Coronavirus - worldwide spread and control

[Barry]

The UK government has just published the papers that have been informing it's decisions:

https://www.gov.uk/government/news/...vidence-supporting-the-uk-government-response

This paper "SPI-M-O: Consensus view on public gatherings" ...

https://assets.publishing.service.g...i-m-o-consensus-view-on-public-gatherings.pdf

... seems to work on the assumption that people parachute into their seats. In reality people mingle very closely in packed queues, run their hands along the backs of chairs, hand rails, toilet and wash facilities, etc. Let alone the shared public transport to and from.

 

[Jonathan Edwards]

Also there's this evidence list for SPI-B. 3 of the 7 papers have Wessely as a co-author. It will be interesting to see if any of them have any good evidence to support the decision to delay social distancing.

I do not see how there can have been any relevant evidence. The psychological situation is different for each infectious disease - smallpox, TB, flu, syphilis, measles, coronavirus. Without ever previously having an epidemic with the parameters of Covid19 there is no way of knowing how people will behave. People may forget that TB was more or less eradicated from the UK by social distancing and legally enforceable isolation. It worked very well. There is the story of the village that isolated itself against the plague. Attempts to stem influenza outbreaks may have been unsuccessful but they were in different times with different means of communication and the infectivity was high and incubation short.

By the end of January Wuhan told us all we needed to know. There was nothing to model or theorise about. It was clear that without lockdown you had failure of your healthcare system. Anything beyond this is just fiddling while Rome burns.

 

[FMMM1]

There are several figures and other preliminary info and speculations.
I can't summarize it well.
I'm sure the subject will be covered more as time passes.

Thanks @Roy S I managed to find some stuff online. One of the factors is that women are less likely to die ; however, those with respiratory problems etc. are more likely to die ---. Not getting the virus before being vaccinated sounds like the best strategy!

 

[Simon M]

I put my posts about the Imperial college paper out as a blog, with a bit more explanation. I know this group has moved on but it's here as a reference.

The section on Yo-yo control might be of interest

Until very recently, the US and UK governments were taking a relatively gentle approach to controlling the new coronavirus epidemic – compared with most other governments around the world. A very recent report from UK academics shows that the strategy would probably have led to a huge number of deaths — well over a million in the US. The report is based on a detailed model using information from many sources. This blog explains how the model works, what it finds and why it is likely those numbers changed US and UK government plans for the better. It also explains the Yo-Yo control strategy that the UK government has started to mention.

https://mecfsresearchreview.me/2020...ifts-in-policy-by-uk-and-us-governments/#yoyo

 

[Esther12]

This paper "SPI-M-O: Consensus view on public gatherings" ...

https://assets.publishing.service.g...i-m-o-consensus-view-on-public-gatherings.pdf

... seems to work on the assumption that people parachute into their seats. In reality people mingle very closely in packed queues, run their hands along the backs of chairs, hand rails, toilet and wash facilities, etc. Let alone the shared public transport to and from.

Yes, I wonder what they mean by 'close contact' here?

In most larger events, such as sports matches, attendees will come into close contact with at most a handful of people, so the risk to attendees is low.

Isn't it pretty normal to be pushed up close to a range of people while queuing to get in, for food, etc?

I do not see how there can have been any relevant evidence. The psychological situation is different for each infectious disease - smallpox, TB, flu, syphilis, measles, coronavirus. Without ever previously having an epidemic with the parameters of Covid19 there is no way of knowing how people will behave. People may forget that TB was more or less eradicated from the UK by social distancing and legally enforceable isolation. It worked very well. There is the story of the village that isolated itself against the plague. Attempts to stem influenza outbreaks may have been unsuccessful but they were in different times with different means of communication and the infectivity was high and incubation short.

By the end of January Wuhan told us all we needed to know. There was nothing to model or theorise about. It was clear that without lockdown you had failure of your healthcare system. Anything beyond this is just fiddling while Rome burns.

It does seem a problem! I'd like to at least be able to see the evidence that was cited, and claimed to be relevant. That's largely because I'm interested in spin.

 

[Invisible Woman]

Cornwall has asked people not to take holidays in the area:

Too late. One of my husband's colleagues is from Cornwall. Many of their 2nd home owners are already there.busily filling cafés, restaurants etc.

 

[Sasha]

Too late. One of my husband's colleagues is from Cornwall. Many of their 2nd home owners are already there.busily filling cafés, restaurants etc.

