What caught my eye this week.
The graph of this week’s GDP forecast from the Office for Budget Responsibility looks like something from a comic book:
Great Recession? “Pah!” says Covid-19. “Hold my drink…”
That’s not an economic projection – that’s the punchline to a three-panel cartoon.
Of course the hope is that like a sack full of garden manure dropped onto a trampoline, what goes down must surely bounce up again. And it will. But how?
Will we see a V-shaped recovery? A U-shaped recovery? Maybe a W-shaped start-stop affair? Or even a Nike Swoosh?
The idea is to pick the letter of the alphabet that best fits how you expect the graph to go over the next few months.
Personally, I think it’ll probably be more like a Chinese character, darting up and down all over the place.
Modern economies are fabulously complex, and switching ours off wholesale will have broken numerous connections. When we restart, some areas will fly but others will be literally waiting for parts.
China tried to reboot its big factories first, but then discovered most of them relied upon smaller suppliers. So they were switched on, too – but then they found workers had nowhere to eat, because the street canteens hadn’t yet been allowed to reopen.
Britain on pseudo-FIRE
We’ve got plenty of time to think about all this, what with lockdown officially extended for “at least” another three weeks.
Indeed it seems that many Britons have become more reflective now their alarm clocks have stopped buzzing and they’re working within sight of their gardens and kids.
It’s bemusing to me to read articles or hear podcasts in which people gush about how proud they are to be managing to work from home.
Apparently it’s a revelation to many that the technology is available, and that people will get on with work without the clattering distraction of an office or the time suck of a commute.
Fifteen years ago I co-founded a company that eventually grew to dozens of employees and scattered contractors. We never had a central office and ran the thing using Skype, Gmail, and early on Google Spreadsheets.
We’d meet fancy clients in a London member’s club to avoid awkward questions. But mostly we plotted strategy around our dining room tables, and then beavered away in our homes.
It seems this is fairy story stuff for many workers. I’ve written before that I believe more things will stay the same than change post-Covid-19.
But maybe I’ve been presuming too much?
Sky News reports that only 9% of people want life to return to normal after lockdown:
The survey found that 61% of people are spending less money and 51% noticed cleaner air outdoors, while 27% think there is more wildlife.
Others say that having glimpsed the freedom of working from home, many won’t want to go back:
“Once they’ve done it, they’re going to want to continue,” said Kate Lister, president of consulting firm Global Workplace Analytics.
She predicts that 30% of people will work from home multiple days per week within a couple of years.
Lister added that there has been pent-up demand by employees for greater work-life flexibility, and that the coronavirus has made their employers see the light, especially as they themselves have had to work from home.
Indeed some are already anticipating a rearguard action from The Man and His Minions, who are presumed to be desperate to keep us in our (work)place and on the hedonistic treadmill.
In a widely-shared Medium article, Julio Vincent Gambuto celebrated the global lockdown:
The treadmill you’ve been on for decades just stopped. Bam!
And that feeling you have right now is the same as if you’d been thrown off your Peloton bike and onto the ground: What in the holy fuck just happened?
I hope you might consider this: What happened is inexplicably incredible.
It’s the greatest gift ever unwrapped. Not the deaths, not the virus, but The Great Pause.
It is, in a word, profound.
But Gambuto predicts capitalism won’t stand for it.
“We are about to be gaslit in a truly unprecedented way,” he says, using the neologism for manipulating somebody into doubting their own sanity.
Lock heeding martians
While of course I’m breezily doing as directed – it’s not a big weekday change for me, to be honest – I do have mixed feelings about the full lockdown strategy, as we’ve been discussing in the Monevator comments over the past few weeks.
Sweden, for instance, has no mandatory lockdown and yet far fewer deaths per million citizens, as cited in the links below. Indeed different countries are as figuratively all over the map with their Covid-19 pandemics as they are on the globe. It seems there’s a lot going on we don’t yet understand.
But all that aside, I’ve been moved by seeing the lockdown in action in London.
When China shut-up Wuhan, the few over here who were paying attention wondered whether we could ever manage anything similar in the individualist West. I admit I had my doubts.
Yet with no coercion and minimum fuss, the vast majority of us have followed the government’s strictures and it’s a little wonderful.
Out on my daily walk, every time someone steps off the pavement into the car-less road to give me space before I can do the same for them, I almost want to hug them. (Oh the irony!)
The London air is clean to breathe. You really can hear birds sing.
Even as the economy craters. Even as Romanian workers are being flown in to pick fruit because the farming industry still can’t find British workers to do it, despite a million more jobless than last month. And not even Covid-19 can slow down Brexit.
