Boris's message to people going back to work, cross your fingers.
But who is going back to work.
Can someone explain this to me like I'm five?
Prior to Sunday, at the beginning of lockdown, we were told to work from home if we could, but could still travel to work if it was necessary - the travel that is, not necessarily the job. Places which actually closed had staff furloughed.
So what actually changed on Sunday - people were encouraged to go back to work, but surely everyone's furloughed because their place of work is closed, working from home or already travelling to work.
So who is just going back now?
The place where my wife works is making noises about resuming, but she is not. But she can work on the phone. I assume some places will reopen. Do you feel lucky?
The other odd thing is that furlough is being extended. So you would be mad to go back?
If it's anything like here, the people going back to work will be those whose jobs cannot be done remotely and that are the most crucial to keep critical infrastructure and services going, closely followed by outdoor jobs where distancing is easier to maintain.
In other words, refuse collectors, maintenance staff, agricultural labourers, and construction workers. All of which overlap considerably with the "poor brown/foreign people" category.
If it's anything like here, the people going back to work will be those whose jobs cannot be done remotely and that are the most crucial to keep critical infrastructure and services going, closely followed by outdoor jobs where distancing is easier to maintain.
In other words, refuse collectors, maintenance staff, agricultural labourers, and construction workers. All of which overlap considerably with the "poor brown/foreign people" category.
Not entirely here either, but I'd say that it still holds true that in general, even just to maintain the things that never stopped, the "first" to go back to on-premise work will tend to be the lower-paid. Car mechanics spring to mind.
But if the tories sacrifice the poor, brown people who do a lot of the Real Work, who will look after the said tories when they have to go to hospital/hospice/care home?
Who will wipe their bottoms? Who will bring them a cuppa tea?
Or, who will sanitise the telephones?
ROTFL--H2G2 reference! But I think the phone sanitizing people aren't a major problem, and don't need to be sent off in a space ship. Nor most of the other H2G2 passengers. How about we send the *nastiest* of the elites off in a space ship, this time? Especially those like the nasty, rich brothers in "Trading Places". But, this time, they should be sent to an uninhabited planet. You know what happened *last* time!
My brother, for one. He’s an engineer. His place are introducing shift work so 1/3 of the workforce are in at one time, spreading out the vehicles he builds (ambulances, specialist vehicles for zoos etc) and social-distancing the workforce.
Starting tomorrow.
(He’s lucky, he has a car to get there and he’s self employed - if he doesn’t feel safe, he doesn’t have to turn up.)
My brother, for one. He’s an engineer. His place are introducing shift work so 1/3 of the workforce are in at one time, spreading out the vehicles he builds (ambulances, specialist vehicles for zoos etc) and social-distancing the workforce.
Starting tomorrow.
(He’s lucky, he has a car to get there and he’s self employed - if he doesn’t feel safe, he doesn’t have to turn up.)
But why from tomorrow? Why wasn't he included in the "if you can't work from home" in the original advice?
My brother, for one. He’s an engineer. His place are introducing shift work so 1/3 of the workforce are in at one time, spreading out the vehicles he builds (ambulances, specialist vehicles for zoos etc) and social-distancing the workforce.
Starting tomorrow.
(He’s lucky, he has a car to get there and he’s self employed - if he doesn’t feel safe, he doesn’t have to turn up.)
But why from tomorrow? Why wasn't he included in the "if you can't work from home" in the original advice?
He was, but his place wasn’t safe so he walked. They’ve upped their game now. Their work is so specialised a lot of the workforce are self employed and simply walk out if things aren’t right.
He couldn’t claim any money as his profits are more than £50,000 a year and he has savings (all accounted for in tax owed etc but the schemes don’t take account of that, they just see savings)
He’s fine, he’s very adaptable and skilled being an engineer. He was already planning other work when the place said they wanted him back.
United Arab Emirates - 19,661 (13,446 / 6,012 / 203)
Poland - 16,921 (9,951 / 6,131 / 839)
Bangladesh - 16,660 (13,263 / 3,147 / 250)
Israel - 16,529 (4,186 / 12,083 / 260) 2.1%
Ukraine - 16,023 (12,225 / 3,373 / 425)
Japan - 15,968 (6,780 / 8,531 / 657)
Austria - 15,961 (1,190 / 14,148 / 623) 4.2%
Romania - 15,778 (7,091 / 7,685 / 1,002)
Indonesia - 14,749 (10,679 / 3,063 / 1,007)
Colombia - 12,272 (8,808 / 2,971 / 493)
Philippines - 11,350 (8,493 / 2,106 / 751)
South Africa - 11,350 (6,787 / 4,357 / 206)
South Korea - 10,962 (1,008 / 9,695 / 259) 2.6%
Dominican Republic - 10,900 (7,277 / 3,221 / 402)
Denmark - 10,591 (1,484 / 8,580 / 527) 5.8%
Kuwait - 10,277 (7,101 / 3,101 / 75)
Serbia - 10,243 (6,423 / 3,600 / 220)
Egypt - 10,093 (7,223 / 2,326 / 544)
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1.
Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries twenty-seven of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Germany and Turkey.
Kuwait and Egypt have joined the 10,000 case club since the last compilation. Russia seems to really be rocketing up this list.
@Crœsos you do know your United Kingdom figures are the English figures? We hit 40 000 deaths in the last couple of days when Scotland, NI and Wales are included too.
CK. They are the UK figures from worldometer which uses the daily figures published on the NHS website and announced daily in the government briefing. Those figures only include deaths for which there was a confirming test in hospital or a registered test centre.
What was your source for over 40,000 deaths? Was it the Guardian report? That uses ONS figures which will include deaths registered by GPs as due to COVID-19 or for which COVID-19 was believed to be a contributory cause. These may include deaths for which there was no previous test confirmation.
I'm not saying the Guardian report is wrong. Different counting standards are at work.
But the Government figures as broadcast are for England and Wales, Scotland and NI figures are separate, so it is misleading to use those England and Wales figures for the UK.
I suspect the large discrepancy emphasises the large numbers of deaths in care homes. I know personally of two deaths in care homes (friends' parents) which were registered with COVID-19 as a contributory cause but for which there was no prior test.
It's been observed that the numbers attributable to COVID-19 may become clearer in time by looking at the excess deaths in comparison with figures from previous years. The government uses figures daily that it can get at daily and it isn't wrong to use a prior confirming test as a standard. It is including now deaths in care homes for which there has been such a test.
