What caught my eye this week.
Mixed events in the global soap opera saga Coronavirus this week.
The good news is the Prime Minister returned from that episode to tell us we’re probably past the peak of Covid-19.
The focus now is on R, aka the reproduction number. Keep it under ‘1’ and the pandemic is not spreading exponentially.
As a nation our R number is now somewhere under 1. Probably between 0.5 and 0.75, although it may still be higher in some places like (tragically) care homes.
The lower the R the better, obviously, but the question will increasingly be how much more [insert what matters most to you] damage we can take to lower it further?
Getting R down from the 3 to 4.5 level that looked like it might overrun the NHS was a no-brainer. But there’ll be diminishing returns.
Full lockdown – or even just heavy social distancing – has health as well as economic consequences, too. Some people will die earlier because we brought a recession upon ourselves.
Yet equally, every micro-notch higher in R that we accept means someone somewhere will die before their time from Covid-19.
That’s the equation for the upcoming weeks.
There are no easy answers. Perhaps there was a more promising hypothesis, but the past seven days looks to have done for it.
I’ve been mildly obsessed with Covid-19 since January (and mildly infected, I believe, in early March). I’ve ridden a rollercoaster from being precociously concerned to evasive action to believing things might not be as bad as was thought and now I’m halfway back again.
Long story short1 a series of intuitions (or guesses, if you prefer) informed by endless reading about Covid-19 convinced me the virus was spreading far faster in the UK than was generally thought likely.
All the experts knew the virus was spreading more quickly than reported cases, of course. But I (no expert) believed it was circulating faster again.
That was a comforting thesis because it suggested (1) the virus wasn’t as deadly as even the more middling predictions suggested and (2) we might reach some level of herd immunity sooner rather than later.
It’s long been clear this virus has a Great White Shark’s nose for the elderly and vulnerable, and I’ve been frustrated we either couldn’t or didn’t shield them better.
But in a super-infectious scenario, for the vast majority of us Covid-19 would be a very mild infection, mostly asymptomatic.
And by the time full lockdown was called, I felt it was possible a large number of us in London at least had already had it.
That proved to be right… a bit.
Peak deaths for the virus occurred in early April. Working backwards gets you to peak infections towards the end of the second week of March.
But how many? For that we can first consider deaths.
It’s hard to unpick the roughly 30,000 or so excess deaths we’ve seen so far in England and Wales in 2020.
Most will be due to Covid-19, but some may have been attributed to the virus incorrectly. For example, there were fewer heart disease related deaths in March. Perhaps some were blamed on Covid-19?
But just crudely guessing 30,000 and assuming an infection fatality rate (IFR) of 1%, that gets you to three million or so infected, with peak infection probably occurring in or around the period of voluntary lockdown, but just before mandated lockdown.
So overall millions have been infected – but not enough to be good news.
Unless… the IFR was much less than 1%, because far more people had been infected?
Start spreading the blues
That left antibody testing carrying the baby.
The hope was antibody testing would reveal that in areas of rampant morbidity to the coronavirus – such as Italy, London, and New York – many, MANY more people had been infected.
If this was true then you could indeed pull down the IFR.
Well, over the past seven days we got the first large scale data – from New York City and Stockholm – and it’s probably not good enough.
The New York City testing is the most promising, implying 25% of its citizens have had Covid-19. However, while that shocked the media it was much lower than I’d been hoping for.
Indeed as reader @Vanguardfan points out, 25% implies an on-consensus IFR of around 1%, if you take into account the number of presumed deaths to Covid-19 in New York City.
And 1% is no comfort if you apply it to the UK’s population of 67 million.
Now, not every last citizen will need to throw the viral dice – we should get some natural resistance to the virus on a population level, before everyone has had it.
However if we assume the chunky herd immunity thresholds that most experts think we’d need to see – at least 50%, possibly more like 70+% – even New York is far from having ‘earned’ an inherent resistance through its deathly exposure2.
This is disappointing to me, though it won’t be unexpected to the experts. It looks like they called it.
Much is still unknown about this virus. For every potential fact I find in early research about it, you can retort with another. Anyone waiting for scientific confidence (proof, for shorthand) better have a lot of series lined up on Netflix.
The huge list of Covid-19 links below (perhaps 20% of what I’ve read this week) gives just a taster.
It’s possible that amid this uncertainty there may be other off-ramps from the bad (though not worst-case) scenario:
- Maybe a large number of people can kill the virus with their immune system so easily that they don’t develop antibodies.
- Or maybe it’s spread much more widely among the most vulnerable parts of society, which is terrible news right now, but may have elevated the fatality rate and hopefully left the survivors with some resistance.
- Summer could well curb the spread anyway, which at the least should give us time to better prepare for any resurgence.
- Maybe the herd immunity threshold will prove lower than presupposed.
- Or more likely it may turn out that just a few key social distancing actions – no handshakes, avoiding crowds indoors, and washing your hands – will do 90% of the R-lowering. (The Swedish approach.)
- Kids may not be infectious, too, taking them out of the equation altogether.
I have reasons for making all those suggestions, based on my own reading.
But the truth is there’s an equally long list of reasons to be pessimistic.
As Freddie Sayers concludes in a sober piece on UnHerd that pits Sweden’s top epidemiologist against our own leading figure:
…it’s time to stop pretending that our response to this threat is simply a scientific question, or even an easy moral choice between right and wrong.
It’s a question of what sort of world we want to live in, and at what cost.
An ‘ell of a recession
Bottom line: I no longer hope for a very quick exit from this nightmare, unless perhaps R collapses extremely rapidly in the next few weeks and we can go back to trying test and tracing.
And this probably kicks the V-shaped recovery into the long grass. The drag from physical distancing and other anti-viral precautions alone could knock a few percentage points off GDP, even if we go back to semi-normal.
What are football matches, trade conferences, pubs, easy air travel, and the Glastonbury Festival worth to GDP, to name but a few lost causes?
Even if fatal Covid-19 cases do plunge and more normality can be reinstated, for as long as outbreaks flare up it may be hard to persuade some people to take their chances.
We’ve been bombarded with deathly warnings about the virus and kept under house arrest for a couple of months on its account. Dinner and a show on Friday night? Many may continue to Deliveroo and chill instead.
And while a cocktail of better treatments (drugs and regimens) will probably be assembled by the end of the year, that’s, well, the end of the year.
So L-shaped recovery it is. Probably what’s priced in by the global stock markets, anyway.
You see, a lot of people are talking about market mania after the quick bounce from the March lows.
But this is mostly a US market thing. And in the US market it’s mostly a tech thing. And of the tech companies, it’s mostly a bunch of cloud giants who couldn’t have come up with a better driver of demand than ‘shelter in place’. Strong demand now, plus their valuations turn on the years of prodigious earnings they’re expected to make long after Covid-19.
No, if you want a market that’s geared to the global economy, look to the UK’s FTSE 100. Its 2020 performance (red) already looks like an ‘L’, versus the (blue) S&P 500’s squint a bit ‘V’:
I’ve always been more worried about the financial impact of global lockdown than most, even while I was slightly more sanguine about the virus.
And now I see economy-dinging restrictions continuing.
So I’ve a horrible feeling that while the UK pandemic probably is past its peak, with the economy it’s like we’re back when people were gasping at footage of Italians stuck inside, hardly realizing the sort of misery we’d soon face.
Note: Fed up with virus chat? I’m planning to drastically reduce the number of Covid-19 links here next week. We’ve just hit that peak, too!
Do US Treasury bonds protect UK investors better than gilts? – Monevator
From the archive-ator: Reminiscences of a stock market wallflower – Monevator
Note: Some links are Google search results – in PC/desktop view you can click to read the piece without being a paid subscriber. Try privacy/incognito mode to avoid cookies. Consider subscribing if you read them a lot!3
Sales of almost 400,000 homes stalled due to lockdown, says Zoopla – Guardian
Millions face ‘financial cliff edge’ due to Covid-19 crisis, says Citizens Advice – Guardian
Nationwide: Pre-pandemic house prices rose 3.7% – Financial Reporter
British manufacturers record worst slump since records began 30 years ago – ThisIsMoney
Royal Dutch Shell cuts its dividend for the first time since 1945 – Guardian
Virtual rate cut forces Nintendo Animal Crossing gamers into riskier assets [Free to read] – FT
The US has now seen 30 million people file for unemployment – NPRGood letter to investment partners on the current Covid-19 reality [PDF] – Mary Meeker
Products and services
Treasury to allow first-time buyers to access Lifetime ISAs without penalty – ThisIsMoney
Investment platform account openings surge, despite coronavirus uncertainty – Which?
Tui cancels all beach holidays until June; a million customers affected – Guardian
Sign-up to Freetrade via my link and we can both get a free share worth between £3 and £200 – Freetrade
How to apply for a three-month mortgage payment holiday – Which?
Homes on a hillside for sale [Gallery] – Guardian
Comment and opinion
Three points to note on active funds and bear markets – Evidence-based Investor
Less is more – Humble Dollar
A defensive move: Looking at gilts – DIY Investor
What was the catalyst for the market rising? – The Irrelevant Investor
Talk is cheap – Of Dollars and Data
Quick look at what a bear market does to a real-life financial plan – Where Eagles Fear To Perch
But what if we’re wrong and the market never bounces back? – Abraham Okusanya
Why I’m not invested in gold – Get Rich Slowly
When you have no idea what happens next – Morgan Housel
Why value died – A Wealth of Common Sense
Naughty corner: Active antics
Terry Smith: If you must do dividends, look to family-owned firms – Portfolio Advisor
Three burning questions for Warren Buffett at tomorrow’s Berkshire event – Morningstar
When Buffett was a quant [On deep value] – Verdad [via Abnormal Returns]
This market-timing model just flashed a bullish four-year outlook for stocks – MarketWatch
Musings on misadventure and market madness – Simple Living in Somerset
Timing, luck, and surviving – Fred Wilson
[In email? Visit Monevator if you can’t see a YouTube lecture from CMO Chris Witty]
Self-care in a coronacrisis
This is why you can’t remember yesterday – Medium
Why you should give up on your social life when you’re in a pandemic – Slate
People are having less sex in lockdown – BBC
Feelin’ Groovy – Humble Dollar
Nobody knows what is going on – Mark Manson
All about those antibodies
Antibody testing: A user’s guide to the immune system [Great primer] – The Atlantic
It usually takes about 13 days for antibodies to show up in the blood [Research] – Nature
25% of NYC residents test positive for Covid-19 [Sadly, result supports a c.1% IFR] – Newsweek
Can antibody tests tell if you’re immune to Covid-19? – LiveScience
The false hope of antibody tests – The Atlantic
What policymakers need to know about Covid-19 protective immunity – Lancet
The rest of Covid-19 cornered
Social distancing reduces ‘overshoot’ on the way to herd immunity – Carl Bergstrom via Twitter
Why the Coronavirus pandemic is so confusing [Primer] – The Atlantic
Which epidemiologist do you believe? [Sweden versus UK, with videos] – Unherd
Experts fail to find a single case of children passing virus to adults – The Age
Social-distancing at airports is ‘impossible’, says Heathrow boss – BBC
What drug trials tell us so far about the anti-viral treatment remdisivir – Science
US germ warfare lab creates test for pre-infectious Covid-19 carriers – Guardian
How does Britain compare with other countries? [It’s too soon] – Guardian
Covid-19 deaths twice as high in poorest areas in England and Wales – Guardian
Low Covid-19 death toll raises hopes Africa may be spared worst [Free to read] – FT
AI models suggest that masks can ‘significantly’ reduce the spread of coronavirus – Venture Beat
Masks & emasculation: Why some men refuse to take safety precautions – Scientific American
A cautionary tale from San Francisco’s re-opening in the 1918 flu pandemic – NBC News
Many US prisoners test positive in four US jails; reportedly few with symptoms… [to-date] – Reuters
…although later stories talked about deaths [Seemingly earlier in breakout?] – NBC News
Sweden had no lockdown, but its economy is expected to suffer as badly as neighbours – CNBC
What is the hidden health cost of coronavirus? – BBC
How Italy became ground zero for Europe’s coronavirus crisis [Deep dive, blames business] – CNBC
Coronavirus & Brexit: the connections and their consequences – Chris Grey
Has Sweden’s coronavirus strategy played into the hands of nationalists? – Guardian
Kindle book bargains
The Basic Laws of Human Stupidity by Carlo Cipolla – £0.99 on Kindle
What You Do Is Who You Are: How to Create Your Business Culture by Ben Horowitz – £1.99 on Kindle
Money: A User’s Guide by Laura Whateley – £0.99 on Kindle
The Hating Game [‘The very best book to self-isolate with’] by Sally Thorne – £0.99 on Kindle
Off our beat
Meteorologists say 2020 on course to be hottest year since records began – Guardian
Microsoft Word now flags double spaces as errors, ending the great space debate – The Verge
Pentagon releases three UFO videos taken by US navy pilots – Guardian
“Even the darkest night will end and the sun will rise.”
–Victor Hugo, Les Misérables
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The Lifetime ISA link description might be a bit of a click bait. From reading the link, I think they are saying penalty will be 20% instead of 25%.. effectively the bonus will have to returned but no further penalty on the investor’s contribution.
At the risk of being charged with being part of the Imperial conspiracy, take a look at the projection of the infection rate on this modelling report
That winter peak disturbs me. I have been amazed at the ability of countries to keep the wheels running on what is basically a skeleton staff. But we all had big stocks of stuff etc. We have done well in keeping people fed and keeping the lights on.
So there will be a summer lull, and the weakened economy will not restock as efficiently. And as October draws to a close the rates will rise again, as winter comes.
Britain didn’t handle the first peak well. The NHS will be worn down by the months long battle, and supply chains will be less well stocked. We sort of won the fight against the first peak, the Nightingale hospitals are empty, which is not a sign of failure or error. But the second peak will hit us at a bad time and in a bad state. This fight is not over, IMO. Hopefully we will prevail. But looking at that report does not give me the feeling that we are match fit for the late autumn/winter.
Thanks for the links. I’m finding the debate on masks fascinating and enjoyed your two articles on this. Boris Johnson’ comments this week implied they will be soon recommended to some degree in the UK and the Arxiv study seems to show the science/modelling is moving that way. It’ll be homemade masks initially but I’m also going after a quality one for the longer term with a proper facial seal, high grade filters and that isn’t going to have any impact on healthcare availability (this one if interested: https://the-airhead-pollution-mask.kckb.st/06ba9bd4)
The psychoanalysis on Trump and masculinity makes sense. He is an unusual character so hopefully his position on this is not too widespread.
I keep hearing we’re past the peak, presumably referring to deaths, but the rate of new confirmed infections looks more like an inverted hockey stick: increasing dramatically until restrictions began and now plateau’d near that peak with scarcely any decline in several weeks. My own region shows virtually the same new daily case count this week as in late March.
That daily rate has to show significant decrease before people will be comfortable resuming normal life and the gradient right now suggests that scenario is a very long way off. I feel for folks being forced to return to work in May.
Neil Ferguson from Imperial College went head to head against Swedish epidemiologist Professor Johan Giesecke in an interesting series of interviews recently:
As they say in Scandinavia, your boys took a hell of a beating.
@ermine. RE “I have been amazed at the ability of countries to keep the wheels running on what is basically a skeleton staff. But we all had big stocks of stuff etc. We have done well in keeping people fed and keeping the lights on.”
Whilst agreeing with you about this point, my eyes have been opened to just how much of our income we no longer need to spend and so how much of it was not necessary (I thought we were already frugal!). I shop for an elderly couple in my hamlet as they are late eighties/early nineties and very much in the at risk bracket. Their weekly grocery bill is usually less than £20, mainly from Aldi and they eat well. I can’t afford to travel to work for that money. Looking at our own reduced expenditure it only highlights just how much we spend upon leisure and socialising, which, arguably we could (if we wished) cut down on. My point is the necessities are cheap, my thoughts upon the option of retirement, which for me is the point of this money building game have been consolidated. I believe I can live on less and live well now. We have just tested it out. The Irony is that we will need to unless the markets manage to put on some serious fat in the next five years.
If they are going to ease lockdown schools/nurseries need to be the first thing to start back in some form. There is evidence that under 10s have caused zero cases if transmission.
I’m a hospital doc and I have noticed with mild bemusement how many of the same people in my local area who are out clapping for the nhs are also treating me like I’m a carrier of the plague (to be fair I do work on the COVID wards).
Some comments I have read on the local Facebook:
– I’m not sending my kids back to school if they have to mix with key workers kids
– it’s disgusting they let NHS staff into the shop an hour early, spreading all their COVID around.
What a difference in gravity, serenity, perspective, you name it from the Swedish heavyweight expert, vs the shrill, hysterical 24/7 wall of fear emanating from most politicians and mainstream media. (Professor Johan Giesecke) He was an oasis of calm in that interview and we should be asking why people like that can never get to be minister of health in our systems, you truly do get the government you deserve.
As for sanctifying the NHS and its staff now after decades of creeping sabotage by piecemeal privatisation, underfunding, removal of free nursing training, low pay, extortionate charging in hospital carparks to name just a few, yes the hypocrisy is gargantuan. People say one thing but do another, which shows their real values, if I worked in the NHS I would keep quiet to protect myself from ignorance, like landlords evicting tenants out of primitive fear.
Public support for the lockdown may be riding high now, but for John or Jane Unconnected, wait until savings have been eroded away, the mortgage is biting and your job is lost, trashing the economy is a high cost.
Why don’t they just remove LISA from benefit/bankruptcy assessment putting it more on par with a pension and keep the early withdrawal at 25% – suppose it would cost in universal credit claims…Just looked up our total welfare bill – has more than doubled allowing for inflation last few decades
@Penelope — That’s an excellent article that I somehow missed. I’ve added a reference to the piece above!
Jim Jim, I’ve had very similar experiences and thoughts recently (pre-Covid) on retirement which has changed my views and plans considerably. My partner’s gran is 84 and had came through knee replacement surgery and I was doing her shopping. She had £400 in her bank, built up from her state pension while she was in hospital, and genuinely felt well-off. Long story short, she is active and lives well for her age but manages to do so off a basic pension. During this period I also visited my old aunt (84) and uncle (90). More or less the same story, with both very content pottering about in their garden and taking visitors. My 65 year old dad is slowing down from workaholic to a happy grandfather, now enjoying furlough as a prelude to (again) a basic retirement which he’ll top up doing a bit of training work to pay for some holidays. My mum took early retirement at 60 on a paltry 7 grand a year occupational pension but they quite happily get by and get their couple of holidays a year in the sun. So what’s likely – bar a wee bit of aspiration for far-flung foreign travel – to be different about me and to require a significant higher retirement income (presuming the mortgage has been paid)? Not a lot, I don’t think. The main difference will be that I want a bit more financial freedom during my working life and not to have to go through the grind til I hit the age where someone else can provide for me.
