Coronavirus in the UK - news, lockdown and discussion

[PD58]

NS view today on the 5 tests and exit...

Good morning. It's official: the government has extended the lockdown and set out five tests that must be met before the lockdown will end.

Those tests are: 1) can the NHS function? That metric is crucial and often-forgotten: the big reason why the British government changed approach and went for lockdown is that Plan A would have overwhelmed the health service, essentially meaning the end of 20th century healthcare, not only for people with Covid-19 but for anyone requiring hospital care.

2) We have moved beyond the peak, seeing a consistent and daily fall in the death rate. We may well have reached this point already - in any case, you can achieve this target with or without lockdown. It's the knock-on effects for healthcare in general that caused government to go down this route.

3) We know the rate of infection is decreasing. A simple one this - how many new cases does each Covid-19 patient beget?

But it's the fourth and fifth tests that are really worth watching and highlight the government's exit strategy.

4) We have a supply of testing and personal protective equipment to meet demand. At the moment, we simply don't know how many people in the United Kingdom have had the novel coronavirus, because we have a limited testing regime. The first priority of testing is to prevent hospitals becoming vectors of infection due to asymptomatic staff and patients spreading the disease. But in the long term, if you want to emulate the only models that, thus far, have been shown to allow a measure of normality to return - that is, if you want the UK at the end of 2020 to look a lot like Taiwan and South Korea now - you need a major increase in the level of testing equipment and personal protective equipment.

And 5) we do not risk a second peak - that is to say, we don't exit lockdown only to trigger a fresh spike in cases.

That would appear to leave just two exit strategies available to the government: a long and indefinite wait for a vaccine or a long but not indefinite wait for the necessary infrastructure around test and trace to be put in place. Neither option is risk-free but they are the only exit strategies that meet the government's objectives here.

Which should give those people confidently asserting that you can't publish an exit strategy with so many known unknowns some pause - the fact is the government has essentially ruled out all by two ways out of the maze.

 

[elbows]

Does Hancock seriously believe that the Uk has the curve under control? I don't see how he could possibly know that.

They've got more data than me but even with what I have got, the signs are there. But it depends what people think counts as the curve being under control. It would be too easy to overstate the 'under control' point, but I couldnt call it a lie.



For example, the above graph shows promising signs, but it would also be easy to misinterpret it by forgetting that large numbers of hospital deaths contribute to the data looking that way.

(source Slides and datasets to accompany coronavirus press conference: 16 April 2020 )

 

[littlebabyjesus]

NS view today on the 5 tests and exit...

Good morning. It's official: the government has extended the lockdown and set out five tests that must be met before the lockdown will end.

Those tests are: 1) can the NHS function? That metric is crucial and often-forgotten: the big reason why the British government changed approach and went for lockdown is that Plan A would have overwhelmed the health service, essentially meaning the end of 20th century healthcare, not only for people with Covid-19 but for anyone requiring hospital care.

2) We have moved beyond the peak, seeing a consistent and daily fall in the death rate. We may well have reached this point already - in any case, you can achieve this target with or without lockdown. It's the knock-on effects for healthcare in general that caused government to go down this route.

3) We know the rate of infection is decreasing. A simple one this - how many new cases does each Covid-19 patient beget?

But it's the fourth and fifth tests that are really worth watching and highlight the government's exit strategy.

4) We have a supply of testing and personal protective equipment to meet demand. At the moment, we simply don't know how many people in the United Kingdom have had the novel coronavirus, because we have a limited testing regime. The first priority of testing is to prevent hospitals becoming vectors of infection due to asymptomatic staff and patients spreading the disease. But in the long term, if you want to emulate the only models that, thus far, have been shown to allow a measure of normality to return - that is, if you want the UK at the end of 2020 to look a lot like Taiwan and South Korea now - you need a major increase in the level of testing equipment and personal protective equipment.

And 5) we do not risk a second peak - that is to say, we don't exit lockdown only to trigger a fresh spike in cases.

That would appear to leave just two exit strategies available to the government: a long and indefinite wait for a vaccine or a long but not indefinite wait for the necessary infrastructure around test and trace to be put in place. Neither option is risk-free but they are the only exit strategies that meet the government's objectives here.

Which should give those people confidently asserting that you can't publish an exit strategy with so many known unknowns some pause - the fact is the government has essentially ruled out all by two ways out of the maze.

Yep. I felt that 4) was a key factor in the three-week extension. It allows them more time to get their act together. It's been a pitiful effort so far, but perhaps with peak hospital take-up probably passed, they will be able to focus on it now. They singularly failed to establish a system wherein they focused both on the immediate crisis and the planning for exit.

