UKH

It looks like we're sleepwalking into Herd Immunity, now that there is 1/160 people having Covid-19 (in England at least). Although, probably more like 1/100 or something like that.

The government thinks it has a deck of cards to play with by playing with different lockdown strategies, when in fact it doesn't, and the virus is going to have the final say on how all this is coming to a head and an end ?

It feels like they've lost the oars to the boat (even though they won't admit that) and really we're at the mercy of the current ?

L

With infections nearly doubling on average across the UK every week, despite the local lockdowns, it will take no more than 2 weeks to realise the current strategy is going to be a disaster and force a rapid U turn. Those 2 weeks on top of the 3 weeks since the SAGE short lockdown advice will have cost over an order of magnitude increase in deaths and significantly more economic disruption than if we had followed the SAGE recommended circuit breaker.

I think we've missed any chance to stop the virus or even slow it down much. It's exponential now and we're all going to get it, it was always going to be 'let it rip' in the end as we wasted Jan, Feb and most of March pretending it would magically stay in the East and not trouble us as that kind of thing just doesn't happen over here. 

Complete nonsense, a lockdown would stop it this time just like it did last time. Even in London only about 17% have had it. After another 17% in any area will mean some hospitals will be 'on their knees' again and most people in the risk groups with a brain will be isolating as much as they can. There is no certainty herd immunity applies in the case of this virus, so even some of those numbers could be infected again (quite a few reported cases had second time infections having much worse outcomes). The only solution that prevents local collapse of the NHS is a general lockdown or a much more extensive (than Tier 3 rules) regional lockdowns with no travel in or out unless for good reasons.

We didn't stop it though did we? We unlocked and it came back. What's the long term plan? I'm not saying 'let it rip' or being anti lockdown as such but what is the endgame? Do you really think most of us aren't going to catch it? The UK has such little hospital capacity (the NHS can't cope with a normal winter) that we would have to have pretty crippling restrictions for months on end to keep hospitals working. And hospitals did fail during the first lockdown because so much non-covid stuff was halted. If you lockdown too much then unemployment and poverty will kill as many as the virus over the next few decades. 

P.S. re-infection seems very rare thankfully. I'm not one of the anti-mask 'let it rip' brigade but what is the endgame? Aiming for zero-covid has a cost to lives elsewhere so it is a tricky optimisation to really 'save lives'.

P.P.S. if you don't lockdown enough then the economy crashes anyway so we're stuffed either way. Hence my original point of us blowing our only chance to save the situation by ignoring the virus and having such a normality bias in Jan, Feb and March. Lockdown didn't stop the virus in spring it just bought us time (at a cost of 20% of GDP, which will kill people), but what do we want to buy more time for have we not prepared?  Either way I think it's too late to stop it or have that much effect on the timing.

Nobody knows yet if naturally acquired herd immunity is actually achievable.

They're not missing oars, they're missing conviction and clarity of purpose.  They're driven by A/B testing the popularity of proposed policy changes through media "leaks" rather than by the strength of their conviction in doing what is right and explaining clearly to the public why it is right, and why it is in the best interests of everyone.

Government is playing policy chicken with the virus.

They'll swerve.  After delaying the inevitable to the point that perhaps 2x as many deaths are locked in as could have been, along with far more human misery in the staff and patients of medical facilities.

Again.

The end game is widespread effective vaccination.

Things before then that could be game-changing:

- Enough of a good vaccine to use on people who are more vulnerable (old, or with complicating conditions), or those more likely to spread the disease (e.g. paramedics, hospital staff, public transport workers).

- A good supply of a less effective vaccine, letting us reduce the spreading rate significantly.

- Better treatment reducing the death rate and ongoing debilitation.

Reinfection seeming rare at the moment is good news - but if it turns out that's just because immunity mostly lasts 6-12 months, we can't get herd immunity without vaccination.

So we have to limit damage in the meantime. That can't mean full lockdown for long, as you're right, that's very damaging - but it also can't mean letting it rip, as that would result in massive economic and social damage too, on top of the unnecessary death and debilitation.

I share your frustration, but there probably is a path out of this - it's just going to be rubbish on the way. And for some time after, probably.

The problem is that your ways out rely on being lucky. Anti-viral drugs are very rare and hard to discover. Treatments may or may not be found. The record for the fastest ever vaccine development is 4 years. Unemployment and poverty do kill people. These are linear risks rather than multiplicative ones like a virus but there does come a point where the former is worse for life expectancy especially when quality life-years are considered rather than number of deaths.

I'm not actually proposing anything as I have no idea what to do now but I don't think we can stop it or have much control over it now, I see it as a runaway train and if the next few months are terrible then at least the virus may have burned out by spring. Re-infection would have to be really quite common for herd immunity not to happen. 

P.S. just because antibodies fade after a few months doesn't mean immunity does. You can be immune to things you caught years ago despite antibodies having long. You have memory cells in your immune system which can see the virus and make the antibodies immediately rather than waiting for your immune system to figure out what to do.

Not particularly, there has never been this much resource thrown at something like this before, solutions will be found. How long it will take to be ready for large scale deployment is a real question, though.

I've been checking this now and then, progress is happening:

https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracke...

Now that's really relying on luck. There are several less dangerous coronaviruses in constant circulation, reinfecting people every couple of years or so and usually resulting in them getting 'the cold'.

I didn't mention antibodies - and I certainly don't know a huge amount about how immunity works, but I do know that it fades fairly rapidly for many diseases, including close relatives of this one.

We were told back in the summer that face masks were a useful tool in the fight against Covid. Countries across Europe have been clamouring to impress with how strict their face mask rules are, probably a couple of billion has been spent on them, and several hundred million of them will end up in the sea, and what for - in the light of CV surges across Europe they appear to be having all the effect that a sticking plaster would of over the bow of the titanic...

(ps pissed off, went for a run at lunch through the countryside and came across three disposable masks separately floating around in farmers fields in places where they would quickly enter rivers)

Indeed it would.

The long-term outcome of the circuit breaker is another matter though. According To Karl Friston, one of the Independent SAGE group members, a circuit breaker effected now would only reduce deaths over the long term given a more effective test and trace system, which I haven't heard any proposals for.

With an increasing number of people ignoring the guidelines now, and an increasingly frustrated less compliant public, I'm not entirely sure a complete 'lockdown' would be complied with.

So our fate is in our hands.

Our fate is in fates hands and I’m a very good friend of hers if you know what I mean?

My assumption is that the problem with the mask rule is that it stops pubs and cafes functioning, so everywhere has rules which allow them to be removed when seated. This is useless as aerosol travels around the facility. There are also parties happening (illegally), just like here.

I think masks are effective, if used! When they stop actually being used, they stop working!

You'd think £12bn would have procured a genuinely world-beating system, as opposed to an utterly useless excuse for a system that was nonetheless falsely touted (and widely reported as such by sycophant newspaper editors) as world-beating.

Does anybody really think the current measures will have any long term benefit unless a vaccine or effective treatment suddenly and magically appears?

Not that current measures to reduce infection are necessarily wrong to implement, but it does seem like a pretty futile gesture (and potentially a very expensive precedent) in the longer term if there's absolutely no plan for what comes afterwards.

I agree most of us will get it but not for the reasons you do. We know we can reduce it to a manageable state if we're willing to pay. We know we can keep growth low if we're willing to pay. We have some cause to believe we're less than a year from a vaccination program so the end game, for now, is to get there.

My fear, after a long hard slog and with such a weak populist government is we collectively lose our shit long before vaccination hits critical mass simply on the news of the program starting, especially so if it's a slow two step process and delivery is hampered by ongoing infection. 

Jk

The problem is for a large proportion of society life revolves around either shopping, eating or drinking alcohol. They aren't normal like us, they aren't capable of filling their time with activities that keep contact with other humans to a minimum. 

It would if there was the will to ensure it was. So far there has been no carrot or stick required but both are still available.

Jk

They told us the same  here in the Czechia. When they reitroduced mandatory face masks again in the begining ot September they claimed it would reduce the R number from 1,4 to 0,9. The real effect was zero reduction of the R numer. They imposed partial lockdown on us then and the result is the R number - 1,4 already..

Hoping for a working vaccination programme.

In the meantime society has to learn how to get to this state with minimal losses. In my view the boundary conditions are that it is unacceptable to collapse the healthcare system and also that a zero-covid strategy is unobtainable, therefore there will be more covid-deaths. So I would use "lockdowns" to prevent collapse of the healthcare system as a last resort (the German version, so enforced social distancing as opposed to staying homebound), but I am sceptical about going into lockdown early. Because once you go into lockdown you stop learning how to deal with the virus in other ways.

PS. And vaccination is going to come with problems as well. It will take a lot of time to produce enough vaccines for everybody. So the vulnerable + care workers should get it first. Once they are safe, are we going to do another lockdown to prevent the rest of the population from the virus?

Nowhere near it. With between 20,000 and 60,000 deaths at a widely accepted 0.3% IFR we’ve had between 6m and 12m infections. Not even 1/10th to 1/20th of the way through. 
 

At the peak we had between 100k and 300k infections a day. They’re claiming around 60k a day at the moment. 
 

The NHS can’t cope with the throughput required for herd immunity. 

It's quite possible you have the worst behind.  There probably is some prior immunity to the virus, thanks to the exposure to other coronaviruses anf the number of people in Britain already infected can be quite high

The number of new cases in some of the worst affected places is already declining

https://coronavirus.data.gov.uk/cases?areaType=ltla&areaName=Manchester

Some very interesting things happening.
 

That could be down to people altering behaviour without being forced to. 
 

This. What's failed the UK is national attitude. I think the UK self-sabotages faster than it progresses, in a Zeon's paradox sort of way; the areas where masks work are sabotaged by people proving the point by not using them, lock downs are nullified by surge-buying and celebrations, the moment a vaccine is announced people will throw caution away and the supplies won't keep up with demand.

The UK has found a point of sustainable stupidity where it's a bit better than the truly bad places and with that it's collectively satisfied to stumble forward, expecting a hopeless government to eventually randomly pick a functioning response. It's kind of a British tradition for most things.

'Herd Immunity' is a useful meme that nicely balances enough apathy, hope, fear and  irresponsibility to suit most people regardless how much proof there is behind it. To the degree I believe it's the only option on the table, vaccine or not. Revisionist hindsight I think is already starting to give the meme credit.

Masks clogging the waterways is not a mask problem it's a people problem and not a reason to not use them.

The 'it' I was refering to was large scale infection due to runaway exponential growth. The virus may never go away but with time treatments and vaccines will likely have improved enough to make its population impact much less serious. Until that happens we cant live anything close to normal without reducing infection numbers fast when R starts to exceeds 1. The more we delay in an exponential growth phase the more economic damage we will face and the more deaths (and long covid) and the more disruption we will face to the treatment of other serious conditions in hospitals. That is the mainstream science and the mainstream economic link to that science. This government is f*cking up for the second time on this and has burnt 12 billion on a failing track and trace system (something neccesary to deal with the virus), run by their incompetent cronies, when if we had provided half that money to local public health teams we would have a viable system by now.

​​​​​​When you can't eliminate a virus from a population the 'game' is quite simply to buy time using control measures until newly developed medical help is available. Life in the UK over the summer wasn't so bad. However as soon as we knew the effective R number exceeded 1 in early September, restrictions should have kicked in. We also sadly wasted months on an incredibly expensive and faulty track and trace system and desperately need a functioning process. Once the virus is under control again following a new lockdown, if people don't meet unnecessarily indoors, socially distance, wash hands regularly, wear masks where in closer proximity indoors there is no reason why we wont have many more months without a new runaway outbreak.

I somewhat agree with that but the idiots who ignore pandemic prevention measures can do much less damage in lockdowns; they are mainly restricted to covertly risking the lives and health of their local friends and family. Its why I think Tier 3 controls can probably never work but what Wales and Scotland are doing probably will. It's also why Andy Burnham's call and the Labour calls for a national circuit breaker are the right ones, irrespective of party politics.

I'd add the summer clearly evidenced that the influence of idiots was less than some worried it might be. R stayed below 1 for several months despite that obvious widespread bad behaviour.

Phase 3 trial results are due out in the next couple of weeks. Then the EU will push for accelerated acceptance of the vaccine. 
 

We are also saving 1/3rd of the lives we were losing before with less severe ventilation and better use of steroids. 
 

In addition, the current infection levels are much lower than they were in March when we were testing only people admitted to hospital. The actual infection rate was probably as high as 100-200,000 a day back then. 
 

The  government know this, there’s no need to panic.

https://www.bbc.co.uk/news/health-54568926

This.  What we need is a system where some clear, objective parameters about cases per 100K population in defined regions, and/or R number and/or hospital occupancy which trigger a defined level of restrictions.

Oh, wait, didn't we have that in place earlier in the year - when although we hadn't actually reached the agreed levels, Boris declared us to at Tier 3.5 or something and loosened the restrictions anyway?

