Coronavirus

[exile]

6 minutes ago, Hertsscot said:

Presumably its because they're being rigorously and regularly tested for Covid but that is costly.  Which is why the moneybags EPL can get back into action but why its a financial nightmare for smaller clubs that don't have the income from TV, sponsorship and have to rely on supporters coming through the gate.

OK, I can see that could be why. As well as being for some exceptionalism reason. Like MPs when they were cramming together.

[exile]

And one other question for now. What has happened to all the people complaining that % deaths in care homes higher than % deaths in hopsitals? What is the % now? Why is or was that % significant? Was it just a political football? We've moved on to schools and businesses now?

[exile]

"Ministers have been accused of playing down the gravity of the coronavirus pandemic after it emerged that more than 1,000 people died every day in the UK for 22 consecutive days – in stark contrast with daily tolls announced by the government."

https://www.theguardian.com/world/2020/jun/19/over-1000-deaths-day-uk-ministers-accused-downplaying-covid-19-peak

[Orraloon]

1 hour ago, exile said:

Another possibly stupid question, whatever happened to the nightingale hospitals, and the louisa jordan and dragon heart one? It seems some are on standby and some never operated on any patients? We don't hear about them any more... or are they on standby for a second wave? Obviously it's a good thing if they were/are never needed. But maybe the thing I missed is why, if they were to provide extra capacity for COVID intensive care, they didn't put more actually in there and free up more capacity for the normal patients - routine operations, and frail people who were instead discharged to care homes? I mean it seems that there has been a lot of criticism of routine operations and treatments being cancelled, and criticism of people being sent out of hospitals into care homes... while the COVID hospital lie empty. Maybe I missed something.

I think we should be glad that we haven't had to use them, ........yet.

[exile]

41 minutes ago, Orraloon said:

I think we should be glad that we haven't had to use them, ........yet.

Absolutely. I am not criticising building them. Maybe the question is, would it be possible, or would it have been possible, to shift more people into those new hospitals, to allow more routine treatments in the existing hospitals?

[aaid]

26 minutes ago, exile said:

Absolutely. I am not criticising building them. Maybe the question is, would it be possible, or would it have been possible, to shift more people into those new hospitals, to allow more routine treatments in the existing hospitals?

I think it boils down to something like this.  The Louisa Jordan - and others - were built for contingency with the hope they'd never be needed.  Only a fool would criticise that and I'm not suggesting you are doing that.   They're also set up specifically to deal with COVID and aren't suitable for other patients.

Similarly they haven't needed to use the full - increased - capacity of ICU beds in the standard hospital system.  Individual hospitals might have struggled at one point or another but they've never come close to using the full capacity available across the country

Suspending a lot of non-urgent or elective procedures has been as much to do with the increased risk of carrying out those operations during the pandemic than a lack of capacity.  It's kind of a chicken and egg but as an example, if you need a hip replacement you're probably better to delay it and stay at home than to go into hospital and risk being infected.  Similarly for something like cancer treatments that's even more problematic as people on chemo and the like will have seriously compromised immune systems.     Having stopped all hip-replacements and the like you can then repurpose that staff to work on COVD subject to training and the like  

 

[phart]

2 hours ago, exile said:

And one other question for now. What has happened to all the people complaining that % deaths in care homes higher than % deaths in hopsitals? What is the % now? Why is or was that % significant? Was it just a political football? We've moved on to schools and businesses now?

Were folk complaining about the percentages being higher or was it the protocol of how it was managed? Moving untested patients back into high risk zones, non-provision of gear for staff, non-testing of staff, reports of pressure on non-resuscitation (DNAR) signing etc.

What people are we talking about?

 

[TDYER63]

20 minutes ago, exile said:

Absolutely. I am not criticising building them. Maybe the question is, would it be possible, or would it have been possible, to shift more people into those new hospitals, to allow more routine treatments in the existing hospitals?

