Coronavirus - General Chat - No statistics

[zico]

Is it just me or are the new plans on self-isolation totally mad?
First of all, there appears to be a plan to reduce numbers of people self-isolating by changing the NHS app to make it less sensitive. The sensitivity was designed initially for the Wuhan strain of Covid-19. Since then, the Kent variant was about 70% more transmissible, and the Delta variant a further 50-70% more transmissible. So shouldn't the NHS appn have been changed to make it much more sensitive, not less, so as to reflect the increased chance of the virus being passed on.

I'm of two minds on this one. On the one hand relaxing the thresholds because they are inconvenient is not a good thing.

OTOH you should change your mind when you learn things. The app should be updated based on all available information. They should know the facts that triggered each quarantine and whether it turned out to be necessary (i.e. the subject developed COVID) and adjust as indicated. This would take into account changes in transmissibility, and a lot more. If the thresholds don't change they either are not checking or the estimates used to set the original thresholds were preternaturally good.

A clearer, more detailed, explanation is certainly warranted.

You're right. What we really should do is go back to first principles about what self-isolation is trying to achieve, and whether it's worth it.
The aim is/should be to reduce the spread of the virus. I've just read the self-isolation guidance and I'm not surprised compliance is so low. For example, "You must not go outside for the 10-day period"! "If you want to exercise, do it in your home, garden or yard". If people took this seriously, they couldn't drive out to exercise somewhere where they could keep well away from any other person.

It's not surprising that people are deleting the NHS app. In my view, government should be aiming at the maximum overall protection, which would be achieved by maximum compliance. Shortening the 10-day period would almost certainly lead to big increases in compliance with very little increase in risk, particularly amongst the most likely spreaders who perhaps can't afford to be off work for 10 days.

Project fear explanation - I heard a figure from someone from the NHS being interviewed on TV yesterday that even now about 20% of NHS staff are off work self isolating. Imagine how bad that will get if cases do grow to 50,000 let alone 100,000 or more cases a day. You can't care for the vulnerable if you're not at work.

True, but this raises the question, if the plan is for infections to become so high that the number of people self-isolating would cripple the country and NHS, shouldn't we be rethinking the plan to open up, rather than moving the goalposts on self-isolation? You mentioned the NHS staff will have regular tests rather than the full 10-day self-isolation period, which seems more sensible.

It also seems the testing system may also be overwhelmed if cases increase rapidly, in which case we'll be moving closer to Iain Duncan Smith's suggestion of suppressing Covid data so people don't realise what's happening.

[dealtn]

True, but this raises the question, if the plan is for infections to become so high that the number of people self-isolating would cripple the country and NHS, shouldn't we be rethinking the plan to open up, rather than moving the goalposts on self-isolation?

Yes if that was the plan, it should be reconsidered.

But what if the plan was to increase personal freedoms, with the downside of increasing infections, but that the subsequent level of infections wasn't sufficient to be so high it would "cripple the country and NHS". Would that be an OK plan, and if not why not?

[servodude]

True, but this raises the question, if the plan is for infections to become so high that the number of people self-isolating would cripple the country and NHS, shouldn't we be rethinking the plan to open up, rather than moving the goalposts on self-isolation?

Yes if that was the plan, it should be reconsidered.

But what if the plan was to increase personal freedoms, with the downside of increasing infections, but that the subsequent level of infections wasn't sufficient to be so high it would "cripple the country and NHS". Would that be an OK plan, and if not why not?

They've tried that one a few times though haven't they?
How's it worked?

They had planned to vaccinate everyone (enough that it made a difference sufficient to stop overwhelming things) before giving it another go
- that would have been a sensible change
Not sure they've managed that

-sd

[zico]

Analysis of the nation's healthcare provision should be viewed in the aggregate, not just in a narrow Covid sense in my opinion.

I agree completely, but often when people say this they mean "we need to focus on non-Covid patients, so let's stop suppressing Covid". Or to put it another way "We treat lots of Covid patients, let's treat non-Covid patients instead." The problem is that we know that, unlike other major health problems, Covid spreads exponentially if not suppressed, and it requires NHS resources to treat it, which takes NHS resources away from treating the non-Covid disease. Also, Covid is more likely to infect vulnerable hospital patients being treated for non-Covid problems, and as we know from last year, fear of Covid infection led people to miss important cancer treatment and screening appointments.

So more Covid cases inevitably leads to fewer non-Covid treatments.

Doesn't sound like you agree completely to me, rather agree conditionally.

