[stefano]

One region of Italy is close to their ICU beds limit, despite a full lockdown. And they have more beds per person than the UK. Without a full lockdown, won't they run out of beds very quickly, thus increasing the death rate a lot?

[vanniv]

The average age of a fatal case is still north on 80 years.

The UK plan is effectively to get as many people as possible that are young, and thus at a super low risk of needing hospitalization to get infected, so that they can recover and then be immune, thus making it hard for the virus to sweep through again. If 30% or more of the population were immune, it would be much harder to get a new outbreak started. With a lockdown, either the lockdown suppresses spread, in which case ending the lockdown risks re-igniting the epidemic, or it doesn't, in which case it didn't help materially anyway.

If the UK can get 10x or more of the cases with only the same hospitalization numbers, they'll be in better shape than everywhere else.

The core question ends up being whether they're able to effectively inoculate that many young people without it spreading to just everybody.

Flattening the curve preserves medical capacity somewhat, but it also prolongs the epidemic. And since the lockdowns required to do the flattening have their own cost on lives, it's unclear whether the incremental increase in the number of lives that the medical system can preserve will or will not exceed the number of other lives caught short because the disease and also the lockdowns are extended by the extra time.

You might not be saving lives, just changing which people die.

Or you might save some, or you might lose more. Counting in advance is... let's say nontrivial. Even counting afterward will be hard and full of wide error bars.

It's relatively easy to count how many died directly from an illness, difficult to count how many will die because they delayed necessary non-emergency care for 4 months (unrelated to the virus except for the need to preserve hospital capacity or avoid infection risk) instead of 2 months because the outbreak was prolonged, and virtually impossible to count how many die from things like "I lost my job and my life savings at the same time, and I never fully recovered, and now my whole family is much poorer, which gives us higher all-cause mortality"

Everybody's talking about the first group. Occasionally, I see people admit that the second might exist and be non-empty. But, I keep feeling like I'm the only person on HN (and in my regular life) reminding people that the economy actually affects real life in major ways. (I'm probably not the only one, but still...)

[greedo]

Are we sure that you're immune once you've been infected?

[vanniv]

Certain? No. Nobody can realistically be certain yet.

There is only one case that I've been able to find of a person who was diagnosed twice that can't easily be explained away as having been discharged while still infected. And even that case might be one like that.

[fspeech]

We only know that you are likely to be immune for six month. Whether you will have life time immunity is anyone’s guess.

[emkemp]

Citation needed.

[bitL]

No. There might be even opposite effect - antibodies might make subsequent reinfections easier. That happened with some previous coronavirus. As well as with some vaccinations that didn't generate sufficient amount of antibodies - some kids acquired some illness much faster than non-vaccinated ones because the vaccine wasn't strong enough.

Current coronavirus has already multiple distinct strains. Even if they don't mutate further, we would need multiple vaccines. They might also mutate to something more deadly, given the COVID-19 is a mutation of the original SARS with some characteristics of HIV and Ebola.

We are in uncharted territory.

[aemreunal]

> [...] antibodies might make subsequent reinfections easier. That happened with some previous coronavirus.

I never read about this, can you point me to a source, please?

[yulaow]

A lot of young people still need icu treatments here in italy. If you don't flatten the curve early a lot of younglings too are gonna die and fast considering the very limited number of icu beds and the very high number of early contagions the uk seems to want to reach.

[vanniv]

Some will. Possibly more than would have if we spread the illness over time.

But that set of outcomes has risks and costs too.

But regardless, it isn't really clear that the curve-flattening efforts are even effective. Italy is clearly experiencing an utterly uncontrolled outbreak. Despite pretty much the maximum amount of lockdown possible to achieve.

Don't believe that they have only 20k cases, or only 3k new ones today -- even with their increase in testing, they are still strongly test limited; that's why the Italian mortality rate looks so absurdly high -- they still aren't detecting most of the mild cases. (Either that or somehow the Italian version of the virus is about 10x as deadly as the everywhere-else version)

It seems much more likely that the mortality rate everywhere is relatively similar and it is the detection rate that varies. (Notice how all of the places that have really thorough testing all have the lowest -- and similar -- mortality rates? And the places with really high mortality rates are those with known inadequate testing)

[yulaow]

To clarify current national-level lockdown effects are expected to be seen starting twelve days from now.

Some or the old red zones which covered the starting point of the infection are currently with 0 new detected cases since 3 days so it seems lockdown works IF u put them in place soon enough. [ https://translate.googleusercontent.com/translate_c?depth=1&... ]

[vanniv]

Of course, if you ever let up on the lockdown, the disease will immediately start spreading again.

[yulaow]

Exactly, but the government hope is to manage new cases with heavy tracking and testing as south korea is doing, so to keep the future spread far more under control. That's not possible until the current situation is resolved

[mantap]

What exactly is the risk of needing hospitalisation if you are young? Does anybody know?

[dharma1]

It's too early to say with reliable data. We will definitely know in 2-3 weeks with data from many European countries. In Italy, it looks like the percentage of younger hospitalised people is 12%, but growing.

https://www.independent.co.uk/news/world/europe/coronavirus-...

[vanniv]

That is not 12% of cases. That is 12% of hospitalizations are under the age for 50.

The overall hospitalization rate is difficult to know, due to the huge inaccuracies in the case numbers.

[robryk]

12% of _COVID ICU patients_ in Italy are below 50 years old. Note that this doesn't let us answer the question of how common are ICU cases among young infected people.

[mantap]

And the question was about hospital admissions not ICU admissions anyway.

[bonzini]

> The UK plan is effectively to get as many people as possible that are young, and thus at a super low risk of needing hospitalization to get infected

The risk is already not that low at 55-65. These are people that are working and thus very likely to catch it.

[kgwgk]

51% of patients requiring intensive care in Italy are in the 50-70 range. 12% are younger than 50.

[bitL]

The first ICU patient in Italy was a 38-year old man who ran two half marathons a week before hospitalization. Iranian 22-year old futsal national team member passed away as well. Many young people have damaged lugs for life after surviving on ICU. I am not sure why people downplay the potential of damage for younger and healthier people just because it predominantly targets old and sick people. The virus might also mutate to more deadly strains.

[Engineering-MD]

What is your source for those figures? I haven’t been able to find the breakdown.

[kgwgk]

https://www.epicentro.iss.it/coronavirus/bollettino/Bolletti...

Unfortunately they don't give a more detailed breakdown.

[dharma1]

How do you target young people exclusively? You can't.

The only thing that has worked is China/South Korea style careful tracking, rapid and extensive testing and strict quarantine measures. Nothing else so far is working.

[mattmanser]

Italy is almost a month ahead of most of the world in infections though, their first outbreaks were weeks ago and the source for infecting most of the rest of Europe.

A lot of the UK infections can be traced to Italian holidays, for example.

Even if the government does plan to lock down the UK eventually, every day must cost 10s of millions, you can understand the strategy to wait longer, and even to play it down a bit.

[lultimouomo]

The biggest EU countries are 1 to two weeks behind Italy:

https://twitter.com/MarkJHandley/status/1238604695700209664

(mind the log scale)

[mhandley]

I just posted today's update: http://nrg.cs.ucl.ac.uk/mjh/covid19/

Denmark and Norway are less than a week behind Italy in terms of confirmed cases per million inhabitants, as is Switzerland. Spain moved closer the last two days as well.

[new2628]

According to the growth rates along the exponential curve, it seems more like a week or two than a month.

[christkv]

Yes the model they operate on is around 40% of the population will get this. Even with a lower real death rate of say 1% that still leaves over 250k people dead.