How well is the government handling the pandemic?

[BeElBeeBub]

As an addendum to the posts about "compete recovery rate" I looked up polio, generally regarded as a pretty nasty disease.



Polio has a case fatality amongst adults of about 1 in 1000 (1%) about that of a bad flu.



The kicker with polio isn't it's fatality



It's that 5 in 1000 (0.5%) of victims suffer from life long after effects (paralysis)



Imagine CV19 was "neo Polio", a variant which we had no vaccine and was as infectious as CV19.



Would anyone argue we should just man up and get on with it when 0.5% (350kish) of the population could end up with some form of paralysis?

[BeElBeeBub]

As I said last week, if you've been hospitalised with Covid-19 you will be breathless for many weeks, and quite possibly for several months - my wife is the same and she wasn't even in ICU.



That said, nobody has told her so far that she will have long term / permanent damage and her peak flows seem to be pretty much back where they were.  



Recovery from this illness can be very slow and take a long time, and as stated above, I don't think we know yet whether some of the worst affected will have long term damage.

To be clear, I don't know there will be long term damage or what it will be.



The point is nobody knows and the narrative at the moment (not helped by Johnson pretending he was working when in hospital and pretending to be back to work now) that deter a week or two you'll be back to normal isn't quite right.



Given we don't really know now (and certainly didn't in February) what the "complete recovery rate" is, the gung-ho "herd immunity" approaches are (and were) reckless.



If it turns out that CV19 really is just like the flu then we can let it year through the country later. You can't do the reverse.



Caution should have prevailed.



As for the economy, even if the UK was miraculously unaffected (due to British grit and bulldog spirit or some such twaddle) and could carry on as normal the UK economy would be severely damaged simply by virtue of all the other countries locking down.



Glad your wife is on the mend.

[Javert]

To have a clear picture will take years. It will need each person to have a scan and that won't happen until they turn up at their GP struggling for breath each time they get a cold/cough. They will need inhalers and regular checks and frequent antibiotics. Not a pretty future. I don't suppose they are looking for ongoing damage yet, just enough recovery to get them out of the door. BJ's breathlessness told me more than anything how ill he had been. Ideally he should still be at best off sick or part-time. It takes time to appreciate that better is something he might not feel again.

As I said last week, if you've been hospitalised with Covid-19 you will be breathless for many weeks, and quite possibly for several months - my wife is the same and she wasn't even in ICU.



That said, nobody has told her so far that she will have long term / permanent damage and her peak flows seem to be pretty much back where they were.  



Recovery from this illness can be very slow and take a long time, and as stated above, I don't think we know yet whether some of the worst affected will have long term damage.

[Streetwalker]

To have a clear picture will take years. It will need each person to have a scan and that won't happen until they turn up at their GP struggling for breath each time they get a cold/cough. They will need inhalers and regular checks and frequent antibiotics. Not a pretty future. I don't suppose they are looking for ongoing damage yet, just enough recovery to get them out of the door. BJ's breathlessness told me more than anything how ill he had been. Ideally he should still be at best off sick or part-time. It takes time to appreciate that better is something he might not feel again.

Well that's cheered me up no end after my dose of the virus . I was around the same time as the PM but from reports not as bad but yes still tired and not feeling 100% so he must be feeling like a right bag of manure .



I was delighted that the government managed to get the figures right (never trust a tory) at last with the testing kits if only to shut that self opinionated gobshite Piers Morgan up.  You just know it wont though

[T00ts]

Exactly, we don't yet know the full extent of the damage the disease causes.  Unsurprisingly we have been focused on deaths, which inevitably leads to many arguments over exactly what the rate of infections vs deaths is.



What we need to be focusing on is almost the reverse - what is the complete recovery rate.



What's worse:



a disease that kills 5 in 1000 but the other 995 make a complete recovery with no long term effects



or



a disease that kills 1 in 1000 but only 99 make a full recovery, the remainder (900) suffering long term after effects?



On our current "deaths only" view the first disease is by far the worst (0.5% IFR vs 0.1% IFR, 5x as deadly)  but I would suggest that the second would have a much greater impact on society, especially if the long term effects were anything other than very mild.



at the moment we are assuming the complete recovery rate is the inverse of the death rate i.e. somewhere around 99%



Until we have a reasonable picture of the disease and it's implications trying to "rush it through" to get to "herd immunity" is extremely reckless.

