England's new three-tier lockdown system

[birchesgreen]

Is a circuit breaker lockdown instead effective? Israel tried it. But it'll only be for a short time yeah?

Painful but effective? UK can look to Israel for example of short lockdown

Israel imposed ‘circuit breaker’-style lockdown at same time UK ministers ignored advice to do just that

www.theguardian.com

Days before UK ministers rejected advice to impose a shortened “circuit breaker” lockdown in late September, Israel made the opposite decision and enforced the unpopular and painful policy to stem the spiralling number of virus infections.

The country of 9 million – less than 15% of the population of Britain – was shut down for a second time, with Israeli officials arguing it was essential to halt infections or risk overloading hospitals.

As the UK and other countries consider implementing shorter lockdowns, Israel presents an example of their benefits and perils. While clearly stalling infections, the second lockdown has further pummelled the economy and infuriated much of the public, some of whom have defied the rules out of frustration and apathy.

Originally scheduled for three weeks, the lockdown has already been extended, dealing a hammer blow to many small businesses.

 

[Philip]

BBC news is reporting that Greater Manchester and Lancashire are likely to be put into tier 3 along with Merseyside in the near future; this is probably appropriate, given the similar Covid infection rates. There also needs to be police enforcement of non-essential travel to/from/within the tier 3 areas to reduce the need for a national lockdown in the way that Starmer and others are demanding.

Covid-19: New three-tier restrictions come into force in England

Most of the country is in the lowest tier but millions in the North and the Midlands face extra curbs.

www.bbc.co.uk

Government health officials are due to meet later to discuss the possibility of Greater Manchester, Lancashire and some other areas joining the top tier.

I agree. The extra restrictions should be targeted at Lancashire/Liverpool/Manchester and the West Riding (Leeds/Sheffield), rather than the whole of England.

Greater Manchester rates have levelled off in the last week with Manchester itself seeing a drop, so what is putting GM in tier 3 going to achieve?

 

[daodao]

Is a circuit breaker lockdown instead effective? Israel tried it. But it'll only be for a short time yeah?

Painful but effective? UK can look to Israel for example of short lockdown

Israel imposed ‘circuit breaker’-style lockdown at same time UK ministers ignored advice to do just that

www.theguardian.com

Israel is different to the UK (or even England) in that it is fairly compact, and even within the country, most of the population lives within the central belt from Haifa to the Tel Aviv conurbation and extending to Jerusalem. In addition, family and community play a big part in Jewish life, with formal prayer requiring a gathering of at least 10 adult males, which encourages viral spread, and unfortunately has led to a Covid death rate among the Jewish community in the UK 4-5 times higher than that of the general UK population.

 

[Bantamzen]

Is a circuit breaker lockdown instead effective? Israel tried it. But it'll only be for a short time yeah?

Painful but effective? UK can look to Israel for example of short lockdown

Israel imposed ‘circuit breaker’-style lockdown at same time UK ministers ignored advice to do just that

www.theguardian.com

Yeah, it will just be a few weeks, months, years....

 

[big_rig]

Yeah, it will just be a few weeks, months, years....

Yep. Another lie we can add to that is that Keir Starmer (or anybody else for that matter) has any idea what ‘getting a grip on test and trace’ actually means in practice and that whenever they think it means can be achieved in two weeks.

 

[duncanp]

Greater Manchester rates have levelled off in the last week with Manchester itself seeing a drop, so what is putting GM in tier 3 going to achieve?

Quite - and a similar pattern is happening in Liverpool

The table below shows, for each week, the percentage increase in the infection rate in the city of Liverpool compared with the week before

Week 37 - 118%
Week 38 - 78%
Week 39 - 69%
Week 40 - 61%

For the last 7 days, the infection rate is about 10% higher than that for week 40, so unless there is a dramatic spike in cases in Liverpool before tomorrow, the rate for week 41 will be about 10 - 15% higher than that for week 40.

This clearly shows that the rate of increase is slowing down, and given a few more weeks, it will stop rising and start to fall again, without the need for further interventions.

