
Ask HN: Is UK government insane or genius? - TheAlchemist
While virtually all countries adopt the lockdown strategy to eliminate the virus spread, UK is apparently going on with &#x27;herd immunity&#x27; strategy. It&#x27;s pretty well explained in this tweet:
<a href="https:&#x2F;&#x2F;twitter.com&#x2F;iandonald_psych&#x2F;status&#x2F;1238518371651649538?s=20" rel="nofollow">https:&#x2F;&#x2F;twitter.com&#x2F;iandonald_psych&#x2F;status&#x2F;12385183716516495...</a><p>Basically, the idea is to get the young infected, as the virus seems to be relatively inoffensive for young people, and thus becoming immune. Once the country reach a threshold percentage of immune population, the virus cannot spread effectively anymore, hence protecting the vulnerable ones.<p>My gut feeling is that this is the rational thing to do, however only in theory. In practice, people won&#x27;t be disciplined about isolating vulnerable ones in the first phase, thus leading to disaster.
======
knzhou
Their reasoning is that if the only things you can do are China-style lockdown
or nothing, then the disease will just resume exponentially growing the second
lockdown ends, so it's pointless to do it at all.

While that may be technically right (under some optimistic, unverified
assumptions, e.g. no reinfection), it's a false dichotomy. Singapore, Hong
Kong, and South Korea aren't under lockdown, they're stopping the spread by
just having good testing and case tracking capacity, and good hygiene. And the
longer things go on, the better they're getting at doing that. If things are
getting out of hand, a temporary lockdown is effective (as it was in China),
to get the numbers down while building up this kind of capacity. But lockdown
doesn't have to last forever; China has already lifted restrictions in most
cities.

The UK seems to be ignoring this, and I don't understand why. I suspect the
real logic, as some government officials have outright said, is that a
completely failed response would free up money for the NHS by killing off "bed
blockers".

The social _signalling_ around it is "prudent caution", in the sense that they
are talking slowly and confidently while using big words. This gives some
people the gut feeling that this must be the "rational" thing to do, but it's
just window dressing. The plan is neither prudent nor cautious; it's
recklessly endangering millions of lives. Experts in the UK are horrified;
there's an hours-old petition against this with hundreds of academics already
signed on [0]. The WHO has condemned it, and half the people I know studying
abroad in the UK have fled the country over it.

0:
[http://maths.qmul.ac.uk/~vnicosia/UK_scientists_statement_on...](http://maths.qmul.ac.uk/~vnicosia/UK_scientists_statement_on_coronavirus_measures.pdf)

~~~
rzwitserloot
I haven't checked too closely, but surely the age distribution of conservative
voters is such that if they are so callous as to treat corona as a convenient
boomer remover, they torpedo their own re-election chances.

So, _even if_ you ascribe to the current UK government a conspiracy-esque,
cold as nails approach to just effectively _murder whole boatloads of older
folks_, it doesn't actually make sense: Who would they be so cold as to just
casually acquiesce to a solution that results in a lot of death, but they are
still human enough to care about the country first and are willing to
sacrifice the electoral future of their party?

I'm on 'do not attribute to malice that which can be explained by stupidity',
modifying it slightly to 'incompetence'.

~~~
toyg
Replace “boomer remover” with “working-class-boomer remover” and the strategy
makes more sense.

Personally, I don’t think Johnson and his cronies are deliberately targeting
this or that group. They just _don’t care_. They are scared like everyone
else, and are prioritizing the survival of their immediate circles _and their
social status_ \- i.e. they keep the economy working, keep an appearance of
order, and ensure people they care about are “cocooned”, ready to come out
when the worst is over. _That_ is their priority. Working-class lives are not
priority, that’s all. Health-service capacity woes are relatively unimportant,
because people “who matter” will be prioritized anyway.

If they go to full-lockdown, they risk upsetting the existing social order
(economy tanks even harder, unemployed people start rioting, etc). That is
their worst fear; consider that we’ve had actual riots in London only a few
years ago. Saving a bunch of working-class grandpas is clearly not worth the
risk of upsetting the current social order, from Johnson’s position. He’d
rather have a functioning elite ruling over rubbles, than risk the very own
existence of such elite just to save “nobodies”. Add to it a sprinkle of
academic Strangeloves, and there you are.

------
simonh
I’m going to try and lay out the case in as neutral terms as I can, although
to be clear I think they are probably right. They’re going to take an awful
lot of stick for it though, and indeed already are.

They believe that there are basically two mitigation strategies. One is to
have a very drastic early lockdown that shuts down the virus before it spreads
widely. The problem with that is, once you lift the lockdown it will simply
start all over again. The problem with this is lockdowns are most effective
the first time you do them, and then mostly in the first few weeks of the
lockdown. Do it too early, and yes it will be very effective in the short
term, but later on when cases become much more prevalent the lockdowns will be
less effective.

The option they are going for is to start the lockdown a little later in the
cycle. The hope is this will make the lockdown more effective at a higher
point in the spread. Effectively instead of a series of booms and busts, you
get one longer slower initial burn and then you’re mostly done. They believe
that in the long term this will make it easier to protect those most
vulnerable to the virus, because you only have to do it once, at the cost of
increased prevalence among people least vulnerable to it. So they see it as a
better longer term strategy.

~~~
knzhou
But there's a third strategy that works better than either: don't lockdown,
but do effective testing, case tracking, and treatment, well enough so that
exponential growth can't happen in the first place. That's the policy of Hong
Kong, Taiwan, and Singapore, who are doing great.

~~~
Silhouette
_That 's the policy of Hong Kong, Taiwan, and Singapore, who are doing great._

All of which have tiny populations compared to the UK.

For larger nations, there simply aren't enough tests available, nor enough
treatment facilities for those who are likely to become very sick if the virus
spreads rapidly through the population.

~~~
knzhou
> For larger nations, there simply aren't enough tests available

Why? If your nation is twice as big, then all else equal, your government has
twice as much money, twice as many resources, and hence twice as many tests.
China now has more tests than they need and they're the 2nd most populous
nation in the world.

~~~
Silhouette
No amount of money helps if there aren't enough tests available to buy. What
is missing are manufacturing and distribution facilities, which of course are
calibrated to the normal levels of work and not to a relatively sudden
pandemic outbreak of one particular virus.

China has huge resources but has managed so far to keep the infection mostly
contained to one specific area. It's not clear how long they'll be able to
sustain that or whether they'd have enough resources to go around if all of
China were the same as Hubei.

Of course all of this also assumes that tests are effective and that you can
then do something useful if you confirm that a patient is indeed infected.

------
thom
You can read some of the rationale behind the plan here:

[https://assets.publishing.service.gov.uk/government/uploads/...](https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/215666/dh_125333.pdf)

I'll be honest, I watched the announcement on Friday in open mouthed horror. I
can't claim I have a concrete refutation for either the broad logic or the
specific evidence underlying it, but even the best case scenario is a disaster
of historic proportions. I wish us luck. I wish the rest of the world luck if
it turns out we're right and they're wrong.

~~~
magicsmoke
You could think of this as the advantage of a decentralized world with every
country making decisions and experimenting independently. Maybe the UK's
approach is the right one, maybe it isn't. If it turns out to be more
effective we'll learn something useful for future pandemics. If not then only
the UK goes down the drain and we'll still learn something from it. Best of
luck.

~~~
thom
Well surely the advantage here would be for us to be able to observe and
exploit the hard won knowledge of countries out ahead of us, but that doesn't
appear to be what we're doing.

~~~
magicsmoke
The thing is, what the UK is doing is truely experimental compared to what
China, SK, and Italy have already done. And we won't know for sure what the
full effects are until the end of the current pandemic. If the UK copied the
lockdown and trace playbook already implemented, once this pandemic is over
we'll have no data point for the quarantine old people only strategy to plan
for the next pandemic with. How can you observe whether the UK strategy will
work when nobody's done it before?

------
xadoc
There is no proof immunity will happen, the UK Gov is thinking in economic
terms and worried about GDP.

[https://www.theguardian.com/education/2020/mar/13/coronaviru...](https://www.theguardian.com/education/2020/mar/13/coronavirus-
school-closures-uk-gdp-ministers-warned)

~~~
amiga_500
Exactly. We have huge debts and our "economy" runs on the assumption that, if
very little goes wrong, we might be able to stay afloat.

The time for creating choice on the cornonavirus response was during the last
20 years. They chose rampant financialisation, leveraging future income.

The UK has no energy security. No food security. I feel the corner we have
painted ourselves into makes a prolonged shutdown far, far harder.

~~~
Gormisdomai
Genuinely curious about where you read that the UK has no energy security?
It's not something I've read about before, but is something I'm pretty
invested in as a UK citizen.

The one source I could find was [https://www.globalenergyinstitute.org/energy-
security-risk-i...](https://www.globalenergyinstitute.org/energy-security-
risk-index) which placed the UK in the top 3 countries for energy security
(many years running).

Do let me know if you have some data that would change my mind! (and ditto for
food security)

~~~
amiga_500
I mean to say we are a net importer of energy

[https://www.theguardian.com/money/2019/sep/01/uk-energy-
pric...](https://www.theguardian.com/money/2019/sep/01/uk-energy-price-fears-
as-electricity-imports-climb-to-record-high)

And food

[https://www.businessinsider.com/no-deal-brexit-percentage-
br...](https://www.businessinsider.com/no-deal-brexit-percentage-british-food-
imported-shortages-2019-1)

------
anothermouse
The NHS makes a huge difference. As a single entity it can pivot in a way that
I wonder if other countries can come close to.

My daughters dentist commented yesterday that all her surgeries (and her team
usually do 50 a week) had been cancelled. The reason? All the
anaesthesiologist had been requisitioned as they will be required to do
ventilation. All elective surgeries had been cancelled, and her paeds
specialists sent on refresher courses for adult patients.

We're in uncertain territory here, the NHS's response may not be 100% perfect
and a lot of people will argue that some minutiae could be done better, but I
believe it has the huge advantage.

I wonder if other countries, and particularly the US, can manage such a
coordinated healthcare response?

~~~
ck425
It's definitely at an advantage over systems like the US, but the NHS is far
more federalised under the hood than you might imagine and there are lots of
countries where the government or other regulators can take control of private
healthcare when needed so it's not as much of an advantage as you might think.

------
csomar
Thinking about it from where I am right now, I don't think it is crazy.

Let's think about it again: China, Japan, South Korea, Hong Kong and Taiwan.
They are countries which are very connected to each other; and yet, somehow,
they managed to contain it. It's 'herd responsibility'. The people are
applying social distancing and hygiene rules, that's why it's working.

It's possible, as a knowledgeable politician, that you recognize that it's
_impossible_ to implement such measures in your country. The reasons are
beside the technical abilities of your government: Your citizen are not
committed enough to the hygiene. And that's not because Asians are cleaner or
superior, they have been exposed to these viruses before and thus they are
already trained to deal with them.

It's not the same deal for many countries of the west. We didn't have much
trouble in the last few decades and thus people have forgotten why we do most
of the hygiene measures in the first place.

Also, here is my first reaction, as a citizen, if the government has declared
'herd immunity' as their strategy: STAY AT HOME. I'd also probably warn the
closer one and avoid contact with them too.

So the UK might win twice here: Have enough social distancing by _fear_ (and
fear is a hell of a thing as you experienced in the last few days); and also
have its population adopt strict hygiene and distancing rules making it safer
in the future and readier for the next disease.

~~~
jariel
"that's why it's working"

It's only 'working' while the country is on lockdown, and FYI the country
spirals towards economic meltdown.

If they come out of 'lockdown', then 'it stops working'.

See the paradox here?

I really have no clue: maybe we'll develop therapies, a better understanding,
maybe a vaccine, but possibly this 'herd immunity' idea at least on some
scale. I really don't know.

