No new measures in England before New Year

[Jourdain11]

Has just been announced by the Health Secretary and reported across BBC etc.

@cantkeepawayforever

I also think it is easy to overlook how desensitised we have become to cases and deaths.

Back in the summer of 2020, 1000 cases and associated deaths were still seen as shocking - and without vaccines yet being available, a rapid surge in cases would lead to a predictable, high number of hospitalisations and deaths.

It's very easy to look back now and say 'pah, 1000 was nothing, we have 100,000 now and over 150 deaths per day, we don't care', but that wasn't the value system in place at that time.

I think if you had the mind set to step back look at the virus, look at the data, look at history even in the very early days within a few weeks it was obvious this wasn't Ebola or MERS.

Now that mind set is setting in for a massive proportion of the population.

What do you think is an acceptable rate of infection and death. What do you think is the maximum cost our kids should bear to save the vulnerable?

Yea my acceptable may be higher than most but unless you want zero COVID you are also saying some deaths are acceptable.

Againstmachine I mentioned all public services

Pink no it wasn’t

But many like to think what they do doesn't have an impact what we all do has an impact

What do you think is an acceptable rate of infection and death.

I'd say 'excess deaths down to zero on average over the course of a year' would be a reasonable benchmark?

Because I am not saying 'nobody should die' - we know that people die every day, of cancer and pneumonia and flu and accidents, by suicide and through addiction etc etc. I am saying that, in the same way as we try to keep winter 'flu deaths down to the historic average through annual vaccination and other mitigations, we should aim to do the same for Covid.

That also has the obvious corollary that we can't just prevent Covid deaths at the expense of cancer patients or suicide victims. That's part of the delicate and careful dance of mitigations - to keep covid low enough to enable hospitals to open fully for cancer patients; to maintain social contact and support services at a high enough levels to prevent a spike in suicides. It's not simple, but it doesn't mean that we allow covid to run unchecked, as then we get more deaths from Covid AND more deaths from cancer AND more suicides.

it was obvious this wasn't Ebola or MERS FFS, this again.

@cantkeepawayforever

What do you think is an acceptable rate of infection and death.

I'd say 'excess deaths down to zero on average over the course of a year' would be a reasonable benchmark?

So zero COVID (or other new viruses) if you want deaths to be as low as pre-covid you need rid of it or another cause of death. Mine is around 200% of average as long as those deaths don't involve a large number of under 60s.

@cantkeepawayforever

That also has the obvious corollary that we can't just prevent Covid deaths at the expense of cancer patients or suicide victims. That's part of the delicate and careful dance of mitigations - to keep covid low enough to enable hospitals to open fully for cancer patients; to maintain social contact and support services at a high enough levels to prevent a spike in suicides. It's not simple, but it doesn't mean that we allow covid to run unchecked, as then we get more deaths from Covid AND more deaths from cancer AND more suicides.

Whitty dealt well with the often-repeated lie that covid has been prioritised at the expense of other illnesses. He said it was only said by those with little understanding of healthcare.

vicky, no, there is a strong overlap between Covid and other causes of death. Flu, dementia, pneumonia - all diseases of the elderly, and obviously only 1 of them can kill any given person. Many of the mitigations that work against Covid also restrict transmission of other diseases.

@cantkeepawayforever

What do you think is an acceptable rate of infection and death.

I'd say 'excess deaths down to zero on average over the course of a year' would be a reasonable benchmark?

Should we do the same for flu as well? Lock the country down until no one ever dies from flu?

Completely unfeasible. Covid is with us forever now, and unfortunately people will always die from it. As the virus continues to mutate and get milder, and our vaccines and treatments get better, deaths will reduce substantially. They will never be zero though.

Zero is not a realistic aim. Even Whitty acknowledges acceptable level for society

@cantkeepawayforever

vicky, no, there is a strong overlap between Covid and other causes of death. Flu, dementia, pneumonia - all diseases of the elderly, and obviously only 1 of them can kill any given person. Many of the mitigations that work against Covid also restrict transmission of other diseases.