Just to clarify my point, which is that the NHS can treat more non-Covid patients with
Option a) 200 Covid patients being treated in hospital.
as opposed to
Option Bb) 20,000 Covid patients being treated in hospital.

Many other health issues are also "exponential", such as flu, measles, ebola, that isn't restricted to Covid.

True, and if we had outbreaks of flu, measles, ebola, we'd take appropriate action to control the spread of those diseases depending on the scale and severity of the threats posed to lives and to NHS capacity for non-infectious health problems.

[dealtn]

True, but this raises the question, if the plan is for infections to become so high that the number of people self-isolating would cripple the country and NHS, shouldn't we be rethinking the plan to open up, rather than moving the goalposts on self-isolation?

Yes if that was the plan, it should be reconsidered.

But what if the plan was to increase personal freedoms, with the downside of increasing infections, but that the subsequent level of infections wasn't sufficient to be so high it would "cripple the country and NHS". Would that be an OK plan, and if not why not?

They've tried that one a few times though haven't they?
How's it worked?

They had planned to vaccinate everyone (enough that it made a difference) before giving it another go
- that would have been a sensible change
Not sure they've managed that

-sd

Glad to see you acknowledge you are not sure. That's surely the point. What was claimed was the plan was designed to " ... cripple the country and the NHS." It seems you and I agree that is unlikely to be true. The discussion then turns to whether the proposed increases in individual freedoms, and the risks of higher infections that come with that, are too much, about right or not enough. I would suggest that is a separate conversation.

You use the phrase "enough to make a difference". I agree that's an important metric. Some will feel having more than 50% at least single jabbed, and a large proportion of the remainder free to start that journey to full vaccination immediately, is sufficient to meet your criteria.

[dealtn]

Just to clarify my point, which is that the NHS can treat more non-Covid patients with
Option a) 200 Covid patients being treated in hospital.
as opposed to
Option Bb) 20,000 Covid patients being treated in hospital.

Or could they?

That's true if all else is equal. but what if the options were

a) 200 Covid patients in hospital and 10,000 fewer nurses and b) 1,000 Covid patients in hospital and no fewer nurses?

Many other health issues are also "exponential", such as flu, measles, ebola, that isn't restricted to Covid.

True, and if we had outbreaks of flu, measles, ebola, we'd take appropriate action to control the spread of those diseases depending on the scale and severity of the threats posed to lives and to NHS capacity for non-infectious health problems.

We do have outbreaks of flu and measles though. It is agreed the appropriate action in that case isn't to impose lockdowns and freedoms on the entire population. Alternative actions are taken, and have been for many years. I don't believe I am arguing we shouldn't be taking action I am merely questioning what is meant by "appropriate".

[servodude]

Just to clarify my point, which is that the NHS can treat more non-Covid patients with
Option a) 200 Covid patients being treated in hospital.
as opposed to
Option Bb) 20,000 Covid patients being treated in hospital

I'm not sure there were generally that many beds lying empty before COVID was a thing?
- it's all additional load on a system that had little headroom

It unfortunately also happens to be quite easy to spread and generally something you want to avoid when you are otherwise unwell; that's not something that is easy to manage without dedicated hospital facilities and staff (such as the old sanatoria for TB)

-sd

[zico]

Just to clarify my point, which is that the NHS can treat more non-Covid patients with
Option a) 200 Covid patients being treated in hospital.
as opposed to
Option Bb) 20,000 Covid patients being treated in hospital.

Many other health issues are also "exponential", such as flu, measles, ebola, that isn't restricted to Covid.

True, and if we had outbreaks of flu, measles, ebola, we'd take appropriate action to control the spread of those diseases depending on the scale and severity of the threats posed to lives and to NHS capacity for non-infectious health problems.

We do have outbreaks of flu and measles though. It is agreed the appropriate action in that case isn't to impose lockdowns and freedoms on the entire population. Alternative actions are taken, and have been for many years. I don't believe I am arguing we shouldn't be taking action I am merely questioning what is meant by "appropriate".

"That's true if all else is equal. but what if the options were
a) 200 Covid patients in hospital and 10,000 fewer nurses and b) 1,000 Covid patients in hospital and no fewer nurses?"

That wouldn't be a feasible option, because if there were 10,000 fewer nurses it would be because Covid cases were much higher.

