COVID-19

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Woodchopper
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Re: Wuhan Coronavirus

Post by Woodchopper » Sat Feb 15, 2020 12:39 pm

bob sterman wrote:
Sat Feb 15, 2020 12:07 pm
Woodchopper wrote:
Sat Feb 15, 2020 10:56 am
Not quite that simple. Those call centre people also need to be medically qualified, speak fluent English (or how are they to be trained) and understand how the NHS works.
111 call centre people "medically qualified"? If you adopt a very loose definition of "medically qualified".

NHS 111 helpline scandal: 'Inexperienced teenagers are handling medical calls' to beleaguered phone service
https://www.mirror.co.uk/news/uk-news/n ... ed-7377760
Yea, I’d hope there would be a better standard of training for people dealing with a pandemic.

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Re: Wuhan Coronavirus

Post by TheScientificHippy » Sat Feb 15, 2020 1:36 pm

111 Call handlers have access to interpreters on the phone. There can be some delay but there is normally a Mandarin or Cantonese speaker available without too long a wait.
A problem would be if the caller has some English, engages with triage and says yes and no in all the right places but did not entirely understand all that was said but did not ask for an interpreter.

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Re: Wuhan Coronavirus

Post by Bird on a Fire » Sat Feb 15, 2020 1:42 pm

I'm shocked that 111 isn't a national service. Why should the advice vary geographically? It's not like there are pockets of endemic disease in the UK (yet - lol). Surely something like the national health service ought to be pretty easy to standardise at a national level?
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Re: Wuhan Coronavirus

Post by nefibach » Sat Feb 15, 2020 1:56 pm

mikeh wrote:
Sat Feb 15, 2020 12:06 pm
epicentre
Sorry to nitpick, but an epicentre is what an earthquake has. An epidemic just as a centre. ;)

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Re: Wuhan Coronavirus

Post by Herainestold » Sat Feb 15, 2020 2:07 pm

Good piece in the SCMP about China's heroic effort to battle the virus, and what little credit they are getting from the rest of the world.
Some British pundits, too, can barely conceal their delight at China’s misfortune, with the Financial Times editorialising that the outbreak challenges the basis of China’s social contract
, that is, its legitimacy to govern. A Guardian op-ed casts doubt on the Chinese government’s ability to deal with the crisis. China bashers are having a field day indulging in their favourite sport.
But this gloating hides another side to the unfolding story that China bashers refuse to see: China’s whole-nation, whole-people resolve to contain the virus. Never before in human history has an entire country been put on a war footing
just to fight a contagious disease.

World Health Organisation officials could hardly believe the boldness and power of China’s national mobilisation, locking down entire cities
with populations of tens of millions, and building purpose-specific 1,000-bed hospitals
complete with negative-pressure isolation wards in 10 days.
This could only happen in China. Compare this to the US handling of the 2009 swine flu
outbreak that infected 60 million Americans and claimed the lives of at least 18,000 people.
https://www.scmp.com/comment/opinion/ar ... ted-battle
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Re: Wuhan Coronavirus

Post by nefibach » Sat Feb 15, 2020 3:24 pm

The 2009 swine flu stats do put this into perspective:
From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases (range: 43.3-89.3 million), 274,304 hospitalizations (range: 195,086-402,719), and 12,469 deaths (range: 8868-18,306) in the United States due to the (H1N1)pdm09 virus.
https://www.cdc.gov/flu/pandemic-resour ... demic.html

And worldwide it might have been much worse than thought
The swine-flu pandemic of 2009 may have killed up to 203,000 people worldwide—10 times higher than the first estimates based on the number of cases confirmed by lab tests, according to a new analysis by an international group of scientists.
The researchers found that when the H1N1 deaths due to causes other than respiratory disease are included, the 2009 pandemic toll might be as high as 400,000 people.
https://www.livescience.com/41539-2009- ... igher.html

This doesn't mean that COVID19 might not eventually get out of hand, but it has a way to go before it does.

