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It is likely next week we will return to #lockdown, and with it we lose certain freedoms. Many feel angry and betrayed, many others scared. But let's stop for a moment and think, take a breath and consider where we are, and how we got here. I will touch on the science and psych.
Lets start with what COVID-19 is, a novel variant of coronavirus. Coronavirus itself is a large family of viruses under the branch. This version is 'novel' because it is new to the ecosystem and our immune systems (in part.) https://coronavirus.dc.gov/page/what-covid-19
The virus likely resulted as a new mutation. Mutations occur upon reproduction of genes, the rate of which are dependent on time. For humans this is low, once every 16-25 years (i.e when we get doooown,) but in viruses this can take minutes, and occur in vastly greater numbers.
To put that in perspective, what could take us millions of years could take a virus a percentage of that. Thus the rate of mutation and the variance of it is exponentially higher. But this is not always bad, or good. It is simply a change, and its adaption is specific.
Some mutations reduce the survival of an organism, so it does and the mutation is not passed on. It is not simply the mutation (altho some are lethal,) it is that it does not provide an advantage in the ecological niche in which it developed. Others do https://science.howstuffworks.com/life/evolution/evolution.htm
So for a virus with a high mutation and replication rate, the sum total of these changes is likely to be overall negligible, but in some cases an adaption can cause a superior branch for that niche. This is where COVID - 19 and others like Spanish flu,) stand out. This is nature,
So we have a relatively unpreventable event which is predictable in time to a degree, and nature to a degree. We have evidence for how something like this will spread, but not concrete evidence. This is where we must learn as we go. As such, things can get out of hand quickly.
Covid-19 first started in Wuhan, most likely as the result of coronavirus endemic to animals mutating and jumping to a human host. This was a game of chance (to an extent,) and we lost. It then spread like most coronaviruses do, because it holds on to most of the old adaptations.
Although there were some subtle changes reported by concerned doctors who noticed abnormal symptoms different to normal corona infections. This was a missed opportunity, and in every pandemic, there are many events we miss to stop spread.
( https://www.msn.com/en-us/news/world/focus-on-eyes-chinese-ophthalmologist-warned-about-covid-19-outbreak/ar-BB11CVce)
( https://www.msn.com/en-us/news/world/focus-on-eyes-chinese-ophthalmologist-warned-about-covid-19-outbreak/ar-BB11CVce)
One critical factor in the spread, apart from its similarity to most 'cold-like viruses', was the incubation period (i.e the in which a virus reproduces before symptoms emerge,) and the nature of society. It took a while to spot, was missed, and people moved around alot.
So by the time the world began to recognise this new virus and its risks, it was already out there in multiple countries. The boat was missed, and this is likely inevitable. We often see fire because of the smoke.
As time wore on, governments did not act quickly or decisively enough. We know how viruses spread, and we have a good idea how to stop them. But mostly, approaches have been suboptimal and did not address vectors properly, or track spread. Simply put, it was a clusterfuck.
Due to the long incubation period, any data we have today on infection rates is usually a few weeks old, so we are always behind the times. So we must make changes based on predictions, which can be inaccurate. So we need to act proactively, which to be honest, we did not enough.
. On the 23/3/20, the UK government announced a lockdown on 422 deaths, behind Spain and Germany. We already had notice for several weeks what was coming. And as @DrDomPimenta shows, in an exponential increase in cases, time matters. https://en.as.com/en/2020/03/23/other_sports/1584955521_254944.html
At this time there was a lot of confusion about the 'R-number.' Put simply, this is a measure of how much a virus spreads. If R=1, then 1 person will infect 1 other. If R = 0.5, two people will be needed to infect 1, and if its 2, 1 will infect two. https://www.gov.uk/guidance/the-r-number-in-the-uk
The issue here is that this is a cumulative measure, so if we do simple math (literally multiply each infection number by the r,) we can see a gross picture of numbers of infected. I will do it for 2 different R rates (massively simplified)
https://indra.mullins.microbiol.washington.edu/vgrc/doc/about.html
https://indra.mullins.microbiol.washington.edu/vgrc/doc/about.html
Key R= R, x = new infections, (y) = total infected
R = 1. 1(1), 1(2), 2 (5), 10 (17) ...
R = 2. 1(1), 1(3), 6 (10) , 20 (36) ..
As you can see a doubling of R does not mean double infections, it means an exponential *increasing by a multiple) each time.
R = 1. 1(1), 1(2), 2 (5), 10 (17) ...
R = 2. 1(1), 1(3), 6 (10) , 20 (36) ..
As you can see a doubling of R does not mean double infections, it means an exponential *increasing by a multiple) each time.
It is not this simple, as we need to factor in incubation, survival time, mutation etc. But as a rough concept, it shows us how something like this can spread. The r is dependent on a number of variables, one of which is how we adapt for how it spreads.
By reducing spread (i.e by cough,) we reduce the R number, and thus the number of new and total infections. Our target is to drop it below 1, which means the virus burns out. This is our goal, and the goal of a lockdown. So lets talk about some myths.
'Herd immunity' was bandied around as a solution. This generally means that enough of the public is immune (through exposure and development of immunity,) for it not to spread. This is usually reserved only for vaccines, as 'natural herd immunity' is a little bit of a misnomer.
Although this is debated, most agree that the term should not be used for wild type viruses. In gross terms, if a virus has a high enough fatality rate and likeliness to spread, aiming for herd immunity wouldn't work. Eventually no one would have the virus, as all are dead.
