4 ms·

That was the initial strategy of herd immunity, and everything we learned about this virus vindicated this strategy. But it didn't go well because the vulnerabl

by cm2187 6y ago

That was the initial strategy of herd immunity, and everything we learned about this virus vindicated this strategy. But it didn't go well because the vulnerable population wasn't isolated. My opinion is that it is because instead of passing on the message of what to do to isolate the sick and the elderly, the media were busy trashing "evil Boris" and his herd immunity strategy. And no the lockdown isn't about "lot of people are not willing to take the risk of contracting the virus", it is about keeping the pace of the tiny fraction of infections that go bad to under the capacity of the NHS / ICUs. At least that was the stated goal. It seems now that we have switched to a goal of zero infection (and not sure that it makes sense, given that I hear the WHO now refering to this virus as an "endemic disease").

justin66 6y ago
> That was the initial strategy of herd immunity, and everything we learned about this virus vindicated this strategy. This is just completely wrong. It's a useful exercise to work out how many people would need to die before herd immunity could be achieved. Use mortality numbers based on what we've learned about the virus and estimates of what percentage of the population would need to be infected to achieve herd immunity based on the behavior of any number of other viruses. And that's assuming infection confers immunity with this virus, which we don't know yet.
- cm2187 6y ago
  If you are still questioning whether infection confers immunity, then what other strategy than herd immunity do you suggest? If we don’t develop immunity naturally, there won’t be a vaccine either. Permanent lockdown? As for the death rate, the rate to the non vulnerable population is immaterial. With appropriate isolation we could absolutely achieve herd immunity with minimal losses. Instead we have sent covid infected patients back in nursing homes in both the US and the UK with catastrophic results.
  - justin66 6y ago
    > As for the death rate, the rate to the non vulnerable population is immaterial. The numbers don't look very immaterial to me. [1] Granted there's a weird amount of variance between regions and there's a lot that isn't certain. > If you are still questioning whether infection confers immunity, then what other strategy than herd immunity do you suggest? If we don’t develop immunity naturally, there won’t be a vaccine either. Permanent lockdown? (Let's hope some reasonable amount of immunity is conferred! It seems likely, but I think it's useful to consider the worst case.) I'd be happy with people doing what they ought to be doing anyway: exercising some caution and doing the obvious things to limit the spreading of the bug. I'm in a constant state of amazement at how bad we are at all of this. In the crazy worst case where there isn't much immunity conferred by the infection, we could hopefully rely on Darwin to eventually provide us with a less dangerous version of the virus. [1] https://en.wikipedia.org/wiki/Mortality_due_to_COVID-19#Mortality_by_age https://en.wikipedia.org/wiki/Mortality_due_to_COVID-19#Mort...
    - myk9001 6y ago
      Do you like good news? Then I have good news! You're looking at the numbers for the case fatality rates (CFR). The CFR is not the same as the infection fatality rates (IFR) which represent "the fatality rate in all those with infection: the detected disease (cases) and those with an undetected disease (asymptomatic and not tested group)... The IFR will always be lower than the CFR..."[1] Spanish government ran a seroprevalence study and got the following estimates of COVID-19's IFR[2]: For the age group under 50, the estimated IFR is about 0.003% For the age group 50 - 69 yo, it's 0.04% And for those over 70, it's 4.1% [1] https://en.wikipedia.org/wiki/Case_fatality_rate#Terminology https://en.wikipedia.org/wiki/Case_fatality_rate#Terminology [2] https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/ITCoronavirus.pdf https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/a... Look for the table on page 15
      - justin66 6y ago
        I don't know, an overall IFR of 0.8% is not great news, but thank you for sharing the estimate! (and for reminding me that reading Spanish is not the kind of skill you retain without practicing it every now and then... sigh) Does the document break out IFR-S? Some news came out in recent days indicating IFR-S in the United States was around 1.3%.
cameronbrown 6y ago
My mum works in a care home, and the stories are harrowing. Anecdata leads me to believe they are the worst hit.
- cm2187 6y ago
  I don’t think it is just anecdata. I think in NY care homes represent something like 40% of covid deaths.
TheOtherHobbes 6y ago
Well - "evil Boris" is responsible for one of the highest death rates in the developed world. And media trashing is the correct response when a senior adviser says that it doesn't particularly matter if some pensioners die, and the "herd immunity" strategy makes absolutely no scientific sense, and never did. There is no practical way to "isolate the sick and the elderly" when there are no supplies of PPE or testing kits for care workers. The whole point is that the sick and elderly need care, and when there's a pandemic that care requires extra measures to prevent the spread of infection. In reality the government did the exact opposite - knowingly sending elderly people with Covid infections back to care homes, and then saying "Oh that's nothing to do with us - every move was signed off by a clinician." And that in turn makes even less sense when you realise that tens of millions were spent on Covid-ready Nightingale Hospitals, which were opened to great fanfare - and then literally left empty, while old people were being sent to nursing homes to infect others. Evil, or "simply" stupid and incompetent? It doesn't even matter any more A lot of people are dead for no good reason, and far more are going to die in the UK before this is over.

