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Angoose
27 Mar 20 12:30
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Date Joined: 18 Jul 02
| Topic/replies: 20,654 | Blogger: Angoose's blog
I didn't know, so I went and checked.
So, without checking yourself, would you like to hazard a guess as to either the annual total or the daily equivalent.
Pause Switch to Standard View How Many People Die Each Day In the UK
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Report HonkyJoe March 27, 2020 1:16 PM GMT
Flu is not a notifiable disease, unlike COVID-19.

That's true. But that's more of a technical distinction rather than a real one.   Most of the people who 'die' of the flu are dying primarily because of an underlying condition (or an immune system worn out by many years of being alive). It's just the case that the flu is the final thing that carries them off when they were close to death in any case.  The same is true of the Coronavirus deaths.

However, if you die of the flu, but have an underlying condition, the latter will usually be put down as the reason for death.  In contrast, if you have tested positive for CV, then the CV will be put down as the reason for death - even if, as with flu, the CV may have been no more than the final straw for your weakened system, and something else could easily have carried you off in a few months instead.
Report Angoose March 27, 2020 1:21 PM GMT
Someone posted an article by a senior retired doctor just yesterday that discussed that technical distinction.
What does appear to be measurable is the brutality of COVID-19, individuals requiring, on average, more time on a ventilator.

From Cuomo's press briefing yesterday:

COVID-19 patients average time on ventilator: 11 - 21 days (vs. 3 - 4 days for non-COVID-19 patients). "We have patients that have been 20 days 30 days on a ventilator. The longer you are on a ventilator, the more likely you are not going get off a ventilator"
Report HonkyJoe March 27, 2020 1:32 PM GMT
They do require more treatment. Although 90% of the ones on ventilators do go on to die. Basically, if you're really that sick, the ventilator probably won't help you.  I take your point, though.
Report GAZO March 27, 2020 1:35 PM GMT
are there any known lasting effects on people who recover ?
Report CLYDEBANK29 March 27, 2020 1:38 PM GMT
"are there any known lasting effects on people who recover ?"

This was a question asked on the Q+A to a medical practitioner.

The answer was if you had severe symptons then it was likely.
Report Angoose March 27, 2020 1:40 PM GMT
In reality, it is far too early to be able to provide definitive answers.
Report casemoney March 27, 2020 1:42 PM GMT
The lockdowns will Spread the spread , other than that there is no much can be done , Depending on Numbers I would expect an extension
Report HonkyJoe March 27, 2020 1:43 PM GMT
Gazo, if it was just me, and I didn't have to care about public opinion, I'd just send everybody under 60 back to work. I'd insist that the older people and those with serious underlying conditions were keeping themselves apart, and I'd wait for the virus to work its way through the population - which I think it would do within a couple of months. Plenty of people would get it, but most would fight it off.   Obviously I'd want to keep expanding hospital capacity - I might have to ration the use of ventilators, particularly for those over 80.  I might also insist on a ban (or a 14 day quarantine) on those flying in.   That wouldn't be popular, but it would keep the country ticking over, and I reckon we would mostly come back from it. Crucially, it wouldn't cause the sort of economic damage to the country that'll see many lives needlessly sacrificed in the future, and which will condemn the majority of us to a very much reduced quality of life.

If I did have to care about public opinion, though - and as soon as deaths starting coming in across Europe at the beginning of March, it should have been clear that this needed a proper solution that would 'fix' it and satisfy the press and public as well - then I hope I would have learnt the clear lessons coming out of the bundles of data emanating from Asia towards the end of February. It was fairly clear that we needed some sort of mass testing system similar to the one in South Korea. I've bored enough people on the forum with my ideas on this, but if you're really interested, see my post at 12:16 on March 25th on the 'How is a 3 week lockdown going to fix this' thread:

https://community.betfair.com/chit_chat/go/thread/view/94038/31636471/how-is-a-3-week-lockdown-going-to-fix-this#flvWelcomeHeader
Report casemoney March 27, 2020 1:47 PM GMT
I believe the Figures from London over the coming weeks will determine what plans are going forward  .....
Report casemoney March 27, 2020 1:53 PM GMT
I have been unwell for a few days were I in London  I would deffo say covid , the numbers are so low where I live , I doubt I have it , Never the less , We will follow the rules and the Mrs has self isolated , I have to wonder how many have been tested in some areas compared to others ???
Report CLYDEBANK29 March 27, 2020 1:54 PM GMT
Spectrum of illness severity — The spectrum of symptomatic infection ranges from mild to critical; most infections are not severe [31,33-38]. Specifically, in a report from the Chinese Center for Disease Control and Prevention that included approximately 44,500 confirmed infections with an estimation of disease severity [39]:

