Ask HN: Is UK government insane or genius? - <AUTHOR> While virtually all countries adopt the lockdown strategy to eliminate the virus spread, UK is apparently going on with 'herd immunity' strategy. It's pretty well explained in this tweet: https://twitter.com/iandonald_psych/status/12385183716516495...
Basically, the idea is to get the young infected, as the virus seems to be relatively inoffensive for young people, and thus becoming immune. Once the country reach a threshold percentage of immune population, the virus cannot spread effectively anymore, hence protecting the vulnerable ones.
My gut feeling is that this is the rational thing to do, however only in theory. In practice, people won't be disciplined about isolating vulnerable ones in the first phase, thus leading to disaster. <comment><USER3> Their reasoning is that if the only things you can do are China-style lockdown or nothing, then the disease will just resume exponentially growing the second lockdown ends, so it's pointless to do it at all.

While that may be technically right (under some optimistic, unverified assumptions, e.g. no reinfection), it's a false dichotomy. Singapore, Hong Kong, and South Korea aren't under lockdown, they're stopping the spread by just having good testing and case tracking capacity, and good hygiene. And the longer things go on, the better they're getting at doing that. If things are getting out of hand, a temporary lockdown is effective (as it was in China), to get the numbers down while building up this kind of capacity. But lockdown doesn't have to last forever; China has already lifted restrictions in most cities.

The UK seems to be ignoring this, and I don't understand why. I suspect the real logic, as some government officials have outright said, is that a completely failed response would free up money for the NHS by killing off "bed blockers".

The social _signalling_ around it is "prudent caution", in the sense that they are talking slowly and confidently while using big words. This gives some people the gut feeling that this must be the "rational" thing to do, but it's just window dressing. The plan is neither prudent nor cautious; it's recklessly endangering millions of lives. Experts in the UK are horrified; there's an hours-old petition against this with hundreds of academics already signed on [0]. The WHO has condemned it, and half the people I know studying abroad in the UK have fled the country over it.

0: [http://maths.qmul.ac.uk/~vnicosia/UK_scientists_statement_on...](http://maths.qmul.ac.uk/~vnicosia/UK_scientists_statement_on_coronavirus_measures.pdf)

<comment><USER4> I haven't checked too closely, but surely the age distribution of conservative voters is such that if they are so callous as to treat corona as a convenient boomer remover, they torpedo their own re-election chances.

So, _even if_ you ascribe to the current UK government a conspiracy-esque, cold as nails approach to just effectively _murder whole boatloads of older folks_, it doesn't actually make sense: Who would they be so cold as to just casually acquiesce to a solution that results in a lot of death, but they are still human enough to care about the country first and are willing to sacrifice the electoral future of their party?

I'm on 'do not attribute to malice that which can be explained by stupidity', modifying it slightly to 'incompetence'.

<comment><USER5> Replace "boomer remover" with "working-class-boomer remover" and the strategy makes more sense.

Personally, I don't think Johnson and his cronies are deliberately targeting this or that group. They just _don't care_. They are scared like everyone else, and are prioritizing the survival of their immediate circles _and their social status_ \- i.e. they keep the economy working, keep an appearance of order, and ensure people they care about are "cocooned", ready to come out when the worst is over. _That_ is their priority. Working-class lives are not priority, that's all. Health-service capacity woes are relatively unimportant, because people "who matter" will be prioritized anyway.

If they go to full-lockdown, they risk upsetting the existing social order (economy tanks even harder, unemployed people start rioting, etc). That is their worst fear; consider that we've had actual riots in London only a few years ago. Saving a bunch of working-class grandpas is clearly not worth the risk of upsetting the current social order, from Johnson's position. He'd rather have a functioning elite ruling over rubbles, than risk the very own existence of such elite just to save "nobodies". Add to it a sprinkle of academic Strangeloves, and there you are.

</comment></comment></comment><comment><USER6> I'm going to try and lay out the case in as neutral terms as I can, although to be clear I think they are probably right. They're going to take an awful lot of stick for it though, and indeed already are.

They believe that there are basically two mitigation strategies. One is to have a very drastic early lockdown that shuts down the virus before it spreads widely. The problem with that is, once you lift the lockdown it will simply start all over again. The problem with this is lockdowns are most effective the first time you do them, and then mostly in the first few weeks of the lockdown. Do it too early, and yes it will be very effective in the short term, but later on when cases become much more prevalent the lockdowns will be less effective.

The option they are going for is to start the lockdown a little later in the cycle. The hope is this will make the lockdown more effective at a higher point in the spread. Effectively instead of a series of booms and busts, you get one longer slower initial burn and then you're mostly done. They believe that in the long term this will make it easier to protect those most vulnerable to the virus, because you only have to do it once, at the cost of increased prevalence among people least vulnerable to it. So they see it as a better longer term strategy.

<comment><USER3> 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.

<comment><USER7> _That 's the policy of Hong Kong, Taiwan, and Singapore, who are doing great._

All of which have tiny populations compared to the UK.

For larger nations, there simply aren't enough tests available, nor enough treatment facilities for those who are likely to become very sick if the virus spreads rapidly through the population.

<comment><USER3> > For larger nations, there simply aren't enough tests available

Why? If your nation is twice as big, then all else equal, your government has twice as much money, twice as many resources, and hence twice as many tests. China now has more tests than they need and they're the 2nd most populous nation in the world.

<comment><USER7> No amount of money helps if there aren't enough tests available to buy. What is missing are manufacturing and distribution facilities, which of course are calibrated to the normal levels of work and not to a relatively sudden pandemic outbreak of one particular virus.

China has huge resources but has managed so far to keep the infection mostly contained to one specific area. It's not clear how long they'll be able to sustain that or whether they'd have enough resources to go around if all of China were the same as Hubei.

Of course all of this also assumes that tests are effective and that you can then do something useful if you confirm that a patient is indeed infected.

</comment></comment></comment></comment></comment><comment><USER8> You can read some of the rationale behind the plan here:

[https://assets.publishing.service.gov.uk/government/uploads/...](https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/215666/dh_125333.pdf)

I'll be honest, I watched the announcement on Friday in open mouthed horror. I can't claim I have a concrete refutation for either the broad logic or the specific evidence underlying it, but even the best case scenario is a disaster of historic proportions. I wish us luck. I wish the rest of the world luck if it turns out we're right and they're wrong.

<comment><USER9> 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.

<comment><USER8> Well surely the advantage here would be for us to be able to observe and exploit the hard won knowledge of countries out ahead of us, but that doesn't appear to be what we're doing.

<comment><USER9> The thing is, what the UK is doing is truely experimental compared to what China, SK, and Italy have already done. And we won't know for sure what the full effects are until the end of the current pandemic. If the UK copied the lockdown and trace playbook already implemented, once this pandemic is over we'll have no data point for the quarantine old people only strategy to plan for the next pandemic with. How can you observe whether the UK strategy will work when nobody's done it before?

</comment></comment></comment></comment><comment><USER10> There is no proof immunity will happen, the UK Gov is thinking in economic terms and worried about GDP.

[https://www.theguardian.com/education/2020/mar/13/coronaviru...](https://www.theguardian.com/education/2020/mar/13/coronavirus- school-closures-uk-gdp-ministers-warned)

<comment><USER11> Exactly. We have huge debts and our "economy" runs on the assumption that, if very little goes wrong, we might be able to stay afloat.

The time for creating choice on the cornonavirus response was during the last 20 years. They chose rampant financialisation, leveraging future income.

The UK has no energy security. No food security. I feel the corner we have painted ourselves into makes a prolonged shutdown far, far harder.

<comment><USER12> Genuinely curious about where you read that the UK has no energy security? It's not something I've read about before, but is something I'm pretty invested in as a UK citizen.

The one source I could find was [https://www.globalenergyinstitute.org/energy- security-risk-i...](https://www.globalenergyinstitute.org/energy-security- risk-index) which placed the UK in the top 3 countries for energy security (many years running).

Do let me know if you have some data that would change my mind! (and ditto for food security)

<comment><USER11> I mean to say we are a net importer of energy

[https://www.theguardian.com/money/2019/sep/01/uk-energy- pric...](https://www.theguardian.com/money/2019/sep/01/uk-energy-price-fears- as-electricity-imports-climb-to-record-high)

And food

[https://www.businessinsider.com/no-deal-brexit-percentage- br...](https://www.businessinsider.com/no-deal-brexit-percentage-british-food- imported-shortages-2019-1)

</comment></comment></comment></comment><comment><USER13> The NHS makes a huge difference. As a single entity it can pivot in a way that I wonder if other countries can come close to.

My daughters dentist commented yesterday that all her surgeries (and her team usually do 50 a week) had been cancelled. The reason? All the anaesthesiologist had been requisitioned as they will be required to do ventilation. All elective surgeries had been cancelled, and her paeds specialists sent on refresher courses for adult patients.

We're in uncertain territory here, the NHS's response may not be 100% perfect and a lot of people will argue that some minutiae could be done better, but I believe it has the huge advantage.

I wonder if other countries, and particularly the US, can manage such a coordinated healthcare response?

<comment><USER14> It's definitely at an advantage over systems like the US, but the NHS is far more federalised under the hood than you might imagine and there are lots of countries where the government or other regulators can take control of private healthcare when needed so it's not as much of an advantage as you might think.

</comment></comment><comment><USER15> Thinking about it from where I am right now, I don't think it is crazy.

Let's think about it again: China, Japan, South Korea, Hong Kong and Taiwan. They are countries which are very connected to each other; and yet, somehow, they managed to contain it. It's 'herd responsibility'. The people are applying social distancing and hygiene rules, that's why it's working.

It's possible, as a knowledgeable politician, that you recognize that it's _impossible_ to implement such measures in your country. The reasons are beside the technical abilities of your government: Your citizen are not committed enough to the hygiene. And that's not because Asians are cleaner or superior, they have been exposed to these viruses before and thus they are already trained to deal with them.

It's not the same deal for many countries of the west. We didn't have much trouble in the last few decades and thus people have forgotten why we do most of the hygiene measures in the first place.

Also, here is my first reaction, as a citizen, if the government has declared 'herd immunity' as their strategy: STAY AT HOME. I'd also probably warn the closer one and avoid contact with them too.

So the UK might win twice here: Have enough social distancing by _fear_ (and fear is a hell of a thing as you experienced in the last few days); and also have its population adopt strict hygiene and distancing rules making it safer in the future and readier for the next disease.

<comment><USER16> "that's why it's working"

It's only 'working' while the country is on lockdown, and FYI the country spirals towards economic meltdown.

If they come out of 'lockdown', then 'it stops working'.

See the paradox here?