So my plan has changed quite a lot, on that reflection (helped admittedly as I have a decent career average pension which will provide the income floor I’ll need, even if accessed early). Rather than forego that family holiday now to oversave for the future I’m going to have it. And rather than pay into (additional) pensions for the tax advantages, I’ll save or invest a bit of cash into ISAs every month which I can access as and when I might need or even just fancy it.
@Jim, does that welfare bill include state pensions and/or allow for increased population?
It would be interesting to see a proper non-political breakdown of where the money is going compared with 10 years ago and the reasons behind the changes. Spending on pandemic preparation definitely of interest!
The LISA rules do seem contradictory. Either they are assessed for benefits and the withdrawal penalty is 20%, or they are not and the penalty is 25%. Penalising people who are trying to do the right thing but fall on hard times is bonkers.
Let’s see how the Imperial College fanboys try to spin this one away…
Pedant’s corner: R without the zero is the infection rate under current circumstances, R0 is the value in the absence of any measures.
The Oxford Centre for Evidence Based Medicine which seems to be a good source recently gave their best estimate of infection fatality rate as between 0.1% and 0.41% (https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/) but in another of their papers on that website they point out that the IFR for previous pandemics was over-estimated at the time by up to ten times.
So @TI you can still indulge your pet theories!
The good thing is that the number of RT-PCR tests now available means they can do reasonable scale random population sampling to determine R, and they finally seem to have got their heads round using lab-based ELISA antibody tests to start estimating the number infected to date. They might be able to plan the next steps rationally.
Watched those interviews with Neil Ferguson and Johan Giesecke a while back. It’s scary to me to think that Neil Ferguson is influencing UK Government policy.
I’ll leave it to others to watch both interviews and make up their own minds as to whose critical thinking is clearest.
Indeed. Maybe one day Neil’s spreadsheet models will be right…just like a broken clock is right twice a day.
@FI Warrior On shrill voices: I thought @TI might post Elon Musk’s outbursts this week 😉 https://www.theguardian.com/technology/2020/apr/29/tesla-quarterly-earnings-coronavirus-shares
@Jonathan — Thanks for the clarification, I’ve seen it used interchangeably which is probably due to all the people like me who are writing about something they only learned about in the past few months! I’ve amended the article.
Re: the IFR, I’ve seen estimates all over the place but I’m trying to tone my confirmation bias down for a while as I’ve been pretty dismayed by that raw antibody count in NYC so far. Give it another two weeks and it should tick up as more people who were infected late develop antibodies, but can’t see it getting much about 30-35% on the back of this wave.
Re: My pet theories, I suppose I still lean Swedish — take measures, but not the most Draconian — and even more so shield the vulnerable/elderly. Nothing in the crisis has changed the view they’re overwhelmingly the most at risk (from memory we’re running at half of deaths above 80yo and the vast majority over 70yo) and despite the odd horror story the numbers for young people getting seriously ill from the virus are tiny.
Given all the spare hospital capacity we have now (six Nightingales as the PM mentioned, all pretty much empty) it seems to me we should get the under-30s who are able to mix with each other more or less exclusively out pronto. Assuming that goes okay, maybe the under-45s a few weeks later, and see what happens. This view is informed by my darker prognosis for the consequences of a deep recession/depression. Others may legitimately feel different. This crisis is evolving into world view territory as the curve flattens.
I know some feel demographically-targeted lockdown isn’t realistic because of this or that reason (most pertinently elder-adjacent transmission, but also because it half-arses a return to companies functioning properly etc) but out of a bunch of bad choices, I don’t really see why demonizing 22-year-olds who want to hang out with other 22-year-olds has much justifiable road left to run.
In a fantasy world where all the under-30s had been infected and now had (presumed, maybe temporary) immunity and kids don’t spread the virus (as seems very likely albeit not conclusively proven) we’d surely be in a far better place — we’d have 25-million odd firebreaks in our population, slowing the viruses spread.
@Guido, maybe Musk is panicking in case he drops down the Forbes list of billionaires, I can’t know for sure, but it could be that that’s how the uber-rich feel mortal pain. 🙂
More likely he (Musk, not @TI) is worried about car sales, my close cousin in Northern Italy has a company that earns him a living derived from car advertising and he is justifiably terrified about his business surviving this.
Came across this report on the ICL model recently – applied to Sweden.
As the Guardian author (David Spiegelhalter) states we won’t know for months which strategy works and has the least impact on us – every (developed) country is pursuing it’s own experiment – and some, like the US, multiple experiments by state. Sometimes its for good reasons, if debatable, sometimes…not so much.
Happy to be here in NZ though – we seem to be doing well so far (fingers crossed!)
“Experts fail to find a single case of children passing virus to adults”
This is probably the best news so far.
I wouldn’t be surprised if we also find that transmission without symptoms is rare, at least without close contact.
@JimJim This has been our experience as well. I think of us as a fairly frugal family but our spending has fallen through the floor.
@FI_Warrior Yeah, I guess this is how Musk thinks he’ll remain top-dog. On the other hand I’m somewhat surprised their not embracing the Creative Destruction taking out their competitors; somehow it is always the small guys who end up being the victims.
@ TI thank you for the brilliant links and excellent analysis that is completely on point IMHO. I am a slightly long in the tooth ICU Consultant who has worked through the Covid-19 response in London but I am not an epidemiologist so make of these observations what you will. I have used data from hospital deaths from public health England, Census 2011 data on nursing home residents, the FT analysis looking at excess deaths, David Spiegelhalter’s twitter feed and other data referenced by you and others.
1. C-19 is overwhelmingly a disease of the elderly. 52% of patients dying in hospital are over 80 and 0.7% (149 in England up to 30 April) are less than 40.
2. 80% of nursing home residents are over 75 of who 44% are over 85. Some 70-80% of these people will have dementia. The median survival of residents is less than 18 months.
3. ICU and ventilators have attracted a lot of attention but in public health terms are almost a side-show. By the end of this surge there will have been 8,000-9,000 admissions of whom 4,000-4,500 will have survived. These ICU patients are mainly in the 40-69 age group with only 20% over 70 – so a very very selected group compared with the general population of C-19 patients.
4. Looking at the decline in hospital admissions and the known figures for excess weekly deaths (FT analysis) a very back of the envelope estimate would be that 30,000 will have died in hospital with perhaps 20,000 outside hospital. Combining the age distributions of the hospital deaths and nursing home deaths significantly more than 50% of deaths will be in people over 80 most of whom are frail for their age and many of whom suffer with dementia. Less than 0.5% of deaths will be in under 40s.
5. All this is with the lockdown of course with perhaps 15-20% of people getting the disease. So if say 75% of the population get Covid (a slightly high estimate for herd immunity) there may be 200-250,000 deaths in total with say 1,000-1.500 deaths under 40 (most of whom by the way will have serious health conditions). There are some 600,000 deaths a year in normal times.
This is all terrible of course and I wouldn’t want to imply that the lives of people with poor chronic health or elderly people with or without dementia shouldn’t be valued. I also think that the lack of protection for people in nursing homes with PPE, testing of residents of staff etc has been a serious policy failure. But is doesn’t seem right to me that the opportunities of people in the under-40 age group are being sacrificed and perhaps their lives permanently diminished for a disease of old age.
The rational policy would surely to be reduce restrictions on the young, give better protection to nursing homes, and make help the elderly to voluntarily socially distance. I do understand that it is difficult (perhaps impossible) to control R precisely once it gets above 1 but the current strict lockdown of the whole population is not rational or fair to the young.
As a front line anaesthetic doctor, and producer of many protocols and policies over the last couple of months, I am absolutely delighted and relived by the double space after a full stop issue. It drives me nuts. A million thanks
Correction final paragraph:
….. and help the elderly to voluntarily socially distance (but not completely isolate).
….but the continuing strict lockdown….
Re IFRs – I’ve said this before so apologies – it’s not a single fixed rate, it will vary by time and place, depending on population characteristics and access to healthcare (in a surge that overwhelms, like in Wuhan, NYC and N Italy, it will likely spike upwards. I hate to think what it may be in Rio, or Calcutta, or Mogadishu). It looks like anywhere between 0.1 and 1% has been experienced in populations so far, and it cannot be lower than 0.15% in NYC, as that’s the death rate so far.
Re children’s role in transmission. I would urge caution before concluding that it is insignificant. There is very little evidence to go on. I have tried to track down primary research papers with limited success. I believe the epi studies from China (which I think are the source of this ‘no transmission from under 10s’ idea), were conducted quite early in the spread of the infection. If the virus circulated first where adults gathered, and they took it back into households, then that could explain why adults were more likely to be index cases in family clusters. There have, certainly, been reported cases of children transmitting the disease within households. I think it’s entirely possible that schools could become significant sources of infection (which wouldn’t affect the kids so much as vulnerable staff and family members) – we just don’t have the evidence or experience to rule it out yet. After all, in the places where the epidemic has surged, schools are closed.
This is the Royal College of Paeds president outlining what is, and isn’t, known:
I want to see schools open as soon as possible. However, I think we need to be careful not to make assumptions at this stage that the risks are low. It would be unusual if children did not transmit, given they certainly become infected (albeit with less severe symptoms than adults).
@passive investor. The population distancing policy is certainly rational. It is the only tool we have to put a brake on population level transmission when an outbreak threatens to overwhelm. It works by reducing the social connections by which the infection spreads. That protects the vulnerable from becoming infected. It’s crude, but effective. It is however a tool of last resort. And fair? Nothing about this is fair.
The other effective tool to control an outbreak of infection is to separate infected and uninfected by means of rigorous contact tracing and quarantine: we gave up on this, and many other countries found it insufficient to contain the initial surge . It might work once the first peak has subsided, if done well enough. My confidence is not high.
Personally, I think trying to separate vulnerable people from less vulnerable people is simply not going to be effective or feasible. I’d reconsider my view if I read a convincing study of this approach in a respiratory outbreak.
@Vanguardman. I agree with both your comments above. What keeps being stressed to me on calls on COVID is that IFR is a range. I’m hearing 0.2%-1.2% is a broad consensus. A big question being asked is why viral loads vary so substantially from region to region. Is it variations in strains of SARS-Cov-2? Is it due to factors like mass transit resulting in multiple exposures in places like NY or London etc?
I’ve had two calls with German institutes who are arguing to be very careful with the view that “children are not vectors” and therefore schools can be reopened. It might be the case that children have milder cases and thus that the transmission channel adult -> child -> child -> adult is a low probability event. Nonetheless, given the high number of interactions, the cumulative probability of transmission could still be significant. Again we just don’t know.
We simply don’t have a handle on this disease yet. I still think Knightian uncertainty is dominant. Any relaxation of the lockdown needs to be taken in small steps. I also continue to think that we haven’t really quantified how much excess damage the economy is taking from the lockdown. We know significant outright damage is being done but what proportion would exist in the counterfactual scenarios where no lockdown had occured and what sort of damage will still persist once the more severe elements of lockdown have been relaxed is again very hard to quantify.
@naeclue must admit to scan reading it but this is the website I went on
Appears state pension is 40%, which can’t really grumble with if NI has been paid in expectation of receiving.
You can hardly say this if you’re a public figure, but I’m not so sure it’s unfair that very old people over-80 who find themselves with multiple health conditions and very near the end of their life are more likely to die in a pandemic than young people at the start of theirs.
I’ve said this a few times during this crisis and had variously reasonable levels of pushback, but try inverting it: a disease that killed 0.1% of the over-80s but 15% of young people under-20. Now that would be ‘unfair’, if such a term can be applied in this circumstance anyway.
From memory estimates of the case fatality rate for over-80s has been estimated at 10-30%, but varies a lot as usual by how you count (some territories more severe etc). So call it 15%. That means 85% of over-80s don’t die of it, either.
Should we try to protect them? Absolutely. I’ve never advocated no measures or no social/physical distancing, and I’m not now. Content with the first emergency lockdown, too, even more so given the latest data that’s come in that I’ve talked about above. I want more shielding. I want targeted food drops, PPE and testing directed towards care homes, etc. That should always have been at the top of the focus for me.
But should we accept, say, a multi-year economic depression, with all its knock-on consequences including life expectancy for everyone if that’s what the cost was, to stop the life expectancy of all 80-year olds declining by a few months in a once-in-a-century global pandemic?
We keep hearing it’s a war. Well, we accept the deaths of thousands of soldiers and civilians — sometimes hundreds of thousands — in the prime of their lives, with 60+ years to live, in a war.
I say none of this glibly, and I don’t really like some of the bedfellows even my more modified view of this pandemic puts me in.
p.s. Regarding the ultimate cost of various lockdown strategies, it’s true we don’t know this yet and obviously no counterfactuals.
Also, there’s a prisoner’s dilemma element to all this. An argument could be made that if the whole world had ‘done a Sweden’ then the global economy would have suffered far less and it’d be more rationale for us to as well, but given that the world didn’t we’re set to import a recession anyway, so why sacrifice a few thousand more lives in a vain attempt to prevent one. I understand that line of thinking.
With all that said, I feel we’re reflecting our biases in where we’re more prepared to take the uncertainty.
For instance, a serious piece of research highlighted above — observational, certainly, but hardly based on one bloke talking about his mates or whatnot — said that contact tracers failed to find a single case of child transmission of Covid-19. It’s not proof they can’t, but it’s pretty suggestive. Why continue to say that it’s pretty likely that school children will be pretty significant sources of infection, given the only data we have is they aren’t? Sure they could be, but that isn’t what the early findings suggest.
At the same time, we have economy uncertainty of course — but we also have for instance 30 million Americans filing for unemployment in the space of about a month. That’s out of all precedent in the history books, we’ve never seen anything like it. Ditto literally half the world in lockdown and working from home. It seems to me that looking rationally at such data, one would at least bias your uncertainty to the downside.
I’m not saying here I’m right and anyone else is wrong. I am just noting how we weight our uncertainties according to our model/fears of what’s going on.
The low level of antibodies in the population may not be quite as disappointing as it sounds. The Times quotes Sir John Bell, regius professor of medicine at Oxford, as saying that in Sars the long-term immunity is all T-cells, not the antibodies. Apparently the vaccine being developed at Oxford is designed to produce both antibodies and a T-cell response.
@Vanguardfan re Mogadishu, and in response to FT link on Africa: https://www.theguardian.com/world/2020/may/02/somali-medics-report-rapid-rise-in-deaths-as-covid-19-fears-grow
Potential risk factors of lower income countries: underdeveloped health systems, testing/reporting/CRVS systems, population density; potentially mitigating: age structure, mostly warmer climate (I think evidence on that re virus spread is weak or tentative). Sorry for post format, writing on mobile.
@vanguardfan – The rationality or otherwise of the population distancing policy is contingent on the desired goal. So certainly it was rational to dampen the surge to avoid overwhelming the hospitals and that is why I and most people supported it.
It would also be rational (though wrong in my view) if the stated aim was to prioritise deaths from C-19 over other causes of death (cancer, heart disease, domestic violence etc). Or indeed if there were a vaccine or treatment available in the near future (there isn’t).
My argument is that (provided the hospitals aren’t overwhelmed) it isn’t rational to continue such extreme social distancing to save lives (or arguably even just to postpone deaths – area under the curve of deaths vs time seems to be the same whatever the speed of spread of the disease).
It is an irrational and an ugly policy (I would say) that puts a disproportionate burden on under-40s for what is mainly a disease of the very elderly. All the more so when the financial cost of any lives saved by continuing the current policy are way higher than what we normally consider right.
Finally, yes there is much that is unfair about covid-19 and indeed life in general. But policy-makers shouldn’t aim to increase unfairness.
I am disappointed that you aren’t optimistic about the test-trace-quarantine policy (your field not mine). In the absence of a vaccine or testament I had been pinning some hope on that.
@ Passive Investor #23
You say “nursing homes” several times. Do you mean just nursing homes, or do you mean nursing homes and care homes, since in my experience the former are for people who are ill enough, or who are recuperating, to need at least some degree of “real nursing”, and who may thus be more likely to be in the pre-existing health condition category?
@factor Apologies for the sloppiness – I wrote nursing homes but meant care homes which is what the figures I gave were referring to.
Whilst we’re talking about Neil Ferguson and Imperial, a reminder that Private Eye’s Not The Foot And Mouth report into the 2001 fiasco is available to read for free:
Thank you for that link. It is how discourse should be done, in a measured way
> Let’s see how the Imperial College fanboys try to spin this one away…
It isn’t tribal 😉 Johan’s discourse was cogent and delivered in a measured way. I see nothing wrong with his arguments. As he said, perhaps we will only know in April 2020. How one responds to the very uncertain information and balance the costs and benefits is a political decision. I am glad that I don’t have to make these decisions.
@TI. What about Drosten’s research (leading virologist in Germany) ?
https://www.bloomberg.com/news/articles/2020-04-30/children-with-coronavirus-may-be-just-as-infectious-as-adults. I think there is a huge risk here basing policy decisions on limited scientific studies with poor confidence levels.
I tend to think the same about the economic side. The volatility cone in UK economic consensus forecasts already shows huge dispersion (https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/879642/Forecomp_April_2020.pdf). These were late Mar/early Apr forecasts so will clearly be marked more negative in May. It’s not clear to me that at that point, economic data will be clearly tilted to the downside vs. that resulting probability density. Moreover, the UK economy is likely to come out of this weaker than many other economies due to pre-existing conditions, most of them self-inflicted.
In terms of world view, I think I differ from you in the sense I’m more relaxed about many UK businesses going bust. The high street was obsolete anyway, airlines should go bust, the petroleum industry needs massive downsizing. The FTSE is not coming back because it full of crap companies with obsolete business models. The S&P and Nasdaq are not.
