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messageRe: Ignoring lockdown in ED
Posted by Jules-and-Boo May 03, 09:56AM

So it's the government's fault people are still going out and they are at fault?

Do those who believe this also believe people cannot be responsible? Are you actually endorsing a nanny state?

The arrogance of people is astounding.

messageRe: Ignoring lockdown in ED
Posted by KidKruger May 03, 10:34AM

Fair play to jimlad for stating his view on this virus situation even if it may come across as topical.
Problem with opening-up right now would be that virus can transmit and more people will die, it's not just a case of whether as individuals we think WE are safe/resistance but the vulnerable people who will inevitably be infected, many of whom are not old and in the 'departure lounge already'.
Personally I'd prefer the entire population get rid as best and as quick as it can, so I'd go the other way and enforce a proper lockdown for a few weeks (I doubt this will ever happen here until 2nd wave becomes unmanageable and we've lost several weeks pussy-footing around playing at pandemics).
Whatever is decided, there are already a minority of people who are intent on maintaining no or limited distance, apparently convinced that they are above the regulation or cannot catch or carry the infection to others.

messageRe: Ignoring lockdown in ED
Posted by binkylilyput May 03, 11:01AM

Interesting (if unpopular) viewpoint from jimlad. Id say youll get mobbed for expressing it but its good to question and have alternative perspectives

It has got me thinking about how the government hasnt banned the sale of cigarettes despite being the biggest health threat we have

But anyways, this is maybe going off topic from the OP and I fear lindylou might report us!!!

messageRe: Ignoring lockdown in ED
Posted by malumbu May 03, 11:45AM

In a zoom catch up with ex-colleagues one considered that we should be taking a life years lost approach rather than total deaths. We'd worked in both radiation protection and in air pollution. Here you take a whole population approach as with sub critical exposures it is difficult/impossible to identify exposure from the pollutant as the principle cause of death, as opposed to other factors. In turn you monetise the costs and benefits. So for example air pollution is caused by construction, transport, farming, energy, industry. Which all benefit society in various ways = X. Across the population there will be a total of Y years of life lost = Z detriment. X should be >>> Z

So in a most simplistic cost benefit analysis the economic hit from lockdown should be less than the cost in terms of life years across the population. Which brings us back to the argument that most of those deaths were going to happen anyway sooner or later.

It may have appealed to me a couple of months when I was quite happy for life to go on near normal. But not sure that any serious government would countenance the mass fatalities, impact on social cohesion, collapse of the NHS leading to other deaths etc etc. Ultimately it will be interesting to compare the actions of Italy, Germany and the like with those who didn't go into full lock down - Sweden probably being the best example. One of our group now works in Vienna, 50 days plus lockdown and apart from shopping they are in total isolation. But very impressive in handling the pandemic. And deserve greater liberty as the Austria starts to reduce restrictions.

This thread has become more interesting with some good debate rather than berating others.