I really have no clue: maybe we'll develop therapies, a better understanding, maybe a vaccine, but possibly this 'herd immunity' idea at least on some scale. I really don't know.

But coronavirus is not going to disappear in a few weeks, we know that.

<comment><USER15> > It's only 'working' while the country is on lockdown, and FYI the country > spirals towards economic meltdown.

Nope.

> In Taiwan, most residents carry on as normal, with offices and schools open. > Many restaurants, gyms, and cafes in the capital, Taipei, are still > bustling, although most premises will take temperatures and spray hands with > sanitiser before allowing customers in.

Source: [https://www.theguardian.com/world/2020/mar/13/how-taiwan- is-...](https://www.theguardian.com/world/2020/mar/13/how-taiwan-is- containing-coronavirus-despite-diplomatic-isolation-by-china)

<comment><USER16> 'Nope'

That Taiwan has 'less lockdown' doesn't respond to the fact that whatever the degree of 'lockdown' whenever it is removed, the contagion will grow again, and that any level of lockdown will have bad economic repercussions.

That Taiwan is getting away with 'less severe' lockdown is not relevant because:

a) They do have a really long list of measures (more than 120 published by their Gov.) that are unsustainable in the long run and

b) It's a selective example - most other nations need more aggressive.

c) Due to the fragility from 'a' and economic downturn around the world due to 'b' a deep recession is guaranteed in Taiwan.

The point remains: there is currently no rational answer to 'how to end the lockdown' while economies go down.

</comment></comment></comment></comment><comment><USER17> [https://twitter.com/AdamJKucharski/status/123882151552689766...](https://twitter.com/AdamJKucharski/status/1238821515526897664) appears to give a better explanation from the modellers.

The aim is to flatten the curve, any herd immunity is a by-product but not the aim.

<comment><USER6> 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.

<comment><USER18> > However we do not have a vaccine yet and have no idea if or when we might > ever get one.

[https://www.jpost.com/HEALTH-SCIENCE/Israeli-scientists- In-t...](https://www.jpost.com/HEALTH-SCIENCE/Israeli-scientists-In-three- weeks-we-will-have-coronavirus-vaccine-619101)

<comment><USER19> No reputable news outlets are reporting a vaccine breakthrough by the 'Galilee Research Institute'.

Serious estimates are that it will take around 18 months [0]

[0] [https://www.bbc.co.uk/news/business-51454859](https://www.bbc.co.uk/news/business-51454859)

</comment></comment></comment></comment><comment> edouard-harris 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.

<comment><USER20> (warning: conspiracy theory, but at least an original one)

I'm thinking this only makes sense in the context of Brexit. Brexit will be a massive hit to the competitiveness of British businesses... somebody in government is hoping to counteract this by taking an approach different to the rest of Europe. If the UK's approach works, it will end up economically ahead of all the other European countries, something like the US post-WWII (but to a lesser extent).

<comment><USER21> Counter-point: is Brexit Britain actually going to be worst off than post- pandemic EU or what's left of the EU?

I don't think the risk of this pandemic approach is worthwhile, especially given how poorly the EU is doing in general. Terrible economy, catastrophic pandemic response, and the symbolism of countries closing borders on fellow EU states are all quite telling.

By contrast Britain almost seems like it dodged a bullet - although they seem to have jumped in front of a train instead with their pandemic gamble.

<comment><USER22> the uk is bust - germany is injecting 600 billion in the economy, while the uk a mere 30. the uk NEEDS people to work so they keep the country afloat.

<comment><USER23> The UK can raise as much cash as Germany so it is a choice they are making.

</comment></comment></comment></comment></comment><comment><USER24> I like tomp's comment from a few days ago, feels like the UK playing a game theory [https://news.ycombinator.com/item?id=22555643](https://news.ycombinator.com/item?id=22555643)

1) no pandemic, no action -> government was "right", avoided wasting money -> reelected

2) no pandemic, action -> government was "wrong", wasted a lot of money, damaged the economy, inconvenienced the lives of the population -> voted out

3) pandemic, no action -> government was "wrong", caused loss of lives and damaged the economy -> voted out

4) pandemic, action - this is the trickiest scenario, so let's consider two options:

4a) pandemic, action, it works -> government was "right", saved lives, spared the economy -> reelected

4b) pandemic, action, doesn't work -> government was "wrong", their actions failed, they're incompetent -> voted out

<comment><USER25> 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](https://m.youtube.com/watch?v=qNjFIwRYEIo)

<comment><USER24> What's the title of the show? :D

<comment><USER26> 'Yes Minister'. There is also a follow up series called 'Yes Prime Minister'. Very funny stuff - especially if you have any insight into the public service bureaucracy.

</comment></comment></comment></comment><comment> cirrus-clouds Here is a discussion on Channel 4 on the approach taken by the UK government.

[https://youtu.be/C98FmoZVbjs?t=590](https://youtu.be/C98FmoZVbjs?t=590)

Debating are:

\- John Edmunds: a professor in the Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine

\- Tomas Pueyo: his modelling of the pandemic has gone viral on the web: [https://medium.com/@tomaspueyo/coronavirus-act-today-or- peop...](https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will- die-f4d3d9cd99ca)

During the debate, Pueyo throws up his hands in horror at what the professor says. Listening to them both, I honestly don't know who is right. You may think a level-headed response is the right approach rather than an emotional one. But there is something cold, clinical and unemotional about the UK's strategy to tackle this pandemic.

And can you "nudge" people to adopt certain behaviours in one country when the rest of the world is doing the opposite to what you advocate?

<comment><USER27> Wow, Tomas Pueyo is a self proclaimed "growth hacker" with no experience in epidemiology. I would prefer to have people weigh in on the issue that actually have more than two weeks experience in this. Everyone can have good ideas but giving people like Pueyo a platform for their self marketing must be an insult for all real experts that work on these issues.

<comment><USER28> With statements like "the markets are up", and the hyperbole of "so we're saying 'we want to kill 200,000 people'" and "killing everybody", which even the anchor has to reign him in on, Mr Pueyo seems like such a douchebag. he comes of as incredibly unlikeable (at least to me). especially compared to Mr Edmunds, who goes through how herd immunity is a good end-game in a measured and calm manner. to which he seems to offer no counterpoint. they even both agree on lowering the peak, just not on how to do that/when to do it.

edit: it seems reasonable to me to suggest not impose quarantine measures too early, to not drag those measures on for longer than necessary - that just makes it more likely people will disobey it. indeed, because a vaccine is so far off, herd immunity seems like the only plan for now.

<comment><USER29> Funny thing about this is that they don't disagree on herd immunity. They argue over optimal rate and tradeoffs (where/when measures slider should be moved).

In this rare case Pueyo credentials don't matter much as he pretty much echoes open letter from scientific community coming from Italy.

What is not mentioned is that buying a bit of time also increases a chance for many people to get treatment that is yet to be discovered/approved.

<comment><USER28> absolutely, although it's a balancing act. there's also a mental health component to isolation/quarantine, and how do you measure that? it's a tough and complex call in any case, and i'm glad i don't have to make the call.

</comment></comment></comment></comment></comment><comment><USER30> I think we (UK) are trying to be too cute about managing the curve, like we can ramp it up to the capacity line then slam on the brakes with the big measures at exactly the right time and keep it ticking along there nicely through the spring and summer and have this thing wrapped up by the end of the year. It could all go very badly wrong.

I get the impression we're being overly influenced by a few gurus of behavioral science, a field which must surely make even experimental psychology look replicationally robust, and in particular by 'nudge theory', for which our politicians have a particular penchant. I also gather we war- gamed this exact scenario two years ago, which may have led to a degree of overconfidence amongst some key players.

<comment><USER31> I would be on board with the UK plan if it was more proactively protecting the at risk population.

Why aren't large events stopped? I get one infected person won't infect a whole stadium... the main thing for me is people from all over go to these large events and so there is a high risk of introducing the virus to new areas by having them.

There should be more testing and local alerting. It would keep people on their toes and help individuals be more aware of potential risk around them.

At risk groups should be making use of social distancing at a minimum.

Even with this it seems risky. That said I understand the approach and reasoning. The implementation - so far - seems half baked and risky as hell.

<comment><USER20> And now more details of the plan are trickling out - over 70s being advised to stay at home (but not yet), etc.

At every point people will ask, "if cancelling large events/closing schools/WFH would have helped, why didn't you announce it weeks ago instead of now?"

Plus, it isn't as if people are actually keeping calm and carrying on. Their shopping has been disrupted, half their friends are staying home (despite no government advice to do so), they can't visit their doctors in person any more, and everybody is stuck to the news. Productivity in offices has dropped due to the anxiety and uncertainty, and I don't think Boris' "life goes on as normal for now but that may change later" speech late Friday has done anything to prevent that.

</comment></comment></comment><comment><USER32> My intuition on this is that any strategy that relies on rather precise targets to hit in terms of infection rates is doomed to fail. There is simply far too much uncertainty about the exact properties of the virus, the behaviour of the community and the effectiveness of the various measures that are employed to try to contain or mitigate the pandemic.

The incubation period is something like 5-6 days on average, it'll probably take at least another day, likely more to get test results. So you're always at least a week behind when you're trying to examine the results of your actions, and the pandemic spreads at an exponential rate if no containment or mitigation measures are preventing it. If you get this kind of strategy wrong, at the point where you're noticing it you will have doomed your healthcare system and your population.

It is the nature of exponential spread that you will have to act before it is obvious, and that if you don't do that it'll be far too late once you notice that.

</comment><comment><USER33> It looks like to me just a comfort pill for the public. They basically acknowledged that they can't handle the crisis already. So what they gonna do? They want it to appear to be an advice from expert, to persuade the public, rationalize a forced decision.

The uncomfortable truth is, the British government have weighted cost and benefit, and they have decided, the death of thousands or more is not worth the cost of near-absolute lockdown of a country, It might lead to total breakdown of the economy, full-recession, and that may cost more lives anyway. These elder people are old enough anyway, and the death rate for young is just 0.2%. (which rise to 1.3% for people elder than 50, and 6% for elder than 60 according to data from China)

What does those number mean? If you and your partner's parents are elder than 60 years old, there is 25% chance, at least one of them will die. That is, very likely, you're going to hear it from your best friends that one of their parents died from COVID-19. Are you okay with that? (Under the assumption everyone will get infected anyway). And beware, these statistics are not final, and mostly from patients who received some level of medical care, although we do not yet know how many of those heavily-ill patients received intense care. Without medical care, the number could easily double, after all, it takes time to die, that's just how lung disease works.

