Purgatory: Coronavirus

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  • Alan Cresswell Alan Cresswell Admin, 8th Day Host
    Martin54 wrote: »
    Can we isolate ourselves correlated with age and other health condition related risk? Can the young, those with low risk get back to 'normal'?
    How would you do that? Set an arbitrary threshold at, say, 40 and ensure no contact at all between anyone younger than 40 and anyone older? Would work be normal without the 40+ old people who have the experience? How would you manage someone like me who's 50 with school age children ... should my children spend the next three months with younger parents of their friends?

    And, besides, as @Doc Tor said the numbers would still overwhelm the NHS. If a small fraction of the under 40s, say 1 million in total, get infected that's still more than 10,000 hospital cases. And, without social distancing those are all at more or less the same time.
  • Martin54 wrote: »
    Ask Toby Young, our eugenics advisor.

    What will be the mortality rate caused by the economics of another two years of blanket lock down?

    I didn't think anyone was suggesting 2 years. In fact, there is talk in France and Spain of being over the peak. Well, maybe. I don't think people would tolerate 2 years.
  • CharlesReadCharlesRead Shipmate Posts: 24
    Interesting traffic light solution to the lockdown suggested by Lyons and Ormerod, summarized by Larry Elliott in the Guardian, who doesn't seem to give a link. Red would mean a few shops reopen, Amber would allow car journeys, and restaurants to open, green would allow sport, church, etc. No idea if this would work, but no doubt the number crunchers are crunching it. One problem is that results would take weeks to show up.

    I think some kind of small (tokenistic?) relaxation as soon as medically possible would obviously boost public morale but needs people to abide by it and not go beyond it. I am not sure the specifics of the scheme above are the only way to configure it. Hong Kong has kept the restaurants open but with no more than 4 to a table and each table 2 metres from the next table. (Yes, I know they have approached the pandemic differently from the UK.) Could we do that (eventually) in the UK? What about allowing clergy back into churches to livestream or opening churches for private prayer subject to the 2 metre rule?

    Perhaps a new thread is needed to speculate on the steps out of lockdown...
  • Doc TorDoc Tor Admin Emeritus
    Martin54 wrote: »
    Ask Toby Young, our eugenics advisor.

    What will be the mortality rate caused by the economics of another two years of blanket lock down?

    The virus doesn't have a choice whether it kills or not. We do.
  • DoublethinkDoublethink Admin, 8th Day Host
    edited April 2020
    Puts the world wars into perspective doesn’t it - we’ve been asked to put up with confinement for months, not conscripted into the trenches for years.
  • But to separate out the vulnerable and keep them safe, would be a huge logistical problem, if everybody else is swanning about. OK, they stay at home, then what?
    To protect the most vulnerable you'd need to keep them isolated.

    But, the vast majority (almost by definition) are needing medical care. So, how do you make sure those who are coming into their homes or hospital wards aren't infected?

    You only allow pre-approved people to see them, and maintain a rigorous testing regime on those people to ensure they’re virus free.
    Then, of course, you need to make sure all those people who come into hospital from a car accident, or whatever, have also been in isolation for a couple of weeks before their accident ...

    Or you just designate certain hospitals - ideally the ones without A&E facilities - as Covid-free zones with only the pre-approved and tested people allowed to enter.
    You end up that the only way to protect the most vulnerable is something almost indistinguishable from what we have now got in place.

    Only because it’s more politically palatable to isolate everybody from everybody else than it is to separate out a section of the population and not allow them to mix with the rest.
  • Doc Tor wrote: »
    Those numbers would still completely overwhelm the hospitals' capacity to cope - and then every hospitalisation case would rapidly become a fatal case.

    It also assumes herd immunity in the young, and then at some point, the old and vulnerable are liberated into open society, with no repercussions. There are an awful lot of ifs here.

    We’re going to have to be liberated into open society at some point anyway. Aren’t we? Oh, I do hope so.
  • Puts the world wars into perspective doesn’t it - we’ve been asked to put up with confinement for months, not conscripted into the trenches for years.

