Being in two at-risk groups – immune compromised and asthmatic (and just a year outside the 50+ warning zone) – I am awaiting a tornado mixed with a hurricane, and I have no storm shelter. I have started to self-isolate, and it seems that vulnerable people are going to be told to lock-down for three months.
I don’t know about you, but I’ve been checking the Johns Hopkins tracker as if it was BBC Football page. So far, Covid-19 is ahead, and like Liverpool throughout 2019/20, likely to extend its lead. Although maybe like Liverpool, it will also be denied victory right at the last moment.
(The ever-excellent John Oliver sums up how most of us Reds are feeling.)
As ever on TTT, the debate about almost anything behind our paywall is enlightened. We have a number of scientists, academics, PhDs and medical doctors, some of whom have been sharing their wisdom (and front-line experience), and we also have some people with the virus who are in isolation.
So, we thought we’d share just a few of the 1,000+ comments on the issue in a free piece, to help spread some of that wisdom and some of our concerns. (Comments under this article will be disabled to keep the discussion on the dedicated Covid-19 thread.)
There’s also been some panic, albeit mostly from me; I’m quite rational about football, quite terrified dying (particularly in a hospital corridor); which is not helped by the government’s handling of this, albeit some on here have sought to explain why it might have been the right move, whilst others have been as baffled and scared as I have. That’s one of the beauties of the site: polite, rational debate. These comments date back across the past few days, and in a fast-changing situation some may already seem out of date. It seems that the UK is finally doing something to halt the spread, but it will be a long spring and summer.
Briefly, my own take on the football itself is that it will not resume before the autumn.
Even if it somehow resumes within a month or two, it will have to be behind closed doors, and teams will be in quarantine on and off as the virus spreads, which would just make playing regularly scheduled games near impossible.
It’s now beyond doubt that the vast majority of people will get it, and while other countries acted quickly and both test and trace people, we haven’t acted quickly here and we don’t test anyone outside hospitals, so our spike may be sooner. So it will be everywhere, before long, given the nature of exponential spread. (Oh for the days in football where there were enough toilet rolls to throw onto the pitch with gay abandon.)
The government’s plans for herd immunity may have been misunderstood, but it seems they wanted to have the coronavirus spread, what with them allowing 3,000 Madrid fans into England. Maybe if all vulnerable people can be kept safe then it can just run through the healthy population in the next few months, but it seems a risky strategy. Certainly the NHS will be overwhelmed, and the economy will be under serious strain. (One of the comments below is something I wrote about this late last night.) Anyway, these are the types of things debated below.
Perhaps by the end of the summer there will be enough healthy and immune people for life to start returning to normal, as us vulnerable ones are sheltered away until then (and hopefully not just left to die in some form of eugenics).
Either way, there will be a new race of people – the Covid-19 Immune – and they shall inherit the earth, for a while at least.
We’ll continue to bring you the best football writing that we can, health permitting (a few of us are in high-risk categories), and find new things to analyse.
I will be publishing extracts from some of my older Liverpool FC books for subscribers (including last year’s Mentality Monsters), as I await to see if there will be an end to the season (and thus, to complete my latest book). While we need to retain subscribers to survive, we also appreciate that people losing their jobs will mean they have to cancel, and that’s perfectly understandable. If any existing subscribers are having financial difficulties then please email us and we can sort something out for you to keep you accessing the site.
Anyway, onto the comments…
StevieB:
I thought I would share some of my experiences. I am not the most eloquent of writers but bear with me.
Two weeks ago I started getting some flu-like symptoms, starting with a sore throat, and what I would describe as mild hot flushes. The next day (Monday) I started having a dry cough and felt weak, so I was off work. I decided that I should self-isolate and have been home ever since. I was fortunate enough to be able to work from home during this period, and my symptoms have pretty much gone now, though I still have a cough, so am still staying inside.
I called 111 several times and the advice was I didn’t need to be tested as my symptoms weren’t severe enough and I hadn’t been in contact with any known cases. Fair enough, I’m sure there are people who are higher in priority than me, who need more urgent care. I am 40 and healthy so am not in the high risk category. However, I still don’t know whether I have the virus or if it’s just a normal flu, which isn’t ideal, so I am taking all precautions.
My wife is Chinese and her parents are currently in lockdown on the east of China, as they have been for the past couple of months. At the moment they are fine but we have been living with this anxiety for some time. We were hoping to see them in the summer, but right now there is no way to do this, as it’s completely closed off. Not being able to see loved ones is particularly hard for my wife, but we are trying to keep each other going.
