Relaxation of restrictions

This might sound harsh, but isnt it fair to say, that with the ages of many dying and the underlying conditions, that many would die in the relatively short term any way?

Idbatterim wrote: »

This might sound harsh, but isnt it fair to say, that with the ages of many dying and the underlying conditions, that many would die in the relatively short term any way?

We don't know their ages.

alwald

lord quackinton wrote: »

what are the mean and median ages of people dead from corona virus?
the rest of your post comes from you heart and so must be discounted
what is needed now are hard decisions made by people with their heads.
we must make decisions that protect all of society not the few.
we cannot expect young men and women who very likely wont even get the virus and if they did will recover in their homes be asked to give up plans for their future.
let people decide - you want to go back to work, school, living and really go to war with this virus then do it
or you can decide to hide away yourself in the hope we get a vaccine soon, then you do that.

pick a side and then get out of the way of the other side.

Most of your posts, which pretty much have the same content, put a smile on my face.
There is no such thing as pick a side or do what you want. There is a law that applies to all regardless if we agree or not with it.

Idbatterim wrote: »

This might sound harsh, but isnt it fair to say, that with the ages of many dying and the underlying conditions, that many would die in the relatively short term any way?

Why do you care so much about people dying?

Do you understand that if hospitals are over run, then even "healthy" people who get this virus will die, as they won't get treatment.

I really don't get how Ireland is considered a well educated country, when so many people just think well only old people will die, therefore lets get back to work, and don't for a second think about the sick in hospital, and who actually cares for them if we run out of beds/staff.

On dark side of things, at some point your going to die - are you happy to "take one for the team" now?

FloatingVoter wrote: »

We don't know their ages.

isnt it the mean age we know and its pretty old, 80 I think...

Idbatterim wrote: »

isnt it the mean age we know and its pretty old, 80 I think...

Nope, it's the median age. Explained throughout the thread.

Idbatterim wrote: »

isnt it the mean age we know and its pretty old, 80 I think...

No we don't know the mean, we only know the median which doesn't give the full picture, but that wont' stop people saying this virus only affects the very old.

Ace2007 wrote: »

Why do you care so much about people dying?

Do you understand that if hospitals are over run, then even "healthy" people who get this virus will die, as they won't get treatment.

I really don't get how Ireland is considered a well educated country, when so many people just think well only old people will die, therefore lets get back to work, and don't for a second think about the sick in hospital, and who actually cares for them if we run out of beds/staff.

On dark side of things, at some point your going to die - are you happy to "take one for the team" now?

I believe many of those getting sick in nursing homes, arent being admitted to hospital. No at mid thirties, I am not prepared to take one for the team. I am just pointing out, that many dying from this, particularly if in nursing homes, were already in **** positions maybe with dementia or god knows what, before this **** hit

Ace2007 wrote: »

No we don't know the mean, we only know the median which doesn't give the full picture, but that wont' stop people saying this virus only affects the very old.

nobody is saying it only effects the old, but the likelihood of dying if younger, with no underlying condition, is very very slim...

Thelonious Monk

Well if Ciara Kelly says we need to lift restrictions what are we waiting for?

growleaves

This might sound harsh, but isnt it fair to say, that with the ages of many dying and the underlying conditions, that many would die in the relatively short term any way?

That's been admitted in the last few days by Dr. Deborah Birx, Coronavirus Response Coordinator for the White House, and Dr. Jenny Harries, the Deputy Chief Medical Officer of the UK.

Dr. Harries said: 'These are Covid-associated deaths, they are all sad events, they would not all be a death as a result of Covid.' Still no numbers on how many deaths were caused by the virus.

Idbatterim wrote: »

I believe many of those getting sick in nursing homes, arent being admitted to hospital. No at mid thirties, I am not prepared to take one for the team. I am just pointing out, that many dying from this, particularly if in nursing homes, were already in **** positions maybe with dementia or god knows what, before this **** hit

I was in a nursing home / rehab clinic out in Clontarf three years ago recovering from a broken hip. I'm 45 now and was by no means the youngest inmate. It was more like a luxury spa (and very good they were too) but I can easily see how the virus would spread in that sort of loose environment.