●Mild (no or mild pneumonia) was reported in 81 percent.

●Severe disease (eg, with dyspnea, hypoxia, or >50 percent lung involvement on imaging within 24 to 48 hours) was reported in 14 percent.

●Critical disease (eg, with respiratory failure, shock, or multiorgan dysfunction) was reported in 5 percent.

●The overall case fatality rate was 2.3 percent; no deaths were reported among noncritical cases.

According to a joint World Health Organization (WHO)-China fact-finding mission, the case-fatality rate ranged from 5.8 percent in Wuhan to 0.7 percent in the rest of China
Report CLYDEBANK29 March 27, 2020 1:56 PM GMT
That data would suggest to me that most patients who require a ventilator make it out the other side, but I'm not a medic
Report jollyswagman March 27, 2020 1:59 PM GMT
14% is pretty high, the worry is if the recovered have long term damage  -lung x rays on some of the chinese who were discharged werent great.

it really isnt like the flu.
Report Injera March 27, 2020 2:03 PM GMT
16 or 1700 deaths a day in the UK.

From the media and govt coverage it’s as if the only deaths each day are covid-19 ones.
Report ----you-have-to-laugh--- March 27, 2020 2:04 PM GMT
lockdown and social isolating has been vital

but was brought in far too late.


pity we go down the herd immunity route with flu, and spikes occur when
we vaccinate for the wrong strains

still, the government like to keep pension costs down, and the old fools
are easily foxed.
Report Angoose March 27, 2020 2:24 PM GMT
Highest daily totals so far for the UK, 2,921 positive tests and 188 deaths.
Report CLYDEBANK29 March 27, 2020 2:24 PM GMT
"14% is pretty high"

Sure but it's 14% of confirmed cases.  There will be more uncomfirmed cases than confirmed ones.  That's probably the main reason why the Wuhan death rate was so much higher than the rest of China.
Report CLYDEBANK29 March 27, 2020 2:32 PM GMT
That 14% is 4.26% if applied to the rest of China, and we don't know how many cases in the rest of China there were that weren't tested.  Severe cases would be 3.5% tops on that basis, and could be as low as 1%
Report HonkyJoe March 27, 2020 2:38 PM GMT
The Diamond Princess could act as a good proxy. Over 3,700 people - many of them rather, erm, advanced in years - stuck together in close confinement. They were basically left to fend for themselves.  In fact, only 10 of them have died.
Report HonkyJoe March 27, 2020 2:39 PM GMT
I will concede it's hard to remain calm when the figure jumps up by over half for two days in succession.
Report Angoose March 27, 2020 2:43 PM GMT
Sky misreported, 181 deaths today, 113 yesterday, and 43 the day before but that was just an 8 hour period.
Report jollyswagman March 27, 2020 2:45 PM GMT
115 active cases still on the diamond princess and 15 serious/critical - and it started over a month ago.
Report jollyswagman March 27, 2020 2:46 PM GMT
105 active
Report Angoose March 27, 2020 2:47 PM GMT
Here are the updated graphs for the UK.
Worrying beginning of trends on both.

