Should restrictions be eased fully if Indian Variant case rates do not decline before June 21st?

[kristiang85]

So why was the border closed to neighbouring countries to India?

Well that was obviously political rather than epidemiological, but even if he had put India on the list it would still have come here.

 

[Purple Orange]

Well that was obviously political rather than epidemiological, but even if he had put India on the list it would still have come here.

Correct, but it would have slowed the rate of infection. Just like locking down earlier would have slowed the rate of infection, and therefore pressure on hospitals and reduced the death rate.

 

[Lampshade]

Well that was obviously political rather than epidemiological, but even if he had put India on the list it would still have come here.

There would have been fewer seeding events though, with most cases confined to hotels, and more opportunity to stamp out local outbreaks (a la Brazil/South African variants).

 

[Nicholas Lewis]

Well that was obviously political rather than epidemiological, but even if he had put India on the list it would still have come here.

We all know it will find its wayin in the end but the issue here is you moderate the impact by using quarantine/red list as this would have reduced the number of outbreaks and potential for onward transmission so that you got a lot more people vaccinated and potentially prevented cases reach critical mass before June 21st. Yes this is all a bit hit and miss but caution was supposed to be the watchword since this lockdown yet they didn't act with caution so here we are for another four weeks. Its alright for him and his mates they just do what they enjoy whilst the rest of just have to what the establishment want - as it ever was.

 

[DelayRepay]

Well that was obviously political rather than epidemiological, but even if he had put India on the list it would still have come here.

I don't think we could have kept it out.

But I think we could have slowed it down by importing fewer cases. This might have been enough - it would have meant lower infection rates initially, and lower community transmission. Whilst they would have risen later, even a two week delay would have been beneficial in terms of extra vaccines being given.

I don't think, as a general policy, closing boarders is the way to tackle Covid. But in the very specific circumstances of late March/early April, when we had very low infection rates in the UK, but still a large unvaccinated population, it may have helped.

Like everything though, the government dithered and dathered and only acted when it was too late. In reality there was no point adding India to the red list when we did, as everyone who wanted to come to the UK had already travelled.

 

[Nicholas Lewis]

I don't think we could have kept it out.

But I think we could have slowed it down by importing fewer cases. This might have been enough - it would have meant lower infection rates initially, and lower community transmission. Whilst they would have risen later, even a two week delay would have been beneficial in terms of extra vaccines being given.

I don't think, as a general policy, closing boarders is the way to tackle Covid. But in the very specific circumstances of late March/early April, when we had very low infection rates in the UK, but still a large unvaccinated population, it may have helped.

Like everything though, the government dithered and dathered and only acted when it was too late. In reality there was no point adding India to the red list when we did, as everyone who wanted to come to the UK had already travelled.

Form your own opinion on the facts

Delta Farce: How Boris Johnson's incompetent handling of the new variant extended lockdown

 

[Cdd89]

By how many weeks would earlier red listing have slowed the spread of delta? I would accept a number between two and four; I would highly question whether that is worth such a punitive measure, and I would especially question whether it justifies throwing all Amber countries on the red list pre-emptively, as the opposition are suggesting.

There would have been fewer seeding events though, with most cases confined to hotels, and more opportunity to stamp out local outbreaks (a la Brazil/South African variants).

When Covid leaks into Australia, as it inevitably does, they stamp it out entirely. I don’t buy that it’s possible to stamp out a single “variant” while accepting a higher background level of Covid circulating. Brazil/South Africa haven’t made significant headway in other countries that haven’t tried surge testing to eliminate, so I would be wary of accepting the lack of dominance of those as evidence of the success of surge testing.

I’d also ask those in favour why, if this is such a great policy, comparatively few Western countries (at lest among those without a stated aim of zero Covid) have instituted it?

 

[yorkie]

The virus is adapting for humans through natural selection.

This is a natural process which results in increased fitness for the virus; talk of it becoming "more transmissable" isn't the best terminology to use and is avoided by virologists.

These adaptations do not prevent us reaching a very high level of immunity, though they do ensure the virus is able to constantly evolve to a sufficient degree to continue to circulate in the population, causing mild symptoms and spreading at low levels.

We will soon reach an 'endemic equilibrium' which is a totally natural concept, which is related to, and often gets confused with, the concept of "herd" immunity (which is a term

Recent statements that the delta virus is now said to be 60% more infectious than other variants...

