Coronavirus: Some scientists say UK virus strategy is 'risking lives'
bbc.com
bbc.com
- You don't get immune due to strains and changes (flu)
- You get it forever latently and it comes back from time to time (HSV)
- malignant tissue abnormalities, Cancer, organ failure over time (some HSV strains, HEP)
- You get immunity but if another strain hits you you bleed from all orifices and may die (dengue)
- It stays with you forever and makes you more vulnerable to tons of other virii (Eppstein-Barr - I know, killer combo, HSV, HEP)
- Chronic fatigue syndrome (Epstein-Barr)
- It depletes your immune system leaving you vulnerable for life (HIV)
- Permanent lung, liver, kidney or heart damage (SARS)
- chronic joint and muscle pain, vision and hearing loss, abdominal pain, bleeding, malaise, and psychological problems (Ebola)
- birth defects, chronic joint pain and inflammation (Zika)
We have NO IDEA right now if this one has such effects or interactions ... it's too early. But we have indication for several side effects from Wuhan that are being studied like permanent lung scarring and T-cell exhaustion.
So this "strategy" (They would all speak German if they used this to save the economy in 1940) is beyond madness.
Please please please do not take this lightly with a I'll get it anyway attitude. More time buys understanding, treatment, lower severity and better survival chances.
(Same reason to be cautious with rushed vaccines (well tested ones are just fine) - especially if they show up unseasonably early for election time. Read up on the Philippines dengue vaccine for the gory details)
There is several studies in pre-read discussing permanent lung scarring (not exactly surprising from what we know about serious cases spending weeks incubated) and two discussing t-cell exhaustion but they are not peer reviewed yet but you should have no problem locating them.
For SARS we saw significant long term ling damage and, in a statistically significant number of people, terminal, worsening lung scarring over 4 years, so given the strong similarities in the genome of Cov-SARS-2 it's a concern too... we will only know in a few years time.
Humans have the ability to learn from patterns. Many viruses have long term effects, especially if the initial infection was rough - I listed a few examples.
Now we can call this fearmongering and ignore the possibility, but that seems more like a reflexive reaction to dismiss a realistic, potentially dangerous threat than a serious addition to this conversation.
Ignoring risks we cannot personally control is a human staple and we found many ways over the years do deal with that, chiefly religion - but it does not remove the risk, it just makes us feel better about it
I'm not an expert but I found this preprint: https://www.medrxiv.org/content/10.1101/2020.02.12.20022418v...
https://www.businessinsider.com/coronavirus-recovery-damage-...
Also, there's reported cases of people relapsing after being "recovered". Some of them even died, increasing suspicion that this virus might be biphasic:
https://www.reuters.com/article/us-china-health-reinfection-...
We simply don't know a lot about this virus yet.
Source is this Twitter thread analysing the reports coming out: https://twitter.com/davidasinclair/status/123897208631765401...
Thread starts at https://twitter.com/davidasinclair/status/123897208275664896...
It is looking good for immunity in monkeys right now, do knock on wood. Failing that...
Get much much better at hygiene and science.
Let's hope it does not come to that but be respectful of the fact that, many times in our history as a species we have been confronted with challenges like this and it did force dramatic changes on the way we live. We are by no means exempt from such dynamics today.
We are still working through HIV and its implication. In the tropics dengue and malaria require constant vigilance and the plague certainly hit the world when their known tools and frameworks failed.
We are a resilient species, if anything we adopt to visible risks quite well once we get out of flight or fight but our lifestyle is not guaranteed and any politicians promising that reality is not real is bad news for our ability to adapt to the threats
I dont think any of our measures are strong enough to actually stop the disease without getting to herd immunity.
A) I did not mention social distancing at all. It may be in a pool of measures needed to handle this (see other island nations who have managed that so far) but still not the topic of the comment.
- We don't know yet if there can be hard immunity yet. Probably, maybe likely at least short term, but
B) Herd immunity. It's not a strategy. It's just saying 'let's pray. The costs of just doing that are unknown but have risks based on what we know from many other virii. Risks, not certainties. Regardless
- It won't happen at 60% given the infectiousness of this pathogen. Not even close. We are at much higher vaccination rates (86%) for measles (R0=18) globally.
