UK government releases scientific evidence supporting Covid-19 response | Hacker News Reader

UK government releases scientific evidence supporting Covid-19 response

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I don’t think I’ve ever felt as proud of my university - Imperial - than right now. Their research is making a big difference in the actions government is taking, and it could save many thousands of lives.

If you read/watch/listen to Peak Prosperity, Imperial pretty much copy/pasted everything what was said before by them, plus added some charts which everyone can understand. Nothing to be proud of to be honest, especially coming from university.

Link: https://www.peakprosperity.com/

Edit: for downvoters, would be happy to hear your thoughts. Especially let me know if you have followed Peak Prosperity info since January and if you read Imperial report.

With so much noise it's understandable that people are dismissing information from less known third-party sources in favor of very well established higher learning institutions. I am also critical of the way Western governments handled the situation, but these are two orthogonal concerns. Maybe you could link to particular information rather than their homepage. I am always willing to give a fair chance but please help us first :)

Imperial is the hidden workhorse of the UK government and has been for many years. They do a lot of great research work and yes, they proper from that work but, they are very good at it.

Does anyone have access to good data? There is so much fake news that is hard to trust any articles. If somone is 30 years old, healthy, workout, don't smoke, what is the probability of hospitalization, serious injury, icu or death?

Previous link https://www.imperial.ac.uk/media/imperial-college/medicine/s...

For under 50’s 2% chance of hospitalisation, then 4% of mortality. From the following summary, presumably mostly based on Chinese data which may not be applicable.

https://assets.publishing.service.gov.uk/government/uploads/...

Common reply seems to be 0.4 . I trust this old Doctor who likes numbers. https://www.youtube.com/user/Campbellteaching

In Italy there were no deaths for people under 30 so far.

The youngest I’ve heard is a 14y/o in China.

Are we able to know that for sure? What if he died of autoimmune disease, flu etc. But just happen to have covid19?

Wa there anyone with long term health issues?

Really interesting to watch the evolution of the advice on Behavioural and Social interventions. It is absolutely clear from this that the idea of "flattening the curve" rather than completely suppressing an outbreak was being seriously considered until very recently. Luckily, this is not something being pursued anymore and they moved away from it in time but you can certainly understand the attraction when you consider the consequences of the almost total shutdown required to suppress.

Flattening is still important at first - gives time to respond, to improve treatment and response plans.

>Luckily, this is not something being pursued anymore and they moved away from it in time but you can certainly understand the attraction when you consider the consequences of the almost total shutdown required to suppress.

Imperial suggested a very interesting approach, turning the measures on and off as the cases rose above and fell below a couple thresholds. You can't hit R0=1.0 exactly, but you can swap between 3.0 and 0.3 as conditions change. This would allow businesses to have a chance of survival.

From all appearances this is more or less what China is doing today. Lockdown until the number of new cases in a geographic area is zero, then slowly loosen the grip of suppression and calibrate based on new information. When the second wave starts I'm sure the response will be a little more measured this time.

Quoting one of their sources:

    It is a political decision to consider whether it is
    preferable to enact stricter measures at first,
    lifting them gradually as required, or to start with
    fewer measures and add further measures if required.

It's not a scientific question in the sense that there _is_ a consensus that methods to "flatten the curve" will reduce the load on the healthcare system, which can easily be overloaded well before the peak. It is also clear that solid scientific data will come only _weeks_ after widespread contagion. What's not clear is how to handle this _politically_, i.e which decisions to make confronted with large uncertainty and relatively short timeframes.

This is mainly what Trudeau was criticized for. Sure he might be very well advised by top scientists, but he did not seem particularly interested in solving the issue _politically_. It took a few weeks before he (at least publicly) exhibited any serious interest, and then we went from 0 to 100 over a weekend.

The political response to this situation will and has to preface any solid scientific understanding.

> It is absolutely clear from this that the idea of "flattening the curve" rather than completely suppressing an outbreak was being seriously considered until very recently

Wait I'm out of the loop. The #FlattenTheCurve campaign is already wrong?

The report from Imperial College [0] indicates that it may be impossible to flatten it enough for it not to overwhelm medical care capacity.

It wasn't (and still isn't) wrong to try to flatten it - it's what gives time to investigate the appropriate course of action. But unfortunately it seems like flattening won't be enough and more extreme measures (called "suppression" in the report, whereas flattening strategy is called "mitigation") need to be taken.

The report also notes that such extreme measures have never been taken on the timescale they anticipate to be required to successfully suppress the disease (basically until the cure or vaccine is found and widely distributed - at least 18 month and possibly years), so we have no idea how that will turn out.

[0] - https://www.imperial.ac.uk/media/imperial-college/medicine/s...

It's not wrong, necessarily, the issue is that ICU admission rates even in young people are high enough that you need to flatten the curve an incredible amount in order not to overwhelm ICU capacity. (They're not high in absolute terms, but an arithmetically small change in a small number can have massive effects)

This does give me some relief that Boris is taking little or no part in the important decision making and just rubber stamping what experts agree on.

