But WHY do we need to flatten the curve? (anxiety warning!)

DeVore

You might think you know why, but there are some things that are going to shock you here.

WARNING:
Look, there are some things here that are Not Good [tm]. If you arent up for that, feel free to close the browser and play with your dog or go for a 2km walk and back. Your mental health is paramount. Other people have got this. Take the day off, we're good.

So, remember when Boris Johnson suddenly changed his mind and went from "I shake hands with everyone" to "for God's sake stay at home" practically overnight.... Well its because of a report from the Imperial College London. I've attached the report below and its good, if scary, work. Its a pretty terrifying read to be honest.

So, not wanting to scare people unnecessaraily I want to explain WHY we need to flatten the curve and what that actually looks like.

You might have seen this explanation or something like it.



Some of you are thinking "yes yes, I know about this".... but heres the problem: the jist of that graph is true (we need to not over load the health care system), but its soooo badly out of scale as to be almost fake.

The concept is good. The scale is deceptive.

Lets look at the UK.

The graph is pretty simple. On the bottom is Time Passing. On the left is the number of ICU beds needed per 100,000 population.

To be clear, thats not ventilator beds, thats Intensive Care Beds.
We have 1229 vents, with 900 arriving (should be here) and 100 a week on order.
Thats about 30-50 per 100k (this is good news).

So, the black line is the "do nothing" line and its pretty grim. The other lines arent much better but the orange line (the tactic Ireland is following) is a lot better than the others.

The terrifying thing is the red line. Yeah, that red line. The one almost at the bottom. That red line is the estimate surge capacity ICU beds in the NHS. Not the current capacity, the surge capacity. So, in the "Do Nothing" strategy, the peak has about 280 ICU beds needed per 100k population and 8 available.

Everyone, everyone above that red line isnt getting an ICU bed. Ireland has a very similar red line, if anything slightly worse but on this scale it hardly matters.



Just to zoom in on that line:



Now, being on a vent isnt a life saver, in fact there are a lot of bad numbers around vent usage at all. I dont want to go into that but really... needing a vent at all is very bad news. Needing a vent and not getting one.. I don't think I need to finish that sentence.

So when we say we need to flatten the curve. Thats the curve. We need to flatten that.


So we're doomed, dooooomed?!? Well, no. No we're not!

I'm going to write something tomorrow to explain why we arent doomed but here's the spoilers.
1. We are doing all the right things and our numbers look good day on day. Keep doing this. Our curve is flattening (we hope!).

2. The red line wont stay flat. We, the public, are buying time for the medical people, the army, the engineers and the politicians to build/supply/source more.

3. We're buying time for the world to maybe find a good way of treating/triaging this.

4. This is a model. Its a pretty good one but its still only a projection and a prediction. There are reasons why it might be wrong and more importantly there are things we can do to affect it, substantially.

I have staff to look after today and family, but I'll be here if anyone wants to ask questions.

Dont be scared. Be alert. Be informed.
Wash your hands. Stay inside.

Podge201

How will Sweden get on?

DeVore

Podge201 wrote: »

How will Sweden get on?

I dont have data for Sweden nor do I have a model built for them.

Ill see what I can find. There seems to be a reasonable variance between country predictions as each will be at a different point in the initial upward curve, with different compliance and different response approaches.

We have no medical indication that this virus is mitigated (or encouraged) by any genetic or medical property of a population.

In English that means it doesnt seem to be more vicious for one nation or another and we shouldnt expect to see differences *solely* on nationhood. It will depend on their actions.

You can see where they stand in comparison to other nations on sites like WorldOfMeters (which is excellent).

https://www.worldometers.info/coronavirus/#countries


ps: there does seem to be a susceptibility of men vs women, and pooooossibly some blood types BUT we need to be very careful making those kinds of statements because if you list 20 properties of people (hair colour, eye colour, height etc) and then look to see if any of them have a propensity to be susceptible or not susceptible to COVID, there is a very good chance that asking that many "questions" will return a positive/negative answer which SEEMS statistically significant simply by random chance.

Rufeo

The original post was a long post.

DeVore

Rufeo wrote: »

The original post was a long post.

It did have pictures.....

DeVore

Podge201 wrote: »

How will Sweden get on?

So quick look at their figures shows they have 1.5 times our cases (roughly) but 3 times our deaths.

That would lead me to believe they arent testing enough and are further up the graph than they believe. (my opinion).

Beasty

Podge201 wrote: »

How will Sweden get on?

Well they're not going to win the European Song Contest this year anyway

DeVore

Beasty wrote: »

Well they're not going to win the European Song Contest this year anyway

I think this IS the new ESC and one where Null Pointe is the top prize!

Sweet.Science

All very depressing . We are just slowing down Armageddon

manonboard

No questions. Just wanted to say i found it a clear and useful explanation.

