The L Word

‘Stay the fuck home’. A less effective means of gaining general co-operation from the instinctively anti-establishment would be hard to imagine. How about you get the fuck out of my face? Our more formal UK government messaging has plumped for the ‘will-no-one-think-of-the-the-children’ emotional arm-twist of ‘Stay Home, Protect The NHS, Save Lives’. This appears at the foot of the rash of notices that has appeared all over my own rural region requesting people to approach a farm gate on a public path as they would open heart surgery, and disinfect or wear gloves before touching. After a day slapping cows’ backsides (I am hazy on the details of the profession!), it would be too much to expect farmers to take responsibility for their own biosecurity, and wash their own hands before dining.


The Government was almost begged by a large proportion of its citizens to imprison them. Their slogan (from the same people who gave us the infamous Brexit slogan-on-a-bus, a pledge they are now in a position to fulfil, but won’t) was taken up as a clarion call by the more rule-based sector of society. Cyclists, runners, walkers out for their ‘permitted’ daily exercise were branded ‘selfish’ for being out too long, too often, in too great a number. “Stay at ‘ome” grumbled one farmer, virtually the only person I saw all day. Inner city types sunbathing in parks were shamed by widely-shared long-lens Daily Mail pictures. You could almost see the Facebook squawk from space. Go for a run, you might as well stab a nurse.

Now after the second of two 3-weekly reviews, Boris Johnson announced on Sunday that we will begin to ease certain measures. The red border of the old slogan was replaced by green, the message now ‘Stay Alert, Control the Virus, Save Lives’. Facebook is furious again. Too soon. They’ve invested heavily in the notion that lives are lost in the act of leaving the front gate. Was the government lying then, or now? Some parents are adamant that their kids won’t return to school this side of a vaccine. I hate to break it to them that that could be years away, or never. The technology, RNA vaccine, is new, and carries no guarantees.

If ‘lockdown’ were a drug that deferred deaths but cost billions, rendered people unable to work or study and had significant further side-effects on physical and mental health, we’d want some clinical trialling done. Compare control groups with and without the intervention, before administering it en masse. Particularly if the only way to get off this addictive substance was another pharmaceutical intervention not even developed. If we shortcut that trialling process, then got something wrong, the consequences for society and confidence in vaccine in general would be catastrophic. But many people are vowing to stick with one untrialled intervention until another comes along, which they’ll seemingly grab both-fisted.

We didn’t have the luxury of trialling, of course. We had to do something to prevent health services being swamped. The government’s early plan was ‘herd immunity’ – a perfectly respectable concept already poisoned by anti-vaxxers, now finished off by attachment to Tory policy. I have learnt to be careful in my use of the term, to try and avoid those knee-jerk associations. Governments the world over, meantime, were administering ‘lockdown’ instead, in varying doses. Our own government, particularly influenced by Neil Ferguson of Imperial College and a vocal sector of our medical profession, did a swift one-eighty and announced our own resort to this new wonder-drug – in lower doses than France, which in turn took less than Italy and Spain. Sweden opted to be the control group.

But the longer we administer it, the more severe the side effects: the relationship is not linear. It’s not just a cold-hearted trade-off of lives for money. Lives are directly threatened by the effect of lockdown on mental and physical health, and economic downturn. Poorer countries tend to have worse healthcare. And in not circulating socially, the ‘learning’ process by which immune systems adapt to the common pathogens in the population is turned off – immunity is not gained solely by noticeable illness, and it isn’t inherited. A newborn gets a starter dose of antibodies through the placenta and in colostrum; after that, you’re on your own.

There are some offsetting benefits. There will be fewer road deaths, while some 40,000 excess deaths annually are due to air pollution – a cost in lives we don’t hear much uproar over; the uproar there is reserved for Greta Thunberg. The unprecedented clear air at the moment will save a significant number of lives, additionally improving outcomes in those catching Covid. And of course if the health service is less swamped, we get better outcomes generally. I must declare a competing interest here: my daughters are respectively on and near the front line. So the longer lockdown proceeds, the less they are threatened, but the longer till we meet again. My eldest soundly rejected my suggestion we meet up outdoors – despite agreeing the risk was minimal, she has seen too much suffering to contemplate bearing the burden of passing it to me, however remote.

There are two fundamental outcomes for a novel virus: eradication, or herd immunity gained through infection/vaccination. Much is made here of New Zealand’s success in eradication. They hit it hard and early; had all nations been able to do the same at a similar stage, we could conceivably be looking at global eradication now. Instead, New Zealand’s victory could prove Pyrrhic. For all the successes or failures of this or that government, the world has gone past the point of eradication. Each nation is surrounded by others; collective fate is sealed by the actions of the worst, not the best. Herd immunity is not a policy but an inevitable – and desirable – consequence of infection. Clumsy, poorly-led governments are moving slowly towards it, at great cost of suffering and lives. Those nations with the best early responses may yet have to bite that bullet, if a vaccine cannot be found, or remain sealed.

