COVID-19, balancing one restriction against another.

Jamiescott1

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The school I work in opens for pupils on 1st September. I'm back to work on Monday after a month annual leave so will see then how we are planning on opening.

My biggest issue is that so much focus is given to the R number and number of cases. I think hospital admissions and deaths are a better indicator because more cases doesn't necessarily mean more deaths
 
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AdamWW

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He is professor of infectious disease modelling at the London School of Hygiene & Tropical Medicine and the director of the Centre for the Mathematical Modelling of Infectious Diseases. If that doesn't give him credentials as an expert in this field we truly are lost and I have no idea what would qualify someone as an expert.
That's easy - anyone who can bash out a thread on Twitter....
 

DannyMich2018

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The school I work in opens for pupils on 1st September. I'm back to work on Monday after a month annual leave so will see then how we are planning on opening.

My biggest issue is that so much focus is given to the R number and number of cases. I think hospital admissions and deaths are a better indicator because more cases doesn't necessarily mean more deaths
Very sadly cases are rising and the daily death/weekly totals have stopped going down. In the UK W/E 26th July we had 452 deaths, for W/E 2nd August we are on 441 already with one day to spare, if Sundays are more than 11 be higher than last weeks. Bojo's plan of opening up too quickly has I'm afraid not worked too well. Just look at Wales or (Scotland has all but eliminated deaths) and their more cautious strategies have resulted in far fewer cases and deaths.
 

AdamWW

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The school I work in opens for pupils on 1st September. I'm back to work on Monday after a month annual leave so will see then how we are planning on opening.

My biggest issue is that so much focus is given to the R number and number of cases. I think hospital admissions and deaths are a better indicator because more cases doesn't necessarily mean more deaths
There is a good reason to focus on R.

Suppose it goes above 1.

That means infections will start rising. Very hard to see how this won't result in more hospital admissions and deaths - but they come through a bit later (particularly deaths) - the first warning you get is from infection figures.

R is about whether cases increase or decrease. not the overall level.

So it's all very well to say that the NHS has capacity and we can relax things. If we do and - say - R goes to 1.5, at some point we've reached whatever capacity the NHS has and to prevent it from being overwhelmed we need to get it down again.

And if for whatever reason the chance of being hospitalised or dying has gone down, the same applies it just takes a bit longer, unless we get to the point where the chance is so small that no matter how high infection rates get we can cope. There's nothing at the moment to suggest we are there.
 

DelayRepay

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I think it's quite a logical statement and I am surprised to see the Professor's credentials challenged as a result.

More social interaction = more cases = more hospitalisations = more deaths.

Within the equation you can reduce deaths through improved treatment
You can reduce hospitalisations by protecting the most vulnerable
You can reduce cases by effective test and trace, and by social distancing, maybe face coverings, hand washing, cleaning, plastic screens...
But if all of that fails, you gotta reduce social interaction which means closing something. Then you have to decide whether the least bad thing to close is pubs, schools, leisure venues, places of worship, workplaces or some combination. Or banning meeting other households inside, in the garden, in the park...
 

AdamWW

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I think it's quite a logical statement and I am surprised to see the Professor's credentials challenged as a result.

More social interaction = more cases = more hospitalisations = more deaths.

Within the equation you can reduce deaths through improved treatment
You can reduce hospitalisations by protecting the most vulnerable
You can reduce cases by effective test and trace, and by social distancing, maybe face coverings, hand washing, cleaning, plastic screens...
But if all of that fails, you gotta reduce social interaction which means closing something. Then you have to decide whether the least bad thing to close is pubs, schools, leisure venues, places of worship, workplaces or some combination.
Quite.

But if you have convinced yourself that all that matters is the death figures and as they are now at a low rate compared to other risks of dying that means that the epidemic is nearly over in the UK, then what he's saying will seem unnecessarily alarmist.
 