Report HonkyJoe March 27, 2020 2:48 PM GMT
Most of them were high-risk, though, and valuable time was lost getting them medical help. A number had deteriorated quite severely before they were given the necessary assistance. Under the circumstances we should be expecting high casualties. So far the number of deaths has remained fairly low.
Report HonkyJoe March 27, 2020 2:50 PM GMT
After a week of treading water, it does look as though we're finally getting into the serious part.
Report jollyswagman March 27, 2020 2:50 PM GMT
if we had taken the appropriate response at the time we wouldnt be shutting the economy down now.
Report Angoose March 27, 2020 2:52 PM GMT
Yes, it does feel like the next couple of weeks will be grim.
Report treetop March 27, 2020 2:53 PM GMT
An interesting article in the Spectator about interpretation of death rates and how we record them in relation to this virus

www.spectator.co.uk/article/The-evidence-on-Covid-19-is-not-as-clear-as-we-think
Report HonkyJoe March 27, 2020 3:02 PM GMT
If the lockdown has its effect, we ought to see the death rate starting to drop beginning with the figures which will be released a week next Thursday. That is virtually a fortnight away though.
Report casemoney March 27, 2020 3:05 PM GMT
Could reach a thousand daily figure next week  ..... Hopefully not
Report jollyswagman March 27, 2020 3:08 PM GMT
lets hope not.

no one sane wants anyone to get it but the fact that the pm and health secretary have it may help concentrate the minds of the public.
Report treetop March 27, 2020 3:10 PM GMT
Fair comment swagger.
Report Angoose March 27, 2020 3:10 PM GMT

Mar 27, 2020 -- 4:02PM, HonkyJoe wrote:


If the lockdown has its effect, we ought to see the death rate starting to drop beginning with the figures which will be released a week next Thursday. That is virtually a fortnight away though.


From what we have seen regarding time spent on ventilators, it appears to be taking those in ICU a long time to die.

Also, the incubation period appears to be quite long.
For example, it was reported yesterday that Prince Charles likely was infected on March 15.

We haven't seen a decrease in either the new positive cases or deaths in either Italy or Spain, in fact they are still increasing.
And if you look at the chaos in the first few days of the UK shutdown, it's impact will be delayed.

Report HonkyJoe March 27, 2020 3:19 PM GMT
Italy's lockdown started just over a couple of weeks ago, so theoretically we should only be starting to see the effect working about now. In fairness, the number of deaths hasn't actually gone up from the high set last weekend, although it hasn't noticeably moved down either.

Spain declared their lockdown a few days after Italy, so we shouldn't expect to have seen much effect from that yet.
Report Angoose March 27, 2020 3:29 PM GMT
Yeah, Italian lockdown from 9 March, Spain and France from 14 March.
Report eyeball March 27, 2020 6:09 PM GMT
I don't believe the virus is anywhere as dangerous as it is portrayed . The article treetop put up is pretty accurate in my opinion . Iceland have a far better way of testing and their infection and death rates are probably nearer the mark . . it's not smallpox.....
Report breadnbutter March 27, 2020 6:20 PM GMT
Are people supposed to know the death rate from small pox? Its the RO numbers but even its the death rate by age group in for sars-cov2 will for some groups easily the same if not higher than smallpox, for some it will be on a par with ebola.
Report eyeball March 27, 2020 6:29 PM GMT
The testing does not give a true figure . You can't just test people who show symptoms and from that create an infection and/or death rate . Testing needs to be indiscriminate to give a better guess . It goes against any scientific study . Almost amateurish in approach . I am amazed .
Report breadnbutter March 27, 2020 6:46 PM GMT
Yea, in Scotland update today they raised the estimate of potential undiagnosed  cases from 50k to 65k, they have tested and this is a bit of a guess as can't find the number to check but sure it's around  8k, and 1k posative. But figures could be skewed cause prob only testing the ill or front line staff. Not sure you can do anything with the figures, they need to do random testing of the UK population, find out what they are dealing with.
Report breadnbutter March 27, 2020 6:55 PM GMT
Is that a total estimated in Scotland of 0.10%?    Seems very low, math not a strong point, along with English ect ect....no bad at growing spuds (no qualifications)
Report treetop March 27, 2020 7:48 PM GMT
Ordinarily I would agree about the need to do random testing to determine percentages bnb but when we have a shortage of testing kits globally we probably have to use whatever we do have for the immediate needs of front line staff,sadly. The spectator article leans towards a true figure closer to Iceland for fatality rates and seems accurate.
Report terry mccann March 27, 2020 7:53 PM GMT
500,000 die each year on average in England each year,do the maths and then why the lockdown,it don't make any sense to effect millions of peoples futures, yes killing our dieing but so they do any given year.
Report Angoose March 27, 2020 7:55 PM GMT
How many will die this year?
Report Coachbuster March 27, 2020 7:56 PM GMT
and you think COVID deaths  would be as low as 500,000 terry if left unfettered ? 

