Should we allow the novel Coronavirus to spread in a controlled way in the healthy population?

[yorkie]

https://www.bbc.co.uk/news/health-52611507

...academics from Edinburgh and London universities published modelling suggesting the virus could be allowed to spread in a controlled way in the healthy population if the vulnerable were shielded.

The R could be safely left to rise towards close to two if this were to happen.

The theory being that the overwhelming majority of the risk of serious illness and death lies with older people or those with health conditions.

Prof Sir David Spiegelhalter, one of the country's leading statisticians and a government adviser, pointed out the risk to anyone under 25 was "trivial", while researchers at Stanford University have said deaths in anyone under 65 without a pre-existing illness are "remarkably uncommon".

It means the initial reaction to the statement - the government is planning to published more detailed guidance about its plans on Monday - is one of frustration, certainly in the scientific and medical community.

Prof Trish Greenhalgh, a health care expert from the University of Oxford, perhaps best sums it up.

She is worried we could now find ourselves in the "worst of both words" by both trying to move forward and kick-start the economy (by encouraging people to return to work) while maintaining the lockdown is effectively still in place.

Employers will not yet have worked out how social distancing can be incorporated into everyday life, while its not clear how the public transport system can cope with more passengers given the reduction in service that has been seen during lockdown.

Right now I think that politically, the Government cannot do this, due to too much pressure from people who want harsh/extended lockdowns.

But in time we may be forced to do this anyway, as clearly we cannot lock down forever.

At the moment no-one really knows what the best strategy should be, but see this too:

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

WHO's Nabarro: We must learn to live with Covid-19


The coronavirus is not going to go away so we must learn to live with it, the World Health Organisation's special envoy for Covid-19, David Nabarro has said.
He told Hardtalk's Stephen Sackur that it was not known how long it would take to develop a treatment or a vaccine.
"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.

Certainly if I was given a choice between leading a normal life and risking getting the virus, or going through what we are going through now and will have to go through over coming weeks and months, I would absolutely take my chances with the virus, I would not hesitate at all to make that choice and would be entirely happy to do so.

Those who need to shield are obviously in a very different position and should be shielding, but should everyone else be going through this?

Even if we find a vaccine, we need at least 40 million plus to be vaccinated to achieve herd immunity; it would give us a head-start if many of the healthy population could have been exposed to it already.

 

[bramling]

https://www.bbc.co.uk/news/health-52611507


Right now I think that politically, the Government cannot do this, due to too much pressure from people who want harsh/extended lockdowns.

But in time we may be forced to do this anyway, as clearly we cannot lock down forever.

At the moment no-one really knows what the best strategy should be, but see this too:

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

Certainly if I was given a choice between leading a normal life and risking getting the virus, or going through what we are going through now and will have to go through over coming weeks and months, I would absolutely take my chances with the virus, I would not hesitate at all to make that choice and would be entirely happy to do so.

Those who need to shield are obviously in a very different position and should be shielding, but should everyone else be going through this?

Got to say too early to say as things stand at the moment. I really don’t think we know enough. Also with the aggressive spread capabilities we’ve seen to date, would it be possible to have such a thing as “controlled” spread?

Honestly, I wouldn’t want to take the chance with family members in their 50s or 60s.

 

[43066]

I think this approach has a lot going for it. Indeed something similar to this was the government’s initial strategy, until it became politically impossible not to take more draconian steps.

There’s a good argument for young, healthy people to be able to get on with things. The death rate is vanishingly small amongst this group so it’s difficult to see how it could lead to the NHS being overwhelmed and “herd immunity” will be achieved rapidly, especially in densely populated towns and cities.

I suppose the difficulty comes where such people live in close quarters with elderly or otherwise vulnerable family members. And this is where the potential damaging increase in hospital admissions could come from, when low risk people get careless and end up spreading it to the vulnerable.

