Ask HN: Is UK government insane or genius?

It kills maybe 1% to 2% of people under 50 with no comorbitities.

If we assume everyone in the UK is under 50 and there are 60m people and we want to infect 60% of them that's 36m people infected, and 1% of that is 360,000 dead.

That's ignoring all the people who do have comorbitieis (diabetes, high blood pressure, etc), and all the people over 50.

It's also ignoring all the people who eg get into road traffic accidents and need an ICU bed, which won't be available if we cram hospitals full of covid-19 patients.

There will be pockets that will see this carry on for years globally. Currently it is mostly prevalent in climates in their winter phase months, and UK just entered spring.

Then there is this virus mutating, could it mutate into something less harmful, or something more harmful.

Past pandemic the spanish flu saw the initial infection decline in the summer and in the winter saw a higher wave of infections and deaths - which would be at a time when health services with climate phases tend to be less able to handle extra volume.

Policy seems to be around accepting people will die, no escaping that or dressing that up and to manage infected and control the spread and managing response/restrictions accordingly. So by managing the effected numbers needing medical intervention and dragging out the first seasonal phase so that the summer months lul can be used to level out the impact down the line.

Once testing procedures are prevalent, and the curve has been bent, there is no reason why you cannot continue largely as usual well before a cure or vaccine exists.

However this age group is also predominantly conservative voting so they would not want to off their core support base.

This in a nutshell. The tory party hate spongers.

What reputable officials are on record regarding re-infection, please?

There are a few suspicious cases but given how human immunity system works, it is very very unlikely that it is due to reinfection (i.e. a cured patient getting infected again).

A far more likely explanation is either poor testing that gave a false "all clear" while the patient was still sick. The tests are not 100%, that you don't detect the virus in the sample doesn't mean that the patient is not infected - it only means your sample didn't contain the virus. Which could happen for all sorts of reasons. That's why multiple tests are usually required - commonly two, in some cases up to eight consecutive tests had to be clean before the patient was discharged.

Or the patient has not been completely treated and the virus became dormant for a while, reappearing again later. This is known to happen with other diseases as well - e.g. ebola virus could stay dormant for weeks in the eyes and cause the disease to return again.

The UK government announced the policy in a press conference with the Prime Minister and the chief scientific advisor.

Here is an interesting follow up interview with the chief scientific advisor: https://www.youtube.com/watch?v=2XRc389TvG8

My personal opinion, after watching the interview, is that the UK government is not doing anything that radical. They will follow the reactions of other countries but want to time the reaction so that it is most effective.

> while there exists substantial evidence to the contrary (people getting reinfected)?

No. There are instances of people testing negative and then testing positive again, but the strong consensus is that this probably results from faulty testing and/or changes in how viral material manifests at different stages in a person's infection. The chance is very small that people are truly getting re-infected.

I think herd immunity is an integral part of the strategy. If a population never gets herd immunity, it will keep on getting infection breakouts and keep on having to impose lockdowns. The only way to stop doing lockdowns is either to prevent the ingress of the virus, ever, or eventually reach herd immunity.

The virus is everywhere now, it’s part of the landscape, so preventing breakouts is just flat out not possible, at least for large countries with lots of travel and especially with large rural hinterlands like the UK. In this view the only strategies are long term strategies.

There is a way to get herd immunity without an epidemic, and that’s inoculations. However we do not have a vaccine yet and have no idea if or when we might ever get one. So you can bet everything on red 13 and cross your fingers for a vaccine in 6 months, or pick which longer term strategy works best for your country, with its particular demographics and geography.

The primary reason why other countries go into a lockdown is to prevent their strained healthcare systems from collapsing.

It's not just sick people who can't get a hospital bed. It's everyone else too. People who get heart attacks, strokes, accidents, other illnesses,...

A lock down is NOT meant to stop the virus in its tracks. It's meant to slow the infection rate and avoid hospitals and health care centers from getting swamped.

Any chart about China and Italy published thus far shows how the infection rate thus far grows exponentially. As such, the most impactful time to perform a lock down isn't next week or in 10 days. It is NOW.

