> HSJ understands that the briefing was part of an attempt to get senior clinical leaders to focus on what they would have to do, if current growth trends were not surpressed by the tighter lockdown.
So, er, what if the growth trends are suppressed by the tighter lockdown, as seems likely? Will things then be better than the "best" case scenario?
It sounds like there's a bit of misreporting going on here. The leaked document forecasts demand based on pre-lockdown trends, to highlight the significant risks. But the article is reporting it as if running of beds is totally guaranteed in all circumstances, which doesn't appear to be the case, if the lockdown works.
The only meaningful change in the past couple of days is the "takeaway pint" ban (which is unlikely to make any difference and is purely symbolic).
There's two lag factors to consider. The first is the lag between restrictions and cases dropping, this takes a couple of weeks and cases and the growth isn't likely to even slow for 1 week. The second is the lag between infections and people getting seriously sick and needing hospitalization, that takes 3-4 weeks. There's also the serious possibility that the restrictions arn't strict enough to make a big difference.
This scenario is basically baked in, avoiding it required action weeks earlier.
Plenty of people outside. In fact, I would call it lightly crowded, although less than other years. Many people don’t wear masks. It’s not a surprise that transmission has increased.
Nevertheless, London looked absolutely beautiful. Not sure if this was worth the risks though.
You can be sure if people are this lax in a busy commercial district in public, they are just as lax when they gather with their friends and family in private, which is where the bulk of the spread happens. I wonder how many are gathering to watch football matches with booze and friends.
But yes: people gathering, indoors, largely with recirculated air.
Not the most reliable source, but confirmed by other sources which are unfortunately behind a paywall.
https://www.dailymail.co.uk/news/article-9115357/amp/Coronav...
This is a common claim and I have seen it made about various periods of lockdown in various countries. "Look, rate of increase started to slow within a week of lockdown, but it should take two weeks to see the effect, so it can't be that lockdown has made any difference." There is usually far too much noise in the figures to make such a claim about small differences in time scale. Also if you were expecting a sudden drop after two weeks then you were bound to be disappointed. The amount of time it takes for an infection to become a recorded case of Covid will be random according to some distribution (possibly with a mean of one or two weeks) so the transition will be smooth.
* coronavirus is invented as a government power grab
* the government locking down is a deliberate ploy to kill small businesses
* the government should just let this run its course, it’s Just A Flu TM
* hospitals are actually empty (the “proof” being people recording empty waiting rooms in outpatient departments on bank holiday weekends)
* coronavirus doesn’t exist (!)
Maybe this will be a bit of a wakeup call.
Just like the US government banned (discouraged?) pictures of caskets coming back from war.
These images need to be on the news and on news websites 24/7.
Unfortunately in this context, it is illegal to film people in a hospital. I think that's a fair rule but I really would like to have a few videos floating around with no voiceover and no commentary just to scare the shit out of people. I think it would work.
https://theintercept.com/2020/12/27/covid-photography-hospit...
But when this happened in Italy, a large number of the conspiracy crowd just said the photos were faked.
And there are many theories to explain, for example NY morgues may have been overflowing because morgue owners were afraid to accept people who died from Covid.
Is there actual evidence that people died because they couldn't receive care? Even in Italy I have not seen the evidence, just YouTube videos of some alleged doctors making such claims.
Serious question. I would love to see evidence of people dying because they couldn't receive care (in the Western world).
Isn't it just an opinion? I personally think that way. Why wouldn't I be allowed to think that?
I mean, the evidence is pretty clear by now isn't it?
Countries that responded to the pandemic with swift strong action, especially restrictions on movement, have had the best outcomes for both health and the economy.
Countries that tried to protect the economy / their nation's finances by enacting watered down measures have fared very much worse.
It's interesting to me how far views in different places have diverged on where the balance point is for this. Australia's recently been having a debate about whether or not 20 cases a day is enough to justify a full lockdown of a city (the NSW premier decided no) and border closures (most states decided yes). Meanwhile, in the UK...
Our hospitals would be overwhelmed, the morality rate would skyrocket amongst COVID and non-COVID patients alike.
I’m not sure I see what kind of upside they see for anyone if this happens, much less the government.
With the masses sedate at their screens, the bureaucracy has no cognitive experience or expectations for anything different.
Decades of headlines being fed to Main Street going on about growing inequality did not really motivate Main Street to do much but shuffle back into the office.
