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The Corona Files: Covid Nonsense – Part 1

The amount of nonsense that is communicated about Covid-19 and what should be done with or against it is just astonishing. And interestingly that is not limited to Social Media channels, or people’s own opinions but includes other media and even Government announcements and policies.

In this post I will attempt to analyse a few of the misconceptions, misinterpretations and confusing nonsense, but I expect that this is only one of a few posts. There sis just too much dodgy information out there to pack all in one post.

Social Distancing – Where do the 2 meters come from?

The concept of social distancing was created to avoid infection by droplet. As long as experts thought that the main infection route is through droplets that are more or less spat out while sneezing, coughing or talking, they also thought that staying away from each other would reduce the risk sufficiently to be save.

But bit by bit, we found out that an additional infection route is through aerosolised virus in the air in enclosed spaces. And now the expectation is that around 10% (only!) of infections happen through touch and then transfer of the virus to the nose, mouth or eyes. 40-45% through droplets and the rest aerosol. So in comparison to the beginning, we now have a completely changed understanding of the transfer. And it also looks like our mad washing of your hands, might have been a little over the top!

The distance between two people protects against droplets because these droplets fly a certain distance before they drop down on the ground. But it is very very strange that in different countries the droplets seem to travel different distances!

Here are the distance rules for different countries:

WHO: 1m
Hongkong: 1m
Austria: 1m
Italy: 1m
Spain: 1.5m
Germany: 1.5m
USA: 6ft (1.82m)
UK: 6ft (1.82m)
Ireland: 2m

Do you see anything odd? Yep, Hongkong and Austria (and as far as I know also Norway and Sweden), who all had relatively low death rates followed the WHO advise and the 1m distance was perfectly fine. Germany, also with a low death rate, pushed it to 1.5m. But for some inexplicable reason the droplets seem to fly MUCH further in Ireland.

Can we trust our scientists and doctors and politicians if they overexaggerate already with that simple issue?

Ireland got away lightly

Not so! Don’t be fooled by a relatively low number of deaths in Ireland. You always have to compare the number of deaths with the amount of people in a country. (Not with the number of infections, because that number depends on how good you test!). And compared to the population, Ireland is at the time of writing this No. 8 in the list of European states. Sure, that is better than in the top 5, but 8th is much higher than many – who just look at comparison of the Irish 1500 death with maybe the UK’s 34,000 – would expect.

Ireland did actually not do too well. And definitely not as well as DOUBLE the distance for Social Distancing in comparison, should have achieved.

Temperature Check in future

One of the ideas for the re-opening of society is that every time you enter your work place or an restaurant or other enclosed spaces, your temperature should be checked and if it is below 37.5 degrees you are good to go in and if it is above that, you will be rejected.

The HSE on their current website “A high temperature or fever, for most people, is when your body temperature is 38C or higher. This can be a sign that you are unwell. It usually means you have an infection such as a cold.” The NHS in the UK says “A fever is usually when your body temperature is 37.8C or higher. You may feel warm, cold or shivery.”

So going by this, both assume that 37.5 is not fever yet. We also know that some people never have a raised temperature even when they are sick and other people have temperature fluctuations even when they are not sick.

As a result the “cold” people would be allowed in even if they were Covid-19 infected and the “hot” people would be rejected even if they are perfectly healthy.

But even worse: The people with a temperature of 37.5 degrees of above will just get rejected at that place they wanted to enter. Nobody will tell them, hey, you should go home immediately and stay there for the next 2 weeks. No, they are free to try the next restaurant and the next one again and so on.

Temperature tests are an extremely weak route to “diagnose” infected people.