Irony indeed.
Have a philosophical weekend!
From Monevator
How diversification is working during the coronavirus crisis – Monevator
Another strong Covid-19 discussion followed last week’s links [Use ‘Next Comments’ at the bottom of each tranche of 50 comments to read through all 120+] – Monevator
From the archive-ator: How to spot a bear market bottom – Monevator
News
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!1
IMF head: dire recession forecasts may be too optimistic – BBC
UK economy losing £2bn every day in deepest slump since the Great Depression – ThisIsMoney
Government extends furlough scheme until end of June – GOV.UK
Bank of England tells lenders to ‘get on with’ Covid-19 business loans – Guardian
How coronavirus almost brought down the global financial system – Guardian
Morgan Stanley: In a post-Covid-19 world, employers will have to pay workers more [Search result]– FT
Products and services
Price of high-demand food bought online rises sharply – Guardian
NS&I cancels plans to cut Premium Bonds prizes and variable savings rates – Which?
Pension transfers under lockdown [Search result] – FT
Sign-up to Freetrade via my link and we can both get a free share worth between £3 and £200 – Freetrade
Home electricity consumption now peaks at 1pm; data suggests we’re having early nights AND late mornings – ThisIsMoney
Marcus cuts its easy-access rate, after £17bn pours in from savers – are top rates headed below 1%? – ThisIsMoney
Open a SIPP with Interactive Investor by 30 April and pay no SIPP fee until April 2021, saving you £110 – Interactive Investor [Affiliate link]
Unusual homes for sale [Gallery] – Guardian
Comment and opinion
The virus broke the stock market weighing machine – Advisor Perspectives
Downturns this deep can take a long time to recover from, financially and mentally – Schroders
Larry Swedroe: Stop being bewildered that the market has bounced back – it’s not the economy – T.E.B.I.
Should the state pension triple lock be axed to help pay coronavirus bill? – ThisIsMoney
Robo advisers are easier to blame – Klement on Investing
Covid-19 and the equity markets – Albert Bridge Capital
Post-retirement calculator updated [US parameters, but interesting] – Engaging Data
Portfolio tracking spreadsheet: v2.0 release notes [Tool] – Fire V London
What is the average net worth, adjusted for age and education [US but interesting] – Of Dollars and Data
Naughty corner: Active antics
A bull’s view in a China shop – Sum Zero
Will investment trust dividends hold up? – IT Investor
The S&P 500’s CAPE Ratio says the US market is still expensive – UK Value Investor
Have small value stocks become a bargain? – Morningstar
High Yield in the Covid Crash: Risky, but potentially very rewarding – Bond Vigilantes
How working from home has slowed down Wall Street’s trading pros – New York Times
Rob Arnott: Why the stock market hasn’t even got cheap yet [Video] – YouTube
Jason Calacanis on ‘intelligent risk’ and angel investing [Podcast] – Farnham Street
The unprecedented stock market impact of Covid-19 [Research, PDF] – NBER
Covid-19 corner
(Click to enlarge)
The Covid-19 reproduction number is falling below 1 in several key hot spots – Epiforecasts
Tim Harford: why we fail to prepare for disasters [Search result] – FT
Critics question Swedish approach as coronavirus death toll reaches 1,000 [Really? It should also make them at least question our approach then, given Sweden has no lockdown and is seeing about one-third fewer deaths per million citizens] – Guardian
Market up after Gilead’s Covid-19 treatment Remdesivir shows promise in leaked report – CNBC and Stat
Owner directors ‘come out of this with nothing’ due to lack of government support – BBC
Ten reasons to doubt the Covid-19 data – Bloomberg
UK is [supposedly] set to restart contact tracing – Guardian
Nine out of 10 dying of Covid-19 had existing health issues, on average three of them – BBC
Our pandemic summer [US but relevant] – The Atlantic
Nursing home residents make up nearly half of Belgium’s coronavirus deaths – Brussels Times
Locked and loaded – Bennallack
China outbreak city Wuhan raises death toll by 50% – BBC
Why is there a flour shortage in the UK? – CBBC
You Clap For Me Now: meditation on racism and immigration in Brexit Britain [Video] – YouTube
Kindle book bargains
Exactly: How Precision Engineers Created the Modern World by Simon Winchester – £0.99 on Kindle
Gordon Ramsay’s Ultimate Cookery Course by Gordon Ramsay – £0.99 on Kindle
Remote: Office Not Required by David Heinemeier Hansson and Jason Fried – £0.99 on Kindle
Side Hustle: Build a Side Business and Make Extra Money by Chris Guillebeau – £0.99 on Kindle
Coronavirus government briefing mini-special
A study of the increasingly bizarre backgrounds of Matt Hancock’s video briefings – Independent
Hancock is channelling James Blunt, Raab looks terrified – Marina Hyde
Little Brother is watching you [Images] – Guardian and Steve Bell
Off our beat. Ish.
