COVID19

[nirvana]

This is a long read (about 40 pages) but does a good job of pulling together all the pieces of the UK decision making up to lockdown.
The tone is balanced & non-hysterical - obviously that will deter some.

https://www.iiss.org/blogs/survival-blog/2020/05/the-uk-and-covid-19

Morning

It is a good piece and looks to be impeccably researched, no surprises in it for anyone who has been following events closely but it is a valuable account of what’s happened to this point all the same. As he rightly points out, having a regularly updated contemporaneous log of events will be valuable for the inquiry. Actions should only be critically judged on what was known at the time, not what is known/obvious with hindsight.

It's very good. And it is packed full of information, there's very little rhetoric at all - if anyone wants to read it you should put time aside for it because it's really not suitable for skim reading.

I did like the description,

"Known for his optimistic, blustery style and his inattention to detail,
Johnson may have been naturally inclined to accept options that demanded
the minimum rather than the maximum, and so content to be advised to
follow a gradual path of escalation"

... it's good that Johnson's character is so well known that this judgement can probably be taken as objective observation rather than opinion.

From reading that I think there are questions of detail such as PPE provision, but in terms of overall strategy I think the two main pillars of any enquiry should be the time between the 10th March to the 23rd of March and what 'should/could' have been done dfferently then and communication throughout the whole process.

Finally got through it all, thanks for positing it Jakally and Jon, your summary seems about right.

Even with what we know now I feel our gradual move to locking down from 10th -23rd was about right for this country (obvs just a personal opinion not a fact).
Yes PPE, and I'm sure if this happened again the absolute focus on clearing hospital beds would be accompanied by some kind of staged release of people, via quarantine, back into the community.

[Jon MW]

https://m.youtube.com/watch?v=H2TEOnOnHVM

This Swedish Professor has interesting views on the handling and on the Imperial Study. Appears well qualified in this area.

Thought it was worth a look to get different views, not sure if he’s right or wrong.

Perhaps it’s fair to say that the situation has a long way to go and ultimately history will judge how this has been/should have been handled when it fully plays out.

It is interesting - his view about how it should have been handled is basically identical to how the UK government were planning to do it before the Imperial modelling came out.

To defend the mathematics of the Imperial model - what you get out is only as good as what you put in. It certainly underestimated the asymptomatic and mildly symptomatic range of patients - although I haven't seen anywhere anything that justifies his statement (guess?) that the case fatality rate for COVID19 is as low as 0.1% - but what they used in the modelling was what was understood at the time to the best of their knowledge.

He didn't mention it but the level of compliance modelled in the Imperial model was far below what actually happened. They predicted 50% and it's been more like 85% - but that was before the government came up with the scheme to pay 80% of furloughed wages; if they hadn't done that then 50% may have ended up being an over prediction.

I think the biggest mistake is his statement - "the people aren't stupid" - has he even met people? They really are very stupid

[kukushkin88]

https://m.youtube.com/watch?v=H2TEOnOnHVM

This Swedish Professor has interesting views on the handling and on the Imperial Study. Appears well qualified in this area.

Thought it was worth a look to get different views, not sure if he’s right or wrong.

Perhaps it’s fair to say that the situation has a long way to go and ultimately history will judge how this has been/should have been handled when it fully plays out.

It is interesting - his view about how it should have been handled is basically identical to how the UK government were planning to do it before the Imperial modelling came out.

To defend the mathematics of the Imperial model - what you get out is only as good as what you put in. It certainly underestimated the asymptomatic and mildly symptomatic range of patients - although I haven't seen anywhere anything that justifies his statement (guess?) that the case fatality rate for COVID19 is as low as 0.1% - but what they used in the modelling was what was understood at the time to the best of their knowledge.

He didn't mention it but the level of compliance modelled in the Imperial model was far below what actually happened. They predicted 50% and it's been more like 85% - but that was before the government came up with the scheme to pay 80% of furloughed wages; if they hadn't done that then 50% may have ended up being an over prediction.

