My opinion: Things need to change

[Huntergreed]

I think many will agree with me when I say that the government have created quite the predicament for themselves.

They started off with trying to achieve herd immunity naturally by allowing the virus to simply spread through the population, however due to the public being disgusted by this (possibly because they don't have a fully developed understanding of epidemiology), they suddenly decided to switch to an elimination approach through a nationwide lockdown, which initially was to prevent the NHS from getting overwhelmed, however in recent weeks it's become clear that the government are no longer clear on what their own approach is to getting out of this situation.

I do think that one thing is for certain, however. The only way that the United Kingdom can fully exit this pandemic and return to normal is through achieving herd immunity, either through a vaccine (which is absolutely not guaranteed) or through natural immunity caused by antibodies which form after infection. In my opinion, we are going to have to, sooner or later, switch to an approach of natural herd immunity to allow for the virus to work its way through the healthier population who are least at risk of dying from it. This is, inevitably, going to cause some deaths which would have been entirely preventable if we were able to eliminate the virus, however, given the state of our economy, and the impact this is having on our society, the education of our children, our livelihoods, and our mental wellbeing as a country, I think this is an inevitable sacrifice which as a nation we are going to have to make due to the mistake of switching our approach to elimination too late into the pandemic. There are multiple reasons why I think this is the correct approach to take:

• Given around half of our deaths have occurred in care homes, where the most vulnerable are, I believe this supports my belief that the risk of dying from the virus is tiny for the vast majority of the healthy population under the age of 55, which would mean the resulting death rate from letting the virus work through all members of this sample of the population would actually be relatively small.
• Given that over 90% of deaths are caused in people who have an underlying health condition, I believe this supports my belief that letting the virus spread naturally through the majority of the population who do not have a condition would not result in a high death toll.
• Given the two above facts, if we were to pursue this approach as a nation now, we would not risk overwhelming the NHS as we would be allowing the virus to spread amongst those who we have identified as least at risk of getting seriously ill from it, meaning that, whilst of course some hospitalisations and fatalities are inevitable, this is going to be necessary in order to prevent economic collapse and to allow us to return to a more functional form of society than this useless limbo which we are stuck in at present.

I propose that we advise those shielding to continue to do so for the meantime and we essentially 'lock off' care homes for the meantime in order to protect those who are most vulnerable of dying from this virus. Aside from this, I propose that the above changes should be made in order to allow us to switch to this more realistic and meaningful approach:

• Completely scrap social distancing for anyone under 55 who is not in the shielding category, as in this approach we actually want the virus to spread as widely as possible. This would mean we would scrap social distancing in shops and on public transport, we would reopen pubs and the tourism and hospitality sectors with no distancing requirements, and we advise those under 55 to return to working in the workplace where possible.
• For those over 55, and not in the shielding group, we would advise them to keep 2m distancing from anyone outwith their household, to continue to work from home where possible, however, this would not be enforced as it would be down to the individual to decide whether they are willing to accept the risk associated with catching the virus in order to stop social distancing and return to work.
• Fully reopen schools and universities, the vast, vast majority of teachers and lecturers are not in the 'shielding' group, and for those who are there can be solutions worked out, including providing cover until herd immunity is achieved, allowing them to deliver their classes online, or with them being willing to accept the slightly increased (but still relatively minimal) risk and return to the workplace.

This approach would, of course, result in some preventable deaths, but that's just inevitable. The current approach is simply not working, we are placing the education of our children, the economy, and our livelihoods at risk, and I think it's time for some major change to come and for us to adopt a more realistic approach. There is practically no way that we can eliminate the virus given the number of cases and the rate we are easing the current lockdown, which simply means that, realistically, the only possible way to exit this pandemic is through achieving herd immunity. If a vaccine becomes available, then following this approach we would still have protected the most vulnerable and would be able to vaccinate them to allow society to return to normal more quickly, however, we need to realise that achieving herd immunity is our only way out and since a vaccine is not yet readily available (it may never) and our economy is already seeing huge damage caused from the current lockdown, we need to move to a different approach to minimise all-round damage and try to emerge from this pandemic as economically healthy as we possibly can.

 

[NorthOxonian]

I broadly agree with this strategy, but it fails to solve the biggest conundrum facing exit plans: how do we change people's psychology?

