While that may be technically right (under some optimistic, unverified assumptions, e.g. no reinfection), it's a false dichotomy. Singapore, Hong Kong, and South Korea aren't under lockdown, they're stopping the spread by just having good testing and case tracking capacity, and good hygiene. And the longer things go on, the better they're getting at doing that. If things are getting out of hand, a temporary lockdown is effective (as it was in China), to get the numbers down while building up this kind of capacity. But lockdown doesn't have to last forever; China has already lifted restrictions in most cities.

The UK seems to be ignoring this, and I don't understand why. I suspect the real logic, as some government officials have outright said, is that a completely failed response would free up money for the NHS by killing off "bed blockers".

The social signalling around it is "prudent caution", in the sense that they are talking slowly and confidently while using big words. This gives some people the gut feeling that this must be the "rational" thing to do, but it's just window dressing. The plan is neither prudent nor cautious; it's recklessly endangering millions of lives. Experts in the UK are horrified; there's an hours-old petition against this with hundreds of academics already signed on [0]. The WHO has condemned it, and half the people I know studying abroad in the UK have fled the country over it.

0: http://maths.qmul.ac.uk/~vnicosia/UK_scientists_statement_on...

No, that is almost entirely wrong.

You can certainly disagree with their position but you should at least present it accurately. Their position is that this is a pandemic (i.e. spread too widely to eradicate this year), we have moved from the contain phase to the delay phase, and their plan is to gradually introduce measures up to full quarantine rather than jumping to lockdowns straight away. For example here are the measures planned in coming weeks:

https://www.itv.com/news/2020-03-14/elderly-to-be-quarantine...

If they manage to flatten the curve by timing measures, and if there is a second outbreak this winter, it may well save lives. The Chief Scientific Adviser and other experts are not horrified, they came up with the plan and are defending it, so no, ‘experts’ are not horrified, though some disagree (which is fine).

I’d be more worried living in the US right now given the mixture of denial and bluster which has been the response so far.

It will take some time before we know more about how successful these strategies are. Different countries are at different phases in the infection spread which makes comparisons unfair.

If anything, the politically easy decision would be the lockdowns which shows voters strong leaders capable of "doing something" (even if the value of this "something" is at best unclear).

Teachers are still waiting for test results and are supposed yo come back to work on Monday.

I can't really explain why there are so few casualties yet in Germany, but I think it's because many young and healthy people got infected (that's the case in Berlin, for instance), so hospitals aren't yet saturated.

I hope it stays that way, but I think we can expect much more deaths in the next days.

Germany is doing pretty well at just 9 deaths on 4.5k cases. The WHO is not the only or the best source of recommendations, nor is this over in China. I'd be very surprised if they don't see another outbreak there now that this is a pandemic it will spread to Africa for example, which has a huge no of Chinese working there who will bring it back.

I think much of Europe is a little bit like this. Germany will probably be relatively well off because German culture is fairly anti-social, Germans are typically very healthy, and the healthcare system is somewhat robust.

However, I haven't seen any sign whatsoever of a consistent or coherent response to the coronavirus. I expect whatever response eventually percolates out will be fairly rational, since german civil servants are well-paid and competent, but so far, it's been all over the place.

That has not been my experience. How could the culture of an entire country be antisocial? A nation of hostile hermits?

"I think it is very beautiful for the poor to accept their lot, to share it with the passion of Christ. I think the world is being much helped by the suffering of the poor people." --Mother Teresa

This is how some people think. It seems like there are no serious people in charge. It's going to be a catastrophe like we have never experienced.

The other issue is that of getting the leak at the wrong time. If the UK manages to partly control it, but then realises containment will fail in say November, the peak will occur at the worst possible time in winter.

By controlling the spread and aiming for summer, best medical care can be achieved given limited resources.

This logic is not true for equatorial countries such as Singapore due a lessened seasonal effect, so they should continue with their current Methodology. I suspect others will move to the UK approach once initial social distancing process inadequate (assuming they are that is).

Death and Active cases are a good measure. Both of these are under control in SK vs. still growing in Italy/Spain.

You forgot Taiwan, who is faring much better than all three of the countries you mentioned.

What mostly helped was lack of mainland Chinese people entering the country. Also Taiwanese wear their face masks religiously and are used to obeying the rules set by the government.

Finally (AFAIK) they have a very good health care system which handled the cases quickly and efficiently.

N95 masks, fitted properly, do help prevent catching the virus. For a mask to be called N95 it has to be approved by the CDC. It’s specifically designed to block >95% of airborne particles. That’s why they’re recommended for caretakers at hospitals and frontline workers dealing with infected patients. Replaced every ~3 hours and worn in combination with goggles and ear protection, they minimize the risk of infection through mucosal membranes. They have also been in short supply.

Surgical masks do not prevent catching the virus, but they help sick people not to spread it due to the mask catching some of the spray droplets when they cough / sneeze

That's not true at all. There is a reason why surgical masks are used by surgeons, but for the protection level needed by medical professionals, it is used as a part of a wider system.

Used casually it prevents much of the droplets in the air from entering your respiratory system, as well as preventing a lot of touching of the face. There are studies that indicate wearing a mask decreases virus respiratory several-fold.

