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Corona please read very important

Discussion in 'The Bar' started by dougs, Mar 15, 2020.

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  1. mally United Kingdom

    mally Well-Known Member

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    As I mentioned earlier my Mrs works in a&e and tels me the vast majority of the patients she has seen with Covid19 are elderly >75 plus with other underlying issues. Out of the 20 or so she has seen, all but a couple have been DNR'd (do not resuscitate) - down to health/nedical reasons not patient choice. Out of an icu of 30 beds, about 10 are being used by Covid patients although not all on ventilators. Other Covid patients are in high dependancy units. The annoying thing she finds is its still taking upto 4 days to get Covid test results back although that's just changed having received a machine that was approved yesterday that does the tests in 45 minutes on site (not sure how many it can do or if it's one after the other).

    She tells me it's getting busier but there's still plenty of space (north east England)
     
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  2. Domain Forum

    Acorn Domains Elite Member

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    articles.co.uk
     
  3. bonusmedia

    bonusmedia Well-Known Member

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    I can't honestly tell you what I would say because I don't know. I imagine it would be very difficult and I would probably be angry about it. I do know those decisions have not been made lightly.

    I can honestly tell you that I'm worried about my mum and her school, and I'm worried about my brother and his partner who are ill, and I'm worried about my very elderly grandparents who can't be isolated. My grandma has Alzheimers and my mum is not even able to give her a hug, it's heartbreaking.

    The NHS has always had to make difficult decisions about how to allocate limited resources - e.g. whether to fund a cancer drug with a low chance of success. The National Insitute for Health and Care Excellence makes those decisions on the basis of QALYs - Quality of Life Years. Those decisions are never popular because they always involve choosing one life over another. They generally make them on the basis of the greatest good for the greatest number (utilitarianism). I honestly believe that's what they're trying to do now.

    I agree the economic consequences are very serious. We're still in the early stages of this. Let's look at how it progresses over the next few weeks, let's find out what impact lockdown is having. They are collecting data like our lives depend on it (because they do) and that will allow us to make better informed decisions as time goes on.
     
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  4. LCHappy United Kingdom

    LCHappy Active Member

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    It is a scary time for all @bonusmedia that is for sure. We are going to look back in a year or two and have a few more answers. I hope that they are being cautious. I honestly don't know, I do hope that someone is filming one of those behind the scenes documentaries in Downing Street.
     
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  5. LCHappy United Kingdom

    LCHappy Active Member

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    This one is doing the rounds today. I don't know what to make of it. It is a genuine quote from the Gov website

    https://www.gov.uk/guidance/high-consequence-infectious-diseases-hcid

    "As of 19 March 2020, COVID-19 is no longer considered to be a high consequence infectious diseases (HCID) in the UK.

    The 4 nations public health HCID group made an interim recommendation in January 2020 to classify COVID-19 as an HCID. This was based on consideration of the UK HCID criteria about the virus and the disease with information available during the early stages of the outbreak. Now that more is known about COVID-19, the public health bodies in the UK have reviewed the most up to date information about COVID-19 against the UK HCID criteria. They have determined that several features have now changed; in particular, more information is available about mortality rates (low overall), and there is now greater clinical awareness and a specific and sensitive laboratory test, the availability of which continues to increase.

    The Advisory Committee on Dangerous Pathogens (ACDP) is also of the opinion that COVID-19 should no longer be classified as an HCID.

    The need to have a national, coordinated response remains, but this is being met by the government’s COVID-19 response.

    Cases of COVID-19 are no longer managed by HCID treatment centres only. All healthcare workers managing possible and confirmed cases should follow the updated national infection and prevention (IPC) guidance for COVID-19, which supersedes all previous IPC guidance for COVID-19. This guidance includes instructions about different personal protective equipment (PPE) ensembles that are appropriate for different clinical scenarios."
     
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  6. Admin

    Admin Administrator Staff Member

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  7. BREWSTERS United Kingdom

    BREWSTERS Well-Known Member

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    See post #393
     
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  8. LCHappy United Kingdom

    LCHappy Active Member

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    Arr yep, good spot. It's finally got some traction on twitter. Lots of people asking about it, nobody can explain it.
     
