OK, question. If we take no action and cases rise to the levels of the first wave why will we not get as many deaths and hospitalisations?
I am advocating being cautious, which current policy is - the country is pretty much open.
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Covid : Infection rates v death rates and a possible second wave
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There’s many possible reasons. One being that a lot of those “vulnerable” were wiped out in the first wave and thus the second wave wouldn’t be as deadly. We also have improved treatment (dexamethasone being just one example) which will lead to a reduced death toll. It’s possible that the virus has mutated to become less deadly (there is, however, no evidence of this being the case). Cases are mostly amongst the young and healthy at the moment, who are mostly the “safest” group when it comes to this virus, but we can’t keep society shut down forever just because something might happen.
Again with the “possible reasons” etc! That’s not enough for policy making that could kill a lot of people.
Society isn’t shut down. You can go to school, work, go on holiday, go to the pub!
Wow! But we're expected to comply with nonsense like masks because they "possibly help", they also possibly make things worse!
Why navel gaze over the reasons why? The facts are plain - infections are apparently rising exponentially, here, in France, in Spain and elsewhere. In all these cases, the hospitalisations and deaths are not following the same trajectory. And it's not the lag, there's plenty of time for significant movement to have started on those measures, unless the lag period has magically multiplied since the spring.
No, you’re entirely right that “possible” reasons are not acceptable justifications for policy.
Need I remind you that the policy is the restrictions, and I simply intend to remove (not add a new) policy. So by your own argument, you’ve now admitted that you don’t believe policy should be based off of a theoretical possibility and that these restrictions are not justified.
Try telling those who are losing jobs or businesses and are on the verge of homelessness that society isn’t shut down and see what they say. Tell the millions who are worried about furlough ending and having no job to go back to that society isn’t shut down, and see if they agree.
I think you are forgetting that an out of control resurgence would be an economic disaster.
Society is largely open and keeping the economy going is clearly a priority - ie they are restricting what we do at home but keeping the pubs and holidays open.
The word definitely is useless when predicting the future, we can't even say that the sun will definitely come up tomorrow, only that it's highly likely.
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What is it we have on the other side? Possible death tolls, estimates and predictions?
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Would it? We don't blink at 50K deaths due to influneza, and the "reasonable worst case" isn't a huge amount higher, at 85K.
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Seconded. In fact if I can be brutal for a moment, I'd posit that the slightly earlier death of a hundred thousand generally frail and sick people, who require lots of ongoing medical care would actually be a boon to the economy. I mean for years we've been worrying about the rising cost of long term care.
Bletchleyite
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That's the "eugenics" argument and it's one that isn't likely to find much favour, even though personally I'd rather die quickly of a respiratory disease once I've lost my independence; I have no desire to be alive once I require care to help me complete basic bodily functions, so if I was in a home and it got me, good.
(I think you would find a lot of people in homes would say that, to be honest - they would rather see their families accepting the risk than be banned from seeing them - i.e. a shorter, higher quality life over a longer, lower quality one - I get the impression much of the "protect the old people" argument comes from people in their 20s terrified of losing their grandparents and people in their 40s-50s terrified of losing their parents)
Agreed. I think there’s far too much emphasis on keeping people alive as long as possible. These people, especially those in care homes (which, let me tell you, I would never want to end up in), often have little to no decent quality of life but are kept alive because of our societal belief that we “can’t let people die”. If I had a choice between dying quickly and painlessly 5 years earlier, or living my last 5 years in a care home, fully supervised and unable to do anything without support, I would choose the former.
I agree it's not a popular opinion.
The point remains that 85,000 deaths out of a population of 64,000,000 is never going to result in some kind of economic crash.
For my whole adult life I've said once I get to the point I can't wipe my own backside and look after myself, it's time to go. I'll happily take the barbiturates and slip off. Preferably sat outside in a wilderness with family.
Pneumonia was known as "the old man's friend".
The concern is that An unrestricted second wave would bring the economy to a halt, through a forced lockdown and/or significant absenteeism
Bletchleyite
Veteran Member
Exactly. I must admit my greatest fear is loss of independence, not death, and I do very much hope something like "living wills" is available by the time I get to the sort of age where that sort of thing becomes relevant. If it didn't, a bad flu or COVID would bring welcome relief.
