Not sure how to quote! anyway, not my perception today, must admit…drove from Ashington to Alnwick, back down to Scotswood then back to Ashington and very quiet all the way…having said that, walking home from work 10 reg Golf passed (well, passed really quickly with a super loud exhaust!) me with 5 20odd yr olds in…you just think, what are they thinking of 🙁
Alnwick, Belford, Amble then down to Cramlington then Ashington back to Alnwick. The spine road was ridiculously busy lunchtime early afternoon.
Listened to any questions on radio 4 tonight. Those interviewed were of such unanimous and sycophantic allegiance to our incompetent masters that we might as well just all infect ourselves with Covid and stick out our stiff upper lip. As a clinician it made me realise more than ever those in power are so horrendously in the same pocket as one another including the BBC. Teresa Joff-f*** face was made to look like an innocent bystander when my colleagues in ITU are likely going to have to go without proper PPE this weekend. Beyond outraged.
This morning Hancock told a select committee that he expected to have adequate supplies of gowns in place for the weekend. Only a couple of hours later they confirmed there would be widespread shortages. Just lie after lie from him, usually the same ones- "pushing forward" "doing all we can" "x number of tests by day y"
Tbf Milton Keynes still seems to be very quiet , but it's possibly not 1st place on everyone's end of lockdown bucket list !
Everyone seems to be sticking to distancing very well in supermarkets etc too
Certainly much much better than when lockdown was being discussed denied & then implemented & everyone was touring 5 supermarkets a day looking for bog roll
Hancock just cannot help himself !
you know you're doing a bad job as a tory government when even the daily fail is sticking the boot in. The express seemed to have given up on covid-19 reporting (except where it can be used to bash the EU/China/Foreigners) and is just running Brexit stories as theres no positive tory spin to be made.
Testings not the be all & end all, but....
https://twitter.com/Peston/status/1251216765893455875?s=19
TBF, none of those numbers look particularly stellar. Just sayin'
Certainly not enough to isolate every case (except maybe Iceland & uae)
Greece for example, barely tested any, medical infrastructure already in poor state, so they went into lockdown very early, and have had only 100or so deaths so far , how they get out without testing capacity remains to be seen
Also, from Fauci at white house press conference, this sounds quite worrying
In South Korea, a growing number of recovered patients appear to be relapsing. Korean authorities reported that 163 patients have tested positive for the virus after making a full recovery.
South Korea, that number hasn’t been rocketing up since the last time it was posted a week or so ago at around 70ish(?)
It’s not great, but is it defined as reinfected/relapsed? And you’d expect some to test positive again so it’s not a surprise.
Edit, 2% of recovered apparently. Any valid comparisons available with other viral infections?
This article refers to them as relapsed.
Edit again https://www.sciencedirect.com/science/article/pii/S1201971215002921
Similar line but with Ebola
The Greeks look in real trouble if that’s the case with testing. They do not have long to find a way out and with the limited testing capacity across all of Europe it’s hard to see what they can do.
Are we obsessed with tests though? They are certainly important for healthcare workers and those that work with the vulnerable.
If we stop looking at big numbers (how do we test the whole nation?) and break this down to smaller communities where we have track and trace run by what would essentially be health visitors, you don't need as many tests. You were in contact with a Covid-19 patient, and 5 days later you have a temperature and dry cough? Not sure we need a test, but we do need someone to check in and make sure they are staying at home/have the resources to stay at home.
Maybe idealistic, but people aren't as scarce a resource as swabs and reagents at the minute, and we're not going to control this waiting for Matt Hancock's magic wand.
16 nurses on my wife's ward have gone off with symptoms, 6 have tested positive and 10 are awaiting results. Despite this none of the other staff on the ward are being tested so could be spreading the virus around the hospital and the wider community.
Despite this none of the other staff on the ward are being tested so could be spreading the virus around the hospital and the wider community.
They don’t test unless you have symptoms as it’s very likely it’ll be negative.
I tested positive on monday, as have four of my colleagues. We all attended the same incident with no / inadequate ppe just over two weeks ago.
But Drac, wouldn't the common sense approach be to test all the staff who have been in contact with a known positive? The hospital staff cannot social distance and because of lack of PPE the risk of cross infection is high.
Of course, that would assume there are sufficient testing resources....
I admire your loyal and level headed attitude Drac, but the delay in building up testing and PPE capacity [edit: and the delay in introducing social distancing measures] isn’t being taken on the chin so stoically by all health staff in areas hit harder. Not sure it should be either. The government relied on their ethics and efficiency rather than treating this seriously when it was coming our way.
With one of the unions suggesting to their members that if there is no PPE they should consider refusing to treat patients I can see this situation coming to a head in a few days unless a mahoosive delivery of PPE magically appears at every hospital on Monday morning. I pray it doesn't come to that but it's the reality we are staring at.
wouldn’t the common sense approach be to test all the staff who have been in contact with a known positive?
As Drac says, the test would be probably be negative if they're not showing symptoms anyway. It would prove nothing.
