Are there actually many credible, verified examples of NHS staff (as opposed to, say, those in the wider community who may or may not be a priority) not having the PPE that they need? As opposed to, say, hospitals worried about how they will be supplied in 1-2 weeks time (but “tomorrow/next week never comes”).
There seems to be something of a reality gap in the way that, for example, the Turkish shipment was reported (as if the country was going to run out tomorrow if it didn’t arrive and it was only half a week’s supply anyway) and what must actually be going on, since it’s non/delayed arrival didn’t result in immediate collapse.
Or is it, as I think the Govt claims, more a situation of some isolated/localised shortages as a result of distribution issues from centrally held stockpiles?
And are the doctors and nurses who have died, dying because of a shortage of PPE, or “just” because hospitals (COVID wards) are very dangerous places to work at the moment and even adequate PPE isn’t a guarantee of safety?
The allegation is that the ward that Dr Tun worked on had its PPE taken for a Covid-19 ward, and only reappeard after several ward patients developed it, and then only simple masks.
It is notable that very few of the recorded fatalities have been working on ICU or ED or respiratory wards when infected. They were mostly working (like myself) on the non covid side. Dr Riyat in Derby ED was an exception.
On these wards, social distancing is physically impossible and undetected cases are a real risk, until the whole ward including staff are exposed. I am told that psychiatric units are getting quite a few cases now.
PPE does protect staff, but is needed to protect patients from cross infection too. An HCW not changing apron etc between patients is quite a transmission risk. Patients on other wards are right to be wary.
In my hospital ICU and ED are well equipped, and we have a weeks supply of all PPE in stock. Whether mask, gloves and apron are really adequate when treating Covid-19 patients (current UK recommendations) is another question indeed. The hoods and long-sleeved gowns are required for aerosol generating procedures.
Right, so these doctors are no different to bus drivers or shop workers.
I thought the argument was about not having enough kit for those working with COVID-19 patients.
That is where the long sleeved gowns come in, on known Covid-19 patients.
Patients do not however arrive at a hospital with a label on their forehead saying Covid-19. Many present with ambiguous symptoms and signs. A confusional state for example, or simply being breathless. It is only after investigation that we find out if it is a urinary tract infection, worsening heart failure or Covid-19. Hence the importance of rapid, reliable testing.
PPE matters for crossinfection risk too. If we admit 6 undifferentiated patients to a bay, and 1 has it but we don't know, all 6 could have it within a couple of days.
In many ways the non covid wards are the riskiest place to be at the moment. It is Russian roulette.
When I took my dad to the Royal Surrey a couple of weeks ago, it looked like they had a separate entrance for suspected COVID-19 patients. But I guess so many people turn up at hospital with symptoms that could be COVID-19 that it’s unrealistic to consider them all as potential cases.
At the Queen Charlotte Hospital in West London - which is kind of attached to another hospital (The confusingly named Hammersmith) - the campus is a vast area. I was told that COVID was being treated in another part of the hospital, with deliberately different entrances for staff, patients and even cleaning staff.
I was there this week. I asked - and was told the above by a consultant.
I was born in the Queen Charlotte Hospital.. a long time ago!
Are there actually many credible, verified examples of NHS staff (as opposed to, say, those in the wider community who may or may not be a priority) not having the PPE that they need? As opposed to, say, hospitals worried about how they will be supplied in 1-2 weeks time (but “tomorrow/next week never comes”).
There seems to be something of a reality gap in the way that, for example, the Turkish shipment was reported (as if the country was going to run out tomorrow if it didn’t arrive and it was only half a week’s supply anyway) and what must actually be going on, since it’s non/delayed arrival didn’t result in immediate collapse.
Or is it, as I think the Govt claims, more a situation of some isolated/localised shortages as a result of distribution issues from centrally held stockpiles?
And are the doctors and nurses who have died, dying because of a shortage of PPE, or “just” because hospitals (COVID wards) are very dangerous places to work at the moment and even adequate PPE isn’t a guarantee of safety?
The allegation is that the ward that Dr Tun worked on had its PPE taken for a Covid-19 ward, and only reappeard after several ward patients developed it, and then only simple masks.
It is notable that very few of the recorded fatalities have been working on ICU or ED or respiratory wards when infected. They were mostly working (like myself) on the non covid side. Dr Riyat in Derby ED was an exception.
On these wards, social distancing is physically impossible and undetected cases are a real risk, until the whole ward including staff are exposed. I am told that psychiatric units are getting quite a few cases now.
PPE does protect staff, but is needed to protect patients from cross infection too. An HCW not changing apron etc between patients is quite a transmission risk. Patients on other wards are right to be wary.
In my hospital ICU and ED are well equipped, and we have a weeks supply of all PPE in stock. Whether mask, gloves and apron are really adequate when treating Covid-19 patients (current UK recommendations) is another question indeed. The hoods and long-sleeved gowns are required for aerosol generating procedures.
Right, so these doctors are no different to bus drivers or shop workers.
I thought the argument was about not having enough kit for those working with COVID-19 patients.
That is where the long sleeved gowns come in, on known Covid-19 patients.
Patients do not however arrive at a hospital with a label on their forehead saying Covid-19. Many present with ambiguous symptoms and signs. A confusional state for example, or simply being breathless. It is only after investigation that we find out if it is a urinary tract infection, worsening heart failure or Covid-19. Hence the importance of rapid, reliable testing.
PPE matters for crossinfection risk too. If we admit 6 undifferentiated patients to a bay, and 1 has it but we don't know, all 6 could have it within a couple of days.
In many ways the non covid wards are the riskiest place to be at the moment. It is Russian roulette.
When I took my dad to the Royal Surrey a couple of weeks ago, it looked like they had a separate entrance for suspected COVID-19 patients. But I guess so many people turn up at hospital with symptoms that could be COVID-19 that it’s unrealistic to consider them all as potential cases.
At the Queen Charlotte Hospital in West London - which is kind of attached to another hospital (The confusingly named Hammersmith) - the campus is a vast area. I was told that COVID was being treated in another part of the hospital, with deliberately different entrances for staff, patients and even cleaning staff.
I was there this week. I asked - and was told the above by a consultant.
Yes, we have had separate entrances for some weeks now too. The problem is that identification of early infectious cases is difficult, so the division will never be very reliable.
I also think that staff returning to work 7 days after resolution of fever, rather than the 14 days recommended by WHO is foolish. I don’t know why our government is so keen on this.
I think that's from the same playbook as discharging sick patients into care homes.
They rightly had as an early priority the maximum number of available beds - but there seems to be a deep institutional reluctance to question the subsequent negative effects of policies put in place to achieve that, in the face of developing evidence.
LOL @ CDS giving a press conference in his No.8 cammo rig just so we know this is srs bizniz. What a prick.
Senior military figures often seem to be seen in cammo for no reason. So I doubt it was so we know this is serious business. More likely it's so people remember who is who.
I remember watching a "modern" version of Macbeth where everyone (except Mrs M) was dressed up in cammo with face paint. It made it impossible to work out who was who in each scene until you could identify them by the script. It was....suboptimal.
Years ago I saw a film 'Joe Macbeth' where Macbeth was a New York gangster. The banquet ghost scene was at a dinner.
The common cold Coronavirus seems to be remarkably successful despite (or because of) its regular mutation.
There are several different common cold coronaviruses which regularly recur (and represent only a relatively small proportion of 'common cold' infections).
I'd have to look up how fast they mutate compared with this thing (and they won't have been studied in the same detail), but there are other reasons for their success, and lack of immune memory, which don't apply to this virus. For example:
A Human Coronavirus Responsible for the Common Cold Massively Kills Dendritic Cells but Not Monocytes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3416289/ ...Human coronaviruses are associated with upper respiratory tract infections that occasionally spread to the lungs and other organs. Although airway epithelial cells represent an important target for infection, the respiratory epithelium is also composed of an elaborate network of dendritic cells (DCs) that are essential sentinels of the immune system, sensing pathogens and presenting foreign antigens to T lymphocytes. In this report, we show that in vitro infection by human coronavirus 229E (HCoV-229E) induces massive cytopathic effects in DCs, including the formation of large syncytia and cell death within only few hours. In contrast, monocytes are much more resistant to infection and cytopathic effects despite similar expression levels of CD13, the membrane receptor for HCoV-229E. While the differentiation of monocytes into DCs in the presence of granulocyte-macrophage colony-stimulating factor and interleukin-4 requires 5 days, only 24 h are sufficient for these cytokines to sensitize monocytes to cell death and cytopathic effects when infected by HCoV-229E. Cell death induced by HCoV-229E is independent of TRAIL, FasL, tumor necrosis factor alpha, and caspase activity, indicating that viral replication is directly responsible for the observed cytopathic effects. The consequence of DC death at the early stage of HCoV-229E infection may have an impact on the early control of viral dissemination and on the establishment of long-lasting immune memory, since people can be reinfected multiple times by HCoV-229E....
We know from the earlier SARS outbreak that antibodies to that persisted in the blood for over a decade.
The point has also been made that an effective vaccine would likely produce a far more specific and significant antibody response than seems to be the case with the infection itself in many individuals.
We've not seen that with common cold coronaviruses because it's never been even remotely economic to think about developing a vaccine to an individual common cold coronavirus.
I looked at @Black_Rook 's suggestion yesterday that under 60s be allowed to exit the lockdown due to their lower (comparative) risk. And because I wanted it to be feasible, I crunched the numbers.
There's a perception that covid-19 is "less fatal than seasonal 'flu for the under-60s, and we don't lock down for that," so surely we can do this?
Infectivity Problem is R0 (well, Rt - the transmission rate after interventions). In essence, most of the time, you aren't catching seasonal flu, even when someone around is infective. R0 for seasonal flu is around 1.3, and we vaccinate 14 million per year (over 20% of the population). This gives us almost the level we need for herd immunity, anyway (Rt goes to 1.02). Compare to R0 of 3.0 for coid-19 (may be higher).
