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We're all fucked. elbows what do you make of this thread?

I dont have time to read it properly at the moment. But healthcare system collapse is something I would expect, and is the aspect that has bothered me most from the start. The only reason I'm not going on about it more is that I dont actually enjoy being a doom-monger, and for some people I think the penny will only drop once this stuff actually happens here in the UK.

I dont have much in mind in terms of how it could be avoided. I suspect a huge chunk of luck would be required, eg if we somehow only got a large outbreak in a few locations at a time, so resources could be redirected from elsewhere. And even then it would be extremely difficult.

I dunno, I dont work in healthcare, but I dont know how to read about 10% of cases requiring intensive care in Italy without fearing the worst.
 
So glancing at the stats in UK so far by local authority, it looks like cases are pretty dispersed, no particular hotspots in the main, with most places having zero or 1-4 cases. I assume this is pretty good news so far?
 
Nope, the opposite in fact, if cases were concentrated it would be easier to restrict the spread.
I think that would only be the case with much higher numbers... So far many of these are likely returned travellers and immediate contacts.

I'm not optimistic about this - it will take off - but it feels like we are doing better than others so far eg US.
 

I'm a doctor and an Infectious Diseases Specialist. I've been at this for more than 20 years seeing sick patients on a daily basis. I have worked in inner city hospitals and in the poorest slums of Africa. HIV-AIDS, Hepatitis,TB, SARS, Measles, Shingles, Whooping cough, Diphtheria...there is little I haven't been exposed to in my profession. And with notable exception of SARS, very little has left me feeling vulnerable, overwhelmed or downright scared.

I am not scared of Covid-19. I am concerned about the implications of a novel infectious agent that has spread the world over and continues to find new footholds in different soil. I am rightly concerned for the welfare of those who are elderly, in frail health or disenfranchised who stand to suffer mostly, and disproportionately, at the hands of this new scourge. But I am not scared of Covid-19.

What I am scared about is the loss of reason and wave of fear that has induced the masses of society into a spellbinding spiral of panic, stockpiling obscene quantities of anything that could fill a bomb shelter adequately in a post-apocalyptic world. I am scared of the N95 masks that are stolen from hospitals and urgent care clinics where they are actually needed for front line healthcare providers and instead are being donned in airports, malls, and coffee lounges, perpetuating even more fear and suspicion of others. I am scared that our hospitals will be overwhelmed with anyone who thinks they " probably don't have it but may as well get checked out no matter what because you just never know..." and those with heart failure, emphysema, pneumonia and strokes will pay the price for overfilled ER waiting rooms with only so many doctors and nurses to assess.

I am scared that travel restrictions will become so far reaching that weddings will be canceled, graduations missed and family reunions will not materialize. And well, even that big party called the Olympic Games...that could be kyboshed too. Can you even
imagine?

I'm scared those same epidemic fears will limit trade, harm partnerships in multiple sectors, business and otherwise and ultimately culminate in a global recession.

But mostly, I'm scared about what message we are telling our kids when faced with a threat. Instead of reason, rationality, openmindedness and altruism, we are telling them to panic, be fearful, suspicious, reactionary and self-interested.

Covid-19 is nowhere near over. It will be coming to a city, a hospital, a friend, even a family member near you at some point. Expect it. Stop waiting to be surprised further.The fact is the virus itself will not likely do much harm when it arrives. But our own behaviors and "fight for yourself above all else" attitude could prove disastrous.

I implore you all. Temper fear with reason, panic with patience and uncertainty with education. We have an opportunity to learn a great deal about health hygiene and limiting the spread of innumerable transmissible diseases in our society. Let's meet this challenge together in the best spirit of compassion for others, patience, and above all, an unfailing effort to seek truth, facts and knowledge as opposed to conjecture, speculation and catastrophizing.

Facts not fear. Clean hands. Open hearts.
Our children will thank us for it.

#washurhands #geturflushot #respect #patiencenotpanic
 
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I understand the intent of such messages, and there is a logic to directing attention towards the things that humans do have control over. However, any message that builds itself around a 'the virus itself wont do much harm' stance is not a message that I would spread around at this stage.
 
Take for example the notion that it is the 'worried well' that will overload the healthcare system.

It will probably be a factor. It wont be directly responsible for intensive care bed shortages etc.

I'd much rather have a pandemic where everyone who warns about the terrible impact of the virus itself is proven wrong. I'd far rather be subject to ridicule in a few months than have to watch various things collapse. I'd rather have a pandemic where the overly reassuring messages turn out to be the right ones, where letters of opinion about this being a story of inappropriate human overreaction turn out to be spot on rather than a sad misdirection that will not survive this pandemic.
 
Edited to take that bit out. Wise words thanks elbows.

