The Covid-19 serious chat thread

[RDW]

First topic message reminder :

A thread set up to house the more serious chat relating to the global pandemic.

Nothing has changed in what we expect from discussions on here though:

- Please treat each other with respect
- Avoid hyperbole and fake news
- This thread shouldn't be used for a political soapbox, but political discussion will likely happen. See point 1!

A reminder that we have a community thread here for people to vent, look for help and all round support each other. https://www.606v2.com/t69506-the-covid-19-community-thread#3896653

[RDW]

I don’t doubt that, there’s caveats in every situation. There’s the age profile element and the fact that we have a city of 9 million people. But 2.5 times the amount is pretty damning. While we had Cheltenham going ahead, they cancelled St Patrick’s day. There’s a wider psychological impact at play with regard to
how seriously people take the situation as well as the infection at the specific events.

Population density must indeed have a big impact - but the fact that even now there are no checks on people flying into the UK sounds simply bizarre.

I didn't realised that. For the last 2 weeks anyone arriving in Australia have to stay in s hotel for 14 days and aren't allowed to leave their rooms (paid for with public funds). You can also only get in the country if you're Australian.

I love across from a hotel in Sydney - there's police and army guarding it!

Something like 70% of our cases were people arriving in the country, so you can understand why.

[123456789.]

Population density is something that we need to take into account. We have a far more dense population than Ireland. However it is similar to Germany's and actually far smaller than South Korea's. Again it is right that we take that into account. I suppose I have been rather oversimplistic at points in that regard. My feeling though is that it is quite obvious that our airports are busier than those in Ireland, so it would have made sense to act earlier to cater for that. It is quite obvious that our population is denser than Ireland's, so it was imperative for us to act decisively and early. The lessons ubiquitous when you compare us to South Korea, Germany and Ireland for example seem to be that those who test early and more extensively see fewer deaths, that those who acted earliest and decisively see fewer deaths. We acted slowly and have one of the poorest testing records in Europe. To put in plainly; in European terms we acted slower than almost every country, we have fewer tests per million than almost every country and we have more deaths per 100,000 than all but five countries in Europe and our death rate is accelerating faster than any of them. We are projected to be the worst hit country in Europe. I can't see how that's anything but a pretty damning failure.

[Duty281]

I don't think it is as clear-cut as that. Italy has fantastic testing (15,935 per million) which is better than most in Europe, including Germany (15,730 per million), but they've been the fourth hardest hit country in the world in terms of deaths per million (322).*

* The two hardest hit countries in the world in terms of deaths per million are San Marino and Andorra, and their tiny populations distort the proportional analysis, so you could argue Italy is the second hardest hit.

Meanwhile Japan is in a state of business as usual and they're hardly being affected by it, so far at any rate, in spite of their dense populations and inaction by the government.

Furthermore, the UK is currently at a state of having fewer deaths per million than Spain/Italy/France/Belgium/Netherlands - similar countries in terms of living standards, population movement, dense cities etc. So the UK clearly isn't failing by as much a margin as you think. Germany is certainly the outlier for Europe in terms of how they're dealing with it, and there are certain factors that go some way to explaining that.

"we have fewer tests per million than almost every country' - around the same as France, but yes in terms of proportion this is broadly correct. However, testing works in raw numbers, not proportion. It costs the UK far more (in monetary value and infrastructure and manpower) to test 10% of their population, for instance, than it would for Portugal or Switzerland to do likewise. In terms of the raw number of tests, the UK has done around 350,000 which is the tenth highest in the world, with testing capacity being increased soon (I believe).

I certainly don't think Johnson's government has been perfect, far from it, but to paint them as useless or damning failures is wide of the mark. The government has had to make some incredibly tough decisions, in awful, bleak circumstances, with no clear and obvious answers and much information unclear. Very tough job.

[WELL-PAST-IT]

Duty, I think most people with agree that the government have got some things right, however they sat on their posteriors for 2 weeks and did nothing, then gave advice rather than dictate a lockdown. They could have done a lot better and saved a lot of lives, the evidence was there to see from what happened in China and then Italy, lockdowns had to be enforced, not recommended, it only takes 10% of the population to ignore the recommendation to infect 30%.

Also they did nothing about ppe or respirators until they were told it was a disaster, " the email was in my spam box" does not show that we have a functioning government. We are still getting throw away phrase coming out to to try and make it look like they are doing something, todays was " we have record amounts of ppe now available to the NHS", well I wonder why? They had two weeks to get it sorted ready for when it is needed, BoJo came on telly to spout that "today, we have had 9 million pieces of ppe delivered to the NHS". This was clearly an underestimation on the governments part as 3 days later Hancock was saying we have now ordered 45 million pieces of ppe. Ordered, i.e. when we had already got an epidemic hitting us , they just realised that the NHS and all the  carers and pharmacists which the government are relying on to free up doctors also need ppe. It is a shambles, the NHS is saying we still need more, the others have none at all other than rudimentary off the self stuff.

They are now relying on small businesses and people like the "ScubsClub" who normally are in the fashion trade to make all the equipment needed as they cannot supply it.

I saw one report this morning with Bill Gates saying that the world should have been expecting this after ebola, it was always on the cards and the world should have been working together for the last 10 years to have the facilities to get on top of it a lot quicker. He warned in unequivocal terms that a pandemic was coming 5 years ago.

[Duty281]

Yes, though as previously mentioned by a different poster (Soul, I think), PPE shortage is a global issue not just a national issue.

I agree that governments all round the world should be better prepared for the eventuality of potential global crises such as this one, and it is a weakness of parliamentary democracy that governments often look no further than until the next election.

[123456789.]

