Corona Virus main thread

[sonyc 5,517]

There was an interesting R4 piece, probably a month ago about how producers (globally) need to work together regarding vaccines for the very point of being able to provide adequate production capacity. Working alone, he suggested, would be a huge mistake and stated it didn't matter who was first to market because they will want collaboration and a solution. Yet, the biggest challenge of all was that tens of billion of pounds (dollars etc) was needed to support such a global response.

[Van wink 2,994]

Good to see the Scottish Govt. beginning to see some sense about wearing of face masks.

[sonyc 5,517]

5 minutes ago, Van wink said:

Good to see the Scottish Govt. beginning to see some sense about wearing of face masks.

Up to a 9000 euro fine for not wearing them in certain public situations in Germany. T might advise. Incredible really that two countries have such a wide interpretation of the case  (or advice) about wearing them 

[Wacky Waving Inflatable Arm Flailing Tube Man 3,820]

8 minutes ago, Van wink said:

Good to see the Scottish Govt. beginning to see some sense about wearing of face masks.

 

Just now, sonyc said:

Up to a 9000 euro fine for not wearing them in certain public situations in Germany. T might advise. Incredible really that two countries have such a wide interpretation of the case  (or advice) about wearing them 

The UK's stance on masks is quite confusing. They're really hot on distancing in supermarkets, one-in-one-out in certain shops and doing everything possible to prevent contact but very few seem to be wearing masks, whereas in other countries they're essential. In Italy, there's freedom of movement within supermarkets but everyone wears a mask, and in some of the northern regions where the virus is considerably worse than the south, it's mandatory. Masks are also freely available in the supermarkets and they cost less than €1 each.

It's peculiar that UK are being very strict on many things but completely ignoring something else, when the rest of the world see it is being very important.

[Van wink 2,994]

7 minutes ago, sonyc said:

Up to a 9000 euro fine for not wearing them in certain public situations in Germany. T might advise. Incredible really that two countries have such a wide interpretation of the case  (or advice) about wearing them 

It is, especially when the evidence for prevention of spread has been there for so long.

Edited April 28, 2020 by Van wink

[sonyc 5,517]

 

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[Mark .Y. 352]

3 minutes ago, Wacky Waving Inflatable Arm Flailing Tube Man said:

 

The UK's stance on masks is quite confusing. They're really hot on distancing in supermarkets, one-in-one-out in certain shops and doing everything possible to prevent contact but very few seem to be wearing masks, whereas in other countries they're essential. In Italy, there's freedom of movement within supermarkets but everyone wears a mask, and in some of the northern regions where the virus is considerably worse than the south, it's mandatory. Masks are also freely available in the supermarkets and they cost less than €1 each.

It's peculiar that UK are being very strict on many things but completely ignoring something else, when the rest of the world see it is being very important.

I have literally just read an article which stated that the members of the advisory group (SAGE, I assume) cannot all agree on what is the best advice to give to the Government regarding the use of masks.

[Mark .Y. 352]

Interesting article from The Bronx ( the real one that is, not Gt. Yarmouth 😉)

 

I’m an emergency physician at St. Barnabas Hospital in The Bronx. I have been in the ER every day these last few weeks, either supervising or providing direct care. I contracted a COVID-19 infection very early in the outbreak, as did two of my daughters, one of whom is a nurse. We are all well, thank God.

COVID-19 has been the worst health-care disaster of my 30-year ­career, because of its intensity, duration and potential for lasting impact. The lasting impact is what worries me the most. And it’s why I now believe we should end the lockdown and rapidly get back to work.

From mid-March through mid-April, the ER staff at St. Barnabas huddled in groups of about 20 every morning. We asked ourselves what had happened over the previous shift. We generated a list of action­able tasks for the following 24 hours. At first, we addressed personal protective equipment and the management of patients with mild illness who were seeking COVID-19 tests.

Then came the wave of critically ill patients in numbers none of us had ever seen. This lasted for two weeks. The number of patients on ventilators accumulated in the ER and throughout the hospital. We witnessed an unprecedented number of deaths. The tone of the huddles became more somber. We became accustomed to the morbidity; we did our jobs.

It is precisely what I have witnessed that now tells me that it’s time to ease the lockdown. Here’s why.

First, the wave has crested. At 1 p.m. on April 7, the COVID-19 arrivals slowed down. It was a discrete, noticeable event. Stretchers became available by 5 p.m., and the number of arriving COVID-19 patients dropped below the number discharged, transferred or deceased.

This was striking, because the community I serve is poor. Some are homeless. Most work in “essential,” low-paying jobs, where distancing isn’t easy. Nevertheless, the wave passed over us, peaked and subsided. The way this transpired tells me the ebb and flow had more to do with the natural course of the outbreak than it did with the lockdown.