To the extent that if I get a bit stuck when rock climbing or similar the thing I worry about if I fell is breaking my neck, not dying. I did actually have a bad fall from an obstacle course race thing a few years ago and that was what went through my mind then - "I'm about to end up in a wheelchair", not "I'm about to die". Fortunately I got away with it with nothing more than bad whiplash which was painful for a few months and slightly reduced neck movement afterwards.
Hmm. But if you go for a "let it rip and get herd immunity" approach you wouldn't be locking down.
Absenteeism isn't a problem when people are working from home. Factories etc might struggle for a few weeks, but 99.9% of their employees would return after a week or two with no further fear of catching it.
jumble
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Or it could be as simple as first time only people suspected of having covid were being tested and now the testing incorporates many who are healthy, and will shrug it off without ever knowing they had the disease
Perhaps liken it to a dental surgery
If you looked at the figures for when people go to the dentist for a checkup every month you would find the number of people with cavities and need treatment would be a certain proportion
If you only look at the ones who go when they are in pain the ratio of visits to treatment would obviously rise dramatically and would have no correlation with the previous analysis
I am firmly in the camp of those who believe in getting on with and enjoying whats left of my life without being in the slightest bit fearful of Covid
Last time the herd immunity/suppression policy quickly collapsed into a lockdown as the hospitals filled up......
The absenteeism could go on for months - look at the disruption shielding apparently causes the railways.
Bletchleyite
Veteran Member
Once they'd worked it out it caused unprecedentedly high punctuality and reliability. There's a lesson there. Clue to any timetable planner involved in Castlefield, the south WCML etc - plan with some leeway beyond your resources, don't plan for rest day working, don't plan for 100% staff usage when you know you're going to have N absent for various reasons, max your train lengths out, and keep diagrams (crew and unit) really, really simple. It's what happened for COVID and funnily enough it worked.
What is an "unrestricted second wave"?
Bletchleyite
Veteran Member
I guess one that does not have any suppression measures acting against it?
I think the point some people are missing is that this is only relevant to the timing of restrictions.
Unless you think far fewer people will go to hospital this time then it’s absolute numbers that matter (in terms of the NHS coping)
Are you assuming that we can let Covid rip through the rest of the population unrestricted and hospitalisations will stay below capacity this time? That is a possibility (vulnerable are already dead, more capacity, new treatments meaning shorter stays etc etc) but that would be a courageous call for the politicians who will be standing in front of the enquiry.......
Is anyone saying there should be no measures at all?
Bletchleyite
Veteran Member
Only because the ridiculous decision to turf out all of the elderly in hospital beds back to their care homes. Without testing any of them and in some cases it being known that they were infected. Hardly surprising the hospital's then filled back up with people from care homes.
As I've said, importantly you need to properly support the vulnerable for a few months. That means food deliveries, prescription deliveries, doctors doing home visits for management of chronic conditions etc.
I'd suggest we could all have been looking forward to a normal future now had the government properly prepared for and stuck with the herd immunity strategy. The government made zero preparation for it, and then made ridiculous errors when they swapped to a lockdown strategy so that we needed up with a lot of the deaths from the former but none of the benefit.
That Is a gross simplification and does a protecting the vulnerable strategy (if it is even possible) make any sense without the guarantee of a working vaccine, or are you going to lock them up until herd immunity is reached?
For me personally, I’m not in favour of “no measures”, but certainly fewer measures than there are now. Generally allowing the virus to run through the healthy population would be my favoured approach.
Yes, that would lead to increased hospital admissions and more Covid deaths. We need the government to be brave enough to admit that we need to learn to live with it rather than mindlessly suppressing it with no exit strategy.
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So what exactly are you proposing? Locking *everybody* up until we have a vaccine?
What if a vaccine isn’t as effective as hoped?
You don't lock anyone up. You ensure they have no need to go to crowded spaces for a few months. If they want to take the decision to see family and friends they can do so, personal responsibility.
