COVID-19

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AMS
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Re: COVID-19

Post by AMS » Thu Apr 16, 2020 8:40 pm

Bird on a Fire wrote:
Thu Apr 16, 2020 8:28 pm
Ah ok, so developing the automation with available kit rather than the tests themselves? (As noted above, South Korea had already sorted automation out because of SARS, and other countries failed to learn from their experiences then).
Yep. Equipment from our lab has been borrowed for this, and it's not the RT-PCR kit, but the automated systems for sample handling. (It's usually used for screening large panels of antibodies.)

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Re: COVID-19

Post by Bird on a Fire » Thu Apr 16, 2020 8:49 pm

That's interesting, thanks, and does make a certain amount of sense to me. I'd assume that that kind of kit is sufficiently specialised that factories can't just switch to banging out a hugely increased number of widgets per day.

It's odd that the issue isn't getting more media attention, though, or doesn't seem to be well explained. (Unless I'm just myopic and/or a bit dense!)
We have the right to a clean, healthy, sustainable environment.

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Re: COVID-19

Post by dyqik » Thu Apr 16, 2020 10:22 pm

On the day when US deaths have risen by over 25% over yesterday, before 6pm, Trump is talking about how to reopen things as fast as possible.

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Re: COVID-19

Post by Bird on a Fire » Thu Apr 16, 2020 10:52 pm

I really hope he gets it, to be honest. What a c.nt.

How much damage could Penice do in 8 months anyway? (Don't answer that - US politics always surprised with just how much worse things could get)
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Re: COVID-19

Post by raven » Thu Apr 16, 2020 10:57 pm

Article in the Guardian about how the UK has capacity to do more tests, but they aren't being done:
https://www.theguardian.com/commentisfr ... outh-korea

Seems like we're offering tests that aren't being taken up. Perhaps because people have to travel long distances to get swabbed? That chimes with something I heard on TV, that no-one wants to get in their car and drive to a testing centre when they're really sick.

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Re: COVID-19

Post by Squeak » Thu Apr 16, 2020 11:06 pm

Just to prove that right-wing western government can get it pretty right (how the f.ck am I writing things like this?!) new Australian modelling has the R0 at ~ 0.5, down from 2.5 in early March. At the start of March, I had little faith that Australia would go any differently to the UK, though I had a little more faith in the Australian health system than the US one to manage the storm. But we had enough test reagents and labs and got serious about testing early, and eventually sorted out the really tricky things like not letting thousands of people get off a cruise ship that had likely sick passengers and use public transport to spread the disease across the entire f.cking country. And, well, it worked. It's worked so well that we have fewer than half as many CASES as the UK has DEATHS. And, with positive test rates around 2%, we're actually picking up most of the symptomatic cases (93% according to the latest government model) so our numbers are probably fairly reliable.

This should absolutely outrage Brits and USians. We had really similar early exposure and looked to be on similar trajectories until the Australian government listened to infectious diseases experts and moved fast to pump money into the economy to make it financially possible for most people to socially distance - doubling the dole, creating a new JobKeeper allowance that paid money to companies to pass onto staff who they keep on the books - payments to pensioners. This is a government that's as ideological and economically dry as any Western democracy and they've missed some groups (international students and asylum seekers, most notably) but even their hard right wing members are keeping their mouths shut as the money rolls out the door.

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Re: COVID-19

Post by bjn » Fri Apr 17, 2020 2:04 am

Yep. The tyranny of distance worked in Australia’s favour, giving the fuckwits running it time to wise up and implement the right policies. New Zealand has done even better, they have a real chance of eliminating the virus within their borders.

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Re: COVID-19

Post by lpm » Fri Apr 17, 2020 6:36 am

Or is it seasonal?

If the virus is not seasonal, the timings are going to make it look seasonal. Didn't take hold in the southern hemisphere in autumn - then outbreaks in winter? And in the northern hemisphere it's declining sharply this spring.
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Re: COVID-19

Post by plodder » Fri Apr 17, 2020 6:40 am

Evaporating droplets etc? Sounds legit.

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Re: COVID-19

Post by mediocrity511 » Fri Apr 17, 2020 6:53 am

raven wrote:
Thu Apr 16, 2020 10:57 pm
Article in the Guardian about how the UK has capacity to do more tests, but they aren't being done:
https://www.theguardian.com/commentisfr ... outh-korea

Seems like we're offering tests that aren't being taken up. Perhaps because people have to travel long distances to get swabbed? That chimes with something I heard on TV, that no-one wants to get in their car and drive to a testing centre when they're really sick.
It might not even be a case of wanting too. If you are in a public transport dependent city then you might simply not have access to your own private transport to get tested. You can't get a tube, bus, tram or uber there and most people wouldn't want anyone to give them a lift. Drive through test centres only work for people who drive.

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Re: COVID-19

Post by shpalman » Fri Apr 17, 2020 7:12 am

The number of deaths from coronavirus in Wuhan has doubled, rising by 1,290 - a 50 percent increase.

Can they not get a moron who "went into PR and then the world of music" with "a few years working on festivals and events" to write anything which has numbers in it please? (Alternatively I could not try to get serious news from ladbible.)

