Coronavirus

[nffc]

Originally Posted by TheDaddy

Yes don't be influenced by the scientists advising government even though they've been telling us for months that we must follow the science

Doesn't seem like that long ago we were clapping the NHS workers, now those nasty parasites we call a government have declared war on GP's

The thing is that following the science isn't an exact thing because especially at the cutting edge (which this is, as it's a new virus and understanding changes) the views change and this can even depend on who you are asking.


Even now there are plenty saying that we need to move to "Plan B" (whatever that entails, since it seems to be a list of possible options) or more to control it (yet actually it isn't running out of control - cases are decelerating, and hospital admissions aren't at a high level on the current measuring), and others saying (including SAGE modelling, which has a habit of being an overestimate even at the most optimistic) that it will be fine on the current parameters. And yes, those who ask for more restrictions are probably right that it will reduce cases and hospitalisations but that if everyone stays at home all day there will be other effects from this, if for example people didn't go clothes shopping, then all the clothes shops wouldn't make any money, and they would have to close, resulting in job losses, repeat this for anything which could be affected, with no furlough it would literally be that.


It's also pretty fair to suggest that a lot of the NHS, unions etc, are relatively Labour-leaning and don't like the Tories, so would definitely like to see what's in no doubt a right-leaning Tory government put under undue and perhaps unjust pressure.



The key point is that none of the key medical people such as Whitty and Vallance are yet calling for restrictions. These are the people the Government will listen to, and in their situation, it is definitely an advisory capacity since again they can only really advise on the situation with the virus itself, not the idea of "living with" the virus, which is something Whitty suggested some while back.



To me it seems unsurprising that with the levels of vaccination we have, with a variant which is now pretty transmissible and more so than the original (which wasn't too bad here either) the infection has shifted into primarily children (who aren't vaccinated) and adults who have chosen not to.

---------- Post added at 22:41 ---------- Previous post was at 22:36 ----------

Originally Posted by Hugh

Speaking to friends who are GPs, one of the major challenges is the increase in older patients* (who often have complex needs, so a 10 minute standard appointment isn’t sufficient, and they require more appointments due to the complex needs).

Also, there are fewer GPS - there are now just 0.45 fully qualified GPs per 1000 patients in England – down from 0.52 in 2015. https://www.bma.org.uk/advice-and-su...neral-practice



*5.5 million over 75, 1.6 million over 85, 600k over 90.

I know they have to put a window on it but surely the follow up needs of known complex patients could mean the GP pops forward a longer time slot.


If someone (like me) who hasn't been to the GP for years on end presents with something relatively routine you'd expect the initial consultation would be a 10-15 minute job to gather info and stuff, but based on that if any follow up needs longer, then this should be longer - and if you're asking Mrs Scott with her bunions, piles, dodgy ticker and arthritic knees to come in for her pain next week, that this might take 30-45 mins, that's surely the time slot you say it needs to see her?



Maybe it's obvious to me but less so to others you adapt to the needs of the people you're serving?

Agreed, but longer time slots means seeing less patients…

Less doctors, longer time slots, less appointments

[Carth]

Originally Posted by Hugh

Agreed, but longer time slots means seeing less patients…

Less doctors, longer time slots, less appointments

. . . and A&E taking up the slack, which is causing more problems.

2 aspirin, large brandy, fat joint . . doesn't cure you but who cares

[nffc]

Originally Posted by Hugh

Agreed, but longer time slots means seeing less patients…

Less doctors, longer time slots, less appointments

Well, I suppose it depends doesn't it (though you aren't wrong).


If you know that the appointment for Patient A will take 10 mins but the one for Patient B will be 40, but you can't allocate more than a 10 minute slot for each patient (which means you discard the obvious solution), do you then:
- force B out after 10 minutes, knowing that you're only 1/4 through the way, and that at the best case you'll still need that appointment time with them later anyway
- keep the appointment running ignoring the fact you're over time and that your schedule is full and you will be making all of your subsequent patients who are already waiting at least 30 minutes late. (Which is a cumulative effect on both your schedule through the rest of the day especially if you have more Bs - or even As who need longer - booked in, meaning you'll run late all day and end up finishing late)


Thing is, if you basically neglect patients' needs like anything else the situation can and probably will get worse and then you'll just put pressure on other areas of the NHS anyway due to it not being dealt with properly to begin with. And if they have lost staff (no matter what the cause) then this isn't going to be anything they can fix quickly as even a qualified medic who has completed their first course still then needs to take years specialising as a GP, Effectively you need to know a little about absolutely everything in order to push it down the right path later.


