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@P-Jay, I don't think it's deaths per se that's the problem (though on an individual basis it's upsetting and tragic) but the amount of care required for those who are ill. A person being in a coma and on a ventilator for six months ties up a lot of resources. That leads to a knock-on effect of there not being enough staff, beds, theatre time, etc. for all those treatments that aren't Covid related.
When all this started I thought it would be September at the earliest that things would get back towards "normal". Now I'm thinking more towards two years, not so much to "beat" the virus, it's here and it's not going away, but to have the data from the varying strategies each country has employed to be able to decide what works best in minimising its effects in the general populace whilst still having a functioning economy. There may not be a "one size fits all" strategy, rural areas will be different from urban ones for example, and while we know the make-up of fatalities, that might be skewed by many of the early victims being susceptible anyway. With their passing what are the ongoing risks for everyone else? Age is a definite factor for example, a figure I've seen is that every seven years extra age doubles your risk.
We'll probably end up with a multi-pronged response: a vaccine; a cocktail of drugs to suppress symptoms once you have the virus; legal enforcement of isolation when you test positive; ICU care for the most sick.
Tory MPs in the North can say what they want and write as many letters as they like. They’re along for the ride as much as the rest of us
I think it must be dawning on even the most Brexitty and Boris-cheerleadery of the new Northern Tory intake (and we're not talking about a bright bunch here) that they’ve simply been added to Dom’s list of ‘Useful Idiots’
Tory MPs in the North can say what they want and write as many letters as they like.
And let's be honest, putting your signature on some whining letter or other isn't really up there with actually voting against the government. It's a fig leaf, the appearance of opposition, a couple of days in the news cycle and probably sanctioned by no.10. None of them are resigning and forcing a by-election.
Most of these MPs are not working for their constituents, but simply trying to occasionally give the impression so they can continue to trouser their MP salary.
Victoria Derbyshire should be sacked
Is there anyone else you'd like sacked for hypothetically ignoring an arbitrary number?
Who said it was anything to do with Corona?
In that case, fire away! 😀
So you want someone sacked because they have no taste in bottled alcoholic beverages?
How long until a Tier 4 arrives?
The unpalatable emerging truth, soon to be confirmed I fear over the school holiday lockdown, is that like influenza, children are a significant path of transmission, and that closure of education is the primary means by which R falls below the magic unity. In the absence of other forms of protection than contact restriction, that leaves few palatable options.
I'd be considering prospective prophylaxis studies to look for evidence of any effect of Vit D and even HCQ. I have little confidence in these, btw, but one should not write off hypotheses without ANY data.
Well kids are little chemical weapons in a normal year......
How long until a Tier 4 arrives?
About a week. ScotGov are just finalising the 5 Levels for Scotland. That'll be 0 through 4.
Yes, some folk have queried having a Level 0. It's been explained that using 0 through 4 means that 1 through 3 are almost the same as England and therefore maintains some UK-wide consistency.
Just had a look at the figures today and we are now halfway to the peak of patients in hospital with a fast upward trend and the number of cases steaming upwards too. How long do we reckon before we hit the 18k in hospital and us running out of capacity? I know the Nightingale hospitals weren't really used last time but from what I can gather they would just suck staff away from their primary roles anyway so they're more about keeping spread out of the main hospitals.
Definitely looking like we've missed the point of keeping this all under control by a country mile.
The reopening of schools was always a political decision driven by the desire to reopen the wider economy. The government's attempt to portray their decision as 'following the science' was disingenuous. The lack of proper reporting of infection rates in secondary schools is a concern.
The reopening of schools was always a political decision driven by the desire to reopen the wider economy.
Slag the government all you like but this always seemed like a noble aim. Missing 1 year of school for 4 year old from a disadvantaged background could be life changing just as much as CV19 could be for an older person. There's no good choice but the kids are quite literally the future.
I would think that children are highly likely to be asymptomatic carriers. My guess is that there isn't enough data on this currently to provide a compelling argument either way.
We'll see if there is a change in the curves a couple of weeks after half-term.