Vaccinations aim to reduce this risk by training immunity using exposure to weakened or dead viruses, allowing the body to develop recognition and kill any wild type encountered before it can reproduce and spread on wards. . https://www.immunology.org/celebrate-vaccines/public-engagement/guide-childhood-vaccinations/how-vaccines-work
This is how we saved countless lives from smallpox and measles, but also why we don't vaccinate against colds, simply not worth it, most colds have a high spread, but low fatality. But for small pox, its worth it. But due to bullshit antivaxx movements, we are seeing resurgences.
So during the lockdown we reduced the r number and hampered the virus. Coming out we tried to reduce the rate but return to normal life. We did it too quickly, we did not do it carefully, and fake news and poor scientific/political understanding acted to thwart efforts.
The concept of 'bravery' was conflated against masks, 'masculinity' against masks and 'freedom' against masks. Group thinking led to polarisation, creating an ideological argument based on immaturity and narcissism which helped the virus to spread again.
https://en.wikipedia.org/wiki/Groupthink
https://en.wikipedia.org/wiki/Groupthink
As a result we slowly saw the R number rise again. As this happened groups became angry at the potential of 'more curtailed freedoms (fair,) and used irrational and self-referrential quasi-delusional logic to back this up (unfair.) This became enmeshed with other movements.
The fight against COVID-19, became a war not just against the virus, but interest groups, individuals, politicians, economies, private companies, liars, charlatans, fake information and the misunderstand and vulnerability of the public. Another clusterfuck.
One example is @realdonaldtrump enabling the concept of masks meaning an end of freedom. Its categorical bullshit in most senses. Another the concept that 'masks are dangerous,', which, for the most part, is bullshit. There are exceptions, but these are staggeringly rare.
For example, 'I have copd' so the mask will kill me, no it wont. But covid will. So, in broad terms (always check with your doctor,) its safer to wear a mask. Most 'breathlessness' comes from anxiety and altered breathing patterns, not oxygen reduction. Its rather simple.
Or else, most surgeons would die. I would be dead. Most of the nurses on my ward would be dead. The populations of many and concerns of the scared do not readily add up. But some of this is acceptable, as many believed the liars who enmeshed this with the fairytales.
So here we are, about to go into lockdown again. On one side we have survival, reducing the risk to those vulnerable, and on the other, the economy, livelihood of many and all the others mentioned before. I will say clearly this is not a win win.
Businesses may go under, and its a moral question where we draw the line on what is acceptable. Many rightly state that delayed diagnosis will increased death rates from other illness, and others will argue that 'these people will die anyway (some may, most wont.)'
When we consider survival on a global scale, we think in terms of small percentages affecting big numbers. A death rate of 3% is 3/100, but 30000 in 30000000. For the NHS, this is not something we can deal with. We are not built for these added numbers.
This has always been a fight against a virus that will effect the vulnerable more than most of us, and we need to accept that. We need to accept that our sacrificed freedoms will give freedom from death to many, even if that freedom is only a short time.
Where we draw the line is debatable. A month lockdown to give 10000 people an extra week? A year to give 100 people an extra year? What if the people were children vs elderly. We are dealing with the value of human life, and we all have different perspectives.
I often consider to myself where would I draw the line if I was 75, what freedoms would I ask the masses to lose to give me more time. I suppose my life is easier to measure from my perspective, and my judgement would be more selfish than for judging someone elses.
We are genetically programmed to make decisions to enable the survival of ourselves and immediate kin, so sacrifice for the distant is simply not our normal state. Our ability to do so is a miracle of social evolution, but it may have its limits. We have seen those limits already
Every time you do not wash your hands, every 20 year old going out to party, every elderly person sent covid + to a care home, these were all moral decisions based on numerous factors. As much of a war against a virus, this is a test of our collective morality.
I cannot tell you what is right. I can only tell you what I believe. I believe we need to try and save as many lives as possible, in the most efficient way, whilst providing for those who will suffer as a result. We can do this if we make changes like this:
1) Lockdown for four weeks, but properly. Crush the r number, no half measures.
2) Gov stops spending on serco and pays a good furlough and protects businesses, this is in all of our economic interest
3) We talk openly about how to help one another
4) We predict imperfection
2) Gov stops spending on serco and pays a good furlough and protects businesses, this is in all of our economic interest
3) We talk openly about how to help one another
4) We predict imperfection
As said early on, this is a marathon, not a sprint. But the marathon has been hijacked by misinformation, frustration, exhaustion and subterfuge. In the end we all need to take responsibility for helping out, and ownership to become educated.
If we rely on others to stop the spread, it will not work. If we rely on ourselves, we all take part. Remember, its little % over big numbers. Four weeks does not ask much over a lifetime, but we must be sympathetic and help those who will struggle. It will not be easy.
So as we move on I will say this, whatever your politic, consider how you would best protect your loved ones, and apply this to everyone. Consider that failure is potential, but limited by action. Consider that it is within our power to help, but limited by choice.
I will continue at work during lockdown. I will think of all of you at home helping me. I will think of this as I help those with mental illness who suffer new fears. I will go home exhausted on empty tube trains knowing I am part of something greater.
We are not a virus, we do not survive only for ourselves. So lets work together. Lets give this a shot.
And please consider a #retweet and add your thoughts. Xx
Apologies for the long thread. I do not do things by half-measures. X
You have your decision to make, and that is yours alone and you will live (or die) with the consequences.
Are you with me?
Are you with me?
