Covid 19 Part XXIV-37,063 ROI (1,801 deaths) 12,886 NI (582 deaths) (02/10) Read OP

Always_Running · 30-09-2020 01:01AM

HSE Daily operations update

In hospital 117 (increase of 3)
In ICU 18 (increase of 1)

Last Tuesday it was 94 in hospital and 16 in ICU.

Connacht hospitals still has the least for covid cases, from 4 cases last week to only 2 covid cases in Galway,Mayo and Sligo hospitals now.

quokula · 30-09-2020 01:02AM

douglashyde wrote: »

No, but some laterally / creative thinking is needed. Pareto law principle.

- Ship N95 masks to every person over the age of x.
- Statistical analyse and identify conditions that lead to comorbidity alongside CV19 and apply guidelines to them - give them all financial benefits / protections / distance learning as required.
- Put stringent and regimented systems in nursing homes (rapid testing) / week on week off shift work / staff/patient pods.
- As previous poster suggested - Deploy health care workers who've had the disease to higher risk patient hospitals.
- Assign 2-3 hours of the day for shopping / recreational use for at risk people.
- Continue the use of clean hospitals like the Beacon (where no CV19 are present)

I'm not accepting rebuttal to these above points , they are just some random thoughts and I'm sure there is problems.

On a separate point, if the Case Fatality of this virus actually is .1-.2% range as seems now to be the case, I'd argue that even a lot of the above would not be needed.

If you let the virus run rampant then how would it be possible to somehow suppress it for 2 - 3 hours per day while all the at risk people come out and go shopping? That makes no sense. It would also be impossible to designate a COVID free hospital as they can’t stop the virus at the door. Same goes for nursing homes.

The relatively low levels of the virus we’re seeing right now is because of the various restrictions. If you let it go exponential again we’ll be quickly overrun, as we saw happened in Italy, or the mass graves from Iran to New York. The only way to play this is to keep the numbers low through restrictions, there’s a reason why every single competent government in the world with expert advisors available to them have decided to do this.

ArthurDayne · 30-09-2020 01:07AM

Deleted User wrote: »

The current attempt at shielding is based on the rest of society obiding by the present restrictions. If there was to be a return to normality for the non vulnerable the current shielding protocols would no longer be sufficient to protect the vulnerable as you would be intentionally allowing for a substantial increase of the prevalence of the virus in general society.

Yes, but the point is that that the abiding of society by the present restrictions is not a long term viable strategy because there are other important ethical and socioeconomic problems which are going to fester. For example, and this is just one out of a entire slew of examples, we have to appreciate that we are currently subjecting young people to unprecedented suppression of their opportunities, education and development. Something has to give — we need balance.

Nobody is talking about a return to “normality”. It is almost unconceivable that those living with vulnerable people will simply abandon hygiene and protective protocols. If the virus is circulating widely through the low risk population, then yes, this makes it more likely that infection will slip through nets — but it doesn’t change the practical aspect of what vulnerable people and those living with them should be doing already. As I have said, I hold my hands up and concede that this all increases the likelihood of at least some further deaths than would otherwise be the case, but those searching for an ethically pure way out of this crisis could spend a lifetime failing to find it.

Yes, there will be impracticalities — but the answer to addressing impracticality has never been to apply impracticality universally to all other things to make it seem more fair.

The_Brood · 30-09-2020 01:09AM

What are people's thoughts on the fact that China, the world's most populous country, hasn't had domestic cases for a month now and their life and economy is completely back to normal?

Should there not be a recognition then that Europe and the US are abysmal failures in how their populations function?

Some kind of lecture I await to hear about how monstrous it would be to lose 20% more freedoms than what we already lost during the lockdown and partly now....and not losing that is worth all these months, soon to be year(s?) of ruin and misery?

Because we are too stubborn for 2-3 weeks of total lockown we accept potentially years of ruin and misery. And we think that's a good deal and accept it. How.

douglashyde · 30-09-2020 01:10AM

Deleted User wrote: »

As you are not accepting rebuttal, I'll leave it at that.

But in relation to your separate point the case fatality rate will be liable to rise sharply once a health service cannot provide treatment to all patients. 0.16% of the entire population of Lombardy died, 100% of the population did not catch the virus.