I did try to add this, but I ran out of editing time:
But the Government figures as broadcast are for England and Wales, Scotland and NI figures are separate, so it is misleading to use those England and Wales figures for the UK.
The figures for England and Wales as of Tuesday with the additional ONS deaths from care homes and homes was 35,044, and there are the additional deaths from Scotland and NI to add in, which the Guardian adds up to 40,496.
OK - I accept that the Worldometer figures include all four nations of the UK. I was trying to work out why the figures from yesterday did not include the ONS additional numbers from care homes and homes. Possibly because they aren't easy to aggregate into the government figures as they are on a different time scale. ONS declaring to 1 May, when the government hospital figures are daily.
Yes, I've seen that figure in the Financial Times. See excess death graphs.
It's not a simple equation. The lockdown will also reduce incidental deaths (road traffic deaths for example) and increase incidental deaths (delays in urgent hospital treatment).
It's wrong to get hypnotised by the degree of inaccuracy in any raw figures, whether NHS or ONS. The processes of collection, vetting and publication are not always straightforward.
Cross country comparisons are subject to analogous criticism. And in the US I suspect there may be variations in counting standards from State to State.
What they do make clear is that later lockdowns "let the cat out of the bag". And that's obvious from the infectiousness of the virus. The latest scare in South Korea shows via tracing to date that one infected person visiting nightclubs has produced 119 consequential infections in a few weeks. And tracing is not over. Two of those infected visited their churches all unknowing and all those attending those services are still being tested. This cat can get out of the bag very easily. And that is an ongoing challenge to all governments and all of us.
New cases are trending down in the UK but are still above 3,000 a day. Even with the limited lifting of social restrictions, just think about the size of the army needed to trace the movements of 3,000 people a day newly tested as positive. Interviews, credit cards, phones etc all being followed up.
Scotland is publishing a full breakdown each Wednesday. This week's will be published this afternoon.
This is some of the data published daily: Scottish COVID-19 test numbers: 12 May 2020
A total of 75,570 people in Scotland have been tested through NHS labs to date. Of these:
61,807 were confirmed negative
13,763 were positive
1,912 patients who tested positive have died
These figures will be an underestimate. Not everyone with COVID-19 will display symptoms and not all those with symptoms will be tested.
Management information reported by NHS Boards shows:
81 patients with confirmed or suspected COVID-19 were in intensive care last night, with 69 of those having tested positive
there were 1,131 people in Scottish hospitals with confirmed COVID-19 (including those in intensive care), and a further 487 where it was suspected
On 11 May there were:
2,539 tests carried out by NHS Scotland in hospitals, care homes or the community, making a total of 103,661 COVID-19 tests through NHS labs to date.
In addition, there were 1,544 drive through and mobile tests carried out by the Regional Testing Centres in Scotland bringing the total to 29,191 tests to date.
3,084 calls to 111 and 349 calls to the Coronavirus Helpline. The number of calls to 111 includes all calls, whether or not they relate to COVID-19.
1,500 Scottish Ambulance Service (SAS) attendances, of which 295 were for suspected COVID-19. SAS took 198 people to hospital with suspected COVID-19.
434 (40%) adult care homes with a current case of suspected COVID-19 as at 10 May. At least one resident in the care home has exhibited symptoms during the last 14 days.
613 (57%) adult care homes which have lodged at least one notification for suspected COVID-19 to the Care Inspectorate since the start of the epidemic. 440 of these care homes have reported more than one case of suspected COVID-19.
4,643 cumulative cases of suspected COVID-19 in care homes. This is an increase of 140 suspected cases on the previous day.
a total of 5,962 staff, or around 3.6% of the NHS workforce, reporting as absent due to a range of reasons related to COVID-19.
3,167 inpatients have been discharged from hospital since 5 March, who had been tested positive for COVID-19, up from yesterday’s total of 3,122. (Note yesterday’s discharge total was revised from 3,114 to 3,122 due to a resubmission from a Board).
610 people delayed in hospital as at 11 May. This is 1002 less than the baseline period (04/03 weekly return). An initial target to reduce delays by 400 by the end of March and a further target of reducing by a further 500 by the end of April have now been met.
3,672 staff were reported as absent in adult care homes due to COVID-19, based on returns received from 822 (76%) adult care homes as at 5 May. Staff absent due to COVID-19 represents 8.5% of all adult care home staff (43,403) for whom a return was provided. The absence figures for NHS staff and care home staff are calculated in different ways and caution should be exercised in making comparisons – see the data sources and definitions document for full details. This data will be updated weekly.
Deaths of health and social care workers related to COVID-19
As at 5 May, we have been notified by Health Boards or the Care Inspectorate of 7 deaths of healthcare workers and 6 deaths of social care workers, related to COVID-19. We are not able to confirm how many of these staff contracted COVID-19 through their work. We will update this information every Wednesday.
We'll get the bigger picture this afternoon, including the excess deaths figures.
Looking globally, there is now increasing concern about under-reporting, not for political reasons, but because of lack of capability to test, measure and treat.
This report from Ecuador is almost a month old. And it is a horror story. The official death total from Ecuador, almost a month later, is just over 2,000, suggesting that administration still hasn't caught up with reality.
No one is saying it is typical but it is an awful story of how a region can be overwhelmed by an outbreak. Here's a quote from the Financial Times article I linked above.
There are concerns, however, that reported Covid-19 deaths are not capturing the true impact of coronavirus on mortality around the world. The FT has gathered and analysed data on excess mortality — the numbers of deaths over and above the historical average — across the globe, and has found that death tolls in some countries are more than 50 per cent higher than usual. In many countries, these excess deaths exceed reported numbers of Covid-19 deaths by large margins.
I'm rapidly coming to the conclusion that the excess deaths count - while not perfect by any stretch - is the most reliable statistic for measuring the true impact of coronavirus on a country. It's not reliant on testing or the opinion of an individual doctor as to what caused a death, and it's a lot harder for a government to hide the fact that a death has happened than it is for them to hide the cause of that death.
I'm rapidly coming to the conclusion that the excess deaths count - while not perfect by any stretch - is the most reliable statistic for measuring the true impact of coronavirus on a country. It's not reliant on testing or the opinion of an individual doctor as to what caused a death, and it's a lot harder for a government to hide the fact that a death has happened than it is for them to hide the cause of that death.
Agreed. There are a few issues with it, but it's a lot better than the alternatives.
I'm rapidly coming to the conclusion that the excess deaths count - while not perfect by any stretch - is the most reliable statistic for measuring the true impact of coronavirus on a country. It's not reliant on testing or the opinion of an individual doctor as to what caused a death, and it's a lot harder for a government to hide the fact that a death has happened than it is for them to hide the cause of that death.