The "herd immunity" strategy isn't a strategy. By the time this is over, the population will have achieved "herd immunity" regardless of how this will have played out. What matters is where we would like society to end up 6 months down the line: a relatively preserved, functional society with low mortality; or a dysfunctional one where likely anyone of this forum will have lost loved ones.

All of this ignores the moral aspect of sacrificing human lives at the feet of the economy. And, to be fair, it's totally plausible that said leaders are themselves ignoring the moral aspect. But it does matter when we judge them on the actions they decided to take (or not take).

> through very little fault of his own

https://www.snopes.com/fact-check/trump-fire-pandemic-team/

Get out of here with this. We had expert teams and processes in place to combat the possibility of this exact thing and his administration fired them without any replacement.

The virus existing is not his fault, but nearly all of the national consequences rest directly at his feet.

It's a technical term.

> The very phrase 'herd immunity' says a lot about what they think of people

...You know they didn't invent the phrase, right? It's a term of art, and has been the standard term for that epidemiological concept for many decades. https://en.wikipedia.org/wiki/Herd_immunity

paper - https://www.medrxiv.org/content/10.1101/2020.02.12.20022418v...

> They are ignoring any sensible model of this

Meaning what? They've explained their reasoning.

Doing what someone else does, but a week later doesn't necesarily mean you made a mistake, or that you are a week late in making a decision.

Yes, they've already said that they will bring in those measures in a week or two.

But there's a third strategy that works better than either: don't lockdown, but do effective testing, case tracking, and treatment, well enough so that exponential growth can't happen in the first place. That's the policy of Hong Kong, Taiwan, and Singapore, who are doing great.

Do you have sources for these claims?

> The problem with that is, once you lift the lockdown it will simply start all over again.

Well, no, because the world at the end of the lockdown is not the same as the world before the disease started spreading. Some differences:

- People now know there is a dangerous disease and how to act and sanitize to mitigate its spread.

- Manufacturing and other logistics for medical providers have had the time of the lockdown to ramp up.

- Testing has had the time of the lockdown to ramp up.

- A vaccine is that much further along--which is the only viable long-term strategy.

- And most important, scientific understanding of the disease has had that much longer to develop.

Britain's "expose the youngsters" strategy has a terrible flaw, which is that we don't know if the disease is actually safe for young people! All we know are some basic statistics about messy data that was reported by overwhelmed medical systems with spotty testing.

There are reliable reports of a) some young people getting very sick from this disease, b) people who seem to have recovered going back into decline and in some cases death, and c) long-term lung damage among those who did not die.

The ideas that this disease is somehow safe for young people, and that contracting it once confers long-term immunity, are ideas that are yet to be scientifically proven. They are, for now, at best heuristics to aid triage.

It seems like trying to time the stock market. You can make an educated guess, but in the end it's still a guess.

Please don't post duplicate comments to HN (https://news.ycombinator.com/item?id=22577808). It strictly lowers the signal/noise ratio and makes merging threads a nightmare.

Why would operating as normal and mostly ignoring the problem cause a "slower initial burn"?

It won't. This is nonsense of the most obvious kind, because we're already past the stage where the virus is spreading quickly.

In fact the reverse is likely to be true. Lockdown minimises the number with the disease, but that number is not zero.

Which means that if immunity is possible (questionable for a CV, but let's pretend), immunity will spread wider and wider in each lockdown wave - and the health system won't be swamped.

This plays for time, raising the odds that a vaccine or some other treatment will appear.

Successive lockdowns will do exactly what they're supposed to do - spread out the peaks, minimise casualties over time, and minimise health system stress. (Although it will still be very high.)

What they won't do is keep businesses afloat. Mass bankruptcies are going to be a huge problem throughout the entire global economy.

Other countries understand this, and are stepping in with financial measures to help. Presumably the UK doesn't want to do this.