Relativity pervades all experience. Reading about history in books is not exactly experiencing history.
Not saying they don't fit the definition... but maybe the reaction doesn't actually help.
It doesn't help, however, when activist NHS nurses lie on (and abetted by) national media; imagining bed occupancy and oxygen supply levels out of thin air, implying the mutant strain is more virulent among children etc. causing panic, confusion, and supplying fuel to the very people you're trying to lampoon.
There was a good piece in the private eye a few years ago listing headlines saying the NHS is doomed tomorrow going back to before Blair.
Winter pressure this year, no matter how you count it, is considerably worse than it has been in the past.
I don't necessarily think the government is doing it on purpose and colluding with big businesses that are profiting from the situation, I think it's more likely that politicians are just incompetent (they need to save face with people who are pro and against a lockdown) and that big companies are better positioned and can push the government a bit to get what they want. As usual.
If you fear for you life isolate yourself. If you can't afford to isolate ask for charitable donations (even if the more preferred approach has been to just give taxpayers money, taken with force from everyone).
I isolated myself and my family 2 weeks before the government forced a lockdown on us, because there was no data and I was scared of the mortality rate. After seeing the mortality rate and the age range, I stopped caring but I started keeping a distance from old people. I still led a pretty isolated life for personal reasons - and wore my mask to avoid fines and to respect my social contract with society, which took this decision against my will.
I'm genuinely curious to see if the doomsday is going to arrive or not in 2-4 weeks time.
If it does, I hope it will crash the economy and that I'll make a profit or that house prices will go down (assuming I don't die, given my kids go to nursery and are probably spreading all kind of viruses).
If it doesn't, your argument won't look very good and you'll regret calling idiots those with a different opinion. And I guess there is still a chance of an economy crash, given the lockdown.
Maybe this will be a bit of a wakeup call.
https://www.england.nhs.uk/statistics/statistical-work-areas...
If you do decide to promote this talking point anyway, flag it with the appropriate disclaimer from the NHS:
…caution should be exercised in comparing overall occupancy rates between this year and previous years. In general hospitals will experience capacity pressures at lower overall occupancy rates than would previously have been the case.
https://www.england.nhs.uk/statistics/statistical-work-areas...
I'm sorry that I briefly lowered the tone by linking to data, thanks for your help.
Why?
1033 open adult critical care beds; 882 in use. 85% utilisation.
Best-case forecast Jan 2021:
2078 critical care beds required, 1,661 available (increase of ~600). Forecasted 125% utilistation.
The columns in the spreadsheet are "Sum of Number of adult critical care beds open" and "Sum of Number of adult critical care beds occupied".
LONDON COMMISSIONING REGION
Adult Critical Care Beds:
Open: 1033
Occupied: 882
--------------
Total: 1915
BEST CASE
Adult Critical Care Beds:
Unmitigated: 1392
Mitigated: 1661
https://www.england.nhs.uk/statistics/statistical-work-areas...
Even if they were used in the first wave it was in the expectation that any hospitals sending patients there would also send staff to look after them, which was never realistic.
You can hire a hall and stick a bed in it, but if there’s no one to look after the sick person in it they don’t have much of a chance.
You can't build a hospital like that in a week, and there are no staff.
For a large metro area like London, you might have some hospitals at high utilization because they're very close to other ICUs and can redirect incoming patients. It's not supposed to be at high utilization regionally, otherwise a single minor disaster can cause the system to tailspin.
Dunno why you're downing me but... The data is all here https://www.england.nhs.uk/statistics/statistical-work-areas...
This is a consequence of loosening the lockdown for Christmas.
And it is also ideal delay from Christmas to Dec 31st for most of the people that got infected over Christmas to start spreading the virus but not yet show symptoms.
1: https://nypost.com/2020/12/20/londons-covid-19-christmas-loc...
EDIT: It's weird that people don't believe me. Here is a BBC article talking about the Tier 4 lockdown that occurred right before Christmas:
https://www.bbc.co.uk/news/uk-england-london-55380644
From the article:
"Millions of people across England have been banned from meeting friends and family indoors over the festive season as they enter a new tier-four level of Covid restrictions, while indoor mixing has been restricted to Christmas Day alone for the rest of the country."
Perhaps someone in the comments could show me evidence that London was "loosening the lockdown for Christmas"?
Also I live in London (and did during Christmas, where I cancelled my plans because of said lockdown), and am British.