After 10 transmissions, the index case of seasonal flu has infected 11.4 other people on average (so a clump of 100 sufferers infects a total of 114 others over the season).
After 10 transmissions, the index case of covid-19 has infected 88,572 others on average (so a clump of 100 sufferers infects a total of nearly 9 million others).
Exponential growth is a bastard.
Fatality rate Say, for the sake of argument, the death rate is only a tenth in our "freed" population. And it is 300 per day when we unlock (most of which are elderly). It would equate to only 30 per day in the "freed" population. Deaths doubling every 3-4 days means 120 per day after one week.
After 2 weeks, just under 500 per day.
After 3 weeks, 2000 per day (and, remember, these are the "freed" population).
Ah, but won't we hit herd immunity amongst this population? (I may be reaching for straws, but let's check to see if it's a straw or a vine)
The problem comes from saturation of the NHS (again). We escaped it this time, probably be a decent factor - but time is so crucial against an exponential rise (if we were only reaching 25% saturation of the NHS, then if we'd waited more than 7 days before imposing the restrictions we did, we'd have blasted past the maximum capacity while still accelerating. Exponential growth is a bastard).
Get past saturation, and those who need hospitalisation - don't get it. So what happens to you if you need hospital help and it's unavailable? One would expect your chance of death would go up quite significantly (otherwise, well, you didn't need hospital, did you?). If one third of those who need hospitalisation and don't get it end up dying, and the hospitalisation rate is compatible with an overall 0.66% IFR (which may be significantly too low, from the report yesterday) - Over 250,000 of the "freed" population will die
Okay, shift to only under fifties. (So I stay in the population). It improves - to a degree. Over 140,000 of them die.
Okay, only people up to their thirties. Over 70,000 die. Which looks better - but only in comparison to what we've seen before. If 70,000 were to die in "normal" circumstances, we'd be horrified.
Doesn't look to be a goer. Bugger.
To add to that - these are the optimistic numbers. The antibody test alluded to last night implied that the hospitalisation and death rates could be double what they are assumed to be in this calculation. And, of course, those needing hospitalisation and not getting it could easily be more likely to die than assumed. Numbers could very plausibly be as much as triple what they are above.
LOL @ CDS giving a press conference in his No.8 cammo rig just so we know this is srs bizniz. What a prick.
Senior military figures often seem to be seen in cammo for no reason. So I doubt it was so we know this is serious business. More likely it's so people remember who is who.
I remember watching a "modern" version of Macbeth where everyone (except Mrs M) was dressed up in cammo with face paint. It made it impossible to work out who was who in each scene until you could identify them by the script. It was....suboptimal.
As Twitter pointed out, though, the press conference cammo was itself sub optimal in front of a wood panelling backdrop....
Clearly Conservative voters are much more supportive of the government than Labour voters, and leave voters are more supportive than remain voters. Given that Conservative voters tend to be leave supporters and Labour voters remain supporters this is no surprise.
However, some leave supporters must be very worried about the economy. If the economy is flattened by the lockdown the UK might have to realign with the EU or rejoin it eventually. This is exactly what many leave supporters do not want to happen.
Also, leave and remain supporters may have different values on social issues related to their different views on the EU. These different values may also influence people's views on the response to the epidemic.
I’m of the view that Covid-19 is one of the best things that could have happened for the ultra-hard tungsten-tipped Brexiteers.
The whole EU could impose a boycott of all British goods from 1st January 2021 and the French could set-up machine gun posts at Calais to shoot up any British lorries that try to get through and the economic consequences would still be blamed on coronavirus.
It will mask everything and virtually any form of Brexit will pale into insignificance next to its fall-out, so HMG can basically now pursue whatever form of it they like.
I looked at @Black_Rook 's suggestion yesterday that under 60s be allowed to exit the lockdown due to their lower (comparative) risk. And because I wanted it to be feasible, I crunched the numbers.
There's a perception that covid-19 is "less fatal than seasonal 'flu for the under-60s, and we don't lock down for that," so surely we can do this?
Infectivity Problem is R0 (well, Rt - the transmission rate after interventions). In essence, most of the time, you aren't catching seasonal flu, even when someone around is infective. R0 for seasonal flu is around 1.3, and we vaccinate 14 million per year (over 20% of the population). This gives us almost the level we need for herd immunity, anyway (Rt goes to 1.02). Compare to R0 of 3.0 for coid-19 (may be higher).
After 10 transmissions, the index case of seasonal flu has infected 11.4 other people on average (so a clump of 100 sufferers infects a total of 114 others over the season).
After 10 transmissions, the index case of covid-19 has infected 88,572 others on average (so a clump of 100 sufferers infects a total of nearly 9 million others).
Exponential growth is a bastard.
Fatality rate Say, for the sake of argument, the death rate is only a tenth in our "freed" population. And it is 300 per day when we unlock (most of which are elderly). It would equate to only 30 per day in the "freed" population. Deaths doubling every 3-4 days means 120 per day after one week.
After 2 weeks, just under 500 per day.
After 3 weeks, 2000 per day (and, remember, these are the "freed" population).
Ah, but won't we hit herd immunity amongst this population? (I may be reaching for straws, but let's check to see if it's a straw or a vine)
The problem comes from saturation of the NHS (again). We escaped it this time, probably be a decent factor - but time is so crucial against an exponential rise (if we were only reaching 25% saturation of the NHS, then if we'd waited more than 7 days before imposing the restrictions we did, we'd have blasted past the maximum capacity while still accelerating. Exponential growth is a bastard).
Get past saturation, and those who need hospitalisation - don't get it. So what happens to you if you need hospital help and it's unavailable? One would expect your chance of death would go up quite significantly (otherwise, well, you didn't need hospital, did you?). If one third of those who need hospitalisation and don't get it end up dying, and the hospitalisation rate is compatible with an overall 0.66% IFR (which may be significantly too low, from the report yesterday) - Over 250,000 of the "freed" population will die
Okay, shift to only under fifties. (So I stay in the population). It improves - to a degree. Over 140,000 of them die.
Okay, only people up to their thirties. Over 70,000 die. Which looks better - but only in comparison to what we've seen before. If 70,000 were to die in "normal" circumstances, we'd be horrified.
Doesn't look to be a goer. Bugger.
To add to that - these are the optimistic numbers. The antibody test alluded to last night implied that the hospitalisation and death rates could be double what they are assumed to be in this calculation. And, of course, those needing hospitalisation and not getting it could easily be more likely to die than assumed. Numbers could very plausibly be as much as triple what they are above.
Do you consider the IFR as a function of age? Not clear from the above, but since there is such a clear effect you would have to incorporate that in any such analysis, no?
The NZ nurse who attended Johnson on R4 - he needed to be there, got same treatment as everyone else and didn’t get special treatment.
I get why she is saying what she is saying, but I would hope that the Prime Minister would get special treatment if necessary.
Do other patients in intensive care typically get two nurses standing by their bedside 24/7?
My experience, sample one, from the Royal London is that intensive care is delivered in wards of four beds with four nurses in the room, each patient being dedicated a nurse but so that as and when that nurse needs to leave the room briefly there are other nurses available to keep an eye on their patient. So the ratio was 1:1 24/7, but more than one nurse at any given time would be very familiar with each patient.
The NZ nurse who attended Johnson on R4 - he needed to be there, got same treatment as everyone else and didn’t get special treatment.
I get why she is saying what she is saying, but I would hope that the Prime Minister would get special treatment if necessary.
Not sure that doctors etc would accept that under modern medical ethics.
I remember being present when a stupid hack asked a very senior medical chap about his service in the Falklands. The mere suggestion that he would have treated Argentine and British casualties differently was taken as a disgusting attack on the surgeons medical ethics.
I looked at @Black_Rook 's suggestion yesterday that under 60s be allowed to exit the lockdown due to their lower (comparative) risk. And because I wanted it to be feasible, I crunched the numbers.
There's a perception that covid-19 is "less fatal than seasonal 'flu for the under-60s, and we don't lock down for that," so surely we can do this?
Infectivity Problem is R0 (well, Rt - the transmission rate after interventions). In essence, most of the time, you aren't catching seasonal flu, even when someone around is infective. R0 for seasonal flu is around 1.3, and we vaccinate 14 million per year (over 20% of the population). This gives us almost the level we need for herd immunity, anyway (Rt goes to 1.02). Compare to R0 of 3.0 for coid-19 (may be higher).
After 10 transmissions, the index case of seasonal flu has infected 11.4 other people on average (so a clump of 100 sufferers infects a total of 114 others over the season).
After 10 transmissions, the index case of covid-19 has infected 88,572 others on average (so a clump of 100 sufferers infects a total of nearly 9 million others).
Exponential growth is a bastard.
Fatality rate Say, for the sake of argument, the death rate is only a tenth in our "freed" population. And it is 300 per day when we unlock (most of which are elderly). It would equate to only 30 per day in the "freed" population. Deaths doubling every 3-4 days means 120 per day after one week.
After 2 weeks, just under 500 per day.
After 3 weeks, 2000 per day (and, remember, these are the "freed" population).
Ah, but won't we hit herd immunity amongst this population? (I may be reaching for straws, but let's check to see if it's a straw or a vine)
The problem comes from saturation of the NHS (again). We escaped it this time, probably be a decent factor - but time is so crucial against an exponential rise (if we were only reaching 25% saturation of the NHS, then if we'd waited more than 7 days before imposing the restrictions we did, we'd have blasted past the maximum capacity while still accelerating. Exponential growth is a bastard).
Get past saturation, and those who need hospitalisation - don't get it. So what happens to you if you need hospital help and it's unavailable? One would expect your chance of death would go up quite significantly (otherwise, well, you didn't need hospital, did you?). If one third of those who need hospitalisation and don't get it end up dying, and the hospitalisation rate is compatible with an overall 0.66% IFR (which may be significantly too low, from the report yesterday) - Over 250,000 of the "freed" population will die
Okay, shift to only under fifties. (So I stay in the population). It improves - to a degree. Over 140,000 of them die.
