Corona Virus

[Dahnsouff]

Just now, Facecloth said:

People were still visiting before lockdown. The carers have to go home, they have to shop, some will travel on public transport. The care homes will take deliveries of things. Theres numerous ways it could have got in.

Yes, there is the standard ways it passes between people in public spaces, I guess I was wondering (And @Guesty has alluded to as much) if the care staff and other staff travel to multiple homes

[RowlattsFox]

No real surprise care homes are struggling, essentially hotels full of the most vulnerable and those likeliest to die from contracting this virus. I don't how early they stopped family members visiting, care workers aren't prepared for this type of thing.

[Kopfkino]

10 hours ago, leicsmac said:

With respect to healthcare systems, the one we have over here (one nationalised and centralised insurance option, accepted everywhere and pretty much meaning free at the point of service, but not necessarily the same "government" employer at all hospitals across the country) seems to have done pretty well over here, but I might suspect there are more important factors at play here in terms of how well each country has dealt with the problem so far.

 

More important factors than the institutional structures within which decisions are made and actions are taken such that they can constrain what we do? You can even broaden institutions to include culture and shared beliefs. 

 

Obviously if you just think about how different countries finance their health systems, then yeah probably not particularly important but the whole way they structure public health is quite damned important. For example, the UK response may very well benefit from the national pride stored up in the letters NHS. Along with the BBC and I guess the monarchy, its the one thing where a bit of perceived British exceptionalism unites people across the board, irrespective of whether its rational or not. That means you can build the messaging around the NHS to inspire action from people. In France, there's pride around the Republic and the presidential office so the messaging can be built around Franc being great, but that probably wouldn't work so well here. Another way the UK system might help is that it's highly organised and not fragmented so switching resources across the system is easier. 

 

Now where might the UK suffer. Well PHE has been obsessed with centralising the whole testing process, setting up its own super labs and using a small number of NHS facilities rather than integrating lots of different sources across the country. France has a similarly centralised public health system that has also struggled to build testing capacity. The CDC in the US started the whole thing determined to keep testing centralised so up until recently the testing situation there was the joke of all jokes for a country of its capability. On the otherhand, the RKI in Germany oversees regional networks of facilities and very quickly worked with local administrations to develop a test and utilise the power of the public and private sector dispersed across the country to manufacture and deliver it in the community, hundreds of facilities involved. Korea, whilst having a reasonably centralised healthcare system, has a very decentralised public health system did similar and very quickly had 600 testing facilities.  Norway, also a super-tester has decentralised public health and health delivery systems due to low population density and quickly built a network of testing facilities. Austria tests well, I don't know the specifics of its testing regime but it's general system works very similarly to Germany so possibly explains it. 

 

Of course, I do not know the exact causative effect of the balance of centralisation/decentralisation, I would not confidently say either way just on simple correlations. But you have France and the UK relatively poor at testing, you have the US that's got better after decrntralising it to some extent and you have a host of countries that are more decentralised either being held up as beacons to follow publicly or showing great testing numbers. 

 

What I will confidently say is that institutions matter hugely. And like you're worried that after this that China will be scapegoated so that governments let themselves off the hook, I worry that lots of people will just blame governments probably based on a very simplistic measure like number of deaths per x of the population, with very little consideration of the context and unique situations they are working in. The whole thing is far more complex than anybody really makes it out to be. Government isn't quite as simple as sprinkling a little bit of leadership onto some advice from a range of experts with a little bit of luck thrown in, then communicating with relevant people and voila we have great outcomes. 

[urban.spaceman]

I ****ing knew it. 
 

 

[Sampson]

18 minutes ago, MattFox said:

 

 

Reality is every country is almost certainly massively underestimating the amount of deaths due to this.

 

It’s going to be a year or so before we know the full impact of this once all the numbers of crunched.

I don't think that necessarily determines the direct deaths due to coronavirus though - a lot of those excess deaths above the confirmed covid ones are going to be deaths for other conditions that the healthcare systems had no resource for. Not that makes it any better - just that you cant use that data to jump to conclusions to say how we've been massively underestimating covid deaths.