Similar patterns can be seen in other boroughs in the Liverpool City Region and also in the North East, where every local authority is projected to have a smaller percentage increase in their infection rate for week 41 compared to week 40. Sunderland and South Tyneside have even seen small decreases in their infection rates.

I do hope Boris Johnson holds his nerve and doesn't introduce further measures without waiting at least 4 weeks to see whether the three tier system is working properly.

One way or another, we will find out whether these so called "circuit breaker" lockdowns work by the middle of next month.

Tighter measures have been imposed in Scotland and are about to be imposed in Northern Ireland.

The leaders of these two countries will no doubt be praying that the figures come down sufficiently, because if they close down the hospitality sector and the figures are still rising, they can't blame the hospitality industry any more.

 

[Bantamzen]

And in other news, Bradford council joins the list of local authorities chasing a few extra bones from the government by wanting Tier 3 restrictions, in the same week it was announced that universal credit claims were up 75% from April. Clearly as with others, they have their fingers on the brown paper envelopes, erm pulse...

 

[ChrisC]

Think you're forgetting we've put up with restrictions for best part of 7 months so expecting continual compliance is not realistic. Many are fed up and for their own wellbeing, and maybe for that of a family member, are ignoring certain rules. The virus is not the only issue out there, need to remember that.

Completely agree. I have followed the rules right from the beginning, and although I have not been one of those who has been terrified to go out, I have been extremely careful where I go and who I mix with, due to having my elderly mother with dementia living with me. Since March, I have not been in any crowded places, not been into any large shops, not been into a pub, avoided towns as much as possible, very rarely been on public transport etc. I have recently been away on a couple of short holidays but they have been in very quiet country areas avoiding all busy attractions and tourist locations. I’ve really missed regularly seeing my friends and holidays travelling around the country by train but I’ve done it to protect my mum.

I found the first 3 months of lockdown very difficult having to look after mum on my own without the help of my sister and her partner who live about 40 miles away. Since the beginning of July it’s been much easier when restrictions were relaxed and overnight stays were allowed together with the introduction of support bubbles and a limited amount of households able to meet first outdoors and then indoors.

Now that where I live with my mum is in Tier 2 and where my sister and her partner live is in Tier 1, the meeting of both households is probably not allowed. I find the rules for support bubbles difficult to understand but I don’t think it technically allows 2 households, each with 2 people in to meet indoors or stay overnight. I think it’s mainly intended for a single person to be able to meet with another household. I’ve decided this time, for the sake of my mums well being and even more for my own mental health, I’m not caring for my mum single handed. We will continue to drive over and meet once a week and my mum will continue to go and stay with my sister and her partner for a few days each month to give me some respite. My sister and her partner are also being as cautious as I am to allow this to happen safely.

 

[duncanp]

And in other news, Bradford council joins the list of local authorities chasing a few extra bones from the government by wanting Tier 3 restrictions, in the same week it was announced that universal credit claims were up 75% from April. Clearly as with others, they have their fingers on the brown paper envelopes, erm pulse...

Quite, it beggars belief that any local authority would actually want to have extra restrictions.

The fact that the government offers the council £2 per head of population if you are put into Tier 3, and £1 per head of population if you are put into Tier 2, may have something to do with it.

Of course, none of this extra money is likely to find its way to the people who really need it, ie those who have been made redundant, or those whose businesses have been forced to close.

 

[Bantamzen]

Quite, it beggars belief that any local authority would actually want to have extra restrictions.

The fact that the government offers the council £2 per head of population if you are put into Tier 3, and £1 per head of population if you are put into Tier 2, may have something to do with it.

Of course, none of this extra money is likely to find its way to the people who really need it, ie those who have been made redundant, or those whose businesses have been forced to close.

This I believe is part of the Cummings / Johnson strategy. They know that more restrictions equal more economic woes, I'm just Sunak has been badgering them about this for month, and they know that they will be deeply unpopular even amongst their own ranks by forcing Tier 3 on areas. So they chose one helpfully un-Conservative area, i.e. Liverpool to act as the fall guy, then dangled extra cash £2 per head instead of £1 for any other councils taking the bait. Then when they do and the local populations kick off, the government just points at the councils involves and sits back.

