The Covid19 thread

[embee]

I suppose what I was trying to investigate was the tolerance level for deaths (for want of another simple measure).

Cases are increasing at around 2.5 times in 3 weeks, and so are deaths, following about 3 weeks after the cases. Today's ship has sailed, so in 3 weeks time I predict 120 deaths/day (7 day average) based on https://www.worldometers.info/coronavirus/country/uk/
I know some will dispute that source, but in the absence of anything better I'll refer to that.

If we do absolutely nothing to affect the curve for cases in the next 3 weeks, take no additional precautions and just let it go, then by 6 weeks time deaths will be near 300/day, and 3 weeks later near 750/day (I stand to be shot down in flames for getting this wildy wrong, but hey ho).

Whatever the actual numbers, the question is at what level does the govt decide to intervene? There must be some level, they couldn't let it just keep on rising (could they??). What would the public tolerate? Or would everyone just shrug their shoulders and say we'll just let it run regardless. A moral dilemma to be sure.

Of course it might just top out at say 100/day and then start coming down, in which case the strategy will (arguably) have been proven right.

[Ruffy]

Originally Posted by embee

I still like to compare attitudes to Covid deaths and road deaths. Typically 5 people die on UK roads per day, and that's among the millions of everyday folk travelling out there. If the rate suddenly jumped to 50/day, who would say "Oh well, it's just something we'll have to learn to live with, we go out on the road and some people die even when they were doing nothing wrong."
I suspect not many proponents for the laissez faire approach, yet that's just what some are saying about Covid.
If there are reasonable measures which aren't really a hardship (distancing in shops, masks on transport etc) then why not do it, just like we wear seat belts and have speed limits. We still go about our daily business but take reasonable precautions.

There is also a conundrum in approach to treatment. If we say "Oh well, some folk will get Covid and die", then why bother to treat anyone who ends up in ICU? They are treated because we try to avoid people dying unnecessarily, and it's the decent thing to do. If we say it's worth trying to save someone's life in ICU, the why not say it's worth trying to avoid that person ending up in ICU in the first place? Prevention better than cure, and usually much cheaper.

Cogent arguments here.

Did you pick your 50/day challenge point deliberately? As it happens that's about the daily average for 'regular' flu, which may (or may not) be a better comparator for Covid. I agree that setting the threshold of acceptability is a tough challenge. I think the only thing firm about my own considered current position is that we have to accept it can't be zero.

The point about moral philosphy for treatment is well made. You're right, it's a conundrum, made even more puzzling when we compare to other things where the causation is much clearer, e.g. smoking -> lung cancer, drinking -> liver disease, obesity -> heart disease.

Personally, I'm surprised there hasn't been more pickup on the dominant "Protect the NHS" mantra that's been ever-present. Why do we seem to have no overt intention to increase the systemic support for our health service now that we have a new demand to cater for? When should we shift to "Invest in the NHS", so that we expand its capacity to be able to "save lives" that are put under new threat because of this virus? Isn't the health service to support the population (as they go about their desired lives), not the other way around? Shouldn't we first decide the pattern of life we want, then define the service infrastructure to support it? You're right, prevention is better than cure but maybe the 'cure' environment (i.e. doctors, nurses, hospitals) is just easier to control, so more feasible to concentrate management effort there? Prevention challenge: How do you persuade a whole globe of nations & individuals to behave in the same way?
(And yes I know that sounds a bit utopian and conveniently ignores very real funding/economic issues, thus taking us right back to 'where's the limit'?)

[Ruffy]

Originally Posted by embee

I suppose what I was trying to investigate was the tolerance level for deaths (for want of another simple measure).

Cases are increasing at around 2.5 times in 3 weeks, and so are deaths, following about 3 weeks after the cases. Today's ship has sailed, so in 3 weeks time I predict 120 deaths/day (7 day average) based on https://www.worldometers.info/coronavirus/country/uk/
I know some will dispute that source, but in the absence of anything better I'll refer to that.

If we do absolutely nothing to affect the curve for cases in the next 3 weeks, take no additional precautions and just let it go, then by 6 weeks time deaths will be near 300/day, and 3 weeks later near 750/day (I stand to be shot down in flames for getting this wildy wrong, but hey ho).

Whatever the actual numbers, the question is at what level does the govt decide to intervene? There must be some level, they couldn't let it just keep on rising (could they??). What would the public tolerate? Or would everyone just shrug their shoulders and say we'll just let it run regardless. A moral dilemma to be sure.

Of course it might just top out at say 100/day and then start coming down, in which case the strategy will (arguably) have been proven right.

Yes, I agree, it's a heck of a dilemma. Gazing into the crystal ball is imprecise, the future is uncertain. But it's good to try to put some numbers to it to help the debate along, as you have done.

And, as you say, if it happens to turn out how they wanted, were they clever and wise or just plain lucky? (Of course they'll claim the former but will anyone ever be able to prove one way or the other for definite?)

