We need the current argument between Westminster and Manchester on the best strategy to tackle coronavirus. The issues involved need wider informed debate than has so far been allowed. Both government and science should accept challenge, and refine policy accordingly.
We are told that policy is science-led and evidence-based. But extensive use continues to be made of blunt lockdown and furlough measures, without scientific evidence of their efficacy. These are both clearly extremely harmful in themselves. Here is an evidence-based case for the superiority of infection control, testing, and shielding.
1. Infection control works
After extensive mortality in March-May, UK care homes have reduced both infection and excess mortality rates to zero.
This has been achieved through rigorous infection control procedures. Note that the initial increased mortality affected all elderly people, not just those in care homes.
2. Lockdown doesn’t work
In the 4 months following the March-May lockdown, mortality did not increase.
Greater Manchester leaders claim that areas currently under lockdown have soaring infection rates.
3. The second wave is less deadly
We now see a huge increase in infection, but low mortality. In March-May, mortality was significant and occurred in the same time frame as infection. This is not the case in the second wave. Infections are in less vulnerable younger groups.
It is possible that this is due to careful shielding of vulnerable people, particularly those in care homes.
4. Excess mortality is not occurring in the current outbreak of infection
Whilst the daily death rate has risen, as shown above, excess mortality has not occurred. This may be because, whilst Covid-19 may be noted on a death certificate, this is not necessarily the cause of death in frequent cases of co-morbidity in elderly people.
There is therefore sufficient evidence to justify a case for relying on rigorous hygiene and testing for all, together with shielding of vulnerable elderly people, rather than resorting to lockdown and furlough schemes. The majority of people subjected to lockdown are not infected. Testing would avoid this universal lockdown. It would also avoid the huge cost to the economy of furloughing all staff, regardless of whether they are infected or not.
We need to do better. Germany today records a cumulative 119 deaths per million population whilst the UK figure is 649, ie 5½ times greater.
We urgently need wider energised debate where government ministers and their medical and scientific advisers respond to challenges to their blunt ineffective strategies.
* Geoff Crocker is a professional economist writing on technology at http://www.philosophyoftechnology.com and on basic income at www.ubi.org. His recent book ‘Basic Income and Sovereign Money – the alternative to economic crisis and austerity policy’ was recommended by Martin Wolf in the FT 2020 summer reading list.
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167 Comments
Interesting approach and definitely shows the rush by Starmer, unfortunately supported by our Lib-Dem MPs, to a simple national lockdown is not the best approach. The first one was needed because nothing else had been planned and it was too late to wait for something better. Now government has had time to work out something better; they are making a mess of regional responses and refused to engage early on with local officials and politicians. We should be shouting that both Labour and Conservative leaderships have got it wrong.
I’m sorry this evidence doesn’t show anything of the kind and the logic is faulty.
Look if you have an idea to improve hygiene, testing and shielding then let us know it. You are not suggesting anything new is done that is not already attempted, and you are not therefore offering an alternative to lockdowns, merely that we don’t bother with them and let the virus spread uncontrolled.
1. Graph 1 is not a graph of excess mortality. Excess mortality reduced when covid mortality reduced and not by some magic that would work if we bring covid mortality back up.
2. Graph 2 shows mortality decline under lockdown and come back as restrictions have been eased.
3. We should expect the second wave to be a bit less deadly thanks to dexamethasone and other improvements in clinical practise, but the graph does not show this. The case rates shown for the first wave are not comparable because testing was not generally available. Death rates are in the hundreds per day now.
4. The issue of deaths of/with covid hasn’t substantially changed since the first wave.
I’m glad Joe Otten has done the work of pulling this non-argument to pieces, and saved me the bother!
I would only add that Graph 3 is on an obviously unhelpful scale and that Graph 4, if it means anything at all, shows that excess mortality has risen – slowly, so far – since September.
Thanks Joe – an anticipated total rejection of every point from you. But I’m raising some issues and calling for an informed debate, not advancing a settled policy.
I am indeed suggesting that we improve hygiene, testing and shielding. I would have thought such a simple suggestion would be uncontested. The UK population is noticeably more reluctant to use masks, use hand sanitiser and maintain distance than other country populations. So yes, we should improve our practice. It is universally recognised that our testing system is insufficient and needs radical improvement. As a result, we are quarantining huge numbers of uninfected people. They should be tested and if negative released from quarantine, just as infected people should be identified by more widespread testing and then quarantined. The question which I don’t know the answer to, and neither do you, is whether such improvement would limit infection rates, or limit infection to non-vulnerable groups. I am simply suggesting that we think about this more carefully.
As you say, graph 1 is not excess care home mortality. I share responsibility for 4 care homes in SW UK. We have found, in common with other high-quality care providers, that rigorous infection control has kept infections to zero for some 4 months now. I do have a graph of excess mortality in care homes but it shows substantial recent negative excess mortality, which as you’d be the first to point out, doesn’t make immediate sense, but is because ONS data does not record mortality by location prior to the pandemic, so exact data on excess mortality isn’t immediately available. However, the above observation confirms the rough finding that there is no current excess care home mortality. This does indicate that rigorous infection control is effective.
Graph 2 shows that for 3-4 months after lockdown, mortality did not increase. Again, I’m not so certain of the reason for this as you are, but a possible interpretation is that the removal of lockdown did not lead to increased infection and mortality in a period within which both could well have occurred. If autumn is more responsible than lack of lockdown for increased mortality, then lockdown is not necessarily the right response.
Joe
I agree that data for infection in the first wave is unreliable and there were probably many more. Nevertheless, the time profile of infection and mortality in the first wave was almost the same. This time it’s not. Better hospital therapy might as you say be one explanation. But current infections are largely amongst non-vulnerable groups, one report saying that as many as 75% are even asymptomatic. I also agree that mortality is rising, but this does not yet appear to be excess mortality. It may indeed be seasonal. The definition of Covid mortality in frequent cases of co-morbidity remains problematic, but is a factor which would reduce any excess mortality reported.
So the question arises as to whether infection in non-vulnerable groups should be countered with lockdowns and furloughs if vulnerable groups are adequately protected, demonstrated by zero excess mortality. Once again, I am not claiming to know the answer, but I am saying that these issues need debate, and more explanation from chief medics and scientists than we are getting.
Malcolm Todd
As I’ve demonstrated above, the points I offer for discussion are not at all so easily dismissed as you and Joe claim. I agree that it’s difficult to get the scale on graph 3 to read well. I also agree that I should slightly modify my statement about current excess deaths. After a correction on 4th September of 1,443 excess deaths incorrectly previously reported by ONS, excess deaths for the week of 9th October were 143. This compares to 11,854 for the week of 17th April, despite the apparent current immense increase in infection rate. Any year may well see an increase in excess deaths of this level.
I emphasise that I am not necessarily driving to a conclusion against lockdown and furlough, but I am suggesting that some more nuanced debate is needed. It’s undeniable that we in UK have fared immensely worse than Germany, and that we therefore urgently need to examine the issues thoughtfully. I am advancing suggestions – I don’t mind being proved wrong.
I am not suggesting for one moment that every pensioner should or would decide to shield, there has to be an informed choice.
But we do know that the older you are the more at risk you are from covid.
However, if the government were to decide to go down the “do nothing route” The Great Barrington Declaration and instead put a ring of steel around the elderly and vulnerable, then a few flaws in the logistics need addressing
There were 12,374,440 people aged 65+ in the UK in 2019. But there are 14,843,119 people who lived in a household with someone aged 65+ Additionally (in England alone) there were 2,240,850 patients on the Shielded List – though some of these over 65, so there’s some overlap)
Trying to isolate and supply food to all these 15-16m people while the virus spiked would be a monumental undertaking, & much like a hard (6 month at least) lockdown for a large part of the population. It’s not clear how we’d safely supply them with food as the virus spiked, or medical care for that matter for their underlying conditions.
Do we remove the pensioners or vulnerable adults from multi-generational households? And if so, where do you put them? Where is the housing going to come from?
Do you remove Children from households? with a vulnerable shielding adult? If so where do you put them and what effect would this have on mental wellbeing?
The whole idea of doing nothing and allowing this virus to take its course is illogical, unethical and impracticable and would bring public health to its knee’s
Geof Crocker, whilst I support the direction of your overall argument, I also have to agree with Joe Ottoen and Malcolm Todd in their critique of the way you have chosen to present the data. There is a really good book called ‘Calling Bullshit’ by Jeven D West. The book is based on a 12 week course which he co-delivers at one at the American universities, the course is aimed at teaching people to recogonise accidental or deliberate misuse / presentation of numerical data. Your Graph 3 is a classic example, it needs a second x axis with a more appropriate scale to plot deaths, as it is , it is fairly meaningless but looks good, if you are trying to make a certain point.
In fact I would agree that the premise of your argument has some merit and that a full national lock down with all the associated negative consequences is not yet necessary.
Geoff,
You mentioned Germany doing better.
Germany has a thriving private health sector, with a culture (sic) of testing.
Obviously they test a lot to drum up trade.
This meant in the initial stage of the pandemic they could the find the cases quicker than other countries.
They also have a stronger regional/local government structure then here.
Fixing those issues are long term, so we are stuck where we are.
Matt
I’m not of course suggesting doing nothing. I’m also not sure whether other commentators think we should go into a second lockdown? If so, are we facing a series of on/off lockdowns against a virus which doesn’t go away, and is there to get us each time we emerge from lockdown, ie is lockdown just kicking the can down the road, spreading the load etc? I’m not sure we would need to shield 12m >65s. Care home residents are now better shielded, and that’s where mortality is most threatening. Maybe other >80s?
Imagine we could test everyone every day and quarantine positive cases. This has been proved to eradicate the virus in one small Italian village. Identification of positive cases by testing is clearly preferable to the blunt tool of locking down everyone. So testing clearly is preferable to lockdown. The question is how much more and better testing we can achieve, and whether this is above a level which can avoid lockdown.
Gerald Stewart
Thanks for your didactic tuition in presentation skills. Graph 3 could clearly be better and suffered in transposition from my original to the web page. But I don’t see why you need to be so dismissive and make ‘bullshit’ references. You’re welcome to improve it from the ONS data if you like. However, it does still make it reasonably clear that the mortality/infection rate in the first wave (around 20%) was far higher than so far in this second wave (around 0.6%). I realise that there are many possible reasons for this including the lack of true cases reported in the first wave. But it’s also possible that the concentration of current infection in non-vulnerable groups, with 75% being asymptomatic, needs a different nuanced response.
Alan Jelfs
I don’t see why you think developing an adequate testing system is necessarily so long term. It’s sadly possible that we’re just not very good at it ☹
You need controlled experiments to compare such things. Real data based on populations are anything but controlled and the rate of spread is probably a measure of non-adherence to the rules. Lockdown would probably not be necessary if more people used common sense, basic hygiene and kept a reasonable distance from others.
Unfortunately, too many people don’t.
Geof Crocker no offence intended, it is the title of the book, which I would add has had high praise, not just from me, if you have time check it out and see if you agree with me. The lectures are on line, the title of the course is clearly aimed at getting maximum attention, as was a certain Lib Dem slogan that was in use a while back, however there is real substance behind the the title as there was behind the slogan.
I stick by the pint that graph 3 could easily be an example used in the book though. It would be easily fixed with the addition of a second axis, as I mentioned above.
Let us start with what we mean by science. I can see no way that the evidence presented to us by the government can be labelled as science. But words mean what you want them to mean.
Science needs to start with what is known about viral infections, including the previous outbreak of a SARS, plus Ebola with all the work that is at the moment to control the outbreak in the DR of Congo. In fact there is a great deal of discussion on the internet about this.
There is also the need to look at the work that has been done on the mechanisms that are used by a virus to get into a cell to reproduce. In fact there is enormous amounts of discussion on the internet about this. In particular a lot from the United States which give references to the research published in scientific literature.
There is a need for properly controlled trials and again there is a lot published not only on the internet but often in our national press.
There is a saying is there not that correlation does not imply causation.
I remember the first lecture I attended on statistics. The example was given that in Sweden the number of births was highly correlation with the stork population. The lecturer pointed out that this might not mean that storks brought babies. He favoured the theory that storks built nests on houses. As the population increased there more houses and hence more storks. I have never checked the changes of the stork population or the human population in the years leading up to 1960, the year of the lecture. But the point is clear.
A problem is that it is very difficult to do controlled experiments on people. We have to do the best we can – and my impression is that this is precisely what is happening around the world.
The things we hear from Downing Street – I see no way they have much relationship with science.
Although words can mean what you want them to mean.
Geoff,
Nice try and bless you for your efforts but you are fighting hysteria, not rational thought.
The logic for lockdown is superficial and flimsy.
“Lockdown?” What lockdown? It’s more clutching at straws. All the food shops will be open, all will have shoppers, staff, deliveries, all sorts of services and trades will be out and about. The percentage of us actually indoors and out of contact with others may not make double figures. Just window dressing, play acting, show not substance.
Meanwhile, thousands will die as their undetected cancers become inoperable or their chest pains are ignored by the NHS.
Their death certificates should have ” murdered by SAGE” as cause of death.
Well, here’s a radical option from a Cambridge professor of immunology https://www.theguardian.com/world/2020/oct/22/covid-parties-could-become-the-norm-immunology-expert-says
We’ve really got to consider a wide range of possibilities and outcomes.
Gerald, ‘I stick by the pint’ could be improved 🙂 Geoff
Look, whatever you do or not do, we have a pandemic on our hands, which, whatever we do, might eventually become endemic, like influenza.
Testing for COVID will not make it go away. Not even a vaccine can guarantee that; but it can make it manageable in future. Treatments have improved so that more lives can be saved. Lockdowns, difficult as they are to maintain, definitely do help to put a brake on the virus’s ability to spread; but, as soon as you release the restrictions, it kicks off again. That’s surely not rocket science.
So, the answer is surely pretty straight forward. Until an effective vaccine becomes available we had better get used to life being difficult for many of us, which could see us facing many more twists and turns as well as dilemmas.
What really concerns me is that there could be more viruses out there waiting to cross the species divide and they will do so unless we show more respect for nature and do something to reverse the decline of the natural environment.
@Geoff
A quarter of hospitalisations were in people under 60 during the first wave of the pandemic and that was with lock-downs and mitigations.
It is now being reported that 1 in 10 people are suffering from long-covid suffering chest pains, breathing problems and chronic fatigue and this is occurring in ALL age groups.
Where do we draw the line at who is vulnerable? Where is the cut-off point? At the end of the day, the Government and public health have defined those over the age of 65 are at significantly increased risk that increases with age and comorbidities.
So if they were to pursue a strategy that did not involve suppressing the Virus to manageable numbers, then morally they have a duty to provide a full shielding support service for those people who wish to be protected.
This would have to include those family members that live with them, otherwise, it is not shielding, so again, do you remove the vulnerable person from the household and place them somewhere else, do you remove the children? what do you do, where do they go?
At the end of the day, until more is understood about this virus and whether natural herd immunity is even attainable through studies of T-cells, because the evidence is showing that antibodies are not long-lasting and until we have better antiviral treatments at the very least, then I am afraid that we have no alternative but to have regional and localised lock-downs to suppress the transmission rates.
It is not just about protecting the lives of the elderly and vulnerable who are susceptible to this virus, it is about protecting the wider public health and NHS which would not be able to cope with out of control infection rates. That would put a whole host of people at risk, i.e those receiving cancer treatments, organ transplants to name just a couple.
Quite so!😄
Happy – for once – to agree with Joe Otten. Mr Crocker on both UBI and Covid seems to have an imaginative answer for every objection.
@ Alan Jelfs, “Germany has a thriving private health sector, with a culture (sic) of testing”……… England – but thankfully not Scotland, Alan, has a very profitable ( £12 billion and counting) private test & trace system which is failing abysmally with an under 60% (and falling) success rate, compared to Wales and Scotland which have had publicly-run contact tracing services, which report extremely high levels of contacts
Interesting to note that Boris chum (and Tory Peer) Baroness Dido Harding is captaining the sinking England ‘world beating’ organisation.
In three short years, the good Baroness has gone from the woman who failed to stop a massive cyberattack on telecoms giant, Talk Talk, to be head of Britain’s new health protection agency. Nice work if you can get it.
I’m little surprised that Geoff clearly doesn’t understand the purpose of the furlough scheme – it isn’t to prevent the spread of CoVid-19, it is to help businesses to maintain capacity and potentially survive the reduced levels of economic activity caused by CoViD-19 counter-measures, and thus hopefully enable economic activity to resume from a higher-level than if businesses are simply left to go bust.
