UKH

(necessarily) 

There is an awful lot of shouting (forum shouting) that we are following Italy, what's happening in Italy is happening here etc.

With the idea that any other outcome is not possible. 

And any suggestion of a different outcome is met with 'that's not what is happening in Italy'

Can I suggest that this -may not- be the case. If you look at the worldometer there are very different numbers for different countries. (check out Japan for example). There will be other factors involved, some social, some connected with healthcare, and potentially some with genetics. Identification (asymptomatic, ill, or death) will also change the data.

So please stop blindly saying 'we are following Italy'. We may follow Italy's trajectory, but it is not a given..

We are following Italy

Looks like we are to me.....    http://nrg.cs.ucl.ac.uk/mjh/covid19/

It's plainly obvious that the only European nations not following Italy are the ones locking down or testing and tracing harder and faster than Italy did.  Expect to see an explosion of cases in a week's time when all the people who went out on the 'last night of the pubs' start showing symptoms.  Due to the lack of testing the country is running blind, and the general population aren't as worried as they would be if case numbers were higher. Because they're not as worried they were ignoring the social distancing rules. Until they start seeing deaths in their towns they think it doesn't affect them, and the fact that they're infective before being symptomatic, or aren't symptomatic at all plus it takes time to get tested (plus the infectivity of the virus) means the virus gets out of control before people realise it has.

Oh dear.

Even the government are now saying we appear to be following Italy with a difference of about 14 days.

I’ve not seen anybody saying we are bound to continue along the same path.

I have seen people note why Italy is different to us to our advantage (more old people, more inter-generational households, more physical contact between friends) and  where there are similarities (generally slow and reactive not proactive response, not taking things seriously in the critical early part).

I’ll note various posters including myself were making the case that the UK needed to take more drastic action   if we wanted to avoid serious consequences.  Well, now we have the greatest ever curb on individual freedom ever seen in the UK and we are still lagging Italy by about 14 days.

I guess you missed the various discussions about how the policy and reaction in the UK is much more like that in Italy than that in Japan?  

Again, this has been discussed.  The detection rate is not so good a comparator between countries but the death rate is.  Ours is currently 14 days lag from Italy’s.

Good.

I hope that you are right. 

It could be that we do follow them, but we may not. 

An unknown is how quickly we can adopt assays for antibody status of individuals. Are these all or nothing type tests, or do they give some idea of antibody titres/levels of response?

Rob

At the moment. And we may. But, as I said, not necessarily. 

I don't think it's a good straw man to say that we WILL (sorry I don't know how to do italics) follow Italy.

That's what everyone seems to say, in response to everything 'look what's happening in Italy'. What's happening in Italy is going to happen here. etc.

No.  What people are saying - exhaustively is “we are currently following Italy and our policy and actions are like Italy’s so we are likely to continue to follow Italy”

I talked about these reasons and your “but Japan” argument in my post.  You apparently chose to ignore all of this.  

Why don’t you try reading my post again?  I went in to a lot of explanations specifically for you.  You’ve just cherry picked one line and reverted to the stance from your OP.

Doesn't matter if we do or don't academically. What matters is seeing what could happen and being prepared for it or trying from others experience to do better. 

It could of course be worse than Italy.

Interesting that the mayor of bergamo, the epicentre of the Italian outbreak, brought his daughters home from the UK because he thinks them safer there.

What is really important to know is that those measures will have a delayed effect.  The incubation period is about a week, and the time to death typically 2-3 weeks.  This means that we are only just now seeing the effect of the first "please work from home" last Monday, and won't see the effect of the pub closures for a few days, nor the effect of the tighter lockdown for another week or so, and much longer on the death figures.

Agreed.  5-7 days seems reasonable.   I also expect the effect of Monday’s changes on detection rates to be masked by a massive rise in testing coming soon - 7 qPCR machines were moved by the Navy from Newcastle Uni to a testing centre in Milton Keynes a couple of days ago and are now set up for testing.  I imagine more are coming in from elsewhere.  The death rate takes over as the accurate reporter and that’s got more lag.

So, people, keep the faith - even if there’s an accelerating rate of detected cases for the next two weeks, lockdown is making things less bad than they would otherwise be.

It didn't chose to ignore the rest of your post. Forgive me for me not fully extrapolating - yes people are saying we are currently following Italy and our policy and actions are like Italy's so we are likely to continue to follow Italy. 

I'm say I don't believe this is necessarily the case. I'm not saying it is, or isn't correct, but I am saying that people who are presenting it as a fait accomplis are wrong. I believe there are too many interlinked factors to just say if we follow Italy's lock down time frame we will have the same out come as Italy

Morning wintertree!

Help me out ... i've not been keeping up (moving too fast )

Yesterday I was looking at a chart of Y: Reported infections per 1 million people vs X: # of days after total reported cases reaches 100.  i.e. objective was to baseline countries at the same starting point ... then look at their curve and asses how quickly the growth was thereafter.

Page 2:  https://www.jpmorgan.com/jpmpdf/1320748295335.pdf

In this chart ... after 100 cases/million Switzerland took off like a rocket, then Spain, then Italy, then Germany, then France ... then UK.  Agree 100% ... UK is ~14 days behind Italy ... but in this chart UK growth after 100/million hasn't been as aggressive as either Switzerland (which we really should be worried about), Spain, Italy, Germany or France.

Can you bring me up to date on why we think the UK is so similar to Italy?  Or you are saying our detection rates are off and we are in fact on the Italy trajectory and will catch up once we start testing more?

Cheers

I don’t think we are “so similar”.   The link Toerag posted is by far the best visualisation I have seen.  Our detection rates are slowing down now - just like Italy’s did a couple of weeks ago - social awareness, increasing control measures kicking in etc.

Our exponential growth curves still align well with a time lag of about 14 days.  It’s now better alignment for 15 days, so I’m the last week we’ve bought ourselves about a day - going off detection rates.

Detection rates are not the most useful as they under-detect by different amounts in different counties and the testing fraction can change.  Death rates are a better readout (other than old people being left unreported to die in care homes as in Italy) until healthcare is overwhelmed as in Italy, raising rates.

The UK will probably have a large rise in detected cases soon representing more testing not more infection.

It does look like the detection and death rates are lowering slightly for the UK for a 14/15 day lag compared to Italy, over the last 3 days.  If that continues to be the case that’s great.  Not nearly great enough. 

I’ve never said we are bound to continue following their trajectory, and have repeatedly said the only way we are likely to break out of their track is through taking more extreme measures and doing so sooner with respect to that lag.

You seem to be misreading the chart severely.  It is from 4 days ago before the UK passed 100/million so there is no “UK growth after 100/million”.

My own wishful thinking is that this is going to slow down as it runs in to all the people infected/immune from a mid January UK wave of infections spreading out from international students and businesspeople returning from Christmas and that puts herd immunity ahead of the infection.  Highly speculative, something that’s been discussed for a long time on UKC and now there’s the oxford study discussed elsewhere to give me hope.  It just doesn’t seem credible however

Can you actually find and link a post where it’s presented as a “fair accomplishment”?  Several people have been going out of their way to interpret posts as that despite clear explanations otherwise.

The point is if we do not want to be like Italy we have to do other than Italy did.  Simple point, clearly made throughout and the point remains the same.  If it’d been heeded nationally and individually a few weeks ago we could have perhaps been more like Japan.

Hey thanks for getting back to me winterfree.

Why are you choosing T-14/15 rather fixing the starting at a fixed point , for example, 100 recorded deaths as a result of Covid-19?  I ask because an exponential curve can be made to look like another exponential ... if you slide it back along the scale until it fits.  This chart aims to remove the T-X days guess work and instead start the counting from a fixed baseline.

Agree.  We could use the WHO sit reports data on deaths, baseline at 100 ... and chart for UK vs Italy.

https://www.who.int/docs/default-source/coronaviruse/situation-reports/2020...

You'll need to help me with that one wintertree.  The chart is showing that after the UK reached the same baseline starting point as Italy (100 reported cases = day 0) the growth of infected per 1M is less steep than that of Italy i.e. People are getting infected much faster in Italy and/or Italy is detecting the infected much more effectively than the UK.   Help me out ... you are reading the chart differently and in fact the UK is on the same trajectory as Italy?  What am I getting wrong and what does the fact that the chart is 4 days old have to do with it?  

I'm not getting at you.  I'm only asking you to help me understand why you think the UK is on the Italian trajectory.

Thanks for keeping it civil!  Cheers.

  http://nrg.cs.ucl.ac.uk/mjh/covid19/

Makes you wish they used the graph colour consistently - same colour for each country on every graph...

okay ... I've dug the numbers out from the WHO daily sit reports using deaths rather than infected as requested.

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

***Data***

date,UK,UK_death_million,Italy,italy_death_million
04/03/2020,,0.0000000000,80,0.0000013228
05/03/2020,,0.0000000000,107,0.0000017692
06/03/2020,,0.0000000000,148,0.0000024471
07/03/2020,,0.0000000000,197,0.0000032573
08/03/2020,,0.0000000000,243,0.0000040179
09/03/2020,,0.0000000000,366,0.0000060516
10/03/2020,,0.0000000000,463,0.0000076554
11/03/2020,,0.0000000000,631,0.0000104332
12/03/2020,,0.0000000000,827,0.0000136739
13/03/2020,,0.0000000000,1016,0.0000167989
14/03/2020,,0.0000000000,1268,0.0000209656
15/03/2020,,0.0000000000,1441,0.0000238261
16/03/2020,,0.0000000000,1809,0.0000299107
17/03/2020,,0.0000000000,2503,0.0000413856
18/03/2020,55,0.0000008278,2503,0.0000413856
19/03/2020,103,0.0000015503,2978,0.0000492394
20/03/2020,144,0.0000021674,3407,0.0000563327
21/03/2020,177,0.0000026641,4032,0.0000666667
22/03/2020,233,0.0000035069,4827,0.0000798115
23/03/2020,281,0.0000042294,5476,0.0000905423
24/03/2020,335,0.0000050421,6077,0.0001004795

If rather than using T-14/T-15 ... we instead use 0= 100 deaths.  UK = 19/03, Italy = 05/03.  (Which incidently is T-14 anyway.)

Rebaseline the data (get rid of the deaths/million .. irrelevant since population ~the same)

T,UK,Italy
0,103,107
1,144,148
2,177,197
3,233,243
4,281,366
5,335,463

By this measure ... Italy took off on different trajectory from UK - much steeper.

Help me out.  What are you seeing in this that I'm not.  How are you coming to the conclusion that the UK is on the same trajectory as Italy?

I appreciate you sticking with me on this one.

Cheers.

[1] I didn't go back on the UK after I reached 100.  Stopped there on purpose.

[2] I used google population of UK =66.44M and Italy = 60.48M respectively.

*Fixed my dodgy 2nd set of data.  Yeek.

The starting point used by the JP Morgan study you linked was 100 reported cases, not deaths.  This makes a massive difference to how piss poor their methodology is.

It's not "me" its the author of the document Toerag linked.  I find their approach useful.  To explain their methodology - it's not a "fixed point", and it's not "chosen".  It's the time offset that is "found" to give the best agreement between the curves.  The two things measured by doing this are how far "behind" one country another is and how "fast" the infection spreads in terms of the exponential rate.  

The first recorded cases are highly misleading as they can be dominated by imported cases which are - hopefully - quarantined and not by the local-local transmission, and by differences in how pro-active the countries are in testing travellers from infected regions and suspected cases.  The analogy I have use before is counting sporadic small fires vs studying the one that grows out of control into a giant moorland fire. 

Not true.  This can only happen for exponential curves with the same growth rate.  If the growth rate is different, they will never look "similar".  In a log-y axis plot (as in the document Toerag linked), the exponential growth rate is the linear gradient.  

I wouldn't like to speak about their "aim".  Hopefully I have now explained how "T-X days" is not "guesswork" but a method based approach.  Saying we are "14 days behind Italy on the curve" does not mean "we are 14 days behind Italy on the ground" but it does mean we have the same exponential growth rate (very bad news) and our detected cases are following theirs by 14 days (somewhat good news as it gave us more time we could have acted more in)

Rather than baselining on 100 deaths, time shifting is more appropriate as I mentioned above; in either case the key parameters is the day-to-day growth as a ration, percentage, fraction or whatever.   In practice, deaths whilst still in the 100s are a better reporter of true infection rates and so there is good agreement between "T-X" days and baselining to 100 total deaths.  You can see this in the plot "Western Europe, Deaths Per Million Inhabitants" in the document Toerag linked.