The reason the N95 filters work is because when the air is sucked in, it must pass through the filter before entering your respiratory system, and that filter is designed to filter >95% of airborne particles (and often times even higher). For the surgical masks, the air just gets sucked in from the side, the path of least resistance. So the airborne particles would also just get sucked in from the side. The masks may cause changes in behavior that lead to lower infection probability (such as reminding you not to touch your face), but dipping your hand in glitter would be just as effective.

Very early on they instituted a 14-day quarantine period for anyone arriving from mainland China (later expanding this to Hong Kong and Macau), Korea, Italy and Iran. As of today, this now applies to the entire Schengen area (i.e., most of the EU).

The government has also taken over mask production (increasing capacity) and distribution (with a rationing system and an online map of where they can be bought).

Their website is very informative, with very transparent information about how many have been tested, confirmed, recovered, etc.: https://www.cdc.gov.tw/En

The strategy of UK seems valid as long as you protect the more vulnerable, which they don't do.

What is the strategy after a lock down? You go back to work? It needs only one person infected to get the virus propagating again...

The UK and devolved governments signaled on Thursday that the plan is for the vulnerable to be self-isolating for a long period; and based on the briefings to UK jornos on twitter - it'll be 16 weeks of self isolation for over 70s and those with underlying health conditions (they've not said what conditions yet) - I've seen it referred to as 'cocooning' by some.

I think the UK was doing a really good job, and has been doing a good job with this - I do think they've really misspoken when they've talked about herd immunity and have been trying to walk the term back.

You've got to bare in mind, that they aren't doing the politically easy things here. It would be easy to close the schools. Based on people I've spoken to, its going to happen soon - but I suspect they want this to happen after the over 70s and the vulnerables are into self-isolationg, and not shouldering childcare responsibilities. None of this is easy, we can't magic this virus away.

The schools issue is very tricky as a lot of NHS staff will not be able to work if their children need to stay home. I can see them going to a softly, softly approach - parents working from home will be able to keep kids out of school with no consequence and they will probably extend all the school holidays a bit as well.

I can't believe this government wants to kill off the elderly out of choice, it forms a good section of their voter base, if nothing else.

I think overall it's good long term strategy, though very risky, which is never going to be perfect, but seems to have a lot of science and rationale behind it, even if not obvious at first.

I had no choice but go out and to do my weekly food shopping yesterday. This was definitely not what I experienced at all. Families crowding out in the supermarket with small children and grandparents abound. People coughing openly, not maintaining distance and so on.

People still have no sense of urgency to change their behaviour, and this is the critical time that we need to mobilise. Any success would be down to pure luck rather than their strategy.

You will invariably have people breaking quarantine after a few weeks, especially if there is a sense of the threat subsiding.

I’m guessing that when things start getting Wuhan level crazy people will isolate anyway and they’ll get the worst of all results.

I despise the current government, and have no idea if this plan is better than alternatives, but please if you want to criticise it, do so for what it actually is, not a straw man of your own construction.

The actual plan and how to isolate the almost 20% of the population at high risk is not outlined here or anywhere I've seen. If you know (or anyone in the government knows) what it is, please provide a description or link. I've only seen hope... and undefined "measures".

The idea that a "second wave" can even be avoided or that infection prevents reinfection is not known. https://www.theguardian.com/commentisfree/2020/mar/15/epidem...

The U.K.’s Coronavirus ‘Herd Immunity’ Debacle. https://www.theatlantic.com/health/archive/2020/03/coronavir...

https://en.wikipedia.org/wiki/Invasion_of_Normandy

So, _even if_ you ascribe to the current UK government a conspiracy-esque, cold as nails approach to just effectively _murder whole boatloads of older folks_, it doesn't actually make sense: Who would they be so cold as to just casually acquiesce to a solution that results in a lot of death, but they are still human enough to care about the country first and are willing to sacrifice the electoral future of their party?

I'm on 'do not attribute to malice that which can be explained by stupidity', modifying it slightly to 'incompetence'.

Personally, I don’t think Johnson and his cronies are deliberately targeting this or that group. They just don’t care. They are scared like everyone else, and are prioritizing the survival of their immediate circles and their social status - i.e. they keep the economy working, keep an appearance of order, and ensure people they care about are “cocooned”, ready to come out when the worst is over. That is their priority. Working-class lives are not priority, that’s all. Health-service capacity woes are relatively unimportant, because people “who matter” will be prioritized anyway.

If they go to full-lockdown, they risk upsetting the existing social order (economy tanks even harder, unemployed people start rioting, etc). That is their worst fear; consider that we’ve had actual riots in London only a few years ago. Saving a bunch of working-class grandpas is clearly not worth the risk of upsetting the current social order, from Johnson’s position. He’d rather have a functioning elite ruling over rubbles, than risk the very own existence of such elite just to save “nobodies”. Add to it a sprinkle of academic Strangeloves, and there you are.

First, there is the best of them all you forgot to mention, Taiwan.

Second, To sum up the difference as I have posted elsewhere, it comes down to The East willing to do Social Distancing AND Wear Mask. The west simply refuse to wear mask.

Taiwan did heavy school closures but is now coming back online. Hopefully, things hold up.

