The US Medical establishment really shouldn’t be throwing stones....
Isn't that a function of how expensive and inefficient the US system is compared to ours which is built around efficiency?
US system is out of reach for many people and ludicrously expensive but as a result has a lot of redundancy in it which ours doesn't.
Yes, an almost totally public system (as in the UK) will work out cheaper in general, and is easier to organise centrally in a time of crisis - but has little in the way of excess capacity to cope with a pandemic.
A mostly private system (as in the US) will be the opposite, having excess capacity but being more difficult to organise centrally and more expensive in normal times.
Both of these systems are sub-optimal, in normal times and in crisis times.
The 'ideal' system lies somewhere in between the two. Germany seems to be doing well at the moment, as was Singapore earlier.
Germany spend massive amounts more on their health care per head than us.
Maybe we could spend as much as the Germans?
Such levels of expenditure are the rewards of a highly productive and efficient economy that pays its way in the world and then some. You cannot wish the result without having the means and we don't have them.
Germany spends more %-of-GDP per head. It spends more as a ratio not just in absolute terms.
This ludicrous conversation of "adopt the healthcare system of country X" without discussing how much they spend has to stop.
So what are you willing to reduce spending on so that you can increase spending on healthcare ?
We are all going to be paying a lot more tax. And those individuals and businesses that currently avoid tax by going offshore are going to find it a whole lot tougher to do. We are also going to be running a higher deficit for the forseeable future. This will be the case just about everywhere, not just the UK.
A combination of taxes or fees for non critical services provided by the government including e.g. £10 for a doctors appointment for all but the poor would fill the gap.
The NHS should be focussing on critical care including pandemics from now on - not some of the frippery and waste previously indulged.
News that a friend of mine, retired nurse in mid seventies, previously well is breathing her last in my hospital. Ordinarily she would have had 10 more years with her grandchildren.
That's sad to hear. The situation hits home far more, when people one knows become part of the statistics.
That's important - and evidence in front of us rather than on the box makes a difference.
For the last couple of weeks I have been pointing out to friends that since the house numbers on our road go up to about 360, for 700-1000 people (mainly houses not flats), the potential overall mortality rate 0.1% - 0.5% as suggested means perhaps a couple of people dead amongst them, repeated everywhere.
Stocky....the fact that you have posted here (with some others) against the lockdown speaks volumes...
I'll give you a number 66 doctors so far have died in Italy.....
If we haven't lockdown the economic cost would have been much worse....that is discounting the terrible human cost...
I cannot understand how anyone is still posting this view...just makes me realise that people really are quite ignorant....
I bet if you had children working in the front line you wouldn't be quite so frivolous with your opinions....
The lockdown (which I support) is killing people. Different people than would have died from not having a lockdown. Suicides have already occurred.
At the moment the effect seems to have been a *dip* in overall deaths in the UK - part of why I support the lockdown.
It is a legitimate question to ask as to what the excess deaths from continuing a lock down past a certain point vs stopping it.
Honestly...I cannot believe that people are projecting this view the the lockdown is killing people....
The cost of not doing it are so much higher.....and until we have a vaccine, or a gamechanger (anti virals, monitoring technology) that enables people to return safely to normal life...we will remain in lockdown, or under some level of serious containment....
If China did have tens of thousands of deaths and millions of cases how are they now opening up just 3 months after the first case was indentified?
China did not have tens of thousands of deaths.....my wife works on medical journals which includes a number of contributors from China..the level of transparency (since the mishaps at the start) from China, and from the health sector in particular has been one of the positive things about Covid 19....
How is your wife getting on with work, considering the PPE equipment you listed the other day.....??
How is your company doing...considering it's employees are using this crisis to skive...
Stocky....has a liberal view that I find grossly irresponsible in this time.....
You on the other hand are something quite sinister...and you are deliberately spreading misinformation and falsehoods which I find very worrying...
All our employees are on Furlough, it is likely that if this situation continues for 3 months the company will close.
Interestingly we have received this press release from the Government this morning. Clearly they did not want for the Construction Industry to shut down like it has.
At Winchester Hospital there is no shortage of PPE, as mentioned yesterday 4 wards are shut due to lack of patients. The hospital is as quiet as it has ever been.
On Monday at Bournemouth Hospital there were 136 empty beds.
What hospital does your nephew work at?
Hospitals are quiet places because people are not going to A and E in the previous numbers..and operations have been suspended, and out patient appts curtailed.....
The health service is mobilising against the pandemic....
Different parts of the country will have different realities than described above
My local hospital is very busy - some wards have been moved into other buildings to free up space for Covid patients.
They would also not recognise "no shortage of PPE"
Although I believe they had another delivery of same yesterday, they were scheduled to anyway.
I spoke with a nurse friend of mine yesterday in a large population centre and it was the same. Enough PPE and the hospital was busy, but nowhere near capacity.
They said they were quite surprised actually, as they had rushed to reorganise, expecting the wave to have hit by now, but it hasn't.
However, they were still on high alert and under no illusion that its coming.
It is clearly patchy and I think the issue of PPE comes when you get hit with the tsunami like in London and as fast you as you try and react the water keeps rising.
The difference is made up mostly of private health insurance, I would agree that an expansion of this in the UK would be for the better.
The one thing guaranteed not to work, is throwing ever more public money at an unreformed NHS.
I think you're misreading that chart.
We spend slightly more than Germany on private healthcare (2% of GDP vs. 1.7% of GDP), but much less on public healthcare (7.9% of GDP vs 9.3% of GDP).
The Germans fund health through public insurance paid for by employer and employee not through income tax
What difference does it make? A tax is a tax.
Health insurance is not a tax but provides a specific purpose
Only if Health Insurance is paid based on someone's risk (like car insurance) and not income (like tax).
National Insurance etc are taxes not insurances.
Even national insurance was set up only to fund state pensions and contributory unemployment benefits (with receipt still based on national insurance contributions and credits) with healthcare later added too, income tax funds the whole range of government
It is simple. We enforce the lock down and social distancing until it is medically appropriate and if people try and violate beforehand shoot them or imprison them.
Or exile them to the Pitcairn Islands.
Or worse make them listen to Radiohead live at Glastonbury on loop for 14 days...that'll learn em.
Are you suspending laws that prevent cruel and unusual punishment during the lockdown then?
This sort of thing makes the whole testing thing even more confusing. This operation has clearly been carefully planned and implemented with the minimum of fuss. The same with a load of other elements of the response from supplying food boxes to the ventilator / CPAP challenges, but the testing, they either don't want to up the amount (for some unknown reason) or Chris Grayling is actually in charge of it.
Like the Book of Job, the Trolley Problem generates argument, rather than providing answers. The problem with taking a purely consequentialist approach to ethics is that you often don't know what the consequences of alternative courses of action will be. I may do something terrible, for what I believe to be the greater good, only to discover that I did not achieve the greater good. I just ended up doing something terrible.
OTOH, refraining from ever doing a bad thing, however bad the consequences might be, treats inaction as being a virtue. And that can't be right.
The PPE situation that I have heard from a hospital in the South of England is that those designated for COVID19 are getting it while those that aren't are completely unprotected. Thing is, neither the workload not the disease itself is that clearly demarcated.
Like the Book of Job, the Trolley Problem generates argument, rather than providing answers. The problem with taking a purely consequentialist approach to ethics is that you often don't know what the consequences of alternative courses of action will be. I may do something terrible, for what I believe to be the greater good, only to discover that I did not achieve the greater good. I just ended up doing something terrible.
OTOH, refraining from ever doing a bad thing, however bad the consequences might be, treats inaction as being a virtue. And that can't be right.
But we know (not believe) the consequences of inaction.(Italy)...this is not a philosophical dilemma....
Like the Book of Job, the Trolley Problem generates argument, rather than providing answers. The problem with taking a purely consequentialist approach to ethics is that you often don't know what the consequences of alternative courses of action will be. I may do something terrible, for what I believe to be the greater good, only to discover that I did not achieve the greater good. I just ended up doing something terrible.
