The percentage of the population who need to be immune to provide herd immunity depends on the particular disease - the figure you are citing is for measles - which is highly contagious.
Well, I'm not an epidemiologist. And, even if I was there isn't the data needed to quantify how contagious this coronavirus is relative to measles. In the absence of contrary data, it doesn't seem too far fetched to assume that it's as contagious as measles.
Well, I'm not an epidemiologist. And, even if I was there isn't the data needed to quantify how contagious this coronavirus is relative to measles. In the absence of contrary data, it doesn't seem too far fetched to assume that it's as contagious as measles.
The things I've read (if memory serves) suggest it doesn't aerosolise and linger in the air like measles or smallpox and suggested herd immunity levels around the 60-80% mark but obviously it's very much up in the air.
It seems clear to me that the UK didn't impose lockdown as soon as it could have done, not due to any public unwillingness to accept the idea, but because the prevailing government wisdom was that herd immunity was a better strategy. Only when it was realised just how many more deaths this might result in due to revised modelling did it do a U-turn, and it was a U-turn.
It should be clear from this thread that I'm no fan of bashing the government merely because of its political hue, but pretending that there was no U-turn in the UK does indeed look Orwellian to me.
There was a rapid move from the original containment strategy to lockdown. I think the publication/greater circulation of the dire predictions of the Imperial College report might have accelerated that move (which was forecast in the original containment strategy). Does that justify the label U-turn? Probably.
The entire world is pursuing a herd immunity policy (in the sense that they realise the pandemic won`t be over `till it happens) - that is what a vaccine is *for*. That is what anti-body testing - that we aspire to have - is *checking for*.
That's true. The moral and ethical question is "yes but how".
Eutychus, I don't think the political policy was herd immunity in the original Dominic Cummings sense (laissez-faire). It looks to me that it moved from pure laissez-faire to "a bit of that for a while, but modified by containment", with the backing of Witty and Vallance representing "the best scientific advice". It ceased to be "the best scientific advice" within a few days. What was really going on? Did Witty and Vallance think the Imperial College model was OTT? What changed their minds? Was it the rapidly moving statistics, producing the dawning realisation that the model might not be the "worst case scenario"? Or the realisation that once that model was out in the open, the original containment policy could not be sustained politically?
To answer that question, we would need to know the inner thoughts of Witty and Vallance as well as those of the Prime Minister. I can certainly imagine Matt Hancock saying that if the model was anywhere near right, modified laissez-faire would not just kill very large numbers of people, it would both kill the NHS and kill the political credibility of the Tories for years. So I wouldn't be in the least surprised if the political opinion switched very rapidly away from modified laissez-faire. As seems to be supported by the report of Cummings change of mind.
The problem with the concept is still the numbers involved. We still don't really know how many people infected suffer serious symptoms requiring hospitalisation (if we get an anti-body test then we could get that data), but let's assume it's 1%. To get 50% population immunity you'd need to have 30 million people in the UK infected, that's 300,000 people in hospital ... spread out over several months we might just about manage 30,000 people in hospital. Which is just the measure of pressure on the NHS, the pressure on our undertakers and crematoria will also be overwhelming, just to reach the 50% immunity level.
On masks, I read that they're dangerous, because people keep touching their face. But every TV shot of a street in Asia, China, Korea, Taiwan, people are wearing them. I can accept that we don't have enough, and they have to be kept for Health staff. And then, there's the convex curve, ha ha.
Yes. In the world of the Spanish flu (a much less mobile world) the global estimates are about a quarter of the population was infected over a three year period and up to 20% of them died. In our much more mobile, economically integrated, world, I'd be surprised if a quarter were nearly enough.
We not only need an effective vaccine, we need a lot of it. And hope that this virus doesn't mutate out of range of the vaccine whilst still retaining its present ability to create extended sickness and death.
Yes, the buck stops with the PM. That's the way collective responsibility works.
And yes, the buck for weighing the best scientific and medical evidence and advising on it, stops with Vallance and Witty. Advising is always a secondary responsibility. But a significant one.
There are two possible explanations for Witty and Vallance throwing their weight behind the containment policy.
1. They trimmed their judgment to fit political considerations.
2. When weighing the range of scientific and medical advice they made the wrong summary conclusion. As Doc Tor put it, they backed the wrong horse.
Either way, they share some of the responsibility.
Ferguson argued that the Imperial College model forecasts of deaths moved rapidly from being worst case scenario to most likely outcome. Looking at the situation today, we might, if we are lucky, get out of this first spike of the epidemic with about 20,000 deaths. It depends how slow the decline from the peak turns out to be.
But it remains to be seen whether we will ultimately avoid a quarter of a million deaths. It seems as though there is division in the UK Cabinet over relaxing the present constraints. I'm not surprised. Deaths do result from collapsed economies. It's a pretty horrible balance to have to weigh.
