Re: Lockdown
 

It would be a huge error to believe the modelling is conservative. All the data sets being used by epidemiologists are wildly inaccurate. Oxford University is doing a regularly updated forest plot of death rates and it demonstrates the outcome from different countries is so completely disparate that you shouldn't rely on them. They won't even do a point estimate. This is the core problem - garbage data in, garbage models out.

https://www.cebm.net/covid-19/global...atality-rates/

Re: Lockdown
 

As we all know (presumably), modelling an epidemic relies on a set of assumptions much like any other mathematical model. Most useful models will allow for a range of assumptions to be tested, for example the progression of the R0 value as the epidemic in any given territory progresses. The 20% simultaneous population incapacitation rate with no controls is at the low end of outcomes predicted by most reliable models (principally IHMES but also Imperial College when they did their famous adjustment which led to the abrupt change in policy by the UK government). So I think it's fair to characterise that as conservative.

On the other hand, it's a pretty wilfull misreading of my comment to infer that I think all the modelling driving public policy is conservative because I don't. But it is clear that there has been a great deal of wishful thinking in the early stages of many government responses, choosing to dismiss bad news projections because of unreliable and contradictory data. Similarly in this forum. But that just shows that they didn't grasp how epidemiological modelling works. Uncertainty about the scale of many factors does not mean we can't determine a few big important things and acting early always reduces the range and scale of bad outcomes. The key is to choose the right actions of course. Dithering and then finally capitulating (Spain, UK, USA) is rarely the best option. Though data is evolving rapidly and of variable quality, it is just plain ignorant to dismiss the usefulness of expert (I use the word very deliberately) models. Well designed models, which can still provide meaningful output even with high degrees of uncertainty around the input, are the most powerful and useful drivers of public policy during an epidemic.

The IHMES models are probably the most widely accepted globally and have the distinct benefit of evolving to reflect the latest data and information. They are currently predicting over 60k UK deaths by August by the way, even with all the restrictions that have been put in place. The burning issue in the coming weeks in the UK will be the critical shortage of all hospital beds (and possibly staff) and in particular ICU places (less than 10% of projected requirements). That may be a big contributor to the high rate of UK deaths in the model as that situation is much worse here than elsewhere, even worse than in Italy.

So it's not just about fatality rates, which even the linked article acknowledges are of limited use (because the denominator is so completely unknown without mass testing), and massively variable. Other important factors can be reasonably characterised based on relevant knowledge from past epidemics. The longer we go on with Covid-19, clearly the more we know. While the models will thus improve, they will naturally become less useful as the policy dies will have already been cast. But the incontravertible evidence from Italy and Spain makes abundantly clear that the priority must remain urgently stopping too many people getting sick too soon. Otherwise we will have a far higher price to pay than that currently being exacted.

Re: Lockdown
 

IHMES? What about JHU, the WHO, the many university / epidemiological teams and other national health bodies looking at this?

As for conservative, Imperial is using a point estimate with a 95% confidence interval. If you think that's conservative...

Also note Imperial assumed a 0.95% IFR; Oxford University today predicts 0.1% to 0.39%, and they caution that is likely still a overestimate due to data collection methodological flaws see: https://www.cebm.net/covid-19/global...atality-rates/

Re: Lockdown
 

Again, I am not saying any MODEL is conservative. The confidence interval will be for the described outcome based on the assumptions used. Most decent models, including all those you mention, can be run with a range of assumptions to determine a range of possible outcomes. A 95% confidence interval gives you that level of confidence in the outcome, if the assumptions are valid, no more than that. The assumptions are what is critical. That's the essence of modelling. So those models can be run with sets of assumptions which are conservative, say with an R0* less than 2.5, or aggressive, say with an R0 of 6 or above. Each of these scenarios appears to have been the case of how this epidemic progressed in some places and at some times. The purpose of the models is to determine the likely outcomes against any one of these assumptions (and a bunch of others, often inter-dependent). Policy is determined on the basis of which assumptions are considered most likely and which outcomes must be favoured or completely excluded.

