Lockdown must end very soon

It seems inevitable that the government will soon announce an extension to lockdown, and that it will be made more severe. Most of us will have several more weeks of being confined to homes, probably only except for trips to the supermarket or doctor. For many people, that means solitary confinement, in small flats with no garden. Even murderers in prison area allowed out for daily exercise.

Lockdown is due to be ‘reviewed’ soon, but it must end soon. The ongoing costs will be too damaging if it is allowed to continue, not just economic cost but extra deaths, mental health issues and lingering social and political damage

UK Health Authorities and Government negligence got us into this mess, but they are still making serious blunders

The handling of COVID by both the government, the health authorities and the police has been pretty poor so far. If you disagree, consider the following.

Experts have been warning frequently for decades that one of the biggest risks faced by humanity this century would be pandemics – every competent futurist has certainly always had it in their top three risks. They have been warned frequently that global travel and large city living would enable the very rapid spread globally of any new virus and that any time, a new outbreak could happen that would mean millions could die. Government cannot claim they did not have good warning that we would face a major pandemic. In fact, we’re fortunate this one only kills 0.66% of those it infects, it could have been far worse, it might have been 30%. Yet government and especially its Department of Health was very badly unprepared, with far too few incubators, intensive care beds, even face masks, let alone ensuring the ability to rapidly develop testing capability or vaccines. This unpreparedness goes back several governments. Hancock is doing his best and can reasonably claim he hasn’t been in that job long, but his many predecessors can’t escape condemnation. For example, I could never understand how someone who believes in homeopathy could possibly be be made Minister of Health, or why a PM would expect someone with such beliefs to have good analytical skills.

We knew COVID was a such a potential risk before the first cases were allowed to enter the UK.

In the weeks following, even though they knew large numbers of infected people were coming into the country, government did nothing. It didn’t close the airports. It made no attempt to prevent flights from infected areas, no attempt to check passengers even for obvious symptoms such as fever. It didn’t even give passengers any appropriate health guidance other than weakly suggesting they should consider self-isolating if they develop symptoms. It allowed passengers from infected area to be huddled closely together with others at passport control, greatly facilitating cross-infection. It made no attempt to quarantine anyone likely to be infected or to track their contacts. In short, government sat and watched as the virus spread beyond control, even helping it to do so.

During all that time, while it asked vulnerable people to isolate themselves, it allowed the idiot mayor of London to reduce tube services, forcing those who needed to travel into close proximity on platforms and trains, again facilitating the spread of the virus.

Faced with the choice to limit the virus coming into the UK, finding, isolating and contact tracking the manageable number of infectees, our government negligently watched as the virus became widespread. Its early policy was to achieve ‘herd immunity’, which needs 80% or more people to become infected. Many would develop serious symptoms and suffer terribly and many would go on to die horrible deaths. The estimated 250,000 deaths from a herd immunity approach contrast starkly with the few dozen that might have resulted from the alternative early action approach.

The governments response then changed to a ‘flatten the curve’ approach, still accepting that most people would be infected, but limiting the number of simultaneous cases to the small numbers the unprepared NHS could cope with. Because of their previous actions, they had little choice. They hoped that eventually, a vaccine might be developed, in 18 months or so.

When the virus seemed to be spreading too quickly, instead of reducing the rate of spread by concentrating on the gaping holes in their approach – allowing people to be crammed together in tube stations and passport control, and still letting others enter the country – they decided instead to introduce lockdown for a large part of the population, regardless of the level of infection in different areas, varying by as much as a factor of 20. Those people would suffer lockdown, while many others would still be crammed together spreading infection. In low infection areas, that lockdown could only reduce a small figure by a small amount. In other areas with high infection, a stricter lockdown would have achieved far more.

Many areas of London have very high infection rates. Given the 75% reduction in traffic, it would be extremely simple to lift London traffic controls and encourage as many as possible to use their private cars, especially for those living in the most infected areas, greatly reducing cross infection in the tube system. Instead, one of the heads of Public Health England made the comment that she was ‘slightly alarmed’ by the switch of travel from public transport to private vehicles. PHE has also stated that there is no point in wearing masks (a simple mask may not prevent you catching the virus, but they will greatly reduce how many virus-laden particles people emit when they talk, cough or sneeze and therefore will reduce the rate of infection. It may well be the case that PHE wants to reduce demand by the public for scarce masks so that enough will be available for those who need them, but if so, they should say so and not talk rubbish). I find it more than slightly alarming that people with such poor analytical skills should be in positions of decision making. Masks should be worn, prioritizing availability if need be to high infection areas.