Flatten the curve vs “Let’s finish the job”

In one of his many not-so-succesful attempts to motivate people to believe or trust him, The Health Minister Simon Harris said on 10 May “We got this – let’s finish the job.” This statement is in the face of a pandemic total nonsense. We can not “finish the job”, because that implies that ‘we can kill that virus’. That is not the case and interestingly was never planned! All the government wanted to achieve was to “flatten the curve”. And THAT was achieved. This graph gives an indication and it is also in a tweet by Simon Harris. twitter.com/SimonHarrisTD/status/1260882652439207936
Now that the curve is flat and ICU beds are available, we have to allow new infections, not panic when they happen.

There are even people at the moment that wait for the day when the number of deaths that is still announced on daily basis will got to ZERO. People, that can’t happen! Every day people will die and some will die of pneumonia.

The Corona Files: Covid is staying … get used to it!

No Vaccine for Covid-19?

People in Ireland are a friendly bunch, and dealing with others on a first name basis is absolutely normal (apart from in very formal settings). So, since Covid-19 has moved in and isn’t leaving soon, let’s call it by its first name. Hi Covid! Welcome to Ireland!

How does reading that feel in your gut? For many, this might feel VERY uncomfortable. Imagine welcoming British doctor and serial killer of at least 218 people, Harold Shipmann (www.biography.com/crime-figure/harold-shipman), with a “Welcome to Ireland, Harold!”. It just doesn’t feel right!

But during the week, I listened to my daily schedule of virology podcasts and one of the doctors said something really interesting. He said: “Many of us think that the flu is harmless, but this is completely wrong. The flu (also known as “influenza” virus) is a dangerous and often deadly disease.” He then continued to explain that the flu spreads quite fast, it kills people (often through pneumonia) if they are in a high-risk-groups (i.e. have underlying illnesses or are of advanced age) and it can “get us” at any time between October and March.

If some aliens landed on Earth and you told them about the flu, they probably would be VERY VERY afraid. But for us Earthlings, the flu is NORMALITY. We got used to it and it is nothing we think overly about. You probably had it at some stage and you might even know people that died from it. (Although it was probably said that they died of pneumonia or something else that was caused by the flu. It is unlikely that someone said that that person died of the flu.)

But despite that deadly disease (flu!) among us, we do not change our behaviour much during the flu season. MOST of us have never been vaccinated against the flu, at least not if you are young-ish or not in a healthcare profession or risk group. If it hits us we take it on the chin, are out of action for a few days and then go back to work when it is over.

And there are other dangerous and life threatening things that we willingly accept in our lives. Car accidents, plane crashes, smoking, drinking, overeating, “under exercising” and many other things kill people on a daily basis and we all have directly or indirectly been affected or at least know someone who has directly or indirectly been affected. But we still don’t freak out too much over it.

I have no intention to compare the number of deaths and claim that Covid is harmless, it isn’t! But what struck me when I heard the virologist talk about the “normality” of the influenza in our life was the fact that the presence of Covid might just become a new normality! :-O

A yearly or even permanent risk that has to be minimised by certain actions (like using seat belts when in a car), but something we will get used to (because will HAVE to get used to)! And in a few years, it might just be normal to talk about Covid as we talk about the flu today.

Someone born in Ireland today, has an average life expectancy of 81.5 years. This is an average, no promise and certainly no guarantee and many do not reach that age. But in 1960, the average life expectancy in Ireland was just 69.80 years. And in 1946 it was below 60 and in 1900 even below 50. Imagine, on average you only lived until 50 if you were born in 1900! That is a very young death from our point of view today. (Source: www.esr.ie/article/view/730/157)

So from 1900-2020 we removed so many risks and dangers and we improved the health system so much that it resulted in an increase of the life expectancy of more than 30 years. That is a big achievement, but nothing that was guaranteed. If we are honest, we expected that it would continue to go up and up and we NEVER considered that there could be a setback.

Covid might have changed this and will probably put a dent in the graph!

However, it is still completely normal that we will have to die one day and that fact will not change – at least for another long while. What Covid has done is that it has added another risk factor to our lives and my prediction is that we will get used to it

So the real question today is not “How much longer will it take until I can go back to work again?” The real question is “What do we have to do to continue life with this new normality?”.

