Forum menu
My sister (a GP) told me last night that with 6 members of practice staff off with covid currently the remaining stretched receptionists and GPs are getting abuse from people asking why they haven’t been scheduled yet. Just not on.
Yeah, but the customer clapped in the street so they are right to expect to be at the front of the queue...*
.
.
.
* It's crap what many are dealing with at the moment, such selfishness is appalling.
How can you argue against things like this?
Even if it was 7.6%...so what? Everyone in hospital jumps out of bed and is fine again and we all forget the whole thing?
how did they get to their vaccination appointment?
If they have a smart phone registered with their GP they'll be able to book both appts. through a link embedded in a text. If not, they'll get a phone call to invite them
Also if you took an elderly person did you/they have to fill in a form (as a permission) during the pandemic?
You shouldn't need to fill any form if you're just taking them to be vaccinated, and you should be able to help them with the admin process should they need.
Any other info about taking the person safely if they or you have been sheilding would be welcome. Thanks.
If they've been shielding successfully, it may be more sensible to wait till the DN team can come and give them the AZ vaccine at home. You should have that conversation with their GP
Hope that helps
nickc - thank you.
Testing is not normally done completely at random. The false positive rate when confounded with a sample selected due to symptomatology will be much lower. Whats the rate for someone with a persistent cough and temperature, for example?
How do you prove a false positive? Or a false negative for that matter?
How do you prove a false positive? Or a false negative for that matter?
Sensitivity and specificity for test any approval is normally done on stock samples spiked with known viral contamination (or not, obvs). Those quoted percentages will be from in vitro testing not patient samples. Hence the bias is so much reduced by sampling from someone with symptoms. One can use test samples from healthy and diseased patients with other confirmation methods too, for blood sampling in lateral flow tests based on PCR positivity, for example.
The roads near me are as busy as a normal day. I read also that some schools have 50% to 70% attendance because all parents are claiming to be key workers.
^^ hardly surprising seeing as last March more businesses just shut down, but this time, everyone has adjusted and food places/non essential shops are doing click and collect
the list covers a vast amount of jobs, what's left?
our local primary, have adjusted already, from only having 35 places 2 days ago due to limited tech they have essentially said in order to have safe consistent bubbles if your kids has to attend any day, they would prefer to have them in all 5 days,
We are opening up more places to Critical worker children, and because of the large numbers involved, we have decided that to try to keep everyone in school safe we need to have consistent bubbles. We think the safest way of doing this is to ask that all children attend school 5 days a week starting from Monday 11th January.
https://twitter.com/gnomeicide/status/1347240927753080832?s=19
This is profoundly worrying and depressing.
Sensitivity and specificity for test any approval is normally done on stock samples spiked with known viral contamination (or not, obvs).
Somewhat obviously! Thanks.
I have a question for the covid genius’s amongst us.
My son (4) had an outbreak of covid at his nursery and had to isolate. A few days he became symptomatic and tested positive.
We all isolated at home but neither my wife or I took any precautions to stop catching it from him as he was quite upset and needed lots of cuddles etc.
Neither my wife or I caught the virus (no symptoms and were tested twice. How is that possible?
The outbreak at the nursery was quite large and other children seemed to pass it to their parents making them sick in turn. According to the nursery / health board it was the “new” strain which makes it even more confusing that I didn’t catch it.
What tests did you have?
Perhaps you had it before him.
Neither my wife or I caught the virus (no symptoms and were tested twice. How is that possible?
Household attack rate is about 0.33 (range 0.25 to 0.5), so probability of not catching it is 0.67 per person. Never catch it (2 people) is 0.67^2, at least one catch it is 1 - 0.67^2 = 0.55 or 55%. Pretty much a coin toss that at least one will catch it.
The attack rate from a 4yo might be on the low end, reducing the chances further.
https://en.wikipedia.org/wiki/Coupon_collector%27s_problem
^^ hardly surprising seeing as last March more businesses just shut down, but this time, everyone has adjusted and food places/non essential shops are doing click and collect
the list covers a vast amount of jobs, what’s left?
