Yes. The mistakes made up to about a week ago, absolutely. Totally callous disregard for life. That they are now doing better doesn't undo those mistakes.
I say this respectfully but do you not think it might just be that it’s really fucking hard doing that job? People are so quick to jump in damning others, but it’s the man in the arena that counts. It’s like on the frontline of the NHS, mistakes will be made, but if your standing on the sidelines criticising, well...
I’m no Tory but I don’t think they are evil or completely incompetent. And I absolutely definitely think their aim is to preserve life.
Yes, it's really hard. It's even harder to manage a crisis when you prioritise other things over life, which is what they were doing. Where is the ppe? Where are the testing kits?
They have done a very difficult job very badly. And a big reason why they did it badly is because they had callous intentions.
Even if they largely get away with their botched timing and messages, I dont think they will get off the hook for the massive PPE scandal and the damage of the austerity years. I dont yet know how history will judge them regarding testing because so many other countries were similar, EC documents include plenty of testing caveats related to limited test capacity, etc.
Anyway there are now signs that they are going to try to blame China as much as possible. More thoughts and quotes on that shortly.
I disagree with your interpretation of the graphs. Remember that in the first few days the numbers are so low that natural variation will put the lines in quite different places. As the numbers ramp up, the lines adopt a remarkably similar straight line behaviour while unchecked exponential growth is taking place. For instance, move Italy back a couple of days and it sits right on top of Spain for a good deal of its trajectory (Spain a bit worse if anything than Italy, now). But Spain and Italy are now curving, indicating that exponential growth is finally being tackled. (And the '10 deaths' marker has the big disadvantage that we're not comparing like with like - Italy is bigger than Spain: 10 deaths in Spain means something more serious than 10 deaths in Italy.)
If there was variation in starting point, though, they wouldn’t all line up so perfectly a week or two down the line. If you advanced Spain by a few days too, it would not line up on that curve — its growth rate is faster. It seems pretty clear that to date, Germany, U.K. and France (as well as the Netherlands, Belgium and a bunch of others) are following very, very similar patterns.
I have, because this is part of how I deal with anxiety and uncertainty, been trying to model what 'achieving' 20,000 deaths in the UK would look like in terms of peak time and size and daily deaths to get there.
Usual caveats apply - I have limited data with unknown error both systematic and random, I am not an epidemiologist, there are implicit assumptions (such as that death rates will not be increased by healthcare collapse, that lockdown measures here will have similar effects to elsewhere (not identical, but qualitatively similar) and that they continue in effect until at least the end of April, and many more). NB also like the government I am only counting deaths in hospitals, as that's the only data I have. Small studies elsewhere have suggested that deaths outside hospitals may be 2, 3 or even 4 times the hospital number, but I assume also that the reported hospital number is the 20,000 'target'. (Let's not think about how that target can be manipulated by just not taking people to hospital and letting them die at home).
Anyway, I thought I'd share my conclusions and predictions/targets for those who are interested. It's something to compare the daily numbers to to see how we're doing in respect of that 20,000 number.
I could be completely wrong, this is just a bit of (and what a misnomer in the circumstances) fun, please don't promulgate this on social media as true or anything or as either good news or bad news depending on how it pans out.
Warning: distressing daily death totals predictions.
Going to spoiler it so people who want to completely ignore it can.
So, in short:
The peak (daily deaths) looks like being around the 11th april (+/- about a day, day and a half), at 1300 (+/-5%). The next few days (including todays) death figures should look something like 195, 240, 300, 375,470, after which the rate of increase of the rate of increase should hopefully start to drop off. Approximate daily deaths to the 'peak' (actual data will likely be lumpy of course):
This is, I think, quite a 'pessimistic' model, as that's how I roll, so if the numbers come out better than this it's less good than it is bad if the numbers come out higher. Ie this is I think the top 'edge' of the range of death figures that we can sustain and keep deaths under 20,000.
Again: I could be completely wrong! Please take with a large pinch of salt! If you've got any left.
If there was variation in starting point, though, they wouldn’t all line up so perfectly a week or two down the line. If you advanced Spain by a few days too, it would not line up on that curve — its growth rate is faster. It seems pretty clear that to date, Germany, U.K. and France (as well as the Netherlands, Belgium and a bunch of others) are following very, very similar patterns.
