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Are there any details of exactly what the Nightingale hospital will have? Are they planning on 4000 beds, all with ventilator access?
molgrips - with the dust disturbance from cleaning garages everyone will be sneezing; cue panic in your street.
Uncannily far sighted of China, to have all of that kit, ready to go.
Are there any details of exactly what the Nightingale hospital will have?
A lady with a lamp hopefully.
Are there any details of exactly what the Nightingale hospital will have? Are they planning on 4000 beds, all with ventilator access?
@dantsw13 Not all that clear, suggestion is oxygen only as far as I’ve heard, also unclear where the staff are going to come from.
Uncannily far sighted of China, to have all of that kit, ready to go.
They didn’t have most of it ready to go… they built it.
@kelvin Maybe. There were apparently a number of SE Asian countries that had stockpiles of the necessary kit ready to go after SARS.
Must be nice living in a country with such a well funded health service and proactive leaders. Although I am amazed they have been able to make all these temp hospitals so quick.
There a Wired article on the Excel Nightingale here @dantsw13 https://www.wired.co.uk/article/nhs-nightingale-excel-centre-hospital-london
It mentions up to 10-13 others like it.
It also mentions onsite accommodation for staff and the MOD use of City Airport.
Someone on the Healthworkers thread said they had received a msg for volunteers for the Nightingale (A&E nurse)
My prediction a week ago was a cumulative number of deaths of 1000 would signify things are not getting worse. That appears to have come to pass, sadly. The news lists an imperial group making predictions based on other country data.
I have been using this method for two weeks now (and the results have always been shared with authorities) the prediction interval is very wide, but trends are well described.
I now have a much more sophisticated (Think AI/stats) method for interval predictions. For this time next week, I anticipate a range that is much higher and too grim to post. It is too early to call any flattening of the curve. But if the number of deaths this time next week is less than 3700, then there are grounds to be optimistic that intervention is having an effect.
They dropped a load of "pre-fabricated" units on a hastily prepared site.
Not suggesting anything untoward, but I can't see how (or why) the UK would have that level of preparedness for such an event.
The game has now changed, of course.
I’m sure they were predicting 250,000 at one point with their curve control they’d hope ‘only’ 220,000 maybe I’m though.
Different methodology Drac. Mine is data driven so the uncertainty about parameters in the model is not so important when estimating prediction interval. I also have a novel methodology that allows relatively short-term forward projection without the error blowing up. It’s the interval that matters. My number is the lower 95%: I will be 19/20 times confident that things are getting better if we are below that number.
How’s your stats?
That Wired article is a good insight, thanks.
@Franksinatra - good to see your latest post, take it easy, hope you're home soon.
How’s your stats?
I don’t have any. I was merely saying I thought they’d predicted 250,000 deaths.
I may be wrong or misunderstood that’s what they said.
https://www.bbc.co.uk/news/health-51979654
I misunderstood.
Renfrewshire & Inverclyde Police Division
2 hours ago
CORONAVIRUS ACT 2020 - PAISLEY
Three males have been issued with fixed penalty notices in Paisley today for leaving their home addresses without a reasonable excuse.
A building site has also been closed as carrying out non-essential work.
Please stay home if you don't need to go out.
I'm interested in anything you post, TiRed. You've been too close for comfort so far in your predictions; even if the latest ones are "too grim to post" they're probably more reliable than any other source we have access to.
Pure numbers in Italy don't tell the whole story. I think the concentration of all the action in Lombardy is what overwhelmed it. Whilst London is ahead, our cases are definitely more spread across the system.
If you don't think the numbers in Italy tell the whole story have a look at Spain or France for the story at slightly different speeds.
Paris hospitals have reached saturation and people are being trained/flown out to anywhere with a lower incidence including Germany and I think Luxembourg. There but for a few days goes the UK.