I think the biggest mistake is his statement - "the people aren't stupid" - has he even met people? They really are very stupid

I won’t pretend to know more than him on this, of course. He’s wrong on some of the things that can already be measured though. Link to the study through Twitter, as it’s in Spanish and the key parts are translated ITT. 0.1 won’t even be in the ballpark for CFR. The big seroprevalence study says only 11% of residents in Madrid have had it.

https://twitter.com/_miguelhernan/status/1260625031119409156?s=21

[kukushkin88]

This is a long read (about 40 pages) but does a good job of pulling together all the pieces of the UK decision making up to lockdown.
The tone is balanced & non-hysterical - obviously that will deter some.

https://www.iiss.org/blogs/survival-blog/2020/05/the-uk-and-covid-19

Morning

It is a good piece and looks to be impeccably researched, no surprises in it for anyone who has been following events closely but it is a valuable account of what’s happened to this point all the same. As he rightly points out, having a regularly updated contemporaneous log of events will be valuable for the inquiry. Actions should only be critically judged on what was known at the time, not what is known/obvious with hindsight.

It's very good. And it is packed full of information, there's very little rhetoric at all - if anyone wants to read it you should put time aside for it because it's really not suitable for skim reading.

I did like the description,

"Known for his optimistic, blustery style and his inattention to detail,
Johnson may have been naturally inclined to accept options that demanded
the minimum rather than the maximum, and so content to be advised to
follow a gradual path of escalation"

... it's good that Johnson's character is so well known that this judgement can probably be taken as objective observation rather than opinion.

From reading that I think there are questions of detail such as PPE provision, but in terms of overall strategy I think the two main pillars of any enquiry should be the time between the 10th March to the 23rd of March and what 'should/could' have been done dfferently then and communication throughout the whole process.

Finally got through it all, thanks for positing it Jakally and Jon, your summary seems about right.

Even with what we know now I feel our gradual move to locking down from 10th -23rd was about right for this country (obvs just a personal opinion not a fact).
Yes PPE, and I'm sure if this happened again the absolute focus on clearing hospital beds would be accompanied by some kind of staged release of people, via quarantine, back into the community.

It would be interesting to hear some thoughts about the positives of moving gradually through that period, it’s looking catastrophic and is primary amongst the things that have us well placed for the ‘worst of both worlds’, economic harm/most fatalities double.

[nirvana]

This is a long read (about 40 pages) but does a good job of pulling together all the pieces of the UK decision making up to lockdown.
The tone is balanced & non-hysterical - obviously that will deter some.

https://www.iiss.org/blogs/survival-blog/2020/05/the-uk-and-covid-19

Morning

It is a good piece and looks to be impeccably researched, no surprises in it for anyone who has been following events closely but it is a valuable account of what’s happened to this point all the same. As he rightly points out, having a regularly updated contemporaneous log of events will be valuable for the inquiry. Actions should only be critically judged on what was known at the time, not what is known/obvious with hindsight.

It's very good. And it is packed full of information, there's very little rhetoric at all - if anyone wants to read it you should put time aside for it because it's really not suitable for skim reading.

I did like the description,

"Known for his optimistic, blustery style and his inattention to detail,
Johnson may have been naturally inclined to accept options that demanded
the minimum rather than the maximum, and so content to be advised to
follow a gradual path of escalation"

... it's good that Johnson's character is so well known that this judgement can probably be taken as objective observation rather than opinion.

From reading that I think there are questions of detail such as PPE provision, but in terms of overall strategy I think the two main pillars of any enquiry should be the time between the 10th March to the 23rd of March and what 'should/could' have been done dfferently then and communication throughout the whole process.

Finally got through it all, thanks for positing it Jakally and Jon, your summary seems about right.

Even with what we know now I feel our gradual move to locking down from 10th -23rd was about right for this country (obvs just a personal opinion not a fact).
Yes PPE, and I'm sure if this happened again the absolute focus on clearing hospital beds would be accompanied by some kind of staged release of people, via quarantine, back into the community.

It would be interesting to hear some thoughts about the positives of moving gradually through that period, it’s looking catastrophic and is primary amongst the things that have us well placed for the ‘worst of both worlds’, economic harm/most fatalities double.

Too early to say with any confidence but I think it moved the people to new behaviours in a way that was tolerable without the army on the street (personal perspective). For me this is a definite and meaningful consideration irrespective of the absolute numbers of dead.

