Covid-19 the unlockdown

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Millennie Al
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Covid-19 the unlockdown

Post by Millennie Al » Thu Apr 09, 2020 4:16 am

I have read in the media several very bad suggestions on how to get out of lockdown. They seem to be based on a failure to understand exponential growth. The correct method should be something like this:

All new cases are subject to contact tracing and quarantine. When there is a sufficient period (e.g. a week) with no new surprising cases then lockdown ends. A surprising case is a case in someone who is not quarantined as a result of the contact tracing. The contact tracing and quarantine scenario continues until a treatment is found which renders Covid-19 reasonably harmless or the risk of a large outbreak is very small due to herd immunity (whether by vaccine or otherwise). Obviously all of this can only start when the resources are sufficient to handle the necessary volume of contact tracing and quaratine. Anybody arriving from abroad is presumed infected unless they have spent all of the last 14 days (or as approriate) in other countries which have a similar scheme in operation.

A very stupid idea would be to relax lockdown merely because the number of cases or deaths had fallen because that's just getting us back to the same situation we were in which got us into this mess in the first place. I assume this idea is the explanation for models which predict a second wave after lockdown is lifted. We were already stupid not to have paid attention to how places like China, South Korea, Italy etc. handled the pandemic. To let the same thing happen again would be quite incredibly stupid.
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Re: Covid-19 the unlockdown

Post by Martin_B » Thu Apr 09, 2020 5:34 am

Yes, I expect that individual countries, or areas within countries, may get self-isolation lifted; and this may even happen relatively soon for some areas. But quarantining people coming from outside could continue for months until all areas of the world become 'free' of Covid-19.

For instance, I've got a trip back to the UK booked for September/October this year so that I can attend my parent's 50th wedding anniversary celebrations. I booked this in January, and to get the best deal I booked a flight Perth-KL-Muscat-Heathrow. Come September, lets say Australia and Britain are both Covid-free, but Oman isn't. For the sake of 2 hours in the terminal at Muscat I might have to go through 2 lots of 14-day quarantine (1 in the UK, the other in Oz). Of course, the more likely scenario is that my flights get changed to fly via somewhere else which is Covid-free, but possibly until a week or two before hand we've no idea where that might be, or whether my tickets will be considered valid. There may be as big a scramble to get seats on flights once international flying starts again as there was when international flying was (largely) shut-down.

As with a conversation I had with one of my managers who wanted to alert me to the fact that I may be asked to take a 20% pay cut, when my pay is in fact directly linked to my charge-out rate which the Client hasn't mentioned cutting at all (yet) - you can hypothesise about and plan for the scenario, but until the reality arises we don't know how far or how deep the measures we need to take will be.
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Re: Covid-19 the unlockdown

Post by Woodchopper » Thu Apr 09, 2020 7:08 am

Norway, Denmark and Austria appear to have got the contagion under control and have announced that they will relax some of the controls.

As far as I can tell, all of them are doing so slowly and gradually. One issue is that we know that the lockdown is working but no one really knows which bits are most or least effective. So there is a need to experiment and ease the bits of it that don't have much of an effect anyway. So Norway is first going to open the kindergartens and first three years of junior school, ease restrictions on internal travel and allow some services (eg hairdressers). Then the government will monitor infection rates. We'll see how it goes.

But there is no sign that the airports and ports will be opened in the near future.

Info on Norway: https://www.thelocal.no/20200407/norway ... d-lockdown
Denmark: https://www.bloomberg.com/news/articles ... y-response
Austria: https://www.euractiv.com/section/corona ... -schedule/

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Re: Covid-19 the unlockdown

Post by tenchboy » Thu Apr 09, 2020 7:17 am

It's still going to be out there, you are still going to catch it, it will still kill you.
All that has changed is that you now might have a better chance of receiving treatment before you die.
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Re: Covid-19 the unlockdown

Post by lpm » Thu Apr 09, 2020 7:20 am

What's the problem with allowing exponential growth to restart if we have a method to halt it? Lockdowns are now a proven success.

You can set a base level lockdown to remain in place till 31 March 2021 e.g. all who can work from home must work from home, no foreign travel, no holiday travel, 2 metre distancing, no football, theatre and festivals.

This base level permanently slows restarts of the exponential and sets them running at lower slopes.

You then overlay full lockdowns when exponentials get too big. Hence 2 or 3 more big waves to come in the next year.

Also, the virus becomes less lethal and transmittable with time. A wave next year is less damaging than the current wave. Not because of any change to the RNA but because of change to the human hosts - far more hospital beds, thousands of ventilators, nurses with PPE. And better techniques, experience of which drug combinations work and millions of tests. The virus becomes less infectious because 2 metres becomes second nature.

