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The Flu (Health)
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Wile E. Coyote


In: Arizona
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Grant wrote:
But epidemiology is like economics - a pretend science which can predict nothing beyond the bleeding obvious.


Actually I have noticed a predictable pattern which appears to have been missed, namely that an epidemic will slowly grow, then accelerate, then the acceleration slows down, and then finally stops to almost nothing, irrespective of policy direction. Can I have a Nobel?
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Boreades


In: finity and beyond
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Coronaphobia grips the nation!

So shouts yesterday's Daily Mail.

Britons do not want to go back into work because they fear the lockdown is being eased too quickly – and they enjoy being at home, a poll revealed last night.

Why?

It showed that on average people have more money in their pockets than when the lockdown started – with public-sector workers gaining the most. ... a total of 76 per cent – more than three quarters – of those in the public sector are either no worse off or are better off.

No surprise then that some sectors of the public-sector workers have been the most vocal about not going back. Will nobody think of the children?

Shouldn't this condition, new to medical science, be more properly called Coronaphilia ?
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Mick Harper
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In: London
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The biggest sector of public workers, the teachers, are demanding a coronavirus outbreak every summer for six weeks with two smaller ones in winter and spring. Plus a week in between each. And, to prepare for this new reality, there will have to be some training days.
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Boreades


In: finity and beyond
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I've just discovered an unexpected health benefit of being the only transgender lesbian on ADT in my village.

An Italian study investigating the prevalence and severity of COVID-19 in men with prostate cancer has revealed that patients treated with androgen-deprivation therapy (ADT) were less likely to develop COVID-19, and in those who were infected, the disease was less severe. Published in Annals of Oncology, the results of the study suggest that therapy, such as androgen-deprivation, could potentially be used to protect men from COVID-19 infection.

Ref: https://www.annalsofoncology.org/article/S0923-7534(20)39797-0/pdf

What do young male children and men on ADT have in common? It's not Harpo's court order, it's no testosterone and not so badly affected by Covid-19.
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Mick Harper
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In: London
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I think you're missing the wider point. How many Italian men suffering from prostate cancer could be rounded up in the time available, then divided into two groups -- those treated with androgen-deprivation therapy and those that weren't. Surely there is an approved therapy in Italy for men in the same condition. But even allowing for all that, how long has there been to observe whom among them 'caught', 'developed', with 'what severity' COVID-19 since we have learned all these terms are highly ... shall we say, subjective. This is all supposing that someone decided to test this group ahead of time on the offchance that ADT, prostate cancer and COVID-19 would somehow be related.

Then tabulate the results, then write up the account, then have it peer-reviewed, then have it published.
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Boreades


In: finity and beyond
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Your feedback is valid, but more appropriately (re)directed at the AoO

Try here?:
https://www.annalsofoncology.org/article/S0923-7534
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Ishmael


In: Toronto
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In the racial melting pot that is the USA, the median age of death by coronavirus is 81.

81.

I believe that's just called "death."
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Boreades


In: finity and beyond
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Boreades wrote:
John Corbett McDonald, as a dedicated public servant, should be commended for emphasising what should have been done to ensure that the medical services were fully equipped for what might happen, to provide a resilient and robust systemic service.

And that's where he went wrong.

Early in my career as a systems designer I learnt a harsh lesson, that the bill payers weren't interested in paying for what might possibly happen at some undefined time in the future (and building in resilience and fail-safe contingency), they only wanted to pay the minimum for what would happen now.

What John Corbett McDonald needed was some kind of apocalyptic doom-sayer or prophet that scared the shit out of the bill-payers.


It appears SAGE was thinking along the same lines.

Our UK government has published a discussion paper on increasing social distancing, written on 22nd March 2020.

Ref: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/887467/25-options-for-increasing-adherence-to-social-distancing-measures-22032020.pdf

As commendable as that is, it struck me as quite unusual. It's an official publication, not a document leaked to the press. It must be a sign of the times, that government committee deliberations are being released so quickly, not buried under a 25-year rule.

It contains a few gems like this:

The perceived level of personal threat needs to be increased among those who are complacent, using hard-hitting emotional messaging. To be effective this must also empower people by making clear the actions they can take to reduce the threat.

