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So, that Spanish study was published in February?
Have to wonder how many people in the UK would still be alive if we had been using this stuff since then.
Question for medically knowledgeable folk:
the Spanish study addressed ARDS, which I gather is a frequently-fatal complication of a number of diseases including COVID19. So how much of a leap is it to study use of the drug in COVID19 cases? Does the British study actually merit all the fanfare? It seems more like confirmation of what might have been already deduced from the Spanish study?, rather than an original discovery? Am I being unfair?
None of this is new or news...
The use of steroids in any kind of sepsis, or in sepsis in respiratory failure is not a new topic. It has been researched many times over the years with no actual gold standard ever produced.
Dexamethasone is not a wonder drug despite what you've been told.
https://www.cochrane.org/CD002243/EMERG_corticosteroids-treating-sepsis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949415/
https://www.thebottomline.org.uk/blog/steroids-in-sepsis/
https://www.jwatch.org/na48210/2019/01/09/more-about-steroids-sepsis
The recovery study is the first study to show an increase in survival. We like to say death is the hardest endpoint. You can’t argue with it (unlike time to get better). So yes it’s an important result. But no it’s now unexpected. It’s A not particularly large effect either, sadly, but other drugs will be tested on top of this new standard of care.
As for the conduct of the trial itself. This analysis will have been preplanned and protocolled. When we conduct trials, we write the analysis plan often years in advance. This must be absolutely strictly adhered to. You can’t just test what you want. That’s called “post hoc” and violates the principles of statistical inference. If you accept 1/20 as statistically significant, then guess what - you’ll find if you repeatedly test/torture your data, then left-handedness is a predictor of mortality in about 1/20 trials. So we don’t do it. Except we do sometimes in our early trials to see if subgroups might benefit. Never in “confirmatory” Phase 3 trials.
Now the Oxford Study is an academic study, but they will have employed a CRO (Clinical Research Organisation) to do the heavy lifting of data management. I have not seen the reporting analysis plan (RAP) but they will have one before doing the analysis.
People have no idea how rigorous a double blind randomised placebo controlled trial is. One Unplanned look at the data and your £200M Phase 3 trial is deemed invalid. You just don’t. Instead you have an Independent Data Monitoring Committee (IDMC) who look at the data from time to time and tell you if you should stop or not (either for futility - common sadly, or overwhelming benefit - rarer but very good news). At the end of the trial you run your planned analyses. With all the covariates you’ve collected. We just stopped a trial for PrEP in HIV for overwhelming efficacy for a monthly injectable against tablets. This is the same against placebo. It won’t be ethical to conduct placebo trials for survival now.
[TL:DR] Gold standard evidence that steroids prolong life in the very sickest COVID19 patients. Not unexpected, but good news.
So it's still good news then.. Let's hope there's more next week, the week after and the week after that..
Meanwhile in app land.
<makes shocked face>
TiReD
The recovery study is the first study to show an increase in survival. We like to say death is the hardest endpoint. You can’t argue with it (unlike time to get better). So yes it’s an important result. But no it’s now unexpected. It’s A not particularly large effect either, sadly, but other drugs will be tested on top of this new standard of care.
I guess this is my frustration ....
It seems to me that a lot of covariates would fall under "not unexpected" and that a biased sample will easily mask not unexpected results. If the overwhelming majority of patients are over 80 and have weak immune systems then this would easily mask the much lower numbers of people with a overactive immune system that it wouldn't be unexpected if they showed better results.
This analysis will have been preplanned and protocolled.
It seems to me that presenting the results without the plan and protocols is at best mis-leading. The BBC article doesn't mention the constraints .... however I find it more disturbing when some politician who is incapable of reading a full side of A4 14pt bold then makes statements and influences or even directly controls funding.
Meanwhile in app land.
