Do we need to create an artificial spike? If so, when?

[CheriLittlebottom]

Was thinking about this off the back of random musing about when schools might reopen.

Do we need to try to get a lot of society infected with this in the early summer, say June, so that the NHS have June, July, August to deal with the biggest wave of sick people, then hopefully see numbers coming down from September as we start getting into autumn and winter?

Obviously we can't stay in lockdown forever, or until there's a vaccine, the economy will completely tank. Is there a "best" time to increase transmission in the hope that we can push up herd immunity? Was also thinking about those in the shielded groups, how long can they realistically keep themselves completely isolated?

If schools did reopen after the May half term, and most people went back to work (not the most at risk) would that work? Would the NHS have the capacity and equipment in place by then?

I don't know enough about transmission rates etc to know if this is a good idea or not!

I thought the Imperial paper basically suggested exactly what you said - we all have to get it at some point, relax restrictions in July/August as that's the time the NHS will have the most capacity and no winter pressures. Then restrict again in Autumn if needs be.

I have far more faith in the German gov than most

The point of lockdown isn't so we all avoid it, it's to reduce infections to just below the capacity of the NHS. In summer that capacity is highest, and cases may be milder due to warm weather, so of course it makes sense to "spike" then.

You can't get to herd immunity without totally overrunning the health service. The numbers just don't add up.

Beijing - the imperial paper idea sounds right but oxford study thinks we’ve had more cases already. So the ‘getting more cases’ can come sooner.

Problem is we don’t have proper testing so although we play know people who have it they aren’t recorded officially

it could create a new kind of dystopian caste system, further penalising the old, those with disabilities and existing health conditions

What is the argument---that everyone needs to stay on lockdown so that the elderly and those with preexisting health conditions feel better ("At least everyone else is having as miserable a time as I am")?

Look, I "get" that if you have to stay inside for a bit longer, then seeing other people going around as normal would feel really galling and frustrating.

But what is the alternative? The longer we continue with full lockdown for everyone, the bigger the economic catastrophe for everyone, and the elderly and disabled and long-term ill will be the ones who suffer most because public services will be gutted. If you have a chronic health complaint or are elderly, it is in your interest to have other people going about propping the economy up, because it means that the state will actually be able to afford to pay for some services to help you out after this is over. Even as it is, public services are going to be hollowed out after this. Let's not make it even worse.

Nelode - the Oxford paper thinks half of uk have already had it. So we are on our way to herd immunity already. I hope they are right.

www.imperial.ac.uk/news/196234/covid19-imperial-researchers-model-likely-impact/

There's another one I've seen that modeled opening and closing schools and universities but can't find that.

I'm thinking more like enough people catching it to increase herd immunity while keeping the number of people needing treatment at a level the NHS can cope with, on top of everything normal that they have to deal with.

I think that was the original plan then the model showed the numbers getting sick was going to exceed the NHS capacity - hence the change in policy.

Plus flattening the curve prolongs it but does mean they can continue to add capacity into winter - the second peak is expected in Nov which isn't great - so they may change policy again or may not. I expect they are studying the data and working out what's best including the effects on the economy of their policies.

You can't get to herd immunity without totally overrunning the health service. The numbers just don't add up.

That will depend entirely on how many people are immune already. If large numbers have already had this thing, you wouldn't need all that many more infections.

We will know more once the serological tests are unrolled.

I understand your speculation. Certainly september has a peak of asthma hospital admissions anyway. So much so that PHE alerts schools to the fact in a letter sent in September. That makes me nervous for my son going back to normal in august and september as to me thats his riskiest point health wise...There is also winter flu that can kill 20k on a bad year. So if the virus is still out there we face quite a difficult september and winter again. Although maybe all the winter flu victims will already have been a victim of this instead
There seems such a lag between trandmission and needing a hospital bed and then from being admitted to either recovering or dieing. So to be ill in July / August we need to catch it in may and June but not too many of us or the nhs cant cope.
Im glad its not my job to work it out!

I read that Germany were issuing certificates if you have CV antibodies so that you can return to work. I think this is a good move towards getting the country running again.

God forbid the economy should suffer, throw a few more disabled people and elderly on the fire Jeeves, that should speed things up.

Disabled/old/vulnerable people need food too prinny - economy is for everyone not just rich bankers

Don't be childish, Prin, and if you're going to accuse people on here of wanting to throw people on the fire, at least tell us your ideas for avoiding an economic meltdown that will kill more people than Corona.

