Who wants a circuit breaker?

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Removed User 13 Oct 2020

Keir Starmer has just called for one, for two or three weeks.

"It wasn't inevitable but now it's necessary".

I think I agree, is a fortnight long enough?

27
 minimike 13 Oct 2020
In reply to Removed User:

Me. And no, three weeks would be far more effective

9
 elsewhere 13 Oct 2020
In reply to Removed User:

Go early and go hard. Better in terms of lives lost, jobs lost and businesses lost to deal with a small problem than a big problem.

Post edited at 18:36
8
In reply to Removed User:

Do it. Three weeks please. Last one to the shelves of pasta finds them empty.

T.

3
 Neil Williams 13 Oct 2020
In reply to Removed User:

I'm not opposed to it BUT with the full furlough scheme reinstated, and additional money for businesses to stop them collapsing.

Could it perhaps be "bought" by saying restrictions would be amended for 24th, 25th and 26th December to allow all reasonable family Christmases to take place?  Let's say the rule of 6 temporarily becomes the rule of 12?  But on 27th reinstate as before.

Three days would increase cases a fair whack, but not *that* much even with R at about 2, which would probably be the effect.

Post edited at 18:29
15
 WaterMonkey 13 Oct 2020
In reply to Removed User:

If it was over half term would I be able to go on holiday in the uk still?

3
 Yanis Nayu 13 Oct 2020
In reply to Removed User:

Should have happened a few weeks back and I’d say if the incubation period is upto 14 days it would need to be 3 weeks. 

1
 balmybaldwin 13 Oct 2020
In reply to WaterMonkey:

Probably knowing the half arsed measures used so far by the gov, but it shouldn't be allowed tbh.  We need a proper lockdown, and that means people not moving about the country

9
In reply to Removed User:

Me. I think a routine of 2-week lockdowns, every 4-6 weeks or so, with relaxed measures in between, might be a more palatable way of getting the public to comply (which, apparently, many are not doing at the moment). Being able to plan for it, knowing when it will end will hopefully bring the patience that we seem to be lacking with current measures. And a strict lockdown should dramatically reduce transmission.

15
 profitofdoom 13 Oct 2020
In reply to Neil Williams:

> Could it perhaps be "bought" by saying restrictions would be amended for 24th, 25th and 26th December to allow all reasonable family Christmases to take place?......

Thanks for your suggestion, but no thanks. "Merry Viral Christmas"? "Happy Covid Christmas, Grandma, have a massive viral load"? I am not being sarcastic, I am pointing out that it's very unlikely that the virus will slack off for the holidays and put its feet up for 3 days

Thanks for listening

4
 Toccata 13 Oct 2020
In reply to Removed User:

If he called for it a month ago he’d have some credibility. It’s now too late for a short break to be effective (said the chap on PM tonight). Keir might be clever but I’m yet to be convinced he’s a leader. 

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 FactorXXX 13 Oct 2020
In reply to profitofdoom:

>  I am pointing out that it's very unlikely that the virus will slack off for the holidays and put its feet up for 3 days

Covid never sleeps...

1
 wintertree 13 Oct 2020
In reply to Removed User:

Given incubation times and infectious duration and multi-occupancy households I think it would need to be 3 weeks to be effective.

The sooner we do it the better.  Unless something dramatic changes, we plan another one 6 weeks after this one ends and let everyone know now, along with the criteria to pull it forwards or to delay it - this gives everyone a direct incentive to work at reducing their role as a transmission route as well as giving maximum opportunity to plan.  

The economic savings from either (a) not completely buggering up the whole healthcare system and killing hundreds of thousands of people or (b) ending up in a two-month long lockdown will more than balance the cost of good economic support for a “circuit breaker” lockdown pattern I think.

It should never have come to this.

In terms of circuit breakers, there’s a spoon wedged in to the socket instead of a fuse, and what’s about to happen is the spoon plasmerising under the load.

Post edited at 18:59
2
 Michael Hood 13 Oct 2020
In reply to captain paranoia:

> Me. I think a routine of 2-week lockdowns, every 4-6 weeks or so, with relaxed measures in between, 

I think this might be a sensible way to go, which might become necessary anyway.

The amount of decay and then re-growth in each cycle can be used to vary the length of the "relaxed" period appropriately. 

1
Removed User 13 Oct 2020
In reply to wintertree:

Yes, I was wondering if two weeks was long enough.

I guess that in a fortnight anyone who contracts C19 on the last day of freedom would have shown symptoms and been tested, with contacts tracked and traced by then if we have an efficient system... I'm not sure how long asymptomatic carriers can remain infectious for?

The other thing I wondered was whether it could be lifted at different times in different parts of the country provided travel between open and closed parts was prohibited? Given for example that the islands of Arran and the Shetlands have no cases at the moment do they need to shut down for two or three weeks? I guess if we want zero cases then probably not but if we think that impossible and are looking for a maximum number of new infections per day then more plausible? 

1
 Dave the Rave 13 Oct 2020
In reply to captain paranoia:

> Me. I think a routine of 2-week lockdowns, every 4-6 weeks or so, with relaxed measures in between, might be a more palatable way of getting the public to comply (which, apparently, many are not doing at the moment). Being able to plan for it, knowing when it will end will hopefully bring the patience that we seem to be lacking with current measures. And a strict lockdown should dramatically reduce transmission

I would be with you on that, but in reality we have groups of people of all ages and ethnicity that don’t want to comply and will continue as normal , sneaking to closed pubs and each other’s houses for group activity. I don’t know how you Police this.

Being from quite a rough council estate, admittedly with good folk in the mix, not many are going to grass up their neighbours. A lot wouldn’t pay the fines anyway. With the dark nights looming it will be even harder to stop people attending gatherings.

So, a lot of compliant folk will comply with potential losses to their freedom and livelihood for the greater good, whilst the non compilers carry on unchecked.

This is a major part of the reason for the second wave and third and.......

1
mattmurphy 13 Oct 2020
In reply to Dave the Rave:

> I would be with you on that, but in reality we have groups of people of all ages and ethnicity that don’t want to comply and will continue as normal , sneaking to closed pubs and each other’s houses for group activity. I don’t know how you Police this.

Exactly - compliance will be low in the next lockdown. It’s next to impossible to convince young people not to mix with each other when they’ve got a greater chance of dying from being hit by lightening than dying of covid.

How do you stop an 21 year old from going to see their boyfriend/ girlfriend?

I read the SAGE minutes of circuit breaker lockdowns paper and theirs next to no acknowledgement of the economic impact of it - it only comes into the discussion in the context of compliance amongst lower socioeconomic groups. It’s not exactly a balanced discussion.

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 Richard Horn 13 Oct 2020
In reply to Removed User:

After two weeks the death rates will still be on the rise (due to the lag), so politically it would be suicide to release the circuit breaker, and we would end up locked in for much longer. Personally I cant see how it buys us anything except a delay in the inevitable, meanwhile more people lose their incomes.

4
 Dave the Rave 13 Oct 2020
In reply to mattmurphy:

Yeah, it’s people at SAGE covering their arses. Boris must follow his three tier thing and hope for the best. It’s probably got as much chance of being effective as a harsh lockdown that the main culprits won’t follow, whilst keeping some form of business alive.

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 Si dH 13 Oct 2020
In reply to Removed User:

I would definitely support a three week circuit breaker. I'd like to see it repeated again a couple more times before the spring to help keep things in check, along with other local measures where required.

I'm worried though that in some places the infection rates are so high that even after a 3 week break there would be a lot around that would quickly rebound.

I don't support any travel bans to and from very high risk areas and wouldn't support different lengths of circuit breaker between areas either. We didn't put a fence around the worst hot areas in the first peak, we all went through it together.

7
 Dave the Rave 13 Oct 2020
In reply to Si dH:

> I would definitely support a three week circuit breaker. I'd like to see it repeated again a couple more times before the spring to help keep things in check, along with other local measures where required.

> I'm worried though that in some places the infection rates are so high that even after a 3 week break there would be a lot around that would quickly rebound.

> I don't support any travel bans to and from very high risk areas and wouldn't support different lengths of circuit breaker between areas either. We didn't put a fence around the worst hot areas in the first peak, we all went through it together.

So in effect, you don’t support a circuit breaker?

3
 Si dH 13 Oct 2020
In reply to Dave the Rave:

Why do you say that?

What I'd support is closing all non essential businesses (with financial support), banning all socialising outside household groups and support bubbles and ensuring everyone work from home or not at all, unless a key worker. Possibly also revert to public transport being reserved for key workers.

A circuit breaker does not need to require a travel ban. I've never seen any evidence they help and they indiscriminately prevent people doing important things like seeing people in support bubbles across county boundaries and getting some fresh air and exercise in the countryside. They are bad all round as far as I'm concerned - relaxing travel quickly in May was the thing Boris has got closest to right in this whole affair.  There is no risk of people going for a pub crawl in the next town if their pubs are shut anyway.

Edit to say that I'm not against advising that non essential travel being avoided, just against it being legally banned.

Post edited at 20:51
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 wintertree 13 Oct 2020
In reply to Removed Userthread:

A sensible wiring scheme has different breakers on each circuit.

We only need to pull the critical circuits.  Other than badly run pubs and WMCs I’m not convinced that business are driving much of the current spread.  I think private parties and household visits without any sort of policing are the biggest culprit.

How do we throw that circuit breaker only?  Hard lockdown achieves this because if everyone is required to stay home, they’re not partying or socialising inside other houses.  But it closes many service businesses that perhaps don’t need to close, and that provide a safer, more regulated way for people to meet without so much transmission.

Difficult.

Post edited at 20:56
 Dax H 13 Oct 2020
In reply to Removed User:

I would be all for it but there would be conditions. 

1 it's a proper lockdown with only genuine key workers allowed to go to work, I was amazed at how many companies suddenly claimed to be key workers during the last one. 

2 all none essential international travel stops for the rest of the year. There is no point breaking the cycle then letting people get off a plane with it. 

5
In reply to Dave the Rave:

> but in reality we have groups of people of all ages and ethnicity that don’t want to comply 

I'm afraid that does appear to be a major part of the problem we have now.

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mattmurphy 13 Oct 2020
In reply to Dax H:

> I would be all for it but there would be conditions. 

> 1 it's a proper lockdown with only genuine key workers allowed to go to work, I was amazed at how many companies suddenly claimed to be key workers during the last one. 

I’m amazed that so many people seem to be passionate supporters of as many people losing their jobs as possible.

I guess we do have on average a public sector, left leaning viewpoint on UKC, so you get a I’m alright jack mentality to the wider economy.

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Removed User 13 Oct 2020
In reply to Dax H:

> 2 all none essential international travel stops for the rest of the year. There is no point breaking the cycle then letting people get off a plane with it. 

It seems incredible to me anyway that anyone would risk their health by sitting thigh to thigh with a stranger in a sealed aluminium tube for several hours. In Germany they test everyone when they get off the plane and the results are available in 15 minutes. I don't know why we can't do that.

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 wintertree 13 Oct 2020
In reply to mattmurphy:

> I’m amazed that so many people seem to be passionate supporters of as many people losing their jobs as possible.

I think that’s because you’re not really listening to them.  Certainly I think a managed, supporter lock down is going to be less harmful to jobs than the chaos of continued exponential growth in cases, hospitalisations and deaths.

> I guess we do have on average a public sector, left leaning viewpoint on UKC, so you get a I’m alright jack mentality to the wider economy.

I’m a founder of a new business and I want what’s best for that business - which I strongly believe is aligned to what I think is best for my family, my community and everyone else - not having uncontrolled growth in cases to the point test/trace/isolate breaks.  There are other business owners on here who I think have similar views.  

What we have here is a difference of opinion on how to protect the wider economy. Some of us believe that this is best done by protecting healthcare, life and public confidence, those being three critical pillars of the economy.

1
 mik82 13 Oct 2020
In reply to Removed User:

It's too late.

As before the government has delayed things rather than making an early intervention. There's (well, in England) still no effective track and trace system.  Given past experience there is no way they can implement this in a 2-3 week "circuit breaker" or even in the month or so that this might buy.  The jobs in hospitality and other vulnerable sectors have already been lost as any further measures are going to be protracted. 

 Dave the Rave 13 Oct 2020
In reply to Dax H:

> I would be all for it but there would be conditions. 

> 1 it's a proper lockdown with only genuine key workers allowed to go to work, I was amazed at how many companies suddenly claimed to be key workers during the last one. 

> 2 all none essential international travel stops for the rest of the year. There is no point breaking the cycle then letting people get off a plane with it. 

Ten out of ten. This is my major bugbear with the first wave. Why were people flying, landing and discerpating everywhere. 

3
mattmurphy 13 Oct 2020
In reply to wintertree:

I don’t disagree with you (and good luck for your business).

I just try to explain things from my point of view - to caveat part of my job is to produce and analyse cash flow forecasts.

Some people are pro-lockdown without any understanding of how a business works. It’s why I keep calling for balance in the discussion.

16
In reply to mattmurphy:

And some people seem to be anti-lockdown without any understanding of the consequences of exponential pandemic growth. Including the consequences to businesses.

4
 kipper12 13 Oct 2020
In reply to Removed User:

Asked out of ignorance; but I thought I saw it reported by one of the senior scientific advisors that a short lock down would again buy us time.  However, would we simply find ourselves in 2-3 weeks back in the same predicament. 
 

 pec 13 Oct 2020
In reply to Removed User:

To echo what a number of posters have said about non compliance, this happened to me today.

I bumped into a friend's son. He's done 4 years of a medical degree and is taking a year out to do an MSc in public health before finishing his course next year. One would assume therefore he is more intelligent and better informed on infectious diseases and coronavirus than your average person.

First he reached out to shake my hand and then when I asked him how he is doing he said he's pretty sure he had covid a few weeks ago but didn't get tested because then he'd have to comply with all the restrictions if he was positive.

He's a nice lad but you have to despair. . . . .

A circuit breaker will at best slow the rate of increase which will then return to it's current trajectory as soon as it is lifted because too many people have decided they don't care. It will merely delay the peak by three weeks.

I don't see the public mindset changing now until the deaths start rocketing and it finally dawns on people that the near normality of summer was just a pleasant interlude.

And anyway, the one thing that now guarantees there will be no circuit breaker is Starmer laying down the gauntlet so melodramatically as he did today. He's playing politics with this, actually he's been playing politics all along but not quite so blatantly. That is is job of course, but it's now politically impossible for Johnson to be seen be to jumping to Starmer's tune.

10
In reply to mattmurphy:

> I’m amazed that so many people seem to be passionate supporters of as many people losing their jobs as possible.

> I guess we do have on average a public sector, left leaning viewpoint on UKC, so you get a I’m alright jack mentality to the wider economy.

and I’m amazed that so many people seem to be passionate supporters of as many people losing their lives as possible 

I guess we do have on average a sizeable minority of private sector, right leaning viewpoint on ukc, so you get an I’m alright jack mentality to the other people dying by the tens of thousands

see, we can all do the sneering misrepresentation of other people’s positions. But it is crappy thing to do. Unbelievably, the pandemic seems to be turning into the latest front in the culture war. It’s a grim enough situation without adding fuel to that fire. So I’ll do you the credit of not assuming bad faith on your part, and ask you again what you think SAGE meant when they said “catastrophic consequences”?

3
 richardhopton 13 Oct 2020
In reply to mik82:

Agreed, far too much far too late and anyone that feels that this is a good idea is either a works in Aldi, a public sector worker, fintec worker or someone that doesn’t realise that they are only moments away from being called into then Boss’ office for the last rites. 
Hospitality alone, is worth over £100 Billion and if anyone here thinks that they won’t feel it is sadly mistaken. 
We’re being led by Brexiteers not Pandemic experts, and not even good politicians at that. We need to accept we’re in the blast radius rather than try and dig a bigger hole to hide in. 

4
Removed User 13 Oct 2020
In reply to pec:

Your friend's son sounds like a total dick. I think I would have said something.

Of course there's a lot of politics in this as with the Tories on an 80 seat majority and 40 of them rebelling on the rule of six it would be incredibly difficult to get this past the Tory party at the mmoment. Starmer has been listening to the mayors I expect and probably the Welsh FM if not the all the other FMs and gauging the mood of the country which is for stricter lockdowns. On the other hand the Sage advice recommending a lockdown was only published yesterday and it gave it something to advocate (rightly in my view). Also I believe that the cabinet were all in favour of stricter lockdown but were persuaded against it by Rishi Sunak so who knows, we may see something come out of this. Certainly if public opinion is clearly supportive it makes it easier for the government to act more decisively.

I expect Anniliese Dodds will be on Newsnight tonight. Certainly it will be interesting to see what Labour's economic approach to this would be.

1
 The New NickB 13 Oct 2020
In reply to Removed User:

I think it's needed. It may be too late, but should be tried, three weeks ago when SAGE recommended it would have been better.

1
 Neil Williams 13 Oct 2020
In reply to The New NickB:

There is an advantage to doing it on the October half term plus a week, as you could close schools for "2 weeks for the price of one" then and get better results in a shorter time.

1
 wintertree 13 Oct 2020
In reply to no_more_scotch_eggs:

> Unbelievably, the pandemic seems to be turning into the latest front in the culture war.

As far as I'm concerned, that started back in March with a couple of brand new accounts posing thoughtful questions about what a life is worth, and if it's better to let the old die to preserve the future of our bright younglings.  This was a reflection of wider discussion of that on the nutter-sphere at the time including for example the blog of a certain loony tunes M.D.   I was convinced then and remain convinced now that these pop-up accounts were part of a wider alt-right culture war - they used an exceptionally high amount of emotionally charged language and carefully used the "only asking a question" approach to establish and cast in a solid light a set of dodgy prepositions around the false equivalence of lives and the economy that drew people in.

At least now nobody is coming along to share some dodgy "research" about how we're just on the cusp of herd immunity meaning we should just stop worrying about it.  

Post edited at 22:29
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 The New NickB 13 Oct 2020
In reply to Neil Williams:

> There is an advantage to doing it on the October half term plus a week, as you could close schools for "2 weeks for the price of one" then and get better results in a shorter time.

The disadvantage being exponential growth. I appreciate it isn't the R0 isn't as high as March, but the consequences are significant. Move half term.

 Dave the Rave 13 Oct 2020
In reply to The New NickB:

> The disadvantage being exponential growth. I appreciate it isn't the R0 isn't as high as March, but the consequences are significant. Move half term.


I think that the only R factor that we need to be concerned about is , R you coming to our house tonight as we R having a party. If they were pirates they would indeed say Aaarghhh. 

3
 Michael Hood 13 Oct 2020
In reply to The New NickB:

It's all feeling rather gloomy. We've got 3 parents in their 90's who are physically in reasonable shape. When this all started one of my first thoughts was "are we going to get to the (Jewish) new year with all 3 still alive". Well that's been managed but now I'm thinking the chances of all 3 still being around come spring time is looking more and more remote.

