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Covid 19, novel corona virus. Split from off-grid thread


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The Pfizer vaccine is a 'concentrate' - I know nothing of the AstraZeneca.     Once allowed to defrost, it is diluted into a solution from which individual doses may be drawn.     This is a skilled task, that is being allocated to experienced nurses and pharmacists who are familiar with the techniques, not to the retired medics and others who will give the injections.

There are, I think, six doses per vial, but careful diluting and drawing up can sometimes deliver one more at full strength.      My previous experience of new medical devices and such lead me to think that this will be corrected in the future!

Nice idea, Roger, unless one is a marmalade fan, but these are vials, with a rubber cap, though which the dilution and drawing up is done.     Although early production of penicillin was done in any glass vessel that could be adapted, milk bottles  or winchesters.

How the 'wonder drug' penicillin went from discovery to mass production,  and the role St. Louis had in it | Post-Dispatch Archives | stltoday.com

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1 hour ago, MilesA said:

Indeed. If he or his staff had looked even superficially at the other modules they would have realised that many others were also irrelevant to the role. 

My wife has now successfully passed all modules - the final one took  about 4 hours study (I did mention she was driven). We will now see what the next stage in the process is.

Miles

Miles

Your wife's dedication is commendable - I am full of respect.

As for the next stage... I fear that recent history suggests that she and selfless others like her can look forward to a sudden change of direction that renders the time and commitment pointless.  But I hope my cynicism is ill-placed.

Paul

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4 hours ago, JohnD said:

The Pfizer vaccine is a 'concentrate' - I know nothing of the AstraZeneca.     Once allowed to defrost, it is diluted into a solution from which individual doses may be drawn.     This is a skilled task, that is being allocated to experienced nurses and pharmacists who are familiar with the techniques, not to the retired medics and others who will give the injections.

There are, I think, six doses per vial, but careful diluting and drawing up can sometimes deliver one more at full strength.      My previous experience of new medical devices and such lead me to think that this will be corrected in the future!

Nice idea, Roger, unless one is a marmalade fan, but these are vials, with a rubber cap, though which the dilution and drawing up is done.     Although early production of penicillin was done in any glass vessel that could be adapted, milk bottles  or winchesters.

How the 'wonder drug' penicillin went from discovery to mass production,  and the role St. Louis had in it | Post-Dispatch Archives | stltoday.com

They're the things.  A couple of dozen should sort it.

 

Roger

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5 hours ago, PaulAA said:

Miles

Your wife's dedication is commendable - I am full of respect.

As for the next stage... I fear that recent history suggests that she and selfless others like her can look forward to a sudden change of direction that renders the time and commitment pointless.  But I hope my cynicism is ill-placed.

Paul

Paul,

Au contraire, I am hoping your cynicism is justified. A sudD3en change in direction will end the pandemic whatever new variants evolve. The crash in deaths in summer across several nations shows what could be  achieved with year-round good 25(OH)D. 

http://www.drdavidgrimes.com/2020/12/

While Hancocks public health experts blame the dip upon open windows in summer and virus killing in sunlight, the dramatic drop suggest there's an amplified process at play. Serum 25(OH)D in UK rises from below 50 in March to around 75 nmol/L at end-summer due to sunlight and incidental D3 production. The stimulation of innate immunity not only reduces risk of death from C-19 but also reduces infectivity of an individual by inacivating the virus before it gets into cells to multiply. Amplification of biological action is at play in that summer dips.

Popping a couple of gel capsules costing a couple of pennies a day is vastly more feasible than re-vaccinating a nation twice again and again as the virus mutates to avoid the vacccine. And that is what Hancock envisages: repeated weaked vaccination, like flu. (answer to MP question, BBC today) There is concern that the SA variant with 5 mutations in the spike protein will not be effectively disabled by the current vaccine. And teenagers in SA are falling seriously ill. We also seee the young to middel aged adults falling ill with the Kent variant. So all ages will be vulnerable and the nect geneartion tweaked vacccine will need to be injected inot most of the 60 million at risk, twice.  And then yet another variant evolves somewhere on the planet............

Sad to see ignorance of D3 creating such  easily avoidable death and destruction.

