COVID19

[Donny osmond]

I think it is perfectly possible to criticise the actions of the UK government in isolation. Simply looking at decisions made without reference to other parts of the world leaves plenty of material to analyse.

I agree, to an extent, but I find a lot of the criticism is a little incoherent.

The only way thru this to truly minimise deaths is to lock down from before the virus arrived until there is an effective vaccine. Anything else is a course of action that could be seen to cause "unnecessary" deaths.

So unless one is arguing for that, we're all on the same page of finding our way thru this as best we can. Which makes it a little, as I say, incoherent to be quite so excited about perceived mistakes if one isn't arguing for an 18 month lockdown.

You're saying that there are only two possible choices:
1) you argue for an 18 month lockdown, or
2) you cannot criticise the government for their mistakes
That's a classic false dichotomy.

Of course there are other options.

No one expects to "truly minimise deaths" from Covid-19 in the way you suggest above. We don't take that approach with any other disease, eg we don't shut down the economy every winter to prevent deaths from influenza, it would wreck the economy and ultimately mean we'd have more deaths because we couldn't afford the NHS and emergency services in their current forms. It's ridiculous because it considers only Covid-19 deaths.

The truth is that we should be trying to minimise total deaths, regardless of the cause. Since Covid-19 is relatively deadly, this means paying it special attention, which sometimes (when it has spread too widely) mandates lockdown. However, if it can be managed with measures which allow us to avoid lockdown (and all the economic and psychological and social harm that entails), then that is preferable. As has been demonstrated by South Korea.

that's not what i'm saying at all.

if we're all on the same page, and you admit that we are, then assuming some moral high ground over others and not allowing them to make mistakes without lambasting them for incompetence is clearly going to be self-defeating. it puts the govt in a damned if they and damned if they don't position and poisons the whole conversation about how to move forward. there is no route thru this, beyond the most extreme shut down, that doesn't involve making mistakes.

ftaod this is not me saying there is no criticism to make

[Donny osmond]

It should really be noted that South Korea is taking a different path THIS TIME as they got it badly wrong in the past and GOT THE OPPORTUNITY TO LEARN FROM THEIR MISTAKES which is clearly not an option for anyone else.

Why is it not an option to "learn from their mistakes"? The Far East's previous experience with respiratory disease was not in secret. It's all public knowledge and it's not rocket science.

Their different path also involves an invasion of personal privacy that simply wouldn't be tolerated in pretty much any western European country,

Which invasion of privacy are you thinking of here which was both:
1) essential to their Covid-19 strategy, and
2) not something that most people routinely allow Facebook and Google to do?

but sure, let's keep looking at stats that we are pretty sure are inaccurate and taking our direction from a press corp that we concurrently deride as being untrustworthy.

Give us some evidence for why "we are pretty sure" the South Korean stats are inaccurate.

i was saying that SK got the chance to learn from their own mistakes, but that is not a 'luxury' that you are allowing our govt to have in this situation.

there's a world of difference, in public perception, between most people routinely but ignorantly 'allowing' facebook and google access to their data in return for using their services, and a national govt standing up and mandating that everyone will give govt agencies access to their data.

why would we assume the SK stats are any more accurate than ours or anyone else's? that's just being down on our govt for the sake of it, see previous post

[Stom]

It will take a while before we can distinguish between countries such as the UK, France, Italy, Sweden, and the USA.
It will take a while before we can distinguish between countries such as South Korea, Singapore and Taiwan.
But we've already had enough time to distinguish between these two groups and to point out which made the most "egregious mistakes".

What do you mean by multiple "waves" of this virus?
If we get the cases and deaths well down, the only reason for them rising to this kind of level again is if we mishandle the epidemic.
Its not a foregone conclusion that there will be "waves" and saying so is handing our leaders an excuse in advance.

South Korea and Singapore will not be experiencing anything other than slight ripples in their death and case rates, and that's because they're doing the right things.