by cm2187 6y ago

justin66 6y ago

> That was the initial strategy of herd immunity, and everything we learned about this virus vindicated this strategy. This is just completely wrong. It's a useful exercise to work out how many people would need to die before herd immunity could be achieved. Use mortality numbers based on what we've learned about the virus and estimates of what percentage of the population would need to be infected to achieve herd immunity based on the behavior of any number of other viruses. And that's assuming infection confers immunity with this virus, which we don't know yet.

cm2187 6y ago
If you are still questioning whether infection confers immunity, then what other strategy than herd immunity do you suggest? If we don’t develop immunity naturally, there won’t be a vaccine either. Permanent lockdown? As for the death rate, the rate to the non vulnerable population is immaterial. With appropriate isolation we could absolutely achieve herd immunity with minimal losses. Instead we have sent covid infected patients back in nursing homes in both the US and the UK with catastrophic results.
- justin66 6y ago
  > As for the death rate, the rate to the non vulnerable population is immaterial. The numbers don't look very immaterial to me. [1] Granted there's a weird amount of variance between regions and there's a lot that isn't certain. > If you are still questioning whether infection confers immunity, then what other strategy than herd immunity do you suggest? If we don’t develop immunity naturally, there won’t be a vaccine either. Permanent lockdown? (Let's hope some reasonable amount of immunity is conferred! It seems likely, but I think it's useful to consider the worst case.) I'd be happy with people doing what they ought to be doing anyway: exercising some caution and doing the obvious things to limit the spreading of the bug. I'm in a constant state of amazement at how bad we are at all of this. In the crazy worst case where there isn't much immunity conferred by the infection, we could hopefully rely on Darwin to eventually provide us with a less dangerous version of the virus. [1] https://en.wikipedia.org/wiki/Mortality_due_to_COVID-19#Mortality_by_age https://en.wikipedia.org/wiki/Mortality_due_to_COVID-19#Mort...
  - myk9001 6y ago
    Do you like good news? Then I have good news! You're looking at the numbers for the case fatality rates (CFR). The CFR is not the same as the infection fatality rates (IFR) which represent "the fatality rate in all those with infection: the detected disease (cases) and those with an undetected disease (asymptomatic and not tested group)... The IFR will always be lower than the CFR..."[1] Spanish government ran a seroprevalence study and got the following estimates of COVID-19's IFR[2]: For the age group under 50, the estimated IFR is about 0.003% For the age group 50 - 69 yo, it's 0.04% And for those over 70, it's 4.1% [1] https://en.wikipedia.org/wiki/Case_fatality_rate#Terminology https://en.wikipedia.org/wiki/Case_fatality_rate#Terminology [2] https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov-China/documentos/ITCoronavirus.pdf https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/a... Look for the table on page 15
    - justin66 6y ago
      I don't know, an overall IFR of 0.8% is not great news, but thank you for sharing the estimate! (and for reminding me that reading Spanish is not the kind of skill you retain without practicing it every now and then... sigh) Does the document break out IFR-S? Some news came out in recent days indicating IFR-S in the United States was around 1.3%.

cameronbrown 6y ago

My mum works in a care home, and the stories are harrowing. Anecdata leads me to believe they are the worst hit.

cm2187 6y ago
I don’t think it is just anecdata. I think in NY care homes represent something like 40% of covid deaths.

TheOtherHobbes 6y ago

Well - "evil Boris" is responsible for one of the highest death rates in the developed world. And media trashing is the correct response when a senior adviser says that it doesn't particularly matter if some pensioners die, and the "herd immunity" strategy makes absolutely no scientific sense, and never did. There is no practical way to "isolate the sick and the elderly" when there are no supplies of PPE or testing kits for care workers. The whole point is that the sick and elderly need care, and when there's a pandemic that care requires extra measures to prevent the spread of infection. In reality the government did the exact opposite - knowingly sending elderly people with Covid infections back to care homes, and then saying "Oh that's nothing to do with us - every move was signed off by a clinician." And that in turn makes even less sense when you realise that tens of millions were spent on Covid-ready Nightingale Hospitals, which were opened to great fanfare - and then literally left empty, while old people were being sent to nursing homes to infect others. Evil, or "simply" stupid and incompetent? It doesn't even matter any more A lot of people are dead for no good reason, and far more are going to die in the UK before this is over.