An increase of 0.5 is very pessimistic and I would be surprised if you could find a document where SAGE said that. I believe that 0.2-0.3 is much more what the consensus view is for the likely change, and it could even be lower under very optimistic conditions.
OTOH the current SAGE range for R is pretty silly really, they are clutching at straws to pretend it is any lower than 1.1 right now. 1.1 + 0.2 will be quite problematic enough.
R will rise when all kids are back in school buildings… not just because of transmission in and on the way to/from school, but because it will also result in more parents being told to stop working at home and get commuting and working together physically again. And then there is what kids do, and where, between school gates closing and parents getting home.
An increase of 0.5 doesn’t sound pessimistic, given all that. Which is why getting cases as low as possible before the return to school should have been policy. We’ve wasted the opportunity this summer gave us.
Anyone able to shed light on increasing numbers not leading to increasing deaths. Can the current uptick by extraperlated backwards to shed light on how many cases we may have actually had in the country before it all turned to shit in March?
R is not linear. What we know is that unrestricted, R is about 2.5 to 3. That’s not particularly high actually but typical for a respiratory infection. In lockdown R falls to about 0.5, so roughly An 80% drop. Let’s assume that closing schools accounted for roughly half that decline - not implausible. That would be a 40% drop or a fall from 2.5 to 1.5. We started with a relaxation of lockdown and a rise to 1. Expect a further increase. The remainder is public transport, return to offices and workspace transmission.
I predicted an increase in cases with doubling time of about 7-14 days. Hope I’m wrong.
AA: the increased cases is due to increased testing in Tier 2 (community). This finds a younger age base than Tier 1 (hospital). You have to be older to be ill enough to need to seek hospital treatment where you are tested as Tier 1. I think Community cases are now more than 80% of all new cases. They used to be 0%!
Combination of new infections being in the younger population and the hospitals having learned a lot of lessons and turned that learning into better outcomes, fewer people in intensive care and better outcomes for those that are.
Anyone able to shed light on increasing numbers not leading to increasing deaths.
Was mentioned in Nicola Sturgeons briefing today. More younger folk who are less likely to show symptoms, get very ill, die. Possible there will be a lag between young folk catching it, passing it on to grandparents and then an increase in deaths again.
And, of course, increased and more targeted testing.
I'm on a train out of London now
It's getting busier , but still ghost town
More families than commuters on the train
I'd say 20% of adults not wearing masks 😬
With testing - track + trace targets being missed by big margins, i could easily see things getting out of control once winter starts properly
Hospital admissions and Tier 1 are where you will see the signal. People with more severe disease will continue to represent a small but constant fraction of the total. We don’t know the total (all cases) but we will continue to see the cases who need medical attention. These are being monitored carefully. Guess what? Regions with special measures do show small increases in admissions.
AA: the increased cases is due to increased testing in Tier 2
I know so having a measure of where we actually were in reality rather than just a number based on very limited testing would give us a good idea of when we need to push the panic button would it not?
I think Community cases are now more than 80% of all new cases. They used to be 0%!
So if we have that figure of 80% and some data on numbers now and then we could work out where we might have really been then and when to start panicing in the future couldnt we. Only with some proper maths not back of fag packet stuff!!
Hospital admissions and Tier 1 are where you will see the signal.
Bit late isnt it? Like that old economics quote about driving a car down the motorway by looking out the back window
No, monitoring initial consultations is the most concrete signal of doom. Community mass testing is going to help too, but there are too many unknowns as to how we interpret that. The ons mass survey is informing on prevalence and it was declining. Back extrapolation is as bad as forward when you don’t know the parameters!
The Royal College of GPs have a weekly monitoring for consultations for flu like symptoms. This is where I predict we will See any first signs of a big second wave. People go to the doctors when they have symptoms. Or at least they now phone them.
Back extrapolation is as bad as forward when you don’t know the parameters!
Fair enough, I suppose it comes back to my usual frustration with trying to understand things from watching the news. The numbers they quote whether its cases in different sized countries or now quoting case numbers when testing is so vastly different its impossible to compare or understand.
