Coronavirus Pandemic (COVID-19) (SARS-CoV-2) [2020]
- Thread starter RDGoodla
- Start date
Silent_Buddha
Legend
Are you certain?
https://www.msn.com/en-nz/news/othe...tly-by-people-showing-no-symptoms/ar-BB117Xi0
We are still early enough in the pandemic that little is known and not much is certain about it.
Regards,
SB
I think that this is important to remember. But even if kept in mind (rather than taking a position based on early evidence) it still elicits a range of responses - from the cautious (this can get really bad, we need to take strong action) to business as usual (this is another influensa it will pass, and we’ll have a vaccine the next time it rolls our way).
That goes for governments as well as individuals, with the strong symbolic action also driven by a desire to show ”leadership”.
I look at this at many levels. As a scientist, as a member of society and as a father and as a son to two elderly parents. As in the last major financial crisis, the observations you can make are quite interesting.
D
Deleted member 7537
Guest
One of the best interviews about the coronavirus I've seen.
They are not testing everyone at random. They are testing people who are at risk for having come into contact with the virus. People who were in contact with people who have the virus or people who have traveled to areas where the virus has spread and/or people who are exhibiting symptoms. The fact that not everyone exhibits symptoms makes it imperfect, it doesn't make it useless.
Allowing it to spread unchecked will use a lot more resources than judiciously testing and quarantining.
green.pixel
Veteran
Bookmaker genes are strong lads!
If I were to recode this: With respect to this forum; we use rasterization and approximation techniques in rendering for the same reason. Achieve useable results with limited resources.
if we brute force everything we’re get accuracy but much too late to be useful
That Twitter thread unrolled - https://threadreaderapp.com/thread/1238518371651649538.html
1. The govt strategy on #Coronavirus is more refined than those used in other countries and potentially very effective. But it is also riskier and based on a number of assumptions. They need to be correct, and the measures they introduce need to work when they are supposed to.
2. This all assumes I'm correct in what I think the govt are doing and why. I could be wrong - and wouldn't be surprised. But it looks to me like. . .
3. A UK starting assumption is that a high number of the population will inevitably get infected whatever is done – up to 80%. As you can’t stop it, so it is best to manage it.
There are limited health resources so the aim is to manage the flow of the seriously ill to these.
4. The Italian model the aims to stop infection. The UKs wants infection BUT of particular categories of people. The aim of the UK is to have as many lower risk people infected as possible. Immune people cannot infect others; the more there are the lower the risk of infection
5. That's herd immunity.
Based on this idea, at the moment the govt wants people to get infected, up until hospitals begin to reach capacity. At that they want to reduce, but not stop infection rate. Ideally they balance it so the numbers entering hospital = the number leaving.
6. That balance is the big risk.
All the time people are being treated, other mildly ill people are recovering and the population grows a higher percent of immune people who can’t infect. They can also return to work and keep things going normally - and go to the pubs.
7.The risk is being able to accurately manage infection flow relative to health case resources. Data on infection rates needs to be accurate, the measures they introduce need to work and at the time they want them to and to the degree they want, or the system is overwhelmed.
8. Schools: Kids generally won’t get very ill, so the govt can use them as a tool to infect others when you want to increase infection. When you need to slow infection, that tap can be turned off – at that point they close the schools. Politically risky for them to say this.
9. The same for large scale events - stop them when you want to slow infection rates; turn another tap off. This means schools etc are closed for a shorter period and disruption generally is therefore for a shorter period, AND with a growing immune population. This is sustainable
10. After a while most of the population is immune, the seriously ill have all received treatment and the country is resistant. The more vulnerable are then less at risk. This is the end state the govt is aiming for and could achieve.
11. BUT a key issue during this process is protection of those for whom the virus is fatal. It's not clear the full measures there are to protect those people. It assumes they can measure infection, that their behavioural expectations are met - people do what they think they will
12. The Italian (and others) strategy is to stop as much infection as possible - or all infection. This is appealing, but then what? The restrictions are not sustainable for months. So the will need to be relaxed. But that will lead to reemergence of infections.
13. Then rates will then start to climb again. So they will have to reintroduce the restrictions each time infection rates rise. That is not a sustainable model and takes much longer to achieve the goal of a largely immune population with low risk of infection of the vulnerable
14. As the government tries to achieve equilibrium between hospitalisations and infections, more interventions will appear. It's perhaps why there are at the moment few public information films on staying at home. They are treading a tight path, but possibly a sensible one.
