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

[elbows]

In a more serious note the concept is still batshit crazy, as lockdowns and isolation work ok in the short term to reduce person to person contact but ultimately you end up in the same position at the end as you did when you started - so ultimately fail.

No, because the idea is you do that stuff to buy time to develop and deploy vaccines and treatments, which then make a huge difference, as demonstrated by the impact of the more recent waves in the UK compared to the first few waves. And you encourage people to take things more seriously in between the lockdowns, and for sensible mitigation measures to be adopted, when still at the stage of waiting for vaccines to become available.

In theory there are also other versions of this story where you dont ultimately end up exactly right back where you started, but they will sound batshit because they do not resemble how we'd expect humans and authorities to behave, or the alternative options available given enough time, and even China wont be expected to go down that path for the long term. But just to give a vague idea about some of the theoretical scenarios, if we had a situation where there were never going to be vaccines and decent treatments, and the disease was so bad that there was actually the will to keep having lockdowns for many years, you'd still eventually end up with a different picture after decades had gone by. Because a small proportion of the most vulnerable would still be killed off with each wave, and a proportion of the younger population who could catch it without severe consequences would catch it with each wave, slowly changing the overall population immunity and vulnerability picture. This still wouldnt likely neatly resemble a very slow version of the hideously oversimplified 'herd immunity' approach, but it would gradually change the picture and the consequences. Its too early to say whether the consequences of covid are certain to be very different if we fast forward to a future where everyone on the planet was first exposed to the virus at a very young age, but on paper thats one of the things that can radically alter the consequences of a particular disease even if the virus itself and treatments havent changed.

Obviously there are other complications too, such as how the virus evolves and what the consequences of that evolution turn out to be. But thats also another way that strong measures ahve an impact - we'd expect the virus to evolve more slowly if far less people were allowed to catch it. Whether slowing its evolution is considered a bad thing or a good thing of course depends on the traits it picks up during this evolution, and whether there is any sort of relatively settled destination of its traits.

 

[Thesaint]

No, because the idea is you do that stuff to buy time to develop and deploy vaccines and treatments, which then make a huge difference, as demonstrated by the impact of the more recent waves in the UK compared to the first few waves. And you encourage people to take things more seriously in between the lockdowns, and for sensible mitigation measures to be adopted, when still at the stage of waiting for vaccines to become available.

In theory there are also other versions of this story where you dont ultimately end up exactly right back where you started, but they will sound batshit because they do not resemble how we'd expect humans and authorities to behave, or the alternative options available given enough time, and even China wont be expected to go down that path for the long term. But just to give a vague idea about some of the theoretical scenarios, if we had a situation where there were never going to be vaccines and decent treatments, and the disease was so bad that there was actually the will to keep having lockdowns for many years, you'd still eventually end up with a different picture after decades had gone by. Because a small proportion of the most vulnerable would still be killed off with each wave, and a proportion of the younger population who could catch it without severe consequences would catch it with each wave, slowly changing the overall population immunity and vulnerability picture. This still wouldnt likely neatly resemble a very slow version of the hideously oversimplified 'herd immunity' approach, but it would gradually change the picture and the consequences. Its too early to say whether the consequences of covid are certain to be very different if we fast forward to a future where everyone on the planet was first exposed to the virus at a very young age, but on paper thats one of the things that can radically alter the consequences of a particular disease even if the virus itself and treatments havent changed.

Obviously there are other complications too, such as how the virus evolves and what the consequences of that evolution turn out to be. But thats also another way that strong measures ahve an impact - we'd expect the virus to evolve more slowly if far less people were allowed to catch it. Whether slowing its evolution is considered a bad thing or a good thing of course depends on the traits it picks up during this evolution, and whether there is any sort of relatively settled destination of its traits.

Interesting you mention the possibility of lockdowns delaying omicron arriving which doesn't get much coverage or thought.

The problem with using lockdowns in hope something else comes to the rescue is they aren't 'free' - There's huge economic and psychological costs which aren't immediately apparent.
How those costs will long term impact Beijing is hard to know and how the controlling powers will behave to cover this up is where the worry might be the invasion of Taiwan might be a useful distraction if there's dissent.

 

[elbows]

Interesting you mention the possibility of lockdowns delaying omicron arriving which doesn't get much coverage or thought.

Well not just lockdowns, anything that makes a notable difference to case numbers. Because the simplistic version of how viral evolution happens involves a really straightforward numbers game, based on the simple fact that mutation occurs when the virus is inside hosts. The reality is more complex than that because its also about paying special attention to people whose immune status leaves them vulnerable to having the virus inside their bodies for a prolonged period of time. Plus its a global picture so you have to make sure that every large population is protected, and that when the vaccine era arrives that there is decent global availability of the vaccines. And certain treatments come with additional mutation risk, and even stuff like vaccination is a double edged sword because vaccinated populations causes selection pressure on the virus to change to try to bypass the immunity vaccines have provided, although thats also true for natural immunity, providing another reason why letting huge numbers get infected will affect the pace of viral evolution. And if you do manage to keep the number of cases in humans down to low levels, you also have to watch out for evolution within animal hosts.

The problem with using lockdowns in hope something else comes to the rescue is they aren't 'free' - There's huge economic and psychological costs which aren't immediately apparent.
How those costs will long term impact Beijing is hard to know and how the controlling powers will behave to cover this up is where the worry might be the invasion of Taiwan might be a useful distraction if there's dissent.

Not doing lockdowns wasnt free either, we had some big lessons about how trying to avoid lockdowns for as long as the authorities can hold their nerve ended up increasing the ultimate economic and psychological costs. Countries that locked down earlier than the UK fared better and usually ended up being able to ease individual lockdowns sooner than we did. And the 'herd immunity' justification for the slacker, do little moments in the UK approach didnt end up bearing significant fruit due to the pace of viral evolution and immune evasion.