OTOH, refraining from ever doing a bad thing, however bad the consequences might be, treats inaction as being a virtue. And that can't be right.
"generates argument, rather than providing answers" - a nice definition of philosophy itself!
This sort of thing makes the whole testing thing even more confusing. This operation has clearly been carefully planned and implemented with the minimum of fuss. The same with a load of other elements of the response from supplying food boxes to the ventilator / CPAP challenges, but the testing, they either don't want to up the amount (for some unknown reason) or Chris Grayling is actually in charge of it.
The explanation is very simple: producing a sensitive, medoical-grade test on tiny strands of RNA is not something that can easily be massively scaled up. You can call in the Army to help erect cubicles and shift beds around, but you can't call in the Army to manufacture reagents or assemble sterile testing kits, or train people quickly to process them.
Moth trap news from last night: 53 moths of 11 species
Frosted Green x 1 (new for the year)
Powdered Quaker x 3 (new for the year)
Clouded Drab x 3
Common Quaker x 10
Dotted Border x 1
Early Thorn x 1
Hebrew Character x 16
March Moth x 2
Oak Beauty x 3
Red Chestnut x 4
Small Quaker x 9
Powdered Quaker is a moth that appears for a short period in early spring. Never numerous, it gives cause to learn todays word of the day: irrorate, meaning covered in small spots.
Like the Book of Job, the Trolley Problem generates argument, rather than providing answers. The problem with taking a purely consequentialist approach to ethics is that you often don't know what the consequences of alternative courses of action will be. I may do something terrible, for what I believe to be the greater good, only to discover that I did not achieve the greater good. I just ended up doing something terrible.
OTOH, refraining from ever doing a bad thing, however bad the consequences might be, treats inaction as being a virtue. And that can't be right.
But we know (not believe) the consequences of inaction.(Italy)...this is not a philosophical dilemma....
We do. But we don't know the consequences of lockdown.
The PPE situation that I have heard from a hospital in the South of England is that those designated for COVID19 are getting it while those that aren't are completely unprotected. Thing is, neither the workload not the disease itself is that clearly demarcated.
That's false....I know Covid wards where the NHS staff are still using flimsy gear...
Moth trap news from last night: 53 moths of 11 species
Frosted Green x 1 (new for the year)
Powdered Quaker x 3 (new for the year)
Clouded Drab x 3
Common Quaker x 10
Dotted Border x 1
Early Thorn x 1
Hebrew Character x 16
March Moth x 2
Oak Beauty x 3
Red Chestnut x 4
Small Quaker x 9
Powdered Quaker is a moth that appears for a short period in early spring. Never numerous, it gives cause to learn todays word of the day: irrorate, meaning covered in small spots.
Like the Book of Job, the Trolley Problem generates argument, rather than providing answers. The problem with taking a purely consequentialist approach to ethics is that you often don't know what the consequences of alternative courses of action will be. I may do something terrible, for what I believe to be the greater good, only to discover that I did not achieve the greater good. I just ended up doing something terrible.
OTOH, refraining from ever doing a bad thing, however bad the consequences might be, treats inaction as being a virtue. And that can't be right.
But we know (not believe) the consequences of inaction.(Italy)...this is not a philosophical dilemma....
We do. But we don't know the consequences of lockdown.
Like the Book of Job, the Trolley Problem generates argument, rather than providing answers. The problem with taking a purely consequentialist approach to ethics is that you often don't know what the consequences of alternative courses of action will be. I may do something terrible, for what I believe to be the greater good, only to discover that I did not achieve the greater good. I just ended up doing something terrible.
OTOH, refraining from ever doing a bad thing, however bad the consequences might be, treats inaction as being a virtue. And that can't be right.
But we know (not believe) the consequences of inaction.(Italy)...this is not a philosophical dilemma....
We do. But we don't know the consequences of lockdown.
Mortality rate in Italy is apparently the lowest for 4 years. And a 3 year low for over 65s
Moth trap news from last night: 53 moths of 11 species
Frosted Green x 1 (new for the year)
Powdered Quaker x 3 (new for the year)
Clouded Drab x 3
Common Quaker x 10
Dotted Border x 1
Early Thorn x 1
Hebrew Character x 16
March Moth x 2
Oak Beauty x 3
Red Chestnut x 4
Small Quaker x 9
Powdered Quaker is a moth that appears for a short period in early spring. Never numerous, it gives cause to learn todays word of the day: irrorate, meaning covered in small spots.
Excellent. I must start running my trap soon. However as I stay in the North of Scotland and its freezing and windy here, suspect I may not get quite your numbers!
I suspect the fed up at home factor will be a big motivant for change in 4-6 weeks time. People aren't going to lock themselves away for ever.
You mean it isn't the April 1st article?
It still remains to be seen which is the better approach and only time will tell. Currently we are all focussing on Covid 19 direct deaths but there will be other deaths or indeed longer lives in areas affected by current actions.
Try having no health service for 2-3 months because it's collapsed under the weight of the pandemic, and see how many "other deaths" there are then!
This sort of thing makes the whole testing thing even more confusing. This operation has clearly been carefully planned and implemented with the minimum of fuss. The same with a load of other elements of the response from supplying food boxes to the ventilator / CPAP challenges, but the testing, they either don't want to up the amount (for some unknown reason) or Chris Grayling is actually in charge of it.
The explanation is very simple: producing a sensitive, medoical-grade test on tiny strands of RNA is not something that can easily be massively scaled up. You can call in the Army to help erect cubicles and shift beds around, but you can't call in the Army to manufacture reagents or assemble sterile testing kits, or train people quickly to process them.
But we have been stuck on max ~8,000 for several weeks now. I know we have less PCR machines than say Germany just lying around, but the government haven't sequester ones in private labs and universities.
There was the claimed it was an issue of lack of reagent chemicals. Peston, caveat emptor, claims the UK chemical industry says they can make this stuff, but never been approached to ramp up production.
This might be true, might be nonsense. We know the oxygen suppliers were approached weeks ago to quadruple production.
My take is perhaps they were working on the principle that the anti-body test would be ready by now and that has hit a snag in terms of accuracy. Because obviously if we had even 100,000s of those kits we can get through the NHS frontline staff pretty quickly and give the plague survivors their badge.
Anecdotally I've noticed ambulances heading out and about (During my runs) without blue flashers on recently. The roads are quiet so they're probably not needed round here.
@Foxy (and anyone else) I posted this on the last thread, and wondered what people make of it ?
The proposal is that novel vaccines bypass the normal (and lengthy) phase 3 trial process by seeking medical professionals (or others) who are very likely to be exposed to the virus, as informed volunteers. In ordinary times, this would be completely unethical - but what about in the current circumstances ?
(Bear in mind that by doing this, information on the vaccines' efficacy before the trial would be necessarily limited; indeed it's possible that some might even be net harmful. And you would be giving it to people you know have a high likelihood of exposure.) But it would save many months.
Human challenge studies to accelerate coronavirus vaccine licensure https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiaa152/5814216?searchresult=1 Controlled human challenge trials of SARS-CoV-2 vaccine candidates could accelerate the testing and potential rollout of efficacious vaccines. By replacing conventional Phase 3 testing of vaccine candidates, such trials may subtract many months from the licensure process, making efficacious vaccines available more quickly. Obviously, challenging volunteers with this live virus risks inducing severe disease and possibly even death. However, we argue that such studies, by accelerating vaccine evaluation, could reduce the global burden of coronavirus-related mortality and morbidity. Volunteers in such studies could autonomously authorize the risks to themselves, and their net risk could be acceptable if participants comprise healthy young adults, who are at relatively low risk of serious disease following natural infection, they have a high baseline risk of natural infection, and during the trial they receive frequent monitoring and, following any infection, the best available care...
This sort of thing makes the whole testing thing even more confusing. This operation has clearly been carefully planned and implemented with the minimum of fuss. The same with a load of other elements of the response from supplying food boxes to the ventilator / CPAP challenges, but the testing, they either don't want to up the amount (for some unknown reason) or Chris Grayling is actually in charge of it.
