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Harvard epidemiologist: my colleagues assumed UK coronavirus plan “was satire”

196 points by knzhou 7y ago

boshomi 7y ago
Two Women Fell Sick From the Coronavirus. One Survived.[1] Sui-Lee Wee and Vivian Wang, nytimes.com March 13, 2020 [1] https://www.nytimes.com/interactive/2020/03/13/world/asia/coronavirus-death-life.html https://www.nytimes.com/interactive/2020/03/13/world/asia/co...
- deleted 7y ago
  [deleted]
knzhou 7y ago
I'm posting this because of the narrative on this site that all experts agree with the UK's plan. To the extent that there is a consensus, it's a consensus against it.
- watwut 7y ago
  I havent seen that narrative.
  - knzhou 7y ago
    I was trying to make this argument yesterday and got piles of comments responding exactly this way: "oh, that's only 300 signatures from UK scientists in opposition", "oh, but some of the people who agree with you don't have enough credentials".
    - watwut 7y ago
      I am glad I missed that.
  - pknight 7y ago
    The BBC ran a piece designed to explain why the Govt policy was kosher and the logic behind it, it said there were no scientists in disagreement. Then it corrected the article to say no epidemiologists rather were in disagreement, which is ostensibly false as well. Now it says that at the time of publication no UK epidemiologists had spoken out in mainstream media. They basically admit they didn't do any due diligence when they wrote the piece (they were in a rush to give the Govt cover). https://www.bbc.co.uk/news/science-environment-51874084 https://www.bbc.co.uk/news/science-environment-51874084 and here was the first published version: https://web.archive.org/web/20200313155320/https://www.bbc.co.uk/news/science-environment-51874084 https://web.archive.org/web/20200313155320/https://www.bbc.c...
    - watwut 7y ago
      Thank you.
- chimprich 7y ago
  I'm not sure there is a consensus against it. I've seen a few articles like this (which is worrying) but articles in favour of the status quo tend to not get so much prominence. I really hope the government knows what it's doing. They have promised to publish their models, so hopefully that will give some more confidence.
  - mytailorisrich 7y ago
    The government has somewhat changed the message and they are now saying that their priority is to save lives, which does sound like contradicting their previous message of rapid herd immunity.
    - grey-area 7y ago
      They’ve never had a message of rapid herd immunity, unless by rapid you mean spread out over 6-8 months. The whole point is to avoid either a slow burn (where it comes back at the worst time in winter) or a fast burn (where health services are overwhelmed). Maybe their models are wrong, maybe other approaches will work better, but I like they are having an honest grown up discussion about it instead of insisting eradication is possible, or that there are no tradeoffs to be made and total global lockdown of society for 6 months is the answer (which apart from being of questionable efficacy would certainly cause another Great Depression and more deaths from poverty).
      - mytailorisrich 7y ago
        6-8 months is rapid! That's 40+ million cases during that period and impossible to manage for the health services. This is actually a fast burn. Everyone agrees on that. Whether eradication is possible or not, the FACT is that 6-8 months is extremely fast and can only lead to a collapse of the health services.
        grey-area 7y ago
        I agree it is far more rapid than we’d like, but the options are not clear cut, there is no good choice with a guaranteed outcome, as this article indicates, experts disagree significantly on how to approach this, and due to a lack of data we will not know till after the fact.
- mellosouls 7y ago
  As a counter to that, unless proven otherwise, you can assume a significant bias in any article on government policy coming from The Guardian, as in the OP here. That obviously doesn't mean it's incorrect, but try to be aware of all biases, there are plenty on all sides.
  - disgruntledphd2 7y ago
    Note that the article is in the opinion section of the Guardian. Incidentally, their live blog has been really good on the corona-virus stuff.
  - TheOtherHobbes 7y ago
    Apparently the government's own (secret) figures suggest around 500,000 deaths, and around 8 million people in need of hospitalisation - in a country which currently has around 4,000 ICU beds, and almost no spare capacity in hospitals. 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... Even if the peak is spread out over nine months, that still means setting up, equipping, and staffing around a million extra beds over the next few weeks. At a time when existing medical staff are incapacitated. This is not going to happen. The only way it might be possible is with civil conscription - literally taking people off the street and putting them through basic nursing boot camp. Even then there would be huge issues with supplies of equipment and consumables. So the reality is that most people who need to be hospitalised in the UK (and probably the US) won't be - at least not effectively. Italy has shown what this means: without adequate care the CFR rises from 1% to 7% or so. Which in turn means that without aggressive containment measures to slow the spread, the actual death toll will be in the millions, heavily concentrated among the over 65s. There are around 10 million over 65s in the UK. If these numbers are right, around 10% of them will die.
    - mellosouls 7y ago
      I'm not trying to downplay the crisis - I'm under no illusions that that is not where we are, but a quick look at that article seems to show stuff already revealed in the news conference the other day, and some misstatements. Just an observation on your Guardian link, not the numbers you've derived.
globular-toast 7y ago
But "herd immunity" is not the plan, that's just what people on social media are saying.
- leadingthenet 7y ago
  People on social media ... and the Prime Minister!
- mytailorisrich 7y ago
  Quote: In another interview with the BBC, Sir Patrick said: “If you suppress something very, very hard, when you release those measures it bounces back and it bounces back at the wrong time.” He added: “Our aim is to try to reduce the peak, broaden the peak, not suppress it completely; also, because the vast majority of people get a mild illness, to build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission, at the same time we protect those who are most vulnerable to it.” Source: https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea68b5 https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea6...
  - hilbertseries 7y ago
    So, the U.K. plan is survival of the fittest. I’ve been reading reports that high severity cases cause lung scarring even in young people who survive. Given that high severity cases seem to have the same incident rate in young people, this seems insane.
    - CraigJPerry 7y ago
      It is expressly not survival of the fittest. It is fine to state this is risky, it is. It’s unproven, also true. However the methodology is not survival of the fittest (do nothing). Don’t miss label.
    - globular-toast 7y ago
      Of course it's not survival of the fittest. We're not shutting down the NHS. People with manageable symptoms are being told to stay at home so the NHS will be able to take care of those who can't manage.
gentleman11 7y ago
I’m anxiously waiting for the news that we will block travel from the UK to my country. If they are deliberately making their people into pathogen spreaders, we can’t let them visit us
- lightgreen 7y ago
  Your country (whatever it is) likely already has more carriers than UK, and probably will have more carriers in any moment of time in the future. Anyway, this comment of yours is just offending to the people of UK, non-informative, fear-mongering and does not contribute anything to the discussion.
  - londons_explore 7y ago
    > Your country (whatever it is) likely already has more carriers than UK The UK is pretty high on the charts...
    - lightgreen 7y ago
      Per capita, it is somewhere in the middle and on par with neighbouring EU countries.
      - tigershark 7y ago
        Show me some other country in the world that has the declared objective to infect 60% of its population, please.
        londons_explore 7y ago
        I wonder what endgames these other countries are hoping for. I only see: 1. Eliminate virus entirely. Without a vaccine, almost impossible. 2. Infect 1-1/R of the population, relying on the fact that people who have already had the virus will provide herd immunity. 3. Give a vaccine to 1-1/R of the population. 4. Virus control measures of lockdowns stay in place forever. As far as I can see, the UK is choosing option 2, while most of the rest of the world seem to be attempting 1, which is probably impossible, therefore will end up doing 4.
throw7337 7y ago
Hospitals are already stretched, it takes hours of waiting to treat normal injuries such as broken legs. Waiting list for some operations is years long. How many people are going to die from other causes, if we shutdown entire country for 6 months? How many of those will be children and young people? It may sound harsh, but as a younger person I prefer this plan.
- Zenst 7y ago
