New lockdown in England, including school closures, announced by Johnson, 4/1/21

[Cdd89]

I then apply it to the context of someone I know (late 80s, early stage COPD, generally frail) who is in a small care home, well out in the country. There isn't the space in the home for staff to have accommodation

I agree that perfect shielding of those in care homes is sadly not possible. But with the greatest of respect, this shouldn’t shut down the argument.

When comparing “lockdowns vs shield the vulnerable”, the question then becomes one of balancing the negatives on each side.

In favour of lockdowns is that it gives more protection to someone in a care home, already above the average life expectancy, to have the chance to continue living a further few years beyond average life expectancy. (Note it doesn’t give 100% protection, the virus still spreads and the risks you described are still there, the benefit is incremental).

On the other side of the scale are the countless harms lockdowns definitely do, primarily concentrated on the young. Indeed they degrade the quality of life for many young people to something tantamount to being in a care home. Some will commit suicide, and every one of those counts for at least a hundred care home deaths based on a quality of life years calculation.

I do accept now vaccines are actively being injected into the elderly and care home workers, the calculus has changed. But that won’t take long, and if there are any setbacks the above argument comes to the fore again.

 

[bramling]

I agree that perfect shielding of those in care homes is sadly not possible. But with the greatest of respect, this shouldn’t shut down the argument.

When comparing “lockdowns vs shield the vulnerable”, the question then becomes one of balancing the negatives on each side.

In favour of lockdowns is that it gives more protection to someone in a care home, already above the average life expectancy, to have the chance to continue living a further few years beyond average life expectancy. (Note it doesn’t give 100% protection, the virus still spreads and the risks you described are still there, the benefit is incremental).

On the other side of the scale are the countless harms lockdowns definitely do, primarily concentrated on the young. Indeed they degrade the quality of life for many young people to something tantamount to being in a care home. Some will commit suicide, and every one of those counts for at least a hundred care home deaths based on a quality of life years calculation.

I do accept now vaccines are actively being injected into the elderly and care home workers, the calculus has changed. But that won’t take long, and if there are any setbacks the above argument comes to the fore again.

Excellent post.

 

[MikeWM]

I agree that perfect shielding of those in care homes is sadly not possible. But with the greatest of respect, this shouldn’t shut down the argument.

If the current strategy was sucessful at protecting people in care homes and hospitals, then there would at least be some argument for continuing with it over attempting a 'focused protection'/Great Barrington style approach.

But it demonstrably isn't when you look at the number of issues that are still occurring in care homes and hospitals. In many respects the current strategy is the worst of all possible approaches - it doesn't do what it claims to do, and the collateral damage is truly enormous.

 

[DustyBin]

Your comparison on compliance/contagion doesn't logically work - fear can be widespread, but people still break rules; widespread is not the same as universal. As for the risk, I have a reasonable understanding of risk, know that my risk of a severe outcome is low, but know enough from acquaintances who have had Covid that it is a disease I want even less than I want flu, and will manage my lifestyle to reasonably minimise that risk for myself and my family.

Meanwhile, I see the logic in your suggestion about shielders. However, I then apply it to the context of someone I know (late 80s, early stage COPD, generally frail) who is in a small care home, well out in the country. There isn't the space in the home for staff to have accommodation, and they aren't all full time - they have their own personal responsibilities to consider. Those are challenges that money can't necessarily solve or buy off, and I'm sure - in different flavours - will apply in most cases. It's noticeable that reports of health workers who isolated themselves from their families are exceptions, not the rule.

We may have to agree to disagree but I really don’t believe enough people are fearful of the virus for the negative effect on economic activity to be remotely comparable to the effect of lockdowns. I honestly think that if restrictions were lifted tomorrow we’d see shops full, pubs full and people booking holidays.

In regard to shielding, I do accept that it’s not as easy or as simple as I perhaps made it sound; there are of course significant challenges. But look at what we’ve done instead, and the money we’ve spent, and I’m sure there’s a viable solution. For example when it comes to accommodation, stick them in hotels. Furlough their partners so they can stay at home and look after the children if that’s an issue. Give them financial assistance with childcare. Let them go home every say four weeks for a couple of days to visit, or get them on some kind of rota. It’s no different to working away, and they would be getting paid commensurately. These are just ideas, I don’t have all of the answers but I can’t see how this isn’t a more practical strategy than the one we’ve actually pursued.

