The UK is in a grim place when even Donald Trump now has a more enlightened attitude to the crisis than our own Chief Medical Officer and Chief Scientific Adviser. Trump on herd immunity: "well you know it’s a concept, it’s a concept - if you don’t mind death."
— James Kelly (@JamesKelly) April 1, 2020
Among the dwindling band of enthusiasts for the "take it on the chin" / "herd immunity" approach, a favourite refrain is that it doesn't actually matter if an unimaginable number of people die, because (supposedly) "they would have died anyway". Incredibly, even the BBC tried that line the other week. The idea is that many of the deaths are elderly people with severe health conditions who would otherwise have had an extremely short life expectancy. Now let's be clear what we're talking about here: Imperial College estimate that without a full-on suppression strategy, around 250,000 people would die of the virus in the UK, and of those, around half to two-thirds "might" otherwise have died of another cause at some point this year - although of course that leaves open the possibility that they could have lived on for many months, and no price tag can really be put on that.
But even if those people are completely excluded, that means the real total of excess deaths would be "only" somewhere between 83,000 and 125,000. As we've seen, many of those victims would be relatively young, and a significant minority would have no underlying health conditions. We're talking about people who can reasonably expect to live a great many years or decades in the absence of a herd immunity strategy.
For comparison, the death toll from the nuclear bombing of Hiroshima in 1945 is estimated to have been somewhere between 90,000 and 146,000.
"They would have died anyway" would work as an excuse for murder.
ReplyDeleteIt is necessary to treat figures referring to covid-19 deaths with caution. Because the NHS has had to take extreme measures to cope with covid-19, it has meant that patients with other conditions have not received the quality of care that they would otherwise have received. This is no criticism of NHS staff - it is just an inevitable consequence of the need to re-allocate resources in response to a massive crisis. As well as comparing numbers with annual expected deaths of older people, what happened at Hiroshima, etc, it is necessary to translate these numbers into what they will mean in terms of all of our lives, in terms of losing people we know and love, in a terrible way that makes it hard to grieve. There has been a lot of attention, quite rightly, to the inadequacy of many aspects of the UK government's response to the crisis. But, alongside the equipment and new hospital buildings, there is also a need for be able to hear the voices of human solidarity, hope and meaning. At the time of the Spanish flu epidemic of 1918-20, this was the voice of the Church. Now, one hundred years later, it needs to be a diversity of voices.
ReplyDeleteJohn, I actually can't make any sense of the point you're making. The suppression measures necessary to avoid Hiroshima-type numbers are the only means of preventing the NHS from being totally overwhelmed. What do you think would happen to those patients you mention with other conditions if we let the virus rip and allow the NHS to collapse? They certainly wouldn't receive "the quality of care they would otherwise have received" - but that's just for starters. Most of them would catch the virus and some of them would die of it.
DeleteSays it much better than I can:
ReplyDeletehttp://www.pulsetoday.co.uk/views/blogs/who-has-the-right-to-decide-who-lives-or-dies/20040524.article
My response above also covers that link, which I'm deeply puzzled by.
DeleteFurther apology to everyone. I had not realised that access to this article required a login.
DeleteSo may I take it that, after a vaccine has been developed and when the next ordinary flu season rolls around and dispatches the usual number of elderly, sick and sufferers from underlying conditions, we may expect a similar lockdown to what we've been sitting down under for the last couple of weeks?
ReplyDeleteNo you may not do that. What you call "the ordinary flu" causes 9000 excess deaths, not 83,000 to 125,000. Of course the words "the ordinary flu" imply that what we are currently facing is a form of flu, and even Donald Trump now recognises that is not the case.
DeleteOK, so we're playing a numbers game, then. "9,000 excess deaths" is acceptable, "83,000 or 125,000" is not. But we don't know that there actually ARE going to be 83,000 or 125,000 excess deaths, and we're only speculating this on the back of a heavily contested piece of modelling by Imperial College, a piece of modelling which the designers refuse to release the coding for (or, to put it another way, refuse to open to peer review) and which is, in any event, only modelling, the academic term for guesswork.
DeleteAnd on the basis of this modelling, parliament has been shut down, the population is under house arrest, the cops are going nuts demanding "papers please" from every jogger and dog walker, the social networks of the healthy old are being destroyed because they can't get out of their houses, businesses are collapsing, jobs are being lost, pension funds destroyed, the yellow press is stoking the panic like the coal shoveller on the Flying Scotsman and most disturbing of all, the public are taking it up the tailpipe with no complaint.
