Neil O'Brien Profile picture
Oct 16, 2020 25 tweets 5 min read Read on X
1 or 2 MPs have advocated the ideas in the “Great Barrington Declaration”: that we should get back to normal, go for herd immunity, & try to shield the elderly & vulnerable. Rather than dismiss this out of hand I've tried to crunch some numbers on what it would mean in practice.
First, how many people would need to totally isolate as the virus accelerates through the rest of the population?
There were 12,374,440 people aged 65+ in the UK in 2019.

But there are 14,843,119 people who lived in a household with someone aged 65+

Additionally (in England alone) there were 2,240,850 patients on the Shielded List - though some of these over 65, so there's some overlap)
Trying to isolate and supply food to all these 15-16m people while the virus spiked would be a monumental undertaking, & much like a hard (6 month at least) lockdown for a large part of the population. It’s not clear how we’d safely supply them with food as the virus spiked.
Second, how many people would likely die? If we look at English mortality rates from this Nature article and apply them to the UK population, we can get a range of answers.…
Everyone accepts that the isolation of old and ill people couldn't be 100% complete: some will choose not to isolate, some will have to go to hospital or see carers, or live in care homes, or the young people living with them will not fully isolate and they’ll get it.
About 8% of people have had the virus (call it 10% to be generous). Lets say we need to get to 60% for herd immunity. So we’d need a bit over 50% of the younger population to get it (and somehow avoid overshooting, which seems unlikely, but lets assume we could do that for a mo)
Using data from England suggests that if only half of the younger population got it and (miraculously) only 5% of pensioners (because isolation is near complete), that would mean 90,000 deaths. If 10% pensioners get it, that would be 130,000. If 15% then about 175,000.
…That’s a lot of deaths. But that’s still assuming that healthcare is not overwhelmed, and so all those who need treatment for Covid are still getting it. It’s also assuming there are no non-Covid deaths caused by the NHS being overwhelmed. Both assumptions are very unlikely.
Let’s look at data on hospitalisation rates from this paper in the lancet. And apply them to the UK population.…
If we again assume 50% of younger people get the virus and 5% to 15% of pensioners, that means between 860,000 and around 1.1m hospitalisations. Given the geometric way the virus grows without interventions, they would likely come at roughly the same time in a pronounced spike.
In England there are 4,123 adult critical care beds (up from 3,550 in 2010). Not everyone in hospital would need critical care, but even a small % of hundreds of thousands of people into 4,000 beds doesn’t go. Liverpool is already at 95% capacity.…
So the likely spike in admissions would likely wash over the NHS like a tidal wave over a tiny sandcastle. So we should add to the directly-caused deaths two additional large numbers...
... first, the covid patients who would die because they won’t be able to get treatment, and second, the patients with other diseases who would die because the health service is knocked out. It's likely to add up to hundreds of thousands dead.
There is then a further cost in terms of people who get the disease, don’t die but will have long term health problems. We don’t know how large this would be. The KCL study suggests 60,000 have been seriously ill for over three months. Scale that up and it is a large number.
To go with the GBD, you’d have to be 100% certain than NONE of the three permanent solutions will arrive: no vaccines, no mass rapid testing & no medical improvements such that ppl get the virus but don’t die. It seems pretty likely that several of these will arrive next year.
Vaccines are getting close, and various countries like China have started rolling out experimental vaccines before end of clinical trials...……
The US is starting to roll out mass rapid testing:

So good solutions are coming.

Lets look at the track record of the people behind the GBD.
One of the lead authors of the GBD predicted in May: “I think that the epidemic has largely come and is on its way out in this country.” She said the decline in cases was “due to the build-up of immunity.” This prediction proved radically wrong.
This matters because they make the same argument now: that SAGE are wrong because many more people out there are immune to Covid-19. The exact reason they say this will work now, is the same reason they said it was all over and fizzling out in the summer.
As a kicker, because people can get reinfected, it is not even sure we'd ever get to herd immunity, even if you think an elected government could somehow ride this out for the duration.
No countries are currently following the strategy suggested in the Great Barrington Declaration. The countries doing best have followed completely different approaches. Germany has local lockdowns. Japan has massively high mask use. Korea sacrificed privacy for great tracing.
We should learn from them, rather than embark on a route which, I'm sad to say, would definitely see the NHS overwhelmed and would be likely to lead to hundreds of thousands of unnecessary deaths.


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More from @NeilDotObrien

Jan 23
I have a new (data-heavy!) article on migration & ethnicity which includes:
- The "missing million" difference in migration figures
- Interactive maps for parliamentary constituencies
- An in-depth examination of changes in schools from a WPQ on DFE data…
The theme of the piece is that the effect of migration and ethnic change varies massively between different places and people. For some people, immigration hasn’t really changed their world. For others, it has absolutely transformed it.
I've used census data to make interactive maps of the impact of migration at the local level. While many shire and coastal constituencies have seen less than 5% of the population arriving since 2001, many London constituencies had more than 30%.
Read 15 tweets
Dec 12, 2023
My new article looks at how changes put in place by Boris Johnson both massively increased overall immigration, and also took us further away from being the 'grammar school of the west' (1/10)…
The UK has shifted from mainly EU migration to mainly non-EU migration (2/10) Image
Within non-EU migration, the mix has shifted towards poorer countries and away from richer. (3/10) Image
Read 10 tweets
Oct 24, 2022
There is a lot on this super-timely @ukonward mega polling report - things I thought were interesting included: (1/7)…
Why voters left - scandals, being too liberal on migration and (for some) the economy (2/7)
How much store voters put on honesty from PM (3/7)
Read 7 tweets
Aug 30, 2022
Energy Thread:
1 reason energy package will need an element of direct help is massive variation in energy cost WITHIN different income groups.

Chart below (which is old) shows huge variations, and all these costs will now go up a lot, making absolute variation even bigger (1/7)
In the old example above, the median household in the bottom spending decile was spending 14% of post housing income on energy, but the top quartile of same group were spending 23% and top tenth safely over a third. (2/7)
Different way to visualise (also old, this time income decile)

If you do enough for the average lower / middle income family, there are still a bunch of people with higher energy costs who are still stuffed (top left - I've coloured them red) (3/7)
Read 7 tweets
Aug 15, 2022
The latest in my series of pieces on challenges for the new PM looks at migration. Quick thread:

Since '97 there’s been unprecedented net migration to the UK. England and Wales’ population rose just 1.2 million from 1971 to 1991, but 7.6 million over the last twenty years (1/13)
Many Leave voters assumed Brexit would reduce immigration. But since the referendum gross migration has increased not reduced. (2/13)
The proportion of UK residents born overseas increased from 7.5% to 14.5% since 2000.

In Manchester and Birmingham it’s over 1/4 . 37% Londoners were born overseas.

Though we think of the USA as a “melting pot”, we now have a slightly higher proportion born overseas. (3/13)
Read 13 tweets
Jan 23, 2021
*Networks of disinformation: a thread.*

The covid-sceptic campaign group @pcrclaims have deleted all their tweets from before the last couple of days.

They are trying to cover their tracks & look more 'respectable' by deleting stuff like the below (from 16 December). 👇
But they still claim Covid is a "pseudo epidemic".

Their website features Clare Craig saying:

"it is all based around false positive test results, when there is no real disease behind it, and I think that's what we are seeing here." (2/3)…
Concerningly, it seems to be part of a network of slick disinfo sites: / @china_files

The sites share people. EG Mike Yeadon has his own site & *was* a spokesman for PCRclaims.
Read 8 tweets

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