Thursday, April 23, 2020

Scottish Government document decisively repudiates the catastrophic 'herd immunity' approach that the whole UK was following only six weeks ago

As you may have seen, the Scottish Government have today published a document setting out the principles that will guide the eventual and phased easing of the lockdown.  It ticks pretty much all the boxes that most of us were hoping for.  Here are the key lines -

"Our objective is to contain and suppress the virus in order to minimise the harm it can do."

"As and when we lift restrictions, we will need to put in place public health measures to stop cases becoming clusters, clusters becoming outbreaks, and outbreaks becoming an uncontrolled peak..."

The use of the word 'suppress' is significant, because a suppression strategy is the opposite of the previous 'herd immunity' strategy that applied UK-wide until March, and that the Scottish Government's own Jason Leitch evangelised for during his infamous tour of the TV studios, and that would have deliberately allowed 60%+ of the population to be infected.  But the use of the word 'contain' is arguably even more significant, because the UK explicitly abandoned containment efforts in mid-March on the grounds that containment of the virus was literally impossible, in spite of experience in China and South Korea suggesting that was not true.  At least as far as Scotland is concerned, that stance has now been fully reversed and containment is regarded as both achievable and desirable.

"We are clear that an assumption that there is a proportion or section of the population that it is safe or acceptable to allow to be infected forms no part of the Scottish Government's policy or approach."

Again, those words are an unmistakeable repudiation of the discarded 'herd immunity' approach, which only sought to shield a relatively small percentage of the population from the virus. The vast majority of people under the age of 70 and without known underlying health issues would have been allowed to be infected, precisely because of an outrageous assumption that it was "safe and acceptable" for that to happen.

"To contain the virus we must keep the R number below 1, and this means minimising the risk of spreading the virus at every turn."

"Suppress the virus through compliance with physical distancing and hygiene measures, ensuring that the reproduction number remains below 1..."

"The World Health Organisation has stated that before any decision is made to lift restrictions, transmission of COVID-19 must be controlled. That means that we must see R stabilise below 1.0 and ensure that the impact of any decision to ease restrictions must maintain R below 1.0."

This is absolutely vital, because keeping the reproduction rate below 1 ensures that the epidemic is always in retreat. That effectively 'locks in' the suppression strategy and makes the pursuit of herd immunity through mass infection impossible.

"If we see evidence of outbreaks of the disease we will need to be ready to act decisively to suppress them and so prevent wider transmission. This will require both a very high degree of virus-aware public behaviour along with enhanced public health services. These services would come in five stages."

Those five stages are the 'test, trace, isolate' approach that the World Health Organization have been urging all along, but that the UK has been so resistant to. The Scottish Government have now - albeit belatedly - accepted the need for it completely.

The only caveat that has to be placed on this good news story is that the document reiterates that Scotland is committed to the '4 Nations' collective decision-making process, and suggests there will only be a departure from this at the margins, for example on "optimal timings". Given that it appears the UK government advisers are still split on whether or not to attempt the type of full-on suppression strategy that the Scottish Government are now committed to, what happens if Westminster shoots off in completely the wrong direction and lifts the lockdown without 'test, trace, isolate' in place? How can Scotland follow a completely different strategy with only small discretionary differences in the measures that are enforced?

That would be a difficult circle to square. But the hope must be that the Scottish Government have laid down a strong marker today that will ensure any collective UK approach that sidelines contact tracing and that doesn't attempt to fully suppress the virus is a non-starter.

58 comments:

  1. Super glad to read this document just a while ago and super glad to see your headline.

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  2. Very good to hear.

    Unfortunately, we are still part of the union, so some aspects of dealing with this crisis are out of the Scottish government's hands.

    Being part of the UK will cost hundreds to thousands of lives, which we have been told to 'take on the chin' to maintain the value of Johnson an co's share portfolios. We just need to look at Norway to see what could have been.