That's was a really good post Duty. I didn't know anything about Japan so that's quite interesting. I do disagree with elements of it. For me, Italy was the big warning for all of us. If it could happen there, it could happen here. The conditions in Italy meant that they were likely to be worse effected than anyone else. They have an ageing population that's more frequently integrated into family homes and so harder to isolate. That's why, with the extra preparation time we had, I find it so galling that we are creeping up to, and if predictions are correct, beyond Italy. What made Germany's so effective in comparison to Italy was that it was pre-emptive rather than reactive. Italy's numbers are good because they've had so many people in hospital.
In terms of testing I'd disagree there too. There is an economy of scale. We have a much larger population than certain countries but we have a much larger economy too. With the larger population there are more people to test, that is true, but there are also more people to test. My issue with the testing is how long it took us to get started. In Germany and South Korea they tested early, they tested extensively and they traced from there. Iceland has tested around 10% of its population (I am not saying that's the proportion we should be hitting) and it has shown that around 50% of its cases have been asymptomatic. In effect fifty percent of people who suffer from coronavirus will be unwitting assassins, testing and tracing is crucial in the early period. Equally it seems likely that because the messaging about the situation was poor early on and the lockdown was comparatively late coming into effect we are struggling compared to Germany and Ireland. The mess with regard to the European scheme is just embarrassing.
I should say that from the moment the lockdown came into effect much of the government response has been pretty effective. The hospital constructed in London was incredibly impressive, that's usually the sort of thing we get wrong in this country. Equally, the chancellor's plans to deal with the economic fallout have been very good. I know a few people who work for the treasury and apparently those plans were very much from the top down. Unfortunately I am very strongly of the opinion that the slow start outweighs all of that and if we continue as we are projected I do think it would be honourable for Boris Johnson to prioritise his health and allow someone else to step in as Prime Minister permanently.

[hampo17]

you think the chancilor has done a good job? Leaving tens of thousands with no income?

[Pr4wn]

Aye. My brother would certainly disagree. He's a newly qualified Osteopath with less than 12 months of "self-employment" under his belt so he's high and dry.

[123456789.]

I'm sorry to hear about your brother and I don't think it's been perfect by any means. I do know that the work that went into those policies involved almost the entire treasury working themselves into the ground and that most people have been covered. Hopefully the work they've done is only the beginning and they'll look to patch up the holes in it so far. I don't think they've been put there by design. Generally speaking, I think we've been rather ahead of the curve on economic measures. I think it's reasonable in a country as wealthy as ours to expect to be ahead of the curve in international terms. That's why I am so vehement in my criticism of the initial response of the government, where we were behind the curve and continue to be there. I do think we've got to try to be even handed in these things.

[123456789.]

In terms of Covid News:
https://gov.wales/wales-playing-leading-role-antibody-transfusion-treatment-coronavirus-patients

Wales has started looking at antibody transfusion to spread immunity to the disease. I suppose if this is shown to work they could start rolling it out on a gradual basis to the most vulnerable groups over the coming months.

[hampo17]

I disagree with you on the chancilor entirely. I'm one of those people who have been left with zero income with no sign or acknowledgment of the damage it will cause.

The fact that he changed the rules for TUPE so quickly after his father in law took over a company shows that it can be changed and can be changed quickly. He is choosing not too.

[RDW]

In terms of Covid News:
https://gov.wales/wales-playing-leading-role-antibody-transfusion-treatment-coronavirus-patients

Wales has started looking at antibody transfusion to spread immunity to the disease. I suppose if this is shown to work they could start rolling it out on a gradual basis to the most vulnerable groups over the coming months.

Australia have announced this too - looks like lots of countries are getting into it. Hopefully the global scientific community are talking to each other- logistically I'm sure that's quite challenging though.

[123456789.]

https://www.theguardian.com/world/2020/apr/13/uk-missed-three-chances-to-join-eu-scheme-to-bulk-buy-ppe?utm_term=Autofeed&CMP=twt_b-gdnnews&utm_medium=Social&utm_source=Twitter#Echobox=1586802100

We apparently missed the chance, or chose not to enter into the European Union PPE procurement programme. I am not sure this is entirely surprising.We have a government of Eurosceptics, their modus operandi is that they believe we can do things better on our own rather than in conjunction with Europe. I am a pretty staunch Europhile. I believe in participation in the European project in ideological terms and I thought membership of the European Union made sense in practical terms. I can't understand how not taking part in a joint procurement scheme makes any sense whatsoever but that's a natural consequence of my personal position, as I suppose any decision by Raab, Gove, Johnson and Patel (insofar as she's actually capable of thinking) will reflect their own.

[RDW]

The UK government has previously said it was unable to join the EU’s procurement schemes as it had not received an email of invitation.

I wonder why that was!

[Soul Requiem]

The EU procurement scheme has resulted in how many purchases so far?

[Pr4wn]

The EU procurement scheme has resulted in how many purchases so far?

European doctors and nurses are preparing to receive the first of €1.5bn (£1.3bn) worth of personal protective equipment (PPE) within days or a maximum of two weeks through a joint procurement scheme involving 25 countries and eight companies, according to internal EU documents.

Literally taken from the second paragraph of the article linked above. Keep up.

[WELL-PAST-IT]

https://www.theguardian.com/world/2020/apr/13/uk-missed-three-chances-to-join-eu-scheme-to-bulk-buy-ppe?utm_term=Autofeed&CMP=twt_b-gdnnews&utm_medium=Social&utm_source=Twitter#Echobox=1586802100

We apparently missed the chance, or chose not to enter into the European Union PPE procurement programme. I am not sure this is entirely surprising.We have a government of Eurosceptics, their modus operandi is that they believe we can do things better on our own rather than in conjunction with Europe. I am a pretty staunch Europhile. I believe in participation in the European project in ideological terms and I thought membership of the European Union made sense in practical terms. I can't understand how not taking part in a joint procurement scheme makes any sense whatsoever but that's a natural consequence of my personal position, as I suppose any decision by Raab, Gove, Johnson and Patel (insofar as she's actually capable of thinking) will reflect their own.

