[Paul B]

Lancs went into no household mixing around the end of July (Leicester etc.). They didn't appear to work locally here

Okay, here's Leicester. Firts region to go into local restrictions, on 4th July. Seems to have worked.

Can you link the source? I'm struggling to find a timeline of cases in Pendle/Hyndburn etc.; my memory (and I was looking fairly often) was that we went into local restrictions at ~50 per 100k and we didn't get back down to that level despite a prolonged period of restrictions. There was brief respite as they harmonised the tiers (which was more like the admin glitch Bolton saw for 48H) which led to about a week of being able to mix in gardens. I'm not saying that such restrictions didn't have any impact but perhaps sufficient impact, given the long lasting nature of the restrictions?.

[Johnny Brown]

Ribble valley?

https://coronavirus.data.gov.uk/details/cases?areaType=ltla&areaName=Ribble%20Valley

As I said, the numbers back then just look tiny now.

[Paul B]

Ribble valley?

https://coronavirus.data.gov.uk/details/cases?areaType=ltla&areaName=Ribble%20Valley

As I said, the numbers back then just look tiny now.

No, the RBV was unique in its surroundings as an area that remained low in terms of cases. The other side of the hill!

[Johnny Brown]

There's a dropdown at the top. I don't know where you live.

[spidermonkey09]

Local restrictions are a waste of time. National or nothing as far as I'm concerned, they spread enormous resentment and don't work. All the examples linked above of them "working" are pre the emergence of the more transmissible Kent variant. Given the main concern re the Indian variant is its enhanced transmissibility over the *Kent* variant, the chances of local restrictions stopping the spread seem basically zero, so not sure what those advocating it think they would achieve.

Given the above, I'm interested in what people think the endgame is here. Lock down and wait for a newer vaccine? For me the game is completely different with so many vaccinated so I am very much in the proceed as planned until we see evidence on the ground of the strategy not working.  Not least because getting any significant buyin from the public without evidence of, to be blunt, deaths and hospital admissions, will be nigh on impossible.

[macca7]

Have to agree the country is too small for regional lockdowns, too easy to just move across the border to a county with fewer restrictions and therefore is actually achieves the opposite and spreads the virus further.

Buy in will be tricky not only from the public but a large part of the Conservative party!

[tomtom]

Local restrictions are a waste of time. National or nothing as far as I'm concerned, they spread enormous resentment and don't work. All the examples linked above of them "working" are pre the emergence of the more transmissible Kent variant. Given the main concern re the Indian variant is its enhanced transmissibility over the *Kent* variant, the chances of local restrictions stopping the spread seem basically zero, so not sure what those advocating it think they would achieve.

Given the above, I'm interested in what people think the endgame is here. Lock down and wait for a newer vaccine? For me the game is completely different with so many vaccinated so I am very much in the proceed as planned until we see evidence on the ground of the strategy not working.  Not least because getting any significant buyin from the public without evidence of, to be blunt, deaths and hospital admissions, will be nigh on impossible.

It appears SAGE don’t share your optimism…

https://www.theguardian.com/world/2021/may/14/india-covid-variant-could-lead-to-third-wave-uk?CMP=Share_iOSApp_Other

Assuming the vaccines hold up, more people could be hospitalised than in the first wave – putting the NHS at risk – if the variant is much more than 30% more transmissible, University of Warwick models show. At 40% more transmissible, hospitalisations could reach 6,000 per day, far above the peak of the second wave, and 10,000 per day if the variant is 50% more transmissible.

That is if we do nothing. If step three easing of restrictions in England on Monday is cancelled, the third wave will be far more modest, reaching 300 hospitalisations per day, even if the virus spreads 50% more easily than the Kent version.

Feels a lot like December all over….

[spidermonkey09]

Depressing news evening!

I still don't really understand where we are trying to get to. Are we waiting in hope of a vaccine that reduces transmissibility? for how long? And what about the variant after that; viruses mutate, that's what they do.

I do think a discussion is going to have to take place very soon about the levels of deaths we will be forced to tolerate in exchange for a semi normal existence, if that Guardian piece is even halfway correct. The alternative is living like this for years, no?

I don't mean to be callous in the slightest, the whole thing is shit, but if vaccines don't get us out of this, then what's the plan after that?

[TobyD]

Depressing news evening!

I still don't really understand where we are trying to get to. Are we waiting in hope of a vaccine that reduces transmissibility? for how long? And what about the variant after that; viruses mutate, that's what they do.

I do think a discussion is going to have to take place very soon about the levels of deaths we will be forced to tolerate in exchange for a semi normal existence, if that Guardian piece is even halfway correct. The alternative is living like this for years, no?