I could be completely wrong here as I have not read or heard anything  but could the hospitals be empty due to lack of staff to man the wards ?
My niece is a nurse and was working in a cardiology ward.  Her ward were taking in Covid patients at the end of April, she said most wards in the  hospital  were taking in Covid patients . Were they centrallising the covid patients in existing  hospitals as there was simply not enough staff to service the new hospitals, or to deal with the patients sent back to care homes ? 
 

[exile]

23 minutes ago, aaid said:

I think it boils down to something like this.  The Louisa Jordan - and others - were built for contingency with the hope they'd never be needed.  Only a fool would criticise that and I'm not suggesting you are doing that.  [good, cos I just said that I wasn't!] They're also set up specifically to deal with COVID and aren't suitable for other patients.

Similarly they haven't needed to use the full - increased - capacity of ICU beds in the standard hospital system.  Individual hospitals might have struggled at one point or another but they've never come close to using the full capacity available across the country

Suspending a lot of non-urgent or elective procedures has been as much to do with the increased risk of carrying out those operations during the pandemic than a lack of capacity.  It's kind of a chicken and egg but as an example, if you need a hip replacement you're probably better to delay it and stay at home than to go into hospital and risk being infected.  Similarly for something like cancer treatments that's even more problematic as people on chemo and the like will have seriously compromised immune systems.     Having stopped all hip-replacements and the like you can then repurpose that staff to work on COVD subject to training and the like  

 

Thanks that's useful. I just wonder, then, why people appeared to be complaining about effect on those non COVID patients, if as you say they were being kept away to stay protected (similarly, why some frail people were discharged).

[exile]

27 minutes ago, phart said:

Were folk complaining about the percentages being higher or was it the protocol of how it was managed? Moving untested patients back into high risk zones, non-provision of gear for staff, non-testing of staff, reports of pressure on non-resuscitation (DNAR) signing etc.

What people are we talking about?

 

Ian Murray, for one. Seemed to think the % care homes deaths (becoming higher than % hospital deaths) was of itself an indication of failure. More than once. Links exist but no time right now.

[phart]

2 minutes ago, exile said:

Ian Murray, for one. Seemed to think the % care homes deaths (becoming higher than % hospital deaths) was of itself an indication of failure. More than once. Links exist but no time right now.

That's fine I can find them myself, I was paraochially thinking you meant folk on here lol.

I was thinking not seen who has said that! I've basically never listened to Murray in my life!

[Ally Bongo]

Transferring old people on delayed discharge from one hospital to another (Louisa Jordan) was never an option

 

[aaid]

23 minutes ago, phart said:

Were folk complaining about the percentages being higher or was it the protocol of how it was managed? Moving untested patients back into high risk zones, non-provision of gear for staff, non-testing of staff, reports of pressure on non-resuscitation (DNAR) signing etc.

What people are we talking about?

 

Opposition politicians and the media I guess.

Given the demographic most susceptible to COVID, the level - or to be more correct the percentage - of deaths amongst Care Home residents shouldn't come as a surprise.   The absolute number of deaths is another matter entirely.

Obviously most of the evidence isn't in the public domain yet, possibly some will never be,  but to take each of your points in turn.

The inference being drawn on the release of people from hospitals to Care Homes untested is that a significant number had picked up COVID while in hospital and that was - in part - responsible for the spread within Care Homes and turning them into "Killing Fields".    I suspect that's a "truthy" argument and will be shown to be at best be totally false or at worst to have a minimal impact.   

Of course, what we don't know is how many people who fall into this category subsequently were either tested positive or developed symptoms so could be reasonably assumed to have had contracted the virus in the two weeks after leaving hospital.  Then you have to take that and look at further cases in that home for evidences of community transmission based on that "patient 0" who was released from hospital.   Only then would you know for certain.

Of course, even if it were true that there were numbers of infected patients being released to Care Homes then it shouldn't have mattered - at least not as far as transmission was confirmed.

