Have people's opinions changed?

[MassiveOverthinker]

Just wondering really, if the last few months have changed people's opinion on how we managed covid in this country.

Anyone wondering if maybe fewer restrictions would've been better and if more draconian ones (often called for) were unnecessary. Anyone wondering if we needed to close schools, swab and isolate our kids, test and trace etc etc.

Or do people generally feel we did what was necessary at the time and are only okayish now because of weaker variants and higher vaccination levels?

Anyone feel less angry at the rule breakers, those who don't want to be vaccinated etc?

If it all happened again, do you think your response to restrictions would be the same, or would you be a bit more inclined to think "sod that for a laugh".

(Asking for a friend).

@AppleandRhubarbTart there is a historical precedent for smaller scales of lockdowns/restrictions but you do have to account these examples aren’t a straight like for like comparison. Movement, due to transport improvements, of people has increased dramatically since the second half of the last century along with the size of the population. The tiers, for example, would have worked much better amongst a smaller population with less access to a range of vehicles to move long distances.

Exactly, there isn't a historical precedent for the national lockdowns we've had this pandemic. Nobody thinks restrictions per se were brand new, but lockdown was. Anyone arguing to follow historical methods in March 2020 would've been arguing against locking down.

This isn't a pro or anti lockdown point, but it is one that needs to be made because this is now the 2nd time in the thread that poster has made incorrect claims about historical precedent.

Agree the tier system isn't something that could now work in a society like England. Because of vehicles, but also population density and our lack of a police state for enforcement.

I agree that widespread societal lockdown doesn’t really have a template, but that’s where I think the changes in society are relevant. Historically controlling an infectious disease didn’t have widespread movement as a factor generally. One of the damaging factors identified after the 1918 flu was mass movement of soldiers, we move similarly today far more regularly and casually forcing it to be considered and factored into measures.

The closure of public spaces and businesses absolutely have precedent internationally (www.historyextra.com/period/first-world-war/spanish-flu-britain-how-many-died-quarantine-corona-virus-deaths-pandemic/ towards the end of the article it touches on what various countries did differently) as does quarantining the ill out of the home which wouldn’t have gone down well even if it was possible for us to do it (it isn’t really nowadays).

I’m not really arguing for or against either really, but I am arguing that infection control measures aren’t particularly sophisticated compared to other advances in medicine made harder by the introduction of an unknown virus. Prior to vaccination, choices were limited to bad and bad with only projections based on very little to go on. I don’t really see how lockdowns can be permanently ruled out ever again.

There will be those who would argue that death and illness are inevitable, which they are, but it’s not in out zeitgeist that we accept that without utilising the medical science we know we’re capable of. For covid, vaccination was the game changer and once that was rolled out lockdowns weren’t really considered seriously again, perhaps when omicron first emerged but it was quickly forgotten as the data emerged. People were/are still dying but the mindset is different because, generally, people believe they’ve done everything they can to avoid the worst effects of covid.

Are the bubonic plague and the 1918 flu great examples of infection control, though? The restrictions in place maybe achieved limited and specific protection (for island places like Venice, for the rich who could up and move to less dense places). But on a population level, I don’t think anyone would look at eg the Black Death and think “ah, now there’s an infection we successfully controlled, let’s do that again.”

None of this affects the point that the choice to go for a full societal lockdown in March 2020 was a brand new one though. Again, nobody thinks restrictions per se are brand new: giving examples of previous restrictions doesn't affect that. If you want to argue that it was a logical choice based on previous historical experiences, by all means do so, but it is not the same thing.

Historical precedent is pretty important in understanding the public health thinking on this; I haven't made any unfounded claims and have linked to good sources to help understanding [smile

It was a reasonable choice based on public health understanding from previous experiences of pandemic infection. Slightly more nuanced, but yes.

You most certainly have. You claimed upthread that there was a long history of lockdowns as a tool in managing pandemics, which is just plain incorrect, and threw this in with quarantines. I'd like to give the benefit of the doubt and assume this was a genuine error rather than an attempt to blur things, but you're still attempting to downplay the undoubted fact that lockdown in 2020 was brand new and without historical precedent. 'Slightly more nuanced' is simply not a description that has any basis in reality and your sources for this are non-existent.

And none of this is necessary for the defence of lockdown either. It's still possible that lockdown was the least worst option available to us, despite being a new policy very unlike anything that had ever been attempted before.

From the 2013 article to which I linked earlier www.ncbi.nlm.nih.gov/pmc/articles/PMC3559034/

"More than half a millennium since quarantine became the core of a multicomponent strategy for controlling communicable disease outbreaks, traditional public health tools are being adapted to the nature of individual diseases and to the degree of risk for transmission and are being effectively used to contain outbreaks, such as the 2003 SARS outbreak and the 2009 influenza A(H1N1)pdm09 pandemic."

