Saturday 9 May 2020

Lockdown Open Thread

Three more weeks.......  and time for a new open thread


  1. The BBC's news regarding new manufacturers of ventilators is supportive of EU companies to the detriment of UK companies. I am reminded of a story from November 2019:

    ..'NHS hospitals take thousands of Dyson fans worth £1.2million off wards because they are 'linked to infection'. ... This from the Mail online.

    Having looked at this type of fan, I can report that unlike bladed fans these have filters. Not only that, but by using a wi-fi link the user can keep up to date with the condition of the filter. There are no filters on bladed fans - which then recirculate bacteria etc efficiently. Not only that, but there is a version that allows controlled moistening of the air, and in that application, UV light is used to sterilise outward water droplets. It seems therefore that the decision to 'put into storage' the fans was purely political - seizing upon a falsehood for justification.

    That same slant is being used by the BBC and NHS to discourage UK innovation at a time when it would help unite the country. The helplessness of this lockdown needs to be relieved by the UK working together and not just relying on others. Approvals for F1 and Airbus as possible suppliers to the NHS are fast-tracked, whereas Dyson, G-Tech and other smaller engineering companies are caught up in 'approval issues'.

    1. ...Approvals for F1 and Airbus as possible suppliers to the NHS are fast-tracked,... F1 is shorthand for Mercedes - a jewel in the crown of the EU.

    2. I wouldn't mind betting that the Dyson fans were never connected to wi-fi, that nobody in the NHS hospitals ever checked the filters, and that after several months there was a build-up of dust etc on the filters and that this build-up contained bacteria. Bureaucratic management methods probably didn't have a job description for a Dyson fan filter monitor.

      Oh for some decent journalism that exposed poor management in the NHS. That will be some time in coming - from the BBC at least.

    3. There was (for once)an interesting item on ventilators on Newsnight last night. Seems like the disease is not now being thought of as primarily a respiratory disease, but more one of general inflammation involving creation of numerous harmful small blood clots. It is felt putting people on ventilators is not the best way to treat them if it can at all be avoided. This seems to be the latest consensus. It wasn't explained quite why but I think it migth be because people on ventilators are often sedated - maybe sedation is felt to be harmful.

    4. From the telegraph

      Intensive care doctors question the 'overly aggressive' use of ventilators in Covid crisis
      Doctors are seeing patients with blood oxygen levels so low they are surprised they are conscious – yet they are sitting up and talking

      British and American intensive care doctors at the front line of the coronavirus crisis are starting to question the aggressive use of ventilators for the treatment of patients. 
      In many cases they say the machines, which are highly invasive and require the patient to be rendered unconscious, are being used too early and may cause more harm than good. Instead they are finding that less invasive forms of oxygen treatment through face masks or nasal cannulas work better for patients, even those with very low blood oxygen readings.
      Dr Ron Daniels, a consultant in critical care at University Hospitals Birmingham NHS Foundation Trust, on Thursday confirmed reports from US medics that he and other NHS doctors were revising their view of when ventilators should be used. 
      At the heart of the issue was the “bizarre” and “frankly baffling” phenomenon of Covid-19 patients presenting with catastrophically low blood oxygen levels but few other ill effects.

      “We’ve had patients with oxygen measures of just 5 kilopascals [70-75 per cent of normal] who are talking to us normally and have no obvious air hunger [gasping for breath]”, said Dr Daniels. “Normally anyone with numbers like that would be ventilated but increasingly with Covid patients we are considering holding back. 
      “The question everyone is asking is, do we treat symptoms or do we treat the numbers? It’s a good question and one that I think doctors everywhere are now grappling with.”

      The initial recommendations from doctors in China and Italy were to ventilate Covid patients early and aggressively, with the so-called “PEEP” pressure on the machines turned up high so their lungs did not contract when they exhaled. 
      “The initial message was treat as if you were treating for acute respiratory distress syndrome (ARDS) with a high PEEP,” said Daniels. “But now we are becoming braver. We are tolerating much lower blood oxygen levels and using lower pressures. We are learning as we go along”.
      The alternative to mechanical ventilation is oxygen treatment delivered via a mask or a nasal cannula or via a non-invasive high flow device. This is the sort of treatment the Prime Minister Boris Johnson is said to be receiving in an intensive care unit at St Thomas’s hospital London. His blood oxygen levels are not known.
      Increasingly doctors in the UK, America and Europe are using these less invasive measures and holding back on the use of mechanical ventilation for as long as possible.
      “Increasingly we are making the decision to focus on symptoms rather than numbers – predicting the point of fatigue where the patient is struggling to breath independently,” said Dr Daniels. 
      Doctors in Italy and Germany wrote to the American Journal of Respiratory and Critical Care Medicine last week making a similar point. They urged other doctors to be “patient” with Covid patients, arguing for “gentle ventilation” wherever possible.