Dsspite the poor testing data from March/April  you can work the numbers backwards... with an IFR between 0.5% and 1%, and peak deaths at over a thousand a day (the much more accurate ONS numbers) your stated infection numbers are very close. 

1/3 less of mostly preventable death isn't good in any respect. Pretty much everyone who ends up on a ventilator has permanent lung damage from the Dutch study.

So while I agree there is indeed no need to panic, there are very real reasons for serious concerns. Our government actions are going to lead to thousands more unnecessary deaths and disability as they didn't put the brakes on early enough and because they gave that 12 billion to their cronies for a (neccesary) test and trace that just isn't working.

I mistyped that. It’s a 1/3rd of the deaths not reduced by a 1/3rd, and it looks like we aren’t putting people on ventilators just using oxygen. So that lung damage is prevented.  

You are wrong in that speculation. Those changes in numbers almost certainly represent outbreaks in student populations where strict action is being taken and is starting to have an effect. Sadly there is an inevitable 'leak' into the general population evidenced from the exponential increases in hospital admissions of older people and changes in the infection maps with time. 

These are the Nottingham Uni numbers and the map of infection in Nottingham showing the highest infection levels where the students live. This started as a student outbreak in my city but it won't end there.

The time graph of infections at Nottingham Uni:

https://www.nottinghampost.com/news/nottingham-news/graph-shows-changes-num...

Weekly numbers for Nottingham and related maps here:

https://www.nottinghamcity.gov.uk/coronavirus-covid-19/covid-19-surveillanc...

The latest numbers and map:

http://documents.nottinghamcity.gov.uk/download/8759

The same argument applies, 2/3rds reduction of mostly preventable deaths is no reason to celebrate. I don't believe that number will hold up as hospitals get closer to capacity limits and as infection rates in the older population keep increasing.

580 currently on mechanical ventilation (with exponential growth)

https://coronavirus.data.gov.uk/healthcare

Satire struggles to exceed harsh reality:

https://www.theguardian.com/commentisfree/2020/oct/16/conservatives-party-b...

You have to balance all this with the economy. 
 

The divisions in Manchester aren’t about whether to lock down or not. They’re about the money. It’s deeply political. London has agreed but only because Boris has agreed to hold off the TFL funding withdrawal for another two weeks for talks. 

That is a completely illusory balance other than for initial up front costs. Jeremy Farrar from SAGE and the Welcome Trust has been very clear on that. The later you wait for an obvious lockdown requirement the longer it takes to return to levels low enough to release it and the more economic damage occurs. He thinks currently schools could still stay open in a short circuit breaker national lockdown but not if we wait much longer. The economic damage and deaths if we wait so long that hospitals start to fail will make the earlier lockdown damage look tame.

You are right that Manchester is about money. Tier 3 is barely different from Tier 2 in effective braking capacity on the spread of covid but the local economic damage of Tier 3 could be incredibly serious without extra support and the effect on the working poor who's jobs are affected (at 2/3rds minimum wage at best, or no employer linked income for many) will be very serious, due to failings in an already seriously overstretched Universal Credit system efficiency and effectiveness. Tier 3 seems to me to be almost designed for maximum economic damage for any gain in fighting this pandemic.

I think you are wrong

Firstly I want to state that I am not at all in favor of a let if rip approach , I think there is a good possibility of a vaccine in the next 6 months and  therefore to give up on all of these lives would be an evil madness.   However I don’t believe that a let it rip approach would destroy society and the NHS anything like some posters on here seem to suggest.  

Herd immunity will stop the virus at 70% infected i.e 45,000,000 infected in the uk.

0.3% of 45,000,000 = 150,000 dead in the U.K  

43,000 have already died in the U.K so we have 110,000 deaths still to come.

43,000 deaths at 0.3% IFRwould suggest 14,000,000 infected i.e  22%  of uk already infected

The rate that deaths are currently increasing and by looking at other European countries it would seem  we are about a month away from reaching the sort of hospitalisations and deaths that we saw in April.     By the time hospital capacity starts to approach these levels it looks like we will  already have infected around 30% of the population.   That effectively means that the virus will be 30% less infectious than it was in April,  this will make limiting  spread much much easier, on top of this I think hospitals will cope better this time around and with emergency hospitals we could probably somewhat cope with around 1500 deaths a day

If you have people dying at around 1000-1500 a day it would take 2- 3 months for us to reach herd immunity. 

Again it is important to remember the more people that have been infected the easier it is to control the virus, 6 weeks ago i was trying to convince m.r Wintertree that New York, New Jersey, Connecticut, and Massachusetts (places which had highest death rates in the world ) were benefiting from herd immunity and not seeing a second wave,  look at them now, they are still not seeing second waves whatsoever.  go and look at most countries with the highest death rates per million, Chille, Bolivia, Peru spain, they all are seeing mass declines or plateauing deaths and cases, (admittedly Belgium is an exception here). 

I know this is totally grim and I want to state again I am not at all in favor of let it rip.  Three months of Deaths like we had in April would be a national disaster unlike we have seen but it wouldn’t bring society to it’s knees, I think most people could carry on as normal.

I would be interested to hear peoples responses to a hypothetical situation in which we know with 100% certainty that there is no vaccine coming, how would this chage peoples approaches? 

I think with no vaccine our best bet would be to infect as quickly as possible, this has two advantages, 1 it is easier to shield the vulnerable, if you know it will be over in 2 months, you can take extreme measures and not leave your house, or have carers who cant leave nursing homes. 2. you have a better chance of maintaining your immunity because everybody will become immune at the same time and therefore you will cut the virus off in ints tracks rather than dragging it out over a year and having many people loose their immunty and get reinfected

The fallout would be horrific and it would not be over in 2 months....

As I said at the time, if anywhere was close to that point it’s NY and surrounding areas.

However it remains an argument for which you have present no compelling evidence what so ever beyond that observation.  A counter observation from a biological scientist turned teacher on the ground there with - I believe - an MD as a partner - is that people are following the rules over there far more, because of how bad it was.

We know that following the rules can hold a stable baseline of cases, it was in the UK until mid August.

You argument was - if I recall - that there must be herd immunity because the baseline rate was low.  As I said then, and as I repeat now, increasing the fraction of people with immunity lowers R.  R sets how fast cases rise or fall in terms of doubling rates.  That immune fraction is absolutely not represented in a stable baseline number.  As stable baseline number indicates R is about 1, and “remembers” the level of cases that were around when R was first lowered to about 1.  Your inference was based on a flawed understanding of the maths.

You could be right, I could be wrong but with what I see and understand it would be foolish to jump to any conclusions.  

I don’t know what fraction of SUNY students come from the state - most I imagine (?)- but there scale of the recent outbreak there suggests no effective herd immunity.  

I agree.

I think you've failed to imagine what the reality of "let it rip" would be like. Infections go up, hospital admissions go up, deaths go up ("shielding the vulnerable" is completely impossible because they need carers - community infection = infection of vulnerable). Everyone gets terrified and locks themselves in at home. Economic devastation, cases start to go back down slowly, herd immunity nowhere near achieved. It's an incredibly shit idea.

It would bring society to its knees because you are ignoring a number of factors. 
 

1000-1500 people dying a day represents 21,000 - 31,000 in hospital waiting to die. They don’t come in and die the next day. 
it represents 61,000-91,000 on ventilators 2/3 of them will recover. It represents 300,000 - 450,000 in hospital on oxygen. 
 

With that many people in hospital we won’t be able to treat them and the death rate will soar. We also won’t be able to treat anything else. Have a car crash and you’ll probably die. 
 

Also that 60-70% of those 45m people all have to have two weeks of work with a nasty virus that incapacitates them. All in the same 3 months. 

Why lockdown a small Cornish village when the virus is in Manchester? 

•  If it turns out to be achievable then it’s hard decision time - total eradication or naturally acquired herd immunity?  In the mean time I’d see how many herd immunity advocates would participate in an experiment to optimise the protocols for infecting people with the live virus under controlled conditions to allow “focused infection” to be carried out during the following year rather than the unrealisable “focused protection” of the weak, to avoid the carnage of a “let it rip” approach.   Plenty of people are so vocal for naturally acquired herd immunity that there should be no shortage of volunteers. 
• If it turns out that sufficiently persistent, naturally acquired immunity is not possible, well, we’ve had another year of optimising our way of living and quality of life vs transmission risk and we’ll just have to work the problem as it stands.  Perhaps we’d end up with immunity fading and being gained at similar rates and a 2x as lethal winter respiratory season, perhaps we’d end up with people getting weaker with each reinfection.

I think the chances of no vaccine emerging soon enough are so slim that I find myself pondering why it gets so much air time.

IFR seems to be a lot higher in the UK currently; CFR is about 1% (with a 14 day lag from infection to death), and ONS random sampling cases are about 2x detected cases suggesting an IFE of 1%/2 = 0.5%.  That’s when the demographic data suggests very low prevalence in over 70s - so it could yet rise a bit.   So I’d suggest you double your estimates of the dead - prudent to err on the side of caution really when forecasting this sort of thing.   Then there's the potential increase in lethality associated with the higher viral loads in a scenario where infection is widespread and healthcare overloaded... 

(Edit - I just went back to the ONS and PHE data for the week of Oct 2 to Oct 8 and revised my "actual is z1.5x detected cases" to 2x, which gives an IFR of 0.5% - interestingly quite a bit higher than France's CFR - something there to be got to the bottom of...)

0.3% IFR is an extremely low estimate and suggests numbers that antibody testing doesn’t support.

If 0.5% is more accurate, as the data seems to support, that is another 100,000 dead, even with out the issues of NHS overload and significant increases in other deaths. Suppression is definitely needed, anything else is pure folly.

Everything you say is fair enough, i just dont really buy the idea that those four states have learnt their lesson but europe just didnt have it bad enough to learn their lesson properly, it seems that europe has tried pretty hard to learn from before.

But we had learnt our lesson in August and R was holding at ~1.  Then people relaxed as there wasn't a visible problem at the time.  

I could be wrong; but there's only interpretation based hunches to argue otherwise - not a sound basis for decision making.  The SUNY outbreak could be a key piece of evidence - how many of the students came from surrounding areas?

I was replying to dancing on Rock and he stated 0.3% was widely accepted.  I also have seen this number quoted often in many countries it is now thought to be much lower than this.

I agree - I just revised my IFR estimate from 0.66% down 0.5% as outlined in my post above.  That's using a 14 day lag from cases to deaths, and the ONS random and PHE testing data to calibrate cases to infections.  What's odd is that France has a 0.35% CFR for the same period - so what's going on there?  The mind boggles but I can't find anything like enough information to understand this - so many possibly factors.  The PHE data is a bit "salted" by the inclusion of undergraduates living in halls who are not covered by the ONS data.   It makes me uncomfortable about our fatality rates which seem high given the low prevalence in the >70s.    I don't think we're over-recording covid deaths under the "28-day" protocol as the death certificate numbers are higher.

Whilst it's not getting any press, we've also been under-reporting deaths it seems; the last 5 days of data released through the dashboard have included about 150 deaths back dated over the proceeding two weeks...

No one knows what it is. We had a load of deaths when no one was getting tested and no one knew what they were doing so loads of vulnerable people got it. The situation now is totally different, we're testing everyone with sx and surveying, and the vulnerable are avoiding getting it. So the apparent IFR will have changed beyond measure.

It's almost as if people start taking risk control measures seriously when bodies start piling up in the streets...

Leaving aside COVID-19 deaths a government report from April predicted nearly 1m non COVID-19 deaths as the result of the NHS collapsing in a let it rip scenario... 

I dont need to imagine anything, i just need to look back to April, if 0.3% is correct than 3 months like April would achieve immunity, I think you underestimate how much harder it will be for the virus to spread once 30, 40 ,50 % have had it, it will not keep exponentially rising it will flatten very quickly.  However its true that 0.3% could turn out to be a huge underestimate which is  another very good reason not to let rip.

Sunetra Gupta thinks she knows, definitely less than 0.1% probably nearer 0.01%. Despite the obvious problems with this she is quite certain and has plenty of cheerleaders.

The infection curve is sigmoidal.  Up to the point where half the final number of people are infected, it's basically exponential.  A reasonable estimate from March might have ended up with 20,000 people being hospitalised a day and and 6,000 people dying a day before rates started to decrease as infection hit 50% of its final value and immunity started to have an effect.  Except that hospitals would be overloaded and so deaths would be way up.  Keep in mind that all the gains in clinical care don't apply in a "healthcare overload" situation, so the various reasons fatality rates are lower now would no longer apply and they'd be back up again.

true, but as wintertree points out, in france even cfr is only 0.35 so ifr surely cant be more than 0.2%, again uk is not france and it does seem to be higher in u.k.

How suneptra Gupta is still taken seriously i dont know, her predictions back in april have turned out to be so undeniably and catastrophically wrong,  Oxford should be embarrassed.

Is that the April in which we were in lockdown? Can you see the flaw in your logic?

