This new chart from The London School of Hygiene and Tropical Medicine, via the Guardian, makes clear that the government's own Covid advisers think another wave of the disease is very likely this summer, fuelled by the government's reopening strategy.
The question to ask is what will happen if they are right? So far forecasts have been reasonably accurate as to the likelihood of such events, even if not always as to precise numbers. SAGE reflect that in a range of projections.
The obvious questions that need answers are:
1. Will there be another lockdown?
2. Will the government support those impacted again, most especially as this will happen at peak tourist season?
3. Will the NHS be able to cope at a time of the year when it is not geared to do so? They have holidays too.
4. Will people accept this?
5. Will there be a political backlash?
6. Will the Opposition be ready to oppose this time?
7. Will business confidence survive this?
8. Will jobs survive this?
9. Will employers survive this?
10. What do recurring patterns of Covid suggest life will be like from now on?
11. Can we adapt to this?
12. Will we adapt to this?
13. If not, what happens?
I do not know the answers to these questions. I am saying that to ignore the likelihood of this next wave and not ask these questions now would be irresponsible.
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They have never asked themselves ‘can we suppress the virus to near zero as in Aus,NZ, Taiwan, S Korea, China’ etc. These countries are now operating with a semblance of normality. We should have done already, and should do now, – ‘living with’ the virus=further lockdowns, ‘suppressing it’ gives some hope. Test & Trace has to be rebuilt.
https://drive.google.com/file/d/1EfBODZPQwyEQ77jaIjNL_yyncz-x50Cf/view?usp=sharing
The local rued and trusted, test, trace and isolate response is the one that was dumped 12 months ago by the government to make way for the profiteering for their masters and mates.
Billions were pocketed in setting up and implementing the voracious NHS App built on technology and platforms with suspect foreign countries and their MIC.
It is merely a data harvesting and future electronic ID tool.
The failure to have adequate PPE for medics never mind the rest of us was CRIMINAL.
As was the shunning of joining the European efforts.
Leading us into farcically sending military cargo planes to Turkey to demand supplies of dodgy ppe.
In 12 months we should have not only designed but set up manufacturing of advanced Ppe , plenty of tech co’s had progressed this by summer last year. I’d seen designs of transparent, well fitting, reusable masks with advanced filtering.
Where are they?
Why have we instead created massive amounts of ecologically damaging waste which has undone whatever petty gains of years of gaslighting our kids about getting rid of plastic carrier bags?
The third wave is not a surprise and it is not directly caused by the chaotic management of emergence from lockdown – which has exarcebated it.
There were 3 waves in the Pandemic a hundred years ago.
Where this is pointing to is the third wave actually being bigger rather than smaller than even the second.
What it points to is many more under 50 year old casualties. The vulnerable oldies having been ‘harvested’ last year already.
To some extent the doubts being cast on the AZ vaccine works towards a defensive narrative excuse if the next wave is that bad.
It is clearly mass avoidable deaths. It is a crises from which the usual spivs fill their boots with Treasury printed funds in a wartime economy.
The only thing that will make a difference on a worldwide scale is the herd immunity derived of a getting 60+ percent of the whole worlds population vaccinated. That is 5 billion people.
It is not going to happen with the high priced, low production vaccines manufactured in the West by avaricious BigPharma and protected with their IP.
It has to be the easily transported and reliable tested vectors of the likes of AZ, Sputnik and most important the Sinovacs of China. They expect to be producing 10 million doses per day by our summer and having 60% of their billion plus people vaccinated. Vast amounts will then be able to flow to the RoW.
I’m expecting the EU to approve these vaccines knowing the supply will be available so that by the end of summer we have got to that magic 60+ % vaccinated in the EU. We can then look to a return to normality from the Autumn/Winter.
Fingers firmly crossed.
In the previous posting you said “this virus grows exponentially.” This is true for any virus in the early stages of any epidemic which is left to naturally run its course. But it cannot grow exponentially for ever. The UK pattern of the 1918 Spanish flu showed two waves which were very similar in shape to the two Covid waves we’ve already seen. There was a separation between the two waves during the summer months. This was probably caused by the same factor. A more outdoor lifestyle in the summer months makes it more difficult for the virus to spread.
