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!

The variance in any of the papers is because we don’t have enough testing. Oxford best scenario might be right. It might be wrong. So might imperial which many think is worst case. A summer ‘spike’ for want of a better word must be better than an autumn one?

Cheri - Prof Whitt’s etc has said with any virus’s there is a recatch possibility but it tends to be v low numbers and milder. We have to trust that they know 👍

That's something, at least, newgirls!

You know what i found worrying recently? A thread here on MN (i'll look for it) where a poster asked who'd be happy to have the vaccine when it comes out and quite a large portion of respondents said no.

@Ihatemyseleffordoingthis so what’s your solution then? There is no ‘ideal’ scenario. This is a shit show all round. But instead of damning someone’s else’s idea give us your solution.

@cherilittlebottom yes I think people are reacting to the use of the word spike. But I know what you mean.

@ButteredGhost agree. And I have been saying that Ireland are too locked down for a while now and have flattened their curve too much but get shouted down.

Yes I was on that one, it was scary how many people didn't want to be vaccinated if given the chance. I had to stop reading after a while!

@cherilittlebottom yep agree. Maybe they can’t grasp the concept that if they don’t get a vaccine they risk getting it themselves and other people getting it. It’s what is happening with the measles vaccine. You need 95% group immunity with measles and the people refusing to do it are opening up measles spreading again. Would you rather the vaccine or the illness. I know what I would choose!

My gut reaction to the question was YES of course. I'm usually a staunch vac. supporter. But for the sake of total honesty reading through the reasoning behind the 'no' replies put me on more shakey ground.

Massive decisions with massive consequences for all of us all right now and going forward.

www.mumsnet.com/Talk/coronavirus/3866532-Would-you-vaccinate-yourself-against-CV

I wonder how we'd fit the flu jabs in with a summer relaxation and a tightening up of restrictions in September. Presumably they'll still need to do that for the vulnerable and children.

A thread here on MN (i'll look for it) where a poster asked who'd be happy to have the vaccine when it comes out and quite a large portion of respondents said no.

I think there were side affects with the swine flu vaccination.
www.buzzfeed.com/shaunlintern/these-nhs-staff-were-told-the-swine-flu-vaccine-was-safe

Though I've also read that many of the NHS staff don't take up the annual flu vaccine offered.

Last year, over 70% of frontline healthcare staff got the flu jab – the highest ever according to PHE. However, the contract was not renewed with NHS Employers for this flu season.
www.nursingtimes.net/news/public-health/years-nhs-staff-flu-vaccination-campaign-take-new-approach-20-09-2019/

I am asthmatic so get the flu vaccine every year as does DS, my parents and my IL.

Presumably come autumn GPs are going to have open back up to give flu injections - and there's a large number who need them very year.

If they offered me the vac this afternoon i'd probably say yes. But not as happily as before reading that thread. Sometimes a little info. is worse than none at all ....

Sorry i don't want to derail this discussion.

With 567 deaths today in UK not sure you will have to artificially spike anything

I think I have finally found my people on this thread.

I live in Germany, so I understand Merkel's strategy better than Boris's - as she has explained it to us,
but most governments around the world are doing something like this:

The lockdown is temporary, to "flatten the curve" of new cases
and will stay until the doubling of new cases happens only every 10 days or longer

This level has been calculated as what the German health service and public health services can cope with,
and still have some extra capacity if needed.
(The NHS has far less capacity, so would need a stricter target)

The lockdown time is also being used to ramp up PPE production and build new COVID hospitals with many thousands of critical care beds

Mass testing is continuing - currently 500,000 per week - that's one major difference to the UK
Other differences are closer monitoring of confirmed cases and less stringent requirements for admission to hospital.

When lockdown is removed, schools and most work will resume immediately,
but other restrictions will only be raised gradually, e.g. restaurants, gyms, pubs opening at some stage
but a long time until mass public events like trade fairs or carnivals could be allowed - maybe next year ?

