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[Jeremiah18.17]

So here is how the UK strategy comes unstuck. By advising people with symptoms to self isolate and not tracking or testing contacts of people who have tested positive or developed more severe symptoms, non symptomatic people/ people with minor “self deniable” symptoms will not self isolate and will spread the virus. Additionally, people with symptoms may self isolate for seven days and then come out into circulation, whilst still infectious or symptomatic, because the Govt only advised 7 days. Because people now understand that testing is only available to those showing more serious symptoms, it means people with minor symptoms can convince themselves that they are not infected, in order to go to work, or make an important appt or any number of things they see as more important....

 

[two sheds]

As said above, the essential part of this is monitoring - we need to be testing people and tracing contacts to build an accurate model of what's going on.

Seems to me that they're just adopting the least-cost approach, a medical laissez faire that values old and infirm peoples' lives at £0.

 

[elbows]

As the WHO director general said on Friday:

Second, detect, protect and treat.

You can’t fight a virus if you don’t know where it is. Find, isolate, test and treat every case, to break the chains of transmission.

Every case we find and treat limits the expansion of the disease.

Third, reduce transmission.

Do not just let this fire burn.

Isolate the sick and quarantine their contacts. In addition, measures that increase social distancing such as cancelling sporting events may help to reduce transmission. These measures, of course, should be based on local context and risk assessment, and should be time-limited.

Even if you cannot stop transmission, you can slow it down and save lives.

WHO Director-General's opening remarks at the media briefing on COVID-19 - 13 March 2020

www.who.int

 

[Marty1]

Scientists save coronavirus patient they feared would die with experimental drug — The Mirror

A woman in the US who was critically ill with coronavirus is now 'doing well' after being given the drug remdesivir, sparking hopes of a cure

apple.news

Meanwhile, in the UK, a lab in Whitechapel in London is offering volunteers £3,500 to be infected with a form of coronavirus in the race to find a vaccine.

Any takers?

 

[platinumsage]

It might be worth noting the weekly UK flu reports, which give respiratory illness figures for GPs, hospital admissions and also excess death figures. The week to 5th of March saw low levels of seasonal flu: National flu report summary: 5 March 2020 (week 10)

 

[Buddy Bradley]

Coronavirus: Tokyo Olympics will go ahead, says Japan's PM Shinzo Abe

Japan Prime Minister Shinzo Abe says the Tokyo Olympic Games will go ahead as planned in July, despite coronavirus concerns.

www.bbc.co.uk

This seems a particularly virulent case of blind optimism by the Japanese. Even if they can hold it, nobody's going to show up.

 

[Indeliblelink]

Spain going into lock down from Monday

PM due to make statement after seven-hour debate on state of alert measures

Draft decree includes banning all journeys in Spain apart from travel to work or to buy food. The delay on Saturday was reportedly due to differences between the Socialists and their coalition partners, Unidas Podemos

english.elpais.com

 

[Fez909]

Revised these figures seeing as we have a few more days worth of data:

Date	Original (40% then 20% from 13th)	Revised (30% then 20% from 13th)
Friday, 6 March 2020	163	163
Saturday, 7 March 2020	228	212
Sunday, 8 March 2020	319	275
Monday, 9 March 2020	447	358
Tuesday, 10 March 2020	626	466
Wednesday, 11 March 2020	877	605
Thursday, 12 March 2020	1227	787
Friday, 13 March 2020	1473	944
Saturday, 14 March 2020	1767	1133
Sunday, 15 March 2020	2121	1360
Monday, 16 March 2020	2545	1631
Tuesday, 17 March 2020	3054	1958
Wednesday, 18 March 2020	3665	2349
Thursday, 19 March 2020	4398	2819
Friday, 20 March 2020	5277	3383
Saturday, 21 March 2020	6333	4060
Sunday, 22 March 2020	7599	4871
Monday, 23 March 2020	9119	5846
Tuesday, 24 March 2020	10943	7015
Wednesday, 25 March 2020	13131	8418
Thursday, 26 March 2020	15758	10101

All the same caveats apply, etc., but these numbers put us about 13 days behind Italy.

The revised figure is out by only 7 compared to today's reported numbers.

 

[elbows]

Any takers?

The coronaviruses in question are ones that have been out there in the human population for a very long time, causing seasonal colds.

