SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

@sullydnl

Slightly scathing opinion on that BMJ article from surgeon pal.


Not peer reviewed
Represents 14% of all cases and 28% of admissions: therefore half of their positives in UK are admissions....only 13% of our positives are admissions-Brits are not testing...ignoring it won’t make it go away
Median age 72....our median is 49. This suggests they are admitting the sickest and diagnosing only them: we know that age is the biggest prognosticator...this study is a function of them not testing enough and admitting too much...our old people are cocooned and safe or dying in nursing homes
Study contributes little and confounds lots
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Virgil said:
Unfortunately the half term holiday in England was from Monday 17 Feb to Friday 21. If you include the weekends this means a large portion of the country was holidaying abroad from the 15th to the 23rd Feb. In many cases in Spain, Italy and France. Would not have been possible to quarantine or track and trace that number of U.K. residents let alone tourists into the country. Timing of the pandemic and the first school holiday period of 2020 combined to create a perfect storm for transmission of the virus. If you wade through the early posts you will even find entries from contributors that had booked/planned breaks abroad in early March who were still intending to travel.
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That's interesting thanks. Looking at some ONS data there were 4.2 million UK resident visits abroad in Feb 2019, difficult to manage those numbers.
That said at some point, maybe late Feb/early March, it would've been appropriate to self-quarantine arrivals from specific regions e.g. Lombardy.
 
RK said:
That's interesting thanks. Looking at some ONS data there were 4.2 million UK resident visits abroad in Feb 2019, difficult to manage those numbers.
That said at some point, maybe late Feb/early March, it would've been appropriate to self-quarantine arrivals from specific regions e.g. Lombardy.
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I think that was a dropped ball for the UK and Ireland. Not just Lombardy. Seems like most ski resorts were petri dishes. If EVERYONE arriving back from the slopes was told to stay at home and keep an eye on their temperature for even just a week it could have had a huge effect on the numbers right now.

Late Feb/early March was a different era though. Would have seemed like a massive over-reaction at the time.
 
Very promising week of lower numbers in hospital terms. Tallied up, after tomorrow there's a good chance we're looking at around 500-600 fewer deaths this week than last. And last week was a bit lower than the one before.

Encouraging to hear Boris mention laying out plans next week. I'm still guessing it's gonna be end of May and we'll get a three-week rollout of sorts with mild lifting of restrictions each week until Monday June 1st which will be considered actual 'out of lockdown' time......but with social distancing etc still highly encouraged and followed.

We're on the way out of this, slowly but surely. Hoping for a good morale boosting number tomorrow to cap the week. I think it was 684 last Friday in hospital terms. Anything below 600 would be good.
 
Balljy said:
Indeed, I had no hot water for a week during the early stages of the lockdown. The fact a plumber came, fixed the issue and maintained a safe distance whilst still putting himself at risk was amazing. I gave him a good tip and he went on to the next urgent job. Without that I would have had months with no hot water.

Electricians, plumbers and the like are at the top end of essential for house owners.
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Yea my phones not ringing though.
 
Wibble said:
If you are old and ventilated the death rate is very high is probably what the article meant.
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Not really. They included ALL hospital admissions. So death rate is very high whether or not ventilated. The median age is high, though. Much older than median age of Irish admissions. Which is hard to explain.
 
Pogue Mahone said:
By the way, I just shared that BMJ article on whatsapp group with friends working in Irish hospitals. They don’t think we’re seeing anything like that kind of mortality. It’s an astonishing figure. Are only very very sick people being admitted in the UK? Do you have step down facilities in the community for less sick people who just need a bit of oxygen?

@africanspur
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So I've just had another look at our numbers as of Monday 27th April, in a trust I would say is one of the best in the country.

Including patients we are still treating, we've had/ have over 1100 patients with Covid. Over 200 of those are still inpatients though. Mortality so far....337, which means our MR (even assuming that those 200 survive, which they obviously all won't....is almost 30%. If we're talking about closed cases, its 36%.

I don't actually know exactly what ED are doing in terms of who they're choosing to admit/discharge generally. I'd say anyone who needs Oxygen is getting referred to us though.

As for step down...we're sometimes discharging patients with saturations in the early 90s if they're clinically well and improving but its a difficult balance.

The numbers make for grim reading.

One thing the trust started doing a while ago which seems to have been picked up by a few others is we're treating d-dimers basically. Giving escalating doses of anticoagulation with rising d-dimer levels.

We'll see in time if this affects outcomes.

What kinds of numbers are you seeing in Ireland?
 
