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What would you do about coronavirus in the UK if you were in charge?

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Yew

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3) Yes but probably nowhere near enough to give us herd immunity

It's an interesting one though, as I do wonder if in some areas we would reach herd immunity before the NHS reaches capacity. Specifically given the

It's also worth considering that the threshold for herd immunity is dependent on other measures, and doesn't exist in a vacuum
 
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island

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I am starting to think the Welsh had it right by mandating 2m in law, particularly in workplaces where it is being ignored.
Has the law actually been enforced though or is it like most of the other measures where people who comply put themselves at a disadvantage for no gain?
 

MikeWM

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This week we would prepare to put all of the below in place. Then next Monday all of the below would happen:


- Repeal the Coronavirus Act and all the regulations made under the 1984 Public Health Act.

- Put in place proper mechanisms to allow the vulnerable to shield *if they choose to do so*. Guaranteed free deliveries (food, medicine, etc.) Full furlough scheme for all such people of working age. Proper community support so they don't feel abandoned.

- Protect care homes. No bank staff moving between homes. Proper financial support for staff who have symptoms so they don't have to force themselves into work.

- No mandated social distancing, masks, covid-compliance workplaces or anything else like that. Everything opens and is back to normal. Tell people to wash their hands, stay home if ill, and otherwise use their common sense.

- Massive media and political campaign to communicate the actual risks to each section of society.

- Supply Vitamin D supplements for the entire population - special attention for those who naturally have lower vitamin D levels (eg. the BAME community).

- For people with symptoms - or those living with them - prescribe HCQ, Zinc and the other thing that goes with them.

- For people who are deteriorating, get them proper oxygen etc. treatment *as quickly as possible* - don't wait until they are effectively at death's door before admitting them to hospital. Use the Nightingale hospitals or similar for these so that the regular hospitals can get back to operating as normally as possible. Ventilators should be an absolute last resort.


With all that in place, we'll find that we're either close to herd immunity already (and we'd see that fairly quickly), or we'll get the virus through the remaining population within a couple of months. We'd be back to complete normal by the start of November at the latest, probably sooner.
 

Bletchleyite

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Oh dear. That has been proven to do more harm than good and discredits the argument somewhat.

If you'd mentioned that corticosteroid that does appear to be working, I'd have more time for the argument. (I wonder if anyone has done a study to find out if asthma preventer inhalers, which use corticosteroids, reduce severity?)
 

Scotrail12

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More stupid ideas. As it is, kids and young people are getting a very bad deal out of all this - and I have no doubt that many of them would treat any stipulation along these lines with them contempt it deserves.

No surprise that this idea comes from James Jordan. I totally agree that it would be a stupid idea and yet again would disadvantage the youth who have been totally disregarded throughout all of this.
 

HSTEd

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- All the evidence suggests that if we don't control exponential growth the health system won't be able to cope - particularly over the winter - and I find it very hard to imagine that the population would stand for that.
Sweden rather blows a hole in the hypothesis that without lockdown exponential growth is inevitable.

And either way the alternative is lockdown, or quasi lockdown, without end.
How long do you think the public would stand for that if the government wasn't lying about likely duration?

Vast numbers of people are being quietly liquidated through economic damage, psychological damage and all the manifold health impacts of this state of affairs.
They aren't photogenic pensioners, but still their lives have value.
 

MikeWM

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Oh dear. That has been proven to do more harm than good and discredits the argument somewhat.

This time a couple of weeks back I'd have agreed with you. Then I asked myself the question 'why am I so sceptical about everything else that the media and 'science' are pushing about this virus, but believing what they say on this?' Maybe I just don't like being associated with Trump much. But I did my own research and my conclusion is that it probably does work, and rather well in most cases. I made a couple of fairly detailed posts on this at the end of last week (on the vaccine thread, I think). Feel free to dig them out and discuss.

If you'd mentioned that corticosteroid that does appear to be working, I'd have more time for the argument.

