SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

[Brwned]

He could be wrong in that herd immunity might end up being the way out of this for some countries whether we like it or not.

That's a different point altogether, surely. What Trump said was that they went for the herd immunity approach to begin with, saw some bad signs, and reversed quickly. That's as close to a statement of fact as you'll get from Trump. It is whataboutism, but what part of that is untrue?

We don't know the precise message that was delivered to Boris but his portrayal of it, and the complete policy reversal, are right there for everyone to see. Maybe he misconstrued the message or maybe he was poorly advised, but the initial approach to "take it on the chin, take it all at once and allow it to move through the population" [in an uncontrolled manner] has and never will be an appropriate policy. It would have overwhelmed the healthcare system and there's no shortage of evidence now to demonstrate that, but the clearest evidence is the speed at which they moved away from that idea and implemented policies in opposition to it.

Whether a policy that allows the population to get infected at a controlled rate will be implemented is up in the air. As you've said yourself, there's at least an element of faith that leads you to believe that - you want it to be true because if it doesn't work, the alternatives of mass civil unrest or an unmanageable spread are too dark to imagine. I agree with you that it's a possible route, at least.

But that doesn't change the fact that what the UK did in the early stages, under that broad header of "herd immunity", immediately sent out some dangerous signals and the key experts advised something drastically different in response.

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Lockdowns will not stop in the next two months. They likely won’t stop at all until vaccine is there. I know people are still in denial about this but this is how it will likely play out.

Fancy a £100 bet on that?

 

[fergieisold]

This is an excellent point. I located an old paper here and quickly looking at it in Fig. 3, yes, droplets can evapourate very quickly. I also found another paper here with similar conclusions. It is important to stress that these results appear to be for pure liquid water (I'd need to check more closely).

With regards to droplets with viruses I found one study here. According to this paper:


The fig.8 is shown here:


I'm not really sure what they mean by "droplet nuclei". The paper above seems to be based on a model, with a handful of data compared to experimental data, but it does give a good idea of some of the mechanisms involved. Generally with regards to size, you need to be careful. Droplets less than a particular scale of the air flow (called the Kolmogorov scale) can be considered to be "small". Droplets larger than this size are called "finite sized" and have more complicated and poorly understand dispersion mechanisms. So it isn't really the absolute droplet size you consider but a size ratio.

Hope that helps.

Some good information. The droplet nuclei is likely referring to what we call in cloud physics the 'Cloud Condensation Nuclei'. A liquid droplet has to form on a substrate. So the next question is what happens when the droplets evaporate leaving the virus? Is it instantly destroyed or is it aerosolised?!

edit - thinking about it I'm not sure you'd even need a nuclei for coughed droplets.

 

[0le]

Some good information. The droplet nuclei is likely referring to what we call in cloud physics the 'Cloud Condensation Nuclei'. A liquid droplet has to form on a substrate. So the next question is what happens when the droplets evaporate leaving the virus? Is it instantly destroyed or is it aerosolised?!

Yeah it seems that way. I have no idea about whether the virus itself is destroyed or not, I would need to do some more reading. I've looked at cloud physics before, what part of cloud physics did you study?

 

[Smores]

Until/unless the country runs out of ventilators you can't say that with any conviction. So far we are keeping ahead of the pace of the infection in terms of available beds.

It's not just ventilators though, that's just one problem (albeit one which could be huge). Within the health department there's plenty of issues but I'm talking across every ministerial department.

I've no idea if it's ministerial or civil service so I'm not attributing blame but there's going to have to be a detailed review of why the delay in preparation. On the positive side I'd hope part of that is putting in place plans for next time something like this happens.

 

[Simbo]

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I wonder if there's anything that lists the qualifications / working experience of these people?

 

[0le]

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I wonder if there's anything that lists the qualifications / working experience of these people?

Yes, there is, at least for some of them listed via the expert groups here:
https://www.gov.uk/government/groups/new-and-emerging-respiratory-virus-threats-advisory-group
https://assets.publishing.service.g...6/NERVTAG_Member_Bios_update_November2018.pdf

 

[Enigma_87]

It's not just ventilators though, that's just one problem (albeit one which could be huge). Within the health department there's plenty of issues but I'm talking across every ministerial department.