It was crass in the extreme to hear rabid, free market Tories suddenly, and for the first time, championing the interests of the poor and dispossessed youth as a means of justifying a 'reopening' of the economy. Remember this was at the same time as B. Johnson was chastising civil servants for working from home while urging us all to 'eat out to help out'. The current cabinet would not recognise 'nobility' if it smacked them in the face.
There’s no good choice but the kids are quite literally the future.
Which is why focussed random testing in schools to mitigate the risks to staff is necessary. That or rotate year groups to allow some distancing. Had the gov not just shoved its thumb up its arse all summer and did some planning things could have been worked out
Missing 1 year of school for 4 year old from a disadvantaged background could be life changing just as much as CV19 could be for an older person.
Or losing a parent to a deadly virus.
It was crass in the extreme to hear rabid, free market Tories suddenly, and for the first time, championing the interests of the poor and dispossessed youth as a means of justifying a ‘reopening
Just because they're tories doesn't mean everything they do is wrong. Sure they get loads wrong but I'm struggling to see this as one of them.
Or losing a parent to a deadly
That's a very small risk for people with school age kids. The risk difference by age group is astounding
Or losing a parent to a deadly virus
You make it sound like the disease on the film Contagion where everyone drops dead at infection.
That’s a very small risk for people with school age kids.
What about staff in schools?
What about staff in schools?
Don't take this the wrong way, but is there any data regarding teachers being infected at schools? Totally anecdotally, the first two infections at the schools my kids go to were teachers who were contact traced as having picked it up outside of school. Despite several kids testing positive since, no more staff have tested positive in this half term.
I know that there are cynics who state opening schools was purely an economic exercide, and I absolutely agree that the lack of government planning and support has been truly shocking, but reopening schools was a totally laudable aim. It's made a massive difference to my two (aged 13 and 17). But it's only worked because their schools have put in a colossal amount of time and money to make it work.
Is there any evidence teachers are facing an intolerable risk from covid? I haven't seen any. Other worker groups in the UK have annual risk of death 10, 100 or even 1000 times more than teachers at the best of time so honestly I'd say suck it up.
TomD - the problem is the Tories don’t give 2 hoots about underprivileged kids. They wanted kids back in school so their parents could get back to work, period.
Calling something Covid Secure doesn’t make it so.
Don’t take this the wrong way, but is there any data regarding teachers being infected at schools?
No idea, I seem to recall the data for kids, school staff and Unis was all lumped together so that drawing conclusions was impossible.
Anecdotally I know three teachers who appear to have caught it in school, and one of them is my partner but then I know a lot of teachers.
Totally anecdotally, the first two infections at the schools my kids go to were teachers who were contact traced as having picked it up outside of school
That doesnt mean a lot, its just known link, correlation not cause.
Is there any evidence teachers are facing an intolerable risk from covid?
How many other workers are spending an hour with 30 people in a small room five or six times a day?
If , as Tired postulated kids and schools a big vectors it would seem inconcievable that school staff are not at increased risk.
Other worker groups in the UK have annual risk of death 10, 100 or even 1000 times more than teachers at the best of time so honestly I’d say suck it up.
So what do you do for work oh brave one? IT consultant?
But it’s only worked because their schools have put in a colossal amount of time and money to make it work.
Very little money, schools dont have any
Bit of science. NIOSH, part of the CDC have consistently identified teaching as a risk profession for influenza
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0048806
The most likely reason they have not to date, is that schools were down on occupancy during lockdown. I won’t say closed. But the numbers of contacts was low enough to control spread in schools in a way it is not now.
Oh and forget HCQ prophylaxis. A preclinical study showed no effect in two animal models where both vaccines and antibodies work.
Isn't this the same reason the NHS want their staff to take the flu jab each year?
They don't want staff to infect vulnerable patients but on a mundane level it's assuring that resources are available throughout winter when they are needed. The NHS commissioners even set targets for this and attach extra funding to it as a dangling carrot.
We have the highest flu vaccine take up in the world. It sadly does not mitigate the world class healthcare service we don't seem to have as well as it does in some other countries that record lower excess mortality.
