Further Restrictions Announced by Johnson (22/09)

[Bantamzen]

There are dangers when comparing countries

Sweden has

• a very low population density
• a low number of people per household (most cases are transmitted within households, in the UK it was ~60% in household till early September)
• a personal space culture (i.e. natural 1m social distancing pre Covid)
• a very low proportion of multigenerational (i.e. 3 or more generations) households

Just because something appears to work in one country doesn't mean it is easily transferable with similar results to other countries with different circumstances.

Is it Groundhog Day already? Gee, the year's flown by....

How many times has this "Sweden not like us" be debated and shown not necessarily to be true?

 

[Yew]

Prof Gupta is seen as some what of an outlier in their own department and with in the epidemiological community. Gupta was one of the authors of a modelling paper earlier this year that suggested circa 50% of the UK population had already had Covid in March, that it would be over in 2-3 months and therefore there was no reason for a lockdown.

Perhaps it could have, but since we locked down and called a stop to it, we'll never know; therefore it's pointless to try and use it as an argument against such assertions.

 

[hwl]

So how do you think it' not going to get to those people whatever happens? We seem to be back to the policy of trashing the economy and causing many other massive social issues based solely on the hope that a vaccine proves viable.

The German work concluded it was going to get to them what ever happened, the important question was what degree of control you still had at that point (or not).

The key thing is being able to control the rate it spreads to ensure that healthcare isn't overwhelmed (till we get a vaccine or not)

Studies in many countries (the UK isn't good at this kind of analysis because we don't collect the data properly with our Track and Trace, we only trace forwards (who else might have been infected) not backwards (who the individual got it from) in the community (forwards and backwards does happen for UK hospital transmission analysis) where they do forward and backward tracing suggest that ~70% of infected individuals don't pass it on to anyone else, ~10% pass it on to just 1 person with ~20% of people passing it on to between 2 and 50 people. It is that last category that every country needs to worry about as regards spread (both R and k), especially the super spreaders at the top end of that category.

The UK is finally beginning to wake up to the need to control high spread opportunities (both people and locations as seen with the screen grab leaks yesterday suggesting 40% of out of home transmission is in the hospitality sector), which means the most effective control mechanism available is closing hospitality as it happening both here and in France, Belgium etc.
Hospitality is a comparatively small part of the overall economy. Plenty of the economy can get on provided we remove the higher risk spreading opportunities i.e. we target based on evidence / risk modelling.

e.g. (UK analysis) Having been on an international flight in the preceding weeks results in a 4 fold greater chance of having a positive covid PCR test than if you haven't

 

[trebor79]

The German analysis is pretty sound, it showed that the virus would get to those isolating over time anyway (they have plenty of real case studies for how this happens already) and the higher the level in the general non isolating population is then the big driver for severe cases among those isolating. Then there are all the severe cases in those that aren't self isolating because isolating won't capture all the high risk individuals.
The Barrington declaration authors haven't actually done any detailed work on their own proposals and how well they would work it is a very big PR exercise.

But how is it not going to get to those people eventually anyway? We aren't doing anything in particular to stop it happening.
So much the same result, but we also have a tanked economy and all the problems that brings with it.

There are dangers when comparing countries

Sweden has

• a very low population density
• a low number of people per household (most cases are transmitted within households, in the UK it was ~60% in household till early September)
• a personal space culture (i.e. natural 1m social distancing pre Covid)
• a very low proportion of multigenerational (i.e. 3 or more generations) households

Just because something appears to work in one country doesn't mean it is easily transferable with similar results to other countries with different circumstances.

Please read this article, which explains why these arguments are facile:

The thing about Sweden and coronavirus

Christopher Snowdon blogging about the nanny state, smoking, drinking, vaping, gambling and food policy. Established 2009.

velvetgloveironfist.blogspot.com

To quote the section dealing with population density:

The most stupid of the excuses is Sweden's low population density of 59 people per square mile. Forgive me for insulting your intelligence but it seems some people need to hear this: Swedish people are not evenly spread out across the country. Scotland has a low population density of 65 people per square mile because most of the country is wilderness. It has not stopped Glasgow becoming a COVID-19 hotspot.
The country with the highest per capita death rate from Covid is Peru, which has a population density only slightly higher than Sweden (65 per square mile). Brazil and Chile have also had more deaths per capita than Sweden despite having low population densities of 65 and 60 people per square mile respectively. Like Sweden, these countries have vast areas in which nobody lives. There is no reason to think that this should help combat the coronavirus.