 

[GRALISTAIR]

I am a scientist and mathematician but this is not my field but I have friends who know/understand more. Even the flu vaccine people still get flue and die from it. if we do not have an economy we do not have a National health service. In my opinion isolate the very high risk and learn to live with it. Once you have a vaccine prepare the next one for the mutations that will occur. Isolation can not and must not last. The mental health toll would be horrendous and the economic toll worse. I agree with the professor

 

[yorkie]

I am a scientist and mathematician but this is not my field but I have friends who know/understand more. Even the flu vaccine people still get flue and die from it. if we do not have an economy we do not have a National health service. In my opinion isolate the very high risk and learn to live with it. Once you have a vaccine prepare the next one for the mutations that will occur. Isolation can not and must not last. The mental health toll would be horrendous and the economic toll worse. I agree with the professor

Indeed.

This is an interesting article:

Science | AAAS

www.sciencemag.org

Long lockdowns to slow a disease can also have catastrophic economic impacts that may themselves affect public health. “It’s a three-way tussle,” Leung says, “between protecting health, protecting the economy, and protecting people’s well-being and emotional health.”


The economic fallout isn’t something epidemic models address, Longini says—but that may have to change. “We should probably hook up with some economic modelers and try to factor that in,” he says.

 

[43066]

Indeed.

This is an interesting article:

Science | AAAS

www.sciencemag.org

Indeed. The final paragraph is very telling:

“The economic fallout isn’t something epidemic models address, Longini says—but that may have to change. “We should probably hook up with some economic modelers and try to factor that in,” he says.”

What a shame there’s no model that takes into account economic/long term societal damage caused by measures to restrict the progress of a disease.

There was certainly a great deal of emphasis placed on the Imperial College model. I suppose time will tell how accurate it was, although of course we’ll never know whether the Dutch/Swedish approach adopted initially might not have led to the vast number of cases feared had it been allowed to continue.

The fact the Nightingale hospitals haven’t been used certainly makes me question whether the current approach is too heavy handed.

 

[DaveTM]

No, simple maths and the experimentation we have already done suggest why allowing the virus to go through the population would be BAD. BAD to a ball park of 230,000 unnecessary deaths in the UK. Much better to go for the plan undertaken in other first world island countries like New Zealand, Cyprus, Australia, Taiwan, S Korea (practically an island), where an early hard lockdown has brought the number infected down to a level of less than a thousand; now the virus can be traced, isolated, and eradicated. These countries are already reaping the rewards by safely reopening for business (although carefully - one city in S.Korea today had to shut clubs bars and restaurants as there is a cluster of cases there).

In normal society C19 has an R0 value of about 3.5. That means that to have herd immunity, at least 2.5 people out of every 3.5 people would have to be immune leaving less than 1.0 people for each infected person to pass the virus on to. Given the current lack of vaccine, that means in our population of 65,000,000 people about 46,000,000 people would have to have had the virus in order to achieve herd immunity. Given a mortality rate of about 0.5%, that means about 232,000 people would have to die before we achieve herd immunity.

Now you might argue that we can shield the elderly and infirm until herd immunity is reached in the general public, thus reducing the 0.5% mortality. However the experimentation we have done so far shows that actually the elderly and infirm tend to associate within their own groups both domestically (such as in hospital or care homes or retirement villages etc) and socially (bridge club, WI, church, etc). Once one person brings infection to that sub-population it spreads with the usual R0 of 3.5.

And even after the unnecessary deaths the worry would go on for the vulnerable. If we reached a steady state of low but non-zero infection like we currently have with the 4 already known coronaviruses that cause some common colds, vulnerable people would still have to live with a choice of either self-imposed isolation for life, or permenently living in the knowledge that they might catch it from any social interaction...

 

[yorkie]

No, simple maths and the experimentation we have already done suggest why allowing the virus to go through the population would be BAD. BAD to a ball park of 230,000 unnecessary deaths in the UK....

Which part of their research to you disagree with?

Is the "simple maths" you refer to the modelling from Imperial College London? I think that is what you are referring to, in which case how do you explain this:

Sweden tames its ‘R number’ without lockdown

Sweden has been the world’s Covid-19 outlier, pursuing social distancing but rejecting mandatory lockdown. Schools, bars and restaurants are open – albeit with strong voluntary social distancing compliance and streets that often look almost as empty as Britain’s. Has this been enough? Sweden’s...

www.spectator.co.uk

....So Imperial College’s modelling – the same modelling used to inform the UK response – was wrong, by an order of magnitude. ....

