WHY do people keep saying we all need to get it...

[nellodee]

When Matt Hancock is clearly saying that we need to get cases right down, so we can move into the next stage, which is contact tracing?

From Guardian updates:

Easing lockdown depends on fall in number of new infections, says Hancock
Easing the lockdown depends on the speed at which the number of new cases of Covid-19 falls and that is as yet “unknown”, the health secretary, Matt Hancock, has said.

The number of new cases is being tracked through hospital admissions, through a new testing study in the community announced on Wednesday, and data that will be gathered from people coming forward for tests under an expansion of the programme.

However, he added that there was no prospect of easing the lockdown yet, and that cases needed to drop substantially before the next phase of isolating infected people and their contacts could be truly effective.

@dotty202 Regarding contact tracing, I heard that they wanted to recruit thousands of contact tracers for manual contact tracing. This would be complemented by an app that would, if someone tested positive, automatically alert anyone who had been in close proximity to that person that they are at risk so they can be vigilant/isolate/get tested. Unless download of the app is mandatory, it will only be effective if a significant number of people download it.

it's not that we want everyone to get it. It's that "Everyone has to get it" before we abandon social distancing and go back to normal OR everyone has to be vaccinated before we go back to normal.

The expectation is that if we went back to normal today too many people would catch it at once to be treated and too many would die. The numbers would climb too rapidly.

Social distancing slows that down.
Having a large percentage of people who have survived it and are immune slows that down
Having a vaccine slows that down

I can't see any scenario where "Contact tracing" solves the problem as it is out there in numerous places. If for example a nurse tests positive she can list all her contacts including patients and staff, but it has to include all those she was near on the tube and in the streets too.

And even if that were possible what use is that? You then test those 100s of people and they write their lists but too much time has passed for it to be useful.

it might be useful just to get an idea of how easily you passed it on for statistical analysis.

Cat-

I understand that more now. I would download contact tracer myself happily, however I wonder how many people will cooperate. I can see many people having privacy concerns, not liking tracking, etc... People will be very sceptical.

How could that have worked, back at the beginning? We are a democracy. We didn't have the laws or infrastructure in place to track and trace all residents. That has been changed...

There were no reliable, speedy tests available. That too has changed

Where was ground zero, Patient One?

We were way too complacent, bordering on reckless, to have allowed this to become so widespread in our population. In the absence of data, err on the side of caution - that was the message of WHO from the beginning but our health chiefs seemed to think they knew better about this "flu".

Yes. I got very very upset in early March about it and had panic attacks due to anxiety over it. My family shot me down and dismissed my concerns. Oh its just flu etc.

Then a few weeks later my dad conceded 'things are going to be a bit grim for a while'.

Now I'm a bit desensitised to the horror of it for my own sanity. I think the contact trace strategy is absolutely futile but the public want something to cling on to and the politicians want to show us they are doing something.

I don’t see how contact tracing works with a virus that some people have asymptomatically.

It starts with a symptomatic person - let's call them person A. They infect person B and person C before their symptoms develop. Once person A gets symptoms, person B and person C are told to self-isolate - hopefully before they've had chance to infect anyone themselves. Then, even if person B is an asymptomatic case, it doesn't matter because they're self-isolating and won't be infecting others. In theory, you can extract it out another layer to account for the fact that person B might not have started self-isolating in time. So person B has close contact with person D and person E, and at the point that person A tests positive, B, C, D and E are all told to self-isolate. You potentially end up with a lot of people self-isolating unnecessarily, but it's still better than the entire country in lockdown.

If everyone got on board with the app that's being launched, the process should be far easier and more reliable than trying to do it manually, because of the kind of situation that @LastTrainEast described.

Most of us probably will get it at some point, but we don't all need to get it so it's over and done with. Not all at once anyway.

Can we train person A to only infect two people at a time and to get their full names and addresses?

Can we also train people to light up and maybe sound a siren when they are infected as currently some time will pass before we know. By which time they have probably been in contact with many other people.

A time machine would help or a crystal ball.

"We were way too complacent, bordering on reckless, to have allowed this to become so widespread in our population."

We didn't know in advance how serious it was.
Next time someone gets a flu we don't recognise let's try the other way and close down the country. We'll be doing that 2 or 3 times a year though.

Maybe just keep our borders closed forever?

On the diamond Princess, a large number of people who tested positive were asymptomatic - this number grows depending on the age of the population.. I know people who feel they've had it and with hindsight feel it came from their child who was just a bit headachy or not quite themselves. This means a potential month of shedding the virus before their likely show enough symptoms to consider testing. I don't see how contact tracing can work here unless well established and these asymptomatic people are a link in a chain that's already been tracked.

