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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. A

by 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.
- m0zg 7y ago
  #2: we'll see about that; the UK is betting that China's strategy, even if it could be applied in the West (which it can't be) will be ineffective in the medium to long term #3: there is: if 60-70 percent of people are equipped to kill the virus, it's the best "quarantine" imaginable for people who are at risk #4: those who have comorbidities could also self-isolate; it's still much better than telling _everyone_ to self-isolate - that's simply not going to happen unless you weld people's doors shut
  - threeseed 7y ago
    China's strategy is largely what is being adopted in Europe and Australia/NZ. And as we've seen in Italy it's absolutely possible to have everyone self-isolate. You just police it.
    - m0zg 7y ago
      Italy is _way_ not out of the woods yet. Their case growth remains exponential. It's too early to tell if their strategy is working at all. Germany is already planning for herd immunity scenario (as per Merkel - she expects 60-70% of Germany's population will be infected, and hundreds of thousands will die). In fact I don't see any difference in the rate of doubling between Italy (which is imposing hardcore containment measures) and the UK where the measures are much less severe. Although I'm sure Italians feel like they're "doing something" and "in control" of the situation, so it should be psychologically easier. But that's not the reality I see in the graphs.
Taek 7y ago
The situation today is: + treatment plans not well understood, but evolving rapidly + not enough face masks + not enough sanitizer + not enough test kits to identify and isolate outbreaks All four of those elements are absolutely critical to controlling the virus, and all 4 will be in a much better place 30-60 days from now than they are today. If you want to go the route of herd immunity, do so when you are at appropriate levels of preparedness.
tzmudzin 7y ago
> 1. You can't shut down the economy indefinitely. At least not if your goal is to minimize fatalities. It's not a binary choice between life as normal and total shutdown. The whole discussion is about reducing non-essentials to slow down the spread, so the health system can cope with the demand spread over time. > 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". Again, not a binary situation. Given the degree of individualism and freedom, that's unlikely to work anyway. > 3. Vaccine is over a year out in the best case, assuming it works at all. Agreed > If it's anything like the flu vaccine, chances of it working reliably on mutated strains are approximately nil. While this is likely -- I'm not an expert, so I'd rather refrain from such categorical statements. > 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. False dichotomy -- younger people can still be better protected by reducing non-essential contacts. > 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. That's right, but counting primarily on herd immunity while neglecting other measures does NOT minimize deaths.
- PuffinBlue 7y ago
  > while neglecting other measures Neglecting what? There's widespread information in the UK concerning symptoms and self-isolation, huge changes in working patterns and people undertaking their own 'social-distancing'. Information on hand washing is pretty much universally understood and huge numbers of events have been postponed or cancelled. Ordinary citizens, businesses and events are undertaking huge changes. Sports, music and other events are postponed or cancelled for example, and a large percentage of people are looking to work from home. I have a wide network of friends/former colleagues as a by product of work/charity/previous careers/family spread across a huge swathe of jobs/life in the UK. Massive amount of planning and preparation is taking place and there are huge changes to peoples everyday lives. Just because a Government hasn't mandated a lock down doesn't mean nothing is happening or people are walking around licking handrails on public transport because there is no threat.
mmsimanga 7y ago
From an African perspective a lot of what you say makes sense. Many people live hand to mouth. We have high unemployment and good number of our population just do not have the money to buy supplies for the month and stay away from work. South Africa has taken some initiatives to limit the spread of the disease but not much in terms of concrete plans coming from sub Saharan Africa.
- m0zg 7y ago
  This simple fact has low penetration into the HN well-to-do bubble. A lot of people here could just stop working for six months or more and assuming that people outside the bubble continue to come to work to stock the grocery store shelves (and make the stuff that's on the shelves), they'd be just fine. The vast majority of the population has to work to make that happen though, and you can't stop it all every time someone in China eats something they probably shouldn't have.

by m0zg 7y ago

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.
m0zg 7y ago
#2: we'll see about that; the UK is betting that China's strategy, even if it could be applied in the West (which it can't be) will be ineffective in the medium to long term #3: there is: if 60-70 percent of people are equipped to kill the virus, it's the best "quarantine" imaginable for people who are at risk #4: those who have comorbidities could also self-isolate; it's still much better than telling _everyone_ to self-isolate - that's simply not going to happen unless you weld people's doors shut
- threeseed 7y ago
  China's strategy is largely what is being adopted in Europe and Australia/NZ. And as we've seen in Italy it's absolutely possible to have everyone self-isolate. You just police it.
  - m0zg 7y ago
    Italy is _way_ not out of the woods yet. Their case growth remains exponential. It's too early to tell if their strategy is working at all. Germany is already planning for herd immunity scenario (as per Merkel - she expects 60-70% of Germany's population will be infected, and hundreds of thousands will die). In fact I don't see any difference in the rate of doubling between Italy (which is imposing hardcore containment measures) and the UK where the measures are much less severe. Although I'm sure Italians feel like they're "doing something" and "in control" of the situation, so it should be psychologically easier. But that's not the reality I see in the graphs.

Taek 7y ago

The situation today is: + treatment plans not well understood, but evolving rapidly + not enough face masks + not enough sanitizer + not enough test kits to identify and isolate outbreaks All four of those elements are absolutely critical to controlling the virus, and all 4 will be in a much better place 30-60 days from now than they are today. If you want to go the route of herd immunity, do so when you are at appropriate levels of preparedness.

tzmudzin 7y ago

> 1. You can't shut down the economy indefinitely. At least not if your goal is to minimize fatalities. It's not a binary choice between life as normal and total shutdown. The whole discussion is about reducing non-essentials to slow down the spread, so the health system can cope with the demand spread over time. > 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". Again, not a binary situation. Given the degree of individualism and freedom, that's unlikely to work anyway. > 3. Vaccine is over a year out in the best case, assuming it works at all. Agreed > If it's anything like the flu vaccine, chances of it working reliably on mutated strains are approximately nil. While this is likely -- I'm not an expert, so I'd rather refrain from such categorical statements. > 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. False dichotomy -- younger people can still be better protected by reducing non-essential contacts. > 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. That's right, but counting primarily on herd immunity while neglecting other measures does NOT minimize deaths.

PuffinBlue 7y ago
> while neglecting other measures Neglecting what? There's widespread information in the UK concerning symptoms and self-isolation, huge changes in working patterns and people undertaking their own 'social-distancing'. Information on hand washing is pretty much universally understood and huge numbers of events have been postponed or cancelled. Ordinary citizens, businesses and events are undertaking huge changes. Sports, music and other events are postponed or cancelled for example, and a large percentage of people are looking to work from home. I have a wide network of friends/former colleagues as a by product of work/charity/previous careers/family spread across a huge swathe of jobs/life in the UK. Massive amount of planning and preparation is taking place and there are huge changes to peoples everyday lives. Just because a Government hasn't mandated a lock down doesn't mean nothing is happening or people are walking around licking handrails on public transport because there is no threat.

mmsimanga 7y ago

From an African perspective a lot of what you say makes sense. Many people live hand to mouth. We have high unemployment and good number of our population just do not have the money to buy supplies for the month and stay away from work. South Africa has taken some initiatives to limit the spread of the disease but not much in terms of concrete plans coming from sub Saharan Africa.

m0zg 7y ago
This simple fact has low penetration into the HN well-to-do bubble. A lot of people here could just stop working for six months or more and assuming that people outside the bubble continue to come to work to stock the grocery store shelves (and make the stuff that's on the shelves), they'd be just fine. The vast majority of the population has to work to make that happen though, and you can't stop it all every time someone in China eats something they probably shouldn't have.