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Thread: Planning for the next pandemic

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    Supporting Member spot's Avatar
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    Planning for the next pandemic

    This thread dates from early 2020 and assumes we have collectively recognized that our planning for pandemics was catastrophically inadequate.

    We got away lightly with Covid-19 because it only had a mortality between 0.1% and 2%. We could have another of those every year from now to eternity and not bat an eyelid, to be honest. That was a pinprick. The only thing we immediately recognized from 2020 is that global terrorism is a made-up fantasy as far as problems are concerned, and if we have any sense we'll pretend the War on Terrorism never happened because it was too stupid for words. If we shut down our security services it would make no difference to the sum of human happiness, what we urgently need is spare capacity in a health system free of charge at the point of use instead of squeezed resources and a rapacious profitable insurance industry.

    So. Planning for the next pandemic. What must the world put in place to handle an equally transmissible, equally asymptomatic pandemic, with the following mortality rate within a month of contracting the disease:

    a) 10%

    b) 33%

    c) 66%

    because that's the problem. Covid-19 is a very welcome warning we've been entirely unprepared to handle, and it's important that we make an effort now to find a workable defence before a significantly worse pandemic is triggered.
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    Supporting Member spot's Avatar
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    Re: Planning for the next pandemic

    Governmental reaction to Covid-19 has been the exact opposite of what was needed, this time round. Because it's so non-lethal it should have just been allowed to run with no public reaction, saving the national economies. As it is we have the worst possible consequence, mass business collapse and another decade of austerity digging out of debt and joblessness. It was so obviously avoidable.

    But with a breakout an order of magnitude more lethal, which is out there down the line eventually, we do need a strategy. I think we need to create and practice a worldwide vaccination plan that can develop, test and implement protection within three months at the most, not this useless eighteen months we saw this time round. Creating that capability has to be an essential legacy from this warning shot.

    Telling businesses to close for months on end is self-inflicted damage, next time or this time. I have no idea why anyone with half a brain would even contemplate it much less make it happen.
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    Who has a spare two minutes to play in this month's FG Trivia game!

    The watch of your vision has become reasonable today.

    England's troubles will increase until the bishops open Joanna Southcott's box.
    It’s normal. You must provoke. You must insult the belief of all monotheists. You must make fun of the belief of all monotheists.
    From the upper tier of the Leppings Lane End of the Hillsborough Stadium, I watched the events of that day unfold with horror.
    When the flowers want to oxygen and nutrition, or you’re a wedding or party planner, I will help you too much.
    Write that word in the blood

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    Proudly humble LarsMac's Avatar
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    Re: Planning for the next pandemic

    Well, it seems to me that we are looking at a ~4% mortality.
    Given that 90% of the fatalities, so far, have been in the + 70 years age bracket, though, and of those most were with compromised health to start with, that may affect whatever plan you can come up with.

    But, firstly, there probably needs to be a more immediate global reaction that manages travel restrictions, right up front.
    By the time most people had even heard of this thing, the containment had already failed.
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    Supporting Member spot's Avatar
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    Re: Planning for the next pandemic

    Quote Originally Posted by LarsMac View Post
    Well, it seems to me that we are looking at a ~4% mortality.
    I think we'll find that speaking solely of Covid-19, 7% of those sick enough to need a hospital bed will die and nobody else. That's what my spreadsheet says, now that I've finally projected it all the way.

    What baffles me is the lack of recognition that the number who don't catch it before the vaccine is ready will be trivially few. Between 10%-20% perhaps.

    If the world doesn't get a process in place to mass-vaccinate in weeks rather than years, though that would be preferable, and the world can't be so authoritarian as China has been, which is arguably preferable, then we need an alternative.

    I can put the procedure for the next pandemic here but I know in advance nobody will adopt it. It makes no difference how lethal the next pandemic is, this process still reduces the final death toll.

    What you do is this, if you can't extinguish the outbreak and it's capable of spreading worldwide the way this one has.

    You work out the minority most affected if they catch it - for Covid-19 that's everyone over 70 and everyone with hypertension or heart problems. You put them into their homes and tell them to stay safe and not mingle.

    Then, working out from your key workers - the health providers first - you quarantine volunteer batches from the general population and you infect them all. You get as many ill as your health system can cope with, and you put all the survivors back into the population as healthy and protected, and they go back to work. You quarantine more batches and keep your health system at full operation but not overstretched. You stay way ahead of virus transmission in the wild.

    Once you've got a high enough proportion of your population protected from re-infection to make the pandemic fizzle out, you can let the old folk out of isolation and wait for the vaccine to finish off the job.

    On a virus like Covid-19 that might reduce the death toll worldwide by as much as good hospital care with the best known available treatment improves on no hospital care. I can't think of anything else which might. It could be done, it's an optimal procedure, it's politically impossible.
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    Who has a spare two minutes to play in this month's FG Trivia game!