“Anybody can do this game” – a pretty funny (NSFW) three-week day trading diary [Video] – Jason Portnoy via Twitter
I always feel crabby too after a long flight [Video, funny] – via Twitter
And finally…
“Wisdom comes to us when it can no longer do any good.”
– Gabriel García Márquez, Love in the Time of Cholera
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Comments on this entry are closed.
@zx, did you read about the French study of the 9 year old boy (part of the early ski chalet outbreak) who passed a couple of other respiratory viruses to his siblings, but did not pass coronavirus to anybody in his family or school? Only one case, of course, but interesting.
@vanguardfan. Yes, I did read that. It’s part of the research I was alluding to Unfortunately, the RKI expert on a conference call I was on Monday was asked about that French study and responded “it’s the statistical equivalent of an anecdote” (in a very dismissive German accent … perhaps he doesn’t like the French research team!)
In mid-Feb, I was probably in the “take the mortality rate and divide by ten camp”. Unlike TI, I don’t feel we’re heading lower in terms of the consensus for mortality rates; more that we went higher in March and have come back to where we all started. I’m genuinely worried by the lack of progress in terms of nailing down the parameters of the disease. I’m disappointed with the lack of progress on therapeutics. Then again it feels like whack-a-mole with 30+ variations of SAR-CoV-2 and each one producing very different viral loads.
Honestly, I get more confused the more experts I listen to and the more studies I read. When I listen to epidemiologist’s views on SARS-CoV-2 I get a feeling of deja vu. It’s like listening to a bunch of economists. I do worry about the ratio of hard science/stats to opinion.
Yes, one case is one case, no more and no less. But better news than if he’d caused a massive hot spot at his school…(and of course, the next case report might show that..)
Inevitably, when there is this little known about something, the gap will be filled with opinion and speculation- by experts as much as anyone else.
Time will reveal more.
@Vanguardfan
I wasn’t going to reply again but I can’t let you get away with turning my
“help with improving outcomes to coronavirus by improving metabolic health” into
“could prevent coronavirus transmission now, in an acute pandemic situation”
I’m not saying that eating a real food diet reduces transmission of the virus. What I am saying is it is extremely likely, on the basis of all the evidence, that eating such a diet for a sufficient, possibly fairly short period, will increase the probability of a good covid-19 outcome once you’ve been infected by the virus because of improved metabolic health.
ZX – huge respect for your views but I must admit I thought you might be posting a response to inflame views! We are also super lucky per your situation but
– as vanguard says there are many children for whom school is a lifeline if they are in a vulnerable situation such as low incomes or risk of abuse. Being stuck at home for some children must be a v negative experience
– many parents haven’t got the time or inclination to help their teachers learn
– ive not come across many state schools who are offering online access with parents being sent work via email or looking at other resources. Just about works short term if you are a dedicated parental resource or a motivated child
– for me the great part of school was the extra activities beyond the core that you mention that helped develop social skills and friendships
– most parents I’ve come across are super keen for their children to go back but I agree with you they are nervous as to the health consequences
– so I am in the camp of them going back as soon as the NHS won’t be overwhelmed and believe what we are offering now is a v poor substitute despite best intentions. I accept and understand the different views
No, you said ‘there is a preventative intervention which would address the route [sic] cause of susceptibility to the virus….eating nutrient dense real foods’. That was the sweeping claim I was challenging, not the article you linked to.
I’ll leave it there for now, as I’m sure readers can make up their own minds.
@seeking fire, there’s a massive disparity between the lockdown offerings of private and state schools (based on my anecdotal knowledge, of course). State schools are not offering real time online lessons, as some private schools are, and by no means all students will have a personal computer and good internet access. That before you factor in home situations, parents with loss of income, etc etc…It’s a disaster for many many school kids. In some ways I’m glad mine are exam years, if they were missing a whole term of year 10 or 12 it would be very very hard even in a home with every other advantage.
I very much hope getting at least primary, yr 10 and yr 12 back will be given high priority.