This might be a worrying thought initially, but think for a moment about all the risks that we are prepared to accept in our lives already and ask yourself WHY we are prepared to accept these risks. And then think about how you might be able to accept this new and added risk.

So, Covid is here to stay! Now we have to find a way to get used to it! …and at the same time again try to reduce the risk of a new danger while still continuing our lives.

——————————————

And just to pre-empt that question: No, we are not doing that at the moment! Currently the politicians and doctors in Ireland are trying to REMOVE the risk and therefore have decided to lock us in for another while. They are talking about lifting the restrictions “when it is safe”. But this is not the solution for the future if you accept that it might never be safe. It is like saying “We will let you use your car again when it is safe.” or “We will let you smoke again when it is safe.”

And a final warning: Do not hang all your hope on the discovery of a vaccine! There is still no 100% effective vaccine for Influenza A or Influenza B. Pharmaceutical companies guess every year which strand might break out and combine bits of a number of strands in a vaccine to hopefully cover the one that will hit us that year.
Also, there has never been a vaccine for SARS-1 or for MERS and Covid, which is SARS-2, will most likely mutate so much as well year after year, that there might never be a 100% effective vaccine. Oh, and remember, there is also NO “vaccine” against most cancer types despite them being around for so many years and despite their devastating effect on the life expectancy graph! So it is definitely possible that there will never be a 100% effective vaccine.

And that is another reason why we have to think about this new normality in a way where there is no going back to the old normality.

The Corona Files: Can we trust our leaders in this crisis?

[This post got a bit longer than planned and you might not have the time to read the whole post, but I can promise you that it is worth it, because there is some amazing and unheard of news towards the end of it!]

After more than a month in “lockdown”, with a significantly changed infection rate and considering what is happening in other countries, it is now time to think about the trust we can or should have in the politicians in Ireland to do the right thing.

While the picture here is by far not as shocking as in the USA, where Trump suggested to put UV light “inside people” to kill the virus or maybe to inject disinfectant (www.youtube.com/watch?v=33QdTOyXz3w) so that the virus dies, we still need to keep a close eye on what is done with our lives and to us by the people who are in power.

Because I do believe that we are dealing with a virus, a virus that is more dangerous than other viruses (I will write another time about THAT discussion and the Conspiracy Theories that are connected to it.), I do think that the soft-ish lockdown that we were put under, was the right thing to do.

But I am wondering of the people in charge are the right ones to get us out again.

Who is in charge?

First let’s have a look at the power structure in Ireland to see who is really in charge right now.

It seems that the following people and organisations/forums are on this list: Taoiseach Leo Varadkar, Health Minister Simon Harris, National Public Health Emergency Team (NPHET), Chief Medical Officer Tony Holohan and maybe also Professor Philip Nolan, who is leading the modelling team.

This is an interesting list for many reasons:
The majority of people on it are seemingly un-elected and are employees or subcontractors of the Department of Health. It seems to be really difficult to find out who is part of the NPHET (I wasn’t able to!) and the NPHET doesn’t release any minutes of their meetings anymore. But it seems that the two elected politicians (Don’t worry, I will come to that!), Varadkar and Harris, leave ALL or nearly all decisions to the NPHET. Alan Kelly, the Labour leader, has some justified concerns about NPHET: www.thejournal.ie/taoiseach-nphet-alan-kelly-5082184-Apr2020/

In a setup like this, there is a huge risk that experts are experts ONLY in their area, but don’t really see/understand or want to care about any other aspects of their decisions. You probably know the saying, to a man with a hammer, everything looks like a nail!

Because a modeller cares very much about his models and a Chief Medical Officer cares very much about the medical aspects of this pandemic, they definitely have to be PART of the advisory group, but after that should it not be the elected politicians that carry the responsibility and also then make the decisions and announce the decisions?