    The watch of your vision has become reasonable today.

    England's troubles will increase until the bishops open Joanna Southcott's box.
    It’s normal. You must provoke. You must insult the belief of all monotheists. You must make fun of the belief of all monotheists.
    From the upper tier of the Leppings Lane End of the Hillsborough Stadium, I watched the events of that day unfold with horror.
    When the flowers want to oxygen and nutrition, or you’re a wedding or party planner, I will help you too much.
    Write that word in the blood

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    Proudly humble LarsMac's Avatar
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    Re: Planning for the next pandemic

    Quote Originally Posted by spot View Post
    I think we'll find that speaking solely of Covid-19, 7% of those sick enough to need a hospital bed will die and nobody else. That's what my spreadsheet says, now that I've finally projected it all the way.

    What baffles me is the lack of recognition that the number who don't catch it before the vaccine is ready will be trivially few. Between 10%-20% perhaps.

    If the world doesn't get a process in place to mass-vaccinate in weeks rather than years, though that would be preferable, and the world can't be so authoritarian as China has been, which is arguably preferable, then we need an alternative.

    I can put the procedure for the next pandemic here but I know in advance nobody will adopt it. It makes no difference how lethal the next pandemic is, this process still reduces the final death toll.

    What you do is this, if you can't extinguish the outbreak and it's capable of spreading worldwide the way this one has.

    You work out the minority most affected if they catch it - for Covid-19 that's everyone over 70 and everyone with hypertension or heart problems. You put them into their homes and tell them to stay safe and not mingle.

    Then, working out from your key workers - the health providers first - you quarantine volunteer batches from the general population and you infect them all. You get as many ill as your health system can cope with, and you put all the survivors back into the population as healthy and protected, and they go back to work. You quarantine more batches and keep your health system at full operation but not overstretched. You stay way ahead of virus transmission in the wild.

    Once you've got a high enough proportion of your population protected from re-infection to make the pandemic fizzle out, you can let the old folk out of isolation and wait for the vaccine to finish off the job.

    On a virus like Covid-19 that might reduce the death toll worldwide by as much as good hospital care with the best known available treatment improves on no hospital care. I can't think of anything else which might. It could be done, it's an optimal procedure, it's politically impossible.
    We have to be consistent on the numbers, I think.
    What we have to work with is limited. We can work with "Confirmed cases" and Deaths, pretty easily. When you start trying to work with ethereal numbers, like "% of those sick enough to need a hospital bed" we can get in the weeds fairly quickly.

    I would like to be able to include "those who were infected, but showed no symptoms."
    However, that is another value that remains "out there, somewhere."

    Some of the numbers are very interesting. South Korea seems to have a fairly effective plan in the works.
    Switzerland must be doing something right, as well. While the cases are growing rapidly, they have minimal fatalities.

    On the other hand, Italy has now topped China for fatalities, with barely half the confirmed cases being reported.

    The vaccine is still pretty far off on the horizon. Unless, possibly something already in the inventory for other bugs can test out as being effective on this one.

    Before we can even hope for a vaccine, global testing needs to be available, and the lesson from this must be that travel restrictions and isolation must be launched globally and quickly if there is to be any hope of containing this kind of thing.

    Reviewing the history of vaccinations and epidemic behavior suggests that we will be seeing COVID-19 for a very long time.
    Hopefully its general fatality rate remains fairly low.
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    Re: Planning for the next pandemic

    Quote Originally Posted by LarsMac View Post
    We have to be consistent on the numbers, I think.
    What we have to work with is limited. We can work with "Confirmed cases" and Deaths, pretty easily. When you start trying to work with ethereal numbers, like "% of those sick enough to need a hospital bed" we can get in the weeds fairly quickly.

    I would like to be able to include "those who were infected, but showed no symptoms."
    However, that is another value that remains "out there, somewhere."
    The trouble with "confirmed cases" is that it originated in China where everyone listed as confirmed was in hospital and had been tested. There was a week when they changed away and back to that definition.

    In the Rest of the World the confirmed cases count isn't reliant on tests because there aren't the resources. The actuality is that they're the hospitalized ill. I used the phrase "% of those sick enough to need a hospital bed" to be equivalent to confirmed cases when confirmation was no longer being checked. They're ill enough to need a hospital bed. They might, eventually, not get one but they're still in that category. If someone's "sick enough to need a hospital bed" they're clearly a confirmed case whether they have been confirmed by testing or not, it's just a more accurate and more provable term.

    I took the % with antibodies but only mild or asymptomatic from the UK government statistics, where they put 84% in that category and 16% needing hospital and therefore "confirmed cases". I've no problem using a figure as official as that. The easy-to-see figure is how many have been put in hospital, and we can call them "confirmed cases" if you prefer. I was trying to be to be consistent on the numbers by choosing an accurate description of a generic label that will cease to be true.