The Devil's Alternative. I feel we're all truly complicit in this. Everyone acted in good faith. Wrongly as it turns out. We have never been here before. And we will learn by surviving the suffering of our victims. There is no other way it seems.
Yes, the buck stops with the PM. That's the way collective responsibility works.
And yes, the buck for weighing the best scientific and medical evidence and advising on it, stops with Vallance and Witty. Advising is always a secondary responsibility. But a significant one.
There are two possible explanations for Witty and Vallance throwing their weight behind the containment policy.
1. They trimmed their judgment to fit political considerations.
2. When weighing the range of scientific and medical advice they made the wrong summary conclusion. As Doc Tor put it, they backed the wrong horse.
Either way, they share some of the responsibility.
Ferguson argued that the Imperial College model forecasts of deaths moved rapidly from being worst case scenario to most likely outcome. Looking at the situation today, we might, if we are lucky, get out of this first spike of the epidemic with about 20,000 deaths. It depends how slow the decline from the peak turns out to be.
But it remains to be seen whether we will ultimately avoid a quarter of a million deaths. It seems as though there is division in the UK Cabinet over relaxing the present constraints. I'm not surprised. Deaths do result from collapsed economies. It's a pretty horrible balance to have to weigh.
The Devil's Alternative. I feel we're all truly complicit in this. Everyone acted in good faith. Wrongly as it turns out. We have never been here before. And we will learn by surviving the suffering of our victims. There is no other way it seems.
[citation needed]
We have a government in office that is a living, breathing (with some difficulty in the PM's case) example of bad faith.
I don’t support this government, but I also don’t think they are a combination of Pol Pot and Darth Vader.
I imagine they go instinctively to more private sector solutions and less state intervention - but I also suspect they are desperate to make whatever protective strategy work and for the whole of society not fall over and not to have to order the army to dig mass graves in the public parks.
On masks, I read that they're dangerous, because people keep touching their face. But every TV shot of a street in Asia, China, Korea, Taiwan, people are wearing them. I can accept that we don't have enough, and they have to be kept for Health staff. And then, there's the convex curve, ha ha.
Though, one factor is that in Asia people have been routinely wearing face masks in public for decades. That creates a level of familiarity that people largely ignore them; if you haven't worn a face mask before it will feel odd, and you're much more likely to feel the need to constantly adjust it. And, of course, it doesn't stop people touching their face anyway.
Also, the masks people routinely wear in Asia are not the same standard as those needed by our health and care professionals. At least in Japan the masks you can buy in convenience stores are very flimsy and not close fitting, they're worn for cosmetic and psychological reasons - it's a fashion item and creates a social "leave me alone" signal that many find vital when they live in high population density cities where there's no way to maintain actual personal space in public.
I don’t support this government, but I also don’t think they are a combination of Pol Pot and Darth Vader.
I imagine they go instinctively to more private sector solutions and less state intervention - but I also suspect they are desperate to make whatever protective strategy work and for the whole of society not fall over and not to have to order the army to dig mass graves in the public parks.
But will they prioritize the economy? In some ways, they have to, but will Tories extra prioritize it? See Peter Hitchens, et al.
It looks to me that it moved from pure laissez-faire to "a bit of that for a while, but modified by containment"
So where's the containment? Because it seems to have disappeared to the same place as the notion of 'cocooning' (which I presume must involve something other than letting things rip through care homes).
I don’t support this government, but I also don’t think they are a combination of Pol Pot and Darth Vader.
I imagine they go instinctively to more private sector solutions and less state intervention - but I also suspect they are desperate to make whatever protective strategy work and for the whole of society not fall over and not to have to order the army to dig mass graves in the public parks.
I think there are enough market fundamentalists in the government that they were of the opinion that they could contract out anything necessary and rely on subtle messaging to change behaviour (epitomised by the behavioural team coming to prominence) -- so in this case political fundamentalism ended up circumscribing the set of possible policy responses at a time when big state solutions early were what was called for.
The headline policies since then, while eye catching, have mostly been around preserving existing power relationships.
Please, will some grownup back in DC decide this is the time to announce that T has been so overwhelmed with worry and responsibility that he's slipped a few gears, and needs to rest for a few weeks? And then firmly escort him to an undisclosed location where he can do that?
It looks to me that it moved from pure laissez-faire to "a bit of that for a while, but modified by containment"
So where's the containment? Because it seems to have disappeared to the same place as the notion of 'cocooning' (which I presume must involve something other than letting things rip through care homes).
