The virus. PPE. Part 1

[Nod]

Volunteers for the Nightingale hospital have been told that 50-80% of patients on ventilators are likely to die.

Source?

 

[nilagin]

So, if operating at full capacity (4000 patients) the new NHS Nightingale Hospital in London will require 16 000 staff:

https://www.itv.com/news/2020-04-01...to-run-nightingale-hospital-at-full-capacity/

Just where are these staff members coming from? I guess some will be army medics and volunteers, but presumably the bulk of
the staff will have to come from other hospitals. Surely there simply isn't the numbers to spare anyone or are all London COVID-19 cases being sent to NHS Nightingale?

I got the impression all of the London cases will go to the Nightingale. The same for the similar set ups in other cities. Then standard hospitals can return to some sort of normality and lower the risk of spreading the virus.
Aside from the temporary mortuary being built in the car park of our local crematorium, I see another temporary mortuary is being built near Nightingale

 

[Donnie]

So, if operating at full capacity (4000 patients) the new NHS Nightingale Hospital in London will require 16 000 staff:

https://www.itv.com/news/2020-04-01...to-run-nightingale-hospital-at-full-capacity/

Just where are these staff members coming from? I guess some will be army medics and volunteers, but presumably the bulk of
the staff will have to come from other hospitals. Surely there simply isn't the numbers to spare anyone or are all London COVID-19 cases being sent to NHS Nightingale?

A percentage will be cleaners, food prep and other ancillary staff so won’t need to be nhs staff.

It will be harrowing for any involved through so I hope there is thought to counselling afterwards.

yes some will be cleaners etc, but it was reported in the news that it will be used for covid19 patients already on ventilators. This means covid19 patients already in ITUs will be transferred (known to increase risk in mortality alone) to the nightingale. Again you need 3 nurses per ventilated patient (4000 beds x 3 = 12000) and that's before you even think of how many drs you will be needing, plus pharmacy staff (there will be a pharmacy on site though Ive seen no mention of that) then the physios, the Care assistants, IT support, medical equipment support workers, canteen staff so I personally believe they are underestimating at 16000. Just remembered the portering and mortuary staff too!

As for counselling, I hope so, hope it wont be the usual NHS "debrief".

 

[Donnie]

Can people transmit the disease if immune? Maybe if I tested that I have had it and unlikely to get it I could move more freely and we could get back to some normality. Would be peace of mind for millions.

Umm of course they can transmit if immune!

 

[Retune]

Seems to me unless you're able to fully lock down the population, stop flights coming in from COVID hotzones and further restrict people's movements, the whole testing issue (other than key workers) would seem to be a complete waste of time.

South Korea, Singapore and Taiwan disagree. Guess which countries appear to be containing the situation most effectively?

 

[sphexx]

Can people transmit the disease if immune? Maybe if I tested that I have had it and unlikely to get it I could move more freely and we could get back to some normality. Would be peace of mind for millions.

Say you get tested and it proves you’ve had it, how are going to move freely? When you are stopped how will you prove your ‘immunity’? Possibly if we had identity cards you could have a certificate with it’s number on it but otherwise?

 

[tarric]

I would like an explanation why places like South Korea and Germany were able to get thousands of testing kits some weeks ago but the UK was not and is now only starting to catch up.

Dave

The answer

Competent leadership and forward thinking on their part.

As I was always told if You Fail to plan you are planning to fail.

This is the problem is for years successive UK governments have fail to do any long term planning they basically plan in at maximum 5 year terms i.e. election to election because all that matters is that your team win regardless of what the country needs. The UK and other countries have been seduced by populist politicians who have little or no regard for the good of the country all that matters to them is them.

 

[arclight]

Thats easy to say, but when did we last have a pandemic of this magnitide? 100 years ago? etc.....

As Broc mentioned, the NHS did have a testing exercise. Having an exercise certainly indicates that the possibility of a pandemic was very real.

It was actually pretty damned well seen as being highly likely. Watch

View: https://www.youtube.com/watch?v=as9JRKed7Cs


Just how much evidence do people need ?

 

[nilagin]

Say you get tested and it proves you’ve had it, how are going to move freely? When you are stopped how will you prove your ‘immunity’? Possibly if we had identity cards you could have a certificate with it’s number on it but otherwise?

But as the virus is supposed to be mutating, who's to say that just because you have been tested as immune, you would remain immune to a mutated stream.

How often will NHS staff get tested? I would expect they would need regular testing to make sure they aren't infected.

 

[Retune]

I got the impression all of the London cases will go to the Nightingale.

