Coronavirus - worldwide spread and control

[Snow Leopard]

What I replied here may be the answere to this question:
It doesn´t account for many unknowns. I guess it is not known why common colds do not infect the whole population. It comes and goes, changes and reappears. (For R0 in common colds: wiki/Basic_reproduction_number, 2-3)

They do infect most of the population, it just takes more time than you think. As I keep saying, it can take many years before "herd immunity" is achieved.

A German newspaper titled a quote from a doctor: We rescue people who are about to die anyway in the next half year.

You are also rescuing the young who are not yet diseased with post-viral complications!!!!!

 

[BurnA]

It is perhaps surprising but it is worth considering what it takes to recognise a new illness.

The suggestion is that there were 1200 Lombardy cases at the point the penny dropped. Of those maybe 200 might have presented to hospital. With a certain amount of movement let us guess that most cases went to four hospitals. Very likely they would have a rota with a physician doing one day on duty each week. That means that by this time the average emergency physician might have seen 7 cases. The majority of these would have looked like bad cases of respiratory viral infection. Maybe three or four might look obviously different.

That's plausible but I would say this.

The first case identified in Italy was in Rome on 31st Jan. By then even a single case in Lombardy that resembled respiratory infection should have rang some alarm bells.
It wasn't until 21st Feb that 16 cases in Lombardy were confirmed.

I have read here and other places about a strong link between China and Northern Italy due to the textile industry. I don't know how true that is but if true, I assume anyone living in Lombardy is very aware of that link, so any doctor who sees a case of respiratory illness after the Wuhan outbreak would be on high alert.
I remain skeptical.

 

[JaneL]

This section on the claims about 'Behavioural Fatigue' could be of interest to people here:

I'm somewhat suspicious of some of the framing there, but it's interesting to see who is trying to present what story.

I wonder if the idea of behavioural fatigue came from this paper (co-authored by Wesseley and on SAGE’s evidence list):

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Frustration and boredom

Confinement, loss of usual routine, and reduced social and physical contact with others were frequently shown to cause boredom, frustration, and a sense of isolation from the rest of the world, which was distressing to participants. 10, 11, 13, 14, 15, 16, 25, 26, 31 This frustration was exacerbated by not being able to take part in usual day-to-day activities, such as shopping for basic necessities 16 or taking part in social networking activities via the telephone or internet.17

They also advised against having “an overly precautious approach” to quarantine/lockdown (“keep it as short as possible”). And they suggested that a long Wuhan-style lockdown “might be more detrimental than strictly applied quarantine procedures limited to the period of incubation”

What can be done to mitigate the consequences of quarantine?

Keep it as short as possible

Longer quarantine is associated with poorer psychological outcomes, perhaps unsurprisingly, as it stands to reason that the stressors reported by participants could have more of an effect the longer they were experienced for. Restricting the length of quarantine to what is scientifically reasonable given the known duration of incubation periods, and not adopting an overly precautionary approach to this, would minimise the effect on people. Evidence from elsewhere also emphasises the importance of authorities adhering to their own recommended length of quarantine, and not extending it. For people already in quarantine, an extension, no matter how small, is likely to exacerbate any sense of frustration or demoralisation. 40 Imposing a cordon indefinitely on whole cities with no clear time limit (such as has been seen in Wuhan, China) might be more detrimental than strictly applied quarantine procedures limited to the period of incubation.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext

 

[AliceLily]

It's been interesting to learn over the last couple days how our health ministry here in NZ had strongly advised the government at the beginning to close our border until measures were in place. Excellent advice was given from our health ministry but it wasn't taken.

Those measures would have been setting in place appropriate quarantine conditions.

The appropriate quarantine measures weren't implemented until a couple of weeks into Alert 4 lockdown.

 

[Esther12]

https://www.scmp.com/news/china/soc...ange-pneumonia-seen-lombardy-november-leading

https://www.scmp.com/news/china/sci...r-repeats-warning-coronavirus-may-have-spread

I wasn't sure if the South China Morning Post was likely to be a useful source, and then googling the doctors name led to complaints that the Chines government had been twisting his words. I've not looked into the details of this, but thought I'd add a warning to anyone reading those articles

I wonder if the idea of behavioural fatigue came from this paper (co-authored by Wesseley and on SAGE’s evidence list):

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

They also advised against having “an overly precautious approach” to quarantine/lockdown (“keep it as short as possible”). And they suggested that a long Wuhan-style lockdown “might be more detrimental than strictly applied quarantine procedures limited to the period of incubation”

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext

Could be. There's not much of substance there to justify delaying social distancing measures, but what little substance there is around the government's concerns about 'behavioural fatigue' seems to relate to Wessely's work - or maybe it was just utterly empty speculation from Whitty? What sort of evidence would be needed to justify not even considering an extended period of substantial social distancing - maybe just a few people's hunches?