Anyway, Wuhan has revised its death toll up from 2,579 to 3,869. Given that its population is 11 million and Lombardy, with a similar population, has had more than 11,000 deaths (and even that is an underestimate) either Hubei has been as good as Germany in terms of testing and critical care (Bavaria, with a population of 13 million, has had 1,137 deaths so far) or it's still being massively under-reported.
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Re: COVID-19

Post by PeteB » Fri Apr 17, 2020 7:45 am

Couple of interesting links

I don't agree with all this article but I think he makes a convincing case that Hospitals and Care Homes are the biggest spreaders of the disease - what policy steps need to be in place to stop this, e.g. use Nightingale hospitals for all C19 cases and keep other hospitals free, don't discharge patients to Care Homes from hospitals without testing them

How the government has tapped into the NHS mythology to shield itself, despite us having the worst death toll in Europe, the government is seen as doing a good job.

Also Richard North for those that can stomach him

And then we have the utterly fatuous and embarrassing display of public emotion, with the moronic clapping and banging of saucepans every Thursday night (pictured).

Rather than cries of outrage at the way the system has been so abused, and is so egregiously failing that ordinary people dare not use their own hospitals, it seems that the nation has entered into its second childhood, simpering after its masters and allowing itself to be distracted by facile displays, instead of demanding that the government is held to account for its failures.

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Re: COVID-19

Post by shpalman » Fri Apr 17, 2020 8:08 am

PeteB wrote:
Fri Apr 17, 2020 7:45 am
Couple of interesting links

I don't agree with all this article but I think he makes a convincing case that Hospitals and Care Homes are the biggest spreaders of the disease - what policy steps need to be in place to stop this, e.g. use Nightingale hospitals for all C19 cases and keep other hospitals free, don't discharge patients to Care Homes from hospitals without testing them
As if patients in care homes are taken to hospital. Or even count towards the statistics. (Some care homes in Italy are now under criminal investigation.)
Veneto tested far more widely than Lombardy, but the main difference is how patients were treated. In Lombardy, 65 percent of people who tested positive were sent to the hospital. In Veneto, only 20 percent of people who tested positive were sent to hospital while most were encouraged to stay home.
I think that's exactly because Veneto tested far more widely, so a smaller proportion of those tested were serious enough to need the hospital.

But I think the major outbreaks in the Bergamo area are traceable to hospitals.

Why are hospitals so rubbish at dealing with people who show up with a disease?
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Re: COVID-19

Post by headshot » Fri Apr 17, 2020 8:48 am

don't discharge patients to Care Homes from hospitals without testing them
How was this ever allowed to happen?!?!

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Re: COVID-19

Post by PeteB » Fri Apr 17, 2020 9:27 am

shpalman wrote:
Fri Apr 17, 2020 8:08 am
As if patients in care homes are taken to hospital. Or even count towards the statistics. (Some care homes in Italy are now under criminal investigation.)
It's not so much that - it is hospitals have been trying to free up beds

e.g. “Hundreds of older people have been discharged from hospital in recent weeks to relieve pressure on our NHS"

Together with people cross infecting care homes

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Re: COVID-19

Post by lpm » Fri Apr 17, 2020 9:41 am

... which is what Nightingales should have been used for?

- Build a non-Covid Nightingale for people recovering from normal illness and not yet well enough to go back to care homes, and do everything possible to test and keep it Covid-free

- Build a separate Covid Nightingale for recoverers - survivors discharged from ICU, spend a day or two in regular hospital wards, then moved to a specialist Nightingale for however many days it takes to be well enough to go home. Johnson was lucky, in that he could leave hospital promptly to recover in a second home in the country, waited on by servants, but many people need a couple of weeks in hospital or more

Much of this is the persistent NHS problem of how to care for elderly and frail people, not ill enough for a full hospital bed, not well enough to return to independent life at home or a care home. Covid is a multiplier of this - 85% of over-80s survive, but a fairly large proportion of these will be severely knocked back and in need of extended after-care. The headline death rate is only part of the problem - the additional care burden is far larger and if not addressed it will lead to premature deaths months later among patients not recovering their fitness/mobility.
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RoMo
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Re: COVID-19

Post by RoMo » Fri Apr 17, 2020 10:03 am

PeteB wrote:
Fri Apr 17, 2020 7:45 am
I think he makes a convincing case that Hospitals and Care Homes are the biggest spreaders of the disease
For the last two weeks I have looked at all of my trust's new positive cases and the vast majority are community non-care home associated.

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Re: COVID-19

Post by mediocrity511 » Fri Apr 17, 2020 10:20 am

RoMo wrote:
Fri Apr 17, 2020 10:03 am
PeteB wrote:
Fri Apr 17, 2020 7:45 am
I think he makes a convincing case that Hospitals and Care Homes are the biggest spreaders of the disease
For the last two weeks I have looked at all of my trust's new positive cases and the vast majority are community non-care home associated.
But isn't it only in the last few days that care home testing has been introduced? And with mass DNRs in place care home patients by and large aren't going in to hospital?