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68 thoughts on “The L Word

  1. Each nation is surrounded by others; collective fate is sealed by the actions of the worst, not the best. Herd immunity is not a policy but an inevitable – and desirable – consequence of infection. Clumsy, poorly-led governments are moving slowly towards it, at great cost of suffering and lives. Those nations with the best early responses may yet have to bite that bullet, if a vaccine cannot be found, or remain sealed.

    That’s assuming that herd immunity from this coronavirus is possible, yes? Do we even know that yet?

    I suspect that the global death toll from this thing is going to be staggering and indiscriminate.

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  2. Kantian Naturalist: That’s assuming that herd immunity from this coronavirus is possible, yes? Do we even know that yet?

    Yes, I think so. Antibodies have been found in the majority of patients in several studies, despite some alarmist headlines. With the caveat that coronaviruses mutate regularly, so it’s not lifetime. We don’t get flu all the time, individually, and Covid is likely to follow a similar pattern, a kind of partial, shifting immunity. Once a disease settles, infections tend to become milder on average. It’s unlikely to be the first ever disease we couldn’t mount some kind of response to!

    I suspect that the global death toll from this thing is going to be staggering and indiscriminate.

    High, for sure. But depends on infection mortality rate, which is hard to get a handle on, particularly given the sharp age profile, and nonrandom testing. I had a stab the other day and came up with a 50% excess on a normal year’s mortality to reach 60%, a quoted herd immunity threshold. 10x current UK deaths of 30,000.

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  3. I am puzzled as to what constitutes a “herd immunity” strategy, as (apparently) initially proposed by the UK gov.
    The best I can come up with is the idea that you get all the vulnerable people to isolate, and let the virus sweep through the ‘healthy’ population, such that it will flame out, having infected the requisite 80% of the population.
    Well, if the virus made zero demands on the healthcare system, that would not be insane.
    The whole point of pandemic counter-measures, as they have been understood for years, is to “flatten the curve”. You may perhaps have heard this phrase. The goal is to slow the spread, such that everyone can get optimal care, and there is the hope that what comprises ‘optimal care’ may improve significantly over the course of the pandemic. Waiting for a vaccine is not really part of that equation: research and trialing (even with ethically iffy challenge trials) just takes too long.
    I am going to take issue with one sentence in your excellent post:

    And in not circulating socially, the ‘learning’ process by which immune systems adapt to the common pathogens in the population is turned off – immunity is not gained solely by noticeable illness, and it isn’t inherited.

    You appear to be talking about pathogens other than SARS-CoV2, and the downside of overly sterile living. Not really relevant this year.
    What I do find eye-opening is just how much so many people revel in displaying their sanctimony, whether on line or in public (physical) spaces.
    [replaces fuse in irony meter]
    I’m referring to people on both sides of the ‘distancing’ battle: people who harangue others for wearing a surgical mask and deliberately get in their face, and people who harangue others for choosing to not wear a mask.
    As my wife put it to our daughters: “Wear a mask when you are out. The surgical masks help prevent you infecting people with whom you interact. It’s a sign of respect.”
    But there’s also been instances of people getting harangued for wearing an N-95 mask (which, unlike the surgical mask, is effective in protecting you from getting infected. Need eye protection too.) The complaint being that N-95’s are in short supply and needed by healthcare workers, so wearing one to Costco is a mite entitled.
    So my wife also explained to our daughters “The N-95 that you have came from an opened box at work, that I’ve had since November. The hospitals won’t accept donations of opened boxes….”
    “Just in case someone gives you a hard time for wearing an N95.”
    My view on lockdown is that easing should be done slowly, whilst monitoring the effect on infection rates to avoid overwhelming healthcare resources again.
    I am very concerned that rural USA is about to get stuffed.
    We also need to understand the relationship between immunity to infection and antibody titres. These are both continuous, multidimensional variables.

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  4. DNA_Jock,

    The best I can come up with is the idea that you get all the vulnerable people to isolate, and let the virus sweep through the ‘healthy’ population, such that it will flame out, having infected the requisite 80% of the population.

    Yes, that’s how it was presented. It was mentioned with approval by Swedish epidemiologist Johan Giesecke in an interview with Unherd (a coincidental name, coined before the present situation). But Ferguson and others persuaded them this was insane, that everyone had to be locked down, and the term has become synonymous with a cold, Tory economy-before-lives approach, which one is assumed to approve of if one even mentions it as an end point.

