Extrapolate that and…you're still a very annoying troll
🤦♂️
30s? Mine took at least 5 mins with getting the documentation checked etc.
Shouldn’t you all have time on your hands now there are so many fewer frail and elderly left?
No, we're busier than before...Second doses.
Well it arrived here faster than I expected.
Indian variant found in UK "A variant of concern"
The Guardian is more pessimistic!
Place your bets on when the next set of restrictions will kick in.
So, you can delay bad news as regards the pandemic because of the elections, but not good news from the Bank of England (good news that was dependent on there not being any bad news as regards the pandemic). Stitched up good and proper.
Well..... we've had two new cases in Sydney since Wednesday (husband and wife). Our first for ages - the cluster over new year maybe? They know what the original source of the infection was (somebody arriving from the US, positive test on arrival in quarantine) but we don't know how it moved from that chap, to this couple in the eastern suburbs of Sydney. The search is on for "the missing link".
They have reinstated some restrictions over the weekend to try to keep a lid on it while the testing/tracing happens: We have to wear masks in shops/public transport again, no more than 20 people round your house, no singing in church, that kind of thing.
Sewage testing has shown virus fragments from a (pretty large) cluster of suburbs, including ours, so Mrs Batfink and I had a test yesterday as she's got a bit of a cold.
My first time getting tested - just waiting for my result.
Well it arrived here faster than I expected.
Given that 100,000 people from the UK went to or from ****stan in the first three months of the year (BBC article yesterday), your optimism is impressive.
About a dozen cases in the East Midlands by last week.
The Guardian article highlights the data reported two weeks ago by PHE regarding emergence of strains that have the S gene in PCR tests. Our World-beating U.K. variant, B.1.1.7 is being replaced by strain(s) that have the S-gene register in PCR tests. These may be the South African strain B1.351, the Indian strains B.1.617.x (there are at least three) or another home grown up and coming star.
The consequences for vaccine escape are not known. Certainly vaccines have been less effective (but not ineffective) against the SA variant. Perhaps the immune selection pressure is replacing the U.K. strain - we shall see.
I’ll post an analysis later showing the replacement. This is normal evolutionary biology. The fact that we are seeing evolution in real time is testament to the intensity of study, nothing special.
[tl:dr] On a background of falling overall infections, new strains are replacing the U.K. strain that took off from November. This is normal evolution. Vaccines may provide a little less protection but still keep people out of hospital.
Ps
Such patience, and always stays calm and clear. How does he do it?!?
High ASQ 😉
Given that 100,000 people from the UK went to or from ****stan
There's a tranche of people that Border Force could legitimately send back to ****stan/India for being thoughtless and careless of our public health.
No, it highlights how porous our “travel ban” is.
No, it highlights how porous our “travel ban” is.
This. Government ups vaccine success and economic bounce ahead of elections, yet more failures of border control/quarantine come out the morning after.
I think your 30s is way underestimated too, but then I don’t really understand your point. Are you suggesting this hasn’t been a massive effort and that the NHS aren’t really that busy?
First, 150,000 dead are no longer visiting surgeries. Second, I would otherwise have had three GP consultations, two prescriptions, one referral, a scan, a consultant, maybe some treatment - but actually spent less than a minute being vaccinated. I doubt I am the only one not to seek treatment I would otherwise have sought.
This would suggest surgeries are quieter than normal even with vaccinations to do.
Pulling the other way would be absenteeism, but it shouldn’t be much of a problem now that the virus has gone right down.
And quite how that is trolling, I don’t know.
@chrispo - You continue to only look at this your way, other opinions are out there, some more realistic and considered than your frequent petulant outbursts. You consistently present your opinions as facts but refuse to yield your position when called out on their inaccuracies. You know what this behaviour resembles don't you?
actually spent less than a minute being vaccinated
Are you aware that the time being vaccinated as you call it, is just the bit where they stick the needle in your arm? There is a whole lot of other work going on at the same time that you're not party to.
This would suggest surgeries are quieter than normal even with vaccinations to do.
They've got quite a substantial backlog to get through, so no, the GPs and medical staff are not twiddling their thumbs waiting for punters to arrive
What is this absenteeism you are referring to? Please provide some context
No, it highlights how porous our “travel ban” is.
My comment was more along the lines of "just because you can. . ." Failure to consider the big picture compared to your personal needs should be grounds for ejection because you're not our type of person. (A more verbose way of saying failure to obey Rule 1).
Nope, not touching that
This would suggest surgeries are quieter than normal even with vaccinations to do.
haha, feel free to come to my surgery and tell my doctors and nurses that they should feel grateful for the little work they're getting. Average list size for GP in the UK is about 8000 pts, there are about 7000 practices in the UK, Even if every one of the dead people are registered, that's 21-ish patients from each surgery, that's a drop in the ocean. Without really checking I think I've had that many new patient registrations this week already.