It is not as if everyone in Sweden lives in little villages either. 88 per cent of Swedes live in urban areas. This compares with 84 per cent in the UK, 78 per cent in Peru and 81 per cent in Spain. Sweden is one of the most urbanised countries in Europe.

Sweden has been the model response to SAR-COV-2 and I only wish politicians here and in other countries would have the decency and self-confidence to say "Hmm, perhaps there's something to be learnt there" rather than ignoring the evidence of making up "Ah, but..." excuses for why it couldn't possibly work elsewhere.

 

[hwl]

Perhaps it could have, but since we locked down and called a stop to it, we'll never know; therefore it's pointless to try and use it as an argument against such assertions.

The large scale antibody testing results a few months ago concluded the UK average was 7% after the first wave, hence we do know that the 50% claim was very wrong and the modelling tools and assumption that suggested it. That equates to major egg on face if you go on the Today programme in March with your work claiming 50% already infected when it was only 7%, the 50% number was an input for the 2-3month claim, with just 7% the modelling would have shown it would take years which is the reality we are faced with. Using lower % having been infected would have undermined Gupta anti-lock down belief but would have been sensible for sensitivity analysis.
Barrington in Prof Gupta's case is about rebuilding a career after a major oops.

 

[trebor79]

The large scale antibody testing results a few months ago concluded the UK average was 7% after the first wave, hence we do know that the 50% claim was very wrong and the modelling tools and assumption that suggested it. That equates to major egg on face if you go on the Today programme in March with your work claiming 50% already infected when it was only 7%, the 50% number was an input for the 2-3month claim, with just 7% the modelling would have shown it would take years which is the reality we are faced with. Using lower % having been infected would have undermined Gupta anti-lock down belief but would have been sensible for sensitivity analysis.
Barrington in Prof Gupta's case is about rebuilding a career after a major oops.

TBF Neil Ferguson has had several examples of massively incorrect predictions the other way, yet is (still) listened to by government.

 

[MikeWM]

The large scale antibody testing results a few months ago concluded the UK average was 7% after the first wave,

We've established that antibody testing isn't the whole story - there are other types of immunity. So 7% is the lowest bound - the actual number will be higher, probably significantly so.

 

[Bletchleyite]

e.g. (UK analysis) Having been on an international flight in the preceding weeks results in a 4 fold greater chance of having a positive covid PCR test than if you haven't

Which begs my eternal question - why are we allowing any non-essential international travel?

 

[DB]

The German work concluded it was going to get to them what ever happened, the important question was what degree of control you still had at that point (or not).

The key thing is being able to control the rate it spreads to ensure that healthcare isn't overwhelmed (till we get a vaccine or not)

Studies in many countries (the UK isn't good at this kind of analysis because we don't collect the data properly with our Track and Trace, we only trace forwards (who else might have been infected) not backwards (who the individual got it from) in the community (forwards and backwards does happen for UK hospital transmission analysis) where they do forward and backward tracing suggest that ~70% of infected individuals don't pass it on to anyone else, ~10% pass it on to just 1 person with ~20% of people passing it on to between 2 and 50 people. It is that last category that every country needs to worry about as regards spread (both R and k), especially the super spreaders at the top end of that category.

The UK is finally beginning to wake up to the need to control high spread opportunities (both people and locations as seen with the screen grab leaks yesterday suggesting 40% of out of home transmission is in the hospitality sector), which means the most effective control mechanism available is closing hospitality as it happening both here and in France, Belgium etc.
Hospitality is a comparatively small part of the overall economy. Plenty of the economy can get on provided we remove the higher risk spreading opportunities i.e. we target based on evidence / risk modelling.

e.g. (UK analysis) Having been on an international flight in the preceding weeks results in a 4 fold greater chance of having a positive covid PCR test than if you haven't

But the NHS is nowhere near to being overwhelmed.

Your claim that hospitality is a small part of the economy is facile - it is interlinked with many other parts of the economy. Presumably you are just happy for all those businesses to go bust?

You still haven't said what you see as the fall-back position if a vaccine isn't available soon, or is of limited effectiveness.