What’s really had me fuming, is Matt Hancock telling us that “we found people responded better to the human side of the tracking and tracing” … and Dido going on about the app just being “the cherry on the cake” … we already knew from other countries that the human side of the track/trace/isolate programme is the most important part … this isn’t news … what is news is that, no only is that part late … but the extra and very useful tool that is a mobile phone contact tracing app is not only very very late, but is still being developed in a way that means uptake and usefulness will be far lower than would be possible if they listened to people who know what they are talking about, rather than kept up their Cummings controlled circle jerking.
It seems to me that presenting the results without the plan and protocols is at best mis-leading.
Both available online. But nobody will be interested in the RAP! I’ve only actually read the protocol (and did a little bit to help with it)
The stratification by ventilation, oxygen and no support is planned. There will be the categorical scale for severity too, but death is the simplest endpoint (hence fastest to report and the primary endpoint). I’ll read the RAP later. It will be carefully protocolled. You can’t make up analyses - that’s against the rules of inference. You pick your primary endpoint first (death here) and analyse that. The. You can have all sorts of rules to control for multiple testing of secondary endpoints (test 20 and guess what?).
Edit. Covariate marching below, so lots of subgroup potential!
Age at randomisation
Sex
Ethnicity
Time since COVID-19 symptoms onset
Time since hospitalisation
Current respiratory support requirement
Currently requiring renal dialysis or haemofiltration
Comorbidities (diabetes, heart disease, chronic lung disease, tuberculosis, human
immunodeficiency virus, severe liver disease, severe kidney impairment)
If female, known to be pregnant
Second randomisation
In addition to the above:
Type of ventilation support currently required (none, CPAP alone, non-invasive ventilation, high-flow nasal oxygen, mechanical ventilation, ECMO)
Latest oxygen saturation measurement (%)
Latest CRP measurement (mg/L)
Latest ferritin measurement (ng/mL)
Latest creatinine measurement (μmol/L)
Allocation in first randomisation
Interval between first and second randomisation
To nobody's surprise, government funded IT project is complete disaster zone for everyone except the company coining it in for supplying the thing.
Much as predicted:
https://www.nytimes.com/2020/06/17/world/europe/uk-contact-tracing-coronavirus.html
Trying to link a NYT on test and trace but it ain't having it
Seems like a good place to ask if I am being too sensitive or rightfully cautious...
A big group of leadership team and chief engineers from the business units have been "requested" to attend a capability strategy meeting on site next week. Between 15-20 people taking up a large meeting room/lecture room for 6 hours. It's in the middle of the building so no natural ventilation, just aircon.
I have no doubt we can all be way over 2m apart but it seems very excessive, if not just due to the shear cost of the meeting in person hours.
BTW, case rates and all that.
Lining up the peaks of the death figures seems to show that we had very similar deaths/per million pop at the peak, vs spain/italy, yet at this point, we are now double the deaths/per million pop at the comparable time later.
I notice the exact same problem when lining up the infection rate / per million population for the three countries, in fact on that one the UK seems to be about triple that of spain and italy at this point in time.
Hmm.
Rest of world is, once more, laughing at our predictable shitshow.
Internal news in this country is going the direction of 'tractor production is up this month'.
Having no luck with this link but I'd strongly recommend a squizz at that NYT article on Britain's response to the pandemic. https://nyti.ms/2Bj89f8
Lining up the peaks of the death figures seems to show that we had very similar deaths/per million pop at the peak, vs spain/italy, yet at this point, we are now double the deaths/per mi
Yes, Strength of lock down affects rate of decline as well. Hugely overlooked by one and all, but there is a reason why Sweden have effectively endemic transmission and deaths. It’s not just “lives saved”. Plot it on a log scale to make it even more obvious.
Yes, I can't see the UK having anything other than C19 slowly burning through the population now.
Sweden's infection rate seems to be climbing again.
TiReD
Both available online. But nobody will be interested in the RAP!
I'm struggling to match that SAP with the BBC link....
As I remember it didn't mention the randomisation or anything else... just drew some conclusions that are from Part B at this stage... which are not the quoted parts from the actual researchers.
