Coronavirus in the UK - news, lockdown and discussion

[Azrael]

So what do you think will happen?

Judging by the contact tracing app they've announced today, something resembling the South Korean approach of using geolocation tech to suppress the virus' spread until a vaccine's available.

This being Whitehall, expect to see a string of blunders along the way, and the need for constant pressure to get a functioning system in place, but at least the intent now appears to be there.

 

[mauvais]

As I previously mentioned the app is mostly balls. It's turning out to basically be a framework around an anonymous 'sorry I might have given you corona' tip-off system for people who you know you were in prolonged contact with.

 

[Azrael]

I’m speculating here but I wonder if the app is being seen as an alternative to actually having to set up teams of people at a local level to carry out contact tracing.

Exactly my thoughts, contact tracing on the cheap. Won't be enough, South Korea combined their tech with rigorous physical tracing and testing, and will need to apply pressure to get same here, but at least they've accepted the principle now.

 

[littlebabyjesus]

I’m speculating here but I wonder if the app is being seen as an alternative to actually having to set up teams of people at a local level to carry out contact tracing.

Sadly this was exactly my thought as well. And beyond that, is it an alternative to setting up teams to provide ongoing support to those isolating?

 

[elbows]

I believe the paper was completed on 9 April and published 10 April. So those week counts are from the 9th, which seems to tie in with the plots.

Have you got me on ignore or something?

From the body of the report:

For the UK, the peak case rate predictions were estimated at April 11th for the HMM and April 17th for the ODE model.

 

[Azrael]

As I previously mentioned the app is mostly balls. It's turning out to basically be a framework around an anonymous 'sorry I might have given you corona' tip-off system for people who you know you were in prolonged contact with.

The app may be junk, or it may be useful, but the concept of anonymous alerts is one used by other countries. If this particular app fails, others will be working on them (Apple and Google are already at it).

It's Whitehall and IT, my hopes aren't high for the first attempt. What's crucial is the shift in underlying thinking, to seeing the lockdown not as a temporary measure to ease strain on the NHS before we're back to unchecked spread, but a tool to buy time to get a suppression system in place. That's a major shift.

 

[Azrael]

Sadly this was exactly my thought as well. And beyond that, is it an alternative to setting up teams to provide ongoing support to those isolating?

We expect this gang of incompetent spivs to try and do it on the cheap. Important thing's that the principle'e conceded, and uncontrolled spread is no longer being pursued, whether covertly or overtly.

There's now ample scope to set up volunteer teams to aid contact tracing if the government drags their feet, although I'd want to check the volunteers closely!

 

[mauvais]

I'm not sure I agree with any of that unfortunately. Forget the app in this country IMO, and not just because it's government technology procurement. I'm not sure it demonstrates a coherent plan about anything, I think it's more a belief that there is some magic bullet to get us out of this and back to normal. Well there ain't.

 

[Azrael]

I'm not sure I agree with any of that unfortunately. Forget the app in this country IMO, and not just because it's government technology procurement. I'm not sure it demonstrates a coherent plan about anything, I think it's more a belief that there is some magic bullet to get us out of this and back to normal. Well there ain't.

There's no "magic bullet", but a range of interlinked measures to improve the situation. Ultimately, normality can only be achieved via elimination of the virus in the general population, which will come via it being starved of hosts via test-trace-isolate and vaccination (although if countries like New Zealand and Iceland succeed in eliminating SARS-CoV-2 domestically via quarantine and testing, they may get close to normality by shutting their borders and riding it out until a vaccine's available).

 

[elbows]

A suggestion here that the herd immunity idea lingered on after the denials.

Documents contradict UK government stance on Covid-19 'herd immunity'

List of possible interventions included simulating impact of allowing majority to be infected

www.theguardian.com

Ah, we wondered at the time whether it lingered on. I'm not surprised there were still traces of it for another couple of weeks, and I will have to continue to keep an eye on the broader data, modelling, antibody survey and international picture to see if any opportunities for such policy to come back on the radar emerge at any future point.