AM9

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Personally, I think that Professor Medley has chosen to highlight the situation in a way that is almost guaranteed to create a debate. As several here have explained, a characteristic of this epidemic is that the rate of increase (and decrease) in infections is determined by the number of persons that each infected individual passes it on to, (the 'R' figure). However that figure is generated and might be subjected to local inaccuracies, the global (as in national) figure can be derived from the infection rate. As has also been explained, the social activities permitted and the behaviour of people when engaged in those activites are the major driver in the progress of the epidemic. The more activities allowed, the more likely they will facilitate the spread, even if every citizen follows the recommendations religiously. So by releasing all children to attend school, full time - a worthy aim given all the expert advice that children and their parents/guardians are facing long-term difficulties, the government is tipping more infection opportunities into the public domain. If the infection rate does start on a trajectory that could cause a runaway increase of cases, the government is duty bound to do something about it.
That is where the debate now rests, i.e., where to look first. Professor Medley has judiciously chosen two freedoms that would probably each have a different impact if curtailed. Their impacts probably have quite different demographic defenders. So far, nobody here has attempted to engage on that debate, many preferring to make ad hominem attacks on the professor or other experts that would probably be involved in that debate at government level.
 
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CaptainHaddock

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He is professor of infectious disease modelling at the London School of Hygiene & Tropical Medicine and the director of the Centre for the Mathematical Modelling of Infectious Diseases. If that doesn't give him credentials as an expert in this field we truly are lost and I have no idea what would qualify someone as an expert.
Ah but he's not an expert on politics or the economy, is he?

The big issue now is that several scientists (Chris "Dim" Whitty being another example) are enjoying their new found celebrity status a little too much and seem to think they should be determining government policy rather than simple advising and letting the politicians make the decisions.

After all the hospitality industry's efforts to reopen under ridiculously stringent health&safety restrictions it would be catastrophic for the economy and people's livelihoods if there were any suggestion they should close again. Prof Meddly should stop meddling in politics and stick to what he knows about!
 

Jamiescott1

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22 Feb 2019
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There is a good reason to focus on R.

Suppose it goes above 1.

That means infections will start rising. Very hard to see how this won't result in more hospital admissions and deaths - but they come through a bit later (particularly deaths) - the first warning you get is from infection figures.

R is about whether cases increase or decrease. not the overall level.

So it's all very well to say that the NHS has capacity and we can relax things. If we do and - say - R goes to 1.5, at some point we've reached whatever capacity the NHS has and to prevent it from being overwhelmed we need to get it down again.

And if for whatever reason the chance of being hospitalised or dying has gone down, the same applies it just takes a bit longer, unless we get to the point where the chance is so small that no matter how high infection rates get we can cope. There's nothing at the moment to suggest we are there.
Increased infections doesnt necessarily mean increased deaths and hospital admissions. I guess we'll find out in about 2 weeks
 

Baxenden Bank

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Ah but he's not an expert on politics or the economy, is he?

The big issue now is that several scientists (Chris "Dim" Whitty being another example) are enjoying their new found celebrity status a little too much and seem to think they should be determining government policy rather than simple advising and letting the politicians make the decisions.

After all the hospitality industry's efforts to reopen under ridiculously stringent health&safety restrictions it would be catastrophic for the economy and people's livelihoods if there were any suggestion they should close again. Prof Meddly should stop meddling in politics and stick to what he knows about!
Also, I dare to presume that he is not an expert in mental health (ie increased depression and suicides) nor sociology and criminology (ie domestic violence and civil unrest). I note from an article today that one of the SAGE sub-committees received a paper some time ago on the likelihood of serious, large scale, civil unrest if hard lockdown had not been eased. As professionals, I would expect Messrs Whitty and Meddly to refuse to comment on areas outside their respective professional expertise, but an acknowledgement that there is life beyond the virus may be useful. Unfortunately, the media seems no longer interested in balance and objectivity.
 

AdamWW

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Increased infections doesnt necessarily mean increased deaths and hospital admissions. I guess we'll find out in about 2 weeks
I don't think there is much to make us think they won't. But indeed we'll see.

Ah but he's not an expert on politics or the economy, is he?

The big issue now is that several scientists (Chris "Dim" Whitty being another example) are enjoying their new found celebrity status a little too much and seem to think they should be determining government policy rather than simple advising and letting the politicians make the decisions.