i thinks not
Report terry mccann March 27, 2020 8:01 PM GMT
Cant answer that Coach one way or another,can you really?
Report HonkyJoe March 27, 2020 8:10 PM GMT
That's the problem. We have no idea whether they would be a fraction of that number, or much higher. Perhaps after the frailest have gone, the rest will be left standing.  But perhaps they won't. Maybe the health service gets so overwhelmed that deaths go through the roof?  And maybe the virus mutates and switches to a much higher death rate.

The latter one, in particular, seems unlikely. But it will happen at some point. And that's why some argue that we should be prepared to take the hit, even if it sets the global economy back several decades.  At least humanity survives more or less intact..

If you load up a 1,000-barrel gun with bullets, and play Russian Roulette, you can be fairly certain that pressing the trigger won't kill you. But if you keep doing it, you can be 100% sure that at some point you'll blow your brains out!

Annoying argument for those of us who'd just like to let this play out, but the logic is hard to avoid..
Report Injera March 27, 2020 8:17 PM GMT
450 cancer deaths every day in the UK.
Report HonkyJoe March 27, 2020 8:25 PM GMT
May be more soon Injera. Quite a few cancer ops being postponed to make room for CV patients!   Not sure cancer will simply wait patiently while we get this other thing out of the way.
Report breadnbutter March 27, 2020 9:33 PM GMT
Thing is TT, the tests are pcr I think and looking for live virus, which if present should manifest with other symptoms, as there is no magic pill atm all we are doing is proving if someone has it that's already ill or saying to a front line worker that 3/4/5 days ago they were  OK. We need antibody test capability ASAP. What's the problem here?
Report Darlo Bantam March 27, 2020 9:44 PM GMT
If you read some of the science, some of those who recover are going to have to live with lung and heart conditions. There's more to this than deaths alone.
Report casemoney March 27, 2020 10:39 PM GMT
Italy has recorded its single biggest leap in coronavirus deaths, announcing that 969 people have died from Covid-19 in the past 24 hours.Cry

They thought them had Stemmed the Flow
Report casemoney March 27, 2020 10:41 PM GMT
What lays in wait for us Sad
Report TheBetterBettor March 27, 2020 10:46 PM GMT
Sky news has just broke down the numbers......

https://youtu.be/j220GrF8XZI

Took the numbers of natural deaths 'overlap' and came up with 6667 direct.covid 19 deaths
Report terry mccann March 27, 2020 10:49 PM GMT
Just stop and think about it.In the UK normal flu led to 15,000 deaths last year,16,000 deaths the year before,so on and so forth year in and year out....only 759 coronavirus deaths so far.Why have they then closed the whole UK down for that,its a pimple of the devils arse against other years.If they tell you over and over again a lie you in the end believe but why are they going it? Hmmm!
Report Angoose March 27, 2020 10:52 PM GMT
Where are you getting your 15k and 16k from ?
Report doantwin2easy March 27, 2020 10:53 PM GMT
are there any known lasting effects on people who recover ?

Can't remember the exact figure. Somewhere between 10-20% permanently diminished lung capacity. Presumably for those that have been through the mill.
Report HonkyJoe March 27, 2020 11:45 PM GMT
Angoose, the figures from 2014 to last year are on page 51 of this PDF:

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/839350/Surveillance_of_influenza_and_other_respiratory_viruses_in_the_UK_2018_to_2019-FINAL.pdf