It really wouldn't take very long for herd immunity to be reached. It's estimated that infections were 100,000 per day around the time of lockdown. So 3 days after that you're at 200,000 and 3 days after than 400,000 per day. Next stop 800,000 per day. The infection rate would level off at some point and then start declining, but it really wouldn't take very long to have 80% of the population done.
You say don’t suppress it and do suppress it in that first couple of paragraphs?
We suppress to protect the NHS.
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Hows that going in Brazil?
In the balance of probablities, I'd say that herd immunity is likely to beat a vaccine under such circumstances.
Agreed. My preferred approach would be to take proportionate measures to protect the elderly and vulnerable but otherwise to allow the virus to run through the healthy, younger parts of the population unmitigated as far as reasonably possible to build up some herd immunity, thus making it safer for those who have not caught it to come back out.
I would introduce a non-mandatory shielding recommendation for over 60's and those with underlying conditions, and this would be fully paid if someone had to quit work, by the government.
I would properly lock down care homes (no visitors, staff living on site for weeklong shifts etc), as the damage the virus can cause if it gets into one is very bad indeed.
I would cancel all mask mandates and enforced social distancing (and contact tracing), provided hospital capacity was sufficient as the virus works through the younger demographic.
This, in turn, would build up herd immunity in the population, and once this has been achieved, it would really depend on the % herd immunity built up in order to determine the best approach from here.
The current approach is just completely bonkers. It's over-the top, follows no clear strategy, and has no clear aim. It's a completely illogical approach which perfectly compliments this cabinet.
With an R number of 3 and an incubation time of (on average) 1 week, I imagine it would go (as a very, very rough estimate) as follows:
Week 1 (now), roughly 3,000 infections per day (21,000 infections total)
Week 2, roughly 9,000 infections per day (84,000 infections total)
Week 3, roughly 27,000 infections per day (273,000 infections total)
Week 4, roughly 81,000 infections per day (840,000 infections total)
Week 5, roughly 243,000 infections per day (2,541,000 infections total)
Week 6, roughly 729,000 infections per day (7,644,000 infections total) (10% Herd Immunity achieved)
Week 7, roughly 2,187,000 infections per day (22,953,000 infections todal) (33% herd immunity achieved)
Week 8, roughly 6,561,000 infections per day (68,880,000 infections total) (103% herd immunity achieved)
Of course, there would be mitigations put in place at any point that it looked like NHS capacity may become overwhelmed, and I'm aware that the young demographic does not represent the whole of the population (I suppose the under 60's must be the majority though). If we started allowing it to run unmitigated through the young (and basically non-vulnerable) demographic, we would have achieved herd immunity by mid-November at the absolute latest.
Of course, I'm aware that allowing 1,000,000 infections is very risk in terms of hospital capacity, which is why, if hospitalisations and deaths started to rise, I would introduce mitigations to keep the NHS at roughly 80% of capacity, to ensure nobody got denied treatment who required it.
Considering all of this, the above strategy is still likely to present at least some risk of overwhelming the NHS, so instead let's aim to keep infections around roughly 200,000 per day.
75% of the UK population is 49,000,000
It would take 5 days per million people to get infected.
This means that it would take roughly 245 days to reach herd immunity. This would look at the pandemic being completely over around May next year (however, bear in mind the amount of people that are likely already immune, it would be looking like early next year, perhaps Feb/March at the latest).
The only issue with this would be that those vulnerable would be unable to spend christmas with their families, which would have a profoundly huge effect on mental wellbeing. I can't think of an easy way around this (the only thing I would say, is that I could, with this strategy, categorically promise that the pandemic would be over by March, which may just make up for the lack of a family christmas this year). but I do not believe that continued suppression and aiming for elimination is at all sustainable.
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Yes, you take reasonable steps to isolate the vulnerable, and to avoid the NHS being overwhelmed. That was the government’s stated aim initially, but that approach now seems to have morphed into suppression to zero cases which is clearly going to be unachievable.
I’ll ask again, what is your favoured exit strategy? It sounds like you simply want to lockdown until we have a vaccine...
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