Covid : Infection rates v death rates and a possible second wave

[DB]

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?

It won't be 100% effective - nothing ever will be - but it's far more workable than what you seem to be advocating. The quicker it's allowed to spread among the general population, the quicker herd immunity would be reached.

 

[Bletchleyite]

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.

Except it doesn't. I'd actually support that if it did, but what we are doing is a halfway house which is good for nobody.

 

[Bantamzen]

I believe @Bantamzen advocates that (apologies if I've misunderstood), and a few others on here?

Then you believe incorrectly.

 

[43066]

Except it doesn't. I'd actually support that if it did, but what we are doing is a halfway house which is good for nobody.

The government isn’t aiming for zero cases? It seems to be close to it, or at least a level of cases so low that the restrictions required to maintain it will be completely unsustainable.

 

[WelshBluebird]

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.

The problem there is that you are asking those groups of people to take all of the burden for the rest of society.
Not sure that is exactly a fair way of managing such a crisis.
Also remember some of those underlying conditions are fairly widespread (e.g. diabetes). I am not sure the government could afford to fully pay everyone who falls under those categories after they have spent so much on furlough etc!

 

[43066]

The problem there is that you are asking those groups of people to take all of the burden for the rest of society.
Not sure that is exactly a fair way of managing such a crisis.

They’re the people most at risk of dying, so they are taking the burden of protecting themselves. That seems reasonable enough to me.

What’s the alternative? We all have to continue to suffer, and all end up worse off as a result?

 

[Huntergreed]

The problem there is that you are asking those groups of people to take all of the burden for the rest of society.
Not sure that is exactly a fair way of managing such a crisis.
Also remember some of those underlying conditions are fairly widespread (e.g. diabetes). I am not sure the government could afford to fully pay everyone who falls under those categories after they have spent so much on furlough etc!

That's the issue we have now, and the problem with having no workable strategy. We've wasted all that money and where has it got us? Back where we were in Feb/March, with no effective way out or strategy to cope with this. If it was me, I would have followed this strategy as soon as I realised how unlikely the young and healthy are to be seriously affected.

Frankly, if that meant the people of this country were unhappy, then I would prepare a long, very honest presentation about the realistic situation we face, and the way out of it. I'm sure a lot of the 'you're killing people' camp are like that due to a simple lack of understanding and/or appreciation for the situation we now find ourselves in, through no fault of their own (the government and 'project fear' are to blame for that)

 

[Yew]

The problem there is that you are asking those groups of people to take all of the burden for the rest of society.
Not sure that is exactly a fair way of managing such a crisis.

And asking everyone to make vast personal sacrifices, including delaying life-saving medical treatments, and deal with massive economic fallout, for the sake of the few. Is somehow fair?

 

[trebor79]

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, but I do not believe that continued suppression and aiming for elimination is at all sustainable.

Agree with all of this.

The problem there is that you are asking those groups of people to take all of the burden for the rest of society.
Not sure that is exactly a fair way of managing such a crisis.
Also remember some of those underlying conditions are fairly widespread (e.g. diabetes). I am not sure the government could afford to fully pay everyone who falls under those categories after they have spent so much on furlough etc!

How is it a burden to be asked to stay away from crowded places for a few weeks, and if that means you can't go to work we'll pay your wages?
Are all of the underlying conditions actually at greater risk? I get the impression it was a catch-all list as not much was known. I think we have far better data now and could whittle the list down a lot.
I agree we probably can't afford to do it now. But not can we afford to do what we are currently doing, which had no end point.
It's a pity so much money and public patience has been wasted to achieve essentially nothing. I knew they'd completely lost the plot when eat out to help out was born. How to waste a billion quid lesson 101.

 

[WelshBluebird]

And asking everyone to make vast personal sacrifices, including delaying life-saving medical treatments, and deal with massive economic fallout, for the sake of the few. Is somehow fair?

I am not suggesting that we should delay medical treatments and the like, and I am not suggesting we need to go into lockdown with everything being closed again.
However I do think the rest of society should make some personal sacrifices for the time being so that it all doesn't fall on just those who are particularly vulnerable, especially as many who are classed as vulnerable just aren't going to be able to shut themselves away for however long it takes. Things like wearing masks to try to reduce the spread, things like avoiding mass indoor events (which seem to be "superspreader" events) etc.

How is it a burden to be asked to stay away from crowded places for a few weeks

Claiming it will be just a few weeks is a pretty big assumption!

 

[Bletchleyite]

Then you believe incorrectly.

What measures would you put in place, then? I've generally observed you as being opposed to pretty much all of them? And by extension what is an acceptable death rate to you?

 

[43066]

I am not suggesting that we should delay medical treatments and the like, and I am not suggesting we need to go into lockdown with everything being closed again.