 

Would be interesting to see a graph comparing the number of deaths for each cause on their death certificates in those weeks.

Edited 14 April 2020 by Sampson

[StanSP]

Spain's numbers coming down compared to last week is encouraging news... 

[leicsmac]

1 hour ago, Kopfkino said:

 

More important factors than the institutional structures within which decisions are made and actions are taken such that they can constrain what we do? You can even broaden institutions to include culture and shared beliefs. 

 

Obviously if you just think about how different countries finance their health systems, then yeah probably not particularly important but the whole way they structure public health is quite damned important. For example, the UK response may very well benefit from the national pride stored up in the letters NHS. Along with the BBC and I guess the monarchy, its the one thing where a bit of perceived British exceptionalism unites people across the board, irrespective of whether its rational or not. That means you can build the messaging around the NHS to inspire action from people. In France, there's pride around the Republic and the presidential office so the messaging can be built around Franc being great, but that probably wouldn't work so well here. Another way the UK system might help is that it's highly organised and not fragmented so switching resources across the system is easier. 

 

Now where might the UK suffer. Well PHE has been obsessed with centralising the whole testing process, setting up its own super labs and using a small number of NHS facilities rather than integrating lots of different sources across the country. France has a similarly centralised public health system that has also struggled to build testing capacity. The CDC in the US started the whole thing determined to keep testing centralised so up until recently the testing situation there was the joke of all jokes for a country of its capability. On the otherhand, the RKI in Germany oversees regional networks of facilities and very quickly worked with local administrations to develop a test and utilise the power of the public and private sector dispersed across the country to manufacture and deliver it in the community, hundreds of facilities involved. Korea, whilst having a reasonably centralised healthcare system, has a very decentralised public health system did similar and very quickly had 600 testing facilities.  Norway, also a super-tester has decentralised public health and health delivery systems due to low population density and quickly built a network of testing facilities. Austria tests well, I don't know the specifics of its testing regime but it's general system works very similarly to Germany so possibly explains it. 

 

Of course, I do not know the exact causative effect of the balance of centralisation/decentralisation, I would not confidently say either way just on simple correlations. But you have France and the UK relatively poor at testing, you have the US that's got better after decrntralising it to some extent and you have a host of countries that are more decentralised either being held up as beacons to follow publicly or showing great testing numbers. 

 

What I will confidently say is that institutions matter hugely. And like you're worried that after this that China will be scapegoated so that governments let themselves off the hook, I worry that lots of people will just blame governments probably based on a very simplistic measure like number of deaths per x of the population, with very little consideration of the context and unique situations they are working in. The whole thing is far more complex than anybody really makes it out to be. Government isn't quite as simple as sprinkling a little bit of leadership onto some advice from a range of experts with a little bit of luck thrown in, then communicating with relevant people and voila we have great outcomes. 

I was referring more to simply the way the structures are organised and funded, to be honest - if we're going to bring cultural identity as an influence into it too then of course it becomes probably the most prime factor. And yes, all of these things are quite inextricably linked.

 

Korea has certainly shown an amount of flexibility and adaptability in this situation that other nations have lacked, and the idea that testing facilities (as opposed to taking care of cases that are diagnosed) shouldn't all be "under one roof" does have merits if you look a bit closer, as you say.

 

I can certainly see the fear behind people going for a simple blame game - whether its people blaming governments or governments blaming other governments - but I'm worried that such a thing simply cannot be stopped, that the desire for a simple solution to a complex problem has its own inertia and I'm not sure how we get around that.

 

[StanSP]

 

100,000 tests/day looks very far away. Just saying. 

 

[leicsmac]

https://www.bbc.com/news/world-us-canada-52276004

 

Interesting op-ed.

