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Concerns about shutting down the Economy in Q4?

FORMER_FYRDMAN

LE
Book Reviewer
That's the effect, not the cause.
Indeed, because we have such success controlling flu every year.

The vulnerable need to shield and the rest of us need to get on with it.
 
Indeed, because we have such success controlling flu every year.

The vulnerable need to shield and the rest of us need to get on with it.

I suspect the 44,000 that died of flu in 2014/15 would question your definition of "success". Even with freely-available vaccinations for the vulnerable.

I'm sure your quasi-herd-immunity-lock-up-the-old-duffers-suck-it-and-see experiment wouldn't work out quite the way you think it would.
 
Just caught up with Thursday's The Week In 60 Minutes on Spectator TV. Amongst the topics were the likelihood of PM being under a lot of pressure to lockdown England and the arguments over free school dinners. This graph seems more credible than others we have been shown, if a few weeks out. This time Fraser says they are looking uncannily accurate.

1604260077171.png

Fraser followed this up with an article in the Spectator yesterday (Saturday).
Why have No. 10’s Covid forecasts changed so much? | The Spectator
 
Yes I do actually - they've backed themselves into a corner and are more concerned with pandering to the hysterical types on social media who insist "something must be done" than actually letting people get on with their lives. The scientists have set out their stall that local restrictions won't work so now is the time for them to strike to get the national lockdown they want, give it another week and the opportunity would have passed when the impact of the Tier 3 restrictions really begin to show in the declining cases negating the need for another national lockdown.

Don't forget the previous lockdown was driven by panic at the Imperial report that suggested up to 500k dead using a model that turned out to be so flawed that even Microsofts best engineers couldn't fix it. I remember the scientists being incredulous that the public were actually following the lockdown guidance so rigorously that cases dropped even lower than their most optimistic models had suggested..
As for the scientists: if you're not part of the solution, there's money to be made prolonging the problem.

So, this may reduce/delay a rise of cases, which will handily kick the can down the road for it to continue into next year.

If it looks like we're getting close to herd immunity, it'll be time to announce a new variant of covid which will kill everyone like the last one didn't. The needle returns to the start of the song, and we all sing along like before.
 

Chef

LE
The lockdown was meant to flatten the peaks of infections and thus preventing the NHS being swamped with cases. This seems to have been achieved at a cost to the public purse and the health of the nation as regards other diseases and conditions.

I would suggest that the majority of the public could see the point of a national effort in March and seemed to be behind it.

However the subsequent politics played with it the concept of lockdown, the competitive efforts of Wales and Scotland to lockdown harder or provide more tiers than England have lost a lot of good will and caused much confusion to the extent that even senior police officers have admitted that they don't know what's applicable.

Be that as it may, the government has instituted a series of measures that the old cold war enemies would recognise: House arrest for indeterminate amounts of time, restricted travel outside one's own area without due cause. No association in groups of more than six (actually that's more the old South Africa association laws). Internal border controls.

Bearing in mind that the three tiers start at the rule of six does it seem likely that these rather handy and arbitrary rules* will be rescinded or merely put on hold to be kept for future use.

*Look how the rules were enforced during the BLM demos. If they are needed to protect the vulnerable then surely they should have been rigorously enforced in the case of BAME high risk people?
 

JCC

War Hero
It's reaching critical level where there is a risk of there being no working Emergency Department or Intensive Care Units in a significant number of hospitals in the country.

These places can't be filled by other nurses, they aren't trained for either jobs.

Question - how much training would it take to bring a nurse from, say a less vital department, and bring them up to speed on masking - not tubing but only masking?
 
The lockdown was meant to flatten the peaks of infections and thus preventing the NHS being swamped with cases. This seems to have been achieved at a cost to the public purse and the health of the nation as regards other diseases and conditions.

I would suggest that the majority of the public could see the point of a national effort in March and seemed to be behind it.

However the subsequent politics played with it the concept of lockdown, the competitive efforts of Wales and Scotland to lockdown harder or provide more tiers than England have lost a lot of good will and caused much confusion to the extent that even senior police officers have admitted that they don't know what's applicable.

Be that as it may, the government has instituted a series of measures that the old cold war enemies would recognise: House arrest for indeterminate amounts of time, restricted travel outside one's own area without due cause. No association in groups of more than six (actually that's more the old South Africa association laws). Internal border controls.

Bearing in mind that the three tiers start at the rule of six does it seem likely that these rather handy and arbitrary rules* will be rescinded or merely put on hold to be kept for future use.