1. https://www.moh.gov.sg/news-highlights/details/additional-pr...

But, I guess this question is just begging for all of us arm-chair quarterbacks, fear mongers and un-informed to jump in with anecdotes and opinions knowing full well that only time will tell which it is.

Personally, I think only a few things are clear.

1) Our society and government is totally unprepared.

2) This is going to be a bad year financially for most of us and a terrible year for many of the poorer among us. I just hope that we don't end up pushed yet another group into homelessness.

3) It seems like most of us don't know some really basic information about disease - like:

Q: How many died in the 2017-2018 flu season?

A: 61,000 in the US.

Source: https://www.cdc.gov/flu/about/burden/index.html. And, nope, that's not 61 people, not 610 or not 6100. That's right, the CDC estimates 61,000 people who died in the US alone in 1 year from the flu.

Which left me wondering why hasn't more been done to stop the spread of the flu?

How many have died from Coronavirus? A: 68 as of today in the US. 3,199 in China. 6,515 WorldWide. 3,213 in China, 1,809 in Italy. Source: https://www.worldometers.info/coronavirus/

Time for an anecdote. My wife had a medical emergency about a month ago - before Coronavirus. The emergency room was swamped. Sick people everywhere. Some not too sick. A bunch who were really sick. The nurses were handling out masks to everyone asking them to wear them to avoid making others sick. It was crazy. I had no idea.

Why now?

drawing the infections out so that the hospital system can stay stable and thus minimizing the amount of people who die from the disease. Not to mention that there will likely be a vaccine within 12-24 months and medication approved within the next few months.

Mind you this is in addition to South Korea having ~13 hospital beds per 1000 people, compared to ~8 in Germany and 2.5(!) in the UK. This strategy in the UK to let the virus eat through the population is insane.

The long term strategies for Korea and China are the same: carefully identify new cases as they come in from outside, find their contacts, and isolate them as soon as possible. Temporarily lock down small regions on an individual basis if necessary. They've already been doing that with some new cases coming in from Italy.

That was true a day or two ago, but that's a bit outdated now: Wuhan at most has had a bare majority of total cases in the world now, and probably a minority. In any event, it'll be a minority in a few hours.

Before quarantine we had many people infected not knowing they are infected, spreading the virus around.

After a few weeks of quarantine the ones infected will be known and separated from the rest, so the virus should be stopped. That is assuming the quarantine is strict.

https://www.washingtonpost.com/graphics/2020/world/corona-si...

The success of Hong Kong and Taiwan look like extensions of the social distancing paradigm to me.

Of course, maybe UK government recognizes that the its citizens are equally incapable of effective social distancing. Whatever the case, this looks like madness.

Not nothing, the latter is what #flattenthecurve thingy is. Reducing the exponent thereby keeping the NHS load below maximum.

Being an island is definitely a contributing factor though.

Both of them have more than 5 million people so they aren't tiny either.

https://www.nbcnews.com/health/health-care/doctors-push-trea...

Antivirals won't stop the outbreak but they could save thousands of lives.

The British Society for Immunology have also wrote an open letter of concern. They are immunologists and know about immunity.

Yes, not everybody signing is a specialist in epidemiology, but so what? The point is that a good number are -- there is no clear consensus among UK experts for the UK government's position. And among global experts, there is a clear consensus against their position.

Well there is a huge government drive to portray that this is the case right now.

Whenever that happens, it always arouses suspicion that something is not quite right.

As a group, it's hard to imagine that UK experts in Epidemiology and related fields deviates significantly from their peers globally.

0: https://petition.parliament.uk/help

On a more serious note, petitions and other methods by experts to publicly state a position isn't just about influencing government policy. It's also a political tool in the aftermath of failed policy. Just like the current panel of experts is a political tool employed by the government to justify the biases in its policy.

So I should listen to a bunch of students, astronomers and others over the Chief scientific officer and health scientist in the country? Riighht....

Or the British Society for Immunology: https://www.immunology.org/news/bsi-open-letter-government-s...

Or the two distinct open letters from UK scientists, which are now hitting 1200 signatures total: http://maths.qmul.ac.uk/~vnicosia/UK_scientists_statement_on... https://sites.google.com/view/covidopenletter/home

If you believe nobody credible opposes the UK government, you've been fed a narrative.

That's a complete strawman. You gave a letter signed by a massively padded out list of "academics" (probably intended to scare your average layman) and when pointed out that astronomers and students probably don't have much to offer right now

They believe that there are basically two mitigation strategies. One is to have a very drastic early lockdown that shuts down the virus before it spreads widely. The problem with that is, once you lift the lockdown it will simply start all over again. The problem with this is lockdowns are most effective the first time you do them, and then mostly in the first few weeks of the lockdown. Do it too early, and yes it will be very effective in the short term, but later on when cases become much more prevalent the lockdowns will be less effective.

The option they are going for is to start the lockdown a little later in the cycle. The hope is this will make the lockdown more effective at a higher point in the spread. Effectively instead of a series of booms and busts, you get one longer slower initial burn and then you’re mostly done. They believe that in the long term this will make it easier to protect those most vulnerable to the virus, because you only have to do it once, at the cost of increased prevalence among people least vulnerable to it. So they see it as a better longer term strategy.

https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...

https://hn.algolia.com/?dateRange=all&page=0&prefix=true&que...

