Coronavirus - worldwide spread and control

He is talking about centralised quarantine (something which isn’t being done in the UK and US and infact many countries, anyway, so I don’t know what the furore is about), and this is something they did in China - to stop it spreading to other family members and to stop whole families getting ill. Or if someone is critically ill, they would need to go to hospital. My friend in Italy, his grandfather died and his whole family got ill with two others hospitalised with COVID-19 because it does spread within families.

 

Special Report: Johnson listened to his scientists about coronavirus - but they were slow to sound the alarm
https://www.reuters.com/article/us-health-coronavirus-britain-path-speci-idUSKBN21P1VF

 

Spread of virus in UK and US:

US:
Virus Is Twice as Deadly for Black and Latino People Than Whites in N.Y.C.

https://www.nytimes.com/2020/04/08/nyregion/coronavirus-race-deaths.html

The coronavirus is killing black and Latino people in New York City at twice the rate that it is killing white people, according to preliminary data released on Wednesday by the city.

The disparity reflected longstanding and persistent economic inequalities and differences in access to health care, Mayor Bill de Blasio said on Wednesday morning.

UK:

Are minorities being hit hardest by coronavirus?


https://www.bbc.co.uk/news/uk-52219070

Unlike in some US states, both the overall number of confirmed coronavirus cases and deaths in the UK are not currently broken down by ethnicity.

But there is some evidence to suggest that coronavirus is having a disproportionate impact on people from ethnic minority backgrounds.

Data from the Intensive Care National Audit and Research Centre (ICNARC) suggests that 35% of critically ill coronavirus patients are from black or minority ethnic backgrounds.

 

Paul Mason and Afua Hirsch host a video conference call (zoom I think) with 5 experts on the government response to covid.

https://www.youtube.com/watch?v=05-jbrHRmrs

I really like the format, it would be good to see something like this about ME.

 

Here are his words verbatim....

As we are being told anyone is susceptible to getting the symptoms even down to mild symptoms that includes children, parents and grandparents.

He wants to go and look in families to find people who "MAY be Sick" and remove them.

 

The statement in the clip is from
Dr Michael Ryan, Executive Director, WHO Health EmergenciesProgramme

he is not talking on behalf of the US he is talking as an official in the World Health Organisation.

Michael J. Ryan
Surgeon
Description
Michael "Mike" Joseph Ryan is a former trauma surgeon and epidemiologist specialising in infectious disease and public health. He is Executive Director of the World Health Organization's Health Emergencies Programme where he leads the team responsible for the international containment and treatment of COVID-19. Wikipedia

Born: 1965 (age 55 years), Sligo, Ireland
Nationality: Irish
https://en.wikipedia.org/wiki/Michael_J._Ryan_(doctor)

 

I am aware of that.

This is an interesting thread on centralised quarantine by a scientist I follow:

https://twitter.com/user/status/1245950157021036546


https://twitter.com/user/status/1245950174691618816


https://twitter.com/user/status/1245950181264084992

 

@lunarainbows

Is centralised quarantining the official term?

 

I think the UK could have acted far quicker than it did.

It's akin to a group of people all gathered on a river bank at a time when there is a lot of intense rain, and flash floods known to be happening elsewhere and a potential hazard where they currently are. If they notice the river level starting to rise, and knowledgeable local experts saying they need to get the f' out of there now, then that is exactly what they should do, with the emphasis being on the 'now'.

Instead what the UK did was along the lines of appointed experts saying "Well, it's not risen much yet, at the rate it's rising we can watch to see what happens, and if we need to later we can reassess the situation then." So they dally on the river bank longer, watching with interest how the river level still rises gently, and apparently ever so benignly, completely ignoring the local experts who are imploring them by now to get out whilst they still can.

And then out of nowhere the flash flood hits them with incredible speed and force, taking many lives with it. The appointed experts, if still able to, proclaiming there was no real warning because the river was rising slowly for much of the time beforehand. The local experts telling them that the slow rising river and other known risk factors were the very warnings that could have saved so many lives ... if only they had listened to those experts who understood this.

 

How long do asymptomatic people remain infectious?

I don't feel secure regarding the "14 day window".

 

https://twitter.com/user/status/1245950181264084992


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So as we are being told that millions may be carrying this virus are you in favour of a cenrtalised quarantining ......

matching the notions you linked to above from Daniel Falush and after hearing the comment from Michael Ryan of the WHO?

Just how many people would this centralized quarantining stretch to is it hundreds is it thousands is it millions? Where would they all be kept/centralised?

Exactly how would one define a carrier and how would you insure you are not making people sick by rounding them up with others who are spreaders?

Are children to be included in this centralized quarantining?

If children are to be included how is their safeguarding going to be managed.