We do have outbreaks of other infectious diseases. We make the choice to accept thousands of flu deaths per year, vaccinating the most vulnerable and keeping society running, because flu deaths very rarely exceed 20,000 per year. Covid is different. Even with lockdowns, well over 100,000 people have died from Covid. If we hadn't locked down, then far more would have died. When a society has over 100,000 people dying from a new infectious disease, it affects the entire society as we've seen - freedoms and economy. If Covid was like the flu, we'd treat it like the flu. But it's not, so we don't (or shouldn't, at any rate).

[servodude]

Yes if that was the plan, it should be reconsidered.

But what if the plan was to increase personal freedoms, with the downside of increasing infections, but that the subsequent level of infections wasn't sufficient to be so high it would "cripple the country and NHS". Would that be an OK plan, and if not why not?

They've tried that one a few times though haven't they?
How's it worked?

They had planned to vaccinate everyone (enough that it made a difference) before giving it another go
- that would have been a sensible change
Not sure they've managed that

-sd

Glad to see you acknowledge you are not sure. That's surely the point. What was claimed was the plan was designed to " ... cripple the country and the NHS." It seems you and I agree that is unlikely to be true. The discussion then turns to whether the proposed increases in individual freedoms, and the risks of higher infections that come with that, are too much, about right or not enough. I would suggest that is a separate conversation.

You use the phrase "enough to make a difference". I agree that's an important metric. Some will feel having more than 50% at least single jabbed, and a large proportion of the remainder free to start that journey to full vaccination immediately, is sufficient to meet your criteria.

I'm getting confused by which words you're quoting and from where and which you are trying to emphasize for whatever point it was you were aiming to make

However...

As far as I can see the plan has always been to "open up as soon as possible"
- the intent was never to overwhelm the NHS
- but that's what the plan achieved previously

It's too early to know whether they've done enough stop the same plan doing the same thing again
- which just seems a bit silly given the risks involved
- but they'll try it again to appease their fan base, and can rely on apologists if it goes to pot ("what were they supposed to do?")

They SHOULD get everyone vaccinated (not just jabbed) who wants to beforehand

-sd

[9873210]

True, and if we had outbreaks of flu, measles, ebola, we'd take appropriate action to control the spread of those diseases depending on the scale and severity of the threats posed to lives and to NHS capacity for non-infectious health problems.

We do have outbreaks of flu and measles though. It is agreed the appropriate action in that case isn't to impose lockdowns and freedoms on the entire population. Alternative actions are taken, and have been for many years. I don't believe I am arguing we shouldn't be taking action I am merely questioning what is meant by "appropriate".

Apples to oranges.

A measles outbreak is at worst a few hundred cases in a few square km. And we have already done at least 80% of the work of vaccinating the community.

The non-pharmaceutical measures we have taken to at best barely contain COVID have almost completely eliminated flu.

When the facts are different the response should be different.

[9873210]

But what if the plan was to increase personal freedoms,

Uncontained virus outbreaks will also restrict freedom.

Very few serious thinkers support anarchy. Most go for "ordered liberty", they consider some degree of government is necessary to maximise freedom. There is of course much discussion about how much government and whether we have too much.

[dealtn]

"That's true if all else is equal. but what if the options were
a) 200 Covid patients in hospital and 10,000 fewer nurses and b) 1,000 Covid patients in hospital and no fewer nurses?"

That wouldn't be a feasible option, because if there were 10,000 fewer nurses it would be because Covid cases were much higher.

Ok so there are more Covid cases and more hospitalisations. Lets have 200 and 1,000 as the 2 cases being compared - the latter 5 times more than the former, I think we can agree that.

So now compare the cases where NHS workers don't have to isolate because they get "pinged by the app" because they have been vaccinated.

200 in hospital but lots of nurses being pinged and isolating - lets say 10,000.

A wider number of people in hospital "because Covid cases were much higher", and 5 times as many genuinely ill nurses as the previous state. But crucially there are 9,900 maybe that are working that would otherwise be at home isolating unnecessarily.

You have 2 states, one with few patients but also fewer nurses, and the other with more patients and more nurses. the ratio of patients to nurses will depend on which is the more dominant factor - the spread of Covid, or the unnecessary isolating of vaccinated nurses.

There are many versions of this where the isolating rules of vaccinated nurses are the dominant factor in the resources available to the country. Changing the necessity to isolate will have a greater bearing on the health of the country.

[dealtn]

True, and if we had outbreaks of flu, measles, ebola, we'd take appropriate action to control the spread of those diseases depending on the scale and severity of the threats posed to lives and to NHS capacity for non-infectious health problems.