15. This is probably the best strategy, but they should explain it more clearly. It relies on a lot of assumptions, so it would be good to know what they are - especially behavioural. Most encouraging, it's way too clever for #BorisJohnson to have had any role in developing.
1. The govt strategy on #Coronavirus is more refined than those used in other countries and potentially very effective. But it is also riskier and based on a number of assumptions. They need to be correct, and the measures they introduce need to work when they are supposed to.
2. This all assumes I'm correct in what I think the govt are doing and why. I could be wrong - and wouldn't be surprised. But it looks to me like. . .
3. A UK starting assumption is that a high number of the population will inevitably get infected whatever is done – up to 80%. As you can’t stop it, so it is best to manage it.
There are limited health resources so the aim is to manage the flow of the seriously ill to these.
4. The Italian model the aims to stop infection. The UKs wants infection BUT of particular categories of people. The aim of the UK is to have as many lower risk people infected as possible. Immune people cannot infect others; the more there are the lower the risk of infection
5. That's herd immunity.
Based on this idea, at the moment the govt wants people to get infected, up until hospitals begin to reach capacity. At that they want to reduce, but not stop infection rate. Ideally they balance it so the numbers entering hospital = the number leaving.
6. That balance is the big risk.
All the time people are being treated, other mildly ill people are recovering and the population grows a higher percent of immune people who can’t infect. They can also return to work and keep things going normally - and go to the pubs.
7.The risk is being able to accurately manage infection flow relative to health case resources. Data on infection rates needs to be accurate, the measures they introduce need to work and at the time they want them to and to the degree they want, or the system is overwhelmed.
8. Schools: Kids generally won’t get very ill, so the govt can use them as a tool to infect others when you want to increase infection. When you need to slow infection, that tap can be turned off – at that point they close the schools. Politically risky for them to say this.
9. The same for large scale events - stop them when you want to slow infection rates; turn another tap off. This means schools etc are closed for a shorter period and disruption generally is therefore for a shorter period, AND with a growing immune population. This is sustainable
10. After a while most of the population is immune, the seriously ill have all received treatment and the country is resistant. The more vulnerable are then less at risk. This is the end state the govt is aiming for and could achieve.
11. BUT a key issue during this process is protection of those for whom the virus is fatal. It's not clear the full measures there are to protect those people. It assumes they can measure infection, that their behavioural expectations are met - people do what they think they will
12. The Italian (and others) strategy is to stop as much infection as possible - or all infection. This is appealing, but then what? The restrictions are not sustainable for months. So the will need to be relaxed. But that will lead to reemergence of infections.
13. Then rates will then start to climb again. So they will have to reintroduce the restrictions each time infection rates rise. That is not a sustainable model and takes much longer to achieve the goal of a largely immune population with low risk of infection of the vulnerable
14. As the government tries to achieve equilibrium between hospitalisations and infections, more interventions will appear. It's perhaps why there are at the moment few public information films on staying at home. They are treading a tight path, but possibly a sensible one.
15. This is probably the best strategy, but they should explain it more clearly. It relies on a lot of assumptions, so it would be good to know what they are - especially behavioural. Most encouraging, it's way too clever for #BorisJohnson to have had any role in developing.
The CDC also says everyone will get this. It will be about flattening the curve. These delays are all about curve flattening. But eventually everyone will need to return to work so hopefully they have better plans in place for that to keep the infection rate low
That's exactly what the UK did and it helped slow progress, but it couldn't stop it for the very reason that you can't test everyone and people didn't know about asymptomatic carriers to test like everyone coming back from Italy, say, rather than just those with symptoms and tracing their contacts. It also wasn't clear that there was a risk as there was no visibility for all infected, so you could have one person travel from Singapore to France, infect someone there, then that person travel from France to Denmarl and infect someone there, then that person travel to the UK from a, at the time, 'safe' nation, and introduce it.
The only alternative is quarantining everyone coming in from abroad for 2 weeks whether they have symptoms or not regardless of destination. I don't think that's practical and if the virus wasn't spreading, would be seen as excessively strong. Consider SARS, MERS, etc. that were contained - imagine if they had resulted in everyone travelling being quarantined for a week or two, only to find it wasn't spreading. And then asking the same for the next latest threat. People wouldn't accept it.
