IOM Covid removing restrictions

[pongo]

12 minutes ago, Nom de plume said:

Hail Boris & his three tier lockdowns!

The National Lockdown will be his victory lap, what a guy.

Govt's cannot win. Labour must be so happy not to be in government.

On the one hand they've got to try to keep people safe and the economy ticking over by expanding the money supply.

On the other hand they've got to deal with blowhards, conspiracy nutters and Twitter people who believe that the whole thing is either a hoax or an over-reaction. Plus Steve Baker and co.

Edited November 6, 2020 by pongo

[BenFairfax]

9 minutes ago, trmpton said:

So.  News from the uk that the spread has plateaued or is dropping.

Of course intelligent people knew that anyway.

Liverpool looks to have past the peak of its 2nd wave, Liverpool council has data here UK 2nd wave evolving with shallowing peak than much of Europe now, but now from what I can tell the gold standard states have NZ and IoM alone.  

5 minutes ago, Nom de plume said:

Hail Boris & his three tier lockdowns!

The National Lockdown will be his victory lap, what a guy.

Will never know if tier 3 would of been enough in Liverpool, I think it likely would have, but without global lockdown nothing to stop people from driving from higher infection area to lower ones and restarting new chains of infection. 

[Beelzebub3]

17 hours ago, Roxanne said:

He always sounds to me as if he is reading from a child's story book. 

You are being polite.

[Beelzebub3]

20 hours ago, monasqueen said:

I picked those comments because most people on here seem to think that the Channel Islands systems are wonderful.

While the Channel Islands may not be the best of solutions, they are trying different methods of testing at the borders, which in reality may be fruitless, at least they are doing something as opposed to us doing nothing and hoping someone else will come up with a feasible resolution to the current virus, I feel we have buried our heads in the sand and will try and sit it out. We could be waiting a long time!

[Escape Artist]

On 11/6/2020 at 1:57 AM, BenFairfax said:

For IoM the shielding group taking into account these peoples likely immediate social network could mean 30K people. Idea is simple particularly for 1st degree relatives, if an outbreak occurred then all social network would change behaviour. At least people I know would opt to lose (say) going out to pub over risk of potentially passing on pathogen to a family member at significant risk of serious illness from that pathogen. Theoretically you could split island onto two and say all people who want tight controls go into one area and other with no controls into other..... But in practice that not workable. The networks are embedded. You have front line medics on IoM (who I know) who have close family members who are at high risk, ditto I assume all other sections of economy, biggest fear for such people is risk of infecting their own family. You can say high-risk people should isolate themselves, brings number down to 3,400; which likely to happen anyway in significant outbreak, but the effect on society particularly economically will be disproportionate. Remember the shielding group are typically 35-70 (over 70 not in this group [explain why I think later], young rarely have chronic disease) bulk of years when have greatest earning power. Reason I believe over 70s not put in this group is because of metric used by NICE (National Institute of Clinical Excellent) which measures expected value of 'addition quality life years' as a measure of whether a procedure/drug if effective. Clearly as get older your years left reduces, so COVID interventions have less life expectancy years to win. But besides 4% shielding people I would expect over 70s to also radically change behaviour on significant outbreak. Whatever NICE says, I do not think they are keen on risk of becoming very ill.

With above cancer data, cancer is a disease in main of old age, and reason additional no risk for under 40, is because the set is empty (in this case). If want to consider another risk group could consider autoimmune conditions which effects all ages (even few kids, but mostly over 30). Here a BMJ study I found:

https://ard.bmj.com/content/annrheumdis/79/7/859.full.pdf

which for this group put hospitalisation risk at 46% and mortality at 9%. Break down by comorbidity but shame did not stratify by age but guess with only 600 people over various conditions data set not big enough. But there again I guess if in this box and saw COVID coming you would lock yourself in the cellar (if you had one).  

Looking at UK data on how prevalent these conditions are, I would estimate have 300 rheumatic disease patients on IoM, but load other conditions mentioned too, so 500 could be closer estimate (I just do not know). But say assume have 300 in this box, and the all get infected, report has 46% hospitalisation rate so end up with 136 of them in Nobles. Nobles has 200 beds and 6 ICU beds (in standard configuration). So just this group of 300 people could bring Nobles to its knees.

For everyone, you definitely want to reduce the risk of people who are extremely clinically vulnerable of getting infected. As said in previous post stratification of risk is particularly large for this pathogen, so you would expect behavior of different risk groups to vary and I think makes sense for state to manage risk for all for greatest common good. That means steps to reduce spread of pathogen and get such groups to take much stricter precautions than general population. 

