Covid - What would YOU do?

[Galant]

Level B

Anything I do that affects (as in harms or risks harm to) others quite rightly is for wider society to have an opinion on, and/or regulate or legislate on.

The difference here is that what the government is choosing to do to help with COVID is also having a negative impact on others.

Therefore the choice is between two things that could/will have a negative impact. The exact chances of a negative impact from not doing what the government is doing/recommencing/enforcing is questionable. It's possible that what the government is doing will have very little long term positive effect (but let's just say it will have some positive effect). On the other hand, the negative impact of what the government is doing is very real and predictable and will only increase in severity with time. That negative impact also includes an unpredictable but certain impact on health too. Lastly, the government's current path prohibits others from doing something that will have a positive impact - so they are interfering with the rights of others to help. That also weighs in.

On balance, as is no doubt clear from my posts, the governments needs to stick what is can control and encourage others to do the most good they can. Which brings to mind a John Wesley quote:

“Do all the good you can,
By all the means you can,
In all the ways you can,
In all the places you can,
At all the times you can,
To all the people you can,
As long as ever you can.”

I think we have enough evidence that the current path is ineffective. We need to take another.

[MrJim]

Except it isn't Herd Immunity. The authors aren't some cranks, but World leading experts in epidemiology and medicine.

Not entirely true. Whilst there were some legitimate scientists involved, anyone could sign the 'declaration', and indeed many of the signatories were individuals such as homeopaths and massage-therapists. There were even a number of obviously fake names including 'Professor Commonic Dummings' and 'Jonny Bananas' (https://www.theguardian.com/world/20...-bananas-covid). It'd be quite funny if it weren't such a serious subject.

The concepts outlined in the GBC have been widely criticised on many grounds, too numerous to list here. This is a good summary of criticisms: https://www.sciencemediacentre.org/e...ed-protection/

[TeePee]

Not entirely true. Whilst there were some legitimate scientists involved, anyone could sign the 'declaration', and indeed many of the signatories were individuals such as homeopaths and massage-therapists. There were even a number of obviously fake names including 'Professor Commonic Dummings' and 'Jonny Bananas' (https://www.theguardian.com/world/20...-bananas-covid). It'd be quite funny if it weren't such a serious subject.

The concepts outlined in the GBC have been widely criticised on many grounds, too numerous to list here. This is a good summary of criticisms: https://www.sciencemediacentre.org/e...ed-protection/

There are three authors, who are indeed experts, and hundreds of thousands of co-signers. There are tens of thousands of legitimate scientists and medical practitioners.

[Galant]

Not entirely true. Whilst there were some legitimate scientists involved, anyone could sign the 'declaration', and indeed many of the signatories were individuals such as homeopaths and massage-therapists. There were even a number of obviously fake names including 'Professor Commonic Dummings' and 'Jonny Bananas' (https://www.theguardian.com/world/20...-bananas-covid). It'd be quite funny if it weren't such a serious subject.

The concepts outlined in the GBC have been widely criticised on many grounds, too numerous to list here. This is a good summary of criticisms: https://www.sciencemediacentre.org/e...ed-protection/

The criticism isn't really that wide. It consists mainly of "we don't know if herd immunity can be achieved" and "we don't know how to effectively protect the vulnerable" and "If we do this, people will definitely die". All of which is true, but the critics often don't point out their own uncertainties, and they all tend to miss the bigger picture. Indefinite or repeated lock downs aren't a safe solution. They cause damage. It can most definitely be said that there is a point (if we haven't already reached it) where lock downs will cause more damage than the virus. If a given expert or body doesn't consider this and determined a solutions/response, then they haven't properly considered the situation.

The success of lockdowns is a large uncertainty.
There is an obvious flaw to lock downs, they only postpone the inevitable.

There is no response to this scenario that does not include risk. In those scenarios one must do one's best to understand as much of the risk as possible and then make a decision.

[Zhaoman]

The success of lockdowns is a large uncertainty.
There is an obvious flaw to lock downs, they only postpone the inevitable.

From my understanding, I don't think current evidence would suggest this to be true. I assume the inevitable you refer to is that the disease will spread through the population.

