So, Sweden may well have been right.....

[DB]

It's not now decreasing, it's stabilised and is running roughly constant in the UK.

Which is what many would expect to happen - and it shows that a policy of trying to eliminate it by supression won't work.

 

[scarby]

There seems to be a view that humanity is so clever now that it can avoid natural happenings such as pandemics. There's no reason to asume that this is the case.

It will also need to be looked at in future as part of a five year average - this is not a particularly bad pandemic as they go.

Yes, there is of course still 5 months to go but it looks as if Sweden’s death rate this year could still end up better than in 1993 and 2000 when there were bad flu outbreaks.

 

[WestCoast]

I've heard a lot of people comparing Sweden to Norway but I think Denmark is potentially more interesting. Denmark didn't go as far as Norway but did introduce more restrictions than Sweden. The economies and populations of Southern Sweden and the most populated bits of Denmark and its capital are closely linked together across the bridge, Malmo and Copenhagen are what about 40 minutes or so away from each other?

Denmark had a somewhat stricter lockdown initially, actually one of the first European countries to introduce travel restrictions but then a more speedy relaxation and they've had far fewer Covid related deaths. If we're going by deaths then you could argue that no Sweden didn't get it right compared to Denmark. Economically speaking there doesn't seem to be much in it. Long term effects - who knows?

I doubt we'll know which countries if any "got it right" for quite some time.

 

[yorkie]

...infection rates are no longer falling in the UK..

At least they're not [yet?] rising, like in Spain and France!

But they're not falling, as they are in Sweden.

Of course infection surveys aren't the whole story, but neither are death numbers.

What's happening in some other countries isn't looking promising

You mean the countries that had harsh lockdowns? Many of us predicted that!

As for Sweden, the impression I often get here is that Sweden just kept on pretty much as normal and I don't think that's true...

It's not true but their measures were - and still are - sensible, proportionate and have a long-term exit strategy.

I've heard a lot of people comparing Sweden to Norway but I think Denmark is potentially more interesting. Denmark didn't go as far as Norway but did introduce more restrictions than Sweden. The economies and populations of Southern Sweden and the most populated bits of Denmark and its capital are closely linked together across the bridge, Malmo and Copenhagen are what about 40 minutes or so away from each other?

Denmark had a somewhat stricter lockdown initially, actually one of the first European countries to introduce travel restrictions but then a more speedy relaxation and they've had far fewer Covid related deaths. If we're going by deaths then you could argue that no Sweden didn't get it right compared to Denmark. Economically speaking there doesn't seem to be much in it. Long term effects - who knows?

I doubt we'll know which countries if any "got it right" for quite some time.

True and I agree Denmark will be a better comparison. But a lot of it has to do with how many cases were imported in the early stages; if I recall correctly it was estimated that the virus in the UK had at least 1356 origins

Coronavirus came to UK 'on at least 1,300 separate occasions'

There was no one 'patient zero' that started the UK epidemic, research shows.

www.bbc.co.uk

They found the UK's coronavirus epidemic did not have one origin - but at least 1,356 origins. On each of those occasions somebody brought the infection into the UK from abroad and the virus began to spread as a result.

So that's yet another factor to to take into account if people are measuring the success so far.

But as you say, we won't know for quite some time.

 

[AdamWW]

That's what's happened here. Why are so many people not seeing what is in front of their eyes.....

The lockdown started unwinding a few weeks after it started. I worked right through this, traffic on the roads started going up within a few weeks and more people started coming out and so on. But the death rate didn't go up (allowing for the 18 day delay from contracting the virus to dying from it) it actually started going down (see the graph in the opener). I'm not saying one happened because of the other, I'm saying that the lockdown and extreme social distancing was having only a marginal effect, if any at all.
Similarly, when the government officially started unwinding the lockdown all these "experts" were saying it's too much of a risk, we'll get a second spike, etc etc. But that's not what happened, the death rate actually continued to drop.
Same thing with some schools reopening. Again all the over cautious experts* "too much of a risk, we'll get a second spike" etc etc, but guess what ? Yes you're right, the death rate continued to drop.

What is very sad, almost criminal, is that if I'm right, and our high death rate reflects high exposure to this virus and its burning itself out, then all these social distancing measures we're continuing to inflict on ourselves are achieving very little, if anything. We should be using our hard won position of relative immunity to get back to normal as soon as possible and, as an additional very welcome side effect, consign all those awful face masks to the bin.

* Over cautious in terms of Covid, but not at all in terms of the massive damage this virus is causing society and the economy. They act like that's not a factor worth considering at all.