Clever, very clever, at least by this government's standards, albeit hugely cynical. Pay councils to p*** off their locals by risking their jobs for the pittance the government might eventually give them.

 

[jtuk]

Highly unlikely I feel as they reached their highest ever daily rate of infections late last week, and amongst those testing positive in Geneva was the U.N. high commissioner for human rights who heads the U.N. refugee agency.

Really? They had the level of testing they do now back in March/April?

 

[Peter Sarf]

We need to study the feasibility of cheap tools (in terms of economic/mental damage) to limit the spread and so reduce the damage caused by progression to higher tiers. From my experience at work that is limiting number of people in areas - particularly rest areas (eating = no mask). We have added new rest areas. And also the steadily increasing enforced use of masks at work. We are also cleaning all door handles daily. We clean office/machine areas where an isolating (not even positive) person was working. A negative is we have a lot of temporary staff who are less likely to isolate because their break will be unpaid. I do hope these measures are providing more than just reassurance otherwise we will all end up in tier-3 or even a new tier-4 !.

.........
How much human suffering are you willing to cause to try and defeat the undefeatable?

I see Covid-19 as not defeatable. We are just trying to let it through our population at a manageable rate. Keeping within NHS capacity including all other ailments. We will have to learn to live with it. the Tiered system is a way of locking down parts of the country selectively. That is its advantage. It allows parts of the country with lower rates of infection ,and so hospital admissions, to carry on more normally. Those parts of the country will suffer less economic damage and so the economic (and psychological) damage is only done where strictly necessary.

And the above is fair because the UK economy overall will be better placed to support the hardest hit tier-3 areas.

Talking of hospital admissions. I have not studied the figures but what exactly is a driver of the tier system ?. Is it number of infections or is it number of hospital admissions ?. If you have a massive number of infections but very low hospital admissions then no need to protect the NHS. Perhaps that is happening in university towns ?. I suspect that the indicator of what tier an area is heading for is going to be how many Nightingale hospitals are being opened up nearby.

My gut feeling is that the Three Tier system won't last long enough for anyone to find out whether it is working. I suspect that within the next 7 - 10 days, if that, there will be a further announcement that the figures are still rising and we must have a short 3 week month national lockdown.

I hope the tier system lasts because it is a less blunt instrument than a national lockdown. But I think this is going to be determined by how Covid-19 flourishes in a Winter not by any political parties individual (point scoring) ideas.

 

[Yew]

I see Covid-19 as not defeatable. We are just trying to let it through our population at a manageable rate. Keeping within NHS capacity including all other ailments. We will have to learn to live with it. the Tiered system is a way of locking down parts of the country selectively. That is its advantage. It allows parts of the country with lower rates of infection ,and so hospital admissions, to carry on more normally. Those parts of the country will suffer less economic damage and so the economic (and psychological) damage is only done where strictly necessary.

I understand it to be cases, but I agree that hospitalisations is a better measure, as it's less susceptible to observer effects.

 

[Trackman]

Greater Manchester rates have levelled off in the last week with Manchester itself seeing a drop, so what is putting GM in tier 3 going to achieve?

What’s changed since Monday?
Someone made a decision then. I’m baffled.
As you say rates are going down, if it was the other way- well fair enough.

 

[adc82140]

What’s changed since Monday?
Someone made a decision then. I’m baffled.
As you say rates are going down, if it was the other way- well fair enough.

To put it bluntly, and apologies for my coarseness here(and indeed if it breaks any forum rules), it's turned in to a dick waving competition between the metropolitan mayors.

They are playing with people's livelihoods. This is not the time or place for them to try and cement their legacy.

 

[Skimpot flyer]

So 30 boroughs had reduced 7 day averages today with 2 having increases - overall average is 84 across the city so at city wide level thats OK but some areas as you detail are significantly higher but the virus is like a pebble in a pond it ripples out but whether intervening at borough level will work let alone be enforceable is debatable

Let’s get some perspective

Even if positive test levels (note: not cases) were slightly higher at say 100 per 100,000, that means

You have a 1 in 1000 chance of being close to an infected person.
The mortality rate is, what? 0.13%

Calculate the risk of catching and dying from this virus in London... it will be substantially less than dying from other causes

 

[kristiang85]

Is a circuit breaker lockdown instead effective? Israel tried it. But it'll only be for a short time yeah?

