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It's not just inside the schools that the virus can spread, it will also be the immediate neighbourhoods round the schools that need to be considered.
While I don't have kids so non direct input into the school opening discussion I do have a fear of what happens with regards to the school drop-off and pick-up. My parents live very near the local High School, both their house and their temporary accommodation, and the lane is used as a walkway for kids to get from the school to either walk home or get picked up on the main road. At the moment mu ad dad can walk the dog up and down the lane and go to their house to do some gardening, it's genuinely the only things keeping them relatively sane and compliant to the rules. If the school goes back then they will have to avoid large periods of the day where there will be too many kids floating around for them to be able to go out safely. This will be at a serious detriment to their health and well-being.
As ever with these issues the problem is more complicated than it initially seems, something this government seem completely unable to grasp.
The problem is that we need a proper discussion about how we ‘return’ to the ‘new normal’.
The (UK) government is not interested in this. They want a return to the old normal, turnoff the money fountain (I understand that there isn’t an infinite amount of money trees out there in the orchard). And they don’t want the responsibility for the inevitable increase in deaths and illness as of its result.
They’ve already thrown the healthcare workers to the covid wolfs (lack of PPE and testing) and now it’s the plebs turn...
Establish what is safe. And when it’s safe to implement it. Inform the public. It’s really not that ****ing difficult.
Interesting article in the telegraph today on sniffer dogs detecting asymptomatic carriers.
oh, it doesn’t take much to work out (on the back of a fag packet say) that the maximum occupancy of a typical classroom whilst maintaining the current social distancing recommendations (which are for outside...) is only 5 or 6 pupils...
What’s the typical class size again? 🤔
A_a, you are the only one throwing around terms such as stupid and idiotic and making personal attacks. Pretty much the definition of ranting.
Crying, ranting etc...you need to look at what you have posted.
If you expect to wait until that happen then they will never reopen.
You could also try to avoid making it personal if you get upset by me calling you stupid. Youu continually ignore what I write and then ramble on about what you hope I have written as if it is my view.
We need to get to the new ‘normal’. That has to include education so we have to work out how to do that.
Everyone agrees with that. Many people think the first week in June, for increased classroom use, has been arbitrarily picked, and the advice designed to support it inadequate. Timing and support is what we are disagreeing about, no?
And… repeat after me… education changed, and yes was reduced, during lockdown… but it never stopped. It needs to be increased again, with more face to face time, for more pupils, as soon as it is reasonably safe to do so without spreading the virus. We are so close to that being possible, for the sake of a few weeks, let’s not waste the opportunity by prematurely getting larger groups of kids into the classroom before the virus is under control. Timing.
Metalheart, you make some thought provoking points about CO2 concentrations and the problems in ensuring buildings can satisfy the revised guidelines for occupation.
I have seen no evidence that this has been considered by gov or their advisors.
Guidelines are pretty useless in the current context as compliance is optional; they should be re-worked and re-issued as regulations but that won't happen.
I have little doubt that corporate lawyers will have been reviewing possible exposure to criminal negligence and corporate manslaughter in various scenarios.
MCTD - how very true; there are fewer people posting to this thread, it's become very narrow in it's focus and is no longer a discussion
can you two not just call a truce so we can all move on?
can you two not just call a truce so we can all move on?
Nope, when people continually and wilfully keep telling me what I said when its not what I said I can be positively TJ like in my persistence. Anyway it looks like he's thrown his toys out of the pram now as some dont agree with him on this or Brexit.
Oh boy are we in trouble. I cycles through a local (Epping Forest) car park this morning to find it open. My god, it was so crowded people were arguing over parking spaces, and in the nearby pub car park a motorcycle club of about 30 riders appeared to be having a meet-up. Very little social distancing in evidence.
I've sent a message to EFDC in the hope they'll send a ranger to investigate and close it off again, but I bet they won't.
Metalheart, you make some thought provoking points about CO2 concentrations and the problems in ensuring buildings can satisfy the revised guidelines for occupation.
I have seen no evidence that this has been considered by gov or their advisors.
Guidelines are pretty useless in the current context as compliance is optional; they should be re-worked and re-issued as regulations but that won’t happen.
I have little doubt that corporate lawyers will have been reviewing possible exposure to criminal negligence and corporate manslaughter in various scenarios.