Think it works out as an average of over 17,000 a year. Note how many of them are over 65..     Last winter (and also this winter just gone) were fairly light on influenza deaths, which might leave more to be whittled down by CV.
Report Angoose March 27, 2020 11:55 PM GMT
Cheers for that.
Quite a variation between years, that’s the seasonal nature I guess.
Report breadnbutter March 27, 2020 11:56 PM GMT
Weather
Report HonkyJoe March 28, 2020 12:44 AM GMT
It can depend on the effectiveness of the vaccinations as well. Different strains are in circulation, and sometimes they're the ones caught by the vaccination, and other years many of the strains will slip through the net. I think this year's vaccination managed to work against around half of all the common strains, which is partly why only a few thousand died from flu. I believe the same was true last year. Before that there were a few dicky years when the vaccinations often had a very low hit rate.
Report Just Checking March 28, 2020 1:30 AM GMT
Look Angoose why not call it quits and become an actuary? You LUV this subject and crunching numbers :)

Seriously, this stuff seems to draw you like a moth to a flame! You should do what you love, rule #1 for a happy life.

I'm not even sure if you get an actual degree in it? Probably but person I knew from Uni who went to be one, straight Maths.
Report Just Checking March 28, 2020 1:48 AM GMT
PS Death, reason for death, age of death, is obviously very highly stastically analysed already.
Everyone has an eye on that pie, insurance companies, health insurace, drugs companies, government.

I've looked at it a little before, a bit out of morbid curiosity, and because I want to live to 167 so I can be the oldest **** on chit chat.
Identifying the things most likely to kill you then avoiding them is not exactly a bad life strategy. Anyway..

What I found interesting (and depressing) is how various things peak and trough with age.
For males #1 is suicide when a bit younger with a bit of the old murder thrown in so Taggart gets re-runs, then after about 50 heart disease, then when above 90, murder again so Midsomer Murders can get reruns. (That last bit may not be true :)).

I still don't rule out topping myself, but I think it's unlikely as if I did .. who would Protect The Grail?
Report Coachbuster March 28, 2020 2:15 AM GMT
Terry ,well even if it wasn't 500,000  and say it was much less  ...that's still a lot of deaths for just one virus  .....

heart disease i think may be the biggest killer  but that and lung cancer is  within peoples court  to a large degree  ...but covid in a lot of ways discriminates a bit too much  .

you could  also say re economic benefits  ,well bring back cigarette smoking  ..that generates millions in tax revenue and is good for the economy Plain
Report Angoose March 28, 2020 9:09 AM GMT
So called "deaths of despair" have been on the rise in recent years and, I fear, unlikely to recede anytime soon.

The diseases of despair are three classes of behaviour-related medical conditions that increase in groups of people who experience despair due to a sense that their long-term social and economic outlook is bleak. The three disease types are drug overdose (including alcohol overdose), suicide, and alcoholic liver disease.
Report Injera March 28, 2020 9:52 AM GMT
Interesting goose. Ironic then that the government deemed offies as essential. I’m guessing more people are getting plastered every night to relieve boredom.
For every person who we see running or cycling during the lockdown, there are probably hundreds eating and drinking themselves to an even earlier death.

Have a good day everyone Grin
Report Darlo Bantam March 28, 2020 10:01 AM GMT

Mar 28, 2020 -- 1:44AM, HonkyJoe wrote:


It can depend on the effectiveness of the vaccinations as well. Different strains are in circulation, and sometimes they're the ones caught by the vaccination, and other years many of the strains will slip through the net. I think this year's vaccination managed to work against around half of all the common strains, which is partly why only a few thousand died from flu. I believe the same was true last year. Before that there were a few dicky years when the vaccinations often had a very low hit rate.


Flu vaccinations are a little bit of guesswork as the virus evolves and scientists have to evolve the vaccine as they predict will be the likely flu virus each year. Something like that anyway.

Report Injera March 28, 2020 10:03 AM GMT
“The number of excess winter deaths in England and Wales in 2017 to 2018 was the highest recorded (50 000) since the winter of 1975 to 1976. However, peaks like these are not unusual – we have seen more than eight peaks during the last 40 years. It is likely that last winter’s increase was due to the predominant strain of flu, the effectiveness of the influenza vaccine and below-average winter temperatures”.

ONS.
Report elisjohn March 28, 2020 10:04 AM GMT
talking above about drugs, ive just been for a nice 45 mins stroll, hardly anyone about town, then a fight outside the chemist, around 20 druggies with their dogs, it seemed one had tried to jump the orderly queue, why was there  no police there?, throughout the last 2 weeks ive seen less police on the street than before (and then they were scarce)
Report Angoose March 28, 2020 10:43 AM GMT
Updates to this chart will become widely discussed during the next few months, so stand by your beds.