Here is a March 12 link. In the video link towards the bottom, Patrick Vallance's comments over about a four minute period, in conjunction with the other information in the BBC article, seem pretty well to summarise the policy and understanding at the time. It didn't stand the test of time for very long. It's also a pretty good example of how he (and Chris Witty) spoke as scientists supporting the policy. He doesn't look like a pressed man, rather more like someone who believes what he is saying.
If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection.
Wear a mask if you are coughing or sneezing.
Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water.
If you wear a mask, then you must know how to use it and dispose of it properly.
More detail on that page about how to use a face mask.
I think epidemiologically at a population level there’s little or no significant benefit from the widespread use of face masks.
As far as containment is concerned it only works when you’ve got a limited number of cases with a reasonable chance of tracing contacts. If infection is more widespread then the assumption is that the virus is present at large in the community and containment ceases to be a viable strategy. Here’s a report in the Independent.
So the delay strategy is designed to soften that peak and push it into the spring and summer months when the disease may also be less able to spread in the warmer weather.
It’s at this stage when the government will consider measures such as closing schools, postponing or cancelling large gatherings like football matches and concerts and encouraging people to work from home.
Isn’t this what in fact happened, it is mid April and we haven’t hit peak yet - delay strategies are pushing the peak later toward the summer.
That at the point the strategy was announced there was nothing to achieve it - the shielding letters were still several weeks away in many cases (and the measures available to follow the guidance seem to be somewhat patchy).
He is talking about something that was going to be implemented in the future, not on the 11th of March.
In two weeks they had the volunteer recruitment up and running, resilience hubs collating lists for additional social care support, and one week after that they sent out the letters.
How fast do you imagine it is possible to do this stuff ?
In the world of the Spanish flu (a much less mobile world) the global estimates are about a quarter of the population was infected over a three year period and up to 20% of them died. In our much more mobile, economically integrated, world, I'd be surprised if a quarter were nearly enough.
The world may have been less mobile generally, but there was a huge movement of people surrounding the return of the men from fighting in Europe.
He is talking about something that was going to be implemented in the future, not on the 11th of March.
He's talking about something to be implemented outside a lockdown - in the event its clear (given that he also mentions training up people over the Easter holidays) that they assumed the spread thus far would be much slower than it was.
As it is some people have yet to receive their letters, and others got them prior to any measures local to them and panicked as a result.
My understanding was that we did have containment - those people returning from Wuhan who spent fourteen days in a hospital in Liverpool, similar for the returnees from the Diamond whatsit cruise ship, anyone identified as having been in contact with the virus.
Our lack of testing and skiing holidays in Italy over the half term holiday put paid to that, because we were beyond containment two weeks after that half term holiday - too many people bringing the virus in and untrackable without the testing we had. That's when we hit the limbo and the realisation we had uncontainable spread in the community.
I was youth working until 16 March, when the announcement about shutting down after school clubs was made. We, the after school club, were expecting to be shut down any time for a couple of weeks before and I had suggested we stopped running Guides a couple of weeks before as we had girls from 5 primary schools and 3 secondary schools, which seemed to be a good way of spreading anything from the returning skiers and/or parents commuting to London far and wide. Schools didn't shut for another week, but we knew at the time it was only time before that happened. (I went into 2 weeks isolation on 18 March due to suspected symptoms, so it was in the community then.)
He is talking about something that was going to be implemented in the future, not on the 11th of March.
He's talking about something to be implemented outside a lockdown - in the event its clear (given that he also mentions training up people over the Easter holidays) that they assumed the spread thus far would be much slower than it was.
As it is some people have yet to receive their letters, and others got them prior to any measures local to them and panicked as a result.
And if we have a shortage ? (Which we clearly do.)
I know the NHS is resource starved, and the government hasn’t stockpiled effectively, I am just not clear what you think care homes should be advised other than isolation, restricted visits etc.
He is talking about something that was going to be implemented in the future, not on the 11th of March.
He's talking about something to be implemented outside a lockdown - in the event its clear (given that he also mentions training up people over the Easter holidays) that they assumed the spread thus far would be much slower than it was.
As it is some people have yet to receive their letters, and others got them prior to any measures local to them and panicked as a result.
You can’t repair 10 years worth of underfunding and a lack of PPE globally, when you haven’t stockpiled, in a month.
Of course you can't -- but I'd argue that if they had confidence that they had funded the health service adequately they should be held to that conviction (and so should their supporters).
Given our resources are shit, what is it you think they should advise care homes to do ?
I have no idea what they should do, because obviously if you want to 'cocoon' people in care homes you wouldn't start from here.
I think the whole point about crises is that one never wants to start at all, let alone from "here".
With hindsight, failing to provide lots more health service funding seems criminal, but how politically acceptable would huge amounts of relatively under-used hospital beds have been? People would have been up in arms about government white elephants. And even if there'd been more funding, there's no guarantee that the specific needs generated by this disease would have been addressed.