Idbatterim wrote: »

I believe many of those getting sick in nursing homes, arent being admitted to hospital. No at mid thirties, I am not prepared to take one for the team. I am just pointing out, that many dying from this, particularly if in nursing homes, were already in **** positions maybe with dementia or god knows what, before this **** hit

So by your logic - who are we treating in hospitals - who are getting admitted to ICU. 22% of all cases have ended up in hospital - 49% of all hospital cases have been people less than 65.

Just because someone is in a nursing home, doesn't mean they are in bad positions, it's because situations at home change, or no one will look after them, or they aren't able to live independently.

The more read boards, the more you see some sides of people, it's basically someone who is 80 is "old" - regardless the fact 1 in 5 20 year old are expected to live to 100. Someone in a nursing home is just going their to die.
People really need to understand society and not just think of their own surroundings.

Two people under the age of 34 have died from this virus in Ireland - but you don't see that getting any media attention....

FloatingVoter wrote: »

I was in a nursing home / rehab clinic out in Clontarf three years ago recovering from a broken hip. I'm 45 now and was by no means the youngest inmate. It was more like a luxury spa (and very good they were too) but I can easily see how the virus would spread in that sort of loose environment.

interesting, didnt know they would put people in rehab there! With the rapid testing that is being talked about, how rapid are the results going to be?

Two people under the age of 34 have died from this virus in Ireland - but you don't see that getting any media attention....

right and will be able to claim corona virus as the cause of death for suicides , sparked by this situation, if it goes on much longer?

I linked to an article in uk pages back, with big spike in suicides in the last year, god knows what this year is going to be like!

lord quackinton

Ace2007 wrote: »

Comes from the heart? What are you talking about - i gave you the figures that show young people are ended up in hospital and ICU and then you come out with a comment "young men and women who very likely wont even get the virus and if they did will recover in their homes"

We aren't provided with the mean, only the median which has been explain hundreds of times on here, and it doesn't really tell us much overall.

Ok let's say john wants to go back to School, but his teachers don't want to risk their lives - what happens then?

It's laughable your approach - if you want to go back you can. So you could end up with health and safety issues - but let's not think about them?

its been linked here before i believe re deaths mean was 85 and median 71? open to correction

regards john who wants to go back to school, firstly his parents can make that decision, secondly schools dont need to reopen until september but the leaving cert should happen in july as planned. place cctv cameras in exam halls and get on with it.
remote working if possible to continue for those who can
sites, builder suppliers, garden centres etc open Tuesday.
pubs, hotels, restaurants open up - you want to work in one and drink/eat/stay in one then thats our choice.

now i get your point - public sector are in a different position to private sector- they believe there union job is a protected class.
public sector employees are conditioned to believe this and they were right up to this point - the public sector and the welfare state will be gutted by the economic fallout.
and so teachers should be out shouting that schools open soon.
it affects everyone this time

https://www.dailymail.co.uk/news/article-8207783/150-000-Brits-die-coronavirus-pandemic-domestic-violence-suicides.html

150,000 Brits will die an 'avoidable death' during coronavirus pandemic through depression, domestic violence and suicides
Fraser Nelson, editor of The Spectator, raised concerns of thousands of deaths
Predictions for 'indirect' coronavirus deaths could surpass those of COVID-19
The pandemic is expected to have a knock-on effect on people's mental health
Charities have recorded spikes in helplines from domestic abuse victims
Pressure is mounting on the government to reveal how lockdown will be eased

https://blogs.scientificamerican.com/observations/covid-19-is-likely-to-lead-to-an-increase-in-suicides/

Not surprised to see these issues not brought up by the irish politicians or media!

and before you bring "the daily mail" roll eyes :rolleyes: look at the sources they use! Nearly two weeks ago on the radio, I was hearing about the domestic violence increases here and we literally had just entered this ****!

skallywag

niallo27 wrote: »

What would you consider an acceptable amount of deaths per day to be, by acceptable I mean one where you would think, **** it could be a lot worse.