For anyone who still believes I’m over-egging the financial impact of this flavour of lockdown (plus all the external / ex-UK factors of course):
(my bold)
https://www.bloomberg.com/news/articles/2020-04-23/u-k-labor-market-outlook-is-horrendous-blanchflower-says
@vanguardfan
I agree my language could have been clearer in the first post but I was talking about being susceptible to the affects of the virus not susceptible to transmitting the virus.
It was made more than clear in my next post, but I don’t think you were interested in understanding my point.
At least
@SeekingFire. It wasn’t meant to inflame. Or perhaps it was meant to inflame those whose attitude seems to be anyone 45+ is expendable for the good of the economy.
The attitude on here from some is “the probabilities are really low so what’s the issue”. I’m 45-50 but probably a good third of the parent in my school (4-13) are 50+ and perhaps 10% are 60+. When you see BoJo (55, male, fat but historically healthy) with basically a 50:50 chance of survival, parents quickly put themselves in those shoes and think that’s not a risk I’d want to take.
Moreover, the probabilities are not clearly low. Honestly, I’ve looked at this and I could justify a my own probability of death at anything from 0.1% to 5%. That’s not a useful range to base a risk assessment on. When the background probability is 0.3% then even 1% is far too much risk to take. Yes, like many others I suspect that the lower end of the range is far more likely than the top. But that’s an opinion, a hunch, a punt. Personally, I don’t ever gamble. Dying with young children is not something to play dice with. I’m surprised so many others are willing to take that punt … or perhaps it’s just because they won’t be the people taking that punt.
I think one area of disagreement is weighing the uncertain risk of Covid-19 on the majority of the population versus the uncertain (but definitely bad) impact of extreme lockdown on other health consequences and on the economy (with further impact on health consequences).
From the start I’ve been arguing the contraction will be large (albeit I still hope short) and that will have massive impacts, especially for the huge numbers of Britons who don’t even have £500 in savings. That it will reduce routine diagnosis of this or that disease. It will reduce tax revenues and in turn have a knock-on on future health care funding. All this is no longer debatable.
In this thread alone I’ve provided evidence from specialists suggesting we’re already a couple of thousand cancer diagnosis short, and plenty of operations being cancelled. One cancer specialist quoted is already willing to say more will die from cancer than Covid-19 (same link)
And this is cancer — the top of the pyramid of importance. What else is being missed?
As I’ve cited before (FT) at least some in government have found expert opinion ready to suggest 150,000 deaths eventually from lockdown. I have no way of evaluating that figure of course.
Of course it’s hugely complicated; Covid-19 is crowding out other hospital treatments, and there’s the risk of actually getting infected in hospital etc.
Then there are the economic effects. Some may consider it the opportunity for a great reset etc. Others may be wondering how they’re going to pay their rent or mortgage, or buy their kids toys this Christmas.
Finally, I take the well-made and easily missed point that we’d probably see a recession anyway (e.g. Sweden is forecasting a steep recession) so it’s certainly not appropriate to only blame our lockdown. However clearly our own extreme lockdown makes it worse, likely a hell of a lot worse.
If extreme lockdown was a free precautionary principle — like “better to give up cigarettes than vape because we don’t know whether vaping is bad for you” then I’d have zero problems with it. But that isn’t the case.
And all this with a *relatively* less dangerous disease that overwhelmingly hits those who have low life expectancy already (very very sad, but if we wanted to give e.g. 35% of GDP to treating them and buying them an extra few months of life we’ve had decades to do it, so are we really being rationale here?)
What should we do? Well, as the joke involving direction-givers from variously maligned nationalities says, we “wouldn’t want to start from here”. But here we are.
There is another scary possibility. There is some evidence (though perhaps it has already been discredited) herd immunity may not be possible due to previously infected having low/no antibodies. This may mean an effective vaccine is also not possible. So where do you go from there? A 19th C darwinian survival of the fittest to get the economy up and running or this level of restrictions for the forseeable future? The only answer then (other than Darwin) is a hard worldwide stamp down until new cases are 0 worldwide and all known cases are resolved. But every country is approaching this in their own way, so the chances of flair ups and sliping back through the net are very likely.
@TI, the impact on non covid health outcomes (like cancer) isn’t going to be made better by lifting the lockdown, rather, the opposite. The reason these health issues are being neglected is because treatment of covid has sucked up all available health resource. ‘Running the epidemic hot’, or hotter than it is, will mean it is longer before health care capacity can be freed for other stuff. One of the consequences of running rather lean on our healthcare spending.
(And before you misinterpret this, I want to make clear this is not me arguing for or against a particular time frame for lockdown easing, rather, I am just saying I don’t really understand what point you are making about the non covid health outcomes, as your own argument here would seem to favour a longer lockdown.)
