Coronavirus - worldwide breaking news, discussion, stats, updates and more

[sihhi]

Here's the key line: "Evidence to-date from China, and emerging evidence from Korea, indicates that early decisive actions may reduce community transmission."

This is a good timeline summary of Italy

https://www.luca-dellanna.com/how-bad/

 

[Indeliblelink]

Look like France is tightening things up. Lock down soon?

Coronavirus: Spain and France announce sweeping restrictions

Spain sharply restricts citizens' movements while France has closed non-essential public places.

www.bbc.co.uk

French Prime Minister Edouard Philippe has ordered the closure of all non-essential public locations from midnight (23:00 GMT Saturday) in response to the coronavirus outbreak.

The measure applies to restaurants, cafes, cinemas and discos, as well as non-essential businesses.

Mr Philippe also called on French people to reduce their travel, especially between towns.

France reported a sharp rise in cases on Saturday, from 3,661 to 4,499.

 

[Supine]

The modelling used by our experts hasn't been shown in detail which I think has caused a lot of problems. As these threads have shown people don’t understand how the government policy has been formulated and therefore misunderstand the reasoning.

A friend of a friend just posted the attached which is a summary of the SPI-M modelling technique used by the Pandemic Influenza Group. It goes some way to showing the thought processes used to address this pandemic.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/756738/SPI-M_modelling_summary_final.pdf

 

[elbows]

That document does help with certain detail and gives a fair sense of the previous pandemic influenza response consensus, which was based on various assumptions about influenza, and assumptions about what steps would be considered practical and tolerable.

When read alongside the ECDC documents, we can see the contrast. ECDC stuff, which has been updated numerous times already, provide a lot of signs about how thinking has evolved in response to certain characteristics of the new coronavirus, the lack of vaccine and antivirals, the intensive care burden, and the strong response of certain countries which was quite dissimilar to the sort of responses it was assumed would be taken in an influenza pandemic.

The UK does not operate in a vacuum. People can tell the difference between clumsily delivered narratives involving herd immunity, and the very strong responses being seen elsewhere. We are not going to accept that the UK has some special reason to indulge in limited and late options just because politicians, technocrats and the managerial classes have a resistance to 'thinking the unthinkable'.

The quote from the EU I already gave several times is a good fit, the first sentence is a good fit for the stated UK attitude and planning assumptions (because the UK was not unique, and their approaches are still harmonised with the EU to a great extent) but it points out the lessons from other places. Even if governments havent learnt those lessons, their people have become aware of them! Nowhere in the EU document is the word herd used, and immunity is only mentioned briefly.

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.

 

[little_legs]

So Peston appears to be getting all the scoops

 

[little_legs]

That's what Evening Standard will turn into in a few days' time

 

[elbows]

I'll split the UK stuff into three things in order to be extra clear about my own position right now:

The communications
The timing
The actual measures
Who actually triggers those measures

Weirdness and other problems with the communications made people nervous about the timing and the actual measures.

It is not possible for me to judge the timing and the measures themselves properly yet. Mostly because of the various issues that have arisen out of their communication strategy. If I look at the public numbers they release, I can begin to imagine what stage they really think they are at. If I look at what the EU documents from a few days ago say about things like preparing hospitals, the UK seems in alignment with that. If I factor in the effects of non-governmental action, such sports leagues shutting down (due to their own issues such as people involved in the sport testing positive or travel issues), other countries restricting travel and flights being cancelled, then the timing here so far hasnt actually ended up too far adrift yet either.

School closure timing is the obvious exception to this. It, and the botched narrative about herd immunity, need to be sorted out quickly, both in terms of public communication and the actual timing of action to be taken. Obviously I also have some specific other concerns with timing (I keep going on about 4 weeks being crap), but based on recent evidence I am more inclined to think this is down to more botched communications. If they did genuinely make crucial timing errors, they've now got the chance to fix that pronto.

 

[sihhi]

The modelling used by our experts hasn't been shown in detail which I think has caused a lot of problems. As these threads have shown people don’t understand how the government policy has been formulated and therefore misunderstand the reasoning.

A friend of a friend just posted the attached which is a summary of the SPI-M modelling technique used by the Pandemic Influenza Group. It goes some way to showing the thought processes used to address this pandemic.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/756738/SPI-M_modelling_summary_final.pdf

I've ploughed through about half of that but it's different viral enemies.

This virus r0 is higher, lethality is certainly higher than any pandemic flu since 1918, there's no flu antivirals waiting to be built on and developed.

