Chat about Novel Coronavirus - 2019-nCoV - COVID-19

That's sad and worrying news.

The new coronavirus may already have infected far more people in the UK than scientists had previously estimated — perhaps as much as half the population — according to modelling by researchers at the University of Oxford.

If the results are confirmed, they imply that fewer than one in a thousand of those infected with Covid-19 become ill enough to need hospital treatment, said Sunetra Gupta, professor of theoretical epidemiology, who led the study. The vast majority develop very mild symptoms or none at all.

“We need immediately to begin large-scale serological surveys — antibody testing — to assess what stage of the epidemic we are in now,” she said.

The modelling by Oxford’s Evolutionary Ecology of Infectious Disease group indicates that Covid-19 reached the UK by mid-January at the latest. Like many emerging infections, it spread invisibly for more than a month before the first transmissions within the UK were officially recorded at the end of February.

The research presents a very different view of the epidemic to the modelling at Imperial College London, which has strongly influenced government policy. “I am surprised that there has been such unqualified acceptance of the Imperial model,” said Prof Gupta. 

However, she was reluctant to criticise the government for shutting down the country to suppress viral spread, because the accuracy of the Oxford model has not yet been confirmed and, even if it is correct, social distancing will reduce the number of people becoming seriously ill and relieve severe pressure on the NHS during the peak of the epidemic.

The Oxford study is based on a what is known as a “susceptibility-infected-recovered model” of Covid-19, built up from case and death reports from the UK and Italy. The researchers made what they regard as the most plausible assumptions about the behaviour of the virus.

The modelling brings back into focus “herd immunity”, the idea that the virus will stop spreading when enough people have become resistant to it because they have already been infected. The government abandoned its unofficial herd immunity strategy — allowing controlled spread of infection — after its scientific advisers said this would swamp the National Health Service with critically ill patients. 

But the Oxford results would mean the country had already acquired substantial herd immunity through the unrecognised spread of Covid-19 over more than two months. If the findings are confirmed by testing, then the current restrictions could be removed much sooner than ministers have indicated.

Although some experts have shed doubt on the strength and length of the human immune response to the virus, Prof Gupta said the emerging evidence made her confident that humanity would build up herd immunity against Covid-19.

To provide the necessary evidence, the Oxford group is working with colleagues at the Universities of Cambridge and Kent to start antibody testing on the general population as soon as possible, using specialised “neutralisation assays which provide reliable readout of protective immunity,” Prof Gupta said. They hope to start testing later this week and obtain preliminary results within a few days.

I'm having similar issues with biscuits and the close proximity to my laptop... Joe Wicks each morning will help I hope!

Worth mentioning that the 5+ weeks is about faecal samples though, which - while infection that way cannot be ruled out of course - is definitely not the main way people infect each other with Coronavirus.

I’ve made the decision not to work but told it’s unpaid, there’s no guarantee if/how this magical 80% will be paid and the company can’t float wages til it comes through. I’m not working as it’s the right thing to do.

If I name and shame it really wouldn’t go well for me. My boss is a law unto himself so lawyering up is pointless.
I actually have a great deal of respect for the man but we’re talking mafiso fear/respect type situation here.

Thanks, Dave!

And fuck me I would like that to be right.

That seems implausibly optimistic. If half of us have had it and 'only' 400 dead, what has gone on in Italy?

Did anyone official come out and say they were employing the Imperial modelling? Not sure these conflicting models do anything to help keep everyone on the same message, but it's interesting.

didn't all the early cases have direct links to recently traveling abroad? Surely if it had been here and spread around a while before the first recorded cases then they would appear to have no direct cause of infection?

I'm not posting this to support the paper, but:

It was confirmed by the Chinese government at the end of December. So it was spreading in December for certain - perhaps earlier. So it doesn't seem implausible that it could have got to London during this period. Getting to your point: Once it was announced by China to be a thing, and the Who got on board, it's possible that testing was directed at those who had direct links to recent travels. Resources directed towards potential positives, rather than wasted on almost certain negatives?

Matt Hancock has just said the army have got 7.5 million pieces of PPE out to NHS workers over the last 24 hours. I guess if you want something done, get the army in.