I hope you're right, but looking at what's happening round the world I see very little to suggest that you are.

We went into lockdown with quite a large number of infections, some of which then lead to (and may still lead to) deaths. Not everybody who dies of it takes the same time to do so.

So imagine a perfect lockdown with zero transmission and - for the sake of argument - everyone infected was infected the day before lockdown. (Given exponential growth, not too bad an assumption perhaps). Then you'll see deaths continuing until everyone who is going to die of it has done so, and the deaths vs time graph is just showing you how many people die a certain number of days from infection - usually with such things the closer you get to the average value the more people will take that time, so you'll see a peak.

Of course some people were infected before lockdown, so the graph gets smeared out a little. But the same principle applies.

Now the lockdown isn't perfect, but if it has drastically reduced transmission then you have far fewer infections occuring after lockdown than before, so the resulting deaths are seen against the much larger number from before the lockdown.

I've also assumed that improved understanding in how to treat Covid patients also doesn't affect the death rate, and that as numbers in hospitals drop the remaining cases don't get better treatment - that will also cause a drop in the death rate.

So if the lockdown was very effective, seeing deaths dropping even as it is relaxed a bit is in fact exactly what you would expect to see.

In terms of whether the lockdown/social distancing has an effect, you need to look at how the infection rate changes (though this doesn't tell you if deaths per infection go down). It looks as if as lockdown has been released this has gone up, and the infection rate is now constant, within the uncertainty in measuring this.

That to me really doesn't look like something that has burnt itself out and we should stop taking precautions against.

But we will see. If infection rates (not just deaths) start falling again, then we'll know we're in a good position, and I'm pretty sure that further relaxations will follow. It's think that they will be relaxed as soon as there is reasonable evidence that they can be.

Bottom line - my view is not that the experts aren't seeing the obvious, it's that concentrating just on death rates just isn't the right way to look at things.

 

[Justin Smith]

It's not now decreasing, it's stabilised and is running roughly constant in the UK.

7 Day moving average (per day) :
4 Jul = 97
11 Jul = 86
18 Jul = 68
25 Jul = 67

That's dropping to me, but in any case they are at a level now (in a country of 66,000,000 where around 1500 die every day) that it is not worth knackering society to try and get them even lower, particularly as :
1 - How many of those have actually died of something else but happened to have Covid when they died ?
2 - How many people will die of something else (or just earlier than they would otherwise due to poverty) due to a crashed economy ? I 100% guarantee you it'll be significantly more than the current number dying from Covid.

Certainly for the second half of June the average death rate in this country is below the 5 year average. So why are we continuing to do this to ourselves ?
Junk the social distancing, junk the face masks, other than for those who choose to self isolate, or indeed wear a face mask. After all, it is supposed to be a free country......

 

[AdamWW]

You mean the countries that had harsh lockdowns? Many of us predicted that!

Well I also mean places that haven't done much in the way of mitigation.

And as for infections going up if a harsh lockdown is released - that's why the government was being advised by the experts not to lock down in the first place - until it became clear that in the UK with the number of existing infections this policy would be likely to swamp the hospitals and cause a large number of deaths.

 

[yorkie]

Well I also mean places that haven't done much in the way of mitigation.

And as for infections going up if a harsh lockdown is released - that's why the government was being advised by the experts not to lock down in the first place - until it became clear that in the UK with the number of existing infections this policy would be likely to swamp the hospitals and cause a large number of deaths.

Sorry I don't really understand the point you are making.

 

[AdamWW]

7 Day moving average (per day) :
4 Jul = 97
11 Jul = 86
18 Jul = 68
25 Jul = 67

That's dropping to me, but in any case they are at a level now (in a country of 66,000,000 where over 1500 die every day) that it is not worth knackering society to try and get them even lower, particularly as :
1 - How many of those have actually died of something else but happened to have Covid when they died ?
2 - How many people will die of something else (or just earlier than they would otherwise due to poverty) due to a crashed economy ? I 100% guarantee you it'll be significantly more than the current number dying from Covid.

Certainly for the second half of June the average death rate in this country is below the 5 year average. So why are we continuing to do this to ourselves ?
Junk the social distancing, junk the face masks, other than for those who choose to self isolate, or indeed wear a face mask. After all, it is supposed to be a free country......

Because unless we have a good idea that this won't just start infections rising exponentially again, it would be a bit foolhardy.

 

[Richard Scott]

Well I also mean places that haven't done much in the way of mitigation.

And as for infections going up if a harsh lockdown is released - that's why the government was being advised by the experts not to lock down in the first place - until it became clear that in the UK with the number of existing infections this policy would be likely to swamp the hospitals and cause a large number of deaths.