In other words it reads to me like the Health Editor and Health correspondent didn't actually read it but spent some time instead making a infographic.
I didn't watch Hancock or Boris present this either ... but I think it's unlikely they read it either.
Yes, I can’t see the UK having anything other than C19 slowly burning through the population now.
How will a stronger but shorter lockdown prevent this from happening in other countries? Surely this will just mean that it will take the virus a little longer to re-build the infection rate.
How will a stronger but shorter lockdown prevent this from happening in other countries? Surely this will just mean that it will take the virus a little longer to re-build the infection rate.
I guess if you get the infections down to a certain point then you can track and isolate new outbreaks. Assuming, that is, that you actually have a track and isolate systen in place and not just politicians' blether.
How will a stronger but shorter lockdown prevent this from happening in other countries? Surely this will just mean that it will take the virus a little longer to re-build the infection rate.
You need to leave lockdown with low infection levels, paired with effective track/trace/isolate measures being in place. Anything else is just accepting ongoing infection and deaths.
I guess if you get the infections down to a certain point then you can track and isolate new outbreaks
That makes sense - but for that to work, you'd need a permanent qurantine in place for anyone who enters your country by any means, until global eradication or a vaccine. You'd also be very vulnerable to an infected person evading border security.
As for a government-developed track and trace system, I am almost 100% certain that the money will just go down the drain. I'm the stupid one for not working out how to get on that gravy train!
How will a stronger but shorter lockdown prevent this from happening in other countries? Surely this will just mean that it will take the virus a little longer to re-build the infection rate.
The practicalities of lockdown mean that even a half-hearted version has to end at some point.
If you can properly suppress case numbers before you release (eg New Zealand, hopefully still after this week's events), then it gives an effective track and trace system the opportunity to keep a lid on potential hotspots. This means there would be a substantial delay before any further peaks, perhaps you could suppress this altogether, maybe until a vaccine was available.
If, when you are forced to release lockdown, there is still a small but signficant baseline number of cases grumbling away in the community (which is where we are), not only does this make the chance of re-emergence much more likely, but it makes the job of your 'world beating' track and trace system much, much harder, and shortens the likely timescale to any second wave.
The end goal is a vaccine, we hope, and the aim is to reduce mortality to that point in time. If you can somehow delay or suppress your second (or third) wave past the point at which a vaccine is available, that saves thousands of lives.
Even if there were no vaccine, the results from the RECOVERY trial are a reminder that, month by month, doctors around the world will get better at saving people from this virus. Every month you delay your next wave of infections, there is a better chance that treatment protocols for the most seriously ill patients will have improved, and their chance of survival/good quality of life post covid increases too.
TL:DR Pushing back cases in time saves lives.
I’m the stupid one for not working out how to get on that gravy train!
No, you’re not stupid, there are very strong links between those earning the money and the no10 team.
No, you’re not stupid, there are very strong links between those
earninggetting the money and the no10 team.
FTFY
So in the best case scenario, we need to live under permanent semi-lockdown and with all movements being tracked and recorded, and under the risk of being told at any time we need to go back to our houses and isolate for days/weeks. We would need the track and tracing to be incredibly thorough, and for our country borders to be completely locked down, for this to work. The system would be very vulnerable to any slip in track/trace, or infected people entering the country. I just don't see how this is feasible in the real world, and how life could continue and support an economy that can pay for that.
How ‘severe’ all those measures need to be is dependent on ‘us’ getting infection levels low enough before opening up lock down… and the ‘completeness’ of that lock down determines how long that takes. ‘We’ failed in the UK on both counts… no real lock down and opening up while infection still ongoing.
Oh, if you can’t imagine how keeping infection under control once low enough is ‘feasible’, try looking at other countries. And, again, it won’t be good for the economy not to do so.
So in the best case scenario, we need to live under permanent semi-lockdown and with all movements being tracked and recorded, and under the risk of being told at any time we need to go back to our houses and isolate for days/weeks.
