Weekend reading: Stuck in the middle with you

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• 1 ermine April 3, 2020, 4:45 pm

  Great title, and gotta be worth a quick blast of the soundtrack from 1972. Thanks for the link!
• 2 Neverland April 3, 2020, 5:47 pm

  Viewed from distance FIRE is looking an awful lot like day trading v2.0 now
• 3 Berkshire Pat April 3, 2020, 7:43 pm

  @ermine
  Great song, but always gives me earache for some reason…
• 4 Naeclue April 3, 2020, 8:04 pm

  Dividend cancellations are interesting. Loads of companies prudently holding on to cash, yet the most leveraged (banks) think they don’t need to. Some kind of macho banker thing?

  Faced with inestimable losses, I suspect many bank execs will be secretly relieved they have been strongarmed into suspending dividends.
• 5 Naeclue April 3, 2020, 8:18 pm

  You are right about smart-arse pundits and all the after the fact armchair experts. Unfortunately this punditry and scrutiny may lead to a lot of decision paralysis as fear of making the wrong decision can slow progress to glacial speed. Pundits and the rest of us need to cut the government and key decision makers some slack. Bold decision making is needed, so let them make mistakes and don’t hang them for it when they do.

  On the other hand, politicians need to learn to be more straightforward, cut the waffle and stop trying to spin out of criticism.
• 6 Matthew April 3, 2020, 8:57 pm

  We have more confidence now because 2008 proved one way to solve part of the problem, that QE is ok when used right, and it brought in regulation. Every crash brings evidence of solutions for next time, and this one will give us better policies, better respect for the need to lockdown, better research into vaccines, testing techniques, and understanding of viruses. There are only so many ways the market can crash, we know that the 1920s depression was not insurmountable, war didnt stop us, neither did new computer systems in the 80s or overexcitement in the dotcom crash, neither did the housing market/credit crunch.

  Strip away the virus in time and you have either a 2008 or 1920s problem, both of which recovered
• 7 Antarcticatic April 3, 2020, 9:22 pm

  I found this interesting – what if there is a seismic shift towards China, with how the US is handling the epidemic.
  https://www.bloomberg.com/opinion/articles/2020-03-31/coronavirus-could-end-dollar-s-reign-in-favor-of-china
• 8 Barn Owl April 3, 2020, 11:13 pm

  “I continue to have doubts about how we’re approaching this crisis, whilst conceding most policy makers are striving to do the right thing with incomplete data and faced with horrible choices.”

  Which aspects do you have doubts about and why? Just curious.
• 9 xxd09 April 4, 2020, 12:18 am

  I think that the problem will be between the politicians covering themselves by doing the “right thing” and prolonging the closedown for ever and also having to decide when the economy cannot take any more punishment
  Our politicians and the civil servants are in secure well paid jobs -so will err on the side of prolongation-they are under no immediate pressure
  The people however are out of work, out of money and stuck in small houses with their kids-when is their breaking point?-not far away I think.
  I notice that traffic rate is up on my local main road-A straw in the wind?
  xxd09
• 10 JimJim April 4, 2020, 7:22 am

  Thanks for the links again TI, the Humble Dollar “this too shall pass” chimed to my present mind-state, my soundtrack is “were busy doing nothing”.
  Traffic is still low out here in the sticks, the vast majority are leaving the lake district alone as per the instructions of our local constabulary, who, on the whole, are doing a sterling job with only a few reported cases of heavy-handedness in these difficult times.
  This Easter week will prove the test up here, nothing is open for tourists so hopefully it will stay quiet.
  It is interesting to see which economic activities are continuing. Farmers still farm, about half the builders are still building, the local Andrex factory is hiring temps for shift work (well paid for relativity unskilled work). Looking at the state of our paper recycling boxes, internet shopping is on the rise (packaging companies must be on a tear) The local shop is busy and village life, albeit at a distance of two to three metres, is more social than ever with shopping pools and heightened communication.
  So far so good in the hood.
  Stay safe all.
  JimJim
• 11 Vanguardfan April 4, 2020, 8:23 am

  Now that I’ve more or less managed the transition to the home life, I find myself with more time on my hands to ponder how we ever get out of here. Like Jim I’m in a part of the country somewhat behind London and big cities in terms of the epidemic spread. Clearly one issue with the management of the outbreak is that we moved through approaches at a national level, when the spread is really a series of local outbreaks. In some parts a containment strategy could still be effective in snuffing out these smaller outbreaks.

  I am also acutely aware of the unequal nature of the economic and social impact. Thus far our income remains unaffected, we’ve just pivoted to work from home. Others will be suffering greatly.
• 12 Snowman April 4, 2020, 8:30 am

  One thing the crisis is showing up is the lack of numeracy, lack of analytical skills and lack of understanding of risk shown by decision makers and broadcasters.

  This is an excellent podcast with David Spiegelhalter, who definitely can’t be accused of not understanding risk. Read his excellent book the Norm Chronicles a number of years ago.

  https://riskytalk.libsyn.com/coronavirus-understanding-the-numbers
• 13 Big Boss Man April 4, 2020, 9:12 am

  This whole coronavirus situation is mad isn’t it
• 14 William III April 4, 2020, 9:45 am

  Ok so Vanguard investors are sitting tight?
  Buffet *sold* airline shares yesterday at half what he paid for them less than a year ago. It will be interesting to see what happens to airline shares on Monday – and what happens to stocks overall especially if the Vanguard 401ks follow the oracle and are calling it a day. (Hey is this a sign that we might mark the bottom sooner rather than later? Is buffet manipulating the market in further sell off because he thinks there’s still better bargains to be created?)

  Blankfein tweeted about a sharp stockmarket snapback scenario, when a treatment or vaccine gets announced, which he seems to find a reasonably likely one given the focus of all big pharma on this. (It would also seal trump’s re election, mind)

  It’s a right crapshoot at the moment but the sentiment is definitely still downward and what we saw may have indeed been the bull trap. I hope that Matthew is right and we learn the lessons.

  @barn owl: Russ Roberts (@Econtalker) has a good thread on this: suggesting softening lockdown sooner than later, starting with letting under 30s out while increasing protection of vulnerable, to avoid further fiscal instability.

  @Jim: wish I was stuck up in the sticks at this time… Robert MacFarlane is doing a beautiful Twitter book club for lockdown times on Nancy shepherd’s work on the Cairngorms. This virus makes one long for a solitary existence up steep slopes.
• 15 Vanguardfan April 4, 2020, 9:55 am

  The problem with age related phased lifting of lockdown is that we don’t live or work in age segregated environments – we live together, old and young, vulnerable and less so.

  Geographical phasing might be more logical, as long as there were restrictions on travel into or out of green/red zones. Epidemics are by nature spatial in their spread, as it’s chains of people and their movements and connections that drive it.
• 16 PC April 4, 2020, 10:00 am

  “To be honest, social distancing rather suits me.” yes me too .. in normal times I have to force myself to go out and socialise.
• 17 Bob April 4, 2020, 10:32 am

  Just taking an opportunity to say well done for maintaining MV site quality three weeks in. The proof of this pudding is in the helpful and informed comments BTL. Thank you.
• 18 xxd09 April 4, 2020, 10:45 am

  ‘‘Tis truly the day of the “Introvert”!
  xxd09
• 19 jim April 4, 2020, 11:59 am

  @big boss man fascinating insight as always…

  Have just been prepping for new tax year. Vanguard VLS100 around 20% down from the last time I checked (August last year). Still going to max the LISA on the 6th

  Problem is economy/industries is/are so interlinked. I am allowed to keep on working but struggling for materials.
• 20 The Investor April 4, 2020, 12:27 pm

  @ermine — Welcome. It is indeed a classic!

  @neverland — Except most people who try day trading will eventually trade away all their money, or at least lose to the market. Whereas most people who (can) save and invest sufficient quantities will sooner or later achieve financial independence. I’ll grant there was a bubbly element that’s similar in the final months before the crash though.

  @naeclue — The banks are really awash with capital. In any normal recession/disruption they were almost bombproof. Incredibly we’ve managed to come up with something that looks a lot like a bomb. 😐 The irony is the likes of Lloyds had finally finished mailing out cheques for PPI (some £20 *billion* in its case) and long-suffering shareholders were finally about to be rewarded… (Disclosure: I own a handful of Lloyds shares). Agree on the whole about cutting slack but I think we’re getting to the point where we’re entitled to assess how things are going. As opposed to some of the knee-jerk usual suspects on Twitter who are condemning first, thinking later.

  @Matthew — The problem isn’t the market, and this isn’t a financial market crash. IMHO it’s an economic crash. The market is reflecting real damage being done (and to be done) to the economy. If the economy is tanked indefinitely, the market won’t come back.

  @William III — I don’t think Buffett selling airlines tells us much about what Vanguard investors should be doing, or even how Buffett views the crash in total. It clearly tells us he doesn’t like airline stocks! 🙂 But he could want to sell those but still be bullish on the overall market at these prices. For instance there’s a good chance of a dilutive bail-in for airline stocks; I’d say there’s zero chance for say Apple or CostCo. If he judges that’s the case and it’s not in the price, then as an active investor he has to act. It’s always dangerous to presume too much from just one trade made by an active investor. 🙂

  @Snowman — A friend of mine is an old friend of his and suggested an introduction. Possibly I could arrange an interview even? Hmm. Will ponder.

  @xxdo9 @barn owl @vanguardfan @others

  Which aspects do you have doubts about and why? Just curious.

  I’ve been reluctant to speculate on managing the epidemic, partly because I’m no medic/statistician, and partly because 10,000 other people are.

  However as the impact is running into the economy I feel slightly more qualified to comment. In addition as citizens and taxpayers, we’re all entitled to have a view.

  So I’ll make a few comments here since you asked, safely snuck down in the comments. 🙂 Mostly I’ve alluded to all this over the past few weeks anyway. Really going to try to be brief so apologize for a lack of caveats, sourcing, and whatever else people fancy picking up on. 😉

  1) Almost everything in this crisis post-Wuhan has been predictable. This is still the case today. For instance, it was always going to come here and break out, I’d say from the start but certainly once we saw it was embedded in Italy. Politicians, citizens, and even the medical establishment seem to have been indulging in wishful thinking.

  2) I will state flatly because people always criticize otherwise, that every life lost is a tragedy. This is not a story about how we want people to die. The fact is that the virus is here, and people are going to die whatever we do.

  3) It’s also a fact we juggle lives/costs ALL THE TIME. We allow people to smoke though it kills them. We allow people to drive at 55mph though at 20mph nobody is killed. We allow people to go on holiday and buy champagne even though people die because we don’t tax at 100% and spend it all on healthcare. I could go on and on.

  4) It’s fatuous nonsense to say that because we’re in a pandemic that threatens millions and also our economy, that we should suddenly pretend we don’t run society according to such an equation. We do, and especially now it’s critical.

  5) It’s increasingly my impression that the medical establishment and statistical modellers are telling us what to do to prevent deaths from COVID-19 exclusively. I am quite prepared to believe their models show that, albeit with huge variances (as detailed in links above). However I have been wondering in asides here and widely with friends why the reporting isn’t breaking out who would die soon anyway from other medical complications, let alone from the measures taken to combat the spread of the virus. This weekend we have government ministers saying (see The Times, pay-walled) that the wider impact was not at all considered, and the deputy chief medical officer finally saying it should be considered. Very little of it has been publicly discussed. Look at the graph above from the BBC and read the article. Even the official IC model shows huge crossover with C-19 deaths and deaths that would have happened soon anyway. And again, this is not even counting the economic impact/consequences/

  6) On the economic impact/consequences, as I’ve written before we don’t get to turn the economy off ‘for free’. It’s not just about fatcats not making as much money, or billionaires buying fewer mansions. Like the statement we’d go into a recession with lockdown, this was controversial even a few weeks ago. “Even if one life is saved!” etc was the retort. But people are rapidly seeing that in fact there’s an immediate impact from lockdown. Ten MILLION people having become unemployed in the US in two weeks. Nearly a million in the UK. Many of these people have little to no savings. Yes, we can support them in the short-term but the disruption is intense and the future cost will fall on everyone.

  7) People are finally speculating about direct health consequences from lockdown (suicide, domestic violence, lack of exercise). But the long-term impact is equally important to consider. The reason the Government can cover lost income now and provide medical support is because we’re a rich country with a large tax base. We damage that tax base at our peril. It matters for future healthcare funding and impact too! This is CRITICAL. Talking about GDP gets you shot down by left-wing types but it cannot be ignored.

  8) Let’s say we have the 12- to 18-month lockdown until vaccine bandied around by the maximal-c19-curbing proponents. I think it would be optimistic to say that would be a 25% hit to GDP, ballpark. UK GDP is just over £2 trillion. So call it a £500bn hit. The UK spends from memory just under 10% of GDP on healthcare. Call it £200bn. State spending is c.40% of GDP. Play with these figures however you like, but you will soon see that conservatively tens of billions will be lost from healthcare spending, much of it forever.

  9) That will mean some people don’t get screened in time, don’t get drugs, don’t get a hospital bed, don’t get their ward cleaned, don’t see some other treatment developed for an extra two years, don’t find a GP surgery conveniently open to diagnose their child’s rash. People will die, likely thousands. It will be less visible though. In five years time the NHS (which I support) will be as usual crying out for more funding. One new reason it will need more funding is because we’ll have the same population but less money in absolute terms to spend on it.

  10) All of this is not even to put a value on the other – important – reasons why we strive to have an economy that grows and keeps most people in work, hopefully earning higher real wages over time. I won’t insult or annoy anyone by listing them all.

  11) Now, we have a virus that is massively infectious, and yet which overwhelmingly threatens the old and vulnerable. Generalizing, the old and vulnerable are less in work then the young and less vulnerable.

  12) The current strategy is to freeze the economy, destroy GDP to curb the spread of the virus, and to send old people out into the shops to fend for themselves. As I wrote a few weeks ago, they were flocking around the streets of my part of London, which was recently revealed to be in a top 10 area for virus cases to-date. Meanwhile productive young people who are likely to shrug off the virus are cooped inside. They are being paid up to £2,500 by the government to stay inside. That’s the strategy.

  13) Even the IC modellers casually tossed out the fact that 1/15 Londoners may well have been infected by the virus already. Huge numbers (at least 50% going on Iceland and the Diamond cruise liner) don’t even show symptoms when they get it. For most people this is not a dangerous disease.

  14) There is no official exit plan until vaccine. Often tossed into the mix the medical officers or government will say “ultimately most people will get the virus and we hope become immune” or similar. That is the exit plan. If they are quoted saying it they are torn to shreds, because someone will say that their old gran is worth saving (and she is, just like my mum who has been in self-isolation for three weeks and who I am massively fearful for). But we cannot have it all.

  15) Ultimately then, the plan is in fact for us all to get it. Only to have a self-enforced recession along the way.

  16) I am prepared to believe this first initial lockdown was the correct strategy. It flattens the curve and buys more time. This time should be spent getting ventilators etc (from proper ventilator manufacturers, as well as from flashy offers from high-profile political allies), testing, and protective gear. We have to admit the record on this is patchy. At least they’ve built the Excel hospital and got some more protective gear. Elsewhere it’s hard to know what to believe. (And as the links show above it’s not even clear buying time for ventilators is sadly much different. We can write ‘gasping for air in the corridor’ otherwise and we all agree that is horrible. But lots of people on ventilators are effectively ‘dying unconscious with a tube down their throat’. I’m not being gratuitous. I’m pointing out the role of rhetoric and denial.)

  17) More than 600,000 people die in the UK every year. That’s 50,000 a month, or call it 12,000 a week. If we read out these numbers every day on the news I’m sure we’d all be horrified. Would we divert every pound to taxes, and from taxes to healthcare? Maybe for three months.

  18) If you’ve been to a hospital you’ll know there are wards and wards of old vulnerable people who will never get out again. It is HORRIBLE and my heart ACHES for them. Many of these people *are* going to die soon, that’s the fact, however. They know it better than we do — they see their ward mates dying. It’s grim beyond compare, but it happens.

  19) 12,000 EXCESS deaths are caused every year from winter flu. Do we go into lockdown every year to prevent this? We do not. Again, we do the maths.

  20) What would I do? FWIW, starting from here I would say this is a one-time lockdown. When the case rate has really come down I would re-open the economy pronto. But…

  21) I would enforce social distancing where possible. For example (1) Everyone who can works from home, maybe with a £100 a week cashback from the government or similar as an incentive (2) Stagger opening times for offices to curb peak on public transport (3) Restaurants and pubs re-open to sitting customers only. (4) Nobody is allowed to hug or shake hands. The population maintains social distancing. (5) CRUCIALLY everyone old/vulnerable stays in self-isolation

  22) I agree point (5) is discrimination and ‘unfair’. But it’s another way to curb the impact on hospitals. Stop as many of those as will get the disease from ending up there.

  23) Instead of spending £300billion+ (and more to come) paying productive young and fit people to watch Netflix and row with their kids, I’d spend the money giving direct grants to supermarkets etc to support online shopping deliveries to those elderly and self-isolated. Perhaps I’d even do a ‘citizens hamper’ or similar where they get weekly food drops paid for by the state. (It would be still be far cheaper than direct cost of lockdown, not to mention indirect economic cost of lost GDP)

  24) I’d instigate a nationwide system of self-reporting via Apple/Google/Smartphones so we can get a handle on where cases pop up, and auto alert friends family etc. (Could go on for hours about this but you can imagine the sort of thing).

  25) I’d stop dreamily looking to China — a country where even today somebody going out from their (self-contained ‘community’, which is how they all live in the big cities) might have their temperature checked 4-6 times and at least a couple of times will have to scan a barcode to enter/leave stores, with all their movements tracked, even outside Wuhan where there was ZERO entering/and exit. THEIR LOCKDOWN IS NOT LIKE OUR LOCKDOWN ANYWAY.

