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Ask HN: Is UK government insane or genius?

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Re: Ask HN: Is UK government insane or genius?

#261
post #223

Earlier quoted context omitted.

I'm going to go with the guy who was awarded an OBE for his work in infectious disease control: https://www.lshtm.ac.uk/newsevents/news/2016/leading_infecti...

OBE is a political honour, not a scientific one.

I'm not sure following honors/awards is always the safest path, but your answer doesn't make sense to me at all: he was awarded for infectious disease control "particularly the Ebola crisis response in West Africa", which sounds to me like valuable experience, and solid ground to claim some knowledge.

Re: Ask HN: Is UK government insane or genius?

#262
The UK approach is highly interesting. It's assuming that a government telling people to social distance themselves is highly effective. You then direct the elderly to social distance themselves; they are mostly protected from the virus; it runs rampant through the general population; and after a two months of relatively mild, mass cases among the young, you've effectively built a herd immunity firewall around the elderly.

Three possible issues:

1) Telling people to social distance themselves has a weak effect, not a strong one. In that case, the fire burns through the young population and burns through the old population, and you end up with a pile of flaming corpses.

2) I don't know if herd immunity of the young population is enough, epidemiologically, to give herd immunity to an older population. Old people can pass it to each other, and their day to day interactions are disproportionally among the elderly. So you risk an older subgraph all catching it at once still. I don't think this is a big risk compared to 1).

3) Individuals don't develop an immunity. This would be disastrous for this strategy. Then again, it's disastrous for all strategies.

The first issue seems like the biggest issue to me, and I think it's pretty damning. If that's the case, the elderly never have the protection of herd immunity, and you're not flattening the curve but sharpening it.

Another possibility: the government knows it won't work to seriously change the number of deaths, but it also believes all measures possible in Western countries are likely to fail. In that case, you immolate the elderly population as fast as possible and then get used to a new norm instead of spending months in a futile battle. Essentially, it's possible that even with heroic efforts that the curve can only be flattened a bit, so it's just a matter of timing the deaths and how long you want to be enduring terrible economic damage. And if every other country suffers pretty much as much as you do, political impact is limited.

Re: Ask HN: Is UK government insane or genius?

#263

Earlier quoted context omitted.

Exactly. We have huge debts and our "economy" runs on the assumption that, if very little goes wrong, we might be able to stay afloat. The time for creating choice on the cornonavirus response was during the last 20 years. They chose rampant financialisation, leveraging future income. The UK has no energy security. No food security. I feel the corner we have painted ourselves into makes a prolonged shutdown far, far…

Genuinely curious about where you read that the UK has no energy security? It's not something I've read about before, but is something I'm pretty invested in as a UK citizen. The one source I could find was https://www.globalenergyinstitute.org/energy-security-risk-i... which placed the UK in the top 3 countries for energy security (many years running). Do let me know if you have some data that would change my mind!…

I mean to say we are a net importer of energy

https://www.theguardian.com/money/2019/sep/01/uk-energy-pric...

And food

https://www.businessinsider.com/no-deal-brexit-percentage-br...

Re: Ask HN: Is UK government insane or genius?

#264

Here is a discussion on Channel 4 on the approach taken by the UK government. https://youtu.be/C98FmoZVbjs?t=590 Debating are: - John Edmunds: a professor in the Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine - Tomas Pueyo: his modelling of the pandemic has gone viral on the web: https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop... During the debate,…

A more cynical question: can a PM win the next elections or politically survive the next weeks if a lot of people die and he just shrugged his shoulders, when the rest of the world did their best to keep people alive, successfully or not? I bet he'll have to change course pretty soon.

Yes, if the Tory press back them up. Brexit has shown that the narrative can be spun in their favor.

Re: Ask HN: Is UK government insane or genius?

#265
post #230
post #42

Earlier quoted context omitted.

I think herd immunity is an integral part of the strategy. If a population never gets herd immunity, it will keep on getting infection breakouts and keep on having to impose lockdowns. The only way to stop doing lockdowns is either to prevent the ingress of the virus, ever, or eventually reach herd immunity. The virus is everywhere now, it’s part of the landscape, so preventing breakouts is just flat out not possible…

> so preventing breakouts is just flat out not possible Why not?

Because it isn’t possible to screen every single person entering a country like the UK, which means it is inevitable the virus will get in again and you’ll have another outbreak.