But Drac, wouldn’t the common sense approach be to test all the staff who have been in contact with a known positive? The hospital staff cannot social distance and because of lack of PPE the risk of cross infection is high.
They’d be testing pretty much every single member of staff after every shift. It’s just can’t be done so they go off those showing symptoms. Therefore better to test the symptomatic to find if it is covid or something else.
Could recovered covid-19 clinicians work safely with infected patients without all the PPE? Of course it comes down to how effective immunity is, but what is the current thinking?
Could recovered covid-19 clinicians work safely with infected patients without all the PPE?
There's still a risk of physically transferring the virus by touch.
I tested positive on monday, as have four of my colleagues. We all attended the same incident with no / inadequate ppe just over two weeks ago.
Shit mate that’s awful. Let us know how you’re getting on.
An article about Anti Body testing in California
https://edition.cnn.com/2020/04/17/health/santa-clara-coronavirus-infections-study/index.html
The study estimated that 2.49% to 4.16% of people in Santa Clara Country had been infected with Covid-19 by April 1. This represents between 48,000 and 81,000 people, which is 50 to 85 times what county officials recorded by that date: 956 confirmed cases.
Sorry to hear that. Hope you are ok.
Could recovered covid-19 clinicians work safely with infected patients without all the PPE? Of course it comes down to how effective immunity is, but what is the current thinking?
Too early at the moment to make assumptions about immunity I think. WHO warned about any relaxation of lockdowns reliant on serology testing yesterday. Also noticed Prof Karol commented on it - I think teams at Rutherford Centres are testing staff.
'Good & bad news on antibody tests.
We have a number of positives in our testing at Rutherford – some asymptomatic.
I agree with PHE - 'immunity certificates' useless for now. Public shouldn't get tested yet.
We need to understand the other immune mechanisms involved.
To be clear - the antibody tests work, but it seems some people are not producing the antibodies and are using other immune mechanisms.
We will publish the full details soon.'
An article about Anti Body testing in California
https://edition.cnn.com/2020/04/17/health/santa-clara-coronavirus-infections-study/index.html
/blockquote>The people in that study self-selected - I could imagine someone thinking "you know what, I did have a bit of a nasty flu last month, I wonder if it was CV" and volunteering to find out.
That paper matches the Dutch study of blood donations. We’re about 3% prevalence. For a pathogen that has the potential to infect 50-67%. Maybe more. Now recall the Oxford paper that didn’t have this number to speculate, and it tells you there is a long way to go to any form of herd immunity.
As for immunity, well having antibodies may provide some protection, I hope so anyway as I’m working on precisely this hypothesis. But in a healthcare setting with a high viral challenge, natural antibody titre may be less protective than it is for a one-time walk past someone’s cough in a supermarket aisle. We don’t know.
The PPE situation is truly appalling. To say otherwise is negligent and disrespectful. I don’t think Hancock has got a lot wrong if I’m honest, other than be somewhat economical with the actuality. But here I’m not impressed at all.
Direct link to the paper fort anyone interested that’s not already seen it https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1
I think people are missing the point with NHS PPE, it's mainly there to prevent contamination between patients. I would have thought the most useful protection for NHS staff is full face shields to reduce them from being coughed on or touching their own faces, in conjunction with appropriate masks.
PPE is also pretty vital for stopping other pathogen transmission, anti-biotic resistant bacteria haven't gone away and most NHS staff are not treating Covid-19 patients so their PPE use should be at normal levels.
Talking to my midwife neighbour before lockdown she said PPE and infection control should be normal practice anyway, staff come into contact with much nastier and more infectious diseases every day during business as usual.
So the big question is what's caused the shortage? Inability to replenish stocks due to global supply chain constraints, increase in patients leading to more regular changing of PPE, inappropriate use of excess PPE by staff and the general public. I would suspect it's mainly the two former issues which the government should have foreseen and had stockpiles in place on rotation. There's lots of non-covid patients being put at risk of other infections now.
Talking to my midwife neighbour before lockdown she said PPE and infection control should be normal practice anyway, staff come into contact with much nastier and more infectious diseases every day during business as usual.
Did your midwife friend tell you the PPE level worn is higher then normal recommendations? That’s is why the NHS is using so much every member of staff in contact with a patient wears full PPE beyond the normal levels. Hence why there’s vast quantities used on a daily bases.
I think people are missing the point with NHS PPE, it’s mainly there to prevent contamination between patients.
No, it’s to protect staff equally so.
inappropriate use of excess PPE by staff
FFS! Look stop making shit up.
A few on here have given projections and graphs. Now that there may be thousands missing off the true fatality figure due to the care home situation, do these projections have to be amended?
inappropriate use of excess PPE by staff
Look stop making shit up.
To be fair to stumpyjon, he didn’t make that up someone else did. (Hancock suggested it)
The rest of that post makes it clear he thinks it is the other issues he lists in the question that are issue, not the things people have unhelpfully suggested, I thought.