The tentatively good news there is that in the last 3 days (time since the JP Morgan document you refer to), the UK is dropping below Italy in the "T-X" curve.  This suggests we are either lowering (exponential) rate of spread of infection and/or are providing better clinical care.  This is what happens if we do more or do it better than Italy and is really promising to see.   

About the JP Morgan document you linked, you said "but in this chart UK growth after 100/million hasn't been as aggressive as either Switzerland".  I pointed out that in the 4-day old data in that chart you linked the UK had not reached 100/million and so you must have misunderstood it as it's nonsensical to talk about "UK growth after 100/million" (your words) for a country that is (my words) "before 100/million".  What you are talking about does not exist in the plot.

The UK is so squashed down to the bottom of that chart it's hard to tell much about it, and comparing exponentials on a linear plot is really difficult.  If you trace the UK curve on a piece of thin paper and slide it along to the left it matches the Italian one quite well.  The massively misleading thing about the JP Morgan data is using "100 reported cases" as their baseline.  This is my "sporadic little fires vs giant wildfire analogy".  Their baseline is subject to an awful lot of randomness in small numbers before the freight train of exponential growth takes over.  

Consider two otherwise identical countries with 10x different testing (and therefore detection) rates both done randomly across the population.  The country testing more aggressively would explode sooner on the JP Morgan plot but both countries would actually be equally screwed.  The testing rate does not change the exponential rate of the curve however, it manifests as a left/right shift.  

The specific statement you made and asked me to reply to is invalid.

Any time.  It's been very interesting for me to see a lot of very smart people (some I am sure quite smarter than me) are having such difficulty seeing what I and other people from similar fields to me see in the data.  It really is very easy to be mislead, and quite a few people in the media preparing analysis are completely out of their depth in doing so and don't realise it.  

Edit: The key point to me is not to get drawn into endless navel gazing over numbers riddled with unknowns and situation dependant differences.  The simple point behind the Italy comparisons several poster have been making is that they were in real trouble and that the UK was taking fever protective measures and appeared to be going the same way, and should probably do something about that whilst it could.  We are now doing things - partial lockdown, preparing for a massive ramp in testing capability, preparing massive field hospital capacity.  I think we will now break the back of this virus sooner than Italy but by god until their U-turn this government took us closer to the brink than I can believe.  

This is why you think I am not listening to you.

I don't agree. that 'if we do not want to be like Italy we have to do other than Italy did'

Other than your poorly explained mention of “genetics” what do you think is going to make us fare better than Italy *without doing things differently*?

To repeat I am not and have never been blindly saying that we are following Italy.  I have been saying we need to work hard to not end up going down the same road as Italy.  You apparently also disagree with this?  Perhaps the warmer weather in England will save us compared to Italy...

Here is a fact if you dont think we are.

My sister is manager of a care home, on friday evening a work colleague of hers with whom she had been in close proximity of for a number of days, Fell seriously ill and was taken to hospital with suspected Meningitis.

It turns out it was covid.

So my sister had to be informed, my sister fell ill on monday evening with symptoms, it doesnt take a rocket scientist to know that she has it. Yet they will not test to see if she can go back to work.

She is so upset that her residents may have also caught it who are all vulnerable.

Her family are all now at home thats four under one roof I think we can safely say they are all infected!

The outcome of which so far we will not know.

My partner also works in the care sector for NYCC.

She was informed last night that one of her clients though not tested is also most likley infected this information was given to her by the local doctor.

So this is just me, how many others like me know of almost certain case's.

Give it two weeks you will see the full magnitude of what is unfolding!

Thanks for that fact, it is a nicely emotive scare story.  You have completely misunderstood my point. I haven't said that there isn't a huge health problem about to sweep through the population (or however you wish to describe it) I have just said I wish people would stop banging on about Italy as the poster child for what happens to a country if it gets hit by the virus and follows the same actions that Italy did. 

Edit: aside from the discussion, I should say I am sorry to hear about your sister and the residents in her care home. It is quite horrible how it is going to closely effect everyone.

What do you mean poorly explained? Humans are not identical and different genetic make up will make them differently susceptible to different diseases. That is fairly well understood and agreed on.

Additionally, cultural behaviour will change the natural spread of the virus if there is no intervention. For example the Italians frequently live in multigenerational families, they are far more tactile and generally more sociable than the British. Who knows if this would make a difference or not, but I disagree with the assumption that we are the same and equally susceptible. 

They also mostly live in flats in their cities, we mostly don't other than London.  Most people in the UK can go out and return home (say for a run) without touching anything that anyone else has touched at all.  Most urban people in Italy, Germany, France etc can't - think doors, banisters, lifts, passing people on stairs etc.  It's only really the Netherlands that are suburban house dwellers to anything like the same extent as us.

You mean what we do will be different to what Italy is doing?  That has been my part of my point all along one one you disagreed with not two posts ago.

Although it’s remarkable that despite the big social differences we have been following such a similar track Italy with a lag of about 14 days.  The funny thing about lots of different factors is some are one way, some are the other and they tend to average out somewhat.  A phenomena called a “Fermi estimate”.  You focus on the ones that make it worse for Italy.  Yet our similar course to date suggests there must be others that make it worse for the UK; finding and controlling those should be a priority.

From my view you continue to argue against a stance I haven’t actually seen made on UKC, more against your misinterpretation of what has been said here and even lately Boris himself.

arghhh! No! I mean pre virus, I mean cultural norms. I mean standard cultural behaviour pre virus intervention. 

Then how do you explain the exponential rate being so similar for both countries in the first month or so of local infection?    That’s unarguable now and has solid data (Toerag’s link) and has been recognised by sensible government

For that similarity to change going forwards, something different has to change, or there has to be a pre-existing societal difference that only “kicks in” about now.

It looks like the UK is going to take tougher control measures and do much more testing now so I expect the trajectories to diverge more.  Critical to this seems to be that the government got the message that we had to do more than Italy to avoid ending up in their situation.  

But all the evidence suggests that it most likely is. We definitely should be banging on about it!

https://www.facebook.com/photo.php?fbid=10219301871391874&set=a.1147301...

As an engineer I review a lot of study results like this - my main concern in drawing concrete solutions is that the author has shifted the plots sideways on each plot in order to overlay them but not by the same amount on each plot.

We know that different countries are recording the cases/deaths in different ways - Germany is not postmortem testing (i.e. if someone dies before a +ve CV test, then their death is not recorded as CV related), and France is not testing people who die outside of hospital, so both countries have artificially lower death rates. Britain is not testing as much so our cases rate is likely to be a significant under-estimate.

If I were "in charge" though I think the data is showing enough risk to justify the action the government is taking. Whether or not we will do an "Italy" is largely irrelevant. 

The picture will become much more complete when antibody testing is rolled out, until then we have to act to avoid the worst case scenarios...

So far our trajectory is slightly worse than Italy. We’re much more similar to Spain right now. But we took action just a little bit Italy, relative to where we are, so maybe won’t be as bad.

That’s intentional and is one of the key points.  This shift does not change the *gradient* of the log-y plots, with the gradient being another key point.  Doing the shift makes a measurement (the X in T-X days) and along with a log y axis makes it very easy to compare by eye the key measurement embodied by gradient.

The amount each is shifted he is a measurement not an arbitrary quantity and is a holistic (using all dat) way of giving some sort of comparison between different countries with different local transmission start times.

I agree with the rest of your post.

Ok, let's take a different, non-numerical perspective. If we are not following Italy, how will that change things for you?

Will you feel better?

Will you behave differently?

It is a special (and slightly technical) property of exponential growth (and the log-y graph linked earlier being linear shows that the growth is exponential) that, if a country detects a fixed proportion of cases, or records a fixed proportion of covid deaths as being covid, then, if the true infection or death rates are following the same exponential growth, the graphs will fit if shifted sideways (wintertree alluded to this earlier in the thread). So it is entirely reasonable to shift the plots different amounts sideways to make them fit - the different shifts simply reflect different detection rates - and conclude that the true rates are similar.

The UK as a whole might not follow Italy. But London might follow Lombardy, dense urban area, high footfall in shops and transport etc. With an incubation period of up to 14 days, plus (according to r4 more or less) the average time to Death, for those that die, being 2 weeks, the measures that started yesterday are a few weeks away from having a significant impact on fatalities, new infections should now of course fall. 

Being alarmed at the prospect of following Italy doesn't seem like a bad thing if it means we do things to make sure we don't. 

Our deaths are dominated by London. 1/3 of them. Also London has a massive ability to work from home and are mainly young people. However, we have been cramming people into trains. But we have all been washing our hands like mad and are generally quite socially distant compared to the kissing Europeans. 
 

Italy deaths are dominated by old people in villages and care homes. 
 

Different demographics and behaviours. 

I have no wish to underplay the risks, and I think our numbers will continue to rise scarily for the next couple of weeks, but there is one significant difference between the U.K. and Italy. 
That is, that even while the government dithered and delayed, a lot of the population and a lot of companies were making significant social distancing steps, especially the most vulnerable, precisely because we could see what was happening in Italy. 

Totally agree - I pushed hard for my employer to react in advance of the government as did many others, and react they did.  Many individuals did too.  Those of us far from London will have that as further motivation.  I really hope to see this difference develop over the weeks ahead.

It will make me feel better if there are less articles in the media (print, online, old and new) about doctors from Italy, people from Italy, the world and his wife saying that if we don't act fast we'll end up like Italy. 

Sorry, but that sounds as if you want to bury your head in the sand. I hope not, but I think there is a very good chance you might be looking back on that post in a few weeks and seeing it as somewhat foolish - either we shall be like Italy or the fear of being like Italy will have led us to take drastic action to avoid being so.

nah, I'm well aware of the problems that we face, several friends work in the NHS, another in emergency planning for the government etc. blah blah.  I'm just bored of hearing about Italy, we're not Italy.

But you're stichtplate and I claim my £5  

Yes but we are like Italy

Oh yes we are

He's behind you

Why did you start a thread about Italy then and contribute about 10 posts to the thread?

I guess none of us are busy key workers.

Hi Robert, you miss my point, if you look at the cases graph, Spain is 5 days behind Italy, on the deaths chart the author has had to shift the plot by 8 days for Spain to overlay. This suggests the deaths/cases ratios are not the same, which in turn suggests we are not getting the full picture perhaps for either country. The overall message is pretty clear though...

We *have been* following Italy, the graph is absolutely clear.

We still are not doing enough to get off that path.   London in particular probably has a disaster already locked in.  Maybe some other regions have shut down hard enough and fast enough.  But we don't have proper cordons between regions and folk with symptoms - including Prince Charles - are running from London and spreading it.

Or the infection/detection ratios 

Totally agree.

Yup, and the key point to me is that the day-on-day fractional increase - the key measure of spread - is unrelated to the x-axis shifts and relates only to the gradients, which are not changed by the shifts.  

Or the deaths/reported cases ratios are not the same; the shifts are a combination of the actual lag between the countries and the proportion of cases or deaths recorded. Either way, the graphs suggest that the doubling times for cases are similar and that the doubling times for deaths are similar.

What is it that you think we will gain, by not considering ourselves on the same path as Italy unless we do something about it?

Exactly. 

Edit: It's a case of 'What happens if we hurry and take preventative measures which have a temporary economic hit but save lives?

Italy aside, has anyone seen any reports from Russia as they seem to be conspicuous by their absence in tables?
 

I reckon it's all just another Westminster conspiracy.

Why not?

There was a lot of this said a week or two back and it sounded like the usual English exceptionalism, I didn't agree then and I'm struggling to now.

jk

...If they're sufficient.

It may well be in a dense urban environment like London or New York that is very heavily dependant upon public transport that it's impossible to fight/treat the disease without the transport network open but that the environment is sufficiently contaminated it's impossible to contain the growth with it open. In which case different measures are needed, whether they're practically achievable or palatable...

jk

I understand. So you think there's a chance that the UK experience will be different - better or worse? Should we not act, or are you just a bit fed up with all the CV coverage?

Of course you are not Italy.

If you were, you would have won the football world cup more than once (and would not have needed the help of some dodgy linesman ...).

CB

My apologies for the delay in getting back to you wintertree ... home school to run. 

