COVID-19

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sheldrake
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Re: COVID-19

Post by sheldrake » Wed Oct 13, 2021 7:19 pm

bob sterman wrote:
Wed Oct 13, 2021 7:17 pm
This may sound reassuring to a certain extent - but you have to bear in mind that triage, admission and discharge practices were and are dynamic - changing as hospitals start to get close to full occupancy.

So when a hospital is getting close to full occupancy - you can be sure that some patients are not being admitted that would be admitted during more normal times. While others are being discharged early (notoriously into care homes).
I haven't yet seen good evidence that hospital admissions were abnormal against a background of 20 years or more, but I absolutely agree with you about the disaster of discharging into care homes. People should be held accountable for that.

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bob sterman
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Re: COVID-19

Post by bob sterman » Wed Oct 13, 2021 7:23 pm

sheldrake wrote:
Wed Oct 13, 2021 6:56 pm
lpm wrote:
Wed Oct 13, 2021 6:48 pm

I think we need to introduce you to the word "exponential" at this point.
If you think infections in real epidemics grow exponentially continually until everybody has caught the disease or been vaccinated, you are mistaken. We saw waves peak before any tightening measures were introduced on at least one occasion in the UK.

The rest of your lurid apocalypse scenario didn't happen anywhere, even in countries like Sweden, Japan and Belarus with no lockdown.
There were some pretty awful scenes of healthcare systems being overwhelmed in India and South America.

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lpm
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Re: COVID-19

Post by lpm » Wed Oct 13, 2021 7:23 pm

Again, Sweden did lockdown. In March 2020. It was a voluntary lockdown by the public that significantly reduced interactions - at a time when cases per million were very low.

And likewise the UK lockdowned before the govt acted. Nursing homes closed. The football season collapsed. Theatres shut. Public transport rates fell.

The reality is we've got a pretty good public, which should make you optimistic. We acted while Johnson dithered. Your counterfactual of no govt lockdown is invalid because it was us who chose the path, not them forcing us.

The waves we've seen in the UK have responded to lockdown strength. Countries with out of control Covid - Iran, Brazil - see waves because people distance themselves. The apocalypse doesn't happen even in Iran because people act. There wasn't a single place that didn't lockdown to some extent because this is how human societies always respond to epidemics - it's in the bible, the Byzantines quarantined, people isolated from the black death.

Take a look at the Google mobility data. You will see UK public transport fall well before the govt lockdown on 23 March. You will see supermarket and pharmacy visits rise well before lockdown then fall afterwards.
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sheldrake
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Re: COVID-19

Post by sheldrake » Wed Oct 13, 2021 7:26 pm

lpm wrote:
Wed Oct 13, 2021 7:23 pm
Again, Sweden did lockdown. In March 2020. It was a voluntary lockdown by the public that significantly reduced interactions - at a time when cases per million were very low.

And likewise the UK lockdowned before the govt acted. Nursing homes closed. The football season collapsed. Theatres shut. Public transport rates fell.
I think we've been working to different definitions of lockdown, as before. I use the term lockdown when the government order things to close and threaten to arrest people for going out for a walk, not when people start voluntarily working from home etc..
Your counterfactual of no govt lockdown is invalid because it was us who chose the path, not them forcing us.
Only if you ignore the other states.
The waves we've seen in the UK have responded to lockdown strength. Countries with out of control Covid - Iran, Brazil - see waves because people distance themselves. The apocalypse doesn't happen even in Iran because people act. There wasn't a single place that didn't lockdown to some extent because this is how human societies always respond to epidemics - it's in the bible, the Byzantines quarantined, people isolated from the black death.

Take a look at the Google mobility data. You will see UK public transport fall well before the govt lockdown on 23 March. You will see supermarket and pharmacy visits rise well before lockdown then fall afterwards.
Yes. Remember our different definitions of lockdown? We can call mine 'government lockdown', if you like.