It really is. Fuller discussion of why here and here.
The one caveat I would add (in addition to the detailed explanations I've linked to from previous pages on this thread) is that it depends on the question you are asking. As MtM referred to the most reliable statistic for measuring the true impact of coronavirus on a country then Excess Mortality is the only figure to use.
If you want to track the progress of the epidemic in a particular population (i.e. for vital decision making at the national level) then what you really want is extensive testing. Then you can track the infection rate in real-time. In the UK, our testing regimen is so far from being useful for this, it's ridiculous. This is why when talking about the progress of the epidemic, I've referred to the hospital mortality figures. These are pretty robust but come with something like a 10-14 day delay when compared to the infection rate. As I said, for decision-making the infection rate is the key data and such a delay big is a really bad thing. However, whilst our testing regimen is so poor, it's still more informative than the recorded number of positive tests. So I have comfortable with the progress we've made with the disease in the past 6-7 weeks but I do not know if the infection levels are genuinely low enough to allow relaxation of lockdown provisions. I suspect the scientists advising the government have given very wide predictions because this gap in the data is hugely problematic. It may be a good time to start a relaxation from an infection level perspective but I am very nervous about this because the precision with which we know this is very poor (as it is essentially reverse-engineered from the mortality data).
However. And this is a big fucking however....
However, any relaxation of lockdown must, must, must be accompanied by an effective testing, tracing and isolation plan. Which we do not have.
This is why I am very worried and why I am very angry with the morons who are running the country. I am only guessing here but I would bet that scientific advisors were asked about the effects of the relaxation of lockdown and because of the huge unknowns the answer they gave would come with a HUGE range of possible outcomes. Who wants to bet the cabinet decided to believe the best-case scenario and ignore the rest? As I said, I am only guessing but this theory is consistent with the science and the behaviour of our Lords and Masters. Not that it really matters, because without effective testing, case numbers will go up again quite significantly.
Sorry, this was just going to be a post about excess mortality being the most meaningful statistic (It got away from me slightly). It still is, to know the true effect of Covid-19 on a population. (See my long previous posts for detailed explanations).
Quite right AFZ. Even the published figures of new cases don't give me much confidence. The South Korean example gives us some idea of the cluster size which can be created by one index case, and the consequential tracking and tracing challenges. At current published levels, we face massively greater challenges than South Korea.
ISTM that, however the deaths are computed, this sad little island is going to end up with a HUGE mortality rate. Comparisons with other countries are not necessarily helpful - it's bad enough, anyway.
Thanks, Boris & Company. Hopefully, there'll be enough of us left by the next General Election to pay you back in a suitable manner.
The UK government has issued advice on making facemasks (not like they didn't have 5 months notice on the impending mass demand of masks or anything -- though will be interesting when there is a mass run on elastic).
.
If my experience in town yesterday is anything to go by, there already is.
I haven't even thought of trying to make my own (possessing, as I do, several particularly clumsy thumbs), so I'm glad my new Bright Yellow Neck Gaiter arrived a few days ago.
This is the sort of government that, five minutes before the arrival of an atomic bomb, would be issuing advice on how to construct one's own lead-lined nuclear bunker...
...whereupon, of course, lead would instantly become unavailable...
I haven't even thought of trying to make my own (possessing, as I do, several particularly clumsy thumbs), so I'm glad my new Bright Yellow Neck Gaiter arrived a few days ago.
This is the sort of government that, five minutes before the arrival of an atomic bomb, would be issuing advice on how to construct one's own lead-lined nuclear bunker...
...whereupon, of course, lead would instantly become unavailable...
More like:
"The thing, with the bomb, the nuclear bomb, the thing is. To put one's lips, which is to say one's head, between one's legs and, with the best of British luck, to kiss one's arse, goodbye."
The Scottish figures for excess deaths in the week ending 10 May are out:
All Deaths
The provisional total number of deaths registered in Scotland in week 19 of 2020
(4 May to 10 May) was 1,434. This is a decrease of 245 from the number
registered in the previous week.
The average number of deaths registered in the corresponding week over the
previous five years was 1,034. There were 39% more deaths registered in week
19 of 2020 (4 May to 10 May) compared to the average. Of these 400 excess
deaths:
96% (383) had COVID-19 as the underlying cause
7% (26) came from an increase in dementia and Alzheimer’s deaths
4% (17) were due to an increase in deaths from other causes
deaths from cancer and respiratory diseases were lower than the average
for this time of year.
However, any relaxation of lockdown must, must, must be accompanied by an effective testing, tracing and isolation plan. Which we do not have.
Do you have a sense of how many tests per capita are required for such a plan to be effective? Here in Los Angeles County we are regularly told how many tests have been conducted on any given day, but I have no idea if it's enough. It might be - anyone who wants one can get a free test.
We learned yesterday that the stay-at-home restrictions in the county will last through July at least, as the number of new cases daily has plateaud, not fallen. But those restrictions have been loosened a bit. A lot of shops are now allowed to sell stuff via curbside pick-up the way restaurants have been doing, and the beaches are now open for active exercise - you can walk on the beach but not sunbathe. Local street traffic has picked up a bit, but based on how many cars are still parked in the neighborhoods, people are still staying home a lot.
However, any relaxation of lockdown must, must, must be accompanied by an effective testing, tracing and isolation plan. Which we do not have.
Do you have a sense of how many tests per capita are required for such a plan to be effective? Here in Los Angeles County we are regularly told how many tests have been conducted on any given day, but I have no idea if it's enough. It might be - anyone who wants one can get a free test.
It depends on how widespread the virus is. There was an exchange during yesterday's Coronavirus Task Force testimony in the U.S. Senate between Senator Mitt Romney and Dr. Brett Giroir of the Department of Health & Human Services. Dr. Giroir was touting the fact that the U.S. has now conducted more tests per capita than South Korea. Romney responded:
You ignored the fact that they accomplished theirs at the beginning of the outbreak while we treaded water during February and March. As a result, by March 6, the U.S. had completed just 2,000 tests, whereas South Korea had conducted more than 140,000 tests. So partially as a result of that, they have 256 deaths and we have almost 80,000 deaths.
So it's not just per capita tests, it's administering them in a timely manner and following up on contact tracing. I'm reminded of a strategic analysis attributed to Rommel about the (then anticipated) Allied invasion/liberation of France, where he expressed the opinion that one Panzer division on the front line on the first day of operations would be worth more than six Panzer divisions a week later. The U.S. is in a similar situation now. Because of failure to test early, a lot more tests per capita will now be required.