The 'hope that something else comes to the rescue' was justified because we did get vaccines which changed the game. And most countries had to impose restrictions of one kind or another to take the very harshest edge off the pre-vaccine waves, there was no magic dodge that could avoid the social and economic cost. Some countries approaches were far more optimal than others, but even people like me will acknowledge that the 'zero covid' nations like New Zealand and Australia were better positioned to attempt that strategy in the pre-vaccine era because they were not structured to be 'global travel hubs' like the UK is. And Chinas political system and level of control enabled them to go for 'zero' despite their huge size and economic structure, an option not really so viable in 'democracies' once people had been round the lockdown loop a number of times.

Make no mistake, I certainly agree with the common view that unless a genuine global attempt at covid eradication or minimisation was done wholeheartedly from the early days onways, 'zero covid' is not a strategy that seems well balanced and sustainable for the long term. And so I am very much of the opinion that China has certainly botched their ability to transition away from that approach at the most optimal time, once vaccines had been readily available for a good while. Whether this ends up having the most severe of consequences for their regime eventually depends on many factors including if/when they decide to change their approach.

But it also depends on the perceptions of their population, which are affected by crude propaganda but also whether there are any real and obvious setbacks in future for nations that swung to the opposite extreme at the first opportunity. For example there are nerves within the UK establishment about the coming autumn and winter, sponsored by concerns about how frequently we've had waves this year, the current state of the NHS, and the prospect of significant flu pressure returning to the health system for the first time in years and coinciding with the next winters covid burden. As far as I'm concerned, at this stage of the pandemic the 'all or nothing' nations have taken risks which they may or may not manage to get away with. China has stuck rigidly to 'all' and the UK is a good example of a nation that rushed straight back to 'almost nothing'. Neither seem anywhere close to optimal or highly satisfactory to me, although I sincerely hope we dont get to see that played out in the most dramatic ways in the months ahead.

 

[Thesaint]

Well not just lockdowns, anything that makes a notable difference to case numbers. Because the simplistic version of how viral evolution happens involves a really straightforward numbers game, based on the simple fact that mutation occurs when the virus is inside hosts. The reality is more complex than that because its also about paying special attention to people whose immune status leaves them vulnerable to having the virus inside their bodies for a prolonged period of time. Plus its a global picture so you have to make sure that every large population is protected, and that when the vaccine era arrives that there is decent global availability of the vaccines. And certain treatments come with additional mutation risk, and even stuff like vaccination is a double edged sword because vaccinated populations causes selection pressure on the virus to change to try to bypass the immunity vaccines have provided, although thats also true for natural immunity, providing another reason why letting huge numbers get infected will affect the pace of viral evolution. And if you do manage to keep the number of cases in humans down to low levels, you also have to watch out for evolution within animal hosts.



Not doing lockdowns wasnt free either, we had some big lessons about how trying to avoid lockdowns for as long as the authorities can hold their nerve ended up increasing the ultimate economic and psychological costs. Countries that locked down earlier than the UK fared better and usually ended up being able to ease individual lockdowns sooner than we did. And the 'herd immunity' justification for the slacker, do little moments in the UK approach didnt end up bearing significant fruit due to the pace of viral evolution and immune evasion.

The 'hope that something else comes to the rescue' was justified because we did get vaccines which changed the game. And most countries had to impose restrictions of one kind or another to take the very harshest edge off the pre-vaccine waves, there was no magic dodge that could avoid the social and economic cost. Some countries approaches were far more optimal than others, but even people like me will acknowledge that the 'zero covid' nations like New Zealand and Australia were better positioned to attempt that strategy in the pre-vaccine era because they were not structured to be 'global travel hubs' like the UK is. And Chinas political system and level of control enabled them to go for 'zero' despite their huge size and economic structure, an option not really so viable in 'democracies' once people had been round the lockdown loop a number of times.

Make no mistake, I certainly agree with the common view that unless a genuine global attempt at covid eradication or minimisation was done wholeheartedly from the early days onways, 'zero covid' is not a strategy that seems well balanced and sustainable for the long term. And so I am very much of the opinion that China has certainly botched their ability to transition away from that approach at the most optimal time, once vaccines had been readily available for a good while. Whether this ends up having the most severe of consequences for their regime eventually depends on many factors including if/when they decide to change their approach.

But it also depends on the perceptions of their population, which are affected by crude propaganda but also whether there are any real and obvious setbacks in future for nations that swung to the opposite extreme at the first opportunity. For example there are nerves within the UK establishment about the coming autumn and winter, sponsored by concerns about how frequently we've had waves this year, the current state of the NHS, and the prospect of significant flu pressure returning to the health system for the first time in years and coinciding with the next winters covid burden. As far as I'm concerned, at this stage of the pandemic the 'all or nothing' nations have taken risks which they may or may not manage to get away with. China has stuck rigidly to 'all' and the UK is a good example of a nation that rushed straight back to 'almost nothing'. Neither seem anywhere close to optimal or highly satisfactory to me, although I sincerely hope we dont get to see that played out in the most dramatic ways in the months ahead.

I wonder if China's earlier 'sucess' with zero covid fooled their leadership their political system was superior to the West's and had beaten nature, and they didn't take note of what was happening all around the world or simply darent act on it safe in the knowledge dissent is suppressed.

To a certain degree here theres a been the same whereby because no wants to do a u turn.

Either way I suspect no matter what you do any country will have to accept a certain number of casualties - it's just of a case of when.

 

[elbows]

Either way I suspect no matter what you do any country will have to accept a certain number of casualties - it's just of a case of when.

Certainly once any opportunity to stop the virus from going global was missed, it was inevitable that the its ongoing presence would make a permanent difference to the death picture. Well permanent may not be quite the right word due to uncertainties about how the story will evolve decades down the road, but I'll stick with that term for now.

That still leaves a lot of room for variation between nations though. Not every nation had severe spikes in mortality which show up in a profound way in their excess mortality graphs during the first few waves. And although the notable increase in deaths that I showed in graphs for New Zealand and Australia was inevitable even in the vaccine era once they decided to change approach, its still nothing like the level of death that they would have experienced if they went for the same approach in the pre-vaccine era. And it also needs to be offset against the fact that they had thousands less deaths than usual during their zero covid phase, since their measures also suppressed other things like influenza.