<comment><USER34> _The uncomfortable truth is, the British government have weighted cost and benefit, and they have decided, the death of thousands or more is not worth the cost of near-absolute lockdown of a country, It might lead to total breakdown of the economy, full-recession, and that may cost more lives anyway._

And so begins the Great Reaping. Get rid of the old and the sick, so the nation can move on, freed of the burden of caring for an elderly population that consumes but does not produce.

<comment><USER35> isn't the current government disproportionately voted in by the old? It seems somehow short-sighted this.

<comment><USER36> They will be replaced by the next set of old. A population can always be segmented, they might just not be as old as before.

</comment></comment></comment></comment><comment><USER37> Modelling disease spread seems like the kind of scientific endeavour that one can dedicate one's whole life to becoming an expert in, and many people presumably do. Considering that, why should anyone give much credence to a random medium article on the topic by a 'silicon valley tech executive'? (lol)

There are 10's of thousands of scientific research papers [1], by scientists, on COVID-19 already, and this guy is just some tech exec who knows how to play with a jupyter notebook. I see no reason to pay much attention to him.

[1] [https://twitter.com/freereadorg/status/1236104420217286658](https://twitter.com/freereadorg/status/1236104420217286658)

<comment><USER3> Because the models the government's epidemiologists are using _explicitly_ don't account for all possible actions.

Back when this was taking off in China, a bunch of epidemiologists came out and said it was completely uncontrollable there. They were wrong, because they hadn't accounted for the extreme actions the Chinese government was willing to take; it was not even a possibility in the models. The same story repeated itself for Hong Kong, Taiwan, Singapore, and South Korea. They defeated the models by taking effective actions that were "out of the training data" for epidemiology. Given these 5 examples, there's no reason other countries can't defeat the models too.

<comment><USER38> These may be legitimate criticisms of the UK government's epidemiologists - I'm not in a position to judge - but I'm not sure it explains why we should be listening to Tomas Pueyo on the matter.

<comment><USER3> Well, you don't have to. There are plenty of actual epidemiologists unhappy with the government's actions. Just because Pueyo was arbitrarily chosen to represent one side doesn't mean professional support for that side doesn't exist.

Honestly, choosing a bad representative for a position is a classic media tactic for unfairly discrediting that position.

</comment></comment></comment></comment><comment> tuna-piano I don't understand how Europe+US governments (and epidemiologists!) say things like "It's basically inevitable that 40-70% of our population gets infected overtime". It feels like the Western countries gave up without even trying.

But yet, there's at least temporary evidence among several Asian countries (South Korea, China, Singapore, Taiwan, Hong Kong) that it's possible to get the R0 < 1, the infection rates to shrink, and seemingly be well contained well before any herd immunity effects happen.

In the US we spent only $7B to fight the virus but yet hundreds of billions to manage the economic impact. And yet, our companies/people will still suffer economically and humanitarily.

In an ideal situation, in ~8 weeks, Italy/US/Europe will only have dozens of new cases per day and will try extremely hard to contain these limited new cases and their spread. The only difference between Early Feb and Early May in these places will be that we had 3 months of potentially avoidable economic and humanitarian destruction- just to teach us the problem was serious and give us time to prepare systems to contain.

If the successful Asian countries (specifically Taiwan, Singapore, Hong Kong, but also South Korea) show that this was possible to keep small, the voters in the Western countries should demand accountability from their scientists and government leaders.

<comment><USER39> The voters have the leaders they deserve

</comment></comment><comment><USER40> Insane. Here's the key line, from one of the people in charge of that clown car:

"There's going to be a point, assuming the epidemic flows and grows, as we think it probably will do, where you'll want to cocoon, you'll want to protect those at-risk groups so that they basically don't catch the disease and by the time they come out of their cocooning, herd immunity's been achieved in the rest of the population."[1]

Here's the thing about this: it's plainly moronic. Because this strategy only works if they can _identify the point in question._ And there's no universe in which a government can identify that point under incomplete information and exponential growth. It's the sort of thing that only a psychologist who has spent too much time hanging out with Cass Sunstein and other believers in the omnipotence of the administrative state could possibly come up with.

[1] Quoting a psychologist in charge of something called the "behavioral insights team" in [https://www.theguardian.com/world/2020/mar/13/herd- immunity-...](https://www.theguardian.com/world/2020/mar/13/herd-immunity- will-the-uks-coronavirus-strategy-work)

<comment><USER41> _Because this strategy only works if they can identify the point in question._

Why wouldn't they, they know the rate of new cases. When it's low enough they lift the quarantine. Out of all the problems this seems the smallest to me.

<comment><USER40> They don't know the rate of new cases. They know the rate of observed new cases. They don't also know the innumerable little connections that are hard to lock down across and within age groups.

This is the sort of thing that confounds centralized state policy. Read, among other things, James C. Scott's _Seeing Like a State_

<comment><USER41> Then start testing people from the population to see who has had it and who is currently infected.

 _This is the sort of thing that confounds centralized state policy._

The UK isn't America.

</comment></comment></comment></comment><comment><USER42> I'm pretty confident they'll start copying everyone else in 10-14 days.

They are ignoring any sensible model of this and they won't be able to deal with the uproar once the numbers reach a psychological threshold. Happened last Sunday in Spain BTW.

<comment><USER43> 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.

<comment><USER42> I think it does, you don't wait a week to put out a fire, it gets worse. China has essentially contained it already. Maybe alternating lockdowns and releases we might be able to keep it manageable until there's a vaccine.

This is not hard to model once there are a few cases in a population, again IMO.

<comment><USER25> How much does every day in lockdown hurt the economy?

Flattening out the infection curve too much means increasing the economic harm by a much larger degree.

Calling a lockdown a week too early, means continuing it a week extra on the other end or you risk a sudden, unmanageable peak.

I don't envy any politician the decision, but pandering to panic and locking down too soon will cause a lot of harm too.

<comment><USER42> I'm somewhat puzzled about this doomed economy idea. Many businesses are doomed of course, but some opportunities arise: economy changes, it adapts to the environment. We've been building the perfect tool for this scenario during the last 25 years, if we manage to sustain the logistics the economy won't stop. Had this happened in the early 90s we'd have been in deep trouble.

<comment><USER25> Reduced spending on leisure, tourism, travel, etc, less decisions made because no meetings, etc., will MASSIVELY outweigh any opportunities.

Even putting aside the sick leave, which will happen either way.

</comment></comment></comment></comment></comment></comment><comment><USER44> The other countries are going for herd immunity too. The goal of all lock- downs and red zones is just to prevent the health system from collapsing.

<comment><USER45> Merkel apparently is trying to (or tried to), but was more coy about it. But none of the technocratic Asian governments seem to.

</comment></comment><comment><USER46> Okay so here is my dispassionate take on it.

1) everyone (>= 60% of population) will get it

2) the modelling that's been done by the British government is probably very good and almost certainly includes more variables than the shut it all down countries

3) we don't know enough about how the virus operates but we might know enough by the time peak cases occurs in the UK

4) It's very likely to come back in China et al, they think in the Far East it's under control but it only takes one person arriving in Beijing to reignite the problem and you're back to square one

5) they are trying to limit peak deaths including a lot of factors I have to assume that is their strategy

6) do you go with the models that give you a way to return to some normality sooner?

7) what is the best case outcome according to the best scientific models we can get? It's very easy to just do what everyone else is doing without thinking through the best path.

8) I actually trust the people thinking about this issue, I know it's hard to believe but I do think the UK government is going with a view that there are more factors than are immediately apparent in this equation.

9) will the UK turn out to be right that stopping this permanently will involve herd immunity. Unfortunately the American/Italian/Western society situation means stopping this virus will be impossible so you then start calculating if you want international travel to continue how can we keep our societies interconnected?

My guess is based on a lack of information and a load of assumptions about this, but I think it'll prove to be the right decision medium term. We are going to be in this thing for some time, some countries much longer than others.

</comment><comment><USER47> I strongly disagree with the approach in the UK. We should be following the WHO guidelines and the rest of Europe

It feels like we're the big version of one of those corona-virus cruise ships

</comment><comment><USER48> The government isn't going with a herd immunity strategy. It's waiting for the most impactful time to lockdown.

<comment><USER49> 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.

<comment><USER50> This is not updated for March, but here's a chart that disagrees. China's new cases started dropping after the lockdown: [https://miro.medium.com/max/9350/1*r-ddYhoUtP_se6x-NOEinA.pn...](https://miro.medium.com/max/9350/1*r-ddYhoUtP_se6x-NOEinA.png)

From [https://medium.com/@tomaspueyo/coronavirus-act-today-or- peop...](https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will- die-f4d3d9cd99ca)

<comment><USER49> I think the core message of Tomas Pueyo's blog post is sound, but he undermines it completely with the number juggling.

He's not a specialist. He's not an expert. This is an entrepreneur who knows how to create viral content. His previous blogpost was "How to deliver a funny speech".

So, I wouldn't accept the details, the number or the graphs he has cobbled together at face value. This is true for pretty much anything that is published on medium.com and doesn't come from a sources verified by experts or officials.

While people are slightly optimistic about China and South-Korea, I think it's far too soon to try and make any detailed forecasts on how the next few weeks will pan out. We simply don't know enough yet. All we know is that this is an infectious disease spreading at a lightning speed. Stay home, and adhere to WHO and health administration protocols. That's all there is to do right now. Anything else is conjecture until this has played out completely in a few weeks time.

</comment></comment></comment></comment><comment><USER51> Here is a link to the Coronavirus Action Plan on GOV.UK: [https://www.gov.uk/government/publications/coronavirus- actio...](https://www.gov.uk/government/publications/coronavirus-action- plan/coronavirus-action-plan-a-guide-to-what-you-can-expect-across-the-uk)

I would suggest anyone read this and other official publications before any Twitter thread to understand the UK government's approach to the virus. Large, complex decisions are hopefully not made off of a few hundred word summary of the situation.

<comment><USER52> That document says "Published 3 March 2020" \- do you know if it still reflects current government thinking?

<comment><USER51> It is still linked on all of the relevant sites. [https://www.gov.uk/guidance/coronavirus- covid-19-information...](https://www.gov.uk/guidance/coronavirus- covid-19-information-for-the-public) is a page with more frequent updates.

Specific local health authorities probably have the most up-to-date information for any given geographic area.

</comment></comment></comment><comment><USER53> One region of Italy is close to their ICU beds limit, despite a full lockdown. And they have more beds per person than the UK. Without a full lockdown, won't they run out of beds very quickly, thus increasing the death rate a lot?

<comment><USER54> 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...)

<comment><USER55> Are we sure that you're immune once you've been infected?

<comment><USER56> We only know that you are likely to be immune for six month. Whether you will have life time immunity is anyone's guess.

<comment><USER57> Citation needed.

