Fuck this fucking virus with a fucking farm implement.

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  • A friend asked me, why won't everyone be infected. Errm, I stuttered over that. Presumably the lockdown shrinks the available candidates, then some get it and become immune, and in the end, there is a vaccine. Am I missing something?

    Not everybody exposed to a disease gets it. Differences in immune system, presumably. Partly innate and partly acquired. They were exposed to something similar, albeit really mild, that their system created antibodies to. It certainly needs to be studied, in my opinion.
  • If the lifecycle of the virus is (say) three weeks, and we all stay inside for three weeks, the virus is dead. It needs us to transmit it to other hosts. If we're good, and keep the rate of transmission as close to zero as possible, we get let out earlier.
  • jedijudyjedijudy Heaven Host, 8th Day Host
    Kelly!!!! <3 <3 <3

    Robert Armin! Thanks for sharing your Great News!! :blush:
    Let's have a shout out for Coronavirus Arseholes Of The Day... "Christian" "Concern" who have decided that the most important think they can do right now is to challenge the change in the rules on medical abortion in England. Just... fuck off. Then fuck off again. No, no, keep fucking off. And fuck off a bit more, to be sure.

    So, our house is on fire, and instead of helping, they decide this is the best time ever to pee on people whose lives are None Of Their Business? (My biggest soap box.)
  • Doc Tor wrote: »
    If the lifecycle of the virus is (say) three weeks, and we all stay inside for three weeks, the virus is dead. It needs us to transmit it to other hosts. If we're good, and keep the rate of transmission as close to zero as possible, we get let out earlier.

    "All" being the crucial word there. We all can't stay inside for 3 weeks, and certainly won't.
  • Government is getting roasted on BBC, daily debrief, Laura K says the peak is coming faster than expected, and testing is inadequate. Well ...
  • PigletPiglet All Saints Host, Circus Host
    Hello, @bunnywithanaxe - good to see you! :)
  • Government is getting roasted on BBC, daily debrief, Laura K says the peak is coming faster than expected, and testing is inadequate. Well ...

    Except it might not be the peak, just one of these false summits you see when you are climbing up a hill, when the top is much higher than your legs expected.
  • chrisstileschrisstiles Shipmate
    edited April 2020
    Government is getting roasted on BBC, daily debrief, Laura K says the peak is coming faster than expected, and testing is inadequate. Well ...

    The papers seem to have woken up and the BBC takes their lead from them, and I assume what this means is that there are elements of the ruling party who have decided that they are more likely to survive in power by jettisoning the current PM.
  • Hi, bunny!

    ... The other thing is that, as the number of infections go up, AND as people begin to recover and be immune, the laws of statistics ensure there are going to be people who simply don't come in contact with the infection. Probably not a great many, but it can and will happen, especially with people who have fewer contacts.
  • john holdingjohn holding Ecclesiantics Host, Mystery Worshipper Host
    Given the inadequacies around testing in different jurisdictions, the numbers infected figures are largely illusory and almost certainly grossly understate the real situation. Hard numbers matter, though: numbers in hospital, numbers in ICU, numbers dead, numbers cured/released/whatever phrase is used. And I really don't need totals-- I need daily figures.
  • EutychusEutychus Shipmate
    edited April 2020
    Given the inadequacies around testing in different jurisdictions, the numbers infected figures are largely illusory
    Yes
    and almost certainly grossly understate the real situation
    Misleading. If you count only serious cases, the mortality rate looks a lot worse than it actually is per instance of the disease. Here we are told that the disease is benign in 85% of cases. The 15% are certainly a source of major concern, but I'm glad the first figure is not lower...
    Hard numbers matter, though: numbers in hospital, numbers in ICU, numbers dead, numbers cured/released/whatever phrase is used. And I really don't need totals-- I need daily figures.
    Yes and no, and it depends what for. If you're counting the cost of the pandemic after the fact, total excess deaths for this cause is the figure you're after (or perhaps total excess deaths for this cause PLUS excess deaths due to lack of usually available treatment. Or...).

    Right now, what interests me and is really difficult to find are rates, and several of them. The day-on-day rate of new infections in any given area is the single most interesting piece of data as far as I can tell, followed by the percentage of those that turn serious, the recovery rate, and (from a hospital management point of view) how long cases requiring hospital treatment fill up a hospital bed for, and how long that is after when they first fall ill.

