Not necessarily. Lockdown followed by relaxation of constraints (with maybe another lockdown in a few months when things get worse). A bit like China and South Korea are doing.
SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)
- Thread starter Don't Kill Bill
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In the latest episode of the United Hour Podcast, Nik and Imran hold a long overdue conversation about United's awful league form with 1 win in 7. They discuss a disappointing draw at Bournemouth, a not so disappointing draw against Liverpool and a crushing defeat at Chelsea - Is time nearly over for Erik Ten Hag?
Then in a special second half of the pod, Nik welcomes Natalie ( https://twitter.com/natalie_17) to discuss the fortunes of Manchester United Women as they booked a place in the FA Cup Final after a historic first ever win vs. Chelsea.
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I don't know why you insist on this. South Korea and China are having double-digit new cases and single-digit new deaths per day. In each of them, there isn't even a lockdown (except in Wuhan that now is almost being lifted). S. Korea didn't have a lockdown at all.
Why we should not try to emulate them, instead of accepting that millions are going to die?
You haven’t included potentially asymtomatic cases in this, or indeed the percentage population that have already had the disease.
South Korea and Germany have tested widely and the percentage is between 0.4 and 1.4%, and that is without testing the entire population.
There is no way a million people will die in the U.K.
As for second and third waves, the comparisons with things like the Spanish flu don’t have any bearing in 2020.
Almost every country will be more readily prepared for a second or third wave. This won’t just come in and devastate again in the same way.
Lessons will have to be learned for the future and thousands will die, but I really feel people are making calculations and statements in this thread that are overly pessimistic and outlandish. Probably because we are scared.
But try and be more realistic and remember those who are more tense and afraid that are reading this thread.
There are reasons to be positive and we should include those in our speculations on death figures and the danger of the virus.
Any reason for the 2% CFR?
Also, surely after a week or two lockdown, 30% per day new cases will be very high?
Back from Asia just popping out to the shops for a snack.
Oblivious dickheads will literally be the death of us.
Oblivious dickheads will literally be the death of us.
A low estimate for the number of cases in the UK is 300,000 (which is about 20 times the number of positive test results). Those 300,000 are spread out over the entire country.
What China and S Korea did was contain an identifiably limited number of cases. We simply don't have that luxury right now.
It's like the difference between one small bush fire in one corner of the wilderness, and hundreds of bush fires spread out over the whole landscape. China and S Korea dealt with the former fantastically well. The UK is metaphorically dealing with the latter at the moment and can no longer realistically contain the situation. The best we can do is delay the inevitable and manage the fire as it consumes itself without causing to much damage to the everything around it.
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So 2 reasons why. I'm in USA but same applies UK or US.
We and you are too far ahead in transmission now. It's all in community. So identifying and isolating cases is not feasible in these numbers. Might as well general lockdown.
Even in the beginning their level of isolating identified cases would not be tolerated in either country imo. For example I know in S. Korea they used GPS to ensure isolation and monitor the quarantined people. That level of privacy invasion is difficult here or UK.
That's my take on it. Has been that way for a while.
2% is the widely reported estimate for the CFR.
I adjusted the growth rate to 15% after the lockdown.
Pretty interesting video
I'm not sure UK and USA are comparable. We have a nationwide lockdown here in Britain which is being mostly very well observed. The government is demanding we stay at home, and on the whole, this is being followed in a very conformist manner.
In America, the government is actively encouraging people to get back to work as soon as possible. I know people in Florida who are still working, still largely unaware of the thread, I know a woman in NY (the worst hit state of them all) who is still working her office job, relying only on the desks being spaced 6ft apart.
The key difference I think is Trump. He doesn't want to acknowledge the scale of the problem, even the face of the fact that America is now the most affected country in the world.
Here, the government are at least now enforcing quite robust and Draconian measures to ensure compliance.
Equally, the whole optimism with large undetected asymptomatic cases is strange and unsupported by vast majority of studies (estimates say it's around 20%). Moreover, people have rallied behind South Korea's numbers when they were low and now that they have risen people have switched to Germany. False optimism is dangerous as it can lead to reckless behaviour and to people not taking the proper precautions.
300k low estimate is if you do nothing. Like, treat this like the flu, pretend that it doesn't exist and continue with life. It also does not count that the number of ventilators and ICU beds is gonna significantly increase (for example, if one ventilator can get converted to 4, that is 4 times as many ventilators without buying any). And finally, it doesn't take into account the real possibility that there is a very large number of asymptotic cases, which at this stage is virtually certain.