They do but if COVID and flu are circulating the odds of someone vulnerable getting one or the other are higher than if we only had flu or only had COVID so it's not necessarily 1:1 over 5 years you might be closer to 1:1.

@rrhuth what it isn't Ebola that kills everyone including large numbers of children

@cantkeepawayforever

So how long do you want these mitigations to keep going on for?

That's a bit like asking 'how long do you want there to be speed limits', isn't it?

If you think about it like a variable speed limit motorway, I would say very much like that. Available to be turned on and off (in sections) at all times, and closely adjusted to the condition of the road ahead. Much of the time, national speed limit applies. Occasionally, a lane is closed if there is an accident up ahead. Sometimes, the whole road is slowed down to make the road safer for everyone while keeping things moving.

So you want there to be social distancing and mask wearing to go in indefinitely? What a miserable way to live.

I didn't say that there should be zero deaths from Covid.

I said we should aim for zero EXCESS deaths - where we get to the 'acceptable long term death rate from all causes, including from the full range of endemic diseases against which we have treatments and vaccinations'.

So, in future, if you take 100 very elderly and frail people who die over the course of a year, some of them in future will die of Covid rather than flu or pneumonia or dementia or heart failure, and I accept that completely - everyone will one day die, however good our vaccinations and effective our treatments.

Vicky is happy, instead of there being a change of 'precise cause of death' within that 100, for that number to double to 200.

Ok sorry @OhWhyNot, I wasn’t sure.

So you want there to be social distancing and mask wearing to go in indefinitely? What a miserable way to live.

No, I want it to be asked for when required - as i said, mostly on a motorway, national speed limit applies. However, when there is a crash, a lane is closed. When there is congestion that could cause accidents, the overall speed is reduced.

In some countries, it is common to see mask wearing when someone has a respiratory infection. Ventilation in schools would prevent many of the illnesses that can cause interruptions in children's education as well as illnesses in their families. Neither seem to me to be more miserable than a permanently elevated death rate and permanently-challenged health service?

@cantkeepawayforever

I didn't say that there should be zero deaths from Covid.

I said we should aim for zero EXCESS deaths - where we get to the 'acceptable long term death rate from all causes, including from the full range of endemic diseases against which we have treatments and vaccinations'.

So, in future, if you take 100 very elderly and frail people who die over the course of a year, some of them in future will die of Covid rather than flu or pneumonia or dementia or heart failure, and I accept that completely - everyone will one day die, however good our vaccinations and effective our treatments.

Vicky is happy, instead of there being a change of 'precise cause of death' within that 100, for that number to double to 200.

Yes I am happy with 200 because the social and economic cost of stopping that is too great for our kids to bear when >40% of the deaths even without vaccination were over 75!! I would be happy for life expectancy to fall to accommodate this aswell.

You have got to remember we aren't talking about something as simple as giving everyone an injection every year to stop this in its track we are talking about drastically altering our way of life likely permanently to achieve your aim of not increasing average yearly deaths

vicky

Looking at the excess deaths throughout the pandemic:

Latest ONS report here

Your view of the acceptability of 2x as many deaths as normal as 'perfectly acceptable' does seem a little dramatic. With the exception of a couple of weeks in March / April 2020, there has not been a point in the pandemic where weekly deaths have been twice the 5 yearly average.....

Week ending 10th December (the latest week in the data) showed deaths 11.5% above the long term average, with Covid-related deaths (per death certificate) being about 6.4% of all deaths registered in that week.

Do you want to have another think about whether you are prepared for deaths to be twice the normal rate (so e.g. nearly 24,000 deaths in that week rather than just under 12,000)?

But the five year average death rate is an average that changes and has changed considerably in my life time. in five year time even if we do nothing we won’t have excess death due to covid as the five year average will include covid deaths.

Otherwise you are suggesting we freeze are acceptable level of death at 2019 levels forever?!…that will seem arbitrary in time, why shouldn’t we freeze them at 2000 levels for example and then we wouldn’t have very much excess death even now?!.