Well, in general terms of what I would think would be good or bad, I do not think you can look at one day alone, all statistics will fail if looked on in that manner. You need to look at the trend.

For example, if, say, 30 people are dying every day, then that certainly is not good. If that trend were to continue then you are looking at more than 10,000 dead in a year from now. Think of a situation where another infectious virus, such a measles, was killing 10,000 per year in Ireland. It would be considered totally unacceptable.

Now, take the trend where it is not killing 30 per day over a long period, but this tapers off, i.e. drops down to an average of 20 per day in a month, 10 the month after, etc. This is what I would describe as 'good', and get me thinking 'it could be a lot worse'.

On the other hand, if the 30 a day becomes 40, then 50, then that is going to be a different case.

lord quackinton wrote: »

its been linked here before i believe re deaths mean was 85 and median 71? open to correction

regards john who wants to go back to school, firstly his parents can make that decision, secondly schools dont need to reopen until september but the leaving cert should happen in july as planned. place cctv cameras in exam halls and get on with it.
remote working if possible to continue for those who can
sites, builder suppliers, garden centres etc open Tuesday.
pubs, hotels, restaurants open up - you want to work in one and drink/eat/stay in one then thats our choice.

now i get your point - public sector are in a different position to private sector- they believe there union job is a protected class.
public sector employees are conditioned to believe this and they were right up to this point - the public sector and the welfare state will be gutted by the economic fallout.
and so teachers should be out shouting that schools open soon.
it affects everyone this time

Mean has never been published - so that's you just believing some random poster. Feel free to find the official source.

Let's say we do your approach, and the hospitals get overrun with otherwise young and health men (mainly men on construction sites), and we run out of bed? and some of these men die. Is that ok, because well some will die.

At the moment we are coping just about, but if we get into an overrun state like Italy or Madrid what then?

I feel your the same poster who would flog there government if we were in Madrid's position right now. If you were in Madrid would you be telling the government to just re-open everything as well?

alwald

lord quackinton wrote: »

sites, builder suppliers, garden centres etc open Tuesday.
pubs, hotels, restaurants open up - you want to work in one and drink/eat/stay in one then thats our choice.

The law and current restrictions, which are not our choice but an obligation, state the above businesses won't open on Tuesday as you suggest. They will remain closed until the 5th of May and further restrictions beyond that date are very much possible and desirable to save lives and flatten the curve.

Idbatterim wrote: »

interesting, didnt know they would put people in rehab there! With the rapid testing that is being talked about, how rapid are the results going to be?

.

Three years ago.....broken hip ? I'd imagine that's one of the places they have earmarked for Covid patients if things turn bad though.

skallywag wrote: »

Well, in general terms of what I would think would be good or bad, I do not think you can look at one day alone, all statistics will fail if looked on in that manner. You need to look at the trend.

For example, if, say, 30 people are dying every day, then that certainly is not good. If that trend were to continue then you are looking at more than 10,000 dead in a year from now. Think of a situation where another infectious virus, such a measles, was killing 10,000 per year in Ireland. It would be considered totally unacceptable.

Now, take the trend where it is not killing 30 per day over a long period, but this tapers off, i.e. drops down to an average of 20 per day in a month, 10 the month after, etc. This is what I would describe as 'good'.

On the other hand, if the 30 a day becomes 40, then 50, then that is going to be a different case.

