Herd Immunity

[matthew webster]

Gathering herd immunity within the population seems to be the way we are going with COVID-19 and this requires 60-80% of us eventually getting the virus. This may well be the correct decision but requires everyone to act responsibly to keep the progress of infection to slow rate.

But how does it work for those with serious underlying conditions living within the community?

I am a 51 year old Type 1 with mild asthma. I would like to self isolate but as a husband and father of three this is proving very difficult in a busy household.

All my three kids (9, 15 & 18) still go to school, still socialize and travel on public transport. It is likely that at least one of them and quite possibly all of them with contract the virus at some point. For them this will hopefully be mild and they will (with any luck) become immune.

For me, this maybe not so straight forward. I am home all week and other than locking myself in a room for 3 months how do I avoid the inevitable infection and the potential complications?

Maybe getting it sooner rather than later will afford me better healthcare than potentially getting it when things get really apocalyptic.

 

[mikeyB]

I expect that fairly soon schools will close, it’s not consistent to ban large public gatherings and keep schools open, particularly as youngsters are ideal carriers of the virus.

 

[zoombapup]

Maybe getting it sooner rather than later will afford me better healthcare than potentially getting it when things get really apocalyptic.

I'm "at risk" in a number of categories and did consider this myself. But the reality is that by the time you've worked up the courage to take the gamble, the health system is likely to be overwhelmed anyway. My risk is somewhere between 7.9 and 14.5 percent if the WHO figures are to be believed. Not a great gamble.

In your position, you might want to think of the nuclear option and find someone else in the same boat to self-isolate with temporarily. Maybe a family member who might need some support anyway? In China they are taking people out of the family home if they test positive, which makes sense as most infections are coming from within families. But of course we're not going to do that because our govt has the master plan of simply letting the dice roll for the ones who are at higher risk.

Save yourselves 🙂

 

[grovesy]

I'm "at risk" in a number of categories and did consider this myself. But the reality is that by the time you've worked up the courage to take the gamble, the health system is likely to be overwhelmed anyway. My risk is somewhere between 7.9 and 14.5 percent if the WHO figures are to be believed. Not a great gamble.

In your position, you might want to think of the nuclear option and find someone else in the same boat to self-isolate with temporarily. Maybe a family member who might need some support anyway? In China they are taking people out of the family home if they test positive, which makes sense as most infections are coming from within families. But of course we're not going to do that because our govt has the master plan of simply letting the dice roll for the ones who are at higher risk.

Save yourselves 🙂

China were not taking people out of the family home to isolate at the beginning , I caught abit of a film called lockdown in Wuhan. There was a nurse who caught, there were no beds for her to quarantine, and she had to initially self isolate at home. It was quite a number of days before she was sent somewhere to quarantine.

 

[zoombapup]

China were not taking people out of the family home to isolate at the beginning , I caught abit of a film called lockdown in Wuhan. There was a nurse who caught, there were no beds for her to quarantine, and she had to initially self isolate at home. It was quite a number of days before she was sent somewhere to quarantine.

Yes, but NOW they send people to another place entirely. Because they've learnt the lesson that transmission happens mostly in the home. But have WE learnt that lesson? I suspect not. Given the advice is to self isolate at home, with.. your family around you. Perfect advice.

 

[zoombapup]

I believe those percentages are based on an analysis of the outbreak in China so not sure if they would stack up the same here. Time will tell, I suppose.

I can't see any reason to suspect that their rates wouldn't be similar to ours? OK their population might have fewer diabetics and those might be more poorly managed, but even if the figures are off by quite a lot, the difference between the diabetic deaths percentage vs the non-diabetic is pretty stark. I'm not happy to "risk it" with those odds, especially given the ease by which I can isolate.

 

[Eddy Edson]

I can't see any reason to suspect that their rates wouldn't be similar to ours? OK their population might have fewer diabetics and those might be more poorly managed, but even if the figures are off by quite a lot, the difference between the diabetic deaths percentage vs the non-diabetic is pretty stark. I'm not happy to "risk it" with those odds, especially given the ease by which I can isolate.

Agree about not risking it, but the data/studies so far don't really have the detail or power to say how much extra risk you get from age, high BP, diabetes, CV disease, high BG etc etc independently. A lot of these are correlated.

This is an ongoing review of what is/isn't known for some of these aspects: http://www.nephjc.com/news/covidace2

 

[Eddy Edson]

I read yesterday that the Italian media have started reporting the number of active cases rather than the total number of cases by deducting the numbers who have recovered or died. In the UK this would mean that we have 1,336 cases as of yesterday out of 1,391 total cases. In Italy, of course, the difference is in the thousands so you can see why it looks less bad.

I often wonder why the media don't report on how many people have recovered (globally 77,865 currently).

Martin

Anyway, you can get what seems to be a reasonable up-to-date picture from https://www.worldometers.info/coronavirus/#countries Obviously, it's only as good as the individual countries' reporting.

It just makes my teeth itch when I compare what's happened in Asia vs elsewhere.