- It may wane after a few months
Herd immunity right now is a fancy word for The Vast Majority of people will get it.
Your comment, in turn, just wasted 10 seconds of my time to read it.
All advanced societies are built on the exploitation of someone else, you just did not get to see who those people were.
Note: I am not endorsing the choice - just observing.
This stuff always involves complicated choices.
For example, would you advocate a policy of taxing all restaurant owners at a 90% marginal rate forcing most into bankruptcy to pay for a very expensive new medical treatment that only works on the elderly and extends their life just a few years?
If you proposed that do you think it would be unanimous or controversial?
Do you believe that, in normal circumstances, we should repurpose all money typically spent on primary education and firefighting to go to elder care instead?
If you weren’t arguing for that last year then you believe in complicated trade-offs too.
The concept of trade-offs is the absolute core basis of all major public policy decisions.
It’s also the basic of many personal decisions. If you’re familiar with hospice care or a DNR order then you know that end of life questions have trade-off calculations as well, even within families or between life partners.
Pretending this is a binary decision is just nonsensical.
In rereading your post carefully, the answer is yes. You did describe it that way and offer a reason to think it’s not so bad. Doing so is shameful.
Marines say "no one left behind", for a reason, because it creates a group... A society.
The UK decision smells like eugenics.
Hell, the young and healthy can go skydiving 100 times and have less chance of dying vs coronavirus.
Nevermind the not dying part. Over 50% of ICU spots in France and the Netherlands for coronavirus are taken up by people under 60. Pneumonia this severe can cause permanent lung damage.
*some of you will die even without the virus, more of you will die than normal because of it, this is awful, but true.
UK seems to be playing a very dangerous game.
The higher death rates have occurred in places where the health system was overrun.
Of course with the current trajectory the UK health system will be over run.
Claiming you can isolate at risk groups well enough while the whole country is going about its business is just putting your fingers in your ears and going lalalalala.
It is like seeing an experiment playing out at a societal scale. We are all looking at it from a personal level, but successful societies have always been built on sacrifices of various kinds - their costs or others (colonization)
The future benefit being get the state out of medicine.
I don’t subscribe to this view at all but having read Rees-Mogg’s daddy’s book, the Soverign Individual i will happily stake my house on the above being very close to the victorian geezer’s view on this.
AFAIK viruses tend to mutate to be less lethal because killing the host is bad for reproduction.
random source: https://en.wikipedia.org/wiki/Spanish_flu
>This is a common occurrence with influenza viruses: there is a tendency for pathogenic viruses to become less lethal with time, as the hosts of more dangerous strains tend to die out
The ideal evolutionary strategy is to produce excess bodily fluids from sweating, coughing and sneezing, while not making people so sick that they lay down and stay home, let alone die.
Viruses don’t get bonus points for being lethal, unlike certain video games.
wtf people. Use your brains. It's totally irresponsible for you to be spreading this to everyone else.
Ironically, even the actual terrorists decided to back down in fear from it, suspend their terrorist activities, and teach themselves how to wash hands properly.
https://www.politico.eu/article/coronavirus-isis-terrorists-...
From my understanding, this isn't really true. "Stopping the spread" is an unreasonable and incredibly difficult undertaking. Isolation is about reducing the rate of cases. It's likely that similar infection numbers will be reached over the course of the whole pandemic no matter what. Nobody is going back to "normal life" any time soon - the only question is how drastic the counter-measures will be.
Or more critically, if we learn that lasting native immunity is even possible.
For the coronaviruses which cause the cold (such as CoV-OC43) the adaptive immune response is not particularly strong and immunity lasts only months. -- not due to mutation, but because of behaviors in the immune system which we don't yet understand. This has contributed to the difficulty in creating a vaccine for the prior sars virus.
As a result, the whole "get people immune for next season" idea may be a largely pointless goal. The best comparisons we have so far suggest that it is, though we just don't have enough information yet.
From what I understand, work on developing a SARS vaccine stopped because the epidemic was over, and there was no longer an interest or will to continue working on it.
