I have been reading comments generally saying whilst the lockdown is a good thing the Government need to be wary of the economical and social impact this will have on society ( "people losing jobs leading to mass unemployment /starving") Are you worried about that or happy to let the Government take as long as is possible to ensure the vast majority are safe and well? Presume we might see the lockdown gradually lessen over time if adhered to now. In the mean time keep well and healthy!
I think it’s a question of whether we are truly “all in this together” or not. That wasn’t the case with ‘Austerity’, as it seems to be known now. Given the absence of immunity to this virus, and that worldwide numbers testing positive are still less than 2 million, I can’t believe we are close to leaving lockdown. If we do too soon, the second wave will be a tsunami the NHS couldn’t possibly cope with, hundreds of thousands would die, and the social and (less importantly IMHO) economic cost would massively outweigh sticking tight for foreseeable. Any changes to lockdown need to be gradual, judiciously gradual, not motivated by the greed of ‘elite’, eg as Trump was clearly trying on with the US workforce. I hate the term ‘elite’ when describing the people orchestrating our society, because it necessarily implies superiority. I hope our society is waking up to whom the real elite are and have been, and that we seek to treat them properly in the future.
I agree it needs to be managed and does with careful process. At the moment lives and health are more important than businesses but then I am on the vulnerable list. Priorities probably change for someome who isn't and fighting for their job? Some middle ground has to be found.
Lives come first Mark - however this needs to be balanced against the fact that poverty kills as many people as viruses do. Theoretically, if the government tells people to stay at home for the duration then the government should pay them for doing so - but the problem is that we do not know how long that will be for. I am sceptical about the phrase 'we're all in this together' - that's what they said during World War 2, but it turned into an empty phrase afterwards. The problem is that it is not enough to kill off the virus in one country if it survives somewhere else - countries cannot fully get back to normal until their neighbours have also succeeded in this.
From a nurse in NY I lost a patient today. He was not the first, and unfortunately he's definitely not the last. But he was different. I've been an ER nurse my entire career, but in New York I find myself in the ICU. At this point there's not really anywhere in the hospital that isn't ICU, all covid 19 positive. They are desperate for nurses who can titrate critical medication drips and troubleshoot ventiltors. I've taken care of this man the last three nights, a first for me. In the ER I rarely keep patients for even one 12 hour shift. His entire two week stay had been rough for him, but last night was the worst. I spent the first six hours of my shift not really leaving his room. By the end, with so many medications infusing at their maximum, I was begging the doctor to call his family and let them know. "He's not going to make it", I said. The poor doctors are so busy running from code to code, being pulled by emergent patients every minute. All I could think of was the voice of my mom in my head, crying as I got on the plane to leave for this place: "Those people are alone, you take good care of them". I was the only person in that room for three nights in a row, fighting as hard as I could to keep this man alive. The doctor was able to reach the family, update them. It was decided that when his heart inevitably stopped we wouldn't try to restart it. There just wasn't anything else left to do. Eventually, he gave up. It was just him and me and his intubated roommate in the next bed. The wooden door to the room is shut, containing infection and cutting us off from the rest of the world. I called the doctor to come and mark the time of death. I wished so much that I could let his family know that while they might not have been with him, I was. I shut the pumps down (so horribly many of them), disconnected the vent, took him off the monitor. We didn't extubate him, too much of a risk to staff. Respiratory took the vent as soon as I called. It's just a portable one, but it's life to someone downstairs. The CNA helped me to wash him and place him in a body bag, a luxury afforded only to those who make it out of the ER. Down there the bodies pile up on stretchers, alone, while the patients on vents wait for the golden spot my gentleman just vacated. We'll talk about the ER another time. My patient was obviously healthy in his life. I look at his picture in his chart, the kind they take from a camera over a computer when you aren't really prepared. A head shot, slightly awkward. I see someone's Grandpa, someone's Dad, someones Husband. They aren't here with him. My heart breaks for them. I fold his cute old man sweater and place it in a bag with his loafers, his belongings. I ask where to put this things. A coworker opens the door to a locked room; labeled bags are piled to the ceiling. My heart drops. It's all belongings of deceased parents, waiting for a family member to someday claim them. A few nights ago they had 17 deaths in a shift. The entire unit is only 17 beds. These patients are so fragile. It's such a delicate balance of breathing, of blood pressure, of organ function. The slightest movement or change sends them into hours long death spirals. The codes are so frequent those not directly involved barely even register them. The patients are all the same, every one. Regardless of age, health status, wealth, family, or power the diagnosis is the same, the disease process is the same, and the aloneness is the same. Our floor has one guy that made it to extubation. He's 30 years old. I view him as our mascot, our ray of hope that not everyone here is just waiting to die. I know that most people survive just fine, but that's not what it feels like in this place. Most of the hospital staff is out sick. We, the disaster staff, keep our n95 masks glued to our faces. We all think we are invincible, but I find myself eyeing up my coworkers, wondering who the weak ones are, knowing deep down that not all of us will make it out of here alive. A bus takes us back to the hotel the disaster staff resides in, through deserted Manhatten. We are a few blocks from Central Park. We pass radio city music hall, nbc studios, times square. There is no traffic. The sidewalks are empty. My room is on the 12th floor. At 7pm you can hear people cheering and banging on and pans for the healthcare workers at change of shift. This city is breaking and stealing my heart simultaneously. I didn't know what I was getting into coming here, but it's turning out to be quite a lot. So sad.......