Not really, if case numbers are low enough, then lockdown can be lifted completely, with the proviso that new cases are aggressively tracked and their contacts isolated. This is what has happened in NZ.
Obviously we're not in that happy place, so some form of lockdown restrictions will carry on, with each easing accompanied by lots of praying and crossed fingers that numbers stay where they are. Losing your summer fun/livelihood/family life is the price you pay for a poor government which wasn't prepared to make the difficult decisions because it didn't want to be unpopular with a vocal minority.
What other countries have shown is that to be successful track and trace needs to be done on a local level and done through trusted, open, accountable local agencies like healthcare trusts, allowing action to be rapidly tailored to the needs of specific places
So the government have done their usual and ignored all evidence from experts (who needs those eh?) as it doesn't fit their chosen ideology.
Instead, they've done what they always do - ignored all evidence and advice and done the polarv opposite. They've centralised the decision-making in Whitehall, kept it opaque and secretive, and farmed the implication out to the same private sector companies (Capita, Serco) that have repeatedly demonstrated that they are incapable of delivering anything like this and certainly can't be trusted with personal information.
And does anyone actually believe that a fully functioning app will ever be operational?
They're a bunch of ****ing clowns!! Utter incompetents!! But, as per bloody usual, I bet their mates are making an absolute killing out of this shambles. Both metaphorically and literally
Oh, if you can’t imagine how keeping infection under control once low enough is ‘feasible’, try looking at other countries.
Are there any countries in particular that are claiming success due to a hard, short lockdown followed by track and trace? Personally, I think that the story there is far from over.
Not really, if case numbers are low enough, then lockdown can be lifted completely, with the proviso that new cases are aggressively tracked and their contacts isolated. This is what has happened in NZ.
We will see how that develops, but it's already not looking great again for NZ. I think it will only demonstrate that trying to maintain anything like a normal economy, complete with large numbers of international arrivals, is not compatible with a "complete elimination" policy.
In other words it reads to me like the Health Editor and Health correspondent didn’t actually read it but spent some time instead making a infographic.
Exactly. The analysis will have been done by the IDMC. It’s the headline look to see if it ethical to stop or continue. That analysis has shown a robust effect, hence it is time to stop. The other planned analyses will follow (including subgroups). Interestingly (for me) they have not used the standard 7-point categorical scale that everyone else is using. One measure is fraction of patients making a one and two point improvement. 7 is death btw. Remdesivir gave a modest one point improvement in mild patients.
but it’s already not looking great again for NZ
You have a strange idea about what looks great.
How many new deaths in NZ in the last week? How many here?
How about schools, shops, cafes etc… how many are back in proper use there? How about here?
You have a strange idea about what looks great.
Not really. Sure, living with very little restrictions does look great, but they've already had two known infected people fly in, leave quarantine early for "compassionate reasons", and make known contact with 320 other people. Other people are known to have left quarantine early, and just today someone was caught flying while infected with Covid-19. At the rate that they are having to make contact with people who have potentially been infected, pretty much everyone will be back under lockdown in NZ very soon. My point is only that this approach is not practical, unless you completely rigidly enforce your country's borders.
To explain a bit re Enzed - there is some cultural stuff around funerals that makes it harder to limit them.
Queen Cindy's face at the briefing about the latest developments almost made me cry!
and make known contact with 320 other people
Which I assume are mostly the other passengers on their flight who were already sitting in quarantine. Either that or the pair went on a doorknob-licking tour of Auckland.
EDIT: Or not! What's the cultural stuff about funerals, Hels?
Even a 'world beating' track and trace system will not find all contacts, but I'd take the task of dealing with 320 contacts of two people is a lot easier than dealing with the potential contacts of the 328 positive tests we had in the UK yesterday.
I can understand the deep frustration of everyone in the UK who is watching other countries opening up and getting on with life. It's doubly frustrating because we could be in a much better position right now.