You continue to only look at this your way, other opinions are out there, some more realistic and considered than your frequent petulant outbursts. You consistently present your opinions as facts but refuse to yield your position when called out on their inaccuracies. You know what this behaviour resembles don’t you?
You are digging yourself a troll-shaped hole there. Every time someone shouts troll, I see a closed mind refusing to engage with something that doesn’t fit their narrative.
Are you aware that the time being vaccinated as you call it, is just the bit where they stick the needle in your arm? There is a whole lot of other work going on at the same time that you’re not party to.
Although both my brain cells are currently busy transmitting data to Mr Gates, yes I am aware of that. Are you aware that the admin etc around the consultations and treatments I listed as not having had would dwarf that? My point stands. My personal health care burden has been a fraction of what it would have been.
They’ve got quite a substantial backlog to get through, so no, the GPs and medical staff are not twiddling their thumbs waiting for punters to arrive
Did I say that? But what backlog would surgeries have? Much of the hospital backlog will not materialise either due to people dying or getting better.
What is this absenteeism you are referring to? Please provide some context
I mean staff off with Covid.
If surgeries are in fact busier than normal, then I would be very interested in learning why. Which is why I raised the issue in the first place. Logic suggests to me that demand must be down.
Why is that, nickc? Everyone I know is staying away from the NHS as much as possible.
Logic suggests to me that demand must be down.
You are making a huge assumption that your demands on the NHS in the last year are in some way representative for other people, therein lies your first error in "logic".
Much of the hospital backlog will not materialise either due to people dying or getting better.
Yes the 52yr old lady who needs a hip replacement has obviously died according to your view
Have you considered, even for just one moment, that in the last 13months people could have developed new problems but have been unable to get an appointment until recently. It's very hard to diagnose ulcers or lymphoma over the phone
You also need to consider the wider perspective, not every GP practice is like yours, not every NHS Trust is like yours. Your comments are reductive but we all know that this is not a simple issue nor are there simple solutions
Why is that, nickc? Everyone I know is staying away from the NHS as much as possible.
people are still sick, the vast array of "lifestyle" illnesses we generally treat (chronic manageable conditions like asthma and diabetes) still need to be managed Throw into the mix that counterintuitively it's probably easier to "see" a GP these days, we're mostly doing online telephone or video conferences with patients, so the barriers that normally keep folk away have been removed. You don't have to come to the surgery in worktime anymore, you're doctor will actually call you.
edited
Throw into the mix that counterintuitively it’s probably easier to “see” a GP these days, we’re mostly doing online telephone or video conferences with patients, so the barriers that normally keep folk away have been removed.
That’s an interesting point. I hadn’t thought of that.
Why is that, nickc? Everyone I know is staying away from the NHS as much as possible.
Well, everyone I know is using the NHS as much as before. It's just the method of delivering the service that changed a bit.
Wife still getting her checkups with the neuro consultant and physios. Parents still having cancer checks, biopsies, heart checkups. Friend took a tumble, ambulance called, all OK, checkup with doc the next day, I called about an ear infection that wouldn't clear...
You are making a huge assumption that your demands on the NHS in the last year are in some way representative for other people, therein lies your first error in “logic”.
There will be all the usual ailments needing GPs’ attention.
Less various infections that have been reduced due to social distancing etc.
Less me (and possibly others too) not going to the GP for minor stuff.
Less the dead (many of whom needed lots and lots of care).
Less STW members doing no gnar.
Plus vaccinations.
That, to me, spelt reduced demand.
But it turns out people phoning up with trivial stuff they couldn’t be bothered to queue for before is outweighing that. Which is a surprise, and quite shocking.
But it turns out people phoning up with trivial stuff they couldn’t be bothered to queue for before is outweighing that. Which is a surprise, and quite shocking.
That's because you've overlooked all the people who put off being treated over the last 12 months who are now feeling it's safe to get looked at.
That, to me, spelt reduced demand.
That sounds like pent up demand waiting to be released to me. The NHS is going to be busier than ever over the next year, in all services.
There will be all the usual ailments needing GPs’ attention.
Those folk with long term chroinic diseases haven't gone away in any significant numbers, or suddenly got better, a few have died, but that's normal as well.
Less various infections that have been reduced due to social distancing etc.
STD are still at about the same level there have been, and we still have to vaccinate children, pregnant mums etc
Less me (and possibly others too) not going to the GP for minor stuff.
Not that I can see. Most middle aged blokes* tend not to go to the GP anyway, but our routine patient load hasn't changed at all
Less the dead (many of whom needed lots and lots of care).
Already been said, as a per-practice number, it's not significant
Less STW members doing no gnar.
Doesn't account for as much A&E as you probably think, and at best; sports injury visits to A&E happen over just a couple of days, and are pretty straightforward anyway.
Plus vaccinations.
Yet to take effect, give it some time.
That, to me, spelt reduced demand.
Demand hasn't changed, will increase as the backlog of unresolved issues stars to really make it's presence felt, plus Long-COVID, plus I'm expecting a mini up-tick in mental health problems.