In suitably-official tones, it seems they decided that they really did have to scare the shit out of the general population.

A substantial number of people still do not feel sufficiently personally threatened; it could be that they are reassured by the low death rate in their demographic group.

Translation: Put the frighteners on them, tell them they need protection.

Caveats. Much of the evidence that has been drawn on is very recent and has not been subject to peer review. In some cases, the source is a SPI-B paper that involves expert opinion. This report has been put together rapidly and been subject to limited scrutiny and review.

SAGE Note: This paper was prepared by SAGE’s behavioural science sub-group SPI-B, for discussion at SAGE #18 on 23rd March 2020.

Translation: This product contains no manufacturer's guarantee or warranty. It's a Public Health medical policy written by sociologists and psychologists, not by medical people. If the wheels fall off, it's not our fault.
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Chad


In: Ramsbottom
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Consideration should be given to use of social disapproval but with a strong caveat around unwanted negative consequences.

Our Dom must be wondering what happened to the ‘strong caveat’.
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Boreades


In: finity and beyond
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Given the impact that this SAGE behavioural science sub-group SPI-B has had, AEL may be curious to learn more about this sub-group SPI-B (and its behaviour).

A few MSM articles have complained about "secret" SAGE meetings. But that might just be sloppy journalism, or not knowing where to look. The membership of the SAGE committe is published.

Gov.UK list of participants

https://www.gov.uk/government/publications/scientific-advisory-group-for-emergencies-sage-coronavirus-covid-19-response-membership/list-of-participants-of-sage-and-related-sub-groups

The key member appears to be Dr David Halpern (Behavioural Insights Team, Cabinet Office).

It's mentioned by Gov.UK

The Behavioural Insights Team – also known as the Nudge Unit – is now a social purpose company. It is partly owned by the Cabinet Office, employees and Nesta. For more information, please visit the Behavioural Insights Team’s website.

https://www.gov.uk/government/organisations/behavioural-insights-team

It has a well-designed website : https://www.bi.team/

Wiki says the Nudge Unit is not just a UK operation

The Behavioural Insights Team (BIT), also known unofficially as the "Nudge Unit", is social purpose organisation that generates and applies behavioural insights to inform policy and improve public services. BIT works in partnership with governments, local authorities, non-profits, and businesses to tackle major policy problems.

And it's a big operation.

Originally set up within the UK Cabinet Office to apply nudge theory within British government, BIT became a social purpose limited company in 2014. Its work now spans across seven offices, having run more than 750 projects in and conducted over 500 randomised controlled trial (RCTs). The Behavioural Insights Team is headed by psychologist David Halpern.

How did UK advice so quickly become USA advice?

BIT has expanded to the United States setting up an office in New York. The North American operation is working with cities and their agencies, as well as other partners, across the United States and Canada, running over 25 randomized controlled trials in the first year of operation.

It now appears to be government policy, on both sides of the Atlantic, to use the opinion of the privatised quango as a feed into official policy.

The model has been followed in the United States. The White House Office of Science and Technology Policy has a "Social and Behavioral Sciences Initiative", whose goal is "to translate academic research findings into improvements in federal program performance and efficiency using rigorous evaluation methods". On 15 September 2015 President Obama issued an Executive Order which formally established the Social and Behavioral Sciences Team and directed government agencies to use insights from the social and behavioral sciences to improve the efficiency and effectiveness of their work.

https://en.wikipedia.org/wiki/Behavioural_Insights_Team

All of which is very good, but slightly misinforms/misdirects how an important Public Health medical policy can be written as an opinion by sociologists and psychologists, not by medical people with evidence-based medicine.
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Mick Harper
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In: London
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The true scandal of the 'nudge unit' is that it was actually a Who Wants To Be A Millionaire? scam. It was originally set up by a hippy mate of David Cameron's called Steve Hilton, as part of the Big Society programme. Which was in turn modelled on, would you believe, Bhutan's Ministry of Happiness. Basically it involves government spending small amounts to achieve large effects -- hence Nudge Unit.