I have it annually
I’ve had the flu jab for the last few years via work. When I first did it it was because it was free and I didn’t want to get sick - cos I’m a selfish git - but the last couple of years I’ve been very aware that it’s more about protecting others. Sadly whilst I can get it through work I’m well down the hierarchy of those who need it, and rightly so.
All-cause mortality has been bumping along at the maximum of the past 10-year range. Week 42 shows an acceleration (that's for week-ending 11 days ago). It's not hard to predict where Week 43 will be. Under 23/100k would be a success by year end.
Ignore the dip at Week 36. Bank holiday was a week later this year compared to 9/10 of the previous 10 years.
Bit of science. NIOSH, part of the CDC have consistently identified teaching as a risk profession for influenza
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0048806
/blockquote>That link says that teachers are low risk doesnt it? Unless I'm reading it wrong, it does reference other work that says the opposite though I think....only skimmed a few bits.
Why are councils agreeing to Tier 3 without insisting there is a clearly articulated exit plan?
Those councils/areas which have followed GM should have taken their lead from Andy Burnham - prepared to work with central gov but there must be a plan, including how to return to lower level.
S Yorkshire agreed to T3 and then, after the event, asked the question.
Warrington did the same.
This morning, Nottingham are doing the same.
It's difficult to avoid the conclusion that many councils are either running scared of central gov or lack competence.
It’s difficult to avoid the conclusion that many councils are either running scared of central gov or lack competence.
it's probably a bit of both
Some sobering stats from my local hospital (Warrington). Under normal circumstances has 500 beds and 20 in ICU, current COVID inpatients are 118 with 16 in ICU. Think the peak in spring was just over 120 (for some reason we seemed to be fairly lightly hit back then).
Makes me laugh (well sort of!) when people suggest too much of a fuss is being made of COVID, dread to think what those numbers would be without some restrictions in place.
What's the deal with the massive dip in Week52 in that graph, TiRed?
Nobody does recording over the Christmas week and then it all catches up during weeks 1 and 2.
Some sobering stats from my local hospital (Warrington). Under normal circumstances has 500 beds and 20 in ICU, current COVID inpatients are 118 with 16 in ICU. Think the peak in spring was just over 120 (for some reason we seemed to be fairly lightly hit back then).
So you're essentially at the spring peak already...?
I'd guess lack of reporting.
What’s the deal with the massive dip in Week52 in that graph, TiRed?
gonna guess at the bloke whose job it is to records deaths doesnt work xmas to new year, and then spends the first 2 weeks of january catching up.
death has christmas off, obviously.
@klunk - he's still working but filling in for The Hogfather rather than his normal job
I guess I knew that was the answer rather than it being a real effect, it just seems so primitive to be unable to back-date the data to the actual date of death.
So you’re essentially at the spring peak already…?
Yes, in terms of inpatients, which is at least a fairly absolute measure. For whatever reason the spring wave seemed fairly light here, but cases have been high for weeks now (Tier 3 from yesterday)
Other worker groups in the UK have annual risk of death 10, 100 or even 1000 times more than teachers at the best of time so honestly I’d say suck it up.
Well this is shitty.
People who take risky jobs usually know that they are risky and that often forms part of their decision. Teaching is not normally that risky, but they are being forced to accept more risk than they originally signed up for.
I have a question that we were discussing earlier: why is it that South Wales seems to be worse affected than the UK in general when our lockdown was stricter, lasted longer and we started local lockdowns sooner?
My thoughts were:
A) we are doing better at testing
B) environmental factors (lots of close together low income housing, less chance to work at home (compared to the SE))
C) chance - a few super spreading events bearing fruit.
Any thoughts or explanation from the more knowledgeable?
Think TiRed mentioned the reporting is suspected cases vs confirmed cases, so the numbers are higher (and less accurate, such as any of the UK's case numbers could be considered accurate).
All of those things you mentioned plus there are a lot of people that travel to work in London every day or during the week. Add in a generally unwell population and the geography of the Valleys making everyone flow in narrow travel corridors to their work in Swansea/Cardiff/Newport and you have a ready-made route for the virus to spread quickly all over South Wales.
