Percy plunkett wrote:This is a new virus,there must be new viruses coming along throughout history,why is this one said to be so deadly.The best remedy against any virus is,healthy diet,regular exercise and good personal hygiene.

This is a new Corona virus. Which is potentially serious, more so than the flu which kills 10,000 people annually simply because there is no vaccine. You are right of course with your healthy diet, regular exercise and personal hygiene. However you fail to recognize that unfortunately there are many people who have underlying health issues and many people who are simply knocking on a bit. So whilst I agree that diet, exercise and good hygiene are of vital importance, I can't condone an attitude which suggests that the old or the chronically sick are somehow expendable.

faerun exile wrote:Cambridge Utd's Abbey Stadium chosen as govt pilot for 2 games next week. Tinpot cup on 8th (1,000 capacity) and EFL2 game on 12th (2,500 capacity, which is 30% of normal capacity).

The test scheduled for Saturday's match has now been postponed..

The buffoon must be very confused. Not enough noughts on the crowd size. If they had announced 2,000,000 he would have got very excited.

Stan A. Einstein wrote:

Percy plunkett wrote:This is a new virus,there must be new viruses coming along throughout history,why is this one said to be so deadly.The best remedy against any virus is,healthy diet,regular exercise and good personal hygiene.

This is a new Corona virus. Which is potentially serious, more so than the flu which kills 10,000 people annually simply because there is no vaccine. You are right of course with your healthy diet, regular exercise and personal hygiene. However you fail to recognize that unfortunately there are many people who have underlying health issues and many people who are simply knocking on a bit. So whilst I agree that diet, exercise and good hygiene are of vital importance, I can't condone an attitude which suggests that the old or the chronically sick are somehow expendable.

The figures I have seen suggest that 17000 in England only,die from the winter flu virus yet there has never been a lockdown.As for the elderly and chronically sick being expendable,it appears that the Government have allowed that to happen unfortunately.Hospitals didn’t have enough PPE and care homes were forgotten completely until many deaths occurred.Was this down to Government negligence or was it a separate agenda.

Stan A. Einstein wrote: I think I might have said this earlier. In 1968 the 'flu killed 80,000. But we just carried on. Back then I was a primary school pupil. Now as a man in my mid 60's I'm a little less sanguine about 'collateral damage'. However whilst this is a difficult decision, I am beginning to wonder if there may have been if not an over reaction perhaps a misguided reaction. For people under 50 the mortality rate is minimal. It might have been a better idea to have offered furlough etc to the vulnerable, and treated the rest of society as the robust individuals they are. For those in our dotage we are old enough to make our own decisions. That I chose to go back to a former profession and become a front line worker is a move I don't regret. And in the event I croak, I guess that a few on here won't regret my decision either.

I missed the original "80,000" comment, and I almost didn't respond to this one, as a (probably too) long reply is necessary, but then Percy plunkett also made a comment that required some sort of answer (which as I'm about to post this I see you've done).

Two things. First, your original post's argument (knowingly or unknowingly) is a case of false equivalence, because you are not comparing like with like. And second, the number of deaths in the UK attributed to the Hong Kong (HK) flu of 1968 was not 80,000 (as headline figures in newspapers often regurgitate).

Taking the 1968 HK flu deaths aspect first.

The HK flu epidemic actually appeared over the three years from late 1968 to early(ish) 1970 in the UK, not just 1968.

In late '68/early '69 there was an outbreak in the UK that was prolonged but with low morbidity and relatively low mortality, with reported excess deaths due to pneumonia and influenza in England and Wales of a little over 11,000 for that time period. This figure was below some flu excess mortality rates seen in the 1970s.

The HK flu then reappeared (mutated strain) in late '69/early '70, with a shorter outbreak but with higher morbidity and mortality. The reported excess deaths due to pneumonia and influenza in England and Wales were a little under 40,000 for that time period.

So, excess mortality (the magnitude of which will be greater than attributed deaths totals) due to HK flu in England and Wales was around 51,000 over the two flu seasons. You can probably add around 7000 to that figure (given likely pro rata infection and mortality rates for the then population sizes of Scotland and Northern Ireland) to arrive at a likely UK total figure for excess deaths due to pneumonia and influenza. So, say ~58,000 excess deaths, over two flu seasons (probably around 18 months or so), not 80,000 over one flu season. There are a few good international reviews around. The figures I quote are from https://academic.oup.com/jid/article/192/2/233/856805.

Now to the false equivalence argument aspect.