Without going too deeply into the mathematics of virology, we can say the exponential growth part only applies to the start of the wave. The end of a wave can be described as an exponential fall. The part in the middle isn’t exponential.
This epidemic isn’t being left to run its course naturally as was the epidemic of 100 years ago. They didn’t have vaccines. We now do. So the future course of the UK epidemic, not the worldwide pandemic, will be very much influenced by how effective our vaccination program turns out to be. Also it is surprising that there is a prediction of a third wave in July when the experience of last summer shows that the virus was unable to spread even though we had dropped our guard quite significantly compared to earlier in the year and at a time when there were no vaccinations.
The Imperial College and Warwick Uni groups are also reporting a potential problem albeit much less serious than the LSHTM group. Both are saying that the risks come after the 4th step out of lockdown so maybe we should just settle for steps 1-3 at this stage until the situation is clearer.
https://www.theguardian.com/world/2021/apr/05/easing-of-england-lockdown-next-week-highly-unlikely-to-overwhelm-nhs
I disagree with your suggestions
A pandemic is always exponential – but even exponential growth appears very small over very large ranges until it then appears expl;osive. RThere is no m middle. All we keep doing is bringing the rate of growth back to a lunch point again
See comments my Clive and Andrew – both get the reality of this
Of course, exponential growth can’t go on “forever” – nothing is forever….. “R” will eventually decline naturally due to build up of immunity in the population. But the key word here is “eventually”…. it might be quite a while and with dire consequences.
Government policy seems to be about keeping R close to 1 by balancing vaccination levels against easing lockdown restrictions…. and it is a dangerous game because if it is miscalculated then real damage is done before we know it and the difficulties of reversing course are immense. Better, surely, to crack down on transmission on ALL fronts.
Agreed
And when the time line that matters is ‘can I go to Spain this summer?’ eventually takes in its own special meaning.
Incidentally, no one is quite sure why the Black Death ended. One say the same might be said of Covid 19. That will define eventually.
We are a long way from it, I suspect.
I think you may be talking at cross purposes. I think you both agree that pandemics have an exponential profile while resources (in this case, access to people to infect) remain unconstrained so the disease can replicate without limit (R>1). In the real world, all exponential processes hit some sort of a ceiling at some point due to a change of circumstances – usually due to resources running out: in this case, either the number of vulnerable people (perhaps due to immunity), or access to them (perhaps due to mitigation to reduce transmission, such as lock downs, or masks or social distancing) – and the exponential increase slows down and stops. You reach a peak, and then you get an exponential decline as replication falls (R<1).
We have seen that twice (arguably three times) already – growth through February into March 2020 stopped by lockdown and slowly brought back down to low levels last July, then increasing again from September through to November 2020 stabilised but not reduced by lockdown 2, and then in December 2020 and January 2021 stopped by lockdown 3. We are again reaching low levels, but what is stopping infection rates from leaping up again if we release the lockdown measures too quickly?
If we just "let the virus rip", many millions of people could still get it all at once, and tens or hundreds of thousands could die and many more suffer adverse health outcomes, but in all likelihood the disease would run its course within a year or so and then die out. Albeit there might be pockets of disease remaining elsewhere in the world and a variant might come back. Is that what we want? We have chosen to lock down instead, which has bought us some time – flattened the peak, if you like – so we have the opportunity to put in place strategies to stop everyone getting the disease. Have we used that time wisely, or wasted it?
An interesting question now is what impact vaccination will have. About half the UK population have had one shot, and under a tenth of had had two. I'm not likely to get my first vaccination for example until May, possibly June, and my adult children not until July. Meanwhile, is about four months since the first vaccinations were given, and we will shortly see what quality of immunity continues after six or more months. And whether any variants arise that get around the vaccinations. Similarly, as time goes on, we will see what quality of immunity a previous infection gives after six months or a year. Is this thing like measles where you generally get it just once, or more like the cold or flu where it mutates and you can get the infection again and again. But perhaps not so serious the second time. Or like chickenpox, which sits around waiting to reactivate you.
The government's massive experiment with the health of the nation continues.
