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politicalbetting.com » Blog Archive » 28 Weeks Later: The Coronavirus Aftermath for the NHS and its

SystemSystem Posts: 11,002
edited May 2020 in General

imagepoliticalbetting.com » Blog Archive » 28 Weeks Later: The Coronavirus Aftermath for the NHS and its Political Implications

“Now this is not the end. It is not even the beginning of the end. But it is, perhaps, the end of the beginning” 

Read the full story here


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Comments

  • DecrepiterJohnLDecrepiterJohnL Posts: 23,926
    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".
  • philiphphiliph Posts: 4,704
    It appears that the only wise move is to adopt a preventative life style negating the need for many hospitalisations.
  • TimTTimT Posts: 6,328

    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".

    I had that conversation with my dentist in February, before the virus got to DC. I asked him what advice he was getting from ADA (none) and what he was going to do (having seen the aerosols emanating from my mouth as he drilled). He had no clue, but knew it would be problematic.
  • IanB2IanB2 Posts: 47,080
    The search for the unicorn is over. We were merely distracted by looking for the horn:

    https://www.theguardian.com/world/2020/may/16/llama-coronavirus-antibodies-study-benefits
  • FoxyFoxy Posts: 44,052

    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".

    The critical question is how long do we need to follow the AGP PPE protocols. Six months? Permenantly? We just don't know.

    It isn't just staff protection either. In an operating theatre 20 minutes of air exchange is regarded as sufficient for the aerosol to clear, but that is a higher airflow environment*. In a dental office 20 minute fallow time between consultations may not be quite long enough, depending on ventilation. Then there is cleaning time, so the environment is safe for the next patient.

    Swabbing each dental patient a week in advance and getting them to self isolate would be impractical.

    *operating theatres have positive pressure ventilation, so the air pressure is always a little higher. This means that when doors are opened, the airflow is outwards, to protect the patient. There are concerns that with AGPs, the aerosol could contaminate operating theatre suite corridors etc.


  • IanB2IanB2 Posts: 47,080
    Foxy said:

    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".

    The critical question is how long do we need to follow the AGP PPE protocols. Six months? Permenantly? We just don't know.

    It isn't just staff protection either. In an operating theatre 20 minutes of air exchange is regarded as sufficient for the aerosol to clear, but that is a higher airflow environment*. In a dental office 20 minute fallow time between consultations may not be quite long enough, depending on ventilation. Then there is cleaning time, so the environment is safe for the next patient.

    Swabbing each dental patient a week in advance and getting them to self isolate would be impractical.

    *operating theatres have positive pressure ventilation, so the air pressure is always a little higher. This means that when doors are opened, the airflow is outwards, to protect the patient. There are concerns that with AGPs, the aerosol could contaminate operating theatre suite corridors etc.


    This can’t be the first disease where this is an issue. TB? It is just a question of prevalence?

    Surgery and the like must have gone through such considerations before, for example when the HIV crisis broke.
  • FoxyFoxy Posts: 44,052
    IanB2 said:

    Foxy said:

    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".

    The critical question is how long do we need to follow the AGP PPE protocols. Six months? Permenantly? We just don't know.

    It isn't just staff protection either. In an operating theatre 20 minutes of air exchange is regarded as sufficient for the aerosol to clear, but that is a higher airflow environment*. In a dental office 20 minute fallow time between consultations may not be quite long enough, depending on ventilation. Then there is cleaning time, so the environment is safe for the next patient.

    Swabbing each dental patient a week in advance and getting them to self isolate would be impractical.

    *operating theatres have positive pressure ventilation, so the air pressure is always a little higher. This means that when doors are opened, the airflow is outwards, to protect the patient. There are concerns that with AGPs, the aerosol could contaminate operating theatre suite corridors etc.


    This can’t be the first disease where this is an issue. TB? It is just a question of prevalence?

    Surgery and the like must have gone through such considerations before, for example when the HIV crisis broke.
    It is the aerosol aspect that is most problematic. Bloodborne conditions such as HIV are relatively easy, double gloves and visors etc.
  • BluestBlueBluestBlue Posts: 4,556
    Could e.g. dental clinics use a same-day test that detects even asymptomatic cases? So you take your test on arrival at the clinic, and if you're clean, you can go ahead and have your procedure done? That would cut down the risk to everyone substantially.
  • OldKingColeOldKingCole Posts: 31,715
    Thanks Dr Foxy. Thought-provoking. Must be challenging working in any aspect of the NHS now.

    I am led to believe, from contacts I still have in NHS management, that second wave of viral infection. is expected in September. Elective surgery waits may well be pushed back beyond pre 2000 levels.
  • OldKingColeOldKingCole Posts: 31,715
    Foxy said:

    IanB2 said:

    Foxy said:

    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".

    The critical question is how long do we need to follow the AGP PPE protocols. Six months? Permenantly? We just don't know.

    It isn't just staff protection either. In an operating theatre 20 minutes of air exchange is regarded as sufficient for the aerosol to clear, but that is a higher airflow environment*. In a dental office 20 minute fallow time between consultations may not be quite long enough, depending on ventilation. Then there is cleaning time, so the environment is safe for the next patient.

    Swabbing each dental patient a week in advance and getting them to self isolate would be impractical.

    *operating theatres have positive pressure ventilation, so the air pressure is always a little higher. This means that when doors are opened, the airflow is outwards, to protect the patient. There are concerns that with AGPs, the aerosol could contaminate operating theatre suite corridors etc.


    This can’t be the first disease where this is an issue. TB? It is just a question of prevalence?

    Surgery and the like must have gone through such considerations before, for example when the HIV crisis broke.
    It is the aerosol aspect that is most problematic. Bloodborne conditions such as HIV are relatively easy, double gloves and visors etc.
    I suspect that local ventilation may be part of the answer. A steady stream of clean air across the patient, coupled with masking of the practitioner, although that will make dental work even more alarming for those who find it so.
  • MysticroseMysticrose Posts: 4,688
    Great thread Foxy. Thank you for such an informative piece.
  • MysticroseMysticrose Posts: 4,688
    I was fairly gobsmacked when the other day an ICU nurse lampooned the Gov't's stay alert message in a tweet which went viral. She said, how can you be expected to be alert against something "you can't see."

    I felt like responding along the lines of, 'thank god I'm not under your nursing care.'

    Germs, like viruses, weren't visible the last time I searched.
  • BluestBlueBluestBlue Posts: 4,556

    I was fairly gobsmacked when the other day an ICU nurse lampooned the Gov't's stay alert message in a tweet which went viral. She said, how can you be expected to be alert against something "you can't see."

    I felt like responding along the lines of, 'thank god I'm not under your nursing care.'

    Germs, like viruses, weren't visible the last time I searched.

    The germ theory of disease is simply going to Blow. Her. Mind. :wink:
  • SockySocky Posts: 404

    Could e.g. dental clinics use a same-day test that detects even asymptomatic cases? So you take your test on arrival at the clinic, and if you're clean, you can go ahead and have your procedure done? That would cut down the risk to everyone substantially.

    Depending on the % who have had it, an anti-body test could also help (schedule an immune person between each non-immune).
  • ydoethurydoethur Posts: 66,730

    I was fairly gobsmacked when the other day an ICU nurse lampooned the Gov't's stay alert message in a tweet which went viral. She said, how can you be expected to be alert against something "you can't see."

    I felt like responding along the lines of, 'thank god I'm not under your nursing care.'

    Germs, like viruses, weren't visible the last time I searched.