But that should have been the only reason to lockdown, get it to a stage where hospitals could cope then allow those who were able to (majority of population) get back on with their lives so economy wasn't too damaged. Could have then followed Sweden and been in a much better position and doubt with many, if any, more deaths. But unfortunately now we have paranoia and normal doesn't appear to be coming back any time soon.

 

[AdamWW]

Sorry I don't really understand the point you are making.

My point is that given a chance coronavirus spreads like wildfire and I cannot see any evidence from anywhere that if we just went back to normal now we wouldn't see infection rates shooting up again, leading to rather a lot of deaths, never mind people who 'recover' suffering from long term or permanent consequences.

 

[Richard Scott]

Because unless we have a good idea that this won't just start infections rising exponentially again, it would be a bit foolhardy.

What's the problem with them rising, at some point we need to learn this isn't going anywhere and we will have to live with it?

 

[AdamWW]

But that should have been the only reason to lockdown, get it to a stage where hospitals could cope then allow those who were able to (majority of population) get back on with their lives so economy wasn't too damaged. Could have then followed Sweden and been in a much better position and doubt with many, if any, more deaths. But unfortunately now we have paranoia and normal doesn't appear to be coming back any time soon.

OK. let's say your're in charge.

You're going to run the country now to keep infection levels at a point where the hospitals can cope.

What do you do now?

 

[duncanp]

until it became clear that in the UK with the number of existing infections this policy would be likely to swamp the hospitals and cause a large number of deaths.

Ah yes, that was the well thought out research paper by Professor Neil Ferguson Pantsdown.

Who then proceeded to break the rules of the lockdown that he himself advocated, as did the Mayor of Leicester and the leader of Luton Borough Council.

The NHS never even came close to being overwhelmed, otherwise the Nightingale hospitals would have seen far greater use than they actually did.

The harsher the lockdown, the greater the risk there is when the lockdown is relaxed.

Perhaps this is the issue in Spain.

 

[Richard Scott]

OK. let's say your're in charge.

You're going to run the country now to keep infection levels at a point where the hospitals can cope.

What do you do now?

Carry on with life! This isn't smallpox or the plague. If country is allowed to run, those who need to shield will make up a small percentage of population, meaning rest of us can keep economy going and maybe by us having this virus help those out who are shielding.

 

[Justin Smith]

I hope you're right, but looking at what's happening round the world I see very little to suggest that you are.

We went into lockdown with quite a large number of infections, some of which then lead to (and may still lead to) deaths. Not everybody who dies of it takes the same time to do so.

So imagine a perfect lockdown with zero transmission and - for the sake of argument - everyone infected was infected the day before lockdown. (Given exponential growth, not too bad an assumption perhaps). Then you'll see deaths continuing until everyone who is going to die of it has done so, and the deaths vs time graph is just showing you how many people die a certain number of days from infection - usually with such things the closer you get to the average value the more people will take that time, so you'll see a peak.

Of course some people were infected before lockdown, so the graph gets smeared out a little. But the same principle applies.

Now the lockdown isn't perfect, but if it has drastically reduced transmission then you have far fewer infections occuring after lockdown than before, so the resulting deaths are seen against the much larger number from before the lockdown.

I've also assumed that improved understanding in how to treat Covid patients also doesn't affect the death rate, and that as numbers in hospitals drop the remaining cases don't get better treatment - that will also cause a drop in the death rate.

So if the lockdown was very effective, seeing deaths dropping even as it is relaxed a bit is in fact exactly what you would expect to see.

In terms of whether the lockdown/social distancing has an effect, you need to look at how the infection rate changes (though this doesn't tell you if deaths per infection go down). It looks as if as lockdown has been released this has gone up, and the infection rate is now constant, within the uncertainty in measuring this.

That to me really doesn't look like something that has burnt itself out and we should stop taking precautions against.

But we will see. If infection rates (not just deaths) start falling again, then we'll know we're in a good position, and I'm pretty sure that further relaxations will follow. It's think that they will be relaxed as soon as there is reasonable evidence that they can be.

Bottom line - my view is not that the experts aren't seeing the obvious, it's that concentrating just on death rates just isn't the right way to look at things.

