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I'm watching the UK government decide not to implement 'delay' measures today, ostensibly to protect the economy. It seems there is always a reason not to do th

I'm watching the UK government decide not to implement 'delay' measures today, ostensibly to protect the economy. It seems there is always a reason not to do the right thing. I hope they change their mind very soon.

gambiting 7y ago
Have you watched the presentation yesterday? Or just reading the news articles today? Because that's precisely not what they said. What was said was - from epidimiology point of view, there's no point in telling everyone to stay at home right now when the spread is in the early stages. It will have a marginal effect, and the spread will continue anyway. By government's own estimates 80% of people in the UK will get infected, and imposing a quarantine right now won't change that. What would help is setting the quarantine for 14-18 weeks, and they know that people won't abide by that, so instead, they clearly said they will impose quarantine just before UK hits the predicted peak infections - to lower the stress on the NHS and to achieve the maximum effect of the quarantine. Like, it all made sense if you watched the actual conference.
- empiricus 7y ago
  I watched a part of the presentation, but it was actually unclear to me what is the peak infections mentioned. I mean, in Italy, the numbers are very small compared to 80% of population, and the health system is already not able to cope, and mortality rate is quite high. Does it mean that UK will wait for their numbers to be 10 times the current Italy numbers before starting the quarantine?
  - gambiting 7y ago
    No, it means that UK government knows that it cannot stop the situation getting a lot worse, and a quarantine will be a lot more effective as a tool later on. They seemed to be quite realistic about this, not going " it will be all fine, trust us". They know things will get fucked and a full quarantine is one of the many tools to use against the virus - so let's use it when it's most effective. Otherwise like they said - if we quarantine the entire country right now, it won't stop the spread anyway. So we'll come out of quarantine and then have to do it again in a month - and people will get fed up with it and won't obey a quarantine if it goes on for too long or too frequently. So if the spread is inevitable, let's use the quarantine at the point that prevents the most possible number of infections.
    - mistersquid 7y ago
      The UK are not following quarantine and isolation protocols to mitigate the virus because they are trying to protect the economy post-Brexit.
      - gambiting 7y ago
        I mean, maybe, but I'm yet to see proof of that. The reaction yesterday seemed perfectly reasonable.
    - wwweston 7y ago
      I can see some discussion about trying to figure out which restrictions will work best with the psychology of a given population. But the idea that the "most effective" time is going to be later doesn't make much sense to me. Marginal rate changes in exponential spread are most likely to have the biggest impacts early. It doesn't much change the total volume of people who get sick, but it very likely changes the volume of people who get sick at once, and that can save lives. This sounds like saying "we can only imagine quarantine working if things get fucked, so we're going to let things get fucked, so that the quarantine will work except for the fact that things are already fucked oh well too late."
      - aljungberg 7y ago
