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I'm all for criticism and investigation. But it seems so early to make these kinds of definite proclamations. There is so much about the virus and how it's tran

I'm all for criticism and investigation. But it seems so early to make these kinds of definite proclamations. There is so much about the virus and how it's transmitted that we still don't understand. The UK government had no idea what they were doing, but really neither does anyone else. And until we are a little further along in successfully containing this epidemic, it's not going to be clear what the best course of action was. Here are some of the most basic things no one seems to have figured out yet: - As of today, there have been 23,953 deaths in England. Of those, exactly 33(!) involve someone <= age 40 without a co-morbidity. Across all ages, 95%(!) of deaths are people with a co-morbidity, typically diabetes (26%). Why does this disease attack so many diabetic people? What should we do to best treat or prevent it in that population? [1] - Why is the transmission rate in London so low now (R = 0.4, < 25 infections a day) while still high everywhere else in the UK (R = 0.7 - 08)? Is that because the lockdown in London is somehow different or better or because some critical segment of the population is immune now and slowing down transmission? Or something else? [2] - Why weren't the Nightingale Hospitals (field hospitals) needed? Were we just wrong about the need for ventilation? Was the lockdown super effective? Or something else? - How many people are currently immune? Different studies in place the immunity rate in London anywhere from 10% (tests) to 29% (statistical models). Several studies suggest that there is significant cross-immunity with preexisting coronaviruses causing much slower spread, but it's too early to know for sure and that could be totally wrong. - Why do some scientists think this will be a serious, on-going epidemic and others think the disease will "burn itself out" [3]? Is that based on science or wishful thinking? Because the difference in the best course of action would be significantly different if we knew the answer with a strong degree of certainty. - Why do some places with lax lock downs have lower death rates than places with severe lock downs? Why aren't we seeing big upticks in deaths in the US where they are just willy nilly opening the economy? Is it just lagging indicators or are we not totally sure yet how this disease spreads in the community? - How soon will we get an effective therapeutic? Will we really have a somewhat effective vaccine from Oxford in September or might we never have a vaccine? Will it matter anyway as immunity builds up in the population? How long are people immune? - What is the actual cost of locking down in terms of lives lost as a side effect in the long term due to economic, social and psychological effects? Is it minuscule or significant? Again, there will be plenty of time to bash the UK government after this is over. But it seems very early to be proclaiming that anyone has any idea what the right course of action was. This epidemic could totally vanish this year or it could go on for years. No one has any idea. [1] https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-daily-deaths/ https://www.england.nhs.uk/statistics/statistical-work-areas... [2] https://www.mrc-bsu.cam.ac.uk/now-casting/ https://www.mrc-bsu.cam.ac.uk/now-casting/ [3] https://www.telegraph.co.uk/news/2020/05/16/coronavirus-could-burn-naturally-vaccine-not-needed-former-director/ https://www.telegraph.co.uk/news/2020/05/16/coronavirus-coul...

DanBC 6y ago
> As of today, there have been 23,953 deaths in England. No. 1) The actual number is 34,796 https://coronavirus.data.gov.uk/ https://coronavirus.data.gov.uk/ 2) That only includes people who were tested positive for covid-19. That's only tests carried out by government labs, not private tests. We've only just started to include deaths that happened outside hospital. > Why weren't the Nightingale Hospitals (field hospitals) needed? Because we didn't transfer elderly people from care and nursing homes to hospital. We left them to die in those homes. Because we cancelled elective procedures, we converted operating theatres to ICUs, we changed nurse:patient ratios, to create surge demand. Because we didn't have enough ICU nurses to staff Nightingale:London. Of those, exactly 33(!) involve someone <= age 40 without a co-morbidity. Across all ages, 95%(!) of deaths are people with a co-morbidity, typically diabetes (26%). Why does this disease attack so many diabetic people? What should we do to best treat or prevent it in that population? [1]
- zelos 6y ago
  > Because we didn't have enough ICU nurses to staff Nightingale:London. I guess the idea was that military medical services would have moved in to run the Nightingale hospitals if things got really bad?
- ageitgey 6y ago
  You've confused England with the UK (England, Wales, Scotland and Northern Ireland).
niffydroid 6y ago
These are some very good points. I'm glad the Nightingale hospitals were not used, as they were set up if we had to scale response massively. But I think we really need to look at the deaths and where they occurred. I have a feeling in some areas they've pushed people out of hospital to keep the hospitals ready for the worse cases. A neighbour works in a hospice and she said her place and the local hospital do not have patients. So we need to look at the balance of avoiding sending people to hospital which could make it worse vs being in hospital with the virus. - Has this made the death rate worse than it could have been? - Has this made the care home issues worse as well? - How has this affected the accuracy of the reporting of deaths Testing, to me appears to be an absolute joke, I think they are defining tests as having taken the swabs and not processed it. (as the 40k of tests were home tests that had been sent out) I saw my nearest test station (Portsmouth) last Sunday, the only cars there were the people that worked there. I'm wondering what the hell the government has done to increase the actual capacity from taking the test to processing it. I feel this is being avoided in the media, we just hear we're doing X tests a day. Now I can understand if people are showing the common symptoms of covid-19, then testing isn't much help unless you want to know the strain etc. But if we're talking about people with mild symptoms that aren't on the government symptom list, then that's could be a big issue for the R value. The government only just updated that list yesterday. I had a slight cough and had breathlessness, my peak flow was around 650, doctor doesn't think it's asthma or covid, but then went on to talk about how his colleagues had mild symptoms and didn't feel right. The right thing would be to just test. Without testing we could be missing out on a lot of information that could shape how we respond to covid-19 in the following years. Personally I think it will be quite some time before we get a better understanding of the deaths. People will be needing to go through the death and medical records to understand why patient X died. My mum has a friend who father died out of the blue and it classed as covid, despite no symptoms. As for PPE, the government has failed, we've seen the interviews with suppliers who have been ignored by the government. It wouldn't be that hard to get someone to inspect items initially, then have it sent to some location for further distribution. Seeing hospitals wearing home made masks and 3d printed face shields isn't right, the NHS/government purchasing/logistics has failed here. The government should have taken a larger interest in the production and distribution of PPE early on, even having control over the export. I'm all for free market but we need some centralisation to know what we have and capacity to produce so we know it's going to the right areas.