You can tell already (see the general response to mooted tracking apps) that the UK pop isn't really interested in tolerating a Govt intrusiveness level of say S Korea so a really heavy handed lockdown approach wouldn't necessarily have yielded a much different result given where we were on 12th March.

Meaningful comparators are the larger Western European nations - one can argue about the detail but our outcomes so far are much the same as Italy, France, Spain, and given a raft of underlying factors, very unlikely they emerge economically stronger than the UK, measured over a reasonable period.

Germany, with far higher death  rates than the strong Asian performers, and the backwaters like NZ and Australia, are something of an exemplar in Western European terms and no doubt the UK, France, Spain, Italy, and others in the 300pm dead zone currently, will be trying to learn as much as they can from them for the future.

[kukushkin88]

This is a long read (about 40 pages) but does a good job of pulling together all the pieces of the UK decision making up to lockdown.
The tone is balanced & non-hysterical - obviously that will deter some.

https://www.iiss.org/blogs/survival-blog/2020/05/the-uk-and-covid-19

Morning

It is a good piece and looks to be impeccably researched, no surprises in it for anyone who has been following events closely but it is a valuable account of what’s happened to this point all the same. As he rightly points out, having a regularly updated contemporaneous log of events will be valuable for the inquiry. Actions should only be critically judged on what was known at the time, not what is known/obvious with hindsight.

It's very good. And it is packed full of information, there's very little rhetoric at all - if anyone wants to read it you should put time aside for it because it's really not suitable for skim reading.

I did like the description,

"Known for his optimistic, blustery style and his inattention to detail,
Johnson may have been naturally inclined to accept options that demanded
the minimum rather than the maximum, and so content to be advised to
follow a gradual path of escalation"

... it's good that Johnson's character is so well known that this judgement can probably be taken as objective observation rather than opinion.

From reading that I think there are questions of detail such as PPE provision, but in terms of overall strategy I think the two main pillars of any enquiry should be the time between the 10th March to the 23rd of March and what 'should/could' have been done dfferently then and communication throughout the whole process.

Finally got through it all, thanks for positing it Jakally and Jon, your summary seems about right.

Even with what we know now I feel our gradual move to locking down from 10th -23rd was about right for this country (obvs just a personal opinion not a fact).
Yes PPE, and I'm sure if this happened again the absolute focus on clearing hospital beds would be accompanied by some kind of staged release of people, via quarantine, back into the community.

It would be interesting to hear some thoughts about the positives of moving gradually through that period, it’s looking catastrophic and is primary amongst the things that have us well placed for the ‘worst of both worlds’, economic harm/most fatalities double.

This is a good indicator of why the conscious decision to move slowly, looks so bad, with a little bit of hindsight:
(I only mention hindsight, because you say that even with hindsight, you think it was the right thing to do)

https://twitter.com/jburnmurdoch/status/1260235465065664514?s=21

[nirvana]

By the way, although I don't appear too exercised by failings so far. I do think we are about to head into a new phase where the level of Government detail and planning about moving forward in the safest way possible for the medium term seems pretty dreadful.

No doubt we need to wrap our heads around living with a reasonable degree of risk for the forseeable future but the lack of real detail on structural changes that protect care homes for example, is really poor.

[Doobs]

https://m.youtube.com/watch?v=H2TEOnOnHVM

This Swedish Professor has interesting views on the handling and on the Imperial Study. Appears well qualified in this area.

Thought it was worth a look to get different views, not sure if he’s right or wrong.

Perhaps it’s fair to say that the situation has a long way to go and ultimately history will judge how this has been/should have been handled when it fully plays out.

It is interesting - his view about how it should have been handled is basically identical to how the UK government were planning to do it before the Imperial modelling came out.

To defend the mathematics of the Imperial model - what you get out is only as good as what you put in. It certainly underestimated the asymptomatic and mildly symptomatic range of patients - although I haven't seen anywhere anything that justifies his statement (guess?) that the case fatality rate for COVID19 is as low as 0.1% - but what they used in the modelling was what was understood at the time to the best of their knowledge.

He didn't mention it but the level of compliance modelled in the Imperial model was far below what actually happened. They predicted 50% and it's been more like 85% - but that was before the government came up with the scheme to pay 80% of furloughed wages; if they hadn't done that then 50% may have ended up being an over prediction.

