So if we're going to live with covid

[Lelophants]

And counties like Australia and NZ have a no covid policy, how on earth will we integrate? I know the UK is too far gone. But how will we be allowed to travel if we keep getting vaccinnes but they don't always stop transmission because we have constantly new strains?

Or do you think other countries will give up on no covid policies too?

"The best way for me to imagine it is flu scenario. We don’t alter behaviour or test community cases but do work with new variants for vaccine and accept level of deaths each year"

@MarshaBradyo what level of deaths should we accept then? And to what benefit? And before anyone jumps on me, of course with all illnesses we accept a level of deaths. But so far with Covid it's been proven time and again that the herd immunity policy, with intermittent lockdowns, isn't working and leads to exponential growth which then means nothing else can function

Given that even countries with a zero Covid policy have consistently had outbreaks Covid will be here for a long time yet

@twelly yes they have outbreaks. Of course. It's a pandemic. They then work on excellent test and trace to quell them

@Nellodee

I’m not saying it would necessarily be a desirable thing to even try given where we are now, just futile.

@Nellodee so what do you propose we do instead, if you had a magic wand and things could go as you believe?

Those of you who say that Zero Covid is being able to buy time - you're admitting that Zero Covid isn't the best long term strategy.

What is the long term strategy that follows ZC & when does it become the better strategy? What are the conditions that would enable the subsequent long term strategy to be implemented?

I still don't know how a country (UK)

• with land border with a country (RoI) that has commitment to Freedom of Movement with 26 other countries (EU) and
• used as a landbridge for 200k freight journeys to that other country and
• that has world's largest international travel hub (Heathrow)

... could have pursued Zero Covid as successfully & painlessly as Taiwan or Aus. did

"What is the long term strategy that follows ZC & when does it become the better strategy? What are the conditions that would enable the subsequent long term strategy to be implemented?"

@yeOldeTrout the best long term strategy: vaccinations that continuously improve. Therapeutics. With all illnesses we learn and adapt. Think HIV, polio, SARS etc. Test and trace in the interim. In the meantime zero Covid countries have done much better in all areas. I'm not saying this to compete / prove a point. Just show me they haven't if you believe it's the case.

@stilllovingmysleep

"The best way for me to imagine it is flu scenario. We don’t alter behaviour or test community cases but do work with new variants for vaccine and accept level of deaths each year"

@MarshaBradyo what level of deaths should we accept then? And to what benefit? And before anyone jumps on me, of course with all illnesses we accept a level of deaths. But so far with Covid it's been proven time and again that the herd immunity policy, with intermittent lockdowns, isn't working and leads to exponential growth which then means nothing else can function

Still flu level - is it about 20k? It does fluctuate.

We only shut down because hospitals can’t deal with overload but if vaccine removes this threat for majority then we no longer need to do so.

It’s hard to give definites, and even Whitty has suggested above, but new variants aren’t known. Although we will change vaccine to match them each year.

I don’t know what the plan is for variant part. Whether light restrictions or higher border control.

@stilllovingmysleep if our borders had been shut straight away I wonder how many people would still be waiting to get home. 35,000 still sounds a lot to me, especially if I was one of the 35,000.

Btw the benefit of accepting a flu scenario is huge economically. The cost of not doing so is massive.

But we won’t care as much as when was the last time you knew or felt annoyance over flu statistics?

[quote ineedaholidaynow]@stilllovingmysleep if our borders had been shut straight away I wonder how many people would still be waiting to get home. 35,000 still sounds a lot to me, especially if I was one of the 35,000.[/quote]
@ineedaholidaynow so does a zero Covid strategy have to be 100% perfect, thus absolutely no cost, for you to consider it works better?

It's a cost benefit comparison. And on comparison the costs they have had to pay are much much lower than ours.

Many of us here in the U.K. have family abroad who we can't visit. So it's not as if our way is better, even in that respect

@MarshaBradyo

Btw the benefit of accepting a flu scenario is huge economically. The cost of not doing so is massive.