If anyone is interested, this is my prediction for winter 2020. Not all doom and gloom, but we shall see. Half-term should be an important milestone with regards to school transmission, vaccine development and emergence of influenza.
Summary
An Autumn/Winter SRS-COV2 epidemic will follow the first epidemic wave, with doubling time >1 week (rather than 2-3 days). There will be added influenza mortality but reduced overall transmission due to school precautions (including lockdown/closure), reduced commuting and office working, use of public barrier precautions, testing and isolation of the elderly and healthcare workers, testing and tracing of cases. Regional lockdowns will be necessary but are unlikely to prevent overall spread. Excess mortality of up to 30000 deaths (half the first wave) should be anticipated, again predominantly in the elderly. Any reductions in 2020-21 influenza mortality due to reduced contacts and increased vaccination will be offset by COVID19 mortality. There will be no effective vaccine or new treatments available, however earlier treatment of mild/moderate cases may mitigate mortality.
Thanks tired, appreciate your posts on here and I find them very informative and thoughtful too.
If it's ok, like to ask your thoughts on the ending of "shielding" and how you think that will go. There were people that took some serious survival measures for the four months, and the support to do that has gone. Some can afford to protect themselves again, but a lot are being pushed back into contact again. Lots of workplaces are doing what they can through extra risk assessments as they have a duty of care, but there's some obvious transmission vectors that it just looks like a matter of time before the virus gets through.
Schools being a big example - even a perfect track, trace isolate system will only kick in after children have mixed then been sent home to parents. If they are vulnerable ( I'm thinking the health condition shielders, not really older grandparents) then they look very at risk of worse outcomes.
Stupidly I popped in to Wetherspoons the other night with the kids around 5pm. I know, I know but it was one of those days.
Tried the Marstons Pub nearer to us first, it was full but everything inside looked well organised. Tables were well spaced and staff were meeting people right at the door and taking people to tables.
Wetherspoons was an absolute rammy. No staff on the door - so folk piling in with nowhere for them to go. No obvious extra separation between tables just crappy screens here and there. Due to the poor spacing and extra screens, walkways were limited so lots of contact between people going to bar, toilets, arriving etc. I took a few steps in and then promptly left - just a disaster waiting to happen. I have defended Wetherspoons in the past, but holy crap it's fairly obvious they're trying to get cash in and to hell with the consequences.
Considering how many pubs they have if that is representative it doesn't bode well for the winter.
Not all doom and gloom
Excess mortality of up to 30000 death
☹️
Does this assume the government act in the same way? Or maybe even get it beter? Testing is much better now so that will help but I'm not confident they will move to a large scale lock down if needed again, although do we think that is necessary?
Tired, pretty much every one of the R numbers you wrote are pretty badly wrong. There is no way that school opening is going to be a really big effect (note they were already open anyway for some) but it may well be enough to matter.
Testing is much better now so that will help but I’m not confident they will move to a
Turnaround times are actually much worse than they were in June/July
Which is worrying, a cold wet winter & lots more tests being done could see it struggle
That it's performing so badly in the summer is a red flag IMO
Be interesting to see how busy London gets once Schools are back
I'm not sure much will chant, I'd say trains into London are definitely getting busier, may 50% of normal at rush hour (tho I'm avoiding that)
My work goes to 1m distancing, so more people can come on, but we have to wear masks all day(shift- as we are working shifts to minimise contacts) now
I’m not sure much will chant, I’d say trains into London are definitely getting busier, may 50% of normal at rush hour (tho I’m avoiding that)
Maybe less. Everyone I know who works in town or uses it as a transit is working from home, and company’s are either maintaining wfh policies as Is, or changing offices to be Covid friendly choices of workplace. People who’ve been distracted by kids at home for the last few months are actually stating it’ll get easier as they will be at school 9-3 and the wfh polices help with schooling arrangement.
I don’t see even 50% rushing back. As has been said many times, it’s be proven that wfh is sustainable and cheaper, and changes the work like balance. Maybe over a couple of years.