 

[MrCurry]

Coronavirus: Tokyo Olympics will go ahead, says Japan's PM Shinzo Abe

Japan Prime Minister Shinzo Abe says the Tokyo Olympic Games will go ahead as planned in July, despite coronavirus concerns.

www.bbc.co.uk

This seems a particularly virulent case of blind optimism by the Japanese. Even if they can hold it, nobody's going to show up.

The Japanese obsession with not backing down, so as to avoid “loss of face”

Hiroshima gets bombed: “No, let’s not surrender, let’s wait and see what happens next”
Fukushima blows up: “We can fix this, it’s no problem”
Covid-19 pandemic: “The most important thing is we carry on with the Olympics!”

Japanese Logic.

 

[Brainaddict]

The Japanese obsession with not backing down, so as to avoid “loss of face”

Hiroshima gets bombed: “No, let’s not surrender, let’s wait and see what happens next”
Fukushima blows up: “We can fix this, it’s no problem”
Covid-19 pandemic: “The most important thing is we carry on with the Olympics!”

Japanese Logic.

I do not think you have enough data points to make any generalisations.

 

[T & P]

These images of my bustling home city as a ghost town are mind blowing, for me at least....

Madrid se vacía por el coronavirus, en imágenes

La ciudad amanece con las calles desiertas y los comercios cerrados, salvo los de alimentación y primera necesidad

elpais.com

 

[magneze]

US travel ban extended to UK & Ireland.

 

[Indeliblelink]

been looking at live cams in Venice - utterly deserted

【LIVE】 Webcam Venice - Piazza San Marco | SkylineWebcams

Visit St. Mark’s Square in Venice live now! Watch our Venice Webcams and explore Piazza San Marco! Find out destinations in Italy with over 2000 HD live cams.

www.skylinewebcams.com

 

[T & P]

On further reading about the situation in Spain, word is the government is about to implement a nationwide lockdown. No one allowed to leave the house other than to go to work (for those who cannot work from home and must carry on working), to care for vulnerable relatives, or to buy food and medicines. Wow.

 

[prunus]

The Japanese obsession with not backing down, so as to avoid “loss of face”

Hiroshima gets bombed: “No, let’s not surrender, let’s wait and see what happens next”
Fukushima blows up: “We can fix this, it’s no problem”
Covid-19 pandemic: “The most important thing is we carry on with the Olympics!”

Japanese Logic.

I’m not sure we in Britain are in any position to be casting aspersions on anyone else’s gung-ho attitude to the approaching storm (I don’t know that you are in Britain of course).

 

[sihhi]

No, the message and mood music is different, they know this isnt the same or similar.

It does certainly seem to be the case that they want to start with the traditional 'business as usual' approach, but expect to have to switch to something very different.

The impression has certainly been put out there today that they'd like to have the business as usual phase last this whole month. I'm not sure if that is likely or not, I havent done the maths. I'd be tempted to say no, maybe 3 weeks if they are lucky, maybe much less than that, maybe I am miles off.

The mood music is different but the protective equipment is the same:

There were one and a half months since the WHO said it was a global emergency, but no PPE.
Surgical masks are ineffective - this is how the front line go down.
Given the lack of PPE ruthless containment measures are needed urgently, instead rugby league today simply carries on after Cheltenham.

 

[elbows]

I do rather expect a massive scandal about the lack of PPE at some point. The signs are there, its just a question of the issue rising to the top in the press etc.

They certainly havent relaxed the PPE requirements because of any actual belief that SARS-CoV-2 is not dangerous, its because the status of supplies is probably appalling before we have even started.

 

[cupid_stunt]

On further reading about the situation in Spain, word is the government is about to implement a nationwide lockdown. No one allowed to leave the house other than to go to work (for those who cannot work from home and must carry on working), to care for vulnerable relatives, or to buy food and medicines. Wow.

Well, they are at over 6,000 confirmed cases & 191 deaths now.

 

[elbows]

All travel suspended to the UK and Ireland effective Monday, Vice President
Vice President Mike Pence has announced all travel to the UK and Ireland will be suspended from midnight Monday EST.

25m ago 16:46

 

[sihhi]

I do rather expect a massive scandal about the lack of PPE at some point. The signs are there, its just a question of the issue rising to the top in the press etc.

They certainly havent relaxed the PPE requirements because of any actual belief that SARS-CoV-2 is not dangerous, its because the status of supplies is probably appalling before we have even started.