  26) I would hope and expect — without certainty, but based on similar viruses from what I’ve read — that warmer/sunnier weather will curb the spread until autumn.

  27) We as a nation would have to accept that some young people would be exposed and die of the virus. Again, as many as 1/15 Londoners have very possibly already had the virus and very few of them have died. But some would die. This would be the price we’d pay for economic growth — and for SAVING ALL THOSE FUTURE LIVES that we can’t see we’re saving, due to a higher standard of living, better healthcare, better diet, better education, and so on and so on.

  All FWIW, I’m no expert.

  But basically something like this is going to happen soon in the West anyway, because as I wrote in my article we *cannot* go on for months and months like this.

  So we may as well get used to the idea and do it properly, accepting it will be difficult and cutting all concerned some slack.
• 21 The Investor April 4, 2020, 12:28 pm

  @Bob — Thank you!
• 22 Far_wide April 4, 2020, 12:30 pm

  @neverland “Viewed from distance FIRE is looking an awful lot like day trading v2.0 now”

  Ok, I’ll bite 🙂 I’m sure you’re just jesting, but it is odd how some outlets are trying to portray this as the end of FIRE. I think they just love the potential for schadenfreude. But what god-fearing FIRE practitioner wouldn’t be expecting a 30% drop in the markets to come along, or for that matter 50-60%? I think we’d need to see something as deep and, importantly, sustained as the Great Depression to come along to perhaps get towards that.
  I’ll be sure to let you know if I start genuinely squirming. As it is, I’m just glad the markets have kindly waited until the start of the new tax year to start their (perhaps) renewed plummet downwards – there’s a new ISA there that needs filling 🙂
• 23 FI Warrior April 4, 2020, 1:28 pm

  @TI, I agree with your analysis of the lockdown and extraordinary situation in general, but if you spout commonsense in public at a time like this when the masses have been whipped into a frenzy of fear it can be dangerous. History is littered with examples of shooting messengers (modern-day whistleblowers) and anyone else not parroting the establishment sanctioned lines. Hysteria prevents people from thinking for themselves even more than usual, so it is wise to be careful with your unguarded opinion with strangers in these times. (Food-shopping yesterday, I was struck by the change in people from even a couple of days previously, they were now avoiding eye-contract and there was none of the usual small casual pleasantries) As always, it is interesting to note cui bono when we are conditioned to group-think.
• 24 An Admirer April 4, 2020, 1:34 pm

  I’ll say it again – Capitalism isn’t dead. But I do think we’ll have a double-down bounce like what happened in the 2008-9 financial crisis. Phase 1: The bad news arrives, markets tank. Phase 2: The dust settles, lockdown lifts and people open their doors to see what the damage really is (and collect their tax bills to pay for it all). Then, things can start to rebuild (and markets rise).

  People think this is a health crisis – it’s not, it’s a politically contrived situation. The health impact *has to be bad* regardless of the reality – it’s really important actually that a lot of people die from this or at least perceived to have. Why? That might sound like a perverse thing to say, but there has to be justification for the economic and social impact. If not, then then politicians lose face (printed 100’s of billions, wrecked people’s lives and achieved little) and – critically – the next time this happens, people won’t take it so seriously. So it’s really important the media stay all over it and keep reporting more dramatic stories. The worse it gets, the better. We’re all being carefully stage managed here.

  Maybe Boris is trying to do all this to heal the Brexit rift? Who knows. I still haven’t worked out the motivation but it sure isn’t altruism, for certain.
• 25 Jonathan April 4, 2020, 2:27 pm

  @TI, a good list of the contradictory issues all of us are bouncing around in our minds. But I don’t think anyone (bar Trump) is arguing nothing should be done, and one has to feel personal pity for whoever (even Johnson) who has to decide what in the face of such patchy real knowledge.

  At this point, 12 days into UK lockdown, there is no clear let up in the disease. Judging by Italy that will take another 3 weeks, and longer to bring new infections and NHS pressure down to a level where changing measures can be contemplated. A news item today suggested end of May is the earliest feasible point. Once we are there a changed strategy balancing all the issues you raise would be fantastic. I just hope there are people currently gathering data to inform government about what could be relaxed without creating a further surge, while at the same time properly treating the sick and also some of the backlog of non-Covid-19 urgent cases.

  I suspect the economy right now is worse than has yet filtered through from the numbers, but with luck half the drop might be restored relatively quickly. It may then take 1-2 years for full activity, and longer to make up what has been lost forever. What I don’t know is to what extent the stock markets have already priced in this sort of future, all I can do is stick to my plan of investing some (but not all) of my ISA allowance next week.
• 26 Amit April 4, 2020, 2:57 pm

  The graph in the A wealth of sense article is so illuminating. Captured in one picture both the advantages of long term investing and investing in recessionary times.

  Because recessionary periods have been relatively shorter in duration, over the last 20 years at least, I do wonder if it is sensible to double down on regular pension contributions in times like these, much like a regular mortgage overpayment, to then take an equivalent holiday at any time when markets are at all time high.
• 27 Neverland April 4, 2020, 3:01 pm

  @investor

  Your 20 odd points above are simply the governments original argument for not doing anything in February and early March

  Ultimately most people are moved by narratives and not spreadsheets and not letting a million or so of your fellow citizens die is a pretty effective narrative

  But yes the bill will be huge unless (which looks unlikely) there is a quick resolution

  Economy will be smaller, taxes will go up, life will go on
• 28 Neverland April 4, 2020, 3:06 pm

  @farwide

  I was thinking more about the FIRE movement being a top of the market indicator

  That Catching FIRE documentary being the LastMinute.com flotation of the 2020s
• 29 Naeclue April 4, 2020, 3:06 pm

  @FI Warrior, what gives you the impression that the “masses have been whipped into a frenzy of fear”? (Have you? )That is far from my experience. I can only think of one (very odd) acqaintance that description might apply to.

  I popped out to the local Sainsbury’s garage for some bread, milk and a paper earlier. Person in front and behind me in the queue both seemed very cheerful and we had a laugh when a guy nearly drove off with a bag of ice on his roof.

  @TI, I might quibble over some of the details, but on the whole I think the government have done the right thing so far. After losing the tracing battle they really had to go for some form of lock down to slow the rate of infection. I suspect and hope we may be able to start lifting mass indescriminate restrictions in a couple of months, but they really need to ramp up testing so they can do that. In modern parlance we need to move to “Smart” lock downs.

  @an admirer, all I can say is I am pleased you are not in charge 😉
• 30 Neverland April 4, 2020, 3:19 pm

  @naeclue

  “On the whole I think the government have done the right thing so far”

  I beg to differ but it will be two or three years before you could even begin to calculate the effectiveness of different countries responses

  What’s really obvious to me is the UK is going to go into two consecutive economic shocks: 2020 virus lockdown; 2021 EU exit

  I keep saying this but the autumn budget economic forecast is going to be horrible
• 31 Naeclue April 4, 2020, 3:27 pm

  @TI, I hold a few Lloyds shares as well, via my tracker funds. So I am a long suffering shareholder and personally, under the circumstances, I am happy to forgo the dividends. Better that if it helps avert another banking crisis, which is something we definitely do not want over the next year.

  Banks still have a load of expensive debt outstanding following the previous crisis, which has now become cheaper. Continuing to buy that in is probably a better use of surplus capital than handing out dividends and buying back ordinary shares, although probably not as lucrative for bank directors due to the warped remuneration schemes.
• 32 WhiteSheep April 4, 2020, 3:31 pm

  Re Coronavirus, I am not an expert either. But in general, the types of responses to outbreaks that could be pursued appear to be known. (See for instance, in a more publicly accessible version – “The Hammer and the Dance” – from the previously cited Thomas Pueyo: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be9337092b56. Or from expert sources: https://www.aei.org/research-products/report/national-coronavirus-response-a-road-map-to-reopening/ or https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf. )

  The puzzling aspect is that so far the UK appears to have chosen to completely ignore some of the more effective but less intrusive measures, such as rigorous contact tracing. (Possibly helped by comprehensive testing, but testing without tracing is of much more limted value.) One can speculate that this may ultimately result in more extended lockdown periods and more economic damage.

  Also as to the comments (even here) that this is no worse than the flu, or simply panicking. There is now ample evidence what happens if the virus is allowed to propagate exponentially. In severely affected regions like Italy they struggle to bury the dead. Coronavirus is not only the leading cause of death, but you are are more likely to die of Coronavirus than of any other cause even if you are young. Yes this will eventually pass even if nothing is done about it but it may take many months, many rather pointless deaths and the economic damage is likely to be very high regardless.
• 33 Naeclue April 4, 2020, 3:40 pm

  @Neverland, with the benefit of hindsight we will of course discover how this could have been better tackled, but faced with the prospect of 250,000 additional deaths (as a central estimate), the government’s u-turn was entirely sensible.

  I would hope all but the most fervent followers of the Brexit religion would see the sense in postponement.
• 34 Neverland April 4, 2020, 4:43 pm

  @Naeclue

  Or the fact that the buses still run at the end of 2020 and almost everyone is still alive will convincingly show that “the will of the people” to “get Brexit done” to “release £350m a week for our NHS” must be followed and we leave the EU only a little late because “everyone has had enough of experts”

  People look at events through the narrative they want to see
• 35 The Investor April 4, 2020, 4:50 pm

  @WhiteSheep @others — As started in links above even the Imperial modellers are now saying something like 1/8 to 1/15 Londoners could have been infected.

  So call it at least a million people.

  The death toll in London at that point was from memory something like 1,500 people.

  Multiply these numbers and you get to about 90,000 deaths nationwide.

  As the sources in the links above indicate these deaths were mostly coming soon anyway. Horrible and sad but a fact.

  Equally, as I’ve stated above and is also in the links many will die from lockdown. The BBC link above states at a 6.5% recession it may cause more deaths than the virus.

  So simply on these facts, let’s stop talking about “letting millions of your fellow citizens die”. C19 is dangerous but that’s not on the cards.

  Something isn’t adding up in the numbers / narrative except the desire not to overwhelm the NHS with even five digit thousands.

  And as I’ve said above, we have no choice but to modify the plan in time anyway.
• 36 Richard April 4, 2020, 4:52 pm

  @TI – I agree with what you say. But it is not just about saving lives. It is also PR. If we don’t keep below capacity then you get things like my gran was sent home to die, care homes full of dead etc. Doubt any government can survive their nation looking like a medieval plague town. Thus need to keep it below capacity. For me this is the key. They need it to hit a point where new cases vs recoveries keep below capacity. Once they have say X% excess capacity they can start to lossen restrictions, as an increase can be handled – to a point. Rationale for building new hospitals fast. Increase capacity means you can start to loosen restrictions faster as you can now cope with more cases. Herd immunity also starts to kick in reducing new cases further and the economy can fully open again. A balancing act, a very hard balancing act
• 37 ZXSpectrum48k April 4, 2020, 5:54 pm

  @TI. Sorry but I don’t feel the Imperial team has much credibility anymore. Only a week ago Ferguson was adamant on a conference call I was on that asymptomatic carriers were perhaps only 30-40% of the total. Now the same team is implying that asymptomatic carriers are an order of magnitude higher. I’m a great fan of mathematical modelling, but what we’re seeing here is an example of it’s fraility. If your estimates move by an order of magnitude in a week, you should simply shut up and wait for better data.
• 38 Vanguardfan April 4, 2020, 5:56 pm

  Those of you saying it’s just PR, and hardly any deaths, of people who would die anyway, do you know anyone working in hospitals right now? This is really not normal, or just some kind of flu season but a tad worse.
  So far, 6 doctors and nurses have died in the UK. It is not normal for doctors and nurses to go to work and risk their lives, or to have to reengineer their entire way of working, to cope with what is coming through the doors. (Only 6, I can almost hear you say. Why, we can spare them…).
  I really don’t think half the world is in some kind of lock down because of some overblown PR exercise, or because a few old people are going to die a few months early.

  As yet, we have no idea how widespread the infection is within the community. But even with the highest best guess I’ve seen touted, 1 in 15, that still leaves a loooong way for it to run. (And no, the correct death rate at that level is not 1500, it can take several weeks to go from infected to dead. And you also need to factor in the dead outside hospital).

  Yes, of course it is not good that the economy is shut down. But we’re in a tight spot here.
• 39 The Investor April 4, 2020, 6:08 pm

  @Vanguardfan — That’s an excellent point re: 1,500 deaths. Sloppy on my part.

  I don’t dispute things are hard. A very close family member is a nurse. I’ve made various comments about how *something* needs to be done. I’m just not convinced it’s “turn off the economy indefinitely.” That is the logical extension of the “lockdown until a vaccine/treatment” policy.

  Nobody wants to be in this situation and I don’t envy the decision makers. But as I said above people will die in all scenarios.

  I don’t associate myself with the PR comments. I feel people are trying hard with bad/incomplete information.

  I suspect several million Britons have already had C19 at this point, including me. But it’s just a hunch and doesn’t inform my reasoning above.

  I hope you and your loved ones stay well!
• 40 Neverland April 4, 2020, 6:12 pm

  @Investor

  Our problem is we have a pretty underfunded health service and elderly care system by western european standards, if it gets swamped then the death rate goes up a lot

  No one has any idea what the death rate really is

  Population of UK was 67m in 2018, so a 1,5% death rate gets you to 1m deaths

  Its not implausible at all
• 41 The Investor April 4, 2020, 6:14 pm

  @Richard — Your comments about the hospital capacity make a lot of sense. As in said above I agree this initial lockdown makes sense to buy time / equipment / testing capacity.

  When we try to transition out of it we are going to have the other side of the argument that Vanguardfan has articulated so well (and before) on this blog.

  So if the plan is indeed to transition out of universal lockdown, it needs to be clearly stated and there needs to be additional support / measures such as the ongoing isolation of the vulnerable (with servicing etc).

  As well as reassuring the population there was a strategy, it would help / encourage some businesses to see light ahead, borrow to get there instead of dumping staff, etc.

  As things stand we are soon going to be looking at 2-3 million unemployed even with Sunak’s support. Those are Thatcher era numbers, achieved in a few weeks.

  The reality is it’s unsustainable however much we wish otherwise.
• 42 Jim April 4, 2020, 6:23 pm

  Death rate will work out a lot lower than current estimates were not testing asymptotic or mild cases. A country who are testing a lot more like Germany or south Korea, what’s their death rate?
  That’s without even factoring in whether corona is the cause or underlying health conditions.
• 43 The Investor April 4, 2020, 6:26 pm

  @naeclue — To be somewhat pedantic even that would be MILLION not “millions”. I don’t mean to sound Stalinist but that’s the nature of this thing.

  I repeat 600,000 die a year in the UK. The vast majority are elderly. There’s clearly massive crossover.

  I understand how this sounds and indeed this is exactly how we got to full universal lockdown. Nobody wants to say “old sick people die” or to sound like a callous heartless misanthrope. My own mother has been isolating on my instruction for three weeks.

  But the fact is we can’t stop many of those 600,000 annual deaths. We are potentially blowing up the economy to choose the way many of them die.

  Also, again, in my strategy we’d be strategically isolating and supporting the vulnerable. I’m not saying “to heck with them”. I’m saying let’s come up with a plan that doesn’t demand they go out shopping and risking their lives.

  Re: The IC model I’m inclined to agree they seem way out of their depth or the data is too fast changing. But I wouldn’t dispute that stop as many people coming into contact with each other produces the biggest impact in curbing C19 deaths in the model. It seems obvious. But does it include any externalities? Other causes of death? Long term health consequences? Economic? It seems not at all from all I’ve read.
• 44 Neverland April 4, 2020, 6:36 pm

  @Investor

  “As things stand we are soon going to be looking at 2-3 million unemployed even with Sunak’s support. Those are Thatcher era numbers, achieved in a few weeks. […] The reality is it’s unsustainable however much we wish otherwise.”

  I had a quick look back at the 80s and the country had over 10% unemployment for 5 years in the early to mid-80s so it is clearly neither unprecedented not unsustainable.

  I think its possible that this time while a lot of jobs disappear, a lot (but not as many) could be created, but who knows.
• 45 Vanguardfan April 4, 2020, 6:44 pm

  I think the one thing anyone semi-informed can agree on, is that there are clearly a lot more infections than we have counted.
  And I think it’s also clear, that the greater the proportion of asymptomatic infections, the better, as it will ultimately shorten the duration of the pandemic. Nothing would be better news than to discover many millions of previously unnoticed infections, which is why I think we have to beware of wishful thinking/undue optimism. I’ve not seen any data that suggests we’re currently in that situation.

  It’s also obvious, and I would say undisputed, that lockdown brings its own costs, including a considerable health impact. Everyone semi-informed knows that, too, and that will bring pressure to release lockdown as soon as is humanly possible. But like I said, we’re in a tight spot. I don’t know the optimal answer, and nor does anyone else. I do know that we could have been a darn sight better prepared, and could have moved quicker and more decisively at the early stages. We failed at basic public health, and I don’t see any signs that we have capacity to gear up to do it better in next phase, although I hope I’m wrong.

  And although many/most of the dead will be old, there will be an awful lot who aren’t, or who at least had years of worthwhile life in front of them. I’d really like to not be one of them.
• 46 Neverland April 4, 2020, 6:49 pm

  @Investor

  You know you could easily put the argument the other way…

  A lot of businesses that are going to the wall are the ones who were going to go to the wall eventually anyway: Bright House, Carluccios, Debenhams, New Look, Intu, Norwegian Airlines…. just off the top of my head

  Is it worth anyone dying early just so their employees can collect another paycheck?

