Exit strategy predictions

[chris11256]

Some of it will be informed by what works in e.g. Germany, but yes, I think it will be soon time to outline what it is, even if it isn't yet possible to say when.

Exactly. I do also think there'll have to be a subtle change of messaging as well. Currently it's essentially stay at home & live or go outside & die, if they want people to return to work that message will need to change. Wouldn't surprise me if we start to see a new slogan soon.

 

[takno]

If I've understood today's briefing correctly, Dominic Raab has said it's up to Sage to determine whether the 5 test have been met or not. The Sage meeting for lockdown review is early may, so either Friday or Monday/Tuesday next week.

Remains to be seen whether the Government will announce the plan(not dates) before the lockdown review.

Very much a blame-the-scientists plan then. I really wouldn't want to be in those folks shoes when this all blows over.

 

[Harvey B]

Some of it will be informed by what works in e.g. Germany, but yes, I think it will be soon time to outline what it is, even if it isn't yet possible to say when.

Agreed, even if it gets extended yet again (which I believe it will) the government should still reveal some sort of plan on how to come out

 

[chris11256]

Very much a blame-the-scientists plan then. I really wouldn't want to be in those folks shoes when this all blows over.

I fear the same, it would explain the constant following the science mantra. It's as if they think that epidemiology is an exact science full of certainties, it's far from it.
Wouldn't surprise me if come the inquiry all members of sage plus government advisers get thoroughly thrown under the bus.

Agreed, even if it gets extended yet again (which I believe it will) the government should still reveal some sort of plan on how to come out

It does feel like there's going to be another rollover(unless there's a sudden change of message next week). Although given how the numbers are going I think it'll be very difficult to extend it and not say anything about loosening in mid/late May.

 

[takno]

I would have thought psychology would be part of the medical brief so Whitty should take that into account, and probably is

True enough, and I meant to take it out of the list. I think I was thinking more more of the psychology of whether people will actually continue to abide by the restrictions, given that the way our lockdown operates you could have really widespread abuse of it and you'd potentially never even know. Perhaps a more general point that the opinions of the police and others about what's actually possible is an important input

 

[Enthusiast]

You know, as much as everyone thinks Sweden's strategy is insanity,...

I never did.

They seem to be falling at about 30% per week under current lockdown conditions,

If you're referring to new hospitalised cases (the only ones being reliably counted) I believe that's not correct.

The lockdown proper began on 23rd March. On that date the seven day average of new cases stood at 730. Let's begin three weeks later by which time the lockdown should have begun to do its stuff. On 13th April that number was 5,288. A week later it was 5,160 (down 2.4%). Last Monday it was 4,629 (down 10.3%). Today (admittedly only two days) that average is 4,532 (down 2.1%). In fact there hasn't been a single day during that period when the reduction of new cases from seven days earlier was anything like 30%. The best, in fact, was the 10.3% from 20th to 27th April. Other than that there have been no seven day drops in double figures.

 

[Bletchleyite]

Agreed, even if it gets extended yet again (which I believe it will) the government should still reveal some sort of plan on how to come out

I think looking at my reading of the figures one more period of three weeks should be enough to get the figure down (the "hammer") so we can then proceed with the R~=1 "dance" phase pending a vaccine.

 

[Jozhua]

It's difficult to say, but I do think in the longer term there is every chance that Sweden will indeed be better off.

The restrictions are not going to be suddenly eased that much; the aim will be to avoid the R value exceeding 1.

The restrictions may not suddenly be eased that much, but I think even the slightest easing will cause a significant amount of people to begin going back to normal. After almost two months of being stuck inside and not seeing friends, everyone is going to want to catch up on lost time and will be tired of trying to abide by strict social distancing measures.

That said, I think we should gradually move towards a more sustainable approach to dealing with COVID-19. It would be good to encourage more stores that are under the category of essential to open and perhaps let people meet friends and family within a certain distance and in groups of three or less and from no more than two different households. That could probably happen next week.

Then by mid/late may I'd look at groups of up to 4/5 from two different households and some "non-essential stores". Allow non-key workers to book travel in advance on trains/coaches, with reservations only allowing one person per two seats if travelling alone.