I think it was a consultant who was quoted here on this thread, an Irish one. I think he reckoned the acceptable death count, would be 30 or so a day...

say 10,000 in the year, its 0.2% of population...

https://www.percentagecal.com/answer/10000-is-what-percent-of-5000000

skallywag

Idbatterim wrote: »

I think he reckoned the acceptable death count, would be 30 or so a day...[/url]

Over what time period?

There is no way that any competent medical professional would make such a comment without time boxing it?

i.e. 30 a day for one week, one month, one year, ten years, etc.

Idbatterim wrote: »

I think it was a consultant who was quoted here on this thread, an Irish one. I think he reckoned the acceptable death count, would be 30 or so a day...

say 10,000 in the year, its 0.2% of population...

https://www.percentagecal.com/answer/10000-is-what-percent-of-5000000

Just so everyone is on the same page, are you ok for these 10,000 people or 0.2% of the population to be made up of health people under the age of 65 and maybe some health 45 years olds, if it means we get the economy back on track?

Ace2007 wrote: »

Just so everyone is on the same page, are you ok for these 10,000 people or 0.2% of the population to be made up of health people under the age of 65 and maybe some health 45 years olds, if it means we get the economy back on track?

have you seen the links I posted? about the deaths which are going to be coming about from suicide etc, lets not make this as black and white as you are making out!

skallywag wrote: »

Over what time period?

There is no way that any competent medical professional would make such a comment without time boxing it?

i.e. 30 a day for one week, one month, one year, ten years, etc.

its very informative, I am going to try find it...

niallo27

Ace2007 wrote: »

No we don't know the mean, we only know the median which doesn't give the full picture, but that wont' stop people saying this virus only affects the very old.

Well we have data from other countries that clearly point to it affecting the older generation on a huge majority.

So for anyone that didn't know this poster is a HSE consultant doing an AMA here on boards.

Essentially thinks we'll have to accept a certain amount of daily deaths even post lockdown

Quote:
Originally Posted by Pseudonym121 View Post
So, I see lots of talk about when restrictions will be lifted and the probable course and so I think it makes sense to post a reasonable middle case scenario ( not best case and not worst case ). I'll refer to best and worst case alternatives later. The key point about this post is that NO-ONE knows how this will turn out. What we can know is what is probable based on a number of assumptions.

So, what are those assumptions:
1. That this has some seasonality - there is growing evidence that this will be so. This would lead to a scenario where we could expect a Q4 resurgence.

2. That a vaccine is possible - it isn't possible for all viruses or at least isn't possible in the sort of time frame we need. Everything I've seen says that vaccines should be possible for SARS-CoV2.

3. That by the time a vaccine arrives there will be multiple strains. This isn't a huge problem as we have many vaccines for seasonal viruses which protect against multiple strains of said virus.

4. That the decision about lifting restrictions will be at least partly political and economic and not just based purely on medical advice.

5. That the decision about lifting restrictions will be based largely on medical advice, although not solely - this doesn't contradict point 4.

6. That SOME treatment currently being trialled will be found to be effective by September 2020. I don't know which one but I'm certain some reasonable treatment(s) will be found and production increased to meet demand.

7. That the majority of high risk individuals will continue to largely cocoon until such time as they can access a vaccine. If they come out before a vaccine is available, irrespective of government advice, deaths will skyrocket again.

Overall I think this is a good news story in that we aren't facing the destruction of technological society or the death of western liberal democracy but we are about to lose a lot more people than seems to be understood in the megathread. This isn't surprising as one of the defence mechanisms most people use to deal with the fragility of life is simply denial of its fragility... in spite of all evidence to the contrary.

So, first phase: Now till end of September
This will be the phase in which we will likely see 1500 to 2000 dead in Ireland by the end of May and a smaller daily number from June to September - I expect Ireland would tolerate 5 to 10 dead per day during that period in return for things largely returning to normal. So call it a low of 2100 and a high of 3200 dead by end of September. The main clusters will be in nursing homes, roma gypsies and traveller groupings because of their medical risk factors, proximity and intergenerational living setups.