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  9. bonusmedia

    bonusmedia Well-Known Member

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    I can tell you what I make of it: This is technical guidance aimed at professionals. As you can see on that page there are specific criteria for a disease to classified as HCID:

    Definition of HCID
    In the UK, a high consequence infectious disease (HCID) is defined according to the following criteria:
    • acute infectious disease
    • typically has a high case-fatality rate
    • may not have effective prophylaxis or treatment
    • often difficult to recognise and detect rapidly
    • ability to spread in the community and within healthcare settings
    • requires an enhanced individual, population and system response to ensure it is managed effectively, efficiently and safely
    As it says in your quote, we now know that the fatality rate is relatively low in these terms. Even if it turned out to be 5%+, that's considered relatively low for these purposes. Diseases such as MERS and Ebola had much higher fatality rates, 50%+.

    However, those other diseases present very obvious symptoms, those who got them could not move about and infect others, most of them died fairly quickly, there were no asymptomatic cases. A disease with a low mortality rate but a much higher infection rate is a much bigger threat.

    We are also now able to detect it rapidly, we have effective tests, so it no longer meets two of those criteria.

    Again as it says on the page, this classification affects things like what standard of PPE is required. Eg for Ebola, everyone had to be in full hazmat gear.
     
    Last edited: Apr 3, 2020
  10. Admin

    Admin Administrator Staff Member

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    @bonusmedia a barrage of NHS posters every 4 minutes is a bit much, thank you.
     
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  11. BREWSTERS United Kingdom

    BREWSTERS Well-Known Member

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    To be classed as a HCID, it doesn't need to match all those criteria. As you correctly state, CV doesn't match the two you've highlighted. So we can assume that because CV is downgraded and no longer (since 19 Mar 20) classed as a HCID...then it doesn't match any of the criteria.
     
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  12. bonusmedia

    bonusmedia Well-Known Member

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    You've just made that up. Why?
     
  13. BREWSTERS United Kingdom

    BREWSTERS Well-Known Member

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    I'll let everyone else read it and decide if it makes sense to them.

    Are you saying that to be a HCID, it needs to match all the criteria? Because if so you're previous statement on it is wrong.
     
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  14. bonusmedia

    bonusmedia Well-Known Member

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  15. bonusmedia

    bonusmedia Well-Known Member

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    No.

    "To be classed as a HCID, it doesn't need to match all those criteria"

    Why would you say that when it isn't true?
     
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  16. bonusmedia

    bonusmedia Well-Known Member

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    "So we can assume that because CV is downgraded and no longer (since 19 Mar 20) classed as a HCID...then it doesn't match any of the criteria."

    No, we cannot, because that would be a ridiculous, utterly illogical assumption
     
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  17. LCHappy United Kingdom

    LCHappy Active Member

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    https://www.ecdc.europa.eu/sites/de...s-of-high-consequence-infectious-diseases.pdf

    Source: ECDC HCIDs constitute serious human health threats (Table 1). Patients with such diseases typically develop severe symptoms and require a high level of care. Moreover, the case-fatality rates can be high. Several HCIDs are transmissible from person to person and therefore require healthcare workers to take precautions to prevent transmission [10]. HCIDs may be airborne or can be transmitted via droplets that become airborne under certain conditions (e.g. in the case of secondary aerosolisation.) According to a classification used by Public Health England (PHE) and the UK’s National Health Service (NHS), an HCID has some or all of the following characteristics:

    • Acute infectious disease;
    • Typically, a high case-fatality rate;
    • May not have effective prophylaxis or treatment;
    • Often difficult to recognise and detect rapidly;
    • Ability to spread in the community and within healthcare settings;
    • Requires an enhanced individual, population and system response to ensure it is managed effectively, efficiently and safely [11].
     
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  18. BREWSTERS United Kingdom

    BREWSTERS Well-Known Member

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    Again, are you saying that to be classed as a HCID, it needs to match all the criteria?
     
  19. bonusmedia

    bonusmedia Well-Known Member

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    I stand corrected. The fact remains that it is no longer classified as such because it no longer meets all the criteria, as explained in the quote LCHappy posted.

    I jumped to the conclusion it had to meet all criteria. You have jumped to the conclusion that it no longer meets any criteria.
     
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  20. BREWSTERS United Kingdom

    BREWSTERS Well-Known Member

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    Huh, you're really not getting it are you...

    "an HCID has some or all of the following characteristics: "

    If it met any of the criteria it would still be a HCID!
     
  21. Murray

    Murray Well-Known Member

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    I don't know if the following is true, but I can believe it

    I read that it's no longer classed as such because when this is all over, families would have more ammunition to sue if their loved ones were working and not giving the right level of protective gear for that level of threat
     
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