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6 minutes ago, Barbe bleu said:

I'm going with, in order of term and chronology:

1) inherently unhealthy towns and cities allowing rapid spread

2) poor personal health at younger ages exacerbating impact of infection (reducing ability of immune system to clear the infection?)

3) lack of adequate mobilisation of resources at the 'contain' phase and unwillingness to take further preventative measures ahead of availability of hard data

4) too many assumptions made about efficacy of infection control in care sector / failure to protect care homes.

5) lack of compliance with advice and instruction 

 

I am not wholly convinced that NHS funding is particularly important in the course of this infection as it is primarily a public health emergency and not a medical one. By the time you talk about funding for medical (tertiary) intervention on massive scale you have already missed the primary and secondary reponses.

 

In terms of controlling infections, you’re probably right re nhs. In terms of deaths though I disagree.

In terms of covid deaths specifically, you look at lack of PPE, putting front line staff and patients at avoidable risk, leading to avoidable deaths. Lack of ventilators at the outset - and I know ventilation isn’t always used now, but it may have helped at the outset. You look at not having enough physical room to space people out safely so you’ve had people go into hospital with one thing, catch covid and die from that whilst there. 

In terms of non-covid deaths, we don’t know how many premature deaths there have already been and will continue to be in the next couple of years as a result of cancellation of non-covid treatment and missed diagnoses (or suicide/mental health problems/ poverty related health issues). That’s because we haven’t got enough staff predominantly but also facilities to have been able to keep things open. I should stress that’s not new and happens every year - we already have ridiculous waiting times and cancellation of operations most winters.

I’m not massively convinced by your number 2, although it depends what you mean by younger ages. When we see these 18-65 deaths, almost all of them are 60 plus. In the under 40s, the deaths have been very very minimal. If you’re talking about that 50-70 age group though, I’d agree. And that’s not to say the health in the under 40s is good - I imagine lots of under 40s are well on the way to being high risk when they are in their 50s and 60s, but I’m not sure there have been enough deaths in under 40s to call poor personal health in that age group one of the four main things leading to the sheer number of deaths. 

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5 minutes ago, paul moy said:

The point is that the NHS will always get the money when needed. 

You are obviously so pig headed, you cannot bring yourself to admit, no matter which Government is in power, the NHS, the jewel in the crown, has been underfunded.

Now, even people like you who believe in self reliability, must realise it is mend and make do anymore. Its sustained funding plus 5%.

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44 minutes ago, Barbe bleu said:

2) poor personal health at younger ages exacerbating impact of infection (reducing ability of immune system to clear the infection?)

This one leaves me confused BB.

I suspect basic hygiene is better these days in the young than their elders.  We certainly take more baths and showers and soap now and we won't even mention smoking and similar in the past or poor diets and obesity.

Oddly I think its now accepted that exposure as children to dirt and bugs helps the immune system develop. One counter argument is that we're too 'clean' these days.

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30 minutes ago, paul moy said:

The point is that the NHS will always get the money when needed. 

When reviews and a public inquiry at some stage look at lessons to be learned from the handling of the pandemic in the UK, the question of the readiness of the NHS is sure to be considered. 

NHS Providers has highlighted one key part of this - the relative lack of critical care beds in hospitals, reflecting in part insufficient investment going back many years. 

The UK has fewer hospital beds for seriously ill patients relative to the population than leading European economies such as France, Germany, Italy and Spain. 

So going into the pandemic the health service was in some ways not as well resourced as it might have been. 

The NHS coped astonishingly well last April and in the most recent surge, and hospitals were not overwhelmed.

But sufficient critical care beds were created for Covid patients only by using wards which could not therefore be used by others - much routine and non urgent care had to be postponed.

The argument now being made is that there needs to be a review of what is needed as a safety net for future crises - and funding to go with it.

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2 hours ago, Yellow Fever said:

This one leaves me confused BB.

I suspect basic hygiene is better these days in the young than their elders.  We certainly take more baths and showers and soap now and we won't even mention smoking and similar in the past or poor diets and obesity.

Oddly I think its now accepted that exposure as children to dirt and bugs helps the immune system develop. One counter argument is that we're too 'clean' these days.

In a more crude form this might translate as  we have lots of obese and immobile middle aged people.  The older generation are susceptible almost by definition but our lifestyles in the next age groups have probably left us really exposed to this and more so than elsewhere.

Perhaps we shouldn't mock Japanese factory workers doing  their daily group exercises..

Edited by Barbe bleu
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1 minute ago, Indy said:

image.png

Brilliant Indy. It sums up how feel about many of my generation at present. Now we've had our vaccinations the fit elderly want to party and the devil may care about the rest.