And a temporary 4,000-bed hospital will be opened at the ExCel centre. Really hope I have already had it because I don't fancy that much.

That seems implausibly optimistic. If half of us have had it and 'only' 400 dead, what has gone on in Italy?

Speculation:-

Different infection demographics. We tend to pile our elderly into isolation or old people's homes. Italians tend to keep their elderly at home with younger generations.

Is the UK a ticking timebomb in terms of the elderly generation? I guess we'll know a bit more in 2 weeks when the current set of people who are infected are either in the grip of severe illness or getting over it - possibly even without even knowing they had it.

Herd immunity can't work in elderly dense places (retirement villages, old people's homes, etc) as the numbers just don't work, ~80% of people would include a lot of the specifically vulnerable.

ALSO, I was really ill mid-January. taps nose

But what about the doctors and nurses that are now dying or being ventilated in Italy and UK, this is surely a rare occasion under more normal circumstances.

Given the test statistics of 90436 tests conducted and 8077 being positive (8.9%) how could the up to half the population having had the virus be true?

The tests would largely be on people suspected of having it, or been in contact with those that have.

Hopefully their figures prove to be accurate.

re: The argument about models

"All models are wrong. Some are useful" - George Box

Or in the longer version from his 1978 workshop.

"Now it would be very remarkable if any system existing in the real world could be exactly represented by any simple model. However, cunningly chosen parsimonious models often do provide remarkably useful approximations. For example, the law PV = RT relating pressure P, volume V and temperature T of an "ideal" gas via a constant R is not exactly true for any real gas, but it frequently provides a useful approximation and furthermore its structure is informative since it springs from a physical view of the behaviour of gas molecules. For such a model there is no need to ask the question "Is the model true?". If "truth" is to be the "whole truth" the answer must be "No". The only question of interest is "Is the model illuminating and useful?".

So what is not clear is how much more useful the new model is in planning and managing the crisis. It's just "we think more people are infected" but since testing has been insufficient no one knows who is right. So, it is literally, completely academic.

They aren’t antibody tests, only people that actively have the virus.

Oof. That's a tough situation. If this is how you're treated for piping up on something as important as this though, I don't have much hope if anything personal happens to you and you need help.

What you're describing sounds proper dodgy. It is not clear why you don't want to take any action.

If you and your colleagues are not being treated appropriately then lawyering up/ consulting a union rep/ other measures are perfectly reasonble.

I am sorry to hear of your situation.

ExCel Centre.. I could probably walk there in half an hour from home, so that’s convenient if I need to admit myself

I’m also liking Jamie Oliver showing the nation how to make pasta and bread from scratch on Channel 4.

Not like there's any flour to be had for love nor money...

@edmundro that is tough, thoughts are with you

I figured that, as people lurch from toilet rolls, to dried pasta, to plain flour

thanks! :)

Here's the actual paper for those interested (the 50% one). https://www.dropbox.com/s/oxmu2rwsnhi9j9c/Draft-COVID-19-Model%20%2813%29.pdf?dl=0

The claim (as I read it) is not that the UK has already had 50% infected, but that it could be much higher (and as high as that), because we (and everyone else - including Italy which is also part of the study) started counting quite late. They use a method which backtracks from the first deaths to estimate how long the virus would have been around to result in deaths, and how many people would therefore have been potentially infected.

The real conclusion of the paper is that a lot more emphasis needs to be placed on testing. Which, with the news that 3.5 million anitbody tests have been purchased, we'll start seeing, I suppose.

Our simulations are in agreement with other studies that the current epidemic wave in the UK and Italy in the absence of interventions should have an approximate duration of 2-3 months, with numbers of deaths lagging behind in time relative to overall infections. Importantly, the results we present here suggest the ongoing epidemics in the UK and Italy started at least a month before the first reported death and have already led to the accumulation of significant levels of herd immunity in both countries. There is an inverse relationship between the proportion currently immune and the fraction of the population vulnerable to severe disease.

This relationship can be used to determine how many people will require hospitalisation (and possibly die) in the coming weeks if we are able to accurately determine current levels of herd immunity.