I've no idea if it's ministerial or civil service so I'm not attributing blame but there's going to have to be a detailed review of why the delay in preparation. On the positive side I'd hope part of that is putting in place plans for next time something like this happens.

One thing that is not stressed enough and not mentioned often is regular operations and procedures like transplantations, people in need of intensive care and others in need of emergency admission because of other incidents or diseases that are not related to corona. We see more and more items and hospital structures locked down and patients sent back for home treatment who are in dire need of hospital care.

What China did I haven't seen so far implemented even in countries with big resources - you need to isolate the infected in separate structures and not use the resources of other hospitals that are overloaded at this time of the year anyway..

 

[Regulus Arcturus Black]

That's a different point altogether, surely. What Trump said was that they went for the herd immunity approach to begin with, saw some bad signs, and reversed quickly. That's as close to a statement of fact as you'll get from Trump. It is whataboutism, but what part of that is untrue?

It depends if you believe they were going for a Swedish model or just a “feck it” model doesn’t it?

Now I think Boris is a tit and I despise the conservatives but I don’t think they were going for a feck it model, I think they were always following the advice of their experts and it was constantly updated.

 

[Simbo]

Yes, there is, at least for some of them listed via the expert groups here:
https://www.gov.uk/government/groups/new-and-emerging-respiratory-virus-threats-advisory-group
https://assets.publishing.service.g...6/NERVTAG_Member_Bios_update_November2018.pdf

Perhaps they should just furlough the entire cabinet right now and put these people in their place.

 

[Brwned]

It depends if you believe they were going for a Swedish model or just a “feck it” model doesn’t it?

Now I think Boris is a tit and I despise the conservatives but I don’t think they were going for a feck it model, I think they were always following the advice of their experts and it was constantly updated.

That's a convenient belief given your position, but I'm not sure how you line it up with the evidence.

How do you align the statement of "take it on the chin, take it all at once and allow it to move through the population" with the subsequent actions? Are we taking it all at once and allowing it to move through the population, or are we taking measures to slow the spread as much as possible? They aren't progressions along a scale, they're opposing goals.

 

[0le]

@fergieisold

From this paper:

...The physical mechanism of the generation of droplets and particles carrying pathogens is largely unknown, though indirect measurements are reported in this volume.

... Respiratory droplets can carry microorganisms such as bacteria and viruses and constitute a medium for the transmission of infectious diseases.

... Small droplets start to evaporate after release, and thus change their size resulting in droplet nuclei that are sufficiently small to remain suspended in the air for a long time and still be infectious

...The survivability of pathogens in the air depends on many factors, including residence time in the air, the level of moisture (which in part depends on temperature), atmospheric pollutants and UV light (if outdoors in the sun, for example). Both temperature and humidity affect the lipid envelope and protein coat, affecting the period of survival. Temperature and humidity will work together to either destroy the organisms or stabilize them. Chemical pollutants in the air such as carbon monoxide and sulphur dioxide, together with UV light, will add to this disruption and may decrease survival in such an environment (Cox 1989, 1998). And, although movement in air may play a role in moving pathogens between spaces, they have a potential to act as secondary sources when they sediment onto inanimate or animate surfaces.

There is also a review here which I have not read but its review is given below:

Over the past few years, prompted by pandemic preparedness initiatives, the debate over the modes of transmission of influenza has been rekindled and several reviews have appeared. Arguments supporting an important role for aerosol transmission that were reviewed included prolonged survival of the virus in aerosol suspensions, demonstration of the low infectious dose required for aerosol transmission in human volunteers, and clinical and epidemiological observations were disentanglements of large droplets and aerosol transmission was possible. Since these reviews were published, several new studies have been done and generated new data. These include direct demonstration of the presence of influenza viruses in aerosolized droplets from the tidal breathing of infected persons and in the air of an emergency department; the establishment of the guinea pig model for influenza transmission, where it was shown that aerosol transmission is important and probably modulated by temperature and humidity; the demonstration of some genetic determinants of airborne transmission of influenza viruses as assessed using the ferret model; and mathematical modelling studies that strongly support the aerosol route. These recent results and their implication for infection control of influenza are discussed in this review.