The explanation is very simple: producing a sensitive, medoical-grade test on tiny strands of RNA is not something that can easily be massively scaled up. You can call in the Army to help erect cubicles and shift beds around, but you can't call in the Army to manufacture reagents or assemble sterile testing kits, or train people quickly to process them.
You could say the same about the ventilators, but the government have been very proactive in organising action from manufacturing companies, apparently with success imminent.
I think it's deliberate policy because the best available test right now isn't that good. The 25% false negative rate means that it's utility at this stage is limited - and there are scenarios where it could do more harm than good.
This sort of thing makes the whole testing thing even more confusing. This operation has clearly been carefully planned and implemented with the minimum of fuss. The same with a load of other elements of the response from supplying food boxes to the ventilator / CPAP challenges, but the testing, they either don't want to up the amount (for some unknown reason) or Chris Grayling is actually in charge of it.
The explanation is very simple: producing a sensitive, medoical-grade test on tiny strands of RNA is not something that can easily be massively scaled up. You can call in the Army to help erect cubicles and shift beds around, but you can't call in the Army to manufacture reagents or assemble sterile testing kits, or train people quickly to process them.
But we have been stuck on max ~8,000 for several weeks now. I know we have less PCR machines than say Germany just lying around, but the government haven't sequester ones in private labs and universities.
There was the claimed it was an issue of lack of reagent chemicals. Peston, caveat emptor, claims the UK chemical industry says they can make this stuff, but never been approached to ramp up production.
This might be true, might be nonsense. We know the oxygen suppliers were approached weeks ago to quadruple production.
My take is perhaps they were working on the principle that the anti-body test would be ready by now and that has hit a snag in terms of accuracy. Because obviously if we had even 100,000s of those kits we can get through the NHS frontline staff pretty quickly and give the plague survivors their badge.
I've had Sky on in the background this morning, on repeat they've basically had Kate McCann saying the Peston line and saying 'questions need to be asked', but just now she said something different which basically ended up being "its complicated".
I suspect the fed up at home factor will be a big motivant for change in 4-6 weeks time. People aren't going to lock themselves away for ever.
You mean it isn't the April 1st article?
It still remains to be seen which is the better approach and only time will tell. Currently we are all focussing on Covid 19 direct deaths but there will be other deaths or indeed longer lives in areas affected by current actions.
Try having no health service for 2-3 months because it's collapsed under the weight of the pandemic, and see how many "other deaths" there are then!
Indeed there was a study from a community in North Italy which actually saw a bigger increase in deaths from non-COVID19 (heart attacks and so on) than from COVID19 itself
There is absolutely no doubt, reducing the incidence of the virus will see other deaths reduce as well.
This sort of thing makes the whole testing thing even more confusing. This operation has clearly been carefully planned and implemented with the minimum of fuss. The same with a load of other elements of the response from supplying food boxes to the ventilator / CPAP challenges, but the testing, they either don't want to up the amount (for some unknown reason) or Chris Grayling is actually in charge of it.
The explanation is very simple: producing a sensitive, medoical-grade test on tiny strands of RNA is not something that can easily be massively scaled up. You can call in the Army to help erect cubicles and shift beds around, but you can't call in the Army to manufacture reagents or assemble sterile testing kits, or train people quickly to process them.
You could say the same about the ventilators, but the government have been very proactive in organising action from manufacturing companies, apparently with success imminent.
I think it's deliberate policy because the best available test right now isn't that good. The 25% false negative rate means that it's utility at this stage is limited - and there are scenarios where it could do more harm than good.
I have to say I was shocked when Dr Foxy said this the other day. I genuinely presumed they were much more accurate than that.
I previously linked to a video showing that even a test that is 98% accurate can lead to extremely significant issues when deployed at mass scale.
Is this 70-80% accuracy rate true across the world e.g. South Korea, Germany etc?
This sort of thing makes the whole testing thing even more confusing. This operation has clearly been carefully planned and implemented with the minimum of fuss. The same with a load of other elements of the response from supplying food boxes to the ventilator / CPAP challenges, but the testing, they either don't want to up the amount (for some unknown reason) or Chris Grayling is actually in charge of it.
The explanation is very simple: producing a sensitive, medoical-grade test on tiny strands of RNA is not something that can easily be massively scaled up. You can call in the Army to help erect cubicles and shift beds around, but you can't call in the Army to manufacture reagents or assemble sterile testing kits, or train people quickly to process them.
But we have been stuck on max ~8,000 for several weeks now. I know we have less PCR machines than say Germany just lying around, but the government haven't sequester ones in private labs and universities.
There was the claimed it was an issue of lack of reagent chemicals. Peston, caveat emptor, claims the UK chemical industry says they can make this stuff, but never been approached to ramp up production.
This might be true, might be nonsense. We know the oxygen suppliers were approached weeks ago to quadruple production.
My take is perhaps they were working on the principle that the anti-body test would be ready by now and that has hit a snag in terms of accuracy. Because obviously if we had even 100,000s of those kits we can get through the NHS frontline staff pretty quickly and give the plague survivors their badge.
I believe the largest manufacturer of the specialist swabs required is in Lombardy.
This sort of thing makes the whole testing thing even more confusing. This operation has clearly been carefully planned and implemented with the minimum of fuss. The same with a load of other elements of the response from supplying food boxes to the ventilator / CPAP challenges, but the testing, they either don't want to up the amount (for some unknown reason) or Chris Grayling is actually in charge of it.
The explanation is very simple: producing a sensitive, medoical-grade test on tiny strands of RNA is not something that can easily be massively scaled up. You can call in the Army to help erect cubicles and shift beds around, but you can't call in the Army to manufacture reagents or assemble sterile testing kits, or train people quickly to process them.
But we have been stuck on max ~8,000 for several weeks now. I know we have less PCR machines than say Germany just lying around, but the government haven't sequester ones in private labs and universities.
There was the claimed it was an issue of lack of reagent chemicals. Peston, caveat emptor, claims the UK chemical industry says they can make this stuff, but never been approached to ramp up production.
This might be true, might be nonsense. We know the oxygen suppliers were approached weeks ago to quadruple production.
My take is perhaps they were working on the principle that the anti-body test would be ready by now and that has hit a snag in terms of accuracy. Because obviously if we had even 100,000s of those kits we can get through the NHS frontline staff pretty quickly and give the plague survivors their badge.
I've had Sky on in the background this morning, on repeat they've basically had Kate McCann saying the Peston line and saying 'questions need to be asked', but just now she said something different which basically ended up being "its complicated".
Doesn't that qualify as suffering cruel and unusual punishment ?
Anecdotally I've noticed ambulances heading out and about (During my runs) without blue flashers on recently. The roads are quiet so they're probably not needed round here.
I used to live where just one road from a major hospital, could see the hospital out my window. Hearing and seeing the blue light lights/sirens was a very common event but the amount of ambulances that traveled without them was always surprisingly common too. Tendency is to only put them on when needed.
66 doctors dead.... many more critically ill, and on the pathway to dying....about 5-10 a day are dying....
And will more than 66 healthy people die due to the consequences of lockdown? Probably.
Edit. Maybe. Point is lockdown will save vastly more lives than are caused by it. Not just CV deaths. Other deaths will be prevented thanks to having a functioning healthcare system.
Moth trap news from last night: 53 moths of 11 species
Frosted Green x 1 (new for the year)
Powdered Quaker x 3 (new for the year)
Clouded Drab x 3
Common Quaker x 10
Dotted Border x 1
Early Thorn x 1
Hebrew Character x 16
March Moth x 2
Oak Beauty x 3
Red Chestnut x 4
Small Quaker x 9
Powdered Quaker is a moth that appears for a short period in early spring. Never numerous, it gives cause to learn todays word of the day: irrorate, meaning covered in small spots.
Excellent. I must start running my trap soon. However as I stay in the North of Scotland and its freezing and windy here, suspect I may not get quite your numbers!
But some of the moths you'll get up there I can only dream of trapping!