Its funny that the March 11th BBC article that Guardian story links to, featuring quotes from the nudge unit bloke, includes this:

from Care home residents could be 'cocooned' over virus

"There's a lot of goodwill, let's try and figure out what that will be and if they need training let's get it in place before we hit the summer."

Given it was only a month ago, there sure were some strange suggestions about when the peak would be back then. I can find other examples too, once I've had more time to prepare.

But I mention it now because it reminds me of something else. There is a graph from the influential Imperial College report of March 16th which shows critical care beds occupied over time. The orange and green lines on the lower graph are of note. Note that the green one peaks around now, the orange one, which didnt involve school & uni closures, peaks in summer. Please ignore the length of the lockdown measures (shaded area) and the 2nd peak in winter, thats not my focus and we've already moved on to considering more nuanced approaches for what comes next, my point is only about the first wave.



OK so that is interesting in itself, maybe that helps explain these strange variations in rhetoric describing wave timing (easter vs summer). But now lets take a look at a BBC article that was discussing the change of approach the government suddenly had to take. Oh its got a graph in it that looks familiar. But oh, they've tacked some 'explanations' onto it, and hmmm, they havent used the green line from the Imperial report, they've used the orange one!

Coronavirus: UK changes course amid death toll fears

Ministers were warned hundreds of thousands of people in the UK would die without stronger measures.

www.bbc.co.uk

 

[2hats]

Have you got me on ignore or something?

From the body of the report:

No. I only refresh periodically.

(Slightly) interestingly those dates don't appear to quite tally with their summary or plots. But one would have to run the MATLAB code to check the precise numbers. Obviously, the actual trend over the UK window of interest won't be clear for the best part of another week, at least. Or two.

 

[Azrael]

Given that the government were pushed into acting by organizations like the Premier League closing unilaterally and parents withdrawing kids from school, picture appears to be emerging that lockdown was imposed without a coherent justification beyond appearing to be in control of events.

They've now been left with roughly three short term choices: indefinite lockdown until a vaccine's available, which if it's even possible, would be socially, medically and economically ruinous; go back to generating "herd immunity" via rolling lockdowns, with the attendant death toll; or attempting an open suppression strategy like Germany's or South Korea's.

Don't see a way in which even the most ruthless politician would be able to pull off "herd immunity" in this fashion, leaving only suppression, however incompetently they go about it.

 

[zahir]

I’m not sure how relevant this is but here’s a report on Exercise Winter Willow, an influenza pandemic modelling exercise in 2007. There was a follow up to this, Exercise Cygnus, in 2016 but as far as I know reports on it haven’t been released.

http://iaem.com/documents/winter_willow_lessons.pdf

 

[SpookyFrank]

Given that the government were pushed into acting by organizations like the Premier League closing unilaterally and parents withdrawing kids from school, picture appears to be emerging that lockdown was imposed without a coherent justification beyond appearing to be in control of events.

They've now been left with roughly three short term choices: indefinite lockdown until a vaccine's available, which if it's even possible, would be socially, medically and economically ruinous; go back to generating "herd immunity" via rolling lockdowns, with the attendant death toll; or attempting an open suppression strategy like Germany's or South Korea's.

I expect them to pick option two while pretending to do option three.

 

[elbows]

No. I only refresh periodically.

(Slightly) interestingly those dates don't appear to quite tally with their summary or plots. But one would have to run the MATLAB code to check the precise numbers. Obviously, the actual trend over the UK window of interest won't be clear for the best part of another week, at least. Or two.