When Imperial first made its models, everyone was guessing. We know more now. Every day, in The Spectator's Covid-19 email, we bring new studies that add more detail to our understanding of the virus. At present, Britain is considering the South Korean model: an ambitious combination of tech, surveillance, track and trace. But given that Sweden achieved what Imperial College had thought undoable, without the surveillance or the tech or the loss of liberty, its lessons are also worthy of consideration.

Much better to go for the plan undertaken in other first world island countries like New Zealand, Cyprus, Australia, Taiwan, S Korea (practically an island), where an early hard lockdown has brought the number infected down to a level of less than a thousand; now the virus can be traced, isolated, and eradicated. These countries are already reaping the rewards by safely reopening for business (although carefully - one city in S.Korea today had to shut clubs bars and restaurants as there is a cluster of cases there).

We are not capable of time travelling back to a period where this may have been possible, so we may as well not talk about hypotheticals that are no longer possible in the UK.

If we reached a steady state of low but non-zero infection like we currently have with the 4 already known coronaviruses that cause some common colds, vulnerable people would still have to live with a choice of either self-imposed isolation for life, or permenently living in the knowledge that they might catch it from any social interaction...

If? But is that actually achievable?

 

[43066]

Now you might argue that we can shield the elderly and infirm until herd immunity is reached in the general public, thus reducing the 0.5% mortality. However the experimentation we have done so far shows that actually the elderly and infirm tend to associate within their own groups both domestically (such as in hospital or care homes or retirement villages etc) and socially (bridge club, WI, church, etc). Once one person brings infection to that sub-population it spreads with the usual R0 of 3.5.

The expectation of this approach would be that elderly/vulnerable people wouldn’t be associating with their peers, or anybody at all, and certainly wouldn’t be going to bridge club etc. So in theory the virus shouldn’t be able to spread amongst them. Care homes could be properly isolated with staff living on site and nobody at all being allowed in.

It might seem unfair that some groups need to face more restriction than others, but that’s simply a reflection of the fact that the virus itself discriminates, and is vastly more dangerous for certain groups.

 

[MikeWM]

Yes. As far as I am concerned it is - always has been - by far the least worst option available.

 

[Clayton]

The expectation of this approach would be that elderly/vulnerable people wouldn’t be associating with their peers, or anybody at all, and certainly wouldn’t be going to bridge club etc. So in theory the virus shouldn’t be able to spread amongst them. Care homes could be properly isolated with staff living on site and nobody at all being allowed in.

It might seem unfair that some groups need to face more restriction than others, but that’s simply a reflection of the fact that the virus itself discriminates, and is vastly more dangerous for certain groups.

That’s not going to happen, is it? You mean you’d never see your old mum in the care home again? And she’d never have any more social activities? The herd immunity theory could lead to half a million deaths, and we don’t even know if you’re immune once you’ve had the disease. The approach is discredited and politically impossible

 

[DaveTM]

We are not capable of time travelling back to a period where this may have been possible, so we may as well not talk about hypotheticals that are no longer possible in the UK.

Time travel is definitely not possible, and there is little point in arguing about what we should have done. But we could still rapidly reduce our infection rate to effectively zero if our leaders tried. This would not save those who have already died, but it would still save many who are still to die, and (apparently more importantly to some people) it would likely bring the day of escape from lockdown forward.

With an R0 of 3.5, coincidentally the doubling time for the virus was around 3.5 days. To a simple approximation we can make a quick inversion of those figures and say that if we could reduce R0 to about 1/3.5 then the rate of infection would HALVE every 3.5 days. Imagine if we had a month of hard lockdown as has been managed successfully in several other countries with an R0 of about 0.3. A month is about 9 halving periods, so by the end of the month we would have 1/(2*2*2*2*2*2*2*2*2) = 1/512 of the infection rate we started the month with. That month would give us the breathing space to set up a test/trace/isolate system to deal with the few remaining cases and we would be able to open up the economy more or less fully.

