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Torquetalk 14th Mar 2020 17:22


Originally Posted by ATNotts (Post 10713866)
Being callous, probably far too much energy and hospital time is being spent trying to prolong the lives of people who, having caught the virus are gonners because of serious pre-existing conditions. I'd bet that even now people are having adrenaline and oxygen pumping into them that results in delaying their final gasp by a few hours, perhaps a day or so, and where the end game is abundantly clear. that's what hospitals do, rather than allow people to slip away. i know, I've watched it happen. You wouldn't do it to your dog, cat or hamster but it's how we deal with humans.

A reoccurring theme of yours ATNotts, usually in connection with overpopulation. You are arguing for implicit passive euthanasia. Where will you stand when a government wants to carry out explicit and perhaps active euthanasia in “extraordinary times”?

SAMXXV 14th Mar 2020 17:25

The Orange One
 
Now that the USA has decided to extend their ban on flights from the Schengen area to include the UK & Eire, do the venerable members of this forum think that the UK government should quarantine members of the US forces on their UK bases - ie not let them travel past the security gate to local shops/towns? I think particularly about RAF Mildenhall. Bear in mind that various "experts" today reckon that some 10,000 to 15,000 US citizens are probably infected as of today. How do embassy's/diplomatic bags/spies from both the UK & USA operate? How do personnel from the numerous US listening posts carry on movement of people? Discuss - because I am puzzled. This "lockdown" of National borders has got out of logical control in the past 48 hours. There is going to be a global economic disaster within weeks with literally millions out of work worldwide. It does make you wonder along the likes of conspiracy theories as to whether one of the major warring superpowers has instigated this.....

Mr Optimistic 14th Mar 2020 17:30

Gesture politics?

VP959 14th Mar 2020 17:44


Originally Posted by Mr Optimistic (Post 10713905)
Well I am inclined to think they have better information than we do and they have applied a logic which aims for the best outcome, all factors considered.

I'm not at all convinced that the government do have better information. My limited experience suggests that the information that gets fed to decision makers within government is often heavily filtered, usually with the aim of fitting within the preconceived view as to what might be easiest to implement. The one thing the Civil Service is very good at is trying not to rock the boat, or suggest that any extreme course of action should be taken - the whole institution is inherently very conservative (with a small c).

It seems clear that the government of the UK is out of step with pretty much every other world government, bar the USA, and, perhaps, Japan. History will show which chosen strategy works best, but I have an ominous feeling that the one chosen by our government is very high risk indeed. What I suspect may well happen is that we get an early explosion of cases that overwhelms our health care system, much as has happened in parts of Italy. I've been plotting the shape of the curve that the reported cases are following, and it's significantly steeper than exponential.

We are doing nothing at all to limit that rate of increase right now. Hell, we're not even bothering to routinely test to find out the extent of the problem we're facing.

Reported cases here are roughly doubling every 4 days, and it's not at all hard to do a few sums and see where that gets us by early May (using the estimate that in all probability we had around 5,000 to 10,000 cases on Thursday). The fact that the majority of cases may be mild isn't at all important. The important figures from China are that about 14% of patients needed hospitalisation and around 6% needed intensive care.

KelvinD 14th Mar 2020 17:50

I don't think the UK should be listening to lessons from Italy. With a death rate of 7.7% and a recovery rate of only 8.15%, Italy is not having a great deal of luck. The one thing Italy should be congratulated on is their testing rate of over 60,000 so far.
There has been a chorus here in the UK of people asking why the UK government is not taking the same actions as other European countries. Why should we? No European country has yet shown any of their measures have contributed seriously to the reduction or containment of the disease. In the UK, a couple of serious scientists have explained the logic of the government's plans and I have to agree with them. We have been reading about Italian doctors being faced with the choice of which patients to keep on a machine and which ones will be left to either get better or die. This has been put down to a massive surge in patient numbers, overloading the health services. The plan here is to flatten out that surge in numbers in order to give the health service a fighting chance and avoid the overwhelming we have seen in Italy.