Report lurka March 28, 2020 11:39 AM GMT
The flu doesn't have the capability of overwhelming a health service. If it did the death rate would be much higher and restrictive measures would have to be taken every year to avoid that and to protect the most vulnerable.

The death rate from coronavirus disease could well end up being lower than flu, ie a less potent disease than flu. But as it is a new virus, it has the capability of overwhelming a health service, in fact it is almost guaranteed to do so, and for as long as that continues it is anticipated that the death rate will be a lot higher than flu. That won't be the case for very long though, once a vaccine is available and immunity is built up it will no longer have the capability of overwhelming a health service and will be treated the same as flu is. The goal is to minimise the period that the health service is overwhelmed and in doing so minimise the period that the death rate jumps to a much higher level than flu. The measures being taken are not in reaction to the current death rate, they are being taken in anticipation of a much higher death rate which is virtually guaranteed for a period.

People seem to be unable to get their heads around this simple concept and think that comparing the current death rate to that of flu is relevant. It is not and won't be until about winter 2021 when neither disease will require restrictive measures and both will have a vaccine and immunity within the population.
Report Darlo Bantam March 28, 2020 11:44 AM GMT
The flu doesn't have the capability of overwhelming a health service.

That's not entirely true. It just doesn't have the same capability. Couple of years ago patients were waiting many, many hours in hospital corridors due to the demand on the NHS because of winter pressures particularly flu.
Report Angoose March 28, 2020 11:51 AM GMT
Would be interesting to see an addition line on here that shows seasonal flu.

Report Angoose March 28, 2020 11:51 AM GMT
Additional line ....
Report Darlo Bantam March 28, 2020 11:57 AM GMT

Mar 28, 2020 -- 12:51PM, Angoose wrote:


Would be interesting to see an addition line on here that shows seasonal flu.


Here's a very timely piece, which albeit doesn't answer that question, does go into the impact on capacity of ICU beds on flu and pandemics. Was published only last October; with a nice line in the opening paragraph of the abstract "Despite this knowledge, we remain largely underprepared for when the next major pandemic occurs."

https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2616-1

Report lurka March 28, 2020 12:00 PM GMT
Fair enough Darlo, but was that predictable or virtually guaranteed?
The most fundamental job of any government is to protect its people and when you have data from other countries showing where you might be in 2 weeks you have no option but to act.
Do people honestly think that governments all over the world are building new temporary hospitals, fighting for medical equipment and locking down entire economies for something comarable to the flu? For as long as it remains without immunity and a vaccine it is simply not comparable to flu is my point.
Report Injera March 28, 2020 12:03 PM GMT
Two hospitals have become so overrun with patients over the last few days they were forced to declare a state of emergency, it has been revealed. The A&E departments of Gloucestershire Royal and Cheltenham General hospitals have a massive backlog of patients due to long waiting times and lack of bed space. The circumstances in the hospitals at the weekend became so dire that patients allegedly took matters into their own hands after waiting for hours to be seen by medical professionals.

5-1-2015

https://metro.co.uk/2015/01/05/two-hospitals-declare-a-state-of-emergency-after-ae-departments-are-overrun-with-patients-5009898/

The total number of NHS hospital beds in England, including general and acute, mental illness, learning disability, maternity and day-only beds, has more than halved over the past 30 years, from around 299,000 in 1987/88 to 141,000 in 2018/9, while the number of patients treated has increased significantly.Shocked 

https://www.kingsfund.org.uk/publications/nhs-hospital-bed-numbers

The strain is at times unbearable. Is the real problem, the lack of capacity, not any one crisis?
Report Darlo Bantam March 28, 2020 12:05 PM GMT
Not sure. Every flu season is different, some much worse than others, and the demands very different to the one we're seeing now. I'm not an expert on the demands of hospitals, but I'd say they're much shorter term due to flu outbreaks than this pandemic outbreak.