  Indeed, you realy want the bulk of those who will not have complications to catch it early and leaving schools open, enables that. Over making every parent stay at home to look after their child! Coz you need to balance out infections and with that manage them, so you will see periodic lockdowns in some parts to throttle back infection and also those most at risk will see themselves issolating for months and however you do things, you want to be doing that anyhow. So infect, isolating those who high risk and letting others carry on and manage infection rate with hospital numbers as you will get risk people getting infected anyhow, so focusing on managing infection in those you can and getting it out the way, has logic behind it. yes people will die, they are not flowing that up, but equally, they are planning for those longterm to be lower than falling victim to the seasonal waves ala spanish flu and how that went. Yes it does seem harsh, but as an older person it is the best plan for the whole and I'm high risk.
  - baq 7y ago
    you seem to believe that the government can control a function exponential in time but with incomplete and delayed information. what could possibly go wrong? you only have to miss one super spreader event and you're left with a runaway transmission that you only get to know about 5-10 days after it happened. also, if bojo wants to ask old people to stay home for 4 months in a couple weeks, why not ask them now to stay home for 4 and a half months? not enough dead in the calculation or what?
    - Zenst 7y ago
      I believe people are going to die, and looking at the long term counts over a short-term mentality and with that, having less deaths overall is a better plan than not. But if you have a solution to how an entire country can completely isolate and operate in today's times for any European sized country then I'm all ears to hear it as we are talking a year at least until any sort of vaccine is available. As for `super spreaders` that's a given, just the same way Europe has easy access to heroin and cocaine that are all imported - you can't stop things spreading even with best intentions and efforts and viruses are much smaller than smuggled drugs. So given that, people who spread this will happen and how would you ever stop that? Sure isolate from the vulnerable and at risk and those groups are already on the case, heck the amount of old people I know and saw 2 weeks ago buying a years worth of toilet roll - well, they are already self isolating and no need to be told by some PM they may or may not respect when they have a lifetime of common sense and experience to draw upon and effectively kick into war-mode mentality lockdown. Though many will learn that over the comming year as this is a world war, only it's the entire world this time fighting a virus. Looking at how the spanish flu went, the real fear is not the hear and now, but the winter to come.
xhkkffbf 7y ago
I spoke with one doctor neighbor from England who now lives in the US. He said he felt much more optimistic about the UK plan because the government was doing a better job of consulting experts. He seems to think the US plan is "satire." But let's not get too political.
- deleted 7y ago
  [deleted]
- DFHippie 7y ago
  It's nice to hear there is a US plan.
elorant 7y ago
I doubt this plan will be long lived. Once the bodies start piling-up there will be a riot.
- nknealk 7y ago
  Bodies piling up is a lagging indicator. I think there’s some consensus that once the bodies start piling up it might be too late to do anything
  - jacquesm 7y ago
    That's roughly three weeks from now. Once ICU capacity is saturated it goes downhill very fast. In Italy that took less than three weeks because their population skews elderly, so in the UK it might take a bit longer.
    - k__ 7y ago
      They also only had half of the beds of, for example, Germany.
      - Taek 7y ago
        Some areas of Italy had a doubling rate of once per 2.4 days. So Germany, with twice as many hospital beds, gets 2.4 days extra of reaction time. Exponents are terrifying.
        jacquesm 7y ago
        It is surprising how many people do not seem to realize these things.
        CraigJPerry 7y ago
        It’s not an exponent, it’s a logistic. That may or may not change the outcome but you can’t just ignore the part of the trace line that doesn’t fit the scare narrative right?
leonixyz 7y ago
UK will survive, UK's economy will survive, they are consciously sacrificing many of their elders and weaker people - who are in most part a mere cost for the society - in favour of young and productive individuals. They are rationally addressing the consequencies of Brexit by doing so, taking an advantage over EU, who is likely to fall into recession. UK traded their moral for their economy.
- jacquesm 7y ago
  Well, then they're idiots. Plenty of people under 50 will end up in intensive care, roughly half of them survive, the remainder will have a good chance of lung issues for the rest of their lives.
  - gpderetta 7y ago
    > roughly half of them survive, the remainder will have a good chance of lung issues for the rest of their lives. Luckily they will not have to live with those issues for very long. (Sorry, with all the bad news I had a need to lighten up the mood)
  - leonixyz 7y ago
    I agree with what you say, but I also believe they did their pretty accurate calculations, and the net result is still going to be positive for them.
- enitihas 7y ago
  But aren't their elder people highly likely to be conservative voters, and also voting in large percentages. If those people do not vote in the next elections, won't the tories lose by a large margin? Source: https://yougov.co.uk/topics/politics/articles-reports/2019/12/17/how-britain-voted-2019-general-election https://yougov.co.uk/topics/politics/articles-reports/2019/1... (And anything else I could find by googling gives similar stats) The government may not be moral, but I don't know if any government makes plans for losing election in a landslide. Is there something I am missing here?
  - 7y ago
petilon 7y ago
Sir Patrick Vallance, England’s chief scientific adviser, said the government was looking “to build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission.” [1] Britain’s chief scientific adviser ... said that about 40m people in the UK could need to catch the coronavirus to build up “herd immunity” and prevent the disease coming back in the future. [2] Sir Patrick told Sky News that experts estimated that about 60 per cent of the UK’s 66m population would have to contract coronavirus in order for society to build up immunity. [2] Read more: [1] https://www.nytimes.com/2020/03/13/world/europe/coronavirus-britain-boris-johnson.html https://www.nytimes.com/2020/03/13/world/europe/coronavirus-... [2] https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea68b5 https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea6...
- baq 7y ago
  for reference, at this moment there are 21,157 (according to john hopkins map) confirmed cases in Italy, which probably translates to anything between 50k-500k infections total. lombardy healthcare is near collapse and there's 1.5k people dead already. multiplying by 80-800 (best-worst case to get to 40M) left as an exercise to the reader. at that point the government might not only buy all ventilators on the market but also all diggers.
  - enitihas 7y ago
    But if the UK government can managed to isolate elder people, and can get those 40M to contain almost exclusively younger people, won't the fatality rate be far lesser?
    - runako 7y ago
      I'm not an expert on this, but based on what has been published my understanding is: 1) Fatality rate is based on hospital care being available for people who do get sick. This will include some nonzero percentage of otherwise healthy young people. Some of these patients will need advanced support, including ventilators. 2) Assuming you could contain to 40M young people (likely impossible), if even .5% of them need hospitalization, the UK hospital system will be overrun. (Not even accounting for all the other people who need hospitalization.) 3) Therefore: the low fatality rate assumption in #1 would likely not hold. TL;DR; the absolute numbers are too big relative to health system capacity.
eanzenberg 7y ago
The disparity of death rates among countries has more to do with infrastructure than the virus. Germany and Switzerland are proving this is just a flu, albeit a pretty bad one (0.1-0.5% death rate). More testing will prove this out by increasing the denominator by 10x.
- nostromo 7y ago
  Testing is the biggest variable. More testing = lower mortality rate. The alarming mortality statistics from Wuhan and Italy turned out to be extremely high due to lack of available testing and mild cases that were never reported. Statistically there are likely already thousands of unreported cases in Seattle, but nobody can get tested. If you have a fever, people are being asked to stay home and not go to the hospital at all. So they’re not even counted in the official numbers.
  - eanzenberg 7y ago
    Exactly, and then this hysteria becomes the flu.
  - photon-torpedo 7y ago
    This is also showing in UK already, where mortality rate seems to be ~3% now. And it is already announced that people who don't need hospitaliztion won't be tested. So number of confirmed cases will appear relatively low but death rate will go up.
- bobjob 7y ago
  Germany is not at the point where the dying start. That will, most likely, take us 2-3 more days.
  - eanzenberg 7y ago
    Look at the “serious cases”. https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
  - RalfWausE 7y ago
jrochkind1 7y ago