Pogue Mahone said:
Not really. They included ALL hospital admissions. So death rate is very high whether or not ventilated. The median age is high, though. Much older than median age of Irish admissions. Which is hard to explain.
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I wonder if there are a lot of younger Brits with Covid sitting at home with sats in the 80s/ early 90s who aren't being picked up and hospitalised because of our poor accessibility to testing....
 
africanspur said:
I wonder if there are a lot of younger Brits with Covid sitting at home with sats in the 80s/ early 90s who aren't being picked up and hospitalised because of our poor accessibility to testing....
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That was my first thought.

I actually don’t know the numbers in Ireland. Apparently median age of admissions is 49 though. So would expect them to be a lot better.

Re the d-dimers thing, did you see this publication?

https://doi.org/10.1111/bjh.16749

Everyone seems to be giving lashings of LMWH to all inpatients now. Maybe they need some protection after discharge though? Warfarin? DOAC? Definitely needs to be studied. Can add to long list of treatment decisions desperately in need of proper RCTs.
 
redshaw said:


505 today under the old criteria so a very solid week of lower numbers
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25% of those tested infected, does that feel accurate? And is it too simplistic to scale that up as estimate given total population of U.K is pretty much 68 million.

Really fascinated what the current infection rate in U.K is estimated as when reliable antibody tests finally get rolled out.
 
FootballHQ said:
25% of those tested infected, does that feel accurate? And is it too simplistic to scale that up given total population of U.K is pretty much 68 million.
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The vast majority of the people tested have Covid or flu-like symptoms. So you can't extrapolate those figures, they are not from a random sample.
 
spiriticon said:
Not sure about Belgium, but I absolutely believe that the UK and US were not trying their best to save as many as they can from the start. They changed strategies in a hurry though, when it looked like hundreds of thousands are going to die. Sweden is still going, even when the death by capita rate is much higher than the rest of Scandinavia. I don't know if they don't care, or just don't want to care. Either way I find the readiness to take this risk a little too distasteful for my liking, whether or not it works out well in the end.

In the UK, I find the high number of care home deaths and the lack of hospitalisation for this specific population EXTREMELY dodgy, but I don't really want to go too much into any tinfoil hat theories. I'll speculate in my own mind for that one.
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I would counter that median age of patients with COVID in hospital is 72 years old.

Care home deaths are scandalous though, I think a lack of forward planning with regards to not recognising the role staff, visitors might play as spreaders into a vulnerable population with inadequate supervision of testing and PPE.
 
FootballHQ said:
25% of those tested infected, does that feel accurate? And is it too simplistic to scale that up as estimate given total population of U.K is pretty much 68 million.

Really fascinated what the current infection rate in U.K is estimated as when reliable antibody tests finally get rolled out.
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Studies in Germany and Miami put it at five times the registered infections.

The German virologist put the death rate in Germany at 0.37%.

That is still huge given that seasonal flu is less than 0.1%.
 
africanspur said:
I wonder if there are a lot of younger Brits with Covid sitting at home with sats in the 80s/ early 90s who aren't being picked up and hospitalised because of our poor accessibility to testing....
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And also not wanting to come in, not ringing 111, a pandemic of silent hypoxics

Wonder also the BAME demographic perhaps contributing to the slightly mortality rate? Especially in West Midlands and London? And slightly higher rate of south asian population compared to European counterparts in affected hotspots from covid spread?
 
Ish said:
https://www.power987.co.za/news/western-cape-expects-80-000-covid-19-cases-per-week-by-august/

Seems our peaks are far from being reached - July and August being currently envisaged for us (Cape Town), based on their modelling.

The developing world is going to suffer. We've done so well, doing a stringent lockdown very early because of our "unique" society. Truth be told, we don't have the economy that is strong enough to sustain any form of lockdown, so we're having to open up a bit now (after 5 weeks of one of the strictest lockdowns around the world). Now the virus has started spreading through the townships (informal settlement) and there the people just physically cannot self isolate. (imagine families or homes, no bigger than your kitchen, housing 4-7 individuals and they are stacked one on top of the other).

Then we have the issue of aids and TB within the population as well. It's a pity, really. Because we've acted early and we acted swiftly, but there's just no way we had the resources to get ahead of it for a sustained period.

Hope for the best but prepare for the worst I guess.
@kouroux @Shakesey
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Tbh I don't look at numbers anymore, I'm numb to the whole thing. I don't know what to believe, the numbers here have decreased and stabilized after an alarming increase in a span of 4-5 days, still on 2 deaths officially and more than half the contaminted cured officially (that's what makes me skeptical). They say they use the treatment from Professor Raoult and it's helped keep the numbers of deaths low. What is true and what isn't it ? Who knows ? 1089 total infected and 689 cured supposedly.
I do believe that lockdowns and confinement will pay a hefty price long term, many businesses have already shut down and people are very desperate.
 
