Coronavirus

[nffc]

Originally Posted by jfman

It depends why infections are falling. All things being equal - yes. However the problem with the mass infections in school strategy is that while it’s easy for the figures to come down (there’s only so many susceptible schoolchildren left) the onward transmission into other age groups won’t be as easy to curtail and that’s where the hospitalisations and deaths are happening.

They are clearly going to be (in the main):
- double-vaccinated adults for whom this protection isn't sufficient to stop them getting seriously ill, either because their immune system hasn't responded to it, enough, or because the vaccine just didn't work well enough
- adults who have had the opportunity to be vaccinated but have declined the offer
- adults who have been advised not to be vaccinated for various reasons but mainly medical (or else they will be in the above)
- kids with medical issues for whom getting covid would still be an issue.


You will see that the infection levels do seem to correlate with schools being open. When we had the first restrictions which eased over the summer then stayed low until the schools and universities went back, it then went out of control again, until the schools shut in January again and it went down again, but then when we got the delta in, along with schools reopening, it went up. You even saw it go down in Scotland first and then back up again and same with England a few weeks later with school holidays, and we're now seeing it go down again as it's half term.


You're right that it will eventually hit the buffers when it runs out of kids who haven't had it but we don't know how far this is and how much risk we have from spill over until it does.

[jfman]

Originally Posted by nffc

A few days can be a long time with this but they do need to be in possession of the trends and consider multiple angles which even Whitty and Vallance don't. When your decisions could affect all sorts of things it's important you take time to decide what is the right course and what the exit plan is if you do tighten things.

We don't need a repeat of last years tiers where they were keen to escalate measures but conversely didn't have a clear de-escalation plan and ended up back in a full lockdown twice.

As for mass infection, well, isn't that what happens with most viruses? We don't do mass vaccination for flu, colds, noro, or other viruses, and don't lock down for them (aside for targeting flu jabs at the higher risk groups). For all of these they're just allowed to spread and people are advised to stay home if they have it. I suppose with covid it's different as without vaccination the death and serious illness risk is higher but the vaccine has reduced this, and aside from the risk of kids getting "long covid" (a term I still hate, it's post-viral effects same as you can get with other bad viruses) from the increased exposure, and that of spill over events into older people potentially evading vaccines, we aren't hugely far off allowing that to actually be the answer, or at least a potential outcome, not that anyone would actively encourage or condone it as an approach to take. Whilst we still have this level of hospital admissions we're still at the "best it doesn't happen" stage, but this is clearly what the boosters are designed to help with.

The fact a decision is complex isn’t a justification to shirk responsibility, hope for the best and end up having to impose stricter restrictions anyway. Which is inevitable if this “wing and a prayer” approach that has served Britain so well to date is persisted with.

You may hate the term “long covid” but I’d hazard a guess those who suffer it might dislike it more?

In an area where elective hospital procedures are being cancelled and the military are supporting, people are being asked to avoid A&E unless “life threatening” I’d hazard a guess that the wait and see approach is doomed to failure.

[nffc]

Originally Posted by jfman

The fact a decision is complex isn’t a justification to shirk responsibility, hope for the best and end up having to impose stricter restrictions anyway. Which is inevitable if this “wing and a prayer” approach that has served Britain so well to date is persisted with.

You may hate the term “long covid” but I’d hazard a guess those who suffer it might dislike it more?

In an area where elective hospital procedures are being cancelled and the military are supporting, people are being asked to avoid A&E unless “life threatening” I’d hazard a guess that the wait and see approach is doomed to failure.

They have had that kind of message pre-covid when hospitals are full of people throwing up across wards because they have a noro outbreak or if they have a lot in with complications of flu though.



Plus, avoiding A&E unless it's urgent is kind of the point of A&E isn't it? If you haven't had an accident and aren't seriously ill then you don't go, you go to a walk in or the doctor's or stay in bed. They don't need people turning up at any time or under any conditions who could be treated more effectively elsewhere which is presumably one reason why arrivals are triaged.