 

[spitfire]

That's what Evening Standard will turn into in a few days' time

Jesus shitting christ.

 

[Supine]

I've ploughed through about half of that but it's different viral enemies.

This virus r0 is higher, lethality is certainly higher than any pandemic flu since 1918, there's no flu antivirals waiting to be built on and developed.

It's not specific on the enemy but the research applies to any pandemics. The bit I found most interestung was near the end about why studying the first 100 cases is important to define the pandemic spread characteristics. After that you don't need further testing of the whole population as you can work out what happens.

 

[elbows]

So Peston appears to be getting all the scoops

Thanks for posting that. Even if not everything mentioned there is exactly what ends up happening, much of it seems consistent with the sort of measures to be expected in this pandemic. It may go some way towards undoing some of the comms damage of recent days, if they do it sooner rather than later. The school plans mentioned in it are still at odds with some of the latest wisdom, and NI have started signalling that they are looking at closures of 14-16 weeks. So the politics etc of this may rumble on for some time yet before everything is clearer. Or maybe things will move faster now, hard to say.

 

[elbows]

It's not specific on the enemy but the research applies to any pandemics. The bit I found most interestung was near the end about why studying the first 100 cases is important to define the pandemic spread characteristics. After that you don't need further testing of the whole population as you can work out what happens.

Yes, they did the 'first few 100' (FF100) stuff in the swine flu pandemic too, thats when I first became aware of it. And like stuff I mentioned earlier, I was very unsurprised to see it in the EU guidelines, its not something the UK made up on its own.

They did it this time too I'm sure, thats one of the reasons they hospitalised all the early cases they found, even if their illness remained mild.

edit - thought I may as well quote that bit from the EU doc.

Available study protocols to conduct ‘First few hundred’, household transmission or other studies are available from WHO and should be applied. Results should be made available as soon as possible.

And another favourite subject of mine:

Engagement and efforts should also include serological studies to analyse the impact on a population level and compare with potential pre-existing immunity in the population. Such studies require sensitive and reliable serological tests, which are currently under development requiring validation. Study protocols are currently being developed and should be conducted in a harmonised way across the EU/EEA.

From the 'Research needs' section of https://www.ecdc.europa.eu/sites/de...f-novel-coronavirus-disease-2019-COVID-19.pdf

 

[agricola]

So Peston appears to be getting all the scoops

As bad as his conduct was during the election, how he has behaved since this crisis kicked off is even by British journalist standards, disgusting. Not a mention of the fact the plan has clearly been torn up in two days. A claim that "army hospitals" will be used, when they don't exist.

 

[sihhi]

Four infectious disease epidemiologists have an article here called The direction of the UK Government strategy on the COVID19 pandemic must change immediately to prevent catastrophe

Dropbox

www.dropbox.com

worth reading

Yes, they did the 'first few 100' (FF100) stuff in the swine flu pandemic too, thats when I first became aware of it. And like stuff I mentioned earlier, I was very unsurprised to see it in the EU guidelines, its not something the UK made up on its own.

They did it this time too I'm sure, thats one of the reasons they hospitalised all the early cases they found, even if their illness remained mild.

What you can't necessarily get from the first 100 cases you catch is gauge how quickly it spreads and how likely superspread events are when quarantine containment is not effected.
You need the bigger picture which should have been available from China, Korea, Iran & Italy.

 

[elbows]

Not a mention of the fact the plan has clearly been torn up in two days.

As I have attempted to explain in all manner of posts in the last few days, I cannot actually prove that is the case. They might have just badly botched the comms or tried to be too clever for their own good with psychology. Some of these measures were planned already for sure, they just hadnt announced them yet and on top of that they made their own timing judgements look questionable this week by saying weird and alarming things. They might have torn up their timetable now, but even on that front I cannot truly claim to know the extent to which they have been forced to change, as opposed to the extent they absolutely messed up the communication of the likely timing.

 

[elbows]

What you can't necessarily get from the first 100 cases you catch is gauge how quickly it spreads and how likely superspread events are when quarantine containment is not effected.
You need the bigger picture which should have been available from China, Korea, Iran & Italy.

FF100 studies are for clinical purposes. Epidemiology is handled by other means, although some clinical info feeds into it (informs it).

 

[sihhi]

Thanks for posting that. Even if not everything mentioned there is exactly what ends up happening, much of it seems consistent with the sort of measures to be expected in this pandemic. It may go some way towards undoing some of the comms damage of recent days, if they do it sooner rather than later. The school plans mentioned in it are still at odds with some of the latest wisdom, and NI have started signalling that they are looking at closures of 14-16 weeks. So the politics etc of this may rumble on for some time yet before everything is clearer. Or maybe things will move faster now, hard to say.

