Published On: Wed, Apr 15th, 2020

The smaller, earlier peak; and the determined effort to maintain the lockdown regardless

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In the daily coronavirus “war situation” press conference on Tuesday, Patrick Vallance, the UK Government’s chief scientific advisor, tackled a subject that had been the issue of an FBEL article two days before. In that article, titled A coronavirus peak nears (ahead of time), the modelling is clearly wrong, and lockdown unjustified, there was a reiteration of an argument for ending the lockdown because of how “Covid-19” in the real world was underperforming according to the Imperial College London (ICL) modelling (after certain assumptions were made concerning the accuracy of the modelling, a real connection between SARS-COV-2 and Covid-19, and the efficacy of the PCR test). It was noted that hospital bed occupancy for “Covid-19” cases appeared to be coming to a peak, and that there might even be a decline in critical care beds during the course of the week commencing 13th April.

As for Vallance, he spoke to predict the “plateauing” of a number of indicators: death toll, transmission of the disease “within the community”, as well as hospital bed occupancy, but appeared to indicate that only the daily death toll would increase, across the aforementioned week, before itself stabilised and then started to decrease.

While it is understood here at FBEL that numbers of dead and numbers of cases of infection, or positive testing (per se), aren’t relevant for understanding if suppression is warranted, it is noted that the confirmation of the peaking of hospital bed occupancy is incredibly significant. People in beds is a tangible indicator. There is no chance of a false positive: a bed is occupied, or it is not. There is no chance of a death being due to some other cause: a bed is occupied, or it is not.

If critical care bed occupancy is indeed plateauing, and decreasing this week, then it will be earlier than the model predicts. Now, it is true that the body of the pertinent document published by the Imperial College modellers (please find a link in the aforementioned article) says that “a reduction in critical care requirements [will occur] from a peak approximately 3 weeks after the interventions are introduced”, and that this current week is occurring three weeks after 23rd March (which saw the start of school closures), and a bit less after the 26th March (which is when the Government introduced the Coronavirus Restrictions Regulations, and supermarkets started to enforce strict distancing), in the graph produced by the ICL, a peak of critical care bed occupancy occurs at the start of May after the execution of “a suppression strategy incorporating closure of schools and universities, case isolation and population-wide social distancing beginning in late March 2020”.

In other words, the peak is early, and perhaps more significantly, it is smaller than planned. The last Intensive Care National Audit & Research Centre (ICNARC) report told of 2194 “Covid-19” patients currently occupying critical care beds in England, Wales and Northern Ireland. That figure would represent 3.5 beds per 100,000 of population, a very feeble showing when contrasted with the 5 beds per 100K of population that had been predicted as the number occurring at the peak. Indeed, 3.5 beds per 100K would represent less than 50% of NHS surge capacity.

So while Vallance attributed the reduction of “illness we are seeing in hospital” to social distancing, and therefore the modelling, it is plain that the modelling has been wildly incorrect. Be that as it may, there is no exposure of this in media, corporate or otherwise, and indeed there is a great deal of effort instead to discuss an issue that, on the surface, looks to support the narrative of a contagious and virulent disease.

Data released by the Office for National Statistics shows there has been higher rate of deaths than a five year average in a sudden leap in the week ending 3rd April. It has been interpreted by the purveyors of official narrative (the BBC’s Coronavirus:  One in five deaths now linked to virus, article is an example) as 6,000 more deaths than average, with 3,475, where the death certificates cited “coronavirus” as at least being incidental to expiration, being amongst this number.

Now, one doesn’t have to be completely obtuse to appreciate the existence of an angle to a presentation so it is made to seem that there have been more deaths at this time of year – and the wording is crucial – than otherwise would have been expected. In turn, the impression that this is supposed to evoke is of “Covid-19” as a valid source of additional death that would not have occurred otherwise.

However, the ONS data only proves that more people have died than the average; it cannot be said of it that it shows that there is more death than that which would have been expected.

To explain: if a situation arises where old or very ill people find themselves on death’s door in a culture where there is an expectation of death (real or imagined), and where the NHS has prioritised treatment of a particular illness above all others (to the extent that it has discharged patients from hospital to create expected capacity – see footnote†), and also where patients have complied with requests from their GPs to authorise orders not to be resuscitated (see footnoteǂ), then one might not be surprised to see a higher number of deaths. This doesn’t make it more than expected. In short, the higher than average number for deaths at this time merely reflects the culture that has gripped the NHS. Or rather, it reflects a quickening of the culture that the NHS usually operates within.

When all is said and done, it can never be restated enough that the death toll is irrelevant when it comes to how the UK Government conducts itself in terms of its handling of the economy and the people in the name of something called “Covid-19”.