I don't even think that the IFR or deaths are the crucial measure. What I'm bothered about is avoiding the breakdown of society - so if lots of people are very ill but don't die, you could have a very low IFR but still see all our lives descend into utter chaos.

It’s population specific. A population with older people or people with more co-morbidities it’s higher. 
 

I think the best way of looking at deaths is by looking at excess deaths, rather than the 28day or whatever they’ve decided on. Even if an excess death isn’t down to that particular person catching Covid, it’s caused by the pandemic in some way. 
 

If we use seroprevalence data and then do some very basic rough sums it comes out at around 0.3 for most countries, but that seems to be for under 75s? 
 

https://www.who.int/bulletin/online_first/BLT.20.265892.pdf

I suspect she knows which side of her toast is buttered.  

My judgement in professional parlance would be that “she’s gone full professor”.  There’s no professional standards body licensing academics or holding them to any competence, and once someone becomes a professor, it takes an almost unbelievable level of lunacy before anyone thinks about suggesting they should retire early to avoid a court case or at least break their association with the institution’s good name come the court case...  Unless there’s a media shitstorm that threatens charitable donations or student recruitment it’s unlikely anyone is going to rock the boat just because someone is (ab)using their “academic freedom” to knowingly fuel a giant misinformation machine whose victims internationally could eventually number in to the hundreds of thousands.

I forget, which oxford academic was I ranting against?  G or H?

It's really going to be dependent on the population being infected - the estimated IFR in the first wave in the UK was 1.16% total but 0.27% in the under 70s.

A couple of US states already have a mortality of close to 0.2% of the entire population

The IFR in a let it rip scenario would increase significantly as the majority of these needing hospital treatment would not get it....I reckon it'd be closer to 2%.

I suspect the levels of obesity, heart disease and diabetes are astronomical in those states. 

I think people will throw the towel in and start ignoring advice and legislation. It feels were on our way there.

There was a good paper written about optimism, it's optimism that makes some people think they won't get Covid and just carry on as normal. Maybe it's optimism, ignorance and desperation that's pushing the numbers up.

Given that we are talking about NY and NJ, these are ranked 10th and 11th healthiest states out of 50, there is much much worse.

I think you’ll be surprised. The internet and in particular Twitter is full of whackos less than 20% of people are on Twitter and 80% of the noise comes from less than 20% of that 20%. Most people are normal, not stupid and are concerned. 
 

The media amplify the dissenting voices for their own means. 

Our initial strategy and the one we continue with, is  Whack-a-Mole, the lockdown and the one still advocated by our governmental health advisors, non of whom have any experience of dealing with anything on this kind of scale before.    A number of these folk failed to comply with their own advice.  That doesn't help public confidence.

We still don't have a vaccine anymore than we have a "world class" track and trace system.  I have absolutely no idea how the government thinks its possible to ensure the vast majority of the population would take it or how quickly it be introduced to all those who might want it.  We don't have a cure yet.

It is quite obvious that locking us all up works in preventing the spread of the virus.  As soon as the restrictions were lifted again, there was huge rise in the number of infections and just a few hundred deaths reported in recent days, the vast majority who with an average age of 82, which is just about your average life expectancy anyway.     Now there's call for a 'Circuit-Break' lockdown.  Which is back to square one again.    As any electrician will tell you, you need to find the fault in the system otherwise you'll always be having Circuit-breaks.

The idea that the dead will be overflowing onto the streets is total nonsense any more than our morgues are full to overflowing now..

It is a nonsense to say we can continue this approach for months and months or more likely years without any huge cost to our society.   Our society is also our economy.  If we carry on like we are with Whack-a-Mole and Circuit Breaks, then we won't have anything left to look forward to.  We already have massive unemployment, record numbers of businesses closures and we cannot - perhaps we can?,   keep throwing money at the problem in terms of grants and loans, in the hope the government won't have to ask us, the public never to pay it back.

We need to take less heed of  what the medical mathematical statisticians  say and let the government run the country in a more democratic way, rather than the dictatorial way it has had to do over the last 9 months.

It is quite obvious that more and more people are ignoring the various restrictions imposed upon them, in the face of the reality of the situation.  People will just not abide by the continue restrictions on their lives for months and months, any more than people take the  advice of medical 'experts' who tell us its going to kill us if we smoke, drink, take no exercise, eat the wrong food, take too much sugar, fat and so on.  

Life, loving and living, involves a level of risk.

You didn't detail any solution in all that....what is yours? 

Optimist is in advisable in the current circumstances. I keep telling this to people at work. We need realism. Some people might say that’s a pessimistic view but the facts speak for themselves. 

The reason it came back is test and trace was a shambles and people weren’t self isolating anyway due to not getting financial support to do it. 

I’ve often thought that if most people followed my spending habits, we wouldn’t have much of an economy beyond supermarkets, outdoor activities shops and the odd coffee shop...

Yes. Very frightening. In NY State 67% are overweight or obese. 

Didn't boris originally say that herd immunity was our plan. Got immensely criticised for it and then had to introduce lots of nonsense to show that we are doing something. Essentially it's the only viable mid term plan now anyway. 🤷‍♂️

What makes you think that?

The idea that the dead will be overflowing onto the streets is total nonsense any more than our morgues are full to overflowing now.. - if that is so nonsensical why was the situation in Italy, Spain so bad earlier this year?  Do you think Britishimmune systems are stronger?

A few points. First, you are assuming that anyone already infected won’t get it again. That is not clear. For mild infections, the immune response may well be weak (as with the common cold) so reinfection may well be possible later on. Second, I thought IFR is more like 0.5. Third, serological studies suggest less than 10% infected. Fourth, we don’t know if 70% will be enough. 

What are you suggesting?

If restrictions were lifted, then cases would go up a bit faster, hospital admissions would go up, and eventually exceed capacity. Once hospital capacity is exceeded, economic and social meltdown would obviously follow.

You haven't been at all clear about what you think would happen.

Are you saying that with no restrictions, it would be fine because hospital admissions would not be high enough to exceed capacity? What makes you think that? Do the data support you? Here's a clue:

https://coronavirus.data.gov.uk/healthcare

Or are you saying that if hospital capacity is exceeded it won't matter? Have you actually thought about what trying to get by without hospitals would be like? I suspect not.

You don't seem to have thought through anything at all, you're just saying "it'll be fine" without giving a single reason. Why should we believe that "it'll be fine" when all the available evidence says "it'll be grim" - and that's with the half-baked measures the govt is taking.

I'll believe you if you can give good reasons. If not, I'll go with the obvious interpretation of all the data we have about the pandemic: it looks bad. Life will not continue as normal, restrictions, circuit breaker, or let it rip. The game is to find the policy that has the lowest impact on human lives, not just deaths. All I hear from the "let it rip" camp is "it'll be fine" in a complete vacuum of reasons I should believe that.

Give the reasons, or we should all assume you've not understood the facts correctly.

If no vaccine, zero Covid has to be the way, with an effective test and trace to contain any outbreaks. It won’t be easy but it’s the only surefire way as herd immunity is unproven. Would need to give up on overseas holidays for a few years until the rest of the world gets to zero Covid as well. 

But it has come back in pretty much all of europe as well and some of those countries have don e agood job with T&T and rule following. It came back because it i now well-established in the population.

Much in line with the OP, Lone.s

It looks like we're sleepwalking into Herd Immunity, now that there is 1/160 people having Covid-19 (in England at least). Although, probably more like 1/100 or something like that.

The government thinks it has a deck of cards to play with by playing with different lockdown strategies, when in fact it doesn't, and the virus is going to have the final say on how all this is coming to a head and an end ?

It feels like they've lost the oars to the boat (even though they won't admit that) and really we're at the mercy of the current ?

Me? I don't do much in the way of making wild predictions based on various data pulled from off the nearest government website. - your 1,000,000 deaths for example?  Where on earth do they drag that nicely rounded off figure from?  Oh, I know!!  Someone else's guesstimate, based on someone else's  approximated calculations and mathematical modelling .

Lets just hurry the whole thing along as quickly as possible so the rest of us can carry on with life.  

He's probably missing going to the pub with his mates... 

Was shown to be completely mental when hospital admissions started going through the roof and he was forced to follow the lockdown strategy having left it too late, and thus it went on for ages and decimated the economy.

Read the government report and you can critique it properly.....would you like the link? 

Wouldn't that be nice and easy?

What are you proposing we do about the healthcare system? Let's hear these brilliant ideas.

Because you don’t know if in it’s the small Cornish village as well. That said, realistically no one is going to police a small Cornish village so they can do whatever they think is sensible. Once the local pub there is closed, they’re probably going to be fairly self isolated anyway. 

Have your read the OP's summary of the current situation?  

Please don't drop into your patronising manner.  Whack a Mole, lift restrictions.  Whack a Mole, lift restrictions can't go on for ever.

I have not said "It'll be fine. And I have not said, "Let it rip":.    

Clearly if you cannot see the continued futility of carrying on with Whack a mole and Circuit breakers,. then you don't understand what many people are thinking.  Most people are just not interested in endless mathamatical models which can be, and are, often manipulated to suite one's own agenda.

What don't you understand about the current pandemic?

Go on then, if you consider these are wild predictions and guesstimates, what is your estimate on the number of deaths that the required (60-80% infected with antibodies of sufficient longevity that they provide immunity)

Big assumption that "the rest of us" includes you.

Yes.

You said

I don't know how else to interpret that. You're extremely unclear.

I can see the immense frustration caused by the pandemic and by there being no end in sight. Once I've appreciated "what many people are thinking", what now? How does that help find the best policy?

I don't understand anything of the technical details of the disease, the likely impact of different policy options, how it feels to lose someone close to it...but I also don't understand what you're getting at with your question.

I've no idea what point you're trying to make, except "I'm fed up with it and so are loads of people". Well, yeah. You're not saying "let it rip", you're not in favour of lockdowns or restrictions, so what (for the love of christ) is your point?

In fact, the epidemic appears to be stagnating across the UK

https://www.cebm.net/covid-19/tracking-uk-covid-19-cases/

Compare it with with the situation here in Czechia

https://onemocneni-aktualne.mzcr.cz/covid-19?utm_source=general&utm_med...      (11 000 here is something like 70 000 in the UK)

That all despite relatively strict rules and partial lockdown for last week.

The big difference is we effectively suppressed the first wave, so we basically didn't have it

We're a bit over 3 weeks away from hospital admissions hitting the same peaks as they did back in April. This necessitated the shutdown of all routine hospital work. My local hospital built temporary morgues for all the dead people. Even at this kind of level of intensity, it would take a year or so before 50% of the population would have had it. 

By "hurry the whole thing along" I presume you're going for the "Bergamo" approach - this would necessitate 0.58% of the entire population dying.

No one in Europe went for zero Covid though and actually locked down borders (eg my understanding is NZ actually quarantine people for 2 weeks in a government facility). This shit spreads exponentially so unless you get to very very low numbers which can be controlled and you stop importing cases, it will come back again.

Another crap plot from the CEBM with another barely disguised subtext aligned to the boss’ ”on the record” libertarian based anti-lockdown stance.

Of bloody course actual cases are falling below Vallance’s projection - which was a projection for the status quo continuing - which provided the critical context to enact tighter restrictions - which caused cases to stop rising exponentially.

This isn’t rocket science.

On the crap plot front “7 day moving average” - moving average of what?  They have 3 different data sets presented, which one do they average?  Never trust people who can’t put a proper plot together; it means they’re not paying attention...  Also, there are far more suitable smoothing methods available than a moving average, and have been for 50 years...  

Have a look at figure 4 in the latest ONS random sampling survey report [1] https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/con...

Potentially levelling off in 2 regions of England (that plateau could disappear if cases rise again - that happens with their approach to smoothing curves), sub exponential in one and exponential on 6.  This does not support a claim that it’s stagnating across the UK

As I obviously know nothing and have little idea on what to do, perhaps you'll share your wisdom by telling me how we'll, errr, shuffle along for the next year, or two, or three or................??

It sounds to me like you are proposing herd immunity, right? In which case you have to accept exponential growth in cases, hospital admissions and deaths, eventually exceeding NHS capacity. As Jon says, that will in itself lead to the economy taking a nosedive due to many (most?) people shielding themselves.

What happened in Latvia back in spring is instructive (my girlfriend lives there so this is based on what she has told me). They didn’t have government mandated closures but lots of people got scared and didn’t go out to shops and bars, so many of those shops and bars closed anyway.

Its been documented since antiquity that people go into a self driven lockdown during a plague / pandemic in the absence of central action.  Just another piece of history overlooked by the anti-lockdown brigade.  Recent history too - a lot of informal lockdown was going on in the two weeks before UK lockdown.  

My view is that government, having cocked it up twice, are now backed into a corner with essentially no options that are significantly different. Basically, there's no choice but to carry on with the disruption of temporary lockdowns and restrictions where we try to keep life as normal as possible while mitigating the threat of overwhelming the NHS.