Why do that? If they said it then its a part of their message and should be left in. My criticism of it doesnt make sense if you chop out a bit I dont like, a bit that is important to understanding their overall stance.

edit - oh I guess its because of my choice of language 'not a message I would spread around myself'. Sorry, that wasnt supposed to be a criticism of you posting it, it was just another way of me saying that I dont agree with the sentiment they are expressing (although they are right about some stuff).
 
Why do that? If they said it then its a part of their message and should be left in. My criticism of it doesnt make sense if you chop out a bit I dont like, a bit that is important to understanding their overall stance.

edit - oh I guess its because of my choice of language 'not a message I would spread around myself'. Sorry, that wasnt supposed to be a criticism of you posting it, it was just another way of me saying that I dont agree with the sentiment they are expressing (although they are right about some stuff).
reverted ! The message is out and running now quoted in the Guardian live feed.
 
I may as well take the opportunity to say that the various bad responses by some people, governments, etc are on my mind too. I'm not trying to pretend those things arent happening or are not an important part of the story. Its just that I get sick of the focus on those aspects at the expense of the correct impression about the damage the virus itself will do.

Nor do I think it is simply wrong for various people who are trying to do their responsible bit for society saying things designed to reduce panic and irrational, ugly behaviours. But the way some people are doing this is inappropriate in my opinion, not least because it ends up sending confusing mixed messages. This is a situation where very draconian steps may be taken by the authorities, and if people buy into the idea that this is all a story of panic and unnecessary economic damage then how are people supposed to square these very different messages and acts?

Its not just people writing letters online, The current UK stance is at an awkward moment. The BBC news last night was almost in war time mode, and even then some very mixed messages were on display, sometimes within the same sentence. I'm sure there will be more opportunities ahead for me to describe this in more detail.
 
Something we'll see more and more outside China as well: whole blocks quarantined, foot distributed to its foyer from the outside.

Chinese CDC article here making the case against isolation at home :

To control the infection, confirmed case-patients should be separated and managed centrally; thus, the government has designated special hospitals to admit patients with suspected or confirmed cases.

Also stressing children are a key factor:

We found a sharply increasing proportion of infected children (from 2% before January 24 to 13% for January 25–February 5; p<0.001), implying that increased exposure for children and intrafamily transmission might contribute substantially to the epidemic.

So as a rough guideline: after someone is infected they will pass the infection on to people they live with after about 3 days - before they are symptomatic.
 
One of the heads of the Italian government has announced he's got it now

Nicola Zingaretti?



ESgwZ5jWAAAf4qo


8 days ago he said: 'The watchword is normality, we cannot shut down Milan.' Now confirmed case.
 
BBC breaking news -
A hotel has collapsed in south-eastern Fujian province, trapping dozens of people under the rubble, state media has reported.

The Xinjia Hotel in the city of Quanzhou collapsed at around 19:30 local time (11:30 GMT) on Saturday.

According to the Global Times newspaper, the building was being used to hold people who had been in close contact with others confirmed to have the virus. They were under medical observation.

About 70 people were in the building when it collapsed and 32 have been rescued so far, says the newspaper, which belongs to the Chinese Communist Party.

It is not yet clear what caused the building to collapse.

Plus
UK cases up to 206
 
If you look at Italy's numbers, they've got around 4k infections currently. It's taken 11 days to get there from the position we're in.

If you look at how they got there, their figures grew by about 40% a day for about half that time, then 20%-25% since then.

We're currently growing at 40% a day, so we're matching Italy at the equivalent point in time in their outbreak.

I plotted these numbers and this is what it looks like for the UK:

Friday, 6 March 2020163
Saturday, 7 March 2020228
Sunday, 8 March 2020319
Monday, 9 March 2020447
Tuesday, 10 March 2020626
Wednesday, 11 March 2020877
Thursday, 12 March 20201227
Friday, 13 March 20201473
Saturday, 14 March 20201767
Sunday, 15 March 20202121
Monday, 16 March 20202545
Tuesday, 17 March 20203054
Wednesday, 18 March 20203665
Thursday, 19 March 20204398
Friday, 20 March 20205277
Saturday, 21 March 20206333
Sunday, 22 March 20207599
Monday, 23 March 20209119
Tuesday, 24 March 202010943
Wednesday, 25 March 202013131
Thursday, 26 March 202015758

Obviously lots of caveats on this: This assumes we don't do anything and carry on as we are now. We know that if things get this bad then additional measures will be taken.

It also assumed that the growth rate stays at 20% after an initial fall, but we only have Italy to go on there. Our growth rates might be higher or lower. We don't know.

etc., etc.
Today's number is 206 .
 
So phillm what is your opinion of how the UK is responding to this virus thus far, and do you think the NHS will be able to cope with an escalation?
 
