Social distancing could worsen population level outcomes from Covid-19

[Yew]

Hi All, A recent study published by the Royal Society suggests that social distancing could worsen population level outcomes.

https://royalsocietypublishing.org/doi/10.1098/rsif.2018.0296

The outbreak of an infectious disease in a human population can lead to individuals responding with preventive measures in an attempt to avoid getting infected. This leads to changes in contact patterns. However, as we show in this paper, rational behaviour at the individual level, such as social distancing from infectious contacts, may not always be beneficial for the population as a whole. We use epidemic network models to demonstrate the potential negative consequences at the population level. We take into account the social structure of the population through several network models. As the epidemic evolves, susceptible individuals may distance themselves from their infectious contacts. Some individuals replace their lost social connections by seeking new ties. If social distancing occurs at a high rate at the beginning of an epidemic, then this can prevent an outbreak from occurring. However, we show that moderate social distancing can worsen the disease outcome, both in the initial phase of an outbreak and the final epidemic size. Moreover, the same negative effect can arise in real-world networks. Our results suggest that one needs to be careful when targeting behavioural changes as they could potentially worsen the epidemic outcome. Furthermore, network structure crucially influences the way that individual-level measures impact the epidemic at the population level. These findings highlight the importance of careful analysis of preventive measures in epidemic models.

[my bold]

 

[Shaw S Hunter]

An interesting intellectual study but sadly lacking in any useful suggestions as to how we should proceed from where we are now. I also didn't see any acknowledgment of the most challenging aspect of the pandemic, namely the significance of asymptomatic transmission. As such I'm not sure that this study adds anything useful to the wider public discussions.

 

[Yew]

An interesting intellectual study but sadly lacking in any useful suggestions as to how we should proceed from where we are now. I also didn't see any acknowledgment of the most challenging aspect of the pandemic, namely the significance of asymptomatic transmission. As such I'm not sure that this study adds anything useful to the wider public discussions.

I don't see where the study said it was going to look into asymptomatic transmission? This feels like a "but HS2 doesn't do anything for Cornwall type of argument"

 

[Bletchleyite]

I don't see where the study said it was going to look into asymptomatic transmission? This feels like a "but HS2 doesn't do anything for Cornwall type of argument"

It would be useful to know if there is any asymptomatic transmission or not. As if there isn't, or if there is very little, it comes down to the rather simple situation of "if you've got symptoms stay in", and everything else becomes unnecessary.

 

[Shaw S Hunter]

I don't see where the study said it was going to look into asymptomatic transmission? This feels like a "but HS2 doesn't do anything for Cornwall type of argument"

The point is that the report merely highlights that if we could go back and do things differently that social distancing might have been deemed less essential. But by now we are where we are and the report has nothing more than intellectual value for those interested in such academic discussions.

 

[Yew]

The point is that the report merely highlights that if we could go back and do things differently that social distancing might have been deemed less essential. But by now we are where we are and the report has nothing more than intellectual value for those interested in such academic discussions.

Surely, as rumblings of another lockdown are, um, rumbling. Learning what to and not to value is as important as ever?

 

[yorkie]

. Some individuals replace their lost social connections by seeking new ties

This is very true. Our forum pub meets/meals and our forum walks/cycle rides are often not attended by many of our previous regulars. I've since met a load of new forum members I've not met before and others who were less regular are now more regular (if anyone is reading this and wants to be a part of this, please do get in touch).

I've also switched which football games I play. I am absolutely seeking to replace lost social connections and I would urge anyone in a similar position to do so.

 

[SuperNova]

Has this been peer reviewed? Because it seems to me an idealistic viewpoint and yearning for times of old. Realistically, people need to start accepting that a) Covid is here to stay for the foreseeable near future at least b) social distancing and face masks are going to play a big role in limiting cases until a vaccine is found that sufficiently protects humans for a good period of time c) life will never quite be the same as it was at the start of 2019.

 

[Yew]

It would be useful to know if there is any asymptomatic transmission or not. As if there isn't, or if there is very little, it comes down to the rather simple situation of "if you've got symptoms stay in", and everything else becomes unnecessary.

