[Offwidth]

I think the UK was more the exception on statutory sick pay for covid isolation in western Europe. In public health terms it was a disaster as it added to hospital pressure and cost many lives (and extended the lockdowns and economic damage).

jwi is right that better urban planning made a difference but their care homes were not so dissimilar and they got hit hard in the first wave. In subsequent waves covid variants were just more infectious, so the factors like better urban planning and better compliance wasn't good enough with first wave measures to stop the spread. Their government was too slow to spot this new problem and hospitals struggled and many outside care homes died.

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

[Offwidth]

This has very worrying implications for the UK  (thanks for the link due to minimike on the other channel).

https://twitter.com/twenseleers/status/1466501989500653568?s=21

The one consolatory element I can pick out: that's looking at potential immune escape when it comes to infection, and all the info we have suggests that even when the vaccines don't prevent infection, they can still offer substantial protection against severe illness. They don't "fail" all at once.

(And that's assuming that vaccine-produced immunity and immunity from infection with a previous variant perform the same; I have seen some speculation that vaccine-produced immunity might perform better when it comes to a heavily-mutated variant like this, but I don't have the background to evaluate how plausible or likely that is: https://twitter.com/jburnmurdoch/status/1466493406704807941 ).

Obviously it's still bad news because, as I repeat ad nauseam to people, a small percentage of a very very big number is still a big number. Even if only a small percentage of people with breakthrough infections get severely ill -- if you have enough breakthrough infections, that's a big number.

There are a lot of key things about Omicron that we don't know right now, but are going to be finding out very fast.

IndieSAGE data presentation on Omicrom was good this week. They had a nice curve of infectiousness vs immunity escape on which Omicron must sit somewhere but wherever it is on that curve the implications are we need to tighten measures in the UK. We are in a better position with vaccine immunity and overall immunity levels than most other western EU countries. It starts about 10 minutes in to the youtube link below.

One thing that was totally new for me is there was a small but significant increase in primary school age hospitalisations.

[Oldmanmatt]

Another factor into the mix, that I don't see discussed much anywhere, is the levels of statutory sick pay available to people required to isolate.  In Sweden it is 80% of full pay by law with many companies offering more than this. 
The level of statutory sick pay in the UK is insulting and I am sure leaves many already low paid workers, struggling to get by, less inclined to get tested if they are sick but able to function. 
Another reflection of the very differing attitude of ruling classes here where profit overrides welfare.  Likely to be a false economy but we seem to be unable to think that far ahead.

When we had to isolate, in the summer, prior to the both of us returning to work. We were on the highest level of Child Tax Credits etc. We applied for and received the £500 grant. I know of others who have done that more than once (one acquaintance has 7 children and has had to isolate three times, anti-vaccer unfortunately, so whole family shut up and living in separate rooms every time).
Anyway, it was better than a “normal” month, not worse.
The grant will be partially recovered now that we have both returned to full time employment. It’s not a bad system, we’ve blown right through the Tax Credit cap, so last years will be recovered from us, which seems fair.

[Offwidth]

This report illustrates the UK problem that led to far too few self isolating

https://www.nuffieldtrust.org.uk/research/tackling-covid-19-a-case-for-better-financial-support-to-self-isolate

[petejh]

So out of interest, in terms of what you want to happen based on the data you look at, you'd be in favour of an immediate lockdown, return to furlough etc?

I think its fairly likely that we'll see a wave this winter but I'm unconvinced it is politically possible to lockdown again for numerous reasons, so the more likely outcome is muddling through. Not least because if the variant is as bad as you suggest, we won't be able to stop it spreading anyway, even in a lockdown.

You haven't answered this.. (pointless answering with hypotheticals about an underfunded health service). What exactly would you do now if you were UK king, with what the UK has. 

[andy popp]

I spent much of 2020 fending off of UK lockdown sceptic friends who repeatedly tried to argue Sweden had been "proved right." It happened again from a US friend last week: "if Sweden got it so wrong why is it doing so much better than Denmark" (short answer: it's not)

A Scandinavian city does not look like or function like a continental city, except for the most deprived areas of said Scandinavian city. IMHO, of course.