    At least in the trenches they could mingle with one another, have a chat and a cuppa, even have a quick kick about or go to see a movie from time to time.
  • DoublethinkDoublethink Admin, 8th Day Host
    You are romanticising the experience of industrialised warfare I think.
  • Probably, but the fact remains that they did at least have meaningful and varied human contact.
  • Before they went 'over the top', and got slaughtered...

    But I see your point.
  • CrœsosCrœsos Shipmate
    I didn't think anyone was suggesting 2 years. In fact, there is talk in France and Spain of being over the peak. Well, maybe. I don't think people would tolerate 2 years.

    The tricky bit is that South Korea, which seems to have done the best fighting COVID-19, still seems to have a "long tail", which makes such decisions complicated.
  • I don't know how they predict the peak, although you can detect a decline. I guess there are typical graphs for viral rise and fall, except that the damn thing can rise again.
  • Isn't this one of the problems with the "segregate the old" idea? The young all catch it and acquire immunity, then the old are released, and then the virus returns, or mutates. What then?
  • Alan Cresswell Alan Cresswell Admin, 8th Day Host
    But to separate out the vulnerable and keep them safe, would be a huge logistical problem, if everybody else is swanning about. OK, they stay at home, then what?
    To protect the most vulnerable you'd need to keep them isolated.

    But, the vast majority (almost by definition) are needing medical care. So, how do you make sure those who are coming into their homes or hospital wards aren't infected?

    You only allow pre-approved people to see them, and maintain a rigorous testing regime on those people to ensure they’re virus free.
    Then, of course, you need to make sure all those people who come into hospital from a car accident, or whatever, have also been in isolation for a couple of weeks before their accident ...

    Or you just designate certain hospitals - ideally the ones without A&E facilities - as Covid-free zones with only the pre-approved and tested people allowed to enter.
    You end up that the only way to protect the most vulnerable is something almost indistinguishable from what we have now got in place.

    Only because it’s more politically palatable to isolate everybody from everybody else than it is to separate out a section of the population and not allow them to mix with the rest.
    But, you still face the problem of numbers, because those who are most vulnerable are at greater risk but there's a risk for everyone else. So, let's say we isolate 20% of the population, we still have 50 million people walking around. If we assume a 20% infection rate then we still have 100,000 people with a severe enough infection to require hospital treatment and a few thousand dead.
  • Then, of course, you need to make sure all those people who come into hospital from a car accident, or whatever, have also been in isolation for a couple of weeks before their accident ...

    Or you just designate certain hospitals - ideally the ones without A&E facilities - as Covid-free zones with only the pre-approved and tested people allowed to enter.

    Our local NHS trust is using the local private hospitals to do as much of the 'still urgent' stuff as possible. Obviously some things like obstetrics and cancer treatment that need specialist kit have to still be in the main hospitals, but the maternity unit is labour ward only for most mums - the midwife led unit has been designated the space for Covid-19 suspected/confirmed women in labour.
  • The virus mutating is a problem for every single tactic. We could stay on lockdown for 18 months until a vaccine is rolled out and it might still mutate and go right back to killing people. What then - another 18 months of lockdown until another vaccine is developed?

    This is why I’m so worried about the restrictions being permanent. We have literally no other reliable way of fighting the virus, and we may never have one. So it’s either accept a whole lot of deaths or stay prisoners in our own homes for ever. Which would you choose?
  • One thing I keep forgetting is that S. Korea didn't do a lockdown, but used test and trace and quarantine, recommended WHO practices. They were ready, we weren't.
  • Scylla and Charybdis, I agree, but perhaps it's a bit too soon to speculate?

    A few weeks' time (and yes, that's a whole lot of lockdown too much), and we may be able to see a bit less darkly.
  • 50% of intubated people on average will die.

    There are ratings and checklists for everything in health care. If the score for a person is low enough that they know in advance that the survival rate approximates zero, and there's a shortage of staff and ventalators, then choices will be made. This is just how it happens. But is it going to get there? For most if not all of our countries, "no". The discussion is to help decision makers spend money and justify that they're doing the spending to political bosses and the public.
  • You can't segregate the old, because the old need caregivers. And it isn't possible to completely screen out all asympomatic virus carriers. Even if you could, there's still contaminated surfaces on incoming goods. Make one false move and the old people corral becomes a death trap.

