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London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

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Re: London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

#311

Post by spion »

alimw wrote: post #241
oxfordmale wrote: post #197

Looking at COVID models, the hospital admission peak is around the 10th of January UK wide. Cases have already started to level in London. Lockdown has been implemented too late to make any significant difference to that. 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...

> Cases have already started to level in London. Lockdown has been implemented too late to make any significant difference to that. 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 usuall…

Adding android mobility trends % increase in stay at home is more illuminating. Qute a large percentage of the people that can afford to "lock down" already do: https://imgur.com/jPctkws (thats London) but lockdowns do add another layer to that.

Re: London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

#312

Post by jlokier »

Aeolun wrote: post #223
ldrndll wrote: post #166

Earlier quoted context omitted.

Care to cite any stats supporting your assertion that a maximum of 2% of the population would die? During periods where the healthcare system has been overloaded the mortality rates have been many multiples of that during times when healthcare is provided at an appropriate level. What’s more, do you have any reasonable figures to suggest why letting a percentage or more of the population die unnecessarily, consigning…

> What’s more, do you have any reasonable figures to suggest why letting a percentage or more of the population die unnecessarily, consigning even larger numbers to long-term health problems and so forth is somehow a good choice? If I squint my eyes a bit. Reduce the burden on the pension system?

If I squint my eyes, I don't think it would even reduce the burden on the state pension system when you take into account the benefit system it is part of.

Long-term disabled or ill people who are unable to work will effectively take early retirement (in some cases they can draw on their actual pension early too), and depend on state support from then on whether it's called pension or something else. The duration of payouts will be longer than for ordinary retirement age.

It's not just miserable for those survivors, it's expensive for the state.

Long-term health problems are also likely to cost more in healthcare later.

Re: London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

#313

Post by liquorice »

patrec wrote: post #141
polote wrote: post #94

Earlier quoted context omitted.

Well then why do some people think it is idiotic?

Speaking only for myself, I think your opinion is idiotic based on some simple back of the envelope math I did many months ago (when the UK announced its herd immunity plan), relating to hospital capacity, likely peak case numbers, proportion of cases that would need hospital treatment or die and some simple minded guesses about knock-on effects for the rest of the health system. I have not bothered to redo these cal…

I think the conclusion of a death toll estimation exercise may shift if you adjust for expected remaining lifetime.

In Scotland, the mean COVID death age was higher than the average lifetime expectancy[1], which indicates that on average those people would probably live There have been a significant amount of excess deaths that are not attributable to COVID [2]. I suspect that such deaths have a lower average age (e.g. due to suicides), than COVID deaths, further reducing the average life years saved due to the lockdowns.

I'm not proposing that we should optimise for life years saved, but I do think that the death of a 86 year old is less tragic than that of a 38 year old, and that we perhaps shouldn't evaluate lockdown vs no lockdown purely based on the percentage of the population which died.

[1] https://www.bbc.com/news/uk-scotland-54433305 [2] https://www.newswise.com/factcheck/are-a-third-of-the-excess...

Re: London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

#314

Post by postalrat »

lolc wrote: post #306
postalrat wrote: post #270

Earlier quoted context omitted.

Nothing in nature grows exponentially. If it did it would overwhelm the universe. 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.

We are right now observing exponential spread of a virus. And we don't want to hit the natural end of exponential spread for this virus.

I've been hearing that for months. If coronavirus had a doubling time of 7 days we should be well over 1,000,000,000,000,000 cases by now.

And you or nobody else knows what the natural end would be for this virus.

A fast spreading variant could overall reduce deaths over the next 5 years.

Re: London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

#315

Post by d1zzy »

core-questions wrote: post #176
IkmoIkmo wrote: post #55

Earlier quoted context omitted.

Can't believe after 12 months this argument is still being made. 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…

My point is more like, 10x the number of people could be dying of COVID per day than are dying right now, and I would care about 10x more than I care about all those people who are dying of heart disease, which would still be an indescribably small amount of care, even with the multiplier. I am not making the argument that it's "just a flu", but I will make the argument that it's "just death". Death is. Only a shelte…

The problem with airborne infectious diseases is that in order to protect that "minority" that has a high risk of death you have to ensure the spread doesn't use the "majority" that doesn't have the high risk to reach the high risk people. You do that by limiting contact between people, social distancing, wearing masks, etc. The end game here for the high risk individuals is to buy enough time for us to vaccinate a large enough amount of the population so that then there's no need for a lockdown as the virus just can't spread in a largely immune population.

But lockdown and the other measures aren't just meant to protect the high risk individuals. We still don't understand how the virus affects many lower risk individuals long term because it's a very new virus. Strictly looking at the "death rate" may make us miss that significantly large portions of recovered individuals (from the lower death risk segment) develop long term health issues that may significantly reduce their lifetime expectation.