 

[littlebabyjesus]

Dunno if this has been posted already. Free London bus travel.

Sadiq Khan announces free bus travel in London to protect drivers

Follow our live coronavirus updates HERE Coronavirus: The symptoms

www.standard.co.uk

Good. Should have done this three weeks ago, but good that they finally have.

 

[Wilf]

''Firstly it's fewer meaningful jobs, not less.''

Don't you mean Firstly, it's fewer meaningful jobs, not less.


''Secondly, fuck off.''

Unless you are the owner of this site, in which case you'll undoubtedly delete my account, I fail to understand how a neanderthal such as yourself should feel they have the supreme right to tell anyone to ''fuck off.''

The important bit to focus on here is FUCK OFF.

 

[Wilf]

Now you know how everyone else in the country feels having to hear about all the shit that happens in London.

Urban: all in it together.

 

[Teaboy]

So my dad, who's a very with it and active 93 year old living in London, let me know today that his 'old people lockdown' has been extended to the end of June. Personally I think this is crazy! Here in Aus the earliest we'll get out of lockdown is July 31st. The earliest. It'll likely carry on without change until September.

Now look at the stats for Australia versus the UK and you'll see where my confusion lays...

Sounds like the 12 week lockdown for those who are most vulnerable to the virus. It was just an initial 12 weeks with a review to come. Depends what the situation looks like then.

 

[NoXion]

The pop. of the UK at the inception of the NHS in 1948 was 49.4 million. The current pop. of the UK is 67.8 million. If its any consolation, I'll amend the 20 to circa 20 million.

You've already been told that the problems with the NHS have fuck-all to do with population. So are you one of those neo-Malthusian cunts, or are you one of those eugenicist cunts?

 

[elbows]

So my dad, who's a very with it and active 93 year old living in London, let me know today that his 'old people lockdown' has been extended to the end of June. Personally I think this is crazy! Here in Aus the earliest we'll get out of lockdown is July 31st. The earliest. It'll likely carry on without change until September.

Now look at the stats for Australia versus the UK and you'll see where my confusion lays...

Where are you getting July 31st as earliest lockdown release from for Australia? I've seen police and others say the lockdown was for 90 days, which is the end of June. But all of that can change if the numbers change. And there could be regional variations too - eg if some cities are still having a problem then their lockdowns might last longer than elsewhere.

I dont think I would like to take a guess at this myself because there are two potentially conflicting factors - on the one hand Australias epidemic was so much smaller than the UKs one at the moment lockdowns were introduced. But obviously Australias seasons are the other way round to ours, so there will be unease about what winter could mean for Australia and this pandemic.

 

[The39thStep]

Urban: all in it together.

Cancel HS2, Build the Wall.

 

[andysays]

The pop. of the UK at the inception of the NHS in 1948 was 49.4 million. The current pop. of the UK is 67.8 million. If its any consolation, I'll amend the 20 to circa 20 million.

Many people might see the fact that the population has been able to grow by circa 20 million in the last 70 years as a positive consequence of the creation of the NHS and other social and economic reforms dating from the same time as its creation.

You appear to view it rather differently

 

[editor]

Dunno if this has been posted already. Free London bus travel.

Sadiq Khan announces free bus travel in London to protect drivers

Follow our live coronavirus updates HERE Coronavirus: The symptoms

www.standard.co.uk

Should have happened ages ago.

 

[xenon]

Yeah, first week it felt spontaneous and was really rather touching. It's still far from militaristic in tone in my street - people banging pots and pans and whooping raucously - but then like others, I live in a highly non-Tory borough, so it doesn't feel hypocritical. But the thing that did it for me in the second week was seeing the front page of The Sun ordering everyone to do it. It's started to stick in my craw now. Haven't joined in since. Feel bad about that, but I'd feel bad about joining in as well. Can't win.

Yeah. I haven't joined in the last couple of times. I did stand on the door step and record (audio) it last night. Just for posterity. A few pots and pans, kids cheering. People clapping from their windows in the flats opposite as far as I can tell.

So my dad, who's a very with it and active 93 year old living in London, let me know today that his 'old people lockdown' has been extended to the end of June. Personally I think this is crazy! Here in Aus the earliest we'll get out of lockdown is July 31st. The earliest. It'll likely carry on without change until September.

Now look at the stats for Australia versus the UK and you'll see where my confusion lays...

Was chatting to my mate in Sidney last weekend. He's from New Zealand originally. Says the lock down is much tighter in NZ. In terms of places that are closed I think. He's mostly working from home but as working in industrial sales, he's had to go out occasionly to meet a client for fear of losing business down the line.

