Suggested ways to cope with the Pandemic

I’ve already suggested:

  • Mecial students being trained for specific CV treatments
  • Vets being turned into doctors and their equipment being redeployed for humans
  • Closing of Universities and redeploying students into a host of roles
  • Everyone is suggesting using the army

In addition other strategies

Prisons

In the worst case scenario, we are not going to have enough beds. Therefore we should release all low-risk category prisoners for a couple of months and turn their prisons into hospitals.

Sale of Alcohol & other age-related goods

People delivering supermarket food to homes cannot be asked to ask for proof of id to verify age. As such, there is a strong rational to ban age-related goods from being sold. However it may be possible to permit it in specific casess where age verification  can be done online via a means like a driving licence.

Reducing A&E need

I couldn’t find good evidence on the causes of A&E (except alcohol) so instead I’m trying to remember what are the commons causes.

We will be banning all social gatherings, which means pubs and nightclubs, so the level of drunken injuries will reduce. But we cannot afford to allow drunk injuries to then occur at home, so limiting alcohol sales may also be prudent for that reason.

Many A&E injuries are caused by sports, but organised sports should be banned or will be self-stopped

Car accidents are another big contributor. But if travelling is curtailed, then this may naturally drop.

DIY is another cause of A&E attendance.

Education

The Chief medical officer is not very supportive of the idea of closing schools. I personally thought it was a no brainer, but perhaps there are issues with the effect this has on the NHS as mothers tend to have to look after children, and perhaps the rest will be looked after by grandparents – who if anything ought to be kept away from children who are very likely to pass on CV.

But it’s pretty obvious that any large gathering like an assembly needs to stop.

However, we still ought to attempt to limit the spread of CV within schools. One simple approach is to keep each class separate from all other classes. This ought to be easy in a primary school but could be very difficult in a secondary school when pupils are streamed to take a variety of mixed subjects. Fortunately, those taking mixed subjects are probably largely old enough to look after themselves. So, the best strategy may be to have strict segration of classes in schools and either put older pupils into “single subject” classes or they will have to be schools remotely.

Another simple approach is to simply close the schools for the “summer break” when the crisis hits and to re-open them during the summer “break” to let pupils catch up and to take exams.

This however isn’t the perfect solution, because CV will still spread between pupils in a class, and then within families to other pupils in other classes in the school. So, another refinement is to “surname” segregate pupils. That is, all people with the same surnames share a very limited group of classes (perhaps doubling or trebbling years). That will dramatically low the spread.

Workplaces

Companies should be following a similar approach to education. Workers should be prevented from co-mingling and large gatherings such as using work canteens should end. Also where possible companies should encourage people to break the pattern of a “normal day” and to travel at times of lower demand on the transport network

Stop Public transport

Where possible, people should avoid public transport. Instead, it would be sensible to car share. As such, most parking restrictions in towns and cities should be temporarily suspended.

Public gatherings

At the moment there are ~150 known cases and probably ~600 unknown. As such there is one infected person per 100,000 people. For obvoius reasons no one should be attending any indoor event with more than 100,000 people. But even an event with 10,000 means there is a 1 in 10 chance of being in the room with someone with CV. Next week the chances are 1 in 10,000 and the week after most large schools of 1000 pupils will likely have one person infected in them.

Medical Doctors & Nurses MUST start wearing face masks

There is a great reluctance amongst doctors to endorse the use of face masks, but we have to ignore them, and think of what is best for the patient, and what is best for the patient is not doctors & nurses either being ill from CV or worse spreading it. As such we are going to have to mandate that medical staff wear face masks even if they protest strongly about it and come up with lame medical excuses why they are immune to CV. (It’s always the same people have no problem insisting that others take health seriously, but as soon as they have to wear protective equipment, there is always a host of reasons why accidents never happen to them).

Isolate the elderly?

There is a rational for the elderly to self-isolate. But I strongly suspect from the elderly people I know, that they will not do so. Instead they will “self-isolate” by only seeing their own grandchildren and daily gonig to the shops to get the paper.

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Coincidence?