For what it is worth, there were three peaks of the Spanish flu in the UK in 1918/19. A relatively small first one during the summer months in June/July 1918, then a big second one in the autumn/winter in October to December 1918, and finally a third intermediate one the next spring, in March/April 1919. So, warm weather in the summer is not necessarily a cure-all.
Thanks
@ Tom
Erm. I’m not sure how much you work with data modelling and curve fitting, but all of those curves are clearly exponential in shape (rising exponential on the left, falling exponential on the right).
To suggest otherwise is either disingenuous, or you don’t possess the required knowledge to comment.
To dispel whataboutery – exponential curves often look linear to the human eye beyond the initial upward tick, but they are not. It’s likely that we’re cutting the data (and quite rightly so) such that the top section looks linear because of such rapid increases.
I would suggest asymmetric Gaussians would provide a decent fit to all the curves shown above (with the asymmetry only a little off of symmetric). I’ll stop waffling on about curve fitting now…
@ Johan,
I do have a degree in Physics so, although not a mathematician, I do know enough to appreciate that an exponential increase in the infection rate of Covid can be scary, if the doubling time is short, and conversely an exponential fall, if the halving time is equally short, is just what we need.
No-one is saying anything about the Imperial/Warwick models. I, together with most other non-specialists, are not in a position to contradict any of the expert predictions. However, we can note that their conclusions don’t match too well. This is not to say that we can discount any of them, but we do need to proceed with caution.
I wouldn’t, if I were a politician, be making any promises about this being the last lockdown. I’d be wanting to keep my options open. If we need another lockdown later in the year the that’s what it will have to be.
Right.
I was really just calling you out on stating that the exponential growth/decrease is limited to only specific parts of the curve. Your implication was that once transmission gets under way, it becomes linear. A linear increase of the gradient shown in the graphs above is scary enough, but not even close to half as scary as an exponential increase!
Of course, at some point, exponential increase would no longer be possible, once enough people became infected – but I don’t think thats a part of the curve we ever want to see..
Not sure what your comments on the studies were about?
But I would agree that assuming this was the last lockdown would be a monumentally stupid decision. Unfortunately, critical thinking doesn’t seem to be in abundance in our government…
Johan,
I didn’t say it was linear. You can’t say because it’s not exponential it therefore becomes linear. You can work through the mathematics of bell shaped curves if you like. At the left hand edge you can say that an increasing exponential is a reasonable approximation and also that a decreasing exponential is reasonable approximation at the right hand edge. Just what goes on in between is a proverbial exercise for the student!
I have to suggest this not very useful
Pandemics behave exponentially
Suppression impacts but does not change that unless and until the virus is eliminated
So what is your point?
Tom, you are playing at whataboutery.
Of course, you didn’t say “linear” at any point, but you did say “not exponential”.
Anyway, the exact “not exponential” form isn’t the point – the fact of the the matter is that the curves are exponential. In their entirety. If you don’t believe me, look at Gaussian curves and look at their mathematical description. I believe that should satisfy you.
I will leave it here as I don’t want to hijack the thread with stupid squabbling over curve shapes.
I will also say that I believe you are arguing with an ulterior motive – somewhere toward Covid denial (not actual Covid denial). I could be wrong, and I apologise if I am. But you’re putting an awful lot of effort in to downplay case growth rates and I can’t think of any other reason…
@ Johan,
No I’m not trying to downplay anything. Last year I was a relative pessimist. I remember certain so-called experts claiming that “Covid was on its way out”. The pubs had reopened and there was a “eat out to help out” scheme etc. That was obvious nonsense at the time and so it proved. I was expecting another wave over the winter of approximately equal size to what we’d seen previously. It was at least twice as bad as that, so I wasn’t pessimistic enough.
The difference this year is the number of vaccinations. There is controversy over the gap between doses and I would have preferred to have everyone receive two doses over a shorter timescale but I’m not an expert so I don’t have a firm opinion. So we’ll just have to wait and see how it works out and so far the figures are encouraging. The fall in the infection rate since the start of the year is as good as anyone could have reasonably hoped for.
However, we do know things can change rapidly so we need to be prepared for another setback.
