Coronavirus - worldwide spread and control

[Mij]

I am having trouble understanding the points being made here. The idea that only those on the brink of death anyway are dying from covid is simply incorrect. In the UK a lot of people have been misled by the reporting in the early stages that those who died had 'underlying conditions'. This was taken by some to mean that they were about to die anyway, when all it actually meant was that they had risk factors such as asthma, obesity, diabetes, etc. Some were simply over 60.

People older than 80 accounted for 71 per cent of Canada's COVID deaths, followed by those aged 70 to 79 (18 per cent) and 60 to 69 (seven per cent). Together, those three groups account for more than two-thirds of all COVID-19 hospitalizations.

To date we have 10,032 deaths in Canada.

 

[Binkie4]

Epidemiologist from Zagreb on BBC news just announcing that levels in U.K. are accelerating, especially in south east. He is advocating more action soon or it will get worse fast.

He has just been thanked. Seems to have some link with Uni of Edinburgh but was speaking from Zagreb.

 

[Leila]

Death tolls and ICU capacities might be the most urgent numbers to look at but LongCovid the more important ones?

I'm not saying having long term damage is worse than dying but it's something that needs more attention when it comes to arguing about spread and control.

Yesterday, our governemnt decided on a "lockdown light" starting next week; today, a group of intensive care specialists held a press conference desrcribing why these measures are necessary.

They do mention LongCovid and "chronic fatigue syndrome" (minute 25).

But still, not much discussing LongC from our politicians.

 

[Jonathan Edwards]

Trying not to break forum rules, my wife is expecting to have an early detected, small and non spread breast cancer removed in the next 18 days here in Essex. Is your 'insane' due to post surgery radiotherapy issues?

Sorry, conversations on forums and emails sometimes get too telegrammatic.
I was intending to imply that it would be insane to go to a hospital for routine post-cancer follow-up just now - which I think was the context of the previous exchange. I am sure going for scheduled treatment is sensible, although there must be a chance of picking up Covid. I have a friend who has just been through surgery for breast cancer and she got Covid at some point during the to-ing and fro-ing, although not seriously.

I wasn't thinking of immune deficiency with surgery or radiotherapy - these are not going to be significant except in cases like bone marrow transplantation for leukaemia. The radiotherapy for local breast cancer does not have a significant effect on the immune system.

 

[Andy]

COVID-19 Has Crushed Everybody’s Economy—Except for South Korea’s

The United States and South Korea both recorded their first case of the new coronavirus on the same day; since then, cases in South Korea peaked at 851 new daily cases in March, before flattening to the single digits. In the United States, the cases never really plateaued until mid-July, where the peak was at 74,818 confirmed infections in a single day. South Korea has recorded seven deaths per million people; the United States has seen nearly 600 deaths per million, according to the U.S. Centers for Disease Control and Prevention and Johns Hopkins University. Economic success went hand in hand with success in tamping down the pandemic.

That efficacious handling of the outbreak made a strict national lockdown—of the sort that paralyzed entire European economies for months on end—largely unnecessary in South Korea, which in turn meant less economic dislocation from shuttered factories, closed restaurants, and the like.

https://foreignpolicy.com/2020/09/1...conomic-impact-recession-south-korea-success/

 

[spinoza577]

Death tolls and ICU capacities might be the most urgent numbers to look at but LongCovid the more important ones?
...
Yesterday, our governemnt decided on a "lockdown light" starting next week; today, a group of intensive care specialists held a press conference desrcribing why these measures are necessary.

They do mention LongCovid and "chronic fatigue syndrome" (minute 25).

They seem to refer to this paper: sick-and-tired-of-covid-19-long-haulers-and-post-viral-fatigue-syndromes-2020-outhoff.17249/

from the abstract

At the end of July, the Centers for Disease Control and Prevention (CDC) in the USA reported that 35% of 292 COVID-19 patients, young and old, with mild disease, had not returned to their usual state of health, 2–3 weeks post testing positive for the virus.4

Common residual symptoms included cough (43%), fatigue (35%), or shortness of breath (29%).