However, any relaxation of lockdown must, must, must be accompanied by an effective testing, tracing and isolation plan. Which we do not have.
Do you have a sense of how many tests per capita are required for such a plan to be effective? Here in Los Angeles County we are regularly told how many tests have been conducted on any given day, but I have no idea if it's enough. It might be - anyone who wants one can get a free test.
We learned yesterday that the stay-at-home restrictions in the county will last through July at least, as the number of new cases daily has plateaud, not fallen. But those restrictions have been loosened a bit. A lot of shops are now allowed to sell stuff via curbside pick-up the way restaurants have been doing, and the beaches are now open for active exercise - you can walk on the beach but not sunbathe. Local street traffic has picked up a bit, but based on how many cars are still parked in the neighborhoods, people are still staying home a lot.
The short answer is no. Partly because I am not fully across the detail of all this and partly because it's not a fixed answer. Once the infection numbers are low enough within the community it is technically possible to contain the virus by a rapid and aggressive response to new cases. (Including new possible cases). What this means is that anyone who shows any signs of Covid-19 is immediately tested and if positive, their contacts will then be traced and tested. So in any given week, the number you need to test can vary enormously. I am sure official estimates exist for what sort of capacity is needed (and spare capacity is the key), I just don't know what they are. I do know that we are not even achieving sufficient testing for where we are now. Wuhan province has just had 6 (six) new cases and so is testing 11 million (yes million!) people. (Sky News.) I suspect that's overkill but who can blame them?
What you do need is the ability to test, trace, test and isolate new cases as they are discovered. If you can't then the only alternative to stop exponential growth in total lockdown. South Korea is probably the most successful country at the moment and thus is the best place to look. They had tested a month ago about 11,000 people per million population. (C.f. the UK's 7,000) at that point. But that number needs to be taken in the context that because S.K. acted so much earlier their total disease burden has been so much less. It is likely that the UK needs many, many more tests because the number of clusters will be correspondingly higher - unless we stay in lockdown for longer. As of this week, the UK has now tested nearly 30,000 per million population (many more than S.K.) but with the number of cases we've had, that's still a woefully small number. And more to the point, going forward, to a large extent it's about being able to do the number of tests you need very quickly - i.e. a cluster of a dozen or so cases will have hundreds, possibly thousands of contacts who all need testing. And they need to be traced and tested as soon as possible before they can infect somewhere else. Remember these data are total number of tests performed. Someone who tested negative a month ago, may well need retesting if they've had a more recent exposure!
I'm sorry that's a bit of a vague answer, I'll see if I can find the official calculations of the numbers needed but it will depend on the level of disease in the community (which because of our poor testing so far, is essentially unknown!).
AFZ
Eta: X-posted with @Crœsos - with whom I completely agree.
Do you have a sense of how many tests per capita are required for such a plan to be effective? Here in Los Angeles County we are regularly told how many tests have been conducted on any given day, but I have no idea if it's enough. It might be - anyone who wants one can get a free test.
If you double the number of tests you perform and the number of positives you get roughly doubles, then you are testing nowhere near enough.
It's quite simple, really - what you're trying to do with testing is to remove infected people from the general population so they don't go around infecting others. And testing wants to be combined with contact tracing, so you quarantine people who have been exposed to a positive tester.
What actually matters is a combination of the efficiency of testing and contact tracing. If you have good contact tracing, you can get away with fewer tests, and if you have more testing, you can be less good at contact tracing.
I've seen several studies (random testing, municipal sewerage, ...) that suggest that the number of infections is something like a factor of 10-20 bigger than the number of positive tests at the moment. That's not a perfect answer, but I think it starts to set the scale for what you need.
(You can be smart about testing - you want to test everyone who is wanting to return to work / wide social contact, but can get away with testing fewer people who are mostly staying home.)
However, any relaxation of lockdown must, must, must be accompanied by an effective testing, tracing and isolation plan. Which we do not have.
Do you have a sense of how many tests per capita are required for such a plan to be effective?
AIUI, the ideal for test and tracing would be that if someone shows symptoms of covid19 then they should be tested, along with anyone who has been in close, regular contact (members of the same household, work colleagues if they're at work) which would be a relatively small number - especially if social distancing and limited personal contact is maintained. You would still be maintaining the system of anyone who shows symptoms immediately self-isolating until tested negative. It's not so much a question of per capita capability, but actual number of people infected cf testing capability.
[all numbers in the following analysis are hypothetical averages for discussion only, epidemiologists will have models that contain more realistic numbers]
If someone tests positive then, obviously, they'd maintain self-isolation. But, also testing should be extended to a greater number of contacts - those who are not regular or close contacts, which is where life gets more difficult, we can all name members of our household and people at work but will struggle with naming visitors to work or the security guard we pass everyday entering the building, much less the checkout operator at the grocery store. It's probably impractical to track everyone someone who's tested positive has been in contact with over the previous couple of weeks, but we should be able to track the majority of those someone has spent more than a few minutes with, providing we haven't removed all restrictions. You want to test each of those people, for two purposes - one to identify anyone who has contracted the virus (and, get them to self-isolate and start contact tracing for them), two to see if it's possible to identify who the virus was contracted from (with much the same result of contact tracing).
What resource is needed for this is going to depend heavily on how much social distancing is still in place as well as the number of people who test positive. If we still have quite strict restrictions then someone showing symptoms will probably only automatically lead to household members and maybe a few people who share an office at work; let's say 6-10 people. On the other hand, if we go all the way back to how we lived 6 months ago then you would need to add in more work people, friends who regularly hang out and that number gets much larger - in which case it's probably going to be possible to test a few of them and hope for the best, or even only do further testing if a positive result comes back. If there's a positive result then you do need to do much more extensive testing.
So, an easing of lockdown where people can return to work where social distancing can be maintained, bars and restaurants reopen with 2m between groups of customers and the like you would be testing about 10 people for every person showing symptoms and possibly 100 for everyone who tests positive (depending on how easily you can track people who ate in the same restaurant etc), and you want to do that tracking fast enough that you get all these contacts and potential contacts self-isolating and tested before the virus can spread further. So, if you ease lockdown while you have 1000 new cases per day you'll probably need capacity for tracing and testing 100,000 people per day, if you wait until you have 10 new cases per day your capacity needs to be 1000 per day. And, if you go all the way back to where we were 6 months ago the numbers go through the roof to the point where you can probably only do that where the number of new cases falls to 1 per day or where the chances of spreading the virus has plummeted (eg: there's a widely used and effective vaccine).
