Their reasoning is that if the only things you can do are China-style lockdown or nothing, then the disease will just resume exponentially growing the second lockdown ends, so it's pointless to do it at all.
While that may be technically right (under some optimistic, unverified assumptions, e.g. no reinfection), it's a false dichotomy. Singapore, Hong Kong, and South Korea aren't under lockdown, they're stopping the spread by just having good testing and case tracking capacity, and good hygiene. And the longer things go on, the better they're getting at doing that. If things are getting out of hand, a temporary lockdown is effective (as it was in China), to get the numbers down while building up this kind of capacity. But lockdown doesn't have to last forever; China has already lifted restrictions in most cities.
The UK seems to be ignoring this, and I don't understand why. I suspect the real logic, as some government officials have outright said, is that a completely failed response would free up money for the NHS by killing off "bed blockers".
The social signalling around it is "prudent caution", in the sense that they are talking slowly and confidently while using big words. This gives some people the gut feeling that this must be the "rational" thing to do, but it's just window dressing. The plan is neither prudent nor cautious; it's recklessly endangering millions of lives. Experts in the UK are horrified; there's an hours-old petition against this with hundreds of academics already signed on [0]. The WHO has condemned it, and half the people I know studying abroad in the UK have fled the country over it.
Their reasoning is that if the only things you can do are China-style lockdown or nothing, then the disease will just resume exponentially growing the second lockdown ends, so it's pointless to do it at all.
No, that is almost entirely wrong.
You can certainly disagree with their position but you should at least present it accurately. Their position is that this is a pandemic (i.e. spread too widely to eradicate this year), we have moved from the contain phase to the delay phase, and their plan is to gradually introduce measures up to full quarantine rather than jumping to lockdowns straight away. For example here are the measures planned in coming weeks:
If they manage to flatten the curve by timing measures, and if there is a second outbreak this winter, it may well save lives. The Chief Scientific Adviser and other experts are not horrified, they came up with the plan and are defending it, so no, ‘experts’ are not horrified, though some disagree (which is fine).
I’d be more worried living in the US right now given the mixture of denial and bluster which has been the response so far.
Europe right now shows the full spectrum of possible solutions. It is not as if draconian lockdowns are the only alternative. Look at Germany, for example. They've been using testing quite effectively and are also looking at primarily isolating vulnerable people.
It will take some time before we know more about how successful these strategies are. Different countries are at different phases in the infection spread which makes comparisons unfair.
If anything, the politically easy decision would be the lockdowns which shows voters strong leaders capable of "doing something" (even if the value of this "something" is at best unclear).
Germany doesn't test well at all.
My wife's school in Berlin has been closed since Thursday because of a positive parent who partied in a club the same night as over 16 now infected persons.
Teachers are still waiting for test results and are supposed yo come back to work on Monday.
I can't really explain why there are so few casualties yet in Germany, but I think it's because many young and healthy people got infected (that's the case in Berlin, for instance), so hospitals aren't yet saturated.
I hope it stays that way, but I think we can expect much more deaths in the next days.
Europe is a chaotic mess. Germany is preventing exports of urgently needed masks and other medical supplies to Switzerland and Austria, Austria announced that no curfews were coming yesterday and today Tirol is under curfew and harsh curfew-like restrictions will be in place from Monday in all of Austria. I'm not really sure what the strategy is, the WHO recommendations after their China mission have been known for 3 weeks and there is no recommended middle ground.
Germany is doing pretty well at just 9 deaths on 4.5k cases. The WHO is not the only or the best source of recommendations, nor is this over in China. I'd be very surprised if they don't see another outbreak there now that this is a pandemic it will spread to Africa for example, which has a huge no of Chinese working there who will bring it back.
I'm not sure german successses are anything to do with action on the part of the government. I've been consistently surprised by the abrupt reversals in policy - with border controls or school closures going from 'out of the question' to 'tomorrow' with very little time elapsed.
I think much of Europe is a little bit like this. Germany will probably be relatively well off because German culture is fairly anti-social, Germans are typically very healthy, and the healthcare system is somewhat robust.
However, I haven't seen any sign whatsoever of a consistent or coherent response to the coronavirus. I expect whatever response eventually percolates out will be fairly rational, since german civil servants are well-paid and competent, but so far, it's been all over the place.
Growth in Germany is exponential. It doesn't matter how many people they manage to test if they are still going to wait and see before taking measures to reduce the infection rate.
It's worrying that the US might be doing the same thing but without openly saying it. Little is being done here about the virus. Most people can't get tested. The Senate took a vacation. The Republican Party doesn't want older and unhealthy people depending on social programs. Pray the virus away. Suffering will bring people to God.