The tell is the fact that the government has plans to quarantine for four months - i.e. place under house arrest - over-70s who are infected. Without access to intensive care - it won't be available if the NHS is swamped - the mortality rate in this demographic is going to be higher than that of any other developed country. It could easily be twice the nominal 15% CFR for this demo in China.

It's hard to avoid the conclusion that the real plan is to cull the old and sick while pretending that's not happening.

I believe the current UK Gov’s huge majority and long remaining term allow them to make decisions that many other countries would not be able to make at this time. I think they’re right, not that this makes things any easier, both my parents are in their mid 70’s and have health problems.

The lockdown as implemented by Italy and France aims at slowing down the spreading of the virus. It is not meant as a strategy to overcome the virus. It is meant to flatten the curve of the exponential growth of infection to minimize overloading the health system and to provide more time for preparation and for the acquisition of best practices regarding the situation. There is no disillusion that this might somehow stop the virus. The expected total infected percentage of population, with lockdowns is still in the range of 50-60%. Italy went into lockdown on March 9th when # of new cases reached 1791 and total deaths was 463. This does not seem to qualify as a very drastic early lockdown, as stated by parent.

Given everything we know regarding exponential spread, the high percentage of cases requiring icu treatment, and the mortality rate, I fail to see how the absence of any measures to mitigate the spreading of the virus makes sense.

The assumption that there are only two viable strategies, lockdown & no measures, is a plain wrong oversimplification. There is a wide range of intermediary steps that can be taken in between to attempt to slow down the virus.

Attempting to minimize the degree of overload on the health system by applying such measures in a coordinated fashion is meant to reduce casualties caused by system overload.

Yes the model they operate on is around 40% of the population will get this. Even with a lower real death rate of say 1% that still leaves over 250k people dead.

Italy is almost a month ahead of most of the world in infections though, their first outbreaks were weeks ago and the source for infecting most of the rest of Europe.

A lot of the UK infections can be traced to Italian holidays, for example.

Even if the government does plan to lock down the UK eventually, every day must cost 10s of millions, you can understand the strategy to wait longer, and even to play it down a bit.

The average age of a fatal case is still north on 80 years.

The UK plan is effectively to get as many people as possible that are young, and thus at a super low risk of needing hospitalization to get infected, so that they can recover and then be immune, thus making it hard for the virus to sweep through again. If 30% or more of the population were immune, it would be much harder to get a new outbreak started. With a lockdown, either the lockdown suppresses spread, in which case ending the lockdown risks re-igniting the epidemic, or it doesn't, in which case it didn't help materially anyway.

If the UK can get 10x or more of the cases with only the same hospitalization numbers, they'll be in better shape than everywhere else.

The core question ends up being whether they're able to effectively inoculate that many young people without it spreading to just everybody.

Flattening the curve preserves medical capacity somewhat, but it also prolongs the epidemic. And since the lockdowns required to do the flattening have their own cost on lives, it's unclear whether the incremental increase in the number of lives that the medical system can preserve will or will not exceed the number of other lives caught short because the disease and also the lockdowns are extended by the extra time.

You might not be saving lives, just changing which people die.

Or you might save some, or you might lose more. Counting in advance is... let's say nontrivial. Even counting afterward will be hard and full of wide error bars.

It's relatively easy to count how many died directly from an illness, difficult to count how many will die because they delayed necessary non-emergency care for 4 months (unrelated to the virus except for the need to preserve hospital capacity or avoid infection risk) instead of 2 months because the outbreak was prolonged, and virtually impossible to count how many die from things like "I lost my job and my life savings at the same time, and I never fully recovered, and now my whole family is much poorer, which gives us higher all-cause mortality"

Everybody's talking about the first group. Occasionally, I see people admit that the second might exist and be non-empty. But, I keep feeling like I'm the only person on HN (and in my regular life) reminding people that the economy actually affects real life in major ways. (I'm probably not the only one, but still...)

The dividing line for what's on topic on HN not fact vs. opinion, it's intellectual curiosity (https://news.ycombinator.com/newsguidelines.html). That doesn't limit itself to authoritative information, by definition.