I know the UK, at least with the exception of some of the most isolated parts of the country, is no where near the point where the number of new cases per day is low enough for our ability to track and test people is high enough to be an effective means of identifying and suppressing any new outbreak. We need to both increase that track and test capability and maintain the lockdown longer to bring down the number of new cases before we can relax our lockdown restrictions at all. [/quote]
It's probably impractical to track everyone someone who's tested positive has been in contact with over the previous couple of weeks, but we should be able to track the majority of those someone has spent more than a few minutes with, providing we haven't removed all restrictions.
Not that impractical. Most people carry around smartphones with GPS on them. It seems very easy to identify which smartphones were within 5 meters* of each other within a certain time frame.
*A smartphone GPS is accurate to within 4.9 meters under clear skies, open terrain conditions. If you're in a building or under a bridge that radius increases so maybe 10 or 15 meters might be a better standard. I'll leave that question to the more technically oriented.
How do you propose that working? Make it a legal requirement that everyone turn on GPS tracking on their phone and upload that to some central data base that then compares your movement with the movements of someone who's tested positive? That would be quite a feat of software engineering, and of course will have a lot of blackspots (eg: when you go inside a large building like a shopping mall or get an underground train), even without considering the data security issues and personal freedoms. And, if you're in a multi story environment then, even if you get a half decent positional lock, you'll also need to work out where everyone actually is - I could very easily be sitting within 5m of my neighbour in the flat below me and well within the vertical precision of GPS (generally if you can get an x-y fix your accuracy of z-fix is at least a factor of three worse - so that 5m open sky accuracy will be about 15m accuracy on height above datum)
The UK government trial app which uses bluetooth to log phones within range seems simpler as it's a direct measure of phones that are nearby. Of ocurse, there's a power and battery life implication of using bluetooth (but the GPS uses power too), and knowing the way other government issued apps work it'll probably be limited to a small fraction of phones.
How do you propose that working? Make it a legal requirement that everyone turn on GPS tracking on their phone and upload that to some central data base that then compares your movement with the movements of someone who's tested positive? That would be quite a feat of software engineering, and of course will have a lot of blackspots (eg: when you go inside a large building like a shopping mall or get an underground train), even without considering the data security issues and personal freedoms.
I'm pretty sure that data is already being tracked. There will be exceptions and imperfections as with any tracking system, but I'd favor a system that over-tests (e.g. SARS-CoV-2 tests for your neighbors on the other side of a wall) than one that under-tests (e.g. not bothering to trace contacts).
It's probably impractical to track everyone someone who's tested positive has been in contact with over the previous couple of weeks, but we should be able to track the majority of those someone has spent more than a few minutes with, providing we haven't removed all restrictions.
Not that impractical. Most people carry around smartphones with GPS on them. It seems very easy to identify which smartphones were within 5 meters* of each other within a certain time frame.
There are a lot of ifs and buts therein...
Qualifier: I am currently mostly working from home these days but the rest of my group/team are still at work... (I'm 'healthy' replacement/resource if they start to go off sick)
I work for the NHS
I do not have a patient facing role, but am lab based
If I were at work, given the space available in my department/building, and what is required of my team, if I (or any of them) were to test positive, it is likely I/we would have been in contact with around 10 members of our own department, not to mention those others who share the same office/communal space (you cannot eat lunch/have coffee in a lab area). So call that closer to 15-20 folks in whose vicinity I/we may have spent more than a few minutes. Each. And not necessarily the same extra 5-10 people.
I do not have a smart phone so whilst I know who has been in the workplace environment, AFAIK there is no way of tracking other folk (eg supermarket/shop queues) with whom I may have been within 5m for a while.
And, in the event of my (or indeed any of my onsite colleagues) testing positive, if all those who were in my/their immediate environs at work were to be isolated, it is entirely feasible that an entire department or two (production & patient scanning) would have to shut down for a fortnight. Social distancing is not physically possible in the space we have available, and we have to produce a product in a fixed time frame, which is not achievable if TPTB were to try & stagger starts etc. We still need to have a product released by 09:00 which requires a certain number of people to comply with regulatory requirements. And so, again and again, one/two departments could be required to temporarily shut down if staff members were to test positive.
Whilst track, trace, isolate is, IMNSHO, the way we should be proceeding, nevertheless, within a/the healthcare environment, there is a risk that entire departments/teams could (theoretically) need to go into quarantine. Which isn't going to go down so well with the HealthboardPTB. Current SOP is that you stay at work unless you are symptomatic, in which case go get a test and if it is negative, return to work. And in 7 - 14 days time, there is no guarantee that you will not test +ve/be asymptomatic and it hasn't spread further....
How do we balance the risks of track/trace/isolate vs continuing patient treatment/care? And remember, not everyone has a stroke&poke (smartphone).
How do you propose that working? Make it a legal requirement that everyone turn on GPS tracking on their phone and upload that to some central data base that then compares your movement with the movements of someone who's tested positive? That would be quite a feat of software engineering, and of course will have a lot of blackspots (eg: when you go inside a large building like a shopping mall or get an underground train), even without considering the data security issues and personal freedoms.
I'm pretty sure that data is already being tracked. There will be exceptions and imperfections as with any tracking system, but I'd favor a system that over-tests (e.g. SARS-CoV-2 tests for your neighbors on the other side of a wall) than one that under-tests (e.g. not bothering to trace contacts).
And I raise you a hospital environment where there is bugger all reception; you can only get a phone signal if you stand in specific places in the building (which is not where the occupants spend most of their time). And those who do not have smartphones.
Comments
The place where my wife works is making noises about resuming, but she is not. But she can work on the phone. I assume some places will reopen. Do you feel lucky?
The other odd thing is that furlough is being extended. So you would be mad to go back?
Until the UK adopts a proper testing strategy, the total case numbers remain essentially irrelevant.
AFZ
That depends on how quickly our cases ramp up again now Johnson has blundered his way into making people think the lockdown is over.
If it's anything like here, the people going back to work will be those whose jobs cannot be done remotely and that are the most crucial to keep critical infrastructure and services going, closely followed by outdoor jobs where distancing is easier to maintain.
In other words, refuse collectors, maintenance staff, agricultural labourers, and construction workers. All of which overlap considerably with the "poor brown/foreign people" category.
They never stopped working here.
ROTFL--H2G2 reference!