It's apparently for 'London patients in need of intensive care but with the best chance of survival':
https://www.theguardian.com/world/2...-london-to-treat-less-critical-covid-19-cases

 

[Peter10d]

But as the virus is supposed to be mutating, who's to say that just because you have been tested as immune, you would remain immune to a mutated stream.

How often will NHS staff get tested? I would expect they would need regular testing to make sure they aren't infected.

That would be a worrying thought. But does a mutation of any given virus still show up in antigen tests for that virus or does it depend how much it has mutated?

 

[Deleted sulking member 63079]

But as the virus is supposed to be mutating, who's to say that just because you have been tested as immune, you would remain immune to a mutated stream.

How often will NHS staff get tested? I would expect they would need regular testing to make sure they aren't infected.

Reports are saying that it has a very slow rate of mutation, this is a good thing. And mutations that will benefit the virus, will likely lessen its severity anyway.

It's more about testing the NHS staff who are showing symptoms and self-isolating, so they can get back to work if clear. Than testing everyone.

 

[Retune]

But as the virus is supposed to be mutating, who's to say that just because you have been tested as immune, you would remain immune to a mutated stream.

How often will NHS staff get tested? I would expect they would need regular testing to make sure they aren't infected.

Although viruses, including this one, mutate all the time and anything is possible, according to one prominent virologist the pattern of mutations seen to date suggests it may not evade immunity for 'a few years'. Therefore a test for immunity would only need to happen once during this pandemic:

View: https://BANNED/trvrb/status/1242628550563250176

Edit: Other kinds of tests (the current RT-PCR test or the viral antigen test we may see soon) look for active infections rather than immunity. In these cases a negative test doesn't, of course, guarantee future negative tests, though a positive test could allow someone to return to work after a suitable period of isolation.

 

[myotis]

Umm of course they can transmit if immune!

Bit confused here. Do you mean spread the virus on their hands etc. Doesn't being immune mean you can deactivate the virus and break the transmission chain. Or am I missing some subtlety of transmission?

 

[Donnie]

Bit confused here. Do you mean spread the virus on their hands etc. Doesn't being immune mean you can deactivate the virus and break the transmission chain. Or am I missing some subtlety of transmission?

Nope, thats what i mean, just because someones immune (still to be proven) doesn't mean you cannot transmit the virus on hands, clothing, items, giving a lift in a car, shopping, etc etc.

 

[ancient_mariner]

I've just discovered TWiV (The Week in Virology) podcast: http://www.microbe.tv/twiv/

Talk 595 discusses a bunch of stuff with US medic Daniel Griffin including what may be a treatment to prevent catastrophic respiratory failure. It seems that the immune system doesn't manage the change very well between cell-mediated and antibody response, and rather than ramping down the neutrophils and increasing lymphocyte numbers, the opposite happens with a variety of 'cytokine storm' and excess production of certain interleukins that stimulate the neutrophil response. They tried an experimental treatment using an anti-IL-6 monoclonal antibody on a patient in the end stages of failure, and at the time of the interview the patient appeared to be recovering. It's unlikely this will be a universal life-saver, but it might save some individuals without otherwise life-threatening conditions and helps make sense of why an otherwise relatively unexciting virus is proving a little lethal.

They also mentioned about a hydroxychloroquine trial that doesn't appear to have gone well.

It's an interesting listen to an extent, but might be a bit technical for some. Also quite long at 117 min.

 

[Uncle Fester]

Over 950 000 people have applied for Universal Credit since the COVID-19 outbreak in the UK.

It’s a good job then that we have a tried and tested, efficiently run benefits system with no major flaws or operational problems ....

 

[ancient_mariner]

Bit confused here. Do you mean spread the virus on their hands etc. Doesn't being immune mean you can deactivate the virus and break the transmission chain. Or am I missing some subtlety of transmission?

Immunity is a process, and you might be making antibodies etc that are clearing your infection while still producing an amount of live and infectious virus. Of course that should not be for long unless the virus has found a way to co-exist with your immunity..

 

[myotis]

Nope, thats what i mean, just because someones immune (still to be proven) doesn't mean you cannot transmit the virus on hands, clothing, items, giving a lift in a car, shopping, etc etc.

Obviously, that was what I assumed, and of course always a risk, even if you are immune.

 

[myotis]

Immunity is a process, and you might be making antibodies etc that are clearing your infection while still producing an amount of live and infectious virus. Of course that should not be for long unless the virus has found a way to co-exist with your immunity..

Thanks, I did think of that just after I posted :-(

 

[NeilA1975]

South Korea, Singapore and Taiwan disagree. Guess which countries appear to be containing the situation most effectively?