I should add that, yes - but that's for when things are getting bad. HCQ needs to be used earlier than that.

(I wonder if anyone has done a study to find out if asthma preventer inhalers, which use corticosteroids, reduce severity?)

There was an 'article' (actually only about three lines, but it links to another set of research) in the Independent a few weeks ago on this, though it only hints at what you're asking.

https://www.independent.co.uk/indep...hma-risk-death-research-rutgers-a9604261.html
Asthma does not increase the severity of coronavirus, study finds

Explanation may lie in social behaviour, age of sufferers or steroid inhalers
 

HSTEd

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Sweden does have social distancing measures, and many people are voluntarily "in lockdown".

One cannot be "voluntarily" in lockdown.

Because the person being locked down also has the key to the lock holding them.

Some people voluntarily acting as thought hey are is not the same as the vast apparatus of state coercion being brought to bear on all who dissent.
 

Richard Scott

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Sweden does have social distancing measures, and many people are voluntarily "in lockdown".
But then 'lockdown' is voluntary as you say. They do have social distancing. I'd much rather have what they have as seems allowing people to choose doesn't cause instant Armageddon.
 

AdamWW

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Sweden rather blows a hole in the hypothesis that without lockdown exponential growth is inevitable.

Sweden is interesting. They did bring in restrictions (including pretty strict ones such as no non-essential travel) and relaxed things later but still with restrictions. If they thought that lifting all restrictions now wouldn't cause a significant increase in infections they would presumably have done so.

Unlike us, it looks as if they got R down to 1 and kept it there, whereas we got it a lot lower then let it rise - quite possibly this was necessary for us because we started later - keeping it at 1 would have locked in infections at an unacceptaby high level (look at the peak deaths).

But we still have stricter restrictions than Sweden so maybe some of what we are doing isn't helping much.

But I would argue we should find that out by dropping things gradually, not just all of the restrictions and sitting back to see what happens.
 

AdamWW

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But then 'lockdown' is voluntary as you say. They do have social distancing. I'd much rather have what they have as seems allowing people to choose doesn't cause instant Armageddon.

I think looking at whether restrictions are volunatary or mandaory is not relevant when it comes to the effect of policy (it might make a huge difference to someone's mental health).

The important thing is compliance, and in country A that could be lower with legal restrictions than in country B with voluntary ones.
 

Bletchleyite

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But I would argue we should find that out by dropping things gradually, not just all of the restrictions and sitting back to see what happens.

Which is what we have been doing, though now we seem to have reached the point where we can't drop any more - though I wonder if that is due to poor compliance rather than the measures themselves. For which a certain Mr Cummings is probably at least partly to blame - "project fear" was working very well until he went for his trip to Specsavers.
 

Richard Scott

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I think looking at whether restrictions are volunatary or mandaory is not relevant when it comes to the effect of policy (it might make a huge difference to someone's mental health).

The important thing is compliance, and in country A that could be lower with legal restrictions than in country B with voluntary ones.
Don't disagree but it isn't in most people's nature to be self destructive. We are at the point where there is no obvious way out and Government will find compliance is less and less as time goes on irrespective of consequences. It's sensible to have well thought out, well explained guidance/laws not just something that may or may not work as that gets people's backs up. Afraid at some point the choice has to be given to the population and some will make wrong choice but that's life.
 

SouthEastBuses

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This is what I would have done:

Impose a full lockdown on the entire UK like we had but at the same time as Italy did. People are allowed to go outside for shopping, work or exercise, but MUST wear masks in indoor settings such as supermarkets. No need to wear a mask outdoors where social distancing of 2 metres can be observed.

Completely lift the lockdown around the 14th of May, with all non essential businesses such as pubs reopening. Masks continue to be mandatory in indoor settings and outdoors where social distancing is impossible, appropriately marked where this is the case. People can start using public transport for leisure everywhere in the UK from that date but MUST wear a face mask unless exempt.
 