We have daily demands from a variety of reasons and many of those are not going to go away quickly, some will be virtually non-existent right now.
Report Darlo Bantam March 28, 2020 12:05 PM GMT
it is simply not comparable to flu is my point.

100% correct here though.
Report HonkyJoe March 28, 2020 12:07 PM GMT
Two years ago the US was overwhelmed by the flu, and there were various reports of medics have to administer emergency medicine to lots of patients in car-lots, just because the hospitals were being overwhelmed.  Nobody was following this in any great detail. Many other epidemics were causing big problems. Again, hospitals were being overwhelmed, but few were publicising the fact.

But, as Lurka and others on here have pointed out, CV does seem to place demands on hospitals that the others don't. Of course, that in itself raises a few questions. I'd like to know if there's any truth in that report this week that around 90% of the CV patients who go on to ventilators will die in any case. If that figure's anything like the truth then wouldn't it be best just to do away with the ventilators? That would be tough on the 10% who would have survived, but it would presumably lead to a massive lightening of the caseload and resources, and could well end up saving far more lives overall.
Report Injera March 28, 2020 12:11 PM GMT
Is CV posing greater challenges because hospitals the world over operate too close to their limit?

We know the waiting times for hips, knees and A & E are far from ideal, to say the least.....
Report GoBallistic March 28, 2020 12:15 PM GMT
"...report this week that around 90% of the CV patients who go on to ventilators will die in any case"

what report ? which country ?
Report Angoose March 28, 2020 12:17 PM GMT
Medical science is, in some regards, it's own worst enemy.
The more advances that are made, the more treatments that become available, the greater the resources required to provide those treatments.

It creates an enormous economic, moral, and ethical dilemma.
You can create a valid medical case for spending a higher and higher proportion of GDP om the health service.
Report HonkyJoe March 28, 2020 12:17 PM GMT
I'm trying to find it. Unfortunately I've read so much in the last week that it could be one of hundreds of articles!    I think it may have been an American specialist, and it might have been anecdotal.   But I definitely read the figure as only 10% surviving...
Report GAZO March 28, 2020 12:23 PM GMT
the governor of new york did say something about if you are on a ventilator over a certain amount of days (cant remember how many he said) you probally are not getting off it
Report Angoose March 28, 2020 12:24 PM GMT
New York State Gov. Cuomo press briefing:

- COVID-19 patients average time on ventilator: 11 - 21 days (vs. 3 - 4 days for non-COVID-19 patients). "We have patients that have been 20 days 30 days on a ventilator. The longer you are on a ventilator, the more likely you are not going get off a ventilator"
Report HonkyJoe March 28, 2020 12:28 PM GMT
I think it was from this Spectator article:

https://www.spectator.co.uk/article/herd-immunity-might-still-be-key-in-the-fight-against-coronavirus

The relevant paragraph is:

'Some have suggested that using that delay to increase life support capacity (i.e. sourcing mechanical ventilators) in hospital intensive care units could help. Sadly, preliminary (and limited) data suggests that up to 90 per cent of Covid-19 patients who go on life support will die. So ‘more ventilators’ does not seem like the game-changer we seek. As a life support specialist, myself, I am greatly chagrined to admit this.'


It's a good article, and the chap seems to know his onions. But that bit is annoyingly vague. The phrase 'up to' could mean anything, and he doesn't say what data he was going on.
Report Angoose March 28, 2020 12:32 PM GMT
At this stage, it can only be but vague and the study he refers to, whilst published in The Lancet, is based on data coming out of China.
Report GoBallistic March 28, 2020 12:35 PM GMT
Thanks

The only report I've seen which goes into ICU cases was this one from the first covid patients in this country to go into ICU
.
https://news.sky.com/story/coronavirus-first-analysis-reveals-trends-in-uks-critical-cases-11962457

Small numbers.  17 recovered, 16 died, 163 still in ICU.  About 75% were on a ventilator
Report Angoose March 28, 2020 12:40 PM GMT
Covid-19’s mortality profile is peculiarly age-specific. Bird flu, swine flu, SARS and MERS outbreaks were all equal-opportunity killers. They showed no mercy to the young and healthy. This does not seem to be the case with Covid-19. The crude mortality data from China by age points us in this direction:

Again, only Chinese data, but the general point does appear to be relevant.
More data required though to get some useful actions out of it.
Report HonkyJoe March 28, 2020 12:41 PM GMT
Thanks Angoose. (I read it thoroughly earlier this week, but only skimmed it for the relevant bit today.)