I’m also more relaxed about higher unemployment. The UK made a sort of Faustian bargain: low unemployment for high underemployment and low skill base. Taxpayers subsidize many corporates and SMEs, through low taxation and incentives, to provide rubbish jobs on low pay. These jobs should have been offshored to EM markets years ago. It’s unsustainable for UK workers to be paid 3-5x an EM worker for something where they offer no advantage. It’s also results in terrible productivity and low capex.
I’m clearly going to have to pay more tax after this crisis. I’d much prefer to pay people UBI so that they could stare at the ceiling, than see my tax used to subsidize Richard Branson, Mike Ashley or Phillip Green. Machine learning and AI is going to make many middle class people unemployed. We might start getting used to it now and stop stigmatizing those who don’t have jobs. A generation or two from now being unemployed might well be the norm.
Exactly, Ferguson’s magic spreadsheet has form. Anyone can google the number of human deaths that his model predicted from Mad Cow disease and then compare them to actual deaths. Garbage In => Garbage Out.
@ZXSpectrum48K — Well I’ve not seen the primary research, but on the basis of that article he is saying kids can get infected (which we knew) not that they are in turn infectious (which the other research said they could not find evidence of). But certainly it’s all, um, uncertain and not yet proven.
On the economic front, big picture we probably agree with the way things are going far more than we disagree, with perhaps the exception that I have dialed back my concerns about middle-class jobs going to AI/robots. (I think today’s jobs will go, but I’ve moved back towards thinking there’ll be other new jobs. A discussion for another day). Certainly agree about the High Street etc. I’ve had a good 2020 so far return-wise, amazing relatively speaking, and it’s partly because I’m overweight tech/growth/disruption. So we’re on the same hymn sheet there.
Where I’d disagree I think is the pace of change. If what you describe happens over 5-15 years that’s one thing. If it all happens in six months, that’s another.
I’d draw a parallel with the Thatcherite changes of the early 1980s. Unlike many with my (albeit personally non-party) political leanings — and unlike more or less everyone where I grew up — I believe the most of those changes were necessary. The world was changing rapidly.
However was it too much, too soon, too recklessly? I have a lot of sympathy with that view, too.
On another note, I wanted to ask if you have any links to whether the various strains of Covid-19 have different virulence levels? I mentioned it in an offline discussion as a potential cause of varying fatality rates in different regions (not saying it was, just raising) and I was more or less laughed down. On Googling, I could only find people saying it “might” be the case that different strains were more virulent, but we didn’t know. Would love to see anything more concrete if it’s out there, cheers.
@ZX, Hahaha, the UK’s ‘productivity mystery’ solved in a few pithy words, excellent !
I too would rather have my taxes pay UBI than crucify the underclass (which will soon encompass the majority) after the coming bonfire of bullsh*t jobs. What I’m betting will happen instead though is what always does, the likes of the oligarchs you sample will have another pass at the taxpayer trough while the poor, the most recent immigrants and others who can’t defend themselves, get scapegoated again. Why change a winning formula.
I would be surprised if different strains have different virulence levels.
The difference between most strains only involve nucleotide mutations that do not result in amino-acid changes (i.e. the proteins, which are the parts that are going to form the virus, are the same) and thus virulence should be identical.
There are now some sub-groups of mutations that do cause amino acid changes and thus, could change the structure of viral protein(s). Whether one amino acid modification is enough to change how the virus will act (and its virulence) is a good question.
The authors do caution that “Nevertheless, it would be prudent to consider the possibility that mutational variants might modulate the clinical presentation and spread of the disease.”.
@passive, you wrote that the current lockdown was irrational, which I took to understand that you thought the intervention had no basis in logic or science. I’m glad that wasn’t what you meant.
Re contact tracing and quarantine. My lack of confidence comes from two issues. The first is the nature of the virus. If a lot of transmission is driven by unnoticed or presymptomatic infection, then it’s going to be harder to break transmission – it needs lots and lots of testing, and it also needs very quick turnaround of test results. We’ve not done so well on that, but in fact, no country has been able to control this epidemic by this method alone, that’s why the globe is in lockdown.
My other concern is how well we will implement it here in the UK. From what I’ve seen so far of the testing debacle and the lack of integration with local services, I think this might be another cock up in the making. Public health manpower has been much reduced in the last decade, organisationally fragmented and disconnected from the NHS. PHE is run by government diktat, with no local autonomy. My heart sinks when Hancock announces the number of staff to be recruited before he outlines the strategy – how can they know how many are needed before they’ve worked out how it will operate? It’s just another simplistic government slogan like 50,000 nurses (and 100,000 tests per day).
It’s not that I think it’s a flawed approach, I just don’t believe we’ll do it well enough. We’ve destroyed our capability.
“Peak deaths for the virus occurred in early April. Working backwards gets you to peak infections towards the end of the second week of March”.
“More or Less” Radio 4 on 29 April ( about 9 mins in to broadcast) Tim Harford made a claim in the programme the previous week that working backwards from 8 W April took you to 18 March for peak of infections i.e prior to lock down. The maths was disputed by a mathmatician – and they discussed the Mean /Medium /Mode /Average and skewed distribution. Conclusion – lockdown was main factor in reducing infection.
@anyone who favours age stratified release from lockdown. I’m sure ONS will have, somewhere, data on household composition by age. I can’t be bothered to do the legwork, but why don’t you check how many households are inhabited exclusively by under 30s, under 45s or whatever you think is the best age cut off?
(declaration of interest – two under 30s and two over 50s in our household!)
@ Indecisive. What a distressing read on the foot and mouth crisis of 2001. But to pull out the Imperial model from all that is being ridiculously super-selective.
Prof. Anderson (Imperial, but a refugee from Oxford, having exhibited male entitled professoriasis one too many times), with Chief Scientist King (Cambridge chemist) neither with any animal disease experience whatsoever. But lots of confidence, eh?
EU rules/directives and intransigence, MAFF’s witlessness, desperation and illegal activities. Blair’s dithering and image fixation, not to mention blindness for rural life. (A London-centric bubble, you say?) Ministerial and opposition incompetence.
After 11 September it largely disappeared from the headlines. Many farmers’ livelihoods gone, suicides, bloated compensation for some, nothing for others. £2.5 bn spent to save a £0.5 bn export market.
Surely we know 20 years later that models can be no good without proper data. And we can only wait to see what a similar report will reveal about the current virus strategy in months or years to come.
@TI. Regarding different strains producing different viral loads. There is the well publicised paper from China (Zhejiang University School of Medicine https://www.medrxiv.org/content/10.1101/2020.04.14.20060160v2). This implied that the strains in Europe/NY produced larger viral loads and mortality rates than say the Seattle cluster in the US or parts of Asia/Australasia. If you look at https://nextstrain.org/ncov/global then you can see clear clusters of different strains and how they migrated.
I haven’t seen any other preprints on this topic but it’s been getting attention for a few weeks on conference calls to possibly help explain varying mortality rates, especially NY. Demographics, population density, mass transport etc explain this to some degree but attention has moved toward looking at the various strains. Initial thoughts (two months ago) seemed to imply the strains were fairly similar but it seems that researchers are questioning that. I was on a call over a week ago with a US uni computational virology lab (who are heavily involved in nextstrain) and they found that adding in some level of “strain lethality” as an explanatory variable did help predict why the Seattle cluster and NY cluster produced quite different mortality rates. Like everything else we know far too little.
@ZXSpectrum48k @Art — Very interesting, thanks for those contributions. Will read up further.
*It’s not that I think it’s a flawed approach, I just don’t believe we’ll do it well enough. We’ve destroyed our capability.*
I’ll take some reassurance from that. Although clearly down the line we will need to understand how the UK went into this so badly prepared (ICU beds, ventilators, PPE, testing etc) it has been impressive to see the hospitals mobilise, the Nightingale hospitals get built and the testing get scaled up quite quickly so perhaps we will be able to build the contract tracing capability in time. Fingers crossed.
There are clearly some non-trivial number of households with multiple generations in them. Perhaps the Government policy will need to be flexible so that those with mixed households can make a call without losing income support such as furlough. But locking *everyone* into self-isolation, on/off, for 12+ months under the current arrangement because a minority would risk infection (in most cases even then not suffering hugely) doesn’t seem like a good alternative policy. I imagine there would need to be opt-ins/outs and other protections.
We know a huge amount of current deaths are in care homes. In Scotland more than *half* of all deaths involving Covid-19 were in case homes week ending 26 April. (https://www.theguardian.com/world/2020/apr/29/how-many-people-are-dying-of-covid-19-in-the-uk) (Though of course this is with full lockdown, so the proportion would almost certainly be lower if we weren’t doing that for wave one. But we’re past the peak of wave one.)
Anyway, while there will certainly be complications from multi-aged households in the community, at the least somehow devising a strategy to properly shield the c. half a million elderly people living in care homes while trying to allow the rest of the population to develop an immunity has to be on the table in my view. Over-80 deaths alone are contributing massively to complicated cases and the fatality rate. Stopping them getting infected (assuming possible, but you wouldn’t think it would be beyond the wit of man given care home residents live in select communities by definition) would reduce hospital load accordingly, which could help counter a rise in hospital cases from any lessening of lockdown restrictions.
As Passive Investor said earlier:
He makes a very salient point. As I understand it, we need to accept more will get infected.
I’m not hearing many alternatives (for instance we just heard test and trace won’t work in a comment above) — even our own advisors have at times said that in the long run a huge proportion of UK citizens will get it.
25% at least of residents in NYC have had Covid-19 and the city hasn’t been turned into a morgue or an army of invalids. It’s been horrible for a minority, and no doubt unpleasant for some who don’t die but had a rough time off it. But the overwhelming majority of people shrug off Covid-19.
So when I look at it objectively, choosing from a bad set of cards, phasing the acquisition of (presumed) immunity from least affected to most (to reduce the number of the more susceptible who have to endure the virus) while trying far harder to shield the super-vulnerable — and making good use of the time / facilities / testing / whatnot we’ve now bought ourselves — seems at least worthy of serious consideration.
Rather than multi-aged households, which at least one can make rules about, I’d be more concerned about fuzzier vulnerability.
For example if I was an obese person under-50 with pre-diabetes, I’m sure I’d look askance when it came turn for my age cohort to “go over the top” so to speak. That’s a real issue I concede.
But as I see it, demographic de-restriction has the potential in principle, if done in a controlled way, to quickly build up tens of millions of firebreaks, on top of the millions we’ve already “earned” from wave one of the infection, and so getting us to the immunity most seem to agree we will need to get to while potentially minimizing deaths.
Usual caveats, I’m just an interested observer/citizen, and I concede it might not be feasible for various reasons. But when you consider our current lockdown strategy base is ‘shut down the economy, put everyone into a comfortable pseudo house arrest, stop tens of millions of younger people living a normal life, create mass unemployment and a recession and arguably the seeds of a police state, and put tens of thousands of firms out of business whilst running up enormous levels of government debt which we will work out how to handle later’ let’s concede we’ve taking drastic and perhaps, seen through another lens, unfeasible actions already.
p.s. This is not even to make the point, stressed by Merryn Somerset-Webb on Twitter I’ve noted as well as plenty of more theatrical newspaper columnists, that plenty of over-70s would like to roll the dice and see their grandkids — or at least be allowed the choice.
One elderly relative of mine who called for a chat almost couldn’t speak when I updated her on the antibody results the other night that I’d previously implied might mean she could get out of her (now approaching two month long) self-isolation.
She’d already told me she’d rather risk a 1/10 chance and hug her grandkids than spend a year of the relatively few she has left watching them grow up and missing their birthdays etc over a Skype call.
I’m not a grandparent (or a parent) so I can’t really comment in an informed way about that, but it doesn’t appear to be a super-rare viewpoint.
(Edit: Changed “minority viewpoint” to “super-rare viewpoint”. As far as I can tell from general reading it’s not a majority view either. But it is something you hear all the time.)
One issue with the medRxiv pre-print (Patient-derived mutations impact pathogenicity of SARS-CoV-2) is that the authors provide no explanation on how they calculated the viral titer (i.e. the concentration of virus they had in their “stock” solution) prior to the infectivity assay. This is not necessarily straightforward to do and if done incorrectly, could easily jeopardise the infectivity data that they present.
It is good that they say what multiplicity of infection (MOI) they use, which was 0.5. However, we also need to know what how their determined the viral titer.
That’s why peer-review is important 🙂
I am a bit confused as to why the economy comes up when people talk about the stock market… the stock market is not the economy. Stock market depends on how much an investor is willing to pay for a business so a recession may reduce sentiment for a while but not in the long-term. It doesn’t really matter if we have a v recovery, L recovery etc when it comes to the stock market.
What matters to the stock market is 1. loads of cash in the system… central banks coming to the rescue… trillions of dollars..etc…
And 2. Less than zero interest rates as it means investors are willing to pay a higher multiple for growth companies.
I would not be surprised if indices double from present levels.
money printing and zero interest rates will keep house prices and stock markets go on moving higher until Joe public lose confidence in the system or if the sugar rush of cheap money is reigned in… which is not going to happen for a long while yet.
I think people are too bearish on the economy, we have all had a rest from the rat race and hopefully have rejuvenated to the point where productivity is going to go through the roof when workers return. Do not under estimate 2 months of a full night’s sleep on the working population.
@TI I think you’ve perhaps inadvertently made some of the arguments I would make as to why age restricted release from lockdown won’t work! Essentially, I think it will prove ineffective in keeping our R at a level that can be coped with. It’s nice on paper, but practically I think it will be confusing and impractical, and compliance will be very low.
I’m not sure if it’s me you think said track and trace ‘won’t work’ – I don’t think I said that – my view is that it’s a correct strategy, and absolutely needs to be a key part of our next moves, but I am not confident that we will execute it well. Our track record so far hasn’t been encouraging (nightingales and reprioritising NHS resources notwithstanding).
Here’s a few other random thoughts that might help clarify what I do and don’t think:
-I absolutely agree we need to get out of lockdown as soon as is feasible.
-lockdown was used in order to control an epidemic which threatened to surge out of control. (Ie reduce R). It’s been quite effective, but we still have quite a number of new cases compared to say Spain. We might have managed with a shorter less severe lockdown if we’d acted quicker.
– as we ease lockdown, transmission will increase again. There is a very real risk that we will be back at square one, maybe even contemplating another phase of lockdown. Clearly not a good outcome. No one really knows (anywhere) what the room for manoeuvre is, so we need to move carefully, observe carefully, learn from others.
– I don’t think a scenario where R increases rapidly, but somehow only in younger/less vulnerable segment of the population (even if that could be achieved), will necessarily avoid a second surge of critically ill cases. Semipassive might have a more informed view, but it seems to me that it’s not the old and infirm that put pressure on ICU beds and critical care resources, because they don’t get near them.
– trace, track and quarantine will be easier to implement effectively, the lower the case numbers are.
– some kind of distancing (less restrictive than now) is still likely to be needed to support track and trace, until it looks like it can do it by itself.
– on economic policy, one glaring gap, that absolutely needs to be plugged to make track, trace and quarantine work, is better sick pay. Many low paid workers only get SSP, £95 per week, that’s clearly a massive disincentive to comply with quarantine. We need sick pay at 80% of full pay, similar to the other income support schemes.
I am sure most of these issues are being considered by the powers that be as they plan the way out. I expect that we will start to see step by step easing beginning around mid May. I have no idea how things will unfold over the following weeks and months, but like ermine, think the point of maximum risk for a second wave is the autumn/winter.
Hah, well I was trying to see the argument from both sides. 🙂
I suppose the fact that most countries (any?) aren’t doing a widescale demographic-phased exit from lockdown suggests you might be right.
Hopefully there will be a variety of approaches from different countries that the authorities can look at, so we might have a better idea of what does and doesn’t work if/when we do find ourselves having to repeat all this again in six months time. :-/
Another thing we’ll need to see is whether the countries similar-ish to ours (e.g. some in Europe) that have escaped very lightly from ’round one’ of Covid-19 do manage to keep a lid on the virus in their regions without any natural immunity, via existing practices and the sort of responses you highlight here. The fact that early successes Japan and Singapore have both faced big new outbreaks isn’t super encouraging.
I was listening to a podcast discussing some of the Chinese back-to-school measures, incidentally. They seem to be doing phased lunch breaks, segregation in common areas, and so on. I guess they’re not convinced that kids aren’t a factor to worry about, either.
It is no secret that I do not like the current government. And I am aware that this can colour perception of what they do. Despite that, I am still surprised that the court of public opinion does not seem to have turned against them. There appears to have been a litany of dereliction and missteps (amongst them, failure to stockpile against a pandemic per their own plan, the PM going serially AWOL from COBRA, a long delay in calling lockdown, misunderstanding of the role of testing, too late reversed).
On investment, I have seen the light, I think. Not quite Saul on the road to Damascus but there you are. So much investment discussion focuses on the long period of accumulation. Much less focuses on what to do when you have accumulated. I have been up and down the equities escalator many, many times. If (and I think they will over a couple of years) things bounce back and then go further upward, that is when I would move out of accumulation mode and go into preservation mode. Why? Because this time it occurred to me for the first time- what I am going through this for?
Preservation to me means an overall growth rate just in excess of inflation combined with low effect on value from equities drops. The portfolio I would adopt to achieve that would look roughly like this:
Equities (at least 2/3rds equity income) 35%
Straight government debt (10 year stuff; only half UK, non-UK Gbp-hedged) 30%
Inflation-linked government debt (same caveats) 30%
Gold Gbp-hedged ETF 5%
And then I can go and sleep peacefully.
UBI has been mentioned on a couple of blogs/comments in the last week.
This is something I find very interesting but I can’t see UBI being anything other than very basic (under £150 a week), and even that resulting in massive increases in income tax rates > 50% for everyone.
UBServices seemed to make much more sense. I’m keen to hear comments from our authors and commentators about their views.
How do you tell the difference between rational precaution and funk? I am 66 and intend to travel down to London next week for my daughter’s birthday. She is ultra cautious so I imagine this will be a 2m conversation across a front garden in Herne Hill.
@Hospitaller. I am in roughly the same boat, well I vesting wise. You sure about the equity income tilt as opposed to just the market? If you want income because you need the cash, why not just keep it as uninvested cash? Looks like you have the makings of a bucket strategy but without the cash cushion.
“Microsoft Word now flags double spaces as errors, ending the great space debate”
I don’t care who’s ‘right’ about this (except that I am) – if you’re above a certain age, you probably do doubles, and aren’t going to change. It’s dumb to ignore these people.