[Crinklyfox]

I viewed a discussion by a doctor on the effect of vitamin D on resistance to upper respiratory infection viral and biological infections.  This is not specific, but can be applied to, Covid-19.  There have been studies over the past few years of the effect of vitamin D supplements on these contagions which concluded that for a person with normal vitamin D levels the risk of contagion reduced by 14% by taking supplements; however this increased dramatically to 70% for those with a vitamin D deficiency.  The doctor also made the point that white people converted sunlight into vitamin D more efficiently than those with black or brown skins, which frequently left those people with a vitamin D deficiency.

 

From the data I've seen so far on Covid-19 deaths it appears to disproportionately affect non-whites.  Socio-economic situations have been proposed as the reason for this but could this simply be down to vitamin D levels?  Anyway I'm posting a link so that anyone interested can learn more.

 

 

[murphy]

This is quite a good rolling news feed for coronavirus if you want to see snapshots of what is happening in other countries:

 

https://www.theguardian.com/world/live/2020/apr/14/coronavirus-live-news-cases-worldwide-near-2-million-trump-repeats-who-funding-threat-latest-updates

[WigstonWanderer]

1 hour ago, Sampson said:

I don't think that necessarily determines the direct deaths due to coronavirus though - a lot of those excess deaths above the confirmed covid ones are going to be deaths for other conditions that the healthcare systems had no resource for. Not that makes it any better - just that you cant use that data to jump to conclusions to say how we've been massively underestimating covid deaths.

 

Would be interesting to see a graph comparing the number of deaths for each cause on their death certificates in those weeks.

Conversely less traffic on the road means less road deaths. Also probably less stabbings, etc.

[bmt]

9 minutes ago, WigstonWanderer said:

Conversely less traffic on the road means less road deaths. Also probably less stabbings, etc.

Exactly, I agree it's important to see the data at a more granular level (such as by death reason) for current week and the same week over the past few years.

[Dahnsouff]

13 minutes ago, WigstonWanderer said:

Conversely less traffic on the road means less road deaths. Also probably less stabbings, etc.

Yes, less traffic yet somehow significantly more dangerous on the road. People speeding (Really speeding) has gone through the roof. 

[st albans fox]

49 minutes ago, Crinklyfox said:

I viewed a discussion by a doctor on the effect of vitamin D on resistance to upper respiratory infection viral and biological infections.  This is not specific, but can be applied to, Covid-19.  There have been studies over the past few years of the effect of vitamin D supplements on these contagions which concluded that for a person with normal vitamin D levels the risk of contagion reduced by 14% by taking supplements; however this increased dramatically to 70% for those with a vitamin D deficiency.  The doctor also made the point that white people converted sunlight into vitamin D more efficiently than those with black or brown skins, which frequently left those people with a vitamin D deficiency.

 

From the data I've seen so far on Covid-19 deaths it appears to disproportionately affect non-whites.  Socio-economic situations have been proposed as the reason for this but could this simply be down to vitamin D levels?  Anyway I'm posting a link so that anyone interested can learn more.

 

 

Sorry but science based theories have no place is this debate ........  you need to check out the narrative before coming up with these contributions ...... ethnic minorities are all poor (even professionals) and therefore much more likely to catch this because it’s always the poor that suffer the most  - see, sound bites work so much better than science ......

 

anyway, on a more serious note, I’m taking a punt that all shops are allowed to reopen with limits on number/ sq foot at any one time w/c 11 may 

 

Primary Schools will reopen 1st June after half term 

 

Team/ individual sports events behind closed doors allowed after June 1st. 
 

pubs/clubs may have to wait until July but I can see restaurants/cafes being allowed to open some time  in June if they can keep tables 6 feet away from each other and have enough toilet facilities to maintain some distancing. The 2 mts rule will remain the target throughout (which is counter intuitive re schools but I still expect them to re open). Universities will not reopen.  Secondary schools may also not reopen till September. 
 

this is all predicated on those who need to be protected staying at home and a contact/ tracing app being available and working. Also, testing will have to be at least at the 100k/day committed to by the govt and a reliable antibody testing being widely available so those who have had CV can be more relaxed about being out and about. 
 

shouldn’t be too tough ! 