Are the restrictions the same across all states?

 

[SheilaNaGig]

Part 2

So how much vitamin D should we really be getting? There is currently no agreement on the optimal level. UK and US government guidelines focus on getting enough vitamin D to build healthy bones and teeth, and suggest the aim should be around 20 nanograms per millilitre of blood. But for a strong immune system we may need more. The Endocrine Society, a medical organisation dedicated to the study of hormones, says it could be anywhere between 30 and 100 ng/ml.


Even assuming 20 ng/ml is enough, if you live at latitudes above around 35 degrees – north of San Francisco, Seville and Seoul or south of Melbourne, roughly speaking – the chances are that you’re deficient in vitamin D for at least some of the year. Between November and March (or June to August in the southern hemisphere), the angle of the sun means that few UVB rays hit the Earth at high latitudes, making it very difficult to synthesise vitamin D in skin. Neither can you stockpile enough vitamin D to tide you over the winter months, as bodily stores typically dwindle after around 30 days.


One study of white Britons found that in winter and spring, around half have vitamin D levels below the recommended UK figure, and 15 per cent are deficient year-round. The risk is even greater for people with darker skin living at high latitudes, who need more UVB exposure to make the same amount of vitamin D. Few people have levels low enough to cause the adult equivalent of rickets. But given how even a small deficiency increases the risk of bone fractures, and growing evidence for the role in our immune system, should we be doing more to get more?


Fear of skin cancer means many people are understandably keen to cover up during the summer months, and even moisturisers and make-up now often contain sun protection. That’s despite growing evidence that more sun exposure could reduce the risk of getting other cancers – a positive effect also attributed to vitamin D (see “Don’t be modest“).


The good news is that, unless you are housebound, it should be easy enough to get enough vitamin D on a sunny day without getting a dangerous dose of sun. A fair-skinned person in the UK need only expose their face and arms to the midday summer sun for 10 minutes to generate more than twice the amount they need for the whole day, while a dark-skinned person would need closer to 40 minutes (see map). Apps and gadgets have also appeared recently that calculate how long you should stay in the sun at any given time and location to get enough vitamin D while not getting burned.


But the sun doesn’t shine every day, and we can’t all go outside when we want. What if it’s cloudy or you’re stuck in an office? Dense cloud and shade roughly halve the amount of vitamin D you synthesise, while glass blocks it almost entirely. UVB rays also dwindle in the early morning and evening, even though UVA rays continue to penetrate. Sunbeds provide lots of UVA exposure, but very little UVB.

Supplement your sun

So can you eat your way to vitamin D health? Current UK and US guidelines suggest adults need the equivalent of between 15 and 25 micrograms of vitamin D per day from all sources combined, including the sun and diet. A 100-gram packet of smoked salmon would get you there, as would three 160-gram tins of tuna. But if you don’t eat a lot of oily fish, it’s unlikely you’d meet these requirements through diet alone (see “How to get your daily dose“). In the US, where milk is supplemented with vitamin D, the average intake from diet is around a third of the recommended dose. In the UK, where this is not common practice, the figure is lower.


That leaves vitamin D supplements as a possibility. The UK National Health Service already recommends supplements for children, and suggests that certain groups of adults should take around 10 micrograms of vitamin D per day. These include pregnant and breastfeeding women, those aged 65 and over, and people who “aren’t exposed to much sun”. It also points out that dark-skinned people are at greater risk of vitamin D deficiency, though it stops short of recommending supplements.


Taking supplements is not risk-free. You can’t overdose on vitamin D from sunshine, as any excess made by the skin is degraded. But ingesting too much vitamin D can cause high blood calcium levels, which can damage the kidneys – although it’s unclear at what dosage this becomes a genuine concern.


Some think there is a case for much more widespread use of supplements, at higher doses. Current UK advice is to take no more than 25 micrograms of vitamin D per day in supplement form, while the US Institute of Medicine suggests an upper limit of 100 micrograms. “That’s what I take,” says Pakpoor.


Such higher limits could become the norm, both to help healthy people get enough, and also to help treat a growing number of ills. Clinical trials are under way in which vitamin D supplements are being given both to people with cancer and multiple sclerosis to see if they have an effect. Early results suggest it might ease the symptoms of MS.


A stroll in the sun is always a joy for body and soul. But as we learn more about the sunshine vitamin and how it works, it seems that our cells are glad of its benefits, too. So get out there and enjoy – like all things, in moderation, of course.