Link to the paper predicting various countries outcomes wrt China:
https://www.medrxiv.org/content/10.1101/2020.03.25.20041475v1.full.pdf+html
At the moment @kimbers I'd rather not publish them in public. The methodology is novel, and I update them daily for near-term (7-10 day) forward projection. But the numbers are terrible, and I think they destabiise. Should the epidemic look like it does not flatten, then I will do so, because at that point people will need some shock tactics. I started with the naive method in that paper two weeks ago just to get something out there. In the meatime I solved the much harder problem and I've been using my more accurate methodology for the past week. The forward 7-day prediction has an error (stdev log of 0.3). For an exponential problem, I'm very happy with that. I'm now solving longer-term projection, but the errors will blow up fast, so not too helpful.
7-day lower limits (below which we should be confident that intervention is happening)
UK 3700
US 16000
DE 1500
ES 19000
FR 4400
IT 21000
NL 1750
So if total deaths reported NEXT saturday are lower then these values, we have solid evidence that the curve is flattening. Finger's crossed...
That paper DrJ linked to has some dramatically different numbers between the U.K. and France.
TiRed, are the current figures quoted in Worldometers accurate as far as you know?
If so you are predicting some alarming figures for the next 7 days.
Sobering numberz. Been keeping morale high by selling lot of cheap beer to happy customers but the space ivaders, and lack of common sense is astonishing
Told the boss today thst the risk is becoming too high so we will scale back and wind down to mothball nect week.
Still searching for familial mortality rates across Europe but cant find any. Just interested to know if tge shocking numbers coming out of Italy and Spain are either 1 person in a household or 4 to 5. Must be frightening for folk over there. Although i do think africa could see much higher numbers than Europe if they dont take a very harsh position now. Due to poverty, information, unsanitary conditions, overcrowding and a lack of healthcare, plus incredible levels of corruption and stupity.
Some tribal areas would probably be happy if a few thoudsnd of their neighbours died, and they would sit on a delivery of ventilaters until an envelope of cash finds its way in to their inside jacket pocket
I take my data from the ECDC daily. I believe the lnk above uses the same numbers with a pull from the website. Here is the link for all you data junkies:
The've updated the dataset and renamed variables since I started, so I have had to do a little data management. I use SAS 9.4 not that nasty R stuff 😉 . It is all automated to produce a global report in a matter of minutes. The prediction coding is a little tougher.
Stay indoors please.
I fear last weekend stupidity is going to start showing this week and roll on a few another week or 2. 🙁
In France for example they are only counting death at the hospitals.
People dying at home or retirement home are not counted as Cov19.
I hope you are proven wrong Drac, but expect that you will be shown to be correct.
We (as a country) messed up by not acting, decisively, sooner. To expect everyone to mentally switch from chatter about herd immunity, to keeping physically apart and not travelling, in just a matter of days, was foolish. Earlier instructions from the government should have been forthcoming… they had the behaviour experts, they should have expected a lag between a shift to a stay at home message and everyone properly acting on it.
In France for example they are only counting death at the hospitals.
People dying at home or retirement home are not counted as Cov19
What matters for prediction purposes is that they continue to do the same. On a log-scale a constant fraction of mis-reporting is an INTERCEPT (c) not the slope (m) of log(Deaths) = m TIME + c
That's how I can model the data from all countries simultaneously.
Honestly if we don't get to Tuesday and be reporting >1k deaths per day I think we will be doing well.
We’re likely to be at only half that come Tuesday Graham, aren’t we?
I keep hearing the peak to be 9 days from now? By which time we should have got 6000 deaths based on death rate doubling every couple of days.
On a separate note I just went ballistic at my 75 year old dad who doesn't seem to be taking this seriously. My mum is worried, she decontaminates everything when it comes in the house, yet just found out the other day he swans in from taking the bins in and doesn't bother to wash his hands. Whats the point of going into isolation then touching something that a guy who has touched 100 other bins before touches..sheer stupididy
@kelvin
Honestly I have no idea and I really hope so, it was just the attitude seen last weekend worried me.
it has been much better since but has the damage been done.