I think the biggest mistake is his statement - "the people aren't stupid" - has he even met people? They really are very stupid

I have read his stuff before, so not watched this particular version of his altetnative facts.  

But if he has said that the case fatality rate is 0.1% he is wrong.   There is ample evidence showing that it is significantly higher.  We have already lost 60,000 people which would mean everybody has been infected.   Studies have shown that hopes of 50% of the population were already infected were wildly optimistic.  

If the exposed is in single figure percents, then the Imperial Model is going to be in the right ballpark.  

I know he also claims everyone will be exposed before a vaccine, or that it could be ineffective but we don't know that.   It could work, and even if it doesn't, we could find better treatments and so on.   So whilst giving up and having humdreds of thousands die each year is a valid strategy, then not doing that could be better.

FWIW There have been a handful of cars in the country park each weekday for weeks, there are 30-40 today and I observed a higher proportion of social distancing sceptics.  I don't think it is a massive concern for me, but doesn't bode well for city centre parks this weekend.

[kukushkin88]

By the way, although I don't appear too exercised by failings so far. I do think we are about to head into a new phase where the level of Government detail and planning about moving forward in the safest way possible for the medium term seems pretty dreadful.

No doubt we need to wrap our heads around living with a reasonable degree of risk for the forseeable future but the lack of real detail on structural changes that protect care homes for example, is really poor.

Interesting answers, thanks. Yeah, similar to my concern that just how badly we are handling this, hasn’t even really played out yet. I fear courage, defiance and exceptionalism are still the plan and we still have rates of new infection that are higher than the comparable nations/regions.

[nirvana]

This is a long read (about 40 pages) but does a good job of pulling together all the pieces of the UK decision making up to lockdown.
The tone is balanced & non-hysterical - obviously that will deter some.

https://www.iiss.org/blogs/survival-blog/2020/05/the-uk-and-covid-19

Morning

It is a good piece and looks to be impeccably researched, no surprises in it for anyone who has been following events closely but it is a valuable account of what’s happened to this point all the same. As he rightly points out, having a regularly updated contemporaneous log of events will be valuable for the inquiry. Actions should only be critically judged on what was known at the time, not what is known/obvious with hindsight.

It's very good. And it is packed full of information, there's very little rhetoric at all - if anyone wants to read it you should put time aside for it because it's really not suitable for skim reading.

I did like the description,

"Known for his optimistic, blustery style and his inattention to detail,
Johnson may have been naturally inclined to accept options that demanded
the minimum rather than the maximum, and so content to be advised to
follow a gradual path of escalation"

... it's good that Johnson's character is so well known that this judgement can probably be taken as objective observation rather than opinion.

From reading that I think there are questions of detail such as PPE provision, but in terms of overall strategy I think the two main pillars of any enquiry should be the time between the 10th March to the 23rd of March and what 'should/could' have been done dfferently then and communication throughout the whole process.

Finally got through it all, thanks for positing it Jakally and Jon, your summary seems about right.

Even with what we know now I feel our gradual move to locking down from 10th -23rd was about right for this country (obvs just a personal opinion not a fact).
Yes PPE, and I'm sure if this happened again the absolute focus on clearing hospital beds would be accompanied by some kind of staged release of people, via quarantine, back into the community.

It would be interesting to hear some thoughts about the positives of moving gradually through that period, it’s looking catastrophic and is primary amongst the things that have us well placed for the ‘worst of both worlds’, economic harm/most fatalities double.

This is a good indicator of why the conscious decision to move slowly, looks so bad, with a little bit of hindsight:
(I only mention hindsight, because you say that even with hindsight, you think it was the right thing to do)

https://twitter.com/jburnmurdoch/status/1260235465065664514?s=21

That just confirms that, with hindsight, moving slowly was worse than if you could notionally, have moved much faster and ahieved the desired effect. The logical extension of this train of thought is to say, with hindsight, I wish we had moved faster to close all borders in January. I mean it can be said, I could even mean it but it's pretty meaningless.

So I can see it as a powerful metric that we might learn from but it doesn't change my opinion that I think the country was moved on towards what it had to do in a way that is easy for me to understand and align with.