The state that health services have been left in, and the ongoing covid, burnout and backlog burden they face is a significant part of the picture with plenty of variation between nations too. The UK is an example of a country with an ongoing mess that carries the risk of the 'permanently' changed death picture continuing to show up in a statistically significant way. Our mass media doesnt seem terribly interested in this at the moment but it shows up clearly in ONS deaths data compared to 5 year averages, and specialist health media publications like the HSJ continue to run stories about the state of the ambulance service and related matters such as internal memos showing doctors concerns that more patients than before are dying in their A&E departments.

 

[Thesaint]

Certainly once any opportunity to stop the virus from going global was missed, it was inevitable that the its ongoing presence would make a permanent difference to the death picture. Well permanent may not be quite the right word due to uncertainties about how the story will evolve decades down the road, but I'll stick with that term for now.

That still leaves a lot of room for variation between nations though. Not every nation had severe spikes in mortality which show up in a profound way in their excess mortality graphs during the first few waves. And although the notable increase in deaths that I showed in graphs for New Zealand and Australia was inevitable even in the vaccine era once they decided to change approach, its still nothing like the level of death that they would have experienced if they went for the same approach in the pre-vaccine era. And it also needs to be offset against the fact that they had thousands less deaths than usual during their zero covid phase, since their measures also suppressed other things like influenza.

The state that health services have been left in, and the ongoing covid, burnout and backlog burden they face is a significant part of the picture with plenty of variation between nations too. The UK is an example of a country with an ongoing mess that carries the risk of the 'permanently' changed death picture continuing to show up in a statistically significant way. Our mass media doesnt seem terribly interested in this at the moment but it shows up clearly in ONS deaths data compared to 5 year averages, and specialist health media publications like the HSJ continue to run stories about the state of the ambulance service and related matters such as internal memos showing doctors concerns that more patients than before are dying in their A&E departments.

Oz and NZ are curious experiments which we should assume china could learn from. Both Oz an NZ escaped the worst of earlier variants, and it's vax vs omicron only for them. Now even if china could get high vax uptake if they panic everytime there's the odd case they are in for a bad time as it's not going to help stop that - assuming sinovac has the same limits as Pfizer etc.

It looks like it's going to be a long slog here clearing the nhs backlog but other news stories have been more pressing. One thing missed by the news is the recent wave of covid the UK experienced and I think you mentioned the (medical) establishment is worried about winter but the last wave went unhindered by any measures and passed by with out bad outcomes so gives reason to be optimistic given the doom and gloom.

 

[Yossarian]

Hard to see how China's going to find a way out of its zero COVID policy - a nationwide omicron wave would kill an estimated 1.5 million people, and even for a dictatorship that crushes all dissent, there's never a politically convenient time for that to happen.

 

[elbows]

It looks like it's going to be a long slog here clearing the nhs backlog but other news stories have been more pressing. One thing missed by the news is the recent wave of covid the UK experienced and I think you mentioned the (medical) establishment is worried about winter but the last wave went unhindered by any measures and passed by with out bad outcomes so gives reason to be optimistic given the doom and gloom.

Part of the problem is the high bar that was set for what counts as newsworthy, the picture shouldnt be a binary one where only a certain level of doom and gloom unfolding rapidly before our very eyes counts as something worth responding to, something for the public to discuss and ponder how we could do better.

The bar in this country was set at a very high number of daily deaths, or the spectre of the health service being completely overwhelmed. I was very much part of that picture with the way I discussed the potential for systems being overwhelmed in the first few waves, and then again when I wasnt sure if vaccines could carry all the pandemic weight at the height of the next few waves that arrived in the vaccine era. But I've also been very clear about other sorts of pressure, and have referenced on numerous occasions the slow, grinding pressure that is affecting our NHS. Even the media sporadically draw attention to such concerns, and that pressure has been on display in all of our Omicron waves. My own audience here has shrunk down to the people who are still concerned and paying close attention, and the handful of people that can still sometimes be bothered to post in this subforum even though they mostly believe the real danger has past.

It is not fair to say that the last wave passed without any bad outcomes. Such claims can only be made when looking at bad outcomes relative to the first few waves - it is completely understandable that people will look at it in that way, and we can be happy that recent waves have not stood out on the excess death charts in the way that the first few waves did. But that doesnt mean there were no bad outcomes, only that the bad outcomes are more subtle, a different order of magnitude, less intense, more drawn out. They dont have features that demand a massive, life-changing and shocking mass public response of the variety we experienced with lockdowns etc. And so the picture contrasts with what went before in a way that makes it inevitable that far less people are paying attention. And the bad outcomes still have an impact on overall mortality, its running well above the old 5 year average levels that reflected a pre-pandemic world. But it doesnt have the great big 'double the normal number of deaths' spikes in it that the first waves had, and so it does not attract the same sort of attention.

 

[elbows]

I can try to illustrate part of my point using the most basic of death statistics. Since Im going to use deaths from all causes this isnt a picture of the pandemic deaths in isolation, it will reflect other stuff such as weather-related deaths, deaths due to hosiptal and ambulance issues, etc etc. But some of those things are also a consequence of what Im describing in terms of slow grinding NHS pressure.

This shows ONS data for deaths from all causes registered per week for England and Wales. We can see a big chunk of the 2nd wave death spike in the first bunch of weekly figures for 2021. But we can also see how once we get beyond that stage of those years, beyond early March, the 2022 weekly deaths are sustained at higher levels than weekly 2021 deaths, meaning that the 2022 total so far compared to the 2021 total at the equivalent stage of the year is gradually creeping up. And if that carries on for many more weeks the 2022 total will end up exceeding the 2021 total despite 2022 not having featured the same height of horrible covid death spike in the first months of the year as 2021 did. I am not claiming that the 2022 total is certain to surpass the 2021 total, but just the fact it might, and that it has been gaining ground, is worth noting. By the week ending 4th March, the 2022 running total was 35,628 deaths lower than the 2021 running total, but by week ending 5th August the gap had reduced to 12,008.