Elements of what we are calling lockdown are seen in other public health pandemic strategies from the past, such as closing schools, stopping parades and other public gatherings, food deliveries to areas where people were restricted from leaving. These arose out of an understanding of how infection might be spread and a desire to preserve human life, and in 2020 would have reflected practices that had been put in place before.

If you prefer me to say" widespread and stringent community restrictions to prevent infection spread" to describe what we have generally been calling "lockdown", I could use that term instead? For arguments' sake?

www.ncbi.nlm.nih.gov/pmc/articles/PMC2862334/

"Implementing social-distancing measures in these big cities presented a massive public health challenge. They had complex economies dependent on both industry and commerce that could easily be damaged by quarantines and closures. As had happened in earlier epidemics, businessmen resisted the idea of mass closures of transportation and businesses that would cause economic distress both to owners and workers....

Big cities also had large public school systems, flourishing commercial entertainment districts, and extensive systems of mass transit, all of which formed fertile ground for the spread of influenza. Closing schools left parents with children to provide for during the day. Shutting down saloons and theaters meant not only lost revenue for owners but also lost pleasures for their customers. To inflict such economic damage on a city's economy required a public health emergency without precedent"

This is describing the States in 1918, where Philadelphia successfully conducted a set of restrictions in many ways very similar to many aspects of our lockdowns. Of course, people weren't ordering groceries on line or working from home on laptops, but a lot of the same discussions were being had. Whether we refer to their actions as lockdown or not is a matter of semantics really, but there were precedents for many of the choices.

This discusses quarantine, which is not the same as lockdown and which nobody disputes is an ancient strategy. It's an irrelevant strawman. The second post you make describes a response that was neither national nor a 2020 style lockdown, given that there was no legislation governing who people could have in their homes and the restrictions on work were lesser.

Because of the significant distinction between full national lockdown and measures that do not amount to full national lockdown, the description you offer here would be actively unhelpful. It's ok though, I'll be on hand to point out the vast difference between the two any time we see attempts to conflate them.

The 1918 response has been described as a lockdown you know - so this is largely semantics.

Very happy to point out the similarities between Philadephia, Eyam etc. in the spirit of helpful explanation.

Lockdown did not come from nowhere but was based on past experience of managing pandemics - although I'd of course agree that what happened in 2020 was on an "unprecedented" scale,

The 1918 response is not a lockdown in the same way as the 2020 lockdown, regardless of how the term might have been used. This is a fact. The fact that you think this can possibly be described as a semantic issue means you're not in a position to provide helpful explanation.

As for the 2020 lockdown being based on experience of past pandemic management, it's noteworthy that UK pandemic planning prior to covid didn't recommend it. Lockdown wasn't something we were going to do. Then other countries started using it.

The 1918 response is more like our lockdown than, for example, a child with scarlet fever staying in their bedroom.

There was coordination at an area level.

And, importantly, the scientific thinking in how to manage infectious disease is a key part of this. There is an element of trying to use the science for the good of the people - and an element also of trying to work with people on how it is possible to implement this.

It didn't come out of nowhere and there is a very important link to the understanding of quarantine. It is not a red herring at all to link them.

Sorry, not a straw man to link them. They come from the same understanding of infectious disease and its transmissibility.

I don’t think responses to the 1918 flu included national-level restrictions on how often people were allowed out of their homes, how many households were allowed to meet each other, “you must stay at home” messages, work-from-home rules (fairly obviously in a pre-internet era but anyway), etc. Happy to be corrected if I’ve missed something…

As for the 2020 lockdown being based on experience of past pandemic management, it's noteworthy that UK pandemic planning prior to covid didn't recommend it. Lockdown wasn't something we were going to do. Then other countries started using it.

afaik pandemic planning was largely based on flus/known viruses not a novel virus with zero level of existing population immunity. Covid hit a bit of a sweet spot in that it is communicable enough to be fast moving, varied enough in severity that people can be completely asymptomatic yet not severe enough to hold the possibility it would burn itself out. Plus those that could be treated required longer than an average flu patient under hospital treatment.

imo the only reason a lockdown of the likes we experienced was possible was our capabilities with technology. Lockdowns wouldn’t have been at all possible even twenty years ago. Knowing what we know now I think it’s completely reasonable to include elements of lockdown in future emergency planning unless we have a breakthrough in infection control regarding completely novel diseases + no residual population immunity.

