start to overwhelm their hospitals by then. It's not just their people they are risking by laxer social distancing, given the open borders. In the ten days after their total deaths exceeded a hundred their level was 864 (and 1039 the next day) and our total in comparison was 1019 after ten days...pretty similar in logarithmic terms when estimating the exponential growth rate. They are about 2 to 3 days behind us (growing slightly less fast at the current time) and their population would have seen more about things being bad elsewhere and likely have been more cautious with their own choices of social distancing as a result. Our population is just under 4 times theirs so their per capita deaths are right now almost exactly twice ours. Deaths follow infections roughly by 3 weeks so if our state social distancing worked better we will see in a week and a half to two weeks.

I am aware they ar following our track but we put far more constrictive measures in place 10 days ago whilst they stuck to there guns, yet we are still roughly alingned, in fact there figures have flattened a little. Would we not have started to see a difference by now? How long do you think we will need to wait until the accelerate past us, 2 week, 3, 6?

In the last five days the dutch new cases per day has gone down 13% from 1159 to 1019 and the total deaths has gone up 183% from 639 to 1173.

The UK under much tighter controls new cases up by 170% 2546 to 4324 and total deaths by 230% 1019 to 2352.

I am not saying that they have some magic formula that is beating this virus i am saying that maybe all the additional stuff we are doing, that is costing us a fortune, isnt actually doing anything.

The germans and Belgians are not happy with Holland at all, although the germans have offered ICU beds if needed. But  Rutte is sticking to his guns and stating that decisions are made based on their scientists not public opinion, politic or other countries.

[Oldmanmatt]

Does anyone else get bored of OMM not writing what he later says he means, and not reading other posts properly? 

I think you come across as rather cold.

You only wish to prove yourself correct and everyone else to simply agree with you.

If it makes you happy, yes, you irritate me.

Fight. Fight. Fight.

God I'm bored.

Is anybody else just so so ready to watch 15 stone of ex-navy meat and gristle go toe-to-toe with a 6-foot-tall tendon who wouldn't tip the scales to 8 stone? Get it on Youtube Live!

I cheat like a fucker.

Of my four or five attempts at tournaments, I was disqualified in every one...

To be fair, my moral compass is, um, dodgy. Despite appearances on here.

Edit:

Ah bollocks.

I shouldn’t have made a crack about how you feel about your mother Alex. That was fucking dumb. Too many things going on, too little self control.
Other than that, what ever epithets you assigned to me, right back at ya.
😝❤️💃

[Murph]

Galpinos - in a months time fully expect our exponential graph to look better than the Dutch's. (My knowledge of what is happening over there based on nothing other than Gavin's posts). But like I said above the full analysis of this will need to see how long it takes to recover after. Our entire pack of cards economy is based on people going to places they dont need to go to buy shit they dont need and putting the rent up to pay debts they didn't need to take on. If some of these sacred cows get questioned i think normal could be a lasting memory.

Mrjonathan - Dont worry about the 0.2% I'm not navigating by it or any other number to make policy decisions. But presumably someone has a figure in mind and a figure for the cost and some day they will share it with us and it wont be out by a factor of ten.

TT - think that's an excellent simplification.

Gavin - I think it's way too early to say. Looks like the dutch just arent testing. We will know in a few years for sure.

I'm not pretending to have the answer here, just framing the question with some made up numbers. We could use 1% and £100bn if we wanted.

Still cant believe that fags haven't been banned by the way.

[duncan]

We are certainly living through a bit of history ...

We certainly are. I've just come out of a meeting on how to get nearly qualified student health care professionals into hospitals in the next weeks rather than waiting til July when they officially finish. Left me feeling a bit like I'm a World War 1 general leading the recruitment drive in 1914 

[tomtom]

@richD

Seemed legit early on - though there now seems to be an orchestrated media campaign (started by US right wing media - now followed by ours) that China was holding back from numbers and leaving us in the lurch.

From a science point of view - they’ve been very open and all the important info on the virus, it’s spread and it’s treatment has been freely available.

This makes me think that the west is starting to play to  prior perceptions of China - enabling a future blame game and (most importantly) taking the heat off themselves for bungling it’s spread in the West.

The one thing where China is possibly ‘culpable’ is enabling / allowing the animal markets where it’s thought it crossed over to Humans. I’d be surprised though if China was the only country in the world where these happened..