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bob sterman
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Re: COVID-19

Post by bob sterman » Wed Oct 13, 2021 7:28 pm

sheldrake wrote:
Wed Oct 13, 2021 7:19 pm
bob sterman wrote:
Wed Oct 13, 2021 7:17 pm
This may sound reassuring to a certain extent - but you have to bear in mind that triage, admission and discharge practices were and are dynamic - changing as hospitals start to get close to full occupancy.

So when a hospital is getting close to full occupancy - you can be sure that some patients are not being admitted that would be admitted during more normal times. While others are being discharged early (notoriously into care homes).
I haven't yet seen good evidence that hospital admissions were abnormal against a background of 20 years or more, but I absolutely agree with you about the disaster of discharging into care homes. People should be held accountable for that.
The care home disaster worked both ways - elderly people in care homes who in normal times would have been rapidly sent to hospital for assessment for various conditions (not just COVID) were often left at the homes. To help keep hospital bed occupancy down.

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Re: COVID-19

Post by lpm » Wed Oct 13, 2021 7:34 pm

sheldrake wrote:
Wed Oct 13, 2021 7:26 pm
We can call mine 'government lockdown', if you like.
Call it what you like, the little strand of RNA doesn't care. All it wants to know is how many people it can get close to. It doesn't read the legislation you know.
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lpm
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Re: COVID-19

Post by lpm » Wed Oct 13, 2021 7:43 pm

Here you go, Sweden's lockdown, shown as reduction in mobility to workplaces, from the Google mobility data.

Strength of the colours show the reduction in April 2020 from late Jan 2020 levels.

This is without any government legislation, unlike neighbours. The public still lockdowned voluntarily. And of course because they lockdowned less, their death toll was many multiples of Norway, Finland and Denmark, and their economic slump was just as bad.

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lpm
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Re: COVID-19

Post by lpm » Wed Oct 13, 2021 7:46 pm

Have a play with this for the UK:

https://ourworldindata.org/grapher/chan ... untry=~GBR

Lockdown well underway by Monday 16 March, a week before govt announcement on Monday 23 March.
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lpm
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Re: COVID-19

Post by lpm » Wed Oct 13, 2021 7:49 pm

Sweden's version, this one being public transport:

https://ourworldindata.org/grapher/visi ... untry=~SWE
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sheldrake
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Re: COVID-19

Post by sheldrake » Wed Oct 13, 2021 8:00 pm

Lockdown for me is when a healthy 40-something GP won't visit an 80 year old man with no Covid symptoms at home 100 yards from their surgery because they're worried about a 0.4% risk from a disease they may already be immune to due to asymptomatic infection.

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bob sterman
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Re: COVID-19

Post by bob sterman » Wed Oct 13, 2021 8:07 pm

sheldrake wrote:
Wed Oct 13, 2021 8:00 pm
Lockdown for me is when a healthy 40-something GP won't visit an 80 year old man with no Covid symptoms at home 100 yards from their surgery because they're worried about a 0.4% risk from a disease they may already be immune to due to asymptomatic infection.
In which case much of the UK is still in lockdown.

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Re: COVID-19

Post by sheldrake » Wed Oct 13, 2021 8:15 pm

bob sterman wrote:
Wed Oct 13, 2021 8:07 pm
sheldrake wrote:
Wed Oct 13, 2021 8:00 pm
Lockdown for me is when a healthy 40-something GP won't visit an 80 year old man with no Covid symptoms at home 100 yards from their surgery because they're worried about a 0.4% risk from a disease they may already be immune to due to asymptomatic infection.
In which case much of the UK is still in lockdown.
Well quite. I think this is wrong.

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Re: COVID-19

Post by lpm » Wed Oct 13, 2021 8:51 pm

Sadly the delay in the government acting led to the NHS being too stressed to handle non Covid health properly. It's hard and fast lockdown action that preserves healthcare across the board.

Arguably we should have a firebreak lockdown now, to dent the hospitalisation rate and get capacity back. A decade of austerity leaves everything too thin.
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sheldrake
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Re: COVID-19

Post by sheldrake » Wed Oct 13, 2021 9:00 pm

lpm wrote:
Wed Oct 13, 2021 8:51 pm
Sadly the delay in the government acting led to the NHS being too stressed to handle non Covid health properly. It's hard and fast lockdown action that preserves healthcare across the board.
I do not think that is well founded given that infections were already in decline before the first govt. lockdown was announced.