But coronavirus is not going to disappear in a few weeks, we know that.

~~~
csomar
> It's only 'working' while the country is on lockdown, and FYI the country
> spirals towards economic meltdown.

Nope.

> In Taiwan, most residents carry on as normal, with offices and schools open.
> Many restaurants, gyms, and cafes in the capital, Taipei, are still
> bustling, although most premises will take temperatures and spray hands with
> sanitiser before allowing customers in.

Source: [https://www.theguardian.com/world/2020/mar/13/how-taiwan-
is-...](https://www.theguardian.com/world/2020/mar/13/how-taiwan-is-
containing-coronavirus-despite-diplomatic-isolation-by-china)

~~~
jariel
'Nope'

That Taiwan has 'less lockdown' doesn't respond to the fact that whatever the
degree of 'lockdown' whenever it is removed, the contagion will grow again,
and that any level of lockdown will have bad economic repercussions.

That Taiwan is getting away with 'less severe' lockdown is not relevant
because:

a) They do have a really long list of measures (more than 120 published by
their Gov.) that are unsustainable in the long run and

b) It's a selective example - most other nations need more aggressive.

c) Due to the fragility from 'a' and economic downturn around the world due to
'b' a deep recession is guaranteed in Taiwan.

The point remains: there is currently no rational answer to 'how to end the
lockdown' while economies go down.

------
chippy
[https://twitter.com/AdamJKucharski/status/123882151552689766...](https://twitter.com/AdamJKucharski/status/1238821515526897664)
appears to give a better explanation from the modellers.

The aim is to flatten the curve, any herd immunity is a by-product but not the
aim.

~~~
simonh
I think herd immunity is an integral part of the strategy. If a population
never gets herd immunity, it will keep on getting infection breakouts and keep
on having to impose lockdowns. The only way to stop doing lockdowns is either
to prevent the ingress of the virus, ever, or eventually reach herd immunity.

The virus is everywhere now, it’s part of the landscape, so preventing
breakouts is just flat out not possible, at least for large countries with
lots of travel and especially with large rural hinterlands like the UK. In
this view the only strategies are long term strategies.

There is a way to get herd immunity without an epidemic, and that’s
inoculations. However we do not have a vaccine yet and have no idea if or when
we might ever get one. So you can bet everything on red 13 and cross your
fingers for a vaccine in 6 months, or pick which longer term strategy works
best for your country, with its particular demographics and geography.

~~~
draugadrotten
> However we do not have a vaccine yet and have no idea if or when we might
> ever get one.

[https://www.jpost.com/HEALTH-SCIENCE/Israeli-scientists-
In-t...](https://www.jpost.com/HEALTH-SCIENCE/Israeli-scientists-In-three-
weeks-we-will-have-coronavirus-vaccine-619101)

~~~
MaxBarraclough
No reputable news outlets are reporting a vaccine breakthrough by the 'Galilee
Research Institute'.

Serious estimates are that it will take around 18 months [0]

[0]
[https://www.bbc.co.uk/news/business-51454859](https://www.bbc.co.uk/news/business-51454859)

------
edouard-harris
Here is a rule of thumb that will be familiar to many who manage risk in a
professional capacity:

The time to get creative is when you face a capped downside on the one hand,
and an uncapped upside on the other. The time to get conservative is when you
face the opposite condition.

The reason for this rule is that creative policies almost never work; but when
they work, they have a much higher chance of working extraordinarily well than
conservative policies do.

The UK is facing a capped upside and a huge potential downside. The UK is
choosing to handle this situation with a creative experiment. This experiment
will, in all likelihood, not succeed. And unfortunately most values of "not
succeed", in this context, map to catastrophic outcomes.

Time, as always, will tell.

~~~
lozenge
(warning: conspiracy theory, but at least an original one)

I'm thinking this only makes sense in the context of Brexit. Brexit will be a
massive hit to the competitiveness of British businesses... somebody in
government is hoping to counteract this by taking an approach different to the
rest of Europe. If the UK's approach works, it will end up economically ahead
of all the other European countries, something like the US post-WWII (but to a
lesser extent).

~~~
tenpies
Counter-point: is Brexit Britain actually going to be worst off than post-
pandemic EU or what's left of the EU?

I don't think the risk of this pandemic approach is worthwhile, especially
given how poorly the EU is doing in general. Terrible economy, catastrophic
pandemic response, and the symbolism of countries closing borders on fellow EU
states are all quite telling.

By contrast Britain almost seems like it dodged a bullet - although they seem
to have jumped in front of a train instead with their pandemic gamble.

~~~
brrrrr1
the uk is bust - germany is injecting 600 billion in the economy, while the uk
a mere 30. the uk NEEDS people to work so they keep the country afloat.

~~~
iateanapple
The UK can raise as much cash as Germany so it is a choice they are making.

------
haunter
I like tomp's comment from a few days ago, feels like the UK playing a game
theory
[https://news.ycombinator.com/item?id=22555643](https://news.ycombinator.com/item?id=22555643)

1) no pandemic, no action -> government was "right", avoided wasting money ->
reelected

2) no pandemic, action -> government was "wrong", wasted a lot of money,
damaged the economy, inconvenienced the lives of the population -> voted out

3) pandemic, no action -> government was "wrong", caused loss of lives and
damaged the economy -> voted out

4) pandemic, action - this is the trickiest scenario, so let's consider two
options:

4a) pandemic, action, it works -> government was "right", saved lives, spared
the economy -> reelected

4b) pandemic, action, doesn't work -> government was "wrong", their actions
failed, they're incompetent -> voted out

~~~
mattmanser
This clip of the political sitcom Yes Minister from the 1980s is making the
rounds on our social media, as it explains that thought process succinctly,
and hilariously:

[https://m.youtube.com/watch?v=qNjFIwRYEIo](https://m.youtube.com/watch?v=qNjFIwRYEIo)

~~~
haunter
What's the title of the show? :D

~~~
tmnvix
'Yes Minister'. There is also a follow up series called 'Yes Prime Minister'.
Very funny stuff - especially if you have any insight into the public service
bureaucracy.

------
cirrus-clouds
Here is a discussion on Channel 4 on the approach taken by the UK government.

[https://youtu.be/C98FmoZVbjs?t=590](https://youtu.be/C98FmoZVbjs?t=590)

Debating are:

\- John Edmunds: a professor in the Centre for Mathematical Modelling of
Infectious Diseases, London School of Hygiene & Tropical Medicine

\- Tomas Pueyo: his modelling of the pandemic has gone viral on the web:
[https://medium.com/@tomaspueyo/coronavirus-act-today-or-
peop...](https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-
die-f4d3d9cd99ca)

During the debate, Pueyo throws up his hands in horror at what the professor
says. Listening to them both, I honestly don't know who is right. You may
think a level-headed response is the right approach rather than an emotional
one. But there is something cold, clinical and unemotional about the UK's
strategy to tackle this pandemic.

And can you "nudge" people to adopt certain behaviours in one country when the
rest of the world is doing the opposite to what you advocate?

~~~
ThePhysicist
Wow, Tomas Pueyo is a self proclaimed „growth hacker“ with no experience in
epidemiology. I would prefer to have people weigh in on the issue that
actually have more than two weeks experience in this. Everyone can have good
ideas but giving people like Pueyo a platform for their self marketing must be
an insult for all real experts that work on these issues.

~~~
guitarbill
With statements like "the markets are up", and the hyperbole of "so we're
saying 'we want to kill 200,000 people'" and "killing everybody", which even
the anchor has to reign him in on, Mr Pueyo seems like such a douchebag. he
comes of as incredibly unlikeable (at least to me). especially compared to Mr
Edmunds, who goes through how herd immunity is a good end-game in a measured
and calm manner. to which he seems to offer no counterpoint. they even both
agree on lowering the peak, just not on how to do that/when to do it.

edit: it seems reasonable to me to suggest not impose quarantine measures too
early, to not drag those measures on for longer than necessary - that just
makes it more likely people will disobey it. indeed, because a vaccine is so
far off, herd immunity seems like the only plan for now.

~~~
mirekrusin
Funny thing about this is that they don't disagree on herd immunity. They
argue over optimal rate and tradeoffs (where/when measures slider should be
moved).

In this rare case Pueyo credentials don't matter much as he pretty much echoes
open letter from scientific community coming from Italy.

What is not mentioned is that buying a bit of time also increases a chance for
many people to get treatment that is yet to be discovered/approved.

~~~
guitarbill
absolutely, although it's a balancing act. there's also a mental health
component to isolation/quarantine, and how do you measure that? it's a tough
and complex call in any case, and i'm glad i don't have to make the call.

------
hanoz
I think we (UK) are trying to be too cute about managing the curve, like we
can ramp it up to the capacity line then slam on the brakes with the big
measures at exactly the right time and keep it ticking along there nicely
through the spring and summer and have this thing wrapped up by the end of the
year. It could all go very badly wrong.

I get the impression we're being overly influenced by a few gurus of
behavioral science, a field which must surely make even experimental
psychology look replicationally robust, and in particular by 'nudge theory',
for which our politicians have a particular penchant. I also gather we war-
gamed this exact scenario two years ago, which may have led to a degree of
overconfidence amongst some key players.

~~~
SilkRoadie
I would be on board with the UK plan if it was more proactively protecting the
at risk population.

Why aren’t large events stopped? I get one infected person won’t infect a
whole stadium... the main thing for me is people from all over go to these
large events and so there is a high risk of introducing the virus to new areas
by having them.

There should be more testing and local alerting. It would keep people on their
toes and help individuals be more aware of potential risk around them.

At risk groups should be making use of social distancing at a minimum.

Even with this it seems risky. That said I understand the approach and
reasoning. The implementation - so far - seems half baked and risky as hell.

~~~
lozenge
And now more details of the plan are trickling out - over 70s being advised to
stay at home (but not yet), etc.

At every point people will ask, "if cancelling large events/closing
schools/WFH would have helped, why didn't you announce it weeks ago instead of
now?"

Plus, it isn't as if people are actually keeping calm and carrying on. Their
shopping has been disrupted, half their friends are staying home (despite no
government advice to do so), they can't visit their doctors in person any
more, and everybody is stuck to the news. Productivity in offices has dropped
due to the anxiety and uncertainty, and I don't think Boris' "life goes on as
normal for now but that may change later" speech late Friday has done anything
to prevent that.

------
fabian2k
My intuition on this is that any strategy that relies on rather precise
targets to hit in terms of infection rates is doomed to fail. There is simply
far too much uncertainty about the exact properties of the virus, the
behaviour of the community and the effectiveness of the various measures that
are employed to try to contain or mitigate the pandemic.

The incubation period is something like 5-6 days on average, it'll probably
take at least another day, likely more to get test results. So you're always
at least a week behind when you're trying to examine the results of your
actions, and the pandemic spreads at an exponential rate if no containment or
mitigation measures are preventing it. If you get this kind of strategy wrong,
at the point where you're noticing it you will have doomed your healthcare
system and your population.

It is the nature of exponential spread that you will have to act before it is
obvious, and that if you don't do that it'll be far too late once you notice
that.

------
beaunative
It looks like to me just a comfort pill for the public. They basically
acknowledged that they can't handle the crisis already. So what they gonna do?
They want it to appear to be an advice from expert, to persuade the public,
rationalize a forced decision.