People are still travelling between areas of very high infection and areas with very low infection. Many people in low infection areas will be needlessly infected. This will increase deaths. If we must have lockdown, there are far better ways to arrange it. Cellular lockdown, restricting travel between areas of markedly different infection rates would greatly reduce spread.

Even separating people from high and low infection areas in public transport would only require a simple ‘red and green’ trains system. Yet it seems beyond the comprehension of our authorities.

Some police forces have been intimidating people who are driving to open areas to exercise. Although a very few areas might attract occasional crowding greater than town footpaths, generally, urban footpaths will have far more joggers, walkers and cyclists, so exposure during exercise will generally be far higher by forcing people to exercise locally. That will increase cases and deaths. Closing parks and National Trust Gardens is similarly stupid and counter-productive. People will die because of that stupidity. Rather than take the side of common sense and logic, government threatens the people with stricter confinement if they continue to try to enjoy the outdoors, even when they are spread out.

Making it very hard to exercise away from other people will deter many people from doing so. Just when they have the greatest need to maintain peak fitness in case they become ill, their ability to do so is being reduced by officious police and busybodies. That will result in more deaths.

Watching such ongoing stupidity and negligence, I have very little confidence left in our government to make good decisions. I do not believe continuing lockdown is the right policy.

Lockdown

The current one-size-fits-all policy of lockdown is highly questionable, another mistake in a long line. A smarter form might have been justifiable to recover from the mess poor previous decisions got us into, but looking from where we are now, lockdown must be lifted soon, or it will cost far more than it saves.

Mental Health Costs

I was already self-isolating before lockdown, being ‘at risk’ but I don’t find isolation difficult. I’m introvert, normally work from home, and don’t normally leave my home more than a few times a month. I have a nice house and garden and a fantastic partner. So I have barely felt any change and am not suffering. Many are not so fortunate.

Many people live in tiny homes with no gardens and must find it distressing, especially those accustomed to going out frequently. Others live alone and many of them will be feeling very lonely. Still others will be experiencing relationship breakdowns, some of which will not mend when it’s all over. Lockdown will already be taking a severe toll on many people’s mental health. As lockdown continues the mental health costs will grow enormously. Some have already died via suicide and murder. Many more will follow, many will suffer extreme stress or fall into severe depression and start to suffer the wide range of ailments associated with those, especially many who are watching their business collapse.

Loneliness is a terrible problem that affects millions, particularly the old, and is known to contribute to ill health and death. Lockdown obviously is increasing loneliness for very many people, and will result in an unknown number of extra deaths.

Relationship breakdown as people are forced to live with each other 24/7 is inevitable. This is a well-known cause of stress, suicide and health reduction and will cause deaths directly and via reduced ability to deal with infection. Families of those concerned will also be affected.

Domestic violence is likely to increase similarly.

People’s energy bills will increase as they are confined to home. Many who already struggle to pay them will be greatly stressed by increased costs. Stress directly contribute to illness and deaths. If some old people who are already vulnerable have to turn down the heating because of worrying about energy bills, that will make them more physically vulnerable and mean even more deaths.

Death Costs

We now have some figures on the nature of the infection and its lethality. The Lancet suggest that 0.66% of those infected will die. If everyone were to be infected, that would be 430,000 UK deaths, and we’ve heard estimates around that before. On the other hand, the coronavirus app results suggest that as few as 25% of people have already been infected, suggesting future deaths due mainly to COVID might only be a few thousand (the majority of people dying who have COVID on their death certificate had other underlying issues and many would have died anyway, or soon).

Without testing of statistically large enough randomized samples in each area, we really have no idea and the government is flying blind. Letting everyone out and not doing anything at all to limit infection might result a few thousand or a few hundred thousand more deaths caused primarily by COVID. We simply don’t know. What we do know is that to be at the higher end, the mortality figures would need to be that high and almost everyone would need to be infected, but firstly, we can strongly limit infection by implementing sensible policies, and secondly, if we do that, we will have a vaccine in time to prevent most people becoming cases. So the high end is far too high. If we lifted lockdown now in low infection areas and later in higher infection areas after we have significantly reduce infections by better policy implementation and some optimised testing, future deaths would likely be between 5000 and 20,000, a wet-finer estimate, but probably no wetter than the models government seems to be relying on.

Not everyone lives in homes with good ventilation. Some in poor quality housing will have a higher infection rate from both COVID19 and other diseases due to poor ventilation.

Many people still rely on coal or wood fires, both of which produce particulates that can cause breathing difficulty and contribute to respiratory-related deaths.