Over a long enough period of time, almost everything becomes an essential.
(Purely leisure activity providers excepted).
I’m overworked currently as it seems the industry’s natural amount of work is catching up with that 3 months last year where they didn’t do anything
Is this guy really a senior part of the NHS? Honestly what a car crash and it gets worse as the interview progresses.
It is very worrying that there are people in charge who cannot seemingly answer a straight question. Is it any wonder that conspiracy theories have taken hold in the absence of apparent honesty and credibility from the top?
Neither my wife or I caught the virus (no symptoms and were tested twice. How is that possible?
Not everyone is susceptible to it just like other viruses of course gives you the maths. You may have also been the carrier and passed it on to your son but then as your body beat it the tests showed negative. Also which tests did you have in order to get tested twice but without symptoms?
Neither my wife or I caught the virus (no symptoms and were tested twice. How is that possible?
My 14yr old niece tested positive after being notified of close contact to another pupil who had it at her school and had to isolate at home. She had symptoms of losing taste & smell for one day, nothing else. Neither my brother(53) nor my sister inlaw(50) made an effort to stay clear of her and neither of them caught it.
Is it any wonder that conspiracy theories have taken hold in the absence of apparent honesty and credibility from
the topJulia Hartley Brewer?
FTFY
JHB, as usual, uses a highly misleading stat - A&E attendances - which is literally people walking through the door of their local hospital saying help me, I'm I'll. People have been explicitly told not to do this with Covid, as they want to keep the A&E pathway clear of Covid for other illness/injury. Potential Covid patients are triaged via 111 and 999 and directly admitted where appropriate.
Are you seriously suggesting that hospitals in the SE are not on the point of being overwhelmed? The thread I linked to in the post above yours visualises data directly from the NHS.
Is this guy really a senior part of the NHS? Honestly what a car crash and it gets worse as the interview progresses.
We must have been watching a different interview. The couple of minutes I could bear to watch was a guy taking Hate-filled Spewer to task for telling lies.
Not everyone is susceptible to it just like other viruses of course gives you the maths.
Does this suggest that like almost all viruses, there are a significant % of the population who are always going to be immune to something new. I'm guessing this is how our population has survived many 100's of pandemics throughout history before the advent of modern medicine.
We know that the IFR from Covid varies by demographic and location and has been suggested to be anything from 0.1% to 1%. Let's pick the middle number, say around 0.5%. With 79,000 deaths in the UK from (or with a positive test for) Covid this suggests, based on the IFR that around 16 million people have so far been infected. That is 24% of the UK population.
Prior population immunity (the susceptible) has by many scientists been suggested at between 20% and 50%. Again let's pick the middle ground and assume that this is 35%.
So 24% and 35% males 59% which implies that we could right now be very close to the 60-70% threshold needed for herd immunity in any case.
With this in mind I wonder if the vaccine has arrived too late and whether it is even needed if herd immunity is imminent? That said, the WHO guidance seems to have been changed recently to suggest that herd immunity can now only come from vaccination, rather than from a prior infection as always used to be the case in the past. A bit like the masks situation, I wonder what has changed to over-write years of previous scientific consensus?
Someone better anointed than I will be along but surely if that was right then we wouldn't now be seeing an acceleration of cases despite preventative measures.
So 24% and 35% males 59% which implies that we could right now be very close to the 60-70% threshold needed for herd immunity in any case.
I'm sure the Gupta/Barrington musings are an elegantly-constructed hypothesis. But relies somewhat on cases and hospitalisations already starting to dry up. Do you see any sign of that, or is that where the A&E thing comes in, you're being given a marker which doesn't actually reflect Covid activity? Every other marker of Covid activity is still heading skywards.
With this in mind I wonder if the vaccine has arrived too late and whether it is even needed if herd immunity is imminent?
I saw an article from a study in Brazil (can't find the ref just now) that suggests that the infection rate was over 75%, so don't give up your place in the jab queue just yet.