When I say ‘all health resource’, before you pick me up on it, I don’t mean literally all of course. There is still quite a lot of other healthcare going on, it’s just that a lot of resource has been redirected.
@Vanguardfan — Well as you’d expect I don’t really agree with that, accepting of course that I could be wrong and there is huge uncertainty. GP surgeries are closed and numerous health interventions are not taking place. The economy is crashed, scything tens of millions off future healthcare spending every day. Sweden has kids in school and people in restaurants, and it’s not clear to me that our lockdown is doing much better. We have massive Nightingale facilities lying essentially empty (thankfully, but still).
I appreciate your view is that with the milder / more targeted lockdown I’ve (and others of course!) suggested, there’d be an explosion in Covid-19 hospitalisations that would run out of control and crowd out any benefits.
I supported the lockdown for the first few weeks as an emergency measure but the more it goes on the less I feel its continuance is warranted. Listening to Whitty yesterday, it seems pretty clear the man would keep us in lockdown until 2021 (or some new currently unforeseen development). I shudder at that thought.
p.s. I should add “lockdown continuing in its current form…” Like most I think we should proceed out of it in some sort of staggered way, whether by distancing measures, industry, demographics, or whatnot. But don’t think we should drag our feet about it.
@TI. Sigh. I wasn’t asking for agreement or disagreement, I was asking you to explain your line of thinking. How would more cancer and other treatments be able to be delivered by easing lockdown? These treatments have been deferred to free up resources to treat covid. More covid= fewer other treatments. Less covid=more capacity for other treatments. (Part of the deferral of treatment is due to the need to practice healthcare safely, but again, the less covid, the easier to do that). Do you see it differently?
(I’m explicitly not talking about economic impacts here. Or about general arguments about lockdown. I’m just not following your logic and would like you to clarify your reasoning. You’ve answered with a completely tangential combative argument. I wasn’t arguing, merely seeking to understand….).
In answer to my own question, is it that you think we can ease lockdown rapidly, and stay at the same rate of covid healthcare need?
@Vanguardfan — I’m in a bit of a rush this afternoon (partly for posting on here earlier!) but did you read the link I put up earlier in the thread warning of cancer diagnosis being missed?
You may suggest that a majority of oncologists and other health professionals are now being directed to dealing with Covid-19, and this explains the collapse in referrals. I doubt that’s true, and suspect access and also confusion and the fact the GP is closed is a big part of it.
I do agree of course that some – perhaps a lot – of would-be cancer resource has been redirected to tackling Covid-19. I’m not qualified to say whether “too much” has, but there’s a growing chorus of specialists who do suggest we need an urgent taking of stock:
https://www.expressandstar.com/news/uk-news/2020/04/21/academic-warns-about-risk-of-cancer-epidemic-following-covid-19-impact/
Given officials were forecasting far higher Covid-19 hospitalizations at this point a few weeks ago when lockdown began, building Nightingales and whatnot, then what is everyone redirected doing?
If we’ve put everyone on Covid-19 watch on the grounds we need to cope with higher hospitalizations, then biting the bullet and easing lockdown a bit to push through now (accepting higher hospitalisation rate potential, though I suspect it wouldn’t explode as long as we kept physical distancing and self-isolating over-60s say) would seem appropriate.
I can see cancer operations (and other interventions such as stents etc) are trickier, given ICU issues etc. But even getting a diagnosis for cancer now as opposed to in three months could make a big difference.
Obviously my own personal view of the backdrop (infection rates to-date, likely IFR) colours my thinking, too.
I’m the first to admit I’m not an expert, and my opinion here is just that.
Yes, or possibly even sustain a higher rate of Covid healthcare need. Of course this is only worth doing if it means we generally are pushing through with virus exposure. If it’s true only 2% of the population has had Covid-19 (as opposed to the 10-20% I was seeing as likely, although less so with these new WHO findings I admit) then it’s harder to justify. And to be honest in that case I don’t know what we’re going to do.
I’m surprised you found my previous reply “combative”, incidentally, when it includes phrases like “accepting I could be wrong” and “I appreciate your view” and “I feel…”
Edit: “HardER to justify”. *Any* approach is pretty hard to justify, including the status quo, IMHO!
@TI, thanks for that clarification. For the avoidance of doubt, I think cancer diagnosis, screening and treatment is a good thing, and should not be postponed or prevented unnecessarily. Clearly part of the issue is the need to keep immunocompromised patients away from infected sites and healthcare workers, so it’s not straightforward and is definitely facilitated by lower rates of transmission and more testing.