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Re: Wuhan Coronavirus

Post by OneOffDave » Mon Feb 17, 2020 10:39 pm

Bird on a Fire wrote:
Sat Feb 15, 2020 1:42 pm
I'm shocked that 111 isn't a national service. Why should the advice vary geographically? It's not like there are pockets of endemic disease in the UK (yet - lol). Surely something like the national health service ought to be pretty easy to standardise at a national level?
NHS111 is the same service across England but delivered by different providers regionally. All the scripts are produced centrally and distributed. Scotland, Wales and Northern Ireland have their own systems as health is a devolved matter but they effectively follow the NHS111 script as it's shared with them whenever it's amended. They just edit for local variation and translation

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Re: Wuhan Coronavirus

Post by OneOffDave » Mon Feb 17, 2020 10:44 pm

I'm out of the loop this week as I'm delivering training in the US but community sampling was something that was being looked at in order to lessen the impact of testing on the front line NHS. I'm not sure where it's got to by now.

From memory, the limiting factor for ambulances isn't the vehicle,it's the crew. Most trusts have spare vehicles but the crewing is pretty tight on most shifts

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Re: Wuhan Coronavirus

Post by Woodchopper » Tue Feb 18, 2020 8:21 am

TheScientificHippy wrote:
Sat Feb 15, 2020 1:36 pm
111 Call handlers have access to interpreters on the phone. There can be some delay but there is normally a Mandarin or Cantonese speaker available without too long a wait.
A problem would be if the caller has some English, engages with triage and says yes and no in all the right places but did not entirely understand all that was said but did not ask for an interpreter.
Very good, someone who knows what they are talking about.

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Re: Wuhan Coronavirus

Post by mikeh » Tue Feb 18, 2020 7:17 pm

Am currently in the back of beyond in Ghana. Was across the border in Togo yesterday, again very rural.

Can't remember if it was on here or might have been social media, but suggestion was that most of Africa don't know coronavirus exists. Certainly among healthcare workers even in very rural remote places here, there is good and up to date knowledge about coronavirus.

Not sure about general population. But, both Ghana and Togo health service are very adept at communications with their hard to reach communities to let them know about any upcoming health campaigns (for example an intensive polio vaccine campaign has just happened here due to a recent case). Includes visits in-person, and radio campaigns, and what I think are called gong gong beaters, which are the local equivalent of town criers.
So , this is a slight aside, but I found it interesting -word does reach even rural Africa about coronavirus.

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Re: Wuhan Coronavirus

Post by jimbob » Tue Feb 18, 2020 10:08 pm

mikeh wrote:
Tue Feb 18, 2020 7:17 pm
Am currently in the back of beyond in Ghana. Was across the border in Togo yesterday, again very rural.

Can't remember if it was on here or might have been social media, but suggestion was that most of Africa don't know coronavirus exists. Certainly among healthcare workers even in very rural remote places here, there is good and up to date knowledge about coronavirus.

Not sure about general population. But, both Ghana and Togo health service are very adept at communications with their hard to reach communities to let them know about any upcoming health campaigns (for example an intensive polio vaccine campaign has just happened here due to a recent case). Includes visits in-person, and radio campaigns, and what I think are called gong gong beaters, which are the local equivalent of town criers.
So , this is a slight aside, but I found it interesting -word does reach even rural Africa about coronavirus.
A lot of African countries are leapfrogging the infrastructure stages - for example Rwanda has >95% 4G coverage, and is starting 5G trials.
Have you considered stupidity as an explanation

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Re: Wuhan Coronavirus

Post by Gentleman Jim » Wed Feb 19, 2020 1:51 pm

Half term in a 1000 pupil, boys (11-18) and hand sanitiser points have been set up around the school!
I wonder how long they will survive and how much use they will get - teenage boys aren't exactly renowned for personal hygiene practices
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Re: Wuhan Coronavirus

Post by bolo » Wed Feb 19, 2020 1:56 pm

Gentleman Jim wrote:
Wed Feb 19, 2020 1:51 pm
I wonder how long they will survive and how much use they will get
And what the boys will fill them up with after emptying out the hand sanitizer.