Not if I win the lottery!
Which Government?!
It's the UK
What I like about this and Boris Johnson of all people being PM for all the wrong reasons, he knows he knows nothing and is 100% willing to defer to clever people, which is what strong leadership sometimes entails (not that I'd categorise him as strong!). He's clearly listened to their analysis and advice and said, "go with it," without making it personal or political.
I'd like to see a nice animation on Herd immunity to show people how it works. I've a mind to try my own in Unity, although I have got 100 other things I need to do!
green.pixel
Veteran
https://www.independent.co.uk/voice...s-hospital-symptoms-italy-china-a9397736.html
NHS England ramps up Coronavirus testing
I'm an NHS doctor treating coronavirus – you have no idea how bad things could get
If we go the way of Italy, we're going to run out of intensive care beds in two weeks
Anonymous
Thursday 12 March 2020 16:04
By now, most people have accepted – even the government has accepted – that coronavirus is going to put considerable pressure on our NHS. Yet as an NHS doctor currently caring for coronavirus patients, let me tell you: you have no idea how bad it’s going to get.
Without wanting to sound alarmist, the numbers are inescapable.
One week ago, we had 40 confirmed cases in the UK. We took no specific general measures other than to contain and trace the contact patients had had with others. Yesterday, we had over ten times that number of cases, and still apart from screening intensive care patients, our testing criteria have barely changed. We still aren’t testing community cases that clinically look like coronavirus if they haven’t travelled or had contact with confirmed cases. Hospital cases are only beginning to be tested this week, and only at the discretion of clinicians.
Until now, a suspected case was not allowed to be tested unless they had an obvious link to certain countries or infected patients. I’ve seen at least three people with severe disease who weren’t allowed to be tested, and heard of dozens more. This long-overdue policy change will soon be reflected – possibly as soon as the next 24-48 hours – in a big spike in case numbers.
For an idea of how quickly case numbers can explode, look to Italy. One week after it hit 320 cases, the country reported 2,036; a week later, nearly 10,000; next week that number will likely rise to 50,000 or more. There’s nothing I have seen that tells me the exact same thing isn’t coming for us in the UK. We only have around 4,000 intensive care unit (ICU) beds in England, 80% of which are already full. If we follow the same trajectory as Italy, with 10% of coronavirus patients needing ICU treatment, we will need 200 beds next week, 1,000 the week after. That’s already the entire ICU capacity. Every two days after that, we will need twice the number of beds again.
Then there is the collateral damage coronavirus will create. For while we are obsessively tracking deaths from Covid-19, it’s really the non-virus mortality we should be worried about. For every coronavirus patient in an ICU bed, one non-viral patient – possibly older, possibly with more complex healthcare needs – may be turned away. If you need intensive care and you don’t get it, it’s unlikely you will survive.
Of course, the crisis will not end when the virus does. We have already begun shutting down some outpatient hospital clinics, and I suspect will close all of them to all this week. There is already a huge backlog of non-urgent surgery and cancer care, much of which will be cancelled entirely to cope with coronavirus. The knock-on effect will be felt for years to come.
Unabated, we could see a million coronavirus cases or more in a month’s time. What happens after that, I don’t know. One thing I do know, however, is that the Italian mortality rate seems much higher than China’s (around 7%, versus 4%), a fact mostly explained by how Italian local healthcare has been pushed to breaking point. Reading the accounts of Italian doctors dealing with their outbreak reads like a warzone. Hospitals diverting all clinical staff to the care of ventilated patients. This is not healthcare but “catastrophe medicine”, of the kind one usually encounters on the battlefield; save who can be saved, leave the rest.
China had the capacity to build 2,000-bed hospitals, lock down 750 million people, and fly in thousands of medical staff. Italy, despite having a well-resourced healthcare sector, has been overwhelmed. With 100,000 missing staff, 10,000 missing doctors, 40,000 missing nurses and around £3bn missing from our budget, we have neither Italy’s well-resourced healthcare system nor China’s capacity.
I come from a medical family and in my house, it feels like we are preparing for war. My husband and I have talked about wills; hundreds of healthcare workers have died so far on the frontline of this crisis. However I am young, fit and therefore low-risk – but that isn’t true of all my colleagues, all of whom will be out there, putting their lives on the line for their patients.