 

[F-Red]

Dye in the Blue Lagoon for feck sake!

They put dye in it every year. I don't see the issue here?

 

[Jippy]

I can't see lockdown lasting longer than June here (UK). Social distancing rules are most likely to continue up until autumn.

That's going to be impossible on public transport in London- everyone saw the pics of the tube. God knows how they alleviate that without multi-billion investment.

 

[Enigma_87]

Good outlook of the whole situation and summary of the virus by Sucharit Bhakdi - leading specialist and professor in Microbiology and Immunology in Germany and Mainz institute.

 

[Skills]

In Brazil, the first coronavirus case in an indigenous community has been reported. A 19-year-old woman from the Kokama indigenous group in Amazonas state has contracted the virus, health minister Francisco Ferreira Azevedo said. There are fears that the pandemic could hit indigenous communities particularly hard as they often live in remote locations without access to healthcare

feck, I never even thought about the indigenous groups across places like South America. Aren't they especially vulnerable because we at least have some built in resistance to similar coronaviruses through the common cold?

 

[0le]

That's going to be impossible on public transport in London- everyone saw the pics of the tube. God knows how they alleviate that without multi-billion investment.

It will be nearly impossible. A combination of driver shortages due to illness leading to fewer trains and more stations which are closed as well as an increasing number of people. I think the advice will be to stay at home but the "lockdown" will be over - so it would be a lockdown in all but name. People will still go out walking and sitting in parks, but this will not put as much a strain on the NHS compared to allowing non-keyworkers to travel to work. Once the NHS overcomes the increase due to people walking and going to parks, they could gradually introduce some non-keyworkers, but again, via a staggered release.

 

[jojojo]

It depends if you believe they were going for a Swedish model or just a “feck it” model doesn’t it?

Now I think Boris is a tit and I despise the conservatives but I don’t think they were going for a feck it model, I think they were always following the advice of their experts and it was constantly updated.

I also think wishful thinking played a role. I think at the start they still had this vague hope that Chinese numbers on the proportion requiring ICU care and, in particular, intubation were high. Perhaps even an assumption that the number of mild/symptomless people in China was much higher than even China could test.

It was only as things started to hit Italy, that the models showing what happens as a particularly specialised portion of health care gets overwhelmed, that things really heated up.

Even tiny looking changes in the timing and the specifics of the epidemic sent the models through the "careful preparation and handling, public information and social distancing" threshold into overload.

So they may be guilty of wishful thinking, but I doubt even Boris ever thought "1% of the population will die - let's bump that higher because the NHS won't function and say a million people then, but mostly they're economically inactive anyway - well that's ok then, let it rip."

 

[Arruda]

Absolutely love the work me and my colleagues are doing right now. We're on phone vigilance, representing the health authority, signaling people for testing, monitoring positive cases for symptoms, etc.

Most people are incredibly nice in the phone and I love the relief they feel whenever we communicate a negative result in the test or lift an enforced quarantine.

As things get worse I'll probably be moved to the ER or Covid hospital and be replaced by medicine students.

 

[Skills]

That's going to be impossible on public transport in London- everyone saw the pics of the tube. God knows how they alleviate that without multi-billion investment.

I've mentioned potentially programming a certificate into oyster cards, where you can only get on public transport if you have been tested in the last month or whatever suitable number of weeks. It sounds like a pain in the arse, but it could help at reducing them from being a massive a hotspot for infection.

 

[vodrake]

Never thought i'd watch a Nigel Farage speech and nod in agreement all the way through but he's spot on here.

Dye in the Blue Lagoon for feck sake!