In addition, here's what Vincent Racaniello of This Week In Virology[1] had to say about antivirals:
"We could have had antivirals against all coronas or many coronas if we had put the money in to making them, but there was no interest and therefore companies which need to make profits were not interested in pursuing them, but they could have been developed and stockpiled and been ready.
"So if you had infinite money and people you could say, 'Let's get a bunch of RNA polymerases from bat SARS-like coronaviruses and design something that will inhibit them all.' I don't think it would be that hard because they're very conserved. But without the financial incentive... so, antivirals are kind of a different thing because you could develop them and bring them, you could even do a phase one and then have them ready for actual testing when there's an outbreak."
[1] - at about 1 hr and 33 minutes in to episode 590 - http://www.microbe.tv/twiv/twiv-590/
Antivirals for sars-cov-2 seem MUCH more likely to arrive quickly than a vaccine, and I wouldn't be surprised to find that several of the things currently being tested (some of which are already approved for the treatment of other conditions) are effective.
I'm just imagining some programmer in a future interview talking about their familiarity with async functions in Javascript. The interviewer glances down at an app named "Mirror Test Pro" that cross-referenced that claim against an old HN post revealing ignorance about the upshot of social distancing. It consequently overlays a red "X" on the programmer's avatar. "Thanks, we'll be in touch," the interviewer says as the programmer is shuttled out the door.
And I'm imagining many such programmers becoming frustrated when a breach of MTP data reveals why they kept getting rejected in interviews. They would band together and write a powerful DDOS tool to exact vengeance upon the world that humiliated them. Lucky for the world, their sudden, synchronous silence gives enough advanced warning to thwart the attacks while their CPUs helplessly whir on one giant blocking call.
In Italy the number of people that end up in ICU is 10%. Now think of the population of people that are in your area and how many intensive care beds that are available to them... do you think your local hospitals can handle 10% of that number? Probably not. This is what makes it a big issue.
Wait, what? Source?
I haven't found exactly the 10% in ICU (and I'd be especially interested in the percentage of young people requiring ICU), but yeah basically 80% mild cases and the others needing assistance.
Which doesn’t shows that there isn’t a single consensus source yet. The article points out one source with 25.5% severe and another with 13.8% severe. Meanwhile for critical, it shows the numbers 4.7% and 6.1%.
While OP isn’t entirely accurate, for off the top of the head numbers, it’s not wildly off base either it seems.
Now let's factor in that in a developed country there are some 0,5% hospital beds total capacity. Let's say that Covid-19 can have at disposal half of those beds.
If you do not do all you can to flatten the curve, you are probably looking at a 10% death rate over infected population, if not more.
That's over 6 million people in the UK.
IMHO, you have to do something to buy more time, although it is yet to be seen if lockdowns will be effective enough as this guy seems to be too strong.
> For COVID-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical infections, requiring ventilation.
Ventilation would have to be done in the ICU, in my understanding.
Source: 06/Mar/2020 Situation Report from https://www.who.int/emergencies/diseases/novel-coronavirus-2...
The trick is you need to get R0<1, so that when a new case pops up, it dies out instead of blowing up. You do that with mask wearing, hygiene, aggressive contact tracing, broad scale testing, and strict isolation. You keep people alive that get the virus by having good medical care.
The aggressive contact tracing, isolation, and good medical care don't scale. If you have only dozens of cases, you can afford to aggressively isolate and put a lot of manpower into tracing every case. You give the virus no breathing room. If there aren't too many people needing medical care, you can also provide them much better care.
This is why you need the lockdown -- to get R0<<1, to bring down the case count dramatically so that these other measures can work.
We could have just started with Phase 2 outside of China, but we didn't spin up all of the things that you need for Phase 2 in time. The countries that are doing the best had previous SARS experience, which was successfully eradicated with these measures, so they knew what to do right away and were institutionally prepared to act quickly.
The sooner and more aggressively we start, the shorter the lockdown has to be. Half measures that leave R0 above 1 don't help much and just prolong the lockdown.
Take my liberty now so that I can have it later.
Actually no, it's the opposite. "flattening the curve" means spreading the period of time infection spreads to not overwhelm the medical services at any one point. So the quicker we slow down the spread, the longer it'll take to get back to normal.
The idea we can completely stop the spread at this point is unlikely, the best we can do is slow it.