> Is everyone in a high-risk group supposed to withdraw themselves from society for six months until they can emerge once the (so far entirely imaginary) second wave has been averted? OK... but... isn't that what everyone is being advised to do right now? So maybe not a great example of something unrealistic to ask? Since in fact the UK would be asking it of fewer people than... many are saying it needs to be asked of -- although the US government isn't actually telling us to... yet? But that's the alternative those who who think the UK's plan is madness are suggesting, right? Asking everyone to withdraw from society for months? I can see the desire: Wait, could we just ask high-risk people to withdraw themselves from society for months, instead of asking everyone to do that? Cause that'd be a lot less disruptive to our social and mental health maybe it'd be just as good? (There are real costs to mental health and social functioning of asking everyone to avoid all contact with everyone else; it might be the best option anyway, but it's definitely not without it's own health risks and consequences). But I'm no expert. It kind of sounds like the experts are saying "not really, that isn't a good idea, everyone has got to do it". Sometimes what we are called upon to do is not easy or pleasant. One of the frustrating and anxiety-producing things here is that we aren't getting very consistent messaging from the governmental authorities and experts. It seems like really a failure of the kind of consistent and pervasive public health educational messaging that would actually maximize compliance. Instead it's "everyone picks what forwarded chain letter on facebook makes sense to them" and we all know how well that works...
- walshemj 7y ago
  Works for me if you can find a suitably remote cabin and a stock of food etc :-)
  - saagarjha 7y ago
    But what about my Hacker News habit? Surely there is Wi-Fi…
    - dmos62 7y ago
      I'd end up simulating my own HN on paper.
Donald 7y ago
The main issue with the UK's approach is approximately 10% of young people need acute medical care (e.g., ventilator access). There aren't enough hospital beds in the NHS system to meet that demand.
- soccerdave 7y ago
  Do you have a source for the 10% of young people needing ventilators?
  - IAmGraydon 7y ago
    I can assure you that they don’t have a source for that.
    - meddlepal 7y ago
      The amount of misinformation/unverifiable information going on around internet communities right now is really showcasing a huge problem with our modern society. There are no facts anymore, because nothing and nobody can be trusted.
      - wbl 7y ago
        Fish rot from the head.
- JamesBarney 7y ago
  I thought 10% of the general population required hospitalization. With a smaller number of people needing ventilators and a even smaller % of young people needing ventilators.
  - knzhou 7y ago
    At this point, hospitalization basically implies ventilation. Hospitals are crowded. If they were just going to give you a bed and some pills, they'd have you do that at home. France reports that half their patients in critical care are under 60, which is supposed to be the "low risk" group.
confeit 7y ago
I think "herd immunity" is a euphemism for: This virus will see community spread of around 30% to 70% and it is long impossible to contain. The U.S. is preparing for 30%, The Netherlands for 50%, and Germany for 70%. Herd immunity will be hard, since antibodies for coronaviruses last only about 4 months. Even the strictest quarantines possible in the West don't compare to the mild quarantines in the East. The laws don't allow for contact tracing with GPS coordinates and credit card purchases, like they do in Singapore. Quarantine methods put selective pressure on the strain types that are more infective and severe, since such mutations and recombinations are the only ones able to escape quarantines. So the plan seems to be to turn this into a community virus, much like herpes or HIV. Then the selective pressure is for the mortality rate to drop and the disease becomes manageable. It would seem silly to damage your economy with heavy quarantine methods when local community cluster spread continues to pop up. Of course, the UK government can not come out and straight up say this, but they seem one of the few governments that is realistic about facing this virus and its impossible to contain infection rate. I am guessing they ran the numbers from the Italy quarantines and based their decision on that.
- DelightOne 7y ago
  > since antibodies for coronaviruses last only about 4 months. Sources? And if so why?
  - faitswulff 7y ago
    The common cold is a coronavirus that people catch annually. As I understand it, it is because the cold evolves or the immunity doesn't last for some reason. https://www.who.int/health-topics/coronavirus https://www.who.int/health-topics/coronavirus
    - maxerickson 7y ago
      Some infections that people identify as common colds are coronaviruses. There's dozens of other viruses that cause colds, with most infections being a different family of viruses (rhinovirus [https://en.wikipedia.org/wiki/Common_cold] https://en.wikipedia.org/wiki/Common_cold]). It's probably not a good idea to make concrete assumptions about a specific virus from the family it belongs to. A good place to look when starting to characterize, not necessarily a complete guide to how the virus will interact with our immune systems.
Leary 7y ago
UK government behavioral psychologist: Telling people to social distance won't work for the long term because they'll get tired of it. Also UK: People won't react negatively when hundreds of thousands of people die. Keep Calm and Carry On.
ce4 7y ago
This will cause a hard Brexit and isolate the island if they don't turn around quickly...
m0zg 7y ago
I think the UK plan is based on some sobering truths that others are just not prepared to acknowledge (yet): 1. You can't shut down the economy indefinitely. At least not if your goal is to minimize fatalities. And if you don't do that, your "quarantine" is not going to be effective 2. You can't maintain quarantine for more than a month or two, after which your epidemic simply re-starts, and you don't get to re-impose the quarantine then because the first quarantine "failed". 3. Vaccine is over a year out in the best case, assuming it works at all. If it's anything like the flu vaccine, chances of it working reliably on mutated strains are approximately nil. 4. Younger people tolerate the disease much better, and if they build up immunity to it while the senior population self-isolates, the overall number of deaths could be minimized. 5. Due to how widespread and virulent this is, it will just become the "new flu", and it will come back with mutations every year. We can't do what we're doing now every year, at least not if the goal is to minimize deaths.
- fab1an 7y ago
  You've ignored a couple crucial aspects though: 1. while I'm also skeptical re vaccines, we might well have more effective medical treatment options in a few weeks or months. There are a whole range of different phase 3 trials happeninig right now, some of which have shown anecdotal promise, esp Remisdivir. 2. We learn something new about this disease on a daily basis, meaning that in a few weeks we have diff picture of who exactly is most vulnerable (e. g. folks on ACEinhibitors, or we find ACEi actually are protective and ARBs are an issue etc etc
- threeseed 7y ago
  1. China didn't need to. 2. China did. 3. So then there isn't any point to herd immunity. 4. Only younger people who are in good health. There are many disabled and sick young people. 5. It could be the new flu. Or it could be like SARS/MERS.
  - PuffinBlue 7y ago
    I'm not convinced we can look to China for any 'truth' in this outbreak. None of the numbers there are verifiable and the Chinese government doesn't exactly have great credibility.
thu2111 7y ago
The Guardian is such a rag. Why does it still have readers? Finding academics who will criticise anything this conservative pro-Brexit government does is easy: Johnson could make any announcement at all and within 24 hours the Graun would have found a contemptuous academic to tell their readers why it's stupid and bad. People can agree or disagree with the British government's logic. Only someone very biased would treat it as inherently absurd. So let's look past the headline at what this guy is actually saying. He starts this piece by asserting his authority as an expert. But he isn't revealing any new information or critical analysis that would change anyone's minds. In fact as you read further down you find he's actually agreeing with the government's policies. The key points of the article are: • Herd immunity will happen anyway and shouldn't be a goal. • A second wave may or may not happen, it shouldn't drive policy. • Be like South Korea and close everything for an unspecified period of time. • Close the schools! But keep children away from Nana and Grandpa. The entire article says nothing that hasn't been said elsewhere; the only benefit this guy's epidemiology experience seems to add is credentialism. But there are also major logic problems in the argument. Let's start with his last point about children and schools. He obviously realises children shouldn't come into contact with grandparents, but fails to apply the common sense knowledge that many parents can't stop working to take care of them e.g. because they work in the healthcare system, or logistics, or grocery retail, or pharmaceuticals, or government, etc. So those children will all go to their grandparents, assuming they have some: the one place you don't want them to be. This is a point the scientific advisors to the government made in their announcement press conference but he fails to address it. Children need to be kept away from grandparents and in the presence of young, fit, healthy adults. These conditions can be found in schools. He says: Second waves are real things, and we