The summer period typically has less demand on health services
and also the higher UV is thought to restrict virus growth
Hence greater relaxation expected throughout the summer months

At any stage. if the growth in new cases starts to get above target again, then some restrictions will be re-imposed for a few weeks.

All the while, more and more people catch the virus and become immune
Within 12-18 months a vaccine will be available, after which there should be enough herd immunity to resume life & entertainment much as before

I expect it may be up to 2 years before foreign holidays are encouraged / allowed

At one of the daily briefings there was a speech about turning the tap on and off - basically to let it spread in a controlled way so the nhs can cope. That probably does mean turning the tap on that larger numbers of cases emerge before winter flu season starts.

One of the scenarios modelled in the Imperial paper is similar to what you suggest, @CheriLittlebottom. They modelled going into lockdown when there are 100 cases per week requiring ICU care and when there are less than 50 ICU cases per week, social distancing rules can be relaxed, and schools and universities can return until we reach 100 ICU cases per week again, when lockdown till come into force again. However, that model was based on each infectious person infecting 2.2 people (R0) but their latest paper from this week estimates R0 as 3.87 so the on/off lockdown model would no longer be same, it would take much less time to reach the 100 ICU cases trigger. It would also mean that the herd immunity threshold is higher (approx 74%).

Here is are the papers, the first one is the one @enjoyingSun was looking for. The latest paper estimates 2.7% of the UK population was infected by 28 March. They are 95% confident that the percentage of the population infected was somewhere between 1.2% and 5.4% on that date. The Oxford study that suggested 50% of the population has been infected was misreported by the press, it was more a case of "possible" rather than "probable". The estimate from the latest Imperial paper is more credible.

www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf?fbclid=IwAR3PQSzpObyq-ULWzwsNKvDHwPhri47wEsJSDqEJYX0dTzIw1JQc6wVSGCE

www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-Europe-estimates-and-NPI-impact-30-03-2020.pdf

Thanks for those links, going, I'm looking after baby & child at the moment but I'll look later.

And thanks for all those posters who have decided we are allowed to discuss this, rather than accusing me of psychopathy and murder .

This herd immunity bullshit is so dangerous. No, I'd rather not get it at all.

But that might not be an option, Sunflower?

One question (of many) that I have is about those people who have been designated as highest risk and who are self-isolating for 12 weeks. What happens to them? Until a vaccine is available are they expected to choose between long term isolation or expose themselves to risk? If this virus will continue to be in our communities, albeit at a lower level, then they may be infected in the long run.

I understand about maximum protection now to avoid overloading the NHS (these people would be most likely to require hospital treatment), but what happens after that?

This is pretty much the actual plan the government are talking about its not a secret, they've said that restrictions will be gradually decreased probably in 9 to 12 weeks then depending how it goes further relaxing or returning to lock down. They're trying to avoid a big spike though there will be one but they're hoping the current measures will keep it at a manageable level.
Everyone is speculating though even the experts no one knows for sure how this will play out.
Personally I'm hoping the fairly mild but weird illness my household have had the past week or so was IT and we're immune now. I think that the reports/speculations that a high percentage of the population has already had it is the best we can hope for.

@Sunflower20 so what is your solution then? Please let us know what you suggest? None of us want to get this damn virus. But locking ourselves away until a vaccine is just not possible. So tell us what you would do...

@venusandmars good question. My parents are shielded because they are over 70 and my dad had a stroke. My hope is that they can come out of shielding when 65% have immunity. That means that the virus is unable to spread any more. I don’t know when that will be.

We've had various weird little illnesses over the last month or two as well Wiaa and we're also hoping one of them was it!

I am a bit confused about what the vulnerable will do over the next few months as well. Logic dictates that they will have to carry on with basic lock down while it is relaxed for the majority. At first at least.

Given that (understandably) many who are shielding are already quite antagonistic about how much freedom the 'rest of us' have, then how will they cope mentally? And physically to an extent. While they might have risked a walk out while it's pretty deserted out there (i'm thinking of our village at the mo) they wont be able to risk it when more people are out and about.