What's infuriating about the govt approach is they got obsessed with 2nd waves so deliberately ran the first one hotter, while failing to prepare the equipment etc. They missed the fundamental fact that the virus becomes less deadly with time (in a rich country with vast resources to ramp up healthcare).

I'm not too worried about future waves, even if they reach higher than this one - we will have mass testing, PPE and healthcare, plus a proven method of crushing them down again with bursts of full lockdowns.
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Re: Covid-19 the unlockdown

Post by Woodchopper » Thu Apr 09, 2020 7:42 am

tenchboy wrote:
Thu Apr 09, 2020 7:17 am
It's still going to be out there, you are still going to catch it, it will still kill you.
All that has changed is that you now might have a better chance of receiving treatment before you die.
Would surnames beginning D to G now form an orderly queue the hand-shaking booths please
Not necessarily.

It appears that in Norway R0 is down to 0.7. If the easing of the lockdown brings it up to, say, 0.9 or 1 then the vast majority of the population won't get it.
https://www.reuters.com/article/us-heal ... SKBN21O27H

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Re: Covid-19 the unlockdown

Post by Woodchopper » Thu Apr 09, 2020 7:46 am

lpm wrote:
Thu Apr 09, 2020 7:20 am
What's the problem with allowing exponential growth to restart if we have a method to halt it? Lockdowns are now a proven success.

You can set a base level lockdown to remain in place till 31 March 2021 e.g. all who can work from home must work from home, no foreign travel, no holiday travel, 2 metre distancing, no football, theatre and festivals.

This base level permanently slows restarts of the exponential and sets them running at lower slopes.

You then overlay full lockdowns when exponentials get too big. Hence 2 or 3 more big waves to come in the next year.

Also, the virus becomes less lethal and transmittable with time. A wave next year is less damaging than the current wave. Not because of any change to the RNA but because of change to the human hosts - far more hospital beds, thousands of ventilators, nurses with PPE. And better techniques, experience of which drug combinations work and millions of tests. The virus becomes less infectious because 2 metres becomes second nature.

What's infuriating about the govt approach is they got obsessed with 2nd waves so deliberately ran the first one hotter, while failing to prepare the equipment etc. They missed the fundamental fact that the virus becomes less deadly with time (in a rich country with vast resources to ramp up healthcare).

I'm not too worried about future waves, even if they reach higher than this one - we will have mass testing, PPE and healthcare, plus a proven method of crushing them down again with bursts of full lockdowns.
Yes, indeed. The 'lethal second wave' scenario assumed that all controls would be relaxed and that there would be no change to healthcare provision. Its yet another case of how a simplistic model can have a negative effect upon policy.

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Re: Covid-19 the unlockdown

Post by Woodchopper » Thu Apr 09, 2020 7:57 am

lpm wrote:
Thu Apr 09, 2020 7:20 am
What's the problem with allowing exponential growth to restart if we have a method to halt it? Lockdowns are now a proven success.

You can set a base level lockdown to remain in place till 31 March 2021 e.g. all who can work from home must work from home, no foreign travel, no holiday travel, 2 metre distancing, no football, theatre and festivals.

This base level permanently slows restarts of the exponential and sets them running at lower slopes.

You then overlay full lockdowns when exponentials get too big. Hence 2 or 3 more big waves to come in the next year.

Also, the virus becomes less lethal and transmittable with time. A wave next year is less damaging than the current wave. Not because of any change to the RNA but because of change to the human hosts - far more hospital beds, thousands of ventilators, nurses with PPE. And better techniques, experience of which drug combinations work and millions of tests. The virus becomes less infectious because 2 metres becomes second nature.

What's infuriating about the govt approach is they got obsessed with 2nd waves so deliberately ran the first one hotter, while failing to prepare the equipment etc. They missed the fundamental fact that the virus becomes less deadly with time (in a rich country with vast resources to ramp up healthcare).

I'm not too worried about future waves, even if they reach higher than this one - we will have mass testing, PPE and healthcare, plus a proven method of crushing them down again with bursts of full lockdowns.
One problem is though whether the UK or US can actually stop exponential growth (rather than just slow it down).

The lockdown has been less severe than in for example Italy, and the infection is widespread.

If, say, R0 in the UK or US is currently down to 1.7 then any relaxation is going to see infection rates rocket up.

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Re: Covid-19 the unlockdown

Post by Martin_B » Thu Apr 09, 2020 8:05 am

Woodchopper wrote:
Thu Apr 09, 2020 7:57 am
lpm wrote:
Thu Apr 09, 2020 7:20 am
What's the problem with allowing exponential growth to restart if we have a method to halt it? Lockdowns are now a proven success.

