Main Coronavirus / Covid-19 Discussion Thread

[Bozza]

That is a great, ery well thought out post

But not quite as good as my bath/bucket version, right?

 

[Beach Hut]

So basically UK is accepting the inevitable and managing it accordingly whereas Italy is trying to eradicate something that possibly won't go away and current measures they have introduced may well have to be repeated at a later date (several times).

However they may have had to take this action as their medical system has reached breaking point already.

 

[Icy Gull]

But not quite as good as my bath/bucket version, right?

That was a bit more random but once you get your head around it, the bath/bucket version is just as good

 

[Thunder Bolt]

I really don't think so. My analogy may not be easy to understand, but I think it's what the government are trying to do. As does someone who knows more than me about this - and he even talks about a tap!

[tweet]1238518371651649538[/tweet]

1. The govt strategy on #Coronavirus is more refined than those used in other countries and potentially very effective. But it is also riskier and based on a number of assumptions. They need to be correct, and the measures they introduce need to work when they are supposed to.

2. This all assumes I'm correct in what I think the govt are doing and why. I could be wrong - and wouldn't be surprised. But it looks to me like. . .

3. A UK starting assumption is that a high number of the population will inevitably get infected whatever is done – up to 80%. As you can’t stop it, so it is best to manage it.

There are limited health resources so the aim is to manage the flow of the seriously ill to these.

4. The Italian model the aims to stop infection. The UKs wants infection BUT of particular categories of people. The aim of the UK is to have as many lower risk people infected as possible. Immune people cannot infect others; the more there are the lower the risk of infection

5. That's herd immunity.
Based on this idea, at the moment the govt wants people to get infected, up until hospitals begin to reach capacity. At that they want to reduce, but not stop infection rate. Ideally they balance it so the numbers entering hospital = the number leaving.

6. That balance is the big risk.

All the time people are being treated, other mildly ill people are recovering and the population grows a higher percent of immune people who can’t infect. They can also return to work and keep things going normally - and go to the pubs.

7.The risk is being able to accurately manage infection flow relative to health case resources. Data on infection rates needs to be accurate, the measures they introduce need to work and at the time they want them to and to the degree they want, or the system is overwhelmed.

8. Schools: Kids generally won’t get very ill, so the govt can use them as a tool to infect others when you want to increase infection. When you need to slow infection, that tap can be turned off – at that point they close the schools. Politically risky for them to say this.

9. The same for large scale events - stop them when you want to slow infection rates; turn another tap off. This means schools etc are closed for a shorter period and disruption generally is therefore for a shorter period, AND with a growing immune population. This is sustainable

10. After a while most of the population is immune, the seriously ill have all received treatment and the country is resistant. The more vulnerable are then less at risk. This is the end state the govt is aiming for and could achieve.

11. BUT a key issue during this process is protection of those for whom the virus is fatal. It's not clear the full measures there are to protect those people. It assumes they can measure infection, that their behavioural expectations are met - people do what they think they will

12. The Italian (and others) strategy is to stop as much infection as possible - or all infection. This is appealing, but then what? The restrictions are not sustainable for months. So the will need to be relaxed. But that will lead to reemergence of infections.

13. Then rates will then start to climb again. So they will have to reintroduce the restrictions each time infection rates rise. That is not a sustainable model and takes much longer to achieve the goal of a largely immune population with low risk of infection of the vulnerable

14. As the government tries to achieve equilibrium between hospitalisations and infections, more interventions will appear. It's perhaps why there are at the moment few public information films on staying at home. They are treading a tight path, but possibly a sensible one.

15. This is probably the best strategy, but they should explain it more clearly. It relies on a lot of assumptions, so it would be good to know what they are - especially behavioural. Most encouraging, it's way too clever for #BorisJohnson to have had any role in developing.

Regarding 4. Viruses mutate and do the rounds again. It isn't confined to one year. ie Spanish flu started in 1917 and carried on to 1919. The Asian flu started in 1967 but it's peak was winter 1968 (although to be fair, I caught it in December 67 and was ok the following year)

 

[Icy Gull]

Once this all blows over, I'll offer to give him some training on this kinda thing.

I'll bundle it in with my “apology for doubting Ali J" course.