    The germ theory of disease is simply going to Blow. Her. Mind. :wink:
    https://youtu.be/dCKVSPcd8Gs
  • OldKingColeOldKingCole Posts: 31,715
    Socky said:

    Could e.g. dental clinics use a same-day test that detects even asymptomatic cases? So you take your test on arrival at the clinic, and if you're clean, you can go ahead and have your procedure done? That would cut down the risk to everyone substantially.

    Depending on the % who have had it, an anti-body test could also help (schedule an immune person between each non-immune).
    Suspect this emergency might spell the end of the small, one or two person, business structure of current dental practice. If, as seems possible, there are substantially increased operational costs for dental practices too, that might mean the NHS has to fund more dental work.
  • SockySocky Posts: 404

    I was fairly gobsmacked when the other day an ICU nurse lampooned the Gov't's stay alert message.

    A surprising number of people can switch between professional and political-activist modes seemingly without one informing the other.
  • MysticroseMysticrose Posts: 4,688
    Socky said:

    I was fairly gobsmacked when the other day an ICU nurse lampooned the Gov't's stay alert message.

    A surprising number of people can switch between professional and political-activist modes seemingly without one informing the other.
    Quite!
  • SockySocky Posts: 404

    Suspect this emergency might spell the end of the small, one or two person, business structure of current dental practice. If, as seems possible, there are substantially increased operational costs for dental practices too, that might mean the NHS has to fund more dental work.

    I think I am correct in saying that many dentists already do not carry out many major procedures (e.g. anaesthesia).

    Perhaps we will see the emergence of specialist clinics who handle the difficult stuff?
  • rkrkrkrkrkrk Posts: 7,880
    Great article. I suspect laying the Labour majority is a good bet given continued SNP strength. But the next election is a long way away.

    If we can get a sensitive and specific rapid antigen test, that will make a lot of things possible.

    On the NHS, I went to a hospital for the first time in years recently to help a family member get home. Really striking how run down and cramped the hospital looked.
  • tlg86tlg86 Posts: 25,164
    I'm surprised to see that German football fans were allowed to congregate in pubs for the games yesterday.
  • noneoftheabovenoneoftheabove Posts: 20,448
    Socky said:

    Suspect this emergency might spell the end of the small, one or two person, business structure of current dental practice. If, as seems possible, there are substantially increased operational costs for dental practices too, that might mean the NHS has to fund more dental work.

    I think I am correct in saying that many dentists already do not carry out many major procedures (e.g. anaesthesia).

    Perhaps we will see the emergence of specialist clinics who handle the difficult stuff?
    (From my position of near total ignorance!) Id imagine check up's for those with generally healthy teeth could be handed down to someone more junior without much problem, perhaps combined with some new tech.
  • FoxyFoxy Posts: 44,052

    Thanks Dr Foxy. Thought-provoking. Must be challenging working in any aspect of the NHS now.

    I am led to believe, from contacts I still have in NHS management, that second wave of viral infection. is expected in September. Elective surgery waits may well be pushed back beyond pre 2000 levels.

    I was only periphally involved with Covid-19 patients, keeping skeleton services going for other conditions during the peak. I did a lot of updates in case of call up for redeployment, but thankfully it didn't get quite that bad. Busy now trying to reconstruct services, hence the thoughts that led to this header.

    I think it right to plan for a second wave, so we can implement the lessons from the first, but my own hunch is that it will be a single peak with a long fat tail.
  • ydoethurydoethur Posts: 66,730
    tlg86 said:

    I'm surprised to see that German football fans were allowed to congregate in pubs for the games yesterday.

    Bad enough they can’t get into the stadiums. If they couldn’t go to the pubs as well it would be unbeerable.
  • tlg86tlg86 Posts: 25,164
    ydoethur said:

    tlg86 said:

    I'm surprised to see that German football fans were allowed to congregate in pubs for the games yesterday.

    Bad enough they can’t get into the stadiums. If they couldn’t go to the pubs as well it would be unbeerable.
    There is absolutely no chance of fans here being allowed in pubs to watch games.
  • IanB2IanB2 Posts: 47,080
    Foxy said:

    Thanks Dr Foxy. Thought-provoking. Must be challenging working in any aspect of the NHS now.

    I am led to believe, from contacts I still have in NHS management, that second wave of viral infection. is expected in September. Elective surgery waits may well be pushed back beyond pre 2000 levels.

    I was only periphally involved with Covid-19 patients, keeping skeleton services going for other conditions during the peak. I did a lot of updates in case of call up for redeployment, but thankfully it didn't get quite that bad. Busy now trying to reconstruct services, hence the thoughts that led to this header.

    I think it right to plan for a second wave, so we can implement the lessons from the first, but my own hunch is that it will be a single peak with a long fat tail.
    Is it possible that a not insignificant proportion of the population start with some sort of natural immunity? It would explain the disconnect between apparently low infection rates and the pattern of dropping off of new case numbers, which is directing some experts towards theories of widespread infection that aren't backed by any actual test studies.
  • FoxyFoxy Posts: 44,052
    ydoethur said:

    tlg86 said:

    I'm surprised to see that German football fans were allowed to congregate in pubs for the games yesterday.

    Bad enough they can’t get into the stadiums. If they couldn’t go to the pubs as well it would be unbeerable.
    They will be sorry if they start ale-ing...
  • rkrkrkrkrkrk Posts: 7,880
  • ydoethurydoethur Posts: 66,730
    tlg86 said:

    ydoethur said:

    tlg86 said:

    I'm surprised to see that German football fans were allowed to congregate in pubs for the games yesterday.

    Bad enough they can’t get into the stadiums. If they couldn’t go to the pubs as well it would be unbeerable.
    There is absolutely no chance of fans here being allowed in pubs to watch games.
    I fear you missed the awesome pun. Serves me right for being subtle.
  • ydoethurydoethur Posts: 66,730
    Foxy said:

    ydoethur said:

    tlg86 said:

    I'm surprised to see that German football fans were allowed to congregate in pubs for the games yesterday.

    Bad enough they can’t get into the stadiums. If they couldn’t go to the pubs as well it would be unbeerable.
    They will be sorry if they start ale-ing...
    Very good! Stout fellow...
  • StockyStocky Posts: 9,653
    Superb header Foxy. Many thanks. I`m going to read it a second time before commenting.
  • MysticroseMysticrose Posts: 4,688
    ydoethur said:

    I was fairly gobsmacked when the other day an ICU nurse lampooned the Gov't's stay alert message in a tweet which went viral. She said, how can you be expected to be alert against something "you can't see."

    I felt like responding along the lines of, 'thank god I'm not under your nursing care.'

    Germs, like viruses, weren't visible the last time I searched.

    The germ theory of disease is simply going to Blow. Her. Mind. :wink:
    https://youtu.be/dCKVSPcd8Gs
    Very good! :)
  • FoxyFoxy Posts: 44,052
    IanB2 said:

    Foxy said:

    Thanks Dr Foxy. Thought-provoking. Must be challenging working in any aspect of the NHS now.

    I am led to believe, from contacts I still have in NHS management, that second wave of viral infection. is expected in September. Elective surgery waits may well be pushed back beyond pre 2000 levels.

    I was only periphally involved with Covid-19 patients, keeping skeleton services going for other conditions during the peak. I did a lot of updates in case of call up for redeployment, but thankfully it didn't get quite that bad. Busy now trying to reconstruct services, hence the thoughts that led to this header.

    I think it right to plan for a second wave, so we can implement the lessons from the first, but my own hunch is that it will be a single peak with a long fat tail.
    Is it possible that a not insignificant proportion of the population start with some sort of natural immunity? It would explain the disconnect between apparently low infection rates and the pattern of dropping off of new case numbers, which is directing some experts towards theories of widespread infection that aren't backed by any actual test studies.
    Possibly, but I am conflicted on this as we do see incidents such as the Diamond Princess or the Korean Church where infection rates are quite high.

