Coronavirus - worldwide spread and control

Their comment on Italy implies they completely shut down public transport, and massively mobilised government assistance and monitoring. Does anyone have more information on this?

 

The problem is we are still trying to figure this out. We have good data on death rates from those who are hospitalised, less good on the less sick.

 

The lockdown in Italy is only a partial one. In other words a portion of people continue working.

 

I agree with what you are saying, and the UK government has made this distrust even worse by their constant changing of policy on a day by day process. However, the difference between plague and this specific pandemic still needs explaining to people, so those who are willing to listen can have access to the information. They may possibly discuss this with their friends, peer group and colleagues who may be willing to listen to individuals, rather than the media or government.

There is plenty of visual and numerical evidence from countries that were/are ahead of us in the pandemic (such as China and Italy) that the high risk of getting pneumonia and dying are skewed according to age and underlying health conditions. So people who aren't in these high risk categories can look at this evidence for themselves, and see that they do not need to 'escape' to rural areas to be safe. It doesn't require experts to point out the lack of hospitals in rural areas and that a large population influx will put vulnerable rural residents at risk if people bring infection to an area.

 

As a side note: I've been trying to follow the literature on COVID-19, using Pubmed, but what a mess it is!

There were 70 news COVID-publications today, probably more if I had specified my search term more elaborative. All those editorials, letters and perspectives on this and that, none of which report any actual data, experiments or valuable hypothesis. This has little to do with science, in fact, I suspect it makes it harder to do science because researchers have to search through all these useless publications, to find the few that really matter.

It seems that all medical journals have to get on board and publish stuff on COVID-19 even though they have pretty much nothing to say. It's sometimes hard to tell the difference between a newspaper and a scientific journal.

 

I really haven't followed the lockdown bit carefully. The WHO advice is test, test, test and trace.

The Chinese Government welded the doors shut on apartment blocks. In Italy I heard one person was allowed out to do shopping; then they came home, showered washed their clothes and disinfected their food.

The Italian system sounds draconian enough!

South Korea used mass testing to get on top of the outbreak.

 

I’ve now read a few articles from the independent, guardian and TIME magazine to try to figure out what China did. They started off with less “draconian” measures but after a while made those a lot stricter too. So this is what they ended up with:

-widespread testing, isolation and contact tracing and subsequent quarantine
-public transport (one report said mostly, another said completely?) suspended
- even private cars were banned *except* those helping in fight against virus
- schools completely closed
- universities completely closed
-all shops closed except food shops and pharmacies

- no one allowed in or out of Wuhan, even in medical emergencies, it seems
- people not allowed out, except one household member every 2-3 days to collect food and medicine *only*
- some areas even barred residents from leaving, they could only order in food
- security outside apartment blocks and roads to make sure no one was wondering outside
- everyone going out had to wear a mask
- the mass surveillance and role of the Chinese govt meant this was possible. Eg a man was told to quarantine by police but then went out to buy radishes. He straightaway received a phone call from police telling him to go home.
- officials went door to door, anyone with fever ordered into fever clinics
- govt enlisted companies to create apps to give everyone a colour coded “health rating”, based on travel history + health conditions; this controls who goes where
- only people allowed into houses / tower blocks were inhabitants, officials and those caring for the inhabitants

It’s a lot, lot stricter than what’s happening in Europe. The ethical / human rights issues are another topic. But it’s easy to see how they managed to stamp out the virus. Absolutely no extra social contact. No schools. No working in offices. No public transport, no opportunities for mixing. Not even private vehicles. People absolutely had to stay at home, that’s all they could do, and all extra economic activities , eg even the things defined as “key worker” In the UK like barristers and lawyers having to go and about, they were not doing that there.

Possibly the set up of society and societal differences made this possible as well. For eg when schools closed; perhaps more children went to stay with grandparents / relatives / neighbours. As I can’t find anything about schools remaining open for key workers. By reducing cars, I wonder what happened re how disabled people got food. Perhaps neighbours bought their food for them. But maybe most importantly, They were prepared to cease all economic activities and people going out to work, for a short time.

 

The second Wessely review that was presented as important and influential by the Independent Scientific Pandemic Influenza Group on Behaviours is now available as a pre-print:

https://www.medrxiv.org/content/10.1101/2020.03.17.20037408v1.full.pdf

Once again, I don't see anything in there which would warrent the government's decision to delay social distancing.