As for the details, I think a regional approach seems fairer than national policies. I think the 10 o'clock closing time was a terrible idea. I don't believe that closing hospitality will have a big impact as with measures in place I doubt that they're contributing much to the spread. The sacrificial sector should have been universities (who could adapt by changing term dates and online services) - too late now.

There isn't a good answer. There's only realism: do something like what we're doing, for a long time. Vaccination will probably prove helpful. Instant testing would be good too. We'll find technological means to improve life with the virus, but the idea of "we'll just get it over with a go back to normal" is just wishful thinking. It's not going to happen.

That's my view of what's going on, what's possible. 

Any more clarity on what you meant by "lets just hurry the whole thing along as quickly as possible so the rest of us can carry on with life". You weren't saying "let it rip" so what were you saying?

You’re assuming the reported cases reflect reality here. That isn’t necessarily the case. The testing system is under strain and people can’t get tested on demand. Some don’t even bother trying. The office of national statistics does random testing to track spread and their data shows it’s still growing but more slowly than a few weeks back. The hospital admissions numbers are certainly still going up. Not as fast as back in March fortunately, although the national picture hides a lot of regional discrepancy. 

Encouraging to see the levelling off, perhaps the measures and local / national publicity are working? There’s a strong behavioural aspect to this after all. See what happens, early days... I fear January will be a disaster due to Xmas. My money is on a circuit breaker in the next few weeks and then another in January to deal with Xmas. Then another in March to get us through to May and hopefully the start of a vaccine rollout. 

On my way to / from the wall today I saw two queues for cocktail bars. There was no proper social distancing in the queues. Ok, it’s outdoors, but still. People were in groups - who knows if they’re from the same household (we’re tier 2).

Close down the entire pub and restaurant sector apart from takeaway service, furlough the staff (give them local government jobs to do instead, plenty of stuff needs doing) and give loans to the companies if need be.

Only 8 other people at the wall including the member of staff, so that was good...

The same is true here and the observed difference in the rate of spread is huge anyway although we have stricter restriction than in the UK

The other thing I couldn't understand is why they don't force the 16-29 year olds to self isolate for say three weeks ?

Jonathan Van Tam gave this presentation on age breakdown and the young generation were the main spreaders of Corona Virus

https://www.google.com/amp/s/news.sky.com/story/amp/coronavirus-regional-he...

Trouble is, people when not in the pubs will socialise at home. It's only a guess, but I think the policy will be ineffective. 

How do you achieve 'three months like April' assuming one wanted to? Before we shut down it was doubling every few days. What's the rate control and where does the feedback come from to close the control loop? 

Any instability whatsoever and that blows up in your face within days taking our health care system and tens of thousands of citizens with it. 

It's lunacy to think we could sustainably run that hot.

Jk

It comes from looking at the fraction of the infected currently requiring hospital treatment, estimating how many of those would die without it then working out how many of those who would die without care but have a good chance with care we could save by rationing care once hospitals are overloaded. Yes, it's a round number, reasonable given the tower of assumptions it's built upon. It could of course be bigger. 

It doesn't consider the secondary effects of hospital overload, the labour, material and credit shortages which would also be associated with that scenario and their impact on social and political stability. 

Let's hope wiser, calmer heads prevail because you haven't understood the problem.

Jk

Quite; we couldn’t hold R=1 indefinitely with 2,000 cases per day.  How the flying f*** monkeys could we hold R=1 at 150,000 cases per day?  It’s perhaps 8 weeks since we lost R=1 and cases have increased about 10x and we don’t have it under control.  If the same loss of precarious balanced happened in a “burn as fast as possible without overwhelming healthcare” scenario we’d end up locking in 15,000 deaths a day before we reigned it in.  Except we wouldn’t reign it in because everything would go to shit.  The last two months literally showed that a ten fold safety margin is not enough for our current abilities.

I'd agree there. This hasn't been about managing the virus directly for a while now, it's about managing the idiocy that spreads it haphazardly. Whilst a degree of it will be spread despite all best practices being carried out, it's the seemingly larger percentage spread by knowing stupidity that needs the resources put to it, almost in the same way racism and hooliganism do. Dare I say it, there may be significant overlap...

Like other undesirable social influences, it's a matter of how much the population will tolerate and make excuses for before managing itself. It's not at that yet, in the same way society hasn't shed itself of other anti-social behaviours like people speeding near schools or pick-pocketing. We still need a struggling and overstretched authority to do it for us because we lack the collective will ourselves.

Some societies have a lower tolerance for different forms of anti-social behaviour than others and I'd postulate that's why some places fair better regardless of other seemingly counter-active elements like population density, age etc. Said another way, the UK simply doesn't collectively give a shit enough to deal with it.

You do know. If they are having no hospital admissions and no one is asking for tests. 
 

Localised lockdowns seem perfectly sensible way to proceed. There’s no point in shutting down society just for a feel good factor. 
 

The important thing is to emphasise that people don’t travel from tier 2 to tier 1 locations. 

Which is within a percentage point of the figure for the U.K.

For the whole of the U.K.  

60m people in the U.K.  20m in New York. 
Deaths are a little bit more difficult to count depending on what your criteria is. For NY 30k is 0.15% so not really ‘approaching 2%’. 2% would be 40k. Even the U.K. isn’t at 0.10%. 
 

Anyway the exact %ages are academic. The US and the U.K. won’t do well compared to the rest of the world due to astronomical levels of people overweight, obese, diabetic and heart diseased. 

You may be right but not everyone will visit their mates for drinks parties. The youngsters might but older people probably won’t in most cases. Plus a house party is going to be isolated from other people (though of course it could be larger than what would be allowed in the pubs). 

Well may be we need local restrictions as you say but they need to be more drastic.

I agree about travel if it involves contact with people. I don’t see the issue with travel from T2/3 to T1 to go walking or climbing or to do other low risk outdoor activities. Having said that, if local or national lockdowns come with mandatory travel restrictions, it would be a price worth paying for the greater good. 

I'm not sure why you wrote this in a reply to me, however currently deaths in NY are 0.172% of the population, for NJ it is 1.84%, both according to Worldometer. Cases are rising in both states, so whoever said they are approaching 0.2% seems right to me.

Well, it's also been to do with 'restarting the economy', reopening schools, and forcing university students into halls. There's been a fair bit of idiocy in those measures, too.

Like I said.  I don't do wild prediction based on someone else's guestimates.  By the way where did you get the figure 60%-80% etc., etc from?

 Where does the  0.58% figure come from and how was it worked out?

istIn reply to lone:

India is another interesting example When considering Herd immunity, the goernment eased lockdown restrictions at the start of September, cases continued to rise for another 2 weeks before starting a continuous rapid decline over the last month.  For the vast majority of Indians voluntary social distancing just isnt an option like it is for us here,  many live in  small houses in tightly packed slums, they will not have the luxury of a furlough scheme, they wont have access to PPE like we do here, so if it's not herd immunity how are they managing to so much better than us?

Its the same with brazil and other countries in S.America, I find it very hardd to believe that after four months of complete failure in dealing with the disease Brazil got its act together in August and has now chaged their behavior so scuccessfully that they have achieved a 50% decline in deaths/cases, my guess is that just like everywhere else they will have experienced lockdown fatigue and probably have less distancing now then before. My guessis that it is Herd immunity driving this decline.

If anyone has any other theories/information why these countries are seeing rapid declines I would like to hear it, i know very little about what is going on there.

This is document detailing the projected impact of a Let rip scenario. Page 4 summarises it:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/...

It should be read by anyone proposing this approach if only to make them realise how terrible it would be....

I quite agree with you actually.  We started off badly, and we we can't really get out of it now.

Whack a mole.  Whack a mole, carry on lads.  There's another one - whack a mole.  Keep calm and carry on.  

Eventually we may have a vaccine.  We may end up with herd immunity - we may not.  Unlike a lot of other people is see no end in sight.  Not now, not in months, or even years.  Unlike other people I don't have the answers.  I'd just like to get it all over as quickly as possible and we must accept we just cannot save everyone from the virus.

 

Lots of estimating & guesstimating going on with the figures.  Are they based on the last pandemic we had?  

I rather liked prof. Neil Ferguson's estimates on death numbers.   "Between 250 & 250,000" I think he said.  

Please don't make condiscending remarks.  I do understand the problem.  You clearly don't have the answers any more than I do.  Like me you  just have an opinion.

.  Making up restrictions like no public gatherings of more than  6 and expecting everyone  to meekly obey was rather naive.   Would I be inaccurate to say there were large public gatherings after the pubs close in York and elsewhere a week or two back.  And where did all those people come from?  Well it certainly wasn't from visiting Grandma or mum in the care home was it?  They were spilling out from the pubs which like where I live were full to overflowing.  Indeed my local hasn't had such good trade in years. 

All we are doing is muddling along.  And I haven't a clue what we can do about it.  I just wish we could muddle along a bit quicker. 

Can you cite where the Neil Ferguson claim is from because I have never heard it and I've read more stuff on COVID-19 than is probably good for me.... 

A very interesting but waffly summary there.  My eyes glazed in awe when I saw some of the figures were sourced from Mr N Ferguson, (the bloke who didn't follow his own advice)

Its just waffle.  ".....based on, .......estimated on,........."Contains large uncertainties..."; "It has not been possible to account for.....~"  "...Assuming...."; "could be..".  "Maybe...

I loved the bit about losing up to 59,000 years of life lost in total.  What on earth is the point of that figure?  Was the author a reporter for The Star newspaper?

Here's my prediction.  A lot of people are going to die. Mostly those who are going to die anyway.  These are people predominately older than 70, increasing with age.  Most of those are also going to have underlying health issues and would die of something else anyway*

*NB.  Some people will defy all these predictions and live longer than the average person and others will  live much shorter lives than predicted.

Keep calm and carry on.  But faster.

Did you read any of the detail on the methodlogy used, this was in the additional pages?....and Mr Ferguson had no input into the non COVID-19 deaths as he is not qualified to do so. 

Perhaps you would like to tell us where they went wrong....

Mate, with all due respect you don't have a clue and readily dismiss a report compiled with the input from different government departments and god knows how many qualified people...

It's very hard to have a reasonable discussion on this basis because you will automatically dismiss anything that paints what you want in a terrible light...

Are you congenitally lacking in empathy or is it something you've been working to achieve?

I agree and hoped by using 'haphazardly' I'd covered some of those elements. There's varying degrees of idiocy, ranging from crazy valor to simple selfish ignorance.

My gist was the degree and type of stupidity British society will tolerate, 'seemingly any' being the apparent answer. Covid block parties the night before lockdown just don't seem to happen in places renowned for handling things well.

It may be a case of cultural flexibility too, some places are less worried about temporary seemingly dystopian measures. Initially I thought maybe it was linked to trust in government, that the new rules wouldn't become permanent infringements on liberties, but then I considered China.

Nope, I think at the root of it is a British expectation to just f*ck it up, and that's what's happening.

The 10pm shutdown is probably to take pressure of the NHS A&E services which get busy on Weekend evenings.

A wise post.  People in past pandemics worked out what to do and as you say alot of people have already figured it out and take their own measures

its interesting over in the USA Chris Chrise, having been in intensive care, is now saying wear a mask, having been an anti mask campaigner.  
 

Yes, the population fatality rate in Bergamo was 0.58% back in mid-May.

This was with 57% testing positive on serology a few weeks later, so in the same ballpark as the number of people we'd need to get it here, to start "getting it over with"  (if that was even possible by this method).

If herd immunity is achieved would it be a bad thing, after all we would then be immune? Of course not providing the cost of excess deaths to get to that point was less than the cost of excess deaths of another course of action.

Bear in mind that it's highly likely that the vaccine will only be administered to those who have compromised immune systems and therefore the rest of us will likely need to become herd immune, like flu. 

Do you have an authoritative source for that statement or are you just spitballing?

I doubt it strongly.  Not least as a compromised immune system isn't magically patched up by a vaccine; it's more likely the first targets for vaccination will be the healthy people who interact the most with the vulnerable, to prevent them from transmitting infection to the vulnerable.

"Herd immune" means that those without immunity are protected by those they interact with having immunity.  It has nothing to do with how that immunity is achieved.  So when you say "to become her immune" you mean "to become immune through infection"

Current plan

https://www.google.com/amp/s/www.bbc.com/news/amp/uk-scotland-54573288

I think Kate Bingham may be competent too, which is a refreshing change.

Thanks; that sort of addresses the first half of JohnBson's claim (elderly in the article, "compromised immune system" in his claim) - I haven't seen anything to suggest the wider plan is to leave most of us to get immunity through infection as he suggest - quite the opposite in fact.

To quote the article

So a mix of immunising those likely to infect the vulnerable and the vulnerable themselves.  We'll await the various trials' Phase 3 results to see how effective a vaccine actually is on a person with a weakened immune system...

It's quite interesting because not only do you not do "wild prediction", you don't appear to do ANY prediction, and your views appear to be based on nothing more than your opinion, which in itself is based on no actual facts, theories, estimates that I've been able to see in your posts.