A huge proportion of the public are scared witless of the virus. They believe its death rate for healthy young/middle-aged adults is high, and also believe that death rate for those "at risk" is essentially 100%. These people will condemn any loosening of lockdown or removal of social distancing as murder, and certainly won't be going out and supporting the economy. How do you get those people onside?

 

[MikeWM]

I agree; we are in precisely the situation now that I deeply feared we would end up in when the government panicked and changed tack around March 16th, because the issues you rightly raise were apparent to me then - and I couldn't see how a lockdown would solve anything other than cause many, many more problems. (Even then, I didn't expect some of the crazier things, such as the NHS stopping much cancer treatment and screenings)

A decent government would know that you don't do something in a panic without an exit strategy, even when sticking with the current plan is causing short-term pain. To go down the route of implementing the most draconican restrictions on society ever seen in peacetime (indeed, moreso than in wartime in many respects) without proving that it was necessary or of any clear benefit in solving the problem in the 'least worst', most efficient way possible, is probably the biggest domestic mistake made by a government in my lifetime.

I increasingly believe we may find ourselves remarkably fortunate, however, and due to a decent proportion of the population already seeming to be immune, we may be not far from herd immunity anyway. I'm optimistic about that, at least.

 

[MikeWM]

One other point, that may be controversial now but it seems would have been common belief in 1968 when Hong Kong flu was around - I don't actually think it should be the job of government to try to prevent the spread of a virus, other than issuing basic public health information. It isn't a political issue (or at least ought not to be - it certainly appears that it wasn't in 1968)

 

[Abpj17]

The death rate is only one statistic. There are extensive reports of Covid leaving people with varying degrees of what looks to be long term damage, in some cases very significant.

We remain a very very long way from immunity - very low outside London; within London it's around 20%. And...there is no guarantee of long term immunity anyway. Some may never get immunity despite having caught. In other cases the immunity will wear off, or become ineffective as the virus mutates. There is already evidence of multiple strains - with no guarantee that immunity from one means you are immune from others; or that a vaccine for one type will work for others.

 

[greyman42]

I broadly agree with this strategy, but it fails to solve the biggest conundrum facing exit plans: how do we change people's psychology?

A huge proportion of the public are scared witless of the virus. They believe its death rate for healthy young/middle-aged adults is high, and also believe that death rate for those "at risk" is essentially 100%. These people will condemn any loosening of lockdown or removal of social distancing as murder, and certainly won't be going out and supporting the economy. How do you get those people onside?

I believe the simplest way is to return to normal within a few weeks. 'Normal' people would then go back to pre covid ways and hopefully that would encourage the more paranoid members of the population to follow suit, as they see people getting on with their lives and not dying. Regarding those who want to spend the rest of their lives indoors, then let them do so. They may well of lived that sort of lifestyle pre covid so are not going to change now.

 

[philosopher]

Lets say the R value of Covid-19 is 3. If my thinking is correct, this means two thirds (1- 1 divided by 3 = 67%) of people need to get Covid-19 for there to be herd immunity. This is what I think frightened most people as it in effect means most people will get Covid-19. Getting ill with an illness that could be fatal is not a very pleasant thought.

However if the R value could be reduced to 1.5, then herd immunity could be achieved with a third of the population getting Covid-19, meaning most will not get Covid-19. Reducing the R value to 1.5 would still require social distancing, but likely not to the same degree as current. It may be to get the R value to 1.5, it still requires large gatherings to be banned, people encouraged to work from home, enhanced hygiene, etc, however shops, pubs and other parts of society could operate somewhat normally.

The government could then say to people that you can either play safe and minimise social contact and you likely will not get Covid-19, or you can decide to live somewhat normally, but you will be putting yourself at increased risk of getting Covid-19. Therefore it is putting it into the hands of the individual on what risk they are willing to take.

 

[thejuggler]

The true test of assessing someone's risk appetite for going back to normal is to offer them the option to be deliberately infected.

Any takers from those on this thread?

 

[Scrotnig]

The true test of assessing someone's risk appetite for going back to normal is to offer them the option to be deliberately infected.

Any takers from those on this thread?

That's ridiculous.

Before all this, I strenuously avoided catching colds as far as possible. For various reasons. However, I still carried on life normally. And I still caught a few, but probably fewer than I might have done without being careful. I wouldn't have deliberately infected myself though.

 

[talldave]

It's a shame that more isn't being made of the risk of death to obese people, down to the little discussed blood clotting aspects of CV-19. If ever there was an opportunity to persuade people to stop stuffing their faces, this is surely it.