Yup, it’s all being devolved to the individual authority/business/management. Without proper guidance.
The obvious outcome is obvious!
Let us not forget, this is an airborne virus, correct ventilation strategies are vital in minimising it’s progress. The organisations I mentioned are providing some quick guidance based on sound engineering principles, surely they need to formalised, codified and rolled out. The virus doesn’t care for sophistry... (just ask the ‘leader of the free world’ how calling it nasty names is working out...)
I popped back in the thread as it looks like Metalheart has posted a valid view of what needs to happen.
Turns out teachers spend way too much time in a world where "it wasn't me it was him what started it" is a normalised form of debate 😄
Turns out teachers spend way too much time in a world where “it wasn’t me it was him what started it” is a normalised form of debate 😄
Oh, thats not true, for clarity I most definitely started it as his simplistic bobbins was grinding my gears.
I do love that what MH said totally agrees with A-A position, yet somehow it's still all A-A's fault in the eyes of some.
Which neatly encapsulates the problems that teachers face, like the police, they're an easy target to be blamed in order to hide systemic deficiencies, and the great unwashed are happy to lap it up.
A lot of the people slagging of teachers on here should frankly know better, given their vocations.
Anyhoo, the company I work for is closing both of our offices and looking for new premises, as they can't physically be reopened while maintaining any kind of social distancing, do we think that this will happen with schools?
Teachers already have a bad enough reputation, the currentb union stance isn’t helping that perception. The unions could probably wrong foot Boris very easily with some lateral thinking rather than just shouting NO, NO, NO.
But that's not the unions stance
They've said they don't want to open schools until government have shown them the science behind their reasoning
Considering how badly handled aspects of the crisis have been so far thats a pretty legitimate response
Unfortunately too many people believing the torygraph/mail headlines rather than what's actually been said
metalheart - I like the revolver analogy.
What I'm reading from this thread is...
ITU workers - 5 bullets.
Care workers - 3 bullets
Shop workers, posties etc - 2 bullets
Teachers - there's a gun?
The problem is that we need a proper discussion about how we ‘return’ to the ‘new normal’.
[...]
Establish what is safe. And when it’s safe to implement it. Inform the public. It’s really not that **** difficult.
I think this is where I am too. What does this "new normal" look like? For a lot of people it seems to be a codeword for "jump under the bus for the sake of the wealthy", and just accept the likelihood of an early death. What a "new normal" needs to include is some way of reducing the risk of new epidemics and consequent burden on the health system. We can't continue with our hospitals turned into Covid-only dealing with an endless stream of infected people, and we can't accept the current risk of any sort of proximity.
I'm not sure what the answer is but the absolute minimum would seem to be the infrastructure and capablities for mass testing and tracing so that small fires are caught and stamped out before they take hold. If the govt would come forward and say how they are implementing that, I'd be a lot more confident than I am in seeing arbitrary targets being met with bogus tests mailed out in a fragmented system.
Is the virus truly airbourne? Are we talking about people's breath or sneezes etc? Don't they drop to the ground quite quickly? I'm putting lots of question marks in because I don't know the answer!
I know about its persistence on surfaces, just wondering how far it travels in the air. I guess flicking bogies at each other at school is off the menu now.
And so it begins: I realised only after the editing window had lapsed that in my list, the third item needs to be transparency...
The unions could probably wrong foot Boris very easily with some lateral thinking rather than just shouting NO, NO, NO.
My wife is a member of a teaching union, the magazine isn't full of no no no. It's discussing the issues that they would face. As mentioned above it's an H&S issue as much as anything else. How would your H&S assesment go?
It's mostly asking for better guidance and work on how to improve the situation. You might be surprised but it's quite an intelligent view.
I have only dipped in and out of the thread but I have seen a lot of posts stating what schools and teachers should be doing from folk who clearly have no clue
I'm not surprised AA is a little techy
Yes, but that doesn’t suit the Boris Blame Agenda.
Can we PLEASE have a separate schools thread. It’s making this place unreadable.
Is the virus truly airbourne? Are we talking about people’s breath or sneezes etc? Don’t they drop to the ground quite quickly? I’m putting lots of question marks in because I don’t know the answer
Coughs and sneezes are culprits, they produce large aerosols which are projected over comparatively large distances. Hence all the screens, visors, etc.