Many experts are suggesting that this virus will disappear then reappear. Hence more than one wave. Part of that will be due to the virus hitting different countries at different times.

Yes South Korea took a different path and so far they are managing this well. But there have been different approaches in Europe and we will see which is the most successful.

Well, as I've said before, if we wait till this is all over before we learn from everyone's experiences, we'd better pray that we're operating a good strategy despite our numbers being approx 100 times worse than the Far East's at this point.

Given the vast difference between the numbers in Europe and the Far East, I'm not sure why you'd be paying so much attention to differences between the European countries. As Gore Vidal said "one does not bring a measuring rod to Lilliput".

You mean what Keunssbeeg said?

[Mellsblue]

[Son of Mathonwy]

We absolutely must find the source for this and make sure it's fixed (or shut down if that's not possible) whether it's the food industry or a virus lab. We must put pressure on the Chinese to do this, albeit it's not our top priority at this point.

[Stom]

We absolutely must find the source for this and make sure it's fixed (or shut down if that's not possible) whether it's the food industry or a virus lab. We must put pressure on the Chinese to do this, albeit it's not our top priority at this point.

Horse, stable, door, bolt...

[Son of Mathonwy]

I agree, to an extent, but I find a lot of the criticism is a little incoherent.

The only way thru this to truly minimise deaths is to lock down from before the virus arrived until there is an effective vaccine. Anything else is a course of action that could be seen to cause "unnecessary" deaths.

So unless one is arguing for that, we're all on the same page of finding our way thru this as best we can. Which makes it a little, as I say, incoherent to be quite so excited about perceived mistakes if one isn't arguing for an 18 month lockdown.

You're saying that there are only two possible choices:
1) you argue for an 18 month lockdown, or
2) you cannot criticise the government for their mistakes
That's a classic false dichotomy.

Of course there are other options.

No one expects to "truly minimise deaths" from Covid-19 in the way you suggest above. We don't take that approach with any other disease, eg we don't shut down the economy every winter to prevent deaths from influenza, it would wreck the economy and ultimately mean we'd have more deaths because we couldn't afford the NHS and emergency services in their current forms. It's ridiculous because it considers only Covid-19 deaths.

The truth is that we should be trying to minimise total deaths, regardless of the cause. Since Covid-19 is relatively deadly, this means paying it special attention, which sometimes (when it has spread too widely) mandates lockdown. However, if it can be managed with measures which allow us to avoid lockdown (and all the economic and psychological and social harm that entails), then that is preferable. As has been demonstrated by South Korea.

that's not what i'm saying at all.

if we're all on the same page, and you admit that we are, then assuming some moral high ground over others and not allowing them to make mistakes without lambasting them for incompetence is clearly going to be self-defeating. it puts the govt in a damned if they and damned if they don't position and poisons the whole conversation about how to move forward. there is no route thru this, beyond the most extreme shut down, that doesn't involve making mistakes.

ftaod this is not me saying there is no criticism to make

You said "Which makes it a little, as I say, incoherent to be quite so excited about perceived mistakes if one isn't arguing for an 18 month lockdown". Which is to say, the only coherent criticism is to call for an 18 month lockdown. Which is manifestly not true.

I don't know what you mean by "we're all on the same page". Who are "we" and what is the "same page"?

If we're in the unknown, mistakes - even big, lethal ones - are excusable. But we're not in the unknown. This is a virus which causes respiratory disease. The virus is novel, but what it does is not. Techniques for dealing with this are not secret, or confined to countries in the Far East. So there is no excuse.

The government is not damned if they do, damned if they don't. They don't need to operate by trial and error and I'm not going to blame them for minor tactical errors. They just need to follow the general procedures for dealing with such things, as advised by the WHO, as enacted by various countries, most obviously in the Far East.

When you say "this is not me saying there is no criticism to make" you seem to be contradicting your earlier point about the 18 month lockdown.

