COVID19

[Jon MW]

The closing non-essential work is a bit trickier, if we don't go over the ICU capacity then it definitely wasn't needed and if we do go over the ICU capacity there's a chance it would have made a difference.

Crikey. I assume this just slipped through and you don't really mean it.

No. I dont really understand your thinking.

Every measure is aimed at keeping critical cases below ICU capacity so if we don't breach that it implies we don't need any of the few extra restrictions to be put in place.

Can you elaborate on what you mean?

ICU capacity is a critical measure for everything not getting out of control, but it’s not the only thing that matters. You’re saying that stopping non-essential work isn’t required so long as we don’t breach that line, which suggests it doesn’t matter about the grannies who may die as a result. Suppressing the number of infections and deaths is worth doing, irrespective of the ICU limit because, well, fewer people die.

Suppose capacity is 100% and we are currently at 30%. So if allowing non-essential work takes us to 120%, we should stop it, but if it only took us to 90% it’s ok, even though stopping it might have kept us at say 60%? Do the ones between 60% and 90% not matter? And, with more infection going around, the group who don’t even make it as far as ICU will also be larger.

And if we are in a situation where we’re going over IICU capacity no matter what we do, would suppressing demand to 130% not be better than 200%?

(Numbers just for illustration - I’ve no idea what the numbers would be or what the current fill actually is, but it doesn’t matter for this purpose.)

Most of the non-essential businesses that are being closed aren't public facing businesses.

i.e. the difference that closing non-essential businesses will make is not likely to be 60% to 90%; or 130% to 200% - it's more likely to be 60% to 70%, or 130% to 140% for example.

So just like closing airports when air traffic is down 90% probably won't make much difference, closing down non-essential businesses probably won't either.


The idea that 'you can't put a price on a human life' is nice but isn't really true. As well as the long term implication of how economic damage can affect future health there's the more prosaic illustration that NICE evaluate the efficacy and cost effectiveness of every drug all the time. If a drug will reduce cholesterol but doesn't improve life expectancy - it's not effective. If a drug can extend a 90 year olds life for an extra 5 years at the cost of a million pounds a year - it's not cost effective.

If closing non-essential businesses cost a billion pounds and saved a million lives - that's cost effective.
If closing non-essential businesses cost a 100 billion pounds and saves a 100 lives - that's not cost effective.

Whatever level you set the threshold at - there is a threshold.

How do you know that?

And even if a relatively small number are in non-essential roles (do we know that is the case?), it wouldn't necessarily mean that their effect would be small. Sometimes the effect of the added small number has a major effect on the whole system - eg the number of people who drive their children to school, who wouldn't be driving to work anyway, is small compared with the numbers going to work, but that extra causes the system to tip into overload. The number of non-essentials (or any other group out and about) is likely to have a disproportionate effect on infections as the network of possible infection routes increases exponentially, even if that group is relatively small (and I thought the non-essentials were a larger group than the essentials).

I agree with the rest of what you've written after that, but it doesn't really relate to the point I made, other than saying that there is a cost/benefit. In this case, we don't know the benefit, cos I don't think the 10% is justifiable. And we don't know the cost.

My implication is that it's a small amount not a large amount (rather than an exact number): the evidence is empirical and theoretical.

The theoretical is that - if you are not a business which has members of the public interacting with you, the only people that you can pass the virus on to are other people in your workplace, and their family.
This might still be a fair few people, but it's a fraction of the proportion that an employee at a retail outlet could pass it on to, for example.
Particularly in that in a non-public facing company you can control the actions of everybody concerned. You can oversee hand washing and social distancing. A lot of businesses have found many ways to let people work from home, so there's absolutely no chance they can spread any virus; even if they come into contact with it.

The empirical would be related to figures like before.

Mobility changes 29th March 2020

Retail - figures make sense given that Italy and Spain are basically at a standstill, the others are all pretty close to each other
UK       -85%

Grocery & Pharmacy UK                -46%

Transit Stations
UK                 -75%

Workplaces
UK                  -55%

If, what could be non-essential, retail is already down 85% and, what is likely to be essential, Grocery & Pharmacy is down 46% (i.e. that figure can't be changed); coupled with public transport use being down 75% and workplace traffic being down 55% - just how much difference could it ever make?

It could reduce total infections - but most of those won't need the hospital
Most of those that need the hospital - don't need intensive care.

Even if you reduced work place attendance by 75% rather than 55% that extra 20% wouldn't result in 20% less infections.
Whatever infections it did reduce it would be less than that who needed the hospital, and less than that who need ICU - I don't think it lkely that you would get more than 10% difference.