[Jon MW]

This is a long read (about 40 pages) but does a good job of pulling together all the pieces of the UK decision making up to lockdown.
The tone is balanced & non-hysterical - obviously that will deter some.

https://www.iiss.org/blogs/survival-blog/2020/05/the-uk-and-covid-19

Morning

It is a good piece and looks to be impeccably researched, no surprises in it for anyone who has been following events closely but it is a valuable account of what’s happened to this point all the same. As he rightly points out, having a regularly updated contemporaneous log of events will be valuable for the inquiry. Actions should only be critically judged on what was known at the time, not what is known/obvious with hindsight.

It's very good. And it is packed full of information, there's very little rhetoric at all - if anyone wants to read it you should put time aside for it because it's really not suitable for skim reading.

I did like the description,

"Known for his optimistic, blustery style and his inattention to detail,
Johnson may have been naturally inclined to accept options that demanded
the minimum rather than the maximum, and so content to be advised to
follow a gradual path of escalation"

... it's good that Johnson's character is so well known that this judgement can probably be taken as objective observation rather than opinion.

From reading that I think there are questions of detail such as PPE provision, but in terms of overall strategy I think the two main pillars of any enquiry should be the time between the 10th March to the 23rd of March and what 'should/could' have been done dfferently then and communication throughout the whole process.

Finally got through it all, thanks for positing it Jakally and Jon, your summary seems about right.

Even with what we know now I feel our gradual move to locking down from 10th -23rd was about right for this country (obvs just a personal opinion not a fact).
Yes PPE, and I'm sure if this happened again the absolute focus on clearing hospital beds would be accompanied by some kind of staged release of people, via quarantine, back into the community.

It would be interesting to hear some thoughts about the positives of moving gradually through that period, it’s looking catastrophic and is primary amongst the things that have us well placed for the ‘worst of both worlds’, economic harm/most fatalities double.

This is a good indicator of why the conscious decision to move slowly, looks so bad, with a little bit of hindsight:
(I only mention hindsight, because you say that even with hindsight, you think it was the right thing to do)

https://twitter.com/jburnmurdoch/status/1260235465065664514?s=21

"Utility of the "how many regions" measure is it shows whether a country managed to contain its outbreak in one broad area, as Italy & China did.

Bad outbreaks in multiple regions suggest action was taken too late."

That is an interpretation - it is not the only interpretation.

As mentioned in the article Jakally linked to - the virus was circulating for a long time before anybody did anything.

A lot of countries have had much more of a concentration of virus outbreaks than the UK - but I don't tihnk most of them could have been said to have 'managed' the outbreak to do this. China is the only country to have actively managed it to any significant effect - every other country has just got lucky/unlucky in how the epidemic spread in their country (unlucky would be because a strongly concentrated outbreak is harder for a health service to cope with).

[kukushkin88]

This is a long read (about 40 pages) but does a good job of pulling together all the pieces of the UK decision making up to lockdown.
The tone is balanced & non-hysterical - obviously that will deter some.

https://www.iiss.org/blogs/survival-blog/2020/05/the-uk-and-covid-19

Morning

It is a good piece and looks to be impeccably researched, no surprises in it for anyone who has been following events closely but it is a valuable account of what’s happened to this point all the same. As he rightly points out, having a regularly updated contemporaneous log of events will be valuable for the inquiry. Actions should only be critically judged on what was known at the time, not what is known/obvious with hindsight.

It's very good. And it is packed full of information, there's very little rhetoric at all - if anyone wants to read it you should put time aside for it because it's really not suitable for skim reading.

I did like the description,

"Known for his optimistic, blustery style and his inattention to detail,
Johnson may have been naturally inclined to accept options that demanded
the minimum rather than the maximum, and so content to be advised to
follow a gradual path of escalation"

... it's good that Johnson's character is so well known that this judgement can probably be taken as objective observation rather than opinion.

From reading that I think there are questions of detail such as PPE provision, but in terms of overall strategy I think the two main pillars of any enquiry should be the time between the 10th March to the 23rd of March and what 'should/could' have been done dfferently then and communication throughout the whole process.

Finally got through it all, thanks for positing it Jakally and Jon, your summary seems about right.