You can set a base level lockdown to remain in place till 31 March 2021 e.g. all who can work from home must work from home, no foreign travel, no holiday travel, 2 metre distancing, no football, theatre and festivals.

This base level permanently slows restarts of the exponential and sets them running at lower slopes.

You then overlay full lockdowns when exponentials get too big. Hence 2 or 3 more big waves to come in the next year.

Also, the virus becomes less lethal and transmittable with time. A wave next year is less damaging than the current wave. Not because of any change to the RNA but because of change to the human hosts - far more hospital beds, thousands of ventilators, nurses with PPE. And better techniques, experience of which drug combinations work and millions of tests. The virus becomes less infectious because 2 metres becomes second nature.

What's infuriating about the govt approach is they got obsessed with 2nd waves so deliberately ran the first one hotter, while failing to prepare the equipment etc. They missed the fundamental fact that the virus becomes less deadly with time (in a rich country with vast resources to ramp up healthcare).

I'm not too worried about future waves, even if they reach higher than this one - we will have mass testing, PPE and healthcare, plus a proven method of crushing them down again with bursts of full lockdowns.
One problem is though whether the UK or US can actually stop exponential growth (rather than just slow it down).

The lockdown has been less severe than in for example Italy, and the infection is widespread.

If, say, R0 in the UK or US is currently down to 1.7 then any relaxation is going to see infection rates rocket up.
I don't think that the US or UK are in any position to remove restrictions at present, not with current rates. New York seems to be levelling off, but I'd say you want the case load to decrease substantially (to at least manageable levels in the hospitals) before any restrictions get lifted. That's probably not for another 3-4 weeks, given the quoted recovery period and level of bed/medical staff usage.
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Re: Covid-19 the unlockdown

Post by lpm » Thu Apr 09, 2020 8:10 am

I'm pretty confident we've achieved R0 of better than 1.7. There are millions of people in the UK with such tiny risk of catching anything they have to imagine scenarios where it's transmitted by remote country stiles. The virus is meeting dead ends in millions of households, which offsets its freedom of movement among healthcare workers and bus drivers.

But it will be there as a permanent backdrop, simmering way (and geographically fully dispersed across the UK). Whatever we do in June to ease the lockdown will lead to it coming back to the boil. What matters more is speeding up the expansion of healthcare from our inadequate beginnings

The US is very different. They've barely reduced R0, except in the worst hot spots.
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Re: Covid-19 the unlockdown

Post by lpm » Thu Apr 09, 2020 8:14 am

Martin_B wrote:
Thu Apr 09, 2020 8:05 am
That's probably not for another 3-4 weeks, given the quoted recovery period and level of bed/medical staff usage.
3-4 weeks is insanely fast, even for countries ahead of the UK and US. That's early May. Surely the starting assumption is lifting 30 June and then flexing earlier or later depending on circumstances? For example, allowing limited cross-household mixing in early June to permit families to get together again, or reopening schools early, or reopening non-essential shops - all against a backdrop of continued lockdown.
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Re: Covid-19 the unlockdown

Post by Grumble » Thu Apr 09, 2020 8:14 am

lpm wrote:
Thu Apr 09, 2020 8:10 am
The US is very different. They've barely reduced R0, except in the worst hot spots.
Roughly half of the US seem convinced the whole thing is a plot to get rid of Trump, as if people dying in Asia and Europe somehow furthered that idea.
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Re: Covid-19 the unlockdown

Post by Woodchopper » Thu Apr 09, 2020 8:38 am

lpm wrote:
Thu Apr 09, 2020 8:10 am
I'm pretty confident we've achieved R0 of better than 1.7. There are millions of people in the UK with such tiny risk of catching anything they have to imagine scenarios where it's transmitted by remote country stiles. The virus is meeting dead ends in millions of households, which offsets its freedom of movement among healthcare workers and bus drivers.

But it will be there as a permanent backdrop, simmering way (and geographically fully dispersed across the UK). Whatever we do in June to ease the lockdown will lead to it coming back to the boil. What matters more is speeding up the expansion of healthcare from our inadequate beginnings

The US is very different. They've barely reduced R0, except in the worst hot spots.
May well be lower than 1.7, but the trend for new confirmed infections and new deaths is still upwards. Of course the data is fuzzy, but I don't see how we can assume that its down to close to 1. The people who are worrying about country stiles probably also need to queue up to buy food in a supermarket.