[Woodsey]

Here’s a morality meets economics question for everyone.........how much are you happy for the govt to spend to prevent a death from Covid? £1 per death would be a bargain but £50 billion is clearly too much, what’s your number?

[Doobs]

The closing non-essential work is a bit trickier, if we don't go over the ICU capacity then it definitely wasn't needed and if we do go over the ICU capacity there's a chance it would have made a difference.

Crikey. I assume this just slipped through and you don't really mean it.

No. I dont really understand your thinking.

Every measure is aimed at keeping critical cases below ICU capacity so if we don't breach that it implies we don't need any of the few extra restrictions to be put in place.

Can you elaborate on what you mean?

ICU capacity is a critical measure for everything not getting out of control, but it’s not the only thing that matters. You’re saying that stopping non-essential work isn’t required so long as we don’t breach that line, which suggests it doesn’t matter about the grannies who may die as a result. Suppressing the number of infections and deaths is worth doing, irrespective of the ICU limit because, well, fewer people die.

Suppose capacity is 100% and we are currently at 30%. So if allowing non-essential work takes us to 120%, we should stop it, but if it only took us to 90% it’s ok, even though stopping it might have kept us at say 60%? Do the ones between 60% and 90% not matter? And, with more infection going around, the group who don’t even make it as far as ICU will also be larger.

And if we are in a situation where we’re going over IICU capacity no matter what we do, would suppressing demand to 130% not be better than 200%?

(Numbers just for illustration - I’ve no idea what the numbers would be or what the current fill actually is, but it doesn’t matter for this purpose.)

Most of the non-essential businesses that are being closed aren't public facing businesses.

i.e. the difference that closing non-essential businesses will make is not likely to be 60% to 90%; or 130% to 200% - it's more likely to be 60% to 70%, or 130% to 140% for example.

So just like closing airports when air traffic is down 90% probably won't make much difference, closing down non-essential businesses probably won't either.


The idea that 'you can't put a price on a human life' is nice but isn't really true. As well as the long term implication of how economic damage can affect future health there's the more prosaic illustration that NICE evaluate the efficacy and cost effectiveness of every drug all the time. If a drug will reduce cholesterol but doesn't improve life expectancy - it's not effective. If a drug can extend a 90 year olds life for an extra 5 years at the cost of a million pounds a year - it's not cost effective.

If closing non-essential businesses cost a billion pounds and saved a million lives - that's cost effective.
If closing non-essential businesses cost a 100 billion pounds and saves a 100 lives - that's not cost effective.

Whatever level you set the threshold at - there is a threshold.

How do you know that?

And even if a relatively small number are in non-essential roles (do we know that is the case?), it wouldn't necessarily mean that their effect would be small. Sometimes the effect of the added small number has a major effect on the whole system - eg the number of people who drive their children to school, who wouldn't be driving to work anyway, is small compared with the numbers going to work, but that extra causes the system to tip into overload. The number of non-essentials (or any other group out and about) is likely to have a disproportionate effect on infections as the network of possible infection routes increases exponentially, even if that group is relatively small (and I thought the non-essentials were a larger group than the essentials).

I agree with the rest of what you've written after that, but it doesn't really relate to the point I made, other than saying that there is a cost/benefit. In this case, we don't know the benefit, cos I don't think the 10% is justifiable. And we don't know the cost.

There is what might be a geeky maths point here.   If you design flood defences and observe an event where the next observed flood goes one millimetre from the top, have you designed it well or just got really lucky.  I'd say almost certainly the latter.

I think if you get near peak ICU/ventilator use you'll get a fair few unnecessary deaths anyway, as peaks will be different in different areas.  Also people may make the decision to not treat person x because capacity is near the maximum, and they may not make that decision if more space was available.  There will be more cancer deaths due to covid linked cancellations as we are near capacity etc.  In addition we are already seeing some when not close to the peak.  I read one the other day where somebody didn't go to hospital as they didn't want to get in the way.   People are dying in nursing homes as they aren't going to hospital (triage in all but name?).  People are ringing 111 and getting told to treat themselves at home when 3 months ago they would have been told to get to hospital.    

So the aim really shouldn't be to go just under peak, it should be to peak with a decent margin of safety.  The extra beds weren't a waste even if they are never used.  And you are balancing extra beds on one side vs extra deaths on the other, so even if you don't accept my geek point, you dhould still go for caution.

Of course, there may not be a choice, and they may hit peak even with tighter measures.  

[nirvana]

Why are people calling for exit strategies to be published now ? Makes no sense does it ?