messageRe: Ignoring lockdown in ED
Posted by jimlad48 May 03, 01:16PM

For whats its worth, my view on the situation is that lockdown is becoming increasingly untenable. I dont doubt Corona is a horrible virus/bug/thing and it can be truly awful for some people, but we need to have a national conversation around the risk we want to take here.
Im concerned that we have potentially overplayed the fatality figures by adding Corona as a cause of death, not as the sole cause of death unlike other countries. For example you could have terminal cancer in its final stages, and very mild corona symptoms, but if you died, youd be recorded as a corona victim even if you only had it in the mildest of ways.
While there is no suggestion that having it is not a factor in these deaths, it makes people assume that its perhaps more lethal than may actually be the case compared to other reporting rates. There is some good work done on this by the Guardian around how nations record fatalities in very different ways.
The next question is how many who have died of Corona would have died anyway, probably in fairly short order? Its a blunt question but when you listen to accounts of people in their late 90s dying (or in one case I heard a 105 year old) then you need to ask if were overemphasing the impact its having. Many of those impacted would almost certainly have had underlying health conditions that probably played a very significant part here not COVID itself.
The other question to ask, particularly of care homes is how many of those whose cause of death was listed as COVID related would have passed on anyway? I have a relative who spent their career working in social care and they said the long held view was that the majority of people sent into care homes (not all, but a majority) usually died within 3 months of moving we have to have the awkward conversation around if many of those in care homes would have died.
The next question we have to ask is what is an acceptable COVID death rate? We accept that even with a vaccine, each year thousands of people will die of flu, yet continue business as usual. What is the number we are prepared to accept for COVID and how do we decide that 19,999 is fine, 20,001 is a disaster? Ultimately this will drive all other measures?
The final view we have to take is what matters more -COVID or the economy? Ive got friends whove lost jobs and businesses that were doing well, because theyve been impacted so badly by this. How many more will be, and how long will we need to pay the bill for the lockdown years, decades, centuries and do we accept that there will need to be huge spending cuts in essential services to pay for this the longer this goes on, the more damage is being done to the ability to raise funds to pay for the NHS and other essential services in the future.
For whats its worth I think the time has come to treat people like grown ups and let them decide. I would advise those in high risk categories to remain indoors and isolate, but for those who are not, let them get on with their lives again because the long term costs are far too grave to warrant the price we are paying.
My local postcode has, last time I checked, 6 deaths linked to COVID-19 how many people have died in car crashes, of smoking, drugs, violence and other issues in the same time frame probably a lot more. At some point we need to return to normalcy, and the sooner the better in my book.

messageRe: Ignoring lockdown in ED
Posted by Spartacus May 03, 02:25PM

Jim lad, as part of your people's decision are you going to ask the opinion of staff in hospitals who have been working day and night to make sure the numbers of people who die are lower than predicted ? Who have been getting Covid as a result of looking after people who thought the lock down didn't apply to them till they became ill, and who are looking forward to being able to take a bit of time off to catch up on rest, get counselling for PTSD type symptoms after seeing so many extra people die because of Covid ?
Or care home workers who, whilst they expect the people they look after to die, are also seeing them die prematurely and the workers are also catching covid either from their patients or from idiots who ignore the lock down ?
What about bus drivers, shop staff, restaurant and pub staff and so on who will catch it from someone who didn't isolate when they have symptoms ?

Your suggestion of a people's decision makes a mockery of the hard work and sacrifice everyone has made so far to keep the peak low and to try and save the system from being overwhelmed ! Just so that people can get back to work, to stop being inconvenienced and to enable them to go to the pub, watch a football game or other selfish things. Do the lessons from the Spanish Flu pandemic not serve as a warning ?

Yes when the time is right, the numbers of new infections are so low that a second wave is not on the horizon then, and only then should we really consider relaxing the lock down in controlled and measures phases, but doing it for any other reason is blatant stupidity and selfish in my opinion.

messageRe: Ignoring lockdown in ED
Posted by keano77 May 03, 03:19PM

Posted by Spartacus Today, 02:25PM

... Yes when the time is right, the numbers of new infections are so low that a second wave is not on the horizon then, and only then should we really consider relaxing the lock down in controlled and measures phases, but doing it for any other reason is blatant stupidity and selfish in my opinion.

My reading of jimlad48s post was an attempt to ask the question when is the time going to be right to relax lockdown? Many European countries are about to start to do so in some limited fashions.

Unfortunately Spartacus the emotive argument you present will only go so far. The longer lockdown continues in the U.K. the danger is the economy will collapse, house prices and pensions will collapse and unemployment will be unprecedented.

A destroyed economy will be no reward for the carers who are sacrificing so much nor for the rest of us.

messageRe: Ignoring lockdown in ED
Posted by malumbu May 03, 03:24PM

Rereading my post a point that I did not raise was my work on air and radioactive pollution was very different to the risks from coronavirus. If you are poorly due to radiation (cancer) or breathing polluted air (mainly cardiovascular) you will not pass this onto those in the NHS and bus drivers. It may sound like I am taking about cross purposes but this links to the discussion above, essentially why are we so worried about bringing deaths forward when many will die sooner rather than later? In case I wasn't clear it is right to go into lockdown etc etc.