To have a clear picture will take years. It will need each person to have a scan and that won't happen until they turn up at their GP struggling for breath each time they get a cold/cough. They will need inhalers and regular checks and frequent antibiotics. Not a pretty future. I don't suppose they are looking for ongoing damage yet, just enough recovery to get them out of the door. BJ's breathlessness told me more than anything how ill he had been. Ideally he should still be at best off sick or part-time. It takes time to appreciate that better is something he might not feel again.

[BeElBeeBub]

I think that the real question is how much notice is the public taking of the government and will it be forgiven. The pubs are shut and the shops are doing their best to piss off their customers,  but there are more and more people out enjoying the sunshine and Plod seems to be keeping a low profile.



Meanwhile all we are getting from the government, which seems to be confusing priggishness with virtue, is more and more arse numbingly ineffectual dos and don'ts.

what is your perception of the government's handling



to be a bit more nuanced describe it as a split between right/wrong



eg 25% right/75% wrong.



what areas in particular do you think they got it right/wrong?

[BeElBeeBub]

The pictures of  lungs before and after tell a story. Damage to the air sacs in the lungs will not repair. This tells me that many will carry lung damage for the rest of their lives. This can only get worse and will be a burden to the NHS for decades. Even those who have not required oxygen and hospital care may well find that they are not as fit afterwards. There is a lot to consider before we burst forth into the world as if nothing has happened and at present there is possibly far more than we are being told, all for the sake of reducing panic.

Exactly, we don't yet know the full extent of the damage the disease causes.  Unsurprisingly we have been focused on deaths, which inevitably leads to many arguments over exactly what the rate of infections vs deaths is.



What we need to be focusing on is almost the reverse - what is the complete recovery rate.



What's worse:



a disease that kills 5 in 1000 but the other 995 make a complete recovery with no long term effects



or



a disease that kills 1 in 1000 but only 99 make a full recovery, the remainder (900) suffering long term after effects?



On our current "deaths only" view the first disease is by far the worst (0.5% IFR vs 0.1% IFR, 5x as deadly)  but I would suggest that the second would have a much greater impact on society, especially if the long term effects were anything other than very mild.



at the moment we are assuming the complete recovery rate is the inverse of the death rate i.e. somewhere around 99%



Until we have a reasonable picture of the disease and it's implications trying to "rush it through" to get to "herd immunity" is extremely reckless.

[Borchester]

I think that the real question is how much notice is the public taking of the government and will it be forgiven. The pubs are shut and the shops are doing their best to piss off their customers,  but there are more and more people out enjoying the sunshine and Plod seems to be keeping a low profile.



Meanwhile all we are getting from the government, which seems to be confusing priggishness with virtue, is more and more arse numbingly ineffectual dos and don'ts.

[T00ts]

There is a body of evidence (mostly anecdotal at the moment) that aside from the death rate, there are lingering effects for the "recovered"

The pictures of  lungs before and after tell a story. Damage to the air sacs in the lungs will not repair. This tells me that many will carry lung damage for the rest of their lives. This can only get worse and will be a burden to the NHS for decades. Even those who have not required oxygen and hospital care may well find that they are not as fit afterwards. There is a lot to consider before we burst forth into the world as if nothing has happened and at present there is possibly far more than we are being told, all for the sake of reducing panic.

[papasmurf]

Apocalyptic (and unlikely) scenario.  90% of under 35's infected become sterile.  We wouldn't know for several months by which time humanity would be in very deep trouble (see https://www.imdb.com/title/tt0206634/">https://www.imdb.com/title/tt0206634/)

Nothing to do with Covid-19 things have been heading that way for many years:-

https://www.nhs.uk/news/pregnancy-and-child/western-sperm-counts-halved-in-last-40-years/">https://www.nhs.uk/news/pregnancy-and-c ... -40-years/">https://www.nhs.uk/news/pregnancy-and-child/western-sperm-counts-halved-in-last-40-years/

[BeElBeeBub]

There is a body of evidence (mostly anecdotal at the moment) that aside from the death rate, there are lingering effects for the "recovered"



https://www.theguardian.com/world/2020/may/01/lingering-and-painful-long-and-unclear-road-to-coronavirus-recovery-long-lasting-symptoms">https://www.theguardian.com/world/2020/ ... g-symptoms">https://www.theguardian.com/world/2020/may/01/lingering-and-painful-long-and-unclear-road-to-coronavirus-recovery-long-lasting-symptoms



The flu can be nasty (sometimes fatal) but in a complete recovery with no permanent after effects is the norm.



