Coronavirus - worldwide spread and control

[Marco]

What hits me starkly about today's press conference is that although the impression is given that we are catching up with other countries in the UK we are still unique (maybe with the US although I am not sure there is a plan there) in assuming that the epidemic will play out and infect most of the population. As indicated earlier the maths doesn't;t work. to stay within the capacity limits of the NHS you would need to string out the epidemic for at least 4years, more likely 10 and maybe 20.

From today's conference and other sources I'm becoming increasingly convinced that the UK approach is one of the few intelligent approaches where politicians are actually listening to the experts rather than 'ooh parents want schools closed and there's an election coming up so ...knee-jerk reaction'.

It's not a matter of 'total lockdown' or 'let it rip' as portrayed in the mainstream media; more a Goldilocks when to apply the lockdown - not too soon and not too late. I'd suggest Italy left it a little too late and Ireland have gone much too soon.

 

[Jonathan Edwards]

Do you think they're banking on a vaccine coming in a lot faster than that?

I'd rather they kept us all shut down to wait for a vaccine and more effective treatments...

I don't think anyone is banking on a vaccine. It is not predictable.
I would rather they kept us all shut down as well, but why not try to do what other countries are trying to do with shutdown - terminate the epidemic. We are planning to be left as the one country shut off from the world still having an epidemic when the others have stopped theirs. It seems crazy. There is no economic argument because as long as we are the bad apple our economy will go nowhere.

 

[Jonathan Edwards]

It's not a matter of 'total lockdown' or 'let it rip' as portrayed in the mainstream media; more a Goldilocks when to apply the lockdown - not too soon and not too late. I'd suggest Italy left it a little too late and Ireland have gone much too soon.

But as I have been trying to point out there is no Goldilocks position, unless you want to be socially distancing for ten years, by which time a new generation will have been born to keep the epidemic going!

I know quite a lot of the experts in this area and Vallance is not one of them. He is a political who rose to be head of Glaxo rather than doing actual research.

 

[Mij]

https://www.nih.gov/news-events/new...trial-investigational-vaccine-covid-19-begins

 

[ME/CFS Skeptic]

 

[Sasha]

I don't think anyone is banking on a vaccine. It is not predictable.
I would rather they kept us all shut down as well, but why not try to do what other countries are trying to do with shutdown - terminate the epidemic. We are planning to be left as the one country shut off from the world still having an epidemic when the others have stopped theirs. It seems crazy. There is no economic argument because as long as we are the bad apple our economy will go nowhere.

I'd like to understand more about the possibility of terminating the epidemic at this stage - thousands infected in many countries, and many countries in the developing world without strong health systems. Is it still possible? Even if we terminate it in the UK, won't it start up again as soon as we open our borders?

 

[ahimsa]

It looks like officials and scientists who've been trying to convince our president to take this pandemic seriously have finally made some progress

Live updates: Trump says outbreak could last months and gatherings should be limited to 10 people

https://www.washingtonpost.com/world/2020/03/16/coronavirus-latest-news/

President Trump told governors Monday that states should work on getting respirators and ventilators, and not wait for the federal government to provide them. The president’s comment was confirmed by multiple officials briefed on the call to governors earlier today.

“When you look at the projections, there’s every chance that we could be Italy,” the U.S. surgeon general warned Monday. Widespread social distancing could help change that trajectory, he said.

(there should be no paywall for this article - all coronavirus news is supposed to be free)

 

[lunarainbows]

Mr Johnson slipped in 14 days at the press conference instead of 7 - hoping nobody would notice they had changed things, I assume.

Haha yes. It was 7 days for everyone just a few days ago. Now it’s 14 for families though. Not for individuals (7 days).

What hits me starkly about today's press conference is that although the impression is given that we are catching up with other countries in the UK we are still unique (maybe with the US although I am not sure there is a plan there) in assuming that the epidemic will play out and infect most of the population. As indicated earlier the maths doesn't;t work. to stay within the capacity limits of the NHS you would need to string out the epidemic for at least 4years, more likely 10 and maybe 20.