Peter

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6 hours ago, JohnD said:

The Pfizer vaccine is a 'concentrate' - I know nothing of the AstraZeneca.     Once allowed to defrost, it is diluted into a solution from which individual doses may be drawn.     This is a skilled task, that is being allocated to experienced nurses and pharmacists who are familiar with the techniques, not to the retired medics and others who will give the injections.

There are, I think, six doses per vial, but careful diluting and drawing up can sometimes deliver one more at full strength.   

IIRC, the official guaranteed doses per vial was 5.  In practice though, I think it's been found that most vials yield 6 doses and some 7.  This is why the vaccination session that SM was involved with found they had almost 200 extra doses - + 20%.

this RPS page has some interesting links on it

https://www.rpharms.com/resources/pharmacy-guides/coronavirus-covid-19/covid-19-vaccines/vaccine-dose-interval-changes?utm_source=Royal Pharmaceutical Society&utm_medium=email&utm_campaign=12077764_January COVID Newsletter no. 52 for members&utm_content=vaccine dosing interbal&dm_i=EQ,76V9G,3IH0I1,T4SK6,1

This shows for example that up to 12 weeks between doses is built into the Astra Zeneca vaccine, but the case for doing the same with the Pfizer one is at best unproven. 

I'm taking my D3 and advising my nearest and dearest to do the same.  As I'm sure I've said before - it costs buttons, won't don't you any harm and might well save your life.

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I heard the news today, oh boy! Not about holes in Blackburn, but that massive vaccination centres are to open next week.     In Lancaster and Morecambe, Vaccination Centres have been operating for TWO weeks!      Already, they have vaccinated 40% of the vulnerable people in the area.    It would have been more, but several deliveries of vaccine have failed and some have been much smaller than promised.  I was helping on Friday and we were getting to younger age groups and community NHS staff.       That this project and the safety of the people of this town is so much more advanced than nationally is all about the enterprise of the local medical practicesand showw the folly of the increasingly centralised, control-freak Government.

 

On VitD, I read with relief that the impact of Covid in Africa is much less than feared, especially with the state of many helath services in that continent.     South Africa is probably best placed to record infections and they have had 200,000 in their population of 60 million, the same as the UK, where we have 3 MILLION cases.   The SA CMO has no explnation save for the younger profile of the SA people.

In SA, VitD levels are "Sufficient" according to Norval, but grossly insufficient by the advocates above.       So how is it that Africa has escaoped the worst of the virus?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086758/#:~:text=The levels of 25(OH,to the cultural preference to

 

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On 1/7/2021 at 10:47 AM, PaulAA said:

Miles

Your wife's dedication is commendable - I am full of respect.

As for the next stage... I fear that recent history suggests that she and selfless others like her can look forward to a sudden change of direction that renders the time and commitment pointless.  But I hope my cynicism is ill-placed.

Paul

For any who have not yet lost the will to live in following this process, the next stage was as follows.

All 23 certificates confirming that the training had been completed and test passed had to renamed with the title of the course, my wife's initials and the date it was 'awarded', something that could have been done by the system automatically when sending her each certificate.

Each had to be uploaded individually, not in bulk.

All her degree certificates needed to be located, scanned and uploaded.

Four identifying documents needed to be located, scanned and uploaded: passport, driving licence, birth certificate, P60/P45. Anyone tried scanning a British birth certificate on a standard A4 home printer?

Four referees were then requested: two employers and two character. All four had to have 'work' emails; no personal emails allowed. The work referees had to be line managers. She also had to record the date each assumed that responsibility.

My wife then had to give an explanation of what she had been doing since she left work earlier last year having retired at 66.

The passport need to be uploaded again in a different section.

My wife then need to be photographed via the Mac holding up an identifying document close to her face The example showed a woman with a driving licence. Having done this half a dozen times, the system could not locate any document in the draft photos. She then tried her passport. Success, but the passport photograph was so small there is no way it would verify her.

All of this took more than two hours, principally because at the outset, the system does not explain what documents / images will need to be uploaded - online application instructions 101! 

Oh, and the process is run buy a third party supplier.