Incidentally, I am right now eating some Chinese medicine, which my wife has been making for me, called snow ear fungus soup, which is supposed to help my cough. To be honest I haven’t noticed any improvement so far but I’ll try anything! It looks terrible and doesn’t taste any better, but at least it’s making my wife happy!
I have suffered from anxiety in the past and this period will of course be difficult for everyone. However, I know anxiety is something that will go in time and am trying to stay calm as possible. I am having trouble sleeping, but it’s not so bad.
I was up at 3am one night and decided to watch some TV. I had recorded the Royal Institution Christmas Lectures, which Hannah Fry was presenting and this episode was about luck. Ironically in this episode there happened to be a section on diseases (just what I needed!) and the mathematics of having enough immunity in the population, which will help protect the rest of the population. The theory is that as enough people are vaccinated or have immunity it helps protect everyone else. It’s worth a watch if you are interested (from 22 mins on):
I’d recommend watching the whole programme if you are mathematically minded as it’s an interesting watch.
Funnily enough the item immediately after this was about LFC! They had one of the Data analysts Tim Waskett on from Liverpool talking about player analysis, so that helped me put the virus to one side for a little while. Maybe worth a separate discussion elsewhere!
I just want to give everyone my best wishes and as Jürgen said yesterday it’s important to take any possible precautions to help prevent the spread of this. During these anxious times it’s important not to bottle things up too much and help each other through as best we can.
Tash:
As per my earlier post, I’ve fallen ill with what may or may not be Coronavirus after perhaps foolishly putting aside my concerns and travelling to the UK (from Spain) for our game v Bournemouth.
If my own experience is anything to go by Spain has a huge problem.
I appreciate I’d be seen as low risk, but having been completely unable to get through to the designated COVID-19 Helpline (which has been totally collapsed since it went live) and being unable to go to a medical centre (or anywhere else) for fear of potentially contaminating others, I am asked instead to call the emergency services.
I’ve called them since Wednesday and we follow the same process each time; They take my details, tell me to self-isolate and to wait till they come and test me. Its now Saturday. No call backs. No tests. Its beginning to feel like the test is ‘See if they survive 2 weeks’. Yes or No the problem is then essentially solved…
My point is really that if this is the situation in a town with few cases so far, then I really fear for their capacity to respond when the situation worsens. Whilst I appreciate there will have been many tests done in addition to those resulting in a Positive, there was 1 solitary case in my particular town on Wednesday and less than 10 across the 3 other towns with which we share emergency services. Even now, we are collectively below 50.
…
As per usual at this time of the day I’m busy spending the first waking hours coughing up an incredible amount of crap from my lungs and/or chest. Initially this was a positive because we were told that we the symptoms don’t include industrial amounts of snot. Now, it appears that it might in some cases.
Still no sign of anyone from the authorities calling or coming to test me despite several calls throughout the 5 days. I’m assuming that I have a light strain and have decided now that I’ll only call back if I worsen. From their side, I’m assuming that I’m low-risk as a reasonably healthy 48 year old (Wednesday was my birthday. I’ve had better parties) with no underlying conditions. Normal flu should have eased up on Day 5, but while Day 1 was like being hit by a sledgehammer, its been pretty constant since. Not better, but mercifully, no worse. I also appreciate that they’re probably very close to collapse and as they cant do anything anyway there seems little to be gained from ringing and getting angry.
The rest of Spain has now joined me in lockdown which makes the whole situation even more surreal. I don’t live on a busy street, but I overlook 2 foootball pitches, so there’s normally plenty of football sounds in the background. Not today. It almost feels like Christmas Day in that respect. The odd dog walker, but nothing and no-one else at all. Even the sky is pefectly clear. Id normally see a cris-cross of vapour trails building up by now.
I can’t help noticing how the sound of birds singing is incredibly loud. At least the rest of nature – not to mention pollution in general – is getting a massive shot in the arm as the serial polluters are locked away for a while. Id rather we’d arranged this in a more humane and orderly fashion, but how often do humans do humane? We’re better at doing things when forced.
I’m in the strange position of missing my wife and kids, even though they’re next door or downstairs (and mercifully so far OK). We have an en-suite and I’ve got a kettle and coffee maker in the room to ensure I have no reason to leave. I feel a bit like Alan Partridge in a Travel Tavern, but with less laughs. I did sneak out last night when the kids were asleep. But only to throw the bins. Yes, that was done by opening doors with elbows.
It now occurs to me that I’m not even sure why I’m writing this, but its killed 5 minutes so there’s another positive.
Have we won the league yet?