However that’s assuming you can eradicate it. That might be possible in an isolated population centre like Singapore, but the UK has an extensive rural area where the virus can hide out, slowly propagating through many different sparse populations until it gets back into an urban centre. It can survive outside the body on some surfaces for 9 days according to recent studies so it can infect someone who has light symptoms, they put it on a new surface, then when they recover up to 9 days later it can up again in someone else. This can go on for months. You might track down some of these smouldering brush fires, but not all. That’s how flu keeps coming back every winter.

Re: Ask HN: Is UK government insane or genius?

#266
"In practice, people won't be disciplined about isolating vulnerable ones in the first phase, thus leading to disaster."

That is the point. One can catch the virus, become asymptomatic then continue to live normally and become even more dangerous to anyone in vicinity ("hug me, I'm safe!"). Eventually most of us will be infected anyway, and some will recover becoming immune (hopefully; this is far from guaranteed), so the correct line of action IMO would be to isolate everyone from everyone to gain time and resources. Nothing would stop them later from making people immune through controlled infection (aka vaccination) when the crisis is over.

To me they don't have a clue and just chose the only option that might paint them as still in control.

Re: Ask HN: Is UK government insane or genius?

#267
The UK government is criminally insane to the point that they should be locked up and shot.

For every person who would die in the normal course of the disease, around 3 more needed hospitalization. The Wuhan experience showed that when hospitals are overwhelmed and cannot put them on ventilators, the fatality rate roughly doubles.

The UK course of action is guaranteed to overwhelm local hospitals. At which point even if half the vulnerable population does not get sick, you have as many fatalities in that group as you would have if the rate of spread was reduced.

Worse yet, it is currently unnecessary. Both China and South Korea have demonstrate that aggressive containment and quarantine efforts can result in exponential declines in the disease. As a result we should not yet be giving up hope that the disease can be contained, avoiding mass casualties. And even if we did want to take the UK approach, you could always switch to it after you had demonstrated that you can't contain the disease.

Re: Ask HN: Is UK government insane or genius?

#268
post #250

Earlier quoted context omitted.

But where is South Korea going with its strategy - are they going to keep doing that forever? And whats China's long term strategy? Wuhan is still locked down.

Wuhan had the great majority of cases in the entire world. The other provinces of China are more analogous to individual European countries. They locked down for a few weeks and have already come back up. The long term strategies for Korea and China are the same: carefully identify new cases as they come in from outside, find their contacts, and isolate them as soon as possible. Temporarily lock down small regions on…

> Wuhan had the great majority of cases in the entire world.

That was true a day or two ago, but that's a bit outdated now: Wuhan at most has had a bare majority of total cases in the world now, and probably a minority. In any event, it'll be a minority in a few hours.

Re: Ask HN: Is UK government insane or genius?

#269
post #101

Earlier quoted context omitted.

What exactly is the risk of needing hospitalisation if you are young? Does anybody know?

It's too early to say with reliable data. We will definitely know in 2-3 weeks with data from many European countries. In Italy, it looks like the percentage of younger hospitalised people is 12%, but growing. https://www.independent.co.uk/news/world/europe/coronavirus-...

That is not 12% of cases. That is 12% of hospitalizations are under the age for 50.

The overall hospitalization rate is difficult to know, due to the huge inaccuracies in the case numbers.

Re: Ask HN: Is UK government insane or genius?

#270

It looks like to me just a comfort pill for the public. They basically acknowledged that they can't handle the crisis already. So what they gonna do? They want it to appear to be an advice from expert, to persuade the public, rationalize a forced decision. The uncomfortable truth is, the British government have weighted cost and benefit, and they have decided, the death of thousands or more is not worth the cost of n…

> It looks like to me just a comfort pill for the public. They basically acknowledged that they can't handle the crisis already. So what they gonna do?

Well, they could do what every other developed country is doing: implement social distancing measures. Social distancing can't stop the spread of the virus, but it can slow the spread down.

People seem to have an impression that the case fatality rate (CFR) has some fixed value somewhere between 0.1% and 4%, and that the CFR is set in stone; but obviously there are many confounding factors, such as access to ventilators. If a sizable portion of the UK population contracts the virus all at once, the NHS will be overwhelmed and many otherwise preventable deaths will occur (see the graph near the end of this BBC article [1]). In contrast, social distancing would "flatten the curve", reducing the burden on the NHS (eg, see this interactive Washington Post article [2]).

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[1] https://www.bbc.com/news/explainers-51632801

[2] https://www.washingtonpost.com/graphics/2020/world/corona-si...

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