My point is that creative/targeted thinking is needed, not blunt force shut down. Refute that all you like

Italy had a significant infiltration in older people and those with underlying health conditions - their own prime minster said this. All the more reason targeted & aggressive intervention is needed.

Also, there was almost no testing happening in Italy in March when this happened so we have no idea what an accurate CFR for Italy in March actually was.

douglashyde · 30-09-2020 01:15AM

quokula wrote: »

If you let the virus run rampant then how would it be possible to somehow suppress it for 2 - 3 hours per day while all the at risk people come out and go shopping? That makes no sense. It would also be impossible to designate a COVID free hospital as they can’t stop the virus at the door. Same goes for nursing homes.

It would be 2-3 hours only designated to those at risk, i.e. separate those not a risk from those. They've already done this to some degree. I'm not sure what doesn't make sense to you.

COVID Free hospitals already exist - The beacon hospital do this now.

*no idea is perfect, obviously

douglashyde · 30-09-2020 01:20AM

quokula wrote: »

The relatively low levels of the virus we’re seeing right now is because of the various restrictions. If you let it go exponential again we’ll be quickly overrun, as we saw happened in Italy, or the mass graves from Iran to New York. The only way to play this is to keep the numbers low through restrictions, there’s a reason why every single competent government in the world with expert advisors available to them have decided to do this.

In March, April the Case Fatality Rate was reported at 3.5%-ish - with the media saying up to 25%.

It's been revised downward ever since.

The point is; governments are reacting based on old data. As is the way with governments they slow to react, but I have no doubt they will react.

I have faith that by January we won't have rolling on/off lockdowns and a more pragmatic approach (social distancing, masks, hand washing) with targeted intervention for those at risk.

quokula · 30-09-2020 01:28AM

douglashyde wrote: »

It would be 2-3 hours only designated to those at risk, i.e. separate those not a risk from those. They've already done this to some degree. I'm not sure what doesn't make sense to you.

COVID Free hospitals already exist - The beacon hospital do this now.

*no idea is perfect, obviously

Ok, let’s say I’m 25 years old and have diabetes. Or I’m 35 and have asthma. Or I’m 75. Or I’m a healthy 40 year old but I’m caring for my elderly mother at home.

The country has followed your advice, the virus is now rampant across the country, hundreds of thousands of people have it, we’ve miraculously kept it to healthy people so only 0.1% of them have died, so that’s only a few hundred grieving families, no big deal.

Meanwhile I’m locked up for my designated 21 hours per day, waiting for my alarm to tell me I can go out and get food. Every surface in the supermarket has virus on it. The supermarket staff probably have the virus. But it’s between 8am and 11am so you’ve decided it’s safe for me to go and do my shopping, and we’ll just tell the virus not to infect anyone during those hours.

I’m not convinced that plan will work.

COVID free hospitals exist now because of the measures were taking now. If you let the virus run rampant, it won’t decide to stop at the door of the beacon.

bb1234567 · 30-09-2020 01:33AM

douglashyde wrote: »

In March, April the Case Fatality Rate was reported at 3.5%-ish - with the media saying up to 25%.

It's been revised downward ever since.

The point is; governments are reacting based on old data. As is the way with governments they slow to react, but I have no doubt they will react.

I have faith that by January we won't have rolling on/off lockdowns and a more pragmatic approach (social distancing, masks, hand washing) with targeted intervention for those at risk.

The media never said 25% of people who got it died. Well I never heard it anyway.
And the CFR was 3.5% globally at the time , that wasn't a made up number, as more testing was done this figure changed. Youre acting like you've found out some secret information. Anyone should be able to figure out that the original CFR would have been exaggerated due to mild infections not being registered.

quokula · 30-09-2020 01:41AM

bb1234567 wrote: »

The media never said 25% of people who got it died. Well I never heard it anyway.
And the CFR was 3.5% globally at the time , that wasn't a made up number, as more testing was done this figure changed. Youre acting like you've found out some secret information. Anyone should be able to figure out that the original CFR would have been exaggerated due to mild infections not being registered.