Again I refer to countries like Thailand, Vietnam, Taiwan, or even most of Africa where lockdown measures and following the recommendations of the scientific consensus has been effective in both suppressing the virus and allowing daily life (and thus the economy) to largely continue normally. South Korea and China are perhaps more interesting examples where they had bad outbreaks but are now largely back to normal. People are congregating in theme parks, celebrating in restaurants and going to concerts because of effective lockdowns and test and trace systems not the other way round. This is what gives me hope that we can do the same if we follow the science.

I agree with and appreciate the sentiment of tackling this together, supporting our communities and taking personal responsibility for your part to play. However all evidence suggests that this on its own is simply not enough. It's wishful thinking that we would be able to cope with this virus if it is left unchecked. The mounting evidence suggests Covid spreads faster, easier and mutates like the flu but leaves lasting damage to your body and lungs similar to pneumonia. You can potentially get it multiple times (perhaps over many seasons like the flu) but each time it will damage your body permanently more and more. If we simply stop restrictions, not only will the death toll mount but large swathes of the population could be left with long-term health complications. An overwhelmed health service along with a less healthy population is a serious problem for the country and the economy that can last well into the future.

Again the evidence so far suggests not having strict lockdowns hurts the economy (look at US, Europe, Brazil) while the countries that have gone back to normal all have policies of strict local lockdowns backed up by an effective test and trace system. The way to save the economy is to suppress the virus so that we can go back to normality not the other way round. Governments just have to be courageous enough to communicate this truth clearly - life cannot go back to normal unless the virus is suppressed. I certainly do not want to live in a world where I can't hug my grandparents because we shrugged our shoulders and gave up, I would rather the government did the right thing to allow the economy and society to open back up fully. I'm not sure the current governments of US and UK are capable of that unfortunately.

[Saracen999]

The difference here is that what the government is choosing to do to help with COVID is also having a negative impact on others.

Therefore the choice is between two things that could/will have a negative impact. The exact chances of a negative impact from not doing what the government is doing/recommencing/enforcing is questionable. It's possible that what the government is doing will have very little long term positive effect (but let's just say it will have some positive effect). On the other hand, the negative impact of what the government is doing is very real and predictable and will only increase in severity with time. That negative impact also includes an unpredictable but certain impact on health too. Lastly, the government's current path prohibits others from doing something that will have a positive impact - so they are interfering with the rights of others to help. That also weighs in.

On balance, as is no doubt clear from my posts, the governments needs to stick what is can control and encourage others to do the most good they can. Which brings to mind a John Wesley quote:

“Do all the good you can,
By all the means you can,
In all the ways you can,
In all the places you can,
At all the times you can,
To all the people you can,
As long as ever you can.”

I think we have enough evidence that the current path is ineffective. We need to take another.

In relation to First couple of sentences of second para, yes. Hence this thread.

Doing nothing is bad. Doing what they're doing is bad. Doing pretty much anything else is bad.

Figures just released show Covid infections currently running at something like four times government's "reasonable worst case" scenario. It shows the number of people needing hospital care already exceeded the estimate for the winter plan, and deaths "almost certainly" exceeded predicted winter figure within next two weeks.

Therein lies part of the problem.Nobody seems to be able to accurately predict the course of this thing. Over-react, and they get the blame. Don't react harshly enough, and those same people (media, mainly) moaning about over-reacting will be bitchig about them under-reacting .... with a straight face.

Hence me saying I'm glad not to be in the hot seat, as this is a "heads we win, tails you lose" situation.

[Galant]

Yes the disease will, mostly, spread through the population.

Some of the problems with comparisons with other nations are the assumptions one has to make, for example:
1 - Similar physical make up, namely, immunity. It has been speculated that East Asia has seen lower incidences even in areas of high populations density, because the population have already been exposed to similar viruses that have meant more of the population have immunity or at least a stronger immune response resulting in weaker infections. Without knowing the state of the different populations it's a massive assumption to state that their statistics are mostly a result of their lockdown measures.

2 - Same methods and quality of counting - Number comparisons assume that all reporting is of the same quality. Again, a rather massive assumption.

3 - Same quality of tests and results - Comparisons assume that the tests are all the same type and administered in the same way - or at least very similarly.