Excellent points @bramling @Cdd89 and @MikeWM incidentally.

 

[Bantamzen]

I agree that perfect shielding of those in care homes is sadly not possible. But with the greatest of respect, this shouldn’t shut down the argument.

When comparing “lockdowns vs shield the vulnerable”, the question then becomes one of balancing the negatives on each side.

In favour of lockdowns is that it gives more protection to someone in a care home, already above the average life expectancy, to have the chance to continue living a further few years beyond average life expectancy. (Note it doesn’t give 100% protection, the virus still spreads and the risks you described are still there, the benefit is incremental).

On the other side of the scale are the countless harms lockdowns definitely do, primarily concentrated on the young. Indeed they degrade the quality of life for many young people to something tantamount to being in a care home. Some will commit suicide, and every one of those counts for at least a hundred care home deaths based on a quality of life years calculation.

I do accept now vaccines are actively being injected into the elderly and care home workers, the calculus has changed. But that won’t take long, and if there are any setbacks the above argument comes to the fore again.

The problem is that by using lockdowns to shield the vulnerable, you also potentially shut them off from the very people they want to keep going for. So whilst you might add a few years to some, the quality of that life might be worsened into almost complete isolation, which in turn might see you lose those years anyway. Many older people, particularly those with limited lifespan might just want quality over quantity. They don't want to sit alone for years on end with limited or no contact with family.

 

[Yew]

Wow. So many medical experts on here. How about everyone just following the rules for 6 weeks? It’s people not following the rules that’s caused this. For those saying “The other lockdowns didn’t help”... once again it’s people not following the rules that’s caused this. Pure and simple. And yes, I do have a source. It’s called “Common Sense”.

Common sense would be following all the plans that we spent decades cultivating, rather than going off-piste with experimental lockdowns

Common sense is ensuring that the harms of the measure we're undertaking are outweighed by the benefits.

Common sense is focusing on protecting the vulnerable.

 

[kristiang85]

Boris is doing another press conference today at 5pm with Professors Gloom and Doom, if anybody is interested.

 

[jkkne]

Boris is doing another press conference today at 5pm with Professors Gloom and Doom, if anybody is interested.

It's ok - the experts on here don't need any form of information that they can twist to fit their posting agenda. They've all read the latest wikipedia updates and know much better than any so called Professor or Doctor.

 

[PHILIPE]

Boris is doing another press conference today at 5pm with Professors Gloom and Doom, if anybody is interested.

What's the point. They are basically the same every time and nothing we don't know already.

 

[brick60000]

They're not in bubbles though are they? They are still living at home with their families. As you say, several fixtures have been postponed due to COVID cases. It will circulate in those bubbles and then the families of the people in those bubbles, then the work colleagues of their spouses, etc. I would take no pleasure in football being cancelled just for the sake of it but my point is if we are in such a dire situation outdoor leisure activities, which they have stressed time and time again are very low risk, which affect millions are banned there is no case whatsoever for football to continue. I don't want football banned, I want safe activities enjoyed by far more people to be permitted.

Absolutely agree with this.

Personally - I have absolutely zero interest in football, whatsoever. I couldn't give two hoots whether its cancelled or not. But to be told I can't go and sit and enjoy the fresh air, but professional 'elite' sports can continue in teams, is just another insult.

I know they have testing. That doesn't reduce the risk though if they test positive - it just means future fixtures are cancelled. It doesn't prevent the spreading throughout their families, etc.

I don't necessarily think football and other elite sports should be cancelled - but why can they continue when other, much less risky forms of recreation are banned?

 

[birchesgreen]

I don't necessarily think football and other elite sports should be cancelled - but why can they continue when other, much less risky forms of recreation are banned?

I suspect it is to boost morale, for a lot of people football is their life. As a Villa fan though personally its a life sentence.

 

[takno]

It's ok - the experts on here don't need any form of information that they can twist to fit their posting agenda. They've all read the latest wikipedia updates and know much better than any so called Professor or Doctor.

The daily press conferences should be interesting them, since they are a great source of no information. It's strictly beside the point that their litany of lies of deceit is delivered by two splendidly well-qualified professionals and a scarecrow.

I suspect it is to boost morale, for a lot of people football is their life. As a Villa fan though personally its a life sentence.

Escaping relegation and the subsequent pretty good performance this season has been one of the year's few high points. I definitely wouldn't fancy spending the year being in lockdown and being a Baggies fan

 

[35B]

I agree that perfect shielding of those in care homes is sadly not possible. But with the greatest of respect, this shouldn’t shut down the argument.