  Better to let the weak [businesses] die off, I thought creative disruption was central to capitalism?
• 47 IanT April 4, 2020, 6:53 pm

  @TI I’m not saying I agree with it, but here’s a well thought out alternative view that’s well worth a read. It’s US based, but relevant:
  https://medium.com/@tomaspueyo/coronavirus-out-of-many-one-36b886af37e9
• 48 The Investor April 4, 2020, 7:12 pm

  @Vanguardfan — I need to bow out here, I’m really not claiming to have the answer and the nature of Internet discussion is the more it goes on the more one argues as if you do.

  Just on the millions of unrecognised infections though, even the Imperial modellers are implying something like a million in London. We could probably double that in back of napkin terms for 2 million in UK? This is far far away from the official tally. Everyone recognised that’s the nature of the beast as you say, but until this week I thought it was a fringe view / pet theory that the number could be so high (or as I think likely myself, higher.)
• 49 Dan H April 4, 2020, 7:23 pm

  Ramping up capacity during this lockdown is key to managing phasing back into a semblance of normality. The other key is reliable antibody testing.

  As pointed out in several posts, the variables on which models are based result in major shifts to the expected course of the epidemic. What is needed is to turn these estimates into facts which will greatly assist with the strategy for containment and management of hospital capacity.

  My hope / personal view is that once this in place we will find that the infection fatality is much lower than many current models suggest. Key reasons for this are:

  – Countries with widespread testing, rather than just testing people serious enough to be admitted to hospital, provide a better indication of what the actual case fatality rate (CFR) is. They tend to report fatality rates sub 1%. (Yes, other things play a part too such as age demographics)
  – Even countries with widespread testing are likely missing many asymptomatic cases. These would bring the CFR down further.
  – In the UK, and most other countries, any death where the patient was found to have Corvid-19 is counted in the death statistics for Corvid-19. The patient may have died of other causes. (Yes, some deaths may be may be being missed as well)

  I’m not sure how far the government will go lifting the lockdown until they have these facts in place. The risk to being wrong will be seen as too great. Fortunately the ability to carry out this kind of testing should be available far in advance of any potential vaccine. If it isn’t, or my views above are wrong, then tough decisions will have to be made.
• 50 ZXSpectrum48k April 4, 2020, 7:26 pm

  @TI. I’m not at all in the camp that we should let up on SARS-COV-2 to “save the economy”. I tend toward a minimum of a 3 month lockdown but if necessary 6 months. True, the longer the lockdown, the greater the hysteresis. The two quarter depression will never become the V-shaped recovery everybody seems to want.

  The first reason is that if well let up before R0 is really close to zero, before we have therapeutics, we risk another wave later in the year. The damage of multiple shorter lockdowns will be even greater than a single longer lockdown. Until we know it’s over, uncertainty will not fall, animal spirits will not reappear. A temporary respite is no respite for the economy.

  The second issue is, in prioritizing the economy over healthcare, what economy are we trying to save? The problem of the last decade is not that equity prices of innovative companies like Amazon have rocketed. The problem was that the equity prices of obsolete companies also went up. These companies, who should have been defaulting on their debt, whose equity prices should have gone to zero, instead have been allowed to lever up their balance sheets to engage in buybacks to artificially puff up their equity prices.

  So I don’t think it’s time to let people die for the “good of the economy”. Large parts of the economy are rotten and should have died a decade ago. Are we really happy that the SPX is now nothing more than a highly correlated proxy for central bank balance sheets? Why don’t we instead try allowing the SPX to be a function of the real economy.
• 51 Dawn April 4, 2020, 7:26 pm

  I’ve learned so much from monevator which i am grateful and will carry on doing but the Invester himself tends to add a slight negative and pessimistic twist.
  “Ill repeat…we carn’t take much more of this” are his words.
  Are you a virgo by any chance, they can be very negative?
  A recent interview with Bernstein said ,if we can survive the Great depression we can survive anything. He also added markets were very resilient.
  How long did the world wars last , years, certainly not a few months.
  I also read 2008 was much worst because the banks were about to go bust.
  Mathews comment seemed more balanced and IMO.
  Anyway ,I’ve held on and sold nowt!
• 52 The Investor April 4, 2020, 8:02 pm

  @Dawn @Neverland — Yes, we survived the Great Depression / the Thatcherite retrenchment. Few would argue permanent scars weren’t left by both, and plenty of deaths in the former. Survival is a low bar. But sure, if that’s the bar we will clear it easily.

  @ZXSpectrum48k – I don’t understand the “one long lockdown and done” theory. We got to this point with a tiny (known) infection source over just a couple of months. We now have the virus rampant here and abroad across the entire globe.

  Let’s say we bring the current wave in the UK down to near zero and finally turn off lockdown. Surely we get untracked new clusters again? That ramp up fast once more?

  Of course far faster testing and tracking in the future would help. I guess the presumption would be we sat on our hands two months ago but we are now alert to the reality.
• 53 Neverland April 4, 2020, 9:17 pm

  @Investor

  I’m guessing you stamp it out domestically, close your borders, prepare and then do what you should have done in the first place

  At this point I wouldn’t assume the UK government has a plan that looks that far ahead
• 54 Seeking Fire April 4, 2020, 9:18 pm

  Some very interesting links and well thought out comments by people. I’m not selling (again – I think for those with a couple of decades accumulation to go please don’t unless you can market time) but equally global equities just look less expensive, not cheap. But who knows for certain why, my best reasoning is (a) rates are zero (b) markets think we’ll basically adopt the Investor’s strategy (which FWIW, which is nothing, I agree with). Do not sell (unless you think you can market time – you v likely can’t).
• 55 Snowman April 4, 2020, 9:56 pm

  My hunch TI is that your estimate that 7 million of the UK population have or have had the virus is a reasonable one. I might even guess higher than this. The difficulty is in estimating the overall death rate (e.g. 0.3% or 0.6%?) because we still don’t know the proportion of asymptomatic cases or even how many symptomatic cases there have been. Only the Italian town data has come close to giving us help with the asymptomatic proportion here although the Chinese seem to be claiming there are a large proportion of asymptomatic cases. And it is hard to estimate how long UK deaths will increase as even the death and cause of death data is sketchy, and it isn’t clear what time lags are present, and how the lockdown measures will have affected the R(t) and so whether the peak in deaths will be in 2 or 3 weeks or longer and how high they will go up to in that period to the peak. Deaths are on average from people who were infected 4 weeks ago, so knowing future deaths for the next 4 weeks and the death rate would give us an estimate of sorts but we can’t really estimate either.

  So it can only be a hunch at this point so could be completely wrong. But if Porton Down really can do 3,500 accurate antibody tests on some sort of random selection of the population as was suggested at a press conference this week then in a couple of weeks it shouldn’t be too difficult to come up with a reasonable estimate accurate to within say a factor of 2. Whether that information is made public is another matter.
• 56 Vanguardfan April 4, 2020, 10:31 pm

  Those of you who think we’ve got millions of unknown infections out there. I don’t know how you’re reaching those figures.
  At present the UK has about 4300 deaths and 42000 positive tests. We know we are under testing (although maybe most hospitalised cases are tested). In China the mortality rate for the clearly symptomatic cases was about 1%, so let’s say we actually have more like 400,000 clearly symptomatic cases. I’ve not read anything that estimates higher than 50% for asymptomatic/so mild they are unnoticed cases, so that takes us up to about 800,000.
  That’s clearly loads more than we have recorded, but it’s nowhere near 7-8m, or even 2m.
  I accept that this is no better than a fag packet calculation, and proper studies are needed, but I do have a problem with ‘there must be millions already’. Much though I would love to believe it, and I hope you are proved right.
  (Also, remember the critical spatial nature of the spread. You who are in London will have a very different perception of prevalence, because you are in the first epicentre. This might explain why your hunches are different from mine).
• 57 Neverland April 4, 2020, 10:51 pm

  @Vanguardfan

  “Those of you who think we’ve got millions of unknown infections out there. I don’t know how you’re reaching those figures.”

  They are getting it from wishful thinking. No one knows.
• 58 The Investor April 4, 2020, 11:23 pm

  @vanguardfan — Did you read the FT “1 in 15 in London” article in the news links above? That’s from the IC model group who drove the UK gov policy towards full lockdown.

  From memory their latest working paper estimates between 1 and 5.5% or so of the population has been infected with C19. At the upper end that’s 3 million plus. Just under three-quarters of a million at the low end.

  So say 1.5million in the middle.

  Again, from the official Imperial modelling team! Not from my fag packet! 🙂

  The latter packet skews higher on a various hunches, one of which is that the official estimate seems to always run a week or so behind reality! 😉

  As @neverland remind us in his inimitable fashion, of course nobody knows for sure. Presumably he intends to reveal his constructive thoughts and strategy in a decade or so when all the data is in.
• 59 The Investor April 4, 2020, 11:28 pm

  @Snowman – Agreed. Assuming the serum test is accurate we’d have to be very unlucky not to get some great insights from such a survey.

  I remember in the very early days the government picked 10 places in the country where it was going to test randomly (for live infection) as a sort of early warning system / indication of spread. Not sure what happened to that, presumably it was overwhelmed by incoming. 🙁
• 60 xxd09 April 4, 2020, 11:56 pm

  Sweden remains an interesting outlier
  Will they pull it off without total economic shut down?
  If they do (master the Coronavirus outbreak that is)-how did they do it?
  xxd09
• 61 Vanguardfan April 5, 2020, 5:43 am

  Ah yes, Imperial College has the very highest quality fag packets ;-). So even their very highest estimate might get us to 3m, not 7-8m. And 3m, still leaves us with a huge number of unexposed. Therein lies the issue.

  Btw, the scheme to randomly test was based on existing flu surveillance mechanisms:
  https://www.gov.uk/guidance/sources-of-uk-flu-data-influenza-surveillance-in-the-uk
  I’d forgotten about that, perhaps it was stood down along with the contact tracing efforts.
  It would certainly be difficult to implement now that primary care has pivoted to seeing virtually no patients face to face, and people with respiratory symptoms have been told to stay home and dial 111..

  The problem with crisis mode is that the emergency response takes all the bandwidth. That’s my fear for coming out of lockdown – we really need to be planning and gearing up for a massive trace and isolate exercise to accompany that, but right now all capacity is going to the immediate treatment and response. That’s going to go on for some weeks, judging by Italy and Spain. Lifting restrictions too soon would actually be the worst of all worlds, as we would have gained very little.

  Btw I’m with ZX and, yes, Neverland, in pointing out there is another way of viewing the ‘economy vs lives’ tension. Thanks for that.
• 62 Penelope April 5, 2020, 7:45 am

  Is it just a co-incidence that Imperial College was named after a large publicly-quoted cigarette manufacturer? I think we should be told.
• 63 Snowman April 5, 2020, 7:59 am

  In terms of the numbers, assume:

  Period from infection to death = 22 days (20 days infection to death + 2 days reporting delay on average)

  Assume infections have doubled every 5 days until 24th March 2020 (lockdown) and so deaths will increase every 5 days until 15th April 2020 (22 days after lockdown).

  Assume infections halve every 8 days from 24th March 2020 and so deaths halve every 8 days after 15th April 2020

  Assume the real death rate is 0.5% (probability of someone with the virus dying) to take into account asymptomatic cases.

  Ignore lots of other things (e.g. care home coronavirus deaths – sadly there have been multiple covid19 deaths at a care home near me, they aren’t hospital deaths so won’t count in the daily figures, and anecdotedly it appears the death certificates aren’t even showing covid-19 so won’t even be in the ONS statistics, and ignore covid-19 hospital deaths where covid-19 is likely to be the cause of death and so case should be reported as covid-19 but isn’t in practice).

  Question 1: Do those assumptions get you to around 8 million currently with the virus or who have had the virus in the UK?

  Question 2: If you think it does get you to ballpark 8 million, which of my assumptions do you think is wrong?

  Not remotedly pretending that this is anything more than guesswork, and accept my assumptions will be wrong, but I think it is enough to form the basis of a hunch.
• 64 BBlimp April 5, 2020, 8:25 am

  Estimations across the 70m pop of the U.K. kind of impossible because the deaths etc figures are so scewed toward London which is ahead of the other regions

  I suspect the proportion of Londoners who’ve had Coronavirus is huge.

  Of the tiny group of people being tested think how many are coming back positive – Prince Charles / Boris/ Matt Hancock etc etc … and it’s hard to imagine this group of people were packed in like sardines on the tube before the lockdown

  I had a temperature and a headache, woke up with sore limbs, for about fifteen days. Had it not been for Coronavirus the symptoms would have been at the ‘carry on as normal it’s one of those things’ level, albeit for far far longer than one normally has a temp.

  Did I have corona ? Sadly we won’t know until June at the earliest.

  ( I live & work in Inner City London, what some might generously call ‘central London’ )
• 65 The Investor April 5, 2020, 8:41 am

  @vanguardfan – Morning. 🙂 I don’t think I ever said 7-8m, I believe I said “several” and @Snowman numerated it thusly. Perhaps I should have said “a few”. Still very much higher than anything like the official cases still guiding the public discussion, and I’d be more surprised if the true number now was less than 1m versus more than 7m.

  @BBlimp – I had a sore throat for a week or so, a day of hotness and tiredness, and a two-day headache. It never became anything else (eg a cold). At the time we were still looking for fever and continual cough, so I presumed not CV. Sore throat with neither has now edged into the CV symptom list and it’s become understood mild CV is fairly commonplace, so I think it possibly was. We’ll see, but I hope so.
• 66 The Investor April 5, 2020, 8:48 am

  P.S. Edited my comment as less than / greater than symbols were edited out by browser. Also I agree with you about testing and tracing. As stated above given where we were I think this first lockdown was the right call. But we do need to do something with it. Hospitals and equipment, testing system set up etc.

  Going to just monitor comments from here as like I said I’m in questioning mode, not “I know it all” mode but this sort of discussion ends up implying the latter as it goes on. Have a good day all!
• 67 Dan H April 5, 2020, 8:57 am

  @Vanguardfan to get the total infected you have taken the current number of deaths and multiplied it by an estimated fatality rate of 0.5% including asymptomatic cases.

  Assuming you want to include those currently infected, using the current number of deaths is invalid due to the time lag from infection to death. You would need to estimate the number of deaths in 3-4 weeks time to use for your input. This would give an output several times higher than 800,000. This is where the higher infected figures come from.

  Of course this can also be massively affected up or down by changing the estimated fatality rate.
• 68 Neverland April 5, 2020, 9:13 am

  Here are some figures to think about

  UK government tax revenues £600bn

  Latest estimate of conovirus support cost from the IFS £200bn

  That tax take in 2020 will collapse too due to lost income/profits

  Taxes are going to go up a lot

  Can’t really make a hole in that without raising income tax
• 69 Naeclue April 5, 2020, 9:21 am

  The exit strategy I think has always been clear. Scale up testing so we can return to trace and isolate, together with isolation of the “most vulnerable”. Better information is of course key to getting there. The trade off between economic damage and number of deaths is much easier to handle once we have more reliable data on the death rates.

  Innovation/experience on how best to treat the infected will help bring down the death rate. Antivirals will likely come along, but again we need scale. There has been some talk about introducing alternatives to ventilators for some patients that may help, such as old fashioned iron lungs.

  Although we need more, ventilators are far from a panacea, very much a last resort. They are horribly intrusive, can damage lungs and put more pressure on the heart. I have a couple of relatives in their 90s who have already said if they get the disease they do not want to be resuscitated or ventilated. The more treatments that can be introduced earlier that keep people off ventilators the better.

  I suspect as well that infection rates in London may be quite high, in line with the spirit of the latest IC paper as, anecdotally, I know quite a few people who think they may have had it. A family of 5 living next door are fairly certain they have. The mother had all the symptoms and has just about recovered. Kids had it and barely noticed.
• 70 Naeclue April 5, 2020, 9:25 am

  @Neverland, inheritance tax will likely rise 😉
• 71 Jonathan April 5, 2020, 9:31 am

  In terms of exit strategy, I was intrigued by a story on the BBC website today describing how Holland has a much looser lockdown than the UK and other countries – and concern whether it was enough. (Basically, most shops and activities where social distancing can be maintained are still open, only things like pubs and restaurants are closed along with activities requiring person to person contact like hairdressing).

  So I looked up Holland on the Worldometer coronavirus tracker. They have had these measures in place for approximately 3 weeks, and the exponential factor for deaths is now easing off in the same way that Italy’s did after 3 weeks of much stricter lockdown. To be optimistic, that gives at least a model for partial easing of UK restrictions once the infection rate gets under control.

  The important stage for reaching something near normality will be having schools return. That has been pretty much discounted for the entire summer term so the target is next September. The question is whether by then it is identified how to control any new surge, and how to deal with new cases better so that a much smaller proportion end up in a life-threatening condition.
• 72 ermine April 5, 2020, 9:46 am

  @Penelope 62 What the world doesn’t need at the moment are any more conspiracy theories 😉 Imperial College was my alma mater, so I will defend its historical record. No, it wasn’t named after the cigarette brand. It was formed out of institutions created at the height of Britain’s imperial past in Victorian times, although it was chartered by that name in 1907, the sun had yet to set on the British Empire at that time.

  You can certainly charge the name with being not woke, but it wasn’t established by a cigarette manufacturer to deny the consequences of smoking. HTH.
• 73 Jonathan April 5, 2020, 9:59 am

  @ermine I am another with a connection to Imperial.

  For ages they preferred to call themselves IC because of the embarrassment of the Empire connection (not tobacco!) until they realised that their reputation was bigger than that. They now get the benefit of a name with widespread single-word recognition like Harvard or Yale. Most other universities are named after the city which happens to house them.
• 74 Tom April 5, 2020, 10:05 am

  By being our own antisocial selfs of course. Have you seen swedish bus stops, even before this pandemic? You’re talking about the people who will wait at their door until they hear the neighbour has cleared the stairway before leaving apartment.
• 75 Penelope April 5, 2020, 10:13 am

  @Ermine 72 @Jonathan 73.