    Covid-19 is a permanent disease in the world, but this year it has an open goal with no resistance at all. That can only ever happen once for any disease.
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    Who has a spare two minutes to play in this month's FG Trivia game!

    The watch of your vision has become reasonable today.

    England's troubles will increase until the bishops open Joanna Southcott's box.
    It’s normal. You must provoke. You must insult the belief of all monotheists. You must make fun of the belief of all monotheists.
    From the upper tier of the Leppings Lane End of the Hillsborough Stadium, I watched the events of that day unfold with horror.
    When the flowers want to oxygen and nutrition, or you’re a wedding or party planner, I will help you too much.
    Write that word in the blood

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    Re: Planning for the next pandemic

    The mortality rate is ten times that of "normal" flu. It' shighly infectious and while it;s true that for most people the effects are milld what you don't seem to take in to account is what the number of deaths would be if those hospitalised did not actually have access to those hospotal beds, Icu units ventilators etc. China, europe have socialised medical care where access to medical care is a given. The US has a far bigger proiblem imo because people will not be going to the doctor because they can't affoird to. I classic highlighting of the simple fact that the health of your neighbour matters for yours free medical is a necessity not a luxury. Hopefully it might stop the sell off of the NHS.

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    Re: Planning for the next pandemic

    Quote Originally Posted by gmc View Post
    The mortality rate is ten times that of "normal" flu. It' shighly infectious and while it;s true that for most people the effects are milld what you don't seem to take in to account is what the number of deaths would be if those hospitalised did not actually have access to those hospotal beds, Icu units ventilators etc. China, europe have socialised medical care where access to medical care is a given. The US has a far bigger proiblem imo because people will not be going to the doctor because they can't affoird to. I classic highlighting of the simple fact that the health of your neighbour matters for yours free medical is a necessity not a luxury. Hopefully it might stop the sell off of the NHS.
    It is highly infectious, it seems, but the only statistics we really have are the ones based upon those who report to a facility to be tested and treated.
    Only those who feel symptomatic are likely to be tested, and only the ones with positive test results will be counted in the WHO and CDC stats.
    Therefore, the fatality rate is a portion of those "confirmed cases"
    I have seen those estimates of infected vs Confirmed, too.
    So, if we assume that the reported "Confirmed" cases are 15% od the actual infected, then we are looking at somewhere around 1.6 million active cases in the world, already.
    The reported fatalities now becomes a much smaller percentage of the whole. (somehere around 0.6%) Still a bit higher than for the common influenza.

    Of course, now we have to consider how we determine how many of those will have developed antibodies, and immunity to further infection.
    And, how many of the asymptomatic cases can still infect other people? For how long?
    And, how many of those who have recovered are susceptible to re-infection? for how long?
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    Senior Member Bryn Mawr's Avatar
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    Re: Planning for the next pandemic

    Quote Originally Posted by LarsMac View Post
    It is highly infectious, it seems, but the only statistics we really have are the ones based upon those who report to a facility to be tested and treated.
    Only those who feel symptomatic are likely to be tested, and only the ones with positive test results will be counted in the WHO and CDC stats.
    Therefore, the fatality rate is a portion of those "confirmed cases"
    I have seen those estimates of infected vs Confirmed, too.
    So, if we assume that the reported "Confirmed" cases are 15% od the actual infected, then we are looking at somewhere around 1.6 million active cases in the world, already.
    The reported fatalities now becomes a much smaller percentage of the whole. (somehere around 0.6%) Still a bit higher than for the common influenza.

    Of course, now we have to consider how we determine how many of those will have developed antibodies, and immunity to further infection.
    And, how many of the asymptomatic cases can still infect other people? For how long?
    And, how many of those who have recovered are susceptible to re-infection? for how long?
    About a week ago the (I think) UK government admitted that the probable count of infections here was between ten and fifty thousand rather than the four hundred that had tested positive at the time.

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    Re: Planning for the next pandemic

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    Quote Originally Posted by Bryn Mawr View Post
    About a week ago the (I think) UK government admitted that the probable count of infections here was between ten and fifty thousand rather than the four hundred that had tested positive at the time.
    That's because it's suspected that it may have been around longer than realised - just that we didn't realise that it was anything other than Seasonal Flu, the vast majority of which cases never get reported. If this is the case, then I suspect this may be what I had over Christmas as the symptoms match exactly what is said of C19. Dry cough, difficulty in breathing, etc.

    I'm in 2 minds about the Lockdown principle. I see the logic behind it, but other countries which have had the full Lockdowns (Italy, Spain, etc) are also the countries with the highest Death Toll, so the effectiveness of this protocol does leave itself open to be qestioned.

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