[Son of Mathonwy]

We absolutely must find the source for this and make sure it's fixed (or shut down if that's not possible) whether it's the food industry or a virus lab. We must put pressure on the Chinese to do this, albeit it's not our top priority at this point.

Horse, stable, door, bolt...

Of course, but this is to stop the next horse.

[Son of Mathonwy]

Many experts are suggesting that this virus will disappear then reappear. Hence more than one wave. Part of that will be due to the virus hitting different countries at different times.

Yes South Korea took a different path and so far they are managing this well. But there have been different approaches in Europe and we will see which is the most successful.

Well, as I've said before, if we wait till this is all over before we learn from everyone's experiences, we'd better pray that we're operating a good strategy despite our numbers being approx 100 times worse than the Far East's at this point.

Given the vast difference between the numbers in Europe and the Far East, I'm not sure why you'd be paying so much attention to differences between the European countries. As Gore Vidal said "one does not bring a measuring rod to Lilliput".

You mean what Keunssbeeg said?

She's basically saying it will most likely be years before we can make a judgement as to which countries have the best and worst approaches to this. (Which broadly means we cannot be critical of them until this is all over). And I'm saying that some of the evidence is so overwhelming that we should take notice of it now.

[Stom]

Well, as I've said before, if we wait till this is all over before we learn from everyone's experiences, we'd better pray that we're operating a good strategy despite our numbers being approx 100 times worse than the Far East's at this point.

Given the vast difference between the numbers in Europe and the Far East, I'm not sure why you'd be paying so much attention to differences between the European countries. As Gore Vidal said "one does not bring a measuring rod to Lilliput".

You mean what Keunssbeeg said?

She's basically saying it will most likely be years before we can make a judgement as to which countries have the best and worst approaches to this. (Which broadly means we cannot be critical of them until this is all over). And I'm saying that some of the evidence is so overwhelming that we should take notice of it now.

Look, I'm no fan of hers, but she's not using every word she speaks to be nice to the govt. She most likely means...what she says.

There's an interesting thought.

[fivepointer]

It will be a long time before anyone can draw up a definitive or complete record of how the Govt have handled this crisis, but that shouldnt rule out day to day questioning about the management of the crisis.
Goodness knows this would have tested a Govt of all the talents, which, i'm afraid, this one is a very long way from being.
I can forgive errors, which in a situation this complicated and unprecedented are to be expected, but i really cannot abide flat out lying, the witless refrain that they are "following the science", the appalling press conferences where important questions are routinely dodged and the lack of any kind of humility in accepting mistakes have been made.

[Which Tyler]

It should really be noted that South Korea is taking a different path THIS TIME as they got it badly wrong in the past and GOT THE OPPORTUNITY TO LEARN FROM THEIR MISTAKES which is clearly not an option for anyone else.

Why not? Are human beings unable to communicate now? When did we stop being able to learn from other peoples' mistakes? How come New Zealand (for example) were able to learn from previous mistakes made by South Lorea, but much of Europe wasn't?

[Mellsblue]

It will be a long time before anyone can draw up a definitive or complete record of how the Govt have handled this crisis, but that shouldnt rule out day to day questioning about the management of the crisis.
Goodness knows this would have tested a Govt of all the talents, which, i'm afraid, this one is a very long way from being.
I can forgive errors, which in a situation this complicated and unprecedented are to be expected, but i really cannot abide flat out lying, the witless refrain that they are "following the science", the appalling press conferences where important questions are routinely dodged and the lack of any kind of humility in accepting mistakes have been made.

This is mostly fair.....which may cop you a ban from this board.
However, the govt is being guided by SAGE to a very high degree. So much so that a lot of junior govt ministers think the country is currently being run by scientists rather than politicians. Asking for humility from a politician of any persuasion is a thankless task. To make matters worse, lessons have been learnt that publicly accepting you have got something wrong will automatically be portrayed as a u-turn and/or weak. We reap what we sow.
As for the lying, it’s sadly seeping in to our politics. It used to be ‘spin’ but due to incremental gains and fast paced media cycles it’s is now just straight up lies.