This lack of understanding, makes me question the entire basis of the article…
Just one additional point – out of many misrepresentations of scientific data; according to the scientists, the strains of Sars-Cov-2 being seen now, are the same as the ones circulating last winter – they are just as deadly, so the reasons for a lower mortality rate in the “second wave” (assuming we are seeing a second wave and not just ripples) are down to other factors.
Matt
I agree with the factors you set out, but you conclude that ‘we have no alternative but to have regional and localised lock-downs’. You might be right about this too, but we surely must carefully reflect on whether we do in fact have any alternatives, which is what I’m trying to do. Closing the door to considering whether massively expensive lockdowns are necessary, effective, and ultimately bearable in multiple doses, is short sighted. Alternative thinking must be encouraged and considered, given the huge cost of lockdown and furlough strategies.
David Raw
I’m lost as to what you have against ‘imaginative thinking’. We need more, not less of this. Try it sometime. It’s risky of course – you might get immediately derided and slapped down ☹
Roland
Equally it’s a strange process posting on LDV when someone takes the time and effort to think about something and post it for discussion to then get dismissive comments from the waiting pack, ie ‘Geoff clearly doesn’t understand the purpose of the furlough scheme’. Thanks. Furlough is a concomitant of lockdown and for some purposes it’s reasonable to consider the two together as a wide shutting down of society.
And yes, the difference in morality/infection rates between the first and second wave could be due to a number of factors – it’s such a big difference that it needs thoughtful discussion.
@ Geoff Crocker There you go again, misquoting me….. “I’m lost as to what you have against ‘imaginative thinking’.
I didn’t say that and you’ve proved my point. I wrote you seem, “to have an imaginative answer for every objection”. Quite a different thing.
You’re supposed to kick the ball into the opposition’s goal not your own.
There’s probably not much chance of the testing system being rectified. The time to have had it working properly was over the summer and as that hasn’t happened….
“Lockdown doesn’t work……”
It depends on what you mean by work. It worked in April in that the death toll peaked some two weeks after lockdown started. The death rate then fell to single figures per day into August. We couldn’t have expected anything better than that. The drawbacks are the negative effects on everything else, including the economy and people’s mental heath, if we focus exclusively on Covid.
“The second wave is less deadly…”
It’s too early to say. There are many more tests being done than it the first wave. The number of cases then is unknown. Many would have been missed.
The rising number of patients admitted into hospitals now is more worrying. On the optimistic side the rate of increase now is much less than it was during the first wave. So we can probably expect a much flatter wave over the winter and the NHS should just about be able to cope but this is not a reason to loosen restrictions.
It looks like we’ll get a flatter wave but it will probably be longer than the first one. The number of deaths in the second wave could be about the same again even though the daily total is unlikely to reach the peak levels we saw in the first wave.
So there are some grounds for optimism but no reasons for relaxing the restrictions until we have at least another month’s figures for comparison.
https://coronavirus.data.gov.uk/healthcare
It’s curious that infections of this highly contagious virus didn’t increase for several months after lockdown ended. The thought is then that if lack of lockdown didn’t increase infections, is it lockdown which is necessary to combat infection, or is hygiene and testing sufficiently or more effective . I agree though that increased hospitalisation is worrying but still not leading to excess mortality which came much more quickly last time .
David Raw
OK I’m lost as to what you have against “having an imaginative answer for every objection”.
isn’t it likely that hospitalisations and deaths started increasing again once shielding ended in August?
There is a lag of a couple of weeks in the data and as we now know, the usual path of the virus is 5 days incubation, a further 7 days if you were to become so unwell that you needed hospitalisation and then sadly another 2 weeks till death.
So if you look at the link kindly supplied by Peter Martin, we see Hospitalisations beginning to increase again about a month after shielding ended.
It was much easier for the elderly and vulnerable to have at least some social interactions in the warmer months when it could be done relatively safely outdoors, this obviously because much harder in the colder months and as winter approaches.
But this does not enforce the arguments that it proves the elderly and vulnerable should just be shielded and everyone else goes about their business as normal, for the same reasons that I have set out in previous posts, its neither logical, practical or ethical. The only way through this at the moment is for everyone to play their part in order to suppress the virus to manageable levels because high community transmission inevitably finds it was into the vulnerable group
Matt
I’m not sure. My data comes from the same source that Peter Martin refers to – click the source links under my diagrams, as well as from ONS. If you’re arguing (perfectly reasonably) that the end of shielding led to hospitalisation and mortality, why do you then say that shielding is not part of the solution?
Of course, we all want to be ethical and play our part etc. The question is what that part should best be. The widespread infection control practised in China and Japan does seem to be effective (the last time I looked at Japanese data, there were zero excess deaths). This could be due to other factors, but strict infection control must make a major contribution, as it has in UK care homes.
Brits are noticeably lax about masks, sanitisers, and distancing. The possible UK causal factor was the irresponsible widespread crowding of beaches in the summer, and various similar mass socialising in city centres. These observations reinforce the argument that infection control is effective. Testing to identify infected people for quarantine, and release uninfected people to normal life and work has got to be effective on all outcome measures. My question is whether these together can achieve the result we want without resorting to lockdown and furlough. They are sustainable in the long term whereas lockdown is not.
As regards the initial article and headline which I’ve only skim read it’s not an either/or but both/and situation. Sadly we have about 600-800 daily deaths “baked in”. People sadly die about 3-4 weeks after they get the infection if they do so that’s about 2 doubling periods 4*150 – 600+
Remember we were blind at the beginning of the spring wave no testing and little knowledge so it’s probably much the same.
I suspect that we will get to a national lockdown even if it’s regionsl ones across the whole UK.
In the meantime stay safe folks and sanitise your hands, clean shopping baskets and don’t mix to keep the r down
Good luck!
Innocent Bystander – only just noticed your comment, but thanks, and I agree
Here’s an attempt to summarise
1 We must avoid excess all-cause mortality
2 If at all possible, we must avoid lockdown and concomitant furlough because i) it’s very costly ii) it could well lead to civil unrest, iii) it can’t be a permanent solution
3 Enhanced infection control, masks, sanitisers, distancing may suffice to achieve 1. There are indications in the data that this may be the case.
@Geoff
I’m not arguing that shielding is not part of the solution, It has to be, however, I do not believe that it will work on its own for all the reasons that I have set out above. It requires a huge amount of logistics and of course money. When you take into account all the people over 65 and families that either live with someone over the age of 65 or someone clinically vulnerable, we are talking about 1/4 of the population ( As I said before, I understand that there are many that would choose not to shield and that is understandably their freedom of choice) But the Government would have to put in enough resources to provide the shielding service for all of those and their immediate family members who wanted to be a part of that. So it would not bring an end to the furlough scheme altogether as the Government would still need to be paying a significant number of households their wages if they were living with a clinically vulnerable family member or pensioner and part of a shielding programme, How much would this cost? and like I said what about the education of children living in these households?
Yes, I do think we need to get tougher on enforcing social distancing and mask-wearing.
I am astonished at the lack of people not only not following the rules but total disregard for others. Over the last month in my own experience, I am in the process of selling my house and I have had so many run-ins with trade people having to enter my house and attempting to not follow the rules by wearing a mask, from the estate agent to the photographer, to the energy performance guy, all trying to enter my property without a mask and then frowning at me when I insisted upon it, I then had to listen to the Photographer complain and carry on for almost an hour about how wet the British people had become and what an embarrassment we are. I have never felt so uncomfortable and intimidated in my own home ( not a pleasant experience at all)
I do firmly believe that half the problem is with the government and their complete lack of competence with track and trace and testing capabilities, however, we have a significant problem with compliance amongst the public, refusing to follow the rules and refusing to engage with track and trace. This is also being stirred up by the media who seems to be relishing in causing disobedience against the rules.
So where does that leave us? If we do not have an effective testing/tracking tracing system and we do not have enough public compliance and we have a reluctant government who are unwilling to change the rules from guidance to legislation, then unfortunately that only leaves us with one option and that is intermittent local and regional lockdowns to suppress the virus to manageable levels until a vaccine or effective antiviral come into play
Graph 3 is invalid because the rate of testing has changed considerably over the period.
The title states ‘Why hygiene, testing and shielding are better …’ but there is very little on this. What sort of hygiene? How can it be ensured that whatever it is Geoff Crocker means by hygiene is implemented? Whilst hand washing is might help, I doubt that it is anything like sufficient, – ditto masks (worn properly), but viruses are unseen so we do not necessarily know the measures needed. Testing in itself does nothing, it is the follow up response that matters, but Geoff Crocker is silent on this: is it because the responses involve the same sort of steps that he claims do not work? Then there is shielding, how is this to be achieved in a mixed population with mixed households?
Then there is the issue of public transport which in some places, where there is overcrowding looks like the equivalent of John Snow’s infected Broad Street water pump. The article is short on what needs to be done.
Graph 3 isn’t invalid. It’s direct government data from https://coronavirus.data.gov.uk.
It does of course need interpretation, including for the fact that infections in March were very likely under-recorded. But it does appear to show, as a refined statement, that the current wave is apparently less immediately deathly. Hence the possibility that it’s non-vulnerable groups who are infected, and we may be able to restrict infection to these groups. It’s true that hospitalisation now looks worrying, but again the solution is not necessarily lockdown.
Hygiene would include masks, sanitisers and distancing, which as Matt points out are all poorly observed by Brits. More testing means more positives and fewer negatives are quarantined, which has got to be a better outcome. We have to accept that there could be low compliance with any further lockdown, as well as with infection control.
I offered the article to share some thoughts and to stimulate debate, not to provide complete answers. But my current inclination would be to massively reinforce hygiene disciplines to sanction non-compliance, to massively increase testing and then quarantine according to test result, and to maintain rigorous infection control in care homes.
@Geoff
“But it does appear to show, as a refined statement, that the current wave is apparently less immediately deathly.”
I think it is far too early to come to that conclusion, remember our first wave came towards the end of flu season, we are now about to be going into our second wave at the beginning of flu season, so we have no idea what kind of effect that is going to have, one thing is for certain though that Hospitals and ICU units always come under considerable strain every year during flu season. Maybe flu will not be quite as bad this year due to increased social distancing and hand hygiene? that remains to be seen.
” Hence the possibility that it’s non-vulnerable groups who are infected, and we may be able to restrict infection to these groups”
That is an almost impossible task as it will always find its way into the vulnerable members of society.
As I pointed out before in the first wave a 1/4 of all hospitalisations were in people, under the age of 60 that is pretty significant numbers in itself for hospital and care staff to be dealing with. And people who would be in the shielding group along with their shielding family members, still need to be able to access daily medical care for their underlying conditions. I just do not see how shielding is the holy grail unless the entire population were playing their part with much harsher enforcement of the rules, public compliance to track and trace.
The Hospitality Industry is always going to be a breeding ground for the Virus in the Winter months, poorer ventilation in pubs and restaurants and not forgetting the silly season of December. if the youth are not allowed to get tanked up in the pubs, they are going to break the rules and get tanked up in house parties instead ( That is not a reason for pubs to open in my opinion) the point is that you have a very significant amount of society who simply will not follow the plan that you wish to set out and considering the way in which this virus spreads, it really does not need that many people to be not complying in order to get out of control again, especially at the worse time of year that we are now coming into.
So, what do you do? how do you appeal to people who are against the lock-down measures to act sensibly and comply with the rules when restrictions are eased again? Appealing to good sense did not work last time
@ Geoff Crocker,
“It’s curious that infections of this highly contagious virus didn’t increase for several months after lockdown ended”
Not at all. It was predicted that the onset of winter would be the danger period.
There is always an increase in the incidence of ‘flu infections as the summer ends. The Covid outbreak is simply following the same pattern.
“Hence the possibility that it’s non-vulnerable groups who are infected, and we may be able to restrict infection to these groups.” .
No. It’s impossible to prevent the spread if the virus within the household. Non-vulnerable groups and the vulnerable cannot be separately housed. This isn’t realistic. Even when the vulnerable are naturally isolated they will still need to venture out for shopping or receive some form of social care. There is always going to be some social interaction. This doesn’t mean that we don’t try for better hygiene and shielding measures but if the virus is prevalent amongst the young, we can’t expect them to be sufficiently socially responsible to always do the right thing.
“….we must avoid lockdown and concomitant furlough because i) it’s very costly ii) it could well lead to civil unrest, iii) it can’t be a permanent solution”
There is a general consensus that we can’t return to a general lockdown. Even the tier 3 areas aren’t locked down to the same extent as in April. So it looks like the situation will slowly worsen and we’ll be back to a “flattening of the curve” exercise to protect the NHS from being overwhelmed. It could be close if the infection rate is still rising later in the year but I’d be confident that won’t happen.
@Peter Martin
” “Hence the possibility that it’s non-vulnerable groups who are infected, and we may be able to restrict infection to these groups.” .
No. It’s impossible to prevent the spread if the virus within the household. Non-vulnerable groups and the vulnerable cannot be separately housed. This isn’t realistic. Even when the vulnerable are naturally isolated they will still need to venture out for shopping or receive some form of social care. There is always going to be some social interaction. ”
Quite. It seems to me that there is a push to regard elderly and/or particularly vulnerable people as potentially expendable. Maybe just to allow others to go out and have a good time and perhaps drink more that they can safely accomodate..?
“but if the virus is prevalent amongst the young, we can’t expect them to be sufficiently socially responsible to always do the right thing.”
Why not? If we support being able to vote at 16 that implies the willingness of such people to take some responsibility for their own behaviour doesn’t it – if we expect them to be able to use voting rights responsibly? It appears that younger people – primary school age – might be less liable to passing the virus on to others – so is there an issue over some teenagers…?
“But it does appear to show, as a refined statement, that the current wave is apparently less immediately deathly.”
This isn’t a conclusion, it’s a possibly valid interpretation of the data we have to date, and we should think through its possible implications. Infections are in non-vulnerable groups, so the question is to what extent infection will spread to vulnerable groups, and whether lockdown will prevent cross-infection anyway, given that people will infect each other domestically.
” Hence the possibility that it’s non-vulnerable groups who are infected, and we may be able to restrict infection to these groups”
I have in mind care homes here, and I have direct data that rigorous infection control has reduced care home infections to close to zero, and that there is good reason for expecting this to continue to be the case. Shielding others of course is problematic, but where people live alone or as a couple, is not impossible. I know of several cases personally for whom it works OK, although it is boring for them. I assure Nonconformistradical that in no way do I ‘regard elderly and/or particularly vulnerable people as potentially expendable’. I had to personally scour global supply sources for masks for carers when the outbreak started in March and had to drive across the country to get our first 1,200 FFP2 medical masks due to the failure of responsible authorities to have previously stockpiled any PPE. It’s this failure, which was responsible for the huge excess mortality we suffered, which drives me to question what these same medical leaders say we should do now. It’s also what makes me hope that current adequate supplies of PPE will avoid a second surge in excess mortality, and possibly make lockdown avoidable.
I agree that policing compliance is very difficult, but this applies to whatever restrictions are decided, including lockdown. There is a real risk of substantial civil disobedience and unrest which has to be taken into account in policy formulation.
“It’s curious that infections of this highly contagious virus didn’t increase for several months after lockdown ended”
Of course, summer may partly explain this. But the first wave occurred in spring, and the second wave mortality rate may still be seasonal. I still think we should think about this factor. But you may be right.
To make it clear, I’m not trying to defend any position. I’m just thinking about possible alternative interpretations and implications which we should surely do, so thanks for corresponding.
“together with shielding of vulnerable elderly people”
How can you post about need for evidence and then drop this sentence in without considering how it would work, which country has successfully managed it and how etc.?
“There were 12,374,440 people aged 65+ in the UK in 2019.
But there are 14,843,119 people who lived in a household with someone aged 65+
Additionally (in England alone) there were 2,240,850 patients on the Shielded List – though some of these over 65, so there’s some overlap)
Trying to isolate and supply food to all these 15-16m people while the virus spiked would be a monumental undertaking, & much like a hard (6 month at least) lockdown for a large part of the population. It’s not clear how we’d safely supply them with food as the virus spiked.
Everyone accepts that the isolation of old and ill people couldn’t be 100% complete….Using data from England suggests that if only half of the younger population got it and (miraculously) only 5% of pensioners (because isolation is near complete), that would mean 90,000 deaths.
