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Coronavirus in the UK - news, lockdown and discussion

Lots of us are learning new things here. Rnought is a new term I've learned. The beauty of it is that the maths is simple and it's really easy to understand. Basically get the R0 under 1 - ie on average each infected person infects less than one other person, say 0.9 - and the virus will eventually disappear. Anything above 1 and it spreads.

It is that simple. :)

What Is R0? Gauging Contagious Infections
It might be that simple if you know the R numbers, but you don't. You just think you do.
 
Wishful thinking. You're overlooking the fact that we don't know who's carrying it. We don't know how many people are getting it or how many of those have no symptoms. Those are just a couple of the huge unknowns.
Yes, of course there's unknowns. As littlebabyjesus says, this is why a national programme of intensive contact tracing and targeted testing is needed, along with quarantine of anyone crossing our borders.

Australia and New Zealand are now close to eliminating community transmission via a combination of these methods. Given the major cities in Oz, this isn't down to luck and population density, but policy. As an island, we're ideally suited to doing the same, and should start at once.
 
It might be that simple if you know the R numbers, but you don't. You just think you do.
There's a time lag admittedly, but unless you have an idea different from this, the number of people reporting symptoms of Covid 19 is very tightly correlated to the number of people becoming infected with Covid 19 virus. You speak of this as if it were some magically hidden process, but it's not. We can measure it well enough by measuring the thing we don't want that is a direct result of it.

That holds true however many people there are who are symptomless or who are resistant to catching it in the first place, so long as the proportions of such people in a large population are the same across time and place, which they likely are at the population level, again unless you know different.
 
This shouldn't even be a debate: we have clinical data from other countries, we know how the virus spreads, we know how to contain and reverse its spread, and countries that can effectively seal their borders can work towards eliminating the virus in the general population. Given the horror it inflicts on a minority of its victims, there's absolutely no reason to delay pursuing this goal with all we have.

If a state can't (or worse won't) protect the lives of those within its borders, what's the point of it?
 
This shouldn't even be a debate: we have clinical data from other countries, we know how the virus spreads, we know how to contain and reverse its spread, and countries that can effectively seal their borders can work towards eliminating the virus in the general population. Given the horror it inflicts on a minority of its victims, there's absolutely no reason to delay pursuing this goal with all we have.

If a state can't (or worse won't) protect the lives of those within its borders, what's the point of it?
Certainly, New Zealand may be close to total elimination. But they will have to exist in perfect isolation for the next couple of years unless others follow suit. If they manage it, I think it will certainly change the discussions elsewhere, although tbf East Asia has always been after that goal. It is a bit odd really how little anyone talks about South Korea here, like it's some totally different problem they faced.

It's interesting reading NZ's stats. They aim for a full history of every single infection. 'Source under investigation' just 2%.
 
That's exactly why we need test and trace. And why test-trace-isolate is such an effective way to drive down and keep down the infection rate. That isn't theoretical. Look at the examples of South Korea and now what's happening in Germany. Even without perfect understanding, indeed even without perfect tests or even perfect compliance with quarantine orders, you can get the R0 under 1 and know that it is down at that level from the lead indicators, primarily the number of people getting sick, which after all is the only thing that actually matters in the end.

We'll never, ever have global, reliable test and trace. So outbreaks will continue, indefinitely. The virus will continue to cross borders. Lockdowns will be eased, and every time they are, the virus will spread again. Only mass vaccination can reduce the number of infections to the level where we can say the virus has been 'beaten', not that it will ever go away completely.

We're not likely to have mass vaccination in developed countries until the end of next year. That's why I think the total number of deaths from Covid in the UK by the end of next year will be somewhere between 60,000 and 600,000. If you take Jan 1 this year as the starting point we'd have had roughly 1.2 miilion deaths by the end of next year without Covid. We can't know how long the people who die of covid would have lived. But in a few months there'll be enough data to make some quite accurate assumptions.
 