  Thanks for clearing that up. Where do you stand on the question of the Moon Landings?
• 76 two shilling and sixpence April 5, 2020, 10:18 am

  On the number of asymptomatic cases i understand that in one village in Italy all the population was tested. For every positive test with symptoms there was three positive tests without symptom.

  Our best way forward i feel is the antibody home test currently been developed and the hope that the virus dose not mutate so those infected have some immunity
• 77 Richard April 5, 2020, 10:25 am

  There are only two apparent ways out I see. Firstly, and the one I have been assuming, is herd immunity. High deaths by default, though as long as you stay below capacity you can minimise this. It truley ends (or at least bubbles away quietly in the background and life returns to normal).

  The other is squash it now and revert to containment. In theory much lower death toll. To date I have not really entertained this as a valid approach considering the world wide infection rate. While the rest of the world is infected you will be forever fighting against sudden re occurances and super spreaders. It also didn’t work first time around and many ideas are yet untested. The result could be lots of little lock downs in the future if not handled well and still high death rates.

  But maybe there is something to the second approach. It appears to be working well in South Korea. I guess time will tell, but thanks to these comments for making me think about it further.
• 78 Matthew April 5, 2020, 10:26 am

  With the intrusiveness of ventilaters, their low success rate and shortage, maybe we should make people sign DNARs as a condition to going into/working in a hospital, nursing home, prison etc, or have an opt out system
• 79 Vanguardfan April 5, 2020, 11:13 am

  Ok, I concede that many realities are compatible with current observations (th Scottish CMO is working on 1000 cases for every 1 death, I had doubled that).
  I hope the UK government acts more quickly and effectively on antibody testing than it has done so far, of course the whole globe sees the need for this, and I suspect our first useful data will come from elsewhere.
  Btw I do of course hope that all of you who suspect you’ve had it are correct – I’m sure all that any of us wants is to have had a mild infection that confers lifelong immunity. I had a cold myself last week, and was wishfully trying to identify odd things about it. On the other hand, only about 25% of those who’ve had tests so far have been positive….

  I think isolating the vulnerable is for the birds, to be honest. The most vulnerable, those in care homes (not all of whom are elderly), are being left high and dry, along with those still prepared to care for them (who are some of the heroes of this crisis). Other people with ‘underlying health conditions’ live in households with the rest of us. What about the doctor or supermarket worker whose teenage daughter is a brittle asthmatic, or whose husband is immune suppressed?

  Oh and no 90 year old will be offered a ventilator. I doubt that would happen even in normal times. And Matthew, GPs are very busy trying to have difficult discussions with all their vulnerable patients about DNACPR, so as to save hospital resources for those with better chance. Frankly it’s bad enough sending workers to care for the vulnerable without PPE, they deserve utmost protection, not a waiver from treatment!!

  Anyway I’m off to enjoy some outside air. I really hope we don’t get a uniform national ban on outside exercise, driven by issues in urban areas….

  Good luck and stay safe.
• 80 Matthew April 5, 2020, 11:41 am

  @vanguardfan – they deserve a humane final hours, the whole process of ventilation or resusitation is questionable for anyone, and it could be argued that choosing to work in these environments is a form of self neglect itself
• 81 Duncurin April 5, 2020, 12:07 pm

  @Vanguardfan. Many thanks for your expert commentary.

  I’m not sure whether to be reassured by the BBC report that at my age (mid-sixties) the risk of dying of coronavirus appears to be little more than my chances of dying of something else.
• 82 Aidan Williams April 5, 2020, 12:32 pm

  There are some great interactive charts here:

  https://ourworldindata.org/coronavirus

  What worries me is the fixation on the death rate. Anyone entering hospital with Covid19 is likely to suffer long term lung damage (and earlier death) even if they do leave hospital alive.
• 83 Vanguardfan April 5, 2020, 12:52 pm

  @matthew, I think you’re just trolling now, and I’m not going to bite again.

  @aidan, again, no data yet on long term outcomes, but the last snippet I caught was more optimistic. Remember that lots of those hospitalised won’t need ventilation/intubation, just extra oxygen and other supportive care.
• 84 Matthew April 5, 2020, 1:09 pm

  It’s hard to justify the logic of ‘brave’ staff risking their life for no personal gain, vs universal credit that isn’t miles off the wage of the lower paid staff, at some point they had to tell their spouses why theyre choosing to put the health of random unknowns above their own family, it’s not an easy one to answer, especially when the gap to universal credit is small.

  So to be brave, you have to accept the risk of death, like a soldier it’s what you sign up for. In the crunch of making hard decisions about who gets ‘help’ it might be a factor
• 85 The Investor April 5, 2020, 2:18 pm

  @matthew – I don’t think it’s very helpful questioning the braveness of medical staff going into work and in some cases dying of a horrible disease in order to treat the wider population. Just as importantly I’m not sure it adds much to this conversation. They are doing what the nation is asking of them and I’m very grateful for that.

  You’ve expressed your view and further discussion is just going to upset people without adding much to the substance of the conversation. Further comments in this vein will therefore be deleted. Thanks!
• 86 Matthew April 5, 2020, 2:54 pm

  Certainly no intention of causing upset, just please be aware that these workers are having to justify to their spouses – its not something we tend to think about, the domestic arguements these workers face
• 87 marked April 5, 2020, 3:22 pm

  Going to throw this hand grenade in and see what we get as a response 🙂

  The Chancellor, when announcing the self employed package, lamented the lack of NI contributions the self employed pay in contrast to salaried employees.

  Full Disclosure: I’m an employee and a director, so not part of the self employed from a payment perspective.

  My view on adding more NI for the self employed – what a bloody cheek! He is linking NI with the package of measures to support the self employed and I don’t see how that works. The Tory government sometime ago under Cameron admitted NI and Tax are the same.

  So here’s the hand grenade (particularly for FIRE people)…..

  Why not flat rate tax at a new rate which includes NI. That means pensioners pay it too? Much fairer. Of course all those pensioners would then be paying 12% tax over £12500. The tax system is so complex now (and obviously more complex if you have kids, or earn > £100K) maybe this time to simplify, but don’t just pick on the self employed!

  Hand grenade deployed!

  Stay safe everyone!
• 88 Marked April 5, 2020, 3:46 pm

  Edit to #87

  All those pensioners would be paying a further 12% over 9500 for next (this depending when you read) tax year.
• 89 Naeclue April 5, 2020, 4:26 pm

  @Marked, I have never liked employee NI and think it creates a lot of distortions and unnecessary compexity, so I have a lot of sympathy with your suggestion. The difficulty is how we get from where we are now to the new system. A lot of people will only have received 20% tax relief on their pension contributions, so it would be a kick in the teeth to hit them for 32% on withdrawal. With the tax free PCLS though, such contributors would still be in profit if the basic rate was lifted to 25%.

  The other difficulty is that NI contributions are linked with the state pension, which is considered “earned” rather than a benefit by virtue of people making sufficient NI contributions. However, this is watered down to a degree by various NI credits people can claim and also by the fact that pension credit can increase many pensioner’s income to the basic level anyway.

  If the sums worked out I would not object to 25% basic rate and the abolition of employee NI, but I received 40+% tax relief on my pension contributions, so maybe it is easy for me to say 😉

  One thing I think could be done to claw additional tax back from us retirees would be to remove the tax free status of ISAs for those past state retirement age. Prior to state pension age, ISAs encourage saving. I cannot really see the justification for keeping the tax free status beyond state pension age though.
• 90 Naeclue April 5, 2020, 4:37 pm

  @Vanguardfan, I had not thought about over 90s not being offered ventilators, but makes perfect sense of course. My relatives are very fit, still driving and not receiving care, although they did have a cleaner that they reluctantly have stopped coming. With family help, they could easily continue to be isolated as restrictions on others are lifted, but I know they would not want to cooperate with that. They are already fed up with the restrictions and have the attitude that if this virus doesn’t finish them off then something else probably will soon enough.
• 91 Jonathan April 5, 2020, 4:54 pm

  @Marked, @Naeclue, I am another who suspects National Insurance will be the vehicle for overall increased taxation.

  Even though it is to all practical purposes an extension of general taxation, I think it will retain its separate label. As @Naeclue points out it acts as qualification for state pension: for that reason I personally think the threshold should actually be lower than now so that an employee on minimum wage working half time gained qualifying years. And with governments having at some point to deal with the issue of funding elderly care, keeping the label would make it more palatable as an additional tax on pensioners (probably at a different rate from employees).

  At the same time, the fact that it is part of general taxation ought at some point to mean rationalisation of rates for higher earners, with NI rates continuing upwards but the highest rates and some of the complicated taper rules removed.

  The issue of NI for self-employed is obviously a matter of contention, but not one I have ever got my head around.

  And not sure whether changing the tax benefits of ISAs wouldn’t create unintended consequences that neutralised any notional tax gain.
• 92 Vanguardfan April 5, 2020, 5:02 pm

  @naeclue, just don’t mention it to them, ok?! We have an elderly relative who is similarly difficult to keep with the programme. It’s harder I think for those who live alone, and older people can be less flexible/adaptable generally. We are distant from him too so can’t even help with practical stuff like shopping (and online delivery has not been available).

  Re NI. On the face of it it seems a logical simplification to bring it together with income tax, but for all the various reasons others have pointed out, I don’t think it will happen.
  The state pension entitlement is a big issue to unpick, it’s only been 4 years since that was overhauled.
  More relevant possibly, what government is going to want to introduce what will look like a big hike in income tax rates? (And for pensioners, it will actually be a big hike. Politically that would be a hard sell).
• 93 Neverland April 5, 2020, 6:21 pm

  Look at who the government went after last time to see who they will go after this time:

  – corporations (IR35, entrepreneurs relief, standard corporation tax rate, digital taxes)
  – income tax deductions (personal allowance and pension deductions limited by income/LTA reduction)
  – non-residential property owners (buy-to-let, foreigners)

  I would be amazed if this government actual raised inheritance tax or levied NI on pensioners, but I can’t see right now how they won’t have to raise the basic rate of income tax or NI
• 94 old_eyes April 6, 2020, 8:37 am

  I came across this interesting paper from a couple of economists http://www.algorithmiceconomics.com/wp-content/uploads/2020/04/ending_lockdown.pdf. Paul Ormerod I have heard of, but not the other author.

  They argue for staged easing of the lockdown, and suggest that habits will have been changed to the extent that people will not immediately go back to previous habits across the population. Some caution about attending mass events, travelling less, fewer handshakes, kisses and hugs. All of which will help reduce the intensity of any second/third wave.

  Not convinced, but a well made argument.

  Oh and thank you to @ermine and @richard (72 & 73) for leaping to the defence of Imperial. As another alumnus I was going to comment, but you got there first 😉
• 95 Snowman April 6, 2020, 9:02 am

  Interesting take on the health and economic perspective here

  https://drmalcolmkendrick.org/2020/03/29/a-health-economic-perspective-on-covid-19/

  Just to be clear I’m totally supportive of following the guidance to stay at home and protect the NHS by stopping it being overrun. But we do need to be able to think openly about the issues.
• 96 The Investor April 6, 2020, 9:44 am

  @Snowman — Excellent piece, which makes many of the points I’ve alluded to from a far more informed perspective. Thanks for sharing.
• 97 ZXSpectrum48k April 6, 2020, 11:17 am

  @Snowman. The piece is riddled with assumptions. First, the government support package is not costing £350bn. £330bn of that is loans, not handouts. He’s assuming a 100% default rate with zero recovery! That’s a moronic assumption.

  The actual level of direct non recourse “helicopter money” is highly debatable. Large components of the UK packages are not actual direct handouts, much will eventually come back via other channels such as taxation and deferred consumption. The overall fiscal cost is far far less than headline numbers suggest. This doesn’t necessarily require the tax rises people suggest, especially when they is so much room to increase Gilt issuance (given huge demand for Gilts).

  Moreover, he cannot simply assign 100% of any costs to the UK lockdown. The UK is economically it’s one of the most open economies and incredibly vulnerable to the global economy “catching a cold”. Some of these fiscal packages would have been required even in the absence of any UK action. Once China, Europe and the US are in lockdown, the marginal cost of the UK implementing a lockdown is small since all the major global players have already done this. It might be different if nobody went into lockdown.

  This is just another example of people trying to reduce really complex problem to a model than can be calculated on the back of a postage stamp.
• 98 MrOptimistic April 6, 2020, 11:20 am

  A couple of people I know think they might have been infected on the basis I reckon of a spot of hayfever. Thing is, if you were infected and showed negligible symptoms, the probability must be that family members/close contacts must have shared your infection. If all these also showed no symptoms then what chance the infection actually happened? So I am doubtful that the elves have been out painlessly inoculating us, sadly.

  Although an alumnus of Imperial, albeit before they bolted on a medical school, wonder why we haven’t got a panel drawn from across the country’s expertise and more than one model ?
• 99 The Investor April 6, 2020, 11:29 am

  @ZXSpectrum48K:

  This is just another example of people trying to reduce really complex problem to a model than can be calculated on the back of a postage stamp.

  I’m not sure this is qualitatively that different from what the universal lockdown until vaccine approach does (and the assumptions it is based on) in practice?

  At some level it’s a matter of pick your postage stamp. 😉

  @Snowman – A friend I sent the article to is refuting with the doctor’s maths. He replied to me: “I’m afraid I think his maths is fundamentally flawed as his use of average at death doesn’t take into account the asymmetric distribution of current ages against expected lifespan.”

  He also knocked together a quick spreadsheet that does this and suggests the cost per QALY is more like £60K, or double the NICE guidelines. Given the uncertainty band is vast as @ZXSpectrum notes, that seems more reasonable on the surface.

  @ZXSpectrum makes a fair point about loans. On the other hand neither the DR nor my friend’s numbers take into account the permanent loss of GDP from a deep recession / extended lockdown. Again we’re all pulling numbers out of the air, but particularly with a long indefinite lockdown until vaccine supported by so many, this will dwarf the direct costs of State support.
• 100 The Investor April 6, 2020, 11:35 am

  @MrOptimistic — Yes, that is definitely a risk. Availability bias risks are rampant here (e.g. “What are the chances that BJ has got it and only a small proportion of the population hasn’t?” versus “What is the chance someone very much in the public eye would have it?” — clearly the latter is very likely).

  The obvious retort to the “plenty have had it” theory is why haven’t there been more widespread deaths in China, even given the extreme superiority of their lockdown/quarantine/etc? It is hard to believe it decimated Hubei province then got into the world while mostly missing the rest of China.

  Antibody testing of a whole population in a known area of high infection (e.g. one of the Lombardy cities) will be instructive I think. The higher the expected rate of infection the less we need to account for false positives. It may be a long time before such a test can give us reliable ‘immunity certificates’ as they’ve been dubbed, but it should quickly give a handle on whether 5-10% of the population caught the virus pre-lockdown versus say 10-30%.

  More ridiculously, why hasn’t Trump got it if it’s so widespread? Is it because he’s a known germophobe? 😉
• 101 Vanguardfan April 6, 2020, 11:50 am

  ‘The indefinite lockdown while waiting for vaccine supported by so many’ – I haven’t had the impression that this is a widely ‘supported’ strategy at all. More that people are desperately trying to find a way through that allows relaxation of the lockdown, as soon as proves possible. It’s just a recognition that the last five words there are the tricky bit. The last thing we want is to stop the distancing too soon and unleash a greater surge.

  I struggle to understand why you feel that the policy response is in danger of being balanced too far in favour of privileging lives over money. There are very very strong forces pushing to restart/renormalise the economy, everybody wants it, of course, so I think the risk is far greater that we will do it too soon than leave it too late (we were late to act precisely because people didn’t want to damage the economy unnecessarily). It’s proving hard enough to get some people to comply with things that are easy enough to comply with (don’t sit around sunbathing in a public park; and there a groups of young men roaming my town deliberately bumping in to people).
• 102 Naeclue April 6, 2020, 12:09 pm

  A good article from the point of view that this is how the cost/benefit tradeoff should be done, but alas, hugely oversimplified. In addition to ZXSpectrum’s comments which I totally agree with, where are the QALY’s that will be gained from the lockdown? Reduced car accidents, fewer seasonal flu deaths, etc.

  But then he totally blows any credibility by agreeing with his 92 year old mother. I have elderly relatives who had a very similar attitude until I diplomatically pointed out the selfishness of their action. Flouting lockdown because you don’t value your own life is analogous to the difference between topping yourself by taking an overdose and driving down the motorway at 120mph then closing your eyes when you see you are approaching a large group of cars.
• 103 The Investor April 6, 2020, 12:22 pm

  @Vanguardfan — Just quickly on this: “I struggle to understand why you feel that the policy response is in danger of being balanced too far in favour of privileging lives over money.”

  As I’ve repeatedly tried to stress and this article does again, it’s not *only* about lives over money. It’s about lives over lives.

  If as per the doctors’ (likely inflated) calculations the cost of lockdown is say 10x greater than NICE guidelines, this gives us an indication of how spending now on mostly getting a few more years for the very old will cost many more years for the very young. (And less dramatically less elective treatment on the NHS, money for things like psychiatric treatment for depression etc). As we’ve all agreed these numbers can be taken in any direction one wants to make one’s point and it’s all hugely subjective, but the point is it’s not just lives versus money.

  Again, as per the BBC article, the academic quoted in there put the cost of lockdown of *lives* lost as greater than his estimated lives saved from COVID at a GDP drawdown of c. 6.5%.

  @Naeclue — Fair points. On the other hand as I say he doesn’t account for permanently lost GDP. Also if you really want to go down the appalling QALY calculus rabbit hole (and I’m glad it’s not my job to 🙁 ) then say an 85-year in permanent hospital care dying a year early would release a lot of money to spend on a young person, so you would get massively more QALYs that way. (Based on, from memory, spending on the old on healthcare being 6-10x that spent on young).