I guess it entirely depends on speed of disease progression. I am afraid I am being pessimistic at the moment, but we are in a far better state than the US and the potential impact on India and africa isn't something I want to think about currently
I guess it entirely depends on speed of disease progression.
The full effect of last weekend won’t be seen as soon as Tuesday. Read the (New York Post?) article I posted that explains the lag between spread and any easily measurable/observable effect.
Very true, will be glad to be wrong.
I do see us getting to that stage though before this gets better sadly. But like you say not yet
Agreed.
TF1 news (sorry Drac, it'll be on replay in about an hour if you want to check) has given new times from contamination to symptoms and symptoms to serious symptoms resulting in hospitalisation. 5-7 days for contamination to symptoms which is longer than 3-6 days commonly reported up until now. And 7 days from first symptoms to needing hopital treatment for the serious cases, again longer than previous reporting. The first improvements due to confinement in France are therefore anticipated on Tuesday, longer than initially hoped for.
I heard the same figures on (UK) C4 news Ed.
Oh, Ed, please try not to be oversensitive, and please stop the passive aggression thing towards Drac. No need for it. And now is not the time for it. Just leave it.
I just started reading The Stand by Stephen King.
A lady from the village I grew up in had a sudden, fatal heart attack when hanging out her washing the other day.
Weird how you forget all the other things - the economy and social life is on pause....
Oh, Ed, please try not to be oversensitive, and please stop the passive aggression thing towards Drac. No need for it. And now is not the time for it. Just leave it.
There's also no need for fawning, random publications or political wibble-bollocks but it's not stopping anyone so far.
I've got my own 3 line message for internet forums:
Only talk if it's your expertise
Only talk if it's your expertise
Only talk if it's your expertise
Won't catch on.
No idea if this is fake but as an ex Telecoms tech this makes interesting reading and I have to say that I really doubt any figures the Chinese produce, be it weapons performance, economy statistics or Covid 19 death rates. I think the WHO won't reveal the true rates for fear of upsetting the Chinese State, that's if they've been told.
I've just spent a couple of hours reading a presentation of pretty much most of what is known about SARS-COV2. The ratio of published papers to preprints (not-peer reviewed) documents is currently 2:1. I'll put that into plain English. A THIRD of all knowledge of this infectious agent is still preliminary. This is unprecedented and explains the signal to noise ratio.
I only publish within my expertise (not clinical practice, nor political). I will do my best to translate technical findings into plain English, and I won't publish alarming informatino without context. I'll also answer any question within my expertise as best I can.
Daren Austin PhD, Senior Fellow, Clinical Pharmacology, GlaxoSmithKline and formerly Wellcome Trust Senior Research Fellow in Mathematical Epidemiology at Oxford and later Imperial College.
So, now for a hint of good news from the day job - I spent the afternoon isolating in my bedroom devising a rationale to take one of experimental drugs into a COVID19 trial to prevent serious sequelae. I hope it works.
Takes two to tango, Kelvin. Drac's been poking me with a stick for as long as I can remember; I had a "troll" tag then "reformed troll" for years yet what I post isn't exactly super controversial. This time it was an out of nowhere and totally unjustified "#EduFact" tag that restarted the "banter". He hasn't let it drop so I'm playing along, read back, his last jibe was about me being dull or something like that, the ball was back in my court so I've played it. He can let it drop anytime he choses.
I'm never, ever the one to start it, that is a point of honour. He can win any time he wants, he just has to ban me, to his credit he doesn't abuse that adavantage too often. If I really thought there was a serious grudge I'd bugger off into the Internet ether of my own volition, I don't go where I'm not welcome in real life and the virtual world is no different. I think I have a place on the forum, on this thread I'm seeing the same crisis from a different point of view that might be of interest to others if I'm left to express it. The shutters will get painted quicker if not.