DanBC 6y ago

> As of today, there have been 23,953 deaths in England. No. 1) The actual number is 34,796 https://coronavirus.data.gov.uk/ https://coronavirus.data.gov.uk/ 2) That only includes people who were tested positive for covid-19. That's only tests carried out by government labs, not private tests. We've only just started to include deaths that happened outside hospital. > Why weren't the Nightingale Hospitals (field hospitals) needed? Because we didn't transfer elderly people from care and nursing homes to hospital. We left them to die in those homes. Because we cancelled elective procedures, we converted operating theatres to ICUs, we changed nurse:patient ratios, to create surge demand. Because we didn't have enough ICU nurses to staff Nightingale:London. Of those, exactly 33(!) involve someone <= age 40 without a co-morbidity. Across all ages, 95%(!) of deaths are people with a co-morbidity, typically diabetes (26%). Why does this disease attack so many diabetic people? What should we do to best treat or prevent it in that population? [1]

zelos 6y ago
> Because we didn't have enough ICU nurses to staff Nightingale:London. I guess the idea was that military medical services would have moved in to run the Nightingale hospitals if things got really bad?
ageitgey 6y ago
You've confused England with the UK (England, Wales, Scotland and Northern Ireland).

niffydroid 6y ago

These are some very good points. I'm glad the Nightingale hospitals were not used, as they were set up if we had to scale response massively. But I think we really need to look at the deaths and where they occurred. I have a feeling in some areas they've pushed people out of hospital to keep the hospitals ready for the worse cases. A neighbour works in a hospice and she said her place and the local hospital do not have patients. So we need to look at the balance of avoiding sending people to hospital which could make it worse vs being in hospital with the virus. - Has this made the death rate worse than it could have been? - Has this made the care home issues worse as well? - How has this affected the accuracy of the reporting of deaths Testing, to me appears to be an absolute joke, I think they are defining tests as having taken the swabs and not processed it. (as the 40k of tests were home tests that had been sent out) I saw my nearest test station (Portsmouth) last Sunday, the only cars there were the people that worked there. I'm wondering what the hell the government has done to increase the actual capacity from taking the test to processing it. I feel this is being avoided in the media, we just hear we're doing X tests a day. Now I can understand if people are showing the common symptoms of covid-19, then testing isn't much help unless you want to know the strain etc. But if we're talking about people with mild symptoms that aren't on the government symptom list, then that's could be a big issue for the R value. The government only just updated that list yesterday. I had a slight cough and had breathlessness, my peak flow was around 650, doctor doesn't think it's asthma or covid, but then went on to talk about how his colleagues had mild symptoms and didn't feel right. The right thing would be to just test. Without testing we could be missing out on a lot of information that could shape how we respond to covid-19 in the following years. Personally I think it will be quite some time before we get a better understanding of the deaths. People will be needing to go through the death and medical records to understand why patient X died. My mum has a friend who father died out of the blue and it classed as covid, despite no symptoms. As for PPE, the government has failed, we've seen the interviews with suppliers who have been ignored by the government. It wouldn't be that hard to get someone to inspect items initially, then have it sent to some location for further distribution. Seeing hospitals wearing home made masks and 3d printed face shields isn't right, the NHS/government purchasing/logistics has failed here. The government should have taken a larger interest in the production and distribution of PPE early on, even having control over the export. I'm all for free market but we need some centralisation to know what we have and capacity to produce so we know it's going to the right areas.