Numbers, wasn't that the infamous, "missed it because it was in my Junk Mail folder" opportunity.

[navyblueshorts]

https://www.theguardian.com/world/2020/apr/13/uk-missed-three-chances-to-join-eu-scheme-to-bulk-buy-ppe?utm_term=Autofeed&CMP=twt_b-gdnnews&utm_medium=Social&utm_source=Twitter#Echobox=1586802100

We apparently missed the chance, or chose not to enter into the European Union PPE procurement programme. I am not sure this is entirely surprising.We have a government of Eurosceptics, their modus operandi is that they believe we can do things better on our own rather than in conjunction with Europe. I am a pretty staunch Europhile. I believe in participation in the European project in ideological terms and I thought membership of the European Union made sense in practical terms. I can't understand how not taking part in a joint procurement scheme makes any sense whatsoever but that's a natural consequence of my personal position, as I suppose any decision by Raab, Gove, Johnson and Patel (insofar as she's actually capable of thinking) will reflect their own.

Missing out on this does sound peculiar and of the 'cut-off-nose-to-spite-face' school of thought. Think there was probably an element of underestimating seriousness of SARS2 at that point, perhaps?

[rodders]

I'm not sure how much traction this has got yet but I think everyone should, watch it

https://www.youtube.com/watch?v=Eq6YEYfn2zw&fbclid=IwAR0zOLjBDhAvfQXSXXZp3YN-RsDhJS0Ozw3DhEtVMATBaL6FVoq6y0Lw4No

My own anecdotal experience of this makes me believe there is something to this and the implications are that the current treatment and advice is way off and potentially causing a lot of unnecessary deaths.

Early intervention to oxygenate people and avoiding use of mechanical ventilators as much as possible would seem to be what is being suggested.

The UK government cancelled an order of ventilators as the settings couldn't be changed, not sure if this is related -

https://www.independent.co.uk/sport/motor-racing/formula1/coronavirus-f1-teams-ventilator-uk-order-cancelled-red-bull-renault-a9463711.html

[navyblueshorts]

I'm not sure how much traction this has got yet but I think everyone should, watch it

https://www.youtube.com/watch?v=Eq6YEYfn2zw&fbclid=IwAR0zOLjBDhAvfQXSXXZp3YN-RsDhJS0Ozw3DhEtVMATBaL6FVoq6y0Lw4No

My own anecdotal experience of this makes me believe there is something to this and the implications are that the current treatment and advice is way off and potentially causing a lot of unnecessary deaths.

Early intervention to oxygenate people and avoiding use of mechanical ventilators as much as possible would seem to be what is being suggested.

The UK government cancelled an order of ventilators as the settings couldn't be changed, not sure if this is related -

https://www.independent.co.uk/sport/motor-racing/formula1/coronavirus-f1-teams-ventilator-uk-order-cancelled-red-bull-renault-a9463711.html  

Interesting, but I'm not sure what he says is in any way disagreeing w/ what's known re. C-19. The pneumonia caused is interstitial. What he's describing is anoxia - if your lung alveoli are fluid-filled and enflamed via interstitial pneumonia, you simply can't get the oxygen into the bloodstream - and you go 'blue', even w/ vent assistance. Vents help to get the oxygen in and inflate the lungs when the patient can't do so enough on their own.

Best practice acute treatment may well adapt as this is new, but I'm not sure what this guy is saying implies that current practice is radically out of kilter.

[123456789.]

Apparently we have recorded 778 more deaths today, which is a relative plateauing. The caveats being that it tends to be the case that Sunday, Monday and Tuesday show a relatively low number before an increase over the rest of the weekend. The case in point being that at the beginning of last week we saw 621, 439 and 786 - before 938, 881, 980 and 917. The same, rough trend happened the week before. Hopefully we won't see a repeat of that this week. The Seattle report I shared over the weekend suggested we'll see a peak on Thursday or Friday this week of 2700 (It seems way off the mark that we'll see those numbers thankfully unless they included care home cases which have not been recorded as of yet) - other earlier reports said the peak would be Easter Sunday, hopefully they are right and we have passed the absolute worst of it.

[123456789.]

https://www.thetimes.co.uk/edition/news/coronavirus-death-toll-is-50-per-cent-higher-than-government-figures-703sn65h6


Apparently the death rate has been 50% higher than the official government figures. It doesn't say why there's a discrepancy between the actual number and the reported number so it would be wrong to speculate. I suspect this is the case in many countries. If it isn't then it pushes us up to the third highest number of deaths in the world. Although I am pretty sure that every country will be seeing a lag on actual cases to reported cases. There is the practical element to this as well. Deaths will have to be recorded and checked by people. The number of people to do that job will reflect the normal number of deaths per year. It's not surprising that it isn't running smoothly at a time like this.

I highly doubt it's any form of government chicanery to fudge the figures as part of a cover up. I think our government's failures are pretty stark as things stand. Generally speaking I think they are the consequence of incompetence rather than malevolence.

[tigertattie]

It’s just bonkers that someone can die of covid-19 but because they weren’t in the hospital at the time it doesn’t count!!!