Ish said:
https://www.power987.co.za/news/western-cape-expects-80-000-covid-19-cases-per-week-by-august/

Seems our peaks are far from being reached - July and August being currently envisaged for us (Cape Town), based on their modelling.

The developing world is going to suffer. We've done so well, doing a stringent lockdown very early because of our "unique" society. Truth be told, we don't have the economy that is strong enough to sustain any form of lockdown, so we're having to open up a bit now (after 5 weeks of one of the strictest lockdowns around the world). Now the virus has started spreading through the townships (informal settlement) and there the people just physically cannot self isolate. (imagine families or homes, no bigger than your kitchen, housing 4-7 individuals and they are stacked one on top of the other).

Then we have the issue of aids and TB within the population as well. It's a pity, really. Because we've acted early and we acted swiftly, but there's just no way we had the resources to get ahead of it for a sustained period.

Hope for the best but prepare for the worst I guess.
@kouroux @Shakesey
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I agree completely.

On top of that, it's worrying that the government is desperately trying to get kids back to school so that parents can go to work.

And then, SA must be the only country that'll start easing restrictions one day after it's biggest spike in cases.
 
Pogue Mahone said:
Not really. They included ALL hospital admissions. So death rate is very high whether or not ventilated. The median age is high, though. Much older than median age of Irish admissions. Which is hard to explain.
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More overwhelmed so leaving old sick people at home and/or in old people's homes until they are really sick maybe?
 
Just thought I would put a few numbers in here for future reference. As we enter the month of May, Norway's numbers are as follows:

* New cases: 889 the last 14 days (daily average 63,5, down from 200+ in late March/early April)
* Less than 100 people currently in hospital
* 30 patients on a ventilator
* 210 dead since March 12th, roughly a 60/40 ratio of care homes/hospitals

So, everything looks hunky-dory at the moment. But this is where the true test begins. Schools (1st to 4th grade) opened this week, as did several one-to-one businesses like hairdressers, physiotherapists, etc. Malls and most other shops have been open throughout this period, so no real change there. A week from now, we'll go from a ban of groups more than 5 to a new limit of 50 people. Oslo will once again be able to provide its people with a cold beer in the spring sunshine. And here is where it gets interesting: Businesses and trade organizations smell blood, probably feeling that the restrictions are somewhat negotiable, and are pressing hard for further relaxation of the rules.

It will be interesting to see the development, as this is a country where the virus is currently very much under control. The people, including the youths, have been remarkably loyal to the restrictions, in all likelihood because they've been able to enjoy quite a bit of freedom, and I hope we're pretty much used to this new way of life to keep sticking with it for the foreseeable future. But there's no doubt that the risk of major outbreaks will increase. The WHO mantra of "test, trace and isolate" is going to be put to the test, and it seems like the authorities are ready now. Even though we have already had a pretty good test per capita ratio, it has been mostly limited to health care personnel and sick patients. But now, everybody with the slightest bit of symptoms are encouraged to get tested, and as others Noggies have mentioned, thanks to the scientists at the NTNU university, we are good to go for anything between 100 - 500.000 tests per week.

While the focus quite rightly have been on some of the bigger European countries having endured incredible pain and hardship this spring, there are many medium/small-ish countries in Europe that have done a great job so far. Czechia, Portugal, Iceland, Finland, the countries in the Baltics and the Balkans, etc. As this is a long, long struggle, it would be interesting in the months to come to hear more from Caftards in said countries about what works and what doesn't.
 
Lena church, pastor sue Pritzker for ‘flagrantly violating’ religious rights during COVID-19 pandemic

LENA (WREX) — An Evangelic Christian church in Lena has filed a lawsuit against Illinois Governor JB Pritzker and leaders in Stephenson County, saying their religious rights have been violated.
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https://wrex.com/2020/04/30/lena-ch...ng-religious-rights-during-covid-19-pandemic/

I'm so tired of these arseholes, I can't imagine being one of the sane ones living other there.
 
sullydnl said:


Is it really that dangerous once you get admitted to hospital? Christ.
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I wish I caught the details but a doctor discussed death rates in hospitals around NYC yesterday. He was quite impressed with the best recovery rate of something like 10% which he called a massive improvement over initial rates. But other hospitals were at 60%. If this takes hold outside of NYC, especially in rural areas, its going to be just awful. They simple aren't equipped and won't have or gain the experience.
 