In a way, the desire to not be defeated by the system has almost overtaken her desire to make a contribution to defeating the virus by becoming a volunteer vaccinator!

Miles

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Basically it's the full recruitment guff...... this is the expedited version btw - Typically takes 3 months -drives SM nuts that staff she recruits in June can't start until September.

1 hour ago, MilesA said:

Oh, and the process is run buy a third party supplier.

Wonder what they charge the taxpayer for the "service"? 

 

BTW, SM is vaccinating as I type, she had a hour's training on Wednesday afternoon - actual physical injecting training on live patients as she'd not done it before.  Mind you she's been an NHS employee continuously since about 1988 so her file was already up to date.  Session started at 8.30 this morning and finishing about 7pm.  Long day.  Best have the gin ready!

BTW, has she had any confirmation that the process has been successful?  Or would be to offer her my congratulations be premature?  Please offer her my great respect for her determination in any case!

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Gosh, Miles!   I'm vaccinating for the Lancaster project.     I gave up my registration as a doctor three years ago, and it hasn't been an impediment, although I've been asked if to do so "if its not too much trouble"(!) as it would remove some beurocracy.   I think I said above that my recruitment could not have been easier - scan of passport, two online courses, which which I used to be familiar but were valuable refreshers, in resuscitation and anaphylaxis, and an online tutorial on vaccination procedure.

I was baby-sat for my first session, then 'observed' and then I was solo!     Except that the H£%&&^* computer that logs all the recipients kept breaking down - until I was given an 'assistant'.    Pure coincidence, of course!

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3 hours ago, PaulAA said:

Prominent piece in the Guardian this morning about Vitamin D and the inexplicable failure of PHE to endorse it:

https://www.theguardian.com/lifeandstyle/2021/jan/10/does-vitamin-d-combat-covid

Paul

Paul, Tks for the headsup, have alerted my MP. Slooowly, slowly, catchee D3.

No signs of Amazon supplies running out, so I guess most are still not aware.

Peter

 

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I saw this elsewhere, from a doctor who happens to be a petrolhead (probably to maintain his sanity) Seems there are too many layers of admin between those "at the top" and the highly qualified staff on the ground. And as usual those in the middle have not got a clue.

I think it's simple. Ideally wouldn't be sent home, agree. Ideal went out the window long time ago. This Tuesday gone London Ambulance Service had 200+ category 2 patients waiting for an ambulance (I think average response time for those is normally 7 minutes?). We rang through 2 such patients, they were pleading with us to get the patients to hospital some other way: "stick them in an Uber". They said if that wasn't possible the wait would be over 4 hour. This is for a patient with oxygen saturations of 85% at rest (which is seriously scarily terrirtory).

Is sending patients to hospital in an Uber idea (certainly not for the driver!)? Is 4 hour waits for Category 2 patients ideal?

It's chaos.

Truth is they'll send anyone they can home because they need the bed (and the consequences of that decision can wait for another day). In London most hospitals are turning 100% covid beds. Unless someone is on death's door they go home.

People like saying it's not as bad as it seems and in a way I wish I could believe that. Truth is it's not as bad as it seems- it's worse. The decisions required by medics and the planning documents I've read go so far beyond compassion they quite frankly scare me.