Bit depressing really.

 Dave the Rave 13 Oct 2020
In reply to Michael Hood:

> It's all feeling rather gloomy. We've got 3 parents in their 90's who are physically in reasonable shape. When this all started one of my first thoughts was "are we going to get to the (Jewish) new year with all 3 still alive". Well that's been managed but now I'm thinking the chances of all 3 still being around come spring time is looking more and more remote.

> Bit depressing really.

Feckin hell, get your chin up. We will be fine

7
 The New NickB 13 Oct 2020
In reply to kipper12:

> Asked out of ignorance; but I thought I saw it reported by one of the senior scientific advisors that a short lock down would again buy us time.  However, would we simply find ourselves in 2-3 weeks back in the same predicament. 

Potentially it could buy quite a bit more time than that, depending on how successful it is at reducing the R0. I've not seen any modelling, but I'm sure it exists.

1
 jkarran 13 Oct 2020
In reply to Removed User:

Wants is the wrong word. 

Unless something changes fast (the regional lockdown tiers doesn't look like it) we will need a lockdown. On that basis sooner is better. 

Is it inevitable or could the situation be saved another way? I'm on a knife edge but I don't for one second believe this government will do what's needed until it's forced. 

2 weeks is fanciful, we already need at least 4, in another 2 weeks make that 8.

We need to know what went wrong. Those that failed us need to be held accountable, now not in 2024.

Jk

3
 jkarran 13 Oct 2020
In reply to pec:

> A circuit breaker will at best slow the rate of increase which will then return to it's current trajectory as soon as it is lifted because too many people have decided they don't care. It will merely delay the peak by three weeks.

What mechanism causes this peak you think will be delayed by a short hard lockdown? 

> And anyway, the one thing that now guarantees there will be no circuit breaker is Starmer laying down the gauntlet so melodramatically as he did today. He's playing politics with this, actually he's been playing politics all along but not quite so blatantly. That is is job of course, but it's now politically impossible for Johnson to be seen be to jumping to Starmer's tune.

It'll be impossible for him not to in 4-5 weeks but we'll be shut down for months then, not weeks to clear up the mess. 

Jk

2
mick taylor 13 Oct 2020
In reply to Neil Williams:

Longer half term breaks Oct and Feb (3 weeks) and a much shorter summer break?  No doubt this would be viewed as too radical, but in the grander scheme is easy (we are just too stuck in our ways and loathe change).

1
 The New NickB 13 Oct 2020
In reply to jkarran:

I'm slightly more optimistic, working back through the reduction in cases / deaths* since the peak, we are perhaps in a similar position to where we were in late May. We could probably get case numbers fairly low, fairly quickly. It would possibly give us a bit of a reset and buy a few months. Maybe optimistic and I would have preferred it to happen three weeks ago.

*Deaths being a better proxy for real case numbers than positive tests due to the variation in testing capacity and protocols.

 Neil Williams 13 Oct 2020
In reply to mick taylor:

Not a bad idea.  No school time lost then.

 Misha 13 Oct 2020
In reply to Removed User:

As with all things Covid, the earlier, the better. Question what it should entail, whether it should be nationwide (including Wales and Scotland for consistency) and how long it should last. I’ll defer to SAGE on those points...

The reality is that a single circuit break probably won’t be sufficient. Two or three would probably be needed between now and Easter. If the government spelled out roughly when they would be (this would be an approximation of course), what criteria would be used for imposing / lifting them and, crucially, what financial support affected businesses and people would get, we could all plan for it and there would be an element of having light at the end of a relatively short tunnel.

As it is, I suspect we’ll need to have an emergency lockdown similar to last spring for about 6 weeks, starting as soon as mid-November. 
 

Let’s face it, with BoJo in charge it’s going to be a total mess. 

 Misha 13 Oct 2020
In reply to Dave the Rave:

I think any lockdown rules are based on most people going with the rules for most of the time. Of course some won’t comply and compliance will be lower this time round but that’s better than not having any rules at all. 

 Misha 13 Oct 2020
In reply to mattmurphy:

To be fair, SAGE are not their to comment on the economic impact. That is not their remit. 

 Misha 13 Oct 2020
In reply to Richard Horn:

Thing is, if the epidemic gets really out of control, the economy will tank anyway even without a lockdown. And once the NHS starts bursting at the seams there will be no choice but to lock down - for a longer time. 

If there is an uncontrolled epidemic, most people will change their behaviour (some already have, including in our climbing world - some people are already not going to the walls and I’m not sure I would be if local infection levels were similar to Liverpool, which isn’t even anywhere as bad as it can get). The pubs etc will stand largely empty.

Then the hospitals will overflow and with people dying gasping for air on hospital waiting room floors the government would have no choice but to introduce a hard lockdown again.

They’re just winging it at the moment, hoping the latest rules will delay the wave sufficiently. Which they won’t - cue a circuit breaker type thing as early as mid November. Mark my word...

Post edited at 23:48
 Dave the Rave 13 Oct 2020
In reply to Misha:

> I think any lockdown rules are based on most people going with the rules for most of the time. Of course some won’t comply and compliance will be lower this time round but that’s better than not having any rules at all. 

Yes

 Misha 13 Oct 2020
In reply to Si dH:

Agree except I would add that if it’s for only 2-3 weeks x say 3 times, it won’t be the end of the world to ban non-essential travel.

 Misha 13 Oct 2020
In reply to Dave the Rave:

Not many people were flying in spring beyond the initial wave of people caught out abroad who had to return home (eg I came back from France when they imposed their lockdown a week before our one). 

 Lord_ash2000 13 Oct 2020
In reply to Removed User:

I don't see much point in a circuit breaker short lockdown. What's does it achieve? Just puts the infection numbers back a couple of weeks then we unlock and watch them rise again as they are now.

If you really want to end this for good then there are only two solutions. A complete lockdown, with heavy fines for unauthorized leaving of your house and military on the streets enforcing it until cases drop to zero. Then a continued complete shut down of international travel or extreme quarantine measures for as long as is needed. This would likely need a few months to work and would cripple business on a scale we haven't seen before.

Alternatively, let nature take its course. Expand NHS capacity where possible but when that is overrun simply recommend bed rest at home for anyone over 75 to allow hospitals to function for the day to day stuff. Still a blow for the economy but unlikely as bad, also a lot more people die.

Nither option is great but that's the sort of scale of action we'd need to fully beat this. The third option and seemingly most likely because it doesn't require making hard choices is to bumble along as we are having wave after wave as we move between varying levels of restrictions and a long drawn out suffering for everyone for the next few years until we either develope, manufacturer and vaccinate the whole country or get to a point where so many have had it that herd immunity takes effect. Basically option two but spread out over years rather than months and likely at far greater overall cost.

Post edited at 23:56
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 Misha 14 Oct 2020
In reply to Lord_ash2000:

I think ‘do nothing’ won’t be acceptable to most governments / people - far too many people would die and far too many would develop long Covid. The economy will fall off a cliff anyway as many people will adapt their behaviour (plenty of people not going to the pub already, I’m certainly not; office workers will mostly stay at home - almost everyone at my 20,000+ firm is at the moment and only about a fifth can go back at any one time in a Covid safe way, so sandwich shops etc will be heavily impacted; retail will be decimated; the list goes on).

We need to get through to spring one way or another, with hopes pinned on a vaccine being rolled out (that will time of course). If there is no vaccine, a zero Covid approach may be the only way but this would require a long, rigid lockdown, coupled with an effective test and trace. I don’t believe in the ‘moonshot’ rapid testing of the entire population, that’s just pie in the sky and pointless anyway if people don’t self isolate.

In reply to Lord_ash2000:

> I don't see much point in a circuit breaker short lockdown. What's does it achieve? 

A fully implemented lockdown, of duration equal to the incubation and infection period, will theoretically knock out all transmission, and therefore eradicate the virus from the population.

Of course, the reality is that the lockdown will be incomplete, due to the need to have some contact due to the need to shop, and treat those who are ill (ignoring those who will, utterly selfishly, disregard the lockdown).

But even incompletely effective lockdown would significantly reduce population prevalence, resetting the exponential growth curve.

That's why I suggested repeated hard lockdown to keep growth under control, whilst allowing economic activity, and some semblance of more normal life to resume in the inter-lockdown periods.

 Jon Stewart 14 Oct 2020
In reply to Lord_ash2000:

> I don't see much point in a circuit breaker short lockdown. What's does it achieve? Just puts the infection numbers back a couple of weeks then we unlock and watch them rise again as they are now.

It's a delaying tactic, flattening the curve.

> If you really want to end this for good then there are only two solutions.

So you assert without having understood the problem correctly.

> A complete lockdown

Not an option because society would disintegrate. There wouldn't be country left to rebuild, and there'd nothing to rebuild it with.

> Alternatively, let nature take its course. Expand NHS capacity where possible but when that is overrun simply recommend bed rest at home for anyone over 75 to allow hospitals to function for the day to day stuff. Still a blow for the economy but unlikely as bad, also a lot more people die.

Not an option because society would disintegrate. 

"Simply recommend bed rest at home for anyone over 75" is an incredibly stupid thing to say. Do you mean 75+ with covid, or for all health conditions? If something sounds like it might be covid you get no treatment, right? You don't actually know if it's a heart attack or liver cancer or covid, but it might be covid so you can't come to the hospital? Is it the receptionist that decides? Or do you get tested before you're allowed in the ambulance? Do you have to do this yourself before they'll come out, or will the ambulance come with the testing kit? But with so many people ill at the same time there's no ambulances left. Oh well - whether you had covid or not, you die at home without treatment. Now, there's a dead body in the house - great. But this is happening all over the place and there's no space in the morgues, funeral services are overrun. So, what are we going to do with Granpa?

What do you reckon, build a big furnace and just shovel in all the bodies of everyone of 75 who were refused NHS treatment? It would be a lot less hassle, and much cheaper if you just shovelled them in now, covid or not, wouldn't it?

Why didn't you think of that solution?

F*ck it, maybe 70, that'll save on pensions too?

So both of your solutions aren't solutions.

> Nither option is great but that's the sort of scale of action we'd need to fully beat this. The third option and seemingly most likely because it doesn't require making hard choices is to bumble along as we are having wave after wave as we move between varying levels of restrictions and a long drawn out suffering for everyone for the next few years until we either develope, manufacturer and vaccinate the whole country or get to a point where so many have had it that herd immunity takes effect. Basically option two but spread out over years rather than months and likely at far greater overall cost.

We're doing that because it's the lowest cost option available after the initial monumental f*ck up of letting the virus spread everywhere in the winter. If rather than dying, requiring hospital care and funeral services, covid just made people disappear without a trace, then perhaps "letting nature take its course" would work out alright. However, the way the world works is that we have system for dealing with sickness and death in society, which we rely on to keep society functioning. If that system became totally overloaded, the economy wouldn't just carry on, not caring about all the bodies in the streets, with happy shoppers stepping over them to pick a few bits up from Marks. That's not what it would be like. Society is an interconnect web of activities, and just like if the road system become completely logjammed, everything would collapse, if the same happened to healthcare, everything would collapse.

People who advocate this position would find that actually, they didn't like the consequences very much, and in fact, rather than carrying on as normal, the economy completely collapsed, and they'd wish they were a bit brighter and better at understanding things because their idea had completely the opposite effect to what they wanted.

This is why the government is doing the only thing it can - trying to keep the economy going while avoiding overloading the healthcare system. Which means trying to keep infections low, because once exponential growth gets going, it takes extremely harsh measures to stop it, as we saw in March.

I suspect that the "circuit breaker" would probably do more good than harm, by setting things back a bit to give more time to improve test-and-trace, and get people taking things more seriously in terms of individuals behaviour changes, but it's impossible to know. But I think it seems really harsh on people who are in regions with low numbers, so the regional approach has advantages too. Remember that the suggestion is just to apply tier 3 nationally so it's not proper lockdown which is what would really make a difference (but I don't support it unless completely necessary as the side effects are too dreadful).

The worry is that if we don't, then we'll just end up with harsher, more damaging restrictions for longer. 

Post edited at 02:10
 daftdazza 14 Oct 2020
In reply to Removed User:

The whole situation is a mess and I think a lot of posters on hear are blind to reality of the situation

I never thought test trace and isolate was going to work from start, mainly due to potential of asymptomatic spread and how we based the idea on say South Korea or New Zealand, which never bared any reality to situation here, my guess in time we will probably find many regions of the world have in built past immunity to covid - 19 from exposure to similar coronaviruses just like we probably have here to a smaller degree shown by different Infections rates during first and second wave in North of UK Vs south east and west, shown again in other European countries such as difference between Berlin and Saxony, or north Vs south Spain etc.  Also I doubt the system in UK can ever be fixed now.

Other major problem with TTI or advocating further lockdowns or circuit breaker is the public compliance is no longer there.

Surveys have been carried out suggesting a very high percentage of people say they would isolate if infected or contacted by Test trace system, around 90 percent.  But follow up studies on people who have a positive test or are asked to isolate found around 20 percent or less actual do.   

so it's not hard to imagine that large proportion of the population are unlikely to comply with stricter measures, we can have a three week circuit breaker but household transmission will remain high and signaficant proportion of thoses who become infected will then be out the house doing what they want anyway.  

I think we need to be careful about any further lockdown as it will do mass damage to economy for probably not the desired benefit, and just now I really can't see how pubs or restaurants in Glasgow etc where I live will be able to open again this winter, it's a hard sell to get the public on board when most have already worked out they are going to instructed not to meet friends or family indoors until the spring.

Mass testing has also be a vast waste of money, I think the old system of if you have symptoms isolate for a week was probably best approach, the money for TTI and mass testing should have been spent on recruiting doctors and nurses from low prevalence countries in Africa, eastern Europe, south East Asia, Australia etc, then staffing proper covid only hospital, so we could treat all covid patients separately keeping NHS open for all.  The situation is dire now in a lot of hospitals with over 20 percent of covid patients having caught the virus while in hospital, a total joke.

I find the whole situation miserable and can't see a desirable solution either way, I am not totally against a second lockdown I am just not convinced the half hearted measure we have just now are going to work or if now is currently right time for it.  Would love to be proved wrong.

​​​​

7
 Misha 14 Oct 2020
In reply to Jon Stewart:

You’re broadly right I think, though I doubt either alternative would involve an end to society as you suggest. It would certainly involve a significant economic hit and negative social impact.

As you say, if infection were to get completely out of hand, even the Great Barrington advocates would probably have second thoughts. Especially when *their* friends and family start dying.

A zero Covid strategy would take time and I question whether it’s feasible in a country which is as large and interconnected as the UK. Might have no choice though if a vaccine isn’t on the cards. 

 Misha 14 Oct 2020
In reply to daftdazza:

The main reason so few fully self isolate is probably that they don’t get sufficient financial support. If someone can’t work from home they should get their usual earnings paid in full by the government and it should be illegal for them to get sacked. It would cost money but it would be money well spent. TTI without the I is useless.  

In reply to Lord_ash2000:

> I don't see much point in a circuit breaker short lockdown. What's does it achieve? Just puts the infection numbers back a couple of weeks then we unlock and watch them rise again as they are now.

It might get the infection down far enough for other techniques to be effective.

Our first lockdown worked pretty well, especially in Scotland where we took another few weeks we got it down pretty low.  Then we started to open up and we went a bit too far and let R get over 1 but not so much that it was growing unacceptably

For me, the thing that kicked it over the edge completely was reopening schools and Unis.  If we are going to do that we will need to have a much harder lockdown in other areas to compensate.

A circuit breaker lockdown could get us to the point where we can have a similar situation to summer but to make that useful we also need to step back a little when we reopen.   Maybe primary and the first couple of years of secondary face to face and home learning for the older pupils.

Post edited at 04:36
 Dax H 14 Oct 2020
In reply to Removed User:

> It seems incredible to me anyway that anyone would risk their health by sitting thigh to thigh with a stranger in a sealed aluminium tube for several hours.

I agree, I just can not get it to compute inside my head at all but loads of people started doing it again as soon as travel was opened then started rushing back to beat the 14 day isolating 

> In Germany they test everyone when they get off the plane and the results are available in 15 minutes. I don't know why we can't do that.

Far too much to ask. 

 Dax H 14 Oct 2020
In reply to mattmurphy:

> Some people are pro-lockdown without any understanding of how a business works. It’s why I keep calling for balance in the discussion.

I'm very pro a short sharp shock lockdown even though if it happens it will A bugger up my holiday at the end of the month (remote cottage in the Peak) and B cost my business. 

I think I have a bit of an idea how businesses work after being involved in one for 33 years and owning and running one for the last 14 years. 

If you want any of my opinions on the subject of lockdown please read just about anything that Wintertree has posted. On this subject we share the same opinion but he is far more eloquent than me. 

Until we can do something like the German airport testing we need to close the borders. 

Stamp in infection right down, move hard and fast on any flare ups, restart the majority of our economy, don't let people bring new infection in to the country. 

The other option is faff about with half measures for years causing personal and economic hardship on a much greater scale

 daftdazza 14 Oct 2020
In reply to Misha:

It is often used as an excuse that it's poor people who don't fully self isolate due to lack of financial support, I think this is certainly true to a degree in case of those on zero hour contracts etc, but only to a certain extent given how few people self isolate, but a lot of stupidity is also involved, people get tested the day they are told to self isolate even when having no symptom, it off course comes back negative and they go back about there lives, I know at least one case where this lead to a significant outbreak and also know of professional educated people who have done similar, so I really don't think money alone is going to change situation

1
 daftdazza 14 Oct 2020
In reply to Misha:

TTI without the I is useless and is basically the situation we have now and I can't see how it is really going to change much no matter what we do, basic human behaviour, 10 days might seem too long for an infected person when they are asymptomatic so they might break it after 3 or 4 days, but if it went back to say a week then psychology it may be easier for people endure and actually stick to.  I am just guessing, but what is deemed as best practice theoretical for reducing spread such as 10 and 14 days might not be best in promoting compliance in human behaviour.  The 14 day quarantine ended up being completely useless as those caught out with travel restrictions while abroad just gave up after a few days at home as they felt unduly penalised, a test after five days with isolation over after 7 would probably have seen more people sticking to full duration and less virus spread from international travel.

1
mick taylor 14 Oct 2020
In reply to Neil Williams:

> Not a bad idea.  No school time lost then.