By planning to open up sooner rather than later, I think the government can maintain control of the situation and better implement social distancing. If strict, unsustainable policies go on too long, people will begin to ignore all advice and at that point we're screwed.

That is one of my big worries for countries like New Zealand - shutting the country down early meant they've not had any big spike now, but it means they're completely dependant on the vaccine working (or some sort of cure) as the alternative is to effectively become permanently isolated by imposing 14 day quarantines on arrivals.

I think for New Zealand, lockdown may actually be an effective strategy. The country shut down with far fewer cases and it has borders that are fairly easy to seal. The fact there were less cases when the country took up this strategy means they haven't had to wait for as long to reduce cases to a very low level.

I think that what strategies work for 2000 cases, don't necessarily work for 20,000, 200,000 or 2,000,000...

14-18 day quarantining of arrivals doesn't seem like too much of a price to pay, if within a couple of weeks life can resume completely as normal.

Very much a blame-the-scientists plan then. I really wouldn't want to be in those folks shoes when this all blows over.

I think waiting for Sage might not be the best idea. Frankly, epidemiologists can provide insights into what needs to happen (a.k.a social distancing) and provide information into potential outcomes, but the actual weighing up of how these measures should be enforced and what sacrifices need to be made is solely at the politicians door.

Also why do we have to wait until May? You'd of thought the review would be a bit more frequent, considering the likely health crisis resulting from Lockdown itself, plus my concern that if it goes on too long, people will socialise even more afterwards.

I never did.

More referring to the general public, than say the members on this thread!

 

[Domh245]

14-18 day quarantining of arrivals doesn't seem like too much of a price to pay, if within a couple of weeks life can resume completely as normal.

It's good for New Zealanders, but not for New Zealand - life isn't resuming completely as normal, certainly not within the next couple of weeks and definitely not for the people within the tourism sector or those who depend on foreign visitors coming to the country. What they have now will see them through until global virus elimination, be that through vaccine or some other means.

 

[chris11256]

Updated this evening via the Guardian. German R rate has been readjusted to 0.75. Suggestions are that Mondays reports of 1 were a blip. Very good for those advocating Germany as an excuse for not adjusting lockdown.

Philip Oltermann on Twitter

“Important update: in today's report Germany's Robert Koch Institute estimates the reproduction number to be back down at 0.75, i.e. spread of virus still slightly slowing down. Would suggest Monday's number approaching 1 may have been a blip. https://t.co/DbnirDJmWW”

twitter.com

 

[yorksrob]

Updated this evening via the Guardian. German R rate has been readjusted to 0.75. Suggestions are that Mondays reports of 1 were a blip. Very good for those advocating Germany as an excuse for not adjusting lockdown.

Philip Oltermann on Twitter

“Important update: in today's report Germany's Robert Koch Institute estimates the reproduction number to be back down at 0.75, i.e. spread of virus still slightly slowing down. Would suggest Monday's number approaching 1 may have been a blip. https://t.co/DbnirDJmWW”

twitter.com

Given that Germany has just begun easing lockdown, I'd say that's very good news for everyone.

 

[111-111-1]

Given that Germany has just begun easing lockdown, I'd say that's very good news for everyone.

As the easing only started a week ago any real effect will not have yet been seen.

 

[chris11256]

As the easing only started a week ago any real effect will not have yet been seen.

You're right, it just felt like a large part of the British media & politicians were jumping on it and making it to be more than it was.

 

[yorksrob]

As the easing only started a week ago any real effect will not have yet been seen.

It would have been pretty bad news if it had started going up.

 

[Enthusiast]

I have to chuckle when I read about the "R" rate. To know how many people, on average, each person with the virus is infecting you have to know how many are infected. I don't know about other countries but here in the UK nobody has a clue.

 

[yorkie]

I have to chuckle when I read about the "R" rate. To know how many people, on average, each person with the virus is infecting you have to know how many are infected. I don't know about other countries but here in the UK nobody has a clue.

I'm sure they have a rough idea, but increased testing will give a lot more information

 

[edwin_m]

If you're referring to new hospitalised cases (the only ones being reliably counted) I believe that's not correct.