After all the hospitality industry's efforts to reopen under ridiculously stringent health&safety restrictions it would be catastrophic for the economy and people's livelihoods if there were any suggestion they should close again. Prof Meddly should stop meddling in politics and stick to what he knows about!
Also, I dare to presume that he is not an expert in mental health (ie increased depression and suicides) nor sociology and criminology (ie domestic violence and civil unrest). I note from an article today that one of the SAGE sub-committees received a paper some time ago on the likelihood of serious, large scale, civil unrest if hard lockdown had not been eased. As professionals, I would expect Messrs Whitty and Meddly to refuse to comment on areas outside their respective professional expertise, but an acknowledgement that there is life beyond the virus may be useful. Unfortunately, the media seems no longer interested in balance and objectivity.
I think this attack is unjustified.

Read what they are saying. They are pointing out that we have probably reached the limit of how we can open up without starting infections rising again, and saying that increasing other restrictinos may be necessary. Look at all the qualifiers they use.

How do you get from that to saying they are meddling in politics, commenting in areas outside their field, determining policy etc?

They have come to a conclusion on something in their field, based on the evidence available. What do you think they should have been saying?

Should he have failed to demonstrate the point by suggesting as an example that pubs might need to close so that schools could open? Is that the problem? Should he have said "Some unspecified activity might have to stop but I can't given an example?"
 

AM9

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Also, I dare to presume that he is not an expert in mental health (ie increased depression and suicides) nor sociology and criminology (ie domestic violence and civil unrest). I note from an article today that one of the SAGE sub-committees received a paper some time ago on the likelihood of serious, large scale, civil unrest if hard lockdown had not been eased. As professionals, I would expect Messrs Whitty and Meddly to refuse to comment on areas outside their respective professional expertise, but an acknowledgement that there is life beyond the virus may be useful. Unfortunately, the media seems no longer interested in balance and objectivity.
As you rightly point out, the experts mentioned in this thread are leading experts in their fields, but AFAIK, none of them have claimed expertise on any unrelated specialisms on which they are not experts. I would be concerned if they did. Politicians don't expect them to be either as they have access to leading experts in those fields and wouldn't be daft enough to ask somebody to comment ouutside their expertise. It seems to me that some of the members of RUK are speaking as if they are experts in many diverse fields of knowledge, especially when they find the acknowledged experts considered opinions 'inconvenient'. COVID-19 seems to be a very fertile breeding ground for opinions from 'armchair experts'.
 

yorksrob

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If whitty or anyone else thinks that I'm going to happily give up going to the pub, just so some youth can eat boiled cabbage and see a picture of an ox bow lake, he's got another think coming.

Come up with some other ideas Whitty.
 

Ianno87

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If whitty or anyone else thinks that I'm going to happily give up going to the pub, just so some youth can eat boiled cabbage and see a picture of an ox bow lake, he's got another think coming.

Come up with some other ideas Whitty.
I don't want my 4 year old's start at school (and thus in life) buggered so a few lads can go on the razz on a Saturday night...
 

yorksrob

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I don't want my 4 year old's start at school (and thus in life) buggered so a few lads can go on the razz on a Saturday night...
We were taught in a hut with no heating. It made no difference.. We still had the same spread who went to Uni and who didn't.
 

CaptainHaddock

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If whitty or anyone else thinks that I'm going to happily give up going to the pub, just so some youth can eat boiled cabbage and see a picture of an ox bow lake, he's got another think coming.

Come up with some other ideas Whitty.

I don't want my 4 year old's start at school (and thus in life) buggered so a few lads can go on the razz on a Saturday night...
Here's a compromise; ban children from pubs and ban adults from schools (apart from teachers obviously!). That way both can stay open as the two groups wouldn't mix socially.
 

yorksrob

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Hi

This is probably a dumb question, but I'm wondering why there always seems to be at least one diesel loco in the sidings at York Station (closest to the York Station Webcam)?

There is one there at the moment (01/08/2020 18:15) but I've seen two before

Jeremy
I don't know if I mentioned my thoughts on the ban on home gatherings specifically at another point in the thread, but their logic for doing it was that "the majority of infections picked up by track and trace were household to household".

But aren't those the only infection chains it can effectively trace, when you know the person who gave it to you? Fat chance of that happening in a restaurant or pub.
So you weren't deprived of an education, like you are proposing for my children?
They could use the upstairs room if they needed to.
 

Reliablebeam

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Ah but he's not an expert on politics or the economy, is he?