Are you seriously suggesting that hospitals in the SE are not on the point of being overwhelmed? The thread I linked to in the post above yours visualises data directly from the NHS.
Hospitals are always overwhelmed at this time of the year though. Yet we have done little about it in previous years.
Euromomo data suggests that excess mortality at present is certainly above the baseline but well down on that seen in April at the peak of the crisis. It is about 2/3rds of April's figures currently.
Ignoring the problems with mass PCR testing, why is there still no data to separate those in hospital because of Covid and those there for something else who happened to have had a positive test but present no Covid symptoms? This is a fundamental issue and we have had 10 months to get a grip on this. Yet the NHS bosses appear to be completely clueless!
It would seem that the problem is not really Covid. It is the perpetual mis-management and systematic year-on-year under resourcing of the NHS that has bought about the current crisis. I would argue that the NHS and its management is currently not fit for purpose and it is this that is crippling the nation rather than the disease itself.
In any case I wonder what are we saving the NHS for? Surely at a time of National crisis like this, it needs to be used in its entirety, not kept with spare capacity 'just in case', crippling the whole economy that will be needed to fund the NHS in the future in the process.
Hospitals are always overwhelmed at this time of the year though.
Things are always bad. The scale of the current problem is something else though. Watch...
https://twitter.com/jburnmurdoch/status/1347200859516645378?s=20
That is 24% of the UK population.
It's probably half that and was waning. Antibody seropositivity declined in the summer and autumn as the force of infection declined. Lifelong immunity to coronaviruses is not noted for the other endemic four viruses, unlike, say, measles.
There is little evidence that immunity has put a brake on the rate of growth of new infections so far. With a more transmissible strain, even higher levels of immunity are required for that brake to work. The vaccine will induce some protection from disease (at the least), cross-protection from new variants (weaker evidence) and possibly transmission to others (little evidence other than precedence of other vaccines).
I’m sure the Gupta/Barrington musings are an elegantly-constructed hypothesis
Unfortunately the narrative has moved on and been overtaken by facts. Lockdownsekeptics - Toby "I was wrong about that" Young's website has lost its analyst. Today's post on hospitals by "A senior doctor" basically says that London is in serious trouble, and the only crumb of comfort is a slight dip in symptoms on the Zoe App over the New Year.
More than half of all patients in London hospitals are receiving treatment for COVID19. That's the ICD100 respiratory disease, not the positive PCR test.
Does this suggest that like almost all viruses, there are a significant % of the population who are always going to be immune to something new.
No, there is no suggestion but it has been mentioned since the start that there is a very small percentage of people who will be immune. It is also has been mentioned many of those will be asymptotic more so than some other viruses which is part of the contribution to spread.
Without a vaccine herd immunity is a long way off.
It would seem that the problem is not really Covid. It is the perpetual mis-management and systematic year-on-year under resourcing of the NHS that has bought about the current crisis. I would argue that the NHS and its management is currently not fit for purpose and it is this that is crippling the nation rather than the disease itself.
In any case I wonder what are we saving the NHS for? Surely at a time of National crisis like this, it needs to be used in its entirety, not kept with spare capacity ‘just in case’, crippling the whole economy that will be needed to fund the NHS in the future in the process.
I'm starting to see a lot of this kind of posting, it's similar in style to the pre-Brexit arguments. As though we're being slowly nudged into accepting that the NHS is a waste of money and we should dump it and move to an American style system instead.
In any case I wonder what are we saving the NHS for? Surely at a time of National crisis like this, it needs to be used in its entirety, not kept with spare capacity ‘just in case’,
"Save" doesn't mean "save for a rainy day", it means "save from being killed". Where do you see this 'spare capcity', by the way?
True herd immunity is unattainable. There will be an ongoing cycle of mutation and revaccination as there is with flu. Over time, acquired immunity will reduce the impact of this virus in terms of mortality and serious illness, but there will always be those who require the additional protection of a vaccine against the dominant strains coming into winter.
Hospitals are always overwhelmed at this time of the year though.
