THREAD: quick look at how some European countries are doing & what we can learn from restrictions... NB there are general "work from home" advisories in all countries, but not clear how much people are. Slight differences in mixing rules. Thanks to @lmortshepherd for the charts!
1. Netherlands - cases went up rapidly from Sept & they tried regional curfews on bars & restaurants. These became national curfews but cases kept going up. Partial lockdown (schools + uni open) started mid October. 2 weeks later cases peaked and are now reducing.
2. France - Again cases started rising in Set and regional bar & restaurant closures were tried. Then national curfews. These were not stopping the spread and lockdown started a week ago - schools open. Today they had another record case day but early days.
3. Ireland - levels in 1st pic, cases 2nd. They tried Level 2, then regional Level 3, moved to national Level 3 (closed bars/rests, minimal mixing).Highest Level 5 (lockdown but schools open) started 2 weeks ago. Cases prob started reducing under Level 3 & rapidly reducing now.
4. Scotland. Strong restrictions nationally (curfews on bars/restaurants, limits on alcohol & mixing) in mid October & stronger restrictions in central belt (inc no alcohol). Schools open. Most effect in central belt. Now moved to levels gov.scot/publications/c…
So? Looks like curfews on bars/restaurants don't do that much on their own. Combined with limits on alcohol nd limited household mixing, working from home, other closures can slow & reverse growth. Takes a few weeks to show have effect! Reductions in cases not nec that fast.
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THREAD: on lockdowns, mitigation, herd immunity strategies. I have a *lot* of problems with this article by Lord Sumption in the Guardian today - so I've decided to do a thread on them. amp.theguardian.com/commentisfree/…
1. Just going to start by saying that no one thinks lockdowns are a good thing and everyone agrees they have serious & bad consequences. They are a last resort measure. I agree with Lord Sumption that they should be avoided if at all possible! But that is about all we agree on!
2. He starts off by saying "Suppose there is nothing that governments can do to stop the spread of Covid-19. What then?". That's his premise. But many countries have shown there ARE things you can do to stop spread. China, S Korea, Vietnam, Japan, Taiwan, Thailand, NZ, Uruguay...
THREAD: where we are with covid in UK, particularly England, right now ... inc schools and circuit breaks... based on my @IndependentSage briefing today (which you can watch here if you want )
Confirmed UK cases still going steadily up - doubling every 2 weeks or so - faster end of Sept and bit slower last 2 weeks. Of course reliant on testing so take with pinch of salt.
Cases continuing to increase in England, NI and Wales. 2 weeks into central belt restirction in Scotland and we're seeing a flattening. Remember impact on cases takes at least a week to show in case numbers. Keep an eye on NI next week and Wales in two weeks...
TLDR: 2 week circuit breaker NOW, then enough restrictions/FTTIS to keep R below 1
Cases are rising across England. SAGE estimate R i s1.2 -1.5 & not below 1.2 anywhere. Although North highest (1), everywhere rising. Plotting each region with start point at first week with over 20 cases/ 100K people/week shows that trajectories similar (2) - all on same course
All charts below assume simple exponential growth or decay (based on R) till end Nov. V v simple but illustrate point! I use hospital admissions as not dependent on testing. Back of envelope, don't take numbers literally.
Overall, doubling rate currently about 2 weeks (R=1.3).
At current growth, covid hospital admissions in North of England less than a week away from levels London had on lockdown day in March (per population)
Covid loves us socialising indoors (pubs & homes) and laughing, chatting over a table for hours... I think right now closing indoor pub service in hard hit areas & restricting household mixing is right thing to do BUT we need to work immediately on plan to reopen inc
Fixing test & trace (e.g. in England, currently works least well where needed most). This inc supporting isolation - financially (£500/2 wks less than minimum wage!), practically (caring responsibilities, grocery, accommodation...) (govt SAGE said same bit.ly/2SBpfKP
THREAD: many of us in healthcare have seen new IT systems hailed as gamechangers. Many don't live up to their promise. Often failure is at final step of implementation - I interviewed people at 4 hospitals who all implemented the same IT system & developed these cartoons...
The hope is that they capture typical stories of what pitfalls happen in real life - and gives tips for how to avoid them! The full cartoons (and a downloadable booklet) are freely available from @nejmcatalystcatalyst.nejm.org/doi/full/10.10… but here are some with real quotes :-)
"Because it involved IT, even tho the CMO had signed off & we had his blessing & the promised resources & the contract, then we had to go through what we call the IT gov committee. Which is not a quick process, so we had to formally present this…and that took another 6 mnths"
SHORT THREAD: Some interesting (if unsurprising) data in NHS test and trace this week on age profile & positivity rates - particularly for kids & young adults. 1/4
Firstly, MASSIVE increase in school-age kids getting tests in September. Stark to see how much extra capacity was needed - not surprising and should have been anticipated! Also surprising that 20-29 yr olds NOT getting more tests even though age group with most infections. 2/4
BUT, no increase in cases among under 10s and only modest increase in 10-19s. Biggest increase in cases by among 20-29 years olds. This age group should really be getting more tests. 3/4