    We remain in the dark concerning where spread is really occurring, what is safe and what is not. I suspect half or more of our social distancing measures are pointless, the problem is that we do not know which half.
  • tlg86tlg86 Posts: 25,164
    Excellent thread @Foxy - I don't envy the task facing those working in the NHS. I would take issue with this:

    Non surgical specialities including mental health will be similarly affected, though these get less media attention.

    You can't turn on the news these days without hearing about mental health. Sure enough, the Sky News presenter Niall Paterson has just said he's starting to suffer and they'll be discussing it on (I think) the Sophy Ridge show.
  • Black_RookBlack_Rook Posts: 8,905
    edited May 2020

    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".

    I think we can probably add dental abcesses to the list of fatal conditions to which people will succumb because Covid. It's going to be a total massacre.
    philiph said:

    It appears that the only wise move is to adopt a preventative life style negating the need for many hospitalisations.

    Good luck with that. The gyms are all shut, team sport has been abolished for the duration, people are still being told to stew in their own juices at home as much as possible, they've had the shit scared out of them over this virus and been told never to go within two metres of someone they don't live with until it's dealt with. Which it might never be.

    The new reality is that we can't see most of the people we love except through a screen, we can't do most of the things we enjoy, if we get sick with almost anything other than Plague, or something that can be solved with a simple prescription, then we're going to be made to wait years to be treated (or simply told to shuffle off into a corner, not waste anyone's time and die quietly,) and we're discouraged from travelling anywhere (and even if we do then there's nothing to do when we get wherever we're going but go for a circular walk and then go home again.)

    Toss 25% unemployment into the mix and you've the perfect conditions for a tsunami wave of obesity, alcohol and narcotic abuse and mental illness. And can you blame people? This is a near-hopeless situation - there is no solution to it in sight, and no guarantee that one will ever be found - so what's the point in looking after yourself? Like I said last night, we're basically being told to slog back and forth to work (if we're lucky enough still to have a job) and otherwise live the remainder of our entire lives like an eternal boring Sunday in 1977, only plus Netflix and minus the opportunity to see any of our friends and family ever again. It's intolerable.
  • MysticroseMysticrose Posts: 4,688
    I was in A&E the other evening and was, literally, the only person there. Medics said they had had their quietest 3 weeks ever. One doctor told me in hushed tones how pleasant it had been.

    Doubt you'll hear about it on the MSM as it doesn't quite fit the trope.
  • ydoethurydoethur Posts: 66,730
    edited May 2020

    I was in A&E the other evening and was, literally, the only person there. Medics said they had had their quietest 3 weeks ever. One doctor told me in hushed tones how pleasant it had been.

    Doubt you'll hear about it on the MSM as it doesn't quite fit the trope.

    I’m not surprised. My GP practice is actually shut. Which is unfortunate as I needed a repeat prescription for a throat problem and I can’t get hold of anybody to authorise it.

    I’m not very pleased with them.
  • Black_RookBlack_Rook Posts: 8,905

    I was in A&E the other evening and was, literally, the only person there. Medics said they had had their quietest 3 weeks ever. One doctor told me in hushed tones how pleasant it had been.

    Doubt you'll hear about it on the MSM as it doesn't quite fit the trope.

    Presumably they were relieved of the burden of the hypochondriacs, those unable to get GP appointments in a reasonable timeframe, RTA casualties, and (depending on the time) the results of drunken nights out?

    Along with assorted TIAs, "minor" heart attacks, scalds, burns, cuts and goodness only knows what else that people tried to deal with themselves because they weren't absolutely forced to join you.
  • Black_RookBlack_Rook Posts: 8,905
    ydoethur said:

    I was in A&E the other evening and was, literally, the only person there. Medics said they had had their quietest 3 weeks ever. One doctor told me in hushed tones how pleasant it had been.

    Doubt you'll hear about it on the MSM as it doesn't quite fit the trope.

    I’m not surprised. My GP practice is actually shut. Which is unfortunate as I needed a repeat prescription for a throat problem and I can’t get hold of anybody to authorise it.

    I’m not very pleased with them.
    Oh. Ours is operational. What (if any) was their excuse?
  • geoffwgeoffw Posts: 8,092
    To all Norgies: Happy Constitution Day!
  • fox327fox327 Posts: 363
    edited May 2020
    There are formidable difficulties still to be overcome in developing a vaccine. There is the possibility of immune-enhanced disease, as happened with a vaccine for RSV in the 1960s. This could set back public acceptance of any other vaccine/trials.

    One solution to the equipment issues is to use staff who have antibodies to the virus for elective surgery including dental care and to prioritise patients who have the antibodies. Eventually this will have to be considered.

    Mental health is another issue, as many people with mental health problems are self-harming or abusing alcohol and drugs. There are also people who are experience severe family problems arising from the lockdown. See https://www.bbc.co.uk/news/uk-52690931 for an example. COVID-19 is an unpleasant disease but for some people worrying about it will be a "high-class problem". This will be more and more the case as the lockdown goes on for longer.
  • MysticroseMysticrose Posts: 4,688
    edited May 2020

    I was in A&E the other evening and was, literally, the only person there. Medics said they had had their quietest 3 weeks ever. One doctor told me in hushed tones how pleasant it had been.

    Doubt you'll hear about it on the MSM as it doesn't quite fit the trope.

    Presumably they were relieved of the burden of the hypochondriacs, those unable to get GP appointments in a reasonable timeframe, RTA casualties, and (depending on the time) the results of drunken nights out?

    Along with assorted TIAs, "minor" heart attacks, scalds, burns, cuts and goodness only knows what else that people tried to deal with themselves because they weren't absolutely forced to join you.
    I think the tricky thing is that alongside those who don't really need to be there will be some who really should be.

    Interestingly I ended up there via 1. An online e-consult at my GP's who then 2. instructed me to dial 111 at once who then 3. called me back urgently and 4. ordered me immediately to A&E.

    They did pick up something with the heart: treatable I hope so all okay.
  • CarlottaVanceCarlottaVance Posts: 59,540
    ydoethur said:

    Foxy said:

    ydoethur said:

    tlg86 said:

    I'm surprised to see that German football fans were allowed to congregate in pubs for the games yesterday.

    Bad enough they can’t get into the stadiums. If they couldn’t go to the pubs as well it would be unbeerable.
    They will be sorry if they start ale-ing...
    Very good! Stout fellow...
    No doubt some will wine....
  • DeClareDeClare Posts: 483

    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".

    I think we can probably add dental abcesses to the list of fatal conditions to which people will succumb because Covid. It's going to be a total massacre.
    philiph said:

    It appears that the only wise move is to adopt a preventative life style negating the need for many hospitalisations.

    Good luck with that. The gyms are all shut, team sport has been abolished for the duration, people are still being told to stew in their own juices at home as much as possible, they've had the shit scared out of them over this virus and been told never to go within two metres of someone they don't live with until it's dealt with. Which it might never be.

    The new reality is that we can't see most of the people we love except through a screen, we can't do most of the things we enjoy, if we get sick with almost anything other than Plague, or something that can be solved with a simple prescription, then we're going to be made to wait years to be treated (or simply told to shuffle off into a corner, not waste anyone's time and die quietly,) and we're discouraged from travelling anywhere (and even if we do then there's nothing to do when we get wherever we're going but go for a circular walk and then go home again.)

