[vhfpmr (OP)]

If you're not a key worker but have symptoms, you can apply for a test (https://www.nhs.uk/conditions/coronavirus-covid-19/testing-for-coronavirus/ask-for-a-test-to-check-if-you-have-coronavirus/), but if you're already symptomatic that's reason enough to isolate, the people we need to find are the asymptomatic ones. According to the stats on the news, 40% of those in care homes are positive, and 50% of those are asymptomatic. Among staff, 80% of those infected are asymptomatic.

[alancalverd]

Absolutely correct.

So we isolate anybody with symptoms, and any asymptomatic carriers. What do we do with the people who are not infected and never have been? Since they are susceptible to infection, isolate.

In short, 100%  quarantine and full PPE for key workers. That would clearly eliminate the disease in a few weeks, as has been shown by experiment. But the UK government is "led by the science" which apparently means ignoring it.

[vhfpmr (OP)]

If you isolate everyone the economy will collapse (more) though. Being as the virus originated in animals, won't they remain a reservoir for new outbreaks and prevent it from ever being eradicated like smallpox was? It just seems to me that non-key workers who have symptoms are the bottom of the priority list for scarce tests.

[Bored chemist]

So we isolate ... any asymptomatic carriers.

How?
But more isolation is the right thing to do. It's just that Boris doesn't understand it. (to the extent that, he thinks it was a good
idea to go round shaking hands).

If you isolate everyone the economy will collapse (more) though.

That's not as clear cut as it seems.
People looked at (and humane ones discounted) the idea of just letting the virus run riot.
Lots of people would die, but it would be over quickly and the economy could then recover.

It works the other way round too.
Have  as near as possible an absolute lockdown with minimal contact- food delivered by military in full PPE whatever it takes.
It's expensive in the short term, but it minimises the death toll and....
It's all over in a month so, after that the economy can pick up again.

By delaying the introduction of any meaningful measures, Boris has left us with the worst of both worlds.

The best way to protect the economy is to get people safely back to work as soon as possible, and the best way to do that is to start quarantine etc early.
The sooner you start it the sooner you can stop it and, critically, the shorter it needs to be.

[vhfpmr (OP)]

It's expensive in the short term, but it minimises the death toll...

..until you lift the restrictions, then the epidemic takes off again. People are declaring winners before the match has reached half time: thus far, nobody has shown that they can re-start the economy without re-starting the epidemic.

[Bored chemist]

..until you lift the restrictions, then the epidemic takes off again

OK, simplistically,  close the borders.
Lock everyone in their house.

After a month, there's no virus- so the epidemic can not bounce back.
In practice, it will but, in effect, you have reset the clock to January where there are few or no cases. Opening the borders again needs care but since it was only a few days ago that Boris actually realised we should close them, we have had plenty of time to work out how.

Here's the really clever bit. Set up some organisation that acts as a health coordinator for the world.
Then you can run the month quarantine across the whole world.
Then it doesn't matter about the borders.
Maybe you could call it the "World Health Organization". That would give it initials  that the English speakers could joke about.

Mind you, it would only work if governments actually listened to it.

[alancalverd]

If you isolate everyone the economy will collapse (more) though. Being as the virus originated in animals, won't they remain a reservoir for new outbreaks and prevent it from ever being eradicated like smallpox was? It just seems to me that non-key workers who have symptoms are the bottom of the priority list for scarce tests.

It's too late to go back, but immediate quarantine of incoming flights, a travel ban from China and rapid, "manual" contact tracing would have contained the UK outbreak in January.  A total 2 week lockdown would have led to manageable hospital workloads with very little effect on the economy - remember that the country pretty well shuts down for a week at Christmas every year - and a phased return to normality within a month. By mid February it was pretty clear from most Far Eastern countries how to do it (lockdown and quarantine) and how not to (pretend it's not important).

As the Chief Scientific Adviser said in February "If people say "what was that all about?" we will have done it right." They clearly haven't.  Responding to a heap of corpses and lying about the statistics of PPE may be sound politics, but it is very bad medicine.     

BC rarely agrees with me, but when he does, it's worth taking note.

[evan_au]

scarce tests

About a month ago, Australia reached the point where they had tested all the severe cases; then they said "if you even have mild cold symptoms, come in and get tested!".

At that point, I had a cold that had been hanging around for a week, so I went to my local hospital and got tested (the test was free for people on Medicare, the national health system).
- They asked me about symptoms
- They took blood pressure and oxygen saturation
- Took a nasal swab and throat swab - it scratched a bit, but didn't hurt
- I was given a pack of face masks and some information pamphlets, and told to self-isolate until the results came back
- They phoned me back with the results the next day (negative, in my case)

They have continued the call for anyone with even mild symptoms to come in for testing - they don't want people with mild coronavirus passing it off as "just a cold".

The "asymptomatic but infectious" cases are a real problem: 12 outlets of a big fast-food chain in Melbourne were shut down with COVID; it was eventually traced back to the delivery truck driver, who was asymptomatic.