…That’s a lot of deaths. But that’s still assuming that healthcare is not overwhelmed, and so all those who need treatment for Covid are still getting it. It’s also assuming there are no non-Covid deaths caused by the NHS being overwhelmed. Both assumptions are very unlikely.”
Twitter thread by Neil O’Brien MP (Conservative): https://twitter.com/NeilDotObrien/status/1317046947224707072
@ Nonconformistradical
“…so is there an issue over some teenagers…”
I was just watching a lady, whose pub had to close, blaming the upsurge on Covid cases on the return of students to universities. She was claiming it was them rather her business which should have to close. I would say it’s probably more the start of the colder weather but all three will be factors.
I don’t think there is any particular issue with young people. It’s just young people doing what young people do. So we put thousands of hormone filled youngsters together away from their previous parental control and we are surprised they don’t always socially isolate? They have parties and jump into each others beds! Goodness me whoever would have predicted that!
We are never going to get out of this pointless destructive medical dictatorship until we start getting angry. Online I encounter lots of people who support the continuation of these panic measures, but I don’t actually know one single person, in person,who does. Friends, family and so on. Not one. They all resent it. We are most definitely not all in this together. Nearly 9 months on and still not a shred of evidence that the pseudo-anthropological anti-human (anti)social experiment has or ever will work. Yet on it goes.This is for a virus that that if you catch it you are told not bother the NHS with because you will get over it without the involvement of the medical profession . That is the bottom line. The medical advice isn’t seek immediate help you are in mortal danger. It is basically, don’t both us, guv.
Should LDV be the place to publish this? Surely if this had merit it could be published somewhere else (where the editing staff have domain knowledge to be able to approve/reject such specific assertions) and then linked in an article here?
I have concerns about this article.
I wonder if you can imagine what this conversation feels like to people like me? I am not the only Lib Dem activist who was shielding to protect someone else for whom a dose of Covid would be fatal.
We decided to self-isolate again three weeks ago. Several things are different this time round – the online supermarkets have sorted themselves out so it is not difficult to get a delivery slot – that was a real problem last time. We now go out for walks most days which weren’t allowed during the first wave, and they seem pretty safe to me. We are getting the medical treatment we need both through our GP and the hospital.
I expect many other people like us are already doing much the same – we don’t need the Government to tell us to protect ourselves. Of course, some people still need a higher level of support, in the form of food boxes etc, but that wasn’t true last time for many of the 2.5 million who were shielding and certainly isn’t necessary for the vast majority of over 65s. Let’s get a sense of perspective.
Peter Martin
Parental control past the age of puberty is pretty much a myth. It isn’t just young people, either. The rules don’t work because they are based on the ludicrous idea that we are all in the thrall of Matt Hancock and that we are sat by the wireless waiting to know how his social rationing scheme will impact on when we see each other or indeed jump into bed. Here’s a secret most people have been seeing partners, friends and family for the whole farce. They follow the measures only when it suites them to. They are only pretending otherwise because they don’t want to be reported to the covid stasi, accused of being heartless and fined.
I’ve explained how I think the most vulnerable elderly people can be protected, whether in care homes (I run 4 of these, and it’s been a very fraught period, but we do now have zero infections like most colleague providers), or by personal shielding as Mary describes, where like many of us I have people close to me needing to shield.
I certainly do think LDV is an appropriate place to discuss all this. The data I present is all direct UK government data with the source stated. I haven’t made it up. Medical and scientific leaders also need to be held to account. There is no other forum where they accept comment or respond. ‘The Science’ has become an unaccountable dictatorship, which moreover has manifestly got it wrong.
My main contention set out in my previous article https://www.libdemvoice.org/passing-the-buck-on-coronavirus-66045.html is that the huge UK failure is i) first wave insufficient PPE ii) second wave insufficient testing. Lockdown then becomes an inevitable result of this failure, passing the buck for the failure onto the general population at huge personal, social and economic cost. So I do want to argue for specific targeted measures rather than blunt instruments.
“Medical and scientific leaders also need to be held to account. There is no other forum where they accept comment or respond. ‘The Science’ has become an unaccountable dictatorship, which moreover has manifestly got it wrong.”
Geoff your submission isn’t “science”, it’s data that you’ve presented your own analysis of, with no peer review. As you’ve found, when it’s peer reviewed people point out that you are wrong _based on the facts of the matter_. “The Science” is one of the most accountable professions on the face of the planet – and as an Economist I would hope you knew that.
To the LDV editors: I would strongly urge you to take this article down. Publishing anti-science rhetoric is extremely damaging to the party and brings it into disrepute.
@glenn
Will they still resent it when they or their loved ones die? May be not from coronavirus but because the hospitals are clogged up. Or the economy is shut down as even if the government didn’t shut it down the people themselves would shut themselves down.
There is longcovid. And fortunately the young don’t die very much at all so even a small increase in death rates for this group is quite significant.
The economic issue is dealt with by sticking it on the national debt which has basically zero cost with zero interest rates.
We didn’t stop making spitfires after we won the battle of Britain. We knew the enemy would be back. And we stuck the cost on the national debt and could still afford to set up the NHS.
We are at 150-180 deaths a day and that’s from infections 4 weeks ago. Probably around 2 doubling periods so thats 600. 2 more and we are in the realms of the peak. And let’s hope the r rate comes right down.
—
I am sorry I am a militant free speecher! And of course we should *discuss* things here and everywhere. People bring different experiences and view points and I found the original article although I disagreed with it useful.
Truth, science, democracies only progress through debate. To invoke Churchill again it’s the worse way to do things until you consider all the others!
Here’s a micro example. Person comes back from France. UK policy = 2 weeks quarantine. Same person also takes test with negative result. So, no quarantine needed, as would be the case in highly successful German policy. Which policy is better? Extend this to other situations eg mass quarantining of all Manchester students, of all school year groups with a single infection in the year. Testing is better than quarantine.
My initial reaction to Geoff’s article was positive because too many people think the choice is between complete lockdown or just trying to isolate the vulnerable. Some of the comments confirm this. As Mary Reid suggests, let’s get more perspective on this and have some simple rules for us all to follow, allowing flexibility for different family circumstances, and local community support for those who really need it. What I did not like was the ease with which our party jumped to support Starmer in calling for a full lockdown for everyone; for how long ? with what support and financial help and for whom ? it is not, as Geoff says, the simple answer that it appears to be and not necesarrily the long-term effective answer either and is it worth the other costs, medical, personal and financial ?
James
It’s the so-called ‘science’ which isn’t science at all since it’s presented without peer review, and usually without evidence. At least I offer some analysis of their own data. Your proposed suppression of comment is certainly in line with the practice of Chris Whitty and Patrick Vallance who allow no questions. It might be acceptable if they’d got it right, but it is they, not I, who have got it wrong, historically over lack of PPE stocks, and currently over lack of tests.
“It’s the so-called ‘science’ which isn’t science at all since it’s presented without peer review, and usually without evidence.”
This is (editor’s note – expletive deleted) – a word which ironically, and unlike your anti-science disinformation, is banned on this site.
Science has a strong tradition of peer review (in fact I think that’s where the phrase came from) and is literally grounded in evidence.
Again, this anti-science discourse brings the party into disrepute.
I must add support for what Geoff has said about testing. Boris has ignored this and now admits its importance but in a manner that blames those organising the tests. Instead he should admit that his government ignored pleas from WHO and our own experts very early on that testing was the major key that could and should have been administered quickly using local authorities and local health and environmental officers. Where local systems have been used, contact rate has been 97% compared to the 59% (as reported yesterday) of the system run by private companies. The LA systems may have benefited from involving only a small number but even if that is the case (and it may not be) they could easily have achieved the 80% scientists say is needed for the system to be effective. Our party should now be shouting this out.
Glenn, parental control past the age of puberty is pretty much a myth, unless you think puberty starts at 18, I very much hope you are wrong, certainly that does not hold for my own two male teens! Nor any of my friends kids , though granted the means of control may change.
I tend to agree with Michael 1 if people choose to break the rules or ignore guidance then, take responsibility for the damage you cause, don’t blame the government, and don’t expect this to be over any time soon.
This isn’t a great help towards persuading people to behave sensibly:
https://www.theguardian.com/world/2020/oct/22/doctors-catch-covid-at-surrey-function-where-distancing-rules-allegedly-ignored
Michael 1
in an average year there are 1600 to 1700 death per day in the UK.
If you catch the virus the medical advise is basically not seek help because you will get over it. This is acknowledged right there in the government’s own guidelines. The cheerleaders of lockdowns keep insisting that any other approach is a wild experiment, but are pushing something that has never been tried in the entire history of virus control ever. They present this as if it is a tried and tested method, when really it’s an 8 month old panic stricken fad inspired by too much faith in and early praise for the actions of the Chinese Communist Party in the police state it controls.
Countries that did not react in the same way do not have worse results.
Welcome to the world of James Belchamber.
1 Government commits to implementing all recommendations of THE SCIENCE.
2 THE SCIENCE orders a total lockdown of the whole community.
3 NO QUESTIONS ALLOWED.
Science fiction couldn’t propose worse. Some societies have approached this practice. We don’t want to go there.
But worryingly there are tendencies in this direction in the management of this pandemic crisis. Chris Whitty and Patrick Vallance take no questions. Contrary to what James Belchamber says, no peer-reviewed scientific evidence is presented for the decisions imposed. I rather hope I’m wrong and that James can present it. Many MPs and business leaders have frequently called for it. The best we get is reference to the work of Neil Ferguson at Imperial. But Ferguson is a physicist by training. Peer reviews are in fact very critical of his work. He has shown by his own behaviour that he doesn’t believe in his own recommendations. This is science at its most discredited. Or we are referred to the head of the Royal College of Emergency Medicine, who with all due respect, is an A&E consultant, not a scientist.
A core question the science should explore is why the UK mortality rate today stands at 652 per million population whilst the German rate is 120. Responsible science should address this question but Chris Whitty repeatedly dodges it, saying that it’s too soon to judge.
I don’t at all pretend that my article is science. But it is a set of reasonable questions to ‘The Science’, and I’d very much welcome ‘The Science’s answers.
The purpose of hygiene rules is to minimise the transmission of the virus while trying to live and work normally. The purpose of a lockdown is to minimise person to person contact when other measures have failed.
It is true that this second wave does not seem to be as dangerous as the first, but time will tell. Treatments have improved, many people are still following a strict policy of isolation. nearly fifty thousand of the most vulnerable have already died. There are new dangers emerging such as Long Covid.
The science can be wrong but common sense tells us that this virus is very infectious and it has killed a great many people. Reckless disregard for safety leads to drastic measures. When people flout the rules the government has no choice because lives are at stake.
Gerald be Stewart.
I’m a parent. I think teenagers tell parents what they think we want to hear. I suspect they’re about as trustworthy as a pop up ad.
P.S
I don’t see advocates of lockdowns as more noble or caring than those of us who oppose them. They have and are causing a lot of serious societal damage.
@ James Belchamber – I do not support your plea to remove or ban such discussions. Debate and argument is at the heart of the way scientific understanding evolves and develops. All scientists are struggling at the moment to understand this virus.
It is equally wrong to politicise the pandemic or try to convince others that lockdowns are not needed. This question will be addressed and answered at a later date.
In the meantime, we need to give the benefit of the doubt to those who are charged with making the difficult decisions.
This article shows graphs but is not ‘evidence based.’ It is, in fact, a rant with pictures.
Worse, as most people read only the headline or at most the first paragraph before sharing articles that match their pre-existing opinion, it is simply arming the ignorant -during a global pandemic.
In subsequent comments, the author says – “‘The Science’ has become an unaccountable dictatorship, which moreover has manifestly got it wrong.” – Frankly, this is the sort of dangerous hogwash I’d expect at QAnon – attacking the scientific consensus and misrepresenting terms and data to arm your conspiracy.
I’d written a longer take down of near every assertion and conclusion but it’s too long for this comment box apparently. Here’s a very reduced summary:
1) Author says “We are told that policy is science-led” – actually, this has been challenged by the media at length, the govenrment has banned some experts for going off message and both SAGE and Jonathan Van Tam have said publicly that the government is making political, not scientific decisions.
2) Author conflates total lockdown (April) with partial lockdown (everything since)- SAGE says that Tier 3 may not be sufficient lockdown to reduce R-number below 1.
3) Author talks about care homes and reduced mortality rate; suggests this is from infection control, not lockdown. Author also admits care homes have residents shielding which is a type of lockdown.
4) Author claims 2nd wave is less deadly than 1st – but they are not comparable because of different testing and different population cohorts being infected. Disease is still as deadly within same groups as 1st wave.
5) Author ignores impact of Covid on other population cohorts e.g. the young. They can still die but also ‘long covid’ can be debilitating and we have no idea for how long.
6) Author suggests low mortality post-lockdown shows that lockdown doesn’t work. There are a great many factors that have been ignored here such as: it was summer and people were outdoors; most vulnerable people stayed shielding; some forms of lockdown were still in place; schools/universities were not open; the general public were more cautious… and on and on.
Try as you might, you cannot represent this article as a question. This article makes assertions, apparently (but not actually) based in fact, that are dangerously misinformed.
Criticise politicians all you want – we must not be a party that demonises science or scientists.
Sorry, I simply don’t accept that we should give ‘the benefit of the doubt’ to Chris Whitty and Patrick Vallance and allow them to answer ‘at a later date’. Too much is at stake. The scientific and medical community has had 6 months to address these questions but still refuses to do so. We have the right to an answer as to why sufficient PPE was not in stock in March, why sufficient testing was not available in September and still isn’t now, why the German management of the pandemic has been so hugely more effective. Many lives have indeed been lost through the PPE failure, and many lives are currently being curtailed through the current testing failure.
Rob and James are entitled to disagree. But I am not ‘demonising’ scientists. I am simply asking them some reasonable questions.
@Geoff- how can you say you are not demonising scientists when you call science an unaccountable dictatorship?
Also, why are you blaming scientists and medics for the lack of PPE and testing? Matt Hancock and Dido Harding are in charge of that.
There is obviously a problem if the response to “Graph 3 is invalid because the rate of testing has changed considerably over the period” is “Graph 3 isn’t invalid. It’s direct government data”
– as though anything the government produces is by valid by definition.
As others have pointed out the validity of data is assessed by peer review – does it stand up to scrutiny? In this case (and other data presented here), the answer is that it does not.
@Geoff Crocker
Thanks for this article and credit to LDV for publishing it. Societies are now starting to have a proper debate about policy choices rather than calling people “anti-science, conspiracy theorists, dangerous nutters” and all of the other nasty comments.
However I must admit that these graphs could be interpreted in a number of different ways.
I think part of the problem is that the response to Covid has been driven entirely by data, mathematical modelling and hypothetical worst case scenarios which has led to poor decisions.
People who don’t think lockdown is the way to go should avoid playing that game and insist on proper quantitative analysis instead. The main arguments eg the collateral damage to wider health and global poverty can’t easily be depicted by a graph.
Martin, any question of the base data should be made to its government source, or to ONS. I cite the links in each case, so you can check it out yourself and with them. I think that if you mapped the same data yourself, you would get the same graphs which I present. I accept of course that analytical interpretation of the data is a matter of intellectual discussion, which we’ve been engaging in.
Rob, you can call it ‘demonising’ science. I call it challenging. I’m not blaming scientists for the lack of PPE and testing. But much is made of the fact that they are the ones advising government. It’s therefore reasonable to ask them whether they advised preparatory stocking of PPE before the pandemic, and whether they advised more extensive testing over the last 6 months. They appear on our TV screens regularly, either with or without the PM. They should therefore be prepared to say what their advice has been, and if it didn’t include preparatory PPE and more extensive testing, then why not? And why Germany has done it better, and whether we could learn any lessons from Germany. Why do they continually refuse to answer such questions?
You object to the style of my article which makes bold assertions and offers them for discussion. I’d be happy to add a question mark after each of the assertions if it makes you happier. Read it like ‘X is the case. No?’. I’m not into unilateral statements. By posting to an open blog, the intent to discuss the points is clear. The discussion has duly ensued.
My resulting assertions are
• Testing is better than quarantine. (See my examples above of returnees to UK, Manchester students, whole school year groups)
• Adequate PPE has led to zero infection rates in care homes.
I think these are fairly defensible assertions?