We do have outbreaks of flu and measles though. It is agreed the appropriate action in that case isn't to impose lockdowns and freedoms on the entire population. Alternative actions are taken, and have been for many years. I don't believe I am arguing we shouldn't be taking action I am merely questioning what is meant by "appropriate".

Apples to oranges.

A measles outbreak is at worst a few hundred cases in a few square km. And we have already done at least 80% of the work of vaccinating the community.

When the facts are different the response should be different.

Absolutely we agree!

If measles were new and it being both more infectious and harmful than Covid I am sure we would be treating it much more seriously than we do today. In the same way when Covid vaccinations are at 90+% we will treat it differently to when the vaccine had yet to be discovered.

Why would that not also apply to when 50% or 60% or 80% are vaccinated compared to 0% - are the rules not allowed to be changed?

The rules can evolve. " ... the facts are different the response should be different."

[dealtn]

But what if the plan was to increase personal freedoms,

Uncontained virus outbreaks will also restrict freedom.

Very few serious thinkers support anarchy. Most go for "ordered liberty", they consider some degree of government is necessary to maximise freedom. There is of course much discussion about how much government and whether we have too much.

Absolutely, and again we are agreeing.

A year or so ago we had a (virtually) uncontained virus and necessary restricted freedoms. Currently the virus is still around, and there is even more of it than there was a week or so ago. However it isn't "uncontained" like it was. We have a vaccine, and this is now in the arms of over 50% of the population and any unvaccinated adult is now free to get it. The degree of that "ordered liberty" can change to reflect the changed situation in society.

[servodude]

But what if the plan was to increase personal freedoms,

Uncontained virus outbreaks will also restrict freedom.

Very few serious thinkers support anarchy. Most go for "ordered liberty", they consider some degree of government is necessary to maximise freedom. There is of course much discussion about how much government and whether we have too much.

Absolutely, and again we are agreeing.

A year or so ago we had a (virtually) uncontained virus and necessary restricted freedoms. Currently the virus is still around, and there is even more of it than there was a week or so ago. However it isn't "uncontained" like it was. We have a vaccine, and this is now in the arms of over 50% of the population and any unvaccinated adult is now free to get it. The degree of that "ordered liberty" can change to reflect the changed situation in society.

Buy a bag of rice
Buy a chess board
Have someone start cutting squares off one side of the chess board while you fill it up geometrically from the other
- you should see that you get the best results (guaranteed least rice down) if you wait till the cutting is finished before you start to place it
Anything else is risking placing rice on squares that are removed

For the purposes of the real world it's not rice it's people; their health, their life, their contribution
- and the vaccination scheme is still removing squares
- opening up too early squanders the excellent efforts made (by jumping the gun on herd immunity that would have been achieved in those who have yet been allowed to achieve the immunity they wanted through vaccination)

It's unnecessarily gambling with people's lives

-sd

[1nvest]

Around 0.075% of the population die each month, many after a period of time in hospital.
Enter hospital for a few days and you're very likely to contract Covid.
Around half of those that die had positive Covid tests within the past 28 days.

If hospitals managed infection controls correctly then the contraction rates within hospitals could be a lot lower. My own mother caught Covid within three days of entering hospital last January following a fall, requiring hip surgery. For four days following the positive test she was bedded on the same ward but moved closer to the nursing station desk ... for company and observation, during regular phone calls I could hear them all chattering in the background. For the remainder of a total 14 days 'isolation' period she was moved to a care home for such. Despite being 89 she showed no outward symptoms, but seemingly might have been spreading/shedding whilst still on the general hip surgery ward that likely was seeing new patients entering. With family in effect banned from visiting sub-standards that might otherwise be highlighted by patients relatives go unobserved.

Same ol same ol. Useless government management that is more often managing crises of its own making. More chiefs than indians managing the likes of hospitals/wards where a single staff nurse could more likely far better manage things than the four white collars following her around with clipboards measuring time and motions and dictating policies.

[dealtn]

Uncontained virus outbreaks will also restrict freedom.

Very few serious thinkers support anarchy. Most go for "ordered liberty", they consider some degree of government is necessary to maximise freedom. There is of course much discussion about how much government and whether we have too much.

Absolutely, and again we are agreeing.

A year or so ago we had a (virtually) uncontained virus and necessary restricted freedoms. Currently the virus is still around, and there is even more of it than there was a week or so ago. However it isn't "uncontained" like it was. We have a vaccine, and this is now in the arms of over 50% of the population and any unvaccinated adult is now free to get it. The degree of that "ordered liberty" can change to reflect the changed situation in society.