Finally, reason I keep banging on about PPE at Nobles is because such groups are going through there all the time bunched up in enclosed indoor spaces. We have continually had patients and medics going back and forth to Liverpool, all hospitals all time have tight infection controls but bacterial and virus infections happen all time (I believe 25% infections occur in hospitals but cannot find reference, but number is large). Staff canteen upstairs and everyone there eating and chatting in close quarters, in clinics have fixed protocols but upstairs people will relax which is natural. Anyway, good to hear someone at hospital must have told someone in Government about use of PPE in Nobles and risk. Two COVID positive patients must fucused minds but I think transmission risk been present all time. Last I heard was in August management told frontline staff to stop using face coverings at Nobles, while UK Health, UK NHS and SAGE where saying exactly opposite, see:

https://www.gov.uk/government/news/face-masks-and-coverings-to-be-worn-by-all-nhs-hospital-staff-and-visitors   

view of this advice varied between medics, but it appeared from various conversations, at least coincidently, that medics with family members in high-risk groups would have preferred to keep facemasks while those without had a more relaxed opinion.   

 

Thanks for your detailed reply to my observations. You come up with a truly thoughtful posting, though it takes some focus to go through it.

The problem is that you arguments rely on assumptions and estimations, and thus, should those assumptions and estimations not be accurate, you may reach the wrong conclusion.

Some other posters took a more evidence based approach by looking at other places/jurisdictions that have adopted different policies from us. Mentioned have been the examples of Jersey, which is controlling its border through extensive testing; and Switzerland, Sweden, San Marino, which are not controlling their borders. These are European examples, but we could also consider the case of several US states, Florida for instance, which are now doing very little to control Covid, and sailing through anyway.

The above mentioned “real-life” examples provide a more reliable indication of what would happen if we were to change our policy than models and estimations.

Our policy, eradication by any mean, is not sustainable for much longer without causing a lot of damage to the island. It was initially adopted because the virus was thought to be much more dangerous than it actually is. It was adopted because politics got in the way of rational thinking.

[Hard Truth]

Lockdown has shifted risk from the professional class to the working class.

Untended consequences of ill-thought policies.

[TheTeapot]

30 minutes ago, Escape Artist said:

, but we could also consider the case of several US states, Florida for instance, which are now doing very little to control Covid, and sailing through anyway.

 

Florida is a disgrace. You can't trust their data, and you certainly can't use that state as a positive example of anything. 

[Banker]

Howie says we can learn from Channel Islands on testing but isn’t actually going to do anything until tests change, so how the others can manage it?!

https://www.manxradio.com/news/isle-of-man-news/iom-could-learn-from-channel-islands-border-testing/

[Hard Truth]

33 minutes ago, TheTeapot said:

Florida is a disgrace. You can't trust their data, and you certainly can't use that state as a positive example of anything. 

Freedom is worth nothing to you.

If you get your way, yes you are going to have your geriatric island for you and your care home chummies.

I won't be here in that case.

[TheTeapot]

2 minutes ago, Hard Truth said:

Freedom is worth nothing to you.

If you get your way, yes you are going to have your geriatric island for you and your care home chummies.

I won't be here in that case.

What the fuck?

[wrighty]

There’s not been much discussion of infectivity, and how it correlates with positive testing and symptoms. Being infectious is clearly a more important determinant of how long quarantine should last for than whether someone is likely to test positive. 
 

There’s been some work on viral culture - that’s growing viable virus from swabs, as opposed to just finding bits of them by PCR. It’s apparently not possible to grow virus from samples taken 8 or 9 days post onset of symptoms, but PCR can be positive for a month or more. People are infectious for a day or two before getting symptoms. 
 

When it comes to border policy then it could be like this. Isolate on arrival. If symptoms develop - test, if positive isolate until day 10 post onset then free to go. If no symptoms test day 7 - if negative get on with it, if positive isolate another 7 then get on with it. I can still see no point in testing on arrival, and once the uk prevalence drops even less so. 

[Banker]

31 minutes ago, wrighty said:

There’s not been much discussion of infectivity, and how it correlates with positive testing and symptoms. Being infectious is clearly a more important determinant of how long quarantine should last for than whether someone is likely to test positive. 
 

There’s been some work on viral culture - that’s growing viable virus from swabs, as opposed to just finding bits of them by PCR. It’s apparently not possible to grow virus from samples taken 8 or 9 days post onset of symptoms, but PCR can be positive for a month or more. People are infectious for a day or two before getting symptoms. 
 

When it comes to border policy then it could be like this. Isolate on arrival. If symptoms develop - test, if positive isolate until day 10 post onset then free to go. If no symptoms test day 7 - if negative get on with it, if positive isolate another 7 then get on with it. I can still see no point in testing on arrival, and once the uk prevalence drops even less so. 

Well Guernsey are picking up a number on testing on arrival, another one today think that makes it about 6 this week so there’s obviously some benefits.

[Cambon]

6 minutes ago, Banker said:

Well Guernsey are picking up a number on testing on arrival, another one today think that makes it about 6 this week so there’s obviously some benefits.

Which is what? 

[Banker]

26 minutes ago, Cambon said:

Which is what? 

Picking up cases obviously!!!!

[Ham_N_Eggs]

41 minutes ago, Cambon said:

Which is what? 

Statistics. This was supposed be an evidence based policy making Government. But when offered the chance to gather evidence they rebuke it. At the moment they seem to be doing things on gut instinct.