[stone]

I'm not sure we won't get a second wave.

There was enough traffic between the M67 and Glossop this afternoon to double the drive time compared to say 6:30 am last Sunday. So lockdown is slipping a lot.

I'd say we will only be safe to come out of lockdown when we have herd immunity (which we'd be lucky to have now by all accounts), or when we have a proper test-trace-isolate regime that can cope with every outbreak.

What flummoxed me is that on BBC R4 this morning they were all talking about the R<1 as being a mark that we could now exit lockdown. How does that make any sense? What we need is to know that we have something in place to keep R<1 when we aren't in lockdown. It is as though someone caught a branch of a tree after falling off a cliff and thought that since they had reduced their downward trajectory, it was now safe to let go of the branch.

[stone]

And how is it scalable if the growth is exponential? Over the same time period wouldn't a country starting with a higher number always end up with an exponentially higher number all other things being equal?

Doubling time was about two days in the UK wasn't it pre-lockdown? So to go from one case to a million takes about forty days. So yes a country that got a million infected people arriving would be forty days ahead of a country that got one infected person arriving. A country starting with ten cases arriving and then sealing itself off, would always have ten times as many as the country with one case arriving and then sealing itself off (if assuming unfettered exponential growth).


However the UK decided not to shut air travel etc when we knew that we had cases coming in. We got to a million cases not by having a million infected people coming over but by having dozens and then letting the outbreak grow here.

[petejh]

Dozens? Or hundreds? Or thousands? We don’t know.

And again as per Nigel it’s just not a valid comparison to use NZ closing its border in the same argument as the UK closing its border(s).

[tomtom]

If you think the UK is a leaky sieve of borders - Germany effectively has none - yet has apparently managed things far better... despite probably being the point of entry for the main European (Then Italian) outbreak.

As stone clearly mentioned it’s the transmission rate within the UK that’s done us over.

Not just Cheltenham and football matches - but all those last min get always people did the weekend before the official lockdown.

[stone]

Dozens? Or hundreds? Or thousands? We don’t know. .

I'm not sure that is true. They are doing a lot of sequencing of viral genomes to assemble phylogenic trees to get and idea of how the outbreaks have been seeded. I think it is a work in progress. i think I heard something about the South Wales outbreak coming from one seeding event.

[petejh]

If you think the UK is a leaky sieve of borders - Germany effectively has none - yet has apparently managed things far better... despite probably being the point of entry for the main European (Then Italian) outbreak.

As stone clearly mentioned it’s the transmission rate within the UK that’s done us over.

Not just Cheltenham and football matches - but all those last min get always people did the weekend before the official lockdown.

Yep Germany is a valid comparison. New Zealand just clearly isn't for loads of reasons that should be obvious.

Edit: Stone I'd call that 'don't currently know'.

[Bonjoy]

What flummoxed me is that on BBC R4 this morning they were all talking about the R<1 as being a mark that we could now exit lockdown. How does that make any sense? What we need is to know that we have something in place to keep R<1 when we aren't in lockdown. It is as though someone caught a branch of a tree after falling off a cliff and thought that since they had reduced their downward trajectory, it was now safe to let go of the branch.

In yesterday's government briefing one of the scientists said they calculated that R0 had been reduced to between 0.6 and 0.9. This seems like very little wiggle room indeed. Given the lag between infection and measured effects, and the anecdotal/traffic data suggesting the lockdown is getting weaker, I wonder if we haven't already lost some of this wiggle room and just can't see it in the data yet.
Can any meaningful reduction in lockdown measures be applied when there's potentially only 0.1 of R0 between the country and wave two.

[tomtom]

Now that our test numbers are (will be?) more meaningful (I'm being generous - I mean having a wider representation of the country rather than just people in hospital..) I'd be really interested to see the breakdown of where - and what context those positives are. How many are in / associated with care homes? What is the geographical spread?

I know we shouldnt compare too much - but if we're that far over the peak, why are our new positive test numbers still really quite high compared to the rest of Europe? I'd be expecting those to drop - maybe more than those offset by the new wider testing critera.