I wonder if there will be a process of grief leading to acceptance about this event, I feel we are in denial now, tending to anger. Next will be bargaining (I think evidenced by isolation and hording) or maybe not - maybe the population will simply fail to process this.
So yeah they probably are making them cannon fodder, whether its intentional or not, the incentives would let higher ups look at the proposal and say "by golly that makes so much sense", whereas the rest of the world wouldn't consider this proposal as killing two birds with one stone and just reject the proposal.
The UK government has also completely denied the “herd immunity” thing is part of any active policy. But that hasn’t slowed down social media... or HN for that matter.
Good choice. Look at what Italy and Spain are doing now. Stay at home as much as possible, don't hang out with others. Wear personal protective equipment if you must go out for some reason.
Italy's had 1800 death, Spain 300, UK 30. They're all roughly the same size population (60, 50, 70 million)
As I've said in other threads on this, I would assume that the earlier you lock down, the longer you have to stay locked down. Or you risk a second peak.
There's a balancing act, given that it's not possible now to stop the spread, only slow it. Lock down too early and you do a lot of damage to the economy and by extension the country. Lock down too late and people die from lack of care.
I would not assume that at all. Containment is still possible in a looser sense; many places in both Italy and Spain may end up being disease-free in a shorter period of time by locking down things early, and then they can contribute healthcare resources to places where the disease is more widespread, or even be put under some sort of protective "reverse" quarantine with less strict measures.
Essentially the whole things a massive balancing act, allow a certain amount of infections, but not too many the health service gets overwhelmed.
Even China's now getting more infections from outside than in, which is only going to grow.
The consensus is that you can't stop it now. So your plan might be an even worse idea, a cascading lock down, that lasts even longer. The only hope being summer stops it like flu, but then you're left with a potential resurgence in autumn and even more lock downs.
I'm not gonna panic, and keep going as usual, with the recommended precautions. Ideally I don't want to get infected, but if I do, oh well, such is life.
some are rational, some petrify and can not move, some try to face it, some turn inside, some turn outside.
some old people are going out on purpose, if they petrify they will not be able to live anyway.
anyway, it is not easy for anyone when the mass is moving in such volatile way, not to mention individual responsibility towards the group is stressed to extremes (as you can see people fighting over toilet paper for example)
i am also staying as isolated as i can, but from time to time i force myself and my family to go out in the forest, to see that the world is not burning yet.
Would be great to see if Boris Johnson and his cabinet and their close ones are staying home or not.
The problem is not getting the virus. But, if everybody gets it at the same time. That will make hospitals collapse as queues of people wait for treatment.
If Goverment officials have access to health care, it does not matter for them what happens to the rest of the population.
Herd immunity works. And one hundred years from now what the government did is irrelevant. The problem is the suffering that may be caused to the current UK citizens.
It may work, but the price to pay if it doesn't is very high. It not only includes lives but the long term trust in the government and its institutions, that is quite eroded already.
https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemi...
Or back in 2014?
https://www.washingtonpost.com/news/to-your-health/wp/2014/1...
Why is the world taking such an extreme reaction towards a disease that's less deadly and infectious than ones from 5 and 11 years ago where there wasn't an air of extreme hostility directed towards people for not worrying?
Is it because the name is scarier? Is it because it's not a flu but a coronavirus?
Because I still remember those, those were genuinely scary, mortality rates were high for healthy people, there were millions of cases around the world, and it was highly infectious.
Yet, there was no massive global quarantine, the world didn't end, and life went on.
Why should a disease that is less bad in every conceivable way be so much more panic inducing?
Because it's worse in every way: the initial containment has failed, the base immunity does not exist, the transmission rate is much higher, and the virus is more deadly.
Explain this, because this is the part I just can't wrap my head around. How is a disease that's deadly towards a much smaller percentage of the population 'more deadly'. Children aren't affected, anyone under the age of 60 is mildly affected barring pre-existing health problems. How is that more deadly than, a 30% mortality rate for young otherwise healthy individuals in the case of 2009's pandemic?
