New Boris Statement: Where is this going?

[DadAManger]

‘We recommend masks but only recommend them’
‘Deaths will increase and we may reach 100,000 new cases per day’
‘We must open now and if not now, when?’
‘The slower we take it, the smaller number of people will die’
‘Return to the office of you can, otherwise keep working from home’

Just before Boris spoke, there was a BBC piece claiming that 10-20% of all Covid cases (mild, without symptoms, or otherwise) will be long-Covid cases of some sort or another. Now there a million long-Covid cases.

Are we aiming for herd immunity? Anyone else think this is going to be confusing for most and lead to a default setting of ‘normal’? Where is this going?

@crocidura

Covid spread in India when the restrictions were minimal - they climbed and climbed. Restrictions were put in place - though it's worth pointing out that they were very inconsistent and poorly enforced, especially among poorer areas, but before those restrictions could have any real effect the virus peaked and dropped massively. That's a normal epidemiological mechanism - it's a very common pattern for viruses to climb and then burn out. I don't know why you think it's lies.

So Covid spread in India when there were no restrictions, they introduced restrictions and the number of cases fell, but that was nothing to do with restrictions, it was the virus burning out, coincidentally at the same time as the lockdown? What's the biological mechanism for burn out of this particular virus and if it's happened in India, why hasn't it happened here?

It hasn't happened here because it hasn't been allowed to happen - we've never been in the position India was with a massive spread of infections. Locking down keeps the virus in a holding pattern, allowing it to chug along at lower levels, slowly finding hosts. Every time you open up, it goes up again, then you lock down again, keeping it going and going and going. If there's one big upsurge, it infects a lot of people at once then has nowhere else to go.

India effectively did away with restrictions at the end of February, believing the virus had already burned itself out. There were a lot of large events - particularly political rallies - that spread the virus very very rapidly. They locked down but at that point it was already too late - the infections were so widespread and the potential to contain them was so poor that it did very very little. So it grew and grew and then very suddenly got to the point where it had nowhere else to go. Infections dropped by 300000 in a month. No lockdown, no matter how strict, can achieve that on its own - that drops comes from the virus essentially running out of hosts.

Where do you think the concept of 'flattening the curve' comes from? The natural curve of pandemics is for it to go up and up and and then come down steeply. The idea of flattening the curve was to maintain that progression but to spread the top of the curve out over time. It didn't work - logically, if you slow the curve down, it never reaches its natural peak, it just chugs and chugs and chugs endlessly. Theoretically, vaccines should artificially create the peak - taking hosts out of circulation. That has worked to an extent but we're at the point now where increased infection will push that peak all the way up so we can get down the other side. Basically, as much as one might attempt to control a virus, viruses just carry on regardless - you can manipulate the situation, especially with vaccines, but at a certain point you have to accept that it will go around and delaying and delaying just piles the problems up.

*Sorry but the NHS was totally overwhelmed, huge number of deaths at home, few elective treatments and now waiting lists heading toward 13m :(

That looks to me like an overwhelmed health service.*

I'm certainly not denying that the NHS was overwhelmed. Just pointing out that the plan was never for it to continue as normal.

@singingstones

What should have happened is a short lockdown, to minimise the impact of the restrictions, during which all the money spunked on the covid app and test and trace was pumped into the NHS to reorganise it and put it into a state to cope - genuinely cope - with infections. Then reopen and stay open.

Reorganising the NHS and putting it in a state to cope with a pandemic without any restrictions - so presumably building new hospitals and training many new doctors and nurses - in a "short" lockdown? 🤔

I think people are so used to the NHS being strung out and underfunded that they don't realise that other healthcare systems ran as normal during the pandemic - the absolute minimum was cancelled, appointments ran face to face, etc. The acceptance of the fact that here everything shut down and the NHS still piled up and astronomical backlog is strange - what was the point of the lockdown if the main reason for it - saving the NHS - didn't happen? Why lockdown, have the massive fallout from that and then have cancelled appointments on top of it?? That situation just extends and multiplies the problems, it doesn't stop them.