What evidence suggests that responsibility isn't enough? Other nations have implemented more stringent lockdowns and fared far worse. Others have implemented much looser lock down fared relatively well. If lockdowns were the key factor then that wouldn't be the case. Something else is going on.

Your statement that each infection incrementally damages your body isn't, to my knowledge, medically verified in any way. Do you have a source to back that one up? We can't just invent ideas about this thing - not saying you did, but maybe someone did. Additionally, even if this is the case, locking down and unlocking and locking down again, will still result in the same thing.

The health service isn't overwhelmed. It wasn't overwhelmed the first time, even when we were least prepared. The idea of the first lockdown was to buy time to get prepared. It's been months now. If the approach is changing it needs to be demonstrated why - especially because the lockdowns caused an artificial 'overloading' of the health care systems in that many, many people lost access to the healthcare system any way. There are confirmed deaths of people who couldn't get medical access for other things.

A virus cannot be suppressed so that it vanishes. That's just bad science. If Asia etc. have truly overcome it without a vaccine then surely that lends weight to the notion of achievable herd immunity without a vaccine? Or at least that some other factor isn't present. The notion that staying indoors long enough will kill off the disease is a falsehood - at least for any length of time that's feasible.

[Galant]

In relation to First couple of sentences of second para, yes. Hence this thread.

Doing nothing is bad. Doing what they're doing is bad. Doing pretty much anything else is bad.

Figures just released show Covid infections currently running at something like four times government's "reasonable worst case" scenario. It shows the number of people needing hospital care already exceeded the estimate for the winter plan, and deaths "almost certainly" exceeded predicted winter figure within next two weeks.

Therein lies part of the problem.Nobody seems to be able to accurately predict the course of this thing. Over-react, and they get the blame. Don't react harshly enough, and those same people (media, mainly) moaning about over-reacting will be bitchig about them under-reacting .... with a straight face.

Hence me saying I'm glad not to be in the hot seat, as this is a "heads we win, tails you lose" situation.

Interesting. I've heard very different figures... someone somewhere is spinning the stats.

And a quick Google around seems to indicate that accurate stats are not easily available.

EDIT - here's one source for statistical interpretation that would seem to indicate that the impact of COVID isn't as big as is indicated by some or as expected/predicted:
https://www.cebm.net/oxford-covid-19-evidence-service/

https://www.cebm.net/covid-19/22268/

[Saracen999]

The figures I mentioned were from a current BBC article on the BBC News app on my phone, and referenced SAGE (Scientific Advisory Group for Emergencies) comments compared to a report dated 14th October but published today.

[badass]

What would I do?

I would Engage in conversations with the various first ministers, the leader of the opposition and attempt to secure agreement for a nationwide lockdown lasting at first three weeks.
It would be like the first lockdown except keep schools open. If, 2 weeks later, the R value keeps rising, close them too.
In the background, continue with getting the test and trace properly online. Negotiate with the various devolved administrations and the opposition on how far it is appropriate to impact civil liberties to make test and trace effective. Listen to the scientists on how much the public can take. Reintroduce the full 80% furlough subsidy and the self employed equivalents. The key here is to get the baseline infections in the populace down to a level where test and trace can contain outbreaks. Introduce the right for businesses ordered to lockdown to apply for 80% of their rent to be claimed and paid directly to the landlord. The landlord can either accept this as "full rent" or they can reject it from the government completely and pursue the tenant business for the full rent. Remember property investors, the value of your investment can go down as well as up!

Exit lockdown after the following conditions are all met:
1 month has passed
the 7 day moving average of new infections is below 800
Test and trace has the ability to work, track etc with infection rates 10 times that high.
Keep the 10pm curfew.
Keep nightclubs shut completely.

Now for the really controversial bit:

Next year (or later - it depends on when the consensus is that Covid-19 is reduced to being like the rest of nasty potentially lethal diseases)
Negotiate with the opposition and the Bank of England around Monetising the "covid debt" - by the time we have covid-19 under control, the scale of monetary supply impact should be clear. The debt needs to be monetised - i.e. cancelled. This is a one off chance where monetising the debt will not have huge inflationary risks. There will be significant slack in the economy. The drop in the value of the pound might cause a minor short term inflationary bump but it will also help make exports more competitive (to a point)
It will end any pointless discussion around further austerity and "who pays for this debt" etc.
Normally, monetising government debt is a bit silly - just look at Zimbabwe. However under certain circumstances it can work. The money supply will already be contracted to a degree and there will be a lot of slack in the economy. It's hard for there to be an inflationary spiral when unemployment is high. Wage negotiations tend to be less aggressive

With the relative lack of government debt, the governemnt can kick start the economy with a spending spree. Focus on foundations to the economy - transport, school, investments that boost productivity in the short, medium and long term.