The "Blue Lagoon" is a pool in a disused quarry that has a pH level equivalent to bleach. The locals have been putting dye in it for years to disuade morons from jumping in and doing damage to themselves, it's not some new draconian police state measure

 

[0le]

I've mentioned potentially programming a certificate into oyster cards, where you can only get on public transport if you have been tested in the last month or whatever suitable number of weeks. It sounds like a pain in the arse, but it could help at reducing them from being a massive a hotspot for infection.

The software programming for Oyster cards is complex. I believe it took something like a year or whatever because of complexity to code the necessary changes to go from hopper fare of only allowed to use two buses in an hour, to hopper fare of "infinite" number of buses in an hour (source):

Whilst rolling out to the 2-for-1 Hopper could be turned around with a few tweaks to the Oyster and Contactless card code, allowing unlimited transfers within an hour is more complex.

“So, to do that on Oyster is seriously difficult.” Says Verma. “Very, very difficult. Because we have to get into quite fundamental functioning of Oyster.“ Unlike the 2-for-1 Hopper, which uses existing functionality on Oyster, an Unlimited Hopper would require making changes to the Oyster card back-end product itself.

Therefore it may be an easy task to do what you suggest, but it may also be a nightmare tasks, who knows. Other railway smart cards may also use different systems.

 

[Pexbo]

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I wonder if there's anything that lists the qualifications / working experience of these people?

This is what I touched upon in my criticisms of Matt Hancock. He's not Secretary of State for Health and Social Care because he's an exceptional candidate for the role and up to it's demands. Like the rest of the cabinet, he's a pro-Brexit grifter who was put in charge of the NHS to help manage it's incremental privatisation and facilitate giving US Pharma access to it upon exit from the EU.



Long winded analogy coming up:

It's like a corporation that has decided that it has reached it's growth potential has to adopt a lean business model to minimise expenditure to maximise profits and appease shareholders so they employ a specialist whose main objective is to identify how to restructure the business, figuring which teams can be made redundant and where the budgets are best cut. They're happy with the amount of business they are doing and they'd also be happy doing less business as long as the profits are maintained.

All of a sudden the market changes due to unforeseen circumstances and there is a huge uptick in demand, proving the growth potential estimates were way off. A good operations manager would cease upon the opportunity and have the talent and dynamism to regroup and identify how the business needs to expand, ploughing money into research and development and boost production to reach the demands in order to make sure the company capitalises on the oportunity.

Instead they are stuck with the guy who doesn't have the first clue how to do any of this, all he knows is how to cut fat and streamline existing operations without effecting profits. In real world, a decision would quickly be made to replace him with someone who has the knowledge and talent to oversee the new scenario and ensure the business is being run suitably to the new scenario.


Instead we have Matt Hancock with his philosophy, politics and economics degree leading the NHS through arguably the greatest challenge it has faced since it's inception and absolutely zero suggestion he is going to be replaced with someone with the knowledge or experience to make the difficult decisions required of the role.

 

[Penna]

Absolutely love the work me and my colleagues are doing right now. We're on phone vigilance, representing the health authority, signaling people for testing, monitoring positive cases for symptoms, etc.

Most people are incredibly nice in the phone and I love the relief they feel whenever we communicate a negative result in the test or lift an enforced quarantine.

As things get worse I'll probably be moved to the ER or Covid hospital and be replaced by medicine students.

Sounds like you're doing good work, Arruda. Much respect to all the healthcare workers - I can't do anything to help now as I don't speak the language well enough to be of any use (and I'd also have to do a clinical update), but I can well imagine what it's like for those in the thick of it.

 

[stepic]

That's a convenient belief given your position, but I'm not sure how you line it up with the evidence.

How do you align the statement of "take it on the chin, take it all at once and allow it to move through the population" with the subsequent actions? Are we taking it all at once and allowing it to move through the population, or are we taking measures to slow the spread as much as possible? They aren't progressions along a scale, they're opposing goals.

i don't think anyone is suggesting that it was a progression. they clearly changed tact completely once they added in the newer data from Italy. clearly their initial modelling was incorrect, which lead to their original herd tactic.

 

[Kentonio]

i don't think anyone is suggesting that it was a progression. they clearly changed tact completely once they added in the newer data from Italy. clearly their initial modelling was incorrect, which lead to their original herd tactic.