Yes (I am getting to that now!), I am fully aware that neither Harris nor Varadkar are confirmed in their roles after the recent election. And strictly speaking, they lost the election and would have to get re-elected or re-appointed before they are confirmed in their roles. However, they are – according to the Irish Constitution – rightly and correctly continuing in their roles until a new Taoiseach is elected and a new Minister of Health has been appointed.

On the way into the lockdown, I think they did do the right thing and performed well. But a critic could say that the getting into a lockdown is easy and you can’t do much wrong, the way out of the lockdown is MUCH more complicated and requires completely different leadership.

I am not convinced that the people in power are the right ones to get us out of the lockdown. The Chief Medical Officer will be judged by the only statistic he focuses on on a daily basis: Number of newly infected and number of deaths. The Modelling expert, only looks at the virus reproduction number R (and surprisingly for an expert he seemingly doesn’t understand that R0 and R are not the same!! R0 is the max reproduction number and R or Reff is the REAL reproduction number. Prof Nolan got it wrong here www.gov.ie/en/publication/ea86cc-covid-19-modelling-data-thursday-16-april-2020/). And if you are judged by ONE specific result or number, then naturally you only focus on that one single issue and tend to loose sight of any other issues.

So who will look at the other effects and impacts? There are social, mental, economic, educational and political impacts as well.

This is the sphere were politicians need to make decisions, but to do that, they might have to tell the medics and modellers that they appreciate their advise but might choose not to follow it for now and do we think Varadkar and Harris would do that? I don’t think Harris would and I am not too sure about Varadkar.

NO politician anywhere in Europe or even worldwide KNOWS what to do in the current situation, so we can’t be tooo harsh with our judgement. No medic or modeller really has reliable and 100% correct data! Apart from the number of deaths, everything else is pure guess work. We have NO idea how many people have been infected. We don’t even know exactly how the infections happen and why some people have a weak reaction and others have a strong reaction to an infection. So all the people in power are totally winging it! Not only in Ireland, but worldwide.

So what can be done? In my opinion, we should watch closely what is happening in other countries. Austria, Germany, Denmark and Czech (and a few more) are starting to ease the restrictions and our politicians should look at that to 50% and listen to the experts with the other 50%.

But this expert forum has to change now! Medics and modellers are still needed, but in addition we need to add people that know about mental health, that are experts in education and in economy. The expert group that will ADVISE our politicians (not lead instead of the politicians) has to spread wider and cover more bases.

How come I dare to say that? Do I think that all the deaths are not real? Do I think that we are over the hospital emergency?
No, I do not think that at all! What our health care workers experience is definitely real and we definitely need to continue the work on easing the pressure they are under.

But we also need to be aware that Covid-19 is not the only health issue in this country. There are people avoiding hospitals that urgently should be seen and possibly operated. And we need to take into account that there is NO good justification for some of the restrictions and the renewed clamping down that gardai have announced for this coming weekend. There is a good justification for the physical distance, but NOT for the 2km radius for exercise and also not for the travel limitations (as long as you continue to keep the physical distance wherever you go to).

And if business life doesn’t continue in some shape of form, we will NOT be able to pay for the out of work aid that is being paid at the moment and we will NOT even be able to keep financing the hospitals. Heck, we were not able to finance hospitals sufficiently to avoid overcrowding when the economy was going well, so how can it be possible when the economy has stopped?

I am NOT talking about a “getting back to normality”, but I am talking about moving out of emergency shutdown mode into a emergency handling mode in the same way as these other European countries do it.

And YES, it could happen that we will get back into lockdown mode again for another 2 weeks or so. Maybe even a few times. And that is absolutely ok, but we now need to work on a plan for getting out and I am not sure we can trust the people who are currently in charge to have the ability to do that in a reasonable way.