Source: am British also (and stayed home and saw no one at all over Christmas and new year, just sayin)
https://www.gov.uk/government/speeches/prime-ministers-state...
The last minute changes are confusing to all of us. You can help by not citing anti-sources like the NY Post.
In real world it is not the restrictions that save lives, it is people following them. If people ignore restrictions it doesn't matter whether they were or were not tightened.
Actually, if people were sane we would not need restrictions. Everybody would wash their hands, avoid touching their face, wear their mask properly (ie. not faking wearing the mask) and avoid physical contact with other people unless necessary. And all research suggests that would be enough to deal with the virus.
The fact is that Christmas in almost every country resulted in mass movement of people that just have to go and meet their families. And it doesn't matter for what reason it happened, it is just a fact.
So, regardless of whether there were or were not tightened restrictions, there is going to be an inevitable increase in cases.
I found it quite strange, since if you were staying at home and had zero symptoms, why would they need a test? However, somebody let slip that they were getting tested in order to get confidence travelling home to visit their family... Therefore, while people were locked-down, I think many worked around this.
You’re inadvertently doing the London thing that Londoners do where you conflate a comment about the whole country to just be about London. London may have had increased restrictions (which I doubt had the level of observance they should have but hey ho) but the rest of the country didn’t. The parent comment didn’t specify London, they were talking generally and, generally, restrictions were loosened for Christmas.
How much of that is the new strain, how much is Christmas, and how much is government decisions (reopening universities, encouraging office workers to work in person, allowing foreign holidays, announcing an end date for the second lockdown before it had even started...) is hard to say.
This is a crying shame.
huh? There were lots of reports about ambulance queues last week already
https://www.bbc.co.uk/news/av/health-42570660
https://www.itv.com/news/london/2020-12-30/ambulances-with-c...
Covid rates have consistently grown at the lowest rate considered likely.
Never, infections have always been a foucs of tracking because infections lead hospitalizations lead deaths (and hospitalizations have second-order impacts on mortality from other causes when they reach a critical level, even beyond direct COVID deaths.)
If you only focus on deaths, you are weeks behind the curve in reacting.
I guess, death numbers weren't growing as expected.
It's a bit like climate warming temperature predictions.
I appreciate it's hard to do forecasts but the media doesn't help selling actual problems to the public by constantly twisting the narrative.
From a non-medical, "just following the news" perspective, there was a pronounced shift. A few simple google news search will show this.
Infections happen earlier than hospitalizations and deaths but the count depends on people getting tested.
Sources:
[1]https://www.bbc.com/news/uk-england-london-52312653
[2]https://www.bbc.com/news/explainers-55056375
Edit: Downvoted? It's not even my opinion. It's facts. Damn.
Or do you think that's not the reason? Timing-wise it matches pretty well.
I've never understood why politicians are allowed to have such blatant conflicts of interest, but they get to write the rules, not us...
However, an increased rate of spread (R factor) is a change in the parameter of the exponential curve, and cannot be dealt with by any sub-exponential response. The only thing that could possibly work is to change the factor. Rapid vaccination or lockdown. It's impossible to vaccinate the population of London in two weeks, which means a full lockdown is the only option now.
YC News is mostly a forum for software developers, which means that these notions ought to be familiar to most people here. When talking about software algorithms, we all learned about big-O notation. We all learned that Exponential time algorithms are (nearly) the worst case, and will always be worse for large data sets than a linear-time or quadratic algorithm, irrespective of the constant factor.
Essentially the new mutant strain changes the "R" term in Θ(a×exp(R×𝑡)), whereas increasing the lethality is a change in the "a" term.
People are concerned about the lethality getting worse, but they shouldn't be. This change in the infection rate is more scary.
Arguments about exponentials mean nothing to anyone in any of these buckets— they'll be flaunting a lockdown up until and perhaps beyond the point where it is administered by force.
I don't know how to deal with this reality, but it feels like the greatest threat at this point.
So: * lockdowns are guaranteed not going to eradicate the virus the way it has in China. * lockdowns are guaranteed to crush small businesses and restaurants, creating an L-shaped economic recovery and putting the West at a disadvantage in future geopolitical conflicts. * the vaccine works but will take a year to rollout to everyone and it is unimaginable that the public will tolerate a lockdown for more than a month * herd immunity might work
I truly welcome any debate on this as I'd love to be wrong about my critique of my country's (Canada) approach to all this. We seem to be not having our cake and not eating it too.