ATNotts 14th Mar 2020 17:50


Originally Posted by Torquetalk (Post 10713908)
A reoccurring theme of yours ATNotts, usually in connection with overpopulation. You are arguing for implicit passive euthanasia. Where will you stand when a government wants to carry out explicit and perhaps active euthanasia in “extraordinary times”?

Perhaps you haven't sat at the side of a hospital bed watching someone trying to slip away, but being pumped with oxygen, adrenaline and other drugs to defer the inevitable. if you had then perhaps you may see from where I am coming.

Nobody in their right mind would argue for active euthanasia, and there is no way that any government, perhaps with a couple of exceptions would ever consider such a thing. However where the prognosis is crystal clear, the where is the case for simply deferring the inevitable. What I was saying, and I'll say it again is that if there is a shortage of ICU beds, and a shortage of equipment to aid breathing, then if there is a patient that has reached that critical point of no return, where is the sense for the patient, their relatives, the hospital staff and facilities in delaying death by hours when there could be another patient waiting on a trolley for that bed, who may have had a better chance of recovery, but is denied it by the prolongation of the life of a terminal patient.

In my personal case, we were advised the grave situation at 15:00 one afternoon, and death arrived, after two resuscitation at 02:30 the next day.

Over population is a completely different case, and I can never recall having advocated (seriously at any rate) euthanasia of people who reach a arbitrary age or state of health.

VP959 14th Mar 2020 17:56


Originally Posted by KelvinD (Post 10713929)
I don't think the UK should be listening to lessons from Italy. With a death rate of 7.7% and a recovery rate of only 8.15%, Italy is not having a great deal of luck. The one thing Italy should be congratulated on is their testing rate of over 60,000 so far.
There has been a chorus here in the UK of people asking why the UK government is not taking the same actions as other European countries. Why should we? No European country has yet shown any of their measures have contributed seriously to the reduction or containment of the disease. In the UK, a couple of serious scientists have explained the logic of the government's plans and I have to agree with them. We have been reading about Italian doctors being faced with the choice of which patients to keep on a machine and which ones will be left to either get better or die. This has been put down to a massive surge in patient numbers, overloading the health services. The plan here is to flatten out that surge in numbers in order to give the health service a fighting chance and avoid the overwhelming we have seen in Italy.


Just how do any of the measures announced here slow down the rate of infection, though?

Italy got seriously caught out by not testing enough people early on, so they just didn't know what was about to happen. Look at the graph of cases in Italy over time; there's a massive step that coincides with them waking up and starting to do mass testing. Sadly this was too late.

We're doing the same. Our government has announced that they are not going to do any routine testing, only those admitted to hospital will be tested. This seems like a recipe for emulating the situation that Italy had to me.

OldnGrounded 14th Mar 2020 18:05


Originally Posted by KelvinD (Post 10713929)
I don't think the UK should be listening to lessons from Italy. With a death rate of 7.7% and a recovery rate of only 8.15%, Italy is not having a great deal of luck.

At this stage of the outbreak, the case fatality rate and recovery rate in Italy are impossible to calculate with even slightly-meaningful results. Don't pay any attention to today's numbers in those categories.

Here's one (interim) statistic to think about: Italy has, by far, the world's highest per-capita known case count, almost 350 per one million population. The UK is at about 17 per million at the moment. I'm pretty sure that the UK isn't any more prepared to handle a similar healthcare system burden than any other nation.

And, just for information, the worldwide closed-case fatality rate is currently at about 7% (using WHO statistics). That's going to change significantly over the long term, also . . . probably.

OldnGrounded 14th Mar 2020 18:09


Originally Posted by VP959 (Post 10713940)
Just how do any of the measures announced here slow down the rate of infection, though?

As you suggest, they won't. They can't. If the UK strategy is to, in some measure, "get it over with" on the way to herd immunity, the world is going to be treated to an interesting experiment.