Exactly. The analysis will have been done by the IDMC. It’s the headline look to see if it ethical to stop or continue. That analysis has shown a robust effect, hence it is time to stop. The other planned analyses will follow (including subgroups). Interestingly (for me) they have not used the standard 7-point categorical scale that everyone else is using. One measure is fraction of patients making a one and two point improvement. 7 is death btw. Remdesivir gave a modest one point improvement in mild patients.
I guess I shouldn't be surprised, perhaps I just expect too much from a heath editor/correspondent, perhaps it's a grass is always greener ?
I get frustrated when marketing or sales try and mis-describe a test result without actually understanding what was tested.
The Recovery Trial, running since March, also looked at the malaria drug hydroxychloroquine, which has subsequently been ditched amid concerns it increases fatalities and heart problems.
The antiviral drug remdesivir, meanwhile, which appears to shorten recovery time for people with coronavirus, is already being made available on the NHS.
Even here they mention hydroxychloroquine as being part of the same trial but its not even clear that remdesivir was part of this trial and Lopinavir + Ritonavir and Azithromycin aren't even mentioned.
Either way... thanks for the link. It makes me more optimistic for me personally but less optimistic overall...
EDIT: Or not! What’s the cultural stuff about funerals, Hels?
Lots of weird stuff.... funerals was one but what was with preventing someone with confirmed COVID seeing a relative who was being put into a coma?
EDIT: Hadn't noticed the stupid tinting on the first word of the above post that indicated a link.
Maybe it is time for the web team to consider wether their colour palette needs a rethink?
There's a permanent smell of burning rubber in Downing Street!
I wonder which of his dimwitted human shields will be wheeled out to take the questions on this farce at Todays Daily Briefing? Boris will be nowhere near it, that's for sure.
I'm going for Hancock. He always gets the short straw. Raab will no doubt have been gagged and locked in a cupboard after his efforts so far today
So they get in someone who knows how to deal with this app development business and within a few days has basically said that everything they've done before he arrived is crap, we're now going to do this the way everyone else has.
That's one hell of a slap in the face for the original team!
Oh and it looks like KFC might be short of a few chickens too. The exact situation the app would help with.
So they get in someone who knows how to deal with this app development business and within a few days has basically said that everything they’ve done before he arrived is crap, we’re now going to do this the way everyone else has.
Given the absolutely fantastically successful track-record of government IT projects in the past, it's difficult to see how this could possibly have happened, isn't it?
One more poke, then I'm done, I promise! (for at least a few days, anyway)
I’d take the task of dealing with 320 contacts of two people is a lot easier than dealing with the potential contacts of the 328 positive tests we had in the UK yesterday.
Where do you stop tracking and tracing? You would need to check each of those 320 contacts for further contacts, if you really are trying to contain the virus this way. I assume there is some minimum period where a person who came into contact with an infected person is not contagious, but if it takes a few days to find and test someone who has Covid-19, the chain of ongoing contacts could be enormous.
Despite the change, the interface presented to users will remain the same.
Should be in the App Store by end of the day then 🙂
So they get in someone who knows how to deal with this app development business and within a few days has basically said that everything they’ve done before he arrived is crap
It’s a funny one,the main thing with apps is you get it to a reasonable level then Blap it into the wild and sort out the bits your unhappy with in updates, as it’s Relatively easy to do on iPhone apps.
They wrote it without the Apple/google api so it was always in a world of pain but as soon as the api was available should have got it out.
I think it was the political wrestling the really iffy centralised data collection which turned it into a farce.
Despite the change, the interface presented to users will remain the same.
So it'll still be World Beating, right?
I think it was the political wrestling the really iffy centralised data collection which turned it into a farce.
Lucky we didn't actually need it then, and we'd prefer to hear some cheery call centre worker telling us to go to Northern Ireland to get a test, then!
the country is being run by Kevin the teenager.
That’s one hell of a slap in the face for the original team!
"Team" encompasses everyone involved in the delivery, not just the app developers and the buck stops with the government who are ultimately responsible for managing the process.