Corrected for you

 

[peterward]

I really don't think so. My analogy may not be easy to understand, but I think it's what the government are trying to do. As does someone who knows more than me about this - and he even talks about a tap!

[tweet]1238518371651649538[/tweet]

1. The govt strategy on #Coronavirus is more refined than those used in other countries and potentially very effective. But it is also riskier and based on a number of assumptions. They need to be correct, and the measures they introduce need to work when they are supposed to.

2. This all assumes I'm correct in what I think the govt are doing and why. I could be wrong - and wouldn't be surprised. But it looks to me like. . .

3. A UK starting assumption is that a high number of the population will inevitably get infected whatever is done – up to 80%. As you can’t stop it, so it is best to manage it.

There are limited health resources so the aim is to manage the flow of the seriously ill to these.

4. The Italian model the aims to stop infection. The UKs wants infection BUT of particular categories of people. The aim of the UK is to have as many lower risk people infected as possible. Immune people cannot infect others; the more there are the lower the risk of infection

5. That's herd immunity.
Based on this idea, at the moment the govt wants people to get infected, up until hospitals begin to reach capacity. At that they want to reduce, but not stop infection rate. Ideally they balance it so the numbers entering hospital = the number leaving.

6. That balance is the big risk.

All the time people are being treated, other mildly ill people are recovering and the population grows a higher percent of immune people who can’t infect. They can also return to work and keep things going normally - and go to the pubs.

7.The risk is being able to accurately manage infection flow relative to health case resources. Data on infection rates needs to be accurate, the measures they introduce need to work and at the time they want them to and to the degree they want, or the system is overwhelmed.

8. Schools: Kids generally won’t get very ill, so the govt can use them as a tool to infect others when you want to increase infection. When you need to slow infection, that tap can be turned off – at that point they close the schools. Politically risky for them to say this.

9. The same for large scale events - stop them when you want to slow infection rates; turn another tap off. This means schools etc are closed for a shorter period and disruption generally is therefore for a shorter period, AND with a growing immune population. This is sustainable

10. After a while most of the population is immune, the seriously ill have all received treatment and the country is resistant. The more vulnerable are then less at risk. This is the end state the govt is aiming for and could achieve.

11. BUT a key issue during this process is protection of those for whom the virus is fatal. It's not clear the full measures there are to protect those people. It assumes they can measure infection, that their behavioural expectations are met - people do what they think they will

12. The Italian (and others) strategy is to stop as much infection as possible - or all infection. This is appealing, but then what? The restrictions are not sustainable for months. So the will need to be relaxed. But that will lead to reemergence of infections.

13. Then rates will then start to climb again. So they will have to reintroduce the restrictions each time infection rates rise. That is not a sustainable model and takes much longer to achieve the goal of a largely immune population with low risk of infection of the vulnerable

14. As the government tries to achieve equilibrium between hospitalisations and infections, more interventions will appear. It's perhaps why there are at the moment few public information films on staying at home. They are treading a tight path, but possibly a sensible one.

15. This is probably the best strategy, but they should explain it more clearly. It relies on a lot of assumptions, so it would be good to know what they are - especially behavioural. Most encouraging, it's way too clever for #BorisJohnson to have had any role in developing.

I was being facetious before very well written and informative reply.

 

[Sorrel]

12. The Italian (and others) strategy is to stop as much infection as possible - or all infection. This is appealing, but then what? The restrictions are not sustainable for months. So the will need to be relaxed. But that will lead to reemergence of infections.

The "but then what?" is the most important part. If we shut everything now and hope to entirely remove the disease it then relies on everywhere else in the world doing exactly that - and being successful - at the same time. This is very unlikely to happen, even with everyone trying as hard as they can.

And if it doesn't work - then what do we do? Stay locked down and not let in any foreigners for a year? The complete lock-down model isn't sustainable for more than a few weeks and I think the medical advisors are thinking longer term than that.

 

[RossyG]

Yes, exactly. I fear this will be a marathon not the sprint most of us assumed it would be.

 

[Bozza]

The "but then what?" is the most important part. If we shut everything now and hope to entirely remove the disease it then relies on everywhere else in the world doing exactly that - and being successful - at the same time. This is very unlikely to happen, even with everyone trying as hard as they can.