I have just been examining data for various countries and extrapolating back the growth to the date at which there would have been one carrier. Here they are:

  • Italy 6th Feb
  • S.Korea: 8th Feb
  • Iran: 15th Feb
  • UK 18th Feb
  • France: 18th Feb
  • US: 20th Feb
  • Germany: 21st Feb

There is clearly a cluster of starting dates around the 18th – 20th of Feb.

To change the subject entirely? It is interesting to note that the Iranian epidemic which postdates S.Korea by a week, is centred around the city of Qom which was the birth place of Qasem Soleimani the Iranian major general killed by the US on 3rd Jan this year.

It is almost as if someone flew from S.Korea, to Iran, then to UK or France, and then the US.

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Somethings gone wrong

After nearly an hour waiting for the current figures on coronavirus, the data has still not been updated and I’m starting to see “distract” type aticles from the press with very little detail. These seem to have been written to “fill a hole” that was left for a real article about the stats and they are not being allowed to do that.

Have the press been gagged? Very worrying!

Possibilities:

  • A death or deaths
  • A very large increase
  • Someone particularly prominent has it
  • They have realised there is not a chance in hell of the NHS coping.

Addendum

Some 2 hours after they were supposed to be released, the department of health have said there are now 115 cases. (of which 6 are in Scotland). I say “claim”, because this kind of delay is usually for a reason. I was predicting around 107-112 cases today so 115 is not massively different, so that doesn’t explain the delay.

Current prediction (assuming we’ve had real data)

11th march (6 days = Wed) I expect to see our first death by then (but it could be a lot earlier)

16-17/march (10 days) we reach the 3000 cases level at which S.Korea’s health service stopped coping.

30th March (3 weeks 4 days) there will be as many cases as there were NHS beds before any emergency increase.

New Addendum

It is regretable that my earlier comments about 3pm now appear to be correct. Today the UK experienced our first UK based death from CV this is obviously appalling news for those invovled. Worse for everyone else, it appears to be UK based person-to-person transmission which means I was right that those being discovered were the tip of the ice-berg of unknown cases.

Based on the sequence of events, I believe news of the death came to those with the figures shortly before 2pm. There then followed a couple of hours when they deliberated as to whether to give out the news, but decided instead to issue the up-to-date number of cases instead at 4pm. The death was then announced just after the 6pm news started, presumably to minimise the amount of time journalists had to investigate.

Exactly 7 days ago I predicted a death in the UK “in the next 7 days”. Sadly I was right. I expect around 9 more in the next ~7days which means by the 12th March it is likely there will be one in Scotland.

 

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How do you fancy being treated by a vet?

The government are already talking about using trainee doctors for the critical period. In addition there is another huge resource which is easily available and that is the large army of vets.

Vets are trained to work on any animal species, and the only thing stopping them treating humans is the law. And if I were faced with no doctor or a vet, I would pick the vet any day (indeed it’s arguable they are better than doctors as they have far wider experience and can be more innovative with treatments).

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What “overtopping the ability of the NHS” means in reality.

Finally, we’re getting the truth from the gov:

“Half of coronavirus cases in the UK are likely to occur over just three weeks, and the NHS does not have enough beds to cope with them, the chief medical officer has warned.”

“Depending on how high the peak, this could be anywhere from a rather bad winter for the NHS but in spring or summer for the NHS through to huge numbers way overtopping the ability of the NHS realistically to put everyone in beds and that obviously would have big pressures on the service,” he told the Health and Social Care Committee.”

https://www.telegraph.co.uk/news/2020/03/05/half-coronavirus-cases-uk-likely-occur-horror-three-weeks/

Although his “overtopping the ability of the NHS” sounds like a gentle wave getting someone’s feet wet on the beach, if 4% of the population need hospitalisation, 80% get the infection and half get it in these critical three weeks we are talking ~1million patients.

There are something like 150,000 beds in the UK with suggestions that ~90% are occupied. If we assume an average hospital stay on 10 days, then there are up to 600,000 patients trying to fit in 150,000 beds or 4 patients to a bed.