There are different types of 'overwhelmed'. There is the kind of 'overwhelmed' where other routine activity is displaced - operations are cancelled etc. Then there is the type where people who would otherwise be in hospital for treatment are cared for in other settings. Then there is the type where urgent activity for cancer and other serious diseases is disrupted, or patients with life-threatening Covid are selected for treatment based on criteria such as age and underlying health, and some simply given palliative care outside hospital.
Presently we are reaching the third tier of this in London and the SE, and will be in some other places within a couple of weeks of that.
The NHS has perhaps used 'overwhelmed' too much in its messaging to try to reduce unnecessary activity in 'normal' winters. But the public are about to find out what that really means.
Anti-lockdown campaigners, who constructed plausible-sounding arguments primarily to serve their own convenience and political leanings, are grasping at statistical straws to avoid the truth of what is happening right now in ICUs in our capital city and beyond.
<deleted>
MH said it far more eloquently than I did.
Am I being paranoid when I hear Johnson saying people will be "offered" a vaccination by such and such a date, and expect that it just means that a few million "offers" will be chucked in the post the day before the end date, and "job done" claimed?
This is the problem we have had all along. Some seem to think you can just wait until the NHS implodes, then say “Right, enough, stop it now”
Sadly at that point you already have another baked in (😖) doubling of cases before we turn the corner.
Going hard early is the only way, but we fail every time.
DrJ
if you are, so am I
In any case I wonder what are we saving the NHS for
It's always worth remembering that the NHS, isn't just three capital letters.
Its one of the worlds largest employers of people. More than a few on here work within it, my partner does as it happens.
There is a human cost of letting Darwinism into the NHS, both to the people it employs and the patients they are attempting to care for through this maelstrom.
Still... clapping, eh?
Just so we can move in. Bratwurst has been banned, again, as they are the abusive troll that keeps popping up.
Thought it might be. He was trying to sound informed and go light on the swearing this time, should have let him warm up a bit.
Euromomo data suggests that excess mortality at present is certainly above the baseline but well down on that seen in April at the peak of the crisis. It is about 2/3rds of April’s figures currently.
In case you've not been paying attention, we have drugs and treatment options now that we didn't have before. Provided we have enough beds, staff and supplies, we will save more people. Ergo, we need lockdown etc to make sure we don't run out of beds, staff and supplies, and we are getting close to that now in places. Nurses/doctors are talking about making choices of who to treat already.
I am in awe of the NHS and it's staff that they are somehow still managing to treat more non-Covid patients than Covid. Incredible skill and dedication.
It's all ok my wife got this tat from the NHS to recognise efforts for operation rainbow 2020. 🙄
Still not got the mystical £500
/ whatever her prorata rate will be from scot.gov payroll told them it will be in theFeb payroll. Sounds like nhs are holding onto this money for a bit
I wasn’t expecting anything but we’ve been given a water bottle and cooler bag thanks to Captain Tom and our trust has agreed to pay us 7.5 hours extra pay at the end of February. Nice little gesture.
In case you’ve not been paying attention, we have drugs and treatment options now that we didn’t have before.
I think this is contributing to the problem. Instead of public-spiritedly freeing up a bed by dying, the selfish buggers are surviving. Have they no shame?
I think this is contributing to the problem. Instead of public-spiritedly freeing up a bed by dying, the selfish buggers are surviving. Have they no shame?
And I bet they clapped every Thursday as well
The news yesterday that anti-IL6 antibodies have an effect on mortality in the sickest patients is very welcome. Previously both tocilizumab and sarilumab failed to show an effect in moderately ill hospitalised COVID patients. By treating the sickest patients in ITU within 24 hours of organ failure support, a signal has become apparent.
Here's the preprint published yesterday https://www.medrxiv.org/content/10.1101/2021.01.07.21249390v1
Like dexamethasone, an anti-IL-6 antibody is a drug that nobody in the ITU should die without having onboard.
For full disclosure, I worked on sirukumab, another anti-IL6 antibody that was not eventually approved for rheumatoid arthritis. It would most likely have the same effect in COVID patients as the above two (which have subtly different modes of action btw).