    It sucks, but I'm afraid the best we can do is take whole population measures to try to stay under ICU capacity, and ride it out. Which will not be years, but certainly weeks and possibly months of restrictions, depending on to what extent we manage to create and mobilize care reponse capacity (PPE, ventilators, staff) and pro-active stuff (increased testing and tracing, antigen testing, possible use of convalescent serum, ultimately vaccines).

    I wish there was something I myself could do, besides confining myself.
  • 1. Will people in London and some big cities do something constructive and not put people at risk?
    2. Will our Government fully bust a gut to get PPE and ventilators out to the level they said they would?

    If not 1. then expect social strife if lockdown is made tougher. There's a tipping point for everything 2.

    If not 2, then who is going to call this rabble to account? Even their own advisors don't follow the rules - why should others? I suggest the Chief Medical Advisor for Scotland is now summarily dismissed and prosecuted. If she isn't then there's an out for everyone ...

  • Alan Cresswell Alan Cresswell Admin, 8th Day Host
    The plus side of mutation is that once diseases are established in a species mutation moves towards reduced virulence; mutations going the other way burn out. So, if there is a vaccine that's effective against the current strain but it mutates sufficiently that the vaccine no longer works then we'll be dealing with a disease that's going to kill and hospitalise far fewer people.
  • Moo wrote: »
    ....Weeks ago I saw a graph which showed the relationship between covid deaths in Italy and pre-existing serious medical conditions. Five serious conditions were listed. Two of them were heart disease and lung disease. I don't remember the other three. Less than five percent of those who died had none of these conditions. ....

    Obesity, hypertension and diabetes.

    Unfortunately, not only are they serious, they're ubiquitous.
  • jay_emmjay_emm Kerygmania Host
    Before they went 'over the top', and got slaughtered...

    But I see your point.

    There are a limited number of places where I'd beg to be transferred to the Western front (The Italian/Austrian front and the Eastern front being the two I'm sure of, that weren't designed to be evil).
    That said there are individual elements which assessed alone the western front comes ahead. The food was better than before, for a start.

    Some aspects associated with comparing loneliness have the potential to be comparable today (and for that matter absolute risk, although here Marvin is in the position of the white feather girls).
    Even this isn't absolute, Marvin for example has his immediate family, so although undeniably worse on the bro contact, has advantages on the Tommy who may have his platoon but is a long way from his wife (and similarly statements could be made.

    That said, this is something that we must be able to do a lot better. Some areas are so already networked that there is more virtual contact than physical before. But in a lot of cases there's nowhere to begin, a known online space to arrange arrangements and advertise would have been useful, in hindsight.
  • Alan Cresswell Alan Cresswell Admin, 8th Day Host
    jay_emm wrote: »
    Some areas are so already networked that there is more virtual contact than physical before.
    And, some areas which aren't. I've a colleague who has severely limited broadband because of where she lives, and is thus unable to participate in Zoom meetings we're using to try and keep in touch. Given the choice, while stuck indoors an urban area with good broadband connection is better than a rural one with poorer connection.
  • ArethosemyfeetArethosemyfeet Shipmate, Heaven Host
    jay_emm wrote: »
    Some areas are so already networked that there is more virtual contact than physical before.
    And, some areas which aren't. I've a colleague who has severely limited broadband because of where she lives, and is thus unable to participate in Zoom meetings we're using to try and keep in touch. Given the choice, while stuck indoors an urban area with good broadband connection is better than a rural one with poorer connection.

    I'm damn glad this didn't happen a year ago when we were still on shitty ADSL <1.5Mbps. 4G is the only thing keeping us sane.
  • Ain't that the truth.

    A few months ago, my local BT Broadband went rather doo-lally, so I went to my friendly PC W**ld store and bought a Dongle, to connect to the best available network.

    OK, it costs me extra, but it works well (mostly), and for some things is actually quicker than BT.

