UKH

I've just made a crude model of Coronvirus spread in the UK in Excel.  I am getting 600000 dead and 2.5 months to a peak.  This is with R_0=2.2, a 5 day period of being infectious and 1% deaths. 

This is alarming so I am hoping I have made a mistake.  Are there any online models to play with?

I can't help you with the numbers or models but this guy has been working with a few. 

https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d...

Good Luck.

That’s really interesting. Thanks. 

My view is that there are so many unknowns that it’s almost impossible to predict, and the estimates are changing daily - for the worse - in Western Europe.

My different models come out with between 100k and 750k deaths.  Any realistic model is very non linear at certain key points due to saturation of resources and the sensitivity of an exponential, which makes prediction almost pointless; with enough motivation and relaxation of regulation, more ventilators can be quickly jury rigged from disposable parts of paramedic manual ventilators and common industrial parts, and more people can be trained quickly in overseeing their ongoing use after set up by core personnel - the risks of this are close to zero when the alternative is patient death -  so we could see a big increase in ICU levels.  I’ve no idea what’s actually going on on the front lines.

I’ve started suggesting to the younger, single people at work that they take immediate leave to go and be with their elderly parents - if they can mutually quarantine for 7 days - as I suspect we’ll be locked down within 10 days and after that everyone will be remote working anyway.

Have you used a consistent R_0, it should reduce over time for a variety of reasons. Assuming post infection immunity will also reduce the R_0 over time.

That said, what you gain from reducing that you will lose from adjusting the fatality rate to a more realistic figure

Thanks for sharing that, really interesting reading. 

R changes as the population gains immunity (i. e. catches it) , so from R=1, things tail off

Fatalities are simply a fraction. 

Maybe. I was surprised to be a  order of magnitude higher than other reports, however. 

Absoletely, hopefully you've managed to incorporate this into your model

Is that case fatality rate or as a % of the population. I'd suggest 1% looks extremely low.

What was the total number of cases out of interest?

I’ve consistently thought the governments view is lowballing things.  I hope to be proved wrong.

Well that was scary, and I'm kind of wishing I hadn't read it just before going to bed. Especially the Twitter thread.

What I take away from that is: Act now. It's later than you think. Your monkey brain intuitions inevitably underestimate exponential growth. Just do it now.

But: who is this guy? He sounds very confident, but what are his credentials? Maybe it's just that it's late and I'm tired, but I'm not finding anything through google. Tell me why this is reliable, someone?

The model is not the territory. But this is scary shit...

Thoughts anyone?

The first few posts on this thread I thought "seems a bit high, there are far fewer cases and deaths in Wuhan than have been modelled by some of UKC's stalwarts".

Then I read the link and some of the twitter stuff and I'm now thinking "holy shit, this is going to get really really bad".

Just deciding what to do personally now but I'm pretty sure I will be home working well before my bosses think it's necessary.

Exactly you can’t forecast something like that, if we are relying on predictions to deal with this, we are doing something very wrong.

We should prepare for all possible scenarios, not only for the likely ones.

The headless chicken approach to planning is always the best. 

Yes - sorry that's whst i was trying to say. 

About 60m out 65m with the inputs above, which is higher than other forecasts so probably i have an error. 

You don’t get it.

If we are dependent on a forecast to be correct for our plan to work then we will be headless chickens.

When gambling, think about what's probable.
When hedging, think about what's plausible.
When preparing, think about what's possible.

All of which require predictions

Preferably a sensitivity analysis over each of the parameters to a reasonable worst case model.

Surely by this type of forecast there should be 100,000's of deaths by now in China.Ot at least in the tens of thousands.

Not really sure it stands upto scrutiny in that context.

Edit: I assume all these worse case scenarios assume that nothing is done to stop and contain the virus. This is probably why such forecasts are very debateable.Clearly measures are being taken.

No. In preparation mode, you cover all contingencies. You don’t rely on a forecast being right.

Not quite on-topic, but these visualisations are good:

https://informationisbeautiful.net/visualizations/covid-19-coronavirus-info...

Situations like this really make you realise the limits of excel, which is a rubbish tool for this sort of modelling without an addon like crystal ball.  You need to run this as a bunch of sensititivities around variables like infection rate, mortality blah blah blah, run it a bunch of times and have a look at what matters.  A single excel realisation isn't going to be worth much

Indeed and no one has suggested otherwise.  I'll now let you write a further 50 posts declaring yourself victorious.

Don't know - not my link.

As I said, it's crude, but it does capture some of the key parameters, as I understand them.  Changing these (e.g. infection rate, incubation period) etc. does give a feel for the range of possible outcomes from the model I have, so it's not a single attempt. However, none really match what I read elsewhere, which was why I interested in interactive models online as a comparison.

1% fatality among 80% infection rate was discussed at least twice on R4 a week or so ago as worst case, which I make over 500000.

That is more than WWII civilian and combat deaths for the UK.

Personally I think the mortality rate might be lower because of undetected infection rates at present making it look higher, but we shall see when more is know about recovery rates

or a cup of hot tea and a piece of fairy cake

See if you can get some kind of free test of crystall ball or equivalent.  You can have a lot of fun predicting stuff

It probably has critical bugs in the maths as well that are so and hidden and hard to spot they go unnoticed for years...

I've no knowledge of modelling, but aren't the real life results dependent on future government (and individual and international) action which can't be part of the model as we don't know what it will be? Hopefully the eventual toll may be less. Obviously such models do concentrate everyone's minds to take action which may itself result in the model being proved wrong.

Edit: I'm probably being a bit stupid here in mistaking a model for an actual long term forecast.

Excuse me if this appears to be something of a hijack, but I'd like to canvass some opinion here.

We're supposed to be hosting a user conference this weekend for approx. 100 of our users; the thing is, they are mostly SME opticians, who do deal with elderly and vulnerable patients. The conference is quite an important event for them and us; but should we cancel it? 

Yes, you did, at 7.48 “All of which require prediction”.  Hence my reply to you that it isn’t the case.

But I can see you are more interested in scoring point than anything else, so goodbye.

The sooner you commit to cancelling the physical presence the sooner you commit to planning something else in its place.

Will it be shut down anyway?  If not, how many people will go?  How many want to go?  Can you get some presentations videod and onto YouTube and set up some group chats and small group video calls? 

Hosting a “mixing event” with any sort of clinical or social care audience is a very bad idea.  
 

These models are more entertainment than anything else. We shouldn’t try to forecast too much except very short term.

The problem with giving forecasts is that even if you give people all the proper caveats and tell them about the uncertainty, it causes people to be completely blinded by that number and then become dependent on it. 
 

We are actually pretty good at dealing with lack of knowledge, however we are generally very very bad at dealing with incorrect information.

I think you underestimate the educational value of implementing a scientific model and fiddling with the parameters.

I would definitely be postponing it.

Depending on the purpose of the conference I might consider having some smaller groups in the short term or trying and set up calls etc.

Cancel.

For comparison UK government flu report for 2018-2019 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/... includes flu death numbers for the last few years. Table 7 "Number of deaths associated with influenza observed through the FluMOMO algorithm with confidence intervals, England, 2014 to 2015 season to 2018 to 2019 (up to week 15)" for all ages:

2014/15: 28,330

2015/16: 11.875

2016/17: 18,009

2017/18: 26,408

Ignoring 2018/2019 because that result only goes up to week 15.

(Please correct me if I;m misrepresenting the report's results.)

It’s very useful in some domains, useless in others.

If your model predicts a peak of 500,000 infected at the same time and you have 10,000,000, but you had planned for only for 500,000, then you have a big problem.

The worst thing is that even if you give people your forecast of 500,000 with all the caveats, the uncertainty, etc etc, having that figure in their head will completely change their approach, instead of covering contingencies they’ll start « gambling » on outcomes. It’s a psychological problem.

I think you have greater problem with uncertainty than most.

The worst thing you can do is be even more uncertain by neglecting the modelling.

Anyone who might become infected at the event and is providing a service to lots of other people, possibly vulnerable, and therefore this could be the seed event for spreading one person's infection to many.  There is thus some gravity to the consequences.

Risking organisers getting accused of being unprofessional for not cancelling.

On the contrary, I embrace uncertainty more than most. There is nothing worse than replacing uncertainty by false certainty. There are definite strategies that work well under uncertainty. 

I disagree, knowing when you don’t know is better than thinking you know when you don’t.

Modelling is VERY useful in domains when things are simple, ergodic and linear. However, in complex non-ergodic systems dominated by extreme and chaotic events, it rarely works.

You can still work with it very well !  We do it every day.

For example it’s impossible for me to predict in advance when I’ll have a car crash. You could come up with a complex model looking at hundreds of variable weather, traffic etc to try to predict it if you tried hard, but it will be shit.

Or instead you could just fasten your seatbelt every time.

Good explanation of the four stage strategy here:

https://www.youtube.com/watch?v=nSXIetP5iak&fbclid=IwAR2HTIPNGLILVIEcoK...

If it is a good model, you can vary all these parameters and compare the outcomes.

Cancel it.  As per the comments here  https://twitter.com/MarkJHandley/status/1237781162153717760 , the graphs are lagging.  The WHO / wikipedia lists will be a day behind the local / national lists, which in turn rely on test results which are taking 4 days, which in turn rely on presence of symptoms which occur after the 'victim' has been infective for a bit.  With the doubling rate being about 5 days, the stats are a doubling behind reality.

Yes, you and your opticians might find it useful, but what real difference will it make in the grand scheme of things? If an optician misses it one year how much does it affect their business? very little.

This is a TedX talk by the same chap, as far as I can tell. I'm at work so haven't had a chance to look at it yet.

youtube.com/watch?v=VUT6GQveD0E&

He seems to be a journalist.

This reporter suggests it was caused by a leak from a Wuhan bio warfare establishment.https://www.bing.com/videos/search?q=Professor+Francis+Boyle+was+speaking+o...