I didn’t read Tom as implying anything linear at all – just that the pandemic grows exponentially at the beginning, then growth slows and it turns over at some point, and then declines exponentially. And that vaccines should have some impact, just as interventions such as lockdowns and social distancing and masks and so on have. Are vaccines enough to prevent a third/fourth peak? We shall see.
Thank you for reminding me that a gaussian is properly exponential all the way through, but turns over in the middle. Of course! The pandemic curves seem somewhat skewed, so I wonder if a log normal distribution might be a better fit.
@ Tom
Fair enough :). I obviously misread the intent behind your comments. My apologies
@ Andrew
Yeah, I was getting riled because the shapes were so obviously exponential to me. As you say, there is a levelling off around the peaks, but this is already described adequately within Normal/Gaussian distribution functions.
My real concern (voiced above) is that people dont recognise the middle bit (between the initial up-tick and the peak) as part of an exponential function, when it really is! However, and by my own admission, I am hyper-sensitive to these issues, having butted up against similar incomprehension time and time again.
Re: the asymmetry. I don’t think you’d need to use a different type of function. Just plug in an asymmetry term in front of the Gaussian function. Such an approach allows for off-centre peaks (and, of course, non-identical rise and fall constants). I did a fair amount of faffing about with this stuff trying to get decent fitting for the asymmetric G-peak in graphene Raman spectroscopy, and it is definitely possible :).
@ Johan,
You are, in a mathematical sense, quite right to suggest that a Gaussian function is also an exponential function. But how many people, including mathematicians too, use the term ‘exponential growth’ to mean anything other than the increase in a variable which is in proportion to its current value?
They don’t mean an exponential function with two or three other constants added to produce a bell like shape.
The use of the term ‘exponential’ has been noticeably growing due to a tendency to also misuse it. Many would say in an exponential manner! But it probably isn’t really. It’s just a piece of hyperbole.
I have to say I agree with that suggestion that the term exponential is seriously abused
Thanks Tom, that gave me a good chuckle
Couldn’t agree more that “exponential” has been hijacked and is constantly used incorrectly.
If only we could somehow get people to differentiate between “fast” and “actually exponential” and integrate the difference into their knowledge. Then, as you say, we can avoid all this hyperbolic nonsense and tales might be more parable-ic in nature. It’d be great to be able to log our concerns over mathematical misunderstandings, but I can’t see any series-ous way to expand around this issue…
Sorry, I couldn’t resist joining in
I’ll get my coat
We have variants floating around out there now which seem meaner than those of last year, more contageous, liable to affect different age-groups. Comparing the two years doesn’t seem valid.
Perhaps the main difference between this virus and previous ones is the level of asymptomatic transmission. When someone has symptoms of a disease they tend to self-isolate – take to their beds, not go anywhere, see only immediate family mebers etc. So the virus has limited resources (new indivudals to infect) so it either mutates to a version that casues less damage, so people do not self isolate or it dies out.
This virus is trickier partly because people who are infectious do not tend to self isolate as they do not know they have the disease for perhaps 5 days during which time they are particularly infectious. Many never know they have the disease, so the pressure on the virus is not to mutate to a less dangerous variant, it can carry on as it is or mutate in any direction, as long as it maintains the asymptomatic infectiousness.
SO the increase remains exponential until ther are few left to infect.
And we have a different virus….
Let’s not ignore that
Also people who are poor don’t isolate even when they know they have it as they can’t afford to. This lack of support from the government, presumably desperate to maintain somehow the fiction of there being a shortage of money and through that the status quo, guarantees continuing infection and continuing production of variations, one or several of which may well evolve beyond the reach of the current batch of vaccines. This is like playing Russian roulette with the well-being of the world. It’s time the UK got leaned on by other nations till it’s forced to act responsibly, whether that precipitates the extinction of our ruling classes or not. We can rest assured our parasitic so-called elites would happily kill us all to preserve themselves but they won’t get away with that attitude towards the rest of the planet.
From the experience of last year’s disastrous handling of the pandemic I think a pessimistic forecast is probably likely unless the government tones down drastically their ridiculous hoping up of how the vaccination programme is a complete cure for Covid. The experience of Germany and other EU countries should make caution the watchword from now on.