Last questions:  

#1 The charts in http://nrg.cs.ucl.ac.uk/mjh/covid19/.  I see on most charts multiple dotted lines at various gradients.  The country lines appear to show initially a steeper gradient before curving round towards a more shallow one.  Am I reading them right to understand that the exponential growth rates are deceasing (for whatever reason)?

I appreciate you sticking with me - thank you.

Correct - keeping in mind it’s either the exponential rate in *detected cases* or *recorded deaths* that is decreasing, They have to curve over at some point until they aren’t exponential any longer, as a country runs out of uninfected / non-immune people.  Hopefully they start dropping under the initial curve sooner as control measures kick in - with a delay from when they start happening to when they show an effect.  Without control measures it goes from an exponential to a “logistic sigmoid” over time - https://en.m.wikipedia.org/wiki/Logistic_function - control measures may just reduce the exponential rate (gradient in the plot you linked), or may force it sigmoidal sooner, may lower the final line and may introduce all sorts of complex structure.

Got you.

Can't help but think that a big part of the problem is the inability for us humans to naturally understand the exponential:  https://www.albartlett.org/presentations/arithmetic_population_energy.html

Anyhoo ... thanks again.  Been a good experience on UKC forums.

Peace out!

If they did, car finance and living on credit would never have become commonplace.

I think the media have a lot to answer for here as well - many of them didn’t understand either and so they did not communicate the situation at all well; I still see that in some of the data in the press now.  To my mind the media should have a duty to understand what they report on.  I’ve been particularly unimpressed by the BBC “expert”.

Two powerful visualisations on an exponential are putting 1 grain of rice on a chessboard square, then 2 on the next, then 4 and so on.  How much rice do you need?  It’s only 64 numbers, doubling each time; a simple paper exercise. Speaking of paper, how many times do you need to fold a piece of paper before it’s a km thick?  About 24!

Yes. On the log scale graphs exponential growth is a straight line. The rate of that growth is denoted by the steepness of the line. It is still exponential growth though. So, most countries do 35% per day to start with - doubling every 2-3 days. Countries with moderate controls (social distancing, partial lockdowns like UK and most of Europe) grow at 22% - doubling every 5 days. Countries with hard lockdowns or strict rules who caught it early (South Korea, Japan) see lower rates still, but it's still exponential, just over a much longer timescale. Growth builds on growth, like compound interest.

Maths experts - can you tell me if the 35% / 22% 'slope rate' is a compound one? I.e. if it's 33% does that mean 33% of today's value each day, or 33% of the previous days value?

What no-one seems to be doing is working out what rate we need to keep below to prevent the NHS being overwhelmed. There's some ideas of ultimate case numbers the NHS can handle being bandied about (NHS have xxx ICU beds, x% of case will require them, therefore the total number of cases = yyy), but nothing on when we'll hit those numbers with what growth rates. For example, South Korea's growth rate is relatively low, but it's still growth and at some point either the health system gets overwhelmed or herd immunity kicks in. Which comes first for the UK at what rates?

The author alludes to that in his commentary on the US death rate per million graph:-

"Confirmed cases in the US have been growing very fast recently. The US testing procedures were very slow to get started, but are reported to have scaled up quickly. How much of the rapid increase in case data is due to this scale-up? This graph shows the US death rate, with Italy and France for comparison. When looking at confirmed cases, the US is roughly 15 days behind Italy, whereas when looking at death rates, the US is roughly 19 days behind Italy. This probably indicates that a small part of the recent increases is indeed due to improved testing, but the difference is nowhere near as large as Germany or Luxembourg, so the underlying infection rate must also be high. If this gap widens in the future, then this would be evidence that testing is getting ahead of the epidemic."

Italy is only testing hospital cases too. This is one of the problems with the whole thing, no two countries are testing the same sorts of people, or counting the deaths the same. Here in Guernsey they're only testing people who are hospitalised or have travel history or contact history with travellers due to a lack of ability to test. They've only identified one 'community seeded' case, but that's because they're simply not testing for it .  However, as long as a country's method remains constant you can compare the graph shapes.  We've now just got a tester on island, so I'm expecting our test and confirmed case volumes to rocket over the next few days.

.........and then only another 18 times to reach the moon.

I do wonder whether there is an inbuilt "biological" reason why we find exponential growth hard to grasp. Is it something we simply were not exposed to affecting our lives while evolving in small groups on the African savannah? Rather like we often massively overestimate risk - if you hear gossip of a man eating lion amongst your small savannah living band, it means a very real and immediate danger, and hence the overreaction when people hear about a paedophile at the other end of the country on the news. Though of course, in the case of Covid-19, the distant danger, through exponential growth, very rapidly does become local!

We probably have evolved to understand the constant acceleration of a lion coming toward us, not that of a lion with increasing acceleration.

oh shit! no scare mongering stories what are todays totals?

17 deaths in lancaster yesterday our nearest a and e.

two ambulances in our street last night.

it aint rocket science.

Any doctors/biologists like to comment on chloroquinine?   

https://www.mediterranee-infection.com/wp-content/uploads/2020/03/Hydroxych...

33% exponential growth is 33% regardless of scale or when on the curve.

10 cases one day , 13 the next

1000 cases one day, 1330 the next

100 thousand cases one day, 133 thousand cases the next.

In reality it's not 33% every day as changes in testing and behaviour have an impact but the general direction is clear.

The log(confirmed cases) Vs date graphs are near enough straight lines so you can extrapolate to a peak when exponential growth stops because a large proportion of the population have already been exposed.

UK confirmed cases grow by about 10 in last 12 days

17,000* cases 28 March

170,000 cases 9 April

1.7 million cases 21 April

17 million cases 4 May 

170 million cases 16 May to emphasise exponential growth CANNOT continue

Looks like growth will saturate mid/late April when a large proportion of the UK population will have been exposed.

*many unconfirmed cases for every confirmed case

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

Actual growth (not those who have just been tested) will slow due to social distancing measures being implemented and mostly adhered to....there is obviously a time lag for them to take effect.

A ramp up in testing may see the recorded growth continue to be higher than it has been due to the simple fact that more people are being tested.

TBH the only real metric we can measure with any reliability is the total deaths as these are fairly unambiguous.

Real question, as I've not found clarity on this point: are the stats quoting deaths caused by covid-19, as opposed to all deaths where people test positive?

I think it is deaths where COVID19 was a contributory factor...as long as the measurement is consistent it gives us a good idea of the impact of any measures we are taking.

Except that Germany and France (and presumably most places) are using different criteria to record CV deaths.

However, as long as each country is consistent in its methodology over time, then on a logarithmic graph the gradient will still show how well (sic) we're doing compared to other countries.

The time shifting (X days behind Italy etc) just makes the comparison easier to see.

Same applies to detected cases, just that changes in methodology (i.e. more widespread testing) are more likely and will make it a bit more difficult to interpret.

The way they are reported suggests that it’s patients who die that have been tested + for Coronavirus, not that they died of Coronavirus.

That means notionally you could die of a heart attach having just been told you have tested +ve for corona virus and be recorded as a Coronavirus death.

it also means people who die of corona virus but do not test positive may not be counted - tests are invariably not 100% accurate.

At this stage there are probably not the resources to pick out which deaths are the ‘just caused by’ corona ones.

Similar to what Blunderbuss has said, as long as each country's measuring is consistent then they can be compared.

Remember that what is being compared is not the amounts, it's the rate of increase in the amounts (sometimes expressed as the doubling time).

If country A always tests 10% of all actual cases out there, but country B always tests 50%, then (even if you don't know that the numbers are 10% and 50%) their rates of increase can be validly compared (even if their actual amounts cannot be validly compared).

Except that never happens.  Typically in Europe all contacts are tested in the initial stage, and later, when the system is swamped, testing is mainly only those in the health system  (patients and staff). Testing robustness varies a lot from country to country (shit initially in the US and good in the far east). The most accurate numbers will be deaths but even then those with underlying conditions might go different ways in different countries on the labelling of comorbility (hence complains from Italian medics about German assignments of causes of death)

In the meantime we are still about 14 days behind Italy and I'm still hoping at some point our numbers start to look better. The Medical Director on the government  BBC news announcement yesterday said he is sure everyone in the UK will be following advice. It's an idiotic thing to say. Lots of people will always do really stupid things. As a coronavirus example mobile data from Paris indicates about a million left the city before it was locked down.

https://www.independent.co.uk/news/world/europe/coronavirus-paris-france-lo...

Not an MD, the French paper was deeply flawed, and had a similar overall mortality.

so far the trials suggest it may help a bit but no great change. Other actual anti-virals look more hopeful.

The official German numbers (rki.de) for deaths include both people who die because of the coronavirus and people who die while having coronavirus and where the cause of death is unclear.

Hypothetical cases of people who die at home during the night without showing any signs of corona symptoms before are not counted. But the virus seems to act relatively slow and therefore most serious cases should be noted.

The other sign that the cases/death ratio is very different is that the ratio between the number of people in intensive care and the amount of cases is also much lower than in other countries.

Statistics do play a role, but cannot explain the entire difference. Germany had some isolated cases early, but the massive increase was largely driven by cases brought in by skiers, i.e. a resonably young and fit section of the general population. Where it hits nursing homes, e.g. in my wife's hometown, death rates are higher.

I actually thought this as well, together with the idea that in Italy more families live together with the grandparents. But, it is rainy and snowy here today and there was not much else to do, so I looked up some numbers. The demographic distribution of cases is here:

https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberi...

Those can be compared to the population pyramid. The result is that the population is pretty much uniformly impacted in terms of age. The largest deviation is that men of 80+ are more affected and persons younger than 15 are less affected.

So the current fatality rate is actually a good representation for the German population. This rate will go up in the coming weeks because the number of cases will level of whereas the number of fatalities will continue to rise for a while longer. And then at a later stage we have antibody testing and then the rate will drop down again once we detect the hidden cases.

Good point, patient population structure does not seem to be the reason, then.

I still doubt that the difference in death rates to, say, Italy, is just driven by testing rate or other statistical effects alone, and certainly not quality of the medical system. There must be some other factor at work. Otherwise, there would not be be a stable time lag relative to Italy of 12ish days for cases but 21 days for deaths.

Whatever that factor is, it needs to be identified before it catches us out when or if it changes (e.g. in my hypothesis, cases shifting from skiers to the general population).

CB

Why not? To get the fatality rates to match, Italy must have been only testing 10% of the cases compared to Germany. With a doubling time of 3 days, this factor of 10 shows up as 9-10 days delay.

I thought this was good:

https://www.youtube.com/watch?v=54XLXg4fYsc&fbclid=IwAR0Fw1szvG51BBVMRp...

very nice!

Presumably it's not so much those caught out, dying rapidly at home that are likely missing, it's those who may not be medical priorities or willing to engage with the state for one reason or another choosing to stay at home so they're not all alone in a swamped hospital for their final days. It's not been put that starkly to the public here yet but we're being softened up to pre-make this choice already.

jk

Hi Jk,

I was specifically answering a point about German statistics. I don't know enough about the situation in other lands to comment about the situation there.

In Germany most of these are not an issue. We are very far away from swamping the hospitals. And the capacity is so large that everybody with serious symptoms is a priority. To give you some idea, there is public data available about half of the ICU units (14000). From these currently 6700 are free, 1100 are used for Covid patients.

Hans

And interestingly still building extra capacity

I've been wondering for the last week what effect the decision not to close London off before last weekend will have.  The flight to second homes etc in almost every corner of the country will surely have an effect on the pattern of the outbreak here.  Just a thought!

A week since your OP and we’re still really close to the trajectory of Italy, but we’ve bought ourself an additional day, now lagging by 15 days not 14.  That might be back to 14 when today’s data is assimilated into the analysis.

http://nrg.cs.ucl.ac.uk/mjh/covid19/

I’ve still seen nobody blindly say we are bound to follow their trajectory, and a week later you’ve not actually referenced anyone as having said that.

Following Italy was splashed across the media many times. Italy is the curve upon which our progress is measured and the 'curve of concern'. I believe this was overhyped.   I don't need to reference it because you ask me to, you know full well that it was what was being said/discussed.

Each country is different, we are different. 

And you and I are never going to agree. 

Until this post you’d not actually qualified your concern as being with regards the media, rather than the many relevant discussions on UKC at the time.

Or a key part of getting the government to start taking Italian style measures.  

> I don't need to reference it because you ask me to, you know full well that it was what was being said/discussed.

