[Ed P]

Richard the 60% WILL happen, that is just the mathematics of a virus propagating in a population that has zero natural immunity it has nothing to do with scaremongering or sloppiness. BUT what is important is the time scale. In the worst case if it happens over a 3 month period then once again quoting Private Fraser – “We are doomed!”. If it happens over two years, then there are no real problems.

What the WHO and Governments around the world are trying to do is to slow down the rate of virus propagation and buy time for vaccine work to complete. They hoped (somewhat irrationally) to avoid the draconian measures used by China, and thought that simple identification of those with the virus and their potential secondary flu victims would solve all. This is what was done for SARS and MERS. Unfortunately Covid-19 behaves more like a ‘normal’ flu virus in which 10-20% of flu transmission is done by asymptomatic people. Adding to the woes it appears (unproven as yet) that people can incubate and disseminate the virus in zero to 27 days – these latter two characteristics make normal isolation/quarantine of individuals fairly ineffective as soon as the virus gets loose from any unidentified sources. That is why China were rapidly forced into isolating areas to allow the virus to ‘burn-out’ to the 60% mark, and not infect the whole population. That is also why you now see Italy adopting a similar but slightly half-baked strategy.

What our incompetent Government should have done from an early stage is to have mandated hospital-style alcohol gel/spray hand-cleaning stations at the entrances to Supermarkets, Shopping Malls, places of public gathering etc. This would have slowed the rate of any propagation and delayed the onset of having to do zone isolation. They could still do this, but they are trying ineffectually to exhort the public to do it themselves without even explaining just why hand-washing would work. When time is of the essence, edict is faster and far more effective. Changes in personal habits would then naturally follow.  Instead of which Mushroom Matt tried to hush it all up with pabulum to the masses, a sure fire recipe for making it really hard to quickly change unhygienic public habits.

[Ed P]

Edits do not work – I wanted to add that I am not second guessing after the event, as our Government had the full simulation study results of the BBC/ICL Pandemic study. IIRC hand-washing halves the rate of transmission, yet our Government continues to dither.

[The VFM Addict]

Richard wrote:

…………. It is absurd to propose bankrupting each other by suggesting the purchase of equipment that could never be delivered in time and for which no trained staff or space would be available in a 60% event.

I presume that in that last paragraph, Richard, you were talking of the NHS ‘buying-in’.    True, some of what WILL be needed might not be delivered in time.   But I fail to see the logic in not buying in that which IS rapidly available and could be delivered in time.

Space is less of a problem than one may think.   Many hospitals have closed/inactive wards that can be reactivated.   Anyone can be trained inside half and hour to set up and manage non-invasive ventilation (i.e. CPAP or BiPAP ventilation which provides breathing support without intubation). Highly trained staff are not required as such;  this level of ventilation is sufficient for many.    BiPAP is already in the case of those with dangerous sleep apnoea often self-administered today by patients at home after training.   No medical degree required.   So even nursing assistants could be trained to deliver such vital care once the patient’s need is signed off by a doctor.   The NHS could then save its highly trained staff for where intubation is needed.

What I have said in this thread may alarm some but hard facts can often alarm.   But it is not ‘alarmist’ to merely state fact.   You possibly consider it alarmist because the facts are uncomfortable to face.   It took me a while looking closely at the FACTS to face up to them so I do have some empathy.  I know facing such isn’t easy.   But it must be done if you and those you care for are to have any chance of taking the best possible action to mitigate the impact of the dangerous viral punch coming in our direction.    This virus has already killed more than SARS, Ebola and MERS put together and in far, far faster order.   No, it doesn’t have the case fatality rate of any of those viruses but, due to its virulence (infectiousness) and because it can infect others effectively covertly, it will wage a horrific war of attrition on the human race simply of its very nature.

Irrespective of whether you do take positive action or simply leave everything merely to chance I wish you well, Richard; and hope that you, as I do with all Forumites, are still with us when we eventually reach the other side of this coming nightmare.