Okay, only people up to their thirties. Over 70,000 die. Which looks better - but only in comparison to what we've seen before. If 70,000 were to die in "normal" circumstances, we'd be horrified.
Doesn't look to be a goer. Bugger.
To add to that - these are the optimistic numbers. The antibody test alluded to last night implied that the hospitalisation and death rates could be double what they are assumed to be in this calculation. And, of course, those needing hospitalisation and not getting it could easily be more likely to die than assumed. Numbers could very plausibly be as much as triple what they are above.
Do you consider the IFR as a function of age? Not clear from the above, but since there is such a clear effect you would have to incorporate that in any such analysis, no?
Yes. Well, the hospitalisation rate as a function of age, since that is what drives the fatality rate in the modelling once the NHS is saturated (which happens quite quickly). Numbers for hospitalisation rates against age taken from estimates at https://www.imperial.ac.uk/news/196573/covid-19-one-five-over-80s-need-hospitalisation/ (which assumes 50% asymptomatic and an overall whole population IFR of 0.66%)
I looked at @Black_Rook 's suggestion yesterday that under 60s be allowed to exit the lockdown due to their lower (comparative) risk. And because I wanted it to be feasible, I crunched the numbers.
There's a perception that covid-19 is "less fatal than seasonal 'flu for the under-60s, and we don't lock down for that," so surely we can do this?
Infectivity Problem is R0 (well, Rt - the transmission rate after interventions). In essence, most of the time, you aren't catching seasonal flu, even when someone around is infective. R0 for seasonal flu is around 1.3, and we vaccinate 14 million per year (over 20% of the population). This gives us almost the level we need for herd immunity, anyway (Rt goes to 1.02). Compare to R0 of 3.0 for coid-19 (may be higher).
After 10 transmissions, the index case of seasonal flu has infected 11.4 other people on average (so a clump of 100 sufferers infects a total of 114 others over the season).
After 10 transmissions, the index case of covid-19 has infected 88,572 others on average (so a clump of 100 sufferers infects a total of nearly 9 million others).
Exponential growth is a bastard.
Fatality rate Say, for the sake of argument, the death rate is only a tenth in our "freed" population. And it is 300 per day when we unlock (most of which are elderly). It would equate to only 30 per day in the "freed" population. Deaths doubling every 3-4 days means 120 per day after one week.
After 2 weeks, just under 500 per day.
After 3 weeks, 2000 per day (and, remember, these are the "freed" population).
Ah, but won't we hit herd immunity amongst this population? (I may be reaching for straws, but let's check to see if it's a straw or a vine)
The problem comes from saturation of the NHS (again). We escaped it this time, probably be a decent factor - but time is so crucial against an exponential rise (if we were only reaching 25% saturation of the NHS, then if we'd waited more than 7 days before imposing the restrictions we did, we'd have blasted past the maximum capacity while still accelerating. Exponential growth is a bastard).
Get past saturation, and those who need hospitalisation - don't get it. So what happens to you if you need hospital help and it's unavailable? One would expect your chance of death would go up quite significantly (otherwise, well, you didn't need hospital, did you?). If one third of those who need hospitalisation and don't get it end up dying, and the hospitalisation rate is compatible with an overall 0.66% IFR (which may be significantly too low, from the report yesterday) - Over 250,000 of the "freed" population will die
Okay, shift to only under fifties. (So I stay in the population). It improves - to a degree. Over 140,000 of them die.
Okay, only people up to their thirties. Over 70,000 die. Which looks better - but only in comparison to what we've seen before. If 70,000 were to die in "normal" circumstances, we'd be horrified.
Doesn't look to be a goer. Bugger.
To add to that - these are the optimistic numbers. The antibody test alluded to last night implied that the hospitalisation and death rates could be double what they are assumed to be in this calculation. And, of course, those needing hospitalisation and not getting it could easily be more likely to die than assumed. Numbers could very plausibly be as much as triple what they are above.
I note that in Leicester, the number discharged home has been running at twice the mortality for some weeks. It looks overall to have a mortality rate of 33% or so for hospitalised patients. This is considerably higher than other countries, possibly because we admit fewer mild cases. There are other possibilities though.
It is NI voters who decide on the Union not GB voters (though most Tory and LD voters do want to keep NI in the UK unlike Labour voters who back a united Ireland)
Guns and tasers be used to force people to go for testing ?
You think that hordes of people are turning down the opportunity?
The government's target is stil on its website. It's a shame to see an experienced, if highly partisan, journalist like Andrew Neil fall for the government's latest spin because it matches his own ideological agenda.
It is NI voters who decide on the Union not GB voters (though most Tory and LD voters do want to keep NI in the UK unlike Labour voters who back a united Ireland)
Given Tories are the staunchest Leavers and LDs the staunchest Remainers and both back the Union clearly Brexit is not the key divide
Are there actually many credible, verified examples of NHS staff (as opposed to, say, those in the wider community who may or may not be a priority) not having the PPE that they need? As opposed to, say, hospitals worried about how they will be supplied in 1-2 weeks time (but “tomorrow/next week never comes”).
There seems to be something of a reality gap in the way that, for example, the Turkish shipment was reported (as if the country was going to run out tomorrow if it didn’t arrive and it was only half a week’s supply anyway) and what must actually be going on, since it’s non/delayed arrival didn’t result in immediate collapse.
Or is it, as I think the Govt claims, more a situation of some isolated/localised shortages as a result of distribution issues from centrally held stockpiles?
And are the doctors and nurses who have died, dying because of a shortage of PPE, or “just” because hospitals (COVID wards) are very dangerous places to work at the moment and even adequate PPE isn’t a guarantee of safety?
The allegation is that the ward that Dr Tun worked on had its PPE taken for a Covid-19 ward, and only reappeard after several ward patients developed it, and then only simple masks.
It is notable that very few of the recorded fatalities have been working on ICU or ED or respiratory wards when infected. They were mostly working (like myself) on the non covid side. Dr Riyat in Derby ED was an exception.
On these wards, social distancing is physically impossible and undetected cases are a real risk, until the whole ward including staff are exposed. I am told that psychiatric units are getting quite a few cases now.
PPE does protect staff, but is needed to protect patients from cross infection too. An HCW not changing apron etc between patients is quite a transmission risk. Patients on other wards are right to be wary.
In my hospital ICU and ED are well equipped, and we have a weeks supply of all PPE in stock. Whether mask, gloves and apron are really adequate when treating Covid-19 patients (current UK recommendations) is another question indeed. The hoods and long-sleeved gowns are required for aerosol generating procedures.
Right, so these doctors are no different to bus drivers or shop workers.
I thought the argument was about not having enough kit for those working with COVID-19 patients.
"I am told that psychiatric units are getting quite a few cases now."
I have been sadly waiting, excepting to hear of terrible problems in psychiatry units (which is like another care home, with a much younger, physically fitter profile). And yet there has been deafening silence, which I took to be unexpected good news.
We can only hope that that younger, fitter profile helps but in my recent experience attending psychiatric wards there is a significant number of older patients who are suffering the longer term consequences of substance abuse/early dementia who must be vulnerable. I also fear that approaching paranoid and delusional patients dressed up in what looks like a space suit is going to have a whole range of challenges in itself.
A lot of patients on psychiatric wards are not delusional but have other issues, and even most delusional patients can tell the difference between wearing PPE and a space suit. However there is a fundamental problem with introducing social distancing measures into a psychiatric ward. Many psychiatric patients have problems with relating to people, and learning to deal with people is part of their recovery. Introducing social distancing into a psychiatric unit would directly interfere with many patients recovery and in some cases this could make them suicidal or could actually cause them to commit suicide or become unstable in some other way. This would be particularly risky with acutely ill patients.
I presume also that there has been a ban on relatives visiting? Again, I have heard nothing.
It seems that the policy for all hospital visitors at the moment is that visitors are discouraged but they may be allowed on compassionate grounds, especially if the patient is severely ill and neither the patient nor the visitor has coronavirus symptoms.
I looked at @Black_Rook 's suggestion yesterday that under 60s be allowed to exit the lockdown due to their lower (comparative) risk. And because I wanted it to be feasible, I crunched the numbers.
There's a perception that covid-19 is "less fatal than seasonal 'flu for the under-60s, and we don't lock down for that," so surely we can do this?
Infectivity Problem is R0 (well, Rt - the transmission rate after interventions). In essence, most of the time, you aren't catching seasonal flu, even when someone around is infective. R0 for seasonal flu is around 1.3, and we vaccinate 14 million per year (over 20% of the population). This gives us almost the level we need for herd immunity, anyway (Rt goes to 1.02). Compare to R0 of 3.0 for coid-19 (may be higher).
After 10 transmissions, the index case of seasonal flu has infected 11.4 other people on average (so a clump of 100 sufferers infects a total of 114 others over the season).
After 10 transmissions, the index case of covid-19 has infected 88,572 others on average (so a clump of 100 sufferers infects a total of nearly 9 million others).
Exponential growth is a bastard.
Fatality rate Say, for the sake of argument, the death rate is only a tenth in our "freed" population. And it is 300 per day when we unlock (most of which are elderly). It would equate to only 30 per day in the "freed" population. Deaths doubling every 3-4 days means 120 per day after one week.
After 2 weeks, just under 500 per day.
After 3 weeks, 2000 per day (and, remember, these are the "freed" population).
Ah, but won't we hit herd immunity amongst this population? (I may be reaching for straws, but let's check to see if it's a straw or a vine)
The problem comes from saturation of the NHS (again). We escaped it this time, probably be a decent factor - but time is so crucial against an exponential rise (if we were only reaching 25% saturation of the NHS, then if we'd waited more than 7 days before imposing the restrictions we did, we'd have blasted past the maximum capacity while still accelerating. Exponential growth is a bastard).