"I think it is very beautiful for the poor to accept their lot, to share it with the passion of Christ. I think the world is being much helped by the suffering of the poor people." --Mother Teresa
This is how some people think. It seems like there are no serious people in charge. It's going to be a catastrophe like we have never experienced.
The problem with this reasoning is that your measure is not a direct measure of infection rates. For South Korea, they tested a large number initially, and now fewer. We don’t know if it’s actually under control without more systematic testing and therefore data on infection rates.
The other issue is that of getting the leak at the wrong time. If the UK manages to partly control it, but then realises containment will fail in say November, the peak will occur at the worst possible time in winter.
By controlling the spread and aiming for summer, best medical care can be achieved given limited resources.
This logic is not true for equatorial countries such as Singapore due a lessened seasonal effect, so they should continue with their current Methodology. I suspect others will move to the UK approach once initial social distancing process inadequate (assuming they are that is).
> Singapore, Hong Kong, and South Korea aren't under lockdown, they're stopping the spread by just having good testing and case tracking capacity, and good hygiene.
You forgot Taiwan, who is faring much better than all three of the countries you mentioned.
And they did it all without closing their airports!
What mostly helped was lack of mainland Chinese people entering the country. Also Taiwanese wear their face masks religiously and are used to obeying the rules set by the government.
Finally (AFAIK) they have a very good health care system which handled the cases quickly and efficiently.
They instituted a 14-day quarantine for travellers from mainland China on the 24th of February and soon after for Korea, Italy and Iran. These were all already in place while other countries were pretending everything was OK and advising people arriving from Italy to go to work.
>What mostly helped was lack of mainland Chinese people entering the country
If the whole world closed their borders to China back in early Jan (and followed up with tracing and quarantine), we would be seeing this right now. Unfortunately, China was lobbying heavily against it.
Now China, being a massive exporter, has a global demand problem in addition to the local supply problem of shutting down their country for 8 weeks.
face masks don't help unless you've got covid19 and are using it to prevent spreading. If you have flu like symptoms you should be staying home anyway.
I wonder if this is in fact working - Not so much to protect oneself from getting it, but preventing the no-symptom/mild symptom carriers from spreading to others.
please distinguish between surgical masks and N95 masks.
N95 masks, fitted properly, do help prevent catching the virus. For a mask to be called N95 it has to be approved by the CDC. It’s specifically designed to block >95% of airborne particles. That’s why they’re recommended for caretakers at hospitals and frontline workers dealing with infected patients. Replaced every ~3 hours and worn in combination with goggles and ear protection, they minimize the risk of infection through mucosal membranes. They have also been in short supply.
Surgical masks do not prevent catching the virus, but they help sick people not to spread it due to the mask catching some of the spray droplets when they cough / sneeze
> Surgical masks do not prevent catching the virus, but they help sick people not to spread it due to the mask catching some of the spray droplets when they cough / sneeze
That's not true at all. There is a reason why surgical masks are used by surgeons, but for the protection level needed by medical professionals, it is used as a part of a wider system.
Used casually it prevents much of the droplets in the air from entering your respiratory system, as well as preventing a lot of touching of the face. There are studies that indicate wearing a mask decreases virus respiratory several-fold.
All the health experts I’ve heard from (and two of my immediate family members work at hospitals) have said that surgical masks do not prevent catching infections. You breathe by suction. Your diaphragm create a pressure difference by increasing the volume of the thorax and the air rushes into your lungs to compensate.
The reason the N95 filters work is because when the air is sucked in, it must pass through the filter before entering your respiratory system, and that filter is designed to filter >95% of airborne particles (and often times even higher). For the surgical masks, the air just gets sucked in from the side, the path of least resistance. So the airborne particles would also just get sucked in from the side. The masks may cause changes in behavior that lead to lower infection probability (such as reminding you not to touch your face), but dipping your hand in glitter would be just as effective.
Given the incubation period is > 14 days, and more than just a few of the patients don't show symptoms at all, you'd be spreading the virus before you know it without a face mask.
Taiwan's extremely successful strategy combines thorough testing and tracing with other measures to slow down the spread, much like what the WHO is recommending but no one else seems to be doing.
Very early on they instituted a 14-day quarantine period for anyone arriving from mainland China (later expanding this to Hong Kong and Macau), Korea, Italy and Iran. As of today, this now applies to the entire Schengen area (i.e., most of the EU).
The government has also taken over mask production (increasing capacity) and distribution (with a rationing system and an online map of where they can be bought).