But at least we are starting to get realistic numbers and there is obviously some thought going into them as:

Medical students could be asked to perform roles on hospitals normally done by doctors, in the event of a coronavirus epidemic

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L & S forms of the virus

Apparently CV has already mutated into two forms, a later L which is more virulent and an original S which is less. However, being more virulent is not necessarily worse. Because it tends to be picked up quickly as people fall ill and so it is more rapidly removed from the population. That’s why we don’t have the  SARS which killed a very high number of people, but we do have flu, which kills many orders less of those people that it infects, but because it’s not enough to take the action to stop, the result is that it yearly kills more than SARS ever did. So, paradoxically the less virulent and deadly form of CV may end up being much more deadly (in terms of total deaths).

And it is too early to know whether immunity from one form gives immunity to the other or whether a vaccine can be developed for both.

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Too few deaths?

Based on early stats, I was expecting the UK to have had its first death by now with about 1 death for every 30-50 cases. And although there was a Brit died from the cruise ships, there has not been one in the UK yet. But more intriguing is that Germany have now identified 349 cases with no deaths. That compares with about one death for each 30 infected in Italy right now. Either Germany are finding almost all cases so their detection rate is astronomically high, OR I’ve not factored in a delay between the stats for cases and those for deaths OR perhaps there a new treatments being trialled that are significantly reducing the death rate.

Looking at information on the pandemic in China, the first death was on the 9th Jan. There’s no data for the number of cases before 16th Jan. But if we project back the known cases, then it would be less than ten. The first death in S.Korea was reports on 20th February when they had 104 known cases.

Thinking this through, one possibility is that German (and UK) are currently dominated by people who have recently come in. Because they know they are an “at risk” group, we may be catching a lot more of these people at an earlier stage before CV has had a chance to push them toward death. In contrast, where the virus is spreading, people will not know they are infected until symptoms get severe, which means they self-report a lot closer to the point where the illness gets critical.

If that is true, then the collapse of the NHS may be delayed by up to a week (so 18th-25th March). Because March is the time when flu is naturally decreasing, this extra delay could dramatically increase our ability to cope with the early “wave”.


Addendum

It is possible that what we are seeing is the tip of the ice-berg of cases who have arrived in the UK/Germany. These cases are then “maturing” and infecting others. Those coming back are likely to be fit and healthy, with relatively few needing hospital treatment. But they will infect others with a much higher risk. The result could be a very sudden and dramatic upswing, going rapidly from 100s to 1000s over a few days.

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The blindness of experts

I was reading today an article which was “How does coronavirus compare to flu, Sars, and other diseases?”. Before looking at what the “experts” say, lets look at the simple stats comparing CV with SARS.

CV increases by about 10x each week. SARS increased by about 2.5x in a month. In a month CV would increase by about 10,000. So the scale of difference is about 4000:1

So, lets now look at how the experts compare the two (link):

According to WHO, the average reproductive rate (r0) of coronavirus ranged between 1.4 and 2.5. That meant, on average, each confirmed case of coronavirus would infect between 1.4 and 2.5 other people.

It is more contagious than some of the most deadly airborne viruses, however. Mers has an r0 of between 0.3 and 0.8.

Someone has totally cocked up here! If the “experts” are saying “it’s not that much different to SARS” and SARS approximately doubled each month, and there are only currently 85 cases in the UK, of course the “experts” are sitting on their fat arses content that they’ll be able to look at it in another month and maybe consider informing the government that maybe they ought to think about doing something.

But in a month we won’t have
160 cases, but nearly a million
not “a death” but nearer 10,000

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14 days till UK health services start collapsing

At first glance the news today in the UK looked good as only 2 new cases were being reported, but then I realised that was only for Scotland. And instead of the 70 cases I had predicted yesterday, I saw 85. I had been hoping the 70 was me spotting a false trend, but apparently not.

This brings forward the day when I expect to get 3000 cases to 18th March which is now just 14 days away.

One bit of good news is that I would have expected 2 deaths by now. That might mean we have just been lucky, but it also might imply a much higher rate of detection. But even at the highest rate of detection I expect deaths to start occurring in the UK by the weekend.

I estimate there is now one person infected per 160,000 people, which means if they were evenly spread, then there is a good chance of there being someone any large town. By Saturday 7th March I predict one person in every 80,000 will be infected which means roughly one person in an average premier league football crowd, but only 4 deaths. But by the following Saturday I estimate one in any crowd of 10,000 people, a 1 in 20 chance of being on a train with someone who has CV and 30 deaths.

