Early days, but no good signs in London hospitals…
Different ppe for different settings. GP surgery vs itu vs theatres. Sure. But the people in those settings have the same ppe and use the same infection control measures as deemed appropriate to the level of risk. Which means assuming that you could have it. To say that known positive clinicians will take more precautions than those who think they are negative is to imply that clinicians aren’t complying with infection control measures. I don’t have to isolate if I have a contact with a positive patient at work because the gloves, flimsy plastic apron and blue mask completely prevents spread. So says nhse. Perhaps ppe will be increased for all to gowns and all the other stuff if omicron spreads past that plastic apron barrier.
We’ve been assuming everyone could have it all along… but putting known infectious clinicians in contact with ill patients seems rather a brave/foolhardy step.
However according to the UKHSA stats there are only 16 Omicron cases in hospital in England up 2 from yesterday. Of course that number may increase as more sequencing is done on recent admissions:
You think rising hospitalisations in London are due to Delta?
[ note, you are referring to sample data two days old ]
You think rising hospitalisations in London are due to Delta
Could be. Given the large numbers of completely unvaccinated people in London I would expect they could well be Delta cases.
What data is two days old though. The numbers on the UKHSA stats are up to 1800 hours 15 Dec...
What data is two days old though. The numbers on the UKHSA stats are up to 1800 hours 15 Dec…
14 December for hospitalisations. And it’s just a sample.
It could well be that rising hospitalisations are almost exclusively due to Delta. If that means hospitals will have an increasing case load before we find out what Omicron means for them, I don’t find that reassuring.
but this is what I mean about ignoring other risks with this obsession of keeping a virus under control which now clearly is not and can’t be.
Pretty much this. I was 100% in support of the original lockdowns but now we are talking about a respiratory virus that is completely uncontrollable (like cold and flu), of which we have a moderately successful vaccine for (like flu), and which causes only mild to moderate illness in the vast majority of people who get it (like cold and flu).
And actually at the moment – yes the NHS is close to collapse but right now, today that is not due to Covid cases as such rather the effects of having had to deal with the first 3 waves and now it just being on its knees due to decades of underinvestment.
This x100000
Also, nobody is going to follow restrictions now, having seen that our leaders showed complete contempt for their own regulations.
What is the point in even discussing potential lockdowns / isolations / business closures etc?
We’ve been assuming everyone could have it all along… but putting known infectious clinicians in contact with ill patients seems rather a brave/foolhardy step.
My wife works on a post-thoracic surgery ward where the flu would as likely kill some patients as Covid.
She is expected to work if she has the former (assuming she is well enough to go in) so why not the latter?
There’s a Whitty quote for this “stop ignoring other healthcare by focusing on coronavirus” fallacy from today…
https://twitter.com/colin_lawson/status/1471506784678408192?s=21
She is expected to work if she has the former (assuming she is well enough to go in) so why not the latter?
If she knows she has flu she will not be well enough to work. Do you mean if she has a bad cold?
If she has flu she will not be well enough to work.
Not what her ward manager said to her. She was told she had to power through regardless...
And I think Covid has been prioritised over other things (though not specifically cancer). I am not saying that is necessarily the wrong thing to have done in the past but it has clearly been the case that it has taken precedent over children's learning, elective operations, businesses etc.
My comments are more about going forward. If Omicron is as contagious as they say then isolating, when a huge percentage of the population have it anyway, strikes me as something that we should look to change as the cost to those other things will ever increase otherwise
If she knows she has flu she will not be well enough to work.
Has the last two years not taught us that this is completely incorrect?
People always used to say if you really have flu you'd know about it, and that thinking is probably why 20,000 people a year die from it because people carry it without realising or having any symptoms.
If you have proper flu, you struggle to get out of bed
Also, nobody is going to follow restrictions now, having seen that our leaders showed complete contempt for their own regulations.
Luckily, there's a not very vocal majority of the population who have higher standards than the government.
If you have proper flu, you struggle to get out of bed
The point remains she would be as deadly to her patients than if she had Covid and yet would be more than welcome on the ward.
At this point, I’m past believing that you are giving us the full story, sorry. If she really has a ward manager insisting she’s on the ward when she is ill with flu (not a cold) then that is ridiculous. She had her flu jab this year, yes?
she’s decided to take her chances.
This is something I am hearing more and more around here. The average age in our town is over 60, it's basically a giant retirement village.
General talk (anecdotal I know) from speaking to and overhearing the elderly on our estate is that they are now protected as best they can be and after 2 years of this quality of life is now more important to them than quantity of life so they will be getting on with doing what they want. I was talking about this with our 86 year old year old neighbour yesterday and her words were "I'm not spending any more of what could be my final months cowering in the house".
Plenty of younger people are also talking along the same lines and if they see the vulnerable groups getting on with it then there will be no restraint.
I hate to point it out, but I think Concern troll is a sadly relevant companion piece to recent pages of this thread.