Get past saturation, and those who need hospitalisation - don't get it. So what happens to you if you need hospital help and it's unavailable? One would expect your chance of death would go up quite significantly (otherwise, well, you didn't need hospital, did you?). If one third of those who need hospitalisation and don't get it end up dying, and the hospitalisation rate is compatible with an overall 0.66% IFR (which may be significantly too low, from the report yesterday) - Over 250,000 of the "freed" population will die
Okay, shift to only under fifties. (So I stay in the population). It improves - to a degree. Over 140,000 of them die.
Okay, only people up to their thirties. Over 70,000 die. Which looks better - but only in comparison to what we've seen before. If 70,000 were to die in "normal" circumstances, we'd be horrified.
Doesn't look to be a goer. Bugger.
To add to that - these are the optimistic numbers. The antibody test alluded to last night implied that the hospitalisation and death rates could be double what they are assumed to be in this calculation. And, of course, those needing hospitalisation and not getting it could easily be more likely to die than assumed. Numbers could very plausibly be as much as triple what they are above.
I note that in Leicester, the number discharged home has been running at twice the mortality for some weeks. It looks overall to have a mortality rate of 33% or so for hospitalised patients. This is considerably higher than other countries, possibly because we admit fewer mild cases. There are other possibilities though.
What mortality rate, from your experience, would you estimate for those hospitalised - if they'd not been able to be hospitalised?
Yes. Well, the hospitalisation rate as a function of age, since that is what drives the fatality rate in the modelling once the NHS is saturated (which happens quite quickly). Numbers for hospitalisation rates against age taken from estimates at https://www.imperial.ac.uk/news/196573/covid-19-one-five-over-80s-need-hospitalisation/ (which assumes 50% asymptomatic and an overall whole population IFR of 0.66%)
We don't know the exact fatality rate, but even assuming 2%, which is probably significantly on the high side, and noting that something like ten times as many over fifties appear to die from the infection as under fifties, that would give a 0.2% fatality rate.
Which if the entire under fifties population were infected would be somewhere around 100,000 deaths. And that is a high end estimate both of total infected and IFR.
For under thirties, I think the numbers would probably be somewhere around a tenth of that.
But of course allowing under thirties out unrestricted means they will very likely infect older people too.
It may seem a pedantic point but I think Mike has this exactly the wrong way round.
It is not that Leave voters are less critical, it is rather that some Remain supporters - who already have a huge axe to grind with the Government over Brexit - are overly critical. They have a preconceived idea of Boris and his ministers and are unwilling to look at failings in a reasonable and reasoned manner. For them it is imply another excuse to attack a Government they already hated.
There is plenty of criticism of the Government handling of aspects of the crisis coming from Leave supporters but it is nothing like the vitriol and instinctive opposition - almost a hope that they will fail - that is coming from some Remain supporters.
LOL @ CDS giving a press conference in his No.8 cammo rig just so we know this is srs bizniz. What a prick.
Senior military figures often seem to be seen in cammo for no reason. So I doubt it was so we know this is serious business. More likely it's so people remember who is who.
I remember watching a "modern" version of Macbeth where everyone (except Mrs M) was dressed up in cammo with face paint. It made it impossible to work out who was who in each scene until you could identify them by the script. It was....suboptimal.
I think that was the Macbeth we saw a couple of years ago in Bath. Just to further complicate the production, different actors took the role of Macbeth during different scenes.
The NZ nurse who attended Johnson on R4 - he needed to be there, got same treatment as everyone else and didn’t get special treatment.
I get why she is saying what she is saying, but I would hope that the Prime Minister would get special treatment if necessary.
Not sure that doctors etc would accept that under modern medical ethics.
I remember being present when a stupid hack asked a very senior medical chap about his service in the Falklands. The mere suggestion that he would have treated Argentine and British casualties differently was taken as a disgusting attack on the surgeons medical ethics.
Surgeon Commander Rick Jolly (who commanded the military base hospital in the Falklands) is an exceptional man. He ran a hospital with very few deaths and two unexploded bombs in the roof, treating both sides by medical need.
I think he is unique in being decorated by both sides for the same action in the same war. A few years later he visited Argentina and effusively thanked by his former Argentine patients.
He is a great guy, and still living, I think. I saw him speak on the subject of treating bullet wounds based upon his work in Northern Ireland.
LOL @ CDS giving a press conference in his No.8 cammo rig just so we know this is srs bizniz. What a prick.
Senior military figures often seem to be seen in cammo for no reason. So I doubt it was so we know this is serious business. More likely it's so people remember who is who.
I remember watching a "modern" version of Macbeth where everyone (except Mrs M) was dressed up in cammo with face paint. It made it impossible to work out who was who in each scene until you could identify them by the script. It was....suboptimal.
Years ago I saw a film 'Joe Macbeth' where Macbeth was a New York gangster. The banquet ghost scene was at a dinner.
Some of us see it as a positive outcome of Brexit rather than an unfortunate consequence. It helps to right a historic wrong.
Actually it is only 2019 Labour voters who back a united Ireland, the vast majority of Tory voters and most LD voters back Northern Ireland staying in the UK.
Of course most Unionists in Northern Ireland are of Presbyterian Scottish origin anyway
The NZ nurse who attended Johnson on R4 - he needed to be there, got same treatment as everyone else and didn’t get special treatment.
I get why she is saying what she is saying, but I would hope that the Prime Minister would get special treatment if necessary.
Not sure that doctors etc would accept that under modern medical ethics.
I remember being present when a stupid hack asked a very senior medical chap about his service in the Falklands. The mere suggestion that he would have treated Argentine and British casualties differently was taken as a disgusting attack on the surgeons medical ethics.
Surgeon Commander Rick Jolly (who commanded the military base hospital in the Falklands) is an exceptional man. He ran a hospital with very few deaths and two unexploded bombs in the roof, treating both sides by medical need.
I think he is unique in being decorated by both sides for the same action in the same war. A few years later he visited Argentina and effusively thanked by his former Argentine patients.
He is a great guy, and still living, I think. I saw him speak on the subject of treating bullet wounds based upon his work in Northern Ireland.
I looked at @Black_Rook 's suggestion yesterday that under 60s be allowed to exit the lockdown due to their lower (comparative) risk. And because I wanted it to be feasible, I crunched the numbers.
There's a perception that covid-19 is "less fatal than seasonal 'flu for the under-60s, and we don't lock down for that," so surely we can do this?
Infectivity Problem is R0 (well, Rt - the transmission rate after interventions). In essence, most of the time, you aren't catching seasonal flu, even when someone around is infective. R0 for seasonal flu is around 1.3, and we vaccinate 14 million per year (over 20% of the population). This gives us almost the level we need for herd immunity, anyway (Rt goes to 1.02). Compare to R0 of 3.0 for coid-19 (may be higher).
After 10 transmissions, the index case of seasonal flu has infected 11.4 other people on average (so a clump of 100 sufferers infects a total of 114 others over the season).
After 10 transmissions, the index case of covid-19 has infected 88,572 others on average (so a clump of 100 sufferers infects a total of nearly 9 million others).
Exponential growth is a bastard.
Fatality rate Say, for the sake of argument, the death rate is only a tenth in our "freed" population. And it is 300 per day when we unlock (most of which are elderly). It would equate to only 30 per day in the "freed" population. Deaths doubling every 3-4 days means 120 per day after one week.
After 2 weeks, just under 500 per day.
After 3 weeks, 2000 per day (and, remember, these are the "freed" population).
Ah, but won't we hit herd immunity amongst this population? (I may be reaching for straws, but let's check to see if it's a straw or a vine)
The problem comes from saturation of the NHS (again). We escaped it this time, probably be a decent factor - but time is so crucial against an exponential rise (if we were only reaching 25% saturation of the NHS, then if we'd waited more than 7 days before imposing the restrictions we did, we'd have blasted past the maximum capacity while still accelerating. Exponential growth is a bastard).
Get past saturation, and those who need hospitalisation - don't get it. So what happens to you if you need hospital help and it's unavailable? One would expect your chance of death would go up quite significantly (otherwise, well, you didn't need hospital, did you?). If one third of those who need hospitalisation and don't get it end up dying, and the hospitalisation rate is compatible with an overall 0.66% IFR (which may be significantly too low, from the report yesterday) - Over 250,000 of the "freed" population will die
Okay, shift to only under fifties. (So I stay in the population). It improves - to a degree. Over 140,000 of them die.
Okay, only people up to their thirties. Over 70,000 die. Which looks better - but only in comparison to what we've seen before. If 70,000 were to die in "normal" circumstances, we'd be horrified.
Doesn't look to be a goer. Bugger.
To add to that - these are the optimistic numbers. The antibody test alluded to last night implied that the hospitalisation and death rates could be double what they are assumed to be in this calculation. And, of course, those needing hospitalisation and not getting it could easily be more likely to die than assumed. Numbers could very plausibly be as much as triple what they are above.
I note that in Leicester, the number discharged home has been running at twice the mortality for some weeks. It looks overall to have a mortality rate of 33% or so for hospitalised patients. This is considerably higher than other countries, possibly because we admit fewer mild cases. There are other possibilities though.
What mortality rate, from your experience, would you estimate for those hospitalised - if they'd not been able to be hospitalised?
Yes. Well, the hospitalisation rate as a function of age, since that is what drives the fatality rate in the modelling once the NHS is saturated (which happens quite quickly). Numbers for hospitalisation rates against age taken from estimates at https://www.imperial.ac.uk/news/196573/covid-19-one-five-over-80s-need-hospitalisation/ (which assumes 50% asymptomatic and an overall whole population IFR of 0.66%)
We don't know the exact fatality rate, but even assuming 2%, which is probably significantly on the high side, and noting that something like ten times as many over fifties appear to die from the infection as under fifties, that would give a 0.2% fatality rate.
Which if the entire under fifties population were infected would be somewhere around 100,000 deaths. And that is a high end estimate both of total infected and IFR.
For under thirties, I think the numbers would probably be somewhere around a tenth of that.