The uncomfortable truth is, the British government have weighted cost and
benefit, and they have decided, the death of thousands or more is not worth
the cost of near-absolute lockdown of a country, It might lead to total
breakdown of the economy, full-recession, and that may cost more lives anyway.
These elder people are old enough anyway, and the death rate for young is just
0.2%. (which rise to 1.3% for people elder than 50, and 6% for elder than 60
according to data from China)

What does those number mean? If you and your partner's parents are elder than
60 years old, there is 25% chance, at least one of them will die. That is,
very likely, you're going to hear it from your best friends that one of their
parents died from COVID-19. Are you okay with that? (Under the assumption
everyone will get infected anyway). And beware, these statistics are not
final, and mostly from patients who received some level of medical care,
although we do not yet know how many of those heavily-ill patients received
intense care. Without medical care, the number could easily double, after all,
it takes time to die, that's just how lung disease works.

~~~
Animats
_The uncomfortable truth is, the British government have weighted cost and
benefit, and they have decided, the death of thousands or more is not worth
the cost of near-absolute lockdown of a country, It might lead to total
breakdown of the economy, full-recession, and that may cost more lives
anyway._

And so begins the Great Reaping. Get rid of the old and the sick, so the
nation can move on, freed of the burden of caring for an elderly population
that consumes but does not produce.

~~~
bryanrasmussen
isn't the current government disproportionately voted in by the old? It seems
somehow short-sighted this.

~~~
lotsofpulp
They will be replaced by the next set of old. A population can always be
segmented, they might just not be as old as before.

------
ubercow13
Modelling disease spread seems like the kind of scientific endeavour that one
can dedicate one's whole life to becoming an expert in, and many people
presumably do. Considering that, why should anyone give much credence to a
random medium article on the topic by a 'silicon valley tech executive'? (lol)

There are 10's of thousands of scientific research papers [1], by scientists,
on COVID-19 already, and this guy is just some tech exec who knows how to play
with a jupyter notebook. I see no reason to pay much attention to him.

[1]
[https://twitter.com/freereadorg/status/1236104420217286658](https://twitter.com/freereadorg/status/1236104420217286658)

~~~
knzhou
Because the models the government's epidemiologists are using _explicitly_
don't account for all possible actions.

Back when this was taking off in China, a bunch of epidemiologists came out
and said it was completely uncontrollable there. They were wrong, because they
hadn't accounted for the extreme actions the Chinese government was willing to
take; it was not even a possibility in the models. The same story repeated
itself for Hong Kong, Taiwan, Singapore, and South Korea. They defeated the
models by taking effective actions that were "out of the training data" for
epidemiology. Given these 5 examples, there's no reason other countries can't
defeat the models too.

~~~
joe463369
These may be legitimate criticisms of the UK government's epidemiologists -
I'm not in a position to judge - but I'm not sure it explains why we should be
listening to Tomas Pueyo on the matter.

~~~
knzhou
Well, you don't have to. There are plenty of actual epidemiologists unhappy
with the government's actions. Just because Pueyo was arbitrarily chosen to
represent one side doesn't mean professional support for that side doesn't
exist.

Honestly, choosing a bad representative for a position is a classic media
tactic for unfairly discrediting that position.

------
tuna-piano
I don't understand how Europe+US governments (and epidemiologists!) say things
like "It's basically inevitable that 40-70% of our population gets infected
overtime". It feels like the Western countries gave up without even trying.

But yet, there's at least temporary evidence among several Asian countries
(South Korea, China, Singapore, Taiwan, Hong Kong) that it's possible to get
the R0 < 1, the infection rates to shrink, and seemingly be well contained
well before any herd immunity effects happen.

In the US we spent only $7B to fight the virus but yet hundreds of billions to
manage the economic impact. And yet, our companies/people will still suffer
economically and humanitarily.

In an ideal situation, in ~8 weeks, Italy/US/Europe will only have dozens of
new cases per day and will try extremely hard to contain these limited new
cases and their spread. The only difference between Early Feb and Early May in
these places will be that we had 3 months of potentially avoidable economic
and humanitarian destruction- just to teach us the problem was serious and
give us time to prepare systems to contain.

If the successful Asian countries (specifically Taiwan, Singapore, Hong Kong,
but also South Korea) show that this was possible to keep small, the voters in
the Western countries should demand accountability from their scientists and
government leaders.

~~~
rusk
The voters have the leaders they deserve

------
paultopia
Insane. Here's the key line, from one of the people in charge of that clown
car:

"There’s going to be a point, assuming the epidemic flows and grows, as we
think it probably will do, where you’ll want to cocoon, you’ll want to protect
those at-risk groups so that they basically don’t catch the disease and by the
time they come out of their cocooning, herd immunity’s been achieved in the
rest of the population."[1]

Here's the thing about this: it's plainly moronic. Because this strategy only
works if they can _identify the point in question._ And there's no universe in
which a government can identify that point under incomplete information and
exponential growth. It's the sort of thing that only a psychologist who has
spent too much time hanging out with Cass Sunstein and other believers in the
omnipotence of the administrative state could possibly come up with.

[1] Quoting a psychologist in charge of something called the "behavioral
insights team" in [https://www.theguardian.com/world/2020/mar/13/herd-
immunity-...](https://www.theguardian.com/world/2020/mar/13/herd-immunity-
will-the-uks-coronavirus-strategy-work)

~~~
tonyedgecombe
_Because this strategy only works if they can identify the point in question._

Why wouldn't they, they know the rate of new cases. When it's low enough they
lift the quarantine. Out of all the problems this seems the smallest to me.

~~~
paultopia
They don't know the rate of new cases. They know the rate of observed new
cases. They don't also know the innumerable little connections that are hard
to lock down across and within age groups.

This is the sort of thing that confounds centralized state policy. Read, among
other things, James C. Scott's _Seeing Like a State_

~~~
tonyedgecombe
Then start testing people from the population to see who has had it and who is
currently infected.

 _This is the sort of thing that confounds centralized state policy._

The UK isn't America.

------
mnl
I'm pretty confident they'll start copying everyone else in 10-14 days.

They are ignoring any sensible model of this and they won't be able to deal
with the uproar once the numbers reach a psychological threshold. Happened
last Sunday in Spain BTW.

~~~
alkonaut
Doing what someone else does, but a week later doesn't necesarily mean you
made a mistake, or that you are a week late in making a decision.

~~~
mnl
I think it does, you don't wait a week to put out a fire, it gets worse. China
has essentially contained it already. Maybe alternating lockdowns and releases
we might be able to keep it manageable until there's a vaccine.

This is not hard to model once there are a few cases in a population, again
IMO.

~~~
mattmanser
How much does every day in lockdown hurt the economy?

Flattening out the infection curve too much means increasing the economic harm
by a much larger degree.

Calling a lockdown a week too early, means continuing it a week extra on the
other end or you risk a sudden, unmanageable peak.

I don't envy any politician the decision, but pandering to panic and locking
down too soon will cause a lot of harm too.

~~~
mnl
I'm somewhat puzzled about this doomed economy idea. Many businesses are
doomed of course, but some opportunities arise: economy changes, it adapts to
the environment. We've been building the perfect tool for this scenario during
the last 25 years, if we manage to sustain the logistics the economy won't
stop. Had this happened in the early 90s we'd have been in deep trouble.

~~~
mattmanser
Reduced spending on leisure, tourism, travel, etc, less decisions made because
no meetings, etc., will MASSIVELY outweigh any opportunities.

Even putting aside the sick leave, which will happen either way.

------
pedro1976
The other countries are going for herd immunity too. The goal of all lock-
downs and red zones is just to prevent the health system from collapsing.

~~~
patrec
Merkel apparently is trying to (or tried to), but was more coy about it. But
none of the technocratic Asian governments seem to.

------
andy_ppp
Okay so here is my dispassionate take on it.

1) everyone (>= 60% of population) will get it

2) the modelling that’s been done by the British government is probably very
good and almost certainly includes more variables than the shut it all down
countries

3) we don’t know enough about how the virus operates but we might know enough
by the time peak cases occurs in the UK

4) It’s very likely to come back in China et al, they think in the Far East
it’s under control but it only takes one person arriving in Beijing to
reignite the problem and you’re back to square one

5) they are trying to limit peak deaths including a lot of factors I have to
assume that is their strategy

6) do you go with the models that give you a way to return to some normality
sooner?

7) what is the best case outcome according to the best scientific models we
can get? It’s very easy to just do what everyone else is doing without
thinking through the best path.

8) I actually trust the people thinking about this issue, I know it’s hard to
believe but I do think the UK government is going with a view that there are
more factors than are immediately apparent in this equation.

9) will the UK turn out to be right that stopping this permanently will
involve herd immunity. Unfortunately the American/Italian/Western society
situation means stopping this virus will be impossible so you then start
calculating if you want international travel to continue how can we keep our
societies interconnected?

My guess is based on a lack of information and a load of assumptions about
this, but I think it’ll prove to be the right decision medium term. We are
going to be in this thing for some time, some countries much longer than
others.

------
fiftyacorn
I strongly disagree with the approach in the UK. We should be following the
WHO guidelines and the rest of Europe

It feels like we're the big version of one of those corona-virus cruise ships

------
ChainsawTom
The government isn't going with a herd immunity strategy. It's waiting for the
most impactful time to lockdown.

~~~
CaptArmchair
The primary reason why other countries go into a lockdown is to prevent their
strained healthcare systems from collapsing.

It's not just sick people who can't get a hospital bed. It's everyone else
too. People who get heart attacks, strokes, accidents, other illnesses,...

A lock down is NOT meant to stop the virus in its tracks. It's meant to slow
the infection rate and avoid hospitals and health care centers from getting
swamped.

Any chart about China and Italy published thus far shows how the infection
rate thus far grows exponentially. As such, the most impactful time to perform
a lock down isn't next week or in 10 days. It is NOW.

The "herd immunity" strategy isn't a strategy. By the time this is over, the
population will have achieved "herd immunity" regardless of how this will have
played out. What matters is where we would like society to end up 6 months
down the line: a relatively preserved, functional society with low mortality;
or a dysfunctional one where likely anyone of this forum will have lost loved
ones.

~~~
viraptor
This is not updated for March, but here's a chart that disagrees. China's new
cases started dropping after the lockdown:
[https://miro.medium.com/max/9350/1*r-ddYhoUtP_se6x-NOEinA.pn...](https://miro.medium.com/max/9350/1*r-ddYhoUtP_se6x-NOEinA.png)

From [https://medium.com/@tomaspueyo/coronavirus-act-today-or-
peop...](https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-
die-f4d3d9cd99ca)

~~~
CaptArmchair
I think the core message of Tomas Pueyo's blog post is sound, but he
undermines it completely with the number juggling.

He's not a specialist. He's not an expert. This is an entrepreneur who knows
how to create viral content. His previous blogpost was "How to deliver a funny
speech".

So, I wouldn't accept the details, the number or the graphs he has cobbled
together at face value. This is true for pretty much anything that is
published on medium.com and doesn't come from a sources verified by experts or
officials.

While people are slightly optimistic about China and South-Korea, I think it's
far too soon to try and make any detailed forecasts on how the next few weeks
will pan out. We simply don't know enough yet. All we know is that this is an
infectious disease spreading at a lightning speed. Stay home, and adhere to
WHO and health administration protocols. That's all there is to do right now.
Anything else is conjecture until this has played out completely in a few
weeks time.

------
jrandm
Here is a link to the Coronavirus Action Plan on GOV.UK:
[https://www.gov.uk/government/publications/coronavirus-
actio...](https://www.gov.uk/government/publications/coronavirus-action-
plan/coronavirus-action-plan-a-guide-to-what-you-can-expect-across-the-uk)

I would suggest anyone read this and other official publications before any
Twitter thread to understand the UK government's approach to the virus. Large,
complex decisions are hopefully not made off of a few hundred word summary of
the situation.

~~~
simonw
That document says "Published 3 March 2020" \- do you know if it still
reflects current government thinking?

~~~
jrandm
It is still linked on all of the relevant sites.
[https://www.gov.uk/guidance/coronavirus-
covid-19-information...](https://www.gov.uk/guidance/coronavirus-
covid-19-information-for-the-public) is a page with more frequent updates.

Specific local health authorities probably have the most up-to-date
information for any given geographic area.

------
stefano
One region of Italy is close to their ICU beds limit, despite a full lockdown.
And they have more beds per person than the UK. Without a full lockdown, won't
they run out of beds very quickly, thus increasing the death rate a lot?