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23 minutes ago, Yellow Fever said:

Brilliant Indy. It sums up how feel about many of my generation at present. Now we've had our vaccinations the fit elderly want to party and the devil may care about the rest.

thing is, much of my generation feel like this as well...

"Now you've had your vaccinations, the young and healthy want to party and the devil may care about the rest"

Thankfully I don't need to worry too much about this debate personally since I snuck on the vaccination list for what I'd say is a very minor underlying condition, not that I'm complaining! I'll be the first one hugging strangers when away days are back!

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19 minutes ago, Tetteys Jig said:

thing is, much of my generation feel like this as well...

"Now you've had your vaccinations, the young and healthy want to party and the devil may care about the rest"

Thankfully I don't need to worry too much about this debate personally since I snuck on the vaccination list for what I'd say is a very minor underlying condition, not that I'm complaining! I'll be the first one hugging strangers when away days are back!

That’s the thing I can’t get my head round,I’m 50 fit, had a medical last April where I was a low risk of any health issues, not over weight nor any conditions thankfully, yet I got contacted and had my Covid jab last Friday, yet others who are older with condition haven’t been vaccinated! It was my surgery who texted me, told me to book online which I did! How’s that?

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29 minutes ago, Indy said:

That’s the thing I can’t get my head round,I’m 50 fit, had a medical last April where I was a low risk of any health issues, not over weight nor any conditions thankfully, yet I got contacted and had my Covid jab last Friday, yet others who are older with condition haven’t been vaccinated! It was my surgery who texted me, told me to book online which I did! How’s that?

My wife was in a supermarket a few days back. Basically said most of the pensioners had stopped social distancing and where pushing in as normal. Go figure!

My guess is lots of low hanging fruit in a few weeks if one of these new variants takes hold.

Edited by Yellow Fever

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1 minute ago, Yellow Fever said:

My wide was in a supermarket a few days back. Basically said most of the pensioners had stopped social distancing and where pushing in as normal. Go figure!

My guess is lots of low hanging fruit in a few weeks if one of these new variants takes hold.

Perhaps she should be narrower.😀

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2 hours ago, Indy said:

That’s the thing I can’t get my head round,I’m 50 fit, had a medical last April where I was a low risk of any health issues, not over weight nor any conditions thankfully, yet I got contacted and had my Covid jab last Friday, yet others who are older with condition haven’t been vaccinated! It was my surgery who texted me, told me to book online which I did! How’s that?

same as me, I even tried my luck on the website before to no avail just in case there were some spares or something. Text then came telling me to get it booked! Presumably for ease of organisation they are just taking a blanket approach to what counts as an underlying health condition.

By the time I'd have rung up and enquired etc. I'd have wasted more valuable NHS time any way so I just went along with it

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Sorry all, just need to have a moan.

My wife received here invitation letter yesterday for the vaccination. Since about 3:00pm yesterday I have been trying to book here an appointment, what a pile of **** the system is.

We have been offered Kings Lynn, Ipswich, Bury St E. hundreds of times.

We did get the Castle Food twice, First time could get nothing as there appeared to be no slots available once selected. Then on a second occasion got all the way through to select the second jab only to get a message that the one of the time slots was no longer available. There was virtually a complete day of appointments available at the start, as a result had to re-try then NOTHING

ARHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH

Still bashing the keys trying to get something local.

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58 minutes ago, SteveN8458 said:

Sorry all, just need to have a moan.

My wife received here invitation letter yesterday for the vaccination. Since about 3:00pm yesterday I have been trying to book here an appointment, what a pile of **** the system is.

We have been offered Kings Lynn, Ipswich, Bury St E. hundreds of times.

We did get the Castle Food twice, First time could get nothing as there appeared to be no slots available once selected. Then on a second occasion got all the way through to select the second jab only to get a message that the one of the time slots was no longer available. There was virtually a complete day of appointments available at the start, as a result had to re-try then NOTHING

ARHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHHH

Still bashing the keys trying to get something local.

Hi Steve

I believe appointments come on regular so keep trying, however in Norfolk can you not book via pharmacies ect, if you have received your letter ?. You sometimes also find their supply is a bit slow, then suddenly they get or are told of a big delivery. Not much help I know when you are trying without success but hope it helps a bit.

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7 minutes ago, Well b back said:

Hi Steve

I believe appointments come on regular so keep trying, however in Norfolk can you not book via pharmacies ect, if you have received your letter ?. You sometimes also find their supply is a bit slow, then suddenly they get or are told of a big delivery. Not much help I know when you are trying without success but hope it helps a bit.

Hi WBB,

the letter states to use the web site & NOT to call your GP.

There is a phone number (119), which I haven't called yet, but I suspect they will only have access to the same website.