So unless you are an epidemiologist, virologist, public health specialist, you are literally the "man down the pub" - and there's probably a reason we don't pop down the local to decide on the best response to a novel lethal infection.

The 60-80% figure is one I have heard quoted for the level of infection required to achieve herd immunity - assuming that an infection gives sufficient immunity to prevent re-infection.

Ferguson's claim, was made right at the start of the 1st outbreak.  Widely reported in every newspaper.  I may be a 100 or 2 out but it was near that sort of figure.  Perhaps you've lost it under newer stuff.

Much the same as you then?

You'd be surprised what I did before this...

The obvious difference is that I am referring to experts, you appear to be dismissing everyone.

I know how much you appear to hate listening to anyone who might actually have an expert opinion on COVID19, but it's a pretty standard figure for COVID19 herd immunity - as any Google will tell you.

Here's one for you to dismiss:

https://www.newscientist.com/article/2257258-it-is-bad-science-to-say-covid...

No way. People with a compromised IS will be the LAST to receive an experimental or newly approved vaccine (it may not work because of whatever compromises their ability to raise a normal immune response, or for live vaccines, may even kill them)!

Herd immunity as a concept should be thought of more from the viewpoint of the virus:

Any virus will, without any interventions and in a virgin population, on average infect a certain number of persons starting from a single infected patient (the famous R0).

This number will drop through interventions like mask wearing or quarantine, leading to an effective rate R.

If this drops below 1, the epidemic will peter out (as, again on average, every patient will infect less than one person. Every patient that does not infect someone else is a dead end for the virus.

Now, the same will happen as more people become immune after infection. If a virus on average infects three further patients in a virgin population, but more than two out of the three persons it manages to jump to are already immune, R will drop below 1 and the epidemic will peter out.

An R0 around 3ish  is actually a reasonable number for coronaviruses, resulting in a rough estimate of 70% immunity required to end the cycle. This is rather low, measles has an R0 of around 20, so to fully prevent outbreaks we need 95% immunity! Given that quite a few people cannot be immunized (e.g. babies), that explains why anti-vaxxers cause so much damage in particular WRT measles.

The true level required for herd immunity is much more tricky to estimate, you need to consider factors like the underlying distribution giving rise to the average number given by R0, how many people become infective again, how long that takes relative to one pandemic cycle, etc...

This virus centred view has consequences for immunization strategy. The obvious way to lower R is to target those that have the highest risk to contract the virus, but EVEN MORE IMPORTANTLY, those who have the biggest opportunity to spread it. Medical/nursing and care home staff obviously fall in both categories, but it is almost as important to get others with many and often close contacts, e.g. bus drivers, teachers, police, .... 

Nursing home residents and other vulnerable section are not that high on the list, but they will benefit indirectly (and even more!) when the potential worst spreaders are removed.

CB

editet for one of the many typos.

I never heard him claim "Between 250 & 250,000" which is what you said....

He said 250k if we followed the governments initial mitigation strategy which involved nothing more than:

- self isolation of those with symptoms

- self isolation of households where someone was displaying symptoms

- social distancing for the over 70s

Thankfully as a result of his model the government ditched this as it would have been disastrous...

I wonder if billhook is misremembering this :

https://factcheck.thedispatch.com/p/did-a-british-scientist-retract-his

I

I'd suggest  at least one of the figures proffered was based on Ferguson's figures.  It says so in the margin.  

I'd love to but I'm not an expert advising the government.  Nor are many other people on here.

I assume you've heard the one about a Duck Billed Platypus being designed by a committee?  You'd be quite happy to fly off on your holidays in an aircraft designed such a varied committee ?   Not everything a committee comes up with is necessarily good.

A bit rich from someone who assumes I'm suggesting that we; 'Let it rip'.  I really haven't made a big point out of saying what I think.  Unless you mean me wanting the current epidemic over more quickly than its likely to last.

The 10 o’clock curfew is more clever than that. 

Most people seem to be under the impression that pubs still close at 11pm and 10pm is only an hour earlier.

They don’t, many close at midnight and nightclubs run all night. 

From a purely anecdotal point of view, on a Thursday I will run with my club, come home, eat and shower and then pop down the pub for a quick catch-up with the locals. I usually get to the pub around 9:30 and we leave about 11:30. The pub is now calling last orders at 9:30 in order to make sure everyone has left by 10:00. So that’s my Thursday night in the pub cancelled. 
 

Couple this with seating only. Last weekend I was away and stayed in a fairly small town with some friends. On Saturday we booked a table in a restaurant for a meal. Went somewhere for a drink first. It was difficult to find a pub with a free table but we managed. Went for a meal and then tried to find somewhere else. Everywhere was full. So this effectively means people will find a pub, and stay there. No pub crawls and standing at the bar and spreading around. 

On the Friday they bought the measures in, there were no seats left in my other local. I normally pop in there for a couple at the end of my dog walk on Friday evening and a catch up with different people. I bought one pint and sat in the garden, in the dark, in the cold, on my own with my dog. Then went home. 
 

Before the 10pm curfew the landlords were all shouting about it being pointless and not going to work and would destroy their trade. After, they claimed footfall was down 15%.

Clear evidence to me if it’s effectiveness. 
 

Parties in the street at 10pm. Good luck to them. Very small minority and they’re outside. When the weather gets colder and it rains it’ll stop anyway. 

I suspect the actual death rates may be lower in places like India and Brazil due to younger, less obese populations. Equally, the official numbers may well be understating Covid deaths because poor people living in slums could be dying without being recorded as Covid related as they never get tested. Just a guess. 

https://www.medrxiv.org/content/10.1101/2020.04.15.20067074v3

I think that's the source and the basic methodology appears to be covered if you're interested.

jk

You don't need to guess about Brazil. Manaus in particular was hell with mass failure in recording as the death rate was so high. Yet not high enough for herd immunity despite predictions of that.

https://uk.reuters.com/article/uk-health-coronavirus-brazil-manaus-idUKKBN2...

https://www.theguardian.com/world/2020/apr/30/brazil-manaus-coronavirus-mas...

Ferguson was bang on IIRC. The mid point of his estimate of deaths with a lockdown was around 60k and we ended up with just over 40k, or more if you include deaths more than 28 days after a test.

Edit - I oversimplified it as there was no midpoint as such (as it depended on what measures were adopted) but his estimates were in the right ballpark given the measures which have actually been implemented and given that the consensus is R started at about 2.7. He certainly didn’t say 250, the lowest was about 5k.

See the table on p13. These are deaths over a two year period. https://www.imperial.ac.uk/media/imperial-college/medicine/mrc-gida/2020-03...

This is just waffle tbh.....and with that I'm out  

It's worth bearing in mind with the southern hemisphere examples they're just coming into summer as we are winter. It won't be all that's going for sure on but straight comparisons need taking with a big pinch of salt.

It's likely some of India's falling death rate is immunity. It's also quite possible it's spreading less freely after the huge wave of spring/summer migration it prompted. It's also likely as the virus has moved around the country and into areas of greater or lesser interest to the ruling party the attention it receives may vary, we may be seeing the virus having swept through a middle class that are now partially immune and managing control better. It could still be raging in an underclass that receives less attention.

If it's immunity, will it last? Is it worth maybe half a million dead to us? Not if a vaccine looks imminent IMO.

jk

UK C19 deaths in that period were over 50k from the ONS. 40k was government total recorded deaths in hospitals and later on including total care homes deaths.

Obviously not, they're based on looking at how sick patients are when they arrive, how much care they need to keep them alive, what happened elsewhere where that care wasn't or wasn't universally available (rationing).

If you showed some understanding how healthcare overload in a developed economy experiencing a deadly epidemic would impact day to day life, how a very bad situation can turn to complete ratshit in days I'd acknowledge it but you appear not to. So no, IMO you don't understand the problem. Sorry.

What do you think would happen if France blockaded the RO-Ro ports as it threatened last time we lost control?

What's the covid CFR for a developed (read fat and aged) country with severely rationed healthcare?

What's the mother and infant mortality rate for births without healthcare?

How many people's lives rely on regular hospital treatment, eg dialysis patients?

I believe there were some press photos of what appears to have been an isolated incident. It isn't the norm by any stretch, around me the pubs are being run and used with impressive care. I'm certainly happy visiting them still. I can find you some photos of York neo-nazi rallies or the annual naked bike ride if you'd like to extrapolate out wildly from those too.

Both my locals are struggling. One will probably survive because it has space for a heated marquee roof, so long as that remains legally 'outside' and we stick at tier 2 (both seem unlikely) they'll be ok, the other probably won't without a grant (lovely, small, no kitchen, no garden).

But we can't. The only sane thing to do for now is keep the economy and healthcare system working as best we can, minimise harm, gather information and wait to see if the vaccine research pays off. Frankly that shouldn't be rushed whatever the cost, the consequences of a botched vaccination program ripple far beyond covid!

If it doesn't then we reevaluate but quitting now with billions invested and the answers on the horizon is nonsense.

jk

THread:

The drop in cases in Manchester seems real

https://www.manchestereveningnews.co.uk/news/greater-manchester-news/latest...

Does this suggest the measures imposed are sufficient and working, or is something else going on?

I think the drop is in Manchester city, rather than taken as an overview of the whole of Greater Manchester.

Yes  - but still?  Maybe a bulge of cases when students arrived?  Or a real drop?

My point being Manchester can't be viewed in isolation, when the Tier 3 debate concerns the whole of Greater Manchester.

That derives from how infectious the pathogen is. In practice that isn't fixed because we modify our behaviour and environment to modify it. The basic idea is that you need to immunise enough people that of those an infected person would ordinarily have spread it to, fewer than one of them is actually susceptible and gets infected bringing R<1.

Let's work a noddy example with round numbers so it's easy to follow:

Day 0: Nobody is immune, we don't know how it spreads but we determine it has an R of 4, for each case we get four new cases.

After a little while we've figured out how it spreads, re-arranged our lives a little and R is now 3. Better but still not good.

Now we have a vaccine, our objective is to bring R<1 so the epidemic dies out. To bring that R of 3 under 1 we have to make sure that of those 3 people someone might expect to infect at least 2 are already immune so crudely you need to immunise at least 66% (100 x 2/3) of the population to put the case load into decline.

In reality some by the time a vaccine arrives may be naturally immune, we can reduce the amount of doses slightly (or a bit more if we know who has immunity and skip dosing them). But then a practical vaccine isn't 100% effective anyway so you need to dose a few more than the bare minimum to account for that. Also as a vaccine becomes available the behaviour modifications (at least those with costs and no other benefit) which brought R down from 4 to 3 unwind so you really need to work with that early R of 4 to be safe. Now 3 in 4, 75%+ (give or take the tweaks just discussed) need dosing. Another factor to consider is that the vaccine may be targeted at a particular group, you may vaccinate 75% of the population and still see growth in cases for a while as it moves through, say, the non-vaccinated young doing little harm because those it normally kills are protected.

As you can hopefully see from this simple example, these aren't just numbers plucked from the air (well my example numbers are but for covid we have their equivalents), they're derived from what we can and do know about the virus, social adaptation, existing background immunity at the point of vaccination etc etc. We don't yet know about the vaccine(s) efficacy. 60-80% seems entirely reasonable given Covid in zero-restrictions Britain (what we want back, right) seems to have had an R between 3 and 4.

jk

Umm. Thanks for the comprehensive explanation, but I'm not really sure it should be directed at me?

that seems unlikely as brazils deaths plateaued in June which is start of their winter

yes i couldnt agree more.   just because i dont think herd immunity is as far away as others do, doesnt mean i think we should go for it. 

I think you meant 'condescending'...

I'd imagine there will be a drop-off in all these university cities when nearly all the kids have had it, providing of course that they keep largely to themselves and don't spread it further afield.

No need to be patrinising.

I think it's burning through first year cohorts faster than other years - halls of residence and all that - the worst places are probably going to saturate infection in L1 in ~3 weeks and later years towards the end of term, so there could be two changes in rate - smeared out by the randomness of it all and differences between institutions.

Bloody pedunts! 

Fair point! I saw Billhook quibbling over the figures being 'made up' so I thought I'd show him how they're made up. I guess I clicked your post because it had the initial '60-80%' reference.

jk

Not really if that June plateau were largely caused by behavioural adaptations and some developed immunity (as ours was, slightly earlier, probably more behavioural) but they haven't (yet) suffered the winter spike we're now seeing in Europe

Fair enough.

jk

Yes you’re right. So around 50k, which is roughly what the paper forecast if you ignore the numbers towards the bottom and top of the range. They didn’t forecast 5k or 500k (with measures) as likely outcomes. So Billhook’s claim that the forecast was all over the place is wrong. It was a forecast so it had a range and we ended up roughly where they expected us to end up. 