And if it doesn't work - then what do we do? Stay locked down and not let in any foreigners for a year? The complete lock-down model isn't sustainable for more than a few weeks and I think the medical advisors are thinking longer term than that.

Exactly.

Going "Full Wuhan", or as close as we could get in this country, would unquestionably slow the spread dramatically in the short-term, which would be fine if it were possible to get a vaccine to the vulnerable in some sort of short order, but we know we can't do that.

It does feel as though we may need to take some short-term pain for long-term gain, and it may take balls of absolute steel to stick with this approach.

 

[atomised]

I think the current approach is the correct one for a better long term. It makes sense when described in detail and I do like the bucket and bath concept

 

[Harry Wilson's tackle]

A friend of mine, serious competition to [MENTION=21064]easy[/MENTION]ten for the annual Hunter S Thompson award, sent this in an email today:

All the nukes in the world and all it takes is for a monkey to shag a pangolin eating a bat, and then someone to decide that impossible union would be good stir fry and the world comes to an end...

 

[Poojah]

It’s an interesting approach and sounds quite plausible as to what we might try to be doing. However, what’s not entirely clear is exactly who is at greater risk and should therefore be bunkering down for their own safety.

I get that it’s people over, say, the age of 65 and those with underlying health conditions - but which ones. I’m a physically fit and active 34 year old bloke, normal BMI. So no problem right? But then I do have a congenital aortic heart valve abnormality which means that a small amount of blood leaks backward on each bear. It means a little more load for my heart, but isn’t something I notice day-to-day - it’s just something that might require treatment in my older years. Is it a Coronavirus risk though, I don’t know for sure.

I’m working on the assumption I’m low risk like anyone else my age, but I’m conscious that if I’ve got that wrong the repercussions could be big for me and my family. I’m sure there are many examples out there like this. How many asthmatics do you know who are generally incredibly fit and healthy? You could probably include many athletes in that.

I get this is something we’re still learning about medically and scientifically, but some official guidance would be helpful to many people.

 

[rogersix]

A friend of mine, serious competition to [MENTION=21064]easy[/MENTION]ten for the annual Hunter S Thompson award, sent this in an email today:

All the nukes in the world and all it takes is for a monkey to shag a pangolin eating a bat, and then someone to decide that impossible union would be good stir fry and the world comes to an end...

 

[redoubtable seagull]

I really don't think so. My analogy may not be easy to understand, but I think it's what the government are trying to do. As does someone who knows more than me about this - and he even talks about a tap!

[tweet]1238518371651649538[/tweet]

1. The govt strategy on #Coronavirus is more refined than those used in other countries and potentially very effective. But it is also riskier and based on a number of assumptions. They need to be correct, and the measures they introduce need to work when they are supposed to.

2. This all assumes I'm correct in what I think the govt are doing and why. I could be wrong - and wouldn't be surprised. But it looks to me like. . .

3. A UK starting assumption is that a high number of the population will inevitably get infected whatever is done – up to 80%. As you can’t stop it, so it is best to manage it.

There are limited health resources so the aim is to manage the flow of the seriously ill to these.

4. The Italian model the aims to stop infection. The UKs wants infection BUT of particular categories of people. The aim of the UK is to have as many lower risk people infected as possible. Immune people cannot infect others; the more there are the lower the risk of infection

5. That's herd immunity.
Based on this idea, at the moment the govt wants people to get infected, up until hospitals begin to reach capacity. At that they want to reduce, but not stop infection rate. Ideally they balance it so the numbers entering hospital = the number leaving.

6. That balance is the big risk.

All the time people are being treated, other mildly ill people are recovering and the population grows a higher percent of immune people who can’t infect. They can also return to work and keep things going normally - and go to the pubs.

7.The risk is being able to accurately manage infection flow relative to health case resources. Data on infection rates needs to be accurate, the measures they introduce need to work and at the time they want them to and to the degree they want, or the system is overwhelmed.

8. Schools: Kids generally won’t get very ill, so the govt can use them as a tool to infect others when you want to increase infection. When you need to slow infection, that tap can be turned off – at that point they close the schools. Politically risky for them to say this.