Given everything we know regarding exponential spread, the high percentage of cases requiring icu treatment, and the mortality rate, I fail to see how the absence of any measures to mitigate the spreading of the virus makes sense.

The assumption that there are only two viable strategies, lockdown & no measures, is a plain wrong oversimplification. There is a wide range of intermediary steps that can be taken in between to attempt to slow down the virus.

Attempting to minimize the degree of overload on the health system by applying such measures in a coordinated fashion is meant to reduce casualties caused by system overload.

It did not take Italy 1 month to to go from 1,143 (today's UK number) positives to 21,157 (today's Italy number, per https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.h...), did it ?

HK, Taiwan and Singapore all acted extremely early on, to the point where HK knew before the news broke out in China. And the culture allows you to wear mask, which seems to be something most western nation are completely against.

Most part of Europe and UK reacted very late in the cycle. Since the Virus has an extremely long stable period before any symptoms appeared or to the point where you could be infected but showing no symptoms at all. It highly likely they are already in wide spread. 500 people each inflecting two, do that 11 times and we have 1 million infected.

Then there is the death rate, at least so far it seems to be extremely mild for anyone below 50.

Not saying I totally agree with Herd Immunity, but judging from the current data and situation it is possibly the best route to go.

It’s certainly not easy, but it seems possible and it’s not clear this would be much worse on the economy in the long run. Plus it saves half a million lives, so it seems like a moral imperative to at least try.

If your population already has lived through similar outbreaks, sure.

But look at the US. There is a sizable portion of the population who thinks this thing is a hoax, who simply don't believe in this pandemic. How do you lock down those people? They're going to completely ignore government recommendations, and they'll scream bloody murder when government cancels events and restricts travel and assembly.

But let's say you manage to lock down the US to contain the current wave, and that you manage to ramp up testing so that you can be more sure about actual infection rates. Once it dies down in the US, then what? Ease the lock down? What about other countries where it's still rampant? What if it flares up again in the US? Go into a second lock down? You've already spent an enormous amount of political capital getting the first one through, good luck getting a second one.

> Plus it saves half a million lives

You pulled this number right out of your ass by multiplying a guesstimated death rate as measured in China, where the virus spread unchecked through an entire province, and where the medical system wasn't prepared, and you're assuming that the demographics of the people catching the virus in the UK is going to be the same.

But if your medical system is prepared, if you're quarantining vulnerable people, if you have good testing, then letting the virus roll thorough the remaining un-quarantined population won't lead to the same death rates, or the same hospitalization rates, because all the underlying factors are different.

You will need a Lockdown AND Mask, or you will simply just need Mask and not even lockdown. I would argue social distancing only is not enough. But somehow even people in Italy refuse to wear mask. So I think a culture issue is also a problem there.

If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection. Wear a mask if you are coughing or sneezing. Masks are effective only when used in combination with frequent hand-cleaning with alcohol-based hand rub or soap and water. If you wear a mask, then you must know how to use it and dispose of it properly.

https://www.who.int/emergencies/diseases/novel-coronavirus-2...

The mask also protects you from bad actors who are not doing any standard hygiene procedures such as washing your hands.

Besides that, I think that especially in times like this, it is important to stick to the recommendations of experts. Here in Germany, the expert recommendation is akin to the parent comment. These recommendations are crafted by people with a lot of expertise on the subject and who care for the health of people, and I think it is not productive to fundamentally questions their advice.

That is the only valid argument I could possibly understand. Although I would argue we could have ramp up production line. And Medicals get priority with Mask.

>I think it is not productive to fundamentally questions their advice.

I dont know, but Japan, South Korea, Taiwan, Hong Kong, ( We exclude China for comparison ) 200M+ Population together has far fewer death than just Italy with a population of 60M. Let alone Europe. And people are dying.

But hey, I guess as long as the people in Germany and Italy and UK are happy with what is being done then that is fine.

Sorry I wasn't being clear enough. We knew very early on N95 doesn't work.

Take London. We could introduce a system of tracking and isolation within the M25, and that might work to lock down community transmission within the London population, but millions of people flow into and out of London each week so it would be completely pointless and ineffective. Meanwhile that level of tracking and isolation simply can’t work across the whole British isles. It’s administratively and logistically impractical.

Was curious about this point in particular - checked the numbers, and Heathrow has essentially equivalent traffic as Hong Kong International.

All of which have tiny populations compared to the UK.

For larger nations, there simply aren't enough tests available, nor enough treatment facilities for those who are likely to become very sick if the virus spreads rapidly through the population.

Why? If your nation is twice as big, then all else equal, your government has twice as much money, twice as many resources, and hence twice as many tests. China now has more tests than they need and they're the 2nd most populous nation in the world.

China has huge resources but has managed so far to keep the infection mostly contained to one specific area. It's not clear how long they'll be able to sustain that or whether they'd have enough resources to go around if all of China were the same as Hubei.

Of course all of this also assumes that tests are effective and that you can then do something useful if you confirm that a patient is indeed infected.

Is 66 million really that qualitatively different than 24 million?