I just saw Wessely is one of the contributing editors of this site: https://coronavirusexplained.ukri.org/about/

Most of the others seem to be amongst the government's Covid-19 'top advisors'.

 

[Esther12]

Just saw that Wessely's 2014 CV says:

EXPERIENCE IN WORKING WITH UK GOVERNMENT
I am or have been a member of the following committees...

2009- Scientific Advisory Group (SAGE): Cabinet Office,
restricted

https://nanopdf.com/download/professor-2_pdf

 

[spinoza577]

But now it’s clear that many more people are dying there than in other neighbouring countries, ...

No, this is not already clear.

Clear may be that many more have just now died, but to look at only one or two months doesn´t give any clue, as they may have died anyway in the next half year or so (and listening to forensics, this is not unlikely).


When lifting the lockdown, other countries (especially when having no excess deaths for now) may experience more deaths as well.

But maybe you want to stay in lockdown for the rest of the year and longer (this will have huge side effects), or want to eradicate the virus (this will not succeed).


The Swedish will have far less side effects from measures (it´s not that they havn´t implemented measures). It will be interesting to see what other health issues will become elevated, for different reasons.

I wonder if the idea of behavioural fatigue came from this paper (co-authored by Wesseley and on SAGE’s evidence list):

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

What I have a problem with, is that there will be data that can support their skewed interpretation.

 

[spinoza577]

You are also rescuing the young who are not yet diseased with post-viral complications!!!!!

I am sorry for myself here, but the prevalence is low.

They do infect most of the population, it just takes more time than you think. As I keep saying, it can take many years before "herd immunity" is achieved.

I will keep an eye on this issue. Thanks for your input.

 

[Esther12]

Was just looking at the NIHR Health Protection Research Unit in Emergency Preparedness and Response website: http://epr.hpru.nihr.ac.uk/

Wessely is the unit director.

Fiona Fox from the SMC is on their 'independent' advisory group:

http://epr.hpru.nihr.ac.uk/sites/default/files/advisory_group/Biographies for advisory group members.doc

Wessely's current bio in that document says "He has served on numerous governmental committees in these areas and continues to serve on the Defence Scientific Advisory Council (MOD), SAGE and the Behavioural Science Advisory Group for the Cabinet Office."

I don't know that the "Behavioural Science Advisory Group for the Cabinet Office" is. Googling turned up this in an article on 'behavioural fatigue', but I don't think Wessely is directly connected to BIT:

Behavioural science came into prominence in the UK during the 2010-2015 Conservative-Liberal Democrat coalition government, which set up its own behavioural science advisory group called the Behavioural Insights Team (BIT) – sometimes known as the the Nudge Unit.

https://theconversation.com/coronavirus-how-the-uk-government-is-using-behavioural-science-134097

 

[Art Vandelay]

After hearing my London niece’s experience of the British National Health Service, I’d like to highlight how exceptional our state and federal health systems are. Aged 37 with no known underlying health issues, her doctor called an ambulance when she developed severe breathing difficulties in her second week of illness.

After hospital tests to check her heart and lungs (thankfully all clear), she was sent home. She had no test for COVID-19 as the staff said she obviously had it. Her asymptomatic husband was not tested. He was not told to quarantine. Nor were they asked for any contacts to be traced.

https://www.theaustralian.com.au/co...t/news-story/ec3482dd38c5187c9e8a41deaa7a13a1

An excerpt from a letter in yesterday's Australian newspaper. I had heard things in the UK were bad, but this is simply mind-boggling.

 

[Sean]

But maybe you want to stay in lockdown for the rest of the year and longer (this will have huge side effects), or want to eradicate the virus (this will not succeed).

Elimination (not eradication) within geo-political regions is certainly possible.

If a government can control its country's borders, then it can eliminate the virus within those borders.

Until a vaccine is available (and there is no guarantee of that) then the longer term social and economic outcomes are going to be largely determined by success or failure at regional elimination.

The worst possible scenario is incomplete control due to emerging from lock down too early, followed by recurring waves of cases and lock down. Nothing will cause more social and economic damage than repeat failure to secure elimination.

