This article is from the WeChat public account: Extraordinary fritters (ID: ffyoutiao) , author: fermented bean curd children, the subject map from: IC photo
The “herd immunity” of bankruptcy
On March 23, local time, British Prime Minister Boris Johnson announced that starting that night, all people must stay at home, except for the same family, except for buying necessities, going out for exercise, seeking medical treatment or commuting to core workers The above gathering will be banned. Libraries, open-air gyms, prayer places, etc. will also be closed, and people cannot hold commemorative or religious ceremonies except for funerals.
With the implementation of the new rules, police will have the power to disperse crowds or impose fines.
Note the last point, the police were granted law enforcement powers for a special period. This means that the above quarantine measures have been enforced. The “herd immunity” announced 11 days ago (I do not like the translation of “herd immunity” because this The translation is as gentle as the accomplice of this rotten epidemic prevention strategy) completely blatantly bankrupt.
11 days ago, the person who officially announced the infamous “herd immunity” was also Boris Johnson, who now announced stricter measures. 11 days ago he calmly said, “Be prepared to lose the one you love,” but now he can spit himself out of his face without heartbeat, but this kind of politician is really good at it.
Although we said on Weibo when Boris Johnson was just elected, this person was unreliable, but he did not expect that this person would be unreliable to the country and the people-when he announced “herd immunity” By the time he was already.
Think now, if Teresa May is the Prime Minister today, maybe it’s better than Boris Johnson. When I was writing “The Prime Minister of the United Kingdom: Don’t Dare to Come Up, Don’t Dare to Take Off”, I never expected that one day I would still help Teresa May speak.
Of course, the British reshuffle now is still good news for the British people. Although the intervention came later, it is better than nothing.
But it ’s too late for Britain to start taking steps now. More than 6,700 people are currently diagnosed in the United Kingdom, and they are not tested for mild cases in the UK, so the actual number of infections is more than this number. One side of the evidence is that currently many imported cases in China come from the United Kingdom. Its death rate is even higher than that of Hubei, which has been hit suddenly. Dare to ask where those people who thought that Britain was okay now?
Epidemiological investigations are more difficult to start if the number of specific infections is unknown, and home isolation in the UK may evolve into home infections. The times are really turning, the British Empire is not even as good as its former colony, Singapore.
As for the 11 days of “herd immunity”, Johnson supporting him and his “scientific adviser” are undoubtedly the British thieves.
How unreliable the idea of ”herd immunity” is, look at a very subtle thing to know. The United States originally imposed travel restrictions on the Schengen area, but the United Kingdom was not included. As a result, shortly after the announcement of “herd immunity”, the United States announced the implementation of travel restrictions on the United Kingdom- Even the United States felt that “herd immunity” was unreliable.
As for the British scientific community, it is strongly opposed to “herd immunity”. In fact, Johnson’s so-called “scientific adviser” is just a fluke who provides a “reasonable basis” for leadership decisions. Most scientists are busy spraying “herd immunity.”
For example, the well-known medical journal “Lancet” magazineThe editor Richard Horton tweeted wildly after the release of “herd immunity”, criticizing the absurdity of this policy.
On the 16th, scientists led by Neil Ferguson, a public health scholar at Imperial College London, published an article entitled “Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and Healthcare demand “ (Effects of non-drug interventions on reducing crown virus deaths and medical demand) report has driven the shift in UK epidemic prevention measures.
Unfortunately, Neil Ferguson was diagnosed with new coronary pneumonia a few days later.
A report that changed the UK
So what does this report that is alarming the British government say?
It divides the response strategies of countries around the world into two types:
(1) Suppress (suppression) . The goal is to reduce R0 to less than 1, thereby reducing the number of cases to a low level, or (such as SARS or Ebola) to eliminate interpersonal transmission . The main challenge with this approach is to maintain non-drug interventions at least intermittently until the virus stops spreading or vaccines appear. In the report, China and South Korea are considered to have adopted this strategy.
(2) Relief. The goal is to use non-drug interventions (and vaccines or drugs, if any) to reduce the health effects of the epidemic, rather than completely Stop transmission, A strategy similar to that adopted by some American cities in 1918 and the world of pandemic influenza in 1957, 1968 and 2009. For example, during the 2009 influenza pandemic, early vaccines were given priority to individuals who already had other illnesses because other illnesses put them at greater risk of the disease. In this case, most people have increased immunity, and mostEventually, the number of cases decreased rapidly, and the transmission rate dropped to a low level.
This report is based on model predictions, so there are many preset conditions. In addition to the pre-set outbreak response strategy classifications above, it also assumes an R0 of 2.4, assuming five non-drug interventions, that is, there are Symptoms are isolated at home; voluntary home isolation; increasing social distance for people over 70 years of age; increasing social distance for all; closing schools and universities.