have seen them in flu pandemics. This is not a flu pandemic. Flu rules do not apply. There might well be a second wave, I honestly don’t know. But vulnerable people should not be exposed to a virus right now in the service of a hypothetical future. The belief a second wave is likely has nothing to do with how flu-like the virus is. Saying flu rules don't apply is a non-sequitur. Second wave is a simple observation based on the fact that stopping infected people coming in and out of the country isn't possible, nor will it be possible going forward. International travel isn't going to remain shut down for long, which means even if the government could somehow wipe out COVID-19 purely via social control policies, it would come back the moment those measures ended and normal life returned. The only way to stop it permanently is if most people are immune so it can't spread. Also, just saying "this might or might not happen, who knows" is a poor basis for policy making. This guy is an expert, where's the probabilities? He says: The UK should not be trying to create herd immunity, that will take care of itself But the UK isn't "trying" to create herd immunity. What would that involve, actually? Encouraging chicken pox style virus parties? It's not doing anything like this. Believing that requires an especially bad-faith reading of a (perhaps poorly phrased) statement by a fellow scientist. The goverment understands that herd immunity is going to happen sooner or later, it's the only way to end this, and that's why reaching it with as few fatalities as possible is the stated aim. Finally, his recommendations are useless. He just recommends social distancing and shutdowns without any time frames attached. Does he believe people can self isolate and schools can remain shut indefinitely? If not, if he believes these measures don't last for long, then there is a question of when the optimal time to deploy them is. And trying to answer that question is how the government arrived at its current policy. I have to say, reading this makes me glad the government has better scientists than this guy advising it. Maybe Dominic Cummings is onto something after all.
toohotatopic 7y ago
Aren't masks and other stuff on short supply? At least Italy didn't have enough and France is restricting exports. Even if it is a good idea to restrict the economy as little as possible, how do they prepare for the moment when there are no masks and nurses will drop out en masse due to being infected?
Engineering-MD 7y ago
The problem is the alternative is even less feasible. Containment is very unlikely to work, and slowing the epidemic too much leads to it happening in winter. The only thing which they should have done is delayed a decision on this. They are a few weeks behind other countries, and could have observed effectiveness of social distancing in arresting spread. If it worked, it could be copied (ina modified form) and if it failed, it would be much easier to sell to the public. Currently it’s a brave (but likely correct) position it would seem. But then again, what do I know. While I’m a doctor, I’m No specialist so my opinion is of limited value, and experts seem to disagree with each other. This is what makes this so difficult, no one seems to know what is the best option this current data.
- joe_the_user 7y ago
  The problem is the alternative is even less feasible. Containment is very unlikely to work, and slowing the epidemic too much leads to it happening in winter. Containment has worked in Wuhan. Containment is being attempted after-the-fact in Italy. Containment is possible, it's just a matter of how extreme gets. But even the most containment does not look the hundreds of thousands or millions dead that letting everyone be infected looks like.
  - cameronh90 7y ago
    It's possible to contain it with extreme measures, of course. But what happens when you release the lock down and it's still burning through the rest of the world, especially Africa and India? Do you ban every foreign visitor for the next year?
    - jacquesm 7y ago
      Seems like a small price to pay.
    - baq 7y ago
      from a high risk country, yes. from a low risk country, test every single arrival.
Gatsky 7y ago
Well satire is a bit strong. But I think the plan seems unwise, due to unvalidated assumptions (especially that immunity will last during a second wave) and the nature of their health system. If an effective treatment emerges, they will also have made a mistake.
adrianhel 7y ago
Take action now.
GrantZvolsky 7y ago
To say the government opted 'to encourage the flames' is disingenuous. Presumably their statistical model indicated they won't be able to contain the spread which is why the current stated aim is to delay the spread[0]. Delay, not encourage. The article's suggestions seem to be in line with the government's stance. The main difference is timing with Dr William Hanage saying measures should have been adopted weeks ago while the government claims their modelling tells them to adopt measures later. The government should be challenged by questioning whether it truly is/was impossible to contain the epidemic and what the best time to introduce different measures is. This article, however, adds very little to that debate with hand-waving in place of evidence. [0]: https://www.gov.uk/government/news/covid-19-government-announces-moving-out-of-contain-phase-and-into-delay https://www.gov.uk/government/news/covid-19-government-annou...
- tigershark 7y ago
  It’s not true, Italy had exactly the same deaths per day two weeks ago. They introduced the complete lockdown what will be tomorrow. They had 2 weeks of advantage compared to Italy, they already knew what the future was going to look like, and they squandered it all without doing anything. Now uk is going to be in a much worse situation compared to Italy because of this. Just one day of delay in an exponential curve can mean possibly tens of thousands death. Here we are speaking about weeks or months of delay if they really want to infect 60% of the people. The nazis probably caused less deaths in concentration camps than boris, but we’ll know for sure in a couple of months.
  - fridek 7y ago
    Holocaust involved death of 1-11 million people (depending on sources and who you want to count). Not a fan of government's current approach, but Boris shouldn't grow a pencil moustache just yet.
- rawTruthHurts 7y ago
  I hope the number of available hospital beds in the UK matches their statistics model.
- 7y ago
adrianhel 7y ago
In Norway we just slipped from the 2nd most infected per capita to the 3rd after government warnings. If your country has >= 1 infected, you should follow the advice at fhi.no/en.
- dirtydroog 7y ago
  "This page isn't feeling well" (LOL in Norwegian)
lightgreen 7y ago
This article is "fake news" and FUD. Quoting the article: > The UK should not be trying to create herd immunity, that will take care of itself. That's a clear blatant lie. UK is NOT trying to create a herd immunity. UK is trying to flatten the curve. And UK is admitting that 60% population will get invected. And then the UK will get herd immunity. For example, it is explained (again) in this video: https://www.youtube.com/watch?v=2XRc389TvG8 https://www.youtube.com/watch?v=2XRc389TvG8 Feel free to downvote, that's a popular sport here on HN.
- DanBC 7y ago
  You keep saying the aim isn't to create herd immunity, but that was the way the government introduced the delay phase. They've pulled back a bit from it because they've seen the vehement public reaction to it. Cummings may well be evil, but he's not stupid.
  - lightgreen 7y ago
    > They've pulled back a bit from it because they've seen the vehement public reaction to it. They did not. I watched an hour long full press conference by PM and two adisors. https://www.youtube.com/watch?v=xRadMzCKnCU https://www.youtube.com/watch?v=xRadMzCKnCU I also watched an hour long Chris Witty Q&A for MP following day. https://www.youtube.com/watch?v=IfJcwDaZrsA https://www.youtube.com/watch?v=IfJcwDaZrsA Both of these talks were about flattening the curve because of NHS capacity etc etc. The scientists mentioned herd immunity couple times, but not like they are intentionally trying to create it. It was rather like: herd immunity will happen in several months. > Cummings may well be evil, but he's not stupid. Likely he got his information from dishonest journalist articles and started self-promotion. But it's a shame that smart people on HN continue to retransmit this fake.
    - tigershark 7y ago
      Maybe you were quite distracted while watching it. As far as I remember the only advice they gave during that press conference was to stay at home for 7 days only if you have a cough. Does it look like flattening the curve to you? To me it looks like “let’s increase the contagion and the deaths as much as possible” compared to what every other country was doing at the time.
YeGoblynQueenne 7y ago
It's interesting to contrast the UK approach to -everyone else's approach. Everyone else is asking _infected_ people to do the socially responsible thing and self-isolate to protect those around them. The UK is asking (or will be asking) the _vulnerable_ people to self-isolate to protect themselves. It is very hard to avoid thinking of it this way but: what happens if a vulnerable person fails to isolate, for whatever reason (stupidity, ignorance, accident, etc)? Is the blame on them? They were told to protect themselves and they failed, so it's their fault? if I think of it this way it very much sounds like the UK government is planning to just er, wash its hands of vulnerable people and refuse to take any responsibility for their fate.