Germany is also following a similar pattern to China at the moment. That's the point - when will they come off exponential growth? Looks like Spain and Italy are finally coming off it now. Will others reach their levels of deaths before flattening out? I'm a lot more confident that Germany will than that the UK will (although I suspect both will be less bad than Spain or Italy because it looks like lockdowns do work).
Asked on BBC One’s Andrew Marr show why Britain did not have sufficient testing, despite the first case in China being known about in December, Gove said: “We’ve been increasing the number of tests over the course of the last month.
“It was the case … [that] the first case of coronavirus in China was established in December of last year, but it was also the case that some of the reporting from China was not clear about the scale, the nature, the infectiousness of this.”
The Mail on Sunday reported that senior Downing Street officials and ministers expect a “reckoning” with China over misinformation in relation to the outbreak. It also claimed there was anger over perceived attempts by China to exploit the crisis for economic gain.
I'm sure I will have plenty to say about that. No time to do it justice now though, so here is a dangerously abbreviated version: Probably fair to blame China for about 3 weeks of lost time (start of year->Jan 20th when the public tone from China changed). Far less room to blame China or others for time lost after that point. And there are minutes from specialist UK advisory groups which we can already use to judge when the establishment started to take it seriously in this country. If data from other countries ends up clearly demonstrating extreme manipulation of Chinas number of reported deaths, then that is a fresh angle to fairly attack them over. Some of the propaganda stuff China has tried is also worthy of condemnation.
I dont think China can be blamed for our approach to testing, contact tracing etc. Thats all about the orthodox pandemic approach that was baked into UK thinking.
I have, because this is part of how I deal with anxiety and uncertainty, been trying to model what 'achieving' 20,000 deaths in the UK would look like in terms of peak time and size and daily deaths to get there.
Usual caveats apply - I have limited data with unknown error both systematic and random, I am not an epidemiologist, there are implicit assumptions (such as that death rates will not be increased by healthcare collapse, that lockdown measures here will have similar effects to elsewhere (not identical, but qualitatively similar) and that they continue in effect until at least the end of April, and many more). NB also like the government I am only counting deaths in hospitals, as that's the only data I have. Small studies elsewhere have suggested that deaths outside hospitals may be 2, 3 or even 4 times the hospital number, but I assume also that the reported hospital number is the 20,000 'target'. (Let's not think about how that target can be manipulated by just not taking people to hospital and letting them die at home).
Anyway, I thought I'd share my conclusions and predictions/targets for those who are interested. It's something to compare the daily numbers to to see how we're doing in respect of that 20,000 number.
I could be completely wrong, this is just a bit of (and what a misnomer in the circumstances) fun, please don't promulgate this on social media as true or anything or as either good news or bad news depending on how it pans out.
Warning: distressing daily death totals predictions.
Going to spoiler it so people who want to completely ignore it can.
So, in short:
The peak (daily deaths) looks like being around the 11th april (+/- about a day, day and a half), at 1300 (+/-5%). The next few days (including todays) death figures should look something like 195, 240, 300, 375,470, after which the rate of increase of the rate of increase should hopefully start to drop off. Approximate daily deaths to the 'peak' (actual data will likely be lumpy of course):
This is, I think, quite a 'pessimistic' model, as that's how I roll, so if the numbers come out better than this it's less good than it is bad if the numbers come out higher. Ie this is I think the top 'edge' of the range of death figures that we can sustain and keep deaths under 20,000.
Again: I could be completely wrong! Please take with a large pinch of salt! If you've got any left.
Minister says China was ‘not clear about the scale, the nature, the infectiousness’ of virus
www.theguardian.com
I'm sure I will have plenty to say about that. No time to do it justice now though, so here is a dangerously abbreviated version: Probably fair to blame China for about 3 weeks of lost time (start of year->Jan 20th when the public tone from China changed). Far less room to blame China or others for time lost after that point. And there are minutes from specialist UK advisory groups which we can already use to judge when the establishment started to take it seriously in this country. If data from other countries ends up clearly demonstrating extreme manipulation of Chinas number of reported deaths, then that is a fresh angle to fairly attack them over. Some of the propaganda stuff China has tried is also worthy of condemnation.
I dont think China can be blamed for our approach to testing, contact tracing etc. Thats all about the orthodox pandemic approach that was baked into UK thinking.
Indeed - and they are probably counting on (or already know that) the reported Chinese numbers are wrong so that they can say they lied about something, even if as you say its zero to do with our response.