This is a hypothetical that I wish our leaders would consider.

If? But is that actually achievable?

A steady rate of infection (which might only be chaotically steady like with flu or might be stably steady like with chickenpox) is the natural progression when an infection is allowed to run through a population. We were lucky that SARS and MERS were eradicated in the countries they first appeared in, but the other human coronaviruses show that a steady state is not just achievable but is actually likely. I certainly don't feel that it is something we want to "achieve"!

 

[43066]

That’s not going to happen, is it? You mean you’d never see your old mum in the care home again? And she’d never have any more social activities? The herd immunity theory could lead to half a million deaths, and we don’t even know if you’re immune once you’ve had the disease. The approach is discredited and politically impossible

But people in care homes are going to be off limits for the foreseeable future, whatever we do. The virus isn’t going away.

What we are discussing here is the idea that those who are low risk should be able to get back to normal life a lot more quickly. That will allow economic recovery to start and, if properly managed, shouldn’t lead to a spike in deaths.

 

[yorkie]

...But we could still rapidly reduce our infection rate to effectively zero if our leaders tried...

Really? How?

With an R0 of 3.5, coincidentally the doubling time for the virus was around 3.5 days. To a simple approximation we can make a quick inversion of those figures and say that if we could reduce R0 to about 1/3.5 then the rate of infection would HALVE every 3.5 days. Imagine if we had a month of hard lockdown as has been managed successfully in several other countries with an R0 of about 0.3. A month is about 9 halving periods, so by the end of the month we would have 1/(2*2*2*2*2*2*2*2*2) = 1/512 of the infection rate we started the month with. That month would give us the breathing space to set up a test/trace/isolate system to deal with the few remaining cases and we would be able to open up the economy more or less fully.

If what you said was true, then Germany - who have done a good job - would have eradicated, or come close to, eradicating the virus.

I don't see any evidence from your posts to suggest that David Nabarro is incorrect?

Where is your evidence that a "hard lockdown" would get the R value to 0.3? The harsher you make the lockdown, the less difference you make to the R value (but you have a disproportionately large effect on things like mental health)

But people in care homes are going to be off limits for the foreseeable future, whatever we do. The virus isn’t going away.

This is very true unfortunately; it's the other stuff that's up for debate.

 

[Qwerty133]

But people in care homes are going to be off limits for the foreseeable future, whatever we do. The virus isn’t going away.

What we are discussing here is the idea that those who are low risk should be able to get back to normal life a lot more quickly. That will allow economic recovery to start and, if properly managed, shouldn’t lead to a spike in deaths.

I don't understand the thinking around care homes. As far as I can see we may as well open them up as usual if we're not going to completely shield the residents (including by having staff shield between shifts) as without such measures it will get into nearly all care homes eventually and realistically as soon as the virus is in such an environment you're not going to stop it spreading.

 

[yorkie]

I don't understand the thinking around care homes. As far as I can see we may as well open them up as usual if we're not going to completely shield the residents (including by having staff shield between shifts) as without such measures it will get into nearly all care homes eventually and realistically as soon as the virus is in such an environment you're not going to stop it spreading.

This is a completely separate topic; feel free to create one and edit your post with a link if you like.

 

[DaveTM]

The expectation of this approach would be that elderly/vulnerable people wouldn’t be associating with their peers, or anybody at all, and certainly wouldn’t be going to bridge club etc. So in theory the virus shouldn’t be able to spread amongst them. Care homes could be properly isolated with staff living on site and nobody at all being allowed in.

It might seem unfair that some groups need to face more restriction than others, but that’s simply a reflection of the fact that the virus itself discriminates, and is vastly more dangerous for certain groups.

Staff living on site in care homes is definitely not possible. I can think of several single mothers who care for my parents and would have to choose either not to work or give up their children in some manner. Also, people who work in care seem to attract partners who also work in health or care. I can think of several who would have to leave husbands/wives working as paramedics/nurses/police/etc. The already under resourced care sector could not cope with the exodus of workers.

