Why can’t we shield the vulnerable?

[Calledyoulastnightfromglasgow]

Can anyone tell me why this wouldn’t work?

It’s been dismissed out of hand by the government as apparently it would still spread. As far as I can see, it’s spreading anyway - maybe restrictions only work for so long and we have non compliance?

But can’t we throw a pile of money at the issue (which would still be less than we currently are spending). Segregated medical appointments/dental etc. Home delivery o iu for shielders. Basically what we did in March but to the vulnerable or vulnerable households.

My mum is elderly and is pretty much shielding until a vaccine anyway. It’s dismal. The sooner the less vulnerable of us get it, then the sooner we can achieve some kind of community immunity.

We would have covid hospitals only - we would actually use them. We would still have restrictions so it didn’t spread so quickly but we wouldn’t paralyse whole sectors.

I appreciate long covid is a thing - but so is most chronic fatigue after a virus (I have had it).

The real issue might be households where the elderly lived with the young. Or the highly vulnerable. My friend is in this category and has spent months shielding. It’s dismal.

If we had adopted this strategy slowly from April we could have avoided hitting flu season.

People go on about antibodies but T cell immunity is repeatedly ignored and the cases where people demonstrate symptoms twice are something like five.

I just can’t believe we are going to save more lives with the current strategy compared to a change of tactic. Thousands will die through other causes as it is.

[sonnenscheins]

No, there is no guarantee that killing everyone off quickly would lead to fewer deaths long term
The resultant economic crash would be worse than the mess we are already in.
This was proven in the Spanish flu , and the economy vs death rates charts in covid are telling the same story. The more deaths, the worse it is for your economy short and long term

Do you have evidence that shows that lockdowns are better for the economy than not locking down?

I struggle to understand how locking down the economy and forcing countless businesses to close, leading to mass unemployment and increase in debt can be better for the economy than letting people get on with their lives and letting the virus take its natural course (which would lead to a large number of deaths initially).

[Badbadbunny]

@sonnenscheins

*No, there is no guarantee that killing everyone off quickly would lead to fewer deaths long term
The resultant economic crash would be worse than the mess we are already in.
This was proven in the Spanish flu , and the economy vs death rates charts in covid are telling the same story. The more deaths, the worse it is for your economy short and long term*

Do you have evidence that shows that lockdowns are better for the economy than not locking down?

I struggle to understand how locking down the economy and forcing countless businesses to close, leading to mass unemployment and increase in debt can be better for the economy than letting people get on with their lives and letting the virus take its natural course (which would lead to a large number of deaths initially).

Because people couldn't "get on with their lives"!

We already had schools and hospital wards closing due to covid-related staff shortages in early/mid March.

Most of the ECV group and may vulnerable would have been avoiding crowded places because of their own risk assessment, so that would hit shops, pubs, restaurants, theatres, sports stadia, due to fewer customers.

Many ECV/vulnerable would be reluctant to go to work in crowded places, so that would hit public transport, workplaces, etc.

Quite simply, there'd be so many people who were either dead or ill, or avoiding crowded places, or working from home, etc., that places reliant upon crowds of people would suffer dramatic falls in customers & staff, that they'd be closing anyway.

There's no easy answer to any of this. It will take years for proper studies to be done as to which countries did better than others, and why.

[sonnenscheins]

Quite simply, there'd be so many people who were either dead or ill

I think it depends on how many 'so many' people would actually be.

[VikingVolva]

OP: several posters have asked how you define the vulnerable, and what the plan to 'protect' actually involves

Any chance of an answer?

[SleeplessGeordie]

MereDintofPandiculation
it seems to have passed you by that this is being asked of the vulnerable. Single people who are vulnerable are losing their chance of dating, they can't see nieces and nephews any more, or even their own children.