But we won’t care as much as when was the last time you knew or felt annoyance over flu statistics?

@MarshaBradyo many people in public health worry and work on flu statistics.

And Covid is very different to flu actually. Which is the issue.

Still yes of course but do you? Will the public? Not really. Messaging will flip and we won’t focus on death count.

And no it’s not the same but listen to Whitty and MPs and the flu like scenario is useful to explain the objective. It’s hard for people to get otherwise.

It took 10 years? to get great treatment for HIV; 4100 people/year in UK still get new diagnoses each year. But HIV isn't easily contagious, it needs bodily exchange of bodily fluids not sharing the same air space.

I reckon if UK wanted to follow Taiwan scenario, on top of blowing up Ireland, they would have had to shut down about 1 Feb 2020 when prevalence was that low. Scaling up that 35,000 Aussies still stranded abroad, would mean a mere 100k Brits trapped abroad still... except Brits travel abroad a huge amount more than Aussies. So probably more like 300k people still trapped abroad, even now.

Another way to calculate... If Uk has booked 4600 rooms for the Quarantine programme, that suggests about 400 people into them each day (10 day programme). To accommodate the current 20k arrivals day, the UK would need 230,000 hotel rooms.

NZ has 4500 managed isolation rooms available, 14 days isolation, for regular population of 5million.
Scaling up but allowing only 10 days quarantine, that suggests UK would need 60,300 hotel rooms, and that means maximum of about 6000 new arrivals/day. 33% of current arrivals by air. I don't know what count is of arrivals on ferry/chunnel, but presumably some that aren't hauliers, so probably would need to reduce UK arrivals to no more than about 15% of what they actually were since Feb 2020. Upshot is I reckon UK would have had far more than 500k people still stranded abroad even in Feb 2021. How ARE Aussies managing abroad to pay their bills etc.? When they probably have no right to work where they are abroad.

& I don't know what Uk would do about all the land bridge journeys. There might be a black market smuggling ring of Irish hauliers bringing over Uk citizens trying to get back into GB. Otherwise Make people from Northern Ireland also quarantine in order to go to GB too, I guess.

@MarshaBradyo

Still yes of course but do you? Will the public? Not really. Messaging will flip and we won’t focus on death count.

And no it’s not the same but listen to Whitty and MPs and the flu like scenario is useful to explain the objective. It’s hard for people to get otherwise.

@MarshaBradyo I do to some degree in that each year I do my flu jab.

My point is that comparisons to the flu and following a flu pandemic roadmap has been exactly the reason the US and European countries have done so badly, while countries that took the virus seriously and followed a SARS roadmap did better.

Still the level of interest is very different. Do you know how many flu cases today and deaths? We have been fed this since pandemic began. This will hopefully drop as we live to next phase post vaccination. You might have the flu jab but you are presumably no longer stressed about getting it as a result.

Yes there have been different paths to the same stage. I can’t see why we wouldn’t all converge with same situation.

I was also thinking of it as a waiting room, some have had a much nicer time, others didn’t shut the door in time and it’s been hellish. But we’ll all move on to the same.

With caveat that variants are unknown but I don’t see huge concern from CMO etc on above being possible.

The best way for me to imagine it is flu scenario. We don’t alter behaviour or test community cases but do work with new variants for vaccine and accept level of deaths each year

Hmm. AZ say they'll have the SA-facing vaccine by autumn, so over six months away. Then got to get it into arms. So maybe eight months. We can probably halve the timescale in future that if we are optimistic.

If you don't test in the community, you wouldn't know people infected with a vaccine-ineffective variant until you see serious illness - by which time your only option would be mass testing and lockdown.

It's an option. But really not sensible.

Community surveillance has got to feature, why would we not use the biggest advantage the UK has - tracking variants? That will keep our vaccines effective and cut risk of lockdowns in future.