Yes capacity in the NHS is an issue, but a lot of it is about money and organisation. There was no need to train extra doctors, there was a need to use the doctors that were there to the best effect. That did not happen.

@singingstones

*Sorry but the NHS was totally overwhelmed, huge number of deaths at home, few elective treatments and now waiting lists heading toward 13m :(

That looks to me like an overwhelmed health service.*

I'm certainly not denying that the NHS was overwhelmed. Just pointing out that the plan was never for it to continue as normal.

The plan was for people who needed care to get care. And that didn't happen for a lot of people.

lack of staff is a huge issue but staffing isn't the only way to approach a crisis. A lot of it is about leadership and planning which seems to have been completely absent over the last year. Even simple things like staff taking holidays has been mismanaged to the extent that some staff are struggling to get any time off and others are having their leave booked for them at times when it doesn't work for them. It's such a disgraceful mess

I think your turn of phrase “lack of staff is a huge issue” is massively understating the problem

Viral load and severity of infection are linked- as Patrick Vallance said last year this is why they think so many nurses and drs died in Italy. Javid, the class traitor, has said there will be a "review " of what's happening in September - whatever that means.I'm very sorry about your son, my 19 year old son has a friend who had to leave uni due to long covid.

@Iggly

lack of staff is a huge issue but staffing isn't the only way to approach a crisis. A lot of it is about leadership and planning which seems to have been completely absent over the last year. Even simple things like staff taking holidays has been mismanaged to the extent that some staff are struggling to get any time off and others are having their leave booked for them at times when it doesn't work for them. It's such a disgraceful mess

I think your turn of phrase “lack of staff is a huge issue” is massively understating the problem

What if there had been a nuclear meltdown or a war? Would we just accept 'oh well not enough staff' as an excuse? There are ways and means in a crisis situation to use the resources you have to the best effect. Other countries managed it. The fact that the UK didn't is a huge failure.

So it grew and grew and then very suddenly got to the point where it had nowhere else to go. Infections dropped by 300000 in a month. No lockdown, no matter how strict, can achieve that on its own - that drops comes from the virus essentially running out of hosts.

I'm afraid I still don't get how the virus has "run out of hosts" in India, where they have had 30M cases out of a population of 1.3B.

@singingstones

So it grew and grew and then very suddenly got to the point where it had nowhere else to go. Infections dropped by 300000 in a month. No lockdown, no matter how strict, can achieve that on its own - that drops comes from the virus essentially running out of hosts.

I'm afraid I still don't get how the virus has "run out of hosts" in India, where they have had 30M cases out of a population of 1.3B.

Ok, I'm not making it up but you don't have to believe me. There are plenty of articles about it, if you feel like looking them up. One thing I would ask is whether you think the 30M figure is accurate. Evidence throughout the pandemic has shown a constant massive underestimate of the actual infection rate (and hence a completely inaccurate IFR in most circumstances).

@singingstones

So it grew and grew and then very suddenly got to the point where it had nowhere else to go. Infections dropped by 300000 in a month. No lockdown, no matter how strict, can achieve that on its own - that drops comes from the virus essentially running out of hosts.

I'm afraid I still don't get how the virus has "run out of hosts" in India, where they have had 30M cases out of a population of 1.3B.

How and why do you get a test there?

Is it symptom based and does everyone do it?

Not sure what figure is but you’d leave to look at process

On health care system I think it’s hard to build capacity for a uncontrolled wave pre vaccine. Even higher capacity countries had more than one lockdown

There's not enough real time data yet on the safety of vaccinating children. And yes they are just letting it rip because of economics and as Burnham said we now have a health secretary who is speaking like the chancellor he was. Speaking to friends who are still working as drs and nurses( i was a nurse) they think it is insane that masks will no longer be mandatory in shops and on public transport. I don't know what's happening with masks in vaccination centres but I certainly won't be volunteering if they are not mandatory.

what was the point of the lockdown if the main reason for it - saving the NHS - didn't happen? Why lockdown, have the massive fallout from that and then have cancelled appointments on top of it??