I genuinely don't understand this comment. It seems as if it's passed you by that non-vulnerable (to covid) people have been living under these restrictions since March too. Normal meeting people and dating hasn't been allowed since then, for example. Obviously in some areas the rules are even stricter, but the basic life-changing and meaningful parts of life involving others are restricted across the board. Being able to go out to the pub or whatever is just window-dressing (though obviously huge for people employed in these industries). The restrictions have a wildly different impact depending on your life circumstances (couple/single, DC or not, geographical closeness of family, employment type, housing type...) For example, ECV people in couples didn't have to undergo the dreadful isolation forced onto single people for the first 2.5 months of lockdown. Those who have had children haven't had the chance for a family taken from them due to the restrictions.

Claiming that Their lives will still be more restricted than yours simply isn't true - it depends far more on your life circumstances pre-covid as to how much this restricts your life, and how much it takes from you. Also, the shielding guidance was only ever guidance, not law - you could still meet someone outdoors or take a walk or whatever if you wanted to, just like non-vulnerable people.

What gets me is the trivialisation of the impact on non-vulnerable people in these discussions. The idea that it wouldn't be fair for someone to lose their job, not see people or so on, whilst ignoring the fact that this has already happened to many people - vulnerable and non-vulnerable alike.

[SleeplessGeordie]

Anyway. Looking at how the virus is spreading is making me increasingly convinced that some kind of optional shielding support should be available, as well as moving people temporarily into less risky roles at work where possible, working from home if possible, and so on.

[EmmaOvary]

'Because when you say shield the vulnerable what you actually mean is lock people out of society completely so that you don’t experience any loss of freedom at all. It’s monumentally selfish, utterly offensive and quite honestly you can just fuck of with your othering and discrimination.

Further, it wouldn’t work. Lots of reasons, educate yourself. So not only is it a selfish and offensive concept, it’s stupid.'

This. Not only is it unethical but it's logistically impossible.

[Oliversmumsarmy]

The graph Calledyoulastnightfromglasgow posted does say it all.

Wear a mask when you are out and if you have people in your house. SD and wash your hands and go about life as normally as you can.

People need to remember this isn’t a death sentence even for the people with multiple problems.
Dp has cancer and type 1 diabetes, high blood pressure and is in the obese category and other health issues (was diagnosed with asthma years ago but never used anything) He had Covid and recovered without any problems.

Just because you are elderly or obese or have dreadful health doesn’t mean you will automatically die if you contract it.
You stand a very good chance of recovering fully.

[Calledyoulastnightfromglasgow]

Sorry - missed the requests for me to define “vulnerable”

I thought we were debating a theory on MN rather than drafting legislation

Anyway, I think it would very careful consideration as it seems that the highly vulnerable are a narrower group than first thought. Asthma for example doesn’t seem to raise the risk as much. Low vitamin d status does!!

[VikingVolva]

It would help,to have some idea if who you think your theory should apply to!!

Plus some idea of what you think is involved in the concept of 'protect'

So we have a starting point to discuss.

Only the most serious asthma was in the 'shield' group, but no-one with diabetes was. Nor BAME. Nor by age. Would you be including any of those? What about the 'flu jab' group?

[Badbadbunny]

@Calledyoulastnightfromglasgow

Sorry - missed the requests for me to define “vulnerable”

I thought we were debating a theory on MN rather than drafting legislation

Anyway, I think it would very careful consideration as it seems that the highly vulnerable are a narrower group than first thought. Asthma for example doesn’t seem to raise the risk as much. Low vitamin d status does!!

Yet on another thread, we have a GP claiming one of their colleagues has asthma and is working from home as he refuses to attend work or see patients as covid "would almost certainly kill him" due to his asthma. If a highly qualified medical practitioner is convinced he will die from catching covid, what hope is there to persuade others to actually go to work?

[LearnedResponse]

Defining what constitutes “vulnerable” is not just a technical detail - it’s key to the feasibility of this idea. If you restrict it to the designated ECV then yes that’s probably a small enough number that you could pay their wages, and their spouses’ wages, and implement a specialist live online tutoring system for all of their children and give them access to specialist COVID-clean health facilities. Whether that’s acceptable is a different question.

But you’d need to deal with the huge numbers of somewhat vulnerable people - whose risk of death is in the 0.25%+ range. That’s millions and millions of people. You can’t shield them. The vast majority of them won’t die, but even a very small minority of tens of millions is a lot of corpses, and they would get hospitalised in enormous numbers. You are not magically more insightful than everyone who’s in charge of this all over the world OP. You simply haven’t sat down with a pencil and paper and done the sums.