  As @ZX has noted, we simplify this stuff at our peril from our armchairs.

  Perhaps I’m betraying my instinctively slightly socially left-wing bias / reading / friend circles as usual and this stuff is being discussed much more widely in the right-wing press than I’ve noted. A friend sent me a similar Tweet from Toby Young, who exists in a circle I don’t like to find myself.

  But anyway, this blog post from the doctor, imperfectly, is one of the only ones I’ve seen trying to publicly discuss these issues.
• 104 Grumpy Old Paul April 6, 2020, 12:35 pm

  @ZXSpectrum48k,
  I don’t claim any particular expertise or intellectual firepower but as soon as I began reading Dr. Kendrick’s analysis, I immediately seized on his use of £350 billion as being absurd for the reasons that you state. What astonished me was that I didn’t notice any comments challenging it!
  So I’ll do a finger in the air job and say let’s assume that the actual net cost of the package is £35 billion then the good doctor’s revised estimates become:

  Best case: £9,720
  Most likely: £38,888
  Least case: £729,166

  Obviously, any digits following the most significant can be ignored and replaced by zero! Really appreciate your evidence-based comments.

  As always, to all who post, regardless of opinion, stay well!
• 105 Vanguardfan April 6, 2020, 12:40 pm

  @TI ok sloppy wording (lives vs money), that was not the main thrust of my point, so let’s not get distracted. My main point is that it’s obvious that lockdown is undesirable, and that we need to get out of it when we can. So I see everywhere the pressure to get going rather than pressure to stop unnecessarily. I don’t think ignoring the virus would ultimate work for the economy either. But most of all I think that human life is not just about how we contribute to economic life. The economy should be there to support humanity, whereas I feel some people see it as the other way around, or at least as almost interchangeable.
• 106 Snowman April 6, 2020, 12:52 pm

  What I liked about the Malcolm Kendrick article was that it was attempting to numerically quantify the situation. Rather than simply saying that you couldn’t put a cost on a human life, we should be saying you have to put a price on a human life. Government actions will have direct immediate affects on whether people live or die but if we concentrate on those, then we miss that the alternative actions will have indirect long term affects on whether people live or die. Putting a cost on life is in some way just a mechanism for balancing out the direct and indirect affects so that we can live full and fulfilling lives (whatever that means).

  I agree that there are major assumptions in the article. I didn’t really make any attempt to verify the numbers, I find the system is too complex for me to analyse.

  My analysis would be simplistic and wouldn’t particularly include costs to the economy etc.

  If we say the average loss of life expectancy for someone dying from covid-19 was 4 years (I’ve no intuition as to what that figure should be). And let’s say that loss of life expectancy applies to say 2% of the population that die through covid-19, who wouldn’t have died for 4 years on average had another strategy been followed (e.g. wait for a vaccine). Then the average reduction in life expectancy is about 28 days per member of the population (0.02 x 4 x 365).

  Then ask yourself this question. If you were put in the hypothetical situation, that the creator of the universe (imagined or real depending on your disbelief or belief) told you they could lift the lockdown, magic the virus away, but that you would with your fellow citizens all be docked 28 days of your future life. Would you or your fellow citizen take them up on that if the alternative was lockdown for 18 months and all the ramifications of that, some of which might in themselves reduce life expectancy?

  Looking at it that way the do nothing to slow the virus option appears quite attractive.

  What does that miss? It misses the social costs and ethical considerations of allowing 250,000 to die suddenly, rather than do something that meant those 250,000 could enjoy another 4 years of life on average.

  It would be totally inhumane to allow those 250,000 to die over a short period in my view, and I wouldn’t want to live in a society that allowed that to happen. Factor that revulsion into the calculation if you like and increase the 28 day number.

  But trying to cost in the social and ethical issues is very difficult numerically. The government does needs to act in a socially responsibly and ethical way (e.g. lockdown currently) but with some balance as to the long term ramifications going forward.
• 107 Naeclue April 6, 2020, 2:51 pm

  Another aspect that really should be included in any quantitative cost/benefit analysis is the extent to which spending now may reduce spending in later, potentially far more dangerous, pandemics. Goodness only knows how valid any assumptions will be on including this, but it is reasonable to expect that part of current spending will result in reduced spending next time compared with just shrugging our shoulders now and saying “too expensive”.
• 108 Naeclue April 6, 2020, 3:21 pm

  Another way that we can all help mitigate the cost (in lives and ££s) of this that I have not seen pushed by the government (other than saying exercise once per day) is to take extra care over our own health. Matthew Walker, sleep evangelist, would advise everyone to do their best to get a good night’s sleep as that would greatly benefit our sleep deprived immune systems and help us to avoid becoming obese. We could consume less alcohol and caffeine, which would help significantly with the sleep. Those of us with more time on our hands could prepare and eat more healthy meals. Those addicted to tobacco could make an extra effort to get off it. Quitting smoking would not only improve our collective health, but also improve our bank balances.

  Many would doubtless ignore the advice and complain of the “Nanny state” telling them what to do and do the opposite, but that makes it more important for the more responsible amongst us to make an extra effort to stay healthy.

  We are certainly eating better, assisted by our currently resident offspring and their partners who eat better than we used to by default, but I have also cut down on the alcohol and don’t touch anything with caffeine (including decaf tea/coffee) in it after about 4pm.
• 109 MrOptimistic April 6, 2020, 4:34 pm

  When someone gets the chance, could they educate me on something ( helicopter money reminded me of my ignorance). All the talk about central banks buying up bonds and expanding their balance sheets. What stops them from just hitting the computer button and setting them to zero? Holders of bonds still get paid so no default, no new real money is injected into the economy so no inflation. I must be holding the wrong end of the stick but don’t see how.
• 110 xxd09 April 6, 2020, 5:13 pm

  Re Mr Kendrick
  The stimulus is 350 bn not 3.5 bn-cost per qualy is not 97k is 97m
  Most of stimulus in Loan form so not expenditure. It’s providing liquidity-cannot use apples and pears in an analysis
  Maths aside -resources are finite even where saving life is concerned
  Doctors been doing it for years
  xxd09
• 111 Grumpy Old Man April 6, 2020, 7:02 pm

  I think the good doctor erroneously put ‘3.5bn’ in brackets but performed the calculation using 350bn!
• 112 Penelope April 6, 2020, 8:04 pm

  There seems to be a bit of an Imperial old boys network here dominating debate and shutting down valid questions. Makes you wonder…
• 113 Passive Pete April 7, 2020, 8:29 am

  I learned a lot from reading Matthew Walker’s book too, I read it after @TI recommended it. However I think I lost sleep initially after reading it, as I was worrying about not getting enough!
  A couple of other fascinating books if anyone’s got some time on their hands; The Madness of Crowds by Douglas Murray and Sapiens by Yuval Noah Harari.
• 114 The Investor April 7, 2020, 9:15 am

  @Penelope — No it doesn’t. Most of these commenters are regular readers and contributors below the line for several years. Not sure how serious you are but please don’t infect this site with nonsense conspiracy talk, further such will be deleted. Thank you!
• 115 Jonathan April 7, 2020, 9:48 am

  The most relevant thing in that Kendrick piece is the illustration of how excess deaths are associated with economic problems. That is the balance that politicians need to be aware of.

  Clearly QALYs are something Dr Kendrick knows well from his own professional work. But actually they were invented for the very specific purpose of allowing a prospective analysis of whether introduction of a new drug (or other medical intervention) would be cost-effective in a resource-limited health service where they would reduce money available for something else. They were not devised for, or indeed appropriate for, individual patient decisions; or for that matter whether a non-medical action (partial salary for furloughed workers) will be effective.
• 116 Indecisive April 7, 2020, 11:20 am

  @Investor, re #99:
  On putting a price on life, and the economic damage of the shutdown vs continuing, I found this article (in response to Toby Young’s comments) compelling – especially as Sam Bowman (https://twitter.com/s8mb) is a fellow at the Adam Smith Institute, so I (unfairly) was expecting the opposite conclusion.

  https://thecritic.co.uk/why-the-coronavirus-shutdown-is-worth-it/

  It introduced me to the concept of life tables, showing me where my “average life expectancy” fag packet calculations were wrong.
• 117 ZXSpectrum48k April 7, 2020, 1:57 pm

  At opposite end of the viewpoint, another piece of research (http://www.healthdata.org/covid/updates) puts the UK as the worst country in Europe in terms of deaths. They see a central scenario where deaths in the first wave in the UK (66k+) are equal to Italy, Spain, France and Germany all combined. The reason: lack of hospital beds and ICU capacity.

  I haven’t read this research so it may be totally flawed. I have been on 75+ conference calls on SARS-CoV-2 in the past two months, and it does follow the broad consenus view (especially from Asian experts) who are hugely critical of the UK (even more so that the US). They think we will come out with one of the worst outcomes globally due to the inflexibility of PHE and brittleness of the NHS. Based on that view, they think the UK needs a longer lockdown that many other countries. We were late implementing the lockdown and didn’t see the vulnerability of London given the relevance of viral load to poor health outcomes. We may potentially pay a price in terms of both more deaths and needing a longer lockdown.
• 118 Boltt April 7, 2020, 3:18 pm

  Wow. Those numbers for the U.K. seem very large.

  UK numbers expected to peak at about 4x current levels, but Spain, France Italy all passed their peak.

  I have little expertise and no facts to add – hopefully the actuals will fair lower than this scenario indicates. (How can I bet against their numbers?)

  B
• 119 Jaygti April 7, 2020, 3:35 pm

  I haven’t read the above report yet, as I’m at work, but I have read a couple of comments on it, and it may be a dud.

  It says we have only 799 ICU spaces. This is taken from the pre virus total of 4000 total spaces which are generally 4/5ths full.

  It’s not taking into account the clear out of beds and all the extras from private hospitals etc.
  It doesn’t take into account the extra beds at NHS Nightingale etc either.

  So the 66000 deaths may be way off.
  I will read it properly when I get home.
• 120 ermine April 7, 2020, 4:12 pm

  @ Penelope 112

  > There seems to be a bit of an Imperial old boys network here dominating debate and shutting down valid questions.

  Facts, please. We are in a troubled time at the moment. A disease is stalking the public health. The PM, whatever you think of his politics, in in a NHS hospital in living proof that there is a problem out there. There is insufficient data to draw clear conclusions of how to proceed, because this is new to us.

  You baselessly implied that Imperial, one of the institutions that is trying to bring the light of reason onto the situation was connected with a tobacco manufacturer, where a modicum of time spent with Google would have informed you this is not the case. Your claim was not shut down. It was refuted.

  Conspiracy theories are dangerous. There are morons attacking the mobile data infrastructure that is connecting many people together because of stupid assertions being made on social media. There may be all sorts of things wrong with 5G but it doesn’t spread coronavirus, which is mostly spreading where’s no 5G, because, guess what, there’s not that much 5G about! These twits trashing people’s bog-standard 3G and 4G connections that are their links with their livelihoods, friends and family and threatening people who are trying to do their jobs are antisocial berks and need to be stopped.

  It’s the easiest thing in the world to snarkily posit the the Deep State means things aren’t as they seem, “Makes you wonder…” Much harder to actually make a reasoned argument and subject it to the light of scrutiny, eh?

  FWIW I searched this thread for Imperial, because you claimed debate was being shut down. I did your claim the respect of trying to evaluate the assertion against the evidence, as one should do. Apart from me and others repudiating your baseless assertion about the tobacco industry establishing it, I was unable to detect any debate being shut down. Evidence of your incorrectness was presented from public sources of record. I actually agree with one of the other Imperial alumni that it would be good to have a plurality of modelling – to wit

  > wonder why we haven’t got a panel drawn from across the country’s expertise and more than one model ?

  Reason and intelligence will guide us out of this darkness into the light. Bullshit conspiracy theories seem to scream round the world before reason has got its boots on. They need to be shot down before they deprive necessary discussion of oxygen.
• 121 ZXSpectrum48k April 7, 2020, 4:18 pm

  @Jaygti. As I said I didn’t read it. The numbers seem very high and, as you point out, may not incorporate the recent additional capacity that is being provided. What it does underline to me is what many foreign experts have said: that the UK was at least two weeks too late on the lockdown, didn’t clamp down hard enough on urban centres, especially London, and remain far too lax on air travel into the UK. We had an advantage of seeing what was going on in some Asian countries who were hit sooner and we blew it.

  It also underlines how we run the NHS with essentially no spare capacity, making it very brittle in any stress scenario. It reminds me of how we build Royal Navy warships these days, using a concept called FFBNW (Fitted for but not with) weapons capacity … because, of course, our enemies will always give us a good year of forewarning of the next war so we can pay for those weapons and fit them in time. Of course this time, our unseen enemy didn’t give us much forewarning and caught us with our pants down.
• 122 Richard April 7, 2020, 4:29 pm

  I thought the UK lock down was roughly the same time as the Italy lock down in regards to position on the curve. At least from a BBC article. So, other than capacity issues, you would expect UK to have a similar result. And the original plan, as i understand it (and possibly still the plan), was to aim for herd immunity while staying below capacity rather than stamp it out and back to containtment.
• 123 Matthew April 7, 2020, 4:35 pm

  @zxspec – its surprising though how empty theyve managed to get our (provincial) hospital by stopping all the normal stuff, most wards half empty – shows what can be done. On the other hand my dad who has pneumonia from flu (negative for covid) can’t go in for help when normally he would, and you have people at home with broken bones etc.

  I think if someone is in hospital for a different reason, and doesnt need access to oxygen, they could go to care homes. Hospitals by and large are a convenient place for doctors to visit patients and make sure they are obvserved and medicated, so potentially a lot of that can be done without the building – but of course access to oxygen is another thing.

  I think when london starts overflowing, theyll send them here, to the hick towns, we’re a few weeks behind london so hopefully when we’re overflowing london won’t be and we can ship them there
• 124 Pendle Witch April 7, 2020, 5:26 pm

  @Penelope.

  Imperial old girl here. I think there were 3 “old boys” identifying above, so not really dominating.

  I’m not sure I saw a valid question from you, so don’t know how they can be shutting anything down. People here are very helpful, sane and logical for the most part, so please ask if you have something relevant!
• 125 Snowman April 7, 2020, 9:38 pm

  No connection with Imperial at all but these weekly forecasts look interesting

  https://www.imperial.ac.uk/mrc-global-infectious-disease-analysis/covid-19/covid-19-weekly-forecasts/
• 126 The Investor April 7, 2020, 10:32 pm

  New BMJ study is suggesting 78% are asymptomatic. Note: It’s seemingly based on a very small sample size though:

  http://theconversation.com/coronavirus-bmj-study-suggests-78-dont-show-symptoms-heres-what-that-could-mean-135732

  I continue to infer from what I’ve read and as I’ve stated before that this disease is much more widespread than is commonly / was initially believed, FWIW.
• 127 MrOptimistic April 7, 2020, 10:58 pm

  The UK national flu reports are worth keeping an eye on. Latest shows a sharp upturn in reports of respiratory incidents from care homes, and ‘ excess deaths’

  https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/877617/National_influenze_report_2_April_2020_week_14.pdf
• 128 Richard April 8, 2020, 9:06 am

  @TI anecdotally i would agree it is more wide spread. I know someone who had all the symptoms back in early Feb. Two weeks with shortness of breath, fever etc. Doctors had no idea what it was. Doesn’t live or work in London, not been abroad etc. Good chance all friends and relatives and work colleagues were exposed as no self isolating back then. Could have been something else of course, but doctors couldn’t say and all symptoms in line with those described.
• 129 Jonathan April 8, 2020, 10:00 am

  @TI, the question of how many asymptomatic cases is crucial but the margin of error seems enormous. Serious estimates have ranged from 25% to this one of nearer 80%. Put that in the context of estimating the total number in the UK affected: whatever you deduce the number of symptomatic cases to be, adding in different proportions of asymptomatic could give total numbers covering a 3-4 fold range. And numbers will at least double before the curve flattens. For anyone planning the exit from restrictions, that either leaves a pool of uninfected who need to be protected from a second peak, or the country already approaching the “herd immunity” point and the likelihood further infections will remain easily within health service capacity.

  Of course lots of us have speculated about possible mild symptoms – we can’t know without a test. My wife and I had a persistent cough without other cold symptoms back at the end of January/beginning of February. It was at the time when that British businessman returning from Singapore infected a chalet in the Alps before others in the UK. We had skiied in that same resort a week before symptoms, but a day or so before the businessman arrived there, and we inevitably asked ourselves if it was possible he had only picked up the virus there and we had done the same.
• 130 ZXSpectrum48k April 8, 2020, 10:21 am

  We’re dealing with Knightian uncertainty. I’ve listened to 75+ conference call since mid Jan all from experts (WHO, academics, the heads of Covid response teams from many countries, PHE, CDC, economists galore etc). The dispersion of views is staggering. Moreover, the time variation of those views. Some who thought it was a minor issue in late Feb, declare it’s a major issue by late Mar etc. Their ideas of what the correct response is, pivots 180 degrees. Just not enough data and too many variables. A huge lack of quantifiable knowledge.
• 131 Vanguardfan April 8, 2020, 11:32 am

  A small study from China on antibodies in recovered cases. Not positive news.
  https://www.scmp.com/news/china/science/article/3078840/coronavirus-low-antibody-levels-raise-questions-about
• 132 Snowman April 8, 2020, 12:26 pm

  Thanks for that link Vanguardfan. Interesting but not encouraging.