Btw, GPs are not closed, I know quite a few. They are conducting as many consultations as possible remotely, but appointments are certainly available, my son has had three since lockdown.
@ti, probably guilty of overreacting to your first sentence ‘I don’t agree with that’!!
Anyway, I think we have probably reached almost complete agreement with ‘and to be honest in that case I don’t know what we’re going to do’. That’s about as far as I’ve got in all this. I can speculate on what I think might unfold in terms of lockdown easing, I can have some opinions about that, but really I think this is all a bit of a sh** show whatever way you slice it. There are no good options, absent suddenly finding that 50% of us are already immune, which sadly, I still think is very unlikely.
Antibody tests showing 13.9% of New York inhabitants have antibodies (perhaps some more have had the virus and don’t have detectable antibodies?).
Crude death rate around 0.5% (not sure precisely how that was calculated)
@Snowman — Source please? Not least so I can link tomorrow. (My understanding was this had only just started?)
https://www.youtube.com/watch?v=IIru8C-ayYk
(around 8 minutes)
Great, thanks.
Hmm. 21.2% in NYC. And the US was behind us. Perhaps this supports 25% / 2million+ in London, which would obviously be way higher than consensus when some of us were hypothesing such 2-3 weeks ago, but also lower than I’d have liked / hoped to see.
I don’t really see why we can’t be doing these tests in London now, incidentally.
But then we’re doing c.20K (live infection) tests out of 40K capability and look very unlikely to hit our 100K end of April target.
I’ve strained to cut the powers that be some slack throughout, this is bombshell and nobody thinks there own government is doing that well it seems, but the British gov and advisers have made it v hard to have confidence in them.
Edit: Clarified 20K live infection tests. Still no antibody testing being done at scale in UK as far as I’m aware after *that order*…
@Richard… vaccines for coronaviruses don’t tend to use a coronavirus as the base so low immunity from having the virus doesn’t mean low immunity from a vaccine thankfully
Also… a further bit of good news… coronaviruses don’t tend to mutate very much, unlike influenza and avian viruses.
There was a segment by a professor on Andrew Marr last weekend… strongly suggest watching it. I had found the bbc insufferable until this past election, and begrudge paying a licence fee, but that at least was worth watching !
@TI
Official information on the UK antibody testing here
https://www.gov.uk/government/news/government-begins-large-scale-virus-infection-and-antibody-test-study
Interested to know if any monevator readers have had a letter?
Thanks for that @Snowman. It’s interesting reading the press/Twitter reaction to the NYC 21% antibody (very preliminary) finding.
I’m pretty disappointed it’s not higher; I’ve been positing here much higher than consensus infection rates for a few weeks now (as has @Snowman and others) so it’s no surprise but I’d have liked much higher for my wider thesis to hold.
Whereas much of the media/Twitter seems to find it very surprisingly high.
E.g. https://twitter.com/brianmrosenthal/status/1253351733163692034
Also, initial Stockholm data is in. They are finding 11% antibodies. A statistics mathematician quoted reckons a third in Stockholm have had it (can’t see his workings) and doesn’t seem too dismayed by the 11% finding, saying the uncertainty bands are very wide and the truth is probably in between. (So between 11-33% — 21% again like NYC? haha.)
https://www.svt.se/nyheter/inrikes/11-procent-av-stockholmarna-har-antikroppar-mot-covid-19
Thanks to everyone for an interesting discussion, especially those with Public Health experience.
Prediction is difficult, especially about the future, but things will probably pan out roughly as follows:
The virologists seem reasonably confident that an effective vaccine (i.e. one producing 80% protection) can be developed, but it will be 12 to 18 months before it is widely available.
Until then R0 has to be kept below 1. The wearing of non-medical grade masks in indoor public spaces, and the use of testing and contact tracing, should allow other social distancing measures to be gradually relaxed. I like the idea of small ‘bubbles’ of people from more than one household to be able to socialise among themselves. This might allow young-ish grandparents to provide child-care. (I don’t see primary schools re-opening any time soon, given the crush of parents outside dropping off and collecting.)
Over time information about the virus will increase, and drug trials may enable more effective treatment of infections.
The UK Government seems to treat its citizens like infants: too sensitive to handle the truth, too stupid to understand anything other than simple messages, and poorly motivated. I suspect that most people are extremely keen to avoid getting infected, not only because of the risk of death, but because the uncomplicated illness can be so unpleasant.
For my part I am trying to avoid reading too obsessively about the epidemic, as that is better for my mental health. But old habits die hard, and I like to have some idea about what is going on.