I don’t care about the politics of the situation but as a nation we got this wrong to start off with and we’ve seen a high number of deaths as a result. We simply closed our eyes and hoped for the best as we didn’t want to hurt the economy to start off with. We’re now paying the price with peoples lives. And it’s not just the government, it’s us as a society. Folk out sunbathing over the weekend. House parties. Hell I still have joggers huffing and puffing passed me on the pavement with no regard for the 2m rule as I do my hour of local exercise going for a walk. I also see people driving their cars to where I walk so they can “keep away” from people. Where I live there’s what was a disused road blocked off at either end. Last year I’d walk along there for an hour each night and I may see the occasional dog walker, with many evenings not a soul to be seen, now I’m seeing dozens of families wandering along it. And as for the joggers, my god if it wasn’t for the uproar in the local press that I’d get!!! I just want to dip the shoulder and put them on their backsides.

We’re starting to flatten out but this is a long way from being over. The only encouragement we can take from this is we’re not Americans and don’t have to put up with Trump rambling on for 45 mins about fake news. Fud!!!

[Pr4wn]

The moron-in-chief has now temporarily suspended US funding to the WHO in a brazen attempt at scapegoating them.

The editor of the lancet has called it “a crime against humanity … Every scientist, every health worker, every citizen must resist and rebel against this appalling betrayal of global solidarity.”

The WHO were recommending shutdowns and serious measures when Trump was still claiming it was a hoax.

[No name Bertie]

... The editor of the lancet has called it “a crime against humanity … Every scientist, every health worker, every citizen must resist and rebel against this appalling betrayal of global solidarity"

The editor of the Lancet announced I think some time last year in an editorial the intention to turn the Lancet into a political vehicle as well as for publishing clinical medical research.  

More and more editors of academic journals are announcing their intention to change society / have a measurable impact on politics.  This includes the articles they are willing to publish which includes an analysis of the authors for things like female and BAME representation. 

Many are calling this a good thing, while a minority say this is a bad thing.

[tigertattie]

Can’t say I agree with the lancet being a political tool. By all means people should push for political change but other platforms should be used.

The lancet and other scientific platforms should be purely left to evidence based science and not opinions. We need something to rely on that can’t be accused of pushing an agenda. Something impartial that everyone can get behind

[navyblueshorts]

... The editor of the lancet has called it “a crime against humanity … Every scientist, every health worker, every citizen must resist and rebel against this appalling betrayal of global solidarity"

The editor of the Lancet announced I think some time last year in an editorial the intention to turn the Lancet into a political vehicle as well as for publishing clinical medical research.  

More and more editors of academic journals are announcing their intention to change society / have a measurable impact on politics.  This includes the articles they are willing to publish which includes an analysis of the authors for things like female and BAME representation. 

Many are calling this a good thing, while a minority say this is a bad thing.

I think it's probably reasonable of me to ask you for a citation re. claim of Lancet acting as a political vehicle, please.

While I'm not saying The Lancet isn't right in calling out Trump here, worth, perhaps, remembering that its Editor was in post when Wakefield's nonsense MMR/Autism paper was published and his behaviour afterwards.

[123456789.]

Lancet's editor didn't cover himself in glory in the early days of Covid-19 and has sort of been playing catch-up ever since.

That being said, it an utterly moronic decision from Trump. The WHO has not worked perfectly on this at all. Part of that is because it does not have the hard power that increasingly makes the world turn. As a soft power organisation with high ideals the WHO provides an outlet for states like China to cultivate a very specific image of themselves around the world. To an extent Trump is right that the organisation panders to China. That's because China has leaders clever enough to realise that you can gain global authority through global organisations. American leaders used to realise that. Trump is a Class A imbecile, I sometimes worry how dangerous he'd be if he had two brain cells. The Chinese Communist government is not a benevolent force in this world; it oppresses its own people, incarcerates millions and distorts the global economy. Trump's reaction to that has been to withdraw from the arenas where it would be safest to combat them. I worry that last night's decision was the moment when global leadership was passed over to a pretty brutal dictatorship simply because in a population of 360 million people the Americans managed to find a President who is the human equivalent of that bit of poop that builds up in the holder of the toilet brush.

Equally elements of the WHO have not been that bad. 'Test, Test, Test' were their early instructions. It helps to identify the cases. To isolate, track and trace those cases. It has largely worked in South Korea and in Germany. In the UK and the USA we were stupid enough not to listen, that is not the fault of the WHO. The WHO asked for $675 million to fund the response to an international pandemic, it received $1.2 million. Just to be clear we have a Prime Minister, who has granted £100,000 to his "friend's" tech company. Spent £43 million on a garden bridge, spent £24 million on a cable car used regularly by 4 people. £5 million on an airport that was never likely to be built. Add in the routemaster fiasco, the overrun on the costs of the BorisBikes, the Water cannons... As a country we could have very nearly fitted the bill for the WHO's Pandemic response on our own by simply matching our commitment to funding the Dear Leader's vanity projects over the years. In fairness to the Indomitable Tw*t he is not a narrow nationalist in the same way that Trump is. It is a tragedy that the free world has abdicated responsibility and global leadership on this. The Chinese government caused this disaster; if the USA or the EU had sought to lead through the WHO they would have furthered the values for which the West is supposed to stand

[Soul Requiem]

An odd criticism of the UK government considering as of now we give more money to the WHO than any other country in the world.

[No name Bertie]

... The editor of the lancet has called it “a crime against humanity … Every scientist, every health worker, every citizen must resist and rebel against this appalling betrayal of global solidarity"

The editor of the Lancet announced I think some time last year in an editorial the intention to turn the Lancet into a political vehicle as well as for publishing clinical medical research.  

More and more editors of academic journals are announcing their intention to change society / have a measurable impact on politics.  This includes the articles they are willing to publish which includes an analysis of the authors for things like female and BAME representation. 

Many are calling this a good thing, while a minority say this is a bad thing.

I think it's probably reasonable of me to ask you for a citation re. claim of Lancet acting as a political vehicle, please.