What is less certain is my policy development proposal from these assertions that infection control, testing, and shielding are better solutions than quarantining, lockdown and concomitant furlough. I’d welcome an engagement with ‘The Science’ about this, as well as the comments of LDV readers.
Thanks Marco and agreed.
“The second wave is less deadly”
This article in the Telegraph appears to support this view. It is really saying that medical science has worked out some more effective treatments. It doesn’t mean that the virus itself has mutated into a less virulent form. That may happen. Hopefully. Viruses do tend to do that. But it could take years.
All the more reason to make sure that the NHS is not overwhelmed with the second wave and is in a position to administer these improvements.
https://www.telegraph.co.uk/news/2020/10/21/data-intensive-care-units-shows-second-wave-wont-deadly-first/
(This is behind a paywall but you can read the article if you right click on the page and select “View page Source”. Then search, using CTRL F for a key word such as ‘intensive’)
Please do not take down this article. The issue discussed here is to what degree there ‘should or should not be’ a lockdown which is inherently political and hence belongs here. If the issue discussed was whether there ‘is or is not’ a virus then that would be scientific. Attempts to shut down debate are fundamentally illiberal. That is what is out of place here, not the article.
I simply don’t understand why we can’t have a discussion which involves creative thinking on LDV. We have a pandemic and our country and the world is up against it and knowledge of the virus and it’s effects is constantly changing.
At the moment we have no real alternative to some form of lockdown as the way to fight the virus, so we have to use it. I’ve become aware of a tale of two cities amidst all this confusion, not Paris and London but Sydney and Melbourne. New South Wales (Sydney) was able to introduce an effective track and trace system because of its localised public health system which was well funded. Victoria (Melbourne) had a lack of investment and relied on lockdown. NSW has never been in the sort of lockdown which we had to impose at the beginning of the pandemic, for example, hairdressers stayed open.
Victoria has learned lessons from NSW and has now developed a similar track and trace system. This may show what combination of measures works best. The track and trace system can not only track the contacts of an infected person but can also work backwards to see where they caught the illness. It provides valuable information about how the illness spreads as well as protecting those at risk.
This ridiculous government of ours just keeps on making mistakes but it’s not impossible for us to develop an effective track and trace system now which would alleviate the economic hardship which will follow from lockdown. Unfortunately it requires elements which the Tories are ideologically opposed to – public provision, localism and community involvement.
Can’t we just agree to attack the government for failing to protect its citizens properly rather than getting very emotional about what is science and what isn’t?
PS I am aware that Australia is a different country and that they have stopped movement between states so it isn’t comparing like with like. No comparison of anti Covid measures is ever going to achieve that, there are just too many parameters.
Regarding the crux of the argument, we don’t really need the graphs to know that lockdown doesn’t and won’t work. It’s really about correctly appreciating how complex human needs really are, and here the lockdown reasoning has been critically flawed from the start.
The simple fact is that the virus does not harm most people – many do not even know they have it. Yet lockdown expects them to nevertheless self-harm (medically, educationally, socially, economically) with immediate and palpable consequences. It doesn’t add up, and it never will.
To try and cover this chasm in their argument, pro-lockdowners rely on talking up altruism backed up with accusations of selfishness to a degree that I am sometimes reminded of the women who handed out white feathers to ‘shirking’ men who – gasp -preferred to stay out of harm’s way rather than die for the greater good. Intolerable selfishness! But is it selfish to want an education? Family life? To enjoy human company? To keep your job? Of course it isn’t. There is just a balance of harms to be considered, which does not always come out in favour of suppressing the virus, and – dare I say it, might just be best understood by the individual concerned rather than society at large during one of its fits of morality.
One of the most depressing things back in March was the failure to have a ‘balance of harms’ conversation. Instead, anything other than lockdown was howled down as ‘murder’. Now, inevitably, the issue of ‘balance of harms’ is inexorably emerging – as it was always going to. Let’s have that discussion honestly, openly and sensibly.
Interesting to read an economist (a discipline infamous for lack of agreement on their own subject) calling ‘science an unaccountable dictatorship’..
Relying on ‘higiene, testing and furlough’, in the real world of Johnson, Hancock, Harding, Sunak, etc.,(to say nothing of Serco, Randox, etc.) shows a naivety which would be touching in any other scenario..
@Geoff – When you declare that science “is an unaccountable dictatorship”, that is not a reasoned ‘challenge’ but rather it is an attack.
Your new revised assertions are still false and ill conceived:
You say that testing is better than quarantine. In actual fact, testing is useless without the trace and isolate strands of work – you may notice that isolate is a type of quarantine. But the test & trace parts only work well when you have reduced the number of infections in the population to a manageable number i.e. after a lockdown or, as you say, quarantine.
You say that adequate PPE has led to zero infection rates in care homes. Zero is hyperbole but I take the point that extensive PPE use has reduced infection rates. But 1) PPE use has not happened in isolation, visitors have been barred and an effective ‘lockdown’ or shielding approach has also been taken amongst other measures 2) it is not possible to extend the level of PPE usage (as well as the levels of control over care workers using PPE) to the population at large – there is not enough PPE and it is not possible to wield that level of control over the public.
For all the people who think this is a jolly debate and that free speech dictates that this erroneous, misleading, dangerous article should be ‘defended to the death’ I would suggest that:
a) most people will not read these comments, the ‘debate’ or even the bulk of the article before sharing the headline and dangerous message with their friends – this is a tested observation of how people behave online. For most people, digital platforms are not arenas of deliberation.
b) there is a saying – you are entitled to your own opinion but not your own facts. This article presents as facts a lot of demonstrably false statements and conclusions. It is not an opinion but a source of fake news or ‘alt-facts’ if you will.
@James Fowler
On the balancing harms issue, being educated, earning a living, having a good time etc. in the present crisis are fine as long as ways of doing so without harming others are worked out and adhered to. Some people might not be able to indulge in absolutely all the freedoms to which they are accustomed if doing so impairs the basic freedoms of other human beings. I’m not going to shed tears over such people losing out like that.
Rob, you’re grasping at straws.
‘Challenge’ or ‘attack’ is a question of choice of spin. I intend it as challenge, you choose to interpret is as attack. But the questions remain the same and ‘the science’ should answer them.
By testing, I mean of course including subsequent quarantining of positive cases, which I compare favourably to mass quarantining of whole untested groups. I can’t see that this is contestable? Quarantining whole groups, well over 90% of whom are uninfected, is harmful, costly, ineffective, and unnecessary.
You’re right that care home infection control includes restricted controlled visiting. But the main point is that we do now seem to be able to keep care home residents safe, and they bore the brunt of first wave mortality. We have to be sure that we can keep them safe within this second wave of infection, and I and colleagues are working on that constantly. It is very challenging and tiring for our teams, but they are committed to their vocation, and have maintained a happy atmosphere in the homes. Wider public infection control will of course have to be less than full care home procedures, but should be more rigorous than it is now, ie, masks, sanitisers, distancing etc, with sanctions.
I do not think this is a ‘jolly debate’. I have personal reasons for having wept at the mortality of this crisis. You can challenge the interpretations I offer, but not the facts I cite. I repeat they are all direct unadulterated government sourced data with sources properly cited.
The rule of six, social distancing, regular washing of hands, use of alcohol gel, wearing of face masks when mixing indoors, all of these have been in force for a while, yet it is clear that they “don’t work” because infections are rising at the rate of many thousands per day.
I suspect these measures do work but they are not being applied correctly or at all. This discussion about the effectiveness of various measures is to some extent a waste of time because if people do not follow the rules then it is impossible to judge their effectiveness.
I meant to say qualitative not quantitative earlier
In other words we are bombarded with data without being given much in the way of analysis or context. This is is supported by sensationalist reporting again without context by the media.
James Fowler sums up the arguments very well. The reality that most infections are mild is s crucial point because this in turn dramatically changes the balance of harms debate.
Society clearly has always accepted a level of mortality and accepts that people will transmit respiratory viruses to other people. Therefore rather than attempt to suppress or eradicate Covid, instead we should aim to reduce the risk to a level that society already tolerates with other illnesses.
” you’re grasping at straws.”
Is this an example of some type of logical fallacy? If not, maybe it should be!
I would say that we all can judge the strength of any arguments, such as from Rob Davidson, for ourselves! So how do these kinds of put-downs add anything to the debate?
Glenn, interesting comment on children!
I don’t think it is about who is more Noble or caring, there is a clear debate to be had, lock down with negative consequences or open up with negative consequences, however I do ask that those that refuse to follow the restrictions and advice take responsibility for their actions. Just as those who demand tougher lock downs should take responsibility for the heir actions. There is no universal right answer to addressing the pandemic, it depends on your priority, do every thing we can to minimize the spread of the virus, then lock down tight. Balance supporting the economy, people’s liberty and reducing the spread of the virus, different answer both have negative consequences.
their actions!
Is ‘missing the point’ more acceptable than ‘grasping at straws’? As for the claim of ‘hyperbole’, I affirm that thankfully the 4 care homes I have responsibility for actually experienced exactly zero infections for the last 4 months. I’m not sure whether this data will be accepted as fact, given that I’ve been accused of publishing ‘false news’ for source-cited UK government data.
@ Geoff,
Maybe its you who are “missing the point”? The implication in your title is there is a choice between better “hygiene, testing and shielding” and “lockdown and furlough”.
But does anyone have any confidence that testing is going to be much good in the near future?
And we are nearly all agreed that we can’t go back to previous levels of lockdown. Furlough is not quite so generous as it was.
That leaves better “hygiene and shielding” vs “semi-lock down and not-so-generous furlough”?
Methinks we might need all four.
@Geoff
You are to be commended for achieving zero infections in your care homes over the last 4 months, however, that is much easier to achieve in a controlled setting with fully trained staff and PPE and strict infection controls.
Unfortunately, that is much harder to achieve in community settings where there are far more elderly and vulnerable living.
There are far more opportunities for someone who is living independently to pick up the infection, from forgetting to wash hands after getting the bins in after collection day, potential infection from mail, Groceries, even opening their own gate.
I am not trying to sound condescending when I say it is more difficult to educate “some” more elderly vulnerable sections of society when it comes to strict hygiene controls, because clearly there are many elderly citizens who are bright as a button and much more clued up than some of our younger generations. But the unfortunate reality is, there are many many elderly vulnerable members of our society who do suffer lapses of concentration.
Your plan to just rely on Good Hygiene, Testing and Isolating, simply is not practical in our current situation.
The virus is currently rife within the community, we are coming into Winter and we have hopeless track and trace system that is unable to cope, along with too many non-compliances.
In order for track and trace to work, the virus needs to be brought right down to manageable levels and the government needs to get its backside in gear and get the system working properly. I wish they would just bring whoever over from Taiwan or South Korea, or Germany or whoever has an effective system and get ours up and running.
But the current situation we are in means we have no alternative but to use local and regional lock-downs to bring down transmission rates.
It is pointless arguing for doing things a different way when the infrastructure and system is not in place to deliver it.
That is unless you want to be like Glenn and arguing against all measures and just allow the virus to rip and hope for the best
I appreciate that there have been some strong feelings expressed about this post, but we still ask for courtesy and politeness. In particular, if you don’t agree with what someone has written then you can say that you disagree or that you think they are mistaken, or that they have got their facts wrong – whichever is appropriate.
What we do not allow is an accusation of lying. That is a cheap shot because it implies that someone is deliberately misleading others, and that you have insight into their motivations. It is rightly not allowed in Parliament, and we do not allow it here. And don’t try to get round it with phrases like “economical with the truth”.
The specific point I’m making at this juncture is that testing, for example, Manchester students, whole school year groups etc and quarantining only positive cases is surely better than quarantining them all? If we can’t do this because of lack of testing capacity, then this indicates government failure, which should be rectified asap.
I’m not sure I follow the point about the challenge in shielding more vulnerable elderly people not in care homes, because this would have to happen in either scenario, with or without lockdown? So it isn’t a point against a non-lockdown strategy.
@Geoff Crocker
Unless I am missing something, I did not think your article was just about the mass testing and quarantining of students?
I thought your article was calling for rigorous testing for the entire population and quarantining the infected and doing away with lock-downs and furlough’s
Have we changed the debate? I am confused.
And yes you are right, we do have to have shielding for the elderly and vulnerable regardless of lock-downs.
But the point is, Track and Trace does not work when you have infections rate as high as what they are and we have a problem with compliance
according to the latest sage “Only 10.9 per cent of people told to self isolate by NHS Test and Trace complete their two-week period without leaving home, SAGE was warned. Scientists at King’s College London, working alongside Public Health England, quizzed 30,000 people living in the UK about how they have acted during the Covid-19 pandemic. Even though 65 per cent of people said they would quarantine if contacted by Test and Trace, only 10.9 per cent actually did.”
So with low levels of compliance and high infection rates in the community, we have no alternative but to have regional and local lock-down measures.
Once the infection rates come down, the government has to pull its finger out and do much much better with track and trace and we also need a better public education campaign on compliance with track and trace and I am afraid proper enforcement.
Otherwise, we are going to be stuck with this perpetual intermittent lockdown until a vaccine or effective anti-viral is found.
Those who are breaking the rules need to accept that their actions have consequences and are likely contributing to prolonging our recovery both financially and medically
Matt, you’re right that I did write, ‘testing for all’ which is ideal but unrealistic. I should have written testing for all people with suspected infections, eg the Manchester students, school year groups, people returning to UK, contacts traced from known infections. Such testing should be the direction of travel of policy, but the indication is that whole group quarantine is being imposed instead.
I accept that compliance is low, but it might well be higher if only people testing positive were required to isolate? I also still dare to think that it’s just possible we can protect the vulnerable without lockdown of non-vulnerable groups. I don’t know whether this is correct, but I think we ought to allow it to be thought about and thought through. I worry that lockdown might also meet low compliance. Thanks for discussing it with me and others.
@Geoff Crocker
In an ideal situation, we would have the capabilities to test everyone who shows symptoms and then contract trace and test every one of their contacts and isolate all of those who test positive. Mind you, that would then require the Government to come up with a better financial package for those who test positive and are ordered to quarantine maybe 80% of their wages? with stiff penalties for non-compliance.
I still do not believe though that the Hospitality sector could return to “normal” especially pubs and clubs, there would still need to be restrictions on numbers allowed in venues to prevent packed bars and clubs because a virus will rip in that environment due to the lack of ventilation and social distancing and obviously you don’t wear a mask and can not be practising good hygiene whilst drinking. So there would still need to be substantial financial support for this industry.
Whether the Government would ever get to the stage where it has the capabilities to test and trace in the numbers that would be required to work, who knows. But until it does, we have no option but to carry on with the intermittent local and regional approach. And I suspect that even if they did finally come up with the infrastructure to do this, they would need to still have a brief circuit breaker to get numbers down so that track and trace then become viable.
Despite what some people think, I am all for an alternative to what we have now, I do not want to see elderly and vulnerable people shielding indefinitely and a better effective mass testing program, track and trace would mean that the so-called “ring of steel” maybe wouldn’t need to be so damned tight and we could all have a better quality of life and live as close to normal until science and medicine can get us out of this.
I’m reading this article and subsequent comments from the perspective of someone who is more likely to end up needing hospital treatment and therefore at greater risk of dying if I get this disease. The same goes for my husband.
I’ll tell you what concentrates the mind – the fact that your local hospital’s Covid ward is full.
This discussion is missing the point in many ways. It’s the capacity of our NHS that has to be a key factor here.
If we do as Geoff suggests, it won’t be long before we’re seeing the sort of scenes we saw in Italy earlier this year where people couldn’t get the treatment that they needed for Covid.
It may be a mild illness for most people, but for those who need it, the treatment is long and labour intensive.
We need to spare a thought for those NHS staff who are approaching Winter exhausted. They have been through the first wave, then worked flat out in their usual jobs to catch up as much of the backlog from the Spring and are now facing the second wave.
A country’s ability to deal with Covid is very tied to the capacity of its health care system. We managed to avoid overwhelming ours in the Spring. We will not be so lucky in the Winter if we don’t get R below one. And a few squirts of sanitiser and a vaguely competent test and tracing scheme isn’t going to manage that.
Had the government been better prepared and more responsive at the beginning, we might have avoided all of this, but we weren’t and now too many people are paying the price.
This disease is a serious threat. The data from across the world shows it to be so. We should not try to lull ourselves into a false sense of security by manipulating data to make it look better. If we do that, we can expect that approach to lead to disaster further along the line.