If you've followed the thread from the start some of the (black) humour in the thread has been from, Drac. We all know the job he does, respect him for it and I for one assume it's part of the coping mechanism and part of the culture. I haven't taken exception to his humour unlike some, it's part of his on-line persona, like having dig at Edukator now and then.
There was another reference to the % reliability of tests on TF1 news tonight but I havent quoted it. 😉
No idea if this is fake
It's blatantly fake.
I spent the afternoon isolating in my bedroom devising a rationale to take one of experimental drugs into a COVID19 trial to prevent serious sequelae. I hope it works.
The was a guy from a German Institute on Eins Extra running through a list of prospective molecules, On TF1 this evening a French expert. They were mainly talking about the same molecules but with surprising differences in attitudes. The French guy was positive on an AIDS drug and Interferon but the German had serious reservations about Interferon because whilst used early it produces good results but used to late becomes dangerous. Only one can be right.
Whoever gets an effective treatment protocol validated is going to be hailed as a saviour and hopefully make a few pounds/euros/dollars along the way. The stakes are high, I hope that for once the good of humanity is first and foremost in the minds of all those involved.
I hope it works too !
I really doubt any figures the Chinese produce
Fair enough, and as long as everyone knows to doubt everything you post in this thread as well, all is as it should be. Just read stuff properly before you post Ming, and check fact checking sites like snopes before spreading that stuff. Please.
“#EduFact” tag
Not talking about the rights and wrongs, just suggest you try being less sensitive and drop it. In other times it might be worth niggling on about, but at the moment, please just leave it. Keep posting, we want to hear the view from France, just don’t do the passive aggressive posting towards Drac while he’s being stretched.
Only talk if it’s your expertise
Only talk if it’s your expertise
Only talk if it’s your expertise
Well thats most of this place stuffed then... particularly the bike stuff 🙂
So what about the paper i read that states its almost always 5 days between contamination and becoming infectious, then another 6 days to developing symptoms.
Hence the extended isolation phase. This is
based on data collected from China and thousands of people
There were outlying numbers but the conclusion was for most the numbers work
.
Tbis would make next week critical in diagnosis and treatment following the big bj weekender
BoJo must go, sign petition:
https://www.change.org/p/uk-parliament-public-vote-of-no-confidence-in-pm-johnson
I give up.
I give up.
Please, please don't.
BoJo must go, sign petition:
https://www.change.org/p/uk-parliament-public-vote-of-no-confidence-in-pm-johnson/blockquote >
Let's not.
That's the last thing we need right now.
CG - not the time for this; it's an unnecessary distraction.
The only game in town is government.
Opposition parties are (generally) supportive of gov in current situation.
A more appropriate petition would be to get rid of cummings.
Jesus, timing is everything, eh?.
They were mainly talking about the same molecules but with surprising differences in attitudes
Unsurprising really, since hardly anything is known about the typical course of the disease, even what the true risk factors are ("heart disease" is a bloody broad term and includes some things that are mostly just markers for getting old, which itself is a risk factor) and there's not yet tfull agreement on what findings early in treatment are genuinely predicitve of good/bad outcomes. If that's true then how do you know that your drug made a difference anyway? (answer: by doing a large trial - preferably with a "no treatment" arm).
The large majority of outcomes being published as yet are out of China, so if you refuse to believe their other numbers why would you trust their trials observational data ?
Experts often have a pet project or hypothesis that they bias towards (consciously or not) and away from others. Just as one example, the "Marseille" data favouring hydroxychloroquine plus azithromycin had tiny numbers of patients, didn't seem to be all that closely controlled (in the clinical trial sense of the word) and didn't look at clinical outcomes at all, just time to no virus being detectable in the swabs - nobody knows if that actually means anything in terms of survival or complications. Under normal circumstances, that woudl be greeted very very cautiously and a call for MUCH more evidence but instead it's one of many "saviours of humankind". As it is, clinicians are clamouring for the stuff - outside of the clinical trials that ARE being set up for many of these drugs. We've got nothing that's obviously better and certainly nothing that's widely available and people want to do something.