Technical note: the 5 year average figures used in this table are no longer a complete reflection of pre-pandemic death figures. Since one of the 5 years worth of data they are based on now is 2021. So its a mix of pre-pandemic years 2016, 2017, 2018, 2019, and pandemic year 2021.

Data comes from ONS weekly deaths spreadsheet from Deaths registered weekly in England and Wales, provisional - Office for National Statistics

 

[Thesaint]

Part of the problem is the high bar that was set for what counts as newsworthy, the picture shouldnt be a binary one where only a certain level of doom and gloom unfolding rapidly before our very eyes counts as something worth responding to, something for the public to discuss and ponder how we could do better.

The bar in this country was set at a very high number of daily deaths, or the spectre of the health service being completely overwhelmed. I was very much part of that picture with the way I discussed the potential for systems being overwhelmed in the first few waves, and then again when I wasnt sure if vaccines could carry all the pandemic weight at the height of the next few waves that arrived in the vaccine era. But I've also been very clear about other sorts of pressure, and have referenced on numerous occasions the slow, grinding pressure that is affecting our NHS. Even the media sporadically draw attention to such concerns, and that pressure has been on display in all of our Omicron waves. My own audience here has shrunk down to the people who are still concerned and paying close attention, and the handful of people that can still sometimes be bothered to post in this subforum even though they mostly believe the real danger has past.

It is not fair to say that the last wave passed without any bad outcomes. Such claims can only be made when looking at bad outcomes relative to the first few waves - it is completely understandable that people will look at it in that way, and we can be happy that recent waves have not stood out on the excess death charts in the way that the first few waves did. But that doesnt mean there were no bad outcomes, only that the bad outcomes are more subtle, a different order of magnitude, less intense, more drawn out. They dont have features that demand a massive, life-changing and shocking mass public response of the variety we experienced with lockdowns etc. And so the picture contrasts with what went before in a way that makes it inevitable that far less people are paying attention. And the bad outcomes still have an impact on overall mortality, its running well above the old 5 year average levels that reflected a pre-pandemic world. But it doesnt have the great big 'double the normal number of deaths' spikes in it that the first waves had, and so it does not attract the same sort of attention.

I know the audience for all things covid has shrunk but all though I have had a macabre fascination with it and I recognise now the direct health emergency is very likey all over and we are left with the political outfall now and the side effects of lockdowns to contend with.
In any case even if it flairs up again we have used up our two biggest weapons of lockdowns and vaccines so have nothing left to counter it anyway. Theres no cavalry coming over the hill.

Cost of living problems and the economy is now going to be dominant, and they themselves will have an even bigger affect on healthcare provision than covid I suspect and we're in a tight spot to out it midly and can't get out.

 

[elbows]

The 'no cavalry' concept is relatively meaningless, authorities will always eventually feel compelled to act in some obvious if the health service really reach a certain stage of collapse. Theres a bunch of different ways it could go, a bunch of different ways it could be framed, and I dont want to speculate excessively about that unless it became clearer that its actually happening and how the politics of it would be squared with the desperate need to act. And even if things down reach a stage where something anywhere close to dramatic as a lockdown is required again, there are a whole bunch of other things the authorities may ask the public to do, plenty of which are not dissimilar to stuff even the Johnson regime ended up asking people to do last winter. I'm not a Tony Blair fan but I notice he was going on about bringing mask wearing back to public transport this winter, and this is an example of a public health measure that can influence the level of pressure faced, if only people didnt tyr to turn everything into politically weaponised ideological scraps and binary fuckwittery. If we have genuinely moved beyond the period of most obvious, acute, intense risk then getting away from the 'all or nothing' approach is even more important. We can do reasonable things at the right time in order to ease the burden without severe negative impact on peoples lives and the economy, if only people avoid poisoning the well by making public health measures part of some crap culture war political narrative, or being defeatist, or refusing to do anything unless total imminent doom beckons.

And when I talk about that sort of thing these days, I certainly dont mean that it has to happen in a direct, tidy covid manner. But then I've always been a flu bore, long before this pandemic, so I remain interested in the rhetoric and the practicalities no matter how much things swing in one direction or another, no matter whether it boils down to simplistic, acute single issue causes or a complex mess of overlapping issues with grinding pressure over long periods of time. In some ways the danger is greater when it unfolds in slow motion, without sudden dramatic shock, long after a period when many people think its all over prematurely.

China is pushing its luck in one direction, we are pushing ours in another. Two different extremes. And there is very little certainty about the extent to which either will carry on getting away with it all the way until we eventually end up in different circumsgtances. At this rate it will be a long time before we've genuinely moved completely beyond that situation of uncertainty and theoretical risk.

In terms of 'the consequences of lockdown', we certainly wont get a tidy analysis of that in isolation. On the economics front much of it will be impossible to separate from the other causes of inflation, and a giant bunch of brexit-related issues. Lockdowns, people having time to reappraise their priorities, and how well they were treated by employers during the pandemic will probably have a lasting effect on the employment market, but again that will get merged in with brexit etc changes to the jobs market, unfilled vacancies etc. In terms of healthcare, NHS backlogs would have happened with or without lockdown, so it isnt fair to claim that such a backlog could somehow have been avoided if we'd somehow dodged lockdowns. Perhaps we might eventually be able to more directly identify unpleasant consequences for younger people as a result of what they had to face as a result of lockdowns and other forms of disruption. But even there some of it may blend with the wider backdrop of opportunities, facilities and support having been eroded by cuts during the long period of austerity that preceded the pandemic.