Generally, reported cases are levelling off. Trouble is, there’s no way of telling whether that corresponds to infection levelling off, until we get the ONS weekly survey data, which is a couple of weeks old by the time it comes out. There could be many reasons for reported numbers levelling off while actual infections continue growing:

Testing at capacity locally

Severe testing / reporting delays aka they’ve f*cked up a spreadsheet again

People not wanting to go for a test

Undetected asymptomatic spread among younger people (ticking time bomb as it will spread to the vulnerable eventually)

Hence hospital admissions are as good an indicator as the ONS data, lagging the moment of infection by a similar amount of time.  They’re so much closer to what “really matters”. 

Currently, the detected cases (by specimen date) is levelling off, whilst hospital admissions and deaths continue to grow exponentially with a ~10 day doubling time on deaths.   (Plots below made from today's update to the government dashboard)

In terms of the ONS data, regionally speaking only a couple of the 9 English regions are levelling off; many of the others (especially tier 1 areas) are on the same sort of exponential but are currently at low numbers; so in a naive model looking at where the restrictions are (not), I'd expect those areas to take over driving cases in the next few weeks as the effects of the enhanced control measures kick in in the tier 2/3 regions.

I don't have much confidence in the "cases" data right now - we've been here before with cases of exceptional reporting lag and the "weekend effect" (where less specimens are taken on a weekend) causing false lulls in the data.  If the detected cases stay level for another week, the random sampling ONS data corroborates this and hospital admissions start to drop below their current exponential, then I'll believe cases are levelling off; until then I'll just hope that they are.

The recent variance in the "cases" data - the vertical displacement of individual datapoint around the trend line - is about 10x what I'd expect for random data, where-as the variance in admissions and deaths is close to the expected level.   This is a massive red flag that testing is no longer running bias free but is a likely a bit messed up.

It's still perplexing to me that the doubling time for hospital admissions remains 50% longer than that for deaths; I can only guess that this is because there are a significant number of deaths coming from outside the hospitals; likely from the care home outbreaks, and that these are on a worse exponential track than hospital admissions and subsequent deaths. 

Yeah hospital admissions and number of patients in hospital are much more reliable indicators. very simplistically, total number in hospital seems to be going up around 300 a day. Assuming that level of growth, by the end of November we’ll end up with roughly as many people in hopital as in the last peak (300 a day going forward would actually indicate slowing growth as a % of the total, so this is probably overly optimistic). Food for thought... and that’s before taking into account regional variation which means some areas will be under much greater stress.

The only thing which surprised me about all of this is that it has come a month or two earlier than I had expected. 

https://www.gov.uk/government/publications/priority-groups-for-coronavirus-...

You're wrong read the link above. Care workers first, somewhat obviously, then the elderly. If a vaccine wasn't used as a patch for a failing immune system then why give the old the flu vaccine? Answer; they are most at risk because their immune response is not sufficient. 

Yes immunity through infection. Considering the average age of death for covid19 is 82, a fraction of a year older than the UK average age of death, and in under 30s the death toll is insignificant.

The combination of a vaccine and community immunity is the solution, particularly when you consider that the immunity is short lived. Early indicators say that immunity could last just two months, this would mean that either we would all get vaccinated and close our borders ad infinitum, or repeat the entire vaccine program at vast cost every two months to prevent imported cases triggering a new outbreak.

If you think that a vaccine is going to be a magic bullet then you might as well pray to God and burn the witches at the stake. Mediaeval mindset. It's not going to disappear, it's here to stay. Accept the increased risk, learn to live with it, or you're going to spend a long time in misery. Look on the bright side, even with covid we have anomalously long lives compared to our ancestors.

apologies for any typos the gboard for android autocorrect forces errors in the text and UKC can't be bothered to make their website compatible. 

Do people really want zero restrictions Britain back? I get the distinct feeling that people here aren't too bothered. Probably because it doesn't affect their social class too much because they can work from home, and let's face it the majority of climbers are pretty antisocial, I mean we literally spend our free time trying to put a good 40m of rope between us and our partner and call it a good day out. 

Have we ever achieved "herd immunity" without a vaccine, i.e. does anyone know of any recorded cases/disease/etc that existed and are now gone due to us naturally achieving herd immunity?

There seems to be plenty of talk of "reaching herd immunity" but it would be nice to have a example to at least prove it is possible!

That link talks about vaccinating older people, not those with “compromised immune systems” as you claimed.  It also talks about vaccinating those at high risk of transmitting the disease as I said.

What?  What?  Immunity fades in two months so immunity by infection is the way forwards?  This makes no sense.  If you’re right then everyone would have to get infected in less than two months and we’d be right back to healthcare overload.  Or we’d be in to a hellish nightmare of constant reinfection causing ever weakened heath and worse infection multiple times a year.

> If you think that a vaccine is going to be a magic bullet then you might as well pray to God and burn the witches at the stake. Mediaeval mindset.

Show me where I’ve ever claimed it would be a magic bullet.  

Why does “learn to live with it” have to involve accepting increased risk and not adapting the way I live to reduce the risk of me transmitting it?  Make that shift, R lowers.  Add a vaccine, R lowers, then R<1 and cases decay away to the point that most changes can be reversed (some I think were coming anyway and have been pulled forwards by the virus).

I'd speculate that if you aimed for herd immunity, at some point of 60% plus of the population catching it, it will mutate and be back to square one. 

Better to aim for a record breaking global vaccination programme and try to stop it within 2 years, before it mutates and previous immunity or the vaccine become weaker. 

Meas

Measles, over and over. They have an R0 > 20, so will still infect new patients as long as there are a few uninfected patient left before an epidemic burns out. Usually, the entire population is then safe, even newborn children through herd protection, until a sufficiently large pool of susceptible people has developed again, and a new starting infection is imported from some other population. Excellent studies on this have e.g. been carried out on the Faroer Islands and on Iceland.

This is why anti-vaxxers are such criminal scum. IMO every time a child dies of SSPE an anti vax youtuber should be shot in public.

CB

The solution to anti vaxers would be a vaccination page on passports. No jabs as a child, no foreign travel. They can't claim they've be forced into vaccinations and at least it's only their homeland they screw up. 

Good idea. I hope you recognize that my suggestion was hyperbole and not to be taken literally.

I have seen a child die of SSPE, this is probably the worst fate imaginable: Loss of sensation in one finger, then loss of motor control in that hand, then the diagnosis, a couple months later the first behavioural changes, and six months later the child is dead. The parents could watch their child slowly deteriorate for almost a year.

The older siblings had all been vaccinated, but the youngest had missed her appointment because she was sick on that day,and  a few months later it was too late. She should have been protected by herd immunity, but the anti vaxxers essentially killed her.

There should be a special place in hell for Andrew Wakefield.

CB

Of course. It would be more appropriate to infect them with something that there is a cure for, giving them the choice of accepting or denouncing science. 

Rabies would be pretty convincing. 

Jk

in different races yes, that's why it was so easy for the europeans to conquer south america/australia, they were all immune to the plagues that they transported over there and the natives were not.

My guess is that much of Africa already had herd immunity to this virus before it even arrived there.

The 1918 spanish Flu pandemic was much more deadly to younger demographics because the older people had beed exposed to a similar outbreak in the decades before

I dont know about world wide herd immunity, this article talks about the history of herd immunity but doesn't mention a specific example.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31924-3/...

Don’t measles antibodies last a long time? 
 

I thought the problem with coronavirus was that the antibodies disappear which means that although you have protection from serious illness due to t-cells, you can still catch and pass on the virus. 
 

Herd immunity is therefore not possible until 100% of the population have caught it. The further problem being the more people who have antibodies at any one time the slower the virus is transmitted. 
 

Natural herd immunity without killing, or hospitalising, millions of people, just isn’t possible.  

25 year old man with no underlying health conditions who had severe symptoms after catching the virus a second time. 

 https://www.bbc.co.uk/news/health-54512034

You are correct. There is no example of herd immunity without a vaccine as per the Mayo clinic.

Slightly different genomes. So he probably didn’t even have t-cell protection. 
 

20+ cases around the world now. 
 

Another danger of let it rip is that every time it replicates in someone’s body, it gets the opportunity to mutate. I believe the vaccine is targeting the parts of the virus that don’t change. 

It's the worst of both worlds in UK academia at present. I agree if Gupta was a member of a professional body she would face ethical consequences, in particular for the dangerous idiocy of a C19 IFR of below 0.1%. In contrast if you piss off your University senior management, protection for your academic freedoms are terrible and hence pay offs are way too common. The UK desperately needs an academic freedom declaration that stops this managerialist exploitation. 

https://www.theguardian.com/education/2019/apr/17/uk-universities-pay-out-9...

I wasn't arguing with you, I was linking to the false assumptions others make. You can catch covid twice. It can be a lot worse the second time and that can apply to healthy young men with no underlying health conditions.

Yup, if she becomes an embarrassment to the higher ups, she won't face a competency hearing, just a nice tidy lump sum to help her go quietly into the night as f**k academic integrity, we have to consider what is best for all the stakeholders.  

Do you honestly believe that? If it was just the set-up for a joke, fine. If it wasn't then I'd suggest you have something of a tin ear.

There have been some positive changes come from all this for sure but for the most part they'll stick as restrictions ease.

jk

So far the rate of re-infection is low, indicating that protection last at least for the current observation window in most cases. Also, AB mediated immunity is how our bodies deal with SARS2 infection.

Even a time limited immunity will usually be enough to induce herd immunity, although the required level will be higher than if the first infection gave permanent immunity.

If immunity were ridiculously short in a majority of patients (unlikely given the data so far) that may fail before the next spike arrives, which is what we do indeed see with the common cold associated coronaviruses (even then, most are probably protected the next winter, but maybe not in two years time...)

Immunity seems to be so short because coronaviruses actively interfere with immune memory formation (by screwing up the cytokine response). This is not going to happen with antibodies against the same proteins but presented by vaccine vectors rather than coronaviruses.

CB

Yes. I wasn’t arguing back.  

The problem is that the rules that applied in June (lowest number of live cases* was on the 11th July by my reckoning) were beyond what the government and economy could bear in the long term, and also benefitted from fantastic spring weather and a relatively low prevalence level.  Those same rules won't be enough at this time of year, thus the rules will have to be even stricter than they were in June to keep a lid on the spread. If I remember correctly things were still pretty restricted in June.

*total cases today minus total cases 2 weeks ago - it takes about 2 weeks on average to get over the virus.

You can but the total cases so far are low tens (so 1 in a million or less), and mostly not worse.  Edge cases like this hardly seem a sensible consideration for decision making over the next few months.  If over time double cases rise, it might then need to action.

^^ This. The level of restrictions required to 'live with the virus' is too much for the economy & governments to bear in the long term. Just look at the 'active case' graphs for European countries on worldometers - the only places not getting a second wave are those that eliminated or virtually eliminated earlier on. Any nation experiencing growth in active cases at the current level of restriction will continue to do so until herd immunity has been reached or restrictions change, and given that nowhere is near herd immunity increased restrictions are inevitable.  It should be entirely possible for Europe's leaders to get together and aim for 'zero covid' and form a safe bubble with good border controls. A European safe bubble would give the vast majority of people a sufficient choice of holiday destinations and cater for the majority of business travel. As more countries eliminate the bubble is grown.  The virus doesn't spread by itself, it needs people to do so. Prevent people meeting people and you beat the virus.

As you say, herd immunity is unproven, and unless you have strict borders anyway you're only going to import a mutated strain from elsewhere in the world at some point.

It came back because restrictions were released too much for T&T to cope with. The problem is the level of restriction required to keep R below 1 is more than people thought / wanted to live with.

I believe some of the small nation / jurisdictions either locked borders or implemented strict quarantine /self isolation rules. Guernsey did (essential travel only to start with / 1-2 weeks SI now depending on where you come in from), IoM did (only locals can travel, 2 weeks SI/quarantine), Montenegro did.

It seems the 'best' border control is 7 days SI or Q and test at that point. This catches nearly everyone infected during or just before travel, whereas test on arrival doesn't but doesn't constitute a tremendous restriction to those who really must travel. Jersey have found this out to their cost, they've been running ToA since July and have had ongoing low volume transmission from contacts and now some unexplained community seeding which is preventing them from exiting lockdown completely and may result in more restriction.  They got away with it in summer when the prevalence was low, but now the prevalence is much higher they can't.

Or they have more controls  like in South Korea with things like the govt having access to your bank account via apps. So it becomes a privacy argument which we in the West would baulk at.

The NZ option is not really viable for us or anybody not on a small Island in Europe.Aus controls maybe but I am not sure they are really  on top of it.Giving a specific example for Aus, you have to pay about AUS $ 2,500 for the quarantineeing in hotels if you return from abroad.That would go down like a lead balloon over here.

 Or as a mate of mine in Italy points out , everybody wears masks indoor and outdoor by consent( worn all the time in climbing walls for example), in the hope it keeps infection rates down.

There is no simple solution ,all involve trade offs.

