[AR] Re: ... Coronavirus
- From: Peter Fairbrother <peter@xxxxxxxxxx>
- To: arocket@xxxxxxxxxxxxx
- Date: Thu, 26 Mar 2020 20:13:34 +0000
On 26/03/2020 08:41, Jake Anderson (Redacted sender jake for DMARC) wrote:
Why do we even have healthcare for people over 60? Their grand kids are
typically grown enough not to need extended family daycare. Yet these
people consume the majority of healthcare costs. They are just a burden
on the economically viable young people.
That's not the world I want to live in.
https://www.youtube.com/watch?v=dcSMxKn66G4
The ones who walk away from Omelas.
"the real hard decision would not have been to focus efforts on
amelioration at the cost of many lives, for some greater eventual good;
but instead to implement strong confinement on ethical grounds, even if
we thought it couldn't work."
UK policy is still to get to the herd immunity point rather than to
eliminate the coronavirus, I guess US policy is the same.
Peter Fairbrother
3- A Coventry Moment
15 March 2020
There is a story that Winston Churchill let Coventry burn under German bombing
in order to protect the secret that the Nazi Enigma codes had been broken. He
made a hard decision to spend lives now, in order to promote the greater good
later.
On TV recently we have seen Boris Johnston looking Churchillian, having
apparently made a similar sort of decision about the coronavirus epidemic -
spending 400,000 [1] British lives now in order to gain some future advantage
The problem is that we don't know what that advantage is. It all seems a bit
nebulous.
And apart from the large death toll, such a massive number of cases means the
country will never be completely free of the disease - indeed it might provide
a reservoir of low level infections which could mutate to produce novel viruses
and turn the present virus into a recurrent seasonal virus, a nightmare outcome.
-
At the start of the epidemic, when we thought that it would prove impossible to
stop the infection, the policy of delay made some sense - spread the peak to
decrease maximum hospital load and thereby save lives.
That 400,000 or so British people would die was unfortunate, but inevitable.
There was nothing we could do about it.
But then the Chinese stopped their epidemic, showing that there was no need for
400,000 or a million people to die, and everything changed. Except the policy.
-
Herd immunity is just what happens if you don't do anything to stop any disease
which leaves the patient immune after it has run its course. It is at best a
distraction.
One other possible line of Government thinking is that after we implement
strong containment we would then have a still-vulnerable population, giving
rise to the fear that we might have to continue strict measures indefinitely.
Possible, but what measures? Strict universal isolation is almost certainly not
necessary once the disease is under control, though close attention to detail
will still be necessary.
Proper control of entry to the country with quarantine where appropriate is the
major continuing need; but other countries will be doing something similar, and
international travel will not be easy for years anyway.
Better social distancing - the elbow or foot tap, enlarging personal space,
avoiding contact where possible; protective measures like handwashing and
handrubs, masks and respirators, perhaps gloves and goggles; widespread testing
and diligent contact tracing once the epidemic is under control (with
short-term but mandatory isolation/quarantine for those testing positive) are
probably all that is needed.
But we can follow the Chinese example as they relax controls, and limit
measures here to those which are necessary and which work.
Medium term, if people get "isolation fatigue", and the disease spreads? We
would still be better off if we implement strict confinement now. We would have
had time to make a billion masks, time to prepare a hundred million tests, time
to open hospital beds, time to get the needed equipment, time to work out
optimal therapies - and most of all time to research the disease.
For instance, how much would closing schools help? To answer that we need to
know whether and to what extent children get the disease in a very mild form
and pass it on, or do they just not get it at all - and we do not know the
answer to that question.
How long does the virus stay active on various surfaces? We don't know.
What are the most important secondary and minor routes of infection? We don't
know.
Why are older people more likely to die, and can anything be done to prevent
this? We don't know.
How do we immunise the population? We don't know (yet).
How can we cure the disease? We don't know.
But we do know how to stop it.
-
Mr Johnston is not Winston Churchill.
Churchill himself never faced a "Coventry Dilemma"; that was just one of many
similar teaching stories used at Bletchley Park to emphasise the need for
secrecy. It wasn't real [2]. Many hard life-and-death balancing decisions were
made by Churchill during the war, but the "Coventry Dilemma" was not one of
them.
As for COVID-19, there is no sacrifice here to be made for the greater good.
There is no greater good to be had. Any sacrifice of lives would just be an
unconscionable waste, somewhere between manslaughter with reckless disregard
for life and pointless mass murder.
We can kill the disease. We do not need to kill the population, or 400,000 or a
million of it.
The Chinese have effectively killed the disease in China. Pretty soon they will
be thinking about quarantining people entering the country, if they aren't
already. That is the kind of turnaround we should be trying for.
As an aside, the real hard decision would not have been to focus efforts on
amelioration at the cost of many lives, for some greater eventual good; but
instead to implement strong confinement on ethical grounds, even if we thought
it couldn't work.
Strong containment can work. It has been tried. It worked. There is no obvious
downside to doing it.
There is no hard decision to make. There is no Coventry Moment. There never was.
Peter Fairbrother
[1] or a million deaths in real numbers, or twice as many British people as
died in WW2. Best to treat the 400,000 Government figure like a contract price
estimate which will inevitably overrun.
[2] It became a meme after a self-aggrandising idiot called Frank Winterbottom
with an ego bigger than Julian Assange reinvented the story with himself in a
leading role, and wrote a book including it as a true story.
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