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I do regret not being able to keep up with the pandemic in very many countries.

Thailand is giving me some cause for concern due to rising cases there. And I see their PM has been fined for not wearing a mask!

 
An Aussie cricketer playing in India is giving $50k to the cause in India. Meanwhile nothing from the hugely paid Indian players apparently. Although giving to something called the 'PM's Fund' might be a bit misguided considering his handling of the shitshow so far.

 
It was on my radar from the start of January but I dont believe in going on about novel outbreaks until there is a certain amount of info available about human to human transmission. Otherwise I'd far too easily have become the boy who cried wolf too often in the past. That threshold was passed only a few days before someone else started this thread on January 20th. I dont know exactly what date it really passed that threshold in my own mind, I didnt start keeping my own timeline records till a bit later, but it would have been somewhere between the 14th and the 18th of January 2020. Then there was a brief period where it was unclear what range the fatality rate was, and where I could not get an exact grip on the pandemic potential of this virus, in part because of the way the original SARS outbreak was contained years earlier despite spreading between people. And then there was a period that seemed to drag on forever where there was an unnecessary reluctance shown by many to call it a pandemic even though it was pretty obvious thats what it would become. I promised not to goo too far out on a limb about that but even with that self-imposed restrain the slowness of the authorities still left me plenty of time to start calling it a pandemic before a pandemic had been declared. And even then there were a few fools who still found it an appropriate stage to sneer at me calling it a bad pandemic unfolding before our eyes.

Apologies for the excessive navel-gazing, reviewing the early months helps me to come to terms with what happened.
I was definitely blind to the disastrous events unfurling until well into February. I remember reading your warnings and thinking “yeah, right, it’s just another one of these panics that doesn’t amount to anything.” I’ve subsequently done a lot of my own navel-gazing to understand why this was. I have a professional stake in not being blind to emerging risks, so it’s crucial for me to understand what went so wrong in my perception of this risk. I’ve certainly learned a lot in the process about the way my own cognitive biases kicked in to protect me from anxiety, and I’ve formulated ways to try to mitigate that in the future. But part of the process is to recognise that I will likely make similar mistakes again, and have red flags to remind me of this.
 
As well as personal bias, complications include authorities trying to buy time by downplaying their language at key early stages. Human to human transmission is key, but we then have to correctly decode stuff about 'currently no evidence' and the word 'limited' being tacked onto the front of human to human transmission. At that stage the best way to bypass the reassuring bullshit is to try to get a better understanding of the scale of the initial outbreak. For example, one way to get an instant giant red flag is if authorities have been alerted to the existence of the outbreak via unusual numbers of patients presenting themselves at hospitals. Healthcare workers contracting the diease is another instant red flag as thats one of the ways an initial picture of human to human transmission is generated.

Testing whether the right balance has been struck requires testing whether the bar is then set too low by applying it to a situation where the word limited actually deserved to be attached to human to human transmission. Concerns about the pandemic potential of the H5N1 bird flu may be a useful test. Over a number of years there were examples of clusters of cases involving some limited spread between people, so we have to look at the detail. eg when clusters typically involve an obvious animal source each time, and then some limited spread between family members, and on occasion the occasional colleague or healthcare professional, then this is not enough to fully raise the sort of red flag we could quickly raise with this current pandemic virus. Another way these variables may be described is in terms of whether there are any signs of 'community spread'. But its easy for inappropriate surveillance to miss that and for authorities to deliberately downplay such concerns (eg early stage of UK first wave). There are also current versions of these sorts of communications and judgements we can study. In the UK at the moment this would apply to mutant variants - authorities will be reassured when they can link most cases to travel history, but as soon as they find cases with no such travel history and no obvious link to other cases, then that should act as tentative evidence of community spread.

Having the right sources and being able to study their language and tone during non-pandemic times, and seeing how such stuff evolves and varies with each outbreak as info comes in and then seeing whether the threat becomes a real big event or a false alarm, is also useful. For disease outbreaks, I recommend becoming familiar with posts on promed. Home - ProMED - ProMED-mail
 
Anotehr key is to try to account for the various sorts of lag between reality and evidence, statements by authorities etc. The lag may vary in future from what I've been used to dealing with in the past, as a result of heightened awareness and surveillance this pandemic has generated. But then there is still the time buffer that authorities like to give themselves to make decisions etc in private before the broader public are informed.