From TomToms bubble, I heard of a friend who's come down with it 4-5 days ago - which is the first 'new' case I've heard of in my world since the second week of the lockdown..

Also - (again the guardian - sorry) a critique that the home test kit is really quite nasty (deep nasal swab and tonsil wipe) that one doctor has sugggested could lead to many false negatives as people will be put off doing it properly... I shudder at having to do that to a child.... be worse than putting on sun cream :D

[TobyD]

Can any meaningful reduction in lockdown measures be applied when there's potentially only 0.1 of R0 between the country and wave two.

I certainly hope not. Meanwhile, some particularly unpleasant people think otherwise;

https://www.theguardian.com/law/2020/may/01/uk-government-faces-legal-challenge-coronavirus-lockdown-businessman-simon-dolan?CMP=Share_AndroidApp_Copy_to_clipboard

The guy attempting to get the lockdown legally reversed doesn't even live here, just makes millions from businesses here while safely living in Monaco.

[andy popp]

From TomToms bubble, I heard of a friend who's come down with it 4-5 days ago - which is the first 'new' case I've heard of in my world since the second week of the lockdown..

For whatever reason (make up of friend groups, colleagues etc.?) I know of a lot of cases. A colleague reported yesterday that one of their students had died (in China, but shortly after returning there from Denmark).

When a NYC friend posted a story about infected but otherwise healthy young people having catastrophic strokes no less than three people (two of them mutual friends) reported that they directly knew someone this had happened to.

[ali k]

some particularly unpleasant people think otherwise;
https://www.theguardian.com/law/2020/may/01/uk-government-faces-legal-challenge-coronavirus-lockdown-businessman-simon-dolan?

Yeh, I read that. Not saying I agree with him but there is certainly a case to be made that the lockdown is having serious consequences on people’s quality of life and health outcomes - the list of knock on effects is endless. So it’s not surprising there would be a legal challenge at some point. If the data and scientific advice that all the decisions have been based on gets released as a result that would be a positive outcome IMO. Sadly, I suspect his motives are purely financial.

[Bradders]

Can any meaningful reduction in lockdown measures be applied when there's potentially only 0.1 of R0 between the country and wave two.

I certainly hope not. Meanwhile, some particularly unpleasant people think otherwise;

https://www.theguardian.com/law/2020/may/01/uk-government-faces-legal-challenge-coronavirus-lockdown-businessman-simon-dolan?CMP=Share_AndroidApp_Copy_to_clipboard

The guy attempting to get the lockdown legally reversed doesn't even live here, just makes millions from businesses here while safely living in Monaco.

Why do you say he's unpleasant Toby?

I've never heard of him before but taking the letter purely at face value it sounds like a fair and reasonable challenge. I'm not saying I agree with it, and I think it's unlikely to succeed, but challenge is not an inherently bad thing in any situation and I think it's particularly needed here where there is clear evidence of significant other harms emerging beyond the number of people dying from Covid-19 itself. It sounds like a lot of what he's asking for is in the public interest, release of SAGE minutes etc.

Suppose we should also be glad that opposition to the lockdown in the UK amounts to a cautious legal challenge, as opposed to heavily armed protesters invading Government buildings 

[Bradders]

On the flip side, just picking up on this point:

he is not taking the case to throw the country into chaos, but to restore the public’s right to decide for themselves if they want to visit friends, go to work or stay indoors

This feels like the sort of thing that people shouldn't be allowed to decide for themselves. It's not Brexit.

[ali k]

For anyone who hasn’t read the linked report I can summarise it as:
THE GOVERNMENT HAVE MET THEIR 100K TESTING FIGURE BY COUNTING TESTS WHICH THEY HAVE POSTED TO PEOPLE IN THEIR NUMBERS.
Sorry for the capitals but you couldn’t make it up...to change the way you count them like that is just ludicrous.