The thing about tests is that IT APPEARS that nasophayngeal swabs aren't reliable sampling techniques right through the course of the illness and if true, false negatives are a given even if the test equipment was 100% reliable. Seriously ill pts who can't have their symptoms explained by another cause (they do test for a lot of other viruses too) are often retested several times and do sometimes eventually score a +ve. It's also possible that newer test kits are more reliable than the early ones - who knows? Takes time
Further to bearnecessities 'only talk if it's your expertise' post - how very true.
Despite drac's request to stick to proven facts, it's not really happening.
Sure we all have views, concerns, interests but all of that noise is drowning out the medical pros on the forum and absolute specialists like TiRed; there are a small number of others who are not front-line or true specialists whose input is also valuable.
Other than that small group of informed and involved individuals whose posts I read with interest, there is so much unnecessary noise; I have been part of that but now backing out.
Will continue to read.
Thanks, as always, to the NHS and other services who underpin society and keep the shit from our doors.
Other than that - good luck, stay strong, be positive and see you on the other side.
7-day lower limits (below which we should be confident that intervention is happening)
UK 3700
US 16000
DE 1500
ES 19000
FR 4400
IT 21000
NL 1750So if total deaths reported NEXT saturday are lower then these values, we have solid evidence that the curve is flattening. Finger’s crossed…
Thanks Daren. That would chime with the 'doubling every three or four days' trend, I guess. Out of interest, with lockdown less than a week old, would we expect to see the effect of intervention in terms of deaths by next weekend, given the likely lag from incubation, infection and death?
As for the 'only talk if you are a specialist' thing, I think there is a value in feeling free to post up stuff you've heard, as there is enough varied expertise on here to reply putting that in context or knocking it down, which can be helpful to lay people.
Experts often have a pet project or hypothesis that they bias towards (consciously or not) and away from others. Just as one example, the “Marseille” data favouring hydroxychloroquine plus azithromycin had tiny numbers of patients, didn’t seem to be all that closely controlled (in the clinical trial sense of the word) and didn’t look at clinical outcomes at all
My analysis of this study using predictions for each patient of their HCQ concentrations on the days they did not measure, show a highly statistically significant response. Tha analysis in the paper is naive, but they very kindly gave a table of all the raw data. My analysis is much more robust. I would - and I'd take a 1200mg loading dose on Day 1.
As for time to see a response on the flattening curve - if we see less than those numbers, then I'd be satisfied there is evidence of a down turn. Above them, means you can't rule out no change at the 5% significance level (19x/20 certain)
Lots of respect for NHS and clearly the worst is yet to come etc, but I'm trying hard to square the stats with all the posts about how stretched the NHS already is.
Worldometer currently has 163 people in UK requiring intensive care (serious/critical case definition).
Is 163 extra people requiring intensive care really so much of an issue in a country of 76m?? (Yes i understand concentrations in London, decade of austerity etc but still seems disproportionate).
Is there a very high % of the non-serious/critical also requiring hospitalisation? Or is all the pushing back of GP appointments, non-urgent/elective surgery etc all to do with preparing for the next phase?
Not sure how accurate those figures are. At one stage they had serious cases at 20 for several days. I also note that 260 people died in a day without serious cases get anywhere near that figure.
TiRed - thanks for taking the time on here. I’ve just been eulogising the power of STW to solve the world!!
As for time to see a response on the flattening curve – if we see less than those numbers, then I’d be satisfied there is evidence of a down turn.
I'd be very satisfied to see those numbers too, believe me (would leave me wondering how the UK has managed that kind of impact in that timescale, but I could live with that!) Would love to see your work when and if you get round to publishing it.