When comparing “lockdowns vs shield the vulnerable”, the question then becomes one of balancing the negatives on each side.

In favour of lockdowns is that it gives more protection to someone in a care home, already above the average life expectancy, to have the chance to continue living a further few years beyond average life expectancy. (Note it doesn’t give 100% protection, the virus still spreads and the risks you described are still there, the benefit is incremental).

On the other side of the scale are the countless harms lockdowns definitely do, primarily concentrated on the young. Indeed they degrade the quality of life for many young people to something tantamount to being in a care home. Some will commit suicide, and every one of those counts for at least a hundred care home deaths based on a quality of life years calculation.

I do accept now vaccines are actively being injected into the elderly and care home workers, the calculus has changed. But that won’t take long, and if there are any setbacks the above argument comes to the fore again.

I don't suggest it does shut down the argument, or that the argument is black and white. But nor do I accept either that the harms of Covid are specific to the old and ill, or that the benefits of restrictions only accrue to that group - the picture is more complex than that.

I am aware that restrictions do cause harm, and impose a cost. However, what I see in this debate is a false dichotomy between the determination to care for the losers from lockdowns, and the disregard for the prime beneficiaries - the Shipman argument for discounting the deaths caused by lockdown sits particularly ill when used in contrast to the harms to the young. As for a QALY calculation, I don't get how you come up with a 100:1 ratio - that would imply that you are comparing a centenarian's death with that of a 1 year old child.

I'd like to see far more, and clearer, data - the trade offs need to be clearer, far clearer. However, right now, the figures emerging from hospitals make clear that the impact of Covid is at the point where it is threatening not just Covid sufferers, but all those in need of medical care. That, to me, is a game changer and justifies strong measures to limit the spread of Covid. Whether this lockdown is the right measure, will achieve the right effect in the short term (I agree completely with those who suggest that restrictions are inevitably limited), or strikes the right balance, is I agree a fair question - but one that protagonists of both sides need to quantify.

 

[kristiang85]

Escaping relegation and the subsequent pretty good performance this season has been one of the year's few high points. I definitely wouldn't fancy spending the year being in lockdown and being a Baggies fan

After a binge on Sunderland Til I Die in last year's lockdown, I'm very thankful I'm not a Sunderland fan...

 

[jkkne]

The daily press conferences should be interesting them, since they are a great source of no information. It's strictly beside the point that their litany of lies of deceit is delivered by two splendidly well-qualified professionals and a scarecrow.


Escaping relegation and the subsequent pretty good performance this season has been one of the year's few high points. I definitely wouldn't fancy spending the year being in lockdown and being a Baggies fan

and your qualifications and expertise is?

 

[TheEdge]

In a normal year, around 8% of care home deaths are attributed to the "common cold" (which is a blanket term for various rhinoviruses and coronaviruses, and this will become one of them as it will become endemic).

Also flu is a very serious illness for some, but most will be fine too.

Yes, in care homes, in the incredibly weak. It doesn't do that to relatively healthy individuals, or in some cases incredibly fit and healthy individuals in the case of Long Covid, which is what Covid is capable of.

Put simply if I (29, healthy) get a cold at worse I'm getting a sore throat. But if I catch Covid there is real possibility (small yes but significant enough to be concerning) that I could end up in hospital with serious side effects. And even if I don't there is a significant chance (1 in 5 (source: NICE/NHS) of some sort of Long Covid symptoms which include significant respiratory and neurological problems.

Now that sounds like a disease we should take seriously.

 

[Darandio]

and your qualifications and expertise is?

You don't have to have any qualifications or be an expert to pinpoint the times they were lying to us through false numbers. We'll see what they come up with tonight.

 

[Cdd89]

As for a QALY calculation, I don't get how you come up with a 100:1 ratio - that would imply that you are comparing a centenarian's death with that of a 1 year old child.

Quality Adjusted Life Years value each year of life progressively less as you get older. SAGE published a paper on this. 100x is a conservative estimate on this me.

the figures emerging from hospitals make clear that the impact of Covid is at the point where it is threatening not just Covid sufferers, but all those in need of medical care.

But this is just another calculation and trade off: how many quality adjusted life years will be lost by people who need healthcare at the point of overload being denied it? And how much more cautious will people be (not just with Covid risks but all risks) in the knowledge that at this point in time healthcare won’t be fully available, and how will that extra caution feed back in?