That's pretty scary - I didn't appreciate the order of magnitude difference in death rates for a health system that is coping vs one that isn't, and it's backed up by the data, including from 2018.

Fortunately I've been social distancing for the last 30 years..................

Is that the same Alex Jones who had to pay $100,000 for making shit up about the Sandy Hook shooting?

Meanwhile there's Chinese conspiracy theory that the virus originated in the US:

https://www.theguardian.com/world/2020/mar/12/conspiracy-theory-that-corona...

Take your pick.

do you realize what that last link has done to your cause?

I think nobody but you thinks people are assigning certainty to models. Everybody else thinks they are for uncertain estimates and exploring options.

Numerical models are good for complexity. For simple systems you attempt analytical solutions.

I doubt an ordinary engine management unit is linear.

FFS Alex Jones--- you have to be kidding me--- the guy is a conspiracy nutter.

That would have been to promote his book: Biowarfare and Terrorism.

Always look for the money, and/or votes if they're a politician. What is the effect of the upcoming Olympics on Japan, and of his re-election chances on the POTUS?

Yes in my view.  You are unlikely to generate sales benefits from it going ahead in the near future (due to likely hood of shutdowns next week), and you could end up causing your customers to go under if infection does spread as a result (and that's just thinking about it commercially without considering the impact on vulnerable customers of the optitions)

So what? Road deaths, strokes, heart attacks, etc  are very significant causes of death too but none overwhelmed a hospital system to the extent that eveything non lethal is 'parked' and doctors are forced to ration who will live; as happened in Wuhan and is happening right now in Italy. Unlike Wuhan things are still getting worse in Italy (western democracies just won't stop all movement until its too late). Anyone still saying this is just like seasonal flu is plain dangerously wrong based on real hard evidence. We are about two to three weeks behind where Italy is now, unless something changes. 

On the subject of mortailty rates being massively overstated, WHO said mortality rates would vary depending on response and the health system capabilities. Below 1% where things are under control in the system and over 3% where the system is overwhelmed. Nearly everyone who gets the virus ends up showing symptoms according to WHO (the asymptomatic who test postive are usually only that until the diesese 'shows' ). Enough countries are testing all contacts to show the WHO estimates on mortality look sensible (rates vary with age).

Unfortunately, in my experience, it couldn’t be further from the truth.

No. Complex system just don’t lend themselves to modelling. For example you could have the best financial model possible, with a perfect historical fit, it wouldn’t have predicted the coronavirus crash.

Good. I'm glad nobody will have to invent an autopilot. /s

We don't have to predict the unexpected. We have to predict the behaviour of an infectious disease we now know exists based on a century or more of science with decades of numerical modelling experience.

FFS Paul, you're linking to stuff that's been on Alex Jones? You're going to get to the point where you've linked to enough neo-nazi bullshit merchants that people will genuinely want to know if you're one as well.

Thought this previously linked page should be included in this thread. It's useful to compare the very topical per capita infection levels and comparative government responses.

https://www.worldometers.info/coronavirus/

With various links to mortality rates...

https://www.worldometers.info/coronavirus/coronavirus-death-rate/

Also this link critical on the UK response, from a past regional director of Public Health  

https://www.theguardian.com/world/2020/mar/12/health-expert-brands-uks-coro...

Cancel it. Was chatting to a hospital ophthalmologist today who made the point about how close they get to patients and vice versa. High transmission risk. 

You might look at the South Korean and Diamond Princess numbers.

One might hope that we are are not as up-close hug and kissy as the Italians or have an devastated infrastructure as the Iraqis. However, we would probably be over-ambitious to hope to be as disciplined as the Koreans or the crew of the Diamond Princess. Most of that stuff is on the WHO website. 

Have fun.

Is MS Excel your method for self-isolation. 

With other viruses I'd be tempted to say it's too high but with the transmission characteristics of this virus I'd say it'll probably happen.

China was so worried about surface transmissions that they took such extreme measures to decontaminate streets and money. Research seems to back this up showing that the virus can survive on surfaces for up to 5 days in 37 degrees.

After today's Cobra meeting it seems Boris is willing to experiment with surface transmission by allowing asymptomatic and symptomatic cases to potentially come into contact with large crowds. We could see the R_0 increase beyond what has been seen in China and Italy with dire consequences

I read one sensible suggestion yesterday.

Work with death figures, not infections as number of deaths will be more accurate.

My guess without any calculations was 400000. 2/3 of the population, 1% mortality.

It's looking like the consensus is that deaths in the UK will be in the hundreds of thousands and looking at how the Italian health service, which has more beds per capita than the UK, has been overwhelmed already this is looking like this may be the most serious crisis I have experienced in my lifetime.

An autopilot isn’t complex system. It’s complicated, but not complex.

And yet, look at it, whole countries going on lock down, none of them predicted in advance they would have to do so.

Yep; conference cancelled. I don't like to say how much it has cost, but there you go.

Never let it be said that we entrepreneurs have an easy ride!

It’s difficult isn’t it? Sorry you’ve taken the hit, but I’m sure it’s for the best. 

One thought: most of the deaths will be elderly or ill or both. Therefore they would likely have died in say 5 years anyway. So maybe on a 5 year view may not be much different. 

You mean they didn't make a public prediction.

I didn’t want to play the “me too” card in my previous post to you.  Now you’ve made a decision I can say it emphatically.  The last two years I’ve poured all the effort I can in to a new business.  It hardly seems proper to be concerned about business as we face down the barrel of this thing, but yes; it is not an easy ride ahead.

There is nothing complex about an autopilot.  Keeping an aircraft pointing in a specified direction is a really easy thing to do.

An autopilot and engine control units are  examples of nonlinear systems that Rom says are not amenable to modelling. Mathematical and numerical modelling of nonlinear systems dates back at least as far as the Manhattan project. It's in one of Feynman's books.

Anyway, whatever the definition of complex or complicated is, they are not the simpler systems that have analytical solutions, so numerical simulations or models are used.

This is complicated, not complex.

A complex system is more like the weather, or the economy, or human societies, or biological systems.

From wiki:

 « Complex systems are systems whose behavior is intrinsically difficult to model due to the dependencies, competitions, relationships, or other types of interactions between their parts or between a given system and its environment. Systems that are "complex" have distinct properties that arise from these relationships, such as nonlinearity, emergence, spontaneous order, adaptation, and feedback loops, among others. »
 

This doesn’t make much sense.
 

Weather doesn't have analytic solutions (pure maths) and is numerically modelled. Thanks too for the other examples of complex systems routinely the subject of modelling.

You mean the stuff numerically modelled because there are no analytical (pure maths) solutions.

It doesn’t mean anything to « numerically model » something. Its numerical simulations you are talking about. Numerical simulation are fine but you still need a model. And complex systems are very hard to model, it breaks down very quickly. 
 

It’s pretty obvious really, nobody can predict the stock market even though we’ve got super advanced models with very good fit, nobody can predict the weather more than a few weeks out etc etc.

This doesn’t mean anything. Are you talking about fitting model parameters through numerical technique, or are you talking about running numerical simulations ?

Either way both technique won’t make any difference, you still using a shit model.

Going back to the topic, instead of relying on a some forecast from some model that we’ll get 100,000 death and be caught out if we are wrong, we should plan for 500,000. Don’t wait for evidence of a crash before putting the seatbelt on !
 

That's true if you don't know anything.

 Have you done the analysis showing expert modelling is not matching reality?

You can’t answer a simple question about what you mean, I’m not sure you even know yoursell.

It’s pretty obvious, really, nobody predicted when and where such a virus would appear. We just knew it was possible. As that what we have to do. Plan for the possible.

Same here, we don’t know how it will evolve. We just have a rough idea of worst case scenario and that’s what we should plan for.

Unfortunately the U.K. is being wrecked by a government listening to nudge idiots and bullshit vendors.
Instead they should be doing what’s tried and tested elsewhere, Hong Kong, China, or Japan.

Look up computational epidemiology. It's an application of numerical techniques.

From what I can tell it’s just an umbrella term including computer simulation and big data mining. 

No. Producing peer reviewed publications, informing planning and developing understanding of epidemics.

If treatment becomes unavailable the case fatality rate looks to be more like 4%, perhaps higher where universal access to healthcare is already compromised (developing world and US). Yesterday's decision not to put a hard brake on the growth to regain control allowing people time to adapt their plans, habits and lives looks set to make that collapse of medical provision in the UK likely IMO. 

Hundreds of thousands was a given, the choice we face is between small single digits (Prepared Asian countries' approach) and small double digits (developing world/US approach). We appear to be on track for the higher end of that if government policy is the prime driver of effective restrictions.

I wonder at government strategy here really, people, groups and businesses are going to take difficult choices of public benefit in isolation for their own reasons (talk of pausing football leagues for example), these may yet prove vital but what's coming will still be bad in real terms from a social, health and economic perspective. By this out of step with our peers softly softly approach the government risks looking lax if it cannot regain control to protect the NHS when it probably has public support right now for short lived tight controls followed by progressive, closely monitored relaxation. In a week if we end up with a significant fraction of government and health staff (planning and shop floor) sick or quarantined it may well be irrecoverable.

jk

The govt strategy looks like its based on building up poulationherd immunity, that this virus is going to be around for a long time and that they need to flatten the peak.

All sounds reasonable to me.

Do you not think there is behind the scenes a hell of alot of work going on to bring things upto speed.All that stuff will be being planned for.The fact that you and I know nothing about it is irrelevant.

Also we do not appear to be out of line with the likes of Germany and the USA( which despite Trump has an excellent Control of infectious Disease practise).In actual fact the UKs predictions are worse than Germany with 80% of the population getting the virus.

Short term knee jerk reactions is not going to keep this virus at bay apppears to be the scientifuc advise ( which the CSO says they can change at an instant based on new evidence as it arises).