However add in to this that habits will have been changed, hygiene, physical distancing etc. Many people will continue to do extra distancing above what is requested, that makes sense to them, so this should keep the r0 lower.

A big problem with track and trace and apps is that entire households will have to be prepared to be in and out of personal quarantine at no notice for a fortnight each time.

We can get back to the point that contract tracing is feasible again - which is the strategy the majority of countries seem to be going for.

This is what I had thought.

Can we train person A to only infect two people at a time and to get their full names and addresses?

Well the estimated R0 for COVID-19 is about 2.3, and if everyone involved has the app, then yes, effectively.

Can we also train people to light up and maybe sound a siren when they are infected as currently some time will pass before we know. By which time they have probably been in contact with many other people.

Did you read my post? This is exactly the point of contact tracing - self-isolate them before they get the chance to pass it to other people.

The plan is for us to get down to about 500 cases a day, I think. Now at this point, if we were all to get it, it would take 364 years at 500 a day. Longer than that - because more than 500 people are being born every day!

So, given the plan is to keep numbers low so we can contact trace, then no, we are not all going to get it. And no, the plan isn't so lots of healthy young people go out and get it either, because this would make the contact tracing impossible.

Because the government messaging is very poor. They talk of “slowing the spread” and “ensuring the NHS is able to cope”. I don’t think it’s that surprising that people have interpreted that to mean “everyone will get it we just need them to get it slowly”.

If the confidence is there that a vaccine will eventually solve the problem and they are therefore looking at a strategy of mass suppression then they need to shift the messaging.

They haven’t because they don’t want to deviate from the “stay at home” message. I think this is where the failure to set out a high level strategy for exiting the lockdown is causing problems.

I think the point of contact tracing is to drag down the R0 further.

Everything we do has an effect of raising, or lowering, R0. Above 1 is very bad. Below 1 is very good. It's unlikely to be spot on 1, but that would be just keeping things steady.

So, we lockdown. In a lockdown like the one we have now, R0 is about 0.7, but it's very hard to live with.
All the things like opening schools, opening shops, mingling with family members, all have an R0 cost. But right now, we only have about 0.3 to play about with.
Contact tracing, if cases are low enough, has an effect on R0. I don't know how big that effect is, I haven't seen any studies that have actually put numbers on it, but I do know that it's almost enough, by itself, to bring R0 down from its maximum to under 1. This would mean we could ease up on lots of other measures. Maybe almost all of them.

This is what people talk about when they say, More haste, less speed. If we try to release lockdown before we have cases low enough, then contact tracing won't work, and we will only be able to ease up to the tune of 0.3 worth of R0.

If we hold tight, get the testing sorted, get the cases low (and they will drop off, because R0 is under 1), then we can do the contact tracing, use THAT to keep R0 low, instead of this lockdown that everyone hates, and then we can keep going, doing that indefinitely instead of this, until we get a vaccine or better treatment.

Because the government messaging is very poor. They talk of “slowing the spread” and “ensuring the NHS is able to cope”. I don’t think it’s that surprising that people have interpreted that to mean “everyone will get it we just need them to get it slowly”.

Wouldn't it be great if the press could actually force them to clarify,

@nellodee

I agree. However the government have not made that clear because they have refused to discuss an exit strategy. It has only been the last few days that’s it’s been clear they planned to operate a test and trace programme at all.

Haven't seen studies that put numbers on it!!!!

Oh, thanks for that. I have been unaccountably somber today. That really did make me laugh!

@nellodee - Yes, true - I should have clarified that the R0 I quoted is the "natural" one.

I believe Hancocks plan could work. Appears that it did in South Korea.

What I dont believe is that Hancock, Johnson and the rest of the bumbling incompetents are capable of planning and carrying this out.

They have lied and fudged up until now. Why would that change?

I get mixed up between what to call the natural transmission number and what to call the one that varies, I have to be honest.

@GabriellaMontez - I do share your reservations, I do. But it's got to be the best option to try, hasn't it?

Yes it would have been the best plan. Weeks ago. When the WHO shouted it from the

Imvho. It's too late.

And I have no confidence the government can achieve it. None.

*rooftops (should have said)

I don't see how contact tracing can work here unless well established and these asymptomatic people are a link in a chain that's already been tracked.

Chains with asymptomatic people may end up longer than those without (although I think it's believed that asymptomatic people are less contagious anyway), but sheer probabilities should mean that every chain should eventually result in a symptomatic case and therefore an opportunity to stop it.

Yes, getting contact tracing well established is absolutely key. I don't know what the current plans are, but early on there was some suggestion that you'd only be allowed on public transport if you could show that you had the app and that it considered you low risk. In China they did it with QR codes instead, but they wouldn't even let you into a supermarket without proof you were "green"