Indeed, an investigation into the actual prevalence would be incredibly useful. I'd guess since masks don't seem to have made a huge impact it'd be tempted to suggest that we are leaning towards it not being the major driver.

Has this been peer reviewed? Because it seems to me an idealistic viewpoint and yearning for times of old. Realistically, people need to start accepting that a) Covid is here to stay for the foreseeable near future at least b) social distancing and face masks are going to play a big role in limiting cases until a vaccine is found that sufficiently protects humans for a good period of time c) life will never quite be the same as it was at the start of 2019.

It's in the Journal of the Royal Society, rather than an article. And whilst I've not done a thorough investigation, I'd expect so.

 

[DB]

Has this been peer reviewed? Because it seems to me an idealistic viewpoint and yearning for times of old. Realistically, people need to start accepting that a) Covid is here to stay for the foreseeable near future at least b) social distancing and face masks are going to play a big role in limiting cases until a vaccine is found that sufficiently protects humans for a good period of time c) life will never quite be the same as it was at the start of 2019.

Lots of unfounded assumptions here!

Evidence for masks making any difference at all is very weak - it's certainly not true to say that they are playing a big role in limiting cases. It is also dangerous to rely on there being a vaccine. And as for the whole 'life has changed forever' type rhetoric - I very much doubt it. There will be some changes, but by and large things will go back to how they were in due course.

 

[SuperNova]

Lots of unfounded assumptions here!

Evidence for masks making any difference at all is very weak - it's certainly not true to say that they are playing a big role in limiting cases. It is also dangerous to rely on there being a vaccine. And as for the whole 'life has changed forever' type rhetoric - I very much doubt it. There will be some changes, but by and large things will go back to how they were in due course.

A very nice misquote from you there. I repeat, life will never quite be the same as it was at the start of 2019, as can be seen from behavioural changes already taking place RE flexible working, the death of the high street etc. Plus evidence suggests Covid is here to stay.

 

[Bantamzen]

A very nice misquote from you there. I repeat, life will never quite be the same as it was at the start of 2019, as can be seen from behavioural changes already taking place RE flexible working, the death of the high street etc. Plus evidence suggests Covid is here to stay.

You are right in a way, life will never be the same whilst some people simply cannot accept that we will not defeat the virus, but also that the virus is not going to kill the vast majority of us. Right now politicians, cheered on by "new normalists" are trying to apply political solutions to this biological problem. They firmly believe that we just need to hide behind the collective sofa and wait for the virus to get bored & go and find a new species to use. Sadly real life isn't like that, viruses don't get bored, they hang around until they get another chance, which they will. Sure a vaccine might help a bit should one ever be found to be effective, but viruses and particularly this family of them are notoriously difficult to get rid of by vaccine alone.

Meanwhile people's lives are being trashed, tens maybe even hundreds of millions of jobs are being lost around the world. People's mental wellbeing are being stretched to breaking point, relationships are breaking down, and new ones might not form as a result of the restrictions in so many countries. It is not the virus you should fear, we have a rather impressive immune system that quiet clearly is doing the job for most people who come into contact with it. No you should really fear what happens when enough people are pushed beyond the limit by measures that are little more than "feel good" factors for politicians and the most neurotic. The "new normal" might not turn out the way it's founders imagined.

 

[DB]

A very nice misquote from you there. I repeat, life will never quite be the same as it was at the start of 2019, as can be seen from behavioural changes already taking place RE flexible working, the death of the high street etc. Plus evidence suggests Covid is here to stay.

More hyperbole! We simply don't know yet what the medium term use of flexible working will be, nor how the situation will pan out with shops. You cannot infer long term behavioural change from a situation where there are loads of theoretically short term restrictions. Proponents of this 'new normal' nonsense seem to be vastly over estimating the public appetite for it.

The fact that the virus will remain is beside the point.

 

[Yew]

A very nice misquote from you there. I repeat, life will never quite be the same as it was at the start of 2019, as can be seen from behavioural changes already taking place RE flexible working, the death of the high street etc. Plus evidence suggests Covid is here to stay.