We veer towards social collapse, an inevitable consequence of promoting the incompetent over the able, generation after generation, just to preserve the ruling class. If we don’t look like Northern Ireland on a bad Saturday night now by the end of July, we will next year or the year after that. After the collapse, some new order will arise, its form to be determined by, I imagine, those prepared to fight hardest for it.
Hardest?
Hmm…….nastiest more like.
Can somebody explain why people don’t object to the change in the gap between doses of the scheduled deployment of the Pfizer vaccine from 3 to 12 weeks? There’s no data or science to support this decision and nobody knows what the efficacy is from week 6 to 12 or what impact this delay has on the efficacy and of the vital 2nd jab. How can we feel confident that this set up provides us older ones with sufficient protection. It’s astonishing that nobody questions this and blindly accepts the official message that we get 90% efficacy from the 1st and 92% from the second. It’s just not true. The truth is nobody knows and misleading the public like this will lead to people having a false sense of protection and dropping social distancing etc which will discredit the vaccine programme and also create the ideal conditions for the emergence of variants. Plus why still no effective test trace isolate and support and a hopeless lack of control at our ports which will allow foreign variants to come in. It’s all a disaster. Yet nobody questions this and instead go Wooop when they get their 2nd jab! It drives me nuts.
There has been some testing
Pfizer works best it seems with 3 week delay. Extension seems to provide no gain and maybe loss of effectiveness
AZ seems to provide a gain by being delayed more than three weeks. 12 weeks seems not to have been tested.
But the decision was political and not medical. Jabs in arms mattered most
Where is the testing that you refer to?
The only data I have seen is from the Scottish study which appears to show that the efficacy of the Pfizer vaccine wanes after peaking at 5 weeks.
The potential for comparing the efficacy between the two different populations of 3 and 12 week gaps are there but has anyone researched it and if so when will the pre print findings be published for peer group review?
The testing is very limited
Pfizer have made it clear they think it a mistake – as they tested a three week delay
AZ have been more relaxed but as far as I am aware did not test 12 weeks
The 12 week decision was political, not medical
The ‘gold standard’ in this is probably Taiwan. The two problems that vaccination programmes, however effective cannot fix are the problem of variants, which may arise from small local outbreaks; and border control. Both these problems remain a threat in the UK, and we have failed comprehensively to take control of our borders right through the pandemic, including now (ironically, the whole alleged purpose of Brexit – and when put to a real test, where for once it may actually help the UK rather than merely bury its trade, it was discarded immediately).
The success of Taiwan possessed border control as a key feature (with state support and considerable care for travellers who had to isolate under rigorously applied rules). Taiwan has a population of around 24m, has had circa 1k total cases, and only 10 deaths (ten); it is an advanced economy, it is almost back to normal, and it is growing its GDP.
@ John S Warren,
Many might disagree that Taiwan was “almost back to normal.” If the borders are sealed, by definition, no-one can go in or out. Is that normal?
I’m also asking the question of when I can go to Spain. Not because I have any real desire to holiday in Benidorm, but because I have family members who live there. Spain but not Benidorm!
Normality will be when they can visit the UK and we can visit them in Spain.
Your reality has changed
That might be something to factor into your model and not something it fights
“If the borders are sealed, by definition, no-one can go in or out. Is that normal?”
Yes you can make that point if you wish, but ‘ceteris paribus’, both the economy and daily life in Taiwan, I understand, are near to normal in all other respects, and have been for some time. I think many, many people here would settle for that; but given our failures to plan and execute sound policy, it seems remote, unless we are going to gamble. We are in the middle of a pandemic, and perfection is not open to us; it never is. This is a time for judging appropriate priorities.
I think the genie is too far out of the bottle to replicate the success of Taiwan and New Zealand. We know that pets including cats and dogs can catch the virus and almost certainly pass it on once again to other animals of their own species. It seems likely to me that, this being the case, it will be all but inevitable that the virus will cross back to humans at some point in time – there is effectively an animal reservoir of infection in the UK now. The aforementioned countries only had very low levels of infection so there wasn’t the same opportunity for the transmission to animals. I should note that I am not an immunologist or virologist!
