UK Politics: What about a Masquerade?

[Tywin Manderly]

Please continue. 

[Spockydog]

Anyway, back to the politics.

UK missed three chances to join EU scheme to bulk-buy PPE

Quote

Britain missed three opportunities to be part of an EU scheme to bulk-buy masks, gowns and gloves and has been absent from key talks about future purchases, the Guardian can reveal, as pressure grows on ministers to protect NHS medics and care workers on the coronavirus frontline.

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.

The EU’s swift work has led to offers of medical equipment, including masks, overalls and goggles, in excess of the number requested, a spokesman for the European commission said. The EU is separately establishing stockpiles within member states, with the first being set up in Romania.

Stuff like this is where our anger at the lack of PPE for NHS staff should be directed. Not at people wearing gloves or badly fitting masks in the supermarket.

[ants]

Tim Brooke-Taylor died on the weekend.

Was front line news in Australia.  

[The BlackBear]

5 hours ago, ants said:

Tim Brooke-Taylor died on the weekend.

Was front line news in Australia.  

Yeah, apparently the Goodies was big over there? I knew him mostly from ISIHaC, he'll be missed.

[ants]

3 hours ago, The BlackBear said:

Yeah, apparently the Goodies was big over there? I knew him mostly from ISIHaC, he'll be missed.

Huge. A generation of kids grew up watching it. 

[Which Tyler]

They've now released the actual important stats. Number of deaths registered in a week, versus the average for that week over the previous 5 years.

It isn't pretty.

 

[ljkeane]

It's not great.

I was actually a little surprised it wasn't significantly worse than a peak from flu deaths, which tends to be in January rather than April. That was about 10 days ago though. I suppose the other lesson from all this is that flu really is a lot worse than we tend to think of it as.

ETA: In terms of the excess number of non coronavirus related deaths you'd think there should be a fall in things like accidental deaths with a large proportion of people just sat at home. I'd guess it's probably down to a lot of people not seeking/struggling to get medical help for other issues.

[williamjm]

4 hours ago, ljkeane said:

It's not great.

I was actually a little surprised it wasn't significantly worse than a peak from flu deaths, which tends to be in January rather than April. That was about 10 days ago though. I suppose the other lesson from all this is that flu really is a lot worse than we tend to think of it as.

I noticed that as well, that there was a spike almost as large in 2015 due to flu and maybe it was mentioned on the news at the time but I've no memory of it now. It would be good if we could learn some lessons from the current situation that might make future flu outbreaks less severe.

Quote

ETA: In terms of the excess number of non coronavirus related deaths you'd think there should be a fall in things like accidental deaths with a large proportion of people just sat at home. I'd guess it's probably down to a lot of people not seeking/struggling to get medical help for other issues.

It feels important to understand what the reason for this is, it might be an unavoidable consequence of the health service having to focus on the coronavirus but if more was known there might be things that can done better in future as well as the obvious things like giving medical staff the resources they need to do their jobs.

I remember reading about similar figures from Bergamo a few days ago where there was an increase in deaths not attributed to coronavirus, I don't know whether the Italians have managed to do more analysis since then.

[felice]

5 hours ago, ljkeane said:

ETA: In terms of the excess number of non coronavirus related deaths you'd think there should be a fall in things like accidental deaths with a large proportion of people just sat at home. I'd guess it's probably down to a lot of people not seeking/struggling to get medical help for other issues.

Some of them will be covid-19 deaths that simply weren't confirmed as such. Maybe even more than all of them! (If the genuinely non-covid-related deaths are below the average for the week, as you expected.)

[ljkeane]

1 hour ago, felice said:

Some of them will be covid-19 deaths that simply weren't confirmed as such. Maybe even more than all of them! (If the genuinely non-covid-related deaths are below the average for the week, as you expected.)

I'm sure it's possible some of them are. You'd think Covid 19 would be at the forefront of all doctors minds at the moment though so it seems unlikely that there are lot of deaths at the moment showing the expected symptoms were it isn't being mentioned as a potential cause.