The current thinking (as far as I understand it) is that the smaller aerosols exhaled during breathing build up within an enclosed space to be transmittable after approx 15 minutes (unless there is sufficient fresh air ventilation to remove the concentrations). Hence my earlier mammoth post about ventilation strategies....
But a good point, airborne (directly) is only one vector of transmission. When the fall or land on hands/materials indirectly too. Cleaning regimes, another major part to play...
To any of the medics on here.
Has treatment of Covid-19 & it’s side effects changed much throughout the pandemic? Are we changing outcomes compared to early in the spread?
Apart from keeping as fit as possible (& hopefuly not catching it!) is there anything we should do if we do catch it that can stop the slide into ICU?
I think this is where I am too. What does this “new normal” look like? For a lot of people it seems to be a codeword for “jump under the bus for the sake of the wealthy”, and just accept the likelihood of an early death. What a “new normal” needs to include is some way of reducing the risk of new epidemics and consequent burden on the health system. We can’t continue with our hospitals turned into Covid-only dealing with an endless stream of infected people, and we can’t accept the current risk of any sort of proximity.
Yup, that’s pretty much my take on it. I was just applying it as universally as I could (not wishing to get dragged in specifically to the ongoing ‘hostilities ‘)...
Well social distancing seems crumbling. Round here, before this weekend everyone was pretty much following the stricter guidelines but really noticable change today.
Out for my ride today loads of groups of 4/6 adults out walking (and MTBing in one case). Mixed family groups. Not distancing from each other or even really giving room to me.
Roads busier they have been in months.
Unclear guidance and people make up their own rules
^^ This.
I rode yesterday and places were beginning to get busy, loads more vehicles on the roads, a big group of motorcyclists, several groups of walkers.
I was planning on a road ride today but having been to the supermarket this morning and seeing the massive extra traffic, the attempts at social distancing standing outside shops (forcing pedestrians to walk in the road which forces cyclists further out again which puts them directly in the line of fire of cars), I've decided against it. This weekend will be chaos, I think a lot of the National Parks are dreading it.
Some pub in Snowdonia said they would open for takeaway bottled drinks only and the backlash they got on social media was appalling. They binned off the idea.
We're at a crossroads. We can't reopen pubs, shops etc because of social distancing but "lockdown" has crumbled to the point that people are allowed to drive to places. But no-one wants them in those places even though they're allowed to be there...
And there's not enough space to allow queues of people outside every shop.
Metalheart, it's not strictly correct to say this virus is airborne, according to the Official Guidance, section 3, transmission. It can be airborne in specific circumstances, where aerosols are created but it's main transmission vectors are via direct contact and respiratory droplets (which are large enough to be affected by gravity) Which is not the same as a truly airborne pathogen which can survive on tiny particles too small to taken out of the air by gravity.
If it was truly airborne the visors and perspex shields being used wouldn't be very effective.
Metalheart, you make some thought provoking points about CO2 concentrations and the problems in ensuring buildings can satisfy the revised guidelines for occupation.
Being cynical I'm going to suggest this will become less of an issue in around 8 months. Free to set own standards and all that.
There are no approved therapies for COVID19. A number of trials are testing some existing and also some unapproved new drugs. The large NHS trial is testing existing medicines.
I believe there is a signal from hydroxychloroquine plus azithromycin for time to undetectable viral load, which may (or may not) subsequently lead to possible avoidance of sequalae. That benefit has not been proven. As with many infections, early treatment is likely to have a better outcome in mild patients.
There is excitement about the unapproved (for any indication) antiviral Remdesivir. This is in two phase three trials in the US and worldwide. Preliminary results are due this week. I don’t believe there will be a huge signal in the severe population, based on the clinical pharmacology (achieving target levels is hard due to toxicity). The entry criteria for the mild/moderate trial (oxygenation of >94% on room air) would not see you admitted to a U.K. hospital (which is a challenge for a daily IV Medicine that needs 10 days of dosing)! I am not hopeful and all of the previous excitement has been based on uncontrolled data (the one randomised trial in severe patients was wholly negative).