Where did they even get that initial modelling? Even the vast majority of people here knew it was nonsensical and would result in a massive death toll, yet they insisted it was based on the 'science' before doing a complete about turn just days later.

 

[Skills]

The software programming for Oyster cards is complex. I believe it took something like a year or whatever because of complexity to code the necessary changes to go from hopper fare of only allowed to use two buses in an hour, to hopper fare of "infinite" number of buses in an hour (source):



Therefore it may be an easy task to do what you suggest, but it may also be a nightmare tasks, who knows. Other railway smart cards may also use different systems.

Yeah potentially it's challenging but they have the time to do it. I'm not a programmer or anything, but it just just seems like an additional validation

i.e. does this person have the correct amount of credit to get on the tube / if yes / does this person have a pass certificate / if yes proceed or if not then deny entry.

Programming unlimited transfers within an hour is definitely a more challenging logic than that.

 

[0le]

Yeah potentially it's challenging but they have the time to do it. I'm not a programmer or anything, but it just just seems like an additional validation

i.e. does this person have the correct amount of credit to get on the tube / if yes / does this person have a pass certificate / if yes proceed or if not then deny entry.

Programming unlimited transfers within an hour is definitely a more challenging logic than that.

The logic is actually very simply. A simple code could be with one while loop. The logic you posted in the second setence actually requires three else-if statements which is longer. I think the issue isn't really the logic, but rather how the underlying data is stored but I'm only making a total guess there. It isn't clear whether they have the means to simply add another check to all ticket types in the way you describe - logically this is simple but it all depends how they've written their codes. Oh well. It is a good idea though, one which I hope they do consider if it is at all possible.

 

[Kentonio]

Yeah potentially it's challenging but they have the time to do it. I'm not a programmer or anything, but it just just seems like an additional validation

i.e. does this person have the correct amount of credit to get on the tube / if yes / does this person have a pass certificate / if yes proceed or if not then deny entry.

Programming unlimited transfers within an hour is definitely a more challenging logic than that.

It's not the maths, that part is extremely simple, it will be the vast bulk of code around it dealing with a ton of other issues relating to actually implementing it.

 

[Regulus Arcturus Black]

How do you align the statement of "take it on the chin, take it all at once and allow it to move through the population"

Boris said that?

 

[Maticmaker]

Better to have them and not need them than to need them and not have them.

That may well be a lesson to be learned when this is over, but somehow I doubt it, government priorities change and after the immediate crisis is passed laws of supply and demand will return... if they are not already!

 

[VP89]

Load of Brits commenting on that tweet are falling for it too so....

He wouldn't get elected here, if that's what you're insinuating.

 

[Conor]

@spiriticon I mean, do we just ignore that we have twice the population of Denmark? And that our worst hit areas (Stockholm & Copenhagen) pretty much follow that pattern?

Should we also ignore that Ireland has locked down yet has 14 deaths per 1,000,000 and Sweden 18 so hardly much difference?

Swiss: 50
France: 54
Belgium: 71

As I said yesterday, all deaths happening now everywhere are from infections before lockdowns and before countries put measures in place. You realise that right?

No-one is throwing people to the wolves ffs. Sweden’s scientists believe the measures we have put in place here are measures that can be maintained for month after month after month to give out health service time to save as many as possible. They do not believe that lockdowns have in anyway proven a longterm solution to save lives, unless you’re prepared to lockdown until a vaccine comes, and well, no-one is locking down for a year, it’s quite simply impossible.

There is no point comparing countries that are early into their lockdown(Ireland) with Sweden.

 

[Fiskey]

Boris said that?

Only if you take what he said massively out of context: https://fullfact.org/health/boris-johnson-coronavirus-this-morning/

 

[fergieisold]

@fergieisold

From this paper:


There is also a review here which I have not read but its review is given below:

Fascinating stuff! Cheers.

 

[Maticmaker]

Donate them to developing countries that need them! We have probably 40-50 vents for our entire country.