The big issue now is that several scientists (Chris "Dim" Whitty being another example) are enjoying their new found celebrity status a little too much and seem to think they should be determining government policy rather than simple advising and letting the politicians make the decisions.

After all the hospitality industry's efforts to reopen under ridiculously stringent health&safety restrictions it would be catastrophic for the economy and people's livelihoods if there were any suggestion they should close again. Prof Meddly should stop meddling in politics and stick to what he knows about!
As a professional scientist in the public sector, it's very interesting to read all of your views! I might inject into the discussion here that this has been a topic of discussion within my team and my collaborators - a number of us are concerned that some SAGE members are enjoying their celebrity a bit too much. Increasingly, we feel that scientists will be blamed when the economy inevitably goes belly up - 'the nerds told me to do it' says BoJo....

As for the R number, this isn't my area but looking at the methodologies the mythical 'R' will inevitably destabilise when you're looking at low to modest infection rates, something which was pointed out to ministers..
 

Richard Scott

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So you weren't deprived of an education, like you are proposing for my children?
They're being deprived already so let's open up schools. Your 4 year old is more likely to die in an accident at school than from this virus of we're being blunt. It'll be your decision to deprive them of their education. We need schools open and parents need to send their children in otherwise we'll be waiting for ever. A few people going to a pub aren't causing much difference. If we keep on like this your child may get an education but country won't have any jobs for them. There's no Utopia and causing people to lose jobs so children can go to school is not acceptable. Children have next to no chance of dying from this.
 

Scrotnig

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Nationally, I think there should be no more easings now until a few weeks after schools go back.
And I'm in favour of getting rid of all this nonsense as soon as possible, (and I do not have children!) but I think the current 'pause' is right because we need to get the schools fully, properly back. No 'blended learning' or other such nonsense.
 

duncanp

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We should also see what happens in Scotland, as schools go back there on August 11th, as opposed to the first week in September for England and Wales.

If Scottish schools re-open and there isn't a dramatic increase in cases there, then that should give confidence that opening schools in England should be safe.

Everyone associated with a school, (teachers, support staff and pupils) should heed strict advice to stay at home, and to get tested if they feel unwell.

The local authority should also consider a mass testing program of all school pupils and staff as early as possible in the term.
 

Yew

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There is a good reason to focus on R.

Suppose it goes above 1.

That means infections will start rising. Very hard to see how this won't result in more hospital admissions and deaths - but they come through a bit later (particularly deaths) - the first warning you get is from infection figures.

R is about whether cases increase or decrease. not the overall level.

So it's all very well to say that the NHS has capacity and we can relax things. If we do and - say - R goes to 1.5, at some point we've reached whatever capacity the NHS has and to prevent it from being overwhelmed we need to get it down again.

And if for whatever reason the chance of being hospitalised or dying has gone down, the same applies it just takes a bit longer, unless we get to the point where the chance is so small that no matter how high infection rates get we can cope. There's nothing at the moment to suggest we are there.
I'm still yet to see anyone who has a legitimate exit strategy from the "Keep R<1" brigade that isn't "Hope we can find a vaccine faster than we've ever found one before". Whilst of course I'd love it to be proven to work, I'm just unsurethat gambling on a phenomenally quick turn around is sensible.

In the absence of a vaccine, we'll have to rely on natural herd immunity, and keeping infection numbers small means that it's going to take a very long time, and has a much higher risk of any immunity wearing off.before a critical mass can be reached.
 

duncanp

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I'm still yet to see anyone who has a legitimate exit strategy from the "Keep R<1" brigade that isn't "Hope we can find a vaccine faster than we've ever found one before". Whilst of course I'd love it to be proven to work, I'm just unsurethat gambling on a phenomenally quick turn around is sensible.

In the absence of a vaccine, we'll have to rely on natural herd immunity, and keeping infection numbers small means that it's going to take a very long time, and has a much higher risk of any immunity wearing off.before a critical mass can be reached.
And as has been pointed out, the lower the number of infections, the more unreliable the R rate is, particularly as there is no ojective way of knowing how many people someone with the virus really infects.

We need to look at how the R rate varies between different regions of the country, so that we can make better and more informed decisions.
 

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