Certainly, New Zealand may be close to total elimination. But they will have to exist in perfect isolation for the next couple of years unless others follow suit. If they manage it, I think it will certainly change the discussions elsewhere, although tbf East Asia has always been after that goal. It is a bit odd really how little anyone talks about South Korea here, like it's some totally different problem they faced.
If Oz pull it off too (and it's a massive debate there, dominating much of their briefings), there's talk from N.Z. of a "protective bubble" between the two nations. If Southeast Asian countries also manage to eliminate SARS-CoV-2 within their borders, no reason they couldn't join it.

That Sunday Telegraph piece I linked the other day was surprisingly on point: the Asian countries had a fundamentally different approach from the start, whereas we, disgracefully, took a fatalistic approach and treated mass infection as inevitable.

This is a long-standing failing, reaching back to the New Labour years and flu pandemic prep. We should never have entertained it, and having witnessed what this new SARS virus is capable of, it'd be straight-up criminal to revert to it now.
 
If Oz pull it off too (and it's a massive debate there, dominating much of their briefings), there's talk from N.Z. of a "protective bubble" between the two nations. If Southeast Asian countries also manage to eliminate SARS-CoV-2 within their borders, no reason they couldn't join it.

That Sunday Telegraph piece I linked the other day was surprisingly on point: the Asian countries had a fundamentally different approach from the start, whereas we, disgracefully, took a fatalistic approach and treated mass infection as inevitable.

This is a long-standing failing, reaching back to the New Labour years and flu pandemic prep. We should never have entertained it, and having witnessed what this new SARS virus is capable of, it'd be straight-up criminal to revert to it now.
Yeah, I was thinking just that. A covid-free travel zone. Rest of us? 2 weeks quarantine. If that were to persist for, say, two or more years, it could significantly remake the world political map.
 
We'll never, ever have global, reliable test and trace. So outbreaks will continue, indefinitely. The virus will continue to cross borders. Lockdowns will be eased, and every time they are, the virus will spread again. Only mass vaccination can reduce the number of infections to the level where we can say the virus has been 'beaten', not that it will ever go away completely.

We're not likely to have mass vaccination in developed countries until the end of next year. That's why I think the total number of deaths from Covid in the UK by the end of next year will be somewhere between 60,000 and 600,000. If you take Jan 1 this year as the starting point we'd have had roughly 1.2 miilion deaths by the end of next year without Covid. We can't know how long the people who die of covid would have lived. But in a few months there'll be enough data to make some quite accurate assumptions.
Forget this defeatism. Borders stay closed until a vaccine's available or, like the first SARS, its successor is contact traced into oblivion (that was a globally reliable test and trace; so too was the elimination of Smallpox, which failed while mass vaccination was relied on).

Anything else is a deliberate choice to allow untold thousands of preventable deaths. It's unconscionable, I won't for a second consider it, and neither should you.
 
Yeah, I was thinking just that. A covid-free travel zone. Rest of us? 2 weeks quarantine. If that were to persist for, say, two or more years, it could significantly remake the world political map.
Yup, although I'm growing increasingly optimistic for a vaccine long before then. Previous work on a coronavirus jab, as with SARS, was dropped not for technical reasons, but lack of will and funding. With money no object and resources unlimited, we're in a radically different situation now.
 
Yup, although I'm growing increasingly optimistic for a vaccine long before then. Previous work on a coronavirus jab, as with SARS, was dropped not for technical reasons, but lack of will and funding. With money no object and resources unlimited, we're in a radically different situation now.
That's the bonkers thing, isn't it? There have actually been years to have been working on this, just nobody could be bothered/there was no money in it. But yeah I do agree - a worldwide effort could easily see some dramatic results.
 