@James Belchamber
“To the LDV editors: I would strongly urge you to take this article down.”
In 14 years as a blogger, you, James, are the only person who I have seen asking for articles to be taken down. You did it also for one of my articles in January this year.
The liberal and Liberal approach is not to take down articles.
The liberal and Liberal approach is to make the arguments against a position, as has been done above.
Not to take down articles. That is a) abhorent to me and b) totally pointless (most people have already seen it and it would still be available in caches, archive.org etc etc).
@Caron
Thank you for the sensible analysis
That was something that I was arguing during the first wave, we must put the welfare of the NHS first and those that work within it.
Yes the NHS, ICU and staff are used to working under intense circumstances in the winter months and during flu season, however, that is not sustainable in the long term with no end in sight. Staff would suffer serious burnout.
You can not expect anyone to handle working 12-hour shifts, day in day out under the considerable physical and mental strain. Many of the NHS staff have had to isolate from their own loved ones and family so as not to put them at risk.
It is simply not just for us to say, well you chose that profession, accept the sacrifices whilst everyone else goes about their business and allow infection rates to keep rising.
I do not believe for one second that the NHS would be cancelling elective surgeries and other services unless they felt they had no other choice, to protect lives and as to not overwhelm the NHS.
Even if people have a mistrust of the scientists, I will always trust what our NHS frontline staff have to say on the pandemic and the effect that it is having. These people care about peoples lives and peoples health, they are not in the habit of wanting to delay people’s treatments.
Caron, I do understand this. My elder daughter works 12 hour shifts as a nurse on a Covid ward and my eldest son has a syndrome which makes him very vulnerable. He’s had to shield for 6 months, and still can’t return to work, even though furlough has ended. I have responsibility for 4 care homes. Nevertheless, we do need to consider alternative strategies. Infection control, which is far more rigorous than ‘a few squirts of sanitiser’, has to date eliminated infection in care homes. I’m the last person to be presumptuous that this will continue to be the case, but we are certainly working very vigilantly to make it so. Discussing alternative strategies should not be taken as an indication of lack of care about the crisis. I’m not ‘manipulating data’, just presenting it and thinking about what it might mean.
Historically I am very critical of government and medical authorities for their failure to provide PPE in March, and testing with quarantining of positive cases in September. I think we are owed an explanation for this failure, the first of which undoubtedly led to many avoidable deaths. And we do need a proper explanation as to why Germany has done so very much better than us.
Currently, I do think we have an alternative to test groups such as Manchester students, whole school year groups, and people returning to UK, quarantining only positive cases rather than whole groups. I think compliance would rise significantly. I may be wrong, but I think I’m making a reasonable point which needs a clear medical answer?
We are now facing 20,000 new infections a day, 1,000 hospital admissions, and 224 deaths. We need to drill down into this data to know how many of the infections are life threatening compared to asymptomatic, and how much of the mortality is excess all-cause mortality. But I do agree with you that the 1,000 daily hospital admissions is the most telling and worrying parameter. Whether lockdown or enhanced test and trace is the best strategy I don’t know, but it needs urgent discussion, and again, clearer explanation of the reasons for the choice by medical leaders, which will again increase compliance.
“Whether lockdown or enhanced test and trace is the best strategy”
It doesn’t have to be either/or.
Please
Few people are really sticking to the rules, the police can’t enforce them and the whole thing is built on pretence because it is based on putting unrealistic, unworkable and unnatural demands on people. The measures have been a dismal failure from day one. More of the same do precisely nothing. Governments can’t control the actions of their own ministers, let alone the private lives of over 60 million people. All that is happening is that our and other countries are being destroyed because their political classes have turned fighting microscopic biology into fanatical quest they can never win. They’re tilting at windmills.
@Glenn
“Few people are really sticking to the rules, the police can’t enforce them ”
So your logic is, People are not sticking to rules, so we should just abandon them and allow the virus to take it’s course?
Personally, I would have thought the logic should be, remove the guidance, make it legislation, increase the penalties for non-compliance and provide the resources to enforce it.
Now, In normal circumstances, I would be against a heavy-handed approach to the state handing out fines and punishments, but these are not normal times and we have a public health emergency that whilst the vast majority might not be at immediate risk from covid, the vast majority are at long-term risk of a significantly diminished public health service caused by the Virus
@Glenn
Thanks for your further comments. In a nutshell earlier, harder and longer lockdowns have proved
Better for the economy,
Better for younger people
Better for people with diseases other than Covid.
The approach of government should in my opinion
To have locked down earlier. With an r rate then of around 3, doubling every 3-5 days, it would have saved a vast number of lives
Taken the restrictions off later and slower aiming to get down to near zero.
Then stamped down harder on outbreaks. With a good track and trace, closing venues that are thought to be sources etc. Sick pay at a 100% of someone’s normal pay subsidised by the government etc.
Quarantine for all countries so it’s not reseeded.
Better for the economy.
As we would now be operating at a much higher level. And an earlier lockdown would have meant a shorter one.
Better for young people.
Nightclubs have never I believe been allowed to re-open here. They are open in South Korea. With no virus they could go out raving in as big a group as they liked!
Better with people with diseases other than Covid
cancer screening cancelled, non urgent surgery has had to be curtailed etc. And you don’t exactly want to pick up a case of Covid with your knee op. NHS staff have worked vast amounts but even drafting in retired and student nurses and doctors, there is a limit to resources. Remember one ICU bed needs I believe one to one 24 hour nurse cover that’s three plus nurse shifts.
Boris has wimped out of taking the difficult decisions – early lockdown, longer lockdown, quarantine etc. in the face of the understandable bleating of industry, people and Tory backbenchers but if he had it would have been in their interests within weeks.
You are right to say we are now where we are and an indeterminate lockdown is probably unrealistic but consider the maths of a 2-3 week firebreak which Boris has now wimped out of. With a firebreak if it achieved an r of 0.7 – .343 of the virus I.e. reduced by 65%. No firebreak and an r of 1.5 – 3.375 more virus that’s a vast difference. But we will see how Wales and England fare. I massively hope and pray that England’s r rate drops towards 1 as that means less suffering.
“Whether lockdown or enhanced test and trace is the best strategy”
“It doesn’t have to be either/or.”
In principle true, but lockdown has severe knock-on health effects, (ie it’s not inaccurate to say that people are dying because of lockdown), as well as huge personal, social and economic costs, so it should be the strategy of last resort? We certainly shouldn’t have lockdown simply because we give in to our (£12bn) failure to deliver test and trace.
I’m arguing that if, where infection has occurred, we only quarantined cases testing positive, then compliance would rise? I’m almost sure of this. Instead we get the blunt knee-jerk reaction to quarantine everybody. This illogicality dangerously undermines public confidence in scientific advice and government decisions.
If lockdown does become inevitable, (where Caron’s point about hospitalisation rates becomes the critical issue, and only until adequate test and trace is in place), then we do need better justification than we’ve been offered so far, including the readiness of Chris Whitty and Patrick Vallance to answer reasonable questions. Again, compliance would then rise?
Honestly, I’d ask the German health authorities for their advice.
Matt
Yes, more or less exactly what I think. Frankly, I suspect you would support any outrageous governmental overreach on offer , whether it works or not, because you are in a spiral of panic and fear. Me, I say if something doesn’t work, you stop doing it. I think the whole episode is a fanatically doomed quest to defeat microbiology by issuing unworkable decrees held together by the pretence of control and the inability of the political classes to admit to the realistic limits of their power.
@Geoff
“(ie it’s not inaccurate to say that people are dying because of lockdown)”
Are you sure that is accurate, is it fair to say that people died because of lock-down? or would it be fairer to say that people died from non-related covid because of Covid?
For someone suffering from Cancer, organ transplant and undergoing treatment puts them at huge risk from covid due to the treatment lowering the Immune System.
Anyone going through any major operation would be at risk from covid.
The list goes on and on.
So I do not believe that it is fair to say that people died from lock-down, that is a lazy argument to justify an objection to lockdown restrictions.
People died from Covid and non-related covid deaths because of a virus that is putting a significant section of society at risk either directly or indirectly from the Virus.
I really do not believe that is appropriate to feed the mantra that people died because of lockdown. Without lock-down, these people would have been in just as much risk from covid if not more.
We would then have the same people who have been putting forward the arguments and downplaying the severity of covid that it is only killing people with underlying conditions.
The facts are there are millions of people in the UK living with diseases that make them very vulnerable to covid. Diseases that though debilitating with medication and treatment can still live perfectly normal and productive lives.
Covid has changed all that, not just for the person with the disease, but the immediate family members who live with them and have to do their utmost to keep themselves from catching this virus and passing it on to loved ones.
I know you think with effective hygiene controls you have managed to stem the infection rates in your nursing homes, unfortunately for an average home in the UK, they neither have the resources or training to put in effective infection controls like that. And quite frankly what household would want to set themselves up to be like a nursing home or hospital ward.
It’s not practical and so I am afraid that we ALL as a society have to do our part to drive down this disease. We are all equal citizens, regardless of whether we are at the start of our lives, or towards the ends of our lives
And as difficult as this is, we all must accept some kerbs to our freedoms until science can find us a way out of this.
@Glenn
“I suspect you would support any outrageous governmental overreach on offer , whether it works or not”
You can hardly say that lock-downs do not work? Where is your evidence that they do not work?
The Government and the Scientists NEVER said that lockdown would get rid of the virus entirely. They said it would flatten the curve and drive down R which is exactly what it did.
Infections came down, Hospital admissions came down and deaths came down.
So what is your evidence that it did not work? It set out to achieve exactly what they said would happen.
Now we can argue whether they let their foot off the brake too early, or whether the Government used the time wisely to put in effective track and trace systems,
But I fail to see what argument you are going to come up with to prove that it did not work.
My understanding from the Scientists from the very beginning was this was going to be a long haul of putting in measures and decreasing measures intermittently to keep hospital admissions down to the point so that they do not get overwhelmed and putting covid and non-covid patients at risk and this was going to be the way of life until a vaccine or antivirals came long to get us out of this.
I think that was pretty clear from the start in what Sage was saying, so how has that not worked?
@ Caron Lindsey,
Thank you so much for mentioning the staff who will bear the brunt of increased physical workload of increasing hospitalisations and also the emotional impact of caring for severely ill patients with Covid and an unbearable death toll.
Already, those who were drawn from various specialities during the last peak are being drawn back to caring for the rising number of covid patients who are filling beds again. The answer to continuing care and treatment for those with non -covid diseases is dependent on beds and staffing levels, neither of which were adequate before the pandemic.
I know from those members of my own family that they are still physically and emotionally drained, but they are now psychologically prepared in readiness to care for people suffering with various severities of the disease in a totally selfless, professional manner.
Stay safe as a family.
@ Geoff Crocker,
The government had plenty of warning of the need to stock up on PPE. They were told to prepare for a respiratory epidemic/pandemic last year, with amongst other things, the need to stockpile PPE., bolster test and trace infrastructure in readiness for mass contact tracing, etc. Check out the 2019 National Security Risk Assessment NSRA report which was signed off by one Sir Patrick Vallance. Blaming the NHS is just another way the government seeks to divert blame for lack of preparation. For example, the rush to get PPE as a reactive rather than proactive measure meant that globally too many countries were all trying to source supplies at the same time.
If we ever return to transparency in government, one day the truth of this government’s laissez faire attitude to risk assessment, preparation and consequences will hopefully be revealed. In the meantime for all members of society the answer to a return to caring for non covid disease, routine surgeries etc., is to follow mainstream evidence -based advice on how best to suppress the spread of the virus. By protecting ourselves, we are protecting others.
Geoff Crocker,
You say lockdown ended in May. This is not how I remember it. According to the Independent https://www.independent.co.uk/life-style/health-and-families/lockdown-end-date-when-boris-johnson-speech-coronavirus-update-a9580531.html. From 13th May people in construction and manufacturing were allowed to return to work. From 1st June lockdown continued but people could meet up to six people from different households outside – only outside, and a couple of year groups were allowed to go to school, but this was not universal even for those year groups. From 23rd June people from two households could meet indoors, but lockdown continued. The 23rd June article couldn’t say when lockdown was going to end.
It was only really from 1st August that lockdown ended, but some restrictions remained. The wearing of face coverings in all shops became mandatory from 24th July.
The number of deaths fell to 3 on 17th August, but by the end of August it was increasing very slowly. On 26th there were 16. During most of September it seems to have stayed at this rate. On 17th September there were 21 deaths. But on 26th September there were 35 deaths. All schools were back by then and some students were going off to University. During October the death rate has risen faster, with 66 deaths on 2nd October, 87 on the 9th, 136 on the 16th and 224 on 23rd.
Therefore it seems to me that lockdown did work.
Your graph 3 shows that since lockdown ended the number of cases has increased dramatically.
Of course this doesn’t mean that a national lockdown is the only answer.
I am not convinced much more can be done to increase hygiene. There has been a reduction since lockdown ended but it is not possible to force people to keep doing what they were doing in April. I think shops could go back to the same level as in April with them cleaning trollies and baskets after every use rather than relying on the public. Should our party be calling on the government to make it law that shops have to clean every trolley and basket after it has been used?
Shielding as pointed out by Matt is problematic. Should shielding be requested again for the over 2.2 million patients Matt says there were, plus those living with them? It is a lot to ask from these people. However, it is possible, and support could be provided for them. Should we protect the over 12 million people over 65 in some way? Can we provide accommodation for those who live in multi-generational households to reduce their contact with the rest of the population? I suppose it could be done, by paying for these people to live in hotels and providing them with the services they need for free. Should we be calling for these measures?
Testing, track and test has to be much better. The government also needs to provide a much higher level of support for those isolating. For those in work I suggest 80% of their normal wages, which is likely to be just over 80% of their normal income, plus support for shopping.
It is clear that the government needs to sort out testing, track and test and the support for those isolating and our party could concentrate our attacks on the government in this area, but it seems sorting this out will take weeks if not months and so local lockdowns do seem necessary.
Matt
My evidence is that everywhere that imposed lockdowns is re imposing them because they had no effect on the spread of the virus. They’re just pointlessly social destructive panic measure that some people cling to because of understandable fears. But the reality is for the vast majority of the population it simply is not the threat that was feared in March. Sadly, people are not immortal. The older you get the closer to death you are. Governments decrees cannot banish mortality. I get that shielding is difficult, but I think that shutting the country down, throwing people onto the dole, wrecking the arts, ruining social lives, scaring people away from seeking medical help, imposing huge fines on people for behaving like people and turning the country into medicalised police state is ugly and short sighted no matter how good the intentions are. I will not pretend to think otherwise.
Matt
These are all fair points (except the implication of laziness, I guess to me ☹). I’ve had a closer look at the ONS data for England and Wales (the only data allowing comparisons), and it appears to show that, in the first month of lockdown (ONS dates 27 March to 24 April), there were 13,299 excess deaths not due to Covid. Since then, deaths from Covid have more than accounted for all-cause excess deaths, bringing excess deaths from other causes over the whole period to 9th October to 6,211.
Excess mortality has therefore arisen from other causes, certainly during lockdown, and it’s a reasonable hypothesis to say this is as a knock-on effect of lockdown. Lockdown does have lots of consequences and I still believe it should only be a tool of last resort, as it simply cannot become a permanent solution pre-vaccine. I’d still want to urgently get test and trace right first. And force Brits to comply with infection control requirements. Take a trip to China or Japan, see the face masks everywhere, and check the results.
jayne mansfield
I’m afraid you are right. All government health ministers, and all leading medical scientists did indeed know, with foresight not hindsight, that PPE and test and trace infrastructure were needed, both from the reports you cite, and from the fact that the risk of a virus pandemic has been evident since SARS in Asia many years ago. It’s astonishing that this responsibility isn’t admitted, that the same people appear on our TV screens telling us what to do, whilst at the same time, refusing to take any questions, ie continuing their practice of non-accountability.
@Michael BG
No-one cleans their baskets or trolleys.
My view is that the virus is a bit like an invisible unexploded bomb that we might pick up unseen that might and might go off in our hands or we might pass on to others.
several thousands must pass through a typical supermarket in a day – so even at 1 in 1000 statistically that’s several a day in each supermarket that may have transferred it to surfaces etc. So I sanitise my hands before and after entering each shop or venue, before and after picking up a basket and wiping that down, if I use a self service checkout I wipe that down and sanitise my hands before and after doing that. I am aware that doing this makes a really minute difference. But why not? it takes mere seconds. I also try and keep two metres from people even when wearing a mask as if I am two metres then I am probably a good metre. And wait for people. Wouldn’t you take literally a few seconds to possibly avoid killing yourself or someone else?