Yes the doctor writing that is being ironic.

An example of border closing amongst allies Azerbaijan and Turkey have cut all flights and only cargo will transported in future.

Russia has closed borders to Finland, Norway & Poland except for goods.

A summary of the urgent need for stricter measures here:

 

[Dan U]

25m ago 16:46

That's the trans Atlantic airlines needing state aid then. Final nail that additional ban.

 

[sihhi]

Seems to me that they're just adopting the least-cost approach, a medical laissez faire that values old and infirm peoples' lives at £0.

The least cost approach will eventually bring them to their knees. Britain will be a pariah - it will take much longer than other nations to control the virus here, the deaths will be far higher. Britain will be a no go zone by next year.
For a start, Asian students will not study in British universities and nor will tourists particularly want to visit Britain.
Deaths by coronavirus will be how the world is judged according to common sense in year's time.

 

[Supine]

The least cost approach will eventually bring them to their knees. Britain will be a pariah - it will take much longer than other nations to control the virus here, the deaths will be far higher. Britain will be a no go zone by next year.
For a start, Asian students will not study in British universities and nor will tourists particularly want to visit Britain.
Deaths by coronavirus will be how the world is judged according to common sense in year's time.

Or maybe you are completely and utterly wrong. Time will tell.

 

[elbows]

A summary of the urgent need for stricter measures here:

Whether 'flattening the curve' is a deadly delusion depends on what you are trying to do with it, what policies you are trying to justify by waving it around, etc.

Certainly various developed nations seem to have been caught off guard by what WHO ended up calling on countries to do once the WHO had a look at the Chinese response and the results. Its not what their existing pandemic plans would have expected, and most Covid-19 response plans were based off of older plans.

I've said it a lot before in recent days, but European Centre For Disease Control documents do feature such graphs and concepts. Its the detail of what to do in response and what capacity they think different countries intensive care facilities have that gets fed into the equation that matters as much as the concept. And in that respect the EU risk assessment docs dont seem completely out of touch. I will fish some bits out shortly as I finally have enough energy for this task.

 

[Jeremiah18.17]

Oh my goodness. Here it is - the argument for the “herd immunity” strategy, with various arrogant god-playing shits thinking it is a good idea. Basically a massive gamble with our lives and our country to gain “competitive advantage” that relies on an epic cross-silo speculative melange of epidemiology, virology and behavioural science. The reasoning behind a proposed law “forcing schools to stay open” becomes clear - our kids are about to be used as a “tap” to attempt to turn up and down the level of infections to achieve “ herd immunity” in the UK and therefore gain competitive advantage. Our vulnerable are “collateral damage”.
Strangelove/Mengele style God playing. It has the fingerprints of Cummings, Johnson and the National capitalist elite all over it.
If it goes wrong, they will be primed to blame those who questioned their strategy, saying we undermined their effectiveness ( apologists are already doing this!)
May our deity of choice have mercy on us. If they are wrong, hell, even if it “works” bloody revolutions have started with less provocation.

 

[sihhi]

Or maybe you are completely and utterly wrong. Time will tell.

I was responding to the government's false economy of limited tests only for those already in hospital.

The ball is the government's court. It's not inevitable it depends on their response.

Right now planeloads of Chinese students have started returning to China to escape their dorms and unis.

 

[elbows]

Some of the EU stuff, I have to cherry pick as there is too much that is somewhat relevant to this angle, and I still end up quoting too much, sorry.

https://www.ecdc.europa.eu/sites/default/files/documents/RRA-sixth-update-Outbreak-of-novel-coronavirus-disease-2019-COVID-19.pdf

The EU/EEA and the UK are quickly moving toward a scenario of sustained community transmission of COVID- 19. The situation is evolving very quickly and a rapid, proactive and comprehensive approach is essential in order to delay transmission, as containing transmission to local epidemics is no longer considered feasible. A rapid shift from a containment to a mitigation approach is required, as the rapid increase in cases, that is anticipated in the coming days to few weeks may not provide decision makers and hospitals enough time to realise, accept and adapt their response accordingly if not implemented ahead of time. Measures taken at this stage should ultimately aim at protecting the most vulnerable population groups from severe illness and fatal outcome by reducing transmission and reinforcing healthcare systems.

