Now ye're talking - to a consultant in the HSE [Questions thread]

ooter · 22-03-2020 6:23pm

apologies if this has already been asked.
it's horrible hearing the figures of people who may die from this virus but especially the fact that healthcare workers in our hospitals will also die, are all healthcare workers at risk due to their high exposure or is it the same as the general public, older with underlying conditions?

con747 · 22-03-2020 7:19pm

Do you think the number of cases so far is an accurate number? Also, is there a shortage of testing kits as 2 members of my family have waited 6 days after being referred for testing due to symptoms and underlying conditions and are still waiting. Thanks for your time and effort in this thread.

derb12 · 22-03-2020 7:40pm

Thank you for doing this and thank you and all the other heroes for trying to keep us safe.

I’ve always understood that a fever is the bodies way of fighting back at an infection and so I’m wondering if it’s always best to take paracetamol straightaway if I get a temp. I know that an extreme temp of 40(?) can be dangerous, but could it be better to see where a 37 or 38 temp goes before taking something to lower it? I’ve always given my kids calpol as they are so wretched with a temperature and to be honest, I can’t remember the last time I had a temp myself but just wondering.

Thanks again.

Cork Boy 53 · 22-03-2020 7:55pm

Hi. Does it concern you that the number of ICU cases has jumped from 13 to 29 in a single day? Do you still think we are on track for the best case scenario of fatalities from this outbreak?

Pseudonym121 · 22-03-2020 7:57pm

Sorry, posted in the wrong thread again.

aquarius10 · 22-03-2020 8:36pm

Thank you for taking time to answer questions.

My 8 year old daughter has been sick since Monday with a low fever, cough and she complains she can’t breathe properly when she coughs.
She was very sleepy & sick Monday but not as bad since.
She’s doing ok with calpol and plenty fluids.
GP had requested she be tested but i understand there is a backlog waiting for tests.
2 children at school had returned from a ski trip before schools closed but we’ve not heard how they are.
My question is if she has COVID19 but has ‘recovered’ by the time she’s tested will it still show in her swab ??
Thanks

up for anything · 22-03-2020 10:27pm

Do you have any idea what ages the four people were who have died from Covid19? All I can find are vague references to elderly.

shesty · 22-03-2020 10:51pm

This question may be more around epidemiology and disease spread, than one you can answer directly, but I will throw it out there anyway.

I am not asking you to commit to a time line here, but does there come a point on the graph of the disease spread where we decide that there is a certain amount of saturation in society, and that people can start moving about normally again?

My angle on this is that if we have flattened the (infamous) curve enough, we essentially have extended the timeline. If you look at it as a mathematical exercise, I don't know what that time extension is, but say it extended to maybe 1 year. It isn't practical to shut the country down for a year. So are there citeria, or decision points along the way where the balance stops being about stopping the spread and become about slowly allowing the herd immunity to build instead?? Is there any information anywhere on that - I think the main point of the question is when does it stop becoming about prevention and move into some form of building up immunity, or whatever the phrase is?

I guess, I am at home with 3 kids, all healthy, keeping away from everyone....how long are we supposed to go on trying to run away from it vs just accepting getting it anyway?

Purple Mountain · 22-03-2020 10:54pm

Would you ever forsee home testing kits that could even be purchased for a small fee at a pharmacy to cut down on testing clinics?

Also, those who are hospitalised as a result of this, are they going to be billed for their care in the hospital?

xzanti · 22-03-2020 11:38pm

Hi, thanks for doing this. Very informative.

I've been giving my kids probiotics for years (FMD Udo's Choice).

I read somewhere that this virus actually uses a persons immune system against them.

Sorry, if this is a stupid question, but could the probiotics actually be a hinderance to them should they catch the virus? Should I stop or continue with them in your opinion?

Edit. They are fit and healthy with no underlying conditions.

Cheers.

