Thread by @adsquires

Very good thread. Those opposed to "zero covid" need to clarify what they're suggesting instead. At the end of the day, either R<1 or R>1.

https://twitter.com/yaneerbaryam/status/1365497804601360387

Keeping R<1 will become easier and easier with vaccination. Under these conditions, covid levels die away, and flare-ups can be stamped out.

Some "steady state" level of COVID" that we "live with" isn't a thing, cos that's not how exponential growth works. Definitely not where (1) we don't have to do anything restrictions-wise, and (2) we still have some control over that level.

R>1 means exponential growth, out of control, until we do something. This *absolutely* has impact, directly on those with it, and collaterally, if many healthcare workers, teachers etc get it and can't work. Those asking the "cost" of restrictions must compare it with this.

Many seem to hope if we treat it like the flu (ie ignore it) it will behave like the flu. However, that's not under our control, and it probably won't:

Without quibbling about R data: flu spreads by people with symptoms. If they stay at home - or, cough/sneeze into tissues or sleeves - it's mostly contained. COVID is spread easily by people without symptoms, talking / singing / exercising indoors.

It's possible that you don't need a law: just as people know not to cough/sneeze openly on the tube, they could also know to wear a mask.

Nonetheless - flu happens to be at levels we can "live with". But if the numbers of people off work with the flu in flu season had been 10x worse, or 100x worse, we would not have been able to "live with" it, and we would have had some restrictions during flu season.

So the options are to leave R>1 and let numbers keep going of control; wait for that to happen, then impose some restrictions (another lock down?) to get it back down. We should be realistic about the costs of either of these. Or keep R<1. This also has costs. However...

These costs are easier and easier with vaccination. We're not talking perma-lockdown. We're talking, masks on public transport. Ventilation requirements in workplaces, pubs, restaurants, schools. Support so people can test and isolate. Essentially: something we *can* live with.

Two final notes. Those against "zero covid", as well as spelling out the alternative and the costs, should also suggest examples of (1) any other country pursuing their model successfully; and (2) any other country who is worse off for having tried to get to zero covid.