Coronavirus - worldwide spread and control

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I’ve been reading more of the minutes of The New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) meetings that I recently posted on here. NERVTAG were asked by the Cabinet Office Briefing Rooms (COBR) to answer the following question:

What are the most effective personal preventative measures recommended to members of the public to stop transmission?

This was discussed at the 5th Covid-19 NERVTAG meeting on 3rd February. The answers mostly related to hand hygiene but there was also this:

JR [James Rubin] asked if there is a point about not attending school or work when ill? It was clarified that NERVTAG is not currently expected to comment on the question of social distancing at this time but could be asked this by DHSC [Department of Health and Social Care] at a later date.
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Which in itself is quite revealing...

https://m.box.com/shared_item/https://app.box.com/s/3lkcbxepqixkg4mv640dpvvg978ixjtf/view/640964947060

ETA: DHSC didn’t appear to have asked NERVTAG to comment on social distancing anytime on or before 27th March as it wasn’t discussed in any of the meetings up until then (I don’t know what discussions took place after that date because the minutes of more recent NERVTAG meetings have yet to be published)
 
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Wonko said:
All I know is that those who are considered 'extremely vulnerable', and me, can now have a food parcel, for free, meant to last for a week, but which is missing thought, and ingredients, to allow this to be possible - so I still have to compete for slots, and the availability of stuff on shelves, to try and obtain the omissions, when according to the government, and the media, and therefore society at large, I am supposed to be fully sorted.

[...]

It's been causing a constant state of stress, anxiety and hopefully, needless expense - because I don't have accurate information, I only have blithe reassurances that at every turn turn out to be self serving lies.
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Pretty much the same as my Sainsbury's delivery the other day: designed to fill in the holes for things we were running out of so that I didn't have to put myself and my caree at risk by going to the supermarket. Instead, I've spent the past 48 hours plus at 4 different supermarkets to try and pick up all the stuff I didn't get in my order. Might just as well have gone to Sainsbury's myself today, done the shop and - eek - taken a cab home. An unnecessarily stressful week thus far. What on earth is the point ...
 
lunarainbows said:
Saw this and just wanted to weep. This is how I used to get off the bus on peak-hour work days. Saw the tube at Canning Town yesterday as well. In London and infact many places, they cannot expect people to “avoid public transport” when told to go into work. You simply cannot do that.
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And this is how the UK govt. wants us to avoid a second spike in cases :( Can't believe so many people upped and went back to work just on their say-so - do they not bother running the information through their brains first? Of course, they may have been desperate, I suppose.
 
I expect many people got a phonecall on sunday night to be back at work the next day or they were out. Sadly the poorest paid have the least rights.

People on minimum wage are treated badly in a lot of cases and they have no resources, living week to week.

One of the links from the forum was to a professor of economics at Oxford (a high position) who said that most people would stay at home voluntarily and that lockdown was only necessary for the irresponsible few and to protect workers from exploitative employers.

On the other hand, the idiots in the antivax group trying to organise mass picnic protests in Scotland by stirring people up are guilty of manslaughter at least.
 
Wits_End said:
And this is how the UK govt. wants us to avoid a second spike in cases :(
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A spike is definitely going to happen.

I don’t understand what the U.K. govt thinks it’s doing. Our cases are far too high to do any sort of contact tracing (20,000 new cases a day, of which only a fraction of that is identified - so how many active cases at any one time?), even if we had a system in place, which we don’t .. and I can’t see how we will, given the infrastructure.

So if we can’t do contact tracing surely we need a lockdown to actually get cases down.. nope not doing that either, instead allowing people to roam around, opening things that were closed just a short while ago, and even those who don’t want to go out are forced to go out if their employees tells them to.

So no contact tracing, no lockdown.

Except soon the NHS will be overwhelmed again. But they’ll just keep cancelling all other operations & appts and keep saying “It’s a success because our NHS didn’t get overwhelmed, unlike what happened in Italy!”. Again conveniently forgetting care homes, those discharged from hospital to care homes without testing, & people dying at home.

But there’s already a massive backlog of hospital admissions, including cancer surgeries. So how can they add even more backlog? I don’t get it. Have they even thought about it?

:( :(
 
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Opinion piece in Dagens Nyheter (Sweden), about the need for ethical considerations in decision making during pandemics. Well worth a read.

