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.bob sterman wrote: ↑Wed Oct 13, 2021 7:17 pmThis 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).
COVID-19
Re: COVID-19
- bob sterman
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Re: COVID-19
There were some pretty awful scenes of healthcare systems being overwhelmed in India and South America.sheldrake wrote: ↑Wed Oct 13, 2021 6:56 pmIf 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.
Re: COVID-19
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.
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.
Awarded gold star 4 November 2021
Re: COVID-19
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..lpm wrote: ↑Wed Oct 13, 2021 7:23 pmAgain, 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.
Only if you ignore the other states.Your counterfactual of no govt lockdown is invalid because it was us who chose the path, not them forcing us.
Yes. Remember our different definitions of lockdown? We can call mine 'government lockdown', if you like.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.
- bob sterman
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Re: COVID-19
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.sheldrake wrote: ↑Wed Oct 13, 2021 7:19 pmI 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.bob sterman wrote: ↑Wed Oct 13, 2021 7:17 pmThis 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).
Re: COVID-19
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.
Awarded gold star 4 November 2021
Re: COVID-19
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.
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.
Awarded gold star 4 November 2021
Re: COVID-19
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.
https://ourworldindata.org/grapher/chan ... untry=~GBR
Lockdown well underway by Monday 16 March, a week before govt announcement on Monday 23 March.
Awarded gold star 4 November 2021
Re: COVID-19
Sweden's version, this one being public transport:
https://ourworldindata.org/grapher/visi ... untry=~SWE
https://ourworldindata.org/grapher/visi ... untry=~SWE
Awarded gold star 4 November 2021
Re: COVID-19
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.
- bob sterman
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Re: COVID-19
In which case much of the UK is still in lockdown.sheldrake wrote: ↑Wed Oct 13, 2021 8:00 pmLockdown 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.
Re: COVID-19
Well quite. I think this is wrong.bob sterman wrote: ↑Wed Oct 13, 2021 8:07 pmIn which case much of the UK is still in lockdown.sheldrake wrote: ↑Wed Oct 13, 2021 8:00 pmLockdown 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.
Re: COVID-19
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.
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.
Awarded gold star 4 November 2021
Re: COVID-19
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
Lol..lpm wrote: ↑Wed Oct 13, 2021 8:51 pmSadly 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.
Masking forever
Putin is a monster.
Russian socialism will rise again
Putin is a monster.
Russian socialism will rise again
- bob sterman
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Re: COVID-19
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.
Re: COVID-19
This was Chris Witty's own conclusion in July 2020 https://www.thetimes.co.uk/article/chri ... -d5kb3fmw2bob sterman wrote: ↑Wed Oct 13, 2021 9:23 pmNot 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.
It was also the conclusion of a paper from Bristol https://arxiv.org/pdf/2005.02090.pdf and Carl Heneghan at Oxford.
- bob sterman
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Re: COVID-19
Ok - will look at those first two.sheldrake wrote: ↑Wed Oct 13, 2021 9:30 pmThis was Chris Witty's own conclusion in July 2020 https://www.thetimes.co.uk/article/chri ... -d5kb3fmw2bob sterman wrote: ↑Wed Oct 13, 2021 9:23 pmNot 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.
It was also the conclusion of a paper from Bristol https://arxiv.org/pdf/2005.02090.pdf and Carl Heneghan at Oxford.
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
Re: COVID-19
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.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
- bob sterman
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Re: COVID-19
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).sheldrake wrote: ↑Wed Oct 13, 2021 9:43 pmHe 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.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 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...
and finishing with...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.
In general, if Carl told me the moon was NOT made of cheese - I'd stock up on crackers.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.
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Re: COVID-19
That suggests that the government should have implemented the lockdown sooner since people started behaving in a lockdowny way anyway.sheldrake wrote: ↑Wed Oct 13, 2021 9:30 pmThis was Chris Witty's own conclusion in July 2020 https://www.thetimes.co.uk/article/chri ... -d5kb3fmw2bob sterman wrote: ↑Wed Oct 13, 2021 9:23 pmNot 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.
It was also the conclusion of a paper from Bristol https://arxiv.org/pdf/2005.02090.pdf and Carl Heneghan at Oxford.
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
having that swing is a necessary but not sufficient condition for it meaning a thing
@shpalman@mastodon.me.uk
@shpalman@mastodon.me.uk
Re: COVID-19
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.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
Re: COVID-19
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.
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.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.
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.
Re: COVID-19
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.
Awarded gold star 4 November 2021
Re: COVID-19
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.
Awarded gold star 4 November 2021