    To hear a lot of people talk, we’re still in eradication mode. In the National Park I live next to, police have been sending every non-local home, with the full approval of the tourist-hating curtain twitchers (talk about sanctimony!). Lurid fantasies of thousands on a path, touching gates … you can almost see their lips curl. But now travelling to Parks has been green-lighted, and they are going into overdrive – vigilantism, farmers dropping haybales to block entrances. But I’m curious to know when their own arguments will cease to carry weight – when the same factors, the clustering on paths and the gate touching, become sufficiently unimportant to lower their hackles. Could be a couple of years.

    You appear to be talking about pathogens other than SARS-CoV2[…]Not really relevant this year

    Bit of everything, really, including this virus in sub-infectious doses. In my conceit of treating it as if a clinical trial, this would be a ‘side effect’, however small.

    The mask issue doesn’t much arise here. It’s been added to advice, but half-heartedly.

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  5. Allan Miller: Bit of everything, really, including this virus in sub-infectious doses.

    Ah, yes. Reminds me of my pet theory for the increase in the incidence of Shingles: old buggers with a history of chickenpox infection are no longer getting ‘challenged’ by exposure to infected kids, so their immunity wanes…
    The main problem with assessing the effect of being exposed to a sub-infectious dose is, err, knowing that it happened. One of the many unknowns in the immunity-titre conundrum.

    The mask issue doesn’t much arise here. It’s been added to advice, but half-heartedly.

    Here in the good ol’ US of A, it seems to have become a way of signalling support for, vs. opposition to, the Narcissist-in-Chief. Whichever way you look at it, this is utterly deranged, and phoodoo is absolutely correct that it means the USA is once more pulling ahead of the UK in the race to be the world’s stupidest country.
    In Massachusetts, the (technically Republican!) governor has mandated that you cannot enter a building without a face covering ($300 fine), and in Manhattan (holders of the copyright on “Fuck you, I’ll do what I want!” ) a mask is de rigeur whenever you leave the apartment; NorthEasterners will step to the side to allow others to pass at a safe distance, whereas in the Carolinas, famed for their courtesy, stepping aside or wearing a mask would be signs of cowardice.
    Words fail me. I cannot describe my confusion at the idea that the citizens of Boston and New York (historically, the greatest assholes in the world, and proud of it) are acting with a sense of community reminiscent of the mythical “Old Country”, whereas people in the Carolinas and Georgia (whose notions of hospitality would shame a Scotsman) are acting like selfish morons.
    But while I am pondering on the stereotypes of the Eastern Seaboard, here’s how one (Marylander) mother of a UMD student described the nation’s Capital:
    “Ah, Washington! The manners of the North combined with the efficiency of the South.”

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  6. DNA_Jock,

    Seem to be missing a link.

    DNA_Jock: the USA is once more pulling ahead of the UK in the race to be the world’s stupidest country.

    I would contest this. Jair Bolsonaro is quite stupid, as are his followers. A Brazilian graduate student I work with regularly tells me about how bad all of Jair’s policies are, how he still insists that Covid is not real, and how the death toll continues to rise while he ignores it. And I’m sure Brazil isn’t the only one. Don’t forget that countries you don’t frequently think of still exist.

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  7. Allen, while your OP is well authored and I always appreciate seeing an OP written by someone willing to use reason and logic, I would take issue with much of the method you use to reach your conclusion. It seems to one such as myself that much of your objection to the current approach to the crisis has to do with how you feel about how the approach is working rather than actual data gathered on the matter. Frankly, I have seen much data about how much these current measures can reduce incidence of mortality to COVID, but I have yet to be presented any data about how the economic crisis imposed by the various lockdowns will actually have a human cost beyond vague handwaving.

    Further, I think Jock’s comment is one that you are giving too little weight to, despite it being the center of much discussion. Without a lockdown, there would be a huge number of cases of COVID, many of which would lead to hospitalizations. If hospitals become overwhelmed and equipment, drugs, and manpower run low, there will be deaths as a direct result of this, and not just to those suffering from the ‘Rona; others entering the hospital and in need of treatment for wholly unrelated conditions are likely to suffer as well.

    Disclaimer: the following section refers mostly to my own country (USA) and I do not possess the knowledge to know how specifically it applies to other countries.