The lockdown proper began on 23rd March. On that date the seven day average of new cases stood at 730. Let's begin three weeks later by which time the lockdown should have begun to do its stuff. On 13th April that number was 5,288. A week later it was 5,160 (down 2.4%). Last Monday it was 4,629 (down 10.3%). Today (admittedly only two days) that average is 4,532 (down 2.1%). In fact there hasn't been a single day during that period when the reduction of new cases from seven days earlier was anything like 30%. The best, in fact, was the 10.3% from 20th to 27th April. Other than that there have been no seven day drops in double figures.

I was looking more at the death rates, but the hospitalization rates are probably a better figure considering that hospital beds are probably the critical resource to be managed. Best of all would be total in hospital, which seems to have gone down by 25% in two weeks or about 14% per week. This suggests a shorter average stay in hospital and the falling death rate suggests treatment is becoming more effective.

I have to chuckle when I read about the "R" rate. To know how many people, on average, each person with the virus is infecting you have to know how many are infected. I don't know about other countries but here in the UK nobody has a clue.

However it's likely that the hospital admission rates you quoted earlier will approximately track total infections, although the constant of proportionality won't be known until there are some results from antibody testing of a random sample.

 

[HH]

You know, as much as everyone thinks Sweden's strategy is insanity, it's actually appearing more and more sensible by the day.

And yet yesterday Sweden had over 100 deaths, while neighbouring (and similar in every way apart from covid-19 strategy) Norway had just 6. It appears that Sweden is relying on herd immunity, despite the scientific evidence that immunity from having the disease is both weak and short-lived.

It's a brave decision to go against what everyone else is doing, but if it weren't for the fact that the majority of the population is voluntarily "locking down" then things might have been very ugly indeed by now. Only time will tell if that has been enough.

The lockdown proper began on 23rd March. On that date the seven day average of new cases stood at 730. Let's begin three weeks later by which time the lockdown should have begun to do its stuff. On 13th April that number was 5,288. A week later it was 5,160 (down 2.4%). Last Monday it was 4,629 (down 10.3%). Today (admittedly only two days) that average is 4,532 (down 2.1%). In fact there hasn't been a single day during that period when the reduction of new cases from seven days earlier was anything like 30%. The best, in fact, was the 10.3% from 20th to 27th April. Other than that there have been no seven day drops in double figures.

This appears to ignore the fact that they are carrying out a lot more tests now, so you would expect to see an increase in cases detected.

Not a prediction, but what I think the governemnet should do as it's first easing, is to allow more businesses to trade. It's already happening, with both large businesses (Maccy D's, B&Q, etc) and small (the increase in car journeys was today described as work related). By making official that what is happening anyway, they avoid some difficult issues and get a chance to see what the effect is on R. Plus it's also the biggest benefit to the economy.

If more people can start working again it may help in a number of other areas (such as domestic violence) as well.

 

[Bletchleyite]

Not a prediction, but what I think the governemnet should do as it's first easing, is to allow more businesses to trade. It's already happening, with both large businesses (Maccy D's, B&Q, etc) and small (the increase in car journeys was today described as work related). By making official that what is happening anyway, they avoid some difficult issues and get a chance to see what the effect is on R. Plus it's also the biggest benefit to the economy.

If more people can start working again it may help in a number of other areas (such as domestic violence) as well.

This was an opportunity for them really - let people "creep" out of lockdown themselves, if it goes well they take the credit, if it goes badly they lock down tighter and blame us.

 

[Yew]

This was an opportunity for them really - let people "creep" out of lockdown themselves, if it goes well they take the credit, if it goes badly they lock down tighter and blame us.

You should go into politics!


As an aside, it's interesting to note that in a a few weeks, the results around Gilead Sciences Remdesivir. The aility to treat the most at-risk would have a strong positive effect on the condition's we're all under

 

[HH]

This was an opportunity for them really - let people "creep" out of lockdown themselves, if it goes well they take the credit, if it goes badly they lock down tighter and blame us.

Worthy of Sir Humphrey himself!

You could well be right, seeing as that they keep mentioning the increase in car use, but doing nothing about it. From my observation there's been a particular jump in van use and just round our area, four sets of scaffolding have sprung up in the last few days (including one in use that was an accident waiting to happen).