How do they define "more infectious", what do they mean by that, and how did they measure this exactly and how did they come up with a figure of 60%?

Virologists don't tend to use terminology such as "more infectious".

and that of the reported deaths said to have been from vaccinated people in the previous period where these people have had both of their vaccinations is now said to be 12

Out of how many people? You do realise that thousands die from influenza, despite having been vaccinated.

are yet another snippets of medical information that my next-door neighbour (who is a medical consultant) has passed on to me. He is based in one of the teaching hospitals in the North-West.

Do I have to take what he says "with a pinch of salt"?

I find it amusing that all sorts of people are considered to be an authority on Sars-CoV-2, yet very few people appear to be listening to virologists.

18:31 i'm always brought back to Ron Fouchier
18:31 you know he says in flu we never
18:33 talk about transmission we talk about
18:34 fitness
18:35 yes and i don't get why the people are
18:38 not
18:38 looking back in the literature and and
18:42 you know learning from the past right
18:45 yeah well it's especially nice because
18:46 we all know that fitness has many
18:48 aspects yes
18:50 and it's harder to oversimplify
18:52 with transmission you can just sort of
18:54 make these oversimplifications that are
18:56 not true yeah yeah um
18:58 with fitness we all know that those
19:00 aren't the case

23:49 they make a nice statement here they say
23:51 during a dynamic outbreak it is
23:52 particularly difficult to unambiguously
23:54 tell whether a particular variant is
23:56 increasing in frequency because it has
23:58 an
23:58 intrinsic advantage that's a biological
24:00 advantage
24:01 and i'm glad they make it vague like
24:0 that and don't just say transmission
24:04 right that's fitness they're talking
24:06 about
24:07 or because of epidemiological factors
24:10 and they say we need multiple lines of
24:12 independent evidence
24:14 in support of it and now they go back to
24:16 the t
24:17 word in support of an intrinsically
24:18 elevated transmission potential i wish
24:20 they would just use
24:21 fitness because really that's what it's
24:23 about
24:24 but you know this is a this is a
24:26 disconnect between the epidemiologists
24:28 and the
24:29 evolutionary biologists and the
24:31 virologists really they think in
24:32 different ways

 

[DelayRepay]

By how many weeks would earlier red listing have slowed the spread of delta? I would accept a number between two and four; I would highly question whether that is worth such a punitive measure, and I would especially question whether it justifies throwing all Amber countries on the red list pre-emptively, as the opposition are suggesting.

I don't think anyone can really answer that. I agree it wouldn't have been more than four, probably less.

I don't think it would be worth doing, normally. But it may have been worth doing given the specific circumstances in the UK at the time - low rates of infection and a large unvaccinated population (plus a large number who were only partially vaccinated).

Slowing the outbreak by 2 - 4 weeks might not sound a lot, but remember we are extending out measures by 4 weeks to allow for the vaccination programme to cover as many people as possible. If we'd been able to delay 'Delta' by a couple of weeks, then we may not now be in the position we are now, with a month's delay to the lifting of restrictions.

Just to clarify - I don't think a New Zealand closed borders policy would work in the UK, and I don't think you can keep variants out by closing borders. I think there were very specific circumstances in the Spring which meant for the UK, adding India to the red list could have made a significant difference.

 

[Yew]

We all know it will find its wayin in the end but the issue here is you moderate the impact by using quarantine/red list as this would have reduced the number of outbreaks and potential for onward transmission so that you got a lot more people vaccinated and potentially prevented cases reach critical mass before June 21st. Yes this is all a bit hit and miss but caution was supposed to be the watchword since this lockdown yet they didn't act with caution so here we are for another four weeks. Its alright for him and his mates they just do what they enjoy whilst the rest of just have to what the establishment want - as it ever was.

I don't believe that there is clear evidence to say that works in practice, nor that it is an effective long-term strategy.

Slowing the outbreak by 2 - 4 weeks might not sound a lot, but remember we are extending out measures by 4 weeks to allow for the vaccination programme to cover as many people as possible. If we'd been able to delay 'Delta' by a couple of weeks, then we may not now be in the position we are now, with a month's delay to the lifting of restrictions.

We are slowing by four weeks because of dodgy models with a history of always massively over-predicting are once again over-predicting.

 

[Bantamzen]

I don't think anyone can really answer that. I agree it wouldn't have been more than four, probably less.