Like any proper plan, it is of course subject to change as more information comes to light.

[Zhaoman]

I must apologise beforehand for my comprehensive reply Galant! It is as much about me wanting to gather my own thoughts and you raise some good points so I don't mean this to be a dissection of your post as it might look at first!

Yes the disease will, mostly, spread through the population.

Some of the problems with comparisons with other nations are the assumptions one has to make, for example:
1 - Similar physical make up, namely, immunity. It has been speculated that East Asia has seen lower incidences even in areas of high populations density, because the population have already been exposed to similar viruses that have meant more of the population have immunity or at least a stronger immune response resulting in weaker infections. Without knowing the state of the different populations it's a massive assumption to state that their statistics are mostly a result of their lockdown measures.

To my knowledge, this is highly speculative. I don't think there has been any evidence of East Asian populations having higher immunity to this virus than other populations. What we know so far is Sars-CoV-2 is an almost entirely novel coronavirus to humans and that's what contributes to it being so effective and transmissible unlike say Swine Flu which had been feared to have pandemic potential at the time.

What is interesting though is a lot of research contribution has been by East Asian, specifically Chinese, researchers (naturally because they were at the epicentre) with much of the research focused on the East Asian population. This is in stark contrast to the majority of medical research which is often primarily focused on white males. If East Asian populations had any kind of prior immunity, it would have been well noted in research by now I would think.

On the other hand, the basic premise that the virus is spread through contact is not in doubt. So it follows that reducing human to human contact will go some way to suppress a viral outbreak. So I don't think the efficacy of a strict lockdown in suppressing the virus is in doubt as the sharp decline in cases during the first lockdown demonstrates quite clearly. I would argue instead that it would be a massive assumption to state that any suppression of the virus was due to anything other than strict lockdown measures in the absence of any other evidence.

2 - Same methods and quality of counting - Number comparisons assume that all reporting is of the same quality. Again, a rather massive assumption.

I would argue this is pointing out a technicality that is largely irrelevant for the purposes of this discussion. When numbers are in the single or double digits compared to the hundreds of thousands or millions, it would amount to some vast and highly sophisticated cover up by any country to be able to produce fraud of this scale. In the age of camera phones and well connected global research networks, even China could not keep hidden the news of doctors sounding the alarm well before January 2020 (as an example).

I don't think it is a massive assumption that we can at least trust the general trend that some countries have low numbers and some countries have high numbers, whichever way they are counted, for the purposes of this discussion. It is the general trends that are interesting rather than picking bones over numbers or counting methods which I'm sure vary greatly from region to region but not so much as to invalidate overall trends.

3 - Same quality of tests and results - Comparisons assume that the tests are all the same type and administered in the same way - or at least very similarly.

Again see above.

What evidence suggests that responsibility isn't enough? Other nations have implemented more stringent lockdowns and fared far worse. Others have implemented much looser lock down fared relatively well. If lockdowns were the key factor then that wouldn't be the case. Something else is going on.

I totally agree that something else is going on and that would be half-assed measures. The difference between lockdowns that have been effective long-term and allowed life to go back to normal verses the crapshoot that we currently have is that effective lockdowns have been followed by competent test-and-trace systems with an overall public health strategy guided by the best science.

What we had was a lockdown in March/April that was extremely effective in reducing cases to manageable levels (to the extent the Nightingale Hospitals were largely not needed) followed by no coherent strategy at all of what to do with this extra time we bought. We now finally cobbled together a test-and-trace that follows up 60% of contacts. The government was reluctant to follow up the country-wide lockdown with strict local lockdowns to suppress new outbreaks, they only started doing this when there were 10,000 cases in Leicester when they should have been doing this when there was one new case.

