Coronavirus - worldwide spread and control

[Jonathan Edwards]

However, people moving to rural areas for the valid, positive and necessary reasons you cite doesn't account for the large numbers in the UK that have headed for both seaside towns and the sparsely populated Scottish Highlands.

The reports of people going to Skegness for a day out in the amusement arcade are horrific. But I think taking a caravan to the Highlands sounds pretty good altruistic sense to me. If those involved then shut themselves away or walk at a distance from others then they are not only likely to escape infection but to escape being unwitting passers on of infection in town.

I suspect a lot of people are in rather similar situations to my wife and I, who have had to leave London in order not to be living in the same house as a daughter who is supposed to be working in a school. Breaking the contract chain has to make sense.

I have a feeling that very soon the community will become divided into two groups. One group will strictly keep themselves to themselves and stay free of infection. The other group will rapidly cross infect each other. Immunity will develop in that group but for it to do so soon there will have to be a phase of breakdown of hospital care (literally nowhere to teat people). For many people in London joining the first group may require being out of town. If others insist on being part of the second group the first lot cannot be blamed for going where they can, as long as they keep clear of others.

I was thinking a bit more about the school policy. The policy of allowing children of essential workers to go to school looks to me to be a disaster. Presumably within a week or two ALL these children will be infected, with the result that ALMOST ALL key workers, as parents, will also be infected. This is the opposite of what we need. My idea would be that if one parent is not a key worker they should do the childcare. If both are key workers they should alternate, not just for their own sake but to preserve a body of key workers for the next month.

Section about schools copied to new thread

 

[FMMM1]

According to the Italian radio this morning, from tomorrow all non essential work will be suspended. Presumably work that doesn't involve physical contact with others will be allowed.

The fines for people that don't respect the lockdown rules and meet in groups will also be increased.

Thanks, hopefully they can get transmission under control.

I went to the shops yesterday and get told off when I got home i.e. for not preparing properly for bringing shopping into the house etc. I had two pairs of gloves on and a make shift face mask; washed my clothes and showered when I got back ---. It's a bit unreal i.e. you can't see anything so the danger isn't clear.

 

[Adrian]

I found the mathematics of engineer Tomas Pueyo very interesting: he proposes a good method of calculating the number of infected people, simply based on the current number of deaths.

He worked out that at any point in time, the number of infected people in a region will be around 800 times the number of coronavirus deaths that have occurred in that region.

I was able to estimate that there have been about 70 deaths in Greater London so far (using this UK map), which implies that there are 70 * 800 = 56,000 infected people in London at present. That works out to around 1 in 160 infected in London.



Tomas Pueyo's calculation is based on the mathematics of exponential growth, and the fact that it takes an average of 17.3 days for death to occur after the person is first infected. So there is a time lag to death, during which the total number of infected people in the region will further increase, as a result of exponential spread of the virus.

In other words, the number of deaths today provides a snapshot of the situation it was 17.3 days ago; but by using exponential growth equations, you can use this snapshot to calculate the estimated number of infected today.

His calculation assumes two figures: that the death rate is 1% (1 in 100 people with the virus will die), and that the rate of exponential growth of infected people is such that the total number infected doubles every 6.2 days. From these two assumptions, you can arrive at the result that the total number infected people at any given point in time is 800 times the number of deaths at that point in time.

I think that is a very simplistic view. The spread rate will depend on what mitigations are in place to prevent spread and the death rate depends both on demographics and the ability of the hospital system to cope.

For example, people are saying Italy has an aging population hence the high death rate. There is an interesting thing in germany in that the Corona virus was spreading in the ski resorts hence it tended to infect younger or healthy fit people - which explains the initial low death rates.

Gross assumptions give very gross approximations and ones that really don't apply well to local situations such as applying to London (or any region).

These days we have decent computer systems and we can build more data into models (such as regional populations) as well as looking at different assumptions such as the effectiveness of social distancing. So we should use proper models rather than back of the envelope calculations which could mislead.

 

[Barry]

Respirators - a thought.

There is clearly a severe impending shortfall in medical respirators. So some people will not have access to respirators who desperately need them. Desperate circumstances sometimes call for desperate solutions. There are a great many industrial respirators that are available, not necessarily intended for life saving but for life preservation - forced air versions are available I believe. Although probably not as effective as medical respirators, would they still help save lives, possibly with some trivial adaptations? Maybe for less critical patients who perhaps need a concentrated oxygen supply but can still breathe it themselves? So that the medical respirators can be used where they are absolutely needed?