What does stick in my mind is just after the lockdown was easing and before people were wearing masks someone picking up an air freshener, holding right close to her face -literally millimetres away and then decide she didn’t like it and put it back on the shelf. I thought she clearly bdidn’t get it! And my own very tough survey of public transport passengers and shoppers was running at about two thirds wearing a mask. Frustratingly that would running at 80% but for people holding them, having them around the necks rather than actually wearing them and lowering them to talk to each other etc. Although where I have been people have been getting a bit better just recently
Now I am no paragon of virtue and I appreciate that it is difficult for humans when the danger is miniscule on each occasion but repeated millions if not billions of times. And I would suspect that there is not a driver alive that hasn’t driven through a 20mph zone at at least 21mph!
@Glenn
“My evidence is that everywhere that imposed lockdowns is re imposing them because they had no effect on the spread of the virus. ”
So Glenn as I pointed out in my post to you, you are wrong. please show where sage or the Government said that lock-down would eradicate the virus? They didn’t, you can’t
The aim was to slow the spread of the Virus, reduce hospital admissions and deaths.
Are you implying that that did not work? Because I think you will find every single piece of scientific data proves that it achieved exactly what it was supposed to achieve. it’s a long haul of increasing and decreasing lockdown measures and other social distancing measures in order to prevent the virus from ripping which would overwhelm the NHS and endanger public health over the longer term.
Now we know you are against ALL lock-down and social distancing measures introduced by the Government and nothing is going to change that, but you can’t say something has not worked when clearly it has.
@Geoff
I was not meaning to imply that you are lazy, in fact, I really do admire you, I have lots of respect for people like yourselves working and running care homes and what you are trying to do for your residents and the psychological effect the first wave of the virus had on many care staff. I have several family members who work in these care home settings and I know the emotional toll it had on them and the passion that they have for their jobs and their residents.
However, I think it is far too easy for people who are against lock-downs to make simplified arguments saying lockdowns caused deaths when it isn’t the blame of the lock-down for the death in most cases, it is Covid that has caused these indirect deaths as routine hospital treatments and services had to be cancelled. I do accept that some deaths occurred, i.e Heart attacks and strokes, as a number of people became too scared to call 999 through fear of going into hospital, but that is a different matter and something that the Government urgently needs to address this time around.
“Lockdown does have lots of consequences and I still believe it should only be a tool of last resort, as it simply cannot become a permanent solution pre-vaccine”
And I think most people would agree with you, we have not been in a full lock-down the entire time, its been a series of different measures being tightened and relaxed and tightened again as infection rates rise and fall. But as I said previously, it is extremely difficult when it comes to hospitality settings as it is impossible to introduce the hygiene controls in these settings that you advocate in your article to bring the virus rates under control. It is simply not an environment where it can work.
I’d still want to urgently get test and trace right first. And force Brits to comply with infection control requirements.”
I would agree, but until we have those capabilities we have to deal with the tools that we have to keep the virus at manageable levels to protect public health and the NHS.
Matt
I’m not going to get dragged into endless debates with you. I think the lockdowns are damaging and dangerous. I think the new normal is a disgusting anti social tyranny perpetuated in a state blind fear and panic by governments that have lost their grip on reality. I do not see anything good or justifiable about them and I will never soften my view on this for you or anyone else.
Thanks Matt
I suggest that the majority of the 13,299 excess deaths not due to Covid, which all occurred pretty quickly in the first wave, are not due to cancellation of routine non-urgent surgery, which is by definition not life-threatening, but to the second factor you mention of people with various life-threatening symptoms not calling to go into hospital. But would it be possible to overcome this knock-on effect in any future lockdown, as people can’t be forced to call 999 if they are fearful? Non-Covid loss of life may therefore have to be factored into any second lockdown decision?
Simple infection control measures are important and it appears, effective. Brits fail to take infection control seriously, exemplified by Caron’s earlier post trivialising hand cleansing, and by overcrowded beaches in August. Whilst in France this summer, it was common practice to wear a mask in a restaurant to go to the table, but it took much longer for Brits to do this – they still weren’t in early September. Japan is serious about infection control, and is currently reporting 550 infections/day (7 day moving average) and 6 Covid deaths/day, whilst China, also with widespread infection control, is reporting 15 infections/day, and no deaths. Other factors may of course contribute to this, but infection control must be making a big contribution?
I’d accept a government decision even to lockdown if I felt all these factors had been carefully taken into account, but the Whitty/Vallance presentations with no questions allowed, no alternatives considered, no admission of previous mistakes, don’t convince me that this is the case.
@Glenn
“I’m not going to get dragged into endless debates with you. ”
That’s fine Glenn, nobody is forcing to you, but you cannot be expected to be taken seriously when you make false and unfounded claims about something that has not worked when clearly the evidence shows that it has worked.
You should just stick to the honest stance that you had before that you disagree strongly with all lock-down measure and social distancing measures and you would allow the virus to take its the course. Your fully entitled to that opinion, as are we entitled to argue against it and state why we think it would be more dangerous to public health and the economy in the long term.
@Paul Walter Lib Dem Voice editors have deleted a reasonable number of my comments, and have insisted on “parliamentary” levels of engagement in a comment thread underneath what is clearly dangerous misinformation.
So, spare me the bleeting about what is and isn’t Liberal. We’re not Libertarians, and anyway a right to freedom of speech isn’t a right to be platformed.
If LDV chooses to promote fake news then they should also own it, instead of pretending they are a benign conduit.
Matt
I don’t expect to be taken seriously. Full stop. I’m not in a position of power or remotely important. I’m just a peasant on the internet railing at the tyranny I’m forced to live under and that I think is wrecking the world. Enjoy your police state. I will not.
@Geoff
Geoff, I would argue that even without lockdown with a virus that is running rampant in society and hospitals full of covid, people would still be too afraid to call 999 in an emergency, probably even more so if Hospitals were at full capacity with news stories and images of people dying in corridors and freezer lorries used as temporary morgues, which would very much be a reality if Covid were allowed to run its natural course.
“Simple infection control measures are important and it appears, effective.”
In some settings, it is possible to have more effective infection controls to mitigate risks, but in other, it is impossible, ie bars and clubs and so, therefore, we are going to have to have partial lock-downs for certain sectors of the economy or very tight controls on numbers, which of course means furlough and support for businesses. That is until Science finds us another way out from this.
I get what you’re saying about Countries like Japan and China, we do need to look into why they seemingly have considerably lower infection rates than us, is it better Hygiene and infection control? is it something actually to do with unknown characteristics of the Virus, is it that they have better immunity due to past exposure to other coronaviruses? We simply do not know yet and it is something that the Scientists need to find out, but we are still in the early stages of the virus and gathering data like that takes time.
In the meantime, our scientists have to work with what we have got, to get us through the hear and now and hopefully, there will be a thorough analysis at the end of all this to learn some pretty harsh lessons for when the next one hits, we cannot make the same mistakes again.
@Geoff,
I do respect and admire where you are coming from, I see that you are desperately trying to put forward a middle way between lock-downs and enforcement and better hygiene controls etc instead of full lockdowns and I agree that it is something that needs to be explored for possibilities. I apologise if some of my comments back to you have been harsh, I don’t mean to be. I think the problem is for people like yourself who are trying to search for a middle ground, you get drowned out by others who are on partially the same side of the argument as you and against lockdowns, but who instead want to allow the virus to rip and run its course.
I think we can both agree that would be an extremely dangerous and damaging thing to do for everybody.
China is nothing like Japan. It has open hole in the ground public toilets in great swathes of the country. It’s the difference between a police state with an authoritarian communist government with low public standards and an advanced democracy with high public social standards. China is actually closer to North Korea. The Japanese do not like being compared to China. I’ve been to Japan and I’ve had family work in China. Their cultures are very very different. Japan is actually much closer to the social models of Sweden than it is to China. Linking China to Japan is one of those weird Western misconception, like talking about Africa when it’s actually made up of 54 separate countries.
@James
That’s not how bleating is spelt.
I just think it is utterly bizarre to demand that something is withdrawn. Completely daft. And it seems you are the only person who does it. I have never come across it before.
Why not just calmly take apart someone’s argument – fisk them – rather than all this righteous indignation?
Geoff Crocker’s piece is not news at all – fake or otherwise. It’s an opinion piece. There have been many constructive and detailed comments and Geoff has engaged with them at length.
That sounds very liberal to me, and deleting articles sounds very illiberal.
It is clearly labelled as opinion. It is not labelled news.
I don’t think you repeating the phrase “fake news” about it helps your case. It sounds like a knee-jerk reaction.
Thanks Matt, I’m not at all offended by your posts. You’ve made some very reasonable points which have helped me refine my thinking, which is what debate is all about.
Glenn, of course China and Japan are very different, although China is far more developed than you suggest, with bullet trains going everywhere and some very modern cities. Huge tension still exists between them for historic reasons. But their approach to infection control has many similarities with similar low infection and mortality results.
Thanks Paul, as you say my piece is an opinion piece, but I do assure readers that the data I present is totally accurate UK government data and can be verified as such by clicking the source links. My interpretation of the data is of course up for discussion, which has duly happened.
Geoff Crocker
Yes, China has a lot of very modern and advanced things , but it also has hole in the floor public toilets in parts of the country and poor sanitation compared to Japan or Britain. China’s approach to virus control is absolutely nothing like Japan’s. It locked down millions of people in the most brutal way possible because it is a police state. Japan banned travel from China, introduced some limited social distancing rules and the gave up on them as a damaging waste of time very early. It did this bebcause it is an advanced democracy.
A big part of the reason we are in the social destructive nightmare we are now in is the bizarre levels of trust in and early praise for China. We would not grant any other oppressive regime that puts religious minorities in concentration camps anything like the credulity or misplaced respect we afford China. I’m not just against lockdowns because they don’t appear to work, I’m against them because they are politically and morally disgusting, much like the political model that inspired them.
@James Belchamber
I don’t see what gives you the right to demand something that you don’t agree with is taken down and to label it “fake news” “misinformation” etc.
Leaving aside the flawed nature of your student-campus-lefty no-platforming approach, the fact is that arguments against lockdown are valid for three reasons:
1. There are many leading scientists and epidemiologists who don’t support lockdown and instead support protecting the vulnerable whilst societies reaches herd immunity (see Great Barrington declaration).
2. Lockdowns are not an established response to a public health crisis. Most pre-existing pandemic plans didn’t recommend them but when China used their quarantine approach many people assumed that is the way to deal with the situation.
3. Decisions about what restrictions will always ultimately be a matter of Government policy not science. Experts advise but elected politicians decide.
So for those reasons it is right to have a debate. There have been numerous debates about this on here about would focused shielding work, are Sweden succeeding etc. and there is probably little to add that hasn’t already been said although I would be interested in reading the source of Matts 1 in 4 claim about hospitalisations. Thanks.
@Marco
The reason why the Great Barrington Declaration would not work is that it has been debunked, it would not be possible to shield that many people along with their immediate family members, we are talking millions of people and not just the 2.2 million in the original shielding program.
They never ran any modelling or peer-reviewed, it was just a silly set of ideals and a petition that attracted thousands of signatures from people with no medical or scientific credentials.
The paper you asked to see is here https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/928740/S0810_Summary_of_SAGE_advice_on_segmentation.pdf
“Although younger people are at relatively lower risk, it is not possible to precisely predict in advance
who will be severely affected by the virus. A quarter of COVID-19 hospital admissions have been in those aged 60 or below, along with 7% of deaths”
Glenn, China hasn’t had a subsequent wave of infection after its lockdown, which may well be due to effective rigorous infection control such as masks, sanitisers and distancing?
Today’s press shows the UK current position that
1 Trace, test, and quarantining of positive cases isn’t working through sheer incompetence
http://www.theguardian.com/world/2020/oct/25/test-and-trace-chief-dido-harding-should-quit-says-senior-tory
2 As a result, draconian lockdown is imposed in Wales with government even deciding what is or is not ‘essential’ to allow people to buy in supermarkets.
http://www.theguardian.com/world/2020/oct/24/welsh-government-urged-to-drop-ban-on-sales-of-non-essentials
Shouldn’t we really fix the first in order to avoid the second?
Geoff Crocker
You’re missing my point. Japan has not had one either without the governmental overreach. I don’t care what China does. It’s a police state and behaves exactly like a you would police state to behave. It runs concentration camps and has one of, if not the highest, execution rates in the world. People who praise China remind of those who used to go on about how great and efficient the Soviet Union was. I think that the trust is misplaced and the praise is macabre. The ” Yeah, I know it’s bad and stuff, but they keep the trains running on time” line of reasoning is not something I’m prepared to go along with.
There are strong views for and against the Barrington Declaration, with senior academic experts on both sides of the argument, see in favour at https://gbdeclaration.org/ and against at
http://www.sciencemediacentre.org/expert-reaction-to-barrington-declaration-an-open-letter-arguing-against-lockdown-policies-and-for-focused-protection/ Sadly, scientists can resort to put downs of each other as well ☹
Is ‘Focussed Protection’ at all possible? ONS data shows that all-cause UK excess morality is 59,275 to date. A caution is that this figure does include co-morbidity, eg people who died in care homes who had other life-threatening conditions, were in end-of-life care etc. On one estimate 13,299 of these deaths were not due to Covid, leaving a total of 45,976 excess deaths due to Covid. Of these, ONS data again shows that 21,239 were in care homes, and 10,149 in those age >80 in the general population. Assuming it’s possible to effectively shield these two groups, and care home zero infections suggest it is, then ‘focussed protection’ could have saved 31,388 lives, ie 68% of the 45,976 excess deaths due to Covid.
These are exploratory thoughts and attempts to understand the data, not assertive conclusions, but they need to be taken into account in determining most effective policy.
Glenn, for the record, I agree with all your political critique of China. I’m only trying to understand whether their Covid data shows us anything.
@Geoff Crocker
The problem with the Great Barrington Declaration is that they did not do any modelling at all, nothing is peer-reviewed.
They simply called for a Shielding program for the vulnerable and Those who are not vulnerable should immediately be allowed to resume life as normal.
They provide no information on how that is either logically or ethically possible considering the vast numbers of the population this would include.
They provide no modelling on how many people in the so-called “healthy population” would require hospitalisation and the effect that this would have on the health services ability to cope and what effect this would have on non-covid related treatments.
It calls for an end to all other measures, mask-wearing, social distancing, closures or limitations to businesses operations, in other words allowing the virus to rip.
Now I don’t know about you, but I am not going to give any credibility to a scientist who comes up with such a dangerous plan who has not done ANY modelling whatsoever on the costs to health service, long-term public health and long term cost to the economy and deaths. And that is why it was shunned by so many scientists and no government in the world is going to allow that kind of approach
Matt
I’m less critical of the declaration than you. It’s by some highly qualified epidemiologists at Oxford, Harvard and Stanford, one of whom is to the forefront of Covid vaccine development, so is unlikely to be superficial. It does need quantification. The opposition has noted figures too. A Guardian article by several of them http://www.theguardian.com/commentisfree/2020/oct/18/covid-herd-immunity-funding-bad-science-anti-lockdown attacks the declaration because it’s not a scientific paper, and because it doesn’t cover all cases, but largely because they claim it’s funded by the wrong people, which is a curious argument from writers wanting scientific justification. Robert Lechler, President of The Academy of Medical Science https://acmedsci.ac.uk/more/news/navigating-covid-19-through-the-volume-of-competing-voices attacks the declaration as ‘unethical and simply not possible’. Like others, he points out that it doesn’t cover all cases, particularly the unknown effect of ‘Long-Covid’. He wants ‘solid evidence and a large amount of certainty’ for Covid decisions. Simon Stevens, the NHS boss also derides focussing protection on vulnerable groups as somehow discriminatory.
But I have shown above that focussed protection of care home residents and those >80 in the general population can, and in the case of care homes, does work, and that these account for a large proportion of the mortality suffered to date. We faced a very uncertain and unknown threat in March. We still face considerable uncertainty today as to the characteristics of this second wave. Those opposing the declaration also have little modelling to rely on – none of the above scientist critics present alternative models or greater certainty for their view. All references seem to be to the modelling of Neil Ferguson at Imperial, the standing of whose work I’ve already commented on.