We're earlier in the stage of spread than Italy, as elbows has pointed out might well be the case. By maybe 11 days.
I am not so sure on this, the first thing we heard from them was a number of deaths suggesting that they had 1 not been taking infections very seriously 2 they would not have been doing the contact tracing we did and 3 they appeared to have been taken by surprise by their infections.
 
So phillm what is your opinion of how the UK is responding to this virus thus far, and do you think the NHS will be able to cope with an escalation?

Anecdotally and from my experience of coming into Heathrow two days ago from Thailand where there was no heat scanning examination of passengers and just a piece of photocopied paper asking you to self-quarantine if you had symptoms of a cough, sore throat or fever didn't seem to be an aggressive way to defend your borders given that the authorities know how serious this is and must have known for several weeks at least.

I would also hope that local areas have requisitioned empty hotels/ barracks and other suitable buildings to use as quarantine /isolation hospitals and are being equipped up as best they can be to help ameliorate the load of our current hospitals like they did in Wuhan. And if such facilities are being prepped then publicise them as part of a programme of letting people know how serious this is and how important it is that everybody does their bit to help in fighting this damn thing.

It would no doubt also be useful for the PM to say that they have asked to suspend Brexit for the foreseeable and the 30k civil servants currently working on it are being deployed to cope with the emergency and to help with local planning. No country it would appear has sufficient healthcare capacity to cope with a threat of this nature and so no we won't be able to cope with the escalation. That seems starkly obvious I'm afraid. but we must hope the plans that are in place and the resources that have been applied to them may just about hold up. Apparently we are number one in the world for pandemic preparedness so let's hope that counts for something when the crisis hits and Professor Whitty is just the sort of calm, safe pair of hands that we need at the moment.

The frontline staff of the NHS must be deeply fearful at what is about to happen and the sacrifices they will be asked to make. Particularly if they have insufficient supplies of protective gear available to them.

I hope all these things are happening but we don't know so I'm not filled with a great deal of hope at the moment. I phoned my elderly next-door neighbour to have a chat and tell them once I'm out of quarantine I'm very happy to help with shopping and any other errands I can do. If there is anything else I can do locally I will try and do my bit, phoning friends and family and keeping our spirits up seems to be the best we can do. These are serious times.

.
 
Dan U spring-peeper

How can a school shutdown be worse than a pandemic if carers' children are looked after someone else who will also be at home for a period of 2-3 weeks?
3 and a half million were evacuated in the war.
The longer you delay it the longer people won't want to take others in for fear of their being infected.
Come on, urge some proactive action plus mitigation.

IF carers' children are looked after by someone else. Why would you assume everyone has access to that? Besides, that wouldn't be much better than shutting down the schools - it would still mean travelling to where your kids are being looked after, and your kids still mixing with others. It wouldn't be quarantine at all.

The government starting to instruct organisers to cancel events seems to me to be a sensible step to take now, as much to demonstrate that this is a serious issue and that dealing with it will require some sacrifices to be made, in addition to the actual risks of transmission at such events

The govt could also help by promising to back up insurance companies being forced to pay out more than expected (I think they've done similar before), and giving small payments to the under-insured.

So phillm what is your opinion of how the UK is responding to this virus thus far, and do you think the NHS will be able to cope with an escalation?

Just so you know, I don't think the post where phillm said "I am a doctor" was intended to say that phillm is a doctor. It was cut and paste from a post by a doctor called Sharkawy that was posted on Facebook.
 
phillm yes I don't really understand why there are not restrictions on inward travel especially as the vast majority of our cases seem still to be individuals that have travelled here from hot spots.

I did wonder if sympathy with the airlines / airports or worry over legal action might have been in the government's thoughts?

On the positive side we do seem to be testing plenty of people which can only be a good thing. And I suppose that comes from the contact tracing which we haven't abandoned yet. If or when they abandon contact tracing will be a serious moment, one at which government accept that the virus is rife and fully abroad in the wider population.

And I understand scientists are being asked for a rapid test kit which if possible could help matters.

At this stage I still hope a full on epidemic in the UK might be avoided even if the infection rate rising as it is suggests we may be passed the point of return.
 
IF carers' children are looked after by someone else. Why would you assume everyone has access to that? Besides, that wouldn't be much better than shutting down the schools - it would still mean travelling to where your kids are being looked after, and your kids still mixing with others. It wouldn't be quarantine at all.

I don't think you've understood. The carer would not be travelling to their children during the epidemic peak. Likewise hospital workers would not be returning to their children.
 
..
Just so you know, I don't think the post where phillm said "I am a doctor" was intended to say that phillm is a doctor. It was cut and paste from a post by a doctor called Sharkawy that was posted on Facebook.
Oh, thanks, I did misunderstand that then, sorry to all concerned :)
 
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