At this point, I’m past believing that you are giving us the full story, sorry. If she really has a ward manager insisting she’s on the ward when she is ill with flu (not a cold) then that is ridiculous.
She was unlucky enough to be on a Stage 4 disciplinary for absences (all with really good reasons - search for my thread on her being suicidal for eg) and she was told if she was absent again, regardless of condition (this was pre-Covid) then she would be sacked.
She was told she would have to just power through whatever illness it was. Honestly, nurses are basically expected to work whatever the condition they have.
Oddly the only exception is D&V and then you have to be clear for 48 hours. You still get a black mark for absence against your name though even though you are not allowed to come in (again pre-Covid. That is also now on the list of conditions you cannot attend work if you have).
But flu - yes, if you feel you are well enough to come in, or are under the duress of a disciplinary - crack on. Nothing stopping you being on the ward at all...
Early days, but no good signs in London hospitals…
Get ready for legal restrictions then. London has driven every other restriction and relaxation whether warranted nationally or not.
@zomg - I hope you are not referring to me. I have been an active member on here for 8 years plus and 3000 odd posts :).
And I don't troll. Never have, never will.
If you have proper flu, you struggle to get out of bed
Indeed. Funnily enough, I think I've only had flu once in my adult life when I was about 19. Feeling like I had a heavy cold coming on, I went to bed and couldn't get out of said bed for about 24 hrs. My heart was racing, I was sweating buckets, shivering headaches, etc. Nothing has come close since. I was almost fully recovered after 48 hrs though. There is absolutely no way I could have functioned in any capacity for the first 24 hrs.
.
If hospitalisations reach the level they were in January, then at that point infections will be much higher than they were then - because vaccination is reducing the percentage who get hospitalised. The number of NHS staff isolating and not able to work will be what creates the crisis (as we saw in the July pingdemic and is rumoured to be happening already). Many of them will have non-symptomatic infections.
If some hospitals could be given over 100% to Covid patients, how much of a risk is there if they are staffed by infected non-symptomatic staff? If I'm in hospital with Covid and the choice is to not get treated because there are no staff available, or be treated by staff with non-symptomatic infection, I'd go for that. There's a problem with infected staff commuting, and also a problem if being in an environment with other infected people creates a risk of ongoing re-infection; in that case it's a non-starter.
I suspect we're going to be a wartime parallel - the objective will be minimise risk, but accept that risks must be taken. I'm not suggesting NHS staff go and work when they're ill, they are going beyond what should be asked of them already, but if they're feeling well, and the only reason they can't work is that they might infect somebody, is working only with people who are already infected a reasonable thing to do?
@Greybeard - hadn't thought about asymptomatic medics treating those who have Covid already. And then redeploy the healthy staff to the non-Covid wards that need cover...
People always used to say if you really have flu you’d know about it, and that thinking is probably why 20,000 people a year die from it because people carry it without realising or having any symptoms.
Often wondered about this, surely Flu (like Covid) has a wide range of severity from asymptomatic to dead?
and she was told if she was absent again, regardless of condition (this was pre-Covid) then she would be sacked
Given the staff shortages that would be worth testing. What could she retrain as?
I went a Covid party today, the ski touring club, the first time since the start of the epedemic I've been surrounded by people who have clearly thrown in the towel on prevention. A sort of fatalism reigned. Weird. The way Omicron has been presented has made people feel that it's so infectious there's no longer any point trying to protect either yourself or others. It felt really wierd. Everyone produced a valid Covid pass though so all up to date on vaccinations.
Given the staff shortages that would be worth testing. What could she retrain as?
As I say this was pre-Covid so they would have sacked her. Funnily enough, given the pressures of the NHS at the moment she is looking around at possible alternate careers...
I went a Covid party today, the ski touring club, the first time since the start of the epedemic I’ve been surrounded by people who have clearly thrown in the towel on prevention. A sort of fatalism reigned. Weird. The way Omicron has been presented has made people feel that it’s so infectious there’s no longer any point trying to protect either yourself or others. It felt really wierd. Everyone produced a valid Covid pass though so all up to date on vaccinations.
Sorry do you mean you went to a party with the express objective of catching Covid?
If you have proper flu, you struggle to get out of bed
I was going to say the same. I’ve only had it once. I was in my 20’s so younger and healthy and it absolutely floored me for about 5 days. I spent those days sweating like a 70’s TV presenter and shaking like a shitting dog. It was absolutely horrible
And as far as contagion goes, pretty much the entire department I was working in went down with it at the same time
General talk (anecdotal I know) from speaking to and overhearing the elderly on our estate is that they are now protected as best they can be and after 2 years of this quality of life is now more important to them than quantity of life so they will be getting on with doing what they want. I was talking about this with our 86 year old year old neighbour yesterday and her words were “I’m not spending any more of what could be my final months cowering in the house”.