Care Home residents are supposed to be locked down even tighter than the rest of the population, they are supposed to be basically restricted to their rooms and have no direct contact with other residents - all communal activity should've been suspended or at least the same social distancing measures in place for the rest of the population should've been observed.   That only leaves two possible options for transmission within Care Homes.  One is surface transmission and Care Homes should as a matter of course have pretty stringent infection control measures in place at the best of times.    The other option is transmission from staff to resident.  Obviously its not possible for staff to do their jobs without getting up close and personal with residents and anyone - anywhere - who was experiencing symptoms should not have been in work anyway.   The problem lies with staff potentially being asymptomatic or incubating the virus but not showing symptoms, essentially not know that they had it.  Which leads me on to.

Lack of PPE - this is where I think the government - both SG and UKG - have big questions to ask as initially at least there was clearly not sufficient numbers of suitable PPE to go around.    This isn't specific to the COVID virus itself but is general contingency planning around pandemics.   I don't know why we were so exposed at the beginning or why it took so long to get going and get up to speed - I could have a guess though.  I don't think you necessarily need to have the benefit of hindsight to see that preparations were woefully lacking here though.

Similarly with testing, at the start there was limited supply of tests themselves and also the capacity to process those.   Given the lack of tests - and PPE - at the start I suspect that prioritising the health service, specifically hospitials and COVID wards, was probably the only option, the question is more about why there was a lack of tests (and PPE) in the first place.    Given this is an unknown, new virus, obviously the government couldn't have a stockpile of tests waiting to use, similarly given there was a global pandemic its probably no surprise that it was difficult to be able to source tests.- so it would be unreasonable to hold them accountable for that.     However, there does seem to be some sense that the rate of building up testing capacity could have been a lot more agressive and Chris Whitty alluded to as much earlier in the week.

Had Care Home had sufficient proper PPE and staff were being tested regularly then there's no doubt in my mind that the rates of transmission - and so deaths - would have been lower.  The question though isn't "why didn't Care Homes have it" but rather "why wasn't there enough".   The likelihood is also that infected staff have picked up the virus outside the care home and brought it in - and you have the added complication of agency staff working in multiple sites.

Finally on the whole DNR issue - again I suspect this may turn out to be another distraction.   There's a lot of emotive - and frankly irresponsible - rhetoric going on around this.  Accusations of people being left to die, being refused admission to hospital, not being saved and the like.   I suspect that the reality is that having contracted the virus, being badly effected and with other serious co-morbidities you're looking at inevitable end of life care in as comfortable as setting and manner as is possible.   That isn't to say that if you're in a Care Home and get COVID you're going to automatically die, rather that if you're in a bad way, going to hospital isn't going to help you.   Again though the key question is - where did the infections come from.

I suspect that, in respect of Care Homes there will be three major takeaways, lack of PPE, too slow to get routine testing up to speed and - in some individual homes - poor practice which may border on he criminally negligent, I wouldn't be surprised to see some prosecutions.

[aaid]

2 hours ago, exile said:

Thanks that's useful. I just wonder, then, why people appeared to be complaining about effect on those non COVID patients, if as you say they were being kept away to stay protected (similarly, why some frail people were discharged).

Some people will just complain about anything.   In seriousness, it's fair enough for the opposition to ask questions about why the Government is doing X or not doing Y, it's part of holding the government to account and pushing them to do as much as they can.  However, you generally expect them to either come up with alternatives or suggest ways in its possible to do both X and Y or at least get some sort of balance.  Of course you rarely get that with the opposition in Holyrood.

Then there are special interest groups who - naturally - think that their particular are should have the highest priority and that everything should be secondary to that.   Again that's understandable but life isn't like that and governments have to make decisions that won't be universally popular.  Of course with health that's doubly difficult as those sort of decisions could effectively decide on whether someone lives or dies, not something I'd like to have to do. 