    I might even venture so far as to speak radically and say this: part of the reason for the suffering we are seeing as a result of the economic downturn has to do with neoliberalism and its emphasis on “I’ve got me and mine” policies; as in, those policies which allow a sort of lasseiz-faire capitalism which allow the very rich to step on the very poor at any moment. We have seen already the effect of privatized healthcare, in that there are many without it. We see also the effect of an insufficient social safety net: 28 million+ unemployed, and a lack of proper resources to sustain life without direct employment or the prospect thereof. In my opinion, it is possible that the long-term benefits of society being awoken to our current crisis (and I’m not talking about the virus one) which has extended well before the lockdowns could outweigh the short-term costs, though they will be borne by the most vulnerable in society, as always. I could speak at great length on the subject and my feelings about it, but I doubt it would prove an interesting read and would take some time to write, and it would most certainly fall under the same category which I accuse you of falling into: debating about feelings rather than facts.

    Of course, I could be wrong on all of this, especially as new data emerges, and I am fully prepared for that possibility.

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  8. Schizophora,

    There are countries with bad leaders. However, there are not many countries with not only bad leaders, but just as ignorant citizens who support them, as America.

    People are protesting that someone is trying to keep their parents from all dying. Holy crap.

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  9. phoodoo: There are countries with bad leaders. However, there are not many countries with not only bad leaders, but just as ignorant citizens who support them, as America.

    I agree that there are “not many” but, as Schizophora correctly notes, Bolsonaro is frighteningly stupid, and he still enjoys the support of about a third of the Brazilian population. That’s similar to Trump. The USA is far from unique in its stupidity — it’s just that America’s failings tend to get more attention, what with the global hegemony and all…

    People are protesting that someone is trying to keep their parents from all dying. Holy crap.

    Well, that’s not entirely accurate, is it? When you exaggerate and create a strawman, that makes you less convincing. I say this as someone who, on this particular topic, agrees with you.

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  10. Anyone care to address Ferguson’s model, or his code? We have lots of coders here.

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  11. Just an observation:

    Of the total currently active cases, the percentage that are serious or critical has dropped from four percent to two percent. I’ve seen no comment on this.

    Maybe related, but the death curve is flattening faster than the new case curve.

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  12. DNA_Jock,

    How is it not accurate to say that the reason for the lockdowns is to prevent lots of premature deaths to vulnerable citizens? They are locking down to rid the culture of bad electric music clubs. Or to prevent rednecks from turkey hunting.

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  13. petrushka:
    Just an observation:

    Of the total currently active cases, the percentage that are serious or critical has dropped from four percent to two percent. I’ve seen no comment on this.

    Maybe related, but the death curve is flattening faster than the new case curve.

    If you’re getting this from Worldometers, it’s probably misleading. There are huge and evolving variations in reporting and testing – the UK, for example, has ‘N/A’ under ‘recovered’, and I’m doubtful that many countries are checking this particularly thoroughly. There are lags between infection, test and death, and the average time to death and recovery respectively will differ, all rendering most snapshot analysis dubious.

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  14. DNA_Jock: Ah, yes. Reminds me of my pet theory for the increase in the incidence of Shingles: old buggers with a history of chickenpox infection are no longer getting ‘challenged’ by exposure to infected kids, so their immunity wanes…
    The main problem with assessing the effect of being exposed to a sub-infectious dose is, err, knowing that it happened. One of the many unknowns in the immunity-titre conundrum.

    Yes, perhaps it is in ‘pet theory’ territory, but there seem few alternative candidates for persistent population resistance to prior-generation pandemic pathogens that are not extinct.

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  15. Schizophora:
    Allen, while your OP is well authored and I always appreciate seeing an OP written by someone willing to use reason and logic, I would take issue with much of the method you use to reach your conclusion. It seems to one such as myself that much of your objection to the current approach to the crisis has to do with how you feel about how the approach is working rather than actual data gathered on the matter.

    I’ve attempted to steer a broadly neutral course on the fundamental question, rather than having a personal objection per se. There are, of course, many versions of ‘lockdown’ in use in various countries; it’s not possible to object to, or favour, all of them simultaneously. I certainly have an objection to the measures with doubtful biological merit, which does colour my piece!

    Frankly, I have seen much data about how much these current measures can reduce incidence of mortality to COVID, but I have yet to be presented any data about how the economic crisis imposed by the various lockdowns will actually have a human cost beyond vague handwaving.

    ‘These current measures’ is a massive broad brush, given your aversion to handwaving! I’m not convinced that Spain’s banning of exercise has a net positive effect on mortality, for instance, as might come out of an actual trial of different ‘doses’. All measures are not equal, and I’m not arguing there should be none.