[Ivan Tsarevich]

To yet address the discussion from the last thread about whether or not the coronavirus can be transmitted via air: @Spockydog is not the only one who has seen such info. It may be old news, but I've seen such statement in this writing (24.3.2020) by Finnish MP Mika Niikko (Finns party), who writes that the virus can float in air even three hours and infect via air. According to him, this piece (in English), which he links, says so. If you're interested (I am not, really), read it for yourself and see if you agree. Other source, a piece of news by Tekniikan Maailma, also shared by him and also in Finnish, here, has claimed the same 12.3.2020. The latter shares this link, which according to them is report by NIH researchers, and also says this is reported by Time. That last link does not work for me for some reason. Perhaps it has been deleted. Regardless, I duly copied it. For the record; Tekniikan Maailma also says that the report is not peer reviewed. I've no idea whether such review would have happened since and what conclusion it would have reached.

I do not necessarily trust any of these sources myself - I am not at all familiar with US Institutes, I do not read TM and Niikko, afair, has some recent history that may raise doubts of his reliability, not to mention that his political affiliation might be problematic to some - but information is information regardless of the source, and taking a note of a warning hardly hurts. I share this due the existent possiblity that it might do some good in case it's true, and in case it's not, it's actual harms would be mostly limited to possible additional worry and perhaps some social backlash.

@Filippa Eilhart, you voiced some interest to the matter in that convo. See above, if you're interested. @Isis and @Werthead, I'll tag you in case you might want to refute this, though you may think it was already done in the previous thread. It's nothing new, after all.

I do not have further input for the discussion, so stay safe.

[Werthead]

A sobering assessment that suggests that immunity may not be long-lasting, based on the performance of other coronaviruses, and as such there will need to be periodic lockdowns until 2022, since they don't expect a vaccine to have been researched, developed and replicated on the scale needed for worldwide distribution and then actually gotten out until then.

Interesting notes that if the current vaccines are not effective (this appears to be unlikely, given how thoroughly the genetic structure of the virus has been sequenced) and we want to expose the population to the disease to achieve herd immunity without overwhelming the NHS, it will take over five years to achieve this, and this will only work if developing COVID-19 grants you permanent, lifelong immunity to the virus (which it appears is not the case so far, although further study is required).

Given how quickly information is changing, we may have happier news soon, but that's certainly another cross against the herd immunity as a realistic way of ending the lockdown quickly plan.

Quote

 

I suppose the other lesson from all this is that flu really is a lot worse than we tend to think of it as.

 

I think most people are wary of the ordinary flu. I've had it twice, at 28 and 40, and it was horrendously debilitating on both occasions. The nanosecond I qualify for an annual flu shot, I'm taking it. When I've had elderly relatives who've had the flu, it's certainly been a big deal and they've been closely monitored by their doctors.

What is interesting is all the "Well, 20,000 people die from the flu every year and no one cares" rhetoric seems to be designed to make people think we should say fuck it and carry on, when in fact the question it is raising is how much of those 20,000 deaths can be avoided if we take other measures, or if we really push it to make the annual flu vaccine available to 100% of the population instead of just the elderly.

[Which Tyler]

9 hours ago, ljkeane said:

I'm sure it's possible some of them are. You'd think Covid 19 would be at the forefront of all doctors minds at the moment though so it seems unlikely that there are lot of deaths at the moment showing the expected symptoms were it isn't being mentioned as a potential cause.

The impression I have is that for Covid to be on the death certificate, it needs to have been tested, and tested positive. If you don't test people, they can't have "Covid 19" on their death certificate. These people end up with "pneumonia"m and only appear in the official figures when looking at Total Deaths (until someone looks at a breakdown that looks at pneumonia). I wouldn't be too surprised if different regions within the UK use different "official" cause of death - such as Acute Respiratory Distress etc.