LibreOffice all day anyway.
I winced rather when I saw Neil Ferguson quoted as saying the r rate was 0.67 – it reminded me of listening to actuaries and the words ‘precisely wrong’ came to mind, closely followed by ‘is this chap really advising HMG?
My experience with actuaries, not a million miles from epidemiologists in intellect – ie both very brainy people with complicated models – is that when the data sets are solid and go back many years they are perfectly reliable in a ‘borrow your watch to tell you the time sort of way’, However, when the data is without much in the way of history and they have to fill in the gaps with assumptions and variables, as they do here, the forecasting quickly enters the realms of fantasy. The fact here is that we just don’t know enough about this disease to confidently fill in the gaps and I am supremely confident that Neil Ferguson will be miles out come the final whistle. I do wonder how much experience there is in government of being let down by these people – when it happens a few times one is inclined to review ones opinion on the usefulness of their expertise. I suspect too many politicians are overawed by them and that would be a mistake. Most on this board have trained themselves to ignore stock market forecasts and ‘unfollowing’ epidemiologists would be similarly good for ones mental health.
Incidentally, the only pundit I find worth reading is David Speigelhalter. He posts rarely but is measured as is rather saying that it will be a very long time before we really understand this disease.
PS. – I thought it was a considerable ‘PR Fail’ for the government to appoint Neil Ferguson as their epidiemiology front man. While I understand that academics fight like ferrets in a sack, it is evident that Ferguson has made some pretty wild predictions in the past and it was pretty naive of whoever made the appointment to think his wild and reckless past wouldn’t be scrutinised intently and then used against him and, by extension, HMG. It’s a British tradition, right?
I suspect the policy decisions taken by the government would be easier to swallow all round if they they had been supported by the work of a faceless nonentity with a blemish free record rather by someone with an erratic past who seems to be enjoying it all a bit too much.
I had failed to spot that the news item which eclipsed all others this week was the spacing one. For what it is worth I go for a single space after each sentence. Even though back in the dark age of slide rules I did a typing course which taught double spaces.
Thanks for the brilliant links as always. For CV, intrigued by such low child transmission if true. Of personal interest, since as mentioned in a previous thread we had skied in the resort where that chalet got infected (its name Les Contamines looks unfortunate) and the child mentioned did part of his schooling in the village where we stayed – and on a subsequent visit there was clearly no infection anxiety locally. Understanding the biological basis for that might be helpful in guiding therapy strategies.
The mutation analysis is extremely interesting in term of letting people track transmission connections. Obviously one can speculate about the very few which cause amino acid changes, but as a rule you would expect a reduction in virulence. From the point of view of virus evolution, a successful strain is one which reproduces best by infecting the maximum number of new individuals (natural selection). A strain which causes whole chunks of the world to lock down is not successful in that, a milder strain causing minor inconvenience like a cold which doesn’t change people’s behaviour is much more successful in allowing the virus to multiply. So fingers crossed mild strains will eventually dominate, though that does assume they create immunity to each other.
As a scientist myself I thought Jenny Harries was particularly poor in the government briefing tonight. She got herself in a pickle with a question about open air events, and pointedly failed to answer the very straight question of who is currently getting infected if everyone is observing physical distancing. The only poor excuse I can think of is that she was instructed not to give any clues about what the government might announce next week. Her counterparts the last two nights did better, Jonathan Van-Tam carefully stuck to the science not the policy when answering that transmission rates in the open air were less than outside, and similarly Steven Powis carefully did not defend a blanket instruction to over-70s but explained why those who had been singled out for “shielding” should continue to avoid risk.
On the investment front I sympathise with @PreKa. I can make my personal guesstimate of how the economy will pan out (which by the way suggests the first Swedish scenario quoted seems pretty good) but haven’t the faintest idea of what that means for equity values. As commented here before, currently in a fortuitous cash-rich position I continue drip-feeding investments just as previously.
For those who think I’ll be fine, just a cold etc watch out for Karma….. we could be reading your obituary soon.
Time is the cure, a combination of changes of behaviour, gently relaxed restrictions, improvements in understanding treatment etc life will move on.
We can read every article available now but the data is dodgy, it all takes time…
Stay safe, be patient, wait for the good times to roll!
Data from care homes shows that 4,516 out of 15,517 care homes (29%) in England have confirmed or suspected outbreaks of COVID.
On the subject of the definition of R0 and R(t) my understanding, and I may be wrong in relation to R(t) is that
R0 is the number of people that an infected person will infect on average when all the population is susceptible
Rt or R(t) is the number of people that an infected person will infect on average at time t (which will be different to the original R0 because of social distancing measures etc) but again assuming all of the population is susceptible.
Anyway let’s work based on that definition until someone corrects me.
The talk about getting R0 or more accurately R(t) below 1 is imprecise, although I understand why it might be done in relation to simplifying communications and messages.
Perhaps 12.5% of the UK population has already had the virus and are hopefully immune. We need to wait for serology results and immunity research to see if that is near the reality. If there is a second wave then maybe another 12.5% of the UK population will get infected.
At that point we don’t need to get ‘R0 below 1’ or ‘R(t) below 1’, because 25% of the population have already had the virus.
We actually need to get R0 or R(t) if you prefer below 1.333 at that point.
I don’t expect them to explain that numerically as explained above, but I would like to see the ‘experts’ acknowledge the concept that as more people have had the virus you can start to ease interventions to slow the growth, because of the herd immunity that is building up, even if we are well below the herd immunity threshold
When I hear explanations from the ‘experts’ they give the impression that if R0 is 1.1 (or R(t) less than 1.1) then we are doomed and the NHS will be over-run because of exponential growth. This isn’t the case as explained above.
What I am trying to say in words, is that things are less sensitive to the precise point at which one person infects one than the ‘experts’ are suggesting. If you take measures which accidentally push you just above the one infects one point, perhaps one infects 1.1, there is a spring like affect where more get infected, and the force of herd immunity gets greater and exponential growth doesn’t happen.
In other news, I watched Berkshire Hathaway’s annual meeting last night, which due to Covid-19 was no longer ‘Woodstock for capitalists’ but rather ‘Warren Buffett on a webcam’.
Two things jumped out for me.
Firstly, if you’re a market-beating billionaire with several decades of saying worldly wise things worth hearing behind you, you can get away with Microsoft Word slides in the default font on a broadcast watched by tens of thousands. Have a look on YouTube, it’s hilarious.
Secondly, Buffett clearly believes there’s a chance of a depression here. He spent 20 minutes talking about 1929 and the aftermath, and while it was couched as reinforcing his Never Bet Against America mantra and applauding the Federal Reserve’s recent actions, I don’t think it was an accident. He’s also managed to sell all his airline stocks (four huge positions, representing 10% each of the four leading US carriers). He sounded extremely glad he didn’t own hotels or casinos or cruise liners or holiday companies, too.
It would be too much to say that he sounded like he *expects* a depression. But I’d say he definitely believes it’s a non-trivial possibility, and feels the need to guard Berkshire against that.
I’ve never heard him sound so gloomy, and I’ve read all his annual letters going back to the 1960s. He is 89-years old, which probably doesn’t help, but still.
Given many medics post here (I’m not): I too was aware the typical care home stay was under 2 years (Passive Investor’s posts 23 and 36, though nursing homes will be worse than non-nursing care homes). Never end up in a care home is one of my personal amibitions/hopes (albeit all I can do is influence that risk by lifestyle). I do find it curious everyone’s rightly fearful of catching Covid-19. But less so, in terms of behaviour, the massively higher chance of developing dangerous diseases like cancer, dementia, heart disease, diabetes. Smoking, drinking, obesity etc. According to Cancer Research UK, 1 in 2 people will be diagnosed with some form of cancer during their lifetime. It kills about 62% of them. One in 3 will get dementia. (You’d have to google the stats for the parameters). Meaning 1 out of 6 will get both. If we could get the population to be as focused on their health generally as presently over Covid-19, think of the health improvements and economic benefits.
@Tony — I heartily agree with your sentiments, but of course healthy living is no panacea. Firstly you can be unlucky. Secondly, even if you’re not you still eventually become decrepit and end up needing care and dying of something. One ‘downside’ (perhaps unintended consequence is better) of our medical success has been more years of vulnerability to live through at the end.
(Absolutely not referring to you here but…) reading Twitter, columnists, even a couple of comments here over the past couple of months it’s hard to escape the feeling that the existence of death seems to have come as a revelation to some people. Perhaps modern society’s ability to shove it all away in an unseen care home or hospital wing is to blame.
I can’t see age-related lockdown easing working too well either. I think it would immediately go to ‘under 30s do exactly as they would like to’.
In my area, it’s rare for an under 30 to be physical distancing in public unless it’s controlled by security staff monitoring a supermarket queue. And that’s in a lockdown in a well behaved part of north London.
(I’m in my early 40s and not a curmudgeon).
@Hare — So much depends on whether we ultimately do need to see “most of us” get it or not.
If we can drive it down and then use contact tracing etc to keep ongoing cases in the low tens of thousands, then under-30 compliance is an issue because while statistically almost none will likely die in that scenario, they will be spreaders.
On the other hand if we do need to see say 50% or more of the population get it, then in theory we may as well let all the under-30s do what they want to do for 4-6 weeks while the infection is still raging and get it over and done with. In this scenario you would get deaths, several hundred at least I suppose, but remember the scenario is predicated on it being necessary for a lot of us to get it so many of these deaths would have happened anyway (ignoring likelihood of better treatment in time).
After that, you have a 20+ million people walking around presumed immune, who legitimately can do whatever they want as a result. They can work in the NHS. They can go to restaurants. They can spend money in pubs. They can cough in a lift or on the tube and it doesn’t matter.
The issue is of course we still don’t know whether a majority of us need to get it. Posters here disagree, but that’s no surprise because world-leading epidemiologists disagree, too.
@The Investor (69). Absolutely. I was just comparing the hugely different personal behavioural response to this pandemic with general (and also partly avoidable) health risks. It’s doubly relevant given 90%+ of UK deaths per the ONS stats are for those with pre-existing conditions. Obesity being a risk factor too. One obvious difference though is this risk feels imminent for people, unlike future cancer and dementia risk. However you live of course luck/chance and genetics come into it. And you can get run over by a metaphorical bus. Yes indeed, in developed countries, people don’t know death until they see it up close with a family member. There’s a great book by a consultant anesthetist, “With the end in mind”. Her experience is just what you say. Previously death was all around us, people lived in larger families and we died at home. Now it’s hidden away in hospitals and care homes. So when you see someone die for the first time, it’s one hell of a shock.
@TI – thanks for the timely update on Buffett.
For anyone trying to see what’s coming for the economy and our investments, I’d also recommend these recent pieces from Ray Dalio and the Economist:
@Sparschwein. Dalio is always a good read and he makes some excellent points. Historically his track remains remains good. In recent years, however, the performance of his Alpha fund has been pretty terrible.
In 1Q it lost 20%. In 1Q20 anyone operating a decent alpha strategy should have made a killing. Instead the Alpha fund was long equities and short Treasuries. How is that an “alpha” strategy? He was just long risk. He was even telling people it was stupid to hold cash. It might help he spent more time trading, less time lecturing other people and didn’t waste his PM’s time forcing them to read his book “Principles”.
“I think the policy of herd immunity is the right policy. I think Britain was on exactly the right track before they were fed wrong numbers [by Neil Ferguson].” Professor Michael Levitt
I see his physics degree is from Kings College rather than Imperial, so he must be right 😉
@ruby (61). I am fairly sure Ferguson said “0.6 to 0.7” (not “0.67”) I watched both interviews expecting to be much more sympathetic to the Swedish epidemiologist. In fact I found Ferguson much more impressive. He answered most of the questions about his modelling very authoratively. He had good insight into the scope of mathematical modelling, its limitations and the danger of psychological bias that someone in his position must be alert to (being inflexible in the light of new facts). On the detail of the hospitals not being overwhelmed the answer is that at least three in London were effectively overwhelmed and that with a doubling time of 5-7 days all would have been (even with the extra capacity) if social distancing had been delayed for a few weeks.
@snowman. The reproductive rate R is dependent partly on the biology of the virus (how infective it is, how it survives on surfaces, whether it is shed in sputum etc) and on the environment the virus finds itself in. R0 is just the reproductive rate in ‘normal’ conditions. For example for Sars Cov 2 (and I suppose most viruses) R0 was around 2.5 but if everyone stood 2m apart for several weeks then R (sometimes seen as Re – e for effective) would become 0.
R > 1 is always exponential growth but *exponential* growth describes the pattern (not the speed) of growth where the rate of growth is proportional to the size of the population. So exponential growth can start slowly where say the doubling time is 100 years or quickly where the doubling time is a few days. The point with exponential growth though is that the rate of growth will get faster and faster with time – it ‘tears away’.
Who knows when this will end but we can only hope that more people have immunity than we think, that shielding is more effective than predicted by Ferguson and @vanguardfan and that test trace track is effective.
I’d rather we didn’t get partisan about this, either by academic institution or by pet theory please. Let’s keep discussing the (various and contradictory 😉 ) facts.
I’ve noted before that my more outlying hunch (nothing more solid than that) is that extreme government interventions may not be actually making much difference to the path of this virus (clearly they must make some) although I was just basing that on a combination of eyeballing the numbers where the thing does get embedded, noting the insanely varied outcomes in different countries (e.g. Where is the Italy of Asia or Africa? It’s been *months* now – they’ve had time to catch up, surely? They have worse health systems in many instances), and also the way the causal narrative seems to mutate to fit the facts as they develop.
To give one example, we were told time and time again just ahead of our ramp up the curve that the reason Italy’s death count was so high was because their ICUs were overwhelmed and the excess had a massively higher chance of dying, and that we had to avoid this at all costs.
Well, AIUI our ICUs were never overwhelmed (I mean in cold numerical terms of beds — I don’t doubt for a moment individual testaments from health workers saying they were personally overwhelmed by the horribleness of it), there were always spare beds in critical care, and yet we seem to have ended up with a ballpark similar death toll on most measures. Yet we haven’t heard much discussion about that at all.
I’m not second-guessing those who suggested having spare critical care capacity wasn’t important… (1) maybe it was (2) it certainly looked like it was to a layman at the time (3) they know far more than me so I’m just making the observation.
But I think it behooves us to be open-minded about what’s going on here. And if a Nobel prize winning scientist thinks the same then all the better. 🙂
For example for Sars Cov 2 (and I suppose most viruses) R0 was around 2.5 but if everyone stood 2m apart for several weeks then R (sometimes seen as Re – e for effective) would become 0.
Viruses have very different Ro – measles is 12 for example but the “and I suppose for most viruses” was intended to refer to the effect of standing 2m apart!
@Passive, the SARS-Cov-2 R of around 2.5 is one I consider rather low. Flu is usually ascribed a lower value, but as far as I know that is for a population which will have partial immunity because so many people will have been exposed to a closely related variant.
The good news about that is that the amount of virus to initiate infection is probably less than the amount released in the very small aerosols in normal breathing, it needs the more virus-laden droplets spread by coughing or talking using certain consonants. And probably also needing several minutes of exposure. As well as reduced to almost nothing by 2 metres range.
(Personally I don’t see picking up from surfaces more than a minor component of infections, though it is clearly a risk in some clinical settings. But I could be wrong).
But, big but, my guess is that the value of 2.5 came from assuming all cases are symptomatic. Once you assume a significant proportion of asymptomatic cases, the chances are that transmission is higher, leading of course to higher exposure and higher potential immunity. I look forward to the results of the forthcoming random sample tests, especially using an antibody test.
New York’s Cuomo updated yesterday on antibody results. Unfortunately the percentage found to have been infected by this measure has gone *down* not up:
@ Passive Investor – maybe I misheard but my general point remains; Ferguson has a position (and history) to defend, and while and I wouldn’t expect him to yield easily I suspect he is going to be overwhelmed by the evidence and will not come out of this well. There’s an article the Telegraph this evening by Ross Clark which will only increase the pressure.
Apropos nothing – I see BJ gave his ‘death’s door’ story to Murdoch and The Sun. Got to keep him sweet for when he wants to encourage the masses to get back to work!
Why do you keep deleting my comments?
@TI Within London there is no doubt that ICU and hospital capacity was almost overwhelmed despite a rapid and massive expansion in bed capacity (factor of at least 3 in the case of ICU beds). This was heroic, seat of the pants stuff with barely adequate ventilators being brought down from the operating theatres, doctors who had done perhaps 6 months of ICU at some point in their training being re-deployed, highly trained ICU nurses looking after 4 patients with the help of only clinic nurses (usually its 1:1), physiotherapists turning (‘proning’) patients in teams, oxygen supplies almost running out, vital drugs and kit being unavailable and so on. It was a close run thing and there can be doubt that with two extra doublings of patients (within 10 days) we would have been the same as Italy and NYC. The reason that Excel was never used was partly because the exponential rise was switched off by social distancing or the lockdown (I accept that there is room for debate over which) and partly because there was a political tussle in the London ICU world. Many people had serious concerns about the quality of medicine that could be delivered in a field hospital and thought that Excel should be a last resort. The hospitals were asked and basically declined to send their staff to Excel as long as they had capacity in-house.
If the ICUs had been overwhelmed then our death rate would certainly have been even worse but as mentioned previously there were nationally only 9,000 ICU admissions half dying so 4,500 lives saved by ICU. In the context of perhaps 50,000 deaths this is clearly quite small so there are other factors in play. It is virtually impossible to make sensible comparisons between different countries with different death reporting arrangements so we will have to wait for seasonal excess deaths correct for age and other factors. (I am not optimistic that this will necessarily flatter the UK). The FT data team, John Burns Murdoch @ twitter are starting to do this (without demographic correction).
@Ruby I hope you are right about Ferguson being wrong (I think he said this himself in the interview). There are many uncertainties as @TI has described so he might be. To give just one example if cell mediated immunity (rather than antibody levels) is quite widespread and protective then herd immunity might be reached more quickly. I can’t help pointing out that the Swedish epidemiologist’s prediction of 13,000 UK deaths at most wasn’t too reassuring though. The one thing I did feel about the Ferguson interview is that as the bearer of bad tidings he has become a bit of a bogeyman in some circles. From the interview it was clear though that he is a (stellar) academic acting in good faith and doing his job, to advise policy-makers on the range of possible outcomes of each policy, to the best of his ability.