I should mention something else as well and I have to admit that it influenced my opinion a good bit. It is a very important aspect and maybe I should put up a separate post about this, because it is VERY surprising:

The deaths that we are currently experiencing is the only reliable number. We don’t know in a lot of cases if a death was caused by Covid-19 or not and for the dead person or his/her family it is not even relevant. But we know that these deaths are real! The ridiculous and brutal restriction to just 10 family member at a funeral, no matter how big the church or funeral venue is is also real and there is not the slightest justification for it. Thanks NPHET for one of exceptionally nonsensical rules!
But I discovered something else this week and I have not found ANYBODY writing or talking about it!!

There is a European Project that has the cute name “EuroMOMO”, but is not cute at all. EuroMOMO is a European mortality monitoring activity, so they cound the number of deaths that happen in Europe. And the goal of EuroMOMO is to detect and measure excess deaths related to seasonal influenza, pandemics and other public health threats.

So, the 24 participating countries report their number of deaths to EuroMOMO and EuroMOMO creates graphics and reports to show if and to what degree the deaths in a certain period of time are above or below the “normal” death rate. In normal years the deaths that are above the normal death rate are considered as influenza deaths if they happen between October and May. EuroMOMO has a lot of graphs and stats on their website, but the most relevant is the Z-scores by country and you should have a look at that here www.euromomo.eu/graphs-and-maps/#z-scores-by-country

The results are shown on a time graph and the Z-score shows by how much the current number of deaths varies from the normal number of deaths. In Belgium, France, Italy, Netherlands, Spain and UK you see a significant peak. That shows that they are having significant more deaths than in normal years.

But now check Ireland! And you will be surprised to see that Ireland has LESS deaths in this Covid-19 period than it would be normal this time of the year. LESS!!!

I have no idea why that is, maybe it is because there are less other hospital operations. Maybe because there are less accidents because people stay at home. Maybe the fact that people avoid going to hospital if they have some other issues, keeps them alive longer? I have no clue! It also doesn’t mean – and I repeat that on purpose again – that Covid-19 is not happening or that it is harmless or that it is just like a normal flu. NO! That is all nonsense! And the numbers in other countries clearly show that. But if our excess mortality at the moment is lower than normal, then maybe the 1014 deaths (as of yesterday) are at least in Ireland, just normality. And if that is the case then we have to continue keeping the virus under control by keeping a physical distance, but we have to wonder if the current lockdown is justified in its current form!

Soooo, can we trust the people in charge? What do you think?

The Corona Files: We did go too far!

Johann Wolfgang von Goethe wrote a poem that is called “The Sorcerer’s Apprentice” and when I went to school, we had to learn it. I did exceptionally badly that day and got the worst mark on reciting the poem that I ever got in my whole school “career”. So it is a poem that I will never completely forget. One of the lines is “Die Geister die ich rief, werd ich nicht mehr los.” and that translates to “The spirits that I called, I can’t get rid of anymore.”

We are clearly still in the middle of the Covid-19 crisis (some think we are only at the beginning of it!), but a lot has happened and I am genuinely and deeply concerned about the long term effects that policy decisions had already and will have on our behaviour to each other.

The “We are all in it together!” is long forgotten and fear and panic has replaced the we-will-fight-through-this attitude from before.

I came across a whole range of scenarios that worry me! Here are just a few examples:

1) The Police State

Over the Easter weekend when the much stricter restrictions where in place a friend of mine and his partner went on a food shopping trip for his and her parents who are elderly and are cocooning. Because they live a little bit apart at the outskirts of Dublin, they had to travel a bit to shops and then to deliver the food. On their way, they were stopped at SIX garda checkpoints and they were never able to deliver the food. On one of the checkpoints an ill informed garda gave them nearly the full “E-E-E-E” treatment that was used as garda strategy that weekend. The four Es is Engagement / Explain / Encourage / Enforcement. (www.rte.ie/news/coronavirus/2020/0409/1129677-what-to-expect-from-gardai-during-covid-19-restrictions/)