That doesn't explain how it's more deadly. More deadly implies it kills more people faster. This is very much not the case no matter how much it's spread and by comparison, it's still contained more than both of those other pandemics were. Those each affected millions of people over a few months.
https://www.worldometers.info/coronavirus/
We're at 167,543 with a total of 76,590 recoveries as of this comment.
For a website full of people used to dealing with big numbers there sure seems to be a lot of blind just ignoring of said numbers in exchange for emotional reaction.
Furthermore, the "deadliest" viruses in terms of rate and velocity of death are not as dangerous to the population as a whole, because most of the infected people fall over dead before infecting anyone else.
> We're at 167,543 with a total of 76,590 recoveries as of this comment.
We're also doubling the number of cases every 2.5 days in those countries that haven't managed to contain the spread. In Italy, that number (~20,000) has exceeded the capacity of the healthcare system.
For all ages, it's basically 12-24x more lethal than the flu. For 0-19, 12 to 25x For 20-49, 6-16x For 50-59, 9-21x For 60+, 4-7x
Also, this virus may be as deadly in Africa as H1N1... but Southeast Asia seems to have learned good lessons from 2009 and been better prepared.
People are locking down to AVOID a 2009 rerun.
Corona will probably never "go away" again unless we want to fundamentally change the way we live (which I think won't happen), so the only option right now is to slow the spread until more research has be done and the infrastructure has been built up to deal with severe cases.
I'm not changing anything unless I get ill. And then, it will only be to stay away from at-risk people and large gatherings. If I worked in an office, I'd work from home, but I work from home already. I'm certainly not going to barracade myself in my house for weeks/months.
That's just my perspective, and one which may explain why you're seeing this behaviour from other Brits.
[edit] Yeah, I thought this comment might be controversial. General response seems to be that I should be more scared than I am, and that I should do more than I am to stop the spread of the disease. I'm still not scared, and I still feel my response is proprotionate at this time.
https://www.rtlnieuws.nl/nieuws/nederland/artikel/5056536/se...
As the classic asks: Do you feel lucky, punk?
What matters is what the level of risk is, and what the cost of reducing that risk is.
I feel lucky.
This assumes that you can get comprehensive treatment from the healthcare system. If you can't, the numbers get very scary, even for the young (relatively speaking). If we really want the "herd immunity" strategy to work, we should still start containment now in order to flatten the curve, accounting for long lags due to the incubation period. "Wait and see" is not a viable approach, and other countries were mistaken in trying it.
The whole point of the social distancing strategy is that it's not just about you.
You might still need intensive care and not get it?
You might be infected and not know it?
This is really a huge gamble you're making, for your health and others'
So I addressed that by pointing out that most people risk the lives of others, but do care about the potential harm.
Now you've gone off on a tangent, and made an entirely different point, but presented it as an argument related to your first comment, or my response to it. It is neither.
I understand your position to be: Something bad is happening, and anything other than the most extreme response is to be criticised. Which is usually the response to be expected on Internet forums, so I'm going to move on now.
Suppose you caught it. It means you may get sick for several days. Sucks, but hey. However, it also means you'll be contagious for the next couple of weeks. Before you get sick, but also after you got better. Anyone who comes in contact with you runs a risk of catching it from you.
What does that mean "contact"? Simple. You're basically shedding viral particles. An invisible cloud of them hovers around you. A cough, talking, touching anything ranging from toilet seats to doorknobs to tables,... You basically leave a trail of particles that has the potential to infect others long hours after you've passed by. And you wouldn't even realize you're doing it.
Because this is exactly where you'll get a demonstration of power laws in action. Suppose 1 person infects 2 others over the course of those weeks, those will go on to infect 4, 16, 32,... you'll get what's going on here. Basically, you're that first match in a stack of matches that got lit, and before you know it, the entire stack has burned down.
Why is that bad? Because maybe two or three hops from you, there's a specialist, a couple of nurses, a few people who are designated to help out elderly people and maybe a couple of people with health conditions such as asthma, COPD, diabetes, high blood pressure,...
You didn't just got sick, you also provided a gateway for the virus to jump to all those people as well. Meaning all those who got sick can't provide healthcare anymore; and a ton of people end up in an already strained healthcare system.