Equally, (for the UK) if someone has Covid but (likely) dies of something else, then both get written on the death certificate.

[ljkeane]

30 minutes ago, Which Tyler said:

The impression I have is that for Covid to be on the death certificate, it needs to have been tested, and tested positive. If you don't test people, they can't have "Covid 19" on their death certificate.

No that’s definitely not the case. That’s why there’s significant differences between the ONS figures and the testing figures. To be mentioned on the death certificate a doctor just has to have a reasonable basis to believe it might be the cause of death.

[Isis]

16 hours ago, ljkeane said:

I was actually a little surprised it wasn't significantly worse than a peak from flu deaths, which tends to be in January rather than April. That was about 10 days ago though. I suppose the other lesson from all this is that flu really is a lot worse than we tend to think of it as.

The flu has a low case fatality rate CFR but a high mortality (it's the converse of Rabies - which kills almost everyone but not many cases per year). Hence most people tend to underestimate how bad it is.

9 hours ago, ljkeane said:

I'm sure it's possible some of them are. You'd think Covid 19 would be at the forefront of all doctors minds at the moment though so it seems unlikely that there are lot of deaths at the moment showing the expected symptoms were it isn't being mentioned as a potential cause.

I can tell you that the converse of this is also true and has caused at least one death that I am aware of this year. We saw the same with Ebola - because there's a pandemic people (and by people I mean medical and health professionals) become fixated with it and assume every case is Ebola.

Lab diagnosis is a little bit like solving a murder mystery. People (the public) want it to be black and white but it isn't always like that. Sometimes there's an obvious suspect but there's no evidence to pin it on them (and we need evidence!). Sometimes we never find out whodunnit.

9 hours ago, TsarGrey said:

 

@Filippa Eilhart, you voiced some interest to the matter in that convo. See above, if you're interested. @Isis and @Werthead, I'll tag you in case you might want to refute this, though you may think it was already done in the previous thread. It's nothing new, after all.

I do not have further input for the discussion, so stay safe.

Again, people want everything to be black and white, for there to be definitive answers. But it's ok to say 'we don't know yet' if that's the truth. Far better to tell the truth than to guess or pass on misinformation just because you're desperate for an answer.

So, no, I don't "want to refute this". From everything I have read, heard and seen, experts do not consider this to be a true airborne infection. Most of the spread will be via droplets (aerosolised liquids), e.g. where people cough on others or contaminate objects with respiratory secretions containing viable virus. I don't see any value right now in arguing about whether it is airborne or not.

7 hours ago, Werthead said:

A sobering assessment that suggests that immunity may not be long-lasting, based on the performance of other coronaviruses, and as such there will need to be periodic lockdowns until 2022, since they don't expect a vaccine to have been researched, developed and replicated on the scale needed for worldwide distribution and then actually gotten out until then.

Interesting notes that if the current vaccines are not effective (this appears to be unlikely, given how thoroughly the genetic structure of the virus has been sequenced) and we want to expose the population to the disease to achieve herd immunity without overwhelming the NHS, it will take over five years to achieve this, and this will only work if developing COVID-19 grants you permanent, lifelong immunity to the virus (which it appears is not the case so far, although further study is required).

It's a bit more complicated than knowing the correct sequence though. Immunology is very complicated. This is a new pathogen to us. As you've just noted, we don't know much yet about the immune response we make. It is not as simple as stimulate an antibody against a pathogen = be immune to that pathogen. Antibodies function in multiple ways in the body. The strongest immune defence against a pathogen is not always neutralising antibodies. Until we know how much of a response (and whether it is the right kind of response which takes place in the right location in the body at the tight time) a given vaccine will prompt, we don't know how useful it will be.

We've seen that within the population, some people get a mild infection and others get a more severe one. Why would we assume that every person who is given the vaccine will respond to it in the exact same way and therefore mount the same type and strength of immune response. 