 

[Thesaint]

The 'no cavalry' concept is relatively meaningless, authorities will always eventually feel compelled to act in some obvious if the health service really reach a certain stage of collapse. Theres a bunch of different ways it could go, a bunch of different ways it could be framed, and I dont want to speculate excessively about that unless it became clearer that its actually happening and how the politics of it would be squared with the desperate need to act. And even if things down reach a stage where something anywhere close to dramatic as a lockdown is required again, there are a whole bunch of other things the authorities may ask the public to do, plenty of which are not dissimilar to stuff even the Johnson regime ended up asking people to do last winter. I'm not a Tony Blair fan but I notice he was going on about bringing mask wearing back to public transport this winter, and this is an example of a public health measure that can influence the level of pressure faced, if only people didnt tyr to turn everything into politically weaponised ideological scraps and binary fuckwittery. If we have genuinely moved beyond the period of most obvious, acute, intense risk then getting away from the 'all or nothing' approach is even more important. We can do reasonable things at the right time in order to ease the burden without severe negative impact on peoples lives and the economy, if only people avoid poisoning the well by making public health measures part of some crap culture war political narrative, or being defeatist, or refusing to do anything unless total imminent doom beckons.

And when I talk about that sort of thing these days, I certainly dont mean that it has to happen in a direct, tidy covid manner. But then I've always been a flu bore, long before this pandemic, so I remain interested in the rhetoric and the practicalities no matter how much things swing in one direction or another, no matter whether it boils down to simplistic, acute single issue causes or a complex mess of overlapping issues with grinding pressure over long periods of time. In some ways the danger is greater when it unfolds in slow motion, without sudden dramatic shock, long after a period when many people think its all over prematurely.

China is pushing its luck in one direction, we are pushing ours in another. Two different extremes. And there is very little certainty about the extent to which either will carry on getting away with it all the way until we eventually end up in different circumsgtances. At this rate it will be a long time before we've genuinely moved completely beyond that situation of uncertainty and theoretical risk.

In terms of 'the consequences of lockdown', we certainly wont get a tidy analysis of that in isolation. On the economics front much of it will be impossible to separate from the other causes of inflation, and a giant bunch of brexit-related issues. Lockdowns, people having time to reappraise their priorities, and how well they were treated by employers during the pandemic will probably have a lasting effect on the employment market, but again that will get merged in with brexit etc changes to the jobs market, unfilled vacancies etc. In terms of healthcare, NHS backlogs would have happened with or without lockdown, so it isnt fair to claim that such a backlog could somehow have been avoided if we'd somehow dodged lockdowns. Perhaps we might eventually be able to more directly identify unpleasant consequences for younger people as a result of what they had to face as a result of lockdowns and other forms of disruption. But even there some of it may blend with the wider backdrop of opportunities, facilities and support having been eroded by cuts during the long period of austerity that preceded the pandemic.

I'm fairly sure the pro mask 'ultras' like Blair and prof Susan Michie will be pushing for a repeat of previous winters, but several things stand in their way:
-The government has no legal powers in implement them as the corona act expired.
-The media are slowly turning against the idea and entertaining the concept the cure(s) is worse than the disease, and the public are openly questioning things now.
-Van Tam and Vallance have distanced themselves from their previous roles.
-Both sunak and truss have distanced themselves from previous policies.
-inflation, recession and heating costs will dominate the news as more pressing for most people.
To combat other pressing concerns these 'ultras' will need some drastic data to support them in order to scare the public, and even ICL won't be able to model anything scary enough!

The public (and some media) are questioning things slowly (eg exam results being down) and may overeact the other way if they feel they've been conned by the authorities, and this maybe the single biggest obstacle in the end...no one will take any notice.

The political weaponisation is partly unavoidable as tricky policy decisions are ultimately political, but it's easy to blame the 'covid deniers' and 'antivax' brigades but the authorities have been as bad or worse.

 

[elbows]

The idea that people who suggest masks in winter can be called 'ultras' is in itself political and a poisoning of the well.

It remains relatively trivial to turn the state of the NHS into a top story, and thats what will happen if the situation demands it. If the political and media will and urgent necessity isnt deemed to be there then sure, we have a situation like the current one where it doesnt feature as a top story, and can be routinely downplayed. But that can be changed very quickly indeed, mood music can be changed in less than a week, even in the vaccine era, and even when the public have other pressing concerns that are affecting their lives.

Plus stuff like masks in certain circumstances in winter is not comparable to bringing back really heavy stuff like lockdowns and school closures. We cant get 100% compliance in this country, but thats not what they aim for anyway. Getting people to modify their behaviour a bit in winter is in the same realm as getting people to go for their booster and flu jabs, its well doable. It doesnt require scary modelling of the sort that was necessary to get the authorities here to think the unthinkable in terms of lockdowns etc.

Also in terms of the most common public attitudes in the UK towards the pandemic, I know absolutely loads of people who were very happy to move on once the vaccine era was fully established, who did not wait too long to go back to their previous patterns of behaviour. But plenty of those people were slightly hedging their bets mentally, in that they did not completely accept the idea that 'its all over' in its most pure and extreme sense. They are not going to leap straight back to the sense of risk and doom that characterised the early period of the pandemic, but they retain in reserve the possibility that they may end up expressing 'here we go again' feelings at some future point if certain situations deteriorate beyond a certain extent. I believe I can rely on those people to move with the times in any of the plausible directions that could arise, especially in winter, especially if a common narrative unfolds where a combination of flu and covid/latest covid variant and the state of the NHS pushes things to a certain level of health system overload. I dont think Im pushing my luck by expressing confidence that a big chunk of them will be as ready to accept and engage with reasonable public health measures under certain circumstances as they were in the first pandemic period. Especially since people do pay some attention to the responses of other countries, and if the northern hemisphere winter ends up demanding a response in many other countries too, people will notice and have their expectations partially guided by it. Also, the 'spectre of lockdown' has another use during this stage, it can be used to appeal to people to do the other, less extreme stuff in order to keep the prospect of lockdown far away from the table. Its not clear whether we'll need a repeat of the 'do this to save Christmas from lockdown' stuff routinely, but if the authorities look at the numbers (either covid or NHS or vaccine uptake numbers) and start to fret, thats the sort of thing that could be used again during any winters that look especially challenging. And reasonable people, of whom there are very many, will understand.