[Donny osmond]

You're saying that there are only two possible choices:
1) you argue for an 18 month lockdown, or
2) you cannot criticise the government for their mistakes
That's a classic false dichotomy.

Of course there are other options.

No one expects to "truly minimise deaths" from Covid-19 in the way you suggest above. We don't take that approach with any other disease, eg we don't shut down the economy every winter to prevent deaths from influenza, it would wreck the economy and ultimately mean we'd have more deaths because we couldn't afford the NHS and emergency services in their current forms. It's ridiculous because it considers only Covid-19 deaths.

The truth is that we should be trying to minimise total deaths, regardless of the cause. Since Covid-19 is relatively deadly, this means paying it special attention, which sometimes (when it has spread too widely) mandates lockdown. However, if it can be managed with measures which allow us to avoid lockdown (and all the economic and psychological and social harm that entails), then that is preferable. As has been demonstrated by South Korea.

that's not what i'm saying at all.

if we're all on the same page, and you admit that we are, then assuming some moral high ground over others and not allowing them to make mistakes without lambasting them for incompetence is clearly going to be self-defeating. it puts the govt in a damned if they and damned if they don't position and poisons the whole conversation about how to move forward. there is no route thru this, beyond the most extreme shut down, that doesn't involve making mistakes.

ftaod this is not me saying there is no criticism to make

You said "Which makes it a little, as I say, incoherent to be quite so excited about perceived mistakes if one isn't arguing for an 18 month lockdown". Which is to say, the only coherent criticism is to call for an 18 month lockdown. Which is manifestly not true.

I don't know what you mean by "we're all on the same page". Who are "we" and what is the "same page"?

If we're in the unknown, mistakes - even big, lethal ones - are excusable. But we're not in the unknown. This is a virus which causes respiratory disease. The virus is novel, but what it does is not. Techniques for dealing with this are not secret, or confined to countries in the Far East. So there is no excuse.

The government is not damned if they do, damned if they don't. They don't need to operate by trial and error and I'm not going to blame them for minor tactical errors. They just need to follow the general procedures for dealing with such things, as advised by the WHO, as enacted by various countries, most obviously in the Far East.

When you say "this is not me saying there is no criticism to make" you seem to be contradicting your earlier point about the 18 month lockdown.

Ok chief, whatever. I'm not as inclined to try and debate your obtuse absolutes as Mells, so I'm out.

Sent from my CPH1951 using Tapatalk

[Donny osmond]

It should really be noted that South Korea is taking a different path THIS TIME as they got it badly wrong in the past and GOT THE OPPORTUNITY TO LEARN FROM THEIR MISTAKES which is clearly not an option for anyone else.

Why not? Are human beings unable to communicate now? When did we stop being able to learn from other peoples' mistakes? How come New Zealand (for example) were able to learn from previous mistakes made by South Lorea, but much of Europe wasn't?

See my follow up post, I was talking about RR's allowing mistakes.

Sent from my CPH1951 using Tapatalk

[Banquo]

Been reluctant to dive into this, but I am privy to some briefings which you might find interesting- and which aren't just 'spin', as it also chimes with the reality being observed by my redeployed staff working in ICU's and community in my patch. This was as of 1pm yesterday- and is big picture.

On PPE- big concern is a specific use gown (see shipment from Turkey), and there are enough at the moment. Ample supplies currently of everything else, though extending the supply chain from 233 to 30,000 has caused problems (see Army comments).
On Ventilators- there is a lot of spare capacity
On ICU beds- there remains a comfortable amount of spare capacity, though in some places staff illnesses has caused pinch points. (I do think the Nightingale (s) are likely and hopefully redundant- imo they were prepping for an Italian scenario where the seriously ill were not given active care- grim.)
On oxygen- there is plenty
On testing- more capacity than tests being taken.See 233 to 30,000 as above- Hancock will be caned in a week over his 100k a day nonsense.
One worry is muscle relaxant supplies for intubation, down the track a bit.