And yet delayed medical treatments and circa 200k excess deaths (from the first lockdown) are exactly what your favoured approach has led to far.

However I do think the rest of society should make some personal sacrifices for the time being so that it all doesn't fall on just those who are particularly vulnerable, especially as many who are classed as vulnerable just aren't going to be able to shut themselves away for however long it takes.

If people are high risk they should be asked (not forced) to shield, regardless of what the healthy population is doing. You seem to want to see everyone worse off just for the sake of it. That isn’t a solution, it’s just levelling downwards.

Do you really want the entire country to remain in the current state of paralysis until we have a vaccine?! Before long there won’t be a functioning economy (or a functioning NHS) - but I suppose you’ll be happy with that, just so long as everyone is equally badly affected?!

 

[Bletchleyite]

Do you really want the entire country to remain in the current state of paralysis until we have a vaccine?! Before long there won’t be a functioning economy (or a functioning NHS) - but I suppose you’ll be happy with that, just so long as everyone is equally badly affected?!

Is it now paralysed?

Most things are back open to a point. There are a few industries which can't reopen, however, which we do need to decide what to do with.

It might for instance be better to subsidise theatre to run at reduced capacity than to allow it to fail.

 

[43066]

Is it now paralysed?

Most things are back open to a point. There are a few industries which can't reopen, however, which we do need to decide what to do with.

It might for instance be better to subsidise theatre to run at reduced capacity than to allow it to fail.

It will be interesting to see how the next batch of economic figures look. We are still existing in the false reality of furlough, and the government is subsidising meals out, so the true economic reality is being masked.

Yes, things are back open, but how realistic is it to run a pub/restaurant/airline/cinema (and many other types of businesses) longer term, with distancing in place?

It’s also becoming clear that the current level of easing is further than we can go without causing an increase in cases that the government deems unacceptable.

 

[trebor79]

I am not suggesting that we should delay medical treatments and the like, and I am not suggesting we need to go into lockdown with everything being closed again.
However I do think the rest of society should make some personal sacrifices for the time being so that it all doesn't fall on just those who are particularly vulnerable, especially as many who are classed as vulnerable just aren't going to be able to shut themselves away for however long it takes. Things like wearing masks to try to reduce the spread, things like avoiding mass indoor events (which seem to be "superspreader" events) etc.

But "reducing the spread" doesn't help the vulnerable people - it'll get to them eventually anyway, just a bit later. When they'll be even older and more vulnerable.
Properly shielding them for a few weeks and allowing a "big bang" herd immunity would work, as they would then be at far less risk of catching it, being surrounded by a largely immune population.

Claiming it will be just a few weeks is a pretty big assumption!

Not really. The unrestrained doubling period is about 3 days.

 

[yorkie]

The problem there is that you are asking those groups of people to take all of the burden for the rest of society.
...

The burden has been on the younger, and poorer, population for too long.

Enough is enough; people who are extremely unlikely to become ill from this cannot be expected to lose their livelihoods, face a mental health crisis and generally lead miserable lives .

You offer no viable solutions.

 

[trebor79]

Yes, things are back open, but how realistic is it to run a pub/restaurant/airline/cinema (and many other types of businesses) longer term, with distancing in place?

OT but why are airlines seemingly exempt from the distancing thing? Ridiculous rules of train and bus occupancy (in some parts of the country), but fine to pack a 737 to 100% capacity?

 

[Bletchleyite]

OT but why are airlines seemingly exempt from the distancing thing? Ridiculous rules of train and bus occupancy (in some parts of the country), but fine to pack a 737 to 100% capacity?

I suspect part of it is that contact tracing is easy with an aircraft as you have an allocated seat and can be enforced to sit in it.

 

[Bantamzen]

What measures would you put in place, then? I've generally observed you as being opposed to pretty much all of them? And by extension what is an acceptable death rate to you?

My preferred measures are as they were at the start, identify those most at risk, concentrate mitigation towards them whilst asking the general public to observe good levels of hygiene, explaining why they are so important in minimising the spread. And I would not have a target for deaths, you concentrate on what is happening on the ground.

 

[43066]

OT but why are airlines seemingly exempt from the distancing thing? Ridiculous rules of train and bus occupancy (in some parts of the country), but fine to pack a 737 to 100% capacity?

I suspect part of it is that contact tracing is easy with an aircraft as you have an allocated seat and can be enforced to sit in it.

Presumably also because it would immediately become completely unviable to operate an airline with 50% (or less) occupancy, in a way that isn’t the case for bus or train companies.

 

[Bletchleyite]

Presumably also because it would immediately become completely unviable to operate an airline with 50% (or less) occupancy, in a way that isn’t the case for bus or train companies.

