Could the Coronavirus 'burn out' in the UK?

[AlistairCowell]

Earlier this month on Sky News website, there was an article with the headlines: 'Coronavirus is cornered and will burn out due to UK distancing measures'.

Coronavirus 'is cornered and will burn out' due to UK distancing measures, ex-WHO official says

Research suggests that each person infected with COVID-19 will infect just 0.62 other people - crucial to eradicating the virus.

news.sky.com

The UK's social distancing measures are working and mean coronavirus now "has nowhere to go and will burn out", a former World Health Organization director has said.

While estimates previously indicated each person infected with COVID-19 would infect 2.6 other people, research conducted by the London School of Hygiene and Tropical Medicine revealed that number has fallen to 0.62.

Keeping that figure below one is seen as crucial in the effort to slowly eradicate coronavirus, and Professor Karol Sikora suggested the new study showed the nationwide lockdown was on the way to halting its spread.

"Somehow, if we could test the population and find out who exactly has gone through the process of coronavirus, then you can release them into the population.

"If it's 40% or 50% - and the epedemiologists argue about that already - it may be possible to liberate social distancing [in the] first [or] second week in May.

"We'd all be delighted if that is the case. At the same time, if it's not the case and, say, only 10% of the population have been infected, we may have to wait until September, and that would create huge social problems for this country and other countries."

With Nicola Sturgeon saying yesterday "we all have to learn with the virus for sometime" until the vaccine comes out next year would mean social distancing in the long term, and a warning that there might be another lockdown once more if the virus is out of control, but that's in Scotland. What impact will bring for places like leisure centres, pubs & restaurants and preserved railways once it re-opens?

 

[Cardiff123]

Earlier this month on Sky News website, there was an article with the headlines: 'Coronavirus is cornered and will burn out due to UK distancing measures'.

With Nicola Sturgeon saying yesterday "we all have to learn with the virus for sometime" until the vaccine comes out next year would mean social distancing in the long term, and a warning that there might be another lockdown once more if the virus is out of control, but that's in Scotland. What impact will bring for places like leisure centres, pubs & restaurants and preserved railways once it re-opens?

A very similar announcement was also made by the First Minister today in Wales (but with it being Wales, it won't get any national media coverage by the London based national media) and Chris Whitty didn't mince his words on Wednesday when he said that "highly disruptive social distancing measures" will be with us for at least the rest of this year, and until we get a vaccine and/or effective drugs to treat the symptoms of the virus.
It's obvious that the leisure and hospitality industries will be the very last to re-open, and even then it'll be with strict social distancing measures and capacity limits in place.

 

[bramling]

Earlier this month on Sky News website, there was an article with the headlines: 'Coronavirus is cornered and will burn out due to UK distancing measures'.

The trouble with that line, unless I’m missing something, is that only works if the rest of the world is in the same position. It could be essentially eradicated in country A, but then brought back in by someone on a flight from country B, in the absence of closed borders, or more significantly a robust process to be followed by anyone coming in (which in the absence of testing is quarantine, and can we rely on people to do that properly?).

 

[yorkie]

Earlier this month on Sky News website, there was an article with the headlines: 'Coronavirus is cornered and will burn out due to UK distancing measures'...

But the same article speculates that it may only happen soon if around 40 to 50% of people have already been infected (ie. close to reaching herd immunity). This seems to be overly optimistic. I suppose it could be true in London, but not elsewhere.

 

[Bletchleyite]

It could, but we would need to carry on the lockdown for another couple of months to achieve it, then close our borders.

This might well be preferable to 18 months of distancing, however.

 

[BRX]

That article is nearly a month out of date. Back then there was some hope that a large proportion of the population would have had the disease without symptoms. More up to date info seems to suggest that it might only be 10 or 15% or even less.

 

[Bletchleyite]

That article is nearly a month out of date. Back then there was some hope that a large proportion of the population would have had the disease without symptoms. More up to date info seems to suggest that it might only be 10 or 15% or even less.

If we keep the R value below 1 then the virus will eventually burn out.

The question is whether we could survive, mentally and economically, waiting that long before lifting lockdown.

 

[MattA7]

Isn’t that what happened in China the virus just “disappeared” or at least far less common. yes they are still daily cases but they are apparently largely imported from other countries

I doubt we can stay in the current situation much longer it is already starting to cause problems (esp with crime/anti social behavior and mental health) Not to mention the fact we might not get a vaccine or highly effective drug as mentioned in other threads. The governments over reliance on this vaccine is concerning to say the least. Even if we did get a vaccine a significant percentage of the population may be hesitant to take it due to the fact it was rushed and therefore the safety of the vaccine dubious.