tbf you're not really saying that much there. Care to plump for a single order of magnitude? ;)
That's what I originally said, so I'm just reminding you! And it would be a mistake to be more specific...which is my whole point. We should keep an open mind, and avoid attaching too much significance to this or that headline. If you read elbows' posts you'll see detailed reasons for why he or she is keeping an open mind. Elbows' posts are the most valuable resource in the thread. All I'm suggesting is that people should compare those posts with the media narrative, mostly in the papers, which says that after the current surge there may be a second surge, and...then...problem solved? I suspect lots of people are telling themselves that a second surge will, with a bit of luck, be the end of the disaster. They're understandably desperate for the lockdown to end and for the economy and employment to be salvaged. But these surges are mostly about the virus overwhelming the NHS. If the NHS can cope, that's not a surge in many people's minds. When hospitals stop being charnel houses there will be a perception that things are back to normal. But deaths will continue at a high rate, with covid continuing to suck up a high proportion of hospital resources, with wards and theatres repurposed as ICUs until the end of next year. That will be the new normal. And as the months go by while we wait for vaccines, the number of deaths may reach a much, much bigger number than the most popular figures in the papers, which so far don't seem to be higher than forty-something thousand. The papers are also desperate for survival, let's not lose sight of that. They know that if they start with the big, bleak numbers, readers won't thank them. It's a difficult balance for a paper to get right.
 
That's what I originally said, so I'm just reminding you! And it would be a mistake to be more specific...which is my whole point. We should keep an open mind, and avoid attaching too much significance to this or that headline. If you read elbows' posts you'll see detailed reasons for why he or she is keeping an open mind. Elbows' posts are the most valuable resource in the thread. All I'm suggesting is that people should compare those posts with the media narrative, mostly in the papers, which says that after the current surge there may be a second surge, and...then...problem solved? I suspect lots of people are telling themselves that a second surge will, with a bit of luck, be the end of the disaster. They're understandably desperate for the lockdown to end and for the economy and employment to be salvaged. But these surges are mostly about the virus overwhelming the NHS. If the NHS can cope, that's not a surge in many people's minds. When hospitals stop being charnel houses there will be a perception that things are back to normal. But deaths will continue at a high rate, with covid continuing to suck up a high proportion of hospital resources, with wards and theatres repurposed as ICUs until the end of next year. That will be the new normal. And as the months go by while we wait for vaccines, the number of deaths may reach a much, much bigger number than the most popular figures in the papers, which so far don't seem to be higher than forty-something thousand. The papers are also desperate for survival, let's not lose sight of that. They know that if they start with the big, bleak numbers, readers won't thank them. It's a difficult balance for a paper to get right.
Paragraphs, David, paragraphs. :)

But you've kind of ignored a lot of what's been said to you there. Why, for instance, would the UK continue to fuck up each new wave as badly as it did the first one? Even with the current clown cabinet, that seems unlikely.
 
That's what I originally said, so I'm just reminding you! And it would be a mistake to be more specific...which is my whole point. We should keep an open mind, and avoid attaching too much significance to this or that headline. If you read elbows' posts you'll see detailed reasons for why he or she is keeping an open mind. Elbows' posts are the most valuable resource in the thread. All I'm suggesting is that people should compare those posts with the media narrative, mostly in the papers, which says that after the current surge there may be a second surge, and...then...problem solved? I suspect lots of people are telling themselves that a second surge will, with a bit of luck, be the end of the disaster. They're understandably desperate for the lockdown to end and for the economy and employment to be salvaged. But these surges are mostly about the virus overwhelming the NHS. If the NHS can cope, that's not a surge in many people's minds. When hospitals stop being charnel houses there will be a perception that things are back to normal. But deaths will continue at a high rate, with covid continuing to suck up a high proportion of hospital resources, with wards and theatres repurposed as ICUs until the end of next year. That will be the new normal. And as the months go by while we wait for vaccines, the number of deaths may reach a much, much bigger number than the most popular figures in the papers, which so far don't seem to be higher than forty-something thousand. The papers are also desperate for survival, let's not lose sight of that. They know that if they start with the big, bleak numbers, readers won't thank them. It's a difficult balance for a paper to get right.

Well there are a whole bunch of reasons why I only believe in taking it one week a time at the moment. If there was a time where it looked like I knew what would happen next in the first few months, its only because I knew what the traditional approach to pandemics was, so I knew what the original plan was likely to be. And I realised how transmissible the virus was, and quickly found the right experts to listen to. This made it possible for even a fast-moving pandemic to appear to be unfolding in a predictable, slow-motion way from my vantage point. But by mid-March it was clear that even the UK establishment could not stick with plan A, and at that point all bets were off as far as I was concerned, we were into uncharted territory (or at least uncharted in modern times in the west).