Indeed, trains and buses typically operate off-peak at lower loadings, it's unusual not to have a pair of seats to one person on most off-peak train services even normally.

 

[DB]

But "reducing the spread" doesn't help the vulnerable people - it'll get to them eventually anyway, just a bit later. When they'll be even older and more vulnerable.
Properly shielding them for a few weeks and allowing a "big bang" herd immunity would work, as they would then be at far less risk of catching it, being surrounded by a largely immune population.

Not really. The unrestrained doubling period is about 3 days.

That's all true, plus some of the things which WelshBluebird is suggesting - such as wearing masks to reduce the spread - are not in any way proven to actually do what is claimed. We have seen no evidence of them making a difference since they were mandated in this country, and the same appears true of every other country which has mandated them.

I really don't understand the logic of what WelshBird (and the many others with this view) are actually hoping to achieve - the current list of damaging ineffectual measures are probably slowing the spread down a bit, but will take much longer to reach herd immunity, and those genuinely at risk remain at risk. Letting it run through the population while providing ways for those genuinely at risk to stay at home would overall give a better outcome for everyone.

 

[Howardh]

OT but why are airlines seemingly exempt from the distancing thing? Ridiculous rules of train and bus occupancy (in some parts of the country), but fine to pack a 737 to 100% capacity?

Don't aircraft have excellent air filters which can prevent covid being passed through the plane? I'd be interested to learn how many pilots and cabin crew have been infected.

 

[Bantamzen]

Don't aircraft have excellent air filters which can prevent covid being passed through the plane? I'd be interested to learn how many pilots and cabin crew have been infected.

They do, as well as mixing in compressed fresh air meaning that on a modern passenger aircraft the air can be completely replaced every 2-3 minutes.

 

[Meerkat]

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...

if the alleged aim is zero cases why are pubs open etc etc?

Properly shielding them for a few weeks and allowing a "big bang" herd immunity would work, as they would then be at far less risk of catching it, being surrounded by a largely immune population.

Herd immunity will take more than a few weeks. Have you heard proof that post-recovery immunity is strong and lasting by the way?
As for the idea that you aim for 80% NHS capacity - how do people propose pulling back from the huge spread that would be ongoing by that point. I thought you were against lockdowns?

 

[trebor79]

Herd immunity will take more than a few weeks. Have you heard proof that post-recovery immunity is strong and lasting by the way?
As for the idea that you aim for 80% NHS capacity - how do people propose pulling back from the huge spread that would be ongoing by that point. I thought you were against lockdowns?

I don't think I've said anything about aiming for 80% capacity. I don't think it can be managed in that way, for the reason you outline.
I am against lockdowns, they do not solve the problem, merely delay it.

It's reasonable to assume post recovery immunity is present. The virus isn't mutating very quickly. If there's no immunity then all the vaccine work is for naught. If there's no immunity then the only course of action left is to allow it to do it's things. Those who react poorly and die will die and for everyone else it's either a non event or just another illness they get from time to time like a cold.

I'd lay money on betting that we aren't going to see a huge rise in death an hospitalisations as a result of this recent rise in "cases". Let's park it and come back in 2 weeks?

 

[43066]

if the alleged aim is zero cases why are pubs open etc etc?

They were closed for weeks on end, along with virtually every aspect of the economy, in a ruinous effort to get the virus figures down to the lowest levels possible. To what end? We have had threats to close them down again, and lockdown again, as soon as cases began to rise, as they inevitably did when we started to reopen.

I’ll ask you again, what is your suggested way out of this (other than trashing the economy in order to postpone the inevitable)?

If there's no immunity then all the vaccine work is for naught. If there's no immunity then the only course of action left is to allow it to do it's things. Those who react poorly and die will die and for everyone else it's either a non event or just another illness they get from time to time like a cold.

Indeed, and if that worst case scenario turns out to be the case, a more honest approach would be for the government to manage expectations: there will be many more cases and deaths, hospital and mortuary capacity will need to be increased accordingly.

 

[yorksrob]

Pubs have been open for months now and they haven't been at the route of many clusters, and there's nothing to suggest that they're at the root of the current rise.

 

[Bletchleyite]

Pubs have been open for months now and they haven't been at the route of many clusters, and there's nothing to suggest that they're at the root of the current rise.

It's house parties and family gatherings that are being mostly implicated.

 

[NorthOxonian]

Pubs have been open for months now and they haven't been at the route of many clusters, and there's nothing to suggest that they're at the root of the current rise.

There are certainly cases where they seem to be responsible for a few clusters - there have been a number of such incidents in the North East. That said, they won't be the only cause of the current rise, and the vast majority of pubs aren't seeing outbreaks.