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Re: COVID-19

Post by Herainestold » Wed Oct 13, 2021 9:19 pm

lpm wrote:
Wed Oct 13, 2021 8:51 pm
Sadly the delay in the government acting led to the NHS being too stressed to handle non Covid health properly. It's hard and fast lockdown action that preserves healthcare across the board.

Arguably we should have a firebreak lockdown now, to dent the hospitalisation rate and get capacity back. A decade of austerity leaves everything too thin.
Lol..
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Russian socialism will rise again

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bob sterman
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Re: COVID-19

Post by bob sterman » Wed Oct 13, 2021 9:23 pm

sheldrake wrote:
Wed Oct 13, 2021 9:00 pm
lpm wrote:
Wed Oct 13, 2021 8:51 pm
Sadly the delay in the government acting led to the NHS being too stressed to handle non Covid health properly. It's hard and fast lockdown action that preserves healthcare across the board.
I do not think that is well founded given that infections were already in decline before the first govt. lockdown was announced.
Not sure how we can know this given that we didn't have effective testing infrastructure in the UK - and consequently community testing was stopped on March 12th.

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Re: COVID-19

Post by sheldrake » Wed Oct 13, 2021 9:30 pm

bob sterman wrote:
Wed Oct 13, 2021 9:23 pm
sheldrake wrote:
Wed Oct 13, 2021 9:00 pm
lpm wrote:
Wed Oct 13, 2021 8:51 pm
Sadly the delay in the government acting led to the NHS being too stressed to handle non Covid health properly. It's hard and fast lockdown action that preserves healthcare across the board.
I do not think that is well founded given that infections were already in decline before the first govt. lockdown was announced.
Not sure how we can know this given that we didn't have effective testing infrastructure in the UK - and consequently community testing was stopped on March 12th.
This was Chris Witty's own conclusion in July 2020 https://www.thetimes.co.uk/article/chri ... -d5kb3fmw2

It was also the conclusion of a paper from Bristol https://arxiv.org/pdf/2005.02090.pdf and Carl Heneghan at Oxford.

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bob sterman
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Re: COVID-19

Post by bob sterman » Wed Oct 13, 2021 9:40 pm

sheldrake wrote:
Wed Oct 13, 2021 9:30 pm
bob sterman wrote:
Wed Oct 13, 2021 9:23 pm
sheldrake wrote:
Wed Oct 13, 2021 9:00 pm


I do not think that is well founded given that infections were already in decline before the first govt. lockdown was announced.
Not sure how we can know this given that we didn't have effective testing infrastructure in the UK - and consequently community testing was stopped on March 12th.
This was Chris Witty's own conclusion in July 2020 https://www.thetimes.co.uk/article/chri ... -d5kb3fmw2

It was also the conclusion of a paper from Bristol https://arxiv.org/pdf/2005.02090.pdf and Carl Heneghan at Oxford.
Ok - will look at those first two.

But Comedy "No Sign of a Second Wave" Carl has a long history of being catastrophically wrong about most COVID issues. He's even wiped his own Twitter history to destroy the evidence of how often he was very wrong...

https://twitter.com/_johnbye/status/1402034988267212808

sheldrake
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Re: COVID-19

Post by sheldrake » Wed Oct 13, 2021 9:43 pm

bob sterman wrote:
Wed Oct 13, 2021 9:40 pm


But Comedy "No Sign of a Second Wave" Carl has a long history of being catastrophically wrong about most COVID issues. He's even wiped his own Twitter history to destroy the evidence of how often he was very wrong...

https://twitter.com/_johnbye/status/1402034988267212808
He was wrong about that, but Neil Ferguson and various other alarmists have been pretty wrong about things in their careers too. He's still a Professor of medicine. I'd be interested in the flaws you see in his reasoning if you read his work on it.

