9 ms·

It’s already too late. They’re on the Italy path. This “herd immunity” thing is nonsense. So much so that doctors and scientists are warning against it: https

It’s already too late. They’re on the Italy path. This “herd immunity” thing is nonsense. So much so that doctors and scientists are warning against it: https://www.theguardian.com/world/2020/mar/14/coronavirus-nhs-private-hospitals-join-forces-academics-warn-over-strategy https://www.theguardian.com/world/2020/mar/14/coronavirus-nh...

ajross 7y ago
It's not "nonsense". It's real. It works for almost every other virus out there (even colds and flu, even though it's imperfect: new seasonal cold and flu strains don't become pandemics, because many people have some immunity from previous infections). If you let a large enough fraction of the UK contract and recover from COVID-19, we have every reason to suspect that the society will develop good enough herd immunity to make further pandemic-scale propagation impossible. This part is good science, and reasonably well understood. The question is on the impact side. The reason this theory seems to work is that the seeming danger from COVID-19 is all on the elderly and immunocompromised. If you can prevent them from getting the same disease everyone else is, then they'll be protected by the herd -- new clusters won't form and infect them. So this all comes down to those assumptions: 1. The virus is genuinely of low danger to the young and healthy 2. The vulnerable can be adequately protected during a pandemic of the general population If either is wrong, we're looking at a staggering disaster. Are they wrong? We have no fucking idea. I'm not even on the continent and I'm terrified.
- rumanator 7y ago
  > It's not "nonsense". It's real. It works for almost every other virus out there (e You're failing to take in consideration that the virus incubation period is on average 1 to 2 weeks, and those who manage to recover from the disease take about 2 weeks from diagnosis to confirmed cure. This means that you're comparing 4 weeks of exponential growth with 2 weeks of constant recovery. Sure, those who survived the disease will be immune afterwards. That's great for herd imunity. But the thing you fail to understand is that as the disease increases exponentially, when that time arrives the whole nation has already become infected, and it's too late by then because health services will be unable to cope with the demand and a lot of people will die due to lack of basic medical care.
  - ajross 7y ago
    > But the thing you fail to understand No no, I understand that. But the thinking is, and it seems to be backed by data, that the health system will be able to cope with a full-population maximal pandemic, as long as it is limited to the much less vulnerable segments of the population. The ICUs in Italy and Hubei were filled, for the most part, with elderly patients. The math, such as it is, checks out. The risk management analysis, again, is IMHO batshit crazy. But the theory seems about as sound as it could be given the data we have.
    - rumanator 7y ago
      > No no, I understand that. But the thinking is, and it seems to be backed by data, that the health system will be able to cope with a full-population maximal pandemic, as long as it is limited to the much less vulnerable segments of the population. It really doesn't seem that you're getting it, because the whole point of this exercise is that it's quite patently obvious that no health care service in the world is able to keep 10 to 15% of their population in intensive care, which so far is the expected incidence of cases that require medical care. If that was the case then no one would be bothered with yet another flu-like viral infection.
      - ufov2 7y ago
        What is the age distribution of the ICU requirement? Is it really in the ballpark of 10% for all age groups?
      - ajross 7y ago
        > the expected incidence of cases that require medical care. Among the general population! Among people under 50, the best data we have is that the fraction needing ICU care is something like 0.2% (I think, I'd have to look it up again). The intent is to quarantine the at-risk and let it propagate in the "safe". I genuinely think it's you who's failed to understand the plan. You're arguing against something that is not the stated UK policy.
        7y ago
- dathinab 7y ago
  Herd immunity works because: 1. Vaccines, immunitized people don't get sick in the process of imunization, don't need hospitalization, don't die 2. Slow and gradual imunization over multiple years. Neither of this is uphold all other cases of herd imunization in history I'm aware of always had a massive price in human lives. Also it only works if the virus doesn't mutate to much, party of the reason the flu is still around even through you would believe we got herd imunization in last many decades since the flu is a think. > 1. The virus is genuinely of low danger to the young and healthy Except it's not really that low it's only compared to old people low. And it's close to practically impossible to only affect young people without having idk concentration camps for young people with strict separation from the older people (like over 20?,30?) for a duration of over a month and still 2 in 1000 or so dying. AND it's anyway to late for that measurements as it's already to widely spread in the UK eitherway.
  - ajross 7y ago
    That is... not a good description of herd immunity at all. It has nothing to do with vaccinations or time scales. Wikipedia's is quite clear: https://en.wikipedia.org/wiki/Herd_immunity https://en.wikipedia.org/wiki/Herd_immunity The idea is that once a significant fraction of the population has some immunity to an infection, the ability of an infected person to spread the virus (a term called "R0" in the jargon) is fundamentally impeded by its ability to find infectable targets. So the R0 drops, and so does the exponent to the growth. Once that exponent goes below 1, the number of cases drops over time instead of growing, and new infection clusters can't start. This works. It's why we don't have things like measles outbreaks (or didn't, until the anti-vax crowd messed things up) and why newly mutated flu strains can't find purchase and become pandemics.