Even so, assuming that strategies that appear to have been relatively successful in a smaller, more densely populated country will necessarily also work in a larger and less densely populated one seems to be dubious. We know that we don't have the resources we'd need to implement that strategy in the UK right now, and I haven't personally seen any experts arguing that it's a viable option for us, so I'm cautious about extrapolating too much here.

The quarantine measures, once introduced, do seem to have been viewed favourably by the experts and do seem to have been remarkably effective. This assumes we trust the reported statistics, which I acknowledge as a possible risk in this instance.

On the other hand, it may be that China has been able to achieve that in part by pulling resources from all over to focus on the main region affected. That isn't necessarily an option that will be open to other nations, particularly if their outbreaks are distributed across their whole area almost immediately.

Instead of criticizing my tone, which was in fact fairly restrained, you should thank me for taking the time to correct you. For instance: https://news.ycombinator.com/item?id=22580049 https://news.ycombinator.com/item?id=22569806 https://news.ycombinator.com/item?id=22529609 https://news.ycombinator.com/item?id=22505631 https://news.ycombinator.com/item?id=22504690 https://news.ycombinator.com/item?id=22370446

It is true that the UK does not have sufficient resources to cope with a widespread, uncontrolled outbreak, lacking for example one to two orders of magnitude in ventilator capacity; but, as should be obvious, this is not a result of the UK being a large country — the UK is much smaller than China, slightly smaller than Japan, the same size as South Korea, and slightly larger than Taiwan. But this conversation would be of higher quality if, instead of containing such your obviously false assertion and also fact-based rebuttals such as these, you had not posted the assertion in the first place (perhaps because you had read enough to see that it was false), so no rebuttal would be necessary.

I don't know enough to say that the UK strategy is correct (i hope it is - i live here, and more importantly, so do my parents). But i think the situation isn't cut and dried.

Hopefully, we will get a lot more detail in the next few days, and then the real experts can come to a consensus.

The UK approach here is basically just accepting that a majority of the population is going to get infected by design. That's fine. It might even be true. (It obviously will be if you don't do anything to stop it, but even in aggressive lockdowns I mean)

But it benefits nobody to have it spread quicker. Maybe life in the UK gets back to normal a little faster for people who are not at-risk or aren't treated at risk but we live in a very global society and if everyone else is locked down then it's hard to see much benefit for the UK itself.

And your parents and the portion of the population who are most vulnerable are more at risk.

An imperfect defense is better than not even trying.

Amongst other problems, the term "expert" is ill defined (see discussion above about mathematicians) and there's always value in contrarianism for people who aren't directly making decisions. If they're wrong nobody will remember and there's nearly no reputational impact. If they're right, they can win fame and glory.

I do not understand how not communicating a comprehensive action plan is meant to be the harder choice ("a decision many other countries [...] not able to make") when contrasted with messures such as declaring national emergencies and widespread lockdowns of public life.

Well, no, because the world at the end of the lockdown is not the same as the world before the disease started spreading. Some differences:

- People now know there is a dangerous disease and how to act and sanitize to mitigate its spread.

- Manufacturing and other logistics for medical providers have had the time of the lockdown to ramp up.

- Testing has had the time of the lockdown to ramp up.

- A vaccine is that much further along--which is the only viable long-term strategy.

- And most important, scientific understanding of the disease has had that much longer to develop.

Britain's "expose the youngsters" strategy has a terrible flaw, which is that we don't know if the disease is actually safe for young people! All we know are some basic statistics about messy data that was reported by overwhelmed medical systems with spotty testing.

There are reliable reports of a) some young people getting very sick from this disease, b) people who seem to have recovered going back into decline and in some cases death, and c) long-term lung damage among those who did not die.

The ideas that this disease is somehow safe for young people, and that contracting it once confers long-term immunity, are ideas that are yet to be scientifically proven. They are, for now, at best heuristics to aid triage.

https://co.vid19.sg/cases/singapore-case-28-6-month-old-male...

A 5 year-old was in hospital for six days, but has been discharged today:

https://co.vid19.sg/cases/singapore-case-160-5-year-old-male...

A 17-year old evacuated from Wuhan tested positive, but never showed any symptoms during the 3 weeks he was quarantined despite having the virus:

https://co.vid19.sg/cases/singapore-case-23-17-year-old-male...

(There's more cases that can be explored on the Singaporean website.)

I hate that this fact is spreading in the Netherlands without a proper explanation.

It won't. This is nonsense of the most obvious kind, because we're already past the stage where the virus is spreading quickly.

In fact the reverse is likely to be true. Lockdown minimises the number with the disease, but that number is not zero.

Which means that if immunity is possible (questionable for a CV, but let's pretend), immunity will spread wider and wider in each lockdown wave - and the health system won't be swamped.

This plays for time, raising the odds that a vaccine or some other treatment will appear.

Successive lockdowns will do exactly what they're supposed to do - spread out the peaks, minimise casualties over time, and minimise health system stress. (Although it will still be very high.)

What they won't do is keep businesses afloat. Mass bankruptcies are going to be a huge problem throughout the entire global economy.

Other countries understand this, and are stepping in with financial measures to help. Presumably the UK doesn't want to do this.