Painful but effective? UK can look to Israel for example of short lockdown

Israel imposed ‘circuit breaker’-style lockdown at same time UK ministers ignored advice to do just that

www.theguardian.com

Israel, like Czechia, is a classic example of a harsh lockdown just delaying the inevitable wave to later in the year, thus just prolonging the epidemic in the country.

And What this article doesn't mention is that of 297,274 positive tests in Israel there have been 2,055 deaths. That's a fatality rate of 0.6%. Which, considering there are probably a lot of missed positives, means the ballpark figure of 0.2-0.3% is about correct. It is also roughly in line with Israel's annual influenza deaths, which I'm pretty sure they haven't destroyed their economy to try and stop in the past.

 

[Howardh]

What’s changed since Monday?
Someone made a decision then. I’m baffled.
As you say rates are going down, if it was the other way- well fair enough.

Manchester is one part of the ten boroughs* (eg Bolton, Bury are another two) Some boroughs have stabilised, some gone up, one gond down, Manchester. However, that borough was the highest by a mile.
*Boroughs might not be the correct term, Salford's a city etc.

 

[Skimpot flyer]

They absolutely have to use hospitalisations as the sole trigger for putting an area into a higher tier of restrictions.
If those opposed to more restrictions are intelligent, they’ll soon realise that not going for a test at all means that new ‘cases’ in their area will ‘fall’ and thus no harsher measures will be applied

 

[kristiang85]

They absolutely have to use hospitalisations as the sole trigger for putting an area into a higher tier of restrictions.
If those opposed to more restrictions are intelligent, they’ll soon realise that not going for a test at all means that new ‘cases’ in their area will ‘fall’ and thus no harsher measures will be applied

Agreed, hospitalisations and deaths are a more accurate measure than positive tests.

However, even these have to be viewed with caution. Here is a document of definitions from the NHS England website: https://www.england.nhs.uk/statisti...tes/2/2020/07/Publication-definitions-doc.pdf

Definition of confirmed COVID-19 patients:
• For all relevant data items: a confirmed COVID-19 patient is any patient admitted to the
trust who has recently (ie in the last 14 days) tested positive for COVID-19 following a
polymerase chain reaction (PCR) test.
• Patients who have been diagnosed via X-ray and assessment rather than a positive test
should be counted as suspected (and not confirmed) COVID-19 patients.
• Report a patient as a confirmed COVID-19 patient in the sitrep for as long as they are being
treated as a COVID-19 patient – so either they are being treated for COVID-19 caused
symptoms or the trust is still taking the precautions they would take with a COVID-19
positive patient.
• A patient who has previously but not recently – (ie not in the last 14 days) had a positive
COVID-19 test and is admitted for non-COVID-19 related treatment should not be counted
as a confirmed COVID-19 patient.

The first and last points seems to infer that if you go in, for example, due to injuries sustained in a motorbike accident, but they test you on admittance and it comes back positive, then you are added to the official stats as a COVID-19 hospitalisation.

Given that we are seeing the usual seasonal increase in respiratory infections (of which many are the coronavirus version of the common cold, and these are likely being picked up as a PCR positive case as well), then the rise in hospitalisations is a virtual certainty, no matter what is actually going on with the virus.

 

[DB]

The first and last points seems to infer that if you go in, for example, due to injuries sustained in a motorbike accident, but they test you on admittance and it comes back positive, then you are added to the official stats as a COVID-19 hospitalisation.

This one really wouldn't be difficult to address either - all they need is two sets of stats, one for those admitted because of Covid symptoms and one for those admittted for something else but who incidentally tested positive for it.

It does seem like yet another attempt to make the stats look worse than they are in reality.

 

[Solent&Wessex]

And in other news, Bradford council joins the list of local authorities chasing a few extra bones from the government by wanting Tier 3 restrictions, in the same week it was announced that universal credit claims were up 75% from April. Clearly as with others, they have their fingers on the brown paper envelopes, erm pulse...

This does not surprise me.