I'm a big fan of public health in general and amazed that governments don't usually spend more on it than they do if only because of the economic costs in the long run of not doing so (as we now see...), but again, I don't think all the mishandling is down to party politics.
Well, I'm not an epidemiologist. And, even if I was there isn't the data needed to quantify how contagious this coronavirus is relative to measles. In the absence of contrary data, it doesn't seem too far fetched to assume that it's as contagious as measles.
The things I've read (if memory serves) suggest it doesn't aerosolise and linger in the air like measles or smallpox and suggested herd immunity levels around the 60-80% mark but obviously it's very much up in the air.
Your memory serves you wrong.
WHO suggests the virus can survive airborne for hours in the right conditions. And it makes sense. If fog, which is water droplets, can remain airborne then the virus, whose vector is water, can as well. As long as the water is there, the virus lives.
Of course you can't -- but I'd argue that if they had confidence that they had funded the health service adequately they should be held to that conviction (and so should their supporters).
The problem is that we’ve suddenly been hit by a once-in-half-a-dozen-lifetimes pandemic that nobody had foreseen and that very very few countries have proved able to manage at all well. Of course the NHS wasn’t funded enough to be able to instantly cope with such an event - you simply can’t manage public policy on the assumption that such a thing is going to happen soon.
It’s the equivalent of those people who complain about the lack of snowploughs In the UK when it snows enough to disrupt travel, when anybody can see that spending all that money just to have them sitting in sheds for the other 90% of the time would be a ridiculous waste.
Of course you can't -- but I'd argue that if they had confidence that they had funded the health service adequately they should be held to that conviction (and so should their supporters).
The problem is that we’ve suddenly been hit by a once-in-half-a-dozen-lifetimes pandemic that nobody had foreseen and that very very few countries have proved able to manage at all well. Of course the NHS wasn’t funded enough to be able to instantly cope with such an event - you simply can’t manage public policy on the assumption that such a thing is going to happen soon.
It’s the equivalent of those people who complain about the lack of snowploughs in the UK when it snows enough to disrupt travel, when anybody can see that spending all that money just to have them sitting in sheds for the other 90% of the time would be a ridiculous waste.
Yes. It looks as though the whole world has been wrong-footed by this bloody plague, so it's not surprising that actions, and reactions, have been a bit chaotic...
Of course you can't -- but I'd argue that if they had confidence that they had funded the health service adequately they should be held to that conviction (and so should their supporters).
The problem is that we’ve suddenly been hit by a once-in-half-a-dozen-lifetimes pandemic that nobody had foreseen and that very very few countries have proved able to manage at all well. Of course the NHS wasn’t funded enough to be able to instantly cope with such an event - you simply can’t manage public policy on the assumption that such a thing is going to happen soon.
So compare responses against that adopted by health services across the rest of Europe and the ensuing outcomes.
Donald McAskill, chief exec of Scottish Care has been on BBC Radio Scotland saying that he has been told that PPE suppliers based in England, who usually supply UK-wide, are now prioritising England.
Can this be true? Or is it just that the shortages are more severe in England, and the need greater there?
I think the whole point about crises is that one never wants to start at all, let alone from "here".
With hindsight, failing to provide lots more health service funding seems criminal, but how politically acceptable would huge amounts of relatively under-used hospital beds have been?
It is possible to do a comparison of the amount of surge capacity in the NHS vs health services elsewhere. Similarly - as per a previous post - it is instructive to see the progress made in countries where neo-liberalism hasn't eroded away the ability of the state to act.
Of course you can't -- but I'd argue that if they had confidence that they had funded the health service adequately they should be held to that conviction (and so should their supporters).
The problem is that we’ve suddenly been hit by a once-in-half-a-dozen-lifetimes pandemic that nobody had foreseen and that very very few countries have proved able to manage at all well. Of course the NHS wasn’t funded enough to be able to instantly cope with such an event - you simply can’t manage public policy on the assumption that such a thing is going to happen soon.
So compare responses against that adopted by health services across the rest of Europe and the ensuing outcomes.
I thought that some health professionals had viewed SARS and Ebola with deep suspicion, and had made provisions. However, the team I was thinking of, formed under Obama, was cancelled by Trump. Europe, I don't know.
So compare responses against that adopted by health services across the rest of Europe and the ensuing outcomes.
I think it's far, far, far too soon to be doing that. It's (relatively) easy to compare numbers of per capita deaths from covid-19 between one country and another, far harder to determine what overall excess mortality there might be factoring in the results of bringing the economy to a grinding halt for months, let alone other wellbeing considerations.
I think the whole point about crises is that one never wants to start at all, let alone from "here".