@TI Definitely agree about keeping an open mind and no harm in having Nobel Prize winners on side, though thinking of Long Term Capital Management perhaps not an Economist one 🙂
@TI. What I’ve heard from NHS consultants working in a number of London hospitals is that capacity was on a knife edge in early April. They so desparate for staff that one of my colleague’s sons, a 4th year medical student at UCL, was asked to do shifts for the princely sum of £11/hour!
@Ruby. We don’t have enough data yet to build good models. The confidence levels on the inputs are too low. I’m not really a fan of Prof. Ferguson but I think he’s fully aware of the limitations of his models. I respect him. I’ve said it before, epidemiologists remind me of economists. They job is make constant forecasts, so they build models to make those forecasts. Most are smart enough to understand how limited those models are, but that’s their job so they do it. If the people using those models to decide policy don’t understand their limitations that’s not the fault of the epidemiologist/economist. Perhaps if we had more scientists in government and less people with PPE degrees then perhaps better decisions might be made.
Compared to Ross Clark, however, Prof Ferguson is a wonderful human being. That’s the same Ross Clark who wrote in the Spectator on Feb 29 that there were “strong signs” the virus had peaked. There were about 86k cases then; it’s now over 3 million. Clearly his ‘model’ needs a bit of improvement. Then again Ross Clark thinks fossil fuel companies are “the unsung heroes” of the modern world. Enough said.
@ZXSpectrum – I remember Dalio’s “cash is trash” in Jan, and he got skewered for it, perhaps rightfully so. During Feb at least, a macro hedge funds with all their resources should have seen Covid-19 coming as a risk to “hedge”?
I think the inflationary scenario is convincing enough (25% probability?) but the bond market seems to think otherwise. Maybe expecting continued asset price inflation while no inflation in the real economy? Dalio’s piece doesn’t analyse the driving forces for one vs. the other.
Would be interesting to read other points of view.
@Penelope — They’ve mostly been the sort of comments that turn discussion forums into bitter places of nasty rows, and on the whole this site is blessed not to have those sorts of comments. Lots of people post one or two in their lifetime posting. Some people post them all the time.
As you’re new-ish commenting here you may not know the comment policy. It is basically I delete what I like on any reason I see fit. That’s it.
Most people never see any comments deleted. One or two get all the deletions in any particular period.
I won’t presume that you know this and you’ve commented in a troll-ish fashion on other forums before now, and hence had this kind of response before. Because I don’t know you specifically. But again, in my experience of moderating discussion forums for over 15 years now, that’s usually the case.
Totally understand this may not be acceptable to you, in which case feel free not to comment.
@Passive Investor @ZXSpectrum48K — Thanks for the extra information/colour! To be fair I did note I didn’t doubt the pressures on a personal level (perhaps should have added professional), and it was clear from the reporting that things were stretched. Your anecdotes make this clear, too.
However as I understand it (and I don’t think even @PI’s comments contradict it) we didn’t run out of ICU beds / treatment, even if it was a close run thing.
That distinction is not pedantic, because the point I’m making here is that the thesis 6-8 weeks ago (sorry, forget the specific dates now) was that Italy was seeing a particularly high death toll because of over-running ICUs meaning people who should be in an ICU were dying in corridors (and from media evidence they certainly were) because they couldn’t get such treatment.
Yet according to the data I’ve seen our death rates adjusted for population are close (423 per million in UK versus 475 per million in Italy according to this: https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/) despite them overruning and us not.
Of course there will be all sorts of reporting quirks and so on, but our rates at the least appear to be in the same ballpark compared to, for instance, Sweden at 262 per million, the US at 203 per million, or Canada at 99 per million.
My point is simply that what was presented as a *crucial* factor two months ago doesn’t on this evidence seem to be crucial, or a way of explaining the huge variations we’ve seen.
Again, I’m not saying here we shouldn’t have got more ICU capacity set up, that the Nightingales were some sort of unjustifiable panic (I think they were probably prudent, especially the London one) or that we shouldn’t have done the first full emergency lockdown — and certainly not that any of this would have been clear two months ago (when we didn’t have the deaths per million data!) looking at Italy.
I’m saying dramatic aspects of the narrative / thesis change (I still remember very early when there was debate about whether human-to-human transmission was possible) so we should be prepared (as I think we all agree) to see them change again — perhaps quite radically.
Viral titter? I’m with TIs elderly relative… I’m in early sixties and live in rural England. I’m sick to my rear dentures with the whole thing. Ok our roads are as quiet as 1959, so quiet this afternoon to afford a speeding delivery driver the opportunity to kill our dear old cat of past 10 years.
Mainly in reply to @The Investor and @Snowman –
I’m on the ‘Swedish side’ of the spectrum of “Which epidemiologist do you believe? [Sweden versus UK]”, and so I am still biased to thinking the IFR is on the lower end (0.1%) in more places than the higher end (0.8%) Could IFR in less dense regions be closer to 0.1 – 0.2%, and more dense plus co-morbidities 0.8%?
Reason I ask (and keep coming back to) is, what if there really were many more infections already all around many weeks before testing confirmed cases, and the lockdown measures were put in place on purpose only after some spread was allowed?
If a low end IFR of 0.15% is used on a few countries, it yields infection rates roughly as 14% for US, 28% for UK, and 18% for Sweden. Then for lower death rate countries, 6% for Germany, 7% for Canada, etc. I realize tweaking IFRs up and down from 0.15% to 0.8% makes all these vary a lot. I.e. if you set UK IFR to 0.3% then infection rate would halve to 14%.
Is there not some chance that it was for our own good the actual rates of early infection were not reported in the multitude of ‘tracker’ sites out there? I’m sorry if this sounds like the ‘noble lie’ aspect from Plato/Leo Strauss, but would make sense if it was for our own good – helps the lockdown narrative more on the government side. And it gives the West its first ‘dry run’ at this for if a truly deadly virus should come.
It all still boils down to me wanting to believe a lower IFR/more infected has happened already. I want to believe what @Snowman commented on – what if waves of 10-15% infection rates started before lockdown, varying by country based on co-morbidities/densities etc. Larger less dense countries need waves of only 6-10% (Australia, Canada), others need waves of 10-20%. I get odd replies when I comment that I am worried we (Canada) have not had enough infections.
And then Sweden ‘let’s just have one giant wave’.
@TI Just to confirm that as you say although a few individual hospital ICUs were overrun the whole system wasn’t (high numbers of patients were moved around London by specially set up teams). I think I might be missing your point here but doesn’t this just mean that our death rates would have been even worse if extra ICU capacity hadn’t come on line and the viral spread hadn’t been stopped?
As an aside I think much of the horror of the system being overrun wasn’t (contrary to Neil Ferguson) purely about numbers of deaths. It was about the psychological (and subsequent political) effects of people in advanced Western conurbations in the 21 century facing the fact that their healthcare system was back at 19 century levels of capability.
* I’m saying dramatic aspects of the narrative / thesis change* – I completely agree with you. In my area it became clear that many people don’t benefit from invasive ventilation for example. People used a lot of CPAP (tight fitting high flow face mask). Paradoxically this method of respiratory support requires much higher oxygen demand which was another unforeseen practical consideration.
The Swedish Epidemiologist, the Nobel Prize wining Chemist, John Ioannidis, Patrick Minford, Professor Raoult (notable but maverick French ID specialist) who all basically think there has been much more transmission than is realised and therefore the virus has almost run its course may still all be right. I certainly hope so but I am less convinced having seen the Unherd interviews. We’ll know for sure in a month or two I guess and until the end of this anyone who doesn’t acknowledge the huge uncertainties you have highlighted is being foolish.
@Passive Investor: Cheers for the confirmation. On this:
Yes, very probably! I guess I’m writing a lot of words with tons of caveats and as a result not being clear.
I’m just saying that the peak-Italian timescale conjecture for why so many were dying in Italy doesn’t seem to have been correct (or the whole story) when in our pandemic, given that we *did* flatten the curve to leave us with spare ICU capacity and yet we still saw a high death rate. There’s clearly some other reason(s), such as the structure of our societies, or pollution, or strains, or treatment protocols, etc, or of course as you say far more people having been infected in Italy and the UK and ICU treatment being not so relevant to who survives once they unfortunately get the disease.
On that last point, as you know mass unrealized infection has been my hope too, note least due to reading a couple of those people, but I have wavered due to what I see as low antibody rates in NYC (as posted earlier in the thread, now back down at just under 20% for NYC itself).
As mentioned in my article above, perhaps this could still be compatible with very high infection rates if lots of people can routinely see off an infection without producing an antibody response, but while I’ve seen some medics make suggestions of that sort, I haven’t a clue to be honest!
Roll on more understanding indeed. 🙂
On inflation, why doesn’t “printing money” cause prices to rise? As there’s more in circulation, it feels like every unit should be worth less (cf Germany in the 1930s – yes my economics education came from school history books!).
I find the monetary system deeply unintuitive, especially if it’s not a closed system. Can ppl give me recommended reading?
On Nightingale hospitals, I have a relative who has been on the team planning a yet-unannounced hospital. My takeaway is that different parts of government are responsible for saying “let’s build them” and “do we need/can we staff then?”. It was prudent to create extra capacity (though think about who’s going to staff it first!) but the optics of “being seen to do something” – especially in light of the Chinese hospital builds – should not be underestimated.
@Indecisive — On inflation, there’s a long complex and doubtless more correct answer that I’m ill-placed to give, and then there’s a short answer.
The short simple way to think of it is that massive deflationary forces (technology, aging, globalization, debt) are offsetting any inflationary stimulus. In addition you note “more in circulation” but it’s worth exploring whether there really is more in circulation. Velocity of M1/M2 money has been very clearly at historical lows in the US for instance, suggesting most of it isn’t whizzing about the economy being spent by consumers. This suggests its sitting around somewhere. It’s another of those mysteries of current times; explanations may include bank or even corporate hoarding (regulation / post-crisis lack of demand for credit) and not enough money getting into the real economy / workers (inequality/1% etc).
I certainly see the pandemic as deflationary in the short to medium term. Eventually perhaps inflationary if we (societies) inch towards that being seen as the only way to get out from the debt burdens, for right or wrong.
@TI I don’t think significant population levels of non antibody mediated immunity is a completely forlorn hope. I can’t speak with any authority though as Immunology definitely not my thing!
@Passive Investor — Fingers crossed! (Also thanks for the various comments from the medical field on this thread, interesting!)
This was an interesting, and sobering, read. Worth bearing in mind that the Chinese almost certainly know more about the virus than anyone else (although, they may find it harder to accept and adapt to changing data if it contradicts their current approach).
On epidemiology 101, I’d be careful about reading too much into comparisons between country level mortality rates. Of course we all try to wring out as much as we can from the scraps of data that we have, but I suspect it’s almost meaningless. Firstly there are the obvious likely differences between recorded covid deaths – excess death comparisons would be more valid. Perhaps more importantly though is that you can’t ignore the clustering effect of the virus spread – it’s not a steadily rising tide, it’s a series of connected forest fires, if you will. So a better comparison would be London vs Milan or Madrid (though I could only find Lombardy level death numbers, that gives roughly 14,000 deaths for 10m, with London on 5000? for 8m – though figures may not compare as Italy always included care homes). Even in London however the mortality rates vary four fold by borough. In any event, it will take a lot more detailed analysis to work out what health care interventions and approaches may or may not have saved lives, and how we compared to other countries with different systems and approaches. I know nothing about Italian or Spanish healthcare systems. I was however struck by how our public messaging has been all about keeping people with symptoms of Covid away from the NHS unless/until they are in extremis – in the final analysis, my hunch (no more) is that this may have avoidably cost lives, even if it did spare the relatively few hospitals that were overwhelmed, in this first wave, from worse.
But I’m possibly channelling TI now when I ask, have we imposed a nationwide shutdown to deal with a surge which only really threatened London? It wouldn’t be the first time our government appears, from afar, to be by London, for London.
So perhaps geographical approaches to easing lockdown make more sense than age related approaches – they certainly seem more practicable. But we seem peculiarly resistant to travel restrictions as part of our toolkit, in contrast to many other countries.
Thanks @Passive for the insider story. It is rather what I suspected, the NHS couldn’t have managed another doubling of numbers without huge risk to quality of care of the most ill.
It also underlines the way the government didn’t realise the scale of the problem until almost too late. In some ways the fact that Neil Ferguson’s model was flawed (as all models are until too late to be of predictive use) didn’t matter, its success is that he eventually made Johnson see the inevitable outcome of exponential rise. If there had been lockdown at the point when working from home was suggested, a week before the actual lockdown, UK deaths would have been less by at least 2-fold.
@Indecisive, I am also struggling to get my mind round the likely consequences of the monetary intervention. I wonder whether one factor is the fact that most countries have done similar, a lot of measured inflation comes from changes in exchange rate due to relative strengths. And there isn’t a supply and demand imbalance (except in PPE where inflation has apparently been rampant). But as you can tell, I am no economist.
Ratesetters rates are not set!
Ratesetter should honour the fixed accounts interest at least I think
I put 10 in to get the 20 bonus but its taking forever to withdraw, clearly the company doesn’t have much of a seperate float to settle transactions, I’d be dubious anout that level of p2p risk for such returns even before the cut
@TI – I’m with you, insufficient data to really get a sense of how successful any country has been – and until it’s over (2nd/3rd wave?) any analysis and judgement is premature, despite the pressure on media and social media to confirm personal biases. I’ve a great deal of respect for John Ionaddis and other experts but we are all in the dark at the moment. Lots of armchair virologists and epidemiologists on social media right now!
Having just finished a long shift in an NZ hospital all I can say is we have been lucky and well served by Jacinda and her coalition government so far. We’ve not been under the same pressure as other countries and our clusters of infection (and mortality) have been limited. Nursing homes sadly affected even here (and I’ve a 90 year old father in a Welsh care home). Closing our borders and having mandatory isolation to travelers from late March has possibly been one of the positive factors as well as our own lock-down which will have negative economic consequences. I find it difficult to understand how movement has continued into the UK through airports for so long…
Maybe long standing UK pandemic control plans lacked international travel control mechanisms but I’m reminded of the title shots in the old TV series “Survivors”.
Personally I find ourworldindata.com a really good resource on this and other issues.
If this sustains, it is massive in terms of public health upside:
A reminder that not all unintended consequences are negative!
MMM (merely Monday musing), and not meant to be in any way provocative or sexist, but there is one of the various government ministers who have presented the daily coronavirus briefings who has irritated me, whilst in my opinion all of the others have done acceptably well, or very well in the case of Matt Hancock. In my experience it is not at all easy to be reading from a detailed written brief and yet be making good head up eye contact with an audience (or screen), and bar the one exception I have been impressed with their handling of this.
The irritant is Priti Patel, and the irritation is her constant omission of the “g” sound when pronouncing any word ending in “ing” – e.g. “tryin”, “aimin”, “workin”. When listening to her, I quickly reach the point where I am concentrating more on hearing when the next “g” is dropped, dare I say the g spot, rather than what she is actually saying. She must either know that she is doing it, and not be bothered about it or not be able to eschew it, or not know that she is doing it.
Either way, I am genuinely surprised that a senior minister has this problem.
@Passive Investor #95
This – absolutely, for me. Just before the lockdown I came to the conclusion that for the first time in my life, there was no medical assistance available in the UK. And that really wasn’t a good feeling. As my aged mother said on the phone yesterday, this in the first crisis I have seen in getting on for sixty years of life. I don’t have need of medical assistance, so far touch wood. But the world felt a much more fragile place – there is always the risk of an RTA, even in gardening taking a prick from a bramble and the resulting bump that always goes down there is the what if it doesn’t? In February we chainsawed down a diseased apple tree. We wouldn’t have dreamed of sparking that chainsaw up now.
That feeling is widespread, though it appears unfounded, a a google search on NHS we are still here for you I am still not sure I quite believe it, but the message seems consistent.
@Factor — It annoys/pulls at me too, but lots of people in the UK talk that way and if she’s able to handle her brief then fair enough I say.
I don’t think you need to be insanely woke to see that our lawmakers in Parliament still don’t reflect the nation’s demographics. Getting to a point where they do will no doubt involve listening to lots of people who are far from 1950’s BBC RP! 🙂
@ ZX Spectrum – I think you’re absolutely right about the shortage and reliability of the available date and the confidence, or otherwise, we should have in the outputs. However, humility is not the defining characteristic of the very brainy modellers I’ve come across and I think there is a tendency for them to fall in love with their own models. This lack of awareness of their own fallibility has encouraged the media to take the outputs as gospel and to launch it’s reign of terror. I bring no scientific expertise to this debate, just weary cycnicism as the failings of models, but we now see perfectly healthy under 40 somethings, who are at next to no risk for this disease, more or less barricading themselves in there homes as a consequence of a modelling construct. My favourite stat in all of this, uncorroborated, is that the under 40’s are at greater risk of dying by their own hand than due to COVID-19, yet still they support a draconian lockdown. This doesn’t seem terribly normal to me and how the government and media prise them out of their homes and encourage them to return to being productive citizens will be interesting to watch!
As long as she doesn’t start rappin’ 🙂
@Factor and @TI
Tony Blair was purposefully dropping his Gs twenty years ago in the the belief that it made him sound like a man of the people. I dare say Priti Patel is doing the same. It’s the artifice rather than the accent that annoys.
Nicola Sturgeon in her daily Covid-19 briefings always amuses me when her excellent educated Scots lawyer accent occasionally reverts to her native Ayrshire. She pronounces “yesterday” as “yisturday” and “next” as “nixt”, etc. I love it.
Firstly thanks for all the informed and respectful debate. A few thoughts
1. while death rates for COVID are low for the under 50s, it can still be a pretty nasty disease. Anecdotes are not data, but around a dozen of my colleagues in the 30-45 (and healthy) age group have had it. Of that dozen, one needed hospitalization, and two needed paramedics due to breathing difficulties. There are risks to healthcare systems of going for herd immunity.
2. Yes, the NHS is still there for you. A&E attendance is way down, there’s doctors and nurses who have nothing to do. I hope we can get the non-COVID NHS back to full speed soon, to save other lives.
3. This is just wave one. We may yet need those Nightingale hospitals for the second (or third) wave…
4. I would not want to be the expert trying to draw conclusions as to what works and what doesn’t, what should be done when and so on, with the different testing and statistics standards in different countries. The final reckoning of what worked, sadly, will not be for a couple of years at least.