 

[yorkie]

Isn’t that what happened in China the virus just “disappeared” or at least far less common. yes they are still daily cases but they are apparently largely imported from other countries

No, it didn't just disappear. They did an incredibly strict lockdown for a very long time, forced quarantines (removing people from homes into field hospitals) and intense contact tracing.
https://www.theguardian.com/world/2...avirus-lockdown-strategy-brutal-but-effective

transport into and out of the city was closed, with no exceptions even for personal and medical emergencies.

Initially people were allowed out of their homes, but restrictions soon tightened. ...

the policy became even more aggressive, with officials going door to door for health checks, and forcing anyone ill into isolation. A disabled boy reportedly died after he was left without food, water or help when his his father and brother were quarantined.

If you want to know more about their quarantine centres, see https://edition.cnn.com/2020/02/22/asia/china-coronavirus-roundup-intl-hnk/index.html

But on Tuesday, despite having recovered from the illness and been given the all-clear, the 30-year-old lawyer said she was forced into a makeshift quarantine center at a technology park....

Their methods were effective at containing the virus (though further outbreaks could yet occur) but place zero value on the wellbeing of individuals and completely ignore factors such as mental health and physical wellbeing. There is no way that could happen here.

I doubt we can stay in the current situation much longer ...

Please other threads for a discussion on that, to avoid duplication in this thread.

 

[HH]

If we keep the R value below 1 then the virus will eventually burn out.

The question is whether we could survive, mentally and economically, waiting that long before lifting lockdown.

I'm sure that the plan is to get the number of infections to a level and then go back to containment, but now with testing & tracing. That would still require some social distancing to keep the numbers tested and traced to reasonable levels. As this drives the numbers down further, the lockdown can be gradually eased, but we still need something else (a vaccine, drugs that reliably and significantly reduce the death rate, the elusive herd immunity) to lift restrictions fully.

 

[Mag_seven]

I'm sure that the plan is to get the number of infections to a level and then go back to containment, but now with testing & tracing. That would still require some social distancing to keep the numbers tested and traced to reasonable levels. As this drives the numbers down further, the lockdown can be gradually eased, but we still need something else (a vaccine, drugs that reliably and significantly reduce the death rate, the elusive herd immunity) to lift restrictions fully.

I think that sums up the position quite nicely in that its all we can really do. We could of course had been much further down the line with that strategy had we not given up testing and tracing in the first place. When was that decision to stop doing it made, who made it and why?

 

[JonathanH]

I think that sums up the position quite nicely in that its all we can really do. We could of course had been much further down the line with that strategy had we not given up testing and tracing in the first place. When was that decision to stop doing it made, who made it and why?

The decision to stop testing and tracing happened when it became impossible to keep up with the spread of the virus on 12 March.

Prime Minister's statement on coronavirus (COVID-19): 12 March 2020

Prime Minister Boris Johnson made a statement on coronavirus.

www.gov.uk

The infrastructure to do it simply wasn't in place.

 

[Bletchleyite]

The decision to stop testing and tracing happened when it became impossible to keep up with the spread of the virus on 12 March.

Prime Minister's statement on coronavirus (COVID-19): 12 March 2020

Prime Minister Boris Johnson made a statement on coronavirus.

www.gov.uk

The infrastructure to do it simply wasn't in place.

In many ways the lockdown was "oh, ****, we need to stop this growing further while we work out what to do" - and it has achieved that.

 

[HH]

In many ways the lockdown was "oh, ****, we need to stop this growing further while we work out what to do" - and it has achieved that.

I agree with you all. Of course that begs the question of why we were so under-prepared in the first place...

 

[cactustwirly]

It could, but we would need to carry on the lockdown for another couple of months to achieve it, then close our borders.

This might well be preferable to 18 months of distancing, however.

No it's not, if we were to stay in lockdown until the virus burned out, then that could permanently cripple our economy.
It's better to have 18 months of distancing which would at least maintain some of the economy.

 

[HH]

No it's not, if we were to stay in lockdown until the virus burned out, then that could permanently cripple our economy.
It's better to have 18 months of distancing which would at least maintain some of the economy.

Do you have any evidence for this, or even a rational explanation for why it would be true?

 

[johnnychips]

Do you have any evidence for this, or even a rational explanation for why it would be true?

No of course Cactuswirly doesn’t - that his or her opinion - and I don’t think it’s fair for you to vaguely sarcastically denounce him or her. These are difficult times with conflicting informetion flying in from here there and everywhere. At least if we disagree with someone else, we could start with ‘ I can see what you’re saying but...’. There is no need to be aggressive and impolite.

 

[C J Snarzell]

The news suggest Boris Johnson is resuming his duties tomorrow (Monday 27th April).

The present situation with the death toll passing the 20,000 barrier (the actual figure is probably well into the 20s by now) the prediction for what decision BJ makes on the 7th May is not looking good. There's every chance the figure will pass 30,000 by the time the PM makes his decision.