    - BubRoss 7y ago
      Newly mutated flu strains don't become pandemics because they aren't severe enough for people to care, they certainly proliferate.
    - NhanH 7y ago
      You seems to think that people who is against the idea either doesn't understand what herd immunity is, or doesn't understand the plan. We understand both, we just think that the risk analysis is wrong. Specifically with the GP, his argument is that herd immunity gaining through large percentage of the population being infected in a short amount of time is a bad idea. Normally we got herd immunity via vaccination of the population, since it is much safer than being infected. That's why vaccination was mentioned.
- necovek 7y ago
  3. the immunity gained through an infection holds for a long enough time (how long would need to be checked with the infection rate), which we do not know yet Additionally, we know nothing of the long term effects even for the "young and healthy". Mortality rates for people 10-39 is 0.2%, 40-49 it's at 0.4%, 50-59 1.3%, 60-69 at 3.6%. Serious conditions develop in a bigger proportion of cases, so you are looking at 4-10% of under 60 population in ICU with unknown long term effects. Translation: good luck!
  - hedora 7y ago
    > unknown long term effects Ultimately, it’s a just a really inconsistent cold. The vast majority of cases are mild. However, if it spreads to the lungs, it’s worse than the flu. As far as I know, there’s no evidence that it’s any more exotic than that.
    - deleted 7y ago
      [deleted]
    - angry_octet 7y ago
      There are reports from China of significant lung scarring among patients who had to be hospitalised.
      - poooogles 7y ago
        This is the concerning thing for me, as an asthmatic if I stop taking meds I'm already 30% down on lung capacity, adding another 20% on top of that is scary. That 20% can't be mitigated by meds either.
  - bcrosby95 7y ago
    Yes, the idea that only those 70+ are "at risk" is weird. But they probably can't afford to isolate everyone 50+ - both from an economic and herd immunity viewpoint - so they will risk losing 3.6% of people aged 60-69 and 1.3% of people aged 50-59. According to https://www.statista.com/statistics/281174/uk-population-by-age/ https://www.statista.com/statistics/281174/uk-population-by-... 8.96 million aged 50-59, 7.07 million aged 60-69.
- nikkev 7y ago
  This ignores the risk of spreading the virus to other populations.
- AncientTree 7y ago
  And if the worst case occurs, with millions of elderly and immunocompromised dying, there are billions in potential savings in pensions and old-age healthcare, as well as improvements in housing affordability and overall reductions in national CO2 emissions.
OJFord 7y ago
Some are against it, others (such as presumably a majority of those advising the government) are for it. That's just good debate. > It’s already too late. They’re on the Italy path. Well, that's pretty much the point of the policy. 'Already screwed this year, let's try to cope, and be less screwed next year'. I was very critical at first, but I'm more interested/satisfied with the response now, it does seem to be well thought through, even if there are also arguments against (of course there are).
- dathinab 7y ago
  It's basically: Throw 2 or 3 hounded thousand lives away to have less economical impact next year. I.e. pure evil IMHO. especially because there is a non small chance that it will be more like 1-1.5 Million more death then necessary.
  - CPLX 7y ago
    That’s a misconception though. Economic depression and deprivation also causes death, and staggering amounts of human misery. Evil is reserved as a description for gross failures of moral duty. Choosing pragmatically between several terrible options with highly unpredictable outcomes does not meet that standard.
    - ethbro 7y ago
      > Economic depression and deprivation also causes death, and staggering amounts of human misery. Let's quantify things here, for a first world country with a social net. On the one hand, we have people getting evicted from their homes and having to visit soup kitchens. On the other hand, we have dead people (more likely, dead poor people). Evil seems pretty fair.
      - lmm 7y ago
        > On the one hand, we have people getting evicted from their homes and having to visit soup kitchens. Which translates directly into many years of reduced life expectancy, no?
asdf21 7y ago
Yeah, like, the parents of all the kids will get it and many will die. Others will infect everyone at work. This seems like a obviously bad idea.
- BubRoss 7y ago
  Most parents that have young children aren't in their 70s
  - aygthrwy 7y ago
    But they have parents who are. Maybe in UK this works, different cultures have different degrees of socialization between adult children and their parents.
    - BubRoss 7y ago
      I'm not sure what your point is here, the comment I replied to said that many of the parents of kids will get infected and die.
foobarbazetc 7y ago
cough https://www.theguardian.com/world/2020/mar/15/uk-coronavirus-crisis-to-last-until-spring-2021-and-could-see-79m-hospitalised https://www.theguardian.com/world/2020/mar/15/uk-coronavirus... Imagine going ahead with this instead of... doing something. And no, the NHS doesn’t have the capacity to handle this. So...
- foobarbazetc 7y ago
  “Strategy”.
foobarbazetc 7y ago
Here, we can stop “debating” dumb st: https://www.buzzfeed.com/alexwickham/coronavirus-uk-strategy-deaths https://www.buzzfeed.com/alexwickham/coronavirus-uk-strategy...