    Can anyone point to the source of any such data? It would be a lot more interesting than headlines saying "death toll continues to rise in country X" without saying whether that means the total number of deaths (well DOH, of course this number is going to rise for the foresessable future), more deaths yesterday than the day before (i.e. conveying data about who fell ill about two weeks ago, not who's falling ill today), or what.

  • Eutychus wrote: »
    Given the inadequacies around testing in different jurisdictions, the numbers infected figures are largely illusory
    Yes
    and almost certainly grossly understate the real situation
    Misleading. If you count only serious cases, the mortality rate looks a lot worse than it actually is per instance of the disease. Here we are told that the disease is benign in 85% of cases. The 15% are certainly a source of major concern, but I'm glad the first figure is not lower...
    Hard numbers matter, though: numbers in hospital, numbers in ICU, numbers dead, numbers cured/released/whatever phrase is used. And I really don't need totals-- I need daily figures.
    Yes and no, and it depends what for. If you're counting the cost of the pandemic after the fact, total excess deaths for this cause is the figure you're after (or perhaps total excess deaths for this cause PLUS excess deaths due to lack of usually available treatment. Or...).

    Right now, what interests me and is really difficult to find are rates, and several of them. The day-on-day rate of new infections in any given area is the single most interesting piece of data as far as I can tell, followed by the percentage of those that turn serious, the recovery rate, and (from a hospital management point of view) how long cases requiring hospital treatment fill up a hospital bed for, and how long that is after when they first fall ill.

    Can anyone point to the source of any such data? It would be a lot more interesting than headlines saying "death toll continues to rise in country X" without saying whether that means the total number of deaths (well DOH, of course this number is going to rise for the foresessable future), more deaths yesterday than the day before (i.e. conveying data about who fell ill about two weeks ago, not who's falling ill today), or what.

    There's some good stuff here:
    https://ourworldindata.org/coronavirus-data#confirmed-deaths
  • EutychusEutychus Shipmate
    Thanks. I think they're gonna need log scales soon though.
  • Eutychus wrote: »
    Thanks. I think they're gonna need log scales soon though.

    The difficulty with log scales is that probably <10% of the population have a clue how they work, and even fewer journalists or politicians.
  • EutychusEutychus Shipmate
    Richter, anyone?
  • People don’t understand that as a log scale, just ranked.
  • BoogieBoogie Shipmate
    A friend asked me, why won't everyone be infected. Errm, I stuttered over that. Presumably the lockdown shrinks the available candidates, then some get it and become immune, and in the end, there is a vaccine. Am I missing something?

    No you aren’t. The race is for a vaccine. Meanwhile we need to keep as few people as possible from catching it.

    Eventually, one day, we will go for our Corona vaccine and our flu vaccine as a matter of course.

  • EutychusEutychus Shipmate
    People don’t understand that as a log scale, just ranked.

    That was kinda my point. I don't remember exactly when I realised it was a log scale, but it wasn't too many years ago...
  • Eutychus, not sure if you’re on Twitter, but this guy is producing the most comprehensive and useful data visualisations I’ve seen anywhere daily.

    daily stats
  • A bit of relevant respite:

    I checked the xkcd comic page a bit ago, and I've been laughing for the past several minutes. The artist, Russell Munroe, has included some observations on the corona virus in several recent installments.

    Start with the most recent: "Pathogen Resistance". After you read it, mouse over any of the pictures. A message will pop up--one of the trademarks of the strip. This installment is a much larger format than he usually uses, and it tells about the virus from the virus's point of view.

    Then you can see previous installments by clicking on the Prev nav button.

    Have fun! (YMMV, etc.)
  • Jemima the 9thJemima the 9th Shipmate
    edited April 2020
    CJCfarwest wrote: »
    Eutychus, not sure if you’re on Twitter, but this guy is producing the most comprehensive and useful data visualisations I’ve seen anywhere daily.

    daily stats

    I was just going to suggest the same, it’s the graph I look at daily.
    Eutychus wrote: »
    Thanks. I think they're gonna need log scales soon though.

    The difficulty with log scales is that probably <10% of the population have a clue how they work, and even fewer journalists or politicians.