The model concludes that without any non-drug interventions, 81% of the UK and US population will be infected. Peak deaths occur after 3 months. Without considering the potential negative effects of an overloaded health system, the UK will have 510,000 deaths and the US 2.2 million.
Using certain interventions combined with mitigation strategies requires fine and accurate micromanipulation to control the time point. The model concludes that The most effective combination of interventions is home isolation for symptomatic individuals, home isolation for the entire family, and high-risk groups. (Age 70 +) Extend social distance. But even so, the best response strategy will still cause peak demand for intensive care beds to exceed the UK and US capacity by 8 times.
So, even considering the most optimistic situation, the number of general wards and ICU beds in the UK needs to be expanded by eight times. Even with that, the report predicts that 250,000 people will still die in the UK.
The report therefore states that countries that have the ability to implement strict control measures need to adopt containment strategies.
☉Image source: Serial Number 54129 / wikipedia
However, suppression strategies also have their potential risks. If the intervention is relaxed, it may lead to a second outbreak, and when there is no vaccine, the second outbreak may causeThe line size is getting bigger.
This report also argues that Restraint measures will cause more social damage than mitigation measures. At the end of the report, the report deliberately emphasized that it is not certain that containment strategies will also succeed in the long run, and that public health interventions that have had such a devastating impact on society have never been tried before. How the population and society will react remains unclear.
Even so, this article proposes that, Even in countries in the early stages of the epidemic, although the social and economic impact of the measures needed to implement containment strategies will be profound, (such as the United Kingdom at the time) also need to take these measures immediately.
meaningful, but rough
Some reports have been translated into Chinese by the media, and there has been some discussion on the Chinese Internet.
I think this report was still very meaningful in the United Kingdom at the time (March 16) . For China today, it has some meaning, although it is relatively limited.
The significance to the United Kingdom is that the report mentions that if no non-drug intervention is adopted, the United Kingdom will die 510,000 people; the best results of precise regulatory measures will require more than 8 times the number of beds and eventually 250,000 deaths. people. This bloody result is before the British government, and even a brazen politician such as Johnson has to hold his nose to reconsider a 180-degree turn in policy.
In this sense, the unfortunate diagnosis of Neil Ferguson is really “I recommend England to my blood.” He should be praised more, and Johnson should be nailed to the pillar of history’s shame.
However, the strength of this report is mainly to persuade the UK to take more non-drug interventions and eventually to take restraint measures. It achieves this goal, but its model is still relatively rough, and many discussions seem to be brief, and its meaning to the rest of the world is relatively limited.
For example, this paper divides the response strategies of countries around the world into suppression and mitigation, but it also mentions that the “mitigation” strategy is based on past experience with influenza-this new crown is obviously not a ” Large streamSense “.
And the “inhibition” and “mitigation” dichotomy is too crude. In this report, examples of “inhibition” are given to China and South Korea. We do not know that there are still many differences between Chinese and South Korean measures. China’s measures have become more rigid and more comprehensive. Such measures as closing the city have never been done before. South Korea has not taken measures to close the city. Its core strategy is to conduct large-scale nucleic acid detection. It has detected more than 300,000 people, quickly located potential patients with zero number, and accurately controlled them.
How do you classify other top student cases outside China and South Korea? For example, 800 outpatient clinics in Singapore are accompanied by strong penalties, but daily life is open as usual, and even external communication has not been cut off for a long time. ( Recently, Singapore has banned all foreigners from entering or transiting. Is it “inhibition” or “mitigation”? If it is considered “suppression”, Singapore’s measures are very different from those of China and South Korea.
A loose defense like Japan is probably a “mitigation”? However, it seems that the situation is not serious in Japan, and this report does not mention the Japanese case. Of course, with the postponement of the Olympic Games, we can see the specific situation of Japan in a few days, but Britain does not seem to refer to Japan.
☉Image source: dave souza / Wikipedia
The five non-drug interventions mentioned in the report include home isolation for those with symptoms; voluntary home isolation; increasing social distance for people over 70 years of age; increasing social distance for the entire population; closing schools and universities. This formulation is still too rough.
For example, a large number of tests in China and South Korea, and mild isolation. (The Chinese side cabin hospital and the Korean life treatment center have done a good job in light isolation treatment.) , not mentioned, and this is a very critical measure. Sorry, if a large number of tests are not possible, even”Solution” strategy, the data required is not clear, let alone precise strategy.