My brother, for one. He’s an engineer. His place are introducing shift work so 1/3 of the workforce are in at one time, spreading out the vehicles he builds (ambulances, specialist vehicles for zoos etc) and social-distancing the workforce.
Starting tomorrow.
(He’s lucky, he has a car to get there and he’s self employed - if he doesn’t feel safe, he doesn’t have to turn up.)
But why from tomorrow? Why wasn't he included in the "if you can't work from home" in the original advice?
All drivers looked Very Alert, though, I'm pleased to say...
He was, but his place wasn’t safe so he walked. They’ve upped their game now. Their work is so specialised a lot of the workforce are self employed and simply walk out if things aren’t right.
He couldn’t claim any money as his profits are more than £50,000 a year and he has savings (all accounted for in tax owed etc but the schemes don’t take account of that, they just see savings)
He’s fine, he’s very adaptable and skilled being an engineer. He was already planning other work when the place said they wanted him back.
The listings are in the format:
X. Country - [# of known cases] ([active] / [recovered] / [dead]) [%fatality rate]
Fatality rates are only listed for countries where the number of resolved cases (recovered + dead) exceeds the number of known active cases by a ratio of at least 2:1.
Italics indicate authoritarian countries whose official statistics are suspect. Other country's statistics are suspect if their testing regimes are substandard.
If American states were treated as individual countries twenty-seven of them would be on that list. New York would be ranked at #2, between "everywhere in the U.S. except New York" (#1) and Spain (#3). New Jersey would be between Germany and Turkey.
Kuwait and Egypt have joined the 10,000 case club since the last compilation. Russia seems to really be rocketing up this list.
What was your source for over 40,000 deaths? Was it the Guardian report? That uses ONS figures which will include deaths registered by GPs as due to COVID-19 or for which COVID-19 was believed to be a contributory cause. These may include deaths for which there was no previous test confirmation.
I'm not saying the Guardian report is wrong. Different counting standards are at work.
It's been observed that the numbers attributable to COVID-19 may become clearer in time by looking at the excess deaths in comparison with figures from previous years. The government uses figures daily that it can get at daily and it isn't wrong to use a prior confirming test as a standard. It is including now deaths in care homes for which there has been such a test.
But the Government figures as broadcast are for England and Wales, Scotland and NI figures are separate, so it is misleading to use those England and Wales figures for the UK.
The figures for England and Wales as of Tuesday with the additional ONS deaths from care homes and homes was 35,044, and there are the additional deaths from Scotland and NI to add in, which the Guardian adds up to 40,496.
From the ONS figures
I guess from there the Guardian is adding in the hospital deaths as declared over the previous weeks to get to deaths as of 12 May.
Source.
It's not a simple equation. The lockdown will also reduce incidental deaths (road traffic deaths for example) and increase incidental deaths (delays in urgent hospital treatment).
It's wrong to get hypnotised by the degree of inaccuracy in any raw figures, whether NHS or ONS. The processes of collection, vetting and publication are not always straightforward.
Cross country comparisons are subject to analogous criticism. And in the US I suspect there may be variations in counting standards from State to State.
What they do make clear is that later lockdowns "let the cat out of the bag". And that's obvious from the infectiousness of the virus. The latest scare in South Korea shows via tracing to date that one infected person visiting nightclubs has produced 119 consequential infections in a few weeks. And tracing is not over. Two of those infected visited their churches all unknowing and all those attending those services are still being tested. This cat can get out of the bag very easily. And that is an ongoing challenge to all governments and all of us.
New cases are trending down in the UK but are still above 3,000 a day. Even with the limited lifting of social restrictions, just think about the size of the army needed to trace the movements of 3,000 people a day newly tested as positive. Interviews, credit cards, phones etc all being followed up.
This is some of the data published daily:
Scottish COVID-19 test numbers: 12 May 2020
A total of 75,570 people in Scotland have been tested through NHS labs to date. Of these:
61,807 were confirmed negative
13,763 were positive
1,912 patients who tested positive have died
These figures will be an underestimate. Not everyone with COVID-19 will display symptoms and not all those with symptoms will be tested.
Management information reported by NHS Boards shows:
81 patients with confirmed or suspected COVID-19 were in intensive care last night, with 69 of those having tested positive
there were 1,131 people in Scottish hospitals with confirmed COVID-19 (including those in intensive care), and a further 487 where it was suspected
On 11 May there were:
2,539 tests carried out by NHS Scotland in hospitals, care homes or the community, making a total of 103,661 COVID-19 tests through NHS labs to date.
In addition, there were 1,544 drive through and mobile tests carried out by the Regional Testing Centres in Scotland bringing the total to 29,191 tests to date.
3,084 calls to 111 and 349 calls to the Coronavirus Helpline. The number of calls to 111 includes all calls, whether or not they relate to COVID-19.
1,500 Scottish Ambulance Service (SAS) attendances, of which 295 were for suspected COVID-19. SAS took 198 people to hospital with suspected COVID-19.
434 (40%) adult care homes with a current case of suspected COVID-19 as at 10 May. At least one resident in the care home has exhibited symptoms during the last 14 days.
613 (57%) adult care homes which have lodged at least one notification for suspected COVID-19 to the Care Inspectorate since the start of the epidemic. 440 of these care homes have reported more than one case of suspected COVID-19.
4,643 cumulative cases of suspected COVID-19 in care homes. This is an increase of 140 suspected cases on the previous day.
a total of 5,962 staff, or around 3.6% of the NHS workforce, reporting as absent due to a range of reasons related to COVID-19.
3,167 inpatients have been discharged from hospital since 5 March, who had been tested positive for COVID-19, up from yesterday’s total of 3,122. (Note yesterday’s discharge total was revised from 3,114 to 3,122 due to a resubmission from a Board).
610 people delayed in hospital as at 11 May. This is 1002 less than the baseline period (04/03 weekly return). An initial target to reduce delays by 400 by the end of March and a further target of reducing by a further 500 by the end of April have now been met.
3,672 staff were reported as absent in adult care homes due to COVID-19, based on returns received from 822 (76%) adult care homes as at 5 May. Staff absent due to COVID-19 represents 8.5% of all adult care home staff (43,403) for whom a return was provided. The absence figures for NHS staff and care home staff are calculated in different ways and caution should be exercised in making comparisons – see the data sources and definitions document for full details. This data will be updated weekly.
Deaths of health and social care workers related to COVID-19
As at 5 May, we have been notified by Health Boards or the Care Inspectorate of 7 deaths of healthcare workers and 6 deaths of social care workers, related to COVID-19. We are not able to confirm how many of these staff contracted COVID-19 through their work. We will update this information every Wednesday.