I am in US too.
I totally agree that we (and every European country) didn't act as fast as they should have, that is not game over. A lockdown actually reverses the situation, and brings back the number to a more manageable number, when we can do identification, tracing and quarantie. It is gonna be harder and more lives will be lost than if those measures happened in January, but it is still very possible.
That's what the 300k refers to.
Italy 
I’ve just worked 14 days in a row in a busy London hospital. More than 3/4 of the patients I’m admitting under acute medicine are possible COVID-19s.
It’s an easy, boring diagnosis - ARDS on the CXR, normal white cell count with lymphopenia and a raised CRP. Management options are incredibly frustrating - all we can do if oxygenate and hope they get better.
It’s mental, and will only get worse - patients who would’ve gone straight to ITU a month ago are being admitted to medical wards. And the ones admitted to ITU haven’t done well so far, although the majority of them are still tubed and might still improve.
Admitted a couple of younger, fit patients from resus today - fit, muscular men in their late 40s with no past medical history (pO2 of 4 on room air!!!). Requiring 15L to barely maintain 85+% O2 sats.
We’re going to see incredibly sad things over the coming months.
It’s an easy, boring diagnosis - ARDS on the CXR, normal white cell count with lymphopenia and a raised CRP. Management options are incredibly frustrating - all we can do if oxygenate and hope they get better.
It’s mental, and will only get worse - patients who would’ve gone straight to ITU a month ago are being admitted to medical wards. And the ones admitted to ITU haven’t done well so far, although the majority of them are still tubed and might still improve.
Admitted a couple of younger, fit patients from resus today - fit, muscular men in their late 40s with no past medical history (pO2 of 4 on room air!!!). Requiring 15L to barely maintain 85+% O2 sats.
We’re going to see incredibly sad things over the coming months.
It depends on where in the USA. In California (at least in my county) almost everything is closed, and there is a lockdown which people are apparently respecting. There are many states in the US that have still not that many cases.
The US number of cases is to a large degree because of the number of testings. When you're doing over 100k cases for day, of course you are gonna find a lot of infections. It is also the reason why the US had a mortality rate of 1.5% while the UK has a mortality rate of 5%. Not different viruses, but just more testings in the US. It is a conjecture, but if we assume the same mortality rate then the number of infections in the UK should be around 5/1.5 * 11658 = 3.33 * 11658 = 38821 cases. Considering the difference in the population, the UK is actually worse hit than the US. Add to that, the US has a better health system, the ability to build new hospitals and a higher ability to make masks and ventilators. I believe that both countries are in deep shit, but the US is in less shit than the UK.
Norwegian health officials, at least, are very confident the real CFR will be below 1%, and probably comfortably so.
It depends on how many of them are really asymptotic. If there are 10 or so sick people (with no symptoms or very mild symptoms) for every documented official case, then there is no worst-case scenario that put the number of deaths to 300k.
Assume 50% being infected within the year (Dr. Byrx in the US says that this can happen on 3 seasons, not in one) that means 32 million infections. 90% of them asymptotic (or mild symptoms) put the number of infected to 3.2 million. From these, a conservative 3% mortality rate, would put the number of fatalities to around 100k.
Now, of course, it might well be that the number of real infections is not as high. On the other hand, the recent Oxford study (too good to be true) says that up to 50% of people might be already infected, which essentially means that this is not a big deal. I don't believe this is true, but there are many reasons to believe that there are many more cases than documented cases (which by definition puts the mortality rate much lower).
Then, just the social distancing and the hygiene will ensure that the infections won't reach those catastrophic numbers. Don't get me wrong, I think it is going to be really bad, but I think you are being me two weeks ago when I thought that the world is gonna burn. It is gonna be much better than 1 million deaths in the UK, it is gonna be much better than 300k deaths IMO.
This is certain. The mortality rate in Germany is 0.6%, while in UK is 5% and in Italy is over 10%. The main difference between these tthree countries is not that Germany likes beer, Italy likes wine and UK likes tea, but that Germany is doing more testings. All countries with a high number of testings (per capita) are essentially reporting a mortality rate of below 1%. And this is an overestimate considering that unless they are testing every citizen (which they are not), there are infected people who do not get a test. Heck, in Germany and the US despite doing tests like crazy, it is extremely hard to get a test unless you are really sick (or you are very rich). The majority of infected people with mild symptoms or no symptoms at all are not getting tested, and so the mortality rate is inflated.