Annual health MOTs and National Insurance discounts for healthy BMIs could be rolled out under a continuing "protect the NHS" message.

 

[Huntergreed]

One thing that’s becoming more puzzling to me as time goes on:

Why haven’t the medical advisors realised this yet?

It’s not difficult to figure out that elimination at this point is just impossible, and that other than a vaccine there’s only one way to exit the pandemic. It seems odd that Whitty or Vallance haven’t realised that a change in approach is needed to allow us to exit this pandemic more quickly.

 

[yorkie]

We remain a very very long way from immunity - very low outside London; within London it's around 20%. And...there is no guarantee of long term immunity anyway.....

Not this again!

I'm going to make a dedicated thread on this shortly as it's increasingly obvious that this is false. I will edit this post and add a link when I have done so; we can continue the discussion there Edit: Here it is:

We have more immunity to SARS-CoV-2 than thought

Firstly, a lot of people appear to think that anyone who does not have SARS-CoV-2 antibodies has no immunity against the virus; this is false. Anyone who has been exposed to other coronaviruses (some of which are deemed to be "common cold" viruses, though not all "common cold" viruses are...

www.railforums.co.uk

But back on topic: do you think the virus could actually be eliminated, even though WHO have said it's here to stay? If so, how would you propose to achieve this?

Covid-19: 'We must learn to live with the virus'

The coronavirus is not going to go away, says WHO's special envoy for Covid-19 David Nabarro.

www.bbc.co.uk

"We have all got to learn to live with this virus, to do our business with this virus in our presence, to have social relations with this virus in our presence and not to be continuously having to be in lockdown because of the widespread infections that can occur," Mr Nabarro added.

I'm yet to hear anyone give a good argument against what Mr Nabarro has said.

The true test of assessing someone's risk appetite for going back to normal is to offer them the option to be deliberately infected.

Any takers from those on this thread?

I think what you really mean is "be vaccinated"; we can't deliberately "infect" people (even as part of vaccination trials) in which case sign me up straight away! Some vaccinations do contain a small dose of live virus but they are weakened so as not to cause serious illness (more info here), but really this is a whole new topic in its own right.

 

[Scrotnig]

A huge proportion of the public are scared witless of the virus. They believe its death rate for healthy young/middle-aged adults is high, and also believe that death rate for those "at risk" is essentially 100%. These people will condemn any loosening of lockdown or removal of social distancing as murder, and certainly won't be going out and supporting the economy. How do you get those people onside?

Stop their free money.

Attitudes will soon change.

 

[Yew]

The true test of assessing someone's risk appetite for going back to normal is to offer them the option to be deliberately infected.

Any takers from those on this thread?

If there was a kit available, I'd gladly take it. I can get back to proper normality afterwards, and do my part to protect those who are at risk

 

[Huntergreed]

Stop their free money.

Attitudes will soon change.

Sadly, I’ve had a lot of people saying they would rather lose their jobs and go on benefits than to “sacrifice their family for the government”, so even this may only change the attitude of some. It’s very worrying just how scared everybody is and the government only have theirselves to blame, to the point where it’s going to be difficult to ever exit this pandemic quickly if we don’t start changing our tune

 

[Scrotnig]

Sadly, I’ve had a lot of people saying they would rather lose their jobs and go on benefits than to “sacrifice their family for the government”, so even this may only change the attitude of some.

I strongly suspect that many don't understand the reality of that.
A lot of these people believe the media hype about the 'easy life' benefit claimants all have.
Once they realise that the car and house and holidays and nice clothes and lots of other stuff have to go, attitudes will definitely change.

You will have a hard core, I am certain, but these are probably people well adjusted to surviving on benefits int he first place.

It’s very worrying just how scared everybody is and the government only have theirselves to blame, to the point where it’s going to be difficult to ever exit this pandemic quickly if we don’t start changing our tune

What's worrying is not just that the government are to blame, but also that they seem to have no desire to try and get us out of it.

I have said since the start that they are reluctant to let go of the huge and unprecedented power over people's lives that they have acquired. I think they have decided they want to keep it like this, and are trying to condition us to accept it permanently.

 

[NorthOxonian]

The true test of assessing someone's risk appetite for going back to normal is to offer them the option to be deliberately infected.

Any takers from those on this thread?