    For now, the Scottish government can just do their best with what limited powers they do have.

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  3. Slightly of subject. The Republic of Ireland is paying between 350 and 450 Euros per week to all unemployed and laid of workers.

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    1. And we British are still subsidising the EU block. So where did the Irish get this money!

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    2. Irish GDP per capita is higher. Simply put, they are more productive than Brits.

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    3. Sorry, should huv said 'we' are more productive.

      You brexiters are just lazy as feck, hence the shortage of fruit pickers for British farms. Yer aw mooth and nae breeks as folk suspected.

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    4. Yeah producing rotten spuds. You forgot you were a Paddy for a moment.

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    5. This comment has been removed by the author.

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    6. As a Scot, I call them tatties.

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    7. You only use the tattie word when it is used in the context with mince. Watch the Steamie. Real Scots pronounce it as tottie as in tottie scones with fried eggs an bacon. Fuck I am getting hungry.

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    8. GWC is English so he calls them spuds .
      GWC understands fully that his England had zero to offer the world other than loud mouth hooliganism they’re very good at that as you all know and see on your tv every year .
      GWC celebrating st George day he was actually Turkish !!

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    9. Covidia is as confused in this as it is in all other matters it fulminates about.
      It's proud of its wilful ignorance.

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  4. By taking the lead on this matter (supported even by the likes of George Osoborne) at least they might help drive forward the process with the UK government following (or else *they* would have to justify taking a different approach).

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  5. 4 Nations ? Since when did the six counties in the north of Ireland become a Nation ? Why does SNP go along with this travesty ?

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    1. It is a free country within the UK. The Republic is a free country outwith the UK although they have sold out to the EU.

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    2. Northern Ireland is not a country it’s part of a country and that country is called Ireland.
      England calls it Northern Ireland because the south the east and the west of Ireland told them to stick it.

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  6. Seems the USA military intelligence knew about this virus during November 2019. Vietnamese intelligence acted quickly once know.
    New York woman has passed the virus onto her seventeen children. She must be used to lying on her back.

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    1. And that would be why the stable genius acted so quickly...
      The usual evidence-free guff from Covidia, then.

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  7. Comment from the offensive "killer sniffle" troll deleted. Apologies to Scottish Skier, because that automatically deleted his replies to the troll.

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    1. The YouTube interview is actually really good, but it doesn't tell us a lot more than we already know, nor advocate anything other than what governments are now doing.

      https://youtu.be/cwPqmLoZA4s

      The Dr in question is very clear that the situation is really serious, we should ease lockdown carefully, and mass test, even if just to better understand the situation. Cautious optimism.

      A case fatality rate of 0.3% is suggested, which is like a really bad influenza outbreak, but made worse by the lack of any vaccine, particularly in hospital environments where it spreads because of this. Better situation than first feared though.

      The WHO conspiracy theory guff is just guff though. The harvard doctor even sings the praises of vaccines, but nots they are not necessarily a magic bullet.

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    2. 0.3% case fatalities in the UK with an 80% infection rate is 156,000 dead.

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    3. Which of course is totally unacceptable, with a fair chance that the real mortality rate is actually higher than 0.3%. Mr Troll claimed the other day that there was "breaking nooz" that the mortality rate was the same as seasonal flu - well, seasonal flu actually has a mortality rate of 0.1% or lower, and only around 10% of the population are affected each year.

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    4. Absolutely. 0.3 is a hell of a lot better than 3, but as the harvard guy says, it's still really serious, particularly for vulnerable groups that need protecting.

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    5. I haven't watched the whole video, but from the opening remarks I'm getting the impression he's based the 0.3% estimate on the Santa Clara study, which many people regard as seriously flawed. I won't go so far as to say it's been 'debunked', but it's widely regarded as not particularly credible. So even though a 0.3% figure would be devastating enough with an 80% infection rate, it seems likely that's a significant underestimate.