    If BT becomes unbearably slow, I plugs in me Dongle, and off we go!
  • Gramps49Gramps49 Shipmate
    @KarlLB

    Thank you for the clarification.
  • You can't segregate the old, because the old need caregivers. And it isn't possible to completely screen out all asympomatic virus carriers. Even if you could, there's still contaminated surfaces on incoming goods. Make one false move and the old people corral becomes a death trap.

    It sucks, but I'm afraid the best we can do is take whole population measures to try to stay under ICU capacity, and ride it out. Which will not be years, but certainly weeks and possibly months of restrictions, depending on to what extent we manage to create and mobilize care reponse capacity (PPE, ventilators, staff) and pro-active stuff (increased testing and tracing, antigen testing, possible use of convalescent serum, ultimately vaccines).

    I wish there was something I myself could do, besides confining myself.
    This is very funny: 21 days of quarantine. Many ideas within:
    https://m.facebook.com/ConorMaynard/videos/259125731790066/
  • Anselmina wrote: »
    Moo wrote: »
    Bullfinch wrote: »
    Moo - do you know if the preexisting conditions analysed were only ones considered serious or did they include common conditions that might ordinarily appear minor to sufferers?
    <snip>
    .. or are they only referring to things like CPD?

    They were referring to things like CPD--conditions that require close constant medical supervision. It's no accident that so many people who have died were in nursing homes. They were already in such bad shape that they could not take care of themselves.

    Working medical staff are dying in Europe - they must have been relatively fit and healthy to start with.

    Another factor, I understand, is 'viral load'. That is, what size of a dose you get, or how much exposed you are to the virus, which is probably what is often most affecting the staff working at hospitals who catch it.
    That is not what viral load means, from what I have read.
    From the Sience Media Centre:
    We also suspect that the amount of virus that an infected individual is producing – sometimes referred to as the viral load – and potentially shedding, will also impact on transmission; the higher the viral load the more infectious someone is likely to be.
    So it is not the size of the dose you get from others, but the percentage in your body. Which can effect how you transmit to others.
  • Moo wrote: »
    Working medical staff are dying in Europe - they must have been relatively fit and healthy to start with.

    I think they were fit and healthy to begin with, but repeated close exposure to the virus, combined with severe fatigue and probably lack of a healthy diet during the emergency weakened them. Moreover, the study I cited showed that a small number of cases had no underlying chronic problems. I suspect many of these cases involved medical staff.
    Fit and healthy people not in the health industry have died from Covid. Whilst the elderly and those with underlying heath issues are more vulnerable, everyone else is still potentially vulnerable.
    People with heart disease, diabetes, etc. can live quite long if they manage the issues. However, severe sickness, like Covid, can put a strain on the body which overwhelms the management. So someone could die of a heart failure and you might label that death with Covid, but it would more accurately be death from Covid.
  • lilbuddhalilbuddha Shipmate
    edited April 2020
    Or you just designate certain hospitals - ideally the ones without A&E facilities - as Covid-free zones with only the pre-approved and tested people allowed to enter.
    There are not enough hospitals to do this. More precisely, there aren't enough beds in the designated Covid hospitals to manage the potential load.
    You end up that the only way to protect the most vulnerable is something almost indistinguishable from what we have now got in place.

    Only because it’s more politically palatable to isolate everybody from everybody else than it is to separate out a section of the population and not allow them to mix with the rest.
    You do not appear to understand how society works. If we had concentration camps to send the elderly to, that might work. Otherwise, no.
    Corrected quoting code. BroJames Purgatory Host
  • jay_emmjay_emm Kerygmania Host
    jay_emm wrote: »
    Some areas are so already networked that there is more virtual contact than physical before.
    And, some areas which aren't. I've a colleague who has severely limited broadband because of where she lives, and is thus unable to participate in Zoom meetings we're using to try and keep in touch. Given the choice, while stuck indoors an urban area with good broadband connection is better than a rural one with poorer connection.
    I was actually thinking in terms of social network, and it preceded a 'but' (in my case there's quite a lot of the groups I'm on the fringes of and wouldn't know their surname, and the places I'd expect chat seem more silent than usual).

    In the current situation I could see some advantages to the rural for nearby almost contact. You're less dependent on going to busy places and have more space to potter. Of course that doesn't help if what you actually need to do is Zoom indoors.

