#Coronavirus: Page 25 - The Arsenal discussion forum and community: One More in the Tolly

#Coronavirus

y va marquer

goon wrote:
y va marquer wrote:
Why do the concerns raised by the WHO in relation to the path the UK is taking not concern you?

I don’t think they have, have they? They’ve just reiterated that it cannot be allowed to spread unchecked, which isn’t what is happening over here. A lot of the measures people want put in place are going to happen here in the next week or so, it’s all simply about timing.

Whether it’s right or not who knows. I don’t think even the experts themselves will claim they know for certain they’re taking the best approach, how could they? But at least it’s one grounded in science and math rather than populism and panic.

The WHO have questioned the timing.
They alert and call for proactivty and action now.
The stance is that proactive measures to enforce social distancing should be implemented immediately along with testing and contact tracing.

The notion that it's just populism and panic that supports early implementation of school closures and bans on mass gathering is incorrect.

goon

No one said it is.

Have you got a link to what the WHO have said on the matter? I’ve only heard bits that were pretty vague.

y va marquer

What was it that you were saying was grounded in "populism and panic" then?

Mirth

y va marquer wrote:
goon wrote:
I don’t think they have, have they? They’ve just reiterated that it cannot be allowed to spread unchecked, which isn’t what is happening over here. A lot of the measures people want put in place are going to happen here in the next week or so, it’s all simply about timing.

Whether it’s right or not who knows. I don’t think even the experts themselves will claim they know for certain they’re taking the best approach, how could they? But at least it’s one grounded in science and math rather than populism and panic.

The WHO have questioned the timing.
They alert and call for proactivty and action now.

https://www.standard.co.uk/news/health/uk-herd-immunity-coronavirus-who-margaret-harris-a4387346.html

The whole discussion on Radio 4 was around herd immunity and how valid it was as a strategy. Subsequently the gov issued a clarification (see Ricky's article) which made it clear that herd immunity was a by product and not the goal.

Mirth

Anyway

https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection

The country’s health minister, Olivier Véran, who is a qualified doctor and neurologist, tweeted on Saturday: “The taking of anti-inflammatories [ibuprofen, cortisone … ] could be a factor in aggravating the infection. In case of fever, take paracetamol. If you are already taking anti-inflammatory drugs, ask your doctor’s advice.”

Klaus

Mirth wrote:
As far as I know, the WHO warned against the idea of developing herd immunity unchecked. The gov just clarified that it's not the stated goal - it'll be the by product and the goal is still to flatten the curve.

There has been a lot of discussion about that over here too, with the chief epidemiologist being portrayed in the papers as going against WHO:s recommendation, which is not really what happened. Rather, it was decided that finding out the exact number of infected was no longer the main goal once it turned out that they couldn't all be traced to sources from abroad; instead the situation became about making sure that the healthcare system would be able to handle the most vulnerable 10% of those who might become infected.

The finer details of how national responses are shaped will vary based on several factors I imagine, but over here it would have been an untenable position to close down so many socially bearing sectors a this stage for a multitude of reasons. Resources, both human and material, would dry up very quickly, and there's zero evidence that it'll help once the infection has become endemic. There might come a point when no one has any choice but to do so, it's probably very likely, but I see epidemiologists being able to explain why that time is not now, and why it could actually have a worsening effect instead of making things better, while it's unclear exactly from where the dissenting voices who think that the entire society should just shut up shop are coming, aside from passionate appeases to the common sense.

Ricky1985

goon wrote:
Have you got a link to what the WHO have said on the matter? I’ve only heard bits that were pretty vague.

https://www.independent.co.uk/news/health/coronavirus-update-testing-news-herd-immunity-who-uk-cases-map-a9402051.html

But Dr Tedros called on all nations to take comprehensive action, after hitting out at a lack of “political commitment” to tackling coronavirus in unnamed countries.

“Our message to countries continues to be: you must take a comprehensive approach,” he said.

“Not testing alone. Not contact tracing alone. Not quarantine alone. Not social distancing alone. Do it all.

“Any country that looks at the experience of other countries with large epidemics and thinks ‘that won’t happen to us’ is making a deadly mistake. It can happen to any country.”

Dr Tedros called on countries do to everything possible to reduce transmission by quarantining people who had contact with infected people.

