Coronavirus Sars-CoV-2/Covid-19 Megathread

[Richard Hakluyt]

Was just about to post that link myself 

I see Hertfordshire are top of the table, three points clear and a death in hand 

[Tamas]

Poland, with 26 cases, will be shutting down schools, unis, restaurants and cinemas from Monday.

Hungary is rumoured to follow suit soon, with schools and kindergartens at least.

[Richard Hakluyt]

The number of daily confirmed cases is not rising as rapidly as I would expect. Under-reporting, or have even our relatively lightweight measures slowed the growth  ?

[Tamas]

Was just about to post that link myself 

I see Hertfordshire are top of the table, three points clear and a death in hand 

[Sheilbh]

Was just about to post that link myself 

I see Hertfordshire are top of the table, three points clear and a death in hand 

Still doesn't seem to be a hotspot - or even a connection.

You look at that top five (Hertfordshire, Kensington and Chelsea, Devon, Hampshire and Brighton and Hove) and the best I could say is they strike me as areas with a higher than average rate of affleunt retirees who may have recently been to Italy.

[Tamas]

The number of daily confirmed cases is not rising as rapidly as I would expect. Under-reporting, or have even our relatively lightweight measures slowed the growth  ?

Check the quotes I quoted earlier. Only people who can be directly traced to a positive case are tested. So there needs to be a chain of you a) calling the hotline and b) being already aware that you have been in contact with a person with a confirmed infection.

[Richard Hakluyt]

Was just about to post that link myself 

I see Hertfordshire are top of the table, three points clear and a death in hand 

Still doesn't seem to be a hotspot - or even a connection.

You look at that top five (Hertfordshire, Kensington and Chelsea, Devon, Hampshire and Brighton and Hove) and the best I could say is they strike me as areas with a higher than average rate of affleunt retirees who may have recently been to Italy.

Yes, places with more skiing trips per head. I find it interesting that there seems to be no correlation with university towns; so Chinese students returning after the winter break are not part of the problem. The numbers are so low though, may all just be chance.

[Sheilbh]

Although that's still over 25,000 tests - we're not at the same per capita testing as Italy (and nowhere near South Korea) but it is striking.

And it looks like the Public Health England risk assessment is taking a fairly restrictive approach

There are no plans to test any UK ministers, including Boris Johnson, for coronavirus after Health Minister Nadine Dorries become the first MP to be diagnosed with Covid-19, PA reports.

The Department of Health and Social Care said ministers would not need to undergo testing as Public Health England worked to advise those who have been in close contact with Dorries.

PHE said it had assessed the risk of Dorries' individual close contacts and only those with symptoms need to self-isolate. For each Covid-19 case, a risk assessment is carried out and advice tailored to that group, a spokeswoman said.

[Sheilbh]

Yes, places with more skiing trips per head. I find it interesting that there seems to be no correlation with university towns; so Chinese students returning after the winter break are not part of the problem. The numbers are so low though, may all just be chance.

Yeah - that was thought/worry I had. I wonder if it's just that most universities start again in early January and it seems that the virus was still mainly in Wuhan/Hubei in December/early January.

So it wouldn't necessarily be a Chinese connection (support your local Chinese takeaway!) until late January/Chinese New Year. It would be more of a risk if your university had a particular link to Wuhan/Hubei?

[Richard Hakluyt]

Apparently 9 UK universities have specific links with Wuhan :

https://www.theguardian.com/education/2020/jan/23/uk-universities-issue-health-warnings-over-travel-to-china-coronavirus

It does look like it isn't a problem though.

[Sheilbh]

As I mentioned earlier the government is apparently listening closely to the advice of the behavioural scientists (or "nudge unit")

Some of their points seem to make sense to me and are being implemented from what I can see - so people don't know what "self-isolation" is, so UK messages are changing to "stay at home".

Others are bold, but I could see as being right, so apparently the models assess that cleaning door handles and lift buttons is a more effective control measure than banning large public gatherings. I haven't been to my office in weeks but I assume this has been communicated to building management people because, speaking to someone from work, they said there's basically permanently roaming cleaners cleaning the lift buttons and door handles through the building.

It's interesting that the behavioural scientists are taking the lead - but this does strike me as a very high risk area to let them have too much of a say
https://www.bloomberg.com/news/articles/2020-03-11/keep-calm-and-wash-your-hands-britain-s-strategy-to-beat-virus

I also think on a purely political level it's a very high risk strategy because the easy thing to do is announce quite strict measures - I think there's probably a sense from MPs and the public (self included) that the government might not be doing enough. Hopefully they're right and we're wrong.

Keep Calm and Wash Your Hands: Britain's Strategy to Beat Virus
By Robert Hutton
11 March 2020, 04:00 GMT Updated on 11 March 2020, 11:41 GMT

While China quarantined 56 million people and the whole of Italy is on lock down to counter the spread of coronavirus, the U.K. is taking a radically different approach. Instead of keeping people inside their homes, Boris Johnson's government is trying to get inside their heads.

A little-known team of advisers specializing in behavioral psychology is helping to steer the prime minister's response to the health crisis, shunning headline measures like travel restrictions and quarantines to focus on a more banal task: finding ways to persuade people to wash their hands.