Their website is very informative, with very transparent information about how many have been tested, confirmed, recovered, etc.: https://www.cdc.gov.tw/En
THe strategy in Asia seems to keep the virus under control but people in those countries are much more disciplined than European, not sure the measures they take would be as much effective in Europe.
The strategy of UK seems valid as long as you protect the more vulnerable, which they don't do.
What is the strategy after a lock down? You go back to work? It needs only one person infected to get the virus propagating again...
> The strategy of UK seems valid as long as you protect the more vulnerable, which they don't do.
The UK and devolved governments signaled on Thursday that the plan is for the vulnerable to be self-isolating for a long period; and based on the briefings to UK jornos on twitter - it'll be 16 weeks of self isolation for over 70s and those with underlying health conditions (they've not said what conditions yet) - I've seen it referred to as 'cocooning' by some.
I think the UK was doing a really good job, and has been doing a good job with this - I do think they've really misspoken when they've talked about herd immunity and have been trying to walk the term back.
You've got to bare in mind, that they aren't doing the politically easy things here. It would be easy to close the schools. Based on people I've spoken to, its going to happen soon - but I suspect they want this to happen after the over 70s and the vulnerables are into self-isolationg, and not shouldering childcare responsibilities. None of this is easy, we can't magic this virus away.
I think there's a lot behavioural science going on with the strategy here as well. A lot of the UK public now seem to realise this is serious and have automatically changed behaviour without government mandating it. Long term, that's a big win, people are bought in (seemingly) of their own volition and there is huge value in that.
The schools issue is very tricky as a lot of NHS staff will not be able to work if their children need to stay home. I can see them going to a softly, softly approach - parents working from home will be able to keep kids out of school with no consequence and they will probably extend all the school holidays a bit as well.
I can't believe this government wants to kill off the elderly out of choice, it forms a good section of their voter base, if nothing else.
I think overall it's good long term strategy, though very risky, which is never going to be perfect, but seems to have a lot of science and rationale behind it, even if not obvious at first.
>A lot of the UK public now seem to realise this is serious and have automatically changed behaviour without government mandating it.
I had no choice but go out and to do my weekly food shopping yesterday. This was definitely not what I experienced at all. Families crowding out in the supermarket with small children and grandparents abound. People coughing openly, not maintaining distance and so on.
People still have no sense of urgency to change their behaviour, and this is the critical time that we need to mobilise. Any success would be down to pure luck rather than their strategy.
To be fair, if all the "take it seriously people" stay at home as much as possible, you'll be far less likely to encounter them and 90% of the people you'll encounter in public are the people who don't change their behaviour.
If that's the case, I would also encounter a lot less people than usual in my weekly food shoping. That didn't happen. There's no need to bring all out your extended family out to Waitrose, Tesco or Costco. People are still doing it, nothing's changed.
I'm not sure how people will react by say, week 4 of isolation. I've been cooped up indoors for a week and it's already taking a toll on my well being.
You will invariably have people breaking quarantine after a few weeks, especially if there is a sense of the threat subsiding.
With entertainment venues being shuttered as “non-essential” at the same time as people are worried about both their health and livelihoods, there’s a very real risk of widespread morale problems as this crisis evolves.
It’s almost Swiftian in its satire... oh wait, they’re serious. Strange that it may be quite a few of their own voters who die. I know Boris idolizes the mayor from Jaws who says the beach is safe to keep businesses open so maybe they are that dumb or maybe they’ll be really lucky. Risking an extra 2% of 50M dead (or even 20% of that) is a big gamble. How many allies died in Normandy? 200k? Hope it’s worth it.
I’m guessing that when things start getting Wuhan level crazy people will isolate anyway and they’ll get the worst of all results.
What better plan for vulnerable people is there than isolating them? You also seem to be under the impression that the plan is for no lockdown. The government has already said that there will be increasingly tight measures over the next few weeks.
I despise the current government, and have no idea if this plan is better than alternatives, but please if you want to criticise it, do so for what it actually is, not a straw man of your own construction.
I truly wish you good luck. Planning for the virus to expand (rapidly) through the younger less vulnerable population to protect businesses and provide herd immunity is what was described. I understand they're trying to walk that back now... good idea!
https://politicshome.com/news/uk/health-and-care/illnesstrea...
The actual plan and how to isolate the almost 20% of the population at high risk is not outlined here or anywhere I've seen. If you know (or anyone in the government knows) what it is, please provide a description or link. I've only seen hope... and undefined "measures".
What could the government realistically do to protect the vulnerable? It's ultimately up to the people to be disciplined and protect vulnerable people. That will only be done by educating the people, which has been done.