Buy a bag of rice
Buy a chess board
Have someone start cutting squares off one side of the chess board while you fill it up geometrically from the other
- you should see that you get the best results (guaranteed least rice down) if you wait till the cutting is finished before you start to place it
Anything else is risking placing rice on squares that are removed

For the purposes of the real world it's not rice it's people; their health, their life, their contribution
- and the vaccination scheme is still removing squares
- opening up too early squanders the excellent efforts made (by jumping the gun on herd immunity that would have been achieved in those who have yet been allowed to achieve the immunity they wanted through vaccination)

It's unnecessarily gambling with people's lives

-sd

Absolutely true. By your definition of "best result".

Some in society will argue that "best result" means something else though. Quality of life as well as quantity of life is important in determining "best result". If that wasn't true in the real world we wouldn't accept any preventable death at ant time, and literally we would be protecting all life "at all costs".

If you think that is what we should be doing, then fine, that is a consistent argument, but we will never open up, and you should be arguing for stringent measures for all preventable deaths from all causes. I suspect neither you, nor anyone on the planet really has that view. So if it can be conceded Governments, and decision makers generally, don't have the literal zero deaths objective, the argument becomes one of when it is appropriate to change the restrictions, and by what measure.

That's a legitimate argument, and many won't align their thoughts with each other, or with the government on this. Many will be on the side of "too little, too late", many on the "too much, too early". You appear to prefer the more emotive phrase "gambling with people's lives". I don't think it's gambling, but is considered thinking taking advice. That's the job of government, and they won't always get it right.

[servodude]

Absolutely, and again we are agreeing.

A year or so ago we had a (virtually) uncontained virus and necessary restricted freedoms. Currently the virus is still around, and there is even more of it than there was a week or so ago. However it isn't "uncontained" like it was. We have a vaccine, and this is now in the arms of over 50% of the population and any unvaccinated adult is now free to get it. The degree of that "ordered liberty" can change to reflect the changed situation in society.

Buy a bag of rice
Buy a chess board
Have someone start cutting squares off one side of the chess board while you fill it up geometrically from the other
- you should see that you get the best results (guaranteed least rice down) if you wait till the cutting is finished before you start to place it
Anything else is risking placing rice on squares that are removed

For the purposes of the real world it's not rice it's people; their health, their life, their contribution
- and the vaccination scheme is still removing squares
- opening up too early squanders the excellent efforts made (by jumping the gun on herd immunity that would have been achieved in those who have yet been allowed to achieve the immunity they wanted through vaccination)

It's unnecessarily gambling with people's lives

-sd

Absolutely true. By your definition of "best result".

Some in society will argue that "best result" means something else though. Quality of life as well as quantity of life is important in determining "best result". If that wasn't true in the real world we wouldn't accept any preventable death at ant time, and literally we would be protecting all life "at all costs".

If you think that is what we should be doing, then fine, that is a consistent argument, but we will never open up, and you should be arguing for stringent measures for all preventable deaths from all causes. I suspect neither you, nor anyone on the planet really has that view. So if it can be conceded Governments, and decision makers generally, don't have the literal zero deaths objective, the argument becomes one of when it is appropriate to change the restrictions, and by what measure.

That's a legitimate argument, and many won't align their thoughts with each other, or with the government on this. Many will be on the side of "too little, too late", many on the "too much, too early". You appear to prefer the more emotive phrase "gambling with people's lives". I don't think it's gambling, but is considered thinking taking advice. That's the job of government, and they won't always get it right.

No.

Let's try a blunt literal statement of what I think should happen:

Give everyone that wants immunity from vaccination the chance of that immunity and then open up.

It's not a "never open up" scenario
It's not a semantic straw man
It's not a fanciful bit of mental masturbating
- nor any other of your flights of fancy

It's pretty simple

What's happening now isn't that
- and will cause unnecessary death as a result
- avoiding unnecessary death shouldn't be too hard a motive for most to understand?

Particularly when you are so close to achieving it (EDIT: where it is having given vaccine immunity to everyone that wants it)

-sd

[XFool]

Nadhim Zahawi says mask wearing will be ‘expected’ after 19 July

The Guardian

Minister signals harder stance on face coverings in England as soaring Covid infections cause concern

[88V8]

Nadhim Zahawi says mask wearing will be ‘expected’ after 19 July

Expected... guidance... it all sounds rather woolly.

All very well for those of us who don't have to budge from home... feel sorry for shop and hospitality workers and commuters.

V8