[UPinCarolina]

2 hours ago, MattFox said:

 

 

Reality is every country is almost certainly massively underestimating the amount of deaths due to this.

 

It’s going to be a year or so before we know the full impact of this once all the numbers of crunched.

One look at New York City, along with those numbers, more or less confirms this. I'm far more bearish on the economic outlook globally than many seem to be for this reason. Premature / unexpected deaths are far, far worse economically than what has been done via mandatory shutdowns.

[Sampson]

30 minutes ago, WigstonWanderer said:

Conversely less traffic on the road means less road deaths. Also probably less stabbings, etc.

Definitely with road traffic. Unsure about stabbings. Domestic abuse rates have gone through the roof and I'd be worried that figures on stabbings like that might have just shifted from the streets to the home.

Either way, I guess the main point is we can't draw any conclusions these excess stats are due to COVID deaths or other factors - the ONS does say that there are about 2,750 excess deaths which were not listed as corona on the death certificate - whether this was a misdiagnosis or due to the lack of health care/care workers for other conditions or for mental health or economic reasons I guess we won't know until we can compare by actual cause of deaths.

Dementia is the biggest cause of death in the UK for example (though I think they separate out different types of cancers, so not sure if cancer as a whole is higher) and I'd expect a lack of carers atm as there are to have an impact on that and cause the death rate to rise.

The ONS only seems to do annual reports on causes of deaths though from what I can find on their website: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/datasets/leadingcausesofdeathuk


 

Edited 14 April 2020 by Sampson

[st albans fox]

Saw an article today where it was pointed out that the 45 day period re redundancy consultation means that with furlough ending end may, the weekend will see companies begin to make employees redundant as it’s the cleanest option with the uncertainty that lies ahead. 
 

and also, that commercial landlords are circumventing the new law whereby they can get rid of tenants who cannot pay their rent. 
 

now what are the chances that someone will ask either of these questions to the chancellor ??  Of course not - they’ll ask the same questions in six different ways about care homes and the long term economy  ....... neither of which have a decent answer available and neither of which are going to make any difference to what’s actually happening ...... as sad as the care home deaths are,  it doesn’t change the fact that they’re occurring and having reliable daily stats won’t make any difference. The long term future of the economy is a complete unknown and it’s a bit pointless discussing it now ....... no one has any answers to an unknown question ....

Edited 14 April 2020 by st albans fox

[worth_the_wait]

Here's a quick example of the "damned if you do, damned if you don't" approach ...

 

On the BBC Live feed at 16.24

NHS field hospital has no patients or staff

 

A field hospital built to help the UK cope with coronavirus currently has no patients or staff, the BBC has learned.

Work on the NHS Birmingham Nightingale Hospital was completed last week, but the facility - which has 500 beds and capacity for 1,000 more - stands empty.

A spokesperson for NHS England said that they were not staffing the temporary facility because the 23 local hospitals that feed into it haven’t needed to use it.

They added that the Nightingale can be opened and staffed with 24-48 hours notice, should the situation change.

A medic in the West Midlands told the BBC: “Birmingham Nightingale has stood down for the moment. Medics have been told not to come to Nightingale as of yesterday and will be called upon when needed.”

...

 

The tone of the article, is that it's bad because it's not being used.

 

But the point is that it's been built incase capacity elsewhere is exceeded, and it needs to be brought into use.  

 

Which is exactly what everyone is screaming out for ... ie preemptive action to have things in place if needed.

 

[Spiritwalker]

41 minutes ago, worth_the_wait said:

Here's a quick example of the "damned if you do, damned if you don't" approach ...

 

On the BBC Live feed at 16.24

NHS field hospital has no patients or staff

 

A field hospital built to help the UK cope with coronavirus currently has no patients or staff, the BBC has learned.

Work on the NHS Birmingham Nightingale Hospital was completed last week, but the facility - which has 500 beds and capacity for 1,000 more - stands empty.