BJ has already made it clear he is worried about a second spike with the virus if the lockdown is relaxed and the Chinese have suffered a second wave that has rocketed in the last week as a result of restrictions being lifted in certain parts of the country. This will confirm BJ's fears about the consequences of relaxing the lockdown any time soon.

It does seem likely that the present lockdown restrictions will probably continue into June, but as I have said in a previous thread - after 6 weeks many people are starting to 'buckle' under the pressure of being confined indoors. I think ultimately there will be a 'crunch' period when some element of the exit strategy has to be implemented for the sake of things like the economy, mental health, domestic violence, etc but the primary goal for the government is to save lives and in the present climate, the death rate is too high to look at relaxing the lockdown.

CJ

 

[yorkie]

I don't agree. Locking down until June won't make the virus go away. It will just cripple the economy further and cause more hardship and more deaths for other reasons. You can't sacrifice an entire generation like that.

 

[6862]

I don't agree. Locking down until June won't make the virus go away. It will just cripple the economy further and cause more hardship and more deaths for other reasons. You can't sacrifice an entire generation like that.

I agree we shouldn't sacrifice an entire generation,
but then you could also take the view that the damage is already done, which the government seem to be doing as they seem far more concerned about avoiding a 'second peak' (which won't be a peak like we have just seen, but a continuous increase in cases and deaths until a vaccine or virus burn out) than they are about long term economic damage. I imagine we'll see another 3 weeks of this after 8th May, with a vague wishy washy exit strategy (see Nicola Sturgeons 'announcement' last week). And yes it will damage the economy even more, leading to even more collateral damage. I think that for the majority, the cure will be worse than the disease.

 

[Bletchleyite]

Yes, I'd predict 3 more weeks of the present situation (possibly with higher fines to prevent "lockdown fatigue" having too much more effect) and then a start to loosen.

3 weeks is a long time in this situation - it's quite possible we will learn a lot more about the disease in that time. An interesting recent discovery is the possibility that the lung issues causing death are actually from blood clotting - more understanding of that could allow it to be prevented. This is pretty key - if we can stop it killing people, it just becomes an expensive nuisance.

 

[yorkie]

I agree we shouldn't sacrifice an entire generation,
but then you could also take the view that the damage is already done, which the government seem to be doing as they seem far more concerned about avoiding a 'second peak' (which won't be a peak like we have just seen, but a continuous increase in cases and deaths until a vaccine or virus burn out) than they are about long term economic damage. I imagine we'll see another 3 weeks of this after 8th May, with a vague wishy washy exit strategy (see Nicola Sturgeons 'announcement' last week). And yes it will damage the economy even more, leading to even more collateral damage. I think that for the majority, the cure will be worse than the disease.

Yes there is no doubt the 'cure' will be worse than the disease for most people and locking down forever isn't the answer.

Covid-19: 'We must learn to live with the virus'

The coronavirus is not going to go away, says WHO's special envoy for Covid-19 David Nabarro.

www.bbc.co.uk

"We have all got to learn to live with this virus, to do our business with this virus in our presence, to have social relations with this virus in our presence and not to be continuously having to be in lockdown because of the widespread infections that can occur," Mr Nabarro added.

 

[yorksrob]

Yes, I'd predict 3 more weeks of the present situation (possibly with higher fines to prevent "lockdown fatigue" having too much more effect) and then a start to loosen.

3 weeks is a long time in this situation - it's quite possible we will learn a lot more about the disease in that time. An interesting recent discovery is the possibility that the lung issues causing death are actually from blood clotting - more understanding of that could allow it to be prevented. This is pretty key - if we can stop it killing people, it just becomes an expensive nuisance.

Yes, this is the thing to hold on to. The possibility of discovering how to effectively treat the symptoms could be even more important than a potential vaccine in many ways.

 

[Mogster]

Yes, this is the thing to hold on to. The possibility of discovering how to effectively treat the symptoms could be even more important than a potential vaccine in many ways.

Yes I think treatment will improve, particularly for the small proportion of younger people that are very sick. ECMO where if the patients lungs are compromised you oxygenate blood outside of the body seems to have potential, I say younger people as they have a greater capacity to recover from immune lung damage than older people. ECMO requires complex equipment and trained staff though so (like most other things nowadays...) it’s not easy to scale up quickly. Its use is becoming more common in ARDS respiratory failure cases though caused by influenza like illnesses (ILIs). In the short term there’s a big push to provide immune plasma, Matt Hancock was donating yesterday.

UK approves clinical trial of plasma treatment for coronavirus patients

‘I have every hope this treatment will be a major milestone in our fight against this disease,’ says health secretary

www.independent.co.uk

A clinical trial to establish if plasma from the blood of recovered coronavirus patients could help treat others fighting the illness has been given approval.

Health secretary Matt Hancock said thousands of patients could potentially benefit from the treatment if it is deemed to work.