I don't know what others may think of this, but I'm viewing it as a positive - trade talks with the US have been postponed indefinitely. http://archive.is/0FiyT
An article on the Covid-19 Growth Factor. Statiticians do like playing around with numbers and fancy graphs, but this does seem to give an easy to understand stat, which acts as a target too. The main focus of the article is on Australia, but scrolling down to the 'How are other countries doing?' gives some interesting reading - one part which will interest OFH, and another which shows that Sweden's strategy may well have been ill-advised. https://www.abc.net.au/news/2020-04-10/coronavirus-data-australia-growth-factor-covid-19/12132478
Other studies represent this as the reproduction ratio. Basically if the average infected person is only infecting less than one other person then a virus will die out. Australia appears to be winning the battle, just as South Korea did using other methods. Some European countries appear to have turned the corner, in as much as that the numbers of new cases are falling - Austria is leading the way on this, followed by Italy, Spain, Germany, Switzerland and Norway. In Germany the RO factor is heading towards 1:1. Countries where the rate appears to have levelled off include Portugal and the Netherlands. The biggest 'problem' countries appear to be the UK, France, Belgium and Sweden. There needs to be a coordinated approach on this - Sweden's strategy is not only ill advised but is also dangerous for neighbouring countries which have taken a more responsible approach such as Norway.
I think that in many cases we are seeing just how prepared countries were to deal with a major health crisis. The CMO let the cat out of the bag a couple of days ago when he admitted that the UK was ill prepared despite warnings given in various studies that the government had suppressed. When you see reports sent back to the authors to 'reconsider' the conclusions, then what it actually means is, it is too expensive. You might be lucky as a government to get away with it if there is no crisis, but if there is one you see a plan put into place that has to use the limited resources you have available. Once you realise that your resources are not sufficient you rush around to try and increase them, but spin becomes vital to try and convince a population that you have always been in control of the situation. This is being controlled by politicians, and we should never forget that they have one eye on the next election even if it is several years away.
Whereas this suggests that Austria are on a par with the UK, Sweden and Russia are both in trouble and France is leading the way. Makes you wonder who to believe...
Although the government tries to say otherwise, the talks between the EU and UK have actually been stopped. You cannot have hundreds of civil servants dealing with legal texts that have to be agreed with their bosses conducting the talks over the internet.
Germany had the ability to carry out mass testing, which they used as their focal point in their attack against the virus. France does not have the same quantity of testing available, so chose the rigid keep people apart approach. The UK doesn't have the testing ability either, and chose what seems from here to be a half-hearted approach to lock down. There are still reports today of the police having to break up parties and BBQ's.
My neighbour ( civil servant) has been working on some of the UK'S policy's for the past few weeks at home. He understands that talks have been held over the past week at top-level given the updates he has been given. He has been asked to amend certain things in the past few days based on minutes of briefings that have taken place between the two sides. Apparently it is all preliminary discussions at this stage and is not being delayed. He does not discuss specifics but happened to mention it to me when we were in a general conversation over the garden fence saying his workload had not eased at all.
I think from what I have been told that preliminary work has continued, but the real negotiations have ceased between the two sides. It was reported this week that a new program for talks will be discussed in the next week to see if they can be restarted. I do know of some civil servants employed on Brexit who have been moved to deal with the coronavirus.
A group of would-be holidaymakers who flew in a private jet from London to the Côte d’Azur in France have been turned back by police. Seven men and three women arrived on the chartered aircraft to Marseille-Provence airport, where helicopters were waiting to fly them on to Cannes, where they had rented a luxury villa. The men, aged 40-50, and women, aged 23-25, were refused permission to enter France and ordered by police to fly back to the UK.
Where they should, by rights, also be refused entry - apparently they were made up of several nationalities - Croatian, German, French, Romanian and Ukrainian. Seven middle-aged men and three young women - sounds like their dirty weekend was ruined...
The Covid Report - on Testing. Trying to establish what we know, what we don't know and what we're not being told.
"Coronavirus is hurting America's place as a world leader" I would have thought that Trump is doing more damge to be honest - but, nevertheless, a disturbing read. https://www.abc.net.au/news/2020-04...uggle-between-donald-trump-and-china/12138772