Indeed, immunity is necessary and infection looks like the only realistic way we build it for now but that only works if what they've proposed (frankly not very much) does anything to flatten the curve before hospitals fail and mortality rates soar. We have a sizeable reservoir of hidden infection at present, that's manageable but absolutely needs to be stopped from growing exponentially. The situation needs to be kept under tight control if we're to to infect the masses while protecting the vulnerable in the coming months and years. Might-work half measures now risk losing control of the situation completely decimating out health care system so the later panicked harsh controls in a few weeks time leave us where we should have been today, regaining control of the infection rate but with our medical infrastructure damaged and lots of people needlessly dead.

I know there is. That doesn't mean there isn't tension between people with competing interests and ideas. The best idea doesn't always win out (eg brexit), the most powerful person's tends to.

US CDC may be good but if undocumented, uninsured and the poor won't come forward for treatment or stay off work they're going to have an outcome at the worse end of the spectrum. Trump isn't the problem, he just epitomises it. It'll be interesting to see if the adults left in the room depose him as he flounders in the face of significant fraction of the population dying.

I'm not under any illusion they will keep it at bay, there will be a reservoir worldwide for the rest of our lives, we can't hide from it unless we develop an effective vaccine (not a given) but they do buy time now while it's growing exponentially and our services are still working. That time can be used to entrench to protect our emergency services and boost their capacity as best we can. This is going to run for a year or more before anything like normality returns, personally I think we should be biting the bullet now for a few weeks so we're better prepared for and can manage the inevitable serious consequences of infecting a large fraction of the population at a manageable rate in the coming year. We should at least have functioning hospitals if we're going to get seriously ill.

jk

As I originally said - comparable with British deaths in WW2, civilian and military

Not sure if you have children ,but biting the bullet now by closing schools is going to be desperate;ly complicated for most families, especially if it has little effect on the future.( which in effect is what the CSO and CMO is saying).

There is no right or perfect solution at the moment as I see it.

It is surprising how quickly peoples hygenie habits have changed over a coule of days.

I expect we have the best minds in medicine and disease control working on this and if they follow a policy that seems odd to me then I assume it's because they know more than me, not less and have thought about it harder than me, not less.

At the same time, it's my intention to do everything I can to avoid getting this. If other people want to go to public gatherings then fine, but I'll be giving them a miss and spending most of my time at home.

I have one on the way right about the time infection looks set to peak if we carry on pissing about. Frankly I want a hospital available if that goes to worms.

But doing too little too long creates chaos and damage which closes off the better compromises.

jk

Desperately complicated for parents, versus a copy of Italy...an overwhelmed NHS and mortality rates over 3% plus other deaths as the service can't cope.. mmmm?

I'd love to know where this herd immunity guff came from. They stopped SARs without this idea and the rich eastern nations seem to be stopping Coronavirus while infection rates are in the fractional or small single figures percent of the population.

On the quality of the CDC and other response... I think you are a President too late. Trump cuts have damaged effectiveness. 

https://fortune.com/2020/02/26/coronavirus-covid-19-cdc-budget-cuts-us-trum...

https://www.cnbc.com/2020/03/10/coronavirus-testing-delays-caused-in-part-b...

So whats your experience of virus control etc to counter the govts view point. Are you some form of epidemic or virus expert. Whats your knowledge of it other then being a very  anxious father to be?

Midwifery will be one area given priority you can take that as read.

Better to ask why is Britain the exception in country terms?  It's our government response that is the outlier. Read all these links in these threads from epidemiologists and WHO and where is lockdown boredom mentioned or herd immunity as the critical issues to consider. The experts alongside Boris are not independent, they have agreed to sell the government line. If they are wrong we will know in a week and parts of the NHS will almost inevitably suffer as hospitals have in Italy. Japan, Korea, Singapore, Hong Kong, Taiwan, Thailand, and China (outside of Wuham) acted much faster and the infection levels seem to be heading to a controllable state.

"Midwifery will be one area given priority you can take that as read."  Have you read the reports from Italian doctors?...... keeping as many people alive as they can is the current overriding priority and they are often losing like an overwhelmed service dealing with casualties in a war.

Did you watch the entire BOJO, CSO and CMO broadcast yesterday?

Well worth it. Serious stuff and explains the process in alot more details. The snippets in the news do not do justice to the message that was spelled out.

For example. Schools closed for 3/4 months when they currently they have no need to be. At some stage yes, but not just now.

All this stuff has been clearly reviewed.

80% of the population are going to have the virus in worst case for example. ( higher than the Germans predictions)

Mate in Milan, so fully aware of what is happening.

For now I agree. The advice seems well balanced. It may turn out to be mistaken but assumming its casual or political isn't correct. There is also the question for e.g. china of their long term plans. Yes they have  controlled this outbreak but 95% plus still have no immunity. What happens next time? 

None, just a gnawing concern that this government is not the most competent we've ever had and that it has interests slightly different from those of the public health people advising them. I don't doubt they're getting good advice, I fear they're playing a dangerous game by tempering it.

I don't doubt that's the intent for a second. That doesn't mean surgeons, anaesthetists, midwives, obstetricians, nurses, theatre technicians, office staff, cleaners, maintenance staff and the people in the broader supply chain are any more immune to infection, weeks of quarantine for suspected infection and burnout than others working in or in regular contact with an overwhelmed hospital. A hospital is a system, each bit of it has to stay working well enough for the whole to stay working well. Some of those individual bits are just a few people who are not easily replaceable, that's not especially resilient. I'm sure every effort will be made to protect other essential services from the impact of the COVID19 and that there is a plan in place, it's probably a very good plan made by people far brighter and better informed than me but plans fail. They are more likely to fail under more severe pressure.

jk

Now you are just throwing random terms and banalities with no logical connection between posts... goodbye.

Well that’s exactly the problem, the government is adopting a so called « evidence based » approach instead of a precautionary approach.

This is the climbing equivalent of waiting for evidence that you are falling before tying your knot.

I’ve made the point before, when there is so much we don’t know about the virus and the way it spreads,  trying to optimise the response based on « modelling » is completely the wrong strategy. Quite a big part of it as far as I understand is driven by nudge behavioural scientists pseudoscience bullshiters this government is endeared with. 

What we should be doing now is tripling or quadrupling the number of ICU beds, we have about two times less per head than Italy, three times less than Germany.

And why do we have so few ? Because of years of  so called « evidence based » policy designed to  « optimise » NHS ressource based on « models ». See any parallels there ?

Epidemiology 

Statistics

Finance

Risk 

Modelling 

Have I missed any other areas in which you are a  world expert? 

To be honest I think you political perspective is getting in the way of some hard headed rationality and we are why we are so to speak.But there you go.

Personnally I would rather Hunt was in charge of the Health Service at the moment, but you cannot have everything.There was an interiew on R4 today with a former chief exec of the NHS who was now in charge of a couple of trusts. he said Hancock was doing fine. What he wanted was Hunt to sit above Hancock and also kick ass on things like education and transport where there needed to be a political trouble shooter who knows the systems.

There was apparnetly a serious pandemic plan put in place in 2012 post SARS and generally this is what they are following.

Individually there are going to be cock ups, almost inevitbale. All govt can do is control and guide the main principles and strategy.

Its worth emphasising that one region of the italian health system has been overwhelmed - concentrating the disease in one area and having a quarantine maximises the pressure at that one point.

I would suggest they are doing that already on ICU beds from what I have read.That stuff is hardly rocket science in current situation.

Must go got stuff elsewhere to do.

Which is exacly why the CSO and CMO is saying imho.

As usual. No arguments.

Why don’t you try saying something interesting / useful and engage with reasoned arguments instead of just throwing your bile ?

Too much effort is it ?

Excuse me for gently commenting that there are some very high figures for the UK on this thread, e.g. yours (above)

I see that in recent days the numbers of new cases per day, and of deaths per day, in China have greatly decreased. And as of today, only about 1 out of every 17,000 people in China caught the virus. And as of today, only about 1 out of every 430,000 people in China have died from the virus

I am wondering - why the enormous discrepancy between actual numbers in China and forecasts for the UK??

What you need to do is take the example of countries that have successfully kept the virus under control.

I’d rather rely on what’s known to work in the real world rather than rely on so called « models » and « best scientific advice » which strangely enough nobody gets to see and is done being closed doors.

Fundamentally we have a government taking  decisions based on what their model tell them is *likely* to work (although with these behavioral nudge idiots it's likely to not work). Totally the wrong approach we should take decisions based on the systemic costs of the error.

Edit: I finally found one U.K. politician with half a brain who totally gets it. I suddenly became a big fan.

https://twitter.com/olidugmore/status/1238092742770733056

Worth a watch

I know very little about the science but in light of what's happened in the UK over the last 4 / 5 years and especially the last 6 months or so I'm making my mind up based on this:

https://pbs.twimg.com/media/ES8erMEWsAA35u-.jpg

E

I think some of this is a matter of perspective, looking to the immediate crisis of stemming the exponential growth or looking to the longer term where we have to live with this. Both are essential, we have to get the outbreak under control so we can manage the consequences of infecting people at a more constant rate. The British plan seems reasonable in the longer term, we can't hide forever assuming vaccination is either unlikely (no idea) or we'd be bankrupt and exposed to disease and other risks by the chaos anyway before it arrived (1-2 years of very very deep recession...). There doesn't seem to be much there to bring this still somewhat unknown outbreak to heel in the first instance.

Desperately hoping I'm wrong but expecting to see the public and business lead the government by the nose on this as it explodes over the next two weeks. Hopefully that's not too late.

jk

So - we are closest in response to Germany - another sensible country.

Blo Jo was looking very sober with Buffoon mode turned of in the press conference yesterday. I dont think we are dicking about.

The Irish decision was made before they planned too, and they do not have as much in place as we do at this stage.