It's the death rate that counts, it's the only thing that counts. If hospitals got far better at treating Covid and the infection rate went up markedly but the death rate stayed the same nobody would be bothered (or should be bothered). And in any case hospitals are getting better at treating Covid, but you rarely hear about it because there is an unofficial conspiracy to keep everyone frightened, I really believe that. I've been on forums where many posts which, in the opinion of the moderators, play down the seriousness (as they see it) of Covid they delete the post. Similarly, I can remember when face masks were made mandatory all the news outlets just had Vox Pops with people who thought it a good idea, or at least were not opposed to it, which does not reflect my view or that of many people I know. I know what it's like to live in a censored society now.
Anyway, why focus on the infection rate, which cannot be accurate anyway, not unless everyone is tested every day.....

 

[AdamWW]

What's the problem with them rising, at some point we need to learn this isn't going anywhere and we will have to live with it?

For one thing, because the nature of exponential growth is that once the infection rate starts to rise we can very quickly find ourselves in the position where our hospitals are being overwhelmed.

 

[Bletchleyite]

What's the problem with them rising, at some point we need to learn this isn't going anywhere and we will have to live with it?

Because lots of people will die and the NHS will be overwhelmed.

"Living with it" is not going to look like "old normal". A vaccine or effective treatment truly is the holy grail.

 

[DB]

For one thing, because the nature of exponential growth is that once the infection rate starts to rise we can very quickly find ourselves in the position where our hospitals are being overwhelmed.

Well, better to get it over with if that's going to happen - the Nightingale hospitals are all still available currently.

 

[AdamWW]

Carry on with life! This isn't smallpox or the plague. If country is allowed to run, those who need to shield will make up a small percentage of population, meaning rest of us can keep economy going and maybe by us having this virus help those out who are shielding.

So just go back to normal, and if the hospitals are overwhelmed, we just crack on?

It's one approach. I'm quite thankful it's not one we are taking though.

Are you going to completely isolate care homes? No staff in or out?

How about hospitals?

Even the much-lauded Sweden didn't go for a strategy of just letting nature take its course.

 

[Richard Scott]

For one thing, because the nature of exponential growth is that once the infection rate starts to rise we can very quickly find ourselves in the position where our hospitals are being overwhelmed.

It never happened though did it? Not even close. The number of people requiring hospital attention isn't very high and now we have other ways of dealing with it with some drugs that help the admissions would be even fewer. Let those that need to shield do so and the rest of us carry on, highly unlikely we'll come close to causing the hospitals to be overrun. Look at those it affects badly, they're mostly retired with very few in working age bracket.

 

[Richard Scott]

So just go back to normal, and if the hospitals are overwhelmed, we just crack on?

It's one approach. I'm quite thankful it's not one we are taking though.

Are you going to completely isolate care homes? No staff in or out?

How about hospitals?

Even the much-lauded Sweden didn't go for a strategy of just letting nature take its course.

I didn't say that, I said let those that need to shield do so and others get on with life. There was no need for schools, universities, factories, cafes etc to stay closed. If you think we can carry on like we are for next 10 years or so (it'll actually be longer than that at current rate) if no vaccine is found then hospitals will be overwhelmed, with mental health cases.

 

[DB]

Because lots of people will die and the NHS will be overwhelmed.

"Living with it" is not going to look like "old normal". A vaccine or effective treatment truly is the holy grail.

The NHS never came close to being overwhelmed despite the preductions - the initial reason for the lockdown was to allow it to prepare. Which it did, and still has that extra capacity available.

It really is worrying that some people seem to genuinely believe that this virus can be eradicated in a fairly short timescale. There is nothing in the history of medicine to suggest that this is going to happen.

 

[Bletchleyite]

The NHS never came close to being overwhelmed despite the preductions

Because we locked down. If we hadn't, I'm confident it would have been.

It really is worrying that some people seem to genuinely believe that this virus can be eradicated in a fairly short timescale. There is nothing in the history of medicine to suggest that this is going to happen.

Other than, say, New Zealand?

 

[AdamWW]

It's the death rate that counts, it's the only thing that counts. If hospitals got far better at treating Covid and the infection rate went up markedly but the death rate stayed the same nobody would be bothered (or should be bothered). And in any case hospitals are getting better at treating Covid, but you rarely hear about it because there is an unofficial conspiracy to keep everyone frightened, I really believe that. I've been on forums where many posts which, in the opinion of the moderators, play down the seriousness (as they see it) of Covid they delete the post. Similarly, I can remember when face masks were made mandatory all the news outlets just had Vox Pops with people who thought it a good idea, or at least were not opposed to it, which does not reflect my view or that of many people I know. I know what it's like to live in a censored society now.
Anyway, why focus on the infection rate, which cannot be accurate anyway, not unless everyone is tested every day.....

Right - for a start we shouldn't just be looking at death rates but also how many people suffer long term from Covid-19. But putting that aside, while deaths may be what count, they are absolutely not the only thing that we should be looking at to make policy, for the reasons I've given above.