I haven't checked too closely, but surely the age distribution of conservative voters is such that if they are so callous as to treat corona as a convenient boomer remover, they torpedo their own re-election chances.
So, _even if_ you ascribe to the current UK government a conspiracy-esque, cold as nails approach to just effectively _murder whole boatloads of older folks_, it doesn't actually make sense: Who would they be so cold as to just casually acquiesce to a solution that results in a lot of death, but they are still human enough to care about the country first and are willing to sacrifice the electoral future of their party?
I'm on 'do not attribute to malice that which can be explained by stupidity', modifying it slightly to 'incompetence'.
You really have to understand that this government hires "superpredictors". It's not malice, it's just incompetence. They're making decisions based on how "truthy" they sound to them.
Replace “boomer remover” with “working-class-boomer remover” and the strategy makes more sense.
Personally, I don’t think Johnson and his cronies are deliberately targeting this or that group. They just don’t care. They are scared like everyone else, and are prioritizing the survival of their immediate circles and their social status - i.e. they keep the economy working, keep an appearance of order, and ensure people they care about are “cocooned”, ready to come out when the worst is over. That is their priority. Working-class lives are not priority, that’s all. Health-service capacity woes are relatively unimportant, because people “who matter” will be prioritized anyway.
If they go to full-lockdown, they risk upsetting the existing social order (economy tanks even harder, unemployed people start rioting, etc). That is their worst fear; consider that we’ve had actual riots in London only a few years ago. Saving a bunch of working-class grandpas is clearly not worth the risk of upsetting the current social order, from Johnson’s position. He’d rather have a functioning elite ruling over rubbles, than risk the very own existence of such elite just to save “nobodies”. Add to it a sprinkle of academic Strangeloves, and there you are.
The Conservative party is fresh off one of the greatest electoral landslides in history, and is 5 years away from the next election. So perhaps they think that people will have come around to their point of view by then? I'm just grasping at straws here, it's almost incomprehensible.
> they're stopping the spread by just having good testing and case tracking capacity, and good hygiene
First, there is the best of them all you forgot to mention, Taiwan.
Second, To sum up the difference as I have posted elsewhere, it comes down to The East willing to do Social Distancing AND Wear Mask. The west simply refuse to wear mask.
HK and SK both have huge amounts of social distancing in effect (notably schools shut down). Singapore is about the only country I'd view as never having used lockdown.
Taiwan did heavy school closures but is now coming back online. Hopefully, things hold up.
Singapore is gradually increasing[1] measures now as more imported cases show up - broader travel restriction, no events of more than 250 people, and enforced WFH, among others.
Wow, that's a cynical view. Is this the backdrop for another push to end Obama-care? As in claiming there's going to be death-councils deciding to lives and who dies?
But, I guess this question is just begging for all of us arm-chair quarterbacks, fear mongers and un-informed to jump in with anecdotes and opinions knowing full well that only time will tell which it is.
Personally, I think only a few things are clear.
1) Our society and government is totally unprepared.
2) This is going to be a bad year financially for most of us and a terrible year for many of the poorer among us. I just hope that we don't end up pushed yet another group into homelessness.
3) It seems like most of us don't know some really basic information about disease - like:
Q: How many died in the 2017-2018 flu season?
A: 61,000 in the US.
Source: https://www.cdc.gov/flu/about/burden/index.html.
And, nope, that's not 61 people, not 610 or not 6100. That's right, the CDC estimates 61,000 people who died in the US alone in 1 year from the flu.
Which left me wondering why hasn't more been done to stop the spread of the flu?
How many have died from Coronavirus? A: 68 as of today in the US. 3,199 in China. 6,515 WorldWide. 3,213 in China, 1,809 in Italy. Source: https://www.worldometers.info/coronavirus/
Time for an anecdote. My wife had a medical emergency about a month ago - before Coronavirus. The emergency room was swamped. Sick people everywhere. Some not too sick. A bunch who were really sick. The nurses were handling out masks to everyone asking them to wear them to avoid making others sick. It was crazy. I had no idea.
Because COVID-19 has a higher infection/transmission rate than the seasonal flu and a higher mortality rate. The economy isn't shutting down because 68 people have died, it's shutting down because 61,000 people died from the flu and COVID-19 has a distinct potential of being significantly worse.
But where is South Korea going with its strategy - are they going to keep doing that forever? And whats China's long term strategy? Wuhan is still locked down.
drawing the infections out so that the hospital system can stay stable and thus minimizing the amount of people who die from the disease. Not to mention that there will likely be a vaccine within 12-24 months and medication approved within the next few months.