My point, again, is that even conservative assumptions indicated unacceptable outcomes in most of the models, without the imposition of social controls. Hence why almost every affected country has imposed some sort of controls (even the oft cited Sweden). And the evidence suggests these controls are having the desired impact even though most were implemented very late and thus some countries have had to bear a lot of pain before that impact is felt.

Fatality rate, at this stage in the epidemic, is slightly academic. It's very difficult to establish yet with any level of certainty because it depends on really knowing the total number of infection cases, and as you point out, that number is often very unreliable or incomplete. IFR is not the factor driving immediate policy decisions right now and uncertainty in IFR is not yet a valid basis to challenge the policies that are being implemented. Total fatalities, number of critically ill and number of people incapacitated are much more important outcomes to understand at this stage and these can be measured with high degrees of precision. Ultimately IFR is critical to understand to manage this disease going forward and hence why these data are being accumulated. At the moment those data are just too uncertain and incomplete to be useful.

[*Note: R0 is the number of further infections generated by any one case. Normal policy objective is to drive it, and keep it, below 1 to stop the epidemic. Without a vaccine or cure, the only mechanisms available to do this are social controls and physical barriers such as PPE.]

Re: Lockdown
 

Which models are you talking about? Imperial (in the UK) was alarmist. Most others were not as alarmist (although there was a wide range).

Countries are like sheep; once one country imposes a restriction, politicians in other countries are forced to as well otherwise the electorate in the non-compliant country believe they are more at risk. A race to the bottom ensues where the most restrictive restrictions spread worldwide, even if they make no sense. Think school closures / border closures / flight bans etc.

If you think the lockdown has empirically worked, explain Japan? No lock down, 4,200 cases, 93 deaths vs UK - heavy lockdown, 61,000 cases, 7,000 deaths? Singapore & Sweden also.

https://coronavirus.jhu.edu/map.html

This is not correct. There is a wide variance in the way countries record fatalties (e.g. Italy - dying with Covid counts as a covid death, in UK - dying OF covid counts as a covid death). And Oxford says no significant increase in overall UK death rate can be seen: https://www.cebm.net/covid-19/england-and-wales-mortality-during-the-covid-19-outbreak

R0 is not the right measure - you need to be looking at Rt. Also note R0 is not a "truth", it's merely an empirical measure that varies depending on numerous external factors.

Re: Lockdown
 

Right, this argument about models is going nowhere. On the larger point, I struggle to believe that you could reasonably be arguing that social controls were not necessary given where we are. I agree that not everything that has been done everywhere can be justified but, if anything, the evidence suggests the UK acted too late and has further compromised the effectiveness of the announced controls by almost a week of mixed messaging. Daily covid deaths in the UK are approaching annual deaths from car accidents. The NHS is buckling (you can't get to see a doctor now for anything unless you are already an emergency case). What alternative do you think was available in the absence of reliable testing and tracing?

On a few points of information:
- I think you need to get updated on how the situation in Japan is developing.
- Singapore and Sweden (and to an extent Hong Kong) acted much earlier on the curve and therefore did not require such severe restrictions. They also have populations who are much more geared to comply with public health guidelines.
- I agree deaths are not being recorded everywhere systematically and consistently but that's a question of organisation and protocols that can easily be corrected (as has just happened in France). This is quite unlike infection rates (and hence fatality rates) which can only be accurately determined by mass testing which is, as we know, not available in most places.
- R0 is the measure that is most commonly used in epidemiology e.g. as mentioned here and in any number of reports on this epidemic. I don't know what Rt is and havent found it in a quick search so I will be happy to be enlightened.

Re: Lockdown
 

I think you lot need to get acquainted with a different type of model. They've got names and tits and arses, depending on your preference.

Re: Lockdown
 

You'll enjoy reading this article - even IHMES have massively revised the death count downwards :) https://nymag.com/intelligencer/2020...ronavirus.html

Re: Lockdown
 

https://cimg2.ibsrv.net/gimg/british...b478362eed.png
Dragging this back to data - here's how well the US has managed to control the outbreak so far. Days on labels are doubling rates (i.e. how long it takes to double the number of cases). FYI UAE is about 5.4 days.