They were told that they are NOT allowed to drive to their parents to bring them food despite the fact that “caring for the elderly” was clearly classed as ESSENTIAL during the Covid-19 crisis. They were also threatened with legal action if they don’t turn around. Nonsensically, the garda told them that instead they should bring all their shopping to the next garda station so that the food would be delivered by gardai to their parents. (There was no answer on how to deal with frozen food.)
Maybe this was just ONE garda on a power trip or an extremely badly briefed garda? But at another one of the six checkpoints, they were berated by a garda because two people (who live together!!!) were in the same car. :-O There is no rule or law in Ireland that disallows that.
By the way: They had to give up and turn around to avoid being prosecuted or arrested…and the parents didn’t get the food for Easter!

2) Inexcusable Misinformation

A situation that was not related to Covid-19 forced me to be in A&E in a Dublin hospital 2 weeks ago. I was there with my partner and as it is normal and natural during the waiting period and between examinations we sat next to each other and talked about what happened. The shift of the office based A&E staff had changed and the new admin at the reception had taken over. 10 minutes later he spotted us and came running out from behind his glass screen, shouting at me for not keeping a social distance. I explained to him that this was my partner who I live with. But that didn’t stop him! Instead he got even more excited and told me that this does not matter in the slightest. We are in a hospital and therefore have to keep a distance of 2m from each other.
He either didn’t understand the rules OR he was taught nonsensical rules and didn’t question them.

3) Blinding Fear

Someone I am “friends” with on Facebook wrote in a Facebook conversation
during the week:

“If people meet and don’t keep the distance at the moment, they could infect others. The infected people could die. So meeting others is akin to murder!”

I am lost for words in this case. How can any sane and sensible person draw that conclusion?? The person who wrote that clearly lost all reason and I can only conclude that this is caused by a blinding fear.

4) Attacking the people who help!

Luckily we have not reached the lowest of lows in Ireland: In the UK, Health Care workers are being attacked and abused for being “virus spreaders”. Tires of ambulances are slashed and cars of hospital employees are damaged. The ITV news on 15 April had this report:

How can it come to this? My guess is: Irrational fear, stirred by sensational media reports. This is shocking stuff!

5) No Way Out

At some point in the not toooo distant future, we will have to go back to offices again and kids will have to go to schools. But the virus will not be gone! So how will we deal with that?
In Denmark, where they are a little faster with lifting restrictions and thought about letting young children return to school first, rapidly 18,000 parents declared that they will refuse letting their kids go back to school.

How will we deal with a loosening of the restrictions? Will we also refuse to go to work? Let kids go to school? If a vaccine is another 12-18 months away, will some of us lock themselves in at home and refuse to go to work until then? How will YOU react when you have to go back to work? Enter a room again with other people inside?

In my opinion, we have definitely overdone it! We have over-egged the pudding!! And it is all based on fear that has been whipped up by our authorities, lead by the government and advised by medical officers and epidemiologists.

Don’t get me wrong, I think the lockdown was the right thing to do, BUT what did the Taoiseach do to “incentivise” the country? He said on 09 March that in Ireland 85,000 people could die from the Coronavirus. (www.independent.ie/world-news/coronavirus/up-to-85000-irish-people-could-die-from-coronavirus-in-worst-case-scenario-taoiseach-indicates-as-three-more-diagnosed-39029363.html) This was not wrong information, but it was information that was used to get us worried so that we would adhere to the restrictions.

Later on, language was used that suggested to us that our lives were in serious and immediate danger. All measures were “to save lives”. “Stay home stay safe!!” This is also not wrong, but we can’t be surprised that then many look at the other people on the same footpath as a threat to their life. Or when leaving your home to go back to work is seen as risking ones life.

And now you see where “The spirits that I called, I can’t get rid of anymore.” becomes relevant! We over did it! We became so fearful that the care that people showed for each other in the beginning turned into people being prepared to report their neighbours for the smallest Covid-19 rule infringement.