Noteworthy, was that prolonged convalescence occurred in 20% of young adults who had no chronic comorbidities, potentially leading to loss of function at work, studies, or other activities.

My underline, and this they mentioned.

 

[Daisybell]

From today’s Spectator:
https://www.spectator.co.uk/article/the-long-winter-why-covid-restrictions-could-last-until-april

The Sage scenario assumes 66 per cent of people with Covid showing symptoms: the last UK sample put this figure at 33 per cent. It assumes an ‘infection fatality ratio’ of 0.7 per cent: a World Health Organisation paper recently put the average estimate at 0.3 per cent. There is no ‘red team’ of experts in No. 10 challenging the assumptions; and there can be no debate about them in public when they are being kept secret.

It’s not hard to see the problem. If the government prepares for a tsunami that never arrives, it can end up using language that scares people away from using hospitals and seeking care. Then you end up with what we had last time: 40,000 empty NHS beds at the peak of the virus and many of those who would otherwise be treated dying at home. Not that this is discussed much in Covid strategy meetings. Sage, SPI-M and the Joint Biosecurity Centre — which all shape the Covid strategy — are focused only on the virus. There is no equivalent group calculating the harm done by lockdown: the cancer deaths, mental health caseload and the loss of life that always accompanies economic crashes.

We would of course all like to have a scenario where no-one dies. It isn’t going to happen. This is about numbers - and there does need to be balance between the numbers likely to die of Covid and the numbers likely to die because of Covid... Both of these numbers need to be kept as small as possible. And realistically, any government is also going to be thinking in terms of the age of the people dying. What should be chosen if you are given a choice? An average age of over 80 or an average age of over 60? It’s horrible to think about, but it must be a consideration...

 

[Jonathan Edwards]

There is no equivalent group calculating the harm done by lockdown: the cancer deaths, mental health caseload and the loss of life that always accompanies economic crashes.

This is just political disinformation, like the fake news in the US. The fact is that countries who restricted adequately -NZ, South Korea, Taiwan, etc. have no health or economic problems.

Nobody is dying because of lockdown. They are dying because of failure of lockdown in time.
There is no 'balance' to be set here either in health or economic terms. The only solution is to minimise the level of infection - which once you have it everywhere means lockdown.

Nobody seems to be calculating the harm done by spreading disinformation of this sort - which is stopping the health system from doing its normal job and getting things under control.

It is easy to say that certain aspects of lockdown may be unnecessary but if you have a house on fire you do not stop and say oh maybe we do not need to hose down the garage. You hose down the lot in the hope of saving something.

 

[Trish]

https://www.bbc.co.uk/news/health-54718318

Coronavirus doctor's diary: 'Our hospital could soon be overwhelmed'
A rapid rise in patients acutely ill with Covid-19 is threatening to overwhelm Bradford Royal Infirmary, and other Yorkshire hospitals. Regular diary writer, Dr John Wright, and two consultants from the infirmary describe the pressure on beds and staff.

Bonfire night and Halloween have come early in Bradford. The hospital is on fire and things are getting scary as more and more wards are engulfed. As with the first wave in March, the surge in cases came gradually and then suddenly. We have 130 in-patients acutely ill with Covid-19, overtaking our peak at Easter. Fifty patients were admitted in the space of 48 hours. The pressures of finding beds and staff are huge. Over 200 staff are off sick and the school half term has compounded the situation as our clinicians take much-needed breaks or just child-mind at home.

It is all so familiar, and yet at the same time all so different. In March we had emptied out the wards to become a dedicated Covid-19 isolation hospital. This time we have our normal flow of patients admitted with seasonal infections and acute exacerbations of chronic diseases, while also trying to maintain some of our urgent elective surgery.

In March there was a call to arms and all staff rallied around the flag. This time there is a weariness and fatigue. "Groundhog day without the adrenaline," as one of my colleagues described it.