    Toss 25% unemployment into the mix and you've the perfect conditions for a tsunami wave of obesity, alcohol and narcotic abuse and mental illness. And can you blame people? This is a near-hopeless situation - there is no solution to it in sight, and no guarantee that one will ever be found - so what's the point in looking after yourself? Like I said last night, we're basically being told to slog back and forth to work (if we're lucky enough still to have a job) and otherwise live the remainder of our entire lives like an eternal boring Sunday in 1977, only plus Netflix and minus the opportunity to see any of our friends and family ever again. It's intolerable.
    I was thinking the other day, where is the next generation going to come from?

    Couples who are already together will still be able to produce children and the birth rate might even go up in the short term because they are cooped up together.

    But if we're not allowed to meet people we don't know, how are new couplings going to take place? and how are new babies going to be conceived after the initial baby boom?
  • SandyRentoolSandyRentool Posts: 20,392
    Prediction:

    Before the end of this week the government announces that R has increased to 0.8 - 1.1

    Therefore it would be premature to reopen schools
  • Black_RookBlack_Rook Posts: 8,905
    Yep. I think we can probably surmise what caused this. There was such a desperation to get rid of the elderly from hospitals, to clear capacity for new Covid patients, that they were just thrown at the care homes to get them out of the way. I seem to recall reading elsewhere that homes which initially refused to have them back were threatened (by councils?) with having funding withdrawn if they dug their heels in, so they gave in. We all know how this ended.

    Looking at what's happened abroad it looks like pretty well everyone screwed up when it came to care homes, but that doesn't make the failure any more excusable.
  • AnneJGPAnneJGP Posts: 2,869
    Thank you, @Foxy, that's a really interesting & informative header.

    Perhaps there's a possibility that all our services will emerge from the aftermath of this much more fit-for-purpose, for the future with more joined-up thinking and fewer gaps for people to fall through. NHS, care services, dental health, mental health, housing ...... even supply chains.

    Strangely enough, this virus is showing me to be much more of an optimist than I realised. I keep noticing myself offering a possible positive side to the negative aspects that so many people dwell on. In small things, of course; the big things like death, pain, fear & disaster don't lend themselves to optimism.

    Good morning, everyone.



  • malcolmgmalcolmg Posts: 41,670
    ydoethur said:

    Foxy said:

    ydoethur said:

    tlg86 said:

    I'm surprised to see that German football fans were allowed to congregate in pubs for the games yesterday.

    Bad enough they can’t get into the stadiums. If they couldn’t go to the pubs as well it would be unbeerable.
    They will be sorry if they start ale-ing...
    Very good! Stout fellow...
    We can't beer any more
  • malcolmgmalcolmg Posts: 41,670
    tlg86 said:

    Excellent thread @Foxy - I don't envy the task facing those working in the NHS. I would take issue with this:

    Non surgical specialities including mental health will be similarly affected, though these get less media attention.

    You can't turn on the news these days without hearing about mental health. Sure enough, the Sky News presenter Niall Paterson has just said he's starting to suffer and they'll be discussing it on (I think) the Sophy Ridge show.

    Have to say the UK has turned into a bunch of wimps. Everybody seems to be ill and cannot cope with anything nowadays, why does it have top billing in every disorder known to man.
  • Dura_AceDura_Ace Posts: 12,880
    Foxy said:

    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".

    The critical question is how long do we need to follow the AGP PPE protocols. Six months? Permenantly? We just don't know.

    It isn't just staff protection either. In an operating theatre 20 minutes of air exchange is regarded as sufficient for the aerosol to clear, but that is a higher airflow environment*. In a dental office 20 minute fallow time between consultations may not be quite long enough, depending on ventilation. Then there is cleaning time, so the environment is safe for the next patient.

    Swabbing each dental patient a week in advance and getting them to self isolate would be impractical.

    *operating theatres have positive pressure ventilation, so the air pressure is always a little higher. This means that when doors are opened, the airflow is outwards, to protect the patient. There are concerns that with AGPs, the aerosol could contaminate operating theatre suite corridors etc.


    Mrs DA reckons she's only going to see 2-4 patients a day and then it will be in alternating rooms. So one room will be being nuked sterile while she's hammering overpriced implants into some poor bastard's maxilla in the other,
  • FishingFishing Posts: 4,555
    edited May 2020

    rcs1000 said:


    Internal balance? Maybe I'm being dim, but what is the internal balance?

    I've not heard it phrased that way before but I imagine he means eg stability in prices (low inflation) over stability in exchange rates which is an argument I've often made here.
    No - internal balance means domestic labour and product markets clearing, rather than any particular price level. It's a real economy concept, not a nominal economy one. But, yes, one of the symptoms should be price stability. The other important one is a low level of unemployment.

    One being off can lead to the other one being off too, but not always and sometimes only one of the two can be balanced.

    If they both balance at once, it's an accident, certainly in an economy like ours (Germany's), which is heavily skewed towards non-tradeable (tradeable) goods. It won't be the normal state of affairs.

    That is why we'd be crazy to tie ourselves to them in a fixed exchange rate system - as we found out to our cost in 1990-92.
  • AnneJGPAnneJGP Posts: 2,869

    Prediction:

    Before the end of this week the government announces that R has increased to 0.8 - 1.1

    Therefore it would be premature to reopen schools

    I've been thinking that the arrival of second-home owners in less-populated areas is now a good thing. Yes, there's a risk that they will bring the virus with them, but hopefully not beyond the local capabilities. They're all in permanent housing, not camp-sites, so won't be swelling the population beyond what the local services should be able to cope with.

    By definition, they don't need to go to work (either retired or able to work remotely) so by moving away they're reducing the numbers milling about in the densely populated areas.
  • fox327fox327 Posts: 363
    DeClare said:

    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".

    I think we can probably add dental abcesses to the list of fatal conditions to which people will succumb because Covid. It's going to be a total massacre.
    philiph said:

    It appears that the only wise move is to adopt a preventative life style negating the need for many hospitalisations.

    Good luck with that. The gyms are all shut, team sport has been abolished for the duration, people are still being told to stew in their own juices at home as much as possible, they've had the shit scared out of them over this virus and been told never to go within two metres of someone they don't live with until it's dealt with. Which it might never be.

    The new reality is that we can't see most of the people we love except through a screen, we can't do most of the things we enjoy, if we get sick with almost anything other than Plague, or something that can be solved with a simple prescription, then we're going to be made to wait years to be treated (or simply told to shuffle off into a corner, not waste anyone's time and die quietly,) and we're discouraged from travelling anywhere (and even if we do then there's nothing to do when we get wherever we're going but go for a circular walk and then go home again.)

    Toss 25% unemployment into the mix and you've the perfect conditions for a tsunami wave of obesity, alcohol and narcotic abuse and mental illness. And can you blame people? This is a near-hopeless situation - there is no solution to it in sight, and no guarantee that one will ever be found - so what's the point in looking after yourself? Like I said last night, we're basically being told to slog back and forth to work (if we're lucky enough still to have a job) and otherwise live the remainder of our entire lives like an eternal boring Sunday in 1977, only plus Netflix and minus the opportunity to see any of our friends and family ever again. It's intolerable.
    I was thinking the other day, where is the next generation going to come from?

    Couples who are already together will still be able to produce children and the birth rate might even go up in the short term because they are cooped up together.

    But if we're not allowed to meet people we don't know, how are new couplings going to take place? and how are new babies going to be conceived after the initial baby boom?
    This is the kind of question that was not permitted to be asked in March when the lockdown was imposed. There are plenty of other such questions. E.g. what is the % of the population who must be infected to reach herd immunity. If anyone tells you it is 60-80% ask them how they know and what is their evidence for this claim. Neither swine flu nor Spanish flu infected more than one third of the population. We could be nearer to herd immunity than we realise.