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    6. It's why we need mass testing of the population. Germany has been quite busy in this respect and this is likely why its case fatality ratio is looking lower than other reports at just over 1%.

      https://www.bmj.com/content/369/bmj.m1395

      It really is key for understanding risks, and of course strategy.

      For example, 'test, trace and isolate' works at very low % infected. However, if you start to get 5, 10, 20% infected, soon, everyone has recently encountered an infectious case, so the entire population would theoretically need isolated.

      Which is what's actually been done. Lockdown makes that assumption. We were all locked down because it was assumed if we go out, we would likely encounter a case.

      Scottish government need to mass test in a mass 'polling sample' type way to understand where we are, the risk, and how best to manage that.

      I'm not a medical doctor, just a chemistry one, but I've got to be critical of overestimates as much as underestimates. Without the data, we are clutching at straws.

      We really do need to know our enemy so we properly rank it alongside the others we're dealing with in terms of risk. We desperately need to know total number of infections, and how these are spread across the country.

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    7. Yea the pilot for one of those 'polling surveys' is starting in England soon.
      https://news.sky.com/story/coronavirus-study-begins-to-track-covid-19-in-the-uk-population-11977336

      With it spreading out across the UK post that. Of course there can be multiple versions of this type of research going on at once.

      The game changer will, of course, be big data, when you can get data from millions of people but will have to wait for the app to get that.

      with that survey expanding

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    8. Would certainly make sense to target the worst affected areas first, then move to where things are more under control.

      With infections 50% higher per head in England, it will also be easier to determine reliably for smaller sample sizes.

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    9. "Lockdown makes that assumption. We were all locked down because it was assumed if we go out, we would likely encounter a case."

      I think you're overstating the case somewhat. The experience from China and South Korea suggests that only close contacts need to be isolated. To the extent that modelling can be trusted, the percentage estimated to have been infected when lockdown was imposed was not high enough to suggest that everyone (or anything like everyone) was a close contact of someone with the virus. That's why contact tracing should have been going on during lockdown, particularly in lower-intensity areas.

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    10. Sure, but you get my point.

      If we assume a death rate of 1%, then 3-4 weeks ago, 3% of Scotland's entire population was infected. My work has 11k folk; that would be 330 cases walking around it. That's getting to the point that it would be hard to not encounter a case in a lift, at the canteen, in the loos.... If we were not socially distancing.

      It's why it was time to lock down! Soon, everyone would be a traced contact!

      It's another reason why we need widespread testing of everyone, not just symptomatic people. We need to know the level in the population and that it's down to a level where most of us will not meet an infection if we go out work etc, ergo we are not all traced contacts needing quarantined!

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  8. GWC has never lived in Northern Ireland because if he had he would know that it is not free.
    I have lived in Northern Ireland I know it’s anything but free, it’s a restrictive strangulated subordinate thread hanging off the skirt of England but not for much longer , liberation will come

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    1. I have lived in NI and the Republic as did my ancestors. Stay aff the alter wine and keep yer troosers roon yer waist.

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    2. A brit migrant taking the high road to the emerald isle in search of a better life eh! Many English have tread that path before you.

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    3. Most Irish do not realise they are offspring from the Brits. The Irish are Brits. They have Cromwells genes.

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    4. Covidia needs to cite its evidence.

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    5. If Cromwell as alleged wiped out all the male Irish then how did the Irish women breed so quickly.

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    6. 300,000 USA troops trained in the six counties of Ulster for the invasion of Europe. The Irish Republic remained neutral and friendly with Adolf. NI deserves to be autonomous from the fascist loving Republic.

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    7. The Irish let British troops fly over Ireland, so were not neutral.

      A nice thing to do given the English invaded Ireland, shut down its democracy, slaughtered its people and destroyed its cities just a few years earlier.

      Hitler never touched Ireland by contrast.