</comment></comment></comment></comment></comment><comment><USER58> This strategy is not insane only if there is also a concerted effort to protect those who are vulnerable while the virus spreads. The problem is there isn't one. At all. None. Zip. Zero. Some care homes are, off their own back, banning visitors but apart from that the old and the vulnerable are not being asked to self isolate or engage in social distancing, only those who have symptoms themselves are being told to self isolate, and not members of their households. Social clubs, churches, pubs, cafes, day centres, restaurants etc. where a lot of older people congregate are all still open. None essential home visits have not been curtailed and people are not being advised to socially distance themselves from the vulnerable.

<comment><USER59> ^^^ 2000% this, a large proportion can't change their ways, is not paying attention or simply doesn't care. It's shocking to still tonight walk past a packed pub on a Saturday night

<comment><USER60> Personally, I'm 30, have no contact with folks over 65, have no co-morbid conditions and so I have no reason to keep away from folks. I'm at zero risk. In fact if I get it now and develop an immunity, all the better. I have to assume the same is true of the folks at the pub -- otherwise it's them who are being irresponsible, not me.

<comment><USER61> I've seen this attitude quite a lot among younger people lately, it's just super irresponsible and arrogant. In a situation like this, the responsibility must be shared, no one should consider themselves free from the responsibilities of stopping the spread this virus.

<comment><USER62> > In a situation like this, the responsibility must be shared

Why not in other situations though? The elites avoid taxes, Boomers have houses, banks are pumping up the asset bubble, while young people have student debt, can't buy a place to live (or even a car), have no assets and, if they're lucky and productive and high-earners, they "enjoy" 20% higher tax rate than owners of capital... Why exactly should _anyone_ now act in a way that is detrimental to themselves, to save some other predators?

<comment><USER63> You might find T.M. Scanlon's _What We Owe to Each Other_ interesting.[1]

[1] [https://www.scribd.com/document/127602229/Scanlon-1998-What-...](https://www.scribd.com/document/127602229/Scanlon-1998-What- We-Owe-to-Each-Other)

</comment></comment></comment></comment></comment></comment><comment><USER35> I do wonder if this decision doesn't have a Brexit component, the transition period will be over the end of this year, so I guess that is when the real bad stuff from Brexit will start becoming clear, if you mess up your economy the year before by lockdowns then what happens when things go really downhill?

If you don't lockdown, and other countries do, can you somehow benefit? I would say no that doesn't make sense but I somehow have the feeling that the people who currently lead the UK do not share my understanding of what is reasonable in any way whatsoever so maybe they would have a Baldrick level cunning plan in mind?

</comment><comment> q-__-p I think it would be rational if we knew more about the virus, but we really don't know much, given how new it is. There could be long-term health effects from contracting it, but we just don't know. The UK seems to be making a lot of assumptions, which may not bear out. +1 insane.

<comment><USER64> 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.

</comment></comment><comment><USER65> It's totally insane and I am amazed more people in politics and the media aren't calling it out. Other countries have already demonstrated it can be contained with rapid testing, tracing and limited lockdowns so why are we doing this?

Lets assume 60% of the population are to catch it, they have said they want the worst of it over by the winter. That's 40 million people. If 5% need an ICU bed and the average ICU stay is 2 weeks (both conservative numbers) and infections are spread out perfectly over the next 8 months we will need 125,000 ICU beds, the NHS has something like 5,000 and most are already used for non-coronavirus patients.

You run our of ICU beds the fatality rate is going to rocket, more like 3-6% then 1-2% and we are looking at deaths of 1.2million - 2.4million, let alone all the deaths that come from a completely over-run NHS.

How can you describe a plan that will allow the collapse of the NHS and the death of millions anything other than insane?

</comment><comment><USER66> The UK approach is highly interesting. It's assuming that a government telling people to social distance themselves is highly effective. You then direct the elderly to social distance themselves; they are mostly protected from the virus; it runs rampant through the general population; and after a two months of relatively mild, mass cases among the young, you've effectively built a herd immunity firewall around the elderly.

Three possible issues:

1) Telling people to social distance themselves has a weak effect, not a strong one. In that case, the fire burns through the young population and burns through the old population, and you end up with a pile of flaming corpses.

2) I don't know if herd immunity of the young population is enough, epidemiologically, to give herd immunity to an older population. Old people can pass it to each other, and their day to day interactions are disproportionally among the elderly. So you risk an older subgraph all catching it at once still. I don't think this is a big risk compared to 1).

3) Individuals don't develop an immunity. This would be disastrous for this strategy. Then again, it's disastrous for all strategies.

The first issue seems like the biggest issue to me, and I think it's pretty damning. If that's the case, the elderly never have the protection of herd immunity, and you're not flattening the curve but sharpening it.

Another possibility: the government knows it won't work to seriously change the number of deaths, but it also believes all measures possible in Western countries are likely to fail. In that case, you immolate the elderly population as fast as possible and then get used to a new norm instead of spending months in a futile battle. Essentially, it's possible that even with heroic efforts that the curve can only be flattened a bit, so it's just a matter of timing the deaths and how long you want to be enduring terrible economic damage. And if every other country suffers pretty much as much as you do, political impact is limited.

<comment><USER3> It is indeed highly intellectually interesting to observe... and absolutely terrifying to experience. It will give the world lots of interesting data, in precisely the same sense that the WWII Axis biological experiments did.

God help the British people. I'm so glad I moved out of the UK half a year ago.

</comment></comment><comment><USER67> I remember when I was a kid, I didn't really understand refrigerators. Like I knew that the cold would eventually leak out, so how was it cold inside if the cold would eventually leak out? How does insulation even work?

So, I eventually figured it out. The insulation slows down the heat transfer. The fridge still has to do work to keep cold, but the insulation means that it can keep up with the losses and spend less energy on that.

The countermeasures to COVID19 are like that. The virus is going to spread, but we still need to slow it down, so that the healthcare system can deal with individual cases, and not a flood.

Some people are going to get it, but that doesn't mean we have to be fatalistic about it. We should take it seriously, but also rationally.

</comment><comment><USER68> Isn't there a higher likelihood for the virus to mutate if a large population gets it?

<comment><USER69> I also wonder about the virus laying dormant in the body and reinfecting like shingles or for example.

</comment></comment><comment><USER70> Is there even conclusive proof that people can be immune from the virus after being infected?

<comment><USER71> I think I even heard of people getting re-infected after having been cured

<comment><USER19> Opinions vary. Dr. Amesh Adalja is an infectious disease specialist, who thinks it's more likely that this isn't the case, and that it was just the impression given by false-negatives from the tests. (That is, if you test someone 3 times over 3 weeks, and see _Infected_ , _Uninfected_ , _Infected_ , it could either be a false negative, or a reinfection.)

I'm afraid I don't have a written source, I heard it in this interview podcast: [https://samharris.org/podcasts/191-early-thoughts- pandemic/](https://samharris.org/podcasts/191-early-thoughts-pandemic/)

</comment></comment></comment><comment><USER72> We have no long term effect data on Covid-19 so it's absolutely insane to do anything but minimize infection rates.

</comment><comment><USER73> According to other famous virologists, this is a risky strategy to play. This is an RNA virus, this means that you cannot safely assume that the population will be immune after the first infection.

<comment><USER74> Could you cite these sources please?

<comment><USER75> He just means that RNA mutates more than DNA during replication, which you can learn from Wikipedia. That's why flu keeps coming back every year.

<comment><USER74> Thank you!

</comment></comment></comment></comment><comment><USER76> I suggested this a few days ago and it was not a popular idea, but if you can enforce a sufficiently strong quarantine for the elderly, I believe this could decrease the total number of deaths (although the total number of infections will be higher than with universal social distancing, the faster it spreads, according to most simulations).

</comment><comment><USER77> There are already some reports of re-infection. It may be that immunity isn't so easy to build for this virus. Not enough is known about it yet. This is a huge gamble.

<comment><USER78> What reputable officials are on record regarding re-infection, please?

<comment><USER79> I don't think there is any evidence of reinfection. What seems to have happened in some cases is that a person's symptoms have dissipated but resurfaced a bit later. In other words, the patient thought they had recovered when they hadn't.

That said, the chief scientific officer has stated that this is likely to be an annual virus: [https://www.telegraph.co.uk/news/2020/03/13/coronavirus- outb...](https://www.telegraph.co.uk/news/2020/03/13/coronavirus-outbreak- likely-annual-virus-says-governments-chief/)

</comment></comment></comment><comment><USER80> The idea of not testing except the most serious cases, wait for herd immunity is starting to attract criticism from many scientists

[https://www.bbc.co.uk/news/science- environment-51892402](https://www.bbc.co.uk/news/science-environment-51892402)

</comment><comment><USER81> I think they're taking more or less the right approach. I do think they could have gone further and banned big events and told anyone with cold or flu to stay at home for 7 days (instead of with specific symptoms).

It's already too late to ban travelers, and will do more damage than benefit. Well it's possible to score political points by closing borders, the damage it will do the economy is not necessary.

Countries like New Zealand and Israel are so isolated from their neighbors they may benefit from closed borders, but tbh it feels like more short term planning when what we need is long term thinking. What happens in 2 weeks when the crisis is still unfolding?

I wouldn't be surprised if more cases pop up in China in new locations because of the nature of this virus (delayed feedback system)

<comment><USER41> Most of the big events seem to have decided to shutdown on their own, I'm not sure a ban would make a huge difference now.

</comment></comment><comment><USER82> I'll go out on a limb here and say that this sounds "Dr Strangelove" level bad. Like, phenomenally cavalier.

They need to release the data and assumptions they're basing their simulations on, because this _will_ affect the entire world, not just the UK.

The current numbers have COVID-19 at something like 20x more deadly [than the flu] for people under 50. It's not _nothing_. At scale, that's a lot of people dying. Those numbers are also a reflection of the treatment being done in all the other areas of the world right now. Does their model adjust for an increased mortality rate that would surely occur in an overwhelmed medical system? Are they assuming a nearly perfectly executed quarantine of the elderly?

They need to share their data and assumptions.

</comment><comment><USER83> One question here: Do we have any scientific way to verify which strategy works? I been waiting for related research that can either proof or disproof the usefulness of the "Lock-down strategy" which China been using in the past couple of months and still not fully lifted.

We had little less than 30 total cases in our city with just over 1 million population, and the city was in lock down mode for few weeks. I can feel the slow rise of living costs during that period of time.

It's quite funny to see how people reacts to this, panic-buying all the face masks for example. Makes me think whether or not it's worth it to go full-out panic, because panic usually creates way more chaos/problems than the problem itself.

</comment><comment><USER84> There is a huge flaw in this thinking which is that the disease takes about 5 days before symptoms and another 5 before hospitalization.