There was lots of talk early on linking COVID hotspots to pollution (globally) . Has there been any further study into this?
There was lots of talk early on linking COVID hotspots to pollution (globally) . Has there been any further study into this?
Presumably a 'pollution concentration' map overlayed with a 'population density' map would look pretty similar? Not saying pollution isn't a factor, but it could be quite easy to draw the wrong conclusions from a pollution map in isolation.
it does reference other work that says the opposite though I think
Yes it was just an under-powered pilot from NIOSH. They fully back protection of teachers. Probably should have chosen a better study!
As for the Christmas dip... well I imagine Father Christmas is beating Death back. Or the registrars have a holiday too. My cousin is one of them. I think she's having a break 😉
Re: pollution, the discussion many months ago was around towns in Spain and Italy with narrow pollute streets combined with the prevalence of smoking across all age groups, multi-generational households, small concrete apartment blocks with poor ventilation
It’s difficult to avoid the conclusion that many councils are either running scared of central gov or lack competence
Or they looked at what happened in Manchester - they locked down later without really getting what they wanted, and thought they'd take what they could and lock down ASAP?
Burnham made a stand and fair play to him for that, he had sound logic, but one wonders what the cost was...
And the Lombardy region of Italy is a bowl in the hills where smog/pollution can get trapped. It is also the industrial area.
I can’t remember the source, but there were definite links made.
Apparently all of Nottinghamshire now going into Tier 3. Suspect those of us already at Tier 2 just over the border will be next.
Re. The pollution, is it feasible that the virus can land on particulates in the air and then stay ‘active’ for longer? You get similar in rivers I believe with bacteria.
I have no faith that the uk government will do the right thing to get this second wave under control, we’ve exceeded the number of cases in hospital per day that triggered the first National lock down and the rate of increase doesn’t look that much slower!
Apparently all of Nottinghamshire now going into Tier 3. Suspect those of us already at Tier 2 just over the border will be next.
https://twitter.com/JimMFelton/status/1321454395159171079?s=19
We've spent £12billion on track and trace and Serco are now "upskilling" minimum wage call centre staff to do work that should be done by trained clinicians.
The staff are made to sign NDAs to prevent them talking about what the actually do. Does this sound like a fair and transparent way to run an essential service that has hoovered up billions in public funds?
Robber ****ing Barons
Looks like Bristol has a new tiering that’s not in the published tiers - tier 1+. Clear as mud all this stuff.
Presume this is negotiation between local government and central government to avoid tier 2 where hospitality businesses suffer.
Suspect those of us already at Tier 2 just over the border will be next.
You say that, but we live in a bit of north Yorks that sticks into West Yorkshire and Lancashire, and rates are pretty high locally. Tier 1 for us, presumably because news of the virus hasn't yet reached leafy Northallerton where our County Council is quartered.
There is virtually no logic to any of this shit.
Looks like Bristol has a new tiering that’s not in the published tiers – tier 1+. Clear as mud all this stuff.
Is that like TV channels? Tier 1 but an hour (day/week/month?) behind? Sort of describes Bristol quite well...
Tier 1 here as well, even though Tier 3 Manchester is literally just up the road.
There's another tier up as well. Crocodile Tier which is where MPs pretend to be upset about the loss of life. This is only applicable within the M25; they've already shown that not only do they not care about the North, very few of them can even point to it on a map.
Well, Germany on National lockdown from the 2nd and it appears France will announce the same/similar within the next 40 minutes.
Whats the betting we'll have dither and delay pre-empted by an Etonian-Churchwellian "will shall not be swayed from Local Lockdowns" speech tomorrow night.
FFS, he has/had the chance, he could still get it done before the kids go back next week and extend that advantage.
Don't knock Brizzle - they've got Covid Marshalls!
Don’t knock Brizzle – they’ve got Covid Marshalls
All 8 of them - once they recruit them presumably. Going to make all the difference........not!
I’m on the edge of Bristol (but not in the county of Bristol - in South Glos) so don’t really see what goes on in town as the office is locked and I’m wfh. Looking at the figures I can’t quite workout how we can get away with no being in tier 2 though looking at the rapidly rising infection rate.