    I think the lockdown restrictions on meeting friends and family will gradually break down over the next year or two as their impossibility becomes apparent.
  • Big_G_NorthWalesBig_G_NorthWales Posts: 60,001
    Thank you Dr Foxy for an excellent piece

    It looks like covid 19, and especially the consequencies, is going to cause a huge change in so many areas we took for granted and will require enormous amounts of innovation and change which will make governing the country, no matter the party in power, a challenge of gigantic proportions
  • Morris_DancerMorris_Dancer Posts: 60,933
    Good morning, everyone.

    In unrelated news, I saw Stellaris is coming to the PS4 but, weirdly, the digital version has been out for over a year. It currently has a 50% discount (deluxe, which has a couple of DLCs and an expansion pack) on the digital store.

    Also, Age of Wonders: Planetfall is available for just over a fiver on the Game website right now.

    Trying to decide whether to bother buying stuff (or pre-ordering the physical copy of Stellaris, I'm not a fan of digital).

    It's about six weeks until the F1 season is meant to kick off, and it seems like the Silverstone situation has been resolved, with two races behind closed doors. Nice to see that groups with wildly different opinions managed to negotiate and compromise for mutual benefit.
  • Big_G_NorthWalesBig_G_NorthWales Posts: 60,001

    Yep. I think we can probably surmise what caused this. There was such a desperation to get rid of the elderly from hospitals, to clear capacity for new Covid patients, that they were just thrown at the care homes to get them out of the way. I seem to recall reading elsewhere that homes which initially refused to have them back were threatened (by councils?) with having funding withdrawn if they dug their heels in, so they gave in. We all know how this ended.

    Looking at what's happened abroad it looks like pretty well everyone screwed up when it came to care homes, but that doesn't make the failure any more excusable.
    https://www.theguardian.com/world/2020/may/16/across-the-world-figures-reveal-horrific-covid-19-toll-of-care-home-deaths?CMP=Share_AndroidApp_Link_Sharing
  • Black_RookBlack_Rook Posts: 8,905

    Good morning, everyone.

    In unrelated news, I saw Stellaris is coming to the PS4 but, weirdly, the digital version has been out for over a year. It currently has a 50% discount (deluxe, which has a couple of DLCs and an expansion pack) on the digital store.

    Also, Age of Wonders: Planetfall is available for just over a fiver on the Game website right now.

    Trying to decide whether to bother buying stuff (or pre-ordering the physical copy of Stellaris, I'm not a fan of digital).

    It's about six weeks until the F1 season is meant to kick off, and it seems like the Silverstone situation has been resolved, with two races behind closed doors. Nice to see that groups with wildly different opinions managed to negotiate and compromise for mutual benefit.

    I read about that - but it's presumably contingent on the Government exempting absolutely everyone involved from its forthcoming 14 day quarantine rule. Has there been any indication that it is willing to do this?
  • Big_G_NorthWalesBig_G_NorthWales Posts: 60,001
    My arthritic fingers do on occasions hit 'off topic' rather than quote

    I have no idea what happens with off topic when I do this

    I am hoping someone can clarify this

    Thank you
  • FoxyFoxy Posts: 44,052
    AnneJGP said:

    Thank you, @Foxy, that's a really interesting & informative header.

    Perhaps there's a possibility that all our services will emerge from the aftermath of this much more fit-for-purpose, for the future with more joined-up thinking and fewer gaps for people to fall through. NHS, care services, dental health, mental health, housing ...... even supply chains.

    Strangely enough, this virus is showing me to be much more of an optimist than I realised. I keep noticing myself offering a possible positive side to the negative aspects that so many people dwell on. In small things, of course; the big things like death, pain, fear & disaster don't lend themselves to optimism.

    Good morning, everyone.



    Yes, there certainly a lot of innovative ideas getting the go ahead. Hence my remark about changes of a decade in a few weeks.

    Hospitals are familiar territory to me, and perhaps the most obvious problem, but similar issues arise across so many areas. Hotels, the travel industry, public transport, performing arts, sports,politics, schools, we are all struggling to try to think of a way back. It won't be the same place we left.

  • Morris_DancerMorris_Dancer Posts: 60,933
    Mr. Rook, my understanding is the F1 circus plans to have its own bubble for the season. Provided that's the case there should be scope for the Government to permit it.

    F1 brings in about a billion pounds a year. If it gets into serious trouble that will cost us a lot of money and a decent number of well-paying jobs.
  • FoxyFoxy Posts: 44,052

    My arthritic fingers do on occasions hit 'off topic' rather than quote

    I have no idea what happens with off topic when I do this

    I am hoping someone can clarify this

    Thank you

    nothing!

    If you tap it again it unflags too.
  • malcolmgmalcolmg Posts: 41,670

    Yep. I think we can probably surmise what caused this. There was such a desperation to get rid of the elderly from hospitals, to clear capacity for new Covid patients, that they were just thrown at the care homes to get them out of the way. I seem to recall reading elsewhere that homes which initially refused to have them back were threatened (by councils?) with having funding withdrawn if they dug their heels in, so they gave in. We all know how this ended.

    Looking at what's happened abroad it looks like pretty well everyone screwed up when it came to care homes, but that doesn't make the failure any more excusable.
    https://www.theguardian.com/world/2020/may/16/across-the-world-figures-reveal-horrific-covid-19-toll-of-care-home-deaths?CMP=Share_AndroidApp_Link_Sharing
    In England and Wales, 9 039 out of 12 483 covid-related deaths, by 1st May, were in care homes and that is 72.4%.
    In Scotland, by 10th May:
    More than four in 10 coronavirus deaths have now been in care homes (44.8%).
    Jackson Carlaw ( TORY ) has been lying about Scottish figures
  • SandyRentoolSandyRentool Posts: 20,392
    AnneJGP said:

    Prediction:

    Before the end of this week the government announces that R has increased to 0.8 - 1.1

    Therefore it would be premature to reopen schools

    I've been thinking that the arrival of second-home owners in less-populated areas is now a good thing. Yes, there's a risk that they will bring the virus with them, but hopefully not beyond the local capabilities. They're all in permanent housing, not camp-sites, so won't be swelling the population beyond what the local services should be able to cope with.

    By definition, they don't need to go to work (either retired or able to work remotely) so by moving away they're reducing the numbers milling about in the densely populated areas.
    Our neighbours with a cottage in the Lake District are keen to visit, just to check that everything is OK. Reckon they could take everything they need with them so they wouldn't need to interact with the local community.

    Also noted that in theory their insurance is invalid if they don't visit for over 60 days.

    Just an anecdote, but I reckon more people will be spending weekends in their holiday homes and hoping not to get caught.
  • Big_G_NorthWalesBig_G_NorthWales Posts: 60,001
    malcolmg said:

    tlg86 said:

    Excellent thread @Foxy - I don't envy the task facing those working in the NHS. I would take issue with this:

    Non surgical specialities including mental health will be similarly affected, though these get less media attention.

    You can't turn on the news these days without hearing about mental health. Sure enough, the Sky News presenter Niall Paterson has just said he's starting to suffer and they'll be discussing it on (I think) the Sophy Ridge show.

    Have to say the UK has turned into a bunch of wimps. Everybody seems to be ill and cannot cope with anything nowadays, why does it have top billing in every disorder known to man.
    To be honest Malc we have a close family member suffering from PTSD after rescuing bodies in an earthquake zone. It is not something to dismiss so easily to be honest
  • CarlottaVanceCarlottaVance Posts: 59,540

    Yep. I think we can probably surmise what caused this. There was such a desperation to get rid of the elderly from hospitals, to clear capacity for new Covid patients, that they were just thrown at the care homes to get them out of the way. I seem to recall reading elsewhere that homes which initially refused to have them back were threatened (by councils?) with having funding withdrawn if they dug their heels in, so they gave in. We all know how this ended.