Don’t be modest
How much sun is too much? While sunbathing until your skin burns is clearly going too far, evidence is emerging that covering up too much could be counterproductive. People living in sunnier low latitudes are less likely to develop certain cancers, including breast, prostate and colorectal cancer, than those in more northern climes.
Why is that? The presence of receptors for vitamin D on a range of tumour cells suggest they respond to it, and vitamin D is known to influence the expression of genes that regulate cell growth. Studies on animals also show that vitamin D can slow tumour growth, and even encourages certain types of malignant cell to commit suicide. Once again, it seems the sunshine vitamin is at work.

How to get your daily dose
Each of the following will provide you with 15 micrograms of vitamin D – the daily dose recommended by the US Institute of Medicine
0.5 tablespoon of cod liver oil
88 g smoked salmon
10 tablespoons of margarine
15 eggs
15 bowls of fortified cereal
2.8 kg swiss cheese

Read more: Let the sunshine in: We need Vitamin D more than ever

Further to this, it’s important to know that at U.K. latitudes it’s not possible to use the sun to make Vitamin D during some months of the year. Also, if your shadow is longer on the ground than your own height, there isn’t enough UVB rays to make Vitamin D.

 

[FridgeMagnet]

Should have happened ages ago.

And they should stay free after all this too.

 

[littlebabyjesus]

Further to this, it’s important to know that at U.K. latitudes it’s not possible to use the sun to make Vitamin D during some months of the year. Also, if you’re shadow is longer on the ground than your own height, there isn’t enough UV rays to make Vitamin D.



View attachment 207264

Yeah, maybe in that NS article or a related one, they actually outline the benefits of going out in the midday sun in the UK, and without any suncream, but just for enough time to get your Vit D. I've been trying to do it when I can ever since reading the article, and was moved on from a park bench the other day when I was doing just this.

 

[xenon]

Reckon I'm low on vit D. I don' bother going out in the sun much at the best of times and CBA just walking around the streets during this. I take a multivit (when I remember.) OTOH I eat eggs, cheese and tuna quite often.

 

[SheilaNaGig]

Yeah, maybe in that NS article or a related one, they actually outline the benefits of going out in the midday sun in the UK, and without any suncream, but just for enough time to get your Vit D. I've been trying to do it when I can ever since reading the article, and was moved on from a park bench the other day when I was doing just this.

Yes, it’s does say to go out in the midday sun. But it’s worth adding in the understanding that the reason for this is because the rays of the sun need to be of a certain wavelength to be used to make Vitamin D. Some people will think “Welli I prefer to walk the dog at dawn/ in the late afternoon and I’m getting my sun then, I’m in the sun for more than 10 minutes, I’m sure that’s the equivalent of 10 minutes at midday” and that’s not right.

Also, I speak with people who say yes, they go out in the sunshine but then it turns out they’re covered up, sitting in the shade, or going out of the house but then indoors (cinema, shopping, visiting friends, at a cafe...). Once you know something, it becomes common sense (like not touching a mask, taking off gloves correctly) but it’s really easy to misinterpret or misuse information if you don’t have the full picture.


ETA
Also some people find it easier to take in information if it’s in a visual form like that that chart rather than the than the written word. I found that chart memorable when I first saw it,so I thought I’d share it.

 

[SheilaNaGig]

Reckon I'm low on vit D. I don' bother going out in the sun much at the best of times and CBA just walking around the streets during this. I take a multivit (when I remember.) OTOH I eat eggs, cheese and tuna quite often.

We can absorb and use the vitamin d in meat and dairy and eggs but my understanding is that the vitamin D we make ourselves is more easily available to us. We don’t need to extract it from another source if we’vemade it ourself, it’s instantly available.

And/but also the whole thing is further complicated by the different forms of vitamin D (D2, D3 are the main ones) and the fact that we need other cofactors in order to utilise vitamin D properly (vitamin K, boron, magnesium...)

And we make it from cholesterol. Vitamin D is actually a hormone but the “vitamin” but has stuck and it’s kinda pointless trying to change that now.

 

[two sheds]

And/but also the whole thing is further complicated by the different forms of vitamin D (D2, D3 are the main ones) and the fact that we need other cofactors in order to utilise vitamin D properly (vitamin K, boron, magnesium...)

I learned on here that drinking enough milk means you don't need the vitamin K at least.

 

[2hats]

Some people will think “Welli I prefer to walk the dog at dawn/ in the late afternoon and I’m getting my sun then, I’m in the sun for more than 10 minutes, I’m sure that’s the equivalent of 10 minutes at midday” and that’s not right.

You'd have to be out for something like 4 times longer at 7am this morning to have any chance of getting the same levels as around midday today (and that assumes comparable cloud cover and ozone column length which are time varying anyway).