In addition, the entire report did not mention that ordinary people generally wear masks, and masks may be an important reason for the slow spread of the Japanese crown. In the case of a slow response by the Japanese government, the slow rate of infection in Japan may be because the Japanese people are hygienic and have the habit of wearing masks. Of course, this is uncertain, after all, Japan’s lid has not been opened. However, the role of masks is not mentioned in this report, and its significance may be limited to alerting the British, but it has limited reference to us.
Never be arrogant
Even so, this report is valuable.
For example, it mentioned that If the intervention is relaxed, the suppression strategy may lead to a second outbreak, and when there is no vaccine, the second outbreak may make the epidemic larger.
This is why China has recently guarded against imported cases. Today, globalization has been very deep, and the outbreak of overseas epidemics is not good news for China. In the past two months, China has prevented the outbreak in the country. However, if a second outbreak is caused by an imported case, this is equivalent to letting the people of the whole country put the efforts of the previous two months to nothing.
The epidemic is quite scary. The virus is highly contagious. It spreads tirelessly in different countries. It is day and night, without errors, without prejudice. Anyone can drill through the loopholes. And there are still loopholes in the domestic system-we will not forget that the loopholes two months ago were full of holes, and now, although the situation has improved, we need to be vigilant.
If imported from overseas, the outbreak may occur at multiple points, which is more difficult to deal with than the initial concentrated outbreak in Hubei—now there are overseas imported-related cases in Beishangguang.
This requires us not to take off our masks at will, and not to pin all our hopes on the government. The government is also composed of human beings. At the same time, we must step up our efforts to explore specific medicines and vaccines. Until the mass production of the vaccine, can we say that we will win.
In addition, the situation in South Korea today is similar to unblocking all cities to prevent secondary outbreaks, but unfortunately there have been small-scale outbreaks. On March 19, there were 152 new outbreaks of confirmed cases of new crown pneumonia. Compared with the British experience, some of the lessons of South Korea seem to be more meaningful.
Furthermore, the implementation of suppression strategiesIt is also worth noting that the needed measures will have far-reaching social and economic impacts.
In the past two months, the national economy has been under tremendous pressure. Many people can’t resume work and resume production. They can only rely on savings to survive, and economically vulnerable families can’t support them. After the resumption of work and production, whether the economic stimulus plan is effective and whether it can stabilize the people’s livelihood is a major test of the next stage. As far as we know, some light industry sectors related to foreign trade are about to collapse, and some manufacturing industries are facing unprecedented shocks. Who can save them?
In short, it is difficult to relax epidemic prevention and the economy.
The huge economic and social impact is why it is difficult for Western countries to make up their minds to adopt powerful measures to control the epidemic. But from the current point of view, if we do not take strong measures, the epidemic will continue to develop and we will not be able to maintain our economy. A new study from Oxford University claims that half of the British population is already infected with the new crown virus. Due to insufficient detection capacity in the United Kingdom, the results of this theoretical study are difficult to confirm, and the current infection situation in the United Kingdom is a mystery.
☉Image source: Philafrenzy / Wikipedia
I also agree with Professor Ferguson that there is still a lot to learn about the contagious nature of this new virus. It is not time to take it lightly. We should also be open to learning from more countries, and we must not be proud or gloat over the spread of overseas epidemics.
In terms of this report and the British government ’s response, they may have made arrogant mistakes, the Chinese example is invisible, and the advantages and disadvantages of South Korea seem to be ignored. If these are all linguistic pots, what does the Singapore experience say? After all, the sadness and joy of all human beings are not connected. The shouting of East Asian countries to the city is probably noisy in the ears of European and American countries.
The scariest thing is that some people think their deafness is reasonable.
Escalation control measures in the UK: Banning the gathering of 2 or more people who are not in the same family_News Channel_ 中国 网 https://news.china.com/internationalgd/10000166/20200324/37964114.html
Chief Medical Officer in England: New Crown Virus testing will no longer be performed on people with only mild symptoms-Top view https://www.jfdaily.com/news/detail?id=223907
British public health scholar Neil Ferguson diagnosed with new coronary pneumonia-upstream news gathers upward power https://www.cqcb.com/kangyi/2020-03-21/2274151_pc.html < / a>
Korean media: South Korea’s epidemic rebounded, and the number of newly diagnosed patients broke 100 in a single day. Epidemic | New Crown Pneumonia_Sina News http://news.sina.com.cn/o/2020-03-19/doc-iimxyqwa1624044.shtml
From an increase of 800 people to less than a hundred people, how can South Korea stabilize the epidemic? -News-Beijing News Network http://www.bjnews.com.cn /video/2020/03/24/708134.html
Ferguson N, et al. Impact of non-pharm