Not only that, but schools can do a higher % of outdoor learning in spring summer. My wife’s school have bought a big canopy with weather proof seating. Children love it, all weathers, some wussy teachers not so keen. Like I say, (too) many folk hate change and compromise and going out of their way for the greater good (better message would help with this, but BoJo has lost grip).

 daftdazza 14 Oct 2020
In reply to Dax H:

Everyone coming into Germany is not tested on arrival, unless it's changed recently.  Basically you are only required a test if you come from a very high risk area within certain countries, so people from Scottish central belt and not the Highlands or islands would require a test, and you don't get a 15 minute result but are instructed to travel straight to accomodation and isolate for upto 48 hrs waiting on test result.  But I think they are relying on people volunteering themselves to get tested on arrival outside the airport rather than forcing everyone on that incoming flight to go get tested, again unless things has changed since last month.

 rurp 14 Oct 2020
In reply to Lord_ash2000:

> I don't see much point in a circuit breaker short lockdown. What's does it achieve? Just puts the infection numbers back a couple of weeks then we unlock and watch them rise again as they are now.

Being back in the same place in a month is good, relatively. 
You are a young man in the north west and at the moment if you fall off the bowderstone and break your arm the NHS can fix it. 
3 week circuit breaker now and  in one month we are in the same situation and the nhs can still fix it plus  covid vaccines are a month closer.

no circuit breaker cases double every 7-10 days and your arm can’t be fixed, your appendicitis or infected minor wound goes septic and you die because the NHS in your area can’t do everything. Your house burns down as the fire brigade are helping the NHS. That’s what uncontrolled exponential growth in virus looks like. It’s not just ( in some people’s views) frail ‘ expendable’ people that die. 

And a vaccine is coming. Keeping things as they are for a few more months may mean we can crawl through to the vaccine and the world starts turning again.

Don’t shoot yourself when the cavalry are on their way. 
 

IMF say it’s a good idea to circuit break early and hard, apparently they know shit about money. So it’s good for the economy too.

Problem at the moment = 1x

Problem without circuit breaker in 1 month and 7 day doubling = 16x

Exponential f*cks you up real good

1
In reply to Removed User:

Very much agree with the need for a circuit breaker lockdown. This is the first time I've seen Starmer offer a meaningful alternative to the government line though, so finally he deserves some credit. Better late than never.

Needs to include school closures to be effective though.Towards the bottom of this article there's a list of how big an effect various interventions are expected to have on R with a link to the paper. Closing schools could reduce R by 0.5.

https://www.google.com/amp/s/www.bbc.com/news/amp/health-54514387

No need for it to cost jobs and crash the economy, this will happen in a purely neoliberal economy but, seeing as we have a global crisis going on, a benign government would step in to manage the economy so that the economy works for the benefit of people rather than the other way around. This is what I'd like to see Kier Starmer making the case for.

 DaveHK 14 Oct 2020
In reply to rurp:

> Exponential f*cks you up real good

​​​​​​If Quentin Tarantino was a maths teacher...

gezebo 14 Oct 2020
In reply to Removed User:

How long is the average stay in hospital for a  severe Covid patient? Would having a 1/2/3/4 week break be enough to clear any beds? 
 

Should the furlough system be changed so instead of 80% salary if you are off work you get paid 100% of your salary but capped at £8.72 an hour for 40 hours per week? 

 doz 14 Oct 2020
In reply to Removed User:

I'm in if Dom is...

1
 Richard Horn 14 Oct 2020
In reply to daftdazza:

I agree that irrespective of the consequences, the public are now largely lost on compliance. If people are fed up after a summer of nice weather and generous furlough schemes, then life is going to feel a lot less rosy over a cold winter being stuck indoors with the screw being tightened as the government run out of money. We could be heading for a winter of discontent.

 daftdazza 14 Oct 2020
In reply to Richard Horn:

Definitely, plus a problem with advocating for immediate strict lockdown now is people associate the dramatic decrease in case numbers in the spring to be due entirely from lockdown alone, two advantages we had in March/April was public willingness to comply and the clear seasonality effect of virus spread.  Now we have the reverse of low public compliance and increase virus spread due to seasonality effect.  We can go in for a hard three week circuit breaker but reality might be it achieves nothing we go for another three week etc, and before you know it we are in preputial lockdown until spring, all at it time when lockdown was instituted when NHS was far from being overwhelmed.  How likely are we going to see a Argentina/Peru example here, were we can't get out of a winter lockdown as it's not having the desired effect?

Cases are growing a lot slower in March, but unlike what others say back then you could get treated in A And E for a broken arm as emergency departments where empty, no one house burnt down due to fire fighters driving ambulances, we are not seeing un controlled exponential growth this time, Re now seems to be significantly lower than original R0.

Out of interest If the current level of Infections were to remain at today's levels for rest of winter would people deem this as to be acceptable with a little bit of society open or would people still like to see a zero covid strategy going forward?

 Lord_ash2000 14 Oct 2020
In reply to rurp:

> no circuit breaker cases double every 7-10 days and your arm can’t be fixed, your appendicitis or infected minor wound goes septic and you die because the NHS in your area can’t do everything.

That wasn't how it played out last time though was it? The reality was, covid wards were rammed and most other departments were half empty because either people were avoiding hospital for minor things and generally not getting hurt as often due to not going out as much. 

It all comes down to if we can get an effective vaccine developed, tested, mass-produced then administered nationwide in a time span short enough for the combined damage of repeated lockdowns and general restrictive measures to have done less overall damage in both lives and money than the more drastic measures I outlined above. 

If we can come up with one next month, then great let's do that. But if it's going to be 2 or 3 three years away then I'd rather go for a rip the plaster off quickly and get it over with approach. As opposed to a drawn out saga which still results in hundreds of thousands of deaths and crippling long term economic damage but also puts the whole population through the protracted misery of years of hardship and restricted social lives and job insecurity.  

4
 Jon Stewart 14 Oct 2020
In reply to Lord_ash2000:

> That wasn't how it played out last time though was it? The reality was, covid wards were rammed and most other departments were half empty because either people were avoiding hospital for minor things and generally not getting hurt as often due to not going out as much. 

Do you remember what we did last time? Total lockdown to protect the NHS! 

I can't fathom how you're finding this so difficult to understand.

> If we can come up with one next month, then great let's do that. But if it's going to be 2 or 3 three years away then I'd rather go for a rip the plaster off quickly and get it over with approach. 

You haven't managed to understand what would happen in that approach. The economy would be completely destroyed. It wouldn't turn out how you'd like it to. You would not like it.

2
 wintertree 14 Oct 2020
In reply to Lord_ash2000:

> that. But if it's going to be 2 or 3 three years away then I'd rather go for a rip the plaster off quickly and get it over with approach

Not enough time has passed to evidence whether or not naturally acquired immunity - especially from mild cases - is sufficiently persistent for this to work.

We have to plan to get to - at least - summer 20201 before the risk can be retired or proved - the risk of immunity fading fast enough to make this impossible.

 rurp 14 Oct 2020
In reply to Lord_ash2000:

It didn’t ‘play out’  last time you are correct. 
 

wrack your brain, maybe if you think hard you may remember what happened on the 23rd March to stop it playing out! 

Of course you could be so deluded you don’t think the previous lockdown had any effect on it ‘ playing out’ 

Every chance of a vaccine being with us in a way to make a difference within 6 months. 

3
 Jon Stewart 14 Oct 2020
In reply to wintertree:

> Not enough time has passed to evidence whether or not naturally acquired immunity - especially from mild cases - is sufficiently persistent for this to work.

Even with perfect immunity, it's nonsense from a purely economic perspective. The economy would be destroyed.

1
 Neil Williams 14 Oct 2020
In reply to Jon Stewart:

Do you have more evidence or analysis of that than a simple statement?

1
 wintertree 14 Oct 2020
In reply to Jon Stewart:

> Even with perfect immunity, it's nonsense from a purely economic perspective. The economy would be destroyed.

That is strongly my view, but what's the point in having that discussion when we don't know if naturally acquired immunity is sufficiently persistent?  The critical point being that regardless of one's economic take, we have to plan to get to - at least - Summer 2021 intact to know if its even possible.

On the other hand, I think "let it rip" would be such economic and political suicide that it can be nocked on the head regardless.

Rather than the "focused protection" approach now being advocated by the let it rip brigade, I suggest they adopt a "focused infection" approach - facilitate them to get isolated and batch infected in controlled conditions to start building the old herd immunity; this is far fairer to isolate those who want this and are young and healthy than isolating those who don't want it and are old and higher dependancy.   If their early volunteering for these experiments shows it to be safe, I'm sure many more people will do likewise as they'd rather get it under controlled conditions than in the wild, and can plan their time accordingly.  If it doesn't show it to be safe, well, they're heroes for finding out.  We can have a clap for them.

Do you reckon many of the high level people advocating for this would volunteer?  

Post edited at 11:45
1
 Jon Stewart 14 Oct 2020
In reply to Neil Williams:

> Do you have more evidence or analysis of that than a simple statement?

Do you live on planet earth? We've seen exactly what happens when there's no effective control of this virus, because it happened in New York, Brazil, Northern Italy...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7183991/

3
 Jon Stewart 14 Oct 2020
In reply to wintertree:

Not a bad idea!

 Stichtplate 14 Oct 2020
In reply to Removed User:

I’d be all in favour of a super hard lockdown. Three weeks where nothing and nobody moves and we could have this over and done with. Unfortunately it just isn’t possible, too many people need to be out keeping the wheels turning and the lights burning, too many sick and vulnerable, too many thick and insufferable.

A total lockdown of the severity necessary to stop covid in its tracks would be like solving the issue of your left arm being on fire by beating out the flames with a lump hammer. 

I just can’t see a quick solution. Distancing, masks, personal hygiene and social opprobrium heaped on those who flout the guidelines. It’s going to be a slog and unless more of the public take heed, it’ll be a very long and very costly slog.

 Richard Horn 14 Oct 2020
In reply to Jon Stewart:

> You haven't managed to understand what would happen in that approach. The economy would be completely destroyed.

Playing devils advocate here, but it does seem that the argument for lockdowns etc has moved from saving lives to claims that the economy would be totally destroyed. I am just wondering what empirical evidence there is to back this up?

Speaking from a personal perspective, a lockdown that mandated closing offices even for a short period would cause severe damage to the company I work for (we would lose customers to foreign competition, possibly forever). None of our customers are UK based, or even based in countries with significant CV outbreaks - our income streams would not be affected if more people died in the UK of CV this winter at all. Thats the brutal truth, I am not saying it pleases me to say this.

Post edited at 12:08
 Neil Williams 14 Oct 2020
In reply to Richard Horn:

Why is it not possible for your office to operate from home?  I can barely think of any office work which, with the right infrastructure, could not.  Time to get it in place?

In reply to Richard Horn:

What sort of work do you do, in your office, that can't be done from home? Production work, or access to special equipment obviously can't be done at home, but most office work can be done from home.

 Jon Stewart 14 Oct 2020
In reply to Richard Horn:

> Playing devils advocate here, but it does seem that the argument for lockdowns etc has moved from saving lives to claims that the economy would be totally destroyed. I am just wondering what empirical evidence there is to back this up?

Look at countries where there was a poor lockdown response. What happened to their economies? Was it better than those with effective lockdowns?

The whole idea of a whether policy should "for lives" or for "the economy" is garbage. The aim is just to keep society running, that's all. That means not too many people being sick at the same time because if the are, then you get a lot of deaths (bad) and an economic crash (also bad). Of course lockdown measures also create economic crash, so the question is which is worse, society with an effective coronavirus response, or a poor one?

I mean, it's just totally obvious if you've got a hand full of brain cells you can rub together. You can't go to work when you're sick, or when your partner's seriously ill, or when your parent has died - how could the economy possibly function in the midst of an out-of-control pandemic. It's a completely stupid idea pushed by people who are utterly thick. It's as if they don't understand that for the economy to work you need a healthy population. It's staggering levels of total stupidity.

> Speaking from a personal perspective, a lockdown that mandated closing offices even for a short period would cause severe damage to the company I work for (we would lose customers to foreign competition, possibly forever). None of our customers are UK based, or even based in countries with significant CV outbreaks - our income streams would not be affected if more people died of CV this winter at all. Thats the brutal truth, I am not saying it pleases me to say this.

How would your company work without its employees being able to come into the office, because they're all either sick, caring for someone with severe illness, or grieving, or trying to work out how to make sure they've got food and medicines that aren't being distributed, or looking after kids because the school has shut becasue all the teachers are sick/grieving/caring? Don't you think that might affect your income stream a little bit?

Is your company somehow immune from coronavirus? If so, please share your solution!

Post edited at 12:17
3
 wintertree 14 Oct 2020
In reply to Richard Horn:

> None of our customers are UK based, or even based in countries with significant CV outbreaks - our income streams would not be affected if more people died in the UK of CV this winter at all. Thats the brutal truth, I am not saying it pleases me to say this.

I guess you don’t work in supply chain management, and you don’t have any staff who are vulnerable or have vulnerable people in their households. 

1
 Richard Horn 14 Oct 2020
In reply to captain paranoia:

Yes we have a skeleton team needing to access special equipment. Actually 80% of the company has been WFH since the start of March which we were able to do seamlessly as we all WFH 1 or 2 days a week anyway. We did this ahead of the government mandating WFH as losing this on site function (to a CV outbreak) would be disastrous. There is a massive difference for us between this situation and a blunt instrument type approach Sir Keir is proposing of completely shutting offices. 

 Dax H 14 Oct 2020
In reply to Removed User:

If today's experience is anything to go by I personally think we are doomed. 

One of my guys came in to work today and announced that his mum has tested positive but it's okay because he hasn't been near her. 

Hang on you took your washing round on Friday night, well yes but I only did the washing. Was your mum in? Yes, did she come in the room, well she passed through a few times. 

Ffs go home. 

 The New NickB 14 Oct 2020
In reply to Removed User:

I have done a bit of number crunching looking at current growth rates, the effect of lockdown on reducing new infections and deaths and put together a couple of charts. One for continuing as we are, one with a four week lockdown.

* Cases numbers is based on a deaths using IFR of 0.5% and a three week lag. It is probably overestimating cases early in the pandemic.

** Projected deaths are based on current average weekly rises. They do not take account of exceeding NHS capacity.


 Jon Stewart 14 Oct 2020
In reply to Richard Horn:

> Yes we have a skeleton team needing to access special equipment. Actually 80% of the company has been WFH since the start of March which we were able to do seamlessly as we all WFH 1 or 2 days a week anyway. We did this ahead of the government mandating WFH as losing this on site function (to a CV outbreak) would be disastrous. There is a massive difference for us between this situation and a blunt instrument type approach Sir Keir is proposing of completely shutting offices. 

In situations like yours where you could save a business with a minimum of travel/mixing, I'd support making exceptions. Quite how applications for exceptions would be assessed I have no idea, but you could have a rule like "go into work in cases where that work does not involve (some definition of) mixing and cannot be done remotely". Might just be exploited though, don't know.

 balmybaldwin 14 Oct 2020
In reply to wintertree:

I think I agree, but I think the obvious circuit to break isn't being discussed

What one institution joins hundreds or thousands of households together? Which portion of the population are most likely to be a-symptomatic? Which portion of the population are least fearful of the virus? Which portion of the population run around sticking fingers up their noses and wiping it on things (I don't mean Iain Duncan Smith)?

It just seems so obvious that the schools are a large part of the problem most likely obscured from view by the asymptomatic nature of the transmission

 The New NickB 14 Oct 2020
In reply to Richard Horn:

Are Starmer or SAGE advocating anything more severe than March / April?

mattmurphy 14 Oct 2020
In reply to The New NickB:

> I have done a bit of number crunching looking at current growth rates, the effect of lockdown on reducing new infections and deaths and put together a couple of charts. One for continuing as we are, one with a four week lockdown.

> * Cases numbers is based on a deaths using IFR of 0.5% and a three week lag. It is probably overestimating cases early in the pandemic.


Good post.

Can you extend your graphs out to March/ April please. I’m curious to see the difference in overall deaths over the longer period of time (keep the current assumptions they’re good).

 The New NickB 14 Oct 2020
In reply to mattmurphy:

Under the current approach everything goes to complete shit, including the economy, before Christmas. Far too many unknowns to make prediction beyond then.

 Jon Stewart 14 Oct 2020
In reply to The New NickB:

> Are Starmer or SAGE advocating anything more severe than March / April?

Less severe, schools still open. Not sure if he is proposing all offices shut rather than wfh if possible.

I suspect Richard is assuming "harsh lockdown" for political reasons rather than being clear about what has actually been proposed. 

My understanding is the proposal is T3 for all. I think it's too harsh on people in low virus areas, yet not effective enough to make a real difference. More about politics from Starmer than actually a good policy suggestion, but at least he's being effective at exposing the gvts hypocrisy on "it's not our fault, we're following the science". Can't have it both ways Boris, you complete and utter tool.

Post edited at 13:00
 wintertree 14 Oct 2020
In reply to balmybaldwin:

> It just seems so obvious that the schools are a large part of the problem most likely obscured from view by the asymptomatic nature of the transmission.  More of an issue for older children it seems given random prevalence testing (it's just not in younger ones much, so transition is ruled out proportionately).

It's really hard to tell from the data I've seen - but now is a time for erring on the side of caution.  If we go down the "circuit breaker" route it seems like we'll need several over the coming months.  So perhaps the thing to do is to flip >14s to distance learning for a subset of proximal schools in each high risk area to try and measure the effect of transmission within schools.  Then there's hard data either way to plan with in the future.

 timjones 14 Oct 2020
In reply to Removed User:

It's an unecessarily crude and clumsy answer.
 

Strike early with strong lockdowns in areas where cases are rising but why shut the whole country down when other areas are doing better?

 Jon Stewart 14 Oct 2020
In reply to balmybaldwin:

> I think I agree, but I think the obvious circuit to break isn't being discussed

> What one institution joins hundreds or thousands of households together? Which portion of the population are most likely to be a-symptomatic? Which portion of the population are least fearful of the virus? Which portion of the population run around sticking fingers up their noses and wiping it on things (I don't mean Iain Duncan Smith)?

> It just seems so obvious that the schools are a large part of the problem most likely obscured from view by the asymptomatic nature of the transmission

True, but the impact of closing schools is horrendous. I would support doing everything else first, it's the nuclear button.

 TomD89 14 Oct 2020
In reply to Dax H:

> If today's experience is anything to go by I personally think we are doomed. 

We're not doomed, we just have to accept that government being able to control a pandemic with anything short of extreme measures is folly and obviously unworkable in the real world.

You go one of two routes logically.

  1. A military enforced lockdown of the country, only critical international travel and trade allowed and via military supervision, curfews, rationing, the works until virus disappears or cure found OR
  2. Cease lockdowns. Look at the data, make up your mind on risk and behave according to that risk. Wait for miracle cure/vaccine or eventually get used to having this virus circulate like the many others we've come to accept as part of daily human life.