But of course allowing under thirties out unrestricted means they will very likely infect older people too.
That estimate is assuming they get care. If too many are infected, they won't be getting care.
1-2% of those in their 20s will need hospital care. 3.5-7% of those in their 30s. 4.3-8.6% of those in their forties, and 8.2-16.4% of those in their fifties.
Moth du Jour: Peppered Moth. Starting to get some of the big bruisers turning up at the trap now. I have a sneaky feeling the Vulcan bomber designer might have been a lepidopterist....
Forget that, Michael Farzan talk linked on last thread. By a country mile the best CV video i have seen so far. Not can it beat it, how exactly IT WILL.
True - but he is building his argument on some assumptions that other experts aren’t yet taking for granted. For example that the virus is relatively stable and non-mutating, and therefore a vaccine should be effective and enduring.
I don’t know whether this is so or not. It does seem to me that we are still finding out about it, through research. And I have seen other medical experts warning that it is too early to say how long any vaccine might work for. And it isn’t so long since we were hearing about different strains of the virus in different locations.
But in all those strains, the regions of interest from the point of view of how the virus binds with its target (and from a vaccine point of view) are conserved. If they were to mutate significantly then the virus itself would likely be ineffective. (Which is to say that such mutations might well already have occurred, but not reproduced.)
The common cold Coronavirus seems to be remarkably successful despite (or because of) its regular mutation.
Common cold is Rhinovirus not coronavirus.
There are 5 (I think) viral families that produce “cold-like symptoms”.
Rhinovirus (“the common cold” Coronavirus (SARS, MERS, Corvid-19) Parainfluenza RSV
I looked at @Black_Rook 's suggestion yesterday that under 60s be allowed to exit the lockdown due to their lower (comparative) risk. And because I wanted it to be feasible, I crunched the numbers.
There's a perception that covid-19 is "less fatal than seasonal 'flu for the under-60s, and we don't lock down for that," so surely we can do this?
Infectivity Problem is R0 (well, Rt - the transmission rate after interventions). In essence, most of the time, you aren't catching seasonal flu, even when someone around is infective. R0 for seasonal flu is around 1.3, and we vaccinate 14 million per year (over 20% of the population). This gives us almost the level we need for herd immunity, anyway (Rt goes to 1.02). Compare to R0 of 3.0 for coid-19 (may be higher).
After 10 transmissions, the index case of seasonal flu has infected 11.4 other people on average (so a clump of 100 sufferers infects a total of 114 others over the season).
After 10 transmissions, the index case of covid-19 has infected 88,572 others on average (so a clump of 100 sufferers infects a total of nearly 9 million others).
Exponential growth is a bastard.
Fatality rate Say, for the sake of argument, the death rate is only a tenth in our "freed" population. And it is 300 per day when we unlock (most of which are elderly). It would equate to only 30 per day in the "freed" population. Deaths doubling every 3-4 days means 120 per day after one week.
After 2 weeks, just under 500 per day.
After 3 weeks, 2000 per day (and, remember, these are the "freed" population).
Ah, but won't we hit herd immunity amongst this population? (I may be reaching for straws, but let's check to see if it's a straw or a vine)
The problem comes from saturation of the NHS (again). We escaped it this time, probably be a decent factor - but time is so crucial against an exponential rise (if we were only reaching 25% saturation of the NHS, then if we'd waited more than 7 days before imposing the restrictions we did, we'd have blasted past the maximum capacity while still accelerating. Exponential growth is a bastard).
Get past saturation, and those who need hospitalisation - don't get it. So what happens to you if you need hospital help and it's unavailable? One would expect your chance of death would go up quite significantly (otherwise, well, you didn't need hospital, did you?). If one third of those who need hospitalisation and don't get it end up dying, and the hospitalisation rate is compatible with an overall 0.66% IFR (which may be significantly too low, from the report yesterday) - Over 250,000 of the "freed" population will die
Okay, shift to only under fifties. (So I stay in the population). It improves - to a degree. Over 140,000 of them die.
Okay, only people up to their thirties. Over 70,000 die. Which looks better - but only in comparison to what we've seen before. If 70,000 were to die in "normal" circumstances, we'd be horrified.
Doesn't look to be a goer. Bugger.
To add to that - these are the optimistic numbers. The antibody test alluded to last night implied that the hospitalisation and death rates could be double what they are assumed to be in this calculation. And, of course, those needing hospitalisation and not getting it could easily be more likely to die than assumed. Numbers could very plausibly be as much as triple what they are above.
I note that in Leicester, the number discharged home has been running at twice the mortality for some weeks. It looks overall to have a mortality rate of 33% or so for hospitalised patients. This is considerably higher than other countries, possibly because we admit fewer mild cases. There are other possibilities though.
What did you make of the suggestion that Germany (for example) has a lower fatality rate partly because they actively admit patients at an earlier stage of disease progression ?
Is Angela Merkel still planning to step down as Chancellor next year? If so, is there any chance she could be asked to come over here and take over from Boris?
Is Angela Merkel still planning to step down as Chancellor next year? If so, is there any chance she could be asked to come over here and take over from Boris?
Some of us see it as a positive outcome of Brexit rather than an unfortunate consequence. It helps to right a historic wrong.
There's nothing positive about the break-up of the UK - whatsoever.
And I'd be very careful about reaching into history and arguing that your political preferences today help to correct some of those (heavily mythologised) wrongs, particularly where such black & white views could lead to all sorts of unintended consequences.
You might find your political opponents want to do the same when they take office over something they really value too.
Guns and tasers be used to force people to go for testing ?
That really wouldn't be necessary. As the government (and Raab yesterday) acknowledge, it is they who have are managing demand for tests. If the capacity were readily accessible, there are tens of thousands of healthcare and care home staff who would want testing now.
Forget that, Michael Farzan talk linked on last thread. By a country mile the best CV video i have seen so far. Not can it beat it, how exactly IT WILL.
True - but he is building his argument on some assumptions that other experts aren’t yet taking for granted. For example that the virus is relatively stable and non-mutating, and therefore a vaccine should be effective and enduring.
I don’t know whether this is so or not. It does seem to me that we are still finding out about it, through research. And I have seen other medical experts warning that it is too early to say how long any vaccine might work for. And it isn’t so long since we were hearing about different strains of the virus in different locations.
But in all those strains, the regions of interest from the point of view of how the virus binds with its target (and from a vaccine point of view) are conserved. If they were to mutate significantly then the virus itself would likely be ineffective. (Which is to say that such mutations might well already have occurred, but not reproduced.)
The common cold Coronavirus seems to be remarkably successful despite (or because of) its regular mutation.
Common cold is Rhinovirus not coronavirus.
There are 5 (I think) viral families that produce “cold-like symptoms”.
Rhinovirus (“the common cold” Coronavirus (SARS, MERS, Corvid-19) Parainfluenza RSV
Forget the other
That's only four Edit: Sorry I mis-read your post!
According to Wiki coronavirus causes 15% of common colds.
It is NI voters who decide on the Union not GB voters (though most Tory and LD voters do want to keep NI in the UK unlike Labour voters who back a united Ireland)
Given Tories are the staunchest Leavers and LDs the staunchest Remainers and both back the Union clearly Brexit is not the key divide
Tory voters support a border poll by 32 to 30 in the same poll.
Do we have stats on that question pre 2015 though?
I’m a mainland unionist who thinks it would be a shame but it’s up to them and if they decide to go I won’t really care. Nothing t do with Brexit though.
Is Angela Merkel still planning to step down as Chancellor next year? If so, is there any chance she could be asked to come over here and take over from Boris?
It may seem a pedantic point but I think Mike has this exactly the wrong way round.
It is not that Leave voters are less critical, it is rather that some Remain supporters - who already have a huge axe to grind with the Government over Brexit - are overly critical. They have a preconceived idea of Boris and his ministers and are unwilling to look at failings in a reasonable and reasoned manner. For them it is imply another excuse to attack a Government they already hated.
There is plenty of criticism of the Government handling of aspects of the crisis coming from Leave supporters but it is nothing like the vitriol and instinctive opposition - almost a hope that they will fail - that is coming from some Remain supporters.
I don't think he has it the wrong way round at all. But your point is valid, too. There is deep prejudice on the fringes of both sides.
Is Angela Merkel still planning to step down as Chancellor next year? If so, is there any chance she could be asked to come over here and take over from Boris?
We could do with having a grown-up in charge.
She would have to back hard Brexit
Er, that's not happening... you missed the point where I said she's a grown-up.
LOL @ CDS giving a press conference in his No.8 cammo rig just so we know this is srs bizniz. What a prick.
Senior military figures often seem to be seen in cammo for no reason. So I doubt it was so we know this is serious business. More likely it's so people remember who is who.
I remember watching a "modern" version of Macbeth where everyone (except Mrs M) was dressed up in cammo with face paint. It made it impossible to work out who was who in each scene until you could identify them by the script. It was....suboptimal.
You get the same thing with films where much action is set underwater and everyone has a wet suit, mask, O2 tank and flippers on. You can't tell who's who. Case in point being Thunderball, which was on TV recently. Great film for most of it, some iconic violent and misogynist scenes, but then the last 40 mins or so is this big underwater battle between a cast of hundreds, you've got Bond, and the Brits, the Americans, the Russians, plus the "Number Two" bloke of SPECTRE and some of his goons, all of them thrashing about in the water and looking pretty much the same except that Bond's legs are bare (not sure why). It's a really tough watch because you have absolutely no clue what is going on. It ends up fine, with everyone dead apart from Bond (and a girl), but it's not my favourite and I'm glad they returned to dry land for the next one - You Only Live Twice.
It is NI voters who decide on the Union not GB voters (though most Tory and LD voters do want to keep NI in the UK unlike Labour voters who back a united Ireland)
Given Tories are the staunchest Leavers and LDs the staunchest Remainers and both back the Union clearly Brexit is not the key divide
Tory voters support a border poll by 32 to 30 in the same poll.