It may be unthinkable to many in the U.K. but in many countries it is the norm that if you get ill there will not be ideal treatment available. “Protecting the NHS” cannot be valued so highly it supersedes any other cost or consideration. The NHS didn’t even exist in the U.K. until comparatively recently. We may well be about to see this tested if theories that current levels of lockdown are insufficient to control the virus turn out to be true. Do you have a limit as to the measures you’d accept in order to preserve healthcare?

 

[GodAtum]

Still busy in London on the trains and buses with commuters. I wore a builders outfit so i won't be stopped by the police.

 

[kristiang85]

Yes, in care homes, in the incredibly weak. It doesn't do that to relatively healthy individuals, or in some cases incredibly fit and healthy individuals in the case of Long Covid, which is what Covid is capable of.

Put simply if I (29, healthy) get a cold at worse I'm getting a sore throat. But if I catch Covid there is real possibility (small yes but significant enough to be concerning) that I could end up in hospital with serious side effects. And even if I don't there is a significant chance (1 in 5 (source: NICE/NHS) of some sort of Long Covid symptoms which include significant respiratory and neurological problems.

Now that sounds like a disease we should take seriously.

"Long COVID" is the media's rebranding of "Post viral syndrome", which is well understood and quite normal. Not pleasant by any means, but nothing too out of the ordinary when put aside comparable illnesses. Of course there are people who get it really badly, and it is horrible for them, and they get the interviews on the BBC. But this is a very small amount of people that get disproportionate air time, to put it bluntly.

I'm sure the average healthy person in their 20s/30s/40s would prefer a 20% chance of a few fatigued weeks with PVS over the chance of losing their job completely or have long term mental health consequences, which is the side effect of lockdown.

COVID is a serious disease, but the debate is over the proportionality of the interventions.

 

[Reliablebeam]

I am rather deflated, as are many of my colleagues and social circle. We seem to be going nowhere, very quickly; I am struggling to see a path through this. On a more positive note, it does look like our labs will stay largely open with our management being keen for us to be in if required. There is some concern though about what happens if Cronenberg-covid lays a lot of us low say later this month or February, as we need a minimum staffing level to operate safely, ergo we may be knocked off by default, not to mention the problems with child care a lot of my co-workers are now experiencing. I am working at home this week and probably next, when I went out to get lunch little change in business, this area is already tier 4 as it is. People have started to do social distance again though.

I'm not sure what kind of compliance this lockdown 3.0 is going to get - we've already had the sight of Gove piping up this morning and moving the covid goal-posts, whose castors as we know are very efficient - indicating people will have to obey this until March(!). I've also noted friends and colleagues who sealed themselves in their houses last March now looking for 'exemptions' where they can bend the rules. Some have even become rather efficient at evading the policing of all this, and this is not limited to the UK as a conversation with French collaborators revealed yesterday.

Ironically, despite being a lockdown critic I actually find myself reasonably compliant with the 'guidance'.....!

 

[High Dyke]

We are being led by an absolute monster. How that man sleeps at night is beyond me.

Horlicks!

 

[takno]

and your qualifications and expertise is?

I've got two degrees covering ethics, statistics, computer modelling and optimisation. I'm by no means an expert in the field, but I suspect there are a lot of people in SAGE or supporting SAGE who aren't any better qualified or specialised. I understand that Neil Ferguson is a physicist by training for example.

Either way, like many people on this thread and forum, I've got enough background to understand what's being put in front of me without having to blindly trust it. I've also been around academics and doctors long enough to not automatically trust everything they say just because they have a fancy title. A huge amount of what is happening at the moment is having the label "science" attached, but isn't really backed by anything more than blind panic, gut instinct, and some very very large egos and god complexes.

It's not necessary for you believe us when we talk on here - we aren't government advisers and nobody is going to do a single thing based on what we say. Please don't assume we are idiots or pointlessly try to bait us though.

 

[island]

Show me it. You seem to have a good handle on posting laws on here whether anyone asks or not, surely you've got it to hand?

This is incorrect.

Posting a letter or parcel has never been proscribed and Post Offices were operating a full service throughout (albeit with social distancing etc)

I am afraid it is you who are incorrect.

https://www.legislation.gov.uk/uksi/2020/350/regulation/6/2020-03-26 lists the reasonable excuses for leaving home between 26 March and 2 April (though materially equivalent restrictions were in place until at least mid-May), and posting a letter or parcel isn’t on the list.