If I was quarantined from others for the duration (ideally in fairly nice surroundings to compensate for the infection), and I was sure things would get back to normal afterwards, then yes. But other than being male and from a city, I'm in about the lowest conceivable risk group.

 

[APT618S]

Totally agree with the OP, and this is as a retired male who will be in a higher than average risk group and to be clear I would certainly take the risk of getting the virus and would not be shielding myself, assuming I have not already had the virus.
My concern is that the media and various groups/people for political purposes have latched onto the excess deaths metric rather than in my opinion the much better total Years of Life Lost (YLL) or the more nuanced and even better metric of QALYs (Quality Adjusted Life Years) lost across the whole of the population both now and in the future.
So as an extreme example of what I mean - if there was a binary choice between 60 elderly people dying 6 months prematurely now or a newborn baby dying 40 years prematurely in approx 40 years time my choice would be in favour of allowing the baby to live the additional 40 years of life and the the 60 elderly people losing a combined 30 years of life as this is the lowest YLL by 10 years.
Whereas this decision would result in the highest eccess deaths figure.
I strongly believe that the lockdown policies will result in a significantly higher YLL over the next decades than if we had gone for the original herd immunity due to two main causes.
Firstly, the cessation of a lot of normal NHS work e.g cancer screening etc. and secondly the economic damage that is being inflicted on a huge number of working age people and people about to enter the job market. This is because we know that poverty and unemployment affect peoples life expectancy in a negative way.

 

[Mag_seven]

The true test of assessing someone's risk appetite for going back to normal is to offer them the option to be deliberately infected.

Any takers from those on this thread?

That's a ridiculous argument - its almost like saying in order to prove you are happy with the risk of getting run over when crossing the road you should deliberately walk out in front of a car.

 

[6Gman]

I think many will agree with me when I say that the government have created quite the predicament for themselves.

They started off with trying to achieve herd immunity naturally by allowing the virus to simply spread through the population, however due to the public being disgusted by this (possibly because they don't have a fully developed understanding of epidemiology), they suddenly decided to switch to an elimination approach through a nationwide lockdown, which initially was to prevent the NHS from getting overwhelmed, however in recent weeks it's become clear that the government are no longer clear on what their own approach is to getting out of this situation.

I do think that one thing is for certain, however. The only way that the United Kingdom can fully exit this pandemic and return to normal is through achieving herd immunity, either through a vaccine (which is absolutely not guaranteed) or through natural immunity caused by antibodies which form after infection. In my opinion, we are going to have to, sooner or later, switch to an approach of natural herd immunity to allow for the virus to work its way through the healthier population who are least at risk of dying from it.

This all presupposes that herd immunity can be achieved. There is considerable doubt whether infection does in fact lead to long term (or even medium term) immunity.

If immunity does not arise from infection then herd immunity cannot be achieved.

 

[6Gman]

One thing that’s becoming more puzzling to me as time goes on:

Why haven’t the medical advisors realised this yet?

It’s not difficult to figure out that elimination at this point is just impossible, and that other than a vaccine there’s only one way to exit the pandemic. It seems odd that Whitty or Vallance haven’t realised that a change in approach is needed to allow us to exit this pandemic more quickly.

Perhaps because they know more about the subject than random posters on a railway forum?

 

[greyman42]

Sadly, I’ve had a lot of people saying they would rather lose their jobs and go on benefits than to “sacrifice their family for the government”, so even this may only change the attitude of some.

What do these people plan on doing for a pension, or do they believe you can live off a state pension?

 

[Starmill]

Emerging evidence suggests that the disease has vascular effects rather than only respiratory ones. It does not seem like any of your proposals recognise this though?

Perhaps it would assist if more people took a moment to accept that they're not doctors and also that they probably haven't done enough literature review (the equivalent of at least a full time job) to actually give out informed opinions about the virus?

There's been a lot of arguing and anger, as opposed to civil disagreement on technical points, in this forum. Admittedly, this has been augmented by callousness and insensitive choices of words by contributors like the OP (and I see their contributions in this thread are no exception), but to my mind the root cause is a quick-fire posting of opinions based on a narrow and uninformed view. Some posters do this about almost every topic, putting no real thought into forming their opinion, but the ones doing it about this topic which is both very serious and also very complicated and nuanced, are bound to start arguments.