While I'm not saying The Lancet isn't right in calling out Trump here, worth, perhaps, remembering that its Editor was in post when Wakefield's nonsense MMR/Autism paper was published and his behaviour afterwards.

I was responding to and adding to Pr4wn's comment. I am not here to persuade anyone out of their own opinion or belief. That is a fools errand for the internet. Basically you have to decide whether the quote from the "editor of the lancet" was a political statement or not a political statement and whether that is the type of thing academic journals should be getting involved in.

The problem is once someone politicizes an issue then people end up talking about politics rather than the "science" and the practicalities that follow from that.

I have seen endless threads that begin with something and then someone throws in "but what about Donald Trump" and then the thread goes to pot.

[No name Bertie]

Lancet's editor didn't cover himself in glory in the early days of Covid-19 and has sort of been playing catch-up ever since...

Are you a regular reader of the Lancet?  Can you add to what you mean by the editor not "covering himself in glory in  the early days of Covid-19".  

To be honest as soon as someone mentions Trump I tend to switch off - I am not interested in political squabbling - I would be far more interested in hearing about what the editor of the Lancet has been saying.  

[123456789.]

Lancet's editor didn't cover himself in glory in the early days of Covid-19 and has sort of been playing catch-up ever since...

Are you a regular reader of the Lancet?  Can you add to what you mean by the editor not "covering himself in glory in  the early days of Covid-19".  

To be honest as soon as someone mentions Trump I tend to switch off - I am not interested in political squabbling - I would be far more interested in hearing about what the editor of the Lancet has been saying.  

I'm pretty sure the Lancet editor said that Coronavirus wasn't all that serious in February, I may be wrong on that as I can't find it now.

[No name Bertie]

Lancet's editor didn't cover himself in glory in the early days of Covid-19 and has sort of been playing catch-up ever since...

Are you a regular reader of the Lancet?  Can you add to what you mean by the editor not "covering himself in glory in  the early days of Covid-19".  

To be honest as soon as someone mentions Trump I tend to switch off - I am not interested in political squabbling - I would be far more interested in hearing about what the editor of the Lancet has been saying.  

I'm pretty sure the Lancet editor said that Coronavirus wasn't all that serious in February, I may be wrong on that as I can't find it now.

I did a google search and I got a lot of headlines along the lines of "Editor of Lancet accuses UK government of national scandal".  Then checked his Wikipedia page and he seems to be a political loud mouth - constantly making political statements and demands.  It corroborates what you are saying but it occurred in January and then he changed his mind:  "Dr. Horton's initial response to the outbreak of Coronavirus was cautious, telling his Twitter followers on 24 January 2020 that Covid-19 probably "has moderate transmissibility and relatively low pathogenicity."
https://en.wikipedia.org/wiki/Richard_Horton_%28editor%29

[Pr4wn]

Because this is a far more worrying thing that the President of the United States cutting off funding to the World Health Organisation during a pandemic for purely political reasons.

[rodders]

I'm not sure how much traction this has got yet but I think everyone should, watch it

https://www.youtube.com/watch?v=Eq6YEYfn2zw&fbclid=IwAR0zOLjBDhAvfQXSXXZp3YN-RsDhJS0Ozw3DhEtVMATBaL6FVoq6y0Lw4No

My own anecdotal experience of this makes me believe there is something to this and the implications are that the current treatment and advice is way off and potentially causing a lot of unnecessary deaths.

Early intervention to oxygenate people and avoiding use of mechanical ventilators as much as possible would seem to be what is being suggested.

The UK government cancelled an order of ventilators as the settings couldn't be changed, not sure if this is related -

https://www.independent.co.uk/sport/motor-racing/formula1/coronavirus-f1-teams-ventilator-uk-order-cancelled-red-bull-renault-a9463711.html  

Interesting, but I'm not sure what he says is in any way disagreeing w/ what's known re. C-19. The pneumonia caused is interstitial. What he's describing is anoxia - if your lung alveoli are fluid-filled and enflamed via interstitial pneumonia, you simply can't get the oxygen into the bloodstream - and you go 'blue', even w/ vent assistance. Vents help to get the oxygen in and inflate the lungs when the patient can't do so enough on their own.

Best practice acute treatment may well adapt as this is new, but I'm not sure what this guy is saying implies that current practice is radically out of kilter.

So in my laymans understanding what he is inferring is that the patients lungs operate fine (at least in terms of being able to inflate and deflate), unlike with pneumonia but patients blood oxygen is rapidly depleting, even in relatively healthy patients.

I've seen it hypothesized in several places that covid 19 isn't actually infecting the lungs in the way the current medical understand suggests, it is binding to haemoglobin causing it to lose its binding with O2, causing hypoxia - causing similar effects to altitude or carbon monoxide poisoning.

The haemoglobin is permanently damaged, so until the key is keeping blood oxygen levels up until body produces more haemobglobin and the immune system fights off the disease (or something like that). Mechanically ventilating patients at the later stages, when they have little capacity to transport the oxygen is not only a waste of time, it could actually be damaging the lungs - hence the extremely high mortality rate in ICU patients (>50%)

He is also saying People can have extremely low blood oxygen without even being aware of it, so I would suggest that many people self isolating at home, with "mild symptoms" could be much sicker than they realize.

If this is correct then early intervention/treatment is key and the current approach in some countries to only treat the sickest patients may be contributing to the extremely high mortality rate, that wasn't seen in the earlier outbreaks in asia and diamond princess.

[Soul Requiem]

Medically I do not believe that the western world can be wrong in their agreement of how best to treat the disease.

The mortality rate isn't actually that high anywhere in the world; Germany with their higher capacity for testing are giving a truer representation in that regard, there will be thousands of survivors who aren't included in the statistics.