Bradford Council have been particularly keen on locking their residents and businesses down throughout the whole affair.

The "Do not leave your home unless you need to / Essential travel only" message and banner has never been taken off their website and has been displayed throughout, even when we were allowed out to socialise.

The roadside orange info signs have said similar throughout.

In my area the enforcement officers are known to visit pubs and premises on an almost weekly or fortnightly basis to check they are complying.

They have been in constant battle with some of the MPs in the area about the extent of the restrictions and were most upset when some wards got removed from the local restrictions for a bit, even though at the time, those wards on the outskirts of the district had no Covid cases at all for weeks on end and all the cases were centred on Bradford City itself. Their constant message has been "we are all in in together, if one part of the district suffers so do you all" without recognising that residents from some parts of the district, eg Ilkley, never go anywhere near Bradford, but associate with, shop in and work in Leeds.

When local restrictions were reintroduced in those wards a few weeks ago they publicised that it was illegal to meet other households in hospitality. It wasn't, it was merely guidance. They went round telling venues they had to enforce this made up law. Even when they did correct their messaging it was very begrudgingly done and they made no apology for (some would say deliberately) providing misleading information.

They still have this obsession that the whole council area is in love with Bradford and everyone is closely associated with it. I couldn't think of anything further from the truth.

Even now a look at the localised figures show comparatively very low levels of Covid on the outskirts of the district with most cases being centred on the Bradford City area, with a small blip in one ward near Keighley.

 

[big_rig]

This one really wouldn't be difficult to address either - all they need is two sets of stats, one for those admitted because of Covid symptoms and one for those admittted for something else but who incidentally tested positive for it.

It does seem like yet another attempt to make the stats look worse than they are in reality.

The CEBM recently had a look into this, along with the similar investigations they did into figuring out that people dying three months after a test (probably of something else in many cases) were still counted as covid deaths, and something similar about hospital numbers in Scotland being many times higher than the rest of the UK.

From my reading of their work it sounds like people are tested on/prior to arrival to hospital, and seven days later. They think 10-20% or so of people tested negative on the first test and positive on the second, so chances are they got it in hospital (or in some cases of course acquired the virus before going into hospital but it hadn't come on enough on the first test to register).

Obviously this means the figures aren't right (but no matter what they are some people will still say they're too high), but it also means highlights regional differences which suggest some hospitals are better/worse than others in terms of having covid in them, which I think is the more important point given the imperfect data..

Probable healthcare associated infections in England - The Centre for Evidence-Based Medicine

Daniel Howdon, Jason Oke, Tom Jefferson, Carl Heneghan Recent days have seen an apparent rise in the proportion of patients

www.cebm.net

Recent days have seen an apparent rise in the proportion of patients newly admitted in hospital with COVID-19 that represent probable healthcare-associated infections (HCAIs), with these comprising 18% of all new hospital cases on 6 October. This is most apparent in the North West of England, where HCAIs made up 24% of all patients on this date.

 

[Peter Sarf]

Agreed, hospitalisations and deaths are a more accurate measure than positive tests.

However, even these have to be viewed with caution. Here is a document of definitions from the NHS England website: https://www.england.nhs.uk/statisti...tes/2/2020/07/Publication-definitions-doc.pdf



The first and last points seems to infer that if you go in, for example, due to injuries sustained in a motorbike accident, but they test you on admittance and it comes back positive, then you are added to the official stats as a COVID-19 hospitalisation.

Given that we are seeing the usual seasonal increase in respiratory infections (of which many are the coronavirus version of the common cold, and these are likely being picked up as a PCR positive case as well), then the rise in hospitalisations is a virtual certainty, no matter what is actually going on with the virus.

That is interesting, thanks for posting.

What I would say is that back in March-May approximately we saw :-

1. Large increases in hospital admissions when we expect things to calm down towards the end of winter.
2. Lots of patients moved out of hospitals into care homes etc even though they had been there for a reason.
3. Large numbers of people suffering respiratory failure in hospital and dying.
4. A large backlog of treatments for other fatal/non-fatal ailments that persists to this day.
5. Nightingale/backup hospitals setup.
6. Very worn down hospital staff.
7. My GF works in a private hospital - they were very busy with non-Covid-19 cases diverted to them.