 

[two sheds]

We've been scammed

UK pays £16 million for coronavirus tests that don't work

‘The UK is likely to be certainly one of the worst, if not the worst affected, country in Europe’ says Jeremy Farrar of the Wellcome Trust medical research fund

www.independent.co.uk

 

[TheHoodedClaw]

This has been going on long enough that we now have rituals about it and that upsets me.

That's one of the most thought-provoking things I've read about this whole mess.

 

[Fruitloop]

They've got more data than me but even with what I have got, the signs are there. But it depends what people think counts as the curve being under control. It would be too easy to overstate the 'under control' point, but I couldnt call it a lie.

View attachment 207252

For example, the above graph shows promising signs, but it would also be easy to misinterpret it by forgetting that large numbers of hospital deaths contribute to the data looking that way.

(source Slides and datasets to accompany coronavirus press conference: 16 April 2020 )

True (thanks for all the charts and updates by the way!)
I guess my concern is that because there hasn't been the mass testing that there ought to have been, they're using what are essentially proxy figures. I would love to believe that this curve correlates with the number of total coronavirus cases, but it seems to me that there is very little certainty that this is the case.

 

[SheilaNaGig]

You'd have to be out for something like 4 times longer at 7am this morning to have any chance of getting the same levels as around midday today (and that assumes comparable cloud cover and ozone column length which are time varying anyway).

If your shadow is longer than you are tall (is that the case at 7AM at the moment? ) then you’re not going to be mad making Vitamin D, regardless of how long you’re standing there naked.

 

[SheilaNaGig]

I learned on here that drinking enough milk means you don't need the vitamin K at least.

Full fat milk is a much better source for Vitamin K than skimmed milk.


However, there are issues with too much milk. The excess calcium seems to be a risk factor for heart disease in some people. And children given too much milk can end up anaemic. Also, because micronutrients like calcium etc need to be in the correct ratio to their cofactors and other micronutrients, too much milk can oblige the body draw down from the body’s stores to correct the imbalance, which can then cause other problems.

Yes, You Can Take Too Much Vitamin D and K

Not getting enough vitamin D is a common problem, but over-supplementation can also hurt your health. And too much of its partner vitamin K can be harmful, too. Here’s what you need to know.

health.clevelandclinic.org

Milk may be linked to bone fractures and early death

"Drinking more than three glasses of milk a day may not protect bones against breaking – and may even lead to higher rates of death," the Mail Online reports. Do not be alarmed – your milkman is no Hallowe'en death-bringer…

www.nhs.uk

Dairy monsters: Just how healthy is milk?

We used to take it for granted that milk was good for us. But now the industry faces a crisis, with the public questioning such assumptions. So just how healthy is milk? Anne Karpf investigates.

www.theguardian.com

 

[2hats]

If your shadow is longer than you are tall (is that the case at 7AM at the moment? ) then you’re not going to be mad making Vitamin D, regardless of how long you’re standing there naked.

I was referring to levels of UV-B not epidermal vitamin-D production. The UV-B level may well need a trigger point to initiate vitamin-D synthesis but shadow length is meaningless for a cut off level of any given wavelength of incident sunlight.

 

[SheilaNaGig]

I was referring to levels of UV-B not epidermal vitamin-D production. The UV-B level may well need a trigger point to initiate vitamin-D synthesis but shadow length is meaningless for a cut off level of any given wavelength of incident sunlight.

I thought the length of the shadow is a good rough indicator that the wavelength was insufficient to trigger vitamin d synthesis...?


Okay, I’ve just found this wiki so I’m going to work on my understanding of vitamin d with this website.

Vitamin D Myths - SUN | VitaminDWiki

Science-based Vitamin D

vitamindwiki.com

 

[2hats]

I thought the length of the shadow is a good rough indicator that the wavelength was insufficient to trigger vitamin d synthesis...?


Okay, I’ve just found this wiki so I’m going to work on my understanding of vitamin d with this website.

Vitamin D Myths - SUN | VitaminDWiki

Science-based Vitamin D

vitamindwiki.com

It might be a decent handwaving rule of thumb for guesstimating adequate circumstances for vitamin D synthesis, but it's most definitely not a factor for computing incident solar radiation (at any wavelength)!

 

[Petcha]

Great to see the curve flattening on the briefing today. Now can someone please explain to me why 250,000 people were allowed to attend Cheltenham over three days and they let thousands of Madrid fans into Liverpool for the football and subsequent mingling in the city centre and pissup? When even Madrid clubs were playing behind closed doors?

Idiots.