I guess that's because they reacted very quickly whereas we haven't and therefore it becomes much more difficult for us to control.

 

[Deleted sulking member 63079]

I guess that's because they reacted very quickly whereas we haven't and therefore it becomes much more difficult for us to control.

Because SARS hit them hard and they knew what to expect. Everyone should have followed their example. SK have been very proactive at testing and contact tracing.

 

[myotis]

I guess that's because they reacted very quickly whereas we haven't and therefore it becomes much more difficult for us to control.

You might find the link I posted earlier useful:

https://theconversation.com/coronav...-due-to-its-acceptance-of-surveillance-134068

A selective quote from the article:

"The most conspicuous part of the South Korean strategy is simple enough: test, test and test some more. The country has learned from the 2015 outbreak of MERS and reorganised its disease control system. It has a good, large-capacity healthcare system and a sophisticated biotech industry that can produce test kits quickly."

 

[AndrewFlannigan]

The important thing I take from the story so far is how very lucky the British have been. Despite gross mismanagement by the current and previous governments the death toll has thus far been relatively low. I have no idea whether this low level can be maintained but the one thing I am certain of is that no good outcome will come from having the current incompetents running our government.

 

[Uncle Fester]

The answer



As I was always told if You Fail to plan you are planning to fail.

This is the problem is for years successive UK governments have fail to do any long term planning they basically plan in at maximum 5 year terms i.e. election to election because all that matters is that your team win regardless of what the country needs. The UK and other countries have been seduced by populist politicians who have little or no regard for the good of the country all that matters to them is them.

I totally agree with what you say, but it's not as if there was no plan or no awareness of the danger of another Pandemic.

In 2007, 'The National Framework for Responding to an Influenza Pandemic' was developed:

http://antibiotic-action.com/wp-con...emic-influenza-a-national-framework-v2007.pdf

Here's a quote:

"The possibility of a worldwide influenza epidemic (a pandemic) presents a real and daunting challenge to the economic and social wellbeing of any country and a serious risk to the health of its population. Planning and preparing now will help to lessen its impact and to avoid panic later. The Government will therefore continue to take every practical and proportional step to ensure that the UK prepares well for a pandemic and to mitigate its health and wider socio-economic effects."

And another quote:

"5.1 The critical need for pre-planning

The periods between previous influenza pandemics have varied widely and the fact that nearly 40 years have elapsed since the last should not induce complacency. As it is probable that another pandemic will emerge, spread rapidly and result in grave consequences, robust and resilient preparations are essential."

The 'Framework' has been updated since 2007.

I can only presume that subsequent governments have paid it little or no heed, or simply been unaware of it.

 

[Uncle Fester]

The important thing I take from the story so far is how very lucky the British have been. Despite gross mismanagement by the current and previous governments the death toll has thus far been relatively low. I have no idea whether this low level can be maintained but the one thing I am certain of is that no good outcome will come from having the current incompetents running our government.

I really dislike the idea of my survival being dependent on 'luck' .....

 

[mex]

I can only presume that subsequent governments have paid it little or no heed, or simply been unaware of it.

FTFY

 

[LongLensPhotography]

One more important supplement to take would be Zinc. For this and in general. I've highlighted vitamin C and good nutrition a lot of times but will repeat it again. Anyone on junk food diet you need to rethink it now.

 

[ancient_mariner]

You might find the link I posted earlier useful:

https://theconversation.com/coronav...-due-to-its-acceptance-of-surveillance-134068

A selective quote from the article:

"The most conspicuous part of the South Korean strategy is simple enough: test, test and test some more. The country has learned from the 2015 outbreak of MERS and reorganised its disease control system. It has a good, large-capacity healthcare system and a sophisticated biotech industry that can produce test kits quickly."

Let me quote a very important part from that article.

"What hasn’t been so widely reported is the country’s heavy use of surveillance technology, notably CCTV and the tracking of bank card and mobile phone usage, to identify who to test in the first place. And this is an important lesson for more liberal countries that might be less tolerant of such privacy invading measures but are hoping to emulate South Korea’s success. "

I have an acquaintance recently moved to London after living a long time in Asia, most recently a number of years in Tokyo. He can't understand why the UK isn't intrusively monitoring everyone's movements as would be done in Asia, using all the above systems. My perception, possibly incorrect, is that infringing personal freedom, and also the pushback against a heavy-handed government lockdown, has been a part of why the present situation has been implemented gradually. The 'freedoms' of a liberal capitalist society like America with fragmented healthcare, politicised and protectionist regulatory bodies are a part of the reason they're being hit so hard, and will get hit harder yet, while the British are more compliant, socialist with centralised control, and willing to do as they're told to a degree.