Todays choice "CHEVINGTON CLOSE BURY ST. EDMUNDS IP33 3FT" only 1hr 15 (46miles) away

Edited by SteveN8458
spelling police :)

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Quite a fascinating article on the factors around suppression versus elimination .... and there are themes that have emerged on this thread that are intimated in this piece too. It seems suppression will have to be the way globally if only because those countries intent on elimination will remain vulnerable. Yet, learning too on the sheer scale of deaths.

Do posters have their thoughts on a future post pandemic world should the virus truly be controlled in the coming year?

https://www.theguardian.com/commentisfree/2021/mar/03/covid-19-elimination-versus-suppression?

 

 

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49 minutes ago, sonyc said:

Quite a fascinating article on the factors around suppression versus elimination .... and there are themes that have emerged on this thread that are intimated in this piece too. It seems suppression will have to be the way globally if only because those countries intent on elimination will remain vulnerable. Yet, learning too on the sheer scale of deaths.

Do posters have their thoughts on a future post pandemic world should the virus truly be controlled in the coming year?

https://www.theguardian.com/commentisfree/2021/mar/03/covid-19-elimination-versus-suppression?

 

 

I would imagine you could pluralise year Sonyc.

Speaking to my in laws in NZ, they tell me that cases keep appearing just when they thought it was like the Dodo.

There is no general vaccination program yet with only medical staff being offered anything.

But of course, vaccination will not eliminate the darn thing.

So a country like NZ, while able, at the moment, to close its borders and lockdown immediately, will always be vulnerable because of the transient nature of its population. Kiwis like their freedom to move about. So it has to be large lockdowns such as Auckland, where a quarter of the population lives.

I think eventually, despite the tragic collateral damage in lives, the UK could control the virus internally but I do worry that foreign travel etc may well cause the odd flare up.

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1 hour ago, sonyc said:

Quite a fascinating article on the factors around suppression versus elimination .... and there are themes that have emerged on this thread that are intimated in this piece too. It seems suppression will have to be the way globally if only because those countries intent on elimination will remain vulnerable. Yet, learning too on the sheer scale of deaths.

Do posters have their thoughts on a future post pandemic world should the virus truly be controlled in the coming year?

https://www.theguardian.com/commentisfree/2021/mar/03/covid-19-elimination-versus-suppression?

 

 

An interesting read @sonyc but having read it, I can't see any possible way to eliminate Covid now, given it has been completely worldwide for a long time.  Elimination is a radical and difficult strategy and I don't see how you could ever stop it being re-introduced from elsewhere ?

 

As I read the article, it's more trying to make the point that next time around, the world should be a lot more "on it" from the start and be seriously aiming for elimination from the beginning ?  Which makes a lot of sense, but with Covid I suspect it was actually pretty widespread already by the time China was willing to admit to there being a problem and given how infectious it is, I am dubious whether elimination would ever have been a realistic strategy.

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Good news

"A crucial wing of the immune system appears to be just as good at recognising all the new coronavirus variants, a study has found.

In laboratory tests, T-cell responses in those vaccinated or previously infected with coronavirus were largely unaffected by each of the key variants. This included the new Brazilian variant, found in small numbers in the UK last week.

The new findings suggest that even if people are able to be reinfected by the variants, some of which are believed to partially evade our first immune response, the body will have key tools for preventing severe disease.

However, the scientists behind the findings cautioned that the protective abilities of the T-cell response remained to be proven in the field.

“If you have a good T-cell response you may not be able to prevent infection, but you should be able to soften the blow,” Professor Alessandro Sette, from the La Jolla Institute for Immunology in San Diego, California, said. “That is important. The opposite scenario would have been really concerning, if the new variants had been able to evade both the antibody response and the T-cell response.”

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8 hours ago, sonyc said:

Quite a fascinating article on the factors around suppression versus elimination .... and there are themes that have emerged on this thread that are intimated in this piece too. It seems suppression will have to be the way globally if only because those countries intent on elimination will remain vulnerable. Yet, learning too on the sheer scale of deaths.

Do posters have their thoughts on a future post pandemic world should the virus truly be controlled in the coming year?

https://www.theguardian.com/commentisfree/2021/mar/03/covid-19-elimination-versus-suppression?

 

 

I think for sometime to come we will be facing restrictions on non-essential international travel. While business travel has to go ahead we may see some imposition on international leisure travel. I don't like the sound of it but it slows down the potential spread, removes the anonymity of travel making tracing easier, boosts local tourism, and as an aside is a nod to the environmentalists. The days of unrestricted hopping onto a plane may well be over. 

Edited by Rock The Boat

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National

6385 - 315

Local

looking good in NR2

image.png.c4bcd7d29fff996d6cc5306f8970436c.png

image.png.3588190643db21c8a45a96b3f8c90809.png

image.thumb.png.d0522031fbaf08e3aed028836450f149.png

 

Edited by ricardo

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On 02/03/2021 at 09:22, Van wink said:

This debate seems to run and run, I wish we wouldnt seek simple definitive answers when the reality must surely be an intertwining complexity of issues, some of which will have a high significance in terms of deaths and others less so, but all will have surely played a part and as we have said many times this aint over yet.