We need to carefully consider all proposals, and not dismiss contributors on superficial and unsubstantiated claims about their ethical or funding base.
@Geoff
The difference between Professor Ferguson and the Scientists who wrote the great Barrington declaration is at least Ferguson did modelling to get to his figures, now we can argue whether his modelling was out or not, whereas no suck modelling existed for the Barrington.
Surely if you are going to propose a policy of allowing a Virus to rip through society unchecked in order to achieve herd immunity, then you need to model
a) Who is defined as vulnerable and need to shield along with their immediate household
B) what resources would be needed to provide the ring of steel and where would they come from
C) What proportion of the “healthy public” who are going to go about as normal would need hospitalisation, and how many deaths would be involved
D) What would be the effect on NHS Resources and how would this affect the NHS ability to carry out Non- covi related treatments
E) How many non-covid deaths would occur
F) How would Public Behaviour change if a Virus were allowed to rip through the country unchecked and NHS resources struggled to cope, would people still go to work or change social behaviours and stop spending in the economy.
G) How would this affect the Mental Health of the NHS staff on the front line and would they be able to cope with such high volumes of Covid and Intense pressures of ICU over a long period
H) where do the staff come from to treat such high volumes of patients who would no doubt need ICU support? ICU is a specialist field
I) What effect would this have on long-covid and public health overall in the long-term
J) And most importantly, “Natural Herd Immunity” has not even been proven for this virus, so how many cycles or years of infections do they anticipate before it would be safe to release the vulnerable population back into society.
Don’t you think that a bunch of scientists advocating such a course of action should at least address these principles, do the modelling and have it peer-reviewed?
There is a reason they didn’t because it would be been pulled apart in minutes.
@Geoff
“But I have shown above that focussed protection of care home residents and those >80 in the general population can, and in the case of care homes, does work, and that these account for a large proportion of the mortality suffered to date”
Sorry, I must have missed it as I have not seen where you have shown how focused protection can be achieved in the general population.
And your article and the Barrington declaration calls for shielding of All elderly and vulnerable not just the over 80’s.
I am yet to read any suggestions on how this would be achieved.
I.e delivering of food medicine for the entire household, Are vulnerable members of household removed? Are children removed from vulnerable adults household? Are people with underlying conditions given in-home treatment instead of having to go to hospital and Gp Settings? Are working adults with a vulnerable member in the household paid their wages in full so they can also shield as well?
I am sorry Geoff but you have yet to answer how any of what you are proposing can be achieved and that’s all before we have even got on to the ethics of treating elderly and vulnerable people as second class citizens who must be locked up indefinitely so everyone else can go about their business as normal.
That is not what a Liberal and humane society is about
Matt
Yes I agree that all these implications of any policy need to be fully considered. But I don’t know whether any of the Barrington Declaration proposers have run such models or written such scientific papers. Are you absolutely sure that they haven’t? Ferguson’s initial papers predicted 600,000 deaths without lockdown, and we simply have no way of knowing whether he was right or not. As I’ve pointed out before, his own behaviour demonstrated his own lack of belief in lockdown policies.
I also don’t know whether any models predicted our present position of 20,000 infections/day, 1,000 hospitalisations/day and 167 deaths/day (current 7 day moving average though not excess all-cause deaths)? I suspect that policy is being determined by current variable levels more than by modelling.
I’ve had an amateur go at quantitative answers to your questions A and B on protecting the vulnerable. Your further points on the NHS impact are clearly important, and 1,000 hospitalisations/day is probably the most worrying current factor. Both Covid and non-Covid are of course the critical concern. But 167 deaths/day just seems very surprisingly low (thankfully of course). I don’t know whether either Barrington or Ferguson models expected this from current conditions, and I also don’t know exactly what to make of it. Maybe, hopefully not of course, it’s about to shoot up to the 1,000/day levels of March, in which case we’d better all lock down immediately (not forgetting that up to 1,500 people die daily normally). But maybe very few of the 20,000 daily infections are going to lead to increased mortality, maybe many will remain asymptomatic, maybe we have protected the vulnerable from being infected from them? Acceptance of mild or asymptomatic infection is different to the herd immunity argument. These are valid questions and not an indication of carelessly wanting to let the virus rip through the population.
Quoting from https://www.nytimes.com/2020/10/19/health/coronavirus-great-barrington.html ‘Dr. David Nabarro, a special envoy to the World Health Organization, has urged governments not to resort to lockdowns as the primary method to control the virus. Masks, social distancing, fewer crowds, testing and tracing — these are the ways to control the virus in the long run, he said in an interview. But the lockdowns in the spring were necessary, he added, as emergency measures to give countries time to put in place strategies to control the virus. “There is a middle way,” Dr. Nabarro added, between strict lockdowns and letting the virus freely infect people. “If only we had a few more world leaders who would understand this, we wouldn’t have this debate going on.” That’s pretty much where I am.
Matt, that’s because you are proposing a much larger number of people for targeted protection than I am. I am referring to care home residents and >80s in the population and I justify this because I’ve shown that’s where 68% of excess mortality occurred. I realise that I don’t have source data to be able to categorise the other 32% of mortality.
The so-called Barrington Declaration is more a right wing libertarian motivated political statement rather than a public health strategy based on scientific expertise. There does seem to be a natural inclination on the part of those of very right wing inclinations to try to minimise any collective problem that humanity faces.
We’ve seen this in their attitudes to climate change. They don’t like the idea of everyone acting in a co-operative manner to tackle a global problem. It just doesn’t sit well with their view of how things should be. Therefore it can’t be. The scientific consensus just has to be wrong!
There’ll be the same people involved in both political campaigns.
PS my attempt was in my post at 1045 this morning. I accept that this may not have convinced you. Fair enough. I then have to rest my case undetermined, because I don’t have access to the more detailed data I’d need to take the point further.
Here we go, damning an argument by caricaturing its proponents 🙁
@Geoff
” But I don’t know whether any of the Barrington Declaration proposers have run such models or written such scientific papers. Are you absolutely sure that they haven’t?”
No they haven’t and yes I am sure, I have read the declaration and nowhere in it does it point to or reference any modelling. I have scoured the Internet for it and there is not a single paper from these 3 who advocate this. That is why it has been ridiculed from the rest of the scientific community.
And I happen to agree with the Guardian Article you referenced too, it seems as though this declaration was funded and lobbied from a Rightwing Libertarian think-tank
Dr. David Nabarro, a special envoy to the World Health Organization, has urged governments not to resort to lockdowns as the primary method to control the virus. Masks, social distancing, fewer crowds, testing and tracing — these are the ways to control the virus in the long run, he said in an interview.”
Which is exactly what we have been doing, we have not been in full lockdown for months. Fewer crowds would mean limitations on the hospitality sector as one example which means there would still be a need for furlough, something your article is arguing against?
As I said to Glenn, I think Sage was clear from the outset that tackling this virus would require us to constantly keep adjusting the brakes at intervals in order to manage infection rates and hospitalisations, so as not to overwhelm the NHS and to ensure that covid and non-covid patients could receive treatment, until Science can find us a different path out of this.
One thing is for certain though, there is no way that track and trace have a chance of working, whilst infection rates are as high as what they are.
On a final point, I think it’s about time that we start seeing opposition parties and especially the Liberal Democrats start getting answers from the Government on Shielding and having the infrastructure in place now to deliver it.
If things carry on at the rates that they are at, it would not be long before the Government tells all these people to shield again and they must make sure they have the facilities in place
The Tories are already the party of starve a kid to save a quid over free school meals and are digging their heels in on providing vital support and are yet again relying on food banks and communities to come to the rescue.
We cannot allow them to keep getting away with this
“Ferguson’s initial papers predicted 600,000 deaths without lockdown, and we simply have no way of knowing whether he was right or not.”
It’s not that hard. We’ve had 45,000 deaths with around 8% of the population infected and the NHS not being overwhelmed by the number of Covid patients needing hospital care.
So let’s scale that up to 70% of the population being infected if the virus had been allowed to rip through the population. That gives around 400,000 deaths. But the NHS wouldn’t have coped, there wouldn’t have been much in the way of medical treatment for those who needed it and the death rate would have been proportionately higher. 500k to 600k deaths under such circumstances would be a reasonable estimate.
@Matt
I don’t accept that Great Barrington has been debunked at all. All the attempts to do so are unconvincing.
The SAGE memorandum you link to does not convince, although the issues it raises are legitimate they are by no means insurmountable for example:
“• It would not be possible to prevent the virus spreading from younger people to older people.”
It is possible with imagination. Their claim is based on the fact that there was transmission between age groups in Feb-Mar however this was before shielding actually started but when it did start higher risk groups were better protected.
No model provides perfect levels of protection, but focused protection speeds up the path to immunity.
Multi-generational households are a challenge whatever model is chosen. During the national lockdown many people moved in with extended family and essential workers eg NHS staff in multi-generational households continued to go to work potentially bringing the virus home with them.
“• A very large proportion of the population would need to withdraw from daily life for many
months, which would have profound negative effect on them.“
Many people have chosen to shield anyway so focused protection just formalises what a lot of people are doing. There is little alternative because lockdowns mean everybody withdrawing from daily life. Focused protection is effectively tier 3 guidance for high risk groups and tier 1 for everyone else minus rule of six and curfews. Hand washing and isolating when sick should still be expected and definitely not Covid parties.
“• An uncontrolled epidemic in younger age groups would have dire consequences for the NHS
as well as having unknown long term effects in those infected.”
One possible explanation for the one in four figure is that earlier on a lot of younger people might have been admitted to hospital as a precautionary measure but would have got better anyway and the threshold for admission might be higher now (only 7% of deaths have been among under 60’s).
“• We do not know if long term immunity results from infection with SARS-nCOV-2”
That would mean that a vaccine wouldn’t work either because vaccination is reliant on lasting immunity as well. In reality almost all viruses of this type do provide immunity.
I also don’t get why you think “modelling” is such a good idea as it is only as good as the inputs which are all assumptions.
@Geoff
“That’s because you are proposing a much larger number of people for targeted protection than I am. I am referring to care home residents and >80s in the population and I justify this because I’ve shown that’s where 68% of excess mortality occurred.
I actually feel a little uncomfortable talking about this Geoff as I am very aware that LDV has many readers over 65 and people with underlying conditions, I worry about the psychological impact of this discussion could have on people, but, I have to point out where I think you are wrong.
Your article is calling for an end to furlough and lockdowns by shielding a certain segment of society. However, this is not just about mortality, unfortunately, people over the age of 65 are more likely to have complications from covid and require hospital treatment, they might not necessarily die from covid, their chances are much better than someone who is 80, however, it is the mere fact that a large proportion of 65’s and over would still require this hospital support which of course would put a huge strain on the NHS ability to cope and carry out Non-covid care and treatment as well.
So I am afraid to say that in my opinion, your article was unfeasible in the first instance and it is even more so now if you are only talking about shielding the over 80’s. It would lead to the NHS being overwhelmed in no time at all.
@Marco
Maybe you can have a go at the questions I put to Geoff @ 25th Oct ’20 – 8:34pm
“No model provides perfect levels of protection, but focused protection speeds up the path to immunity.”
And yet The Great Barrington did no modelling whatsoever unless you can prove otherwise, do you not think that a bunch of scientists advocating such a policy shouldn’t at least model it and get it peer-reviewed? isn’t that what science is all about? Focused protection does not speed up the path to immunity as it is yet to be proven that long term immunity is gained from covid. Later you say “That would mean that a vaccine wouldn’t work either because vaccination is reliant on lasting immunity as well” that is not entirely accurate as we have annual flu vaccinations and so I don’t see why Covid will be any different when there is likely to be different strains along the way.
Vaccines are not the only way out of this, It could be the case itis better anti-viral medications that get hospitalisation rates down, the point is until we have whatever it is, we have to ensure the NHS is not overwhelmed.
Something your Great Barrington Declaration has failed to take into consideration at all
@Matt
Perhaps they take the view that there has been too much low quality, worst case scenario modelling and therefore the answer to dodgy modelling isn’t more modelling. As I said to Geoff previously we need more qualitative analysis.
Although given how much attention was paid to Ferguson’s modelling which I don’t think was peer reviewed either, you would think it would be tempting to bash something out. They have published research on immunity saying there is a lot of pre-existing immunity to Covid from other Coronaviruses.
“Let’s scale that up to 70% of the population being infected if the virus had been allowed to rip through the population”.
There is an intermediate position between lockdown and letting rip, and that’s what many of us are advocating, including David Nabarro.
I don’t accept this denigration of eminent scientists. The Barrington Declaration never pretended to be a scientific paper. Only the scientists themselves can answer whether they have run as yet unpublished analysis. The reality is that reaction timescales are so short in this crisis, that nobody has time to produce peer-reviewed scientific evidence to support their policies, and that includes Chris Whitty and Patrick Vallance who have failed to produce any for their policy advice.
@Marco
“(only 7% of deaths have been among under 60’s).”
So taking Peter Martins figures that so far only 8% of the population has been infected with covid and assuming we need 70% for herd immunity. If 7% of deaths have occurred thus far in under 60’s what would that equate to when the other 62% has to get the infection? How many under 60’s would that be dying from covid and how many non-covid deaths would occur due to overstretched resources?
How many would have long-covid and what effect would that have on long term public health?
“Focused protection is effectively tier 3 guidance for high risk groups and tier 1 for everyone else minus rule of six and curfews.”
Dont attempt to change what the Great Barrington Declaration calls for. It calls for the isolation of elderly and vulnerable and everything else back to normal for everyone else, No social distancing, mask wearing, limitations on venues, sporting events, or any other measures, It calls for life back to normal and allow the virus to rip, so please don’t pretend otherwise, https://gbdeclaration.org/ “Those who are not vulnerable should immediately be allowed to resume life as normal.”
Marco
The thing about the Great Barrington Declaration is that it puts a pin in the balloon in the right place for it to deflate rather than pop. You can feel the political and media support in the Tory press leaking, along with more people just ignoring Hancock’s arbitrary rules. The scare tactics aren’t working anymore. There is an increasingly obvious desperation to Johnson when he is delivering yet another of his droning would be inspirational speeches whilst appearing to bang his fists on an invisible table in what he imagines to be statesman like manner, but actually makes him look bonkers . People are also starting to spot that the idea that you can only have medium alert,high alert and very high alert in the tier system is a blatant propaganda attempt to keep the fear ramped up.
3.9 million people with diabetes and around 700 people a day diagnosed
7.4 million people with heart disease
3 million people with COPD
360,000 people diagnosed with cancer each year
10,500 cystic fibrosis
1.8 million kidney disease
6000 people waiting for organ transplants and around 4000 transplants carried out each year
850,000people with dementia ( I include dementia because anyone with dementia catching a virus can experience delirium which can advance dementia rapidly from which they do not recover) it can send someone from early stages of dementia to advance stages through catching a virus. That in itself would put a huge strain on resources
That is just some of the lists of people who are vulnerable to covid, so by the time we add in the elderly and all other family members from the household, we are talking around a 1/4 of the population.
Is anyone really going to argue that in a humane society we tell a 1/4 of the population they need to withdraw from society for an undetermined period and allow the rest to go about life as normal?
I can’t help wondering if this virus mutated, which I hope it doesn’t and it started becoming deadly towards people between the ages of 18-40 with no underlying health conditions, would the same people still be arguing about lockdowns? would attitudes change if it was a different demographic?
@ Geoff.
“There is an intermediate position between lockdown and letting rip, and that’s what many of us are advocating, including David Nabarro.”
It’s what nearly everyone is advocating. The question is where that position is. The important consideration has to be keeping schools and the economy going, on the one hand, and protection of the NHS on the other. In parts of the country, NHS capacity is fast running out. Improved treatment means that more capacity is needed now than it was in the first wave.
@ Matt,
“…… taking Peter Martins figures that so far only 8% of the population has been infected with covid ”
I must admit this was my estimate based on a figure of 6% quoted in this August newspaper article.
https://metro.co.uk/2020/08/14/one-ten-people-london-have-coronavirus-antibodies-13129184/
Matt
We can extend the groups of vulnerable people almost indefinitely. Ultimately everyone is vulnerable, since even apparently healthy people like Boris Johnson can succumb to the virus. A population-wide approach is almost bound to lead to future lockdowns.