What gives you the ability to assert what I do or don’t know?  I maintain that the news stories I read and the discussions on UKC were sufficiently nuanced that the consistent message was not “the UK will blindly follow Italy”, rather that the point was made things could rapidly spiral out of control if we didn’t rapidly enact tough measures, and that the head in the sand approach wasn’t likely to work out any better for us.  I suspect you can’t reference any UKC or main stream media stories to back up your position because things were more nuanced than that.

No, but the curves continue to.

Has your opinion changed now that the UK is recording 700 deaths a day?

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

nope. Each country has it's own profile. We are not Italy. (Italy is not France, France is not Spain ad infinitum.) 

This is very interesting

https://giftarticle.ft.com/giftarticle/actions/redeem/f7de3a3e-ff0c-49e2-8c...

Apparently the divergent hospitalisation policies of Lombardy and Veneto have led to a significant contrast in casualties. Basically, increased hospitalisation accelerates the death rate. 

I presume that once a hospital becomes overloaded, and/or the medical staff have insufficient PPE, they become centres of infection.

Two weeks later, higher number of deaths.

But up until that point (not overloaded, enough PPE) I can't see how hospitalisation would make things worse.

Problem is, most places are reaching (or will reach) overload. Maybe there is a tipping point where you stop admitting people for the good of society as a whole. That will be tough on those individuals denied medical intervention that might stop them dying.

Edit: https://go.nature.com/2yqz47x is pretty uncomfortable reading.

An article on Germany.

https://www.theguardian.com/commentisfree/2020/apr/06/matt-hancock-biotech-...

I think Monday is the same timepoint for us as the day Italy reached 10,000 dead.  At that point we were said to be about 16 days behind.

Yup.  15 days after the OP and the UK has slipped by 1 day with respect to Italy.  Turns out having similar policy and somewhat similar populations leads to a similar growth rate.  Who’d a thunk it.

The OP still hasn’t posted any examples of people actually blindly saying “we will follow italy” either.

I never really understood the point being made on this thread. We have the same virus, we have similar populations, similar social structure, similar mitigation in place. All we really had going for us was two weeks of good luck. Now we're seeing a remarkably similar lack of significantly encouraging results as the virus smoulders in our family homes, hospitals, transport and shops. Neither nation yet has a clear way out of our restrictions in the medium term.

We're not Italy but without putting too fine a point on it we're not doing very well.

jk

I can't believe some doctor on the telly saying how, withholding fluids, which is what they normally do with lung infections (it helps with fluid build up in the lungs, normally) doesn't help in CV-19 and ends up dehydrating patients. Surely they must have found this out in Italy / Spain / China weeks ago. It almost sounded like we were doing our own exploration of the virus and it's effects. I hoping this isn't true, but that's how it came across, like we're not learning from others, but finding stuff out for ourselves. I realise everyone is on a massive learning curve, it just seemed a bit strange.

On another note, some bloke that runs a lab, usually testing for cancer and other ailments, said HE was trying to get a number of labs together and to raise funds FFS (£30k) to start doing a large number of test for CV-19. WHY THE F*CK IS HE HAVING TO DO THIS? The government should be sorting this out, and there should be no problem get £30k to achieve this. That's 3 MPs working from home bonus FFS!!

Seems like 'herd immunity' is still alive and well in the Home Office.

https://bylinetimes.com/2020/04/09/leaked-home-office-call-reveals-uk-gover...

If that is correct then let's have parliament back first please. They can be the test case on how safe it is to go back to work. 

In terms of deaths vs times, unfortunately we are following a similar trend to Italy only two weeks behind. 

This of course is based on what has already happened and doesn't necessarily mean we will continue at the same rate as Italy over the coming two weeks. Our preventative measures could be enough to stop us reaching the peak death rate that Italy reached.

http://www.alex-law.co.uk/covid19-dashboard

Select UK and Italy and look at Graph 2

are we recording deaths the same as Italy? eg if you include deaths with covid on the death certificate we have already exceeded the peak rate of italy

It came across to me as one of the later cases of total denial that was going round at the time.  Potentially combined with some ill explained exceptionalism (swept up as genetics and social structures) that the UK would do substantially better than Italy. 

I'm not sure exactly how we're recording deaths. I imagine there will be some variation, but out of all the statistics going around, death rate is unfortunately one of the most reliable.

Try going on the ONS website then add all the deaths where cv19 has been recorded as a cause, very scary.

In England they are using hospital deaths in the daily numbers but the numbers taken from death certificates which include care homes and deaths at home are getting on for 2x hospital deaths.

https://www.theguardian.com/world/2020/apr/09/covid-19-hundreds-of-uk-care-...

I think Scotland is now including non-hospital deaths.

Totally amazing the newspapers are full of Boris getting out of intensive care and when lockdown will end when UK is getting close to 2k deaths per day when you include non-hospital deaths.   The press are shielding the Tories from the consequences of their inaction.

Don’t exaggerate.   It says an extra 1000 deaths in total.

Good discussion here - https://www.ft.com/content/88f993a0-74ed-11ea-95fe-fcd274e920ca - there is no simple answer and death counts will keep rising for days in the past as more data filters through the different systems.  

The first figure in this article suggests 2x hospital deaths may be valid - https://www.ft.com/content/c07e267b-7bca-418f-ad9e-8631a29854cb

Useful, and a sensible conclusion. 

(As usual with the FT this is paywalled but, again as usual, if you search via Google or equivalent you can find open versions. I found this one:

https://app.ft.com/cms/s/88f993a0-74ed-11ea-95fe-fcd274e920ca.html?sectioni... )

I wasn't getting the 2x figure from that article.  There was a table somebody had posted on Twitter with both numbers (hospital and total with Covid on death certificate) for each day.  It jumped about from day to day but it was roughly 2x.

The 1000 deaths in the article is just an estimate from a care home organisation, it doesn't include deaths at home.  Also the number isn't evenly distributed over the period it was collected because the rate is growing exponentially.  Most of them will be towards the end of the period.

I don't often use this word but I think it's an effing disgrace that we have had a huge organisation since 2013 dedicated to dealing with this type of crisis, and after 7 years they cannot even provide accurate statistics. This is what they should have been planning for.

^ this

The problem is that this we have a a highly centralised government which wants to control everything, but actually doesn’t have the means of it ambition in practical terms. No surprise, they can’t organise a piss up in a brewery.

Put the statistics aside for a moment. When the OP made the comparison with Italy, I'm guessing these are the questions he had in mind:

Are ICUs and the emergency overflow facilities full?

Is the NHS so overwhelmed that doctors are playing god as to who receives the critical care?

Are the ill being treated in corridors? Are they dying out there on trolleys?

Is the military shipping nightly truckloads of bodies to an out-of town cremation?

Has the NHS been decimated by infections to the staff?

I don't know all the answers but the news headlines have yet to reach that intensity. And this at a point when the infection rate suggests it ought to have, were the UK to provide a carbon copy of Italy. From which it would appear that we are not (yet) following Italy in the sense that "Italy" has become a by-word for the worst nightmares of CV-19.

None of the above is to diminish the palpable failures in testing and the speed of government reaction, although I would point to the communal failure of urgency on the part of ALL western governments, not having experienced the salutary lesson of SARS in 2003. Would the majority of UKC posters be so vociferous in their condemnation if the election had produced a different outcome and this were a government that they had voted for?

It's worth remembering that a majority of the smartest brains in the world, many paid £millions to see only a few weeks into the future, were caught napping by the damage wrought to populations and the economy by CV-19.

Which smartest brains are you thinking of here and in what context? I'm struggling to think of many top level scientists/academics paid £millions. Or are we in financial analyst/super forecaster  territory?

And yet italy never had as many deaths per day as we have now. I suspect part of the horror of the Italian situation was due to concentration of cases in lombardy.

I find it strange that the press arent jumping up and down when 1000 a day are dying

It would be interesting to see the salary bill for PHE, let alone consultancy fees they pay out.

I don’t think any amount of money would convince me to downgrade NHS PPE in the face of covid 19 without any supporting clinical studies. Last month, someone in PHE decided such a gamble was worth the (30 pieces of) silver.

I'm not sure I understand what you are saying?

check out this forecast: http://www.healthdata.org/news-release/correction-uncertainty-intervals-cum...

https://www.theguardian.com/world/2020/apr/07/uk-will-be-europes-worst-hit-...

Is that supposed to be a forecast of total deaths? Spain are already past the projected lower limit so I’d be curious about the validity of the model.

When the higher ups realised that CV19 meant that the global production capacity for the necessary PPE could only meet 10% of global demand, the decision was made to downgrade the standard of PPE required when attending suspected and confirmed CV19 patients.

Modern clinical procedures are supposed to be predicated on evidence based practice driven by high quality clinical studies. In this case the PPE requirement was changed due to circumstance rather than evidence. While I accept needs must when the devil drives, front line clinicians deserve full disclosure before taking risks that don't just impact them but also their families as well as everyone else they subsequently come into contact with.

Apparently, according to the government at least, "We have enough PPE to protect all health workers, providing it's used correctly". Whatever the f*ck that means, sounds like you've been using it wrong.

We are currently experiencing a higher daily death toll than Italy or Spain ever had. We are not only following Italy we are in a worse position.

We are not asking politicians to predict the future, anybody who is relying on that is a fool, we are asking them to build resilient systems so that we don’t have to.

If you’ve got cash in the bank instead of debt you don’t need to predict when the shit hits the fan in the economy, If you have overcapacity in the health system instead of undercapacity then you’re in better position to wheather any public health crisis.

The problem is that we are run by a generation of people for whom everything around them perpetually got better every day since the time they were born, as a result when crisis hit they are completely inept and surprised, and blame “black swans”. I think it was Peter Thiel who made that observation and I tend to agree.

I think this is yet another occasion where you haven't fully comprehended what I've written. Nowhere have I indicated the level of PPE I'm using while attending.

They are, just not the British press.

It looks quite bad, we have about the same number of daily death of other european countries when they reached their peak, and we know that we are two weeks behind.

No, we really aren't, at least not yet. Italy had the vast majority of its cases concentrated in the North, while ours are spread out fairly evenly and Spain has a much smaller population than the UK. By and large the NHS is coping remarkably well (so far). In my own area the hospital A&Es are quieter than at any period I've experienced since beginning training in 2017. Please, no scaremongering.

rather like neil ferguson saying UK deaths could reach 7000-20000 just a few days ago

Similar here I gather.  Because lockdown was nationwide but was driven by London, a lot of the more provincial areas - which lag London quite a bit - have had the spreading process really slowed down way before crisis point, and healthcare is nowhere near overwhelmed.  It’s a bit of a limbo state mind you.

Sure - I’m curious about when the projection was made as much as anything else!

I am very much on the edge of my seat awaiting stuff going mental, but the story has been the same at each of the hospitals I've attended over the last block...quietest they've ever been. I don't think most of the general public comprehend how few genuine emergencies rock up at A&E normally. There were a couple of weeks in December when hospitals in our area were completely over run, War Zone levels of over run. I can only speculate that many of the usual healthy but health neurotic attendees, have been dissuaded from visiting EDs as they have quite rightly ascertained that hospitals are the best places to pick up a dose of CV19.

Aside: I note that I've picked up a couple of dislikes for my previous post outlining how well the NHS is currently coping. Please step forth and let me know what exactly it is you've taken issue with cos I haven't a Scooby???

I’ve been trying extra hard not to have accidents lately.  So yesterday there I am putting a screw into a joist to hang something off when I fumble the screwdriver and drop it on my face.  10 mm long, dirty and wide cut just below my left eye.  Absolute bloody idiot.  Any other time I’d have gone to the local urgent care centre to have someone do a good job with steristrips; the way my skin heals, a tidy job would probably mean no scaring.  This time I did it myself and will just have to tell people I had a knife fight and they should see the other guy.

I’m not quite sure what it would take to get me to go to a hospital right now.  Severe toothache perhaps.

These projections are done by the University of Washington in the US. I saw this forecast for 60k+, up to 200k deaths a few days ago and had a look at it. It took no account of any preparations we had made and the numbers were actually based on both our hospital and critical care beds already having been overwhelmed. This hasn't happened yet as hospitals stopped all routine work and a lot of critical care capacity was made available. 