 

[hwl]

We've established that antibody testing isn't the whole story - there are other types of immunity. So 7% is the lowest bound - the actual number will be higher, probably significantly so.

Agreed 7 is the lower bound, it doesn't cover cytokine or T-cell response, the later of which is likely to be the most prominent response overall. The work on comparative levels of T-cell vs B-cell covid response suggest that 16-19% max for a 7% antibody number.

 

[Bikeman78]

The German work concluded it was going to get to them what ever happened, the important question was what degree of control you still had at that point (or not).

The key thing is being able to control the rate it spreads to ensure that healthcare isn't overwhelmed (till we get a vaccine or not)

Studies in many countries (the UK isn't good at this kind of analysis because we don't collect the data properly with our Track and Trace, we only trace forwards (who else might have been infected) not backwards (who the individual got it from) in the community (forwards and backwards does happen for UK hospital transmission analysis) where they do forward and backward tracing suggest that ~70% of infected individuals don't pass it on to anyone else, ~10% pass it on to just 1 person with ~20% of people passing it on to between 2 and 50 people. It is that last category that every country needs to worry about as regards spread (both R and k), especially the super spreaders at the top end of that category.

The UK is finally beginning to wake up to the need to control high spread opportunities (both people and locations as seen with the screen grab leaks yesterday suggesting 40% of out of home transmission is in the hospitality sector), which means the most effective control mechanism available is closing hospitality as it happening both here and in France, Belgium etc.
Hospitality is a comparatively small part of the overall economy. Plenty of the economy can get on provided we remove the higher risk spreading opportunities i.e. we target based on evidence / risk modelling.

e.g. (UK analysis) Having been on an international flight in the preceding weeks results in a 4 fold greater chance of having a positive covid PCR test than if you haven't

How long do you propose we do this for? If there's no vaccine then we close anything remotely enjoyable forever? At the moment, I'm not allowed to leave Cardiff. I'm not allowed to meet anyone outside my household unless I want to sit outside in the cold and the drizzle. Frankly, if this is what life is going to be like, what's the point in being alive?

 

[hwl]

Which begs my eternal question - why are we allowing any non-essential international travel?

Keep people happy until they have the evidence to suggest that it isn't a great idea.
DfT's proposal as I understand it (for possible November !!! roll out according to Grant) is quarantine/isolation and test on day 5 with negative test allowing escape for quarantine or continued isolation if positive. (similar to some other countries thinking)

 

[Bantamzen]

Keep people happy until they have the evidence to suggest that it isn't a great idea.
DfT's proposal as I understand it (for possible November !!! roll out according to Grant) is quarantine/isolation and test on day 5 with negative test allowing escape for quarantine or continued isolation if positive. (similar to some other countries thinking)

Any particular reason why it isn't a good idea, most countries seem to be in the same situation, i.e. the virus continues to spread. So what's the difference between travelling to the Lake District or Lyon?

 

[hwl]

How long do you propose we do this for? If there's no vaccine then we close anything remotely enjoyable forever? At the moment, I'm not allowed to leave Cardiff. I'm not allowed to meet anyone outside my household unless I want to sit outside in the cold and the drizzle. Frankly, if this is what life is going to be like, what's the point in being alive?

The government strategy is effectively herd immunity with or without a vaccine, they just haven't phased it like that yet! But it is much easier to get there with a vaccine than without.
Hopefully having had it will provide a better immune response if someone gets it a second time so they are less likely to pass it on (as the immune system prevents mass reproduction of the virus) hence R drops as more and more people have still had it. The implication is that over time restriction can be eased with transmission rate remaining constant.

There is a reasonable probability that a vaccine may not stop people getting it, just reduce that rate of serious cases as the body is more prepared. The most useful impact of having been vaccinated might actually be a quicker immune response so the vaccine has far less chance of reproducing in large numbers so a much lower chance of it being transmitted to others. Hence we need to measure vaccine effectiveness is several ways.

The virus spreading rampantly in universities and schools currently means that the spread rate will be much lower there in the future (i.e. lower R). We should have been prepared for this though! Much more mixing in just over 10m people who are lower risk on average was always going to have a noticeable effect.

== Doublepost prevention - post automatically merged: 9 Oct 2020 ==

Any particular reason why it isn't a good idea, most countries seem to be in the same situation, i.e. the virus continues to spread. So what's the difference between travelling to the Lake District or Lyon?