Cafes, pubs and restaurants being told to close tonight in the UK:

https://www.bbc.co.uk/news/uk-51981653

About flipping time...

 

[Simbindi]

Too late. One of my husband's colleagues is from Cornwall. Many of their 2nd home owners are already there.busily filling cafés, restaurants etc.

Yes. Influx from urban city dwellers is my concern too for my area of West Somerset, where there is no hospital with an ICU (just a small community hospital in Minehead, with a very small Minor Injury Unit) and a third of the population over 65. I did the census in 2011 in West Somerset, loads of 2nd homes usually empty, and I heard lots of stories of how awful the locals were treated by the owners when they did come.

There is an exclusive Health Farm and Spa, which has lots of hotel rooms and several self-catering units located in my nearest village where the 2 nearest small shops are (2 miles from my hamlet). I checked their website and they are still accepting bookings and presumably won't fall under the 'restaurant, pub and cafe' forced closures. Yes, they are only going to attract the wealthy, but they are no more immune to the coronavirus than the poor. So I'm thinking if I do have to go out to shop (if the supermarket delivery system continues to fail) then I will drive to the small town where my GP practice is located, 10 miles away.

 

[Mij]

Car manufacturers in Canada ready to make ventilators: An interesting business angle on the COVID-19 situation to watch is how business is coming together to help address the crisis. Here’s a great story from FP reporters Emily Jackson and Naomi Powell about how auto manufacturers are looking at retooling their manufacturing lines to build vital medical equipment.

 

[NelliePledge]

I don't think folk do get it. But because [some people] have warned the govt against scaring people too much, they seem to be much more worried about causing PTSD than they are about people actually dying. Human beings are not good at assessing risk, and sometimes we just need to be shouted at to get us to act. All this "would you mind awfully" is not terribly effective!

Right. When I was outside Kings Cross St Pancras at 9 am on 7/7 the guy with the high viz and the megaphone wasn’t saying ‘please could you very kindly avoid the area’ he was saying ‘leave the area immediately!- walk North‘ nobody was under any illusions about the seriousness of the situation.

 

[NelliePledge]

Yes, I wonder what they mean by 'close contact' here?



Isn't it pretty normal to be pushed up close to a range of people while queuing to get in, for food.

Absolutely - with football matches you queue up to get in and are patted down by security then you go through very tight turnstiles which are made of metal and have to be pushed to get through. Then straight into the crowded concourse where the food and drink is served basically like walking across a crowded bar. Then through to the stadium through your entrance. The seating is not generously spaced especially for the hefty built you are brushing past people as you go to your seat x2 if you go back out to the concourse at half time - even if just for the loo rather than beer or a pie. Getting food/beverage is very much like trying to get served in a busy pub.

 

[Simbindi]

I'm not sure which thread to put this in, but here's the (I believe) latest guidance for GP practices in England:

https://www.england.nhs.uk/coronavi...redness-letter-primary-care-19-march-2020.pdf

 

[Jonathan Edwards]

Don't be too hard on us second home owners. We have always had a second home (actually our first own home) as a way of surviving working in London NHS hospitals during the week. Now our daughter works for a state school we need two homes so that she can work and we can hide away in Suffolk.

Now that the bars and cafes are closed I doubt the SHOs will cause too much trouble. They might provide some other badly needed work. When we decamped to Woodbridge we tried to book a table at a restaurant to celebrate having our offer accepted on a flat for our daughter to live in in the future. But everywhere was booked up by big parties of locals no doubt joking about all the unnecessary panic!

And getting the wrinklies out of London may be the best way to allow normal business to recover with all the youngsters getting over Corona and getting back to work!

 

[Simbindi]

At least Butlins have taken the decision to close their holiday centres before being forced to. However, there are still a lot of caravan parks in the area.

https://www.itv.com/news/westcountr...ose-all-uk-resorts-amid-coronavirus-outbreak/

 

[Simbindi]

Don't be too hard on us second home owners. We have always had a second home (actually our first own home) as a way of surviving working in London NHS hospitals during the week. Now our daughter works for a state school we need two homes so that she can work and we can hide away in Suffolk.

Now that the bars and cafes are closed I doubt the SHOs will cause too much trouble. They might provide some other badly needed work. When we decamped to Woodbridge we tried to book a table at a restaurant to celebrate having our offer accepted on a flat for our daughter to live in in the future. But everywhere was booked up by big parties of locals no doubt joking about all the unnecessary panic!