You can check out the latest runs of the model here

https://covid19.healthdata.org/united-kingdom

It's still assuming (at the point of checking) our critical care bed capacity was reached 4 days ago, and has already revised it down to 37k deaths (range 26k-62k)

Not a confusion, I simply thought you might like to know, you may not be using it right. I'm sure you have plenty as have your colleagues. Sorry I bothered you

Ah yes thanks, some of their numbers are well of.

Locally, yes. Patience.

Locally and occasionally yes. Patience.

They were before this crisis.

No, we're building temporary morgues. Patience.

Some wards are reporting they're down to 60% of their staff. Decimated? With luck in a couple of weeks.

We have plenty to be proud of and far more to lament but let's not kid ourselves.

It's worth noting plenty of pretty average people were screaming from the top of their f*cking lungs that this was coming weeks before it was absolutely unavoidable.

When did we start measuring intelligence by income.

jk

I think this is another occasion where the internet is tricky and the two of you are violently agreeing despite yourselves.

jk

Very possibly. Great as these forums are, nuance and tone are entirely absent .

We could easily get far more deaths than Italy without necessarily having such a visible problem.

The visibility of the problem depends on whether it is concentrated in one region and whether all patients are taken to hospital or many are left to die in care homes and their own homes.  Facilities like the conference centre hospitals with on-site morgues and no visiting are also going to reduce the visibility of death.

The Tories are playing the media.   They are doing things like quoting a low number at their news conferences and then revising it up a few days or a week later 'as more data comes in' with no publicity and using patient confidentiality for not giving out numbers which would sound bad.  

If we had a reasonably competent government we'd be in the same kind of shape as Ireland.  If we had a really excellent government we'd be looking like New Zealand.  Instead we are second worst of the advanced economies after the US.

I'd be cautious of judging any governments performance, we are just at the beginning. Give it 2 - 3 years, a chance to see if there are second or seasonal phases, see how lock downs are released, compare economic damage with varying methods of containment. 

Declaring success and failures when the world is barely into month 4 is a little premature. 

Except that the only people being left at home to die are those people in end of life care and the only reason we leave those people at home is preserve some dignity and peace in their final hours. The NHS doesn't abandon people to their fate to prop up the Tory party's public image.

The US isn't the worst hit and we aren't the second worst.

https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-pe...

Deaths per million are useful but the virus just needs a population to attack, so it will grow at about the same rate, with the same prevention measures, irrespective of country size. Plus outbreaks started at different times in different countries, so per capita comparisons are going to be most indicative long after it has peaked and we should not be comparing countries in the latter phases of growth (like the UK) with those past peak. The UK, and especially the US, will look much worse in a few weeks time, while Italy and Spain per capita data won't shift as much.

I think the NHS in parts of London is right on the edge even though its often a lot quieter elsewhere. More hidden carnage is in care homes, where Care England estimate deaths may be around 1000 with much worse to come. 

"Care industry leaders and the Alzheimer’s Society told the Guardian that they believed the virus to be active in around half of care settings, which look after about 400,000 people in the UK. However, Prof Chris Whitty, the UK government’s chief medical officer, said on Tuesday that just over 9% of care homes had cases of Covid-19."

https://www.theguardian.com/world/2020/apr/10/ministers-urged-to-include-ca...

It’s hardly surprising that the stats are high with care homes. Have you been in one?they are not exactly places filled with fit and healthy people.

frankly I am amazed there have not been more deaths in that environment which indicates most homes are being well managed at the moment. 

You may have missed this:

https://www.ft.com/coronavirusfree

The easiest way to bypass most paywalls is to copy article titles into google news and copy their subsequent link.

I forgot to add that Spain's population is 2/3rds of the UK.

We have no idea where this will go. Care homes are the most vulnerable accommodation for risk but have received the least government help. Most are doing their best but workers with no proper PPE will be causing transmissions in both directions. Many homes were struggling with finances before this outbreak. On a 400,000 population we could easily lose tens of thousands.

Then we have the wider community. In some N Italian towns it is estimated the deaths from the virus were four times the hospital reported deaths.

Have a mate who owns care home and does cate at home service. Surprising how much govt support he has been receiving. His main gripe is the cost of PPE masks which have shot upto £1. 
 

he has commented that a lot of families are now looking after their elderly relatives ( instead of his business) for the obvious reason and services for care in the community are having to adapt as there is less demand!

he covers Wigan and Warrington 

I’m a bit confused, 1000 deaths a day in the UK sounds bad, and people saying we are in a worse place than Spain & Italy. But, assuming no vaccine, then most of us are expecting to get it. So, a fixed number of people are expecting to die, 05-2% of population depending on who you believe. So the best we can hope for is a steady stream of people dying upto that amount without overwhelming the NHS. So comparing daily deaths in lockdown doesn’t mean much, as long as the NHS isn’t overwhelmed. Once Spain & Italy come out of lockdown the deaths will continue. If we had an NHS with unlimited resources then we could all get it at once, the 0.5-2% would still die but the economy would have recovered in a few weeks. Surely, assuming no vaccine we’re heading for the same result, just over a long time?

That assumes that the treatment won't get better, improving survival rates (hopefully it will), and that pushing the system to near its limit doesn't increase the death rate (it probably does), and that nothing else positive will develop or be developed as we go.

There's a lot to be said for just buying some time, when you don't yet have a very good plan.

They had an eloquent  Manchester based muslim guy on the BBC breakfast news about 9.30am. He said his brother in the W Midlands and other family members almost certainly caught the virus visiting their mum (untested) who was in hospital with pneumonia. She recovered. His brother fell seriously ill and was tested (positive) but was told to try and manage at home as there were no hospital beds. He died in his sleep a few days later. No post- mortem will take place and death is recorded as by natural causes but with possible covid 19 influence. The body had to stay at home as the local morgues were full, so the family arranged to wait in protective gear until a local undertaker could collect. The story then moves to the burial plans in the will, important as a practicing muslim:  these unfortunately having to be completely abandoned. 4 days on they still have no idea of when they can arrange to bury him. All local cemetaries are full or have a long waiting list. The undertakers said they have 15 similar cases, waiting to be buried, just in the local muslim community this week.

Without being alarmist (oh yes alright I am) I'm not sure of that range of fatalities. Germany has started testing entire populations and finding that a very small proportion has been infected, which means that the fatality rate could be much higher than previously thought.

There are quite a lot of people who are paid to think about these things but the results of their cogitations don't seem to be particularly well communicated. 

Only those believing in herd immunity ideas say that. Most epidemiologists still think this will end (if slowly and with new smaller outbreaks) following lock-downs, and they do not expect most people to catch it. If the herd immunity people are right and the well tested death rates in controlled and highly tested health systems like Singapore are correct, which point to a minimum of 0.3% hospital deaths, then to stop the NHS being overwhelmed this will go on for nearly a year with repeated  peaks at around 1000 deaths a day, as that's well over 100, 000 deaths. By which time we will hopefully have vaccines. 

That is just a false fatalistic argument to excuse failure / giving up.

Most people won’t get the virus if we keep a lid on its spread.
bringing the cases down to a small number, then track and trace the virus aggressively, whilst keeping r0 lower through behaviour changes should do the trick.

Modellers reckon keeping r0 down to 2 combined with 70% effective tracing effectively chokes the spread of the virus. It looks doable. Seems hard now but we will get increasingly better and efficient at it over time.

It may be that in the end this is impossible but this is waaaaay to early to give up.

I assume he's referring to yesterday's death figure for the UK exceeding Spain and Italy''s worst days. 

Not really making any point though, well apart from the difficulty in meaningful measurement and comparisons at this time.

A self fulfilling prophecy perhaps.

Indeed, I don’t understand this somewhat weird obsession referring to all sort of heavily massaged country comparisons, as it if was some sort of competition between countries and a matter of misplaced national pride, when it is in fact a global problem with local policy consequences.

Correct - I hadn’t seen that. Good to know, thanks. When I clicked the link originally I just got the usual subscription page so I Googled it. 

It was Nazir Afzal, former Chief Prosecutor for the North West of England, he was instrumental in the prosecution of many of the grooming gangs in the North West. I know him a little as he is the Chair of the Corporation of my local college, which I have some involvement with professionally. He is a good guy and usually worth listening to.

There is in normal times often a surprising waiting list for burials . Had to wait 8 weeks last Msy. for my Mums. Comes as a bit of a shock as you would think it was quicker  

London and West Midlands are hot spots. London hardly surprising. 
 

Always very difficult and heart rendering these tales. I am surprised they were allowed to visit hospital to see mum. I know in the local ones this has now been stopped.

I wonder how that 59 yr old from Wales  Is doing  after his wife spoke to the BBC very courageously 

There are 8-10,000 deaths a week during normal times from all causes including accidents. 
In a bad pandemic winter week that has on occasion risen to 13,000 for one week.

23-29th March there were 14,000 total deaths. That’s about 5,000 more than we would expect for this week of the year. 
 

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

a superforecast

Absolutely not.  Just like we don't all expect to get rabies or all the tropical diseases we aren't vaccinated for.  It is quite possible to eliminate a disease from a country with public health measures.   Since the Chinese have pretty much managed this with the corona virus it is illogical to assume it is impossible.  The Tories are worried that it may not be possible without changes in the distribution of wealth and they may be right but they should be honest about it and ask the public whether they'd prefer the death and disease or to have a flatter distribution of wealth.

We need to lock it down, push it until there's only a few cases in the whole country then put a quarantine round the country and strong contact tracing within the country so we can stamp out any flare ups.  At that point we can run indefinitely without significant numbers of infections and wait for a vaccine or cure.

Let me unhide that carnage for you.  All our deaths here in Guernsey (9 in 3 weeks since the first death) have been pensioners. Not one person has been in ICU, and out of our 200 detected cases only 3-5 are in hospital at any one time so far. Small numbers I know, but it demonstrates how people are dying without going into hospital.

I think the OP's point was that we don't necessarily have to be following Italy, there are many factors that might make a difference.

Of course in the usual UKC "not bothering to read things properly" fashion this immediately got taken to mean "we aren't following Italy" so the OP was shouted down by loads of people and is probably why little has been seen subsequently on this thread from the OP.

Note: He never actually said "we aren't following Italy" in the OP.

An exceedingly generous interpretation. We still might not follow Italy exactly, we might be better, we might be worse. The numbers for both countries are a little muddy. However, we are definitely dealing with a human crisis that is every bit as big as Italy was dealing with when the OP started the thread just over two weeks ago.

I think “being used correctly” may refer to the care home manager who on the BBC said that “ we are not getting enough PPE, we use 400 pieces of PPE per day” yes, 400.

They're probably mostly talking about the single-use disposable aprons and gloves.

I don't know care home protocols, but for community physio it means those per NHS staff member per patient's house. If it's those two pieces of PPE per member of staff per visit to someone's room in a care home, it'll rack up quickly.

The OP said  “There is an awful lot of shouting (forum shouting) that we are following Italy, what's happening in Italy is happening here etc. With the idea that any other outcome is not possible”

At the time, what posters were actually saying was “it’s really bad in Italy and we are taking this less seriously so it is going to be even worse here”. Corollary to this was the view that “if we act more seriously than in Italy, it could be less bad”.  The whole point was that other outcomes *were* possible.

Despite specifically referring to “forum shouting”, the OP has since tried to say that they were talking about the media and not the forum.

The OP has still not produced one quote, reference our citation where someone was saying that we have no other possibility them to become like Italy.

The absolute tragedy being that in terms of per capita deaths, it looks like we are going to be *worse* than Italy.

Some of the most poignant commentary at the time the OP started this thread was from doctors in Italy saying “what on earth are you doing, unless you take this seriously you will end up like us in two weeks”

It’s not too late for the OP to admit that they were reading what they wanted to read, and that nobody was actually saying we were bound to follow Italy but rather they were pleading for us to act more robustly than Italy , with the specific intent that we would then then not follow Italy but would have less disaster.

For an example of a country that has not followed Italy (per capita) look to New Zealand.

I'm not entirely convinced by your political point. The Chinese autocracy isn't particularly noted for its equality ideals. They are, however, much better placed to rapidly introduce and enforce severe civil liberty restrictions and need not overly worry about privacy concerns.

I'm not quite sure what form you instantaneous redistribution of wealth might take, perhaps a la Idi Amin?

The economic repercussions of the current lockdown, and associated measures, will have an impact on the health of the nation in the years to come - recession and thus a worse economy almost always results in poorer population health. It is here/then there may be greater merit in your argument for a more equitable society.