Bonus option 3, keep increasing and decreasing the severity of what is basically government advised, self-enforced lockdowns with wildly varying results and constantly bicker with friends, family, colleagues and on forums about what should/shouldn't have been done when that inevitably fails.

If it's not clear, I'm all for option 2. A two week breaker would simply buy you a marginal amount of time at the cost of jobs, loss of freedom, mental health, enjoyment of life, strength of economy etc.

7
 Jon Stewart 14 Oct 2020
In reply to TomD89:

> You go one of two routes logically

> A military enforced lockdown of the country, only critical international travel and trade allowed and via military supervision, curfews, rationing, the works until virus disappears or cure found OR

That's one extreme which no one has seriously considered because it makes life not worth living.

> Cease lockdowns. Look at the data, make up your mind on risk and behave according to that risk. Wait for miracle cure/vaccine or eventually get used to having this virus circulate like the many others we've come to accept as part of daily human life.

It's overwhelmingly likely that this policy, in our densely populated, not very healthy, not particularly bright country would lead to overwhelming the healthcare system.

Do you have a solution to this? Once the healthcare system is overwhelmed, people will start dying a lot and then they'll stop going to work. So then the things you say you like (freedom, mental health, economic activity, etc) all go down the drain.

It's not a very good idea is it, because it would achieve the opposite of what you actually want.

Post edited at 13:23
 jkarran 14 Oct 2020
In reply to gezebo:

> How long is the average stay in hospital for a  severe Covid patient? Would having a 1/2/3/4 week break be enough to clear any beds?

No, occupancy would be expected to keep growing during the lockdown period.

> Should the furlough system be changed so instead of 80% salary if you are off work you get paid 100% of your salary but capped at £8.72 an hour for 40 hours per week? 

No. I get the desire to shift or at least equalise where the pain is felt but it would defeat the (wider social good) purpose of the scheme (which obviously had multiple objectives), to protect the economy from shock, to preserve it as intact as possible for better times to come minimising the restructuring pain and cost. Minimum wage furlough is ok if you're adapted to living near that but for people who ordinarily earn a fair bit more it means loan and mortgage defaults which creates a big new problem. Of course the existing furlough scheme was capped anyway so many of those on higher (not that high) pay who were unable to work took a pretty painful cut when sent home. Better might be a tapering from full or 90% cover at minimum wage down to something like the existing cut-off but it's harder to administer, would doubtless create as many perverse seeming problems as it solved is and tougher to sell to Conservative voters the scheme seeks to shield from the wantonly cruel and inadequate Universal Credit system.

jk

Post edited at 14:18
 jkarran 14 Oct 2020
In reply to TomD89:

> You go one of two routes logically.

> A military enforced lockdown of the country, only critical international travel and trade allowed and via military supervision, curfews, rationing, the works until virus disappears or cure found OR

> Cease lockdowns. Look at the data, make up your mind on risk and behave according to that risk. Wait for miracle cure/vaccine or eventually get used to having this virus circulate like the many others we've come to accept as part of daily human life.

> If it's not clear, I'm all for option 2.

It doesn't work like that. Option 2 if it is seriously and determinedly implemented by a sociopathic tin-eared government just puts back at option one couple of months later when all the options run out but now with a huge pile of bodies, ruined healthcare, tanked economy, market instability, blockaded borders, empty shops and a frightened angry population finally united in baying for the PM's head on a platter. Not all bad!

jk

 Richard Horn 14 Oct 2020
In reply to Jon Stewart:

> I suspect Richard is assuming "harsh lockdown" for political reasons rather than being clear about what has actually been proposed. 

Keir Starmer was mandating closing all non-essential offices (what counts as essential wasnt made clear). The March lockdown it was stipulated that people should WFH where at all possible, thats different from forcibly closing offices.

gezebo 14 Oct 2020
In reply to jkarran:

So a lockdown wouldn’t work but giving less than NMW to people who are used to very little is ok but giving more than NMW to people who are used to more is bad because it would mean they default on payments because they didn’t live within their means when they were earning ‘not that high’ a salary? 

1
 Jon Stewart 14 Oct 2020
In reply to Richard Horn:

> Keir Starmer was mandating closing all non-essential offices (what counts as essential wasnt made clear). The March lockdown it was stipulated that people should WFH where at all possible, thats different from forcibly closing offices.

In March, all non-essential businesses were closed weren't they? My workplace closed and we're key workers in healthcare! 

1
 The New NickB 14 Oct 2020
In reply to TomD89:

You are suggesting it is a choice between “letting it rip” and marshal law. This is either very stupid or very dishonest.

Post edited at 14:36
 jkarran 14 Oct 2020
In reply to gezebo:

> So a lockdown wouldn’t work

What has given you the impression I think that? Assuming by work we mean to reverse the rate of covid case growth then we already know 'lockdown' works.

> but giving less than NMW to people who are used to very little is ok but giving more than NMW to people who are used to more is bad because it would mean they default on payments because they didn’t live within their means when they were earning ‘not that high’ a salary? 

Take a deep breath and look at this objectively. We we have a very right wing Conservative government working within a pretty difficult set of circumstances. What might be ideal simply isn't on the table. Look at what is reasonably and sustainably (short-mid term) deliverable support wise and what it needs to do to achieve the maximum public good.

If you want to preserve productive capacity through a short crisis and ward off a another banking crisis which will yet again hurt the young and poor the worst (on top of the pandemic and brexit and the Tories) then yes, people who earn quite a bit above minimum wage will need help paying their mortgages when they can't work and while them not working but preserving their capacity to do work they're skilled in, temporarily, is in the public interest. Having a mortgage and maybe a car loan isn't, by any reasonable definition, living beyond your means. If both, potentially totally disconnected household incomes suddenly dry up and they default on the loans the problem ripples out from that household far into the wider economy. If tens of thousands of previously stable households also do so over a couple of months you simply don't have an economy or not one you'd recognise anyway.

jk

Post edited at 15:31
mick taylor 14 Oct 2020
In reply to Dax H:

Teacher in staff room: 'I have to take my son for a Covid test, he has symptoms'

Colleague: 'Well you need to until self-isolate until his results come back.'

Teacher: 'No I don't, are you sure? we can't, we have work to do.'

Colleague informs headteacher who says:  'they are correct, you need to self isolate etc.'

Next day, headteacher to teacher: 'How did you get on with the Covid test?'

Teacher: 'Decided not to bother, his symptoms eased off a bit anyway.'

Headteacher: 'Oh well, I suppose you know your son best.'

Cases in this area sky-rocketed few days after. 

 Neil Williams 14 Oct 2020
In reply to mick taylor:

What an idiot.

1
gezebo 14 Oct 2020
In reply to jkarran:

But is it right that the majority who make up the workforce who have kept the country working are kept on minimum/low wages to support the skilled in their nice houses with nice cars?  
 

These are the care home staff, supermarket workers, delivery drivers, bin men, bus drivers, cleaners, factor workers and all manner of other folk who have kept us all going while others who are supposedly more skilled have sat at home get paid by the government because suddenly when push comes to shove it’s realised that their job isn’t so important after all? 

3
 jkarran 14 Oct 2020
In reply to gezebo:

> But is it right that the majority who make up the workforce who have kept the country working are kept on minimum/low wages to support the skilled in their nice houses with nice cars?  

Discussing furlough type measures specifically: frankly yes. If you don't provide that support across the board then everything turns to dogshit crazy fast, for nearly everyone.

> These are the care home staff, supermarket workers, delivery drivers, bin men, bus drivers, cleaners, factor workers and all manner of other folk who have kept us all going while others who are supposedly more skilled have sat at home get paid by the government because suddenly when push comes to shove it’s realised that their job isn’t so important after all? 

The emotional argument isn't going to win me round, I get it then I have to get past it. It doesn't change how fragile our whole house of cards is or who'll suffer when it collapses.

Be really really careful what you wish for.

jk

Post edited at 16:18
In reply to gezebo:

All those essential workers would continue to work through any lockdown. That's what 'essential' means, in this context.

I've continued to work throughout, either at home, or at work, with suitable measures, where I could not do my job from home. Continuing economic activity that will pay for those on furlough.

I'd be in favour of furlough being NMW at the same hours as were being worked prior to lockdown. Capping furlough at minimum and maximum levels. But an 80% figure was a quick compromise; assessing every individual case would have taken too long.

 neilh 14 Oct 2020
In reply to Jon Stewart:

Incorrect. Your business was allowed to operate as long as you took measures to protect your employees. You were asked to work at home where possible. 
 
There was at the time a lot of misunderstanding on this. 
 

you only had to read the guidelines at the time to figure this out. 

some business owners went into panic mode and shut down when there was no need to. All of course depended on your staff and if they needed to isolate for example. 
 

Post edited at 17:15
 HansStuttgart 14 Oct 2020
In reply to Removed User:

the problem with the circuit breaker lockdown idea is that society and the state are too slow to go from normal to lockdown in a day and a few weeks later back again. It is magic wand waving policy making: the state wants the people to behave in a certain way, they say the word and it is done.

 wintertree 14 Oct 2020
In reply to HansStuttgart:

> It is magic wand waving policy making: the state wants the people to behave in a certain way, they say the word and it is done.

Which, if people did this, would mean no lockdowns would be necessary.

There is the conundrum.  The state needs to rapidly built both trust and a clear, consistent messaging approach with the public to build a national team largely willing to commit to measure short of lockdown - under legislate over comply not over legislate under comply.

Its not to late to hang DC out to dry on his misconduct in a public office as a bridge building excercise with the public...

1
 Misha 14 Oct 2020
In reply to tom_in_edinburgh:

Trouble is, home learning is very inconsistent. Some schools are good at it, some mediocre and some rubbish. I'm not sure many fall into the 'good' category. Nor is home learning a great way of learning, particularly at school level. There is also the issue of children not having proper home schooling facilities and not getting the social interaction they need. So schools have to stay open, I think. Slightly longer holidays coinciding with circuit breakers are an option.

I do wonder though whether unis should just have been closed to undergrads for a year and both unis and students provided with financial support to get through it. 

2
 Misha 14 Oct 2020
In reply to Dax H:

> The other option is faff about with half measures for years causing personal and economic hardship on a much greater scale

If it's definitely a question of years then I'd definitely go for the zero Covid approach like NZ. It would be hard but worthwhile. However hopefully it won't be years - all eyes on vaccine development and hopefully roll out in Q2 2021 (Q1 seems optimistic, beyond very limited initial rollout). We will probably need a few circuit breakers to get through winter but we don't need a drastic lockdown for 3 months to stamp it out (I imagine that's how long it would take, more or less, given how prevalent it is), assuming there will be a reasonably effective vaccine. If we get to Easter and it looks like an effective vaccine is a pipe dream, we'd need to reconsider. A drastic lockdown would be psychologically easier over late spring / early summer. 

Of course any lockdown would need people's general consent as you can't police 70m people even if you wanted to. That would require financial support and a clear, well articulated strategy which people can believe in, as well as an effective test and trace system. Too much to ask for, I fear...

1
 Michael Hood 14 Oct 2020
In reply to gezebo:

> These are the care home staff, supermarket workers, delivery drivers, bin men, bus drivers, cleaners, factor workers and all manner of other folk who have kept us all going while others who are supposedly more skilled have sat at home get paid by the government because suddenly when push comes to shove it’s realised that their job isn’t so important after all? 

It's almost a separate discussion but what you're saying here is not dependant on Covid. Are a lot of these jobs generally under-valued? Yes.

Covid has just made more people realise that these jobs are undervalued because of their importance to actually keep society going in the short term.

Will things change to make these jobs more valued - I wouldn't bet on it.

 Misha 14 Oct 2020
In reply to daftdazza:

This may be the case but that's due to poor messaging. Back in the summer there was lots of spare testing capacity and people were encouraged to get tested. Now people can't get tested even if they have symptoms! There should be clarity regarding when it's appropriate to get a test. If someone is contact traced and told they were exposed on X day, they should also be told they should only go for a test on X + Y day and the system should be updated so that a test request before X + Y day is rejected.

It's not just zero hours though. Lots of self employed people - taxi drivers are the classic example. There are also plenty of people who aren't on zero hours or self employed but might get pressured to keep working (not from home). That could be due to employer pressure or simply because they can't get bonuses if they stay at home.

1
 Misha 14 Oct 2020
In reply to daftdazza:

You raise interesting points. Regarding maintaining the current level of infections (if we take somewhere like my home city of Birmingham as an example - c. 150 / 100k), I suspect that would be manageable, both in terms of NHS capacity and the economic and social impact. Most placed are open after all, it's just that there are restrictions on whom you can meet, which isn't easy for people but it's manageable. Unfortunately I doubt it's possible to maintain the current level of infections with the current measures. We will find out in a couple of weeks - if cases don't level off, it won't have been enough.

What I fear, the more I think about it, is that Covid won't go away just because the days get longer and warmer. Of course respiratory diseases spread more readily in winter but once something is really prevalent it will take a while to fizzle out. We had very few cases in July because we had just come out of lockdown, not because it was July. So I fear that we'd need to have fairly extensive measures well into next year, until such time as a vaccine gets rolled out. The Oxford vaccines chief was quoted yesterday as saying that we'd need to have face masks etc until July. That seemed optimistic to me - I'd have thought that face masks and SD will be with us for all of next year even if a vaccine is rolled out but hopefully by this time next year we'll have a lot fewer restrictions.

1
 Misha 14 Oct 2020
In reply to Lord_ash2000:

I agree (if you mean a zero Covid approach) - if we knew what's going to happen with the vaccine efforts. There is reason for optimism given how many scientists are working on them. So I'd rather go with middle ground approach for the next 6 months and then reevaluate.

Post edited at 19:49
1
 Misha 14 Oct 2020
In reply to wintertree:

I assume the 'rip the plaster off' approach was a reference to a zero Covid extreme lockdown.

I really hope we don't have to wait till 20201, whatever strategy we adopt.

1
 Misha 14 Oct 2020
In reply to captain paranoia:

> What sort of work do you do, in your office, that can't be done from home? Production work, or access to special equipment obviously can't be done at home, but most office work can be done from home.

Most but not all. There's stuff which requires really powerful computers and/or very tight security. For example something related to defence, nuclear, aviation, bits of financial services. These are very much the exceptions though.

1
In reply to Misha:

> I assume the 'rip the plaster off' approach was a reference to a zero Covid extreme lockdown.

I took it to be a 'let it rip' approach, not a lockdown. The 2-3 years bit is the clue; a fire break lockdown wont save us 2-3 years.

It would also be consistent with his others posts.

Post edited at 19:46
 Misha 14 Oct 2020
In reply to Richard Horn:

I don't think he is proposing shutting literally every office. We probably wouldn't have a banking system then. I imagine there would be exceptions for work which is essential. How that is defined is another question. Back in spring, my dad had to go into the lab every couple of weeks to top up the liquid nitrogen in his NMR machine as otherwise it would overheat, catch fire and burn the place down. I did ask him if it was possible to shut it down, as it wasn't being used anyway. He said that would require an engineer to travel from Manchester to Norwich (and then again to get it started up) and would cost thousands of pounds. I suppose it wasn't strictly speaking essential in that there was, in theory, an alternative approach. However it seemed reasonable for him to go the lab every couple of weeks, particularly as there was no one else there anyway. A much better example would be a blast furnace, which has to keep going 24/7. 

1
 Misha 14 Oct 2020
In reply to captain paranoia:

May be, he could have been clearer. I don't think herd immunity is something that would be acquired quickly in any case, even if it worked as a concept for Covid (about which there is some doubt). Lots of people would end up fully or partially shielding and that would mean it would take many months (years?) to actually get to the required level of herd immunity. 

1
 Jon Stewart 14 Oct 2020
In reply to neilh:

> Incorrect. Your business was allowed to operate as long as you took measures to protect your employees. You were asked to work at home where possible. 

OK, thanks for that clarification.

My workplace closed because the company I work for liked the smell of the sweet, sweet furlough money, which was a lot easier to snaffle than it was to carry on providing a service during a pandemic - what a hassle! Didn't quite work out for them, but they had a go.

What I'm not quite sure on is whether Starmer's proposal is actually more harsh (offices must shut) than this or not (Richard Horn's claim). Starmer said "It would mean only essential work and travel. That everyone who can work from home should do so." which sounds a lot like March lockdown, but with schools open.

 Misha 14 Oct 2020
In reply to Jon Stewart:

Re the economy, the UK and Spain have done very badly. Germany less so. The Far Eastern countries which go things under control quickly have done best. Interestingly, the US has done better than the UK but the US has been a bit of a hotch potch of different approaches and it would probably be better to review it on a state by state basis. One of the reasons the UK has done badly is that the government has messed up. Another reason is that we have an economy which is heavily focused on services, which have been hit disproportionately. So it's not quite as simple as you suggest but broadly you are right.

 Jon Stewart 14 Oct 2020
In reply to Misha:

> Re the economy, the UK and Spain have done very badly. Germany less so. The Far Eastern countries which go things under control quickly have done best. Interestingly, the US has done better than the UK but the US has been a bit of a hotch potch of different approaches and it would probably be better to review it on a state by state basis. One of the reasons the UK has done badly is that the government has messed up. Another reason is that we have an economy which is heavily focused on services, which have been hit disproportionately. So it's not quite as simple as you suggest but broadly you are right.

That all makes sense.

What tickles me, in a rather dark way perhaps, is that some people think a service-based economy like ours could just carry on going with the pandemic going totally nuts and the hospitals overflowing, as people are being shovelled into mass graves. Like everyone'll be out shopping and going to the football like nothing's happening (it's just a few pensioners croaking it a couple of months early, nothing to worry about - let's go bowling and for a curry after). It's a total misunderstanding of how the world works! Who educated these people? I wonder if they kept the receipts.

In reply to Misha:

> Most but not all. 

I know. That's why I mentioned special equipment. And said 'most'. And stressed office. And didn't quibble with the response.

And I'm in that situation; equipment I can't use at home.

Post edited at 20:22
In reply to Misha:

> I don't think herd immunity is something that would be acquired quickly in any case

The biggest problem with the 'let it rip' argument is, as has been pointed out repeatedly here, is that it would destroy the economy anyway, probably worse than the lockdown 'alternative'.

 mik82 14 Oct 2020
In reply to TomD89:

> Cease lockdowns. Look at the data, make up your mind on risk and behave according to that risk. Wait for miracle cure/vaccine or eventually get used to having this virus circulate like the many others we've come to accept as part of daily human life.

We don't accept the circulation of viruses like this though.  One of the strains of smallpox prior to eradication had a fatality rate in a similar ballpark to Covid and we certainly didn't accept that.

The reality of allowing the virus to circulate is that it needs numbers of cases and hospital admissions similar to that at the peak for an entire year for any kind of "herd immunity" so this would also completely destroy any semblance of a health care system, and presumably the economy.