[navyblueshorts]

... The editor of the lancet has called it “a crime against humanity … Every scientist, every health worker, every citizen must resist and rebel against this appalling betrayal of global solidarity"

The editor of the Lancet announced I think some time last year in an editorial the intention to turn the Lancet into a political vehicle as well as for publishing clinical medical research.  

More and more editors of academic journals are announcing their intention to change society / have a measurable impact on politics.  This includes the articles they are willing to publish which includes an analysis of the authors for things like female and BAME representation. 

Many are calling this a good thing, while a minority say this is a bad thing.

I think it's probably reasonable of me to ask you for a citation re. claim of Lancet acting as a political vehicle, please.

While I'm not saying The Lancet isn't right in calling out Trump here, worth, perhaps, remembering that its Editor was in post when Wakefield's nonsense MMR/Autism paper was published and his behaviour afterwards.

I was responding to and adding to Pr4wn's comment.  I am not here to persuade anyone out of their own opinion or belief.  That is a fools errand for the internet.  Basically you have to decide whether the quote from the "editor of the lancet" was a political statement or not a political statement and whether that is the type of thing academic journals should be getting involved in.  

The problem is once someone politicizes an issue then people end up talking about politics rather than the "science" and the practicalities that follow from that.  

I have seen endless threads that begin with something and then someone throws in "but what about Donald Trump" and then the thread goes to pot.

You said:

...The editor of the Lancet announced I think some time last year in an editorial the intention to turn the Lancet into a political vehicle as well as for publishing clinical medical research...

Given the import of that, I asked you to point me to the quote so that I can see that he actually said, what you claim he said. You choose to obfuscate. Up to you.

[lostinwales]

Medically I do not believe that the western world can be wrong in their agreement of how best to treat the disease.

The mortality rate isn't actually that high anywhere in the world; Germany with their higher capacity for testing are giving a truer representation in that regard, there will be thousands of survivors who aren't included in the statistics.

Hate to agree with you but I do. Particular issues arise because although the virus does not discriminate as such certain groups in society are just more vulnerable, either because of their general health (e.g. care homes) or because of exposure - medics primarily but also transport staff etc. There is also the 'collatoral damage' associated with people missing out on life saving treatment for other conditions for all sorts of reasons, and patients admitted for other reasons then catching CV19 in hospital.

The knock on effect is that it is all too easy for health services to get overwhelmed. It seems as if we have, narrowly, avoided the worst with the NHS but too many medical staff are dead or dying.

[navyblueshorts]

I'm not sure how much traction this has got yet but I think everyone should, watch it

https://www.youtube.com/watch?v=Eq6YEYfn2zw&fbclid=IwAR0zOLjBDhAvfQXSXXZp3YN-RsDhJS0Ozw3DhEtVMATBaL6FVoq6y0Lw4No

My own anecdotal experience of this makes me believe there is something to this and the implications are that the current treatment and advice is way off and potentially causing a lot of unnecessary deaths.

Early intervention to oxygenate people and avoiding use of mechanical ventilators as much as possible would seem to be what is being suggested.

The UK government cancelled an order of ventilators as the settings couldn't be changed, not sure if this is related -

https://www.independent.co.uk/sport/motor-racing/formula1/coronavirus-f1-teams-ventilator-uk-order-cancelled-red-bull-renault-a9463711.html  

Interesting, but I'm not sure what he says is in any way disagreeing w/ what's known re. C-19. The pneumonia caused is interstitial. What he's describing is anoxia - if your lung alveoli are fluid-filled and enflamed via interstitial pneumonia, you simply can't get the oxygen into the bloodstream - and you go 'blue', even w/ vent assistance. Vents help to get the oxygen in and inflate the lungs when the patient can't do so enough on their own.

Best practice acute treatment may well adapt as this is new, but I'm not sure what this guy is saying implies that current practice is radically out of kilter.

So in my laymans understanding what he is inferring is that the patients lungs operate fine (at least in terms of being able to inflate and deflate), unlike with pneumonia but patients blood oxygen is rapidly depleting, even in relatively healthy patients.

I've seen it hypothesized in several places that covid 19 isn't actually infecting the lungs in the way the current medical understand suggests, it is binding to haemoglobin causing it to lose its binding with O2, causing hypoxia - causing similar effects to altitude or carbon monoxide poisoning.

The haemoglobin is permanently damaged, so until the key is keeping blood oxygen levels up until body produces more haemobglobin and the immune system fights off the disease (or something like that). Mechanically ventilating patients at the later stages, when they have little capacity to transport the oxygen is not only a waste of time, it could actually be damaging the lungs - hence the extremely high mortality rate in ICU patients (>50%)

He is also saying People can have extremely low blood oxygen without even being aware of it, so I would suggest that many people self isolating at home, with "mild symptoms" could be much sicker than they realize.    

If this is correct then early intervention/treatment is key and the current approach in some countries to only treat the sickest patients may be contributing to the extremely high mortality rate, that wasn't seen in the earlier outbreaks in asia and diamond princess.
 

None of that explains the inflammatory issues and the effect of the interstitial pneumonia. If your lung alveoli are full of water (essentially), no amount of oxygen, useable Hb or not, is going to help; except maybe via ECMO and if you need that, you're seriously ill.
While there's clearly a lot more to learn about this virus, I don't think this story makes a lot of sense. Certainly, nothing he said enables one to discount severe pneumonia as the cause of an inability to oxygenate blood.

[No name Bertie]

... The editor of the lancet has called it “a crime against humanity … Every scientist, every health worker, every citizen must resist and rebel against this appalling betrayal of global solidarity"

The editor of the Lancet announced I think some time last year in an editorial the intention to turn the Lancet into a political vehicle as well as for publishing clinical medical research.  

