I'm posting this because of the narrative on this site that all experts agree with the UK's plan. To the extent that there is a consensus, it's a consensus against it.
I'm not sure there is a consensus against it. I've seen a few articles like this (which is worrying) but articles in favour of the status quo tend to not get so much prominence.
I really hope the government knows what it's doing. They have promised to publish their models, so hopefully that will give some more confidence.
Starting on about page 14 - a sizeable majority of USA voters who claim to prefer the GOP or claim to be independent do not think this covid-19 pandemic is a big deal.
The government has somewhat changed the message and they are now saying that their priority is to save lives, which does sound like contradicting their previous message of rapid herd immunity.
They’ve never had a message of rapid herd immunity, unless by rapid you mean spread out over 6-8 months. The whole point is to avoid either a slow burn (where it comes back at the worst time in winter) or a fast burn (where health services are overwhelmed).
Maybe their models are wrong, maybe other approaches will work better, but I like they are having an honest grown up discussion about it instead of insisting eradication is possible, or that there are no tradeoffs to be made and total global lockdown of society for 6 months is the answer (which apart from being of questionable efficacy would certainly cause another Great Depression and more deaths from poverty).
The fact they haven't published their models worries me.
At a minimum, I'd like to know what their models are optimizing for. Is it "Minimum number of deaths" or "Minimum economic cost", or "Minimum economic cost taking into account a cost of $XM per death".
Minimum number of deaths probably isn't a smart metric, because the solution to that is to tell 99% of people to stay home in bed for the rest of their lives. Hard to catch a disease if you never leave bed.
Minimum economic cost (with a factor for cost of a death) is hopefully the model they've used, but it's politically suicide to accept that grandpas life was 'worth' $X.
The health services do make difficult choices like that every day though. NICE (National Institute for Health and Care Excellence) restricts expensive medicines which can save lives for that reason - to spend the money on something else.
Rationing happens and it will be necc. in the coming months in every country, whether that is by patient income or by outcome, I’d prefer it by outcome personally.
Please, try to tell this to uk general public when pretty much 1 people over 2 or 3 has one of their parents killed by the Coronavirus because of boris inaction.
I think what will happen to you will not be a pretty sight.
It's pretty challenging to get a model published in the time span required - I believe that the team at Imperial College are racing to do this, but given the behaviour of the virus is still a topic of research it's unsurprising that they are not out there at this time.
A model can begin as a spreadsheet with a handful of guesstimates in.
You can start making decisions based on such a model.
Then in parallel, you get teams refining the model and making it more accurate, while other teams work on implementing those preliminary decisions, potentially changing course if newer, more refined, models come up with different results.
There's no reason the crude model can't be published 1 hour after it was made.
If anything, publishing the model will help localized branches of government make their own decisions ('hmm, looks like we'll be expecting lots of ambulance use at the end of march, that isn't a good time for the fleet inspection!').
Private companies would also benefit from the model, and can better schedule logistics. Even a hugely inaccurate model is better than "who knows! panic!".
A model has nothing to do with the underlying data. If they thought that the model was good enough to justify the deaths of hundreds of thousands of people they should release it right now, so we all can take a look at that abomination and decide for ourselves if they should be prosecuted for mass murder in a couple of months.
It is new data - the assumptions that were in the model showed that the surge capacity of ICU could cope in a social distancing scenario, but once they factored in the rates from Lombardy they got a different result. The horrible truth is that this thing is going to cause a huge number of deaths, I wish it weren't so.
> fast burn (where health services are overwhelmed).
To reach 'heard immunity', if it is even possible at all for sars-cov-2-- there is good reason to expect that it won't be-- without overwhelming critical care will, unfortunately, take years.
Unfortunately, too great a percentage of cases need critical care.
Even with places trying to mitigate-- with the exception of the few places where it was actually contained-- their ICUs are going to be (or are already being) overrun.
> , but I like they are having an honest grown up discussion about it
There is no evidence of this. Experts have been calling on the UK to publish their models and so far they have declined to do so. I would take a sizable bet that no such models exist which support their initial stance (which they are slowly and quietly backing away from, and moving to a position much more like other western countries).