From memory, asymptomatic infectious flu carriers are about 5% of the flu population, whereas covid-19 asymptomatic infectious carriers seem to be around the 40% level. Also from memory, the death rate from most flus runs at about 0.1%, whereas death rates from covid-19 appear to be as much as five times that (though this might eventually be nearer double, i.e. 0.2%, if we get a handle on true infection rates in a year or so's time when all the figures are in and analysed and standardised). There is an additional point here, too: with flu, the patient is generally most infectious during their enforced self-isolation period (sick in bed), whereas in the case of covid-19 infection the infectious stage can be days prior to the patient showing symptoms (walking around meeting loads of people and touching many surfaces), and consequently spreading it more widely.

So, the point is not that more people died from a particular flu strain back when (or will die next winter from next season's flu strains). First, one doesn't (generally) go into lockdown for flu, and you get a level of excess deaths a year that depends on strain virulence and general health of the infected. However, left unchecked (i.e. no lockdown to bring case levels down), the death rate from covid-19 would be a lot more than it is now (more on this below) and a helluva lot more than it is with all the annual flu strains encountered since the "Spanish" variety in 1918–1920 (double to about five times as many possibly).

Covid-19 is not like your "normal" annual flu (or even HK flu, which still circulates and is now a component of the normal annual flus circulating), in any shape or form, other than they are both viruses. [As an aside, where there is a similarity between "Spanish" flu and covid-19 outcomes is that cytokine storms and subsequent bacterial pneumonias are thought to have contributed to a large number of the "Spanish" flu deaths.] Covid-19 lockdown has likely saved tens of thousands of UK lives so far, and it prevented the NHS from being overwhelmed and being left unable to treat very large numbers of patients. There hasn't been a flu epidemic (yet) that would have overwhelmed the NHS. And if there were to be a flu pandemic of the type and severity that the "Spanish flu" was, then a lockdown/regional isolation would no doubt be instituted as otherwise health services would be overrun quite quickly. Yes, life went on during the HK flu epidemic outbreaks, but output dropped and transportation and "normal life" was disrupted because of the number of people off work.

Covid-19 is also more infectious than flu and its pathology is a lot more insidious: whereas people recover from severe flu with maybe a few days to weeks of recuperation, and may feel very tired for a couple of months or so in some exceptional cases, people with covid-19, while suffering similar long bouts of tiredness in recovery, can experience other changes to health not associated with flu viruses (e.g. heart issues, kidney issues, brain issues, lung issues), and some of these ensuing health issues may yet be life-long or even life limiting.

HK flu probably led to around 1 million deaths worldwide. Covid-19 worldwide acknowledged deaths (Johns Hopkins Coronavirus Resource Center) are approaching that figure but would be well past it if not for lockdowns across the world.

To get some possible perspective on what might be the current state if most of the world hadn't gone into covid-19 lockdown, just think of the USA, which because of politics could be said to maybe be a halfway house in terms of lockdown. The USA has ~4.25% of the world's population and ~190k (~20%) of the worldwide covid-19 deaths (~900k). So, if the rest of the world had followed the "US lockdown model" this would equate to a current worldwide covid-19 deaths total in excess of 4.7 million. This would dwarf (almost double) the combined death totals from HK flu and the late 1950s Asian flu outbreaks. So without lockdown (which the US did undergo to a degree) we would now be well north of 5 million deaths. That is why covid-19 is different to and worse than any flu since the "Spanish flu".

Again, apologies for the essay length! Back to football.

Let's face it, none of the above facts are to be sneezed at

NearlyDead wrote:

Stan A. Einstein wrote: I think I might have said this earlier. In 1968 the 'flu killed 80,000. But we just carried on. Back then I was a primary school pupil. Now as a man in my mid 60's I'm a little less sanguine about 'collateral damage'. However whilst this is a difficult decision, I am beginning to wonder if there may have been if not an over reaction perhaps a misguided reaction. For people under 50 the mortality rate is minimal. It might have been a better idea to have offered furlough etc to the vulnerable, and treated the rest of society as the robust individuals they are. For those in our dotage we are old enough to make our own decisions. That I chose to go back to a former profession and become a front line worker is a move I don't regret. And in the event I croak, I guess that a few on here won't regret my decision either.

I missed the original "80,000" comment, and I almost didn't respond to this one, as a (probably too) long reply is necessary, but then Percy plunkett also made a comment that required some sort of answer (which as I'm about to post this I see you've done).

Two things. First, your original post's argument (knowingly or unknowingly) is a case of false equivalence, because you are not comparing like with like. And second, the number of deaths in the UK attributed to the Hong Kong (HK) flu of 1968 was not 80,000 (as headline figures in newspapers often regurgitate).

