Corona-virus - Impact of the Health Situation worldwide

[Nearholmer]

And G-Mex in Manchester.

[melmerby]

Also SECC and one in Cardiff

 

NEC will have 5000 beds and the Gmex 1000

Edited March 30, 2020 by melmerby

[Reorte]

1 hour ago, Nearholmer said:

And G-Mex in Manchester.

Station to car park to conference centre to hospital. Some people places just can't hold a career down.

[monkeysarefun]

We've had our third day in a row of decreasing infections - any news is good news ATM! 

The majority of our cases are people returning from overseas with it so the hope is that we've caught them early enough to limit transmission through the general community.  Also of concern is the overseas backpacking community based in the Eastern Suburbs of Sydney who even up to this weekend still insisted on partying  and going to the beach despite social distancing rules - it was this lot rather than locals who featured mainly in the pictures of Bondi beach a couple of weeks ago. This has caused  most of the cases in the East of Sydney and led to the NSW government setting up a testing station there..

 

For some reason we also seem to be pretty lucky on the death count  so far -  19 deaths out of just under 4500 cases.

 

(QLD and Victoria have banned the sale of guns...)

Edited March 31, 2020 by monkeysarefun

[LBRJ]

Well I have been officially furloughed ( i like that word) from the sortta part time job and also decided to hang up the chainsaw and mothball the table saw for the duration....

Accidents with the latter two are never likely to be a " sticking plaster and kind words" sort of thing, and I am sure the local hospital is busy enough without me turning up in more than one piece

and more selfishly I dont wanna go in with an unattached digit or limb and come out erm, not feeling very well....

Edited March 31, 2020 by LBRJ

[LBRJ]

One must wonder when the handily placed Regional Detention Units we often call Centre Parcs will start being used?

 

I am joking but such places do remind me of ready made units for housing some people at some point......

[Ozexpatriate]

4 hours ago, LBRJ said:

decided to hang up the chainsaw and mothball the table saw for the duration....

Accidents with the latter two are never likely to be a " sticking plaster and kind words" sort of thing, and I am sure the local hospital is busy enough without me turning up in more than one piece

and more selfishly I dont wanna go in with an unattached digit or limb and come out erm, not feeling very well....

A sensible precaution.

[Ozexpatriate]

I saw online that the Mercedes F1 engineering team have modified a CPAP machine that could provide intermediate assistance for COVID-19 patients needing help in breathing, but not requiring intubation and ventilation on a ventilator.

 

This appears to be a positive and useful innovation - particularly if they can ramp up manufacture of them. 

[Dunsignalling]

4 hours ago, LBRJ said:

One must wonder when the handily placed Regional Detention Units we often call Centre Parcs will start being used?

 

I am joking but such places do remind me of ready made units for housing some people at some point......

Self-catering holiday accommodation in the West Country has already been made available to health professionals who are staying away from home to protect their families. I'd think Centre Parcs could readily fulfil that function.

 

On the patient side, a number of closed-down retirement/nursing homes are being made ready to accommodate virus survivors who aren't yet fit enough to go home, but who no longer require hospital-level supervision.

 

John

[Joseph_Pestell]

1 hour ago, Ozexpatriate said:

I saw online that the Mercedes F1 engineering team have modified a CPAP machine that could provide intermediate assistance for COVID-19 patients needing help in breathing, but not requiring intubation and ventilation on a ventilator.

 

This appears to be a positive and useful innovation - particularly if they can ramp up manufacture of them. 

 

We mentioned this early yesterday.

 

The more I think about it, the more it seems to me that it must always be wrong to use a ventilator on someone who is trying to recover from a virus. Ventilator is fine for someone who is injured and needs help with breathing while the injuries heal. But to use a ventilator, you have to sedate the patient and that is going to impair their ability to produce antibodies against the virus. So CPAP must be better than ventilators in this situation.