Anyone who works in IT could have told you that delivering a project of this scale would be hugely complex and Hancock's delivery dates were utterly implausible lies. That means the government have chosen to ignore expert opinion from people who understand this stuff, and just spin stories.
I'm seeing that our world beating track and trace set up has failed to make contact with 25% of the people who have had a positive test for the virus.
So did a quarter of people testing positive give false or incorrect details when they did the test? I mean, you do have to provide your details when you have a test? Please!?
Kevin is king of the world now.
It’s a funny one,the main thing with apps is you get it to a reasonable level then Blap it into the wild and sort out the bits your unhappy with in updates, as it’s Relatively easy to do on iPhone apps.
They wrote it without the Apple/google api so it was always in a world of pain but as soon as the api was available should have got it out.
I think it was the political wrestling the really iffy centralised data collection which turned it into a farce.
"Blapping something into the wild" might be OK if you are writing a mobile phone game. It's completely inappropriate for an application which is tracking and retaining information about people and their movements, and which you expect most of the country to download and use.
There are a host of critical requirements about system architecture, security, privacy, reliability, data retention, etc, etc you need to sort out for a project like this, before you even think about writing an app, and you can't release an app of this nature without testing it to death in every scenario and on every platform you can find. You also need to stand up a serious support team to monitor performance, deal with technical issues, and provide operational call centre support for app users. It's a massive project.
Where do you stop tracking and tracing? You would need to check each of those 320 contacts for further contacts, if you really are trying to contain the virus this way. I assume there is some minimum period where a person who came into contact with an infected person is not contagious, but if it takes a few days to find and test someone who has Covid-19, the chain of ongoing contacts could be enormous.
A 'world leading' track and trace system* is designed to find the contacts of the original case before they become contagious, which is, on average, 5-7 days after infection. If you can do that for the majority of cases, it makes a significant dent in transmission, even allowing for people who either cannot be contacted or can't be identified.
You can't stop all transmission, but if you stop most of it, through adherence to social distancing measures, good hygiene and robust track and trace, then the number of cases will stay low enough to allow everyone to resume a fair amount of normal activity - work, school etc.
*Some sarcasm possible
Kevin is king of the world now.
Thought you were just blowing your own trumpet there for a minute.
Oh and it looks like KFC might be short of a few chickens too
Time for some PROPER rioting then, none of this peaceful shit.
So Dido wasn't up to it, who'd have thunk it?
So Dido wasn’t up to it, who’d have thunk it?
Did she put up the White Flag?
Late to the party kelvin - see an hour ago up there ^^^.
Harding is still in charge of the wider programme.
is designed to find the contacts of the original case before they become contagious, which is, on average, 5-7 days after infection.
Where is that number from? I struggled to find good info on this, but here is one source:
https://www.health.harvard.edu/diseases-and-conditions/if-youve-been-exposed-to-the-coronavirus
The time from exposure to symptom onset (known as the incubation period) is thought to be three to 14 days, though symptoms typically appear within four or five days after exposure.
We know that a person with COVID-19 may be contagious 48 to 72 hours before starting to experience symptoms. Emerging research suggests that people may actually be most likely to spread the virus to others during the 48 hours before they start to experience symptoms.
With those figures, it is possible for someone to become contagious from 2 days after contact with an infected person. They then have 2-3 days being contagious before starting to notice any symptoms. I'm not sure if the track and trace allows self-reporting (which, I'm sure, would result in every sneeze being reported as Covid and everyone ending up back in isolation), but if not, it would then take a further few days to get tested and receive a result. I still don't see how these figures stack up to make a useful system. Personally, I think that flattening the peak is about the best we can do, but only time will tell.
Late to the party kelvin – see an hour ago up there
Sorry, didn’t see the “inevitable” link at all, so didn’t click, or know what it was about.
It's possible yes, but my figure (5-6 days actually, apologies) is the average from the WHO. Some patients take 14 days from infection, and there may be a pre-symptomatic period where patients are contagious in some form. As I said, you won't catch all contacts before they become contagious, but if you catch the majority, that will put a brake on transmission, if you are doing the other stuff instead.