ajross 7y ago

It's not "nonsense". It's real. It works for almost every other virus out there (even colds and flu, even though it's imperfect: new seasonal cold and flu strains don't become pandemics, because many people have some immunity from previous infections). If you let a large enough fraction of the UK contract and recover from COVID-19, we have every reason to suspect that the society will develop good enough herd immunity to make further pandemic-scale propagation impossible. This part is good science, and reasonably well understood. The question is on the impact side. The reason this theory seems to work is that the seeming danger from COVID-19 is all on the elderly and immunocompromised. If you can prevent them from getting the same disease everyone else is, then they'll be protected by the herd -- new clusters won't form and infect them. So this all comes down to those assumptions: 1. The virus is genuinely of low danger to the young and healthy 2. The vulnerable can be adequately protected during a pandemic of the general population If either is wrong, we're looking at a staggering disaster. Are they wrong? We have no fucking idea. I'm not even on the continent and I'm terrified.

rumanator 7y ago
> It's not "nonsense". It's real. It works for almost every other virus out there (e You're failing to take in consideration that the virus incubation period is on average 1 to 2 weeks, and those who manage to recover from the disease take about 2 weeks from diagnosis to confirmed cure. This means that you're comparing 4 weeks of exponential growth with 2 weeks of constant recovery. Sure, those who survived the disease will be immune afterwards. That's great for herd imunity. But the thing you fail to understand is that as the disease increases exponentially, when that time arrives the whole nation has already become infected, and it's too late by then because health services will be unable to cope with the demand and a lot of people will die due to lack of basic medical care.
- ajross 7y ago
  > But the thing you fail to understand No no, I understand that. But the thinking is, and it seems to be backed by data, that the health system will be able to cope with a full-population maximal pandemic, as long as it is limited to the much less vulnerable segments of the population. The ICUs in Italy and Hubei were filled, for the most part, with elderly patients. The math, such as it is, checks out. The risk management analysis, again, is IMHO batshit crazy. But the theory seems about as sound as it could be given the data we have.
  - rumanator 7y ago
    > No no, I understand that. But the thinking is, and it seems to be backed by data, that the health system will be able to cope with a full-population maximal pandemic, as long as it is limited to the much less vulnerable segments of the population. It really doesn't seem that you're getting it, because the whole point of this exercise is that it's quite patently obvious that no health care service in the world is able to keep 10 to 15% of their population in intensive care, which so far is the expected incidence of cases that require medical care. If that was the case then no one would be bothered with yet another flu-like viral infection.
    - ufov2 7y ago
      What is the age distribution of the ICU requirement? Is it really in the ballpark of 10% for all age groups?
    - ajross 7y ago
      > the expected incidence of cases that require medical care. Among the general population! Among people under 50, the best data we have is that the fraction needing ICU care is something like 0.2% (I think, I'd have to look it up again). The intent is to quarantine the at-risk and let it propagate in the "safe". I genuinely think it's you who's failed to understand the plan. You're arguing against something that is not the stated UK policy.
      - 7y ago
dathinab 7y ago