You would think they've got enough data from China (and other more trustworthy parts of Asia!) that moderately reliable statistics could be created. How many people were put on ventilators? And of those, how many were still alive after 10 days, 20, days, 30 days, 45 days etc. And how many of those went on to recover and be taken off the ventilator again.

Obviously little can be truly definitive at this stage, but I don't think we can really afford to wait months for 'definitive'. If there's any suggestion that the figures are likely to be pushing on 85-90% then that's probably something that should be considered. I wonder if there's any more info in the Lancet article itself.
Report Angoose March 28, 2020 12:43 PM GMT
It's definitely a well balanced article, here is the closing section.

I am glad that extreme social distancing has been enforced. I do not think that either the young or the old would have taken the pandemic seriously until they saw schools and offices close.

But once these measures have proven their effect, and the virus is demonstrably suppressed, public health authorities could consider ratcheting restrictions down in a way that respects demographic vulnerability.

Perhaps two weeks from now, healthy people under 40 could return to work provided that they have no vulnerable people in their household.

Perhaps a week after that, healthy people aged 40-50 could join them, and nurseries could reopen.

I have discussed this strategy here as a matter of consideration for ongoing public health conversations.

I absolutely do not raise it for personal decision-making.

Whether or not you are convinced of this reasoning, you do not have license to disobey public health pronouncements in your jurisdiction.

But maybe, just maybe, once all the data is in and things are under control, this could be our collective way out of here.

Matt Strauss is the former medical director of the critical care unit at Guelph General Hospital, Canada. He is now an assistant professor of medicine at Queen’s University.
Report Darlo Bantam March 28, 2020 12:45 PM GMT

Mar 28, 2020 -- 1:17PM, Angoose wrote:


Medical science is, in some regards, it's own worst enemy.The more advances that are made, the more treatments that become available, the greater the resources required to provide those treatments.It creates an enormous economic, moral, and ethical dilemma.You can create a valid medical case for spending a higher and higher proportion of GDP om the health service.


Can't find the exact figures but I think if you equated ventilators to stealth bombers, the US could quintuple its number of current ventilators right now.

Report Angoose March 28, 2020 12:49 PM GMT
For despot dictators, ventilators are a sign of weakness, stealth bombers a sign of strength and virility Sad
Report Angoose March 28, 2020 12:50 PM GMT
Ultimately, the cost per aircraft weighed in at 2.1 billion dollars per aircraft as the B-2 was perfected in 1997. Here are reason Why Does the B-2 Spirit Stealth Bomber Cost $2 Billion. So the Defense Authorization Act and Congress authorized 20 B-2’s for $44.65 Billion, or 2.2 Billion each.
Report Angoose March 28, 2020 12:53 PM GMT
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Report HonkyJoe March 28, 2020 12:55 PM GMT
There's no real case for spending lots to have a great excess of equipment that you mostly won't need. The key is whether you spot these things coming along, and then put into action a plan for expansion. In fairness to our government and the NHS, they do seem to have done a good job there.

Simon Stevens, the Whitty-stand-in for yesterday's press conference, was saying that in one month they had freed up the equivalent of 50 hospitals.  (Boris, in his election campaign, had claimed he would build just 40 hospitals over ten years.)  That scale of expansion is pretty impressive.
Report Darlo Bantam March 28, 2020 12:57 PM GMT

Mar 28, 2020 -- 1:49PM, Angoose wrote:


For despot dictators, ventilators are a sign of weakness, stealth bombers a sign of strength and virility


Yes unfortunately.

Report HonkyJoe March 28, 2020 12:58 PM GMT
I'm reminded of The Great Dictator..
Report Darlo Bantam March 28, 2020 12:59 PM GMT
There's no real case for spending lots to have a great excess of equipment that you mostly won't need.

Supposedly, fewer than half of the US's stealth bombers are in a position to be even flown. So no difference on that side of the scales anyway.
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