15 votes

'Herd immunity': Why Britain is actually letting the coronavirus spread

18 comments

  1. [7]
    Comment deleted by author
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    1. [5]
      Comment deleted by author
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      1. [5]
        Comment deleted by author
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        1. DanBC
          Link Parent
          If there's no immunity there's no point to the UK's policy, which was explicitly about developing herd immunity. (Although politicians are walking that line back a bit because it's deeply...

          especially if there is no immunity

          If there's no immunity there's no point to the UK's policy, which was explicitly about developing herd immunity. (Although politicians are walking that line back a bit because it's deeply unpopular with the public.)

          7 votes
        2. [3]
          Omnicrola
          Link Parent
          Isn't this why they recommend people get a flu shot every year? Even the existing flu strains continue to mutate and change enough that your antibodies from last year's flu won't quite work as...

          apparently previous corona viruses like SARS don't build immunity post infection

          Isn't this why they recommend people get a flu shot every year? Even the existing flu strains continue to mutate and change enough that your antibodies from last year's flu won't quite work as well against this years?

          1 vote
          1. [3]
            Comment deleted by author
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            1. [2]
              patience_limited
              Link Parent
              This isn't fully established - there's evidence that "reinfections" may be due to faulty testing.

              This isn't fully established - there's evidence that "reinfections" may be due to faulty testing.

              8 votes
              1. vektor
                Link Parent
                Nevermind that the cases I've read of are also in the elderly - not the population you want to rely on to build the herd immunity.

                Nevermind that the cases I've read of are also in the elderly - not the population you want to rely on to build the herd immunity.

                2 votes
    2. skybrian
      Link Parent
      I think it's madness because there are so many unknowns. It's like driving fast in a blinding snowstorm rather than hitting the brakes, because "if we stop, then what?" The answer is that we...

      I think it's madness because there are so many unknowns. It's like driving fast in a blinding snowstorm rather than hitting the brakes, because "if we stop, then what?" The answer is that we decide that after we stop, if we even manage to.

      12 votes
    3. NaraVara
      Link Parent
      I would guess the assumption is that this is based on previous experiences with the spread and containment of SARS. I doubt they’d hinge an entire epidemiological response if the WHO wasn’t fairly...

      especially because there is no evidence of immunity post infection

      I would guess the assumption is that this is based on previous experiences with the spread and containment of SARS. I doubt they’d hinge an entire epidemiological response if the WHO wasn’t fairly confident. Coronavirii are apparently fairly stable and slow to mutate.

      2 votes
  2. [2]
    Comment deleted by author
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    1. post_below
      Link Parent
      I think this is the most important argument against the plan. If you let it run wild, your healthcare infrastructure is going to get overwhelmed and you find out how high the mortality rate can...

      I think this is the most important argument against the plan. If you let it run wild, your healthcare infrastructure is going to get overwhelmed and you find out how high the mortality rate can really go.

      Another point: According to Chinese scientists this virus (as with so many others) doesn't like warmer temperatures. Spring and summer may not stop it completely, but they will almost definitely slow it down. Even if you want to run an experiment on public health, it would make sense to at least wait until it warms up a bit first.

      6 votes
  3. [2]
    psi
    Link
    I've posted about this elsewhere and there's a decent enough discussion at HN. Having said that, I think this is an absolutely horrible idea. Let me start by quoting a particular comment on HN...

    I've posted about this elsewhere and there's a decent enough discussion at HN.

    Having said that, I think this is an absolutely horrible idea. Let me start by quoting a particular comment on HN which resonated with me:

    Here is a rule of thumb that will be familiar to many who manage risk in a professional capacity:
    The time to get creative is when you face a capped downside on the one hand, and an uncapped upside on the other. The time to get conservative is when you face the opposite condition.

    The reason for this rule is that creative policies almost never work; but when they work, they have a much higher chance of working extraordinarily well than conservative policies do.

    The UK is facing a capped upside and a huge potential downside. The UK is choosing to handle this situation with a creative experiment. This experiment will, in all likelihood, not succeed. And unfortunately most values of "not succeed", in this context, map to catastrophic outcomes.

    Time, as always, will tell.

    Obviously a maxim is not proof. But let's consider some of the possible catastrophes that could eventuate:

    1. The NHS is overrun with coronavirus. With an unmitigated spread, most cases will peak around the same time. Many young people will not be able to receive the treatment they need to survive; doctors will be forced to triage, choosing who gets access to necessary care and, therefore, who lives. Frankly, calling this a "possible catastrophe" is an understatement. In my mind, this is almost certain if the UK proceeds with their plan.

    2. Vulnerable people get sick anyway. How can you reasonably expect to limit the risk of infection if most people are infected? How would that even work? Do you ship all the healthy young people to England, the rest to Scotland, and build a great, hulking wall between them? The idea that you can cleanly separate the vulnerable from interacting with the young and healthy is laughable. Again, in my mind this would almost certainly be inevitable.

    3. The virus mutates. Right now the disease the virus causes, covid-19, has a case fatality rate (CFR) estimated somewhere between 0.1% and 4%. This is rightfully terrifying, but not nearly as bad as it could be (compare with SARS and MERS which have CFRs of 9.6% and 34.4%, respectively). Currently what makes the novel coronavirus so potent is its transmissibility. Were it to mutate and become more deadly, the UK would become the epicenter of an even more dangerous epidemic.

    4. Reinfection occurs. If so, this would preclude herd immunity from ever forming. The only means to fight the virus, in this case, would be to either quarantine everybody, or wait it out until a vaccine is created (if possible). Fortunately, evidence so far suggests that reinfection is unlikely.