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Re: Covid-19 the unlockdown

Post by Woodchopper » Thu Apr 09, 2020 10:08 am

lpm wrote:
Thu Apr 09, 2020 8:10 am
I'm pretty confident we've achieved R0 of better than 1.7. There are millions of people in the UK with such tiny risk of catching anything they have to imagine scenarios where it's transmitted by remote country stiles. The virus is meeting dead ends in millions of households, which offsets its freedom of movement among healthcare workers and bus drivers.

But it will be there as a permanent backdrop, simmering way (and geographically fully dispersed across the UK). Whatever we do in June to ease the lockdown will lead to it coming back to the boil. What matters more is speeding up the expansion of healthcare from our inadequate beginnings

The US is very different. They've barely reduced R0, except in the worst hot spots.
The 7 April Imperial College weekly forecast has R0 as being over 2 in the UK.

On that basis they predicted 'very large' (over 5000 deaths) in the UK, which is what's happening.

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Re: Covid-19 the unlockdown

Post by lpm » Thu Apr 09, 2020 10:29 am

Obviously UK will be over 5,000 in the coming week, because we are already at close to 1,000 per day.

It seems harsh to lump the UK in with the mad countries like the USA in a >2 bucket. Looks like it puts UK at 3.05 (with a range of 2.73 - 3.25) but USA only 2.56. How can an effective R be worse in locked down UK than f.cked up USA?

If I'm understanding it right, it gives the following "Effective Reproduction Number":

Algeria 6.88 (4.06 - 9.96)
Canada 3.85 (2.97 - 5.19)
Mexico 3.76 (2.71 - 6.01)
France 3.68 (2.98 - 4.41)
Israel 3.41 (2.14 - 5.86)
India 3.11 (2.20 - 4.47)
United Kingdom 3.05 (2.73 - 3.25)
Poland 3.03 (1.95 - 5.47)
Brazil 2.93 (2.59 - 3.23)
Philippines 2.86 (2.15 - 3.95)
Turkey 2.78 (2.28 - 3.56)
Japan 2.57 (1.39 - 6.07)
United States of America 2.56 (2.24 - 2.81)
Denmark 2.50 (1.67 - 3.97)
Switzerland 2.40 (2.13 - 2.64)
Romania 2.39 (1.56 - 3.83)
Ecuador 2.31 (1.71 - 2.96)
Germany 2.30 (2.04 - 2.52)
Argentina 2.21 (0.67 - 4.18)
Sweden 2.11 (1.44 - 3.05)
Czech Republic 2.07 (1.06 - 3.55)
Peru 2.01 (1.22 - 3.22)
Ireland 2.00 (1.53 - 2.79)
China 1.94 (1.02 - 4.11)
Norway 1.84 (0.79 - 2.85)
Belgium 1.68 (1.39 - 2.34)
Egypt 1.68 (1.05 - 2.53)
Portugal 1.50 (1.14 - 2.09)
Netherlands 1.43 (1.14 - 1.77)
Morocco 1.43 (0.44 - 3.38)
Greece 1.42 (0.62 - 2.15)
Malaysia 1.19 (0.45 - 1.83)
Spain 1.18 (1.04 - 1.39)
Panama 1.11 (0.41 - 2.55)
Iran 1.07 (0.69 - 1.46)
Dominican Republic 1.03 (0.61 - 1.67)
Indonesia 0.99 (0.68 - 1.52)
Italy 0.95 (0.85 - 1.03)
South Korea 0.86 (0.54 - 1.39)
Austria 0.82 (0.57 - 1.69)
Iraq 0.75 (0.22 - 2.11)
Luxembourg 0.53 (0.12 - 1.44)
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Re: Covid-19 the unlockdown

Post by Woodchopper » Thu Apr 09, 2020 10:57 am

lpm wrote:
Thu Apr 09, 2020 10:29 am
Obviously UK will be over 5,000 in the coming week, because we are already at close to 1,000 per day.
Yes, for the UK they're predicting:

Deaths: 13,900 (8,380 - 16,200) with an R0 of3.05 (2.73 - 3.25)
lpm wrote:
Thu Apr 09, 2020 10:29 am
It seems harsh to lump the UK in with the mad countries like the USA in a >2 bucket. Looks like it puts UK at 3.05 (with a range of 2.73 - 3.25) but USA only 2.56. How can an effective R be worse in locked down UK than f.cked up USA?
One explanation is that outside New York and a few other urban centers the US has a far lower population density. It already has social distancing built into society. For example, all the suburbs in which houses are separated by large gardens, there is minimal or no public transport and people have to drive everywhere. Far easier to isolate there than in, say, high density housing in London where someone has use the tube to get to their essential job and walk to the supermarket.