I dont think the original strategy was informed by a callous disregard for life so much as a technocratic 'long view' which tried to take in the damage to lives that closing down the economy might do. In the end I think it just became clear that allowing so many short term real deaths for the sake of some theoretical deaths further down the line wasnt actually politically possible.
Assuming government is in the hands of dick dastardly doesnt really help tbh.
I’ve been quite impressed with the Government so far in the crisis. They are taking, and acting on, scientific and medical advice. On the whole they’ve communicated clearly. They have not been afraid to make big decisions, such as the 80% wages, closing non-essential business, and constructing with the Army and the NHS a massive new covid hospital NHS Nightingale very quickly.
After a slightly beurocratic and slow start, NHS England appears to be doing a reasonable job at making us as ready as possible. Yes, we need more PPE, more testing, more ventilators- but visible steps leading to procurement as quickly as possible appears to have occurred. Overall, I feel as if we have leadership and there is a national effort underway.
LOL and those who died before the lockdown and immediately after are just sacrificial lambs whose lives had to be dispensed with to make the government shook, right?
I dont think the original strategy was informed by a callous disregard for life so much as a technocratic 'long view' which tried to take in the damage to lives that closing down the economy might do.
That technocratic 'long view' is a callous disregard for life. All the damage to the economy caused by a couple of months on a pandemic economy can be repaired in a year, given the will to do it. I hate the comparisons to war, and one reason is that those comparing it to WW2 fail to remember that that war lasted six years. This is nothing compared to that. It's a temporary inconvenience, or it would be if we had a sane system.
As for your 'dick dastardly' comment, well ffs where have you been for the last 10 years? 'Austerity' is another example of a policy borne of a callous disregard for life. That's a really stupid comment.
I'd advise that people should take the trouble to try to understand the herd immunity thing, even if it sounds weird at first hearing, because the evidence is growing that it was the correct policy. They might discover it makes more sense than what is currently happening (imitating the Italian and Chinese policies). The latest figures (yesterday) report that only 12 people of 1019 deaths so far in the UK were outside high-risk groups. That means that a policy of stringently sheltering the 20% in high-risk groups would be 99% effective in preventing deaths. The problem with this virus is that it spreads to an average of 2.4 people in the next generation from every person infected. A vaccine can make people immune by getting people to generate antibodies to the virus. If you inoculate about 60% of the population, then only 1 in 2.4 people that an infectious person meets will be susceptible to infection. A bit more inoculation and the figure is less than one. That means that there will be fewer sick people in the next generation of the illness than in the current group of sick people. Over a few more generations the disease dies out in the population (and can never grow again). Unfortunately, a vaccine is a year away. However, people who get a mild dose of the virus (virtually all the 80% low-risk people) also develop antibodies when they recover and become immune. It would only take a couple of months of sheltering the high-risk people for more than 60% to develop immunity among the low-risk groups. So we could have both lowered the death rate by 99% and altogether stopped the virus spreading into the high-risk groups by following the government’s original policy. As it is, the social isolation is also stopping low-risk people developing immunity, so it is protracting the duration over which the disease can spread, meaning that the high-risk people and the low-risk people will have to socially isolate for much longer. The way disease dynamics works is complicated and people’s instincts do not necessarily tell them the best way forward. The reason the government abandoned its original policy was partly pressure from people who did not understand it and partly a risk that they could not sufficiently accurately identify the high-risk groups, but the latest statistics show that the high-risk groups have been sufficiently well identified to crash the death rates to negligible levels. The other thing to remember is that current daily death rates reflect infection rates three weeks ago, before any significant measures had been taken. It is important to wait long enough to see whether measures have any effect upon the death rate.
Indeed - and they are probably counting (or already know) that the reported Chinese numbers are wrong so that they can say they lied about something, even if as you say its zero to do with our response.
We can conclude with some certainty that poor information from the early period in China cannot really be blamed for obscuring the UKs view of matters by late January.
Because, for example, if I look at the NERVTAG minutes from January 28th, they were not blind to the R0 estimates:
2.14The epi-update included the estimated reproduction number from a WHO Emergency Committee meeting on 22 January 2020 where they stated that “Human-to-human transmission is occurring and a preliminary R0 estimate of 1.4-2.5 was presented. Amplification has occurred in one health care facility. Of confirmed cases, 25% are reported to be severe. The source is still unknown (most likely an animal reservoir) and the extent of human-to-human transmission is still not clear.”