    Looking at what's happened abroad it looks like pretty well everyone screwed up when it came to care homes, but that doesn't make the failure any more excusable.
    https://www.theguardian.com/world/2020/may/16/across-the-world-figures-reveal-horrific-covid-19-toll-of-care-home-deaths?CMP=Share_AndroidApp_Link_Sharing
    Yep - even small jurisdictions which have otherwise handled Covid well (Guernsey, Man) have screwed up Care Homes. In Guernsey they account for all of the deaths and in Man 20 out of the total of 24 deaths from a single Care Home.
  • Big_G_NorthWalesBig_G_NorthWales Posts: 60,001
    edited May 2020
    malcolmg said:

    Yep. I think we can probably surmise what caused this. There was such a desperation to get rid of the elderly from hospitals, to clear capacity for new Covid patients, that they were just thrown at the care homes to get them out of the way. I seem to recall reading elsewhere that homes which initially refused to have them back were threatened (by councils?) with having funding withdrawn if they dug their heels in, so they gave in. We all know how this ended.

    Looking at what's happened abroad it looks like pretty well everyone screwed up when it came to care homes, but that doesn't make the failure any more excusable.
    https://www.theguardian.com/world/2020/may/16/across-the-world-figures-reveal-horrific-covid-19-toll-of-care-home-deaths?CMP=Share_AndroidApp_Link_Sharing
    In England and Wales, 9 039 out of 12 483 covid-related deaths, by 1st May, were in care homes and that is 72.4%.
    In Scotland, by 10th May:
    More than four in 10 coronavirus deaths have now been in care homes (44.8%).
    Jackson Carlaw ( TORY ) has been lying about Scottish figures
    I do not think this is a competition Malc

    There are serious issues in care homes across all four corners of the UK and in others countries as per the guardian link
  • FoxyFoxy Posts: 44,052
    Dura_Ace said:

    Foxy said:

    Dentistry would seem to present huge problems since almost every appointment is an "aerosol generating procedure".

    The critical question is how long do we need to follow the AGP PPE protocols. Six months? Permenantly? We just don't know.

    It isn't just staff protection either. In an operating theatre 20 minutes of air exchange is regarded as sufficient for the aerosol to clear, but that is a higher airflow environment*. In a dental office 20 minute fallow time between consultations may not be quite long enough, depending on ventilation. Then there is cleaning time, so the environment is safe for the next patient.

    Swabbing each dental patient a week in advance and getting them to self isolate would be impractical.

    *operating theatres have positive pressure ventilation, so the air pressure is always a little higher. This means that when doors are opened, the airflow is outwards, to protect the patient. There are concerns that with AGPs, the aerosol could contaminate operating theatre suite corridors etc.


    Mrs DA reckons she's only going to see 2-4 patients a day and then it will be in alternating rooms. So one room will be being nuked sterile while she's hammering overpriced implants into some poor bastard's maxilla in the other,
    Yes, in the private sector costs will be transmitted to the consumer.

    No one yet seems interested that Private Medical Practice has effectively been abolished. There may well be a lot of demand there when services are resumed. Single rooms, less crowding, long waiting lists could revitalise the sector, for those with a few bob.

    At the moment my Private Secretary is operating a PP waiting list. Many insured patients are wondering what they are paying for.
  • SockySocky Posts: 404
    edited May 2020
    Foxy said:

    we are all struggling to try to think of a way back. It won't be the same place we left.

    It is reminiscent of the effect a war can have on a society.

    For example you could compare it to how the UK changed between 1939 and 1945 and (say) 2014 - 2020. It seems these big events force societies out of their local minimums.
  • TGOHF666TGOHF666 Posts: 2,052
    malcolmg said:

    Yep. I think we can probably surmise what caused this. There was such a desperation to get rid of the elderly from hospitals, to clear capacity for new Covid patients, that they were just thrown at the care homes to get them out of the way. I seem to recall reading elsewhere that homes which initially refused to have them back were threatened (by councils?) with having funding withdrawn if they dug their heels in, so they gave in. We all know how this ended.

    Looking at what's happened abroad it looks like pretty well everyone screwed up when it came to care homes, but that doesn't make the failure any more excusable.
    https://www.theguardian.com/world/2020/may/16/across-the-world-figures-reveal-horrific-covid-19-toll-of-care-home-deaths?CMP=Share_AndroidApp_Link_Sharing
    In England and Wales, 9 039 out of 12 483 covid-related deaths, by 1st May, were in care homes and that is 72.4%.
    In Scotland, by 10th May:
    More than four in 10 coronavirus deaths have now been in care homes (44.8%).
    Jackson Carlaw ( TORY ) has been lying about Scottish figures
    Whataboutery isn’t much of a defence malc.

    Krankie is feeling the pressure.
  • MysticroseMysticrose Posts: 4,688
    Scott_xP said:
    Hitting retail feels hugely counter-intuitive.

    I don't know what the answer is but, crikey, they've got to be careful.
  • MysticroseMysticrose Posts: 4,688

    malcolmg said:

    tlg86 said:

    Excellent thread @Foxy - I don't envy the task facing those working in the NHS. I would take issue with this:

    Non surgical specialities including mental health will be similarly affected, though these get less media attention.

    You can't turn on the news these days without hearing about mental health. Sure enough, the Sky News presenter Niall Paterson has just said he's starting to suffer and they'll be discussing it on (I think) the Sophy Ridge show.

    Have to say the UK has turned into a bunch of wimps. Everybody seems to be ill and cannot cope with anything nowadays, why does it have top billing in every disorder known to man.
    To be honest Malc we have a close family member suffering from PTSD after rescuing bodies in an earthquake zone. It is not something to dismiss so easily to be honest
    Totally agree. I have C-PTSD following several severe traumas close to home. Mental ill health is an awful, awful, thing.

    Malcolm can be funny. He can also occasionally be a dick.
  • Morris_DancerMorris_Dancer Posts: 60,933
    Mr. Scott, I find the food retailers aspect pretty weird.

    They've been working hard and ensured supplies remained solid even when people were panic-buying, and their staff have been some of the few to be persistently in contact with the public on a daily basis.

    Not sure why they should be subject to a pernicious tax on top of that.

    Not a fan of windfall taxes generally but there's more of a case for one (or less of an argument against, to be precise) when it comes to online retailers.

    Don't see why people doing business should be penalised. The money they make allows them to do helpful things like provide the public with food and the state with taxes.
  • malcolmgmalcolmg Posts: 41,670

    malcolmg said:

    tlg86 said:

    Excellent thread @Foxy - I don't envy the task facing those working in the NHS. I would take issue with this:

    Non surgical specialities including mental health will be similarly affected, though these get less media attention.

    You can't turn on the news these days without hearing about mental health. Sure enough, the Sky News presenter Niall Paterson has just said he's starting to suffer and they'll be discussing it on (I think) the Sophy Ridge show.

    Have to say the UK has turned into a bunch of wimps. Everybody seems to be ill and cannot cope with anything nowadays, why does it have top billing in every disorder known to man.
    To be honest Malc we have a close family member suffering from PTSD after rescuing bodies in an earthquake zone. It is not something to dismiss so easily to be honest
    G, I understand people can be really ill with these types of things but why does UK have so high a number for all these ailments and disabilities. It is the saddest , fattest , unhealthiest , most disabled country in the developed world.
  • algarkirkalgarkirk Posts: 10,341

    Socky said:

    I was fairly gobsmacked when the other day an ICU nurse lampooned the Gov't's stay alert message.