Its making me thing about the lock downs and distance only lasting 5 months. I hate them. HATE them.. but to save alot of people in that orange line.. I'd be willing to deal with some suffering to help those.

I've got bad asthma and its not well controlled at the moment. Been badly controlled for nearly 10 weeks now.. I'm very scared. Trying my best though, and i very very much appreciate efforts of those without issues doing it for people like me.

It's odd to be in a high risk group. I'm 34. I run like the wind. I climb like a monkey. I eat 'well'. It's so oddly humbling to see its like a random lottery pick who is high risk.

manonboard

Do you think there is likely to be much increase in our surge capacity? Could we get to 30? 50 beds per 100k?

PaybackPayroll

Podge201 wrote: »

How will Sweden get on?

I believe (from something I saw) that they have far more one person households and they kind of 'naturally' socially distance themselves.

Hogzy

Am I correct in saying that the orange line above suggests that the UK will peak towards the end of 2020 if the current social measures remain in force? What is driving it to peak so late if all the social measures are adhered to between now and December 2020? I don't understand what is driving the December peak of the orange line in that graph.

Wibbs

Sweet.Science wrote: »

All very depressing . We are just slowing down Armageddon

Oh FFS. NO. No we are not. This is not armageddon or anything bloody like it.

Right. Imagine it's not 2020, but 1920. Imagine your class at school, look around that classroom. About a third would be dead before they were adults. Two years previously in the middle of a world war no less which killed millions, 50 plus million would be dead from influenza. Smallpox which kills a third of infected people and spread like this covid 19 was still a thing. Measles killed millions, polio crippled kids and adults and if you got an infection, well good luck, because no antibiotics. And in twenty years time you'd be looking down the barrel of another wider and more vicious world war which killed 80 million. And yet no armageddon then. In fact life and lifestyles in the west and elsewhere kept going in an upward curve and in short enough order we were flying to the moon and chugging martinis on Concorde.

People need to be aware, but they also need to get a bloody grip too.

GreeBo

So the obvious question seems to be, how long to we need to maintain social distancing to keep the numbers at or below the red line?
i.e. how long is the flat curve?

Vic_08

Hogzy wrote: »

Am I correct in saying that the orange line above suggests that the UK will peak towards the end of 2020 if the current social measures remain in force? What is driving it to peak so late if all the social measures are adhered to between now and December 2020? I don't understand what is driving the December peak of the orange line in that graph.

The later surge is what happens after the restrictions are lifted.

hmmm

The second wave per the models hits in the middle of flu season, which would be a disaster on the face of it.

However, every bit of time we buy ourselves gives us more time to develop therapeutics and build capacity. There are multiple drug trials ongoing, and some of the more interesting will be reporting results in April (Remdesivir in particular). Regeron's antibody is due to go into trials in June, and we should know within weeks if it is working or not.

If you're going to get this, get it last. That's when we'll know what works to treat this and what doesn't.

160 free ICU spaces two days ago and more coming on stream this week.
If we all adhere to the guidelines we can hopefully ensure everyone who needs ICU gets it and we can also minimise the numbers needing it.

RiseAbove4

So ...

We’re fúcked then?

All we’re really doing is slowing down the inevitable?



(Anyone else’s mental health in absolute bits more and more each day?)

deathbomber

Somewhat of a dramatic post, it is well known the number of ICU beds per head of population. People should adhere to the guidelines, full stop!

it irritates me when non medical professionals post up and then "explain" reasoning behind such reports, it is actually just as bad as the crap circulating on social media. There is information being made available to various healthcare professionals on a daily basis which you won't see published in mainstream media and for good reason.

Leave it to the professionals and behave and 99% chance you and loved ones will be fine!

darklighter

manonboard wrote: »

I've got bad asthma and its not well controlled at the moment. Been badly controlled for nearly 10 weeks now.. I'm very scared. Trying my best though, and i very very much appreciate efforts of those without issues doing it for people like me.

It's odd to be in a high risk group. I'm 34. I run like the wind. I climb like a monkey. I eat 'well'. It's so oddly humbling to see its like a random lottery pick who is high risk.

This is me to a tee.....except to make things worse, the gf is pregnant as well, so not ideal for either of us at present.

Its extremely depressing to see people not grasping the concept of adhering to social distancing, the typical Irish mentality of "sure it'll be grand" is not the approach to be taking at present :mad:

RiseAbove4

My gut feeling on this as soon as the schools were closed was “There’s no fùcking way our hospitals can handle this”

Whilst we have some absolutely incredible healthcare workers, our HSE system has felt akin to a Second World country’s for over a decade now

RiseAbove4

RiseAbove4 wrote: »

So ...

We’re fúcked then?