I don't mean to be callous in the slightest, the whole thing is shit, but if vaccines don't get us out of this, then what's the plan after that?

I understand what you mean,  but the obvious issue is that you can tolerate a level of mortality,  but if it's infectious enough to quickly reach a stage where hospitals are full, then you have the current situation in India

[tomtom]

There seem to have been three main ways of dealing with CV19

1. Lockdown - relax - lockdown - relax etc.. (most of Europe).

2. Close Borders / Isolation (Australia, NZ)

3. Somewhere between option 1 and doing nothing (Brazil, USA)

Perhaps we (as an Island nation) should have looked at 2 - and rather than weighing up whether or not NHS being overwhelmed and lives lost is a suitable price to pay to avert economic devastation and be looking at how economically it would compare with Borders Closed and semi normal life vs Open borders and periodic lockdowns.

Of course we won’t know - and we’re too far down the path we’re on now…

Wonder whether we’d be in this position if there had been no vaccine delays in production - as we’d now be finishing up the 20-25 year olds or have finished first doses….

The catch22 I mentioned earlier still holds

[TobyD]

The issue with trying to rely on vaccination to stop infections is that it's not instant, they take 2-3 weeks to be effective. We should have restricted borders more, especially from India. That was clearly not done as BJ was worried about a trade deal. Bringing in travel now is unutterably stupid, and it's storing up a reservoir of infections, so more lockdown is more likely.

[Ged]

I'm obviously missing something here, so would someone mind explaining how we are set for another wave just as big as January. We're on to about 55% vaccination, much higher than that of elderly and vulnerable.

 Are we just talking those who haven't had it/the few it doesn't work for/had it less than 3 weeks ago? That seems like a much smaller population to be getting ill and hospitalised

[IanP]

I'm obviously missing something here, so would someone mind explaining how we are set for another wave just as big as January. We're on to about 55% vaccination, much higher than that of elderly and vulnerable.

 Are we just talking those who haven't had it/the few it doesn't work for/had it less than 3 weeks ago? That seems like a much smaller population to be getting ill and hospitalised

As far as I can understand there's a lot of uncertainty and the worst case numbers mentioned are based on models where the new variant is 50% more transmissable than the already more transmissable Kent variant which is not in any way proven at the moment.  They also model 10%, 20% etc which has much more minor impact.   It appears there's also some modelling from London School of Hygiene & Tropical Medicine which predicts lower (though still significant) impact at 50% more transmissable.

I'm not a huge fan of the Guardians coverage of this sort of thing, it often lacks detail from the stuff it quotes, strangely the Daily Mail coverage seems pretty good, including more charts and discussion of the factors involved!

https://www.dailymail.co.uk/news/article-9578503/Coronavirus-SAGE-models-warn-hospital-admissions-soar-India-variant-infectious.html

[mrjonathanr]

I do think a discussion is going to have to take place very soon about the levels of deaths we will be forced to tolerate in exchange for a semi normal existence, if that Guardian piece is even halfway correct. The alternative is living like this for years, no?

Or actually implementing test track isolate and see how much of a brake it can apply to transmission. 

[tomtom]

Not going near the Mails website.. browser overload by popup/clickbait last time I was there :D

However, to date most of the real world outcomes have been worse than the more optimistic modelling scenarios. And the models themselves have had a fair amount of real data with which to be calibrated/refined since last March.

We’ll all find out one way or the other soon anyway - as there’s no real change in govt actions. Aside from speeding up vaccinations (that take 2-3 weeks to work as Toby said).

 

[spidermonkey09]

Or actually implementing test track isolate and see how much of a brake it can apply to transmission.

I think getting infections down to a level where TTI could actually work will require an extremely draconian and long lasting national lockdown which would be impossible both politically and practically.

There always was a big gap between what was politically possible and what was advantageous from a virus control perspective and that gap is only getting bigger now vaccines have arrived. The interesting (and perhaps concerning) issue for me is that given the way vaccines have been sold as the way out, if it turns out that they aren't, how will that affect public compliance/attitudes towards risk?

[TobyD]

I'm obviously missing something here, so would someone mind explaining how we are set for another wave just as big as January. We're on to about 55% vaccination, much higher than that of elderly and vulnerable.