    Of course the best would be to have good broadband everywhere and accessible space everywhere.
  • MaryLouise wrote: »
    Taking courage from international appreciation of South Africa's tough stance on lockdown. And it is a scary and potentially abusive stance. The BBC report.
    That really puts a sharp point to all the first world whinging.
  • I have a dread of being rural in this situation, apart from broadband. We go to Norfolk a lot, but not right now. One shop 4 miles away, and all that empty space, <screams>.
  • Martin54Martin54 Suspended
    Doc Tor wrote: »
    Martin54 wrote: »
    Ask Toby Young, our eugenics advisor.

    What will be the mortality rate caused by the economics of another two years of blanket lock down?

    The virus doesn't have a choice whether it kills or not. We do.

    Poverty kills.
  • CrœsosCrœsos Shipmate
    Hey, remember the saga of Captain Crozier, the commander of the USS Roosevelt who was relieved of command because he wanted to save his crew from COVID-19? Here's the coda to that story:
    Capt. Brett E. Crozier, the Navy captain who was removed from command of the coronavirus-stricken aircraft carrier U.S.S. Theodore Roosevelt, has tested positive for Covid-19, according to two Naval Academy classmates of Crozier’s who are close to him and his family.

    A Navy spokesman declined to comment on Crozier’s Covid status.

    The commander began exhibiting symptoms before he was removed from the warship on Thursday, two of his classmates said. Crozier was fired following a leak to The San Francisco Chronicle of a letter he had emailed to Navy leaders that detailed the failures on the service’s part to provide the necessary resources to swiftly move sailors off the carrier and disinfect areas on board as the virus spread through the ship.
  • Moo wrote: »
    There is a difference between deaths from covid and deaths with covid. Consider a man who, with the best possible medical care, is rapidly going downhill with congestive heart failure. The day before he dies he tests positive for covid. It is misleading to classify this as a death caused by covid. It is a death with covid.

    Then there are deaths caused by covid that aren't from covid. Someone who can't get a bed in the hospital because they're full of covid patients. Someone with an otherwise treatable condition who can't get their meds because the Mango Murderer has said the meds they depend on can treat covid. People who won't get treatment because so many doctors have died from covid there aren't enough to treat people who don't appear critical. I was pondering what I'd do if one of my kidney stones decided to cut loose right now. They're both large enough to block the exit, and I'd likely eventually die from some kind of internal damage or septicemia if I couldn't get it removed. But if the hospitals are overburdened with people drowning in their own white blood cells, I'd be low priority.
  • Asthma is a risk factor. Plenty of young people with that.
  • Doc TorDoc Tor Admin Emeritus
    Martin54 wrote: »
    Doc Tor wrote: »
    Martin54 wrote: »
    Ask Toby Young, our eugenics advisor.

    What will be the mortality rate caused by the economics of another two years of blanket lock down?

    The virus doesn't have a choice whether it kills or not. We do.

    Poverty kills.

    The point is, we choose to put people into poverty. There is, as has been shown, enough money to go around - it's just badly distributed because some folk have been hoarding it like it was toilet paper.
  • Doc Tor wrote: »
    Martin54 wrote: »
    Doc Tor wrote: »
    Martin54 wrote: »
    Ask Toby Young, our eugenics advisor.

    What will be the mortality rate caused by the economics of another two years of blanket lock down?

    The virus doesn't have a choice whether it kills or not. We do.

    Poverty kills.

    The point is, we choose to put people into poverty. There is, as has been shown, enough money to go around - it's just badly distributed because some folk have been hoarding it like it was toilet paper.

    And additionally: to those currently railing against their inability to go out of the house and do anything; after the bank bailouts were balanced on the backs of the poorest, these are exactly the kinds of privations faced by - say - a young mother with small children, living in a flat who had no transport and lived in an area where all the children's centres and libraries suddenly closed.
  • lilbuddha wrote: »
    That is not what viral load means, from what I have read.
    From the Sience Media Centre:
    We also suspect that the amount of virus that an infected individual is producing – sometimes referred to as the viral load – and potentially shedding, will also impact on transmission; the higher the viral load the more infectious someone is likely to be.
    So it is not the size of the dose you get from others, but the percentage in your body. Which can effect how you transmit to others.
    [/quote]

    Trust me to get it back to front. Or upside down. Or whatever.
  • The plus side of mutation is that once diseases are established in a species mutation moves towards reduced virulence; mutations going the other way burn out. So, if there is a vaccine that's effective against the current strain but it mutates sufficiently that the vaccine no longer works then we'll be dealing with a disease that's going to kill and hospitalise far fewer people.