    This is a bit of a problem. I had to dust off my very vague knowledge of log scales from A level maths 25 years ago, but it’s by far the most useful way of looking at the growth in numbers. The BBC reported yesterday a “shocking” rise in deaths. It is shocking from a human life point of view, but from a maths point of view it’s exactly what we would expect an exponential rise in deaths to look like. Similarly when Gavin Williamson (Education Sec) said the number of deaths was rising “faster than expected”. It was only unexpected if he didn’t understand what a log graph would look like. It’s certainly very grim, but it isn’t surprising.
  • Yes, so many people get this wrong. All the people who are saying that we should save the economy, and stop the lockdown, don't get it. Do they think that it will bump off all the old, and then take a vacation?
  • I suppose they all think they're invincible. Perhaps it will only dawn on them that the virus is a threat to us all if/when someone close to them dies.
  • This website seems clear and helpful: http://nrg.cs.ucl.ac.uk/mjh/covid19/#wn2.
    A friend circulates the world plots every day: http://nrg.cs.ucl.ac.uk/mjh/covid19/31mar2020/covid-world-norm.png.
  • RooKRooK Admin Emeritus
    edited April 2020
    I've been following THIS - because I appreciate the live data, plus the ability to select regions of interest and see the logarithmic and daily numbers.

    Also, relevant to the logarithmic scale comments: decibels.
  • RooK wrote: »
    I've been following THIS - because I appreciate the live data, plus the ability to select regions of interest and see the logarithmic and daily numbers.

    Also, relevant to the logarithmic scale comments: decibels.

    I've been as well. Because data is our friend. It has been up to 24 hours behind on occasion for obscure and unnotable jurisdictions such as here.
  • .
  • RooK wrote: »
    I've been following THIS - because I appreciate the live data, plus the ability to select regions of interest and see the logarithmic and daily numbers.

    Also, relevant to the logarithmic scale comments: decibels.

    Well two people died in Launceston in Northern Tasmania and I see no red dots there. Typical. At least they included Tasmania on their map.
  • I've been gathering the numbers and showing the logarithmic nature of the increase by posting "days to double." Over the last 2 days the deaths (U.S.) are at 2.46 days to double. As that number decreases (which it is doing), then the disease is getting markedly worse.
  • A cynical friend said to me that the UK was unprepared for an epidemic, witness the struggle over testing, but will probably be quite good at disposing of bodies, so there is something to be proud of.
  • Bishops FingerBishops Finger Shipmate
    edited April 2020
    Those of us who are Lay Ministers in the C of E, and licensed to officiate at funerals, have already been asked if we are available at short notice to conduct such services (graveside or crematorium).

    24/7 crematoria, and mass burials, were mentioned as possibilities...
    :grimace:
  • I heard a BBC spot discussing untested care workers going to multiple care homes in the course of a day or work week, and the care homes being told not to ask for hospital care. Disturbing. Even worse was report of directing do not resuscitate orders. Sounds completely botched gov't management.
  • Yes, I thought some care homes are being told that many elderly people with corona will not be taken into hospital. It's not really surprising.
  • The director of a local care home was quoted in the paper as saying this:
    Doctors have learned there is no benefit for seniors with COVID-19 to go to the hospital and they would not survive intensive care."
    It's a long time since I turned 60, but am not much impressed by someone who would dismiss me that easily.
  • This is the Daily Fail but the headline says: Only patients with reasonable certainty of survival will be put on ventilators - London hospital. All people identified by GP surgeries as vulnerable will have had a letter telling them so in the last couple of weeks and have been advised to remain inside for the 12 weeks recommended - the nicer name for it on Instagram is cocooned. But it's also basically saying that if there has to be a choice made, those vulnerable will not get a ventilator.

    I know a number of people in that position, irl and online: those on certain steroids, vulnerable older people, the guy with diabetes or others with additional illnesses - not a lot of fun.
  • Follow-up to my last one above. The GP at the care home happens to be a friend, and I e-mailed to ask what he knew about it. It turns out that the quote was taken out of context, as is the duty of local papers everywhere, and what was actually said in the original letter (that also had his signature on it) was similar to CK's post above, i.e. those with a reasonable probability of survival will be taken to the ICU and put on a ventilator, while the families of the more frail will be advised that it would not help them and should not be done.
  • Yes, I thought some care homes are being told that many elderly people with corona will not be taken into hospital. It's not really surprising.