With hindsight, failing to provide lots more health service funding seems criminal, but how politically acceptable would huge amounts of relatively under-used hospital beds have been?
It is possible to do a comparison of the amount of surge capacity in the NHS vs health services elsewhere. Similarly - as per a previous post - it is instructive to see the progress made in countries where neo-liberalism hasn't eroded away the ability of the state to act.
What about the use of testing and tracing, why does this vary so much?
Of course you can't -- but I'd argue that if they had confidence that they had funded the health service adequately they should be held to that conviction (and so should their supporters).
The problem is that we’ve suddenly been hit by a once-in-half-a-dozen-lifetimes pandemic that nobody had foreseen and that very very few countries have proved able to manage at all well. Of course the NHS wasn’t funded enough to be able to instantly cope with such an event - you simply can’t manage public policy on the assumption that such a thing is going to happen soon.
Some of the people who have died lived through the Spanish flu. Even if by 'lifetime' you mean 'generation', the Spanish flu is only three or four generations back.
When you say nobody had foreseen the pandemic, you mean nobody had looked at the four or five near-miss pandemics in the last twenty years and thought they should plan for the contingency? They did a drill. They had a stockpile.
When you say very few countries have managed it at all well, that's true but the UK is handling it worse than most countries with comparably developed economies. The only one that's doing significantly worse is the US and that's being run by a sociopathic ignoramus (who jettisoned their contingency plan in case of a pandemic that nobody had foreseen).
The problem is that we’ve suddenly been hit by a once-in-half-a-dozen-lifetimes pandemic that nobody had foreseen and that very very few countries have proved able to manage at all well.
This is false. Quite a lot of people foresaw the possibility of a global pandemic. Even moreso recently, since the 2002-2004 SARS outbreak was an event where the world narrowly avoided a situation much like the current one.
BTW, a human lifetime is ~75 years, so I dispute your claim that the world hasn't seen a pandemic like this for 450 years, given that the Spanish Flu was about a century ago. Did you maybe mean once-in-half-a-dozen-generations? Generation ≠ lifetime.
It’s the equivalent of those people who complain about the lack of snowploughs In the UK when it snows enough to disrupt travel, when anybody can see that spending all that money just to have them sitting in sheds for the other 90% of the time would be a ridiculous waste.
Depends on what kind of waste you consider "ridiculous", I suppose. For example, all passenger airports in the U.S. are required to have a fire fighting unit on site. Some might consider this "a ridiculous waste" given that the overwhelming majority of passenger planes do not burst into flames on take off or landing. Others might look at the potential for massive property damage and loss of life, coupled with the access restrictions on most airports and the specialized training and equipment needed to fight an aviation fuel fire, and consider the precautionary expense justified. I'd suggest that a lethal pandemic is more akin to an airport fire than the "dangers" of people having to shelter in place (gasp! horrors!) because of an exceptionally heavy snowfall.
Of course you can't -- but I'd argue that if they had confidence that they had funded the health service adequately they should be held to that conviction (and so should their supporters).
The problem is that we’ve suddenly been hit by a once-in-half-a-dozen-lifetimes pandemic that nobody had foreseen and that very very few countries have proved able to manage at all well. Of course the NHS wasn’t funded enough to be able to instantly cope with such an event - you simply can’t manage public policy on the assumption that such a thing is going to happen soon.
It’s the equivalent of those people who complain about the lack of snowploughs In the UK when it snows enough to disrupt travel, when anybody can see that spending all that money just to have them sitting in sheds for the other 90% of the time would be a ridiculous waste.
Yeah, but no. The pandemic MIGHT be once in a lifetime, but it did not come from nowhere. There have been warnings and pandemics are not something one should wait for to happen to begin preparations. Governments should have been better prepared and reacted more quickly and more cohesively than most did. They were warned, they ignored the warnings
And having preparations for any intermittent probable is not wasteful. Planning for every possible event is not practicable, but planning for likely events is responsible. Governments do acceptable loss calculations and, unfortunately, that is reasonable.* But having stored materials for intermittent events is responsible, not wasteful. Especially for materials that cannot be produced on demand.
I think the whole point about crises is that one never wants to start at all, let alone from "here".
With hindsight, failing to provide lots more health service funding seems criminal, but how politically acceptable would huge amounts of relatively under-used hospital beds have been?
It is possible to do a comparison of the amount of surge capacity in the NHS vs health services elsewhere. Similarly - as per a previous post - it is instructive to see the progress made in countries where neo-liberalism hasn't eroded away the ability of the state to act.
I completely agree with you about that, and that given people were warning about deficiencies in the pandemic preparedness in 2017 things should have been done.