~~~
vanniv
The average age of a fatal case is still north on 80 years.

The UK plan is effectively to get as many people as possible that are young,
and thus at a super low risk of needing hospitalization to get infected, so
that they can recover and then be immune, thus making it hard for the virus to
sweep through again. If 30% or more of the population were immune, it would be
much harder to get a new outbreak started. With a lockdown, either the
lockdown suppresses spread, in which case ending the lockdown risks re-
igniting the epidemic, or it doesn't, in which case it didn't help materially
anyway.

If the UK can get 10x or more of the cases with only the same hospitalization
numbers, they'll be in better shape than everywhere else.

The core question ends up being whether they're able to effectively inoculate
that many young people without it spreading to just everybody.

Flattening the curve preserves medical capacity somewhat, but it also prolongs
the epidemic. And since the lockdowns required to do the flattening have their
own cost on lives, it's unclear whether the incremental increase in the number
of lives that the medical system can preserve will or will not exceed the
number of other lives caught short because the disease and also the lockdowns
are extended by the extra time.

You might not be saving lives, just changing which people die.

Or you might save some, or you might lose more. Counting in advance is...
let's say nontrivial. Even counting afterward will be hard and full of wide
error bars.

It's relatively easy to count how many died directly from an illness,
difficult to count how many will die because they delayed necessary non-
emergency care for 4 months (unrelated to the virus except for the need to
preserve hospital capacity or avoid infection risk) instead of 2 months
because the outbreak was prolonged, and virtually impossible to count how many
die from things like "I lost my job and my life savings at the same time, and
I never fully recovered, and now my whole family is much poorer, which gives
us higher all-cause mortality"

Everybody's talking about the first group. Occasionally, I see people admit
that the second might exist and be non-empty. But, I keep feeling like I'm the
only person on HN (and in my regular life) reminding people that the economy
actually affects real life in major ways. (I'm probably not the only one, but
still...)

~~~
greedo
Are we sure that you're immune once you've been infected?

~~~
fspeech
We only know that you are likely to be immune for six month. Whether you will
have life time immunity is anyone’s guess.

~~~
emkemp
Citation needed.

------
throwaway936482
This strategy is not insane only if there is also a concerted effort to
protect those who are vulnerable while the virus spreads. The problem is there
isn't one. At all. None. Zip. Zero. Some care homes are, off their own back,
banning visitors but apart from that the old and the vulnerable are not being
asked to self isolate or engage in social distancing, only those who have
symptoms themselves are being told to self isolate, and not members of their
households. Social clubs, churches, pubs, cafes, day centres, restaurants etc.
where a lot of older people congregate are all still open. None essential home
visits have not been curtailed and people are not being advised to socially
distance themselves from the vulnerable.

~~~
aberoham
^^^ 2000% this, a large proportion can't change their ways, is not paying
attention or simply doesn't care. It's shocking to still tonight walk past a
packed pub on a Saturday night

~~~
arcticbull
Personally, I'm 30, have no contact with folks over 65, have no co-morbid
conditions and so I have no reason to keep away from folks. I'm at zero risk.
In fact if I get it now and develop an immunity, all the better. I have to
assume the same is true of the folks at the pub -- otherwise it's them who are
being irresponsible, not me.

~~~
hellofunk
I’ve seen this attitude quite a lot among younger people lately, it’s just
super irresponsible and arrogant. In a situation like this, the responsibility
must be shared, no one should consider themselves free from the
responsibilities of stopping the spread this virus.

~~~
tomp
> In a situation like this, the responsibility must be shared

Why not in other situations though? The elites avoid taxes, Boomers have
houses, banks are pumping up the asset bubble, while young people have student
debt, can't buy a place to live (or even a car), have no assets and, if
they're lucky and productive and high-earners, they "enjoy" 20% higher tax
rate than owners of capital... Why exactly should _anyone_ now act in a way
that is detrimental to themselves, to save some other predators?

~~~
elliekelly
You might find T.M. Scanlon's _What We Owe to Each Other_ interesting.[1]

[1]
[https://www.scribd.com/document/127602229/Scanlon-1998-What-...](https://www.scribd.com/document/127602229/Scanlon-1998-What-
We-Owe-to-Each-Other)

------
bryanrasmussen
I do wonder if this decision doesn't have a Brexit component, the transition
period will be over the end of this year, so I guess that is when the real bad
stuff from Brexit will start becoming clear, if you mess up your economy the
year before by lockdowns then what happens when things go really downhill?

If you don't lockdown, and other countries do, can you somehow benefit? I
would say no that doesn't make sense but I somehow have the feeling that the
people who currently lead the UK do not share my understanding of what is
reasonable in any way whatsoever so maybe they would have a Baldrick level
cunning plan in mind?

------
q-__-p
I think it would be rational if we knew more about the virus, but we really
don't know much, given how new it is. There could be long-term health effects
from contracting it, but we just don't know. The UK seems to be making a lot
of assumptions, which may not bear out. +1 insane.

~~~
thawaway1837
This is the part people are missing. We don’t know enough about the virus, and
due to the extreme nature of the worst case scenarios it’s probably a better
bet to act as if the worst case scenarios are true.

We can recover from an economic hit. We’ve done it several times before, and
there are several tools that can be used. A major pandemic with mutating
viruses is not something we are as prepared for.

------
hellodave555
It's totally insane and I am amazed more people in politics and the media
aren't calling it out. Other countries have already demonstrated it can be
contained with rapid testing, tracing and limited lockdowns so why are we
doing this?

Lets assume 60% of the population are to catch it, they have said they want
the worst of it over by the winter. That's 40 million people. If 5% need an
ICU bed and the average ICU stay is 2 weeks (both conservative numbers) and
infections are spread out perfectly over the next 8 months we will need
125,000 ICU beds, the NHS has something like 5,000 and most are already used
for non-coronavirus patients.

You run our of ICU beds the fatality rate is going to rocket, more like 3-6%
then 1-2% and we are looking at deaths of 1.2million - 2.4million, let alone
all the deaths that come from a completely over-run NHS.

How can you describe a plan that will allow the collapse of the NHS and the
death of millions anything other than insane?

------
scarmig
The UK approach is highly interesting. It's assuming that a government telling
people to social distance themselves is highly effective. You then direct the
elderly to social distance themselves; they are mostly protected from the
virus; it runs rampant through the general population; and after a two months
of relatively mild, mass cases among the young, you've effectively built a
herd immunity firewall around the elderly.

Three possible issues:

1) Telling people to social distance themselves has a weak effect, not a
strong one. In that case, the fire burns through the young population and
burns through the old population, and you end up with a pile of flaming
corpses.

2) I don't know if herd immunity of the young population is enough,
epidemiologically, to give herd immunity to an older population. Old people
can pass it to each other, and their day to day interactions are
disproportionally among the elderly. So you risk an older subgraph all
catching it at once still. I don't think this is a big risk compared to 1).

3) Individuals don't develop an immunity. This would be disastrous for this
strategy. Then again, it's disastrous for all strategies.

The first issue seems like the biggest issue to me, and I think it's pretty
damning. If that's the case, the elderly never have the protection of herd
immunity, and you're not flattening the curve but sharpening it.

Another possibility: the government knows it won't work to seriously change
the number of deaths, but it also believes all measures possible in Western
countries are likely to fail. In that case, you immolate the elderly
population as fast as possible and then get used to a new norm instead of
spending months in a futile battle. Essentially, it's possible that even with
heroic efforts that the curve can only be flattened a bit, so it's just a
matter of timing the deaths and how long you want to be enduring terrible
economic damage. And if every other country suffers pretty much as much as you
do, political impact is limited.

~~~
knzhou
It is indeed highly intellectually interesting to observe... and absolutely
terrifying to experience. It will give the world lots of interesting data, in
precisely the same sense that the WWII Axis biological experiments did.

God help the British people. I'm so glad I moved out of the UK half a year
ago.

------
csours
I remember when I was a kid, I didn't really understand refrigerators. Like I
knew that the cold would eventually leak out, so how was it cold inside if the
cold would eventually leak out? How does insulation even work?

So, I eventually figured it out. The insulation slows down the heat transfer.
The fridge still has to do work to keep cold, but the insulation means that it
can keep up with the losses and spend less energy on that.

The countermeasures to COVID19 are like that. The virus is going to spread,
but we still need to slow it down, so that the healthcare system can deal with
individual cases, and not a flood.

Some people are going to get it, but that doesn't mean we have to be
fatalistic about it. We should take it seriously, but also rationally.

------
Mulpze15
Isn't there a higher likelihood for the virus to mutate if a large population
gets it?

~~~
quickthrower2
I also wonder about the virus laying dormant in the body and reinfecting like
shingles or for example.

------
tyteen4a03
Is there even conclusive proof that people can be immune from the virus after
being infected?

~~~
dirtnugget
I think I even heard of people getting re-infected after having been cured

~~~
MaxBarraclough
Opinions vary. Dr. Amesh Adalja is an infectious disease specialist, who
thinks it's more likely that this isn't the case, and that it was just the
impression given by false-negatives from the tests. (That is, if you test
someone 3 times over 3 weeks, and see _Infected_ , _Uninfected_ , _Infected_ ,
it could either be a false negative, or a reinfection.)

I'm afraid I don't have a written source, I heard it in this interview
podcast: [https://samharris.org/podcasts/191-early-thoughts-
pandemic/](https://samharris.org/podcasts/191-early-thoughts-pandemic/)

------
RobLach
We have no long term effect data on Covid-19 so it’s absolutely insane to do
anything but minimize infection rates.

------
ReDeiPirati
According to other famous virologists, this is a risky strategy to play. This
is an RNA virus, this means that you cannot safely assume that the population
will be immune after the first infection.

~~~
xenonite
Could you cite these sources please?

~~~
thu2111
He just means that RNA mutates more than DNA during replication, which you can
learn from Wikipedia. That's why flu keeps coming back every year.

~~~
xenonite
Thank you!

------
lend000
I suggested this a few days ago and it was not a popular idea, but if you can
enforce a sufficiently strong quarantine for the elderly, I believe this could
decrease the total number of deaths (although the total number of infections
will be higher than with universal social distancing, the faster it spreads,
according to most simulations).

------
allears
There are already some reports of re-infection. It may be that immunity isn't
so easy to build for this virus. Not enough is known about it yet. This is a
huge gamble.

~~~
smitty1e
What reputable officials are on record regarding re-infection, please?

~~~
ldjb
I don't think there is any evidence of reinfection. What seems to have
happened in some cases is that a person's symptoms have dissipated but
resurfaced a bit later. In other words, the patient thought they had recovered
when they hadn't.

That said, the chief scientific officer has stated that this is likely to be
an annual virus: [https://www.telegraph.co.uk/news/2020/03/13/coronavirus-
outb...](https://www.telegraph.co.uk/news/2020/03/13/coronavirus-outbreak-
likely-annual-virus-says-governments-chief/)

------
dharma1
The idea of not testing except the most serious cases, wait for herd immunity
is starting to attract criticism from many scientists

[https://www.bbc.co.uk/news/science-
environment-51892402](https://www.bbc.co.uk/news/science-environment-51892402)

------
wyiske
I think they’re taking more or less the right approach. I do think they could
have gone further and banned big events and told anyone with cold or flu to
stay at home for 7 days (instead of with specific symptoms).

It’s already too late to ban travelers, and will do more damage than benefit.
Well it’s possible to score political points by closing borders, the damage it
will do the economy is not necessary.

Countries like New Zealand and Israel are so isolated from their neighbors
they may benefit from closed borders, but tbh it feels like more short term
planning when what we need is long term thinking. What happens in 2 weeks when
the crisis is still unfolding?