And getting the wrinklies out of London may be the best way to allow normal business to recover with all the youngsters getting over Corona and getting back to work!

I don't think locals have any problems with second home owners that use their properties on a regular basis, contribute to the local economy and treat the locals with respect. But there are some homes that are empty for over 10 months of the year and pockets of the country where 2nd homes form a high percentage of the available housing stock - a very problematic combination.

 

[Sasha]

I'm not sure which thread to put this in, but here's the (I believe) latest guidance for GP practices in England:

https://www.england.nhs.uk/coronavi...redness-letter-primary-care-19-march-2020.pdf

Do we know how GP practices are coping? Are they also becoming overwhelmed?

 

[FMMM1]

I put my posts about the Imperial college paper out as a blog, with a bit more explanation. I know this group has moved on but it's here as a reference.

The section on Yo-yo control might be of interest

Until very recently, the US and UK governments were taking a relatively gentle approach to controlling the new coronavirus epidemic – compared with most other governments around the world. A very recent report from UK academics shows that the strategy would probably have led to a huge number of deaths — well over a million in the US. The report is based on a detailed model using information from many sources. This blog explains how the model works, what it finds and why it is likely those numbers changed US and UK government plans for the better. It also explains the Yo-Yo control strategy that the UK government has started to mention.

https://mecfsresearchreview.me/2020...ifts-in-policy-by-uk-and-us-governments/#yoyo

Haven't read your blog yet but thanks in advance. I was surprised when I listened to the Radio 4 6pm news this evening. Apparently, they can ease restrictions/re-instate restrictions to manage the availability of ventilators in ICU. When there are ventilators available --- the cafe's will open and when the ventilators are full the cafes will close --- who would have thought it was that easy! Modelling who needs it!

 

[Mithriel]

BPS theorists do not seem to understand that we do not have teleports. They never consider how much effort it takes to get to a clinic or to work when they say how much exercise people with ME should take.

Never considered transport before no need to start now

 

[Adrian]

Also there's this evidence list for SPI-B. 3 of the 7 papers have Wessely as a co-author. It will be interesting to see if any of them have any good evidence to support the decision to delay social distancing.

https://assets.publishing.service.g...t_data/file/873741/09-spi-b-evidence-list.pdf

This one from Wessely is very poor and certainly not evidence just opinion. He seems to think quarantining happens to a whole area rather than house by house in a lock down. Also talks of stress of being quarantined but no concept of the stress of government inaction.
https://www.bmj.com/content/368/bmj.m313.long

 

[ME/CFS Skeptic]

Noticed that Ioannidis has published an editorial where he criticizes some of the more stringent isolation measures taken by western governments. He seems to defend the position that the US and UK governments were taken before gradually changing course.

Regarding the Case Fatality Rate (CFR) he writes (my bolding):

Early reported CFR figures also seem exaggerated. The most widely quoted CFR has been 3.4%, reported by WHO dividing the number of deaths by documented cases in early March.7 This ignores undetected infections and the strong age-dependence of CFR. The most complete data come from Diamond Princess passengers, with CFR=1% observed in an elderly cohort; thus, CFR may be much lower than 1% in the general population; probably higher than seasonal flu (CFR=0.1%), but not much so. Observed crude CFR in South Korea and in Germany8 , the countries with most extensive testing, is 0.7% and 0.2%, respectively. Even in these countries, many cases probably remain undiagnosed. Therefore, CFR may be even lower.

But at the time of writing the crude CFR for South Korea has risen to 1.06% and the CFR for China to 4%. The reason is quite simple: there is a significant time delay between diagnosing someone as a case of COVID-19 and death as a result of COVID-19. The WHO report wrote that "Among patients who have died, the time from symptom onset to outcome ranges from 2-8 weeks" and Zhou et al. write the median time from illness onset to death was 18.5 days.

So if you're able to determine X cases of COVID-19 you have to wait two weeks or more to see how many of those X cases have died because of the illness. I think most CFR reported simply divide the number of cases and deaths momentaneously, which makes them a bit of an underestimation. It explains why the CFR has been increasing in countries like China and South-Korea where the number of cases has fallen dramatically as the death rate has a delay in catching up. Similarly, in Germany, the epidemic probably has only just started so one could expect the CFR to rise significantly over the coming weeks.

I've tried to make a graph for South-Korea and China (they have different Y-axes so the crossing of the lines doesn't mean anything, also the South-Korean graph starts at a later date)