Seen an interesting comment this morning suggesting this might be another ‘tactically controversial’ number by Dominic Cummings to keep it repeated in the news for days and days. Like the £350k/wk figure. Makes sense.

[James Malloch]

For anyone who hasn’t read the linked report I can summarise it as:
THE GOVERNMENT HAVE MET THEIR 100K TESTING FIGURE BY COUNTING TESTS WHICH THEY HAVE POSTED TO PEOPLE IN THEIR NUMBERS.
Sorry for the capitals but you couldn’t make it up...to change the way you count them like that is just ludicrous.

Seen an interesting comment this morning suggesting this might be another ‘tactically controversial’ number by Dominic Cummings to keep it repeated in the news for days and days. Like the £350k/wk figure. Makes sense.

It makes me wonder about the other numbers. If you've 120k tests, 5k positive, 75k negative (just making up numbers here), and 40 yet to be complete. When do these 40k get reported?

Do they quietly adjust the positive and negative figures for 30 April, or do the tests get added to the day when the tests are actually competed? I'm which case we would be double counting

[TobyD]

Can any meaningful reduction in lockdown measures be applied when there's potentially only 0.1 of R0 between the country and wave two.

I certainly hope not. Meanwhile, some particularly unpleasant people think otherwise;

https://www.theguardian.com/law/2020/may/01/uk-government-faces-legal-challenge-coronavirus-lockdown-businessman-simon-dolan?CMP=Share_AndroidApp_Copy_to_clipboard

The guy attempting to get the lockdown legally reversed doesn't even live here, just makes millions from businesses here while safely living in Monaco.

Why do you say he's unpleasant Toby?
... It sounds like a lot of what he's asking for is in the public interest, release of SAGE minutes etc.

He runs a company selling ppe. He lives safely abroad.  I think it's much more likely his motives are selling millions of masks,  were the lockdown lifted, to anyone who wants to use public transport etc etc

I think its very unlikely that hes got public interest in mind.

Of course,  I don't know that.

[petejh]

I can't find any evidence his company sells PPE. It appears he runs a charter cargo airline and a 'motorsport business' (does any motorsport business make a profit? Has always seemed like a lifestyle business to me). Seems they've been delivering PPE to the UK via their cargo airline business.

But yeah I share your unease about the motives behind a wealthy, non-resident, business-owner's legal challenge of the lock down. His sentiment strikes me as similar to a couple of wealthy friends, both millionaire entrepreneurs, who've been complaining about the lockdown since day 1. Basically motivated by financial self interest - their rental income from commercial lets has dried up - and liberty to do whatever they want to do.

[Nigel]

What has New Zealand got to do with the UK? It’s absurd to me that anyone would even consider mentioning them in the same breath when comparing outcomes from a pandemic virus that relies for transmission on THE PROXIMITY OF PEOPLE 

All I said was that NZ had done well on their death rate, which they have. It wasn't a direct comparison with the UK but you've given a good explanation of the differences nonetheless!

RE borders, we are one of the very few countries on Earth who haven't controlled our borders at all. A large number of countries put some level of border control in place in the period March 14-23 - https://www.aljazeera.com/news/2020/03/coronavirus-travel-restrictions-border-shutdowns-country-200318091505922.html  Whether it is a worthwhile thing to do or not I don't know, and sure it would have been more difficult for the UK than some other countries. But of course it is possible with the political will, even for the UK. You would think that will would be strong here, given the "Take Back Control" mantra of the past few years. Obviously not. Anyway its a moot point now as its already here.

Hey Nige how’s the UK doing compared to Antarctica.   

I don't know? Is the British Antarctic Territory doing much worse than the NZ one? 

[Nigel]

That does not surprise me....

Good grief - why can't they just mea culpa this... I think many people would understand and see that we'll be at 100k soon....

Really tiresome stuff isn't it? You would think it would be quite easy to count things then tell people a straightforward number, but apparently there's shades of grey even to that. Interesting that they went for the "big lie" of 122K rather than the reality of 75K ish. Looks like they are more concerned with meeting an arbitary target than actually implementing a useful strategy. What are they going to do with the test results?