Margin of error but supporting a border poll and still wanting Northern Ireland to vote to stay in the UK in that poll still makes you a Unionist.
However Northern Ireland has a Unionist First Minister so there will be no border poll for the foreseeable future, especially as the Withdrawal Agreement ensures there will be no hard border with the Republic of Ireland anyway
The NZ nurse who attended Johnson on R4 - he needed to be there, got same treatment as everyone else and didn’t get special treatment.
I get why she is saying what she is saying, but I would hope that the Prime Minister would get special treatment if necessary.
Do other patients in intensive care typically get two nurses standing by their bedside 24/7?
My experience, sample one, from the Royal London is that intensive care is delivered in wards of four beds with four nurses in the room, each patient being dedicated a nurse but so that as and when that nurse needs to leave the room briefly there are other nurses available to keep an eye on their patient. So the ratio was 1:1 24/7, but more than one nurse at any given time would be very familiar with each patient.
Is Angela Merkel still planning to step down as Chancellor next year? If so, is there any chance she could be asked to come over here and take over from Boris?
We could do with having a grown-up in charge.
She would have to back hard Brexit
Er, that's not happening... you missed the point where I said she's a grown-up.
Well she can stay in Germany then unless she wants to run for the LD leadership
Is Angela Merkel still planning to step down as Chancellor next year? If so, is there any chance she could be asked to come over here and take over from Boris?
Yes. Well, the hospitalisation rate as a function of age, since that is what drives the fatality rate in the modelling once the NHS is saturated (which happens quite quickly). Numbers for hospitalisation rates against age taken from estimates at https://www.imperial.ac.uk/news/196573/covid-19-one-five-over-80s-need-hospitalisation/ (which assumes 50% asymptomatic and an overall whole population IFR of 0.66%)
We don't know the exact fatality rate, but even assuming 2%, which is probably significantly on the high side, and noting that something like ten times as many over fifties appear to die from the infection as under fifties, that would give a 0.2% fatality rate.
Which if the entire under fifties population were infected would be somewhere around 100,000 deaths. And that is a high end estimate both of total infected and IFR.
For under thirties, I think the numbers would probably be somewhere around a tenth of that.
But of course allowing under thirties out unrestricted means they will very likely infect older people too.
That estimate is assuming they get care. If too many are infected, they won't be getting care.
1-2% of those in their 20s will need hospital care. 3.5-7% of those in their 30s. 4.3-8.6% of those in their forties, and 8.2-16.4% of those in their fifties.
What happens to them when the hospitals are full?
Don't know where you are getting those 'hospitalization rates' form considering we do know know exactly how many people have been infected?
I looked at @Black_Rook 's suggestion yesterday that under 60s be allowed to exit the lockdown due to their lower (comparative) risk. And because I wanted it to be feasible, I crunched the numbers.
There's a perception that covid-19 is "less fatal than seasonal 'flu for the under-60s, and we don't lock down for that," so surely we can do this?
Infectivity Problem is R0 (well, Rt - the transmission rate after interventions). In essence, most of the time, you aren't catching seasonal flu, even when someone around is infective. R0 for seasonal flu is around 1.3, and we vaccinate 14 million per year (over 20% of the population). This gives us almost the level we need for herd immunity, anyway (Rt goes to 1.02). Compare to R0 of 3.0 for coid-19 (may be higher).
After 10 transmissions, the index case of seasonal flu has infected 11.4 other people on average (so a clump of 100 sufferers infects a total of 114 others over the season).
After 10 transmissions, the index case of covid-19 has infected 88,572 others on average (so a clump of 100 sufferers infects a total of nearly 9 million others).
Exponential growth is a bastard.
Fatality rate Say, for the sake of argument, the death rate is only a tenth in our "freed" population. And it is 300 per day when we unlock (most of which are elderly). It would equate to only 30 per day in the "freed" population. Deaths doubling every 3-4 days means 120 per day after one week.
After 2 weeks, just under 500 per day.
After 3 weeks, 2000 per day (and, remember, these are the "freed" population).
Ah, but won't we hit herd immunity amongst this population? (I may be reaching for straws, but let's check to see if it's a straw or a vine)
The problem comes from saturation of the NHS (again). We escaped it this time, probably be a decent factor - but time is so crucial against an exponential rise (if we were only reaching 25% saturation of the NHS, then if we'd waited more than 7 days before imposing the restrictions we did, we'd have blasted past the maximum capacity while still accelerating. Exponential growth is a bastard).
Get past saturation, and those who need hospitalisation - don't get it. So what happens to you if you need hospital help and it's unavailable? One would expect your chance of death would go up quite significantly (otherwise, well, you didn't need hospital, did you?). If one third of those who need hospitalisation and don't get it end up dying, and the hospitalisation rate is compatible with an overall 0.66% IFR (which may be significantly too low, from the report yesterday) - Over 250,000 of the "freed" population will die
Okay, shift to only under fifties. (So I stay in the population). It improves - to a degree. Over 140,000 of them die.
Okay, only people up to their thirties. Over 70,000 die. Which looks better - but only in comparison to what we've seen before. If 70,000 were to die in "normal" circumstances, we'd be horrified.
Doesn't look to be a goer. Bugger.
To add to that - these are the optimistic numbers. The antibody test alluded to last night implied that the hospitalisation and death rates could be double what they are assumed to be in this calculation. And, of course, those needing hospitalisation and not getting it could easily be more likely to die than assumed. Numbers could very plausibly be as much as triple what they are above.
I note that in Leicester, the number discharged home has been running at twice the mortality for some weeks. It looks overall to have a mortality rate of 33% or so for hospitalised patients. This is considerably higher than other countries, possibly because we admit fewer mild cases. There are other possibilities though.
What did you make of the suggestion that Germany (for example) has a lower fatality rate partly because they actively admit patients at an earlier stage of disease progression ?
I think the rate would be better as the denominator would be bigger.
Whether spotting progression earlier in milder cases would give better outcomes is unknown. I suspect it would.
Forget that, Michael Farzan talk linked on last thread. By a country mile the best CV video i have seen so far. Not can it beat it, how exactly IT WILL.
True - but he is building his argument on some assumptions that other experts aren’t yet taking for granted. For example that the virus is relatively stable and non-mutating, and therefore a vaccine should be effective and enduring.
I don’t know whether this is so or not. It does seem to me that we are still finding out about it, through research. And I have seen other medical experts warning that it is too early to say how long any vaccine might work for. And it isn’t so long since we were hearing about different strains of the virus in different locations.
But in all those strains, the regions of interest from the point of view of how the virus binds with its target (and from a vaccine point of view) are conserved. If they were to mutate significantly then the virus itself would likely be ineffective. (Which is to say that such mutations might well already have occurred, but not reproduced.)
The common cold Coronavirus seems to be remarkably successful despite (or because of) its regular mutation.
Common cold is Rhinovirus not coronavirus.
There are 5 (I think) viral families that produce “cold-like symptoms”.
Rhinovirus (“the common cold” Coronavirus (SARS, MERS, Corvid-19) Parainfluenza RSV
Forget the other
That's only four Edit: Sorry I mis-read your post!
According to Wiki coronavirus causes 15% of common colds.
There are also four main types of common cold coronavirus - so the market for a vaccine for any one would be miniscule (which is why we don't have any).
RSV, in contrast, is quite a big market, as it is both common, and can cause severe illness in infants. There are various antibodies and vaccines in development.
Do we have stats on that question pre 2015 though?
I’m a mainland unionist who thinks it would be a shame but it’s up to them and if they decide to go I won’t really care. Nothing t do with Brexit though.
Indeed, given it is also only Labour voters who voted for Corbyn to be PM in 2019 who back a united Ireland Alistair is also speaking rubbish, the most anti Brexit voters ie 2019 LD voters, still want to keep Northern Ireland in the UK.
Just got a message from Betfair saying they're restoring the next Conservative leader and Boris Johnson markets tomorrow.
Did they void then start afresh or have they suspended and resumed worth all bets in situ.
If its the latter then people who acted fast on Boris info can rightly feel incredibly pissed off.
I got that message yesterday saying that the markets would be unlocked in what is now just six minutes' time
Edit/ And it's the latter
And, yes, the BF markets are now unsuspended.
I will probably be judged for this but I laid Boris's exit at near evens moments before the markets were suspended, so I'm healthily green on this market now.
Over £200+ up if Boris exits in 2021, 2022 or 2023 and break even for 2024 or after.
The lockdown itself must be causing deaths. People having treatment cancelled, mental health problems, lack of support.
My dad passed away last week in a care home. We were unable to visit him for the last month. I'm sure that alone shaved several weeks off his life. The undertaker cheerfully told me they were very busy but that only a small percentage of the numbers were from covid.
Do we have stats on that question pre 2015 though?
I’m a mainland unionist who thinks it would be a shame but it’s up to them and if they decide to go I won’t really care. Nothing t do with Brexit though.
Interesting question.
I want to see NI and Scotland leave the Union not because of Brexit but because I think it is the right thing for them. I firmly think that NI and Scotland will develop better once they leave the Union so why would I back it?
I voted Leave, but that doesn't mean I want them to Leave because of Brexit. My opinions predate Brexit. However my philosophy that nations develop better if they take responsibility for their own actions underpins both my Brexit vote and my belief they'll do better if they leave - its the same logic for both.
If you believe in independence why would you deny it to others? Mr Meeks is wrong to assume that independence is a negative or bad thing.
Is Angela Merkel still planning to step down as Chancellor next year? If so, is there any chance she could be asked to come over here and take over from Boris?
We could do with having a grown-up in charge.
She would have to back hard Brexit
Er, that's not happening... you missed the point where I said she's a grown-up.
Well she can stay in Germany then unless she wants to run for the LD leadership
According to some Covid-19 has done for Sindy; I wonder what Brexit would look like in that alt-history where instead of Covid-19 we had had Covid-18, or even Covid-15?