    But this is why I went for the conceit of an imagined ‘clinical trial’ in the first place – imagining a world in which we had the luxury of gathering empirical data, which we would demand if it were a drug. Because it isn’t, ISTM that a lot of the impetus is based on modelling, not empirical data. I could give you economic models too (in theory; I’m not an economist, and GIGO in both cases!), but you’d reject them. Until we’ve seen whether countries can sustain this cost indefinitely without a net excess of lives lost, how would we know? But, it seems reasonable to argue it.

    Further, I think Jock’s comment is one that you are giving too little weight to, despite it being the center of much discussion. Without a lockdown, there would be a huge number of cases of COVID, many of which would lead to hospitalizations. If hospitals become overwhelmed and equipment, drugs, and manpower run low, there will be deaths as a direct result of this, and not just to those suffering from the ‘Rona; others entering the hospital and in need of treatment for wholly unrelated conditions are likely to suffer as well.

    This is undisputed; sorry if my acceptance of this point does not come across. But I’d note that non-hospital, non-Covid deaths are rising. How much of this is due to lockdown, rather than general ‘Covid fear’, is unclear of course. But there is a potential lockdown link in the lurid means by which certain sectors try to ‘encourage’ people to respect it. You can’t promote fear of passing cyclists on the one hand, then say ‘but go to a big building full of ill people’ on the other.

    Disclaimer: the following section refers mostly to my own country (USA) and I do not possess the knowledge to know how specifically it applies to other countries.[…]

    Your concerns have a strong echo here as well. The debate has settled down on distinct ‘left-right’ lines, and in withholding full-throated support for full-on lockdown, I’m finding myself viewed as aligned with the Right (and anti vaxxers, and 5g nuts). This pains me, because it’s not where I belong. Still, it’s a global issue, and individual politicians can only have so much influence on a global brushfire.

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  16. Allan Miller,

    I am still not getting why you think if every country did what China has done that would be a bad thing. I get that they just won’t, but they should.

    China still has some imported cases coming in, but they tend to know about it right away, and it has not exploded again just from a few individuals

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  17. DNA_Jock: The USA is far from unique in its stupidity — it’s just that America’s failings tend to get more attention, what with the global hegemony and all…

    That, and the USA historically has had a strong democratic tradition. It is disconcerting to see its checks and balances be powerless against an unscrupulous populist demagogue.

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  18. phoodoo:
    Allan Miller,

    I am still not getting why you think if every country did what China has done that would be a bad thing. I get that they just won’t,but they should.

    It’s too late, and we don’t have the manpower or state apparatus to enforce it.

    China still has some imported cases coming in,but they tend to know about it right away,and it has not exploded again just from a few individuals

    Unfortunately, there’s a whole ‘rest of the world’ out there, as with New Zealand. With a billion people, you’re looking at indefinite sealed borders, as less efficient nations go the herd immunity route, as much through accident as design. I don’t fancy the alternative much either, though.

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  19. It is a fact that the percentage of confirmed cases that are hospitalized is declining.

    One might posit it is the result of increases testing, but I don’t think so. It’s happening all over the world.

    My best guess is it represents either better treatment, or better triage. But a good percentage of hospitalized patients survive. So two percent is the maximum probable mortality rate, and it’s likely to be half that. Fifty percent of those hospitalized, or less.

    Antibody testing suggests that there are ten or more asymptomatic cases for every one with symptoms. So, at most, ten percent of infections get diagnosed and reported, two percent of those are hospitalized, and half or more of those survive.

    Those are flu numbers. Given errors in reporting, maybe double flu numbers. Which is consistent with actual deaths being a fraction of projected deaths..

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  20. petrushka: Of the total currently active cases, the percentage that are serious or critical has dropped from four percent to two percent. I’ve seen no comment on this.

    Maybe related, but the death curve is flattening faster than the new case curve.

    For what geographical area?
    Two things come to mind: higher diagnosis rates will increase the proportion of milder cases, and (hopefully) more effective symptomatic management that keeps people out of the ICU.

    phoodoo: How is it not accurate to say that the reason for the lockdowns is to prevent lots of premature deaths to vulnerable citizens?

    Well that‘s entirely accurate. But you claimed “People are protesting that someone is trying to keep their parents from all dying.” Apart from anything else, Covid-19 does not have 100% case fatality.

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  21. petrushka,

    It is a fact that the percentage of confirmed cases that are hospitalized is declining.

    One might posit it is the result of increases testing, but I don’t think so. It’s happening all over the world.