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    8. Hitler had considerable admiration for the violent, repressive and racist Greater English Reich, which spanned much of the world at the outbreak of WW2. His plan was to emulate it with a German version.

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    9. You are liar herr Skier. Try the Irish Times, 9 & 15 May 2017. Ireland and the Nazis:a troubled history. You will be telling us next that the Vatican had nothing to do with the Holocaust.

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    10. I quote the article:

      De Valera’s depiction as a half-caste Jew in a German newspaper in July 1933, coupled with the deprecation of Irish republicanism as part of a Jewish world conspiracy in other Nazi publications, resulted in an Irish protest to the German Foreign Office

      Aye, best mates by the soond o' it.

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    11. Loved each other:

      The Irish Government did not recognise the German annexation of the rump Czechoslovakia in March 1939. Hitler’s employment of force, coupled with the absence of a German national claim on these regions, crossed the Rubicon...

      ....in an irrevocable bout of insubordination, Bewley [Irish foreign minister to Germany] criticised de Valera’s foreign policy as pro-British, anti-Irish and anti-German.

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  9. Those of us who are old and grisly survived the Hong Kong flu of 1968, which had a mortality rate of 0.5% and killed 80,000 in the UK. The main difference with this coronavirus is it seems to be more infectious and thus spreads more quickly and potentially to a higher percentage of the population.

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    1. Different sources give different mortality rates for the Hong Kong flu - I've seen as low as 0.2%. But as you say, Craig, the problem is that coronavirus would probably infect 60%, 70% or 80% of the population if left to spread freely. That means even with a mortality rate of around 0.5% or 0.6%, it would kill a similar percentage of the overall population as the Spanish flu did in 1918-20.

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    2. Just to add, there was a degree of natural immunity to Hong Kong flu, because it was similar to a previous strain. At the start of the current outbreak, nobody had any immunity at all.

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  10. "Those five stages are the 'test, trace, isolate' approach that the World Health Organization have been urging all along, but that the UK has been so resistant to. The Scottish Government have now - albeit belatedly - accepted the need for it completely. "

    I think the UK and Scotland didn't want to admit that it would have been totally impossible as they didn't have the resources or means to do it en masse - until now or fairly soon anyway.

    Some better news:

    https://www.gla.ac.uk/news/headline_720507_en.html

    One of three Lighthouse Labs in the UK, taking tests from all over the UK, three regional cetnres in Scotland so far, but able to concentrate on Scotland if there's enough demand. Meaning that Scotland can use one-third of the UK's whole capacity just for Scotland. Hopefully it'll build up rapidly having just opened on Wednesday. Hancock may have his half hour and the last laugh, after all. And Sturgeon over the doubters. This is what that's all about, and worth a full read:

    https://www.lighthouselabs.org.uk/

    Massively unreported by any media for some odd reason. Always look, on the bright, side, of life! Unlike the media ...

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    1. But the reason the testing capacity wasn't there was strategic - in February the government decided to let the virus spread freely and that testing could therefore be completely neglected. And of course if testing capacity was limited, that made it even more vital to end mass gatherings and close pubs and clubs far earlier than we did.

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    2. Dr Anthony Costello (ex-WHO, and strong critic of UK approach) has said that, even if tests are not available, Covid cases can be diagnosed by SYMPTOMATIC diagnosis. Scotland should do this, if necessary, to achieve maximum effect from Test, Trace and Isolate.

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    3. Indeed. Medical personnel in any patient interface seem to have a well grounded ability to recognise symptoms where present. Very Dr Findlay style - but much as I remember childhood GP practice. There will be many many cases where testing is not a diagnostic tool but merely a statistical one.

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    4. Yesindyref2
      The Lighthouse Lab in Glasgow has been reported by BBC Reporting Scotland in its news bulletins and by newspapers such as The Herald.

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    5. Thanks Legerwood, now I found it in the Herald I do remember vaguely seeing it. I've a feeling it had a picture of Alister Jack and my eyes glazed over and I went "next".