Guns and tasers be used to force people to go for testing ?
That really wouldn't be necessary. As the government (and Raab yesterday) acknowledge, it is they who have are managing demand for tests. If the capacity were readily accessible, there are tens of thousands of healthcare and care home staff who would want testing now.
An interesting follow up - I mentioned a friend who has been given a kick by the hierarchy for daring to get things done in this crisis.
Apparently the latest thing is that her mangers are all running round, exclaiming in horror about the Government using the military "to bypass existing organisations". They apparently regard this as the beginnings of a "coup".
The utmost horror is reserved for cases where the military has been given lead position.
Some of us see it as a positive outcome of Brexit rather than an unfortunate consequence. It helps to right a historic wrong.
There's nothing positive about the break-up of the UK - whatsoever.
And I'd be very careful about reaching into history and arguing that your political preferences today help to correct some of those (heavily mythologised) wrongs, particularly where such black & white views could lead to all sorts of unintended consequences.
You might find your political opponents want to do the same when they take office over something they really value too.
So we should not ask for justice because there are some issues on which justice might be against us?
It takes 5 minutes looking at a map and a history book to see that the existence of NI is an anomaly.
It may seem a pedantic point but I think Mike has this exactly the wrong way round.
It is not that Leave voters are less critical, it is rather that some Remain supporters - who already have a huge axe to grind with the Government over Brexit - are overly critical. They have a preconceived idea of Boris and his ministers and are unwilling to look at failings in a reasonable and reasoned manner. For them it is imply another excuse to attack a Government they already hated.
There is plenty of criticism of the Government handling of aspects of the crisis coming from Leave supporters but it is nothing like the vitriol and instinctive opposition - almost a hope that they will fail - that is coming from some Remain supporters.
More likely to be age. Remain supporters being predominantly of working age are being seriously affected by the lockdown and have a lot of uncertainty about the future. Leave supporters being predominantly retired are enjoying doing their garden and sitting on fixed incomes once again expecting to be unaffected by the fallout, provided of course they don't catch the virus.
I looked at @Black_Rook 's suggestion yesterday that under 60s be allowed to exit the lockdown due to their lower (comparative) risk. And because I wanted it to be feasible, I crunched the numbers.
There's a perception that covid-19 is "less fatal than seasonal 'flu for the under-60s, and we don't lock down for that," so surely we can do this?
Infectivity Problem is R0 (well, Rt - the transmission rate after interventions). In essence, most of the time, you aren't catching seasonal flu, even when someone around is infective. R0 for seasonal flu is around 1.3, and we vaccinate 14 million per year (over 20% of the population). This gives us almost the level we need for herd immunity, anyway (Rt goes to 1.02). Compare to R0 of 3.0 for coid-19 (may be higher).
After 10 transmissions, the index case of seasonal flu has infected 11.4 other people on average (so a clump of 100 sufferers infects a total of 114 others over the season).
After 10 transmissions, the index case of covid-19 has infected 88,572 others on average (so a clump of 100 sufferers infects a total of nearly 9 million others).
Exponential growth is a bastard.
Fatality rate Say, for the sake of argument, the death rate is only a tenth in our "freed" population. And it is 300 per day when we unlock (most of which are elderly). It would equate to only 30 per day in the "freed" population. Deaths doubling every 3-4 days means 120 per day after one week.
After 2 weeks, just under 500 per day.
After 3 weeks, 2000 per day (and, remember, these are the "freed" population).
Ah, but won't we hit herd immunity amongst this population? (I may be reaching for straws, but let's check to see if it's a straw or a vine)
The problem comes from saturation of the NHS (again). We escaped it this time, probably be a decent factor - but time is so crucial against an exponential rise (if we were only reaching 25% saturation of the NHS, then if we'd waited more than 7 days before imposing the restrictions we did, we'd have blasted past the maximum capacity while still accelerating. Exponential growth is a bastard).
Get past saturation, and those who need hospitalisation - don't get it. So what happens to you if you need hospital help and it's unavailable? One would expect your chance of death would go up quite significantly (otherwise, well, you didn't need hospital, did you?). If one third of those who need hospitalisation and don't get it end up dying, and the hospitalisation rate is compatible with an overall 0.66% IFR (which may be significantly too low, from the report yesterday) - Over 250,000 of the "freed" population will die
Okay, shift to only under fifties. (So I stay in the population). It improves - to a degree. Over 140,000 of them die.
Okay, only people up to their thirties. Over 70,000 die. Which looks better - but only in comparison to what we've seen before. If 70,000 were to die in "normal" circumstances, we'd be horrified.
Doesn't look to be a goer. Bugger.
Good analysis, but what if social distancing and large-scale meetings were capped with a culture of very good personal cleanliness.
The lockdown itself must be causing deaths. People having treatment cancelled, mental health problems, lack of support.
My dad passed away last week in a care home. We were unable to visit him for the last month. I'm sure that alone shaved several weeks off his life. The undertaker cheerfully told me they were very busy but that only a small percentage of the numbers were from covid.
I looked at @Black_Rook 's suggestion yesterday that under 60s be allowed to exit the lockdown due to their lower (comparative) risk. And because I wanted it to be feasible, I crunched the numbers.
There's a perception that covid-19 is "less fatal than seasonal 'flu for the under-60s, and we don't lock down for that," so surely we can do this?
Infectivity Problem is R0 (well, Rt - the transmission rate after interventions). In essence, most of the time, you aren't catching seasonal flu, even when someone around is infective. R0 for seasonal flu is around 1.3, and we vaccinate 14 million per year (over 20% of the population). This gives us almost the level we need for herd immunity, anyway (Rt goes to 1.02). Compare to R0 of 3.0 for coid-19 (may be higher).
After 10 transmissions, the index case of seasonal flu has infected 11.4 other people on average (so a clump of 100 sufferers infects a total of 114 others over the season).
After 10 transmissions, the index case of covid-19 has infected 88,572 others on average (so a clump of 100 sufferers infects a total of nearly 9 million others).
Exponential growth is a bastard.
Fatality rate Say, for the sake of argument, the death rate is only a tenth in our "freed" population. And it is 300 per day when we unlock (most of which are elderly). It would equate to only 30 per day in the "freed" population. Deaths doubling every 3-4 days means 120 per day after one week.
After 2 weeks, just under 500 per day.
After 3 weeks, 2000 per day (and, remember, these are the "freed" population).
Ah, but won't we hit herd immunity amongst this population? (I may be reaching for straws, but let's check to see if it's a straw or a vine)
The problem comes from saturation of the NHS (again). We escaped it this time, probably be a decent factor - but time is so crucial against an exponential rise (if we were only reaching 25% saturation of the NHS, then if we'd waited more than 7 days before imposing the restrictions we did, we'd have blasted past the maximum capacity while still accelerating. Exponential growth is a bastard).
Get past saturation, and those who need hospitalisation - don't get it. So what happens to you if you need hospital help and it's unavailable? One would expect your chance of death would go up quite significantly (otherwise, well, you didn't need hospital, did you?). If one third of those who need hospitalisation and don't get it end up dying, and the hospitalisation rate is compatible with an overall 0.66% IFR (which may be significantly too low, from the report yesterday) - Over 250,000 of the "freed" population will die
Okay, shift to only under fifties. (So I stay in the population). It improves - to a degree. Over 140,000 of them die.
Okay, only people up to their thirties. Over 70,000 die. Which looks better - but only in comparison to what we've seen before. If 70,000 were to die in "normal" circumstances, we'd be horrified.
Doesn't look to be a goer. Bugger.
Good analysis, but what if social distancing and large-scale meetings were capped with a culture of very good personal cleanliness.
Some of us see it as a positive outcome of Brexit rather than an unfortunate consequence. It helps to right a historic wrong.
There's nothing positive about the break-up of the UK - whatsoever.
And I'd be very careful about reaching into history and arguing that your political preferences today help to correct some of those (heavily mythologised) wrongs, particularly where such black & white views could lead to all sorts of unintended consequences.
You might find your political opponents want to do the same when they take office over something they really value too.
So we should not ask for justice because there are some issues on which justice might be against us?
It takes 5 minutes looking at a map and a history book to see that the existence of NI is an anomaly.
Some of us see it as a positive outcome of Brexit rather than an unfortunate consequence. It helps to right a historic wrong.
There's nothing positive about the break-up of the UK - whatsoever.
And I'd be very careful about reaching into history and arguing that your political preferences today help to correct some of those (heavily mythologised) wrongs, particularly where such black & white views could lead to all sorts of unintended consequences.
You might find your political opponents want to do the same when they take office over something they really value too.
So we should not ask for justice because there are some issues on which justice might be against us?
It takes 5 minutes looking at a map and a history book to see that the existence of NI is an anomaly.
There are all sorts of "anomalies". South and North Korea. Divided Cyprus. The Kaliningrad enclave. Republika Srpska.
History and human affairs are very complicated. And even more so when identity and religion are involved, which is extremely visceral.
You can't just click your fingers and wipe the slate clean.
The lockdown itself must be causing deaths. People having treatment cancelled, mental health problems, lack of support.
My dad passed away last week in a care home. We were unable to visit him for the last month. I'm sure that alone shaved several weeks off his life. The undertaker cheerfully told me they were very busy but that only a small percentage of the numbers were from covid.
Do we have stats on that question pre 2015 though?
I’m a mainland unionist who thinks it would be a shame but it’s up to them and if they decide to go I won’t really care. Nothing t do with Brexit though.
Interesting question.
I want to see NI and Scotland leave the Union not because of Brexit but because I think it is the right thing for them. I firmly think that NI and Scotland will develop better once they leave the Union so why would I back it?
I voted Leave, but that doesn't mean I want them to Leave because of Brexit. My opinions predate Brexit. However my philosophy that nations develop better if they take responsibility for their own actions underpins both my Brexit vote and my belief they'll do better if they leave - its the same logic for both.
If you believe in independence why would you deny it to others? Mr Meeks is wrong to assume that independence is a negative or bad thing.