Having got all that out of the way I will add that I think that pretty much all of Huntergreed's opinions are completely wrong. There's very little evidence presented in support of them and some of the points go into detail based on an incomplete or inaccurate understanding, or outdated information. I could go further than this into the details but I've tried to do that before and it turns the thread into a bin fire.

 

[43066]

This all presupposes that herd immunity can be achieved. There is considerable doubt whether infection does in fact lead to long term (or even medium term) immunity.

If immunity does not arise from infection then herd immunity cannot be achieved.

Ok then, say heard immunity can’t be achieved, and we never end up with a vaccine. Do we just continue to drive the economy into the ground?

Sorry, but at some point normal life needs to resume, even if that means more deaths from the virus. And normal life doesn’t mean 2m social distancing and wearing bloody masks everywhere.

What do these people plan on doing for a pension, or do they believe you can live of a state pension?

Quite. I suspect attitudes will change when the reality of £70 a week JSA (or wherever it is) hits home.

Perhaps because they know more about the subject than random posters on a railway forum?

I have absolutely no faith that they (or the government) have the slightest clue what they’re doing.

 

[Starmill]

But back on topic: do you think the virus could actually be eliminated

You've deployed this straw man again and again. Nobody is arguing for the end of all transmission. Instead people are arguing for proper control: testing and contact tracing, and improved treatment options. All of these are in their infancy in the UK, although other countries have deployed the first two extremely effectively. The third is part of a global effort which has just borne its first fruits. I am sure that there will be more to come.

 

[43066]

The true test of assessing someone's risk appetite for going back to normal is to offer them the option to be deliberately infected.

Any takers from those on this thread?

I’m not particularly bothered about contracting it myself.

But that’s because, unlike a large % of the population, I’m able to think critically and I understand the virus poses a negligible risk to me, as a healthy young(ish) adult.

 

[6Gman]

I’m not particularly bothered about contracting it myself.

But that’s because, unlike a large % of the population, I’m able to think critically and I understand the virus poses a negligible risk to me, as a healthy young(ish) adult.

I'm not particularly bothered about contracting it myself either. (Though I'd prefer to avoid it.)

I am bothered about passing it on to, for example, the elderly couple whose shopping I've been doing for the past 11 weeks while they screen due to their health conditions.

If masks and social distancing (and handwashing and other hygiene precautions) reduce that danger I'm happy to do so.

 

[6Gman]

You've deployed this straw man again and again. Nobody is arguing for the end of all transmission. Instead people are arguing for proper control: testing and contact tracing, and improved treatment options. All of these are in their infancy in the UK, although other countries have deployed the first two extremely effectively. The third is part of a global effort which has just borne its first fruits. I am sure that there will be more to come.

This is the key. If we can keep the infection rates below the capacity of the NHS to cope then we minimise unnecessary deaths.

 

[43066]

I'm not particularly bothered about contracting it myself either. (Though I'd prefer to avoid it.)

I am bothered about passing it on to, for example, the elderly couple whose shopping I've been doing for the past 11 weeks while they screen due to their health conditions.

If masks and social distancing (and handwashing and other hygiene precautions) reduce that danger I'm happy to do so.

I take that point, I would not want to pass the virus on to someone who is high risk either.

But if these people are isolating themselves, there is no reason for the healthy population to remain locked down. It’s increasingly clear that social distancing is completely incompatible with normal life.

Something that also seems to be lost on a lot of people is that recessions can be just as deadly as pandemics, and we’re now heading into the worst recession for three hundred years, according to the Bank of England.

This is the key. If we can keep the infection rates below the capacity of the NHS to cope then we minimise unnecessary deaths.

But what about the thousands per week of missed cancer diagnoses? In many cases these would have been curable cancers, that will now become terminal, due to late diagnosis/treatment. What about the patients dying from many other conditions, on waiting lists for operations that have been delayed, due to the obsession with this virus.

Are these not “unnecessary deaths”? In many cases the victims are a lot younger than the average COVID 19 victim.

EDIT: and a sizeable % of the population apparently *do* believe that lockdown is intended to eliminate the virus, and that we should remain locked down until there are no more cases, or until we have a vaccine.

Utter madness.

 

[Bantamzen]

This is the key. If we can keep the infection rates below the capacity of the NHS to cope then we minimise unnecessary deaths.

Sorry but you've missed that boat, there will now be people who won't receive the treatment they need because what they are suffering from is not covid. Do those potential deaths count?