Tag Archives: R number

How do we unlock a lockdown?

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Britain’s poking its nose out of lockdown and looking around to see if it’s safe for the rest of the body politic to follow. A lot of people have been vaccinated–or half vaccinated, which will, we hope, hold us for the time being. The number of new Covid infections is dropping. The number of deaths is dropping. The daffodils are blooming.

Daffodils have no antiviral properties, but they do make people feel good.

So what are the prospects of getting out of this mess without setting off a new spike?

 

Daffodils. Take three and call me in the morning–or is that joke so dated that you have to be over 70 to get it?

Peeking out of lockdown

Britain’s four component nations will chart their own routes out of lockdown and each will look contemptuously at the choices the other three made, but we’ll only follow England’s here, because that’s complicated enough, thanks. 

Stage one is reopening the schools, which will open on March 8, and initially all students from secondary level on up were supposed to return at once, bright-eyed and with a negative Covid test in hand.

How were they supposed to get that negative test result? We’ll skip the details, but headteachers said there wouldn’t be time–it would take a good three weeks to get everyone tested. Teachers unions and school governors had been calling for a phased return for a good long while, although the government was ignoring them.

Hell, what do they know?

Then two days after announcing the plan, the government did a U-turn. Of course secondary schools can bring the kids back in stages. 

You’d think a government would be embarrassed to be this visibly disorganized, but if it bothers them they hide it well. And the outrage machine that makes up a large segment of the British media doesn’t seem to be bothered by it.

Once they’re back in school, older kids will take a continuing series of tests–the quick kind called lateral flow tests, which are problematic. They miss a lot of cases in the best of circumstances and miss more when done by non-experts. The kids will have a few tests at school and after that they’ll take them home to do themselves. 

These are school kids, remember. They’re the definition of non-experts. So don’t expect too much from the results here.

The government’s Scientific Pandemic Influenza Group on Modelling says the scientific consensus is that opening the schools this way will drive up the R number–the number of people that each infected person goes on to infect–by anywhere between 10% and 50%. 

Have I mentioned that teachers haven’t been a priority category in the drive to vaccinate the country? So they’re being asked to take a deep breath, walk into class, and roll the Covid dice. Masks are at least recommended for older kids in class, not just in the hallways, but that’s recommended, not required. 

Elementary school kids? Nope, they haven’t even gone that far. 

And in case the message on masks sounds too coherent, though, the school standards minister (who knew we had one?) went on TV to say that masks and testing weren’t compulsory. Parents could decide whether their kids would use either. 

“I despair,” the head of one school was quoted as saying.

Let’s not go through the unlocking stage by stage. What matters is that before the country moves from one stage to the next, the situation will be evaluated. If it looks good, we move on. If not, we wait. So far so good, but what they’ll be measuring isn’t the number of cases but the number of deaths, the number of hospital admissions, the number of people vaccinated, the variant situation. So if a gazillion twelve-year-olds all test positive, it’s okay as long as deaths and hospitalizations don’t get out of control.

Are you getting a sense of why this makes my skin itch? People who test positive are the early warnings of a new spike, but the assumption seems to be that cases can be contained as long as they’re not hospitalized or dying. That kids won’t pass it to families. That teachers won’t be hospitalized and won’t pass it to partners and parents. That kids themselves won’t get seriously ill. That somehow you can get through this thing without having to worry about new cases. That as long as the hospitals aren’t overwhelmed and people aren’t dying in the streets, it’s okay. 

What the government’s doing is betting heavily here on vaccines and tests, hoping to keep the number of cases down to a manageable level until those save our hash. And it may work. In the meantime, forgive me if I scratch where it itches. I like our hash. I don’t want to see us lose it.

The Royal College of Paediatrics and Child Health says that vaccinating children and teenagers could be the way out of this mess,  but the vaccine trials involving kids have only just begun. We should hear the results in six months or so. That’s not a quick hash-saver.

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Another detail that makes me itch as we poke our collective nose into the open air is that healthcare workers still don’t have proper protective equipment. Twenty healthcare bodies have written  to the prime minister about this. In response, the prime minister rumpled his hair and asked if he didn’t look cute. 

Okay, what the government actually said was that it was monitoring the evidence and would update advice “where necessary.” And by the way, didn’t the prime minister look cute?

Healthcare workers are four times more likely to become infected than the rest of us, and within hospitals people working in intensive care have gotten the highest grade protective equipment, but it turns out that people working on the general wards have double their rate of infection–and less effective protective gear.

But, what the hell, the country’s only had a year to get this right. And we do have a prime minister who knows how to rumple his hair.

Meanwhile, the government is paying consultants to locate the protective equipment that it owns and that it stored someplace, although no one person knows exactly where. Billions of pounds worth of the stuff is stashed here and there.