There have been plans mooted to recall recently-retired doctors to help shore up frontline services, or to train up final-year medical students. The government proposed both with some fanfare weeks ago – and yet nothing concrete has materialised on either front. The plans surrounding revalidation, supervision, and basic role expectations have simply not been laid out. I asked a medical student about coronavirus preparation today, he had looked at me blankly.
If we are going to be throwing everybody we have at this in two weeks, why aren’t we training them now? We should be throwing every single resource we have at this, immediately. Rishi Sunak promised “unlimited money” to fight the pandemic – and yet we haven’t seen anything. We should be recalling every medic we can find, rapidly training up existing staff and resourcing central hospitals with every scrap of PPE and ventilation equipment we can lay our hands on. Hospital managers should be told to do whatever they have to, and don’t worry about budget constraints or fiscal penalties. The government should be providing the public directly what we need to contain the epidemic: handwashing areas at transit hubs, supplies at foodbanks, mass disinfection of public transport. We are far behind where we need to be, and every second lost will cost lives.
It is not exaggerated – in fact, it is proportionate – to think of this as a war, a national crisis with a huge potential loss of life. Our army is poorly provisioned after years of neglect, our leaders are woefully underprepared. Now is the time the government must step up and truly deliver us the resources we need. No more delay – right now. Countless lives are on the line.
The author is a doctor working in the NHS.
NHS England ramps up Coronavirus testing
I'm an NHS doctor treating coronavirus – you have no idea how bad things could get
If we go the way of Italy, we're going to run out of intensive care beds in two weeks
Anonymous
Thursday 12 March 2020 16:04
By now, most people have accepted – even the government has accepted – that coronavirus is going to put considerable pressure on our NHS. Yet as an NHS doctor currently caring for coronavirus patients, let me tell you: you have no idea how bad it’s going to get.
Without wanting to sound alarmist, the numbers are inescapable.
One week ago, we had 40 confirmed cases in the UK. We took no specific general measures other than to contain and trace the contact patients had had with others. Yesterday, we had over ten times that number of cases, and still apart from screening intensive care patients, our testing criteria have barely changed. We still aren’t testing community cases that clinically look like coronavirus if they haven’t travelled or had contact with confirmed cases. Hospital cases are only beginning to be tested this week, and only at the discretion of clinicians.
Until now, a suspected case was not allowed to be tested unless they had an obvious link to certain countries or infected patients. I’ve seen at least three people with severe disease who weren’t allowed to be tested, and heard of dozens more. This long-overdue policy change will soon be reflected – possibly as soon as the next 24-48 hours – in a big spike in case numbers.
For an idea of how quickly case numbers can explode, look to Italy. One week after it hit 320 cases, the country reported 2,036; a week later, nearly 10,000; next week that number will likely rise to 50,000 or more. There’s nothing I have seen that tells me the exact same thing isn’t coming for us in the UK. We only have around 4,000 intensive care unit (ICU) beds in England, 80% of which are already full. If we follow the same trajectory as Italy, with 10% of coronavirus patients needing ICU treatment, we will need 200 beds next week, 1,000 the week after. That’s already the entire ICU capacity. Every two days after that, we will need twice the number of beds again.
Then there is the collateral damage coronavirus will create. For while we are obsessively tracking deaths from Covid-19, it’s really the non-virus mortality we should be worried about. For every coronavirus patient in an ICU bed, one non-viral patient – possibly older, possibly with more complex healthcare needs – may be turned away. If you need intensive care and you don’t get it, it’s unlikely you will survive.
Of course, the crisis will not end when the virus does. We have already begun shutting down some outpatient hospital clinics, and I suspect will close all of them to all this week. There is already a huge backlog of non-urgent surgery and cancer care, much of which will be cancelled entirely to cope with coronavirus. The knock-on effect will be felt for years to come.
Unabated, we could see a million coronavirus cases or more in a month’s time. What happens after that, I don’t know. One thing I do know, however, is that the Italian mortality rate seems much higher than China’s (around 7%, versus 4%), a fact mostly explained by how Italian local healthcare has been pushed to breaking point. Reading the accounts of Italian doctors dealing with their outbreak reads like a warzone. Hospitals diverting all clinical staff to the care of ventilated patients. This is not healthcare but “catastrophe medicine”, of the kind one usually encounters on the battlefield; save who can be saved, leave the rest.