 Misha 14 Oct 2020
In reply to TomD89:

> constantly bicker with friends, family, colleagues and on forums about what should/shouldn't have been done

What else is there to do in life?

 Misha 14 Oct 2020
In reply to jkarran:

> frightened angry population finally united in baying for the PM's head on a platter. Not all bad!

Silver lining... It's incredible that from about July there were rumblings from within the Tory party that Johnson might not last that long, never mind leading them into the next election. My working assumption is that he would be got rid of next summer, once the worst has passed. Someone else (Rishi?) could then get the (somewhat) easier and more enjoyable job of rebuilding the economy. BoJo will just get thrown under one of those cardboard buses which he allegedly enjoys making in an attempt to move on from the Covid disaster. Then again, if he hangs around until 2024, he'd be a sitting duck for someone like Starmer - but BoJo is so incompetent that I really wish he goes sooner rather than later.

 Misha 14 Oct 2020
In reply to gezebo:

> These are the care home staff, supermarket workers, delivery drivers, bin men, bus drivers, cleaners, factor workers and all manner of other folk who have kept us all going while others who are supposedly more skilled have sat at home get paid by the government because suddenly when push comes to shove it’s realised that their job isn’t so important after all? 

I think you'll find that most 'middle class' type people either worked from home (and still do) or kept going to work in essential services such as schools and the NHS. Furlough has disproportionately impacted the less well off people in sectors such as hospitality and retail.

I think the cap was about right. A lot less than some people earn but it meant you didn't have to work. A sort of bonus paid holiday. I would have considered it, if it was offered!

 Misha 14 Oct 2020
In reply to captain paranoia:

> > I don't think herd immunity is something that would be acquired quickly in any case

> The biggest problem with the 'let it rip' argument is, as has been pointed out repeatedly here, is that it would destroy the economy anyway, probably worse than the lockdown 'alternative'.

Agree but I think the reason for that is it would take a long time to actually get to herd immunity. If it was just a case of a few weeks and everyone who is reasonably healthy gets it while the vulnerable properly shield themselves, that might actually work. However it won't work like that. It's not just the fact that it's hard or impossible to shield some people - it might be for a relatively short period of time but it will need to be a few months at least and that's where it falls down. 

 neilh 14 Oct 2020
In reply to Jon Stewart:

My view is that most company are doing that anyway. All the people I know who have been working at home since March are for the most part continuing to do so. So Starmers view is not really reflective of what actually is going on in the outside world  

 neilh 14 Oct 2020
In reply to mik82:

Herd immunity is a myth anyway as there is no proof you cannot get it a second time.  

2
 Jon Stewart 14 Oct 2020
In reply to neilh:

> My view is that most company are doing that anyway. All the people I know who have been working at home since March are for the most part continuing to do so. So Starmers view is not really reflective of what actually is going on in the outside world  

Yes, I get the impression that "wfh if you can" is standard now. But what is it that you think Starmer's not got?

 jkarran 14 Oct 2020
In reply to Jon Stewart:

> Yes, I get the impression that "wfh if you can" is standard now. But what is it that you think Starmer's not got?

A blue rosette  

Jk

 colinakmc 14 Oct 2020
In reply to WaterMonkey:

> If it was over half term would I be able to go on holiday in the uk still?

This is part of what’s wrong, we need to stop thinking what’s in it for me, and start risk assessing what we do. Never mind if catching a dose might be trivial for you, who do you know who is overweight, or has diabetes or cancer, or is over 70? Then think about the consequences of your actions, possibly, for them.

BTW I’m not engaging in a game of bash the public, the government performance has been lamentable and venal; but we still do have a bit of personal responsibility towards our family and neighbours.

 Jon Stewart 14 Oct 2020
In reply to Misha:

> it might be for a relatively short period of time but it will need to be a few months at least and that's where it falls down. 

It'll take a very long time, since anyone with any kind of rational self-interest will do their level best to try not to get the rather nasty bug that's going round. That'll slow this "short sharp shock" and drag it on a bit, won't it? Personally risk feeling shite for months on end? No thanks, think I'll keep washing my hands, wearing a mask, and not hanging out anywhere crowded if you don't mind. Sorry we won't all catch it next week and collapse the health service, but I'm looking out for number one, for starters.

Sure the right-wingers can see where I'm coming from here, I'm trying to talk their language

Post edited at 22:56
 Jon Stewart 14 Oct 2020
In reply to Misha:

> but BoJo is so incompetent that I really wish he goes sooner rather than later.

I'm very surprised he's still here, but I guess no one else wants the job, and it's what he's always wanted after all. Wasn't quite what he thought it would be like, is it? It must be quite a substantial turning point for him, to realise that he isn't actually anything like the person he thought he was. When it comes to crunch time, he's a complete failure.

In reply to Jon Stewart:

> It must be quite a substantial turning point for him, to realise that he isn't actually anything like the person he thought he was.

I don't think he has that level of self-awareness. He will rationalise it as someone else's fault.

In reply to Removed User:

The second graph in this article of cases in the UK, France, Spain and Italy is really instructive and it shows the UK government's complete failure to act with foresight.

https://www.independent.co.uk/news/world/europe/paris-curfew-coronavirus-fr...

You can see the first wave and the UK having about a months warning about what was coming if it had looked at the other countries, but doing nothing and getting it just as bad  (or worse because the UK infection numbers on the graph are limited by the capacity of its testing system and the peak was probably a lot higher).

Then you see how opening up too much and too early led to the UK figures coming down at a far slower rate  than those in France/Spain/Italy.  Which did not help the economy at all, we could have been closer to normal faster by sticking with the harder lockdown and getting the rate of decrease in infection seen in the other countries.

Then you see the second wave developing in Europe as they too opened up too much and summer holidays mixed populations.  Hust like the first wave the UK government did not react on the warning but waited for it to happen here.

Finally you see it go totally mental in the UK.  The timing pretty much proves this was caused by opening schools and Unis.  And it should never have happened.  The graph shows there was a problem developing in the UK which had already developed in other nearby countries and instead of clamping down to squash it again the UK government undertook a far larger re-opening measure and made it a much worse.

The Scottish Government's response was far from perfect either but the direction of the criticism of their actions is completely wrong.  They are getting criticism for being 'draconian' and going too far when actually they didn't go far enough.

3
 Misha 15 Oct 2020
In reply to Jon Stewart:

That’s exactly it. If it was actually trivial for a 39 year old healthy male, I’d be up for being a guinea pig but long Covid is a concern so I’ll pass...

 Misha 15 Oct 2020
In reply to Jon Stewart:

It’s easy to say ‘I could do better than the person in charge of whatever’. In BoJo’s case, I actually think I’d be able to do a better job. I’d never cut it as a politician though - a bit too honest for that and don’t do sounbites...

May be he no longer wants to be PM? But he certainly wants to have been PM.

Post edited at 00:05
 Misha 15 Oct 2020

It’s a bit more nuanced than that.

First, the UK’s case count was only a couple of weeks behind Italy. I really don’t think that a significantly earlier lockdown would have been palatable to any government or to the population as a whole. After Italy locked down and seeing the reports from hospitals there, most people here realised this was serious. We could have locked down about a week earlier, same as France. It would have saved lives back in spring (so would have been worth doing of course) but won’t have made any difference to where we are now.

Second, whilst cases came down quicker in the other three countries as they had a harder lockdown, their case count started going up earlier as well. The trough of the curve is about the same for the UK, France and Spain, it’s just that the UK’s trough was a few weeks later. Italy was doing better but they’ve lost control as well now.

Third, it’s curious what’s happening in Spain. Their biggest hotspot is Madrid and that’s been in special measures for a couple of weeks I think, so may be that’s having an effect - or their testing system is simply maxing out.

Fourth, the harsher lockdown in Scotland and Wales was completely pointless as they’re now in the same situation as England.

 Jon Stewart 15 Oct 2020
In reply to Misha:

Perhaps there's a problem that what is actually achievable with policy is vastly smaller than what policy sets out to achieve. I saw this when I worked in immigration - the policy goal was to turn immigration for each specific sector on and off like a tap, depending on economic need, but the reality was that people did pretty much what they wanted.

Maybe a competent PM would have ended up with basically the same results, but just wouldn't have looked like a complete tit while s/he was doing it. 

1
 Lord_ash2000 15 Oct 2020
In reply to Jon Stewart:

> How would your company work without its employees being able to come into the office, because they're all either sick, caring for someone with severe illness, or grieving

I've heard a few people come out with this line, have you any evidence this would happen? Because when I look at it, during the last lockdown when cases were estimated to be over 100k a day very few people of working age were having problems including in the NHS and supermarkets even when PPE was in short supply and the public wasn't wearing masks.

Most of the workforce is in an age range where covid  has a minor to no effect at all. Deaths and hospital cases are in the vast majority of cases confined to age ranges that would see most people already in retirement. I'm not saying there would be no issues with staff shortages but I don't think it would be anywhere near as bad as you predict and it wouldn't have to be for that long. 

6
In reply to Lord_ash2000:

> I've heard a few people come out with this line, have you any evidence this would happen? Because when I look at it, during the last lockdown when cases were estimated to be over 100k a day very few people of working age were having problems including in the NHS and supermarkets even when PPE was in short supply and the public wasn't wearing masks.

> Most of the workforce is in an age range where covid  has a minor to no effect at all. Deaths and hospital cases are in the vast majority of cases confined to age ranges that would see most people already in retirement. I'm not saying there would be no issues with staff shortages but I don't think it would be anywhere near as bad as you predict and it wouldn't have to be for that long. 

I saw this estimate on another forum. I haven't had time to fact check it but it seems reasonable and worth a share as a starting point for a discussion on the effect of a let it rip scenario. 2m severe cases over the 6 months needed until 70% are infected for herd immunity is the headline.

UK population is 67m, of whom 4m are aged 0-4, 11m are aged 5-18, 43m are aged 19-70 and 9m are over 70. Estimates of vulnerable people (elderly or younger people with relevant underlying health conditions which give them a moderate or high risk of severe illness should they catch C19) are
0-18 years 4% of 15m = 0.6m
19-70 years 25% of 43m = 10-11m
Over 70 66% of 9m = 6m
(Data from ONS and peer-reviewed article in Lancet. Further data used below from national household survey and similar reputable sources).
A) Hence about 500,000 schoolchildren are vulnerable and would have to shield and be educated at home (or attend school and almost certainly catch C19). Implications for parents unable to work
B) 10-11m people of working age would have to shield for 6 months or more, or take high risk of catching C19. Amongst key workers there are 500,000 teachers, 1.4m NHS workers and 1.5m social care workers. All these are needed at work. If say 70% caught C19 over the 6 months that would total about 600,000 severe cases.
C) There are 6m vulnerable elderly including 400,000 in care homes, 80,000 in nursing homes and 360,000 receiving care in their own homes. Of these 840,000, perhaps 500,000 would get C19 as they are reliant on key workers for the 6 month C19 rampant period. The other 5m or so elderly vulnerable would be at risk over 6 months from shopping, living with younger relatives, lapses in shielding, and a variety of other possible sources of infection. A conservative estimate of likely cases maybe 20% or 1m
D) Of the remaining 49m population – 14m aged 0-18, 32m aged 19-70 and 3m over 70 – at least 70% will get C19 and a small but important number will become severely ill. If this proportion is say 1 in 1,000 that means another 50,000 or so distressing cases.
So the total number of severe C19 cases is likely to be in the region of 2m. The average severe C19 case lasts 3-6 weeks – lets say a month. So over a period of 6 months rampant Covid we have 2m cases each lasting 1 month – that’s about 330,000 cases of severe illness at any one time. The UK has 165,000 hospital beds in total, and a maximum of about 8000 beds in all the Nightingale hospitals. The NHS also has about 30,000 ventilators and ????? items of PPE.

Post edited at 07:54
1
 Richard Horn 15 Oct 2020
In reply to cumbria mammoth:

> 0-18 years 4% of 15m = 0.6m

How does that tie up with the fact that only 3 children under 14 have died of CV so far in the whole of the UK? (to provide perspective in the same period several hundred children have died from other causes)

 WaterMonkey 15 Oct 2020
In reply to colinakmc:

> This is part of what’s wrong, we need to stop thinking what’s in it for me, 

It was a question. Please don't get all high and mighty with me. I've complied with every single restriction and guidance so far.

We cancelled our holiday in April due to Covid, I was merely asking if we would have to cancel in October if they put us in lockdown. I bet the government won't say anything. The holiday company won't offer to cancel either.

I imagine if I was visiting a castle it would be ok to carry on anyway..

 Michael Hood 15 Oct 2020
In reply to Richard Horn:

We're not just talking about deaths, but about how the NHS (and society as a whole) would cope or not if large numbers of people became infected in a short time - and hence large numbers seriously ill in a short time.

Put the numbers in a spreadsheet and play with some of the estimates/assumptions. See what kind of numbers are required to get the effects down to what you think is a manageable level. Then look at the estimates/assumptions you've made and decide whether they're reasonable or obtainable.

Then post it on UKC for peer review. 

mattmurphy 15 Oct 2020
In reply to cumbria mammoth:

The flaw in your entire workings is you equate vulnerable to getting severe covid symptoms.

The vulnerable children would be fine. Those younger than 40, but vulnerable would also be fine.

Yes as you get older and the co-morbidities stack up the chances of you getting a nasty case increase, but you maths is far to simplistic to work. 
 

Classic example is George Alagiah, the news reader, who was receiving treatment for cancer and was immunosuppressed. He caught covid and thankfully wasn’t badly affected.

9
 jkarran 15 Oct 2020
In reply to Lord_ash2000:

> I've heard a few people come out with this line, have you any evidence this would happen? Because when I look at it, during the last lockdown when cases were estimated to be over 100k a day very few people of working age were having problems including in the NHS and supermarkets even when PPE was in short supply and the public wasn't wearing masks.

Prevalence in the general population probably didn't pass 1% nationally at peak, the majority of us living outside London didn't even experience that. The disruption was enormous if you'll cast your mind back to panic buying bogroll and queuing for groceries. Try running a country with 10 times that prevalence (this likely becomes self limiting as fear and personal action takes over where policy steps aside) sustained for many weeks, not peaking for a couple. See how we react knowing there is no hospital care if we get a bad dose, that as a result the CFR is running at >5%, not the <1% we trivialise now. When we all know and care for someone who's died of it or is about to. See what happens to the public mood and behaviour when hospitals can't provide routine or emergency non-covid care. I wouldn't want to be on record as having pushed for that carnage in it's bitter aftermath.

jk

1
 The New NickB 15 Oct 2020
In reply to cumbria mammoth:

Good post, although I would say it over plays NHS capacity. Some good contributions to my hospital capacity thread.

 Jon Stewart 15 Oct 2020
In reply to Lord_ash2000:

> I've heard a few people come out with this line, have you any evidence this would happen? 

Well, one of my sites is shut because a colleague in his 20s just tested +ve and another has Sx. 

1
 Stichtplate 15 Oct 2020
In reply to cumbria mammoth:

> So the total number of severe C19 cases is likely to be in the region of 2m. The average severe C19 case lasts 3-6 weeks – lets say a month. So over a period of 6 months rampant Covid we have 2m cases each lasting 1 month – that’s about 330,000 cases of severe illness at any one time. The UK has 165,000 hospital beds in total, and a maximum of about 8000 beds in all the Nightingale hospitals. The NHS also has about 30,000 ventilators and ????? items of PPE.

Good post. Might be worthwhile adding some costings to those numbers to provide some back of a fag packet figures for those contemplating the economic costs of 'let rip' Vs 'let's lockdown'.

£7 to call an ambulance

£252 when the ambulance arrives, treats & transports you

£160 minimum to be seen in A&E

£1932 per night in ICU (x 14 approximately)

£413 per night on a ward (x 7 approximately)

£30 for a GP follow up

£89 for some ongoing basic therapy

Roughly 30-35K per patient presenting with a serious case. This doesn't factor in the costs of long covid, nor does it factor in the large numbers of elderly who'll leave hospital but will never get back to their former levels of independence and will require long term enhanced care packages.

In reply to cumbria mammoth:

> So over a period of 6 months rampant Covid we have 2m cases each lasting 1 month – that’s about 330,000 cases of severe illness at any one time. 

And that assumes a uniform distribution, which is not how exponential growth pandemics work, so the peak demand would be much higher than that figure.

 The New NickB 15 Oct 2020
In reply to Stichtplate:

I thought I would post this.

https://www.google.co.uk/amp/s/amp.theguardian.com/commentisfree/2020/jun/1...
 

Party to say we should be thankful for our “evil, commie, socialised single payer system”. Partly to illustrate what it can cost, acknowledging that US healthcare prices  are hugely inflated.

 daftdazza 15 Oct 2020
In reply to cumbria mammoth:

Sorry I don't find your estimates creditable, did you use the paper in link below?

https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30264-3/...

It gives some of the figures you quote but revised to say it would expect 1 percent of under 20s to be hospitalised and 20 percent of over 70 if infected.   But these numbers are for global population as a whole not specific to UK demographics.  It actually gives a worse picture for Europe as a whole with estimate that 31 percent of population has a comorbidty that would mean they would likely need hospitalised if infected.  But reading the paper I felt it was over estimate the risk quite considerably being based on Data from China at start of the outbreak.

Tens of thousands of school children and university students have been infected in the last month, but I have heard no government news reflecting 100s of young people currently in hospital.

Looking at current European data I see no evidence of amount of hospitalisation the paper suggest would happen, I of course might have looked at a wrong paper but it had same numbers you gave in it.

With a recent who publication suggesting global IFR of 0.05 percent for those under 70 I really can't see how your figures would happen in reality, we are not seeing uncontrolled exponential growth, I have seen research from the Zoe kings college team suggesting past Infections levels might be slowing second wave in London and parts south east of England.

I think long covid is a genuine worry for some, by why more concern for this than other viral infections? and the health care burden for long covid won't be all that extreme as it's largely untreatable, I had a year of my life ruined with grandular fever and it took me four years to completely recover, I wouldn't wish such chronic fatigue on anyway, but like the Esptein-Barr virus I have a feelings a similar pattern will emerge with covid that only a small percentage of those infected will end up with long term chronic fatigue, but In no way what to down play it as it is horrible.

2
 Stichtplate 15 Oct 2020
In reply to The New NickB:

> I thought I would post this.

> Party to say we should be thankful for our “evil, commie, socialised single payer system”. Partly to illustrate what it can cost, acknowledging that US healthcare prices  are hugely inflated.

Jesus! 30K suddenly seems a bargain.

 wintertree 15 Oct 2020
In reply to daftdazza:

>  we are not seeing uncontrolled exponential growth,

Do you think we are seeing controlled exponential growth then?  Because the data sure as shit looks exponential to me.  Perhaps not the last 5 days, but perhaps that's reporting lag (again).