My analysis is much more robust. I would – and I’d take a 1200mg loading dose on Day 1.
Is your robust endorsement likely to have any impact on RW interventions, or do we have to wait for other trials to report?
currently has 163 people in UK requiring intensive care (serious/critical case definition
Apparently there were 100 folks on icu in scotland middle of last week, so that 163 number seems miles off.
5-7 days for contamination to symptoms which is longer than 3-6 days commonly reported up until now.
It was commonly reported enough in the UK for me to pick up that 5-7 days from contamination to symptoms was typical.
Is your robust endorsement likely to have any impact on RW interventions, or do we have to wait for other trials to report?
We're writing the manuscript this weekend. Another for the medarXiv. Normal dose is 600mg but it takes time to accumulate in the body. A laoding dose would get you to higher concentrations faster. HCQ reduces acidification inside the cell when the virus goes inside the endosome, but you won't reach the concetations until about day 3
Only talk if it’s your expertise
I literally don’t have an expertise 😧
Morning folks, it's British Summer Time in the rabbit hole
We're short one hour today, time to make the best use of the remaining 23. A good day to bank some of the bickering until we get the hour back - seven months might give a whole different perspective.
Other than that, surprisingly
Take care, be kind
Is 163 extra people requiring intensive care really so much of an issue in a country of 76m??
The number is probably higher than that but yes a small additional number is an issue. The numbers of critically ill and the numbers dying each year are fairly predictable and although they are going up and down over time they are roughly the same from year to year.
Introduce something such as a highly contagious virus with a 15% critical illness/1% death rate and a system made to accommodate the predicted number cannot cope wth it.
Not many healthcare systems around the world have capacity to deal with something like this and when it is over they will probably not maintain it. Why would you run a health service with an excess of 5,000 intensive care beds being empty all the time.
Only talk if it’s your expertise
I literally don’t have an expertise 😧
You might have noticed that I've been quiet too! 😄
Props to the clever people (TiRed et al) and the front liners.
A question from me though.....any confirmation on cases "before it all kicked off"?
I'm convinced I had it January, all the symptoms we now know about, was ill for about 4 weeks, then another month before I felt remotely back to normal.
We have been self isolating for 8 days now as my wife has all the symptoms, she's fine, but we are sure as can be without a test.
A big gap between infection between us. Just two of us at home, work from home so together a lot.
The "buzz" in French media this morning comes from Mediapart and an article on how the BCG tuberculosis vaccine can be used to boost the immune system.
I’m convinced I had it January, all the symptoms we now know about, was ill for about 4 weeks, then another month before I felt remotely back to normal
I had similar just before xmas, coughed so much I started coughing up blood, scared the shit out of me. I posted a thread here about my worries. My uneducated guess is most flu virus symptoms are pretty much the same so the overwhelming probability is that you and I had something else
Sadly, but perhaps not surprisingly, I've just unfriended someone for posting stuff saying people who voted no in the indyref were responsible for the lack of ventilators.
Is it a general feature of crises that they bring the worst out of some people?
And the best out of others fortunately.
And that's the problem, without testing us all how do we know.
Will see if I get what the missis has over the next week 😷🤒
Yup, this is no time for politics, or shite like that youve seen spin.
The key points on the BCG vaccine
THe Italians noted that immigrants don't develop severe forms of Covid19 symptoms - immigrants are all vaccinated for tuberculosis on entering Shengen space.
Kids don't develop severe symptoms - all recently vaccinated.
Tuberculosis is a bacteria not a virus so the protection can't be BCG antibodies it has to be something to do with the immune rsponse to the vaccine.
The medic on Europe 1 talked about three types of immune response; the one you are born with, what you body learns through life developing antibodies to fight pathogens, and he talked about a third effect which is the side effect of vaccins - they boost the immune system in general.
A Dutch lab and Institut Pasteur are working on it.