@MarshaBradyo but the reason we know all the numbers is that we've had more than 100,000 deaths in this country in less than a year from a new disease that we've added to our existing diseases. It's not as if we just know the numbers because of some kind of morbid fascination

@PracticingPerson

The best way for me to imagine it is flu scenario. We don’t alter behaviour or test community cases but do work with new variants for vaccine and accept level of deaths each year

Hmm. AZ say they'll have the SA-facing vaccine by autumn, so over six months away. Then got to get it into arms. So maybe eight months. We can probably halve the timescale in future that if we are optimistic.

If you don't test in the community, you wouldn't know people infected with a vaccine-ineffective variant until you see serious illness - by which time your only option would be mass testing and lockdown.

It's an option. But really not sensible.

Community surveillance has got to feature, why would we not use the biggest advantage the UK has - tracking variants? That will keep our vaccines effective and cut risk of lockdowns in future.

I said about three times we’d track variants?

It may be in hospital or even community.

"Sacrifice the lives of people I don't care about so that I am not inconvenienced in any way."

This conversation will continue to be circular as long as people minimize the sacrifices people are making everyday (or dismiss the fact that sometimes lockdowns are effective and the only good option).

Lockdowns are effective ways of reducing case levels but also carry enormous costs. The optimal strategy is to find the equilibrium where benefits and costs balance.

I'm happy to be "inconvenienced" in many ways but, in my opinion, pressing pause on children's education / development for months / years that this cohort of kids will never get back is too high a price.

My point is that comparisons to the flu and following a flu pandemic roadmap has been exactly the reason the US and European countries have done so badly, while countries that took the virus seriously and followed a SARS roadmap did better.

This is a very important point, the failure to move away from flu comparisons is unhelpful but I suppose we are so comfortable with flu so the emotional pull is understandable.

Scientifically incorrect though and covid clearly isn't listening. The variants in covid require more surveillance/reepinse than flu simply because covid is nothing like flu. I wish it was like flu!

@PracticingPerson

My point is that comparisons to the flu and following a flu pandemic roadmap has been exactly the reason the US and European countries have done so badly, while countries that took the virus seriously and followed a SARS roadmap did better.

This is a very important point, the failure to move away from flu comparisons is unhelpful but I suppose we are so comfortable with flu so the emotional pull is understandable.

Scientifically incorrect though and covid clearly isn't listening. The variants in covid require more surveillance/reepinse than flu simply because covid is nothing like flu. I wish it was like flu!

Oh come on. It’s being used by CMO to explain. It’s shorthand for people to understand next phase. A pity that we had the whole it’s not the flu stage as now we can’t use it as a useful model to explain (for some anyway).

Can you outline future scenario without it then?

Once NZ and Australia have vaccinated their population, they will start to open up to international travel and accept some Covid cases which because of vaccines won't spread so aggressively

If we don't test for covid in the community, we can't track variants. That would just be stupid surely, given what happened with the Kent variant when we were testing widely. So we'll have to still test.

@stilllovingmysleep If I had my way, we would open up gradually, not with a big bang. We have downwards pressure on viral growth from the ever increasing amount of vaccinations and formerly infected people, we have upwards pressure in the form of new variants and the relaxation of restrictions. We should get cases lower initially (as we are doing), and then attempt to keep those things in balance as we move forwards. To do this, we need a government that reacts to the data and not to the public mood of the day.

@bumblingbovine49

Once NZ and Australia have vaccinated their population, they will start to open up to international travel and accept some Covid cases which because of vaccines won't spread so aggressively

I think they'll just continue to TTI though, but vaccination will mean the risk of outbreaks is much much lower.

@PracticingPerson

If we don't test for covid in the community, we can't track variants. That would just be stupid surely, given what happened with the Kent variant when we were testing widely. So we'll have to still test.

We may track in the community. I haven’t said we definitely won’t.

Or it may be in hospital.

Although a lot of messaging is to get us to test and this may change as threat changes.