If it's exponential growth it doesn't really mater if its "controlled" or "uncontrolled"

> I have seen research from the Zoe kings college team suggesting past Infections levels might be slowing second wave in London and parts south east of England.

It looks to me that they're lagging in time but not in exponential growth rate, but it's a couple of weeks too early to really say I think.  Past higher infection levels can slow spread through behavioural modification as well as by granting persistent immunity which appears to be in too few people to make a significant difference to R right now.,,

 daftdazza 15 Oct 2020
In reply to wintertree:

Controlled exponential growth might be a better term,  I just feel term exponential growth is used as a fear tactic with no differencing between 2-3 doubling time experienced in March in hospital setting to what we are seeing now.  Not to suggest thing are not worrying, just to point out that we have time to make decisions and with data we have it really would stupidity if the we let NHS get overwhelmed as others suggests as a possibility.

I don't know what the solution is, the fact local lockdowns have failed would suggest the whole tier system is a total joke, up to tier 2 might control the Exponential growth but it won't bring R below 1, should we just have a two stage system, either late summer level restrictions or total lockdown?  I don't think a circuit breaker will work, and will a lockdown with high schools and universities and shops and gyms still open work?  

Do we lock down now and open up in January and hope to make it to the spring without a further lock down, or do we try as much controls as possible to slow the grow just now and lockdown after Christmas with aim to open up late March?  I have no idea what's best and obviously neither does the government.

 wintertree 15 Oct 2020
In reply to daftdazza:

> Controlled exponential growth might be a better term,  I just feel term exponential growth is used as a fear tactic with no differencing between 2-3 doubling time experienced in March in hospital setting to what we are seeing now.  

I think we're in agreement then.  The difference in risk control measures now vs March is that as you say the doubling time is 2-3x longer, which gives us more chance to avert disaster.  But, until we step off the exponential we're still heading for the same disaster.  Just more slowly.

As you say, the critical point appears to be that nothing we're doing is making R<1; or less than whatever value means we could string the exponential phase out until after the winter season.

> Do we lock down now and open up in January and hope to make it to the spring without a further lock down, or do we try as much controls as possible to slow the grow just now and lockdown after Christmas with aim to open up late March?  I have no idea what's best and obviously neither does the government.

I think we have to get people following the control measures that had R<1 in early August in the absence of any lockdown.  We know we can do it.  Trust.  Good, clear, consistent messaging.  Teamwork.  It might need a period of lockdown to get things to the point that is viable, it might not.  I have little to no hope left that this will actually happen.

In reply to daftdazza:

> the fact local lockdowns have failed would suggest the whole tier system is a total joke,

That's due to a combination of inappropriate 'lockdown' measures, and lack of compliance, even with those inappropriate measures. I suspect.

 Neil Williams 15 Oct 2020
In reply to captain paranoia:

And that lack of compliance is due to Cummings.  That was literally *the day* what they actually called "overcompliance" ceased.

3
 jkarran 15 Oct 2020
In reply to daftdazza:

> Sorry I don't find your estimates creditable, did you use the paper in link below? Tens of thousands of school children and university students have been infected in the last month, but I have heard no government news reflecting 100s of young people currently in hospital.

Last time I looked Pillar I (healthcare) cases were currently dominated by the 20-40 age range. This isn't broken down by staff and admissions but neither option paints a cheering picture!

> Looking at current European data I see no evidence of amount of hospitalisation the paper suggest would happen, I of course might have looked at a wrong paper but it had same numbers you gave in it.

> With a recent who publication suggesting global IFR of 0.05 percent for those under 70 I really can't see how your figures would happen in reality, we are not seeing uncontrolled exponential growth, I have seen research from the Zoe kings college team suggesting past Infections levels might be slowing second wave in London and parts south east of England.

It'd be an odd infection if they weren't though I suspect the effect is still pretty marginal. The behaviour modification driven by the experience of living through spring in London likely dominates. That and it being an urban heat island with plenty of hospitality business still conducted outdoors unlike oop norf where it's now distinctly autumnal.

> ... I have a feelings a similar pattern will emerge with covid that only a small percentage of those infected will end up with long term chronic fatigue, but In no way what to down play it as it is horrible.

If it's all the same I'll be waiting for a more convincing argument before I'm persuaded to go under the covid bus for the greater good.

jk

 Richard Horn 15 Oct 2020
In reply to jkarran:

> The behaviour modification driven by the experience of living through spring in London likely dominates. 

Do you mean in a more relaxed or more scared way?

I only know what I saw, which living somewhere south of London, everyone in my family got ill in late Feb, every family we know in the local area got ill in late Feb and spent time in 14 day isolation, 3/4 of the people in my office got ill, my brother who lives 40 miles away got ill. No-one official ever recorded any of this. Areas of the SE saw big outbreaks, and *maybe* this is slowing the rate of wave 2.0. I would say people are not being complacent and still respectful of the rules but for most people having got ill and recovered there is not so much fear (rightly or wrongly).

3
 jkarran 15 Oct 2020
In reply to Richard Horn:

> Do you mean in a more relaxed or more scared way?

I mean people may be more careful in London than elsewhere having been through a bad outbreak once already. I get mixed anecdotal reports from my brother and friends so I'm speculating.

> ...I would say people are not being complacent and still respectful of the rules but for most people having got ill and recovered there is not so much fear (rightly or wrongly).

Just to be clear are you saying you believe most (a majority) of the people in the greater London area have already had covid, or that most of the people who have had it are now unafraid of getting it?

jk

 Cobra_Head 15 Oct 2020
In reply to Richard Horn:

> ........ but for most people having got ill and recovered there is not so much fear (rightly or wrongly).

And yet, there's STILL no evidence of long term immunity.

Don't you think late Feb is a bit late for mass infections of Covid in the UK?

Since you are talking a good month or so before the hospitals started getting patients.

Post edited at 16:18
1
 Richard Horn 15 Oct 2020
In reply to Cobra_Head:

> Don't you think late Feb is a bit late for mass infections of Covid in the UK?

> Since you are talking a good month or so before the hospitals started getting patients.

No - there was ambulances running around constantly at the time...

 Si dH 15 Oct 2020
In reply to wintertree:

.

> I think we have to get people following the control measures that had R<1 in early August in the absence of any lockdown.  We know we can do it.  

I find this interesting. Anecdotally on the streets of Sefton I am sure people are already being significantly more cautious now (and for the last few weeks) than they were in late July and early August. Yet the rate is increasing fast whereas then it was flat. Obviously the schools are now open which will increase some transmission. And it's getting colder. But otherwise, you would definitely expect transmission to be substantially less than it was then. Far fewer people out and about mixing in restaurants, shops, cafes etc, more mask wearing (it's no longer unusual to see them worn routinely outside or by lone car drivers), people wanting to distance properly again on the pavement. People had relaxed in summer.

So I'm left wondering whether the R rate is a function of not only the measures we take, our behaviour and our environment, but also a function of the prevalence of the virus itself. Ie, with higher existing prevalence, do we now need to do more to reduce R to below 1? Is this perhaps a property of a virus - related to its high "k" value and super-spreading nature? It doesn't seem entirety intuitive but perhaps when there is more of it about and more people get a higher viral load, you are likely to see more super spreading events. Any epidemiologists about?

Edit, it s of course possible my anecdotal experience is not representative, or equally possible that the schools and the temperature change are driving factors - but I think it's an interesting question.

Post edited at 17:00
 Danbow73 15 Oct 2020
In reply to Removed User:

The problem with a circuit breaker lockdown is that it only buys time and I have no confidence that the time will be used wisely to get an effective test and trace system up and running. 

I'd support one if there was an end in sight or a hope things will get better but there just isn't while this bunch of clowns are in charge.

2
 Cobra_Head 15 Oct 2020
In reply to Richard Horn:

> No - there was ambulances running around constantly at the time...


Err, no, my aunty works in a hospital and my BIL in another, and they didn't start getting patients until late March early April.

 Richard Horn 15 Oct 2020
In reply to Cobra_Head:

> Err, no, my aunty works in a hospital and my BIL in another, and they didn't start getting patients until late March early April.

If I said "from late Feb" would that make you happy? It obviously didnt all occur on the same day. What is your point, are you saying spreadsheets and conjecture are more accurate than what people saw was actually happening? (I also have medics in the family FWIW)

Post edited at 17:16
4
In reply to Danbow73:

> The problem with a circuit breaker lockdown is that it only buys time and I have no confidence that the time will be used wisely to get an effective test and trace system up and running. 

It won't, I'm sure.

But it will bring the numbers down, reducing the population prevalence, and thus returning us to the July/August situation. That's why I'm arguing that repeated, regular firebreak lockdowns, even when the numbers aren't rising as high as they are now, is a way to return to some semblance of normality, with restrictions people will be able to plan for (since they are not imposed randomly), and may be able to endure with good compliance, knowing they are for a fixed duration, and unlock is only ever two weeks away.

In reply to Richard Horn:

> What is your point, are you saying spreadsheets and conjecture are more accurate than what people saw was actually happening?

Did they have a positive COVID test?

There were nasty bugs going around over winter (as there usually are). Many of these have similar symptoms. I had a chest infection for seven weeks, which I finally got cleared up just as lockdown started. It wasn't COVID.

 Cobra_Head 15 Oct 2020
In reply to Richard Horn:

> If I said "from late Feb" would that make you happy?

Not really no, because it would mean people caught it, but didn't get ill enough to have to go to hospital.

> It obviously didnt all occur on the same day. What is your point, are you saying spreadsheets and conjecture are more accurate than what people saw was actually happening? (I also have medics in the family FWIW)

You did say "every family we know in the local area got ill in late Feb and spent time in 14 day isolation, 3/4 of the people in my office got ill, my brother who lives 40 miles away got ill."

That's a lot of people, or it would be if it were me. If there was so much of it around, why didn't it just run rampant?

Why were we behind the curve for the rest of Europe, yet seem to follow the same trajectory?

 wintertree 15 Oct 2020
In reply to Si dH:

> And it's getting colder. But otherwise, you would definitely expect transmission to be substantially less than it was then.

This is the conundrum.  It's not exactly news that respiratory infections surge in winter, but cold hard facts aren't so strong as to why.  Humidity (or lack thereof) is implicated in viral lifetimes, as well as changes in human behaviour.  Likewise UV and viral particle lifetimes and perhaps human sun exposure and vitamin-D.  

> So I'm left wondering whether the R rate is a function of not only the measures we take, our behaviour and our environment, but also a function of the prevalence of the virus itself. Ie, with higher existing prevalence, do we now need to do more to reduce R to below 1? Is this perhaps a property of a virus - related to its high "k" value and super-spreading nature? It doesn't seem entirety intuitive but perhaps when there is more of it about and more people get a higher viral load, you are likely to see more super spreading events. Any epidemiologists about?

I have also pondered the feedback loops whereby case levels affect R.  

  • Viral load is one - evidence around this doesn't seem to have crystallised but it doesn't seem crazy as a hypothesis.
  • If we (charitably?) assume that test/trace/isolate is reducing R, then we've hit two public speed bumps in T/T/I that will have increased R - first when demand for tests hit capacity, and second when 17,000 cases didn't go to contact tracing for a week because positive cases exceeded the row capacity of antiquated .XLS files used by PHE to move data between systems.  Lag in T/T/I data reporting surges now and then suggesting more unpublicised speed bumps.

I'm not sure anyone really understands what's going wrong right now compared to August.   I bloody don't! 

 Neil Williams 15 Oct 2020
In reply to wintertree:

> I'm not sure anyone really understands what's going wrong right now compared to August.   I bloody don't! 

I think it was students, and might actually naturally come back down a bit with the help of some extra measures.

 wintertree 15 Oct 2020
In reply to Neil Williams:

> I think it was students, and might actually naturally come back down a bit with the help of some extra measures.

Have a look at figures 4 & 6 - confirmed cases and test positivity by age - https://assets.publishing.service.gov.uk/government/uploads/system/uploads/...

The age bins are useless for separating secondary school and university; whilst university ages are higher than the others, everything is going up - so it’s not limited to the students.

Our local institution had a 4.4x weekly rise in numbers reported today; at that rate the fresher cohort will have all had it in a few weeks...  

In reply to wintertree:

The reason I'm continuing to be super-cautious:

https://www.gordonstainforthbelper.co.uk/images/DerbysCovid15Oct2020.png

1
 wintertree 15 Oct 2020
In reply to Gordon Stainforth:

My geography of Derbyshire is a bit hazy but there's no universities in those boroughs?...

1
 Stichtplate 15 Oct 2020
In reply to wintertree:

> My geography of Derbyshire is a bit hazy but there's no universities in those boroughs?...

Are you discounting the University of Derby through sheer academic snobbery?

mattmurphy 15 Oct 2020
In reply to captain paranoia:

I think unless you live in London it’s a bit difficult to understand how prevalent it was.

Not everyone I know living in London got Covid, but 25-30% of the people I know did seem to get symptoms.

I had a colleague who flew home to Australia and tested positive at the border (completely asymptotic).

I’ve got a feeling that a significant proportion of Londoners caught Covid back in March.

Post edited at 19:45
4
In reply to wintertree:

There's a quite good modern university in Derby. It has wisely concentrated on things like catering and leisure (because of nearby Peak). I've just been keeping this little chart on a Numbers spreadsheet for my own interest.

Your reply is also a bit disingenuous, because you must have clicked that link and seen that Derby is one of the boroughs.

Post edited at 19:49
 Blunderbuss 15 Oct 2020
In reply to Neil Williams:

> I think it was students, and might actually naturally come back down a bit with the help of some extra measures.

SAGE estimate opening schools adds 0.2 - 0.5 to the R value.

If we take the midpoint of 0.35 it would seem keeping them open and getting R0 below 1 is nigh on impossible unless we shut down large parts of the economy... 

 wintertree 15 Oct 2020
In reply to Stichtplate and Gordon Stainforth:

I've never heard of it - I'm not sure if that's down to academic snobbery or just sheer ineptitude... 

> Your reply is also a bit disingenuous, because you must have clicked that link and seen that Derby is one of the boroughs

Not disingenuous - just ignorant.   I was unsure of myself enough to add a question mark...

Post edited at 20:04
1
 Stichtplate 15 Oct 2020
In reply to wintertree:

> I've never heard of it - I'm not sure if that's down to academic snobbery or just sheer ineptitude... 

It's my old alma mater, though when I attended they couldn't even validate their own degrees. As a result I have a lovely certificate declaring (rather fraudulently) that I'm a graduate of the much more prestigious Nottingham University

 Neil Williams 15 Oct 2020
In reply to Blunderbuss:

> SAGE estimate opening schools adds 0.2 - 0.5 to the R value.

> If we take the midpoint of 0.35 it would seem keeping them open and getting R0 below 1 is nigh on impossible unless we shut down large parts of the economy...

Or we do what we should have done in the first place and redesign the system to allow 2 metre distancing.

A start would be looking at the idea of 50% attendance in secondary schools, with the school week including Saturdays.  In the other 2 days, kids could be set extended homework projects.  The reason I say secondary schools is because those kids are old enough to be "home alone" with parents at work.

I reckon the benefits from smaller class sizes (15 rather than 30, or thereabouts) could offset those two days.

Post edited at 20:18
 jkarran 15 Oct 2020
In reply to Richard Horn:

> No - there was ambulances running around constantly at the time...

In February, are you sure?

It only officially arrived on Jan 31st and that was contained. It was a good week after that that new isolated clusters were being found around returning skiers IIRC.

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

The pre mid-March data is poor but extrapolating back from what was an exponential growth curve post 18/3 doesn't really suggest the hospitals were heaving with covid in Feb'.

jk

 Richard Horn 15 Oct 2020
In reply to Cobra_Head:

> That's a lot of people, or it would be if it were me. If there was so much of it around, why didn't it just run rampant?

It was pretty rampant, people did die in the local hospital, I never said the picture was rosy.

If we are going the get pinickety about timings, I can recall the first CV case I was aware of - storm ciara, 16th Feb, myself and 4 plane loads of people (approx 500) spent an entire day, and then some of the following day stuck in a building not much bigger than a portacabin at chambery airport trying to get home. The following week people from our group suffered fever, coughs and loss of taste...

 jkarran 15 Oct 2020
In reply to Si dH:

> So I'm left wondering whether the R rate is a function of not only the measures we take, our behaviour and our environment, but also a function of the prevalence of the virus itself. Ie, with higher existing prevalence, do we now need to do more to reduce R to below 1?

I remember speculating in spring when a similar effect was observed that there may come a point where the physical environment becomes sufficiently contaminated (and remains so as new victims top up degrading contamination on surfaces) that distancing alone is insufficient to stem growth, we need then to use the shared space less and more carefully even when alone. Masks in shops and more rigorous washdown of shared facilities between uses should be mitigating that though.

> Edit, it s of course possible my anecdotal experience is not representative, or equally possible that the schools and the temperature change are driving factors - but I think it's an interesting question.

It is possible but as I say, it did seem to happen in spring too.

Equally it's possible it's just the effect of larger numbers of asymptomatic spreaders as prevalence increases, they don't know to isolate so carry on in jobs and activities which pass it on. also asymptomatic transmission chains in younger groups can leave it lurking unnoticed for weeks.

jk

 mik82 15 Oct 2020
In reply to mattmurphy:

No need for a feeling, 13% of Londoners had detectable antibodies in June.

 jkarran 15 Oct 2020
In reply to wintertree:

> Have a look at figures 4 & 6 - confirmed cases and test positivity by age - https://assets.publishing.service.gov.uk/government/uploads/system/uploads/...

Interestingly that surge in 10-19yo isn't translating, yet, into a matching trend in the 40-49yo parents. That's weird given how infectious it appears and most kids can't be isolating outside the family home unless that's almost all uni freshers!

The way I look at the positivity numbers is lower suggests more dilligent (or better access to tests), that may be borne out in the stark male female difference (or it may be routine screening of largely female carers) but either way the kink in the 20-29 line looks good, that has to be mostly highly available on-campus testing.

edit: scratch that, it's pillar I male only that kinks. Male care workers getting into a testing routine I guess...

> Our local institution had a 4.4x weekly rise in numbers reported today; at that rate the fresher cohort will have all had it in a few weeks...  

Which will be an interesting experiment.

jk

Post edited at 21:16
 Si dH 15 Oct 2020
In reply to Neil Williams:

> I think it was students, and might actually naturally come back down a bit with the help of some extra measures.