New (for the UK) respirator hoods are being deployed in a NHS hospital (I read an Asian country has used something similar to great effect).
Press release: https://www.uhs.nhs.uk/AboutTheTrust/Newsandpublications/Latestnews/2020/April/Hospital-trust-becomes-first-to-introduce-pioneering-respirator-hoods-for-staff-treating-coronavirus-patients.aspx
And the much better link IMO: https://www.southampton.ac.uk/publicpolicy/support-for-policymakers/policy-projects/perso.page
Imagine these being available in decent quantity. Many shops and offices could reopen, and people wear hoods to go into them. Bit difficult for restaurants…
@BBlimp, there are NO vaccines for coronaviruses, at least none that infect humans.
@Snowman, very interesting about NYC.
Sorry should have been more specific, the vaccine under development for Mers, which has proved effective in mice, doesn’t use mers as a base,
The important point being low immunity from having caught covid does not necessarily equate to low immunity from a vaccine
Thanks for the link to the Stockholm study TI. That’s interesting.
Interestingly they talk about the accuracy of their test. They say their test gives no false positives (false positives could skew the results quite badly when % infections are quite low) and 70-80% false negatives.
How would they work that out? You need an accurate test to tell you if a less accurate test works, and if such an accurate test exists, you would use that accurate test instead for a small sampling exercise. And if you use a number of different tests then they may all show a systematic bias in getting it wrong.
So this is my guess on how they work out the accuracy based on my thinking and what I’ve read.
You can look at those who have tested positive under the antigen test (where false positives seem to be small) but negative under the antibody test, to detect 20-30% false negatives from the antibody test.
But it is harder to identify the false negatives from those who have had the virus, have never tested positive under an antigen test, but test negative under the antigen test. This is because the antigen test only tells you if virus is detectable at a point of time and particular location of the body e.g. nasal passages. So you need to test someone continually every 3 days (regardless of the presence of symptoms because of the asymptomatic) to have a reasonable chance of picking up the virus when it is detectable. But then there are numerous examples of couples who have identical classic symptoms of covid-19 at the same time where one tests positive and one tests negative for the antigen; would every 3 day testing ever have picked up the virus in the person who tested negative, quite possibly not.
So when they say 70-80% accurate they can be fairly sure it is not above 80% accurate but they can’t really be sure it is it is less than 70% accurate. So it could be 35%, not remotely saying it is, but they have no way of knowing, even if they are guessing it isn’t that low. And if it is 35% then means one third have been infected as Tom Britton believes.
False positive antibody tests they have ruled out by testing old pre covid-19 blood samples etc, as they should all test negative, so I think they can have some but not total confidence there are negligible false positives.
I’ve not seen anything to suggest we have a reliable understanding as to how many will have detectable antibodies, and the distribution of these antibodies over time. Seem to be a lot of people who fight off the virus with their innate immune system, and would love to see some study and analysis of what their typical antibody response is. Those whose adaptive immune system kicks in and are symptomatic presumably have an antibody test that is detectable and measurable over time. But we need to see which antibodies they are testing for IgG or IgM and at what concentration, and how quickly that level would show up on average after infection. Chris Whitty talks about 21 days to show up but that’s the necessarily simple press briefing explanation.
Because we don’t understand the antibody timing, it is hard to know when we say 11% have been infected, at what point in time that is. When new infections are increasing exponentially every 2-4 days the percentage of the population who have had the virus can double in days rather than weeks. So an antibody test that shows 5% have had the virus could a week later show 10% have had the virus.
There are other factors involved too. For example in all this sampling there is a lot of selection going on, it’s not random sampling. People in shopping centres tested = people moving about more, but healthier. Blood donors = healthier. So how will this skew the results relative to a random sample?
That’s a long waffle, but my overall conclusion is that the distribution around say the 11% infected in the Stockholm study is heavily skewed around that 11% estimate. So it might be 9% – 35% now. The main points in saying this are the 11% is at a past point in time and may miss a good chunk of those who have had the virus due to false negatives.
So if attempting to justify a high percentage of the population have already been infected theory, I would be encouraged by the New York and New York State results. While we have less detail about how the testing was done and when, we can reasonably expect the New York State percentage to be around 13.9% and possibly a lot higher, but probably not much lower.
One thing that the New York results did show (which surprised me but probably shouldn’t have surprised me) was the huge variation of % infected between different parts of New York State, between 3.6% and 21.2%.
I think the same will be true of the UK. Perhaps London is 25% infected so far and Somerset is 3% for example (made up figures).