It is a good idea, just the waiting till November bit is silly! Acting earlier has a higher impact. (Any MPs have half term holidays booked???)

One reason the government got into a big mess in March was that they didn't realise they are importing ~100cases a day from France which blew their patient zero type thinking out of the water (ditto Spain and Italy at the time).

Domestic holidaying has a much lower transmission impact than international.

 

[Bantamzen]

The government strategy is effectively herd immunity with or without a vaccine, they just haven't phased it like that yet! But it is much easier to get there with a vaccine than without.
Hopefully having had it will provide a better immune response if someone gets it a second time so they are less likely to pass it on (as the immune system prevents mass reproduction of the virus) hence R drops as more and more people have still had it. The implication is that over time restriction can be eased with transmission rate remaining constant.

There is a reasonable probability that a vaccine may not stop people getting it, just reduce that rate of serious cases as the body is more prepared. The most useful impact of having been vaccinated might actually be a quicker immune response so the vaccine has far less chance of reproducing in large numbers so a much lower chance of it being transmitted to others. Hence we need to measure vaccine effectiveness is several ways.

The virus spreading rampantly in universities and schools currently means that the spread rate will be much lower there in the future (i.e. lower R). We should have been prepared for this though! Much more mixing in just over 10m people who are lower risk on average was always going to have a noticeable effect.

== Doublepost prevention - post automatically merged: 9 Oct 2020 ==


It is a good idea, just the waiting till November bit is silly! Acting earlier has a higher impact. (Any MPs have half term holidays booked???)

One reason the government got into a big mess in March was that they didn't realise they are importing ~100cases a day from France which blew their patient zero type thinking out of the water (ditto Spain and Italy at the time).

Domestic holidaying has a much lower transmission impact than international.

Does it? Do you have a data source for this?

 

[Yew]

Domestic holidaying has a much lower transmission impact than international.

I don't think there is suitable evidence to back up that assertion. It may reduce the number of imported cases, and perhaps have a higher percentage of private car use, but I don't think it's reasonable to say that it's entirely due to travelling abroad.

 

[Bletchleyite]

Any particular reason why it isn't a good idea, most countries seem to be in the same situation, i.e. the virus continues to spread. So what's the difference between travelling to the Lake District or Lyon?

Cramming loads of people into a tin tube for a few hours is a fairly big difference. Most people going to the Lake District will drive there in a private car.

== Doublepost prevention - post automatically merged: 9 Oct 2020 ==

I don't think there is suitable evidence to back up that assertion.

There is - aircraft.

OK, if you go by ferry it might be lower, but most people don't go by ferry.

 

[Bantamzen]

Cramming loads of people into a tin tube for a few hours is a fairly big difference. Most people going to the Lake District will drive there in a private car.

A thin tube with constant HEPA standard filtering, blown from the top of the cabin down, and fully replaced with fresh air on average every 2 to 3 minutes. We've done this before, right?

 

[Howardh]

A thin tube with constant HEPA standard filtering, blown from the top of the cabin down, and fully replaced with fresh air on average every 2 to 3 minutes. We've done this before, right?

I'd love to know how many pilots and cabin staff have gone down with CV compared to the general population, if flying's that dangerous.

 

[Bantamzen]

I'd love to know how many pilots and cabin staff have gone down with CV compared to the general population, if flying's that dangerous.

To be fair, cockpits tend to have separate air con flows. But there are plenty of YouTube videos from pilots explaining how aircraft systems work and how safe they are.

 

[Howardh]

To be fair, cockpits tend to have separate air con flows. But there are plenty of YouTube videos from pilots explaining how aircraft systems work and how safe they are.

Yes there are, but I did include cabin staff who will be in the same air as the passengers, and there are more staff than pilots generally.

 

[scarby]

France is adding more cities to its harsh lockdown which sees bars and restaurants closed completely...

I don't know what you define as "harsh lockdown" but I would consider lockdown to mean mandatory home confinement, which ended in France on May 11.