This sort of thing makes the whole testing thing even more confusing. This operation has clearly been carefully planned and implemented with the minimum of fuss. The same with a load of other elements of the response from supplying food boxes to the ventilator / CPAP challenges, but the testing, they either don't want to up the amount (for some unknown reason) or Chris Grayling is actually in charge of it.
The explanation is very simple: producing a sensitive, medoical-grade test on tiny strands of RNA is not something that can easily be massively scaled up. You can call in the Army to help erect cubicles and shift beds around, but you can't call in the Army to manufacture reagents or assemble sterile testing kits, or train people quickly to process them.
But we have been stuck on max ~8,000 for several weeks now. I know we have less PCR machines than say Germany just lying around, but the government haven't sequester ones in private labs and universities.
There was the claimed it was an issue of lack of reagent chemicals. Peston, caveat emptor, claims the UK chemical industry says they can make this stuff, but never been approached to ramp up production.
This might be true, might be nonsense. We know the oxygen suppliers were approached weeks ago to quadruple production.
My take is perhaps they were working on the principle that the anti-body test would be ready by now and that has hit a snag in terms of accuracy. Because obviously if we had even 100,000s of those kits we can get through the NHS frontline staff pretty quickly and give the plague survivors their badge.
I believe the largest manufacturer of the specialist swabs required is in Lombardy.
I heard Bill Gates say that those swabs that go way down inside the nose have been shown to be not really any more accurate than just swabbing the main part of the nose with much more common ones.
@Foxy (and anyone else) I posted this on the last thread, and wondered what people make of it ?
The proposal is that novel vaccines bypass the normal (and lengthy) phase 3 trial process by seeking medical professionals (or others) who are very likely to be exposed to the virus, as informed volunteers. In ordinary times, this would be completely unethical - but what about in the current circumstances ?
(Bear in mind that by doing this, information on the vaccines' efficacy before the trial would be necessarily limited; indeed it's possible that some might even be net harmful. And you would be giving it to people you know have a high likelihood of exposure.) But it would save many months.
Human challenge studies to accelerate coronavirus vaccine licensure https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiaa152/5814216?searchresult=1 Controlled human challenge trials of SARS-CoV-2 vaccine candidates could accelerate the testing and potential rollout of efficacious vaccines. By replacing conventional Phase 3 testing of vaccine candidates, such trials may subtract many months from the licensure process, making efficacious vaccines available more quickly. Obviously, challenging volunteers with this live virus risks inducing severe disease and possibly even death. However, we argue that such studies, by accelerating vaccine evaluation, could reduce the global burden of coronavirus-related mortality and morbidity. Volunteers in such studies could autonomously authorize the risks to themselves, and their net risk could be acceptable if participants comprise healthy young adults, who are at relatively low risk of serious disease following natural infection, they have a high baseline risk of natural infection, and during the trial they receive frequent monitoring and, following any infection, the best available care...
Oxford University are asking for 500 volunteers to test the vaccine....
we are still over a year from a vaccine.....and probably much longer
Excellent post. This point of view really needs putting.
I tend to agree. And as for 0.5% of the population inevitably getting it? Not so (Diamond Princess).
Although NHS capacity is of course an issue.
You mean uncontrolled less than 0.5% will be infected?. The infection rate on the Diamond Princess was a lot higher than that and the ship did eventually have lockdown in place.
If you are talking about mortality from infection, these people imply a 1.3% IFR on an aged demographic (half a million deaths in the UK at herd immunity)
Like the Book of Job, the Trolley Problem generates argument, rather than providing answers. The problem with taking a purely consequentialist approach to ethics is that you often don't know what the consequences of alternative courses of action will be...
True, of course; it's a thought experiment, not the real world.
But the serious point from Stocky's header (and FWIW, I don't agree with his conclusion) is that the negative consequences of continuing lockdown have not adequately been assessed or expressed. Which is I think a fair point.
If you've got a 25% false negative rate then the test can be used to discern patterns and numbers (Increase by 25% of those tested) but quarantine rules should be observed even if you test negative.
This sort of thing makes the whole testing thing even more confusing. This operation has clearly been carefully planned and implemented with the minimum of fuss. The same with a load of other elements of the response from supplying food boxes to the ventilator / CPAP challenges, but the testing, they either don't want to up the amount (for some unknown reason) or Chris Grayling is actually in charge of it.
The explanation is very simple: producing a sensitive, medoical-grade test on tiny strands of RNA is not something that can easily be massively scaled up. You can call in the Army to help erect cubicles and shift beds around, but you can't call in the Army to manufacture reagents or assemble sterile testing kits, or train people quickly to process them.
You could say the same about the ventilators, but the government have been very proactive in organising action from manufacturing companies, apparently with success imminent.
I think it's deliberate policy because the best available test right now isn't that good. The 25% false negative rate means that it's utility at this stage is limited - and there are scenarios where it could do more harm than good.
I have to say I was shocked when Dr Foxy said this the other day. I genuinely presumed they were much more accurate than that.
I previously linked to a video showing that even a test that is 98% accurate can lead to extremely significant issues when deployed at mass scale.
Is this 70-80% accuracy rate true across the world e.g. South Korea, Germany etc?
My wife was tested last week in Ireland, where they are doing more tests, but she hasn't been told the result. It's possible that the sample is waiting to be processed, but I wondered whether they simply weren't communicating negative results as a way of handling the false negative issue.
On topic: It would politically interesting if the government ended lockdown just at the point where deaths are likely to be at their peak.
My wife works at a GP surgery and they've been told the peak is expected over the easter weekend. I think this is likely to be peak hospital admissions rather than peak deaths.
they are opening good friday and easter monday to help field calls and she thinks all GP surgeries nationwide will be doing the same. she is not management though so just going from what she was been told.
On banks, they have cancelled the dividends but are arguing over bankers bonuses.
Somethings never change, time to put 100% emergency tax on all these bonuses
Disgraceful if RBS bonuses continue given they are majority government owned. For private firms shareholders should rein in bonuses very significantly, but the structures essentially give the board free license to do as they see fit, which is generally pay them and their immediate reports as much as possible.
Anecdotally I've noticed ambulances heading out and about (During my runs) without blue flashers on recently. The roads are quiet so they're probably not needed round here.
I used to live where just one road from a major hospital, could see the hospital out my window. Hearing and seeing the blue light lights/sirens was a very common event but the amount of ambulances that traveled without them was always surprisingly common too. Tendency is to only put them on when needed.
Ambulances do plenty of non-emergency journeys.
eg Taking patient home, or if patient not admitted (though perhaps less now that the first responder is likely to be a paramedic in a car).
Excellent post. This point of view really needs putting.
I tend to agree. And as for 0.5% of the population inevitably getting it? Not so (Diamond Princess).
Although NHS capacity is of course an issue.
You mean uncontrolled less than 0.5% will be infected?. The infection rate on the Diamond Princess was a lot higher than that and the ship did eventually have lockdown in place.
If you are talking about mortality from infection, these people imply a 1.3% IFR on an aged demographic (half a million deaths in the UK at herd immunity)
Focusing on mortality is misdirection, the greater issues are the numbers who require treatment in hospital and the infrastructure not being there to cope. In the future, government need to ensure that the infrastructure is there to come online if necessary, as they have seen the false economy that it has created.
On topic: It would politically interesting if the government ended lockdown just at the point where deaths are likely to be at their peak.
Sounds politically unlikely to me :-) I think that the effects of the 2-week lag between actions and outcomes will kick in in the opposite direction. On the up-curve, each new measure or imposition intuitively feels like an overreaction because we measure it against what we see now, not against the extrapolated two-weeks-in-the-future; on the down-curve we'll worry that the government is being too eager to let the lid off for exactly the same reason.
The PPE situation that I have heard from a hospital in the South of England is that those designated for COVID19 are getting it while those that aren't are completely unprotected. Thing is, neither the workload not the disease itself is that clearly demarcated.
That's false....I know Covid wards where the NHS staff are still using flimsy gear...