All we’re really doing is slowing down the inevitable? ...............

Not at all.

If we continue as we are going and more ICU spaces are made available anyone needing an ICU space might well get one. That's the best case scenario.
Results / number of cases up until now are more or less pre the measures brought in last Fri night to an extent.........






Green Total number hospitalised.
REd Total number admitted to ICU.

Earthhorse

I don't understand the point you're trying to make. We need to flatten the curve to prevent huge over capacity on beds and also to give us time to add more capacity.

What am I missing?

Earthhorse

Earthhorse wrote: »

I don't understand the point you're trying to make. We need to flatten the curve to prevent huge over capacity on beds and also to give us time to add more capacity.

What am I missing?

I am in same boat as you, I presume his key point is "The concept is good. The scale is deceptive.", in reference to the really simple graphs bandied about.

It's a strange post to start a topic with IMO.

deathbomber

deathbomber wrote: »

it irritates me when non medical professionals post up and then "explain" reasoning behind such reports, it is actually just as bad as the crap circulating on social media. There is information being made available to various healthcare professionals on a daily basis which you won't see published in mainstream media and for good reason.

Leave it to the professionals and behave and 99% chance you and loved ones will be fine!

This isn't crap. You can download the numbers yourself and do the same calculations and get the same conclusions if you have a reasonable knowledge of statistics. It corresponds with the best knowledge out there.

It irritates me that someone who has built a career and business on mathematical and statistical modelling and the understanding of same is somehow dumb when it comes to modelling medical emergencies and medical personnel are experts at it when the medical professionals turn to people like DeVore when faced with this.

If we ignore people like DeVore, we should just adapt the "herd immunity" strategy and our wonderful heroic medical personnel can end up like those in Italy, Spain, and very soon, the UK and the US.

Don't get me wrong, the medical professionals are fantastic, I have nothing but praise and admiration for them, but they aren't superhuman as some seem to think, they make mistakes too as we well know in this country.

I think they are currently doing a fantastic job, but the Irish people are doing a fantastic job too. The vast majority (99.99+ %) are adhering to social distancing, at least where I live, which wouldn't be the richest part of Cork city by a long shot.

Muahahaha

How many ICU beds does Ireland have per 100k population? Think I heard before we are lower than the UK who themselves are lower than some other European countries?

ITman88

Wibbs wrote: »

Oh FFS. NO. No we are not. This is not armageddon or anything bloody like it.

Right. Imagine it's not 2020, but 1920. Imagine your class at school, look around that classroom. About a third would be dead before they were adults. Two years previously in the middle of a world war no less which killed millions, 50 plus million would be dead from influenza. Smallpox which kills a third of infected people and spread like this covid 19 was still a thing. Measles killed millions, polio crippled kids and adults and if you got an infection, well good luck, because no antibiotics. And in twenty years time you'd be looking down the barrel of another wider and more vicious world war which killed 80 million. And yet no armageddon then. In fact life and lifestyles in the west and elsewhere kept going in an upward curve and in short enough order we were flying to the moon and chugging martinis on Concorde.

People need to be aware, but they also need to get a bloody grip too.

I have never agreed with a post more!

We have lived in the most privileged times ever experienced

Augeo

Augeo wrote: »

It's a strange post to start a topic with IMO.

Is it? I think it's a lot less strange than some media articles that report some random celebrity's opinion on the whole thing.

rossie1977

Muahahaha wrote: »

How many ICU beds does Ireland have per 100k population? Think I heard before we are lower than the UK who themselves are lower than some other European countries?

Both are around 7 per 100,000 about half of what Italy has or less than 1/4 of Germanys roughly 30 per 100k

deathbomber

Deleted User wrote: »

This isn't crap. You can download the numbers yourself and do the same calculations and get the same conclusions if you have a reasonable knowledge of statistics. It corresponds with the best knowledge out there.

It irritates me that someone who has built a career and business on mathematical and statistical modelling and the understanding of same is somehow dumb when it comes to modelling medical emergencies and medical personnel are experts at it when the medical professionals turn to people like DeVore when faced with this.

If we ignore people like DeVore, we should just adapt the "herd immunity" strategy and our wonderful heroic medical personnel can end up like those in Italy, Spain, and very soon, the UK and the US.

Don't get me wrong, the medical professionals are fantastic, I have nothing but praise and admiration for them, but they aren't superhuman as some seem to think, they make mistakes too as we well know in this country.

I think they are currently doing a fantastic job, but the Irish people are doing a fantastic job too. The vast majority (99.99+ %) are adhering to social distancing, at least where I live, which wouldn't be the richest part of Cork city by a long shot.

rubbish my wife is a medical professional and i didn't call the op poster dumb, however he is not a medical professional and there are a lot of key factors between the lines and not considered, the post is inaccurate at best