Coronavirus - worldwide spread and control

@mango the UK has not done any of those things. They’ve said they are in a “plan”, but infact right now they are still in containment phase which consists of telling people to wash their hands while singing god save the queen or happy birthday, telling people who have the symptoms of virus to self isolate and call 111, and tracking people they’ve had contact with after they’ve been diagnosed with Covid-19.

See, for example, our very own scientific advisor saying large crowds are not a problem, directly contradicting WHO advice. This is the level of maths and science we are working with here

Note also we have a PM who has said one theory is that we can just “take it on the chin and allow the virus to move through the population”

https://twitter.com/user/status/1237067646727749633

 

However if one person is suspected of having a virus or is diagnosed, individual schools do sometimes shut (often against the advice of Public Health England), and often workplaces and hospital wards do shut to do deep cleans.

 

There are two different issues. One is the time from picking up infection to being infectious. That tends to go along with the incubation period, which for Covid-19 is around 4-14 days. The virus has to replicate in cells and for there to be a significant excretion that is going to mean several generations of spread ( although for viruses there is no fixed generation time). If infectivity started before 4 days I think the epidemic would have expanded much more quickly.

The second is whether at the point of being infectious the person has symptoms and the answer to that is clear. Most do but a significant minority have no symptoms. So once there are a reasonable number of people around with the virus picking it up from people with no symptoms is going to be routine.

 

"One person in a 70,000 seater stadium is not going to infect the stadium, they'll infect potentially a few people they've got very close contact with"

Chief Scientific Adviser Patrick Vallance on risk factors within crowds of people#COVID2019 latest: http://bbc.in/2TAXmE1

I know Patrick Vallance well. He was head of our department for a few years. This seems a very irresponsible thing to say. It is hard to credit that a scientist with integrity should say something like this. Being in a position to infect a dozen people is easily bad enough. And the tracing task for the health service would be vast, since presumably people at football matches rub shoulders going in and out regardless of where they sit. What if they sneeze into hand that they then use to hold on to a rail twenty yards long that 500 other people then hold on to?

 

Edit: regarding the Tweet, I think what also has to be taken into account is the travel back and forth. Public transport is crowded with every major event.

 

At the moment most of the infection spread seems to be coming from people entering from outside the UK. I imagine a critical point is when the infection spread is mostly from others within the UK; akin to a fire no longer relying on kindling to keep it going, but becoming self-sustaining. At that point I imagine it becomes extremely difficult to control. Additionally complicated I imagine by the fact that people will only know to self isolate some time after they may have already been infecting others.

 

Yes. It may be important that the whole of Italy is now in lockdown. The ridiculous business of Italy infecting the rest of the world after China has got itself sorted out may now stop. With luck Spain, Germany and France will follow suit and we will be free of the second hand cases too.

In the long run, control without 100% of the population being affected is going to need a ban on air travel for a period of a few months. I do not understand why governments do not see this and do it now.

 

And if they feel well enough they may not bother to self isolate. Especially if there's an event they don't want to miss. Or they decide they want to "just" nip to the shops or something.

 

Absolutely. And each and every person who went to the football match or gathering, who caught it off someone there, will then spread it back in their community as well, let alone the transport. This person put it well:

https://twitter.com/user/status/1237069000011468802


https://twitter.com/user/status/1237070948655927298


I agree @Jonathan Edwards. Worst thing is because he’s chief scientific adviser, lots of people think this is totally credible and ok to follow his advice. Probably why Cheltenham is going ahead. :/

 

I also wonder just how achievable self isolation will be in practice, even for the most diligent. Suppose a single Mum with two young children. There will be no practice runs, you have to get it right first time. I find it very hard to believe that in that situation there won't be some reason why Mum has no choice but to go out to get something vital that was overlooked.

 

Do you think we have not yet reached the point where the UK infection spread could self-sustain, if air travel bans prevent the virus being 'imported' from outside? I imagine it depends if there are pockets of infection anywhere within the general population; presumably such a pocket needs to achieve some notion of critical mass in order for it to take hold and risk running out of control?

 

I do not see our government ever putting restrictions on flights in terms of stopping flights altogether. Even flights coming from locked-down areas are still going ahead at the moment, without any checks or much info. If I understand correctly, once the govt issues advise saying people shouldn’t fly, insurance companies have to pay out to cover the cost of the flights etc?

 

Meanwhile in Italy the whole country has been declared a red zone and the number of cases increased by 1598 in a day (from 7985 yesterday).

 

That's a 20% increase in a single day. If that continues that would be one hell of an exponential increase. Would mean another 1900 tomorrow, etc.

 

My GPs use these people for contacting them, plus requesting refills for meds. I thought their advice seems relatively OK for people in UK. Might be useful for others too if you disregard the telephone numbers quoted.
https://patient.info/news-and-features/covid-19-how-to-protect-yourself-against-coronavirus

 

But, in the long run, isn't this new coronavirus going to become endemic anyway? I don't believe it can be contained, so the best we can do is flatten the curve of new cases to relieve pressure on public services. I think this is the reality recognised by governments and balanced against any disruption caused by containment measures (that will ultimately prove unsustainable and ineffectual).

That's my feeling. I know recent data shows a downward trend in new cases in China and Korea, so I hope I could be wrong. But how long will we continue to see a reduction of cases, once life returns to normal? I'd be surprised if the curve has peaked in those countries.

This doesn't mean we shouldn't put in firebreaks to slow the spread where practical measures can be taken, but there's something to be said for getting through the initial epidemic and out the other side. That way we get 'back to normal' life sooner than later, instead of a protracted period of living in fear of what seems inevitable.

 

A science geek on Reddit posted a complicated mathematical formula showing that for every large gathering of people (even if made up of only young people) it leads directly to X amount of deaths. People need to realize that even if they are at low risk of complications and/or death from Covid-19 that their actions literally can mean life or death for someone else. Do people care enough though?

 

I agree but even 'getting through the initial epidemic' is going to need a complete ban on air travel as far as I can see, as judged by the fact that Italy has already run out of hospital beds and the fatality rate there is around 5-6% probably at least in part as a result.

Without closing down air travel I think there are likely to be up to quarter of a million unnecessary deaths in the UK. Can we accept that?

In contrast the Chinese experience indicates that with adequate will the epidemic can be halted now with only one person in about 100,000 affected.

 

I posted a video of what he said earlier in the thread. That is what Jonathan Edwards actually quoted.

https://twitter.com/user/status/1237067646727749633

 

Thankfully all St Patrick's Day parades, nationwide, have now been cancelled in Ireland. That happened yesterday. So that's something.

I found it interesting to hear this patient's account that their only symptom was fever. Not surprising if you've been scouring the literature, but I think it's important that the general public hears accounts like that, so they spot that they potentially have coronavirus even if they only have one symptom, or if what they're experiencing doesn't seem to match what they've heard about on TV/online. https://www.irishtimes.com/news/ire...reland-only-symptom-i-had-was-fever-1.4197988