It does my head in that a bunch of people here were better at taking some forms of lag into effect when reaching judgements about the stage of pandemic in this country, than some of the establishment experts were. They were some weeks behind the curve for ages and didnt begin to catch up until mid-March 2020. As seen most vididly with the rubbish claims that we were 4 weeks behind Italy, when we were actually 2 weeks behind. In this sort of area I remain a massive fan of the sort of shared information and analysis, both formal and informal, that the internet offers at quite some scale.

When it comes to other detail such as asymptomatic transmission, masks, the need to close schools, a bunch of my judgements worked out pretty well. I put this down to some prior knowledge, managing to listen to the right people, and at all times having authority and expert bias against 'inconvenient possibilities with unthinkable implications' firmly at the forefront of my mind, and compensating for that.
 
I think I didn't take it very seriously until only a week or two before the first lockdown happened. At the time I was doing some work with some people which involved me going into their offices a couple of days each week; a couple of them (one of whom is from Hong Kong) had been following it very intently for a few weeks already and even buying face masks in advance. They were also already making plans for how the office would operate if there was an outbreak which would involve everyone working from home. I thought they were being a bit paranoid and these seemed quite extreme circumstances to be preparing for. Eventually I realised that this probably was going to be a "real" thing that would affect the UK and from that point everything happened quite quickly. I remember joking as I left that office one day that I'd see them next week or 'maybe not' and it turned out that indeed I did not see them the next week because we were in lockdown by them.

I can also vaguely recall a gradual realisation of what the consequences of everything were going to be... which started out with "this is annoying, some trips and events are going to get cancelled" to "this is the next year or two screwed up possibly with things never quite returning to the same".
 
I also being particularly depressed when it came time to tell people here that no, the WHO would not recommend border closures and travel restrictions. Indeed almost the opposite, they put more effort into press releases about how they were working with the world tourism board. I was able to say that stuff only because I'd looked at some of the history, and which way institutions priorities are ordered in a neoliberal era. Not that my own output on this angle was great looking back, since from the start of this thread I took a 'horse has already bolted' view and mostly restricted myself to talking about what various authorities would actually do, rather than what they should do.

I was reminded of this again recently because there was a recent article looking at Vietnams early successes which focussed on the border and travel aspect, and including quotes from a humbled expert who bought into the previously established view.


“In the age of mass travel and globalization, it seemed virtually impossible — counterproductive even — for cities or countries to isolate themselves. The mantra in global health became ‘diseases know no borders,’” said Lawrence Gostin, a Georgetown University global health law professor who helped write the international law governing how countries should deal with outbreaks.

“That’s why Vietnam is now among a few countries upending the global health community’s almost religious belief that travel restrictions are bad.”

“I have now realized,” Gostin added, “that our belief about travel restrictions was just that — a belief. It was evidence-free,” he told Vox.
 
Speaking of which, we should expect some changes to global health laws as a result of this pandemic, but the wheels turn very slowly when it comes to reform of that stuff so I cannot predict when or how far they will go.
 
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Italy largely (15 out of 20 regions) reopened today. Outdoor seating only (unlike last summer when even indoors was allowed) for bars and restaurants, end of restrictions on movement among those 15 "yellow" (low risk) regions, but nationwide curfew at 10pm remains.

Very worried about this backfiring if what I can only assume is a hyper-contagious Indian variant takes off here. Only 20% of the population have had their first jab.
 
I managed to avoid for a couple of days the footage from Delhi and elsewhere in India. Seen some now and I'm in bits.

Especially thinking of those villages and slums where millions won't go near a doctor, will die away from the headlines.

No words.

Its very sad, its good the world is starting to send help.

I don't think it could be much more contagious than the UK variant, probably was that that kicked started this wave . Its puzzling it didn't hit the 1st time around, genetics perhaps.

If anyone has been to India will well know the cities are insane mutating grounds for anything transmissible in the air. Now the blue paper has been lit, nothing good is going to happen.
 