• Social distancing measures should be implemented early in order to mitigate the impact of the epidemic and to delay the epidemic peak. This can interrupt human-to-human transmission chains, prevent further spread, reduce the intensity of the epidemic and slow down the increase in cases, while allowing healthcare systems to prepare and cope with an increased influx of patients.
  Such measures should include:
  •  the immediate isolation of symptomatic persons suspected or confirmed to be infected with
    COVID-19;
  •  the suspension of mass gatherings, taking into consideration the size of the event, the density of
    participants and if the event is in a confined indoor environment;
  •  social distancing measures at workplaces (for example teleworking, suspension of meetings,
    cancellation of non-essential travel);
  •  measures in and closure of schools, taking into consideration the uncertainty in the evidence of
    children in transmitting the disease, need for day care for children, impact on nursing staff,
    potential to increase transmission to vulnerable grandparents;
  •  cordon sanitaire of residential areas with high levels of community transmission.

• If resources or capacity are limited, rational approaches should be implemented to prioritise high-yield actions, which include: rational use of confirmatory testing, reducing contact tracing to focus only on high-yield contacts, rational use of PPE and hospitalisation and implementing rational criteria for de- isolation. Testing approaches should prioritise vulnerable populations, protection of social and healthcare institutions, including staff.

• The 14-day cumulative notification rate of COVID-19, a measure of the prevalence of active cases in the population, is
  3.28 per 100 000 population in the EU/EEA as of 11 March, ranging from low rates of <0.1 to 16.3 per 100 000 in Italy and 19.8 per 100 000 in Iceland. The 14-days notification rate increased 10-fold over the last 10 days and, assuming no effect of mitigation measures, the EU/EEA and UK is predicted to reach 100 per 100 000 population (the Hubei scenario) by the end of March.

• Reports from some healthcare facilities in northern Italy indicate that intensive care capacity has been exceeded due to the high volume of patients requiring ventilation

ECDC estimated the risk of saturation of intensive care unit (ICU) beds and non-ICU beds, as well as hospital isolation capacity (airborne infection isolation rooms and single-bed rooms), through a simulation approach using hospital data of the 2016-2017 ECDC point-prevalence survey of healthcare-associated infections in acute care hospitals [52]. Hospital capacity was evaluated as a function of increasing prevalence of hospitalised COVID-19 cases per 100 000 population, for three levels of hospitalised COVID-19 patients requiring ICU care (5%, 18% and 30% severity scenarios), and using bed occupancy rates measured outside the winter season. The 14-days cumulative notification per 100 000 population was used as a proxy of the prevalence of active COVID-19 cases.

Based on these estimates four EU/EEA countries [0 - 10, depending on severity] would have a high risk of seeing their ICU capability saturated at a prevalence of 10 hospitalised COVID-19 cases per 100 000 population (approximately twice the Mainland China prevalence scenario at the peak of the epidemic). At a prevalence of 18 hospitalised cases per 100 000 (the Lombardy scenario as of 5 March) 12 countries [0 – 21, depending on severity] have a high risk of ICU capability becoming saturated. The ICU capacity of all [7 - 28] countries would be exceeded at a prevalence of 100 hospitalised per 100 000 (the Hubei province scenario at the peak of the epidemic) (Annex 2). Nonetheless, despite ICU capacity saturation in most countries, more than half of the countries (17) would still have a residual non-ICU bed capacity in the Hubei scenario.

According to predictions of the 14-day cumulative notification rate, the majority of EU/EEA countries would reach the Hubei scenario by end of March and all countries by mid-April 2020. These predictions need to be interpreted with caution because of prediction intervals inherent to modelling, and because of the underlying assumptions of: 1) a stable diagnostic testing policy and capacity and 2) an absence of effective mitigation measures.

The control measures have, up to now, only been able to slow the further spread, but not to stop it. If numerous local sub-national clusters of community transmission arise simultaneously, they could merge into a situation of widespread national community transmission. The likelihood of this occurring depends on the speed of detection of local transmission and whether effective response measures are applied early enough and at-scale. Early evidence from several settings globally indicates that rigorous public health measures, particularly related to isolation and social distancing, implemented immediately after identifying cases can reduce but does not exclude the probability of further spread. Evidence to-date from China, and emerging evidence from Korea, indicates that early decisive actions may reduce community transmission.