I had a really nasty one about 15 years ago, 2 weeks unable to get out of bed, lost over 10kg.  Yet a month or two after I was 100% fine



There may be a significant % of people who get a "mild" case that end up with long term health problems.  We just don't know.



Which means any policy that doesn't try to minimise the number of infected as opposed to manage the rate of infection is very rash.



The sensible thing to do is to take all necessary steps to buy time to both understand the disease more and to work on a vaccine/treatment.  Yes the economic (and social) costs are high but those costs are dwarfed by the potential costs of something we missed.



Apocalyptic (and unlikely) scenario.  90% of under 35's infected become sterile.  We wouldn't know for several months by which time humanity would be in very deep trouble (see https://www.imdb.com/title/tt0206634/">https://www.imdb.com/title/tt0206634/)

[BeElBeeBub]

^^ Fair and well reasoned post BBB.  :hattip

Thank you.

[Javert]

The reality is that we simply don't know as we don't really understand how many people are having the virus without symptoms but most scientists think that the stories that half the people have already had it are highly unlikely.



We also don't yet understand how the immunity process works on this particular virus, nor whether being immune prevents someone from being a silent carrier if the virus.  



The sampling process with antibody tests is already underway but will require several rounds of testing before any tentative conclusions are possible, and even then the conclusions may be polluted by the lock down itself which is completely new and therefore presumably doesn't have a good evidence base for how it will affect the spread of virus.  



The antibody tests so far available are not accurate enough for making individual decisions on whether you personally are safe, but they are good enough to get some rough estimates of the scale of exposure in the population.

[Barry]

^^ Fair and well reasoned post BBB.  :hattip

[BeElBeeBub]

OK. Let's not go down that road.



What I suggested was that your figures were obtained by a bit of guess work.

Guess work is probably too strong.  Extrapolations from evidence would be better, but yes, until mid May we won't know exactly.

So I'll go for a bit of guess work of my own.

In one of the worst affected places, Madrid, 1 in 1000 of the population has died.

If your figure of 40k is correct, then about 40 million people in this country have already been exposed. Over half the population are immune.

Most people I speak to have had it, which bears my theory out.

Can you explain how you got from 40k deaths in the UK to 40m infections?  That would imply a infections/death (IFR) of 0.1% i.e. 1 in 1000 people who get it die.



That is an extremely low estimate.  I haven't seen a credible source (i.e. not a columnist for the telegraph/spectator etc) propose that the rate is as low as 0.1% - have you got one?

 

NZ, S.Korea, Germany are 1.5%, 2.5% and 4% (rounded).



Right now Iceland has the highest tests/capita rate at 140/1000 or 14% of the population and their IFR is 0.6%, bear in mind their population skews slightly younger than the UK eg 65+ is 14% vs 18% which will have an impact on the death rate.



Let's say the real rate in the UK is 0.5% - That would seem a conservative estimate.



Then 40k deaths would imply total 8m infections in the UK, about 12.5% of the population. In other words a realistic best case estimate is one eighth of the population may have immunity.

 

Assuming R0 of 3 then for "herd immunity" to work, over 66% (43m) of the population would need to be immune. We aren't even a quarter of the way to the mythical herd immunity.



Bear in mind that an IFR of 0.1% and 66% infection would imply over 400k deaths assuming you managed the progression to prevent overload of the health care system and overshoot of the 66% infections (if you let it run rampant, it is likely you would far exceed the 66% infection level before herd immunity kicked in)



Data on IFRs, tests etc from the excellent https://ourworldindata.org/coronavirus">https://ourworldindata.org/coronavirus