AdamWW

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Which is what we have been doing, though now we seem to have reached the point where we can't drop any more - though I wonder if that is due to poor compliance rather than the measures themselves. For which a certain Mr Cummings is probably at least partly to blame - "project fear" was working very well until he went for his trip to Specsavers.

Quite.

But it is possible that we are relaxing the wrong ones. We probably can't drop much more without infections going up, but we do seem to have more restrictions than Sweden and it's not looking particularly convincing that herd immunity is playing a big part there. (It if is, it shouldn't be long before we're in that position too).

Maybe Sweden shows that a fair amount of what we are doing isn't actually helping much. I would hope that someone in SAGE is looking at that.
 

scarby

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Sweden does have social distancing measures, and many people are voluntarily "in lockdown".

I wouldn't say "many" by a very long stretch, and I've been out and about in several parts of Sweden over the past month in numerous different environments.

People are generally good at observing social distancing. Another notable measure is that mass social gatherings such as at sports events, festivals, expos, etc., are not taking place.

The Swedish public health authorities say they currently have "no plans" to lift its current recommendations, and that also includes advising people to work at home if possible.

What they have done is introduce measures that are sustainable for some time. By allowing normal life to continue as much as possible, they haven't wrecked society or demoralised the people. They can keep financially propping up the sectors that have major restrictions, such as mass events, sports can be played behind closed doors as they already get substantial government funding for youth activities anyway, and they also get a good chunk of TV money. It offers a clear and sustainable path forward to manage the situation.
 

scarby

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Maybe Sweden shows that a fair amount of what we are doing isn't actually helping much. I would hope that someone in SAGE is looking at that.

There's almost no virus "what-iffery" in Sweden - e.g. no disposable menus, no acting as if you can get it from food, no regimenting ordinary things such as going to the pub or shops, etc.

Basically keep distance where possible, wash your hands, don't be around people if you are ill.
 

AdamWW

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I wouldn't say "many" by a very long stretch, and I've been out and about in several parts of Sweden over the past month in numerous different environments.

People are generally good at observing social distancing. Another notable measure is that mass social gatherings such as at sports events, festivals, expos, etc., are not taking place.

The Swedish public health authorities say they currently have "no plans" to lift its current recommendations, and that also includes advising people to work at home if possible.

What they have done is introduce measures that are sustainable for some time. By allowing normal life to continue as much as possible, they haven't wrecked society or demoralised the people. They can keep financially propping up the sectors that have major restrictions, such as mass events, sports can be played behind closed doors as they already get substantial government funding for youth activities anyway, and they also get a good chunk of TV money. It offers a clear and sustainable path forward to manage the situation.

I think people are overplaying the impact of the difference in approaches.

We are currently seem to be taking an approach of keeping infection levels constant (R=1 if you like).

Sweden took the approach of making sure their health system could cope. I have argued earlier that I think these two policies are simliar - because once you go above R=1 and exponential growth kicks in it's not long before any health system is overwhelmed. And indeed while not explicitly chasing R, they have indeed kept R to 1.

So if there is a difference, it's that they've found a less onerous set of restrictions that work (for them) to achieve the same goal as us.

Now maybe actually they've reached a much higher level of immunity - I don't think so but if so then we can't be that far behind.
 

Richard Scott

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I think people are overplaying the impact of the difference in approaches.

We are currently seem to be taking an approach of keeping infection levels constant (R=1 if you like).

Sweden took the approach of making sure their health system could cope. I have argued earlier that I think these two policies are simliar - because once you go above R=1 and exponential growth kicks in it's not long before any health system is overwhelmed. And indeed while not explicitly chasing R, they have indeed kept R to 1.

So if there is a difference, it's that they've found a less onerous set of restrictions that work (for them) to achieve the same goal as us.

Now maybe actually they've reached a much higher level of immunity - I don't think so but if so then we can't be that far behind.
What is your obsession with this R number? As it's relevant to a random event, which catching/spread of a virus is, then low numbers render it meaninglessness. It's only of any use with much larger number of infections.
 