Really useful information. Thanks.

The UK aren't taking much account of privacy any more either.  They are hooking up with Apple and Google to track contacts via Bluetooth on cellphones and handing over NHS data to Vote Leave associated AI companies.

https://www.thetimes.co.uk/article/coronavirus-phone-app-will-trace-every-c...

https://www.theguardian.com/world/2020/apr/12/uk-government-using-confident...

What I would like to see is:

a. Universal Basic Income during the lockdown period.  Say £100 per adult per week.

b. All loans set at 0% interest i.e. no interest payments during lockdown.  No rent and no income/corporation/council tax either.   

People have to pay food and utilities from their Universal Basic Income but all the other big bills disappear.   The important thing is that people and businesses are not forced to pay for the lockdown period by borrowing money and everybody has enough to be fairly OK given that they aren't allowed out anyway.   So it is like hibernation.

The problem with making people and companies borrow money to support themselves during lockdown is that the repayments and interest will kill their cash flow when the economy restarts.   There wont be any demand for perfectly good products and services because everyone is crippled by debt.  They might easily become insolvent.

So several hundred billion pounds need to come from somewhere to pay the UBI and keep things ticking over during lockdown.   The first option is to QE the money out of thin air and if all the major economies do that it might work, but if the US breaks ranks there is a safe haven currency and anyone trying to print their way through this will see their currency crash.

The next option should be a one-off wealth tax.   The rich are locked down and can't travel as easily.  So draw a line - say about £10 million quid - and 100% tax any assets above that.   Hammer the 2% most wealthy and protect everyone else.  We come out of it with no billionaires, and no 100 millionaires but nobody is impoverished or hungry.

Yes it is rough and kind of like what the Saudi's did when they locked the rich up in a fancy hotel until they coughed up.   But the alternatives are far worse:  government taking on debt to an extent which results in years of austerity or businesses and companies taking on debt to an extent which kills demand in the economy.

We're a densely-populated country with over 80% urban; we're not really in "lockdown" when people can go out to buy garden furniture, and there are enough people ignoring social distancing to perpetuate the spread of infection.  I worry the situation will continue to worsen until much stricter and enforced lockdown measures are imposed.

Bonkers as usual.

Similar to the Danish lockdown - which looks to have worked well so far.

its not clear how hard a lockdown you need - I vaguely heard a target of reducing interactions by 70%.

Would not raise anywhere near enough money on the top 2 %. 

the obvious error is that there are not many with that sort of wealth anyway.

the ifs have looked at this before. It would only raise a few billion, despite what you think .

Not just how “hard” the lockdown is but how “geographic” it is; softer lockdown with harder internal borders looks very effective.  

The UK’s defected case number is getting harder to consistently interpret but it looks like our lockdown May be enough for tipping R0 over from >1 to <1.  The gov have (I presume!) much more detailed breakdowns of figures than armchair pundits like me.  We await their review of lockdown in the coming days...

It would, I worked out the numbers on another thread a week or so ago based on Inland Revenue estimates from taxes on estates.

Something like 25% of the wealth is in the hands of the top 2%.   There's more than 10 trillion total wealth.  I think it's reasonable to guess you could get £250 billion and leave the wealthy with at least £5 million.

citation needed.  Also, the IFS are hardly unbiased when it comes to wealth taxes.

You have just said it yourself, in your 'intro'. Posters were consistently saying that we are going to follow Italy, or even worse. My point still stands, that we are not Italy, and shouldn't be compared to Italy, they are a different country with a different socio/economic/demographic/structural system to the UK. Now will you please stop bleating for the OP to 'show where people have said we are going to follow Italy'

No I didn’t.  The example I used gave *reasons* and you said *blindly* which implies *without giving reasons*

Yes, and I never questioned that.  But they gave *reasoned arguments* for this and didn’t *blindly* state it.  They were also pretty much right in hindsight.

Who should we compare ourselves to?  They seem a reasonable comparator in terms of a country that acted too little too late, and tragically the progress since the OP has only confirmed this.

I never said that.  I noted that you have never been able to support your opening stance of posters (later revised by you to the media, but now back to posters) *blindly* saying we would follow Italy.  Nobody ever said that, that would be a stupid thing to say.  Italy was being used as an example of what happens when the virus wasn’t treated seriously enough, early enough. It was a very pertinent example and if government here had taken that example more seriously earlier on, things could have been different

The tragedy now is that our own government science advisors are saying we could have more deaths than anywhere else in Europe.  It’s flipping around to Italy saying “we are not the UK”.

And here lies the little nugget that shows the cognitive bias in your posting (s), and why you don't seem to be able to understand the simplicity of what I am saying (Italy is a different country to us, please don't bother to make comparisons)

We didn't act too little too late.  You can't say that. It will only be able to be said a long time after the fact when all the realities of what did and didn't happen have come out in the wash. We may well have acted appropriately. 

No I understand that, but you seem entirely unable to note the use of the word *blindly* by yourself.  Posters gave many reasons for their compassions with Italy and you insist on rejecting them all “because it’s a different country.”  None of the comparisons were blind, they were reasoned, rational and sensible.   These recognised that Italy is not the U.K. but that there were many valid comparisons to be drawn and lessons to be learnt.  The key principles of controlling this virus are universal despite some ill evidenced cries of “but genetics”.

> We didn't act too little too late.

In my opinion we absolutely did.

I just did.  It’s my opinion.

Yes, having 20,000 citizens killed already and months of lockdown is definitely better than a sharp 3-week lockdown in early Feb followed by quarantine of inbound travel and a few deaths.  

Bless. Your poor little mind.

You even used the phrase 'had killed'. 

Giving up and resorting to insults?   

If your argument really was just “Italy is a different country to us, please don't bother to make comparisons” it was a very poor argument.  I had time for the OP asking for no blind comparisons, but I maintain it was pointless as no blind comparisons were made.  That would be stupid.  If you think there is no value in reasoned, rational comparisons with other countries that is not a view I can understand or support at all.

Not that I can find.  I noted that 20,000 have been killed (by the virus) (including estimates of excess deaths not currently attributed to covid but likely related). 
 

We are not following.... we were 16 days behind Italy on total deaths when the argument started and are sadly now only 12 days behind so are currently on a worse trajectory.

Try not to worry, we will lose it on penalties.

Worryingly it's looks like you might be right, we're not following Italy, it looks like we're going to be worse.

OK, so what is your alternative?    

This is a hell of a big problem to solve with actions that look 'normal' and not 'bonkers'.

Now they are digging mass graves in Chislehurst.

https://twitter.com/bcomininvisible/status/1249288672048013314

ClimberEd has also dug himself a mighty fine hole - we could use that too.

In all seriousness - it's chilling to see mass graves being dug.

Borrow the couple of hundred billion, it's only 5 or 10% of the existing national debt and to service it is peanuts in the greater scheme of things. Better than forcing a fire-sale of the economic assets which the government are trying to protect in the first place AND making the UK a place nobody would invest in for the next century.

And lockdown doesn't mean the rich can't leave, it's just slightly more inconvenient though why this is relevant I don't know, they don't move their fortunes around in suitcases.

A " sharp" 3 -week lockdown is a waste of time. Have you not figured this out yet?

Re-read what I wrote.

I think if we’d done hard lockdown and hard borders in early Feb we could have eliminated it if we then switched to quarantine on inbound travel.  Now we’d probably need 4-5 weeks of hard lockdown (much harder than we have now) and it’s almost impossible we could now tolerate such a duration of hard lockdown.  We’d probably need some miracles as well like being able to supply the PPE and perform the testing needed with infections at this scale (Cvs that in early Feb).

I'm not in a hole. My hole is a mountain   My OP was that I was bored of people warning that we are going to follow Italy if we don't do x or y or Z. I couldn't give a toss what Italy does or doesn't do and what the outcomes are, we aren't Italy. We still aren't Italy. For better or worse we aren't Italy. They are another country, with different people and different socioeconomic/demographics. Wintertree doesn't seem to understand this, despite it being factual, so I am no longer engaging with it. 

And yes, in all seriousness, the current outcome is horrific. 

I’vd said I understand it more than once.  I can only guess you’re not reading what I write.  What you give in your most recent post is very different to your OP.  “Blindly” vs “if we don’t do x or y or z” are very different takes and still omit that most posters at the time were saying “Italy is an example of what happens when we don’t do x y of z because of reasons”.

What you are now saying is that a country with a relatively similar demographic, genetics, technological and healthcare system to us is of no use as a source of information or point of comparison on the links between policy and effect.  The argument in your OP was fair (blindly following) but irrelevant as nobody had actually said that.  Your new stance is just daft.   This virus is tearing a swathe through many different counties and policy experts and medical experts are sharing information widely between them because they understand how universal many of the lessons in control a pandemic are.

Are you going to stop all road and sea freight coming in/ going out?

No.  But you can put a 72 hour quarantine on a lot of it, and put hard human borders in.  Hell of a disruption but turns out that was the alternative all along...  

As for going out, that’s not up to us... France seem to be on the same path as us so I can’t see them stopping it.  

Clearly you are not involved in logistics.

I didn’t say it would be easy.  Given the massive holding facilities set up in the “no deal brexit chicken” period we had a head start.  We have an army that wouldn’t have ended up building field hospitals.  We’re past any such options now.  It is tough with so much of our food being imported.

AS I understand it...the key difference between Italy trajectory and the UK is that a. Italy had a very big flu season this year and the UK had a next to nothing Flu season. Italy already had a very pressurised health service. Throw Corona virus on top and they were instantly overwhelmed.   It is far worse for Britain as we had all the benefits. seeing other countries and time to plan. What seemed a good government response will be seen to be a shambles in the distant future. We had all the positives in our favour. Time delay to assess China, Italy, S.Korea. Time to get PPE/tests and plan, Estimated 3 weeks behind. Our outcomes are likely to be worse than Italy as this continues as their was an underestimation that a. this could have been a Mers (far east only) virus or b. Herd immunity/just like the flu. Its contagion was higher and they haven't acted quickly enough. In S.Korea they have used technology to track this effectively. As in Germany. S Korea and Asan countries have seen how these things spread and were well aware. We should have modelled this stuff. UK govt used the 20000 potential deaths figure. Does this seem like a target? Scary. 

A less sensationalist report 

https://news.sky.com/story/coronavirus-burials-changing-for-muslims-amid-uk...

We were modelling this stuff 3 months ago. The Imperial team were working on it 24/7 as per govt advices and have openly stated this.

Maybe we should have took more notice of Operation Cygnus. 2016

Quite agree.

But if you dig away you will probably  find that part of the planning was for Imperial to do modelling.These things do not happen at the drop of a hat..as you well know. I cannot imagine UK Gov or a Civil Servant just picking up the phone and saying to Imperial-- lets rustle up some modelling, now are you the right people to be doing it?

The authorities listened to some IC data. They ignored European data. It took 100 scientists and a groundswell of public realisation/journalism to get them off the 'Herd immunity nonsense..its like flu'  ...and to start to act. Doubling times were way faster than they were spouting etc. And they did not comment on European progress and European science assessment of our progress.

Dig through the documentation and reports they kept classified?

If I had a plan that included a rapid response modelling group, a key part of if would be to have those models put in the public domain and subject to scrutiny and peer review.  What we actually got was one epidemiologist’s home grown model, the code of which he’d worked on 12 years ago.   A model like this elevated to such importance needs a multi-disciplinary team behind in - people with a lot of experience in - and of the pitfalls off - this technical class of modelling, as well as domain experts in the specifics of the particular model.  The thing about subjecting the model to peer review years ago as part of the preparation is that academics would have fallen over themselves to do it for free. 

An email much like that went around the mathematics and physics communities about a month ago...

That's how we 'solved' the 2008 banking crisis.  Government's borrowed money, made sure that the housing market and savings in banks were protected.  Intervened to buy financial assets and support banks.  It ended up with the rich even richer, bankers even richer and a decade of austerity to 'pay down' the debt - which wasn't actually payed down, all they achieved was to grow it less fast than usual.

This crisis is potentially even bigger.   The take it on the chin and get back to work option is falling apart even if you find 500k deaths acceptable with evidence that there is long term health damage from infections.

https://www.latimes.com/science/story/2020-04-10/coronavirus-infection-can-...

I don't see how we can keep solving problems by increasing debt.  At some point you have to say f*ck it, the rich are going to take the hit this time and we are going to level things up a bit. 