I wouldn’t be surprised if more cases pop up in China in new locations because
of the nature of this virus (delayed feedback system)

~~~
tonyedgecombe
Most of the big events seem to have decided to shutdown on their own, I'm not
sure a ban would make a huge difference now.

------
gdubs
I’ll go out on a limb here and say that this sounds “Dr Strangelove” level
bad. Like, phenomenally cavalier.

They need to release the data and assumptions they’re basing their simulations
on, because this _will_ affect the entire world, not just the UK.

The current numbers have COVID-19 at something like 20x more deadly [than the
flu] for people under 50. It’s not _nothing_. At scale, that’s a lot of people
dying. Those numbers are also a reflection of the treatment being done in all
the other areas of the world right now. Does their model adjust for an
increased mortality rate that would surely occur in an overwhelmed medical
system? Are they assuming a nearly perfectly executed quarantine of the
elderly?

They need to share their data and assumptions.

------
nirui
One question here: Do we have any scientific way to verify which strategy
works? I been waiting for related research that can either proof or disproof
the usefulness of the "Lock-down strategy" which China been using in the past
couple of months and still not fully lifted.

We had little less than 30 total cases in our city with just over 1 million
population, and the city was in lock down mode for few weeks. I can feel the
slow rise of living costs during that period of time.

It's quite funny to see how people reacts to this, panic-buying all the face
masks for example. Makes me think whether or not it's worth it to go full-out
panic, because panic usually creates way more chaos/problems than the problem
itself.

------
JamesBarney
There is a huge flaw in this thinking which is that the disease takes about 5
days before symptoms and another 5 before hospitalization.

And many places put the virus doubling time in several days. So the hospital
situation will get 5x to 20x worse after they initiate lockdown.

------
drakonka
I feel like this is what Sweden is doing without saying it. They have stopped
testing anyone except the elderly, severely ill, or healthcare professionals.
It kind of seems like they'll just expect most of us to get it with only mild
symptoms since it's out there now anyway, and confirming a mild case isn't
really going to change treatment. At the same time they are stopping
gatherings of over 500 people and telling people to stay home when sick. Many
people are now working from home, but schools are still open. But without
testing people and proper statistics how do we know when it's safe to resume
gathering, or go back to the office?

------
jennyyang
You can't do this without adequate testing. If you can do tens of thousands of
tests per day, and you're testing everyone, then you can potentially control
the rate of infection by opening and closing public places and schools, etc.
But without testing you won't know and the goal of not putting strain on the
NHS will fail.

Places like the US are completely in the dark because of incompetence, but
once we have the visibility as to who is sick, and having widespread testing,
then I think this might make sense. Heck, if I knew I would have access to a
critical care bed if things got bad, I would probably volunteer to get
infected now.

------
ookblah
lol it sounds more on the insane side to me. you have to have a thought out
plan to protect the vulnerable and do exposure in "phases", but has that ever
been done ever?

and even if you are young and healthy why would you knowingly expose yourself
to something that, while wouldn't kill you could put you in a life threatening
situation, regardless. i know there are probably way more statistical higher
ways to die, but there's a reason i don't go rubbing my face in a sick co-
workers hand. even the flu symptoms are no joke.

i've heard that there's a chance of re-infection, but not sure how accurate
that is.

------
boznz
unless the world plans to stay isolated until there is a cure this may be the
alternative that doesnt also bankrupt a lot of businesses and put people out
of work.

~~~
Zenst
There will be pockets that will see this carry on for years globally.
Currently it is mostly prevalent in climates in their winter phase months, and
UK just entered spring.

Then there is this virus mutating, could it mutate into something less
harmful, or something more harmful.

Past pandemic the spanish flu saw the initial infection decline in the summer
and in the winter saw a higher wave of infections and deaths - which would be
at a time when health services with climate phases tend to be less able to
handle extra volume.

Policy seems to be around accepting people will die, no escaping that or
dressing that up and to manage infected and control the spread and managing
response/restrictions accordingly. So by managing the effected numbers needing
medical intervention and dragging out the first seasonal phase so that the
summer months lul can be used to level out the impact down the line.

~~~
vanniv
It is very much more likely that, as it mutates, it will be to a less-deadly
virus.

Evolutionary pressure works that way -- as a less-deadly version will spread
faster and outcompete a more-deadly version (because it won't kill as many
hosts -- dead hosts cease spreading -- and because less-ill hosts are less
likely to stay in bed until better, thus encountering more people and thus
more spread)

This is why, broadly, endemic diseases like influenza become less lethal over
time

It's why severe influenzas are usually those that just mutated to cross over
to humans from some other animal -- like swine flu from last decade, which was
not that deadly to swine, but remarkably so to humans those first seasons, or
avian flus which also have appeared occasionally.

The Spanish Flu was one of those -- an Avian flu that had newly mutated to
infect humans.

~~~
pubby
Spanish Flu mutated into a far deadlier version over time because it spread
faster in hospitals and troop transports than on the streets. We may see a
similar situation with corona virus if the quarantines and social distancing
are too effective. Ideally, we want most cases to be transmitted from the weak
cold-like corona virus cases, not the lung-infesting killer cases.

[https://en.wikipedia.org/wiki/Spanish_flu#Deadly_second_wave](https://en.wikipedia.org/wiki/Spanish_flu#Deadly_second_wave)

~~~
vanniv
To quote that article:

In civilian life, natural selection favors a mild strain. Those who get very
ill stay home, and those mildly ill continue with their lives, preferentially
spreading the mild strain. In the trenches, natural selection was reversed.
Soldiers with a mild strain stayed where they were, while the severely ill
were sent on crowded trains to crowded field hospitals, spreading the deadlier
virus.

~~~
Zenst
Given that, the UK policy seems to make more sense now, thank you.

------
TheHeretic12
There is evidence from China and Korea, that you do not build immunity from
the disease.

[https://archive.is/Gv1iu](https://archive.is/Gv1iu)

This makes the UK response almost as bad as doing nothing at all. Maybe some
people will show to have a natural immunity, but many people will die. The UK
is in arrears politically and socially. There honestly is no response that
would be appropriate, that they could hope to deploy.

------
petilon
> _the virus seems to be relatively inoffensive for young people_

Not enough is known about the long term effects of this virus. There are
reports that those who recover are experiencing reduced lung function [1].

[1] [https://www.sciencealert.com/even-those-who-recover-from-
cor...](https://www.sciencealert.com/even-those-who-recover-from-corona-can-
be-left-gasping-for-breath-afterwards)

------
johndoe42377
Lockdowns are just to decrease the rate of spreading (and avoid high
concentration of virus particles) not to eliminate the virus, so everyone
should prepare oneself to face it and get through. Just this.

Some small percentage of population in isolated regions have chances never
meet the virus, but hiding is not the stable strategy.

Getting through and become immune is. This is what UK government is saying.
Let's face it.

~~~
droopyEyelids
Sounds like you may not have heard about the importance of "flattening the
curve" yet

[https://www.statnews.com/2020/03/11/flattening-curve-
coronav...](https://www.statnews.com/2020/03/11/flattening-curve-coronavirus/)

~~~
johndoe42377
As any third-worlder knows perfectly will, everyone is on your own.

Aside from that, there are so many different factors (variables) that this
oversimplified model is almost useless.

Every place, except China, which locked down a whole magapolis, will reach
overcapacity of hospitals very quickly and UK government advisers know this.

'Flattering the curve' is a nice catchy meme though.

------
e12e
I watched a presentation/session by Norwegian directorate of health that
included some comments from Italy [1]. I think they shed some light on the
mortality rate - in effect 50% of those intubated died. And they were some
percentage of those needing icu care. Assuming the icus are overrun, and all
ventilators taken - _all of those patients_ would be dead.

So (given the size of population, and relative lack of ventilators) - in an
actual uncontrolled spread, I think we will/would see much higher mortality
rates than we've seen so far.

I hope the UK won't be the first to prove that (I suspect the US might be the
first to do so). Or indeed, maybe Iran already has.

I heard there was mentioned that in areas hard hit in China, where low(ish)
mortality rates were reported, they were also desperately seeking more people
for

[1] in English, starts at 4h mark:
[https://youtu.be/LtWti5prxzg?t=4h](https://youtu.be/LtWti5prxzg?t=4h)

------
js2
FWIW, I submitted this earlier today:

 _When an epidemic outbreak such H1N1, Zika or SARS viruses occurs,
containment measures may seem to be the most reasonable solution. However, an
EPFL study casts doubt on that idea, showing that such measures make a society
less resilient and less able to return to pre-epidemic economic and social
conditions. The study, published in Nature Scientific Reports, coincides with
another publication on the same subject but based on other mathematical
models, published in Nature Physics in December. That study also compared the
advantages of containment measures with those of non-intervention, and reached
the same conclusion: Preventing travel and social interactions is not always
the best way to deal with an epidemic outbreak._

[https://phys.org/news/2018-01-epidemics.html](https://phys.org/news/2018-01-epidemics.html)

------
mingabunga
and causing the deaths of >80 year olds, thus reducing the costs of dependency
on the health system? #consipracy :)

~~~
celticninja
However this age group is also predominantly conservative voting so they would
not want to off their core support base.

~~~
tonyedgecombe
On the other hand the next election is nearly five years away, by then most of
them will have fallen off their perch anyway.

------
EnderMB
It's hard to say, especially when you consider that the NHS has had its
funding cut for years, and that even with a full lockdown it is likely to
struggle even with a modest rise in patients over time.

This might sound dark, but as others have said, it feels like the government
would rather see the country overwhelmed over a short amount of time, compared
to a prolonged battle where their failures in healthcare will be highlighted.

I won't pretend to be a virologist, but one thing I will say is that it is
wishful thinking to assume that the elderly are going to go into lockdown as
the rest of the population builds an immunity. There is a level of arrogence
and entitlement, mixed with regular doses of misinformation, that will ensure
that the UK public will "keep calm and carry on" throughout this entire mess
if there is no enforced lockdown.

------
lubujackson
I think this is really a battle against ignorance. Until people see results in
front of them they aren't going to respect these rules without authoritarian
measures.

Best is to shut everything down for a month THEN let 40s and under back to
work. By then, hospitals will have been overrun but hopefully on the upswing
and people will be a lot more sober and willing to listen.

I imagine once the shutdowns happen and reality sets in, people will not want
to go out and expose themselves willingly and politicians will rather keep
everyone locked up as long as possible, but that is a mistake too. Everything
hits with a 2 week lag so it is import to trust the trends and the analysis
rather than the current situation - I expect us to be too conservative on the
way out just as we have been too cavalier on the way in.

~~~
jariel
" Until people see results in front of them they aren't going to respect these
rules without authoritarian measures."

Doubtful.

Here in Montreal, the streets are bare. Restaurants are at 50% capacity, there
is no toilet paper anywhere.

We only have ~100 official infections in 30M people.

People are taking this pretty seriously and at least as far as 'not going out'
and 'social distancing' it's going to be relatively easy to enforce.

There are few 'draconian' measures being taken by any government really
anyhow.

I think we'll be doing this for 6 months at least.

------
btilly
The UK government is criminally insane to the point that they should be locked
up and shot.

For every person who would die in the normal course of the disease, around 3
more needed hospitalization. The Wuhan experience showed that when hospitals
are overwhelmed and cannot put them on ventilators, the fatality rate roughly
doubles.

The UK course of action is guaranteed to overwhelm local hospitals. At which
point even if half the vulnerable population does not get sick, you have as
many fatalities in that group as you would have if the rate of spread was
reduced.

Worse yet, it is currently unnecessary. Both China and South Korea have
demonstrate that aggressive containment and quarantine efforts can result in
exponential declines in the disease. As a result we should not yet be giving
up hope that the disease can be contained, avoiding mass casualties. And even
if we did want to take the UK approach, you could always switch to it after
you had demonstrated that you can't contain the disease.

~~~
TeMPOraL
> _The UK government is criminally insane to the point that they should be
> locked up and shot._

This plan may end up with a coup once the body count starts racking up and
people get angry.