Re: Lockdown
 

"Cases" of outbreak sound scary, but in reality are just a function of testing.

If country A does 10,000 tests and finds 500 infected, it sounds so much scarier than country B which does 500 tests and finds 100 infected, it can be painted as "Country A has 5 times as many sick people as Country B"

What is more important is how many people are hospitalized, require Ventilators, and the eventual fatality rate

Re: Lockdown
 

The best way to contain this is to stop testing.

Re: Lockdown
 

OK, here are cumulative fatalities, following the 100th cumulative death. US still looking pretty special. As is the UK. I've added Ireland, which is as close as an analogue to the UK as you can get (even has the same number of ICU beds per capita). The difference between Ireland and the UK is stark.
https://cimg0.ibsrv.net/gimg/british...50e024fb19.png

Re: Lockdown
 

The US is interesting, up until 2 days back, NY counted for almost half the deaths, rest of US is a different ballgame....

If you take it as 2 separate places (NY and outside NY), you would probably see ex-NY being better than the larger European countries and UK.

California took measures early, Texas is still going along nicely; Seattle was feared as a hotspot but somehow controlled it without an official lockdown. New Orleans doing bad (probably because of Mardi Gras)

NYC is the only city in the country with 1) so many apartment blocks, 2) so much dependence on mass transit

Re: Lockdown
 

i love the time and effort you have put into your spreadsheet. My only request is to format the numbers with commas every thousand so the hard of thinking like me can see the big numbers.

have you also done a log chart?

Re: Lockdown
 

Aware that you are almost certainly taking the piss, here you go:
https://cimg0.ibsrv.net/gimg/british...9e7bc7316b.png

None of them start exactly at 100 because, obviously, none of them had exactly 100 cumulative deaths on any given day.

Re: Lockdown
 

half piss taking, half serious actually. I always complain of the same to our analysts. I’m very format focused!

a log chart makes things look better than they actually are but does show it slowing... except for USA, they are winning.

Re: Lockdown
 

Fingers crossed. Got told last night we're all being lined up this week. Might get canned, might be safe. Lockdown just cranked the anxiety to 14.

Re: Lockdown
 

Sorry to hear that. One of our investee companies is a bit bloated (before the crisis) and they are cash poor, but we have decided to give them 60days grace before making any decisions.

Another recruiter told me he got a 25% pay cut.

Re: Lockdown
 

It is what it is. Got a few complications around what it would mean depending on the scenario so can't really plan too much until I know.

My role is EMEA wide so the fallout in Europe is hurting, the MENA business is doing well in the part I service but the panic for cash is strong.

The equation is a bit like this:

('we must protect our people' + 'marketing content showing desks at home' + 'videos from group leadership') x ('can only actually think short term' + 'where is the $15bn+ of cash we made last year' + 'we're all way out of our depth') = uh oh.

Re: Lockdown
 

It's a good article thanks and confirms that the case for social controls is irrefutable. As it says, far more cogently than I could manage (my emphasis):

"Nevertheless, the gap between what experts projected a few weeks ago and what they are projecting now is absolutely astounding, and it is primarily a reflection of just how much has been done, and how quickly, to defend against and respond to the coronavirus. In many cases, we have achieved so much more than modelers even imagined possible that the range of outcomes we are now looking at did not even appear at the very low end of initial forecasts. The models weren’t “wrong,” exactly, they seemingly just underestimated how widespread, thorough, and steadily maintained social-distancing measures could be."

Re: Lockdown
 

Good luck mate. Something tells me you'll land on your feet whatever way it goes. Surely BritishExpats owes you a tidy sum for keeping the ME forum going singlehandedly for the last 5 or 6 years (well maybe with the occasional assistance of Millhouse's tiny little baby fingers)?

Re: Lockdown
 

Thanks, hopefully don't need to. Guess I'll know this week.

Millhouse and I are the dreamteam, let's face it. :lol::typing:

Re: Lockdown
 

Quite a popular holiday destination for the Aussies. Generally quite a pleasant place, Cyclones permitting...