You don't have to test everyone every day. You take a sample of the population and test them on a frequent basis and from that extrapolate to the population as a whole.

Yes this is not precise, and that's why even though the infection numbers have rised, it's not being reported as such because within the uncertainties they could have remained stable. We need to wait a bit and see.

But it is what the governments should be focussing on and fortunately they are.

 

[Justin Smith]

Ah yes, that was the well thought out research paper by Professor Neil Ferguson Pantsdown.

Who then proceeded to break the rules of the lockdown that he himself advocated, as did the Mayor of Leicester and the leader of Luton Borough Council.

The NHS never even came close to being overwhelmed, otherwise the Nightingale hospitals would have seen far greater use than they actually did.

The harsher the lockdown, the greater the risk there is when the lockdown is relaxed.

Perhaps this is the issue in Spain.

Absolutely right in everything you say. Wasn't it Ferguson who scared the government by saying up to half a million could die ? What absolute ballcox. He was assuming everyone would catch it and be susceptible to it and 1% would die. Bearing in mind that even I, as an arch opponent of the lockdown / social distancing, thought the vulnerable should be protected and isolated (if they chose to be so) that was never going to happen. But he was wrong about the death rate even then anyway, by a factor of two. He obviously didn't read about the Diamond Princess* either.....
Hasn't he got an OBE ? It should be taken back off him !

* Diamond Princess - cruise ship with 3771 people on it, and 2666 passengers (av age 69 ! ), the virus was free to infect for over two weeks (20 Jan to 4 Feb) yet only 17% contracted the virus and only 14 died. If old Neal had been right it should have been between 100 and 150 deaths. And he was driving government policy and being interviewed on the radio every day (whilst not making trysts)......

 

[AdamWW]

The NHS never came close to being overwhelmed despite the preductions - the initial reason for the lockdown was to allow it to prepare. Which it did, and still has that extra capacity available.

It really is worrying that some people seem to genuinely believe that this virus can be eradicated in a fairly short timescale. There is nothing in the history of medicine to suggest that this is going to happen.

Well that's not the world I live in.

In mine, SAGE told the government that the NHS would be likely to be overwhelmed without a lockdown. The lockdown ensued. The NHS wasn't overwhelmed.

Of course the extra capacity came at the expense of the NHS doing much else - yet a lot of people seem to be blaming the lockdown itself for deferred treatments etc.

There is a big difference between thinking we can eradicate this in a short timescale and thinking that the right thing to do is just let infections rocket again.

 

[Justin Smith]

Because we locked down [the NHS was not overwhelmed]. If we hadn't, I'm confident it would have been.

And I'm confident it wouldn't have been. But, as it happens, 70% of those who had Covid bad enough to be put on a ventilator died (and many, particularly weaker older people would not have been put on one anyway). So massive availability of ventilators or ICU provision would not have had a big effect on the death rate.

 

[DB]

In mine, SAGE told the government that the NHS would be likely to be overwhelmed without a lockdown. The lockdown ensued. The NHS wasn't overwhelmed.

That was based in predictions that proved to be way out (as comparison with the predicted and atual death rates in Sweden shows).

 

[AdamWW]

Absolutely right in everything you say. Wasn't it Ferguson who scared the government by saying up to half a million could die ? What absolute ballcox. He was assuming everyone would catch it and be susceptible to it and 1% would die. Bearing in mind that even I, as an arch opponent of the lockdown / social distancing, thought the vulnerable should be protected and isolated (if they chose to be so) that was never going to happen. But he was wrong about the death rate even then anyway, by a factor of two. He obviously didn't read about the Diamond Princess* either.....
Hasn't he he got an OBE ? It should be taken back off him !

* Diamond Princess - cruise ship with 3771 people on it, and 2666 passengers (av age 69 ! ), the virus was free to infect for 18 days (20 Jan to 4 Feb) yet only 17% contracted the virus and only 14 died. If old Neal had been right it should have been between 100 and 150 deaths. And he was driving government policy and being interviewed on the radio every day (whilst not making trysts)......

It was also Ferguson who said originally that we shoudn't lock down because there is no exit strategy.

The calculation of how many people were likely to die comes from the "R" factor (how many people one person infects) which tells you when you reach herd immunity, and the liklihood of dying of it.

If it was wrong, it's because the best values available at the time were wrong. And as for protecting the vulnurable, that didn't work out too well, did it?

And Diamond Princess - your argument seems to be that if you take the current best estimates of transmission and death rates, and then compare them against one example, that once example disagrees so they must be wrong.