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bob sterman
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Re: COVID-19

Post by bob sterman » Wed Oct 13, 2021 10:04 pm

sheldrake wrote:
Wed Oct 13, 2021 9:43 pm
bob sterman wrote:
Wed Oct 13, 2021 9:40 pm


But Comedy "No Sign of a Second Wave" Carl has a long history of being catastrophically wrong about most COVID issues. He's even wiped his own Twitter history to destroy the evidence of how often he was very wrong...

https://twitter.com/_johnbye/status/1402034988267212808
He was wrong about that, but Neil Ferguson and various other alarmists have been pretty wrong about things in their careers too. He's still a Professor of medicine. I'd be interested in the flaws you see in his reasoning if you read his work on it.
He's a Professor of Medicine, who despite being all over every news channel, radio station and newspaper website as an expert on every aspect of the pandemic has only managed to publish one research paper on COVID (a systematic review of evidence on fomite transmission).

He did have a go at publishing a review suggesting that airborne transmission was probably not an issue with COVID - but it was savaged by reviewers...

https://f1000research.com/articles/10-2 ... onse-82591

with one peer reviewer writing...
As I am sure you are aware, the WHO Ebola 2014 IPC guideline states 'scientists are unaware of any virus that has dramatically changed its mode of transmission'. So, in light of what is already known about human-to-human Coronaviridae transmission and the potential harms in failing to adequately mitigate every transmission route of SARS-CoV-2, I am curious as to why any infectious disease specialist or team of scientists investigating viral transmission would seek to ‘second-guess’ the inevitability of its [SARS-CoV-2] airborne transmission? This requires explanation please. Thank you.
and finishing with...
I do not think it would be appropriate – and I don’t want to risk wasting your time in reading yet further comments – for me to undertake any further point-by-point discussion/review of the conclusions which you have drawn from your chosen methods, since it is my contention that your chosen methods are so importantly flawed that the present manuscript should be completely re-written using methods with greater scientific validity, and including the whole range of available data towards SARS-CoV-2 transmission, as described. I hope this seems reasonable.
In general, if Carl told me the moon was NOT made of cheese - I'd stock up on crackers.

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Re: COVID-19

Post by shpalman » Wed Oct 13, 2021 10:10 pm

sheldrake wrote:
Wed Oct 13, 2021 9:30 pm
bob sterman wrote:
Wed Oct 13, 2021 9:23 pm
sheldrake wrote:
Wed Oct 13, 2021 9:00 pm


I do not think that is well founded given that infections were already in decline before the first govt. lockdown was announced.
Not sure how we can know this given that we didn't have effective testing infrastructure in the UK - and consequently community testing was stopped on March 12th.
This was Chris Witty's own conclusion in July 2020 https://www.thetimes.co.uk/article/chri ... -d5kb3fmw2

It was also the conclusion of a paper from Bristol https://arxiv.org/pdf/2005.02090.pdf and Carl Heneghan at Oxford.
That suggests that the government should have implemented the lockdown sooner since people started behaving in a lockdowny way anyway.

The excess deaths:

Code: Select all

Week		Registered	Expected	Excess	Deaths with COVID-19
Ending		Deaths		Deaths		Deaths	on the Death Certificate
2020-03-27	10411		10258		153		526
2020-04-03	15434		10076		5358		3352
2020-04-10	17560		8551		9009		5926
2020-04-17	21144		9577		11567		8376
2020-04-24	20834		10837		9997		7864
2020-05-01	17002		9697		7305		5806
2020-05-08	11942		8497		3445		3748
2020-05-15	13783		9587		4196		3663
2020-05-22	11583		9471		2112		2502
2020-05-29	9230		8166		1064		1745
2020-06-05	9997		9072		925		1521
2020-06-12	9394		9006		388		1084
2020-06-19	8720		8923		-203		762
2020-06-26	8417		8762		-345		591
2020-07-03	8541		8782		-241		507
2020-07-10	8108		8738		-630		363
2020-07-17	8274		8582		-308		295
2020-07-24	8317		8559		-242		220
2020-07-31	8408		8563		-155		195
2020-08-07	8373		8581		-208		142
2020-08-14	8772		8586		186		140
2020-08-21	9033		8643		390		137
2020-08-28	8427		8756		-329		105
2020-09-04	7236		7477		-241		83
So for example the worst week in the first wave was that of the 17th of April in which there were 21144 deaths when normally about 10000 would have been expected; only about 8000 were even attributed to covid on the death certificate, but there were only about 5000 deaths per week in the covid stats just because someone won't count as a covid death unless they tested positive for covid, and the testing capacity just wasn't there yet. So yeah some of those tens of thousands of deaths might have been avoided by locking down earlier.
having that swing is a necessary but not sufficient condition for it meaning a thing
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sheldrake
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Re: COVID-19