The one thing I am missing is rigorous discussion so please keep it coming. I'm going to make some subtle enquiries about how much we got caught with our pants down in terms of health emergency planning. I suspect not in terms of identifying the risk. But not so in terms of the capabilities and structures. I recall that much of the focus ten years ago was about the likelihood of terrorism and mass casualties eg [www.londonambulance.nhs.uk]

messageRe: Ignoring lockdown in ED
Posted by jimlad48 May 03, 04:26PM

Keano

Thats precisely my point - we do need to ask these questions because we do, at some point, need to end lockdown. But we do need to think carefully around how and when we do this - relying on a set of emotive responses doesnt solve the longer term issues we face.

messageRe: Ignoring lockdown in ED
Posted by edcam May 03, 05:01PM

What Spartacus said.

messageRe: Ignoring lockdown in ED
Posted by Spartacus May 03, 05:04PM

Keano your statement of "Unfortunately Spartacus the emotive argument you present will only go so far. The longer lockdown continues in the U.K. the danger is the economy will collapse, house prices and pensions will collapse and unemployment will be unprecedented." Is also a dangerous emotive drive for people to make a decision based on protecting their financial assets, over protecting lives in my mind.

My argument above is that the public shouldn't be asked to make a decision because for what ever reason they will be tempted to vote based on their own particular circumstances rather than what is actually best for the country / population as a whole.

Maybe there needs to be an external and balanced, in terms of scientific and economical members, committee to review and make decisions on when and how to come out of lock down rather than a public vote

messageRe: Ignoring lockdown in ED
Posted by Blah Blah May 03, 05:14PM

jimlad48 Wrote:
-------------------------------------------------------
> I've spoken to enough doctors I know socially and
> professionally to hear that many feel the threat
> is not as bad as some people make it out to be.
> Its hitting people who are either on their way out
> anyway, or its hitting people who are made worse
> by very poor lifestyle choices.

Really? because I don't know a single one underestimates the issues with pandemics.

> I'm sorry, I know its a nasty illness, but lets be
> clear, its mainly hitting people who are already
> at risk of infection anyway due to underlying
> conditions.

Have you not also noticed that a high percentage of people who contract the virus need ICU care to recover? And that adults of ANY age can end up in that position? What would you say if 18% of the entire population needed ICU care in just 12 weeks and many of them died because they could not get that care? Because that is the point you are missing here.

> Haven't you noticed how many of the
> death figures contain thewords 'all but X had
> underlying health conditions' -thats the thing, it
> was a factor, it was not the sole factor.

No you are completely wrong here. It is the virus that leads to the onset of the conditions that cause death in their compromised immune systems and biology. It is a premature death caused by the virus in other words. It is the reason why we vaccinate against flu. Flu is another virus that causes premature death in this way.

> I genuinely think we're overreacting here and my
> worry is the medium term ability to pay for an NHS
> to cope for future outbreaks is at risk. The
> sooner we relax the restrictions the better, and
> get on with our lives.

We borrowed far more money to get through the second world war. And every country in the world is in the same position. The thing with economics is that it is a human construct. Resources and a work force do not disappear suddenly. The world will adjust its economic modelling, especially if the virus mutates and brings a second wave.

And therein is the real risk. If the virus were allowed to spread freely, apart from the tens of millions it would kill, the risk of mutation into a more virulent and deadly wave becomes increased. This is what happened with Spanish Flu. You might argue now that the elderly are expendable, so who cares if millions of them die, but what will you say if a mutation starts killing other age groups in significant percentages? We are already heading for a society with differing levels of fear. Imagine what would happen in that latter scenario. A short term economic hit to get public health in a manageable position will cost far less in the longer term considering the alternative.

The truth is that we just do not know enough about this virus yet to risk that. We don't even know if getting the virus delivers immunity, because it takes months and years to genuinely measure that. SARS CoV 1 seems to suggest any immunity is short term and weak. So the only way to beat this may well be with a vaccine in the same way seasonal flu is controlled. And this is also why that Oxford vaccine has been developed using Adenovirus and not the SARS CoV 2 virus. The Adenovirus produces a stronger antibody response that may work to combat Covid - that is the thinking there.