A spokesperson for NHS England said that they were not staffing the temporary facility because the 23 local hospitals that feed into it haven’t needed to use it.

They added that the Nightingale can be opened and staffed with 24-48 hours notice, should the situation change.

A medic in the West Midlands told the BBC: “Birmingham Nightingale has stood down for the moment. Medics have been told not to come to Nightingale as of yesterday and will be called upon when needed.”

...

 

The tone of the article, is that it's bad because it's not being used.

 

But the point is that it's been built incase capacity elsewhere is exceeded, and it needs to be brought into use.  

 

Which is exactly what everyone is screaming out for ... ie preemptive action to have things in place if needed.

 

Much better to have and not need than need and not have.

[davieG]

What Lockdown?   https://www.leicestermercury.co.uk/news/leicester-news/fears-lockdown-being-ignored-streets-4046618

 

A photograph of Humberstone Gate earlier today appears to show people gathering in groups in what a witness said was a senseless contravention of the Government's social distancing advice.

 

A busy looking Humberstone during the lockdown. Picture supplied by member of the public (Image: supplied)

 

The person who took the Humberstone Gate photograph has asked to remain anonymous.

They described themselves as an 'essential worker' currently working from home. They had gone into the city to fetch a laptop computer.

They said: "The number of people was shocking.

"People queuing for buses as normal - not socially distanced, bank queues not socially distanced. Groups of people stopping to chat to mates.

"It literally looked like a normal weekday in town with zero police about."

 

 

A deserted Gallowtree Gate in the early days of the lockdown

[yorkie1999]

57 minutes ago, worth_the_wait said:

Here's a quick example of the "damned if you do, damned if you don't" approach ...

 

On the BBC Live feed at 16.24

NHS field hospital has no patients or staff

 

A field hospital built to help the UK cope with coronavirus currently has no patients or staff, the BBC has learned.

Work on the NHS Birmingham Nightingale Hospital was completed last week, but the facility - which has 500 beds and capacity for 1,000 more - stands empty.

A spokesperson for NHS England said that they were not staffing the temporary facility because the 23 local hospitals that feed into it haven’t needed to use it.

They added that the Nightingale can be opened and staffed with 24-48 hours notice, should the situation change.

A medic in the West Midlands told the BBC: “Birmingham Nightingale has stood down for the moment. Medics have been told not to come to Nightingale as of yesterday and will be called upon when needed.”

...

 

The tone of the article, is that it's bad because it's not being used.

 

But the point is that it's been built incase capacity elsewhere is exceeded, and it needs to be brought into use.  

 

Which is exactly what everyone is screaming out for ... ie preemptive action to have things in place if needed.

 

https://news.sky.com/story/coronavirus-new-washington-nightingale-hospital-may-never-open-says-nhs-chief-11973159

[spacemunky]

Certainly nowhere near flattening the curve here where I am.

 

Most deaths in a single day with 43 for Ontario Canada.

 

483 news cases for my province.

 

 

[worth_the_wait]

11 minutes ago, yorkie1999 said:

https://news.sky.com/story/coronavirus-new-washington-nightingale-hospital-may-never-open-says-nhs-chief-11973159

And that's a good example of an article, where a key word missed out changes the meaning.

 

The headline in the article is New Washington Nightingale hospital may never open, says NHS chief.

 

A more accurate headline would've been article is New Washington Nightingale hospital may never need to open

 

Read a bit further, and the NHS chief says

"I don't think we will need to open,"

"If people can all play their part in social distancing, if a vaccine comes along, my hope is that we don't need to open.
"If we do, we will be ready."

 

 

Edited 14 April 2020 by worth_the_wait

[Desabafar]

https://www.washingtonpost.com/opinions/2020/04/14/state-department-cables-warned-safety-issues-wuhan-lab-studying-bat-coronaviruses/

 

State Department cables warned of safety issues at Wuhan lab studying bat coronaviruses