Yes that s a good idea, some richer countries might do that, but in any case the market price of second ventilators will have crashed with the glut of such machines, so you may be able to get some extra at a reduced price.

Ventilators aside, I suspect life will never return to normal in most countries and lots of things will emerge with either new ways of doing things, or cheaper versions of existing items, or with new markets to exploit, its " an ill wind..." etc.

 

[Virgil]

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I wonder if there's anything that lists the qualifications / working experience of these people?

With due respect you can make the same claim about most politicians in all countries. That’s why Hancock in the U.K. for example has medical experts to call upon. To reinforce my point the current Shadow Health Secretary could be said never to have had a real job in his life unless you count being a party worker much the same as many in the Conservative party. It has always been thus and will remain so. After all folks go into politics because they have a particular view of the world. Nothing at all to do with how intelligent or equipped they are.

 

[Foxbatt]

With due respect you can make the same claim about most politicians in all countries. That’s why Hancock in the U.K. for example has medical experts to call upon. To reinforce my point the current Shadow Health Secretary could be said never to have had a real job in his life unless you count being a party worker much the same as many in the Conservative party. It has always been thus and will remain so. After all folks go into politics because they have a particular view of the world. Nothing at all to do with how intelligent or equipped they are.

Hancock may be a sensible guy but the quality of politicians have gone down massively. There was the fireplace salesman who thought he was a soldier and tried to put guns on farm tractors. He was called Private Pike by many.
No wonder the country has gone to the dogs.

 

[Virgil]

Hancock may be a sensible guy but the quality of politicians have gone down massively.

Totally agree but that’s been going on for donkeys years and not only in the U.K. The days of having giants seem long gone now we are prepared to have pygmies as long as they parrot the soundbites we like. Pathetic really. Then again we probably get the politicians we deserve.

 

[spiriticon]

@spiriticon I mean, do we just ignore that we have twice the population of Denmark? And that our worst hit areas (Stockholm & Copenhagen) pretty much follow that pattern?

Should we also ignore that Ireland has locked down yet has 14 deaths per 1,000,000 and Sweden 18 so hardly much difference?

Swiss: 50
France: 54
Belgium: 71

As I said yesterday, all deaths happening now everywhere are from infections before lockdowns and before countries put measures in place. You realise that right?

No-one is throwing people to the wolves ffs. Sweden’s scientists believe the measures we have put in place here are measures that can be maintained for month after month after month to give out health service time to save as many as possible. They do not believe that lockdowns have in anyway proven a longterm solution to save lives, unless you’re prepared to lockdown until a vaccine comes, and well, no-one is locking down for a year, it’s quite simply impossible.

Well if Sweden isn't locking down then what predictions can we make about their death rate 2-3 weeks from now? It will most likely be higher than what it would be if they had locked down earlier?

I agree than lockdown is not a long term solution, and it cannot be, but it is best used early to regain control of things (in my opinion). Letting the virus pass through the population in its early stages is a high risk strategy because this virus can go from 0 to 100mph in a matter of a few days. Once it reaches 100 mph it is too late because the healthcare system will have collapsed and many will die, wheres they may have survived otherwise if they had access to a ventilator.

The best strategy is the one the pushes the health system to its absolute max without breaking it, I agree with that scientific thought. But to execute that requires such exact calculations and predictions and we don't really have a lot of data at the moment to do that sort of modelling with ultra high accuracy.

Remember that we are gambling with human lives here, not money, not gold, not stocks and shares. We can't just go 'all in', we have to err on the safe side of science because human lives. One small feck up in calculation could mean an extra 100,000 people dead.

 

[Sarni]

I think you’re in denial about how impossible that would be.
It’d be anarchy and likely will be in Southern Italy within the next month.
Lockdown for a year is simply not going to happen.

It won't be a choice, it will be necessity. If you loosen things up and people start getting infected again, panic will be immense. Again, I'm speaking from Poland perspective. There are countries better prepared to deal with outbreak who may start to open up things this year. Many won't though. We will regain some freedom but it will be many months before everything is back to normal. Maybe even years.