Re: part 2 An Ill Wind

On 17/03/2020 16:39, Wendy M. Grossman wrote:
> This is, rather obviously, way out of date now.

Indeed. Well done Neil and co!

The announced change in policy is good, but I still don't really trust 
the Government, especially SAGE, to do the right thing. Advisors who 
have been forced to change their policy often do not implement the new 
policy whole-heartedly.

But here's hoping for the best. At least the news is better than it was :)

For reference and completeness, below are part 3, A Coventry Moment and 
part 4, The Whole of the Moon.

I did not plan any more :) but I may write one on exit strategies.

Please ignore on the slightest pretext. In any case I apologise for 
having proselytised on non-crypto matters here, but I couldn't think of 
anywhere better and thought the message was of mortal importance.

These may contain some still-new and still-relevant material. And part 3 
is even a little relevant to crypto.


Peter Fairbrother


-----------------------------------------------
3- A Coventry Moment

15 March 2020

There is a story that Winston Churchill let Coventry burn under German 
bombing in order to protect the secret that the Nazi Enigma codes had 
been broken. He made a hard decision to spend lives now, in order to 
promote the greater good later.


On TV recently we have seen Boris Johnston looking Churchillian, having 
apparently made a similar sort of decision about the coronavirus 
epidemic - spending 400,000 [1] British lives now in order to gain some 
future advantage

The problem is that we don't know what that advantage is. It all seems a 
bit nebulous.

And apart from the large death toll, such a massive number of cases 
means the country will never be completely free of the disease - indeed 
it might provide a reservoir of low level infections which could mutate 
to produce novel viruses and turn the present virus into a recurrent 
seasonal virus, a nightmare outcome.

-

At the start of the epidemic, when we thought that it would prove 
impossible to stop the infection, the policy of delay made some sense - 
spread the peak to decrease maximum hospital load and thereby save lives.

That 400,000 or so British people would die was unfortunate, but 
inevitable. There was nothing we could do about it.

But then the Chinese stopped their epidemic, showing that there was no 
need for 400,000 or a million people to die, and everything changed. 
Except the policy.

-

Herd immunity is just what happens if you don't do anything to stop any 
disease which leaves the patient immune after it has run its course. It 
is at best a distraction.

One other possible line of Government thinking is that after we 
implement strong containment we would then have a still-vulnerable 
population, giving rise to the fear that we might have to continue 
strict measures indefinitely.

Possible, but what measures? Strict universal isolation is almost 
certainly not necessary once the disease is under control, though close 
attention to detail will still be necessary.

Proper control of entry to the country with quarantine where appropriate 
is the major continuing need; but other countries will be doing 
something similar, and international travel will not be easy for years 
anyway.

Better social distancing - the elbow or foot tap, enlarging personal 
space, avoiding contact where possible; protective measures like 
handwashing and handrubs, masks and respirators, perhaps gloves and 
goggles; widespread testing and diligent contact tracing once the 
epidemic is under control (with short-term but mandatory 
isolation/quarantine for those testing positive) are probably all that 
is needed.

But we can follow the Chinese example as they relax controls, and limit 
measures here to those which are necessary and which work.

Medium term, if people get "isolation fatigue", and the disease spreads? 
We would still be better off if we implement strict confinement now. We 
would have had time to make a billion masks, time to prepare a hundred 
million tests, time to open hospital beds, time to get the needed 
equipment, time to work out optimal therapies - and most of all time to 
research the disease.

For instance, how much would closing schools help? To answer that we 
need to know whether and to what extent children get the disease in a 
very mild form and pass it on, or do they just not get it at all - and 
we do not know the answer to that question.

How long does the virus stay active on various surfaces? We don't know.

What are the most important secondary and minor routes of infection? We 
don't know.

Why are older people more likely to die, and can anything be done to 
prevent this? We don't know.

How do we immunise the population? We don't know (yet).

How can we cure the disease? We don't know.

But we do know how to stop it.

-

Mr Johnston is not Winston Churchill.

Churchill himself never faced a "Coventry Dilemma"; that was just one of 
many similar teaching stories used at Bletchley Park to emphasise the 
need for secrecy. It wasn't real [2]. Many hard life-and-death balancing 
decisions were made by Churchill during the war, but the "Coventry 
Dilemma" was not one of them.

As for COVID-19, there is no sacrifice here to be made for the greater 
good.  There is no greater good to be had. Any sacrifice of lives would 
just be an unconscionable waste, somewhere between manslaughter with 
reckless disregard for life and pointless mass murder.

We can kill the disease. We do not need to kill the population, or 
400,000 or a million of it.

The Chinese have effectively killed the disease in China. Pretty soon 
they will be thinking about quarantining people entering the country, if 
they aren't already. That is the kind of turnaround we should be trying for.


