Coronavirus - worldwide spread and control

Yes, we need to be reporting all-cause mortality figures as well.

In some countries the lockdown is likely saving lives due to lower motor vehicle collisions and less transmission of other viruses. But prolonged lockdown will cause increase in mortality due to suicide, lack of medical treatment (or medication) for other vulnerable people.

 

https://www.buzzfeed.com/alexwickham/uk-coronavirus-testing-explainer

 

Isn't the goal (and likely outcome given current infection rates) to flatten the curve until a vaccine/treatment is available? Which means heavy restrictions for a year or more.

 

So far, China seems to be successful in getting people back to work and businesses running again, without a new epidemic flareup.

Here’s a piece from the reputable Science magazine (run by the journal Science).
https://www.sciencemag.org/news/2020/03/can-china-return-normalcy-while-keeping-coronavirus-check#
Although people seem to suspect that the figures are being manipulated to some extent, it also seems that things really are going pretty well. China is being very careful about how it relaxes controls. And continues to test, trace contacts of cases and quarantine.

 

This will be key I imagine. You cannot control something if you do not know what it is doing.

 

I wonder if the behavioural scientists have been advising Michael Gove to lie:
https://twitter.com/user/status/1245046544501530624

https://twitter.com/user/status/1245046548486131714

 

One of the things that is concerning me about the non eradication policy & what seems to be going to be a continuous loosening & tightening of lockdown indefinitely... It is much worse psychologically to be messed about - now you can go out, now you cant, now you can, now you cant, now you can, now you cant. PEople will get pissed off & tell the gov to stick it... at which point I'm concerned that resentment will grow towards the vulnerable people all this inconvenience & 'hardship' is for the benefit of.

They have been so clear msg that it's for the vulnerable -over 70s & underlyings, & everyone else will be fine... that people think that's who they're doing this for.... which is fine for now, but as time goes on there will be a growing resentment towards all those (who are already considered a burden to society) who are 'making' them do it. If the message doesn't modify it will be us who get 'blamed'.

 

I hope not.
Vaccine could be years away.
People have latched on to the idea that it could be 18 months. Well, it could be 10 years too.

 

By the looks of it in about a week the peak should be reached. After that the number of sick people should begin to shrink.

 

Just watching the news about mass drive thru testing in portcabins and also walk thrus around the world.

I watched the process of collection of the swab to test and the result available in 24 hours and its seems absolutely clear that such mass production of non stop back to back tests in a small area is ripe to produce lab contamination potentially causing an uknown number of false positives.

 

The strategy you are proposing @Jonathan Edwards aligns with Anthony Costello's suggestion i.e. you can introduce measures to ease restrictions
https://twitter.com/user/status/1244641868727623683


In fact it also allows your economy to recover, so those focused on the economy should be able to support the strategy. The South Korean strategy seems to have allowed their communities to return to something relatively normal --- low number of cases (and thereby lower risk to the vulnerable), people returning to work --- OK you wear a mask but at this stage this looks like heading in the right direction

 

I agree that such a policy is going to cause major social problems, but what is the alternative?

Total lockdown of the whole world for months (which won't happen), or years of the virus simmering around the world with partial restrictions.

This is China we're talking about, there is no freedom of the press and the Chinese people are experts in skirting directives from the government when out of view. The virus is not gone.

 

Yes, this. Also the fact that we just won’t feel safe, and won’t actually be safe, out and about, but also in places like hospitals. How will they be able to ever make hospitals safe enough for people to have surgeries, resume cancer and autoimmune treatment, resume scans and screening and blood tests and appointments and so on.. when the virus is continually lurking, continually flares up, and cross infects inside the hospitals and causes surges again.. potentially causing everything to be closed down once again, like we are seeing now. People could go into hospital with something else and come out with coronavirus or die from it. Doctors will get infected.

I don’t know why this sort of thing doesn’t seem to have been taken into account in the strategy of mitigation / only suppressing to a certain level. It’s not just about reducing ICU demand, there’s all these “side effects” that come with it; if they’re not going to be focused on actually eliminating the virus.

 

Not true. Australia has tested nearly 1% of the population (slightly more per capita than South Korea)

 

Great find, Michiel.

I think the problem with a lot of the psychology on human judgement and decision-making is that Psychology loves a story. There's good ink in telling a story about how humans fail at assessing risk ("We're not as good as we think we are!"). There's not much ink in telling a story about how we actually make fairly reasonable judgements in a lot of situations. Ironically Gigerenzer was one of the guys who was trying to get the boring story told a bit more, but he seems to have got caught up in the irrationality stuff lately.

This bit really good:

OMG I just realised I knew this guy Dave Halpern - he was a student in our department when I was doing my PhD. Smart guy, he was, intense. At the time, he was doing a study of how the architecture of prisons could influence the wellbeing of prisoners. I saw him a few months after that, and he said his results had been disappointing and that he was starting to despair about whether architecture could really improve prisoner wellbeing (I kid you not!).

 

You misunderstand - my purpose was not to map the "true cases" of COVID in NZ (of course these aren't the total "true cases" in NZ). The set of reported cases is a highly selected sample, but changes in the rates of detection of those cases are information if the detection practices are reasonably well known.

 

I am pretty sure that the reality will be that Western countries will rapidly come to realise that it is simply not possible to run a hospital based health service for all the other conditions people suffer from unless the infection rate with Covid19 is way down below the 1 in 10,000 level. More than that and you have cross contamination in hospitals because they are busy complicated physical places.

If you can get levels down below 1 in 10,000 then there is no reason not to eradicate - it is the same process taken to conclusion. If we are waiting for a vaccine there will be plenty of time to eradicate. What on earth is the point of not doing so?

I think health care workers are very likely to take industrial action if they are forced to work under the current conditions again under a deliberate policy of letting the virus spread a bit more. Maybe not in the UK but very likely in Italy or Spain who will face the situation first.

 

I guess that the detection policy may be the same and well known but I would not be surprised if the proportion of infected people who make themselves known for testing changed dramatically. I think at the beginning people assumed that getting diagnosis was a good idea. I suspect a lot of people now may be frightened to go anywhere near a hospital and not ask for testing unless they are really sick.

 

This can be more prudence than fear. Hospital waiting areas are likely to be high risk in a pandemic. You want to be really sure you need help before turning up. In fact I keep seeing doctors suggesting that, suggesting instead that patients contact their regular doctor and discuss options, one of which is they might be told to go into hospital for testing ... or avoid it. A doctor can at least make an educated guess for options once they have the specifics of an individual case.