    5. Part 2....

      Invasive ventilation is never a good option for any patient if it can be avoided. It can result in muscle wastage around the lungs and makes secondary infections more likely. It also requires a cocktail of drugs which themselves can prove toxic and lead to organ failure. 
      It is not known why Covid-19 allows some patients to tolerate such low blood oxygen readings without air hunger or obvious confusion. One clue may be that patients are still able to exhale carbon dioxide – a toxin – through their lungs even if they are having difficulty absorbing oxygen.
      “The patients in front of me are unlike any I’ve ever seen,” one American doctor working in a Brooklyn hospital told the specialist health publication STAT this week. “They looked a lot more like they had altitude sickness than pneumonia.”
      Dr Daniels agreed that there were similarities with altitude sickness, itself a potentially fatal condition. “We’ve seen a lot of headache and dizziness”, he noted.
      While doctors are not using mechanical ventilation as aggressively now as they were at the start of the crisis, the machines remain a last resort for many Covid patients. Survival rates are not as good as for those with other forms of viral pneumonia but ventilators are nevertheless still saving many lives.
      Intensive care units are also much more than just a ventilator. Even where patients, like the Prime Minister, are receiving more gentle forms of oxygen treatment their vital signs need to be extremely carefully.
      "It's about having highly skilled staff to care for the patients and a whole plethora of ancillary equipment and medications beyond the ventilator itself," said Dr Daniels.

    6. Thanks for that Charlie - very informative.

      Seems like Newsnight might have been playing catch-up.

    7. TBF if it’s the F1 teams the tech, workforce and factories are predominantly located in the UK and funded by companies around the world. I think even the world beating Merc engines are built here by a rebranded UK based company.

  2. Replying to Charlie's earlier post which ran as follows:

    "The things I don’t understand are:

    Why is it hitting Old Europe the hardest, are we better at recording cases and deaths or is their a genetic or social reason? (USA is originally a colony of old Europe emigres)"

    I would add - why the huge disparity between Poland, Greece, and Croatia (together with some other countries) for example and Italy, Spain, France and Belgium?

    The only persuasive argument I have heard put forward is the BCG national vaccination programme (those countries with such a programme seem to have a much, much lower incidence).

    "Is it lockdown that slows transmission or is it that only 20% of the population is susceptible to catching it?"

    A very good question, because if (according to the Government/WHO) something like 56 million people haven't had the disease yet, the disease is highly infectious and 25% who do are asymptomatic, what's to stop it ripping its way through the population again? I think Lockdowns might have a marginal effect in slowing down the first wave, but that's about it. The effect is far more marginal than claimed in my view.

    "Is it a general lockdown or 14 day isolation of those showing symptoms that is most effective In slowing transmission?

    Worldwide we have not seen it run rampant through an entire population as the models predict - why not?"

    I think if we had urged anyone who had any cold or flu symptoms to isolate at home and made it illegal for employers to allow workers with such symptoms to work, then we could very likely have got the same slowing down of the first wave. But instead the Goverment misleadingly created the impression that a dry cough and a high temperature were necessary signs of Covid-19 infection, rather than just part of a range of symptoms. That was a criminally stupid thing to do.

    "Is it virus we just have to live with rather than hide away from it? "

    Yes is my answer because the alternative to living with it is seeing our culture, our economy, our democracy all die.

    1. Thanks Monkey Brains, your views are much appreciated.

      Like the majority I was happy to go along with the consensus and follow the government guidelines/instructions.

      With the benefit of hindsight the lockdown appears to be a gross over-reaction by politicians who were too easily influenced by the science. The science was in fact epidemiology modelling with a range of assumptions by an expert with a dodgy track record. Not enough was known about the virus to be sure of the modelling results.

      The politicians were frightened by forecasts of a huge death toll and an overwhelmed health service and were not prepared to make difficult decisions in case the predictions came true. It would be a very brave politician to take a different path.

      I can understand why our politicians made decisions to take the route of lowest resistance especially when other governments were already doing it and a partisan MSM were agitating for action and a change of direction.

      At the time I don’t think the economic and social consequences were at the forefront of their minds, just the body count and the political fallout.

      A complete mess really when you look at it.

    2. I agree - a complete mess! lol

      No one's denying it was a very difficult call. Sweden shows it is possible not to over-react. But I accept the pressures on the Government to lock down were huge. That said, there is no reason to prolong the agony now with the Government failing to put in place any relaxation or an open, clear plan for a return to normality - that is sheer political cowardice and dereliction of duty in my view.

      It's probably not helped by the fact our PM has had such a close brush with death thanks to the virus. That must have totally skewed his view and made him reluctant to approve any relaxation.