I sympathise with the anti-lockdown advocates. The economic and social damage from the pandemic is going to be catastrophic, and probably outweigh the clinical impact of the virus. However, when you see patients fighting for their lives, drowning in air, it reinforces the primacy of our humanity and compassion. Above all we must care for our patients, protect the NHS from being overwhelmed and speak up to prevent transmission.

It's getting increasingly busy. We have big problems trying to open wards, especially around staffing them, and staff are tired and fed up with it - people can't see the light at the end of the tunnel.

The other difference this time is that the hospital is busy with other work.

The number of wards we have to go to on our rounds make it feel like a safari ward round - I think I went to about four wards yesterday and it's the same for other colleagues. Some of us are concentrating more on "Red" Covid wards (for infectious patients) and some on the Green (for patients without Covid).

We're struggling to find wards to convert to red and when you come in in the morning it's the first thing you think: has a new ward been converted to be a red ward and how is that being staffed?
[...]
The hospital has cancelled elective surgery but when this started in March time this ward was empty. Now it's full. We will try and turn over as many patients as possible but on Friday morning it will be full. We are running out of resources.
[...]
This means the pressures on the hospital are different but as big and as worrying as they were in the first wave. Modelling shows if we continue on present trends, in three to four weeks we will have filled every bed in the hospital. What do we do after that?

Normally we'd divert A&E to other hospitals, but they're also all full. The only place with critical care beds is Airedale and they have five spare beds. Everywhere else in the region is full.
[...]

 

[Barry]

if you have a house on fire you do not stop and say oh maybe we do not need to hose down the garage. You hose down the lot in the hope of saving something.

And if you spot a fire starting in a waste paper basket in the living room, you don't say "Let's wait and see what happens, and see if we can avoid making a mess" - the inevitable result being the fire has taken drastic hold by the time procrastination gives way to panic. In reality you zap the fire quick as you can while you still have the chance.

 

[Daisybell]

https://www.telegraph.co.uk/news/20...spells-unprecedented-non-covid-health-crisis/

 

[oldtimer]

In Vietnam, which is one of the small group of countries that has low case numbers and has has managed their two relatively small outbreaks quickly and successfully, they were all ready with a strong quarantinig, testing and tracing protocol. They had learnt from Sars and others.

Instead of testing individuals, they combine 6 tests at a time and if the result is positive they test the indiduals separately. A whole family just needs a single test. I wonder why we don't do this too.

 

[Woolie]

This is just political disinformation, like the fake news in the US. The fact is that countries who restricted adequately -NZ, South Korea, Taiwan, etc. have no health or economic problems.

In NZ, we're affected economically. Not as much as the UK US or western Europe, but remember we're not wealthy to start with. So all this has had an adverse impact on a lot of people.

One of the biggest contributors to our economic downturn has been border closure, and its impact on tourism and other industries that rely on an influx of international visitors, such as Universities.

But like @Adrian says, its not a simple decision between restrictions versus no restrictions. If we opened our borders, it wouldn't take long for covid to get a grip here. Our health service has hardly any ventilators, it would be a shit show, and then inevitably, the only way we would cope would be to impose more severe and longer restrictions further down the line.

The answer for us on the border question would seem to be more rapid testing, and more efficient quarantine/clearing procedures to allow visitors to enter.

Another ongoing problem for our economy is that people have also changed their behaviour, not due to government restrictions, or out of fear of covid (pretty much none where I live), but because they got used to a different way of doing things. Since we need to be poised at any time to go into restrictions if there's another outbreak, many companies are making themselves "resilient" by doing more work online, and less people are physically going to work every day which means less incidental spending. At my University, all classes are back to normal, but few students are showing up to class. This is not fear of covid, nor government restrictions. Its partly habit, and partly that we now have excellent online backup resources so its easy to skip class and catch up later.