There was this on duration:

This is asserted in the discussion, which could be seen as being against compulsory quarantine of any length:

When saying something is almost certainly not practicable, it would be nice if there was a citation of some sort.

Later in the discussion they say:

So then, you need to impose a detrimental effect? Enforce the quarantine? Which is almost certainly not practicable? Did I misunderstand something?

 

I'm wondering how this crisis could impact me/cfs research. We were benefitting from stable research in other fields, making me/cfs an attractive "new" field for researchers to enter. Will their attention be turned to viral pandemics? Will the scraps we got go elsewhere? Will research stall over the next two years? I assume the NIH inhouse study is on hiatus. When will it get back on track?

 

However, this total lock down was only happening one area of China, not the whole country. So I can see why Europe and other countries can't go as far as placing all the restrictions Wutan had. But they can obviously go much further than what is currently happening.

 

Whilst some people may be moving to areas to feel safer, other people are moving so they can have more freedom to go out because they don't consider themselves at risk, they are acting for purely selfish reasons with no regard for vulnerable people living in these rural areas. They know that rural areas cant be policed in the way urban areas can. This mass movement of people from cities to rural area is more complicated than being a 'fear response'.

 

There is, at least in some countries, a substantial percentage of the population who just don't do this, or who cherry pick the information.

The only way to stop this is legally enforced lockdown. In modern democracies this level of authoritarian control has issues. I still think it can be done, for a short term basis.

Yet they don't look at it that way. Those that do will do the right thing. Those that don't seem to not care sufficiently ... their own benefit is more important than rural people's benefits. This is a pervasive attitude, and is demonstrated from the issue that despite numerous warnings, many people still choose to go to social events until they are all closed. Here we recently had a huge crowd at Bondi beach. From things they said to reporters it looks to me as if they simply choose interpretations that most favour what they want to do. Reason and human nature are not fully compatible. A tendency to flout rules is also human nature, and for good reasons usually. We have to take that into account.

There will always be some people who will not listen until they are forced to comply anyway. This will then generate anti-establishment sentiment. In most circumstances I am in favour of reasoned anti-establishment sentiment, it encourages people to create change, but in an active pandemic its not helpful unless it is focused on improving public health measures.

 

They even used piloted drones to monitor anyone moving around.

 

Quote from a Guardian piece:

https://www.theguardian.com/world/2...oronavirus-could-overwhelm-nhs-intensive-care

This message really needs to get out to those people leaving urban cities for the rural areas of the country.

 

In Japan life continues (almost) as usual, but until now there doesn´t seem to be a greater spread, presumably through their careful acting they use to do anyway.

(I watched this at tv, and didn´t check any data.)

 

According to the Italian radio this morning, from tomorrow all non essential work will be suspended. Presumably work that doesn't involve physical contact with others will be allowed.

The fines for people that don't respect the lockdown rules and meet in groups will also be increased.

 

It is better to provide good clear explanations to the public as part of the enforcement procedures, so people understand both what is being asked of them and why. Conversing with staff and some customers in my local supermarket earlier this week, it was clear that many average, decent people are completely confused as to what is happening (not helped in the UK by conflicting and rapidly changing government advice).

Yes, some people will not be interested in the explanation and will need strict enforcement action to make them follow instructions, but certainly not everyone. Many, if not most, people like to feel they would choose to do the right thing ti protect themselves and others, given sufficient understanding and awareness to make the correct choice. They want to be decent people, but this situation is unlike anything they've ever experienced. That doesn't mean you don't strictly enforce the rules, just that you enable as many people as possible to make the correct choices autonomously by trying to help them understand the reasons.

 

Of course what you have written is true and needs to be understood by governments, my comment that people moving from urban areas to rural areas might be driven by either fear or wanting more freedom, was made in response to a specific post about people behaving like this being the natural human response to a pandemic, as historically observed in the plague (i.e. I was making the point that people are not just fleeing due to fear of infection, I didn't mean to imply these are the only two reasons people have for moving out of cities).

However, people moving to rural areas for the valid, positive and necessary reasons you cite doesn't account for the large numbers in the UK that have headed for both seaside towns and the sparsely populated Scottish Highlands.

https://www.bbc.co.uk/news/uk-england-51988877

https://www.theguardian.com/world/2...urious-at-travellers-to-highlands-and-islands