I've been following the Covid data religiously for 6-7 weeks since my son got Covid, it kind of got into my head. Basically it's true that some of the highest localised peaks are down to high numbers of students testing positive. There no doubt about that. For example you can see on today's dashboard map that the weekly rate in the MSOA containing Nottingham Trent university is nearly 4500 per 100k  - yes, that's right, nearly 1 in 20 people who live there have tested positive in the last week. Obviously they will be mostly students and it does skew the numbers. However there are also undoubtedly large areas of the high (and very high) risk regions that are also up at high rates, are continuing to grow exponentially, and have negligible student population. My own borough (Sefton) is one. The rates have just been gradually growing from a base 5-10 per 100k/week, where they were in mid August (from memory). The inexorable doubling has led to where we now are with an average across the borough of about 500/100k. In my MSOA it's over 700 and that's just full of family size houses.  I'm afraid most of the country is now simple exactly where we were about 3-4 weeks ago, and looks like following the same trajectory. Although newsworthy the student related localised peaks are in the noise of the general trend.

 The New NickB 15 Oct 2020
In reply to mik82:

> The reality of allowing the virus to circulate is that it needs numbers of cases and hospital admissions similar to that at the peak for an entire year for any kind of "herd immunity" so this would also completely destroy any semblance of a health care system, and presumably the economy.

Worryingly, if my projections aren't completely wrong, we might infect enough people by Christmas to get a reasonable degree of herd immunity, but the numbers would be such that we would see thousands dying every day without getting near a hospital, not just those with Covid either. If herd immunity is a viabiable thing, we could have it by Christmas. Only problem would be that we would be a failed state, digging mass graves with bulldozers by Advent.

In reply to The New NickB:

Gosh, this conversation just goes round and round in circles. I thought the expert consensus now was that herd immunity with Covid is pretty much not a viable thing.

 wintertree 15 Oct 2020
In reply to Gordon Stainforth:

> I thought the expert consensus now was that herd immunity with Covid is pretty much not a viable thing.

1. Herd immunity achieved by a lot of naturally acquired infections may or may not be achievable, and if it is achievable, the consequences of doing so are likely horrific.

2. Herd immunity achieved by a bit of naturally acquired infection and a lot of vaccination may or may not be achievable - but has more chance of being achievable that 1 as vaccines can bypass the anti-immunity mechanisms deployed during/by a live infection of the virus.   The cost of this is likely much less than 1, and it avoids things like mass graves and civil unrest.

We need to wait another 6 months to get a strong handle on how achievable each of 1 and 2 are.  We should use those six months wisely.

 Yanis Nayu 15 Oct 2020
In reply to Gordon Stainforth:

The govt is going for semi-herd immunity...

 The New NickB 15 Oct 2020
In reply to wintertree:

> I've never heard of it - I'm not sure if that's down to academic snobbery or just sheer ineptitude... 

> > Your reply is also a bit disingenuous, because you must have clicked that link and seen that Derby is one of the boroughs

> Not disingenuous - just ignorant.   I was unsure of myself enough to add a question mark...

You obviously never watch Homes Under The Hammer, which is probably a good thing.

In reply to The New NickB:

When I look at this list of UK universities:

https://en.wikipedia.org/wiki/List_of_universities_in_the_United_Kingdom#Un...

there is virtually none that I've never heard of. And I have nothing to do with academia. 

 Stichtplate 15 Oct 2020
In reply to Yanis Nayu:

> The govt is going for semi-herd immunity...

Most of the cabinet look as though semi-herd is all they're capable of going for...

 The New NickB 15 Oct 2020
In reply to Gordon Stainforth:

> Gosh, this conversation just goes round and round in circles. I thought the expert consensus now was that herd immunity with Covid is pretty much not a viable thing.

I don't know. If it is it will be beyond horrific reaching it.

In reply to Yanis Nayu:

> The govt is going for semi-herd immunity...

I know they are. But that doesn't mean it'll work, in fact it's a virtual guarantee that it won't. Because, so far they've shown that they haven't a clue about anything, Covid included. I append below a list of things that the government clearly and demonstrably does know about:

.

Post edited at 21:43
 wintertree 15 Oct 2020
In reply to Gordon Stainforth:

About 25 I’ve never heard of in there, and there’s no obvious reason I’d ever have expected to; the last time I looked at a full list was when applying fo my undergrad in 1996 and only a few dozen did the course I wanted - even fewer now I believe.

The homes under the hammer reference has sailed over my head too...

 Yanis Nayu 15 Oct 2020
In reply to captain paranoia:

Yes, having defined periods is really important I think. The seemingly never-ending nature of the spring lockdown was really hard to deal with mentally and I’d imagine from a business point of view too. Shorter, sharper and time-defined restrictions would be more effective and easier to deal with I think. 

Post edited at 21:48
In reply to wintertree:

Very odd is all I can say. I left the University of Wales (now Cardiff) in 1972 and the RCA in 1975, and have been nowhere near academia ever since. Have had to give lectures promoting my mountain and photographic books at multiple venues, some of them universities. That's all. But not for about a decade.

 Misha 15 Oct 2020
In reply to Lord_ash2000:

The reason workforce shortages weren't a major issue in spring is we locked down just in time and many businesses told people they could / should work from home in the days running up to the lockdown. 

 Misha 15 Oct 2020
In reply to Richard Horn:

> How does that tie up with the fact that only 3 children under 14 have died of CV so far in the whole of the UK? (to provide perspective in the same period several hundred children have died from other causes)

1. The schools were closed and kids were at home with much less interaction with other kids than usual, so few kids caught it.

2. Not all of the 4% (if that's the number) will actually die. Death rates for kids are very low, we all know that. Not all of the 4% will even get severely ill. But some will and there's a big nasty middle ground between 'a bad cold' and 'death'.

 Misha 15 Oct 2020
In reply to WaterMonkey:

> I imagine if I was visiting a castle for an eye test it would be ok to carry on anyway..

FTFY.

 The New NickB 15 Oct 2020
In reply to wintertree:

> The homes under the hammer reference has sailed over my head too...

When I have seen it, probably only half a dozen episodes in total, but there is always a property in Stoke and always a property in Derby. More often than not, the Derby property is described as being in a popular student area close to the university.

 Misha 15 Oct 2020
In reply to mattmurphy:

Whereas the flaw in your logic is that not everyone under 40 will be fine, particularly if they are vulnerable. Even fairly healthy and fairly young people can get wiped out and, worse, end up with long Covid. The more we find out about this virus, the nastier it seems. The last thing I read was spontaneous loss of hearing - seems relatively rare but it's one of the potential complications.

I see you're 20, so would you volunteer to be deliberately infected? Bear in mind that, to build decent immunity, you'd need a decent viral load so that you get hit fairly hard. The trouble with no or mild symptoms is that you might not get much immunity from it.

My understanding is the closest relative of Covid is the common cold. We don't have immunity to the common cold, one of the reasons being that it's so mild that the body doesn't (need to) develop a strong immune response. I guess the immune system just goes, whatever, I brushed that off so not gonna bother making all those antibodies and whatnot, I'll just deal with it next time round, time for a beer! As opposed to a serious illness where the immune system goes, shit just got real, better make sure I'm prepared next time!

No one dies from the common cold so it's fine that there's no immunity. Covid is a cunning f*cker because it spreads like wildfire, doesn't kill most people so it can keep spreading but manages to kill about 0.5% on average and a lot more than than among vulnerable groups.

 Misha 15 Oct 2020
In reply to daftdazza:

As you say, the %s quoted above may be on the high side in terms of how many will require hospital treatment but equally the NHS can't give over all of its capacity to Covid as people will still get all the other things which require hospital treatment. Elective treatments would need to be postponed (some of which you might not consider particularly elective - they could be pretty critical to people's quality of life, such as hip replacements). That would impact on many people and their families. There was a lot to be said for the 'protect the NHS' slogan.

 MargieB 15 Oct 2020
In reply to Removed User:

I've gathered that test and trace system, even if very good, couldn't on its own deal with an  excessive exponential growth in the virus and you have to knock back the numbers down to a low R rate for  TT to keep up. and effectively stifle the disease. I think people expect too much of test and trace, even if it worked really well, against such a rapid virus and lock down has to be used periodically. I may be wrong on this, but I think I read this somewhere. It has inherent limits. Maybe population density also effects the rapid growth of the disease too, so it outstrips TT- England in a bad place in this respect..Add in a vaccine ,and all that changes.

But, Add in the fact that our test and trace system has systemic bottlenecks anyway and isn't working at its best.

Looks like the decision has to be made very soon to lock down or we lose the opportunity to keep a lock down relatively short, just to be able to rapidly reduce R rate and then use  test and trace system as a controlling system - otherwise. only option left is we are committed to very long lockdowns as in March as TT won't have much value in suppressing huge outbreaks of the disease. Have we reached that? Scientists must have some idea and some are calling for it but I'm not sure if this is the reasoning...

I think this is how it is......

Post edited at 22:59
1
Removed User 15 Oct 2020
In reply to MargieB:

Thanks that makes sense.

1
 Misha 15 Oct 2020
In reply to Si dH:

You raise an interesting point. I suspect at least part of the answer, as you suggest, is that where there's more of it around, people are more likely to pick it up even if they're being careful. The chances of picking it up in a supermarket are low if 1 in 1,000 people have it but a fair bit higher if 1 in 100 people have it. Similarly, the chances of risky behaviour leading to super spreading are now much higher.

In reply to daftdazza:

> Sorry I don't find your estimates creditable, did you use the paper in link below?

> It gives some of the figures you quote but revised to say it would expect 1 percent of under 20s to be hospitalised and 20 percent of over 70 if infected.   But these numbers are for global population as a whole not specific to UK demographics.  It actually gives a worse picture for Europe as a whole with estimate that 31 percent of population has a comorbidty that would mean they would likely need hospitalised if infected.  But reading the paper I felt it was over estimate the risk quite considerably being based on Data from China at start of the outbreak.

I had just raided the estimate I posted from a different forum and put it up for discussion because I was impressed by the work the poster had done and thought it could aid the debate here. But yes, I'd agree that this looks like it must be the Lancet paper that he has used.

The paper is estimating two categories, increased risk and high risk (of requiring hospitalization if they become infected with Covid 19 in the world population). The numbers I've posted come from the increased risk category while those you're quoting come from the high risk category.

I think you are right that not all of the increased risk population will definitely end up in hospital if they catch Covid19. On the other hand the same paper quotes another study which found that 71% of people hospitalised by Covid 19 had underlying conditions.

This means that 29% of people hospitalised with Covid 19 would not be considered at increased risk before they became ill. If the poster had picked up on this he would have estimated his part D) not as 50k but as 2m x 0.29 =580,000.

So, lots of assumptions that can be looked at and possibly pulled apart, and also a good chance that there are other factors that this study overlooks. Even if there needs to be a significant revision downwards it's still an illustration of horror.

Post edited at 22:54
 Misha 15 Oct 2020
In reply to captain paranoia:

> restrictions people will be able to plan for (since they are not imposed randomly), and may be able to endure with good compliance, knowing they are for a fixed duration, and unlock is only ever two weeks away.

I think this is key. It would encourage compliance and enable people to plan for things. At the moment I feel like I can't plan for anything beyond the coming weekend!

 Misha 15 Oct 2020
In reply to mik82:

> No need for a feeling, only 13% of Londoners had detectable antibodies in June.

FTFY.

 Misha 15 Oct 2020
In reply to cumbria mammoth:

> This means that 29% of people hospitalised with Covid 19 would not be considered at increased risk before they became ill. If the poster had picked up on this he would have estimated his part D) not as 50k but as 2m x 0.29 =580,000.

Not sure about that. If 29% of people in hospital weren't considered at increased risk, that doesn't mean that 29% of people who aren't considered at increased risk would end up in hospital. 

In reply to Misha:

Agree, but if I'd done what you are suggesting I'd done it would have been 49m x 0.29 =14 million, then the debate really would be over to say the least.

Edit - Actually I have messed up though. The original estimate was 2 million hospitalised with Covid19. If that is 71% of the people hospitalised then there are 2.8 million hospitalised with Covid19 so part D) of the estimate should be 800,000 people hospitalised with Covid19 who were not considered at increased risk before they became ill in the let it rip scenario.

Post edited at 23:29
 daftdazza 16 Oct 2020
In reply to MargieB:

I agree TTI was never the solution it was presented as being as evident with current increased spread in Infections across Europe, not all countries can possibly have as flawed a system as ours, and even if we fix the system how do you make people comply? Handouts alone won't solve the problem.  We are now testing at a higher rate per capita than pretty much any other major country globally but it does not seem to be doing us any good.

I guess the Scottish government is doing the rest of the UK a favour with current restrictions up here, will give us an idea if they will actually work, I would expect to start see a drop in Infections levels tomorrow, followed by reduction in hospital admissions in a week's time.  Obviously the way tests are reported it will probably be a week until we notice any change due to lag in data, so I have a feeling that due to the probable lack of positive data presentable to the public, the  Scottish circuit breaker will either be extended a few weeks or adapted to let central belt pubs and restaurants serve outdoor areas only, but if the data does not start to show a positive locking downward trend over period of a month then we are likely to start seeing more public unrest and lack of compliance as many will deem the sacrifices as not worth it.

 Misha 16 Oct 2020
In reply to cumbria mammoth:

That makes sense. People can argue about the exact numbers but it's clear that the numbers would be huge.

 Neil Williams 16 Oct 2020
In reply to Si dH:

I wonder if that is bleed from the students into the general community to some extent?  Sefton is sort-of between Liverpool (lots of students), Ormskirk (lots of students) and Preston (er, lots of students).  Thus I'd expect the West Lancashire peninsula to get a lot of infection escaping from those students into the wider population.

 Richard Horn 16 Oct 2020
In reply to Misha:

> 1. The schools were closed and kids were at home with much less interaction with other kids than usual, so few kids caught it.

> 2. Not all of the 4% (if that's the number) will actually die. Death rates for kids are very low, we all know that. Not all of the 4% will even get severely ill. But some will and there's a big nasty middle ground between 'a bad cold' and 'death'.

The children were at school until a week(?) before lockdown, by which point enough damage (spread) was done to lead to the bulk of the 65k excess deaths seen, so I think children would have been exposed in very large numbers... Also remember ~25% of children carried on at school / nursery in some capacity all the way through.

 wintertree 16 Oct 2020

In reply to Lisa Jones:

> Perhaps your friend’s son is, as described, an intelligent and well-informed man and does not consider the risk to be as high as publicised. 

Were he intelligent and well informed, he would recognise the critical difference between the immediate and personal risk to himself from catching the virus, and the eventual wider risk to society of healthcare collapse caused by him unknowingly catching and spreading the virus.  He might even recognise that the societal risk loops back to an eventual personal risk as he lives within that society.  

> Why couldn’t those most at risk continue to self isolate?

Because (a) it doesn't work if they need any sort of support or care and (b) we don't know who all of those most at risk are.  With regards (a), just look at the PHE figures on Covid outbreaks in care homes over recent weeks.

> There are many credible scientists and health professionals who advocate herd immunity.

They are in a very small minority, and in some cases their reputation is immolating fast.  

>  How many people are putting off seeing the doctor and failing to be diagnosed of something serious  which could’ve been treated had they gone earlier? This is what really worries me.

Why are they not going?  Why are the "putting it off"?  Because they're worried about the virus?  How is letting it rip and having symptom-free infectious people working in hospitals and other care facilities going to encourage them to go?

> others are not being treated for truly horrible conditions; cancer, heart disease, debilitating depression.

Wait until we have people not being treated for those conditions because there are no ambulances, hospitals are full, 1/3rd of medical staff are self isolating and younger, healthier medical staff are suffering life limiting or ending effects from more serious infection caused by the higher viral loads that happen under your plan.

The Great Barrington Declaration is a bullshit PR piece from a right-wing American lobby group who are in effect an enemy of nationalised healthcare (look at their deliberately wrong commentary over Charlie Guard for example) and whose purpose is to lobby against social welfare.   

(Edit: Well, that very eloquent post didn’t stick around for long)

Post edited at 13:31
In reply to wintertree:

> Well, that very eloquent post didn’t stick around for long)

UKC seems a relative haven of sanity compared to some of the pages I see on social media. It's hardly surprising we have exponential growth, considering the opinions of many I see. My dear sister tries valiantly to counter these idiots (35 years in nursing and hospital management), but it's a losing battle, as these people seem to have boundless time and energy. This morning it was the old 'ah, but covid-related death just means they fell under a bus; it's all a lie folks'. This spawned a flurry of hoax/state control etc. posts. Depressing.

 wintertree 16 Oct 2020
In reply to captain paranoia:

> UKC seems a relative haven of sanity compared to some of the pages I see on social media. 

The sheer quantity of misinformation on this that is spread through social media is horrific, and you can tell from snippets of conversation caught passing down the street how it's nudging the attitudes of many people away from public health and into behaviour more likely to spread the virus.

I'm minded to say that Zuck et all should be investigated for their legal culpability in this pandemic.   I don't see how you ever prove the cause and effect through the chain of people influenced by crap they read on the internet though.  There's something really nihilistic about the suggestion that this misinformation wave (not the source, but the spread) is driven not by malice but by algorithms maximising advertising revenue by pushing what gets read and spread the most.  The people exploring this know exactly how to work it however.

I noticed on once recent thread the site owners added a very visible "Misinformation flair" to one post - this is a  Good Thing, and the shame incurred should be enough to sort any serious poster out.  On the other hand, as many people have commented recently, UKC is about the last sensible bastion of discussion left on the internet.

In reply to wintertree:

> I noticed on once recent thread the site owners added a very visible "Misinformation flair" to one post -

On UKC? Yes, I saw that. Meant to post a thread commending the mods. I had had a rant to them about dangerous nonsense by the poster in question, though... Not sure if the two things were related...

Here's an example of the typical level of nutjobbery you find on news pages. Check out the posts by 'Gary Heaton', for example:

https://m.facebook.com/story.php?story_fbid=10158235350097217&id=228735...

Post edited at 19:40
 MargieB 16 Oct 2020
In reply to daftdazza:

I'm in The Highlands so get Scottish news in detail. I'll look out for the figures. I hope we see it falling.....

 Misha 17 Oct 2020
In reply to Removed UserThe Thread:

So what do people think will happen?

Option 1: 2 - 3 week circuit breaker type semi lockdown (perhaps not national but at least all the tier 2 and 3 areas in England and all or most of the restricted areas in Scotland and Wales). Starting next weekend to coincide with half term.

Option 2: BoJo f*cks around for a few more week having arguments with local leaders while imposing relatively ineffective (given the current level of spread) local tier 2 and 3 lockdowns, then goes 'oh shit' and imposes a longer semi lockdown, probably nationwide. Meanwhile Sturgeon and Drakeford go with option 1.

Sorry forgot option 3, as originally suggested by BoJo: the virus will go away by Xmas. Can't believe he ever said that...

I think option 1 would be the right answer but we'll probably end up with option 2...

