GUARDIAN: Actually, Boris Johnson's Virus Strategy Is Sensible
03/13/2020
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Earlier: UK Coronavirus Strategy: Lie Back and Think of England

From The Guardian on the British government’s virus strategy:

UK government’s coronavirus advice – and why it gave it

The action plan’s recommendations differed significantly from measures imposed in other countries

Kate Proctor

Thu 12 Mar 2020

While school closures can be effective in the case of a flu pandemic, large-scale shutdowns are not thought to be an obvious next step in dealing with the virus in the UK, the government said. Closures would have to be at least 13 weeks long to reduce the peak of Covid-19 by 10-15%.

Considering how bad the peak is likely to be, a 10-15% reduction sounds okay to me.

Measures such as self-isolation for seven days for those with symptoms, as advised by the government, have been modelled and are shown to be much more effective.

The British have been relying on a 2011 planning process. A big question is whether they’ve fully updated from their 2011 simulation to the realities of the 2020 virus.

That reminds me that America has a lot of modeling talent in its baseball analyst hobbyists. Since there probably won’t be any baseball for some time, let me point out that epidemics are interesting to analyze statistically too. We could use some independent perspectives from bright young outsiders.

The 2020 Society for American Baseball Research analytics conference is supposed to begin this afternoon in Phoenix. I don’t know whether it will happen or not, but a good topic would be how sabermetricians can contribute to The Effort. Us oldsters are too old to wrap our brains around a new discipline, at least below the Nick Patterson-level of intelligence, but the younger men could pitch in and help.

Experts also believe it would be difficult for school closures to work in practice, as children off school would end up socialising anyway or spending time with grandparents, who would be worse-affected by the virus. Schools will be asked to stop foreign trips.

As we all know, kids these days are insatiable for face to face socializing. They refuse to stay in their rooms and stare at their screens.

Self-isolation

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The updated guidance asks people to self-isolate at home for seven days if they have a new and persistent cough for up to four hours and a temperature of 37.8C and above. These are considered to be mild symptoms of coronavirus and people do not need to ring 111 for advice unless their condition dramatically worsens, the government said. Following this advice is thought to be an effective way of reducing the peak number of cases by up to 20%. The seven-day period is based on people being infectious just as their symptoms start to show and for a week afterwards. In the future, the government may ask a whole household to isolate for two weeks if one person is affected.

Why wait for “the future?”

The future is NOW.

The government believes that banning large gatherings is one of the least effective measures a country can take, reducing the peak of the coronavirus by less than 5%. The virus is just as likely to spread within a smaller group such as those watching football in the pub as it would in a large crowd.

How about people watch soccer at home?

Scotland has taken a different decision, banning events of more than 500 people from Monday to free up emergency services.

Experts have warned consistently about the importance of not moving ahead too quickly with dramatic lifestyle changes to try to deal with the virus. Anything too onerous suggested by the government – such as a two-week isolation period for a whole household – might be adopted enthusiastically for a few weeks but then people get bored and leave their homes just as the peak of the illness hits, the government fears. A complete and immediate “lockdown” on movement could suppress the virus for a short time but it would return once measures are lifted, the government believes. Instead, the aim is to push the peak back toward the summer months and bring in more stringent measures down the line.

I don’t know … This sounds to me like exactly the wrong idea, but what do I know? My thinking is that if you slam it hard now when there aren’t many cases, it’s more likely to die out than if you slam it hard later when there a million cases.

Am I wrong about this?

Flights
Donald Trump has banned citizens from 26 European Schengen area countries from travelling to the US for 30 days. The decision will not be replicated in the UK following the advice of the chief medical officer and chief scientific adviser. The measure is not effective unless 95% of flights are stopped, the government said, when in reality only 50% stoppage is likely to be achievable. If you are to fly, the World Health Organization guidance suggests the highest-risk area is the two rows in front, behind or next to an infected person.

Lotsa luck with getting a seat more than 2 rows from the infected person …

There will now be a shift in testing. The contain phase was about isolating individual cases, getting a diagnosis and then “contact-tracing” the people they have spent time with and asking them to self-isolate. Many people will no longer be tested if they are showing mild symptoms. Instead, those with the most serious symptoms will be given a blood test in a hospital, and the NHS will move into a phase of prioritising the most seriously ill.