And that's discounting people who have bad luck and end up having a heart attack, a stroke or a bad accident. If the ICU's are overloaded with COVID patients, stark choices will have to be made on who gets to live and who is left to die. That's where they are in Italy right now.
We aren't just talking about "patients", we are talking about your and other people's loved ones. Parents, grandparents, uncles, aunts, friends,... That's what we are discussing here.
Wrapping up. If you think that barricading yourself in your house for weeks/months is a "no go", well, you're not gonna like what's going to happen next either.
Stay in your home. Avoid contact if you can. Follow the WHO recommendations. Be responsible about this. That's how you help saving lives.
Who should we believe, them or CaptArmchair?
Given your apparent self-centered attitude and lack of empathy, I would guess that it will not bother you one bit.
That's not possible, because we don't yet have enough information about covid-19. We're still trying to work out what the death rate is!
> It's just not that scary unless you're in an at-risk category. I say this as a British male in my 30's.
So far we think your chance of death if _you_ (30 years old, no comorbidities) get covid-19 is between 0.5% and 1.5%.
And that's if the hospitals are not overwhelmed. One thing that will overwhelm the hospitals is people like you spreading disease.
By the sound if it, your risk analysis (also based on incomplete information) has lead you to believe that I should take some measures that I am not. That does not concern me.
But the fault lies with the government, they know and should know better
Or, as I saw in one conversation among my friends:
- I thought that the UK is a rational and science-driven country.
- Yes. And it is why they've offered themselves to serve as a control group.
It’s entirely predictable how this is going to play out. Sadly, not for the best, if the current trajectory is not adjusted.
But really, I'd love to hear your opinion on how the trajectory shoud be shifted.
It's not clear to me why we should listen to these people over the likes of Chris Whitty. Especially as they seem to have mischaracterised comments around herd immunity, which I've only seen stated as an aspect that may help rather than the strategy (to reduce the peak).
Government started talking about herd immunity as a strategy, and there's video of Boris saying this.
They've stopped saying it, and they've changed their comms, because it's such an unpalatable message and they were getting (still are getting) considerable push-back from the public.
https://twitter.com/BBCr4today/status/1238390547783528448
https://twitter.com/L__Macfarlane/status/1239190996379930626
Making a decision like this without releasing all of the data and assumptions behind the model feels unbelievably cavalier. It affects the whole world.
A couple of months into this, my lowly opinion is: give us the South Korean response, please. What I’d like to see is massive global cooperation to manufacture a billion masks, and an absurd number of tests — combined with aggressive social distancing, public education, hand sanitizer stations, etc.
It’s interesting that the UK government rode to power on a wave of populism — yet are proposing a solution that requires full faith in elites, with little transparency into the data and assumptions. A very precarious time.
[edit: obviously the South Korean model requires faith in institutions as well — but to me they’ve been fully transparent from the start.]
Minor nit: It was at least widely assumed that Groeteschele in Fail Safe (as well as Dr. Strangelove in Dr. Strangelove) was deliberately modeled on RAND Corporation military strategist Herman Kahn.
What they don't agree on is about measures to take, which is two-dimentional slider (time, social distancing) that outputs multidimentional output of - time, age group death rate/absolute count, nhs capacity, economic impact, heard immunity, retransmission etc.
On one side I'm impressed by the world's rapid response.
On the other hand I'm surprised how poor published scientific modeling/decision making is. We know pretty much all of parameters we need to know by now. Making an online model should be as easy as interview task for data scientist. And we have greatest minds focusing/ready to dedicate time to it. Why are we doing fruitless political arguments? Just share the model and data on github. Refine it every day with new data.
I'd start with real estimated infection counts (they can be derived from official confirmed infection counts by mapping on age weighted symptoms that require hospitalisation - those people are tested only plus incubation period estimated population - those people will not be tested but they are infected).
Any current estimate I've seen seems to lag in time if you take under account incubation period (4d) and real estimated infection count vs confimed cases (5x+).
We need plots for next 3 years or so with breakthrough placeholders - ie. it is highly unlikely that we won't have cure at some level to deal with it in 3 years from now.
It is highly speculative game if you estimate further in the future, yes, but medium term there should be obvious optimal decision.