Post edited at 00:27
2
 Yanis Nayu 17 Oct 2020
In reply to Misha:

They seem to muddle through in a half-arsed way trying to appease all sides of the argument and seeming to get the worse of all worlds. I thought Cummings was a data genius guy with lots of super forecaster mates? 

 Yanis Nayu 17 Oct 2020
In reply to Misha:

We’ll have a circuit dampener. 

 neilh 17 Oct 2020
In reply to Yanis Nayu:

Think he is on the way out. He has been remarkably quiet lately. Bridges burnt. 

 MargieB 17 Oct 2020
In reply to Yanis Nayu:

Then we'll have a vaccine but no glass ampoules or hypodermics to deliver on mass because the production in India is over stressed and we got rid of our factories {in the East of England }a time back.

So is  a bucket and spade job on some British silicate beach and a factory  required? Or we're still be committed to yo yo -ing with lockdowns? worth the money??We can't knit our way out of this one!Oh, we also need a fleet of refridgerated lorries to keep vaccine viable between 2-8 degrees C- but that shouldn't be too difficult- they'll be all parked in Kent. with No Deal WTO rules { AKA Australian Style- disguising language BS! Politicians!}......

Post edited at 09:21
In reply to Yanis Nayu:

> They seem to muddle through in a half-arsed way trying to appease all sides of the argument and seeming to get the worse of all worlds. I thought Cummings was a data genius guy with lots of super forecaster mates? 

I don't believe that incompetence is the reason for this. I think our malicious government is carrying out its plan perfectly. 

We were told in early March that the plan was herd immunity and we had to prepare to lose our loved ones. It wasn't politically possible for them to actually do nothing to mitigate the unfolding disaster but they have done their best to undermine the measures they were forced to implement at every step of the way.

I wouldn't be surprised to learn that Cummings didn't even have Covid during his trip to Barnard Castle. That stunt was a master stroke when seen through the understanding that their aim is to destroy public trust in government so that during the crisis that people will carry on as normal, and beyond the crisis they want to hand public services over to the private sector to be run for profit by their corporate masters.

In reply to Removed User:

So much of England is now under local restrictions it would probably be more effective and get it over faster just to make it national to prevent infection seeding and reseeding between different areas.

Local lockdowns make sense when its just one or two regions but there has to be a point where the tactic no longer works.  You'd hope this is the sort of thing that they would have done computer simulations on.  Although, even if they had, I'm far from convinced the Tories would base policy on them.

1
 Jon Stewart 17 Oct 2020
In reply to Misha:

> So what do people think will happen?

> Option 2: BoJo f*cks around for a few more week having arguments with local leaders while imposing relatively ineffective (given the current level of spread) local tier 2 and 3 lockdowns, then goes 'oh shit' and imposes a longer semi lockdown, probably nationwide. Meanwhile Sturgeon and Drakeford go with option 1.

Probably this, but I've lost faith that any feasible policy would actually be effective. We know from March that total lockdown is effective, but that's not feasible since all the furlough money has been spaffed without achieving the necessary end point: cases low enough and TTI effective enough to avoid a second wave.

So some kind of crappy half-baked policy will be introduced as a weak attempt to get us stumbling along short term, and what we'll see is hospitals still filling up. It'll get so bad that people will just lock themselves down out of self-interest - they know that if they get sick, it could be really bad and there just isn't help available so they'll stay at home. Same would be the case with lifting restrictions - you'd get a bit of growth initially as people went out, then a total collapse when it all got too scary and they stayed in.

We've really f*cked this up.

Post edited at 13:19
1
 fred99 17 Oct 2020
In reply to tom_in_edinburgh:

> So much of SCOTLAND is now under local restrictions it would probably be more effective and get it over faster just to make it national to prevent infection seeding and reseeding between different areas.

> Local lockdowns make sense when its just one or two regions but there has to be a point where the tactic no longer works.  You'd hope this is the sort of thing that they would have done computer simulations on.  Although, even if they had, I'm far from convinced the Tories would base policy on them.

Fixed that for you.

2
 neilh 17 Oct 2020
In reply to Misha:

I think we tend to forget that Europe is generally struggling to figure out which rules work the best. Nobody has found the right mix so to speak. 

And whilst sturgeon is goodbye messenging , it seems to have little impact on the infection rate etc.

In reply to neilh:

> And whilst sturgeon is goodbye messenging , it seems to have little impact on the infection rate etc.

Not true.  It was much better during the first wave and over most of summer.

My guess is that when we see the full curve for the second wave Scotland will be much better for the second wave too but Scotland's second wave will start before England's.    There's a time displacement between Scotland and England because the school and uni terms started a month earlier in Scotland and that's what kicked off the surge in infections.   Comparing infection levels on the same day isn't showing the full story.

1
 neilh 17 Oct 2020
In reply to tom_in_edinburgh:

It is still not great whichever you look at it. 

 Misha 17 Oct 2020
In reply to Jon Stewart:

You might be right, though I think a lockdown is more likely (and they’ll find the money - the markets still seem to be willing to lend and the Bank of England will step in if need be by expanding QE; the unwillingness to spend more money is largely political). M

As you say, once it gets really bad it will self regulate after a fashion as people will lock down themselves as far as they can. Not everyone of course. The healthy teenagers and 20-somethings will probably still be out and about and might get to some level of herd immunity, whereas us oldies will be cooped up at home with the Horlicks. Thing is, teenagers and 20-somethings can’t drive the economy by themselves as they aren’t big spenders...

1
In reply to neilh:

> It is still not great whichever you look at it. 

No.  I think it was an error to open all schools and unis for face to face teaching.  I don't think we kept enough discipline over summer to get the necessary near zero infection rates and I think the mixing between geographic regions with uni students was a problem that was foreseen but ignored.

It was probably a forced error but an error nonetheless.

1
 neilh 18 Oct 2020
In reply to tom_in_edinburgh:

So you are saying that every country - From Germany onwards has made a mistake by reopening education?The policy is really no different from any where else.

Education is a priority 

 MargieB 18 Oct 2020
In reply to tom_in_edinburgh:

Mixing has started it up again, it seems, and  indoors meetings of large numbers.

But I wonder if the sheer dampness of October really is a contributing factor . It just seems too coincidental that this has occurred in the last weeks and it has  spread into the general population. The students have been confined on campuses. I can't dry my bedding on the line outside, even hung beneath on a covered veranda, because of humidity levels  in the air at this time of the year. Changes with cold dry December/Jan/Feb.  Virus spreads more quickly in damp conditions??

Post edited at 10:07
 Neil Williams 18 Oct 2020
In reply to neilh:

> So you are saying that every country - From Germany onwards has made a mistake by reopening education?The policy is really no different from any where else.

> Education is a priority 

I would say not having started to redesign education provision in March to accommodate proper social distancing was a clear error.

1
 neilh 18 Oct 2020
In reply to Neil Williams:

Takes a few years to rebuild all the schools so they have wide corridors etc. There are quite a few issues to address not just exam issues etc. 

 MargieB 18 Oct 2020
In reply to tom_in_edinburgh:

Isn't it more likely that all dense urban populations in UK overally will go under faster than any rural  less densely populated area? so Cornwall  might be like the Highlands in this repect? So rather than Scotland and England - it is a UK patchwork of spread of disease?

 Dr.S at work 18 Oct 2020
In reply to MargieB:

Its clearly the case that there is a rural urban split:

https://www.bbc.co.uk/news/uk-51768274

The zoomable map of case distribution shows that very clearly - just zoom in on SW England and see Bath, Exeter, Bristol compared to the surrounding areas. (edit to add - the vast bulk of the cases in Bristol at least from students - will be interesting to see if it spreads intot the community)

Clearly Mid Wales, the Highlands, the English Fenlands all have that really low population density and also I think, difficulty of access, that prevents widespread spread of the disease.

To what degree the better/worse performance of the four nations is down to this, what down to the administrations, what down to local factors is going to be hard to analyse.

Post edited at 11:12
In reply to neilh:

> So you are saying that every country - From Germany onwards has made a mistake by reopening education?The policy is really no different from any where else.

Yes

> Education is a priority 

Of course education is a priority.  That's why they did it.

But a virus doesn't give a sh*t about our priorities.  All that matters is how many people get in a situation where transmission is possible and sending ten million kids to school vastly increases its ability to spread.  

It might have been possible if we had been totally disciplined over summer and continued squeezing infection rates down until they were almost zero.  But we didn't, we used the leeway afforded by the first lockdown to open up more sectors of the economy and allowed infections to rise a little.   Then we opened schools and unis with significant infection rates in the community and it exploded.   If you look at it totally cold heartedly from a physical perspective this was completely predictable.

Post edited at 11:59
2
 Cobra_Head 18 Oct 2020
In reply to MargieB:

> Isn't it more likely that all dense urban populations in UK overally will go under faster than any rural  less densely populated area? so Cornwall  might be like the Highlands in this repect? So rather than Scotland and England - it is a UK patchwork of spread of disease?


If only we had some sort of testing system in place that might alert us to hot spots around the country.

Out of all the other bullshit thing this Tory gov. has done, this has to have been the most destructive. We had a good chance of very localised lockdowns and minimal isolations if this had been working when we had low numbers. There are too many not to test and trace, so we've missed that boat.

1
 MargieB 18 Oct 2020
In reply to Cobra_Head:

I agree, the TT was disastrous and there is no excuse. It was our first port of call to stem it.

But missing that boat may , and I say may,{ I don't know}  be exacerbated by the conditions of the environment as well -to put us on a very dramatic trajectory, Europe, including Germany, with a good TT, is going up? Why is Germany going up dramatically?

 Neil Williams 18 Oct 2020
In reply to neilh:

> Takes a few years to rebuild all the schools so they have wide corridors etc. There are quite a few issues to address not just exam issues etc.

There are, but the key one to address is to design a system where the kids can sit a minimum of 1m apart, or ideally 2m, when in the classroom.  That will be the main spread vector, not fleeting contact in corridors.

1
 MargieB 18 Oct 2020
In reply to MargieB:

Is humidity an exacerbating factor rather than temperature.? Do hot countries with the humidity of monsoon  season also see a spike at this time?

Do the big outbreaks/spikes in hot countries coincide with the monsoon and very high humidity?

Post edited at 14:44
 Neil Williams 18 Oct 2020
In reply to MargieB:

FWIW, the cold and humid setting of meat packing factories has been a very big spread vector.

 MargieB 18 Oct 2020
In reply to Neil Williams:

If there is a relationship between humidity and the speedier transmission of Covid 19 it could have an implication on when to administer a vaccine before humid months occur eg in late August in UK/Europe before the mists of September, or before the run up to the wet seasons/monsoons in Australia /india etc.  We are assuming flu vaccine timetables, possibly inaccurately.

Post edited at 18:49
 MargieB 18 Oct 2020
In reply to Neil Williams:

German slaughterhouses also were curiously regular places for outbreaks- humid wet/ with animal breath, and worse in the air?

Post edited at 19:27
1
In reply to MargieB:

> Is humidity an exacerbating factor rather than temperature.? Do hot countries with the humidity of monsoon  season also see a spike at this time?

These guys in Japan did a supercomputer simulation of droplet spread indoors and concluded it was significantly reduced when humidity is high.   

https://www.youtube.com/watch?v=GAvO_QdO9eM&feature=emb_logo

 MargieB 19 Oct 2020
In reply to tom_in_edinburgh:

https://www.news-medical.net/news/20200929/How-might-Indias-monsoon-season-... - also seems to suggest what the Japanese say. However, reduced vitamin D with light reduction is not helpful to stopping Covid 19 having ill effects. Extra vitamin D in winter to protect against covid 19 effects?? There are so many factors!

If dryness spreads it better, then that will make the administration of a vaccine in Spring more effective.

Post edited at 09:54
 MargieB 19 Oct 2020
In reply to tom_in_edinburgh:

Could this information be useful in restaurants. Could restaurants acquire humidifiers , a gauge to judge humidity in the space and a temperature gauge for room temperature. You could humidify a room, but set your central heating to be between 20 degrees-25 degrees { anything above is uncomfortable to sit in, especially at 40 degrees with high humidity- I've lived in that!]

You could monitor the restaurant carefully, open windows when it became to hot. And high humidity at about 20-25 degree temperature is fine to sit in and eat. Is this the sort of way we could have public spaces lessen covid transmission?

 Neil Williams 19 Oct 2020
In reply to MargieB:

I'd be inclined to say improving ventilation would provide more gain at a far lower cost.  Particularly if you could manage to engineer an aircraft style situation of "in at the top, out at the bottom" to avoid it circulating around the space.

 wintertree 19 Oct 2020
In reply to Neil Williams:

Agreed.  I’ve been wondering about a hexagon shaped-table dining room with HEPA filtered air blown in to the centre from above and below (central cut out) and seperate air collection ducts behind each 2-person wedge.  Gentle enough air flow to not be annoying but constant enough to bleed viral particles out of the air.  Perhaps with partial clear acrylic screens between the wedges expanding out from behind the diners and in to the centre from about half a meter above the table.  Don’t break the sight lines between people but seperate and cleanse their air flows.  

 MargieB 19 Oct 2020
In reply to Neil Williams:

They should be doing that too- fling open the windows and doors several times a day. But as a general rule, central heating in winter really dries the atmosphere of a room , more than in summer when it is not on. And this is about indoor winter living now.

Post edited at 21:29
 druss 19 Oct 2020
In reply to tom_in_edinburgh:

> These guys in Japan did a supercomputer simulation of droplet spread indoors and concluded it was significantly reduced when humidity is high.   


Thanks for sharing.  That's is useful interesting information which is actionable by public health bodies.  I wish we had viral load and exposure data too.

If only our government and SAGE had invested in research to further develop further guidance to how we strength immune system, ballpark exposure and viral load metrics, aerosol science, mask type+effectiveness etc. in parallel to reliance on vaccine.     

 HansStuttgart 19 Oct 2020
In reply to MargieB:

> German slaughterhouses also were curiously regular places for outbreaks- humid wet/ with animal breath, and worse in the air?


yes, but there are also other considerations:

a lot of migrant workers with low job security => people are not encouraged to stay at home when slightly ill.

cramped living accommodations in groups outside of work

young group of workers that lives in a social bubble separated from older people => no early warnings through hospitalization.

And there were also similar outbreaks in outdoor vegetable picking.

 Neil Williams 19 Oct 2020
In reply to druss:

> If only our government and SAGE had invested in research to further develop further guidance to how we strength immune system, ballpark exposure and viral load metrics, aerosol science, mask type+effectiveness etc. in parallel to reliance on vaccine.     

Our Government is clearly incompetent, and therein lies your answer.  But have other Governments done so?

1
 neilh 20 Oct 2020
In reply to Neil Williams:

How do we know they are not doing so.  I assume it takes time to do these sort of studies and peer review them etc etc. 

In reply to neilh:

> How do we know they are not doing so.  I assume it takes time to do these sort of studies and peer review them etc etc. 

They'll be holding off until one of their friends or relations starts a humidifier business  with union jacks and spitfires all over the box. 

1
 jkarran 20 Oct 2020
In reply to tom_in_edinburgh:

> These guys in Japan did a supercomputer simulation of droplet spread indoors and concluded it was significantly reduced when humidity is high.   

I'm missing something here. As I understand it: Higher humidity reduces air density reducing droplet buoyancy. High humidity will reduce droplet evaporation rate meaning droplets stay bigger and fall faster.

I'll take the study at face value but what am I missing, are those effects more than compensated by lower aerodynamic drag or does the humidity change the nature of droplet formation/projection in/from the airway?

jk

In reply to jkarran:

> I'm missing something here. As I understand it: Higher humidity reduces air density reducing droplet buoyancy. High humidity will reduce droplet evaporation rate meaning droplets stay bigger and fall faster.

I'm not a fluid dynamics expert but that seems consistent with their findings.  If they stay bigger and fall faster they won't go as far so they are less likely to reach the guy on the other side of the table in their simulation.

 jkarran 20 Oct 2020
In reply to tom_in_edinburgh:

LOL, that maybe is what I'm missing, the weird logical reversal I even typed out without spotting.

jk

cb294 20 Oct 2020
In reply to neilh:

For the ten thousands time: Zero immune memory would prevent herd immunity, but while 100% permanent immunity would help it is NOT required to establish herd immunity. Not even all vaccines work in 100% of people.

The duration of immune protection is obviously a distribution around some mean. Currently observed levels of reinfection suggest that most patients are protected for at least months to years (with a rather high level of incertainty because the virus has not been around for long enough) and we see reinfections only in the extreme short end of the distribution, which would be in keeping with all other coronaviruses.

CB

 elsewhere 20 Oct 2020
In reply to tom_in_edinburgh:

Meat processing plants (cool and humid - low evaporation) have been associated with outbreaks in UK & Germany.

https://www.bmj.com/content/370/bmj.m2716

 neilh 20 Oct 2020
In reply to cb294:

OK, understand that not all vaccines work in 100% of people.

In your second paragrpah are you saying we know enough to suggest that without a vaccine some people would have immunity for a few years/ some would have it for a few weeks/ some people would have no immuity.

In turn we do not really know who would fall into which category.

 Neil Williams 20 Oct 2020
In reply to cb294:

> For the ten thousands time: Zero immune memory would prevent herd immunity

Zero immune memory would also prevent a vaccine.  That would be rather a disaster scenario, and we would have a choice between permanent, major changes to our way of life (which would be much harder and more controversial than a year or two and could well kick off significant civil war and unrest about it) or an extinction event.

But there is no precedent for that in other coronaviruses, fortunately, and this one tends to behave very much like the others.

 wercat 20 Oct 2020
In reply to neilh:

thinking of a pandemic as an analogy of a chain-reaction (which it is in a way) you don't need the reactor to contain 100% control rods to bring it under control.

immunised people are like the control rods and once there are enough "neutrals" in the population then the chances of a continuous chain of infection/reaction reduces.   Even better than that, as  the chances of transmission reduce the number of neutrals increases as their infectious state decays, unlike a nuclear pile. So the chances of infection reduce still further.  I can see this but am not sufficiently mathematical to describe it mathematically.

Post edited at 13:33
In reply to wercat:

> immunised people are like the control rods and once there are enough "neutrals" in the population then the chances of a continuous chain of infection/reaction reduces.   Even better than that, as  the chances of transmission reduce the number of neutrals increases as their infectious state decays, unlike a nuclear pile. So the chances of infection reduce still further.  I can see this but am not sufficiently mathematical to describe it mathematically.

The problem with the naive 'random bouncing ball' maths is that in real life some people have far more contacts than others.  If you get the high contact people immunized or if they catch it and get antibodies you could get more of a damping effect on virus spread than would be predicted from the simple mathematical models.

The interesting question would be whether it would be better to immunise people who have a lot of contacts first so immunisation acts like a control rod to limit spread rather than people who have existing medical problems but relatively few contacts.


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