The tell is the fact that the government has plans to quarantine for four months - i.e. place under house arrest - over-70s who are infected. Without access to intensive care - it won't be available if the NHS is swamped - the mortality rate in this demographic is going to be higher than that of any other developed country. It could easily be twice the nominal 15% CFR for this demo in China.

It's hard to avoid the conclusion that the real plan is to cull the old and sick while pretending that's not happening.

https://assets.publishing.service.gov.uk/government/uploads/...

I'll be honest, I watched the announcement on Friday in open mouthed horror. I can't claim I have a concrete refutation for either the broad logic or the specific evidence underlying it, but even the best case scenario is a disaster of historic proportions. I wish us luck. I wish the rest of the world luck if it turns out we're right and they're wrong.

https://www.gov.uk/guidance/pandemic-flu

https://www.theguardian.com/education/2020/mar/13/coronaviru...

The time for creating choice on the cornonavirus response was during the last 20 years. They chose rampant financialisation, leveraging future income.

The UK has no energy security. No food security. I feel the corner we have painted ourselves into makes a prolonged shutdown far, far harder.

The one source I could find was https://www.globalenergyinstitute.org/energy-security-risk-i... which placed the UK in the top 3 countries for energy security (many years running).

Do let me know if you have some data that would change my mind! (and ditto for food security)

https://www.theguardian.com/money/2019/sep/01/uk-energy-pric...

And food

https://www.businessinsider.com/no-deal-brexit-percentage-br...

https://contagions.wordpress.com/2012/02/25/generating-immun...

My daughters dentist commented yesterday that all her surgeries (and her team usually do 50 a week) had been cancelled. The reason? All the anaesthesiologist had been requisitioned as they will be required to do ventilation. All elective surgeries had been cancelled, and her paeds specialists sent on refresher courses for adult patients.

We're in uncertain territory here, the NHS's response may not be 100% perfect and a lot of people will argue that some minutiae could be done better, but I believe it has the huge advantage.

I wonder if other countries, and particularly the US, can manage such a coordinated healthcare response?

Let's think about it again: China, Japan, South Korea, Hong Kong and Taiwan. They are countries which are very connected to each other; and yet, somehow, they managed to contain it. It's 'herd responsibility'. The people are applying social distancing and hygiene rules, that's why it's working.

It's possible, as a knowledgeable politician, that you recognize that it's impossible to implement such measures in your country. The reasons are beside the technical abilities of your government: Your citizen are not committed enough to the hygiene. And that's not because Asians are cleaner or superior, they have been exposed to these viruses before and thus they are already trained to deal with them.

It's not the same deal for many countries of the west. We didn't have much trouble in the last few decades and thus people have forgotten why we do most of the hygiene measures in the first place.

Also, here is my first reaction, as a citizen, if the government has declared 'herd immunity' as their strategy: STAY AT HOME. I'd also probably warn the closer one and avoid contact with them too.

So the UK might win twice here: Have enough social distancing by fear (and fear is a hell of a thing as you experienced in the last few days); and also have its population adopt strict hygiene and distancing rules making it safer in the future and readier for the next disease.

It's only 'working' while the country is on lockdown, and FYI the country spirals towards economic meltdown.

If they come out of 'lockdown', then 'it stops working'.

See the paradox here?

I really have no clue: maybe we'll develop therapies, a better understanding, maybe a vaccine, but possibly this 'herd immunity' idea at least on some scale. I really don't know.

But coronavirus is not going to disappear in a few weeks, we know that.

Nope.

> In Taiwan, most residents carry on as normal, with offices and schools open. Many restaurants, gyms, and cafes in the capital, Taipei, are still bustling, although most premises will take temperatures and spray hands with sanitiser before allowing customers in.

Source: https://www.theguardian.com/world/2020/mar/13/how-taiwan-is-...

That Taiwan has 'less lockdown' doesn't respond to the fact that whatever the degree of 'lockdown' whenever it is removed, the contagion will grow again, and that any level of lockdown will have bad economic repercussions.

That Taiwan is getting away with 'less severe' lockdown is not relevant because:

a) They do have a really long list of measures (more than 120 published by their Gov.) that are unsustainable in the long run and

b) It's a selective example - most other nations need more aggressive.

c) Due to the fragility from 'a' and economic downturn around the world due to 'b' a deep recession is guaranteed in Taiwan.

The point remains: there is currently no rational answer to 'how to end the lockdown' while economies go down.

I'd point out that the HK government has done an okay job, but by no means were the people happy with how they handled it. There were protests from the Hospital Authority demanding them to close the border to Mainland China and they outright ignored it.

The main reason why these countries are doing a good job is because of the people. You go outside and everyone has a mask on. Why? To protect each other. Everyone has been working from home from day 1 of this virus and, impressively, the panic buying only lasted a week or so. The people are in it together and I can't imagine the same ever really happening in Europe.

The aim is to flatten the curve, any herd immunity is a by-product but not the aim.

The virus is everywhere now, it’s part of the landscape, so preventing breakouts is just flat out not possible, at least for large countries with lots of travel and especially with large rural hinterlands like the UK. In this view the only strategies are long term strategies.