The Civil Service didn't have a clue since it is used to spending large amounts to achieve small effects, and hived it all off to the Cabinet Office. It wasn't a bad wheeze in itself but it generated more publicity than happiness since it required ingenuity (in place of throwing money at problems) and civil servants just aren't very ingenious people. So, to get rid off it completely, the Civil Service agreed to privatise it which meant giving the whole thing, complete with government contracts and funding, to the civil servants who happened to be running it at the time. They said thank you very much because as owners of this new company they were overnight millionaires doing exactly the same thing they were doing the week before and at roughly the same risk of going broke.

I cannot begin to tell you -- but Borry may have some choice examples -- how often this little scam has been operating over all the years when governments of both parties (and in this case the Lib Dems as well as part of the coalition) have been trying to upset the private/public balance for all kinds of reasons that have nothing to do with what's best for the dear old taxpayer. Or community-charge payer because local government is doing it all the time as well. Or licence-fee payer because the BBC is another serial offender. [Hatty and I were tangentially involved in one of these.]

But heigh-ho, as usual, nobody knows, nobody cares.
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Boreades


In: finity and beyond
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Chad wrote:
Consideration should be given to use of social disapproval but with a strong caveat around unwanted negative consequences.

Our Dom must be wondering what happened to the ‘strong caveat’.


Very true.

I wonder if Our Dom has (wittingly or not) set some kind of record? It seems he was in attendance at that crucial SAGE meeting which triggered the lockdown. Now it seems he has triggered the, err, unlockdown.

Friends living in seaside and holiday places like Eastbourne, Weymouth, etc say they are suddenly swamped with Camper Vans and the beaches are heaving with people getting closer to each other than the recommended two metres.

Perhaps this is socio-economic groups D & E at play? Or a very British way of protesting. Unlike France, which I'm told has several no-go areas (where the police don't go) and the lockdown was never enforced. Or if it was attempted, people were quick to riot, and the police were smacked down for being "provocative".
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Mick Harper
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In: London
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Speaking as a crypto-native of Dorchester I can assure you Weymouth is composed entirely of D & E socio-economic groups (though we tend to use the more informal F-categorisation) and that the whole area is a police no-go area. One positively shudders.
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Wile E. Coyote


In: Arizona
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As of 26th May we reached 46,383 deaths registered as Covid on the death certificate.

In the New Scientist on 25th March it is reported that to a Select Committee, Neil Ferguson predicted that deaths would reach 20,000 although it might be much lower.

So Neil Ferguson actually massively under predicted the number of deaths, or put another way Neil massively over predicted excess deaths at 500,000, then massively under predicted deaths, once his preferred policy option of a Lockdown had been implemented, which happened just 2 days before the select committee.

Could it be that in Neil's mind it was a case of 500,000 excess deaths if you don't lockdown, 20,000 if you do lockdown.You could argue both figures are right, if you factor in that Neil predicted some folks will choose not to observe the lockdown. Cripes he was right about that as well. This guy is a genius.
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Boreades


In: finity and beyond
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I thought I'd seen the last of these but...

Doh! It Just Gets Worse (part 3)

Britain’s disastrous decision to abandon testing for coronavirus occurred because health systems could only cope with five cases a week, official documents show

What? That must be a misprint. Five? Only five?

Newly-released papers from the Scientific Advisory Group on Emergencies shows routine testing and tracing of contacts was stopped because Public Health England’s systems were struggling to deal with a handful of cases. At a meeting on Feb 18, advisors said PHE could only cope with testing and tracing contacts of five Covid-19 cases a week, with modelling suggesting it might only be possible to increase this to 50 cases.

You've still got to be kidding. Five?

Advisors then agreed it was "sensible" to shift to stopping routine testing - despite acknowledging that such a decision would “generate a public reaction”.

Was there a reaction? Did the public notice the scenery being moved during the pantomime?

Former health Secretary Jeremy Hunt has said the decision to abandon testing and tracing will rank as one of the “biggest failures of scientific advice to ministers in our lifetimes”.

Sigh. Just add it to the list Jeremy.

Earlier this month Sir Patrick Vallance, chief scientific advisor, singled out the failure to ramp up testing as one of the key errors in Britain’s handling of the crisis. "I think if we'd managed to ramp up testing capacity quicker, it would have been beneficial" he said. "And, you know, for all sorts of reasons that didn't happen,” he told MPs.

You know, no names no blame, wave your hands, it's just one of those things.
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