This. The experts are totally aware that the CFR is reduced with higher testing coverage. That doesn’t change the fact that if infections get out of control, hospitals can and will be overrun and the death count will shoot up. We know this because it happened anywhere that didn’t lock down quickly enough. The virus hasn’t changed and we haven’t found a cure. Social distancing is still by far the best weapon at our disposal and the restrictions being implemented here and in other countries are the only thing stopping it getting out of control again.

Renjit · 30-09-2020 01:56AM

Deleted User wrote: »

And with Britain being more densely populated than Ireland you'd have to say they are doing better than us currently.

Be grand!

Goldengirl · 30-09-2020 02:44AM

Agree quokola .

Also in reply to the 2 posters, one of whom doesn't want rebuttal, you are getting it anyway !

Some " creative thinking" , do you not think a lot of this is being done , without boardsies suggestions already ?

Agree re n95 masks for vulnerable. Add AND carers .

Special shopping times in place already. Noone enforcing this . What do you suggest about this issue ?

Covid free wards and areas and hospitals have been deployed since the start . Or do you think hospitals just mix all patients up for the craic?

How long do you think any area will stay Covid free without rigorous testing and ensuring community transmission is kept low ?

To the beaut who suggested redeploying HCW s to care of vulnerable and burning the unions ? ? Ffs !

Staff all over the health service have been redeployed to different areas from the start of this due to Covid / non Covid areas , with no argument given by them or by unions , thank you .

By the way this is not the first time I have read stuff about this on the thread so addressing it now .

Nursing staff have found out on the morning of duty that their area has been closed , either due to Covid , or due to some managers idea of Covid and have been sent to work somewhere else .
In one case an entire children's hospital has been closed ( CHI Tallaght ) with staff turning up for duty on the Monday to find out that they were redeployed to Crumlin or Temple St .! Lovely

Nurses have stayed in BnBs or hotels because there are vulnerable members in their families and they cannot get relocated to non Covid areas .
Or they have self isolated from their families husbands and children , for their entire working time with Covid .

Nurses have had to pay large sums for private childcare to cover 12 hour shifts if they could get it or take unpaid leave if they were allowed , when both parents were essential workers , when creches were closed and grandparents were cocooned , and NOONE wanted to take the risk of minding those children . That went on all through lockdown and until creches opened up .

Nurses have their own vulnerabilities but because not deemed " high risk "can be put " at risk " working in Covid areas .

Healthcare workers who have had Covid , some of whom have recovered , some haven't , are not automatically immune , as immunity is not guaranteed and indeed may only last a couple of months, as far as we know yet , so redeploying them is stupid and a waste of resources.
If you transfer experienced ICU or theatre staff or Cardiology nurses to elderly care , do you transfer HCW s experienced in care of the elderly to ICU or Paeditrics or cardiology ?

I think you have to at least try to understand that it is just not as simple as moving people around .
And these comments are when we have all heard how many staff it takes to open just one ICU bed !

Finally , in no other essential job would you have any Joe Soap telling management to treat their workers like this , without an outcry , which is essentially what some of you are doing here , and these are workers who have been working and doing their best along with a lot of other essential workers throughout this whole bloody mess.

Everybody thought it was right when some retail staff got an extra 10% for working through lockdown .
Yes it was right .
We have got nothing except the satisfaction of knowing we did our best and that some sections of the community appreciate that .
I have seen posts here begrudging the clapping for healthcare staff even .

Don't scapegoat nurses .
Aim your fire elsewhere please .

spookwoman · 30-09-2020 03:31AM

polesheep wrote: »

You try to make out that young people are snatched in their prime by Covid, but the truth is if you are so vulnerable in youth that you can be carried off by Covid then you were very unlikely to make it to a ripe old age ..Covid or no Covid. Spin it whatever way you like but young, uncompromised people do not have to worry about dying from Covid. And now you've sneakily moved the goalposts to age 65. Don't think I haven't noticed

Just remove 77 which is 55-64 age group to make you happy, I said earlier that I did not see 45-54 as old.
How do you know that these "young" people would not have lived to a "ripe old age", do know their medical history and are you a medical expert?. Just because someone may have health problems does not mean they cannot live a full and productive life and life to a "ripe old age". The truth is you seem to lack empathy or understanding of other people's lives and I hope you never have a child that would be "vulnerable" with your views.