[Dunsignalling]

2 hours ago, Ozexpatriate said:

I saw online that the Mercedes F1 engineering team have modified a CPAP machine that could provide intermediate assistance for COVID-19 patients needing help in breathing, but not requiring intubation and ventilation on a ventilator.

 

This appears to be a positive and useful innovation - particularly if they can ramp up manufacture of them. 

Subject to approval, which should be fairly rapid as the unit has been developed from an existing device, Mercedes F1 reckon they can be producing a thousand a day within a couple of weeks.

 

Chinese and Italian sources, reported by BBC news, have suggested that CPAP devices are effective for around 60% of patients who would otherwise need full ventilation, thereby making those machines (and the staff required to use them) available for patients in greatest need.  

 

John

Edited March 31, 2020 by Dunsignalling

[Joseph_Pestell]

9 minutes ago, Dunsignalling said:

Chinese and Italian sources have suggested that CPAP devices are effective for around 60% of patients who would otherwise need full ventilation, thereby making those machines (and the staff required to use them) available for patients in greatest need.  

 

 

Is the 40% who go onto ventilators rather than CPAP, part of the 50% who subsequently die? If so, potentially validates my point above.

[Ozexpatriate]

31 minutes ago, Joseph_Pestell said:

The more I think about it, the more it seems to me that it must always be wrong to use a ventilator on someone who is trying to recover from a virus. Ventilator is fine for someone who is injured and needs help with breathing while the injuries heal. But to use a ventilator, you have to sedate the patient and that is going to impair their ability to produce antibodies against the virus.

I'm not a physician but this doesn't sound accurate to me.

 

Being in an induced coma on a ventilator is no fun for anyone but it saves lives. A former colleague needed this therapy for pneumonia.

 

Clearly there is a point where intubation and ventilation are no longer required, but for many patients they are necessary at some point. I am confident that some of the recovered COVID-19 patients were on ventilation at some point.

[Dunsignalling]

3 minutes ago, Joseph_Pestell said:

 

Is the 40% who go onto ventilators rather than CPAP, part of the 50% who subsequently die? If so, potentially validates my point above.

Good question but, as with most analysis relating to this virus and its treatment, an answer may be some way off.

 

By definition, those ventilated will be the most likely to die anyway. Under such circumstances, it's hard to be certain if any specific patient died because of the treatment received, or in spite of it.

 

There are also questions as to how we treat mortality statistics in general. The Covid-19 virus certainly leads to death, but we don't (and probably never will) know the ratio of fatalities directly attributable to the virus against the number whose "underlying causes" were likely to see them off in a few weeks/months without its assistance.

 

John

[Dunsignalling]

3 minutes ago, Lantavian said:

Who are these sources?

How did you get in contact with them?

 

Reported on BBC news. Post amended.

Edited March 31, 2020 by Dunsignalling

[Ozexpatriate]

5 minutes ago, Dunsignalling said:

the number whose "underlying causes" were likely to see them off in a few weeks/months without its assistance.

"weeks/months"?

 

For many you mean years/decades don't you?

[Dunsignalling]

13 minutes ago, Ozexpatriate said:

"weeks/months"?

 

For many you mean years/decades don't you?

I'd think those would be the ones that could be more definitely attributed to the virus,.

 

There is also the matter of patients already well beyond average life expectancy (defined, perhaps, as frail, but not ill) that the virus might well push over the edge, but who statistically carry an elevated chance of just not waking up tomorrow morning.   

 

It is all these groups for whom it has been decided that staying in offers the best protection.

 

John

Edited March 31, 2020 by Dunsignalling

[Oldddudders]

7 minutes ago, Lantavian said:

 

Coronavirus is different. If someone is spreading false or misleading information -- even if they are doing it with the best will in the world --  then I think we have duty to correct it, rather than scroll on past.

 

Misinformation can kill people.

I think the complaint was more about the discussion of political and economic philosophy, which clearly fascinates some, but has precious little to do with what is happening right now, and for which this thread was intended. And obsessives seldom add value to rational discussion. 