“We have amounts in containers, in storage around the country; there are some on the docks and there are some en route from China,” the auditor general said. 

I wonder if that’s what’s on the floor by my computer. If so, I’d really like it out of there when the prime minister’s done with his hair. It was only supposed to be there for a couple of days. 

Some of the equipment will go out of date if it’s not used. Some of it is needed in hospitals and (yup, see above) isn’t available. Some of it–possibly all of it–was bought by external consultants at inflated prices and I should have known better than to let them store it on my floor but they were being so damn nice. 

Anyway, they don’t seem to have a central system to track all this, so they’re paying consultants to figure out what they own and where they can find it. 

You’d laugh if it weren’t so expensive. 

 

The sciency stuff

Lab studies have confirmed that the mutation common to the British, South African, and Brazillian variants really does make Covid more contagious than the original form. The initial argument was based on modeling, and I was holding out for confirmation, thinking that maybe the variants had just gotten lucky. Now, damn them, the scientists have given me what I asked for. So yup, it’s more contagious.

New York and California–not to be left out–have developed (or found, since we don’t really know where any of the variants first emerged) variants of their own. Let’s not panic about them until more is known. There’s always time for that later.

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A new quick Covid test has been developed in France. It gives you a result in ten minutes–a third the time of the lateral flow tests–and it’s more accurate, although still not perfect. It’s 90% accurate, with the remaining 10% taking the form of both false negatives and false positives.

That’s good news, but it’s going into a three-month trial, so don’t rush out and try to buy a few thousand of them for your local school. 

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The US Food and Drug Administration has said that Johnson & Johnson’s one-dose vaccine is both safe and effective. That’s not yet approval, but it’s a move in the right direction. If you don’t read past the headlines, you may not fall in love with it: It’s only 66% effective, which is lower than the be-sequined two-dose vaccines that crossed the finish line first and got all the cheering.

Read past the headlines, though.

The vaccine was tested in the US, several Latin American countries (sorry–I don’t know which ones), and South Africa, and 66% is the number that comes out of the jar once you pour all those results together and shake them. In the US, it was “much closer” to the be-sequined numbers. The effectiveness depended on which variants were prevalent in which countries. 

How much closer is “much closer”? In the US, it’s 72% effective. In South Africa, 57%. After that, I run out of numbers. Sorry. 

That’s still not in the 90% zones of the star vaccines, but all the vaccines (“all” here means the ones that have been approved in the US, but may well include others that are in use around the world) are 100% effective at preventing hospitalization and death. That’s no small thing. 

 

Creativity and lockdown
In a recent blog post, Emma Cownie asked, Can the boredom of lockdown push us to be more creative? For her, the answer has been yes, and it’s also worked that way for Peter Quinn, who creates special effects for a living. You know special effects–those things we see in movies that kids think are real and adults–um, yeah, we sometimes think they are as well. I won’t try to describe what he’s done, but he’s created a few sequences just to make himself laugh, and he’s strung them together in a video clip. 

They made me laugh too. Go on. Watch it. It’s good for your immune system.

The pandemic update from Britain: lockdown, lunacy, and a mention of Minneapolis

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A pilot flew a private plane from Surrey to an airfield belonging to the Royal Air Force. That set off an emergency response involving the Ministry of Defence and fire crews, who (I’m reading between the lines here) wanted to know what the hell he thought he was doing.

He wanted to go to the beach, he said. 

Since the airfield is in Wales, that was a breach of the lockdown rules, which are different in Wales than in England. Or it’s believed to be a breach, since the rules don’t specifically mention landing your private plane on an airforce base so you can go to the beach. 

I think I can safely say that he’ll be in trouble with multiple agencies. I’m reasonably sure that lockdown will be the least of his troubles.

To put the situation into bureaucro-speak, the police are ‘considering’ whether there were ‘potential breaches’ of coronavirus legislation. And the Civil Aviation Authority has been alerted. It will be demanding a note from his parents.

So far, I haven’t seen any evidence that Dominic Cummings was on board. And if you haven’t followed who Dominic Cummings is, just follow the handy link, which will take you to a post by that noted expert, me, which will explain all. Or enough, anyway.

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England’s contact tracing campaign continues to be a mess, with many tracers not able to log on. Some recruits have set up support groups on Facebook and WhatsApp, pooling their knowledge about what the hell they’re supposed to do, and how. One contact tracer reported (anonymously) that the app wouldn’t work with his or her microphone. Another had been working for three weeks and been asked to do nothing more than join an online training session. A third says he or she has learned to juggle with three balls. 