Where I disagree, is in asserting *current* policy decisions (by which I mean decisions made in 2020), about the use of the resources we have *now* based on the models we had and have changed with new data, are being made owing to some sociopathic disregard for whether or not large numbers of people die. (Arguably, you could make that argument about Trump as opposed to lots of othe US officials busting a gut to protect their people.)
Whereas what you are posting about care homes appears to suggest if might be better, if, for example we closed them down and boarded one elderly inform person with any family with a spare room. That is a policy that would be different, but I suspect much worse in term of their chances of survival.
While I cannot speak for any other government, I can say I do not think the United States government has acted in good faith. Examples
Within three months of taking office, Trump cancels the Executive Orders Obama had instituted that would have insured nursing homes be healthier environments.
The Administration disbanded the Pandemic Panel that had been set up in Homeland Security in 2018.
It reduced CDC staffing by a third over the last three years.
It cancelled the contract that would have kept the ventilators that the United States had in its national stockpile maintained and functional.
It ignored warnings by its own advisors that such a pandemic would be disastrous.
It told the governors they were on their own when it came to getting needed medical supplies AND it continues to refuse to become the "procurement agent" for those supplies.
Even as the pandemic was just beginning to take hold, 45 spent time on the golf course and telling the American people it would be a little inconvenient that would be all over by springtime.
In his daily "briefings." 45 admits that he is more concerned about his "ratings" than fighting the disease.
And, now that Fauci has admitted if the government had acted quicker, it could have saved lives. And, now, 45 is threatening to fire Fauci because he made 45 look bad.
I could go on, but the point is, 45 was not acting in good faith or in the country's best interest. He only thinks for himself.
This came up in the US, when the Trump advisor Navarro argued that nobody could predict pandemics. He specifically challenged the show 60 Minutes to show him where they had. So they played excerpts from 2005, avaian flu, and 2009, swine flu, where pandemics were predicted, incidentally by Fauci in 2005. Of course, this is the US, but "nobody had foreseen" is pushing it. If European epidemiologists ignored swine flu, and avian flu, WTF?
Comments
The things I've read (if memory serves) suggest it doesn't aerosolise and linger in the air like measles or smallpox and suggested herd immunity levels around the 60-80% mark but obviously it's very much up in the air.
There was a rapid move from the original containment strategy to lockdown. I think the publication/greater circulation of the dire predictions of the Imperial College report might have accelerated that move (which was forecast in the original containment strategy). Does that justify the label U-turn? Probably. That's true. The moral and ethical question is "yes but how".
Eutychus, I don't think the political policy was herd immunity in the original Dominic Cummings sense (laissez-faire). It looks to me that it moved from pure laissez-faire to "a bit of that for a while, but modified by containment", with the backing of Witty and Vallance representing "the best scientific advice". It ceased to be "the best scientific advice" within a few days. What was really going on? Did Witty and Vallance think the Imperial College model was OTT? What changed their minds? Was it the rapidly moving statistics, producing the dawning realisation that the model might not be the "worst case scenario"? Or the realisation that once that model was out in the open, the original containment policy could not be sustained politically?
To answer that question, we would need to know the inner thoughts of Witty and Vallance as well as those of the Prime Minister. I can certainly imagine Matt Hancock saying that if the model was anywhere near right, modified laissez-faire would not just kill very large numbers of people, it would both kill the NHS and kill the political credibility of the Tories for years. So I wouldn't be in the least surprised if the political opinion switched very rapidly away from modified laissez-faire. As seems to be supported by the report of Cummings change of mind.
Yes. In the world of the Spanish flu (a much less mobile world) the global estimates are about a quarter of the population was infected over a three year period and up to 20% of them died. In our much more mobile, economically integrated, world, I'd be surprised if a quarter were nearly enough.
We not only need an effective vaccine, we need a lot of it. And hope that this virus doesn't mutate out of range of the vaccine whilst still retaining its present ability to create extended sickness and death.
It is, literally, a hell of a challenge.
The Devil's Alternative. I feel we're all truly complicit in this. Everyone acted in good faith. Wrongly as it turns out. We have never been here before. And we will learn by surviving the suffering of our victims. There is no other way it seems.
[citation needed]
We have a government in office that is a living, breathing (with some difficulty in the PM's case) example of bad faith.
I imagine they go instinctively to more private sector solutions and less state intervention - but I also suspect they are desperate to make whatever protective strategy work and for the whole of society not fall over and not to have to order the army to dig mass graves in the public parks.
Also, the masks people routinely wear in Asia are not the same standard as those needed by our health and care professionals. At least in Japan the masks you can buy in convenience stores are very flimsy and not close fitting, they're worn for cosmetic and psychological reasons - it's a fashion item and creates a social "leave me alone" signal that many find vital when they live in high population density cities where there's no way to maintain actual personal space in public.
But will they prioritize the economy? In some ways, they have to, but will Tories extra prioritize it? See Peter Hitchens, et al.