Some things are still predictable in this strange new world, very much including the media getting bored and moving to the 'whats the next step, the exit strategy and timing?'. And some bits of detail they are rehashing comes from earlier plans and earlier narratives. There are a bunch of reasons why 2nd waves in general may be mentioned in regards to epidemics and pandemics. And there were a bunch of different reasons why the spectre of a 2nd wave came up in the context of earlier versions of the plan too - including when the likes of Imperial College were modelling various sorts of measures, what happens when you lift them, and the idea of switching a bunch of them on and off in response to the number of intensive care patients.

Right now in the world of the press I see that different cabinet ministers are being described in terms of whether they want to end lockdown quickly. And part of the Johnson political response to various recent articles criticising Johnsons first months of pandemic 'leadership' at the weekend seems to involve letting it be known that 'he fears a 2nd wave and will not end lockdown'. Well no shit. Hell if we ended it as early as some in the press quack on about then the results wouldnt even count as a 2nd wave, they would more likely be a 2nd peak of the first wave because we wouldnt even have got down to a level that suggested the end of the first wave before things went back up again. So it would be more tempting to call it a spike than a 2nd wave. I think I heard this spike language used on the BBC on Monday when they were discussing some countries that are starting to relax certain very specific things, and what people are watching for nervously as a result.

But beyond the press talk, it will be rare to find me considering a 2nd wave at the moment because I mostly believe in seeing the first wave fall considerably first, and there is no reason for me to go on about a second wave unless we somehow tried to go back to 'the old normal', or if the 2nd wave we were talking about was much smaller than the first. In various countries around the world some leaders have spoken about a new normal to try to reach after lockdown is lifted, and this is more uncharted territory where few assumptions are safe right now. So I dont really understand your stance in some ways.

Specifically the 'deaths will continue at a high rate' thing you said. One of the bigger reasons I take things one week at a time and dont want to look much beyond the first wave yet is because there are all sorts of options which start to become available once the rate of death dwindles to a rather low level compared to what it has been in recent weeks. Its not supposed to remain anything like a high, constant rate, even if there will be weeks where the reduction in death rate may seem painfully slow as we watch the numbers day by day. Yes the concept of a plateau is often mentioned, but this isnt supposed to last for a very long time either.

I dont utterly rule out having reasons to speak of other waves eventually, perhaps as a result of bad human decisions, perhaps as a result of certain seasons. But who knows what else we will have learnt or come to terms with by then. I suppose there is a quite dull template in my mind for the rest of the year and beyond, but I dont believe in dwelling on it now because the chances are at least one major variable will be different from my present understanding by then, and so the template will be invalid. But even if the reality ends up fitting the template, some of the standard equations the powers that be use have been changed. I am likely to speak more about one particular aspect of that, involving numbers of deaths placed in a number of historical and seasonal contexts, when the latest ONS figures come out on Tuesday.
 
It might be that simple if you know the R numbers, but you don't. You just think you do.

If you dont think the R0 has fallen a lot then you have to offer a different explanation for why hospital admissions and deaths have been the way they have in recent weeks, rather than continuing to soar in the way they would have done if the number of people an infected person was infecting on average remained well above 1. Anything that doesnt resemble continued exponential growth is noteworthy, and so various numbers in recent weeks have been noteworthy.

The really horrible numbers of deaths we started to see were things 'really getting started'. But they would have been dwarfed by continual exponential growth. It didnt happen, humans intervened, behavioural changes robbed the virus of many people that would otherwise have already caught it by now. I can make all these claims about the past and present without implying anything stupid and reckless about the future, there is no complacency in my statement. If R0 did not plummet in a lockdown then lockdown would be pointless!
 
I'm not saying the number hasn't fallen...of course it has to fall because of the lockdown..what I'm saying is the spottiness of testing and contact tracing doesn't encourage confidence in the published numbers. Plus there's the distortion and extrapolation of the numbers by journalists. Reliable numbers from health authorities and academics tend to get hurriedly mangled by journalists who are making clicks their priority. Hardly any of the journalists have any sort of clinical background. Sometimes doctors write a column but they don't cover the news.
 
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