It's no fun looking back at the first page of this thread. I am surprised there was no thread about this till towards the end of January 2020. I spent the whole of that month pet sitting on the southern coast of Turkey (lucky me!) and the disabled cat liked to have BBC World news on, so I was aware pretty early. Then spotted the odd mask back in Istanbul. Due to the outbreak in Iran my main source of work was cancelled mid February. I definitely felt rising panic way before others were affected or concerned.

The Turkish authorities played completely dumb by denying that covid was present in Turkey, despite open borders to the world and thousands of Iranians in and out. Among other ignorant claims was the suggestion that there was no covid there because Turkish people are so clean due to their use of lemon cologne. The Turkish authorities have behaved predictably poorly throughout, and even now tourists are welcomed in and free to roam while residents and citizens face severe restrictions.

Just watched the latest news from India and its so awful that the world is facing this, 16 months on...so much incompetence and despair.
Turkey is going into another lockdown.

Turkey has also announced a "full lockdown" from tomorrow to May 17 after logging 37,312 new infections and 353 deaths in the last 24 hours.

 
I'm probably rather naieve to be surprised how this is spreading like fire in hot countries like India and Brazil. Sun is supposed to minimise transmission of viruses but not so with covid.

I've also been quite alarmed at just how young many people in India I've seen on news reports who are seriously ill with it. It looks truly horrifying over there. To think our government wanted to persue herd immunity in the beginning and just let it go through the population.
 
The age of the sick is worrying. Simply because it’s the section of the population we’ve not vaccinated yet.

I don’t think it’s more transmissible simply because Indian people don’t have much of a concept of personal space, certainly not in the way I do. Cities especially. Packed in tight. You have to have been to truly understand quite what I mean. Can’t think of a meaningful metaphor.
It’s known the more virus you inhale the more deadly it can be. If your sleeping in a room with a number of people that are positive it’s not a good situation.
Kumba mela it’s dorms, 20+ to a room

what I didn’t realise, for such a sunny country, they are all vitamin d deficient. Culturally Don’t expose their skin to the sun, 40-99% deficient. Mainly vegetarian too so don’t get much in the diet.
Vitamins d is very important to the immune system, so could account for the age issue.
 
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What is happening in India and now Nepal as well should scare the shit out of us . No ‘it couldn’t happen here’ because personal space or diet or anything else, please.
Friend just sent me a few of his recent family texts , young (20s and 30s) healthy people are dropping like flies.
it’s absolutely terrifying.

This he sent too. It’s from a Buddhist community. Just for a non-personal example:
F019D0CA-C022-4D4A-9CCD-FCA4057808F5.jpeg
 
I need data about ages because of stuff like this that I said the other day on the covid mutations thread. Which certainly doesnt mean I discount whats being said, just that I cannot form a proper picture of ages etc from what Ive heard so far. Because if an outbreak is large enough then even a low percentage of younger people affected adds up to a considerable number of people.

I find a lot of the claims about age groups severely affected by a particular variant to be hard to judge properly a lot of the time. eg when they are mostly coming via stories about the hospital and death situation in countries that are having a really huge wave of the disease in general.

I say that because of the 'a small percentage of a large number is still quite a lot of people' dynamic that we've seen in various ways in this pandemic. It certainly applies to younger people requiring hospital treatment as a result of this virus, as the risk to them is lower than for older people but it isnt zero, so when there are a huge number of cases there will be plenty of younger people needing treatment. And if the hospital is already full or lacking oxygen etc then there will be no shortage of terrible stories of some of those people dying.

This doesnt mean I discount stories about how a particular variant may be affecting younger people more, it might, its something to be alert for. But I need proper data, proper numbers and proportions before I can form a tentative opinion, and to form a more solid opinion than that I would need to read about proper clinical studies etc.
 
I need data about ages because of stuff like this that I said the other day on the covid mutations thread. Which certainly doesnt mean I discount whats being said, just that I cannot form a proper picture of ages etc from what Ive heard so far. Because if an outbreak is large enough then even a low percentage of younger people affected adds up to a considerable number of people.

I was wondering too.
I doubt right now there is anything meaningful or trustworthy. But it does need to get done, or how do you know where to direct help? It's a big place.
 