“Even if you cannot stop transmission, you can slow it down and save lives,”

Testing:
Contract Tracing:
Quarantine:
Social Distancing:

I understand this is a fluid situation and will change, but in the interim the virus is spreading untested, untraced, unchecked and, ultimately, uncontained. With the only guideline from the government that those that feel ill stay at home for 7 days: not the rest of the household and no testing available for those people; that's in a situation where young people are both the least likely to experience symptoms and are also the biggest spreaders.

The number of people needing hospitilisation is going to overwhelm the NHS within 2 weeks, perhaps less, and soon after people will die because medical treatment won't be available or won't be adequate. I don't understand why that is the strategy or why that is an acceptable situation to anyone?

Mirth

Ricky: It's entirely untrue that the virus isn't being tested or checked. Contact tracing was pretty much a cornerstone of the first wave of infections that were detected in early January and the UK's rate of growth has been slower than other countries despite having cases sooner. IF you claim that there was no testing, tracing or quarantine measures in place then you're factually inaccurate. The only debate to be had is around social distancing measures which is likely to happen at the same stage other countries have implemented it but for some reason your whole opinion is coloured by it.

goon

Ricky1985 wrote:
goon wrote:
Have you got a link to what the WHO have said on the matter? I’ve only heard bits that were pretty vague.

https://www.independent.co.uk/news/health/coronavirus-update-testing-news-herd-immunity-who-uk-cases-map-a9402051.html

But Dr Tedros called on all nations to take comprehensive action, after hitting out at a lack of “political commitment” to tackling coronavirus in unnamed countries.

“Our message to countries continues to be: you must take a comprehensive approach,” he said.

“Not testing alone. Not contact tracing alone. Not quarantine alone. Not social distancing alone. Do it all.

“Any country that looks at the experience of other countries with large epidemics and thinks ‘that won’t happen to us’ is making a deadly mistake. It can happen to any country.”

Dr Tedros called on countries do to everything possible to reduce transmission by quarantining people who had contact with infected people.

“Even if you cannot stop transmission, you can slow it down and save lives,”

Testing:
Contract Tracing:
Quarantine:
Social Distancing:

I understand this is a fluid situation and will change, but in the interim the virus is spreading untested, untraced, unchecked and, ultimately, uncontained. With the only guideline from the government that those that feel ill stay at home for 7 days: not the rest of the household and no testing available for those people; that's in a situation where young people are both the least likely to experience symptoms and are also the biggest spreaders.

The number of people needing hospitilisation is going to overwhelm the NHS within 2 weeks, perhaps less, and soon after people will die because medical treatment won't be available or won't be adequate. I don't understand why that is the strategy or why that is an acceptable situation to anyone?

Because in theory one of the consequences is that by enacting these measures too early you simply delay that peak until the winter when the consequences, toll on the NHS and deaths will be far greater.

Also testing and contact tracing and quarantine were being enacted from an early stage.

Ricky1985

Mirth wrote:
Ricky: It's entirely untrue that the virus isn't being tested or checked. Contact tracing was pretty much a cornerstone of the first wave of infections that were detected in early January and the UK's rate of growth has been slower than other countries despite having cases sooner. IF you claim that there was no testing, tracing or quarantine measures in place then you're factually inaccurate. The only debate to be had is around social distancing measures which is likely to happen at the same stage other countries have implemented it.

I'm talking about as of right now.

The WHO statement was made yesterday; Britain's approach changed on Thursday after the COBR meeting.

y va marquer

From WHO

Our message to countries continues to be: you must take a comprehensive approach.

Not testing alone. Not contact tracing alone. Not quarantine alone. Not social distancing alone. Do it all.

Any country that looks at the experience of other countries with large epidemics and thinks “that won’t happen to us” is making a deadly mistake. It can happen to any country.

The experience of China, the Republic of Korea, Singapore and others clearly demonstrates that aggressive testing and contact tracing, combined with social distancing measures and community mobilization, can prevent infections and save lives.

This virus . . . hasn’t been in our population for long enough for us to know what it does in immunological terms,” WHO spokeswoman Margaret Harris told BBC Radio 4’s Today programme.

“We can talk theories, but at the moment we are really facing a situation where we have got to look at action,” she said when asked about the British policy. “We want all the things you need to do to be done together,” including large-scale testing for the virus and tracing contacts, she added.

https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-mission-briefing-on-covid-19---13-march-2020

https://www.google.com/amp/s/amp.ft.com/content/b88f2c8e-660a-11ea-a3c9-1fe6fedcca75

Mirth

Ricky1985 wrote:
Mirth wrote:
Ricky: It's entirely untrue that the virus isn't being tested or checked. Contact tracing was pretty much a cornerstone of the first wave of infections that were detected in early January and the UK's rate of growth has been slower than other countries despite having cases sooner. IF you claim that there was no testing, tracing or quarantine measures in place then you're factually inaccurate. The only debate to be had is around social distancing measures which is likely to happen at the same stage other countries have implemented it.