    According to the medical people at the Downing Street press conference this afternoon, each case of someone in a care home potentially requiring hospitalization, as a result of the virus, will be assessed in the usual way, as a clinical decision; ie, will this person benefit from hospital treatment. I think there was some hinting that when the pressure finally hits full scale, clinical staff will also be making the decision on who is treated how, based on the likelihood of the best comparative outcomes, if choices have to be made. DNR protocols also remain the same under the coronavirus emergency, as they did previously, with each patient/next of kin being consulted in the usual way.

    Some people perhaps already think these procedures are biased against the sick elderly, even prior to the virus crisis, so may not find this reassuring. But again there was something of a hint of 'We make these decisions every day. The difference now is that we'll be making more of them and under greater pressure.'
  • It is not purely utilitarian either - if you are, say, 87 with moderate dementia and osteoporosis (or family of said person) and you go into cardiac arrest at home. Do you want cpr ? Do you want someone to break your ribs to keep your heart going - to get you as far as icu, your chance of survival will be low, your cognitive function will be worse than it was beforehand (because anoxic damage in the course of the event) and physical recovery will take months or years if it is in fact possible.
  • CameronCameron Shipmate
    edited April 2020
    .

  • TonyKTonyK Shipmate, Host Emeritus Posts: 43
    Those of us who are Lay Ministers in the C of E, and licensed to officiate at funerals, have already been asked if we are available at short notice to conduct such services (graveside or crematorium).

    24/7 crematoria, and mass burials, were mentioned as possibilities...
    :grimace:

    Those of us who are over 70 have been banned from taking funerals - even the limited attendance ones.

  • anoesisanoesis Shipmate
    It is not purely utilitarian either - if you are, say, 87 with moderate dementia and osteoporosis (or family of said person) and you go into cardiac arrest at home. Do you want cpr ? Do you want someone to break your ribs to keep your heart going - to get you as far as icu,
    Sure - quite possibly you don't want these things, in such a situation, but the point is that it's meant to be about what you want, not what is most expedient, and the fact that they're called 'do not resuscitate' orders is a clue toward the default, in normal circumstances, being toward active maintenance of life. Which is good, because it means that not only does an individual have to go to the extent of making a declaration, via an official channel, but also your attending clinicians don't have to check that you've requested to be kept alive before starting to work on you.
    Quite how situations will be managed in the next little while I have no idea, but one thing I'm certain of: I'd rather have clinicians making the coal-face decisions than politicians. Sadly, to the extent that their coal-face decisions are likely to be affected by lack of personnel and under-resourcing, they're inevitably going to be clearing up after the politicians, who will themselves never have to make eye-contact with, much less turn off the machines of, those they've thrown under the bus.
  • TonyK wrote: »
    Those of us who are Lay Ministers in the C of E, and licensed to officiate at funerals, have already been asked if we are available at short notice to conduct such services (graveside or crematorium).

    24/7 crematoria, and mass burials, were mentioned as possibilities...
    :grimace:

    Those of us who are over 70 have been banned from taking funerals - even the limited attendance ones.

    I might have missed that in our Mess Of Guidance, which is rapidly changing all the time, of course.

    I'm not 70 yet, so I may be called upon...though I rather hope not.
    :fearful:

  • HuiaHuia Shipmate
    Care homes will already have a signed statement about whether their residents want a non-resuscitation order as the question is asked as part of the admission process - at least it has been here for my father and brother.
  • PatdysPatdys Shipmate
    edited April 2020
    May I speak to advance care planning.
    Please note - different countries have widely different views regarding health.
    I have had the privilege of studying communication in this sphere on three different continents and am acutely aware I struggled to relate to some of the issues in different cultural settings. Common language does not mean same culture and this seems particularly pertinent at end of life.



    My two cents.

    All medical decisions should be shared- the person concerned, their recognised others and the health clinicians involved- recognising all bring hopes, values, beliefs, skills, and emotions etc to the table and it is in the discussion, shared decision making occurs. This is key.

    Advance care planning
    It is an opportunity to identify the hopes, values and goals of each and every individual. It is an opportunity to identify what is most important to us.

    And as a result of those values, medical care can be discussed and determined.
    It is more important to identify what we do want; stay home, go to hospital, spend time with family; rather than what we don't want; CPR/IV antibiotics etc.