ATNotts 14th Mar 2020 18:21


Originally Posted by OldnGrounded (Post 10713949)
At this stage of the outbreak, the case fatality rate and recovery rate in Italy are impossible to calculate with even slightly-meaningful results. Don't pay any attention to today's numbers in those categories.

Here's one (interim) statistic to think about: Italy has, by far, the world's highest per-capita known case count, almost 350 per one million population. The UK is at about 17 per million at the moment. I'm pretty sure that the UK isn't any more prepared to handle a similar healthcare system burden than any other nation.

And, just for information, the worldwide closed-case fatality rate is currently at about 7% (using WHO statistics). That's going to change significantly over the long term, also . . . probably.

I'm sure the UK isn't prepared, the NHS appears to lurch from one crisis to the next, and with the public believing the emergency department is the go to service for minor coughs, cold, bumps and grazes, without a major change in the mindset of the population at large any really major outbreak of cases requiring hospital treatment will really cause issues.

I'm intrigued by the worldwide closed-case fatality rate. I assume that it is a calculation based upon the number of patients diagnosed, or is it the number of people detained in hospital. What it can't be is a definitive number based upon all cases, many of which will have been mild and handled at home, without any referral to medical services or testing. Statisticians can make a best guess as to how many of those there are, or what percentage of people who have contracted the virus will self treat at home, or even be running around in blissful ignorance, but there can surely be no truly reliable figures.

Mr Optimistic 14th Mar 2020 18:23

Didn't they ask that people self- isolate if they have symptoms? Aren't business's encouraging working from home? How does this really differ from Spain's lockdown which allows people to go to work or go out ' shopping for food'? Of course they could do more but they don't want to because based on their data and their considerations they think there is a better way to address the needs of the whole nation. Don't know whether individuals think themselves better placed to gainsay the government, or have a more humanitarian attitude, but at least allow for the possibility they may be doing the best for us, or at least they think they are.
I am not short of opinions myself but I have sympathy for all authorities at the moment. They are on a hiding to nothing, including internet forums.
I posted a reasoned opinion by a front line doctor above. Ok, he admits he might be wrong, but he concurs with the current actions: at least for now.

VP959 14th Mar 2020 18:29


Originally Posted by Mr Optimistic (Post 10713966)
Didn't they ask that people self- isolate if they have symptoms? Aren't business's encouraging working from home? How does this really differ from Spain's lockdown which allows people to go to work or go out ' shopping for food'? Of course they could do more but they don't want to because based on their data and their considerations they think there is a better way to address the needs of the whole nation. Don't know whether individuals think themselves better placed to gainsay the government, or have a more humanitarian attitude, but at least allow for the possibility they may be doing the best for us, or at least they think they are.
I am not short of opinions myself but I have sympathy for all authorities at the moment. They are on a hiding to nothing, including internet forums.
I posted a reasoned opinion by a front line doctor above. Ok, he admits he might be wrong, but he concurs with the current actions: at least for now.


I don't do Facebook etc, but a friend that does tells me that it's stuffed full of people saying things like "I'm just going to the doctors, as I have a sore throat". If that's indicative of the way many of the sheeple are behaving (and I suspect it is) then the infection rate is likely to increase, as a consequence of their gross stupidity, rather than decrease.

It seems that many are completely ignoring the advice to check the 111 website, or 'phone 111 if they really have to, and are turning up at their GP, or even A&E, with minor symptoms that they'd not have given a moment's concern about a few weeks ago.

ATNotts 14th Mar 2020 18:32


Originally Posted by VP959 (Post 10713973)
I don't do Facebook etc, but a friend that does tells me that it's stuffed full of people saying things like "I'm just going to the doctors, as I have a sore throat". If that's indicative of the way many of the sheeple are behaving (and I suspect it is) then the infection rate is likely to increase, as a consequence of their gross stupidity, rather than decrease.