ETA I'm not in a position to endorse the Imperial estimates. But having closely followed the lock-downs in Spain and Italy I do not find it implausible at all that the UK still has a much higher rate of transmission.

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Re: Covid-19 the unlockdown

Post by lpm » Thu Apr 09, 2020 11:38 am

Well, I don't get this at all.

It's completely contrary to the rosy forecasts coming from Neil Ferguson - 20,000 deaths, slowing down, lockdown eased next month.

Yet Ferguson is one of the authors. How come his pronouncements to the media are at odds with his own report?
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Re: Covid-19 the unlockdown

Post by Woodchopper » Thu Apr 09, 2020 11:42 am

lpm wrote:
Thu Apr 09, 2020 11:38 am
Well, I don't get this at all.

It's completely contrary to the rosy forecasts coming from Neil Ferguson - 20,000 deaths, slowing down, lockdown eased next month.

Yet Ferguson is one of the authors. How come his pronouncements to the media are at odds with his own report?
Depends when they were made. That forecast is from yesterday.

Ferguson has a history of becoming less optimistic as time goes by.

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Re: Covid-19 the unlockdown

Post by lpm » Thu Apr 09, 2020 11:44 am

Andrew Marr show, Sunday 5th April: 7,000 to a "little over 20,000" deaths.
"It’s very difficult to make precise predictions at the moment.

"What we have is an exponentially growing curve of infection which we interrupted for a certain time.

"We can’t say, in regards of infections, where we are precisely on that curve. We don’t have the ability, right now, to measure how many people have been infected, that will come with anti-body tests.

"So we are making statistical estimates of that, and that is subject to a certain degree of uncertainty. It could be anywhere around about 7,000 or so up to a little over 20,000."
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Re: Covid-19 the unlockdown

Post by EACLucifer » Thu Apr 09, 2020 11:49 am

I'm honestly wondering why Ferguson's modelling is still taken remotely seriously when it still seems to be getting very little scrutiny and review from other experts, and has been wildly wrong in the past. Unless my memory is failing me, it was Ferguson's modelling that underestimated ICU need to catastrophically, and that didn't actually start using ICU need data from COVID-19 until the 12th of March.

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Re: Covid-19 the unlockdown

Post by lpm » Thu Apr 09, 2020 11:50 am

FT interview, Tuesday 7 April

https://ftalphaville.ft.com/2020/04/04/ ... strategy-/
We will be putting out updated estimates, probably in the next week, both on intervention impact and on growth rate, but we hope that the two cancel out really. We hope we’re in the same sort of regime of mortality — somewhere between about 5,000 and 30,000 deaths, and probably closer to 10,000-20,000.
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Re: Covid-19 the unlockdown

Post by PeteB » Thu Apr 09, 2020 11:51 am

Woodchopper wrote:
Thu Apr 09, 2020 10:08 am

The 7 April Imperial College weekly forecast has R0 as being over 2 in the UK.

On that basis they predicted 'very large' (over 5000 deaths) in the UK, which is what's happening.
That seems bonkers - 13,900 (8,380 - 16,200) UK deaths week begining 5/4/20 - just had a quick look through their methodology - surely there is a step change starting with the lockdown and this will start feeding through into the death figures probably this week/next week (if we'd not had the lockdown then people that would have been infected at the begining of the lockdown would be dying now) - is this just a 'curve fitting' exercise ?

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Re: Covid-19 the unlockdown

Post by lpm » Thu Apr 09, 2020 12:05 pm

Up to 4 April there were 4,934 UK fatalities.

This report forecasts 13,900 in the week commencing 5 April (range 8,380 to 16,200).

So his own report says 18,000 by the end of this Easter weekend (range 13,400 to 21,100).

Yet he's on TV and radio and newspapers with 10,000 to 20,000 figures for the total first wave. Something has been f.cked up - must be our understanding, surely? He made headlines across the country with his forecasts, the public understanding is to expect something like 20,000 due to him.

What are we missing?
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Re: Covid-19 the unlockdown

Post by PeteB » Thu Apr 09, 2020 12:22 pm

Interesting twitter thread

Our failure, on the Helmand campaign, was not (as the media always assumed) that we were ignoring or overruling military advice. It was that we failed to challenge it, to interrogate it enough, to expose the differences within the expert community and have a proper debate.

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Re: Covid-19 the unlockdown

Post by shpalman » Thu Apr 09, 2020 12:25 pm

Seems to me anyway that the UK could follow the same curve as Germany and Italy because why not? Although the UK is already falling off the curve slightly (maybe because testing can't keep up) and may flatten a bit but cross the other curves as they come down and the UK's one doesn't.

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