TR5tar Posted March 13, 2020 Share Posted March 13, 2020 41 minutes ago, PaulAA said: Hi Chris From what I have seen published, this is still a supposition and not supported by the (admittedly as yet lower) community spread in the southern hemisphere. There is already a report, based on modelling of earlier non-pharmaceutical interventions in China, that suggest substantial reductions in spread would have been achieved if the lock-down had been enforced just one week earlier. Hindsight is great, but the UK Govt does appear to be somewhat cavalier in its response to the risk. Paul It's a difficult decision for any government as to when to pull the trigger Paul. They can only go on the scientific advice that they are being given. That may well be wrong, but it would be a huge gamble to ignore it. I've no doubt that the lockdown will come. We just have to hope that it's the right time. Darren Link to comment Share on other sites More sharing options...
PeterC Posted March 13, 2020 Author Share Posted March 13, 2020 3 hours ago, AB|W said: Ramblings of an old man. Can someone explain what happened in China please? They quarantined 60million people, but only, according to figures about 100k had the virus. That is a very low number why did not 10 million or so catch the virus? An infection of 1:600 is very good, OK the figures are dubious but the result is still very impressive especially with such high-density living accommodation. In the UK in the early days we had relatively few cases but a disproportionate of elderly seemed to die, is that because there are many, many more cases of very low level infection going unnoticed? I was reading of the very low levels of infection in Africa many cases of infection are obviously not being reported but agencies on the ground are not reporting deaths amongst the elderly. Are there substantial percentages of the population out there with an immunity to Coronavirus infections? Or is coronavirus a binary infection needing an additional secondary condition or genetic disposition to do its worst not just the more obvious existing lung infections as per many reports of fatalities? Alan IIRC around 80% of a population have to contract the virus for herd immunity to then stop its spread. It looks like Wuhan stopped the virus spreading but have not got herd immunity. So it could bounce back. UIK present trajectory may be designed to get herd immunity..but it will kill many elderly if we do not isolate now. Peter Link to comment Share on other sites More sharing options...
AB|W Posted March 13, 2020 Share Posted March 13, 2020 Peter, How do we self isolate? I can understand easily a couple of weeks but then back out into the virus ridden community? The UK wants the infection peak in 10-14 weeks time, that then implies another 10-14 weeks to wind down - September, how can we reasonably self-isolate until September at least or more probably until a vaccine is available Feb -Mar 2021. Its a big ask. I have been watching with interest the infection in Iceland I was surprised by its developing pattern with such a small population - and probably D3 deficient up there. F1 Melbourne cancelled for one team member - one case £200 million in revenues gone - that poor sod might hold the record for the most expensive case to date. Unsure how football cancelling for a couple of weeks will make everything OK in April, I expect some rather large bullets need to be bitten in all sports including the Olympics. Without matches and gate receipts hard to see many football clubs will survive. Incidentally I cant ever see the rationale for a lockdown, if we had a draconian lockdown when it started in China we would now be clear but then we would be re-opening the borders again and importing more virus, hard to see a course of action for a single country it needs a co-ordinated global response. Not too much of an upside at the moment, where is remdesivir when you need it? Alan Link to comment Share on other sites More sharing options...
PeterC Posted March 13, 2020 Author Share Posted March 13, 2020 1 hour ago, AB|W said: How do we self isolate? I can understand easily a couple of weeks but then back out into the virus ridden community? The UK wants the infection peak in 10-14 weeks time, that then implies another 10-14 weeks to wind down - September, how can we reasonably self-isolate until September at least or more probably until a vaccine is available Feb -Mar 2021. Its a big ask. Alan, I do not see an alternative. We have no immunity, no vaccine, no drug. It is a big ask, but the alternative , if we are in the unfotunate 1 or2% ( or 6% in Italy) "...is dangerous, it brings on many changes". However there will be an enormous global research effort to discover an answer, assuming that a cull of us oldies is regarded as undesirable. I do wonder about that .... Peter Link to comment Share on other sites More sharing options...
Nick Jones Posted March 13, 2020 Share Posted March 13, 2020 I wouldn’t include anyone who is still able to live an independent life, but to bring a whole county to a halt to try and “save” those relatively few who are basically at deaths door already seems particularly daft to me. Link to comment Share on other sites More sharing options...