Nerryhughes comments are wrong....misinformation
My niece is an A&E nurse in the north of England. She is currently working her notice - in 4 weeks time she will be a community nurse. Because she is working her notice she had had to take some leave, but has been in contact with colleagues in the meantime. She goes back to work this week and is terrified about the lack of proper PPE, as are her colleagues. Although A&E itself is much quieter, the extra space in A&E is being/will be used for those with the virus.
They don’t have proper masks. They don’t have eye guards. If the numbers shoot up, she and her colleagues are at very high risk.
I don’t blame her for being terrified.
My sister is a mental health nurse but has been told if needed she will be drafted onto the wards. She has colitis so has been on immuno-suppressant drugs a lot, though she is not taking them currently. She has been given some PPE but, again, no eye guards.
She too is scared.
So it looks like plenty of medical staff are getting some PPE, but perhaps not the proper masks and other stuff that ideally they should be getting. And how large the stocks are of the less than perfect PPE are is also worrying.
@Foxy (and anyone else) I posted this on the last thread, and wondered what people make of it ?
The proposal is that novel vaccines bypass the normal (and lengthy) phase 3 trial process by seeking medical professionals (or others) who are very likely to be exposed to the virus, as informed volunteers. In ordinary times, this would be completely unethical - but what about in the current circumstances ?
(Bear in mind that by doing this, information on the vaccines' efficacy before the trial would be necessarily limited; indeed it's possible that some might even be net harmful. And you would be giving it to people you know have a high likelihood of exposure.) But it would save many months.
Human challenge studies to accelerate coronavirus vaccine licensure https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiaa152/5814216?searchresult=1 Controlled human challenge trials of SARS-CoV-2 vaccine candidates could accelerate the testing and potential rollout of efficacious vaccines. By replacing conventional Phase 3 testing of vaccine candidates, such trials may subtract many months from the licensure process, making efficacious vaccines available more quickly. Obviously, challenging volunteers with this live virus risks inducing severe disease and possibly even death. However, we argue that such studies, by accelerating vaccine evaluation, could reduce the global burden of coronavirus-related mortality and morbidity. Volunteers in such studies could autonomously authorize the risks to themselves, and their net risk could be acceptable if participants comprise healthy young adults, who are at relatively low risk of serious disease following natural infection, they have a high baseline risk of natural infection, and during the trial they receive frequent monitoring and, following any infection, the best available care...
Oxford University are asking for 500 volunteers to test the vaccine....
we are still over a year from a vaccine.....and probably much longer
I think though it is reasonable to accelerate the process.
Anecdotally I've noticed ambulances heading out and about (During my runs) without blue flashers on recently. The roads are quiet so they're probably not needed round here.
I used to live where just one road from a major hospital, could see the hospital out my window. Hearing and seeing the blue light lights/sirens was a very common event but the amount of ambulances that traveled without them was always surprisingly common too. Tendency is to only put them on when needed.
They’ll only use the ”Blues and Twos” if they’re in a hurry - that is, that they are exceeding speed limits, needing to pass traffic or running red lights.
Most of the time, they use the sirens on the way to the patient, rather than on the way to the hospital - if the patient is stable.
Like the Book of Job, the Trolley Problem generates argument, rather than providing answers. The problem with taking a purely consequentialist approach to ethics is that you often don't know what the consequences of alternative courses of action will be...
True, of course; it's a thought experiment, not the real world.
But the serious point from Stocky's header (and FWIW, I don't agree with his conclusion) is that the negative consequences of continuing lockdown have not adequately been assessed or expressed. Which is I think a fair point.
Someone else will pay, that's the usual thought process.
Moth trap news from last night: 53 moths of 11 species
Frosted Green x 1 (new for the year)
Powdered Quaker x 3 (new for the year)
Clouded Drab x 3
Common Quaker x 10
Dotted Border x 1
Early Thorn x 1
Hebrew Character x 16
March Moth x 2
Oak Beauty x 3
Red Chestnut x 4
Small Quaker x 9
Powdered Quaker is a moth that appears for a short period in early spring. Never numerous, it gives cause to learn todays word of the day: irrorate, meaning covered in small spots.
A few years ago I found a beauty in my garden and later identified it as an elephant hawkmoth. Is that rare for UK?
Elephant Hawkmoths are quite common - they like to feed on fuschia. I can get them into double figures on a warm summer night. Most gardens would have them - but as people aren't out with bright lights at midnight, most won't be observed.
For those who haven't seen one, this is what you are missing:
@Foxy (and anyone else) I posted this on the last thread, and wondered what people make of it ?
The proposal is that novel vaccines bypass the normal (and lengthy) phase 3 trial process by seeking medical professionals (or others) who are very likely to be exposed to the virus, as informed volunteers. In ordinary times, this would be completely unethical - but what about in the current circumstances ?
(Bear in mind that by doing this, information on the vaccines' efficacy before the trial would be necessarily limited; indeed it's possible that some might even be net harmful. And you would be giving it to people you know have a high likelihood of exposure.) But it would save many months.
Human challenge studies to accelerate coronavirus vaccine licensure https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiaa152/5814216?searchresult=1 Controlled human challenge trials of SARS-CoV-2 vaccine candidates could accelerate the testing and potential rollout of efficacious vaccines. By replacing conventional Phase 3 testing of vaccine candidates, such trials may subtract many months from the licensure process, making efficacious vaccines available more quickly. Obviously, challenging volunteers with this live virus risks inducing severe disease and possibly even death. However, we argue that such studies, by accelerating vaccine evaluation, could reduce the global burden of coronavirus-related mortality and morbidity. Volunteers in such studies could autonomously authorize the risks to themselves, and their net risk could be acceptable if participants comprise healthy young adults, who are at relatively low risk of serious disease following natural infection, they have a high baseline risk of natural infection, and during the trial they receive frequent monitoring and, following any infection, the best available care...
Oxford University are asking for 500 volunteers to test the vaccine.... we are still over a year from a vaccine.....and probably much longer
In the normal order of things, absolutely. The proposal here (and it is a fairly extreme one) is that the normal trial process be to some extent short circuited by seeking volunteers, from those most likely to be infected, for a large scale trial of the most promising candidates which emerge from early trials
Moth trap news from last night: 53 moths of 11 species
Frosted Green x 1 (new for the year)
Powdered Quaker x 3 (new for the year)
Clouded Drab x 3
Common Quaker x 10
Dotted Border x 1
Early Thorn x 1
Hebrew Character x 16
March Moth x 2
Oak Beauty x 3
Red Chestnut x 4
Small Quaker x 9
Powdered Quaker is a moth that appears for a short period in early spring. Never numerous, it gives cause to learn todays word of the day: irrorate, meaning covered in small spots.
Excellent. I must start running my trap soon. However as I stay in the North of Scotland and its freezing and windy here, suspect I may not get quite your numbers!
I first took that as a list of winter flowering shrubs.
Need to do something about these off topic posts...
An interesting snippet of news from the US concerning issues surrounding the stockpiling of supplies for those who claim that Governments are not doing enough.
If you've got a 25% false negative rate then the test can be used to discern patterns and numbers (Increase by 25% of those tested) but quarantine rules should be observed even if you test negative.
Italy have a blood test now that has a 90% accuracy for detection of anti bodies- ie tells you if you have had it....this could form the basis for a get out of jail card that enables you to go out
that said...it doesn't tell you if you are going to get it again on another wave...
And very likely to prove all the nonsense theories wrong- like the Oxford study...so only a very small section of the population can go out safely with a bit of crossing fingers that it doesn't come back
@Foxy (and anyone else) I posted this on the last thread, and wondered what people make of it ?
The proposal is that novel vaccines bypass the normal (and lengthy) phase 3 trial process by seeking medical professionals (or others) who are very likely to be exposed to the virus, as informed volunteers. In ordinary times, this would be completely unethical - but what about in the current circumstances ?
(Bear in mind that by doing this, information on the vaccines' efficacy before the trial would be necessarily limited; indeed it's possible that some might even be net harmful. And you would be giving it to people you know have a high likelihood of exposure.) But it would save many months.