[SV650rules]

I have read many articles that firmly blamed aspirin for a great many of the Spanish flu deaths - a lot of the symptoms reported were of aspirin overdose. Aspirin was being pushed by companies and doctors as the new silver bullet, but the toxicity of aspirin and the fact that it suppresses the immune system were known about but ignored. Some of the therapies used lately maybe did more harm than good ( respirators came with a whole new set of problems ).



https://www.bmj.com/rapid-response/2...-1918-pandemic


I really do not like the way that UK counted covid-19 ( or SARS-Cov-2 ) deaths, I think that the total was inflated compared to other countries by the methods used here. I think deaths amongst the over 60's will be lower in coming years because Covid had quite frankly affected the people who would succumb to annual flu and their own multiple chronic health problems within a few years anyway ( pretty much all victims have been over 60 with 2 or more pre-existing serious medical conditions, most of the younger victims were obese ). We need to take our tin hats off and come out of the cellar, but still be wary of large crowds in confined spaces, especially tube trains and buses.

[Seeker]

Government relaxes mask rules
Government "expects" everyone to continue to wear masks inside
Conservative MPs reaction to "expectation":
https://uk.news.yahoo.com/jacob-rees...150404680.html

[embee]

Originally Posted by Ruffy

..Did you pick your 50/day challenge point deliberately?

Just to roughly match the 7 day average for reported Covid deaths at 21st July, and it just happened to be a convenient 10x the actual road death rate. Arbitrary choice.

The question was simply (essentially rhetorical) what would govt/public reaction be to a 10x increase in road deaths? We put huge resource and effort into reducing road deaths by 1 or 2 per week average, yet don't apparently seem to be too concerned by 50 or 100/day for something else, really on the basis that it's less than it might be, could be worse.

[Bibio]

they know exactly how many people die each year in the UK at any given Time Of Year. what they are not telling the public is how many over and above the TOY avg have/are dying due to covid.

they fell off a ladder and killed themselves but tested poz for covid so cause of death on certificate was covid. even though the person never had or got any symptoms like 99% of the population.

i would hazard a guess that pretty much everyone has had covid by now. its just that the vast majority of people dont get any symptoms or if they do its minor and just shrug it off just like the flu/cold and other bugs that we live with every single day.

if you go out in public you come in contact with every known common bug, you can't avoid it as they are on everything.

i have just had a bout of the trots for 3 days solid so was it covid? i had the no taste or smell symptoms twice so was that covid?

[svenrico]

Originally Posted by Bibio

they know exactly how many people die each year in the UK at any given Time Of Year. what they are not telling the public is how many over and above the TOY avg have/are dying due to covid.

they fell off a ladder and killed themselves but tested poz for covid so cause of death on certificate was covid. don't think they would go that far even though the person never had or got any symptoms like 99% of the population.

i would hazard a guess that pretty much everyone has had covid by now. my wife thinks everybody will get it eventually its just that the vast majority of people dont get any symptoms or if they do its minor and just shrug it off just like the flu/cold and other bugs that we live with every single day.

if you go out in public you come in contact with every known common bug, you can't avoid it as they are on everything.

i have just had a bout of the trots for 3 days solid so was it covid? i had the no taste or smell symptoms twice so was that covid? possibly,yes

comments above in bold

[Ruffy]

Originally Posted by embee

Just to roughly match the 7 day average for reported Covid deaths at 21st July, and it just happened to be a convenient 10x the actual road death rate. Arbitrary choice.

The question was simply (essentially rhetorical) what would govt/public reaction be to a 10x increase in road deaths? We put huge resource and effort into reducing road deaths by 1 or 2 per week average, yet don't apparently seem to be too concerned by 50 or 100/day for something else, really on the basis that it's less than it might be, could be worse.

Thanks. I suspected it wasn't total coincidence that it matched the covid levels.

You're right about the wide-ranging difference in base thresholds for different things. It's not always obvous why 'acceptability' thresholds are set where they are. Presumably it's due to statistical jiggery-pokery, a byproduct of normalising to the likely exposed population, so that overall 'risk' numbers are similar? E.g. absolute road death numbers are lower beacuse not everyone is a road user, whereas level for diseases is higher because everyone breathes, but proportionately they're about the same? (I haven't checked, this is just a hypothesis.)

You're also right that sudden changes tend to cause the reactions, rather than overall numbers. I guess the new impact of covid is one example, perhaps the recent 'uproar' regarding smart motorways might be another (picking up your road deaths comparison)?

[Ruffy]

Originally Posted by Bibio

i would hazard a guess that pretty much everyone has had covid by now. its just that the vast majority of people dont get any symptoms or if they do its minor and just shrug it off just like the flu/cold and other bugs that we live with every single day.

Could very well be close to the truth. I wonder what effect that would have on the risk figures (if we assumed, say, 80% of the population were +ve cases rather than just the confirmed ones)? I suspect it would re-frame the debate quite a bit.

Tbh, I do struggle a bit with the "1 in 3 could be asymptomatic carriers" claim - it seems a very high proportion to me if the virus is truly so nasty. It's likely to kill you or it's likely not to have any noticeable effect at all - that's a very weird distribution for range of symptoms. No denying it could be very nasty for some but is there still a whiff of convenient excuse?

Originally Posted by Bibio

if you go out in public you come in contact with every known common bug, you can't avoid it as they are on everything.

I have heard of reports that some younger children have been coming down with other bugs at unusually high rates. This has been explained by lockdown having prevented them from much of the general activity that would alow them to generate natural immunity through day-to-day exposure to the minor stuff etc. - their immune systems haven't developed as fast as previous 'normal'. (I cant find a source so there's a chance this is an urban myth but IMHO it's not as wild as some covid/lockdown hypotheses.)