AdamWW

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What is your obsession with this R number? As it's relevant to a random event, which catching/spread of a virus is, then low numbers render it meaninglessness. It's only of any use with much larger number of infections.

Much larger than what?

The ONS believe that at present we have enough infections in the UK to give a range of values for R to a high probability. However infections have dropped to the point where the regional values are no longer reliable.

Do you have reason to believe that the ONS don't understand the statistics of the calculations they are doing?

If you like I can re-phrase to remove all mention of R:

I think people are overplaying the impact of the difference in approaches.

We are currently seem to be taking an approach of keeping infection levels constant.

Sweden took the approach of making sure their health system could cope. I have argued earlier that I think these two policies are simliar - because once you let infections rise and exponential growth kicks in it's not long before any health system is overwhelmed. And indeed while not explicitly chasing a goal of keeping infection levels constant, this is pretty much what they achieved.

So if there is a difference, it's that they've found a less onerous set of restrictions that work (for them) to achieve the same goal as us.

Now maybe actually they've reached a much higher level of immunity - I don't think so but if so then we can't be that far behind.
 

AdamWW

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So if there is a difference, it's that they've found a less onerous set of restrictions that work (for them) to achieve the same goal as us.

I have just read that 50% of Swedes live alone. I don't know if it's true, and what the figures are for the UK.

But I suspect that we have a lot more multi-generational households. That might in itself be enough to change the balance - i.e. we have to be stricter elsewhere to make up for the impact there.
 

Richard Scott

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Much larger than what?

The ONS believe that at present we have enough infections in the UK to give a range of values for R to a high probability. However infections have dropped to the point where the regional values are no longer reliable.

Do you have reason to believe that the ONS don't understand the statistics of the calculations they are doing?

If you like I can re-phrase to remove all mention of R:

I think people are overplaying the impact of the difference in approaches.

We are currently seem to be taking an approach of keeping infection levels constant.

Sweden took the approach of making sure their health system could cope. I have argued earlier that I think these two policies are simliar - because once you let infections rise and exponential growth kicks in it's not long before any health system is overwhelmed. And indeed while not explicitly chasing a goal of keeping infection levels constant, this is pretty much what they achieved.

So if there is a difference, it's that they've found a less onerous set of restrictions that work (for them) to achieve the same goal as us.

Now maybe actually they've reached a much higher level of immunity - I don't think so but if so then we can't be that far behind.
When you're on a few hundreds per day any shift is going to make an appreciable difference to R rate, when you're in the thousands the same shift has a much smaller impact. Like I said it's a random event and these need largish numbers to be considered reliable.
 

talldave

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I think people are overplaying the impact of the difference in approaches.

We are currently seem to be taking an approach of keeping infection levels constant (R=1 if you like).

Sweden took the approach of making sure their health system could cope. I have argued earlier that I think these two policies are simliar - because once you go above R=1 and exponential growth kicks in it's not long before any health system is overwhelmed. And indeed while not explicitly chasing R, they have indeed kept R to 1.

So if there is a difference, it's that they've found a less onerous set of restrictions that work (for them) to achieve the same goal as us.

Now maybe actually they've reached a much higher level of immunity - I don't think so but if so then we can't be that far behind.
What is your obsession with hospitalisation? Only a minority end up in hospital. The faster we let it pass through society without overloading the hospitals the better. All the doom and gloom from April didn’t transpire - virtually no Nightingale usage.

What happened to the ventilator panic? It vanished because CPAP is better and arterial/blood clot issues were the killer for many.

The current "elimination strategy, without admitting it's an elimination strategy" approach is pointless and doomed to failure.
 

AdamWW

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What is your obsession with hospitalisation? Only a minority end up in hospital. The faster we let it pass through society without overloading the hospitals the better. All the doom and gloom from April didn’t transpire - virtually no Nightingale usage.