[kukushkin88]

This is starting to grate.

https://www.reuters.com/article/us-health-coronavirus-britain-ferguson/uk-coronavirus-deaths-could-reach-7000-to-20000-ferguson-idUSKBN21N0BN

We know that 7,000 can't be a possibility, as we are at 4,000 and rising; I know it went down today, but it is a Sunday do reporting is likely to slow.  Add to that lag in reporting, nursing home deaths, unknown cause deaths, people who have died alone, and unless they get a perfect vaccine, a 2nd wave seems a near certainty.  

20,000 is nowhere near the max either.   We "think" the rules should work, we cannot know they will work.  And the final numbers in scenarios where the rules don't work are subject to much more uncertain outcomes (we don't know the current infected population, how far it spreads, reinfections etc.).

What do you think the explanation is for him saying something so obviously wrong?

[Doobs]

This is starting to grate.

https://www.reuters.com/article/us-health-coronavirus-britain-ferguson/uk-coronavirus-deaths-could-reach-7000-to-20000-ferguson-idUSKBN21N0BN

We know that 7,000 can't be a possibility, as we are at 4,000 and rising; I know it went down today, but it is a Sunday do reporting is likely to slow.  Add to that lag in reporting, nursing home deaths, unknown cause deaths, people who have died alone, and unless they get a perfect vaccine, a 2nd wave seems a near certainty.  

20,000 is nowhere near the max either.   We "think" the rules should work, we cannot know they will work.  And the final numbers in scenarios where the rules don't work are subject to much more uncertain outcomes (we don't know the current infected population, how far it spreads, reinfections etc.).

What do you think the explanation is for him saying something so obviously wrong?

I don't know.   Could be a mistake, could be someone else has done the original modelling and he always believed it was too high.  Nobody lives in a vacuum, so he could be getting pressure?   

I don't really understand the benefit in understating it.   We are reaching a stage where most people are complying, you don't want to be letting them know it was a waste of time.   

If you do now think 500,000 is too high, just reduce it sensibly, don't overshoot the other way. 

[Jon MW]

Is the FT turning into the Sun?

Asking a question that if the government take a stake in any industry will they leave out Virgin Air because Virgin Health sued the NHS?

I'm pretty flabbergasted that a 'proper' newspaper would ask such a tabloidy question.

[RickBFA]

According to this article, exit strategies are :

Vaccinate

Enough people develop immunity through infection

Permanently change our behaviours/way of life

https://www.google.co.uk/amp/s/www.bbc.co.uk/news/amp/health-51963486

(I posted this before).

I don’t think any country can honestly have a realistic time bound plan in place yet (not even one where Keir Starmer was in charge).

[nirvana]

Is the FT turning into the Sun?

Asking a question that if the government take a stake in any industry will they leave out Virgin Air because Virgin Health sued the NHS?

I'm pretty flabbergasted that a 'proper' newspaper would ask such a tabloidy question.

Agreed. Part of the problem with this whole process has been having all the idiots from political journalism asking the questions.

[nirvana]

According to this article, exit strategies are :

Vaccinate

Enough people develop immunity through infection

Permanently change our behaviours/way of life

https://www.google.co.uk/amp/s/www.bbc.co.uk/news/amp/health-51963486

(I posted this before).

I don’t think any country can honestly have a realistic time bound plan in place yet (not even one where Keir Starmer was in charge).

Hopefully Keir will sketch it out for all the idiots in the Govt, public health England, modelling community etc

[Woodsey]

Scottish health minister! 

[Jon MW]

According to this article, exit strategies are :

Vaccinate

Enough people develop immunity through infection

Permanently change our behaviours/way of life

https://www.google.co.uk/amp/s/www.bbc.co.uk/news/amp/health-51963486

(I posted this before).

I don’t think any country can honestly have a realistic time bound plan in place yet (not even one where Keir Starmer was in charge).

Hopefully Keir will sketch it out for all the idiots in the Govt, public health England, modelling community etc

This article touches upon but doesn't explicitly say what Science Wife thinks is the most likely exit "strategy"  - that after on/off measures for a couple of years COVID19 will evolve into a less potent version of it's current strain and either a vaccine will just immunise you against it or it will join the other seasonal flu strains that you have to get an annual vaccination for.

[Chompy]

Thursday was clapping. Friday was shine torch skywards. Nothing last night, which was disappointing, but back on it tonight in a major way.

7pm. It's dancing on the doorstep to S Club 7's inspirational 'Reach". Lovely stuff.

[Woodsey]

Thursday was clapping. Friday was shine torch skywards. Nothing last night, which was disappointing, but back on it tonight in a major way.

7pm. It's dancing on the doorstep to S Club 7's inspirational 'Reach". Lovely stuff.

What are we dancing for?

[Chompy]

Exercise and the NHS at a guess.

I'm in either way.