Interpreting the data for Ireland is difficult because due to the lack of results from testing there is such a huge backlog that the one thing we can say is that our current numbers bear no relation to reality. Saying they might is purely a PR exercise. I understand why that is being said but that information isn't good enough for me to base decisions on the health of my loved ones on.

Anyways the normal rule for an epidemic is that you can say it is over when you've gone two 95% confidence intervals of the incubation period without a new case. This equates to about 28 days for SARS-CoV2.

Another way of looking at this is that we need to get the R0 below 1 to have fewer infections every day than the previous day. With an R0 of 3 and 90% of people obeying the lockdown/disinfecting rules 90% of the time and actually being effective with this 90% of the time you can see that we'd end up with roughly a 73% reduction in R0 from those assumptions. So R0 = 3 would become 0.813. Let's round that to 0.8 and if we had 5,000 transmissions a day to start with that'd drop as follows:
Day 0: beginning of lockdown 5000 new cases per day
Infection Cycle 1: 4,000
IC 2: 3,200
IC 3: 2560
IC 4: 2048
IC 5: 1638
IC 6: 1310
IC 7: 1049
IC 14: 220
IC 21: 46
IC 28: 10

Obviously I'm rounding and just approximating here but as you can see by IC7 you'd reduce transmission by about 80%.

A lot of people would look at IC 14 and say that by then with the number of new daily infections falling by 96% that if you lifted the restrictions then things would be fine but if we went back to the way we were behaving previously you'd be back to 5000 infections a day in 14 more ICs.

Why IC and not day? Well, the best data out there is that infections were growing at about 25% a day when we were looking at an R0 and doubling every 3 days but there's no guarantee that things will rise or fall by 20 to 25% per day. So I used IC. For ease of examples going forward lets just assume an IC is a day as that'll make it easier for people to grasp.

So what does the above tell us?
Well, it tells us that even if do a massive lockdown obeyed by 90% of the people 90% of the time with 90% effectiveness for 28 days if we go back to "life as normal" after that we'll be right back where we starting 28 days later.

And bearing in mind the death rate lags behind infection rate by somewhere between 14 to 26 days the death rate would start to fall just as new infections were really starting to rise again and we'd end up with another bad peak of deaths.

So, where to from there?
Well, it seems that the best way to play this would be to keep a really strict lockdown for about 28 days and then reduce it slightly, combined with advice for people to ALL wear masks when out and about, really strong, rapid testing and contact tracing. There would be separate advice for high risk groups who would be asked to continue cocooning as much as possible for as long as possible.

The 28 days gives the state the time to ramp up swabbing ability and test throughput ability as well as to train and man contact tracing centres and establish rapid response teams to respond once a new case is confirmed.

This would be something akin to the South Korean/Singaporean model and the goal would be to allow low risk groups to return to normal economic activity ( albeit with masks for everyone ) while cocooning those likely to die. Usage of masks by the young would be enforced by peer pressure as there would be a constant drumbeat of people in their 20s and 30s still dying and that would act to motivate them to wear masks. The goal wouldn't be to stop deaths but to keep them to a reasonable level - say 5 to 10 per day with the majority of those being the elderly obviously but probably a good 10% being young to middle-aged.

After another 28 days go by the government could look at loosening restrictions a little more if the death rate was on the lower side. Essentially they'd be balancing daily deaths vs economic activity... And before someone argues that every life is priceless. No it isn't. Your lives all have a very specific monetary value. The measure most used in the UK by NICE is called the QALY - Quality Adjusted Life Year. Most recently it was somewhere between about 15k and 20k Euro

Here's a link to explain it: https://en.wikipedia.org/wiki/Qualit...sted_life_year

For what it is worth this is why we will always have private health insurance. Some people have a lot more than 20K discretionary income per year and if faced with death or spending 30K a year to stay alive with a discretionary income of 50K per year you can bet a rich person will spend the 30K. You can have all the ideology you want but when push comes to shove people who can afford to pay to live longer will find a way to pay for it. Perhaps not a popular thing to say but I'm all about objective reality and that's just objective reality.