And many places put the virus doubling time in several days. So the hospital situation will get 5x to 20x worse after they initiate lockdown.

</comment><comment><USER85> I feel like this is what Sweden is doing without saying it. They have stopped testing anyone except the elderly, severely ill, or healthcare professionals. It kind of seems like they'll just expect most of us to get it with only mild symptoms since it's out there now anyway, and confirming a mild case isn't really going to change treatment. At the same time they are stopping gatherings of over 500 people and telling people to stay home when sick. Many people are now working from home, but schools are still open. But without testing people and proper statistics how do we know when it's safe to resume gathering, or go back to the office?

</comment><comment><USER86> You can't do this without adequate testing. If you can do tens of thousands of tests per day, and you're testing everyone, then you can potentially control the rate of infection by opening and closing public places and schools, etc. But without testing you won't know and the goal of not putting strain on the NHS will fail.

Places like the US are completely in the dark because of incompetence, but once we have the visibility as to who is sick, and having widespread testing, then I think this might make sense. Heck, if I knew I would have access to a critical care bed if things got bad, I would probably volunteer to get infected now.

</comment><comment><USER87> lol it sounds more on the insane side to me. you have to have a thought out plan to protect the vulnerable and do exposure in "phases", but has that ever been done ever?

and even if you are young and healthy why would you knowingly expose yourself to something that, while wouldn't kill you could put you in a life threatening situation, regardless. i know there are probably way more statistical higher ways to die, but there's a reason i don't go rubbing my face in a sick co- workers hand. even the flu symptoms are no joke.

i've heard that there's a chance of re-infection, but not sure how accurate that is.

</comment><comment><USER88> unless the world plans to stay isolated until there is a cure this may be the alternative that doesnt also bankrupt a lot of businesses and put people out of work.

<comment><USER89> 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.

<comment><USER54> It is very much more likely that, as it mutates, it will be to a less-deadly virus.

Evolutionary pressure works that way -- as a less-deadly version will spread faster and outcompete a more-deadly version (because it won't kill as many hosts -- dead hosts cease spreading -- and because less-ill hosts are less likely to stay in bed until better, thus encountering more people and thus more spread)

This is why, broadly, endemic diseases like influenza become less lethal over time

It's why severe influenzas are usually those that just mutated to cross over to humans from some other animal -- like swine flu from last decade, which was not that deadly to swine, but remarkably so to humans those first seasons, or avian flus which also have appeared occasionally.

The Spanish Flu was one of those -- an Avian flu that had newly mutated to infect humans.

<comment><USER90> Spanish Flu mutated into a far deadlier version over time because it spread faster in hospitals and troop transports than on the streets. We may see a similar situation with corona virus if the quarantines and social distancing are too effective. Ideally, we want most cases to be transmitted from the weak cold-like corona virus cases, not the lung-infesting killer cases.

[https://en.wikipedia.org/wiki/Spanish_flu#Deadly_second_wave](https://en.wikipedia.org/wiki/Spanish_flu#Deadly_second_wave)

<comment><USER54> To quote that article:

In civilian life, natural selection favors a mild strain. Those who get very ill stay home, and those mildly ill continue with their lives, preferentially spreading the mild strain. In the trenches, natural selection was reversed. Soldiers with a mild strain stayed where they were, while the severely ill were sent on crowded trains to crowded field hospitals, spreading the deadlier virus.

<comment><USER89> Given that, the UK policy seems to make more sense now, thank you.

</comment></comment></comment></comment></comment></comment><comment><USER91> There is evidence from China and Korea, that you do not build immunity from the disease.

[https://archive.is/Gv1iu](https://archive.is/Gv1iu)

This makes the UK response almost as bad as doing nothing at all. Maybe some people will show to have a natural immunity, but many people will die. The UK is in arrears politically and socially. There honestly is no response that would be appropriate, that they could hope to deploy.

</comment><comment><USER92> > _the virus seems to be relatively inoffensive for young people_

Not enough is known about the long term effects of this virus. There are reports that those who recover are experiencing reduced lung function [1].

[1] [https://www.sciencealert.com/even-those-who-recover-from- cor...](https://www.sciencealert.com/even-those-who-recover-from-corona-can- be-left-gasping-for-breath-afterwards)

</comment><comment><USER93> Lockdowns are just to decrease the rate of spreading (and avoid high concentration of virus particles) not to eliminate the virus, so everyone should prepare oneself to face it and get through. Just this.

Some small percentage of population in isolated regions have chances never meet the virus, but hiding is not the stable strategy.

Getting through and become immune is. This is what UK government is saying. Let's face it.

<comment><USER94> Sounds like you may not have heard about the importance of "flattening the curve" yet

[https://www.statnews.com/2020/03/11/flattening-curve- coronav...](https://www.statnews.com/2020/03/11/flattening-curve-coronavirus/)

<comment><USER93> As any third-worlder knows perfectly will, everyone is on your own.

Aside from that, there are so many different factors (variables) that this oversimplified model is almost useless.

Every place, except China, which locked down a whole magapolis, will reach overcapacity of hospitals very quickly and UK government advisers know this.

'Flattering the curve' is a nice catchy meme though.

</comment></comment></comment><comment><USER95> I watched a presentation/session by Norwegian directorate of health that included some comments from Italy [1]. I think they shed some light on the mortality rate - in effect 50% of those intubated died. And they were some percentage of those needing icu care. Assuming the icus are overrun, and all ventilators taken - _all of those patients_ would be dead.

So (given the size of population, and relative lack of ventilators) - in an actual uncontrolled spread, I think we will/would see much higher mortality rates than we've seen so far.

I hope the UK won't be the first to prove that (I suspect the US might be the first to do so). Or indeed, maybe Iran already has.

I heard there was mentioned that in areas hard hit in China, where low(ish) mortality rates were reported, they were also desperately seeking more people for

[1] in English, starts at 4h mark: [https://youtu.be/LtWti5prxzg?t=4h](https://youtu.be/LtWti5prxzg?t=4h)

</comment><comment><USER96> FWIW, I submitted this earlier today:

 _When an epidemic outbreak such H1N1, Zika or SARS viruses occurs, containment measures may seem to be the most reasonable solution. However, an EPFL study casts doubt on that idea, showing that such measures make a society less resilient and less able to return to pre-epidemic economic and social conditions. The study, published in Nature Scientific Reports, coincides with another publication on the same subject but based on other mathematical models, published in Nature Physics in December. That study also compared the advantages of containment measures with those of non-intervention, and reached the same conclusion: Preventing travel and social interactions is not always the best way to deal with an epidemic outbreak._

[https://phys.org/news/2018-01-epidemics.html](https://phys.org/news/2018-01-epidemics.html)

</comment><comment><USER97> and causing the deaths of >80 year olds, thus reducing the costs of dependency on the health system? #consipracy :)

<comment><USER98> However this age group is also predominantly conservative voting so they would not want to off their core support base.

<comment><USER41> On the other hand the next election is nearly five years away, by then most of them will have fallen off their perch anyway.

</comment></comment></comment><comment><USER99> It's hard to say, especially when you consider that the NHS has had its funding cut for years, and that even with a full lockdown it is likely to struggle even with a modest rise in patients over time.

This might sound dark, but as others have said, it feels like the government would rather see the country overwhelmed over a short amount of time, compared to a prolonged battle where their failures in healthcare will be highlighted.

I won't pretend to be a virologist, but one thing I will say is that it is wishful thinking to assume that the elderly are going to go into lockdown as the rest of the population builds an immunity. There is a level of arrogence and entitlement, mixed with regular doses of misinformation, that will ensure that the UK public will "keep calm and carry on" throughout this entire mess if there is no enforced lockdown.

</comment><comment><USER100> I think this is really a battle against ignorance. Until people see results in front of them they aren't going to respect these rules without authoritarian measures.

Best is to shut everything down for a month THEN let 40s and under back to work. By then, hospitals will have been overrun but hopefully on the upswing and people will be a lot more sober and willing to listen.

I imagine once the shutdowns happen and reality sets in, people will not want to go out and expose themselves willingly and politicians will rather keep everyone locked up as long as possible, but that is a mistake too. Everything hits with a 2 week lag so it is import to trust the trends and the analysis rather than the current situation - I expect us to be too conservative on the way out just as we have been too cavalier on the way in.

<comment><USER16> " Until people see results in front of them they aren't going to respect these rules without authoritarian measures."

Doubtful.

Here in Montreal, the streets are bare. Restaurants are at 50% capacity, there is no toilet paper anywhere.

We only have ~100 official infections in 30M people.

People are taking this pretty seriously and at least as far as 'not going out' and 'social distancing' it's going to be relatively easy to enforce.

There are few 'draconian' measures being taken by any government really anyhow.

I think we'll be doing this for 6 months at least.

</comment></comment><comment><USER101> The UK government is criminally insane to the point that they should be locked up and shot.

For every person who would die in the normal course of the disease, around 3 more needed hospitalization. The Wuhan experience showed that when hospitals are overwhelmed and cannot put them on ventilators, the fatality rate roughly doubles.

The UK course of action is guaranteed to overwhelm local hospitals. At which point even if half the vulnerable population does not get sick, you have as many fatalities in that group as you would have if the rate of spread was reduced.

Worse yet, it is currently unnecessary. Both China and South Korea have demonstrate that aggressive containment and quarantine efforts can result in exponential declines in the disease. As a result we should not yet be giving up hope that the disease can be contained, avoiding mass casualties. And even if we did want to take the UK approach, you could always switch to it after you had demonstrated that you can't contain the disease.

<comment><USER102> > _The UK government is criminally insane to the point that they should be > locked up and shot._

This plan may end up with a coup once the body count starts racking up and people get angry.

BTW. this new plan reminds me of the plot of "V for Vendetta" movie.

(spoiler below)

In it, a fascist government took over by causing an epidemic that killed a hundred thousand people, used that to get itself into power, and promptly buried the evidence.

</comment></comment><comment><USER103> This idea that the primary aim of the UK Government is herd immunity is plain wrong. The primary aim is to flatten the curve with specially timed interventions and any herd immunity is a by product of that. The aim is to flatten the curve so that the systems are able to cope better.

Herd immunity will be a by product in almost every western countries actions today. Ask them and if they are honest they will say the same that it's a long term effect but not the primary driver or the main aim.

The difficult non sound bite criticism is about the flattening of the curve based on their models which basically means they need to get both the timings and the interventions spot on for it to work correctly. Dont let fear win

</comment><comment><USER104> The Italian strategy is simply to try to prevent running out of ICU beds or at least minimize the number of people that can't get IC in the short-term due to the current uncontrolled spread.