Yes I've watched it all, twice, and the more I think about it the worse it gets. Lockdown bordom and herd immunity are simply not major parts of WHO advice for a country in our position. Korea has a profile of a country that responded properly in my view....it's linked below... look at the new cases ....nearly back to where we are now in less than a month from our current new case level. Its not 3 to 4 months in lockdown they face, it's 2 months at most if you act fast (and for us, over Easter). In comparative terms the Korean response was weeks quicker and much harsher and their size of economy is similar to ours.

https://www.worldometers.info/coronavirus/country/south-korea/

In reply to MG

Next time you follow the actions that were most successful... like Korea, and not Italy and where we seem to be heading. Where do WHO say we need to allow infections to get to most to produce herd immunity?

China's approach has been strong restrictions on business and public liberty to bring the outbreak under control. That can't last and infections will re-occur as restrictions lift. Managing those restrictions and building capacity to deal with the consequences should keep hospital admissions manageable and mortality minimised.

So far we're opting to skip that stage presumably for cultural and economic reasons, hoping we can achieve a sort of managed burn from where we're at which is somewhat unknown but likely with widespread undiagnosed infection. It might work, it might get away from us.

jk

What I find extraordinary is that the govenment, even if it does truly believe that their approach is based on the best evidence from experts, has chosen a different approach to other European copuntries. The fact is that once this is all over, we shall see clearly who got it right (or least wrong) and, even if the strategy might as well have been decided by the toss of a coin given the evidence, it is going to look very, very bad indeed for the government if we come off worse than other countries. At least if we do the same and it all trurns to shit, few will be pointing the finger at the government's strategy. It seems an almighty political gamble to me.

Just going with my gut instincts seeing as though one of the countries on that chart has had enough of experts.

E

They don’t care because when it fails they will say « this was the fault of the CMO and the experts ».

I’ve said this in another thread this government isn’t taking responsibility. They are a government of skilled ideologues and demagogues not a government of skilled leaders and decision makers. 

I just watched Emmanuel Macron speech from yesterday. It was exemplary in leadership, setting out the path ahead and taking responsibility for it, as well as providing hope, motivation, and optimism.

What a contrast with Johnson buffoonery and half-arsery, and « you will lose loved ones suck it up »

It's now safe to tick the mass gatherings box for Germany.

E

Even if they don't want to take responsibility, ultimately the buck will stop with Boris Johnson if our death rate is significantly higher than in other European countries with a different strategy.

Thanks for your reply. But I think it doesn't explain the huge discrepancy between actual numbers SO FAR in China, and forecasts on this thread for the UK:

*About 1 out of every 17,000 people in China caught the virus

*About 1 out of every 430,000 people in China died from the virus

Is Germany sensible when, if 70% get it, hundreds of thousands will die, when the big Eastern economies appear to be in control by lockdown methods and holding the deaths in the hundreds or below. Germany is a collection of states, so things vary, but on average it has more controls in place already than the UK (like football matches in closed stadiums).

Read the information on why mortality rates differ...

https://www.worldometers.info/coronavirus/coronavirus-death-rate/

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-g...

Based on this, the CMO's estimate of 1% for the UK only applies if we are on top of things and the serious caseload doesn't overwhelm the NHS. In contrast the government announcement and relative inaction yesterday, and the explanation for it, seems to expect widespread infection. IIf so, the NHS will be overwhelmed in hotspots within a few weeks and the whole of the UK in months. Death rates in an overwhelmed service will be 3 ro 5% just on coronavirus deaths, let alone knock on effects.

Seems to me we should delay the spread as much as possible by all means necessary and buy time to create thousands of new ITU beds and know more about the virus. Once you are prepare then you go for the herd immunity. But not before.

The one thing we know is that the availability of ITU beds makes a huge difference to the mortality rate.

If I've got this right you're saying that regardless of the modelling we should plan and act for the worst (credible) case scenario because the downside of getting that wrong is a load of (unnecessary?) disruption but you've at least minimised deaths.

Is that right?

Seems like a reasonable approach.

Sorry I thought you'd recognise peer reviewed publications by universities and medical institutions as legitimate useful science but clearly not. 

Does it really matter compared to what we face if he is right about the need for fast action for some of the wrong reasons (Rom is certainly right on ITU facility). The other right reasons WHO advice, the independent epidemiology and current successful actions in other countries, like Korea, compared to problem areas like Italy, all point to something close to a UK lockdown now.

100%

Yes it is common sense isn’t it.

Strawman of epic proportions

Thank you for your helpful reply, though I note that the numbers on the "worldometer" are seriously out of date considering the decreases in China in recent days in numbers of new cases per day, and in deaths per day

The Chinese mortality rate is dominated by the Wuhan mortality rate because most of their cases occurred there where mortality rates where high because the health system overloaded. In the coming months and years they'll have to carefully balance the infection rate against maintaining the economic activity they need, protecting the vulnerable and critical care capacity. Or sit it out on lock-down awaiting a vaccine which looks impractical and is uncertain.

Lower mortality rates result from excellent and well protected healthcare services available to all (Korea).

jk

There is a fine line between scepticism and arrogant cynicism.

If you get a pair of binoculars and look behind you, you might still be able to see where you crossed that line.

There is so much that is wrong and just plain stupid in what you wrote I'm not even going to start teasing it apart. Anyway, a detailed reply would lend what you wrote an air of respectability that it does not deserve.

Another disingenuous way to say:

« why you say bothers me but I am unable to make a properly constructed argument against it, so instead I’ll just fart in your general direction »

I bet you haven’t even watched that speech as it wasn’t translated, so most likely you don’t even have a single clue of what you are on about.

Johnson's looking to solve all sorts of problems by getting rid of many of us, no housing shortage, a brief blip on the hospital bad availability graph and then there's plenty, no need for 6 new hospitals, we'll only need 5.

What happens when these countries come out of lock down and the majority of the population is still not immune to the virus......won't it just spread again?

Thanks a lot for your reply, very helpful

PS I'm in South Korea right now - it's all a bit real here

Just edited it a bit as I realised I'd got the poorly define denominator bit arse about face but the Korea point stands, if the hospitals stay working well mortality stays low.

Best place to be by the look of things. Still, good luck.

jk

https://www.worldometers.info/coronavirus/country/china/

These match WHO numbers

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-r...

https://ourworldindata.org/coronavirus

Spot on.

It will. But you can do it progressively, in a controlled fashion, in a way that keep the healthcare system functioning.

And you would have bought time to expand ITU capacity, you would have bought time to know more about the virus and the condition, and possibly even have some treatments.

The Koreans have shown how its down, they are now able to lift restrictions and get going with they lives progressively whilst still keeping new cases low.

Ok so you lock down and the come out and it starts spreading again, what then? Lock down again.....and again and again.

Genuine questions as I don't see a way out until around 70% of the country have had it or a vaccine comes out which will be at least a year away.....I get the idea that lockdown stops the spread but it seems to be only delaying the inevitable....it seems to me whatever approach is taken we are goosed.

This shit genuinely scares the f*ck out of me, more than anything since the threat of nuclear war in the 80's....the economic impact it going to be off the scale, I don't know what levers are going to have much effect across the globe.

whether or not schools colleges and universities are closed down is a very difficult decision.  Apart from the very obvious disruption there could be a resulting surge of cases if there really is a hidden infected population of up to 10000 and growing fast.

1) Older relatives called in in large numbers to provide child care are now intensively exposed to a school population who may be carrying it without symptoms.

2) Students travelling home from a similar potentially asymptomatic infected population bring it with them and also have contact with people on public transport, either spreading it or acquiring it.  Then exposing relatives.

It is really hard and I'm not sure we are outstandingly wrong yet.    The only reassuring thing is that if there really are a lot of cases out there the mortality rate (so far) might be reduced.

perhaps there are models that show that various interventions going wrong can cause more catastrophic consequences than people being informed and making individual sensible choices.

no point in being scared.  Concerned and careful is just as useful.  Age makes me more likely to suffer it seriously and there is nothing I can do about that.

The CSO has openly said that all the evidence is being made publicly open, that was as at this morning. Happy to share it. They do not want to be accused of hiding stuff. In regular dialogue with other countries all sharing lessons and info. Nobody has right answers.

Basically that is what Sir Patrick is saying.

No, you don’t come out of the lock down at once, you do it progressively, in a controlled fashion so that you keep the health system functioning.

This is a much better approach that letting the number of cases explode, then you don’t have a health system anymore and mortality shoots up. And it takes very little for that to happen.

We are even more vulnerable in the U.K. to that than Italy due to numbers of ITU per head about 2/3 times lower.

I am more optimistic, the example of Korea and China shows that you can create functioning human societies in which Corona cannot spread well. 

Fear is perfectly rational. I think ultimately we can come out of this stronger and hopefully a better understanding of the fragilities of globalisation.

please do

Ok, well I am not going to be sat at home worried about catching it, in fact I wouldn't mind getting it being a healthy bloke in his 40s....just to get it out of the way!

It's the impact on the economy that scares me, people say this shouldn't matter but recessions also cause terrible hardship and deaths and a massive hit on GDP means we won't be able to fund an already busting at the seams NHS.

How are thousands upon thousands of SME businesses going to survive when the peak of this is not expected for 10-14 weeks? 

Paul, take a bit of gentle advice on this...you're completely wasting your time posting any more on this subject mate.  Your posts come across as the incoherent ravings of someone who has been locked in a small room with nothing but YouTube conspiracy theories for entertainment, or as someone who, against the advice of their doctor,  stopped taking their medication about three weeks ago.

I often (unintentionally) build up a mental image of different forum members based on their tone, their attitude, etc, and yours unfortunately is of a guy sitting in front of his screen in his underpants, wearing a tinfoil hat, in a room with shelves on the wall containing hundreds of bottles of your own urine which you're storing because you think if you flush it down the toilet, the government will start collecting it for some nefarious purpose.

This isn't meant to be intentionally cruel, it's just the image that you're transmitting (to me at least, but I'd be willing to bet the majority of people who've interacted with you and have tried to reason with you have a similar impression). 