  3. A very interesting article in the Mail.

    It seems there could be THREE strains of Covid-19. Further more one of the strains could have been infecting people since SEPTEMBER 2019. That would make sense of what my brother in law who lives up North said - he thought it might have started in the Autumn as all the people in his workplace went down with a terrible viral infection that no one could shake off for weeks or even months. Mrs Brains also had something similar...she's never had sinsusitis before but these lingered for a couple of months.

    Once again, the plot thickens. Clearly there is much to learn. Of course if tens of millions have already had strain A they might be better able to tackle the Wuhan strain B....who knows?

    Seems like the government is flying blind and more antibody testing is probably unlikely to make a great deal of difference at this stage.

    I remember as well Icelandic researchers claimed they identified 40 mutations of the virus. Not sure when a "mutation" becomes a "strain"...but clearly we are facing a bit of a shape-shifter here.

  4. So Belgium has 260 deaths in one day, the equivalent of about 1560 in terms of UK population - far, far higher than ours (even if, not proven, they report Covid deaths from care homes more accurately, it would not account for them having 90% more deaths than us).

    And yet...they've just reopened DIY stores.

    Is it total Walloonacy as the Sun might say or does it show they've got true Flem? Will Brussels sprout more Covid-19?

    If they - a country more divided than a Celtic-Rangers match, a country bought and owned by the EU - can do it, then we definitely can!

    Time to reopen B&Q.

    1. Ho Ho

      I'm Flandering for an equally witty riposte but am too much of An twerp!

    2. My Liege, that response was truly witty. Low, country humour is always the best.

    3. This is getting on my Mons. Be a Gent and Leuven it out.

    4. MB - With apologies to Popeye: "Ah can't stands Namur!

    5. To all fellow punsters - well done, we went the extra smile there! :)

  5. Just thought I'd re-post this link in the Open Thread as I think this deserves to be more widely known.

    I had been wondering whether perhaps many millions of people in the UK have been exposed to the virus but have warded it off without necessarily creating antibodies. I found this online which seems to confirm that is more than possible - probably very likely:

    "Local infections at surfaces such as the mucosa can elicit local cell-mediated and humoral (IgA) immune responses, but not necessarily systemic immunity. The host has multiple immune defense functions that can eliminate virus and/or viral disease."

    I haven't heard anyone mention this in the media but of course it is vitally important and has huge implications. It means that if you start antibody testing, probably millions of very fit and healthy young people are going to be found not to have "had" the virus - despite their bodies having fought off an infection.

    On that basis, I have revised my view and think that mass antibody testing of the workforce for staggered returns will be a huge waste of time, money and resources.

    Coupled with the story in the Mail about Cambridge scientists having established there are three strains of the virus, and that they might have been around since September of last year, I think the virus has probably done its worst, taking the very elderly and those with compromised health who could not resist it. Most of the rest of the population have warded it off through various body mechanism or have had it more mildly and are now substantially immune.

    Mass testing will not help us make the decisions that now need to be made.

  6. There's an interesting point of view from Marc Andreessen: 'It's time to Build'.

    The feeling of helplessness is the difficult sentiment to throw off. The blame culture aimed at Boris and the Government are negative and destructive. I see that blame should be aimed at the NHS for their failure to procure equipment despite having apparently unlimited manpower and funds to do so as a key failing. The BBC and MSM by deifying the NHS and blaming the Government are contributing to the unease. The so-called front line account for a mere fraction of the NHS when measured in personnel. We should not be expected to applaud anyone other than the ICU doctors and nurses. The procurement dept of the NHS is the real vilain here, and yet they are not called to account.

    1. .... unlimited manpower and funds to do so is a key failing ....

    2. Agreed re NHS and Care Home front line staff. Everyone else is at v. minimal risk really. Not much more than ourselves popping down the shops - perhaps we deserve a medal as well.

      Surely it's got to be the top executives of the NHS - Stewart Stevens and others who should take the blame. Procurement services essentially procure what they're told to procure and within a certain timeframe. Someone somewhere took the decision (or failed even to consider the issue) concerning whether to order sufficient quantities of PPE, ventilators, swabs, reagents, emergency hospital beds and so on, to be able to respond to a serious pandemic.

      To hear the Government talk about pandemics you can tell they assume pandemics always start in other countries. Pandemics have started in the USA before now. There's no reason why it couldn't start in the UK, in which case we would have virtually no notice of the crisis, and would be plunged straight into it.

      Another thing I would totally criticise the Governemnt and NHS on is their complete and craven surrender to the vaccine lobby.

      I've posted here a scientific paper that expressed concern about whether patients who had received the flu virus were susceptible to a previous pandemic pathogen (think it might have been SARS). The evidence suggested they were.

      So what we could be seeing here is that the usual flu viruses are being prevented from doing their usual in the lungs of the very elderly and others with weak health by the vaccine. But that doesn't mean the elderly have suddenly acquired healthy young lungs...they haven't. Their lungs are still vulnerable to any other non-flu pathogen that can get in. That surely is an open invitation to novel viruses to emerge.