Sorry if I sounded arsy, its just I did an initial reply much earlier where I first mentioned those dates and then started going on about error bars, so I got a bit frustrated that the date uncertainty was continuing. #7,524

By the way in comparison to their modelling, it was only a few days ago that Vallance suggested that only a low single digits percentage of people had had it in the UK so far, with maybe some examples of it being a bit higher in some places (I'm assuming he was referring to the likes of London and the Midlands possibly being higher, and certainly I'd like to start to look at this stuff more regionally than as a whole country since the variations might be quite appreciable).

 

[Azrael]

I expect them to pick option two while pretending to do option three.

Even if they wanted to, how would they pull it off? During each subsequent lockdown, calls to impose a suppression strategy would grow to screams, you'd soon see judicial reviews and extraordinary efforts to remove the government from power. And we'd stand alone, with the world looking on in horror. For what gain?

The whole point of "herd immunity" was to avoid a lockdown and keep the economy running. It was callous, not homicidal for its own sake. That's now been lost. The Dr. Strangeloves may still be wedded to it, but it's lost all its political appeal.

 

[littlebabyjesus]

I expect them to pick option two while pretending to do option three.

I don't think that's politically viable. There will be too many examples of other countries doing waaaay better than the UK.

I actually do think that they finally realised three weeks ago that the only politically viable thing to do was to go all out attack on control and suppress. They've just been unable thus far to do it very well, partly due to incompetence, and partly due to only having realised this three weeks ago.

 

[Azrael]

I don't think that's politically viable. There will be too many examples of other countries doing waaaay better than the UK.

I actually do think that they finally realised three weeks ago that the only politically viable thing to do was to go all out attack on control and suppress. They've just been unable thus far to do it very well, partly due to incompetence, and partly due to only having realised this three weeks ago.

Exactly my thoughts. I suspect that many in the scientific and medical establishments secretly want to attempt their Nuremberg Code-flouting medical horror show, but its political appeal's gone. They sold it to a ruthless government as a means to avoid lockdown, save the economy, and, if you're feeling particularly cynical, cut spending on welfare and care homes.

They failed.

All they can offer ministers now are waves of deaths on a biblical scale, with no guarantee that "herd immunity" will ever be achieved, and none of the economic benefits. The government are amoral spivs, not homicidal maniacs. Nothing in it for them any more, and much to lose.

 

[mauvais]

I agree with Frank. Until lockdown is extended (or you know, implemented) we're still very much on 2. I think there are ways of disguising the realities of it, long short of conspiracy theories, although I wouldn't like to assert that they'll be a political success.

 

[littlebabyjesus]

I agree with Frank. Until lockdown is extended (or you know, implemented) we're still very much on 2. I think there are ways of disguising the realities of it, long short of conspiracy theories, although I wouldn't like to assert that they'll be a political success.

Here is where I disagree. There would be no way to disguise the reality of continued death. The govt is getting a bit of a free pass at the moment because we're in panic mode, but as that wears off, things can and will change.

 

[Azrael]

Especially if European countries get control of the situation, and even push towards eliminating the virus from their borders.

Would British citizens simply remain quiet as lockdown two commenced and a second wave of deaths piled up? Even Cummings sold "herd immunity" on the basis of avoiding a deadlier second wave.

Even attempting this is inviting your removal from power and prosecution for whatever your replacement in Whitehall thinks they can get away with. They're the actions of a comic book villain, not a government, however incompetent or ruthless.

 

[weltweit]

A repost from Scientific Advisory Group for Emergencies (SAGE): Coronavirus (COVID-19) response

SPI-M-O: Consensus view on behavioural and social interventions (16 March 2020) (PDF, 43.4KB, 1 page)

4. It was agreed that a policy of alternating between periods of more and less strict social distancing measures could plausibly be effective at keeping the number of critical care cases within capacity. These would need to be in place for at least most of a year. Under such as policy, at least half of the year would be spent under the stricter social distancing measures.

from 16/03/2020 https://assets.publishing.service.g...w-on-behavioural-and-social-interventions.pdf

 

[SpookyFrank]

Here is where I disagree. There would be no way to disguise the reality of continued death. The govt is getting a bit of a free pass at the moment because we're in panic mode, but as that wears off, things can and will change.