In the end, with a working medical system, I believe it is well under 0.5%. With a crashed medical system it's essentially 'who doesn't get a ventilator dies'.
There's a lot of people here going to be depressed when the virus eventually disappears. You'll have nothing to moan, whinge and doom monger about. Putting the shits up people seems to be exciting to a lot of people, without even having a clue about anything, just what they've read. Heads full of cartoons fantasizing about a walking dead type scenario ffs.
Watched a programme the other night, well, half watched it, Mrs had it on. All they went on about was negative and worst case scenarios, like ridiculous worst case scenarios. Bad news is news. Good news isn't profitable so they gloss over anything half positive.
While I'm having a moan about this, I'll have a little moan about everyone saying "this is why we needed to fund the NHS more previously" ... No, we needed to stop people taking the piss out the NHS, drug users, obesity, them people who goto the docs for every single cough, parents taking kids for a sneeze. More funding would have been great, but a massive factor is abuse of the system. People getting free boob jobs cos they're depressed and stuff man. That's wrong.
Putting strain on a system/service supposed to be used for good, for ridiculous reasons, obesity man, just stop eating like fecking whales.
Watched a programme the other night, well, half watched it, Mrs had it on. All they went on about was negative and worst case scenarios, like ridiculous worst case scenarios. Bad news is news. Good news isn't profitable so they gloss over anything half positive.
While I'm having a moan about this, I'll have a little moan about everyone saying "this is why we needed to fund the NHS more previously" ... No, we needed to stop people taking the piss out the NHS, drug users, obesity, them people who goto the docs for every single cough, parents taking kids for a sneeze. More funding would have been great, but a massive factor is abuse of the system. People getting free boob jobs cos they're depressed and stuff man. That's wrong.
Putting strain on a system/service supposed to be used for good, for ridiculous reasons, obesity man, just stop eating like fecking whales.
You're assigning 3% CFR to the 10% percent with non-mild symptoms when the CFR for all cases is estimated to be closer to that. Also note that many estimates for the asymptomatic proportion don't account for the subset of those who later on tend to develop symptoms. One of the first estimates was the Diamond Princess study which found that 50% were asymptomatic. However, they later had revise this as then more than half the asymptomatic proportion went on to develop symptoms, which aligns with what many models are saying (different studies from 17% to 31%).
There are people who seem to think that football will be back in the near future, whilst there's 3 makeshift hospitals being built in London, Birmingham and Manchester. Oh and a 1500 capacity morgue in a Birmingham airport. I mean how does anyone see what's happening and think right... back to football then..
Sure, the info is found at www.gov.uk/affluentandlikemindedindividuals
is this supposed to be one of those pathetic TRUTH posts because some people are reacting differently to you?
as for the rest of the thread, I am just glad you all didn’t die after brexit. OH MY 2% GDP!!
I am assigning CFR based on the current documented CRFs (not estimates). For example, Germany has a 0.6 documented mortality rate (which is an upper bound on the real mortality rate).
Diamond Princess is a good example, but it also has an extremely skewed age distribution. There were so many more people over 70 than in any country, while the number of young people 0-40 was much less than outside of it. It also does not show how severe were the syndroms. If you are as sick as when you catch the cold, unless you are an NBA player or a senator, you are not gonna get a test (while in DP, everyone got a test). If many people with no symptoms (or mild symptoms) is a thing, then we can expect the majority of them to be on young people. Finally, there have been next to no studies on kids. They are a large number of population, and it could be that many of them don't have symptoms at all.
I don't know how much is the number of people with no to mild symptoms, but I wouldn't be surprised if it is much larger than 31%. After all, to get a test you need to be very sick. If you are just a bit sick or even moderately sick (cold-like) it is probably just stay home and get paracetamol, with you never being documented as a case.
I addressed the CFR in a different post further up this page.
The numbers I used in my earlier post were based on widely accepted/reported figures. I could have obviously chosen to editorialise, but I was trying hard to be dispassionate. That's also why I couched every assumption in ifs, buts and maybes.
Hopefully the lower Norwegian estimates you mentioned come true. If they do, I'll happily revise the maths.
Glad you had time for your little telly show. In the real world however, health service workers are witnessing terrible things and getting worse.
I've deemed your ignorance a mitigating circumstance and shall therefore not be telling you what I really think of you.
Well, you essentially used worst-case scenario for infections (again, it is likely that can happen within 3 seasons, not 1), highest mentioned mortality rate, assumed no restriction whatsoever, that social distancing and better hygiene will just not work at all, assumed doing nothing to increase the number of beds/ventilators, assumed that no drug that is on trial is gonna help, assumed that there are no silent cases, and then you came with your numbers.