We'll get the bigger picture this afternoon, including the excess deaths figures.
This report from Ecuador is almost a month old. And it is a horror story. The official death total from Ecuador, almost a month later, is just over 2,000, suggesting that administration still hasn't caught up with reality.
No one is saying it is typical but it is an awful story of how a region can be overwhelmed by an outbreak. Here's a quote from the Financial Times article I linked above.
Agreed. There are a few issues with it, but it's a lot better than the alternatives.
It really is. Fuller discussion of why here and here.
The one caveat I would add (in addition to the detailed explanations I've linked to from previous pages on this thread) is that it depends on the question you are asking. As MtM referred to the most reliable statistic for measuring the true impact of coronavirus on a country then Excess Mortality is the only figure to use.
If you want to track the progress of the epidemic in a particular population (i.e. for vital decision making at the national level) then what you really want is extensive testing. Then you can track the infection rate in real-time. In the UK, our testing regimen is so far from being useful for this, it's ridiculous. This is why when talking about the progress of the epidemic, I've referred to the hospital mortality figures. These are pretty robust but come with something like a 10-14 day delay when compared to the infection rate. As I said, for decision-making the infection rate is the key data and such a delay big is a really bad thing. However, whilst our testing regimen is so poor, it's still more informative than the recorded number of positive tests. So I have comfortable with the progress we've made with the disease in the past 6-7 weeks but I do not know if the infection levels are genuinely low enough to allow relaxation of lockdown provisions. I suspect the scientists advising the government have given very wide predictions because this gap in the data is hugely problematic. It may be a good time to start a relaxation from an infection level perspective but I am very nervous about this because the precision with which we know this is very poor (as it is essentially reverse-engineered from the mortality data).
However. And this is a big fucking however....
However, any relaxation of lockdown must, must, must be accompanied by an effective testing, tracing and isolation plan. Which we do not have.
This is why I am very worried and why I am very angry with the morons who are running the country. I am only guessing here but I would bet that scientific advisors were asked about the effects of the relaxation of lockdown and because of the huge unknowns the answer they gave would come with a HUGE range of possible outcomes. Who wants to bet the cabinet decided to believe the best-case scenario and ignore the rest? As I said, I am only guessing but this theory is consistent with the science and the behaviour of our Lords and Masters. Not that it really matters, because without effective testing, case numbers will go up again quite significantly.
Sorry, this was just going to be a post about excess mortality being the most meaningful statistic (It got away from me slightly). It still is, to know the true effect of Covid-19 on a population. (See my long previous posts for detailed explanations).
AFZ
Thanks, Boris & Company. Hopefully, there'll be enough of us left by the next General Election to pay you back in a suitable manner.
If my experience in town yesterday is anything to go by, there already is.
This is the sort of government that, five minutes before the arrival of an atomic bomb, would be issuing advice on how to construct one's own lead-lined nuclear bunker...
...whereupon, of course, lead would instantly become unavailable...
More like:
"The thing, with the bomb, the nuclear bomb, the thing is. To put one's lips, which is to say one's head, between one's legs and, with the best of British luck, to kiss one's arse, goodbye."
Yes, probably more likely indeed...
All Deaths
The provisional total number of deaths registered in Scotland in week 19 of 2020
(4 May to 10 May) was 1,434. This is a decrease of 245 from the number
registered in the previous week.
The average number of deaths registered in the corresponding week over the
previous five years was 1,034. There were 39% more deaths registered in week
19 of 2020 (4 May to 10 May) compared to the average. Of these 400 excess
deaths:
96% (383) had COVID-19 as the underlying cause
7% (26) came from an increase in dementia and Alzheimer’s deaths
4% (17) were due to an increase in deaths from other causes
deaths from cancer and respiratory diseases were lower than the average
for this time of year.
https://www.nrscotland.gov.uk/files//statistics/covid19/covid-deaths-report-week-19.pdf
Do you have a sense of how many tests per capita are required for such a plan to be effective? Here in Los Angeles County we are regularly told how many tests have been conducted on any given day, but I have no idea if it's enough. It might be - anyone who wants one can get a free test.
We learned yesterday that the stay-at-home restrictions in the county will last through July at least, as the number of new cases daily has plateaud, not fallen. But those restrictions have been loosened a bit. A lot of shops are now allowed to sell stuff via curbside pick-up the way restaurants have been doing, and the beaches are now open for active exercise - you can walk on the beach but not sunbathe. Local street traffic has picked up a bit, but based on how many cars are still parked in the neighborhoods, people are still staying home a lot.
It depends on how widespread the virus is. There was an exchange during yesterday's Coronavirus Task Force testimony in the U.S. Senate between Senator Mitt Romney and Dr. Brett Giroir of the Department of Health & Human Services. Dr. Giroir was touting the fact that the U.S. has now conducted more tests per capita than South Korea. Romney responded:
So it's not just per capita tests, it's administering them in a timely manner and following up on contact tracing. I'm reminded of a strategic analysis attributed to Rommel about the (then anticipated) Allied invasion/liberation of France, where he expressed the opinion that one Panzer division on the front line on the first day of operations would be worth more than six Panzer divisions a week later. The U.S. is in a similar situation now. Because of failure to test early, a lot more tests per capita will now be required.
The short answer is no. Partly because I am not fully across the detail of all this and partly because it's not a fixed answer. Once the infection numbers are low enough within the community it is technically possible to contain the virus by a rapid and aggressive response to new cases. (Including new possible cases). What this means is that anyone who shows any signs of Covid-19 is immediately tested and if positive, their contacts will then be traced and tested. So in any given week, the number you need to test can vary enormously. I am sure official estimates exist for what sort of capacity is needed (and spare capacity is the key), I just don't know what they are. I do know that we are not even achieving sufficient testing for where we are now. Wuhan province has just had 6 (six) new cases and so is testing 11 million (yes million!) people. (Sky News.) I suspect that's overkill but who can blame them?