I get that the response is somewhat area-dependent too, and that one particular area is getting affected more than others at the moment (and that is a good reason not to make national restrictions) which can make the local healthcare system more pressured, but in terms of raw numbers of hospital admissions, it's not growing out of control (e.g. doubling every few days), it's marginally below the levels of last year (if it stays around the 1k mark a day it will probably be no major pressure) although last year it was on a much quicker upward curve than this, and still far below the levels of 4k odd a day we were seeing last January when the NHS really couldn't cope. There is no doubt figures relative to the capacity available which would show this quite easily. And as well if people aren't in hospital as long then this can influence a raw number anyway.

[jfman]

Originally Posted by nffc

They have had that kind of message pre-covid when hospitals are full of people throwing up across wards because they have a noro outbreak or if they have a lot in with complications of flu though.

On a short term, localised basis. Yes. Not nationally, and not for the duration of winter which it will be unless something changes.

Plus, avoiding A&E unless it's urgent is kind of the point of A&E isn't it? If you haven't had an accident and aren't seriously ill then you don't go, you go to a walk in or the doctor's or stay in bed.

There is of course a massive range of “urgent” things that fall below “life threatening”. A broken arm or leg, for instance, would most definitely be urgent but fall beneath the benchmark of “life threatening”.

They don't need people turning up at any time or under any conditions who could be treated more effectively elsewhere which is presumably one reason why arrivals are triaged.

I get that the response is somewhat area-dependent too, and that one particular area is getting affected more than others at the moment (and that is a good reason not to make national restrictions) which can make the local healthcare system more pressured, but in terms of raw numbers of hospital admissions, it's not growing out of control (e.g. doubling every few days), it's marginally below the levels of last year (if it stays around the 1k mark a day it will probably be no major pressure) although last year it was on a much quicker upward curve than this, and still far below the levels of 4k odd a day we were seeing last January when the NHS really couldn't cope. There is no doubt figures relative to the capacity available which would show this quite easily. And as well if people aren't in hospital as long then this can influence a raw number anyway.

Hospital admissions can be problematic without falling into your, presumably completely arbitrary, criteria of

• Doubling every few days
• 4k cases a day

This is where presumably the inevitable Plan B comes into play. We know where both of your criteria land: lockdown.

[nffc]

The issues with Plan B is that it has effects to be annoying but isn't either targeted enough at where the issues are or hard enough to effect hospitalisations.


Given that it's a menu to select from and that maybe not all of it will be applied either...
- Face coverings - well they certainly don't work by themselves and don't have an effect if a non-infected person is in a shop by themselves. Given that the definition of where this could be used is still so vague "in some indoor settings" they could look at the most likely issues and say it's now expected again in schools and on PT where there will be a large number of kids mixing at certain times of the day.

- WFH - a lot of people are still doing this or at least most of the time. Some people can't do it at all and presumably they won't be closing these jobs off again (or determining what isn't essential) without reinstating furlough. Unlikely to have an effect in any case on transmission in schools, or family transmission between infected school kids and their parents, grandparents etc.
- Vaccine passports - Nigh on useless as being vaccinated doesn't mean you aren't going to get or spread covid. But there is admittedly a reduction which makes things safer. Also need to have some fall back for people who can't be vaccinated either because of medical reasons or age, but this again (like face nappies) would depend on the settings you mandate it in. But on the other hand, the settings which are most likely to be super spreader events (nightclubs for example) aren't usually frequented by people who are likely to be hospitalised if they catch covid.



Most of this admittedly depends on what we don't know as opposed to what we do (i.e. what measures they will use and how) but even if they told people who couldn't WFH they just go into work as normal and those who can do, and mandate face masks and vax passports in any public indoor setting, it's difficult to see this would go far enough at reducing transmission in the groups at risk to go to hospital with covid sufficiently. Probably the main effect would be that it would be annoying, and you could see a lot of people just not putting masks back on, for example, which would reduce their effectiveness.


Plus there's little point in Plan B at all if the cases continue to dip as they are. That is the most likely way that hospitalisations will drop maybe in a week or so as they usually do.


Yes, they were arbitrary as the figures from last year don't take account of the vaccination effect, but you'd be sure that Whitty and Javid would have some form of measurement which indicates "danger"...

