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Post by Deleted on Apr 1, 2020 15:32:40 GMT
I was amazed to see on breakfast itv this morning, (some London railway station) hundreds of passengers emerging from one train and immediately transferring to another, all within a few inches of each other and this is going on all day long day after day! What hope have we got, its just crazy! The people of London have always been the most dense.
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Mike
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Post by Mike on Apr 1, 2020 16:29:16 GMT
Not sure if this has already been posted, I am not really qualified to argue with him: www.spectator.co.uk/article/The-evidence-on-Covid-19-is-not-as-clear-as-we-thinkHe does seem to ignore the point about hospital capacity being limited, and the point of the meltdown is to avoid spreading it too quickly - rather than to stop people getting it all AFAICS. But nevertheless, and interesting read to provide some balance of just how OTT the international reaction may yet prove to be (or should that be, as it would be claimed, how _effective_ the international reaction may yet prove to be)
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cb25
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Post by cb25 on Apr 1, 2020 16:50:00 GMT
This caught my eye today. Quite frightening. BBC reports "A GP surgery has apologised after sending a letter asking patients with life-limiting illnesses to complete a "do not resuscitate" form"
I believe they apologized because it wasn't official policy.
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r00lish67
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Post by r00lish67 on Apr 1, 2020 16:56:59 GMT
Not sure if this has already been posted, I am not really qualified to argue with him: www.spectator.co.uk/article/The-evidence-on-Covid-19-is-not-as-clear-as-we-thinkHe does seem to ignore the point about hospital capacity being limited, and the point of the meltdown is to avoid spreading it too quickly - rather than to stop people getting it all AFAICS. But nevertheless, and interesting read to provide some balance of just how OTT the international reaction may yet prove to be (or should that be, as it would be claimed, how _effective_ the international reaction may yet prove to be) His arguments seem a pretty poor bunch to me. He seems to want to reserve the right to say "I told you this may not be the best plan" some months hence without saying what the alternative is, and why. For example: "But when drastic measures are introduced, they should be based on clear evidence. In the case of Covid-19, the evidence is not clear. The UK’s lockdown has been informed by modelling of what might happen. More needs to be known about these models. Do they correct for age, pre-existing conditions, changing virulence, the effects of death certification and other factors?"This implies to me the idea that if you can't concretely prove something will be devastating, that you should then gamble on it not being. Seems an odd one to me. "Governments everywhere say they are responding to the science. The policies in the UK are not the government’s fault. They are trying to act responsibly based on the scientific advice given. But governments must remember that rushed science is almost always bad science."Just how quickly should we have been acting in the face of a pandemic? Another month or so of pontificating on the exponential growth of a virus? He wrote this a week ago now, has anyone's view changed? Do we see Italy/Spain changing tack? He then makes a very odd argument. " The moral debate is not lives vs money. It is lives vs lives. It will take months, perhaps years, if ever, before we can assess the wider implications of what we are doing. The damage to children’s education, the excess suicides, the increase in mental health problems, the taking away of resources from other health problems that we were dealing with effectively. Those who need medical help now but won’t seek it, or might not be offered it"As if, had we had not locked down, then we'd be in a better position to address people's other health concerns? Seems like a forced and rather weak attempt at a contrarian article by the Spectator to me. edit: just to be clear, I'm not saying that in the fullness of time it may not become clear that there were better approaches to be had. But no Government, ours included, had the fullness of time on offer in deciding what to do.
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one21
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Post by one21 on Apr 1, 2020 17:10:02 GMT
I was amazed to see on breakfast itv this morning, (some London railway station) hundreds of passengers emerging from one train and immediately transferring to another, all within a few inches of each other and this is going on all day long day after day! What hope have we got, its just crazy! The people of London have always been the most dense. Apart from p2p forum members that is!😉
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Post by dan1 on Apr 1, 2020 17:53:20 GMT
This caught my eye today. Quite frightening. Is that the shadow of a gun being held to their head I can see?
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michaelc
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Post by michaelc on Apr 1, 2020 18:31:03 GMT
This caught my eye today. Quite frightening. BBC reports "A GP surgery has apologised after sending a letter asking patients with life-limiting illnesses to complete a "do not resuscitate" form"
I believe they apologized because it wasn't official policy.
I'd rather those wealthy (in comparison to the community they are supposed to serve) doctors were struck off for that.
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Greenwood2
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Post by Greenwood2 on Apr 1, 2020 19:29:28 GMT
This caught my eye today. Quite frightening. Is that the shadow of a gun being held to their head I can see? A friend of mine signed a DNR for a tiny routine surgery, I didn't find out until afterwards and they were perfectly fine, but although he was as I thought a very intelligent person and not that old, I found it totally bizarre that he had agreed that had there been some problem (breathing problem, heart glitch) that would have been perfectly treatable they really would have wanted to be left to die?
