The Corona Virus

[Aedilred]

I suspect that the infection rate is a lot higher than known, although that is speculative. We won't know until many, many more tests have been done.

I'm fairly confident that I've had it. If so, it was mild and under normal circumstances I wouldn't have considered missing work (as it was, we were under lockdown by the time that I became symptomatic). I haven't been tested though and there is no prospect of being tested any time soon at current foreseeable testing rates, given my susceptibility and line of work. I know, and know of, several people in similar circumstances. I don't personally know or know of anyone who's been diagnosed with it.

That is of course entirely anecdotal but I think it's also pretty much a given that in most countries and the UK in particular the official tallies for both infection and deaths are understated, the first due to lack of testing, the second due to the counting method.

It also seems likely, given the nature of what we're counting in each instance, that infections are being understated by a much higher factor than deaths are. But that will vary by country.

It's difficult to make sense of the data on a global scale because each country is conducting different numbers of tests, the tests aren't all equally reliable, and each country also reports deaths differently. The more tests are done, the more accurate the infection rate is likely to be, not only because larger sample sizes are better, but because where testing is done on a smaller scale it's likely to be done on patients who are more obviously infected. But the tests also aren't being done in a vacuum: increased testing allows earlier interception of the infection and better management of healthcare resources which should in turn depress the mortality rate.

For instance, Germany's tested around 2% of its population and the infection rate among those tested is a little under 10%. The UK by contrast has tested around 0.6% of the population with an infection rate of around 35%. But the mortality rate among German confirmed infectees is to date about 3.5% and in the UK it's about 13.5%. That doesn't account for differences in how the two countreis count deaths, though.

The flipside is that increased testing also facilitates better containment of the virus. Which is good, because it means fewer deaths. But until a vaccine is ready, its spreading is also the only way to create immunity. And herd immunity is the only viable long-term strategy for dealing with the virus.

This is the looming problem that I don't think anyone, even in countries that have dealt with it pretty well so far, really has a clear idea of how to deal with: how we get out of this. Or more specifically: the goal to date has been to flatten the curve to minimise the short-to-medium-term impact, but what happens once the curve has been flattened? Even if the UK's ludicrous 35% figure is accurate across the whole of the population (it's not), that's still way too low for herd immunity.

Leaving the lockdown in place will keep the virus contained and prevent spread, but it's also just putting the problem on ice while creating a host of other problems which may well prove to be deadlier in some ways than the virus itself. A vaccine is still too far off to seriously consider leaving the lockdown in place until it's ready for use. But once you lift the lockdown, it'll immediately start spreading again and people will start to die. It's an incredibly difficult decision and I worry that nobody will make it, which could end up being the worst of all worlds.