Post by sheldrake » Wed Oct 13, 2021 10:26 pm

bob sterman wrote:
Wed Oct 13, 2021 10:04 pm
[

He's a Professor of Medicine, who despite being all over every news channel, radio station and newspaper website as an expert on every aspect of the pandemic has only managed to publish one research paper on COVID (a systematic review of evidence on fomite transmission).

He did have a go at publishing a review suggesting that airborne transmission was probably not an issue with COVID - but it was savaged by reviewers...

https://f1000research.com/articles/10-2 ... onse-82591
Do you work in this field ? (I'm not a biologist or medic) I'm not sure what Prof Heneghan has done to annoy you so much. I did see the comments, and Heneghan's responses to them (not sure if you did). This isn't the piece I was asking you to read though.

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Re: COVID-19

Post by sheldrake » Wed Oct 13, 2021 10:33 pm

shpalman wrote:
Wed Oct 13, 2021 10:10 pm

That suggests that the government should have implemented the lockdown sooner since people started behaving in a lockdowny way anyway.
I don't think that's a safe conclusion because 'people seeming to behave in a lockdowny way' is not the same as lockdown and it's also not the only reason that epidemics operate in waves. If 'voluntarily behaving in a lockdowny way' got r below 1 I'd be interested in considering leaving the measures there because of all the other costs to human health and quality of life of actual mandatory lockdown.
So for example the worst week in the first wave was that of the 17th of April in which there were 21144 deaths when normally about 10000 would have been expected; only about 8000 were even attributed to covid on the death certificate, but there were only about 5000 deaths per week in the covid stats just because someone won't count as a covid death unless they tested positive for covid, and the testing capacity just wasn't there yet. So yeah some of those tens of thousands of deaths might have been avoided by locking down earlier.
1) 'Excess deaths' depend on what you take as a 'normal' level of deaths. Previous 5 years we had unusually low age-adjusted mortality compared to the norms going back to 1990. You can't assume that all, or even most, deaths above the previous 5-year average were really the result of untested Covid.

2) Deaths that occur even when somebody tests positive to Covid aren't necessarily primarily caused by Covid. I think the cause of admission to hospital (e.g. admitted for Covid, or unknown respiratory) would be the best thing to look at, don't know if it's possible to dig that out.

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Re: COVID-19

Post by lpm » Wed Oct 13, 2021 11:11 pm

sheldrake wrote:
Wed Oct 13, 2021 9:00 pm
lpm wrote:
Wed Oct 13, 2021 8:51 pm
Sadly the delay in the government acting led to the NHS being too stressed to handle non Covid health properly. It's hard and fast lockdown action that preserves healthcare across the board.
I do not think that is well founded given that infections were already in decline before the first govt. lockdown was announced.
The first wave had some peculiar characteristics, thanks to Covid having an extremely uneven spread in its first stage. A nursing home might have dozens of cases, its neighbour none. By the second wave cases were more evenly dispersed.

The regional tiers were a dud for the second wave but might have been pretty effective for the first.

It's certainly true that the national lockdown was more than enough to slam down the first wave. But as you said, with inadequate info on an unknown disease you've got to be cautious.
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Re: COVID-19

Post by lpm » Wed Oct 13, 2021 11:14 pm

Oh, and the measures for the first wave couldn't be fine tuned - the government abandoned testing and we were flying blind. This particular piece of incompetence from Johnson and Co made the first lockdown too crude.
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