I think we will be reliant on a combination of vaccination and new treatments to deal with the effects of the ongoing pandemic. I’m hopeful that the rollout of the vaccines will be able to keep us well away from the levels in the more pessimistic modelling as shown in the chart reproduced by Richard in this post. The same article shows modelling from Imperial and Warwick whose results indicate the potential for much lower levels of mortality, though still far from insignificant numbers of deaths.
Hopefully, the measured relaxation of restrictions will enable us to keep track of what exactly is occurring with the spread of the virus and, if any restrictions need to be strengthened (or at least not relaxed) until more of the population is vaccinated, the government will have the sense to do so this time around.
The graph forecasts a death toll higher this summer under conditions of medium and high population mobility than the death toll the UK had this winter. It forecasts a death toll comparable under conditions of low population mobility to the death toll we had when covid started last spring.
Could someone please explain to me, as a non-scientist, why SAGE predicts that the vaccines will have no efficacy whatsoever, even when given to the most vulnerable as they have been in the last few weeks. Because that it was the graphs seem to suggest.
We have new variants
And we have a half vaccinated population, dosed in a way to reduce efficiency of the vaccine
We are therefore facing a new threat which vaccines do not prepare us for
“And we have a half vaccinated population, dosed in a way to reduce efficiency of the vaccine”
All the evidence suggests that is not true. Have you not noticed the plummeting hospitalisations and deaths (currently running at about 10 a day)?
Have you noticed months of lockdown?
And yes, I can see the falling death rates
I also see that the modelling suggests that this may not be due to vaccines, in the main
Time will tell
@ Denis,
I don’t think Sage are saying the vaccines will have no effect but even so that’s a good question. I’m a scientist and I don’t know the answer. It would seem reasonable to have factored in, say, three different ranges of vaccine effectiveness just as the study has factored in three different ranges of population mobility.
The LSHTM study isn’t the only one but it is the most pessimistic. You might want to take a look at the Guardian link I posted earlier.
On the question of vaccine mutations rendering vaccines ineffective, and in particular the effect of delaying the second dose, it doesn’t look like there is any agreement at all between experts on how to quantify the risk.
The temptation, when there such a range of expert opinion, is to pick the expert that is saying what we’d like them to say. I’d be more optimistic than Richard but it does remain to be seen who is right.
https://www.the-scientist.com/news-opinion/will-delaying-vaccine-doses-cause-a-coronavirus-escape-mutant–68424
The more optimistic fur casts still suggest the issue is real
I added the caveat that it is a forecast with a range of possible outcomes
Meanwhile, in other news, Texas, where the Grim Reaper seems to have decided to retire, at least for the time being. What on earth’s going on over there? Worth keeping an eye on surely.
I think Clive Parry nails it clearly and supports Richard’s blog:
“Government policy seems to be about keeping R close to 1 by balancing vaccination levels against easing lockdown restrictions…. and it is a dangerous game because if it is miscalculated then real damage is done before we know it and the difficulties of reversing course are immense.”
That’s the definitive statement for me if I may.
The Tories are making the worst sort of compromise for the worst sorts of reasons. We now have another Tory Party within the Tory Party called ‘The Covid Recovery Group’ – led by the same bunch of berks who made up the ERG and look where they got us. Arrogant, simple minded, one-eyed – that’s what they are. So, we now have a country ran on the results of Tory infighting!! Supported by the FTPA and the media. Brilliant! We have a virus pandemic being ran by compromises over internal disagreements! Sod the real world. Ha! I ask you?
More than anything else, what Clive is saying is that the Government is taking risks with a very powerful virus that seems to thrive on stupidity as it does human bodily fluids.
Given the lack of the necessary doses of the vaccine needed to vaccinate at the specified intervals, something had to be done.
The big problem is going to be the second dose to those who have received the first dose, because the UK has limited vaccine production capability, and components of same are purchased abroad.
The just-coming Moderna vaccine is made in the USA, but the fill-and-finish process is in France and Spain, and I see a possible problem with them being allowed to export.
As supplies increase the vaccination interval may be shortened, but Andrew Pollard (head of the Oxford Vaccine Group) has said that extending the interval “makes biological sense”.
Either way, there is nothing to be done about it.