Please don't get all political about this - I'm not trying to judge any of the societies in these comments, so much as try to bring light on why the virus is sweeping these societies in different ways.

 

[myotis]

Let me quote a very important part from that article.

"What hasn’t been so widely reported is the country’s heavy use of surveillance technology, notably CCTV and the tracking of bank card and mobile phone usage, to identify who to test in the first place. And this is an important lesson for more liberal countries that might be less tolerant of such privacy invading measures but are hoping to emulate South Korea’s success. "

Indeed, and I have mentioned this in earlier posts when I've suggested this article. My selective quote was to emphasise the importance of testing.

 

[simon ess]

We are rather an odd bunch.

The blitz was a bit of an annoyance, dealt with by a cup of tea and a carry on.

Followed by highly efficient, systematic and total destruction of entire German cities and the inevitable slaughter.

Look like bumbling amateurs, act like hardened pros. Which will prevail this time?

 

[simon ess]

while the British are more compliant, socialist with centralised control, and willing to do as they're told to a degree.

This is surprisingly accurate. Always has been to an extent.

 

[ancient_mariner]

This is surprisingly accurate. Always has been to an extent.

I've lived among you almost my entire life.

 

[mex]

A great post on Faceache- " 20000 farm workers needed urgently, here's your chance to replace all of those Eastern Europeans who stole your jobs "...well it made me laugh anyway.

 

[simon ess]

I've lived among you almost my entire life.

You have achieved great familiarity with our ways.

 

[Retune]

I guess that's because they reacted very quickly whereas we haven't and therefore it becomes much more difficult for us to control.

Lockdown potentially gives us another opportunity to apply the sort of methods that have worked elsewhere. Here's another thread from Trever Bedford I've posted before:
View: https://BANNED/trvrb/status/1240444821593944064

 

[Uncle Fester]

One more important supplement to take would be Zinc. For this and in general. I've highlighted vitamin C and good nutrition a lot of times but will repeat it again. Anyone on junk food diet you need to rethink it now.

I very rarely agree with anything you post, but this time I think you are correct. My incredibly limited comprehension of nutrition, medication ect. leads me to understand that a lot of the current interest in Chloroquine relates to it’s ability to permit greater absorption of Zinc within our cells. Zinc is noted for its anti-viral properties.

My recent personal experiences of diet have made it clear to me what a profound effect the food we consume has on our health and wellbeing. I suspect that COVID-19 will claim many more lives, than otherwise would have been the case, simply because of our modern nutritionally deficient diets.

 

[myotis]

Let me quote a very important part from that article.

"What hasn’t been so widely reported is the country’s heavy use of surveillance technology, notably CCTV and the tracking of bank card and mobile phone usage, to identify who to test in the first place. And this is an important lesson for more liberal countries that might be less tolerant of such privacy invading measures but are hoping to emulate South Korea’s success. "

To reply to this a second time, this is on the BBC web site

Coronavirus: UK considers virus-tracing app to ease lockdown

https://www.bbc.co.uk/news/technology-52095331

 

[MatBin]

The important thing I take from the story so far is how very lucky the British have been. Despite gross mismanagement by the current and previous governments the death toll has thus far been relatively low. I have no idea whether this low level can be maintained but the one thing I am certain of is that no good outcome will come from having the current incompetents running our government.

Currently at about 8% of known cases, I don't see that as relatively low, we were told a short while ago it was likely to be 1-2%, assuming the numbers of infected people are wrong we'd need between 1 and 8 times as many people infected as we are currently showing, is that likely? Having said that, it's 0.003% of UK population.

 

[nilagin]

I very rarely agree with anything you post, but this time I think you are correct. My incredibly limited comprehension of nutrition, medication ect. leads me to understand that a lot of the current interest in Chloroquine relates to it’s ability to permit greater absorption of Zinc within our cells. Zinc is noted for its anti-viral properties.

My recent personal experiences of diet have made it clear to me what a profound effect the food we consume has on our health and wellbeing. I suspect that COVID-19 will claim many more lives, than otherwise would have been the case, simply because of our modern nutritionally deficient diets.

A combination of Zinc, magnesium and vitamin B6 taken before bed also induces REM sleep that the body needs to repair itself after weight training exercise, I would imagine it will benefit the body in a similar way when trying to heal from infection. The combination can be found in health food shops amongst the bodybuilding supplements. Usually called ZMA (don't know why A and not B6) or sometimes just as Zinc and Magnesium, but if you read the contents it should include B6 too.
Just be prepared for some crazy s*** dreams.