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Stonk
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Post by Stonk on Apr 1, 2020 20:11:44 GMT
BBC reports "A GP surgery has apologised after sending a letter asking patients with life-limiting illnesses to complete a "do not resuscitate" form"
I believe they apologized because it wasn't official policy.
I'd rather those wealthy (in comparison to the community they are supposed to serve) doctors were struck off for that.
If the number of hospitalisations keeps heading up, then there will come a point where these kind of decisions are going to be made anyway, regardless of the existence or absence of a DNR form. As the surgery says, they are being frank and realistic -- it's just that this kind of medical frankness and realism is better left unsaid.
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registerme
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Post by registerme on Apr 1, 2020 20:26:47 GMT
DNR's done right can be very useful, very important, and very.... "real" (?) for all concerned. Most especially the family. Done badly they are... at best lazy and uncaring, at worst downright evil. A few of you may remember a post I made, a while back, about a neighbour of mine, and her husband who'd had a bunch of strokes and suffered from dementia? He was a on a DNR then. He's on a DNR now. Three years ago? Maybe four? The stubborn old sod will outlast all of us. More seriously, even before COVID-19, the family didn't want him to be put through indignities of any sort, or pain (even if nobody can detect that he recognises it) or discomfort (likewise). Nor did they want doctors and nurses and ambulance staff to rush to his aid when... there's nothing there. A friend of the wife, Julia, (and a very good friend of mine, one of the "old dears" I am shopping for at the moment) asked to paint his picture. Julia agreed, not really thinking it through. She was terribly upset by the outcome. A picture that is... brutally honest, and unforgiving, in showing, literally, the undead. Because that it what Peter is. Undead. I found it terribly sad, but also terribly moving. Even in the few short years that I knew Peter I never scratched the surface of the man I knew he had to be. It's not a beautiful picture. It is a brilliant picture. For capturing what is. Now? If COVID-19 hits that care home it will rip through it. Knowing Peter he'll survive. But if he doesn't Julia's not even allowed to visit. As with the "stroke / dementia / you do or you will know somebody in this position....", with COVID-19 you do, or you likely will, know somebody in this position. It's creeping slowly closer to me. A small number of friends have it. Colleagues of friends have had it, a very few (at high risk, they were doctors looking after sufferers) have died from it. Anyway, DNRs, as horrible as it may sound, have their place . EDIT: Julia's not allowed out. She's not allowed to have visitors. She's not allowed to see her husband, especially if he dies, or the care home gets hit. I've been going round there three or four times a week for four(?) years? We've had one coffee since the start of "social isolation". She put the pot on and retreated to the garden. I came in, poured the cups, went to the garden, put one cup on a table midway between us. We sat 12 feet apart. It's doing her head in - making her sad, angry, frustrated and more lonely than she would otherwise be. Facetime etc are brilliant but.... you can't hug on Facetime. To IFISAcava 's point (amongst others), this has a cost.
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michaelc
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Post by michaelc on Apr 1, 2020 20:36:45 GMT
I'd rather those wealthy (in comparison to the community they are supposed to serve) doctors were struck off for that.
If the number of hospitalisations keeps heading up, then there will come a point where these kind of decisions are going to be made anyway, regardless of the existence or absence of a DNR form. As the surgery says, they are being frank and realistic -- it's just that this kind of medical frankness and realism is better left unsaid.
But isn't it partly down to ethics. The older folk are made to feel their life if less valuable than anyone else's even if the stated reason is to give priority treatment to those most likely to benefit from it. I know there are plenty of people who believe younger people are more valuable because they have more years left. Even my wife believes are children's lives are more important than ours. I've always felt all lives are equal.
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IFISAcava
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Post by IFISAcava on Apr 1, 2020 23:11:37 GMT
Important not to conflate two things.
The first is that, at some point, we all reach the end of our life. There comes a point where, if your heart stops, you die peacefully (ideally) rather than go through the process of attempting CPR, defibrillation etc that might save you (though usually won't) but more likely would make your final moments on this earth more distressing than they need be. At what point the change comes from resuscitating to not-resuscitating will vary, due to numerous factors in each individual case. I think much better to have an open discussion about this involving the patient, doctors and family. In the bad old days, the patient wasn't involved and medical staff took the decision, perhaps with some family involvement. Or decisions just weren't made and people couldn't die naturally because resuscitation had to be done on everyone. It is also NOT about hastening death, or doing nothing to treat illness - it's about what you do if the heart stops beating or the patient stops breathing. Do you allow death or do you fight it. In the case of COVID-19, it would also be easier to discuss those sorts of decisions beforehand, rather than when acutely breathless and/or unconscious, but I can't imagine many people will have had those discussions.