It is a little early to think about things going back to “normality”, but what type of society do we want when we are going back to a sort of normality? If you have certain preferences, don’t let others pound fears and believes in you that are counterproductive!

Assess for yourself and judge what makes sense and what doesn’t. Then check with people that you trust if your assessment is reasonably and logical. Be prepared to learn and to speak up if necessary!

Oh and never ever forget that MOST others don’t do the (questionable) things they do to hurt or harm you, but because they don’t know better. Always be compassionate!

The Corona Files: Get me out of here!

In Ireland, restrictions of public life started on 13 March, so we are one month into it and last Friday it was announced that the lockdown will continue for at least another 3.5 weeks until 05 May.

So it is much too early to pain for a “back to normality”, we need a lot of patience, but at the same time, it is the right time to think (or learn) about how we will be able to get out of this lockdown situation again.

There are a lot of people that think that as long as we are patient and stay away from other people, the virus will disappear again and we can go back to normality. However, this is a highly unlikely scenario!! The Coronavirus will be with us for a long long time and can (and probably will) flare up again and again.

If you think this through, then there is no straight forward and simple way to lift the lockdown. Not on 05 May and not on 05 June or 05 July unless something else happens.

The job description of a of an efficient virus includes the requirement “must spread…ideally like wildfire”. And in that respect the Coronavirus is a very efficient virus. Not as efficient as measles, but doing a good job nevertheless.

Virus Reproduction numbers are essential

The efficiency is expressed through the “max speed of spread” or reproduction number, which is called R0 (R Zero). For measles this is around 15 and for the Coronavirus it is up to 3, for the influenza virus (flu) it is around 1.3. That means that one infected person will infect 15 others for measles and 3 others for the Coronavirus. 15 is crazy, but even 3 (or on some areas around 2.2) is exponential spread. So to reign it in the effective reproduction or Reff (R effective) has to be brought down to 1 or better below one. That would mean then that one infected person will infect just one other person or maybe even less than one person. At that point the spread is linear or is decreasing (when smaller than 1).

In Ireland we have the advantage that the country is quite small and this combined with relatively fast action that was taken, we are allegedly at the point where Reff is at around 1. I say “allegedly” because I think that the numbers of infected people are MUCH underestimated in Ireland due to the low number of tests that have been carried out. But lets hope that we are actually close to 1.

At that point, the virus is far from being gone. It is just more under control and therefore it is expected that the hospitals will be able to deal with virus patients better.

So what Reff doe the authorities aim for? The simple and complicated answer is “as low as possible”. But be aware that it is unlikely to be Zero, because the Coronavirus is devious and smart. It is hiding its presence for 5-14 days and only after that you will get symptoms. During these 5-14 days a carrier can infect a LOT of people.

With R0 being around 3, ONE single carrier could easily infect all his/her social contacts in a week and for a busy person that could amount to 3-4 per day. So in, let’s say 10 days ONE single highly socially active person could infect 20-30 people and BOOM there is a new cluster that can lead to another wildfire-like spread.

How to lift the lockdown?

If we lifted the lockdown completely, we could be back in a uncontrollable situation within 1-2 weeks. So we can’t do it that way. In Austria they are talking about lifting the limitations for smaller shops and trades people on 14 April and then for hairdressers (WHY them!?) on 01 May and then for the first few pubs and restaurants in mid May. Schools will still stay closed at that time. This is just an idea, a concept that might get changed faster than you can read this blog post, but it shows what we also might have to do.

What do we want to achieve?

That is an important question! The virus can be stopped by only one thing according to virologists and that is a high enough immunity in the population so that it can’t spread anymore. In virology terms, this is called “herd immunity”. This term got a bad meaning because the UK tried to wait for natural “herd immunity” at the outbreak of Covid-19 and now many think that “herd immunity” doesn’t work. This is totally incorrect. Herd immunity is not the same as letting the virus go rampant. Herd immunity just describes that 60-70% of the herd (or population) reached immunity. This can be achieved in two ways: Either they get immunity because they were infected, got through the infection and are now immune OR because they were vaccinated.