The above, to me, are the indicators that something terrible was happening. We do not want to get there again as we are still recovering from that tidal wave. I think the tiered system must be tried as it leaves alone parts of the country that could continue to contribute economically. Economically that is where we are all in it together.

Those sort of indicators are what the vast majority of the population saw and should understand. I think numbers of cases drifts into the - well it won't happen to me realm.

I think a useful indicator looking back and going forward is work out how many excess deaths there have been. That is compared to a normal month/year. But weather plays a part. Of course the figures might not be so dramatic while the restrictions are in force even causing normal flu etc to not spread. So we might not know how well the three tier system or even lockdown has worked because we do not really know how bad it would have been if we had done nothing. That is except for the early months when it was bad. It follows that Covid-19 might have calmed down by now if we had done nothing - but I doubt it.

 

[Trackman]

Manchester is one part of the ten boroughs* (eg Bolton, Bury are another two) Some boroughs have stabilised, some gone up, one gond down, Manchester. However, that borough was the highest by a mile.
*Boroughs might not be the correct term, Salford's a city etc.

Yes, but they are talking about the whole of Greater Manchester, not just Manchester itself.
All very confusing.

 

[Scotrail12]

Starmer yet again suggesting a circuit breaker at PMQ's today.

That's my support for him gone - he can bugger off. Are there any decent people out there to lead this country?

 

[Freightmaster]

Are there any decent people out there to lead this country?

Michael Portillo, going by his excellent performance on Question Time the other day.

He even has bizarre middle names, just like Boris!


I doubt he will fancy coming out of retirement though...






MARK

 

[kristiang85]

Michael Portillo, going by his excellent performance on Question Time the other day.

He even has bizarre middle names, just like Boris!


I doubt he will fancy coming out of retirement though...
MARK

And he's a big fan of railways.

He gets my vote.

 

[duncanp]

Starmer yet again suggesting a circuit breaker at PMQ's today.

That's my support for him gone - he can bugger off. Are there any decent people out there to lead this country?

And same lunatics in SAGE are suggesting that it is too late to have a circuit breaker lockdown over the half terms, so instead we should have a three week lockdown over Christmas & the New Year. Yes you read that right. They would want all restaurants, pubs and bars closed from about December 20th to January 5th, to coincide with the Christmas school holidays.

"Hello - what's the weather like on Mars today?" - because you must be living on another planet if you think that the population are going to stand for this, and it shows how completely detached from reality all the SAGE scientists really are.

I am rapidly coming to the conclusion that SAGE itself is not fit for purpose, and should be disbanded in favour of a committee of scientists, economists and medical professional who could advise the government on COVID-19 policy, and would be subject to the same confidentiality and impartiality rules as civil servants. (ie no leaking stuff to the press, and no throwing your toys out of the pram if the government doesn't do what you want them to do)

I think Boris Johnson knows full well that closing the country down over the festive season would be the last straw for many people, who would be seriously p****d off and would blame him.

Even Ebenezer Scrooge allowed Bob Cratchit to have Christmas Day off.

 

[MikeWM]

Starmer yet again suggesting a circuit breaker at PMQ's today.

That's my support for him gone - he can bugger off. Are there any decent people out there to lead this country?

The SDP seem to be the only party with anything reasonable to say (though good luck finding them on the ballot paper). This is from a month or so ago, but it still holds

https://sdp.org.uk/2020/09/11/social-democrats-oppose-new-covid-19-restrictions/

“A considerate approach is needed in response to COVID-19,” says William Clouston, SDP Leader. “The government should encourage and enable the vulnerable to voluntarily shield themselves, while calling on the rest of the population to behave in a respectful, responsible and tolerant manner. The virus is here and may remain for some time, which means a ‘stop-go’ approach to opening and closing society is unsustainable and inappropriate.

“Furthermore, some restrictions on personal freedom are unacceptable in a free society. The threat of curfews, limits to social gatherings and the compelled wearing of face masks represent an unprecedented encroachment into the dignity and autonomy of Britons, which we fundamentally oppose. The government’s response to COVID-19 must be communitarian, not draconian.”