@Vanguardfan. Re smoking, well the world loves an optimist but it wouldn’t be the first time the Guardian got the wrong end of the stick!
The Economist seems a reliable source and it has lowered the paywall for the Coronavirus tower of Babel eg
The Gangelt (Nordrhein Westfalen, Germany) serology study has now been released
You can access an English translation by downloading the pdf at the end of that link
The study seems to have been very well performed, within their practical limitations, to my uninformed view
The discussion is very interesting, and it’s all very readable for a layperson such as myself. It talks about the accuracy and specificity of their antibody test, amongst other things.
They speculate why they observed relatively low within household spread
“Secondary household members may have acquired a level of immunity (e.g. T cell immunity) that is not detected as positive by our ELISA [enzyme-linked immunosorbent assay], but still could protect those household members from a manifest infection ” (page 12)
A comment above talked about the possibility of this T cell immunity also.
And then talking about the past infections that the antibody test might have missed they speculate
“Likewise a lack of virus neutralization does also not exclude a past infection as there is ample evidence that not all antibody responses neutralize but still may provide some degree of protective immunity” (page 12)
They speculate that increased viral load might explain the worse severity of symptoms identified, in those who attended the carnival vs those who didn’t (and tested positive for antibodies).
Anecdotally my brother-in-law almost certainly had the virus, but my sister and nephew who live in the same household and share a bathroom and towels didn’t have any symptoms at all.
I’m coming to the view that there may be more immunity out there than serology results are indicating. That’s a gut feel; it’s uninformed speculation on my part. And it may be just wishful thinking. But that’s what I’m thinking. Let’s see what the data says when it comes in.
Delayed response, been in the queue at Morrisons at a tactically advantageous time because many folk are chez eux, hunkered down for their lunch, and so only three in front of me. I lived and worked in Auckland for a while, back in the day, and sounding “e” as “i” is a standout Kiwi trait, e.g. “yes” is “yis”, and which mannerism of speech is an easy way for me to distinguish them from Aussies.
@ Snowman #111
Is there an analogy with polio (sometimes known as infantile paralysis)?
“Polio is a serious viral infection that used to be common in the UK and worldwide. It’s rare nowadays because it can be prevented with vaccination. Most people with polio don’t have any symptoms and won’t know they’re infected. But for some people, the polio virus causes temporary or permanent paralysis, which can be life threatening.” https://www.nhs.uk/conditions/polio/
FWIW my twin brother and I shared a tiny bedroom when we were young, barely large enough for our two small single beds, and all the facilities in the property were shared by us and our parents. He contracted polio but I didn’t. Fortunately though, the paralysis in his left leg disappeared completely after a year of physiotherapy.
Sorry I’m not a virologist and don’t really know anything about the polio virus to be able to sensibly comment on the similarities and differences between the two viruses, although there is that similarity that most seem to have mild or no symptoms.
But let’s be grateful all the evidence is that coronavirius isn’t a problem for children, except in rare cases, thank goodness, unlike polio where a significant minority were badly affected before vaccination.
But glad that your twin brother’s paralysis disappeared.
I see the daggers are coming out for Ferguson, even on here. Case of shoot the messenger I suppose. Looking back to his original paper, I find it interesting that the way things have panned out pretty much match what would have been expected given the measures introduced. Better in fact, which can be explained by better than estimated level of observance by the population. He may have just got lucky of course and there are other speculative explanations that may also explain the observations, such as higher R0 and higher proportion of asymptomatic infections. Far to early to write off Ferguson just yet though IMHO.
@Mike, the only cases in the 30-45 (and healthy) age group I personally know of are my next door neighbours. There kids laughed it off, husband described it as unpleasant, but the wife was knocked out for nearly 2 weeks. She described it as the worse illness she has ever had. Worse than a bad flu she once had which lead to pneumonia.
@snowman thanks for German study link. Their takeaway estimates from this hotspot were IFR of 0.37%, 20% estimated asymptomatic infections, and 15% population prevalence of infection.
Also no significant difference in infection rates by age (although there weren’t very many under 15s in the sample, only 6%, but for sure there were infections in the kids).
@vanguardfan. And the German population was quite elderly compared with the UK with about a 1/3 more people in the above 60 age group (36% vs 27% from memory). This is the group where by far and away the most mortality occurs. Seems moderately good news implying significant numbers of infected (and therefore hopefully immune) in the UK.
Curious bit of news from France:
Anyone else following what Belarus are doing?
Not suggesting what they are doing is a good idea (and I’m not just talking about the drinking vodka to protect you from the virus suggestion!), and obviously good luck to everyone living there, but given they’ve taken that approach I think it should be informative in understanding the virus spread to see how it turns out.
p.s. talking of drink I’ve just had a crate of beer delivered from the local brewery, you’ve got to support your local businesses in these tough times (ha ha)
@Snowman — Fascinating as usual. Wikipedia tells me the population of Belarus is 9.5m. According to Worldometer they have had positively confirmed 17.5K cases and 103 deaths, versus our near-200K positive cases and 28,734 deaths.
So while the Guardian talks about infection per capita you might look at deaths per million — 100 per million or so on the face of it, versus our 428-ish per million — and say it’s not doing too badly.
However obviously both infections and deaths data come with the usual bucketful of caveats in all cases, and I trust our stats over theirs.
It’s very easy to Google at least one outlet claiming the authorities in Belarus are not counting Covid-19 deaths properly:
Still, squint a bit at the graph and officially confirmed +ve cases seem to be plateauing. As you say good luck to all those there, be interesting to see in a fortnight either way. 😐
> I’m not just talking about the drinking vodka to protect you from the virus suggestion!
I dunno, beats the living crap out of drinking disinfectant, which is a different way of cleaning out yer insides promotes recently. Treatment was totally successful Mr Prez, not a shred of Covid-19 in him. Unfortunately the patient died.
Compared to that C2H5OH is looking a dead cert. You’re at least in with a chance of waking up the next day, even if you feel like a bear’s armpit 😉
And Belarus is the only country in Europe still playing league football.
Y. That article on the French finding a case from December is what I would expect due to the number of of people who appear to be asymptomatic and with an incubation period to boot.
My guess is that the more evidence comes to light the more the behaviour of the Chinese and the WHO will look insupportable as they suppressed information at a critical time. The Taiwanese unsurprisingly have no trust in the Chinese government and reacted accordingly.
Ratesetter cut their interest rates by 50% in expectation of loans going bad.
I took out a big chunk away from these guys last year but my withdrawals since the pandemic have frozen up now. Fortunately all my money is in their legacy high interest account and has been slowly dribbling into a holding account as the loans mature where I can withdraw it and whisk it away. However what comes next?
Still the 19th c here in the US! Some 30 million American workers (including myself) have had a sudden unplanned reduction in employment recently and with it lost their employer-linked healthcare. Risk has a very tangible edge now, I’m weighing every activity in and outside the house for probabilities and consequences.
I’m starting to wonder what the public sector (in both countries) will look like over the next few years given the cost of fighting this disease. Another decade of austerity with frozen or reduced benefits and wages, and the final death of db pensions? Hopefully some lessons were learned following the GFC.
Very interesting that reported French case from 27th December, where his last overseas trip was to Algeria in August 2019.
The pre-print of the study from the hospital is here
I would like to see them do an independently performed antibody blood test on the patient’s blood now (and his child also) or better still a series of tests now to see if antibodies are present and waning over time given he survived the virus and was discharged and is presumably alive. Given he was hospitalised you imagine he will have detectable antibodies. And that might weight the probabilities as to whether he did indeed have the virus or whether there was some mix up with the sample before it was examined by the two different techniques and staff.
Interesting to see this advising face masks from a group called DELVE (data evaluation and learning for viral epidemics) who are one of several groups feeding in advice to SAGE.
No idea what the position is of other groups feeding into SAGE.
I’ve been in contact with a couple of neighbours who are over 70 and have no pre existing health conditions and so in the clinically vulnerable category (I think).
As well as hearing about some of their life stories (never really had the chance to have an in depth chat before), one of them has been making some cloth masks and gave me a couple of very colourful and stylish masks, which I thought was totally brilliant and a lovely gesture. Unfortunately they are so stylish and colour co-ordinate so well with some of my shirts that it may mean I go out a bit more to show them off, so perhaps there is an argument against face masks after all!
ONS weekly statistics for England and Wales out again
11,540 excess deaths registered in England and Wales for the week ending 24th April (week 17), over the 5 year average of weekly deaths.
That’s gone down slightly from 11,854 the previous week (week 16) because hospital deaths peaked on 8th April and so reported deaths generally are those after the peak.
However it hasn’t gone down much because care home deaths registered (all causes) have gone up from 7,316 (week 16) to 7,911 (week 17). And this almost cancels out the fall in hospital deaths.
So looks like hospital deaths did peak around 8th April, but there appears to be a later peak happening for care home deaths.
And over the past 4 weeks to 24th April: 37,400 excess (registered) deaths have been recorded in England and Wales
Any immunologists in the house? I’m curious about the relationship between anti-bodies and T-lymphocytes and whether memory T-lymphocytes can survive longer than anti-bodies. Is there much testing being performed for the presence of memory T-lymphocytes for SARS-CoV-2 in the general population or, indeed other than those seriously ill, who I read have reduced levels?
No pet theories here. Perhaps just ill-informed grasping at straws.
Apparently there are vastly more annual global deaths from malaria or road deaths than the equivalent from what is being claimed as exclusively from this current viral threat. Yet the former are seen as incurable (as flu was until recently) and the latter are accepted as an unfortunately necessary price of our modern way of living. But inconsistently neither are considered justifiable to excuse shutting down normal life, destituting the vast majority of the people and consigning personal freedom to history.
In most of our societies, given the inequality we accept, a small percentage of people own most assets. The value of those assets, lets use a yacht as an example, is whatever the next buyer will be willing to pay. So if it was 100k yesterday, but today a lot of the pool of millionaires who are the only putative buyers put off buying due to uncertainty and some want to sell to settle margin calls, they may be forced into fire sales. The average price is then dragged down and you get a negative spiral, with anyone at the margins pushing the price down when a forced seller, as they still have to pay fixed costs like marina fees and maintenance, while earnings may be down.
With every additional week of lockdown, this spreads like cancer (how many is that still killing these days?) through the economy. And not just with luxury goods, if you lose your job, max out credit cards and the oven packs in, you have to make do with the hob alone. In time all consumables enter the deflationary cycle as demand collapses. The past shows that people will only start thinking in a cost/benefit balanced way when the pain hits them personally in the pocket, whether untargeted lockdown is really worth it.
I seen clips of that letter.
Maybe he’s just feeling down cos hes lost billions selling his airline stocks.
He also said hes not buying atm cos nothing is cheap enough but is ready to if hes sees a bargain.
Hes very old now aswel.
He DIDN’T say, it’s over, every one sell up and go to cash and bonds. The best has gone, there’s no more money to made in the stock market, its finished, did he?
On the contrary, he told us to carry on. Stocks were better value than bonds and US will rise again.
Fascinating interview of Professor Hendrik Streeck on his recent study in Germany. https://unherd.com/thepost/german-virologist-finds-covid-fatality-rate-of-0-24-0-36/
Lots to think about here, but for me the biggest take away is that we are likely to have adapt the way we live as we may end up living with this this virus for a long time. Herd immunity not guaranteed, vaccine not guaranteed, so mitigation the best we can do.
I was surprised to hear WB held any airline stocks. In the past he has been less than complementary about them. They don’t have the characteristics he typically looks for, such as moats.
@Naeclue — The airlines are much transformed since the old days. Returns on equity have been brilliant for the past few years, due to consolidation, load factors (how many people you get on per flight) and more rational pricing (actually selling first-class tickets instead of freebie-ing them away). They were still ‘cheap’ last I looked because they hadn’t been tested in a recession, so the market wanted to see how well they’d really changed; as you know they’ve been notorious for blowing up for many decades.
The trouble is the global lockdown / virus threat is unprecedented. The former has blown up the short-term economics, the latter has blown up the business model. It’s just about conceivable to imagine how a hotel can re-open in indefinite social distancing. I can’t imagine personally how an an airline can — even if it could prove upgraded air-con filtered out all the viruses, you’d have to distance between seats (which will destroy margins), not to mention at the airport itself.
Some sectors just weren’t built for this current reality, and airlines are one of them. Sit down restaurants are probably another — they can reopen but if they can’t crowd tables they’re not likely to be profitable IMHO.
I could go on and on, and it’s why I’m more gloomy about the economy — unless we get that speedy resolution to the virus that I was hanging my speculative hat on pre-NYC antibody testing coming in high in media’s eyes but low in my thesis/hopes. (Still haven’t totally lost hope, but definitely downweighted the probability in my thinking).
If all these measures result in say 20% of lost GDP and responses can only restore say 10% GDP (e.g. High Street retail versus online delivery, with associated job losses/gains) then we’re in an ongoing 10% recession which is ruinous for most businesses.
I still don’t think most people get just how bad from an economic perspective lockdown already has been, and any heavy ongoing semi-lockdown won’t be pretty either. 🙁
@ The Investor – I found Uncle Warren’s comments a little depressing; not so much that he was revisting economic calamities from the past but the tone seemed rather valedictory to me. Arch rationalist that he is, he is presumably thinking about whether he’ll actually live to see normality resumed and is noraml ebullience has been dented by this not how he wants (perhaps!) to sign off .
I cycle around London (once a day – promise) and agree with your final two paragrahs completely. The number of shops, pubs, restaurants that are shut is quietly terrifying and I’m gloomy about the prospects for many of them. Quite a lot has to do with confidence I suspect and HMG and the media really have done their best to hammer that out of us. It’ll return, of course, but in the meantime I’m braced for a social and economic catastrophe in this country.
That interview with Professor Hendrik Streeck was well worth listening to. A lot of food for thought, nuanced, no ad hominem snipes and not much, I with an over-active bullshit detector, could question. I did wonder whether the sample size he used was large enough to draw such a narrow range for IFR c. 600 people (c. 900 including others in their households). I wondered whether, given that his representative sample was from a fairly small geograpical area, local environmental or genetic factors may have influenced the findings. I also questioned his suggestion that lockdown measures should/could have been introduced incrementally so that we learnt what impact each measure had; however, I’d have thought that the perceived risk in mid-March of doing that was too great but I may have misheard or misunderstood him. I hope that scientific and public health advisers listen to this.
By strange co-incidence, he even mentioned T-Lymphocytes which I referred to up-thread.
Thanks. Very interesting that interview with Professor Hendrik Streeck.
It would be nice to think someone like this was advising the UK government.
So much knowledge, and such a creative, open-minded and clear thinking approach to identifying strategies to tackle the virus. Lots of ideas, but with an insistence that any approach needs to follow the data and adapt to the data.
If only Professor Streeck were Chief Medical officer not Chris Whitty
@GOP, my take re the staggering of the population control measures was that Streek was talking about Germany, where the advance of the epidemic has been somewhat more sedate than in the UK. We tried staging (our plan envisaged gradually increasing measures over a number of weeks) but were overtaken by events.
Very interesting re superspreading events. 40% of carnival-goers infected! So I think we can wave goodbye to any large gatherings, with singing and shouting and drinking, for quite some time. And it’s clear that the ski resorts of Europe and the half term holidays were a key factor in the takeoff of the Europe/UK epidemic.
@Grumpy Old Paul
I’ve also been trying to get some information and read up on T cells.
This article seemed to explain the 3 stage approach of the body to fighting infection, but no idea how accurate that is
Cell mediated immunity is the second line response described there that includes T cells and there seems to be a reasonable wikipedia article on that
But yes it would be interesting to hear from someone who knows something about the subject to explain what the immune responses are, and what the immune responses might be specific to covid-19 and to what extent each stage in the immune response might or might not provide some immunity or partial immunity.
There’s no need. The WHO tells us recirculated air is just fine, and recirculation kills viruses too. To wit:
Of course, when the person in the seat next to you breathes out you get a slice of the action before the ventilation system gets hold of it and all bets are off, particularly since in my experience airline vents blow air at you rather than suck it away from overhead your seat position.
I do not find the prospect of 75% less air travel distressing, however. It’s an ill wind etc.
Looks like the economy first version is going to be battle tested in the US. Results should be in by November, I figure. Perhaps it’s time to lay some money on the conviction that the coronavirus mortal hazard is 0.1% and that most people have had it and are asymptomatic.
VUSA.L stands at your service and is ready to receive funds tomorrow. It’s a big bet, but as Warren Buffet said, never bet against America…
It seems important that the virulence of the infection is probably proportional to the amount of virus that the sufferer was exposed to (the ‘viral load’). This explains why NHS staff (and especially ENT surgeons) have had severe illness and died, because they are exposed to so much of the stuff.
However, for those of us lucky enough not to be on the front line, social distancing measures mean that if we do come into contact with the virus it is likely to be only a small amount (the breath of a passing jogger, a trace on grocery packaging, etc.). This should only produce a mild infection, which might tickle up the T-cells and protect us from worse in future.
I suppose this is really only a paraphrase of the final paragraph of the Unherd article.
I’m sympathetic obviously, up to a point.
I watched our briefing today and the scientist up with Raab showed the slide with all public transport flat-lining near-zero but motor vehicle traffic very slightly up after six weeks of lockdown, and she said it that (microscopic) increase had her very worried.
Perhaps she has to say that, but I hope it didn’t.
You “hope she’s not worried” because you hope it’s not worrying, or hope because you think she’s foolish to worry?
I’m now doubting myself, perhaps she didn’t say “very worried”, but just “worried”.
But my argument is more appropriate would have been “that’s something we’re watching” or “we need to see why this is happening” or even “we don’t want to see this and will closely monitor the consequences”.
I guess we’re probably not going to come out of lockdown in the next few days, perhaps not even for another three weeks, but even if that’s true (and I think it’s too long if there’s literally no change) we need to start de-terrifying the public, and perhaps de-terrifying the scientific advisors, too.
As Christie says, there are consequences to living in a bunker indefinitely. If we agree we can’t live in a bunker indefinitely then we need to start thinking realistically. We can’t be up at night because very slightly more cars are on the road six weeks after the meteor impact of the imposition of lockdown.