Taking the 1968 HK flu deaths aspect first.

The HK flu epidemic actually appeared over the three years from late 1968 to early(ish) 1970 in the UK, not just 1968.

In late '68/early '69 there was an outbreak in the UK that was prolonged but with low morbidity and relatively low mortality, with reported excess deaths due to pneumonia and influenza in England and Wales of a little over 11,000 for that time period. This figure was below some flu excess mortality rates seen in the 1970s.

The HK flu then reappeared (mutated strain) in late '69/early '70, with a shorter outbreak but with higher morbidity and mortality. The reported excess deaths due to pneumonia and influenza in England and Wales were a little under 40,000 for that time period.

So, excess mortality (the magnitude of which will be greater than attributed deaths totals) due to HK flu in England and Wales was around 51,000 over the two flu seasons. You can probably add around 7000 to that figure (given likely pro rata infection and mortality rates for the then population sizes of Scotland and Northern Ireland) to arrive at a likely UK total figure for excess deaths due to pneumonia and influenza. So, say ~58,000 excess deaths, over two flu seasons (probably around 18 months or so), not 80,000 over one flu season. There are a few good international reviews around. The figures I quote are from https://academic.oup.com/jid/article/192/2/233/856805.

Now to the false equivalence argument aspect.

From memory, asymptomatic infectious flu carriers are about 5% of the flu population, whereas covid-19 asymptomatic infectious carriers seem to be around the 40% level. Also from memory, the death rate from most flus runs at about 0.1%, whereas death rates from covid-19 appear to be as much as five times that (though this might eventually be nearer double, i.e. 0.2%, if we get a handle on true infection rates in a year or so's time when all the figures are in and analysed and standardised). There is an additional point here, too: with flu, the patient is generally most infectious during their enforced self-isolation period (sick in bed), whereas in the case of covid-19 infection the infectious stage can be days prior to the patient showing symptoms (walking around meeting loads of people and touching many surfaces), and consequently spreading it more widely.

So, the point is not that more people died from a particular flu strain back when (or will die next winter from next season's flu strains). First, one doesn't (generally) go into lockdown for flu, and you get a level of excess deaths a year that depends on strain virulence and general health of the infected. However, left unchecked (i.e. no lockdown to bring case levels down), the death rate from covid-19 would be a lot more than it is now (more on this below) and a helluva lot more than it is with all the annual flu strains encountered since the "Spanish" variety in 1918–1920 (double to about five times as many possibly).

Covid-19 is not like your "normal" annual flu (or even HK flu, which still circulates and is now a component of the normal annual flus circulating), in any shape or form, other than they are both viruses. [As an aside, where there is a similarity between "Spanish" flu and covid-19 outcomes is that cytokine storms and subsequent bacterial pneumonias are thought to have contributed to a large number of the "Spanish" flu deaths.] Covid-19 lockdown has likely saved tens of thousands of UK lives so far, and it prevented the NHS from being overwhelmed and being left unable to treat very large numbers of patients. There hasn't been a flu epidemic (yet) that would have overwhelmed the NHS. And if there were to be a flu pandemic of the type and severity that the "Spanish flu" was, then a lockdown/regional isolation would no doubt be instituted as otherwise health services would be overrun quite quickly. Yes, life went on during the HK flu epidemic outbreaks, but output dropped and transportation and "normal life" was disrupted because of the number of people off work.

Covid-19 is also more infectious than flu and its pathology is a lot more insidious: whereas people recover from severe flu with maybe a few days to weeks of recuperation, and may feel very tired for a couple of months or so in some exceptional cases, people with covid-19, while suffering similar long bouts of tiredness in recovery, can experience other changes to health not associated with flu viruses (e.g. heart issues, kidney issues, brain issues, lung issues), and some of these ensuing health issues may yet be life-long or even life limiting.

HK flu probably led to around 1 million deaths worldwide. Covid-19 worldwide acknowledged deaths (Johns Hopkins Coronavirus Resource Center) are approaching that figure but would be well past it if not for lockdowns across the world.

To get some possible perspective on what might be the current state if most of the world hadn't gone into covid-19 lockdown, just think of the USA, which because of politics could be said to maybe be a halfway house in terms of lockdown. The USA has ~4.25% of the world's population and ~190k (~20%) of the worldwide covid-19 deaths (~900k). So, if the rest of the world had followed the "US lockdown model" this would equate to a current worldwide covid-19 deaths total in excess of 4.7 million. This would dwarf (almost double) the combined death totals from HK flu and the late 1950s Asian flu outbreaks. So without lockdown (which the US did undergo to a degree) we would now be well north of 5 million deaths. That is why covid-19 is different to and worse than any flu since the "Spanish flu".