And even general isolation would be impossible. You can manage a reduction of exposure with protocols for Sainsburys deliveries etc, but there are too many people who have to come on site to reduce the exposure to zero. At my parents assisted living place for instance, they have had to have a plumber out a couple of times, the roof fixed, deliveries of care aids, a new washing machine looks like it is coming up, etc.

But people in care homes are going to be off limits for the foreseeable future, whatever we do. The virus isn’t going away.

New Zealand for the last week has been reporting only 2 or 3 new infections a day in a population of about 5 million. That is equivalent to about 30 new infections in our population. With that low an infection rate life can be pretty normal until a vaccine is found, including a normal life for the vulnerable. Once a vaccine is found the vulnerable can be given priority and then true herd immunity can be built up in the population at large without loss of life.

 

[itfcfan]

If the government was to take this strategy forward, they'd need to be very confident it was possible to effectively shield the vulnerable if the disease was allowed to spread through the healthy population. Regardless of the scandal with Neil Ferguson, the argument he puts forward around this (the most vulnerable are those that require the most interaction and support and no country has yet been able to effectively shield the vulnerable) is definitely worth a listen:

Prof. Neil Ferguson defends UK Coronavirus lockdown strategy (27:40 onwards covers this topic)

Interviewer: Why can't we put all our energy into doing a better job of shielding those remaining vulnerable people who haven't yet had the disease; and say to those under 40, off you go, go and get it.

Ferguson: We have modelled those scenarios... In practical terms, you would require a very high level of effective shielding for that to be a viable strategy.

The most vulnerable people are also the people who most need care and have most interaction with the healthcare system. and are least able to be truly isolated. You can have perfectly a fit and healthy 85 year-old who is very capable of ordering online - they're not the people most at risk of death. The people most at risk of death are in care homes, are more vulnerable or have other health conditions.

I've very sceptical we can get to the level of shielding which would make that a viable strategy. In theory, it might be - but until I see a country or community do a better job than we've seen so far I remain sceptical that it's achievable. If you just achieve 80% shielding in those groups, we'd still project you'd get well over 100,000 deaths later this year with that strategy.

For what it's worth. I remain optimistic that a "new normal" will emerge and that with sufficient testing and tracing we'll be able to crack down on local hotspots of virus spread as they occur. Countries like South Korea and Germany are showing the way on this. Clearly, we need to get the number of new daily cases down first to make this viable. And there will be set backs (like the recent cluster of cases in Seoul) but much more targetted measures can replace the blunt lock-down (once we have the capacity to detect where the hotspots are and effectively target them!).

 

[43066]

Staff living on site in care homes is definitely not possible. I can think of several single mothers who care for my parents and would have to choose either not to work or give up their children in some manner. Also, people who work in care seem to attract partners who also work in health or care. I can think of several who would have to leave husbands/wives working as paramedics/nurses/police/etc. The already under resourced care sector could not cope with the exodus of workers.

And even general isolation would be impossible. You can manage a reduction of exposure with protocols for Sainsburys deliveries etc, but there are too many people who have to come on site to reduce the exposure to zero. At my parents assisted living place for instance, they have had to have a plumber out a couple of times, the roof fixed, deliveries of care aids, a new washing machine looks like it is coming up, etc.

All fair points. I suppose it’s a case of acknowledging that care homes are responsible for hell of a lot of Covid deaths occur, and doing everything possible

New Zealand for the last week has been reporting only 2 or 3 new infections a day in a population of about 5 million. That is equivalent to about 30 new infections in our population. With that low an infection rate life can be pretty normal until a vaccine is found, including a normal life for the vulnerable. Once a vaccine is found the vulnerable can be given priority and then true herd immunity can be built up in the population at large without loss of life.

I suppose the question then becomes couldn’t we achieve the same objective by adopting an approach more like Sweden’s. It’s clear that the modelling used to inform the current approach was flawed.

The places that implemented a strict lockdown (China and Germany) are both having a resurgence in cases as lockdown eases.