Human challenge studies to accelerate coronavirus vaccine licensure https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiaa152/5814216?searchresult=1 Controlled human challenge trials of SARS-CoV-2 vaccine candidates could accelerate the testing and potential rollout of efficacious vaccines. By replacing conventional Phase 3 testing of vaccine candidates, such trials may subtract many months from the licensure process, making efficacious vaccines available more quickly. Obviously, challenging volunteers with this live virus risks inducing severe disease and possibly even death. However, we argue that such studies, by accelerating vaccine evaluation, could reduce the global burden of coronavirus-related mortality and morbidity. Volunteers in such studies could autonomously authorize the risks to themselves, and their net risk could be acceptable if participants comprise healthy young adults, who are at relatively low risk of serious disease following natural infection, they have a high baseline risk of natural infection, and during the trial they receive frequent monitoring and, following any infection, the best available care...
Oxford University are asking for 500 volunteers to test the vaccine....
we are still over a year from a vaccine.....and probably much longer
I think though it is reasonable to accelerate the process.
66 doctors dead.... many more critically ill, and on the pathway to dying....about 5-10 a day are dying....
Mortality rates in Italy are still below average this season
I would challenge that assertion. It's certainly the case that the Italian healthcare system, which is a decent one in normal circumstances, has never collapsed in the same way before. Also Hubei. Also Spain. Also Iran.
One of my friends cleans for a food processing facility (So obviously key), she reckons workers are dropping like flies there and middle management is even on the floor now. Having observed the (lack of) social distancing at the bus stop outside the facility first hand I can't say I'm surprised. She's trying to keep as safe as she can there, but it's a nightmare in her words.
Along with those videos from ASOS and PLT online I reckon the herd immunity strategy may well be ripping through the warehouse staff of the UK right now.
If you've got a 25% false negative rate then the test can be used to discern patterns and numbers (Increase by 25% of those tested) but quarantine rules should be observed even if you test negative.
The other use is to declare people cured, and not at risk of onward transmission. I think the Chinese required 3 consecutive negative swabs taken a few days apart before discharge from their fever hospitals. The short duration recommended in UK, and lack of discharge swabbing pretty much guarantees onward spread.
Moth trap news from last night: 53 moths of 11 species
Frosted Green x 1 (new for the year)
Powdered Quaker x 3 (new for the year)
Clouded Drab x 3
Common Quaker x 10
Dotted Border x 1
Early Thorn x 1
Hebrew Character x 16
March Moth x 2
Oak Beauty x 3
Red Chestnut x 4
Small Quaker x 9
Powdered Quaker is a moth that appears for a short period in early spring. Never numerous, it gives cause to learn todays word of the day: irrorate, meaning covered in small spots.
A few years ago I found a beauty in my garden and later identified it as an elephant hawkmoth. Is that rare for UK?
Elephant Hawkmoths are quite common - they like to feed on fuschia. I can get them into double figures on a warm summer night. Most gardens would have them - but as people aren't out with bright lights at midnight, most won't be observed.
For those who haven't seen one, this is what you are missing:
The lockdown isn't so bad once you get used to it. It is like a long summer holiday. The government is paying for it with borrowed money, much of it from China. Could Sunak please announce how this money is going to be paid back? This question based on the premise that the lockdown is not completely lifted so that the economy does not return to normal soon. When will the government start repaying the money?
It will have to be taxation. Personally I'd like it to be clear and obvious.
"We are raising the basic rate of tax from 20% to 25%, and the higher rate from 40% to 45%....." and so on and so forth.
But I'm betting they'll try and do it via stealth taxes. VAT to 22.5%. Insurance Premium tax to 20%. Oxygen breathing tax to 10%.
There is one tax that we don't levy, that's very difficult to avoid, and avoids the Laffer Curve issues almost completely (and, almost uniquely, doesn't impact negatively on growth but in most scenarios, boosts growth).
A tax on the unimproved value of land with permissions. The rather boringly named Land Value Tax.
If the point is to raise money through taxes and the issues raised are whether or not that would boost the take overall (or run into Laffer Curve effects), how easy it is to avoid or not, and on the impact to growth, the answer is fairly straightforward.
The PPE situation that I have heard from a hospital in the South of England is that those designated for COVID19 are getting it while those that aren't are completely unprotected. Thing is, neither the workload not the disease itself is that clearly demarcated.
That's false....I know Covid wards where the NHS staff are still using flimsy gear...
Like the Book of Job, the Trolley Problem generates argument, rather than providing answers. The problem with taking a purely consequentialist approach to ethics is that you often don't know what the consequences of alternative courses of action will be. I may do something terrible, for what I believe to be the greater good, only to discover that I did not achieve the greater good. I just ended up doing something terrible.
OTOH, refraining from ever doing a bad thing, however bad the consequences might be, treats inaction as being a virtue. And that can't be right.
But we know (not believe) the consequences of inaction.(Italy)...this is not a philosophical dilemma....
We do. But we don't know the consequences of lockdown.
Mortality rate in Italy is apparently the lowest for 4 years. And a 3 year low for over 65s
I never knew the death rate for Italian doctors was usually that high...
Moth trap news from last night: 53 moths of 11 species
Frosted Green x 1 (new for the year)
Powdered Quaker x 3 (new for the year)
Clouded Drab x 3
Common Quaker x 10
Dotted Border x 1
Early Thorn x 1
Hebrew Character x 16
March Moth x 2
Oak Beauty x 3
Red Chestnut x 4
Small Quaker x 9
Powdered Quaker is a moth that appears for a short period in early spring. Never numerous, it gives cause to learn todays word of the day: irrorate, meaning covered in small spots.
A few years ago I found a beauty in my garden and later identified it as an elephant hawkmoth. Is that rare for UK?
Elephant Hawkmoths are quite common - they like to feed on fuschia. I can get them into double figures on a warm summer night. Most gardens would have them - but as people aren't out with bright lights at midnight, most won't be observed.
For those who haven't seen one, this is what you are missing:
Excellent post. This point of view really needs putting.
I tend to agree. And as for 0.5% of the population inevitably getting it? Not so (Diamond Princess).
Although NHS capacity is of course an issue.
You mean uncontrolled less than 0.5% will be infected?. The infection rate on the Diamond Princess was a lot higher than that and the ship did eventually have lockdown in place.
If you are talking about mortality from infection, these people imply a 1.3% IFR on an aged demographic (half a million deaths in the UK at herd immunity)
This one for example estimates the IFR for China at 0.66% but who can trust the Chinese numbers.
We need to take this day by day. According to some on here we are on the eve of a "tsunami". We shall see.
The point is surely to avoid the tsunami? Stocky allows for that in his argument.
Of course. I think it was a great header (one of the best for some time, in fact, given its eloquence, its timeliness, and the amount of discussion it has generated).
Overall mortality rate of the DP was 0.3% which would translate to 200k deaths in the UK although as the authors of your study note, the mean age of passengers was 58 vs 40 here in the UK. That might lower the numbers.
On balance I think that the lockdown was right. But as @Stocky points out, it needs to be managed carefully vs the known unknown risks of economic and psychological damage.
Plus, @isam made and continues to make a very good point. If flu deaths had been reported death by death in previous years (especially in spike years), what would the action have been from govt and us all.
@tyson also is losing it (understandably, he has family involved) because he seems to be placing an infinite value on lives saved whereas there is very well-tested, and currently operative cost-utility analysis says this is not right.
Excellent header. I agree with the point that once we have the virus down under NHS capacity the imperative will be to manage a controlled return to as near normal as possible pre vaccine.
What I disagree with is the presentation of the initial choice - this "first pull of the lever" - as being between Health and the Economy/Liberty. Once the government belatedly realized that the epidemic without lockdown would knock over the NHS (because of lack of ICU/ventilators), I don't think there was such a choice.
Why not? Well, because in a situation where 200,000 people were - I'll use the @Foxy phrase again since it's not improvable - "dying in hospital car parks", in that situation the economy would in any event have closed down and so would our social life.
Does anyone have the deaths from flu for the U.K. in 19/20? How does it compare with other years?
Any such comparison is meaningless since so much of the population is in lockdown.