Indeed, the fact most LD voters want to keep Northern Ireland in the UK shows it is nothing to do with Brexit whether you back a United Ireland or not, the divide is more whether you are Tory or Labour as it has always been
Do we have stats on that question pre 2015 though?
I’m a mainland unionist who thinks it would be a shame but it’s up to them and if they decide to go I won’t really care. Nothing t do with Brexit though.
Interesting question.
I want to see NI and Scotland leave the Union not because of Brexit but because I think it is the right thing for them. I firmly think that NI and Scotland will develop better once they leave the Union so why would I back it?
I voted Leave, but that doesn't mean I want them to Leave because of Brexit. My opinions predate Brexit. However my philosophy that nations develop better if they take responsibility for their own actions underpins both my Brexit vote and my belief they'll do better if they leave - its the same logic for both.
If you believe in independence why would you deny it to others? Mr Meeks is wrong to assume that independence is a negative or bad thing.
I take the other approach: the Union is a family of nations, and like any family it is only sustainable with the willing accession of the parties
Yes. Well, the hospitalisation rate as a function of age, since that is what drives the fatality rate in the modelling once the NHS is saturated (which happens quite quickly). Numbers for hospitalisation rates against age taken from estimates at https://www.imperial.ac.uk/news/196573/covid-19-one-five-over-80s-need-hospitalisation/ (which assumes 50% asymptomatic and an overall whole population IFR of 0.66%)
We don't know the exact fatality rate, but even assuming 2%, which is probably significantly on the high side, and noting that something like ten times as many over fifties appear to die from the infection as under fifties, that would give a 0.2% fatality rate.
Which if the entire under fifties population were infected would be somewhere around 100,000 deaths. And that is a high end estimate both of total infected and IFR.
For under thirties, I think the numbers would probably be somewhere around a tenth of that.
But of course allowing under thirties out unrestricted means they will very likely infect older people too.
That estimate is assuming they get care. If too many are infected, they won't be getting care.
1-2% of those in their 20s will need hospital care. 3.5-7% of those in their 30s. 4.3-8.6% of those in their forties, and 8.2-16.4% of those in their fifties.
What happens to them when the hospitals are full?
That is why I used a 2% IFR. It is, of course, a guesstimate like yours (and quite possibly not as good), but it was another way of looking at the numbers. In any event, such a policy would be utterly unworkable, I think.
With sufficient testing capacity, and the systems in place to take advantage of it (which is what has yet to be demonstrated), managing some sort of post lockdown re-opening, while preventing another mass outbreak, ought to be possible. It will require the same modification of behaviour (no crowded enclosed spaces; mask wearing in public etc) that we've talked about. And testing will aid in defining what behavioural measures are most effective.
Some of us see it as a positive outcome of Brexit rather than an unfortunate consequence. It helps to right a historic wrong.
There's nothing positive about the break-up of the UK - whatsoever.
And I'd be very careful about reaching into history and arguing that your political preferences today help to correct some of those (heavily mythologised) wrongs, particularly where such black & white views could lead to all sorts of unintended consequences.
You might find your political opponents want to do the same when they take office over something they really value too.
So we should not ask for justice because there are some issues on which justice might be against us?
It takes 5 minutes looking at a map and a history book to see that the existence of NI is an anomaly.
Comments
They rightly had as an early priority the maximum number of available beds - but there seems to be a deep institutional reluctance to question the subsequent negative effects of policies put in place to achieve that, in the face of developing evidence.
We've not seen that with common cold coronaviruses because it's never been even remotely economic to think about developing a vaccine to an individual common cold coronavirus.
The antibody test alluded to last night implied that the hospitalisation and death rates could be double what they are assumed to be in this calculation. And, of course, those needing hospitalisation and not getting it could easily be more likely to die than assumed. Numbers could very plausibly be as much as triple what they are above.
https://twitter.com/YouGov/status/1253236954742820865?s=20
The whole EU could impose a boycott of all British goods from 1st January 2021 and the French could set-up machine gun posts at Calais to shoot up any British lorries that try to get through and the economic consequences would still be blamed on coronavirus.
It will mask everything and virtually any form of Brexit will pale into insignificance next to its fall-out, so HMG can basically now pursue whatever form of it they like.
You have no idea what might happen to the market.
I remember being present when a stupid hack asked a very senior medical chap about his service in the Falklands. The mere suggestion that he would have treated Argentine and British casualties differently was taken as a disgusting attack on the surgeons medical ethics.
https://twitter.com/afneil/status/1253214341425438721?s=21
https://www.channel4.com/news/factcheck/factcheck-the-target-was-for-100000-tests-a-day-to-be-carried-out-not-capacity-to-do-100000-tests
The government's target is stil on its website. It's a shame to see an experienced, if highly partisan, journalist like Andrew Neil fall for the government's latest spin because it matches his own ideological agenda.
Which if the entire under fifties population were infected would be somewhere around 100,000 deaths. And that is a high end estimate both of total infected and IFR.
For under thirties, I think the numbers would probably be somewhere around a tenth of that.
But of course allowing under thirties out unrestricted means they will very likely infect older people too.
It is not that Leave voters are less critical, it is rather that some Remain supporters - who already have a huge axe to grind with the Government over Brexit - are overly critical. They have a preconceived idea of Boris and his ministers and are unwilling to look at failings in a reasonable and reasoned manner. For them it is imply another excuse to attack a Government they already hated.
There is plenty of criticism of the Government handling of aspects of the crisis coming from Leave supporters but it is nothing like the vitriol and instinctive opposition - almost a hope that they will fail - that is coming from some Remain supporters.
One of he worst Macbeths ever imo.
Better late than never, but Britain's testing during March and April has been lamentable.
I think he is unique in being decorated by both sides for the same action in the same war. A few years later he visited Argentina and effusively thanked by his former Argentine patients.
He is a great guy, and still living, I think. I saw him speak on the subject of treating bullet wounds based upon his work in Northern Ireland.
Also, how do we know whether/when that soft target is hit? HMG says 'Rejoice! Testing capacity is not 100,000 per day'?
I will believe there is capacity of 100,000 tests per day when 100,000+ are actually done in a day.
Of course most Unionists in Northern Ireland are of Presbyterian Scottish origin anyway
https://twitter.com/YouGov/status/1253236957326520321?s=20
1-2% of those in their 20s will need hospital care. 3.5-7% of those in their 30s. 4.3-8.6% of those in their forties, and 8.2-16.4% of those in their fifties.
What happens to them when the hospitals are full?
There are 5 (I think) viral families that produce “cold-like symptoms”.
Rhinovirus (“the common cold”
Coronavirus (SARS, MERS, Corvid-19)
Parainfluenza
RSV
Forget the other
Easy to implement too, if the capacity is genuinely there.
We could do with having a grown-up in charge.
And I'd be very careful about reaching into history and arguing that your political preferences today help to correct some of those (heavily mythologised) wrongs, particularly where such black & white views could lead to all sorts of unintended consequences.
You might find your political opponents want to do the same when they take office over something they really value too.
As the government (and Raab yesterday) acknowledge, it is they who have are managing demand for tests.
If the capacity were readily accessible, there are tens of thousands of healthcare and care home staff who would want testing now.
According to Wiki coronavirus causes 15% of common colds.
I’m a mainland unionist who thinks it would be a shame but it’s up to them and if they decide to go I won’t really care. Nothing t do with Brexit though.
But your point is valid, too. There is deep prejudice on the fringes of both sides.
When my Dad was in HDU (1 step down) it was 3 nurses to 2 patients
However Northern Ireland has a Unionist First Minister so there will be no border poll for the foreseeable future, especially as the Withdrawal Agreement ensures there will be no hard border with the Republic of Ireland anyway
Whether spotting progression earlier in milder cases would give better outcomes is unknown. I suspect it would.
RSV, in contrast, is quite a big market, as it is both common, and can cause severe illness in infants. There are various antibodies and vaccines in development.
So it is sod all to do with Brexit
https://twitter.com/YouGov/status/1253236957326520321?s=20
Over £200+ up if Boris exits in 2021, 2022 or 2023 and break even for 2024 or after.
My dad passed away last week in a care home. We were unable to visit him for the last month. I'm sure that alone shaved several weeks off his life. The undertaker cheerfully told me they were very busy but that only a small percentage of the numbers were from covid.
I want to see NI and Scotland leave the Union not because of Brexit but because I think it is the right thing for them. I firmly think that NI and Scotland will develop better once they leave the Union so why would I back it?
I voted Leave, but that doesn't mean I want them to Leave because of Brexit. My opinions predate Brexit. However my philosophy that nations develop better if they take responsibility for their own actions underpins both my Brexit vote and my belief they'll do better if they leave - its the same logic for both.
If you believe in independence why would you deny it to others? Mr Meeks is wrong to assume that independence is a negative or bad thing.
Apparently the latest thing is that her mangers are all running round, exclaiming in horror about the Government using the military "to bypass existing organisations". They apparently regard this as the beginnings of a "coup".
The utmost horror is reserved for cases where the military has been given lead position.
It takes 5 minutes looking at a map and a history book to see that the existence of NI is an anomaly.
What do the numbers look like then?
History and human affairs are very complicated. And even more so when identity and religion are involved, which is extremely visceral.
You can't just click your fingers and wipe the slate clean.
UK has circa 5% of World cases but nearly 10% of world deaths.
Capacity has to lead no of tests performed. Not rocket surgery.
It is, of course, a guesstimate like yours (and quite possibly not as good), but it was another way of looking at the numbers.
In any event, such a policy would be utterly unworkable, I think.
With sufficient testing capacity, and the systems in place to take advantage of it (which is what has yet to be demonstrated), managing some sort of post lockdown re-opening, while preventing another mass outbreak, ought to be possible.
It will require the same modification of behaviour (no crowded enclosed spaces; mask wearing in public etc) that we've talked about. And testing will aid in defining what behavioural measures are most effective.