The science of how to deal with novel viruses and diseases is well researched and the strategies for protecting ourselves have been well published over the last 20 years or more. There are even plenty of popular science books on this subject. I remember reading Viral Storm by Nathan Wolfe over 10 years ago so it's not like government aren't well informed, they just chose to not do what was needed. In this context, the problem is not with the science but with half-assed measures in many countries. The effectiveness of most African countries in suppressing the virus despite extremely poor health infrastructure is also testament to how effective following best practice as guided by the best science can be and how far away from that we are.

And in the context of half taking advise on best practice, I would agree that no lockdown is better than a half-assed lockdown that both kills the economy and does nothing to suppress the virus which is what many governments seem to be doing. What is the point of building 60% of a roof?

So I totally agree that I would rather have no lockdown than this watered down ineffective response with no clear strategy. But to go back to the question of the thread: what I would do if I were in charge is do exactly what is needed and recommended by the latest scientific consensus to suppress the virus because suppressing the virus will both protect the health of the population as well as protect the economy; in fact it is the only way to return to a normal society and economy. As discussed before, it's not health vs economy, it's health and economy vs freedoms but that's another discussion in itself.

Your statement that each infection incrementally damages your body isn't, to my knowledge, medically verified in any way. Do you have a source to back that one up? We can't just invent ideas about this thing - not saying you did, but maybe someone did. Additionally, even if this is the case, locking down and unlocking and locking down again, will still result in the same thing.

I find this BBC article summaries the current research quite well: https://www.bbc.com/news/health-54648684

A sample of latest research papers of three major mechanisms of Covid disease progression:
Syncystia formation in lung cells: https://www.embopress.org/doi/abs/10...mbj.2020106267
Blood thickening and clotting: https://hms.harvard.edu/news/covid-19-blood-clots
Inflammation, immune response and septic shock: https://pubmed.ncbi.nlm.nih.gov/32346093/

The health service isn't overwhelmed. It wasn't overwhelmed the first time, even when we were least prepared. The idea of the first lockdown was to buy time to get prepared. It's been months now. If the approach is changing it needs to be demonstrated why - especially because the lockdowns caused an artificial 'overloading' of the health care systems in that many, many people lost access to the healthcare system any way. There are confirmed deaths of people who couldn't get medical access for other things.

Again refer to above. The first lockdown was very effective however we did nothing with the time it bought us. Now we are back to square one. Deaths of people who couldn't get medical access will only be exacerbated if we allow the disease to spread unchecked.

As for the health service being overwhelmed or not, I think we can trust experts who understand the industry and understand epidemiology when they advise whether our health service will be overwhelmed or not.

Speaking anecdotally, my girlfriend (who is a doctor in a hospital) has noticed in the last 2 months various mitigation measures being put in place:
- working longer hours, often 12h shifts. At least she gets overtime pay but continual 90h work weeks will eventually take its toll.
- non-critical patients being sent home and beds being cleared in anticipation of a surge in demand from Covid patients;
- greater pressure on patients' families to sign NFR (Not For Resuscitation) forms especially for older patients. This way they are dying in the ward rather than in ICU because the hospital is trying to keep ICUs free for younger patients that might come in. It is much easier to get a family to sign a NFR form and never have their relative go into ICU than to try to explain that they need to take their relative off a ventilator when someone younger/healthier comes in.

What is interesting about the above is that hospitals in developed countries are now having to make decisions that are commonplace in developing countries i.e. to choose who gets to be treated. When she worked in Tanzania for a while, the hospital had two ventilators so it was common to keep them free for younger patients who had a better chance of survival and had a better chance to contribute more to society. This is effectively what hospitals are having to do now and there is no suggestion that her hospital is a special exception.

We have taken a fully functioning health system for granted for a long time now and taking the steps above is them doing everything they can to not become overwhelmed which is working so far. But if cases keep rising then even these mitigation measures will eventually not be enough.

A virus cannot be suppressed so that it vanishes. That's just bad science. If Asia etc. have truly overcome it without a vaccine then surely that lends weight to the notion of achievable herd immunity without a vaccine? Or at least that some other factor isn't present. The notion that staying indoors long enough will kill off the disease is a falsehood - at least for any length of time that's feasible.