There are two salient and inescapable facets to life, James - 1) everything in it is a trade-off, and 2) nobody gets out of it alive. Accepting 2) makes 1) a lot easier. I say it's time we started trading.
Don't be so bloody ridiculous. If "we're all going to die eventually anyway" was acceptable logic, we might as well just stop trying to fight illness and abolish the NHS completely. Whether you like it or not, Athanasius, it is actually important to most people whether they die right now, or whether they get to live many more years or decades.
DeleteAnd, by the way, using language like "trade-off" and making comparisons with seasonal flu is exactly why your argument fails. Accepting a few thousand excess deaths from seasonal flu is indeed a trade-off, but when the numbers are many, many times higher than that, the price-tag just can't be accepted anymore. You can huff and puff about "guesswork" as much as you like, but the facts on the ground in Italy and Spain aren't guesswork. You don't get carnage like that with seasonal flu.
Incidentally, the other difference is that with seasonal flu there's a vaccine available, which means that it's already possible to minimise the numbers without extreme social distancing measures. If a bigger percentage of the population was vaccinated, deaths from seasonal flu would fall even further.
The same argument was put forward for letting the nazis invade / make peace with them rather than fight. 'To fight them would come at far to great an economic and social cost, with crippling war debts payments lasting for decades. Better to just let them come in and cull the population (just Jews, disabled etc anyway), with the fittest surviving'.
DeleteNot a hitler reference as such, as the comparison works for all the same situations where collaboration with the murderous invader is chosen by some because it offers apparent short term economic reward. They generally come to later regret this.
DeleteAs it stands, the UK covid death rate is now approaching 4000/week. This compares to ~330/week for seasonal flu over a typical year. So the death rate is already over 10 times that of seasonal flu, and that's for a very low comparative infection rate with covid. If everyone gets it, the death rate could be an order of magnitude greater.
Comparisons with seasonal flu are 'reductio ad Hitlerum'.
A few things you might note, James. The Scottish Health Service seems to have tested 3,800 staff compared to the 2,000 in the English Health Service. Secondly when the BBC and others keep quoting a 'UK' test total I think they actually mean Englandshire. Certainly it does not stack up if they say 8,000 a day in 'UK' yet we also know that Scotland is doing nearly 2,000.
ReplyDeleteMost importantly, all this 'green shoots', maybe the number of cases is plateauing stuff is absolute nonsense. It is simply an artefact of the number of test (in Englandshire) staying more or less the same. It is blatantly obvious that if you only do 8,000 tests a day then you have a cap on how many 'new cases' there can be as it is impossible to identify more than the 8,000 you test. So you are going to have a lovely curve approaching the 8,000 limit while out in the real world there could be hundreds of thousands of cases.
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ReplyDeleteWe can't keep the population under house arrest for months on end. Italy is beginning show small pockets of unrest over the lockdown and that's just after a number of weeks. Herd immunity now has to be considered in a few weeks time. Who knows what health damage is been done behind closed doors.
ReplyDelete'Mass cull of a large section of the herd' is the correct name for the strategy. It's how the eventual immunity is achieved.
DeleteOf course the suppression strategy also creates herd immunity (potentially via vaccine) just over a longer timescale and with less piles of bodies.
Oh yes, of course, Big Z, hundreds of thousands of deaths is a price well worth paying to avoid "small pockets of unrest".
DeleteFrom what I can gather, any unrest in the south of Italy is not really caused by the lockdown itself, but by the government's failure to get emergency payments to people who need them. Of course there'll be unrest if people are literally unable to pay for food.
People understand that over the past coupe of days, the covid death rate has hit 4k/week or 206k/year?
ReplyDeleteThis is the pre-lockdown initial infection spread and confirms 200k dead in a year at least.
It is still accelerating. In the next few days we will very likely hit our 250k dead in a year rate as per modelling.
Of course we can now hope to see the lockdown effect kick in and we go from heading for hundreds of thousands of deaths to a few of thousands.
People saying 'this is like seasonal flu' clearly need to do some school maths revision.
to a few tens of thousands. Fingers crossed.
DeleteFurther to comments you made earlier James. If the flu vaccine was "freely" available to all then even less folk would die from flu James.
ReplyDelete