COVID-19

[raven]

I’ve seen similar on Bookface, people writing that they are relieved that Johnson took a much more relaxed attitude than other leaders. Makes them feel reassured that it’ll all be alright.

Whereas what reassured me was Johnson being bookended between two people who clearly knew what they were talking about...

I've just watched the press conference on youtube, and it did make some sense. They suggested actual cases might be something like 5-10k. Moving to focus testing on people in hospital and isolating them so they don't infect other already vulnerable patients is good. Not tying testing to where you've been but to symptoms and severity also good. Telling everyone to self-isolate for 7 days for any cough or fever might be disruptive, but should slow spread of this and flu/colds, which can only help. Taking the pressure of 111 because it's clearly straining at the seams is probably good too - but does speak to how rubbish it is. NHS advice page is up to date with all this & clear on what to do.

So ... maybe it's all reasonable?

The four weeks behind Italy is perhaps based on deaths not confirmed cases? I mean, if different countries are using different criteria for testing, comparing confirmed cases might be apples to oranges. But deaths might be more reliable. How many deaths did Italy have 4 weeks ago?

And damn it, stop talking about dry eyes and sore throats. I've been croaky all day today.

No hand santiser here either, Brightonian

[lpm]

The best scenario is engineering R0 of 1?

Continual cases at a steady rate until 60% or whatever has been reached and it dies out, even with repeated reintroduction from abroad.

If you had a dial you'd set total new cases per day to X, where X generates intensive care cases of Y which is maximum the NHS can handle, plus X high enough to get through the whole thing reasonably quickly.

The UK plan sometimes feels like it deliberately seeks a high X - permitting things that will give some but not huge transmissions - in order to get it over fast. Going for the peak earlier than the flatliners. There will many more deaths at the spike as things are overwhelmed, but maybe other countries will end up with higher mortality by the end, when dealing with many cases late on with depleted resources and a collapsed economy?

[lpm]

Arteta, who tells men in north London how to kick a ball.

The head of BT.

A govt minister.

There seems to be far too many famous people for the headline number.

If you assume that they have far better access to tests...

Or famous people are strongly biased to gregarious/extrovert, meeting loads of people every day.

Anyone want to hazard a guess at how many famous people there are in the UK? Famous in the sense of Arteta or Dorries - known to many but probably not most. Both have lengthy and long-standing Wiki pages, a reasonable proxy measure.

From the range 5,000 to 10,000 cases, call it 6,000 out of 60 million, we are at one in 10,000.

To have 2 celebrities in 6,000 cases would imply there are 20,000 UK celebrities. Seems very high.

[Pedantica]

You're assuming celebrities are at average risk. But maybe they are 10x or 50x more likely. It's hardly to imagine an individual with a higher risk than a health minister. Just imagine how many people they have met within the last 2 weeks within 2-3 degrees of separation of clinical staff? They're outliers in terms of social interactions.

[Bird on a Fire]

So what happens if some countries go the UK approach, and in a year say half the population is immune (or dead), while others have maintained strict lockdowns until COVID fizzles out?

Do we end up with a weird situation where blocks with different disease status erect borders and restrict movement? Will hostility to migrants increase, even if they're subject to strict antibody testing?

Sounds like a sci-fi premise but it doesn't seem totally implausible right now.

[Bird on a Fire]

You're assuming celebrities are at average risk. But maybe they are 10x or 50x more likely. It's hardly to imagine an individual with a higher risk than a health minister. Just imagine how many people they have met within the last 2 weeks within 2-3 degrees of separation of clinical staff? They're outliers in terms of social interactions.

Yes, 2000 or 400 celebrities of that caliber seems fairly reasonable.

They all hug each other and do the cheek kiss as well.

[dyqik]

You're assuming celebrities are at average risk. But maybe they are 10x or 50x more likely. It's hardly to imagine an individual with a higher risk than a health minister. Just imagine how many people they have met within the last 2 weeks within 2-3 degrees of separation of clinical staff? They're outliers in terms of social interactions.

Yes, 2000 or 400 celebrities of that caliber seems fairly reasonable.

They all hug each other and do the cheek kiss as well.

I've spoken with at least 180 people, and traveled in cramped conditions with at least 800 people in the last week.

I mean, these celebrities aren't taking public transport...

[Woodchopper]

Previous pandemics have gone in waves. Perhaps they're trying to prevent the waves.

Tonight's press conference was pretty sobering.

The CSO specifically said we need to start social distancing measures at the last time its feasible to start. That feels intuitively wrong which makes me think my intuition is off. I'm missing something. I think it might be the this:

Lot of us are assuming that China/Japan/South Korea are managing well. But what if they're just managing well in the short term but storing up problems for later. China in particular has used extreme measures - travel restrictions on most of the population with a whole province where most people aren't allowed to leave their homes at all (1 person per family allowed to leave for 2 hours once a week to collect supplies). They can't keep that up forever and they have millions of people with no resistance sitting in their homes. They've bought time to improve hospital facilities and mass produce testing kits. But if a viable vaccine is 15-24 months away there is a long way to go. And as we've seen from every country in Europe you only need a few cases to spark a new exponential wave.