Lockdown has a massive, massive cost (which still hasn’t been felt by many because of the government furlough scheme etc.) and it can’t go on forever. At the moment Covid deaths resemble a bad flu season, yet we would never consider strictly locking down every winter to prevent 20/30k annual flu deaths.

 

[Starmill]

The reality is that lots of people wanted the government to act fast in closing off the virus, but the government chose the herd immunity policy for political reasons rather than public health. They also bungled their modelling, which was caused by the use of input data that was for the flu, not Sars-CoV-2. They unforgivably refused to publish their model, which cost several days. The decision not to go to the current restrictions in early March at the same time as Ireland has specifically now left us in a state of infections which will be much more difficult to to live with.

All around the world, all developed countries will end up learning to live with on-off social distancing and other mitigation for as long as it takes. Because of the initial government decision, their distraction by Brexit, and marked underpreparedness we will have to wait longer and experience more and stronger social distancing. The key thing here is that the losses we're experiencing are because of the government's bad decisions, not despite them.

There will probably be a 'safe country' club too, perhaps a tiered one with the likes of New Zealand, South Korea and Greece in the top tier, Germany, Portugal and Australia in the second and the UK, US and Sweden in the bottom. Travel might be mutually permitted within these tiers preferentially. To be safer economically we need to climb up higher through these tiers, and have fewer infections. If the government announced anything like this crazy policy, we'd probably be shut in by the rest of the world.

 

[DaveTM]

If what you said was true, then Germany - who have done a good job - would have eradicated the virus.

Where is your evidence that a "hard lockdown" would get the R value to 0.3? The harsher you make the lockdown, the less difference you make to the R value (but you have a disproportionately large effect on things like mental health)

Between April 5th and May 5th Germany got its daily infection rate down from over 6000 (and that's probably an underestimate as their testing was overwhemed too at this point) to under 600. It is currently fluctuating around the 600 mark which may be largely due to unknown imported cases and the resulting internal infections until the initial imported infector is traced. A reduction by a factor of 1 in 10 over a period of 30 days gives a halving time of 30 * log(2) / log(10) which is about 9 days. They didn't get their R0 value down terribly well.

China, from Feb 10th to Mar 10th got their daily infection rates down from 2974 to 20, a factor of 150, giving a halving time of 28 * log(2) / log(150) = 3.8 days. This is particularly impressive given that at that point much less was known about the transmission of the virus.

 

[yorkie]

1) Exactly so the virus is not going to go away anytime soon.
2) I really don't think we can learn much from China! (see https://www.railforums.co.uk/threads/could-the-coronavirus-burn-out-in-the-uk.203758/#post-4549772 )

 

[Starmill]

I don't see any evidence from your posts to suggest that David Nabarro is incorrect?

Why would there be? Nabarro categorically isn't saying that there's benefit in any person being infected with the virus. Indeed, he's actually saying what I've said from the standard: treatments and eventually a vaccine are the only real ways out. He's also correctly pointing out that the countries who learn to live with it will be the ones who most succeed through it. That means social distancing, PPE and barriers, hand-washing and crucially testing and tracing.

 

[yorkie]

Why would there be? Nabarro categorically isn't saying that there's benefit in any person being infected with the virus. Indeed, he's actually saying what I've said from the standard: treatments and eventually a vaccine are the only real ways out. He's also correctly pointing out that the countries who learn to live with it will be the ones who most succeed through it. That means social distancing, PPE and barriers, hand-washing and crucially testing and tracing.

But as article says:

Our ability to trace the close contacts of infected people remains unknown

And various other articles also put doubt on this strategy:
https://theconversation.com/coronav...ny-people-have-had-it-sweden-thinks-so-136893

Protecting a population from becoming infected with aggressive containment is like protecting a forest in the path of wildfire – unless continuous fire fighting efforts are made, the forest will eventually burn. Aggressive contact tracing, testing, quarantine and lockdowns minimise contagion and have substantially reduced early fatalities from COVID-19.

But unless those who remain uninfected are protected until effective pharmacological interventions (vaccines, prophylactics and therapeutics) come online, the ultimate burden of deaths may be the same in countries who opt for lockdown as in those who adopted more liberal containment strategies.