According to the article, The Swedish National Council on Medial Ethics will publish a new report today, proposing a number of ethical values and principles, as part of their ongoing work to create a national ethical framework for decision making during pandemics.

The main 8 points are:
  • Minimize injury and save lives
  • Human dignity
  • Personal privacy and freedom
  • Justice and equality
  • Scientific basis
  • Proportionality
  • Trust
  • Solidarity
Google Translate said:
Decisions should be justified and based on facts, values and principles that community citizens share or can agree on. The decision-making process must be open to scrutiny.

The scientific basis for decisions and the chosen strategy should be made public. Furthermore, the decision-making process should be inclusive so that affected groups are involved in the decisions as far as possible. There should be opportunities to re-evaluate and reconsider decisions when new information and new facts emerge. There should also be mechanisms for handling disputes and complaints. Decision makers must be able to be held accountable for their actions.
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DN Debatt: ”Sverige saknar etiskt ramverk för beslut vid pandemier”
https://www.dn.se/debatt/sverige-saknar-etiskt-ramverk-for-beslut-vid-pandemier/

Google Translate, English
 
If I am allowed to stress what I find especially important in @mango ´s quote, it´s this:
Decisions should be justified and based on facts, values and principles that community citizens share or can agree on. The decision-making process must be open to scrutiny.

The scientific basis for decisions and the chosen strategy should be made public. Furthermore, the decision-making process should be inclusive so that affected groups are involved in the decisions as far as possible. There should be opportunities to re-evaluate and reconsider decisions when new information and new facts emerge. There should also be mechanisms for handling disputes and complaints. Decision makers must be able to be held accountable for their actions.
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I think the biggest problem is that there (still, of course) is uncertainty, and it seems to me that decision makers have problems to deal with it in a focusing way.

I think also researchers have significant problems to present any numbers in a way that allows a halfway reasonable guess on the situation.

Here in Germany, as my impression is, citizens are somehow loose now, if you walk around it seems that everybody comes from another planet. In Sweden at least there is a clear strategy announced. A further advantage might be that Sweden is a small country where communication is easier achieved, I am not sure if this is the case in this situation though.


I have read that in Sweden (some) people lost a bit patience to behave quite carefully. It´s the same here, but the reason may be different (?). I could imagine, that the estimation of a "possible" herd immunity achieved in May was not so wise (but we don´t already know the payout anyway). Whereas here in Germany it seems due to somehow incoherent assessments, I would say.
 
mango said:
The main 8 points are:
  • Minimize injury and save lives
  • Human dignity
  • Personal privacy and freedom
  • Justice and equality
  • Scientific basis
  • Proportionality
  • Trust
  • Solidarity
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The trouble is that these are exactly the point on which policy has been based so far in countries that have failed so badly.

I fear that in reality this is 'keep everyone happy, even of they all die'.
I don't think privacy is relevant in a pandemic.
 
Jonathan Edwards said:
The trouble is that these are exactly the point on which policy has been based so far in countries that have failed so badly.

I fear that in reality this is 'keep everyone happy, even of they all die'.
I don't think privacy is relevant in a pandemic.
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Considering privacy is important because it can help with compliance and gaining access to information. The phone app would work better using the privacy preserving protocols that have been defined (although that is a choice that apple and google have made). Even with a human based contract tracing ensuring information is only used for contract tracing (i.e. privacy) can be important to get all info. I heard an interview with one of the contract tracing teams in South Africa who were set up for HIV tracing but are doing Cov19 and they made this point.
 
Jonathan Edwards said:
I fear that in reality this is 'keep everyone happy, even of they all die'.
I don't think privacy is relevant in a pandemic.
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Yeah the freedom part of “personal privacy and freedom” made me shake my head as I just know where that is leading. Freedom to roam around, knowing you may well be spreading the virus or contributing to its spread...

I think the point about privacy was made well in the C4 documentary about South Korea. The public know that contact tracers can type their name into a system and pull out all their details about where they’ve been and when, credit card details..but they are ok with it in matters like this which concern public health, because they know that they are giving up their privacy in return for actually being able to go about their lives safely and for their country to be safe. These systems were set up following the MERS outbreak very recently. The govt there recently won a landslide election after the handling of this outbreak, so there is very clearly also trust between the population and the government, and I can see why there is.

But while I can see it happening in other countries, I do not think we will see the same situation here, for other reasons - including data concerns around the app and who is running it and where the data is going, how those of us have been treated by state departments (outsourced to private companies too) well before this outbreak (DWP?!), dire lack of transparency - about which an article has been posted here earlier, so to download a centralised app could be very worrying for many.
 