No it’s not, the flu season ended way before lockdown. The point is, how many people vulnerable to flu in a normal season, survived this year only to became very vulnerable to Covid-19?
Does anyone have the deaths from flu for the U.K. in 19/20? How does it compare with other years?
Any such comparison is meaningless since so much of the population is in lockdown.
Also, flu deaths are extrapolated from a sample being tested, which is clearly not going to be reliable while there is another rampant respiratory virus about.
The main distinguishing factor is not just the higher mortality rate, but also the higher rate of hospitalization, duration and intensity of intervention required.
@Foxy (and anyone else) I posted this on the last thread, and wondered what people make of it ?
The proposal is that novel vaccines bypass the normal (and lengthy) phase 3 trial process by seeking medical professionals (or others) who are very likely to be exposed to the virus, as informed volunteers. In ordinary times, this would be completely unethical - but what about in the current circumstances ?
(Bear in mind that by doing this, information on the vaccines' efficacy before the trial would be necessarily limited; indeed it's possible that some might even be net harmful. And you would be giving it to people you know have a high likelihood of exposure.) But it would save many months.
Human challenge studies to accelerate coronavirus vaccine licensure https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiaa152/5814216?searchresult=1 Controlled human challenge trials of SARS-CoV-2 vaccine candidates could accelerate the testing and potential rollout of efficacious vaccines. By replacing conventional Phase 3 testing of vaccine candidates, such trials may subtract many months from the licensure process, making efficacious vaccines available more quickly. Obviously, challenging volunteers with this live virus risks inducing severe disease and possibly even death. However, we argue that such studies, by accelerating vaccine evaluation, could reduce the global burden of coronavirus-related mortality and morbidity. Volunteers in such studies could autonomously authorize the risks to themselves, and their net risk could be acceptable if participants comprise healthy young adults, who are at relatively low risk of serious disease following natural infection, they have a high baseline risk of natural infection, and during the trial they receive frequent monitoring and, following any infection, the best available care...
Oxford University are asking for 500 volunteers to test the vaccine.... we are still over a year from a vaccine.....and probably much longer
In the normal order of things, absolutely. The proposal here (and it is a fairly extreme one) is that the normal trial process be to some extent short circuited by seeking volunteers, from those most likely to be infected, for a large scale trial of the most promising candidates which emerge from early trials
Given previous Chinese behaviour in terms of medical tests, they will probably be testing on volunteers from their social re-education facilities.
An interesting snippet of news from the US concerning issues surrounding the stockpiling of supplies for those who claim that Governments are not doing enough.
Yes. A massive amount of waste, too, if you continually refresh such a stockpile.
I think the best solution is to make sure you have some local manufacturing that can be repurposed in a time of crisis to produce the specialist equipment, and pay them some money to have a plan to switch production when notified. But the difficult bit is maintaining a diverse manufacturing base that can do that.
Moth trap news from last night: 53 moths of 11 species
Frosted Green x 1 (new for the year)
Powdered Quaker x 3 (new for the year)
Clouded Drab x 3
Common Quaker x 10
Dotted Border x 1
Early Thorn x 1
Hebrew Character x 16
March Moth x 2
Oak Beauty x 3
Red Chestnut x 4
Small Quaker x 9
Powdered Quaker is a moth that appears for a short period in early spring. Never numerous, it gives cause to learn todays word of the day: irrorate, meaning covered in small spots.
A few years ago I found a beauty in my garden and later identified it as an elephant hawkmoth. Is that rare for UK?
Elephant Hawkmoths are quite common - they like to feed on fuschia. I can get them into double figures on a warm summer night. Most gardens would have them - but as people aren't out with bright lights at midnight, most won't be observed.
For those who haven't seen one, this is what you are missing:
The PPE situation that I have heard from a hospital in the South of England is that those designated for COVID19 are getting it while those that aren't are completely unprotected. Thing is, neither the workload not the disease itself is that clearly demarcated.
That's false....I know Covid wards where the NHS staff are still using flimsy gear...
Nerryhughes comments are wrong....misinformation
I give in
I don't think people understand the whole "from your perspective and anecdotes" thing. Your experiences may differ from theirs. Just ignore them.
"Chris Hopson, the chief executive of NHS Providers, said if existing NHS pathology labs had unlimited swabs and reagent, there would be enough test machine capacity to process around 100,000 tests a day.
But Mr Hopson said a "reagent and swab shortage is currently limiting this to [around] 13,000 a day".
On banks, they have cancelled the dividends but are arguing over bankers bonuses.
Somethings never change, time to put 100% emergency tax on all these bonuses
Bonuses are part of wages for many of those employees. Do you want a 100% tax on other sectors employees wages?
Are you defending bankers bonuses at a time of economic armageddon
If the banks can afford to pay their staff their bonuses then yes absolutely. I'd say the same for any other business in the country.
If they can't, then no.
According to Taleb banks have made as many historic losses as their profits. I dont know if thats fully accurate but certainly their profits get distributed to senior management, with shareholders repeatedly wiped out and governments required to bail them out.
Over the long term bankers bonuses are not maintained by profits, even if they are over a particular year or bonus period.
I suspect the fed up at home factor will be a big motivant for change in 4-6 weeks time. People aren't going to lock themselves away for ever.
You mean it isn't the April 1st article?
It still remains to be seen which is the better approach and only time will tell. Currently we are all focussing on Covid 19 direct deaths but there will be other deaths or indeed longer lives in areas affected by current actions.
Try having no health service for 2-3 months because it's collapsed under the weight of the pandemic, and see how many "other deaths" there are then!
That's what Sweden is doing, only time will tell if they've called it right.
But in the current UK circumstances there will arguably be fewer road deaths, deaths from pollution etc on one side but on the other hospitals have been cleared so there will be deaths from people not getting the ops they need.
While clearly I hope the NHS can cope with what lies before it, I don't take it as a slam dunk. We are in uncharted waters and nobody knows what the best solution is. Worse, lots of people want different outcomes so there simply is no "right" answer in the circumstances.
Comments
The NHS should be focussing on critical care including pandemics from now on - not some of the frippery and waste previously indulged.
For the last couple of weeks I have been pointing out to friends that since the house numbers on our road go up to about 360, for 700-1000 people (mainly houses not flats), the potential overall mortality rate 0.1% - 0.5% as suggested means perhaps a couple of people dead amongst them, repeated everywhere.
https://www.youtube.com/watch?v=_mesqgyPkpw&feature=youtu.be
They said they were quite surprised actually, as they had rushed to reorganise, expecting the wave to have hit by now, but it hasn't.
However, they were still on high alert and under no illusion that its coming.
It is clearly patchy and I think the issue of PPE comes when you get hit with the tsunami like in London and as fast you as you try and react the water keeps rising.
The timeline can be influenced, as we know.
66 doctors dead....
many more critically ill, and on the pathway to dying....about 5-10 a day are dying....
Like the Book of Job, the Trolley Problem generates argument, rather than providing answers. The problem with taking a purely consequentialist approach to ethics is that you often don't know what the consequences of alternative courses of action will be. I may do something terrible, for what I believe to be the greater good, only to discover that I did not achieve the greater good. I just ended up doing something terrible.
OTOH, refraining from ever doing a bad thing, however bad the consequences might be, treats inaction as being a virtue. And that can't be right.
But we know (not believe) the consequences of inaction.(Italy)...this is not a philosophical dilemma....
Somethings never change, time to put 100% emergency tax on all these bonuses
Frosted Green x 1 (new for the year)
Powdered Quaker x 3 (new for the year)
Clouded Drab x 3
Common Quaker x 10
Dotted Border x 1
Early Thorn x 1
Hebrew Character x 16
March Moth x 2
Oak Beauty x 3
Red Chestnut x 4
Small Quaker x 9
Powdered Quaker is a moth that appears for a short period in early spring. Never numerous, it gives cause to learn todays word of the day: irrorate, meaning covered in small spots.
https://britishlepidoptera.weebly.com/247-orthosia-gracilis-powdered-quaker.html
Nerryhughes comments are wrong....misinformation
A few years ago I found a beauty in my garden and later identified it as an elephant hawkmoth. Is that rare for UK?