The problem is you don't know what strains people have been infected with, and by the time a vaccine comes about there will be many more strains in circulation and it'll be harder to immunise against them all. It would make sense to start compartmentalising continents by implementing tough border controls to make it easier to produce a vaccine for a particular continent.

Give people the choice of inconvenienced holiday or economic devastation and you'll soon find out what really matters. The South Koreans have obviously made the choice to accept a potential loss of privacy versus the other alternatives.  People might bitch and whinge about things that they don't want to happen, but they have to take into account the size of the evils.

That approach does work for isolated communities like the Inuit, New Zealand, and presumably, the Channel Islands, but can you really see that happening in Europe as a whole? Even if someone with the necessary background and authority like Merkel made the suggestion and was backed up by the great and good (Macron etc) would the EU political process get it done? I don't think so. The UK is in theory more isolatable, but there just isn't the political or community will to make it happen unless there is a major change of messaging.

So my response to your excellent suggestion is, it ain't gonna happen - think of something else.

The most promising alternative/addition to the vaccine + restrictions scenario would be better mitigation of the disease itself. Get sick, get a drug, carry on.

Jeremy Farrar (Wellcome Trust CEO) and his colleagues have recently been talking up the need for more investment in treatments: "To date, over $2 billion has been pledged to vaccines while only $300 million has been pledged to treatments through the ACT- accelerator. Although $16 billion is needed in total for vaccines work, compared to the therapeutics target of $7.2 billion, this remains a significant discrepancy in how treatments have been funded to date. Further information on the investment case for the ACT-accelerator can be found on the World Health Organization website (https://www.who.int/publications/i/item/an-economic-investment-case-financi...)".

https://wellcome.org/press-release/wellcome-statements-novel-coronavirus-co...

As we all know, there are no easy answers
 

The vaccines target the spike proteins that are crucial for the virus to work. If the virus loses those spike proteins then the virus stops working and you don’t need a vaccine. 

You cannot give people choices , somebody has to lead and make decisions ,see how they work, be flexible to adapt and be prepared to admit they have it wrong. 

I thought many of the candidate vaccines present more than one target to the immune system...?

A mutation doesn’t mean that the virus “looses” the spike protein - it might for example mean that one amino acid of the many thousands in the monomer is changed to another amino acid.  Perhaps this breaks the spike and goes nowhere.  Perhaps it doesn’t break the spike but it does break antibody compatibility...

The spike protein has already mutated at least once, and as various countries have blossoming case numbers, the probability of another one coming along is rising...

Well yes. The spike protein and other proteins. The number of spike proteins have increased, they haven’t actually functionally changed, but that’s supposed to be what interacts with the ACE proteins in the lung and that’s what makes it deadly. Possibly increasing the number has made it more easily spread because it seems that version is more prevalent. That’s what I have read. 

Then why not try a major change of messaging? The messaging sent out by the government to date has been at best confusing and at worst seriously damaging.

It’ll never happen while we have political journalists doing science journalists jobs. 

It has! I have no wish to excuse their indecision, however that is what you get from the party political system, unless they abdicate responsibility to a group who can do the job - a war cabinet.

If I could wave a magic wand, I would remove all of the politicians (and their advisers) from the pandemic front line, and have a working group from Sage, the Treasury, PHE, and the mayoralties running the show. Then have the politicians say: "we are following ze orders...."

More generally, I think that the increasing involvement/control of and by the regions, and increased funding of the local T&T teams has to be a good thing. If we can get back to an August situation, we should hopefully then get a chance to decide how to proceed.

23 million on one Island with 7 deaths is Taiwan. 
 

But there would be uproar over privacy. 

I like your optimistic take on our glorious leader's messaging skills.

I was aghast at the time about Johnson claiming to have shaken hands when visiting hospital during the early days.  I can't conceive how someone who can presumably wipe their own arse and tie their own shoelaces could be so unbelievably dumb either from either a personal or societal perspective.  

I suppose at least he didn't go on record as stating he licked the door handles as well.

Look on the bright side. That clip will be played over and over again, it will end his career his politics, and it will follow him to his grave. I'd have loved to have blasted it through a PA outside the hospital window when he was on his death bed with covid.

Well yes, it's clearly going to be an ongoing battle but it's one we should at least try to fight before we give up and collapse our society in an orgy of misguided destruction.

jk

NZ is bigger than the UK.

And it's probably overkill, especially for a country with widespread ongoing community transmission, probably better from the UK's (or Aus's) position to treat travellers as suspect, require self isolation then if we ever actually get out sh*t together brief isolation plus test. As we approach zero cases the political pressure on the travel industry to nip off the remaining leakage intensifies but we're a million miles from there.

jk

What an extraordinary use of the term 'abdicate responsibility'! Do you think anyone 'abdicated responsibility' when they formed a war cabinet in 1940? It was an entirely responsible decision, and something we could do with now, but we're never going to get because we're governed by a bunch of world-historical numskulls led by a hubristic moron and supported by a surprising number of dimwits.

The bloke's all kinds of an arsehole and he's also a dab hand at making himself look a tw*t, but this hateful vindictive streak you keep airing on here doesn't do you any favours either.

It should haunt him to his dying day. That and backing Leave. If there were any justice in the world he would be in a two man peer support group with David Cameron for people with incurable night terror but the reality is it'll be water off a duck's back, after a moment of reflection it's all obviously someone else's fault and problem.

jk

I stand by what I posted, Gordon; I believe they they need to let the professionals do their job.

Perhaps there'll be another Norway debate tomorrow with Andy Burnham!

ff

You know me well enough to know for certain that I don't give a shit about that.

When I start being vindictive and nasty to someone who doesn't deserve it, by all means, pull me up on it. When it's Johnson, or the other Brexit c^nts, or anyone else responsible for the death of thousands of people's loved ones, then sorry, I'm just not really interested in your feedback.

Why is it not viable ?

If immunity lasts only a few months, I’d take a vastly expensive regular vaccination programme over regular immunity through reinfection (with death or serious long term effects a possibility each time). 

This is another that should be played over and over again. (And there are many others.)

https://twitter.com/AdamBienkov/status/782633174035787776?s=20

Don't misunderstand me. My concern isn't for Johnson et al, my concern is that if you make a habit of harbouring too many ugly sentiments, eventually it takes its toll.

That's a very good question and I'm amazed to think it hasn't been asked before. I haven't even thought it. Thanks. 

It would be hard but doable to go for zero Covid. Being an island must help. Lock down and close the borders. Trade in perishable and just in time items would be the real issue, not holidays. We can live without foreign holidays for a few more years - I do a couple of trips to the Alps most years bout would happily skip them if it meant no restrictions back home. Potentially any goods coming in would need to get transferred onto British lorries with British drivers. Or the overseas drivers get tested very regularly but that’s not foolproof. Actually, it won’t be an issue as Brexit will take care of cross Channel trade quite nicely...

Just not really a jesus sandles kind of guy. That ship has sailed, long ago - sorry.

No it won't, it'll be forgotten, lost in the static. No one cares, these c+nts can do whatever the f*ck they want and it doesn't f*cking matter. I am beyond incandescent in my rage against these heartless f*cking bastards and it just doesn't matter. Defeated. The jackboot is stamping on our faces and we don't care. So f*cking depressing. 

FTFY. 

No one cares about that either

Let's wait and see. It's one of the best political weapons I've seen in years, nearly as good as Corbyn and his wreath.

There's some crackers in that thread too!

Maybe stop throwing stones in that greenhouse? Your history with some UKC posters hardly merits sanctimonious comments to Jon about being nasty to a genuine c*unt like Boris who has led a government of national self harm.

I would follow Taiwan as a better guide( 23 million on an Island).

Can’t say I’ve ever said I’d like to kick someone to death or love to torture them on their deathbed. A bit of mild piss taking is about my limit.

Yeah right... black humour about a seriously dangerous PM who has led us to tens of thousands of unnecessary UK deaths, versus nasty attacks on someone in our UKC community for major crimes like having a different opinion and having had more than one profile.

We managed to get the virus under control in the UK though most of the summer, so we clearly have the capacity to do it again (and again if required). It's a huge gulf from rocket science.. Step one lock down most of England for a few weeks (a few areas where R is below 1 could be left out) to get the virus infection levels under control again, ensuring proper financial support as we did the first time (the current treasury parsimony is economically dangerous: extra costs are much lower compared to the costs of letting viable businesses go bust and losing useful jobs, and the costs should in any case be regarded as a war budget). Step 2 quickly build an adequate TTI system (no need for world class), adapting the centralised system with trace and isolate efforts mostly led by local Public Heath teams.  Step 3 improve messaging that this virus is mainly spreading by unnecessary close interaction indoors by people from different households (especially where ventilation is poor) so avoid this unless it is your job (and then follow strict H&S rules), wash hands regularly, wear masks in indoor public areas indoors when not eating or drinking.. Step 4 where local outbreaks occur let local teams lead on this, under centralised testing support and monitoring.

Right, nasty attacks being calling someone out on their underhand attempts to manipulate threads? If you’d like to evidence anywhere I’ve come even close to the sort of bile you’re insinuating ? Otherwise kindly get to f*ck with your misinterpretations.

Please keep on proving my point. Manipulation of threads versus tens of thousands of avoidable deaths.

It only works if people start thinking about brexit objectively, as a policy which actually does something, one with costs and benefits. Currently it's an identity and while that remains the case it really doesn't matter what it does, it must be right, it must be defended, its costs must flow not from inevitable compromise but EU punishment and remainer treason. For people who've so proudly and publicly worn their brexit identity for years now it's impossibly costly for them to row back from that. We're fu*ked, the c*nts who dreamed this up and sold it can do whatever they want with it, or bungle it appallingly, nearly cost free to them. They've already lost the 'remainer' support and they still won a huge majority under our broken electoral system.

The combination of that never to be faced brexit voter shame and the ongoing Scottish independence movement (a live GE issue if Johnson/Sunak wants: "Vote Labour, get an SNP coalition to destroy the union!") mean there's a real risk the 'Conservatives' could win again in 2024 even surrounded by the ruins of the nation they destroyed.

jk

It's entirely possible to do what is done for Channel Island freight - trailers are left in a marshalling yard on one side of the channel, stevedores put them on the boat, process is reversed on the other side of the channel. No cabs or drivers cross the channel. Perishables from Europe destined for the CI all go via the UK supermarket distribution centres and an extra ferry journey, so the UK could easily cope with any delay created by load on - load off procedures.  You could even do it within the UK if you were to create geographic boundaries e.g. Welsh / Scottish borders. Yes, it would be more hassle, but it's doable and people would accept it in return for an unrestricted lifestyle where they're not losing their jobs.

Over half of Boris's majority was won because progressives could not hold their nose and vote for a slightly different progressive candidate of a party they didn't favour most. Vernon Coaker's Gedling constituency starts 50m from my property so I know it well. He was an excellent moderate Labour constituency MP.  The political differences between the Lib Dem candidate and him were tiny but because the progressive vote was split the constituency elected a Boris lap dog as a result. Litle Englander UKIP supporters demonstrated much more nouse than highly educated middle class remainers as they tactically voted tory time and time again in key marginals.

I don't agree. I mean anything is possible but it stretches the idea of practical to breaking point, the south coast ports are squeezed in between cliffs and sea and the volume of freight is radically different than for a small island (IoM freight mostly also travels unattended). It would need to be a super slick operation bringing trucks in from inland holding yards at just the right time and rate but the slightest hiccough and it'd choke. Recovery from that would be difficult, to avoid big lags building up some significant slack has to be left in the system for disaster (even minor glitch) recovery, it all slows down operations reducing throughput significantly (necessitating use of less convenient ports since the popular ones have little spare capacity). It also radically changes the business models of the hauliers and companies moving goods through the ports.

That said, no-deal brexit is going to damage the ability of hauliers to operate seamlessly cross border so we may see more of the non-perishable traffic diverted to marginal ports for unattended loading, freeing up some capacity to adapt the flow through Dover.

I don't see any of this happening fast. There'll be a period of chaos followed by market driven adaptation through 2021-22 while the government stumbles about in the way.

jk

That hasn’t answered my question at all. You claimed this isn’t viable. Why ?

You don't give them the choice - you explain the options properly, do a representative survey, and go with the result.

The problem is that people thought it wasn't going to affect them, it was in Italy and they had time to prepare when it was actually already in the UK and spreading. Then they thought there'd be a lockdown for a couple of weeks to knock the virus back, they'd come out of lockdown and T&T would mop up the rest of the cases and their life would be back to normal with maybe some mask use or social distancing in shops.  The reality is very different. The necessary restrictions are more onerous than envisaged otherwise repeated lockdowns are needed.  Things are dragging on longer than envisaged. To 'live with the virus'

mask use is not enough. social distancing is not enough. rule of 6 is not enough.