Best thing I’ve seen on antibody testing state of play, albeit too technical for me
https://www.medrxiv.org/content/10.1101/2020.04.14.20065771v1.full.pdf
New paper suggests 10 years of life may be lost on average to a Covid-19 fatality. That’s definitely higher than I would have estimated. No idea if it’s correct, the data does seem counter-intuitive (e.g. 60-69 year olds with three co-morbidities lose 19+ years of life on mean average) but life expectancy stuff so often is:
https://wellcomeopenresearch.org/articles/5-75
NYC stats need to be treated with caution as Cuomo says. Worth noting that NYC has over twice the population density of London acording to Wikipedia. Also look at the infection rates outside NYC, Westchester and Long Island which are way lower. NYC has around 50% the population of NY state.
I accept the arguments about the economic costs of lock down, both short term and long term. I also accept the excess deaths and other human costs, mental, physical which result from the NHS having to concentrate its resources on COVID-19, from the lock down itself, people not seeking medical attention and, in the longer term, from the long-term impact on the economy.
As the facts change, my opinions change. I was initially sceptical about the herd immunity approach, then became persuaded the the infection rate was potentially massively higher then the number of cases but now have reverted to my initial scepticism. You can forget about the current UK-wide infection rate being 15% or 25% and the IFR being 0.09%. The risks of relying on herd immunity are just too great.
I believe that the main focus should be on improving the management of the current situation which in turn will enable an earlier phased loosening of the lock down. We first need to understand better the prevalence and characteristics of the epidemic. TPTB seem finally to have caught up with the idea of conducting a longitudinal study on a representative sample. At the same time, increase availability and reliability of testing both of disease and anti-bodies and continually refine treatment of infected people.
Examples:
– saliva testing such as described in https://www.medrxiv.org/content/10.1101/2020.04.16.20067835v1
– self-testing
– use of respirator hoods as mentioned above by @Indecisive
– alternatives to the use of ventilators (see https://arstechnica.com/science/2020/04/first-look-at-the-outcomes-of-covid-19-patients-in-ny-hospitals/ ) which refers to a 97% mortality rate for those over 65
– finding and rolling out effective drug treatment
I’m not suggesting that there will be a single magic bullet but we should aim for a situation where we can live in some semblance of normality with the virus without massive fatalities.
Improved management of the current situation will also enable the NHS to reduce its focus on COVID-19 and resume and intensify other vital activities.
@GOP — All fair points. One thing I’d note though re: infection rates outside of epicenters is you have to also ask *why* are the infection rates lower?
Is it because they just got the virus later or is it because the virus is less able to spread so rapidly outside of dense hotspots?
I think circumstantial evidence points to the latter. It appears that all the deaths making the news are in dense urban clusters (NYC, London, Madrid, Wuhan, and lesser scale at places such as Greater Manchester.)
This is important because it means the virus might not be so overwhelming if its infection rate is much lower outside of the major urban centres. It could ‘burn through’ a London or a New York, which then gets a local herd immunity, and outside of these big centers pop up much less.
This is definitely speculation on my part, but I think it passes the sniff test.
TLDR; I agree we won’t have as high rates of infection outside London. I also believe it *may* not matter.
From a quick read of that study TI
They seem to have classed people into groups of same age, sex and same comorbidity mix and then worked out the average future life expectancy for an average person of that age, sex and with that mix of co-morbidities.
Within that group, you will really have a heterogeneous group of people with different life expectancies, averaging out at the average figure for the group.
They’ve assumed the average for the group as the years of life lost due to the virus.
But the virus is likely to select those in that group who would have died sooner rather than later as its victims, rather than a victim of an average life expectancy for that group. Each death a tragedy of course, but that is the selection going on.
So it seems to me their analysis only provides an upper bound on the number of years of life lost. Hence why it is higher than we might expect. If we halve it, who knows if that is correct, we get 5 years.
If you were looking at the number of years of life lost for someone in that age/sex/comorbidity mix group, if they were to die in an avoidable car accident you might want to use the future life expectancy (average) for the group as the average years of life lost, because there is less selection going on by the cause of death. But that’s not what is going on here.
They talk about complex methods, so I can’t say for sure they have missed this obvious point. But there is no mention of it in the limitations only that they have missed out rare severe LTCs.
https://clausen.berkeley.edu/wp-content/uploads/2020/04/Corona_all.pdf
Despite the economic cost of social distancing lockdown policies it would lead to an even worse outcome if these policies were abandoned before the disease replication rate is totally under control.
The results also suggest that a massive testing and control strategy needs to be in place before there can be any easing of suppression strategies.