In reply to Offwidth:
> Give me your odds on the next assessment of R for England as being below 0.8 to 1.0. When was the last time it wasn't close to 1.0?
I think we've been pretty clear for a long time that the "R" measurement both lags reality by a lot and is one of the least useful data outputs, for two different reasons.
Reason 1 - Wide Error Bars.
The assumptions made in translating from concrete measures of "live" infection (ONS) or "new" detected infection (P1+P2) to an estimate of the R number introduce such wide errorbars as to make the results basically useless for understanding.
Reason 2 - We don't expect R<1 in the end
Stepping back, if we move to endemic Covid, we don't expect the endpoint to be R<1 - we expect it to be R≈1, with a time-variant pattern moving between periods of R>1 and R<1 due to bunching effects of the weather, school terms, major events and seasonality.
If you're expecting a true measure of R to be consistently less than 1 you're looking for a unicorn at this point.
What matters is that rising immunity levels in the population (from all sources) manifest in a decrease in the number of cases causing illness, which if achieved will manifest to a great degree in the reduction of hospitalisation and death rates, and to a smaller degree in the reduction of symptomatic case rates, and not at all in the rates of true infection.
As we settle down to an endemic situation, the absolute case rate is going to look like (total population) / (mean time between re-infection), wildly estimating this for England, it's going to look like ROM 20,000 to 100,000 true infections (not detected cases) / day on average, much less in summer, much more in winter. But very few of these would hopefully meet the current gating criteria for going for a PCR test and almost none would be hospitalising people.
Currently...
Back in the grounded world...
- What are PCR detected cases doing now? Falling.
- What are hospitalisations doing now? Falling.
- What are deaths doing now? Falling.
It remains to be seen if all these falling will endure, but it seems to me that as the situation evolves, so does our thinking about which measures actually matter.
Edit:
> Give me your odds on the next assessment of R for England as being below 0.8 to 1.0.
Surely 0.8 to 1.0 means falling.... So why are you asking for below that? Not that I'm interested in the official estimates of the R number very much for reasons explained above.
Edit to your edit made after my reply:
> This is why a reduction in R is more important for other medical emergencies than it is for covid. The NHS desperately needs reduced pressure:
Yes, this situation has had much discussion lately and it’s good to see it finally as headline news coverage.
Reducing Covid’s contribution to the far wider pressures on healthcare doesn’t need R<1, it needs hospital admissions falling. Which mercifully they are. Forcing R<1 through more control measures is one way of reducing Covid’s contribution in the short term. The data for Europe makes it clear IMO that that approach is not sustainable with delta and seasonality.
Off topic but the problems hammering the NHS are not going to go away I think even if covid did; certainly not going in to a winter flu season. Really worrying times ahead.
Post edited at 14:00