Second, I worry about non-coronavirus care. While the inpatient units remain busy with sick COVID-19 patients, our ER has been quiet for more than a week. We usually average 240 patients a day. For the last week, we averaged fewer than 100. That means our patients in this diverse, low-income community are afraid to come to the ER for non-COVID care.

Gotham-wide, the number of 911 ambulance runs declined to 3,320 on April 18, down from a peak of 6,527 on March 30, according to New York Fire Department data. The current nadir is significantly below the average.

A large share of those staying home surely have emergency medical and surgical conditions not related to the novel coronavirus. The growing numbers ­dying at home during this crisis must include fatal myocardial infarctions, asthma exacerbations, bacterial infections and strokes.

Meanwhile, our pediatric volume in the ER has practically disappeared. Visits to primary-care pediatricians are also down, with vaccine schedules falling behind. Everyone seems to be avoiding the health system — an important and unfortunate consequence of the stay-at-home strategy.

Third, inordinate fear misguides the public response. While COVID-19 is serious, fear of it is being over-amplified. The public needs to understand that the vast majority of infected people do quite well.

Finally, COVID-19 is more prevalent than we think. Many New Yorkers already have the COVID-19 infection, whether they are aware of it or not. As of today, over 43 percent of those tested are positive in The Bronx. We are developing a significant degree of natural herd immunity. Distancing works, but I am skeptical that it is playing as predominant a role as many think.

More testing will better establish the numbers among those with mild illnesses and no symptoms. My professional ­experience tells me the number of infected people will be high. Testing is important work, but it should happen in parallel to the immediate resuscitation of the economy and getting people back to work.

At present, the testing is ­imperfect. We can’t wait months. We must protect the vulnerable and mitigate without destroying the economy.

Standing up to this virus can’t be the job of essential workers only. We’ve been strong, but we’re tired, and we need the rest of you to help us. By getting back to work.

Daniel G. Murphy, MD, is chairman of the Department of Emergency Medicine at St. Barnabas Hospital in The Bronx.

[Van wink 2,994]

1 hour ago, Mark .Y. said:

I have literally just read an article which stated that the members of the advisory group (SAGE, I assume) cannot all agree on what is the best advice to give to the Government regarding the use of masks.

Yes I have read that, its a problem if there is one dissenting voice and so a recommendations doesnt go forward. I would hope that in all these things the government is presented with options and the range of opinions. They then have to make the decision. It does throw into some question the phrase "we are following the science" because of course there is often no absolute.

Edited April 28, 2020 by Van wink

[Wacky Waving Inflatable Arm Flailing Tube Man 3,820]

4 minutes ago, Mark .Y. said:

I have literally just read an article which stated that the members of the advisory group (SAGE, I assume) cannot all agree on what is the best advice to give to the Government regarding the use of masks.

Yeah, that generally seems to be the long and the short of it. Most other countries have agreed that there's a benefit, so it's peculiar that the UK hasn't, especially when they are being so strict on other prevention measures.

[T 190]

58 minutes ago, Bagster said:

I think there would be a lot of people that do not share your enthusiasm for those two leaders.

Are you really calling Boris "hard right"

That's a  ridiculous statement!

 

 

58 minutes ago, Bagster said:

I think there would be a lot of people that do not share your enthusiasm for those two leaders.

Are you really calling Boris "hard right"

That's a  ridiculous statement!

 

I think you will find all the refugees that the xenophobic hate are now in jobs or training including essential jobs or where there are shortages so Merkel proven right on that one so that issue died down.   I appreciate that the hard right would prefer refugees would be bombed or drown. Merkel has 90pc approval ratings and also NZ leader highly praised. 
 

No Boris just attached himself to a hard right policy that he doesn’t believe in as he saw it correctly for himself as a political opportunity. He is not hard right just following a  particular hard right policy give the demographics of the conservative memberships that elected him.  Unfortunately on the right and left it is the hard line ideaologists which are most attracted to political involvement as those with strong ideologies feel most passionate about their views. I’m just against racism and for pragmatism which I know is unpopular with hard liners. Consequently because hard liners have undue influence the UK ends up with poor political options unlesss you hold extremist views. 

[sonyc 5,517]

13 minutes ago, Van wink said:

Yes I have read that, its a problem if there is one dissenting voice therefore a recommendations dopant go forward. I would hope that in all these things the government is presented with options and the range of opinions. They then have to make the decision. It does throw into some question the phrase "we are following the science" because of course there is often no absolute.

"Following the science" or being guided by it has become rather a tired statement. It's as if there is one pure answer and to keep saying it implies a convenience. I suppose we don't know enough so the government just has to do it's best. Decisions have to be made and it won't be easy. After seeming to be late to the event, there is probably now more caution. Especially as Johnson, Hancock and Cummings contracted it. I'm guessing that last point must be an influence.