I certainly hope you're right.

 

[elbows]

A repost from Scientific Advisory Group for Emergencies (SAGE): Coronavirus (COVID-19) response

SPI-M-O: Consensus view on behavioural and social interventions (16 March 2020) (PDF, 43.4KB, 1 page)

from 16/03/2020 https://assets.publishing.service.g...w-on-behavioural-and-social-interventions.pdf

Yes that good evidence of the Monday where everything changed, and the extent to which the necessary change had sunk in at that level.

I wont take what they envisaged as being the medium term plan then too seriously now, since the coming months will likely to be filled with all sorts of interesting developments and the evolution of these ideas. And the ideas they had back then were very limited, eg the switching the measures on and off stuff was covered in a basic way by the usual Imperial College report that always comes up in connection with events of that day. All the other options and more nuanced variations of that plan have taken time to be considered in many other countries, and some of them are going to be tried for economic and psychological reasons. A picture where they try to compensate for certain relaxations via new measures (eg reopening some stuff but making the public wear masks as the most obvious example, but I'm sure there will be others).

 

[elbows]

So no, putting it in the terms other have been using in this conversation recently, I dont think they are going to go for a pure version of option 2.

But so much depends on how things go with other countries, and what sort of numbers we can get down to, and how quickly. And to what extent they actually manage to scale up testing. And to what extent hospital acquired cases continue, and so many related things.

Even without the more advanced options around testing and tracing, there are all sorts of ways to fiddle about with the lockdown parameters without resorting back to the crude 'switch the measures on and off over periods' approach. Switch just some bits on and off, try to compensate for relaxations. There are all sorts of things they could try which wont see us go back to anything like normal, but will give some people something, and wont lead us straight back to the sorts of levels of death we are currently experiencing.

Thats not to say I trust them to do the right thing, there are plenty of things they could get wrong as well as right. And its still a numbers game, but I think the order of magnitude of 'tolerable death' changed, and there is no avoiding that for them, especially since Johnson nearly ended up as part of those statistics.

Its very hard for me to estimate what relaxations would be reasonable for the UK soon, since we are only recently into the period where existing measures should make a difference to stats such as critical care beds occupied by Covid-19 cases. And despite the various models, I dont like to assume I have a proper sense of how quickly and how far various numbers will drop.

 

[elbows]

I agree with Frank. Until lockdown is extended (or you know, implemented) we're still very much on 2. I think there are ways of disguising the realities of it, long short of conspiracy theories, although I wouldn't like to assert that they'll be a political success.

Certainly over time we can expect there to be more and more dramatic and pressing examples of some of the people that are suffering terrible outcomes that have been caused by lockdown, fear of attemding health facilities for non-Covid-19 reasons, and related matters. I am glad I do not have to predict the exact political equations right now, but I suppose I expect the picture to get messier as time goes on and these different sorts of human tragedy come in and out of focus, media attention etc.

Yet more reasons for me to take things one week at a time. This coming week sure is an important one in terms of hospital-related numbers in the UK.

 

[Doodler]

Now that the weather is getting warmer, might it not be an idea to start selling food and other goods in the open air? That way people's exhalations would be more quickly dispersed. You could keep your distance more easily than in supermarkets with narrow aisles and blind corners. Supermarkets themselves often have large car parks that could be used to set up outdoor stalls selling the most commonly bought items. You could even get your hair cut outdoors.

 

[cupid_stunt]

You could even get your hair cut outdoors.

The hairdressers/barbers with need scissors with bloody long handles!

 

[Doodler]

The hairdressers/barbers with need scissors with bloody long handles!

They could wear gloves and get masked up.

 

[kabbes]

They could wear gloves and get masked up.

It’s alright, I think I’ll just put up with long hair, thanks