    For those of us with a life limiting illness, it is an opportunity to discuss how we wish to be cared for when we are dying from that illness.

    And the key is the focus is what is on most important to us.

    For many, it is family, independence, functional ability. And for many, if they lose that, then they may have a preference for supportive symptom management over potential life prolonging (Potentially with unacceptable quality of life) measures.

    The treatment for Covid-19 is supportive. It is good nursing care, and management of organ failure for those who get a severe inflammatory response. For many of us, if we get that sick where our organs start to not work, medical support in that organ failure state will not allow us to regain a level of function that we would find acceptable.

    And there are those of us in the grey where we don't know. And this is where our wishes are most important. What treatments would I want if it could be offered? And it is not the treatment but rather - What do I hope to get from the treatment?
    The treatments are purely tools. It is the endpoints we want that are important - And this is what advance care planning offers. What are my acceptable end points- what do I consider living well, what is my function etc.

    Would life be worth living to me if I couldn't communicate? Couldn't walk? Couldn't get out of bed. And this is an individual decision. And hence, Advance care planning.


    Where Covid is a bastard is the surge. When and if there is a surge, we may not have the same level of choices of medical treatment because of health system capacity. Doctors may need to make difficult decisions. This should be at the coal face. And the international experience to date as I understand it, it is.

    Flattening the curve keeps more options for more people.

    May I reiterate, our cultural differences and I write from my culture of heath.
    And my best wishes to stay safe and remember that for the majority of us- this is a benign disease.
  • HuiaHuia Shipmate
    Thanks Patdys, That was helpful.
  • TwilightTwilight Shipmate
    All Walmart employees who have health insurance through the company are required to get all their drugs through the in-store Walmart pharmacy. This way all your co-workers can know about all your embarrassing problems and the drugs you're taking for them. But we're used to that. The latest catch-22 is that while you're on leave, you're not allowed to enter the store. So you can't pick up your meds. So your high-risk mother (me) has to enter the packed, unruly crowd to get my son's prescriptions while he's on leave to protect me from germs he might pick-up in Walmart.

    I'm glad I went, though, so I could tell him what a mess the place was. It's the only place to go in this little town and there are just too many people coming around too many corners to keep safe distances from each other. He has worked there 16 years and actually loves his job, the routine of it has done wonders for him. Now he's afraid he wont get it back when all this is over. Dang virus.
  • We're talking about team decision making re triage. "Operational stress injury" as differentiated from psychological trauma, things in the PTSD spectrum. This is a slow moving, progressive disaster. With repetitive stresses verus specific events or a collection of a few events. How to organize care for our medical people and send them back into the battle. There are no "best practices" because we've no data.
  • PatdysPatdys Shipmate
    Could you unpack that a little more please / I would like to understand better.
  • finelinefineline Kerygmania Host, 8th Day Host
    Interesting. I googled and it seems to be a term used mainly in Canada so far. I was wondering how it is different, in how it presents, to cPTSD (complex PTSD), which is also caused by repetitive stress/trauma, though largely from childhood, so is developmental, while this seems specific to military and frontline workers. I found this article.

    I found interesting the use of the term 'injury' because I have observed a lot of people with PTSD argue that PTSD should be described as an injury rather than a disorder, as it is caused by something that happened to them and thus injured them, and if it had been a physical thing, like an accident/assault causing a broken leg, then it would be called an injury.

    I do hope ways can soon be found to help people working on the frontline deal with this repeated stress and trauma - I have been thinking a lot about the psychological impact it must have.
  • BroJamesBroJames Purgatory Host, 8th Day Host
    It is not purely utilitarian either - if you are, say, 87 with moderate dementia and osteoporosis (or family of said person) and you go into cardiac arrest at home. Do you want cpr ? Do you want someone to break your ribs to keep your heart going - to get you as far as icu, your chance of survival will be low, your cognitive function will be worse than it was beforehand (because anoxic damage in the course of the event) and physical recovery will take months or years if it is in fact possible.
    This almost exactly (including age) describes my mother, who is also bed-bound because of an osteoporosis-related injury. We had already agreed/requested that our prime consideration is her comfort and emotional well-being, and that we are not expecting recovery. If the osteoporosis injury heals sufficiently for her to be able to move without excessive pain, it is unlikely that her muscles will recover sufficiently for her to be mobile again.
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