The current "elimination strategy, without admitting it's an elimination strategy" approach is pointless and doomed to failure.

Because a minority of a large number of people comes to a large number, and in the winter the NHS has barely any spare capacity anyway (though we might have less flu due to shielding/social distancing).

I'd point out that my "obsession" seems to be shared by people with far more knowledge of the matter than me, and who are advising the government.

The UK government is pretty clearly not pushing an elimination strategy - if they were they would be opening up much more cautiously like Wales and Scotland.

When you're on a few hundreds per day any shift is going to make an appreciable difference to R rate, when you're in the thousands the same shift has a much smaller impact. Like I said it's a random event and these need largish numbers to be considered reliable.

Yes I understand. But can you give me a reason to change my view that when the Office of National Statistics say that we have enough infections to get a reliable range of values for R, I should disbelieve them?

We are, of course, currently at the stage of thousands of new infections per day.

I'm not sure what point you're making.

While we are on R, here's that report I was mentioning earlier:


Amazing how if you search for more things you find more things

Very odd. They seem to be suggesting that the government is making the mistake of basing policy on raw test numbers. Or have I missed something?

And implying that the government is saying that cases are on the rise, which I don't think they are.

(Although we are now at the point where a rise in cases is consistent with somewhat more sophisticated analyses than the one referred to here).
 

A Challenge

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Yes I understand. But can you give me a reason to change my view that when the Office of National Statistics say that we have enough infections to get a reliable range of values for R, I should disbelieve them?
The fact they can get a reliable value of R just means that they know that the value of R they have got is an accurate assessment of the current situation, but this doesn't mean that they don't think that on a small number of cases a slight change can be a high % change - which is what R is based on.
 

PTR 444

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Bit late to this, but if I were in charge as soon as the pandemic begun in January, this is what I would have done:
  • Start work on a test, track & trace system as soon as possible.
  • Until adequate testing capacity is available, introduce a mandatory 2-week quarantine for anyone returning from another country with at least one active virus case. Anyone having to quarantine would be eligible for Statutory Sick Pay.
  • As soon as there is capacity, introduce mandatory testing at all airports and seaports for anyone returning from another country. Anyone testing positive will be required to quarantine for 2 weeks and also be eligible for SSP.
  • £1000 fines for anyone who breaks quarantine rules.
  • Advise the over-65s and people with certain underlying health conditions to shield for 2 weeks if there happens to be a local outbreak. Anyone in work having to do this will also be eligible for SSP.
That way, schools, pubs, restaurants and even mass gathering events could have remained open throughout with minimal disruption to society, and we would probably be where New Zealand is today.
 

MikeWM

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HCQ needs to be used earlier than that.

Interestingly there was some news breaking into the 'mainstream' last week on HCQ. Some fairly senior scientists from Oxford University and the Wellcome Trust think we need a proper study on it. Eg. this article (sorry that it is from the Mail...). That we still don't know the efficacy or otherwise, seemingly just due to politics, is appalling.

https://www.dailymail.co.uk/news/ar...ens-thousands-lives-Covid-19-politicised.html
British researchers behind the only large global trial testing hydroxychloroquine as a prophylaxis say their work is in jeopardy because it has become too politicised.

They have warned dropping the drug will block science from finding out if the medicine can really stop coronavirus from entering the body, potentially saving thousands of lives.

...

Sir Jeremy Farrar, director of the Wellcome Trust, said: 'There is no guarantee that we’ll soon have a widely available vaccine against Covid-19.

'Despite all the publicity, we still do not know if hydroxychloroquine can prevent Covid-19, but it’s really important that we find out, one way or the other.

'The only way to do this is to enroll a large number of participants in randomised controlled trials like COPCOV.'

...

Dr Will Schilling, one of the chief investigators of COPCOV, said: 'We really don’t know if hydroxychloroquine works or not in prevention or very early treatment.

'That question remains unanswered. The benefits found in small post-exposure treatment trials although modest could be very valuable if they were confirmed.'
 
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