The Chinese government has presumably decided that crashing the economy is preferable to letting the epidemic take its course. It remains to be seen how long they can continue.

It really is impossibly at this stage to know for sure the best course of action. But it seems to me that the Chinese are best placed to make that decision.

[Woodchopper]

I’ve seen similar on Bookface, people writing that they are relieved that Johnson took a much more relaxed attitude than other leaders. Makes them feel reassured that it’ll all be alright.

Whereas what reassured me was Johnson being bookended between two people who clearly knew what they were talking about...

I've just watched the press conference on youtube, and it did make some sense. They suggested actual cases might be something like 5-10k. Moving to focus testing on people in hospital and isolating them so they don't infect other already vulnerable patients is good. Not tying testing to where you've been but to symptoms and severity also good. Telling everyone to self-isolate for 7 days for any cough or fever might be disruptive, but should slow spread of this and flu/colds, which can only help. Taking the pressure of 111 because it's clearly straining at the seams is probably good too - but does speak to how rubbish it is. NHS advice page is up to date with all this & clear on what to do.

So ... maybe it's all reasonable?

The four weeks behind Italy is perhaps based on deaths not confirmed cases? I mean, if different countries are using different criteria for testing, comparing confirmed cases might be apples to oranges. But deaths might be more reliable. How many deaths did Italy have 4 weeks ago?

And damn it, stop talking about dry eyes and sore throats. I've been croaky all day today.

No hand santiser here either, Brightonian

It seems to me that one issue is the extent to which its assumed that the virus can be spread by people who are asymptomatic - either because they haven't yet displayed any symptoms or because they feel as if they got better last week and want to get back to normal.

The above doesn't seem that unreasonable if the only people who are infectious are those who currently or recently have symptoms. Get them all to self-isolate and slow down the rate of transmission.

Alternatively, if a government assumes that asymptomatic transmission is a big problem then a lock down of the whole country and lengthy periods in quarantine (I've seen 28 days in some places) makes more sense.

[Woodchopper]

Had a busy day yesterday, apologies if this info has been posted already.

Yesterday the Norwegian government brought in a national shut down of: all schools, universities and kindergartens; cultural and sporting events; all bars restaurants pubs etc; all non-essential services such as hairdressing.

People in non-essential jobs are strongly encouraged to work from home where possible, and public transport should only be used by people who are travelling to work in essential sectors (so as to keep it free from crowds). In practice, employers in non-essential sectors are just sending everyone home.

Anyone working in healthcare is prohibited from leaving the country.

Anyone arriving from outside the Nordic region should be quarantined for 14 days (regardless of whether they have symptoms).

Primary schools and kindergartens are to provide daycare for children whose parents work in essential roles (eg anyone in healthcare etc).

The above will continue until 26 March, but I'm assuming that some or all of it will last longer.

A summary in English can be found here: https://www.fhi.no/en/news/2020/norwegi ... rom-6-p.m/

[sTeamTraen]

Can someone with subject matter expertise help with these two questions, which are rattling around my brain?

1. Some people seem to be expecting the virus to spread more slowly as the weather gets warmer (in the northern hemisphere), cf seasonal flu. What is the effect of weather on virus outbreaks generally? Why do we have "seasonal flu" --- is there a physical effect on the virus, or is it that we either behave differently or have different immune responses in summer?

2. Angela Merkel has apparently stated that 70% of Germans may end up infected. But from what I think I've read, other countries not run by Donald J. Trump are forecasting a number of cases that looks more like 1% of the population. I'm not asking for anyone to choose between those numbers, but what do the modeling assumptions look like that lead to them?

[Woodchopper]

Can someone with subject matter expertise help with these two questions, which are rattling around my brain?

1. Some people seem to be expecting the virus to spread more slowly as the weather gets warmer (in the northern hemisphere), cf seasonal flu. What is the effect of weather on virus outbreaks generally? Why do we have "seasonal flu" --- is there a physical effect on the virus, or is it that we either behave differently or have different immune responses in summer?

2. Angela Merkel has apparently stated that 70% of Germans may end up infected. But from what I think I've read, other countries not run by Donald J. Trump are forecasting a number of cases that looks more like 1% of the population. I'm not asking for anyone to choose between those numbers, but what do the modeling assumptions look like that lead to them?

All the circa 1% figures I’ve seen are the case fatality rates if people get adequate medical care.