2.15 SPI-M group met yesterday and TI reported that the literature that was reviewed by SPI-M was of data from earlier in the epidemic and the R0 ranged from 2.2 to 3.1. The impact of the recent interventions by the Chinese Government on the R0 is not yet known. However, there seems to be a broad consensus across modelling groups worldwide that R0 seems to be ranging from 2.5 –3.0 based on the most up to date data.
2.17 NF noted that the case numbers seem to be doubling every three to four days. There is no evidence of it slowing so far but it is hard to tell given the delay in the incubation period and how long it is taking to confirm cases at the moment.
2.18 NF noted that we are witnessing much greater variability in transmissibility between people than we would expect with influenza but this is expected with these types of virus. Although extensive person-to-person transmission outside of China has not yet been seen, in the early days of the influenza pandemic in 2009 it was difficult to detect onward transmission and it is likely that more information on nCoV person-to-person transmission outside of Chinawill come out in the next few weeks.
Disagree - the 'herd immunity' policy period was simply an understanding, put there by CMO/CSA/PHE and NHS, that huge numbers (anywhere between 250,000 and 500,000) were going to die, almost regardless of whether they went to ICU or lay in a wet field, with another 250,000 to 750,000 being only able to survive if they could get into an ICU/HDU. Policy during that period was aimed solely at flattening out the demand peaks so that as great a proportion of those who needed an ICU/HDU and had a reasonable chance of survival could access one as possible. It simply accepted that a huge number of people would die, but wanted to save who it could.
It was described as being like a cruise liner had sunk in the South Atlantic - you simply couldn't get to every lifeboat your AIS system saw before anyone in those lifeboats froze to death, so you used what resources you had to rescue both as many lifeboats as possible, but also to prioritise rescuing lifeboats with 50 people in them rather than lifeboats with 2 people in them.
Remember the tac changed after that Impirial College report indicating up to 500,000 people could die if tougher measures weren't taken. Until this point, the herd immunity idea was live.
I'm not excusing the mistakes, the lack of PPE, ventelators, general, miscommunications etc and obviously I'm no fan of Johnson's. But this seeing Machiavillian evil intent is daft and juvenile.
We can conclude with some certainty that poor information from the early period in China cannot really be blamed for obscuring the UKs view of matters by late January.
Because, for example, if I look at the NERVTAG minutes from January 28th, they were not blind to the R0 estimates:
I agree, and as you said this is nothing to do with the rubbishness of our response, the lack of information etc. What it will be to do with is them being able to construct a narrative that says the real number of deaths in China was X, China lied therefore they are to blame.
Gove telling us that when this goes on for months it will be our fault for not behaving ourselves. And not the government's fault for not protecting hospital staff, allowing non-essential businesses to remain open, generally taking a half-arsed back-of-an-envelope approach to the whole thing.
This is a special kind of evil we're seeing here. Gaslighting on a national scale.
What was the thinking behind the herd immunity plan? Interesting Q&A on Reddit with a 'UK Critical Care Physician':
Over the past decade, eminent figures in public health developed complex models that would help inform the UK response to a pandemic. The response plan would allow slow spread through a population and a number of deaths that would be deemed acceptable in relation to low economic impact. Timing of population measures such as social distancing would be taken, not early, but at a times deemed to have maximal psychological impact. Measures would be taken that could protect the most vulnerable, and most of the people who got the virus would hopefully survive. Herd immunity would beneficially emerge at the end of this, and restrictions could relax. This was a ground-breaking approach compared to suppressing epidemics. It was an approach that could revolutionise the way we handled epidemics. Complex modelling is a new science, and this was cutting edge.
But a model is only ever as good as the assumptions you build it upon. The UK plan was based on models with an assumption that any new pandemic would be like an old one, like flu.
Gove telling us that when this goes on for months it will be our fault for not behaving ourselves. And not the government's fault for not protecting hospital staff, allowing non-essential businesses to remain open, generally taking a half-arsed back-of-an-envelope approach to the whole thing.
This is a special kind of evil we're seeing here. Gaslighting on a national scale.
Don't now what you're seeing (or have seen) people on the streets and in the shops and bars doing round your way, but people not following the guidelines definitely will have played their part in this mess. Both government and the behaviour of individuals and groups can be partly to blame. Calling it gaslighting is ridiculous.
I dont think the original strategy was informed by a callous disregard for life so much as a technocratic 'long view' which tried to take in the damage to lives that closing down the economy might do. In the end I think it just became clear that allowing so many short term real deaths for the sake of some theoretical deaths further down the line wasnt actually politically possible.