I don't think it would be worth doing, normally. But it may have been worth doing given the specific circumstances in the UK at the time - low rates of infection and a large unvaccinated population (plus a large number who were only partially vaccinated).

Slowing the outbreak by 2 - 4 weeks might not sound a lot, but remember we are extending out measures by 4 weeks to allow for the vaccination programme to cover as many people as possible. If we'd been able to delay 'Delta' by a couple of weeks, then we may not now be in the position we are now, with a month's delay to the lifting of restrictions.

Just to clarify - I don't think a New Zealand closed borders policy would work in the UK, and I don't think you can keep variants out by closing borders. I think there were very specific circumstances in the Spring which meant for the UK, adding India to the red list could have made a significant difference.

Its important to consider why the government delayed putting India onto the red list. We have a lot of citizens that have family, friends or business connections in India. Instantly putting India onto the red list would have seen tens of thousands of people instantly rushing back into the country, which could easily have swamped airports / airlines, and would have certainly led to passengers making all sorts of routes to get back to the UK. And then there would have been the logistics of getting hotel space for them all. It would have been a fluster-cluck, and may well have led to more problems & higher spread than we otherwise saw.

But as you say, for reasons discussed time & again a NZ style shut down just isn't workable in this country. And even if it were, doing so is tantamount to trying to stop a forest fire by building a fence around it with signs saying "No fire beyond this point". Sooner or later the fire, as with the virus would find it's way around the fences and start spreading again.

 

[yorksrob]

By how many weeks would earlier red listing have slowed the spread of delta? I would accept a number between two and four; I would highly question whether that is worth such a punitive measure, and I would especially question whether it justifies throwing all Amber countries on the red list pre-emptively, as the opposition are suggesting.

No more punitive than imposing such restrictions earlier on India's neighbours. Also no more punitive than keeping businesses and services closed for defined periods to make sure that each step of easing doesn't have a negative impact on infection rates.

If you're being ultra-cautious with easing restrictions at home, such caution would suggest assuming that any unexplained rise abroad might be due to a varient, rather than wait and see.

Its important to consider why the government delayed putting India onto the red list. We have a lot of citizens that have family, friends or business connections in India. Instantly putting India onto the red list would have seen tens of thousands of people instantly rushing back into the country, which could easily have swamped airports / airlines, and would have certainly led to passengers making all sorts of routes to get back to the UK. And then there would have been the logistics of getting hotel space for them all. It would have been a fluster-cluck, and may well have led to more problems & higher spread than we otherwise saw.

But as you say, for reasons discussed time & again a NZ style shut down just isn't workable in this country. And even if it were, doing so is tantamount to trying to stop a forest fire by building a fence around it with signs saying "No fire beyond this point". Sooner or later the fire, as with the virus would find it's way around the fences and start spreading again.

It's about timing though isn't it. If the Government had put India on the red list earlier, fewer would have travelled there in the first place, meaning fewer to return. I can't help but note that I wasn't able to visit my friends and family at the other end of this country at that time as we were restricted to essential travel only.

 

[Domh245]

But as you say, for reasons discussed time & again a NZ style shut down just isn't workable in this country. And even if it were, doing so is tantamount to trying to stop a forest fire by building a fence around it with signs saying "No fire beyond this point". Sooner or later the fire, as with the virus would find it's way around the fences and start spreading again.

To extend that analogy though, it's a lot easier to deal with the fire when there's only a handful of places where the fire is starting (vs hundreds of 'ignition points'). And of course, we're busily putting in fire breaks, so if you can keep any big fires from starting whilst you finish putting those in, you'll be in a better place when any big fires inevitably do catch.

Fully agreed that it's impossible to keep variants out forever - delta is now well on it's way to being the globally dominant variant in most countries, but if we'd limited the amount of imported cases, we'd have fewer cases now, and more of a vaccine effect. The practicality of achieving that though, given the factors you've noted in the first paragraph is up for debate. As usual it's become very obvious what we should have done now that we're in the future and don't have to worry about the details

 

[Cdd89]

No more punitive than imposing such restrictions earlier on India's neighbours. Also no more punitive than keeping businesses and services closed for defined periods to make sure that each step of easing doesn't have a negative impact on infection rates.

But it is more punitive that what we require of those people in the U.K. who have contracted a confirmed case of Covid (including the Delta variant) domestically. When the way we treat foreign arrivals is much harsher than the way we treat domestic confirmed cases, something is very wrong, and I would suggest it is more about xenophobia than virus control.