Mind you this is in addition to South Korea having ~13 hospital beds per 1000 people, compared to ~8 in Germany and 2.5(!) in the UK. This strategy in the UK to let the virus eat through the population is insane.
Wuhan had the great majority of cases in the entire world. The other provinces of China are more analogous to individual European countries. They locked down for a few weeks and have already come back up.
The long term strategies for Korea and China are the same: carefully identify new cases as they come in from outside, find their contacts, and isolate them as soon as possible. Temporarily lock down small regions on an individual basis if necessary. They've already been doing that with some new cases coming in from Italy.
> Wuhan had the great majority of cases in the entire world.
That was true a day or two ago, but that's a bit outdated now: Wuhan at most has had a bare majority of total cases in the world now, and probably a minority. In any event, it'll be a minority in a few hours.
Yes, but hopefully they'll identify the flare-up much more quickly and be able to contain it with more targeted measures, before things get to the level they reached in Wuhan in late January.
> Their reasoning is that if the only things you can do are China style lockdown or nothing, then the disease will just resume exponentially growing the second lockdown ends, so it's pointless to do it at all.
Before quarantine we had many people infected not knowing they are infected, spreading the virus around.
After a few weeks of quarantine the ones infected will be known and separated from the rest, so the virus should be stopped. That is assuming the quarantine is strict.
Interestingly, to my surprise, social distancing appear more effective than lockdown (in part because full lockdowns are impossible). At least according to this simulation:
The success of Hong Kong and Taiwan look like extensions of the social distancing paradigm to me.
Of course, maybe UK government recognizes that the its citizens are equally incapable of effective social distancing. Whatever the case, this looks like madness.
Indeed, you buy up time to get more medical supplies or figure out more effective treatments. For example, China is now getting over it, but is still producing ridiculous amounts of medical equipment, which will soon get delivered across the world -- even if you must have a peak, you want that peak to be after you get this equipment, not before.
I think the development of a vaccine in a few months is unlikely. I think however the identification of somewhat effective antivirals in a few months is probable. There are already two antiviral candidates in trials, which are simpler to run than vaccine trials: remdesivir and lopinavir+ritonavir. Also, "transmitted immunity" is being (re)developed:
Dead on, the vaccine will just be a novelty, this will be over by then after 70-90% of the population has caught it and is mostly immune to it or dead.
the problem is that because it takes a year or two to get a vaccine out that this will all be over unless it mutates into something completely different.
About those hundreds of academics: about 90% seem to be mathematicians. I checked two at random and none of their top publications were about epidemiology. You can be a scientist, yet know effectively nothing on a specific topic.
In the UK, "maths" is a very broad category. It includes my field of theoretical particle physics, as well as mathematical disease modelling. All of us would be called mathematicians.
Yes, not everybody signing is a specialist in epidemiology, but so what? The point is that a good number are -- there is no clear consensus among UK experts for the UK government's position. And among global experts, there is a clear consensus against their position.
The plan is supposed to be based on science, not politics, yet here you are telling me this isn't the case?
On a more serious note, petitions and other methods by experts to publicly state a position isn't just about influencing government policy. It's also a political tool in the aftermath of failed policy. Just like the current panel of experts is a political tool employed by the government to justify the biases in its policy.
> If you believe nobody credible opposes the UK government, you've been fed a narrative.
That's a complete strawman. You gave a letter signed by a massively padded out list of "academics" (probably intended to scare your average layman) and when pointed out that astronomers and students probably don't have much to offer right now
While that may be technically right (under some optimistic, unverified assumptions, e.g. no reinfection), it's a false dichotomy. Singapore, Hong Kong, and South Korea aren't under lockdown, they're stopping the spread by just having good testing and case tracking capacity, and good hygiene. And the longer things go on, the better they're getting at doing that. If things are getting out of hand, a temporary lockdown is effective (as it was in China), to get the numbers down while building up this kind of capacity. But lockdown doesn't have to last forever; China has already lifted restrictions in most cities.
The UK seems to be ignoring this, and I don't understand why. I suspect the real logic, as some government officials have outright said, is that a completely failed response would free up money for the NHS by killing off "bed blockers".
The social signalling around it is "prudent caution", in the sense that they are talking slowly and confidently while using big words. This gives some people the gut feeling that this must be the "rational" thing to do, but it's just window dressing. The plan is neither prudent nor cautious; it's recklessly endangering millions of lives. Experts in the UK are horrified; there's an hours-old petition against this with hundreds of academics already signed on [0]. The WHO has condemned it, and half the people I know studying abroad in the UK have fled the country over it.
0: http://maths.qmul.ac.uk/~vnicosia/UK_scientists_statement_on...