[plodder]

I assumed seasonality was due to transmission via droplets, which presumably also provide a protective media for the virus. Droplets are more likely to evaporate in warmer weather. (is my guess)

[marbling]

indeed, viruses don't like to dry out or get too warm. They are susceptible to UV, so sunlight has an added effect. I was taught that viruses were more likely to spread in winter because we all spend more time indoors in groups, but that seems less plausible with a 21st century developed world lifestyle - it doesn't feel to me like I spend all of my summer outdoors in the fresh air! But it’s all about pushing the R0 down, so small factors combined with a general increase in herd immunity through the season probably make a significant difference.

[badger]

Arteta, who tells men in north London how to kick a ball.

The head of BT.

A govt minister.

There seems to be far too many famous people for the headline number.

If you assume that they have far better access to tests...

Which is odd, as we were told there was a strict criteria to meet and queue for test.

The head of BT was quoted as saying "I felt a bit ill so had a test and it turned out positive" which is a bit galling for those that have waited ages for testing despite meeting all the criteria (contact with confirmed case/visit to certain country and specific symptoms).

Has Harley St formed a VIP queue?
Or maybe these cases did actually meet the criteria.

Anyway, first premiership footballer now confirmed. No need to cancel big events, as they'll be cancelling themselves...

[bob sterman]

What there does not seem to have been any mention of is the plan for dealing with the people who need hospitalisation. People with fever and cough are being told to stay home - stay away from GPs, A&E. Not even call 111 - use the website instead.

But for people with worsening symptoms, how are those developing dyspnoea supposed to access care?

- Why not plans for nurses (in PPE) to visit people at home to check on worsening symptoms?
- Why not plans for triage centres in the community away from A&Es?
- Why not plans for treatment centres away from hospitals for people who need low level interventions (e.g. IV fluids and O2)?

Even for people in their 60s we're looking at a fatality rate of 5% with this. And they are supposed to sit around at home messing around with a website that will likely keep telling them to stay home - as their respiratory status declines??? Who is going to examine them and where? Without clear plans they will present at A&E.

People with a 1 in 20 chance of death in the next 14 days or so, should not be left unexamined by a clinician.

[bob sterman]

indeed, viruses don't like to dry out or get too warm.

Hindawi but this paper says SARS coronaviruses are less stable at high relative humidity...

The Effects of Temperature and Relative Humidity on the Viability of the SARS Coronavirus
https://www.hindawi.com/journals/av/2011/734690/

[TimW]

What there does not seem to have been any mention of is the plan for dealing with the people who need hospitalisation. People with fever and cough are being told to stay home - stay away from GPs, A&E. Not even call 111 - use the website instead.

The website tells you to call 111 in those circumstances.

[headshot]

After sleeping on it (albeit for 3 hours), I think my business partner and I are going to make the decision to cancel our three outdoor theatre tours with 160 combined dates.

Our tours will be in their most busy, and thus most expensive, period right when the experts are predicting the peak of the virus to hit.

We think it would be irresponsible to encourage mass gatherings when so many serious cases will be happening.

We also can’t make any guarantees that our casts won’t get I’ll and have to self-isolate, meaning the tours would be unviable for 7-14 days. Or that the Govt will put a ban on gatherings in place in the next phase.

That means 16 actors, 2 musical directors, a set designer and writer/director won’t make any money from us this year. It also means we won’t have any form of income stream until January.

[Woodchopper]

It seems to be spreading in Australia where it isn't winter. Latest smitten politician appeares to be in Queensland where its circa 25-30 degrees, though he might have been infected elsewhere. So it doesn't appear that warm weather prevents Covid-19. Though it may slow it down.

[lpm]

From twitter:

The world is conducting a formal experiment in pandemic containment. The UK has been designated as the control group.

This thing about why some of us Scrutablists are challenging expert scientists? We are challenging UK scientists. Who are challenging the view taken by scientists in the rest of the world.

Outlier is a scary place.

[lpm]

Oh, and we are being this outlier while also an outlier in hospital beds per person. 2.5 per thousand, vs 3.2 in Italy. Would have made more sense to have chosen the control group from one of the 6 to 8 countries like France, Germany or Austria.

[mediocrity511]

I'm hoping people get less confused about this change of policy quickly. Lots of people not understanding when it applies from, thinking if they've got a productive cough it doesn't count as corona cough is dry, thinking you need a fever and a cough.

Have also just seen a post on our local Facebook group of someone who has cancelled her child's routine vaccination appointment to try and help avoid overwhelming the health service

[discovolante]

I just found a limited amount of 57.6% ethanol hand sanitizer that I thought I'd used up/lost. Is it worth bothering with? I'm not going to use it as a hand washing replacement.

Genuine question. Will a couple of % make a difference?

[El Pollo Diablo]

No. Lower alcohol levels will still work, but take more time to work.