See figure 4 at the bottom of this preprint from one of the UK research groups about the tactics in Wuhan:
https://www.medrxiv.org/content/10.1101/2020.03.09.20033050v...
they appear to be modeling here that even a total shutdown for a month, or for two months, will still lead to a similar epidemic.
I think that similar thinking is driving the UK policy but that's just a guess.
I wrote a blog post trying to predict the impact of this virus on Ireland. The fatality rates look grim:
https://medium.com/@fergal.reid/predicting-the-impact-of-cor...
This is a really insightful article from Andrew Sullivan where he compares the initial reaction to the Coronavirus to the initial reactions to AIDS. For too long the homosexual community was in denial about the level of risk. The wanted to think that it would blow over, and no dramatic changes were needed.
Sullivan sees the echos now. A lot of people are still determined to downplay it, as though it proves some sort of moral victory over the people stocking up on toilet paper. The reality is that things may not go back to 'normal' for a long time.
But one thing I do know is that now is not the time for political grandstanding or international conflict. We're all in this together as a planet, and our best chance of getting through it is by working together.
And I also know I would prefer to listen to a group of people who have spent their careers specialising in studying how infectious diseases spread. As the original article says, this list has "no leading experts in the science of the spread of diseases", and if anyone has taken the time to look at the list it is largely maths PhD students and the like. Which I guess is still better than the Silicon Valley charlatans and wannabe social media influencers who seem to be getting a disturbingly uncharacteristic amount of airtime on HN at the moment.
Isn't this exactly what the UK strategy amounts to? An acknowledgement that the pandemic can only mitigated at this point? It seems to me that those who are in the "shut down everything" camp are under the illusion that the virus can be stopped.
This weekend there is a huge festival in Mexico City with about 70k assistants every day (Vive Latino). Monday is a national holiday so millions of Mexicans are traveling all over the country.
Mexico City has +20M people and a very fragile public health system. Every month only the underground moves 130M passengers. I hope I'm wrong on this but I fear this will be one of the worse impacted cities on Earth. Thankfully we do not live there but we've been on self imposed lockdown for about a week anyway.
Even if it seems gone, it can pop up and we go on lockdown again?
I wonder if the lockdown people are anti-math.
Since early contagion is an exponential process the rate of growth (and all higher derivatives) also grows exponentially along with the number of infected. As a result, "as early as possible" also ends up being the correct time to maximally spread out the peak with the least intrusive countermeasures.
In order to conclude that delaying mitigations will do a better job of reducing the peak they must be making some highly novel assumptions. ... or just not actually reasoning about it formally at all and instead depending on intuition which is often not particularly accurate for exponential processes.
But for how long can you keep people holed up in their homes? This is a tradeoff that the government (whatever it is, in whatever country), must be prepared to face (even if it just means extending lockdowns).
Also, once the curve is flattened, will you allow people to leave their homes, and if so, what if another outbreak occurs? Will you lock people periodically every year until treatments are available?
(meant with no rhetoric: a question that I keep asking myself) Will this be sustainable in the long run?
Of course, that requires them to be able to "apply the brake" appropriately to keep things from becoming saturated. Which is why I thing the best word to describe the attitude of the UK government is "ballsy".
EDIT: Link to the original Lancet article the figure is from
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
The risk of overly-strict measures is the blue line; the aim of the UK government is to go for the green line.
By choosing these strategies, the UK assures that no other country will allow UK citizens into its borders a long time after the first wave of the virus passed.
UK Policy is a speculative lunacy.
Playing with the toy standard epidemiological SIR model. We have no idea how model parameters cause a yuuuge variation in ourcomes. We don't even know the central parameters/whether stochastic. Try to add perturbations for "herd immunity".
Most of the time your body will fight the flu, but when you get it bad it is very serious.
I cannot imagine why you would do this to your citizens. Depending on how bad they get it even young healthy people will die.
And as others pointed out, the economic impact is minimized. Crashing the economy also has bad health effects.
Add in the fact that that hospital overload is easily hit with small percentages of the population infected and that even relatively young people die at high rates when they can't receive critical care, I am extremely doubtful that they calculated much of anything here.
If large amounts of working age people die because of overloaded hospitals the negative economic effects will be tremendous.