As the number of reported COVID-19 cases in the EU/EEA and the UK has increased in the last 10 days, very quickly in several EU/EEA countries, the probability of increased clusters in local areas and increased widespread community transmission is considered high. Analyses carried out by ECDC indicate that if the pandemic progresses on its current course without strong countermeasures or surge capacity enacted, that most EU/EEA countries will far exceed the available ICU capacity they currently have available by the end of March.

Oh I am not even half way through it and have already quoted all that. So I will stop for this post, but will likely continue in a little while. But hopefully a number of things are noted, including similarities and differences to the publicly stated UK approach, the same but for the UKs actual approach, some timing similarities and differences, acknowledgement of the intensive care and hospital capacity issues, acknowledgement of some things the WHO have said about the effectiveness of Chinas response.

 

[sihhi]

Whether 'flattening the curve' is a deadly delusion depends on what you are trying to do with it, what policies you are trying to justify by waving it around, etc.

Certainly various developed nations seem to have been caught off guard by what WHO ended up calling on countries to do once the WHO had a look at the Chinese response and the results. Its not what their existing pandemic plans would have expected, and most Covid-19 response plans were based off of older plans.

One key point is that r0 in an urban economy for this virus is much higher than assumed initially by non-Chinese analysts. The virus was underestimated so social distancing was assumed to be something that would come by April or May, the belief that contact tracing by professionals would be enough to retard the spread was also wrong.(In China most of the contact tracing and quarantine orders were put by volunteers.)

 

[elbows]

Carrying on with quoting that document, as I now get to the bit most relevant to the whole 'flattening the curve' business:

The situation is evolving quickly, and the currently notified cases reflect a situation in terms of transmission pressures about a week ago. Therefore, a proactive and aggressive approach is needed to delay transmission, as containing transmission in a specific area or country in the EU/EEA is no longer considered feasible (Figure 1). A rapid shift from a containment to a mitigation approach is required as the rapid increase in cases anticipated in the coming days to few weeks may not provide decision makers and hospitals enough time to realise, accept and adapt their response accordingly if not implemented ahead of time.

All EU/EEA countries should immediately and proactively initiate appropriate, proportional and evidence-based response options to prevent a situation of evolution to scenario 4, where the intensive care capacity is saturated and health systems are overwhelmed. The options provided below, therefore, focus on scenarios 2-4, which describe local and nationwide transmission scenarios.

In the current phase of the pandemic in the EU/EEA, priority response measures should focus on high-risk groups, healthcare systems and healthcare workers in order to ensure rapid detection and diagnosis of cases and protect healthcare staff, patients and other contacts from exposure. Measures to ensure appropriate functioning of the healthcare system (including laboratories) with increasing numbers of cases should be implemented. Social distancing measures and risk communication remain essential pillars to effective mitigation approaches, while rational testing, contact tracing and surveillance approaches can be implemented to match resource availability and capacity.

And now we really start to get into stuff that might start to look rather familiar to those who have heard the UK's publicly stated response to the pandemic:

The options proposed for preparedness and response aim to limit the impact of the pandemic on healthcare systems and vulnerable population groups by delaying the epidemic peak and decreasing the magnitude of the peak.

It is important that planned response strategies, including diagnostic testing, can be adapted according to case finding strategies and adjusted to a surge of cases by de-escalating procedures that might no longer be feasible and/or beneficial

The need for individual and shared responsibility should be emphasised through a focus on frequent hand washing, always covering the mouth and nose with tissues or elbow when sneezing or coughing, and implementation of self-isolation when symptomatic. Messaging on self-isolation and voluntary quarantines should encourage consideration of a support system to provide essential services and supplies (e.g. food and medication). Vulnerable individuals including the elderly, those with underlying health conditions, disabled people, people with mental health problems, homeless people, and undocumented migrants will require extra support and perhaps specific communication channels and language. Authorities may want to consider coordinating with and supporting civil society and religious groups who already work with these populations. Please refer to the guidance on community engagement for more details.

And something that has very much not been part of the UKs publicly stated approach. Perhaps it is fair to suggest that this is the crux of the matter in terms of current complaints about UK government strategy:

The evidence for the effectiveness of closing schools and workplaces, and cancelling mass gatherings is limited. However, one modelling study from China estimated that if a range of non-pharmaceutical interventions, including social distancing, had been conducted one week, two weeks, or three weeks earlier in the country, the number of COVID-19 cases could have been reduced by 66%, 86%, and 95%, respectively, together with significantly reducing the number of affected areas [72].