Speculation is inevitable. The question is whether it's curious (thoughtful and fresh) or uncurious (reflexive and predictable).

You could think of this as the advantage of a decentralized world with every country making decisions and experimenting independently. Maybe the UK's approach is the right one, maybe it isn't. If it turns out to be more effective we'll learn something useful for future pandemics. If not then only the UK goes down the drain and we'll still learn something from it. Best of luck.

Just a note that this document is from 2011. I know you did not claim otherwise, but I had assumed from your comment it was a document prepared in response to the current situation.

Merkel apparently is trying to (or tried to), but was more coy about it. But none of the technocratic Asian governments seem to.

This is the part people are missing. We don’t know enough about the virus, and due to the extreme nature of the worst case scenarios it’s probably a better bet to act as if the worst case scenarios are true.

We can recover from an economic hit. We’ve done it several times before, and there are several tools that can be used. A major pandemic with mutating viruses is not something we are as prepared for.

That document says "Published 3 March 2020" - do you know if it still reflects current government thinking?

This clip of the political sitcom Yes Minister from the 1980s is making the rounds on our social media, as it explains that thought process succinctly, and hilariously:

https://m.youtube.com/watch?v=qNjFIwRYEIo

There is already a pandemic, so it isn't a question of pandemic or no pandemic. It's a question of if the medical system gets overwhelmed. It's also hard to judge because spending lots of money and enlisting extreme measures may slow the virus so much it looks as if it wasn't that dangerous to begin with. In which case both sides would be using it as a talking point.

Since there's already a pandemic, I'll assume when you're saying "pandemic" you mean more specifically "epidemic in the UK". Even then, there's some fallacy in your list.

In the best case -- if action is taken and it contains the spread -- then there is no epidemic and it looks like overreaction. Even if it slows the spread allowing the health care system to keep up and keeps the fatality rate fairly low you'll get people claiming it wasn't as big a deal and that whatever action was taken was an overreaction.

This happened with Y2K [1], it happens with hurricane warnings when the storms fizzle out, and despite the glaring evidence of what happens with inaction (China, Italy) there should be little doubt people will be talking about 'overreactions' in any countries that do take action that turns out to be effective.

It's the same problem that nobody goes to a show and says "Wow, the sound technician did a great job, because nobody backstage had a hot mic while they were in the bathroom!"

[1] https://news.ycombinator.com/item?id=22556156

Nah, that was the thinking before the pandemic, when "action" was either close the borders and crash the economy, or not and hope that nothing happens.

Now, I think the following consequences need to be taken into account:

(1) politicians have very little skin in the game (given they have priority access to hospitals, security, flights, ...)

(2) the only skin in the game is next election, which in the UK won't happen for another 5 years, so literally who cares (a.k.a. this won't affect Johnson's decision-making)

(3) capacity - NHS in the case of the UK - of which we (the public) have very little information, and the government (Johnson) has a lot - he might think that if there's even less capacity than in Italy, it makes no sense to even try their strategy

(4) what other countries do - a disaster isn't really a disaster if it's no worse than other countries... and Italy is pretty bad already, so it makes some sense to do something else (can hardly be worse than Italy)... this is also why I think Trump won't fare that bad, as long as the US outcome is better than EU (which is might still be, it's a bigger country with literally more space for people to self-isolate, and banned flights with China a while ago - not sure if that'll have an effect at all but it might) he should be fine

This doesn't make sense as the next general election here is in 2024 and however coronavirus is handled will be in the distance by then. Consider that the Labour government started a very unpopular war in 2003 and then won a landslide two years later in 2005 - and they were in the middle of fighting it.

Except it seems to predominantly affect the elderly, who skew richer and more conservative.

Scientifically, yes? First do we have conclusion that people are immune to coronavirus once infected? Isn't the disease too new to know that? Secondly have we done any experiments and have any evidence that this will work in a smaller scale? Any scale? I thought science is about evidence and repeatability. If anything this will be a large scale human experiment at best without any informed consent given.