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Re: Wuhan Coronavirus

Post by mikeh » Wed Feb 19, 2020 11:35 pm

jimbob wrote:
Tue Feb 18, 2020 10:08 pm
mikeh wrote:
Tue Feb 18, 2020 7:17 pm
Am currently in the back of beyond in Ghana. Was across the border in Togo yesterday, again very rural.

Can't remember if it was on here or might have been social media, but suggestion was that most of Africa don't know coronavirus exists. Certainly among healthcare workers even in very rural remote places here, there is good and up to date knowledge about coronavirus.

Not sure about general population. But, both Ghana and Togo health service are very adept at communications with their hard to reach communities to let them know about any upcoming health campaigns (for example an intensive polio vaccine campaign has just happened here due to a recent case). Includes visits in-person, and radio campaigns, and what I think are called gong gong beaters, which are the local equivalent of town criers.
So , this is a slight aside, but I found it interesting -word does reach even rural Africa about coronavirus.
A lot of African countries are leapfrogging the infrastructure stages - for example Rwanda has >95% 4G coverage, and is starting 5G trials.
Indeed. Pretty good network coverage, even when in Togo. Having done some more digging out of curiosity, citizens in rural areas also pretty clued up on coronavirus, mainly through local radio which reports international news. Plus the public health directorates have been getting requests from national level to ensure their response plans are dusted off and up to date.

Meanwhile, on journey back to Accra, the capital of Ghana, we spotted one of their public health interventions... minimum 14 day stay, excellent medical facilities.
(pic reposted with permission on the good doctor within it)
coronahotel.jpeg
coronahotel.jpeg (87.03 KiB) Viewed 4105 times

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Re: Wuhan Coronavirus

Post by Herainestold » Thu Feb 20, 2020 3:16 pm

Looks like China is very slowly gaining the upper hand in the battle against the Corona virus. New cases continue to decline as China gets back to work.
BEIJING, Feb. 19 (Xinhua) -- The COVID-19 epidemic in Hubei Province, the center of the novel coronavirus outbreak, has been gradually brought under control, according to an official with the National Health Commission.

NHC spokesperson Mi Feng made the remarks at a press conference in Beijing Wednesday, citing the epidemic data in the province over the past week.

The daily count of newly cured and discharged cases in Hubei, excluding the capital city of Wuhan, has exceeded the number of newly confirmed cases for four consecutive days as of Wednesday, said Mi.

He also noted that the number of newly confirmed cases has decreased significantly since Feb. 13 in areas besides Wuhan, and the increase in the cumulative number of confirmed cases has remained flat.
http://www.xinhuanet.com/english/2020-0 ... 798953.htm
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Re: Wuhan Coronavirus

Post by nefibach » Thu Feb 20, 2020 9:58 pm

Herainestold wrote:
Thu Feb 20, 2020 3:16 pm
Looks like China is very slowly gaining the upper hand in the battle against the Corona virus. New cases continue to decline as China gets back to work.
BEIJING, Feb. 19 (Xinhua) -- The COVID-19 epidemic in Hubei Province, the center of the novel coronavirus outbreak, has been gradually brought under control, according to an official with the National Health Commission.

NHC spokesperson Mi Feng made the remarks at a press conference in Beijing Wednesday, citing the epidemic data in the province over the past week.

The daily count of newly cured and discharged cases in Hubei, excluding the capital city of Wuhan, has exceeded the number of newly confirmed cases for four consecutive days as of Wednesday, said Mi.

He also noted that the number of newly confirmed cases has decreased significantly since Feb. 13 in areas besides Wuhan, and the increase in the cumulative number of confirmed cases has remained flat.
http://www.xinhuanet.com/english/2020-0 ... 798953.htm
Cue the media saying this was all a huge overreaction and what were we so scared of.