Whats the betting we’ll have dither and delay pre-empted by an Etonian-Churchwellian “will shall not be swayed from Local Lockdowns” speech tomorrow night.
FFS, he has/had the chance, he could still get it done before the kids go back next week and extend that advantage.
He's got the chance to have 3-4 weeks to restrict the growth of the virus and offer people some chance of being allowed to pass it to granny at Christmas. I suspect he'll miss that.
Anthony Costello
@globalhlthtwit
·
2h
The latest Imperial React study shows R=1.6 and an estimated 96000 cases per day. I can’t see any way out without a circuit breaker.
Is that current cases, i.e. 96k today?
I can’t see any way out without a circuit breaker.
TBH, getting R anywhere near 1 will require more than that now. I guess Boris will continue to be desperate to save face and not appear to be following Labour's recommendations, so he will prevaricate until it is even clearer that Tier 3 restrictions are not doing much.
Christmas is gone, any way you look at it. Or rather, the virus will not be at a sufficiently suppressed level by then, so when quite a lot of people predictably defy the regulations and get together with family anyhow, the results will also be predictable.
Yeah, good old Boris, only a few months back promising near normality by Christmas, anyone else remember that?
Over promise, under deliver.
Should be the official government slogan.
News reports about Nottingham(shire) moving to Tier 3 all make reference to '...betting shops, saunas and tattoo parlours' being required to close.
Is that an accurate representation of Nottingham?
Estimated R of nearly 3 in London and significant rises in the SE, SW, E Mids, Humb, means the N/S divide has disappeared. There has to be a change in strategy but the government has shot its bolt on the private sector and regional lockdowns and recent history shows that any policy change will be too little too late. This is not good.
Is that current cases, i.e. 96k today?
Its an estimate based on a random sample rather than the number of positive tests, they remain around low to mid 20k
Hospital admissions continue to rise as well, around 1200 yesterday
Parents back in national lock down in France from.friday
They are about 2-3 weeks ahead of us since about august....
It's a bit like having a Chrystal ball no ?
France even has the benifit of space. Same population spread over many times the space.
It would appear that the Govt have learned nothing from the past year
Signs for cautious optimism that the restrictions in the central belt are starting to bear fruit.
🙏
Signs for cautious optimism that the restrictions in the central belt are starting to bear fruit.
Dont worry, the rest of us are catching up!
Yeah, we were a couple of weeks ahead, so hopefully if my optimism is well founded, the restrictions in the south* will follow and start to flatten.
* Y'know, the bit you guys think is the north, but is actually not 😉
Scotland just had mid term and shut pubs. Let’s hope the slight decrease in increase improves. Can’t see it when the schools are now back unfortunately.
betting shops, saunas and tattoo parlours’ being required to close.
Is that an accurate representation of Nottingham?
Pretty sure those facilities exist in other cities 🤣 But it does mean I don't have to pluck up courage for my first tattoo for 28 days.
We have a whatsapp group on our 'exclusive semi-'rural new build street' & apparently there's a kind of a street party happening on Christmas day where all the wadbags bring out their chimeneas & drink Pimms. Since we can't be with our own families it's ok to be with loads of other families, including GP's & a chief superintendent of the local police.
Turns out the rule of 6 only applies if you're poor, from the bame community or don't have a LinkedIn profile, who knew?
On our visit to the test centre which was 35 minutes drive and 25 minutes standing around in the cold we were not allowed to use the toilets which was apparently a decree made by Serco managment. There were definatly enough staff to have one memeber as a dedicated cleaner and I was quite happy to disinfect after the kids had used it.
I ubderstand the need for hygience, but this will lead to people with covid having to use other facilities on their way home - after for example a 45 minute walk (told not use public transport) in the cold and wet winter weather followed by a possible 30 minutes standing around/ testing in a cold tent with another 45 minute walk home in the cold. There doesnt seem to be much joined up thinking. Aluding to the post above this kind of thing will not apply to the middle class managers who htought this scheme and policy up therefore it's not even on thier radar.