I'm talking about as of right now.

The WHO statement was made yesterday; Britain's approach changed on Thursday after the COBR meeting.

This is exactly part of the governments plan that they've outlined for a month now - WHO would have been aware of it since February. People are still being quarantined and the contact tracing was used it to delay the rate of infection and have moved exactly how they announced they would - that's reassuring to me. The testing is continuing to happen at a greater rate than before (close to 10k a day) it's just that it's happening in hospitals where the vulnerable patients are so that they can be quarantined.

I don't actually see the WHO statement being directed to the UK anyway.

goon

A friend of mine manages a 111 call centre. Their daily call rate has gone up from 1000 in normal times to 7000 currently, bear in mind this is just covering a section of London. Half of them are people phoning in asking for referrals to be tested with the mildest of symptoms. I saw him on Friday and he was relieved by the new guideline, it allows them to actually help those who need it the most. How do we know these decisions haven’t been made in consultation with people on the front line?

goon

y va marquer wrote:
What was it that you were saying was grounded in "populism and panic" then?

That wasn’t aimed at a policy. The point is if the government was going against what their experts are telling them and making decisions simply to look decisive and in fear of a backlash, then I’d be worried.

y va marquer

Re "the role nonpharmaceutical interventions might play in delaying the temporal effects of a pandemic, reducing the overall and peak attack rate, and reducing the number of cumulative deaths"
(Spanish Flu 1918-19 - US)

School closure and public gathering bans activated concurrently represented the most common combination implemented in 34 cities (79%); this combination had a median duration of 4 weeks (range, 1-10 weeks) and was significantly associated with reductions in weekly EDR. The cities that implemented nonpharmaceutical interventions earlier had greater delays in reaching peak mortality (Spearman r = −0.74, P < .001), lower peak mortality rates (Spearman r = 0.31, P = .02), and lower total mortality (Spearman r = 0.37, P = .008). There was a statistically significant association between increased duration of nonpharmaceutical interventions and a reduced total mortality burden (Spearman r = −0.39, P = .005).

https://jamanetwork.com/journals/jama/fullarticle/208354

y va marquer

goon wrote:
A friend of mine manages a 111 call centre. Their daily call rate has gone up from 1000 in normal times to 7000 currently, bear in mind this is just covering a section of London. Half of them are people phoning in asking for referrals to be tested with the mildest of symptoms. I saw him on Friday and he was relieved by the new guideline, it allows them to actually help those who need it the most. How do we know these decisions haven’t been made in consultation with people on the front line?

People here are calling 999 for advice on getting tested....
Communicating clear, concise and easily understood messages /instructions to the general public is a gigantic challenge.
The fact that people don't know, or potentially don't care, that 999 is reserved for emergency calls is a real problem.

Klaus

Mirth wrote:
The testing is continuing to happen at a greater rate than before (close to 10k a day) it's just that it's happening in hospitals where the vulnerable patients are.

Exactly. This is

WHO need a blanket statement to send out to the entire world, but different countries are at various stages of infection currently. In both the UK and Sweden things have progressed to the point where cases have appeared where people have started to get sick without having been in contact with those who brought it in from abroad. That means it's endemic.

No one has cut down the testing anywhere in the world as far as I'm aware; it's increasing in every country. In our cases it's just focused on where it'll do the most amount of good instead. It's not meaningful to test returning tourists displaying mild symptoms for instance, because it doesn't lead to any new interventive measures. There isn't a single healthcare system in the world that will be able to deal with infection on this scale, not in Europe and not in Asia, which is why it's so important to start thinking about how we handle the biggest risk groups early.

Ricky1985

Mirth wrote:
This is exactly part of the governments plan that they've outlined for a month now - WHO would have been aware of it since February. People are still being quarantined and the contact tracing was used it to delay the rate of infection and have moved exactly how they announced they would - that's reassuring to me. The testing is continuing to happen at a greater rate than before (close to 10k a day) it's just that it's happening in hospitals where the vulnerable patients are so that they can be quarantined.

I don't actually see the WHO statement being directed to the UK anyway.

