I’m not sure it’s been clearly communicated… but as far as I can tell the strategy now seems to boil down to the below, in order of priority:
1) keep infections under sufficient control so NHS doesn’t get overwhelmed whilst waiting for spring/vaccine
2) keep schools open
3) try to keep the economy going as much as possible given (1) and (2)

Playing devils advocate a bit…. you could argue that the current system is more or less ‘working’ in terms of those objectives. Note that driving down infection rate beyond what is required for point 1 doesn’t seem to be on the agenda any more. Which I guess might underpin some of the approach that PHE are taking with schools etc. Public health vs. personal health?

I don’t know about others but our kid are off 18th December to 6th Jan, quite a significant time considering the current issues.

Sorry to hear that Muffin-man… I hope the new plan goes better for her.

I don’t know about others but our kid are off 18th December to 6th Jan, quite a significant time considering the current issues.

But… do they need to be off ’till the 6th? If the generations are going to get together, in doors, for extended periods, over Xmas… why not shift the school holidays so the kids are away from their schools for long enough to get though the incubation period before hugging the older members of the family?

We’re behind her ElShalimo – she wasn’t going to uni anyway and this apprenticeship has come up in the equine world she so desperately want’s to work in and with an ex. Olympic rider.

[probably not realistic, my holiday shifting proposal that is, the dates don’t work]

But… do they need to be off ’till the 6th? If the generations are going to get together, in doors, for extended periods, over Xmas… why not shift the school holidays so the kids are away from their schools for long enough to get though the incubation period before hugging the older members of the family?

Because that’s logical, like an extended break over half term, and this government don’t do logical.

and this government don’t do logical

And their kids break up well before the 18th anyway, because they aren’t at state schools?

Definitely a lack of joined up thinking around this… especially the “keep things normal for the sake of their education” approach… there is no normal this term, not up here anyway, far from it.

Tier 1 does not control spread.

But gosh darn it, the pubs were closed at 10pm, surely that should have done the trick?

We’re behind her ElShalimo – she wasn’t going to uni anyway and this apprenticeship has come up in the equine world she so desperately want’s to work in and with an ex. Olympic rider.

After completing her apprenticeship and working in the industry for a while nobody would really care about her A-level results anyway – it sounds like this might be a good move at the right time.

There is nothing to say she can’t dip back into education at a later date of her circumstances change.

FWIW the new tiers seem to be more logical than the old ones.

Would have thought <50% capacity for events might have been sensible for tier 2. But I guess that might have completely nailed what little currently remains of the events business.

@the-muffin-man – sounds good… there’s no money in it… but it’s a life, not a job. My brother trains and competes event horses… he was going nowhere near A-levels… considered studying for them waiting for life to start, rather than getting on with it. Different paths for different folks… wish her good luck from us all.

not just rate

maybe your areas growth is high enough
maybe your areas ITU capacity isn’t looking good
etc.

I think TiRed has talked about the other factors previously. They just need to be more open and vocal about the reasoning. The “civil liberties” knuckledraggers are having a field day on the local FB posts.

They also need to be open about what (limited) info they have about the sources of infections. Do schools spread more than (currently not allowed) inter household transmission, or supermarkets etc?

Doesn’t need saying again but I will – if the government had put in place the test, track and trace that they themselves said that schools needed in order to reopen, then things may not be so bad. Starmer needs to be reminding them of their failure to deliver and the economic costs and death toll they have created.

I don’t know about others but our kid are off 18th December to 6th Jan, quite a significant time considering the current issues.

But… do they need to be off ’till the 6th?

they cannot go back any sooner than the 4th anyway, which is the Monday, normal to have an inset day first back, mine are back on the 5th

same with breaking up early, no point them going in for 1 day on the Monday 21st,

Cheers Kelvin!

That was our thoughts too – waste the next 6 months? Or grab this chance now?

We know she’ll never earn big money, but quality of life is way more important.

seems like we missed the brake and hit the accelerator!

come up in the equine world she so desperately want’s to work in and with an ex. Olympic rider.

Sounds ideal. I would caution that it looks unlikely that there will be exams next year (and will not be any in Wales), so staying means she would most likely get the credit. But what an opportunity. Follow her heart.

From the Washington Post discussing Thanksgiving 2020 style.

Across the United States, millions of people pointedly spurning CDC advice as they celebrated Thanksgiving during a time of increased covid-19 community spread were excited to hearken back to the very first traditions of European settlement in the Americas.

“We wanted to keep alive the customs these settlers helped start,” explained one family that was traveling hundreds of miles to spread disease to people they didn’t know because they thought the trip would be best for their family. “We just want to do the same thing they did, but in a way that includes a dish that somehow incorporates both marshmallows and sweet potatoes.”

These Thanksgiving reenactors were dedicated to making sure the holiday got the celebration it deserved. “Usually,” another ardent patriot said, “my Thanksgiving celebration is based on a selective and misleading interpretation of history. This year, it will be based on a selective and misleading interpretation of science as well. And I brought green beans with those weird little packaged onion things on them!”

“It’s a point of pride with me to ignore any guidelines that would prevent my bringing pestilence with me to this important family holiday,” one celebrator noted. “The Pilgrims didn’t pay attention to any guidelines! Dare I act as though to be alive now offers me any advantages over what they had?”

Hearing Stoke ITU (and B’ham QE) now full. Stoke not accepting any trauma patients.