Again, apologies for the essay length! Back to football.

Never apologize for for the arguing a matter at length. And I'm not sure we actually disagree.

My point is this. Covid19 has a very low mortality rate for people under the age of 50. Resources are finite. My argument is that in those circumstances more should have been done to protect those who are vulnerable. The blanket one size fits all is not necessarily correct.

I certainty don't see those who are vulnerable as being expendable. However spending a fortune setting up Nightingale hospitals that were never used whilst returning infected older people to care homes was a travesty. So my argument is that perhaps we need a more targeted approach.

Whilst I don't agree with Boris the idiot often, he is in my view correct in that the true extent of any disease outbreak can only be assessed when it is over. As you will no doubt know the 1918/20 outbreak came in three waves. It was the 2nd which was by far the worst. Unless there is a targeted response I wonder if front line workers who are already exhausted will cope.

No, it wasn't a travesty setting up Nightingales. You need to reflect on what was happening at the time.

The Nightingales were set up at a time when the health system in Italy was unable to cope with their covid-19 case load. They were set up when we were considered to be around 3 weeks behind the situation in Italy and when we didn't know how well the limited lockdown we were entering (compared with the Draconian but successful Chinese lockdown model) would affect case numbers. Our NHS just about coped with the covid case load, with only one or two people ending up in a Nightingale (IIRC).

A normal winter flu season case load stretches the NHS, but generally not to the point of collapse. A normal flu season and a covid-19 resurgence would overwhelm the NHS. It was good planning then, and it is good planning since to have had them mothballed rather than to have deconstructed them, as they may well yet be needed over the winter.

NearlyDead wrote:No, it wasn't a travesty setting up Nightingales. You need to reflect on what was happening at the time.

The Nightingales were set up at a time when the health system in Italy was unable to cope with their covid-19 case load. They were set up when we were considered to be around 3 weeks behind the situation in Italy and when we didn't know how well the limited lockdown we were entering (compared with the Draconian but successful Chinese lockdown model) would affect case numbers. Our NHS just about coped with the covid case load, with only one or two people ending up in a Nightingale (IIRC).

A normal winter flu season case load stretches the NHS, but generally not to the point of collapse. A normal flu season and a covid-19 resurgence would overwhelm the NHS. It was good planning then, and it is good planning since to have had them mothballed rather than to have deconstructed them, as they may well yet be needed over the winter.

Maybe with the normal flu season on it's way and the 2nd wave coming on strong perhaps the Nightingales should stay?

NearlyDead wrote:No, it wasn't a travesty setting up Nightingales. You need to reflect on what was happening at the time.

The Nightingales were set up at a time when the health system in Italy was unable to cope with their covid-19 case load. They were set up when we were considered to be around 3 weeks behind the situation in Italy and when we didn't know how well the limited lockdown we were entering (compared with the Draconian but successful Chinese lockdown model) would affect case numbers. Our NHS just about coped with the covid case load, with only one or two people ending up in a Nightingale (IIRC).

A normal winter flu season case load stretches the NHS, but generally not to the point of collapse. A normal flu season and a covid-19 resurgence would overwhelm the NHS. It was good planning then, and it is good planning since to have had them mothballed rather than to have deconstructed them, as they may well yet be needed over the winter.

Your view is valid. However Sweden took a targeted response and have a lower per capita infection rate and a far lower mortality rate. Now there may be other factors at play, none of us know. I certainly don't argue that I know the best course. However I do think it is important to look at what works, what doesn't work, and to be ready to change tack as knowledge increases.

Stan A. Einstein wrote:

NearlyDead wrote:No, it wasn't a travesty setting up Nightingales. You need to reflect on what was happening at the time.

The Nightingales were set up at a time when the health system in Italy was unable to cope with their covid-19 case load. They were set up when we were considered to be around 3 weeks behind the situation in Italy and when we didn't know how well the limited lockdown we were entering (compared with the Draconian but successful Chinese lockdown model) would affect case numbers. Our NHS just about coped with the covid case load, with only one or two people ending up in a Nightingale (IIRC).

A normal winter flu season case load stretches the NHS, but generally not to the point of collapse. A normal flu season and a covid-19 resurgence would overwhelm the NHS. It was good planning then, and it is good planning since to have had them mothballed rather than to have deconstructed them, as they may well yet be needed over the winter.

Your view is valid. However Sweden took a targeted response and have a lower per capita infection rate and a far lower mortality rate. Now there may be other factors at play, none of us know. I certainly don't argue that I know the best course. However I do think it is important to look at what works, what doesn't work, and to be ready to change tack as knowledge increases.