---------- Post added at 17:54 ---------- Previous post was at 17:52 ----------

I suppose the two key questions for invoking Plan B otherwise would be:
1. When and how would you remove these restrictions once cases and hospitalisations do drop
2. What would be the next stage if it has no effect, how would this be measured to ascertain the need for more restrictions and what would be appropriate tightening, and again, what would the exit plan be

[OLD BOY]

Originally Posted by Sephiroth

The hospitalisations must lag the infections - say by at least a week. The deaths must lag the hospitalisations - say by at least two weeks.

If there's a downward trend on infections, the other metrics will follow.
Didn't I do some fag packet maths on this?

It's not that simple. As I said before, the vast majority of infections (which means no more than a positive test) are in younger people, who are not going into hospital with this in any great numbers.

---------- Post added at 18:09 ---------- Previous post was at 18:06 ----------

Originally Posted by jfman

It depends why infections are falling. All things being equal - yes. However the problem with the mass infections in school strategy is that while it’s easy for the figures to come down (there’s only so many susceptible schoolchildren left) the onward transmission into other age groups won’t be as easy to curtail and that’s where the hospitalisations and deaths are happening.

And of course the onward transmission group are largely double-jabbed.

---------- Post added at 18:15 ---------- Previous post was at 18:09 ----------

Originally Posted by jfman

With the best will in the world OB, given your stance throughout has been that mass infection isn’t a problem forgive me for not finding your analysis from a single speculative news story particularly reassuring.



Well consider me fully reassured given their track record of responding too late.

My stance on mass infection at present is indeed as you say, but that was not the case prior to the vaccination programme.

I think you are mistaking what I said when the coronavirus was emerging in this country. I didn't say it was not a problem back then, but that we had to let it pass through the population because a lockdown would only pause the spread.

I think subsequent events have proved that lockdowns alone do not stamp out the virus.

---------- Post added at 18:17 ---------- Previous post was at 18:15 ----------

Originally Posted by jfman

Nobody is equating the numbers of infections then (previous waves)with now.

What they are doing is comparing figures with last week, last month, etc. Where the metrics are going up across the board.

Vaccinations don’t make figures from last week incomparable with this week, or last month with this month. The numbers of additional people benefitting from vaccination in that time is negligible, and more likely to be among age groups highly unlikely to be hospitalised or die anyway.

Hospitalisations have increased only marginally. Infections are already falling so far. Why the concern, other than to be argumentative?

---------- Post added at 18:21 ---------- Previous post was at 18:17 ----------

Originally Posted by Hugh

Pretty sure what they previously said wasn’t good enough for you - you were quite vociferous in your disagreement… ;

They are now in line with my point of view, and Prof Whitty is a person that most sensible people believe does not have an agenda as some of his colleagues do. That's why I mentioned him.

---------- Post added at 18:26 ---------- Previous post was at 18:21 ----------

Originally Posted by jfman

The fact a decision is complex isn’t a justification to shirk responsibility, hope for the best and end up having to impose stricter restrictions anyway. Which is inevitable if this “wing and a prayer” approach that has served Britain so well to date is persisted with.

You may hate the term “long covid” but I’d hazard a guess those who suffer it might dislike it more?

In an area where elective hospital procedures are being cancelled and the military are supporting, people are being asked to avoid A&E unless “life threatening” I’d hazard a guess that the wait and see approach is doomed to failure.

You criticise those of us supporting the current government approach as 'hoping for the best'. However, you have presented very little in the way of figures to support your risk-averse approach. Clearly, you are 'hoping for the worst'.

[nffc]

The thing is, none of us can see where this is going. All of us can suggest where it might but that's not going to necessarily be right.


With the benefit of hindsight those who are saying we need restrictions now may well be right, this downward trend over the next few days may turn into a spike again when the kids are back, we need more than Plan B by that stage as everyone's vaccines drop like scales from Saul's eyes, and the hospitals have to treat people in the street.


Or we could see that this trend is the buffers, cases dip and go back to very low levels (<1000 a day), hospitalisations and deaths become almost unheard of.



Both of those are extreme and unlikely to happen any time soon though.


In all likelihood the SAGE modelling will probably be over-pessimistic as it usually has been, though even that is suggesting now that the current measures will be enough.


I wasn't really posting on here during the earlier stages but I don't need hindsight to tell you that I was in favour of all three periods of national restrictions, a week or so before, and tighter controls internationally, along with faster roll out of the vaccines. I just don't see that anything in the current trends suggests it is suddenly going to roar out of control.