Mwengwe · 23-03-2020 12:42am

This isn't technically a question and feel free to delete it but i've been reading his answers and I think this is going way, way over the line between informing people/impressing on them the gravity of the situation and just plain terrifying people into paralysis. I've read some bleak articles over the past few weeks but the thread of answers by this guy leaves me feeling completely, utterly hopeless. There's got to be a better way to inform.

beolight · 23-03-2020 2:01am

Mwengwe wrote: »

This isn't technically a question and feel free to delete it but i've been reading his answers and I think this is going way, way over the line between informing people/impressing on them the gravity of the situation and just plain terrifying people into paralysis. I've read some bleak articles over the past few weeks but the thread of answers by this guy leaves me feeling completely, utterly hopeless. There's got to be a better way to inform.

Have to disagree

Pop over to the main thread and you will find stories of people packing beaches, parks, ice cream vendors, coffee shops packed, SuperMacs jammed, teenage groups rambling around aimlessly, queues outside chip shops, retail parks jammed with shoppers .... people simply aren’t getting the seriousness of the message ..... over in the UK the same and Boris threatening stronger measures

We all watched the scenes coming from China since December but somehow taught we would be immune

We have a HSE who appointed a CEO whose clear remit was to get the budget under control and consequently we are left with a woefully unprepared HSE .....scrambling to buy essential PPE but all the time time reassuring us through an unquestioning media that our health service is ready. We have a CMO dithering on postponing Parades, closing Schools, airflights from Italy,Cheltenham, and then we have a Government happy to defer any big decision to the CMO. Remember this is the same CMO who advised Government on the cervical smear cover up

Against this backdrop we have somebody trying to get us to prepare, someone who knows what it’s like to work in the Irish health service who knows how the HSE works. Someone who knows we don’t have the necessary resources or staff to cope with the oncoming crisis heck our health service virtually grinds to a halt every winter with a normal flu outbreak! How was it going to cope with this?

The HSE tells us they have plenty of PPE but nobody asks why so many health care staff have contracted Covid 19 then ( yes some were travel related). The CMO knows from the outset that they do not have enough test kits so only tests people with symptoms or the ones that arrive at hospital Emergency Departments with symptoms. Privacy card played by CMO but yet nobody was asking for names just locations we the Irish public couldn’t be trusted with this information. So communities left to panic and the Internet and social media became the only place to try and decipher what was going on. HSE despatched to visit area in Galway and told Community they would write to everyone !!....that really reassured everyone go home and wait for a letter to drop through your letterbox telling you what to do Maybe they didn’t see the memo that time is of the essence

The Government Ministers happily refer to Singapore as the best case model to follow but no journalist is able to ask them why not follow the model properly. Test test test
With contact tracing utilising mobile phone data and total transparency about identified cases locations they had been etc so people could check themselves and identify if they could of come in contact and to be on the lookout at least for symptoms

So everything left to contact tracing how effective was that? RTE had an expert willing to elaborate on that but choose to not follow his line of taught
Airports: seaports no point in screening new arrivals from flights coming from affected areas or advising the public that it mightn’t be the best idea to go Italy. Minister Harris tweets that Rugby Match versus Italy should be postponed but no attempt to prevent the Italian fans coming anyways

We have the case of the Doctor in Waterford returning to work too early

Nursing homes acted to protect their patients and prevented visitors cue calls to Joe Duffy and next the CMO admonishes the Nursing Homes for acting in the best interests of their patients and says for Nursing home patients social well being to allow visitors. At least Paul Reid had the gumption to allow individual hospitals their own autonomy in this regard. Will a journalist ask the CMO if any of the Nursing Home residents who tested positive are in ICU?

Then we have Cheltenham

Need I go on.... with the closing of schools, working from home, ban on mass gatherings and social we had at least some hope but of course the pubs paid no attention and continued on regardless Finally Minister Harris showed some backbone

I have to disagree AMA has informed us and a lot of us feel his despair reading about how the Irish public is treating social distancing We have Italian Doctors screaming at us to act now We have seen the Army trucks ferrying the bodies and yet somehow a percentage of the population seems to think we are immune

How else do you propose we get the message across?