Happydays2020 · 30-09-2020 04:33AM

Goldengirl wrote: »

You are expelling a lot of ...air here
Patients in ICU are expelling high viral loads within aerosols because of procedures like intubation, suctioning , physio etc .
Much worse than any normal person breathing or even coughing .
Very high risk .

Thanks for the education. While you took aim at me, the underlying point of my response was that staff in all areas should have the requisite PPE as a means to protect them and others. Further is it not the case that when someone is really sick from Covid or indeed the flu they have gone beyond peak shedding and therefore lower viral loads - or is that incorrect also?

So perhaps general wards are in fact more dangerous in reality. Otherwise, all those hospital staff and the patients and especially the residents of nursing homes never caught the virus from breathing or even coughing in normal wards/residential rooms.

Seeing your post above, at no time have I ever on these forums taken aim at front line staff and am fully aware of the sacrifices made particularly in the early period when we knew so little.

Widdensushi · 30-09-2020 05:10AM

The_Brood wrote: »

What are people's thoughts on the fact that China, the world's most populous country, hasn't had domestic cases for a month now and their life and economy is completely back to normal?

Should there not be a recognition then that Europe and the US are abysmal failures in how their populations function?

Some kind of lecture I await to hear about how monstrous it would be to lose 20% more freedoms than what we already lost during the lockdown and partly now....and not losing that is worth all these months, soon to be year(s?) of ruin and misery?

Because we are too stubborn for 2-3 weeks of total lockown we accept potentially years of ruin and misery. And we think that's a good deal and accept it. How.

Even mcongle isn't naive enough to mention China when talking about covid free areas.

s1ippy · 30-09-2020 06:57AM

Arghus wrote: »

I guess I'll have to watch this debate between Sam McConkey - who can, to be fair, veer from one pronouncement to another - and his opponent.

Sometimes people see what they want to see when watching people debating anything Covid related.

It was very balanced and surprisingly even. Feeny got a bit tetchy and Mc Conkey hardly felt the need to refute him because his isn't the strategy we're taking (let it run riot), so there's little need to defend against the suggestion of it.

There was no huge victory for the anti lockdown side.

patnor1011 · 30-09-2020 07:00AM

The_Brood wrote: »

What are people's thoughts on the fact that China, the world's most populous country, hasn't had domestic cases for a month now and their life and economy is completely back to normal?

Should there not be a recognition then that Europe and the US are abysmal failures in how their populations function?

Some kind of lecture I await to hear about how monstrous it would be to lose 20% more freedoms than what we already lost during the lockdown and partly now....and not losing that is worth all these months, soon to be year(s?) of ruin and misery?

Because we are too stubborn for 2-3 weeks of total lockown we accept potentially years of ruin and misery. And we think that's a good deal and accept it. How.

Define total lockdown please. Put some meaning to it please. I am genuinely curious at what do you imagine by it.

caveat emptor · 30-09-2020 07:09AM

Sweden not going well. Cases quadrupling in a 2 week period in Stockholm.

https://twitter.com/zorinaq/status/1310996050430234624?s=20

zerosugarbuzz · 30-09-2020 07:10AM

s1ippy wrote: »

It was very balanced and surprisingly even. Feeny got a bit tetchy and Mc Conkey hardly felt the need to refute him because his isn't the strategy we're taking (let it run riot), so there's little need to defend against the suggestion of it.

There was no huge victory for the anti lockdown side.

At least the anti lockdown argument is being aired in the media, you’d have to wonder why it was ever suppressed. I thought McConkey came across as another “medical professional” trying desperately to build a media career, There are so many of them. I’m mean who ever dreamed we’d see so many immunologists on TV, it’s a back office job if ever there was one.

zerosugarbuzz · 30-09-2020 07:12AM

caveat emptor wrote: »

Sweden not going well. Cases quadrupling in a 2 week period in Stockholm.

https://twitter.com/zorinaq/status/1310996050430234624?s=20

And deaths? Are there many deaths? There policy was always to have many cases! If they can keep the death manageable then they are still on the right track.

caveat emptor · 30-09-2020 07:27AM

I think at this stage 6/ 7 months in it's fairly clear what has to happen. The data is in regarding economic damage.