    Increased testing is also happening all over the world! We had a classic example of test-bias yesterday, when various bodies were trying to disincentivise travel to our scenic county off the back of it being the darkest shade on a ‘heat map’, with my own health trust darkest of all. But in fact (whatever the merits of keeping people out), we here are testing far more, and hence finding far more. Testing starts with all health workers and patients, an obvious source of bias, then out to care homes and security services, again hotspots. This isn’t randomised testing, and shouldn’t be treated as such. Even if it becomes more so with time, the initial bias is still there in the consolidated data – and any ‘trend’ one might pick up may be an artefact of that gradual burying of the early bias, not a population change.

    Those are flu numbers …

    I don’t think so. An Italian study came up with 1.29%, sharply divided between the over 60’s (4%) and under. It’s perhaps comparable to flu in young cohorts, but not overall. My own guesstimate, extrapolating up the Stanford study discussed elsewhere, gives 0.7%, 7x deadlier. That’s quite a lot. My expert witness (daughter) perceives it as much more difficult than flu to deal with, and it’s not just numbers.

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  22. petrushka,

    It is a fact that the percentage of confirmed cases that are hospitalized is declining.

    One might posit it is the result of increases testing, but I don’t think so. It’s happening all over the world.

    Increased testing is also happening all over the world! We had a classic example of test-bias yesterday, when various bodies were trying to disincentivise travel to our scenic county off the back of it being the darkest shade on a ‘heat map’, with my own health trust darkest of all. But in fact (whatever the merits of keeping people out), we here are testing far more, and hence finding far more. Testing starts with all health workers and patients, an obvious source of bias, then out to care homes and security services, again hotspots. This isn’t randomised testing, and shouldn’t be treated as such. Even if it becomes more so with time, the initial bias is still there in the consolidated data – and any ‘trend’ one might pick up may be an artefact of that gradual burying of the early bias, not a population change.

    Those are flu numbers …

    I don’t think so. An Italian study came up with 1.29%, sharply divided between the over 60’s (4%) and under. It’s perhaps comparable to flu in young cohorts, but not overall. My own guesstimate, coarsely extrapolating up the Stanford study discussed elsewhere, gives 0.7%, 7x deadlier. That’s quite a lot. My expert witness (daughter) perceives it as much more difficult than flu to deal with, and it’s not just numbers.

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  23. Allan Miller: You can’t promote fear of passing cyclists on the one hand, then say ‘but go to a big building full of ill people’ on the other.

    True, but that’s not important right now.
    To be serious though, this is a very important point: a lot of the scare-mongering is incredibly counter-productive. Elements like the Spanish exercise ban strike me as over the top, and IMO counter-productive. But good data is hard to come by: virtually all comparisons one might look at are rife with confounding factors — initial infection rates, socio-economic and cultural differences and the plethora of different restrictions and how well they were observed.
    I was originally surprised when I read (Ferguson model) that the most important elements for flattening were shutting the schools and universities, and the isolating the vulnerable and the sick had virtually no effect. I now understand why this is the case. However, a lot of the debate around different models suffers from the GIGO principle.
    For instance, I’ve seen people comparing “% change in mobility over time” data for different geographies as if it meant something, apparently unaware that it is the number of times someone accesses Apple Maps asking for directions, hence the {drive|walk|transit} categories. This is “What You See Is All There Is” (Kahneman) on steroids.
    I think that the only usable data on the utility of lockdown measures will come after the fact, probably from Germany, who have actually conducted prospective regional experiments.
    In the meantime, and not without a hint of irony, I give you the Scandinavian experiment:

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  24. Allan Miller: My own guesstimate, coarsely extrapolating up the Stanford study discussed elsewhere, gives 0.7%, 7x deadlier. That’s quite a lot. My expert witness (daughter) perceives it as much more difficult than flu to deal with, and it’s not just numbers.

    That’s in the same universe as my estimate of 0.2 to 0.6.

    Based on the assumption that at least 90 percent of infections are asymptomatic or unreported. That is really the key unknown. It could be 95 percent.

    Making policy in this situation involves the same kind of hard reasoning involved in war. There are no magic wands that avoid deaths. It’s a matter of setting priorities.

    Right now, millions of people are being denied basic healthcare. Cancer surgeries are being postponed. Transplant surgery is reduced by 50 to 90 percent (France).

    So I have to ask, how long can this go on before we invent options to lockdown?

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  25. Serious question: are any of the parameters in the Ferguson mode derived from actual CV data? For example, does it assume that school children transmit CV to their families. And does this actually happen? Has anyone tested this hypothesis?

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  26. DNA_Jock: Well that‘s entirely accurate. But you claimed “People are protesting that someone is trying to keep their parents from all dying.” Apart from anything else, Covid-19 does not have 100% case fatality.

    So?

    This is still what they are trying to prevent. We don’t get to know beforehand who is going to die.