There is no evidence that we can ever reach herd immunity with Covid. 1) because coronaviruses like flu are very quick mutators thus immunity does not tend to last long and 2) there is no evidence that Sars-CoV-2 is any different.

The strategy for combating it effectively is clear imo and I would recommend reading any of the many popular science books on the subject - it is not bad science. We have suppressed and eradicated viruses before (with the help of vaccines). Without a vaccine, there are clear steps we can take to suppress the virus and allow the economy to function largely normally like in the many countries already mentioned that have followed the best science.

[Hoonigan]

Personally, I think we let the virus run its course. Unless we can come up with a way of eradicating it entirely, like we did with Smallpox, it's going to keep coming back each time. Let's see it out and what happens, happens.

[pp05]

https://gbdeclaration.org

Signed by tens of thousands of scientists, experts and medical doctors around The World. Led by Professor of Epidemiology at Oxford University, Sunetra Gupta, who's modelling of the virus in March has proven to be accurate, and should have shaped Government policy, unlike the grandstanding train wreck that was Ferguson.

We didn't overwhelm the healthcare system. The Government spent billions building extra capacity and 'Nightingale Hospitals' that never saw a patient, and ordering the manufacture of 40,000 ventilators, while only needing a couple of thousand from existing supplies.

This is a deadly disease and people die from it. But we can't let the "cure" be worse than the disease, especially when that cure is a placebo.

Those were just show ponys. Half of the test sites are in the middle of forests that no one can get to. Essentially a tent, and security guard at the gate told not to let anyone in. It's for show. There is nothing in the tent. There aren't any queues despite the numbers going up.

[pp05]

We seem to do everything 4 weeks too late. That's to be expected when all they're busy doing is handing out contracts to serco and co. Hand control back to local authorities.

Here is one way I might do things differently from the current incompetents. This won't address every circumstance but I will apply it to those on PAYE for example.

Lock down:
Announce that from Thurs 5th November England is going into an 6 week lock down that will be stricter than the one in March. Food stores will remain open but movement should be restricted to your own street. (basically stay indoors as much as possible).
- After 4 weeks, anyone who gets a covid test and is negative (say from Boots/some other recognised clinic paid for by employer) can submit the results via test and trace app and return to work earlier. Everyone else will be expected to stay at home until the end of the year unless they have a test to prove negative.

Financial implications:
Announce current furlough scheme is to end 31st December for all. A new scheme will operate in 2021 for those unable to work with test and trace app installed.

Test & trace app:
Announce that going forward anyone who has not got the test and trace app on their phone post-lock down will not qualify for future furlough payments in 2021.
Anyone who does will get their FULL salary should they be unable to work because they were asked to self-isolate by T&T, as long as they comply with requirement.
- Anyone who fails to comply during self-isolation will receive none of their salary for the period they were self-isolating.
----- anyone who fails to answer the phone during isolation by the T&T team would lose their salary payment.
----- anyone who doesn't stay indoors for the full two weeks asked of them will lose their salary payment.

It's not perfect but it allows those of us who are okay to return to work in the new year to do so knowing that if we have to self-isolate we won't be penalised financially. But it also makes self-isolating easier for those that have to as it's a no-brainer. Those businesses who do want to open for xmas can do, as long as they bring back people who have been tested. Failure to provide evidence of this should incur a penalty.

Masks are still to be worn until spring as part of any strategy.
Home encouraged to open windows for 20 mins every few hours to get fresh air indoors.

[Gentle Viking]

I am fighting this pestilence with my blinding wits, and blinding white smile

Which in her majesty's English translate to,,,,, not a damn thing is changed for me, but i welcome the rest of the world to my life.

[matts-uk]

The authors [of the GBR] aren't some cranks, but World leading experts in epidemiology and medicine.

Yes, and it was World leading medical and scientific experts advocating eugenics during the 1930s.

Locking up 'vulnerable' minorities for the greater good is a slippery slope. Who decides who is vulnerable? Everyone over 55? Everyone from a Black Asian Minority Ethnic community? Everyone with a BMI over 27.5? Everyone with an income less than £55,000? Essentially, anyone who isn't me!

I accept Hexus can lean more to the right than I prefer but I am (properly) shocked at how quickly the most expensive lesson in history is being forgotten.