196 points by knzhou 7y ago

Two Women Fell Sick From the Coronavirus. One Survived.[1] Sui-Lee Wee and Vivian Wang, nytimes.com March 13, 2020 [1] https://www.nytimes.com/interactive/2020/03/13/world/asia/coronavirus-death-life.html https://www.nytimes.com/interactive/2020/03/13/world/asia/co...

deleted 7y ago
[deleted]

knzhou 7y ago

I'm posting this because of the narrative on this site that all experts agree with the UK's plan. To the extent that there is a consensus, it's a consensus against it.

watwut 7y ago
I havent seen that narrative.
- knzhou 7y ago
  I was trying to make this argument yesterday and got piles of comments responding exactly this way: "oh, that's only 300 signatures from UK scientists in opposition", "oh, but some of the people who agree with you don't have enough credentials".
  - watwut 7y ago
    I am glad I missed that.
- pknight 7y ago
  The BBC ran a piece designed to explain why the Govt policy was kosher and the logic behind it, it said there were no scientists in disagreement. Then it corrected the article to say no epidemiologists rather were in disagreement, which is ostensibly false as well. Now it says that at the time of publication no UK epidemiologists had spoken out in mainstream media. They basically admit they didn't do any due diligence when they wrote the piece (they were in a rush to give the Govt cover). https://www.bbc.co.uk/news/science-environment-51874084 https://www.bbc.co.uk/news/science-environment-51874084 and here was the first published version: https://web.archive.org/web/20200313155320/https://www.bbc.co.uk/news/science-environment-51874084 https://web.archive.org/web/20200313155320/https://www.bbc.c...
  - watwut 7y ago
    Thank you.
chimprich 7y ago
I'm not sure there is a consensus against it. I've seen a few articles like this (which is worrying) but articles in favour of the status quo tend to not get so much prominence. I really hope the government knows what it's doing. They have promised to publish their models, so hopefully that will give some more confidence.
- mytailorisrich 7y ago
  The government has somewhat changed the message and they are now saying that their priority is to save lives, which does sound like contradicting their previous message of rapid herd immunity.
  - grey-area 7y ago
    They’ve never had a message of rapid herd immunity, unless by rapid you mean spread out over 6-8 months. The whole point is to avoid either a slow burn (where it comes back at the worst time in winter) or a fast burn (where health services are overwhelmed). Maybe their models are wrong, maybe other approaches will work better, but I like they are having an honest grown up discussion about it instead of insisting eradication is possible, or that there are no tradeoffs to be made and total global lockdown of society for 6 months is the answer (which apart from being of questionable efficacy would certainly cause another Great Depression and more deaths from poverty).
    - mytailorisrich 7y ago
      6-8 months is rapid! That's 40+ million cases during that period and impossible to manage for the health services. This is actually a fast burn. Everyone agrees on that. Whether eradication is possible or not, the FACT is that 6-8 months is extremely fast and can only lead to a collapse of the health services.
      - grey-area 7y ago
        I agree it is far more rapid than we’d like, but the options are not clear cut, there is no good choice with a guaranteed outcome, as this article indicates, experts disagree significantly on how to approach this, and due to a lack of data we will not know till after the fact.
mellosouls 7y ago
As a counter to that, unless proven otherwise, you can assume a significant bias in any article on government policy coming from The Guardian, as in the OP here. That obviously doesn't mean it's incorrect, but try to be aware of all biases, there are plenty on all sides.
- disgruntledphd2 7y ago
  Note that the article is in the opinion section of the Guardian. Incidentally, their live blog has been really good on the corona-virus stuff.
- TheOtherHobbes 7y ago
  Apparently the government's own (secret) figures suggest around 500,000 deaths, and around 8 million people in need of hospitalisation - in a country which currently has around 4,000 ICU beds, and almost no spare capacity in hospitals. 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... Even if the peak is spread out over nine months, that still means setting up, equipping, and staffing around a million extra beds over the next few weeks. At a time when existing medical staff are incapacitated. This is not going to happen. The only way it might be possible is with civil conscription - literally taking people off the street and putting them through basic nursing boot camp. Even then there would be huge issues with supplies of equipment and consumables. So the reality is that most people who need to be hospitalised in the UK (and probably the US) won't be - at least not effectively. Italy has shown what this means: without adequate care the CFR rises from 1% to 7% or so. Which in turn means that without aggressive containment measures to slow the spread, the actual death toll will be in the millions, heavily concentrated among the over 65s. There are around 10 million over 65s in the UK. If these numbers are right, around 10% of them will die.
  - mellosouls 7y ago
    I'm not trying to downplay the crisis - I'm under no illusions that that is not where we are, but a quick look at that article seems to show stuff already revealed in the news conference the other day, and some misstatements. Just an observation on your Guardian link, not the numbers you've derived.

globular-toast 7y ago

But "herd immunity" is not the plan, that's just what people on social media are saying.

leadingthenet 7y ago
People on social media ... and the Prime Minister!
mytailorisrich 7y ago
Quote: In another interview with the BBC, Sir Patrick said: “If you suppress something very, very hard, when you release those measures it bounces back and it bounces back at the wrong time.” He added: “Our aim is to try to reduce the peak, broaden the peak, not suppress it completely; also, because the vast majority of people get a mild illness, to build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission, at the same time we protect those who are most vulnerable to it.” Source: https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea68b5 https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea6...
- hilbertseries 7y ago
  So, the U.K. plan is survival of the fittest. I’ve been reading reports that high severity cases cause lung scarring even in young people who survive. Given that high severity cases seem to have the same incident rate in young people, this seems insane.
  - CraigJPerry 7y ago
    It is expressly not survival of the fittest. It is fine to state this is risky, it is. It’s unproven, also true. However the methodology is not survival of the fittest (do nothing). Don’t miss label.
  - globular-toast 7y ago
    Of course it's not survival of the fittest. We're not shutting down the NHS. People with manageable symptoms are being told to stay at home so the NHS will be able to take care of those who can't manage.

gentleman11 7y ago

I’m anxiously waiting for the news that we will block travel from the UK to my country. If they are deliberately making their people into pathogen spreaders, we can’t let them visit us

lightgreen 7y ago
Your country (whatever it is) likely already has more carriers than UK, and probably will have more carriers in any moment of time in the future. Anyway, this comment of yours is just offending to the people of UK, non-informative, fear-mongering and does not contribute anything to the discussion.
- londons_explore 7y ago
  > Your country (whatever it is) likely already has more carriers than UK The UK is pretty high on the charts...
  - lightgreen 7y ago
    Per capita, it is somewhere in the middle and on par with neighbouring EU countries.
    - tigershark 7y ago
      Show me some other country in the world that has the declared objective to infect 60% of its population, please.
      - londons_explore 7y ago
        I wonder what endgames these other countries are hoping for. I only see: 1. Eliminate virus entirely. Without a vaccine, almost impossible. 2. Infect 1-1/R of the population, relying on the fact that people who have already had the virus will provide herd immunity. 3. Give a vaccine to 1-1/R of the population. 4. Virus control measures of lockdowns stay in place forever. As far as I can see, the UK is choosing option 2, while most of the rest of the world seem to be attempting 1, which is probably impossible, therefore will end up doing 4.

throw7337 7y ago

Hospitals are already stretched, it takes hours of waiting to treat normal injuries such as broken legs. Waiting list for some operations is years long. How many people are going to die from other causes, if we shutdown entire country for 6 months? How many of those will be children and young people? It may sound harsh, but as a younger person I prefer this plan.