Edited 2 time(s). Last edit was may 03, 05:21pm by Blah Blah.

messageRe: Ignoring lockdown in ED
Posted by keano77 May 03, 05:24PM

Spartacus Wrote:
-------------------------------------------------------
> Keano your statement of "Unfortunately Spartacus
> the emotive argument you present will only go so
> far. The longer lockdown continues in the U.K. the
> danger is the economy will collapse, house prices
> and pensions will collapse and unemployment will
> be unprecedented." Is also a dangerous emotive
> drive for people to make a decision based on
> protecting their financial assets, over protecting
> lives in my mind.
>
> My argument above is that the public shouldn't be
> asked to make a decision because for what ever
> reason they will be tempted to vote based on their
> own particular circumstances rather than what is
> actually best for the country / population as a
> whole.
>
> Maybe there needs to be an external and balanced,
> in terms of scientific and economical members,
> committee to review and make decisions on when and
> how to come out of lock down rather than a public
> vote

Fair enough Spartacus. It was not a direct criticism. I dont have the answers.

messageRe: Ignoring lockdown in ED
Posted by Penguin68 May 03, 05:52PM

'Rules' about lock-down -

1. If you are symptomatic, self-isolate at home (quarantine) and don't leave quarantine until 7 days after you first showed symptoms unless you still have symptoms. Stay at home till these pass (assuming you don't become so ill you need medical treatment) [And there are additional rules if you are sharing a living space with others]

2. If you are well, (mainly) stay at home except for the permitted reasons, including an hour's exercise - by limiting your time there will be fewer people out at any one time to possibly infect each other.

3. If you practice social distancing (2 metres) outside you are very unlikely, in the open air, to contract the virus. [What that means is that socially distancing people who sunbathe or sit down are putting no one, themselves or others, at risk. However spending more than an hour out will start to contribute locally to 'over crowding.]

4. Thoroughly wash your hands if you touch anything you have not brought with you when outside. Which includes a seat you might have sat on.

If only the asymptomatic go out, and if they socially distance, and hand wash, the virus will not spread.

So if people are conforming to this, but not beating themselves about the head to increase their lock-down pain, don't criticise them.

The virus is spreading because either people are not following the advice (and we do see them on our streets), or because they are forced, as key workers or people in contact with key workers to 'break' social distancing rules. You can't nurse someone whilst 2 metres away from them. Or serve them in a shop.

messageRe: Ignoring lockdown in ED
Posted by malumbu May 03, 06:37PM

' We borrowed far more money to get through the second world war. And every country in the world is in the same position. The thing with economics is that it is a human construct. Resources and a work force do not disappear suddenly. The world will adjust its economic modelling, especially if the virus mutates and brings a second wave. '

I do worry though. One benefit of the second world war is that afterwards we had a big competitive advantage in a war torn Europe as industry had adapted, innovated, become leaner and fitter. And the benefits of shed loads of coal. It didn't last of course.

This time we will be lagging behind our European neighbours, in a precarious financial environment. Maybe our financial and sector and other services will be robust enough after we wave good bye to some of our remaining industry - I think automotive is particularly vulnerable.

Not a reason to end lockdown early, just something that we can't ignore.

messageRe: Ignoring lockdown in ED
Posted by wordsworth May 03, 07:02PM

God give me strength... this thread is doing my head in

messageRe: Ignoring lockdown in ED
Posted by Plough Man May 03, 07:17PM

Penguin68 Wrote:
-------------------------------------------------------
> 'Rules' about lock-down
>
> 4. Thoroughly wash your hands if you touch
> anything you have not brought with you when
> outside. Which includes a seat you might have sat
> on.
>

Only go out wearing a pair of boxing gloves.

That way you can't get infected by picking your nose or rubbing your eyes PLUS other people will give you a wider berth than a measly 2 metres.

messageRe: Ignoring lockdown in ED
Posted by Blah Blah May 03, 07:25PM

I agree Malumbu. There are a lot of unknowns but we were already an economy in decline anyway. We seem to think we can stay on top forever (an arrogance delivered by an Empirical past of course) but the rest of the World has been catching up for some time. I still think that if we can get away from that mentality, we can create a more vibrant and meritocratic economy. And maybe one good thing to come out of this pandemic will be a necessary shift away from plutocracy.

messageRe: Ignoring lockdown in ED
Posted by Sally Eva May 04, 08:26AM

[www.youtube.com]

This is a Chris Whitty lecture on Covid. Dry but highly informative.

messageRe: Ignoring lockdown in ED
Posted by doogsey May 04, 08:38AM

jimlad48 Wrote:
-------------------------------------------------------
> For whats its worth, my view on the situation is
> that lockdown is becoming increasingly untenable.
> I dont doubt Corona is a horrible virus/bug/thing
> and it can be truly awful for some people, but we
> need to have a national conversation around the
> risk we want to take here.