Taiwan - 23M people, 59 cases, stopped. They never completely closed down China travel and they never went into full lock down. How did they do it? By treating it like any other damn epidemic: lots of testing, lots of public health measures, trace every contact, isolate cases.

Singapore - 5.6M people, 243 cases, slow growth. How did they do it? Ditto, pretty much.

HK - 7.4M people, 149 cases, pretty much stopped. How did they do it? Ditto, pretty much.

South Korea - 51M people, 8,200 cases, slowed to a trickle & below the recovery rate How did they do it? Ditto, pretty much, after initially overwhelmed in one location & with some very local lock-downs.

Whatever advisors have been playing low-rent Dr Strangelove for govts in the UK, US, Oz, etc with their pathetic "phases", they don't seem to have paid much attention to these examples, for some reason, despite having had apparently ample warning.

 

[trophywench]

We aren't ever going to know a) whether we have it (unless whilst self isolating we become dangerously ill and hence need to dial 999 - do they still test you at post mortem stage?) or b) have it mildly and recover.

 

[Ivostas66]

A friend of my Mum's (type 1 in her early 50s) has been contacted by her doctor and told to self isolate if possible. Doctor said that all the people on his books with underlying health problems are being contacted now and told the same thing. Anyone else had this? I am in my 40s, type 1 with asthma (although not had an attack for many years). Currently not at work as I am awaiting results from an MRI due to dizzy spells and severe headaches for several weeks, but as I work in a school I am somewhat concerned about returning - especially as there are staff off with symptoms of Coronovirus and only about 70% of kids currently in for the same reason.

 

[grovesy]

No I have Type 2 and Asthma .

 

[ljacob1990]

A friend of my Mum's (type 1 in her early 50s) has been contacted by her doctor and told to self isolate if possible. Doctor said that all the people on his books with underlying health problems are being contacted now and told the same thing. Anyone else had this? I am in my 40s, type 1 with asthma (although not had an attack for many years). Currently not at work as I am awaiting results from an MRI due to dizzy spells and severe headaches for several weeks, but as I work in a school I am somewhat concerned about returning - especially as there are staff off with symptoms of Coronovirus and only about 70% of kids currently in for the same reason.

Hi Matt,
I also work as a teacher in a relatively large secondary school and after Boris’ latest statement I’m unsure whether or not I should go into work tomorrow? Any advice greatly appreciated!

 

[Ivostas66]

When the chief medical officer stated 'shielding' for 12 weeks, I did wonder who he meant. The oft used phrase 'underlying health issues' hasn't really been explained until now. I am contacted every October by my doctor and told that my type 1 and asthma puts me towards the top of the list for flu and pneumonia vaccines. Clearly they are concerned about the impact upon us and therefore shielding for 12 weeks is what we need to do.

I have emailed the head at my school to update her on my current health and to say that once my certificate of fitness for work which runs till Friday runs out I will have to follow advice and be 'shielding' at home - I think I will try to ask for advice from my DSNs or doctor tomorrow. It doesn't help that my daughter has come home from pre-school with a temperature and cough!

I can't see schools being open for many more days - how many teachers have health conditions which mean they have to have the flu jab every year? Who will be left to teach the kids? My school (a large secondary too) has about 80% attendance at the moment and the numbers are dropping. There are also about 10 teachers off due to Coronovirus symptoms. The 14 day period for households is also going to cause a serious shortage of teachers.

Stay healthy ljacob1990!

 

[zoombapup]

Did you all see that study put out by Imperial college about the current approach and how it will massively overwhelm the NHS? I'm not exactly trusting of the likes of Boris at the best of times, but we can all see the evidence for a "do everything" strategy being important and part of WHO advice. It seems those countries that take testing, isolation and tracing seriously are the ones who will recover the best.

Honestly, I suspect it will happen eventually everywhere, but it will probably hit us harder for a while because of the incompetence so far. Once it does happen, I can see a longer term shift in how society is structured, with regular monitoring, ubiquitous testing etc. Once the world has a scare on a scale like this, I can't imagine we're going back to the old "normal" right? The risk of reinfection, mutation and a nastier virus spreading could be a spur to action globally. If only we had the same for the climate.

 

[Robin]

Did you all see that study put out by Imperial college about the current approach and how it will massively overwhelm the NHS? I'm not exactly trusting of the likes of Boris at the best of times, but we can all see the evidence for a "do everything" strategy being important and part of WHO advice. It seems those countries that take testing, isolation and tracing seriously are the ones who will recover the best.

Honestly, I suspect it will happen eventually everywhere, but it will probably hit us harder for a while because of the incompetence so far. Once it does happen, I can see a longer term shift in how society is structured, with regular monitoring, ubiquitous testing etc. Once the world has a scare on a scale like this, I can't imagine we're going back to the old "normal" right? The risk of reinfection, mutation and a nastier virus spreading could be a spur to action globally. If only we had the same for the climate.

Eddy Edson has helpfully put a link to the Imperial College modelling here.