[Falling Down]

Wasn't sure which thread to put this in so picked this one.  A good article by Paul Taylor, head of 'Health Informatics' at UCL. https://www.lrb.co.uk/the-paper/v42/n09/paul-taylor/susceptible-infectious-recovered.  The LRB is usually paywalled so it might not be readable but I think if you register you can read a small number of articles.

Here's the final paragraph.

"The burden of the pandemic has so far fallen mainly on countries in South-East Asia, which coped with it relatively well, and Europe and North America, where the results have been more variable. Its spread will be global. We don’t have the data for many low and middle-income countries that would allow us to run detailed simulations of the kind I have described here. The Imperial team used a simple SIR model, adding survey data, where it exists, to estimate age-specific contact rates, which were then combined with demographic data and the Infection Fatality Rate estimates from China. The results suggest that, if nothing is done, the pandemic will lead to seven billion infections and forty million deaths worldwide. These figures could, in theory, be halved if various mitigation strategies were deployed, but healthcare systems everywhere would still be overwhelmed. The conclusion for the world is the same as it was for the UK. The only option is suppression, and its consequences, economic and social, are unknown."

[tomtom]

Good post FD. Looks like it’s ravishing through parts of S America at the moment...

[TobyD]

Re worldwide impact David Milliband was interviewed on the BBC saying that where politicians should be really concerned about is sub Saharan Africa. If they really start getting it, millions are quite likely to die, and migration and immigration will mean that unless it's eradicated or vaccinated against everywhere, then nowhere will be free of it. Essentially our worldwide situation is only as good as the weakest link. Sobering, but probably realistic.

[fiveknuckle21]

Wasn't sure which thread to put this in so picked this one.  A good article by Paul Taylor, head of 'Health Informatics' at UCL. https://www.lrb.co.uk/the-paper/v42/n09/paul-taylor/susceptible-infectious-recovered.  The LRB is usually paywalled so it might not be readable but I think if you register you can read a small number of articles.

Here's the final paragraph.

"The burden of the pandemic has so far fallen mainly on countries in South-East Asia, which coped with it relatively well, and Europe and North America, where the results have been more variable. Its spread will be global. We don’t have the data for many low and middle-income countries that would allow us to run detailed simulations of the kind I have described here. The Imperial team used a simple SIR model, adding survey data, where it exists, to estimate age-specific contact rates, which were then combined with demographic data and the Infection Fatality Rate estimates from China. The results suggest that, if nothing is done, the pandemic will lead to seven billion infections and forty million deaths worldwide. These figures could, in theory, be halved if various mitigation strategies were deployed, but healthcare systems everywhere would still be overwhelmed. The conclusion for the world is the same as it was for the UK. The only option is suppression, and its consequences, economic and social, are unknown."

I’m a short term reader of the LBR and some of these articles really need to be read at full length to appreciate the authors argument - this is one of the best, if not the best, pieces I have read in respect of the virus in the last couple of months. Jacqueline Roses article, in the same issue, is strangely pertinent to this one. Recommend both. Bit off topic. Sorry.

[Falling Down]

Not off topic at all 5knuckle - the LRB’s long form journo pieces are always on the money.

[ali k]

You would think it would be quite easy to count things then tell people a straightforward number, but apparently there's shades of grey even to that. Interesting that they went for the "big lie" of 122K rather than the reality of 75K ish.

Nigel - see above re: ‘tactically controversial’ number to keep it in the headlines. Same as £350k/wk, 50k nurses, 40 new hospitals...
I also hadn’t realised that Hancock sent out a mailshot to Tory members a few days before the deadline promoting the mail order tests with a link to the testing website - that’s where the stockpile of testing kits held back through early April will have come in handy! 

I guess the real test will come in maintaining those numbers and linking to a meaningful contact tracing strategy. And the overall ‘all causes’ mortality rate is a number that he presumably can’t fiddle or shy away from.