As for me, well if this little bugger of a virus takes me then it won’t have done so without me having put up the best fight possible; and I’d rather go into that fight well equipped rather than empty handed.  YMMV.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Richard]

Sorry, that is a clash about what  ‘experts’ are saying. They said that their modelling showed 60% as the worst-case not the only case in the studies I saw and read about. You decided that nothing can be done to stop that worst case. That is your opinion, we can either agree, roll over and play dead now or perhaps panic and end up dead anyway.

Clearly some countries are willing to fulfil the Armageddon desire. Iran will not restrict access to  their epicentres of infection, Saudi is saying no thanks and closing their probably porous border.

The Italians  made errors, they are now working to try to recover.

Yes, the UK could do more, our cases were imported, perhaps the UK should now bar all arrivals for 4 ~ 6 weeks? That sure knocks the hell out of panicking.

Or the UK could order up infinite respirators knowing that there would never be a hope of getting them, the required bed spaces, the staff and supporting services to meet your prophesy. For your tax bill not mine thank you.

[Ed P]

You are correct Richard, if no vaccine is forthcoming and if (as seems likely) warm weather does not inactivate it then the 60% case WILL eventually be reached. However as I previously stated the timeline is the important factor. IF we can halve the rate of infection then we will substantially reduce the load on NHS hospitals and increase survival rates. IF (big if) we can stretch the time between infections to greater than the infective period then we will win the battle. i.e. the focus should be on prevention whether that be gel stations/hand washing, face masks and goggles or just asking people to cut down on travel (work from home, visit less etc). As an aside the BBC study showed that old pharts visiting relatives caused their virtual virus to travel faster and further than previously thought possible.

I became annoyed with the way Mushroom Matt played down the situation from the beginning, even though its seriousness was obvious to anyone with some science/maths training. He has been more concerned about short-term impacts to the economy rather than taking a big picture view of the whole life cycle of a serious epidemic and how the overall economic impacts can be minimised.

Yet another Greyling lightweight in a position of power who will blame his advisors.

[The VFM Addict]

Richard, I hope your view of what’s coming is right.   But too many experts appear to be towing HMG’s line.   Heard a Professor today from the London School of Tropical Medicine saying the warmer weather when it comes will stop this spreading as it does the flu.   What a total plank.    No-one has ever it seems told him that when a theory and reality are in absolute conflict it is always the theory that is wrong.   It is 28 and 21 degrees in Singapore and Kuwait respectively at present and the virus seems to be happily chugging along in its sunglasses.   Moreover 9 out of 19 individuals that attended a BBQ with an infected individual in Singapore were subsequently found positive.    So the perhaps the virus had its shorts and suntan oil on also.

BTW you are grammatically incorrect that my position could be called panic.  Panic is an ‘overwhelming’ feeling of fear and anxiety.     Yes, I have fear of and an anxious about what is coming. But I am not ‘overwhelmed’ to the point of not being unable to face the facts and take positive action to mitigate its impact; quite the reverse, which should be obvious.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Ed P]

The WHO have released some data to chew on which pretty coherently identifies the people who should be considering how to lower their personal risk.

If you are under 40 it isn’t much worse than flu, and if acting selfishly you can pretty much ignore it and treat it like just another case of flu. If you are under 65 and 50 or more, and still working then it may pay to work from home more of the time.

As you get over 65 the risks grow very rapidly. (I’m not sure how to factor in comorbidity for preexisting complaints but it is obviously worse). Ditto male versus female effects. If you are in the upper age bracket then avoiding infection for as long as possible is probably the best strategy e.g. full protective gear when out and cut down on socialising and certainly never shake hands with anyone!

Perhaps I can now cynically understand the secret Cummings Government strategy – do the minimum necessary to avoid public unrest and go for a cull of the non-productive over 65s thereby quickly solving a lot of national problems.