  The following article talks about the American serological plans

  https://www.sciencemag.org/news/2020/04/unprecedented-nationwide-blood-studies-seek-track-us-coronavirus-spread#

  I’ve been wondering how they are able to measure the accuracy of tests both antigen and antibody tests, when they at the same time seem to be saying there is no accurate test at the moment even to do low number random testing. What test do you use to check that a proposed test is accurate? Unless you can apply separate independent tests you can’t really calculate the probability of false positives and false positives. And then if someone has had coronavirus symptoms, has travelled in a heavily infected area but tests negative for antibodies, how much less likely are they to have had coronavirus than someone who has had no symptoms, has remained in an area where the infection is limited but who tests positive for antibodies?
• 133 Vanguardfan April 8, 2020, 12:39 pm

  @snowman. I don’t know enough about the science of the testing process to make sensible comment, although I believe that one of the issues with the antibody test is getting a test specific enough for the Covid19 antibodies (as opposed to antibodies for other antigens). Perhaps a proper scientist will reply.

  With the antigen test it relies on amplification of the viral rna, I think one reason why many false negs are because it’s quite easy to physically miss the viral particles during swabbing – will depend a lot on how much viral load.

  But in any case, I am sure the whole process of inventing reliable and scalable tests for novel pathogens is far from straightforward.
• 134 Jonathan April 8, 2020, 1:16 pm

  @Vanguardfan, the advantage of the RT-PCR test for virus is that the specificity is due to short pieces of synthetic DNA which can be easily made. Any final year bioscience undergraduate would have been able to devise a test once the virus sequence was published, and most university labs would have been able to carry out small numbers of tests to order (probably several hundred a day; larger institutes and pharmaceutical companies would probably have managed several thousand) if a standard version of the test was agreed and they had been asked. The issue for them would have been the samples which depends on swabs, people who know how to use them reliably, and a good recipe for reliably getting the virus sample off the swab for testing.

  To test for antibodies in blood serum, the specificity would ideally be from having stabilised samples of virus protein for the antibodies to react with. In practice growing up large quantities of virus for that purpose would be difficult and risk big batch variation. So I imagine those working on tests are instead using bits of virus protein created by standard “genetic engineering” methods (using bacteria to produce them). They might have to try a range of viral protein fragments before coming up with a cocktail that will pick up antibodies produced by any individual, and then spend time optimising the test conditions so the tests can be rolled out to multiple laboratories. I am sure there are quite a few decent tests for research studies by now, but standardising them for medical diagnosis is a higher order challenge.
• 135 WhiteSheep April 8, 2020, 6:46 pm

  The original WHO RT-PCR antigen test was actually put together within a week of the publication of the virus sequence by a team that did not have access to any SARS-CoV-2 samples themselves. They mostly tested on stored samples from the original SARS epidemic. As Jonathan says, technically the test is easy to perform by any molecular biology lab and there will be at least hundreds of labs across the country with the technical capabilities but not the clinical infrastructure. I work for an organisation who would have the technical capabilities (and like ZX I lost track of the number of technical conference calls I have had on Coronavirus in the last weeks). The difficulties are mostly around making the process repeatable, validating it and the handling and tracking of samples and data – no point in reporting accurate test results if I have mixed up which patient the sample came from.

  A key question about the lockdown is not just the cost (which everyone agrees is very high) but *how* to get out of it. I think this is where the conversation should be focused. TI gave a nice list, but as I and others tried to say earlier, a key component would likely be contact tracing (which the UK has abandoned prematurely. and it still does not seem to be discussed very much in the political news) combined with increased testing – even Neil Ferguson himself appears to think so [1].

  On the possibly good news front, here is another estimate (based mostly on data from the Ferguson group) that only 1.2% of cases were detected in the UK by the middle of March and a total case number of greater than 2 million by end of March [2]. Unfortunately still not enough for “herd immunity”.

  [1] https://www.nature.com/articles/d41586-020-01003-6, last paragraph
  [2] https://www.uni-goettingen.de/en/606540.html
• 136 Sparschwein April 8, 2020, 7:33 pm

  The routine test for active infections is by PCR (actually, quantitative RT-PCR) that detects viral RNA, not an antibody test. Germany has been doing this at 500,000/week scale and the UK has been incapable of ramping it up, although these tests are desperately needed to manage the pandemic. Even NHS staff can hardly get tested.
  PCR is a standard method that has been around for over 2 decades and that is established in most research and diagnostics labs. The know-how and instrumentation is there; of course for a previously unknown virus like this, a new assay needs to be developed. SARS-CoV-2 sequence was published in January, and with that information it’s not very hard to develop a PCR test because the principles of this method are so well known and specific probes can easily be made.
  The method is reliable, sensitive and specific, as long as viral RNA is present (active infection) and captured during the sampling process. As I understand it (and I hope a medical doctor can confirm this), swabbing can miss the virus if the infection has moved deeper into the lungs, but such false negative tests are less problematic because lung infection leads to the characteristic severe symptoms. So most false negatives would be obvious from X-ray and other diagnostics.

  Antibody testing is an entirely different method, that detects a different thing and gives different information. Specificity is a very common problem with antibodies. Positive controls to see if an Ab test works can be simply patients who tested positive by PCR. The negative controls are a bit trickier because of the asymptomatic infections. I suppose there are enough blood samples taken pre-pandemic that could be used.
  Ab tests are no good for identifying those who are infectious. They can identify those who had an undiagnosed SARS-CoV-2 infection and can reasonably be presumed to be protected against the disease for a limited time (perhaps months). But *no one knows yet how long immunity lasts*, and if it entirely prevents re-infection.
  This was one of the fatal flaws in the UK government’s “herd immunity” debacle.
• 137 Sparschwein April 8, 2020, 7:51 pm

  @Jonathan, you beat me to it. That’s spot-on. The antigens used are indeed recombinant virus proteins, e.g.
  https://doi.org/10.1093/cid/ciaa344
• 138 Sparschwein April 8, 2020, 8:22 pm

  @WhiteSheep, we’ve heard of many such grassroots initiatives, research institutes working with local hospitals to implement testing. Someone invoked the “Dunkirk spirit”…
  Great initiative, all the best!
• 139 Vanguardfan April 9, 2020, 9:46 am

  I thought this interesting, if somewhat anecdotal…some careful epidemiological studies of spread would be interesting (they won’t come from the UK though, given that we’ve abandoned contact tracing).
  https://www.theguardian.com/world/2020/apr/09/the-cluster-effect-how-social-gatherings-were-rocket-fuel-for-coronavirus
  I’ve been wondering whether travel restrictions might actually be one of the more effective control strategies. It’s all about separating infected and uninfected, as effectively as possible.
• 140 Vanguardfan April 9, 2020, 9:48 am

  @sparchswein, that is certainly happening in my locality – local university contributing kit and people to the testing effort.
• 141 The Investor April 9, 2020, 10:36 am

  @Vanguardfan — That is interesting. Appreciate you and I have different views about the pay-off from easing lockdown measures sooner rather than later, but if these clusters are more than easily spotted hotspots (i.e. if cluster-to-family is a much more important than say spreading via supermarkets and offices) we could find a halfway house.

  As I said in my article above, stopping kissing/handshakes/hugging and mandating more cleaning / handwashing (/masks) might go some distance to curbing spread while still allowing some element of location mobility.

  I suppose one big problem in London and other world cities though is public transport. It’s hard to avoid recreating a very dour party atmosphere on a crowded tube! (On the other hand, perhaps that also means as I suspect that very many Londoners have already got it so not such an issue).

  Could mean lockdown relief can come sooner to rural/car-based areas.

  Schools are another big issue. I had a day dream for a few moments of segregating playtimes by classes etc, but presumably that’s totally unrealistic.

  I still wouldn’t let the very old/vulnerable out for a couple of months, even if I eased. I appreciate there are still issues with carers mixing them and infecting them.

  Just thinking out loud. Fully appreciate this is one article with a lot of journalistic colour, and not enough to move anyone’s needle. 🙂
• 142 Vanguardfan April 9, 2020, 10:57 am

  This is also interesting, modelling from China about the impact of relaxation of lockdown. Bear in mind that China lockdown is not the same as U.K. lockdown. Stricter, and likely more effective.

  https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30746-7/fulltext
• 143 Vanguardfan April 9, 2020, 11:12 am

  @TI, the principle of control of any communicable disease, absent effective vaccines or treatments, rests entirely on breaking the chain of infection, and this can only be done by separating infected from uninfected. This principle has been the basis of outbreak control for centuries, and fundamentally this outbreak is just the same. Quarantine measure at individual and group level are essentially the only control tool we have.

  Of course the effectiveness of separation measures depends a lot on the type of contact that is needed to transmit disease, and crucially the role of asymptomatic spreaders. So with Ebola, very close contact is needed. And with the earlier SARS outbreak, only those with symptoms were infectious, making both of these easier to contain. Unfortunately with this agent, the ease of transmission means that more strenuous separation efforts are required to control it, which is why we are where we are.

  So really, the question is, how can we reintroduce economic activity while maintaining effective separation. (Bearing in mind we don’t quite know yet how effective our own separation measures have been).
• 144 Snowman April 9, 2020, 12:19 pm

  https://www.land.nrw/sites/default/files/asset/document/zwischenergebnis_covid19_case_study_gangelt.pdf

  Interesting (mainly) serological study in Gangelt, a city in the German Heinsberg district where they did an antibody and antigen test on a representative sample of the roughly 12,500 population.

  About 14% tested positive under the antibody test and 2% tested positive under the antigen test, and 15% were estimated to have or had had the virus (due to crossover it’s not 16% I think).

  This is one of the worst affected areas of Germany, and not sure what date the conclusions apply to (given delay to get and detect antibodies and antigens etc) but interesting all the same.

  The mortality rate came in just under 0.4%, again not sure how indicative that is of the true mortality rate in that area.
• 145 Vanguardfan April 9, 2020, 12:50 pm

  My German isn’t up to that I’m afraid, but that sounds pretty plausible. Are there any figures for proportion hospitalised or needing critical care?

  Serial antibody tests are of course needed to see the rate of infection.
• 146 The Investor April 9, 2020, 12:52 pm

  @Vanguardfan — Well we’re just going to go around in circles discussing this. 🙂

  As I’ve debated with my own friends offline, if lockdown only works in ‘almost full lockdown mode’ then, effectively, it doesn’t work, at least in a Western democracy at this stage of the viruses spread. Because we simply cannot go on like this until we get a vaccine. (Possibly we could until we have a better treatment, as presumably that comes much sooner).

  If the virus is so easily spread that even near-but-distance measures don’t stop it (e.g. my suggestions above, or more medically informed ones) then we’re clearly just going to get waves of reinfection from just a handful of ongoing/undetected carriers again, assuming it doesn’t die back in summer etc (which I suspect it will to some extent) or that it isn’t far more widespread than @Snowman’s link suggests (so no herd immunity).

  And so indefinite lockdown. (Remember we got to this point from a handful of those who’d encountered Chinese carriers, initially).

  The only — and excellent — argument for ongoing on/off lockdown in that circumstance IMHO is to curb peak demand on the critical care capacity of the NHS.

  Leaving aside the very important NHS impact, in my view a 12-18 month full lockdown will probably cause far more loss of ‘life years’ than the virus, due to catastrophic economic collapse, as discussed multiple times in this thread, with its knock-on effects of direct health consequences (e.g. obesity and depression, people with other diseases not being diagnosed and treated) and funding consequences (i.e decades of future underfunding of NHS, more poverty etc).

  This isn’t just a pet theory of mine, it’s also being talked about more and more and numerated (very roughly indeed of course) by economists and even some medical professionals, as we saw in the link above.

  I still don’t think we’re seeing the full picture.

  E.g. I just heard the BBC say “7000+ deaths DUE TO coronavirus”. In reality as we all know these are people who tested positive for CV after death. What % were really “due to” coronavirus? What % would have die from some other horrible condition in the next fortnight?

  It makes a big difference if 80% are healthy-ish people dying due to the virus versus 20%. I don’t have the answer, but the average age of death being near-80 is surely a big clue.

  Again, this isn’t to dismiss those deaths. It’s that saving them (perhaps for a few weeks) will kill other people, perhaps to a limited degree in a short lockdown but certainly in a 12-18 month lockdown.

  In reality we will not do the latter, anyway. I am certain of that. Neither the government nor the public will stand for it. We are not going to go into a Great Depression to fight a virus with a likely fatality rate of well under 0.5%.

  Hence whether we like it or not we need to find some kind of exit route. Partially relieved lockdown, as I suggest, and a flattened curve, with ongoing deaths, may be the price we have to pay. Do you see an alternative?

  The other alternative perhaps is to go ‘full Singapore’ but it is surely far too late for that.

  Finally, for those who look to China and its exit, I say again you may not understand what their lockdown is/was like. Think 6-8 temperature checks a day (including whenever you leave your home community complex), scanning a bar code that logs who you are and your location and temperature when you enter/leave certain buildings, teams of half a dozen people contact tracing an individual infected person, and even removing infected people from their homes/communities to specialized facilities — basically imprisonment for a period.

  Yes, if we could click our fingers we might agree to it and hang the civil liberties. But could we assemble the infrastructure in any realistic time? Is there any sign that this is being done? If so they’re keeping very quiet.

  My personal big hope is this current lockdown is stopped in say 3-4 weeks. The virus abates because (a) it was far more widespread than understood in the first place (b) it hates summer (c) at least some of the most vulnerable have already unfortunately been claimed by it.

  It’s a hope though, not implausible but still I don’t pretend otherwise. 🙁
• 147 The Investor April 9, 2020, 1:02 pm

  p.s. I forgot to add again (which I know some here have already pushed back against) that I believe age/vulnerability indicated self-isolation should be part of the picture. It beggars belief that the most vulnerable were wandering around and meeting up in the fuzzy are we/ aren’t we days before lockdown, not to mention going shopping now.

  What percentage of the critical care patients are over-65, say, and wouldn’t be there if they’d been self-isolated? I suspect a very high percentage.

  I’m not blaming them — they weren’t told to self-isolate (though my mum has been doing so for nearly a month now…) — and clearly the government will need to support them. Many will say it’s not fair. And yes, some young people will get ill and die. But clearly far, far fewer.

  In my view we will have to do something if it doesn’t abate in summer. If we’re sitting here next April still having this debate from our isolation chambers then I’ll concede defeat on an intellectual level, but it will be worse outside my front door. 🙁
• 148 The Investor April 9, 2020, 1:23 pm

  p.p.s. Sorry, I appreciate this is bad form! But we’re now getting more estimates of the cost of the lockdown. For instance, the CEBR puts it at £2.4bn a day (so £876 billion a year), with UK GDP economic output down 31%.

  https://cebr.com/reports/the-telegraph-coronavirus-lockdown-costing-the-economy-2-4-billion-every-day-study-warns/

  If your response is “but this isn’t going to last for a year, it’s a temporary measure needed to flatten the curve” then I fully agree.

  However a temporary measure needs to be temporary. 😐
• 149 Snowman April 9, 2020, 1:41 pm

  @Vanguardfan

  Very little information in that German article, other than what I posted. They appear to have also done written surveys for all those tested. So you’d assume they could estimate the proportion asymptomatic, by looking at the survey responses.
• 150 Vanguardfan April 9, 2020, 1:53 pm

  I don’t think I’m particularly arguing for or against any particular stance – like everyone, I’m trying to make some sense of what is still very patchy data. I can certainly speculate what I think might happen, but the range of possibilities is incredibly wide, from the fairly hopeful to the really rather awful. I have, in reality, no idea how things will unfold, but I don’t think there are any easy/magical options (death rate would certainly not stay at 0.5% if health services did become overwhelmed, and there would be other consequences flowing from that too in terms of unrest and panic). We will have to wait and see.

  Everyone around the globe is facing the same problem, and we need to listen and learn from all of the cumulative experience. One of the failings so far is a lack of global coordination in the response. Too busy fire fighting I guess.
• 151 The Investor April 9, 2020, 2:24 pm

  @Vanguardfan — Fair enough. 🙂 From my perspective I think your responses feel very much on the “we can’t risk lifting lockdown in any direction until we know people won’t die because of it” side and mine no doubt could be (mis)-characterized as “we need to reopen and accept whatever lives it takes, to avoid economic collapse and unintended consequences”.

  But in reality our views are probably much closer than they seem. That’s the nature of Internet discussion I guess! 🙂 Certainly we both agree there are huge uncertainties abounding.

  Anyway I’ve found this whole thread super-valuable, so thanks everyone. Going to link to it tomorrow as it’s better than any individual article we could have written in exploring all the issues I feel.
• 152 The Investor April 9, 2020, 2:28 pm

  Here’s another interesting article on the nature of the virus. Reaffirms to me that quarantining the elderly should be vital no-brainer focus. On the downside, in this account the virus is spectacularly infectious:

  The Covid-19 virus is “incredibly aggressive and spectacularly contagious”, according to leading coronavirus scientists.

  Virus numbers are three times what might be found with other respiratory viruses such as flu, including in older patients, who are more contagious than expected

  “These are the highest viral loads for any virus I know,” said Prof Marc Van Ranst at the Rega Institute for Medical Research in Leuven, Belgium.

  https://www.irishtimes.com/news/science/when-i-look-at-the-viral-loads-we-find-in-elderly-people-it-is-mind-boggling-1.4224985
• 153 Vanguardfan April 9, 2020, 4:30 pm

  No I don’t think that’s what I think (?!) not least because I don’t see that as a likely outcome. What I do fear is that if we relax our interventions too soon, before transmission has been slowed enough (and I think that’s quite likely given the massive pressures to get the economy going), we could end up with another, possibly steeper, surge which will be even more difficult to control. Already, the surge in cases has meant enormous reprioritisation of health care resources, with many important-but-not-immediately-urgent interventions sidelined. To that extent, the NHS is not exactly ‘coping’ with the outbreak, and this is still the foothills, not the peak (of this wave). So it’s not that I’m ‘in favour’ of a lengthy lockdown, not at all, I just think it may genuinely be difficult to achieve quick or complete relaxation of control measures. We should be watching other countries very carefully, and learning.