People always pick up on the population density issue, so that's worth looking at. On paper Sweden has a very low population density, many many times lower than the UK (and many times lower than Denmark, my reference point, which is in turn a lot lower than the UK). But how do people actually live? Stockholm's and London's population densities are much, much closer (5,200 per sq km vs 5,700 respectively). Both cities represent roughly the same percentage of each country's. population. As an aside Copenhagen's population density is higher at 6,800*, but Helsinki's (approx 3,000) and Oslo's (1.500) are considerably lower. Again, in all these cases the capital represents about the same percentage of the total population. Actual lived population density might explain some of Norway's and Finland's experiences, but it I don't think it can be used to say it's impossible to make any kind of policy comparison between the UK and Sweden. Of course, this isn't all the picture. I live in the second most densely populated neighbourhood in Copenhagen, at over 18,000 per sq km. In the next door neighbourhood it is basically 20,000. The most densely populated neighbourhood in London is Islington at about 16,000.

Scandinavian cities are generally considered more "liveable", easy to walk or cycle and some of that is down to urban planning (cycle lanes, high quality pubic transport), but there's only so much urban planning can do to mitigate such high population densities.

*lot of caveats attache to these numbers. which depend a lot on what's being measured of course (e.g. the figure for Copenhagen is for the city proper, not the greater city region).

[mrjonathanr]

Where do people mix though? If the norm is 6 hours in the pub, cinema etc spread over a weekend that is going to produce more transmission than less time in shared settings and more time just with family or out of town.

[andy popp]

Where do people mix though?

In Scandinavia? I don't want to speak for other countries, but can assure you Danes enjoy being out socializing together.

[mrjonathanr]

I've no experience of Denmark but what I have seen of Norway is that people love to go out drinking but it is unaffordable compared with meeting in home settings. So I'd hazard slightly greater transmission but fewer contacts.

[Offwidth]

So out of interest, in terms of what you want to happen based on the data you look at, you'd be in favour of an immediate lockdown, return to furlough etc?

I think its fairly likely that we'll see a wave this winter but I'm unconvinced it is politically possible to lockdown again for numerous reasons, so the more likely outcome is muddling through. Not least because if the variant is as bad as you suggest, we won't be able to stop it spreading anyway, even in a lockdown.

You haven't answered this.. (pointless answering with hypotheticals about an underfunded health service). What exactly would you do now if you were UK king, with what the UK has.

Sorry, its not totally clear but I'm guessing that's a question for me..... I thought I had answered, so I'll repeat in simpler terms:
 
> implement Plan B now (but maybe without some of the more costly vaccine passport bits) as it helps cut hospital strain even if all this current data turns out wrong......it will slow any omicron growth and cut delta. Then fingers crossed we don't need anything else as the booster programme 'cuts the oxygen' from future growth. This will have very low cost and clear benefits.

> If as data improves (especially hospitalisation demographics) it becomes obvious further measures are needed (so far they don't look to need anything like a really tight lockdown, so I don't know where spidermonkey got that idea from ): go fast with clear messaging and proper financial support... as dither, contradiction and parsimony makes things worse.

> If things end up a lot worse than the data currently indicates we just have to do what we can with a hard lockdown. Whatever anyone says about compliance we simply cant function as a society if we overwhelm hospitals. This will be expensive and messy.

[petejh]

Below is the government's 'Plan B', that you say they should implement right now except for the vaccine passport bits:

a. Communicating clearly and urgently to the public that the level of risk has increased, and with it the need to behave more cautiously. We've had messaging from the government that the risk has increased, everyone's aware.
b. Introducing mandatory vaccine-only COVID-status certification in certain settings. You say you wouldn't do this.
c. Legally mandating face coverings in certain settings. Done

''The Government would also consider asking people once again to work from home if they can, for a limited period. The Government recognises this causes more disruption and has greater immediate costs to the economy and some businesses than the other Plan B interventions, so a final decision would be made based on the data at the time.'' Not yet done.


So for all your rhetoric, all you'd actually do differently  if you were responsible for making the decisions at this point in time with what we currently know, is you'd want people 'to work from home where possible'. People already are already working from home btw - I've been WFH since March 2020 and see no reason not to now.

You say a lot without really saying anything.

[Offwidth]

Sometimes think you delight in disagreement just because it's me. You pull apart the first of three points where I said it's quite likely we need to move to the second one. So for now, in your spirit of a 10 minute argument, lets look at the veracity of what you wrote (in the context that this is a serious public heath situation already, with the NHS really wobbling right now):

If we all had a vote here I doubt many would think government messaging has been at all clear, especially when Boris directly contradicts his new Public Health head (Harris) and goes against clear SAGE advice on messaging.

I said I drop the expensive bits of passports... ie make it a requirement but without the expensive cards and systems that make it an evidenced one.

The mask use in 'certain settings' has disappointed many experts, as the govenment watered down the lists to public transport and shops..... why on earth not theatres and cinemas?