Zenst 7y ago
Indeed, you realy want the bulk of those who will not have complications to catch it early and leaving schools open, enables that. Over making every parent stay at home to look after their child! Coz you need to balance out infections and with that manage them, so you will see periodic lockdowns in some parts to throttle back infection and also those most at risk will see themselves issolating for months and however you do things, you want to be doing that anyhow. So infect, isolating those who high risk and letting others carry on and manage infection rate with hospital numbers as you will get risk people getting infected anyhow, so focusing on managing infection in those you can and getting it out the way, has logic behind it. yes people will die, they are not flowing that up, but equally, they are planning for those longterm to be lower than falling victim to the seasonal waves ala spanish flu and how that went. Yes it does seem harsh, but as an older person it is the best plan for the whole and I'm high risk.
- baq 7y ago
  you seem to believe that the government can control a function exponential in time but with incomplete and delayed information. what could possibly go wrong? you only have to miss one super spreader event and you're left with a runaway transmission that you only get to know about 5-10 days after it happened. also, if bojo wants to ask old people to stay home for 4 months in a couple weeks, why not ask them now to stay home for 4 and a half months? not enough dead in the calculation or what?
  - Zenst 7y ago
    I believe people are going to die, and looking at the long term counts over a short-term mentality and with that, having less deaths overall is a better plan than not. But if you have a solution to how an entire country can completely isolate and operate in today's times for any European sized country then I'm all ears to hear it as we are talking a year at least until any sort of vaccine is available. As for `super spreaders` that's a given, just the same way Europe has easy access to heroin and cocaine that are all imported - you can't stop things spreading even with best intentions and efforts and viruses are much smaller than smuggled drugs. So given that, people who spread this will happen and how would you ever stop that? Sure isolate from the vulnerable and at risk and those groups are already on the case, heck the amount of old people I know and saw 2 weeks ago buying a years worth of toilet roll - well, they are already self isolating and no need to be told by some PM they may or may not respect when they have a lifetime of common sense and experience to draw upon and effectively kick into war-mode mentality lockdown. Though many will learn that over the comming year as this is a world war, only it's the entire world this time fighting a virus. Looking at how the spanish flu went, the real fear is not the hear and now, but the winter to come.

xhkkffbf 7y ago

I spoke with one doctor neighbor from England who now lives in the US. He said he felt much more optimistic about the UK plan because the government was doing a better job of consulting experts. He seems to think the US plan is "satire." But let's not get too political.

deleted 7y ago
[deleted]
DFHippie 7y ago
It's nice to hear there is a US plan.

elorant 7y ago

I doubt this plan will be long lived. Once the bodies start piling-up there will be a riot.

nknealk 7y ago
Bodies piling up is a lagging indicator. I think there’s some consensus that once the bodies start piling up it might be too late to do anything
- jacquesm 7y ago
  That's roughly three weeks from now. Once ICU capacity is saturated it goes downhill very fast. In Italy that took less than three weeks because their population skews elderly, so in the UK it might take a bit longer.
  - k__ 7y ago
    They also only had half of the beds of, for example, Germany.
    - Taek 7y ago
      Some areas of Italy had a doubling rate of once per 2.4 days. So Germany, with twice as many hospital beds, gets 2.4 days extra of reaction time. Exponents are terrifying.
      - jacquesm 7y ago
        It is surprising how many people do not seem to realize these things.
      - CraigJPerry 7y ago
        It’s not an exponent, it’s a logistic. That may or may not change the outcome but you can’t just ignore the part of the trace line that doesn’t fit the scare narrative right?

leonixyz 7y ago

UK will survive, UK's economy will survive, they are consciously sacrificing many of their elders and weaker people - who are in most part a mere cost for the society - in favour of young and productive individuals. They are rationally addressing the consequencies of Brexit by doing so, taking an advantage over EU, who is likely to fall into recession. UK traded their moral for their economy.

jacquesm 7y ago
Well, then they're idiots. Plenty of people under 50 will end up in intensive care, roughly half of them survive, the remainder will have a good chance of lung issues for the rest of their lives.
- gpderetta 7y ago
  > roughly half of them survive, the remainder will have a good chance of lung issues for the rest of their lives. Luckily they will not have to live with those issues for very long. (Sorry, with all the bad news I had a need to lighten up the mood)
- leonixyz 7y ago
  I agree with what you say, but I also believe they did their pretty accurate calculations, and the net result is still going to be positive for them.
enitihas 7y ago
But aren't their elder people highly likely to be conservative voters, and also voting in large percentages. If those people do not vote in the next elections, won't the tories lose by a large margin? Source: https://yougov.co.uk/topics/politics/articles-reports/2019/12/17/how-britain-voted-2019-general-election https://yougov.co.uk/topics/politics/articles-reports/2019/1... (And anything else I could find by googling gives similar stats) The government may not be moral, but I don't know if any government makes plans for losing election in a landslide. Is there something I am missing here?
- 7y ago

petilon 7y ago

Sir Patrick Vallance, England’s chief scientific adviser, said the government was looking “to build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission.” [1] Britain’s chief scientific adviser ... said that about 40m people in the UK could need to catch the coronavirus to build up “herd immunity” and prevent the disease coming back in the future. [2] Sir Patrick told Sky News that experts estimated that about 60 per cent of the UK’s 66m population would have to contract coronavirus in order for society to build up immunity. [2] Read more: [1] https://www.nytimes.com/2020/03/13/world/europe/coronavirus-britain-boris-johnson.html https://www.nytimes.com/2020/03/13/world/europe/coronavirus-... [2] https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea68b5 https://www.ft.com/content/38a81588-6508-11ea-b3f3-fe4680ea6...

baq 7y ago
for reference, at this moment there are 21,157 (according to john hopkins map) confirmed cases in Italy, which probably translates to anything between 50k-500k infections total. lombardy healthcare is near collapse and there's 1.5k people dead already. multiplying by 80-800 (best-worst case to get to 40M) left as an exercise to the reader. at that point the government might not only buy all ventilators on the market but also all diggers.
- enitihas 7y ago
  But if the UK government can managed to isolate elder people, and can get those 40M to contain almost exclusively younger people, won't the fatality rate be far lesser?
  - runako 7y ago
    I'm not an expert on this, but based on what has been published my understanding is: 1) Fatality rate is based on hospital care being available for people who do get sick. This will include some nonzero percentage of otherwise healthy young people. Some of these patients will need advanced support, including ventilators. 2) Assuming you could contain to 40M young people (likely impossible), if even .5% of them need hospitalization, the UK hospital system will be overrun. (Not even accounting for all the other people who need hospitalization.) 3) Therefore: the low fatality rate assumption in #1 would likely not hold. TL;DR; the absolute numbers are too big relative to health system capacity.

eanzenberg 7y ago

The disparity of death rates among countries has more to do with infrastructure than the virus. Germany and Switzerland are proving this is just a flu, albeit a pretty bad one (0.1-0.5% death rate). More testing will prove this out by increasing the denominator by 10x.

nostromo 7y ago
Testing is the biggest variable. More testing = lower mortality rate. The alarming mortality statistics from Wuhan and Italy turned out to be extremely high due to lack of available testing and mild cases that were never reported. Statistically there are likely already thousands of unreported cases in Seattle, but nobody can get tested. If you have a fever, people are being asked to stay home and not go to the hospital at all. So they’re not even counted in the official numbers.
- eanzenberg 7y ago
  Exactly, and then this hysteria becomes the flu.
- photon-torpedo 7y ago
  This is also showing in UK already, where mortality rate seems to be ~3% now. And it is already announced that people who don't need hospitaliztion won't be tested. So number of confirmed cases will appear relatively low but death rate will go up.
bobjob 7y ago
Germany is not at the point where the dying start. That will, most likely, take us 2-3 more days.
- eanzenberg 7y ago
  Look at the “serious cases”. https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
- RalfWausE 7y ago

jrochkind1 7y ago

> Is everyone in a high-risk group supposed to withdraw themselves from society for six months until they can emerge once the (so far entirely imaginary) second wave has been averted? OK... but... isn't that what everyone is being advised to do right now? So maybe not a great example of something unrealistic to ask? Since in fact the UK would be asking it of fewer people than... many are saying it needs to be asked of -- although the US government isn't actually telling us to... yet? But that's the alternative those who who think the UK's plan is madness are suggesting, right? Asking everyone to withdraw from society for months? I can see the desire: Wait, could we just ask high-risk people to withdraw themselves from society for months, instead of asking everyone to do that? Cause that'd be a lot less disruptive to our social and mental health maybe it'd be just as good? (There are real costs to mental health and social functioning of asking everyone to avoid all contact with everyone else; it might be the best option anyway, but it's definitely not without it's own health risks and consequences). But I'm no expert. It kind of sounds like the experts are saying "not really, that isn't a good idea, everyone has got to do it". Sometimes what we are called upon to do is not easy or pleasant. One of the frustrating and anxiety-producing things here is that we aren't getting very consistent messaging from the governmental authorities and experts. It seems like really a failure of the kind of consistent and pervasive public health educational messaging that would actually maximize compliance. Instead it's "everyone picks what forwarded chain letter on facebook makes sense to them" and we all know how well that works...