There was the claimed it was an issue of lack of reagent chemicals. Peston, caveat emptor, claims the UK chemical industry says they can make this stuff, but never been approached to ramp up production.
This might be true, might be nonsense. We know the oxygen suppliers were approached weeks ago to quadruple production.
My take is perhaps they were working on the principle that the anti-body test would be ready by now and that has hit a snag in terms of accuracy. Because obviously if we had even 100,000s of those kits we can get through the NHS frontline staff pretty quickly and give the plague survivors their badge.
The roads are quiet so they're probably not needed round here.
I posted this on the last thread, and wondered what people make of it ?
The proposal is that novel vaccines bypass the normal (and lengthy) phase 3 trial process by seeking medical professionals (or others) who are very likely to be exposed to the virus, as informed volunteers.
In ordinary times, this would be completely unethical - but what about in the current circumstances ?
(Bear in mind that by doing this, information on the vaccines' efficacy before the trial would be necessarily limited; indeed it's possible that some might even be net harmful. And you would be giving it to people you know have a high likelihood of exposure.)
But it would save many months.
Human challenge studies to accelerate coronavirus vaccine licensure
https://academic.oup.com/jid/advance-article/doi/10.1093/infdis/jiaa152/5814216?searchresult=1
Controlled human challenge trials of SARS-CoV-2 vaccine candidates could accelerate the testing and potential rollout of efficacious vaccines. By replacing conventional Phase 3 testing of vaccine candidates, such trials may subtract many months from the licensure process, making efficacious vaccines available more quickly. Obviously, challenging volunteers with this live virus risks inducing severe disease and possibly even death. However, we argue that such studies, by accelerating vaccine evaluation, could reduce the global burden of coronavirus-related mortality and morbidity. Volunteers in such studies could autonomously authorize the risks to themselves, and their net risk could be acceptable if participants comprise healthy young adults, who are at relatively low risk of serious disease following natural infection, they have a high baseline risk of natural infection, and during the trial they receive frequent monitoring and, following any infection, the best available care...
I think it's deliberate policy because the best available test right now isn't that good. The 25% false negative rate means that it's utility at this stage is limited - and there are scenarios where it could do more harm than good.
There is absolutely no doubt, reducing the incidence of the virus will see other deaths reduce as well.
I previously linked to a video showing that even a test that is 98% accurate can lead to extremely significant issues when deployed at mass scale.
Is this 70-80% accuracy rate true across the world e.g. South Korea, Germany etc?
we are still over a year from a vaccine.....and probably much longer
This one for example estimates the IFR for China at 0.66% but who can trust the Chinese numbers.
We need to take this day by day. According to some on here we are on the eve of a "tsunami". We shall see.
But the serious point from Stocky's header (and FWIW, I don't agree with his conclusion) is that the negative consequences of continuing lockdown have not adequately been assessed or expressed. Which is I think a fair point.
they are opening good friday and easter monday to help field calls and she thinks all GP surgeries nationwide will be doing the same. she is not management though so just going from what she was been told.
eg Taking patient home, or if patient not admitted (though perhaps less now that the first responder is likely to be a paramedic in a car).
They don’t have proper masks. They don’t have eye guards. If the numbers shoot up, she and her colleagues are at very high risk.
I don’t blame her for being terrified.
My sister is a mental health nurse but has been told if needed she will be drafted onto the wards. She has colitis so has been on immuno-suppressant drugs a lot, though she is not taking them currently. She has been given some PPE but, again, no eye guards.
She too is scared.
So it looks like plenty of medical staff are getting some PPE, but perhaps not the proper masks and other stuff that ideally they should be getting. And how large the stocks are of the less than perfect PPE are is also worrying.
Feeling better this morning BTW.
Most of the time, they use the sirens on the way to the patient, rather than on the way to the hospital - if the patient is stable.
For those who haven't seen one, this is what you are missing:
https://ukmoths.org.uk/species/deilephila-elpenor/
The proposal here (and it is a fairly extreme one) is that the normal trial process be to some extent short circuited by seeking volunteers, from those most likely to be infected, for a large scale trial of the most promising candidates which emerge from early trials
Need to do something about these off topic posts...
https://www.sfchronicle.com/bayarea/article/Coronavirus-California-had-21-million-N95-masks-15164180.php
that said...it doesn't tell you if you are going to get it again on another wave...
And very likely to prove all the nonsense theories wrong- like the Oxford study...so only a very small section of the population can go out safely with a bit of crossing fingers that it doesn't come back
Along with those videos from ASOS and PLT online I reckon the herd immunity strategy may well be ripping through the warehouse staff of the UK right now.
https://twitter.com/DrRosena/status/1244961277828612096?s=19
When we went regularly with the grandchildren it was either a long weekend or a mid week stay
We managed to rescue most of them from the walls, and consequently were able to see a variety of hawkmoths close to. Amazing things.
I think the Eyed Hawkmoths were the largest they brought in.
A tax on the unimproved value of land with permissions.
The rather boringly named Land Value Tax.
If the point is to raise money through taxes and the issues raised are whether or not that would boost the take overall (or run into Laffer Curve effects), how easy it is to avoid or not, and on the impact to growth, the answer is fairly straightforward.
Rick Astley announces massive free gig for NHS workers and emergency services at Manchester Arena
https://www.manchestereveningnews.co.uk/whats-on/music-nightlife-news/rick-astley-announces-massive-free-18018207
Of course, the head honchos in the bank are trying to use that fact as a cover for paying out the Ferrari buying money.
I think the lack of food as a result of the lockdown will take it's toll on some of our urban wildlife
Overall mortality rate of the DP was 0.3% which would translate to 200k deaths in the UK although as the authors of your study note, the mean age of passengers was 58 vs 40 here in the UK. That might lower the numbers.
On balance I think that the lockdown was right. But as @Stocky points out, it needs to be managed carefully vs the known unknown risks of economic and psychological damage.
Plus, @isam made and continues to make a very good point. If flu deaths had been reported death by death in previous years (especially in spike years), what would the action have been from govt and us all.
@tyson also is losing it (understandably, he has family involved) because he seems to be placing an infinite value on lives saved whereas there is very well-tested, and currently operative cost-utility analysis says this is not right.
What I disagree with is the presentation of the initial choice - this "first pull of the lever" - as being between Health and the Economy/Liberty. Once the government belatedly realized that the epidemic without lockdown would knock over the NHS (because of lack of ICU/ventilators), I don't think there was such a choice.
Why not? Well, because in a situation where 200,000 people were - I'll use the @Foxy phrase again since it's not improvable - "dying in hospital car parks", in that situation the economy would in any event have closed down and so would our social life.
Letters - if automated from a big company see above. If handwritten then I dont see why the letter is safer than the envelope.
If they can't, then no.
The main distinguishing factor is not just the higher mortality rate, but also the higher rate of hospitalization, duration and intensity of intervention required.
I think the best solution is to make sure you have some local manufacturing that can be repurposed in a time of crisis to produce the specialist equipment, and pay them some money to have a plan to switch production when notified. But the difficult bit is maintaining a diverse manufacturing base that can do that.
https://www.bbc.co.uk/news/uk-52114719
"Chris Hopson, the chief executive of NHS Providers, said if existing NHS pathology labs had unlimited swabs and reagent, there would be enough test machine capacity to process around 100,000 tests a day.
But Mr Hopson said a "reagent and swab shortage is currently limiting this to [around] 13,000 a day".
Over the long term bankers bonuses are not maintained by profits, even if they are over a particular year or bonus period.
But in the current UK circumstances there will arguably be fewer road deaths, deaths from pollution etc on one side but on the other hospitals have been cleared so there will be deaths from people not getting the ops they need.
While clearly I hope the NHS can cope with what lies before it, I don't take it as a slam dunk. We are in uncharted waters and nobody knows what the best solution is. Worse, lots of people want different outcomes so there simply is no "right" answer in the circumstances.