Coronavirus - worldwide spread and control

The lack of adequate testing in the US is inexcusable.


https://twitter.com/user/status/1240379898465828868

 

"As bioethicists, we teach medical students, residents and fellows that every clinical encounter involves moral and ethical decision-making. As these three stories illustrate, the pandemic sharply focuses this paradigm and raises the stakes. What can clinicians do when faced with these kinds of moral dilemmas?



The answers are both undeniably simple and frighteningly difficult. Ask questions and speak up. Be brave. Stick your neck out."


https://twitter.com/user/status/1240278551989030918

 

https://twitter.com/user/status/1240408437516877824

 

Hi @Simon M thank you for writing up an analysis of the study. I found it really helpful.

Do you know who was responsible for writing the original paper / model - the one which the UK used to go ahead with their mitigation model? And do you know where to get a copy of it?

I would’ve thought it’s the same team (including Neil Ferguson). But today i heard that Neil Ferguson was the person responsible for telling Trump he needed to bring in social distancing measures otherwise in America lots of people would die. And as a result a Trump has taken steps which are actually stronger than the steps taken in the UK (although some of that may be down more to the federal system in the US too). So I’m confused how he could be the author of the original paper, which would have recommending a very lax mitigation strategy in the UK which thought herd immunity as desirable, at the same time as telling Trump it’s a serious matter? Or am I getting it wrong?

 

This is a new hashtag for clever medical supply, etc., solutions.

https://twitter.com/hashtag/macgyvercare?src=hashtag_click

 

Testing in the UK - from a Times journalist. Recently Vallance said we would be able to test 25,000 a day - but in only a months time (no set date given). I’m sure before we were told it would happen a lot earlier than that, and it hasn’t happened. We currently have “capacity” to test 5,000 a day, but the median number of tests so far in March is 1,600. https://www.wired.co.uk/article/coronavirus-testing-uk

https://twitter.com/user/status/1240546843022495744


https://twitter.com/user/status/1240539033501151233


I have also noted that Vallance and Whitty continuously talk about the antibody test, and say the PCR test is not so helpful as it only tells you if you’re infected or not. Not if you’ve had a past infection. That’s also part of the justification given for not needing to test the community and doctors. But so what?! Isn’t the PCR test the very test that China and South Korea and every other country is using to try to beat the virus.. so why does the UK feel that they are exceptional in this regard and the antibody test is the only one they can/should use?

https://www.itv.com/news/2020-03-18...reveal-whos-had-the-disease-with-no-symptoms/

 

Is there any data from Asia on virus mutating?

 

https://twitter.com/user/status/1240521475217596416

 

and of course now he will say "I know about these things because my wife had it.."
so will the government be issuing chelsea scarves to the frontline services, and chicken soup for the patients?

 

According to the latest Imperial College paper, over 70% of patients over 80 require critical care, presumably an ICU placement. We see higher death rates reported on, but demand for critical care goes up radically as age advances. I would guess this is also true for patients in higher risk groups.

So if numbers rise then older patients will rapidly take up all ICU and respirator usage and the death rate in older patients who cannot get treatment is likely to be very high.

The turning point seems to be about age 50 when need for critical care doubles over the adult rate, from about 6% going to about 12%.

I would love to know how this correlates with a range of biomarkers, but I guess we wont know about much of that for many months at least.

https://www.imperial.ac.uk/media/im...-College-COVID19-NPI-modelling-16-03-2020.pdf

 

Does anyone know how being able to test only 25,000 people a day in a population of 66 million is going to help? Presumably it would be some sort of targeted testing?

Don't we need to be testing everyone?

 

A family member had to go to A&E yesterday and then was sent on to another department in the hospital for a vital scan. She said the waiting room was rammed, and she was stuck there for three hours. When the consultant came in to call somebody, she heard him mutter to the receptionist that people were supposed to be a metre apart.

So this in a hospital...

 

https://twitter.com/user/status/1240293938684018688


https://twitter.com/user/status/1240540159159894016

 

From what I’ve gathered, in the UK they are still not thats interested in testing the community.

They said they will use that 25,000 tests to test people in hospitals and also medical staff, but only because then they can be sure whether it’s coronavirus or not, so they can get back to work if it’s not.

The govt are very focused on developing an antibody test (there’s a link in the post I wrote above). Because that way they’ll know if people have had the coronavirus yet - so if they have, they don’t need to bother to self isolate if they get symptoms as it won’t be the coronavirus again; and they can get back to work.

So really.. it all comes down to getting us back to work.

Edit: and like the screenshot I posted before too, the govt certainly has the resources to test many many more people. Even if not everyone, certainly a substantial proportion if not all people who have symptoms.

 

Check out "inside science" on BBC Radio 4.

In fact the reverse is the problem i.e. the virus is so stable so you can't establish whether cases are from one source or multiple sources.

I'm no expert by the way!

 

If everyone is doing their best to keep themselves to themselves testing asymptomatic people is probably not helpful, unless there is a contact line. The problem at the moment is that at least in London they have allowed mixing so much that almost anyone is likely to have a contact history.

I have a feeling that the only sensible strategy is to lockdown as hard as possible and wait for at least ten days. Anyone with symptoms needs testing but since no different advice would be given to asymptomatic people they would not need testing.

 

The UK is not adopting the strategy recommended by WHO; i.e. protect your health care workers, test, trace ---.

The Republic of Ireland has access to testing even for the public, takes about 3 days to arrange ---. I assume Health Care workers have priority.

 

https://twitter.com/user/status/1240597340693712896


https://twitter.com/user/status/1240598111552143362


https://twitter.com/user/status/1240598718858104832


https://twitter.com/user/status/1240599578933682177


https://twitter.com/user/status/1240600250529861633

 

Yea the Government could e.g. turn the veterinary laboratories used to test for foot and mouth to coronavirus testing - there are laboratories doing lower priority work using the same technology!

I've noticed that they have advertised for students, who have DNA extraction experience, to volunteer.