As far as I can tell, what to do long-term is still up to debate, and continuing the lockdown only for higher-risk/older people is certainly an option.

Note however that jumping straight to such a differentiated lockdown seems much less likely to work, because behavior changes are easier in a total lockdown with full media and discourse focusing on it, as well as much easier enforcement since you don't have to distinguish the high-risk people.

</comment><comment><USER105> A sudden surge of infections will overwhelm the health services, number of available hospital beds, ICU units, and ventilators. This means that many more people will die that would have otherwise survived if the spread of the virus was slower and treatment was available.

Unfortunately there are many who view the countless avoidable deaths of those who are older, have underlying conditions or otherwise could have benefited from proper treatment as an acceptable price to pay for a faster "economic recovery".

</comment><comment><USER106> If you read the longer version of the UK's strategy that is not what they are doing... They are waiting until their numbers are high enough to justify lockdown and then lockdown as they know the economic shock is huge. So they wait until it is time, lockdown for 30 days, see if they can flatten the curve, then boot things back up.

The media picked up part of the story, but not the entire story. And, Boris played up one part to the detriment of the actual entire white paper.

</comment><comment><USER107> This is insane. It depends on a bunch of things we don't know turning out to be true: can we develop herd immunity to COVID-19? Can we adequately isolate young/healthy people from old/sick?

IF this turns out to be the UK strategy it will also become imperative for countries trying containment to ban travel from the UK.

I think it's an idiotic brainwave from a bunch of people who have spent way too much time pretending that they are the "smartest people in the room".

</comment><comment><USER108> Herd immunity and keeping the total infected at any one time to a manageable level is the end game everywhere. I think the difference you are seeing is a difference of opinion over how extreme the measures need to be to keep the total infected from overwhelming the hospitals. It's possible that moderate measures early might be enough clearly if you wait too long more extreme measures definitely seem to be necessary.

</comment><comment><USER109> There are three things to consider:

1) Even if they contained it inside the UK, it will be imported every day by people returning from the continent/USA. Unlike the quick flu tests, its 2+days for a result in testing

2) Vaccination at scale is a year+ out (as in at least may 2021)

3) flu season is only 7 months away, which means doing this all again, but with a newer version of the virus. This virus might be more mellow, or not.

Look at the infection rates in spain, france, Nederlands and germany. They are in lock step. Containment has failed.

 _update_ THe last, possibly most important point is this: the voting base most at risk of this virus is Boris's. Its really not in his interest to let them all die. I find the man abhorrent and selfish, but I doubt he's stupid enough to let his vote base disappear.

<comment><USER109> _update_

Given the new data, I'm changing my opinion to insane.

I think we are two weeks away from northern italy in london, but with 1/4 of the equipment.

</comment></comment><comment><USER110> Letting people past a certain age just die only works if people at that age co-operate. No matter how much the authorities try to spin it, there are more than a few "runners" who don't want to die (yet). [https://www.imdb.com/title/tt0074812/?ref_=fn_al_tt_1](https://www.imdb.com/title/tt0074812/?ref_=fn_al_tt_1)

</comment><comment><USER111> Okay about the mortality rate. What about the hospitalization rate? Is it low enough to do not break the health system ? And about the smokers? diabetics ? Cancer patients ? And about the old one already hospitalized ? The kids ? And about the 0.3% that will dye ? How many young people will die in a old population ? And about the doctors and nurses extra exposed to the virus from different people?

</comment><comment><USER112> Scientifically, yes. Politically, suicide.

Herd immunity is what you _hope for_ once the infection has gone through the population. To the extent that they try to build it by telling people they must be infected with it (questionable, and arguably a misinterpretation of public statements) it will be perceived as an attempt to cull the lower classes for the benefit of the ruling ones.

<comment><USER113> 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.

<comment><USER112> Please read the whole comment instead of just the first couple of words.

</comment></comment></comment><comment><USER114> Herd immunity is particularly insane idea if it's confirmed that you don't, in fact, get immunity:

[https://thehill.com/changing-america/well- being/prevention-c...](https://thehill.com/changing-america/well- being/prevention-cures/484942-japan-confirms-first-case-of-person-reinfected)

</comment><comment><USER115> No it's insane. Because you know viruses do one thing: they mutate.

Also heard immunity takes to long at which point all old people will get potentially infected too.

Also cases to death ratio (and infection to death ratio) are still on a magnitude larger then with the flu. Especially given that somewhat between 10-20% of infected need intensive medical care, all roughly at the same time if you don't slow the spread which likely can't be provided if that should happen increasing death ratio.

With such a strategy we at looking a mostly likely at >350000 deaths. Not unlikely even over 1800000...[ _]

Through well there is always very, very small chance that it will work. Less because it's a good strategy but because even if you do nothing there is a very very very small change for a virus to "self destruct" (not correct way to describe they effect but it basically similar to a self destruction to a outside observer knowing nothing about virology).

But gambling hundred of thousand lives one it would be insane.

Well except if you have no morals and want to destabilize the country. Through I don't think that's the case, incompetence is more likely.

EDIT: spelling

EDIT: _ Numbers based on not unlikely infection rate of 60% of population and IDR of 1% (health system not overloaded) and 5% (health system overloaded to some degree).

EDIT: argument based on heard immunity idea not explicitly the UK strategy

</comment><comment> l-andis It looks like they've either backtracked on the idea or it was misconstrued from the start:

[https://www.dailymail.co.uk/news/article-8113011/Downing- Str...](https://www.dailymail.co.uk/news/article-8113011/Downing-Street-hits- against-critics-herd-immunity-virus-strategy.html)

</comment><comment><USER116> Does anyone have a link to an actual policy document explicitly stating the UK's herd immunity policy? The link is a tweet from a random guy.

Herd immunity is the default, and it's also being pursued by the US, despite statements to the contrary. So I'm not sure there would actually be a document, but maybe it does exist.

</comment><comment><USER117> We are about 2 weeks behind Italy in death rate, which is the only measure that can be reliably compared between countries, due to differences in test rates and criteria to be tested.

Is 2 weeks "grace period" before implementing a lockdown and starting the heavy measures worth it in the long run? I don't think so.

</comment><comment><USER118> I'm not really qualified to comment on this strategy, but isn't this going to lead to stronger exposure to virus specimens per individual, i.e. more severe infections and thus higher CFR?

The actual goal of the UK might be to sacrifice a few people to boost the economy while the rest of the world wrecks its economy.

</comment><comment><USER119> [https://philip.greenspun.com/blog/2020/03/14/if-the- british-...](https://philip.greenspun.com/blog/2020/03/14/if-the-british-are- right-everything-the-u-s-is-doing-about-coronavirus-is-wrong/)

</comment><comment><USER120> I don't think there's any working strategy for infecting the young and keeping them separate from the old. Many young people have contact with older people (live together, work together, being taught by them etc.), and anybody who claims it might work is IMHO divorced from reality.

</comment><comment><USER121> I think the main mystery about the UK govts approach can be solved when your realise it is not very clever; just very incompetent. The whole word has been stunned by the herd immunity experiment policy; only to have it denied a week later. We are fools led by clowns.

</comment><comment><USER122> The UK government is neither genius nor insane. What the UK government is, is pragmatic.

</comment><comment><USER52> Turns out they were insane: [https://www.buzzfeed.com/alexwickham/coronavirus- uk-strategy...](https://www.buzzfeed.com/alexwickham/coronavirus-uk-strategy- deaths)

</comment><comment><USER123> No. It's dumb asf.

It'll last like 2 days.

Here's the EIC of The Lancet:

[https://twitter.com/richardhorton1/status/123814984490619290...](https://twitter.com/richardhorton1/status/1238149844906192903?s=21)

</comment><comment><USER124> I'm not sure I understand how this herd immunity strategy can work in the current world. Albeit the UK is segregated from the rest with water, there are still a lot of people entering your frontiers and that are not immune.

</comment><comment><USER125> Herd immunity is basically doing nothing right? How is that any different from what happened in the Spanish Flu? I'm sure herd immunity came into play eventually but at the cost of all those lives.

</comment><comment><USER126> I see lots of praise for Singapore and Taiwan's handling of the crisis.

What about the weather? Is part of the solution for cold dry places to have warm humid weather, which apparently kills the virus?

</comment><comment><USER127> Insane, but we already knew it thanks to their past decisions. This is just the last confirmation. In the best case we'll have close to 1M deaths if they succeed with their strategy.

</comment><comment><USER128> Herd immunity by mass exposure is an interesting, very likely catastrophic, approach. It's interesting that he (of the twitter cite) claims that it is "more refined", as if simply doing nothing and rationalizing your hubris is 4D chess.

Every country realizes it can't be stopped now. Every country realizes that the majority of the population will get it. But as has been cited a thousand times, having hundreds of thousands of vulnerable people, along with a substantial enough number of otherwise healthy people, needing heroic medical care would be _disastrous_. See: Italy. Their approach wasn't "more refined".

I doubt the outcome is going to be good.

</comment><comment><USER129> Meanwhile, people returning from the UK to the EU are being tested positive for Covid-19...

So, maybe the strategy (if it is one) works, but the UK is imposing it on everyone else without a care.

</comment><comment><USER130> It is correct in theory, but Wuhan coronavirus spreads very quickly and easily. I doubt UK has enough hospitals and people to provide proper medical treatments.

</comment><comment><USER131> All the kids get it, infect their parents, and off it goes.

I expected immunity once you'd had it, but have heard of re-infection occurring (not from official sources).

</comment><comment><USER132> This sounds like the "bargaining" stage, in the 5 stages:

denial, anger, bargaining, depression and acceptance.

(Acceptance being a China style lockdown of course...)

</comment><comment><USER133> MMh. is the netherlands then doing the same thing ?

</comment><comment><USER134> The bit I don't understand is how you carefully infect the bulk of young people and simultaneously keep the older folks uninflected.

</comment><comment><USER135> Sounds incredibly risky to me. I suppose if all countries end up crippled anyway then it would be good to be the first to recover.

</comment><comment><USER136> I think this is the path the USA will be taking as well if not "officially" so the old folks won't freak out.

</comment><comment><USER137> The title reads like judging a startup founder. I'm not sure if all the startup rules apply to governments.

</comment><comment> Engineering-MD I feel really torn about this.