*Look how the rules were enforced during the BLM demos. If they are needed to protect the vulnerable then surely they should have been rigorously enforced in the case of BAME high risk people?
It's got nothing to do with health and everything to do with politics. And why has the BLM thing turned up now? That's convenient.
 

cowgoesmoo

Old-Salt
The issue which they don't seem to be be mentioning is the specific threat to the NHS. I don't mean the 'protect the NHS' line, I mean there are some very specific issues that have risen quickly this last month that, unless something is done, will mean there will be no emergency care available.

-One hospital currently has around 250 members of staff off work due to self isolating/illness via COVID. This is translating to ED (A&E) being around 30% understaffed. This is meaning one nurse can be responsible for between 3-30 patients. These are the patients who are needing emergency medicine, not in and out jobs. Some staff have worked 18 days in a row of 12.5-14 hour shifts. They are dropping like flies from burn out before you add the self isolating.

-The nightingale hospitals are warehouses with ventilators. There's no staff to run them. To run the ventilators you need to be ICU trained, or work in one small specific team from one department in a hospital; those which are already massively understaffed and getting worse. The nightingale hospitals are asking staff to come work in them, from those very wards, if they go then the ICU trained staff have left the hospital even more understaffed.

It's reaching critical level where there is a risk of there being no working Emergency Department or Intensive Care Units in a significant number of hospitals in the country.

These places can't be filled by other nurses, they aren't trained for either jobs.

Clearly there's a problem that a number of the general public either don't care about or won't obey the rules in place, so we're left with a national lockdown as one of the few solutions left.

This wouldn't have been needed if that proportion of the public had obeyed the social distancing/mask rules. The bare facts are that enough people are too selfish/stupid enough to follow the rules that could have avoided this.

The economy won't be great if massive numbers of workers die from previously treatable conditions. Heart attacks, strokes, sepsis, fractures, falls, car crashes, cuts, burns, blood loss, sick children, pregnancy/birth complications...the list goes on
What happened to the 15,000 retired medics and nurses who have volunteered to come back to the NHS to help out? Why aren't there enough nurses trained when the NHS has had the best part of 8 months and almost unlimited funding and government support to prepare? I'm not sure it's fair to lay the blame on the public because the NHS can't organise the proverbial piss up
 

JCC

War Hero
Newly qualified Nurses need 6 months experience in a high dependency ward then and training before they are allowed to look after patient under supervision from trained staff.
There's a lot of training that needs to go along with that; tracheostomy care, IV inserted and medication administration, naso-gastric tube training, central lines, ventilator training, advanced life support etc. All of this wasn't being done last lockdown because the education staff (Non clinical staff doing PowerPoints and seminars etc were all sent home.)

Basically there's no scope. You might be able to rush some things in an emergency (A pandemic) but the vast majority isn't able to be, patient safety nevermind the hospital + personal indemnity insurance doesn't allow the specialised stuff to be done off the cuff
Thanks but as far as I understand it tubing is now the very very last resort - it's mostly oxygen masks that will be in use for the bulk of patients. Would that not reduce the time required to bring a existing, if rusty, nurse in from some other department?
 
Having lost two cousins and a mother to CV19 lockdown should have kicked in weeks ago not being allowed in to a hospital to be with your mother in her last hours of life is truly devastating. I hope that this lockdown stops CV 19 in its tracks unfortunately it won’t because the younger generation think the are special and dnt give a toss about social distancing.
 

Chef

LE
Having lost two cousins and a mother to CV19 lockdown should have kicked in weeks ago not being allowed in to a hospital to be with your mother in her last hours of life is truly devastating. I hope that this lockdown stops CV 19 in its tracks unfortunately it won’t because the younger generation think the are special and dnt give a toss about social distancing.

I'm sorry for your loss and the circumstances that precluded you from being with your mother at the end.

Given that the Covid virus seems to be endemic in the environment will the lockdown, however long it is stop it in its tracks? Or will it merely flatten the peaks which was the original premise but seems to have morphed into 'If we lockdown for long enough the bogey man will go away'? Because that seems to be what's being 'promised'.

Equally if Covid is here to stay and a vaccine is not effective will people be happy to isolate for as long as it takes?

Take a fifty year old cancer sufferer in remission. Will they accept virtual house arrest for thirty years? Because that's a distinct possibility.
 

JCC

War Hero
CPAP and BiPAP is used more now yes, training is still required for that although is can be done in a day. But importantly there's a big difference having done the training and being competent, especially if a patient is in such a state of high acuity.

The issue is practicality. Recent example:

ED is full, waiting room is at capacity 40+ people, no social distancing because there is simply no room. 11 ambulances outside are waiting in addition. One nurse is looking after two critically ill patients, one is on CPAP, the other on BiPAP. Because they are aerosol generating procedures that is being done in a sealed hot/red area.
The nurse needs to have been mask fitted to work in that environment (It's surprisingly hard due to the shape of faces, not everyone on shift has this fitting done and would have to use a respirator instead (Take ages to charge up, limited use because of expense and upkeep) and because the patients are critically ill, that nurse spends 6 hours specifically with those two patients, sealed in and needs to have a high degree of ED proficiency, probably 2 years experience minimum to be able to do everything those patients need in that time.