Government tested and assisted quarantine is different to simply recommending self-isolation, especially when there isn't a test available to confirm whether or not someone has the virus, and it's near useless imo when people have jobs to go to, kids to look after, live with other people, are infectious before showing symptoms, and haven't yet had the instruction to adapt to a reality of being largely confined to their homes for an extended period of time.

Which measures are in place right now to stop community transmission, beyond the aforementioned recommendation about staying at home if you feel ill? Considering the current growth rate, what stops the NHS being stretched beyond breaking point in a matter of weeks, as has happened in Italy? In what way are we currently delaying the peak? Surely social distancing now is the only way to move the peak closer to the summer or achieve a delay of any kind? Why are we worrying about a second more deadly peak next winter before we worry about the reality of a peak that is upon us right now?

Genuine questions that I can't come up with good answers for. I just can't see beyond the plan amounting to: "taking it on the chin"--to use Boris' own words--and hoping for a herd immunity to develop; with full knowledge that it can only be achieved with at best ₁₀₀,000 elderly and vulnerable people dying, regardless of when the peak comes exactly.

Mirth

Ricky1985 wrote:
Which measures are in place right now to stop community transmission, beyond the aforementioned recommendation about staying at home if you feel ill? Considering the current growth rate, what stops the NHS being stretched beyond breaking point in a matter of weeks, as has happened in Italy? In what way are we currently delaying the peak? Surely social distancing now is the only way to move the peak closer to the summer or achieve a delay of any kind? Why are we worrying about a second more deadly peak next winter before we worry about the reality of a peak that is upon us right now?

I'm not sure why you're splitting this phase from the last phase, those efforts directly contributed to why the rate of increase was slower than Spain, Germany, France and a few others. If you accept that, then at least you'd get a measure of comfort that the two professors have at least demonstrated a degree of competence.

They said on Thurs that this would peak in 10-14 weeks so we're already on course for it to peak in May/June i.e. summer. So that's their stated goal anyway - I can't crunch the numbers but at least thats what we're working towards.

I'm totally concerned by the NHS being at breaking point with or without Covid-19 - I'm furious that it's always underfunded and the gov deserve all the hate they get for that.

Second peak - I think it's entirely right for anyone modelling this to look at it over a 2-3 year period, if not longer.

Anyway, here's the measures that could be put in place over the coming months: https://www.itv.com/news/2020-03-14/elderly-to-be-quarantined-for-four-months-in-wartime-style-mobilisation-to-combat-coronavirus/

Mirth

Here's a statement from the Health Sec: https://www.telegraph.co.uk/politics/2020/03/14/must-do-everything-power-protect-lives/?WT.mc_id=tmgliveapp_iosshare_At9w8jYPvkKQ

We have a plan, based on the expertise of world-leading scientists. Herd immunity is not a part of it. That is a scientific concept, not a goal or a strategy. Our goal is to protect life from this virus, our strategy is to protect the most vulnerable and protect the NHS through contain, delay, research and mitigate.

We have acted to contain the spread of the virus so far. We have carried out some of the highest number of tests in Europe, our surveillance testing is among the most sophisticated in the world and the UK’s plans for the rapid response to and mitigation of the spread of an epidemic are ranked number one above any other country by the Global Health Security Index. Most importantly of all, thanks to our record levels of tracing the number of people who came into contact with the first people who caught the virus, the initial growth was slowed significantly, and the growth of the virus in the UK has been slower than many major European countries. This action has already prevented the NHS being put under greater pressure in its hardest season of the year. We have bought valuable time to prepare.

Today, we take further action, with a call to arms for a drive to build the ventilators and other equipment the NHS will need. We are better equipped thanks to the NHS than most other countries, but we will need many more. We now need any manufacturers to transform their production lines to make ventilators. We cannot make too many.

In the near future we will take further steps. SAGE has advised the next planned effective interventions will need to be instituted soon, including measures to ‘shield’ older and medically vulnerable people from the virus. Everyone will need to help to ensure they get the support they need to stay at home, and to protect them from the consequences of isolation: loneliness, and a lack of support. Government, local councils, charities, friends and neighbours will need to be part of the national effort to support the shielded. We will provide expert advice and support as soon as we progress to this phase.

Next week we will publish our emergency bill, to give the Government the temporary powers we will need to help everyone get through this. The measures in it allow for the worst case scenario. I hope many of them won’t be needed. But we will ask Parliament for these powers in case they are.

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