[Yellow Fever 3,782]

11 minutes ago, sonyc said:

"Following the science" or being guided by it has become rather a tired statement. It's as if there is one pure answer and to keep saying it implies a convenience. I suppose we don't know enough so the government just has to do it's best. Decisions have to be made and it won't be easy. After seeming to be late to the event, there is probably now more caution. Especially as Johnson, Hancock and Cummings contracted it. I'm guessing that last point must be an influence.

It's rather like the cycle helmet argument. The helmet is of course good - but only if used correctly. If mandatory it might put more people off cycling then 'bad' - not that cycling is that safe a mode of transport anyway!

Ultimately it's  political decision.

 

Edited April 28, 2020 by Yellow Fever

[T 190]

Interestingly in Germany the head of the public health authority speaks independently from the government so it is not a question as in the UK of politicians saying they are following scientific advice you can see whether they are or not   Surely a better approach  

 

Reported deaths include all confirmed cases not just hospital deaths so U.K. really is doing appallingly in comparison

 

R is currently 1 Average age for victims is 81  R is an average so need to act locally  Can currently track 1000 cases so need to massively increase local tracing capacity   School children don’t seem to be a major cause for spread so political decision Sees natural herd immunity as dangerous and difficult to comprehend therefore recommends conservative approach    They can now estimate unrecorded cases using an internationally recognised model. 
 

So the death rate in UK is horrendous compared to Germany due to lack of preparation but the thinking going forward does seem consistent  

 

 

Edited April 28, 2020 by T

[Barbe bleu 825]

My take is that research seems to suggest that face masks have some minor benefit if used correctly and in certain situations.

The government though is looking at figures going the right way and wondering why they would risk this turning around for a potential minor benefit.

I would probably be in the 'if it ain't broke' camp right now. 

The real question is not what advice we have now but what will be given when more liberty is extended

[The Bristol Nest 513]

Mask have merit in protecting others but unless you have a gown, gloves and importantly googles you should not relax social distancing or touch your face.

[Barbe bleu 825]

2 minutes ago, The Bristol Nest said:

Mask have merit in protecting others but unless you have a gown, gloves and importantly googles you should not relax social distancing or touch your face.

And I think that's the crux of the problem.  If we advise facemasks are useful does it then torpedo everything else that has a clearer and bigger value because everyone assumes that they have now become effectively immune /has found a convenient excuse.

 

[T 190]

Agreed as a compulsory mask wearer I’m not convinced. It is not very friendly but is no great imposition to cover your face with whatever when entering a shop or on local transport and guess it reduces risks for other people and they risk of them spreading droplets to you. If it saves other lives marginally happy to do so but no substitute for other measures. 
 

Ideally we would have locally produced washable fffp2 masks. Don’t think there is even such a thing as washable ffp2  Germany looking to introduce publicly available ffp2 masks in second half of year but Germany has a much larger manufacturing base than UK. 

[Van wink 2,994]

21 minutes ago, T said:

Interestingly in Germany the head of the public health authority speaks independently from the government so it is not a question as in the UK of politicians saying they are following scientific advice you can see whether they are or not   Surely a better approach  

 

 

 

 

You make some good points, this being one, some of the other stuff you feel obliged to add about Germany doesnt help.

My concern is that the press conferences are tending to politicise the "experts" whose future will become linked to the fortunes of the Governing party and not to their level of expertise. 

[Van wink 2,994]

13 minutes ago, Barbe bleu said:

And I think that's the crux of the problem.  If we advise facemasks are useful does it then torpedo everything else that has a clearer and bigger value because everyone assumes that they have now become effectively immune /has found a convenient excuse.

 

It would do if badly communicated, its the job of Government to make sure that the correct message gets through.

[Van wink 2,994]

10 minutes ago, T said:

Agreed as a compulsory mask wearer I’m not convinced. It is not very friendly but is no great imposition to cover your face with whatever when entering a shop or on local transport and guess it reduces risks for other people and they risk of them spreading droplets to you. If it saves other lives marginally happy to do so but no substitute for other measures. 
 

Ideally we would have locally produced washable fffp2 masks. Don’t think there is even such a thing as washable ffp2  Germany looking to introduce publicly available ffp2 masks in second half of year but Germany has a much larger manufacturing base than UK. 

Changed your mind on this one it appears

[Wacky Waving Inflatable Arm Flailing Tube Man 3,820]

17 minutes ago, Barbe bleu said:

And I think that's the crux of the problem.  If we advise facemasks are useful does it then torpedo everything else that has a clearer and bigger value because everyone assumes that they have now become effectively immune /has found a convenient excuse.

 

Whilst you are right, I think it's strange that people would think that.

"Ah well, I'm using one form of prevention, so I don't need to do any others."