I think our government is taking some good actions, but I’m concerned that people aren’t actually complying. Their modelling relies on 75% decrease in social interaction. I think some enforcement will be needed.

Yes, and after a few months the "were all in this together" mentality will have worn off and it will get worse. I think that is some of the reasoning behind delaying some measures until they can have most effect.

There's no sports, no events, huge numbers working from home, pubs and restaurants very quiet. Picadilly Circus currently has only a few people walking about. I think more extreme measures would be counterproductive, because clearly there's been a massive decrease in social interaction already, and people are already panicing.

Cheltenham Gold Cup went ahead (about 11th to 14th March), just a few days before wider restrictions were announced.

60,000 people attended Cheltenham, on top of their normal population of about 100,000 people.

It was much quieter in town this year (normally Winchcombe Street is full of people and activities, but this year it was mostly empty).

But still, that's 60k people travelling while the pandemic is in full swing.

I live close to a martial arts studio and they're still open, and that feels sub-optimal.

The other problem with not enforcing measures is that it leaves the public to pick up the bill. Some train tickets ("advance") are not refundable at the moment, and credit card companies are not allowing charge-backs because the trains are still running. If the government announced wider restrictions people could get refunds. This burden of payment is a tricky problem: the public should share some of the cost, but the way it's happening now is a bit haphazard and is disproportionately burdening poor people.

> martial arts studio and they're still open, and that feels sub-optimal.

Here in Norway all non-essential businesses that require close contact between people are required to close until further notice. That includes all gyms, tattooists, hair dressers, nail bars, non-essential physiotherapy, etc.

Bars, restaurants, and cafés have to enforce a one metre separation rule (usually done by removing every second table) and several towns have prepared orders to close them entirely if bars are discovered to not be complying.

We are also encouraged not to travel unnecessarily and people with cabins in the mountains are forbidden from using them unless they already live in the same kommune; this is to avoid overloading the health service in sparsely populated and remote areas.

> not enforcing measures is that it leaves the public to pick up the bill.

I've been bombarded with texts and emails from the companies that I deal with reassuring me that they will allow bills to be deferred, tickets refunded or rebooked without cost, etc. (including from National Express in the UK).

UK train companies are refunding some, but not all, tickets.

They're not refunding "advance" tickets, and probably won't until the government implements a firmer ban or changes the law.

Yet this was one tube line this morning: https://twitter.com/DRileyamusing/status/1240923403919515648

Yes any attempt to force people to stay indoors will lead to a huge amount of reactance and will just backfire a few weeks down the line with mass disobedience. That said, they should close the restaurants, bars, etc.

And in densely populated places it will result in violence that would require police and hospitalizations using the resources that otherwise would be allocated to the pandemic.

Sounds fantastic. Glad most people are doing their part. If only Western governments were encouraging their citizens to wear masks. I know there aren’t enough even for healthcare workers but people in vulnerable groups should really be encouraged to wear makeshift masks. There’s no shortage of tea towels and if you strap one to you face you’re at 70% effectiveness catching virus sized particles when surgical masks are just under 90%. Decreasing the viral load that gets into your lungs decreases the possibility you’ll actually get infected.

> Professional and Home-Made Face Masks Reduce Exposure to Respiratory Infections among the General Population

> Principal Findings

> All types of masks reduced aerosol exposure, relatively stable over time, unaffected by duration of wear or type of activity, but with a high degree of individual variation. Personal respirators were more efficient than surgical masks, which were more efficient than home-made masks. Regardless of mask type, children were less well protected. Outward protection (mask wearing by a mechanical head) was less effective than inward protection (mask wearing by healthy volunteers).

> Conclusions/Significance

> Any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence, personal respirators providing most protection. Masks worn by patients may not offer as great a degree of protection against aerosol transmission.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440799/

It might be difficult for governments to admit that they were "lying to you for your own good." No official is going to want to suffer that embarrassment, and even though this is an emergency situation the normal laws of bureaucracies (avoid embarrassment at all costs) still apply.

Yes, as someone who is isolating entirely until this is all over due to health grounds, how soon I get to go outside again (and whether I even live through this) depends largely on the efforts of others.

It's frustrating that everything so far is "advice" or "recommendations" and nothing is actually mandated yet.

At least shut the pubs, it takes the piss that spoons is still open.

Given who runs spoons are you at all surprised? Tim Martin can make Mike Ashley look like a model of restrained and responsible capitalism...

I'm not surprised, they're essentially making a statement that they'll stay open unless forced to close.

I'm disappointed that it's taken weeks to get to a point of just considering forcing closed the pubs.

Yep, someone texted me and asked if I wanted to go to the pub two days ago. I fear it’s not being taken seriously enough.

That would be excellent news.

I actually think that Dominic Cummings may be having a positive influence there - which is not something I thought I'd ever find myself writing!

Right, but that's exactly what a prime minister should be doing. His role should be to coordinate decision making amongst the relevant subordinates. I have no reason to doubt Boris will do a fine job at this.