They could theoretically make up some of the more routine or simple tasks by using nurses to triage things before they get to a GP but then I suppose there's a shortage there too.


The working conditions probably aren't favourable - I think a lot of hospitals have their staff doing 12 hour shifts. Which is a long time in itself, when it's a busy job to do to start off, then you have the travelling to and from work, getting sleep before you have to do it again the next day, and the possibility that finishing late will erode your time between shifts anyway. Though given that a 48 hour week is only 4 shifts they probably get more clear days off, it might be better all round to reduce that time to 8 hours and rotate people more often, then they could have more rest between working times which would probably be less tiring and less of a deterrent to people wanting to work there.



The NHS has always had pressures especially at this time of year and needs help sorting them out, covid isn't going to realistically make the cause or effect any better or worse, last year what we saw was mainly covid and an almost eradication of breakouts of flu or noro or other seasonal illnesses which we might see again - but as a lot of vaccinated people probably won't get covid that badly but might get flu, we might see a lot of unvaccinated covid patients mixed in with a lot of flu patients and perhaps the odd few who have been vaccinated but it hasn't worked or the immunity has waned before they could get a 3rd jab... remains to be seen.

[papa smurf]

Originally Posted by Carth

. . . and A&E taking up the slack, which is causing more problems.

2 aspirin, large brandy, fat joint . . doesn't cure you but who cares

Watch out for those aspirin

[OLD BOY]

Originally Posted by spiderplant

They have? I totally missed that one. Please provide a link.

The Prime Minister has said on many occasions now that measures will be introduced if hospitals would otherwise be overwhelmed, and that there is no sign of that happening yet.

He has also made it clear that current figures are completely in line with predictions, so we can draw from that the clear understanding that once those predictions are exceeded, consideration will be given for measures to be imposed.

Here is the PM's latest coverage that I am aware of.

https://www.theguardian.com/world/20...ases-top-50000

[EXTRACT]

"The numbers of infections are high but we are within the parameters of what the predictions were, what Spi-M [modelling group] and the others said we would be at this stage given the steps we are taking. We are sticking with our plan.”

[Mr K]

Originally Posted by OLD BOY

The Prime Minister has said on many occasions now that measures will be introduced if hospitals would otherwise be overwhelmed, and that there is no sign of that happening yet.

He has also made it clear that current figures are completely in line with predictions, so we can draw from that the clear understanding that once those predictions are exceeded, consideration will be given for measures to be imposed.

Here is the PM's latest coverage that I am aware of.

https://www.theguardian.com/world/20...ases-top-50000

Yes because he judged it so right with the initial lockdown. Weeks later than it needed to be which caused tougher measures and thousands of unecessary deaths, the most in Europe. You've got to question the credibility of someone who proudly brags about ignoring his own advice, shaking the hands of covid patients, then contracting covid and nearly dying himself. An expert in epidemiology he isn't or anything else, except a bit of pointless Latin.

[OLD BOY]

Originally Posted by Mr K

Yes because he judged it so right with the initial lockdown. Weeks later than it needed to be which caused tougher measures and thousands of unecessary deaths, the most in Europe. You've got to question the credibility of someone who proudly brags about ignoring his own advice, shaking the hands of covid patients, then contracting covid and nearly dying himself. An expert in epidemiology he isn't or anything else, except a bit of pointless Latin.

Why are you trying to justify your view of the government's arrangements by reference to what happened at the beginning of this pandemic when comparitively little was known about it? The comparison is even more perverse when you consider that the parameters now set are completely in line with the scientists' own predictions. So is your view that the scientists advising the government have got it wrong? You don't rate Prof Whittey then, who is on the same page?

I think your remarks are simply party political in nature and unrelated to the actual problem the government is grappling with. Anything the PM does will be wrong in your eyes. The PM makes a statement - so you have to disagree with it.

Good fun if you like that sort of game, I suppose.

[EDIT]

Maybe you should read this, Mr K.

https://www.telegraph.co.uk/news/202...ed-challenged/

[EXTRACT]

The first myth is that the UK has had the highest Covid death rate in Europe and that this is mainly due to locking down too late in both waves. While it is true that we were highest after the first wave, the situation has changed significantly. Ranked against EU countries, the UK is 11th on Covid deaths and 15th on excess deaths.