[The VFM Addict]

Ed, I’d buy your final paragraph but for the fact that such a cull would be of predominantly Tory voters.   Because the over 65’s vote Tory far more often than Labour or Liberal.    I am not therefore not 100% sure such is to the Tories advantage and hence that such could be Cummings’s plan.

Re Age v Risk – the WHO data you linked showed that the virus even in younger age groups is twice as lethal as flu in a bad year.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Ed P]

While I agree with the electoral impacts, maybe Cummings thinks that is easily outweighed by solving the NHS, Social Services, Dementia, Pension costs as well as the shortage of housing stock and blame it all on mother nature. Not only that, the cherry topping is that the Treasury gets a windfall of Estate Duties.

btw I read the comorbidity comments a couple of times and I’m still insure whether they can be treated as separable variables or what it means to have comorbidity factors for both male and female.

[The VFM Addict]

I would not rely on the WHO data because as yet it is effectively just what occurred in the Chinese population.   A far high percentage of Chinese males have smoked and still do than is the norm in Western Europe and hence are more likely to suffer cardiac problems combined with respiratory problems.    In other words the death rate among the previously cardiac compromised will inevitably be higher because they will in the main also be already compromised as regards respiratory function.    It all makes interpreting the data in any meaningful way close to impossible.    Yes, the top three categories (cardiac, diabetes and respiratory) will equally be the main risk factors in the UK just as they are with normal flu.   But as regards percentages they cannot be even loosely relied upon.

I live near a large Chinese Restaurant which until lately had six, seven or eight coach loads of Chinese Tourists dine there each day.   The owner seemed to have a deal with many tour operators.    Truly, hundreds of exclusively Chinese tourists every single day.   Almost every male would be outside smoking after the meal.   As an aside not a single one was ever seen by me vaping.    Looking at them obesity seemed rare.    Therefore one would expect a lot of overlap between cardiac problems and the inevitable respiratory problems that derive of smoking.   But in isolation Diabetes could be the biggest risk factor.   It is just that more of those with cardiac problems died because they also had respiratory problems; both caused in the main by smoking.

I think therefore that we need to see some western data.   However, clearly as with all ‘flu’ type conditions those suffering any of the top three morbidities will be at greater risk and far, far more so it they suffer more than one of the top three.     Finally, the sex differences are actually nowhere near as great as I would expect given the huge difference in the levels of smoking between the sexes in China.   Indeed my gut reaction is that we may well find that the gender differential will actually be the reverse in western states.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[The VFM Addict]

Data re Chinese Smoking Gender Divide

As of 2014, two thirds of Chinese men smoked.  Women smoked much less.  In 2010, smoking caused nearly 1 million (840 000 male, 130 000 female) deaths in China.   That gender divide is massive.

Compare to the UK.   The UK smoking rate had fallen to 14.4% in 2018.  25 – 34 year olds still have the highest smoking rate, with approximately 1 in 5 people within this age range smoking equating to around 1.4 million smokers in the UK.   This could impact the age CFR.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[The VFM Addict]

Of the 650 Italian cases to date, the only sizeable European cohort so far:

284 are in home isolation and 45 patients have recovered from the disease.   Therefore Italy is clearly not putting everyone in hospital as a precaution.

248 are though hospitalised with symptoms; that’s 38% of the 650.   Worse still 56 (yes, 56) are in Intensive Care.   That’s 8.9% of the 650 and almost three times higher than the 3% we were led to believe would need Intensive Care at worst.

Not mentioned in the Italian Press release is that 17 have already died; that’s 2.6%.   No outcome has yet been reached for 605 of the 650 (i.e. neither death nor recovery has occurred).   Sure as hell a fair chunk of the 56 in intensive care will not make it through because 35 are already critical.  So its looking like the CFR (case fatality rate) could far exceed 3% and could even exceed 4%.

Facts.   That’s what those figures are.   Make of them what you will.    But compared to the flu, which kills just 0.1% even in a bad year the figures cannot simply be disregarded except foolishly.

