Yep Nick, there was a Guardian article I linked to earlier in the thread.

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In addition to saying this was France's worst health crisis in century, Macron told the French people that there would be a 'second wave' at some point.

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That’s possibly another reason!  

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There will be next autumn/winter for those countries which have not achieved herd immunity.

This is what policy makers have to decide - countries which have successfully contained the virus cannot let up their guard until and unless max vaccination is available. Countries which have achieved herd immunity don't have that problem.

Personally, I would have restricted foreign travel weeks ago and gone for containment like Taiwan, or rapid close down like Japan. But we are where we are - the only way we can get through this now without ending up in the same boat as Italy, is to ensure our more vulnerable communities are kept safe. That is not simply for the obvious humanitarian reason, but also to prevent the NHS from being completely overwhelmed by people requiring ICU and ventilation.

 

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This is no surprise:

"Slovenia has declared a coronavirus epidemic. It follows a steep rise in the number of cases. There are now almost 100 patients with Covid-19.

All schools will close from Monday and leave for medical staff has been cancelled."

They closed their border with Italy this week - if they had wanted to slow down the cases in their country, they should have done it 10 days ago.

Either you go for containment, which means closing borders, or you go for some other strategy.

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I agree the approach outlined today is the sensible one.Closing schools and banning large gatherings will cause more problems and knock on effects. There is a balance to be struck between doing the best to ensure not everyone comes down with the virus at once and making sure the economy does not totally collapse resulting in mass bankruptcies a nd mass unemployment not to mention social unrest if draconian measures are introduced. I also think trying to build up a herd immunity might be the best way to combat this virus especially as there wont be a vaccine for over a year at least,by which time the covid-19 virus will have mutated. Its an ill wind that blows no one any good and with the markets in free fall it could be a once in a lifetime buying opportunity especially if the FTSE100 goes below 5000.

As an aside re the football..i fully expect the euro`s to be cancelled as well as the champions league and Europa league. As for the premier league and EFL it would not surprise me if they started playing at least 2 matches a week to get the season completed as early as poss whilst they still can.

The UK government is not alone in its approach - Holland has a remarkably similar strategy:

"Flanked by the health minister, Dutch Prime Minister Mark Rutte announced new measures designed to limit the spread of the virus:

• A ban on gatherings of more than 100 people


• Colleges and universities told to offer students online tutorials (but primary and secondary schools will remain open)


• People with low immunity and the elderly advised to isolate themselves


• People who have coronavirus symptoms – cough plus fever - told to stay at home

"The Netherlands is a patient and we must decide which treatment the patient needs and then look at how the patient responds to it," Mr Rutte said, rejecting criticism that the Netherlands had been too slow to react.

These new measures will remain in place until the end of the month.

Eurovision, the Invictus Games and the Dutch Grand Pix planned for May are immune, for now."

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Isn't it inconceivable - and completely unmanageable - that we can reach a level that provides herd immunity in one wave?  Spanish flu came in three waves; this could be the same or more, depending on how effective our controls are and whether we can develop a vaccine.

As others have noted, it's only under control in China (assuming it is) because of the severe measures that have been taken.  The test will be what happens when they try to restore something like normality.

 

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Just back from the local supermarket and they are out of bread, milk and jacks roll. I sometimes wonder about the general intelligence of my fellow apes. 

 

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It is inevitable and to some extent desirable in the absence of a vaccine to develop natural immunity amongst all the population, but that process has to be managed as far as possible to create minimum stress on the health services. I've had a bit of a debrief just now on what's being talked about, and the UK policy is one that is most likely to avoid that 2nd wave IMO. Avoid the spikes, smooth the curve.

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So to achieve that how many people need to be infected?

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The second wave of the Spanish flu was much deadlier than the first, but I read that places which had developed immunity given widespread exposure to the first wave fared much better. Copenhagen was cited as an example of this with a mortality rate of just 0.27% during the second wave.

(mind you, Denmark are not following that strategy this time around, seems we are)

China is trying to get back to normal whilst preventing foreign travel - inward or outward. Will be interesting to see how that develops.