Bottom line, there are a lot of unknowns. A lot. I wouldn't make any assumptions about when there will be a vaccine and how useful it will be. Hope, yes. Assume, no.

[Raja]

Found this educational re: the UK & testing - it's from this NHS Providers report, there's a lot of information there but I thought I'd post the testing bit that I found interesting ( I apologize for the wall of text, but I haven't found a more thorough report on this anywhere else) - the fourth point seems particularly damning & avoidable if there was honesty.

Quote

For trust leaders there were four issues. First, unlike some other nations, the UK did not have a single national testing regime with clear responsibility for policy, capacity levels and pandemic mobilisation in a single set of hands. It was only with the announcement of a clear testing plan and the appointment of a national testing co-ordinator on April 2 that, for NHS leaders, there was clarity on who was ultimately responsible for what.

Second, actual testing capacity is split across a number of different organisations. These included NHS trusts and their pathology laboratories, Public Health England laboratories, the newly commissioned private sector Lighthouse Laboratories, and the wider group of smaller private laboratories now coming on stream. Prior to the beginning of April, there was no clarity on how all these different sources of testing capacity fitted together, what the purpose of each would be, and how quickly their capacity was meant to be growing. The involvement of the private sector added complexity as it brought the involvement of the government’s Office of Life Sciences, the Cabinet Office and the Department for Business, Energy and Industrial Strategy (BEIS) on to an already crowded pitch. Trust leaders argue that it remains unclear to them exactly what contribution each of these sets of laboratories is meant to be making to delivery of the 100,000 target, for what purpose, when.

Third, trust leaders actually running pathology laboratories reported significant shortages of the swabs, plastic testing kits and chemical reagents needed to complete the tests. These shortages were exacerbated by the fact that there are a number of different testing equipment manufacturers with the consumable swabs, reagents and plastic kits often tied to the particular testing platform. NHS trust laboratories have the machine capacity, by themselves, to process around 100,000 tests a day. But shortages of swabs, reagents and plastic kits meant that in late March/early April they were only able to complete less than 10% of that number of tests. The tied consumables also meant that, frustratingly, in the early days when the virus was concentrated in London and a few other hotspots, some NHS testing capacity was going unused. These constraints are now easing but still remain in some places.

Fourth, trust leaders felt that there was a gap between top level government statements about testing and the underlying reality and detail. Statements were, for example, made at various points early in the pandemic about how much testing capacity was available, how quickly it would grow and when antibody (‘have you had it’) tests would arrive. For leaders working on the ground, trying to manage staff expectations and pressure from staff representative groups, these impressions of 'all being well', and the lack of detail on when they would actually be able to start and grow staff testing, made a difficult situation worse.

Also, re: testing for staff which is of more interest to me

Quote

Trusts were therefore formally instructed to use all capacity for patient testing until 29 March when they were allowed to use 15% of that capacity to test staff. This 15% cap was lifted on 1 April. Since then, after a time lag, staff testing capacity has grown and trust leaders tell us that they are now broadly able to get staff tested when required.

The post coronavirus public inquiry will need to identify why UK testing capacity was so constrained and why it took so long to grow that capacity, given the importance of staff testing and mass public testing for long term control of the virus. Indeed, it remains unclear at this point, whether the stated target of 100,000 tests by the end of April will be reached.

 

[Derfel Cadarn]

Supermarket chain Morrisons started a 10% discount today for all NHS staff until July.

On one hand its a nice gesture (or a scheme to lure in part of society with guaranteed income), on the other its a discount for workers not at risk of losing money. Hell, my wife’s doing some OT. Maybe it would be better off for those who’ve just lost all their income?

It’s also a bit iffy in that a household’s NHS worker will now be the one doing most of the shopping, increasing the risk of them getting infected.

[Heartofice]

23 minutes ago, Derfel Cadarn said:

Supermarket chain Morrisons started a 10% discount today for all NHS staff until July.