The model was before our eyes, we could see what had happened in China and everywhere else as it spread out, you might have even taken Italy or Spain as models, and still had some spare time, to react. We had 4-6 weeks where anyone with even a minor interest could see what was likely to happen, look around the world and the places that have had little or no infections /deaths are the exception not the norm. Maybe Boris, thought we were going to be one of the exceptions, he spoke like he thought we were going to be.

we were terribly slow, and STILL are, there are unused labs with testing equipment, and companies producing testing agent, it needs someone to bring the two together. It shouldn't need to be driven by the people who have the equipment, this should be lead from the government, there was a bloke on TV who are currently testing for cancer and other stuff, who had tried and tried to get the government to take notice of what he was offering; a testing facility, which his staff would work overtime time on, he needed £30k and reckoned he could do something like 1000 tests a day. AFAIK he's still not had an answer.

we were fed a load of lies about a month ago, being told they couldn't get the testing reagent, until the company that manufactures it told us all there was no shortage. The government had relied on one lab doing the testing for information on the shortage of reagent, there was a shortage, in that particular lab, not in the country!

Now, now, be fair to the government.  They might just be so incompetent that none of them have a clue what's going on (or more pertinently, what's not going on that could be going on)...

weirdos and misfits with odd skills- did you apply?

This was not Cummings’ terrifying recruitment drive from January, it was a more recent covid targeted thing not let by a ********** *******.  I put down what I do that’s relevant; have had a generic response so far with a mailing list.  I suspect they were totally overwhelmed; I suspect there are thousands of people in the UK with relevant experience...

planned incompetence?

https://www.theguardian.com/world/2020/apr/13/uk-missed-three-chances-to-jo...

So you remove the capital so you can spend it once and lose the taxable income for ever, sell all those assets to foriegners because nobody in the UK has the money to buy them (because you took it) and disincentivise anyone ever investing or holding assets in the UK because it will be confiscated. Even the barmiest socialist government I've lived under (and it's a fair few) wouldn't have thought that would work. The communists tried and it didn't work.

Somehow that story reminds me of how badly Storm Desmond Hit Cumbria and how the government almost (but for the screaming out by people like Tim Farron) managed (it looked deliberate to me) not to apply for regional aid to which we here were entitled from the EU.  Presumably it would have made EU membership appear to have some benefits.

It makes those up here who voted ToryBrexit seem to have very very short memories indeed - Criminal neglect of the interests of people of the UK

And Where is the Russia Report?

I never thought of that, maybe I'm guilty of crediting, some of them at least, with a pair of eyes and a modicum of common sense. The ability to join two dots up?

Your probably right though.

I actually think there would be *more* economic activity if government took action to level the wealth distribution.   Money would be moved from hoarders who are just trying to get more money by charging rent and interest to people and businesses who want to spend it on products and services.  Things would work better for the real economy with 1000 millionaires than 1 billionaire.  We've squeezed out the middle class and are left with working poor and super rich.

I also think that if we use wealth taxes more and income taxes less we can change the balance so it is hard to stay wealthy with passive investments but easier to get wealthy by working hard.   That makes the country more attractive for young entrepreneurs with a good idea: you are taking away the chance that they might become a billionaire but in exchange they get a vastly improved chance of becoming a millionaire.

The whole 'capitalist' vs 'communist' thing is passe.  Both debt-based capitalism as currently practiced with regular bail outs for the rich and the banks and communism are failed systems.  Neither will address a world where AI and robotics can take over many human activities.  We have the technical capability to give everyone a fairly good standard of living but our distribution system is completely broken.   Changing economic systems is always difficult because the people who are ahead at the moment will resist tooth and nail but at some point it becomes necessary.

This isn't 'simple', it's utterly facile, why on earth would anyone you start a thread to say so little?

Wow. I suppose that depends if you're one of the tens of thousands dead and mourning needlessly or one of the many more yet to join them. Those two to three lost weeks where it wasn't yet fully established in the community and our government froze, they were priceless and it was as clear then as it is now. Our economy is in the toilet anyway, two more weeks of restrictions would make bugger all difference to the depth of our recession, it's orders of magnitude out from 'normal' either way.

jk

Bear in mind the current crisis that spending money is the right thing to do.  The failure to do that is what led to the Great Depression.  Bear in mind central banks can just 'print' money, and sort out the consequences later, and there's been little sign of excessive inflation recently (a bit more would be nice to start to remove historic debt)

Its quite unsettling just how close we’ve followed Italy’s curve over the last 3 weeks since the OP; it’s hard to see how the data could be more closely aligned or how it could prove the thread title “We are not going to follow Italy” any more wrong.

 There are a great many differences in the social and demographic and geographic factors of the two countries and in where the infection took hold in each (province vs capital), and the level of lockdown has been quite different between the two. My main point 4 weeks ago was that Italy illustrated a likely possible future for us; in terms of order of magnitude it was a good insight into our likely future if we acted similarly to them.  That we’ve ended up much closer (in a horizontal axis shifted version)  - as have several other Western European countries makes me wonder exactly why that is...

It was one of those fate things. Once the runes have called the judgement, no action or inaction can alter our designated fortune. What has been spelled out shall be.

I absolutely agree with this.  Printing money and a little inflation should be the first choice reaction.

My problem is that I don't think the financial markets will let a medium sized country like the UK get away with printing money on a large scale unless all the other major economies are doing it too.  If the US doesn't follow that path we will need another option.

With a wealth tax, I wonder what Boris and Co. would spend the money on - they'd probably fritter it away on HS2, similar new HS2-type schemes, Boris airport, and 4 new runways for Heathrow. Another thing's for sure, they'd spend huge amounts of it on London. And defence. And supporting the wealthy in many ways - make them richer

In reply:

(continued reply) I'm against such taxes anyway. I agree with jimtitt and what he said in his post at 16:17 yesterday (Tuesday. Nice post, jim)

Not sure you realise that the central banks have printed shitload of money, more than they ever have, and the financial markets are in fact totally dependent on it.

For 2 months or more the UK has suggested what it might need to implement in a week or so time. A warning if you like. But it turned into a one last chance to do x and y before we restrict you. 

So thinking back we had the thousands out in the national parks the week before lock down. One last football match, one last horse racing event, a last chance to visit granny, mothers day etc..  All before they were locked down a week later. It defeated the object. 

If they suggested they might stop 30mins exercise next week.. you'd see a surge of folk making sure they got outside this week. 

Presuming our information is accurate, it begs the question of why? I can only think that resides with a problem I thought was not addressed that, putting aside an individual, the post of Prime Minister is one of decision and accountability and that post, in my  view, is currently vacant.

governance is in a holding position and that come across in the daily TV  government updates and that is not just about the science and trajectory of the disease and the fact that we have continuity in lock down. That is a given. But other decisions are pending.

Where is the responsibility lying? With respect to Raab and Gove and whoever chairs a meeting, they are not inclined to make  decisions because it is unclear who will take responsibility for that decision,-  you can see the chairs of these meetings pulling back on intervention because they do not have the authority enshrined in them at the moment- it is currently unclear, obfuscated...... A sick PM can rightly claim he is not responsible but who is? This is not to underestimate the reach of a coalition of people but that PM position does count.

There are procedures laid down and this is controlled by the Cabinet Secretary ( as per various radio interviews with Gus O'Donell).Govt and decisions do not come to a grinding halt.

While personally I'd like to see a return to a different, better normal when we can, something much more sustainable and egalitarian with a robust and dignified safety net, this isn't the government to do it. We voted them in to do quite the opposite. Let's hope we've re-evaluated.

There's an understatement but we are into a period where revolutionary change has suddenly become both possible and quite likely. We shouldn't expect to be the winners though simply because it is (if it is) the democratic will, revolutions can and in the coming years will go both ways.

jk

Yesterday the recorded cases were 93000 ish and hospital deaths 12000 ish. Deaths to recorded at just under 13 percent. Over 4 weeks we have directly mirrored Italy. 

Absolutely not a grinding halt. If recuperation is protracted the limited powers of Raab and the big decisions made by the cabinet change substantially in the next few weeks , does the responsibility lie with Raab and the cabinet or with Johnson? If  it comes to a protracted absence,  to ensure accountability full powers would have to be transferred wouldn't they because there will be an examination of this eventually. One responsibility of a PM is to delegate powers, maybe fully and temporailly, if a protracted absence likely.

No idea of the PM's true state of health at the moment.

I realise that.  You can see the effect of printed money from the recovery in the stock market.

It's relatively easy to get consensus among bankers about using printed money to support financial assets and banks.  Much less so to support productive industries and people.  

I think Trump's instinct is to start the US back up too early and if the US goes that path there won't be cover for other countries to have an extended lockdown or partial lockdown supported by printed money because people who have the choice will switch into dollars.

It seems to me that all this talk of raising lockdown is far too early.  We need to be looking at the Chinese graph, they kept Wuhan locked down for a long time after the epidemic peak, they pushed it way down to pretty much no new infections and new deaths before easing restrictions.   That's the key to success, it has to be at very low levels if you are going to keep it under control with contact tracing and avoid it getting into exponential growth again.

It's exactly the same as a few weeks ago.  They didn't understand exponential growth so they waited too long to clamp down and as a result got many times as many deaths.   They still don't get exponential growth and they are going to f*ck up again by letting go too soon.

Let's see how it all comes out in the wash eh. 

The wash is already there. Italy and Spain have passed the peak and daily our total and per capita data closes in on theirs. French national daily data include care home deaths, ours don't.  Italy in particular faced overwhelmed hospitals as the virus caught them earlier and much more unprepared and in the middle of peak flu cases. We had more time to prepare and haven't yet faced completely overwhelmed hospitals and fortunately don't look to be heading that way. When hospitals are overwhelmed the death rates from covid 19 increase rapidly: Wuhan indicated 3% mortality when overwhelmed, dropping below 0.5% when not. This means outside those overwhelmed hospitals in Italy where  most of their deaths occurred they must have been handling this better than us. It's quite likely we will be the worst affected nation in Europe.

Give it another year and we'll have our 'wash'. Secondary waves are starting to hit now.

I agree the full picture won't be clear for a year but second waves are very unlikely to be anything like first waves from any previous viral outbreaks (there is more immunity in the population and the response is always way better). Italy already has a peak daily death count below ours and its not certain we have passed our peak yet. Italy has only 8 days above 750 (which we may equal today and will almost certainly exceed in the next week). The total hospital deaths will almost certainly end up similar with the bigger probability that ours will be higher. Care home deaths will come out later but after a better start (thanks more to UK care home responses than government advice) we now have very worrying trends. Italy had more disadvantages in facing this crisis: it has a higher percentage of older people than the UK; it was hit earlier so had less chance to prepare; it was under peak flu stress at the time;  hospitals there were overwhelmed, through no fault, giving massive local increases in mortality rates. Beyond trivia its almost certain now we will have at least followed Italy.

Exactly.  They have no idea how widespread it is and the scale of herd immunity because they've not tested enough.  Without knowing those things they cannot predict the effect of relaxing restrictions. With it so widespread in the community potential sources of infection are everywhere, and even with social distancing the latent levels waiting to explode are simply too high in my opinion.

At least we don't have Trump. He is claiming the US has past the peak after the day with highest number of deaths so far. I worry about the situation in the US, there must be a significant chance of a double peak: the current numbers are dominated by NY which is past the peak but in a large number of other US metropolitan areas numbers seem to be still strongly rising.

and no internal flight restrictions yet? sounds grim. maybe the plan is one (bigger) peak?

The biggest peak.  The best.  Bigerer.

If there is a plan it looks like a head to head race into the bible/rust belt between the virus and the November election. It won't take hold fast in dispersed communities and if the nationalist 'freedom over fear of a foreign disease' narrative can be stoked up to fever pitch he might just persuade his base to live with it in exchange for not being starved while his opposition struggles and dies showing their weakness and lack of true American spirit in their crowded cities.

It could equally be that he's a dangerous simpleton who has failed to grasp the ongoing precarity of his nation's health and economic system.

jk

it's the lag. look out for this excuse in today's press conference if UK get a peak death rate (quite likely after the BH)

It may be that if there are ICU places what happens is that there are fewer immediate deaths but larger cohort of 'ICU survivor' patients with long term health problems.   