    Now let's consider some potential upsides of the UK's plan:

    1. The blow to the GDP is lessened. Perhaps a tanking GDP would indirectly lead to deaths. But now we're trading a known threat (coronavirus) with a nebulous, questionably quantified one.

    2. People can pretend things are normal. Well, they won't be. See (1) and (2) in the previous list.

    In conclusion, the plan's fucked.

    9 votes
    1. DanBC
      Link Parent
      Especially since part of the plan involves isolating anyone over 70. This is a group of people who rely on social care, which is provided by mostly young poor people on terrible zero hour...

      The idea that you can cleanly separate the vulnerable from interacting with the young and healthy is laughable. Again, in my mind this would almost certainly be inevitable.

      Especially since part of the plan involves isolating anyone over 70. This is a group of people who rely on social care, which is provided by mostly young poor people on terrible zero hour contracts with not much sick pay. We're forcing this group to go to work, we're forcing them to get infected, and their work is "spend time in intimate contact with vulnerable people".

      3 votes
  4. [7]
    ibis
    (edited )
    Link
    I really hope that this method works for the UK and then the rest of us can adopt it. It sounds a lot more appealing than a year of event cancellations and no travelling.

    I really hope that this method works for the UK and then the rest of us can adopt it.

    It sounds a lot more appealing than a year of event cancellations and no travelling.

    4 votes
    1. [6]
      cfabbro
      (edited )
      Link Parent
      Me too... but this sure seems like a hell of a risky thing to gamble on though. And given what's happening in Italy right now, with their healthcare system getting completely overwhelmed and many...

      Me too... but this sure seems like a hell of a risky thing to gamble on though. And given what's happening in Italy right now, with their healthcare system getting completely overwhelmed and many more people dying than should be as a result of that, I don't think it's a particularly safe bet or wise decision. :( Time will tell if it pays off for the Brits in the end though, I guess.

      15 votes
      1. [5]
        DanBC
        Link Parent
        The UK only has 5000 ventilators at the moment. There's talk of requisitioning car factories to get them to build more ventilators. tl;dr: we're fucked.

        The UK only has 5000 ventilators at the moment. There's talk of requisitioning car factories to get them to build more ventilators. tl;dr: we're fucked.

        6 votes
        1. [3]
          vektor
          Link Parent
          At 5000 ventilators, assuming you can use all of those, you can sustain 220000 concurrent coronavirus cases, maybe more if you can effectively shield high-risk populations. Let's assume that use...

          At 5000 ventilators, assuming you can use all of those, you can sustain 220000 concurrent coronavirus cases, maybe more if you can effectively shield high-risk populations. Let's assume that use of ventilators for other uses and shielding of high-risk populations approximately cancel out. If you want to get 47 million cases, you're going to have to stretch them out such that you can use every ventilator 213 times. One use is 2 weeks, but let's be generous, 1 week. 4 years. They're going to have to stretch it out for 4 years.

          TL;DR: You're mega fucked.

          6 votes
          1. [2]
            Comment deleted by author
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            1. vektor
              Link Parent
              Well, from the way exponentials go, we can be almost certain that if containment is not done, almost all cases will occur in a relatively brief window. Maybe a month? Two? Let's go with two....

              Well, from the way exponentials go, we can be almost certain that if containment is not done, almost all cases will occur in a relatively brief window. Maybe a month? Two? Let's go with two. That's very generous I think, considering we usually see a duplication in cases every 2 days. In that timeframe you get 8 uses out of a single respirator, being very generous again. If we assume we have 40 million cases during our window, we get 1 respirator per thousand people. The chinese needed 23 times that. And I've given the most generous numbers at every corner here. I don't know how many respirators they needed for the different age groups, but I could easily imagine that no amount of protecting the old will make the need for respirators that low.

              1 vote
          2. cfabbro
            (edited )
            Link Parent
            In looking into Italy vs the UKs healthcare systems with regard to this epidemic, I found this article from Financial Times: European countries search for ventilators as virus cases surge (hard...

            In looking into Italy vs the UKs healthcare systems with regard to this epidemic, I found this article from Financial Times:

            European countries search for ventilators as virus cases surge
            (hard paywall, but can be gotten around by clicking on the google result

            And this image from halfway down the article is very telling IMO. Even ignoring ventilator numbers, Italy has twice the UKs number of critical care beds per 100,000 people and yet they are still struggling. So... yeah, the outlook is really not good for the UK if they go through with this.

            1 vote
        2. cfabbro
          Link Parent
          Given how often Jags and Aston Martons tend to break down, I dunno if that's such a good idea either!! j/k ;)

          Given how often Jags and Aston Martons tend to break down, I dunno if that's such a good idea either!! j/k ;)

          1 vote
  5. Tygrak
    Link
    I am not an expert at all. But this feels like the worst idea. There's no way to make sure the vulnerable people won't get infected. Even if just 0.2% of the young people die that's quite a lot if...

    I am not an expert at all. But this feels like the worst idea. There's no way to make sure the vulnerable people won't get infected. Even if just 0.2% of the young people die that's quite a lot if they let basically everyone get infected. Not only will things most likely go very bad in the UK, it might even screw the rest of the world if the UK becomes a gigantic hotbed of infection.

    4 votes
  6. Eric_the_Cerise
    Link
    Well, then, the UK is just doing it wrong. Nutshell ... the issue is ability to provide health services. Some people will die, no matter what. But the slower the disease spreads, the better...

    Well, then, the UK is just doing it wrong.

    Nutshell ... the issue is ability to provide health services. Some people will die, no matter what. But the slower the disease spreads, the better hospitals will be able to handle the influx.

    Just letting it spread will quickly lead to over-crowded hospitals telling people (who could have been saved with proper care) to go die at home.

    It's also a good way to get all travel to/from your country banned.

    3 votes