Having said that, I will fall into the same trap 😀, for me the three most significant factors in deaths  1) the slowness and inadequacy of the initial government response, an early failure to acknowledge the significance of the pandemic, particulaly allowing large scale probably super spreader events to continue raising the underlying level of community spread 2) the state of health of the nation reflecting a massive failure in public health policy and social policy over many many years 3) failure to adequatey protect the most vunerable in care settings.

Point 2 above

https://www.washingtonpost.com/nation/2021/03/04/coronavirus-covid-live-updates-us/

“The vast majority of global coronavirus deaths occurred in nations with high levels of obesity, according to a new report linking overweight populations with more severe covid-related illness and mortality.”

The report, by the World Obesity Federation, found that 88 percent of deaths due to covid-19 were in countries where more than half the population is classified as overweight — including the United States. The organization called on governments to prioritize overweight people for coronavirus testing and vaccinations.”

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19 hours ago, Rock The Boat said:

I think for sometime to come we will be facing restrictions on non-essential international travel. While business travel has to go ahead we may see some imposition on international leisure travel. I don't like the sound of it but it slows down the potential spread, removes the anonymity of travel making tracing easier, boosts local tourism, and as an aside is a nod to the environmentalists. The days of unrestricted hopping onto a plane may well be over. 

There will no doubt continue to be some tough restrictions for those without vaccine passports but many countries that rely on tourism are realising that some issues are simply bigger than the virus.  Their economies are in dire straits, people are starving , and there will be even more civil unrest unless they restart tourism, so pressure is building on governments specifically in Asia to open up after a year of incessant lockdowns.  There is already talk of those with vaccine passports being given free rein before too long and I can envisage this happening around June when our lockdown should end. 

To these countries tourism is not regarded as non-essential but absolutely essential.  

 

 

Edited by paul moy

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We were talking about this the other day, seems to be evidence to support the strategy, logistics may prove difficult with a mass roll out but surely worth considering.

 

"Italy to give just one Covid vaccine dose to those previously infected

Italy will administer a single vaccine dose to those who have already been infected with Covid-19, the country’s health ministry revealed.

“A single dose of vaccine may be considered for individuals with previous SARS-CoV-2 infection, symptomatic or asymptomatic”, it said in a statement.

The recommendation applies to people diagnosed with Covid between three and six months previously.

France and Spain announced a similar policy last month, in a move that also appears to be aimed at saving vaccine shots and boosting supplies."

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8 minutes ago, Van wink said:

We were talking about this the other day, seems to be evidence to support the strategy, logistics may prove difficult with a mass roll out but surely worth considering.

 

"Italy to give just one Covid vaccine dose to those previously infected

Italy will administer a single vaccine dose to those who have already been infected with Covid-19, the country’s health ministry revealed.

“A single dose of vaccine may be considered for individuals with previous SARS-CoV-2 infection, symptomatic or asymptomatic”, it said in a statement.

The recommendation applies to people diagnosed with Covid between three and six months previously.

France and Spain announced a similar policy last month, in a move that also appears to be aimed at saving vaccine shots and boosting supplies."

That does seem to be commonsense if your immune system has already been primed.  I had a very strong reaction to the first jab, possibly because I already had antibodies from a covid infection in April. 

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On 01/03/2021 at 18:04, Van wink said:

Good news from JVT this afternoon about real time effectiveness of both vaccines after one dose in all age groups who had received vaccination but particilarly amongst the elderly who are the largest group to be vaccinated so far. Hospitalisations in over 80 year olds dropped by 80%

A gentle nudge to our European friends with data which will hopefully help to reassure them.

Germany will authorise the AstraZeneca coronavirus vaccine for people over the age of 65, Chancellor Angela Merkel has said.

The country had previously approved it for under-65s only, citing insufficient data of its effects on older people.

Now, in a significant U-turn, Mrs Merkel said recent studies had now provided enough evidence to approve it for all ages.

She added: "The (German) vaccine commission, whose recommendations we are happy to follow, will authorise AstraZeneca for older age groups."

The change will see Germany follow the UK’s example and space out the first and second jabs of the vaccine by a maximum of 12 weeks, in order to quickly give more people initial protection against the virus.

The German government had been criticised in recent weeks for its comments about the jab, leading to a public perception that the AstraZeneca/Oxford University vaccine was less effective than those developed by Pfizer-BioNTech and Moderna.

It even led to some of the Germans first in line for a Covid-19 vaccine spurning AstraZeneca shots, leaving the country with hundreds of thousands of unopened doses.

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