More and more editors of academic journals are announcing their intention to change society / have a measurable impact on politics.  This includes the articles they are willing to publish which includes an analysis of the authors for things like female and BAME representation. 

Many are calling this a good thing, while a minority say this is a bad thing.

I think it's probably reasonable of me to ask you for a citation re. claim of Lancet acting as a political vehicle, please.

While I'm not saying The Lancet isn't right in calling out Trump here, worth, perhaps, remembering that its Editor was in post when Wakefield's nonsense MMR/Autism paper was published and his behaviour afterwards.

I was responding to and adding to Pr4wn's comment.  I am not here to persuade anyone out of their own opinion or belief.  That is a fools errand for the internet.  Basically you have to decide whether the quote from the "editor of the lancet" was a political statement or not a political statement and whether that is the type of thing academic journals should be getting involved in.  

The problem is once someone politicizes an issue then people end up talking about politics rather than the "science" and the practicalities that follow from that.  

I have seen endless threads that begin with something and then someone throws in "but what about Donald Trump" and then the thread goes to pot.

You said:

...The editor of the Lancet announced I think some time last year in an editorial the intention to turn the Lancet into a political vehicle as well as for publishing clinical medical research...

Given the import of that, I asked you to point me to the quote so that I can see that he actually said, what you claim he said. You choose to obfuscate. Up to you.

Your response proves the correctness of my response.

[navyblueshorts]

I'm not sure how much traction this has got yet but I think everyone should, watch it

https://www.youtube.com/watch?v=Eq6YEYfn2zw&fbclid=IwAR0zOLjBDhAvfQXSXXZp3YN-RsDhJS0Ozw3DhEtVMATBaL6FVoq6y0Lw4No

My own anecdotal experience of this makes me believe there is something to this and the implications are that the current treatment and advice is way off and potentially causing a lot of unnecessary deaths.

Early intervention to oxygenate people and avoiding use of mechanical ventilators as much as possible would seem to be what is being suggested.

The UK government cancelled an order of ventilators as the settings couldn't be changed, not sure if this is related -

https://www.independent.co.uk/sport/motor-racing/formula1/coronavirus-f1-teams-ventilator-uk-order-cancelled-red-bull-renault-a9463711.html  

Interesting, but I'm not sure what he says is in any way disagreeing w/ what's known re. C-19. The pneumonia caused is interstitial. What he's describing is anoxia - if your lung alveoli are fluid-filled and enflamed via interstitial pneumonia, you simply can't get the oxygen into the bloodstream - and you go 'blue', even w/ vent assistance. Vents help to get the oxygen in and inflate the lungs when the patient can't do so enough on their own.

Best practice acute treatment may well adapt as this is new, but I'm not sure what this guy is saying implies that current practice is radically out of kilter.

So in my laymans understanding what he is inferring is that the patients lungs operate fine (at least in terms of being able to inflate and deflate), unlike with pneumonia but patients blood oxygen is rapidly depleting, even in relatively healthy patients.

I've seen it hypothesized in several places that covid 19 isn't actually infecting the lungs in the way the current medical understand suggests, it is binding to haemoglobin causing it to lose its binding with O2, causing hypoxia - causing similar effects to altitude or carbon monoxide poisoning.

The haemoglobin is permanently damaged, so until the key is keeping blood oxygen levels up until body produces more haemobglobin and the immune system fights off the disease (or something like that). Mechanically ventilating patients at the later stages, when they have little capacity to transport the oxygen is not only a waste of time, it could actually be damaging the lungs - hence the extremely high mortality rate in ICU patients (>50%)

He is also saying People can have extremely low blood oxygen without even being aware of it, so I would suggest that many people self isolating at home, with "mild symptoms" could be much sicker than they realize.    

If this is correct then early intervention/treatment is key and the current approach in some countries to only treat the sickest patients may be contributing to the extremely high mortality rate, that wasn't seen in the earlier outbreaks in asia and diamond princess.
 

There is this:

https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

All it is though, is some molecular modelling. It's a far cry from that to actual biological function. Can't find anything else...

Missed the bolded bit earlier. What does he mean by 'extremely low blood oxygen'?? If you're in hospital and your SATs are sub-90%, normally people jump up and down and you get some oxygen. I think people would realise something was amiss if their SATs are low. Sub-80% would tend to make people short of breath, lethargic, dizzy, cyanotic (blueish on peripheries), headachy and worse.

[navyblueshorts]

... The editor of the lancet has called it “a crime against humanity … Every scientist, every health worker, every citizen must resist and rebel against this appalling betrayal of global solidarity"

The editor of the Lancet announced I think some time last year in an editorial the intention to turn the Lancet into a political vehicle as well as for publishing clinical medical research.  

More and more editors of academic journals are announcing their intention to change society / have a measurable impact on politics.  This includes the articles they are willing to publish which includes an analysis of the authors for things like female and BAME representation. 

Many are calling this a good thing, while a minority say this is a bad thing.

I think it's probably reasonable of me to ask you for a citation re. claim of Lancet acting as a political vehicle, please.

While I'm not saying The Lancet isn't right in calling out Trump here, worth, perhaps, remembering that its Editor was in post when Wakefield's nonsense MMR/Autism paper was published and his behaviour afterwards.

I was responding to and adding to Pr4wn's comment.  I am not here to persuade anyone out of their own opinion or belief.  That is a fools errand for the internet.  Basically you have to decide whether the quote from the "editor of the lancet" was a political statement or not a political statement and whether that is the type of thing academic journals should be getting involved in.  

The problem is once someone politicizes an issue then people end up talking about politics rather than the "science" and the practicalities that follow from that.  

I have seen endless threads that begin with something and then someone throws in "but what about Donald Trump" and then the thread goes to pot.