Herd immunity works because: 1. Vaccines, immunitized people don't get sick in the process of imunization, don't need hospitalization, don't die 2. Slow and gradual imunization over multiple years. Neither of this is uphold all other cases of herd imunization in history I'm aware of always had a massive price in human lives. Also it only works if the virus doesn't mutate to much, party of the reason the flu is still around even through you would believe we got herd imunization in last many decades since the flu is a think. > 1. The virus is genuinely of low danger to the young and healthy Except it's not really that low it's only compared to old people low. And it's close to practically impossible to only affect young people without having idk concentration camps for young people with strict separation from the older people (like over 20?,30?) for a duration of over a month and still 2 in 1000 or so dying. AND it's anyway to late for that measurements as it's already to widely spread in the UK eitherway.
- ajross 7y ago
  That is... not a good description of herd immunity at all. It has nothing to do with vaccinations or time scales. Wikipedia's is quite clear: https://en.wikipedia.org/wiki/Herd_immunity https://en.wikipedia.org/wiki/Herd_immunity The idea is that once a significant fraction of the population has some immunity to an infection, the ability of an infected person to spread the virus (a term called "R0" in the jargon) is fundamentally impeded by its ability to find infectable targets. So the R0 drops, and so does the exponent to the growth. Once that exponent goes below 1, the number of cases drops over time instead of growing, and new infection clusters can't start. This works. It's why we don't have things like measles outbreaks (or didn't, until the anti-vax crowd messed things up) and why newly mutated flu strains can't find purchase and become pandemics.
  - BubRoss 7y ago
    Newly mutated flu strains don't become pandemics because they aren't severe enough for people to care, they certainly proliferate.
  - NhanH 7y ago
    You seems to think that people who is against the idea either doesn't understand what herd immunity is, or doesn't understand the plan. We understand both, we just think that the risk analysis is wrong. Specifically with the GP, his argument is that herd immunity gaining through large percentage of the population being infected in a short amount of time is a bad idea. Normally we got herd immunity via vaccination of the population, since it is much safer than being infected. That's why vaccination was mentioned.
necovek 7y ago
3. the immunity gained through an infection holds for a long enough time (how long would need to be checked with the infection rate), which we do not know yet Additionally, we know nothing of the long term effects even for the "young and healthy". Mortality rates for people 10-39 is 0.2%, 40-49 it's at 0.4%, 50-59 1.3%, 60-69 at 3.6%. Serious conditions develop in a bigger proportion of cases, so you are looking at 4-10% of under 60 population in ICU with unknown long term effects. Translation: good luck!
- hedora 7y ago
  > unknown long term effects Ultimately, it’s a just a really inconsistent cold. The vast majority of cases are mild. However, if it spreads to the lungs, it’s worse than the flu. As far as I know, there’s no evidence that it’s any more exotic than that.
  - deleted 7y ago
    [deleted]
  - angry_octet 7y ago
    There are reports from China of significant lung scarring among patients who had to be hospitalised.
    - poooogles 7y ago
      This is the concerning thing for me, as an asthmatic if I stop taking meds I'm already 30% down on lung capacity, adding another 20% on top of that is scary. That 20% can't be mitigated by meds either.
- bcrosby95 7y ago
  Yes, the idea that only those 70+ are "at risk" is weird. But they probably can't afford to isolate everyone 50+ - both from an economic and herd immunity viewpoint - so they will risk losing 3.6% of people aged 60-69 and 1.3% of people aged 50-59. According to https://www.statista.com/statistics/281174/uk-population-by-age/ https://www.statista.com/statistics/281174/uk-population-by-... 8.96 million aged 50-59, 7.07 million aged 60-69.
nikkev 7y ago
This ignores the risk of spreading the virus to other populations.
AncientTree 7y ago
And if the worst case occurs, with millions of elderly and immunocompromised dying, there are billions in potential savings in pensions and old-age healthcare, as well as improvements in housing affordability and overall reductions in national CO2 emissions.