  I do think we are probably already in a worse place (health and economic) than if we’d taken effective and robust public health action at the beginning (not population distancing, but rigorous tracing and monitored quarantine). I could easily be wrong about that though, for all the reasons we’ve discussed re incomplete knowledge of transmission etc.
• 154 The Investor April 9, 2020, 6:27 pm

  No I don’t think that’s what I think (?!)

  Just to clarify, I’m not saying that is what you do think (let alone that I know what you think and you don’t! 🙂 ) — I said this is how it *feels* to me, perhaps in part as an artifact of this kind of discussion.

  I could well imagine if you were discussing it with somebody with a difference stance to me, a different side of your position would be amplified.

  Similarly, let’s not forget I talked my mother into unilateral self-isolation around four weeks ago. 🙂
• 155 Snowman April 9, 2020, 7:36 pm

  Unsatisfactory answer from Patrick Vallance at the press briefing today as to estimating how many of the UK population have or have had the virus. The questioner mentioned we had been told at the briefing some time ago that the Porton Down random sampling preliminary serology results were days away. But apparently Patrick Vallance now has no idea what initial results are coming out of Porton Down, and says the results will be available from Porton Down when the results are available or something equally vague. He then gave some unconvincing answer saying that he thought that the % was most probably in single figures based on other countries, but it could be double figures. So implicitly he was giving a vague indication that he thinks the answer might be less than 6.6 million (10% x 66 million). He also seemed to imply the percentage of those with the virus who were asymptomatic might be between 0% and 90% (not too much variability there then!) but probably wasn’t at the higher end of that range.

  Meanwhile Carlo La Vecchia, a Professor of Medical Statistics and Epidemiology at the Statale di Milano University seems to be guessing that the number who have or have had the virus in Italy could be somewhere between 5 million and 20 million in Italy, so around 8 – 33% of the Italian population.

  http://www.thecommentator.com/article/7651/italy_covid_deaths_could_be_much_higher_than_estimated_mortality_rate_25_times_lower
• 156 Vanguardfan April 9, 2020, 7:53 pm

  @snowman, Germany are planning a suite of antibody studies (reported in FT, I’m sure will be in the weekend links).
  We will get useful info from elsewhere before we get our own, question is will we listen, learn and act?
• 157 Snowman April 9, 2020, 8:24 pm

  Thanks Vanguardfan

  Just read the FT ‘Germany to run Europe’s first large-scale antibody test programme’ article

  “Some governments have seen antibody tests as a crucial stepping stone to relaxing some of the harsher lockdown measures introduced throughout the world to curb the pandemic.”

  Meanwhile Patrick Vallance seems to be giving the message – Oh Porton Down are doing some sort of serology testing, I haven’t asked them about it recently, and the results will be out in due course and it will take them a bit of time, and then we may decide to look at it, and we can just assume 0 to 100% of the population has been infected as a first guess, and we can remain on lockdown in the meantime
• 158 The Investor April 10, 2020, 12:19 am

  Yes, it’s pretty uninspiring isn’t it @Snowman. :-/

  Incidentally, I just read this on the BBC website (my bold):

  …the Home Office deputy scientific adviser, Rupert Shute, told those listening that staying at home was important but “we also have to keep functioning our lives”.

  “You are no more at risk at the workplace as you would be in your home or at the supermarket. It is about minimising it,” he said.

  “We are working on the assessment that 80% of us, if we haven’t already, will get the virus.”

  He added: “We cannot hide away from it forever.”

  https://www.bbc.co.uk/news/uk-52219930

  Meanwhile I know people who leave their mail in their front porch for a day untouched before wiping it down with antiseptic cleaning wipes and opening it wearing a mask, basically fearing for their lives and believing this is the responsible thing to do.

  I guess it was thought that the message had to be simplified to get lockdown to be enforced, but it’s going to be very tricky to unpick in the weeks/months ahead.
• 159 Sparschwein April 10, 2020, 12:59 am

  There are a lot of references to the FT, BBC, the Torygraph etc here.
  These journalists know much about the government’s or the billionaire owners’ political agenda, and very little about the subject matter. So at best you get “Chinese whispers” from someone who has no clue.

  Instead I’d recommend the most respected international journals for science and medicine: Nature, Science, The Lancet, NEJM. They won’t peddle in simplistic slogans and absolute truths. They present the latest findings, expert opinion and encourage rational debate based on facts – quite a necessary antidote to the populists in the UK, US and elsewhere.
• 160 Snowman April 10, 2020, 7:51 am

  Sad thing is here in the UK we can see which countries are handling the virus well, such as Taiwan and possibly Germany, and what things they are doing well, but don’t seem to be able to learn from their experience.

  Another example of where we are obviously going badly wrong in the UK, is the failure to recommend the use of face masks. It’s a simple measure that can help reduce the spread, not on its own, but with other strict hygiene measures and social distancing measures is a possible route out of the full lockdown.

  Even outside of Asia, The Czech Republic and Austria have been big advocates of face masks and the CDC in America are now recommending their use. The evidence from published papers, backed up by associational evidence from face mask wearing countries, for them helping to stop the spread of the virus is significant. They probably don’t help much with stopping you the wearer getting the virus but they do help with stopping it being passed on. You don’t have to be an expert in schlieren optics to get it.

  But all we get in the UK is closed mind, and superficial Professor Jonathan van Tarn saying ‘we don’t recommend face masks for general wearing’ based on an anecdotal conversation with a friend and blind following of WHO guidance.
• 161 The Investor April 10, 2020, 8:05 am

  @Sparschwein — Those sources are indeed excellent, with the proviso that I think it’s hard for a layman like me to get an overview of any particular subject. However I believe the Financial Times’ COVID-19 coverage has been excellent, as it is in most things. Of course it’s biased, but towards a free-market agenda rather than an oligarch. (The Economist is similarly neutral provided you believe in free markets). As for the BBC, I’m a big supporter and believe we’d miss it if it was gone but it seems to be forever in a bind one way or another, often political but also because of its mass-consumption remit and the ‘voice of a the nation’ responsibilities.
• 162 The Investor April 10, 2020, 8:14 am

  @Snowman — I’ve been wearing a mask for weeks whenever I enter a shop (which is rarely) but not if on a long walk around deserted streets. My view is it can’t hurt. It is interesting psychologically — you get funny looks from many, though far fewer than a fortnight ago, but also feel a sort of kinship with say the Japanese and Chinese who are mostly all in masks around here. I do feel it *feels* a bit like virtue signalling, too, even as I do it. But that’s my problem!

  I believe I read somewhere that one reason Western countries didn’t recommend masks is because they needed to keep supply for medical workers and didn’t want reserves to run out. That seems fair enough if true? Mine were sourced directly from contacts in China.
• 163 Snowman April 10, 2020, 9:03 am

  I should have said I think it should be a recommendation to wear some kind of makeshift mask that covers the face and mouth in all indoor areas such as supermarkets. And it should be made clear people should not be trying to obtain medical such as R95 masks.

  I’ve likewise been wearing a mask (I have a few already in the house for DIY sanding jobs and I interchange those) when going shopping. If you’ve researched the evidence and considered the issues, it’s the only responsible thing to do to protect others. But I don’t wear one when outdoors for exercise.

  I think most people are sensible enough to realise medical masks are for the medical profession. I’m not remotely suggesting people should be trying to get hold of R95 type medical masks.

  I don’t think this is a great place to cover all the + and – points of masks, I can’t detail the arguments for and against as fully and eloquently as others have done.

  One good source with links to arguments/evidence is Jason’s Fungs twitter account. I link to him because he comes across as a very open minded person who has come to the current conclusion masks are super important, but he is also someone who would be willing to change his mind if the evidence showed otherwise

  https://twitter.com/drjasonfung/with_replies?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor

  Also quite like this John Campbell video. He’s come round to face masks, and I always like listening to people who have been prepared to change their minds

  https://www.youtube.com/watch?v=ycf6bAMKgjg
• 164 Vanguardfan April 10, 2020, 9:58 am

  I don’t wear a mask, mainly because I don’t have any reliable source. I do have a small number of pretty low quality ones from eBay, they are being kept in reserve in case we have a case in the household, or in elderly relatives who would need live in care from us.

  As for Rupert Shute, he is a robotics engineer who appears to have no relevant scientific expertise in infection control. He’s plainly wrong about the relative risks of home vs work environments. Even with mitigation in place, a typical office will involve many people in one room, with shared toilet and kitchen facilities, adding to the potential likelihood of transmission. But it’s the management approach one might expect from his boss.
• 165 Matthew April 10, 2020, 10:44 am

  I’ve read that masks can in some cases increase your risk, ie in places with lower concentrations of the virus there’s the risk that you’ll trap more inside the mask, especially once it gets damp through breathing, etc. Medical staff face a higher virus load in the air so on balance keeping that out outweighs the risk of trapping virus in, and they change their masks far more frequently, so youve got less risk of them getting damp, etc.

  Also theres the whole false sense of security thing, it passes through touch too – infact most airbourne things are far more likely to survive on a surface than in the air
• 166 The Investor April 10, 2020, 11:31 am

  @Matthew — There’s gazillions of articles and debates about the pros and cons out there. As @Snowman says we’re not going to resolve it here. 🙂 I’m personally happy popping one on for 10 minutes in a shop, but just keeping six-feet clear in the street. Until mandated we can make our own decisions.
• 167 Vanguardfan April 10, 2020, 11:35 am

  In more positive news, apparently ‘oxford recruits 2700 virus patients for fastest growing trial’. (Link will need subscription).

  https://www.ft.com/content/f4e3055e-72e2-459d-ba66-05af7d2c8915
• 168 ZXSpectrum48k April 10, 2020, 12:21 pm

  TI said “Meanwhile I know people who leave their mail in their front porch for a day untouched before wiping it down with antiseptic cleaning wipes and opening it wearing a mask, basically fearing for their lives and believing this is the responsible thing to do.”

  That would be my brother-in-law. Except he uses bleach and leaves stuff typically for 3 to 5 days if possible. We’re now following his advice. He could be paranoid of course. Alteratively, it could be because his PhD is in infectious diseases, he’s got almost 30 year’s of academic and industrial research experience in developing drugs to combat these diseases, and he’s currently head of drug development at a top 3 US pharma company. Plus he’s read 200+ papers on SARS-CoV-2 (I didn’t know there were 200 papers …).

  To be fair though, like me, he’d never be considered an optimist …
• 169 Penelope April 10, 2020, 2:21 pm

  @Pendlewitch #124 – Thanks, great to hear from the girls!

  @The Investor #114 – Fair enough, I think you’re right about conspiracy theories. They don’t help anyone’s mental health. 😉

  @Ermine #120 – Thank you for mansplaining that to me. I may be a woman but I was already aware that the Prime Minister is unwell. I wish him a full and speedy recovery. I note that you appear to have changed your tune from when you were calling him a tosser and a buffoon:

  https://simplelivingsomerset.wordpress.com/2018/06/28/battening-hatches-opportunities-brexit/
• 170 The Investor April 10, 2020, 3:09 pm

  @ZXSpectrum48k — Well I’m bound to ask why didn’t he learn that washing your hands with soap and water after opening the mail kills the virus? 🙂

  https://www.nationalgeographic.co.uk/science-and-technology/2020/03/why-soap-preferable-bleach-fight-against-coronavirus

  This is not to go into the fact that even our deputy chief science officer thinks 80% of us will get the virus anyway, as detailed above. And I think many millions have already. (Even the official estimate was nicely into the millions this time last week.)

  Each to their own, I don’t suppose it does any harm and if you really don’t want to get ill unless/until you have to why not.

  Still, IMHO unless you’ve vulnerable the huge benefit of lockdown is as you know as well as any of us (being hyper enumerate 🙂 ) the impact it has on breaking the exponential capacity of the chains of transmission, not that any individual doesn’t get Covid-19.
• 171 Seeking Fire April 10, 2020, 3:16 pm

  Interesting debate and haven’t too much to add beyond, I am looking at the Sweden approach with interest. I do not have the expertise to comment on if it is sensible but I think this could be equally something we learn from (either what to do or not to do). Would be interested in others thoughts who have more expertise on medical issues than I.

  https://www.ecfr.eu/article/commentary_sweden_goes_it_alone_the_eus_coronavirus_exception

  Back to financial matters, I remember saying a couple of weeks ago DO NOT SELL and the S&P 500 looks very overvalued. Well the two points aren’t mutually exclusive, most people can’t market time and I am definitely one of them. Markets up significantly, S&P500 looks more expensive. Still believe there is plenty downside from here but I have no plans to sell. I assume markets are up on the back of an expectation we will return to some normality soon and rates are zero.
• 172 Sparschwein April 10, 2020, 8:35 pm

  @TI – we read the Economist and I think their science reporting is very good. But I’ve seen none of the UK media (including the Economist) convey how far UK and US government policies have been from the expert consensus. There has been a lot of scathing critique from virologists, public health scientists and medical doctors. The general public seems to remain blissfully unaware.
• 173 Sparschwein April 10, 2020, 8:57 pm

  @ZXSpectrum – same here. We’ve got a simple system of quarantine boxes, cardboard or paper is considered clear after 24h and plastic after 3 days. Stuff that’s impractical to quarantine gets washed. Water and detergent (soap, dishwashing liquid, shower gel etc) inactivates SARS-CoV-2 very effectively.
  Our system is based on the first study on virus surface stability:
  https://www.medrxiv.org/content/10.1101/2020.03.09.20033217v2

  I’ve never seen science move as fast. Lots of groups across the world are onto this, from many different angles. Data gets shared asap so that others can build on the knowledge. Peer review also seems 10x faster than usual.

  Fun fact, as of today:
  COVID-19 SARS-CoV-2 preprints from medRxiv and bioRxiv
  1407 Articles (1092 medRxiv, 315 bioRxiv)
• 174 The Investor April 11, 2020, 5:56 pm

  With those close to the organs of power being keen readers of Monevator, I am not surprised to hear that the issue of deaths caused *by* lockdown that I’ve been banging away about is moving up the agenda.

  From the FT (sorry, paywall):

  ‘One minister said that a paper produced by a cabinet subcommittee suggested that the level of avoidable deaths could “be as high as 150,000 without mitigation” and “addressing that will play a bigger role on when to end the lockdown than the economic impact”.’

  [although…]

  ‘This figure was firmly denied by the government. Matt Hancock, the health secretary, said it was “wrong” and “not part of our internal analysis”. He added, “when we do that analysis and we have confidence in it, then I’m sure we’ll be able to answer it more correctly”.’

  https://www.ft.com/content/8027d913-2e2f-4d4c-93db-89bd726105f0

  I have absolutely no idea what the real figure of premature deaths ultimately caused by lockdown is of course. But I am 100% certain it’s a great deal higher than zero, yet it’s barely mentioned in the debate.

  Instead we still have the BBC reporting the coronavirus deaths figure as “caused by coronavirus” rather than “deaths where the deceased had tested positively for coronavirus”.

  That is not a pedantic difference. Obviously Covid-19 is sadly killing plenty of people, many before their time (as born out by recent figures showing greater mortality in intensive care if the patient has C-19) but still those two things are not the same. Yet they are treated as such by the media.

  The reality is the vast number of people who contract C-19 are like Sir Kenny Daiglish in recent days, who only found out he had it because of routine testing in hospital for something else, and is asymptomatic. (And will hopefully remain that way… I concede it could be early days and he is 69 so unfortunately at much higher risk).
• 175 Finance April 11, 2020, 9:36 pm

  Some of the comments here are very apt. The view that why elderly or people with health issues should be sacrificed for the economy and the alternative as to why dead duck businesses are saved in preference to people’s lives.

  Johnson got his Damascan conversion on herd immunity when he realised that the body count at minimum was going to be in the hundreds of thousands. Trump got his conversion when the body count was put in the millions and when his good friend of the same age in Queens New York got the virus and died. Since then Trump the coward that he is insists that anyone coming in contact with him including reporters have a negative Covid-19 test.

  A secondary but more important reason for the change of course was that the healthcare systems in both countries would be overwhelmed so that other diseases/illnesses would not be treated resulting in untold numbers of preventable deaths leaving the Covid-19 deaths as irrelevant numbers wise. My thesis is that politicians had no choice but to clamp down on the virus even if that damages the economy to a greater extent otherwise they faced been considered as totally divorced from their voters and the political consequences. Politicians love power over anything else.

  As regards funding the cost of the pandemic and downturn afterwards is it not simply moving the deck chairs around on the Titanic. The Government issues bonds at a low coupon and the Central Banks buy them and they are rolled over for ever by the Governments. Printing money essentially!!!
• 176 WhiteSheep April 12, 2020, 10:02 pm

  @TI 174
  There is actually some published data on patient characteristics with COVID-19 in intensive care in the UK: https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports. I am not a clinican but it does not look to me that these patients were all at death’s door before contracting COVID-19. They appear to be significantly healthier than typical pneumonia patients.

  There are rules how cause of deaths are reported and how to distinguish between immediate and underlying cause – see e.g. https://www.gov.uk/government/publications/guidance-notes-for-completing-a-medical-certificate-of-cause-of-death. I would assume that doctors know how to report these properly, unless you have any specific reasons to doubt the published numbers. (At least I have not seen this issue raised by anyone with any medical knowledge so far.)

  If anything the published numbers of COVID-19 deaths are likely to be an underestimate because a) there is a lag between people dying and the deaths being reported nationally (often many days), and b) many deaths outside hospitals will not be reported.
• 177 The Investor April 13, 2020, 12:31 am

  @WhiteSheep — Thanks for the thoughts. Those age numbers (60s) are younger than I would have expected. Not sure how to read the co-morbidities though.

  The figure I last saw for average age of death from Covid-19 was 78.5 years old (but I think this was Italian data. Unfortunately it’s just retained in my brain along with vast amounts of other Covid-19 stuff, so I can’t link).