We are in a pandemic.
People are unemployed because we need restrictions.
We need restrictions because people will get sick.
People will get sick because community transmission is high.
We can't let people get sick because healthcare will be overrun.

We should start looking at those who have done well economically. It's very negative to say "we can't replicate what they did"
Just shows a lack of imagination. As long as this rolls on the economic and health casualties will mount.

https://twitter.com/devisridhar/status/1310849883218292736?s=20

ArthurDayne · 30-09-2020 08:11AM

quokula wrote: »

Ok, let’s say I’m 25 years old and have diabetes. Or I’m 35 and have asthma. Or I’m 75. Or I’m a healthy 40 year old but I’m caring for my elderly mother at home.

The country has followed your advice, the virus is now rampant across the country, hundreds of thousands of people have it, we’ve miraculously kept it to healthy people so only 0.1% of them have died, so that’s only a few hundred grieving families, no big deal.

Meanwhile I’m locked up for my designated 21 hours per day, waiting for my alarm to tell me I can go out and get food. Every surface in the supermarket has virus on it. The supermarket staff probably have the virus. But it’s between 8am and 11am so you’ve decided it’s safe for me to go and do my shopping, and we’ll just tell the virus not to infect anyone during those hours.

I’m not convinced that plan will work.

COVID free hospitals exist now because of the measures were taking now. If you let the virus run rampant, it won’t decide to stop at the door of the beacon.

But again, are people in those categories not already acting under the assumption that anyone could have the virus in the shop and every surface could be infected? I mean, you are making it sound like right now they can skip into the shop and lick every surface because the risk of infection is lower. But the fact is that many of those those types of people know that Covid is circulating in the community right now — so should be behaving as though it could be present anywhere. The practicality of how they behave should therefore not be overly different to what they are doing now. Totally get that the risk would higher, but I’m not quite sure why you think it’s any less workable from a practical perspective from what they should be doing now anyway. I can see why you might be opposed on the basis that the chance of infection is higher, but certainly don’t see why you would oppose it from a workability perspective.

As for hospitals, has the realistic healthcare goal ever been that hospitals would be “Covid free”? I get that some hospitals have managed to avoid any internal transmission of Covid, like the Beacon — but that almost goes against your own argument rather than supporting it.

wadacrack · 30-09-2020 08:20AM

caveat emptor wrote: »

I think at this stage 6/ 7 months in it's fairly clear what has to happen. The data is in regarding economic damage.

We are in a pandemic.
People are unemployed because we need restrictions.
We need restrictions because people will get sick.
People will get sick because community transmission is high.
We can't let people get sick because healthcare will be overrun.

We should start looking at those who have done well economically. It's very negative to say "we can't replicate what they did"
Just shows a lack of imagination. As long as this roles on the economic and health casualties will mount.

https://twitter.com/devisridhar/status/1310849883218292736?s=20

Agree, the only model that has proven to get society back to the ore covid normality is in Asia.
But this is not possible in Western countries for some reason likely due to just a lack of discipline and understanding of the long term implications of a virus that looks like it will lead to most countries struggling to sustain a healthcare system with enough staff. Sweden took that gamble and early evidence is that they will now harsh restrictions in place.
The immune response to the virus have been very worrying. People want to believe that their normal life's can return but they can't and it will be far worse with no restrictions and greater transmission rates. Economic recovery will be virtually impossible. People will not feel safe. Naive to just look at the IFR and think everything will be ok. In cities in South America their are now bringing in restrictions after the first wave and seem to be taking it more seriously.

wadacrack · 30-09-2020 08:30AM

Azatadine wrote: »

That's McConkey and Tomas Ryan schooled over the last week now.

Ryan wasn't schooled by Professor Gupta at all. She was pretty unprofessional and rude tbh.

McConkey is not good at debating, that is pretty clear. Seemed to be more interested in avoiding conflict tbh. Feeney didn't address or discuss the aspect of immunity with this virus for a reason. Theirs clearly a strange bias on this forum more people with this opinion of no restrictions. Its what we all want but strikes me of being in denial about the characteristics virus. Theirs a reason Sweden are bringing in restrictions. The immune response to this virus is very unpredictable for different people.