      Right enough Jack can claim a bit of credit if he wants I don't care. For 1/12th the cost Scotland has 1/3rd the testing capacity of the UK. That'll do for me. I also suspect Hancock's 100,000 tests a day could be just the start once it's in full flood, as it's a "fleet" of machines, meaning they can just get more fleets as long as they have somewhere to put them and people to operate them.

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  11. I'm confused. If what you say is true, why are Scottish Labour and the Scottish Tories complaining that Holyrood's plan is "dangerously different" from the UK plan and we should only unlock as one nation, even if that kills thousands? Genuine question. If it wasn't for Carlaw and Leopold, what you are saying might have seemed believable. However, their comments strongly suggest you are lying, and that Scotland is doing something different. Are unionists just liars, and Scotland is just copying London?

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  12. Why will nobody say it? The Brit Tories and their lickspitles in the Brit Press and Media are quite prepared to murder millions of their so called fellow Brits. The BBC will go along with this plan as well.

    Well the Herd Immunity Policy is equal to a policy of Mass Murder.

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  13. Brian Taylor is impressed -

    https://www.bbc.com/news/amp/uk-scotland-scotland-politics-52401278

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  14. UK just ~500 behind Spain now.

    https://www.newstatesman.com/2020/03/live-data-coronavirus-crisis-all-you-need-know

    Day 42:
    20043 Spain
    19499 UK

    UK could take the lead and have the highest death rate in Europe within a just few days.

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    1. Counting bodies now Skier. If I was the sympathetic type I would feel sorry for you.

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    2. Irrelevant figures as Spain's include some care home deaths and English, Welsh and NI figures don't include those at all.
      Belgium's probably the most open when it comes to their figures and they roughly include 48% deaths in hospitals, 50% in care homes and 2% in wider community. FT is talking about 41.000 deaths in UK so far which is probably right and not really surprising as we've just discovered tonight that Dominic Cummings is the man behind the science Johnson's UK government was following. This revelation puts the whole Led by science phrase UK government keeps dishing out in a completely different perspective.
      But - this opens a new set of questions for SG as well - Did Sturgeon know Cummings was one of the scientific advisors SG together with the UKGov based their predictions on.
      She has to come clean now about what happened in the beginning/mid March - and I'm saying this as an SNP voter - it also politically won't do her, SNP or Indy campaign any harm - it can only harm the Tories and English nationalists in Scotland.

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  15. She dares them to defy WHO. Boris Johnson can deny a Section 30 order until he's blue in the face. Policing is devolved. This is how she defies him. This is how she proves Scotland ought to be independent. Leitch, however, has to go. Quietly, or sacked, If that's actually what she wants. Or she'll go along with the 4 nations strategy and then get the blame from the Scottish media who'll conveniently forget it was a UK idea. In that case maybe Leitch makes a good scapegoat. She needs to play a blinder on this because there's the Salmond revelation coming once this is over. She needs political capital from the population and the SNP voters to survive that.

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    1. Interesting that the corrupt Crown Office is prosecuting C Murray for contempt of court.
      Everyone in Scotland should be in contempt of the court which tried (ha) to have an innocent man locked up for life by a gang of lying whores.

      These women admitted conspiring to achieve their goal of destroying a former First Minister of Scotland. They were proven to be absolute liars in court. Every claim they made was proven false.
      They committed clear perjury and conspired to pervert the course of justice.
      Every one of them should be looking at a minimum of 5 years without parole.
      But they have all been given a lifetime of anonymity. You can't go on trial for perjury without being identified. So it is literally impossible for any one of them to be charged and tried for their crimes.
      There is only one person in Scotland who could have arranged immunity from prosecution for life for her besty mate in cabinet.
      The same person who defended evans and mckinnon.

      She needs to go NOW. Not, "after this is over." This isn't going to be over for years while she hides from the result of her crimes.

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