Please stop.  No one is taking you seriously and posting a link to Alex Jones material is just one more bottle of piss on that shelf.   

I appreciate you think you're the only one knows the truth, and the rest of us are sheeple...we'll live with that

They apply containment all over again, as China have been doing for a while now, as most of their new infections are from those travelling into China. You hope containment works but if it doesnt you keep deaths in any subsequent waves in the hundreds until a vaccine can be found. Much better that, than allow nearly everyone to be infected and get herd immunity while health systems collapse under the strain and millions die. I am still completely bemused on the UK advice yesterday but pressure from what every other country does and our growing deaths compared to brakes on deaths elsewhere will force a change within a week.

A vaccine is over 12 months away.....by that time the world economy will have collapsed if the current measures carry on or even escalate...like I said it seems we are goosed either way.

We are a very rich county. We can fund NHS if we wanted to.
If we lose 2% of GDP is take us back a few years in terms on living standards. Not the end of the world.

Plus once this is over you’ll have a recovery.

Dying however is final.

You can get stuff done even with social distancing ! People are ingenuous.

I seems reasonable that a series of lockdowns might work to flatten out the epidemic and save the NHS from being overwhelmed - lock down until new cases start to fall sufficiently, let them build a bit, then lockdown again..........

If you look at China they just had severe lockdowns where the cases exploded but once you controlled that with a full on lockdown they started phasing out lockdown progressively.

What they do essentially is to keep R0 at around one instead of 2/3.

Much better than going through a cycle of case explosion / lockdown. 

I think Paul Mitchell is a paid troll.

They are happy to share it, not me.....

Ok so it’s not being made public, after all

That is not the plan. The plan is to flatten the curve so the load is spread.

I can well understand you do not like BOJO, that makes us both of the same view, he is incompetent. But the CMO and CSO are in a different class.Seems to me you look at them in the same light as BOJO.

Ask the CSO he has clearly said what I told you, they are making the info publiclly available, they do not want to hide anything.That is a pretty blunt message.

Ok, I understand, I’m just asking where it is published. It doesn’t seem to be.

They are very good experts but they are only experts in their narrow domain and many other equally qualified experts disagree.

Leadership and taking good emergency decisions under uncertainty and incomplete information is a different kind of skillset.

These are the skills you would expect from our politicians unfortunately we have a bunch of ideologues/demagogues/chancers/buffoons.

BoJo and anybody who advocates building herd immunity before the winter should inject themselves with the virus NOW and show some skin in the game.

I'll take the virus now  

I do wonder if they will extend the Easter Holidays - that would be a lot easier to do.

TBH I'd rather get it now while the NHS isn't overloaded too.  Obviously it doesn't work that way though.

Agree with you. Most Uni's finish this weekend. So that is one lot parked out of the way.If they can get to Easter will make sense.

I've explained multiple times I understand and respect their expertise, but they are not specialist epidemiologists on this disease and in being there they are agreeing to support a government message. As such we have no idea what their actual views are or what the more specilist epidemiological advice they do have is. What they say is political, and agreed in advance, not independent expert health advice. The idea the government will release their internal arguments that led to a common position, balancing economics and mortality, is ludicrous.

If the plan is to flatten the curve, no country has done that better given the circumstances they faced than South Korea. To do that they followed WHO advice with no concerns for lockdown boredom nor trying to build any herd immunity (as this risks hundreds of thousands of lives).

"A vaccine is over 12 months away.....by that time the world economy will have collapsed if the current measures carry on or even escalate...like I said it seems we are goosed either way."

Its easy to get carried away with concern but previous pandemics were controlled and the big Eastern economies experienced some of those up close and personal. I'm not convinced this one will keep coming back in huge waves once the initial phase is over; if so there should be indications already in china.  There is no herd immunity for most of the previous pandemics:  they were usually stopped by control measures.

There is lots of talk about people panic in shops etc but thanks to our free markets no one seems to be acting much on shutting down excessive market reactions. These huge market swings suck money out of companies and ordinary investors and place it into the hands of parasites.

As far as I know you have no specialist knowledge of epidemiology, medicine, economics or statistical modelling. If that's correct, I'd suggest a little less dogmatic certainty in your posts might be appropriate. 

Hasnt the US stock market triggered its cool down period at least two times this week?

But surely engineers know everything!!

When was there last a pandemic approaching what we are facing now?

Certainly nothing in my lifetime.....must be the Spanish flu 100 years ago and the world economy is very different now.

You don't come completely out of lockdown in the first place. You come out partially - example - split all the kids in a school into two groups and let each group in on alternate days so there's fewer kids to infect.  You insist restaurants keep people apart more than 6 feet. You keep the vulnerable isolated but let others out etc.  Basically you create just enough interaction to allow the disease to spread, but keeping the amount of new cases matching the amount of recoveries so the volumes don't swamp the healthcare system. Potentially a tricky task if the numbers of people allowed out are tiny compared to the whole population.  It's also why testing needs to be stepped up so that people self-isolating can be tested, proven to have had the virus and be let out again once recovered.  If we don't know who's had it we don't know how much of the population are are risk still.

I'm not sure where the impression has come from that I'm calling for schools or universities to close in particular or that I think the measures we will need to take to break the infection chain are easy cost free choices. There are no good choices here, we need the ones that we can afford which preclude the worst outcomes.

Yes, there should already have been very strong advice on this.

There's no particular reason why students should be a hotbed of infection just waiting to become mobile. Lots of students don't have homes to go to or won't be able to return because of travel restrictions or elderly and infirm people in the family home. For them the safest place probably is at university even once they start making each other ill, they're not an at risk group.

I don't think we have any reason to suspect our mortality rate is going to be at the low end of the spectrum unless we get a serious grip on the infection rate buying time to build and protect our hospital capacity. Yes, that delay is really really expensive and it'll be hard to sell unless we see the consequences of losing control elsewhere. Thing is if we are taking the wrong approach with this soft touch plan and this gets away from us we get to be that salutatory example to others. Many of us die mostly needlessly, by contrast the cost of a more precautionary approach while doubtless very high (by any measure you choose) does not in my opinion compare.

Perhaps they fear the public's wrath will be worse when the infection rate is allowed to climb again after control is restored and stock taken than if they gently wind it back to a manageable rate with selectively imposed restrictions. Fine plan if it works but given the paucity of and the lag in the information we have that seems reckless in the extreme to me.

No doubt there is the risk of unintended consequences with any action, as with inaction of course, but we have a chance right now that we will not get again so cheaply to get the infection rate well under control and to buy time. After that we have a moment of calm to educate, restructure to reduce community transmission and prepare our essential services then we progressively relax restrictions within a feedback loop to manage resources and best protect the vulnerable. Currently it seems we're part of some bizarre laissez faire experiment to see if we'll lead the government to a solution valuing lives over economic activity which I think we will but by which time it could be too late.

As usual I hope I'm being far far too alarmist and cynical.

jk

This is the government's choice, advisers advise. All we know of that relationship until it breaks down is what they tell us and that for now it is not a resigning matter. Everyone may well be fully on board but equally they may be desperately waiting for the penny to drop in government that the British public is not cool with being the guinea pig for laissez faire management of a deadly pandemic.

jk

So maybe thge UK government's strategy is to allow the numbers ill to rise and then hit it really hard at just the right moment to achieve R0 = 1 and stabilse numbers as close as possible to what the NHS can cope with, and so make the epidemic as short as possible without overwhelming the NHS and having more deaths than necessary. If so, it would be a brilliant feat to pull off but, given the unknowns, a probably reckless act of brinkmanship.

Sadly I think you've nailed it. Let's hope the government has too because there is no margin for error.

jk

Maybe...

You hit the Moon at 915 m/sec.

Would You Like Another Game?

MISSING FUNCTION DEFINITION IN LINE 510

A big unknown is when we might get a vaccine.  If there were no prospect of a vaccine, then the above strategy might be close to optimal.        If, however, we were to have a vaccine by October, then clamping down hard until then would likely be better. 

As of 12 March 2020, there have been 2,876 confirmed cases and 61 deaths in France.

As of 13 March 2020, there have been 798 confirmed cases and 10 deaths in the UK.

I'd rather have a buffoonish leader than one who's good at speeches with those figures. The fact is that the UK has some of the lowest numbers of deaths and confirmed cases per capita in the developed world. 

Have you had that first case in your workplace? Has the place been shut down? I expect so since at 17:02 last Friday you wrote:

Rather than "a matter of days" that was over a week ago, what's the news then.

Laissez faire? I do not know where you get that view from. It’s pretty clear cut the plan.

As long as it doesn't go wrong and fail to stabilise numbers at a level the NHS can cope with. But yes, if it works, there are no more deaths than hitting it hard for longer and the economic impact is minimised.

Yes, there would be fewer deaths if it can be prolonged until we have a vaccine, but the economic impact would be much greater.

Because immunity means that the longer the epidemic goes on, fewer people get infected with the same precautions (The precautions necessary to maintain R0=1 initiallly will maintain R0=0.5 once half the population have had the virus and gained immunity), presumably precautions would be gradually eased as immunity increases. I think this is what has been done in China.

All those figures mean is that we are at an earlier stage in our epidemic than France, which could be entirely down to luck or perhaps that we are an island. Most European countries are on a very similar trajectory to Italy, just diferent numbers of days behind. I would have thought the death numbers in the UK were too small to be statistically significant.

I am not sure that stands up to scrutiny.

The NHS will be already completely overwhelmed at circa 50,000 cases, which is only a tiny fraction of the population.

And remember, people who need to be put in ITU often need to stay there for weeks before they can recover.

So at 50,000 cases you need 5000 ITU bed, which is already more than double what’s available, the NHS will be already full up.
 

But with R0 Not controlled your number of cases doubles every 2/3 days. Also, remember that incubation period averages 5 days.
 

