I was part of a US/UK fellowship exchange program, emphasizing the "special relationship" between the countries. The current cohort has largely fled the UK this week, abandoning their fellowships and their degrees, knowing that this kind of travel ban would soon kick in.
They believe that there are basically two mitigation strategies. One is to have a very drastic early lockdown that shuts down the virus before it spreads widely. The problem with that is, once you lift the lockdown it will simply start all over again. The problem with this is lockdowns are most effective the first time you do them, and then mostly in the first few weeks of the lockdown. Do it too early, and yes it will be very effective in the short term, but later on when cases become much more prevalent the lockdowns will be less effective.
The option they are going for is to start the lockdown a little later in the cycle. The hope is this will make the lockdown more effective at a higher point in the spread. Effectively instead of a series of booms and busts, you get one longer slower burn. They believe that in the long term this will make it easier to protect those most vulnerable to the virus, at the cost of increased prevalence among people least vulnerable to it. So they see it as a better longer term strategy.
Also this is basically UK saying they're fine with a million of their population dying...
Now, I've heard older people optimistically say, "COVID-19 isn't such a big deal, it's just like measles coming back, like when I was a kid". But to me, this is a sad signal of societal decline. We can't go to the moon anymore, we can't build big infrastructure anymore, and now apparently we can't even hold on to the public health gains we made 40 years ago.
So can this virus be stopped before herd immunity by just quarantining the whole world for a few weeks? Maybe, but will we be willing or even able to actually do that? Doubtful -- if we actually attempt that, the side effects might be worse. Plus the whole world must participate -- it likely won't happen.
So that the kind of consideration that are likely discussed, and models run to determine the likely outcome of diverse scenario.
The death toll will be high.
Everyone keeps saying there are many more people infected than is known. If true, is there really any other option than accepting many will become infected until herd immunity kicks in?
I'm also not sure quarantines can really work with this virus. The fact the large majority of cases are mild, makes the virus incredibly easy to spread. It remains to be seen if China can keep the virus at bay while they remove the quarantine.
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), I think 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 the UK seems to have just dismissed this option out of hand... which means they seem to be heading blindly to disaster.
No, it's not. Have you done the math?
It's also possible that there are genetic components to these parameters, so what works (or doesn't) in italy might not be the same in thailand.
Having 40+ million cases in the UK this year alone does not seem even remotely manageable for the health services.
I don't even see extra hospitals being built or anything at the moment, just threats to schools if they close.
https://news.ycombinator.com/item?id=22542494
“ If you’re under 30 without any other health issues, you should be fine? Might not realize you have it? I wonder if it would be easier to create a low dosage vaccine for younger people, thus creating a bit of a firewall so it doesn’t spread as rapidly. I know nothing about medicine so this may be silly.”
The nominal death rate of covid-19 seems to be about 0.5% at worst, possibly lower because lots of asymptomatic cases (so the numbers we have right now are likely over-estimates). By comparison the flu is about 0.1% (thought what's also unclear is how much of the population it can spread to before it basically burns itself out, IIRC flu is about 10% but for covid I've seen speculations from 20 to 70%). However if intensive care gets overloaded, it shoots up to 5~7%, possibly even higher. That's a lot of extra and unnecessary deaths. That's going from a single "unavoidable" death to 10 or 15.
That's what "flattening the curve" is about, all the social distancing, hygiene, etc…[0] it's about slowing down the spread from its (again nominal) 33% per day or something, to give the healthcare system the time to ramp up to "full capacity" (and habituation) and keep the number of new cases below its capacity.
That, incidentally, is also why universal testing is not that useful: people with fragilities or comorbidities and medical personnel need to be checked quickly because that impacts either their care or whether / how they can care for others. For the vast majority, if you think you might have COVID you stay home so you're not a spreader, which is what you'd do if you were a confirmed case. That's about it. Sure knowing would be nice, but even South Korea simply can not test everybody, they can test 10000 people a day out of a population of 51 million, this means it'd take them 14 years to test everybody. That's obviously not useful.
It's also why you should absolutely not call (to say nothing of going to) ER for covid. Hopefully your healthcare system has a contact point for covid, look up that number and if you think you need to call these people, not 911 or 112.
Also note: outside is safe, you can go out and watch trees or run or bike. In fact I really should. You should just avoid direct contact, stay out of droplets (coughing) range, try to not cough on other people (cough in your elbow or a hankie), wash your hands when you can (especially when you get home). Also treat all doors like they're the worst toilet doors you've ever seen e.g. if you can open them without your hands do so, if you can't then try very hard not to touch yourself until you've sanitised or washed your hands.
[0] also masks if the supply is good enough which is not the case in most countries, which is why it's recommended to leave them to medical professionals who can't just stay home because they have to go out and treat cases
They want to avoid a lock-down disrupting normal life. Meaning general restriction of any and all individual movement all together.
The trouble is that life as we know it got cancelled in the past few weeks. And the harder society tries to cling to the idea of "business as usual", the worst things are going to get down the line.
> Will they just let the old and weak die as part of their plan?
In a nutshell: Yes.
The idea of "herd immunity" is that if enough people are immune, the virus can't jump from host to host and people can't infect each other.
Vaccination is essentially an artificial way of creating herd immunity without making people actually suffer the illness. Of course, we can't vaccinate, so the other scenario is people actually contracting the disease and getting sick.