@Duncurin — That will be hopeful if true (and has always seemed likely, even a family member of mine, a nurse, thought it likely two months ago) although it still presents big some issues obviously. I think we could limp on for a year without football games and rock concerts, trade conferences maybe, possibly even the pub, without deep economic damage, but we probably can’t live without mass transit.
I suppose masks will help, as per the link someone usefully shared earlier up the thread.
Anyway, do you have a link for that ENT surgeon comment? I’d like to see a source before I repeat if possible. 🙂
@TI scientists advocating your favoured strategy. I still think it’s unworkable.
But I’m beginning to feel that any strategy that requires more than a 3 word slogan is beyond our government’s competence. The app seems massively open to abuse and mischief making. And I have read that Serco have been awarded the contract for 15,000 contact tracers.
Meanwhile the public are being strung along without an adult conversation about how we are going to move on.
@TI. I thought Prof Dame Angela McLean, the deputy chief scientific adviser, said of the transport figure use creeping up “It does trouble me”. Let’s face it, today was the day the UK achieved the worst headline figures in Europe and the second worse globally after the US, a country with 5x our population. McLean is part of the adminstration that delivered that result. Whatever the eventual reality, this isn’t a good look. So she’s probably a bit sensitive to anything that could imply the numbers are going to look even worse!
As for Prof Streeck, he makes a lot of sense in many areas. Except for bringing in the lockdown measures more slowly. Counterexample: Australia, 40% of UK population, very urbanized, closer links to epicentre China, total deaths so far 96. They went into lockdown 23 Feb, 1 month before us, and they actually bothered to close the borders and quarantine people. Active cases are < 1k vs. UK with 195k. That allows sustainable track and trace. The UK totally failed in comparison.
Aside from that I agree very much with Duncurin that viral load is probably a key factor in terms of whether you get a mild or severe disease. While there is some attempt to pin differences in viral load on variations, it's still seems to me that the biggest issue is being exposed to many possible people who carry the virus in a short period. But Vallance keeps repeating that only 10% of London has been exposed. So I don't see how London comes out of lockdown, unless they can get past the issues of crowding on mass transport etc. In other parts of the country it may be far easier.
@ZXSpectrum48K — I went back and listened again. Prof McLean shows the slide and says “We do worry about that creeping up” then talks about how staying home “has worked to protect the NHS and save lives” and then says that as someone who looks at that data and thinks about how it fits into her understanding of the virus, “it does trouble me”.
The YouTube video weirdly cuts off literally the moment after she says “it does trouble me” at 15m 30s. I can’t remember if she said anything more in the live broadcast, worried or not, after this! 🙂
I don’t want to micro-obsess over the particular word, because we all use words that may not precisely reflect our meaning and it’s a bit of a bugbear of mine the way people are hung out on a word these days.
And I suppose she’s being consistent with her hypothesis which is max lockdown is max saved lives is max best policy.
But as you know I have some issues with that, in the big picture long-term sense, so I suppose her leading with this graph bugged me and amplified her use of “worry”.
I don’t think it was (or should have been) the most important statistic of the day. It seemed almost childish.
Otherwise, I found her quite likeable and brisk.
Here’s the briefing: https://www.youtube.com/watch?v=dWSY9AyOslM
Regarding when the lockdown was implemented, I don’t get it either. If you’re going to do a max lockdown, surely you should do it ASAP? If that’s the theory and strategy delaying makes no sense. I guess the inference must be that they weren’t going to do full lockdown, as per the rumours. Not great to see scientists brought into this politicking if that’s true.
I was discussing that Nobel Prize winning (Chemistry) dissenter from earlier in the thread, and a friend was saying the scientist’s theory made no sense because it implied lockdown wasn’t needed as the virus would have stopped being exponential anyway, and yet (my friend said) there’s a clear correlation here and elsewhere between lockdown and then the curve going down.
Of course that could very well be true.
However for the sake of the discussion I pointed out another explanation, which is you need to get to something that looks scary and exponential before you get the political cover/pressure to impose a full lockdown and “do something”. So that could be another reason for full lockdown being what appears to turn the curve down.
Of course having a full lockdown must slow the infection spreading, but to what degree and at what cost?
I wish there were a few more Swedens and even (unverifiable dictatorship though it is) Belaruses in the mix we could contrast with. Anyway I hope our epidemiologists are comparing different strategies and outputs, rather than genuinely worrying about a few more motorists, or (per that last link from @Penelope) telling everyone to do one thing while doing another themselves.
p.s. Oops, forgot to say that yes I agree that perhaps geographic lockdown does make logical sense. When you look at the map of infection some parts of the country are very light (especially the South West) which does imply an intrinsically low ‘R’.
If coupled with “don’t go to the big cities unless you have to” it might be a way to get the economy out of 1st gear without risking too rapid re-escalation, and then seeing what happens.
I quite like this Isle of Wight test case concept, for what it’s worth (arguably not much, as I’m just an interested onlooker not a scientist, so perhaps it’s a bit of smoke and mirrors to impress/distract the likes of me?! But it seems potentially useful.)
> some parts of the country are very light (especially the South West) which does imply an intrinsically low ‘R’
We are thin on the ground and have no huge conurbations. According to Wikipedia
Some of this is part of its charm, though I wouldn’t expect city lovers to feel that way. However, the big cities are where the money is made, lifting lockdown in the South West is likely to be as useful as lifting it in the Scottish Highlands IMO. Not much economically meaningful will happen.
I’ll say it…
…are we even sure that Mr Ferguson has been looking at the correct curves?
@ The Investor – I don’t think the dismissing ‘telling everyone to do one thing while doing another themselves’ is quite as trivial as you suggest. I indicated in an earlier post that humility is not the defining characterstic of these people (Monevator Commemorative Coin please) and while I wasn’t expecting Ferguson to be caught on the job the fact he didn’t believe the rules applied to him. The troubling thing with these people is that the absence of humility infects everything they do – private, personal, professional, you name it – and I hope that Ferguson’s defenestration will encourage a further look at the modelling on which lockdown was based. I suspect it will because 1) there is nowhere quite so bitchy as academia and any number of his friends and colleagues will be lining him up for the shaft and 2) it helps HMG a bit – they now have a fallen academic and should they choose to reverse out of some the statistics they have spoon fed us with they have a very convenient scapegoat.
@Ruby — I’m not dismissing it as trivial, and I agree with your sentiments. We’ve now seen two of these key scientists/epidemiologists do this (remember the Scottish chief medical officer resigned over visiting her holiday home) which I agree potentially reflects on their absence of humility. I have some experience of these people also, and while I generally like them a lot, they are like all of us a mixed bag with very varying qualities. However I’m not inclined to personally kick a man when he’s down and the “married lover” tittle-tattle is kind of odious to me, so I’ll need a few days before I feel like getting on my own soapbox I suppose.
Also — and I can see why you’d say this puts him more on the hook for personal criticism than off it — I’m not surprised he broke the lockdown. I have various friends who are transgressing in various minor ways. The thing is an absolutely massive constraint on our daily lives, especially if you’re an extrovert and you live alone (I’m an introvert and hallelujah for that, but I’ve seen it affect friends). It’s yet another reason why I’m against it lasting a day longer than required, and lifting some of the strictures.
E.g. Fine I might infect 50 people if no lockdown, but if I’m allowed to visit my girlfriend then I can only infect one other. Okay, we can all see it would escalate beyond that, but “stay in your cell” is a very extreme national posture, that should be rigorously questioned on an ongoing basis for efficacy and costs/benefits.
@Ermine — To that last point above, fine London might have to stay in lockdown longer, but I’d be in favour of anything that brought people closer back to reality ASAP. The southwest is not massive, but there’s various other rural localities where this applies. It could easily save thousands of small local businesses from going bust, save a few suicides, save some marriages, save some abuse victims, save some un-diagnosed lumps etc. It’s not perfect but if it can be done without them being overrun as per the earlier fears then let’s do it.
@TI: I’m afraid I don’t have a reference for the ENT comment. Back at the start of the epidemic when the BBC was giving details of everyone who died, the only two hospital doctors among the dead were both ENT surgeons, as I recall. Perhaps @Passive Investor could tell us more?
@Vanguardfan: I share your gloom about the competence of the Government, having spent three decades in the NHS. https://www.theregister.co.uk/2020/05/05/uk_coronavirus_app/ gives further and better particulars about why the NHS app is a bad idea. But our Government prefers things to be centralised so that they have control, and the Brexit spirit demands that as an independent country we develop our own app. Despite our proven rubbish ability to get NHS IT to work.
@ZXSpec: Australia closed not only external borders but internal ones too. Western Australia has been divided into four or five areas, with no travel allowed between areas without permission. And they have rigorous Police control. I’ve been routinely breathalysed more times in WA than in any other country (and never in the UK).
@ermine @TI yes, I sit here in the most sparsely populated county in England (it’s not in the SW) and wonder why our small independent shops and traders can’t open, why we’re waiting for them to work out a safe way to open the London Underground.
Well science is meant to be unemotional. Every scientist is a human being and flawed. Terrible to denounce and reduce an opinion or achievement because the person wasn’t perfect. Four legs good, two legs better.
@duncurin. I certainly remember one ENT surgeon who died and he came up on google. Not sure about the other. The risk to healthcare workers isn’t properly known though:
Interesting figures looking at risk for the US associated with complacency leading to relaxing measures too soon.
We know from investment about the Rule of 72 and how this converts an annual rate of return to a time to double the value of the investment. With Covid we have the reproduction rate (R). But R on its own does not predict a doubling time or indeed a halving time. Why are we also not having a discussion about the time to complete a reproduction cycle? Without an agreed value for that, R is only a qualitative indicator of growth or decline. It’s like specifying a rate of return, but not specifying how long the return is measured over. Am I this only one that finds this odd?
@Barn Owl. With so many variables the utility of the R measure is more to do with simplifying and communication. Isn’t it more straightforward to just look at the data ? Science produces explanatory models to try and explain what experiment and the world shows us. We are still in the experimental stage sadly, still trying to understand what the data is trying to tell us.
If you were to try to construct a model for the propagation of this disease it would be based on interactions between people. The rate of interactions would be key to this and the probability of any interaction leading to an infectious event would just be one parameter.
This R parameter is just an aggregate simplification of many variables which are not constant between communities, demographic strata, cultural norms etc. and may vary over time.
Yes yes yes!
You make such an important point about a need to connect R0 and say doubling time to get a feel for what is going on.
So if Ro is 2, then it is important to know how long it is from when the first person gets the infection, to when the two people who then in the next generation theoretically get infected get the infection.
My understanding is for covid-19 that the period is about 6 days, so with an Ro 0f 2, new infections double every 6 days (possibly 5 but I’ll assume 6 here). But you will struggle to find any discussion of this.
But if the period had been 12 days then with an Ro of 2 new infections double every 12 days.
So over 24 days with an Ro of 2 this means new infections are either 16x higher than at the start (with a 6 day period) or 4x higher (with a 12 day period). A factor of 4 difference.
So just knowing R0 is 2 doesn’t give you the intuition you need, until you factor in the 6 days also.
So if R0 is 1.1 the infection won’t grow out of hand uncontrollably in a short time period and overwhelm the NHS, as that 10% growth in infection is occurring only once every 6 days.
So if R0 is 1.1 then over a month then we might expect only a 60% increase in infections (1.1^5 – 1) which would leave the NHS in a better position than in the first wave given we are currently well below half of peak infections.
But that is still completely wrong, as it ignores that there is a herd immunity affect kicking in, so that R0 of 1.1 isn’t getting out of hand and quietly growing exponentially because once about 10% have been infected and are not susceptible the R0 acts as if it is below 1 in any case so infections stop growing.
Because R0 was initially say 3 and nobody had been infected then of course the infection growth starts off exponentially and quickly gets out of hand and has the potential to overwhelm the NHS.
But don’t say exponential growth is exponential growth and we are doomed at Ro = 1.1, because I will say you you don’t understand the context in which you are saying that, don’t understand your own assumptions, and are are talking nonsense.
Mr Optimistic is absolutely right that R0 is just a communication tool and sensibly used it is a good technique. Things aren’t as homogeneous or as simple as as an SIR or SEIR or other mathematical model assumes.
But I think Ro is useful as long as it is is used in connection with the time between generations of infections, and with clear thought as to what controls an epidemic with an R0 above 1. But all the talk is just about R0 which is not good communication.
The Swedish experience seems to be telling us that with smart distancing policies then you can keep the R0 down to a manageable level, and something else is happening that the models aren’t picking up that is controlling the increase in infections. We need to watch the data and adapt our models to the data.
We have time to adjust released lockdown measures should growth start to get out of control. The end of the school term is one such thing that happens naturally to control infection, should we re-open schools and unexpectedly find that is what is driving a growth in infections.
This “can’t possible lift the lockdown as it will get out of control” or “it will cost lives” thinking is innumeracy with lashings of unclear thinking, closed mindness and unhelpful politics thrown in.
Creating a fancy mathematical model is one thing, but understanding the assumptions, and limitations of that model is more important. You don’t adjust the reality to your model you adjust your model to the reality.
Neil Ferguson’s model completely ignored the socio-economic affects of lockdown and the lives that will cost. Of course it is almost impossible to quantify those affects and do the sums.
But is silly to just say ‘oh but we can vaguely estimate how many might directly die from the virus in the short term, so let’s ignore the potentially larger number who will die in the future either directly from being infected later rather than sooner, or indirectly because of the economics affects of the virus, and while we are at it let’s assume a vaccine will be available to help with our unrealistic assumptions”. Essentially that is what his “500,000 will die” was saying, and he still seems to be spouting this sort of nonsense and I glad others can see it is nonsense.
So good riddance to Ferguson’s unhelpful contribution hopefully. I’ll generously say he was well-meaning and unaware of his own stupidness and arrogance.
I haven’t any reason to think that Ferguson didn’t believe in his model
If he did, then of course he should have shared that data and the priors on which it was based. If it was spitting out 500,000 deaths then that’s what it spat out.
However I do think it’s incumbent on decision makers to interrogate as best they can such models to see what they’re really saying, and what they’re ignoring. Of course it’s impractical to expect ministers and advisors to be diving into the source code (or more realistically to be too involved with all the parameters).
Ultimately I still think the initial lockdown was justified, on a precautionary basis alone — even if we do see successful lighter touch approaches from the rare few dissenters like Sweden. Justified doesn’t mean I think it was necessarily optimal, even at the time, and it certainly wasn’t optimally implemented. (If you’re going to do a full lockdown, do it when we’ve a few thousand cases not a few hundred thousand or potential even seven-figures, surely?) But any reasonable person can see that presented with scientific advisors saying 250,000 to 500,000 of your citizens are going to die if you don’t take drastic measures, a government is going to be inclined to act.
However I’ve always believed it should have been stamped as “to buy us time” to get a handle on things and improve our capacities rather than “to extinguish the killer virus which threatens you and all you love” which is effectively what the messaging has been.
The latter was always going to nail-on an extended lockdown, a lack of intellectual flexibility, and constrain responsiveness. As I’ve said before, if you terrify the population, don’t be surprised when they act terrified when you ask them to go out again to stop the economy crashing. (I also still think it creates a huge problem — warding off an economic depression — and leaves less attention to focus on important sub-measures, such as protecting hyper-vulnerable residents in care homes and hospitals).
It’s been an unprecedented event full of unknowns so I don’t expect perfect action and foresight from government or its advisors. However I would like to see some institutional humility, which appears to be in abundance in (sorry for banging the drum) the Swedish response.
I appreciate the more hardcore lockdown advocates must be getting bored of hearing about Sweden, but it’s incredible to me that faced with as far as we know exactly the same threat, people in Stockholm are chatting about it in bars and restaurants on their way back from the shops — and there appears to be no appreciably worse outcome in terms of death than what we’ve seen here — and yet here a scientific advisor leads her briefing, as I said, being troubled by a tiny uptick in car traffic, urging people to stay locked up, and glossing over the slide showing we’ve lost tens of thousands lives to Covid-19 anyway.
@TI. Regarding Sweden “No appreciably worse outcome in terms of death than what we’ve seen here”. If you set the benchmark at the bottom of the pile, everyone looks good. You shouldn’t compare anyone with the UK: we’ve screwed it up.
When you compare Sweden with another country with an equivalent level of city urbanization, like their neighbours Norway, they are doing terribly. Norway only has 1/13th of their deaths, with 50% of their population. Compare Sweden with Australia which has 2.6x their population and is more urbanized. Australia has less than 1/28th of their deaths.
I find it odd that you seem to accept being bottom of the pile and like to compare ourselves with other failures. We should always compare ourselves to the best and expect to do better.
My understanding, having watched every one of the daily briefings, is that a truly meaningful “C19 performance” comparison between nations awaits excess deaths data, and that these numbers are not yet available.
On fair minded reflection, would you not agree that in what you say at #166 you are adducing opinion as fact?
@ZXSpectrum48k — The reason I compare with Sweden is because it’s a comparison with a country that has not done anything like a full lockdown, not because I think it’s done a great job judged solely on the Covid-19 related death count.
It’s specifically because I believe full lockdown has lots of unintended consequences (including the loss of life expectancy, which will grow the longer it goes on) that it is an interesting comparison to me. As I’ve said before, if I thought that full lockdown had no health / emotional consequences and only trivial economic consequences then I’d be all for it. Much of the commentary seems to proceed as if that’s true — but I think that’s wrong.
Of course the problem is that we and Sweden and Australia can test people for Covid-19 now and chalk positives up as a death (at this point in a bald statistic that ignores age, cause of death, comorbidities, etc etc) and in our case create a clear — horrifying — single number, but we can’t do any such thing for the long-term consequences and results.
Prior academic research has proven that recessions, unemployment, social isolation, and so on all have health consequences, and intuitively thousands of businesses going bust and (potentially) millions unemployed seem likely to produce all kinds of negative consequences. You and I are going to struggle to reconcile this tension because as I understand it you see such as an outcome as less than troubling and potentially even beneficial.
(I appreciate a point you’ve made well before is we can’t assume Sweden’s approach would have saved a deeper crash in our economy because we’d still have suffered from slowdowns overseas — but what if everyone had taken Sweden’s approach? Besides, I can’t believe it wouldn’t have improved matters somewhat, especially for smaller businesses.)
I agree that on the surface Sweden vs Norway is a better comparison, of course, although I’ve seen articles pointing to for instance the demographics of Stockholm as making a difference. (But then you could argue that is irrelevant as Sweden should be making decisions based on its own demographics). As an aside I saw the Swedish lead epidemiologist saying he himself thought it was too soon to be sure Sweden’s decision not to lock down was the right one; that’s the sort of humility I’d like to see more in evidence here.