The natural immunity is still not certain for the Coronavirus. A trial was done with 5 monkeys that showed that after an infection and going through Covid-19 the monkeys got immune and didn’t show any symptoms when they were re-infected afterwards. But monkeys are only similar not identical to human beings, so more tests are needed to be absolutely certain. The indications are good though. The second problem is that we have no clue yet how long the immunity will last. Some viruses (chicken pox) will be kept away because our body will develop immunity forever, but with other viruses, the immunity is time limited. And with a bad ass Coronavirus, it is POSSIBLE that the immunity will only last a few weeks or months or maybe one or two years. We have no clue yet about that!

What do we need to reach herd immunity?

If we need 60% of the population to have survived Covid-19, we need a LOT more infected people than we have at the moment. Right now, there are around 9000 people tested and found infected in Ireland. IT is assumed that in countries with a high test rate around 80% had the virus and didn’t show any or no severe symptoms, so in a best case scenario the 9000 are our 20% and then we would have had a total of around 45,000 people that were infected and survived and now might have immunity. Because the test rate in Ireland is super low, let’s be generous and let’s assume that we actually have only 10% of detected cases. Then the total immunity level in Ireland after Covid-19 would be around 90,000. This is a immunity level of measly 1.8%!!

So to achieve herd immunity (60%) we need to get another 2.79 million people infected. :-O Imagine! And this has to happen soo slow that the Intensive Care Units will not get overwhelmed again. So maybe at a rate of 90,000 every 1.5 months (at the moment we might have 90,000 in one month with catastrophic consequences for ICUs). With this infection rate, it could take 31 *1.5= 46.5 months (!) to reach herd immunity!

Luckily there is an expectation that in a best case scenario we will have a vaccine in about 12-18 months. So we wouldn’t have to go through the whole infection process of 46.5 months, but would only have to do it for around 18 months. Still in these 18 months we would have to continue protect (=shelter) the high-risk groups and we would have to control the planned infection process constantly and be prepared to shut down life again as soon as it threatens to get out of control.

You can see that this is not an easy situation and that we will be dealing with that WELL after 05 May. This is a bit of a grim prospect, right!?

It will be interesting to see IF Austria will go through with their plan and it will also be interesting to keep a close eye on Denmark and other countries.

I expect that the lifting of the lockdown will have to be a very careful gradual lifting ALL the time being prepared to go into full shut down mode again if needed.

Smart Distancing + Tracing App

An alternative possibility would be to move from Social Distancing to Smart Distancing, in this case we would stay away from people that could be infected and we would continue to quarantine them for 2 weeks as soon as they get some symptoms. We would still need to cocoon the high risk group and couldn’t go back to normal international travel and large events (concerts, football matches, olympic games etc.). And we also would have to combine that with a HOPEFULLY anonymous contact tracing app that would tell you when you had contact with someone who is infected and once you had contact, you would have to self-quarantine immediately (and the app information would have to be proof to your employer that you will have to stay at home for 2 weeks). We also would need LOTS of antibody tests so that people with Coronavirus antibodies would be allowed to freely move around again without having to quarantine.

I am not a modeller or epidemiologist, so all the “models” I described above are very much simplified, but it shows that the Social Distancing and “Stay at home” measures are 100% required to protect the health care system at the moment, but they are not an ideal approach to reach a form of “normality” again.

What do you think about Smart Distancing and a Corona tracing app? If antibody tests are available, you might have to check yourself every two weeks or so. Would you be ok with that? And what if the app was NOT anonymised? Like in China now, the authorities would be able to trace EVERY move you make. Would you consider using the app still?

 
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