Here is an interesting video about contact tracing in South Korea, but they acted very quickly and they gather information that I don't think would be possible in the UK:
https://www.bbc.co.uk/news/av/world-asia-52584494/coronavirus-how-south-korea-crushed-the-curve

....the country managed to avoid the peaks and fatalities seen elsewhere due to the government's implementation of an aggressive test, trace and contain policy.

Laura Bicker reports on how technology proved vital in tracing the infected....

 

[DaveTM]

Lockdown has a massive, massive cost (which still hasn’t been felt by many because of the government furlough scheme etc.) and it can’t go on forever. At the moment Covid deaths resemble a bad flu season, yet we would never consider strictly locking down every winter to prevent 20/30k annual flu deaths.

At the moment the excess death rate is like that for a very very bad flu year, and if covid goes through that large majority of the population who have not yet been infected it will be much much worse.

But we are only talking about an economic shock, not a natural disaster like an earthquake or fire. No raw materials have been wasted, no infrastructure has been ruined. When we go back to work the roads/rail/electricity/buildings/etc will all still be there. The total cost to society is only those man hours that a proportion of the population have spent at home instead of working. That cost will be unevenly distributed around society, and will eventually be to an extent evened out by inflation and by taxation. There will be suffering due to unemployment and uncertainty, even deaths. But the level of suffering and death will be nothing compared to that we would experience without lockdown.
Remember that any economic shock is temporary, death is not. If we currently have 4 businesses competing in a sector and one of them is forced to close, then after the shock the other 3 will prosper and expand to fill the hole left by the 4th. Yes, jobs will be lost, but only temporarily. But if you have 4 grandparents and one of them dies, do the other 3 expand to fill the hole? Of course not.

 

[43066]

An excellent article (excerpt below) on why the current approach is flawed.

Get back to work, is Johnson's cry. But the economic hardship isn't over | Simon Jenkins

With the stakes this high, there has to be discussion of the data that guides the prime minister’s decisions, says the Guardian columnist Simon Jenkins

www.theguardian.com

“ The message was unnervingly effective. Lockdown was honoured and Johnson’s approval soared. Thousands of people have indeed died, and drastic measures were certainly justified on account of that. But Britons are now more fearful of Covid-19 than any other people on earth. And having led his country into this state of mind, Johnson must lead it out again.

The prime minister must know that Britain cannot stay locked down until the entire nation is inoculated with an as yet unknown vaccine. At some point he must therefore communicate some sense of the relative risks experienced by different sections of the population and how they are to be handled. This will mean gambling on some as yet untested degree of “herd immunity” – the gamble vastly increased by Johnson’s inability to get his government to test.

It would surely help if at least some of the science to which he attaches so much faith were interrogated further if it is to inform policy choices. The prime minister is fixated on two statistics, the R infection rate and the declared Covid-19 death rate. Both are controversial. The data for Johnson’s R rate relies on a national figure for infections. As Cambridge’s David Speigelhalter has pointed out, there is none. British testing is so fragmentary as to be useless. Johnson might as well rely on crude hospital admissions or excess deaths above the seasonal normal. To use infections as the single metric for which to impose unprecedented hardship on those unable to return to work, or at risk of job losses, cannot be wise. It cannot be good for the nation’s health to be making its people poorer.”

 

[yorkie]

But we are only talking about an economic shock, not a natural disaster like an earthquake or fire. No raw materials have been wasted, no infrastructure has been ruined. When we go back to work the roads/rail/electricity/buildings/etc will all still be there. ..

Have you spoken to many business owners recently? I suspect not. I have. If we do not change course we do risk millions having their livelhioods taken away from them but please see the arguments made in previous threads as this is covering the same debates we've had before.

. But the level of suffering and death will be nothing compared to that we would experience without lockdown.

That's what your "simple" modellers said about Sweden. But, as stated in the article linked to above, they were very wrong. Have you actually read the article?

Remember that any economic shock is temporary, death is not. If we currently have 4 businesses competing in a sector and one of them is forced to close, then after the shock the other 3 will prosper and expand to fill the hole left by the 4th. Yes, jobs will be lost, but only temporarily. But if you have 4 grandparents and one of them dies, do the other 3 expand to fill the hole? Of course not.