Moreover, they now appear to be walking back their plan, suggesting that they will actually trying to slow the progression as much as possible... which is what almost everyone else is doing (as full containment isn't possible).
Whatever the number, it would be nice to save as many lives and as much potential long-term damage to people as possible.
If you could hermetically seal all of your above 60 population for 4 months.
I guess that's what they'll attempt.
Flattening the curve is the idea, so that health services can deal with the critically ill. That means EVERYONE HAS TO LIMIT THEIR CONTACT, as much as possible.
If you thought capitalist society was good at distributing goods, just look at what happened to hand sanitizer. Everybody needs it now, yet it has been bought up by the few that got to it.
The earlier you start with countermeasures, the longer you can try them and see how they affect the spread rate. If you wait to impose them at the last minute, you will have to choose erring on too expensive measures or on letting your people die.
Also, even if they do protect the vulnerable population, that only means they can stand a ~10x larger transmission rate. I don't think anybody knows how large it gets without some kind of action, but yeah, that would in theory make it possible to have milder actions.
That said, if they are indeed protect their population, I don't see how their plan differs from the rest of the world, that is trying to protect their vulnerable population too.
A suicide burn is when you're trying to land on a body (say, the Moon) by letting your ship fall freely, thus accelerating with gravity, for as long as possible, and then at the last second, you fire up your engines at 100% output and decelerate until hitting the ground. When timed right, you'll end up touching the ground exactly as your vertical velocity = 0. It's the most fuel-efficient way of landing, but if you miscalculate that time just a little bit, you'll end up smeared all across the surface.
Suicide burn works in rocketry because you can calculate all the forces to extreme accuracy and precision. Nobody would even think of attempting that if the error bars on your altitude or velocity measurements were +/- 1000%, or if your engine output was unstable. Trying to pull the epidemiological equivalent - timing countermeasures to keep NHS at exactly 100% utilization - seems like an impossible task that's bound to end with a disaster.
Our country is trying the other approach. Ban the sale of protective gear, and distribute it centrally. It's not working great either. GPs don't have any protective gear anymore and can't buy it on the market, as they did up to now, and talk of shutting down their practices soon, because most GPs are run by old people, and they're literally putting their lives in danger by practicing. They're only getting promises since January. They are now trying to get protective gear on black market to at least have any. They're begging the government to lift the ban so that people who're trying to get them protective gear from abroad are not doing so illegally/in great legal uncertainty.
Of course no other profession exposed to masses of people daily like cashiers, have any chance either to have protective gear, under the current system.
The plan is to lockdown the vulnerable and let the virus run its course through the rest of society. In this scenario you think(/hope) that the people not locked down only get mild versions of the disease and so don't require hospitalisation. You come out the other side with herd immunity which (again you hope) stops the disease from gaining a foothold again.
Lots of unknowns, of course, but if your starting point is complete infection of the population is inevitable then it doesn't seem necessarily any riskier than other methods and has the merit of being quicker if nothing else. If you think complete infection is preventable then it looks reckless at best, and a borderline genocide at worst.
The UK is taking measures. The public has been educated and told to stay at home if they show symptoms. If people were uneducated they'd be at work with a slight cough spreading it around. There's a strong social stigma in the UK to not take absence due to a cold. So this is a big deal.
At the end of the day, there's no evidence that the measures other countries are taking will work either. There is a strong argument that closing schools will impact the NHS, even though children aren't very at risk. Other countries are essentially on lockdown indefinitely right now because none of the isolated people have been exposed.
This is a complete moot point. Other countries have implemented free childcare for healthcare workers when schools are shut. There is no reason why the UK cannot do this for NHS staff.
And because children are not at risk of developing serious symptoms, they can be a huge reservoir for the virus, which then infects the middle-aged and elderly.
Other countries haven't shown evidence that their approach is more effective. The UK solution is to not close schools.
Though it has not been proven that schools are a hotbed of contagion for sars-cov-2, there is a lot of reason to expect them to be and little reason to expect that they aren't.
Sweden also made the same point and kept the schools open FYI
The evidence is overwhelming that people who have not developed symptoms are contagious. (It's also extremely likely that people who never develop symptoms are transmitting the virus.) This simply isn't sufficient.