kouroux said:
Tbh I don't look at numbers anymore, I'm numb to the whole thing. I don't know what to believe, the numbers here have decreased and stabilized after an alarming increase in a span of 4-5 days, still on 2 deaths officially and more than half the contaminted cured officially (that's what makes me skeptical). They say they use the treatment from Professor Raoult and it's helped keep the numbers of deaths low. What is true and what isn't it ? Who knows ? 1089 total infected and 689 cured supposedly.
I do believe that lockdowns and confinement will pay a hefty price long term, many businesses have already shut down and people are very desperate.
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Yeah either way you look, there’ll be a hefty price to pay, but I guess you can’t (or at least shouldn’t) stand by idly and risk lives. Not least until your hand is sort of forced. Seems you guys are doing much better than us though.
Shakesey said:
I agree completely.

On top of that, it's worrying that the government is desperately trying to get kids back to school so that parents can go to work.

And then, SA must be the only country that'll start easing restrictions one day after it's biggest spike in cases.
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Yeah the only chance we had was to try and wipe it out almost completely during this 5 week lockdown - which was mission nigh on impossible.

The school bit is also interesting and high risk. Especially after it was confirmed on here (iirc?) that kids are also high transmitters of the virus. I guess they’re caught between a rock and a very hard place.

Yeah it’s going to be carnage. Economically we can’t survive any form of a lockdown and our hospitals are for sure going to get majorly overrun. Medium term prospects isn’t looking too great at all.
 
golden_blunder said:
They started by saying that they have studied effects on children from past events such as Ebola outbreaks.
Concerned about children from neglected areas, for smaller children impact on social development and for older children they have seen that some children simply don’t come back to school, gave the example of African girls.

There is currently no conclusive evidence about kids transmission of infection to adults or that kids are immune.

Studies show that classrooms could be safer environment than travel, exercise, or general community.

Recommendation is that class sizes do not exceed 15 and that all safety measures are put into place (document that could be downloaded is available)

Recommend that only primary and day care is opened initially so that transmission spread is controlled more than if secondary and university level were opened too.

Ended with a study by Dutch and French modellers - France had to redo model after their government unexpectedly announced schools reopen 11 May.

A load of questions were asked which they didn’t get to, follow up to answer those next week.

Pretty much local decisions and community decisions need to be made at local levels to include local contexts

https://www.unicef.org/reports/key-...sease-covid-19-prevention-and-control-schools
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Very early on in this thread closing schools was considered the absolute minimum to control this. It feels like years ago now but I think I argued it would work so long as other strict measures were put in place. Anyhow, if school closures were the primary requirement, surely that means schools have to be the LAST thing to reopen? I don't see how distancing can be achieved without getting really creative. Double the teachers? Two shifts for students? No playtime, limit visitors. etc.
 
sullydnl said:
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Sweden's half-open society is where most similar countries will end up eventually, but it was definitely not the right place to start for them. As many have pointed out, their inability to shield the elderly, which was their main goal, is a direct consequence of three things:

1. Health care workers being exposed to a higher degree of potential infection in their daily lives.
2. The same health care workers bringing the disease into homes through a lack of PPE.
3. Lack of testing.

The authorities should have realized this, and put the brakes on. I have heard repeated calls in their daily briefings to shield the 70+, but I have yet to hear Tegnell & co explain exactly how they were going to take care of the at-risk citizens. The people have been loyal to the plan, but the plan had gaping holes to begin with.
 
Hansa said:
Sweden's half-open society is where most similar countries will end up eventually, but it was definitely not the right place to start for them. As many have pointed out, their inability to shield the elderly, which was their main goal, is a direct consequence of three things:

1. Health care workers being exposed to a higher degree of potential infection in their daily lives.
2. The same health care workers bringing the disease into homes through a lack of PPE.
3. Lack of testing.

The authorities should have realized this, and put the brakes on. I have heard repeated calls in their daily briefings to shield the 70+, but I have yet to hear Tegnell & co explain exactly how they were going to take care of the at-risk citizens. The people have been loyal to the plan, but the plan had gaping holes to begin with.
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Australia had double the population but under 100 deaths. NZ is about half the size and has had 19 deaths. Surrounding countries, even Denmark who are connected to continental Europe and have a far higher population density are all doing much better than Sweden. Lock downs work if done well - which is why the UK and US have done so badly. We will all have to relax restrictions gradually at the right time but not doing from the start inevitably costs a significant number of people their lives.
 