Might I suggest you read this New Scientist article about Sweden.

Willthiswork wrote:

NearlyDead wrote:No, it wasn't a travesty setting up Nightingales. You need to reflect on what was happening at the time.

The Nightingales were set up at a time when the health system in Italy was unable to cope with their covid-19 case load. They were set up when we were considered to be around 3 weeks behind the situation in Italy and when we didn't know how well the limited lockdown we were entering (compared with the Draconian but successful Chinese lockdown model) would affect case numbers. Our NHS just about coped with the covid case load, with only one or two people ending up in a Nightingale (IIRC).

A normal winter flu season case load stretches the NHS, but generally not to the point of collapse. A normal flu season and a covid-19 resurgence would overwhelm the NHS. It was good planning then, and it is good planning since to have had them mothballed rather than to have deconstructed them, as they may well yet be needed over the winter.

Maybe with the normal flu season on it's way and the 2nd wave coming on strong perhaps the Nightingales should stay?

Just to be clear, as you've mentioned "2nd wave", the upsurge in UK covid-19 cases now being seen is not a true second wave of the disease; it's a continuation and resurgence of the first wave.

Too paraphrase Kenneth Wolstenholme, "Some people ... think it's all over! It never was."

In late spring I think it was said the true covid-19 infection rate in the population was likely 5 to 10 times greater than the confirmed cases showed.

I don't know what the actual figure is now for that difference, but it will have narrowed because of increased testing.

So, whereas in late spring a "confirmed" covid-19 infection level of 2000 per day may have been hiding a "true infection level" of say 10,000 to 20,000 a day, a "confirmed" covid-19 infection level of 2000 per day today might well equate to something like a true infection level of 5000 to 10,000 a day if, for example, that difference has now halved because of testing (it'll certainly be more than the confirmed figure).

So 2000 per day now is certainly likely better now than it was in late spring. But R is said to currently be about 1.2 (I think) in England, so it will spread for a few weeks at that level and if not curtailed will be in an exponentially spreading phase quite quickly.

I have to admit that, at the moment, with the economy being expanded, I cannot see how the new rules for England will get the value of R back below 1 (which would mean the disease is in retreat) anytime soon. There are just too many chances for interactions when those interactions can be with anyone other than your own household or bubble. The new rules were needed, but I suspect the decision has been made more in order to try to protect the NHS this winter already rather than to truly squeeze the disease out of the population.

Our best bet is still a working vaccine. And honestly, if you are eligible for a flu vaccine, get one!

I've done enough pontificating now. Time for a rest... for everyone!

I don't think you are pontificating.

However I have to point out that the World Health Organisation are now praising Sweden, not least because as of five days ago the mortality rate in Sweden has fallen below that of Denmark. But the point I am trying to make is that it is important to keep examining the data and to adjust accordingly.

Stan A. Einstein wrote:

Percy plunkett wrote:This is a new virus,there must be new viruses coming along throughout history,why is this one said to be so deadly.The best remedy against any virus is,healthy diet,regular exercise and good personal hygiene.

This is a new Corona virus. Which is potentially serious, more so than the flu which kills 10,000 people annually simply because there is no vaccine. You are right of course with your healthy diet, regular exercise and personal hygiene. However you fail to recognize that unfortunately there are many people who have underlying health issues and many people who are simply knocking on a bit. So whilst I agree that diet, exercise and good hygiene are of vital importance, I can't condone an attitude which suggests that the old or the chronically sick are somehow expendable.

We differ on so many things, but on this I agree with you 100%

Willthiswork wrote:

NearlyDead wrote:No, it wasn't a travesty setting up Nightingales. You need to reflect on what was happening at the time.

The Nightingales were set up at a time when the health system in Italy was unable to cope with their covid-19 case load. They were set up when we were considered to be around 3 weeks behind the situation in Italy and when we didn't know how well the limited lockdown we were entering (compared with the Draconian but successful Chinese lockdown model) would affect case numbers. Our NHS just about coped with the covid case load, with only one or two people ending up in a Nightingale (IIRC).

A normal winter flu season case load stretches the NHS, but generally not to the point of collapse. A normal flu season and a covid-19 resurgence would overwhelm the NHS. It was good planning then, and it is good planning since to have had them mothballed rather than to have deconstructed them, as they may well yet be needed over the winter.

Maybe with the normal flu season on it's way and the 2nd wave coming on strong perhaps the Nightingales should stay?

Some will stay. The Exeter Nightingale is a purpose built, permanent structure that will be incorporated into the local NHS estate.