This is before being moved to ITU, which is already full. They are normally full all the time regardless, in Winter it's even worse. With COVID on top.. you're starting to see why the system is breaking down before even adding in staff shortage and burnout.

So yep the pre-ventilator oxygen therapy is a huge help, but it's not a skill you can use in isolation, more one that someone already with a high degree of experience can use as a tool. Still comes back to that issue of there's no quick way to give someone multi-year experience or training.
So over the last six months the NHS couldn't have pulled experienced nurses out from shrinkable departments and refreshed their skills? Fair enough.
 
Indeed they do prevent cases. But they also destroy consumer based economies. So pick your poison, fewer cases and breadlines. Or more cases but a house that is not on fire.
You can't buy things if you're dead. I'd rather be in lockdown and do my best to avoid catching something that could easily kill me or leave me with serious long term health problems.
 
Bacon can cause serious heart problems down the road.

Can you really undo the economic damage just like that? Or will you be paying in spades for decades?!

At what point does one have to prioritize the 99 percent over the 1 percent?
You'd have to trough a lot of bacon for that to happen but the thing is, you can't catch heart disease from somebody else who's eaten bacon.
 
No, the governmental policies of limiting places on nursing and medicine courses when demand has been extremely high for a decade+

Operating the NHS on a skeleton staff was always going to come back and bite. It's a separate issue of funding the day to day running. The nightingale issues sum it up perfectly. Throwing unlimited funds can build you whatever you want fast.

No staff for them

But what about those doctors and nurses coming over from Calais every day, surely the NHS should have more staff than they need
 
<Snip>

Clearly there's a problem that a number of the general public either don't care about or won't obey the rules in place, so we're left with a national lockdown as one of the few solutions left.

This wouldn't have been needed if that proportion of the public had obeyed the social distancing/mask rules. The bare facts are that enough people are too selfish/stupid enough to follow the rules that could have avoided this.
A mate is a Train Manager. On Saturday he questions one of his passengers who wasn't wearing a mask. (Remember that wearing a mask is a requirement on public transport). Bloke pulls mask out of pocket but asks if he has to wear it because he is sitting down. This is what we are dealing with. Some people are so stupid that they don't deserve to survive. These are the sorts of people that need culling from society. And Beth Rigby from Sky News, obvs.
 
You can't buy things if you're dead. I'd rather be in lockdown and do my best to avoid catching something that could easily kill me or leave me with serious long term health problems.
It’s a hard knock life, but what did it for us was watching the impact on the kids. Upending their lives was a $hit choice, and they are the future. Sometimes you just have to roll the dice and say a little prayer is you believe in that sort of thing.

But one can learn to live with a disability. I guess it all just depends on how one accepts mortality.
 

FORMER_FYRDMAN

LE
Book Reviewer
I suspect the 44,000 that died of flu in 2014/15 would question your definition of "success". Even with freely-available vaccinations for the vulnerable.

I'm sure your quasi-herd-immunity-lock-up-the-old-duffers-suck-it-and-see experiment wouldn't work out quite the way you think it would.
Perhaps not but see what happens when you wipe out the bits of our economy which contain our most entrepreneurial individuals and provide employment for the most economically vulnerable and the bulk of the opportunities for first and second jobbers.

You might have noticed that the under thirties are a bit upset about the current social settlement and the massive economic imbalance and you might have also noticed the consequent appeal of some rather extreme politics to that group - our approach to COVID is making that imbalance even greater.

But hey, forget deaths from chronic disease and a massive increase in mental health issues, only COVID impacts matter so let's save the over-eighties at all costs, even if most of that group agrees that the price is too high.
 

4(T)

LE

No staff for them.


Even given the legacy pre-covid training shambles, I suppose a lot of people don't understand why the NHS is apparently unable to generate staff for the nightingales and other surge facilities out of its own resources (c. 1.5m direct employees).

Granted that there are a finite number of fully-qualified ICU staff. However, there must be a very large number of skilled nursing staff available who would be perfectly competent to work in ICU under qualified ICU team leadership? This is an emergency, so the qualification bar needs to be lowered to meet demand.

The military analogy would be to manage a wartime mobilisation expansion by using its professional regular pool of officers and NCOs to lead expanded units of mixed regulars and reservists.

The GP system has effectively been closed for six months, most out-patient appointments and non-critical in-patient operations have been suspended for the duration, many of the NHS & welfare support services appear to have vanished entirely. There must be an enormous amount of NHS resource available for reallocation.
 

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