The main reason for the lock-down is to flatten the curve and to avoid overwhelming the NFS.

Even if you think you won't catch it, or you think you're in good enough health to survive it, you have to consider the impact that the coronavirus left unchecked would have on all parts of the NHS. That *could* end up having a direct impact on you, e.g. if you need to use A&E for an unrelated reason.

messageRe: Ignoring lockdown in ED
Posted by micromacromonkey May 04, 10:16AM

If you fall out of a tree and break your legs don't come running to me.

dbboy Wrote:
-------------------------------------------------------
> When you eventually catch CV 19, can't breath and
> subsequently die, don't moan, because you didn't
> follow the guidance.

messageRe: Ignoring lockdown in ED
Posted by seenbeen May 04, 11:40AM

micromacromonkey Wrote:
-------------------------------------------------------
> If you fall out of a tree and break your legs
> don't come running to me.
>
> dbboy Wrote:
> --------------------------------------------------
> -----
> > When you eventually catch CV 19, can't breath
> and
> > subsequently die, don't moan, because you
> didn't
> > follow the guidance.

Unfortunately you may yourself very well follow the guidance but if the ICU beds are not protected then you could die of ANYTHING because of a selfish person spreading it around, or the lockdown was eased too soon because of 'pressure' from ignoramuses!

messageRe: Ignoring lockdown in ED
Posted by malumbu May 04, 04:39PM

Interesting article on the BBC following research from Kings College, 45 % willingly following lockdown, 45 % begrudgingly and 10& not, May be higher not in reality as there is always a bias "have you been a good boy?" "yes of course".

But the comments are rather rabid. I sometimes go to the comments on the BBC as you get polarisation and lots of throwing of rocks. If you want to get angry read the ones on this article which are almost universally people ignoring the rules, due to infringement of civil liberty, conspiracies or whatever else they use to justify their behaviour. Not quite America

[www.bbc.co.uk]

messageRe: Ignoring lockdown in ED
Posted by JohnL May 05, 10:27AM

I think some people actually thrive in lockdown (I read that there are a proportion who's mental health improves under these conditions for various reasons) - of course it all depends how much space you have.

Beginning to think it maybe me as I'm alone, can set an exercise regime, get things done I've put off for years, drink less etc.

messageRe: Ignoring lockdown in ED
Posted by JohnL May 05, 11:06AM

jimlad48 Wrote:
-------------------------------------------------------
> Im concerned that we have potentially overplayed
> the fatality figures by adding Corona as a cause
> of death, not as the sole cause of death unlike
> other countries. For example you could have
> terminal cancer in its final stages, and very mild
> corona symptoms, but if you died, youd be
> recorded as a corona victim even if you only had
> it in the mildest of ways.
> While there is no suggestion that having it is not
> a factor in these deaths, it makes people assume
> that its perhaps more lethal than may actually be
> the case compared to other reporting rates. There
> is some good work done on this by the Guardian
> around how nations record fatalities in very
> different ways.
> The next question is how many who have died of
> Corona would have died anyway, probably in fairly
> short order? Its a blunt question but when you
> listen to accounts of people in their late 90s
> dying (or in one case I heard a 105 year old) then
> you need to ask if were overemphasing the impact
> its having. Many of those impacted would almost
> certainly have had underlying health conditions
> that probably played a very significant part here
> not COVID itself.

This doesn't fit with the people I've known who have died where they may have been ill and had been ill for many years but they were hanging on in there - then COVID19 finished them off - but who knows if they would have lasted 3, 5 or 10 years further ?