David W:
The perception of “lockdown” being the panacea for this is misplaced, When I was out in West Africa assisting with Ebola, isolation was promoted but even then ignored by some of the population with a disease that is incredibly lethal. Ultimately, containment was helped by the fact that Ebola is hard to catch.
For lockdown to ‘eradicate’ covid 19 you would need to put the whole population under virtual house arrest with total compliance, and even then due to its ease of transmission it will bounce back once lockdown is eased
This virus (and it’s inevitable variations via mutation) is with us to stay, just like seasonal flu, and in the long term latent resistance within the population will be the main factor in limiting it’s impact.
A mindset of ‘we can get rid of this’ is seriously misplaced.
Italy may or may not see a drop in ‘numbers’, but how long can they sustain their lockdown, and will it be enough to stop them rising again once it is eased.
Ding:
This “herd immunity” idea sounds, to put it mildly, rather nuts. Here is a thread from a University of Liverpool professor on the Tory government’s strategy, which is supposedly “more refined” compared with other countries:
The outline is that the UK wants to infect “particular categories of people”: “have as many lower risk people infected as possible. Immune people cannot infect others; the more there are the lower the risk of infection”. In this context, “the govt wants people to get infected, up until hospitals begin to reach capacity. At that they want to reduce, but not stop infection rate. Ideally they balance it so the numbers entering hospital = the number leaving.”
This would require “Data on infection rates needs to be accurate, the measures they introduce need to work and at the time they want them to and to the degree they want, or the system is overwhelmed.” Furthermore, kids are relatively resilient to the disease so can be used as vectors to spread the infection. (I’m not even joking that he made this point.)
This seems to based on several questionable – again, to put it mildly – assumptions:
1. The key assumption – that recovering from the disease confers immunity – is doubtful. It may confer immunity for a period of time, but it is uncertain whether that period is an indefinite one.
2. It is highly unlikely that the government can control which segments of the population get infected and which don’t. At a minimum it would require Chinese levels of invasive surveillance, resources, and curbs on mobility, none of which exist in the UK, but even then the sheer arrogance to think that you can control this is crazy. But even China probably didn’t bank on letting tens of thousands get infected and almost several thousand dying first.
3. That you can achieve the “ideal” such that the number of recovered people leaving care exactly matches or exceeds the number of infected that go into care is bordering on hubris. Very likely it’s the other way round – that the number of infected greatly exceeds the number recovering, which not only overwhelms hospital capacity but compounds the problem of infection and failure to detect new cases. There are plenty of examples of it at present.
4. And, of course, the assumption that you have accurate sensing data on infection rates – which communities, which population segments, etc – is already a failing one, given the UK’s current response capacity. To think that this will improve by taking a fairly lackadaisical approach to the disease and that your data sensing capacity won’t be degraded as the medical system comes under growing pressure is a serious error of judgment.
5. It goes without saying that using children as vectors for the disease is morally abysmal and shouldn’t be something even contemplated. Yet it is probably in line with the strategy’s unspoken point that the loss of the more vulnerable segments is an acceptable cost. Just sheer madness.
Moreover, as this article points out, the idea of “natural immunity” is insane:
Did you see a small problem between the British government’s definition of herd immunity…and what it actually is? Herd immunity is — the real thing — what happens after enough members of a population have been vaccinated. It’s not…just letting an entire nation be rampaged by a lethal virus for which there’s no vaccine. How much death and mayhem would that cause, by the way? “57 million people infected and 1.1 million people dying.” …
The human species never developed “herd immunity” to polio or smallpox or any virus, really — ever, despite millennia of death and illness and misery. Why not? Because herd immunity depends on vaccines. We vaccinate a large number of people, and then all of us are protected, because transmission rates are reduced (among other things.) Let me make the point again. The human race never developed herd immunity to a lethal virus, precisely because herd immunity is not something that emerges naturally. What happens, instead, when we let a virus simply take its course? What happened with smallpox and polio: they just rampage through populations, forever.
The British government’s Coronavirus strategy, in other words, is founded on the most surreal and astonishing kind of pseudoscience. Why is it pseudoscience? …Because herd immunity isn’t the spread of natural immunity amongst a population… You can’t use my antibodies. That’s what a vaccine is — a refined form of just such a thing. We don’t have one for Coronavirus yet precisely because the work of formulating such a vaccine in the lab hasn’t concluded yet.
In view of the above, the government’s approach basically comes down to this: do nothing rather than to try to do something and be blamed for it likely falling short, let the virus flame through the population, and take whatever losses it causes as acceptable, probably by saying that it was inevitable and going to happen anyway.
