COVID-19


I watched the British Government press conference this evening, and now I understand the government’s view of the epidemic, and where it differs from those who are accusing it of not taking the situation seriously enough.

In the view of the government, its critics have a significant misunderstanding of how bad the epidemic is.

It’s much worse than we think.

People are pointing at Italy, and saying “look at that — it could be like that here, don’t you understand?”

The government view is that that is just the beginning. It is going to get that bad. And then it is going to get worse. And then it is going to carry on getting worse. What they are concerned with is just how much worse it’s going to get.

Conversely, when people point at South Korea, or Taiwan, the response is that they are only putting the problem off. Korea has had 8,000 confirmed cases. Maybe 80,000 actual infections (probably less given their heavy testing) out of a population of 50 million. The measures they have taken to prevent a rapid spread will have to stay in place basically indefinitely. Only one in a thousand of the population has had the disease, so there is nothing other than their protective measures stopping it. They can carry on having a hundred new cases a day for years. They can wipe it out with even stronger measures, but it will come back.

Italy has 12,000 confirmed cases, maybe 150,000 infections, out of a population of 60 million. Again, that’s only the start. 0.25% of the population. It’s going to get much worse than that. It’s going to get much worse than that everywhere.

The government’s view is that this isn’t going away until most of the people who are going to get it have got it. They don’t know how many that is — anywhere from 10% of the population to 80%. But they’re very clear that whatever that number is, it is not something they can affect. It’s going to spread until enough people have had it that it can’t spread any more. So the policy is not aimed at reducing the spread — only at slowing it over a longer time and protecting the vulnerable. In general, if you’re a young or middle aged healthy person, the government thinks you’re probably going to get it and that’s OK.

They also say the fatality rate is up to 1%. So if 80% get the virus and 1% of them die, we are looking at half a million dead this year in Britain. They spelled that out, explicitly stopping just short of doing the multiplication, because the 80% is just a worst-case estimate: it may be a quarter of that and half the death rate, and only 60,000 deaths.

If 60,000 are going to die, mostly over about 90 days at the peak of the epidemic, that means a minimum of hundreds of deaths a day, day after day after day. That’s what the government is telling us to expect. (On top of the thousand or so who die every day normally).

Are they right? How the hell should I know? If they’re wrong, there’s only a few ways they could be wrong.

Maybe the disease can just be wiped out. Nuke the curve, push the R0 below one, and hold it there until the virus doesn’t exist any more. That’s basically what happened to SARS. But even the places where they seem to be doing well are still getting a steady drip of new cases, and there are large regions where it is not under any control, so halting the spread would need a Moldbug-esque abolition of globalisation, which whatever its merits is not politically on the cards.

Maybe we could hold it off until there are better treatments, or a vaccine. The general view is that a vaccine is at least a year off, while treatments might improve over the next couple of months, but the government is already aiming to keep the peak a couple of months away.

Maybe most people just aren’t susceptible for some reason, so the total infections to expect is much lower, and snuffing the epidemic out is much more feasible.

Maybe the virus will just go away somehow. I’m not clear on how that would happen, but I’m no microbiologist.

Note that now it is the government that is taking the pessimistic view, and the critics that are clinging to the hope of a way out.

This is the most important question. If you want to know the future, the most important thing to look at is the places where the virus seems to be on the decline. Is it really finished, or is it just temporarily suppressed? If you can actually get rid of the disease with less than 1% of the population having suffered, then the government has got this completely wrong.

The other side of things is that, aside from protecting the weak and elderly, the government is expecting a big chunk of the population to get sick and doesn’t care whether you or I are in that chunk or not. But you and I can care. In this view, trying too hard to avoid catching it is antisocial: disrupting society and endangering the policy of having the virus burn out in a controlled way over a season, with well-timed interventions to smooth the worst of the peak. But a little selfishness is allowed. Frankly, I’m OK with being ill for a couple of weeks, but I have a close family member with respiratory issues, and I am prepared to go well beyond official advice to avoid introducing the disease to my home. That’s good policy for me even if it doesn’t help the government achieve its goals.




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