      Vaccines to prevent healthy people falling victim to very unpleasant diseases may be one thing. Vaccines designed to help the elderly survive a little longer are quite another matter and, by clearing out the current inhabitants, may actually create homes for new viruses.

  7. +++PLAGUE WATCH+++

    1. Why hasn't the Green Party come out in support of the Government's new policy on recycling and reuse of plastic PPE?

    2. What hasn't Caroline Lucas called for biodegradable plastic visors?

    3. Where is Greta? Has she evaporated? Does she feel that her work on Earth is now completed and she can ascend to heaven, given we no longer go on holiday, hardly ever drive a car, don't meet up with friends for meat-heavy meals, have all turned into asperger types avoiding human contact...and of course our children don't go to school. Greta's Paradise indeed!

    4. Police come down very hard on individual sunbathers in parks...their fingers probably itching to use the tazer. But round my way they don't do anything about the traditional Friday night gathering of East European construction workers gathered in close proximity on street corners sharing a beer or vodka, with some sausage or similar - still taking place! I'm not begrudging their rest and pleasure after working hard (though not at all socially distanced on their construction sites) but it's interesting to see what infringements the Police like to tackle and which they carefully avoid noticing.

    5. There doesn't appear to be any shortage of Police Officers at the moment. I see plenty around my part of London now. As the Lefties like to say "The crisis has shown what can be achieved" - yes, when you take Police away from nonsense stuff like attending transgender awareness courses, tackling online non-crime, visiting here there and everywhere (anything but patrolling!), playing sport in work time, and sitting around in meetings "planning" this that and the other.

    5. The government are said to be proposing a traffic light return to normality. One of the first places to get the green light will be...wait for it...hairdressers. I couldn't think of a location more likely to pass on the virus. People in close proximity, hairdressers handling hair, people coughing into gowns that then get worn by someone else, lots of hard but warm surfaces for the virus to linger on...

    The only reason it would be in the first wave would be because people NEED a haircut, which just means "We don't care about risking the spread of the virus. We need to get to a hairdresser!" Which just exposes how fake the whole thing about "saving lives" has been. Protecting the NHS - yes, I get that. But it hasn't been about "saving lives". if was, then the Government would be saying "We're very sorry but you're all going to have to cut your own hair and look like some out of that movie Deliverance. "

  8. Monday, another day and another letter 'seen by the BBC' critical of the Government. What a surprise! This time it's a delivery of PPE from Turkey which has failed to arrive as expected. This is akin to an army in wartime running out of ammunition. Why not turn to the expectant group of UK manufacturers who are keen to help in some way? The NHS supply chain must be examined to find out why such obvious options are rejected.

    1. I just noticed the same story headline in today's The Guardian. What a surprise! Thursday might be the day we are told to clap for 'the NHS whistleblowers' - without whom the BBC wouldn't have crucial rhetoric with which to attack the Government.

    2. Lewis Goodall, ex (?) Labour activist and Newsnight presenter referred the other night to "our Guardian colleagues". So it's official!

  9. From BBC News website Coronavirus 'Live Coverage':

    'Germany starts to reopen smaller shops after deciding the outbreak is coming under control'. The beacon of the EU is the first out of the blocks!

    Not mentioned though, are the protests in Berlin - h/t Guido:

    ... 'It isn’t just America that is seeing an anti-lockdown protest movement, as this weekend civilised Germany saw protests erupt against the government’s quarantine policies. Radical protestors from groups on the left and right took to the streets of Berlin to oppose the lockdown. Berlin’s protest movement even has its own newspaper, “Democratic Resistance” that claims to have a circulation of over 20,000…' ...

    1. And France.
      “Anti-lockdown riots break out in Paris amid anger at police 'heavy-handed' treatment of minorities after Macron extends social distancing to fight COVID-19 until May 11. Police used tear gas and baton charges in Villeneuve-la-Garenne, northern Paris, in the early hours this morning as fireworks exploded in the street. Armed police were seen moving through the area as groups of protesters congregated.”

  10. Here’s an interesting different view, that is being ignored by the BBC and MSMz

    The UK's coronavirus outbreak peaked a week before lockdown, according to a leading expert who argues the draconian measures were unnecessary.
    Carl Heneghan, professor of evidence-based medicine at Oxford University, claims data shows infection rates halved after the Government launched a hand-washing drive and recommend people keep two metres apart on March 16.
    He said ministers 'lost sight' of the evidence and rushed into a nationwide quarantine six days later after being instructed by scientific advisers who have been 'consistently wrong' during the crisis. The peak of deaths occurred on April 8, and if you understand that then you work backwards to find the peak of infections. That would be 21 days before then, right before the point of lockdown.' 


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