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Isn't allocation of resources to Pandemics similar to snowploughs?


hotblack42

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HOLA441
 

Are you stating pandemics in the future will happen every 50-100 years or hoping ? 

No, the evidence points to 100 years or so.  As a risk manager I would recommend 50-100 as a good working assumption with 5 year reviews* of medical evidence, incident management plans, standing resources and ability to ramp up.
*Or at any time there is a major shift in risk.

Major health emergency management needs to be put in the hands of an impartial, selfless regulator completely insulated from, and immune to, political pressure and media / public opinion.

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HOLA442
 

Disagree.

We bought all the snowploughs amd salt and then threw them all away - that’s way more costly. 

We’ve gone over the top with ‘efficiency’. A bit less ‘efficiency’ and more spare capacity would mean less people sleeping in hospital corridors every year, better pandemic outcomes as in Germany and probably better outcomes overall.

Are you stating pandemics in the future will happen every 50-100 years or hoping ? 

 I fully agree that we've gone over the top on "efficiency" - it's become a word I struggle to say without spitting - but short memories come in to play too. One cold winter and it's "buy more ploughs and salt", if the next one's warm it's "that was a complete waste of money."

The expectation of perfection, that nothing should ever go wrong, that everything should be handled perfectly is another problem we've got.

Edited by Riedquat
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HOLA443
 

No, the evidence points to 100 years or so.  As a risk manager I would recommend 50-100 as a good working assumption with 5 year reviews* of medical evidence, incident management plans, standing resources and ability to ramp up.
*Or at any time there is a major shift in risk.

Major health emergency management needs to be put in the hands of an impartial, selfless regulator completely insulated from, and immune to, political pressure and media / public opinion.

OK I've not researched it but from memory my understanding was that that was a pre 20C disconnected world kind of scale but that we should now expect the gaps between pandemics to shorten. 

Just to add a bit of spice, the question could be reframed as was the government right to unprepare the UK for the pandemic and were we simply 'unlucky' or was what happened inevitable ?

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HOLA444
 

 I fully agree that we've gone over the top on "efficiency" - it's become a word I struggle to say without spitting - but short memories come in to play too. One cold winter and it's "buy more ploughs and salt", if the next one's warm it's "that was a complete waste of money."

The expectation of perfection, that nothing should ever go wrong, that everything should be handled perfectly is another problem we've got.

Had an interesting albeit uninformed (both of us) debate about the NHS early on in the year. Husband of a friend sprained his knee somehow and was going round in circles getting it sorted, frustration at getting to see a specialist I seem to remember. He's German, long story short got it seen to immediately in Germany and therefore sees the NHS as cr4p.

I wondered how that might appear in statistics on 'efficiency' ie cost of providing care vs waiting lists.  We 'save' on spare capacity so cost/head looks amazing, but often deliver a frustrating service whose actual 'cost' is hidden, albeit in a separate stat.

Similarly I've heard stories of 'savings' on refurbishing/renewing infrastructure that will cost more in the long term. And then then eventually you take that short-termism/hidden cost philosophy to preparation for pandemics ...

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HOLA445
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HOLA446
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HOLA447
 

Your comparison doesn't really stand up, as bad weather is relatively frequent, in comparison to a global pandemic which is a once in a lifetime event.

Relatively frequent are weasel words. The risk is formed from the likelihood and the impact. From that, the appropriate mitigations can be made.

Snow at Dubai Airport - high impact (closes the airport down), but incredibly low likelihood (snows once every 100 years). Conclusion - no need for snow ploughs.

A bad flu season - moderate impact (we have flu vaccines for various strains, most people recover). Moderate likelihood - once every 10 years. Conclusion - maintain vaccination capacity in all years, and encourage sanitation.

 

 

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HOLA448
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HOLA449
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HOLA4410
 

Interesting logic. What happens when you apply it to Trident?

 A17 beat me to it, in the risk is how damaging the event is, rather than frequency.

 Snow and viruses just do their thing irrespective, hostile nations will consider our nuclear deterrent first before risking conflict: that human factor input that can moderate the risk of the initial event happening in the first place that the other two examples lack?  (offest of course against the risk of accidents)

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HOLA4411

One thing we can be pretty certain off is that even if lessons are learnt it won't be long before they are forgotten again. The pandemic was predicted Bill Gates spent years banging on about the need to, and relative cheapness of, preparing for the inevitable pandemic. 

Bill Gates warned of a deadly pandemic for years — and said we wouldn't be ready to handle it - CBS News

In the UK it was number 1 on the UK risk register but when it came to spending money it always goes back to us having an underfunded health service making any decision to prepare for the possible future come at the certain cost of lives today. 