Anyhow. Happy happy joy joy. We vaccinated 1200 patients in our hub this weekend (that's the two days you work 24 hours for free after doing the usual week's work) so that's one in the eye for Cov19. Shame in typical NHS fashion the lift broke, the very long slippy path up to the practice hadn't been gritted and I therefore spent an hour not vaccinating people and instead going from one DIY store to another to try and find some rock salt to grit the path with (after a 80+ year old fell on ice and suffered a nasty injury). And no-one knew how to turn on the outside light so after dusk it was pitch-black walking up the aforementioned icy ramp. We had wanted to use our perfectly positioned ground-floor access practice to provide the hub but were told we couldn't so we were at the mercy of NHS property services (who don't do weekends). Thankfully someone knew the mobile number of the mum of the cleaner who knew how to turn them on and eventually I found a DIY shed with some rock salt for sale and we managed to find a very fit medical student who found a wheelchair and ran up and down the (admittidly fairly long three level) ramp to carry the patients up and down to the main entrance from the hub entrance. Common sense was bring the vaccine down to the patients but we were told in no uncertain terms this would not be possible as we would lose our approval and assurance if the vaccine moved vertically (maximum allowed was 3 metres horizontally). I did point out that fairly soon after being stuck in the patient's arm the vaccine would be making this verbotten maneover but fell on deaf ears. So 1000+ 80 year old (plus) patients had to clamber up the ramp (unless the med student was free). Officially of couse I shouldn't have been working at the hub as I hadn't actually completed my mandatory training. I must admit I did do the ones on how to give a vaccine (not sure how I've managed 25 years of medicine without that training) but after 5 hours when I got to the section on "Conflict Resolution" at 9pm at night I realised a conflict of my own in relation to whether I stayed at work completing the BS or went home and had some dinner so I could come back to work the next morning at 8am to start jabbing. All I can say is I resolved that conflict satisfactorily. Just annoys the hell out of me. 40+ clinicians and admin members freely gave up their entire weekends to vaccinate and we're just met with barrier after barrier due to administrative over-reach from DOH pen-pushers and their local wanabees who don't even bother to answer their phones at the weekend to sort out their own mess.

Sorely tempted (getting back to cars) to attend the next meeting with a Kimi quote on a t-shirt "Leave me alone, I know what I'm doing". Unfortunately anything that involves central government gets admnistrated to death (while the politicians say it's all fine and we'll have vaccinated one billion people by next Tuesday).

And breathe........
Crazy times.

 

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Sounds about right...... Happily SMs session over the weekend went smoother than that.  I think the total for the session Friday am to Sunday PM (very PM) was 1,226 vaccinated.  Somewhat more than than the number officially possible from their supplies, so a number of local NHS surgery and care home staff got rounded up at short notice late on Sunday to be done with the vaccine left over.

12 hour day for her.  She was in good spirits afterwards though, if a little grumpier this morning with her standard week looming as usual.......

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Nick Thanks - so far 'silence is the stern reply' following submission of the completed application.

Interestingly, friend of my wife who is doing the same and who is also retired but remained on the Pharmaceutical Register had a far shortened application process - only 3 e-training certificates required, little ID evidence, no referees, etc. Had my wife not come off the Register last less than 3 months ago in October she would have been spared this huge task. Unlike to situation for retired doctors. no allowance is made for recent retirement / removal from the Register for pharmacists.

Will report further when there is news.

In the meantime thanks to those who have stepped up and are vaccinating...

Miles 

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1 hour ago, MilesA said:

Had my wife not come off the Register last less than 3 months ago in October she would have been spared this huge task.

Eh? Couple of SM’s retired friends found they had rejoined the register last March without any input on their part  so they could “volunteer”...... Seems like that’s maybe stopped just at the point where it might have become useful!

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dEAHimage.png.b494f0e7097cde5384edfc102d045eee.png

Deaths in elderly in nursing homes in Andalucia. On Nov 6  they were started on oral calcifediol ( 25(OH)D3, whcih acts faster than D3)  Dosage not released. No change to isolation conditions, no vaccinations. last  data point is today 13 Jan

This is D3 in action, promoting our innate immunity, saving lives.

Peter

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On 1/12/2021 at 8:51 AM, MilesA said:

Nick Thanks - so far 'silence is the stern reply' following submission of the completed application.

Interestingly, friend of my wife who is doing the same and who is also retired but remained on the Pharmaceutical Register had a far shortened application process - only 3 e-training certificates required, little ID evidence, no referees, etc. Had my wife not come off the Register last less than 3 months ago in October she would have been spared this huge task. Unlike to situation for retired doctors. no allowance is made for recent retirement / removal from the Register for pharmacists.

Will report further when there is news.

In the meantime thanks to those who have stepped up and are vaccinating...

Miles 

Latest update.

Later during Tuesday, my wife received a personal email requesting a scan of a document proving her address. At no point in the early stages or when she was required to upload all the documents following completion of all the online training that I have reported earlier, was this requested. Duly done immediately. Again back to radio silence.

This is a pattern that my wife has experienced since she started the application process in late November: information requested, supplied immediately, radio silence.