Inability to replenish stocks due to global supply chain constraints, increase in patients leading to more regular changing of PPE
which the government should have foreseen and had stockpiles in place
Kelvin, thank you for reading my post properly.
Did your midwife friend tell you the PPE level worn is higher then normal recommendations?
No because we had that conversation pre-lockdown and since then we've been following the rules and not socialising.
Drac I was asking a question, not making shit up. You actually answered part of it by explaining that even in non-covid treatment areas recommended PPE use is now higher than normal.
I also didn't say PPE wasn't there to protect staff, I said it played a major role in protecting patients, not something that's covered much when PPE shortages are being discussed. An equally important point when it comes to saving lives.
The PPE situation is truly appalling. To say otherwise is negligent and disrespectful. I don’t think Hancock has got a lot wrong if I’m honest, other than be somewhat economical with the actuality. But here I’m not impressed at all.
Well, getting the timing of lockdown wrong, getting the specs for ventilators wrong, failing to get in on the EU procurement, getting the testing needs wrong, missing testing targets when he is pinned down to setting them, lying about deliveries of PPE - it's been an absolute shitshow from begining to end.
Hancock has form as a liar, remember when he leaked to peston that one of his staffers has been punched by labour protestors bussed into a hospital where that kid was forced to sleep on the floor?
The subsequent video showed one guy on a bike calling him a disgrace, there was no punch, no mob of protestors
At the start he was also caught ling about speaking to supermarkets about supplies, he also claimed that he'd been looking into ppe for care home staff at the start, something later disproved, as well as several undeliverabke promises about testing & then lies about having made them.
I know all politicians lie, but he is erroding trust at a time when they really need it.
That's why Raab & answering starmer & being honest about what they think we need to achieve before exiting lockdown was so good to see.
Now that there may be thousands missing off the true fatality figure due to the care home situation, do these projections have to be amended?
No because as long as the reporting is consistent, the projections are the same. So 20k (or thereabouts) deaths were is only hospitals. Care homes are essentially out of scope and need a different projection. As a worst case scenario, it’s 25% of all residents, but that’s a morbid extrapolation from one Australian study.
The case fatality rate appears to be about about 1/1000 in the population. In a nursing home 1/30 to 1/10 does not seem unreasonable. It’s a pretty grim number though.
DrJ, be fair on the wee poor man, it's not like we knew this was coming for the last 20 years, had multiple previous outbreaks as warnings, had copious numbers of contained infections to learn from, had other countries ahead of us on the curve to help us avoid their mistakes, oh wait we did.
Not entirely sure they got the lockdown timing wrong but everything else you said, absolutely, plus the constant ambiguous messages about what the lockdown actually is compounded by the latest mess created by the CPS. The lies he told about discussing security of supplies with the supermarkets that increased the panic buying. There's probably more we could blame him for. Total rabbit in the headlights.
These are questions, not statements, so no shouting please.
Did we get the timing of the lockdown wrong? What is the end goal? Is completely squashing the first wave actually beneficial in the long run. Everything I heard at the start was about protecting NHS capacity, which we seem to have done.. If a vaccine is over a year away, then we are mostly going to get it at some point. There is no perfect solution where we just stop it.
PPE. Lying helps nobody, and is counterproductive. I think every country has run out of PPE. China did & they make most of it! Italy, Spain, USA & France did too. The numbers of pieces required are huge! I wrote a post days ago about Government Supply chains. They were simply overwhelmed.
Testing. The mistake was early, when we didn't order enough quickly. Now the world wants it and there isn't enough kit/capacity. We certainly seem to be trying/improving capacity/labs/testing sites.How many daily do we really need? what were the German daily numbers?
The whole Project Ventilator seems to have been a mad panic organised by people who didn't really know what they needed. Refusal to engage with industry middle men seems arrogant/reckless. So far we seem to have had enough.Will we need more in coming waves?
My apologies StumpyJ but it didn’t read it as it being Hancock who said. As for the PPE you’re exactly wrong but it’s protection for everyone equally so. PPE or infection is normal yes but PPE level is much higher just now for every patient which as I say why the nhs is using vast amounts.
Yes we could have locked down a week earlier. It is my contention that behavioural difference in Germany, not testing (as they weren’t at the beginning) led to relatively small differences in earlier behaviour that have been blown up by the exponential epidemic process. A 25% difference in contacts four weeks ago explains the four-fold difference now. Germans don’t go to work if they feel a little sick.
PPE shortages are universal, so some simple honesty would be a good start.
Testing is a PHE disaster zone and will be where things really are found wanting.
Project ventilator, whilst perhaps a little misguided and rushed, with spec creep and so on, has actually delivered CPAP that may well be more more useful, and have a better outcome for patients.
Is the long term thinking still that for any societal normality, (new normal at least) a large number of us need to get this thing? Is it just a case of how and when?
How are you going to know when a large number have had it. I would guess a large number have already had it (most who wouldn't even have known), but that is all it would be - a guess.
protecting NHS capacity, which we seem to have done.
Not wanting to split hairs, but running out of PPE indicates we haven't