So where's the containment? Because it seems to have disappeared to the same place as the notion of 'cocooning' (which I presume must involve something other than letting things rip through care homes).
I think there are enough market fundamentalists in the government that they were of the opinion that they could contract out anything necessary and rely on subtle messaging to change behaviour (epitomised by the behavioural team coming to prominence) -- so in this case political fundamentalism ended up circumscribing the set of possible policy responses at a time when big state solutions early were what was called for.
The headline policies since then, while eye catching, have mostly been around preserving existing power relationships.
Explain to me how you stop “letting things rip through care homes” ?
When the word was first being used there was nothing in place to achieve this.
As someone who received a shielding letter, that has not been my experience.
The shielding letters postdated the 11th of March Halpern interview.
Please, will some grownup back in DC decide this is the time to announce that T has been so overwhelmed with worry and responsibility that he's slipped a few gears, and needs to rest for a few weeks? And then firmly escort him to an undisclosed location where he can do that?
Thx.
Here is a March 12 link. In the video link towards the bottom, Patrick Vallance's comments over about a four minute period, in conjunction with the other information in the BBC article, seem pretty well to summarise the policy and understanding at the time. It didn't stand the test of time for very long. It's also a pretty good example of how he (and Chris Witty) spoke as scientists supporting the policy. He doesn't look like a pressed man, rather more like someone who believes what he is saying.
I think epidemiologically at a population level there’s little or no significant benefit from the widespread use of face masks.
As far as containment is concerned it only works when you’ve got a limited number of cases with a reasonable chance of tracing contacts. If infection is more widespread then the assumption is that the virus is present at large in the community and containment ceases to be a viable strategy. Here’s a report in the Independent.
Isn’t this what in fact happened, it is mid April and we haven’t hit peak yet - delay strategies are pushing the peak later toward the summer.
That at the point the strategy was announced there was nothing to achieve it - the shielding letters were still several weeks away in many cases (and the measures available to follow the guidance seem to be somewhat patchy).
That the government is Evil and anything they do or say must perforce be Evil as well.
He is talking about something that was going to be implemented in the future, not on the 11th of March.
In two weeks they had the volunteer recruitment up and running, resilience hubs collating lists for additional social care support, and one week after that they sent out the letters.
How fast do you imagine it is possible to do this stuff ?
The world may have been less mobile generally, but there was a huge movement of people surrounding the return of the men from fighting in Europe.
He's talking about something to be implemented outside a lockdown - in the event its clear (given that he also mentions training up people over the Easter holidays) that they assumed the spread thus far would be much slower than it was.
As it is some people have yet to receive their letters, and others got them prior to any measures local to them and panicked as a result.
Provision of PPE would be a start.
Our lack of testing and skiing holidays in Italy over the half term holiday put paid to that, because we were beyond containment two weeks after that half term holiday - too many people bringing the virus in and untrackable without the testing we had. That's when we hit the limbo and the realisation we had uncontainable spread in the community.
I was youth working until 16 March, when the announcement about shutting down after school clubs was made. We, the after school club, were expecting to be shut down any time for a couple of weeks before and I had suggested we stopped running Guides a couple of weeks before as we had girls from 5 primary schools and 3 secondary schools, which seemed to be a good way of spreading anything from the returning skiers and/or parents commuting to London far and wide. Schools didn't shut for another week, but we knew at the time it was only time before that happened. (I went into 2 weeks isolation on 18 March due to suspected symptoms, so it was in the community then.)
And if we have a shortage ? (Which we clearly do.)
I know the NHS is resource starved, and the government hasn’t stockpiled effectively, I am just not clear what you think care homes should be advised other than isolation, restricted visits etc.
Well, they've had a month to prepare for the strategy, haven't they?
Given our resources are shit, what is it you think they should advise care homes to do ?
Of course you can't -- but I'd argue that if they had confidence that they had funded the health service adequately they should be held to that conviction (and so should their supporters).
I have no idea what they should do, because obviously if you want to 'cocoon' people in care homes you wouldn't start from here.
With hindsight, failing to provide lots more health service funding seems criminal, but how politically acceptable would huge amounts of relatively under-used hospital beds have been? People would have been up in arms about government white elephants. And even if there'd been more funding, there's no guarantee that the specific needs generated by this disease would have been addressed.
I'm a big fan of public health in general and amazed that governments don't usually spend more on it than they do if only because of the economic costs in the long run of not doing so (as we now see...), but again, I don't think all the mishandling is down to party politics.
WHO suggests the virus can survive airborne for hours in the right conditions. And it makes sense. If fog, which is water droplets, can remain airborne then the virus, whose vector is water, can as well. As long as the water is there, the virus lives.