GooglePlus · 30-09-2020 08:46AM

I would much prefer a strict set of restrictions now in order to allow us to open to near normal at Christmas, even if it is just for two weeks or more.

Economically speaking, would it not make sense to shut down during the lull after summer instead of risking one near the boom of December. If we could get a full swing of consumer spending and near full restaurants/bars at Christmas time, it may be a better financial take in compared to on/off or potentially tight restrictions during the festive period.

Probably factors I'm not taking into account here with my limited understanding of economics but it just seems obvious to me.

is_that_so · 30-09-2020 08:47AM

Deleted User wrote: »

And with Britain being more densely populated than Ireland you'd have to say they are doing better than us currently.

Still don't get why people persist with this league table comparison with other countries. There are different approaches and issues almost everywhere and Britain has its own problems. What we need to be comparing is changes in our 7 day and 14 averages not anyone else's.

Happydays2020 · 30-09-2020 08:49AM

wadacrack wrote: »

Ryan wasn't schooled by Professor Gupta at all. She was pretty unprofessional and rude tbh.

McConkey is not good at debating, that is pretty clear. Seemed to be more interested in avoiding conflict tbh. Feeney didn't address or discuss the aspect of immunity with this virus for a reason. Theirs clearly a strange bias on this forum more people with this opinion of no restrictions. Its what we all want but strikes me of being in denial about the characteristics virus. Theirs a reason Sweden are bringing in restrictions. The immune response to this virus is very unpredictable for different people.

The restrictions viewpoint reflects society at large. I am in favour of evidence based decision making (The evidence has not always been there). I also recognise that the initial lockdown was a success. I am ok with restrictions if merited but I am not ok with blind approval of everything NPHET has said as they and the HSE need to be challenged (We have a new social contract). I am in favour of good governance and I also think there is a balance to be struck in terms of managing the risk of the virus vs the broader risks to the economy and society. I think the communication has been terrible in recent weeks.

All in there are many people here who are in the middle on this but hard to actually get that point through.

is_that_so · 30-09-2020 08:50AM

GooglePlus wrote: »

I would much prefer a strict set of restrictions now in order to allow us to open to near normal at Christmas, even if it is just for two weeks or more.

Economically speaking, would it not make sense to shut down during the lull after summer instead of risking one near the boom of December. If we could get a full swing of consumer spending and near full restaurants/bars at Christmas time, it may be a better financial take in compared to on/off or potentially tight restrictions during the festive period.

Probably factors I'm not taking into account here with my limited understanding of economics but it just seems obvious to me.

A precise period just can't be guaranteed. It could go from 2 to 4 weeks quite easily and convincing the public to go with it could be far tougher ask than March.

30-09-2020 08:56AM

wadacrack wrote: »

Ryan wasn't schooled by Professor Gupta at all. She was pretty unprofessional and rude tbh.

McConkey is not good at debating, that is pretty clear. Seemed to be more interested in avoiding conflict tbh. Feeney didn't address or discuss the aspect of immunity with this virus for a reason. Theirs clearly a strange bias on this forum more people with this opinion of no restrictions. Its what we all want but strikes me of being in denial about the characteristics virus. Theirs a reason Sweden are bringing in restrictions. The immune response to this virus is very unpredictable for different people.

Having now watched the piece, McConkey was expecting the usual media fawning over his every word, but chronically ill prepared to be challenged on his view by a well though out argument and showed himself up to be less knowledgeable on his brief than he though he was. Feeney on the other hand had a well thought out position, but it was fundamentally incomplete with no option other than protect the vulnerable, which sounds good in principle but that involves isolating 1 million people for a year or so

GooglePlus · 30-09-2020 09:00AM

is_that_so wrote: »

A precise period just can't be guaranteed. It could go from 2 to 4 weeks quite easily and convincing the public to go with it could be far tougher ask than March.

Maybe they just need to sell it as a stay in doors or Christmas is cancelled scenario. The public suck anything up if it's swung the right way on the right media platforms which is something this government hasn't taken on board.

Covid 19 Part XXIV-37,063 ROI (1,801 deaths) 12,886 NI (582 deaths) (02/10) Read OP

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