    A surprising number of people can switch between professional and political-activist modes seemingly without one informing the other.
    Quite!
    Increasing specialisation together with contempt for education as an end in itself lead to this more and more.
  • SandyRentoolSandyRentool Posts: 20,392
    Windfall tax on cycle shops? They seem to have been having a Covid boom.
  • MysticroseMysticrose Posts: 4,688

    Yep. I think we can probably surmise what caused this. There was such a desperation to get rid of the elderly from hospitals, to clear capacity for new Covid patients, that they were just thrown at the care homes to get them out of the way. I seem to recall reading elsewhere that homes which initially refused to have them back were threatened (by councils?) with having funding withdrawn if they dug their heels in, so they gave in. We all know how this ended.

    Looking at what's happened abroad it looks like pretty well everyone screwed up when it came to care homes, but that doesn't make the failure any more excusable.
    It's a really shocking indictment.

    I have a feeling this, more than anything, is responsible for the slump in Gov't support. I know that the shift from 'Stay at Home' to 'Stay Alert' has wobbled people, but there is something viscerally appalling about the way our elderly and most vulnerable have been, basically, seeded with Covid-19.

    Heads should roll. I doubt they will.
  • MysticroseMysticrose Posts: 4,688
    malcolmg said:

    malcolmg said:

    tlg86 said:

    Excellent thread @Foxy - I don't envy the task facing those working in the NHS. I would take issue with this:

    Non surgical specialities including mental health will be similarly affected, though these get less media attention.

    You can't turn on the news these days without hearing about mental health. Sure enough, the Sky News presenter Niall Paterson has just said he's starting to suffer and they'll be discussing it on (I think) the Sophy Ridge show.

    Have to say the UK has turned into a bunch of wimps. Everybody seems to be ill and cannot cope with anything nowadays, why does it have top billing in every disorder known to man.
    To be honest Malc we have a close family member suffering from PTSD after rescuing bodies in an earthquake zone. It is not something to dismiss so easily to be honest
    G, I understand people can be really ill with these types of things but why does UK have so high a number for all these ailments and disabilities. It is the saddest , fattest , unhealthiest , most disabled country in the developed world.
    See, when you put it like that you have a really good point.
  • Dura_AceDura_Ace Posts: 12,880
    malcolmg said:
    The government are going to have spend serious money to get control of this situation after The Great Day. The Fisheries Protection Squadron is down to three patrol boats. I suspect it's all going to have to be privatised by DEFRA like the aviation component. (Cobham/Directflight).
  • Big_G_NorthWalesBig_G_NorthWales Posts: 60,001
    malcolmg said:

    malcolmg said:

    tlg86 said:

    Excellent thread @Foxy - I don't envy the task facing those working in the NHS. I would take issue with this:

    Non surgical specialities including mental health will be similarly affected, though these get less media attention.

    You can't turn on the news these days without hearing about mental health. Sure enough, the Sky News presenter Niall Paterson has just said he's starting to suffer and they'll be discussing it on (I think) the Sophy Ridge show.

    Have to say the UK has turned into a bunch of wimps. Everybody seems to be ill and cannot cope with anything nowadays, why does it have top billing in every disorder known to man.
    To be honest Malc we have a close family member suffering from PTSD after rescuing bodies in an earthquake zone. It is not something to dismiss so easily to be honest
    G, I understand people can be really ill with these types of things but why does UK have so high a number for all these ailments and disabilities. It is the saddest , fattest , unhealthiest , most disabled country in the developed world.
    I accept we do have problems but mental health is a genuine area of concern
  • MarqueeMarkMarqueeMark Posts: 49,955
    malcolmg said:

    Yep. I think we can probably surmise what caused this. There was such a desperation to get rid of the elderly from hospitals, to clear capacity for new Covid patients, that they were just thrown at the care homes to get them out of the way. I seem to recall reading elsewhere that homes which initially refused to have them back were threatened (by councils?) with having funding withdrawn if they dug their heels in, so they gave in. We all know how this ended.

    Looking at what's happened abroad it looks like pretty well everyone screwed up when it came to care homes, but that doesn't make the failure any more excusable.
    https://www.theguardian.com/world/2020/may/16/across-the-world-figures-reveal-horrific-covid-19-toll-of-care-home-deaths?CMP=Share_AndroidApp_Link_Sharing
    In England and Wales, 9 039 out of 12 483 covid-related deaths, by 1st May, were in care homes and that is 72.4%.
    I presume that in a bad winter flu epidemic, the bulk of deaths are also in care homes?

    Still shocking numbers mind. A tacit acceptance by the NHS that if they were over 80, there really was in all likelihood nothing that could be done for victims? Outcomes were proving very poor for the elderly taken into hospital - they just didn't respond. So let them die in the place they knew as home...
  • malcolmgmalcolmg Posts: 41,670

    malcolmg said:

    Yep. I think we can probably surmise what caused this. There was such a desperation to get rid of the elderly from hospitals, to clear capacity for new Covid patients, that they were just thrown at the care homes to get them out of the way. I seem to recall reading elsewhere that homes which initially refused to have them back were threatened (by councils?) with having funding withdrawn if they dug their heels in, so they gave in. We all know how this ended.

    Looking at what's happened abroad it looks like pretty well everyone screwed up when it came to care homes, but that doesn't make the failure any more excusable.
    https://www.theguardian.com/world/2020/may/16/across-the-world-figures-reveal-horrific-covid-19-toll-of-care-home-deaths?CMP=Share_AndroidApp_Link_Sharing
    In England and Wales, 9 039 out of 12 483 covid-related deaths, by 1st May, were in care homes and that is 72.4%.
    In Scotland, by 10th May:
    More than four in 10 coronavirus deaths have now been in care homes (44.8%).
    Jackson Carlaw ( TORY ) has been lying about Scottish figures
    I do not think this is a competition Malc

    There are serious issues in care homes across all four corners of the UK and in others countries as per the guardian link
    Not a competition but Tories lying about it and trying to make it one is simply shocking. It is hard to believe this clown can stoop so low as to blatantly lie about such a topic. This is the clown who is the Tory regional manager in Scotland. You can add the arse Jack , who has banned Scottish Government guidance from Scottish Office sites in favour of only showing advice for England.
    These corrupt sick lying no users deserve all the opprobrium they receive.
  • FishingFishing Posts: 4,555
    edited May 2020
    Great header, @Foxy. Always nice to hear from people with professional experience.

    A close relative of mine who is also a doctor broadly agrees with your conclusions, particularly about the likely endemic future of the virus.

    How would your projections of future long waiting lists change if there is a widely available vaccine in, say, a year?
  • algarkirkalgarkirk Posts: 10,341
    On design; my local hospital, a 21st century build, has public atrium space which resembles the airport terminal of an a African dictator but the spaces where people might actually be ill, treated, healed etc are cramped like a student squat or fruit pickers accommodation. The general public spotted all this immediately. Why was this not obvious to the professionals?
  • Big_G_NorthWalesBig_G_NorthWales Posts: 60,001
    Just listened to Amber Rudd on Marr

    She was excellent and is a loss to the HOC
  • malcolmgmalcolmg Posts: 41,670

    malcolmg said:

    tlg86 said:

    Excellent thread @Foxy - I don't envy the task facing those working in the NHS. I would take issue with this:

    Non surgical specialities including mental health will be similarly affected, though these get less media attention.