_______________________________________________________________________________________

During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[The VFM Addict]

Correction to the above post – There is no outcome yet is 588 cases and not 605 cases as I wrote.   That is to say 650 cases minus 62 (i.e. 45 recovered and 17 dead).

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Ed P]

In the Beeb interview with a leading Wuhan hospital GP he stated that the death rate appeared at times to be worse than SARS.  As this was an official interview you can be certain that the GP was both a senior figure in Wuhan, and an expert who had already cleared all his data up the chain of command. To remind everyone, although the initial CFR for SARS was 3.8% when the data stabilised they found that the CFR run-rate in Canada was about 17%.

Looks like Mushroom Matt has been piling on the B.S. so as to not scare either the plebs, and the Stock Market. In fact last night he let the cat out of the bag by saying that economic impacts had to be taken into account when looking at precautionary measures such as closures. My Cummings conspiracy theory looks correct!

Joking aside, I still think that this has been handled very incompetently from a crowd psychology standpoint. Small useful measures early with good accurate information would have much better prepared the UK public, and slowed the future rate of spread of the virus. Instead we have been fed comfortable BS from paid (or ignorant) shills.

 

[Richard]

I spent nearly two hours in outpatients yesterday as a follow up to one of the branches of my investigations. It appears that last month’s scan did find the probably source of my previous lung infection several years ago. Happily, though it has slaved away churning out problems, it had not yet caused the lung problem  to repeat. The upshot of this statement is twofold. At some point I will have an operation to clear out and hopefully solve what has been an ongoing issue. The other is that it must quite obviously put me in the possible target group for the present bit of excitement going the rounds. In my mid seventies, with respiration spinal issues all is not perfectly well with me.

Still. I am largely unmoved by that issue. My social circle is very limited, so I live in a way that could most of the time, be considered closely aligned with self isolation. Though, in contrast to that last statement we do have a 500 plus mile round trip for a University open day tomorrow.

Personally, I see little reason for me to panic over Covid-19 there is already amply evidence that others have already taken that course for me. Stock markets are falling with a consequent risk to the pensions of many of us, the next risk issue is that food supplies could become affected. Oh, what will the crushed avocado set do to get their fix of expensive, water intensive imported fruit. Never mind the dire warnings that schools might shut for 2 months and that production via most activities will be slashed. What no new Apple shiny things or mass sports events?

I did have to wonder as I waited for an hour and half surrounded by a growing number of heaving of over weight children and their equally overweight mothers, where do the greatest problems lie? I found a partial answer when my appointment finally started and the doctor was unable to log into obtain my required information. The rejection message appeared to leave him confused, his login credentials were rejected. He left to seek the help of others before returning with an update. Then he left once more to seek a consent form which he then struggled to fill out. No wonder there are delays, cancellations and long waits. It is not the first time that a two stream set up has been seen to function as less than one due to the extra time lost during joint consultations when two function as closer to half a person.

So, I shall try to keep rolling along, in the hope not the expectation of getting somewhere.

[The VFM Addict]

Ed, in the twentieth century a state’s pandemic control was about protecting lives.  In the twenty-first century it is about protecting markets; something which has for some time been very clear.

Anyone looking at what China was doing should have recognised instantly that this was far, far worse than even the nastiest flu.  But then again I feel I am preaching to the converted saying that to you because it is clear that you were reaching the same conclusions in parallel to me.   Others, and perhaps pressure on their time prevented them from doing so, never looked closely at all the data out there and/or forgot the power of the state.  Because it is surely clear that states have exerted a degree of pressure on the MSM possibly merely by telling the media it would crash the markets/economies if they delivered the true facts to their populations.   Personally, I think the impact due to this initial deceit once the truth dawns will do far greater damage to the markets.   Most businesses have due to the deceit not planned for what is coming when they should have been cross-training as fast as they could so that healthy staff could fill in for the unwell and of which there will be many a considerable number never to return.

