3 ms·

This article is confusing. It starts off by saying this is an analysis of "best" and "worst" case scenarios for continued growth in cases, but later it says: >

This article is confusing. It starts off by saying this is an analysis of "best" and "worst" case scenarios for continued growth in cases, but later it says: > HSJ understands that the briefing was part of an attempt to get senior clinical leaders to focus on what they would have to do, if current growth trends were not surpressed by the tighter lockdown. So, er, what if the growth trends are suppressed by the tighter lockdown, as seems likely? Will things then be better than the "best" case scenario? It sounds like there's a bit of misreporting going on here. The leaked document forecasts demand based on pre-lockdown trends, to highlight the significant risks. But the article is reporting it as if running of beds is totally guaranteed in all circumstances, which doesn't appear to be the case, if the lockdown works.

regularfry 6y ago
The hospitalisation curve for the next fortnight is largely locked in by what was happening before lockdown started. If lockdown has a positive effect, it'll be visible in the hospitalisation stats after 12 days or so.
flukus 6y ago
> So, er, what if the growth trends are suppressed by the tighter lockdown, as seems likely? Will things then be better than the "best" case scenario? There's two lag factors to consider. The first is the lag between restrictions and cases dropping, this takes a couple of weeks and cases and the growth isn't likely to even slow for 1 week. The second is the lag between infections and people getting seriously sick and needing hospitalization, that takes 3-4 weeks. There's also the serious possibility that the restrictions arn't strict enough to make a big difference. This scenario is basically baked in, avoiding it required action weeks earlier.
- andy_ppp 6y ago
  Or because of the incompetence of those in charge people just don’t take the lockdown seriously...
  - Blahah 6y ago
    Nobody is in charge of people's perspectives. The UK has really gone all in on psychosocial nudge tactics in this pandemic, and it has massively failed so far. Arguably, they've done so because they knew the population were so belligerent and arrogantly ignorant that a more direct approach would definitely fail. They have leveraged the 'new variant' to implement at the last moment the measures that were being recommended for months by all their expert committees. People here don't want to be told what to do and there are very well organised efforts to encourage people to feel empowered in their ignorance and irresponsibility. The 'people in charge' aren't the only ones to blame for that.
simonh 6y ago
I would expect that if growth trends are suppressed by the tighter lockdown, that would be the best case scenario. That’s not the most likely scenario though, and you need to prepare for the worst case scenario. So that’s what clinical leaders need to focus on, right?
rossdavidh 6y ago
I agree that the "best case" scenario should probably involve some impact from the lockdown (after a delay), but given the experience in California (which was that the lockdown didn't slow things down much, if at all), it seems at least plausible to look at what happens if the same is true in the U.K.
- toyg 6y ago
  Big lockdowns last year definitely made an impact in England and Italy. I expect it will be the same now. What failed here in UK was the regional approach, the continuous attempts at unfounded optimism, and the attitude that covid-related rules were just another game to play and cheat at (like a minster saying that a scotch egg is “a substantial meal” which can justify going to the pub...). The population doesn’t take the message seriously unless the gravity of the situation is stressed and the necessary plans are clear, simple, consistent throughout, and ruthlessly enforced. When most of that happened, lockdowns worked.
  - Taurenking 6y ago
    They made so much of an impact that we're still battling with the virus 8 months later
    - toyg 6y ago
      The critical issue is to ensure the health system is not overwhelmed, and that was achieved. Prolonging the agony is actually a result of unwillingness to extend hard lockdowns for 4+ straight months over whole countries - we keep lowering restrictions as soon as possible. But sure, things might have definitely been faster if only we just let more people die.
    - ben_w 6y ago
      I’m not an epidemiologist, so I’m going out on a limb with this, but: Looking at the infection rate curve, I think the lockdown was working right up until the more-infectious strain took over. (“People tested positive” graph: https://coronavirus.data.gov.uk/ https://coronavirus.data.gov.uk/)
tomatocracy 6y ago
It's not immediately obvious from any reporting but the "rules" in London haven't actually changed significantly since the 20th December (schools did not reopen as planned but they'd been closed since before then anyway for the Christmas break). The only meaningful change in the past couple of days is the "takeaway pint" ban (which is unlikely to make any difference and is purely symbolic).

regularfry 6y ago

The hospitalisation curve for the next fortnight is largely locked in by what was happening before lockdown started. If lockdown has a positive effect, it'll be visible in the hospitalisation stats after 12 days or so.

flukus 6y ago

> So, er, what if the growth trends are suppressed by the tighter lockdown, as seems likely? Will things then be better than the "best" case scenario? There's two lag factors to consider. The first is the lag between restrictions and cases dropping, this takes a couple of weeks and cases and the growth isn't likely to even slow for 1 week. The second is the lag between infections and people getting seriously sick and needing hospitalization, that takes 3-4 weeks. There's also the serious possibility that the restrictions arn't strict enough to make a big difference. This scenario is basically baked in, avoiding it required action weeks earlier.

andy_ppp 6y ago
Or because of the incompetence of those in charge people just don’t take the lockdown seriously...
- Blahah 6y ago
  Nobody is in charge of people's perspectives. The UK has really gone all in on psychosocial nudge tactics in this pandemic, and it has massively failed so far. Arguably, they've done so because they knew the population were so belligerent and arrogantly ignorant that a more direct approach would definitely fail. They have leveraged the 'new variant' to implement at the last moment the measures that were being recommended for months by all their expert committees. People here don't want to be told what to do and there are very well organised efforts to encourage people to feel empowered in their ignorance and irresponsibility. The 'people in charge' aren't the only ones to blame for that.

simonh 6y ago

I would expect that if growth trends are suppressed by the tighter lockdown, that would be the best case scenario. That’s not the most likely scenario though, and you need to prepare for the worst case scenario. So that’s what clinical leaders need to focus on, right?

rossdavidh 6y ago

I agree that the "best case" scenario should probably involve some impact from the lockdown (after a delay), but given the experience in California (which was that the lockdown didn't slow things down much, if at all), it seems at least plausible to look at what happens if the same is true in the U.K.

toyg 6y ago
Big lockdowns last year definitely made an impact in England and Italy. I expect it will be the same now. What failed here in UK was the regional approach, the continuous attempts at unfounded optimism, and the attitude that covid-related rules were just another game to play and cheat at (like a minster saying that a scotch egg is “a substantial meal” which can justify going to the pub...). The population doesn’t take the message seriously unless the gravity of the situation is stressed and the necessary plans are clear, simple, consistent throughout, and ruthlessly enforced. When most of that happened, lockdowns worked.
- Taurenking 6y ago
  They made so much of an impact that we're still battling with the virus 8 months later
  - toyg 6y ago
    The critical issue is to ensure the health system is not overwhelmed, and that was achieved. Prolonging the agony is actually a result of unwillingness to extend hard lockdowns for 4+ straight months over whole countries - we keep lowering restrictions as soon as possible. But sure, things might have definitely been faster if only we just let more people die.
  - ben_w 6y ago
    I’m not an epidemiologist, so I’m going out on a limb with this, but: Looking at the infection rate curve, I think the lockdown was working right up until the more-infectious strain took over. (“People tested positive” graph: https://coronavirus.data.gov.uk/ https://coronavirus.data.gov.uk/)

tomatocracy 6y ago

It's not immediately obvious from any reporting but the "rules" in London haven't actually changed significantly since the 20th December (schools did not reopen as planned but they'd been closed since before then anyway for the Christmas break). The only meaningful change in the past couple of days is the "takeaway pint" ban (which is unlikely to make any difference and is purely symbolic).