Citymapper notability has London about 45% of normal
Tho certainly in parts I'm in it seems much quieter
https://citymapper.com/cmi/london
Cycling is quite pleasant
I work in a lab so can't do all my work from home, but that's reasonably rare
I'm in 2.5days a week, be interesting to see what the 3day season ticket prices are, as I'm currently using off-peak (which is meaningless) so my commuting bill is halved compared to normal season ticket (3 days out of 5 still better than paying rip-off 7 day or monthly season ticket!)
There is no way that school opening is going to be a really big effect
Why not? If the keenness to get all kids on site full time, rather than in shifts or rotas with mixed home/school learning, is about helping get more parents back into their normal places of work more often, then how on earth can you claim it’ll have such a minimum effect?
Some can afford to protect themselves again, but a lot are being pushed back into contact again.
I know someone who has made themselves unemployed as the only way to keep their shielding family members safe. They can ‘afford’ to do it where many can not, but it’s still going to seriously impact their lives, especially if their return to work next year becomes difficult. They are still one of the lucky ones.
Just read the article on beeb about leaked sage report, worst case 80 000 XS deaths but schools wont close...wonder who will be in them though, kids voted with their feet in march and many teachers were off with symotoms.
Marina Hyde in the Grauniad has it right:
Leave Home. Forget the NHS. Save Pret.
Kids had the option of "voting with their feet" back then.
The threats of fines has been pushed strongly in all the information aimed at parents now.
Would be very interested in any teacher's thoughts on how this will be dealt with for vulnerable kids/family members as I've got some real concerns with them going back.
If they try and enforce fines for parents acting to stop the virus entering their homes (due to elderly or at risk people being in their home) the fight back will be far firmer than they imagine.
There is something new in the guidelines issues last night about this, according to the “what’s new” summary… but I haven’t got that far yet.
+
Where children are not able to attend school as parents and carers are following clinical or public health advice, for example, self-isolation or family isolation, the absence will not be penalised.
-
All other pupils must attend school. Schools should bear in mind the potential concerns of pupils, parents and households who may be reluctant or anxious about returning and put the right support in place to address this. This may include pupils who have themselves been shielding previously but have been advised that this is no longer necessary, those living in households where someone is clinically vulnerable, or those concerned about the comparatively increased risk from coronavirus (COVID-19), including those from Black, Asian and Minority Ethnic (BAME) backgrounds or who have certain conditions such as obesity and diabetes.
If parents of pupils with significant risk factors are concerned, we recommend schools discuss their concerns and provide reassurance of the measures they are putting in place to reduce the risk in school. Schools should be clear with parents that pupils of compulsory school age must be in school unless a statutory reason applies (for example, the pupil has been granted a leave of absence, is unable to attend because of sickness, is absent for a necessary religious observance).
It’s going to be messy… that can be read as if acting on GP or clinic advice for family members at risk should not result in fines, but also as if the government bringing shielding to end means that kids in those households must be in school (and therefore liable to fines if absent).
Thank you Kelvin.
If it is a child you are worried about, I would get “supporting evidence” from your GP or clinic, ready to back up removing them from in school attendance, and requesting at home learning support, in case that becomes necessary. That’s my intention for next week anyway. If you’re worried about someone else in your home, I think you might have to be ready to fight against any fines if you decide to shut the household off again this autumn… I imagine schools and councils will see this as futile and avoid such battles though, whatever the government is ‘currently’ saying. The real battle will be where schools say they can’t afford to offer, and don’t have the staff for, at home learning.
Tired, pretty much every one of the R numbers you wrote are pretty badly wrong
They are largely illustrative as I think the values are so confounded by so many other parts of the model - assumptions about incubation, infectiousness, mixing patterns.... as to be unhelpful. The fishing vessel example is impressive - in a cold well-mixed environment, about 80% of people developed the infection. That's an extreme upper bound on transmissibility. The past data on cruise ships and nursing homes can now be viewed in a different light with the advent of serology that was not available.
I'm looking at whether we can even detect the impact of immunity on transmission (unlikely) in the presence of contact restrictions. I think schools will have some impact on transmission but it is hard to quantify how much to be honest. There is little evidence that children cannot be infected not pass the infection onto others, particularly secondary school age children. There is no evidence that they suffer significant morbidity, but then nor do many adults who present as asymptomatic. Hence I am most interested in tracking and trying to predict deaths over all else. The above was my reasonable worst-case.