Also, why is India even still on the Red List? If this were truly a response to exceptional risk, India’s cases are lower than many Amber countries now (their stats may be dodgy, but so are many other Amber countries), and the VoC is well established here so importation is no longer a concern.

Slowing the outbreak by 2 - 4 weeks might not sound a lot, but remember we are extending out measures by 4 weeks to allow for the vaccination programme to cover as many people as possible. If we'd been able to delay 'Delta' by a couple of weeks, then we may not now be in the position we are now.

Even if we accepted the premise that it may have averted this delay (I agree it’s credible), hotel quarantine is an absolute travel ban in all but name (to anyone without a spare £2k, and 10 days losing income unless they can work remotely, and eating inedible food). I’m not sure that’s a proportionate response, and faced with the choice I think I’d choose the Step 4 delay. (Though as above, I think there’s a strong argument that the delay is the result of over-caution).

If you travel from India to almost all countries in the EU (let’s take the Netherlands as an example), you will (to this day) be subjected to less than Amber-style quarantine measures. If you travel to Canada, one of the very few other western countries with hotel quarantine, you only have to stay for three days while awaiting a PCR test result. Why do we demand ten? I struggle to name any other non-Covid-zero western countries with hotel quarantine restrictions (Ireland are obviously heavily influenced by us).

Why are those lesser restrictions considered adequate for other countries, and why is Delta growing slower there despite those looser restrictions? I suggest the answer is that the U.K. has stronger links to India. I’m not sure the right way to respond to that “problem” is to impose draconian measures and to try and cut off those links.

 

[Xenophon PCDGS]

I find it amusing that all sorts of people are considered to be an authority on Sars-CoV-2, yet very few people appear to be listening to virologists.

I am interested in your bringing virologists into the discussion on this thread. I now await the usual suspects on this thread to come forth to deny any comments made by virologists in the same way that these same people have poured scorn on the stated medical opinions of other fully qualified medical staff in high positions in differing medical fields.

 

[Bantamzen]

It's about timing though isn't it. If the Government had put India on the red list earlier, fewer would have travelled there in the first place, meaning fewer to return. I can't help but note that I wasn't able to visit my friends and family at the other end of this country at that time as we were restricted to essential travel only.

I don't think it would have made much of a difference, people travel to and from India in numbers all the time. All that an instant move to red would have done would have been to compress a couple of week's worth of travel into a couple of days.

To extend that analogy though, it's a lot easier to deal with the fire when there's only a handful of places where the fire is starting (vs hundreds of 'ignition points'). And of course, we're busily putting in fire breaks, so if you can keep any big fires from starting whilst you finish putting those in, you'll be in a better place when any big fires inevitably do catch.

Fully agreed that it's impossible to keep variants out forever - delta is now well on it's way to being the globally dominant variant in most countries, but if we'd limited the amount of imported cases, we'd have fewer cases now, and more of a vaccine effect. The practicality of achieving that though, given the factors you've noted in the first paragraph is up for debate. As usual it's become very obvious what we should have done now that we're in the future and don't have to worry about the details

Hindsight is indeed a wonderful thing, however going forward we need to rethink (or is it re-rethink?) how we respond to future variants. Globally we have become so risk adverse that each new (publicised) variant that it triggers wave after wave of knee-jerk reactions. Perhaps we now need to stop reacting to each and every one and concentrate on getting vaccinations available to all citizens & all countries. Vaccines are still going to be the better means to deal with future ones.

 

[yorksrob]

But it is more punitive that what we require of those people in the U.K. who have contracted a confirmed case of Covid (including the Delta variant) domestically. When the way we treat foreign arrivals is much harsher than the way we treat domestic confirmed cases, something is very wrong, and I would suggest it is more about xenophobia than virus control.

If you're travelling in from a red list country, you have to quarantine in a hotel, but then if you have a confirmed positive case here you're supposed to self-isolate by law anyway, so I don't see that it's more punitive than for domestic cases. More expensive admittedly, but the restriction is the same.

 

[Xenophon PCDGS]

I don't think it would have made much of a difference, people travel to and from India in numbers all the time. All that an instant move to red would have done would have been to compress a couple of week's worth of travel into a couple of days.

PIA fly many people into Manchester Airport and there are large Pakistani communities in the areas of Blackburn, Bolton and Burnley who are always seen high on infection rate league tables.