BTW. this new plan reminds me of the plot of "V for Vendetta" movie.

(spoiler below)

In it, a fascist government took over by causing an epidemic that killed a
hundred thousand people, used that to get itself into power, and promptly
buried the evidence.

------
thinkingemote
This idea that the primary aim of the UK Government is herd immunity is plain
wrong. The primary aim is to flatten the curve with specially timed
interventions and any herd immunity is a by product of that. The aim is to
flatten the curve so that the systems are able to cope better.

Herd immunity will be a by product in almost every western countries actions
today. Ask them and if they are honest they will say the same that it's a long
term effect but not the primary driver or the main aim.

The difficult non sound bite criticism is about the flattening of the curve
based on their models which basically means they need to get both the timings
and the interventions spot on for it to work correctly. Dont let fear win

------
devit
The Italian strategy is simply to try to prevent running out of ICU beds or at
least minimize the number of people that can't get IC in the short-term due to
the current uncontrolled spread.

As far as I can tell, what to do long-term is still up to debate, and
continuing the lockdown only for higher-risk/older people is certainly an
option.

Note however that jumping straight to such a differentiated lockdown seems
much less likely to work, because behavior changes are easier in a total
lockdown with full media and discourse focusing on it, as well as much easier
enforcement since you don't have to distinguish the high-risk people.

------
StanislavPetrov
A sudden surge of infections will overwhelm the health services, number of
available hospital beds, ICU units, and ventilators. This means that many more
people will die that would have otherwise survived if the spread of the virus
was slower and treatment was available.

Unfortunately there are many who view the countless avoidable deaths of those
who are older, have underlying conditions or otherwise could have benefited
from proper treatment as an acceptable price to pay for a faster "economic
recovery".

------
bwb
If you read the longer version of the UK's strategy that is not what they are
doing... They are waiting until their numbers are high enough to justify
lockdown and then lockdown as they know the economic shock is huge. So they
wait until it is time, lockdown for 30 days, see if they can flatten the
curve, then boot things back up.

The media picked up part of the story, but not the entire story. And, Boris
played up one part to the detriment of the actual entire white paper.

------
glangdale
This is insane. It depends on a bunch of things we don't know turning out to
be true: can we develop herd immunity to COVID-19? Can we adequately isolate
young/healthy people from old/sick?

IF this turns out to be the UK strategy it will also become imperative for
countries trying containment to ban travel from the UK.

I think it's an idiotic brainwave from a bunch of people who have spent way
too much time pretending that they are the "smartest people in the room".

------
pmorici
Herd immunity and keeping the total infected at any one time to a manageable
level is the end game everywhere. I think the difference you are seeing is a
difference of opinion over how extreme the measures need to be to keep the
total infected from overwhelming the hospitals. It's possible that moderate
measures early might be enough clearly if you wait too long more extreme
measures definitely seem to be necessary.

------
KaiserPro
There are three things to consider:

1) Even if they contained it inside the UK, it will be imported every day by
people returning from the continent/USA. Unlike the quick flu tests, its
2+days for a result in testing

2) Vaccination at scale is a year+ out (as in at least may 2021)

3) flu season is only 7 months away, which means doing this all again, but
with a newer version of the virus. This virus might be more mellow, or not.

Look at the infection rates in spain, france, Nederlands and germany. They are
in lock step. Containment has failed.

 _update_ THe last, possibly most important point is this: the voting base
most at risk of this virus is Boris's. Its really not in his interest to let
them all die. I find the man abhorrent and selfish, but I doubt he's stupid
enough to let his vote base disappear.

~~~
KaiserPro
_update_

Given the new data, I'm changing my opinion to insane.

I think we are two weeks away from northern italy in london, but with 1/4 of
the equipment.

------
pjdemers
Letting people past a certain age just die only works if people at that age
co-operate. No matter how much the authorities try to spin it, there are more
than a few "runners" who don't want to die (yet).
[https://www.imdb.com/title/tt0074812/?ref_=fn_al_tt_1](https://www.imdb.com/title/tt0074812/?ref_=fn_al_tt_1)

------
fefb
Okay about the mortality rate. What about the hospitalization rate? Is it low
enough to do not break the health system ? And about the smokers? diabetics ?
Cancer patients ? And about the old one already hospitalized ? The kids ? And
about the 0.3% that will dye ? How many young people will die in a old
population ? And about the doctors and nurses extra exposed to the virus from
different people?

------
anigbrowl
Scientifically, yes. Politically, suicide.

Herd immunity is what you _hope for_ once the infection has gone through the
population. To the extent that they try to build it by telling people they
must be infected with it (questionable, and arguably a misinterpretation of
public statements) it will be perceived as an attempt to cull the lower
classes for the benefit of the ruling ones.

~~~
theseadroid
Scientifically, yes? First do we have conclusion that people are immune to
coronavirus once infected? Isn't the disease too new to know that? Secondly
have we done any experiments and have any evidence that this will work in a
smaller scale? Any scale? I thought science is about evidence and
repeatability. If anything this will be a large scale human experiment at best
without any informed consent given.

~~~
anigbrowl
Please read the whole comment instead of just the first couple of words.

------
jhki
Herd immunity is particularly insane idea if it's confirmed that you don't, in
fact, get immunity:

[https://thehill.com/changing-america/well-
being/prevention-c...](https://thehill.com/changing-america/well-
being/prevention-cures/484942-japan-confirms-first-case-of-person-reinfected)

------
dathinab
No it's insane. Because you know viruses do one thing: they mutate.

Also heard immunity takes to long at which point all old people will get
potentially infected too.

Also cases to death ratio (and infection to death ratio) are still on a
magnitude larger then with the flu. Especially given that somewhat between
10-20% of infected need intensive medical care, all roughly at the same time
if you don't slow the spread which likely can't be provided if that should
happen increasing death ratio.

With such a strategy we at looking a mostly likely at >350000 deaths. Not
unlikely even over 1800000...[ _]

Through well there is always very, very small chance that it will work. Less
because it's a good strategy but because even if you do nothing there is a
very very very small change for a virus to "self destruct" (not correct way to
describe they effect but it basically similar to a self destruction to a
outside observer knowing nothing about virology).

But gambling hundred of thousand lives one it would be insane.

Well except if you have no morals and want to destabilize the country. Through
I don't think that's the case, incompetence is more likely.

EDIT: spelling

EDIT: _ Numbers based on not unlikely infection rate of 60% of population and
IDR of 1% (health system not overloaded) and 5% (health system overloaded to
some degree).

EDIT: argument based on heard immunity idea not explicitly the UK strategy

------
l-andis
It looks like they've either backtracked on the idea or it was misconstrued
from the start:

[https://www.dailymail.co.uk/news/article-8113011/Downing-
Str...](https://www.dailymail.co.uk/news/article-8113011/Downing-Street-hits-
against-critics-herd-immunity-virus-strategy.html)

------
aazaa
Does anyone have a link to an actual policy document explicitly stating the
UK's herd immunity policy? The link is a tweet from a random guy.

Herd immunity is the default, and it's also being pursued by the US, despite
statements to the contrary. So I'm not sure there would actually be a
document, but maybe it does exist.

------
bencoder
We are about 2 weeks behind Italy in death rate, which is the only measure
that can be reliably compared between countries, due to differences in test
rates and criteria to be tested.

Is 2 weeks "grace period" before implementing a lockdown and starting the
heavy measures worth it in the long run? I don't think so.

------
lazyjones
I'm not really qualified to comment on this strategy, but isn't this going to
lead to stronger exposure to virus specimens per individual, i.e. more severe
infections and thus higher CFR?

The actual goal of the UK might be to sacrifice a few people to boost the
economy while the rest of the world wrecks its economy.

------
notlukesky
[https://philip.greenspun.com/blog/2020/03/14/if-the-
british-...](https://philip.greenspun.com/blog/2020/03/14/if-the-british-are-
right-everything-the-u-s-is-doing-about-coronavirus-is-wrong/)

------
perlgeek
I don't think there's any working strategy for infecting the young and keeping
them separate from the old. Many young people have contact with older people
(live together, work together, being taught by them etc.), and anybody who
claims it might work is IMHO divorced from reality.

------
aziytuiam
I think the main mystery about the UK govts approach can be solved when your
realise it is not very clever; just very incompetent. The whole word has been
stunned by the herd immunity experiment policy; only to have it denied a week
later. We are fools led by clowns.

------
Reason077
The UK government is neither genius nor insane. What the UK government is, is
pragmatic.

------
simonw
Turns out they were insane: [https://www.buzzfeed.com/alexwickham/coronavirus-
uk-strategy...](https://www.buzzfeed.com/alexwickham/coronavirus-uk-strategy-
deaths)

------
foobarbazetc
No. It’s dumb asf.

It’ll last like 2 days.

Here’s the EIC of The Lancet:

[https://twitter.com/richardhorton1/status/123814984490619290...](https://twitter.com/richardhorton1/status/1238149844906192903?s=21)

------
baby
I'm not sure I understand how this herd immunity strategy can work in the
current world. Albeit the UK is segregated from the rest with water, there are
still a lot of people entering your frontiers and that are not immune.

------
LZ_Khan
Herd immunity is basically doing nothing right? How is that any different from
what happened in the Spanish Flu? I'm sure herd immunity came into play
eventually but at the cost of all those lives.

------
MrPatan
I see lots of praise for Singapore and Taiwan's handling of the crisis.

What about the weather? Is part of the solution for cold dry places to have
warm humid weather, which apparently kills the virus?

------
tigershark
Insane, but we already knew it thanks to their past decisions. This is just
the last confirmation. In the best case we’ll have close to 1M deaths if they
succeed with their strategy.

------
endorphone
Herd immunity by mass exposure is an interesting, very likely catastrophic,
approach. It's interesting that he (of the twitter cite) claims that it is
"more refined", as if simply doing nothing and rationalizing your hubris is 4D
chess.

Every country realizes it can't be stopped now. Every country realizes that
the majority of the population will get it. But as has been cited a thousand
times, having hundreds of thousands of vulnerable people, along with a
substantial enough number of otherwise healthy people, needing heroic medical
care would be _disastrous_. See: Italy. Their approach wasn't "more refined".

I doubt the outcome is going to be good.

------
jotm
Meanwhile, people returning from the UK to the EU are being tested positive
for Covid-19...

So, maybe the strategy (if it is one) works, but the UK is imposing it on
everyone else without a care.

------
franzwong
It is correct in theory, but Wuhan coronavirus spreads very quickly and
easily. I doubt UK has enough hospitals and people to provide proper medical
treatments.

------
hyperpallium
All the kids get it, infect their parents, and off it goes.

I expected immunity once you'd had it, but have heard of re-infection
occurring (not from official sources).

------
bouncycastle
This sounds like the "bargaining" stage, in the 5 stages:

denial, anger, bargaining, depression and acceptance.

(Acceptance being a China style lockdown of course...)

------
je42
MMh. is the netherlands then doing the same thing ?

------
sanj
The bit I don’t understand is how you carefully infect the bulk of young
people and simultaneously keep the older folks uninflected.

------
Tycho
Sounds incredibly risky to me. I suppose if all countries end up crippled
anyway then it would be good to be the first to recover.

------
stjohnswarts
I think this is the path the USA will be taking as well if not "officially" so
the old folks won't freak out.

------
michaelyoshika
The title reads like judging a startup founder. I'm not sure if all the
startup rules apply to governments.

------
Engineering-MD
I feel really torn about this.

The intuitive way of managing this is to try all possible containment methods
as long as possible. The benefits of this is that it will give maximum chance
for containment, and failing that, maximum time for therapies/vaccines to
emerge. What are the chances of this? Containment thus far has already failed.
The asymptomatic period make this hard to contain, and even in China with
drastic measures new infections are occurring. Even if this worked, it would
only take one area not doing this effectively to allow reinfection of these
other areas once measures are lifted. The other issue is that an effective
vaccine is not going to appear for at least a year. Other repurpose therapies
are being trialed, and initial results will be released this month. I’m not
aware of any other completely new therapies which may change outcomes. So, it
appears the benefit is limited. The main risk of this approach is that
containment is initially successful, but then fails in Autumn (fall), leading
to a peak in the winter when the health system is already under a large amount
of stress. This would be a disaster, and may well be what happens to other
countries who try this. So, the UK approach of making occur in summer may make
sense for the UK. How appropriate this course of will obviously depend on
level of seasonal variability in health care needs. Therefore countries like
Indonesia or Singapore will do well to stick to containment initially, as they
dont risk a peak occurring in winter.

------
mvkel
Doesn’t herd immunity work if reinfection isn’t possible, which is unconfirmed
at best at the moment?

------
Jemm
As long as the virus does not mutate and start killing young people, which is
a definite possibility,

------
rcpt
Doesn't herd immunity require like 90% immunity?

Even with 5% of cases requiring hospitalization this is insane.

------
xevioso
An interesting experiment is about to be carried out with the British as the
control group.

The only thing we know for certain about C19 is we don't know anything for
certain. The EU recognise that fact and are playing for time. The UK, on the
other hand, is pretending to have a sciencey fix based on some adolescent game
theory nerdgasm. Herd immunity can be conferred by both vaccine and disease.
But there's a difference between vaccine and disease that seems too subtle for
Whitehall to grasp.

The UK is planning for 60% of its population - forty million people - to
contract C19. The gamble is that this won't overwhelm the health system. How?
Because the government has told the virus not to infect people who might get
ill.

In China, healthcare workers were at greater risk than the general population
because of elevated exposure. The UK has told the virus not to infect doctors.

The big risk with RNA viruses is mutation: we could develop a vaccine this
year that's useless next. Obviously, the larger the infected population, the
higher the viral mutation rate. China and the EU are responding by locking
down. The UK has told the virus not to mutate.

When declaring a pandemic, the WHO director-general said, “The idea that
countries should shift from containment to mitigation is wrong and dangerous.”

------
rzwitserloot
Most comments here raise excellent points.

One more in the mix: Many companies in many countries are working on vaccines
and cures. So far some are reporting moderate successes; as I understand it,
those with the experience to tell seem to think odds are pretty decent
there'll be some sort of vaccine available within a span of a year, maybe
sooner.

Whether corona infections 'outpace' the time when a vaccine will be generally
available depends a lot on how long it'll take to get a vaccine out the door,
but presumably a ton of resources (and a lot of leeway on relaxing
regulations) are spent on this, as well as exactly how fast corona spreads.

If it spreads very fast, all of this 'planned herd immunity' stuff is
nonsense, all the taps you can close should be closed and stay closed and
it'll still spread. The UK would be mismanaging this and should be closing
more facilities.

If it doesn't, then the UK is probably mismanaging this, in that it'd be
better to try to slow the spread because the end game is the vaccine.

Effectively then, they appear to be betting on a creative and untested
solution that they more or less have to keep secret because it doesn't work
well if it is generally known, which requires accurate forecasts from
lethality rates amongst various parts of the public to spread rates in
circumstances that are probably unique to the UK then, if they are the only
country to go with this plan, __whilst__ betting that the vaccine solution is
not going to be fruitful for a long long time.

I'm going with 'insane' on this one.

------
sesuximo
I do now know what is right, but I am glad humanity has a diverse set of
strategies

------
warrenmiller
They've backed away from the herd immunity approach now. Embarrassing

------
aurizon
Herd theory works once you have an immunized herd(from recovery from infaction
while we have no vaccine) so that infection passes only from an infected
person to a vulnerable one. As we sit, the current policy will lead to an
exposure to all people - more or less, and then the recovery and formation of
the immune herd commences. Thus the IK government has decided to allow
unfettered spread = all the casualties that involves to form the herd. This is
a million or more people. An isolate into tiny herds-at-home, test
symptomatics - treating positive by supportive care = formation of many
immunized small herds. This second procedure will kill 50,000 or so. Laters it
does not matter if the mini herds mingle as they are all immune. There will be
little subsequent spread. UK is deciding to kill a large number of it's
citizenry = some sort of class war???

------
scotty79
Do you get immunity to cold caused by coronavirus after having it?

------
scurvy
So, it sounds like the UK is having a big chicken pox party?

------
svara
Definitely insane, here's why:

In order to get to herd immunity, you need something around 60% of the
population to get infected and thus immunized [0] (there's a big assumption
here already, that immunity lasts forever, might well be wrong). The UK's
population is 66 million people, so that's about 40 million who need to get
sick.

Let's assume 2% of cases require intensive care (it's closer to 10% in Italy
right now [1], but we can assume for the sake of this calculation that the UK
has the superpower to isolate people over 65 or so perfectly). That's 800000
people who will require intensive care!

There are about 4000 ICU beds in the UK [2]. Let's assume, again highly
optimistally, that only 50% are occupied, so 2000 are available for
Covid19-patients. Covid19 patients may need to spend 7 days in the ICU [1],
which means there can be up to 286 new Covid19 patients starting intensive
care each day.

You can see where this is going. At that rate, it would take 2797 days to
reach herd immunity. It's utterly nonsensical. We will hopefully have a
vaccine way, way before that. What this "herd immunity" strategy is actually
going to do is lead to a total break-down of the hospital system in the UK, if
the government doesn't change course real soon now.

[0] This is 1-(1/R_0), see
[https://en.wikipedia.org/wiki/Herd_immunity](https://en.wikipedia.org/wiki/Herd_immunity)
and unmitigated R_0 is around 3 for SARS-CoV-2,
[https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...](https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2)

[1] [https://www.statnews.com/2020/03/10/simple-math-alarming-
ans...](https://www.statnews.com/2020/03/10/simple-math-alarming-answers-
covid-19/)

[2] [https://www.theguardian.com/commentisfree/2020/mar/03/icu-
do...](https://www.theguardian.com/commentisfree/2020/mar/03/icu-doctor-nhs-
coronavirus-pandemic-hospitals)

------
nknealk
It’s worth noting that many diseases don’t converge to herd immunity except
through very high vaccination rates. Examples include polio, small pox,
chicken pox, etc.

So their assumption about outcome seems flawed.

------
mschuster91
This is utter, utter madness. Assuming UK has 66M people and 2/3 need to be
infected, that's 44M people. Coronavirus has, depending on the quality,
affordability and accessibility of the healthcare system, a fatality ratio
somewhere along 0.7% in best case and 15% (at least!) in old and pre-
conditioned people... which means that there is anything possible between 300k
and 6.6M (!!) deaths.

tl;dr: absolutely fucking nuts to risk more people than the UK lost in WW2. If
BoJo really tries to execute that plan, he has to be stopped.