The intuitive way of managing this is to try all possible containment methods as long as possible. The benefits of this is that it will give maximum chance for containment, and failing that, maximum time for therapies/vaccines to emerge. What are the chances of this? Containment thus far has already failed. The asymptomatic period make this hard to contain, and even in China with drastic measures new infections are occurring. Even if this worked, it would only take one area not doing this effectively to allow reinfection of these other areas once measures are lifted. The other issue is that an effective vaccine is not going to appear for at least a year. Other repurpose therapies are being trialed, and initial results will be released this month. I'm not aware of any other completely new therapies which may change outcomes. So, it appears the benefit is limited. The main risk of this approach is that containment is initially successful, but then fails in Autumn (fall), leading to a peak in the winter when the health system is already under a large amount of stress. This would be a disaster, and may well be what happens to other countries who try this. So, the UK approach of making occur in summer may make sense for the UK. How appropriate this course of will obviously depend on level of seasonal variability in health care needs. Therefore countries like Indonesia or Singapore will do well to stick to containment initially, as they dont risk a peak occurring in winter.

</comment><comment><USER138> Doesn't herd immunity work if reinfection isn't possible, which is unconfirmed at best at the moment?

</comment><comment><USER139> As long as the virus does not mutate and start killing young people, which is a definite possibility,

</comment><comment><USER140> Doesn't herd immunity require like 90% immunity?

Even with 5% of cases requiring hospitalization this is insane.

</comment><comment><USER141> An interesting experiment is about to be carried out with the British as the control group.

The only thing we know for certain about C19 is we don't know anything for certain. The EU recognise that fact and are playing for time. The UK, on the other hand, is pretending to have a sciencey fix based on some adolescent game theory nerdgasm. Herd immunity can be conferred by both vaccine and disease. But there's a difference between vaccine and disease that seems too subtle for Whitehall to grasp.

The UK is planning for 60% of its population - forty million people - <USER2> contract C19. The gamble is that this won't overwhelm the health system. How? Because the government has told the virus not to infect people who might get ill.

In China, healthcare workers were at greater risk than the general population because of elevated exposure. The UK has told the virus not to infect doctors.

The big risk with RNA viruses is mutation: we could develop a vaccine this year that's useless next. Obviously, the larger the infected population, the higher the viral mutation rate. China and the EU are responding by locking down. The UK has told the virus not to mutate.

When declaring a pandemic, the WHO director-general said, "The idea that countries should shift from containment to mitigation is wrong and dangerous."

</comment><comment><USER4> Most comments here raise excellent points.

One more in the mix: Many companies in many countries are working on vaccines and cures. So far some are reporting moderate successes; as I understand it, those with the experience to tell seem to think odds are pretty decent there'll be some sort of vaccine available within a span of a year, maybe sooner.

Whether corona infections 'outpace' the time when a vaccine will be generally available depends a lot on how long it'll take to get a vaccine out the door, but presumably a ton of resources (and a lot of leeway on relaxing regulations) are spent on this, as well as exactly how fast corona spreads.

If it spreads very fast, all of this 'planned herd immunity' stuff is nonsense, all the taps you can close should be closed and stay closed and it'll still spread. The UK would be mismanaging this and should be closing more facilities.

If it doesn't, then the UK is probably mismanaging this, in that it'd be better to try to slow the spread because the end game is the vaccine.

Effectively then, they appear to be betting on a creative and untested solution that they more or less have to keep secret because it doesn't work well if it is generally known, which requires accurate forecasts from lethality rates amongst various parts of the public to spread rates in circumstances that are probably unique to the UK then, if they are the only country to go with this plan, __whilst__ betting that the vaccine solution is not going to be fruitful for a long long time.

I'm going with 'insane' on this one.

</comment><comment><USER142> I do now know what is right, but I am glad humanity has a diverse set of strategies

</comment><comment><USER143> They've backed away from the herd immunity approach now. Embarrassing

</comment><comment><USER144> Herd theory works once you have an immunized herd(from recovery from infaction while we have no vaccine) so that infection passes only from an infected person to a vulnerable one. As we sit, the current policy will lead to an exposure to all people - more or less, and then the recovery and formation of the immune herd commences. Thus the IK government has decided to allow unfettered spread = all the casualties that involves to form the herd. This is a million or more people. An isolate into tiny herds-at-home, test symptomatics - treating positive by supportive care = formation of many immunized small herds. This second procedure will kill 50,000 or so. Laters it does not matter if the mini herds mingle as they are all immune. There will be little subsequent spread. UK is deciding to kill a large number of it's citizenry = some sort of class war???

</comment><comment><USER145> Do you get immunity to cold caused by coronavirus after having it?

</comment><comment><USER146> So, it sounds like the UK is having a big chicken pox party?

</comment><comment><USER147> Definitely insane, here's why:

In order to get to herd immunity, you need something around 60% of the population to get infected and thus immunized [0] (there's a big assumption here already, that immunity lasts forever, might well be wrong). The UK's population is 66 million people, so that's about 40 million who need to get sick.

Let's assume 2% of cases require intensive care (it's closer to 10% in Italy right now [1], but we can assume for the sake of this calculation that the UK has the superpower to isolate people over 65 or so perfectly). That's 800000 people who will require intensive care!

There are about 4000 ICU beds in the UK [2]. Let's assume, again highly optimistally, that only 50% are occupied, so 2000 are available for Covid19-patients. Covid19 patients may need to spend 7 days in the ICU [1], which means there can be up to 286 new Covid19 patients starting intensive care each day.

You can see where this is going. At that rate, it would take 2797 days to reach herd immunity. It's utterly nonsensical. We will hopefully have a vaccine way, way before that. What this "herd immunity" strategy is actually going to do is lead to a total break-down of the hospital system in the UK, if the government doesn't change course real soon now.

[0] This is 1-(1/R_0), see [https://en.wikipedia.org/wiki/Herd_immunity](https://en.wikipedia.org/wiki/Herd_immunity) and unmitigated R_0 is around 3 for SARS-CoV-2, [https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndr...](https://en.wikipedia.org/wiki/Severe_acute_respiratory_syndrome_coronavirus_2)

[1] [https://www.statnews.com/2020/03/10/simple-math-alarming- ans...](https://www.statnews.com/2020/03/10/simple-math-alarming-answers- covid-19/)

[2] [https://www.theguardian.com/commentisfree/2020/mar/03/icu- do...](https://www.theguardian.com/commentisfree/2020/mar/03/icu-doctor-nhs- coronavirus-pandemic-hospitals)

</comment><comment><USER148> It's worth noting that many diseases don't converge to herd immunity except through very high vaccination rates. Examples include polio, small pox, chicken pox, etc.

So their assumption about outcome seems flawed.

</comment><comment><USER149> This is utter, utter madness. Assuming UK has 66M people and 2/3 need to be infected, that's 44M people. Coronavirus has, depending on the quality, affordability and accessibility of the healthcare system, a fatality ratio somewhere along 0.7% in best case and 15% (at least!) in old and pre- conditioned people... which means that there is anything possible between 300k and 6.6M (!!) deaths.

tl;dr: absolutely fucking nuts to risk more people than the UK lost in WW2. If BoJo really tries to execute that plan, he has to be stopped.

<comment><USER45> > If BoJo really tries to execute that plan, he has to be stopped.

But that's the beauty of the plan, it functions as its own dead man's switch.

</comment></comment><comment><USER150> Important to remember that this person doesn't _know_ what the policy is. They're just tweeting their opinion.

<comment><USER151> 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](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.

<comment><USER43> They didn't word it like the OP. The OP got that from the Twitter account extrapolating the contents of the press conference. The press conference mentions herd immunity but it didn't (like the twitter thread) state that keeping schools open was to ensure young people get infected.

</comment></comment></comment><comment><USER152> What could possibly go wrong.

<comment><USER153> A lot. It can potentially wipe out the non young generation.

<comment><USER152> I said what could go _wrong_.

</comment></comment></comment><comment><USER154> They are neither; they are making difficult decisions on the basis of limited information across multiple disciplines. The main aim is to prevent the NHS from being overwhelmed, which would be a humanitarian disaster. A secondary aim is to prevent bringing economic life to an end in the UK, which would also be a humanitarian disaster.

We are at most about five months into this pandemic; to suggest we know what strategies succeeded and failed is very premature. We are just at the beginning.

In another world, we could all spend 2020 in individual seclusion, without any economic, social, familial, cultural, mental, or behavioral concerns. In the world that actually exists, "No man is an island, entire of itself" and so rather annoyingly we must continue to live our lives without being completely governed by epidemiological concerns. SARS-CoV-2 can be transmitted asymptomatically and is basically everywhere at this point, so if your entire strategy is just "don't let anyone get infected, ever", it is surely doomed?

One country did get a legitimate chance to end COVID-19 for all humanity by preventing onward transmission, and they blew it. The next off ramp is global herd immunity (either natural or artificial), which lies years or decades in the future.

It's worth pointing out that the UK already pursues a strategy of herd immunity regarding chicken pox (along with other countries), despite the availability of a vaccine: [http://www.ox.ac.uk/research/everything-you-need- know-about-...](http://www.ox.ac.uk/research/everything-you-need-know-about- chickenpox-and-why-more-countries-don't-use-vaccine) I disagree with that strategy but I am not qualified to make that decision on behalf of a country, and I'm glad it's not my responsibility to do so.

<comment><USER155> > the UK already pursues a strategy of herd immunity regarding chicken pox > (along with other countries), despite the availability of a vaccine: > [http://www.ox.ac.uk/research/everything-you-need-know- > about-...](http://www.ox.ac.uk/research/everything-you-need-know-about-..). > I disagree with that strategy but I am not qualified to make that decision > on behalf of a country, and I'm glad it's not my responsibility to do so.

The UK does not vaccinate against chickenpox because it judges that the overall public health consequences are worse if you vaccinate than if you don't - it would increase the frequency of shingles which is much worse than chickenpox.

<comment><USER154> That for me is where the logic breaks down, a comprehensive vaccine programme for shingles would seem far more effective than just hoping the adults come into contact with infected children.

<comment><USER155> Anti-vaxxers are a thing. If you vaccinate then due to herd immunity the anti- vaxxers don't get exposed to chickpenpox nearly as much and then end up getting shingles.

Also then anti-vaxxer children get chickenpox much later in life when it can be more serious.

If you don't vaccinate everybody gets exposed to chickenpox much more and the proportion of shingles cases ends up being smaller, not only that but anti- vaxxer children don't need to worry about getting their first case of chickenpox at age 30.

</comment></comment></comment></comment><comment><USER156> It is a theoretical solution. That also could backfire fiercely. The more it spreads, the more likely it is to mutate. And not all mutations will be equals. Plus it might make producing a vaccine more complex.

Could also work. Unexplored territory, the truth is we don't know.

</comment><comment><USER157> "In practice, people won't be disciplined about isolating vulnerable ones in the first phase, thus leading to disaster."