I am very concerned that Japan has identified what appears to be a patient who suffered the virus; recovered; was cleared but then subsequently became unwell and tested positive.   Was this a case of –  (a) the virus being in the main beaten but remaining as some viruses do, in immunologically privileged sites within the body only to flare again in similar fashion to that which occurs with Herpes Simplex – or – (b) is the immunity one develops after beating the first infection short lived, which also occurs with some types of infection.   If it is (a) then continuing an anti-viral or Chloroquine for some time even after a negative result may solve it and assist in the absolute clearance of the infection.   If it is (b) the problem is more difficult to address until a 100% effective vaccine is available.   Until then mankind would be certain to lose the war of attrition with the virus coming back again and again until its gets the job finished/you finished, so to speak.   I will be looking very closely to see if more instances like that in Japan occur?    For the record I changed my personal plan yesterday afternoon and sourced 2 further packs of Avloclor and will increase my holding further still today.    If it seems to have helped I will continue with the normal prophylactic dose for malaria for at least three months after my apparent recovery.    No problem with that because the prophylactic dose can be used pretty much indefinitely without significant risk.    Just about any rational evaluation of the likely spectrum of incidence and impact on the NHS once this breaks will overwhelm the NHS which is already breaking under the weight of the current flu season.   So I am truly of the belief that we will be either left or effectively left to our own devices; with little if any chance that the NHS will every be the relief column which comes riding over the hill, bugles blaring to save us if we suffer a severe infection.    This country currently has just over 1,200 NHS hospitals; less than 170K beds and only 6,000 ICU beds.   Until the NHS acquired a potent stone (a 100% effective vaccine or anti-viral) to hurl at this Goliath then it is David without his sling.

For those who think the above is alarmist or scaremongering – I say only that this virus is sound cause for very serious alarm.   Frankly unless folks are truly scared they will take precautions no greater than they do with normal flu; which is typically diddly squat, isn’t it?    That’s why so many catch the flu each year.   But if folks consider this to be quite often deadly then just watch how careful they will be and that alone may delay its spread sufficiently to buy enough time for an effective vaccine or antiviral to be developed.    The bottom line is I make no apologies for warning folks because the evidence is that they need to be thoroughly STERNLY WARNED immediately.   But then again I am fairly certain that you concur, Ed.   It will only dawn on the majority too late for them to prepare for their own defence and by doing fail to add their own barricade to onward transmission.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Ed P]

As the media is in cover-up mode, I think it behoves the better informed to try and disseminate the unbridled truth and allow people to behave maturely and sensibly in reaching their own conclusions. For those who are statistically or scientifically blind then I would hope the Government will issue simple guidelines and ways of getting medication (chloroquine) to those who must self isolate.

At this stage I would not unduly panic over the apparent Japanese reinfection. The person almost certainly will still show markers for covid-19, but may have subsequently contracted a ‘normal’ corona-type flu with all the lung markers that goes with it.

One of the medical challenges will be to triage covid-19 cases from flu, bad colds etc.

[The VFM Addict]

If that is the case then the negative after the first bout must have been a false negative.   I hope it was.   I will be looking closely to see if this is likely because further incidences of apparent reinfection do not become common.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Ed P]

If I take the Diamond Princess as an example, the Japanese do not appear to have a good track record with their covid-19 testing.

[The VFM Addict]

Very true but there were also several reports from China along the way which were often disregarded. The only state which appears to have had a faultless track record in respect of anything like a volume of testing is South Korea.    So as for ‘re-infection’ or ‘residual dormant virus’, for me the jury is still out.    But I’m keeping an eye on it because it is the one thing that does cause the proverbial bricks to exude; after all one cannot self-isolate forever.

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During the Covid-19 Epidemic I will be wearing a mask and goggles while posting so that if I become infected I won't spread it to you.

[Author]

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