    You can't turn on the news these days without hearing about mental health. Sure enough, the Sky News presenter Niall Paterson has just said he's starting to suffer and they'll be discussing it on (I think) the Sophy Ridge show.

    Have to say the UK has turned into a bunch of wimps. Everybody seems to be ill and cannot cope with anything nowadays, why does it have top billing in every disorder known to man.
    To be honest Malc we have a close family member suffering from PTSD after rescuing bodies in an earthquake zone. It is not something to dismiss so easily to be honest
    Totally agree. I have C-PTSD following several severe traumas close to home. Mental ill health is an awful, awful, thing.

    Malcolm can be funny. He can also occasionally be a dick.
    I was not being a dick , merely questioning why the UK has the highest rates in all these types of illnesses, it suggests something far wrong with the country. As per my other post , it has the most obesity , mental illness , disability , unhappiness , etc.
    Something far far wrong here.
  • Black_RookBlack_Rook Posts: 8,905
    fox327 said:

    This is the kind of question that was not permitted to be asked in March when the lockdown was imposed. There are plenty of other such questions. E.g. what is the % of the population who must be infected to reach herd immunity. If anyone tells you it is 60-80% ask them how they know and what is their evidence for this claim. Neither swine flu nor Spanish flu infected more than one third of the population. We could be nearer to herd immunity than we realise.

    I think the lockdown restrictions on meeting friends and family will gradually break down over the next year or two as their impossibility becomes apparent.

    For most people they won't last as long as that. People who aren't vulnerable or shielding themselves, or have close family and friends that are, may not appreciate just what a bloody slog really serious self-isolation is. Doubtless some people who are sufficiently ill or frightened will manage to sequester themselves for however long this takes, but many others (especially older people who are either still sprightly and active, or fear that they may die of something else before this is over and never get to see their families again) will ultimately give up - and that goes double for younger people with no underlying health conditions.

    Basically if you're under 60, in reasonable shape and you don't have a particular responsibility towards a vulnerable person then your incentive for obeying lockdown is very low. And once people start giving up on the restrictions and habitually meeting up in public or going round each others' houses for barbecues and playdates and dinners, then the rationale behind a blanket lockdown is removed and we might as well do a Sweden.

    The problem with that is, of course, that the Government, public bodies, trades unions and the like are now all so completely obsessed with the threat of Covid-19 - to the exclusion of all other problems - that they're incapable of taking any approach that permits anything more than an infinitesimal degree of risk. It's what another poster described last night as the worst of all worlds: private citizens, whose movements are too diffuse and numerous for the police possibly to control, will visit each other, spread the illness and render the lockdown pointless, whilst we'll all still be forced to live through the rationing or outright withdrawal of healthcare and education, and the destruction of whole sectors of the economy, as those businesses and services whose activities can be more easily curtailed are pointlessly throttled to death. All because "something must be done."
  • state_go_awaystate_go_away Posts: 5,415
    Windfall tax on cycle shops? They seem to have been having a Covid boom.

    bike shops operate on a very cyclical model
  • RochdalePioneersRochdalePioneers Posts: 27,007

    Scott_xP said:
    Hitting retail feels hugely counter-intuitive.

    I don't know what the answer is but, crikey, they've got to be careful.
    Fantastic idea. With Morrison's releasing results showing overall decline in sales and a huge increase in costs it's obvious that they are profiteering and can afford a few hundred million in a windfall tax...
  • malcolmgmalcolmg Posts: 41,670

    malcolmg said:

    Yep. I think we can probably surmise what caused this. There was such a desperation to get rid of the elderly from hospitals, to clear capacity for new Covid patients, that they were just thrown at the care homes to get them out of the way. I seem to recall reading elsewhere that homes which initially refused to have them back were threatened (by councils?) with having funding withdrawn if they dug their heels in, so they gave in. We all know how this ended.

    Looking at what's happened abroad it looks like pretty well everyone screwed up when it came to care homes, but that doesn't make the failure any more excusable.
    https://www.theguardian.com/world/2020/may/16/across-the-world-figures-reveal-horrific-covid-19-toll-of-care-home-deaths?CMP=Share_AndroidApp_Link_Sharing
    In England and Wales, 9 039 out of 12 483 covid-related deaths, by 1st May, were in care homes and that is 72.4%.
    I presume that in a bad winter flu epidemic, the bulk of deaths are also in care homes?

    Still shocking numbers mind. A tacit acceptance by the NHS that if they were over 80, there really was in all likelihood nothing that could be done for victims? Outcomes were proving very poor for the elderly taken into hospital - they just didn't respond. So let them die in the place they knew as home...
    Have to say it has been a shocking failure across the UK and many other countries. In the main these homes have been run like puppy farms just to make venture capitalists money. Needs to be a complete rethink of the whole social care policy.
  • malcolmgmalcolmg Posts: 41,670

    malcolmg said:

    malcolmg said:

    tlg86 said:

    Excellent thread @Foxy - I don't envy the task facing those working in the NHS. I would take issue with this:

    Non surgical specialities including mental health will be similarly affected, though these get less media attention.

    You can't turn on the news these days without hearing about mental health. Sure enough, the Sky News presenter Niall Paterson has just said he's starting to suffer and they'll be discussing it on (I think) the Sophy Ridge show.

    Have to say the UK has turned into a bunch of wimps. Everybody seems to be ill and cannot cope with anything nowadays, why does it have top billing in every disorder known to man.
    To be honest Malc we have a close family member suffering from PTSD after rescuing bodies in an earthquake zone. It is not something to dismiss so easily to be honest
    G, I understand people can be really ill with these types of things but why does UK have so high a number for all these ailments and disabilities. It is the saddest , fattest , unhealthiest , most disabled country in the developed world.
    I accept we do have problems but mental health is a genuine area of concern
    Yes and not the only one. Is anyone looking at why UK is so sick.
  • state_go_awaystate_go_away Posts: 5,415
    Scott_xP said:
    Something that happens daily in governments and businesses I would have thought.Better to ask and then deal with.
  • malcolmgmalcolmg Posts: 41,670
    Dura_Ace said:

    malcolmg said:
    The government are going to have spend serious money to get control of this situation after The Great Day. The Fisheries Protection Squadron is down to three patrol boats. I suspect it's all going to have to be privatised by DEFRA like the aviation component. (Cobham/Directflight).
    Can just imagine the shambles they will make of it
  • MarqueeMarkMarqueeMark Posts: 49,955
    malcolmg said:

    malcolmg said:

    tlg86 said:

    Excellent thread @Foxy - I don't envy the task facing those working in the NHS. I would take issue with this:

    Non surgical specialities including mental health will be similarly affected, though these get less media attention.

    You can't turn on the news these days without hearing about mental health. Sure enough, the Sky News presenter Niall Paterson has just said he's starting to suffer and they'll be discussing it on (I think) the Sophy Ridge show.

    Have to say the UK has turned into a bunch of wimps. Everybody seems to be ill and cannot cope with anything nowadays, why does it have top billing in every disorder known to man.
    To be honest Malc we have a close family member suffering from PTSD after rescuing bodies in an earthquake zone. It is not something to dismiss so easily to be honest
    G, I understand people can be really ill with these types of things but why does UK have so high a number for all these ailments and disabilities. It is the saddest , fattest , unhealthiest , most disabled country in the developed world.
    One of the things that I found truly shocking when I stopped working every hour God sent in an office, was the state of the people who are out on the High Street during the day time. Town centres taken over by mobility scooters - and not by any means all elderly. Rich pickings for a virus.

    I was reminded of a cartoon by Kliban - "God gave us these bodies because he has better ones at home..."
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