So even if you lock down everything just as the NHS is full up, 5 days later you’ve got at least another 5000 coming on top of the 5000 you already have.

It just isn’t an option, any way you look at the numbers you realise there is a reason Italy, Korea, China, etc etc did what they did.

Sure, what do figures mean when we can just go with baseless opinions 

Yep. Shut down. All staff  have been asked to work from home across the whole of the U.K. Announced by CEO this morning. 
Only critical operational staff in some area of technology allowed in the premises.

Obviously you don't lock down everything just as the NHS fills up; you do it earlier at just the right moment (ideally!) so that it fills up just as the rate of admissions equals the rate at which people are discharged. Just as, in a game of chicken, you don't jam the breaks on at the moment you hit the wall; you jam them on at the right moment so that you come to a halt at the instant you hit the wall (ideally).

But as you would have noticed it makes no difference. In any case it’s going to be a a marathon.

So no confirmed case then and given your posting history, I’ll take the alleged shut down with a shovel full of salt unless you’re about to tell us where this 3000 person office is. 

I’m more than happy to reciprocate with who I work for.

Absolutely no idea what your point is. The figures are analagous to two cars without breaks heading for the same wall at 100mph, the only difference being that one car is a few seconds behind the other. Both cars and their occupants are f*cked.

I'm not sure what your point is, but clearly the point during the epidemic at which you go into lockdown is going to affect thje trajectory of the number of cases.

Ha yes absolutely. The evidence is, the earlier the better.

What I am saying is you probably won’t reduce the length of time of the epidemic by going in late, because at the very very start you’ll already be late. 

My point is that your analogy is entirely false. In the case of the UK and Italy, both countries started 31st of January at 2 cases a piece. In terms of your analogy, both cars were at the same starting line, but while the Italians may have accelerated into a wall, the UK's car has taken the scenic route, stopped for a picnic and is currently perusing the wall through a pair of binoculars.

Wow Rom, after our little discussion you're still avoiding all questions you can't answer and instead turning to the support of your little sock puppet army. You're hilarious!

If you go in so late that the epidemic is already over (ie not at all) then obviously the spread will be maximally exponential and eveyone will have been ill as quickly as possible and the epiemic over as early as possible. If on the other hand you go in so hard and early that infections are restricted to a trickle, the epidemic will be very prolonged. So clearly how late you go in effects the length of the epidemic. 

No idea what you mean by this. Nothing probably.......

In the very early stages before the epidemic goes exponential all sorts of random things could affect how long the epidemic takes to get off the ground. My point is that once it has gone exponential the trajectories of most European countries have been remarkably similar to Italy's.

No, the UK's car idled on the starting line for a bit and is now accelerating towards the same wall as Italy. Whether we are too late to put on the brakes will be interesting.

Could've been, Should've been, would've been....and yet they haven't have they.

Another analogy without evidence. Calm down on the fear and the panic and just look at what's happened instead.

https://www.bbc.co.uk/news/uk-51858987

The future may be in the lap of the gods but what's been happening in the UK so far is not the complete disaster that more than a few UKCers keep insisting on.

You are correct, but the point I am trying to convey to you is that even a trickle will overwhelm the NHS.

What I mean is that the size of the infected cohort you need to reach before NHS is overwhelmed is very small, so there is only very marginal gain from not going too early, but huge loss from going only a bit too late. 
 

I hope it makes sense.

I predict we will have 1000 new cases that have been tested positive a day, most likely by the end of next week or early the week after. Incidentally we are probably already seeing atleast that a day now just not tested for, as the government said the actual real figures are 10 to 20 times worse than the published figures.

Most of the cases that test positive will probably be serious as currently we won't test people that don't have specific symptoms and even then most the tests are done when it gets serious or there is known contact with a positive case or travel to specific countries. That's why you see of our closed cases, 38% are deaths and 62% recovered (this mirrors Italy, they have been around this same rate for some time now) https://www.worldometers.info/coronavirus/country/uk/ https://www.worldometers.info/coronavirus/country/italy/ . This pattern will likely continue whilst we don't sample the public randomly and don't try to test all contacts of cases (this is how it works I know from people who know people that are positive). That means about 20 days after we get in to the thousands of new cases a day we will see over a thousand deaths a day for a while, we'll probably be locked down by then and soon after the deaths will start to fall.

I take it by your inability to answer a simple question, as well as a quick Google revealing no 3000 employee building being "shut down", that you're full of crap.

I am totally surprised!

I can just imagine 3 weeks after a lockdown in the U.K. ahead of the curve. “We are bored now , cannot we stop this”. Just about everybody on this forum would be breaking it and be out climbing . 

That we are mirroring Italy is a complete myth. At the risk of repeating myself (to the point where even I'm bored), Italy and the UK both started at the same point; two cases each on the 31st of January, after which the trajectories diverge wildly.

Best estimates currently put us at 10,000 cases, confirmed and unconfirmed. That's one person in 6,800.

At nine this morning I was sat fifteen feet from the horse's mouth (or as close to the horse's mouth as makes no difference) and he was quietly confident that the UK's response is being managed as appropriately as is possible by the NHS, given the resources to hand.

And would that be a high risk activity on outdoor rock? No.

Except maybe on Stanage.

Who do you mean by horse - CMO? 

The executive medical director of one of the UKs largest ambulance services.

Edit:  Board responsibility for all the clinical elements of services and provides professional leadership for the healthcare team. This includes paramedics, nurses, pharmacists, emergency medical technicians and doctors. Research and Development is one of his key Director responsibilities.

Good to hear. 

"That we are mirroring Italy is a complete myth. At the risk of repeating myself (to the point where even I'm bored), Italy and the UK both started at the same point; two cases each on the 31st of January, after which the trajectories diverge wildly."

I'm saying our closed case / fatality rate approximately mirrors Italy of cases that tested positive. 

The virus its self takes a while to get going, but once it is it has it grows very fast in every country in the world until measures are taken. I predicted last week we'd see 100's a day of new cases testing positive and today we are seeing 200. Basically it grows by 10 times in 10 days. You'll see the end of next week or early the week after we'll be seeing 1000's of new cases a day. The reason we know it will grow next week is there is a lag on testing positive, it takes a good while to get ill enough they will test you. Any measures brought in now will take about 10 days to have any effect atall. By that time the positive tests per day will have grown by ten times (as will those which are untested).

"Best estimates currently put us at 10,000 cases, confirmed and unconfirmed. That's one person in 6,800."

Yeah I can do the math, you are repeating me now. I wouldn't be at all surprised if that was an underestimate though by an order of magnitude, but it has little bearing on what I'm saying.

"At nine this morning I was sat fifteen feet from the horse's mouth (or as close to the horse's mouth as makes no difference) and he was quietly confident that the UK's response is being managed as appropriately as is possible by the NHS, given the resources to hand."

That really has no bearing on the points I was making.

If people have a differing opinion on a subject, the degree to which they are directly involved and their sources of information both have significant bearing.

Do you disagree?

I'm NOT saying the UK's response is NOT being managed as appropriately as is possible. It may well be and I hope it is. But we will also see some quite startling numbers of new infections next week (or so) and deaths (2-3 weeks later). We can't avoid that.

I take it that what you say is a central plank of govt calculation here: accept that we will have thousands of deaths in 3-4 weeks, but mitigate what comes after and thus avoid a double spike, leading to fewer deaths in the long run. 

it’s a gamble. Nobody knows yet if it will pay off. But based on the available evidence, much like in poker, it may right now, given the information we have, be the right call, *even if* subsequent events prove it to have been wrong (but which perhaps couldn’t be known now). 

alternatively, the UK gets it right, BoJo is hailed as a Churchillian Leader, and he gets what he wants. He is a gambler after all - I think he is gambling that the UK scientists are right and the short term flak will be irrelevant if his gamble pays off and he collects big a year down the line.  

Yeah I guess that could be it.

I've heard people speak on the radio where all 4 are positive tested a while back too, but only the elderly family member got seriously ill. The other three had something they wouldn't even self isolate now for, no temperature and symptoms less than a cold. There could be a growing mass of asymptomatic / extremely mild cases we just don't know about that now are immune.

See my thread elsewhere - given that we know now China lied about when the outbreak began, I think it has been circulating widely much more and much earlier than was realised, but most people are asymptomatic or have non-hospital level responses, and the surge we are seeing in hospitalisations can be traced back to a much larger reservoir - which (good news) means the fatality rate is lower than it seems because the denominator is much bigger than thought.

however, if 75% of the UK population gets it, 0.1% mortality = 50,000 dead. So we’re still staring down the barrel of a major crisis. 

Also, I suspect it has been a mild flu season and this has masked deaths from Covid19 which NHS and other health services assumed was regular seasonal flu. 

Yes, though "small" is always relative, I agree and, as I said, it does seem to me the government might be gambling on delaying drasic action and keeping below this level when there are a lot of unknowns.

Though those numbers are merely akin to normal flu. 

That would surely have shown up as an artifact in the results of the extensive testing that has been conducted.

Maybe this will help you understand.

https://twitter.com/MarkJHandley?fbclid=IwAR1tn9dL2wyBT9-DRMcEOHLbv4DO3GjOi...

Scroll down for the graphs.

Once it takes off and goes exponential, European countries have all followed the same trajectories. The fact that Italy took off earlier is irrelevant. Of course other countries may avoid Italy's current position by taking action earlier and the trajectories will diverge, but if we don't learn from Italy, we shall end up in the same position.

No because 75% of the population doesn’t lack flu immunity and hence flu doesn’t kill 1% of 75% which is why flu deaths every year aren’t 50,000...

50,000 dead would put it at one person in 1,360, hugely concentrated in the elderly and infirm. The demographic who die day in day out, with little fanfare. The same cohort that our society house in stinking care homes, unvisited and unregarded, year in year out.

...but call it corona, add a sensationalist media that imply we're all at equal risk and all of a sudden every neurotic in the land is out filling their car boots with bog roll and pasta.