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HOLA4412
 

The expectation of perfection, that nothing should ever go wrong, that everything should be handled perfectly is another problem we've got.

+1

As is the idea that "if anything falls short of perfection it's the government's fault for not ensuring perfection at all times, payable by everyone except me".

I wouldn't advocate a return to Victorian Health & Safety (ie "building stuff is dangerous work - you're bound to have a few deaths in any major building project") but nor should we somehow rebadge the government as masters of nature "we must never lose a day of work to snow or pandemics - and if we do the government should fully compensate us".

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HOLA4413
 

 A17 beat me to it, in the risk is how damaging the event is, rather than frequency.

I'd say that it's both, which is why we put more effort in to things likely to kill us than things that could but are unlikely to. With the numbers and timescales "could but unlikely" will still happen sooner or later. If that's sufficient to completely wipe out all life on Earth then it's worth worrying about even if very unlikely. If it's about the risk to an individual, less so (if something will probably only kill one person throughout the entirety of human history it makes little sense to pay it any attention at all).

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HOLA4414
 

+1

As is the idea that "if anything falls short of perfection it's the government's fault for not ensuring perfection at all times, payable by everyone except me".

I wouldn't advocate a return to Victorian Health & Safety (ie "building stuff is dangerous work - you're bound to have a few deaths in any major building project") but nor should we somehow rebadge the government as masters of nature "we must never lose a day of work to snow or pandemics - and if we do the government should fully compensate us".

Definitely. I may often sound like I'm rather old-fashioned but Victorian working conditions really are the opposite extreme that I definitely don't want.  And you know something most certainly isn't Health and Safety gone mad if the Victorians felt it necessary to have rules in place to prevent it. But we do need a bit more of accepting "sh1t happens" that they did, without shrugging off everything that they used that to shrug off. I suspect they also had more contingency for railways and shipping and so on, but that might just go back to the point they weren't reliable enough to manage at all without it.

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HOLA4415
 

But we do need a bit more of accepting "sh1t happens" that they did, without shrugging off everything that they used that to shrug off. I suspect they also had more contingency for railways and shipping and so on, but that might just go back to the point they weren't reliable enough to manage at all without it.

I don't honestly know about contingency and reliability in Victorian times.

But they definitely didn't have the same sort of recourse that you have today where basically people can sue for damages when they spill a hot cup of tea because it didn't have "CAUTION: Hot" written on the cup.

In Victorian times, if you sold someone a gold bar and it turned out to be copper polished up the courts would pull you up on it, but if your customer dropped the bar on his foot and broke his toe, that would be laughed at as his own fault rather than you being sued for not having "CAUTION: Heavy" written on it.

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HOLA4416

In Victorian times they began to have a greater appreciation of the need for a social contract, in which we don't leave some people to die of hunger or illness just because they have been unlucky in life...albeit it wasn't really until the State Pension (1909) unemployment benefit (1911) and NHS (1948) that it was really nailed.

However, the Victorians still worked from the bedrock of the idea that the main responsibility to look after you comes from yourself, and not from anyone else (and certainly not from government).

And it's certainly not the government's job to make sure you are never inconvenienced by snow.

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HOLA4417
 

I agree - indeed does anyone NOT agree with that logic?!  Who is calling for wasting lots of resources on a permanent state of pandemic alert?!

The UK actually had pandemic plans in place, they just didn't work for COVID because they made two incorrect assumptions:

- The way to treat severe respiratory illness is with a ventilator (COVID patients are more likely to die on ventilators than not, that's why the second wave has been less fatal and had fewer people in ICU ventilated)

- The way to beat a pandemic is with herd immunity (this is based upon a flu pandemic, but COVID is different, for example the immunity is not as long lasting, and there can be nasty 'long COVID' impacts you don't get with flu)

That's why the initial response of Boris was all aimed at herd immunity and building nightingale hospitals with ventilators.

I suspect there is also an element of the NHS not having much slack (witness the almost yearly Flu scares) and they are doing their best to avoid the spectre of hospitals filling up and inpatients (of all kinds) dying because of lack of treatment - to the extent where they are effectively killing sufferers of other less visible chronic diseases by denying them treatment ,because that won't make the headlines in the same way.

...Loads of cancer sufferers will have either died already or will die earlier due to lack of treatment or diagnosis.  Same for cardiovascular diseases.  Alcohol intakes have surely risen - > more health issues.   Lots more people are going to suffer depression and I would expect suicide rates to rise.