I would be far less confident about what proportion of them would readily accept far more extreme measures if the situation was deemed to be especially bad, I'd have to wait and see what sort of situation and risk we were actually dealing with before making claims about that. A really scary vaccine-busting variant would probably carry a lot of people a long way, including our political classes, but I am not predicting we will face that challenge so there isnt much point dwelling on it at length now. I only mention it because such theoretical possibilities still have tonnes of potential for rapid and dramatic change, they are a reason why assumptions like yours can always be short-circuited - theoretical possibilities that involve 'never say never' and 'think the unthinkable' stuff like we saw in regards attitudes to the possibility of lockdowns in March 2020 never truly goes away, no matter how much attitudes shift and assumptions set in. Such dramatic, assumption-busting stuff is rare, but it would be as foolish to claim it could never ever happen again as it would to claim it will surely happen every time we get a new wave in the vaccine era of this pandemic.

If I was going around telling people that what we really need in the UK in 2022 is a zero covid policy like Chinas then sure, that would be a very extreme position which had absolutely no prospect of winning over a significant proportion of the public or the establishment, and for which terms like 'ultra' might actually be reasonable. But thats obviously not what Im taking about at all, and all the talk of 'ultras' just plays into the extreme binary bollocks that is not a true reflection of the situation, attitudes, winter challenges or the sort of appeals the authorities might feel the need to make to the population.

Anyway I get the idea we will just go round in circles with this conversation so I'm happy to give it a rest for now, lets wait until some of the variables that will dictate the magnitude of our winter challenge start to firm up, so we can start to talk about whats likely to happen in practice rather than the full spectrum of theoretic situations and responses. I certainly dont expect everyone to agree with everything I am saying, but those who reject all of it and claim none of it could ever be relevant again, are painting a mirror image of Chinas opposite extreme, one that is just as easy to label as batshit, risky and extreme as Chinas current approach.

 

[teuchter]

In any case even if it flairs up again we have used up our two biggest weapons of lockdowns and vaccines so have nothing left to counter it anyway.

A properly resourced healthcare service is the biggest weapon that has, as yet, gone unused.

Everyone I know that works in the NHS tells me that it's currently in the worst state they've ever seen it in.

It might be that even a relatively small increase in pressure as a direct result of another Covid flare-up could push things to a state that enough people perceive it as a crisis. Perhaps at the point when they find no ambulance is available for their family member having a heart attack.

 

[elbows]

A properly resourced healthcare service is the biggest weapon that has, as yet, gone unused.

Everyone I know that works in the NHS tells me that it's currently in the worst state they've ever seen it in.

It might be that even a relatively small increase in pressure as a direct result of another Covid flare-up could push things to a state that enough people perceive it as a crisis. Perhaps at the point when they find no ambulance is available for their family member having a heart attack.

Exactly. And such a situation could just as easily then be labelled batshit and unacceptable as the stuff China is doing to the other extreme.

Its hard to predict if and when that stuff will burst fully into the realm of top headlines and the sort of crisis that focusses minds and forces action. Because I'm already finding it surreal that we've had about a whole year of a shocking state of ambulance & A&E services without it gaining that level of attention. But if forced to guess, winter seems like a reasonable time to think that those horrors might rise to the top of the agenda, especially if the southern hemispheres winter flu season was any sort of guide as to what will happen in the northern hemispheres next winter.

 

[weltweit]

Moderna suing Pfizer over Covid vaccine technology​

Moderna suing Pfizer over Covid vaccine technology

Moderna said it is suing Pfizer and its German partner BioNTech for patent infringement.

www.bbc.co.uk

Could be a serious lawsuit this one.

"We are filing these lawsuits to protect the innovative mRNA technology platform that we pioneered, invested billions of dollars in creating, and patented during the decade preceding the Covid-19 pandemic," Moderna chief executive Stephane Bancel said.

 

[Thesaint]

Moderna suing Pfizer over Covid vaccine technology​

Moderna suing Pfizer over Covid vaccine technology

Moderna said it is suing Pfizer and its German partner BioNTech for patent infringement.

www.bbc.co.uk

Could be a serious lawsuit this one.

I notice Moderna's share price has fallen hugely since it's peak in mid 2021 while Pfizer's has been more steady. Im guessing Modena are more reliant on one product which has falling demand so need cash in on some income? I wonder too if this kind of claim is quite common but only becomes news here because of recent history?

 

[elbows]

As far as I know it is indeed common for drug companies to indulge in lots of patent-based legal action. The nature of the pandemic meant that companies like Moderna initially made positive noises about letting other companies develop covid vaccines using tech like mRNA without legal woes. But that was a temporary measure, designed to stop them looking like the bad guys during a global health emergency, and also to take some of the energy out of campaigns that called for covid vaccine related intellectual property laws and rules to be formally suspended, and to mitigate against other pressures and threats to their business model related to the call for fair sharing of vaccines globally. And they didnt promise that their 'enlightened attitude' would last forever.

 

[wemakeyousoundb]

cases up 42% in 2 weeks in France since the end of the holidays, mostly in the under 20s (+111% for the 0 to 9 age range), mostly seem to be BA.5.

 

[elbows]

I expect people are very aware these days that declaring the pandemic to be over is a sort of arbitrary thing that isnt based on a solid definition and may involve mixed messages and uneasy contradictions. And certainly doesnt involve the end of the virus or the end of deaths.

So we have this stuff about Biden saying the pandemic is over in the US, even whilst saying they are still doing a lot of work to control the virus, and they still have thousands of deaths a week.

Covid-19 pandemic is over in the US - Joe Biden

The president says there is still "a lot of work" being done to control the virus in the US.

www.bbc.co.uk

In an interview with 60 Minutes on CBS, Mr Biden said that the US is still doing "a lot of work" to control the virus.