Miles

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20 hours ago, JohnD said:

We have discussed this over on the TRR board, Peter.    See https://www.tr-register.co.uk/forums/index.php?/topic/72125-coronavirus/page/53/ and following posts and pages.      That chart proves nothing.

John, Proof is for the fairies, no scientist ever expect defintive proof. In the context of thee total knowledge of D3 and C-19, all apsects, it is highly probable that  the steep decline in death rate is the result of the intervention. Peter

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23 hours ago, JohnD said:

I am corrected, but that chart is evidence only of what happened in Spain.    It has no relevance for VitD, not even a correlation, let alone an association.

The death rate in Andalucia per miilion is now 25-FOLD lower than In Wales and lock-down was at same time. The difference was that Wales's population includinf the elderly in care are badly D3-deficient and Andalucian eldery are being dosed with 25(OH)D since 6 Nov.  So thee data are highlt pertinent to D3. I suppose you damand placebos? That was done in Cordoba, but that result was so chrystal-clear that it would be unethicla in Andalucia. Knowing that, and detaols of D3 biology in the widest sense the Andalucia result is to be expected. Why else do you think the clinicians introduced it to their pts?

The Cordoba  calcifidiol trial was small but the result so spectacullar that expert mathematicians at MIT showed it was 1 in 1 miilion by chance alone. NICE said it was "too small".

Taking  data in isolation is not how science works. My interpretation fo Andalucia as the result of D3 is entirely reasonable, it was not a de novo study. If it had been for exmple in intervention of banning the  residents from watching television than I would agree with your comments as I can see no science linking telly-deprivaiton  to surviving C-19.

Peter

 

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This is interesting 

https://www.newscientist.com/article/2252699-covid-19-is-becoming-less-deadly-in-europe-but-we-dont-know-why/

No mention of vit D but could well be a factor as summer brought levels up, fewer got very sick/died.

And another

https://www.newscientist.com/article/2248813-why-are-us-coronavirus-deaths-going-down-as-covid-19-cases-soar/

I’m sure there are other factors at play too. More people being tested means more mild/asymptomatic cases in the mix and the medics are undoubtedly getting much better at treating it.

Question is: did the decrease in death rate flatten off or go back up as we went back into winter and D3 levels fall?

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1 hour ago, Nick Jones said:

This is interesting 

https://www.newscientist.com/article/2252699-covid-19-is-becoming-less-deadly-in-europe-but-we-dont-know-why/

No mention of vit D but could well be a factor as summer brought levels up, fewer got very sick/died.

And another

https://www.newscientist.com/article/2248813-why-are-us-coronavirus-deaths-going-down-as-covid-19-cases-soar/

I’m sure there are other factors at play too. More people being tested means more mild/asymptomatic cases in the mix and the medics are undoubtedly getting much better at treating it.

Question is: did the decrease in death rate flatten off or go back up as we went back into winter and D3 levels fall?

Nick,

Seasonality of C-19  death rates of those hospitalised ( ie case fatality rate) and 25(OH)D fall in winter are almosst certainly causally linked as David Grimes blogpost highlighted: http://www.drdavidgrimes.com/2020/12/

The Cordoba trail nails the efficacy of D3 in lowering cfr - hence the "causally"

The real puzzle is why such a small fall in 25(OH)D of around 20 nmol/L in UK ( 50 to 70 in summer) should have such a big effect on C_19, around 50-fold.   The answer may be in this paper, which is difficult to grasp but highlights seasonal changes in D3 promoting prostate cancer. What happens is that 25(OH)D rises in summer sunshine and so does the active hormone  1,25(OH)D. This rise in 1,25 induces more of the enzyme that inactivates it, the 24-hydroxylase. Come winter 25(OH)D falls and production of 1,25 with it. BUT the 24-hydroxylase powers on pulling down the 1,25. This hysteressis in 24 hydroxlase causes a much bigger fall in the active hormone that serum 25(OH) indicates. https://ar.iiarjournals.org/content/29/9/3675.full#F3

This fault in our D3 defences is explicable when we recall we evolved in Africa in constnat sunshine, We have not yet evolved to cope with the seasonality of D3

Peter

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