 

 

 

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HOLA4418
 

In Victorian times they began to have a greater appreciation of the need for a social contract, in which we don't leave some people to die of hunger or illness just because they have been unlucky in life...albeit it wasn't really until the State Pension (1909) unemployment benefit (1911) and NHS (1948) that it was really nailed.

However, the Victorians still worked from the bedrock of the idea that the main responsibility to look after you comes from yourself, and not from anyone else (and certainly not from government).

And it's certainly not the government's job to make sure you are never inconvenienced by snow.

replying to this post and the one above it.

And on those points I'm with the Victorians. Where I'm not are the types of situation where you operated a machine that would take your hand off (or worse) and the attitude was "it's your responsibility to take your hand out in time, even though you've got to keep putting it in there with split second accuracy."

Social-wise I do believe in the safety net and government providing some basic services.

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HOLA4419
 

I'd say that it's both, which is why we put more effort in to things likely to kill us than things that could but are unlikely to. With the numbers and timescales "could but unlikely" will still happen sooner or later. If that's sufficient to completely wipe out all life on Earth then it's worth worrying about even if very unlikely. If it's about the risk to an individual, less so (if something will probably only kill one person throughout the entirety of human history it makes little sense to pay it any attention at all).

 Only both apply here as humans are poor at risk analysis, and selfish about their own survival much more than that of the general population,some to the extent of advocating population reduction.  Dr. Spock would see instantly how selfish ad illogical we are about analysing risks.

 This is related to the fear factor, that if we are too sucessful at containing a pandemic risk, rather than being praised for it, it is seen as evidence for the risk assesment being wrong without hard proof in the way of overflowing mourgues.

 Climate change a similar invisible threat, a hot topic in the 90's amongst the scientific community, but only when joe public started seeing the consequenses first hand did it become a reality-for most. 

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HOLA4420
 

 Only both apply here as humans are poor at risk analysis, and selfish about their own survival much more than that of the general population,some to the extent of advocating population reduction.

Careful with that one - nothing at all selfish about advocating population reduction in general, only if you're saying "bump off a load of people but not me now." There are a lot of potential benefits to be had from reduced population, the trick is finding an ethical way to achieve it (education seems to help, and I very much doubt there's any ethical method of achieving it rapidly).

Edited by Riedquat
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HOLA4421
 

Relatively frequent are weasel words. The risk is formed from the likelihood and the impact. From that, the appropriate mitigations can be made.

Snow at Dubai Airport - high impact (closes the airport down), but incredibly low likelihood (snows once every 100 years). Conclusion - no need for snow ploughs.

A bad flu season - moderate impact (we have flu vaccines for various strains, most people recover). Moderate likelihood - once every 10 years. Conclusion - maintain vaccination capacity in all years, and encourage sanitation.

 

 

You're conflating two completely different risks here, snow fall at "Dubai Airport" is no where near the risk factor of deploying snow plows in various parts of the UK, which was what the OP's comparison was based on.  

 

 

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HOLA4422
 

You're conflating two completely different risks here, snow fall at "Dubai Airport" is no where near the risk factor of deploying snow plows in various parts of the UK, which was what the OP's comparison was based on.  

 

 

It's an example. Settled snow will have the same effect/severity whether it falls at Dubai Airport, Heathrow Airport or Moscow Airport (once it has settled, it needs to be cleared regardless of how deep it is). However, because the frequency is so different for each place (Dubai - 1 day per 100 years, London - 1 day per 2 years, Moscow - 30 days per year) the powers that be have to decide whether the mitigations are worth it.   

Edited by A17
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HOLA4423
 

It's an example. Settled snow will have the same effect/severity whether it falls at Dubai Airport, Heathrow Airport or Moscow Airport (once it has settled, it needs to be cleared regardless of how deep it is). However, because the frequency is so different for each place (Dubai - 1 day per 100 years, London - 1 day per 2 years, Moscow - 30 days per year) the powers that be have to decide whether the mitigations are worth it.   

...And the mitigations are going to depend on the frequency of the event, obviously.  

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HOLA4424
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HOLA4425
 

Severity x probability 

vs

cost of preparation 

Disagree - that's not the right approach to risk management.

For example, because insurers always have a profit margin, "cost of preparation" where preparing is an insurance policy will always cost more than "severity x probability", so is the wrong question.

The question is: "am I willing to pay the cost of preparation to avoid the risk of the severity?"

The probability just steers you down what TYPE of response you need: for example, if your house floods every 5 years you really need stronger flood defences.  If it floods every 50 years you probably need insurance. 

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