The deaths costs from the above causes will be high, probably running into hundreds if it is allowed to continue more than another week or two, and that has to be offset against any gains. But there is an even bigger factor that will worsen if continued lockdown causes severe economic damage. As well as the factors above, some economists have done their analyses and suggested that due to the inevitable recession – up to 17% drop in GDP – far more future deaths will result from economic decline than will be saved by lockdown. For a change, even though they’re economists, I’m not inclined to disagree.

Economic Costs

In terms of saving lives, there are many ways to save lives so with finite funds, we should spend where the most lives can be saved for given funding. If we only save 5000 lives, but spend £500Bn to do so, that works out at £100M each! The NHS currently won’t provide a drug unless it is likely to add an extra year of quality life for less than £30,000. A typical 65-year old dying of COVID today would only expect to have another 20 years of life on average, so the NHS won’t pay more than £600k to keep them alive if they were dying of something that isn’t COVID. Many of those dying are much older than 65 and most have other underlying factors that make their life expectancy much less than normal. Using the same valuations,, an average spending limit of £250k seems more realistic. At £250k each, even the highest current estimate of 250,000 deaths would have a cost limit of £60Bn. On harsh economic terms, we could save more lives by helping those with other illnesses if the cost will exceed £60Bn. If you look a little further, various studies over the last decade have shown that tens of thousands of deaths in hospitals result from negligence, errors and poor hygiene. We could reduce those even more cheaply.

So the cost of lockdown makes no sense in terms of the economic cost of saving lives – there are more cost-effective ways. We could save far more for the same spend.

Social Costs

But there is still another major cost: society. If you are on social media, you will have noticed the rising tension, the conflicts between those who believe in this policy versus those who believe another one, the ones who want to comply versus dissenters, the rule violators versus the snitches.

Confidence in the police is being strained to breaking point, as is confidence in government. NHS worshippers abound, but so do those who believe shelf stackers and binmen are just as important.

Inter-generational conflict will increase. The young see their futures being thrown away to buy a few more years for the very elderly who would die soon anyway.

There will be strong resentment of the private sector worker watching their pension evaporate while the public sector worker next door has their gold-plated pension protected. People who were laid off and have to survive on Universal Credit will likely resent others having 80% of their previous income paid by the state, as will those who had to watch their businesses thrown under a bus with receive no compensation at all. Everyone will have to pay, but only some were protected.

Many of these growing tensions, resentments, conflicts and tribal conflicts will not vanish when it’s all over. Scars will remain for decades. The lingering social costs may well be as high as the economic and death costs.

Political Costs

Finally, we should consider that politics will change too.

Privacy, freedom, free speech and respect for the authorities will be permanently damaged. Social cohesion is an important part of the foundations of democracy.

Respect for the police and the principle of  ‘policing by consent’ has already been eroded by some police gleefully abusing their power like bullies appointed school prefects.

Being left with enormous bills and a trashed economy, with many businesses dead, it will take decades to recover. We already know the huge effects of austerity in politics, but are rapidly adding enormously to the already massive national debt so future austerity will be deep and long-lived.

We can also be sure that this will not be the last virus. In a year or two there will be another, and because of the poor handling of this one, reactions by society and the markets will be even more panicky, and we may take more economic hits. We may take generations to get back to ‘normality’.

Summary

Whichever angle you look at it, lockdown is the wrong solution. It has high mental health costs, it saves fewer lives than freeing everyone, and costs more per life than almost any other way of saving them. And it comes with very high social and political costs.

Whether you look at it from an economic angle, a pragmstic angle or are trying to be compassionate, it still makes no sense.

It should end soon.

 

 

Great news from the coronavirus app

NOTE: The first version of this article was based on the Daily Mail article:

https://www.dailymail.co.uk/news/article-8186479/Coronavirus-symptom-app-suggests-1-9-MILLION-Brits-Covid-19.html

CORRECTION

Looking at the video by the researchers, for which I’m grateful to Kate Brewer) to the link:

https://covid.joinzoe.com/post/covid-research-update-uk

it says that 25-30% of respondents reported ‘some COVID-like symptoms associated with COVID’. It also usefully clarifies that most of the early respondents were likely younger people. This is very different from the 1.9M reported in the DM article and which I re-used in my blog. Humble apologies, I didn’t check the source. Now that I have, I am still unable to find the other figures the DM quoted, so perhaps they used a different source.

So, using the revised figures ….