[Nearholmer]

1 hour ago, Joseph_Pestell said:

you have to sedate the patient and that is going to impair their ability to produce antibodies against the virus

The greatest impairment to the ability to produce antibodies is being dead.
 

The way I understand it that the ventilator is used to stave-off that outcome for long enough to allow the patient to mount a defence.

 

I also understand that about half of those who get to the point of needing a ventilator are already so weakened, either by the virus itself or other debilitating conditions, that, that even with the help of the ventilator they are unable to mount a defence.

 

The video by Doctor Wong explains very well why that is the case ....... the way he explains it, one gets the impression that if you get the advanced symptoms, you need to be bloody fit and strong to be able to get through it.

 

So, the ventilator discussion is about two things:

 

- whether it is right to literally prolong the agony of someone who is vanishingly unlikely to have the strength to fight through it; and,

 

- whether it is right to occupy ventilators for long periods with people who are almost certain not to make it, thereby denying them to people who are otherwise fighting fit, and probably will make it if ventilated, but not if they aren’t.

 

What is mega-sobering is how slight the debilitation needs to be to make it impossible for a person to fight through it ....... the very young woman (21yo?) who was lost the other day was reported to suffer from ‘very mild asthma’.

 

 

[billbedford]

39 minutes ago, Lantavian said:

Who are these sources?

How did you get in contact with them?

 

 

WHO-China joint mission Report

 

Italian ISS report in English

 

Both are relatively old now

 

 

[billbedford]

6 hours ago, Lantavian said:

That links to the Spectator

 

You do realise the Spectator is pretty damn mainstream. 

 

Boris Johnson used to be editor. The owners also own the Telegraph.

 

 

 

Judging a book by it's cover?

[billbedford]

28 minutes ago, Lantavian said:

 

Coronavirus is different. If someone is spreading false or misleading information -- even if they are doing it with the best will in the world --  then I think we have duty to correct it, rather than scroll on past.

 

Misinformation can kill people.

 

How does anyone recognise misinformation?  It's not all printed in green ink. 

[Oldddudders]

6 minutes ago, Nearholmer said:

So, the ventilator discussion is about two things:

 

- whether it is right to literally prolong the agony of someone who is vanishingly unlikely to have the strength to fight through it; and,

 

- whether it is right to occupy ventilators for long periods with people who are almost certain not to make it, thereby denying them to people who are otherwise fighting fit, and probably will make it if ventilated, but not if they aren’t.

 

What is mega-sobering is how slight the debilitation needs to be to make it impossible for a person to fight through it ....... the very young woman (21yo?) who was lost the other day was reported to suffer from ‘very mild asthma’.

 

 

And thus some of us, past 70, and having one or more of the specified underlying conditions, need to think seriously about whether we do press the panic button when the symptoms become serious - or soldier on to certain and uncomfortable demise, but knowing a younger, fitter person may have been saved as a result. I see this in contrast to the useless folk flouting the lockdown, whose selfishness I find deeply offensive. 

[boxbrownie]

5 minutes ago, billbedford said:

 

How does anyone recognise misinformation?  It's not all printed in green ink. 

If it’s on the internet 

 

oh...I forgot.....the newspapers as well of course....

Edited March 31, 2020 by boxbrownie

[Reorte]

7 minutes ago, billbedford said:

 

How does anyone recognise misinformation?  It's not all printed in green ink. 

 

General knowledge of the subject, assessment of the source it came from, general plausibility and reasons for finding it plausible or not.

 

Most of GCSE history seemed to be that for me ("here are some newspaper reports / radio transcripts etc. of an event, work out what was going on and say why you used which sources and why, which you considered reliable or not due to reasons of bias, being in a position to actually know and so on.") Pity it was an optional subject back then, teaching that sort of thinking (irrespective of any historical facts learned) was useful enough then when hardly anyone had heard of the internet, and even more so now.