Under the “we need to have the 2019 death rate”to live a life free from covid restrictions it also means that basically to get my life back I need to look at how to bring deaths down from other causes. So your telling me I need to promote investment in cancer research - if they do bring forward some of the promising developments in the field of cancer then even with 200 people dying a day from covid I can live restriction free?! Or I should beg people to go for a run tomorrow to bring down heart desase deaths as the only way to ensure I remain free to go round to my mum’s for a coffee without it being against the law - really the average death rate will move up and down over the next five years, covid measures will be only one of the factors that impact on it, they were already saying high levels of obesity may risk bringing down average life expectancy before the pandemic hit!

@cantkeepawayforever

I also think it is easy to overlook how desensitised we have become to cases and deaths.

Back in the summer of 2020, 1000 cases and associated deaths were still seen as shocking - and without vaccines yet being available, a rapid surge in cases would lead to a predictable, high number of hospitalisations and deaths.

It's very easy to look back now and say 'pah, 1000 was nothing, we have 100,000 now and over 150 deaths per day, we don't care', but that wasn't the value system in place at that time.

It’s not de sensitisation but the advantage of hindsight. We were more nervous over deaths at the beginning because no one knew how thus would play out. Now we see how effective ( or not ) vaccines are, how long it takes to mutate, how we can treat it better, what happens to the economy our lives abd schools etc we can weigh up pros and cons.

@cantkeepawayforever

vicky

Looking at the excess deaths throughout the pandemic:

Latest ONS report here

Your view of the acceptability of 2x as many deaths as normal as 'perfectly acceptable' does seem a little dramatic. With the exception of a couple of weeks in March / April 2020, there has not been a point in the pandemic where weekly deaths have been twice the 5 yearly average.....

Week ending 10th December (the latest week in the data) showed deaths 11.5% above the long term average, with Covid-related deaths (per death certificate) being about 6.4% of all deaths registered in that week.

Do you want to have another think about whether you are prepared for deaths to be twice the normal rate (so e.g. nearly 24,000 deaths in that week rather than just under 12,000)?

Nope happy with my 200% as don't want any more restrictions on mine or my sons life and 200% to me means that ceiling is very unlikely to be reached. I think it's time we ended isolation, ended testing and got on with our lives if that means we die younger than so be it

Dghgcotcitc

That's a really good point, thank you.

My thinking was that by taking e.g. a 5-10 year view prior to 2019 would give us a decent 'benchmark' against which to measure Covid-related and other fluctuations.

I said we should aim for zero EXCESS deaths

Why would this happen though?

What’s reducing and how

Nope happy with my 200% as don't want any more restrictions on mine or my sons life and 200% to me means that ceiling is very unlikely to be reached. I think it's time we ended isolation, ended testing and got on with our lives if that means we die younger than so be it

Ah, OK. Pile up the bodies of others as long as I am fine to do whatever I like?

I do hope that none of those extra hundreds of thousands of deaths you are happy to tolerate are not anybody who might have been useful to you in enjoying or getting the best out of your life or your son's - a surgeon, say, or an influential boss your child will never get to meet - and that you will never be affected by the inevitable loss of services that those deaths will mean.

@cantkeepawayforever

Nope happy with my 200% as don't want any more restrictions on mine or my sons life and 200% to me means that ceiling is very unlikely to be reached. I think it's time we ended isolation, ended testing and got on with our lives if that means we die younger than so be it

Ah, OK. Pile up the bodies of others as long as I am fine to do whatever I like?

I do hope that none of those extra hundreds of thousands of deaths you are happy to tolerate are not anybody who might have been useful to you in enjoying or getting the best out of your life or your son's - a surgeon, say, or an influential boss your child will never get to meet - and that you will never be affected by the inevitable loss of services that those deaths will mean.

If they are vaccinated (which I think should be mandatory with mandatory boaters) the odds of it happening are less than them getting hit by a bus.