        Sweden is making the same decision and they explained it quite well. A quarantine means children stay home from nurseries, daycare and school. This increases the stress on the medical system because some doctors and nurses have to stay home to take care of their children. In addition, new constellations of people gathering become likely. E.g. children from different schools may play together more in the neighborhoods, opening new pathways for the disease to spread. So when a quarantine is not expected to help in most cases (because most people are not infected), the drawbacks easily outweigh the benefits.
        JoeAltmaier 7y ago
        They are smaller pools in the neighborhood, than in a school. Slowing down the infection rate is the whole game right now. Closing schools is a huge step toward that. It seems strange a hospital cannot respond to daycare needs in their own population in a situation like this...
  - marcosdumay 7y ago
    Ideally, a government would quarantine all probable cases with the aim of extinguishing the disease. But if the disease is spread enough (inside or outside your borders) so that is impossible, the next best thing is to reduce social interaction just before your health system collapses, and just enough to avoid a collapse. That minimizes both the cost and time of isolation.
- thom 7y ago
  I understand that the approach has some degree of internal consistency, but it requires a huge amount of trust in the underlying models, and in our ability to pull the right levers at the right time in the future. I can totally accept that any approach _must_ address what happens for the entire period from now up until immunity or vaccination - we know we can't keep everything shut down until 2021. But the government is hoping to tap the brakes when the outbreak is going at 100mph, compared to controlling acceleration from the standing start of lockdown. This is an immense and shocking gamble. I hope it works, although would mean every other country appears to be making a huge mistake by shutting down now.
deleted 7y ago
[deleted]
codeulike 7y ago
(deleted)
- senordevnyc 7y ago
  Has anyone done the math on how long a flattened curve stretches out if you flatten it enough to not overwhelm the medical system? So for example, if we have 100,000 ICU beds in the US and we somehow make them all available for COVID-19 patients (unlikely), how flat do we need to make the curve to not go above 100k ICU patients, and how long will that flattened curve last? A month? Six months? Two years? Assuming 70% of the adult population gets it, that's roughly 140 million infected. Assuming 5% need ICU beds, that's 7 million ICU patients. And assuming the average ICU stay is 2 weeks, we'd need to therefore spread our ICU patients over 140 weeks, or almost three years. Is that how long we can expect social distancing to last if things go perfectly?
  - nicoburns 7y ago
    The UK only has ~4000 ICU beds, and these are mostly already full. We've got no chance.
    - senordevnyc 7y ago
      Yeah, just to be clear, I think there's no chance in the US either. I just saw something that said we actually only have 45k beds, and they're mostly already full anyway. Plus there's no chance we're going to be able to keep this clamped down for months. We'll be overwhelmed in weeks.
  - empiricus 7y ago
    When we saw the Chinese building hospitals in a couple of days, maybe we should have started building all around the world, slower. We had the time... Also build respirators, train ppl. Even now is better than later...
- deleted 7y ago
  [deleted]
- 7y ago
simonh 7y ago
Imposing a lockdown to soon does a lot of harm and very little good. In fact it makes things worse, because after a few weeks people get fed up of the lockdown and start breaking isolation. So if you lock down a few weeks too soon, people start breaking isolation at exactly the point it's most important the lockdown is maintained. All of this was explained in the presentation.