It's not an area where there is a simple answer that will get it behind us and back to normality. A combination of lots of things is needed, including public cooperation with lockdown, even if individual actions don't seem to carry a lot of risk.
“Blapping something into the wild” might be OK if you are writing a mobile phone game. It’s completely inappropriate for an application which is tracking and retaining information about people and their movements, and which you expect most of the country to download and use.
There are a host of critical requirements about system architecture, security, privacy, reliability, data retention, etc, etc you need to sort out for a project like this, before you even think about writing an app, and you can’t release an app of this nature without testing it to death in every scenario and on every platform you can find. You also need to stand up a serious support team to monitor performance, deal with technical issues, and provide operational call centre support for app users. It’s a massive project.
I don't disagree, but you wanted this er like a month ago and we are in the middle of a pandemic,its not normal times, you don't have the luxury of time.
Sorry, @martinhutch, still don't agree with your numbers. You say 5-6 days is quoted by the WHO - according to their website, that's the incubation period, that is, the period between contact and symptoms starting.
A person is contagious for up to 72 hours before the end of the incubation period, which means it's typical to be contagious within a few days of contact. I am nit-picking over numbers, but IMHO this is the difference between a track and trace approcach working, and it not working.
you don’t have the luxury of time.
Unless you count the four months from the point at which they were warned and should have known they were going to need it, but our leaders were still fapping themselves raw over 'taking back control'.
A person is contagious for up to 72 hours before the end of the incubation period, which means it’s typical to be contagious within a few days of contact. I am nit-picking over numbers, but IMHO this is the difference between a track and trace approcach working, and it not working.
I'm not quibbling with you over that. T&T will not catch all contacts, or identify every case. What it has to do is to find enough reduce the burden sufficiently (alongside other measures) to make sure case number do not start to grow rapidly - and identify local hotspots which may need lockdowns as an additional measure. I think my original point was slightly lost - that if you have anything other than very low numbers to start with, that job gets a lot harder. It's still worth doing, obviously, but we have to accept that our government's failures mean that we are comparatively worse off than other countries.
In short, it would be fantastic to be anywhere near NZ's position, because then you can use T&T in the way it was intended, to respond quickly and accurately to smaller numbers of reported cases while the rest of the country is allowed to get on with life. But it's still worth pursuing it here in conjunction with other measures, because done properly, it will help.
Unless you count the four months from the point at which they were warned and should have known they were going to need it, but our leaders were still fapping themselves raw over ‘taking back control’.
Yep i do like to bang on about them not raising the drawbridge earlier.
Seems weird to have taken back control of our borders to only not to.
Absolute ****ing shambles
https://twitter.com/carolecadwalla/status/1273624889287741442?s=19
There needs to be a public inquiry on this
That’s the way to post it!
Much better than vague links without context or explanation [ I’m guilty! ]
Anyway, good news… I genuinely feared they’d keep doubling down on their obvious mistake*, even if it meant no app or a poor app.
[ for the record, I see it as a decision not a mistake… I think key people saw an “opportunity” worth pursing despite the technical limitations and risk of low uptake - and I don’t mean a money making opportunity, I mean a data capturing/analysing one ]
There needs to be a public inquiry on this
We started developing an app with VMware in Jan. Apple/Google announced their approach 10th April, we carried on and impact assessed the new approach in parallel in May (tested both on the Isle of Wight), decided to switch in June.
Turns out our app is better at determining the distance between phones, but unreliable on Apple (surprise surprise).
Google/Apple solves the reliability, but it's crap at the distance bit. Ongoing discussions with Apple and Google.
I agree we're hardly fleet of foot - but public enquiry?
Why is Dido Harding a "Baroness" and why is she in charge of anything? Did TalkTalk make such a big success of its technology that we want the same crew in charge of Covid T&T ? Is she making it teenage-hacker-proof this time around?