The interview - aired over the weekend - was partly filmed on the floor of the Detroit Auto Show, where the president gestured towards the crowds.

"If you notice, no one's wearing masks," he said. "Everybody seems to be in pretty good shape...I think it's changing."

In August, US officials extended the ongoing Covid-19 public health emergency, which has been in place since January 2020, through 13 October.

To date, more than one million Americans have died from the pandemic.

Data from Johns Hopkins University shows that the seven-day average of deaths currently stands at over 400, with more than 3,000 dead in the last week.

In January 2021, by comparison, more than 23,000 people were reported dead from the virus over a single week-long span. About 65% of the total US population is considered fully vaccinated.

Note that 'pandemic recovery' is not defined but is probably about behaviour and economic activity as much as anything.

Public health officials have expressed cautious optimism in recent weeks that the world is edging towards a pandemic recovery but continue to urge people to remain careful.

Some degree of bet hedging still exists too:

The US recently authorised new vaccines that match the version of the Omicron variant currently dominant in the country, with federal health officials asking Americans to keep their jabs up-to-date.

On 6 September, White House Covid-19 response coordinator Ashish Jha said it marked an "important shift" in the fight against the virus but underscored the need to "prepare for unforeseen twists and turns".

WHO rhetoric these days now includes the concept of the end of the pandemic, though I havent yet explored how they intend to define that.

Last week, WHO Director-General Tedros Adhanom Ghebreyesus said that the world has "never been in a better position to end the pandemic".

"We are not there yet," he said. "But the end is in sight."

Another statistic from that piece:

Covid-19 also continues to have a significant impact on the US economy, with the National Bureau of Economic Research reporting last week that Covid-related disease has slashed the US workforce by approximately 500,000 people.

The UK hasnt dwelt so much on that sort of thing so far, nor this sort of stuff:

Mr Biden said he believes that the pandemic has had a "profound" impact on the psyche of Americans.

"That has changed everything...people's attitudes about themselves, their families, about the state of the nation, about the state of their communities," he said.

"It's been a very difficult time. Very difficult."

 

[teqniq]

This is interesting. Whilst it is primarily aimed at a US audience it could easily be applied to many other countries:

Pandemic Nihilism, Social Murder, and the Banality of Evil | Bill of Health

The nihilism that the Biden administration displays is both convenient and necessary for the personnel who help intensify the pandemic's avoidable harms.

blog.petrieflom.law.harvard.edu

 

[spring-peeper]

Oh, get real!!!!

‘Most discriminated against group’: Alberta premier pledges to protect unvaccinated | Globalnews.ca

Earlier in the day, Smith was sworn into the job by Lt.-Gov. Salma Lakhani at a ceremony at Government House.

globalnews.ca

Danielle Smith, sworn in Tuesday as Alberta’s new premier, said she will shake up the top tier of the health system within three months and amend provincial human rights law to protect those who choose not to get vaccinated.

“(The unvaccinated) have been the most discriminated-against group that I’ve ever witnessed in my lifetime,” Smith told reporters at the legislature.

“I don’t think I’ve ever experienced a situation in my lifetime where a person was fired from their job or not allowed to watch their kids play hockey or not allowed to go visit a loved one in long-term care or hospital, not allowed to get on a plane to either go across the country to see family or even travel across the border.

“We are not going to create a segregated society on the basis of a medical choice.”

 

[wemakeyousoundb]

Oh, get real!!!!

‘Most discriminated against group’: Alberta premier pledges to protect unvaccinated | Globalnews.ca

Earlier in the day, Smith was sworn into the job by Lt.-Gov. Salma Lakhani at a ceremony at Government House.

globalnews.ca

let me guess: rather on the right side of the political spectrum?

 

[spring-peeper]

let me guess: rather on the right side of the political spectrum?

yip - far, far right,

Wanna-separate-from-Canada right.

 

[8ball]

yip - far, far right,

Wanna-separate-from-Canada right.

Worse than the bloody Mancs, that lot.

 

[elbows]

This article by an emergency doctor in Australia is right up my alley:

The notion that COVID-19 has been vanquished is not supported by the facts

The facts of “living with COVID” are far from the soothing fairytale of a complete return to pre-pandemic life. Average lifespans are dropping because of the virus, global mortality data reveals.

www.smh.com.au

I'd like to quote the whole thing but obviously cant really do that. So its better to read the whole thing, even though I've captured quite a chunk of it below.

We are storytellers. It’s what distinguishes us from all other species. It’s how we make sense of the world, how we transmit knowledge down the generations and how we soothe ourselves.

Right now, we are telling ourselves a soothing story about COVID-19, one that follows the pattern of many of the fairytales we have liked to tell since our days around the campfire. It has a typical beginning (a dark threat stalks us), middle (a valiant and desperate fight against overwhelming odds) and end (the foe vanquished, a return to normal).

The pleasing notion that COVID has now been vanquished, however, that it has been turned into “just another seasonal upper-respiratory virus” by vaccination, “hybrid” immunity from repeated infection and natural attenuation of the virus itself, is not supported by the facts.

Actuarial analysis from around the world, including in Australia, shows an ongoing 10 to 15 per cent excess death rate, as compared with before the pandemic. These deaths are mostly in the older age group, of which about half are directly due to COVID-19. An analysis from Singapore shows the rest “can be explained by patients who passed away from other illnesses within 90 days after being infected with COVID-19”.

Data from other countries supports excess mortality in the year after COVID infection and we know COVID causes increased cardiovascular and other mortality. Excess deaths in younger age groups are lower, but still very significant, given lower mortality rates in that group anyway. Average lifespans are dropping by between one and more than two years in various countries, according to global mortality data.

But deaths are not the only metric. High rates of long COVID, consisting of a smorgasbord of chronic conditions, are already being felt in terms of labour shortages and seem set to be accumulating both human and economic effects over time.