Beginning to think I may be in a parallel universe here..

Because without lockdown it would have been even worse? I agree that the NHS was overwhelmed, but things would have been even worse without lockdown.

Ok, I'm not making it up but you don't have to believe me. There are plenty of articles about it, if you feel like looking them up. One thing I would ask is whether you think the 30M figure is accurate. Evidence throughout the pandemic has shown a constant massive underestimate of the actual infection rate (and hence a completely inaccurate IFR in most circumstances).

I'm not saying you're making it up, I'm just asking you to explain what you mean by "run out of hosts" when such a small number of people have had it. Maybe you could post an article as I did search, but only found optimistic predictions from last year that have been disproved by waves two and three, and explanations of why Covid is unlikely to behave like that.

I'm sure most countries underestimate their case numbers but I wouldn't have thought there were so few people left who hadn't had it in a country of 1.3B. More of our population have had it than India, so how come it hasn't burnt out here?

@singingstones

what was the point of the lockdown if the main reason for it - saving the NHS - didn't happen? Why lockdown, have the massive fallout from that and then have cancelled appointments on top of it??

Beginning to think I may be in a parallel universe here..

Because without lockdown it would have been even worse? I agree that the NHS was overwhelmed, but things would have been even worse without lockdown.

The NHS was not overwhelmed for most of the last 16 months. There were times when it struggled due to covid but there were also times when there were hardly any covid patients. The backlog is due to poor management, not due to covid. That's the point I'm making.

Main issue was staffing (lack of appropriately skilled staff, staff sick or isolating), no room to accommodate the extra covid patients and keep the other patients safe, huge logistical issues with ppe, running out of equipment (basic things like syringe pumps, vents, dialysis kits), medication and oxygen.
Hospitals were overwhelmed. Staff were commandered from other areas who didn't have a clue about ICU/HDU patients, experienced staff were supervising the care of 4 or 5 ICU patients by unskilled staff, patients were unstable, in one shift we had an arrest, several intubations, proning and supining. Things going on at once. Whilst wearing full ppe, not having a clue where anything was because your 'ICU' bed was in a former surgical ward, equipment running out, everybody bloody knackered because we were all working overtime to staff the bl*y shifts, needing runners to get stuff which they invariably couldn't find because it had run out or moved.
Short lockdown would have been a disaster, completely overwhelmed the whole service.
Reorganise it ? How ?
What with ? Magic extra staff and equipment, wards from nowhere ? Over a few weeks ? Agree the preparation was too late and rushed but no way could the NHS have carried on as usual in a pandemic.

@TheDailyCarbunkle
What if there had been a nuclear meltdown or a war? Would we just accept 'oh well not enough staff' as an excuse? There are ways and means in a crisis situation to use the resources you have to the best effect. Other countries managed it. The fact that the UK didn't is a huge failure

Other countries managed far better because they didn't go into the pandemic with a health service running at 95 to 100% and still with huge waiting lists.

Have a look at beds/nurse/docs per capita of the UK vs EU15.

Didn’t the WHO produce a paper on the effect of Covid on healthcare systems and find that over 90% of the countries they looked at were experiencing delays to healthcare?

I’m not sure they’d recognise your rosy view of healthcare everywhere else except the nhs. Off the top of my head, over the last 18 months areas of Spain, Italy, the US, Japan and France have all had issues with capacity caused by covid, with medical staff warning of issues. And that’s just the ones I can remember reading about.

I’m not sure the NHS or anywhere can cope with the up 2000 admissions a day that’s being modelled for this wave on top of everything else.

This idea the nhs fails because of organisational failures, rather than funding and long term planning is what govts use to continue to under fund.
Been going on for decades.

here will be a "review " of what's happening in September

Well of course. This relaxing of restrictions coincides with their summer recess......................the SECOND one they have taken during a pandemic as if we are living in normal times while telling the rest of us how unprecedented this all is.