On school closures. My guess is it will start with a week or two then get extended

There is something strange about these tid bits:

Is anyone under 70 is fair game for the herd immunity approach?
Those with underlying health conditions (not necessarily that serious, the first couple or so with underlying health conditions had been travelling abroad), about a quarter to a third of adults have high blood pressure for instance are included too?
How can careworkers have any confidence they will not infect the over 70 unless there are generalised quarantine/containment measures, reducing their interactions with anyone.
Careworkers to have separate quarters? (What happened to that hotel that was requisitioned near Heathrow, was it ever used?)

 

[agricola]

As I have attempted to explain in all manner of posts in the last few days, I cannot actually prove that is the case. They might have just badly botched the comms or tried to be too clever for their own good with psychology. Some of these measures were planned already for sure, they just hadnt announced them yet and they made their own timing judgements look questionable this week. They might have torn up their timetable now, but even on that front I cannot truly claim to know the extent to which they have been forced to change.

Not having a go, but if you look at this list:

• the forced requisitioning of hotels and other buildings as temporary hospitals;
• the requisitioning of private hospitals as emergency hospitals;
• temporary closure of pubs, bars and restaurants - some time after next weekend's ban on mass gatherings;
• emergency manufacture by several companies of respirators that would be necessary to keep alive those who become acutely ill;
• the closure of schools for perhaps a few weeks, but with skeleton staff kept on to provide childcare for key workers in the NHS and police.

... and think they are acting in concert with a plan then I honestly don't know what to say. There is zero excuse for the private hospitals being requisitioned and ordering more respirators things not having been done weeks ago, and it should absolutely have been announced on Thursday if it was. Hotels / other buildings as temporary hospitals sounds very much like it is refloating of this absolute idiocy from a few years back, which as pointed out at the time seems to boil down to them understanding that beds are in hospitals and hotels, therefore a hotel can be used as a hospital. Closing schools for everyone except kids of cops / NHS staff is a daft idea as well - you'd have thousands of schools open with ten kids in each.

 

[sihhi]

FF100 studies are for clinical purposes. Epidemiology is handled by other means, although some clinical info feeds into it (informs it).

Yes I think the plan is very focused on the age spread of morbidity clinical outcomes, but not on the speed of new cases coming when the levee starts to break.

 

[little_legs]

As bad as his conduct was during the election, how he has behaved since this crisis kicked off is even by British journalist standards, disgusting. Not a mention of the fact the plan has clearly been torn up in two days. A claim that "army hospitals" will be used, when they don't exist.

LOL

by the British journalist standards

 

[elbows]

There is something strange about these tid bits:

Is anyone under 70 is fair game for the herd immunity approach?

Getting more and more people to work from home, shutting pubs, and various other things, including the use of cordon sanitaire if particular areas have their own local epidemics, will be some of the things designed to slow the spread amongst the under 70's.

Those with underlying health conditions (not necessarily that serious, the first couple or so with underlying health conditions had been travelling abroad), about a quarter to a third of adults have high blood pressure for instance are included too?

There are a number of issues that require urgent investigation on this front. Such as whether it is the conditions that icrease the risks, or some of the drugs used to treat such conditions.

How can careworkers have any confidence they will not infect the over 70 unless there are generalised quarantine/containment measures, reducing their interactions with anyone.
Careworkers to have separate quarters? (What happened to that hotel that was requisitioned near Heathrow, was it ever used?)

There is lots of potential for institutional spread of the virus, and these sorts of incidents can add a lot to the overall burden and number of deaths. It is a difficult problem to solve, very difficult.

I dont think the hotel got much use for its original intended purpose, but last I heard of it it was being offered as an option for people returning from certain parts of the world once the UK government advice became for everyone coming from there to self-isolate. Intended for use by people who didnt have anywhere else to self-isolate. I read about this once, dont know how much it has actually happened.

 

[sihhi]

Closing schools for everyone except kids of cops / NHS staff is a daft idea as well - you'd have thousands of schools open with ten kids in each.

I was going to mention this aswell. You'd need teachers (even if caretakers are absent) and these kids to be travelling to a site to meet and spread infection when everyone else would be having online classes.