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  27. Allan Miller: It’s too late, and we don’t have the manpower or state apparatus to enforce it.

    Why not? Why can China do it for over one billion people?

    And I still don’t really get how the idea of herd immunity is going to help anything. How are you going to stop the vulnerable from getting it? Just because 80% of the people in a village get it and don’t die, how does that help the others? Is there herd immunity for the flu? For ebola?

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  28. phoodoo,

    The idea about herd immunity, for covid-19, is that if many are immune (in this case because they already got the infection), then there’s fewer “channels” to propagate the virus. Lower probability that the virus will jump from a susceptible person to another. In other words, there’s a “barrier” or immune people between the susceptible ones.

    It entails getting lots of people infected before there’s such herd immunity, which can be risky (many could die), and it assumes that infected survivors do get immune to further infections.

    It doesn’t work for the flu because the flu mutates a lot, and thus the immunity from last year’s infections do not protect against new viral varieties. Apparently, the virus behind covid-19 does not mutate as much.

    I don’t know much about ebola, but seems like it’s a pretty bad one. If it is mortal in most cases, herd immunity would entail the death of too many people.

    The other way to have herd immunity, which has protected anti-vaxxers for a while, is when most people are immune due to vaccination, thus acting as “barriers” against infection, thus protecting both the unvaccinated ones and the immunodepressed people.

    Anyway, the best thing would be if vaccine development is possible for covid-19. Getting herd immunity from actual infections, rather than vaccinations, might be too risky.

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  29. Entropy: The idea about herd immunity, for covid-19, is that if many are immune (in this case because they already got the infection), then there’s fewer “channels” to propagate the virus.

    Do we even know if that is the case, that those who have immunity can’t spread it?

    Furthermore, that also means that before they have any immunity, they certainly can spread it, even if they don’t get sick. So that means more cases, and more spreaders. I don’t see how that helps you now.

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  30. phoodoo:
    Do we even know if that is the case, that those who have immunity can’t spread it?

    Well, by definition if you get immune you cannot spread it other than by direct contact, in the same way that touching objects previously touched by infected people would. What we’re not sure about yet is whether people do develop immunity after being infected.

    phoodoo:
    Furthermore, that also means that before they have any immunity, they certainly can spread it, even if they don’t get sick. So that means more cases, and more spreaders. I don’t see how that helps you now.

    Exactly. This is the risk even if people get immunity after surviving an infection. It doesn’t help now, it means lots of people get it. The hope is that as infections occur, there might be a point where the quarantine can be lifted, even if a bit, because of herd immunity. I’d rather see a vaccine being developed though. The idea of herd immunity from infection doesn’t sound very appealing.

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  31. phoodoo: Do we even know if that is the case, that those who have immunity can’t spread it?

    It seems reasonable to assume that those who have had a bout of covid-19 recovered because their immune system eventually eliminated the virus.

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  32. Entropy: Well, by definition if you get immune you cannot spread it other than by direct contact

    That’s not a great help. How are we going to stop contact?

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  33. phoodoo: That’s not a great help. How are we going to stop contact?

    Because the immune person is more likely to touch another immune person than an infected one. Herd immunity doesn’t make it impossible to get infected, just much much less likely.

    I’m not advocating for it. Just explaining the idea. I’d rather see a vaccine, if possible.

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  34. Entropy: Because the immune person is more likely to touch another immune person than an infected one. Herd immunity doesn’t make it impossible to get infected, just much much less likely.

    I’m not advocating for it. Just explaining the idea. I’d rather see a vaccine, if possible.

    But this doesn’t really make any sense. What you are saying is that, if everyone got the disease, then we wouldn’t have to worry about everyone getting it.

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  35. phoodoo,

    I don’t know if you read that article DNA_Jock linked to that has some scenarios on virus spread. The restaurant scenario is quite scary.

    During this meal, the asymptomatic carrier released low-levels of virus into the air from their breathing. Airflow (from the restaurant’s various airflow vents) was from right to left. Approximately 50% of the people at the infected person’s table became sick over the next 7 days. 75% of the people on the adjacent downwind table became infected. And even 2 of the 7 people on the upwind table were infected (believed to happen by turbulent airflow).

    ETA perhaps “scenario” is the wrong word, they were actual case studies.

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  36. phoodoo: the less we have to worry about more people getting it.

    Assuming immunity exists and persists.

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  37. phoodoo:
    Entropy,
    So the more people who get it, the less we have to worry about more people getting it.

    Yep. Again, I’d rather see a vaccine.