 

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I read a lot of support for the approach the government is taking. That's fair enough but is anyone making an attempt to quantify what it means in terms of deaths? Are we talking about hundreds, thousands, tens of thousands, hundreds of thousands or millions in the UK? I agree that economic cost is an important consideration but the benchmark must be the body count.

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Spot on BG

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That's the odd part because it is said be the CMO to be 80% (whereas Merkel said 70%) and that would mean approaching 50 million people.  

There must be another factor in play that scales the numbers down - maybe the preponderance of mild cases?  Mortality of 1% of 50 million doesn't bear thinking about.

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I support the UK's actions

I think containment simply delays the inevitable. Taiwan may have avoided it so far, but how long can they hold out? I year? 2?

Closing schools increases the immediate social and economic impact. Only time will tell whether it really affects the long term medical impact.

Isolating vulnerable people does seem to make sense. Closing schools does the opposite if elderly people are more likely to then come into contact with kids. This may be a factor in some countries where elderly members of the family live locally and remain in regular contact; ironic if the British pushing the elderly into Homes may actually help save them.

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There appear to be three strategies across the world - from an epidemiological perspective, it will be interesting to see which one is most successful:

 

1. Close borders, require all incomers to be tested and quarantined.


2. Shutdown everything and try to keep a lid on things.


3. Let it rip to some extent in the hope of building up herd immunity.

Examples of 1. Taiwan, Israel, Moldova, Hungary and now China (since it has successfully contained the initial outbreak).

Examples of 2. Most EU countries, South Korea

Examples of 3. UK and Holland

There is also the USA which appears to be a mix of all three :-)

Italy is a special case, since it is attempting strategy 2 but is already in peak epidemic.

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Pretty much everyone. We have to manage the severe cases through the health system without going through those spikes that would stress the NHS too much so that those that need acute care can get it when they need it. That's the policy outlined by UK GOV IMO, and I agree with it as the best way forward.

I'm not worried by comparisons to other countries, but the caveat is there's much that is not known about this virus. It may be something that rears it's head again in those that have already had it with further complications, without of course considering the shift that may occur once a vaccine is widely available and used. Of course if we've all had it, we might not need a vaccine, but that doesn't stop a mutation in other countries where they apply the vaccine.

At the end of the day, it's a bit of a gamble, but a gamble made on science rather than sentiment.

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I think whatever approach we take, the mortality rate will be the same. The only difference will possibly be in how well the NHS holds up, which will depend on us keeping the spikes down.  Remember also there’s an emphasis on protecting the most vulnerable groups to prevent overload. 

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So we're aiming at about 500,000 Brit civilian deaths if Whitty is right about mortality being a tad under 1%. About 8x as many as Hitler managed. If the dude from Hong Kong is right with 1.4% then we ratchet that up towards 3/4 million. If that is the best strategy available I shudder to think of the alternatives. 

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If we can hold out a year or two then a) off-label treatments could be identified b) new purpose built drugs may be in the pipeline c) a vaccine may be available. In life one experience I have learned is that kicking the can down the road can often be a very good approach.

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It is a dizzying question, Brian. There could be large numbers of deaths, many in chaotic settings; huge pressure on the NHS and related services; I won't paint more of a picture. One can understand why the case was made for a slow and steady pace to delay the peaks.

Roger

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The imponderable question is how long will it take to develop and test an effective vaccine and have it available for mass (and I mean mass - hundreds of millions)  use?

When it comes to herd immunity, it really does depend on the bug - for example:

"To achieve herd immunity for measles at least 90-95% of the population need to be vaccinated. A disease like polio is less contagious, and 80-85% of the population would need to be vaccinated for herd immunity to work."

Since COVID-19 is in the highly contagious category, you are looking at 90% plus for herd immunity, either by people having it and getting antibodies by fighting it off, or via an effective vaccine.

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The fact is, it’s here with us so we have to deal with it and I’m not going to let stress weaken my resistance!    

Happy 50th birthday by the way!  

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