    This.
  • This is why, when working on SARS, there was research into a general corona virus vaccine, what they call a pan-corona vaccine. But they cut funding. Unwisely. Because politicians. Because politicians listen to business people.

    Currently labs are working both together and independently. I suspect there will be an absolute all out war if certain private companies are able to patent a vaccine. Because they will want to charge thousands.

    The local univ-affiliatied lab here VIDO-Intervac has infected ferrets with COVID-19, has vaccinated a second group, and is exposing the vaccinated group to the infected ferrets. I looked for a link, but didn't find. As far as I understand, this is pretty similar elsewhere. With some places having decided to see if there's negative effects on humans of unproven vaccines before effectiveness is proved. They plan here on also infecting hamsters and testing the vaccine on them.

    I'm getting the general sense that the behavioural measures - social isolation - will flatten the curve of contagion, and there won't be a vaccine yet, and we stand a chance of a second big or bigger wave if we resume normal social behaviour. Human vaccine before 2021, 12-18 months away is considered not very likely.

    The related but non-central questions re this virus:
    -It has reduced CO2 pollution to 60 year old levels.
    -It has shown that we can afford to give people universal basic income.
    -It shows that we could fully fund health care for everyone worldwide.
    -end homelessness in the developed world

    We could also:
    -have free post secondary education, forgive all student loans and debts
    -have basic services cost nothing or nearly nothing: electricity, internet, phone services, water
    -re-consider how much money everyone needs and redistribute to those we exploit at home and in other countries
    -have universal basic childcare or payments to stay at home parents

    Or we could continue to eat the poor, feed the rich, and keep everyone we can in wage and debt slavery.
  • Come on, this is humanity we're talking.
  • Gramps49Gramps49 Shipmate
    edited April 2020
    Moo wrote: »
    Bullfinch wrote: »
    Moo - do you know if the preexisting conditions analysed were only ones considered serious or did they include common conditions that might ordinarily appear minor to sufferers?
    <snip>
    .. or are they only referring to things like CPD?

    They were referring to things like CPD--conditions that require close constant medical supervision. It's no accident that so many people who have died were in nursing homes. They were already in such bad shape that they could not take care of themselves.

    Working medical staff are dying in Europe - they must have been relatively fit and healthy to start with.

    Not necessarily. Many medical workers have underlying health conditions as well. They are not supermen/women. They age. They develop abnormalities. They contract diseases. Medical people may have access to better resources, but they do get sick.

    I applaud them for going in and taking the risk for their fellow humans. When it is all over, I think all of them should be recognized somehow.

    Yes, this virus is mutating, but the basic structure seems to remain the same. If we find ways of combating the basic structure, we can keep ahead of the curve. Flu viruses are constantly mutating, but we have learned to predict which ones will be the more prominent strains each year and act accordingly

  • Doc TorDoc Tor Admin Emeritus

    The related but non-central questions re this virus:
    -It has reduced CO2 pollution to 60 year old levels.
    -It has shown that we can afford to give people universal basic income.
    -It shows that we could fully fund health care for everyone worldwide.
    -end homelessness in the developed world

    We could also:
    -have free post secondary education, forgive all student loans and debts
    -have basic services cost nothing or nearly nothing: electricity, internet, phone services, water
    -re-consider how much money everyone needs and redistribute to those we exploit at home and in other countries
    -have universal basic childcare or payments to stay at home parents

    Or we could continue to eat the poor, feed the rich, and keep everyone we can in wage and debt slavery.

    Preach it, brother.
  • Amen!

    But politicians. And business people. And rich, selfish, bastards...
  • ....stupidly takes Jesus's example of how to live seriously. Diagnosable.
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