On one hand its a nice gesture (or a scheme to lure in part of society with guaranteed income), on the other its a discount for workers not at risk of losing money. Hell, my wife’s doing some OT. Maybe it would be better off for those who’ve just lost all their income?

It’s also a bit iffy in that a household’s NHS worker will now be the one doing most of the shopping, increasing the risk of them getting infected.

Also at a time where Supermarkets are one of the few sectors to have actually benefited from the crisis it’s probably no skin off their nose to offer discounts. 
 

It’s obviously nothing more than a marketing stunt but what else do you expect 

[Isis]

23 hours ago, Raja said:

Found this educational re: the UK & testing - it's from this NHS Providers report, there's a lot of information there but I thought I'd post the testing bit that I found interesting ( I apologize for the wall of text, but I haven't found a more thorough report on this anywhere else) - the fourth point seems particularly damning & avoidable if there was honesty.

If you're interested in an update on testing from the scientists setting up and doing the testing (the ones who do this professionally, like me) then there's an update from the president of the Institute of Biomedical Science.

The UK must avoid a 'Wild West Testing' scenario
 

Quote

16 April 2020

With the emergence of mass testing centres, it must be restated that it is a global supply shortage holding NHS biomedical scientists back, not a lack of capacity

As President of the Institute of Biomedical Science (IBMS), I speak on behalf of the biomedical scientists and laboratory staff working in NHS hospital laboratories across the UK and stress my concern about the shortage of COVID-19 testing supplies needed to meet the government’s 100,000 tests a day target. The 17,000 NHS laboratory workers that I represent are increasingly expressing their frustration. They have applied themselves innovatively to increase COVID-19 testing capacity and have the platforms ready so that the NHS laboratories are able to meet the Secretary of State’s ambitious target but they are still not able to source the testing kits and reagents they require.

It concerns me when I see significant investments being made in mass testing centres that are planning to conduct 75,000 of the 100,000 tests a day. These facilities would be a welcome resource and take pressure off the NHS if the issue around testing was one of capacity. However, we are clear that it is a global supply shortage holding biomedical scientists back, not a lack of capacity. NHS laboratory managers have already maximised testing capacity, by funnelling their limited test kits to the larger NHS laboratories. The profession is now rightly concerned that introducing these mass testing centres may only serve to increase competition for what are already scarce supplies and that NHS testing numbers will fall if their laboratories are competing with the testing centres for COVID-19 testing kits and reagents in a ‘Wild West testing’ scenario. The UK must avoid this for the sake of patient safety.

It is clear that two testing streams now exist: one delivered by highly qualified and experienced Health and Care Professions Council (HCPC) registered biomedical scientists working in heavily regulated United Kingdom Accreditation Services (UKAS) accredited laboratories, the other delivered mainly by volunteer unregistered staff in unaccredited laboratories that have been established within a few weeks. This has presented another key concern – in that we have not been involved in assuring the quality of the testing centres and are now being kept at arm’s length from their processes, even when they exist close to large NHS laboratories. 

HCPC registration and UKAS laboratory accreditation exist to protect patients and the public and the IBMS would be happy to share our knowledge and decades of experience with the new mass testing centres to help provide assurance regarding the quality of testing processes and outputs. We would also like the NHS laboratories to work closely with the mass testing centres, to merge into one stream – pooling our collective resources, skills and experience to deliver the 100,000 daily tests promised by the Secretary of State. 

Finally, I would like to personally thank the biomedical scientists and laboratory staff who are going above and beyond to help the nation through this pandemic. My concerns reflect theirs and are rooted in their desire to protect the most ill and vulnerable in our society. We all want to work together with the government and offer our help to save as many lives as possible. We believe that begins with an open and clear dialogue about the issues that the NHS is facing around the supplies required for COVID-19 testing, and how to maximise testing capacity across the UK and ensure the quality of test results.

 

[Fragile Bird]

You've all seen this by now?

https://www.youtube.com/watch?v=gXGIt_Y57tc

You Clap for Me Now