walshemj 7y ago
Works for me if you can find a suitably remote cabin and a stock of food etc :-)
- saagarjha 7y ago
  But what about my Hacker News habit? Surely there is Wi-Fi…
  - dmos62 7y ago
    I'd end up simulating my own HN on paper.

Donald 7y ago

The main issue with the UK's approach is approximately 10% of young people need acute medical care (e.g., ventilator access). There aren't enough hospital beds in the NHS system to meet that demand.

soccerdave 7y ago
Do you have a source for the 10% of young people needing ventilators?
- IAmGraydon 7y ago
  I can assure you that they don’t have a source for that.
  - meddlepal 7y ago
    The amount of misinformation/unverifiable information going on around internet communities right now is really showcasing a huge problem with our modern society. There are no facts anymore, because nothing and nobody can be trusted.
    - wbl 7y ago
      Fish rot from the head.
JamesBarney 7y ago
I thought 10% of the general population required hospitalization. With a smaller number of people needing ventilators and a even smaller % of young people needing ventilators.
- knzhou 7y ago
  At this point, hospitalization basically implies ventilation. Hospitals are crowded. If they were just going to give you a bed and some pills, they'd have you do that at home. France reports that half their patients in critical care are under 60, which is supposed to be the "low risk" group.

confeit 7y ago

I think "herd immunity" is a euphemism for: This virus will see community spread of around 30% to 70% and it is long impossible to contain. The U.S. is preparing for 30%, The Netherlands for 50%, and Germany for 70%. Herd immunity will be hard, since antibodies for coronaviruses last only about 4 months. Even the strictest quarantines possible in the West don't compare to the mild quarantines in the East. The laws don't allow for contact tracing with GPS coordinates and credit card purchases, like they do in Singapore. Quarantine methods put selective pressure on the strain types that are more infective and severe, since such mutations and recombinations are the only ones able to escape quarantines. So the plan seems to be to turn this into a community virus, much like herpes or HIV. Then the selective pressure is for the mortality rate to drop and the disease becomes manageable. It would seem silly to damage your economy with heavy quarantine methods when local community cluster spread continues to pop up. Of course, the UK government can not come out and straight up say this, but they seem one of the few governments that is realistic about facing this virus and its impossible to contain infection rate. I am guessing they ran the numbers from the Italy quarantines and based their decision on that.

DelightOne 7y ago
> since antibodies for coronaviruses last only about 4 months. Sources? And if so why?
- faitswulff 7y ago
  The common cold is a coronavirus that people catch annually. As I understand it, it is because the cold evolves or the immunity doesn't last for some reason. https://www.who.int/health-topics/coronavirus https://www.who.int/health-topics/coronavirus
  - maxerickson 7y ago
    Some infections that people identify as common colds are coronaviruses. There's dozens of other viruses that cause colds, with most infections being a different family of viruses (rhinovirus [https://en.wikipedia.org/wiki/Common_cold] https://en.wikipedia.org/wiki/Common_cold]). It's probably not a good idea to make concrete assumptions about a specific virus from the family it belongs to. A good place to look when starting to characterize, not necessarily a complete guide to how the virus will interact with our immune systems.

Leary 7y ago

UK government behavioral psychologist: Telling people to social distance won't work for the long term because they'll get tired of it. Also UK: People won't react negatively when hundreds of thousands of people die. Keep Calm and Carry On.

ce4 7y ago

This will cause a hard Brexit and isolate the island if they don't turn around quickly...

m0zg 7y ago

I think the UK plan is based on some sobering truths that others are just not prepared to acknowledge (yet): 1. You can't shut down the economy indefinitely. At least not if your goal is to minimize fatalities. And if you don't do that, your "quarantine" is not going to be effective 2. You can't maintain quarantine for more than a month or two, after which your epidemic simply re-starts, and you don't get to re-impose the quarantine then because the first quarantine "failed". 3. Vaccine is over a year out in the best case, assuming it works at all. If it's anything like the flu vaccine, chances of it working reliably on mutated strains are approximately nil. 4. Younger people tolerate the disease much better, and if they build up immunity to it while the senior population self-isolates, the overall number of deaths could be minimized. 5. Due to how widespread and virulent this is, it will just become the "new flu", and it will come back with mutations every year. We can't do what we're doing now every year, at least not if the goal is to minimize deaths.

fab1an 7y ago
You've ignored a couple crucial aspects though: 1. while I'm also skeptical re vaccines, we might well have more effective medical treatment options in a few weeks or months. There are a whole range of different phase 3 trials happeninig right now, some of which have shown anecdotal promise, esp Remisdivir. 2. We learn something new about this disease on a daily basis, meaning that in a few weeks we have diff picture of who exactly is most vulnerable (e. g. folks on ACEinhibitors, or we find ACEi actually are protective and ARBs are an issue etc etc
threeseed 7y ago
1. China didn't need to. 2. China did. 3. So then there isn't any point to herd immunity. 4. Only younger people who are in good health. There are many disabled and sick young people. 5. It could be the new flu. Or it could be like SARS/MERS.
- PuffinBlue 7y ago
  I'm not convinced we can look to China for any 'truth' in this outbreak. None of the numbers there are verifiable and the Chinese government doesn't exactly have great credibility.