PeterC Posted March 13, 2020 Author Share Posted March 13, 2020 6 minutes ago, Nick Jones said: I wouldn’t include anyone who is still able to live an independent life, but to bring a whole county to a halt to try and “save” those relatively few who are basically at deaths door already seems particularly daft to me. Saving those tens of thousands in nursing homes probably wont be feasible, not with 3 shifts of carers a day coming and going. And shedding virus before becoming symptomatic. Peter Link to comment Share on other sites More sharing options...
mattius Posted March 13, 2020 Share Posted March 13, 2020 I wouldn't say its just those at deaths door, anyone with lung conditions is particularly vulnerable, take the likes of my dad with chronic lung disease, still fully healthy, still goes fishing twice a week, walks the dog three times a day, hardly at deaths door! Yet if he were to get this virus it would highly likely be critical! Same for anyone with serious asthma or COPD or heart conditions... That being said common sense approach should be applied, i am very surprised the Government haven't told everyone who can work from home to work from home, likewise the English Government not banning mass gatherings. We have isolated ourselves from our parents, but that is because the Mrs is part of the NHS response to the virus and my work has just had two confirmed cases. Common sense like that is what we need, the problem is people ignore it unless they are specifically told! The cases at work are because someone came back from Italy with a cough and spent 2 days in work before seeking help! Now 30 other people who came into contact with them are in isolation! It is an incredibly hard thing though, when to pull the trigger, and im pretty sure it will be when... Link to comment Share on other sites More sharing options...
zetecspit Posted March 13, 2020 Share Posted March 13, 2020 I am in Austria (St Anton) skiing. Until 3pm when all lifts suddenly shut unexpectedly. And as we returned to our chalet, people everywhere with suitcases. It seems the mayor +or suchlike) had had a panic attack, and shut the whole place down. Checkpoints in and out, we are getting forms tonight so we can leave as expected tomorrow. And absolutely no indication of why. Seems a lot of knee-jerk reactions, causing more panic which is seriously bad news for people. This is all a bit unchartered territory for the world population. I am deeply suspicious of the latest Chinese figures, and as above, can see it spreading directly people start to mix again. Many are probably keeping quiet,band their govt is not exactly open about stuff. I just hope things progress smoothly, though I have deep concerns over my parents, and indeed some friends. Just hoping we do better than Italy. Link to comment Share on other sites More sharing options...
Nick Jones Posted March 13, 2020 Share Posted March 13, 2020 Agree Matt. My father would be at severe risk also, so he will take his own precautions. I just think that “stopping the world” will actually have longer lasting and potentially more damaging consequences for the vast majority of the population. Hope you get home without too much aggro Clive. Link to comment Share on other sites More sharing options...
Chris W Posted March 13, 2020 Share Posted March 13, 2020 3 hours ago, PeterC said: …………... assuming that a cull of us oldies is regarded as undesirable. I do wonder about that .... Peter you might wonder, Peter but the 'Twitter crazies' are waaaaaaaay ahead of you. It seems the Government response (out of step with everyone else) is all about a conspiracy to cull the rich, aged, property owning wrinklies, to save on pensions and reduce the pressure on the NHS. Link to comment Share on other sites More sharing options...
Chris W Posted March 13, 2020 Share Posted March 13, 2020 2 hours ago, mattius said: That being said common sense approach should be applied, i am very surprised the Government haven't told everyone who can work from home to work from home, likewise the English Government not banning mass gatherings. I don't think the government can 'tell' people to work from home. Nevertheless my company has already implemented this policy for its employees and travel bans within the UK. Many of our clients are not allowing visitors on their sites anyway so commercial activity is slowing down. Link to comment Share on other sites More sharing options...
JohnD Posted March 13, 2020 Share Posted March 13, 2020 Clive, one of the first of the infected in Europe was someone, just back from business in China and 'enjoying' a family skiing holiday! And he was a "super-spreader"! John Link to comment Share on other sites More sharing options...
thebrookster Posted March 13, 2020 Share Posted March 13, 2020 My employer has just implemented a "moratorium" on crew changes until 30th April. Where shipping is concerned we are tiny (30 odd vessels), some other shipping companies have hundreds of vessels with crew unable to go home (either due to company stopping crew change or because countries have closed borders). Gonna be interesting times. My prognosis right now is I will be delayed crew change by up to two months, so instead of 3-3.5 months trip I am expecting up to 6 months this time. Good thing I have a year's supply of Vit D3 capsules with me Phil Link to comment Share on other sites More sharing options...