As well as working from home if you can, there was also a lot on ventilation system compulsion for certain locations (especially schools). This will cost but is .a good investment for dealing with future cold and flu outbreaks (in schools cutting kids and staff unnecessarily losing class time).

[petejh]

I don't enjoy disagreeing with you because it's you. I disagree with you because I often find what you say to be disagreeable.

I pulled apart your first point because it was easy to. Please point out where you said 'it's quite likely we need to move to my second point'.  Because I'm not seeing that anywhere?

'Wearing masks in cinemas and theatres'. Do you really think cinemas and theatres will move the needle on whether we get a disaster wave or just another wave? Come off it you don't even believe that. I see the sense in masks, but Wales never stopped mandating them yet still have higher per-head cases than England - they're hardly a panacea!

'Messaging' - what message would you personally send out to the public that those already in the choir don't already accept, and that those not in the choir would suddenly take any notice of and change their behaviour? Bearing in mind there's an economy to consider and the country cannot just down tools for the sake of covid at the level it's currently at.

'Installing ventilation systems in schools to prevent future outbreaks' has nothing to do with dealing with the present, and everything to do with future outbreaks.  The question was what would you do differently given what we currently know and given what we currently have.

[duncan]

Australian cluster possibly linked to climbing wall.

[SA Chris]

Those green bucket handles up the arete are ridiculous

[Offwidth]

John Burn-Murdoch from the FT with the latest on Omicron in SA.

https://mobile.twitter.com/jburnmurdoch/status/1468310548609744904

[slab_happy]

John Burn-Murdoch from the FT with the latest on Omicron in SA.

https://mobile.twitter.com/jburnmurdoch/status/1468310548609744904

JBM is a rockstar of data-visualization and explaining. He's one of the people I tend to check first, along with https://twitter.com/kallmemeg .

[slab_happy]

Yo, if you're 40+ (or high risk, or a frontline health or social care worker) and it's been over 2 months since your second dose,  you should be able to pre-book your booster through the website now (or tomorrow, they're adjusting it as we speak):

https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/

[Fiend]

Within 30 minutes of having my booster yesterday (and obviously being processed through the system at the vaxx centre), I got both a text and email informing me that I was eligible and hadn't booked a booster yet and really should 

[petejh]

You'll probably have gotten that text because it was in the system when they switched on your nanorouter.
5GFiend.

[Fiend]

Well. My shoulder has been pretty fucking painful for the last 24 hours. No military press PBs for me at the mo.

But that's massively less painful than a single 24 hours in which I'm prohibited from using indoor sports facilities to either do the life-affirming fitness activity I love the most, or to do essential rehab and training to keep my body going, or 24 hours where I get fucking "Stay Home" seared across my eyes whilst doing a positive, healthy, zero transmission risk activity. So yeah I'll take the shoulder ache.

[mrjonathanr]

But that's massively less painful than a single 24 hours in which I'm prohibited from using indoor sports facilities to either do the life-affirming fitness activity I love the most,

Never realised you were that into Zumba.

[Offwidth]

S gene dropout reported on the beeb to be in excess of 5% already, so they say omicron is probably already around the two and a half thousand cases a day level.

https://www.bbc.co.uk/news/health-59580290

I'm really hoping hospitalisation rates are a lot lower than for delta.

Shopping in the big Sainsbury yesterday, we had the return of tannoy mask advice and everyone aside from one toddler had a mask on. It was a large majority last week (with no announced advice) and about half the week before.

[abarro81]

As someone who largely tries to forecast things for a living, I find it quite reassuring when other people trying to forecast things essentially say "we've basically not got a clue whether it's a total disaster or pretty chill"

[Offwidth]

I struggle to understand your general point's relevance to this specific. The case number estimates from current and  past UK trajectory of S gene drop-out are reliable with known error levels based on known data. The hospitalisation level and the crucial demographic distribution of that for Omicron cases is a genuine unknown (at least for the next week or so)....the case growth is faster than SA data indicated it might be, but it's hardly surprising since we are in winter. Saying it was obvious some restrictions were needed a few days ago wasn't really forecasting it was just setting a range on how bad things could get. Back then it was anything from Plan B light to hard lockdown (as omicron hospitalisations were increasing in SA; a country with a much younger demographic, but with similar high levels of the population having some immunity, be it from vaccines or prior infection)... it's now shifted a bit upwards in risk terms for the UK but the possible range is still huge until we start to get UK omicron hospitalisation data.