gambiting 7y ago

Have you watched the presentation yesterday? Or just reading the news articles today? Because that's precisely not what they said. What was said was - from epidimiology point of view, there's no point in telling everyone to stay at home right now when the spread is in the early stages. It will have a marginal effect, and the spread will continue anyway. By government's own estimates 80% of people in the UK will get infected, and imposing a quarantine right now won't change that. What would help is setting the quarantine for 14-18 weeks, and they know that people won't abide by that, so instead, they clearly said they will impose quarantine just before UK hits the predicted peak infections - to lower the stress on the NHS and to achieve the maximum effect of the quarantine. Like, it all made sense if you watched the actual conference.

empiricus 7y ago
I watched a part of the presentation, but it was actually unclear to me what is the peak infections mentioned. I mean, in Italy, the numbers are very small compared to 80% of population, and the health system is already not able to cope, and mortality rate is quite high. Does it mean that UK will wait for their numbers to be 10 times the current Italy numbers before starting the quarantine?
- gambiting 7y ago
  No, it means that UK government knows that it cannot stop the situation getting a lot worse, and a quarantine will be a lot more effective as a tool later on. They seemed to be quite realistic about this, not going " it will be all fine, trust us". They know things will get fucked and a full quarantine is one of the many tools to use against the virus - so let's use it when it's most effective. Otherwise like they said - if we quarantine the entire country right now, it won't stop the spread anyway. So we'll come out of quarantine and then have to do it again in a month - and people will get fed up with it and won't obey a quarantine if it goes on for too long or too frequently. So if the spread is inevitable, let's use the quarantine at the point that prevents the most possible number of infections.
  - mistersquid 7y ago
    The UK are not following quarantine and isolation protocols to mitigate the virus because they are trying to protect the economy post-Brexit.
    - gambiting 7y ago
      I mean, maybe, but I'm yet to see proof of that. The reaction yesterday seemed perfectly reasonable.
  - wwweston 7y ago
    I can see some discussion about trying to figure out which restrictions will work best with the psychology of a given population. But the idea that the "most effective" time is going to be later doesn't make much sense to me. Marginal rate changes in exponential spread are most likely to have the biggest impacts early. It doesn't much change the total volume of people who get sick, but it very likely changes the volume of people who get sick at once, and that can save lives. This sounds like saying "we can only imagine quarantine working if things get fucked, so we're going to let things get fucked, so that the quarantine will work except for the fact that things are already fucked oh well too late."
    - aljungberg 7y ago
      Sweden is making the same decision and they explained it quite well. A quarantine means children stay home from nurseries, daycare and school. This increases the stress on the medical system because some doctors and nurses have to stay home to take care of their children. In addition, new constellations of people gathering become likely. E.g. children from different schools may play together more in the neighborhoods, opening new pathways for the disease to spread. So when a quarantine is not expected to help in most cases (because most people are not infected), the drawbacks easily outweigh the benefits.
      - JoeAltmaier 7y ago
        They are smaller pools in the neighborhood, than in a school. Slowing down the infection rate is the whole game right now. Closing schools is a huge step toward that. It seems strange a hospital cannot respond to daycare needs in their own population in a situation like this...
- marcosdumay 7y ago
  Ideally, a government would quarantine all probable cases with the aim of extinguishing the disease. But if the disease is spread enough (inside or outside your borders) so that is impossible, the next best thing is to reduce social interaction just before your health system collapses, and just enough to avoid a collapse. That minimizes both the cost and time of isolation.
thom 7y ago
I understand that the approach has some degree of internal consistency, but it requires a huge amount of trust in the underlying models, and in our ability to pull the right levers at the right time in the future. I can totally accept that any approach _must_ address what happens for the entire period from now up until immunity or vaccination - we know we can't keep everything shut down until 2021. But the government is hoping to tap the brakes when the outbreak is going at 100mph, compared to controlling acceleration from the standing start of lockdown. This is an immense and shocking gamble. I hope it works, although would mean every other country appears to be making a huge mistake by shutting down now.

deleted 7y ago

[deleted]

codeulike 7y ago

(deleted)

senordevnyc 7y ago
Has anyone done the math on how long a flattened curve stretches out if you flatten it enough to not overwhelm the medical system? So for example, if we have 100,000 ICU beds in the US and we somehow make them all available for COVID-19 patients (unlikely), how flat do we need to make the curve to not go above 100k ICU patients, and how long will that flattened curve last? A month? Six months? Two years? Assuming 70% of the adult population gets it, that's roughly 140 million infected. Assuming 5% need ICU beds, that's 7 million ICU patients. And assuming the average ICU stay is 2 weeks, we'd need to therefore spread our ICU patients over 140 weeks, or almost three years. Is that how long we can expect social distancing to last if things go perfectly?
- nicoburns 7y ago
  The UK only has ~4000 ICU beds, and these are mostly already full. We've got no chance.
  - senordevnyc 7y ago
    Yeah, just to be clear, I think there's no chance in the US either. I just saw something that said we actually only have 45k beds, and they're mostly already full anyway. Plus there's no chance we're going to be able to keep this clamped down for months. We'll be overwhelmed in weeks.
- empiricus 7y ago
  When we saw the Chinese building hospitals in a couple of days, maybe we should have started building all around the world, slower. We had the time... Also build respirators, train ppl. Even now is better than later...
deleted 7y ago
[deleted]
7y ago

simonh 7y ago

Imposing a lockdown to soon does a lot of harm and very little good. In fact it makes things worse, because after a few weeks people get fed up of the lockdown and start breaking isolation. So if you lock down a few weeks too soon, people start breaking isolation at exactly the point it's most important the lockdown is maintained. All of this was explained in the presentation.