Additionally, Patrick Vallance might well say that lockdown is reducing transmission, but this is not a test for continuation of the lockdown which, as Vallance surely knows, is for safeguarding “NHS capacity and ensure the NHS can function” (people may become infected, but what of it if they don’t go to hospital?). Lockdown depends on NHS volume, and this is measured by bed occupancy. And here is where we came in at the third paragraph of this article.

But let us discuss infection rates a little more, and start with an abstract: numbers of cases of infection are not real or viable things by which to gauge a real epidemic, at least, not when i) positive testing cannot discern infection (PCR tests are not suited [as well as unreliable], and antibody tests don’t work) and ii) testing is not all-encompassing so that spread of infection can be monitored (and nor does it threaten to be in the case of this “epidemic”).

And yet, Patrick Vallance, has in the past (30 March), given an indication that a decision to end the lockdown would be guided by its ability to reduce the R0, or the Reproduction number. This number was introduced in the FBEL article mentioned at the top of the page, but here is more weighty explanation, reproduced here from its authoritative source (so that there is no need to reinvent the wheel):

If the average R0 in the population is greater than 1, the infection will spread exponentially. If R0 is less than 1, the infection will spread only slowly, and it will eventually die out. The higher the value of R0, the faster an epidemic will progress.

R0 is estimated from data collected in the field and entered into mathematical models. The estimated value depends on the model used and the data that inform it.

R0 is affected by:

  • the size of the population and the proportion of susceptible people at the start;
  • the infectiousness of the organism;
  • the rate of disappearance of cases by recovery or death, the first of which depends on the time for which an individual is infective;

The larger the population, the more people are susceptible, and the more infective the virus, the larger R0 will be for a given virus; the faster the rate of removal of infected individuals, by recovery or death, the smaller R0 will be.

It follows from this that R0 can be artificially decreased by restricting contact between infected individuals and those who remain to be potentially infected. And thus it would appear to be the case that lockdown offers an opportunity for disappearance of the virus by many isolated recoveries – but this, apparently, doesn’t happen because the ICL model predicts a rebounding after lockdown has been lifted, indicating the survival of the virus.

So, reduction of R0 by lockdown is a superficial issue that shouldn’t be a factor in a decision to lift the measures for mitigation. Infection rates should especially not be a factor if there is a strong possibility that contamination is happening in hospitals beyond the lockdown, as some are beginning to suspect there is (hopefully, there will be more on this in a future FBEL article).

But generally, the big problem for decision-making by apparent cases of infection is that without testing in the wider population, there cannot be any idea of how many have had the virus and recovered, and thus how smaller the population is in terms of potential to be infected.  The more people who have recovered, the smaller the R0. The UK Government and its scientists do not know what the R0 is because the number of recovered is unknown, and if it has any idea about the rate of disappearance by recovery, then it must be an assumption.

In the previous FBEL article, abovementioned, it was speculated that the Imperial College modellers assumption of an R0 of 2.4, and nothing less than 2.0, appears to be incorrect – by deduction from comparison of their tables with real world data. Who would be surprised now to learn that the infectiousness of SARS-COV/SARS-COV-2 was misconceived at the outset? It was also said in that previous article that “for the UK Government to appear to be playing by the rules which it has asked the British to abide by, it can’t move the goalposts”. This means that, having established that lockdown is determined by NHS capability, we are not to accept excuses about R0, out in the world beyond the clutches of the NHS, not being low enough.

 

Source:

The share of beds unoccupied in London, and Birmingham and the Black Country — where there have been the most serious covid-19 cases — are lower, at 28.9 per cent and 38.2 per cent respectively.

The clearout follows a huge ramping up of discharges from hospital in recent weeks in preparation for the covid-19 surge, with funding rules and checks scrapped, new facilities opened, and staff told to focus on discharge, change their thresholds, and be more directive about patients leaving hospital. The number of patients who have spent 21 days or more in hospital — so called “super stranded patients” — has reduced by 40 per cent, one source said.

There has also been a sharp dropoff in numbers admitted for non-coronavirus care, sparking fears among senior clinicians about the harm being done as people fail to get treatment, and widespread suspensions of planned operations.

ǂ Source:

Last week, a GP surgery in Somerset sent a letter to an autistic support group saying its members should have DNRs arranged in case they become ill, according to the BBC.

At the beginning of April, reports revealed that a GP surgery in Wales was pressuring people with serious illnesses to sign DNRs. The letter claimed there were “several benefits” for the patients to sign away their right to life-saving interventions, including allowing emergency services to focus on “the young and fit who have a greater chance” of survival. The letter also sought to make patients feel guilty over the risk of coronavirus transmission to family and emergency responders through resuscitation.

Doctors are also pressuring senior citizens into sign DNRs, with reports from Scotland that elderly patients are having the forms signed for them by their GPs without their consent or their family’s knowledge. One woman said her father had received a letter confirming that his GP had signed the form following her father refusing to do so after being pressured twice.

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