That is the point. One can catch the virus, become asymptomatic then continue to live normally and become even more dangerous to anyone in vicinity ("hug me, I'm safe!"). Eventually most of us will be infected anyway, and some will recover becoming immune (hopefully; this is far from guaranteed), so the correct line of action IMO would be to isolate everyone from everyone to gain time and resources. Nothing would stop them later from making people immune through controlled infection (aka vaccination) when the crisis is over.

To me they don't have a clue and just chose the only option that might paint them as still in control.

</comment><comment><USER158> More insane than genius.

The government expert on TV was basically saying most people are going to get it eventually so why bother making huge efforts to delay but that kind of ignores that if we delay we may get better treatments or a vaccine. Just fine tuning some of the existing treatments could make a big difference.

</comment><comment><USER159> The economy wasn't important for Brexit but it somehow is for COVID-19, and we're going to sacrifice half a million people (best case).

I say bring back the guillotine

</comment><comment><USER160> To be honest, I don't think this kind of conversation is worthwhile on HN. There are very few facts here, just opinions.

I'm all for posting authoritative information, and interesting side-effects.

But just shooting around opinions is best left for Twitter, Facebook, Reddit.

<comment><USER161> The dividing line for what's on topic on HN not fact vs. opinion, it's intellectual curiosity ([https://news.ycombinator.com/newsguidelines.html](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).

<comment><USER162> But ignorant speculation during a crisis can have serious consequences. Look the fools in this thread claiming that the UK government is deliberately culling the sick and elderly. The last thing we need is ideas like that getting widespread acceptance and causing civil unrest and distrust of the authorities who are essential to managing the situation.

<comment><USER161> It's true. But ignorant speculation forms a chunk of every thread. The solution isn't to try to restrict posting to authorized opinion—that would cause more harm than good and is impossible anyway. The solution—well, there's no solution, but the best we can do—is to let the community respond when it's able to function, and moderate the threads to the extent that it's not.

When I last looked in on this one, it seemed to me that the community was functioning ok—noticeably better, in fact, than in most of the coronavirus discussions, which are highly repetitive. Repetition is bad on HN, not only because it's lacking in intellectual curiosity, but because it leads to flamewars. The mind seems to resort to conflict to amuse itself when nothing new and interesting is available.

</comment></comment></comment></comment><comment><USER163> This might work. But how many people will die in the process? There are many cases of young people, with seemingly no prior health issues, dying after getting severe issues as a result of the virus.

On top of that, you can't guarantee that young people will only get it. With no travel restrictions, it can easily spread to the elderly.

<comment><USER150> 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.

<comment><USER164> The reported numbers in published papers are more like 0.4% under the age of 50 and 0.2% under 40 and probably lower as there could be a large portion of mild unreported cases.

[https://www.worldometers.info/coronavirus/coronavirus-age- se...](https://www.worldometers.info/coronavirus/coronavirus-age-sex- demographics/)

<comment><USER150> >> Death Rate = (number of deaths / number of cases) = probability of dying if infected by the virus (%)

That's not a great way of measuring the death rate during an on-going epidemic. They should be measuring the number of people who died today / number of cases a week ago.

<comment><USER165> Why a week ago? If it takes longer than a week for victims to die, in a situation with rapidly increasing infections that will give a very distorted number.

<comment><USER54> The best source I found on the subject -- a disease modeler with CDC who was giving an interview -- said that their current estimates used 5-day doubling, 15-day median time to death, and 1% CFR to do their estimates.

For the modeler, the purpose was estimating the true number of cases (which they estimate as current_deaths * 800 for a first-order approximation) -- but similarly, you could use that to estimate CFR by taking (num_cases / 8) as the denominator. Except, of course, that you can't realistically estimate num_cases. With the exception of Diamond Princess and _possibly_ South Korea, everybody's numbers tell you more about the number of tests they run than the number of infected that exist.

One doctor from John Hopkins, for example, estimated that there are between 50k and 500k cases in the US as of 3 days ago -- and my own admittedly-amateur estimations using CDC numbers for deaths from influenza and all-cause pneumonia could only set an upper bound of ~400k cases as of March 1st

</comment></comment></comment></comment></comment></comment><comment><USER166> This is the same thing China is doing, except China is also lying about it and saying they have "contained" it with extreme quarantine, in part to trick other nations into doing the same thing to tank their economies while China is going back to work and letting the virus spread.

Good for UK to step up amidst hysteria. Hopefully other democratic nations will follow suit.

</comment><comment><USER167> I wonder how much of it is just playing the odds. Shutting everything down will very likely have a large, but fixed consequence on the economy, which has huge cost, including in lives and health. Whereas biding your time increases the relatively small risk of catastrophic consequences from coronavirus, but avoids the economic consequences. So it comes down to a choice between accepting a known downside, or taking a gamble on a path with the possibility of very little downside, but also much larger worst-case downside. Leaving the expected values of the choices aside, maybe Boris just likes to roll the dice?

There are other considerations, like how well the president/prime minister's incentives are aligned with the countries. Donald Trump, through very little fault of his own[1], faces the possibility of a failed presidency due to the economic consequences of shutdown. If possible, a president might think it worth swinging for the fences, if he is down a couple of runs in the ninth? If he strikes out, he is no worse than before, although the country is. And Boris has kinda made himself out to be a guy who tries for home runs, at least in his public persona.

There is also the game theoretic considerations on the country level. If all the other countries are doing everything to stop the spread and paying the economic cost, than U.K. can take the benefit of that sacrifice, and not crash it's own economy.

[1] of course he is doing his best to compound the external factors.

<comment><USER168> > through very little fault of his own

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

<comment><USER167> I worded it that way because I think that even if he had done everything right, his re-election would still be in trouble because of factors outside of his control.

<comment><USER168> The job is literally to be prepared for the future on behalf of the country. If you take active steps that make us less prepared for something and we therefore suffer greater consequences when it happens, I have a really hard time describing that as being something outside of your control.

Under normal circumstances, an exigent crisis such as war would make a President significantly more likely to be re-elected. He tried to start a war with Iran not long ago for this very reason.

<comment><USER167> If you want to argue about Trump, please find someone else to do it with (or somewhere else to do it).

My comment was not about Trump's response, and I regret even including mention of him, since that one offhand comment has generated uninteresting political arguments, without anybody engaging with what I was actually writing about.

</comment></comment></comment></comment></comment><comment><USER169> I really can't believe how stupid this is, I was starting to feel positive about the whole thing, China got it under control, they are sending resources to Italy to help get it under control, cures and vaccines are being developed while people stay indoors and the number of cases drops. WE COULD ERRADICATE THE VIRUS JUST BY STAYING HOME FOR 1 FUCKING MONTH. Literally that's all it would take, a person isn't contagious after a month, if everyone cooperated for the greater good we could have this under control, it's not too late, it's the one and only chance to not make this virus "the norm" of our society, every day it's gonna get much harder... But then you hear a country with 60 million people just isn't gonna do anything about it, throwing in the towel before the fight even started and dooming the whole world with them. It's beyond insane.

I'm sorry but this is just too much, I was hoping we would have the common sense to do our best to contain the spread but seems we just have to travel, go to the gym, go for beers every night and hang out, even though it will kill a lot of people around you. Your fathers, mothers, grandparents, your friend's parents, your neighbour's family, they might as well all die because you can't stay home for a month. Really I expected too much from people and forgot how stupid the average person is. I expect global warming will also go great, kudos humanity.

</comment><comment><USER170> [https://www.scmp.com/news/china/society/article/3074945/coro...](https://www.scmp.com/news/china/society/article/3074945/coronavirus- hubei-government-deletes-report-claiming-covid-19)

You better hope this isn't true and the virus doesn't have any lasting effects on reproductive health.

<comment><USER80> paper - [https://www.medrxiv.org/content/10.1101/2020.02.12.20022418v...](https://www.medrxiv.org/content/10.1101/2020.02.12.20022418v1)

</comment></comment><comment><USER171> So let's assume that building immunity is even a possibility even though there is no evidence to support this while there exists substantial evidence to the contrary (people getting reinfected)?

Not happy to be living in the UK if that's really the plan.

<comment><USER172> > 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.

<comment><USER173> >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.

This is also why testing everyone and anyone is a bad idea. Half or more of positive tests of people without symptoms being tested because they are in close contact with infected seem to be false positives. [https://www.ncbi.nlm.nih.gov/pubmed/32133832](https://www.ncbi.nlm.nih.gov/pubmed/32133832) I've seen something else I can't find at the moment that says that only about 10% of those with both potential COVID19 symptoms _and_ a contact history indicative of possible contact are positive. It's both pointless and dangerous to have someone get a false positive reading, perhaps do self-quarantine for 14 days, then go out and promptly get (not re)infected.

The US government (and I think UK too) is getting a lot of criticism for restricting testing to those who meet the requirements of symptoms and contact history, but it's almost certainly because the CDC is aware of this. The Canadian government, too; Prime Minister Trudeau is not being tested, although his wife is positive, because he is asymptomatic. [https://www.usatoday.com/story/news/world/2020/03/12/sophie-...](https://www.usatoday.com/story/news/world/2020/03/12/sophie- gregoire-trudeau-tests-positive-coronavirus/5039464002/)

</comment></comment></comment><comment><USER174> This "strategy" is rebranded "do nothing". The journalist running the country (with his "everyone's had enough of experts" and "fuck business" attitudes) is simply displaying his usual contempt for all the non-privately educated, and is miles out of his depth. This is in a similar vein to how they're also rebranding a no-deal Brexit as an "Australia-style" deal. I don't believe they have a strategy at all - and "herd immunity" means hope for the best (a la "sunlit uplands").

</comment><comment><USER175> From a PR point of view this is not a clever move. The very phrase 'herd immunity' says a lot about what they think of people. It is also a highly memorable phrase, much like 'shock and awe' and sometimes you just don't need a 'marketing slogan' for something divisive.

<comment><USER176> > 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](https://en.wikipedia.org/wiki/Herd_immunity)

<comment><USER175> I did not claim that they invented the words. English is a rich language and some words resonate better. From your article:

> Herd immunity (also called herd effect, community immunity, population > immunity, or social immunity).

Community immunity would rhyme and not be received as negatively by those that already hate the government as the herd word. It would also convey community, which is a caring nice word.

</comment></comment></comment><comment><USER177> The kill rate from economic loss far exceeds the virus atm.

You mightn't see it yet as people stick together but a lot of small business owners will be killing themselves in a year's time. (But most of economic deaths are more subtle)

The UK is also reducing this.

They are also coming into Summer, it's crazy to not maximize during this time.

The right thing to do would be to purposely infect people with a spray and isolate.

Society won't allow this. So we have to do other methods. They have a lot of lag and are random and exponential so probably out of real control.

With the UKs plan they can't keep it to young people. That certainly won't work.

But they will save many invisible economic lives.</comment>