[alancalverd]

The Indian cricket team have displayed consummate common sense by agreeing to 14 day quarantine on entering Australia and playing a Test series in effectively empty grounds. There being no other live sport on TV (apart from darts) they will make a load of money and everyone will be happy.

[evan_au]

I heard a suggestion that authorities could use a "sniff test" to supplement temperature checks.
- Some standard sniff tests already exist
- Presumably, such a test would be quicker to manufacture than a vaccine

Symptoms are not very uniform with this virus - temperature is not always a good indicator.
- For some people, a loss of a sense of smell is an early symptom
- A sniff test is not as quick as a temperature test, but it may detect another subset of infected individuals
- Without a baseline sniff test (before infection), it would be hard to tell if someone had lost their sense of smell, or were always poor at detecting scents.

See: https://en.wikipedia.org/wiki/University_of_Pennsylvania_Smell_Identification_Test

[vhfpmr (OP)]

But if wildlife is the reservoir for the virus how do you eradicate it without mass extermination?

[Bored chemist]

But if wildlife is the reservoir for the virus how do you eradicate it without mass extermination?

The only known non-human vector is a bat.
It's pretty unlikely that any bat in the UK will ever get this virus- since they seldom interact with people.

[alancalverd]

No need to exterminate anything, though a cull of idiots might be advantageous.

One of the most common zoonoses is the porcine tapeworm, hence the traditional absence of pig meat from kosher, halal and many Indian diets. The Chief Rabbi, interviewed on Radio 4 for advice on the presence of animal fat in the new £5 note, said "Don't eat them".

You can minimise risk by domesticating animals and regulating the rearing and processing of meat, or being very selective in what you catch and cook, but wild mammals will always be a risk. Fortunately ebola was recognised, publicised and pounced upon very effectively by experts, but COVID was mismanaged by politicians from the start.

[vhfpmr (OP)]

So far it's been found in bats, cats, dogs, lions, tigers and pangolins, so presumably it'll be found in all sorts of other species if and when someone gets around to looking for it. If it got from Chinese bats to Britain once, it can do so again unless it's kept under control. But control isn't really eradication.

[Bored chemist]

So far it's been found in bats, cats, dogs, lions, tigers and pangolins, so presumably it'll be found in all sorts of other species if and when someone gets around to looking for it. If it got from Chinese bats to Britain once, it can do so again unless it's kept under control. But control isn't really eradication.

So, to get back to the OP's question.
We need to test zookeepers.

[alancalverd]

Indeed, if we eradicate all wild mammals, we won't catch any of their diseases, or have anything worth watching on TV.

Frankly I'd rather follow the Chief Rabbi's advice, which has worked OK in deserts and cities for the last 6000 years. See reply#12 above.

The reason COVID got from Chinese bats to Britain was (a) locals not following said advice (Leviticus excludes bats from the menu) (b) Chinese politicians thinking that covering the Party's arse beats public safety and (c) UK politicians not using their authority to protect the nation, lest they become unpopular. 33% ignorance plus 67% arrogance - a proven lethal mixture.

[Bored chemist]

Indeed, if we eradicate all wild mammals, we won't catch any of their diseases, or have anything worth watching on TV.

Frankly I'd rather follow the Chief Rabbi's advice, which has worked OK in deserts and cities for the last 6000 years. See reply#12 above.

The reason COVID got from Chinese bats to Britain was (a) locals not following said advice (Leviticus excludes bats from the menu) (b) Chinese politicians thinking that covering the Party's arse beats public safety and (c) UK politicians not using their authority to protect the nation, lest they become unpopular. 33% ignorance plus 67% arrogance - a proven lethal mixture.

Are  (b) and (c) pretty much the same thing?

[alancalverd]

Only if Xi Jinping has his hand up Boris's arse. In which case he speaks pretty good English without moving his lips - respect!

Edit, after watching the news. There is no room for Xi's hand, as the space is occupied by Dominic Cummings.

[vhfpmr (OP)]

You started off arguing that we can be rid of it for good if we have a blitz on it for a month or two, and now you're talking about control measures that drag on indefinitely. Hardly the same thing.

[alancalverd]

Very few diseases have been eradicated. In fact apart from smallpox, I can't think of any. But where we adopt "indefinite control measures"  we have very few cases of cholera, typhoid, rabies, porcine tapeworm, salmonella.....Imported live animals (other than humans) are quarantined unless certified free of disease.

Life is a war between hosts and parasites. Problem with microparasites is that they don't retreat or surrender, and it's very difficult to kill them all without nuking your own environment. The trick, as with doorstep evangelists and axe murderers, is not to invite them into your home.

The vector for bubonic plague was probably rat fleas. Killing urban rats by burning London to the ground seems to have solved the problem. Outside of Wuhan, the principal vector for COVID is homo sapiens, particularly the subspecies homo politicus and homo stultus (possibly variants of the same animal with different plumage). As hominids cannot travel great distances unaided, it is relatively easy to control the vector and thus confine the outbreaks to Parliament, Southend beach, and quarantine facilities at ports and airports. We need Dunkirk in reverse: fewer meaningless rallying calls from ignorami, and quarantine them on the beach.  Or just immolate a few economists and stay at home for another couple of weeks.