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Re: Wuhan Coronavirus

Post by mikeh » Thu Feb 20, 2020 10:03 pm

nefibach wrote:
Thu Feb 20, 2020 9:58 pm
Cue the media saying this was all a huge overreaction and what we were so scared of.
Guaranteed to happen, that. Esp if the UK daily reports continue along the lines of today's latest which was something like 5900 highest-risk tested, still the 9 known cases.
I recall the headlines saying what waste of money it was to stockpile antivirals during the last flu pandemic.

Chinese have updated their case definitions again. Haven't been able to keep track of stuff over last few days, so unsure how latest change will affect things, but it'll presumably artificially inflate or deflate apparent case numbers again, so may be an upward or downward wobble of some kind over the next few days. Reckon it'll be end of Feb before we can realistically have a reasonable stab at guessing if the outbreak has peaked or not.

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Re: Wuhan Coronavirus

Post by nefibach » Thu Feb 20, 2020 10:12 pm

mikeh wrote:
Thu Feb 20, 2020 10:03 pm
nefibach wrote:
Thu Feb 20, 2020 9:58 pm
Cue the media saying this was all a huge overreaction and what we were so scared of.
Guaranteed to happen, that. Esp if the UK daily reports continue along the lines of today's latest which was something like 5900 highest-risk tested, still the 9 known cases.
I recall the headlines saying what waste of money it was to stockpile antivirals during the last flu pandemic.

Chinese have updated their case definitions again. Haven't been able to keep track of stuff over last few days, so unsure how latest change will affect things, but it'll presumably artificially inflate or deflate apparent case numbers again, so may be an upward or downward wobble of some kind over the next few days. Reckon it'll be end of Feb before we can realistically have a reasonable stab at guessing if the outbreak has peaked or not.
I'm super busy at the moment and have found it hard to keep up too, even with a most excellent twitter list of real honest-to-goodness experts to follow.

But I think that the, er, post mortem around how this was all handled will be interesting and important, if it's done right. There's already gathering dissent regarding China's quarantine enforcement, along with questions over whether keeping people stuck on the Diamond Princess actually increased the number of cases. Not to mention the fact that is seems there was very high nosocomial transmission in at least one hospital in Wuhan early in the outbreak which, if that holds true for other hospitals, cannot have helped the situation.

https://www.poz.com/article/half-initia ... n-hospital

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Re: Wuhan Coronavirus

Post by nefibach » Fri Feb 21, 2020 1:28 am

mikeh wrote:
Thu Feb 20, 2020 10:03 pm
nefibach wrote:
Thu Feb 20, 2020 9:58 pm
Cue the media saying this was all a huge overreaction and what we were so scared of.
Guaranteed to happen, that. Esp if the UK daily reports continue along the lines of today's latest which was something like 5900 highest-risk tested, still the 9 known cases.
I recall the headlines saying what waste of money it was to stockpile antivirals during the last flu pandemic.

Chinese have updated their case definitions again. Haven't been able to keep track of stuff over last few days, so unsure how latest change will affect things, but it'll presumably artificially inflate or deflate apparent case numbers again, so may be an upward or downward wobble of some kind over the next few days. Reckon it'll be end of Feb before we can realistically have a reasonable stab at guessing if the outbreak has peaked or not.
I can't imagine that the epidemiologists are particularly happy about this:

https://www.statnews.com/2020/02/20/exp ... of-spread/

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Re: Wuhan Coronavirus

Post by Herainestold » Fri Feb 21, 2020 6:32 am

nefibach wrote:
Thu Feb 20, 2020 10:12 pm


But I think that the, er, post mortem around how this was all handled will be interesting and important, if it's done right. There's already gathering dissent regarding China's quarantine enforcement, along with questions over whether keeping people stuck on the Diamond Princess actually increased the number of cases. Not to mention the fact that is seems there was very high nosocomial transmission in at least one hospital in Wuhan early in the outbreak which, if that holds true for other hospitals, cannot have helped the situation.