 Are we just talking those who haven't had it/the few it doesn't work for/had it less than 3 weeks ago? That seems like a much smaller population to be getting ill and hospitalised

One of the problems is that although places like S Devon are likely to be fine, if you take a Northern town, with high ethnic minority population, and perhaps a nearby university city or town, more of the population won't have been offered a jab yet as it's a younger demographic; more people live in multi generational households, and there are probably more people with irrational beliefs about vaccines who are likely to turn it down. Also more working people, who cannot work from home. These areas already have worse overall health, lower life expectancy ...
I'm perfectly aware that parts of the South West have social problems, but all of the above is why I'm concerned that the country is going to be in a bad place again.

[Camo]

Depressing news evening!

I still don't really understand where we are trying to get to. Are we waiting in hope of a vaccine that reduces transmissibility? for how long? And what about the variant after that; viruses mutate, that's what they do.

I do think a discussion is going to have to take place very soon about the levels of deaths we will be forced to tolerate in exchange for a semi normal existence, if that Guardian piece is even halfway correct. The alternative is living like this for years, no?

I don't mean to be callous in the slightest, the whole thing is shit, but if vaccines don't get us out of this, then what's the plan after that?

Good post. That type of discussion is quite valuable I feel.

Discussions on the internet seem to vary massively between people wanting endless lockdowns and draconian restrictions to nutters that think bill gates is trying to take over the world with the vaccine.

Not many people seem to be talking about what we do another year or two down the line. If different strains can outpace vaccine developments etc.

I don’t want any unnecessary deaths but I don’t want to spend my entire life in the house either. Really difficult to decide where to find a good balance point, as always somethings got to give.

[petejh]

The core of the issue is how you, me, the population of the UK and the rest of the world defines an 'unnecessary death'. Whose death is ever necessary?

Perhaps over time the language we use to understand death will mutate as the virus does.

[tomtom]

Indeed. Perhaps a place to start is what death rates per activity are deemed socially acceptable - or acceptable by most people.

Eg. A 100 mile motorway journey
A short haul flight
Taking an aspirin
Etc.. etc..

Not got the time today (sorry) but suspect there are figures on stuff like this from which we could compare… if you get my jist.

[wasbeen]

Looking at the case data for India. The cases look like they might have peaked. I am not sure I fully understand why this is  the case despite not having a national lockdown or a high proportion of vaccinated population.

Also, why is there a tendency for the peaks to be symmetrical? i.e. the quicker the cases numbers rise, the quicker they fall (at least initially).

[tomtom]

Looking at the case data for India. The cases look like they might have peaked. I am not sure I fully understand why this is  the case despite not having a national lockdown or a high proportion of vaccinated population.

Also, why is there a tendency for the peaks to be symmetrical? i.e. the quicker the cases numbers rise, the quicker they fall (at least initially).

India was considered unusual in the first wave for having surprisingly very small numbers - despite a large and densely populated cities. Back then there were all sorts of theories about age profile of population. Also at one point IIRC Delhi had 30-40% antibody presence (first wave) so something is clearly different with either this variant or how it’s being handled.

[Nutty]

Indeed. Perhaps a place to start is what death rates per activity are deemed socially acceptable - or acceptable by most people.

Eg. A 100 mile motorway journey
A short haul flight
Taking an aspirin
Etc.. etc..

Not got the time today (sorry) but suspect there are figures on stuff like this from which we could compare… if you get my jist.

The HSE's Reducing Risks, Protecting People (R2P2) is probably the starting point for looking at this. Even has climbing risk in there somewhere (don't know how good an estimate it is though).

[Camo]

Very true, no death is necessary but some seem more tragic than others. I’ve had family members die at different ages - neither from covid but a death at 49 seems significantly more tragic than a death at 85. Even when they’re both family. Of course losing someone is always distressing but some comfort can be found in knowing they lived a long life.

With covid we may hopefully get to a point where deaths are so low that it is comparable to deaths from things like smoking and obesity. That sentence sounds strange to say but as tomtom was saying lots of things that could result in death are deemed acceptable risks by lots of people.

[abarro81]

With covid we may hopefully get to a point where deaths are so low that it is comparable to deaths from things like smoking and obesity.

We're more than there from a quick Google:
70 deaths in last week due to COVID (https://coronavirus.data.gov.uk/)
~600 deaths per week due to obesity (https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2021/april/31000-heart-and-circulatory-deaths-obesity-each-year)

Whose death is ever necessary?

Everyone's, eventually.

The interesting (and perhaps concerning) issue for me is that given the way vaccines have been sold as the way out, if it turns out that they aren't, how will that affect public compliance/attitudes towards risk?

Yeah, without an alternative and convincing "exit plan" I think peoples' ability to tolerate deaths from covid as a by-product of not having too many rules will increase significantly. Unless there's real risk of major impact to other NHS services due to overload I can't see how most people would buy into more restrictions.. I wouldn't.