Alongside the trial, the government said it is ramping up the national collection of plasma so that, if the treatment is shown to be successful, it could be rolled out across the NHS.

The longer high numbers of infections continue It surely seems unlikely CoV2 will “burn out” or disappear like SARS did (we don’t understand why SARS disappeared, really we don't know that much about virus’s full stop, it seems) SARS was much more virulent and because of that people who were infected tended to be far more obvious and so were easy to remove from circulation. CoV2 also seems far more efficient at infecting human hosts than SARS. CoV2 appears to have dropped into the sweet spot of low to moderate virulence so large numbers of people will have symptoms mild enough to continue circulating in the population while spreading the virus. It does make sense that summer weather will reduce the death rate and new infections to a degree, as it does for other ILIs, but long term this increasingly looks like something we are going to have to live with.

The longer cases continue the more I can really see CoV2 becoming endemic and added to the list of other commonly circulating ILIs. We may have to get used to a higher death rate than has been common recently, we can’t stay turtled in our homes much longer.

 

[bramling]

I don't agree. Locking down until June won't make the virus go away. It will just cripple the economy further and cause more hardship and more deaths for other reasons. You can't sacrifice an entire generation like that.

The difficulty is we likewise can’t sacrifice an entire cohort of NHS staff, and a mounting death toll will cause social cohesion issues in itself - there’s already an element of disquiet for example about the way the virus seems to be disproportionately affecting certain groups.

It’s going to have to be a case of finding a *very* delicate balance between all these factors. We also as a society have to be realistic in accepting that our politicians may get this wrong, as there’s so many unknowns as well as conflicting things coming out of the scientific community.

 

[chris11256]

I think that whatever actually happens, it's not going to be as simple and clear cut a decision as it was last time. We still have just under two weeks to go, so deaths/new infections will be lower. We'll also have more data on deaths caused by the NHS essentially being closed to anything not Coronavirus based(which is certainly the situation where I am). Also they'll have the plans for workplaces safely reopening being put together by the Treasury & other departments, so it really won't be as simple as an instant decision for another 3 weeks of lockdown.

 

[AM9]

... You can't sacrifice an entire generation like that.

Which generation are you saying can't be sacrificed?

 

[6862]

The difficulty is we likewise can’t sacrifice an entire cohort of NHS staff, and a mounting death toll will cause social cohesion issues in itself - there’s already an element of disquiet for example about the way the virus seems to be disproportionately affecting certain groups.

I think its inaccurate to say we would be 'sacrificing' an entire cohort of NHS staff - currently there have been approximately 100 confirmed NHS staff deaths (approx 0.01 % of NHS staff, higher percentage if you only count front line staff, but I don't know how many of those there are). Granted that number and percentage will rise, but they will not all be sacrificed/wiped out etc. Don't get me wrong - I think the NHS is doing a tremendous job and every death is a tragedy!

 

[yorkie]

Which generation are you saying can't be sacrificed?

If things continue as they are for too long it will be a case of sacrificing the younger generation; this cannot continue and there is going to have to be a compromise sooner rather than later.

I think its inaccurate to say we would be 'sacrificing' an entire cohort of NHS staff - currently there have been approximately 100 confirmed NHS staff deaths (approx 0.01 % of NHS staff, higher percentage if you only count front line staff, but I don't know how many of those there are). Granted that number and percentage will rise, but they will not all be sacrificed/wiped out etc. Don't get me wrong - I think the NHS is doing a tremendous job and every death is a tragedy!

There are various sources about the death rates but the rates of hospitalisation and death are massively reduced in younger age groups compared to older age groups.

Covid-19: death rate is 0.66% and increases with age, study estimates

The overall death rate from covid-19 has been estimated at 0.66%, rising sharply to 7.8% in people aged over 80 and declining to 0.0016% in children aged 9 and under.1 The estimates, calculated by researchers in the UK, used aggregate data on cases and deaths in mainland China. Unlike other...

www.bmj.com

It reported that 0.04% of 10-19 year olds would probably require hospital care—as would 1.0% of people in their 20s, 3.4% of people aged 30-39, 4.3% aged 40-49, 8.2% aged 50-59, 11.8% in their 60s, 16.6% in their 70s, and 18.4% of those over 80.

 

[bramling]

If things continue as they are for too long it will be a case of sacrificing the younger generation; this cannot continue and there is going to have to be a compromise sooner rather than later.

Regardless of ethics, it simply won’t be practicable to do it, as the public finances will collapse, which will have consequences for everyone not least pensioners.

The lockdown is a tool for getting things under control (and as you know I think we should have gone a bit further so as to try and really get a grip of the situation, which thusfar hasn’t quite happened), but ultimately in the absence of a known end-point it’s not sustainable.

The furloughing scheme alone could well end up costing the equivalent of several Crossrails, to put things in perspective.