The legislation will define what you legally can or cannot do. Its not been published yet but should be available via this link when it is:

Coronavirus Legislation

That link has been a few days behind for most of the last year's restrictions. Once the SI number is identified you will be able to see the legislation sooner by navigating directly to the link.

That link also seems to have been taken off the legislation.gov.uk homepage. I wonder if it will be updated at all now; there have been a number of amendments in the last week of December which have not been put through on the page.

 

[Domh245]

I am afraid it is you who are incorrect.

https://www.legislation.gov.uk/uksi/2020/350/regulation/6/2020-03-26 lists the reasonable excuses for leaving home between 26 March and 2 April, and posting a letter or parcel isn’t on the list.

"(2) For the purposes of paragraph (1), a reasonable excuse includes the need—"

So it's a non-exhaustive list. Posting something may not have been expressly permitted, but I would think it unlikely to not be considered a reasonable excuse

 

[bramling]

Boris is doing another press conference today at 5pm with Professors Gloom and Doom, if anybody is interested.

Count me out. Last night was tempting enough to punch the screen.

Still busy in London on the trains and buses with commuters. I wore a builders outfit so i won't be stopped by the police.

Drove into London just now, traffic just the same as of late (which I’d say is about 10-20% down on normal for the time of day). To be fair the whole area was already in tier 4.

 

[island]

"(2) For the purposes of paragraph (1), a reasonable excuse includes the need—"

So it's a non-exhaustive list. Posting something may not have been expressly permitted, but I would think it unlikely to not be considered a reasonable excuse

That’s your opinion, which you’re entitled to.

 

[Cdd89]

https://www.legislation.gov.uk/uksi/2020/350/regulation/6/2020-03-26 lists the reasonable excuses for leaving home between 26 March and 2 April, and posting a letter or parcel isn’t on the list.

The version of the regs you’ve cited contains the error that the restriction only applies to “leaving home”. In other words having left home for one of those things you’re free to stop doing that thing and remain outside home doing anything you like subject to other laws. This was fixed a month later in the April revision.

The wider point of course is that the list is not exhaustive and that the only notable test is reasonableness.

 

[Darandio]

I am afraid it is you who are incorrect.

https://www.legislation.gov.uk/uksi/2020/350/regulation/6/2020-03-26 lists the reasonable excuses for leaving home between 26 March and 2 April (though materially equivalent restrictions were in place until at least mid-May), and posting a letter or parcel isn’t on the list.

Keep trying. As a very simple example, it was perfectly reasonable to send money via a letter to someone who needed it or provisions to them via a parcel and you could use a Post Office to do this.

 

[35B]

Quality Adjusted Life Years value each year of life progressively less as you get older. SAGE published a paper on this. 100x is a conservative estimate on this me.

But this is just another calculation and trade off: how many quality adjusted life years will be lost by people who need healthcare at the point of overload being denied it? And how much more cautious will people be (not just with Covid risks but all risks) in the knowledge that at this point in time healthcare won’t be fully available, and how will that extra caution feed back in?

It may be unthinkable to many in the U.K. but in many countries it is the norm that if you get ill there will not be ideal treatment available. “Protecting the NHS” cannot be valued so highly it supersedes any other cost or consideration. The NHS didn’t even exist in the U.K. until comparatively recently. We may well be about to see this tested if theories that current levels of lockdown are insufficient to control the virus turn out to be true. Do you have a limit as to the measures you’d accept in order to preserve healthcare?

So let's take 100x as our ball park. Assuming that we don't apply any concept of net present value to factor in when deaths occur, that implies that 75000 deaths to Covid need to be offset against 750 deaths directly due to anti-Covid measures. In reality, I'd expect a discounting for immediacy of deaths - there's a subjective element that needs to be allowed for, which means that greater value will reasonably given to imminent deaths over an overall shortening of some life expectancy.

More generally, we agree completely that we're dealing with trade-offs. But I'd suggest that the baseline for that trade-off needs to be the level of health care that the UK already enjoys, not a comparison against elsewhere. However, I don't suggest that it is to "protect the NHS" but to protect the public's reasonable expectations of a level of care they receive from the NHS if they fall ill. As a question of politics, this is something that the government will get more trouble for than the short run harms of lockdown.