A perfectly reasonable question to want to discuss OP. It does not make you a psychopath. What a ridiculous comment.

Following Germany's lead is generally something I'm comfortable with, Merkel always seems to have her head screwed on right. I wonder if the cultural stereotype re. Germans liking following the rules has a bit of truth to it, and if it would make a immunity certificate based system more workable there than here?

Everybody needs the economy to recover because the alternative is even more public service cuts, price rises and wage freezes which is shit for everyone.

No - this is a complex situation and it is not a simplistic choice between a full lockdown or soaring infection rates. Remember when you talk about a getting a peak done by summer you are arguing for hundreds of thousands of deaths, the nhs being completely overwhelmed , many children and teenagers dieing, ice rinks turned into morgues like in spain, many doctors dieing (over 50 doctors have died in italy). This is the reason the scientists from imperial said the only option is suppression and the gov changed strategy - and are not doing what you suggest. It would be a humanitarian disaster.

We are not looking at full lock down until the vaccine either.

In Taiwan, south korea, japan, hong kong they are not fully locked down (can go to gym, restaurants etc) but also have far, far less deaths than here. One reason is they have agressively tested, contract traced and isolated cases. So this option would be preferable and provide a way out of lockdown without killing off a large number of people (it would require a lot of testing). Look at denmark - they acted early and are looking to lift lockdown rstrictions soon.

Medicines are being trialled which could reduce the death rate. Ventilators are being built. Testing being ramped up.

We don't want a spike, we want a trickle-down. Once this initial flux is over I think we will move to lockdown-release-lockdown. As soon as the NHS shows signs of clearing we will release to cause a manageable number of cases, then lockdown to allow the NHS to clear those cases, rinse and repeat. Each time the lockdown gets smaller because more people have already had it (whatever their prognosis, sadly). The conditions or the lockdowns may become less stringent as time goes on and they will become less frequent.
Although I think we will have some joy as we see the strategy working, I don't think we will 'beat' this until spring/summer of 2022. And that is if a vaccine is produced and, even more important, that there is some immunity once you have had the virus.

And yes I agree that it seems like IN ORDER TO PROTECT THE VULNERABLE GROUPS AND THE NHS's ABILITY TO COPE long term a lot of us that are less vulnerable will need to catch it. I definitely think a managed lifting of restrictions is a possible solution.

God forbid the economy should suffer, throw a few more disabled people and elderly on the fire Jeeves,

If the economy goes down the toilet, then the elderly and disabled will be the first to be fucked. Pensions and PIP will disappear and living costs will hike up, as will unemployment. "The economy" isn't some abstract thing that bankers in Panama guffaw over while quaffing champagne - it's everyone's livelihood.

There will be some anti-vax types who are dubious of medics and refuse "medical treatment" but I think it could particularly help certain groups like carers who work with the vulnerable.

OP there’s nothing wrong with you musing about this concept.
I can see there’d be an argument for doing as much as possible to have less Coronavirus strain on the NHS during busier wintertime.
I don’t understand why some replies were so sharp here right at the onset.
I imagine this is something that would already have been considered when applying the relaxing and tightening of measures over the next1.5-2 years to manage the speed of spread.

Chili that kind of cycling of restrictions makes sense, and yes as you say hopefully with a smaller number of infections each cycle. Providing you can't catch it twice I suppose? That would really fuck everything up.

The Oxford report did not say that most people had already had it. It talked about the variety of different solutions available given limited data. So, the amount of deaths we have could come from a lot of people having a mild virus, or a few people having a more deadly one.

What it did not say was which of these scenarios was more likely.

It also did not use data we have from places like the Diamond Princess which can be used to narrow down which of the potential solutions is more accurate.

If it had, it would have ruled out the very low fatality rate and high infection rate very easily.

People like to cherry pick, but it is very dangerous to say that a paper that gives a range of possible solutions actually gives the most favourable.

As an analogy.

If we say "an apple and a banana cost 200p" then there are 201 possible solutions, with an apple costing anywhere between 0 and 200 pence.

It is right at this point to say, an apple could cost as little as 0p.

This is what the Oxford report basically says.

However, if we also have data that an apple and 2 bananas cost 250p, then it's no longer correct to say an apple may cost 0p. We now know that it costs 150p and a banana costs 50p. The extra data allowed us to narrow down all the possible options.

I've read quite a few analyses of the Oxford report, and although the Diamond Princess data does not give a precise answer (unlike my example) it does mean that the best case scenario of the Oxford paper is very, very unlikely indeed.