Extremely good coordination with vaccine invention, extremely bad with all other aspects.
Humanity is irrational, most people believe crazy, inconsistent things, and are easily manipulated.
The average citizen is stupid, the government is vulnerable to sentiment from the average citizen (and partisan media orgs that seek to influence those citizens for their own power or money).
It's a bad situation.
It's basically like Asimov said, "The saddest aspect of life right now is that science gathers knowledge faster than society gathers wisdom."
I think you mean infectivity (relating to transmission), not virulence.
They should. Lockdowns deal with the exponential phase, but in the long term the process is not exponential. The virus is probably going to infect half of population anyway. There simply aren't ten times more people it could infect. On the other hand, there are ten times more people it could kill or cripple.
Even with this faster spreading strain, it's possible that the vaccination efforts will win out and halt the spread before it reaches 50% of the population.
YC News is mostly a forum for software developers, which means most of us have a tendency to want to keep things simple. That's fine for simple thinks like operating systems or proving all problems in NP are also in P. But nature is on a completely different level.
Yes we can assume there is selection pressure for more benign strains. But that doesn't mean those strains will win.
"It's to keep the roads ice free." he said.
'But dad, there's never ice one the roads here!', I responded.
To which my dad says: "mhh, I guess we might as well stop with the salt then."
----
Just because the mayhem in Germany was prevented doesn't mean it wouldn't have happened if no measures were taken. I live in the Netherlands, and we just went into full lockdown again because we're running out of hospital capacity.
Some cancer treatments and other non-Covid care have already been postponed / cancelled. Believe me when I tell you your politicians are right; it would be mayhem if nothing was done.
The sister of one of my best friends works in ICU in Belgium. Recently with the 2nd peak, they had to pick between 2 patients because they were overwelmed in some timeframe. They let one patient die to save the other.
Don't expect these things to reach the news. In the news we always stayed well below our max capacity.
But it's not because you have 1000 free beds that you can handle 1000 patients on average, because things peak in regions and time.
We should play close attention from afar so we can learn.
I've been working as a volunteer nursing assistant in hospital A&E departments through St John Ambulance it's honestly just insane. I don't know what the plan is for Nightingale but we're focusing on getting mass vaccination centres setup currently and delivering the vaccines.
For example I don't know anyone who arrived from abroad being checked if they are self isolating at home as they declared.
So closing schools and universities reduces R values by 38% (16%-54%) per your excellent link. England R value is about 1.3 at last count.
1.3*(1-38%) = 0.806
So hopefully that's enough.
I'm a cynic and pessimistic so I worry that:
London is likely higher (more workers, denser, people use public transport).
Keeping nurseries open and some pupils in schools will reduce the 38%.
The spike from christmas/new year will ruin things.
I guess the optimist would say:
1.3m people vaccinated (especially in high risk groups) means the hospitalisation rate should go down.
It would have probably made a difference if it was done earlier.
Kid: Dad, what's Fortnite?
Me: Fourteen days
Kid: What? That makes no sense
Me: It's an old word that means two weeks
Kid: Okay I want to play it
Me: What? That makes no sense
Kid: I want to play it, what does it mean?
Me: It means two weeks. What do you mean you want to play it?
Kid: I want to play it. What does it mean?
etc, etc. Weird drive home until I went online.
Fortunately isn’t not contagious and so the solutions to that issue can be different from the solutions we apply to Covid.
You say shutting down the economy so casually, as if it has no impact on an infectious disease spreading during a pandemic.
If there hadn't been any shutdown, it would lead to a tenfold increase in infections and an even higher than tenfold increase in death as hospitals will be completely overwhelmed and unable to provide normal healthcare.
But if you think a 20x death rate from the nr 1 cause of death (heart disease), preventable by a lockdown for a few more months as a vaccine is rolled out, is no big deal, then there really is no arguing with you.
Turns out what happens when government does nothing is things are perfectly fine.
127 per 100,000 people in Iowa http://91-divoc.com/pages/covid-visualization/?chart=states&...
Compared to
70 per 100,000 people in California. http://91-divoc.com/pages/covid-visualization/?chart=states-...
hospitalization by state:
342 per million FL
569 per million CA
444 per million PA
442 per million NY
Can anyone point me to similar chart for death per million, by state, over time?