The problem is that we’ve suddenly been hit by a once-in-half-a-dozen-lifetimes pandemic that nobody had foreseen and that very very few countries have proved able to manage at all well. Of course the NHS wasn’t funded enough to be able to instantly cope with such an event - you simply can’t manage public policy on the assumption that such a thing is going to happen soon.
It’s the equivalent of those people who complain about the lack of snowploughs In the UK when it snows enough to disrupt travel, when anybody can see that spending all that money just to have them sitting in sheds for the other 90% of the time would be a ridiculous waste.
Yes. It looks as though the whole world has been wrong-footed by this bloody plague, so it's not surprising that actions, and reactions, have been a bit chaotic...
So compare responses against that adopted by health services across the rest of Europe and the ensuing outcomes.
Can this be true? Or is it just that the shortages are more severe in England, and the need greater there?
It is possible to do a comparison of the amount of surge capacity in the NHS vs health services elsewhere. Similarly - as per a previous post - it is instructive to see the progress made in countries where neo-liberalism hasn't eroded away the ability of the state to act.
I thought that some health professionals had viewed SARS and Ebola with deep suspicion, and had made provisions. However, the team I was thinking of, formed under Obama, was cancelled by Trump. Europe, I don't know.
What about the use of testing and tracing, why does this vary so much?
When you say nobody had foreseen the pandemic, you mean nobody had looked at the four or five near-miss pandemics in the last twenty years and thought they should plan for the contingency?
They did a drill.
They had a stockpile.
When you say very few countries have managed it at all well, that's true but the UK is handling it worse than most countries with comparably developed economies. The only one that's doing significantly worse is the US and that's being run by a sociopathic ignoramus (who jettisoned their contingency plan in case of a pandemic that nobody had foreseen).
This is false. Quite a lot of people foresaw the possibility of a global pandemic. Even moreso recently, since the 2002-2004 SARS outbreak was an event where the world narrowly avoided a situation much like the current one.
BTW, a human lifetime is ~75 years, so I dispute your claim that the world hasn't seen a pandemic like this for 450 years, given that the Spanish Flu was about a century ago. Did you maybe mean once-in-half-a-dozen-generations? Generation ≠ lifetime.
Depends on what kind of waste you consider "ridiculous", I suppose. For example, all passenger airports in the U.S. are required to have a fire fighting unit on site. Some might consider this "a ridiculous waste" given that the overwhelming majority of passenger planes do not burst into flames on take off or landing. Others might look at the potential for massive property damage and loss of life, coupled with the access restrictions on most airports and the specialized training and equipment needed to fight an aviation fuel fire, and consider the precautionary expense justified. I'd suggest that a lethal pandemic is more akin to an airport fire than the "dangers" of people having to shelter in place (gasp! horrors!) because of an exceptionally heavy snowfall.
And having preparations for any intermittent probable is not wasteful. Planning for every possible event is not practicable, but planning for likely events is responsible. Governments do acceptable loss calculations and, unfortunately, that is reasonable.* But having stored materials for intermittent events is responsible, not wasteful. Especially for materials that cannot be produced on demand.
I completely agree with you about that, and that given people were warning about deficiencies in the pandemic preparedness in 2017 things should have been done.
Where I disagree, is in asserting *current* policy decisions (by which I mean decisions made in 2020), about the use of the resources we have *now* based on the models we had and have changed with new data, are being made owing to some sociopathic disregard for whether or not large numbers of people die. (Arguably, you could make that argument about Trump as opposed to lots of othe US officials busting a gut to protect their people.)
Whereas what you are posting about care homes appears to suggest if might be better, if, for example we closed them down and boarded one elderly inform person with any family with a spare room. That is a policy that would be different, but I suspect much worse in term of their chances of survival.
Within three months of taking office, Trump cancels the Executive Orders Obama had instituted that would have insured nursing homes be healthier environments.
The Administration disbanded the Pandemic Panel that had been set up in Homeland Security in 2018.
It reduced CDC staffing by a third over the last three years.
It cancelled the contract that would have kept the ventilators that the United States had in its national stockpile maintained and functional.
It ignored warnings by its own advisors that such a pandemic would be disastrous.
It told the governors they were on their own when it came to getting needed medical supplies AND it continues to refuse to become the "procurement agent" for those supplies.
Even as the pandemic was just beginning to take hold, 45 spent time on the golf course and telling the American people it would be a little inconvenient that would be all over by springtime.
In his daily "briefings." 45 admits that he is more concerned about his "ratings" than fighting the disease.
And, now that Fauci has admitted if the government had acted quicker, it could have saved lives. And, now, 45 is threatening to fire Fauci because he made 45 look bad.
I could go on, but the point is, 45 was not acting in good faith or in the country's best interest. He only thinks for himself.