I mean it is possible for this to happen. It is just extremely unlikely (as unlikely as the best scenario that 50% of people are already infected).
You're saying the true CFR is 0.3%? Nothing I've read says that. I'd love to read the source.
Keep in mind, for R0 around 2.2-2.5, it drops under 1.0 at around 55-60% infected. If that number looks mighty familiar to anyone in the UK...
I am just making some conjecture. In Germany it is 0.6%. It just cannot be higher than that, considering that if that was the case, then it would have been higher than that. It is extremely likely that it is lower than that (last time I checked, they did not test everyone). In Norway, it actually 0.4%. In South Korea and US is somewhere below 1.5%. In Bahrain it is 0.9%.
What do these countries have in common? They have done a lot of testings.
Have they tested everyone in their country? Hell, no.
Even if we assume that for 2 sick people, they test one (truth must be that for every few, they test one), then the real fatality rate would be 0.3% for Germany, 0.2% for Norway and so on. Which is why I think that the true fatality rate is in that region. Anthony Fauci also thinks that it is below 1%.
Obviously, we won't ever know this unless everyone gets tested every week or so. And in the end, it might well be that the documented CFR to converge at 2-3%, but that won't count for many people who did not get a test in the first place.
I addressed the inaccuracies of the CFR figure in a post further up this page.
1% or less is what Norway and Germany reckon. 4% is what Italy is showing. 2% is middle of the road. There are obviously mitigating factors to all of those numbers. But, as I said, I didn't want to editorialise the maths.
That's not to say I don't appreciate that the widely reported estimates might be wrong (just as you've very reasonably argued). I don't necessarily disagree with you. It's why I went as far pointing out the assumptions in the calculations.
I don't have time to respond to all posts. So sorry about that.
Forget CFR.
Where I am we have around say 50 vents. Our models suggest 150 to 250 cases needing vents over 1-2 months. You do the math.
The sheer numbers are going to overwhelm hospital systems all over like how it is happening right now in NYC.
Another reason to ignore CFR. If you get real sick from it, there is not much we can do. Even if the vast majority are ok, if you are unlucky, can't do anything really.
Forget CFR.
Where I am we have around say 50 vents. Our models suggest 150 to 250 cases needing vents over 1-2 months. You do the math.
The sheer numbers are going to overwhelm hospital systems all over like how it is happening right now in NYC.
Another reason to ignore CFR. If you get real sick from it, there is not much we can do. Even if the vast majority are ok, if you are unlucky, can't do anything really.
That is true. All my assumptions on CFR are based on a medical system that is still functional. Otherwise, CFR is as high as the number of people who need a ventilator but cannot get on.
Are there any attempts in your hospital to use a ventilator for multiple people. In Italy apparently they are using 1 ventilator for 2 people, and in NYC they are experimenting with using 1 ventilator for 4 people.
Finally, kudos to you for your job and stay safe!
These numbers are changing. South Korea rate was exactly the same as Germany a week ago at 0.6%. It's possible that Germany will take the same trajectory. It makes more sense to go by the CFR estimated in published papers by researchers and experts studying this rather than ball-parking our own to be honest.
Everyone is looking into it. There is 0 data on it.
Question is: would it be better to decidie which patient has a better prognosis and using the ventilator for that patient rather than losing 2 patients by using one for both, which might be ineffective to begin with? Having to choose which patient to save is going to be horrible.
No kudos for us. Definitely difficult job but not like we are going to do a good job.
And oh yeah almost forgot, even if you had enough ventilators problem is not solved. You still need resp therapists, nurses, icu physicians to take care of the vents and the patients. Right now there seems to be 10-20‰ rate of infection in Healthcare workers. With the disastrous situation with ppe in USA, expect Healthcare workers to get affected more than elsewhere. That just amplifies the problem then.
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Sure, I am just speculating. Obviously, the models should be based on real data and published papers. If I was a president who make decisions, I would try to be as cautious as possible and base the decisions on published papers. No harm in being over-cautious, and the models will be always over-cautious.
Losing control would imply that there was any control to begin with. We’re being lead by a malignant narcissist megalomaniac who is absolutely clueless. What’s worse there is still a fairly large Amount of people in the U.S. that think either it’s a hoax to ruin Trumps election campaign, or it’s just the flu because they don’t have it.
“Deep state conspiracy” is what I keep seeing on social media.