There is a way to get herd immunity without an epidemic, and that’s inoculations. However we do not have a vaccine yet and have no idea if or when we might ever get one. So you can bet everything on red 13 and cross your fingers for a vaccine in 6 months, or pick which longer term strategy works best for your country, with its particular demographics and geography.

https://www.bbc.co.uk/news/science-environment-51892402

Why not?

However that’s assuming you can eradicate it. That might be possible in an isolated population centre like Singapore, but the UK has an extensive rural area where the virus can hide out, slowly propagating through many different sparse populations until it gets back into an urban centre. It can survive outside the body on some surfaces for 9 days according to recent studies so it can infect someone who has light symptoms, they put it on a new surface, then when they recover up to 9 days later it can up again in someone else. This can go on for months. You might track down some of these smouldering brush fires, but not all. That’s how flu keeps coming back every winter.

Why not? Personally, if I were put before the choice of not having more people enter my country than I can screen or killing off 1M+ of my electorate, I'd at least seriously consider the first option. Meanwhile the UK government clearly thought that even stopping the flow of people from an epi-center, fleeing quarantine (or at least tracking them) would be a grave over-reaction.

> You might track down some of these smouldering brush fires, but not all

I don't see why you can't keep it reasonably contained even with occasional flare ups. I'm not saying you are wrong, but it is certainly not self evident. Since the Chinese were willing to kiss good bye to something in the vicinity of $1T, presumably they think they can. If you keep perfecting testing and procedures and hold out till you've got a vaccine, I don't see that would not be a winning strategy.

> That’s how flu keeps coming back every winter.

Well, this is way worse than the flu and may get worse still, so we should be very motivated to kill it whilst we can. Also, looks like there'll be more where this one came from. Just taking a big hit to global life expectancy every few years will probably start to add up over the long run.

>Why not?

In addition to major airports we also have many minor ones and private airfields. There are 120 commercial ports, and many, many more smaller docks, quays and marinas. We have many islands and remote coastal communities that rely on these for essential supplies and no systematic way to monitor them all. Even then, sealing ourselves completely would have to include stopping goods because goods are carried by people.

Also we now know the virus can survive on cardboard for up to 9 days. We don't have 9 days worth of supplies of everything in the country and don'y have a tracking system for every shipment in or out. We know from the Brexit analysis that we can't track goods enough to tax them, so clearly we can't do the same for medical reasons.

Finally, even if such a lockdown were practically feasible and we developed the logistical and administrative capacity to do it overnight, which we can't, it would destroy our economy. That would inflict massive hardship, particularly on the old and vulnerable, exactly the people we most need to protect. Hardship and poverty kills people, and shutting down all trade and commerce until we have a vaccine, which could be several years or even indefinitely, would take us back to the stone age. It would be far, far worse even than during World War 2, and that's how severe it would have to be to prevent the virus getting in, not just for months but probably for one or more years.

Anyway thats a fantasy, we just don't have the logistical or administrative apparatus to do it fast enough for it to matter.

Serious estimates are that it will take around 18 months [0]

[0] https://www.bbc.co.uk/news/business-51454859

The time to get creative is when you face a capped downside on the one hand, and an uncapped upside on the other. The time to get conservative is when you face the opposite condition.

The reason for this rule is that creative policies almost never work; but when they work, they have a much higher chance of working extraordinarily well than conservative policies do.

The UK is facing a capped upside and a huge potential downside. The UK is choosing to handle this situation with a creative experiment. This experiment will, in all likelihood, not succeed. And unfortunately most values of "not succeed", in this context, map to catastrophic outcomes.

Time, as always, will tell.

This “herd immunity” thing is nonsense. So much so that doctors and scientists are warning against it:

https://www.theguardian.com/world/2020/mar/14/coronavirus-nh...

> It’s already too late. They’re on the Italy path.

Well, that's pretty much the point of the policy. 'Already screwed this year, let's try to cope, and be less screwed next year'.

I was very critical at first, but I'm more interested/satisfied with the response now, it does seem to be well thought through, even if there are also arguments against (of course there are).

Throw 2 or 3 hounded thousand lives away to have less economical impact next year.

I.e. pure evil IMHO.

especially because there is a non small chance that it will be more like 1-1.5 Million more death then necessary.

Evil is reserved as a description for gross failures of moral duty. Choosing pragmatically between several terrible options with highly unpredictable outcomes does not meet that standard.

Let's quantify things here, for a first world country with a social net.

On the one hand, we have people getting evicted from their homes and having to visit soup kitchens.

On the other hand, we have dead people (more likely, dead poor people).

Evil seems pretty fair.

Which translates directly into many years of reduced life expectancy, no?

I'm saying that the two miseries feel like apples vs oranges, given the context.

You'd have to go pretty far to convince me that (even mass) economic depression is more harmful than widespread, near-term fatalities.

That's hard to weigh against a concrete number of very concrete deaths and serious recuperation periods.

Near-term fatalities affect certain groups more than others. Those with access to medical services (or can pay for more of it) will be less affected.

Which side being worse is a determination you have to make for yourself.

Something to remember the next time people harp on about GDP being the most important metric for a country's advancement.

https://medicalxpress.com/news/2019-02-recession-greater-dec...