My approach is to seek to be more targeted. I’ve therefore proposed taking the people types who figured largely in the first round of mortality, ie care home residents and >80s, whom I’ve shown represent 68% of first wave mortality, and protecting them. I’ve also shown that we have achieved this protection for care home residents. I would then propose strategies to protect the remaining 32% of people types who suffered first wave mortality, but I’d need more precise typology data to be able to do this. I do think this targeted methodology works towards the best balance of preventing mortality whilst limiting the wide range of other harms.
I certainly still think we should immediately stop quarantining whole groups of school year groups, university students, and people returning to UK and instead test these groups and quarantine only positive cases. I haven’t heard any counter argument to what seems to me a sensible policy, and one which will almost certainly increase compliance.
@Matt
The herd immunity threshold is nowhere near 70%. It could be as low as 20% it depends on how much prior immunity there is.
The authors of GBD believe that if healthy people were living relatively normal lives with focused protection for the vulnerable, hospital admissions would be manageable, the mortality rate would be within a normal range for the time and year and society would continue to function and people would keep their jobs. People try to mischaracterise GBD but they have a detailed FAQ on their website which I encourage everyone to read.
The NHS was nowhere near being overwhelmed back in April there were 43% of intensive care beds unoccupied https://www.england.nhs.uk/2020/10/nhs-and-other-professional-bodies-response-to-sunday-times/
And Nightingale hospitals were not needed.
The epidemic plateaued and cases fell mainly due to rising immunity in the population. The virus follows broadly the same curve regardless of what measures were taken. You cannot let the virus rip because immunity will slow it down. Infection rates among young people are slowing- attributed to behaviour change but in reality probably due to rising immunity. Nobody wants to talk about immunity at al. However you can go in and out of herd immunity which is when a virus becomes endemic – this is why seasonal flu is seasonal.
Reeling off lists of other illnesses is a rather double edged argument as it reminds people that there are plenty of non-Covid illnesses to worry about as well and the cancelling of screening, diagnoses and operations due to an expected Covid surge surely puts people with these conditions at greater risk. To many people they are probably experiencing the NHS as if it is overwhelmed when in fact it isn’t.
People under 60 with certain conditions eg diabetes severe asthma need to be in the protected group.
If focused protection is applied properly people in this situation and people over 60 would have more protection than at present as they would be allowed to take a sabbatical from their jobs if they can’t work from home (one of the detailed Great Barrington proposals).
@ Geoff,
“I don’t accept this denigration of eminent scientists.”
You’ve had some harsh words to say about Prof Chris Witty and Sir Patrick Vallance! I notice that Oxford’s Sunetra Gupta is one of the scientists in question. In March she was peddling a theory that up to 50% of the population has been exposed to the virus and the level of natural immunity in the population was being underestimated..
In May she was saying “Covid 19 is on the way out”
https://unherd.com/2020/05/oxford-doubles-down-sunetra-gupta-interview/
Whether she is an “eminent scientist” is a matter of opinion. BUT she was obviously wrong and needs to acknowledge that.
@Geoff
“since even apparently healthy people like Boris Johnson can succumb to the virus”
I wouldn’t go so far to say Boris was the healthy type at 56 overweight and from what we were told had suffered from Pneumonia before, he was already at increased risk.
Geoff, I am just responding to your article and your further comments as they come in, You seem to be moving the goalposts as you go along. Your original article is against lockdowns and furlough and is instead in favour of shielding elderly and vulnerable and mass testing and only quarantining positive cases.
As the discussion has progressed and you have realised what a monumental and probably impossible task that is, you have now moved to only shielding the over 80’s, which I would suggest would result in even more deaths and hospitalisations if we were going to take your approach and not use partial lock-down mitigation strategies and there was such a large proportion of the vulnerable and elderly population not receiving shielding support.
“I certainly still think we should immediately stop quarantining whole groups of school year groups, university students, and people returning to UK and instead test these groups and quarantine only positive cases”
And I would agree with you, I wish the UK had the capabilities to carry out that level of testing and it angers me we don’t.
I still do not think it would make any difference to still requiring semi-lockdowns and restrictions on certain businesses (especially in the hospitality sector) due to all the reasons that have been set out above in previous responses. Which of course, would still mean the UK Government having to offer massive amounts of support to businesses and furlough, which your article wants to end
@Marco
“The authors of GBD believe that if healthy people were living relatively normal lives with focused protection for the vulnerable, hospital admissions would be manageable, the mortality rate would be within a normal range for the time and year and society would continue to function and people would keep their jobs”
Where did the GBD say that, where did they model that?
Please provide the link instead og rewriting the declaration
@Marco
“The herd immunity threshold is nowhere near 70%. It could be as low as 20% it depends on how much prior immunity there is.
Please provide proof that herd immunity can be achieved at 20% because that’s not what I have seen
and
“The epidemic plateaued and cases fell mainly due to rising immunity in the population”
The epidemic plateaued because of lockdowns and social distancing, it had nothing to do with herd immunity. Infections began to rise again as restrictions were lifted and especially more so after shielding ended in August.
As Peter pointed out. Professor Sunetra Gupta was wrong in March when she claimed that herd immunity had already been reached. So If that were true we and the rest of the world would not be experiencing the rapid growth again that we are seeing now in the second wave.
Why on earth would anyone take her seriously when she has been catastrophically wrong already and gave no explanations for why she was wrong?
Peter Martin
Sunetra Gupta is busy trying to get a vaccine to us, for which we will all be grateful if she and her team succeed. Even if you disagree with her over the GBD, she is at least seeking to set out her case there (see their FAQs). Meanwhile Chris Whitty and Patrick Vallance advise indiscriminate lockdowns without the peer-reviewed scientific evidence they and their supporters demand of everyone else (no FAQs). By ‘denigration’ I’m referring to the critics of GBD who focus on the claimed political connections of the proposers, rather than on the content of their proposal, something I have nowhere done to Chris Whitty or Patrick Vallance. Sunetra Gupta isn’t placing me under house arrest without adequate justification.
Matt
Of course, my position is evolving through discussion with you and others (which you refer to as ‘moving the goal posts’). Surely that’s what the process of debate is all about? I have accepted in a previous post that my original note implied a proposal for total population testing, which is infeasible and on which I accept others’ correction.
The basic difference is between a targeted and a whole population strategy. Following your challenge, I’m therefore seeking to be more specific about how a targeted strategy might work, and have demonstrated that focussed protection of care home residents and >80s would cover 68% of previous first wave mortality by group. I don’t have typology data for the remaining 32% but would propose a similar methodology. This would work towards a more comprehensive targeted strategy which could then be compared to a whole population strategy (which would also need to set out its implications more than it has to date).
I don’t want to end government support to businesses and individuals, I want to avoid it by avoiding lockdown, if at all possible, by more targeted strategies.
We are currently experiencing a second wave of infection. Failure to observe social distancing eg with crowded summer beaches in UK, is more responsible for this than Sunetra Gupta. It’s not yet clear whether that is going to lead to a second wave of mortality. We all of course desperately hope not. If not, Gupta, or those advocating a more targeted strategy, might have a point.
Marco
The herd immunity argument is red herring hiding behind the elephant (I love me some mixed metaphor) in the room. The vast vast majority of the population shake off the virus quite easily. It is even acknowledged in the official recommendations which is basically to stay at home for a couple of weeks and you’ll be fine without medical intervention. I suspect we are using local lockdowns now because the political classes have turned defeating the virus into an obsessional quest with no get out clauses, no alternative strategy, no thought that it simply might not be possible and no level of social damage deemed too great. If you look through history all the great blunders end with some leader or other crying that the people have let him down because they didn’t fight hard enough, didn’t follow the rules and continued to behave like people rather than an idealised version of people. That is where we are now. Not many people are really sticking to the rules anymore, if they ever did, especially not regarding the absurd rule of six and households not mingling. Politicians and their advisers are simply not that powerful or well regarded or taken that seriously. Not even amongst themselves.
@ Matt and Peter Martin
Professor Gupta wasn’t wrong, she was saying that you can reach herd immunity as a population but because immunity isn’t distributed perfectly in the population you will still get outbreaks.
The point about herd immunity is that it is the point where the virus stops growing exponentially because Re < 1 due to immunity. It is not the point where the virus is eliminated.
I think she makes the 20% claim in the interview Peter Martin links to (worth watching to get insights into Epidemiology from a world expert) and there is also this paper which I haven’t read and don’t pretend to understand: https://www.medrxiv.org/content/10.1101/2020.07.15.20154294v2.full
@ Geoff Crocker
Some examples of how the targeted strategy could work in practice are:
– Testing resources to be diverted to people who visit high risk households eg carers and tests could be available for relatives who want to visit vulnerable relatives
– Negative rest or positive antibody test required for tradespeople etc to visit shielding groups.
– Online delivery slots reserved for shielding groups
– Risk level based on household risk not individual risk
– Paid sabbatical/furloughing for people in higher risk/age groups who are unable to work from home.
Marco
Thanks for the link to Sunetra Gupta’s co-authored article. As it says itself, it’s not yet peer-reviewed simply because this takes time, but it is a credible scientific paper with 26 references etc. The accusation that the GBD team has no credible scientific basis for their proposal should be withdrawn. It would be good to see comparable articles from Chris Whitty and/or Patrick Vallance, or for them to refer to such articles by other authors.
Thanks too for extending the proposals as to how a targeted policy could work
@ Geoff
This is from the Prof Gupta article I linked to earlier:
“…… when we hear results from antibody tests (such as a forthcoming official UK Government study) the percentage who test positive for antibodies is not necessarily equal to the percentage who have immunity or resistance to the virus. The true number could be much higher…..has convinced Professor Gupta that it is this hidden immunity….”
This is all very speculative. “Not necessarily”, “could”, “convinced” and “hidden” aren’t terms on which we can base public health policy. Prof Gupta has to come up with something better than what is little more than a hunch on her part, and start to ‘unhide’ some real evidence to show she’s on to something.
Incidentally her expertise is epidemiology so she won’t be a part of the same Oxford team which is working on development of a vaccine.
@Marco
“Professor Gupta wasn’t wrong,” I disagree as i said, she claimed that we had already reached herd immunity in March / April and if that were true we would not be having the sharp rises in infections again that we are seeing now.
”
Her group at Oxford produced a rival model to Ferguson’s back in March which speculated that as much as 50% of the population may already have been infected”
From the BGD. https://gbdeclaration.org/frequently-asked-questions/
“For COVID-19, what percent of the population needs to be immune to have herd immunity?
That is impossible to know right now. No respectable epidemiologist will mention a specific percentage needed.
So where do you get your 20% from Marco? If the person advocating the GBD does not know the answers, dont you think they should have done a bit more research before advocating it?
” Online delivery slots reserved for shielding groups”
When we were in complete lockdown earlier in the year and 2 million people were in the shielding group although the supermarkets did wonders in extending home deliveries for people in shielding, it still became extremely difficult to get priority slots and you needed to book weeks in advance, I KNOW.
Now even if we were to go down the proposals of the GBD and extend shielding to all those classed as vulnerable households, IF supermarkets were struggling to provide priority slots to 2 million households, how do you expect them to scale this up even further to cover millions more?
Although the government introduced food parcels to the extremely vulnerable group, it was not without floors, it only provided food for the vulnerable adult and not the rest of the household, so therefore someone would still have to go out and get food for the rest of the household. How is this supposed to work with GBD when it is asking for the entire household to shield when there is a vulnerable member?
Regarding Prof Gupta’s co-authored article, we can pick up several weaknesses by the authors’ own admission:
It says ” Evidence is also mounting that some individuals have pre-existing immune responses to SARS-CoV-2 which may confer resistance to infection”
Or it may not.
“We present a general mathematical framework ….. We find that the herd immunity threshold (HIT) can be lowered by the existence of a fraction of the population who are unable to transmit the virus”
This goes without saying! I’m not sure why we need “a general mathematical framework” to prove it.
“Yet the bulk of deaths from COVID-19 has occurred among older age classes and those with comorbidities…. indicating that some level of pre-existing resistance to severe disease…”
There is general agreement on this. The key question is whether resistance to the disease is the same thing as resistance to infection. It’s quite possible to be resistant to a disease, show no symptoms, and still be a carrier. The authors don’t make this crucial distinction. If we have the latter then the incidence of high numbers of asymptomatic carriers makes the disease more dangerous than it would otherwise be.
Readers might remember there was a outbreak of what was known as SARS in 2003 which was successfully contained. It was an order of magnitude more dangerous than Covid. The increased severity of symptoms meant, though, that everyone who was infected could be more easily identified.
So what might appear to be a less dangerous virus has ended up creating a much higher death toll as a consequence of large scale asymptomatic transmission.
I find it extraordinary that having called for peer-reviewed scientific reasoning, modelling, evidence etc for the targeted protection proposal, with a response having cited a draft paper co-authored by Sunetra Gupta, our LDV commentators now consider they are qualified to conduct the peer review themselves. Peter Martin claims to have identified ‘several weaknesses’, states that one of Professor Gupta’s statements ‘goes without saying’, these eminent authors apparently don’t know the difference between being a sufferer and an asymptomatic carrier etc. Peter Martin is apparently also an expert on how teams are constructed at Oxford University, so that he can confidently tell us that Professor Gupta isn’t working on a vaccine (see however https://horizon-magazine.eu/article/we-ultimately-should-be-able-make-pan-coronavirus-vaccine-says-theoretical-epidemiologist). Earlier comments impugn Professor Gupta for unestablished political connections and funding (the latter of which her academic article as required denies). This is now beyond acceptable comment. It has become a relentless attack on Professor Gupta, and is partly ad-hominem. She appears to be an eminent scientist with a long reputable career. Her proposal should at least be treated with respect, and of course subject to peer review and polite considerate debate.
Could those opposing a targeted protection proposal now cite equivalent peer-reviewed, evidence based, scientific articles for the total population lockdown currently imposed in Wales (including how not being able to buy a book in a supermarket helps), the near lockdowns imposed in the north of UK, and other practices such as whole group quarantining of students, school years and those returning to the UK, in place of testing and selective targeted quarantining of positive cases.
@ Matt and Peter Martin
“ So where do you get your 20% from Marco?”
It’s actually in this paper:
https://www.medrxiv.org/content/10.1101/2020.07.23.20160762v2
“ Our inferences result in herd immunity thresholds around 10-20%, considerably lower than the minimum coverage needed to interrupt transmission by random vaccination,”
Also see:
https://www.bmj.com/content/370/bmj.m3563
“At least six studies have reported T cell reactivity against SARS-CoV-2 in 20% to 50% of people with no known exposure to the virus.”
If the virus has a basic reproduction rate R0 of say 2.67 then if the entire population were susceptible then the HIT would be around 63%. However if 50% had innate resistance then HIT would drop to around 25% based on very simple models.
However that assumes that immunity and exposure are evenly spread which they aren’t so the modelling becomes more complicated.
Happy to give a very basic explanation of how herd immunity thresholds are calculated if you like.
@Geoff
“Her proposal should at least be treated with respect, and of course subject to peer review and polite considerate debate.” When she provides modelling and is peer reviewed and proven to be safe, that’s when I will respect the science.
“Could those opposing a targeted protection proposal now cite equivalent peer-reviewed, evidence based, scientific articles for the total population lockdown currently imposed in Wales”
For the record, I do not appose targeted protection, I believe it should be being offered now for those that are extremely vulnerable. I dont believe that targeted protection should be offered in return for stopping all other social distancing measures, lock-down’s, partial-lockdowns and allowing the “healthy population” to go about business as normal. We live in a society where all lives are equal and we all have right to live in this world as “safely” as possible which means we all have to accept some kerbs to freedoms until science can find a way to restore what once was.
As for peer reviewing lock-downs, there is no need for this as we have the benefit of history on our side, Lock-downs and partial lockdowns achieved exactly what sage said it would do, it drove down infection rates, hospital admissions and deaths and it only rose again in August / September when shielding ended.
Sage never said that lockdowns would eradicate the virus, they said we would need to keep applying and adjusting the brake in order to keep the virus at manageable levels so as not to overwhelm the NHS until we had a vaccine or antiviral. How does this need peer reviewing when we know that it worked from evidence.
@ Marco
“Happy to give a very basic explanation of how herd immunity thresholds are calculated if you like.”
No need Marco, I am assuming you know no more than Professors who wrote the declaration and their answers are
““For COVID-19, what percent of the population needs to be immune to have herd immunity?
That is impossible to know right now. No respectable epidemiologist will mention a specific percentage needed.”
So if they don’t know the answers, I am sure you don’t