There's 100+ undeveloped/underdeveloped countries that Covid is currently ravaging through. Their response will be the same as the Spanish Flu. They have no adequate medical authority to test and release numbers for the media to currently obsess over, but in a few weeks (months?), we're going to get status on how post herd-immune countries are doing. Their demographic pyramid skews young, so the numbers might not look as bleak. That said, many countries are going to have to start seriously considering the unpleasant calculus between (old) lives and economic cost because it's increasingly obvious we're not capable of enforcing a proper quarantine.

People seem really positive about this, but I don’t see anything here that seems actionable or materially different from what we’ve seen elsewhere. Can someone point out why this is noteworthy?

It's important because it is political. There have been widespread calls for government to show it's working, and a really determined campaign to show that the strategy is ineffective and is the thing of the prime minister. The document is a chance for the government to try and change some of these perceptions.

Also it is pretty impressive how transaprent the UK prime minister has been in dealing with this pandemic.

- 100% scientific driven approach

- Daily briefings and updates addressed to the public

- Daily Q&A where the PM addresses questions from the press

- Publication of all scientific papers and studies conducated in this short amount of time which are fundamental in decision making

Nobody has a crystal ball to look into the future and therefore nobody can say if what the UK gov has done so far and when they have done it and how they have done it was any good or bad, but I rather have a government which takes such a scientific and transparent approach than anything contrary.

Mistakes can happen regardless which approach one takes, but I rather have a mistake done based on best scientific effort than through negligence.

This title is a bit confusing. It sounds like this provides evidence showing that their response was effective, but it is the evidence they used to draw up their response.

It's not misleading if the former is logically impossible and therefore it is clear that the latter is clearly what is meant.

No single country can at this point in time yet provide any evidence if their response was effective, because in order to do that you'd need:

- Be past the pandemic

- Have other data points of other countries to compare

Both are not true yet.

It is confusing though, my initial reaction was that such evidence should not exist and I only realized my error after browsing it for a few minutes.

Replacing "supporting" with "provided to draft" would prevent my problem.

I agree … it seems like a poor word choice, given nothing can really be certain at this stage. I think a term like rationale would be more suitable …

True :)

It doesn't sound like that to me at all. It says evidence supporting the response, not evidence of the efficacy.

To illustrate why this lockdown really needs to stay as short as possible and why Trump and Boris are aggressively pushing for a test and anti-viral alternative, economists are forecasting jobless claims in the US to be in the 2-3m region next week vs 150-200k a normal month.

We're not going to whitewash Trump; he wasted too much time trying to downplay and deflect the virus and only took it seriously when it became apparent that wouldn't work.

I also think everyone is working to end the quarantine as quickly as possible, as they are aware of the social and economic implications. The problem with rushing however is that if we develop a vaccine that is ineffective or harmful, it will make the situation worse.

To put things into perspective, in tiny Norway companies have issued warnings to 170k, in one week. In six days they received 105k applications for unemployment benefits.

The government is paying full salary (capped at ~600k) for the first 20 days. After that you receive either 62,4% of your salary up to 600k, and if you make less than 300k you receive 80%.

But it's not just Trump and Boris pushing for it. Trials of anti-virals are pushed heavily by the WHO in all countries.

Not in all countries. In France the gvt and newspapers have been downplaying the benefits of these anti-viral drugs. They are launching trials but it feels like it is doing under the pressure of the opinion. They are adament that lockdowns are the only efficient long term solution.

Do we even live in the same time line ? All he did was say "nothing is happening", "we have the best people" and aggressively push to call it "the Chinese virus". None of it being useful. [0]

The US will get absolutely destroyed by this virus. It's way too little way too late and it'll really show how far behind the US is in term of social/job security and healthcare.

[0] https://twitter.com/LeeHolly81/status/1240223327811239936

Here's a transcript from yesterday's press conference. Of the 42 hits of a search for "test", not one of them is Trump referring to the availability of tests. It's either other people mentioning tests, reporters asking about tests, Trump using "test" as an imbecile's synonym for "clinical trial", or referring to various peoples' test result. No "tests are being made available", or "we're working with industry to increase production of testing kits" or anything similar.

https://www.rev.com/blog/transcripts/donald-trump-coronaviru...

Goes in hand with anti-virals. You don't give anti-virals to the whole population, only to people who have been tested positive.

It's not unheard of and some work has been done to study if this would be beneficial (with promising results)[1]:

But I offer as evidence two papers[2] in 2005, one in Nature and one in Science. They both did mathematical modeling with influenza, to see whether saturation with just Tamiflu of an area around a case of influenza could stop the outbreak. And in both cases, it worked.

[1] https://www.wired.com/story/coronavirus-interview-larry-bril...

[2] Journal references: Nature (DOI: 10.1038/nature04017) and Science (DOI:10.1126/science1115717)

Perhaps. But in this case we are just trying to get around the saturation of medical facilities.

Which is really all that most countries are doing. In doing so also they're buying time by decreasing the number of people that get infected per unit of time, thus increasing the likelihood that more people will be infected later when possibly better treatment options exist and/or a vaccine.

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