BRITAIN-HEALTH-VIRUS

Johnson's team say their approach, while more relaxed than other efforts around the world, is based on sophisticated modeling that could ultimately cut the virus mortality rate among high-risk groups in the U.K. by as much as a third. The risk for Johnson is he'll shoulder the blame if the measures prove inadequate in the weeks and months ahead.

"We're trying, in a way that hasn't been done before, to use all the tools to hand: medical and mathematical but also behavioral," said David Halpern, head of the government's Behavioral Insights Team and a member of the committee managing the outbreak response.

In a sign of how determined they are to foster an atmosphere of calmly following advice, even after junior health minister Nadine Dorries was diagnosed with coronavirus on Monday, Johnson's team insisted there was no need to test him, because they hadn't been in close contact and he regularly washes his hands.

Summer Peak

At the heart of the U.K. strategy is a realization that, if coronavirus continues to spread, it will become impossible to stop most people catching it. Scientists on the team say their mission is to slow that process, reducing the number of people infected at any time and pushing the moment of peak infections into the summer months to ensure the National Health Service isn't overloaded.

To achieve this, the U.K. Scientific Advisory Group for Emergencies (SAGE) have so far resisted calls for more draconian measures, such as banning people from attending soccer matches, or closing schools. When few people in Britain have the virus, such moves would achieve little, they argue.

Instead, they are using mathematical models to understand how the disease might spread -- a challenge that relies heavily on predicting behavior.

That's where Halpern's experts come in. The group was set up a decade ago by former Prime Minister David Cameron to implement the insights of American economist Richard Thaler. At the time it was dubbed the "Nudge Unit" -- after Thaler's 2008 book with Cass Sunstein on how small influences can help people to make better decisions.

Biggest Challenge

Early work by the unit, which has carried out consultancy work in more than 30 countries, included text messages reminding people to pay their taxes on time.

But coronavirus is on another scale.

"The models rest heavily on what people will do," Halpern said in an interview. "Will people comply with instructions, and to what extent? If kids don't go to school, what will happen?"

An unintended outcome of closing schools, he said, could be children spending more time with grandparents -- potentially putting a group the government especially wants to protect from infection at more risk.

In the same way, banning people from attending sports events, where scientists regard an infectious person as unlikely to pass the disease to very many around them, could be counter-productive if people instead watch matches in pubs, where the disease is more likely to spread.

Disobeying

Another risk is imposing restrictions too early in the outbreak, leading to people becoming fatigued and ignoring instructions when it matters.

One of the behavioral team's insights is that people are more likely to obey rules if they have a coronavirus test and get results quickly. So scientists have pushed for much wider testing.

The main challenge, though, is more mundane.

"A lot of people don't wash their hands very often," Halpern said. "And certainly not for a very long time."

His team is trying to create a "behavioral scaffolding to form a new habit," he said -- making hand-washing part of a routine, such as when people get home or to work and take their coats off.

While Halpern's methods are new, he said they derive from a long scientific tradition. He cited a doctor working on a cholera outbreak in Victorian London who realized many victims were drawing water from a single pump. Taking the handle off the pump helped to end the outbreak.

No Shaking

One high-profile person who appears to be listening is Johnson, who told reporters Monday he's dropped his policy of shaking hands.

"The behavioral psychologists say that if you don't shake somebody's hand then that sends an important message to them about the importance of washing your hands," he explained.

Johnson also said measures adopted by other countries are not necessarily relevant to the U.K., which had 373 coronavirus cases as of Tuesday, according to the Department of Health. And there's a debate over whether quarantine measures such as China's will be effective, or whether the virus will simply re-emerge when restrictions are lifted.

But a "Keep Calm And Wash Your Hands" approach is still a gamble for Johnson. If locking down millions of people proves successful elsewhere, and the virus spreads uncontrollably across Britain, the policy will look like a terrible mistake.

— With assistance by Tim Ross
(Updates with health minister's infection in fifth paragraph.)

[Tamas]

So we have PR people in charge instead of health professionals, then?

That would not surprise me one bit with this government.

I have very serious doubts about the door handles thing. Who cares about the door handle if the infected people who touch it is in my vicinity just breathing the bloody thing out?

[Richard Hakluyt]

I quite like the current government action; but hope that they maintain a flexible attitude and make rapid adjustments if necessary. We have seen a lot of inflexibility in recent years though.


Tamas has been reported for being un-British; he should know by now that dogged stupidity and a cup of really strong tea is all that is needed to get us through this.

[Tamas]

I quite like the current government action; but hope that they maintain a flexible attitude and make rapid adjustments if necessary. We have seen a lot of inflexibility in recent years though.


Tamas has been reported for being un-British; he should know by now that dogged stupidity and a cup of really strong tea is all that is needed to get us through this.

[Sheilbh]

They are legit scientists - and they have had successes in changing people's behaviour, but....well, it's never been on stuff that's this serious. But behavioural psychology and behavioural science is, from my understanding, is that it's quite contested

See to me the door handle things makes sense. People are not great at washing their hands or sneezing/coughing into tissues. They open doors or push the buttons for lifts. I come on and do the same and I have become aware how often I touch my face following the advice on this - and I don't wash my hands after using a lift/touching a door. So I can see a clear path for me to get infected. Whereas if they're just in my area breathing that seems a lot lower risk - there's a lot of environment that those germs can be in whereas hand to surface to hand is very direct.

It seems to me to be the same reason why hospitals don't have door handles or doors you need to touch?

Now is it more effective than closing off big public events.