The coronavirus symptom tracking app results suggest, according to Tim Spector, that 25-30% of respondents reported ‘some symptoms associated with COVID’. Without proper testing, it’s as good an estimate as we’re likely to get. Extending to the whole UK population, there could be 16-20M people who have already had the disease. (As an aside, and I don’t trust Chinese figures, some reports suggest that 20% of people who are infected develop symptoms. For 25-30% to report symptoms, that would mean almost everyone in the UK would need to have been infected).

The app is a sort of self-selected, self-reported test, but presumably proper tests on a proper sample of the population would reveal more. If you’re trying to solve a problem, knowing its dimensions can make a huge difference to the solution you will pick.

If their figure is true, then only 0.2% – 0.25% of people who have had the disease developed into official cases. But we have no idea how many have been exposed to the virus and not even had enough symptoms to become part of their 25+%. It could be anywhere between 25% and 50% (as other studies have cited).

If true, we might already be a quarter or even half of the way through. We might only see another 40,000 – 80,000 cases, even if lockdown is lifted

So far, 3605 deaths have been announced in the UK from 38,168 cases, but the ONS says the death toll could be 20% higher, at 4325. That gives an 11.3% death rate in the UK but that doesn’t include documented cases that will die later (the numbers that have been listed as ‘recovered’ are only a tenth of the deaths, so that is an important caveat). So the UK figure is likely to be much higher than the 11.3%. On the other hand, as Peter Hitchens has often pointed out, that figure is for all deaths that occurred of people who had the disease, not those who died mainly because of it, very different. Large numbers of elderly people die every year. Every day, around 1650 people die in the UK. Any of those who died from the usual causes but also had COVID would appear in the COVID deaths figures, along with any who did die because of it but would have died in a few months of something else anyway.

Without proper testing of a large and representative sample of the population, we really have no idea how many people have actually already had the disease or are resistant, and without proper recording of deaths, how many known cases are still going to die. Only when we have proper large scale test results will we be able to estimate how many future infections, cases and deaths there might be as the result of lifting lockdown before the disease has been eliminated.

However, a simple calculation using the above suggests that if lockdown were lifted, there might only be 10,000 – 13,000 more deaths that might list COVID on the death certificate, and the number of deaths primarily due to COVID would be far less. Perhaps only a very few thousand more people will die because of COVID if lockdown is lifted.

If it really is only 3000 – 5000, there are far better ways to save that number, such as cleaning hospitals better.

 

Will China be the global winner from COVID?

A joint blog by Tracey Follows, Bronwyn Williams and ID Pearson

Will China be the global winner from COVID?

There have been many conspiracy theories about China suggesting that the virus was deliberately made. We may never know the whole truth.

Regardless of that, it is clear that, however unlikely, there is a greater than zero chance the virus could have been man-made. More importantly, a new virus could be man-made. Now that the West has shown its economically suicidal response to this one, there is a massive temptation for any rogue regime or terrorist group to produce a GM virus variant that is as or more lethal, as or more contagious. Death cults that want population reduction (such as environmental reasons) might well consider sponsoring such virus production in secret labs.

There is already one clear win for China: No-one is really debating democracy versus authoritarianism as it pertains to Hong Kong any more. But then no-one is really debating that choice anywhere because nation-states like the UK, France and USA, built on the core notions of freedom, have removed liberty and imposed a lockdown. Indeed, the few governments who have resisted – or even just delayed draconian encroachments on hard-won human rights to freedom of speech, movement and trade have found themselves cast as at best ignorant and at worst downright villainous by the popular press. This, despite the fact that the epidemiological and economic data and models projecting the socio-economic costs of the various paths of action (or inaction) available to authorities are questionable at best, downright misleading at worst. Perhaps Friedrich Hayek put it best when he said “The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.”. In other words, when faced with incomplete information, the first priority for any government should be to do no harm. When it comes to complex systems, seemingly simple solutions can have serious unintended consequences. This, however, is easier said than done in the face of an imminent threat when citizens, accustomed to having their every need met by their leaders are baying for someone to do something. This may well prove to be the biggest threat of all because populations can get awfully content being told what to do and relying on authorities to make all the tough decisions for them. Some may even be persuaded that this kind of big state, this kind of total state, isn’t really so bad after all.

The trouble is that authoritarian measures – such as state surveillance of health and cellular data and restrictions on freedom of movement or trade – adopted during times of crisis do not tend to simply disappear after the short term threat is passed.. As military men and women will tell you, it is much easier to get into wars than to get out of them. Likewise, it is much easier to lose civil liberties than it is to regain them. Have any governments who have removed or restricted citizen rights outlined any form of exit strategy for how to return those privileged post pandemic? No. The long-term normalisation of surveillance and authoritarianism driven by short-term fear threatens to create a global generation of Stockholm syndrome sufferers, grateful to the generosity of their gilded cage key keepers.