No because there hasn’t been extensive testing for C19, it has been concentrated in people who have returned from east Asia or who had contact with those who did. Only c.2000 tests done by end of last week, right? The 10 C19 deaths now recorded could be the artefact of a disease entrenched much earlier but with lower fatality rate than currently estimated. (South Korea has done the most extensive testing, their denominator therefore most accurate we have, their fatality running at 0.6%, FWIW.)

Yes I think that may be right 

If the reports this morning are true - that this broke in early November and the Chinese tried to cover it up - it’s deeply implausible to believe a) that it took 3 months to reach Western Europe and b) that the first detected cases were also the first true cases.

it’s been here a lot longer than we think  

You have no evidence for that have you?

It may be a fact but it’s a largely irrelevant fact.  Facts that matter to me are the exponential growth rate and the estimated ratio of unreported to reported cases.

Even S Korea's closed case death rate is bad. It's obviously broken taking the total that have tested positive as many of those are not resolved yet and were from the time S Korea's figures were exponentially growing.

S Korea has only tested 210,144 people to date which is what 0.4% of the population, that's nothing with as epidemic like this that has a lot of asymptomatic / very mild cases. We don't know Germanys testing (why not?) figures but we do know they have tested a huge amount of people which is why there deaths and serious cases are low and their death rate of closed cases is better. I reckon we are getting more new cases a day than Germany we just don't know about them! In a way serious and deaths are more reliable indicators of how wide the infection is than positive tests.

Absolutely. This article should be essential reading for all those who just don't get it. It explains the hidden iceberg of exponential growth and unreported cases brilliantly:

https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d...

In other words, you'd rather fret about unknowns than take comfort from what we do know. Each to their own I suppose.

The unknowns are known. They are real.  Just like all the tigers in the jungle that you havn't actually seen but which you know are there and that would like to eat you. But you'd rather bury your head in the sand. Each to their own I suppose.

I normally find myself agreeing with you but not here.

Taking comfort in a subset of what we do know is giving utterly false comfort.  Do you disagree with the UK’s chief medical officer?  Yesterday he put the estimate at 10,000 cases in the UK.  That’ll be 13,000 cases today.  

The link Robert Duran posted really is excellent and clear.  We have every reason to believe we know that there are now > 13,000 cases in the UK.  Plans and policy need to consider that, not the number of detected and reported cases.

I’m not fretting and I haven’t been fretting.  For the last 6 weeks I have been planning.  For what little difference it will make.

I read a really interesting and on the face of it very well researched analysis of the effects of different approaches in different countries, and my concern with the UK approach is that the hospital ICUs will be overloaded because we won’t be buffering the transmission. I think this is what has been increasing the mortality rate in some countries. 

Although from now on we won't be able to compare that any more because we have basically (as of yesterday) stopped testing anyone who isn't hospitalised.

Thing is if the whole world locks down at once we will just die in other ways as the herd immunity could take years to gain and more people may die from other causes if we try and lock down for many months / years waiting for a vaccine / treatment.

I think Johnson on the other hand is also betting against not totally ruining the economy. He doesn't want that to fail any more than similar countries. 

It is advantageous to get a lot of people infected in the first wave to the point that the health service can handle it if you want this over and done with as fast as possible.

That’s a full week you’ve been running with this now. 
 

Perhaps you should be telling this chap, it’s maybe not occurred to him- 

https://mobile.twitter.com/CMO_England/status/1238044316762857472?ref_src=t...

Might also be to some extent because people in Romance countries hug and kiss when they meet, and we shake hands *at most*.  And also they tend to eat out more than we do - most British people spend 5 evenings out of 7 sat at home watching the telly anyway.

Put those together, and if neither us nor Italy/France took any action at all, spread would be slower in the UK than in the Romance countries.

What are you planning that's taken 6 weeks?

I don't have the luxury of burying my head in the sand, or indulging in unwarranted hand ringing. Instead I'll be booking extra shifts, cancelling an imminent family holiday in Florida and trying to help.

Yes, I think this is what he is gambling on.

Well, your posts certainly suggest that you are burying your head in the sand, but, if you are doing the right things, I suppose it doesn't matter that you don't understand what is happening.

The spread hasn't been slower (see graph I linked to), once it has got off the ground and gone exponential. My point was that all sorts of chance things might have delayed that happening when numbers are very low. 

in other words, one in 5,230 will have contracted a virus that kills predominantly the elderly and infirm. 

Plans and policy are considering that.

What have you personally got to fret about? Unless you're an 80 year old COPD patient, your chance of dying now is virtually unchanged from what it was 6 months ago.

The problem with that article is it assumes the problem is solved in China / Korea etc, its not they are locked down.

Since it's currently a large part of my job, forgive me if I do think that I have a fair grasp of the situation. I also have a fair grasp of the fact that the current situation has been greatly exacerbated by media sensationalism, social media bed wetting and numpties hoarding essentials that the whole community needs access to in order to get through this crisis as smoothly as possible.

If you're using social media to ramp up the fear then you are definitely part of the problem.

Having the house stocked (by weekly gentle over shopping) so we don’t need to shop for some months, preparing ways to occupy a rambunctious infant once daycare is unavailable, doing as much of the work that needs a physical presence at my workplaces sooner - in particular with a new business I co-founded and that has very testing times ahead.  Getting maintenance done on cars, seeing the physio pre emptily before that’s a bad idea.  Haven’t managed to get my haircut or go to the dentists.  

This hasn’t taken six weeks - but little bits of it have been going on regularly that whole time.

I personally think we could easily have had 100000 cases by now in the UK. If so most of them caught in the last 10 days. Many others could be / have been asymptomatic or very mild.

Great. and what are you basing that 100,000 on?

Yes, fair point, but they have adopted strategies which don't overwhelm their health services. It is a trade off.

I’m sorry.  I think you need to step back and reevaluate yours posts.  You’re escalating this far beyond my observation.  I told you the figures I find informative.  I’m not passing value judgements on who will or won’t die and I’m not “fretting”.  I think your use of some figures for “comfort” is “false comfort”.  

What am I concerned about?  In no particular order

• The remaining elderly relatives we my wife and I have and maximising my chances of being able to help them
• My colleagues who are significantly older than me, or who have asthma or who have other health complaints
• The long evident and massive disruption coming to one of my jobs/roles/employers with knock on consequences to many people at what is already a highly stressful time in their studies.
• Protecting my family at a time when access to medical care for anything is going to be highly fraught
• My new business and it’s employees
• My elderly neighbours
• Everyone else
• Potential civil disorder

they are about 3 x the figure of deaths for flu

never mind, if there isn't an improvement here by monday I'll find out next week whether I'm sharing a bed with a C19 case

could be "exciting"

All that. 

And, honestly, my summer alpine trip (I'm human...) 

There is no excuse for panic buying, but I don't think there is much in the way of sensationalism. On the contrary I think reporting has generally been very factual. You seem to want to hide facts and go into denial yourself.

I have shared a couple of well researched articles. Sorry if that makes me a problem.

F*ck me. Everybody is now a pub epidemiologist.

Here's another well researched article based on WHO data. It's conclusion? 80% of the population is at the top end of predicted rates of infection, of those an estimated 1% mortality and those deaths massively confined to the old and infirm with multiple co-morbidities.

https://www.theguardian.com/world/2020/mar/13/how-many-will-die-of-coronavi...

Personally I don't think my head's in the sand. I think people should get a grip. Put down the shopping trolley and start using social media to organise ways to help out the people that are actually at risk in our communities.

Edit: typo

Weren't you also concerned enough about all those things that you stockpiled food before the Brexit deadline last May?

I'm honestly not meaning to have a go, but I really believe that the truly vulnerable are being greatly harmed by panic buying and fear mongering. I know you built up those stocks gradually but every time someone earnestly informs social media that 'the end is nigh', some one else is convinced to jump in the car and clear the corner shop of bog roll and paracetamol.

Is there a concession stall in here?  For popcorn and the like?

I keep a buffer of non-perishables.  With the silliness over Brexit I expanded that to 3 months - so it's steady state buying ahead of time rather than "panic buying".  It's incredibly useful to have 3 months of stuff in the cupboards - although it does take some organising to all fit - and it decouples us from a lot of stress.

I've seen your concerns elsewhere about the effect of panic buying in the vulnerable and I agree it's counter productive at the societal level (actually driving spread of the virus for example) and for individuals (for obvious reasons).

Both with Brexit and with this I expanded the buffer of non-perishables well in advance of any panic buying and do so gradually.  This time we put a lot of milk and meat away in the deep freezer as well > 3 weeks ago.  If more people did this it would reduce the panic buying pressure rather than worsen it.  It also means we won't be an unwitting mobile disease vector pushing a trolley around a shop any time soon.

In terms of fear mongering I have seen very little.  I see a lot of lowballed figures and a lot of people quite happily saying "It's no worse than flu" and other than on UKC I leave them to their cosy world view.  I also know a couple of volunteer medically trained people being called up and I can read the stories coming out of Italy.  I work with many scientists including bioscientists and I've never seen so many quite people and ashen faces.   I know  the steps some of these people are taking to prepare.

It's at the core of human nature.  Have you ever watched a 2 year old stuffing their pockets with conkers till they can't walk?  Better to help people feel secure through being secure.  

But keeping death rates down and avoiding ending up like parts of Italy means facing facts and acting on them. You have said you would rather not think about facts but instead take comfort from ignoring them. Fortunately others will face facts, or sensationalism as you seem to prefer to call them, and hopefully take the action required.

So I think they have drawn the same conclusion as I have, they just aren’t spelling it out loud because what’s the point. 

I’m not trying to say I’m the only person who sees The Truth. That would be stupid. I’m just trying to make sense of the facts as we have them, and you making a snarky remark doesn’t do much to show that my reasoning is false. 