China had the capacity to build 2,000-bed hospitals, lock down 750 million people, and fly in thousands of medical staff. Italy, despite having a well-resourced healthcare sector, has been overwhelmed. With 100,000 missing staff, 10,000 missing doctors, 40,000 missing nurses and around £3bn missing from our budget, we have neither Italy’s well-resourced healthcare system nor China’s capacity.
I come from a medical family and in my house, it feels like we are preparing for war. My husband and I have talked about wills; hundreds of healthcare workers have died so far on the frontline of this crisis. However I am young, fit and therefore low-risk – but that isn’t true of all my colleagues, all of whom will be out there, putting their lives on the line for their patients.
There have been plans mooted to recall recently-retired doctors to help shore up frontline services, or to train up final-year medical students. The government proposed both with some fanfare weeks ago – and yet nothing concrete has materialised on either front. The plans surrounding revalidation, supervision, and basic role expectations have simply not been laid out. I asked a medical student about coronavirus preparation today, he had looked at me blankly.
If we are going to be throwing everybody we have at this in two weeks, why aren’t we training them now? We should be throwing every single resource we have at this, immediately. Rishi Sunak promised “unlimited money” to fight the pandemic – and yet we haven’t seen anything. We should be recalling every medic we can find, rapidly training up existing staff and resourcing central hospitals with every scrap of PPE and ventilation equipment we can lay our hands on. Hospital managers should be told to do whatever they have to, and don’t worry about budget constraints or fiscal penalties. The government should be providing the public directly what we need to contain the epidemic: handwashing areas at transit hubs, supplies at foodbanks, mass disinfection of public transport. We are far behind where we need to be, and every second lost will cost lives.
It is not exaggerated – in fact, it is proportionate – to think of this as a war, a national crisis with a huge potential loss of life. Our army is poorly provisioned after years of neglect, our leaders are woefully underprepared. Now is the time the government must step up and truly deliver us the resources we need. No more delay – right now. Countless lives are on the line.
The author is a doctor working in the NHS.
D
Deleted member 7537
Guest
Spain is officially locked down.
Bad times ahead, but I want to leave you with this.
Today people in every city of the country, went out to the balcony to give a round of applause to the medical staff, who are risking their lives trying to save others.
Bad times ahead, but I want to leave you with this.
Today people in every city of the country, went out to the balcony to give a round of applause to the medical staff, who are risking their lives trying to save others.
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There's extremely high risk of it all crumbling down on this point. Based on everything we know so far, getting the virus and COVID-19 doesn't make you immune but you might develop antibodies that will protect you for a time, but no-one knows for how long or even if everyone develops that protection
Silent_Buddha
Legend
And with people who have no symptoms carrying the virus, how do you know who has come into people with people who have the virus?
We've already seen numerous cases where the virus pops up in locations where noone at the location or anyone that recently travelled to the location had contact with anyone showing symptoms or anyone that had gone to a region that was at risk. The first one that comes immediately to mind is the case in Northern California where medical officials have no idea how the virus got there.
It's thinking like this that lures people into a false sense of security. Testing only people that show symptoms and people that have been to regions that have been confirmed to have the virus does little to nothing to track infections or the progression of the virus.
[edit] that article linked by green.pixel is a great example of what I've been trying to get across. Testing does nothing to track or stop the spread of the disease. It's best use is to determine if someone showing symptoms has the virus so they can receive the appropriate care. You can't currently test all people showing symptoms or coming from an at risk location.
Regards,
SB
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We never become immune to the flu either. The flu mutates itself constantly which is why vaccines against any flu are pointless. Our bodies develop antibodies with each mutation. COVID-19 is also a type of flu, a stronger one that develops in a different rate that based on what we are being told spreads easier. It is the mutation of it that makes our antibodies temporarily able to protect us and what makes this virus scary.
I am really curious where this came from. I dont buy it that it came from an eaten bat. In china they have been eating all kinds of uncommon animals for a very very long time. It should have been a birth place of a lot more viral diseases. Also there have actually been cases of doctors facing patients with these kinds of symptoms in January in other countries. So it is possible that it didn't originate from China.