With no consent, no mandate, no public discussion, the “dry tinder” (the elderly, those with chronic disease, those most at risk of “reaping”, as Chief Medical Officer Paul Kelly has termed them) is being burnt off. Deaths and infirmity in these individuals can easily be explained away and so easily discounted.

The only way to identify that this is happening is through statistical analysis of death and illness rates. These analyses accumulate daily and are remarkably consistent around the globe, but statistical reports are not eye-catching and are easily ignored when it is expedient to do so.

In the same way, horror stories from a healthcare system burdened by abnormally high rates of illness can conveniently be explained away by citing “decades of underfunding”, creating “a dam that has finally burst”.

Claims that levels of increased sickness are due to “immune debt” (a phrase only invented in 2021), arising from lack of exposure to common viruses during lockdowns, are simply not credible. Nor are claims that lockdowns themselves have created a backlog of under-treated conditions: these excess deaths and illnesses occur equally in places that never had lockdowns.

The facts of “living with COVID” are far from the soothing fairytale of a complete return to pre-pandemic life.

 

[elbows]

By the way I've been contrasting some of his points from that article with how everything is currently being framed in the UK when it comes to NHS pressures and excess death #47,235 and #47,243 . Its fair to say that its doing my head in that we struggle to have even the most basic conversations or articles about these ugly realities in the UK. And then I think back to my earlier complaints about some of the limitations to our thinking when we see Chinas zero covid as 'madness' and I feel rather sad about it all. But then I have to point ourt that Im not calling for us to follow Chinas policy, am not calling for lockdowns etc at this stage of our struggle against this virus. All I'm saying is what I said a little earlier on this thread, that both our approach and current narrative/framing and Chinas are at the extremes, relying on a crude and inappropriate version of reality and either too much or too little action. Theres a very broad and sensible middle ground where all sorts of more appropriate and useful responses can be found, stuff that can face up to reality and reduce some of the pressures. But this territory has been made invisible and unlike the early phase of the pandemic (especially March 2020) there seems to be little impetus from the population to bust past the flawed orthodox establishment approach in the UK.

 

[Thesaint]

By the way I've been contrasting some of his points from that article with how everything is currently being framed in the UK when it comes to NHS pressures and excess death #47,235 and #47,243 . Its fair to say that its doing my head in that we struggle to have even the most basic conversations or articles about these ugly realities in the UK. And then I think back to my earlier complaints about some of the limitations to our thinking when we see Chinas zero covid as 'madness' and I feel rather sad about it all. But then I have to point ourt that Im not calling for us to follow Chinas policy, am not calling for lockdowns etc at this stage of our struggle against this virus. All I'm saying is what I said a little earlier on this thread, that both our approach and current narrative/framing and Chinas are at the extremes, relying on a crude and inappropriate version of reality and either too much or too little action. Theres a very broad and sensible middle ground where all sorts of more appropriate and useful responses can be found, stuff that can face up to reality and reduce some of the pressures. But this territory has been made invisible and unlike the early phase of the pandemic (especially March 2020) there seems to be little impetus from the population to bust past the flawed orthodox establishment approach in the UK.

When it comes to conversations and brutal realities it's struck me different countries tried differing approaches- China's zero covid, Sweden's relaxed policies, Australia's lock it out policy, and our wait then overreact policy but broadly speaking everyone ends up in the same position. Stopping a virus is like trying to stop a volcano or earthquake in the end and covid is now everywhere. With all our technology we only really managed to soften the fatality risk in 2021 but humankind ultimately was helpless against it and how much collateral damage measures added to the problem is a long way from being assessed or even contemplated.

 

[Thesaint]

This article by an emergency doctor in Australia is right up my alley:

The notion that COVID-19 has been vanquished is not supported by the facts

The facts of “living with COVID” are far from the soothing fairytale of a complete return to pre-pandemic life. Average lifespans are dropping because of the virus, global mortality data reveals.

www.smh.com.au

I'd like to quote the whole thing but obviously cant really do that. So its better to read the whole thing, even though I've captured quite a chunk of it below.

The Australian angle is an interesting one. Oz dodged covid in the early pandemic so presumably their healthcare had minimal interruption? That would tally with the idea it's not that disruption is to blame if they didn't really have it and still have a similar excess death as many European countries.

Counting deaths is easy, but maybe if we knew if people more were falling seriously ill before needing medical care in the first place that would be an explanation of excess deaths?

 

[elbows]

The idea we were helpless is dangerous in some respects because it implies there was no point bothering to do anything. There were limitations to the extent to which different countries could do things on certain fronts, eg the details of global interconnectivity, travel, the economy and various other factors meant it was easier for Australia to implement their strict controls than it was for a country like the UK to. But even the UK ended up feeling the need to take strong action that made a difference.

And there are still choices that countries have made and continue to make that determine what their plight is right now and in the years to come. China is not in an enviable position in terms of the lockdown disruption burden people still face, but depending on what the long term health impacts end up being, their approach could still end up being judged to be less 'insane' than people currently think it is. Or not, since future decisions there could yet squander any advantage they may have gained via not changing approach yet. I cant predict how that will end up, I can only highlight certain possibilities and invite people to dwell on stuff from different angles.

I'd acknowledge that we were helpless to prevent there being any serious impact from this virus at all, but since the amount of death in the initial, pre-vaccine waves was very sharp compared to the picture we see after those first few waves, I cannot accept the idea that it was wrong to respond strongly in the first 18 months. Countries like Australia had 15,000+ less deaths during that initial phase than they normally would have, and that really does count for something even if they have ultimately ended up in the same situation as other countries in later years.

I have started to do some very basic analysis of England & Wales deaths by age group from 2010 to now. Doing this by cause of death would be more illuminating, except cause of death data isnt completely accurate, and some interesting patterns still show up simply by looking at deaths by age over time. I'm not ready to share my results quite yet but I will get round to it at some point. If I can find comparable data for Australia then it will be useful to compare and contrast, although now wouldnt be the right time to do that since they've had one big post-restrictions flu wave and it will take some months before we've had a similar phase here.