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Re: COVID-19

Post by sTeamTraen » Fri Apr 17, 2020 10:30 am

AMS wrote:
Thu Apr 16, 2020 1:28 pm
In what way are blood donors considered not representative of the whole population?

Presumably they are younger and healthier than average, and therefore also higher probability of asymptomatic infection, but the relevant point is whether they are representative in their chances of exposure to the virus.
Something you learn very early on in courses on trial design is that when people are not assigned randomly to do something, those who do and those who don't will differ, often quite strongly, in ways that you cannot predict. In psychology this gives rise to what is known as "the crud factor", or "everything is correlated with everything else". It is a big problem for most observational studies, and explains a large number of the failures of lab research to replicate in randomised trials.

In this case, I would expect the average 23-year-old who has their act together enough to donate blood to be substantially unrepresentative of their age group on a bunch of measures of health-related behaviours.
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Re: COVID-19

Post by tenchboy » Fri Apr 17, 2020 10:31 am

These effects are thought to be mediated via the induction of innate immune memory and heterologous lymphocyte activation, resulting in enhanced cytokine production, macrophage activity, T-cell responses and antibody titres.
I am so remembering that for the queue at Tesco!
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Re: COVID-19

Post by sTeamTraen » Fri Apr 17, 2020 10:32 am

Bird on a Fire wrote:
Thu Apr 16, 2020 10:52 pm
How much damage could Penice do in 8 months anyway?
If that's not a typo, I want to know how you pronounce it. :)
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Re: COVID-19

Post by RoMo » Fri Apr 17, 2020 10:48 am

mediocrity511 wrote:
Fri Apr 17, 2020 10:20 am

But isn't it only in the last few days that care home testing has been introduced? And with mass DNRs in place care home patients by and large aren't going in to hospital?
We have been testing care home patients even if they haven't been admitted.

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Re: COVID-19

Post by PeteB » Fri Apr 17, 2020 11:16 am

RoMo wrote:
Fri Apr 17, 2020 10:03 am
For the last two weeks I have looked at all of my trust's new positive cases and the vast majority are community non-care home associated.
that's encouraging, there was this paper from Wuhan that suggested :Presumed human-to-human hospital-associated transmission of 2019-nCoV was suspected in 41% of patients.

The purpose built 'Shelter' Hospitals in open spaces seemed very good at protecting healthcare workers

On February 22, 2020, at the press conference of the State Council, 3,019 healthcare personnel (HCP) were reported to have been infected. Among them, 1,716 HCP had confirmed infection and 5 HCP had died of COVID-19. In Wuhan city, there were 1,080 infected HCP. However, at the shelter hospitals, with >5,000 HCP, none had been infected between February 5 and this letter.

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Re: COVID-19

Post by JQH » Fri Apr 17, 2020 11:54 am

And remember that if you botch the exit, the carnival of reaction may be coming to a town near you.

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Re: COVID-19

Post by sTeamTraen » Fri Apr 17, 2020 1:06 pm

How likely is it that the apparent levelling off of the exponential curve (in any country, but let's take the UK for now) is due to saturation of testing facilities? That is, if the numbers of both reported infections and COVID-19 certified deaths were continuing to rise, would we know if we can only conduct X tests per day and have already hit that limit?

I ask because the UK's daily numbers for new cases and deaths have been, to a first approximation, rather static for a fortnight now (figures from ECDC.eu below), whereas for reasons that I can't quite put into words, I'd expect them to be going up or down on some kind of trend. I appreciate that my feelings on the matter are not good evidence.

Code: Select all

   dateRep               day month  year cases deaths countriesAndTer~ geoId countryterritor~
 1 2020-04-17 00:00:00    17     4  2020  4617    861 United_Kingdom   UK    GBR             
 2 2020-04-16 00:00:00    16     4  2020  4603    761 United_Kingdom   UK    GBR             
 3 2020-04-15 00:00:00    15     4  2020  5252    778 United_Kingdom   UK    GBR             
 4 2020-04-14 00:00:00    14     4  2020  4342    717 United_Kingdom   UK    GBR             
 5 2020-04-13 00:00:00    13     4  2020  5288    737 United_Kingdom   UK    GBR             
 6 2020-04-12 00:00:00    12     4  2020  8719    917 United_Kingdom   UK    GBR             
 7 2020-04-11 00:00:00    11     4  2020  5195    980 United_Kingdom   UK    GBR             
 8 2020-04-10 00:00:00    10     4  2020  4344    881 United_Kingdom   UK    GBR             
 9 2020-04-09 00:00:00     9     4  2020  5491    938 United_Kingdom   UK    GBR             
10 2020-04-08 00:00:00     8     4  2020  3634    786 United_Kingdom   UK    GBR             
11 2020-04-07 00:00:00     7     4  2020  3802    439 United_Kingdom   UK    GBR             
12 2020-04-06 00:00:00     6     4  2020  5903    621 United_Kingdom   UK    GBR             
13 2020-04-05 00:00:00     5     4  2020  3735    708 United_Kingdom   UK    GBR             
14 2020-04-04 00:00:00     4     4  2020  4450    684 United_Kingdom   UK    GBR             
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