And people will always use their common sense, or enough will anyway, and lessen their activities, work from home, wear masks more to control it anyway. We don't need the government to tell us this. All the Labour people should be following the leader and doing it now he's finally committed to today's Plan B stance...

Unfortunately, a reasonably large percentage of the U.K. population don’t have common sense…

[nffc]

Originally Posted by Hugh

Unfortunately, a reasonably large percentage of the U.K. population don’t have common sense…

Not wrong.


But you would expect sufficient do. Especially in high infection areas.

[OLD BOY]

Originally Posted by Hugh

Unfortunately, a reasonably large percentage of the U.K. population don’t have common sense…

Do you have a link for that, Hugh?

[TheDaddy]

Originally Posted by OLD BOY

I apologise if that was the case, but that post you quoted here was in answer to yours, which said ‘Whatever’!

Obviously that word means something different to you than it does to me!

The point I was alluding to which generated your response was simply to point out that the consequence of that many infections before the vaccines was completely different to the situation we now face.

None of which was relevant to my original post, asking if vaccines mean anything etc wtf was that all about, in fact don't bother, life's to short

[OLD BOY]

Originally Posted by TheDaddy

None of which was relevant to my original post, asking if vaccines mean anything etc wtf was that all about, in fact don't bother, life's to short

I said that because your post did not appear to take into account the impact the vaccination programme is making.

Originally Posted by OLD BOY

Do you have a link for that, Hugh?

Well, September 2020 Boris told people to use "common sense" and then the infections & hospitalisations rocketed…

Mr Johnson also said people now "instinctively" knew how to stop coronavirus from spreading.

He said: "But so much of this is about common sense and about following the basics of the guidance and just restricting the possibility of transmission from yourself to somebody else, or from somebody else to you.


"And I think people do instinctively now understand how to do that. The more we do that, the more efficiently we do that, the better the chance we all have of getting this virus down."

https://www.chroniclelive.co.uk/news...-east-19026349

On a related note re links…

Can I ask how you know it is an "extremely small cohort", please?

[OLD BOY]

Originally Posted by Hugh

Well, September 2020 Boris told people to use "common sense" and then the infections & hospitalisations rocketed…

As I recall, Hugh, that’s because the new Kent variant was much more infectious than the dominant variety in the UK at that time. Nothing to do with the public not having common sense.

---------- Post added at 20:10 ---------- Previous post was at 20:06 ----------

Originally Posted by Hugh

Can I ask how you know it is an "extremely small cohort", please?

https://www.independent.co.uk/news/s...-b1880583.html

Your search skills seem to be letting you down, Hugh!

[jfman]

Originally Posted by OLD BOY

And of course the onward transmission group are largely double-jabbed.

Yes, however that only means they are at lower risk than previous waves. The risk across the whole population isn’t zero or even insignificant. Which is why we, and other countries, are approving booster doses.

My stance on mass infection at present is indeed as you say, but that was not the case prior to the vaccination programme.

I think you are mistaking what I said when the coronavirus was emerging in this country. I didn't say it was not a problem back then, but that we had to let it pass through the population because a lockdown would only pause the spread.

I think subsequent events have proved that lockdowns alone do not stamp out the virus.

Neither, evidently, does the vaccination campaign.

Hospitalisations have increased only marginally. Infections are already falling so far. Why the concern, other than to be argumentative?

As I say, where hospitals are cancelling all elective surgery, military supporting and telling people not to come to A&E is not indicative of a health service coping.

They are now in line with my point of view, and Prof Whitty is a person that most sensible people believe does not have an agenda as some of his colleagues do. That's why I mentioned him.

There’s no real reason to believe they are right because you agree. If anything, it makes me more concerned that you agree with them, not less.

You criticise those of us supporting the current government approach as 'hoping for the best'. However, you have presented very little in the way of figures to support your risk-averse approach. Clearly, you are 'hoping for the worst'.

Suggesting mitigation to avoid the worst is, self evidently, not hoping for the worst.

I’m not sure I need figures to evidence that mitigations work that we can look at the many countries who have successfully implemented them and look at their contrasting outcomes.

At least when Plan B is implemented, and all these mitigations are reintroduced, you will be on board because Whitty says so.