In the absence of protection (vaccine/antibodies) I would ramp up prospective self-testing, schools testing and workplace testing, isolate those positive but keep all schools open as a priority. For those who have been shielding, rates of infection are now very low, but I would personally continue to take physical precautions where possible.
Thanks again Kelvin.
Could you point me in the direction of where that first quote came from. I can see it will be useful.
The details: it's me isolating. We've been shielding as a family as I've been classed as "clinically extremely vulnerable". The thing is, it's not a permanent problem but is due to the treatment I've been recieving over the summer, and things are looking up. Treatment has been working, fingers crossed, and White blood cell count is predicted to be back to normal, or near enough, by the end of October, and I'll be returning into work then (will work from home until then). The family have been so careful over hygiene, and made some big sacrifices already, that it seems wrong to risk it all going wrong for the sake of a couple of months. Can't really go into more detail online as there's still people who should know but don't due to shielding/isolation.
Colournoise linked to the new guidance in the other thread.
Edit: no, sorry, that was just the PR… I’ll get you a link.
See the ‘Attendance’ section here:
What school year is your child? Do what’s best for them (ie keep you safe), but what help you need to push for as regards home learning this term, and the realistic expectations of getting it, might depend on that. Have you contacted the head of year yet?
Hope all goes well for you.
If it comes to it, can you afford a bit of private tuition over zoom etc? Your school should be able to tell you what is being missed, and even assign and mark work, but face to face tuition might not be possible.
I’m curious as to why case numbers are spiking in France and Spain etc but not here.
I don’t think they would be any worse than us for safe practices?
Either we are a few weeks behind the likes of Spain or France, or their culture of more physical contact/greetings is a factor, or maybe more if the UK population is still trying to follow the guidance, despite what media headlines, Facebook idiots and the "glass half empty" types on here are all trying to show.
Probably a combination of all three
The same points were raised before the first spike. Except this time there's less transit and more in transit precaution from those countrys, and Londons transport hub is far less congested.
And more personal protection of course, although this feels highly varied by locale.
Thanks again kelvin.
You’ve all been following this guy, yes?
https://twitter.com/xandvt/status/1300151240899416071?s=21
https://twitter.com/xandvt/status/1300181024735977473?s=21
Iceland has a relatively small population and a company that developed a pcr test very early on to test its populace (300k people). For comparison, that’s typically less than two weeks of passenger arrivals at Heathrow.
Testing system creaking already. Bodes well for the cold season.
https://www.bbc.co.uk/news/health-53990068
Weird. There’s a testing place about 2 miles away from me in North London. If I was told to go to Cardiff, I wouldn’t.
Weird. There’s a testing place about 2 miles away from me in North London. If I was told to go to Cardiff, I wouldn’t.
My local one has gone from being drop in, there was rarely anyone there, to appt only, it's now rammed. Work colleague had to go to Dundee (2hr drive) for his, until we ramp p the number of centres, or get quicker tests, this is the reality. And I don't believe you wouldn't tbh, would be a real act of selfishness to do that.
Thoughts on airport testing? I was under the opinion that a test isn't really definitive, depends on how far or otherwise you are into the infection, which makes the airports airlines claims that airport testing is the manna they need to get back up to speed not quite right?.
Hibs player up here failed one day, passed the next. Papers are calling it a false positive, but it's not, it's a positive, surely?.
As ever, prepared to be educated!.
And I don’t believe you wouldn’t tbh, would be a real act of selfishness to do that.
Depends how shit you're feeling, what with the Covid symptoms and all.
New Theory on how COVID-19 works.
Thanks for posting that.
And I don’t believe you wouldn’t tbh, would be a real act of selfishness to do that.
Plus also my fear of falling prevents me from driving across the bridge, so hey. Aside from that, you don't think an expectation of 7hr return trip, the emissions and fuel costs is a selfish move by the government, when I could self isolate and await my turn more locally? Pft.