PM me if you want the source. This is NHSE, so doesn't cover social care mostly.

Feel free to slate the govt on strategy, especially on testing and sluggish lockdown. and even on the inability to tell the story on capacity (or spin it, ironically) But on capacity, and a capacity requirement not dreamt of until March by most (and in hindsight driven by the lockdown plan), the NHS has actually done ok to well to date- it may yet stumble, but new admissions are falling in London especially. It may not have been a perfect machine, but it was mobilised just about on time and has so far not been materially found wanting as far as I know- touch wood (and that is the issue, its not seamless).

In general, working with the NHS over the last 3 years has been very challenging in terms of urgency and attitude, but whilst not being perfect at all here (there clearly was a need for regional strategies and cancelling everything to prepare for this was patently OTT in some areas), they have found ways to cope in very difficult circumstances. My one massive criticism on the ground is how they have treated some vulnerable staff, but that's more local management idiocy.

Personally think the issues not being really discussed are how we are dealing with very ill patients, and whether we are catching patients early enough to give them a chance to recover with assistance-- Boris was lucky, and he'd been tested positive. There is quite an issue with test reliability as well- up to 30% false negatives for patients between 4-7 days infection, its a big deal and the Germans first reported it.

[morepork]

Banquo are the 30% negatives for the PCR-based diagnostic or serology?

[Banquo]

Banquo are the 30% negatives for the PCR-based diagnostic or serology?

I could BS, but I don't really know; I do know it was a huge concern in the UK at the start, and did wonder if that's why they changed tack (thinking well we might have missed tracing the contacts of a substantial number of infected folks, but what the fck do I know!). The Germans have been talking about it for a long time, apparently, and also about the different way they are treating very ill patients.

[Donny osmond]

Been reluctant to dive into this, but I am privy to some briefings which you might find interesting- and which aren't just 'spin', as it also chimes with the reality being observed by my redeployed staff working in ICU's and community in my patch. This was as of 1pm yesterday- and is big picture.

On PPE- big concern is a specific use gown (see shipment from Turkey), and there are enough at the moment. Ample supplies currently of everything else, though extending the supply chain from 233 to 30,000 has caused problems (see Army comments).
On Ventilators- there is a lot of spare capacity
On ICU beds- there remains a comfortable amount of spare capacity, though in some places staff illnesses has caused pinch points. (I do think the Nightingale (s) are likely and hopefully redundant- imo they were prepping for an Italian scenario where the seriously ill were not given active care- grim.)
On oxygen- there is plenty
On testing- more capacity than tests being taken.See 233 to 30,000 as above- Hancock will be caned in a week over his 100k a day nonsense.
One worry is muscle relaxant supplies for intubation, down the track a bit.

PM me if you want the source. This is NHSE, so doesn't cover social care mostly.

Feel free to slate the govt on strategy, especially on testing and sluggish lockdown. and even on the inability to tell the story on capacity (or spin it, ironically) But on capacity, and a capacity requirement not dreamt of until March by most (and in hindsight driven by the lockdown plan), the NHS has actually done ok to well to date- it may yet stumble, but new admissions are falling in London especially. It may not have been a perfect machine, but it was mobilised just about on time and has so far not been materially found wanting as far as I know- touch wood (and that is the issue, its not seamless).

In general, working with the NHS over the last 3 years has been very challenging in terms of urgency and attitude, but whilst not being perfect at all here (there clearly was a need for regional strategies and cancelling everything to prepare for this was patently OTT in some areas), they have found ways to cope in very difficult circumstances. My one massive criticism on the ground is how they have treated some vulnerable staff, but that's more local management idiocy.