What you do need is the ability to test, trace, test and isolate new cases as they are discovered. If you can't then the only alternative to stop exponential growth in total lockdown. South Korea is probably the most successful country at the moment and thus is the best place to look. They had tested a month ago about 11,000 people per million population. (C.f. the UK's 7,000) at that point. But that number needs to be taken in the context that because S.K. acted so much earlier their total disease burden has been so much less. It is likely that the UK needs many, many more tests because the number of clusters will be correspondingly higher - unless we stay in lockdown for longer. As of this week, the UK has now tested nearly 30,000 per million population (many more than S.K.) but with the number of cases we've had, that's still a woefully small number. And more to the point, going forward, to a large extent it's about being able to do the number of tests you need very quickly - i.e. a cluster of a dozen or so cases will have hundreds, possibly thousands of contacts who all need testing. And they need to be traced and tested as soon as possible before they can infect somewhere else. Remember these data are total number of tests performed. Someone who tested negative a month ago, may well need retesting if they've had a more recent exposure!
I'm sorry that's a bit of a vague answer, I'll see if I can find the official calculations of the numbers needed but it will depend on the level of disease in the community (which because of our poor testing so far, is essentially unknown!).
AFZ
Eta: X-posted with @Crœsos - with whom I completely agree.
If you double the number of tests you perform and the number of positives you get roughly doubles, then you are testing nowhere near enough.
It's quite simple, really - what you're trying to do with testing is to remove infected people from the general population so they don't go around infecting others. And testing wants to be combined with contact tracing, so you quarantine people who have been exposed to a positive tester.
What actually matters is a combination of the efficiency of testing and contact tracing. If you have good contact tracing, you can get away with fewer tests, and if you have more testing, you can be less good at contact tracing.
I've seen several studies (random testing, municipal sewerage, ...) that suggest that the number of infections is something like a factor of 10-20 bigger than the number of positive tests at the moment. That's not a perfect answer, but I think it starts to set the scale for what you need.
(You can be smart about testing - you want to test everyone who is wanting to return to work / wide social contact, but can get away with testing fewer people who are mostly staying home.)
[all numbers in the following analysis are hypothetical averages for discussion only, epidemiologists will have models that contain more realistic numbers]
If someone tests positive then, obviously, they'd maintain self-isolation. But, also testing should be extended to a greater number of contacts - those who are not regular or close contacts, which is where life gets more difficult, we can all name members of our household and people at work but will struggle with naming visitors to work or the security guard we pass everyday entering the building, much less the checkout operator at the grocery store. It's probably impractical to track everyone someone who's tested positive has been in contact with over the previous couple of weeks, but we should be able to track the majority of those someone has spent more than a few minutes with, providing we haven't removed all restrictions. You want to test each of those people, for two purposes - one to identify anyone who has contracted the virus (and, get them to self-isolate and start contact tracing for them), two to see if it's possible to identify who the virus was contracted from (with much the same result of contact tracing).
What resource is needed for this is going to depend heavily on how much social distancing is still in place as well as the number of people who test positive. If we still have quite strict restrictions then someone showing symptoms will probably only automatically lead to household members and maybe a few people who share an office at work; let's say 6-10 people. On the other hand, if we go all the way back to how we lived 6 months ago then you would need to add in more work people, friends who regularly hang out and that number gets much larger - in which case it's probably going to be possible to test a few of them and hope for the best, or even only do further testing if a positive result comes back. If there's a positive result then you do need to do much more extensive testing.
So, an easing of lockdown where people can return to work where social distancing can be maintained, bars and restaurants reopen with 2m between groups of customers and the like you would be testing about 10 people for every person showing symptoms and possibly 100 for everyone who tests positive (depending on how easily you can track people who ate in the same restaurant etc), and you want to do that tracking fast enough that you get all these contacts and potential contacts self-isolating and tested before the virus can spread further. So, if you ease lockdown while you have 1000 new cases per day you'll probably need capacity for tracing and testing 100,000 people per day, if you wait until you have 10 new cases per day your capacity needs to be 1000 per day. And, if you go all the way back to where we were 6 months ago the numbers go through the roof to the point where you can probably only do that where the number of new cases falls to 1 per day or where the chances of spreading the virus has plummeted (eg: there's a widely used and effective vaccine).
I know the UK, at least with the exception of some of the most isolated parts of the country, is no where near the point where the number of new cases per day is low enough for our ability to track and test people is high enough to be an effective means of identifying and suppressing any new outbreak. We need to both increase that track and test capability and maintain the lockdown longer to bring down the number of new cases before we can relax our lockdown restrictions at all. [/quote]
Not that impractical. Most people carry around smartphones with GPS on them. It seems very easy to identify which smartphones were within 5 meters* of each other within a certain time frame.
*A smartphone GPS is accurate to within 4.9 meters under clear skies, open terrain conditions. If you're in a building or under a bridge that radius increases so maybe 10 or 15 meters might be a better standard. I'll leave that question to the more technically oriented.
The UK government trial app which uses bluetooth to log phones within range seems simpler as it's a direct measure of phones that are nearby. Of ocurse, there's a power and battery life implication of using bluetooth (but the GPS uses power too), and knowing the way other government issued apps work it'll probably be limited to a small fraction of phones.
I'm pretty sure that data is already being tracked. There will be exceptions and imperfections as with any tracking system, but I'd favor a system that over-tests (e.g. SARS-CoV-2 tests for your neighbors on the other side of a wall) than one that under-tests (e.g. not bothering to trace contacts).
There are a lot of ifs and buts therein...
Qualifier: I am currently mostly working from home these days but the rest of my group/team are still at work... (I'm 'healthy' replacement/resource if they start to go off sick)
And, in the event of my (or indeed any of my onsite colleagues) testing positive, if all those who were in my/their immediate environs at work were to be isolated, it is entirely feasible that an entire department or two (production & patient scanning) would have to shut down for a fortnight. Social distancing is not physically possible in the space we have available, and we have to produce a product in a fixed time frame, which is not achievable if TPTB were to try & stagger starts etc. We still need to have a product released by 09:00 which requires a certain number of people to comply with regulatory requirements. And so, again and again, one/two departments could be required to temporarily shut down if staff members were to test positive.
Whilst track, trace, isolate is, IMNSHO, the way we should be proceeding, nevertheless, within a/the healthcare environment, there is a risk that entire departments/teams could (theoretically) need to go into quarantine. Which isn't going to go down so well with the HealthboardPTB. Current SOP is that you stay at work unless you are symptomatic, in which case go get a test and if it is negative, return to work. And in 7 - 14 days time, there is no guarantee that you will not test +ve/be asymptomatic and it hasn't spread further....
How do we balance the risks of track/trace/isolate vs continuing patient treatment/care? And remember, not everyone has a stroke&poke (smartphone).
And I raise you a hospital environment where there is bugger all reception; you can only get a phone signal if you stand in specific places in the building (which is not where the occupants spend most of their time). And those who do not have smartphones.