Wibble said:
Australia had double the population but under 100 deaths. NZ is about half the size and has had 19 deaths. Surrounding countries, even Denmark who are connected to continental Europe and have a far higher population density are all doing much better than Sweden. Lock downs work if done well - which is why the UK and US have done so badly. We will all have to relax restrictions gradually at the right time but not doing from the start inevitably costs a significant number of people their lives.
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Do you think Australia may be due to population density and climate? I know cases and density appears to correlate weakly but that plus climate perhaps?
 
Wibble said:
Australia had double the population but under 100 deaths. NZ is about half the size and has had 19 deaths. Surrounding countries, even Denmark who are connected to continental Europe and have a far higher population density are all doing much better than Sweden. Lock downs work if done well - which is why the UK and US have done so badly. We will all have to relax restrictions gradually at the right time but not doing from the start inevitably costs a significant number of people their lives.
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Yes, Australia and NZ have done great, which, in the case of Australia, is slighty surprising to me, since they have a lot of Chinese/Asian connections. in addition, they are very much a city-based country, with the bulk of the population living much more urban than the size of the country would suggest.

As for Sweden, I'd love it if they were right in their predictions about herd immunity in May (for Stockholm), because then we, and many other countries, would be able to open up and combine a relaxed attitude to infection with heavy testing, tracing and isolation, and come out the other side relatively unscathed. As long as the jury's still out, I'd say they have taken a massive gamble. And I'm not sure if they're happy being the darlings of the American right-wing "''muh rights, open up!" media.
 
senorgregster said:
Do you think Australia may be due to population density and climate? I know cases and density appears to correlate weakly but that plus climate perhaps?
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I think the main factors were that we stopped flights from China and then Italy quite early and locked down quite early. Population density and our ability to lock down internationally and between states has helped but half our population lives in Sydney and Melbourne and 75% live in our five biggest cities so the density is quite high for much of the population.

Sydney made a huge feck up letting a cruise liner full of Covid infected people off without quarantine which has been directly and indirectly the source of a large proportion of our cases. However, high testing levels and very good contact tracing has managed this quite well. I think we had only 11 new cases yesterday and not much more the previous day with only 1 of those was from an unknown source. We are heading into winter so if there is a seasonal factor it is good that we got ahead of things.

Lock down and testing works well.
 
Wibble said:
I think the main factors were that we stopped flights from China and then Italy quite early and locked down quite early. Population density and our ability to lock down internationally and between states has helped but half our population lives in Sydney and Melbourne and 75% live in our five biggest cities so the density is quite high for much of the population.

Sydney made a huge feck up letting a cruise liner full of Covid infected people off without quarantine which has been directly and indirectly the source of a large proportion of our cases. However, high testing levels and very good contact tracing has managed this quite well. I think we had only 11 new cases yesterday and not much more the previous day with only 1 of those was from an unknown source. We are heading into winter so if there is a seasonal factor it is good that we got ahead of things.

Lock down and testing works well.
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Agreed on lock down and testing! Just looking at the density of Sidney and Melbourne. Still 20 fold lower than NYC and 10 fold lower than Stockholm.
 
senorgregster said:
Agreed on lock down and testing! Just looking at the density of Sidney and Melbourne. Still 20 fold lower than NYC and 10 fold lower than Stockholm.
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Greater Sydney includes huge National Parks so the figures are deceptive. The density of the City of Sydney is very nearly double that of Stockholm (and close to the density of the whole of NYC, although I imagine they have areas of much higher density) and the Inner West (the next council out where I live) has a density 1.5 times that of Stockholm. Melbourne City is the most densely populated area of Australia with a density of double that of Sydney City.
 
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Wibble said:
Greater Sydney includes huge National Parks so the figures are deceptive. The density of the City of Sydney is very nearly double that of Stockholm (and close to the density of the whole of NYC, although I imagine they have areas of much higher density) and the Inner West (the next council out where I live) has a density 1.5 times that of Stockholm. Melbourne City is the most densely populated area of Australia with a density of double that of Sydney City.
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Ah, interesting! How is transit there?
 
senorgregster said:
Ah, interesting! How is transit there?
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Highly variable. I used to live just outside Greater Sydney but because I was on a main rail line my daily commute was long (over 4 hrs per day) but not that uncomfortable. We have a few light rail/tram lines in the inner suburbs and a reasonable rail and bus system but in greater Sydney as a whole we are far too reliant in cars and on the popular routes driving is terrible with packed roads and inadequate and badly connected motorway systems. I'm so glad I now live 5.5kms from the center and can cycle to work on bike lanes, side roads and parkways.
 
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