There are numerous other experimental therapies being tested, including three I am working on. Mostly in the severe population. These are a year away from filing at best. Every pathway will be explored and I am confident that in two years there will be approved medicines for if/when SARS-COV-2 becomes endemic.
As for non pharmacological intervention, the reasons for the immune response and subsequent ARDS like disease is not known. Why I had a miserable time and the rest of the TiRed household appear not to could be due to many factors. But COVID19 is a disease of the surfactant producing cells in the smallest air sacs of the lungs. Gas exchange is modified and hypoxia is the symptom. I suspect that earlier treatment with oxygen may be beneficial, and that patients have been admitted to U.K. hospitals too late (with high mortality). That’s speculation, and will only come out after cross comparison with other countries with higher healthcare capacity.
As for vaccines, possibly in 12-18mo, but there has been no success with other coronavidae, the pathway is established, and if one vaccine does look promising, there will be manufacturing constraints.
[TL:DR] There are no approved treatments, but they will come in 12-18mo, much earlier if Remdesivir works. Management of patients might be improved with earlier intervention, if there is capacity in healthcare.
Interesting. So if we used Nightingale’s to provide early O2 treatment, rather than “stay at home unless you are really sick” it might improve outcomes? Maybe even a lot more O2 sent to peoples homes, like my dad had in his final years? I imagine we are woefully short of cylinders though.
Has the in-hospital treatment changed at all? We hear about the turning of patients, but not much else.
@stumpyjon:
This earlier in the thread...
But a good point, airborne (directly) is only one vector of transmission.
Interesting. So if we used Nightingale’s to provide early O2 treatment, rather than “stay at home unless you are really sick” it might improve outcomes?
That would be my suspicion. Early intervention is likely to be advantageous. For influenza, the two approved antivirals were not reimbursed, because you need very early treatment, when you may just have a cold. If you do have flu, relenza makes the symptoms less severe. If you have severe influenza, it’s given IV in hospital.
My suspicion is that Remdesivir will benefit mild and moderate patients, but these are not admitted in the U.K. the nightingale hospitals could be where you’d go. But then it may all be over soon (second wave notwithstanding).
Just had a good look into the R figures published for the various different areas and had a think about why London is so much lower than everywhere else. Is it due to the whole of the place having lots of amenities concentrated in lots of small areas? Basically the locals that live there don't have to travel very far to the shops, pharmacies etc so if any spread does happen it's kept to a small area automatically?
Also does the fact that a lot of people who work there but live further afield are not going to work limit any spread too as there's no mass-movement of people to carry it unlike in other areas where people are having to travel further distances for basics.
Basically is London's compactness of infrastructure helping control spread while lockdown is in operation and going to be the opposite during normal times. I do seriously worry that the people in Westminster are presuming that what happens in London is similar to the rest of the country whereas London is rather unique in how the virus interacts and is spread with us compared to a rural or even a less compact city. And I mean compact as in how far one person has to go to get the basics.
If you want to know how we should be treating people, look to how the PM was treated. All that has been learned from medical pros in other countries were applied to his treatment… the right vitals were monitored and early interventions were used. While people with similar symptoms were left in care homes, and “common sense” used to look after them.
Wave 2 in 14-21 days.
It's an absolute free for all in the Country Park car parks (reopened this week) round my way.
But they need their car park money from the dog toileters so public health can go whistle.
I'm more worried about transmission in garden centres and B & Q than people in a car park. Even if it's full of cars people are still probably a decent distance from each other and outside.
But they need their car park money…
They had little choice but to open them… have you been down any roads near where car parks have stayed shut? Parking chaos. Boris said the people can drive anywhere for any exercise, and obviously plenty of people have taken that opportunity. You can’t blame them. Every passing place and gate has a car parked in it here, are we’re no where near a National or Country Park.
The Barrow data is not so special. 3x the Population (of authorities) mean for an exponential process is not so big actually. That’s a standard deviation on a log-scale of about 0.5. For reference, that’s no more variable than paracetamol concentrations you’d see in STW riders ;-).
Did the supermarket run to Aldi this morning - quieter than it has been for weeks, no queue to get in.
A mate cycled through Derby city centre this afternoon, looks dead in his pics.