thu2111 7y ago

The Guardian is such a rag. Why does it still have readers? Finding academics who will criticise anything this conservative pro-Brexit government does is easy: Johnson could make any announcement at all and within 24 hours the Graun would have found a contemptuous academic to tell their readers why it's stupid and bad. People can agree or disagree with the British government's logic. Only someone very biased would treat it as inherently absurd. So let's look past the headline at what this guy is actually saying. He starts this piece by asserting his authority as an expert. But he isn't revealing any new information or critical analysis that would change anyone's minds. In fact as you read further down you find he's actually agreeing with the government's policies. The key points of the article are: • Herd immunity will happen anyway and shouldn't be a goal. • A second wave may or may not happen, it shouldn't drive policy. • Be like South Korea and close everything for an unspecified period of time. • Close the schools! But keep children away from Nana and Grandpa. The entire article says nothing that hasn't been said elsewhere; the only benefit this guy's epidemiology experience seems to add is credentialism. But there are also major logic problems in the argument. Let's start with his last point about children and schools. He obviously realises children shouldn't come into contact with grandparents, but fails to apply the common sense knowledge that many parents can't stop working to take care of them e.g. because they work in the healthcare system, or logistics, or grocery retail, or pharmaceuticals, or government, etc. So those children will all go to their grandparents, assuming they have some: the one place you don't want them to be. This is a point the scientific advisors to the government made in their announcement press conference but he fails to address it. Children need to be kept away from grandparents and in the presence of young, fit, healthy adults. These conditions can be found in schools. He says: Second waves are real things, and we have seen them in flu pandemics. This is not a flu pandemic. Flu rules do not apply. There might well be a second wave, I honestly don’t know. But vulnerable people should not be exposed to a virus right now in the service of a hypothetical future. The belief a second wave is likely has nothing to do with how flu-like the virus is. Saying flu rules don't apply is a non-sequitur. Second wave is a simple observation based on the fact that stopping infected people coming in and out of the country isn't possible, nor will it be possible going forward. International travel isn't going to remain shut down for long, which means even if the government could somehow wipe out COVID-19 purely via social control policies, it would come back the moment those measures ended and normal life returned. The only way to stop it permanently is if most people are immune so it can't spread. Also, just saying "this might or might not happen, who knows" is a poor basis for policy making. This guy is an expert, where's the probabilities? He says: The UK should not be trying to create herd immunity, that will take care of itself But the UK isn't "trying" to create herd immunity. What would that involve, actually? Encouraging chicken pox style virus parties? It's not doing anything like this. Believing that requires an especially bad-faith reading of a (perhaps poorly phrased) statement by a fellow scientist. The goverment understands that herd immunity is going to happen sooner or later, it's the only way to end this, and that's why reaching it with as few fatalities as possible is the stated aim. Finally, his recommendations are useless. He just recommends social distancing and shutdowns without any time frames attached. Does he believe people can self isolate and schools can remain shut indefinitely? If not, if he believes these measures don't last for long, then there is a question of when the optimal time to deploy them is. And trying to answer that question is how the government arrived at its current policy. I have to say, reading this makes me glad the government has better scientists than this guy advising it. Maybe Dominic Cummings is onto something after all.

toohotatopic 7y ago

Aren't masks and other stuff on short supply? At least Italy didn't have enough and France is restricting exports. Even if it is a good idea to restrict the economy as little as possible, how do they prepare for the moment when there are no masks and nurses will drop out en masse due to being infected?

Engineering-MD 7y ago

The problem is the alternative is even less feasible. Containment is very unlikely to work, and slowing the epidemic too much leads to it happening in winter. The only thing which they should have done is delayed a decision on this. They are a few weeks behind other countries, and could have observed effectiveness of social distancing in arresting spread. If it worked, it could be copied (ina modified form) and if it failed, it would be much easier to sell to the public. Currently it’s a brave (but likely correct) position it would seem. But then again, what do I know. While I’m a doctor, I’m No specialist so my opinion is of limited value, and experts seem to disagree with each other. This is what makes this so difficult, no one seems to know what is the best option this current data.

joe_the_user 7y ago
The problem is the alternative is even less feasible. Containment is very unlikely to work, and slowing the epidemic too much leads to it happening in winter. Containment has worked in Wuhan. Containment is being attempted after-the-fact in Italy. Containment is possible, it's just a matter of how extreme gets. But even the most containment does not look the hundreds of thousands or millions dead that letting everyone be infected looks like.
- cameronh90 7y ago
  It's possible to contain it with extreme measures, of course. But what happens when you release the lock down and it's still burning through the rest of the world, especially Africa and India? Do you ban every foreign visitor for the next year?
  - jacquesm 7y ago
    Seems like a small price to pay.
  - baq 7y ago
    from a high risk country, yes. from a low risk country, test every single arrival.

Gatsky 7y ago

Well satire is a bit strong. But I think the plan seems unwise, due to unvalidated assumptions (especially that immunity will last during a second wave) and the nature of their health system. If an effective treatment emerges, they will also have made a mistake.

adrianhel 7y ago

Take action now.

GrantZvolsky 7y ago

To say the government opted 'to encourage the flames' is disingenuous. Presumably their statistical model indicated they won't be able to contain the spread which is why the current stated aim is to delay the spread[0]. Delay, not encourage. The article's suggestions seem to be in line with the government's stance. The main difference is timing with Dr William Hanage saying measures should have been adopted weeks ago while the government claims their modelling tells them to adopt measures later. The government should be challenged by questioning whether it truly is/was impossible to contain the epidemic and what the best time to introduce different measures is. This article, however, adds very little to that debate with hand-waving in place of evidence. [0]: https://www.gov.uk/government/news/covid-19-government-announces-moving-out-of-contain-phase-and-into-delay https://www.gov.uk/government/news/covid-19-government-annou...

tigershark 7y ago
It’s not true, Italy had exactly the same deaths per day two weeks ago. They introduced the complete lockdown what will be tomorrow. They had 2 weeks of advantage compared to Italy, they already knew what the future was going to look like, and they squandered it all without doing anything. Now uk is going to be in a much worse situation compared to Italy because of this. Just one day of delay in an exponential curve can mean possibly tens of thousands death. Here we are speaking about weeks or months of delay if they really want to infect 60% of the people. The nazis probably caused less deaths in concentration camps than boris, but we’ll know for sure in a couple of months.
- fridek 7y ago
  Holocaust involved death of 1-11 million people (depending on sources and who you want to count). Not a fan of government's current approach, but Boris shouldn't grow a pencil moustache just yet.
rawTruthHurts 7y ago
I hope the number of available hospital beds in the UK matches their statistics model.
7y ago

adrianhel 7y ago

In Norway we just slipped from the 2nd most infected per capita to the 3rd after government warnings. If your country has >= 1 infected, you should follow the advice at fhi.no/en.

dirtydroog 7y ago
"This page isn't feeling well" (LOL in Norwegian)

lightgreen 7y ago

This article is "fake news" and FUD. Quoting the article: > The UK should not be trying to create herd immunity, that will take care of itself. That's a clear blatant lie. UK is NOT trying to create a herd immunity. UK is trying to flatten the curve. And UK is admitting that 60% population will get invected. And then the UK will get herd immunity. For example, it is explained (again) in this video: https://www.youtube.com/watch?v=2XRc389TvG8 https://www.youtube.com/watch?v=2XRc389TvG8 Feel free to downvote, that's a popular sport here on HN.

DanBC 7y ago
You keep saying the aim isn't to create herd immunity, but that was the way the government introduced the delay phase. They've pulled back a bit from it because they've seen the vehement public reaction to it. Cummings may well be evil, but he's not stupid.
- lightgreen 7y ago
  > They've pulled back a bit from it because they've seen the vehement public reaction to it. They did not. I watched an hour long full press conference by PM and two adisors. https://www.youtube.com/watch?v=xRadMzCKnCU https://www.youtube.com/watch?v=xRadMzCKnCU I also watched an hour long Chris Witty Q&A for MP following day. https://www.youtube.com/watch?v=IfJcwDaZrsA https://www.youtube.com/watch?v=IfJcwDaZrsA Both of these talks were about flattening the curve because of NHS capacity etc etc. The scientists mentioned herd immunity couple times, but not like they are intentionally trying to create it. It was rather like: herd immunity will happen in several months. > Cummings may well be evil, but he's not stupid. Likely he got his information from dishonest journalist articles and started self-promotion. But it's a shame that smart people on HN continue to retransmit this fake.
  - tigershark 7y ago
    Maybe you were quite distracted while watching it. As far as I remember the only advice they gave during that press conference was to stay at home for 7 days only if you have a cough. Does it look like flattening the curve to you? To me it looks like “let’s increase the contagion and the deaths as much as possible” compared to what every other country was doing at the time.

YeGoblynQueenne 7y ago

It's interesting to contrast the UK approach to -everyone else's approach. Everyone else is asking _infected_ people to do the socially responsible thing and self-isolate to protect those around them. The UK is asking (or will be asking) the _vulnerable_ people to self-isolate to protect themselves. It is very hard to avoid thinking of it this way but: what happens if a vulnerable person fails to isolate, for whatever reason (stupidity, ignorance, accident, etc)? Is the blame on them? They were told to protect themselves and they failed, so it's their fault? if I think of it this way it very much sounds like the UK government is planning to just er, wash its hands of vulnerable people and refuse to take any responsibility for their fate.