Coronavirus - worldwide spread and control

[Jonathan Edwards]

https://www.telegraph.co.uk/news/20...spells-unprecedented-non-covid-health-crisis/

Today's news shows just how ill-informed and misguided this article was.

All theoretical models are wrong, some are just less wrong than others. Cast your minds back to March – Professor Neil Ferguson’s, now infamous, estimation of 500,000 deaths had just thrown the Government into disarray. Despite similar apocalyptic predictions in Sweden of 85,000 deaths, their government held their nerve. Their total of just under 6,000 fatalities shines an unflattering light on Ferguson’s predictions.

Sorry, author, but Ferguson's estimation was right and is now back on the agenda because of failure to lockdown in time and failure to organise test, trace and quarantine. Now that the government has made the same mistake again only worse we will have another 40,000 unnecessary deaths.

Lockdown hasnvthing to do with causing a health crisis- it is the opposite. I find it hard to understand how that cannot transparent to everyone.

 

[Barry]

Lockdown hasnvthing to do with causing a health crisis- it is the opposite. I find it hard to understand how that cannot transparent to everyone.

Surely a secondary effect of lockdown has to be its impact on public health, by way of delayed treatments, people avoiding doctors and hospitals, mental health issues from destroyed livelihoods etc., etc.

 

[Trish]

Surely a secondary effect of lockdown has to be its impact on public health, by way of delayed treatments, people avoiding doctors and hospitals, mental health issues from destroyed livelihoods etc., etc.

I agree these will all be bad outcomes if we go into lockdown. But...

What I think we need to look at also is the effect of not going into lock down, with England at its current escalating infection rate. In some areas hospitals are already reaching their limits and needing to cancel other treatments, and that's without the effect in a couple of weeks' time of all the people currently getting infected who will need hospital treatment. All areas of the country have R values well above 1. In my area recently R was rated at 2.

If this is allowed to escalate, which it will do without lockdown, all the projections suggest hospitals will soon be overwhelmed with covid cases, and those needing cancer and other urgent care will not be able to get their treatment either. Then what?

Both scenarios are awful. Take your pick which you prefer.

 

[Jonathan Edwards]

Surely a secondary effect of lockdown has to be its impact on public health, by way of delayed treatments, people avoiding doctors and hospitals, mental health issues from destroyed livelihoods etc., etc.

Absolutely not. The question depends on the difference between locking down when appropriate and not doing so.
If lockdown had been started when appropriate (mid February) there would have been no cases to block hospital beds. There would have been no cases to infect hospital staff so that services had to be laid off. There would have been no cases to infect people attending hospital for other conditions so healthcare could have continued normally.

So the effect of delaying lockdown is entirely negative on public health. The effect lockdown is positive.
Once it is too late lockdown has no impact on making healthcare more difficult. Lockdown itself did not include blocking hospital services. It always allowed people to access healthcare if they need to - that has been explicit. Accessing healthcare has been blocked purely because of the effects of delaying lockdown - making it impossible to get things to work.

Lockdown has had no negative effects on mental healthcare. If it had not been instituted the situation for mental health would have been worse. If it had been instituted earlier no mental health problems would have arisen. Similarly for livelihoods. Livelihoods had some chance of recovery once lockdown had worked. The ridiculous thing is that the easing of lockdown included measures that ensured it all had to be done again. If lockdown had been instituted in time the only industry to suffer would have been airlines and tourism. It would have cost relatively little to support these- which we probably ought have trimmed down anyway for climate reasons. As it is the cost of supporting almost all non-essentia business is going to be eye-watering.

Lockdown did not cause ANY OF THESE PROBLEMS. The virus caused all these problems. Lockdown made things tolerable again for a while. When considering what is caused by X you have to consider what would happen without X - and the answer is that all these things would be far worse - so X did not cause the problems.

 

[Barry]

I agree these will all be bad outcomes if we go into lockdown. But...