Australia and NZ clearly have elimination within reach, if we can hold our nerve for another 2-4 weeks and not fall prey to scaremongering.

Compare and contrast our situation with that in the UK & USA, both of who failed to act early and effectively, despite having the capacity to do so.

There are some stark lessons from all this for those who choose to pay attention.

 

[Amw66]

FT has updated excess deaths info and placed it with main stats . Link below

https://www.ft.com/coronavirus-latest

 

[Cheshire]

I wonder if the idea of behavioural fatigue came from this paper (co-authored by Wesseley and on SAGE’s evidence list):

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Well, at least, it certainly applies to SW who showed very clear signs of frustration when he was asked to answer radio from home. Projection etc...

 

[Cheshire]

Hope it's true:

Tests in recovered patients found false positives, not reinfections, experts say

South Korea’s infectious disease experts said Thursday that dead virus fragments were the likely cause of over 260 people here testing positive again for the novel coronavirus days and even weeks after marking full recoveries.

Oh Myoung-don, who leads the central clinical committee for emerging disease control, said the committee members found little reason to believe that those cases could be COVID-19 reinfections or reactivations, which would have made global efforts to contain the virus much more daunting.

“The tests detected the ribonucleic acid of the dead virus,” said Oh, a Seoul National University hospital doctor, at a press conference Thursday held at the National Medical Center.

http://m.koreaherald.com/view.php?ud=20200429000724

 

[Woolie]

Thanks, @JaneL for the list of articles. This one coauthored by Wessely is sort of the COVID version of "Air travel will never catch on".

The psychological effects of quarantining a city
https://www.med.uminho.pt/pt/covid19/Sade Mental/Rubin 2020 The psychological effects of quarantining a city.pdf

Not a single piece of research is referenced. Why use references - we can surely just rely on the high esteem in which the authors are held?

According to the piece, one must avoid quarantining because it makes people nervous and trapped, and these upset feelings can causes all sorts of illnesses, you see, because the mind and the body are SO heavily intertwined.

Instead, trust people to do it themselves.

Edit: I see @JaneL has already commented on this study.

 

[lunarainbows]

as they may have died anyway in the next half year or so (and listening to forensics, this is not unlikely)..

This has already been shown to be incorrect. I wrote this post about it earlier. On average more than 10 years of life are lost for each COVID death, and much more than 10 years for some.

 

[lunarainbows]

https://www.independent.co.uk/news/...rate-uk-hospital-symptoms-study-a9491346.html

Coronavirus: Third of those hospitalised with virus in UK dying, study suggests

 

[chrisb]

Preparations may be in hand for a change of strategy. Someone I know, who is no more vulnerable today than two months ago, has just received a letter notifying of the vulnerable status and told to remain indoors for three months and, if sharing accommodation, to isolate from the other person. An announcement as to relaxation of lock down measures for the remainder cannot be far away.

 

[Cheshire]

Hope it's true:

Tests in recovered patients found false positives, not reinfections, experts say


http://m.koreaherald.com/view.php?ud=20200429000724

Antibody responses to SARS-CoV-2 in patients with COVID-19

We report acute antibody responses to SARS-CoV-2 in 285 patients with COVID-19. Within 19 days after symptom onset, 100% of patients tested positive for antiviral immunoglobulin-G (IgG). Seroconversion for IgG and IgM occurred simultaneously or sequentially. Both IgG and IgM titers plateaued within 6 days after seroconversion. Serological testing may be helpful for the diagnosis of suspected patients with negative RT–PCR results and for the identification of asymptomatic infections.

https://www.nature.com/articles/s41591-020-0897-1

 

[lunarainbows]

What I’ve been hearing recently is that you cannot compare death rates in countries like the U.K. with other countries because of how “large” the U.K. population is.

Prof Karol Sikora is an Oncologist and ex director of the WHO cancer programme. Throughout this whole crisis, he has been posting saying things were “improving”, “looking positive” and so on. Now he says this. The reason I’m posting is because I would like to discuss this here. Is it true that we cannot compare the U.K. to other countries? Because that seems to be the latest defence that I’m hearing.

Yet there’s so much that can change the number of deaths, including govt policy. Surely it’s up to the govt and policy makers to stop pockets of outbreaks where they occur and stop it from reaching other parts of the country, even if the country is larger, (as Alyson Pollock put it, Cordon Sanitaire.) Therefore surely the actual population size shouldn’t matter as much, if govt policy did enough to stop the spread.