Where do you draw the line - we all have a death day coming ?

messageRe: Ignoring lockdown in ED
Posted by Blah Blah May 05, 09:57PM

All of us would die from a whole range of bacterial and viral infections if we had sufficiently compromised immune systems. The point here though is that it is a NEW virus. One of the first things to be measured when a new virus emerges, is mode of transmission and rate of infection. If spread is fast enough and people are becoming seriously ill in significant numbers, you assume the worst until you know what you are dealing with. Some things can be understood relatively quickly, like transmission, symptoms, mortality. Other things take much longer to measure, learn and understand.

It really doesn't matter that many of those who have died had underlying conditions. All that means is that they were living with an existing but manageable condition, which became unmanageable once this new virus entered their body and started infecting cells. To suggest that COVID is not really the cause of death here is a denial of the facts. Even healthy people who recover at home have a rough time of it, and a significant percentage of them need ICU care to recover. There is no other virus or cause of death killing people in these numbers at the moment. On top of that, today we became the country with the worst death toll in Europe. Lock down has prevented that figure being higher than it already is.

messageRe: Ignoring lockdown in ED
Posted by malumbu May 05, 10:12PM

Not arguing strongly against your point but seasonal influenza does claim the lives of many older and/or immunocompromised people each year

Public Health England estimates that on average 17,000 people have died from the flu in England annually between 2014/15 and 2018/19. However, the yearly deaths vary widely from a high of 28,330 in 2014/15 to a low of 1,692 in 2018/19. Public Health England does not publish a mortality rate for the flu.

I've been through the 'oh its just a cull, let it run its course', before understanding that this is something very different as you and others have clearly pointed out. I've also lost two close members of family to pneumonia so don't take this lightly. Nor am I trying to play God or the grim reaper.

We of course don't have a mass vaccination programme against seasonal flu, nor have we needed a lock down in our life times.

messageRe: Ignoring lockdown in ED
Posted by Blah Blah May 06, 12:54AM

There would be no point in vaccinating everyone from seasonal flu because it mutates frequently. That's why we only vaccinate vulnerable groups that may benefit from it in that season. But as you also point out, that vaccine has varying rates of success from season to season, mainly because it is created for a predicted mutation of the flu virus. Sometimes what arrives is not really what was expected. Overall though, I would argue that flu vaccines do a good job of keeping annual death rates at lower levels. The caveat though is that we could still see a flu pandemic if a particularly virulent strain appeared.

messageRe: Ignoring lockdown in ED
Posted by TE44 May 06, 08:59AM

flu vaccinations are not efficient especially in older people. the live nasal spray vaccine given to children also sheds for up to 4wks. The fact this is an attenuated does not change the fact it is a live vaccine. hence why parents are given information to keep there children away from immucompromised people. if a psuedovirus can cause infection why is it always ruled out that shedding can be contagious. there was a genetic mutation discovered by John Hopkins researchers with this vaccine flumist in 2017. it was said it may help to restore the vaccines effectiveness after the US stopped using it. A pharmaceutical genetic mutation brought about by doing what may happen naturally. this was not an intention as far as I could see. Did the mutation bring about clinical studies before US then continued using it in its immunisation programme. If my memory serves me right I could not find any information regarding trials around this. I don't remember ever finding out how this mutation helped effectiveness.

messageRe: Ignoring lockdown in ED
Posted by Blah Blah May 06, 05:37PM

This is where we get into the realm of antigenic shift vs drift. And also, the immune system ability to produce antibodies decreases with age. At the same time, the abundance of certain receptors that viruses need to infect cells increases. Pseudoviruses have no ability to replicate, even if they infect a living cell, but at the same time, viral load is the consideration for immucompromised people. Why? Because the risk of a pseudovirus mutating is real also once it enters a living organism.

Influenza A has mutation 'shifts' regularly. That means small changes in the antigenic makeup of the surface antigens. It needs no other virus or viral strain to do this. And migratory birds are monitored all year round to produce the vaccine. It is a well practised process.

'Drift' however is what leads to pandemics, needs an intermediate host usually, and involves a mutation between two strains of the same virus or two completely different viruses to create a novel (new) virus. This is much rarer for obvious reasons.

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