There’s still a lot of unanswered questions in terms of strategy.

If anyone is interested, this is a very good thread by Anthony Costello, (Ex WHO and currently at UCL), he’s been vocal on putting his concerns across to the govt and has been on National news a fair few times. He raises very good points here.

 

[Snowdrop]

Mainly because those who are supposed lead, and to either understand or listen to those who understand what exponential increase really means ... have not. Instead it's been dithering and mumbling procrastination, and now we are told the time is right to start clamping down when ... no ... the time is wrong, it should have been done well before now, before the runaway got going. Later they will say "Well, nobody could have known" ... cr@p, plenty of people have known, if only they had listened. They wait until they know for certain the fire has taken hold, and then when they realise it has ... oh my goodness me ... we can't put it out!

I think that's a very salient point. There are people who can only see what is very much right in front of them and only when it has become crisis level.

We must be able to live with uncertainty in decision making. There is a further problem in that if you choose wisely with the uncertainty you may never know to what extent you were right because the problem has been contained. But the people charged with decision making need to have this level of vision to assess possibilities and take appropriate measures despite the problem not yet being a crisis.

 

[Barry]

But the people charged with decision making need to have this level of vision

Oh ... if only!

 

[lunarainbows]

I can’t make sense of this @Jonathan Edwards

What is Robert Peston talking about? Apparently this is why they changed strategy.





I saw something similar on C4 news but don’t really understand what they’re saying. So they modelled it wrong? Have they changed their herd immunity strategy? Nothing seems clear.

 

[BurnA]

Haha yes. It was 7 days for everyone just a few days ago. Now it’s 14 for families though. Not for individuals (7 days).

It's still 7 days, Vallance was keen to point out.
It's 7 days to account for the first infected member of a household and then 7 subsequent days to account for anyone else picking up the infection during the initial 7 days. So 14 days total for a household with an infected member.

So let's say a household member picks up the infection on day 7 from the first infected member, they will then only have to isolate for 7 days.

 

[Simbindi]

It's still 7 days, Vallance was keen to point out.
It's 7 days to account for the first infected member of a household and then 7 subsequent days to account for anyone else picking up the infection during the initial 7 days. So 14 days total for a household with an infected member.

So let's say a household member picks up the infection on day 7 from the first infected member, they will then only have to isolate for 7 days.

If they expect the public to understand this difference, they really don't grasp the diversity of the public. They need to give a single, over-cautious, time for isolation. Ask any teacher, they will know how the average parent and young person absorb instructions!

 

[lunarainbows]

It's still 7 days, Vallance was keen to point out.
It's 7 days to account for the first infected member of a household and then 7 subsequent days to account for anyone else picking up the infection during the initial 7 days. So 14 days total for a household with an infected member.

So let's say a household member picks up the infection on day 7 from the first infected member, they will then only have to isolate for 7 days.

What is this based on? If, as Sarah pointed out above, WHO advice says self isolate for 14 days AFTER symptoms have gone, then 7 days after first symptoms isn’t really enough at all.

 

[Cheshire]

French people are confined at home, can go out for food shopping or health matters only, (or for work for those whose work is necessary) for at least 2 weeks, Macron just announced.

They are making so many exceptions that it's becoming very confusing, and not a real confinement anymore... Sigh

 

[Jonathan Edwards]

"The aim now is not to slow the rate of growth of cases, but put the epidemic in reverse. Hopefully there will be tens of thousands of deaths. Maybe just a few thousand."

Not clear who Tom Whipple is quoting here but it makes sense to me.

I'd like to understand more about the possibility of terminating the epidemic at this stage - thousands infected in many countries, and many countries in the developing world without strong health systems. Is it still possible? Even if we terminate it in the UK, won't it start up again as soon as we open our borders?

The strength of health systems does not matter. The more there are that are weak the more the argument for terminating the epidemic. The problem will be human behaviour but if people are concerned enough they may manage to isolate sufficiently anywhere.

I am sure it is still possible for individual countries to terminate the epidemic. Opening borders is going to be a very long term thing. I strongly suspect that international travel is going to be off the menu for most people o the planet for about three years even if things go well.