I was wondering too.
I doubt right now there is anything meaningful or trustworthy. But it does need to get done, or how do you know where to direct help? It's a big place.

Frankly when an outbreak is really huge a lot of the challenge that authorities face is to do with demand vastly outstripping supply, and resulting attempts to suppress demand out of desperation. The 'protect the NHS, die at home' aspect was part of the first wave management of the situation in the UK and although this aspect wasnt completely hidden, its not been properly reflected on since then. Point is that under those conditions some of the demand management may focus on those considered more likely to be saveable, overall, as seen most obviously with policies about who to treat in intensive care. But under those conditions I dont think its a high priority for authorities to seek out all younger cohorts who for various individual reasons are likely to be at high risk. Those nuances and the additional pressures from increase in demand that properly dealing with such possibilities would create doesnt get that much of a look in when dealing with a huge crisis in numbers of people seeking medical care :(

This reply assumes I've correctly interpreted what you mean by 'how do you know where to direct help?'.
 
Without statistics telling us where people are sick, what age groups are dying and where, why etc its hard to understand what is going on. Statistics the UK and the CDC have literally tons the touch of a button for anyone who wants to look.

India is still an emerging country really. When it works it's amazing to watch and see there is order to the mad crucible you are now living in. They do have these statistical services and probably work pretty well but when the work is suddenly times a hundred or times a thousand like anywhere there is a tipping point where it stops functioning. With so many people this is something that can happen so fast it's impossible to do much about it.

Some of the help that needs to go out there would be to record accurate statistics or all that aid is going to be difficult to accurately deploy. Or it just becomes 'throw it at Delhi and hope it helps someone'.
Yoss pointed out the death toll there is at least 10x official statistics or 20000 or more a day.

Not sure I see an easy end to this, they definitely need to get on top of the oxygen situation, its the simplest start to solving the mass deaths.
 
I'm a bit upset right now, from reading all this stuff my friend is sending, but really, Sunray, some of your posts about India (so Other so exotic!) strike me as extremely inappropraite and also just pretty stupid, right now.
For instance "some of the help that needs to go out there would be to record accurate statistics' is just nonsensical for so many reasons.
The ten times official figures guess sounds fairly reasonable but also impossible, in realistic terms, to do anything about, even if you sent loads of westerners over there, with special English clipboards, to try to find every bed in every village where some dalit had died recently in his bed, two days walk from a hospital. It's just not a thing that can happen.
 
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I do regret not being able to keep up with the pandemic in very many countries.

Thailand is giving me some cause for concern due to rising cases there. And I see their PM has been fined for not wearing a mask!

Andrew Macgregor Marshall the 'dissident' ex Reuters Bureau Chief in Bangkok has a comprehensive and perceptive view of where they are. It seems like they fiddled the figures with a weaker variant and the emergence of the Kent variant is pushing that narrative to breaking.

 
I'm a bit upset right now, from reading all this stuff my friend is sending, but really, Sunray, some of your posts about India (so Other so exotic!) strike me as extremely inappropraite and also just pretty stupid, right now.
For instance "some of the help that needs to go out there would be to record accurate statistics' is just nonsensical for so many reasons.
The ten times official figures guess sounds fairly reasonable but also impossible, in realistic terms, to do anything about, even if you sent loads of westerners over there, with special English clipboards, to try to find every bed in every village where some dalit had died recently in his bed, two days walk from a hospital. It's just not a thing that can happen.

I've lived in India for 6 months.. I love India and Indian people, it's an incredible country to live in. What I am watching is upsetting. I can do nothing to help.

But the statistics on the pandemic are just not really being recorded. It sounds like they aren't really needed but they are incredibly important. It's a huge country with 1.4 billion people. Without knowing where help is needed how can you maximise any help you are going to provide, randomly pick a hostpital? Without knowing why people are dying, how can you try to stop them from dying? Why is this nonsensical? It's fundamental knowledge to tackling the pandemic in India.

More information here Dr John on India and other things
 
Er. Okay. Let’s just not, your idea that foreign help is needed to go over there & collect stats is what I was talking about. It’s stupid.I have spent a lot of time in India too, over the years, and my work means I get to hear what’s going on from people at several NGOs there.
 
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