On this point, a govt minister on question time said yesterday, Boris Johnson would be addressing parliament next week about contact tracing and that the app would be “rolled out” next week. He seemed very vague on all details despite being questioned a few times. From what I can see, “Rolled out” doesn’t mean fully functioning and working, and it doesn’t mean actual people working as contact tracers will be in place.
 
lunarainbows said:
The govt there recently won a landslide election after the handling of this outbreak, so there is very clearly also trust between the population and the government, and I can see why there is.
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This.

I think we can forget these apps.
If I had Covid19 I would want to announce on Facebook and anywhere else available exactly where I had been for the last few days in the hope that it might keep someone else alive. The idea that people want to hide away and have a right to in this situation seems me dystopian. There is nothing new about the implications of notifiable infectious diseases. They throw privacy out of the window because care for others comes first.

The HIV situation was very different.

I am sorry to sound blimpish but the current fashion for being nice to everyone at the cost of doing what is necessary to save lives seems to me to have no place in an ethical code.
 
I subscribe to the UK Government "announcements". Mostly I just delete unread, but I have just been looking at the latest one on the "Scientific evidence" for re-opening schools for years R, 1, and 6.

https://assets.publishing.service.g...fic_advice_and_information_on_coronavirus.pdf

Where I'm fairly horrified at what it says.

1. Infectivity and transmission in children

The exact rates of infectivity and transmission of children is not fully known yet; this is a novel virus and the scientific understanding is developing all the time. However, the current understanding is that:
• There is a high degree of confidence1 that the severity of disease in children is lower than in adults.
• There is a moderate to high degree of confidence that the susceptibility to clinical disease of younger children (up to age 11 to 13) is lower than for adults. For older children there is not enough evidence yet to determine whether susceptibility to disease is different to adults.
• The susceptibility to infection of younger children (up to age 11 to 13) might be lower than for adults, but the degree of confidence in this is low. For older children there is not enough evidence yet to determine whether susceptibility to infection is different to adults.
• There is no evidence to suggest that children transmit the virus any more than adults. Some studies suggest younger children may transmit less, but this evidence is mixed and provides a low degree of confidence at best.
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I'm particularly bothered about that last bulleted point... "There is no evidence to suggest that children transmit the virus any more than adults."

Well it seems to me that adults seem to have done a pretty good job of transmitting the virus. To say there's no evidence that children transmit it more than adults doesn't exactly fill me with confidence that it's a good idea to send kids back to school. What's the evidence that they transmit it less than adults would be more of interest to me. But I don't think that evidence is there, as if it was they'd have highlighted it.

(Edited to add UK to Government in first sentence to clarify that it's from UK Government)
 
ladycatlover said:
I'm particularly bothered about that last bulleted point... "There is no evidence to suggest that children transmit the virus any more than adults."
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Yes, there is something peculiar about this list. Where is the point that there is no evidence that children transmit virus less than adults - which is the only point that would be of any interest amongst these statements. Why is that crucial admission conveniently not made?

I am beginning to come to the conclusion that the mess up really is the fault of the experts not the politicians. The experts have repeatedly come up with statements that miss the point and clearly indicate some sort of unconscious psychological need not to admit that airports should have been closed in January and contact tracing set up and continued. Costello pointed out that Jenny Harris had no need to support what was apparently a political action to remove world comparisons. Maybe that was at the suggestion of the scientists too.
 
My impression, gained over the last few weeks is this;

Most of the damage, and indeed symptoms, are caused by our own immune systems reaction to the virus, not the virus.

The immune system overreacting certainly seems to be the case for those being made seriously 'unwell' or dying.

I have seen reports of children not necessarily having developed the 'thing' that is responsible for the immune system overreacting and cause 'issues'.

I've seen no evidence that children are not catching coronavirus, it makes no sense to me that they wouldn't, only that when they do they have less severe symptoms, if any - which means they are almost definitely at least as infectious as adults - with any apparent differences being behavioural (children tend to be very 'in your face', most adults not so much).

It may be that, because children's immune systems are not reacting as much as needed, or at least not overreacting, that in some cases this is allowing the virus to do other things not commonly seen in adults - hence the 'mysterious' thing that's seemingly associated with coronavirus that's making some children very ill.
 
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