Result: China 1  – West 0

Perhaps what is most notable is that there have been several pandemics in recent memory: Zika, SARS, Ebola, swine flu, bird flu. None of these caused similar panic. The question is why. The answer lies in the way the current crisis has been handled by both mainstream and social media, both of which thrive on the spread of panic (a viral disease in and of itself), and panic, in turn creates an opportunity for authorities to capitalise on the crisis and consolidate both power and capital to their own ends. New deadly diseases emerge from nature frequently and next time the first news breaks on a future outbreak, the panic cycle we have witnessed in recent months is likely to repeat itself. Panic buying will follow, the media and the public will demand action, stock markets will fall, governments will be tempted to rush to close airports and print more money and take on more debt, and so on so as not to be the last man standing. That means that future outbreaks, however caused, will likely cause panic, confusion and likely major economic damage.

After spending tens or more likely hundreds of billions of pounds to get through COVID19, it may well be the case that the economy is only starting to recover before the next outbreak. The economy may not recover properly until we can end that cycle.

However, China, with its now proven technology to control its people, its centralised economy, and its much more compliant populace, conditioned over centuries of dictatorial rule to obey or face the consequences, would be more able to avoid such crashes.

The West will learn that the only way to avoid coming off second best in a crisis is to emulate its opponent, further eroding human rights and freedoms in the process. 

That is, of course, the rub: liberty has proven to work for the West in the long run. However, in the short run, there are trade offs. Authoritarians can do things that free men and women will not. From current events and reactions, it does not appear that the West has the short term courage (or citizens with the personal responsibility) to pay the price of long term liberty.

China 2 – West 0

Even as it becomes clear that China covered up the initial outbreak, denying other nations the benefits of foresight, and manipulated mortality rates, skewing economic and epidemiological models that could have been used to make better policy decisions, we may never know the full extent of China’s responsibility for this one. However, we can be sure they won this round, and will be the long term winners too, if our response here in the West is anything to go on.

About Tracey Follows

company: https://futuremade.consulting

twitter: twitter@traceyfutures

Forbes contributor: tracey follows 

About Bronwyn Williams

Bronwyn Williams is a futurist, economist and trend analyst, who consults to business and government leaders on how to understand the world we live in today and change the world’s trajectory for tomorrow. She is also a regular media commentator on African socio-economic affairs. For more, visit http://whatthefuturenow.com

Twitter: twitter@bronwynwilliams

About ID Pearson

Dr Pearson has been a full time futurologist for 29 years, tracking and predicting developments across a wide range of technology, business, society, politics and the environment and is a chartered Fellow of the British Computer Society and Fellow of the World Academy of Art and Science

twitter: twitter.com@timeguide

timeguide.wordpress.com

When two tribes go to war

As I predicted, the authorities are starting to realize that there will soon be a group of people who have passed the test to show they are immune, so they can have a special pass (e.g. wristband) that allows them to do certain kinds of jobs or attend events or visit areas where there may be infection. However, even though they are not vulnerable to it, they can still carry it and infect others.

There is another group, who have remained in lockdown, who have not had the disease. They have a strong interest in keeping others away from them who may be infected. Some will become infected and migrate to the other tribe.

Everyone will be in one of those tribes.

Both want to go out, one group can go anywhere and the other group can go anywhere only if the others are kept away.

Their rights conflict.

Whose rights win? Or will we have parallel societies for a time?

Don’t listen unquestioningly to ‘experts’

Listen to the experts! Follow the science! Shut up, you aren’t an epidemiologist! You’re probably as sick of hearing those remarks as I am.

An expert is generally regarded as someone who has been doing something for so long (10k hours or more) that they have become highly proficient at it. If you do a task 5 hours a day for 200 days a year, it takes about 10 years before you could be regarded as an expert. Nevertheless, there are many experts in every field, and some have a lot more than 10k hours. However…

The vast majority of experts are specialists, working in a particular field. They have vast knowledge and expertise – in that field. They may be somewhat knowledgeable in some other areas, especially if they are closely related, but their degree of knowledge generally becomes lower as you move further away from their core field.