PeterC Posted March 13, 2020 Author Share Posted March 13, 2020 1 hour ago, Chris W said: you might wonder, Peter but the 'Twitter crazies' are waaaaaaaay ahead of you. It seems the Government response (out of step with everyone else) is all about a conspiracy to cull the rich, aged, property owning wrinklies, to save on pensions and reduce the pressure on the NHS. I could see the logic in that if I were a 30-something living at home with aged parents. Thinking about it, there's a solution, without having to move home for parenticidals. Link to comment Share on other sites More sharing options...
Chris W Posted March 13, 2020 Share Posted March 13, 2020 8 hours ago, PeterC said: IIRC around 80% of a population have to contract the virus for herd immunity to then stop its spread. It looks like Wuhan stopped the virus spreading but have not got herd immunity. So it could bounce back. UIK present trajectory may be designed to get herd immunity..but it will kill many elderly if we do not isolate now. Peter Hi Peter, I read that it was 60% infection for herd immunity but that is still a staggering 40m people and with the UK demographic there's the distinct possibility of a huge spike in mortality. It also means that there will be a lot of people dealing with complications like pneumonia, at home as there won't be enough beds/equipment to deal with the afflicted, even if spread over a 14 week period. Government policy has to be concerned with the best outcome for the majority but as a consequence, there are going to be a lot of tragic stories at a family level. Link to comment Share on other sites More sharing options...
AB|W Posted March 13, 2020 Share Posted March 13, 2020 Peter, Please find the two following links https://www.livescience.com/how-coronavirus-infects-cells.html This indicates Coronavirus enters human cells. via ACE2 https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(20)30116-8.pdf And a Lancet article / correspondence relating to Coronavirus affecting Diabetes and hypertension patients as the medication increases the expression of ACE2 receptors. At the top of column two however it states that ibuprofen also increases the expression of ACE2 receptors. D3 of course supresses ACE2. Surely this implies that "casual use" of Ibuprofen should be discouraged during the present pandemic. Alan Link to comment Share on other sites More sharing options...
PeterC Posted March 13, 2020 Author Share Posted March 13, 2020 21 minutes ago, Chris W said: Hi Peter, I read that it was 60% infection for herd immunity but that is still a staggering 40m people and with the UK demographic there's the distinct possibility of a huge spike in mortality. It also means that there will be a lot of people dealing with complications like pneumonia, at home as there won't be enough beds/equipment to deal with the afflicted, even if spread over a 14 week period. Government policy has to be concerned with the best outcome for the majority but as a consequence, there are going to be a lot of tragic stories at a family level. Chris, here's a virologists take.....1 million deaths in UK https://theconversation.com/coronavirus-can-herd-immunity-really-protect-us-133583 Peter Link to comment Share on other sites More sharing options...
PeterC Posted March 13, 2020 Author Share Posted March 13, 2020 8 minutes ago, AB|W said: Peter, Please find the two following links https://www.livescience.com/how-coronavirus-infects-cells.html This indicates Coronavirus enters human cells. via ACE2 https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(20)30116-8.pdf And a Lancet article / correspondence relating to Coronavirus affecting Diabetes and hypertension patients as the medication increases the expression of ACE2 receptors. At the top of column two however it states that ibuprofen also increases the expression of ACE2 receptors. D3 of course supresses ACE2. Surely this implies that "casual use" of Ibuprofen should be discouraged during the present pandemic. Alan Alan. Confirmatory piece was on the BMJ site.(now overloaded). I do wonder as the number of ACE_2 receptors will vastyl exceed viral particles if infectivty would alter ? with or without ibuprofen, or D3. Peter Link to comment Share on other sites More sharing options...
mattius Posted March 13, 2020 Share Posted March 13, 2020 The Mrs is privy to a lot more information than i am allowed to hear, all i can say is i have never seen her nervous about situations before (we've been through H1N1, SARS etc), but she is very nervous about the next few weeks! What will happen next week in the NHS is unprecidented Link to comment Share on other sites More sharing options...
PeterC Posted March 13, 2020 Author Share Posted March 13, 2020 https://blogs.bmj.com/bmj/2020/03/12/matt-morgan-a-letter-from-icu/ For decades we have been able to seek help from the NHS. They really do care, as we read above. But this virus means , to me, that our dependency culture upon the NHS perforce must end. All of us oldies need to go into protective isolation, not least as an act of self preservation. We who are retired and independent owe it to the infirm and compromised younger members of society to make every effort to avoid infection. If we do not isolate ourselves and succumb to the virus we may well find that in the triage stakes for admission to an ICU we are bottom of the heap. France has implemented the policy of the aged isolating themselves and I am convinced UK should be doing the same. Dependency upon NHS when it can be avoided should be....must be. It is going to be a looooong year away from family and friends. Peter Link to comment Share on other sites More sharing options...