Would an industrial respirator be better in some cases than no respirator at all? Might they help save lives, both directly, and also indirectly by releasing medical respirators for those who really have to have them?

I appreciate there are strong regulatory issues here, which is partly what I mean by desperate measures. If industrial respirators could help save lives, then maybe there emergency legislation could be passed to allow their use, and for how they should be used, during this crisis.

Could there be any mileage in this @Jonathan Edwards?

 

[Roy S]

This guy makes sense and they are starting this in New York where the confirmed cases are shooting up with increased testing.

 

[Adrian]

What did China do differently, that made their lockdown so effective? It is now looking like what was done in China, with the same sort of social restrictions, may be what is going to be needed in Europe.

One of the things they did was a test and track process where people were tracked by their phones and if they walked near someone who was later tested to have the virus they would be tested and quarantined. I think south Korea also had a massive test program which helped them get things under control.

 

[Adrian]

I'm wondering how this crisis could impact me/cfs research. We were benefitting from stable research in other fields, making me/cfs an attractive "new" field for researchers to enter. Will their attention be turned to viral pandemics? Will the scraps we got go elsewhere? Will research stall over the next two years? I assume the NIH inhouse study is on hiatus. When will it get back on track?

One concern is that the funders will be pushing money into pandemic research rather than into things like ME. However, one argument for increasing ME research is that a pandemic could trigger many more cases (based on studies that report a percent of cases after an infection). Which could put ME or PVFS as an important research topic.

 

[Simbindi]

Another story about people 'escaping to the countryside' and causing problems for the local residents from the Guardian daily updates:

We have had lots of people get in touch about lack of social distancing in the UK, with people going out in the sunny weather.

A reader from the Lake District - a popular holiday destination in north-west England - sent in the picture, below, taken yesterday. They did not want to be named but said:

A picture tells a thousand words - take a look at the attached image. People are escaping to the countryside for days out as normal.

The National Trust shut all its properties, but kept the outdoor places open for people to exercise. They had to reverse this decision overnight as thousands of tourists saw the sunny weather as an opportunity to have a day out. Many of the properties where busier that a normal bank holiday weekend. This is just not acceptable.

The rural areas just can’t cope with this kinds of influx of visitors at this time. Our healthcare system in the Lakes is only meant for the 500,000 permanent residents. It’s already being overwhelmed.

The local community is trying its best to get the message across that we aren’t welcoming visitors at the moment, but it just doesn’t seem to be working. We are overrun. Car parks have turned into campsites, and our small local co-ops are now empty as they can’t keep up with demand from tourists. All the holiday cottages and second homes are full.

 

[lunarainbows]

However, this total lock down was only happening one area of China, not the whole country. So I can see why Europe and other countries can't go as far as placing all the restrictions Wutan had. But they can obviously go much further than what is currently happening.

Yes.. although London is certainly one of a few areas where lockdown should and could have happened. Also in other countries, there were certain regions that were more badly hit.

Also, why are shops still open? A friend is still working in a shop that sells toys and home accessories and towels etc. My local primark (and those in the UK know how busy primark is), is still open, as far as I know. Outdoor areas are still open, and people are congregating there.

 

[Mij]

A infectious doctor said this morning that 25,000 people died of the flu last year in Italy. Perspective.

 

[Jonathan Edwards]

A infectious doctor said this morning that 25,000 people died of the flu last year in Italy. Perspective.

And 5,000 out of about 100,000-200,000 infected people have died from Covid19 in a month. The population has a lot of immunity to flu so it does not spread to everyone. Covid19 can be expected to spread to everyone. So the expected number of deaths from Covid19 in Italy this year is about 1.5 million. Perspective.

 

[Cheshire]

COVID patients need to stay in hospital way longer than flu if I understood correctly, this has a cost in terms of public safety too, and has to be taken into consideration. There'll be indirect deaths caused by delayed care.

 

[lunarainbows]

Todays Sunday Times as to the origins of the herd immunity theory practiced in the UK. (John Harris is a Guardian Journalist). I think this is big in the UK right now.

 

[Hoopoe]

The irony is I think that the reluctance to spend money on containing the virus in order to spare the economy might well end up doing economic damage that exceeds that of an aggressive and early containment strategy. Time is so precious when dealing with a situation where infection and death rates double every few days to a week.

 

[Andy]

Car parks and trails could be shut to stop people from visiting Snowdonia National Park after "unprecedented scenes" on Saturday, according to bosses.

There were so many people on mountain summits it was "impossible to maintain effective social distancing".