https://www.poz.com/article/half-initia ... n-hospital
The Diamond Princess quarantine is starting to look like a disaster.Definitely not the way to do it, and definitely not what we might have expected from Japan. The Chinese response unfortunately got off to a slow start, but has since kicked in to high gear. It was and is still is a Herculean task but
it is hard to imagine any western country doing any better. Lets just hope the worst is over, although I expect we will see cases for a few more months yet.
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Re: Wuhan Coronavirus

Post by mikeh » Fri Feb 21, 2020 11:50 am

nefibach wrote:
Fri Feb 21, 2020 1:28 am
mikeh wrote:
Thu Feb 20, 2020 10:03 pm
nefibach wrote:
Thu Feb 20, 2020 9:58 pm
Cue the media saying this was all a huge overreaction and what we were so scared of.
Guaranteed to happen, that. Esp if the UK daily reports continue along the lines of today's latest which was something like 5900 highest-risk tested, still the 9 known cases.
I recall the headlines saying what waste of money it was to stockpile antivirals during the last flu pandemic.

Chinese have updated their case definitions again. Haven't been able to keep track of stuff over last few days, so unsure how latest change will affect things, but it'll presumably artificially inflate or deflate apparent case numbers again, so may be an upward or downward wobble of some kind over the next few days. Reckon it'll be end of Feb before we can realistically have a reasonable stab at guessing if the outbreak has peaked or not.
I can't imagine that the epidemiologists are particularly happy about this:

https://www.statnews.com/2020/02/20/exp ... of-spread/
Makes it hard to keep tabs on what's really going on. Though definitions do tend to change to some extent during big outbreaks anyway because it's all new knowledge coming in and no one really has any idea what's going on, but shapeshifting back and forth isn't helpful (hard to judge the reasons why, whether motivations are genuinely public health-led or politically-led, or a mixture of both).

I think confirmed cases are more sensible on the whole, since there's so many causes of pneumonia - flu, RSV, bacterial, fungal (to a lesser extent) will all also be causing pneumonia in China right now, especially in already-vulnerable populations. I assume there'll be so much testing going on here that you'll get the vast majority of coronavirus cases anyway, with that confirmed diagnosis.

(Then there's issues of how accurate the diagnostics are)

Bit different with e.g. seasonal flu, you mostly don't get tested if you amble into your GP, and because it's hard to tell what pathogen you're cultivating, the patient is technically the recipient of a shrugging of shoulders and given a shiny clinical label of 'influenza-like illness'. Exceptions where there is testing in specific outbreaks or in hospitalised cases. (See, for example, latest PHE flu weekly stats)

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Re: Wuhan Coronavirus

Post by shpalman » Fri Feb 21, 2020 3:28 pm

A few cases over at the other end of Lombardy: https://www.thelocal.it/20200221/three- ... n-lombardy
having that swing is a necessary but not sufficient condition for it meaning a thing
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Re: Wuhan Coronavirus

Post by nefibach » Fri Feb 21, 2020 5:26 pm

I feel sorry for the poor f.cker who's got COVID and Dengue at the same time.

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Re: Wuhan Coronavirus

Post by shpalman » Fri Feb 21, 2020 6:07 pm

shpalman wrote:
Fri Feb 21, 2020 3:28 pm
A few cases over at the other end of Lombardy: https://www.thelocal.it/20200221/three- ... n-lombardy
Six now.
having that swing is a necessary but not sufficient condition for it meaning a thing
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Re: Wuhan Coronavirus

Post by shpalman » Sat Feb 22, 2020 9:06 am

shpalman wrote:
Fri Feb 21, 2020 6:07 pm
shpalman wrote:
Fri Feb 21, 2020 3:28 pm
A few cases over at the other end of Lombardy: https://www.thelocal.it/20200221/three- ... n-lombardy
Six now.
It's something like 19 or 20 in the whole of Italy, including one death (in the Veneto region). Maybe up to 12 cases in the Lodi area, one of whom (who isn't showing any symptoms but for other reasons needs dialysis) has been transferred to the hospital just outside Como.

https://primacomo.it/cronaca/coronaviru ... -santanna/
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