~~~
patrec
> If BoJo really tries to execute that plan, he has to be stopped.

But that's the beauty of the plan, it functions as its own dead man's switch.

------
DanBC
Important to remember that this person doesn't _know_ what the policy is.
They're just tweeting their opinion.

~~~
papaf
The UK government announced the policy in a press conference with the Prime
Minister and the chief scientific advisor.

Here is an interesting follow up interview with the chief scientific advisor:
[https://www.youtube.com/watch?v=2XRc389TvG8](https://www.youtube.com/watch?v=2XRc389TvG8)

My personal opinion, after watching the interview, is that the UK government
is not doing anything that radical. They will follow the reactions of other
countries but want to time the reaction so that it is most effective.

~~~
alkonaut
They didn't word it like the OP. The OP got that from the Twitter account
extrapolating the contents of the press conference. The press conference
mentions herd immunity but it didn't (like the twitter thread) state that
keeping schools open was to ensure young people get infected.

------
tus88
What could possibly go wrong.

~~~
prtaylor
A lot. It can potentially wipe out the non young generation.

~~~
tus88
I said what could go _wrong_.

------
hyko
They are neither; they are making difficult decisions on the basis of limited
information across multiple disciplines. The main aim is to prevent the NHS
from being overwhelmed, which would be a humanitarian disaster. A secondary
aim is to prevent bringing economic life to an end in the UK, which would also
be a humanitarian disaster.

We are at most about five months into this pandemic; to suggest we know what
strategies succeeded and failed is very premature. We are just at the
beginning.

In another world, we could all spend 2020 in individual seclusion, without any
economic, social, familial, cultural, mental, or behavioral concerns. In the
world that actually exists, "No man is an island, entire of itself" and so
rather annoyingly we must continue to live our lives without being completely
governed by epidemiological concerns. SARS-CoV-2 can be transmitted
asymptomatically and is basically everywhere at this point, so if your entire
strategy is just "don't let anyone get infected, ever", it is surely doomed?

One country did get a legitimate chance to end COVID-19 for all humanity by
preventing onward transmission, and they blew it. The next off ramp is global
herd immunity (either natural or artificial), which lies years or decades in
the future.

It's worth pointing out that the UK already pursues a strategy of herd
immunity regarding chicken pox (along with other countries), despite the
availability of a vaccine: [http://www.ox.ac.uk/research/everything-you-need-
know-about-...](http://www.ox.ac.uk/research/everything-you-need-know-about-
chickenpox-and-why-more-countries-don’t-use-vaccine) I disagree with that
strategy but I am not qualified to make that decision on behalf of a country,
and I'm glad it's not my responsibility to do so.

~~~
JetSetWilly
> the UK already pursues a strategy of herd immunity regarding chicken pox
> (along with other countries), despite the availability of a vaccine:
> [http://www.ox.ac.uk/research/everything-you-need-know-
> about-...](http://www.ox.ac.uk/research/everything-you-need-know-about-..).
> I disagree with that strategy but I am not qualified to make that decision
> on behalf of a country, and I'm glad it's not my responsibility to do so.

The UK does not vaccinate against chickenpox because it judges that the
overall public health consequences are worse if you vaccinate than if you
don't - it would increase the frequency of shingles which is much worse than
chickenpox.

~~~
hyko
That for me is where the logic breaks down, a comprehensive vaccine programme
for shingles would seem far more effective than just hoping the adults come
into contact with infected children.

~~~
JetSetWilly
Anti-vaxxers are a thing. If you vaccinate then due to herd immunity the anti-
vaxxers don't get exposed to chickpenpox nearly as much and then end up
getting shingles.

Also then anti-vaxxer children get chickenpox much later in life when it can
be more serious.

If you don't vaccinate everybody gets exposed to chickenpox much more and the
proportion of shingles cases ends up being smaller, not only that but anti-
vaxxer children don't need to worry about getting their first case of
chickenpox at age 30.

------
ldng
It is a theoretical solution. That also could backfire fiercely. The more it
spreads, the more likely it is to mutate. And not all mutations will be
equals. Plus it might make producing a vaccine more complex.

Could also work. Unexplored territory, the truth is we don't know.

------
squarefoot
"In practice, people won't be disciplined about isolating vulnerable ones in
the first phase, thus leading to disaster."

That is the point. One can catch the virus, become asymptomatic then continue
to live normally and become even more dangerous to anyone in vicinity ("hug
me, I'm safe!"). Eventually most of us will be infected anyway, and some will
recover becoming immune (hopefully; this is far from guaranteed), so the
correct line of action IMO would be to isolate everyone from everyone to gain
time and resources. Nothing would stop them later from making people immune
through controlled infection (aka vaccination) when the crisis is over.

To me they don't have a clue and just chose the only option that might paint
them as still in control.

------
tim333
More insane than genius.

The government expert on TV was basically saying most people are going to get
it eventually so why bother making huge efforts to delay but that kind of
ignores that if we delay we may get better treatments or a vaccine. Just fine
tuning some of the existing treatments could make a big difference.

------
jeanmichelx
The economy wasn't important for Brexit but it somehow is for COVID-19, and
we're going to sacrifice half a million people (best case).

I say bring back the guillotine

------
blowski
To be honest, I don’t think this kind of conversation is worthwhile on HN.
There are very few facts here, just opinions.

I’m all for posting authoritative information, and interesting side-effects.

But just shooting around opinions is best left for Twitter, Facebook, Reddit.