Mwengwe · 23-03-2020 2:20am

beolight wrote: »

Have to disagree

Pop over to the main thread and you will find stories of people packing beaches, parks, ice cream vendors, coffee shops packed, SuperMacs jammed, teenage groups rambling around aimlessly, queues outside chip shops, retail parks jammed with shoppers .... people simply aren’t getting the seriousness of the message ..... over in the UK the same and Boris threatening stronger measures

We all watched the scenes coming from China since December but somehow taught we would be immune

We have a HSE who appointed a CEO whose clear remit was to get the budget under control and consequently we are left with a woefully unprepared HSE .....scrambling to buy essential PPE but all the time time reassuring us through an unquestioning media that our health service is ready. We have a CMO dithering on postponing Parades, closing Schools, airflights from Italy,Cheltenham, and then we have a Government happy to defer any big decision to the CMO. Remember this is the same CMO who advised Government on the cervical smear cover up

Against this backdrop we have somebody trying to get us to prepare, someone who knows what it’s like to work in the Irish health service who knows how the HSE works. Someone who knows we don’t have the necessary resources or staff to cope with the oncoming crisis heck our health service virtually grinds to a halt every winter with a normal flu outbreak! How was it going to cope with this?

The HSE tells us they have plenty of PPE but nobody asks why so many health care staff have contracted Covid 19 then ( yes some were travel related). The CMO knows from the outset that they do not have enough test kits so only tests people with symptoms or the ones that arrive at hospital Emergency Departments with symptoms. Privacy card played by CMO but yet nobody was asking for names just locations we the Irish public couldn’t be trusted with this information. So communities left to panic and the Internet and social media became the only place to try and decipher what was going on. HSE despatched to visit area in Galway and told Community they would write to everyone !!....that really reassured everyone go home and wait for a letter to drop through your letterbox telling you what to do Maybe they didn’t see the memo that time is of the essence

The Government Ministers happily refer to Singapore as the best case model to follow but no journalist is able to ask them why not follow the model properly. Test test test
With contact tracing utilising mobile phone data and total transparency about identified cases locations they had been etc so people could check themselves and identify if they could of come in contact and to be on the lookout at least for symptoms

So everything left to contact tracing how effective was that? RTE had an expert willing to elaborate on that but choose to not follow his line of taught
Airports: seaports no point in screening new arrivals from flights coming from affected areas or advising the public that it mightn’t be the best idea to go Italy. Minister Harris tweets that Rugby Match versus Italy should be postponed but no attempt to prevent the Italian fans coming anyways

We have the case of the Doctor in Waterford returning to work too early

Nursing homes acted to protect their patients and prevented visitors cue calls to Joe Duffy and next the CMO admonishes the Nursing Homes for acting in the best interests of their patients and says for Nursing homes social well being to allow visitors

Then we have Cheltenham

Need I go on.... with the closing of schools, working from home, ban on mass gatherings and social we had at least some hope but of course the pubs paid no attention and continued on regardless Finally Minister Harris showed some backbone

I have to disagree AMA has informed us and a lot of us feel his despair reading about how the Irish public is treating social distancing We have Italian Doctors screaming at us to act now We have seen the Army trucks ferrying the bodies and yet somehow a percentage of the population seems to think we are immune

How else do you propose we get the message across?

There's a medium point (happy medium seems an inappropriate phrase to use) is what I'm saying... I was someone who was already really conscious of social distancing to the point of anxiety. After reading the Answers thread for this I feel like I just want to go to bed for 12 months, or check out altogether. It's too much, he's going on about disinfecting shopping for 6 hours. He's going to lose people who are fighting his corner.
I think some of his more extreme points could really do with a bit more perspective and a bit of challenging. We're not going to get through these dark times by fostering despair.

Heighway61 · 23-03-2020 8:35am

Would you know if any consideration is given to health care workers who live with family members (or others) who are in a high risk category? For example, a spouse or child with cancer, COPD etc.

The percentages are large for:

health care workers infected
rate of transmission in the home
death rates due to existing condtions?

Also, "cocooning" fails in such a scenario.

Thanks.

rn · 23-03-2020 9:06am

There's a fine balance that our politicians have to achieve between not invoking complete panic in the population, but yet take the right measures.

What do you think of the German proposal for groups more than 2 to be banned?

My parents are elderly and my wife is in early pregnancy (10 weeks) . I'm really hoping we don't catch it for a while because at the moment I'm the sole "go for" in our family, doing shopping and bigger jobs. My parents live 5 mins away, but if I catch it my wife and child will get it and that would keep us out of action for weeks at least and that's if one of us doesn't get it in a serious way. We should be OK that way as we're 40 and no under lying conditions (apart from pregnancy) but it seems to be randomly flooring people in our age group in Italy, so it's concerning.