Other experts are generalists. In engineering circles, they are often called systems engineers. In medical circles, they might typically be GPs or general surgeons, or vets. They typically have similarly sized brains, intelligence and knowledge to specialists, but their expertise is spread more thinly across a broader domain, often a much broader domain. Depending on career history, they may still have some regions where they are more knowledgeable than others, but their most important skill is considering many different but interacting parts of a system simultaneously.

“Epidemiology is the study and analysis of the distribution, patterns and determinants of health and disease conditions in defined populations.” Epidemiologists are therefore exactly the sort of people we need right now to advise on the distribution, patterns and determinants of health and disease conditions. I wouldn’t dare to think I know better than an expert epidemiologist in that regard and neither should you.

Outside that well-defined domain, their expertise quickly evaporates and they quickly lose their claim to expertise. I would not bother to ask an epidemiologist for their advice on many other important factors such as politics, economics policy, nutrition, cardiovascular health, exercise or mental health factors of lockdown, loneliness, transport policy, policing, sociology, relationships, divorce or family breakdown.

COVID affects all of the above areas so we need people who can consider all of them, considering all the interactions within the system. That means generalists, not specialists, since no human brain can be expert in all relevant fields. Generalists can make informed decisions on the best overall approach. They would consider inputs from epidemiologists of course, but also inputs from experts in all the other fields too, assimilate and then consider the entire system.

I would suggest therefore that government and media are giving far too much attention and power over decision making to one particular expert group – epidemiologists – and giving far too little consideration to the whole system and the generalists who are the appropriate experts in that domain.

Indeed, even politicians are somewhat generalist. Few have any particular field of expertise other than those skills needed to persuade people to vote for them.

However, an intelligent PM like Boris should be able to make a good overall judgement on the best overall approach to dealing with COVID, taking due account not just of ‘the scientific advice’ but of all the relevant factors – the pain, suffering and deaths resulting from the spread of COVID, social and health issues related to lockdown, the many factors governing the health of the economy, the massive future debts that will need to be repaid and the inevitable severe austerity resulting, social cohesion, the trust in the police, justified fears about state intrusion, mass surveillance, loss of liberty, and many more.

He should certainly not be abdicating decision making to people who are only expert in one of those areas.

And neither should you.

 

Reducing infection rates – common sense

We could greatly reduce suffering, deaths, economic damage and duration of lockdown if the authorities were to apply some basic principles.

Restrict travel between high and low infection areas

Some areas are much more highly infected than others. Travel from highly infected areas to much less infected areas should be severely restricted. The gain from doing so is far higher than by restricting other travel.

Restricting travel within high infection areas will also achieve greater gains than doing so in low infection areas.

Red and green trains

Instead of all trains being made available to everyone, red trains would carry groups more likely to be infected and would be used by people who either live or work in a high-infection area. Green trains would be used by those who both live and work in low infection areas. There doesn’t need to be a very high difference before statistical gains are achieved. Any station would receive a few red trains, then a few green ones.

A further derivative would be to have red and green supermarket hours to separate those who work exposed to high risk from those who aren’t.

Both of the above rely on separating groups that have very different infection rates and both are quite robust against moderate cross-infection.

Travel profiles indicate most effective use of limited testing

We already target health workers and carers, but what about the rest of the population?

The faster we can identify infected people and isolate them, the more we can reduce the rate of spread, the number of total infections, overall suffering, and deaths. Given very limited testing capacity, we must optimise our approach. Some simple reasoning applies.

First, there is little point in testing those in lockdown. It would be nice in an ideal situation but we aren’t in one. The few who become infected will still emerge if they become ill enough.

The rest fall in two categories. One group travels mostly alone in private vehicles. A few will come into contact with large numbers of people through their work. If we can identify those high-contact groups, they can be allocated a higher priority.

Those travelling most on public transport are much more likely to become infected, coming into more frequent contact with infected strangers and once they become infected, are likely to infect many more. Concentrating testing on them will achieve the greatest efficiency at finding (and removing) infected people from the mix. The more infected people that can be found and removed from public transport, the faster the virus will be controlled. We know who uses public transport most via their payment cards. We  also know that those using red trains will have higher incidence than those on green trains.

Simple logic therefore shows that limited testing should therefore be applied in the following priority:

  1. Front line carers
  2. Most frequent travellers on red-train public transport
  3. Less frequent travellers on red-train public transport
  4. Most frequent travellers on green-train public transport
  5. Less frequent travellers on green-train public transport
  6. Those living in red areas who travel mostly using private transport
  7. Those living in  green areas who travel mostly using private transport
  8. Those in lockdown who must still venture out sometimes
  9. Those in total isolation

This isn’t 100% optimised, but it is close enough.