 

[Bantamzen]

PIA fly many people into Manchester Airport and there are large Pakistani communities in the areas of Blackburn, Bolton and Burnley who are always seen high on infection rate league tables.

Its similar in areas like Bradford & Kirklees, where infection rates have been high. The hopefully good news is that despite this rates seem to be levelling off in Bradford, and hospitalisation & mortality rates have continued to fall regardless. So it may be that is partially an exit wave (which was always expected), combined with the added effect of people rushing back from the Indian Sub-Continent with the vaccines starting to really impact the need for medical intervention.

 

[yorkie]

I am interested in your bringing virologists into the discussion on this thread. I now await the usual suspects on this thread to come forth to deny any comments made by virologists in the same way that these same people have poured scorn on the stated medical opinions of other fully qualified medical staff in high positions in differing medical fields.

I've got no idea what point you're trying to make, nor who you are referring to.

I don't think you understand the point I am making.

My point is that people who may well have all sorts of fancy qualifications are making statements that demonstrate a fundamental misunderstanding of how viruses work; just because someone is a Doctor at a hospital does not mean they can speak with any authority about the evolution of a virus in order to justify the extension of harmful restrictions on our freedoms.

Some people are using hyperbolic and misleading terminology in order to justify the restrictions and that needs calling out, in my opinion.

 

[Domh245]

Even if we accepted the premise that it may have averted this delay (I agree it’s credible), hotel quarantine is an absolute travel ban in all but name (to anyone without a spare £2k, and 10 days losing income unless they can work remotely, and eating inedible food). I’m not sure that’s a proportionate response, and faced with the choice I think I’d choose the Step 4 delay.

It'd be a hard sell to 'improve' conditions on the relatively small number of people affected by hotel quarantine at the expense of the general population with the step 4 delay

I now await the usual suspects on this thread to come forth to deny any comments made by virologists in the same way that these same people have poured scorn on the stated medical opinions of other fully qualified medical staff in high positions in differing medical fields.

Are you suggesting that we should be treating comments about virology from any medical staff as equal to comments from a virologist? Would you take comments about a hydroelectric dam from an aeronautical engineer at the same value as comments from a civil engineer? They're both engineers after all...

Hindsight is indeed a wonderful thing, however going forward we need to rethink (or is it re-rethink?) how we respond to future variants. Globally we have become so risk adverse that each new (publicised) variant that it triggers wave after wave of knee-jerk reactions. Perhaps we now need to stop reacting to each and every one and concentrate on getting vaccinations available to all citizens & all countries. Vaccines are still going to be the better means to deal with future ones.

I think it was just a case of poor timing - delta emerged mid vaccine rollout and mid reopening, mid transition from "the only tool is restrictions" to wherever it is we're going. I think we're in a much better place going forward, we only really need to monitor for variants which have complete vaccine evasion (highly unlikely), and like you say we need to focus on getting vaccines out to the rest of the world

 

[Xenophon PCDGS]

Are you suggesting that we should be treating comments about virology from any medical staff as equal to comments from a virologist? Would you take comments about a hydroelectric dam from an aeronautical engineer at the same value as comments from a civil engineer? They're both engineers after all...

I was consultancy head of our Toronto office when we were the project lead on a Canadian hydro contract from 1995-2004. We gave contract work to those engineers both Canadian and American who had demonstrated the required expertise and knowledge of work in the specific field of hydro-electric works all over the world.

 

[brad465]

Its important to consider why the government delayed putting India onto the red list. We have a lot of citizens that have family, friends or business connections in India. Instantly putting India onto the red list would have seen tens of thousands of people instantly rushing back into the country, which could easily have swamped airports / airlines, and would have certainly led to passengers making all sorts of routes to get back to the UK. And then there would have been the logistics of getting hotel space for them all. It would have been a fluster-cluck, and may well have led to more problems & higher spread than we otherwise saw.

But as you say, for reasons discussed time & again a NZ style shut down just isn't workable in this country. And even if it were, doing so is tantamount to trying to stop a forest fire by building a fence around it with signs saying "No fire beyond this point". Sooner or later the fire, as with the virus would find it's way around the fences and start spreading again.

Those reasons will be part of why there was a delay putting India on the red list, but the one that seems to be being ignored (or even covered up) is likely to be Johnson was, until the last minute, happy to fly off to India to try and progress getting a trade deal with them. He was meant to go on the 26th, but cancelled on the 23rd, and is if by coincidence the red list announcement was later the same day (albeit another few days off taking effect). There were some suggestions that SAGE and others potentially were prepared to publicly speak out against the Government unless they put it on the red list when they did.