If anything since then it seems to have determined to go down a route much closer to Sweden's. Up to 1,000 spectators a day have been allowed to attend the French Open tennis, which I cannot see in any way shape or form as being in line with a "harsh lockdown". Other leisure facilities are open, and yes, while bars have been closed in Paris (I think based on people ignoring social distancing in them) restaurants are still open in Paris. In many other parts of France, everything is open, and you can visit France from another EU country without needing paperwork/testing.

 

[Bletchleyite]

To be fair, cockpits tend to have separate air con flows. But there are plenty of YouTube videos from pilots explaining how aircraft systems work and how safe they are.

It is utterly inconceivable, though, that they would be as safe as not sharing airspace with others, i.e. driving.

 

[Yew]

It is utterly inconceivable, though, that they would be as safe as not sharing airspace with others, i.e. driving.

The question is not "as safe" but "acceptably safe"

 

[Bantamzen]

Yes there are, but I did include cabin staff who will be in the same air as the passengers, and there are more staff than pilots generally.

Yes, very true.

 

[RuralRambler]

The virus spreading rampantly in universities and schools currently means that the spread rate will be much lower there in the future (i.e. lower R).

Not necessarily. My son is in a flat of 8. One lad caught covid, so they're all isolating. The other 7 have no symptoms and are probably negative as they had little contact with the covid positive lad who'd buggered off home leaving them to 2 weeks isolation. If none of them have it, the 2 weeks isolation has been a waste of time. When they're allowed out again, if one of them gets it, that's another 2 weeks isolation for them all. And so on. It could take all year for all 8 of them to get it, with a succession of periods of 2 week isolation that is basically a waste of time as it achieves nothing if everyone in their flat is staying apart and basically locking themselves in their rooms and taking it in turns to use the communal kitchen (as per Uni rules, they're not allowed in the kitchen together!).

 

[trebor79]

Not necessarily. My son is in a flat of 8. One lad caught covid, so they're all isolating. The other 7 have no symptoms and are probably negative as they had little contact with the covid positive lad who'd buggered off home leaving them to 2 weeks isolation. If none of them have it, the 2 weeks isolation has been a waste of time. When they're allowed out again, if one of them gets it, that's another 2 weeks isolation for them all. And so on. It could take all year for all 8 of them to get it, with a succession of periods of 2 week isolation that is basically a waste of time as it achieves nothing if everyone in their flat is staying apart and basically locking themselves in their rooms and taking it in turns to use the communal kitchen (as per Uni rules, they're not allowed in the kitchen together!).

Hence the COVID parties that some students have been having.
I must say that 20 years ago there's absolutely no chance that I or my flatmates would have paid any heed to university rules about not being in the shared kitchen at the same time. Whatever happened to the notion of independent thought? How do the university enforce this rule - they can't very well burst in unannounced as they need to give 48 hours notice to enter the flat

 

[Bletchleyite]

How do the university enforce this rule - they can't very well burst in unannounced as they need to give 48 hours notice to enter the flat

What makes you think that? Students in halls live under licence, not tenancy. The licence will give them right of access at any time.

 

[adc82140]

I don't know what you define as "harsh lockdown" but I would consider lockdown to mean mandatory home confinement, which ended in France on May 11.

If anything since then it seems to have determined to go down a route much closer to Sweden's. Up to 1,000 spectators a day have been allowed to attend the French Open tennis, which I cannot see in any way shape or form as being in line with a "harsh lockdown". Other leisure facilities are open, and yes, while bars have been closed in Paris (I think based on people ignoring social distancing in them) restaurants are still open in Paris. In many other parts of France, everything is open, and you can visit France from another EU country without needing paperwork/testing.

According to the French PM, this is their "top level" of restrictions. Don't forget the French public have a history of taking direct action, much more so than us. The government there are on the back foot anyway with the Gilets Jaunes protests, it wouldn't take much for burning tyres to reappear on motorways, and sheep being driven down the Champs Elysees.

 

[DB]

The government strategy is effectively herd immunity with or without a vaccine, they just haven't phased it like that yet! But it is much easier to get there with a vaccine than without.

If that is actually their aim, they are going about it entirely the wrong way - slowing it down as much as possible will simply make it take much longer to reach an immunity level. And the longer it takes, the more societal and economic damage it causes.

The only excuse would be if the NHS was close to capacity, which it isn't, and were told back in March/April that the whole point of the lockdown was to allow it to build up capacity. We are now seven months on, and the claims about lack of capacity are sitll getting trotted out.