 

[elbows]

Not having a go, but if you look at this list:

• the forced requisitioning of hotels and other buildings as temporary hospitals;
• the requisitioning of private hospitals as emergency hospitals;
• temporary closure of pubs, bars and restaurants - some time after next weekend's ban on mass gatherings;
• emergency manufacture by several companies of respirators that would be necessary to keep alive those who become acutely ill;
• the closure of schools for perhaps a few weeks, but with skeleton staff kept on to provide childcare for key workers in the NHS and police.

... and think they are acting in concert with a plan then I honestly don't know what to say. There is zero excuse for the private hospitals being requisitioned and ordering more respirators things not having been done weeks ago, and it should absolutely have been announced on Thursday if it was. Hotels / other buildings as temporary hospitals sounds very much like it is refloating of this absolute idiocy from a few years back, which as pointed out at the time seems to boil down to them understanding that beds are in hospitals and hotels, therefore a hotel can be used as a hospital. Closing schools for everyone except kids of cops / NHS staff is a daft idea as well - you'd have thousands of schools open with ten kids in each.

I didnt say it was a perfect plan and I have concerns about the timing and indeed the long-term healthcare capacity and planning for pandemics, lack of resilience with 'just in time' systems etc.

I think you may have missed the point of the hospital-related measures. Its emergency overflow capacity because the number of cases they have to be prepared to deal with is horrific. And they expect to need to shift lots of people elsewhere, including some of the people who are hospitalised for non-Covid19 reasons. Of course it will suck and there will be many terrible aspects, but thats the situation. Its the same sort of thing as all the relaxation of standards and staff skill levels and paperwork, none of it is great, it has consequences, its an emergency measure.

As for when they made these plans, I cannot say. I can say that the ECDC document I keep going on and on about was updated just 3 days ago, and the intensive care statistics and deaths that have been seen in Italy, and now other EU countries, have focussed minds on the scale of the rapidly approaching healthcare burden. And regardless of what they said publicly on Thursday, the hospital reconfiguration had already begun.

I have been a very harsh critic of their comms this last week. That doesnt mean I think they needed to announce everything last Thursday. They didnt need to do that, but they did need to give a very different overall impression than the one they ended up giving.

 

[elbows]

Closing schools for everyone except kids of cops / NHS staff is a daft idea as well - you'd have thousands of schools open with ten kids in each.

Close the majority of schools and allocate a few in each area to stay open for the children of people working in the essential professions.

 

[weltweit]

I haven't been keeping up with the UK government announcements, do you think I can find them on the BBC iplayer?

 

[sihhi]

Close the majority of schools and allocate a few in each area to stay open for the children of people working in the essential professions.

Presumably volunteers would drive these children to the hub schools (further away than normal school) yes?

 

[clicker]

The numbers of kids needing day care may mean the schools themselves don't need to open.
Use local halls instead to accomodate the smaller numbers of kids.

Presumably volunteers would drive these children to the hub schools (further away than normal school) yes?

 

[weltweit]

Interesting profile of Professor Chris Whitty here, from tonight BBC R4:

Profile - Professor Chris Whitty - BBC Sounds

The coronavirus epidemic is a crisis for England's chief medical officer. How will he do?

www.bbc.co.uk

 

[Maltin]

Although not planned until next week, Berlin's clubs and bars were shut down tonight for at least a month. Museums, cinemas, theatres are all closed too. Some restaurants, shops and public transport are still in operation.

Important information about the current situation in Berlin

Stay mindful

www.visitberlin.de

 

[elbows]

I have to stop for the evening very soon, but just to reiterate the aspect that underpins my suggestion that it was the comms and timing more than the planned measures that the government actually botched this week:

The thing they said that was supposed to indicate that they were not just going to sit around and do nothing, was their stated intention of trying to preserve the NHS, stop it being overwhelmed.

Given the known aspects of this pandemic, this is an insane challenge, one that requires very strong measures indeed, and even those are unlikely to be enough.

But they didnt explain that properly at all, and then they said weird things about the timing, and even more misguided things about herd immunity and losing loved ones. But the fact they said the NHS stuff at all was an indication that their plans were more similar to EU countries than they gave the impression of.

I'm reasonably sure I would be telling a slightly different story if I had actually been a fly on the wall at key meetings, but since I know nothing of that I can only deal with the remaining visible aspects. No doubt Johnsons instincts would be bad news for acting in a timely and appropriate fashion, but the timing of the outbreak here and the speed with which other countries have taken dramatic measures, coupled with the comms disaster and backlash hopefully means that their opportunities to further fuck up the timing, and have a Johnson-style pandemic, are now much diminished.