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Some of England and Scotland’s coronavirus testing centers aren’t matching test results to either people’s National Health Service numbers or their addresses, which means their doctors aren’t told about coronavirus patients on their caseloads and local authorities can’t track outbreaks in their areas.

Back in March, the devolved governments–that translates to Scotland, Wales, and Northern Ireland–told Matt Hancock, Britain’s health secretary, that the system he was setting up had problems, and Northern Irland and Wales insisted on changes. Scotland and England went ahead. 

Wales and Northern Ireland get to play a satisfying round of I-told-you-so. 

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An NHS trial is giving Covid-19 patients blood plasma transfusions from patients who’ve recovered, and the trial’s set to expand. The hope is that the antibodies will help them fight off the disease. 

To date, it’s only been tried on patients in intensive care, but it may be more effective if it’s used earlier. Stay tuned.

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Back in April, the British government’s science advisory group noted that only half the people who came down with Covid-19 symptoms followed the government’s advice to self-isolate for fourteen days. It recommended doing some quick research to figure out what it would take to get people to follow the guidelines. 

As the lockdown eases and the government’s betting its rapidly diminishing stack of chips on testing people, tracing the contacts of anyone who tests positive, and isolating the cases they find, people actually isolating themselves becomes crucial.

Not going into isolation when you should is apparently now known as doing a Cummings. 

Some members of the science advisory group are now warning that easing the lockdown now will lead to a second wave of cases. In England, 8,000 people a day are still becoming infected, and that doesn’t count people in care homes or hospitals. That data’s collected separately and the two data sets aren’t speaking. You know how it is in some families. 

It also doesn’t count cases in Wales, Scotland, or Northern Ireland.

One advisor, John Edmunds, said, “If you look at it internationally, it’s a very high level of incidence.”

The current R rate–the rate at which the virus spreads–is between 0.7 and 0.9. At anything above 1, the pandemic grows. At 1, it stays the same, which at a rough guess means 80 deaths a day.

John Edmunds’ colleague Jeremy Farrar tweeted, “Covid-19 spreading too fast to lift lockdown in England. Agree with John & clear science advice. TTI [test, trace and isolate] has to be in place, fully working, capable [of dealing with] any surge immediately.”

 

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England’s chief medical officer said, in a carefully worded statement, that the country’s at a very dangerous moment. It wasn’t a clear criticism of the government, but a listener could be forgiven for thinking it was.

He also said, mentioning no names, that England’s lockdown rules applied to all.

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MPs’ inboxes have been swamped by messages about Dominic Cummings, most of them critical. So what does an overwhelmed MP do? Conservative MP Anthony Mangnall gave his responses the personal touch by hitting Send before he remembered to delete the part that said, “insert if there has been a bereavement.” 

He is, he said, incredibly sorry. He remembered to delete the part of the script that said, “Don’t get caught again.”

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I don’t write much about American politics. Even though I’m American, I live in Britain. It’s not the best seat to watch the show from. But I have to go off topic and say something about what’s happening there, even though it’s happening in the wrong country and it’s not pandemic related.

I lived in Minneapolis for years, and a lot of you will know what’s happening: A few days ago, a white police officer killed an unarmed black man, George Floyd, by kneeling on his neck for seven minutes. On camera. While Floyd said, “I can’t breathe.”

What had Floyd done? Tried to buy something at a local food store. The clerk thought he’d paid with a counterfeit bill and called the police, because that was store policy. No one claims that Floyd knew it was counterfeit. At this point I don’t know if anyone cares whether it actually was.

First there were protests. Then there were riots. A CNN reporter was arrested while covering them, even after he showed  his i.d. He’s black. Yes, that’s relevant. 

Rumors are flying every which way. I can’t confirm them, so I’ll stick to what’s in the papers.

My old neighborhood’s been on fire. The post office, the library, and a whole lot stores have burned down, along with the police station where the officers involved in the killing were based.  

At a gym in another part of the city, a white man threatened to call the police on some black men because the gym was restricted to the tenants of the building and they couldn’t possibly have a right to use the same gym as he did. That was after demanding that they prove they had a right to be there. 

In Kentucky, police targeted a news crew covering a protest about a black woman who was killed by police in her own home. “Targeted” means they shot the reporter with pepper bullets. 

In Detroit, someone shot into a group of protestors from a car, killing a 19-year-old. 

In several cities, cars have driven into crowds of protestors.

I’m not using the word protestor to mean rioter.

Sorry–I’m supposed to be funny here, or to at least try. That’s the agreement we sort of made.  So to those of you who are in the U.S.: Guys, I know racism runs deep in our national DNA. If there’s such a thing as national original sin, that’s ours. But I also know that racism’s not the whole story, that there’s more to us than that. So I’m looking for you to sort this out, okay?

Don’t make me come over there.