Just like to chime in to say that this (=′ flattening the curve/ herd immunity’) fundamentally doesn’t work, and you don’t need to have a PhD in epidemiology from Imperial College to understand this [but you might need a PhD in epidemiology to misunderstand it], just basic arithmetic and common sense.
Suppose 50% of the UK (33 million people) get the virus of which 5% (~ 1.8 million people) will need serious hospitalization [conservative estimate]. The current capacity of ICU beds in the UK is something on the order of 2000 beds , depending on occupancy rates, ability to scale up et cetera. Let’s be extremely optimistic and somehow the UK is able to quintuple this capacity [as far as I can tell this is unlikely]. When somebody is sick they might need care for 2 weeks. The annual hospital capacity is: 25 weeks * 10.000 beds= 250k. At the moment the capacity is nowhere that (perhaps 50-100k).
You can see that 1.8 million is far larger than 100k or even 250 k. Even wildly optimistic estimates will not yield anything realistic. This assumes that the government is somehow able to control the infection spreading over a year; instead of two months. There is no reason to think they can do this without extreme (partial) lockdown measures. Controlling the R0 is extremely hard. All the mild measures seem to help only a tiny little bit. If the R0 is only a bit over 1, we still have exponential growth; and you have merely pushed timelines back a few months.
Can we perhaps expose young people but lock up older people for one-two years [when the vaccin might arrive]? I find this is extremely unlikely; you need only a couple people to flout the rules to wipe out an entire nursing home.
Is it worth it to (partially) lock down the entire country for a year to save maybe a hundred thousand old people? There are only two real possible approaches:
1. Let the Boomers die. If we’re lucky the death rate is ~0.7 percent. When (not if) hospitals overflow this will easily triple. Without medical care, once you go critical you simply can’t breath [though I heard something to the effect that most/many deaths are due to cardiac arrest]. Simple as that. With a massive host population the virus will mutate and we might have the same problem every year [<- this very real possibility is perhaps the most important to think about].
2. total lock down → squash the curve, followup with massive testing Gangnam style and extensive contact tracing [also: Fast-track all possible vaccins/treatments and fire Chief Medical Officer]. This seems to work so far in all East-Asian countries. Why the people with actual experience and succes in this matter get systematically ignored in these discussion will be a question for historians.
I know my preferred approach. There is no linear response to an exponential tide.
There is a strategy bifurcation: Either you lock down hard and contain/eradicate, or you just accept the losses and tell people to go on as normal, with isolation of the vulnerable.
The middle path is not favorable. You take both the human damage and the economic damage.
Just like to chime in to say that this (=′ flattening the curve/ herd immunity’) fundamentally doesn’t work, and you don’t need to have a PhD in epidemiology from Imperial College to understand this [but you might need a PhD in epidemiology to misunderstand it], just basic arithmetic and common sense.
Suppose 50% of the UK (33 million people) get the virus of which 5% (~ 1.8 million people) will need serious hospitalization [conservative estimate]. The current capacity of ICU beds in the UK is something on the order of 2000 beds , depending on occupancy rates, ability to scale up et cetera. Let’s be extremely optimistic and somehow the UK is able to quintuple this capacity [as far as I can tell this is unlikely]. When somebody is sick they might need care for 2 weeks. The annual hospital capacity is: 25 weeks * 10.000 beds= 250k. At the moment the capacity is nowhere that (perhaps 50-100k).
You can see that 1.8 million is far larger than 100k or even 250 k. Even wildly optimistic estimates will not yield anything realistic. This assumes that the government is somehow able to control the infection spreading over a year; instead of two months. There is no reason to think they can do this without extreme (partial) lockdown measures. Controlling the R0 is extremely hard. All the mild measures seem to help only a tiny little bit. If the R0 is only a bit over 1, we still have exponential growth; and you have merely pushed timelines back a few months.
Can we perhaps expose young people but lock up older people for one-two years [when the vaccin might arrive]? I find this is extremely unlikely; you need only a couple people to flout the rules to wipe out an entire nursing home.
Is it worth it to (partially) lock down the entire country for a year to save maybe a hundred thousand old people?
There are only two real possible approaches:
1. Let the Boomers die. If we’re lucky the death rate is ~0.7 percent. When (not if) hospitals overflow this will easily triple. Without medical care, once you go critical you simply can’t breath [though I heard something to the effect that most/many deaths are due to cardiac arrest]. Simple as that. With a massive host population the virus will mutate and we might have the same problem every year [<- this very real possibility is perhaps the most important to think about].
2. total lock down → squash the curve, followup with massive testing Gangnam style and extensive contact tracing [also: Fast-track all possible vaccins/treatments and fire Chief Medical Officer]. This seems to work so far in all East-Asian countries. Why the people with actual experience and succes in this matter get systematically ignored in these discussion will be a question for historians.
I know my preferred approach. There is no linear response to an exponential tide.
[1] https://www.telegraph.co.uk/global-health/science-and-disease/huge-regional-differences-intensive-care-bed-numbers-threaten/
I agree with this analysis completely.
There is a strategy bifurcation: Either you lock down hard and contain/eradicate, or you just accept the losses and tell people to go on as normal, with isolation of the vulnerable.
The middle path is not favorable. You take both the human damage and the economic damage.