Not much blogging lately on account of a PUPPY. If you haven't read that one yet, you might want to read it after this one to balance out the cynicism.
He who is last shall be first ! And also vice-versa.
To recap, the Czech Republic did an outstanding job of stomping on the coronavirus when it first started. Fifty cases per day ? Total nationwide lockdown. Cases peaked at about 300 per day, but not for long, and steadily dropped. They reached a sustained low of about 50 per day, which lasted a full month or more. A re-opening plan was devised to gradually ease restrictions, which was similarly well-implemented, at first.
Then things hit a snag. The government was found to have implemented certain measures under the wrong act, so a court ruled it had to immediately lift them. It could have re-implemented them under a different act, but instead it said, "meh, let's just bump up the re-opening schedule by two weeks and purely coincidentally avoid having to pay people extra money". To be fair, things were going extremely well at that point. How much lower cases would have fallen with an extra two weeks we'll never know.
At first, they looked to have gotten away with it. Cases didn't do much at all. But gradually - so gradually as to be quite imperceptible at first - they started to climb. Even then they were kept well in check. There was no spike, no explosion, except for a couple of cases here and then (one in a mine and one in a nightclub*). Hospitalisation figures remained steady. I don't really understand how the figures remained so low for so long as they did, given that restrictions were completely over. But they did.
* These two things aren't normally connected, unless there's a craft beer pub in a mine somewhere. MineCraft. It sells itself.
Not any more. Now we're in a far worse state than we ever were before. We had a peak of 300 per day in the first wave - with 4,400 cases yesterday, we're well exceeding ten times that. Growth hasn't been as rapid as in the first phase, but it's been unrelenting, and deaths have gone from a few per day to 20-30 per day.
The contrast to the swift, decisive action at the start of the pandemic could not be greater. For weeks we've been getting nothing but the absolute minimum of incremental changes. Wear masks on all forms of public transport. Close the bars at midnight. Oh, fine, 10pm if you must. Wear masks in public indoor spaces, except for an exception list a mile long. Don't have more than a hundred people at a funeral. That was about it.
Only when cases reached 2,000 per day did we even begin seeing the possibility of localised lockdowns. A state of national emergency has been declared and more radical restrictions are promised on Friday, which there'd damn well better be because mucking about with wedding invitation lists is doing precisely bugger all.
The problem is that this already far too late. We know from the first wave that it's going to take at least a month for any of this to have an effect, so we're looking at tens of thousands of cases at least before things start to improve again. We've already gone from one of the success stories of Europe to being one of the worst failures.
Not so long ago the Tories accused the government's advisors of scaremongering over a possible 50,000 cases per day, which already no longer looks outlandish. Whether the Czech Republic is likely to follow the UK's trajectory and see tens of thousands dead remains to be seen, but it appears to be a worrying possibility as long as we keep making these incredibly petty, incremental adjustments. It doesn't necessarily have to involve a full-scale national lockdown, but something equivalently drastic is needed : a hugely ramped-up contact tracing scheme, more intervention to allow businesses to operate under unusual restrictions, greater outreach and enforcement of the rules, etc.
Originally I planned to say that even the UK is doing better than this : at least they're trying local lockdowns and acknowledging the problem. At least they tried to have covid marshals, even if they had a shite funding scheme and no real powers. But there the failures might just be different, not better or worse. As revealed in PMQs, some areas under lockdown have seen a tenfold rise in cases, which Johnson claimed - with frightening tautology - was due to... the spread of virus. FFS. What did he think it was due to ? Magical eagles messing with the figures ?
Anecdotally, people here are following the rules but absolutely no more than that. They wear masks where they have to. The bars close when they're supposed to. They even use disinfectant in the supermarkets, sometimes. They pay no attention to social distancing whatsoever. They don't mind crowded spaces or make the slightest effort to avoid each other. They're going to bars and restaurants as usual. At least, though, the rules themselves are clear and don't seem to have the crazy complexity of those in the UK.
For my part, I'm doing just fine. I even enjoyed my staycation very much, though it wasn't the visit back home I would have preferred and which seemed perfectly viable just a few weeks ago. I'm enjoying a David Attenborough VR series on insects very much and continuing to hammer the barbarians in Rome 2 Total War, as well as binge watching the hell out of Netflix. But I get why this particular lifestyle isn't what everyone wants, and I would no more want to stop people going mud wrestling or opera singing than I would want to be forced to go mud wrestling or opera singing. The problem is that it seems to be a straight choice between stopping social activities or allowing a catastrophe, and I don't get why people are reluctant to accept that. Who wants to go out if it means risking people's lives ? A hell of a lot of people, it turns out.