  Perhaps if you’re very old you often die and it’s younger ‘older’ patients who fight enough to get into ICU? Anyway speculating, I’m not a clinician.

  Regarding the coincidence of a positive Covid-19 test and a recorded death, this isn’t me being a conspiracy theorist. 🙂 It’s all in the public domain, it’s just not reported clearly by the media as such.

  See this commendably clear BBC article:

  The death figures being reported daily are hospital cases where a person dies with the coronavirus infection in their body – because it is a notifiable disease cases have to be reported.

  But what the figures do not tell us is to what extent the virus is causing the death.

  It could be the major cause, a contributory factor or simply present when they are dying of something else.

  https://www.bbc.co.uk/news/health-51979654

  From the same article:

  Nearly 10% of people aged over 80 will die in the next year, Prof Sir David Spiegelhalter, at the University of Cambridge, points out, and the risk of them dying if infected with coronavirus is almost exactly the same.

  There are definitely many people dying before their time because of Coronavirus. I am in no way denying that. There is definitely significantly excess demand on the health service right now, particularly in the intensive care departments, which is mostly why I have said multiple times on balance I support this initial lockdown. It’s also been seen that Covid-19 patients are more likely to die in intensive care than normal (the last figure I read was from memory 51% with Covid-19 versus 28% baseline).

  But the overall picture is considerably more nuanced than the daily reporting.

  I agree the death count is surely underestimated. But the number of infections probably dramatically more so. (Deaths tend to get noticed one way or another. Someone without symptoms is never known until antibody testing).

  Even the IC modellers were saying probably two million overwhelmingly unconfirmed cases in UK a couple of weeks ago. Let’s say the lockdown slowed that to just one double in the past two weeks. Call it four million.

  Currently we have 10,600 UK deaths. That might imply a current mortality rate of 0.25%.

  We agree that death figure is too low though. Let’s say in fact it’s 20,000 deaths, to count those who will die in the next few days and also untested deaths, but not to count new deaths to come in weeks ahead (because we’re also not counting new infections).

  20K/4m = 0.5% mortality rate, with some unknown degree of crossover with people who were unfortunately nearing their end before Covid-19.

  In practice I’d guess (and that is all it is) that the virus spread more quickly in for instance care homes and hospitals, in early March, if it really did get up to four million UK total infected, and so the percentage of vulnerable in such places infected could be much higher.

  Obviously I’m just kicking numbers around here. But we have very smart middle-aged readers of this website bleaching their mail and fearing for their lives when they’re probably more likely to be hit by the proverbial bus (or more seriously be killed prematurely by a lifestyle disease they’ve never addressed), and a widespread line saying “this killer virus does not discriminate”.

  In reality it does seem to largely discriminate, by age and health at least.

  I know of young people terrified of this pandemic while puffing away on cigarettes. I think that’s crazy (well, leaving aside the likely link with bad lungs. My point is many of them will die of cancer).

  All this matters because we’ve deliberately cratered the economy and doing so *will* also kill people, perhaps a lot if it persists, directly and also through loss of funding. IMHO it can’t be ignored as cold or unempathetic or similar. Really it’s the opposite – a wider empathy.

  Again, I am NOT saying let’s screw the old and vulnerable, go back to business as usual, let’s party like it’s 2019. This is a health crisis, it needs to be dealt with.

  My strategy would have been to try to radically quarantine the old and vulnerable from the start, properly, as I’ve said before, and of course test and trace, as we all agree but is easier written than done. I think something like it’ll end up being the (exit) strategy.

  I know it’s a unpopular/contrarian view but FWIW my gut feel* is this thing will be behind us in a few months, likely sooner, and questions of a different aspect will begin to be asked. I think it’s already spread very widely, especially in London which I believe (like New York) is probably distorting the figures in various ways.

  But I’m just a blogger on the Internet, and one who is grateful I didn’t have to make these very difficult decisions.

  *Before any of the other commentators here say “oh your gut feel eh?”, perhaps consider whether your own views, perhaps significantly more pessimistic, basically similarly reflect your own assessment of the situation. Aka gut feel. I’m not claiming any great expertise in this field. I’m just an interested citizen trying to stand back to assess the situation somewhat dispassionately, which I agree is no easy feat given the obvious misery that is being inflicted every day by the virus.
• 178 Matthew April 13, 2020, 5:58 am

  Well I think any 2nd or 3rd waves should be less deadly since many of the people it was going to kill are already gone, and the population will be a tad more immune, likewise overall deaths should be lower after this because they ‘ve happened early, although I don’t think this is an effective evolutionary force because it’s generally hitting too old. Although I did hear somewhere that the fraction of the population thats had this is thought to only be single digit %’s still.

  Im wondering how the economic stoppage might kill people? I can see why neglected medical problems would, but economically… Maybe people cant pay for care that they need? Asthematics cant afford a house that isn’t damp? People get depressed and smoke and drink more? medicine production/development stalls? – are there any other causes I cant think of?
• 179 Vanguardfan April 13, 2020, 8:05 am

  @TI, the reason for the youngish age profile in ICU is easy to explain – ICU beds are always rationed, only those with a chance of coming out alive get one. (You can see the age profile for viral pneumonia in previous years is very similar). The frail elderly will never get near the ICU, particularly for this illness where there is no treatment, only support.
  This implies that a ‘shield the elderly’ only strategy would have had no impact on pressures on critical care.
  The current number of deaths is probably closer to the 20,000 you estimate, given we’re not capturing the out of hospital deaths or the clinically diagnosed cases in the daily figures.
• 180 Vanguardfan April 13, 2020, 8:07 am

  Sorry I should say a ‘shield the elderly’ only strategy would actually result in higher pressures, if it implies no measures to slow spread among the general population.
• 181 The Investor April 13, 2020, 10:12 am

  @Vanguardfan — Oh, that was a brain failure moment for me! It was late and I was longing for bed… 😉 You have to be right of course (re: ages in ICU). Doubly ironic as the next thing I did was forward an article to my mother about the NHS’ new ‘score’ tool that helps them decide which patients need critical care. (She is mid-70s and was told by Sainsbury’s she did not qualify as ‘vulnerable’ so asked why again is she in self-isolation for a month now?)

  I don’t expect the ‘shield the elderly’ would rely in higher pressures, perhaps partly because I believe the spread has been much wider than you do, and probably also because my definition of elderly would be younger than the average old person’s. (i.e. I have previously talked about 65, and perhaps on reflection < 60 would be more prudent). It would reduce pressure because as I understand it far fewer younger patients end up very ill from Covid-19. But there is a risk of course. Hopefully a couple of smaller nations can/will test it first and we can learn from their experience. Another option might be to phase it so we do three weeks of under-30s or under-40s and see how we get on with them mixing. I appreciate of course this would be a diabolical way to restart the economy, but it might be a compromise with those who urge maximum caution in lifting the lockdown and those who want to see some movement. From the video I've seen most of the lockdown breakers are under-40 so would solve that issue too. @Matthew -- There are loads of direct and semi-direct reasons. Some are very difficult to unpick (lower incomes always correlate strongly to shorter life expectancy, for innumerable reasons, as do periods of unemployment) so I can't list them all here and I'm not an expert. There's plenty of research around you can read up on. The other big thing is lost tax revenue. From a one-month lockdown this can perhaps be ignored as mostly it will or at least can be recouped. But if we saw the pretty-much-lockdown until vaccine strategy that was being bandied about a fortnight ago (though has abated a little) you'd be looking at minimum several tens of billions of funding lost to the NHS, although as I think @ZXSpectrum48K pointed out previously in the thread this is also very hard to quantify exactly, because we never see counterfactuals etc.
• 182 The Investor April 13, 2020, 10:17 am

  p.s. For some reason the browser isn’t showing line break punctuation in my comment. It’s there in the edit so not sure what is going on!
• 183 The Investor April 13, 2020, 10:32 am

  As just shared by @Snowman on the other thread, this is well worth reading in the context of all the comments above. It’s coherent and clear-eyed.

  …and there are only four possible strategies:

  To eradicate the virus from the entire population by enforcing lockdown. Or to enforce lockdown until there is an effective treatment. Or to enforce lockdown until there is a vaccine. Or to enforce lockdown to slow the spread of the virus, so as to prevent the NHS from being overwhelmed.

  Eradication is virtually impossible with such a highly infectious disease. Even if the UK was successful, if other countries were not, keeping Covid-19 out would require border closures for years, maybe decades. Endless checks on planes, boats, lorries, cars. Constant testing and restrictions. It is almost certain that the virus would still slip through. This does not seem a viable option.

  What about finding an effective treatment? The chances are vanishingly small. Influenza, a very similar virus, has been around for decades, and no game changing medications have yet been found.

  As for a vaccine? This solution is so distant that it does not really exist. It will be a minimum of eighteen months before an effective vaccine can be developed, then tested, then produced in sufficient quantities to be of any use. Waiting for eighteen months before releasing lockdown would be socially and economically impossible. We would be committing national suicide.

  Ergo, there is only one overall strategy that can be followed. Control the spread to avoid overwhelming the NHS. This has never been made explicit, but the Government has, albeit indirectly, told us that this is exactly what they are doing.

  https://drmalcolmkendrick.org/2020/04/12/the-lockdown-is-not-a-way-of-beating-this-virus/

  This has been effectively my argument here.

  Basically the Government cannot tell us the truth because ‘the people’ won’t accept it, as was seen in the PR disaster of the early days of the virus outbreak (notwithstanding various flaws on the government’s part, too. I’m not saying they covered themselves in glory!)

  Personally I’d rather deal with the reality in my own thinking.
• 184 xxd09 April 13, 2020, 10:45 am

  Hi Investor – you are up late debating the state of the world-me too!
  Reassuringly even after the fall of the Roman Empire through plagues,financial mismanagement,invasions of “ barbarians “ and climate change -ring any bells?-all the human race could do is set about rebuilding their civilisation
  This they seemed to achieve quite successfully-we are the current benefactors
  An endless cycle repeats and as you say the “status quo”- is that Latin/Roman?- will be restored with some more lessons learned
  Being realistic rather than cynical-this is the human condition and we must just continue to play the game and enjoy it -there is no other!
  xxd09
• 185 Sparschwein April 13, 2020, 11:30 am

  I agree with the comments here that Covid-19 deaths are underreported, and especially so in the UK because:
  c) scale of testing is ~10-fold lower than in other countries, e.g. Germany or South Korea
  d) the government’s inaction has made things worse and they have much incentive to obfuscate.
• 186 Sparschwein April 13, 2020, 12:17 pm

  @TI, where do you get the idea that Covid-19 affects *only* the old and frail?

  Some early data from a credible source (I don’t recall which) for age bracket 40-49 was, ballpark:
  Out of all infected, 10% need hospitalisation
  Out of all infected, 0.5%% die

  A recent study says ~4% & 0.2%, still with large error ranges. That *includes* asymptomatic cases.
  https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext

  Still enough for me to take this seriously.
• 187 The Investor April 13, 2020, 12:25 pm

  @TI, where do you get the idea that Covid-19 affects *only* the old and frail?

  I don’t, and have never said that. I think it largely kills the old and frail. That seems to me pretty uncontroversial.
• 188 The Investor April 13, 2020, 12:31 pm

  p.s. It seems I have to continually repeat myself. I don’t think this virus doesn’t exist, doesn’t kill people, some of those people aren’t young and fit. I don’t think it should have been ignored. I agree we had to flatten the first wave.

  But it is what it is. It’s a virus without much of a treatment and no vaccine. It is apparently super-infectious but (mercifully) not super deadly. Tackling it by the blunt weapon of ongoing universal lockdown has its own large costs, including to health and well-being especially as time goes on. Fine for a first response, but it can’t be a long-term strategy for the UK IMHO. We might wish we had a Singapore style surveillance, testing, and tracking system set up in advance or an indigenous massive testing capacity like Germany, but we didn’t. We are where we are.

  So the fact is all these things and many other factors — including the uncertainty — have to be juggled, however much we’d love a magic bullet.

  [I should have written this in my first comment. Trying to take a break from the computer today!]
• 189 WhiteSheep April 13, 2020, 2:12 pm

  > “the blunt weapon of ongoing universal lockdown […] can’t be a long-term strategy for the UK ”

  Has anyone here actually argued that it should be? I think most of the discussion seems to agree more than to disagree. And even the current lockdown has many exceptions. But the “blunt” alternative (which may equally be just a strawman) of simply going back to the state of the world a month ago by government decree is equally not realistic.

  The UK, in common with many other countries, initially underestimated the severity of the disease and found that the existing influenza response plans led to socially unacceptable death rates. What seems to be more specific to the UK is that some of the approaches to keep the virus in check in ecomically less damaging ways seem to be dismissed with less serious consideration.

  Massive testing capacity is not simply “indigeneous” to Germany – it was built up over the last few months (and after SARS/MERS in Singapore). Yes there may have been a broader lab testing industry to start with but the UK is a world leader in life sciences and I can’t see reason why something similar couldn’t be done here – other than that we decide we do not even want to try because we were late to the party.

  Another (possibly minor) example are temperature measurements in public places. I don’t think it is that difficult, they only need to tackle some hotspots like large office buildings or metro stations. (However, I don’t know how effective they are either.) FWIW, my place of work has already introduced them.

  A lot of responses are going to happen irrespective of what the government decides. Football leagues were shut down before the government lockdown. I wouldn’t be surprised if hairdressers were to face a tough business environment for a while to come.
• 190 The Investor April 13, 2020, 2:40 pm

  @WhiteSheep — Well we’re two weeks and 189 comments in and opinions move. I agree now there’s a much broader understanding of the limits of lockdown and certainly of the likely impact on the economy of lockdown. 🙂

  Two weeks ago people were being shouted down on social media and in the elements of the press for this though, and I when I alluded to such 5-6 weeks ago on Monevator people posted things like “I think we now know The Investor only cares about his portfolio”. (Direct quote). Even now the idea of ‘herd immunity’ is widely castigated, despite it being (in a less scientifically rigorous sense maybe) effectively most Western countries’ medium-term strategy for getting through this. Even now somebody like yourself somehow reached the conclusion that I said I didn’t believe anyone who wasn’t old was affected by Covid-19, principally I presume because of my more optimistic overall tone and my suggestion that we exploit the clear age-related impact on mortality from the virus in our response to it. The conversation is still not neutral (and I’m sure I’m also guilty of this. As I said to @Vanguardfan taking sides is unfortunately an emergent property of the dynamic of online discussion.)

  I can’t keep responding to all points unfortunately, life is finite. 🙂 But I certainly agree with most of your latter paragraphs that there were a variety of responses that could and can still be implement in the face of the ongoing virus crisis.

  *If* Covid-19 has effectively died out as a major threat to UK life (in terms of excessively reducing overall life expectancy) in a few months as I suspect might happen, I’m sure everyone will say that everyone knew the lockdown was temporary. Everyone will agree there was only going to be an initial deadly wave. Many newspapers will say the government overreacted. Large quantities of commentators on this website will make snide jokes about the market throwing a tantrum in early 2020. Silly investors.

  If you express opinions on your own website or even on a consistent social media presence as I do then often you have to take a view, and it comes with the territory. The benefit though is you can back up such revisionist thinking with a paper trail.

  E.g. Here’s my view from March 18th:

  https://twitter.com/Monevator/status/1241725190117171200

  Maybe it’ll still be proven Panglossian in the months ahead, it’s still very short-term and as @ZXSpectrum48k taught me we face ‘Knightian’ uncertainty. But it’s not looking too bad currently.

  In a couple of years, if so, some younger people will bemoan missing the opportunity to “buy cheap in early 2020” just like they complained last year they didn’t have a chance to start investing towards FIRE in the “obvious” buying opportunity of 2008/2009.

  Plus c’est change.

  Hope you and yours are well and enjoying the Easter, um, “break”. 😉
• 191 The Investor April 13, 2020, 3:23 pm

  @Whitesheep — Further to above, I just opened Twitter and literally the first thing flagged up for me was from the sane and rational journalist Ian Dunt (273K followers) who writes:

  Still feel that the economy vs health debate is bizarre. If you let loose and the public start dying in massive numbers, what do you think people will do? Just brush it off and go dancing? Will they fuck. They’ll lock up at home, just as they would under current policy.

  https://twitter.com/IanDunt/status/1249652499084201990

  I’m not saying this is the best example I could find to make my point. I am saying it is the gist of what I read and hear continually.
• 192 WhiteSheep April 13, 2020, 5:10 pm

  @TI
  The reason I and presumably many others come to your fantastic site is the quality of your commentary and thoughtful analysis on so many different topics. And from my perspective I include the recent Coronavirus discussions in that. That’s not even to mention that your site is the best source of information on anything do to with finance that I know of, without any qualifications! A big thank you as always, and I consider it an honour to get a reply to a comment.

  Although I must admit that I had forgotten about some of the quotes you mention, I appreciate that you get a lot of not very productive feedback in addition to general social media noise. In last night’s probably badly phrased comment I did not mean to imply “that [you] said [you] didn’t believe anyone who wasn’t old was affected by Covid-19”, nor did I think that. On the contrary, I thought you had consistently made a strong argument for the impact of side effects and economic damage of the restrictions, and in this context I thought that speculation to what extent Coronavirus may not have been the underlying cause of death for even a subset of cases wasn’t actually necessary or adding to the argument.
• 193 The Investor April 13, 2020, 6:32 pm

  @WhiteSheep — Being called away to a Zoom reception (what a strange moment of history this is) but just wanted to say thanks for your very generous sentiments, before I forget and your comment disappears out of view in my moderation panel. Very much appreciated.
• 194 Lord Odin April 14, 2020, 2:34 pm

  All very interesting views, but as know one knows the future or the answers its all just surmise. A man with no faith in the future, has no place in the future. If you think the world is coming to an end, you should not be investing in it. If you think the world will carry on put your money down.