Bit more traffic on main roads when I went out this afternoon on the bike. People are parking in the country park car parks rather than on the road outside, which I'd say was an improvement. Not sure there were many more out today, didn't really notice any obvious non family groups. A few friends were chatting in parks but keeping a sensible distance.
A couple of Facebook friends have met up for a socially distanced ride. The reaction from most of us has been polite disapproval.
metalheart
What I’m highlighting is that the proper assessment isn’t being made as to whether it’s safe to reoccupy our workplaces full stop. That’s why the IoD have been seeking clarification on immunity from prosecution under the H&SaWA. Without proper ventilation how do you stop being infected by someone else in your work (asymptomatic or otherwise)?
What is the risk? Don’t you think we really should find out before we reoccupy?
I completely agree and we know barely anything to quantify it.
Your CO2 is one aspect .. we don't even know very well what build-up is required on average, let alone how that differs in individuals or specific segments (for example immune deficient vs overactive although it's starting to look like the reason for death is probably different between those) nor is transmission limited to airborne only....
according to the Official Guidance, section 3, transmission. It can be airborne in specific circumstances, where aerosols are created but it’s main transmission vectors are via direct contact and respiratory droplets (which are large enough to be affected by gravity) Which is not the same as a truly airborne pathogen which can survive on tiny particles too small to taken out of the air by gravity.
More accurately an guest-imated viral load that will probably lead directly to infection is caused by aerosols.. that's unlikely to be the same for everyone. The theory says the same amount will build up.. and how quickly it falls to a surface is dependent on outside factors like temperature, humidity and wind. I'm sat now watching a load of pollen defy gravity in barely a light breeze but regardless it has to then fall somewhere.
or ....
metalheart
The current thinking (as far as I understand it) is that the smaller aerosols exhaled during breathing build up within an enclosed space to be transmittable after approx 15 minutes (unless there is sufficient fresh air ventilation to remove the concentrations). Hence my earlier mammoth post about ventilation strategies….
If it was truly airborne the visors and perspex shields being used wouldn’t be very effective.
As per metalheart's post but additionally ...
Airborne, Very and Effective are fairly vague... my shower cubicle isn't very well sealed for example (its got a good 15cm gap at the top) ... if I take a shower with the room closed then the mirror a meter away might get slightly damp after a while from the steam.(looks good enough to shave).. but as soon as I open the shower door all the steam spills out everywhere. It doesn't seem like an effective barrier but it actually does a fair job.
As for non pharmacological intervention, the reasons for the immune response and subsequent ARDS like disease is not known. Why I had a miserable time and the rest of the TiRed household appear not to could be due to many factors.
Which seems to go back to what we don't understand and who is most at risk (other than age)
But COVID19 is a disease of the surfactant producing cells in the smallest air sacs of the lungs. Gas exchange is modified and hypoxia is the symptom. I suspect that earlier treatment with oxygen may be beneficial, and that patients have been admitted to U.K. hospitals too late (with high mortality). That’s speculation, and will only come out after cross comparison with other countries with higher healthcare capacity.
This isn't the only way people have died from the virus though is it?
Unless I misunderstood other organ failure from the cytokine response can also be the direct cause?
This isn’t the only way people have died from the virus though is it?
Unless I misunderstood other organ failure from the cytokine response can also be the direct cause?
You are correct. But people are presenting late with pneumonia, coagulopathy, and so on after they’ve already seen some hypoxia. We are looking at treatments at each end of the spectrum, but I’m sure early is likely to be more successful. Maybe early oxygen reduces the inflammatory cascade in the lungs?
We do know that mopping up some inflammatory signals works when patients are severe. Two antibodies are approved for arthritis and neutralise IL-6 signalling. One (sarilumab) showed a positive response in a small trial against placebo with a severity endpoint at the highest dose tested. That’s encouraging.
Not seen any unlockdown madness around here and personally I'm feeling fairly positive about things and believe we needed a bit of extra freedom to combat the unintended consequences of full lockdown.
There will always be some idiots but that will have been taken into account in the planning.
Tired : What do think of the studies that have shown a correlation between low Vit D levels and the severity of covid 19 immune response?, especially in the amount of BAME deaths in this country which show over 90% have low Vit D levels, i currently take 5000IU's of Vit D3 daily and 1500IU's of Vit C (due to secondary progressive MS) .