OJFord 7y ago

Some are against it, others (such as presumably a majority of those advising the government) are for it. That's just good debate. > It’s already too late. They’re on the Italy path. Well, that's pretty much the point of the policy. 'Already screwed this year, let's try to cope, and be less screwed next year'. I was very critical at first, but I'm more interested/satisfied with the response now, it does seem to be well thought through, even if there are also arguments against (of course there are).

dathinab 7y ago
It's basically: Throw 2 or 3 hounded thousand lives away to have less economical impact next year. I.e. pure evil IMHO. especially because there is a non small chance that it will be more like 1-1.5 Million more death then necessary.
- CPLX 7y ago
  That’s a misconception though. Economic depression and deprivation also causes death, and staggering amounts of human misery. Evil is reserved as a description for gross failures of moral duty. Choosing pragmatically between several terrible options with highly unpredictable outcomes does not meet that standard.
  - ethbro 7y ago
    > Economic depression and deprivation also causes death, and staggering amounts of human misery. Let's quantify things here, for a first world country with a social net. On the one hand, we have people getting evicted from their homes and having to visit soup kitchens. On the other hand, we have dead people (more likely, dead poor people). Evil seems pretty fair.
    - lmm 7y ago
      > On the one hand, we have people getting evicted from their homes and having to visit soup kitchens. Which translates directly into many years of reduced life expectancy, no?

asdf21 7y ago

Yeah, like, the parents of all the kids will get it and many will die. Others will infect everyone at work. This seems like a obviously bad idea.

BubRoss 7y ago
Most parents that have young children aren't in their 70s
- aygthrwy 7y ago
  But they have parents who are. Maybe in UK this works, different cultures have different degrees of socialization between adult children and their parents.
  - BubRoss 7y ago
    I'm not sure what your point is here, the comment I replied to said that many of the parents of kids will get infected and die.

foobarbazetc 7y ago

cough https://www.theguardian.com/world/2020/mar/15/uk-coronavirus-crisis-to-last-until-spring-2021-and-could-see-79m-hospitalised https://www.theguardian.com/world/2020/mar/15/uk-coronavirus... Imagine going ahead with this instead of... doing something. And no, the NHS doesn’t have the capacity to handle this. So...

foobarbazetc 7y ago
“Strategy”.

foobarbazetc 7y ago

Here, we can stop “debating” dumb st: https://www.buzzfeed.com/alexwickham/coronavirus-uk-strategy-deaths https://www.buzzfeed.com/alexwickham/coronavirus-uk-strategy...