BTW thank you and best of luck over the next 2-6 months.

begbysback · 23-03-2020 9:06am

Mwengwe wrote: »

There's a medium point (happy medium seems an inappropriate phrase to use) is what I'm saying... I was someone who was already really conscious of social distancing to the point of anxiety. After reading the Answers thread for this I feel like I just want to go to bed for 12 months, or check out altogether. It's too much, he's going on about disinfecting shopping for 6 hours. He's going to lose people who are fighting his corner.
I think some of his more extreme points could really do with a bit more perspective and a bit of challenging. We're not going to get through these dark times by fostering despair.

I agree, the tone from the very outset has been condescending, the forecast of death rate exaggerated with no specific reasoning, the request that the public are failing to take directions and need to do more, basically asking the public to get tested and if your positive then stay home and hope it doesn’t get too bad, and if it does get bad then all we can do is put you on a ventilator, if we have one which is unlikely given that they are in short supply.

I apologize that I am a bit irate, but unless some of the answers start including some hope then I don’t see any point of continuing the AMA

Yester · 23-03-2020 9:07am

I've been hearing a bit about "viral load" which seems to mean the longer you are exposed to the virus the more infected/sicker you are likely to get. Do you think there is any truth to this?

swirley · 23-03-2020 9:58am

Thank you for taking the time to answer all the questions.

Is it known how long the virus can live on different surfaces? we have been getting groceries delivered and I have been trying to wipe them down with Dettol wipes in case it's on them - my husband says I am being over cautious.
Do you think it is a good idea?

WhiteLight20 · 23-03-2020 12:19pm

swirley wrote: »

Thank you for taking the time to answer all the questions.

Is it known how long the virus can live on different surfaces? we have been getting groceries delivered and I have been trying to wipe them down with Dettol wipes in case it's on them - my husband says I am being over cautious.
Do you think it is a good idea?

Not at all. I am doing the same thing. It’s time consuming but it’s worth it. Supermarkets are the places people are going so it’s definitely in there!!! I’ve also been leaving my post. In a few weeks we’ll be wishing we did more.

up for anything · 24-03-2020 7:00am

up for anything wrote: »

Do you have any idea what ages the four people were who have died from Covid19? All I can find are vague references to elderly.

Pseudonym121 wrote: »

Sure, but I said that I wouldn't reveal privileged information which I come across through the day job. I am answering questions using publicly available information, official websites, publications and extrapolations.

Ah sorry, I didn't realise it was privileged information although that's a bit disingenuous because I suppose I did on some level based on the fact that the actual ages are not released. Why is it privileged? Surely knowing what ages they were would not violate patient confidentiality?

Thank you for answering all the questions. It is reassuring to have somewhere to come and get some clarification from the coal face so to speak. I had another question but can't for the life of me remember what it was now.

Wanderer78 · 24-03-2020 7:52am

I just want to say thank you, thank you for putting your life in danger every time you go to work, we need our health professionals more than ever now, going to work must be a truly terrifying experience for you now. Thank you and best of luck

joeguevara · 24-03-2020 7:57am

Thank you and to all medics (and everyone else involved) for the work that you are doing.

I think politicians should not have a platform like we are seeing. It is clear that medics and scientists have issues with what is being said to the public. That frightens me.

https://time.com/5808283/infectious-disease-fauci-trump-coronavirus/

Yester · 24-03-2020 9:31am

Thank you for all your answers so far. Could I get your opinion on this? Recently we have met 2 separate people that believe it is perfectly safe to be within 2 meters of us as long as it is for less than 15 minutes. One even thought they were going to be invited in for a quick cup of tea. That wasn't going to happen as we are being very careful. They seem to be getting the 15 minute idea from articles like this

https://www.rte.ie/news/2020/0323/1124891-irish-figures-coronavirus/

The relevant bit says "Generally, you need to be 15 minutes or more in the vicinity of an infected person, within 1-2 metres, to be considered at-risk or a close contact."