I think this is very like the last world war. It can be won but it will take a long time.

 

[Jonathan Edwards]

I saw something similar on C4 news but don’t really understand what they’re saying. So they modelled it wrong? Have they changed their herd immunity strategy? Nothing seems clear.

It seems they are admitting they modelled it wrong. But to realise that you would break the ITU system you just need to do some trivial mental arithmetic. You do not need any professional modelling. It is no harder than working out how much rice you need if you have six people to dinner. It was so obvious it hit me that it made no sense before I even did the sums.

It looks as if they are admitting that they have absolutely no idea of reality - a bit like the Cochrane Risk of Bias Tool that allows you to fudge trials however you like.

At least now it seems that they see the mistake. Boris Johnson gave no hint as far as I could see that there was a change in strategy of this sort - just progressing as planned. He can pretend to save face if he wants. I doubt anyone cares. But hopefully the whole plan has now been turned on its head.

 

[alex3619]

I think this is very like the last world war. It can be won but it will take a long time.

I suspect this is right. The secondary consequences will also hit hard. I am concerned what effect this will have on industrial economy, and knock-on effects, and no this is not about money. I cannot discuss this concern here because its outside the issues allowed on this forum, and will invoke controversy and argument.

 

[Sasha]

At least now it seems that they see the mistake. Boris Johnson gave no hint as far as I could see that there was a change in strategy of this sort - just progressing as planned. He can pretend to save face if he wants. I doubt anyone cares. But hopefully the whole plan has now been turned on its head.

So do you think that they're now aiming to terminate the virus? The BBC health correspondent was still talking about it being to reduce the infection rate so that the NHS could cope (suggesting the previous 'flatten the curve' strategy).

They're still leaving the schools open to cross-infect all the parents so I don't have the impression that they're yet going for a 'terminate the virus' approach.

 

[lunarainbows]

It seems they are admitting they modelled it wrong. But to realise that you would break the ITU system you just need to do some trivial mental arithmetic. You do not need any professional modelling. It is no harder than working out how much rice you need if you have six people to dinner. It was so obvious it hit me that it made no sense before I even did the sums.

It looks as if they are admitting that they have absolutely no idea of reality - a bit like the Cochrane Risk of Bias Tool that allows you to fudge trials however you like.

At least now it seems that they see the mistake. Boris Johnson gave no hint as far as I could see that there was a change in strategy of this sort - just progressing as planned. He can pretend to save face if he wants. I doubt anyone cares. But hopefully the whole plan has now been turned on its head.

I’m so glad they’ve changed their tune. Although wish they had been given a much harder time by journalists. I mean it’s a huge blunder. Just before you posted, I found this:

“The UK Only Realised "In The Last Few Days" That Its Coronavirus Strategy Would "Likely Result In Hundreds of Thousands of Deaths"

https://www.buzzfeed.com/amphtml/al...-uk-strategy-deaths?__twitter_impression=true


In this scenario, the Imperial College team predicted as many as 250,000 deaths in Britain.

"In the UK, this conclusion has only been reached in the last few days," the report explained, due to new data on likely intensive care unit demand based on the experience of Italy and Britain so far.

"We were expecting herd immunity to build. We now realise it’s not possible to cope with that," professor Azra Ghani, chair of infectious diseases epidemiology at Imperial, told journalists at a briefing on Monday night.

As a result, the report — which its authors said had "informed policymaking in the UK and other countries in the last weeks" — said: "We therefore conclude that epidemic suppression is the only viable strategy at the current time."

A suppression strategy, along the lines of the approach adopted by the Chinese authorities, "aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely".

It requires "a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members", and "may need to be supplemented by school and university closures".

An "intensive intervention package" will have to be "maintained until a vaccine becomes available (potentially 18 months or more)", the report said, painting an extraordinary picture of what life could be like in the UK for the next year and a half.”

Honestly, disappointed so much in the Imperial research team. They genuinely thought the initial herd immunity policy was even feasible let alone a good policy to implement at first.