PaulAA Posted March 14, 2020 Share Posted March 14, 2020 We entered the first stage of isolation here last night. All public places where people may contact (schools, universities, shops, cinemas, gyms, museums, public offices) have been closed. Food stores and pharmacies stay open. Flights into the country stopped, land borders closed to all but Polish citizens. Gatherings limited to 50 people, business strongly advised to operate from home. Anybody allowed in to the country on grounds of citizenship subject to 14 days quarantine. One of my staff has a colleague in the army, who has been mobilised to the outskirts of Warsaw, suggesting that movement within the country may be restricted. For those that remember it, the ghost of Martial Law in 1981 is being conjured up. Paul Link to comment Share on other sites More sharing options...
PeterC Posted March 14, 2020 Author Share Posted March 14, 2020 https://medicalxpress.com/news/2020-03-coronavirus-quickly-people-symptoms.html Link to comment Share on other sites More sharing options...
JohnD Posted March 14, 2020 Share Posted March 14, 2020 From the BMJ: https://blogs.bmj.com/bmj/2020/03/12/matt-morgan-a-letter-from-icu/?fbclid=IwAR3muC2lg9qRNc3K5Yb34UuRTHH5Zk1LZ_9r2kNsqawg-_f3wTMLEpAXekw Matt Morgan: A letter from ICU March 12, 2020 To those who are elderly, frail, vulnerable, or with serious underlying health conditions, We have not forgotten about you. It must be so hard listening to endless news reports that end with “don’t worry, this illness mainly affects the elderly, frail, vulnerable, or those with serious underlying health conditions.” What if that is you? Our passion as an intensive care community is fixing problems that can be fixed. Yet we often meet patients like you who have problems that cannot simply be fixed. As this virus continues to impact on the world, we will meet many more of you. Although we have fancy machines, powerful drugs, and talented staff, none of these things cure every disease. All they do is give us time – time to work out what is wrong, time to hopefully treat it, and time for people to get better. But sometimes we already know what is wrong, we already know that there is no effective treatment. And so sometimes the machines offer little, intensive care offers no fix. But hope is not lost. We have not forgotten about you. As difficult as this is, we will be honest. We will continue to use all of the treatments that may work and may get you back to being you again. We will use oxygen, fluid into your veins, antibiotics, all of the things that may work. But we won’t use the things that won’t work. We won’t use machines that can cause harm. We won’t press on your chest should your heart stop beating. Because these things won’t work. They won’t get you back to being you. And If these things are still not enough, we will sit with you and with your family. We will be honest, we will hold your hand, we will be there. We will change our focus from cure but most importantly we will continue to care. We have not forgotten about you. Signed, The Intensive Care Unit Matt Morgan, honorary senior research fellow at Cardiff University, consultant in intensive care medicine, research and development lead in critical care at University Hospital of Wales, and an editor of BMJ OnExamination. Link to comment Share on other sites More sharing options...
zetecspit Posted March 14, 2020 Share Posted March 14, 2020 Today was "interesting" We were shuttled to the outskirts of teh resort in a minibus unload, then had to present our "papers" at the armed roadblock. Walk 10yrds and get on teh coach. One bloke was wearing a facemask, looked remarkably like a "nuisance" mask from screwfix, but he kept spluttering, sticking fingers inside the mask (!) and doing everything wrong according to medical advice. And totally isolated. The rest of us were chatting away making the best of the trip, and no doubt enjoyed ourselve all the more for it. Airport was quiet, but landing at Gatwick was eerie. Very few people about, no queues etc. Then picke dthe car up, and popped into a supermarket on teh way home. Hardly worth bothering. We did find 2x1pt of milk (no other options at all) and some rolls. Plenty of eggs, bacon and a few bangers. But no pasta/rice etc or even baked beans! Hoping they restock and we can do a shop on Monday. Otherwise off to the chippy.... Link to comment Share on other sites More sharing options...
PaulAA Posted March 15, 2020 Share Posted March 15, 2020 In a little sign of... humanity, Welt am Sonntag is reporting today that Trump has approached a German pharmaceutical company, looking to purchase exclusivity for a potential covid-19 vaccine they are developing: https://www.welt.de/wirtschaft/article206555143/Corona-USA-will-Zugriff-auf-deutsche-Impfstoff-Firma.html The US govt is quoted as saying "only for the USA" Nice. Link to comment Share on other sites More sharing options...
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