[Newryrep]

On 6/20/2020 at 9:23 AM, exile said:

"Ministers have been accused of playing down the gravity of the coronavirus pandemic after it emerged that more than 1,000 people died every day in the UK for 22 consecutive days – in stark contrast with daily tolls announced by the government."

https://www.theguardian.com/world/2020/jun/19/over-1000-deaths-day-uk-ministers-accused-downplaying-covid-19-peak

latest figures from the ex ONS guy - excess deaths at 68610 up until 20th June  - now over say 12 months this mighten be as bad as it looks as some people may have died a bit earlier than they would of  but cant see it changing the underlining charge that the UK made a complete balls of it 

https://twitter.com/statsjamie?lang=en

 

 

 

[aaid]

1 hour ago, Newryrep said:

latest figures from the ex ONS guy - excess deaths at 68610 up until 20th June  - now over say 12 months this mighten be as bad as it looks as some people may have died a bit earlier than they would of  but cant see it changing the underlining charge that the UK made a complete balls of it 

https://twitter.com/statsjamie?lang=en

 

 

 

The only way you'll see if that is the case is if - big if - COVID deaths are virtually emilinated and there's a corresponding fall in excess deaths over the next six months, ie. those people who "would've died a bit earlier" are already dead and so can't die again.

 

[Newryrep]

1 hour ago, aaid said:

The only way you'll see if that is the case is if - big if - COVID deaths are virtually emilinated and there's a corresponding fall in excess deaths over the next six months, ie. those people who "would've died a bit earlier" are already dead and so can't die again.

 

yes it may change a bit but I doubt  to the extent that the government can turn around and say "there were 20000 deaths  in excess of a normal 12 month period we done a good job in extenuating circumstances"

As I said in an earlier post Irelands excess death rate was reported on the  radio as being close to zero as the covid deaths were offset by the lack of traffic accidents and such like

[aaid]

4 minutes ago, Newryrep said:

yes it may change a bit but I doubt  to the extent that the government can turn around and say "there were 20000 deaths  in excess of a normal 12 month period we done a good job in extenuating circumstances"

As I said in an earlier post Irelands excess death rate was reported on the  radio as being close to zero as the covid deaths were offset by the lack of traffic accidents and such like

Ireland maybe needs to take a look at the levels of driving as an aside if there's 1700 people who die on the roads every three months.

[Newryrep]

27 minutes ago, aaid said:

Ireland maybe needs to take a look at the levels of driving as an aside if there's 1700 people who die on the roads every three months.

"and such like "

 

Though it should , sure you used to be able to fail your test and still drive home on your own. A lot of the older generation were just given driving licences

[aaid]

3 minutes ago, Newryrep said:

"and such like "

 

Though it should , sure you used to be able to fail your test and still drive home on your own. A lot of the older generation were just given driving licences

Well presumably that because of the lockdown meaning people aren't out about as a matter of course, you would expect there to be some sort of reduction in fatalities as a result but if that's running at a rate of 1700 over three months, there's something that probably needs looking at.

[Orraloon]

52 minutes ago, Newryrep said:

yes it may change a bit but I doubt  to the extent that the government can turn around and say "there were 20000 deaths  in excess of a normal 12 month period we done a good job in extenuating circumstances"

As I said in an earlier post Irelands excess death rate was reported on the  radio as being close to zero as the covid deaths were offset by the lack of traffic accidents and such like

The excess death rate in Ireland has been back down to zero for a few weeks now but that doesn't mean it has been zero over the whole period of the epidemic. 

[Newryrep]

14 minutes ago, Orraloon said:

The excess death rate in Ireland has been back down to zero for a few weeks now but that doesn't mean it has been zero over the whole period of the epidemic. 

that's a fair enough point , I only heard it in passing on a radio show , I think Ireland has done a reasonable job North and south , the common travel area probably hasn't help

[aaid]

4 deaths registered in Scotland yesterday, follows 0 on both Saturday and Sunday.

[vanderark14]

lockdown measures eased even more down here as of 4th of July

Pubs to be opened on the 4th, from what I understand most were opening on the 4th anyway regardless of bojos announcement. 

Two households can eat and drink together, restaurants, cinemas and museums to open too

[Squirrelhumper]

1 hour ago, aaid said:

4 deaths registered in Scotland yesterday, follows 0 on both Saturday and Sunday.

Was 0 for the last 6 days before today.