So that, told me all I need to know about the cruelty and stupidity of the UK government at this time.

https://www.independent.co.uk/voices/coronavirus-deaths-trum...

Meanwhile, in the schools, the intention is to get the rate of kids that are immune as close to 100% as possible. That will be difficult without deliberately inoculating them, because they will develop herd immunity at about 66% in their population and it won't spread in that population anymore.

In the nuclear reactor analogy, it's as if you put in half the control rods, but only the ones on the left side of the reactor. That might make the left side strongly subcritical, but the right side might still be critical, even if with an even distribution of the same number of rods, the whole reactor would be subcritical.

This plan is not going to work and it will kill millions of people in Britain unless Chloroquine or something else ends up being a silver bullet for treatment.

so what about those who had to suffer to give this herd immunity? If i were a UK citizen, and i got infected, there's a non-zero chance that i will also need a ventilator. Any, even a tiny misstep will cause the numbers to grow beyond the amount of beds available. That i am asked to take this risk is absurd.

Full isolation and quarantine is a more conservative way - for myself at least. Even if the economic damage is severe.

Why? Politicians have shown several times that they prefer to listen to a minority of scientists that tell them what they want to hear, rather than a majority that doesn't.

I'd rather my top health officials actually have contact with those under them, than sit in a glass bubble.

Number of cases is a trailing indicator, which also only covers those tested.

It sounds more like you're at the bargaining stage now, rationalizing why it might be a good approach because it's happening and you hope for the best.

It sounds insane. Italy quite literally did the same model. Now they're in the worst of both -- mass quarantine / enormous economic damage AND the brutal human toll.

But I can see how it might make sense on a wider societal level, assuming everyone doesn't behave like me. (Which they don't, I've observed plenty of people complaining about how it's just 'media scaremongering' and 'just like Brexit'.)

I definitely think we're (almost every country is, save maybe Singapore) past containing it; so I can see how a relatively controlled exposure might actually be a good policy as far as managing resources, economy, and next season...

https://www.theguardian.com/commentisfree/2020/mar/15/epidem...

The question is on the impact side. The reason this theory seems to work is that the seeming danger from COVID-19 is all on the elderly and immunocompromised. If you can prevent them from getting the same disease everyone else is, then they'll be protected by the herd -- new clusters won't form and infect them.

So this all comes down to those assumptions:

1. The virus is genuinely of low danger to the young and healthy

2. The vulnerable can be adequately protected during a pandemic of the general population

If either is wrong, we're looking at a staggering disaster. Are they wrong? We have no fucking idea. I'm not even on the continent and I'm terrified.

You're failing to take in consideration that the virus incubation period is on average 1 to 2 weeks, and those who manage to recover from the disease take about 2 weeks from diagnosis to confirmed cure.

This means that you're comparing 4 weeks of exponential growth with 2 weeks of constant recovery.

Sure, those who survived the disease will be immune afterwards. That's great for herd imunity. But the thing you fail to understand is that as the disease increases exponentially, when that time arrives the whole nation has already become infected, and it's too late by then because health services will be unable to cope with the demand and a lot of people will die due to lack of basic medical care.

No no, I understand that. But the thinking is, and it seems to be backed by data, that the health system will be able to cope with a full-population maximal pandemic, as long as it is limited to the much less vulnerable segments of the population. The ICUs in Italy and Hubei were filled, for the most part, with elderly patients. The math, such as it is, checks out.

The risk management analysis, again, is IMHO batshit crazy. But the theory seems about as sound as it could be given the data we have.

It really doesn't seem that you're getting it, because the whole point of this exercise is that it's quite patently obvious that no health care service in the world is able to keep 10 to 15% of their population in intensive care, which so far is the expected incidence of cases that require medical care.

If that was the case then no one would be bothered with yet another flu-like viral infection.

Among the general population!

Among people under 50, the best data we have is that the fraction needing ICU care is something like 0.2% (I think, I'd have to look it up again).

The intent is to quarantine the at-risk and let it propagate in the "safe". I genuinely think it's you who's failed to understand the plan. You're arguing against something that is not the stated UK policy.

I too think it's too risky, FWIW. I read a while ago there might be permanent damage as well, but maybe that was hocus.

Edit: Business Insider reported HK doctors found some people have 20-30% reduced lung capacity after recovery: https://www.businessinsider.com/coronavirus-recovery-damage-... (n=12)

Any chance you remember where you found this statistic? I have been looking for any details on hospitalization rates by age range, but haven't had luck so far.

Estimates are closer to 10% of the infected getting severe cases, and some small-ish fraction of those requiring intensive care. (The higher percentage numbers are usually an artifact of low testing rates of infected people.)

Also, epidemiology suggests that 20-70% will get it. So, we’re looking at ~1% of the population in the hospital at once.

The rest of your points stand; we don’t have nearly enough hospital capacity for 1% of the population.

Note that with a two week active phase, the pandemic would have to drag on for 20 weeks to get that number to 0.1%. I doubt there is capacity for that either.

"Sure, those who survived the disease will be immune afterwards." There have been reports of re-infections in China and Japan. This may be mistakes - the never were cured - but this could also point to something more severe. Proceed with caution.