It seems that many are completely ignoring the advice to check the 111 website, or 'phone 111 if they really have to, and are turning up at their GP, or even A&E, with minor symptoms that they'd not have given a moment's concern about a few weeks ago.

The cohort that is usually labelled as the "worried well" and in the current circumstance the bloody irresponsible!. Hypochondriacs is what they would have been called.

VP959 14th Mar 2020 18:37


Originally Posted by ATNotts (Post 10713980)
The cohort that is usually labelled as the "worried well" and in the current circumstance the bloody irresponsible!. Hypochondriacs is what they would have been called.

The problem is that these reckless and inconsiderate people never get sanctioned by anyone for their gross stupidity. Much as I endorse the core principle of the NHS, healthcare that's free for all at the point of use, I have often thought that there should be a refundable deposit paid by everyone who seeks medical attention. If they are genuinely in need of professional healthcare they get it back, if they are time wasters they don't.

Torquetalk 14th Mar 2020 18:42

ATNotts

I doubt very much that when resources get tight, that they will be directed to those cases where there is no hope. When did that ever happen (apart from in a pay to live health system of course...)? Refer to bulldog89's post (2000).

Contrary to your assumption, I have been there (haven't most of us?). And of course, I don't think that needlessly prolonging suffering or life for a very short period of time is a good use of resoruces or always the right thing to do. But whilst some want to go, others don't. The driver for that has to come from the patient and a little professional discretion left to medical staff.

The UK health system has the luxury of capacity and will comfortably take this in its stride. Heaven knows how rough it could get if the health system were already under great stress.

Peter H 14th Mar 2020 18:44


Originally Posted by OldnGrounded (Post 10713949)
And, just for information, the worldwide closed-case fatality rate is currently at about 7% (using WHO statistics). That's going to change significantly over the long term, also . . . probably.

Do you have any guesstimate of the current IFR?

Pontius Navigator 14th Mar 2020 18:45

I see the Government strategy is to get the ones who feel ill off the streets accepting that many will be infected but not ill. We therefore have the cohort of infected but no symptoms, the next with mild symptoms who stay at home for 7 days before venturing out to infect the next cohort also hopefully not requiring treatment. This leaves the vulnerable, the aged, the infirm, and a few not in the at risk group who all need hospital treatment.

That last group is the critical group who can swamp intensive care facilities. I know many in our group are split between social separation and carry on as normal. I have experienced a certain amount of 'reluctant understanding ' or active encouragement not to isolate.

We are the critical group on which the Government policy will be tested.

ORAC 14th Mar 2020 18:45

I have a routine annual set of blood tests plus routine health check weight, blood pressure etc. Arranged and had the blood tests myself in January and left a note for my GP saying if there was a problem with the results, let me know and I’d come in and see him.

Just had an auto generated message from their system saying I am “invited for a review of my health conditions” and to contact the surgery to make an appointment.

If they think I am going into the surgery and sitting in the reception for an hour waiting to have my weight and blood pressure checked during the next few months they’re crazier than I am......

Mr Optimistic 14th Mar 2020 18:49

Yes, and perhaps the public attitude indicates that a lock down wouldn't be honoured until the headlines scream at us. So not yet. Given the selfish panic buying, what would happen if they now said ' ....as from Tuesday...'
But, those who say they should do more will be able in retrospect to say told you so, totally in the absence of any data as to how their counterfactual model would have worked out. As I say, the authorities have my sympathy.
As for the USA, as the virus is already there, what is the point of banning overseas arrivals. Would a restriction on internal travel make more sense? Now try imposing that.

ORAC 14th Mar 2020 18:50

Norway will temporarily shut all its airports from Monday in a move to curb the spread of coronavirus the country’s prime minister, Erna Solberg, said on Saturday.

The death toll in Spain reached 190 on Saturday, up from 120 the day before.

France has reported a total of 4,499 confirmed coronavirus cases – up from 3,661 on Friday


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