Many claim that thousands of lives would have been saved if we had locked down earlier in the first wave, but almost every country with a higher death rate than the UK did lock down early. This gave them very small first waves in spring 2020 but these were followed by very large second waves in the autumn/winter 2021.

Similarly, the claim that the UK made the same mistake in the second wave and that thousands died due to the failure to have a “circuit-breaker” lockdown last October isn’t supported by the evidence. Wales – which did have one – ended up with similar Covid and excess death rates to England.

The current myth is that the UK has the highest Covid rates in Europe now and this is due to our lack of vaccine passports and mask mandates. But these comparisons are flawed. First, because they are based on case rates and ignore the fact that the UK does a lot more testing (test positivity rates also need to be compared – the UK is about average). Secondly, because other countries are at different stages of their third waves and their immunity will wane later than in the UK because their vaccine programmes started later.

The other problem with this interpretation is that Scotland and Wales (which are more valid comparisons) kept their mask mandates and recently brought in vaccine passports, but their rates have been higher than England’s. (This is specifically about mandates – I voluntarily wear a mask in confined spaces and if I’m with anyone at high risk, and encourage everyone to do so.)

The next myth is that only restrictions or lockdowns bring down cases, hospital admissions and deaths. This is clearly not true given what happened in July and September when there were no restrictions and cases fell, most likely due to people voluntarily changing their behaviour in response to risk.

The last myth is that “going early and going hard” with restrictions is always better than waiting. Again, given what happened in July and September when a huge surge was predicted by many, that would have been the wrong advice. Cases actually fell significantly.

[nffc]

I think it's right to say they need to sit tight for now. New infections are stabilising in terms of growth, half terms will probably help with this more, as will people now getting the right result on their PCR tests, once that is under control the numbers will probably drop again.



They need to get more steam with vaccinating teenagers and getting the third doses out to the older or more at risk.



All doing Plan A better, rather than doing Plan B, which is a slippery slope really.


Once you have people screaming for more restrictions, then them doing it, then they know that they just need to scream again and/or for more and they'll cave. It needs to be an easily measurable metric, in terms of the healthcare figures, e.g. so many hospital admissions in the last 7 days, plus above so many in hospital over the last 7 days, we'll discuss it. They may already have this planned out but not made public.



You can also guarantee that for some people Plan B won't be enough. Nor will introducing social distancing measures in places again or rule of 6. Even when we had restrictions last winter people saying that the lockdown wasn't tight enough.



Plus I don't have a great degree of confidence that Plan B will do much anyway.
- Masks - well, putting aside the debate on whether they actually work or not, even when the legal mandate was dropped and it became "personal choice" a fair amount of workplaces still seem to encourage that staff do especially when moving around, it's still encouraged to wear them in crowded situations like busy shops, and on public transport, if it was tightened then people using their common sense would drop out of it, and you'd get silliness such as a bus with 1 passenger on it wearing a face covering which isn't really protecting anyone else (and that's even assuming he has anything to protect people from to begin with).
- WFH - I think this is another thing where they haven't really relaxed the advice to work from home if you can, so it would only really make a difference to people who (or their employers have) asked them to go back either partially or in full.
- Covid passports - another controversial one since we know even double jabbed you can catch and spread the virus, albeit less than someone who isn't. Knowing someone you are letting in is vaccinated is one thing, knowing they aren't going to spread covid is another. It is also discriminatory on the grounds of age for those too young to get vaccinated or those with health conditions who have been advised not to by their doctor or whatever, who will presumably need a "negative test" fall back.

[nffc]

Said it was levelling off.


39962 today down from 45140 last week and a lot lower than some of the days in between too.


If we can get(keep) it under control in kids and Bristol then no need to do anything drastic.


My other worry about Plan B is how we exit it.

Originally Posted by nffc

Said it was levelling off.


39962 today down from 45140 last week and a lot lower than some of the days in between too.


If we can get(keep) it under control in kids and Bristol then no need to do anything drastic.


My other worry about Plan B is how we exit it.

Indeed.

Sooner or later we have to move from preventing the spread of covid to learning how to live with it. It is never going away, and I am curious to know what those who think we should rush back to restrictions, think the exit plan should be.