There was a Czech news report this morning that a few "doctors" (including a homeopathist, which tells you a lot) have said, "stop scaring people", much as Tories in Britain said the same thing or Trump did in America. But it is scary. It should be scary.... if people don't take proper precautions. Johnson keeps banging on about common sense, but the problem is this isn't a matter of common sense at all. This is a matter of highly uncertain science, both of the virology and behaviour. Common sense, for instance, would suggest that people would know that wearing a mask and not shaking hands are highly prudent things during a pandemic, let alone that they probably shouldn't share drinks in nightclubs. Yet people don't follow this, so it either isn't all that common or something else is at work.
I suggest that it's not "common sense" but intuition. Common sense implies some quasi-Bayesian reasoning and at least a small degree of actual thought. Intuition relies on heuristic shortcuts developed over a lifetime of experience, which works very well under normal circumstances but fails abysmally if anything changes. Or at most, it's a little knowledge being a dangerous thing : "sure I can go clubbing, the number of cases is still so small there's very little chance I'll be infected".
And in some ways this kind of reasoning would even be right. The risk to the individual remains low. But the risk of a major spreading event is high. Common sense and intuition just isn't designed to handle the prospect of unlikely events having massively far-reaching consequences, because such things are far from common. The science here is hardly perfect, but it's orders of magnitude better than letting people do whatever they think is sensible - because they don't have any good grounds to decide what actually is sensible. And after all, half of the population are stupider than the average.
I guess I don't really have much of a point to this other than, "things suck". Sorry about that. I plan to stay inside as much as humanly possible. I just hope that governments realise that we need much more dramatic action than limiting bloody wedding attendance, before it's too late.
I think the real issue here is lockdown fatigue, the more rules you make people follow, the more you stop those mud wrestlers and opera singers, the more resentful they get, and the less they trust authority. Then soon they are working to the "letter of the law" and after that defying rules entirely. The trick to controlling pandemics is to only implement mild rules which people will be inclined to follow, and stay inclined to follow. Wiping out covid is a non-starter until there is a vaccine, so is keeping the level very low, but maintaining good hygiene, clean hands, good ventilation and staying away from others if you are symptomatic with it, can help keep the spread at a relatively slow and non-alarming speed. Enhanced protection for those elderly and vulnerable who desire it, as suggested on Sunetra Gupta's gbdeclaration.org , is important too. For most people the virus isn't too bad, but for those vulnerable few it is often very serious. The Swedish strategy looks more attractive with each passing day, they haven't beaten the virus, because it can't be beaten without a vaccine we don't yet have, but they've got normal life very close to running, and they've done it by ensuring rules are unintrusive enough that people don't tire of them. I'm not sure about the Czech situation, but in many of the other places seeing an autumn increase (all respiratory diseases do this when people start being in stuffy heated rooms rather than fresh air) the cases are skyrocketing but the hospitalisations and deaths staying fairly low, this would tend to suggest that testing capacity was minimal in spring so they couldn't see the vast numbers of mild cases alongside the few nasty ones. The spring case spike, if it had been recorded like the autmn one is, would have probably been much bigger than the autumn one. Hospitalisations and deaths might well not rise like they did in spring, but waiting to know would be troublesome, especially as they lag behind cases long enough that it is hard to get realtime info from them. Whether, even uncontrolled, an autumn rise would be as bad as the spring wave is going to be largely down to what has changed since spring. Hospitals have got a lot better at treating the rare severe cases, avoiding ventilators wherever possible, and they might be at even less risk of overwhelming than before as covid patients tend to have shorter stays now than they did in spring, due to the improved treatments developed since, science recognises who needs to worry about covid and who will probably have nothing worse than two weeks of flu like symptoms, and maybe there is some level of herd immunity, some studies say it could arise at as low as 10 to 20% of the population being infected, which might further limit the spread. Avoiding panic is perhaps going to be the most vital part of whatever is done, lockdowns have been so damaging and disruptive, if they were a drug in an RCT the trial would be stopped due to ethics concerns about the side effects. "Keep calm, maintain hygiene, avoid the vulnerable if you think you've got it", seems a good starting point. Donald A Henderson, the man who masterminded the eradication of smallpox, would probably agree with focused protection and normality preserving strategies were he still alive to see these dark days.
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