Re: Lockdown
 

I'm sorry old boy. Been in your shoes a few times. The downsides of working in AEC. The anxiety is no fun even if I survived. I remember back in 2009 everyone being canned left and right and orders were 1 out of every 3 had to go. Then another mini-cull in 2013. And now there's rumblings of another one this year no matter what the CEO says about how strong the backlog is and I'm thinking I'm too old for this shit.

Re: Lockdown
 

Only because 1) China lied and 2) USA is much bigger than anyone else. On a deaths per million basis it's 375 for Spain, 322 for Italy, 215 for France, 160 for the UK and 67 for USA.

Isolate New York City from the US tally, the US would be far lower.

Re: Lockdown
 

Small hands.....

Re: Lockdown
 

Cheers, we'll see what happens. I got told by a colleague that it was happening, so guess I have to wait and see. It's hard being 2 months into a new job and company to show you're good and that you shouldn't fall victim to 'last in, first out'. Such is. We'll see.

Re: Lockdown
 

I'll keep my fingers crossed for you Scamp :fingerscrossed:

Re: Lockdown
 

Come on. In the Middle East, rumours of mass sackings occur on a weekly basis. I lost count of the number of times people my rank were "lined up," including once, at a specially convened meeting just to deliver the message, by an extremely senior manager (and a trustworthy one at that) who told us we were out in 6 months come hell or high water and that our contracts had been redone to all finish on the same date to facilitate this. I ended up walking away happy, and under no pressure to leave, several years later. I understand the current context has ratcheted things up but stick to your plan and keep in mind the grapevine is just the grapevine.

The country with the most cases per capita is actually Switzerland, followed by Luxembourg. It makes absolutely no sense to compare the US with countries like Portugal or Italy. A better comparison would be the US and Europe as a whole, since they have about the same population. The US is at 587,173 cases right now vs a combined total of 597,014 for Italy, Spain, France and Germany. A lot more if you add in all the other countries like the UK, Netherlands etc. Death total is 23,841 in the US vs 56,382 combined total for Italy, Spain, France and Germany. Point being it has run riot across Europe and the US. The US hasn't been harder hit than Europe.

Re: Lockdown
 

I'm always more worried when they reassure me I'm safe.

Re: Lockdown
 

True, good point. Had a positive call with boss in the UK and just had a catch up with a boss here and cuts are coming but fingers crossed. I made it clear I'd take reduced package / hours (lol at the second part of that) or temporary unpaid to protect a job in the long run.

Re: Lockdown
 

Good luck mate , trying to ride this one out is the best thing . I do believe though you're going to see a massive exodus across the board here . Wont be many of us that survive this one long term that's for sure.

Re: Lockdown
 

I figure if you survived 10 years (?) in recruitment in Dubai you must be very good at what you do. You'll be fine no matter what comes.

Re: Lockdown
 

quite right.

Re: Lockdown
 

Yeah, agreed. Cheers.

9yrs a week or so ago. Mental how time flies. I'm just Linkedin famous rather than good :thumbup:

Re: Lockdown
 

World Trade Center has been converted into a 3000 bed field hospital, with around 1000 ICU beds.

This is either exceptional forward planning ahead of the peak, or a sign that we are in deep shit. Remember, the UAE has no shortage of hospital capacity usually as they overbuilt hospitals.

I guess we will find out when it opens if it is full or empty.

Re: Lockdown
 

In fairness, the capacity is lower than we may think: "He said hospitals in Dubai currently have a capacity between 4,000 to 5,000 beds available for coronavirus patients" Link

Re: Lockdown
 

On top of the 1200 or so the American Hospital said they had just allocated.

Re: Lockdown
 

Another interpretation is that a large majority of cases are amongst young, low-salaried workers, with minor symptoms, but who share accommodation with 10+ other people. Thus they can't be quarantined at home, so field hospitals are the only way to reduce infection rates.

Re: Lockdown
 

Nail on the head , it's rife in mass accommodation . The focus will shift quickly to this area now .