Here’s an article from the http://www.stoke.gov.uk website, from 3 days ago arguing that Stoke shouldn’t be put in tier 3. Linky

Hearing Stoke ITU (and B’ham QE) now full

ITU is almost always full, they very rarely have many (if any) spare beds, particularly this time of year. I don’t know about Stoke but QE isn’t full, well, it wasn’t when Ms Lunge was there earlier this week.
Not saying this is good or bad, but ITU occupancy isn’t a good way to measure how busy a hospital is.

ITU occupancy isn’t a good way to measure how busy a hospital is

No one is saying it is. Admissions and current inpatients are more useful guides. But that isn’t why ITUs were brought up.

ITU is almost always full, they very rarely have many (if any) spare beds

Forgive me, but could you point me towards some data about the regularity that hospitals actually “run out” of ITU beds, and not some nebulous headline?

My understanding (and i hope to be incorrect) was that ITU runs close to capacity and adds numbers when a surge occurs. In the above case they have actually run out. There are no more ITU beds. There is no surge capacity left.

Forgive me, but could you point me towards some data about the regularity that hospitals actually “run out” of ITU beds, and not some nebulous headline?

My understanding (and i hope to be incorrect) was that ITU runs close to capacity and adds numbers when a surge occurs. In the above case they have actually run out. There are no more ITU beds. There is no surge capacity lef

I can’t point you to the data, but I am married to someone who works in ITU and her brother does the same at a different hospital. That’s where my info comes from.

In normal times hey rarely “run out” of ITU space as they move patients around so if it’s close to capacity, those who are least ill get put into another ward. There are other high dependency wards that they move people to, some of which are very similar in the treatment they offer to the ITU wards. I can only speak of the QE but there ITU is busy but they’ve not expanded out to other areas of the hospital yet. That may well change, but at the moment it hasn’t.

The issue in March was that people weren’t leaving ITU, the recovery rate was very low. Now they know how to treat people so people don’t stay there as long and they can move them as they recover. This was much harder to do in March.

As I say, I only have a second hand view based on what my wife and brother-in-law tell me. This may not be reflected in other hospitals.

Have QE resumed elective surgery again yet? They had postponed all non-emergency procedures earlier this month because of Covid patients taking up ICU. Are they past that now?

Fiscal prudence! Don’t make us laugh Prime Minister!! Not seen much of that in the pandemic unless it means squeezing communities and business.

I’m a bit confused about how the new rules apply with regard to cycling. A group of six appears to be ok (even in tier three) but what about the advice to not travel into other areas?

Come to the North, very little of it isn’t in Tier 3… I think like the last set of tiers, you shouldn’t be travelling between them except for a very small number of reasons set out in the guidance.

^ as long as you start & finish in your own area then cycling into other areas is considered ok. Just don’t stop.

As expected – AZ to run a confirmatory trial of the low dose regimen. They might get emergency use for the original regimen in the EU. I don’t think they’ll get it in the US.

And hopefully the CMC will be better-controlled than in the first trial. How you MAKE a drug is more important than the clinical trials you conduct to see if it works. This is a prime example of that.

So, can I travel from one tier 3 area to a neighbouring one to go for a walk?
I/we won’t be mixing with anyone else, at least not at close quarters. The rules advise against it but logic dictates it’s a lot better than going shopping with thousands of others. I know it’s a bit selfish and I’m normally compliant with rules but I don’t think I’m the only one starting to feel contempt with arbitrary blanket rules.

^ as long as you start & finish in your own area then cycling into other areas is considered ok. Just don’t stop.

You mean I can’t stop for a quick slash when I ride into the Peak District (Derbyshire) from my house on the West Yorkshire border?!?!? Gah!

Curse you bojo you fiend, I’ll have to cross my legs and pedal home quicker.

I’m taking the guidance as it is written, avoid travelling into/ out of tier 3 to another tier area, but can travel within tier 3 but avoid doing it frequently.

The “rules” advise against it but do not prohibit it. As long as you’re not silly and don’t take the piss it should be okay.  For example, travelling from Lancaster to the Yorkshire Dales is probably okay. Driving to the Lakes from Stoke is not okay.

@BaronVonP7
Lunge’s explanation is pretty much what happens in the trust I work for. We don’t run ICUs at full capacity by choice: occupancy is demand driven subject to clinical need and staffing.
We have been opening more high dependency wards as the demand has increased, these are usually staffed by redeployment.
Our hospitals have had ICU capacity this time around because fewer patients have been on invasive ventilation.

Stretch – is that because of a change in treatment protocols rather than less patients with severe disease?

Dan, yes it’s a change in the protocol. The clinicians are using high flow CPAP (continuous positive pressure – keeps lungs partially inflated) rather than a ventilator. I understand (I’m not a medic) that CPAP creates less device dependency and less lung trauma for the patient. I think it’s easier to wean the patients off too – I remember low flow CPAP being used as a step between invasive ventilation and unsupported breathing on NICUs

@TiRed

A friend down the road (make, 65yo) finished chemo about 9 months ago, he’s in remission now.

I know it’s ridiculously little info to go on but is he basically not going to get any vaccine for the foreseeable?

Thanks matey.

Depends on the past chemo. His cancer centre will advise as vaccination is a common issue. Eventually there will be antibody prophylaxis for those who are immunosuppressed, but that may be a while away.

Thanks TiRed, appreciated as always.

Suggested tiered approach to vaccine deployment:

https://www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-25-september-2020/jcvi-updated-interim-advice-on-priority-groups-for-covid-19-vaccination#vaccine-priority-groups-interim-advice

It might be out of date now