IC COV19 modelling group: suppression vs mitigation

Published today: https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf I think this is one of the main groups informing the UK govt & this work no doubt has contributed to the recent policy shifts. Two...

forum.diabetes.org.uk

The latest measures seem to be following the 'suppression' model now.

 

[Eddy Edson]

Did you all see that study put out by Imperial college about the current approach and how it will massively overwhelm the NHS? I'm not exactly trusting of the likes of Boris at the best of times, but we can all see the evidence for a "do everything" strategy being important and part of WHO advice. It seems those countries that take testing, isolation and tracing seriously are the ones who will recover the best.

Honestly, I suspect it will happen eventually everywhere, but it will probably hit us harder for a while because of the incompetence so far. Once it does happen, I can see a longer term shift in how society is structured, with regular monitoring, ubiquitous testing etc. Once the world has a scare on a scale like this, I can't imagine we're going back to the old "normal" right? The risk of reinfection, mutation and a nastier virus spreading could be a spur to action globally. If only we had the same for the climate.

The countries which have been coping best so far I think all had the benefit of surveillance systems, policies, proceses, resources beefed up after SARS. Maybe the rest of the world just does pretty much the same thing, longer term. I don't think that would be a huge shift - but who knows?

 

[Docb]

The countries which have been coping best so far I think all had the benefit of surveillance systems, policies, proceses, resources beefed up after SARS. Maybe the rest of the world just does pretty much the same thing, longer term. I don't think that would be a huge shift - but who knows?

Good point Eddy. Current happenings are setting precedents for the next viral pandemic so maybe next time there will be more of an early proactive, rather than a real time reactive, response.

 

[Eddy Edson]

Good point Eddy. Current happenings are setting precedents for the next viral pandemic so maybe next time there will be more of an early proactive, rather than a real time reactive, response.

A NYT piece on Singapore, in particular, getting it right: https://www.nytimes.com/2020/03/17/...action=click&module=Spotlight&pgtype=Homepage

 

[zoombapup]

The countries which have been coping best so far I think all had the benefit of surveillance systems, policies, proceses, resources beefed up after SARS. Maybe the rest of the world just does pretty much the same thing, longer term. I don't think that would be a huge shift - but who knows?

I've been thinking of creating an app while I'm in lockdown that will help with contact tracing by monitoring via geolocation the people you've been in contact with, but I know that the public would have a fit with the ethics of it. I guess that's really the difference is that in China etc, they are monitored heavily everywhere already. Of course we are in Britain, but only by video cameras and not by phones (well not totally).

What I think might happen, is that there will be some kind of "health scanner" system put in place everywhere, so that essentially people will have to run through a number of checkpoints per day (simple things like temperature sensors) and that if any of them is flagged, go get tested. This would have to be fast and relatively convenient and benign for people to do it, but people accept having to buy a ticket to ride a train, so I guess this would work (while buying a ticket you might not get it unless you scan for health).

Definitely think society is going to change as a result of this. At the very least, I can see more robots being used because if you think about it, this is of huge benefit to companies like Amazon where they rely less on human labour and more on robotics. The only problem for them is that they still need humans in the loop to pack and deliver, but also to actually be able to buy goods!

 

[Eddy Edson]

I've been thinking of creating an app while I'm in lockdown that will help with contact tracing by monitoring via geolocation the people you've been in contact with, but I know that the public would have a fit with the ethics of it. I guess that's really the difference is that in China etc, they are monitored heavily everywhere already. Of course we are in Britain, but only by video cameras and not by phones (well not totally).

What I think might happen, is that there will be some kind of "health scanner" system put in place everywhere, so that essentially people will have to run through a number of checkpoints per day (simple things like temperature sensors) and that if any of them is flagged, go get tested. This would have to be fast and relatively convenient and benign for people to do it, but people accept having to buy a ticket to ride a train, so I guess this would work (while buying a ticket you might not get it unless you scan for health).

Definitely think society is going to change as a result of this. At the very least, I can see more robots being used because if you think about it, this is of huge benefit to companies like Amazon where they rely less on human labour and more on robotics. The only problem for them is that they still need humans in the loop to pack and deliver, but also to actually be able to buy goods!

My guess is that you will start to see explicit personal tracking integrated with health, travel, whatever records, as they have in HK/Singapore/Taiwan/Korea (I think), and that people will just have to get over their objections to this kind of thing.

(Personally, I don't really care much any more - I just assume that increasingly no one will have any real privacy, but that there will also be safeguards over what can be done with the info.)

Also would surprise me not in the least & in the current situation would welcome spot termperature checks, again as they have in parts of Asia now.

Ultimately, of course, what is wanted is the capability of downloading our minds into our Kindles and other mobile devices 🙂

Hong Kong is putting electronic wristbands on arriving passengers to enforce coronavirus quarantine

Passengers arriving in Hong Kong must wear a bracelet and download a smartphone app, as the city tries to reduce the spread of the coronavirus.

www.cnbc.com