We probably need to go beyond mortality and think about three outcome categories because recovered but with chronic heart/lung/kidney problems isn't the same as fully recovered.  Just looking at mortality makes the consequences of allowing everyone to catch this look more acceptable than they actually are.

Sir Patrick has just repeated that we are 3-4 weeks behind Italy..

Nah, we’re different counties.  Nothing to learn from how the virus behaves elsewhere.  

https://www.economist.com/britain/2020/04/18/why-britain-has-so-many-covid-...

The number from the COVID REPORT based on current conditions is 49000 deaths. If the follow-up is as incompetent as the current lunacy then between 3 and 10 waves of infection follow. 

I think waves are a poor analogy in terms of ending lockdown. This virus will be around for years now and will likely have a seasonal variation, but as immunity and knowledge build, subsequent 'waves' are normally going to be much smaller. Also the biggest idiots who caused the most spread by ignoring social distancing will be proportionatly more in that immunity group (or dead) and so their behaviour will be less important (providing mutation doesn't allow them to get it twice). A better analogy is we have a tidal flood which we are only just holding in the main with our flood protection but it is seriously damaging for some. If we end lockdown too early it's like removing the flood protection when the water level is still much higher than usual... that's not really a second wave it's more allowing the back end of the first wave to cause more damage than it needs. The new peak in damage  still won't be as high, especially as I think we really messed up in the UK (just based on the data heading towards being the worst in the EU) and won't make all the same mistakes again.

In a herd immunity approach allowing the virus back and keeping infection in the population, but not at a level that it overwhelms hospitals, is an aim and a hundred thousand may die in the UK and economically damaging repeat lockdowns will be needed (and it may not even work if the virus mutates). I prefer the WHO recommendation.... get the virus level down low and splat any new outbreaks with testing, contact tracing and isolation of individuals; probably alongside some less strict social distancing (except for the most vulnerable). It can be done as some countries are doing it.

The countries most susceptible to second waves will be those like Singapore but their preparation and alertness will likely mean they only get ripples as they did this time. Expect strict border controls for a long time.

Can you give the main conclusions as it's paywalled. You used to be able to bypass this using google news but it redirects to all the main UK sources now.

It will be interesting when all the stats are finally available including comparisons of deaths in care homes, ages and medical conditions and so on. I am not inclined to think that we will be any worse/better than France for example. Might be a some marginal difference but in the overall scheme of things usually there is only a small % difference between us and the other big developed countries in other areas.The exception being Germany. There again these countries do not have the World Capital City, London and that has to be a factor. We all know its a crowded area.

Hopefully a vaccine will substantially change the position and then more money will be pumped into future vaccine developments ( which the Pharma companys have  not really been interested in as vaccines are not profitable compared with say cancer drugs). Vaccine devlopment has been a sideshow in recent years. I am amazed that there has been no press coverage of this.

https://webcache.googleusercontent.com/search?q=cache:6SEPB2X1DjEJ:https://...

A good trick is to click on the little downward arrow in the google search result and choose 'Cached' from the dropdown. Sometimes works; the search engine has to be able to read the article in order to index it well.

One visualisation I'm looking at currently is how much 'energy' is in the pandemic system for each country. Exponential data is so hard to understand, but at least we can all imagine a firework. The bigger the firework (number of cases over a given period) the higher it will go (number of hospitalisations and deaths) and the longer it will take to come down again (length of pandemic).

Here's a log scale comparison of the northern European countries. The data cluster that the UK are in - UK, France, Spain, ITALY clearly all started with similar energy, but are now seeing the consequences of their actions:

https://aatishb.com/covidtrends/?location=Belgium&location=Denmark&...

Now let's look at that with linear plotting:

https://aatishb.com/covidtrends/?scale=linear&location=Belgium&loca...

Because that mode emphasises the larger data, we can see more clearly the choices that we have. Also it's very clear that acting early makes for a massively improved result.

So while number of cases is the main factor, the big question is, what affects the different trajectories?
 

In Germany there are plenty of cases spreading through care homes as well. In my view the UK was not that different compared to other countries except for communication. UKgov's communication is rubbish. Better testing would have helped as well. But all the discussion about poor protection of the vulnerable and medical personel ignores that other countries also don't manage this well, simply because it is hard. E.g., Germany also has 6500 medical personel infected.

I don't think London is an argument. People have contact with a similar amount of other people regardless of where they live. These hospital stats (https://twitter.com/jburnmurdoch/status/1250904238399598594) indicate that several other regions have a similar amount of cases or more than London.

France, Italy and Spain all got infections earlier than us, we had more time to see the problem. Their major care home disasters were evident long before our government even acted seriously about it. I think we will end up worse (as much because more of our care homes were struggling to cope with finances).

In reply to HansStuttgart

You may be right about the issues being difficult anywhere but its looking like UK care home deaths are already close to total headline German deaths.

I had a really good shout at Steve Brine (Tory ex health official) on Newsnight last night. Kirsty was trying to engage with him about a future policy mitigating damage to the economy so that we are informed and prepared when the time comes, and all the minister could do was a monomanic Protect and Survive, along with a rather Trumpian "the BBC is against me".

Absolutely awful.

Cheers for the tip and the link..Quite a disappointing article really, short, nothing much new and with the horribly glaring error that they say in the week ending April 3rd almost a third extra died (it's 60% best estimate with error bars that go nowhere near 33%). The most interesting thing for me is they say almost half French deaths are in care homes!?....,does anyone have a link to confirm that. 

Sadly, this group includes Boris, Dom and Matt. 

So far, with the stated aim being to not overwhelm the health system, we are being successful. 

In Italy the health system was overwhelmed, hence all the panic.

So, we aren't following Italy. 

from today's Le Monde

A l’hôpital, 11 060 décès ont été enregistrés (417 de plus en une journée), et 6 860 en établissements médico-sociaux (où sont désormais recensés près de 40 % des morts), dont une majorité en maisons de retraite médicalisées (Ehpad).

https://www.lemonde.fr/planete/article/2020/04/17/coronavirus-en-france-une...

This.

Yes. Nobody ever said we were bound to follow Italy. At the time of your OP lots of people said look at what is happening to Italy – if we don’t act differently, that will happen to us.  We acted differently and created a massive amount of space in new and existing hospitals and recruited and retrained many staff.  It looks like we will avoid the overload Lombardy had.  It seems better care practices are also being found which is helping.

It’s an excellent example of how comparison with Italy a month ago led to more preparation here and hopefully less awfulness for us.  This was exactly the purpose of all the “we could be like Italy if we don’t...” discussions that we’re going on 3-4 weeks ago, *not* to blindly say that we were bound to follow Italy.

Although our numbers continue to follow the same path as Italy.

That’s not the aim, the aim is to save lives. Not overwhelming the health system is only one of the means to that end.

The Italian health system was only briefly overwhelmed locally BTW, it’s now coping pretty well.

In the U.K. the strange phenomenon is that many people have stopped seeking treatment for other conditions in our hospitals. Many hospitals are in fact quieter. This is quite dangerous and could result in even more death.

But the health system is overwhelmed in London, in that there is no longer enough capacity to attempt to save all lives. For example, see the passage below from the UKC article 'On The Front Line':

"...the pandemic is shifting the threshold of treatment uncomfortably far away.

We were led up the steps by the carer to the patient's room. His rapid, panting breath was audible from outside. Hooking him up to the monitor confirmed our suspicion: low oxygen saturations, a rapid heart rate, fever and all but unconscious. It was something that could be reversed with intravenous antibiotics, oxygen and fluids, but the prognosis was poor and there were no beds in nearby hospitals."

Thanks, freeflyer. IT SEEMS TO ME, looking at those 2 websites and at the Coronavirus Worldometer, that new daily cases and total deaths have been tapering off/ plateauing for Italy, Spain, and Germany; and that the same will happen in the UK, which started later (visible on the Coronavirus Worldometer); and considering that cases and deaths are now very much reduced in China, Hong Kong, and South Korea................

It seems to me that it's going to taper off in the UK and we'll all get back to work or whatever we were doing. (New York doesn't look good right now though)

What we were doing before was spreading the virus exponentially through a largely susceptible population.

I suggest we don’t go back to that.  Nobody knows but odds are we still have a largely susceptible population.

The health care system in Italy was only overwhelmed in a very localised area - this made for dramatic news reports, as with hospitals in New York more recently, but really the rest of the system coped fine.

With the aim of not overwhelming the heath system, yes we had the extra couple of weeks to prepare and hence this appears to have worked. We've had a much more diffuse outbreak rather that it being concentrated on one region. We are still ventilating patients in operating theatre departments in the same way as those initial reports from Bergamo. 

In respect of the reason for not overwhelming the health system, i.e. saving lives, we're actually doing worse than Italy now. The number of deaths is growing at a faster rate than Italy was at this stage. On the 25th March we were tracking 16 days behind in terms of deaths and it's now 13 days

So no we're not following Italy, we're doing worse than them.

I don't believe it is necessarily correct to say this, you simply can't know. A significant part of the reason for not overwhelming the health system was in order to allow it to treat other patients as per normal, not solely to be able to treat covid patients. So pointing to covid death rates in isolation means nothing.

Let's hope so!

Here's the same (linear) plot as before but including the USA. As you can see, it's pretty impressive. Bigerer is definitely the word I would use:

https://aatishb.com/covidtrends/?scale=linear&location=Belgium&loca...

new cases per million more comparable? https://ourworldindata.org/grapher/daily-covid-cases-per-million-three-day-...

You can get a lovely chart of us "not following Italy"

https://ourworldindata.org/grapher/daily-covid-deaths-per-million-3-day-avg...

Excellent plot.  One of the claims made in the OP was that things go differently in different countries, “check out Japan for example” with the apparent aim of suggesting we could be more like Japan than Italy- as said at the time, our policy was much closer to Italy than Japan - you can now compare all 3 to see which is the closer one to us.  The  data sure is much closer to following Italy and not Japan. 

https://ourworldindata.org/grapher/daily-covid-deaths-per-million-3-day-avg...

Yes, it is, indeed - I couldn't resist a dig at Mr Trump  If you map India Pakistan and China as well however - all fairly similar sizes, you still get a striking view.

I use cases per million for comparisons in the UK counties, as it's the only way to compare radically different size UTLAs. I've also got New York as a separate graph, but there are so many things to take into account - testing regimes being the main one, that it's hard to see what is the actual situation, and what is some artefact of the data. For example the NY deaths per case is about half that of the UK, almost certainly testing related. I'm glad I'm not an epidemiologist...

I actually looked into suggesting this as I think it would be a good feature, but it seems the developers are embroiled in a defence of the status quo which involves no extra work for a feature they don't like, so I moved on: https://github.com/aatishb/covidtrends/issues/30

We might not have followed Italy.....

A really damning article from The Times on the government response (especially Boris)

https://www.thetimes.co.uk/article/coronavirus-38-days-when-britain-sleepwa...

Paywalled but text copied here:

https://threadreaderapp.com/thread/1251616775504113664.html

Gods a dismal read to see it all laid out along with insight into what Boris was (not) doing.  A few scattered thoughts:

The article notes the high death count of our later lockdown but doesn’t go in to how the economic effects of a later lockdown are probably much worse too - as it has to be tougher and longer.

It didn’t help that even towards the tail end of our period of inaction, people who were making accurate predictions were being shot down for hysteria or because of vague but nationalistic reasons why the UK wasn’t like other places.

Many people will still strongly defend the government response jumping to (provably false) claims of the critics deploying hindsight to criticise.  The tragedy is that there was ample foresight provided by 1918, fifteen years of post-SARS literature, Cygnus (2016), China and then.... Italy.

Can we skip past the enquiry straight to the court cases?

Other than removing Cummings from government, what can be done to improve the interface of scientists and government?

The purging of MPs from both parties for ideological reasons has left us with weak, sycophantic yes people totally unfit for a crisis.  Neither party deserves control over which donkey goes in a safe seat any more.

It's ok because we have Superman to come to our rescue:

https://twitter.com/i/status/1251458390028664832

Or, at least, to the rescue of those still breathing after this. It's hard to conceive of a more callous approach to prioritising business interests over human lives, even were it to have been an effective way to reduce the economic impact in the first place.

to be fair to the government they had a very high priority mandated task to perform at that time.  And they can't be blamed because what we got was the will of the people.  How could they have wasted time not performing the prime directive?

We The People cannot now blame the government for concentrating on getting a TRUMPeted policy done.