9. The same for large scale events - stop them when you want to slow infection rates; turn another tap off. This means schools etc are closed for a shorter period and disruption generally is therefore for a shorter period, AND with a growing immune population. This is sustainable

10. After a while most of the population is immune, the seriously ill have all received treatment and the country is resistant. The more vulnerable are then less at risk. This is the end state the govt is aiming for and could achieve.

11. BUT a key issue during this process is protection of those for whom the virus is fatal. It's not clear the full measures there are to protect those people. It assumes they can measure infection, that their behavioural expectations are met - people do what they think they will

12. The Italian (and others) strategy is to stop as much infection as possible - or all infection. This is appealing, but then what? The restrictions are not sustainable for months. So the will need to be relaxed. But that will lead to reemergence of infections.

13. Then rates will then start to climb again. So they will have to reintroduce the restrictions each time infection rates rise. That is not a sustainable model and takes much longer to achieve the goal of a largely immune population with low risk of infection of the vulnerable

14. As the government tries to achieve equilibrium between hospitalisations and infections, more interventions will appear. It's perhaps why there are at the moment few public information films on staying at home. They are treading a tight path, but possibly a sensible one.

15. This is probably the best strategy, but they should explain it more clearly. It relies on a lot of assumptions, so it would be good to know what they are - especially behavioural. Most encouraging, it's way too clever for #BorisJohnson to have had any role in developing.

A problem however is the lack of a co-ordinated European response to the virus. Each country seems to be adopting it’s own strategy. Italy is probably an outlier as they’ve been taken by surprise and have had to impose restrictions in order for their medical services to cope. The US look to be woefully underprepared.

From what I’ve read, the virus will continue to spread across the globe but that most cases will be mild/asymptomatic, which will help drop the fatality rate to less than 1%. The bigger risks come from possible damage by overreacting politicians (trump?) who want to be seen as “doing something”... i.e. travel bans/cancel gatherings/quarantines, etc. and hospitals/facilities being at full capacity.

The virus is likely to become endemic and seasonal, given its similarity with other coronaviruses. Swine flu in 2009 is estimated to have affected 60m worldwide although it was thought older people had already built up some immunity to it. Most of the Covid 19 cases are mild and it is thought there is significant under-reporting of mild cases since so many patients are not being tested or seeking medical care.

I’m no Boris fan, but I think he’s playing this right. One of his ‘strengths’ it seems is he is willing to let others steer his thinking. In this case, working closely with and supporting the advice of science and medicine show wisdom that I did not think he possessed.

 

[Hugo Rune]

Coronavirus / Covid-19

I really don't think so. My analogy may not be easy to understand, but I think it's what the government are trying to do. As does someone who knows more than me about this - and he even talks about a tap!

[tweet]1238518371651649538[/tweet]

1. The govt strategy on #Coronavirus is more refined than those used in other countries and potentially very effective. But it is also riskier and based on a number of assumptions. They need to be correct, and the measures they introduce need to work when they are supposed to.

2. This all assumes I'm correct in what I think the govt are doing and why. I could be wrong - and wouldn't be surprised. But it looks to me like. . .

3. A UK starting assumption is that a high number of the population will inevitably get infected whatever is done – up to 80%. As you can’t stop it, so it is best to manage it.

There are limited health resources so the aim is to manage the flow of the seriously ill to these.

4. The Italian model the aims to stop infection. The UKs wants infection BUT of particular categories of people. The aim of the UK is to have as many lower risk people infected as possible. Immune people cannot infect others; the more there are the lower the risk of infection

5. That's herd immunity.
Based on this idea, at the moment the govt wants people to get infected, up until hospitals begin to reach capacity. At that they want to reduce, but not stop infection rate. Ideally they balance it so the numbers entering hospital = the number leaving.

6. That balance is the big risk.

All the time people are being treated, other mildly ill people are recovering and the population grows a higher percent of immune people who can’t infect. They can also return to work and keep things going normally - and go to the pubs.

7.The risk is being able to accurately manage infection flow relative to health case resources. Data on infection rates needs to be accurate, the measures they introduce need to work and at the time they want them to and to the degree they want, or the system is overwhelmed.

8. Schools: Kids generally won’t get very ill, so the govt can use them as a tool to infect others when you want to increase infection. When you need to slow infection, that tap can be turned off – at that point they close the schools. Politically risky for them to say this.