@TI, not only is comparing covid deaths across countries problematic, but so is comparing lockdown policies. I’m not sure on what objective basis you keep describing our lockdown as ‘extreme’ and Sweden as ‘not in lockdown’. Other than restaurants (what proportion?) still being open. I think to make a fair comparison across countries you’d need to scrutinise both the detail of the measures in place (mandatory and advisory) and also the degree of compliance, ideally with objective data like traffic and public transport usage.
I still don’t see our lockdown as extreme, in relation to personal freedom curtailments, in comparison to Spain, Italy and France, on the basis of what I’ve read. We can leave our homes as often as we like, without any need for a document to give permission. I also perused Austria’s official info today (to see if there’s any chance we might get our August holiday…). They do not permit entry to the country without covid free certification, no flights, very limited train travel, and very limited travel between regions. They are however now able to start opening businesses, since mid April, and seem to have the epidemic pretty much contained.
Our lockdown requires some specific business closures (https://www.gov.uk/government/publications/further-businesses-and-premises-to-close#history) and school/uni closures, but people’s movements are generally not policed and they can travel to work that has not been closed. On the other hand, the message to stay at home has certainly curtailed a lot of work that was/is technically permitted – compliance has gone much further in some areas than mandated. And yet our case numbers are still not fantastically well controlled.
I tend to think that countries that deal better with the virus will be less severely hit economically, as well as health wise, but that all countries will suffer, particularly those with globally connected economies. Of course we have all the Brexit nonsense to suffer as well. It is truly a perfect storm for the UK.
@Vanguardfan — Sorry to be brief, I really have to get some work done today, but thanks for your comments and just wanted to clarify that I don’t think our lockdown is particularly extreme (if I used that word it’s the writer in me looking to vary my synonyms) rather that I think all full lockdowns as pursued in most countries are pretty extreme. See, for instance, the (short-term so far) 30-50% hit to UK GDP, the 30 million unemployment claims in the US, and the PMI number coming in at 12 (!) in Europe this morning.
They may be rightfully extreme, time will tell. Sweden is an interesting counter-example because it suggests (yet to be proven) that a more moderate approach (most schools open, most businesses open, but working from home and physical distancing as judged sensible by individual Swedes) may have produced more moderate consequences.
If it meant we might have “only” seen a recession over the cycle of say 5% in lost GDP verus say 10% GDP (arbitrarily choosing numbers I’ve seen cited here just to illustrate) then that could have been I believe a better strategy.
Of course I agree entirely about Brexit. That nonsense will only be amplified by this, sadly, when we might instead be seeing we’re all in it together. 🙁
Here’s one quick source for some GDP forecasting from PwC. Obviously it will be off like all forecasts, but it shows the magnitude of what’s being predicted (-6% to -10% GDP in its case in year one, with direct costs to public purse of £20bn to £30bn from support measures):
I note Rishi Sunak is already highlighting the issues about the cost of furlough:
p.s. Sorry, I mean “rather THAT I think” of course. Edited and will delete this comment anon. This is what happens when you try to bash out a comment with client work screaming at you in another 14 tabs… 😉
I’ve made this point before, but do you have data that Sweden’s GDP hit is going to be significantly different from other comparable countries?
I am still alarmed by the fact that no one is talking about the importance of sick pay to support track, trace and isolate. By all means plan to scale back the furlough – the workers at greatest risk of contracting and spreading covid are not on it anyway, they are already out at work and cannot afford to quarantine. But when it is scaled back and people are pushed back to work from necessity, they will also need sick pay for quarantine. Otherwise we might as well not bother.
I wonder how many more deaths we would have had if we followed the Swedish model. Imagine if we had had 100,000 deaths by now, the pressure from the public to lockdown hard would have been overwhelming.
The problem with saying we shouldn’t have gone into lockdown is that the people were ahead of the government on this and were well on the way to locking themselves down. Attendance at schools was dropping off quickly, employees were calling on their workplaces to close, and large events were being cancelled voluntarily. Rumour, misinformation, fear, and uncertainty abounded. It was becoming politically untenable for the government not to take charge of the process. We have had poor outcomes because we were woefully unprepared institutionally and in terms of what medical equipment we had stockpiled, and preparations for attempting to come out of the lockdown look set to reprise many of the same problems with quite possibly equally dire results.
Well that’s the £200bn question isn’t it? 🙂
The fact is we don’t know if we would have had 100,000 deaths. We don’t know that full lockdown versus “as practical as possible but keep things going” lockdown would have cost 100,000 deaths.
These are all fair points everyone is making; I don’t dismiss any of it out of hand. However I hope supporters of extended full lockdown are applying the same pressure when evaluating their own preferred strategy?
The fact is it hasn’t stopped 30,000 Covid-19 deaths, it looks likely (though this too is of course yet to be seen) to cost the economy 5-10% of GDP, it will certainly have in itself cost some very hard-to-quantify amount of illness and death, and it’s been an emotional ballache (at least) for 67 million people.
As things stand no country I’m aware of has so far gone “full Imperial” and seen anything like 250,000-500,000 deaths, adjusted for their own population. You might say that’s because we’ve all done a full lockdown, but think that’s very unlikely.
Is the UK really doing a better job of lockdown and treatment than say Africa? Perhaps we have some indigenous disadvantages (more urban, more connected, older population) but when a country like Nigeria has 98 (under-reported, sure, but a big margin for error) deaths so far, a lot of stuff is clearly going on.
An Occam’s Razor approach would suggest the model over-estimated the deaths — especially the preventable deaths of vulnerable/ill over-80-year olds who would have sadly died over the past two months or so irrespective of lockdown.
@Factor. We can argue whether this disease is really an exponential process or not; perhaps the curve would have naturally flattened. Nonetheless, the UK govt has assumed it’s an exponential process so, rationally, if you want to smother that process you go in early and hard. This is what Australia did a month before us, with far more conviction and far better results. We didn’t even close the borders.
I would agree it’s excess deaths that matter (and economically, we should consider only excess economic damage from the lockdown, since much of the economic damage was going to occur anyway). Nonetheless, I see a low probability that Australian deaths will be rising by the required very large multiplicative factor to get anywhere close to the UK excess deaths on a per capita basis. Moreover, they are now in a far better position to exit the lockdown, with positive impacts on the economy.
The long-term impact of COVID in terms of deaths and the economy may be less divergent between countries. In the short-term, however, I stand by the view that the UK govt has at best shown incompetance and, at worst, has shown a total disregard for both lives and the economy. As a result in “wave 1” we rank very poorly compared to many other developed countries.
@TI. I think you overestimate the impact of the lockdown economically on the UK. The UK, as an open economy, deeply dependent on global trade and services, was always going to get absolutely clobbered whatever we did. We’ve had a balance of payments problem for 35 years, global trade has been falling since 2012, and we have a self-inflicted injuries called austerity and Brexit.
To use an analogy: imagine the UK economy was a hospital patient and it died of COVID. If I take your own approach, I would be saying it’s all very sad but the patient had pre-existing conditions so they would have died soon anyway!
I suppose that’s the difference. I see this mainly as just the acceleration of an inevitable process of decline caused by mismanagement, unwillingness to structurally change, and too high standard of living expectations from the general population. It would be better if we could amortize the damage over a longer period but sometimes you just don’t get the chance.
A 4-10% hit to GDP is bad but survivable. I’d be amazed if the direct costs to the public purse are as low as £20-30bn but lets go with it. The government spends >£800bn/annum so it’s not a large number. I’d prefer to issue 30y-50y Gilts but if you want to raise revenue then it’s easy. I can see at least £100bn of tax reliefs that can go right now, which mainly hit the rich. You don’t even need to raise income tax, NI etc.
@ZXSpectrum48k — Very reasonable comments.
As mentioned earlier I’m a bit rushed today so just want to add that I was only citing the £20-30bn direct cost because that was the PwC number in the PDF I referenced. As far as I could see on my (skim) read they weren’t looking at lost tax revenues from full lockdown, for example, which at 10% drawdown would be, what, another c.£75bn? (Lunchtime head maths, may be a bit out).
But of course as you rightly say we would have suffered some kind of recession anyway even if we’d “done a Belarus” (and I”m not suggesting that!) both from the global slowdown and also as @Keith says from citizens voluntarily changing their own behaviour.
However even then I have a hunch that on the micro level (small businesses, self-employed etc) a ‘Swedish lockdown’ might have been more survivable, even if FTSE All-Share companies suffered hits hits of a similar magnitude either way. This is the tranche of businesses I see as most likely to be permanently impaired by an extended full lockdown. Perhaps I’ve forgotten how pervasive deep recessions can be though; let’s see in 12 months I suppose, if we get one.
Probably doesn’t need saying but I agree with all of your sentiments about Brexit and to a large extent austerity, too (I was in favour of some general public spending curbing post-Labour /09-11, perhaps wrongly in retrospect, but I was also in favour of a big infrastructure spend on the back of low interest rates, as documented on this blog).
I’m less willing than you are to put the boot in on the Government at this point, even as I continue to question this full lockdown policy. I think they faced the same uncertainties we kick around here, and very difficult choices.
That said, as I’ve mentioned several times including on this thread, I totally agree that if your policy is do a *full* lockdown, then you should do a full lockdown ASAP.
Letting a couple of million people get it — a number that few seem to think is likely to grant any kind of herd immunity — and then trying to bring cases back down and revert to track and trace, after an often asymptomatic virus has spread very widely, seems intellectually incoherent.
Czech Republic antibody study….
@TI #177 “….. less willing ….. to put the boot in on the Government …..”
Nor me. Apropos of which, are others here barking up the wrong tree when they set upon Ferguson singly, or did he bypass the scrutiny of SAGE (of which I understand he was a member) when presenting his advice?
On the hit to GDP and the cost to the country, Richard Murphy published a depressing essay yesterday on the trade-offs he sees possible when rescuing the economy:
“People and jobs? Or wealth? The government has to decide which to prioritise, and there is only one right answer”
@ Indecisive #180
RM is just one voice among many differing voices. Time will tell whether any of the soothsayers is correct.
@Indecisive. RM tries to come across as centre-left, for a mixed economy and reasonable. He isn’t. Even Corbyn found him too radical.
He’s an MMT advocate and wants People’s QE. Now, to be fair, heterdox MMT types often have a better grasp of what money is and how money is operationally created/destroyed in a fiat currency system than orthodox economists. It helps they don’t treat money as an exogenous variable. They believe in magic money trees and so do I. Thereafter, however, we rapidly part company. They don’t see the need for sterilizing money creation. They don’t see the need for assets, the natural rate of interest is zero, markets are unnecessary etc.
This is his actual key thought: “the economic stupidity of sending vast sums of cash to be saved in financial assets, creating an apparently never ending Ponzi style growth in value because the money coming in always exceeded the money going out when the stock of assets (shares and commercial land) is deliberately constrained. It was inevitable that one day the pretence that there was any value in this system would disappear, and the whole edifice would collapse. That day has arrived.”
He’s called for this every year for the last 20 years. He thinks all the banks will fail but doesn’t tell us why. He’s absolutely desperate for it all to come tumbling down. This is bad (2008 bad, perhaps worse), assets prices may fall but it’s not the end of the world.
And lest we forget, as the VE Day anniversary approaches, the aftermath of the “last great national crisis”, with WW2 being rightly referenced as that by many now, saw the birth of the NHS!
@Factor, @ZXSpectrum48k Thanks, that’s very helpful. I appreciate RM’s focus and campaigning on tax justice, but he seems to have a “New world order” mindset.
Some comments from St Louis Fed President James Bullard today, who in my opinion is nobody’s idea of a doomster:
For whoever was asking about T cell response this twitter thread and journal pre-proof ‘Detection of SARS-CoV-2-specific humoral and cellular immunity in COVID-19 convalescent individuals’ looks interesting
If active investing involves this level of research and work I’m glad I don’t, too much like hard work 🙂
@ Indecisive #184
My pleasure 🙂
@Matthew. Active investing doesn’t involve this level of research because all this type of research does is increase/decrease your conviction about a view. There’s this idea that active investing involves taking views. A few guys are very good at that. The majority are very bad at it. In reality, you should discount your views heavily. Views are dangerous.
Good active investing is about understanding the probability distribution that is priced, how that output distribution is related to changes of the input variables, and then identifying a highly levered skew in the risk-reward payout if those input assumptions change. Repeat and rinse. The market offers plenty of mispricings, inefficiencies and opportunties, so over time you will make money. Without you ever having to take a view.
@Matthew — Haha. 🙂 As I’ve said many times, given the cheap and effective zero-time alternatives the best logical reason for anyone to invest actively these days (other than of course as a job earning mega bucks) is because you love it and the process and so on.
As Covid-19 is demonstrating, this is the way I am and I think regardless; I like active investing because it provides a way to express my (endless) view of the state of the world (among many other things) financially….
Haha, @ZXSpectrum48K is of course correct, especially professionally speaking and (obviously) most especially when it comes to quantitative investing. I’m more akin to a 1980s stock picking dinosaur. 😉
With that said, I did allude to this a little with my “among many other things” comment. Everything from valuation to liquidity discrepancies go into that bucket, and at times like these I spend half my time scalping small caps etc (which wouldn’t work as a job, incidentally).
With all that said, @ZXSpectrum48k, do you not take a view on for instance the interest rate curve over a longer-term view? You’ve mentioned before IIRC having been a structural bull on US Treasuries for 20 years, for example. Are there not some embedded macro views in your mix, or is it all sniffing out arbitrages and pricing opportunities?
It was I. Thanks – I’ll have a read. You may find Marc Lipsitch’s Twitter feed interesting. In the current situation, the more sources of expertise the better, so far as I’m concerned.
Have you encountered Farr’s law on your reading? Nevertheless, we do to need to be wary of “second waves” which have happened on previous epidemics.
@ti – I’ve always been a bit fairweathered with hobbys, like karate, swimming, stock car racing, and gaming – doing it for fun until it got too serious, but what i love about investing is that laziness and halfheartedness wins! I also find the human element just another thing to worry about and monitor (like woodford), I know I have no forecasting ability from events in life and like to rely on probabilities! I like watching the news but I’m time poor!
@zx – I can imagine the most pronounced inefficiency is how each of us is under a different tax/life situation – some home bias is justified because of withholding tax, equities are worth more to people who need them and bonds are worth more to people who cant overpay on a mortgage. Although the easiest way to do all that I suppose is simply to select what vls you feel you need!
I can imagine finding inefficiencies is worthwhile if youre handling large sums, where the likely reward justifies both the risk and the time, and I also suppose theres a place for tax harvesting
@Matthew: You write:
Well, just while we’re on the subject, I almost never invest in funds/trusts and especially not on the basis of personalities (I stock pick companies) although I do sometimes buy investment trusts when I see an opportunity, and I basically see trusts as companies anyway.
“Almost” because I’ll sometimes own Berkshire Hathaway or Lindsell Train or a tiny handful of others for a few months partly on the back of the people behind it. But overwhelmingly I’m in individual companies or else index funds.
If edge exists I doubt people have it both for individual stock picking *and* for manager selection, but even if I thought I did have both I wouldn’t want to have to overcome the extra hurdle of higher fees with funds.
Plus as I say I invest actively 75% because I find it fun/challenging anyway, and what’s the fun of letting someone else do all the stock selection and trading? 😉
@Grumpy Old Paul
I’ll have a look at that twitter feed, thanks.
Vaguely have come across Farr’s Law although hadn’t remembered the name.
For coronavirus in the UK and many other places, infections (or their proxy deaths) are falling away more gradually than they increased prior to the peak so Farr’s Law doesn’t seem to be applying. But I’m assuming that’s because we changed the dynamics by reducing Ro with the social distancing measures. And the asymmetric appearance of the curve is just reflecting that R0 has been well above 1 on the way up but only a bit below 1 on the way down. But had we done nothing and let the curve takes its natural course, I’m assuming that herd immunity would have created a roughly symmetrical curve as per the law (?)
I just wondered if you have looked into the Vitamin D side of this thing?
it looks like having a low Vitamin D status , <30ng/ml or 75 nmol carries up-to 10 x greater risk factor. Please see the great posts and Videos on Ivor Cummins Website and podcast, he goes by the twitter handle of The fat Emperor where his thread follows all he latest studies. getting in the sun is a great idea, especially between 11am and 3pm for your Vit D (UVB) and for NO (UVA). Inflammation in the body also lowers Vit D. Happy reading 🙂
Study released today (not yet peer reviewed) into a Covid-19 mutation that seems to have created a more virulent strain — more virulent in that it appears to have become dominant, which AIUI may suggest it spreads faster than other forms:
Counter-argument that says the study proves no such thing:
@Mcjocko — I haven’t looked into it as such, but it’s been a potential risk factor identified very early on, even by a clueless numpty like me, especially as some suggestions emerged that BAME people may be suffering worse outcomes disproportionately and yet it also seems that in much of the non-Europe non-North America world the virus seems to have been relatively shrugged off so far. (i.e. Vitamin D deficiency would seem a logical difference) Cheers for thoughts though, and as ever with this studies are what is needed so I’ll have a look when I get a moment.
Personally I anyway supplement Vitamin D in the autumn/winter months and make sure I get a splash of sun in spring and summer daily, on looking at research a few years ago in this direction after years of slavish sunblock-ing! 😉
The Nasdaq-100 NDX was 8733 on 31st December 2019, pretty much pre-CV19.
It dipped to 6994 on 20th March, but it is now at 8984, that is higher than pre-CV levels of the start of the year (the all time high this year in January is 9065 so 1% off).
Now I know the Nas has FB, MSFT, GOOG which are pretty chunky as a percentage share of it, but I can’t believe it’s higher than 4 months ago.
@Marked — I know what you mean, but remember many people can only communicate, shop, work, or be entertained right now via the cloud and associated technology enablers. Not only can much of tech earn while others can’t, they will probably profit from some permanent shift in habits. Microsoft said in its earnings call it saw something like two years of ‘digital transformation’ in two months. And a huge part of the valuation of all these tech companies is future earnings anyway.
I think it’s pretty logical but I concede it has left big tech pricey looking (and big looking!) and probably vulnerable to any speedier than expected return to normality versus other sectors.