Worldwide

S.Korea

I see S.Korea continues to find new cases, however their detection rate is falling from 180 down to 160 cases per death. That means that either many people are being missed, or there’s a lag in the death rate. One bit of good news had been that the rate of rise in the number of cases had dropped at about 10 days after they implemented a new pro-active policy, that had given hope they were finding almost everyone and had it under control, but it may now be climbing again.

But it’s difficult to konw whether the increase is due to higher effort being put into finding cases or whether it’s an underlying increase in infections.

It’s now pretty certain that even the S.Korean pro-active searching out for infected people is missing huge numbers and so I suspect that the 180 cases per death may be an underestimate. Over the last few days the rate of day-to-day increase has halved. That suggests they are catching half the carriers. So perhaps 350 people infected per death and nearer to 90% of people are not being caught by self-reporting.

The bad news that brings, is that it will spread like wildfire and the lacklustre “plans” of the UK will do almost nothing to halt it. The good news is that the total death rate and peak of hospitalisation could be half what had been previous thought. So, the health service will still fail in about 14 days, but the peak of the disaster could be half the carnage that I was expecting (but remember I’m expecting scenes far worse than Wuhan – perhaps an order of magnitude worse).

Iran

On a brighter note, Iran has hugely upped its detection rate. It’s still a 32 compared to S.Korea’s 160 but it was closer to 8 when they started.

Italy

Unfortunately, Italy’s detection rate remains low at only 31, however, in the next few days we should get an idea what effect the quarantine has had.

United States

The detection rate in the US is only 14, which is about as bad as Iran when it started. That is immensely worrying. They have found 129 cases. With 9 deaths I would expect at least 1800 cases and probably closer to 3500 cases. As such, it’s extremely likely it is already out of control and will hit the US extremely hard in the next couple of months.

Germany

One odd country is Germany with 244 cases and no deaths. That’s a massive difference compared to the US 14 cases per death. I don’t know the reason, but it seems that for some reason a higher percentage of cases are being found in Germany.

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The madness of crowds = the media

It’s so obvious that the press are being told to censor alarmist talk about coronavirus because you’ve got to be a complete moron to think that coronavirus won’t spread. Yet, repeatedly I read articles saying “if coronavirus spreads”, when it is a lie to suggest it might not and the only truthfull phrase is “when coronavirus spreads”.

Likewise I see the Advertising Standards Authority has done what it normally does and pushed the group-think. People are rightly saying that P3 masks will reduce the infections from coronavirus, so it is entirely wrong of them to ban adverts on that basis. But yet again (as in the subject of climate), the actual science is being ignored, common sense is being ignored and insane group-think is winning.

The main difference between CV and climate, is that whilst the insane group-think on climate has been kept going for decades, the insane group-think on CV may be revealed as insane within weeks.

I see that there have been two further cases reported in Scotland. That makes 3 known with I estimate 15 cases in total. That brings us closer to the UK average – which means we are finally starting to take this seriously and look for the cases that are undoubtedly already here.

Rather than a change in infection rates, these cases appear to me to be a realisation by medics and people, that anyone could be infected. So, cases that a week ago were being ignored as “just a cough”, will now start to be caught. So, it is possible that there are hundreds of individuals spreading CV in Scotland. However, it is also possible that the increase is solely due to the first wave of incoming infection without any substantial “indigenous” infections as yet. We will only tell where we lie in this spectrum as public concern grows and CV is taken seriously (and because of the lag of cases, Scotland has been lagging the UK in taking it seriously).

What is key,  is the way the pandemic escalates in the UK. If sudden awareness that a lot of people could be infected, suddenly reveals a huge pocket (as in Italy), then we are looking at a very rapid onset. In contrast, if increased awareness does not massively increase the number of reported cases, then we may have been lucky and have a relatively low level at this early stage. That is important for us with our braindead politicians in the UK. Because if we are “lagging the pack” so to speak, it may give us an extra week between seeing the healthcare disaster happeningi in other countries … and that week may be enough to bring in the draconian pre-emptive quarantine measures that will be necessary to stop it turning into that disaster.

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