Also, passengers on the London Tube are advised to lick handrails.

The peak
Scientists and medics are using this phrase a lot, and it means the highest potential rate of cases. For the UK, the peak is expected to fall in three months’ time, likely in the summer months, and tail off throughout the autumn, the government said. Vallance said that the UK is around four weeks behind Italy, where there have been 1,000 deaths and more than 15,000 cases.

So … Italy is still two months away from the peak? This peak thing that you speak of blithely, it does not sound so good to me.

The peak also brings the biggest period of challenge for the NHS. There are 5,000 ventilated beds but the service is looking to increase that number. Without a cure, the main treatment is oxygen therapy, which can be provided through a mask, and the NHS is looking to increase supplies.

Hey, they’re looking. You can’t expect them to necessarily find more supplies. This isn’t World War II when Six Companies, led by Henry Kaiser, built a new Liberty-class cargo ship every 18 hours.

iSteve commenter eugyppius writes in response to the UK’s rather laissez-faire response to the virus:

Look, nobody will read this down here at the bottom, but in response to comments supporting the UK strategy above:

1) Measures necessary to flatten the curve (slow the rate of new infections so it does not swamp hospitals) and squash the curve (drive r0 under 1), as people have been pointing out for a while, look very similar to each other. They are both extreme.

2) What the UK is openly confessing to doing, what Germany is secretly planning on doing (but now they are closing schools, so they are taking more steps), along with perhaps also Spain, is not very much of anything. Banning large gatherings is not going to slow the curve. It will have no measurable effect.

3) Germany at least, and I assume other EU countries aside from Italy, is reacting to the virus in the moment. They are speaking as if the known state of the infection today is the actual state. They are saying “of course many more people with mild symptoms are not recorded.” They are saying that they will take measures later if things get worse. Things are *already guaranteed to be several orders of magnitude worse* because a portion of those mild cases will become critical and a portion of incubating invisible cases will become mild. By the time they get worse they will be *several orders of magnitude worse again* This will keep happening.

4) I find it very doubtful that populations will find merely enduring a sudden pandemic wave acceptable. We are talking about the vast majority of all healthcare resources, maybe 75% to 80%, going to supporting the respiration of people 65 years and older. We are talking about apparent mortality creeping up to 6% as now in Italy. We are talking about parents and grandparents being turned away and left to suffocate outside in a tent. We are talking about vastly reduced resources for almost all other health problems. You are in a car accident, you have a stroke, you break your arm, you get a kidney infection, you have a heart attack: All of that happens, for several months, in a world where healthcare resources are 25% what they are now.

iSteve commenter DanHessInMD says:

The CDC has been saying masks are ineffective. What a mistake!

That is completely wrong. Simple masks are obviously very effective! East asians have known this for at least a generation.

The Chinese and Koreans instantly stopped CoronaVirus cold the minute everyone started wearing masks. I think that alone might be enough to get the R0 value below 1, which stops an outbreak.

President Xi just toured Wuhan and declared victory. He was wearing a simple facemask.

Famed Yale Virologist Iwasaki on twitter recently to her 15000 followers, “A mask will certainly keep your nose and mouth warmer and more humidified. I always wear a mask on international flights for this reason, where 10% relative humidity and closed environment makes for a perfect transmission incubator.”

Useful info?

I would once have said not to wear a facemask on account of not causing panic, but I really don’t think the panic can get any worse at this point.

We need about 10 billion N95 facemasks per month in America. At the moment, we are ridiculously short of N95s. I bought 20 a couple of weeks ago for some absurd price per unit that I only agreed to because I’d hit the Stolichnaya hard. But it was one of the better decisions I ever made. Every household needs some in case a member gets the virus so everybody needs to mask up.

Then, when it’s time to get the economy going again, everybody should wear a mask, perhaps until they’ve gotten inoculated with the vaccine, which is likely to be in the spring of 2021.

[Comment at Unz.com]

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