~~~
dang
The dividing line for what's on topic on HN not fact vs. opinion, it's
intellectual curiosity
([https://news.ycombinator.com/newsguidelines.html](https://news.ycombinator.com/newsguidelines.html)).
That doesn't limit itself to authoritative information, by definition.

Speculation is inevitable. The question is whether it's curious (thoughtful
and fresh) or uncurious (reflexive and predictable).

~~~
Veen
But ignorant speculation during a crisis can have serious consequences. Look
the fools in this thread claiming that the UK government is deliberately
culling the sick and elderly. The last thing we need is ideas like that
getting widespread acceptance and causing civil unrest and distrust of the
authorities who are essential to managing the situation.

~~~
dang
It's true. But ignorant speculation forms a chunk of every thread. The
solution isn't to try to restrict posting to authorized opinion—that would
cause more harm than good and is impossible anyway. The solution—well, there's
no solution, but the best we can do—is to let the community respond when it's
able to function, and moderate the threads to the extent that it's not.

When I last looked in on this one, it seemed to me that the community was
functioning ok—noticeably better, in fact, than in most of the coronavirus
discussions, which are highly repetitive. Repetition is bad on HN, not only
because it's lacking in intellectual curiosity, but because it leads to
flamewars. The mind seems to resort to conflict to amuse itself when nothing
new and interesting is available.

------
planetzero
This might work. But how many people will die in the process? There are many
cases of young people, with seemingly no prior health issues, dying after
getting severe issues as a result of the virus.

On top of that, you can't guarantee that young people will only get it. With
no travel restrictions, it can easily spread to the elderly.

~~~
DanBC
It kills maybe 1% to 2% of people under 50 with no comorbitities.

If we assume everyone in the UK is under 50 and there are 60m people and we
want to infect 60% of them that's 36m people infected, and 1% of that is
360,000 dead.

That's ignoring all the people who do have comorbitieis (diabetes, high blood
pressure, etc), and all the people over 50.

It's also ignoring all the people who eg get into road traffic accidents and
need an ICU bed, which won't be available if we cram hospitals full of
covid-19 patients.

~~~
callesgg
The reported numbers in published papers are more like 0.4% under the age of
50 and 0.2% under 40 and probably lower as there could be a large portion of
mild unreported cases.

[https://www.worldometers.info/coronavirus/coronavirus-age-
se...](https://www.worldometers.info/coronavirus/coronavirus-age-sex-
demographics/)

~~~
DanBC
>> Death Rate = (number of deaths / number of cases) = probability of dying if
infected by the virus (%)

That's not a great way of measuring the death rate during an on-going
epidemic. They should be measuring the number of people who died today /
number of cases a week ago.

~~~
rebuilder
Why a week ago? If it takes longer than a week for victims to die, in a
situation with rapidly increasing infections that will give a very distorted
number.

~~~
vanniv
The best source I found on the subject -- a disease modeler with CDC who was
giving an interview -- said that their current estimates used 5-day doubling,
15-day median time to death, and 1% CFR to do their estimates.

For the modeler, the purpose was estimating the true number of cases (which
they estimate as current_deaths * 800 for a first-order approximation) -- but
similarly, you could use that to estimate CFR by taking (num_cases / 8) as the
denominator. Except, of course, that you can't realistically estimate
num_cases. With the exception of Diamond Princess and _possibly_ South Korea,
everybody's numbers tell you more about the number of tests they run than the
number of infected that exist.

One doctor from John Hopkins, for example, estimated that there are between
50k and 500k cases in the US as of 3 days ago -- and my own admittedly-amateur
estimations using CDC numbers for deaths from influenza and all-cause
pneumonia could only set an upper bound of ~400k cases as of March 1st

------
avocado4
This is the same thing China is doing, except China is also lying about it and
saying they have "contained" it with extreme quarantine, in part to trick
other nations into doing the same thing to tank their economies while China is
going back to work and letting the virus spread.

Good for UK to step up amidst hysteria. Hopefully other democratic nations
will follow suit.

------
richk449
I wonder how much of it is just playing the odds. Shutting everything down
will very likely have a large, but fixed consequence on the economy, which has
huge cost, including in lives and health. Whereas biding your time increases
the relatively small risk of catastrophic consequences from coronavirus, but
avoids the economic consequences. So it comes down to a choice between
accepting a known downside, or taking a gamble on a path with the possibility
of very little downside, but also much larger worst-case downside. Leaving the
expected values of the choices aside, maybe Boris just likes to roll the dice?

There are other considerations, like how well the president/prime minister’s
incentives are aligned with the countries. Donald Trump, through very little
fault of his own[1], faces the possibility of a failed presidency due to the
economic consequences of shutdown. If possible, a president might think it
worth swinging for the fences, if he is down a couple of runs in the ninth? If
he strikes out, he is no worse than before, although the country is. And Boris
has kinda made himself out to be a guy who tries for home runs, at least in
his public persona.

There is also the game theoretic considerations on the country level. If all
the other countries are doing everything to stop the spread and paying the
economic cost, than U.K. can take the benefit of that sacrifice, and not crash
it’s own economy.

[1] of course he is doing his best to compound the external factors.

~~~
happierlook
> through very little fault of his own

[https://www.snopes.com/fact-check/trump-fire-pandemic-
team/](https://www.snopes.com/fact-check/trump-fire-pandemic-team/)

Get out of here with this. We had expert teams and processes in place to
combat the possibility of this exact thing and his administration fired them
without any replacement.

The virus existing is not his fault, but nearly all of the national
consequences rest directly at his feet.

~~~
richk449
I worded it that way because I think that even if he had done everything
right, his re-election would still be in trouble because of factors outside of
his control.

~~~
happierlook
The job is literally to be prepared for the future on behalf of the country.
If you take active steps that make us less prepared for something and we
therefore suffer greater consequences when it happens, I have a really hard
time describing that as being something outside of your control.

Under normal circumstances, an exigent crisis such as war would make a
President significantly more likely to be re-elected. He tried to start a war
with Iran not long ago for this very reason.

~~~
richk449
If you want to argue about Trump, please find someone else to do it with (or
somewhere else to do it).

My comment was not about Trump's response, and I regret even including mention
of him, since that one offhand comment has generated uninteresting political
arguments, without anybody engaging with what I was actually writing about.

------
easymodex
I really can't believe how stupid this is, I was starting to feel positive
about the whole thing, China got it under control, they are sending resources
to Italy to help get it under control, cures and vaccines are being developed
while people stay indoors and the number of cases drops. WE COULD ERRADICATE
THE VIRUS JUST BY STAYING HOME FOR 1 FUCKING MONTH. Literally that's all it
would take, a person isn't contagious after a month, if everyone cooperated
for the greater good we could have this under control, it's not too late, it's
the one and only chance to not make this virus "the norm" of our society,
every day it's gonna get much harder... But then you hear a country with 60
million people just isn't gonna do anything about it, throwing in the towel
before the fight even started and dooming the whole world with them. It's
beyond insane.

I'm sorry but this is just too much, I was hoping we would have the common
sense to do our best to contain the spread but seems we just have to travel,
go to the gym, go for beers every night and hang out, even though it will kill
a lot of people around you. Your fathers, mothers, grandparents, your friend's
parents, your neighbour's family, they might as well all die because you can't
stay home for a month. Really I expected too much from people and forgot how
stupid the average person is. I expect global warming will also go great,
kudos humanity.

------
Leary
[https://www.scmp.com/news/china/society/article/3074945/coro...](https://www.scmp.com/news/china/society/article/3074945/coronavirus-
hubei-government-deletes-report-claiming-covid-19)

You better hope this isn't true and the virus doesn't have any lasting effects
on reproductive health.

~~~
dharma1
paper -
[https://www.medrxiv.org/content/10.1101/2020.02.12.20022418v...](https://www.medrxiv.org/content/10.1101/2020.02.12.20022418v1)

------
0x1221
So let's assume that building immunity is even a possibility even though there
is no evidence to support this while there exists substantial evidence to the
contrary (people getting reinfected)?

Not happy to be living in the UK if that's really the plan.

~~~
_bxg1
> while there exists substantial evidence to the contrary (people getting
> reinfected)?

No. There are instances of people testing negative and then testing positive
again, but the strong consensus is that this probably results from faulty
testing and/or changes in how viral material manifests at different stages in
a person's infection. The chance is very small that people are truly getting
re-infected.

~~~
TMWNN
>No. There are instances of people testing negative and then testing positive
again, but the strong consensus is that this probably results from faulty
testing and/or changes in how viral material manifests at different stages in
a person's infection. The chance is very small that people are truly getting
re-infected.

This is also why testing everyone and anyone is a bad idea. Half or more of
positive tests of people without symptoms being tested because they are in
close contact with infected seem to be false positives.
[https://www.ncbi.nlm.nih.gov/pubmed/32133832](https://www.ncbi.nlm.nih.gov/pubmed/32133832)
I've seen something else I can't find at the moment that says that only about
10% of those with both potential COVID19 symptoms _and_ a contact history
indicative of possible contact are positive. It's both pointless and dangerous
to have someone get a false positive reading, perhaps do self-quarantine for
14 days, then go out and promptly get (not re)infected.

The US government (and I think UK too) is getting a lot of criticism for
restricting testing to those who meet the requirements of symptoms and contact
history, but it's almost certainly because the CDC is aware of this. The
Canadian government, too; Prime Minister Trudeau is not being tested, although
his wife is positive, because he is asymptomatic.
[https://www.usatoday.com/story/news/world/2020/03/12/sophie-...](https://www.usatoday.com/story/news/world/2020/03/12/sophie-
gregoire-trudeau-tests-positive-coronavirus/5039464002/)

------
nprateem
This "strategy" is rebranded "do nothing". The journalist running the country
(with his "everyone's had enough of experts" and "fuck business" attitudes) is
simply displaying his usual contempt for all the non-privately educated, and
is miles out of his depth. This is in a similar vein to how they're also
rebranding a no-deal Brexit as an "Australia-style" deal. I don't believe they
have a strategy at all - and "herd immunity" means hope for the best (a la
"sunlit uplands").

------
Theodores
From a PR point of view this is not a clever move. The very phrase 'herd
immunity' says a lot about what they think of people. It is also a highly
memorable phrase, much like 'shock and awe' and sometimes you just don't need
a 'marketing slogan' for something divisive.

~~~
SEMW
> The very phrase 'herd immunity' says a lot about what they think of people

...You know they didn't invent the phrase, right? It's a term of art, and has
been the standard term for that epidemiological concept for many decades.
[https://en.wikipedia.org/wiki/Herd_immunity](https://en.wikipedia.org/wiki/Herd_immunity)

~~~
Theodores
I did not claim that they invented the words. English is a rich language and
some words resonate better. From your article:

> Herd immunity (also called herd effect, community immunity, population
> immunity, or social immunity).

Community immunity would rhyme and not be received as negatively by those that
already hate the government as the herd word. It would also convey community,
which is a caring nice word.

------
aaron695
The kill rate from economic loss far exceeds the virus atm.

You mightn't see it yet as people stick together but a lot of small business
owners will be killing themselves in a year's time. (But most of economic
deaths are more subtle)

The UK is also reducing this.

They are also coming into Summer, it's crazy to not maximize during this time.

The right thing to do would be to purposely infect people with a spray and
isolate.

Society won't allow this. So we have to do other methods. They have a lot of
lag and are random and exponential so probably out of real control.

With the UKs plan they can't keep it to young people. That certainly won't
work.

But they will save many invisible economic lives.