Even with what we know now I feel our gradual move to locking down from 10th -23rd was about right for this country (obvs just a personal opinion not a fact).
Yes PPE, and I'm sure if this happened again the absolute focus on clearing hospital beds would be accompanied by some kind of staged release of people, via quarantine, back into the community.

It would be interesting to hear some thoughts about the positives of moving gradually through that period, it’s looking catastrophic and is primary amongst the things that have us well placed for the ‘worst of both worlds’, economic harm/most fatalities double.

This is a good indicator of why the conscious decision to move slowly, looks so bad, with a little bit of hindsight:
(I only mention hindsight, because you say that even with hindsight, you think it was the right thing to do)

https://twitter.com/jburnmurdoch/status/1260235465065664514?s=21

"Utility of the "how many regions" measure is it shows whether a country managed to contain its outbreak in one broad area, as Italy & China did.

Bad outbreaks in multiple regions suggest action was taken too late."

That is an interpretation - it is not the only interpretation.

As mentioned in the article Jakally linked to - the virus was circulating for a long time before anybody did anything.

A lot of countries have had much more of a concentration of virus outbreaks than the UK - but I don't tihnk most of them could have been said to have 'managed' the outbreak to do this. China is the only country to have actively managed it to any significant effect - every other country has just got lucky/unlucky in how the epidemic spread in their country (unlucky would be because a strongly concentrated outbreak is harder for a health service to cope with).

Agreed that there are other interpretations. I know that people were actively prevented from leaving Lombardy, I will keep an eye out for detail of other similar restrictions.

[Jon MW]

...
Agreed that there are other interpretations. I know that people were actively prevented from leaving Lombardy, I will keep an eye out for detail of other similar restrictions.

That was from the 8th of March - the national lockdown was from the 11th March.

I'd say it's a stretch to say any restrictions in that time period would account for why Lombardy had 50% of the Italian transmissions compared to London only getting 20% of ours.

(Lombardy contains about the same proportion of Italian population as London does of ours - hence direct comparison).

[Jon MW]

To illustrate (assuming the wikipedia references are reliable)

"..The Lombardy outbreak came to light when a 38-year-old Italian tested positive in Codogno, a comune in the province of Lodi. On 14 February, he felt unwell and went to see a doctor in Castiglione d'Adda. He was prescribed treatments for influenza.[35] On 16 February, as the man's condition worsened, he went to Codogno Hospital, reporting respiratory problems.[35] Initially there was no suspicion of COVID-19, so no additional precautionary measures were taken, and the virus was able to infect other patients and health workers.[36] On 19 February, the wife of the patient revealed he had met an Italian friend who had returned from China on 21 January, who subsequently tested negative.[35] Later, the patient, his pregnant wife and a friend tested positive.[35] On 20 February, three more cases were confirmed after the patients reported symptoms of pneumonia.[37] Thereafter, extensive screenings and checks were performed on everyone that had possibly been in contact with or near the infected subjects.[38] It was subsequently reported that the origin of these cases had a possible connection to the first European local transmission that occurred in Munich, Germany, on 19 January 2020.[39] Doctors in Codogno stated that the 38-year-old patient led an active social life in the weeks before his illness and potentially interacted with dozens of people before spreading the virus at their Hospital.[35][36] Afterward, he was transferred to Policlinico San Matteo in Pavia,[40] and his wife to Sacco Hospital in Milan.[41][42]

On 21 February 16 more cases were confirmed – 14 in Lombardy, including the doctor who prescribed treatments to the 38-year-old Codogno man..."

The end of that extract is important. I think it's far safer to say most, if not all, places with regionally concentrated outbreaks are unlucky - not lucky, and definitely not managed.

Places like Italy had increasing restrictions on regional areas - because they had regionally concentrated outbreaks.
They did not have regionally concentrated outbreaks - because of their restrictions.

[Doobs]

https://mobile.twitter.com/_MiguelHernan/status/1260625031119409156

In Spain, they think 5% of the population has been exposed to the virus and only 11% in Madrid.

If we have 60,000 deaths already and assume we are like Spain (ie only 5% of the population have antibodies), then that would mean the Imperial model is more likely to have understated the potential deaths rather than understated.

Really quite grim if true, though not very surprising for the people properly following this.

Disclaimer.  This is only preliminary, and the tests might not be completely accurate.  As I understand they were tested twice.