Finding new trees to bark up. Can coronavirus be trapped using nets?

Coronavirus

Virus use their spikes to latch on to cells. Their proteins bind to ones on the target cell walls, their membranes fuse, and viral genetic material can then enter the target cell. Many antiviral drugs use particular proteins that bind to the spikes to disrupt that process at various stages. It takes a great deal of effort and time to find suitable proteins.

A variety of other techniques have been suggested over the years, but I can’t find one on Google that uses a net with custom sized holes that mechanically trap the virus by using the spike as a whole.

Imagine playing with a tennis racket  and your ball is adapted to look like a big coronavirus:

If the holes between the strings are the right size, the virus will get trapped, like a fish in a net. You don’t need to be really clever coating the strings with some super-smart goo that sticks to a very specific part of the spike. You just need to make the holes the right size. That opens up a new bunch of trees to bark up. If you can make a membrane with the right sized holes, you could use that in a dialysis process, pass the patient’s blood over it, and many of the viruses will get trapped. Blood cells would go right on by, like tennis balls without the spikes.

That still might not be easy, and even if it were, you’d still need dialysis, but perhaps in early stages, it could prevent viruses from becoming rampant for long enough to allow your own immune system to build immunity. Flattening the curve so to speak.

 

 

We should switch to using cellular lockdown

The Telegraph contains an excellent resource that show the current spread of known cases of COVID19 in the UK:

https://www.telegraph.co.uk/news/2020/03/29/coronavirus-uk-how-many-cases-covid-19/

As you can see from the graphic, the disease is far from uniformly spread, even allowing for population density. Some areas (let’s call them cells, just like in mobile phone networks) such as Somerset, Lincolnshire, Suffolk, Cheshire and even East Sussex have fewer than 100 cases per million, while Barnsley has 250 and some areas of London have far more, with Wandsworth and Westminster around 800, Harrow and Brent around 900, and Southwark over 1000.

There are some things that should clearly be left to expert epidemiologists, but you don’t need any medical expertise to know that you are more likely to be infected by someone who has the disease than by someone who doesn’t. Even if all you know about someone is where they have come from, you can still infer that the risk of them infecting you is higher if they have come from a high-infection area.

Containment of the disease would be better if people in low infection areas were protected from having people come in from highly infected areas, who by definition are more likely to have it.

Cellular lock-down would prevent people moving between cells with markedly different infection rates. A few people obviously genuinely need to, but stricter precautions could be imposed for that truly essential travel. A higher bar could be put on definitions of essential travel when it is between cells, and high risk people could even be separated from low risk ones on transport – the very few people who really need to commute to a highly infected area could be forced to use their own cars for example, or taxis, while other people much less likely to be infected might use regular public transport. In areas with low infection rates, people might be able to have lock-down eased.

In large commuting areas such as London, people from any area may work in any other, and many of those currently forced onto densely packed tube platforms and trains are truly essential workers. However, areas have very different infection rates. Some simple principles could be used here too.

Companies that employ staff from around London might be able to re-allocate some staff to their local areas. Some probably already have done this.

For special groups such as front-line medical staff, taxis could be used to get them to their hospitals and back, reducing what must currently be a strong cross-infection risk.

Since infection rates are very different in different areas, the tube system could separate high risk people from low risk ones by having separate trains. So for example ‘red’ trains might serve high-infection areas and ‘green’ trains serve low-infection areas. You would get a green permit if you both live and work in low-infection area, and a red one if you either live or work in a highly infected area. People with a red permit would only be permitted into stations when a red train is due, and green permit holders when a green train is coming. That would obviously mean that trains would have to be grouped somewhat, there would be a few red trains, then a few green ones. If everyone knows what time periods are red and green for a station, it would greatly assist in keeping infected people away from the uninfected. Since the walking part of their journey is likely to correlate with their train time, that would also reduce street level cross-infection too. If that isn’t enough streets could just as easily be ‘time-multiplexed’.

This could only work now because tube traffic demand is far lower than normal, otherwise it would be impossible, so it would be essential to maintain a London-wide lock-down for non-essential travel.

Red and green permits could have local use in the rest of the commuter belt too. Someone who commutes to an infected area would have a red permit, so may only be allowed to use supermarkets during red times. After a red shopping period, shops could be cleaned, then opened for much less restricted green shopping.

This kind of cellular approach would mean that those who present the greatest threat to others are physically separated from those who carry a low risk. They would use transport and supermarkets at different times, and travel between cells would be greatly reduced, and forced to use more controlled mechanisms.