As an aside, the real hard decision would not have been to focus efforts 
on amelioration at the cost of many lives, for some greater eventual 
good; but instead to implement strong confinement on ethical grounds, 
even if we thought it couldn't work.


Strong containment can work. It has been tried. It worked. There is no 
obvious downside to doing it.

There is no hard decision to make. There is no Coventry Moment. There 
never was.



Peter Fairbrother

[1] or a million deaths in real numbers, or twice as many British people 
as died in WW2. Best to treat the 400,000 Government figure like a 
contract price estimate which will inevitably overrun.


[2] It became a meme after a self-aggrandising idiot called Frank 
Winterbottom with an ego bigger than Julian Assange reinvented the story 
with himself in a leading role, and wrote a book including it as a true 
story.


--------------------------------------
4- The Whole of the Moon

17 March 2020

The good news: the worst-hit (or first hit) countries are now stopping 
their coronavirus epidemics.

China has done pretty much stopped their epidemic spreading [1], in 
South Korea it is dying out [2], in Iran [3] and perhaps Italy [4] it is 
getting less of a hold, though it is a bit early to say in Italy's case.

How can we be sure of that? Simple. The daily numbers of new cases are 
falling in all those countries, reaching very low levels in China and 
South Korea.

They have all implemented strong isolation, and it is working for them.

In none of them have even one thousandth of the population become, or 
are likely to become, infected (though Italy may come close).

There is no known case where strong isolation is failing to stop the 
infection.

China and South Korea are considering restrictions on people entering 
their countries in order to prevent infected people bringing the disease 
in, as that is now their major source of new infections.



The bad news: the UK's present policy is still to delay the epidemic 
rather than try to stop it, allowing over 60% of the population to catch 
the disease at a projected cost of 400,000 UK deaths (UK Government 
figures).

-

So why does the UK government still insist strong isolation will not 
work for us?


It doesn't have to be very onerous. Something like this: from Friday 
schools close, as do universities, pubs, public gatherings. Most people 
stay at home for perhaps 4 weeks.

During that four weeks we make a lot of masks, respirators and other 
protective gear. We prepare a very large number of tests. We prepare 
ventilators and people to operate them, and hospital and hospital beds 
in case the confinement does not work, though it should. We plan. We 
research the virus.

During the fourth week we test anyone who might have the virus. It is 
estimated that there are a few tens of thousands of active virus cases 
now, at the end of the four weeks that should be around five thousand, 
many of whom will be in hospital and most of the rest will be isolated.


After the first isolation period we implement mandatory testing if a 
doctor or trained nurse or a policy requires it, and mandatory 
quarantine if infected people do not self-isolate.

We limit personal contact, wear masks, wash hands, bump elbows, supply 
handrub. We monitor all suspected infections and contacts. Schools stay 
closed until we know more about the effects of closing schools, but 
people mostly go back to work.

Until we find a vaccine or cure or the disease dies out, we implement 
long-term restrictions on entry to the country - perhaps five days 
quarantine, with a test on the fifth day. That will not catch everybody, 
but it will probably catch enough people.

I suggest UK people already abroad should not have to pay for this, but 
for UK people leaving then re-entering and foreigners the cost should be 
included in the ticket price, a bit like airport taxes.


That will not be enough to stop the virus completely, but it will be a 
good start. We will by then have a better idea of which measures are 
necessary and which are not.  Perhaps one or two thousand people will die.

We may have to repeat this, or bring in other measures - but like China, 
South Korea, Iran and Italy, if we persevere we will stop the virus.

-

But we have to implement strong isolation now - any delay will cost lives.


The Government's alternative is to let the virus infect 40 million 
people or so, just slowing it down a little. On the Government's own 
figures that will involve four hundred thousand deaths.

This delay policy must stop, now. We want to kil the disease, not delay it.

-

Suppose we try hard to stop the virus and it fails. We will have had 
time to prepare for the peak, time to build ventilators, time to train 
staff to use them, time to make masks, time to expand testing, time to 
provide more hospital beds - time to research the virus, maybe even time 
to develop a vaccine or cure.


But then suppose we try hard and succeed. It seems most other countries 
will succeed too, and the disease will wither away or remain at a very 
low level until a vaccine or cure can be found.

We know how to do strong isolation for infection prevention, and all the 
examples in other countries show where it has been tried it is working - 
we need to do it now.

We also need to drop SAGE, the UK Scientific Advisory Committee on 
Emergencies. Preferably from a great height.


[1] Daily New Cases https://www.worldometers.info/coronavirus/country/china/
[2] Daily New Cases 
https://www.worldometers.info/coronavirus/country/south-korea/
[3] Daily New Cases https://www.worldometers.info/coronavirus/country/iran/
[4] Daily New Cases https://www.worldometers.info/coronavirus/country/italy/

Peter Fairbrother


Slogans for today:

Don't delay the epidemic, kill it.

Don't delay, kill the coronavirus.

Kill the epidemic, not the people.