Pen y Fan in the Brecon Beacons was also busy with visitors on Saturday.

Welsh ministers are considering their legal powers to force people to stay away during the coronavirus outbreak.

https://www.bbc.co.uk/news/uk-wales-51994504

 

[lunarainbows]

Because the govt hasn’t forcefully closed shops in the UK yet, individual employees are resorting to things like this -

 

[Hoopoe]

My home town had its first death (out of 10 known infected cases). There is also a newborn that is infected.

PS: and 4 people recovered, so that is good news at least.

Tomorrow they will begin disinfecting the streets. Just like the Chinese did.

 

[Simon M]

Looks like we have DominicCummins and Patrick Vallance to thank for our current situation - at least according to this Buzzfeed report (thanks to @Andy, I think, for posting earlier)

10 Days That Changed Britain: "Heated" Debate Between Scientists Forced Boris Johnson To Act On Coronavirus https://www.buzzfeed.com/amphtml/alexwickham/10-days-that-changed-britains-coronavirus-approach

Here is what it says:
— despite all that stuff about following expert advice, it turns out the experts in the Scientific Advisory Group for Emergencies, SAGE, didn't agree amongst themselves. Patrick balance, Chief Scientific Advisor to the government, told a Parliamentary committee last week week "if you think SAGE is a cosy consensus of the green, you are very wrong indeed".

Which makes it really strange that the government went out on a limb with its light-touch approach — which proved not to work.

This is the key quote: "a Minister told Buzzfeed news that Dominic Cummings and Vallance were "close allies" and claimed the government had "bet" the future of UK on advice from a very small group of scientists that for a long time differed from the wider international consensus, and other members of SAGE."

Also:

"The Prime Minister has held deep ideological reservations about turning Britain into effective police state, as some other countries have done. On Wednesday, Johnson told press conference that the UK was a "land of liberty","

It was only after the presentation of findings from Imperial College that Vallance and Johnson finally accepted that the NHS would soon be overwhelmed if the UK continued on its previous strategy.

This excerpt is good too
[The experts] also raised concerns that the government must be completely transparent with the public, questioning why Vallance later chose to describe the difference between the mitigation and suppression strategies as “semantics”. “This will all come out in the mother of public inquiries,” a source said.

"If you want to know how much we underestimated this, last Wednesday Rishi's budget gave a £30 billion stimulus for the economy, six days later he had to spend another £330 billion," said a Whitehall official.

 

[Invisible Woman]

Because the govt hasn’t forcefully closed shops in the UK yet, individual employees are resorting to things like this -

I agree that non essential shops should close. I'm not sure why Waterstones hasn't. Perhaps because it hasn't an online presence?

Most of the shops I use online have physical stores. My inbox has been much busier with messages from them saying they are closing their stores, but are still open for business online.

 

[Hip]

The spread rate will depend on what mitigations are in place to prevent spread

That's true, but you can easily determine the degree of exponential growth by looking at the increase in deaths over the previous two weeks say. If for example the deaths were to double every 6 days, then you put that into your exponential calculation. If mitigations are put in place that slow down viral spread, and then deaths then double only every 14 days say, that becomes the basis of your formula.

The death figures are likely to be much more accurate than the reported number of infected, because lots of people have mild symptoms and they do not get included in the figures. So the good thing about this formula is that it is based on the more reliable death numbers, not the reported cases.

PLE report that there are 5,018 infected cases in the UK today, but with the total deaths at 233 so far, Tomas Pueyo's formula predicts that there are actually 233 * 800 = 186,400 infected people in Britain.

and the death rate depends both on demographics and the ability of the hospital system to cope.

Yes, having a large elderly population, and having a shortage of ventilators, are factors which can increase the death rate. Italy have both, which may explain their higher death rate.

But this again is something you can enter into the formula: Tomas Pueyo based his x800 factor formula on a death rate of 1%, but if the death rate is higher, then you adjust accordingly:

His formula is pretty simple:

Number currently infected = D * (100/P) * 2^(17/T)

Where:
D = number of deaths to date
T = death number doubling time in days
P = percentage of infected people who die

These days we have decent computer systems and we can build more data into models (such as regional populations) as well as looking at different assumptions such as the effectiveness of social distancing. So we should use proper models rather than back of the envelope calculations which could mislead.

Do you know of any computer models that are currently being used to predict the number of infected people in the UK on a day by day basis? I have not seen any. That's why I found the formula offered by Tomas Pueyo a useful way of getting a rough figure for the number infected.