The stark consequences of the U.K. strategy are (a) an exponential increase in sick people who need healthcare (b) the implosion of an overran healthcare system and (c) many more people dying. Not just the old and weak, but literally anyone who requires healthcare (i.e. heart attacks, strokes, other illnesses, accidents,...).
Countries such as Italy and Spain enforce a lock-down exactly BECAUSE they want to avoid healthcare systems from collapsing any further.
Confining people at home literally slows the spread infections as there are far less opportunities to pass the virus from host to host. Decreasing the rate at which more people get sick buys time for the healthcare system to process those who are already sick.
Down the road, people will still contract the disease, but less people will die including the weak and the old as resources will stay available to tend to those who really need them.
Remember, when we talk about "old" and "weak" people, we are talking about someone else's family members and loved ones. If you want to show solidarity and at least do some kind of civic service towards your (local) community, then do this:
* Work from home if you can / are allowed to. * Don't make unnecessary social calls. * Wash your hands regularly. * Don't touch your face. * Don't visit people at risk if you don't have to. * Keep a fair distance from other people (6 feet). * If you feel sick, or you're coughing: stay the f- at home. * Don't hoard and don't buy from the black market. * Keep calm and carry on. Society isn't helped if you're going to act like The End is Nigh.
As far as I can see, the following are the fundamental assumptions of this strategy.
1. Much of your population will get infected at some point. This is unavoidable.
2. Heavy quarantine measures as employed in various other countries are not sustainable or effective over the necessary timescales. The quarantine will need to be lifted after a few weeks to avoid all kinds of other negative effects (including those adversely affecting health in other ways) and then the exponential spread will resume anyway.
3. Certain parts of your population are at much greater risk than others, due to age or other complicating conditions. These are the people you most need to protect. Most other people will be able to look after themselves at home with some unpleasantness and inconvenience but relatively little risk of more serious or permanent consequences.
4. Someone who has previously been infected and survived will have a degree of immunity thereafter.
5. There are limited intensive care resources available in the NHS to care for patients in more serious conditions.
6. As time passes, several things improve likely outcomes:
6a. We move past the winter season, which both reduces stress on the NHS generally and also somewhat reduces the effects of the coronavirus.
6b. The NHS is increasing its number of intensive care facilities above normal levels.
6c. Eventually, antiviral medications and vaccines become available, but widespread availability is likely to be at least a year away.
So the plan is to allow a degree of natural infection within the general population spread out over time, with the aim of keeping the number of more serious cases at any given time within the capacity of the NHS to treat as well as it can.
As this happens, we buy some time for the situation as a whole to improve, and there is also likely to be some degree of herd immunity building among the general population. In the meantime, the priority is to minimise exposure for those most at-risk and to ensure as much as possible that anyone who does get infected with more serious consequences can at least be treated as well as possible.
In probably a few weeks, when the level of general exposure and the number of more serious cases have risen and we're in danger of reaching capacity limits in the healthcare system, then we start to deploy the stronger quarantine measures and the like, for the same reasons as everyone else but in the hope that they serve the purposes above in particular.
People who understand the science much better than I do seem to be saying that this actually is quite a reasonable strategy and really could work better than what other nations are doing as long as those assumptions are broadly correct, but also that it does have some specific risks, such as the fact that we aren't 100% sure so far that surviving an infection really does confer some degree of immunity, and the possibility of deferring the peak until it hits the more dangerous winter season at the end of this year.
https://www.sciencealert.com/even-those-who-recover-from-cor...
Polio, but for lungs.
If you weren't worried in 2019 about letting the common cold circulate in case it may get even worse, you probably don't need to worry too much about this one either.
Viruses tend to have an incentive to not kill too many of their hosts -- because it limits how they can spread.
Maybe that isn't the case.
Denial is not an effective response, nor is attempting to quarantine 60 million people indefinitely, or closing schools for indefinite periods (puts more pressure on hospitals as staff need to take time off or find childcare, kids not even confirmed as a vector here).
There are certainly different possible ways to delay and different timings for implementing different measures, it will be interesting to see which is most effective in the end. Let’s just hope that hospitals in most countries can cope with the strain.
Yes but you can use a trick: still allow children of medical staff in schools. That what is planned in France, for now.
Not exactly: https://twitter.com/AdamJKucharski/status/123882151552689766... (threaded)
Having a chance of reducing the strain would mean drastic quarantine measures, which they don't want to enact.
Northern Italy has one of the best health systems in Europe (the NHS is not one of them) and they are discussing whether to let people over 80 die for lack of capacity...
Keep your elderly loved ones isolated and safe because if anything happens to them in the next few weeks they will be on their own.
What do you think that would usefully achieve?
The problem isn't just beds. They don't want most people with the virus to go to healthcare facilities, they want them to stay home and avoid spreading it around.
The problem is intensive care and isolation facilities for the most sick patients who really need extra help. These require equipment, medication, clinical staff, etc. They are trying to increase the number of these facilities available, but the capacity will go from a few thousand normally to a few thousand more in the entire country.
I'm talking about the serious cases who require hospital treatment.
If they have no plan for a drastic increase in capacity then their plan will turn into a horror movie within a month...
If the NHS cannot handle this then serious measures should be taken to stop the spread instead of forcing schools to stay open.