This is an absurd argument.

For a more balanced, sustainable view, see:

See: https://www.bbc.co.uk/news/health-52543692

Our constant focus on the most negative impacts of the epidemic means we have "lost sight" of the fact the virus causes a mild to moderate illness for many, says Dr Amitava Banerjee, of University College London.

The expert in clinical data science believes it is important not to jump to conclusions about the deaths of younger, seemingly healthy adults. Some could have had health conditions that had not been diagnosed, he says.

But he admits there will be otherwise healthy people who have died - as happens with everything from heart attacks to flu.

In future, we need to stop looking at coronavirus through such a "narrow lens", he says. Instead we should take more account of the indirect costs, such as rising rates of domestic violence in lockdown, mental health problems and the lack of access to health care more generally.

I'm open to changing my opinion if you can explain to me why you are correct and Sir David Spiegelhalter and Dr Amitava Banerjee are wrong.

 

[43066]

At the moment the excess death rate is like that for a very very bad flu year, and if covid goes through that large majority of the population who have not yet been infected it will be much much worse.

Well we don’t really know that. It’s clear more should have been done earlier, but also increasingly looks like the government have panicked into following advice based on a model which is deeply flawed.

But we are only talking about an economic shock, not a natural disaster like an earthquake or fire. No raw materials have been wasted, no infrastructure has been ruined. When we go back to work the roads/rail/electricity/buildings/etc will all still be there. The total cost to society is only those man hours that a proportion of the population have spent at home instead of working. That cost will be unevenly distributed around society, and will eventually be to an extent evened out by inflation and by taxation. There will be suffering due to unemployment and uncertainty, even deaths. But the level of suffering and death will be nothing compared to that we would experience without lockdown.

There are plenty of studies out there showing that excess deaths during recessions can be enormous. Recessions can be as deadly as pandemics according to some sources.

Remember that any economic shock is temporary, death is not. If we currently have 4 businesses competing in a sector and one of them is forced to close, then after the shock the other 3 will prosper and expand to fill the hole left by the 4th. Yes, jobs will be lost, but only temporarily. But if you have 4 grandparents and one of them dies, do the other 3 expand to fill the hole? Of course not.

I think again we need to accept that until we have a vaccine we are sadly going to suffer deaths amongst the vulnerable. The VAST majority of whom will die shortly anyway.

It might sound callous but there comes a point where we have to weigh preventing Covid deaths against the economic damage being caused (and indeed excess deaths from other causes, which are being made WORSE by the current restrictions).

 

[Starmill]

I'm open to changing my opinion if you can explain to me why you are correct and Sir David Spiegelhalter and Dr Amitava Banerjee are wrong.

Ah, is that how it is? So you've Googled for two people whom you've never heard of before, who have Doctorate degrees, just so that you can imply that you actually agree with their expert views, rather than your just being unhappy because the so-called lockdown is such an inconvenience.

 

[37424]

I am a scientist and mathematician but this is not my field but I have friends who know/understand more. Even the flu vaccine people still get flue and die from it. if we do not have an economy we do not have a National health service. In my opinion isolate the very high risk and learn to live with it. Once you have a vaccine prepare the next one for the mutations that will occur. Isolation can not and must not last. The mental health toll would be horrendous and the economic toll worse. I agree with the professor

How do you isolate the very high risk if the virus is rampant amongst the healthy population given many of those high risk still have to go to hospital appointments, GP appointments etc and/or may be looked after by Medical people and Carers in their own home or a care home?

I think again we need to accept that until we have a vaccine we are sadly going to suffer deaths amongst the vulnerable. The VAST majority of whom will die shortly anyway.

It might sound callous but there comes a point where we have to weigh preventing Covid deaths against the economic damage being caused (and indeed excess deaths from other causes, which are being made WORSE by the current restrictions).

Well thanks for that I'm in a very high risk group but there a fair chance I will be around for many years if I avoid the virus although clearly not if your in charge.