It makes much better sense to me than the current system that applies exactly the same rules to the 1 in 25,000 Lincolnshire resident as the 1 in 1000 Southwark resident. If we continue to allow people likely to be infected to contaminate the rest, far more people will die and lock-down will have to be much stricter and longer.

Ultrasonic misting to aid fluid removal from COVID19 or pneumonia patients

This is just an idea and would require a feasibility study to confirm whether it is workable and useful. The idea is to use ultrasound to convert fluid building up in lungs into a mist that the lungs can more readily expel, rather like cigarette smoke.

Ultrasonic transducers have been used for many years to make fog or mist for trivial theatrical effects and garden ornaments. Even cheap transducers from Amazon can convert 400ml of water to mist per hour each.

It is also commonplace in radiation treatment to overlap beams from different directions so that normal tissue is unharmed but intensity is high enough to achieve the desired effect where it is needed. This would work for ultrasound beams coming from different directions too. That would prevent fluid from being misted in the wrong places.

Another existing technology used for ultrasonic loudspeakers uses interference between beams from multiple transducers to create audible effects at any point in space.

My suggestion is to combine these existing technologies to make a close-fitting vest or harness fitted with an array of ultrasonic transducers that could be worn by patients suffering fluid build up in their lungs. Conventional ultrasonic imaging could identify locations of fluid build up and then ultrasonic beams could then be targeted precisely to convert some of that fluid to mist, allowing it to be ejected more easily from the lungs during breathing, instead of building up and effectively drowning the patient. Whole regions could be scanned to mist from large volumes at once, or different amounts of mist could be produced from particular problem areas. The effect would presumably look similar to people breathing out cigarette smoke. The rate at which fluid could be converted to mist is far greater than the rate at which it builds up, so even though not all of the mist would be ejected, it could still achieve the goal.

This might not work. It may be too hard to cause misting in fluid not in direct contact with a transducer. It may be too difficult to cause misting of problem fluid without causing problems in nearby tissue or bubbles in blood vessels. Obviously a lot of engineering design would be needed even if it could work, but expertise to do that is out there and suitable vests could possibly start be manufactured within months.

15 basic technologies could help reduce exposure

  1. In lifts (elevators if you’re a Yank), or indeed any room that gets a lot of people traffic and may therefore spread infections, a simple passive infrared detector could monitor whether there are people in it, and if not, a strong UV light could be activated, which would help kill any viruses and bacteria present.
  2. Portable UV sterilisation boxes could reduce contamination on face masks in between uses so that it’s clean again before you go back out there
  3. Tethered drones equipped with strong (and directional) UV lights could continuously sterilise surfaces in some key areas. Untethered drones that can rapidly recharge could also help.
  4. High powered air filters that can remove viruses could be installed in train carriages, hospital wards and corridors etc.
  5. Industrial and domestic smoke and particulate scrubbers could be adapted to reduce the concentration of  airborne viruses in any area with high concentrations of people. Systems that use plasma or static electricity also exist.
  6. In corridors, either of these air cleaning mechanisms could be used alongside blowing the air in a vortex to maintain a narrow channel of purified air, so that limited filtering can still maintain a safe corridor.conjuction with high pressure
  7. Voluntary ‘digital air’ subscription could enable ‘cookies’ or markers to be collected by your mobile phone as you walk around. If other subscribers that have been in contaminated areas are nearby, your phone could alert you so you can stay clear.
  8. Just as we already have pollen and pollution forecasts, virus detectors could produce real-time information on areas to avoid, or that are safe to visit for exercise.
  9. Bongs (bottles that pass the air through a liquid) could be adapted to use rapid anti-viral fluids). Ultrasonic transducers could further continuously mist the anti-viral medium so that a large air volume is exposed to allow longer decontamination periods with a small amount of fluid.
  10. Spiky net face-masks (like an orange bag with soft spikes on each junction) could prevent people touching their faces.
  11. People could voluntarily wear ‘smart bindis’ made from thermal colour-changing materials similar to those used in cheap fish tank thermometers. You could tell at a glance if someone has a fever or not.
  12. Face masks and surface covers could be made from fabrics that contain nanospikes, attached to pizoelectric vibration devices that can send ultrasonic waves through the materials, physically rupturing virus and bacteria.
  13. Piezoelectric misting could also be used to make forehead mist generators that occasionally bathe the face in anti-viral mist
  14. People living nearby should be able to combine online orders to maximise logistics efficiency
  15. Gloves with antiviral insides that sterilise hands when worn. Obvious alternative is to sterilise inside and outside.