School bubbles are necessary. Shielding the vulnerable is necessary. Work from home is necessary. Banning of indoor gatherings is necessary.  Socially-distanced extra-curricular activities are necessary. Banning of spectator crowds is necessary. Banning of contact & team sport is necessary. Banning of gigs and nightclubs is necessary.  Reduced commuter transport capacity is necessary. Additional social distancing and hygiene expense is necessary. Unprofitable levels of hospitality trade is necessary. Travel restrictions are necessary. Reduced day to day hospital capacity is necessary.

All those things hammer the economy, government finances, and community hard. Who would want or countenance that when they could return to normal bar travel restrictions?

What UK government are the least competent in modern history to deal with any hard brexit serious logistics fall out? What UK government are the least competent in modern history to deal with Covid? This one. How did such an awful government ever get elected with a huge majority. Well educated people across the country including plenty of progressives in marginal constituencies didn't do anything like enough to stop it. Too many progressives then blamed poor voters in the north for voting tory, often desperate people who had been abandoned by the political classes. Well meaning UKC posters think thread politics are more important to get angry about than the existential threats to the UK from Boris and his cabinet of clowns.

I want to agree with Toerag's suggestion for the ports.  It can be made to work, it isn't beyond the wit of man.  However, as you note:

Basically you could have plagiarised that text from a criticism of the problems in our test-and-trace system.  Both scenarios are logistics driven, and should be no problem for a well staffed, competent civil service and military working together and using private resources as required.  What actually happened with test and trace was throwing money at over 1,000 consultants from Deloite, who apparently are so technically incompetent they don't recognise that a chucking a bunch of spreadsheet files around isn't an appropriate way to build a bridge between two different database systems. 

But if I give in to this mentality that the government will throw money at the private sector's vampire class to f**k anything up, what hope is there?

The difference between trucks and TTI (mostly) data is trucks continue to share the road with other users and when a blockage occurs it can be very hard to shift. Robust, redundant data pathways should be easier to arrange than new roads and yards where there is physically no space.

It's not even surprising any more, just infuriating. It feels like watching a robbery in slow motion progress but in that dream state where you can't shout or move, you just croak in horror, waking if you're lucky.

jk

You say that, but I’m wondering if the reason they use .XLS files is because they still fit on a 3.5” floppy disk...

I think local eradication was the right approach in Spring, had it worked we would have had a less costly, better year for sure.

I'm not sure right now with the front-running vaccines close to delivering answers about efficacy that it's currently worth the cost. If they don't deliver then yes but for now it seems sensible to muddle through winter as best we can minimising harm. It looks like eradication will be easier to achieve at an acceptable cost in the warmer months anyway and at that point we should have trial results in and we'll know whether it's likely worthwhile.

jk

I'm not convinced the UK government has done much worse than anyone else initially, they had an uphill start with an over weight and unhealthy population, plus an under funded health service. Where they blew it completely was mixed messages, Cummings and then changing the rules nearly every week. Then when cases were hardly low they told everyone to go back to work, holiday and eat out. The British population could of course have used their common sense and ignored this advice. 

I agree totally with all the times you list, but...

I think they screwed the pooch well before then, by having the NHS discharge "bed blockers" back in to care homes without a sufficient test and quarantine regime when covid was already running throughout the hospitals.  I think this is what slammed the death rates to a world leading level so quickly (The US only caught up with our April level of per-capita deaths a few weeks ago) and what pushed healthcare to the brink so soon.  It almost certainly then drove rises in the community as it leaked back out of the homes.

I could be wrong; it's one of the things that will come out one way or the other in the inevitable public enquiry.

When you look across Europe we are marginally no different from everyone else ( well apart from possibly Germany).

I always have the view that in any major economic or social change Western European countries broadly follow the same pattern.Some things we do will in Uk, some things badly( after all we are well ahead in vaccines---(fingers crossed I am right)--- but I am not sure Germany for example is as cutting edge in thta respect)--- its roughly the same in other European countries.

And there have been some ferocious political battles about the right course of action elsewhere.

The sad thing is thta the rest of the world must look at Western Europe  and say what is going on, it does not look good.

I think most countries made errors with care homes, in differing ways, despite it appearing pretty logical in hindsight. 

There were care home managers at the time spelling out the problem clearly and with foresight.  As I recall from the time, some managers who were refusing to allow such discharges were being threatened with legal action.

No, there are no such examples. At least not according to the WHO, who would presumably know.

"...it's important to think about population immunity with respect to a vaccine because there really hasn't been any infectious disease that has been controlled just by allowing natural immunity to happen. So apart from the fact that it would take a very long time - because we've seen from all the serosurveys around the world that on average five to 10% of people have antibodies which means that they were exposed to the virus and they recovered from it."

- Dr Soumya Swaminathan, WHO Press Briefing 27 Aug

2020. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/media-resou...

An unhealthy start that are largely responsible for. They have under invested in public health for decades, under the pretext of fiscal responsibility, and now we are paying the price ten folds, not only in pounds but also in human lives.

Country by country policy comparison are difficult on the grounds of Death rates or cases alone, because there are big geographical and cultural, societal and demographic factors impacting the spread.

On explanation for the lower rates in Sweden despite less controls for example is the much bigger % of single person households.

However what is really important during such a crisis is trust between people and their government. I think it's fair to say that it is rock bottom.

The population is responsible. The public were happy voting for tax cuts and an increased zero rate threshold. You get what you pay for. It isn't the government's fault folk are obese. 

And we agree that this is not unique to the UK.

You think? I suspect the terms of any public inquiry will mean that the government comes out of it effectively smelling of roses.

The first specific fault was before this government; supressing the results (and necessary actions) from the 2016 NHS pandemic test exercise. I still don't think the report's been released.

I think all the evidence in England shows most people in marginals voted tribally rather than making real decisions. The main exceptions were poorer ex Labour red wall voters who switched to the popularist tory brexit line and ex UKIP voters supporting a tory led hardline view on brexit and moderate swing voters not voting Labour due to a stupid fear of Corbyn (stupid as he never stood any chance of winning a working minority for his politics so was either severely hamstrung or more likely toast). This certaintly swung seats like Gedling with a good moderate Labour incumbent to a Boris lap dog.

As for who did worse with covid my expectations of Britain facing pandemics are similar to North European nations. By any measure we had more notice of covid than any other Northern European country and yet made slightly or noticeably worse decisions initially and as time went on into late summer things just went downhill. This was mainly due to trying to save money instead of supporting those who needed it in business and in work (which led to the unworkable, damaging and insufficiently tight Tier 3 system)  and giving too much money to cronies who gave us things like a defective TTI system for £12 billion. We are now playing chicken with a hard brexit as the current covid protections crumble. No other EU country faces such a perfect storm.

It's not unique, but particularly acute in the case of the UK government.
We see the same phenomenon of plummeting trust in other populist led countries such as the US.

It's always someone else's fault. You know that refrain is starting to be bit tiring.

The reality is that the conservatives have been in power for ten years under the promise of making thing better both in terms of  the NHS but also in terms of the fiscal situation, and so far everything has become terribly worse. But hey, always someone else's fault.

The alternative might be true ?

https://www.theguardian.com/commentisfree/2020/oct/20/brexit-gove-no-deal-i...

I'd blame all parties. The UK hasn't just had one of the lowest health service funding per capita in Europe recently. It's been that way for years, decades. Only the lib dems promised higher taxes(1%) for better nhs funding and it went no where. 

It's everyone fault. Everyone expects the UK to have world class everything but the majority aren't prepared to pay for it. It's always someone else who is expected to pay. Just like Labour's last promise of only 5% will pay more tax. 

You could say that of any policy issue. But the gist of it is that the conservatives are in charge and the bucks stop with them. The fact they they don't take responsibility for anything is a unmistakable sign of poor leadership.
Conservative manifesto after conservative manifesto said they woudl make healthcare and the fiscal situation better. They massively fail on all counts.

Probably.

I was going to lay first-fault at the disbanding of the regional public health observatories in 2013 and the centralisation of the staff who didn't quit into the then-new PHE.  

The ongoing suppression of the "Cygnus report" is an absolute bloody scandal.  Imaging having literally just done a crash course in exactly what to do to make it through a global respiratory pandemic, ignoring the findings before the pandemic starts and continuing to ignore them after it starts as well.  As another poster remarked though, the findings would have been written assuming the cabinet to be minimally competent so wouldn't have gone it to the level of detail of "don't visit hospitals, don't shake hands".

Well lets wait until we see the results of the US election to see if it has hit home. Its more a crises of Western European democracy at the moment with a few odd exceptions.

Paradoxically we still have 250,000 or so Chinese students here, so despite China lauding it about suppressing the viris, its still not ideal elsewhere....My brothers English for Foreign language course at a Uk Uni is  full of Chinese students over here.Go work that out.( oversubscibed 10 times).

There are Chinese students in every developed country of the world, I don’t see the point or what the hell are you on about.
I'm talking to you about the fall in trust in government and your reply is "yes but my mate says Chinese students are still coming so we must be ok". This makes for a rather absurd conversation.

Standard have fallen quite low if now the democratic benchmark we are measured against is China. Your clutching at straws here.

If I may say so I find it difficult to have any productive debate with you as you never address any challenge to any of your claim, instead you resort to cheap whatabouteries or just reply with something vague and completely unrelated. Can we just have a bit more focus ?

Works both ways.....if you cannot see the paradox of China allowing its youth here despite saying we are useless-...then I give up

Well it does, but I'm doing my part, you are not doing yours.
 

Well no I don't' see any paradox, I also don't see any relevance to the discussion. Nobody said "we are useless" either.

I'm simply pointing out that we have an incompetent populist government, by modern democratic standards, with historically low levels of trusts,

Your only reply to this is "ho well a small proportion of the student population of an autocracy with a billion people still want to come to study in UK universities so it must mean we aren't that bad"

If you don't' see the absurdity of this kind of lazy reply I can't really do much here. All it means is that we have relatively attractive and prestigious universities. Nice to have but a completely different topic.

I don't know whether that was intentional, but I like it anyway!

At least they didn't sell off the gold cheap, and they didn't claim to end boom and bust. Both parties have neglected the nhs for decades, they've both spent just enough to keep it ticking along. Granted Labour might have agreed a few more pay rises, but with a million staff that's a lot of votes to buy. It's doesn't impact the services though, only the workers. How many politicians of any colour actually accept any responsibility for things not going to plan? 

Ps. Up until covid they were making progress with the annual deficit.  

Funny how you make it an argument about Labour. When I point out a decade of failure to deliver on promises made, your argument go along the lines of « well it’s Labour’s fault » « it’s the population fault » etc etc

Always someone else’s fault basically. After ten years your are still blaming Labour, that familiar trope is starting to wear quite thin. 

Do you even believe your own BS at this point or this is just tribalism ?

Funny isn’t it, when we talk about the large losses or mistakes they have made, they are never responsible, but you give them credit for small gains they have made.

To sum up your reasoning, everything that went well we can credit the conservatives for it, and everything that went wrong they are not responsible.

Your problem is that your are extremely  politically biased and therefore come up with analyses that lack so much objectivity that they reach the point of absurdity.

German companies have two vaccine candiates in phase III and pre-licensing production, and a third one lagging a bit behind (but still financed primarily for pork abrrel reasons).

CB

Even your grudging acknowledgement that Labour increased funding to the NHS while the Tories have consistently cut it comes with the completely unjustified, and frankly laughable, accusation that it was purely for immoral vote buying.

That's Fox News level spin.

Up until my house burnt down, I was making progress on my budget by not paying for home insurance.

I'm not a conservative supporter or voter. I don't think very many politicians of either big party have served the UK population well over the last few decades, they've all been incredibly short sighted when it comes to taxation and investment. 

Just a gentle reminder that you are the one who gets banned from the forums and then have to come along with a new identity. How many times has that happened to you.?

I knew you would come along to update me, thanks for the correction. 

The Labour party and unions are so intertwined of course there is an element of vote buying. But it's no different to the Tory party not closing every tax loophole for their wealthy donors. They are all at in differing ways. Both are essential to stop their political party going bankrupt. The funding of politics is corrupt or rotten as many MPs expenses, or even the peerage system. 

Fair point. That's UK budgeting in general. Look how low tax is, just don't look to closely at the national infrastructure, health, education, social care etc.  

You're going to have to do far better than that to convince anyone that paying medical staff a little better than the absolute minimum you can get away with can in any way be interpreted as vote buying. Your Fox News slant is missing most of the steps in any conceivable line of reasoning.

First of all I have never been banned of UKC. Never. So if you’re going down the road of personal attacks instead of addressing my point, at least get your facts right.

In any case, I note that this last reply from you, again, is pure whataboutery and fails to address any of my points, which was exactly my criticism in the first place.

For someone who doesn’t support them you do spend an awful lot of energy defending the indefensible or excusing the inexcusable.

As such your above statement betrays a fair amount of cognitive dissonance and guilt washing.

That’s a very good point about trailers being detachable and presumably standardised. 

Yep. The only ones that come across with a cab & driver are specialist cargoes such as bitumen or removal trucks.  All the food or general goods comes in on 40ft reefers or curtainsiders.