 

[Saz94]

llAt my University, all classes are back to normal, but few students are showing up to class. This is not fear of covid, nor government restrictions. Its partly habit, and partly that we now have excellent online backup resources so its easy to skip class and catch up later.

Which, incidentally, is something that students with certain disabilities have been asking for for years (at least at my old uni), and being told it couldn't be done

 

[Jonathan Edwards]

In NZ, we're affected economically. Not as much as the UK US or western Europe, but remember we're not wealthy to start with. So all this has had an adverse impact on a lot of people.

OK, I am, sure there are certain economic inconveniences for you too.
But the border problem is because other countries failed to introduce restrictions.
And you admit that without restrictions you would be overwhelmed with virus.
So it seems fairly simple that restrictions are the way to go.They are not causing problems - or at least they are reducing problems.

I am also a bit sceptical about NZ moaning about no tourists. Last year all my NZ friends were moaning about all the grey nomads in camper vans wrecking the countryside. I am pretty sure that NZhas had more tourists than the environment can cope with for a while.

And more working from home is also surely a good thing with less use of petrol?

As for incidental spending... That seems to me to be at the root of the whole problem. Governments have allowed tens of thousands of people to die to protect consumer spending. But consumer spending does not make a country rich. It wastes and pollutes. Human effort goes down the drain. Consumer spending is encouraged because it brings in taxes so governments can claim to have reduced tax rates. It also makes entrepreneurs rich. It isn't good for people or the planet.

The money that would be spent 'incidentally' is still in someone's pocket. The tragedy is that our systems are incapable of making sure everyone has what they need because they are focused on making profits.

 

[Jonathan Edwards]

https://www.theguardian.com/world/2...n-from-spain-accounts-for-most-uk-cases-study

 

[anciendaze]

Florida is back in the news. We just set a record for the most new cases in a single day since August, 5,592 and 72 deaths. Cases are clearly on the upswing, and deaths have not fallen off. Less noticed is that the state has again redefined the way it calculates positivity, again making it drop. If positivity is so low, why are the case load and hospitalizations going up? So far, hospitals can handle the load, now using 2,343 beds, but, with thousands of new cases per day, we aren't far from the point where we must make truly awful triage decisions.

 

[Woolie]

OK, I am, sure there are certain economic inconveniences for you too.
But the border problem is because other countries failed to introduce restrictions.
And you admit that without restrictions you would be overwhelmed with virus.
So it seems fairly simple that restrictions are the way to go.They are not causing problems - or at least they are reducing problems.

Totally, I didn't mean to complain. NZ has escaped very lightly compared to the rest of the world. And all because of the early restrictions. Life here is currently pretty normal, with people going to bars and concerts and parties and generally enjoying themselves without any fear. Everyone, even at-risk groups (which includes me) can go shopping, go to the doctor, and use trains, buses and planes without fear. We have the time and leisure to worry about other issues, like end of life choice and whether to legalise marijuana (recent referendum: yes to the first, no to the second).

A lot of people where I live are still using our covid tracer app, just in case, and a large portion of NZers are on board with the restrictions, particularly those relating to border closure.

And yes, totally, the problems that we do face are the fault of those wealthier and better resourced countries who stuffed around long enough for the virus to spread throughout the world.

 

[Sly Saint]

https://www.theguardian.com/world/2...n-from-spain-accounts-for-most-uk-cases-study

Sridhar said there were two approaches to managing the virus when it came to travel: either keeping borders largely open, as occurred in the UK, but adopting harsh restrictions to try to combat community transmission; or having very tight border controls, as has been the case in Taiwan and New Zealand, but few restrictions on everyday life.

“I feel like in Europe we want it all, we want to be able to go on holiday, we want to have bars open, pubs open, clubs open – but with such an infectious virus and [the] associated hospitalisation rate, it is pretty much an impossible ask,” said Sridhar.

 

[Woolie]

Florida is back in the news. We just set a record for the most new cases in a single day since August, 5,592 and 72 deaths.