I’m seeing that our world beating track and trace set up has failed to make contact with 25% of the people who have had a positive test for the virus.
Do you have any idea what the normal contact rate is for an outbound call centre? Or do you think that you just give someone a call and the right person answers first time, every time.
There needs to be a public inquiry on this
There needs to be a public something, can't think of the word, tip of my tongue...
...ah yes, that's it, move the rope around the neck.
Hanging. That was the word. A public hanging.
I'm actually very interested in these answers, because I've not had much productive discussion about how these approaches will work.
What it has to do is to find enough reduce the burden sufficiently (alongside other measures) to make sure case number do not start to grow rapidly – and identify local hotspots which may need lockdowns as an additional measure.
I'm not sure it does help - the workload for one confirmed case is enormous. Also, how do you lock down a local area?
Let's take the averages of the provided figures, so the incubation period is 5.5 days, and you are contagious for the 48 hours before that. You notice the symptoms a day after the incubation period, self-isolate, and then it takes 4 days to get your test, send it back, and get the result. We're now on day 10.5, and you can inform the track and trace system. However, you were out and about up to day 6.5 in this best-case scenario, and contagious from day 3.5 onwards. In those three days, let's say you saw 30 people. Those 30 people have now had up to 7 days to spread the disease, which is plenty of time to start a second and third chain. You'd quickly end up with thousands of people to contact from a single case, unless you ignore the secondary chain effect, in which case there isn't much point to the whole thing.
IMHO, the only reasonable chance a country has of beating coronavirus (and maintaing anything like a reasonable life for its citizens) is a very hard lockdown, followed by a complete and practically permanent closure of their borders. If it really is as infectious as we think, there isn't much else to be done.
That means the government have chosen to ignore expert opinion from people who understand this stuff, and just spin stories.
My honest opinion is it's "Enterprise" syndrome.
Captain .. "How long will it take to get the warp core stable and online?"
Chief Engineer "about 12 hours if we work round the clock"
Captain "You have 3 hours"
of course it always works on TV ... sign of leadership etc.
A belief by management types that experts just need to be told to do it quicker or in this case...
Captain .. "How long will it take to get the warp core stable and online?"
Chief Engineer "we ejected the warp core and it exploded into atoms"
Captain "You have 3 hours"
ThePurist - isn’t that exactly the problem? Anybody with expertise has called for local solutions - actually knocking on doors - rather than a huge centralised call centre approach.
You’d quickly end up with thousands of people to contact from a single case
Not sure about your maths, but your point is spot on. Which is why you need thousands of staff working on this even with small numbers of new cases. Which is why you need to be at the point of having low to no cases before relaxing lock down and relying on track/trace/isolate. Again… we’re not there, but are acting as if we are.
a very hard lockdown, followed by a complete and practically permanent closure of their borders
True, and many counties included NZ did just this… but, medium term, you only need to keep borders closed (or quarantine in place) for those coming from high risk counties. See what’s happening in Scandinavia, borders are reopening, except for Sweden, because it didn’t do a very hard lock down.
ThePurist – isn’t that exactly the problem? Anybody with expertise has called for local solutions – actually knocking on doors – rather than a huge centralised call centre approach.
That's a separate issue to the effectiveness of the call centre, which (compared to the area I'm familiar with) is actually doing a pretty good job of reaching people by phone. Of course there will always be some people you don't reach by phone, but there will also those you don't reach by going and knocking on the door. How many times will you send someone round to their house to try to contact them? They could be out working, shopping, exercising or even testing their eyesight. There's no magic solution that will guarantee 100% coverage.
This app farce is just obscene. Somehow, the British government procured an app that recognises 75% of Google devices with which it has contact (not good), and only 4% of Apple devices.
4%!! So if a super-spreader of COVID comes into contact with 50 iPhone users, it will pick up 2 of them.
How is that even possible?!
I agree we’re hardly fleet of foot – but public enquiry?
You are aware that other countries have apps based on the Google/Apple approach live already? When can we download one here?