What I think we need to look at also is the effect of not going into lock down

Exactly. If you thought I was suggesting to not lockdown then I was misunderstood. I just find it difficult if the very real consequences of lockdown seem not to be also recognised. I also fully agree that delays in locking down inevitably leads to the worst of both worlds, because massive illness and death toll must itself inevitably hit the economy anyway. I think the trouble is people inevitably look for the easiest way out, not realising that the 'easiest' way is in truth not going to be easy at all, just the least horrible.

 

[Barry]

Absolutely not. The question depends on the difference between locking down when appropriate and not doing so.
If lockdown had been started when appropriate (mid February) there would have been no cases to block hospital beds. There would have been no cases to infect hospital staff so that services had to be laid off. There would have been no cases to infect people attending hospital for other conditions so healthcare could have continued normally.

So the effect of delaying lockdown is entirely negative on public health. The effect lockdown is positive.
Once it is too late lockdown has no impact on making healthcare more difficult. Lockdown itself did not include blocking hospital services. It always allowed people to access healthcare if they need to - that has been explicit. Accessing healthcare has been blocked purely because of the effects of delaying lockdown - making it impossible to get things to work.

Lockdown has had no negative effects on mental healthcare. If it had not been instituted the situation for mental health would have been worse. If it had been instituted earlier no mental health problems would have arisen. Similarly for livelihoods. Livelihoods had some chance of recovery once lockdown had worked. The ridiculous thing is that the easing of lockdown included measures that ensured it all had to be done again. If lockdown had been instituted in time the only industry to suffer would have been airlines and tourism. It would have cost relatively little to support these- which we probably ought have trimmed down anyway for climate reasons. As it is the cost of supporting almost all non-essentia business is going to be eye-watering.

Lockdown did not cause ANY OF THESE PROBLEMS. The virus caused all these problems. Lockdown made things tolerable again for a while. When considering what is caused by X you have to consider what would happen without X - and the answer is that all these things would be far worse - so X did not cause the problems.

Again, I think I'm being misunderstood. People seem to think I'm suggesting two mutually excusive things. I'm not. Both effects happen concurrently. I am a strong advocate of locking down for all the reasons stated. And I have been saying and trying to convince people I know, that when something grows exponentially like this, then you have to stamp on it very hard and very quickly, long before it looks like you need to.

So a properly implemented full lockdown brings the virus under control ... and (inclusive 'and', not exclusive 'or') it also leads to grief and hardship of a different kind. You get both at the same time. I personally think that getting the virus under control has to be the number one priority, because without that everything else goes to pot anyway.

But to not recognise that lockdown also has serious side effects seems odd to me. I'm very lucky. I'm receiving a pension and also still work part time, and most importantly I can work from home. But I'm terribly aware there are many far less lucky than me, who will maybe see everything they have worked for all their lives disappearing from under them. Or they will see it happening to their loved ones. Or both. People's mental health cannot always cope with such trauma. Side effects of lockdown.

So I personally believe we have no choice but to lockdown, and that procrastination means things will be worse overall than they should have been. But I am not unaware of the horrible side effects that will result.

 

[Jonathan Edwards]

Some people seem particularly unable to see what is in front of their nose.Maybe they have been advising the government?

Prof Sir Simon Wessely, the director of King’s College London’s health protection research unit in emergency preparedness and response, says there is no right time for a lockdown.

He said:

Great harm results from not locking down, and great harm results from locking down. Either option is a dreadful one, and we should refrain from saying ‘I told you so’, and accept that lockdown is a political, and not solely a medical, decision.

The costs of a full lockdown are by now predictable – a further deterioration in mental health, greater and more long-lasting damage to people’s livelihoods and future prospects, especially if they are young, and further damage for those with other illnesses, both mental and physical.

Nor does it seem that our close neighbours have a magic formula that has somehow eluded us. All we can do now is support each other, which might include those who find it harder to comply with new restrictions at all times, and trust that, come the spring, there is more hope from either vaccines, an effective track-and-trace system, or sufficient (even if temporary) immunity, because otherwise this whole ghastly saga will repeat itself once more.

(Guardian Live)

 

[Jonathan Edwards]

Both scenarios are awful. Take your pick which you prefer.