You said:

...The editor of the Lancet announced I think some time last year in an editorial the intention to turn the Lancet into a political vehicle as well as for publishing clinical medical research...

Given the import of that, I asked you to point me to the quote so that I can see that he actually said, what you claim he said. You choose to obfuscate. Up to you.

Your response proves the correctness of my response.

Never mind; you clearly don't have the evidence to support your bias.

[tigertattie]

Channel 4 did an interesting program tonight.

On it there was a lady who was hospitalised after showing symptoms for two weeks and her oxygen levels dropped to 60%. They were looking at anaesthetising her to  mechanically ventilate but luckily she started getting back up and now she’s on a 28% oxygen mix and is on her way to getting back to regular 21% oxygen which is the air we breathe.

She didn’t have pneumonia so it is possible that the virus is stopping blood from oxygenating. Hopefully we’re starting to understand this virus now which will help in its treatment. The scary thing about the virus was how little we knew about it.

If it is the blood that’s the issue then transfusions could be a way forward. So don’t forget to give blood folks, it’s important to do this anyway even if transfusion isn’t a viable treatment as we always need blood stocks.

[rodders]

Channel 4 did an interesting program tonight.

On it there was a lady who was hospitalised after showing symptoms for two weeks and her oxygen levels dropped to 60%. They were looking at anaesthetising her to  mechanically ventilate but luckily she started getting back up and now she’s on a 28% oxygen mix and is on her way to getting back to regular 21% oxygen which is the air we breathe.

She didn’t have pneumonia so it is possible that the virus is stopping blood from oxygenating. Hopefully we’re starting to understand this virus now which will help in its treatment. The scary thing about the virus was how little we knew about it.

If it is the blood that’s the issue then transfusions could be a way forward. So don’t  forget to give blood folks, it’s important to do this anyway even if transfusion isn’t a viable treatment as we always need blood stocks.

https://www.bbc.com/news/uk-wales-52299404

Yes it looks like the penny is dropping but why has it taken so long to see we are going down the wrong road?

Places that are identifying cases early via testing and administering hydroxychloroquine are having very low mortality rates. Would they give Tom Hanks and his wife a drug that didn't work? I don't think so.

If we accept this is new understanding of what this virus is doing, then the way the NHS are handling this is completely wrong, by being advised to self isolating for 7-8 days many people could be too sick to help by the time they seek treatment. The exact same phenomena was saw in Italy, where even young/healthy patients had <50% survival rates and were incredibly ill on arrival.

This also begs the question, is this virus even a SARS like disease at all, as in if it is not a typical respiratory illness causing risk of ARDS, rather a blood parasite - do we need to look at this all again and question how this is actually transmitting, it's origin, everything?

Look at the at risk groups again - ask why would pregnant woman be at high risk of pneumonia and young Children not at risk? If you consider the disease as a pneumonia causing virus that makes no sense at all.

But if you consider it is actually somehow hijacking hemoglobin then it makes perfect sense that groups with reduced ability to produce new hemoglobin, or already are depleted due to underlying condition, are going to be far more severely impacted.

Thankfully questions are being asked and some indications protocols are changing - https://twitter.com/cameronks - but when this is over we need a public inquiry to what the hell has gone on.

[Soul Requiem]

Out of interest where are these places administering Hydroxychloroquine with low mortality rates?

[rodders]

Out of interest where are these places administering Hydroxychloroquine with low mortality rates?

Research it is quite easy to find.

[Soul Requiem]

Out of interest where are these places administering Hydroxychloroquine with low mortality rates?

Research it is quite easy to find.

You'll have to help me out as i'm not finding anything.

[Crimey]

I find it so hard to believe that with the entire world focused on this, that something like that has gone unnoticed by the mainstream medical community. I think it's wishful thinking, as it would provide us with a quick way out.

[lostinwales]

Out of interest where are these places administering Hydroxychloroquine with low mortality rates?

Research it is quite easy to find.

What I have seen is very mixed about it, and the side effects for some people are not at all good. Rumors that Trump invested in a company making the drug does not help.

It is being widely tested across the world. A simple search brings up articles such as this

https://www.ibtimes.sg/coronavirus-swedish-hospitals-stop-chloroquine-trials-patients-complain-dangerous-side-effects-42679

It is primarily a treatment for malaria but also an important drug for people suffering from Lupus.

[rodders]

I find it so hard to believe that with the entire world focused on this, that something like that has gone unnoticed by the mainstream medical community. I think it's wishful thinking, as it would provide us with a quick way out.

It hasn't gone unnoticed at all. Only if your source of information is the BBC and UK goverment. It is everywhere.

In Australia they are using it widely, obviously supplies are limited and there is a lot of politics assessing but for sure those who can get it (i.e. the wealthy) are getting it. India is available and they have very low death rate despite low ICU capacity.

The death toll and severity of this disease jumped dramatically when it hit Lombardy. Did it morph into something different or is the answer staring in front of us - the doctors in Lombardy diagnosed nearly every patient with severe Bi-lateral pneumonia and treated them as such , finding terrible mortality rates in all ages in ICU - something completely different to the Asian and German outbreaks, Ireland and Germany too.

One difference Cases weren't being caught in the community but much later, patients were being advised to stay away to retain capacity for the sickest - Spain and the UK have fallen into the same loop. Reserve treatment to the critically ill, logical enough but actually what they are doing is reserving the majority of resources to those with least chances of recovery as they arrive with depleted oxygen and organ damage - even the early published articles in the lancet say early treatment is critical.

In the UK and Italy most treatment begins at day 8. Compare to the the countries doing community testing, some basic math's will show a difference in mortality that can't be explained by demographics and ICU capacity.

[Sponsored content]