 

[Domh245]

I was consultancy head of our Toronto office when we were the project lead on a Canadian hydro contract from 1995-2004. We gave contract work to those engineers both Canadian and American who had demonstrated the required expertise and knowledge of work in the specific field of hydro-electric works all over the world.

My choice of example was very deliberate! The point (which you seem to agree with based on what you've said?) is that you should take advice and more highly prioritise comments from people who have the relevant expertise and knowledge. I don't see why Virology should be any different in this sense

 

[yorkie]

My choice of example was very deliberate! The point (which you seem to agree with based on what you've said?) is that you should take advice and more highly prioritise comments from people who have the relevant expertise and knowledge. I don't see why Virology should be any different in this sense

Exactly.

There seems to be a huge disconnect between mathematicians/modellers/epidemiologists on one side, and evolutionary biologists and virologists on the other side and for some reason the media and Government appear to be listening to the former group, rather than the latter on matters in which the latter group are the real specialists.

 

[Xenophon PCDGS]

My choice of example was very deliberate! The point (which you seem to agree with based on what you've said?) is that you should take advice and more highly prioritise comments from people who have the relevant expertise and knowledge. I don't see why Virology should be any different in this sense

I just wonder why it has taken well over 800 posts on this thread before the matter of the virologists were introduced on this particular thread? It took a website administrator (@yorkie) of high renown and esteem to broach the matter

 

[yorkie]

I just wonder why it has taken well over 800 posts on this thread before the matter of the virologists were introduced on this particular thread? It took a website administrator (@yorkie) of high renown and esteem to broach the matter

Please don't bring my forum position into this discussion; my opinions are an entirely separate matter and I do not expect to be considered any form of authority on this point.

I'm simply making the argument that it is my personal opinion that we should be listening more to the virologists and when we are discussing the evolution of the virus (for example to justify or refute the validity of restrictions) we should all be trying to use appropriate terminology that is descriptive, accurate and to avoid the use of language that is hyperbolic, misleading or incorrect.

For example, I do not think terms such as "60% more transmissable/infectious" are appropriate when it would be far more accurate and descriptive to say that the variant has improved fitness.

I believe one of the main reasons certain Governments, media outlets and doom-mongers (such as hysterical people on Twitter, often displaying cold heart logos) use such terminology is because they want to push a certain narrative and/or justify restrictions.

People are entitled to call for restrictions if they want (just as people like me are entitled to disagree with them) but when they use such terminology it only bolsters my argument that they don't really understand the actual issues and have not actually listened to virologists.

(It's rather like when someone who doesn't understand railway ticketing comes out with some hyperbolic nonsense)

 

[Xenophon PCDGS]

Please don't bring my forum position into this discussion; my opinions are an entirely separate matter and I do not expect to be considered any form of authority on this point.

I'm simply making the argument that it is my personal opinion that we should be listening more to the virologists and we should all be trying to use appropriate terminology that is descriptive, accurate and not hyperbolic in nature.

Mea culpa, mea culpa, mea maxima culpa......

Does it therefore seem strange that eminent medical personages have been reported as using incorrect medical terminology. You would have expected them to have used the correct medical terminology. Perhaps a letter from Mrs Trellis in North Wales to the editor of The Lancet seems to be in order...

Even after the announcement made on Monday, it is interesting to note that in the TfGM bus stations, announcements are still being made for people not to travel on public transport unless absolutely necessary and to wear masks on buses and trams when travelling on them.

 

[yorkie]

....eminent medical personages have been reported as using incorrect medical terminology. You would have expected them to have used the correct medical terminology...

The debate about the use of terms such as "fitness" vs "transmissibility" is not in any way a debate over "medical terminology"; we are not talking about medicine, treatments or anything like that.

Even after the announcement made on Monday, it is interesting to note that in the TfGM bus stations, announcements are still being made for people not to travel on public transport unless absolutely necessary...

I refer you to my (scathing) comments elsewhere on such matters!

 

[Ediswan]

Here is a definition of 'fitness' from a medical dictionary: https://www.merriam-webster.com/dictionary/fitness#medicalDictionary

Medical Definition of fitness​

: the capacity of an organism to survive and transmit its genotype to reproductively fertile offspring as compared to competing organisms