I'd imagine that every 14 to 28 days restrictions will be loosened somewhat. This will be possible because even if the R0 remains above 1 we should find some treatments which reduce mortality. Statistically this will allow us to keep the same death rate for higher rates of infection than is currently possible.

So, Phase 2: October to December
I'll assume we don't even have an experimental vaccine... If that is true then we'll have a choice between accepting higher daily death rates - which we'll have become accustomed to by the next two months - for those three months or we'll go into whatever of lockdown the statisticians and PR guys have figured will result in the daily death rate which the public will tolerate versus the severity of the lockdown.

This will be when you'll really see the selfishness in society. Things happened so quickly this time there wasn't much debate. Come October there will be a very active pushback against another lockdown. There will be a very active - but they're old and will die soon anyway lobby, much more active than it is now.

Unfortunately when push comes to shove people tend to be very selfish and when they've had a taste of freedom after two months of lockdown they really won't, en masse, want to go back to lockdown. The line that those whose families are high risk can choose to behave how they want instead of forcing all of society into lockdown will be prevalent.

How many will die in Q4? Well, easily 6k to 8k but a lot of that depends on the political and economic balancing vs deaths. How many die will be a choice the public and our government will make. They'll have the information to project the death rates from various courses of action much more accurately than they had now. This is why they were so cautious this time. Come October they'll have greater confidence in balancing life vs economics.

I suspect they'll strike a balance somewhat below the peak of April/May as people will be habituated to view anything below that peak as being "good". That would argue that they won't exceed 50 daily deaths for those 3 months and would result in 4500 dead in Q4. They may draw the line differently but I don't see the government enacting a full three month lockdown. I'd be impressed if they did, but I just don't see it happening for economic reasons.

The key point is we'll have the number of dead in Q4 we choose to have politically. There's a lower bound on that number below which we probably can't go but that lower bound may be as low as 1,000... but achieving that number would really impact the economy.

Phase 3: 2021 Q1-Q3 aka waiting for the vaccine.
Well that's what it will all be about. We'll throttle economic and social activity to control death rates. As our treatments improve and the virus adapts to us and selects for greater infectivity at the cost of lethality we'll be able to have more economic and social activity for the same number of daily deaths.

Once we get a vaccine which is good for the main strains around we'll largely return to normal. I, personally, expect we'll have a vaccine which is usable for the majority of the population by March of 2021.

We will probably have an experimental one by Q4 but the risks may outweigh the benefits for all but the highest risk groups with that experimental vaccine as they just won't have had time to prove its long-term safety.

Phase 4: Q4 2021
At that point we'll really get a sense for how effective the vaccine was and whether or not we get a strain which the vaccine doesn't provide protection for. If we guess right with the vaccine then Q4 2021 will be alright and this will just become a yearly "bad flu". If we guess wrong with the vaccine then Q4 2021 will be bad and we'll just have to work harder to get the vaccine right for 2022.

This is the same process that we follow with seasonal flu. The good news is that mostly we get the seasonal flu vaccines right.

Summary:
People talking with any certainty about lockdown being done in 2 to 4 weeks or in for the whole year don't know what they're talking about. The probability is lockdown till the end of May followed by a gradual reduction in the severity of lockdown until a death rate, which is deemed the maximum level which the public will tolerate on an ongoing basis, is reached and allowed run to October. In Q4 we'll have to see a tightening of restrictions again to keep the death rate down. What death rate will they view as acceptable? I suspect 50 dead a day or less will be the level but don't know, a lot depends on what the public tells them is acceptable. In 2021 it'll all be about keeping the death rate at an acceptable daily level until we get the vaccine. As treatments improve fewer social and economic restrictions will be required to maintain a stable daily death rate which is acceptable to the public.