Abnsolutely. Clueless about spreadsheets and excel but I spent a wet day last weekend writing down and trying to solve differential equations to model an epidemic with immunity. Having failed to solve them I googled the subject and was pleased to find I'd come up with the standard model and that the equations don't in fact have elementary solutions.

So now you have the inside track to the thoughts of the Chief medical officer too? That you and Chris Whitty have seen The Truth, but that he’s keeping quiet about it? 
 

the coronavirus was spotted by doctors in Wuhan noting clusters of atypical pneumonia cases. If it had been in the UK for months, there would have been evidence like this. The epidemiologists are working on models which from what is being passed on to us assume the first cases were the York ones. Either they are creating a false impression for some reason to hide the truth from us; or they are wrong; or you are wrong. 

That's a deliberate misrepresentation verging on Rom-esque proportions. This is what I actually wrote:

In other words, you'd rather fret about unknowns than take comfort from what we do know.

and when you say "But keeping death rates down and avoiding ending up like parts of Italy means facing facts and acting on them." What does that actually mean in your own life? What actions are you taking so we don't end up like Italy?

Wow you're a sociopath! Many of these people are our elderly parents or aunts and uncles!

maybe explain the tables at the bottom of this article, or Italy's leading surgeon saying young people are dying too.

https://www.theguardian.com/world/2020/mar/13/how-many-will-die-of-coronavi...

I don't think it is a misrepresentation at all. The "unknowns" are all the cases undiagnosed which we know are out there and which dwarf the diagnosed cases. So there is only comfort in the much lower number of diagnosed cases if you choose to bury your head in the sand and ignore them.

I meant the actions of government which would then obviously affect my own actions.

Exactly right only thing that matter is your doubling rate, difference in numbers are quite irrelevant, it just means we are a few doubling behind. It can be caused by tiny differences in the number of undetected cases at the very start, as it is a multiplicative process.

I’m not sure how you can say that. If you look at the trend of active cases for Italy on the worldometer site you can go back day by day and see their increases. You’ll see that two weeks ago they were at about 600 and it jumped by about 220 the following day. Same as yesterday for us.

 https://www.worldometers.info/coronavirus/country/italy/

Of course it was a misrepresentation. Nowhere have I said anything like "You have said you would rather not think about facts but instead take comfort from ignoring them" ...that's just an outright lie. 

Right, so you're not actually "facing facts and acting on them", you're just another Karen typing on her keyboard but actually doing f*ck all. Meanwhile you're quite happy to misrepresent me and tell me I'm burying my head in the sand when I'm wading through the consequences day in, day out. 

Many of the per-country semilog plots sort of lurch a bit at the start into the exponential stage suggestive of initial under measurement - not surprising perhaps.  I’m skeptical of any claims based on data from the earliest phase.

This is the government theory (or excuse) but frankly, don’t believe it one sec. This hasn’t happened elsewhere where they imposed lockdowns either. Besides, there are many things you can do  outdoors without mixing with other people, including climbing !

Yeah people keep showing me stuff like that. Either me or them don't understand what 'mirroring' means. I'm pretty sure if the time lines for UK and Italy from 31/1/20 to 13/3/20 go...

2 cases..............798 cases

2 cases...............17,660 cases

That's not mirroring. Unless yours came out of a funhouse.

Edit: very weird mirror. A link that doesn't appear to reflect the UK at all

What building was it that was shut down again Rom? Maybe ask one of the sock puppets. And while we're here Rom, for the third time of asking, how did your profile age jump from 37 to 51 overnight? After all, if you cant be trusted to get your own age right, what credence should we place in any other spurious figures you come up with?

If this were not so sad it would be funny. I said by next week... and it took a day.

https://www.theguardian.com/world/2020/mar/13/uk-to-ban-mass-gatherings-in-...

Plus WHO express concerns about the herd immunity approach...

https://www.theguardian.com/world/2020/mar/13/herd-immunity-will-the-uks-co...

As I posted to jkarran above, I'm in South Korea right now, I flew here from Heathrow a week ago. Before I left my friends/ family were looking at me as though I was mad (two of them hinted it too). There aren't too many people in the streets here, and they're all wearing a mask at all times. Most restaurants are closed though we ate in one which had a few customers

But now I'm wondering if I'm in a good location at the moment after all

Good luck to all wherever you are, stay safe, and I hope this thing gets under control

PS Offwidth, thanks for your sensible and helpful replies to me on this thread

Spotted in Wuhan when? If reports are true, early as November. Fatalities didn’t mount up to non-ignorable calamity levels until...January. Three months. 

It is now March. Which is three months after January. So what you are saying about the doctors in Wuhan actually fits with what I’m saying. 

There is an obvious reason not to bother saying “oh yeah it’s probably been here for longer than we thought and lots more people probably have it already”, because have you seen what people have done to the local Sainsbury’s anyway? 

It’s not a conspiracy - it just isn’t worth bothering with from the POV of people trying to deal with the crisis right? And whether I’m right or wrong, the crisis that is about to hit is now inevitable either way.

But I guess for that reason I take your point and I’ll shut up now. 

But the undetected cases are facts. So by taking comfort from the low number of detected cases and not dwelling on the unknowns you are ignoring facts. 

I've no idea what you are actually doing. I am simply commenting on your lack of understanding of the facts as shown by your comments on here.

You don't understand the mirroring we are talking about.

It has been clearly explained to you that it is the exponential phase which mirrors Italy. The UK and other countries very closely mirror Italy from the time cases started increasing quickly up to their present level. It really isn't all that hard to understand. Did you look at the graph I linked?

Sorry if you find me  taking an interest in the current pandemic objectionable. I suggest you ignore the thread - very easy to do. 

Fact: A thing that is know or that is proven to be true. You disagree with that definition? Would you like to quote where I've said anything to justify you writing "You have said you would rather not think about facts but instead take comfort from ignoring them". If you can't come up with a quote then please stop reinforcing your lies.

I work as an NHS paramedic. I'm receiving direct covid 19 updates on a daily basis. Yesterday I was part of a group that received a briefing from the Doctor who is the clinical lead in our Trust (our ambulance service covers a region with a population of 7,000,000). I'm seeing the consequences of panic in homes and hospitals every shift I work. 

I haven't got my head in the sand. I'm not denying any facts. What I'm trying to do is to reinforce that speculating about worst case scenarios is ramping up the fear. At the moment fear alone is clearing supermarket shelves and swamping 111 and GP surgeries with needless enquiries. Fear is currently having a greater impact on our ability to cope than covid 19.

Regardless of details, we clearly going to have very large numbers of ill people soon and probably for several months. Do you get the impression the NHS is planning for this as best is possible? 

Do you not concede that perhaps we were better at containment and contact tracing for the first few weeks before the virus took hold?

Yes, I understand the mirroring you're talking about. It involves totally ignoring most of the early trajectory of the virus spread. It involves ignoring that Italy and the UK started January 31st with 2 cases each. It involves ignoring the fact that UK cases actually overtook Italian cases early on before falling behind dramatically. It involves ignoring that the geographic spread between the two countries is completely different, with the vast majority of Italy's cases concentrated in the North, while the UK's cases are pretty evenly dispersed. It also requires that we retard the UK's epidemiological clock by weeks to get a partial curve fit.

In short, it's a bit like saying "my appearance exactly mirrors the scruffy lad out of One Direction....if you wind the clock back 20 years and ignore 60% of what I actually look like".

So you don't think the undetected cases are facts?

You quoted it yourself! 

Well for a start you are denying that the UK's exponential phase is mirroring Italy.

It is a tricky balance though. Fear causing panic buying is bad, but putting heads in the sand is more likely to result in ending up with something like the worst case scenario.

I concede that we have different strategies, procedures and systems than Italy. I concede that we aren't Italy. I concede that the vastly different rate of spread bears this out.

An undetected case isn't a fact. If you have a high temp and a cough it isn't "a fact" that you have corona...It's called speculation.

No I didn't. and you cant find a quote where I did.

It is spreading at the same exponential rate with a time lag of about 13.5 days.

Your comments on the time lag from 2 cases to hundreds are not valid.  2 cases were imported and it took a different amount of time for imported cases to “go native” in each country.  Now that they have, local transmission is leading to an early phase exponential rise in each country with very similar doubling periods.  

Did your briefing discuss spread rate. Would the UK not expect a faster rate once things get going as the "seeds" are more dispersed than Italy? 

That's great. If you ignore (as you have) everything else I've written, including the rather important point, that our number of cases actually overtook Italy's in the early stages.

Good, so you now accept we are talking about the exponential phase and that they closely mirror each other? And that once they start, particular circumstances or chance events that delayed it for longer in the UK are no longer very relevant?

There could be many reasons for that which are not relevant to the exponential phase.

If you want to continue this discussion, either apologise for misrepresenting me or come up with a quote to back up your assertion:  "You have said you would rather not think about facts but instead take comfort from ignoring them".

You quoted it yourself at 22.41 last night. The unknown, undetected cases are facts. 

I am not overlooking anything although I am keeping my reply narrow and focused on what I consider the core difference in opinion/understanding. The “early stages” are sporadic cases of imported and then detected disease.  Differences in those phases tell us basically nothing about the exponential growth phase.  It’s the exponential growth phase that drives the infections that will kill the majority of people.  In that we clearly are following the same behaviour as Italy with a 13.5 day lag.  If we fall of the same cliff as Italy, what does it matter how each of us came to be at the cliff top?  Especially as the pre-exponential phase is a period of very poor information and the numbers you keep citing are widely recognised to have a serious underestimation from the case on the ground.  

Italy March 1st: 34 deaths, 1694 confirmed cases

UK March 14th: 11 deaths, 798 confirmed case 

Different numbers, different geographic spread, different demographics, different healthcare system, different containment strategy.

What I'm seeing is lots of people on social media, taking the worst hit country in Europe (by a considerable margin), and going "wooo, we're just like Italy".

Great way to ramp up the fear.