And yet another reason for lockdown and the other measures is to keep the health system afloat for the other, much higher death risk, health conditions. If our entire ICU capacity is occupied with COVID patients we won't be able to offer the same quality treatment to much higher risk situations like in emergencies (accidents of every kind) not to mention the COVID death rate itself may spike a lot higher if we can't provide the same quality of health care that we've been able to so far.

Re: London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

#316

Post by jlokier »

PaulDavisThe1st wrote: post #208
polote wrote: post #151

Earlier quoted context omitted.

if we let the virus lives its life, maximum 2% of pop will die, 90 more % will live normally and a few percent will have covid related health issues. so we sacrifice a few percent of population for the future of the others

Congratulations on totally missing the point. [ EDIT: the number I originally used for "requiring hospitalization" were way off. I've edited to reflect data from September provided by the CDC. The 20% -> ICU figure comes from the NYC experience in May, but seems roughly correct from other global hotspots ] Roughly 0.4% of those who catch COVID19 will require hospitalization. Of those, 20% will require ICU treatment.…

> In the end, the entire human race will be exposed to SARS-COV-2.

This statement is false.

(With regard to any reasonable definition of exposure to the current virulent strains and assuming the vaccines do their job.)

One major purpose of the vaccines is to cause R not be exposed to the virus ever in their lives. The other major purpose is for those humans who are exposed to it, to significantly reduce the chance of the virus causing harm.

Like putting out a fire before it spreads everywhere. Some things are burned but not everything is even touched by the flame, if it's put out.

Re: London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

#317

Post by d1zzy »

core-questions wrote: post #26
mike00632 wrote: post #13

3478 people died from COVID in the US yesterday. https://covidtracking.com/data/charts/us-daily-deaths

~1700 people per day die of heart disease in America and have done so for decades. I think we should shut down the economy until we can get everyone's heart healthy.

If heart disease was an airborne infectious diseases for which we have vaccines already being deployed, then by all means let's shutdown everything! (since the death rate like you pointed out is even bigger there)

Re: London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

#318

Post by Hongwei »

mikepurvis wrote: post #32
jiggawatts wrote: post #9

If a mutant strain of COVID-19 becomes twice as deadly, this "merely" doubles the pressure on hospitals. A constant factor like this can be dealt with. 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 imposs…

I agree, but I think there is now a non-trivial group who are either a) in total denial about the virus or believe it's a conspiracy, b) overwhelmed by news of it and unable/unwilling to process anything new, or c) believe in herd immunity and might even welcome a faster spread on that basis. Arguments about exponentials mean nothing to anyone in any of these buckets— they'll be flaunting a lockdown up until and perh…

I don't know. I would say I'm d) believe that the West cannot and should not enforce a lockdown the same way authoritarian China or Singapore can, and therefore it is doomed to fail.

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.

Re: London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

#319

Post by PaulDavisThe1st »

jlokier wrote: post #316
PaulDavisThe1st wrote: post #208

Earlier quoted context omitted.

Congratulations on totally missing the point. [ EDIT: the number I originally used for "requiring hospitalization" were way off. I've edited to reflect data from September provided by the CDC. The 20% -> ICU figure comes from the NYC experience in May, but seems roughly correct from other global hotspots ] Roughly 0.4% of those who catch COVID19 will require hospitalization. Of those, 20% will require ICU treatment.…

> In the end, the entire human race will be exposed to SARS-COV-2. This statement is false. (With regard to any reasonable definition of exposure to the current virulent strains and assuming the vaccines do their job.) One major purpose of the vaccines is to cause R not be exposed to the virus ever in their lives. The other major purpose is for those humans who are exposed to it, to significantly reduce the chance of…

The epidemiology I saw near the beginning of the pandemic was fairly clear that even when R0 drops substantially below 1, the virus will be endemic to human existence.

Sure, it's certainly up for debate (and the future) whether or not the rate will drop low enough that most humans escape exposure. That will depend on more than just R0 - we still don't know if the vaccines (any of them) prevent transference, and the emergence of new variants with higher R0 values but identical infection mechanisms (which most people would agree is the same virus) may also complicate this quite a bit.

So sure, maybe I should have dialed it back to "it's entirely possible that the entire human race will be exposed to SARS-COV-2, though if we are lucky that probably won't happen".

I don't think that changes my fundamental point that the crisis for a pandemic like this is not in personal health - "Am I going to die?" - but in the public health - "can my society's health care systems still function?"

Re: London will be overwhelmed by Covid in a fortnight says leaked NHS briefing

#320

Post by xienze »

jtbayly wrote: post #255
asdff wrote: post #240

Earlier quoted context omitted.

Most of them are far closer than I would be comfortable without a mask outside. I only take mine off when there is no one around for like 25 yards, because you never know when someone will cross paths with you and end up very much in your personal space. 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…

25 yards? Outside? Humans really are bad at evaluating risk, I guess.

But packing tens of thousands of people elbow to elbow outside while wearing a mask is perfectly fine.
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