I think it might be worth flavouring DavidB's comment with "the level of freedom we can expect in our lives has changed forever"

 

[trainophile]

I think it might be worth flavouring DavidB's comment with "the level of freedom we can expect in our lives has changed forever"

A common saying when I was younger and someone was doing something a bit questionable or silly was "it's a free country". Is that not the case from this point on?

 

[Huntergreed]

A common saying when I was younger and someone was doing something a bit questionable or silly was "it's a free country". Is that not the case from this point on?

It’s very far from a free country at the moment, and we need to change that, but it seems like the majority want to, not only continue it, but make it even worse.

 

[trainophile]

It’s very far from a free country at the moment, and we need to change that, but it seems like the majority want to, not only continue it, but make it even worse.

Then they are taking a very short-sighted and potentially irreversible view, and need to think it through.

 

[SuperNova]

It’s very far from a free country at the moment, and we need to change that, but it seems like the majority want to, not only continue it, but make it even worse.

The majority of the people want to control the virus, until a vaccine is available to allow us to return to some sort of normality. If that means restricting some freedoms, so be it.

The irony is, from my experience, those who always bleat about WW2 and the wartime spirit are those unwilling to do their bit for the cause. Imagine if we had rationing, blackouts and curfews right now. Wearing a face covering in shops and on public transport and socially distancing aren't exactly difficult.

 

[yorkie]

Wearing a face covering in shops and on public transport and socially distancing aren't exactly difficult.

The destruction of some peoples livelihoods; the deterioration of mental health; the worsening physical health situation for many; the disruption to education; the lack of social contacts... all these do make life difficult right now for millions of people.

Please don't dismiss these real hardships.

 

[Freightmaster]

The majority of the people want to control the virus, until a vaccine is available to allow us to return to some sort of normality. If that means restricting some freedoms, so be it.

That entire statement is an oxymoron - people want to "return to normality" by "restricting more freedoms" - WTF???!



I despair, I really do.





MARK

 

[Shaw S Hunter]

That entire statement is an oxymoron - people want to "return to normality" by "restricting more freedoms" - WTF???!

And yet that's exactly what was necessary during WW2. Trouble is few people alive today lived through that time. It's not as though elections are going to eliminated. Think what happened to Churchill in the 1945 GE; people felt it was time for change but he was still acknowledged as a great wartime leader. The real issue today is the lack of firm leadership. What if it was made mandatory to wear masks at all times when outside your home and social distancing measures in busier locations were rigourously enforced? The effect on the spread of the various might well be small but it could give a big boost to public confidence in resuming normal patterns of activity. But even those relatively small restrictions are seen as too great an infringement on freedom. Unlike most of Europe. Where real loss of liberty remains strong in societal memory.

We may not be involved in a physical war but the virus is perfectly capable of inflicting unpleasant illness, with potentially life-long after effects if not death, on a random basis. As such a quasi-wartime regime of restrictions is not exactly unreasonable so long as government is transparent in its dealings and keeps Parliament well inside the loop. The Cummings affair has significantly damaged government credibility however and the testing fiasco isn't going to help either.

 

[Bantamzen]

The majority of the people want to control the virus, until a vaccine is available to allow us to return to some sort of normality. If that means restricting some freedoms, so be it.

The irony is, from my experience, those who always bleat about WW2 and the wartime spirit are those unwilling to do their bit for the cause. Imagine if we had rationing, blackouts and curfews right now. Wearing a face covering in shops and on public transport and socially distancing aren't exactly difficult.

So we should all be willing to give up our freedoms that those wars were fought for because the virus has a very small chance of killing the majority of us?

And yet that's exactly what was necessary during WW2. Trouble is few people alive today lived through that time. It's not as though elections are going to eliminated. Think what happened to Churchill in the 1945 GE; people felt it was time for change but he was still acknowledged as a great wartime leader. The real issue today is the lack of firm leadership. What if it was made mandatory to wear masks at all times when outside your home and social distancing measures in busier locations were rigourously enforced? The effect on the spread of the various might well be small but it could give a big boost to public confidence in resuming normal patterns of activity. But even those relatively small restrictions are seen as too great an infringement on freedom. Unlike most of Europe. Where real loss of liberty remains strong in societal memory.