*I'm assuming you're a middle aged bloke, apologies if I'm wrong.
Won’t most of those coughs and colds and rashes and grazes and vague aches and pains have cleared up by now?
(Oops, crossed post. Thanks for the insight, Nickc.)
Is that what you think people use their GP for?
Well if you go with anything else they direct you to casualty🤷♂️
Seriously, though, there must be a fair proportion of trivial things?
Has anyone read the book, sorry meant a communication, from a Derbyshire GP Practice to all their patients? @nickc? any thoughts?
Edit: here's a corrected link:
https://www.pulsetoday.co.uk/views/in-full-gp-practices-16-page-letter-to-patients/
Throw into the mix that counterintuitively it’s probably easier to “see” a GP these days, we’re mostly doing online telephone or video conferences with patients,
This has certainly been my experience. From a practice that previously was almost impossible to get an appointment. Response times have been impressive and consultations meaningful - right up to prescriptions sent direct to our village pharmacy. Where a physical examination has been required, that has also happened following a phone call.
The NHS has adapted and adopted remarkably well in this regard. It won't be going back. Teams or Zoom on every phone, doctor calls for Video, close up phone photo of boil/wart/rash... This was the preserve of the few prepared to pay in London 18mo ago. Their business model was adopted almost overnight.
My experience too. Our surgery had already embraced Engage Consult and telephone triage, guaranteed nurse or doctor phone contact the same day. They've maintained this level of service throughout, with the addition of video consultancy, accepting pics of symptoms and so on. Will obviously vary.
Also add to their workload the impending tsunami of mental health issues ranging from minor to very serious due to Covid-19 (isolation, anxiety, stress, depression etc. etc.)
from a Derbyshire GP Practice
Thanks for the ink CG, that's a depressingly familiar picture
Seriously, though, there must be a fair proportion of trivial things?
Apologies, missed this. It's fair to say that there's a subset of patients who come repeatedly to the surgery with trivial things. Those people are still the same group of patients that they were pre-COVID, and they still take the same effort on our part to deal with them. Most folk don't want to come to the GP and will only do so for serious complaints that need attention.
Video conferencing does have a couple of knock-on effects, It's harder to end a consultation, and it's harder to stop pats talking about multiple problems, so patient interactions are longer, and more difficult.
This would suggest surgeries are quieter than normal even with vaccinations to do.
If I was this ignorant and out of touch with the subject I was banging on about, I'd be very embarrassed.
...but you have empathy and humility.
Just finished some referrals for the Diabetic Eye Screening Project service we have here in Manchester and it made me think of this thread. I've just looked a 9 patients that need referrals, 5 of which have followed the same trajectory New pts->joint pain(online docs appt) ->blood test (nurse appt)-> diabetes diagnosis -> referral, all in just 2 weeks, so that's 9 new patients joined the practice now all going to have to have monitoring. so, that's just today. also there 56 eye screen results back from DESP work through...so yeah, good thing we're not trying to do a mass vaccination programme on the side.
Diabetes in particular is going to create more demand for health services given the likelihood of developing it is apparently increased by Covid-19 infection. I suspect the same is true as people who suffered lung damage and heart damage from Covid-19 age. I susect we will actually have more people managing chronic conditions, and more frail people, because of Covid-19.
I think there will also be more lifestyle related problems. If we're being honest I think a lot of people have drank more booze, ate more junk food etc in the last year
A GP friend was saying that they only allow 1 patient (with carer/family member) at a time. Then the surgery has to be thoroughly cleaned after each visit.
Because these patients think they're the only ones (the waiting room is empty), they start pouring out all their troubles, taking double the time that the appointment would normally take. My friend is worn out by it all and thinking of taking some proper time off.
Another friend working in the nhs says she doesn't have time to go to the loo.
Clive Dix, departing leader of the vaccine task force says C19 will be gone from UK circulation by August.
Ok then. No wonder he’s departing.
Just had an email and text from NHS advising me to rebook my vaccination as its the AZ vaccine and I'm under 40.
Thing is, I turn 40 1 week after the first jab!
I'm thinking I should just carry on and get it. What would STW do? Yay to AZ, or ney to AZ?
If offered the choice, I would take the Pfizer vaccine. But I am old and had the AZ and had COVID.
With regards to gone by August. Maybe. The PHE have released their updated data on Variants of Concern. The Indian variant B.1.617.2 is now listed. There is an impressive replacement of the Uk variant B.1.1.7 that looks faster then its emergence. The report is here
Here's plot of that data (Fig 17) from my own analysis. Recall that the UK variant does not read the S-gene - hence S-Gene Target Failure (SGTF) is used as a proxy for the B.1.1.7 strain. You can see in this data that emergence of SGTF and decline is just shifted in time, likely after multiple founder effects from importation of new variants from South Africa and India. This is "microscope epidemiology". This level of granularity has never previously been available in real time - does it matter? I'm not so convinced, I think vaccines will continue to offer protection against morbidity, if not symptoms.