The scientists who say restrictions will reduce spread are stating the obvious (or at least it’s obvious to us now we’ve been at this for 18 months) but they are speaking from their own expertise, to their own area of expertise. They are concerned with epidemiology, or resource management in the NHS, but they aren’t factoring in issues like the long-term mental well-being of those facing further prolonged separation from loved ones or activities that give their lives meaning and they aren’t factoring in the long-term effect on the economy. Nor should they; there are other experts for that.

It is the politicians job to listen to the expert views from all angles and then devise policy that balances those views for the good of the nation as a whole. The politicians are not necessarily getting it wrong just because they don’t do everything one group of experts wants.

Here in Scotland, Nicola Sturgeon is still furiously virtue signalling and demanding everyone keeps wearing masks in shops, schools etc; in my experience there’s about 60-70% observance of this in major shopping centres but easily less than 15% observance at the university I have just left (but which I now work next door to) and in office and warehouse environments I have visited recently there is next to zero observance at all. Everybody knows we are in the endgame now and that sooner or later we’re all going to catch it. If we’re going to get used to anything, it should be repeated cycles of vaccination and (hopefully) mild infection.

I'm sure some people would have us trying to fight nature for years.

[nffc]

Originally Posted by Chris

Indeed.

Sooner or later we have to move from preventing the spread of covid to learning how to live with it. It is never going away, and I am curious to know what those who think we should rush back to restrictions, think the exit plan should be.

The scientists who say restrictions will reduce spread are stating the obvious (or at least it’s obvious to us now we’ve been at this for 18 months) but they are speaking from their own expertise, to their own area of expertise. They are concerned with epidemiology, or resource management in the NHS, but they aren’t factoring in issues like the long-term mental well-being of those facing further prolonged separation from loved ones or activities that give their lives meaning and they aren’t factoring in the long-term effect on the economy. Nor should they; there are other experts for that.

It is the politicians job to listen to the expert views from all angles and then devise policy that balances those views for the good of the nation as a whole. The politicians are not necessarily getting it wrong just because they don’t do everything one group of experts wants.

Here in Scotland, Nicola Sturgeon is still furiously virtue signalling and demanding everyone keeps wearing masks in shops, schools etc; in my experience there’s about 60-70% observance of this in major shopping centres but easily less than 15% observance at the university I have just left (but which I now work next door to) and in office and warehouse environments I have visited recently there is next to zero observance at all. Everybody knows we are in the endgame now and that sooner or later we’re all going to catch it. If we’re going to get used to anything, it should be repeated cycles of vaccination and (hopefully) mild infection.

The important thing is that the vaccination is turning people getting it, spending months on a ventilator and maybe dying into people getting it and having a week or so in bed with a cold. Yes, some people will be more severely ill, but these will always slip through as the immune system isn't perfect nor is a vaccine.


As for masks, well yes there is no doubt they do have some effect but it's likely overstated in terms of a policy regarding mass mask wearing whenever out of the house, as has been dictated in some parts of Aus.



Probably the most useful aspect of mask wearing (aside from virtue signalling) is that it will reduce the spread from someone who has covid, but then, if you think you have covid because you have symptoms of it, you shouldn't be out the house anyway, and should be isolating and getting a PCR test. So the only real benefit would come from people who are either completely asymptomatic, are shedding the virus before getting symptoms, or have symptoms but don't think it's covid. In all these cases being vaccinated reduces the chance of this anyway. You could quite easily swap the masks with saying that people might be best to do a LFT every other day or indeed any day you're going somewhere where you're likely to be with a lot of people meaning the chances of having an asymptomatic infection is reduced.

[Pierre]

Originally Posted by Chris

If we’re going to get used to anything, it should be repeated cycles of vaccination and (hopefully) mild infection.

It’s the only way now. Those that want and need the vaccine have had it, 80% of the population aged 12+ Have had it.

Over 8.5 million have had the infection and got over it.

Continue with boosters and annual vaccinations and get on with our lives.

It’s not gone, it’ll never be gone, but it’s no longer the threat it was.

[OLD BOY]

Originally Posted by Pierre

It’s the only way now. Those that want and need the vaccine have had it, 80% of the population aged 12+ Have had it.

Over 8.5 million have had the infection and got over it.

Continue with boosters and annual vaccinations and get on with our lives.

It’s not gone, it’ll never be gone, but it’s no longer the threat it was.

Yet still the siren voices keep telling the government to implement plan B. It really is pathetic. Nice to see the government is holding firm on their current stance.