Personally think the issues not being really discussed are how we are dealing with very ill patients, and whether we are catching patients early enough to give them a chance to recover with assistance-- Boris was lucky, and he'd been tested positive. There is quite an issue with test reliability as well- up to 30% false negatives for patients between 4-7 days infection, its a big deal and the Germans first reported it.

Good post, thanks

Sent from my CPH1951 using Tapatalk

[morepork]

It looks like serology tests. A heap of them have been rushed through and not as rigorously screened as normal. 30% is massive. There seems to be a flood of different tests, all with different proprietary technology no doubt. The lack of consensus metrics are really muddying the waters.

[Mellsblue]

Been reluctant to dive into this, but I am privy to some briefings which you might find interesting- and which aren't just 'spin', as it also chimes with the reality being observed by my redeployed staff working in ICU's and community in my patch. This was as of 1pm yesterday- and is big picture.

On PPE- big concern is a specific use gown (see shipment from Turkey), and there are enough at the moment. Ample supplies currently of everything else, though extending the supply chain from 233 to 30,000 has caused problems (see Army comments).
On Ventilators- there is a lot of spare capacity
On ICU beds- there remains a comfortable amount of spare capacity, though in some places staff illnesses has caused pinch points. (I do think the Nightingale (s) are likely and hopefully redundant- imo they were prepping for an Italian scenario where the seriously ill were not given active care- grim.)
On oxygen- there is plenty
On testing- more capacity than tests being taken.See 233 to 30,000 as above- Hancock will be caned in a week over his 100k a day nonsense.
One worry is muscle relaxant supplies for intubation, down the track a bit.

PM me if you want the source. This is NHSE, so doesn't cover social care mostly.

Feel free to slate the govt on strategy, especially on testing and sluggish lockdown. and even on the inability to tell the story on capacity (or spin it, ironically) But on capacity, and a capacity requirement not dreamt of until March by most (and in hindsight driven by the lockdown plan), the NHS has actually done ok to well to date- it may yet stumble, but new admissions are falling in London especially. It may not have been a perfect machine, but it was mobilised just about on time and has so far not been materially found wanting as far as I know- touch wood (and that is the issue, its not seamless).

In general, working with the NHS over the last 3 years has been very challenging in terms of urgency and attitude, but whilst not being perfect at all here (there clearly was a need for regional strategies and cancelling everything to prepare for this was patently OTT in some areas), they have found ways to cope in very difficult circumstances. My one massive criticism on the ground is how they have treated some vulnerable staff, but that's more local management idiocy.

Personally think the issues not being really discussed are how we are dealing with very ill patients, and whether we are catching patients early enough to give them a chance to recover with assistance-- Boris was lucky, and he'd been tested positive. There is quite an issue with test reliability as well- up to 30% false negatives for patients between 4-7 days infection, its a big deal and the Germans first reported it.

Good post, thanks

Sent from my CPH1951 using Tapatalk

Personally, I don’t know who the bloody hell he thinks he is. Coming on here with first hand knowledge and facts. RR is not the place for those sort of antics.

[Banquo]

It looks like serology tests. A heap of them have been rushed through and not as rigorously screened as normal. 30% is massive. There seems to be a flood of different tests, all with different proprietary technology no doubt. The lack of consensus metrics are really muddying the waters.

Fraid so. The worse news is that false +ves are a large proportion of mortalities too.

[Mellsblue]

So, testing not the panacea, as so widely stated? Why are ze German deaths so much lower? A combo of both ICU treatment pathway and testing?

[morepork]

So, testing not the panacea, as so widely stated? Why are ze German deaths so much lower? A combo of both ICU treatment pathway and testing?

That's a little glib. The need for testing has not changed one bit.

[Mellsblue]

Interesting point from Ben Wallace re empty Nightingales. Could be used as “clean” hospitals to pick up slack for eg cancer patients, out patient appts.