In wuhan it was eradicated, in South Korea it is well under control, in Italy it’s still exploding as of today even if they locked down everything last week, but in about 1 week we should see the effects of the containment. Uk was two weeks behind Italy, they already could see the future and they decided to throw away that fundamental advantage that they had by not doing anything at all.
6-8 months is rapid! That's 40+ million cases during that period and impossible to manage for the health services. This is actually a fast burn. Everyone agrees on that.
Whether eradication is possible or not, the FACT is that 6-8 months is extremely fast and can only lead to a collapse of the health services.
I agree it is far more rapid than we’d like, but the options are not clear cut, there is no good choice with a guaranteed outcome, as this article indicates, experts disagree significantly on how to approach this, and due to a lack of data we will not know till after the fact.
The UK gov and their scientific advisors disagree with you or they’d be taking a different course. This really is not clear cut, if we’re being honest, nobody really knows at this stage, there are too many unknowns.
It is clear cut and the government does not necessarily disagree with me.
Handling that many cases over that short period is simply mathematically impossible considering the health care resources available. That is not an opinion, even the Health Secretary acknowledged that today.
I think that a great deal of attention is focused on a few words. The fundamental focus in the UK is on Delay - that is even the title (hence the uppercase) of the reaction phase the UK has entered. From the official plan [1] "If the disease becomes established in the UK, we will need to consider further measures to reduce the rate and extent of its spread. Based on experience with previous outbreaks, it may be that widespread exposure in the UK is inevitable; but slowing it down would still nonetheless be beneficial." and "Action that would be considered could include population distancing strategies (such as school closures, encouraging greater home working, reducing the number of large-scale gatherings) to slow the spread of the disease throughout the population, while ensuring the country’s ability to continue to run as normally as possible. The UK governments’ education departments’ planning assumptions include the possibility of having to close educational settings in order to reduce the spread of infection.
We would consider such measures in order to protect vulnerable individuals with underlying illnesses and thus at greater more at risk of becoming seriously affected by the disease. The effectiveness of these actions will need to be balanced against their impact on society."
The BBC ran a piece designed to explain why the Govt policy was kosher and the logic behind it, it said there were no scientists in disagreement. Then it corrected the article to say no epidemiologists rather were in disagreement, which is ostensibly false as well. Now it says that at the time of publication no UK epidemiologists had spoken out in mainstream media. They basically admit they didn't do any due diligence when they wrote the piece (they were in a rush to give the Govt cover).
I was trying to make this argument yesterday and got piles of comments responding exactly this way: "oh, that's only 300 signatures from UK scientists in opposition", "oh, but some of the people who agree with you don't have enough credentials".
As a counter to that, unless proven otherwise, you can assume a significant bias in any article on government policy coming from The Guardian, as in the OP here.
That obviously doesn't mean it's incorrect, but try to be aware of all biases, there are plenty on all sides.
Apparently the government's own (secret) figures suggest around 500,000 deaths, and around 8 million people in need of hospitalisation - in a country which currently has around 4,000 ICU beds, and almost no spare capacity in hospitals.
Even if the peak is spread out over nine months, that still means setting up, equipping, and staffing around a million extra beds over the next few weeks. At a time when existing medical staff are incapacitated.
This is not going to happen. The only way it might be possible is with civil conscription - literally taking people off the street and putting them through basic nursing boot camp. Even then there would be huge issues with supplies of equipment and consumables.
So the reality is that most people who need to be hospitalised in the UK (and probably the US) won't be - at least not effectively. Italy has shown what this means: without adequate care the CFR rises from 1% to 7% or so.
Which in turn means that without aggressive containment measures to slow the spread, the actual death toll will be in the millions, heavily concentrated among the over 65s.
There are around 10 million over 65s in the UK. If these numbers are right, around 10% of them will die.
I'm not trying to downplay the crisis - I'm under no illusions that that is not where we are, but a quick look at that article seems to show stuff already revealed in the news conference the other day, and some misstatements.
Just an observation on your Guardian link, not the numbers you've derived.