9. The same for large scale events - stop them when you want to slow infection rates; turn another tap off. This means schools etc are closed for a shorter period and disruption generally is therefore for a shorter period, AND with a growing immune population. This is sustainable

10. After a while most of the population is immune, the seriously ill have all received treatment and the country is resistant. The more vulnerable are then less at risk. This is the end state the govt is aiming for and could achieve.

11. BUT a key issue during this process is protection of those for whom the virus is fatal. It's not clear the full measures there are to protect those people. It assumes they can measure infection, that their behavioural expectations are met - people do what they think they will

12. The Italian (and others) strategy is to stop as much infection as possible - or all infection. This is appealing, but then what? The restrictions are not sustainable for months. So the will need to be relaxed. But that will lead to reemergence of infections.

13. Then rates will then start to climb again. So they will have to reintroduce the restrictions each time infection rates rise. That is not a sustainable model and takes much longer to achieve the goal of a largely immune population with low risk of infection of the vulnerable

14. As the government tries to achieve equilibrium between hospitalisations and infections, more interventions will appear. It's perhaps why there are at the moment few public information films on staying at home. They are treading a tight path, but possibly a sensible one.

15. This is probably the best strategy, but they should explain it more clearly. It relies on a lot of assumptions, so it would be good to know what they are - especially behavioural. Most encouraging, it's way too clever for #BorisJohnson to have had any role in developing.

Very well written.

I think you’ve nailed the government’s strategy but I’m very concerned by their supposed premise (point 3) which seems to be based on predictions like the one below:

“We are estimating that about 50,000 new infections per day are occurring in China. [...] It will probably peak in its epicenter, Wuhan, in about one month time; maybe a month or two later in the whole of China. The rest of the world will see epidemics at various times after that.
Prof. Neil Ferguson
Director, Institute for Disease and Emergency Analytics
Imperial College, LondonFeb. 6, 2020”

Essentially, the government believes lock downs like they have had in China and Hong Kong don’t or can’t work here. They assume the virus won’t disappear like SARS etc but will keep coming back time and time again.

We are seeing evidence that countries or regions can isolate themselves and reduce the infection rate to a very slow drip. The hope is obviously that it will just stop but the two things that could cease it (sunlight or vaccine) seem to be a long way away.

I think you’ve rightly identified the key issue in point 11 but it’s very sad that our older generation are being put at risk in the short term for the long term good. Thousands will die and very soon if you’re theory is correct. They won’t be dying at that rate in places like South Korea, Germany and Ireland I suspect. Time will tell if the common strategy of almost every other country was the better one. I think the government have it wrong.

I think you’ve also over played the ‘Italy model’ in terms of strategy, they were trying to do what Hong Kong has done (amazingly successfully so far) but way way too late. They clearly weren’t prepared when it hit, I’m not sure how much planning and strategy went into their approach but it seemed like Corporal Jones was in charge!

Lastly, you’ve not accounted for any financial implications affecting decision making here and have assumed the government is working on a single strategy (saving lives in the long term) alone. Looking at the backgrounds of those in government and the sort of people who fund their party, financial considerations would have been of some concern.

 

[Nobby]

That can't be true?

Have you been to an NHS hospital lately?

There is no spare capacity for this virus

 

[Nobby]

So basically UK is accepting the inevitable and managing it accordingly whereas Italy is trying to eradicate something that possibly won't go away and current measures they have introduced may well have to be repeated at a later date (several times).

However they may have had to take this action as their medical system has reached breaking point already.

As will ours - very soon

 

[wellquickwoody]

Lack of self awareness, perhaps?

As the saying goes.....................
go fxxk yourself

 

[Rodney Thomas]

Can I ask a question which may have been answered already. Italy's healthcare system was overwhelmed very quickly, they have more intensive care beds than us (albeit with an older population and other societal differences), surely we'd get to breaking point just as quickly as them and then we have all the associated problems that [MENTION=6886]Bozza[/MENTION] and others have already outlined (risk to non covid-19 patients who need emergency surgery for example).

It seems an extremely risky game the UK are playing.

 

[rogersix]

As the saying goes.....................
go fxxk yourself

Very eloquent