 

[Domh245]

despite the scientific evidence that immunity from having the disease is both weak and short-lived.

Is there? The only things I've seen has been the WHO cautioning that we can't assume any immunity as no studies have been done

Not a prediction, but what I think the governemnet should do as it's first easing, is to allow more businesses to trade. It's already happening, with both large businesses (Maccy D's, B&Q, etc) and small (the increase in car journeys was today described as work related). By making official that what is happening anyway, they avoid some difficult issues and get a chance to see what the effect is on R. Plus it's also the biggest benefit to the economy.

The government only forced a selection of businesses to close, primarily because they were places where you get large gatherings of people. Every other business, was actively encouraged to remain open - working from home where possible but fully permissible to go into work where WFH wasn't possible. They should by all means remind businesses that they are allowed to stay open unless they're on that list, but I don't think there's many categories on that list which should be opened up until we're further down the line - potentially allowing some more 'non-essential' retail and other businesses where they can demonstrate suitable social distancing measures are in place (eg Libraries)

 

[Bletchleyite]

You should go into politics!

As an aside, it's interesting to note that in a a few weeks, the results around Gilead Sciences Remdesivir. The aility to treat the most at-risk would have a strong positive effect on the condition's we're all under

Yes, a treatment using an existing drug which is already authorised for use ("off label" use, for which there are many - Viagra is possibly one of the more famous ones, its current main use was an off-label one to start with!) is the "holy grail" - this looks positive. If we can stop it killing people, or at least bring the number it kills down to the same magnitude as a bad winter flu, we can bin all the social distancing stuff off entirely. Even if it's not quite that good, a treatment has the potential to allow much more reopening much quicker than a vaccine.

 

[yorkie]

Is there? The only things I've seen has been the WHO cautioning that we can't assume any immunity as no studies have been done

Nope, you're quite right.

 

[chris11256]

Reports from various papers that it’s highly likely there will be no changes to lockdown restrictions at all, so another 3 week rollover with no discussion of what comes next.

Depending on the paper, the reports of the r rate in Germany going up has apparently ‘spooked’ the Government into not easing anything for a while. This is despite the R rate having since been readjusted back down again.

 

[baz962]

But the more important question I would ask if I lived north of the border is "Where is the First Minister getting her hair done?" She's either getting it done by somebody (and I don't think her husband is a hairdresser) or it doesn't grow.

Come now . Remember it's one rule for us and a different one for others. Remember the second home debacle. Boris popped to chequers too , after his hospital visit.

 

[CaptainHaddock]

Reports from various papers that it’s highly likely there will be no changes to lockdown restrictions at all, so another 3 week rollover with no discussion of what comes next.

Depending on the paper, the reports of the r rate in Germany going up has apparently ‘spooked’ the Government into not easing anything for a while. This is despite the R rate having since been readjusted back down again.

Extending the lockdown beyond 7 May would be both political and economical suicide. If the government neither ease some of the restrictions nor give any indication of when they will be relaxed, people will just refuse to obey them.

 

[HH]

Is there? The only things I've seen has been the WHO cautioning that we can't assume any immunity as no studies have been done

You're right that it's too early to be definitive, but there are scientific opinions, e.g. in here and I saw an interview with the woman leading the Oxford vaccine development team who stated categorically that a vaccine would give much stronger immunity than actually having the virus.

Further, one 2007 report on SARS demonstrated that its antibodies dissipated after an average of two years, making patients potentially vulnerable to reinfection. A study of MERS found antibodies tended to stick around for a bit longer, but not in everyone.

Based on all of this I'll change what I said to "immunity from having the disease is likely to be both fairly weak and relatively short-lived".

 

[Enthusiast]

This appears to ignore the fact that they are carrying out a lot more tests now, so you would expect to see an increase in cases detected.

I don't think it does. People go into hospital because they are ill, not because they have been tested and detected with the virus. The number of hospitalisations should not be affected by how many people are tested.

 

[HH]

I don't think it does. People go into hospital because they are ill, not because they have been tested and detected with the virus. The number of hospitalisations should not be affected by how many people are tested.

Except that you were talking about new cases, not hospitalisations...