We may not be involved in a physical war but the virus is perfectly capable of inflicting unpleasant illness, with potentially life-long after effects if not death, on a random basis. As such a quasi-wartime regime of restrictions is not exactly unreasonable so long as government is transparent in its dealings and keeps Parliament well inside the loop. The Cummings affair has significantly damaged government credibility however and the testing fiasco isn't going to help either.

The virus is not capable of inflicting death on a random basis, for goodness sake take a look at the statistics of those who have sadly passed with the virus (and not necessarily because of) and educate yourself. What is a worry is how so many people have taken to hysteria and advocating more authoritarian measures to help them feel safe whilst pretending that they want such measures for altruistic reasons. We are literally sleepwalking into an Orwellian nightmare.

 

[Crossover]

And yet that's exactly what was necessary during WW2.

I'm not sure comparisons to wartime are helpful - in wartime people were actively encouraged to be social. This is the one thing we can't do, despite being social creatures. 6 months on, and its starting to take its toll on many people, myself included

 

[Bikeman78]

That entire statement is an oxymoron - people want to "return to normality" by "restricting more freedoms" - WTF???!



I despair, I really do.





MARK

Yet so many people believe that. They think that "if people just followed the rules we could go back to normal more quickly."

 

[Bletchleyite]

Yet so many people believe that. They think that "if people just followed the rules we could go back to normal more quickly."

That of course only works if you have an elimination strategy. If you don't, it might actually be the opposite of the case.

 

[Bikeman78]

That of course only works if you have an elimination strategy. If you don't, it might actually be the opposite of the case.

Agreed but, in my experience, it's pointless trying to explain that.

 

[Crossover]

That of course only works if you have an elimination strategy. If you don't, it might actually be the opposite of the case.

With this feeling like it is the case at the moment

 

[Shaw S Hunter]

So we should all be willing to give up our freedoms that those wars were fought for because the virus has a very small chance of killing the majority of us?



The virus is not capable of inflicting death on a random basis, for goodness sake take a look at the statistics of those who have sadly passed with the virus (and not necessarily because of) and educate yourself. What is a worry is how so many people have taken to hysteria and advocating more authoritarian measures to help them feel safe whilst pretending that they want such measures for altruistic reasons. We are literally sleepwalking into an Orwellian nightmare.

Thanks to asymptomatic transmission random infection is exactly what can happen, hence the need for masks and social distancing, though those precautions are not the be all and end all. As to freedoms ISTM that younger people are saying that they should not be expected to give up any of their freedoms, even temporarily, but older people should have to give up most of theirs instead. It may be that older people statistically have most to lose but younger people are not immune to serious illness from the virus and even though recovery is much more likely it can be protracted and there is a risk of significant long-term damage to vital organs. This should not be dismissed lightly.

Unfortunately we have become so conditioned to binary solutions that few people seem interested in striking a reasonable balance. In short some temporary loss of freedom is inevitable if we are to avoid collapsing the NHS but OTOH we continue to develop a better understanding of the virus meaning it may not be too long before we can find a way to live with the virus, even without a vaccine, while also restoring life close to the previous normality. But we are not there yet.

 

[Yew]

. It may be that older people statistically have most to lose but younger people are not immune to serious illness from the virus and even though recovery is much more likely it can be protracted and there is a risk of significant long-term damage to vital organs. This should not be dismissed lightly.

I think that mortality statistics severely disagree with your prior statement. And the evidence for severe organ damage, and the so-called "long covid" is seriously questionable.

 

[Shaw S Hunter]

I think that mortality statistics severely disagree with your prior statement. And the evidence for severe organ damage, and the so-called "long covid" is seriously questionable.

You are of course entitled to your opinion. But you cannot deny that some recovered patients, who were previously in perfect health, now have permanent organ damage. As it is a "novel" coronavirus we don't yet know as much as we would like so it is true to say that detailed and reliable statistics about long-term impacts are not yet available. But it is undeniable that such impacts are occurring.

Most of the wider debate stems from different people having different perceptions of risk and the extent to which anyone should be entitled to enforce others to accept a particular level of risk, perceived or actual. Ultimately we elect representatives to take such broader decisions on our behalf but the current government is struggling to maintain credibility, hardly a recipe for social harmony during a pandemic.