It seems like dangerous advice to be giving and makes it harder to get people to stay away when they are getting the impression that less than 15 mins is fine.

What do you think of this?

up for anything · 24-03-2020 3:01pm

I'm really sorry. You took me up incorrectly. I meant I was being somewhat disingenous... NOT you. Apologies for my shite syntax.

Can't get the quotes to work properly.

Originally Posted by up for anything

Ah sorry, I didn't realise it was privileged information although that's a bit disingenuous because I suppose I did on some level based on the fact that the actual ages are not released. Why is it privileged? Surely knowing what ages they were would not violate patient confidentiality?

Thank you for answering all the questions. It is reassuring to have somewhere to come and get some clarification from the coal face so to speak. I had another question but can't for the life of me remember what it was now.

Pseudonym121 wrote: »

That's not how I meant privileged information. At the beginning of the thread I said I wouldn't divulge information which I came across through the day job. I know that information from the day job and so I won't answer that question.

Once that information comes out through other means then I would be able to address it. I resent you saying that my response was disingenuous. Doctors may make incorrect assessments and diagnoses but we don't lie to people/patients. A doctor who lies isn't fit to practice. You may not like where I draw the line, that is your right. But to say I'm being disingenuous is entirely uncalled for.

Pseudonym121 · 24-03-2020 3:25pm

Ah my turn to apologise then. I read it differently. Sorry for the reaction but being dishonest is a red button issue for doctors. Anyways, back to regular programming.

RiseAbove4 · 24-03-2020 5:43pm

Thanks for asking my previous question

I was wondering;

If you’re living with someone in their mid 60s and you get it or have strong symptoms of it, what do you do if you share a kitchen with them?

Is going to a budget hotel for 3 weeks a bit much Going to the kitchen would be fairly essential for all

Or maybe order tskeaways and clean down door latch after?

Thanks

locohobo · 24-03-2020 8:17pm

Hi again....Just reading you're reply on UV sterilization on home items. As you said the cost of them has gone through the roof and then if can be got...
Am wondering here if a home made option could be put together..
I have one of these..https://www.nisbets.ie/electric-fly-killers
Would it be of enough UV intensity to be effective..
Just put it in a light proof box for 20/30 nmins along with items to be sterilized...
What you reckon??

fishy_fishy · 24-03-2020 11:39pm

You mentioned that a lot of support will be needed for medical and emergency services staff in time to come, and that it will be afterwards that it hits (badly paraphrasing, sorry, but I think that is something that the public will be 100% behind in the aftermath of this).

Are there any formal techniques that are taught to medical staff for dealing with crises? It's one thing to be busy and sort of just keep going and not stop, but presumably staff all go home and have time alone and need some sort of coping mechanism then, even with the crisis ongoing.

The whole crisis has caused a knot of anxiety to develop in my throat so can't imagine how tough it must be for medical staff at the moment.

volchitsa · 25-03-2020 9:49am

Hi and thanks for making yourself available to answer questions in such detail.

Like many others, including our government, I've been worried by the Neil Ferguson/Imperial College model of death rates, but there is another more upbeat model, mentioned in the Financial Times (sorry, it's behind a paywall, here's another: https://theweek.com/speedreads/904584/new-oxford-study-suggests-millions-people-may-have-already-built-coronavirus-immunity)

This is an Oxford University study by Prof Gupta IIRC, and they believe that the virus had been circulating for a month or more in the UK before it was identified there, and that many people are already infected and have been fine.

That should mean that the more optimistic herd immunity approach could be the right one, although they do call for far more widespread testing, like SK is doing. But basically, is it wishful thinking to say 50% could already be better?

I'm dubious, going by what I hear from Italy (won't count China as I know nothing of their health service) but do you have any technical detail of why the Neil Ferguson model seems to have been adopted without reserve? Does the Oxford study have some massive flaws we should know of?

Strawberry Swan · 26-03-2020 12:50pm

Thank you for giving such detailed information on all this. All your posts over the past month have been an eye opener for me and this is an invaluable place to come to for honest upfront advice and information. I've shared with others.

I have donated to the Rape Crisis Centre on your behalf. What other charities / campaigns would you recommend donating to, to help the fight?

Now ye're talking - to a consultant in the HSE [Questions thread]

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