[housemdwaswrong]

I'll tell you why not, because we are human. Have you forgotten that somewhere along the line? Why do you have different rights and opportunities from me because I have a condition and you don't? What makes the tax you pay better than the tax I pay? What makes the money you spend have more value than the money I spend?

Why don't you stay at home, stop going out and let me get on with it? Would work just the same.

[housemdwaswrong]

Where does this herd immunity thing come from? We have not got herd immunity from one single virus without a vaccine. Not one. Look at measles. Anti vaxx campaign, people don't get the jabs and it's on the increase. A study today shows immunity lasts less than 6 months. We won't get herd immunity. I don't understand why you say your mum shielding is grim, then suggest it as a solution?

[Oliversmumsarmy]

I think Spanish flu was eventually brought under control through herd immunity.

After 2 years either people were dead, or so many were immune that it couldn’t pass on to anyone

[housemdwaswrong]

@oliversmumsarmy you're right. That's one I hadn't thought of, even if it did mean poeople digging graves and burying their own dead. Are there any others?

They found antibodies and immunity in people that last a lifetime. Not the case with this it seems. Interesting read though: www.cidrap.umn.edu/news-perspective/2008/08/researchers-find-long-lived-immunity-1918-pandemic-virus#:~:text=Aug%2019%2C%202008%20(CIDRAP%20News,future%20generations%20against%20similar%20strains.

[sonnenscheins]

Why don't you stay at home, stop going out and let me get on with it? Would work just the same.

But you being vulnerable makes you more susceptible to being harmed by the virus. So no it wouldn't be the same.

Surely it makes more sense for the young and healthy continue working and paying taxes?

We can try to fight this virus but ultimately only those receiving a vaccine or who have natural immunity will survive long term. Sad but true.

And I'm neither young nor super healthy.

[sonnenscheins]

A study today shows immunity lasts less than 6 months. We won't get herd immunity.

Actually if you read the study more closely you'll see that there may well be long term immunity through T cells. It's too early to tell though for sure. Hopefully we'll know more as this second wave progresses.

[housemdwaswrong]

@sonnenscheins Okay, slight exaggeration. But I'm sick of being treated as dispensable and an inconvenience. OP says it's dismal for her mum, then would happily consign us to it.

I work, I pay taxes, I contribute. Now suddenly I'm to be stuck at home for everyone else's convenience. Am waiting for the article to load and I will re-read.

[sunflowers246]

I think it depends on how effective or otherwise any potential vaccines might be. And on how long natural immunity might last.

Because if we cannot eliminate the virus we will unfortunately have learn to live with it. We can't lockdown indefinitely unfortunately.

I don't think there's an easy answer unfortunately. Even New Zealand will struggle Ito keep the virus out of their country without the help of a vaccine or other immunity.

[housemdwaswrong]

@sonnenscheins that's not what I read from it?

[housemdwaswrong]

'Recently, several studies characterizing adaptive immune responses to SARS-CoV-2 infection have reported that most COVID-19 convalescent individuals have detectable neutralizing antibodies, which correlate with the numbers of virus-specific T cells26,27,28,29. In this study, we observed that IgG levels and neutralizing antibodies in a high proportion of individuals who recovered from SARS-CoV-2 infection start to decrease within 2–3 months after infection.'

[midgebabe]

As well as vaccination, improved treatment will help us live with it, already death rates are down compared to the spring.

In the absolute worst case of no vaccine, no treatment ,no cheap rapid tests, and no long term immunity, then we will have to scale up our health service to cope. That would take about 5 years I would guess.

Leaning to live with it doesn't mean give up and try to pretend we carry on as before

It means leaning about new ways to manage

[sonnenscheins]

@housemdwaswrong I heard it on the 1 o'clock news on Radio 4. They were interviewing the researchers who basically said that it's too early to say how long immunity lasts due to the role of T cells.

[Angel2702]

Many vulnerable are also working full time or are parents. We wouldn’t survive if we couldn’t work.