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  38. Okay, I’m going to make one pass at explaining herd immunity to phoodoo.
    Imagine a virus with an R-zero of 2.0. This means that on average a person infected with this virus will, over the course of their infection, infect 2.0 other people, assuming that no-one has immunity. Let’s imagine (for the sake of simplicity) that it takes three days from getting infected to being infectious.
    Introduce this virus into a large population, what happens? Well by day three there’s two new infected people, day six four new infected people (and three with a history of infection, but first time through, we’re going to pretend that it’s a really large well mixed population), day nine eight new infections, on day thirty one thousand and twenty four new infections, and people start to notice…) Unchecked, it will carry on doubling every three days…
    Now let’s suppose (scenario 2) that, of this really large population, 50% are already immune to infection (for whatever reason). What happens in this case? Well, every infected person still passes the virus on to two people, but on average 50% of these people will be immune.
    So on day three there is one new infection, on day six there is one new infection, and on day thirty there is one new infection. Actually it will almost certainly sputter out, thanks to sampling noise.
    Now imagine (scenario 3) the case where 80 or 90% of the population is immune: the virus cannot get off the ground, it cannot take hold. And therefore, the 10 to 20% who are NOT immune are in fact protected by the immunity of all of the people around them. THIS is herd immunity. It is extremely well-understood, and it is why the anti-vaxers are selfish little shits. They are taking a free ride that is reserved for those immune-compromised people who cannot become immune, whilst at the same time jeopardizing those same people (and, less importantly, their own family…)
    It’s not merely that “the more people get it, the less we have to worry about more people getting it”, it is that once enough people are immune (for whatever reason) then the virus stops spreading.

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  39. phoodoo:
    “Customers in Packed Colorado Coffee Shop Ignore Mask and Distancing Advice.”

    Complete idiots lead by the biggest idiot ever.How hard is it to wear a mask?

    It is virtue signaling, the government can’t make me care if others die because of my action.s And anyway it is all overblown.

    Is something wrong with the water in America?Is everyone retarded?

    A pretty small sample to extrapolate from. Polls show most Americans of every persuasion support a lockdown ( 60%) to the protests( 22%).

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  40. Allan Miller: ‘These current measures’ is a massive broad brush

    It has been my impression that you 1) Live in the UK and 2) have expressed a wide-ranging opposition to lockdown, instead preferring solutions such as herd immunity and allowing exercise and outdoor time to strengthen the immune system. I am getting the new impression that my original impression was wrong; could you clarify your views for my benefit?

    In return, I will provide clarity about that to which I am opposed. I of course do not believe that outdoor exercise should be banned, especially in areas that are not extreme close-quarters urban environments. It is also not my belief that all people should be confined to their homes 100% of the time. As such, I am generally opposed to the policies of countries imposing such restrictions. My opposition is largely to the concept of resuming “business as usual” nearly in its entirety while allowing the death toll to rise as a measure to restart the world economy. I am aware that this is not being suggested by all, but there are many who do believe this is the proper course of action. The state in which I currently reside, though only for a short while longer (South Carolina) is now extending the stay-at-home order with significant reductions in measures. For instance, restaurants are allowed to take dine-in customers, albeit at 20% capacity. While the concept of restaurants which already only had a capacity of 10 customers following this rule is amusing to me, it seems like a premature method to “test the waters.”

    Further, you speak much of how you wish clinical trials could be conducted. While of course clinical trials would be far preferred in an ideal world, a clinical trial by its very nature cannot include all of humanity, or even an entire country at once.

    I think we have much common ground in this. Obviously, the question of how to combat this crisis is extremely complex, especially due to the fact that all countries have to come up with their own unique response. In this situation, as in all situations, I know that I at least am physically unable to be appraised of all details to make the best decision. It is for these reasons that I am willing to take the side of caution and accept that there may be consequences to that decision. I am, of course, not saying that you are not; simply that we disagree on exactly what cautions should be taken and why.

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  41. phoodoo,

    I think this is a case of your bias consuming your viewpoint. There are currently, and there have often been in the past, many countries with leaders who are unintelligent and yet widely popular. I understand you dislike the president; I share those inclinations. However, his negative qualities do not negate those of other leaders. For instance, it is both true that Donald Trump is a bad president and that Calvin Coolidge was a bad president.

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  42. I have never been blessed with certainty about what other people should be forced to do.

    I am, however, certain that I do not support applying the same measures to sparsely populated areas and to densely populated areas.

    I am moderately certain that betting we can survive lockdown until a vaccine is available is a bad bet.

    My observation about US politics is that both sides are hoping to gain political advantage from virus developments. One side is hoping the death rate continues, and the other side is hoping for a backlash against the lockdown.

    Not exactly noble.

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