At what point do people get their children back Etc etc

 

Instead of people having to self isolate at homes, they are isolated away from their homes, so that it doesn’t continue spreading through their homes and/or communities. I think it worked well in other countries. As to whether I’m in favour of it, think there should certainly be a voluntary centralised quarantine available so that there is somewhere for people to go if they don’t want to stay in their family homes incase they are at risk of spreading it to others they live with. (And also where their health will be checked rather than just being alone with health that can get worse quite quickly).

However I can’t see it happening in the West, for so many reasons. Not least the amount of organisation and resources this would need which I doubt they are willing to do. Edit: But right now, I would at least like to see a proper programme put forward of testing, contact tracing, breaking chains of transmission and as Anthony Costello said (a few pages back), community surveillance so GPs and primary care can coordinate between them to monitor and check in every couple of days, on those who are infected at home in the community and to make sure people don’t deteriorate quickly at home. Edit 2: the worry is also that people are being kept at home and then by the time they get to hospital, it’s sometimes too late.

 

It will be thousands but that is manageable.

Maybe people forget that in older people's memories legally enforced centralised quarantine was a very normal part of routine health care in places like the UK and US in the 1950s to maybe 1970s. Anyone with a notifiable infectious disease by law had to go in to an isolation hospital. We had one down the road called Coppett's Wood. I don't know how many beds it had but maybe 200 - for a small region of London. People with typhoid, meningitis, smallpox, TB and all sorts of things were 'taken away from their homes' by law and kept separate until no longer infectious. It is a completely necessary part of any health care system in a world where dangerous infectious diseases are bound to appear from time to time.

Maybe the western world needs a dose of reality. Maybe people need to realise that in order to stay alive for 70 years with luxuries like air travel and world cruises you need a medical system that has the legal power to isolate those with dangerous diseases. The current half hearted restrictions in Europe and the US look as if they are enough to make further infection linear rather than exponential but it is beginning to look as if leakage is such that actually getting infection rates down is overoptimistic. With the accumulation of people on ventilators and needing intensive care for multiple organ failure continuing unabated something is going to have to give.

 

Yet we are being told that millions are carriers and are experiencing mild
symptoms.

We are also being told that children might not even be experiencing any symptoms although they are carriers therefore schools are closed and the children are on isolation from their grandparents if they are in separate households.

So how would that only equate to thousands and not hundreds of thousands or millions of people.

The WHO need to come and get people from houses in Michael Ryans words and at the same time we are being told the virus is airborne and even on all of our everyday surfaces?

People having a bed made available for them in a hospital is one thing if they get very ill but the WHO statement about getting into families and removing people is quite another thing.

 

I have not seen any reliable evidence that millions are carriers. Certainly there will be more infectious people than are recorded. There are currently about 5,000 new reported infections a day in the UK. I think that might scale up to up to 500,000 people infected out of hospital just at present. So yes we may be talking in tens or hundreds of thousands at present. But that rate should fall with current prevention measures over the next two weeks. I do not see centralised quarantine being practical in that time window and anyway it will not be ready. But in order to get the epidemic fully under control = which is the point being made on Twitter - there then will almost certainly need to be a phase of traditional isolation in designated units. At that stage I would envisage perhaps initially tends of thousands and then thousands. Tens of thousands should be practical. The isolation units do not need to be anything very fancy. A hundred units across the country with a few hundred beds each would be enough. There are almost certainly enough conference centres to do the job and they are currently empty.

The problem as I see at present is laziness on the part of governments as much as anything. If the enemy was Martians or a hostile nation we would sort things in no time.

 

A friend commented that a colleague commented to them force-ably (along these lines) -- what are you doing here, can't imagine they'd want to go to a tribunal about you taking yourself off home!
Everyone's circumstances are different. If you can socially distance at work and you don't live with someone who is in a vulnerable group/you are not vulnerable and your work cannot be done remotely, then presumably your employer would be justified. Your manager will probably contact you, from their remote working location (home), to explain that! Try the union rep --- good luck with finding them! You could self quarantine if you were concerned --- wonder what the record will be for an organisation that doesn't facilitate remote working, social distancing ---
All of this should give legal reps a bit of extra work ---.

 

most likely a stupid question but how long are asymptomatic carriers infectious for? Does the virus just 'run its course' in these people and disappear?

 

Boris should have had someone better draft the letter sent to everyone. Remember "Stay at home. Protect the NHS. Save lives"

You are apparently allowed to travel for work purposes, but how that includes sitting in the passport office all day with your colleagues defies the imagination. Perhaps they will all be required to keep walking - two metres apart of course.

 

I doubt anyone has hard data but it is likely to be about 7 days or less. By definition we are talking about someone who is actively excreting virus so PCR positive at Day1. Without symptoms they are fairly unlikely to go on excreting virus for more than 7 days - but that of course can be tested for if they have been shown to be positive. If the question is statistical in relation to working out how many people are infectious at a given time I think 7 days is likely to be a reasonable upper limit as a mean.