Why do people think like that about masks but not, for example, the two-metre distance or the non-essential journeys?

[T 190]

I appreciate the German angle grates with those of a certain disposition and switches them off. I do wonder if it  was another European benchmark they would be so agitated. Some people really do need to move on from the past. 
 

But it is interesting to compare with different countries not just Germany and the important point Is not that it is Germany but what can we learn in the UK from what is going on in other countries further along the curve rather than get hung up about Germany on any other country for that matter. The circumstances in each country are different though so have to be careful with direct comparisons. It doesn’t support the UK preparations but it does support the current UK approach. 

[Jim Smith 2,317]

30 minutes ago, T said:

Interestingly in Germany the head of the public health authority speaks independently from the government so it is not a question as in the UK of politicians saying they are following scientific advice you can see whether they are or not   Surely a better approach  

 

Reported deaths include all confirmed cases not just hospital deaths so U.K. really is doing appallingly in comparison

 

R is currently 1 Average age for victims is 81  R is an average so need to act locally  Can currently track 1000 cases so need to massively increase local tracing capacity   School children don’t seem to be a major cause for spread so political decision Sees natural herd immunity as dangerous and difficult to comprehend therefore recommends conservative approach    They can now estimate unrecorded cases using an internationally recognised model. 
 

So the death rate in UK is horrendous compared to Germany due to lack of preparation but the thinking going forward does seem consistent  

 

 

Yes but in much of Germany they do not test for Covid 19 in post mortems apparently and so unless someone was tested for it before they died they don't count as a Covid 19 death. They also don't seem to publish as regular ONS type stats in order to be able to guage the excess mortality there has been in Germany. The suggestion is therefore that their death numbers have been significantly downplayed. 

Not saying that they haven't dealt with it better than us in terms of testing/isolating etc but I'm not sure their stats are as reliable as is made out. Conversely our ONS stats include anyone who has a possible mention of covid 19 on their death certificate, even if they have not been tested and with deaths in care homes often being certified by nurses as doctors can't get in there. So you could say that by publishing those stats we are being the most "hon est" in Europe in terms of our reporting and probably the ONS stats overstate the numbers.

×.url

[T 190]

9 minutes ago, Van wink said:

Changed your mind on this one it appears

Really? I thinks the views on masks have always been mixed and marginal as my view is now and BB said. I just think you should base views on the latest available expert info and those views will change as more data becomes available. 

[Well b back 3,203]

2 hours ago, ron obvious said:

https://unherd.com/2020/04/when-we-get-the-covid-19-vaccine/

Here’s something to add to this article which does make the positives stand out more than the negatives. This is in relation to the vaccine deliver by Oxford ( Sarah Gilbert ).

On Monday, the world's largest vaccine maker, the Serum Institute of India, said it would not wait for the trial to end and was preemptively making 40 million doses to save time in case it worked.

A lot of money to throw down the drain if they had major doubts.

 

[Van wink 2,994]

Just now, T said:

Really? I thinks the views on masks have always been mixed and marginal as my view is now and BB said. I just think you should base views on the latest available expert info and those views will change as more data becomes available. 

Nothing wrong with changing your view to take account of latest expert info, to be applauded 👍

[Van wink 2,994]

7 minutes ago, T said:

I appreciate the German angle grates with those of a certain disposition and switches them off. I do wonder if it  was another European benchmark they would be so agitated. Some people really do need to move on from the past. 
 

But it is interesting to compare with different countries not just Germany and the important point Is not that it is Germany but what can we learn in the UK from what is going on in other countries further along the curve rather than get hung up about Germany on any other country for that matter. The circumstances in each country are different though so have to be careful with direct comparisons. It doesn’t support the UK preparations but it does support the current UK approach. 

Nothing to do with grating,  or your implied anti Germanic rhetoric, which is also unnecessary and certainly in my case completely ill founded T, but using it as a stick to constantly bash the UK is irritating, as with any other stick, particularly as none of us will have all the accurate info about CV19 related deaths to draw relevant comparisons till this is over and proper research can be done.

[Bagster 101]

2 hours ago, Herman said:

It's a fair statement. 

Well would you like to expand on that.

For instance, other than brexit could you let me know what policies he has that are far right?

[The Bristol Nest 513]

9 minutes ago, Well b back said:

Here’s something to add to this article which does make the positives stand out more than the negatives. This is in relation to the vaccine deliver by Oxford ( Sarah Gilbert ).

On Monday, the world's largest vaccine maker, the Serum Institute of India, said it would not wait for the trial to end and was preemptively making 40 million doses to save time in case it worked.

A lot of money to throw down the drain if they had major doubts.

 

Haven't Glaxo joined up with the big French pharmaceutical manufacturer in order to do something potentially similar but when trials are complete?