@TheDailyCarbunkle

Of course you can prevent infections.

It would be very difficult to create a situation where no one ever from this day forward got a covid infection again. But we aren't trying to do that.

It is however possible to reduce the number of infections at this point, by for example, being careful about wearing a mask in a crowded place (and even more so, by looking at the crowded place and thinking "No fear, I'm not going in there!")

As someone who is clinically vulnerable (and vaxed), I want to put off getting infected if I can.

Each instance of infection is dangerous; and there is no guarantee that any additional immunity will be long lasting. There is a suggestion that immunity may wane after 6 months.

Also, by delaying getting infected, there is more time for us to get more knowledge about vaccinations and more knowledge about treatment.

And, as someone vulnerable, I would rather get infected in 10 years time and die that next month and die, if it's all the same to everyone else.

In addition, if I'm not infected myself, I am not going to pass infection myself onto my nearest & dearest & the community of which I am fond.

Neither will I put pressure on the NHS at this difficult time, by possibly requiring them to look after a complicated moribund patient.

I am not asking to be looked after, to have food packets delivered or telephone support, or anything like that.

I would appreciate some clear direction from the government about masks being worn in public spaces being strongly encouraged.

And I would like anyone not wearing a mask to give me a clear berth please.

This idea the nhs fails because of organisational failures, rather than funding and long term planning is what govts use to continue to under fund

I agree with this, but then it's possible for them both to be true

Certainly we spend less on healthcare than some other nations, but it's also the case that vast amounts of it are p*ssed straight up the wall, and that's down to management or lack of it - not in numbers but in ability and accountability

As things stand we could give the NHS every penny the country has and I'm not convinced it would make a bit of difference; we'd need wholesale reform for that, and it probably won't happen while everyone goes on treating it as some sacred cow

As things stand we could give the NHS every penny the country has and I'm not convinced it would make a bit of difference; we'd need wholesale reform for that, and it probably won't happen while everyone goes on treating it as some sacred cow

Really. Based on what evidence.

@singingstones

what was the point of the lockdown if the main reason for it - saving the NHS - didn't happen? Why lockdown, have the massive fallout from that and then have cancelled appointments on top of it??

Beginning to think I may be in a parallel universe here..

Because without lockdown it would have been even worse? I agree that the NHS was overwhelmed, but things would have been even worse without lockdown.

Amazing how people still don't get it isn't it Also they ignore new variants

@Iggly

As things stand we could give the NHS every penny the country has and I'm not convinced it would make a bit of difference; we'd need wholesale reform for that, and it probably won't happen while everyone goes on treating it as some sacred cow

Really. Based on what evidence.

Funding was trebled over the Blair/Brown years but the service wasn't 3 times better. Maybe because some of that money was paid to GPs to pay them more for doing less - not that it solved the recruitment/retention problem either. Though our local hospital did get a huge piece of artwork attached to the outside wall of the maternity dept that cost tens of thousands! (Not sure how many lives that saved nor how it reduced waiting lists!)

Funding was trebled over the Blair/Brown years but the service wasn't 3 times better. Maybe because some of that money was paid to GPs to pay them more for doing less - not that it solved the recruitment/retention problem either. Though our local hospital did get a huge piece of artwork attached to the outside wall of the maternity dept that cost tens of thousands! (Not sure how many lives that saved nor how it reduced waiting lists!)

That doesn’t prove your argument that the money would be pissed up the wall. Nor does it prove that wholesale change is needed.

I’m a firm believer that it’s rare that full scale overhaul is needed. The nhs needs to be allowed to run without being chopped and changed constantly and with proper funding.

The funding put in under Blair was again after years of under funding and was just to play catch up. And performance did improve. I remember - and I was only a teenager - stories of people dying in corridors under the Tories in the mid 1990s.

The mistake that Blair made was to change things structurally. Politicians always think they know best when it comes to the nhs.