Assuming government is in the hands of dick dastardly doesnt really help tbh.
LOL and those who died before the lockdown and immediately after are just sacrificial lambs whose lives had to be dispensed with to make the government shook, right?
Seb, it’s a fucking pandemic. People are going to die. The Tories can’t stop that and thinking that somehow better policies could have prevented that is magical thinking. Some things are beyond human control.
And to all those going, but where is the PPE, where are the tests etc There’s a global shortage. Frankly I think the fact we have these million tests coming this week is little short of a bloody miracle. But people who are so much in their own rigid bubble of “Tories are evil” just literally cannot see it. Sometimes I think the views on this site are so extreme that you don’t realise how out there your thinking is.
The reason the government abandoned its original policy was partly pressure from people who did not understand it and partly a risk that they could not sufficiently accurately identify the high-risk groups, but the latest statistics show that the high-risk groups have been sufficiently well identified to crash the death rates to negligible levels. The other thing to remember is that current daily death rates reflect infection rates three weeks ago, before any significant measures had been taken. It is important to wait long enough to see whether measures have any effect upon the death rate.
Isnt this a case of you wanting to have your cake and eat it? Problems with your stance:
You are inviting us to wait and see how the measures affect the numbers, and yet you seem to be suggesting those measures werent necessary in the first place.
The other big problem is that I have yet to find anyone who knows exactly what the governments original approach would have meant in terms of lockdown measures and timing. Their original approach still involved mitigation, and no matter what they pretended, we could all see school closures coming, it was mostly just a question of the exact timing of them. They were already softening us up for big things to happen, even before the impression was created that they had to suddenly shift approach completely.
Don't now what you're seeing (or have seen) people on the streets and in the shops and bars doing round your way, but people not following the guidelines definitely will have played their part in this mess. Both government and the behaviour of individuals and groups can be partly to blame. Calling it gaslighting is ridiculous.
Hard to see what other word would be appropriate; the messages they are sending out still contradict the advice they are giving out. Look at those photos of him videoconferencing with a room full of people yesterday, for example.
Pandemics are bad, thats why we plan seriously for them. Tories are bad, thats why they undermined the plans with their fiscal requirements and hollowing out of the health service.
People can believe what they like, but the public inquiry will not be charitable towards the failings of both the elected politicians, and the various other layers of the establishment. Or at least the evidence-based sessions wont be kind. The conclusions will likely be a fudge, unless we have already hung those responsible long before that time comes.
This is broadly my view
Seb, it’s a fucking pandemic. People are going to die. The Tories can’t stop that and thinking that somehow better policies could have prevented that is magical thinking. Some things are beyond human control.
And to all those going, but where is the PPE, where are the tests etc There’s a global shortage. Frankly I think the fact we have these million tests coming this week is little short of a bloody miracle. But people who are so much in their own rigid bubble of “Tories are evil” just literally cannot see it. Sometimes I think the views on this site are so extreme that you don’t realise how out there your thinking is.
I fucking hate the tories, don't get me wrong - but I think it's necessary to try and understand their motivations in a way that goes beyond 'bad man hate poor people', otherwise you miss stuff.
Has anyone found an official webpage where the daily NHS England deaths are listed (ie on a per hospital trust basis)? I keep seeing this data in local newspapers and health journals but I have yet to find the original source (it hasnt been on the NHS England website News section since about the 16th March).
I say this respectfully but do you not think it might just be that it’s really fucking hard doing that job? People are so quick to jump in damning others, but it’s the man in the arena that counts. It’s like on the frontline of the NHS, mistakes will be made, but if your standing on the sidelines criticising, well...
I’m no Tory but I don’t think they are evil or completely incompetent. And I absolutely definitely think their aim is to preserve life.
I'd be interested in how you can look back at the last 10 years of Tory rule and not describe them as evil and callous. I know that you're not blind to what they have done to communities, workers, unwaged people and those that need help so how would you describe them? "Not very nice" doesn't really cut it does it?
Since deaths are 100 times less likely for the low-risk 80%, and the overall death rate is about 2% of infections (without any measures), I think we would see a death rate of 0.02% or one infected person in 5000. We will probably see a death rate higher than that under the current policy, because although the short term death rate may be crashed by the lock-down, the lock-down will be relaxed before herd immunity has been achieved so there will be a non-negligible lingering fatal disease plus re-infections from overseas.
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