That’s just my view. Suspect there will be lots of conspiracy theories floating around about China and this...

[Ru]

I am aware they ar following our track but we put far more constrictive measures in place 10 days ago whilst they stuck to there guns, yet we are still roughly alingned, in fact there figures have flattened a little. Would we not have started to see a difference by now? How long do you think we will need to wait until the accelerate past us, 2 week, 3, 6?

Takes on average 3 - 4 weeks ish from catching it to dying, so you would need to wait that long after starting a lockdown to see if the numbers change. 10 days not enough.

[Oldmanmatt]

I'd urge caution with the figure of 0.2%. It sounds pretty minor. More meaningful would be the total numbers of people we expect will die as a result of different strategies. 0.2% of millions of people plus secondary deaths as a direct result of overwhelmed services is an awful lot of people. And that is without disputing the accuracy of the overall infection fatality rate, which will not be calculable with certainty at this point.

I get the impression from everything I'm reading* that Covid, if left to play out over say the next 24 months without a vaccine, is as lethal as Spanish Flu.
This is because Covid is highly contagious relative to SF, but with a relatively low infection fatality rate.
Whereas Spanish Flu was less contagious than Covid, but had far higher infection fatality rate.

The potential proportion of deaths per head of population (not per head infected) is similar over the long term.


I suppose back in 1918 because there was no vaccination the virus did what it did, eventually. Whereas today there is a hope of vaccine cutting short the natural progress of Covid.


*search for estimates of the infection rates of Covid versus spanish flu

I looked at that, from a very amateurish viewpoint and thought the same.

I also realised most of what I thought I knew about the Flu and it’s lethality was wrong.
It seems from what I read to have killed most through secondary pneumonia(?) and not entirely dissimilar to C19?
The lack of Antibiotics and other modern care being the “real” difference in its lethality?
Any medical bods out there with an opinion?

[abarro81]

Other than that, what ever epithets you assigned to me, right back at ya.
😝❤️💃

  

[Oldmanmatt]

@richD

Seemed legit early on - though there now seems to be an orchestrated media campaign (started by US right wing media - now followed by ours) that China was holding back from numbers and leaving us in the lurch.

From a science point of view - they’ve been very open and all the important info on the virus, it’s spread and it’s treatment has been freely available.

This makes me think that the west is starting to play to  prior perceptions of China - enabling a future blame game and (most importantly) taking the heat off themselves for bungling it’s spread in the West.

The one thing where China is possibly ‘culpable’ is enabling / allowing the animal markets where it’s thought it crossed over to Humans. I’d be surprised though if China was the only country in the world where these happened..

That’s just my view. Suspect there will be lots of conspiracy theories floating around about China and this...

We’re being a little hypocritical on the wild animal thing aren’t we?
I know plenty who indulge in pigeon pie and rabbit stew etc etc.
We eat wild game here too.
 

[mrjonathanr]

hi Murph, sure, I get that. My point is that these numbers are abstractions. It's too easy to be disconnected from the enormity of what is being discussed.

[Murph]

The one thing where China is possibly ‘culpable’ is enabling / allowing the animal markets where it’s thought it crossed over to Humans. I’d be surprised though if China was the only country in the world where these happened..

At best they are grossly negligent though. They have been called out on this for years.

Theres a few year old Ted talk saying this is how it happens. There are papers looking post SARS about China's taste for exotic animals is a biological time bomb. Good call I guess. Weird how the Chinese state can enforce all sorts of stuff but cant stop people doing whatever they do at these wet markets.

Just thankful h5n1 isnt easy/possible to transmit human to human - yet - because that one is a 60%er.

OMM - just seen yours assuming it isnt a joke what we are talking about in china is a completely different sport.

[galpinos]

I also realised most of what I thought I knew about the Flu and it’s lethality was wrong.
It seems from what I read to have killed most through secondary pneumonia(?) and not entirely dissimilar to C19?
The lack of Antibiotics and other modern care being the “real” difference in its lethality?
Any medical bods out there with an opinion?

A secondary pneumonia post flu is normally due to bacterial infection and thus should respond to antibiotics. In the case of having Covid-19, it's a viral infection and as such we have nothing to combat it we only have supportive care whilst the patient does or doesn't recover.

[Murph]

...eg this 2007 paper says "The presence of a large reservoir of SARS-CoV-like viruses in horseshoe bats, together with the culture of eating exotic mammals in southern China, is a time bomb. "