Mike B:
I can’t access Ian Donald’s Twitter thread for some reason, so can’t comment, but just to set the record straight, the article on herd immunity is wrong (and it’s not clear to me what authority the author has for writing it).
Herd immunity refers to the concept that for an infection to spread, a population must contain a sufficient number of susceptible individuals – enough fuel to keep the fire going. Or: the herd (of susceptible individuals) must be sufficiently large. Below that size, each infected individual gives rise, on average, to less than one new infected individual, and infection dies out. Vaccination programs, apart from providing protection to the individual vaccinated, aim to confer herd immunity by transferring a sufficient proportion of the population/herd from the susceptible to the immune/resistant category.
But, in principle at least, herd immunity can arise ‘naturally’ when people move from susceptible to resistant as a result of infection. However, this is almost certain to be only temporary, as new susceptibles enter the population (mostly by birth) and some resistant individuals revert to a susceptible state. Populations tend therefore to hover around the threshold for herd immunity, rising above it as new susceptibles enter the population, but then falling below it again when this new fuel creates enough new infection to create enough new resistant individuals – and so on repeatedly, accounting for the (often seasonal) outbreaks we often see with infections.
So ‘engineering’ herd immunity in the strict sense (see below) through vaccination (in itself, virtually harmless) is best-practice public health – but engineering herd immunity by ‘encouraging infection’ (clearly not harmless to many individuals) is eccentric, to say the least, and likely to be courting disaster.
On the other hand, it’s perhaps best not to see herd immunity in this strict all-or-nothing way. Just as individual immunity is not necessarily either absent or perfect, so, as the size of the susceptible herd goes down, it’s reasonable to think of the herd as becoming ‘more immune’ – such that the rate of spread of infection will slow. And if – very big if in my opinion, but worth considering – if we could somehow allow the infection to spread amongst those with virtually no chance of becoming seriously ill, while simultaneously protecting the vulnerable, then we might get the benefits of increased herd immunity at very little medical cost.
If.
Nari Singh:
What I’m starting to learn is that the UK policy was a mix of both getting people to contract the virus (ideally the healthy and young because the majority of these groups will not have any/many effects of it, and will be fine) to build up some immunity in the UK and to isolate/lockdown the country. As we start to go up towards the peak at a sharper rate, meaning more hospitalisations and urgent treatments, that’s when they introduce the country-wide isolation/stay-at-home policy, so that people who have the symptoms can isolate with their families, who will also contract it and “hopefully” build up some immunity. All the while, making sure that you stay away from the vulnerable and elderly in our society.
Then, in 3 months time, once levels are sufficiently low for the NHS to cope, or the virus is “somewhat” under control, the population needs to start getting back to work and their lives. The scientists have probably modelled that at this point, because quite a lot of the population will hopefully have had the disease and will have some immunity, they’ll not be susceptible to it, nor will they pass it around (the R no cited in the article being the average no of cases each case generates being less than 1). That leaves the NHS to hopefully cope with the people who do get it in the second wave (most experts are saying a second wave will occur).
Most of the experts/scientists are concluding that the other countries who have locked things down earlier and have suppressed the virus so far, will see it rise again when life/work resumes, and then you might have to do the whole thing again and again because each time, it’ll put a strain on the health services. This is why Patrick and Chris Whitty have talked a lot about “timing” being important on when to enforce a lockdown. It’s happened earlier because London seems to be climbing at a quicker rate than the rest of the country, most likely due to people still going in with coughs, but also being packed into tubes on daily commutes.
This is the path the UK govt have chosen, there’s nothing I can do about that, I may not agree, and there are some excellent points of why a lockdown earlier made sense too, but for me, it’s helpful to be able to fully understand their thinking behind it. I personally think in either scenario (earlier lockdown/ containment) and this herd policy have had various pro’s and cons, you can slice and dice it whichever way you want, but ultimately, it’s a grim picture either way.
The other side to this is that, I’ve heard people saying they don’t understand what the panic is about, and that “we’ll be fine” – most of them don’t even understand how this will effect society and how, whilst the majority will be fine, if you pass it on to the elderly or people with existing heart/lung conditions, it’s potentially fatal.
I’m actually not sure the majority of people are really “listening” to what’s being told. It’s as if they’re living in a separate bubble to reality. That’s pretty depressing too.
Paul Tomkins:
Will the knock-on effects basically just crush society as we know it?
Already the airlines, hospitality (pubs, bars, cafes, restaurants), entertainment and football (lower level) industries have asked for government bailouts.