The second point is that when the heath service is overwhelmed, you are forced to ration or triage the care you can give, just like on the battlefield, and focus resources on where you can do most good. You may end up not treating people who might still benefit. That's extremely undesirable (and exactly what we are trying to avoid happening with COVID-19) but if/when it happens unavoidable.
The first really has nothing to do with the second.
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IFISAcava
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Post by IFISAcava on Apr 1, 2020 23:19:17 GMT
DNR's done right can be very useful, very important, and very.... "real" (?) for all concerned. Most especially the family. Done badly they are... at best lazy and uncaring, at worst downright evil. A few of you may remember a post I made, a while back, about a neighbour of mine, and her husband who'd had a bunch of strokes and suffered from dementia? He was a on a DNR then. He's on a DNR now. Three years ago? Maybe four? The stubborn old sod will outlast all of us. More seriously, even before COVID-19, the family didn't want him to be put through indignities of any sort, or pain (even if nobody can detect that he recognises it) or discomfort (likewise). Nor did they want doctors and nurses and ambulance staff to rush to his aid when... there's nothing there. A friend of the wife, Julia, (and a very good friend of mine, one of the "old dears" I am shopping for at the moment) asked to paint his picture. Julia agreed, not really thinking it through. She was terribly upset by the outcome. A picture that is... brutally honest, and unforgiving, in showing, literally, the undead. Because that it what Peter is. Undead. I found it terribly sad, but also terribly moving. Even in the few short years that I knew Peter I never scratched the surface of the man I knew he had to be. It's not a beautiful picture. It is a brilliant picture. For capturing what is. Now? If COVID-19 hits that care home it will rip through it. Knowing Peter he'll survive. But if he doesn't Julia's not even allowed to visit. As with the "stroke / dementia / you do or you will know somebody in this position....", with COVID-19 you do, or you likely will, know somebody in this position. It's creeping slowly closer to me. A small number of friends have it. Colleagues of friends have had it, a very few (at high risk, they were doctors looking after sufferers) have died from it. Anyway, DNRs, as horrible as it may sound, have their place . EDIT: Julia's not allowed out. She's not allowed to have visitors. She's not allowed to see her husband, especially if he dies, or the care home gets hit. I've been going round there three or four times a week for four(?) years? We've had one coffee since the start of "social isolation". She put the pot on and retreated to the garden. I came in, poured the cups, went to the garden, put one cup on a table midway between us. We sat 12 feet apart. It's doing her head in - making her sad, angry, frustrated and more lonely than she would otherwise be. Facetime etc are brilliant but.... you can't hug on Facetime. To IFISAcava 's point (amongst others), this has a cost.And in the next few months, we will see just how much. Social support is one of our main ways of buffering stress, and right now we are piling on the stress at the same time as reducing our major coping mechanisms. Makes me feels sad just writing it.
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Post by bernythedolt on Apr 2, 2020 4:49:28 GMT
Stress, a perspective...
Our stress must be as nothing compared to our forebears who had to endure the even worse Spanish Flu...with far less knowledge & tools... in the midst of fighting a fierce world war.
Our forebears managed, and so we'll have to.
Those at the coal face, under duress for hours dealing with the hospitalised. That's what I would call proper stress. Or stuck in the trenches being shelled for months on end, that's proper stress. Being restricted at home for a few weeks (with food, booze, toilet, armchair, TV and radio, and a daily exercise) is irritating, even upsetting, but is it really stress? Many will claim so in due course, without a doubt... but are they right, or should they be told to go away and grow up?
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Post by bracknellboy on Apr 2, 2020 7:26:27 GMT
Stress, a perspective... Our stress must be as nothing compared to our forebears who had to endure the even worse Spanish Flu...with far less knowledge & tools... in the midst of fighting a fierce world war. Our forebears managed, and so we'll have to. Those at the coal face, under duress for hours dealing with the hospitalised. That's what I would call proper stress. Or stuck in the trenches being shelled for months on end, that's proper stress. Being restricted at home for a few weeks (with food, booze, toilet, armchair, TV and radio, and a daily exercise) is irritating, even upsetting, but is it really stress? Many will claim so in due course, without a doubt... but are they right, or should they be told to go away and grow up? Agree with all of that. But don't forget there are many out there that are facing losing their jobs or massive reductions in income, or being put on furlough with no clear idea whether they will eventually go back to their jobs, or seeing big drops in salary. Not the same as being shelled in trenches I'll grant you, but there are people out there that are in significantly worse positions than many of us keyboard warriors on this forum.
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