Sorry, yes it is. You keep responding to the fact that lockdown was new with evidence of something that is not lockdown. You're factually incorrect. As for the same understanding, this is an opinion and no evidence has been provided.

It's a strawman.

Yes, lockdown was very much of it time and of the disease severity. Sweet spot is a good phrase. It doesn't work without widespread internet access, not only to keep lots of the economy working but also to keep the population pacified. I'd go further than saying it couldn't have worked 20 years ago and say it wouldn't have been possible until the 2010s. Can't see how we'd have done it in say 2001.

It also only worked because covid was scary enough to make most of the population go along with restrictions, whilst also being a low enough threat to most of the working population that we were able to keep essential services functioning (and again this very much includes services that pacify the public like Amazon). The last two years would've looked very different if people in eg their 20s and 30s felt themselves to be at higher risk. Part of the labour market shortage we see now is because older working aged people, more likely to feel themselves at risk, are working in lower numbers than in Feb 2020.

As for lockdown in the future, we need to get as much evidence as we can of what it did, good and bad, and whether we caused more or less suffering overall by choosing to prioritise the people we did over the people we didn't. That's why it's so important to spell out exactly what happened: if we pretend lockdown wasn't something brand new, we potentially detract from the importance of this work.

I don't know whether lockdown would be possible again in future pandemics that don't necessarily hit this 'sweet spot' you mentioned, it's pretty clearly not an option again at the moment, but it seems sufficiently possible that we need to do everything we can to investigate whether it was our optimum choice.

@AppleandRhubarbTart
I don't think you understand the meaning of "strawman" in an argument.

Here is another attempt to discuss "the history of lockdowns". www.livemint.com/news/india/life-lessons-from-the-history-of-lockdowns-11585312953744.html

It boils down to whether the term lockdown is applied to these other attempts to place severe restrictions on society. There certainly have been such restrictions in the past, carried out also to protect life in a pandemic.

We can and should of course learn from our experiences over the past couple of years; but lockdown elements will remain as part of pandemic planning in the future just as restrictions on society in various forms have been pandemic planning for many centuries.

I don’t know if disasters in general really have optimum choices since the variables (that is usually what makes it a disaster) are so wide.

I don’t ever envisage National lockdowns being utilised as a disaster method of management as routine but at the same time, to avoid a lot of scenarios, they may need to consider maintaining over capacity of various services that is only expected to be utilised once in a blue moon. IMO that’s the optimum way to run any public service to ensure continuity but it’s a hard sell politically to spend money ‘just in case’.

this time vaccinations and mutations got us to the position of being able to manage covid (and that’s debatable tbh) but it’s not a certainty that will always be an avenue.Had neither of those things occurred I don’t think we’d have been in perpetual lockdown but I do think we’d have had to massively lower our healthcare expectations and possibly the introduction of field hospitals with few qualified staff and scant equipment. The nightingales basically.

This article also fails to give any examples of things that are lockdowns like we had in March 2020. It's worthless. The problem you have here is that you're trying to turn this into a semantic issue, either through failure to understand or a disingenuous attempt to minimise the absolutely undoubted fact that what we did in 2020 was unprecedented and not informed by previous experience of having implemented these policies.

As for whether lockdown will remain an option in the future, who knows? There is far too much ahead of us to be making calls like that now. Not only do we not have the necessary information, but we don't know if we'll ever have it nor how we'd respond to it if we did.

Some aspects of the 2020 lockdown were unprecedented; some were not.

The term "lockdown" does seem to have begun to be used in association with pandemic strategy before 2020, FWIW. blogs.nottingham.ac.uk/makingsciencepublic/2020/08/07/the-meaning-of-lockdown/

There is a whole medical discipline of Public Health and management of pandemics is part of that. Some of the things we faced were new - a new virus - but some of the problems were very old ones.

In one of the links I posted earlier, from an article pre-pandemic, the dilemma is quite well expressed between the business arguments against restrictions and the public health arguments for infection control measures. In describing American cities over 100 years ago.

So that bit wasn't new.

And understanding this does indeed have a bearing on how we understand 2020.

@AppleandRhubarbTart I totally agree with you You have articulated very well.

@herecomesthsun You keep conflating quarantine with lockdown. They are not the same thing.

I agree that the internet largely enabled it You may not get so much co operation from key workers next time a. if the fear gets ramped up too much and b. society has gone back to treating key workers like shit (which we all knew would happen anyway) We have social housing tenants who are literally being left with having sewage in their homes and yet we are wanging on about health. Im fucking sick of the cogntive dissonance.

Another live one on the TV now warning that Platinum Jubilee may cause a rise in cases. They dont seem very keen on talking to the HAs who are trying to cause a cholera outbreak though.