Plenty of younger people are also talking along the same lines and if they see the vulnerable groups getting on with it then there will be no restraint.
Anecdotally, I’m hearing the same.
My parents, in their 70’s, are definitely of that mind set and their friends of a similar age and older are saying the same.
I think people will be careful over Xmas as they don’t want to risk Christmas Day. But once that one target day is done I think we’ll find all bets are off, particularly given that the latest variant, whilst contagious isn’t particularly dangerous.
The way Omicron has been presented has made people feel that it’s so infectious there’s no longer any point trying to protect either yourself or others.
This is also true.
^^ Unfortunately I tend to agree too. I'm feeling pretty fatalistic about it.
I'm still doing all the "right stuff" but it's in the hope of delaying the inevitable till antiviral drugs like Pfizer's new one are readily available for the likes of the vulnerable at least.
isn’t particularly dangerous.
Is this still just anecdotal, or is there solid evidence?.
But isn’t AIH a genetic autoimmune disorder
Not always, an anti-PD1 antibody led to AIH that killed my mother after a single course for recurrent Stage 4 metastatic melanoma. Ramping up the immune system can have that effect (don't look at the SAEs for the anti-CTLA4 , aka Yervoy).
With regards to GBS, there are case reports of GBS after COVID, and there is a study in Israel of GBS after vaccination in previously recovered vaccine-induced GBS patients. They found one recurrent case out of 702, which is in the range >1/1000 and <1/100 which is "Uncommon" in FDA parlance. That's in people who have already had GBS for a non-COVID vaccination. UK government advice is here
The benefit risk question, is whether one is more likely to suffer GBS after vaccination or infection, when infection is very likely (same argument as using AZ/OX in the young).
Sorry do you mean you went to a party with the express objective of catching Covid?
No, quite the opposite. It's just that the setting was like a Pox party where parents get all the kids together to catch chickenpox. People just out of quarantaine, people not sure if they are Covid contacts, people recovered but not sure how long they should have isolated, people not sure if they have a cold or Covid despite two negative tests. All things that would have had people being cautious and keeping their distance a few months back, but no longer concerned, just fatalistic.
Is this still just anecdotal, or is there solid evidence?.
No idea.
But the way it’s been reported suggests that. And that’s what the man in the street will/does think
Let's hope that's the case lunge.
Witty saying boosters will mean the spike will be shortlived (hopefully)
But is there any evidence that boosters prevent infection? I thought they just stopped you getting symptoms?
It's never been a case of completely preventing infection. The vaccine makers have only ever talked in terms of a percentage protection in that the level of transmission in a vaccinated population is lower. With Alpha that percentage went down and with Omicron it'll no doubt go down again. So there will be some level of preventing infection and the boosters will improve that. More important is the prevention of serious illness, let's hope that the very limited data we have so far is confirmed and the boosters provide a high level of protection.
But is there any evidence that boosters prevent infection? I thought they just stopped you getting symptoms?
There is only very early data to show that symptomatic disease is inhibited by boosting. This is due to the methodology. The patient line-level data links vaccination history to PCR testing. PCR testing is typically done because... errr symptoms! So the analysis looks at vaccination dates (and type) and compares whether somebody produces a positive subsequent PCR test. It matches patients based on other covariates to make the comparison. There are no prospective data to show that the vaccine prevents infections. AZ collected this in their pivotal trial with prospective PCRs. It wasn't really fundamental to the approval.
particularly given that the latest variant, whilst contagious isn’t particularly dangerous.
There are two variants going round, one we know is dangerous, one we don't know but might be. Who's feeling lucky, punks?
But I totally get the fatalism, let's catch it and get it over with attitude.
New Year in Wales will be subdued by the looks of it.
Also a return to one way systems in shops and supermarkets after Christmas. Seems sensible and measured with a decent amount of time for businesses to restore the previous systems. A bit worried about how nightclubs will be supported financially though.
I think people will be careful over Xmas as they don’t want to risk Christmas Day. But once that one target day is done I think we’ll find all bets are off, particularly given that the latest variant, whilst contagious isn’t particularly dangerous.
This seems to be bandied around as fact, but we just don't know for sure yet.
The latest from the experts is that they need a few hundred Omicronners in hospital to have enough data for a severity comparison, and the results of that might come in between Christmas and New Year.
If you have proper flu, you struggle to get out of bed
So is it only “proper COVID” if you struggle to get out of bed ??
Often wondered about this, surely Flu (like Covid) has a wide range of severity from asymptomatic to dead?
Yep. This was covered somewhere up the thread; info on reputable sites seems to indicate that asymptomatic flu is relatively common, perhaps 1 in 3 cases. We don’t test to differentiate between flu and colds. “Man flu” may in fact often actually be flu!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2646474/
We don’t test to differentiate between flu and colds.
Exactly. So if you know you have flu, rather than what could be a bad cold, you only know that because of your severe symptoms and you’re properly ill (and contagious).