It’s not hard to imagine a million people losing their jobs or having them put in stasis for 6-12 months.
The more people who get ill, the more services will be cut. Who will repair your broadband? Who will deliver your mail? Who will fix your boiler? The supermarkets were fairly normal last week, bar toilet roll shortages, but it sounds like they’ve just been gutted by people panicking, or simply by now having to feed themselves at home rather than the office or at a restaurant.
New jobs will be created, in terms of more delivery people if everyone has to stay at home, and businesses that produce medical equipment or things people use when they are housebound should prosper. Undertakers will be coining it in, assuming there’s enough healthy ones to bury the dead! Restaurants may go bust, but not ones who home-deliver.
I’ve seen pictures of people queuing outside gun stores in America, in anticipation of society breaking down – or maybe people are getting ready to become armed robbers. Obviously if tons of people lose their jobs that means tons of desperate people turning to crime. It’s difficult to think of any type of work, or entire industries, that will be totally unaffected either by absent staff or demand for what they do falling off a cliff face.
We’re gonna need a lot of people prepared to cover for the 70% of the population that will get this in the next 9-12 months, in jobs that most people won’t want to do. We’ll need a lot of creative people to think of new ways to help others. Companies like Amazon could redeem their public persona by helping in so many ways, and the super-rich tech companies could do all kinds of things to help.
But then from the ashes the super-race will emerge, the COVID-immune who arise from the illness and can do lots of important jobs, perhaps with tattoos on their foreheads that say “immune!”. For a few months they will be the new masters of the universe! 😉
There’s gonna have to be a lot more redistribution of wealth from now on, until things get back to normal. Governments will have to prioritise healthcare, or be shown the door. Communities are already coming together to help one another, although others are just bulk buying for themselves in Sainsbury’s. It’s an important reminder against our complacency and “first-world problems”, and it could make the world a better place, in time. Alas, the cost will be a lot of deaths and a lot of permanently damaged lungs. It might be nice if we could learn these lessons before it reaches such a point: both in terms of appreciating life, and also, in terms of prioritising health (and preparing for such natural disasters that were wholly predictable in terms of if, if not when).
JCP:
Hi Martin,
I see where your logic is coming from and would agree to some extent, but only if all the knowns were freely available (which they aren’t), the know unknowns were predictable (which they aren’t) and Jesus could provide the unknown unknows (which he won’t), I would be happy (which I’m not).
The ‘herd’ approach has major downsides for wealthy democracies, not least who makes the decision – if Brexit deserved a referendum, I would certainly like to have a referendum as to whether I was happy on the approach, especially as the current bunch appear totally incompetent in every aspect of government.
Would I tick the box to die earlier to benefit those who survive, probably if I could see why and what benefit it would have, but wouldn’t for Johnson’s career.
By the way, I am a 63 years of age, so at the bottom of the high-risk curve, but am relatively healthy. My wife is also a healthy 63 year old, but she works in the NHS, pretty much front line as she is a cardio-respiratory techician, who insisted this morning on going into work – on arrival she discoverd there is no protective equipment left. Her first patient coughed all over her face and them placed a facemask of their own on telling her he had a load at home.
Astounded at the lack of protective equipment for my wife, I made some phone calls. It appears that the majority of equipment is made in China, but delivery of supplies was curtailed in December (this could be nonsense, but has a ring of truth about it). This means the NHS/government had at least two months to deal with the matter.
Information, competence and honesty is all I ask, but you will not get this from the Tories.
DavidW:
@JCP
the UK government policy was the opposite of flattening the curve. They talked about ‘herd immunity’ which requires 80% of the population being immunised or having antibodies due to their being ill with the virus.
If you listen to the part of the press conference when herd immunity was first mentioned, in its entirety, it was noted as a long term consequence, not an aim. Modern misreporting and exaggeration at its best. The truth is that in the long term herd immunity will be the solution to living with this disease and that will be achieved through a mixture of exposure and vaccination. (But I would like to point out that vaccination isn’t necessarily a panacea, it will depend on what the virus does next. We have one of the most extensive flu vaccination programs in the world, but its still out there and we still catch it.)
My wife works in the front line regarding this COVID_19 and they have literally no protective equipment in hospital.
Me too, but I have aprons, gloves and FFP 3 and 5 masks to hand should I need them and even visors if the procedure warrants it. Maybe my particular hospital is better run, but I can’t rage at Boris or Jeremy over that. How long they last is another question, but that is down to people who don’t need them buying them all up to wear walking down the street. The biggest irony in terms of supplies is that the stockpiling we did pre-Brexit has come in really handy.