I don't see lockdown as awful. What April showed is that you can get the spread down to manageable levels in six weeks. As long as you do not do something really stupid like allowing people to go on aeroplanes or mix in bars it should be possible to get to the situation in Australia and NZ within another six weeks. So we could be functioning normally by now. There is no point where it is too late. Dealing with the epidemic was and is possible at any time. China has dealt with several new local outbreaks successfully.

From talking to people my impression on the effect on mental health is chiefly the sense of uncertainty and purposelessness of the current policy. I don't think anyone would have got seriously depressed if they knew from the outset that it was a matter of 3 months rigid restriction and then reasonable normal life. And it can still belike that.

 

[Trish]

Exactly. If you thought I was suggesting to not lockdown then I was misunderstood.

I don't see lockdown as awful.

Perfect examples of me misunderstanding someone - sorry @Barry, and me being misunderstood. My fault.

I'll just say I wish the UK had followed New Zealand's and Taiwan's examples and locked down hard and early, both in February, and in September when Sage advised locking down again.

I agree that economic, unemployment, mental health and health service downsides attributed to lockdown should really be attributed to the virus, and without lockdown these would have been much worse, as we're seeing now.

 

[Jonathan Edwards]

But to not recognise that lockdown also has serious side effects seems odd to me.

I can understand it seems like that but if one considers what the situation would be without lockdown I think the effect on both physical and mental health would be worse. And I think you agree.

The virus has made it impossible for us to continue to live and socialise the way we are used to. That is what drives the mental health problems. The reason why I realised in the first week in February that immediate lockdown was the only tolerable option is that I went through all the other scenarios and concluded that none could work without far more misery.

Maybe it is a question of considering not just the immediate effect or the effect over a month but the effect over a year. Maybe lockdown brings misery in the short term but in the long term it reduces it.

At the moment a large number of people in the UK are suffering because they rein some tier 2 or 3 has measures yet the virus is happily multiplying in other areas and can spread back to the first area any time. People are suffering almost as much from the partial measures- which are the current alternative. For people like me who self-isolate anyway lockdown makes no difference. For people like my daughter whose life should be blossoming, she is just in suspended animation until virus levels are brought down enough for normal life to be practical. A lockdown would give her some chance of keeping sane. My mother is in a care home and lockdown changes nothing.

 

[Sasha]

On the news it just said we're likely in the UK to be going into national lockdown for a month from next week until December 2, except for educational establishments.

That surprises me, because I thought educational establishments were where coronavirus is especially spreading. Am I wrong? I haven't been following closely.

 

[Hutan]

Message from the moderation team:

With the support of the committee, the moderation team has decided to permanently close the 'Coronavirus - Worldwide Spread and Control' thread, and not allow further posting of, or discussing, data on infection and death rates around the world, and discussion of government efforts to control Covid-19, except in the context of a specific impact on people with ME/CFS.

Science for ME exists primarily to discuss and further ME/CFS issues, we are not a Covid-19 forum. This thread has been useful for helping members to find sources of information and get an appreciation of the global situation. However, the moderation team has found it very difficult to manage the thread, as inevitably many posts raise political issues, leading to difficult judgements about rule breaches.

The issues with this topic are similar to those of climate change, politics and religion, which are also restricted on the forum. These are all, for the most part, not directly relevant to ME/CFS and they elicit strongly held opinions. Discussions on these matters require large amounts of moderator time to manage, and do not seem to result in anyone changing their opinion. Most importantly, most discussions on these topics are divisive, do not further Science for ME's aims and can result in some members feeling that our forum is not for them. There are many other platforms available to those members who want to discuss those issues or get information about them.

Threads covering post-covid 19 syndrome, the practicalities of coping with the pandemic or providing emotional support; and the Covid-19 biology thread will continue. Of course, Covid-19 is having a big impact on members' lives, and so members are still free to mention personal issues relating to Covid-19, including those arising from government restrictions and the risk of infection in posts on the threads.

Thanks for your understanding and cooperation.